WorldWideScience

Sample records for unit preclinical experience

  1. United Kingdom's experience

    International Nuclear Information System (INIS)

    Drummond, S.M.

    1994-01-01

    This is a presentation of the United Kingdom's experience with power transmission open access. The topics of the presentation include the objectives of changing, commercial arrangements and economic drivers, long term effects, the effects of moving to a more competitive environment, and factors affecting open access such as political climate and market regulation

  2. Science Experience Unit: Conservation.

    Science.gov (United States)

    Ferguson-Florissant School District, Ferguson, MO.

    GRADES OR AGES: Intermediate grades. SUBJECT MATTER: Conservation. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is divided into 24 experiments. It is mimeographed and staple-bound with a paper cover. OBJECTIVES AND ACTIVITIES: A specific skill or knowledge objective is stated at the beginning of each experiment. Detailed procedures are listed…

  3. Pre-clinical medical student experience in a pediatric pulmonary clinic

    Directory of Open Access Journals (Sweden)

    Thomas G. Saba

    2015-11-01

    Full Text Available Objective: Our objective was to evaluate the educational value of introducing pre-clinical medical students to pediatric patients and their families in a subspecialty clinic setting. Methods: First- and second-year medical students at the University of Michigan seeking clinical experience outside of the classroom attended an outpatient pediatric pulmonary clinic. Evaluation of the experience consisted of pre- and post-clinic student surveys and post-clinic parent surveys with statements employing a four-point Likert scale as well as open-ended questions. Results: Twenty-eight first-year students, 6 second-year students, and 33 parents participated in the study. Post-clinic statement scores significantly increased for statements addressing empathic attitudes, confidence communicating with children and families, comfort in the clinical environment, and social awareness. Scores did not change for statements addressing motivation, a sense of team membership, or confidence with career goals. Students achieved their goals of gaining experience interacting with patients, learning about pulmonary diseases, and observing clinic workflow. Parents felt that they contributed to student education and were not inconvenienced. Conclusions: Students identified several educational benefits of exposure to a single pediatric pulmonary clinic. Patients and families were not inconvenienced by the participation of a student. Additional studies are warranted to further investigate the value of this model of pre-clinical medical student exposure to subspecialty pediatrics.

  4. Preclinical, clinical, and over-the-counter postmarketing experience with a new vaginal cup: menstrual collection.

    Science.gov (United States)

    North, Barbara B; Oldham, Michael J

    2011-02-01

    Menstrual cups have been available for decades, but their use is limited by bulky design and the need for multiple sizes. The Softcup® (Instead, Inc., San Diego, CA) is a simple single-size disposable over-the-counter (OTC) menstrual cup that compresses to tampon shape to facilitate insertion and can be worn during coitus. This report describes preclinical evaluation, clinical testing, and postmarketing monitoring of the Softcup. Preclinical testing complied with U.S. Food and Drug Administration (FDA) guidelines and used standard United States Pharmacopoeia methodologies for assessment of potential toxicity. Clinical testing enrolled 406 women in seven U.S. centers. A detailed written questionnaire assessed safety, acceptability, and effectiveness for menstrual collection. Study safety parameters included pelvic examinations, Pap smears, colposcopy, urinalysis, vaginal pH, wet mounts, gram stain, and vaginal microflora cultures. Postmarketing surveillance of over 100 million Softcups has been conducted by the manufacturer and by the FDA Medwatch system. No toxicity or mutagenicity was observed in preclinical evaluations. In clinical testing, after three cycles of cup use, 37% of subjects rated the cup as better than, 29% as worse than, and 34% as equal to pads or tampons. The cup was preferred for comfort, dryness, and less odor. Cups received lower ratings for disposal and convenience. Eighty-one percent of enrolled women were able to insert and remove their first cup using only written instructions. Use difficulties resulting in study discontinuations included cramping (1%), leakage (1%), and improper fit (3%). No safety parameters were adversely affected. No significant health risks were reported during postmarketing surveillance. These results demonstrate that a single-size vaginal device has no significant health risks and is acceptable to many women without the need for fitting or other medical services.

  5. Investing in success: student experiences in a structured, decelerated preclinical medical school curriculum

    Directory of Open Access Journals (Sweden)

    Cindy G. Arvidson

    2015-09-01

    Full Text Available Purpose: Many students in the Michigan State University College of Human Medicine (CHM are non-traditional with unique needs and experiences. To meet these needs, in 1988 CHM developed a structured Extended Curriculum Program (ECP, which allows students to take longer than 2 years to complete the preclinical curriculum. This work examined the reasons why students extended their programs, their perceptions of that experience, and the outcome with respect to satisfaction and success in their careers after graduation. Methods: The analysis used data from the college database, follow-up surveys of residency directors and graduates, surveys of graduates who extended, and the AMA Physician Masterfile. Results: Graduates who responded to the survey were evenly split between those who extended for academic reasons and those who extended for other reasons. Although feelings about extending were mixed at the time of extension, nearly all respondents agreed that extending was the right decision in the long run. Extended students continued to face academic challenges having lower basic science averages, lower USMLE Step 1 and 2 first attempt pass rates, and more instances of repeated clerkships compared to those who did not extend, however, most were able to secure a residency in the specialty they desired and had comparable career satisfaction ratings. Conclusions: The ECP allows some students to complete medical school who otherwise may not have been able to do so. This analysis has provided valuable information that was used to improve the program, allowing CHM to continue its mission of training a diverse set of students to be exemplary physicians.

  6. Guidelines for standard preclinical experiments in the mouse model of myasthenia gravis induced by acetylcholine receptor immunization.

    Science.gov (United States)

    Tuzun, Erdem; Berrih-Aknin, Sonia; Brenner, Talma; Kusner, Linda L; Le Panse, Rozen; Yang, Huan; Tzartos, Socrates; Christadoss, Premkumar

    2015-08-01

    Myasthenia gravis (MG) is an autoimmune disorder characterized by generalized muscle weakness due to neuromuscular junction (NMJ) dysfunction brought by acetylcholine receptor (AChR) antibodies in most cases. Although steroids and other immunosuppressants are effectively used for treatment of MG, these medications often cause severe side effects and a complete remission cannot be obtained in many cases. For pre-clinical evaluation of more effective and less toxic treatment methods for MG, the experimental autoimmune myasthenia gravis (EAMG) induced by Torpedo AChR immunization has become one of the standard animal models. Although numerous compounds have been recently proposed for MG mostly by using the active immunization EAMG model, only a few have been proven to be effective in MG patients. The variability in the experimental design, immunization methods and outcome measurements of pre-clinical EAMG studies make it difficult to interpret the published reports and assess the potential for application to MG patients. In an effort to standardize the active immunization EAMG model, we propose standard procedures for animal care conditions, sampling and randomization of mice, experimental design and outcome measures. Utilization of these standard procedures might improve the power of pre-clinical EAMG experiments and increase the chances for identifying promising novel treatment methods that can be effectively translated into clinical trials for MG. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Tendinopathies and platelet-rich plasma (PRP: from pre-clinical experiments to therapeutic use

    Directory of Open Access Journals (Sweden)

    Kaux JF

    2015-05-01

    Full Text Available Objectives: The restorative properties of platelets, through the local release of growth factors, are used in various medical areas. This article reviews fundamental and clinical research relating to platelet-rich plasma applied to tendinous lesions. Materials and method: Articles in French and English, published between 1 January 2012 and 31 December 2014. dealing with PRP and tendons were searched for using the Medline and Scopus data bases. Results: Forty-seven articles were identified which addressed pre-clinical and clinical studies: 27 relating to in vitro and in vivo animal studies and 20 relating to human studies. Of these, five addressed lateral epicondylitis, two addressed rotator cuff tendinopathies, ten dealt with patellar tendinopathies and three looked at Achilles tendinopathies. Conclusions: The majority of pre-clinical studies show that PRP stimulates the tendon's healing process. However, clinical series remain more controversial and level 1, controlled, randomised studies are still needed.

  8. Enhancing translation: guidelines for standard pre-clinical experiments in mdx mice.

    Science.gov (United States)

    Willmann, Raffaella; De Luca, Annamaria; Benatar, Michael; Grounds, Miranda; Dubach, Judith; Raymackers, Jean-Marc; Nagaraju, Kanneboyina

    2012-01-01

    Duchenne Muscular Dystrophy is an X-linked disorder that affects boys and leads to muscle wasting and death due to cardiac involvement and respiratory complications. The cause is the absence of dystrophin, a large structural protein indispensable for muscle cell function and viability. The mdx mouse has become the standard animal model for pre-clinical evaluation of potential therapeutic treatments. Recent years have seen a rapid increase in the number of experimental compounds being evaluated in the mdx mouse. There is, however, much variability in the design of these pre-clinical experimental studies. This has made it difficult to interpret and compare published data from different laboratories and to evaluate the potential of a treatment for application to patients. The authors therefore propose the introduction of a standard study design for the mdx mouse model. Several aspects, including animal care, sampling times and choice of tissues, as well as recommended endpoints and methodologies are addressed and, for each aspect, a standard procedure is proposed. Testing of all new molecules/drugs using a widely accepted and agreed upon standard experimental protocol would greatly improve the power of pre-clinical experimentations and help identifying promising therapies for the translation into clinical trials for boys with Duchenne Muscular Dystrophy. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Threats to validity in the design and conduct of preclinical efficacy studies: a systematic review of guidelines for in vivo animal experiments.

    Directory of Open Access Journals (Sweden)

    Valerie C Henderson

    Full Text Available The vast majority of medical interventions introduced into clinical development prove unsafe or ineffective. One prominent explanation for the dismal success rate is flawed preclinical research. We conducted a systematic review of preclinical research guidelines and organized recommendations according to the type of validity threat (internal, construct, or external or programmatic research activity they primarily address.We searched MEDLINE, Google Scholar, Google, and the EQUATOR Network website for all preclinical guideline documents published up to April 9, 2013 that addressed the design and conduct of in vivo animal experiments aimed at supporting clinical translation. To be eligible, documents had to provide guidance on the design or execution of preclinical animal experiments and represent the aggregated consensus of four or more investigators. Data from included guidelines were independently extracted by two individuals for discrete recommendations on the design and implementation of preclinical efficacy studies. These recommendations were then organized according to the type of validity threat they addressed. A total of 2,029 citations were identified through our search strategy. From these, we identified 26 guidelines that met our eligibility criteria--most of which were directed at neurological or cerebrovascular drug development. Together, these guidelines offered 55 different recommendations. Some of the most common recommendations included performance of a power calculation to determine sample size, randomized treatment allocation, and characterization of disease phenotype in the animal model prior to experimentation.By identifying the most recurrent recommendations among preclinical guidelines, we provide a starting point for developing preclinical guidelines in other disease domains. We also provide a basis for the study and evaluation of preclinical research practice. Please see later in the article for the Editors' Summary.

  10. Threats to validity in the design and conduct of preclinical efficacy studies: a systematic review of guidelines for in vivo animal experiments.

    Science.gov (United States)

    Henderson, Valerie C; Kimmelman, Jonathan; Fergusson, Dean; Grimshaw, Jeremy M; Hackam, Dan G

    2013-01-01

    The vast majority of medical interventions introduced into clinical development prove unsafe or ineffective. One prominent explanation for the dismal success rate is flawed preclinical research. We conducted a systematic review of preclinical research guidelines and organized recommendations according to the type of validity threat (internal, construct, or external) or programmatic research activity they primarily address. We searched MEDLINE, Google Scholar, Google, and the EQUATOR Network website for all preclinical guideline documents published up to April 9, 2013 that addressed the design and conduct of in vivo animal experiments aimed at supporting clinical translation. To be eligible, documents had to provide guidance on the design or execution of preclinical animal experiments and represent the aggregated consensus of four or more investigators. Data from included guidelines were independently extracted by two individuals for discrete recommendations on the design and implementation of preclinical efficacy studies. These recommendations were then organized according to the type of validity threat they addressed. A total of 2,029 citations were identified through our search strategy. From these, we identified 26 guidelines that met our eligibility criteria--most of which were directed at neurological or cerebrovascular drug development. Together, these guidelines offered 55 different recommendations. Some of the most common recommendations included performance of a power calculation to determine sample size, randomized treatment allocation, and characterization of disease phenotype in the animal model prior to experimentation. By identifying the most recurrent recommendations among preclinical guidelines, we provide a starting point for developing preclinical guidelines in other disease domains. We also provide a basis for the study and evaluation of preclinical research practice. Please see later in the article for the Editors' Summary.

  11. Imaging tissue hypoxia: clinical and pre-clinical experience with {sup 123}IAZA

    Energy Technology Data Exchange (ETDEWEB)

    Wiebe, L.I. [University of Alberta, Edmonton (Canada). Noujaim Institute for Pharmaceutical Oncology Research, Faculty of Pharmacy and Pharmaceutical Sciences

    1997-10-01

    The molecular mechanisms that underline the selective binding of iodazomycin arabinoside, IAZA, and related nitromidazoles are reviewed as a basis for interpretation of preclinical and clinical data for hypoxic binding of radioiodinated IAZA. Clinical data are presented for {sup 123}IAZA uptake in a number of pathologies including metastatic tumours, peripheral vascular disease in diabetes, muscle stress and rheumatoid arthritis. The results of studies to determine the influence of tumour type on uptake of {sup 123} I-IAZA in patients with a variety of deep-seated solid tumours will be presented. Correlations of hypoxia-dependent binding with {sup 99m}Tc-HMPAO perfusion images will be reviewed and early correlations of uptake to treatment response in cancer will be presented. Unusual features of {sup 123}I-IAZA biodistribution will also be discussed together with detailed pharmacokinetic and radiation dosimetry data for `2{sup 123}I- IAZA in normal volunteers 27 refs., 1 fig.

  12. Imaging tissue hypoxia: clinical and pre-clinical experience with 123IAZA

    International Nuclear Information System (INIS)

    Wiebe, L.I.

    1997-01-01

    The molecular mechanisms that underline the selective binding of iodazomycin arabinoside, IAZA, and related nitromidazoles are reviewed as a basis for interpretation of preclinical and clinical data for hypoxic binding of radioiodinated IAZA. Clinical data are presented for 123 IAZA uptake in a number of pathologies including metastatic tumours, peripheral vascular disease in diabetes, muscle stress and rheumatoid arthritis. The results of studies to determine the influence of tumour type on uptake of 123 I-IAZA in patients with a variety of deep-seated solid tumours will be presented. Correlations of hypoxia-dependent binding with 99m Tc-HMPAO perfusion images will be reviewed and early correlations of uptake to treatment response in cancer will be presented. Unusual features of 123 I-IAZA biodistribution will also be discussed together with detailed pharmacokinetic and radiation dosimetry data for '2 123 I- IAZA in normal volunteers

  13. Small Molecule Sequential Dual-Targeting Theragnostic Strategy (SMSDTTS): from Preclinical Experiments towards Possible Clinical Anticancer Applications.

    Science.gov (United States)

    Li, Junjie; Oyen, Raymond; Verbruggen, Alfons; Ni, Yicheng

    2013-01-01

    Hitting the evasive tumor cells proves challenging in targeted cancer therapies. A general and unconventional anticancer approach namely small molecule sequential dual-targeting theragnostic strategy (SMSDTTS) has recently been introduced with the aims to target and debulk the tumor mass, wipe out the residual tumor cells, and meanwhile enable cancer detectability. This dual targeting approach works in two steps for systemic delivery of two naturally derived drugs. First, an anti-tubulin vascular disrupting agent, e.g., combretastatin A4 phosphate (CA4P), is injected to selectively cut off tumor blood supply and to cause massive necrosis, which nevertheless always leaves peripheral tumor residues. Secondly, a necrosis-avid radiopharmaceutical, namely (131)I-hypericin ((131)I-Hyp), is administered the next day, which accumulates in intratumoral necrosis and irradiates the residual cancer cells with beta particles. Theoretically, this complementary targeted approach may biologically and radioactively ablate solid tumors and reduce the risk of local recurrence, remote metastases, and thus cancer mortality. Meanwhile, the emitted gamma rays facilitate radio-scintigraphy to detect tumors and follow up the therapy, hence a simultaneous theragnostic approach. SMSDTTS has now shown promise from multicenter animal experiments and may demonstrate unique anticancer efficacy in upcoming preliminary clinical trials. In this short review article, information about the two involved agents, the rationale of SMSDTTS, its preclinical antitumor efficacy, multifocal targetability, simultaneous theragnostic property, and toxicities of the dose regimens are summarized. Meanwhile, possible drawbacks, practical challenges and future improvement with SMSDTTS are discussed, which hopefully may help to push forward this strategy from preclinical experiments towards possible clinical applications.

  14. The Usefulness of Systematic Reviews of Animal Experiments for the Design of Preclinical and Clinical Studies

    Science.gov (United States)

    de Vries, Rob B. M.; Wever, Kimberley E.; Avey, Marc T.; Stephens, Martin L.; Sena, Emily S.; Leenaars, Marlies

    2014-01-01

    The question of how animal studies should be designed, conducted, and analyzed remains underexposed in societal debates on animal experimentation. This is not only a scientific but also a moral question. After all, if animal experiments are not appropriately designed, conducted, and analyzed, the results produced are unlikely to be reliable and the animals have in effect been wasted. In this article, we focus on one particular method to address this moral question, namely systematic reviews of previously performed animal experiments. We discuss how the design, conduct, and analysis of future (animal and human) experiments may be optimized through such systematic reviews. In particular, we illustrate how these reviews can help improve the methodological quality of animal experiments, make the choice of an animal model and the translation of animal data to the clinic more evidence-based, and implement the 3Rs. Moreover, we discuss which measures are being taken and which need to be taken in the future to ensure that systematic reviews will actually contribute to optimizing experimental design and thereby to meeting a necessary condition for making the use of animals in these experiments justified. PMID:25541545

  15. [Interdisciplinary longitudinal curriculum "Medical Psychology, Psychotherapy and Psychosomatics." Experiences from the preclinical segment].

    Science.gov (United States)

    Schüppel, R; Bayer, A; Hrabal, V; Hölzer, M; Allert, G; Tiedemann, G; Hochkirchen, B; Stephanos, S; Kächele, H; Zenz, H

    1998-05-01

    The departments of Medical Psychology, Psychosomatics and Psychotherapy developed an interdisciplinary longitudinal curriculum in order to coach medical students for the whole length of their medical education. Experiences from the first four undergraduate semesters are reported. 46 students (33 females, 13 males), mean age 22.3 +/- 2.6 years, attended 60 hours of interdisciplinary group sessions. Frequent motives to join the course were interest in psychosocial disciplines and relevant previous experience. The students expected to benefit from this project in their study, their future practice as a physician, and in their personal development. Important educational goals that could be attained were the adoption of a patient-centred view in medicine as well as strengthening of the students' critical capacities and sensitivity. The students especially appreciated the possibility of group discussions and the opportunity to participate actively in the course. Based on a critical review of the evaluation, the possibility of a transfer of our model is considered and perspectives for the future are developed.

  16. Importance of dosimetry of irradiators for pre-clinical radiobiological experiments

    International Nuclear Information System (INIS)

    Vikram, Bhadrasain

    2014-01-01

    Importance of radiation dose in radiation biology has been increasingly recognized due to translational use of beyond 2Gy dose is in current practice. Hence, accurate dosimetry of biological irradiators is warranted. To address these problems and propose recommendations, the National Cancer Institute (NCI) along with the National Institute of Allergy and Infectious Diseases (NIAID) as well as the National Institute of Standards and Technology (NIST) highlighted a number of recommendations that will be presented in this talk that includes creating dosimetry standard operating procedures (SOPs) for both in-vitro as well as in-vivo experiments. Other recommendations include for journals (as well as to funding agencies) mandating the reporting of dosimetry of biological irradiators. (author)

  17. Transparency in the reporting of in vivo pre-clinical pain research: The relevance and implications of the ARRIVE (Animal Research: Reporting In Vivo Experiments) guidelines.

    Science.gov (United States)

    Rice, Andrew S C; Morland, Rosemary; Huang, Wenlong; Currie, Gillian L; Sena, Emily S; Macleod, Malcolm R

    2017-12-29

    Clear reporting of research is crucial to the scientific process. Poorly designed and reported studies are damaging not only to the efforts of individual researchers, but also to science as a whole. Standardised reporting methods, such as those already established for reporting randomised clinical trials, have led to improved study design and facilitated the processes of clinical systematic review and meta-analysis. Such standards were lacking in the pre-clinical field until the development of the ARRIVE (Animal Research: Reporting In Vivo Experiments) guidelines. These were prompted following a survey which highlighted a widespread lack of robust and consistent reporting of pre-clinical in vivo research, with reports frequently omitting basic information required for study replication and quality assessment. The resulting twenty item checklist in ARRIVE covers all aspects of experimental design with particular emphasis on bias reduction and methodological transparency. Influential publishers and research funders have already adopted ARRIVE. Further dissemination and acknowledgement of the importance of these guidelines is vital to their widespread implementation. Conclusions and implications Wide implementation of the ARRIVE guidelines for reporting of in vivo preclinical research, especially pain research, are essential for a much needed increased transparency and quality in publishing such research. ARRIVE will also positively influence improvements in experimental design and quality, assist the conduct of accurate replication studies of important new findings and facilitate meta-analyses of preclinical research.

  18. Preclinical students’ experiences in early clerkships after skills training partly offered in primary health care centers: a qualitative study from Indonesia

    Science.gov (United States)

    2012-01-01

    Background Students may encounter difficulties when they have to apply clinical skills trained in their pre-clinical studies in clerkships. Early clinical exposure in the pre-clinical phase has been recommended to reduce these transition problems. The aim of this study is to explore differences in students' experiences during the first clerkships between students exclusively trained in a skills laboratory and peers for whom part of their skills training was substituted by early clinical experiences (ECE). Methods Thirty pre-clinical students trained clinical skills exclusively in a skills laboratory; 30 peers received part of their skills training in PHC centers. Within half a year after commencing their clerkships all 60 students shared their experiences in focus group discussions (FGDs). Verbatim transcripts of FGDs were analyzed using Atlas-Ti software. Results Clerkship students who had participated in ECE in PHC centers felt better prepared to perform their clinical skills during the first clerkships than peers who had only practiced in a skills laboratory. ECE in PHC centers impacted positively in particular on students’ confidence, clinical reasoning, and interpersonal communication. Conclusion In the Indonesian setting ECE in PHC centers reduce difficulties commonly encountered by medical students in the first clerkships. PMID:22640419

  19. Prototype detection unit for the CHIPS experiment

    Science.gov (United States)

    Pfützner, Maciej M.

    2017-09-01

    CHIPS (CHerenkov detectors In mine PitS) is an R&D project aiming to develop novel cost-effective neutrino detectors, focused on measuring the CP-violating neutrino mixing phase (δ CP). A single detector module, containing an enclosed volume of purified water, would be submerged in an existing lake, located in a neutrino beam. A staged approach is proposed with first detectors deployed in a flooded mine pit in Northern Minnesota, 7 mrad off-axis from the existing NuMI beam. A small proof-of-principle model (CHIPS-M) has already been tested and the first stage of a fully functional 10 kt module (CHIPS-10) is planned for 2018. One of the instruments submerged on board of CHIPS-M in autumn 2015 was a prototype detection unit, constructed at Nikhef. The unit contains hardware borrowed from the KM3NeT experiment, including 16 3 inch photomultiplier tubes and readout electronics. In addition to testing the mechanical design and data acquisition, the detector was used to record a large sample of cosmic ray muon events. The collected data is valuable for characterising the cosmic muon background and validating a Monte Carlo simulation used to optimise future designs. This paper introduces the CHIPS project, describes the design of the prototype unit, and presents the results of a preliminary data analysis.

  20. Team-based learning in a preclinical removable denture prosthesis module in a United Arab Emirates dental school.

    Science.gov (United States)

    Haj-Ali, Reem; Al Quran, Firas

    2013-03-01

    The purpose of this article is to describe the implementation of a team-based learning (TBL) approach in a removable denture prosthesis (RDP) module and present the results of students' performance in individual and group TBL activities and exam scores, students' experience with TBL and end of course evaluations, and faculty feedback. Course material at the College of Dentistry, University of Sharjah, United Arab Emirates, was transformed into seven conventional lectures and seven TBL sessions. Each TBL session consisted of pre-assigned reading (self-directed learning), in-class individual and group readiness tests (accountability), team problem-solving of patient RDP cases, and faculty-led class discussion (knowledge application). The course was assessed through scores from TBL session activities and course examinations, student satisfaction survey, and faculty feedback. Course grades were found to be higher using the TBL method then the traditional lecture-based method. Student evaluation data and faculty response indicated strong support for TBL as it was implemented in the course. The faculty noted a higher level of student engagement with team learning than in conventional class lecturing. TBL is an active-learning instructional strategy for courses with high student-to-faculty ratios. This approach provides regular feedback and the opportunity for students to develop higher reasoning skills.

  1. Child Poverty: The United Kingdom Experience.

    Science.gov (United States)

    Mansour, Jane G; Curran, Megan A

    2016-04-01

    The United States has long struggled with high levels of child poverty. In 2014, 2 of 5 (42.9%) of all American children lived in economically insecure households and just over 1 in 5 children lived below the official absolute poverty line. These rates are high, but not intractable. Evidence from the US Census Bureau's Supplemental Poverty Measure, among other sources, shows the effect that public investments in cash and noncash transfers can have in reducing child poverty and improving child well-being. However, with significant disparities in services and supports for children across states and the projected decline of current federal spending on children, the United States is an international outlier in terms of public investments in children, particularly compared with other high-income nations. One such country, the United Kingdom (UK), faced similar child poverty challenges in recent decades. At the end of the 20th century, the British Prime Minister pledged to halve child poverty in a decade and eradicate it 'within a generation.' The Labour Government then set targets and dedicated resources in the form of income supplements, employment, child care, and education support. Child poverty levels nearly halved against an absolute measure by the end of the first decade. Subsequent changes in government and the economy slowed progress and have resulted in a very different approach. However, the UK child poverty target experience, 15 years in and spanning multiple changes in government, still offers a useful comparative example for US social policy moving forward. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  2. [Training and experience in stroke units].

    Science.gov (United States)

    Arenillas, J F

    2008-01-01

    The social and sanitary benefits provided by stroke units can not be achieved without an adequate training and learning process. This dynamic process consists of the progressive acquisition of: a) a greater degree of expertise in stroke management by the stroke team; b) better coordination between the stroke team, extrahospitalary emergency medical systems, and other in-hospital professionals involved in stroke assistance, and c) more human and technological resources dedicated to improve attention to stroke patients. The higher degree of experience in a stroke unit will have an effect: a) improving (time and quality) the diagnostic process in acute stroke patients; b) increasing the proportion of patients treated with thrombolysis; c) reducing extra and intrahospitalary latencies to stroke treatment, and d) improving stroke outcome in terms of reducing mortality and increasing functional independence. Finally, comprehensive stroke centers will achieve a higher degree of organizational complexity that will permit a global assessment of the most advanced aspects in stroke management, including education and research.

  3. TMOD-05. MOLECULAR CHARACTERIZATION OF ORTHOTOPIC PATIENT-DERIVED XENOGRAFT MODELS OF PEDIATRIC BRAIN TUMORS AND THEIR USE IN PRECLINICAL EXPERIMENTS

    Science.gov (United States)

    Brabetz, Sebastian; Schmidt, Christin; Groebner, Susanne N.; Mack, Norman; Seker-Cin, Huriye; Jones, David T.W.; Chavez, Lukas; Milde, Till; Witt, Olaf; Leary, Sarah E.; Li, Xiao-Nan; Wechsler-Reya, Robert J.; Olson, James M.; Pfister, Stefan M.; Kool, Marcel

    2017-01-01

    Abstract Genomic studies have shown that multiple molecular subtypes of pediatric brain tumors exist that are biologically and clinically highly distinct. These findings ask for novel subtype specific treatments. To develop these we need more and better preclinical models that correctly reflect the proper tumor (sub)type. Orthotopic patient-derived xenograft (PDX) models generated by intracranial injection of primary patient material into the brain of NSG mice offer the unique possibility to test novel substances in primary patient tissue in an in vivo environment. Prior to drug selection and testing, extensive molecular characterizations of PDX and matching primary tumor/blood (DNA methylation, DNA sequencing, and gene expression) are needed to see how the PDX represents the original disease and to learn about targetable oncogenic drivers in each model. In collaboration with several groups around the world we have generated and fully characterized thus far 75 PDX models reflecting 15 distinct subtypes of pediatric brain cancer. PDX models always retain their molecular subtype and in the vast majority of cases also mutations and copy number alterations compared to matching primary tumors. Most aggressive tumors, harboring MYC(N) amplifications, are overrepresented in the cohort, but also subtypes which have not been available for preclinical testing before due to lack of genetically engineered mouse models or suitable cell lines, such as Group 4 medulloblastoma, are included. All models and corresponding molecular data will become available for the community for preclinical research. Examples of such preclinical experiments will be presented. PDX models of pediatric brain tumors are still quite rare. Our repertoire of PDX models and corresponding molecular characterizations allow researchers all over the world to find the right models for their specific scientific questions. It will provide an unprecedented resource to study tumor biology and pave the way for

  4. Modeling and experiment to threshing unit of stripper combine ...

    African Journals Online (AJOL)

    Modeling and experiment to threshing unit of stripper combine. ... were conducted with the different feed rates and drum rotator speeds for the rice stripped mixtures. ... and damage as well as for threshing unit design and process optimization.

  5. "Anatomy and imaging": 10 years of experience with an interdisciplinary teaching project in preclinical medical education - from an elective to a curricular course.

    Science.gov (United States)

    Schober, A; Pieper, C C; Schmidt, R; Wittkowski, W

    2014-05-01

    Presentation of an interdisciplinary, interactive, tutor-based preclinical teaching project called "Anatomy and Imaging". Experience report, analysis of evaluation results and selective literature review. From 2001 to 2012, 618 students took the basic course (4 periods per week throughout the semester) and 316 took the advanced course (2 periods per week). We reviewed 557 (return rate 90.1 %) and 292 (92.4 %) completed evaluation forms of the basic and the advanced course. Results showed overall high satisfaction with the courses (1.33 and 1.56, respectively, on a 5-point Likert scale). The recognizability of the relevance of the course content for medical training, the promotion of the interest in medicine and the quality of the student tutors were evaluated especially positively. The "Anatomy and Imaging" teaching project is a successful concept for integrating medical imaging into the preclinical stage of medical education. The course was offered as part of the curriculum in 2013 for the first time. "Anatomia in mortuis" and "Anatomia in vivo" are not regarded as rivaling entities in the delivery of knowledge, but as complementary methods. © Georg Thieme Verlag KG Stuttgart · New York.

  6. International boundary experiences by the United Nations

    Science.gov (United States)

    Kagawa, A.

    2013-12-01

    Over the last few decades, the United Nations (UN) has been approached by Security Council and Member States on international boundary issues. The United Nations regards the adequate delimitation and demarcation of international boundaries as a very important element for the maintenance of peace and security in fragile post-conflict situations, establishment of friendly relationships and cross-border cooperation between States. This paper will present the main principles and framework the United Nations applies to support the process of international boundary delimitation and demarcation activities. The United Nations is involved in international boundary issues following the principle of impartiality and neutrality and its role as mediator. Since international boundary issues are multi-faceted, a range of expertise is required and the United Nations Secretariat is in a good position to provide diverse expertise within the multiple departments. Expertise in different departments ranging from legal, political, technical, administrative and logistical are mobilised in different ways to provide support to Member States depending on their specific needs. This presentation aims to highlight some of the international boundary projects that the United Nations Cartographic Section has been involved in order to provide the technical support to different boundary requirements as each international boundary issue requires specific focus and attention whether it be in preparation, delimitation, demarcation or management. Increasingly, the United Nations is leveraging geospatial technology to facilitate boundary delimitation and demarcation process between Member States. Through the presentation of the various case studies ranging from Iraq - Kuwait, Israel - Lebanon (Blue Line), Eritrea - Ethiopia, Cyprus (Green Line), Cameroon - Nigeria, Sudan - South Sudan, it will illustrate how geospatial technology is increasingly used to carry out the support. In having applied a range

  7. HDS unit revamp and operating experience

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, J. [Veba Oel Verarbeitungs-GmbH, Gelsenkirchen (Germany); Balfanz, U. [Aral Forschung, Gelsenkirchen (Germany); Dimmig, T. [TU Bergakademie Freiberg, Freiberg (Germany)

    2002-12-01

    Ruhr Oel GmbH, a joint venture between BP and PDVSA, operates a HDS unit at its Gelsenkirchen-Scholven site. The unit produces a major blend component for diesel fuel. Driven by ambitious German environmental policy and by an agreement between the German car and oil industries on the one hand and the government on the other, more stringent low sulphur fuel specifications will be enforced in Germany much earlier than in the rest of the European Union. In view of this situation a project was developed to fulfill the new product specifications with minimum investment. In a joint effort involving the refinery, the company research facilities and the catalyst supplier (AKZO NOBEL), pilot plant tests were performed to develop the best catalyst system and the new process conditions. Based on these results, an existing HDS unit was accordingly revamped. After the revamp, the unit produced diesel fuel with 50 ppm sulphur content and furthermore test runs at 10 ppm were carried out successfully. These results are displayed in this article. (orig.)

  8. Comprehensive stroke units: a review of comparative evidence and experience.

    Science.gov (United States)

    Chan, Daniel K Y; Cordato, Dennis; O'Rourke, Fintan; Chan, Daniel L; Pollack, Michael; Middleton, Sandy; Levi, Chris

    2013-06-01

    Stroke unit care offers significant benefits in survival and dependency when compared to general medical ward. Most stroke units are either acute or rehabilitation, but comprehensive (combined acute and rehabilitation) model (comprehensive stroke unit) is less common. To examine different levels of evidence of comprehensive stroke unit compared to other organized inpatient stroke care and share local experience of comprehensive stroke units. Cochrane Library and Medline (1980 to December 2010) review of English language articles comparing stroke units to alternative forms of stroke care delivery, different types of stroke unit models, and differences in processes of care within different stroke unit models. Different levels of comparative evidence of comprehensive stroke units to other models of stroke units are collected. There are no randomized controlled trials directly comparing comprehensive stroke units to other stroke unit models (either acute or rehabilitation). Comprehensive stroke units are associated with reduced length of stay and greatest reduction in combined death and dependency in a meta-analysis study when compared to other stroke unit models. Comprehensive stroke units also have better length of stay and functional outcome when compared to acute or rehabilitation stroke unit models in a cross-sectional study, and better length of stay in a 'before-and-after' comparative study. Components of stroke unit care that improve outcome are multifactorial and most probably include early mobilization. A comprehensive stroke unit model has been successfully implemented in metropolitan and rural hospital settings. Comprehensive stroke units are associated with reductions in length of stay and combined death and dependency and improved functional outcomes compared to other stroke unit models. A comprehensive stroke unit model is worth considering as the preferred model of stroke unit care in the planning and delivery of metropolitan and rural stroke services

  9. Preclinical electrogastrography in experimental pigs

    Science.gov (United States)

    Květina, Jaroslav; Varayil, Jithinraj Edakkanambeth; Ali, Shahzad Marghoob; Kuneš, Martin; Bureš, Jan; Tachecí, Ilja; Rejchrt, Stanislav; Kopáčová, Marcela

    2010-01-01

    Surface electrogastrography (EGG) is a non-invasive means of recording gastric myoelectric activity or slow waves from cutaneous leads placed over the stomach. This paper provides a comprehensive review of preclinical EGG. Our group recently set up and worked out the methods for EGG in experimental pigs. We gained our initial experience in the use of EGG in assessment of porcine gastric myoelectric activity after volume challenge and after intragastric administration of itopride and erythromycin. The mean dominant frequency in pigs is comparable with that found in humans. EGG in experimental pigs is feasible. Experimental EGG is an important basis for further preclinical projects in pharmacology and toxicology. PMID:21217873

  10. Acute surgical unit: The consultant experience

    Directory of Open Access Journals (Sweden)

    Patrick J Stokes

    2016-07-01

    Full Text Available Background Establishment of the Acute Surgical Unit (ASU has redefined the approach to emergency surgery in Australia with quantitative data showing improvement in patient outcomes. However, as qualitative data regarding the ASU remains scarce, we sought to determine the impact of the ASU on overall surgeon job satisfaction. Aims The aim of this paper was to specifically address the impact of the ASU on consultant surgeons overall job satisfaction. Methods We designed a 34 – item questionnaire with consultant general surgeons addressing important aspects of the ASU. Themes included on – call rostering and workload, academic pursuits, surgical training, work – life balance and overall job satisfaction. Results We received responses from 88 surgeons currently working on ASU units, responding correctly and in full to the survey. Overall, our surveyed cohort reported better on – call rostering, improved surgical training and higher levels of job satisfaction and overall work – life balance with ASU implementation. Conclusion Preliminary qualitative results indicate that the ASU may improve on – call rostering, work – life balance and overall job satisfaction.

  11. United Kingdom experience in plutonium transportation

    International Nuclear Information System (INIS)

    1978-08-01

    Plutonium has already been transported within the UK over a period of 20 years and to destinations overseas since the early 60's. Experience is recounted with regard to the forms of plutonium transported, regulations, insurance, container design, mode of transport, volume of traffic, physical protection, safety analysis and costs. It is concluded that this traffic could be expanded in the future without danger to the community or the environment

  12. United Kingdom experience in plutonium transportation

    International Nuclear Information System (INIS)

    1978-11-01

    This paper describes the extensive experience of the UKAEA and British Nuclear Fuels Limited in transporting plutonium within the UK over the last 20 years and to destinations overseas since the early 1960s. The aspects covered include: the form of plutonium transported (nitrate, oxide, mixed oxide etc.); UK and international regulations (e.g. covering safety and safeguards matters); insurance; container design; mode of transport; physical protection; and a safety analysis. Costs are estimated to be largely independent of quantity

  13. United Kingdom: Procurement Related Nuclear Experience (Operating Experience)

    International Nuclear Information System (INIS)

    2016-01-01

    Procurement of nuclear facilities in the United Kingdom is subject to nuclear site licence conditions issued by the Government through the Office for Nuclear Regulation (ONR). Each nuclear facility in the United Kingdom must have a nuclear site licence and must comply with the 36 general conditions that are set out in the Licence Condition Handbook (October 2014). In addition, the ONR has published a technical assessment guide for the procurement of nuclear safety related items or services; a guide on intelligent customers and a guide on records management also apply to the procurement phase, and ONR interventions look across all three of these documents. Procurement governance arrangements need to be developed (including a policy, manual, procedures and template documents) and approved within the utility company. The ONR monitors the arrangements via interventions and deems the arrangements to be ‘adequate’. Some procurement contracts become lifetime records for nuclear safety related systems and need to be retained while the plant is in place. A formal record retention schedule needs to be created and managed by the procurement organization. The utility company may elect to set hold points during the various procurement stages and, importantly, obtain approval for the contract and its content from all technical stakeholders (with particular emphasis on the engineering, project management and design authority quality functions before contract award). For contracts with high nuclear safety significance, the ONR may enforce additional hold points before and/or after contract award. There is a general requirement that the utility puts in place adequate arrangements to ensure that suitably qualified and experienced personnel are employed to implement adequate management arrangements and to act as an intelligent customer. This includes being able to demonstrate that any contractor or supplier is suitable, capable and experienced, and has the necessary processes and

  14. Efficacy and safety of novel multi-lumen catheter for chronic total occlusions: from preclinical study to first-in-man experience.

    Science.gov (United States)

    Mitsutake, Yoshiaki; Ebner, Adrian; Yeung, Alan C; Taber, Mark D; Davidson, Charles J; Ikeno, Fumiaki

    2015-02-15

    To report our initial animal and human experience with a new multi-lumen catheter called MultiCross™ (Roxwood Medical, Inc.) in a porcine coronary model and patients with a chronic total occlusion (CTO). Preclinical safety study was done in the coronary vasculature of a porcine model. In a clinical setting, patients with a CTO of a coronary artery (n = 5) were enrolled. After an initial unsuccessful attempt using a conventional guidewire, operators could use the MultiCross system. The primary efficacy endpoint was successful recanalization (technical success) and the primary safety endpoint was serious adverse events through 30 days post-procedure. The MultiCross catheter was used for all patients after failure of the initial attempt with a guidewire. Successful recanalization was achieved in all CTOs attempted (100%). No patients reported any adverse events at 30 days post-procedure. In this first-in-man experience, the MultiCross catheter has the potential to enhance crossing of CTOs. © 2014 Wiley Periodicals, Inc.

  15. Indirect MRI of 17 o-labeled water using steady-state sequences: Signal simulation and preclinical experiment.

    Science.gov (United States)

    Kudo, Kohsuke; Harada, Taisuke; Kameda, Hiroyuki; Uwano, Ikuko; Yamashita, Fumio; Higuchi, Satomi; Yoshioka, Kunihiro; Sasaki, Makoto

    2018-05-01

    Few studies have been reported for T 2 -weighted indirect 17 O imaging. To evaluate the feasibility of steady-state sequences for indirect 17 O brain imaging. Signal simulation, phantom measurements, and prospective animal experiments were performed in accordance with the institutional guidelines for animal experiments. Signal simulations of balanced steady-state free precession (bSSFP) were performed for concentrations of 17 O ranging from 0.037-1.600%. Phantom measurements with concentrations of 17 O water ranging from 0.037-1.566% were also conducted. Six healthy beagle dogs were scanned with intravenous administration of 20% 17 O-labeled water (1 mL/kg). Dynamic 3D-bSSFP scans were performed at 3T MRI. 17 O-labeled water was injected 60 seconds after the scan start, and the total scan duration was 5 minutes. Based on the result of signal simulation and phantom measurement, signal changes in the beagle dogs were measured and converted into 17 O concentrations. The 17 O concentrations were averaged for every 15 seconds, and compared to the baseline (30-45 sec) with Dunnett's multiple comparison tests. Signal simulation revealed that the relationships between 17 O concentration and the natural logarithm of relative signals were linear. The intraclass correlation coefficient between relative signals in phantom measurement and signal simulations was 0.974. In the animal experiments, significant increases in 17 O concentration (P O. At the end of scanning, mean respective 17 O concentrations of 0.084 ± 0.026%, 0.117 ± 0.038, 0.082 ± 0.037%, and 0.049 ± 0.004% were noted for the cerebral cortex, cerebellar cortex, cerebral white matter, and ventricle. Dynamic steady-state sequences were feasible for indirect 17 O imaging, and absolute quantification was possible. This method can be applied for the measurement of permeability and blood flow in the brain, and for kinetic analysis of cerebrospinal fluid. 2 Technical Efficacy: Stage 1 J. Magn. Reson

  16. Experience gained in the cryodistillation unit for krypton removal

    International Nuclear Information System (INIS)

    Geens, L.; Collard, G.; Goossens, W.R.A.; Vaesen, P.J.

    1981-08-01

    This unit with a nominal gas throughput of 8.5 g.s -1 has been used to investigate the removal of krypton from reprocessing off-gases under non-radioactive conditions. During the investigation a total operation time of more than 13.000 hours was reached with an average availability factor of 99.36%. The trapping efficiency for krypton was higher than 99.9%. The operation experience acquired indicates some critical aspects for the design of such a unit. The experimental results obtained allow to show the influence of feed pressure and temperature, reflux flow rate and noble gas concentrations on the performance of the unit. (author)

  17. Nuclear units operating improvement by using operating experience

    International Nuclear Information System (INIS)

    Rotaru, I.; Bilegan, I.C.

    1997-01-01

    The paper presents how the information experience can be used to improve the operation of nuclear units. This areas include the following items: conservative decision making; supervisory oversight; teamwork; control room distraction; communications; expectations and standards; operator training and fundamental knowledge, procedure quality and adherence; plant status awareness. For each of these topics, the information illustrate which are the principles, the lessons learned from operating experience and the most appropriate exemplifying documents. (authors)

  18. Modeling and experiment to threshing unit of stripper combine

    African Journals Online (AJOL)

    User

    2011-05-16

    May 16, 2011 ... L was the free grain which had reached the end of the threshing unit but still not separated. On the designed testing equipment, experiments of threshing performances were conducted with the different feed rates and drum rotator speeds for the rice stripped mixtures. Experimental results showed that the ...

  19. Temelin 1000 MW Units active testing stage - commissioning experience

    International Nuclear Information System (INIS)

    Ubra, O.; Riha, V.

    2003-01-01

    There were three basic stages of the NPP Temelin Units active testing stage- The zero and low power testing, The power ascension testing and Plant Performance Test. The main objective of the start- up process stages and the testing procedures including some operational experience are described in the paper. (author)

  20. Operational safety experience reporting in the United States

    International Nuclear Information System (INIS)

    Hartfield, R.A.

    1978-01-01

    Licensees of nuclear power plants in the United States have many reporting requirements included in their technical specifications and the code of federal regulations, title 10. The Nuclear Regulatory Commisson receives these reports and utilizes them in its regulatory program. Part of this usage includes collecting and publishing this operating experience data in various reports and storing information in various data systems. This paper will discuss the data systems and reports on operating experience published and used by the NRC. In addition, some observations on operating experience will be made. Subjects included will be the Licensee Event Report (LER) Data File, the Operating Unit Status Report (Gray Book), Radiation Exposure Reports, Effluents Reports, the Nuclear Plant Reliability Data System, Current Events, Bulletin Wrapups and Annual Summaries. Some of the uses of the reports and systems will be discussed. The Abnormal Occurence Report to the US Congress will also be described and discussed. (author)

  1. Postdeployment reintegration experiences of female soldiers from national guard and reserve units in the United States.

    Science.gov (United States)

    Kelly, Patricia J; Berkel, LaVerne A; Nilsson, Johanna E

    2014-01-01

    Women are an integral part of Reserve and National Guard units and active duty armed forces of the United States. Deployment to conflict and war zones is a difficult experience for both soldiers and their families. On return from deployment, all soldiers face the challenge of reintegration into family life and society, but those from the National Guard and Reserve units face the additional challenge of reintegration in relative isolation from other soldiers. There is limited research about the reintegration experiences of women and the functioning of the families during reintegration following deployment. The goal was to document postdeployment family reintegration experiences of women in the National Guard. Semistructured interviews were conducted with 42 female members of Midwestern National Guard units. Directed content analysis was used to identify categories of experiences related to women's family reintegration. Five categories of postdeployment experience for female soldiers and their families were identified: Life Is More Complex, Loss of Military Role, Deployment Changes You, Reestablishing Partner Connections, and Being Mom Again. The categories reflected individual and family issues, and both need to be considered when soldiers and their families seek care. Additional research is needed to fully understand the specific impact of gender on women's reintegration.

  2. Experience of Ko-Ri Unit 1 water chemistry

    International Nuclear Information System (INIS)

    Tae Il Lee

    1983-01-01

    The main focus is placed on operational experience in secondary system water chemistry (especially the steam generator) of the Ko-Ri nuclear power plant Unit 1, Republic of Korea, but primary side chemistry is also discussed. The major concern of secondary water chemistry in a PWR is that the condition of the steam generator be well maintained. Full flow deep bed condensate polishers have recently been installed and operation started in July 1982. Boric acid treatment of the steam generator was stopped and only the all volatile treatment method was used thereafter. A review of steam generator integrity, the chemistry control programme, secondary water quality, etc. is considered to be of great value regarding the operation of Unit 1 and future units now under startup testing or construction in the Republic of Korea. (author)

  3. The mothers' experiences in the pediatrics hemodialysis unit.

    Science.gov (United States)

    Mieto, Fernanda Stella Risseto; Bousso, Regina Szylit

    2014-01-01

    The need for hemodialysis exerts a deep impact on the lives of children and adolescents with end-stage kidney chronic failure and their mothers, who predominantly assume the care related to treatment. The hemodialysis requires that the mother accompanies the child during sessions at least three times a week and, since it is not a healing practice, they also experience the waiting for a kidney transplant, attributing different meanings to this experience. To understand what it means for the mothers to accompany the child in a Pediatric Hemodialysis Unit and to construct a theoretical model representing this experience. The Symbolic Interactionism was adopted as a theoretical model and the Grounded Theory as a methodological framework. Data were collected through interviews with 11 mothers. The comparative analysis of the data enabled the identification of two phenomena that compose the experience: "Seeing the child´s life being sucked by the hemodialysis machine" expresses the experiences of the mothers that generates new demands to comprehend the new health conditions of their children and "Giving new meaning to the dependence of the hemodialysis machine" that represents the strategies employed to endure the experience. The relationship of these phenomena allowed the identification of the main category: "Having the mother's life imprisoned by the hemodialysis machine", from which we propose a new theoretical model. The results of the study allow us to provide a theoretical ground for planning an assistance that meets the real needs of the mothers, identifying aspects that require intervention.

  4. An orthopaedic geriatric rehabilitation unit: the first two years experience.

    Science.gov (United States)

    Sainsbury, R; Gillespie, W J; Armour, P C; Newman, E F

    1986-08-13

    Experience of the first two years of an orthopaedic geriatric rehabilitation unit is described. There were 325 admissions comprising 271 females and 54 males. The predominant diagnosis was fracture of the proximal femur. Average length of stay in the unit was 43 days for males and 36.7 days for females. 75.9% of patients admitted from home returned there and 66.1% of patients admitted from residential care returned to similar accommodation. In the first year there was a fall of 13.5 days in the average length of stay for elderly females with proximal femoral fracture, resulting in 2175 less bed days for this diagnosis. This improvement has continued.

  5. The Economics of Reproducibility in Preclinical Research.

    Directory of Open Access Journals (Sweden)

    Leonard P Freedman

    2015-06-01

    Full Text Available Low reproducibility rates within life science research undermine cumulative knowledge production and contribute to both delays and costs of therapeutic drug development. An analysis of past studies indicates that the cumulative (total prevalence of irreproducible preclinical research exceeds 50%, resulting in approximately US$28,000,000,000 (US$28B/year spent on preclinical research that is not reproducible-in the United States alone. We outline a framework for solutions and a plan for long-term improvements in reproducibility rates that will help to accelerate the discovery of life-saving therapies and cures.

  6. Experience with HEPA filters at United States nuclear installations

    International Nuclear Information System (INIS)

    Bellamy, R.R.

    1977-01-01

    Part 50 of Title 10 of the United States Code of Federal Regulations requires that a number of atmosphere cleanup systems be included in the design of commercial nuclear power plants to be licensed in the United States. These filtering systems are to contain high efficiency particulate air (HEPA) filters for removal of radioactive particulate matter generated during normal and accident conditions. Recommendations for the design, testing and maintenance of the filtering systems and HEPA filter components are contained in a number of United States Nuclear Regulatory Commission documents and industry standards. This paper will discuss this published guidance available to designers of filtering systems and the plant operators of U.S. commercial nuclear power plants. The paper will also present a survey of published reports of experience with HEPA filters, failures and possible causes for the failures, and other abnormal occurrences pertaining to HEPA filters installed in U.S. nuclear power installations. A discussion will be included of U.S. practices for qualification of HEPA filters before installation, and verification of continued performance capability at scheduled intervals during operation

  7. Experience of a monographic tuberculosis unit: the first 500 cases.

    Science.gov (United States)

    González-Moreno, Juan; García-Gasalla, Mercedes; Cifuentes Luna, Carmen; Mir Villadrich, Isabel; Pareja Bezares, Antonio; Navarro Fernández, Verónica; Serrano Bujalance, Araceli; Pérez Seco, M Cruz; Payeras Cifre, Antonio

    2013-10-01

    Tuberculosis (TB) remains a highly prevalent and potentially severe disease. However, since 2002 the annual incidence has been decreasing both worldwide and in Spain, where the incidence varies widely between regions. The main objective of this study is to describe the experience of a monographic TB unit in a second level hospital. A descriptive study was carried out which included all cases of TB diagnosed in a monographic unit of a secondary hospital between 2003 and 2011. Demographic, clinical, epidemiological and microbiological data were recorded. We analyzed 500 TB cases and found an increasing annual incidence in all subgroups, including native and immigrant populations. Most cases (63.8%) were male, with a median age of 36 years (range 8 months-90 years). In total, 39.8% of patients were foreign born. Coinfection with human immunodeficiency virus was found in 11% of cases. The pulmonary form was most frequently diagnosed (63.8%). Overall mortality was 5.8% with no significant differences between groups (including foreign born and human immunodeficiency virus positive patients). Although TB incidence is globally decreasing, in our study we found an increasing number of cases in recent years in all subgroups, which can be explained by this being a monographic unit with an intensive contact tracing program. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  8. Families' experiences of intensive care unit quality of care

    DEFF Research Database (Denmark)

    Jensen, Hanne Irene; Gerritsen, Rik T; Koopmans, Matty

    2015-01-01

    PURPOSE: The purpose of the study is to adapt and provide preliminary validation for questionnaires evaluating families' experiences of quality of care for critically ill patients in the intensive care unit (ICU). MATERIALS AND METHODS: This study took place in 2 European ICUs. Based on literature...... validity. RESULTS: A total of 110 family members participated. Response rate was 87%. For all questions, a median of 97% (94%-99%) was assessed as relevant, and a median of 98% (97%-100%), as understandable. Median ceiling effect was 41% (30%-47%). There was a median of 0% missing data (0%-1%). Test......-retest reliability showed a median weighted κ of 0.69 (0.53-0.83). Validation showed significant correlation between total scores and key questions. CONCLUSIONS: The questions were assessed as relevant and understandable, providing high face and content validity. Ceiling effects were comparable to similar...

  9. MAPPING A BASIC HEALTH UNIT: AN EXPERIENCE REPORT

    Directory of Open Access Journals (Sweden)

    Bárbara Carvalho Malheiros

    2015-01-01

    Full Text Available Backgound and Objectives: This study is an experience report on the construction of a map of a Basic Health Unit (BHU. The objective was to understand the relevance and/or importance of mapping a BHU and acquire more knowledge on the health-disease status of the registered population and identify the importance of cartography as a working tool. Case description: After reading some texts, evaluating information systems and on-site visits, it was possible to identify the health status of the population of the neighborhoods. The proposed objectives were considered to be achieved, considering the mapping of the assessed population’s health-disease situation with a closer-to-reality viewpoint, identifying the number of individuals, the diseases, living situation and health care. Conclusion: The mapping approach is a powerful working tool for allowing the planning of strategic interventions that enables the development of assistance activities, aiming to promote health and disease prevention. KEYWORDS: Mapping; Basic Health Unit; Health Planning.

  10. Follicular Unit Extraction Hair Transplantation with Micromotor: Eight Years Experience.

    Science.gov (United States)

    Ors, Safvet; Ozkose, Mehmet; Ors, Sevgi

    2015-08-01

    Follicular unit extraction (FUE) has been performed for over a decade. Our experience in the patients who underwent hair transplantation using only the FUE method was included in this study. A total of 1000 patients had hair transplantation using the FUE method between 2005 and 2014 in our clinic. Manual punch was used in 32 and micromotor was used in 968 patients for graft harvesting. During the time that manual punch was used for graft harvesting, 1000-2000 grafts were transplanted in one session in 6-8 h. Following micromotor use, the average graft count was increased to 2500 and the operation time remained unchanged. Graft take was difficult in 11.1 %, easy in 52.2 %, and very easy in 36.7 % of our patients. The main purpose of hair transplantation is to restore the hair loss. During the process, obtaining a natural appearance and adequate hair intensity is important. In the FUE method, grafts can be taken without changing their natural structure, there is no need for magnification, and the grafts can be transplanted directly without using any other processes. Because there is no suture in the FUE method, patients do not experience these incision site problems and scar formation. The FUE method enables us to achieve a natural appearance with less morbidity.

  11. A high arctic experience of uniting research and monitoring

    Science.gov (United States)

    Schmidt, Niels Martin; Christensen, Torben R.; Roslin, Tomas

    2017-07-01

    Monitoring is science keeping our thumb on the pulse of the environment to detect any changes of concern for societies. Basic science is the question-driven search for fundamental processes and mechanisms. Given the firm root of monitoring in human interests and needs, basic sciences have often been regarded as scientifically "purer"—particularly within university-based research communities. We argue that the dichotomy between "research" and "monitoring" is an artificial one, and that this artificial split clouds the definition of scientific goals and leads to suboptimal use of resources. We claim that the synergy between the two scientific approaches is well distilled by science conducted under extreme logistic constraints, when scientists are forced to take full advantage of both the data and the infrastructure available. In evidence of this view, we present our experiences from two decades of uniting research and monitoring at the remote research facility Zackenberg in High Arctic Greenland. For this site, we show how the combination of insights from monitoring with the mechanistic understanding obtained from basic research has yielded the most complete understanding of the system—to the benefit of all, and as an example to follow. We therefore urge scientists from across the continuum from monitoring to research to come together, to disregard old division lines, and to work together to expose a comprehensive picture of ecosystem change and its consequences.

  12. Early experience with titanium elastic nails in a trauma unit.

    LENUS (Irish Health Repository)

    Shah, M H

    2012-02-03

    The Titanium Elastic Nail (TEN) offers a number of potential advantages over traditional ways of treating long bone fractures particularly in the paediatric population. These advantages include earlier mobilisation and shorter hospital stay and less risk of loss of fracture position. These advantages are most apparent and significant when treating femoral fractures in children where the length of hospital stay is reduced from several weeks to a typical period of 5 to 8 days. We have reviewed our early experience of using these implants over the past 2 years. Patients were assessed clinically and radiologically. 13 patients were treated using the TEN during this period. There were 2 femoral fractures, 4 humeral fractures, 1 tibial and 6 forearm fractures treated using the Titanium Elastic Nail. All fractures united during the study period. However 1 humeral fracture required a secondary bone grafting and plating for delayed union and 1 fracture lost position during follow-up. Insertion point pain was a problem in 4 patients but this resolved after nail removal in all. There was 1 superficial wound infection which resolved with antibiotics and 1 superficial wound infection of an open fracture wound which resolved following nail removal and antibiotics. There were no cases of deep infection. There were no limb length discrepancy or rotational or angular malalignment problems. Biomechanical principles and technical aspects of this type of fixation are discussed.

  13. The experiences of family caregiving in a chronic care unit.

    Science.gov (United States)

    Cho, Myung Ok

    2005-12-01

    The main purpose of this critical ethnography was to examines the process and discourses through which family caregivers experience while caring for their sick family member in a hospital. This was achieved by conducting in-depth interviews with 12 family caregivers, and by observing their caring activities and daily lives in natural settings. The study field was a unit for neurologic patients. Data was analyzed using taxonomy, discourse analysis, and proxemics. All research work was iteratively processed from March 2003 to December 2004. Constant comparative analysis of the data yielded the process of becoming a successful family caregiver: encountering the differences and chaos as novice; constructing their world of skilled caregivers; and becoming a hospital family as experienced caregivers. During the process of becoming an experienced hospital family, the discourse of family centered idea guided their caring behaviors and daily lives. The paternalistic family caregivers struggled, cooperated, and harmonized with the patriarchal world of professional health care system. During this process of becoming hospital family, professional nurses must act as cultural brokers between the lay family caring system and the professional caring system.

  14. Development and evaluation of a community immersion program during preclinical medical studies: a 15-year experience at the University of Geneva Medical School

    Directory of Open Access Journals (Sweden)

    Chastonay P

    2013-04-01

    Full Text Available P Chastonay,1,2 V Zesiger,1 A Klohn,1 L Soguel,3 E K Mpinga,1,4 NV Vu,2 L Bernheim5 1Institute of Social and Preventive Medicine, 2Unit of Development and Research in Medical Education, University of Geneva, Faculty of Medicine, Geneva, 3Nutrition and Dietetics Department, University of Applied Sciences, Geneva, 4Swiss School of Public Health, Zurich, 5Department of Neurosciences, University of Geneva, Faculty of Medicine, Geneva, Switzerland Background: Significant changes in medical education have occurred in recent decades because of new challenges in the health sector and new learning theories and practices. This might have contributed to the decision of medical schools throughout the world to adopt community-based learning activities. The community-based learning approach has been promoted and supported by the World Health Organization and has emerged as an efficient learning strategy. The aim of the present paper is to describe the characteristics of a community immersion clerkship for third-year undergraduate medical students, its evolution over 15 years, and an evaluation of its outcomes. Methods: A review of the literature and consensus meetings with a multidisciplinary group of health professionals were used to define learning objectives and an educational approach when developing the program. Evaluation of the program addressed students' perception, achievement of learning objectives, interactions between students and the community, and educational innovations over the years. Results: The program and the main learning objectives were defined by consensus meetings among teaching staff and community health workers, which strengthened the community immersion clerkship. Satisfaction, as monitored by a self-administered questionnaire in successive cohorts of students, showed a mean of 4.4 on a five-point scale. Students also mentioned community immersion clerkship as a unique community experience. The learning objectives were reached by a

  15. Use of safety experience feedback to design new nuclear units

    International Nuclear Information System (INIS)

    Lange, D.; Crochon, J.P.

    1985-06-01

    For the designer, and about safety, the experience feedback can take place in 3 fields: the operating experience feedback (incidents analysis), the ''study'' experience feedback (improvement of justification and evolution of safety considerations), and the fabrication experience feedback. Some examples are presented for each field [fr

  16. Recent Experiences in the Respiratory Unit of the Johannesburg ...

    African Journals Online (AJOL)

    Fifty-six patients,of whom 47 had intermittent positive pressure respiration, required treatment in an intensive care unit. Twenty-two patients died in the intensive care unit-a mortality rate of 39%. Also discussed and briefly illustrated are problems of intermittent positive pressure respiration, tracheostomy and endotracheal ...

  17. United States experience in the transportation of radioactive materials

    International Nuclear Information System (INIS)

    Platt, A.M.; Rhoads, R.E.; Hall, R.J.; Williams, L.D.; Brobst, W.A.; Shappert, L.B.; Jefferson, R.M.

    1977-01-01

    The transport of radioactive material forms a vital link in the nuclear fuel cycle in the United States. Actual U.S. experience and practice with such systems for the packaging and transport of uranium ore concentrates, uranium hexafluoride, fresh fuel, irradiated fuel, non-high-level waste, and plutonium with low heat generation rates are described. Specific shipping systems in current use for these services are illustrated. A comparison will be made of shipping requirements for nuclear parks versus dispersed facilities. Shipping systems for other fuel cycle materials (e.g., high-level waste and cladding hulls) have not been developed because there has been no need to transport these materials commercially. However, conceptual designs for packaging and transport of such materials have been developed. Selected systems are reviewed and summarized. Transport safety in the U.S. is regulated by the U.S. Department of Transportation and the Nuclear Regulatory Commission. Key regulations defining packaging requirements, allowable radiation dose rates, and handling procedures are reviewed. Although the radioactive material shipping industry has an outstanding safety record, opposition to nuclear fuel cycle shipments has surfaced in several areas. The U.S. congressional ban on the shipment of plutonium by air, the actions of New York City to prohibit certain shipments within the city limits, and the requirement of U.S. railroads to ship spent fuel casks only in dedicated trains are reviewed. In an attempt to provide information on the safety margins inherent in the design of radioactive materials packages, ERDA has undertaken a series of accident studies and full scale crash tests that stress the packages beyond the levels expected in severe accidents. In addition, the level of total risk associated with radioactive materials shipments is being evaluated. Current ERDA crash test and transportation risk assessment studies are reviewed. Concern about the possibility of

  18. Floppy disc units for data collection from neutron beam experiments

    International Nuclear Information System (INIS)

    Hall, J.W.

    1976-02-01

    The replacement of paper tape output facilities on neutron beam equipment on DIDO and PLUTO reactors by floppy discs will improve reliability and provide a more manageable data storage medium. The cost of floppy disc drives is about the same as a tape punch and printer and less than other devices such as a magnetic tape. Suitable floppy disc controllers are not at present available and a unit was designed as a directly pluggable replacement for paper tape punches. This design was taken as the basis in the development of a prototype unit for use in neutron beam equipment. The circuit operation for this prototype unit is described. (author)

  19. An efficient continuous flow helium cooling unit for Moessbauer experiments

    International Nuclear Information System (INIS)

    Herbert, I.R.; Campbell, S.J.

    1976-01-01

    A Moessbauer continuous flow cooling unit for use with liquid helium over the temperature range 4.2 to 300K is described. The cooling unit can be used for either absorber or source studies in the horizontal plane and it is positioned directly on top of a helium storage vessel. The helium transfer line forms an integral part of the cooling unit and feeds directly into the storage vessel so that helium losses are kept to the minimum. The helium consumption is 0.12 l h -1 at 4.2 K decreasing to 0.055 l h -1 at 40 K. The unit is top loading and the exchange gas cooled samples can be changed easily and quickly. (author)

  20. Chemistry experiences from a containment fire at Ringhals unit 2

    International Nuclear Information System (INIS)

    Arvidsson, Bengt; Svanberg, Pernilla; Bengtsson, Bernt

    2012-09-01

    At the refuelling outage in Ringhals unit 2, during an ongoing Containment Air Test (CAT), a fire event occurred at the refuelling deck/entrance floor. Due to the ongoing CAT with high pressure, all attempts to enter the containment to extinguish the fire were impossible. The fire started as a short circuit (spark) in a vacuum cleaner that was left in the containment by mistake and then set fire to nearby material. Approximate, 5 kg of rubber material and 30 kg of plastic material were estimated to have been burned out. The complete inside of the containment from the level of fire (+115) up to the ceiling/dome (+156) was colored black by soot. Soot or smoke was also spread throughout the whole containment building and the cavity/reactor vessel was contaminated by a minor part of soot due to some unsuccessful covering of the area during CAT. All fuel assemblies were stored in the fuel pool building and not affected by the fire. During the pressure reduction of containment, high air humidity with moisture precipitation occurred and caused a rapid general corrosion on steel surfaces due to high levels of chloride in the soot together with some pitting on stainless steel piping. Immediate action was to install portable dryers to lower the humidity, followed by the start of an extensive cleaning program with objectives to prevent plant degradation/recontamination of soot and bring the unit back in operation. More than 1300 people including >150 cleaners has been appointed to this project. All piping, insulation, cables, >4.500 components, 6.340 m 2 of concrete wall surface and 5.100 m 2 of concrete floor surface have been cleaned during 7 months to an estimated cost of 20 million Euro. Chemistry staff has been deeply involved in sampling and chemical analysis of contaminated surfaces/objects as well as establishing criteria's for cleaning equipment, procedures and specifications. Approximately 12000 measurements have been performed using portable salt meters in

  1. BN-600 power unit 15-year operating experience

    International Nuclear Information System (INIS)

    Saraev, O.M.; Oshkanov, N.N.; Vylomov, V.V.

    1996-01-01

    Comprehensive experience has been gained with the operating fast reactor BN-600 with a power out of 600 MWe. This paper includes important performance results and gives also an overview of the experience gained from BN-600 NPP commercial operation during 15 years. (author). 2 figs, 1 tab

  2. Higher Education Relations: Iranian and the United States Experience.

    Science.gov (United States)

    Fereshteh, M. Hussein

    This review examined the views of 35 higher education professionals in order to explore the history of higher education relations between Iran and the United States particularly before and after the revolution in Iran. The study used interviews with participants, correspondence, and published material from journals, monographs, and newspapers. All…

  3. Recent Experiences in the Respiratory Unit of the Johannesburg ...

    African Journals Online (AJOL)

    A. W. W. VAN AS, M.B., B.CH. (RAND) ... females, were referred to the Respiratory Unit in 5 months. (It must be ... of a lymphoma. ... patient who had had a renal transplant; she recovered fully. ... tube to slip down the right main-stem bronchus and obstruct the left ... the rate of spontaneous depolarization of automatic cells is.

  4. Nuclear information and education experience in the United Kingdom

    International Nuclear Information System (INIS)

    Ginniff, M.E.

    1993-01-01

    The presentation discusses the importance of public information and education in the field of energy and particularly in the field of nuclear energy development. The attempt is made to explain some issues connected with the nuclear fuel cycle. Appendix contains comments on the United Kingdom educational materials in this area

  5. NCI Pediatric Preclinical Testing Consortium

    Science.gov (United States)

    NCI has awarded grants to five research teams to participate in its Pediatric Preclinical Testing Consortium, which is intended to help to prioritize which agents to pursue in pediatric clinical trials.

  6. The Lombardia Stroke Unit Registry: a year experience

    Directory of Open Access Journals (Sweden)

    Giuseppe Micieli

    2010-12-01

    Full Text Available Stroke is the third cause of death and the first long-term disability cause in industrialised countries. It is therefore an important problem, not only from a clinical point of view, but also because of the high costs involved in its management. The results of clinical trials, reviews and meta-analysis highlight the importance of the Stroke Unit in the correct and adequate management of the patient with stroke. This article describes the Lombardia Stroke Unit and the related Stroke Registry. In 2010 this Registry includes 27 Centres and recruits patients with acute stroke or transient ischaemic attacks (TIAs. The Registry aims at measuring performance parameters, identifying guidelines, non-compliance causes, and analysing care processes.

  7. Peritonitis: 10 years' experience in a single surgical unit.

    Science.gov (United States)

    Agarwal, Nitin; Saha, Sudipta; Srivastava, Anurag; Chumber, Sunil; Dhar, Anita; Garg, Sanket

    2007-01-01

    Peritonitis secondary to gut perforation is still one of the commonest surgical emergencies in India and is associated with high morbidity and mortality. The present study examines the aetiology and outcome of peritonitis cases operated on in our surgical unit, and compares our findings with those of previous studies performed between 1981 and 1991. A retrospective study of 260 peritonitis patients operated on in a single surgical unit from 1995 to 2006 was done and data involving clinical presentation, operative findings and post-operative course were studied and analysed. Causes of peritonitis were small bowel perforation (96 ileal, 17 jejunal), peptic perforation (45 duodenal, 16 gastric), appendicular perforation (36), primary peritonitis (8), and others (42). The incidence of major complications was 25% (burst-11%, leak-5%, intraabdominal abscess-5%, multi-organ failure-6.5%). The overall mortality was 10%. High mortality was observed in jejunal, gall bladder and liver abscess perforation cases (> 20%). Histopathological evaluation (143 specimens) revealed tuberculosis in 42 (mostly small bowel), malignancy in 8, and inflammation in the rest. Comparisons with a similar study carried out in the same unit and published in 1995 revealed similar demographic features and mortality, but a change in the most common cause (peptic ulcer perforation to small bowel perforation), and an increased performance of enterostomy compared with primary repair in small bowel perforation and a decrease in the leak rate (13% to 4%). Small bowel perforation is the commonest form of perforation and the mortality rate associated with peritonitis remains unchanged.

  8. Acceleration units for the Induction Linac Systems Experiment (ILSE)

    International Nuclear Information System (INIS)

    Faltens, A.; Brady, V.; Brodzik, D.; Hansen, L.; Laslett, L.J.; Mukherjee, S.; Bubp, D.; Ravenscroft, D.; Reginato, L.

    1989-03-01

    The design of a high current heavy ion induction linac driver for inertial confinement fusion is optimized by adjusting the acceleration units along the length of the accelerator to match the beam current, energy, and pulse duration at any location. At the low energy end of the machine the optimum is a large number of electrostatically focused parallel beamlets, whereas at higher energies the optimum is a smaller number of magnetically focused beams. ILSE parallels this strategy by using 16 electrostatically focused beamlets at the low end followed by 4 magnetically focused beams after beam combining. 3 refs., 2 figs

  9. The application experience of ethanol amine at KORI unit 4

    International Nuclear Information System (INIS)

    Lee, Sang-hak; Park, Jong-il; Lee, Jae-won; Kim, Guem-Soo

    2004-01-01

    The secondary system water chemistry in the KORI PWR units has been well controlled by reducing the corrosion in the tubes of the steam generators; the pH agent has been changing from ammonia to ethanol amine (ETA) (1.8 to 2.0 ppm). For example, the iron concentration in the system was reduced by 40 to 70% compared with ammonia treatment. The paper presents the detailed information, such as ETA injection concentration and the variation of pH, concentration of organic acid products, and irons in the system, and a significant change on sludge after ETA application. (S. Ohno)

  10. Simple ADC unit for cosmic ray air shower experiments

    Energy Technology Data Exchange (ETDEWEB)

    Goswami, G C; Ghosh, B; Ghoshdastidar, M R; Sengupta, S K; Chaudhuri, N [North Bengal Univ., Darjeeling (India). Dept. of Physics

    1982-02-01

    The design of a new low cost analog-to-digital converter system is described. It is based upon the method of linearising the charging process of a storage condenser and is controlled by logic gates. Its tested characteristics have been found to be reliable for application in cosmic ray air shower experiments.

  11. Nursing diagnosis in intensive care unit: the Turkey experience.

    Science.gov (United States)

    Korhan, Esra Akn; Yönt, Gülendam Hakverdioğlu; Erdemir, Firdevs; Müller-Staub, Maria

    2014-01-01

    The purpose of this study was to determine intensive care unit nurses diagnostic abilities and diagnoses that they provide. A vignette study was performed. The vignette contained a patient's history, treatment, and signs/symptoms of 18 nursing diagnoses based on NANDA-I as the criterion standard. Turkish intensive care unit nurses (N = 45) stated nursing diagnoses described by patient data in the vignette. The resulting nursing diagnoses were grouped into Gordon's Functional Health Patterns, and descriptive analyses were performed. One-way analysis of variance was used to detect possible differences in diagnostic abilities based on nurses' education levels. Nurses identified 14 nursing diagnoses. Four of the predetermined psychosocial nursing diagnoses were not identified. The highest percentage of diagnoses was risk for impaired skin integrity (62.2%) and impaired oral mucous membrane (60.0%). The lowest number of diagnoses was impaired verbal communication (2.2%). A statistically significant difference was found between the educational level of nurses and their abilities to determine nursing diagnoses (P < .05). The findings are important for nursing education. They demonstrate the need to focus on patients as complete human beings, covering not only biological aspects but also cultural and social values, as well as emotional and spiritual care needs.

  12. Unitized Stiffened Composite Textile Panels: Manufacturing, Characterization, Experiments, and Analysis

    Science.gov (United States)

    Kosztowny, Cyrus Joseph Robert

    Use of carbon fiber textiles in complex manufacturing methods creates new implementations of structural components by increasing performance, lowering manufacturing costs, and making composites overall more attractive across industry. Advantages of textile composites include high area output, ease of handling during the manufacturing process, lower production costs per material used resulting from automation, and provide post-manufacturing assembly mainstreaming because significantly more complex geometries such as stiffened shell structures can be manufactured with fewer pieces. One significant challenge with using stiffened composite structures is stiffener separation under compression. Axial compression loading conditions have frequently observed catastrophic structural failure due to stiffeners separating from the shell skin. Characterizing stiffener separation behavior is often costly computationally and experimentally. The objectives of this research are to demonstrate unitized stiffened textile composite panels can be manufactured to produce quality test specimens, that existing characterization techniques applied to state-of-the-art high-performance composites provide valuable information in modeling such structures, that the unitized structure concept successfully removes stiffener separation as a primary structural failure mode, and that modeling textile material failure modes are sufficient to accurately capture postbuckling and final failure responses of the stiffened structures. The stiffened panels in this study have taken the integrally stiffened concept to an extent such that the stiffeners and skin are manufactured at the same time, as one single piece, and from the same composite textile layers. Stiffener separation is shown to be removed as a primary structural failure mode for unitized stiffened composite textile panels loaded under axial compression well into the postbuckling regime. Instead of stiffener separation, a material damaging and

  13. Experience with the United Kingdom examinations in neurosurgery.

    Science.gov (United States)

    Pickard, J D

    1997-01-01

    The UK Intercollegiate Specialty Board examination in Surgical Neurology was established in 1991 based on the experience of the original Royal College of Surgeons of Edinburgh Assessment in Surgical Neurology, an exit examination that was originally opposed both by surgery in general and by the younger neurosurgical community. Criteria for eligibility encompass both UK, EC and non-EC overseas graduates. Candidates must have completed satisfactorily their 4th year of a 6 year training programme, have personal experience with the more straightforward benign tumours, aneurysms and posterior fossa explorations, and be able to safely manage a conventional neurosurgical practice. The examination consists of a multiple choice question paper, clinical examination and three Vivas. A curriculum is under construction. Examinations are held twice per annum, and rotate between the four colleges. There are strict guidelines for the examiners. The pass rate is about 70%. All aspects of the examination continue to evolve and are carefully audited.

  14. The experience of the thermosetting polymer embedding unit Seth 200

    International Nuclear Information System (INIS)

    Gauthey, M.J.C.

    1989-01-01

    Nuclear facilities generate large quantities of low-and medium-level radioactive waste. Such wastes are produced by the various fuel cycle systems, the functioning of power reactors, research centers, hospitals, dismantled nuclear facilities. They must be encapsulated, possibly after chemical treatment, before final storage. Low- and medium-level wastes generally consists of technological waste, a major part of which are Ion Exchange Resins (IERs), requiring a specific encapsulation technique because of their nature. This paper reports on the development of a suitable encapsulation process for this waste. This process is based on the use of a thermosetting resin associated with an epoxy matrix. Several fixed and mobile units using this process have been operating for several years

  15. Review of the uranium miner experience in the United States

    International Nuclear Information System (INIS)

    Hilberg, A.W.

    1973-01-01

    Mining of uranium ores on a very small scale began in the United States in 1898. In 1948 mining of uranium ores increased significantly as a result of the increasing demands of the atomic energy program, particularly, the weapons program. It was well-known that radioactivity was associated with uranium ore and potential health hazards had been identified as early as 1921. It was then suggested that the large number of lung cancers found in the Schneeberg miners could possibly be caused by ionizing radiation. Radiation exposure to the lungs of uranium ore miners comes about because of varying concentrations of radon decay products in the mine atmosphere. Measurements of the amount of radioactivity in mine atmospheres began in the United States in 1950 and between 1951 and through 1968, approximately 43,000 measurements were made in about 2,500 uranium mines. Periodic medical surveys were made starting in 1950, but it was not until 1954, that a concerted effort was made to examine all miners. At this time an epidemiological study was begun by the U.S. Public Health Service to determine the effects of uranium mining with particular emphasis on the problem of lung cancer induction. The study of the miners, the results of which have been published, revealed a distinct and somewhat dramatic increase in lung cancer. This increase has been ascribed to the radiation exposure to radon-daughters. Because of the presence of a number of other potential occupational carcinogens in the dust of underground mines, there has been some question as to whether radon and radon-daughters constitute the principal cause of increased lung cancer risk among these miners

  16. Development and evaluation of a community immersion program during preclinical medical studies: a 15-year experience at the University of Geneva Medical School.

    Science.gov (United States)

    Chastonay, P; Zesiger, V; Klohn, A; Soguel, L; Mpinga, E K; Vu, Nv; Bernheim, L

    2013-01-01

    Significant changes in medical education have occurred in recent decades because of new challenges in the health sector and new learning theories and practices. This might have contributed to the decision of medical schools throughout the world to adopt community-based learning activities. The community-based learning approach has been promoted and supported by the World Health Organization and has emerged as an efficient learning strategy. The aim of the present paper is to describe the characteristics of a community immersion clerkship for third-year undergraduate medical students, its evolution over 15 years, and an evaluation of its outcomes. A review of the literature and consensus meetings with a multidisciplinary group of health professionals were used to define learning objectives and an educational approach when developing the program. Evaluation of the program addressed students' perception, achievement of learning objectives, interactions between students and the community, and educational innovations over the years. The program and the main learning objectives were defined by consensus meetings among teaching staff and community health workers, which strengthened the community immersion clerkship. Satisfaction, as monitored by a self-administered questionnaire in successive cohorts of students, showed a mean of 4.4 on a five-point scale. Students also mentioned community immersion clerkship as a unique community experience. The learning objectives were reached by a vast majority of students. Behavior evaluation was not assessed per se, but specific testimonies show that students have been marked by their community experience. The evaluation also assessed outcomes such as educational innovations (eg, students teaching other students), new developments in the curriculum (eg, partnership with the University of Applied Health Sciences), and interaction between students and the community (eg, student development of a website for a community health

  17. A Summary of First Year Activities of the United Arab Emirates Unified Aerosol Experiment: UAE(2)

    National Research Council Canada - National Science Library

    Reid, Jeffrey S; Piketh, Stuart J; Kahn, Ralph; Bruintjes, Roelof T; Holben, Brent N

    2005-01-01

    In August and September of 2004, scientists from two dozen international research organizations converged in the Arabian Gulf region to participate in the United Arab Emirates Unified Aerosol Experiment (UAE...

  18. Transition from neonatal intensive care unit to special care nurseries: Experiences of parents and nurses

    NARCIS (Netherlands)

    Dr. A.L. van Staa; O.K. Helder; J.C.M. Verweij

    2011-01-01

    To explore parents' and nurses' experiences with the transition of infants from the neonatal intensive care unit to a special care nursery. Qualitative explorative study in two phases. Level IIID neonatal intensive care unit in a university hospital and special care nurseries (level II) in five

  19. Preclinical models in radiation oncology

    Directory of Open Access Journals (Sweden)

    Kahn Jenna

    2012-12-01

    Full Text Available Abstract As the incidence of cancer continues to rise, the use of radiotherapy has emerged as a leading treatment modality. Preclinical models in radiation oncology are essential tools for cancer research and therapeutics. Various model systems have been used to test radiation therapy, including in vitro cell culture assays as well as in vivo ectopic and orthotopic xenograft models. This review aims to describe such models, their advantages and disadvantages, particularly as they have been employed in the discovery of molecular targets for tumor radiosensitization. Ultimately, any model system must be judged by its utility in developing more effective cancer therapies, which is in turn dependent on its ability to simulate the biology of tumors as they exist in situ. Although every model has its limitations, each has played a significant role in preclinical testing. Continued advances in preclinical models will allow for the identification and application of targets for radiation in the clinic.

  20. An operating nuclear utility's experience with the ALARA design of a new nuclear unit

    International Nuclear Information System (INIS)

    Rodgers, R.C.

    1985-01-01

    This talk presents a review of how operating experience at Northeast Utilities has been factored into the design of a new nuclear unit and the development and management of the radiation protection program. Their operational experience has indicated that there are two facets to keeping radiation exposures ALARA. The first is the proper ALARA design of the unit. The other facet is the design of a comprehensive radiation protection program. The author discusses these facets in some detail

  1. [Demographic influence on economic stability: the United States experience].

    Science.gov (United States)

    Easterlin, R A; Wachter, M; Wachter, S M

    1978-01-01

    Up to the 1930s the international migration rate into the U.S. was very high, while birth and mortality rates had little variation; migration was, therefore, the principal responsible for population growth rate. Migration cycles were induced by economic conditions, and had, in their turn, important effects on economic feedback. The growing of urban areas, i.e., accelerated demand for new homes and urban services in general, prolonged the economic expansion. After World War 2 a new period opened in the relation between demographic and economic cycles. At the end of the 1950s the U.S. experienced a considerable growth in the number of people between 15-29, due to corresponding birth rate increase, which initiated around 1940. This marked difference in the relative number of young adults, or manpower, resulted in an economic situation relatively unfavorable. For the future a decrease in the relative number of young adults is expected, reflecting the decrease in birth rate experienced around 1960. If the U.S. should experience a new "baby boom" in the next few decades, radical changes in the demographic composition of manpower will have to be expected.

  2. Systematic review of qualitative studies exploring parental experiences in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Al Maghaireh, Dua'a Fayiz; Abdullah, Khatijah Lim; Chan, Chong Mei; Piaw, Chua Yan; Al Kawafha, Mariam Mofleh

    2016-10-01

    To determine the feasibility and utility of a thematic analysis approach to synthesising qualitative evidence about parental experiences in the neonatal intensive care unit. Admission of infants to the neonatal intensive care unit is usually an unexpected event for parents who can cause them to experience psychosocial difficulties. A qualitative systematic review is the best method for exploring these parents' experiences regarding this type of admission. Systematic review. Qualitative studies in peer-reviewed journals aimed at understanding parental experiences regarding infant neonatal intensive care unit admission were identified in six electronic databases. Three reviewers selected relevant articles and assessed the quality of the methodological studies using the Critical Appraisal Skills Programme. A thematic analysis approach was used to identify the most common themes in the studies describing parental experiences in the neonatal intensive care unit. A total of eighty articles were identified; nine studies were included in this review. Four studies used semistructured interviews, three used interviews, one used self-reporting and one used both focus group and interview methodologies. Common themes across parents' experiences were the stress of hospitalisation, alteration in parenting roles and the impact of infant hospitalisation on psychological health. Having an infant hospitalised in the neonatal intensive care unit is a stressful experience for parents. This experience is the result of exposure to different stressors related to the infant's condition, an alteration in parenting roles or the neonatal intensive care unit environment and staffing. These parents suffered negative psychological effects, experienced an interrupted development of a healthy parent-infant attachment and/or felt parental role alteration. The study's findings are crucial for neonatal intensive care unit nurses to develop intervention strategies and programmes that help parents to

  3. Experience of our new monitor for betatron therapy unit

    International Nuclear Information System (INIS)

    Kanno, Takenori; Sato, Hisao; Abe, Shunsuke; Suyama, Sachio.

    1975-01-01

    The amount of high energy electron beams is instable owing to lots of factors. As a matter of course, we should be careful in controling the amount of beams and it is also necessary to improve the beam monitoring apparatuses to make them stable. We have improved a usual monitor and had experiments with it. Here is the report. (1) An ordinary monitor is influenced by humidity, air atmosphere induced noise from an apparatus and so on. We made a new monitor with due regard to these factors. When the count is set to 100 with a usual monitor, the standard dose meter (ionex) indicate is 280 R in 16 MeV and the lowest one is 198 R. Between standard dose meter (ionex) and usual monitor is 82 R. With the trial monitor, the highest integrated dose is 103 R and the lowest one is 89 R. The difference is only 14 R and we are satisfied with the result. We gain this value after 16 months' trial. (2) The chamber is made air tight and has a double structure with a collection electrode sandwiched between high tension charging electrodes. In this way, we can eliminate the influences of humidity and induced noise from an apparatus itself and we can putup ion collection efficiency without widening the distance between the electrodes. As for the indicator circuit, we can get an input signal with a big s/n ratio and so we need not use high impedance resistors in the input circuitry. There is little affect from humidity and induced noise, and the circuit is stable. The indicator circuit has a complete electronic system, therefore counting speed is greatly improved and we can measure a large amount of beams in a short time. The trial monitor has four measuring ranges and so measuring is easily done. Our monitor has a circuit tester, too, and we can test the measuring circuit on occasion. (auth.)

  4. A Look into International Graduate Students' Experience in the United States: A Grounded Theory Model

    Science.gov (United States)

    Fujisaki, Shuko

    2013-01-01

    The number of international students in the United States has been increasing each year, but little is known about their experience. There are recent studies on international students, however, only a few research has focused on international students studying at graduate level. To best study international graduate students' experience, a…

  5. School Climate and the Experience of LGBT Students: A Comparison of the United States and Israel

    Science.gov (United States)

    Pizmony-Levy, Oren; Kosciw, Joseph G.

    2016-01-01

    This article examines the school experience of lesbian, gay, bisexual, and transgender (LGBT) students in the United States and Israel. Through comparison of the sociocultural and edu-cational contexts, the authors assess whether school experience of LGBT students differs or operates similarly across countries. The authors use data from the…

  6. Renewables-Friendly Grid Development Strategies. Experience in the United States, Potential Lessons for China

    Energy Technology Data Exchange (ETDEWEB)

    Hurlbut, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Zhou, Ella [National Renewable Energy Lab. (NREL), Golden, CO (United States); Porter, Kevin [Exeter Associates, Columbia, MD (United States); Arent, Douglas J. [Joint Inst. for Strategic Energy Analysis, Golden, CO (United States)

    2015-10-01

    This report aims to help China's reform effort by providing a concise summary of experience in the United States with "renewables-friendly"" grid management, focusing on experiences that might be applicable to China. It focuses on utility-scale renewables and sets aside issues related to distributed generation.

  7. Against the odds: experiences of nurse leaders in Clinical Development Units (Nursing) in Australia.

    Science.gov (United States)

    Atsalos, Christine; O'Brien, Louise; Jackson, Debra

    2007-06-01

    This paper is a report of a longitudinal study to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership by exploring the experiences of the nurse leaders of nine Australian units as they attempted to develop their existing wards or units into recognized centres of nursing excellence. The concept of Clinical Development Unit (Nursing) in Australia originated in the British Nursing Development Unit movement, which has been widely credited with introducing innovative approaches to developing nurses and nursing. A network of nine Clinical Development Units (Nursing) was set up in a suburban area health service in Australia. The aim was to develop existing wards or units into centres of excellence by disseminating a new vision for Australian nurses that was based on the pioneering work of the British Nursing Development Unit movement. Principles of Heideggerian hermeneutic phenomenology provided a framework for the study. Nine Clinical Development Unit (Nursing) leaders participated in qualitative interviews from 1998 to 2002. These interviews were transcribed into text and thematically analysed. Despite attempts to implement a variety of measures to nurture these Clinical Development Units (Nursing) until they had become well established, the new Clinical Development Unit (Nursing) leaders were unable to maintain the Clinical Development Unit (Nursing) vision with which they had been entrusted. This paper discusses their reactions to the problems they faced and the new understandings they developed of their Clinical Development Unit (Nursing) role over time. The findings illuminate the difficulties involved in maintaining the commitment of all levels of staff and management when attempting to introduce new nursing projects.

  8. Prototype radiographic system for emergency and intensive care units: Initial experience

    International Nuclear Information System (INIS)

    Mirvis, S.

    1986-01-01

    A prototype radiographic system has been developed for use in bedside examinations in multibed trauma or intensive care units and emergency rooms. The system features a single-phase, high-frequency 30-kW ceiling-mounted generator with an x-ray tube extending from a long counterbalanced arm. All movements are servo-assisted for ease of operation. Based on initial experience, the unit allows easier access to the patient around resuscitation and monitoring equipment, occupies less floor space, and yields better quality images than do standard mobile radiographic units

  9. Preclinical animal research on therapy dosimetry with dual isotopes

    International Nuclear Information System (INIS)

    Konijnenberg, Mark W.; Jong, Marion de

    2011-01-01

    Preclinical research into radionuclide therapies based on radiation dosimetry will enable the use of any LET-equivalent radionuclide. Radiation dose and dose rate have significant influence on dose effects in the tumour depending on its radiation sensitivity, possibilities for repair of sublethal damage, and repopulation during or after the therapy. Models for radiation response of preclinical tumour models after peptide receptor radionuclide therapy based on the linear quadratic model are presented. The accuracy of the radiation dose is very important for observation of dose-effects. Uncertainties in the radiation dose estimation arise from incomplete assay of the kinetics, low accuracy in volume measurements and absorbed dose S-values for stylized models instead of the actual animal geometry. Normal dose uncertainties in the order of 20% might easily make the difference between seeing a dose-effect or missing it altogether. This is true for the theoretical case of a homogeneous tumour type behaving in vivo in the same way as its cells do in vitro. Heterogeneity of tumours induces variations in clonogenic cell density, radiation sensitivity, repopulation capacity and repair kinetics. The influence of these aspects are analysed within the linear quadratic model for tumour response to radionuclide therapy. Preclinical tumour models tend to be less heterogenic than the clinical conditions they should represent. The results of various preclinical radionuclide therapy experiments for peptide receptor radionuclide therapy are compared to the outcome of theoretical models and the influence of increased heterogeneity is analysed when the results of preclinical research is transferred to the clinic. When the radiation dose and radiobiology of the tumour response is known well enough it may be possible to leave the current phenomenological approach in preclinical radionuclide therapy and start basing these experiments on radiation dose. Then the use of a gamma ray

  10. Preclinical animal research on therapy dosimetry with dual isotopes

    Energy Technology Data Exchange (ETDEWEB)

    Konijnenberg, Mark W.; Jong, Marion de [Nuclear Medicine Department, Erasmus MC, Rotterdam (Netherlands)

    2011-06-15

    Preclinical research into radionuclide therapies based on radiation dosimetry will enable the use of any LET-equivalent radionuclide. Radiation dose and dose rate have significant influence on dose effects in the tumour depending on its radiation sensitivity, possibilities for repair of sublethal damage, and repopulation during or after the therapy. Models for radiation response of preclinical tumour models after peptide receptor radionuclide therapy based on the linear quadratic model are presented. The accuracy of the radiation dose is very important for observation of dose-effects. Uncertainties in the radiation dose estimation arise from incomplete assay of the kinetics, low accuracy in volume measurements and absorbed dose S-values for stylized models instead of the actual animal geometry. Normal dose uncertainties in the order of 20% might easily make the difference between seeing a dose-effect or missing it altogether. This is true for the theoretical case of a homogeneous tumour type behaving in vivo in the same way as its cells do in vitro. Heterogeneity of tumours induces variations in clonogenic cell density, radiation sensitivity, repopulation capacity and repair kinetics. The influence of these aspects are analysed within the linear quadratic model for tumour response to radionuclide therapy. Preclinical tumour models tend to be less heterogenic than the clinical conditions they should represent. The results of various preclinical radionuclide therapy experiments for peptide receptor radionuclide therapy are compared to the outcome of theoretical models and the influence of increased heterogeneity is analysed when the results of preclinical research is transferred to the clinic. When the radiation dose and radiobiology of the tumour response is known well enough it may be possible to leave the current phenomenological approach in preclinical radionuclide therapy and start basing these experiments on radiation dose. Then the use of a gamma ray

  11. Midwives' experiences of facilitating normal birth in an obstetric-led unit: a feminist perspective.

    LENUS (Irish Health Repository)

    Keating, Annette

    2012-01-31

    OBJECTIVE: to explore midwives\\' experiences of facilitating normal birth in an obstetric-led unit. DESIGN: a feminist approach using semi-structured interviews focusing on midwives\\' perceptions of normal birth and their ability to facilitate this birth option in an obstetric-led unit. SETTING: Ireland. PARTICIPATION: a purposeful sample of 10 midwives with 6-30 years of midwifery experience. All participants had worked for a minimum of 6 years in a labour ward setting, and had been in their current setting for the previous 2 years. FINDINGS: the midwives\\' narratives related to the following four concepts of patriarchy: \\'hierarchical thinking\\

  12. Biosafety preclinical trials of xenogenic, Allogeniec and autologous progenitor cells from fat tissue

    OpenAIRE

    Melikhova, Vs; Saburina, I.; Repin, V.; Novikova, N.; Murashev, A.; Orlov, A.

    2008-01-01

    Due to wide spread of new methods of regenerative medicine on basis of stem cells it has become increasingly necessary to establish standards of techniques using them. Preclinical trial of a new technology after receiving preliminary experiment results is a primary stage of its adoption. We carried out the experiments to assess biosafety of autogenous, allergenic and xenogeneic cultures of human and rat cells in models under standard preclinical experiments conditions used in a presentday pha...

  13. Parent experiences of communication with healthcare professionals in neonatal intensive care units

    DEFF Research Database (Denmark)

    Weis, Janne; Lundqvist, Pia

    2016-01-01

    REVIEW QUESTION/OBJECTIVE: The objectives of this review are to explore parents' experiences of communication with healthcare professionals and to identify the meaningfulness of communication to parents in the neonatal intensive care unit (NICU).More specifically, the objectives are to identify....

  14. Lived experience of the intensive care unit for patients who experienced delirium.

    Science.gov (United States)

    Whitehorne, Karen; Gaudine, Alice; Meadus, Robert; Solberg, Shirley

    2015-11-01

    Delirium is a common occurrence for patients in the intensive care unit and can have a profound and lasting impact on them. Few studies describe the experience of intensive care patients who have had delirium. To understand the lived experience of intensive care for critically ill patients who experienced delirium. The study participants consisted of 7 men and 3 women, 46 to 70 years old, who had delirium according to the Confusion Assessment Method for the Intensive Care Unit. The van Manen method of hermeneutic phenomenology was used, and data collection entailed audio recorded semistructured interviews. Four themes were detected: "I can't remember," "Wanting to make a connection," "Trying to get it straight," and "Fear and safety concerns." Nurses working in intensive care units need to assess patients for delirium, assess the mental status of patients who have delirium, and help patients and patients' families learn about and deal with the psychological effects of the intensive care unit experience. ©2015 American Association of Critical-Care Nurses.

  15. Home to die from the intensive care unit: A qualitative descriptive study of the family's experience.

    Science.gov (United States)

    Hutchinson, Amy L; Van Wissen, Kim A

    2017-12-01

    Many people would choose to die at home, and this can be an option for intensive care patients. However, there is limited exploration of the impact on the family. To gain insight into family members' experiences when an adult intensive care unit patient is taken home to die. Methodology is qualitative description, utilising purposeful sampling, unstructured interviews and thematic analysis. Four participants, from two different families were interviewed. The setting was a tertiary level Intensive Care Unit in New Zealand. The experience was described as a kaleidoscope of events with two main themes: 'value' family member's found in the patient going home, and their experience of the 'process'. 'Value' subthemes: going home being the patient's own decision, home as an end-of-life environment, and the patient's positive response to being at home. 'Process' subthemes: care and support received, stress of a family member being in intensive care, feeling that everything happened quickly, and concerns and uncertainties. Going home to die from the intensive care unit can be a positive but challenging experience for the family. Full collaboration between the patient, family and staff is essential, to ensure the family are appropriately supported. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Experiences of Racial Microaggression Among Migrant Nurses in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Emee Vida Estacio

    2014-05-01

    Full Text Available In this article, we explore the experiences of racial microaggression among migrant nurses in the United Kingdom. Eleven migrant nurses kept a reflective diary for 6 weeks to record and reflect on their experiences of living and working in the United Kingdom. The diary entries were then thematically analyzed. The results suggest that migrant nurses experienced racial microaggression from patients and colleagues through racial preferences and bullying. Institutional racism also hindered their opportunities for further training and promotion. As a result, some experienced feelings of anger, frustration, and even paranoia. Despite the negative consequences of racial microaggression on their emotional well-being, incidents were downplayed as trivial because of their vague and subtle nature. To encourage better multicultural interactions in the workplace, supportive organizational infrastructures need to be in place to enhance diversity awareness and to improve mechanisms for reporting and dealing with cases of racial microaggression.

  17. Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings.

    Science.gov (United States)

    Iheduru-Anderson, Kechinyere C; Wahi, Monika M

    2018-04-01

    Successful transition to practice of internationally educated nurses (IENs) can critically affect quality of care. The aim of this study was to characterize the facilitators and barriers to transition of Nigerian IENs (NIENs) to the United States health care setting. Using a descriptive phenomenology approach, 6 NIENs were interviewed about their transitional experiences in the United States. Thematic methods were used for data analysis. The three major themes identified from the participants' stories were "fear/anger and disappointment" (FAD), "road/journey to success/overcoming challenges" (RJO), and "moving forward" (MF). The FAD theme predominated, including experiences of racism, bullying, and inequality. The RJO theme included resilience, and the MF theme encompassed personal growth. NIENs face personal and organizational barriers to adaptation, especially fear, anger and disappointment. Future research should seek to develop a model for optimal adaptation that focuses on improving both personal and organizational facilitators and decreasing barriers.

  18. Integration in a nuclear physics experiment of a visualization unit managed by a microprocessor

    International Nuclear Information System (INIS)

    Lefebvre, M.

    1976-01-01

    A microprocessor (Intel 8080) is introduced in the equipment controlling the (e,e'p) experiment that will take place at the linear accelerator operating in the premises of CEA (Orme des Merisiers, Gif-sur-Yvette, France). The purpose of the microprocessor is to handle the visualization tasks that are necessary to have a continuous control of the experiment. By doing so more time and more memory will be left for data processing by the calculator unit. In a forward version of the system, the controlling of the level of helium in the target might also be in charge of the microprocessor. This work is divided into 7 main parts: 1) a presentation of the linear accelerator and its experimental facilities, 2) the Intel 8080 micro-processor and its programming, 3) the implementation of the micro-processor in the electronic system, 4) the management of the memory, 5) data acquisition, 6) the keyboard, and 7) the visualization unit [fr

  19. [Formative evaluation: experience of the Catalonian family and community medicine teaching units].

    Science.gov (United States)

    Ezquerra Lezcano, Matilde; Bundo Vidiella, Magda; Descarrega Queralt, Ramón; Martín Zurro, Amando; Fores García, Dolores; Fornells Vallès, Josep Maria

    2010-04-01

    The purpose of this article is to report on the experience in formative evaluation that was carried out in the Catalonian family and community medicine teaching units during the years 2001-2007. This formative evaluation project included the use of several evaluation tools such as, self-listening, video-recording, structured observation of clinical practice, cases by computer and simulated patients. Different resident intakes have participated in the development of the project, as well as their teaching unit tutors and coordinators. This accumulated experience has allowed it to progress into the field of formative evaluation, and to adapt and integrate the activities that were being carried out in a resident portfolio, which in our opinion is the best tool for the formative evaluation of the family medicine resident. Copyright 2009 Elsevier España, S.L. All rights reserved.

  20. Demonstrating the unit hydrograph and flow routing processes involving active student participation - a university lecture experiment

    Science.gov (United States)

    Schulz, Karsten; Burgholzer, Reinhard; Klotz, Daniel; Wesemann, Johannes; Herrnegger, Mathew

    2018-05-01

    The unit hydrograph (UH) has been one of the most widely employed hydrological modelling techniques to predict rainfall-runoff behaviour of hydrological catchments, and is still used to this day. Its concept is based on the idea that a unit of effective precipitation per time unit (e.g. mm h-1) will always lead to a specific catchment response in runoff. Given its relevance, the UH is an important topic that is addressed in most (engineering) hydrology courses at all academic levels. While the principles of the UH seem to be simple and easy to understand, teaching experiences in the past suggest strong difficulties in students' perception of the UH theory and application. In order to facilitate a deeper understanding of the theory and application of the UH for students, we developed a simple and cheap lecture theatre experiment which involved active student participation. The seating of the students in the lecture theatre represented the hydrological catchment in its size and form. A set of plastic balls, prepared with a piece of magnetic strip to be tacked to any white/black board, each represented a unit amount of effective precipitation. The balls are evenly distributed over the lecture theatre and routed by some given rules down the catchment to the catchment outlet, where the resulting hydrograph is monitored and illustrated at the black/white board. The experiment allowed an illustration of the underlying principles of the UH, including stationarity, linearity, and superposition of the generated runoff and subsequent routing. In addition, some variations of the experimental setup extended the UH concept to demonstrate the impact of elevation, different runoff regimes, and non-uniform precipitation events on the resulting hydrograph. In summary, our own experience in the classroom, a first set of student exams, as well as student feedback and formal evaluation suggest that the integration of such an experiment deepened the learning experience by active

  1. Contextualizing immigrants' lived experience: story of Taiwanese immigrants in the United States.

    Science.gov (United States)

    Tsai, Jenny Hsin-Chun

    2003-01-01

    Immigration involves extensive changes in living environments. Nonetheless, the predominant approach in the health science literature has been to utilize individual characteristics (including ethnic background) to explain and predict immigrants' lived experiences and health outcomes. Contexts, particularly the larger societal contexts by which immigrants are constituted, are generally ignored. Data from a critical ethnography regarding immigrants' experiences with language, occupation, and economic survival in the United States are utilized to illustrate that immigrants' lives are inseparable from the larger societal contexts, such as immigration policy, Western imperialism, and structural discrimination. The implications for practice, education, and research are discussed.

  2. Modernization of electrical systems in NPP Kozloduy unit 5 and 6. Feedback of experience

    International Nuclear Information System (INIS)

    Stinshoff, H.

    2005-01-01

    In the frame of the modernization program for the nuclear power plant Kozloduy unit 5 and 6 Framatome ANP has implemented measures to increase the safety and availability of the electrical systems. The hardware installation is scheduled in the refueling outages of the years 2003 to 2005. In this paper the following items are presented: 1) an overview of the modernization measures; 2) some important technical features of the new equipment and diagnostic measures; 3) feedback of experience

  3. Midwives' experiences of labour care in midwifery units. A qualitative interview study in a Norwegian setting.

    Science.gov (United States)

    Skogheim, Gry; Hanssen, Tove A

    2015-12-01

    In some economically developed countries, women's choice of birth care and birth place is encouraged. The aim of this study was to explore and describe the experiences of midwives who started working in alongside/free-standing midwifery units (AMU/FMU) and their experiences with labour care in this setting. A qualitative explorative design using a phenomenographic approach was used. Semi-structured interviews were conducted with ten strategically sampled midwives working in midwifery units. The analysis revealed the following five categories of experiences noted by the midwives: mixed emotions and de-learning obstetric unit habits, revitalising midwifery philosophy, alertness and preparedness, presence and patience, and coping with time. Starting to work in an AMU/FMU can be a distressing period for a midwife. First, it may require de-learning the medical approach to birth, and, second, it may entail a revitalisation (and re-learning) of birth care that promotes physiological birth. Midwifery, particularly in FMUs, requires an especially careful assessment of the labouring process, the ability to be foresighted, and capability in emergencies. The autonomy of midwives may be constrained also in AMUs/FMUs. However, working in these settings is also viewed as experiencing "the art of midwifery" and enables revitalisation of the midwifery philosophy. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Parent' s experiences and perceives at premature newborn in the neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Klaudia Urbančič

    2002-05-01

    Full Text Available Text treats parent's experiences and perceives and the significant of their newborn premature infants in the neonatal intensive care unit in the Ljubljana maternity hospital. Aim of health promotion, the significance of health education in health education counselling are presented. The purpose of this study was to introduction parent' s experiences and make an implementation in nursing practice. The advantage is represent by performing health education counselling for parents in intensive care unit permanently. Perceives of parents during living their newborn infant in neonatal intensive care unit are present on five concepts: perceive parents themselves, perceive their infant, perceive the staff and the intensive care setting and perceive their home setting. Results are showing statistic important differences between mothers and fathers at the time of deliver and at the time charging infant home. A questionare was used for collecting data. Process of development instrument is represent. Descriptive statistics and T-test was used for quantitative data analysed. Using method of internal consistent Chronbach alpha tested reliability of scales and mean differences in time are graf protrayed by 95% confident intervals. Results show statistical significant differences on all five concepts of parent's experiences. Methodological findings and reseaarch limitations are also present. Authoress positive evaluates the effect of health education counselling program and find out its positive effect on parent's critical thinking and contributes to quality assurance nursing.

  5. The road to patient experience of care measurement: lessons from the United States.

    Science.gov (United States)

    Zimlichman, Eyal; Rozenblum, Ronen; Millenson, Michael L

    2013-09-17

    Patient-centered care has become an increasing priority in the United States and plays a prominent role in recent healthcare reforms. One way the country has managed to advance patient-centered care is through establishment of a family of national patient experience surveys (the Consumer Assessment of Healthcare Providers and Systems Plans (CAHPS). CAHPS is publicly reported for several types of providers and was recently tied to hospital reimbursement. This is part of a trend over the last two decades that has shifted provider-patient relationships from a traditional paternal approach to customer service and then to clinical partnership. The health care system in Israel, however, is still struggling to overcome barriers to change in this area. While community based biannual patient experience surveys are conducted by the Myers-JDC-Brookdale Institute, there is no comprehensive national approach to measuring the patient experience across a broad range of settings. Only recently did the Israeli Ministry of Health take its first steps to include patient experience as a dimension of health care quality.In its current position, Israel should learn from the U.S. experience with policies promoting patient-centered care, and specifically the impact on clinical services of measuring the patient experience. Looking at what has happened in the United States, we suggest three main lessons. First, there is a need for a set of national patient experience surveys that would be publicly reported and eventually tied to provider reimbursement. Secondly, the national survey tools should be customized to the unique characteristics of Israeli society and draw from recent research on patient-centeredness to include new and important domains such as patient activation and shared decision-making. Finally, newer technological approaches should be explored with the aim of increasing response rates and the timeliness and usefulness of the surveys.

  6. Regulatory application of seismic experience data for nuclear power plants in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Pei-Ying [Nuclear Regulatory Commission, Washington, DC (United States)

    1997-03-01

    On the basis of its review and evaluation (Reference 3) of the SQUG GIP (Reference 2) and on the basis of the differences between current seismic qualification requirements and the criteria and procedures provided in the GIP, the NRC staff does not consider the USI A-46 methodology given in the GIP to be a `seismic qualification` procedure. Rather, the staff considers the GIP methodology to be a seismic adequacy verification procedure, which was developed on the basis of generic equipment earthquake experience data, supplemented by generic equipment test data. The implementation of the GIP approach for USI A-46 plants provides safety enhancement, in certain aspects, beyond the original licensing bases. Therefore, the GIP methodology is an acceptable evaluation method, for USI A-46 plants only, to verify the seismic adequacy of the safe-shutdown equipment installed in the NPPs in the United States. With the new development in the experience-based approach for seismic qualification of equipment currently underway in the U.S. nuclear industry, there is a potential for future regulatory application of an experience-based approach as a seismic qualification method for certain selected equipment installed in NPPs in the United States. However, industry`s use of the experience-based approach will be dependent on the submittal and staff approval of this approach. (J.P.N.)

  7. A data processing unit (DPU) for a satellite-borne charge composition experiment

    International Nuclear Information System (INIS)

    Koga, R.; Blake, J.B.; Chenette, D.L.; Fennell, J.F.; Imamoto, S.S.; Katz, N.; King, C.G.

    1985-01-01

    A data processing unit (DPU) for use with a charge composition experiment to be flown aboard the VIKING auroral research satellite is described. The function of this experiment is to measure the mass, charge state, energy, and pitch-angle distribution of ions in the earth's high-altitude magnetosphere in the energy range from 50 keV/q to 300 keV/q. In order to be compatible with the spacecraft telemetry limitations, raw sensor data are processed in the DPU using on-board composition analysis and the scalar compression. The design of this DPU is such that it can be readily adapted to a variety of space composition experiments. Special attention was given to the effect of the radiation environment on orbit since a microprocessor and a relatively large number of random access memories (RAMs) comprise a considerable portion of the DPU

  8. Experiences of Turkish undergraduate nursing students in the intensive care unit.

    Science.gov (United States)

    Tastan, Sevinc; Iyigun, Emine; Ayhan, Hatice; Hatipoglu, Sevgi

    2015-01-01

    Clinical practicum provides many opportunities for nursing students to learn more about their subject and develop essential nursing skills. In contrast, nursing students often have difficulties during their clinical practicum. This study aims to describe the clinical experiences of undergraduate nursing students in the intensive care unit. A descriptive qualitative approach was used in this study. The study was performed at a military medical academy between 1 March and 30 April 2008. The study was conducted with 15 fourth-year baccalaureate nursing students. Data were obtained through open-ended and in-depth audio-taped interviews, which lasted approximately 35-45 min. Themes emerged from the participants' descriptions of their experiences in the intensive care unit: anxiety, fear of doing harm, emotional connection and empathy, improving self-confidence, perceived responsibility for patients, prioritizing care of patients, preserving dignity, coping with confronting situations, and communication in the intensive care unit. The views and expectations of nursing students regarding intensive care practice are important for the organization of the nursing education environment. The nursing curriculum must be revised and developed according to the needs of students.

  9. Operating experience gained during the copper oxide plugging incident in Koeberg unit 1 generator stator

    Energy Technology Data Exchange (ETDEWEB)

    Mellor, S.P.; Matthee, F.W. [ESKOM, Koeberg Nuclear Power Station (South Africa)

    2002-07-01

    In June 1999 Koeberg's unit 1 started to experience adverse operating conditions which were later ascribed to blockages in the hollow conductors of the generator stator. These blockages were attributed to copper oxide plugs which developed progressively during the following year and culminated in reduced power operation. Many attempts were made to address the plugging by implementing various off-line and on-line cleaning processes. Subsequent to a successful on-line cleaning operation, the unit was returned to full power and the chemistry regime for the stator cooling water system was changed to allow for operation at an elevated pH. This paper discusses Koeberg's experience with copper oxide blockages, describes the initial indications of the problem and the impact on the operating parameters. The remainder of the paper focuses on the actions taken to address the deteriorating situation and the different cleaning methods implemented to remove the copper oxide deposits. The paper concludes with the current status of the unit 1 generator stator and the lessons learned during the resolution of this problem. (authors)

  10. Operating experience gained during the copper oxide plugging incident in Koeberg unit 1 generator stator

    International Nuclear Information System (INIS)

    Mellor, S.P.; Matthee, F.W.

    2002-01-01

    In June 1999 Koeberg's unit 1 started to experience adverse operating conditions which were later ascribed to blockages in the hollow conductors of the generator stator. These blockages were attributed to copper oxide plugs which developed progressively during the following year and culminated in reduced power operation. Many attempts were made to address the plugging by implementing various off-line and on-line cleaning processes. Subsequent to a successful on-line cleaning operation, the unit was returned to full power and the chemistry regime for the stator cooling water system was changed to allow for operation at an elevated pH. This paper discusses Koeberg's experience with copper oxide blockages, describes the initial indications of the problem and the impact on the operating parameters. The remainder of the paper focuses on the actions taken to address the deteriorating situation and the different cleaning methods implemented to remove the copper oxide deposits. The paper concludes with the current status of the unit 1 generator stator and the lessons learned during the resolution of this problem. (authors)

  11. Experience of family members as a result of children's hospitalization at the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Maria Virginia Martins Faria Faddul Alves

    2013-07-01

    Full Text Available Objective. To describe the experience of family members as a result of children's hospitalization at the Intensive Care Unit (ICU. Methodology. Descriptive and cross-sectional study. A structured interview was held with 20 relatives of patients hospitalized at two clinics of the Botucatu Medical School at Universidade Estadual Paulista 'Júlio de Mesquita Filho'. Information was collected between July and September 2010. Results. The main characteristics of the participating relatives were: 80% mothers of the children; 70% low education level and 70% married. Sixty percent of the children were hospitalized at the ICU for the first time. Eighty percent of the interviewees believe that the children's behavior changes inside the unit and 85% consider that visiting hours are sufficient. The predominant negative feelings are fear (50% and insecurity (20%, while the predominant positive feelings are hope (50% and the expectation of discharge (25%. The professional who most supported the relatives was the nurse (35%. Conclusion. The family members' experience as a result of the children's hospitalization at the ICU involves positive and negative aspects, which also affect the child's behavior at the unit.

  12. UnitedHealthcare experience illustrates how payers can enable patient engagement.

    Science.gov (United States)

    Sandy, Lewis G; Tuckson, Reed V; Stevens, Simon L

    2013-08-01

    Patient engagement is crucial to better outcomes and a high-performing health system, but efforts to support it often focus narrowly on the role of physicians and other care providers. Such efforts miss payers' unique capabilities to help patients achieve better health. Using the experience of UnitedHealthcare, a large national payer, this article demonstrates how health plans can analyze and present information to both patients and providers to help close gaps in care; share detailed quality and cost information to inform patients' choice of providers; and offer treatment decision support and value-based benefit designs to help guide choices of diagnostic tests and therapies. As an employer, UnitedHealth Group has used these strategies along with an "earn-back" program that provides positive financial incentives through reduced premiums to employees who adopt healthful habits. UnitedHealth's experience provides lessons for other payers and for Medicare and Medicaid, which have had minimal involvement with demand-side strategies and could benefit from efforts to promote activated beneficiaries.

  13. Maternal experiences with premature children in a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Raphael Colares de Sá

    2012-06-01

    Full Text Available Objective: Understand the maternal experience with premature children in neonatal intensive care unit. Methods: This is a qualitative and descriptive study. A questionnaire was used with semi-structured interview type, analyzed by the technique of content analysis and discussed, using the theoretical framework. The sample consisted of 11 mothers who accompanied their babies every day in the Neonatal Intensive Care Unit. Results: After discourse analysis emerged the following categories: experiencing maternal feelings in relation to the baby at risk; the meaning of the neonatal unit for mothers of premature infants, maternal perceptions about prematurity and experiencing the formation of the maternal-filial bond. Conclusions:The mother of premature experiences difficult times in the face of risk and instability of the baby, causing ambivalent feelings in relation to prematurity. Nevertheless, it was found thatfeelings of happiness, love and desire to see your baby being discharged form hospital and live with his family, were significant in relation to feelings of sadness and fear of losing her child.

  14. Harmonization in preclinical epilepsy research: A joint AES/ILAE translational initiative.

    Science.gov (United States)

    Galanopoulou, Aristea S; French, Jacqueline A; O'Brien, Terence; Simonato, Michele

    2017-11-01

    Among the priority next steps outlined during the first translational epilepsy research workshop in London, United Kingdom (2012), jointly organized by the American Epilepsy Society (AES) and the International League Against Epilepsy (ILAE), are the harmonization of research practices used in preclinical studies and the development of infrastructure that facilitates multicenter preclinical studies. The AES/ILAE Translational Task Force of the ILAE has been pursuing initiatives that advance these goals. In this supplement, we present the first reports of the working groups of the Task Force that aim to improve practices of performing rodent video-electroencephalography (vEEG) studies in experimental controls, generate systematic reviews of preclinical research data, and develop preclinical common data elements (CDEs) for epilepsy research in animals. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  15. Birth Care Providers’ Experiences and Practices in a Brazilian Alongside Midwifery Unit

    Directory of Open Access Journals (Sweden)

    Michelly Christiny M. Nunes

    2016-09-01

    Full Text Available The implementation of a new birthing facility in a country such as Brazil requires an extensive in-depth analysis of the challenges faced. The aim of this study was to explore beliefs, values, experiences, and practices related to the provision of birthing and neonatal care with the implementation of a new birth care facility structure called alongside midwifery units in Brazil. The study utilizes an ethnographic method to evaluate members of a Brazilian public hospital’s midwifery unit. The ethnographic study focuses on the cultural theme of “between the proposed and the possible”: the following birthing care guidelines require overcoming numerous obstacles, and four other cultural subthemes toward revealing the analyzed birth care team’s perspectives. The study found that prior training and preparation of all members of the care team, as well as the provision of adequate institutional infrastructure are essential for the implementation of a new and innovative birthing care center.

  16. Steam generator tube integrity requirements and operating experience in the United States

    International Nuclear Information System (INIS)

    Karwoski, K.J.

    2009-01-01

    Steam generator tube integrity is important to the safe operation of pressurized-water reactors. For ensuring tube integrity, the U.S. Nuclear Regulatory Commission uses a regulatory framework that is largely performance based. This performance-based framework is supplemented with some prescriptive requirements. The framework recognizes that there are three combinations of tube materials and heat treatments currently used in the United States and that the operating experience depends, in part, on the type of material used. This paper summarizes the regulatory framework for ensuring steam generator tube integrity, it highlights the current status of steam generators, and it highlights some of the steam generator issues and challenges that exist in the United States. (author)

  17. [Preclinical horizon of depression in adults].

    Science.gov (United States)

    Jiménez-Báez, María Valeria; Márquez-González, Horacio; Monsreal-Góngora, Juan Leonardo; Góngora-González, Gonzalo; Sandoval-Jurado, Luis; Boquer-Hernández, Rubén

    2016-01-01

    Identify factors related to preclinical depression in healthy adults, their risk factors and concordance with family doctor diagnostic. Case-control study in adult from family medicine consulting room. Beck inventory for depression was applied. The correlation between depression and the diagnosis by the family physician was evaluated. Odds ratio (OR) was determined. Involved 138 patients randomly from four family medicine units (FMU) in the Northern Region of Quintana Roo, Mexico. The mean age 34.9 ± 11.4 years, 55.8% women, prevalence for depression was 26.1%. Being male OR: 3.76; 95% CI: 1.69-8.36, under 30 years OR: 2.76; 95% CI: 1.27-5.99, low socioeconomic status (SES) OR: 2.11; 95% CI: 0.97-4.59 and be married OR: 3.22; 95% CI: 1.41.-7.36 had depression risk. Diagnosis by the family physician and inventory Beck. Kappa Index 0.2, 95% CI: -0057-0176; p = 0.05. Almost a third of young adults have some depression degree in family medicine consulting room, it is necessary a depression screening for male patients, low SES, married, and under 30 years old, attending medical consultation familiar, for a early diagnosis and improve prognosis.

  18. Family members' lived experience in the intensive care unit: a phemenological study.

    LENUS (Irish Health Repository)

    McKiernan, Margaret

    2012-01-31

    AIM: To describe the lived experience of family members of patients in the intensive care unit. BACKGROUND: Admission of a critically ill relative to an intensive care unit causes anxiety and stress to family members. Nursing care is initially focused on maintaining the physiological stability of the patient and less on the needs and concerns of family members. Understanding how families make sense of this experience may help nurses focus on the delivery of family centred care. METHODOLOGY: A phenomenological method was used to describe the lived experiences of family members of patients in an intensive care unit. In-depth interviews were conducted with six family members and analysed using qualitative thematic analysis. RESULTS: Four main themes emerged from the data: the need to know, making sense of it all, being there with them and caring and support. Family members needed honest information about the patient\\'s progress and outcome to make the situation more bearable for them. Making sense of the situation was a continuous process which involved tracking and evaluating care given. Being with their relative sustained their family bond and was a way to demonstrate love and support. Caring reassurance provided by the nurses enabled a sense of security. Support was needed by family members to assist them in coping. CONCLUSION: The research provided an insight into how family members viewed the impact of the admission and how they subsequently found ways of dealing with the situation. RELEVANCE TO CLINICAL PRACTICE: Using a holistic approach to nursing assessment and care delivery in intensive care necessitates that nurses interact with and care for family members of patients. Development of a philosophy of family centred care is necessary, with formal assessment of families to take place soon after admission and an appropriate plan of care drawn up at this time.

  19. Early experience with human papillomavirus vaccine introduction in the United States, Canada and Australia.

    Science.gov (United States)

    Shefer, Abigail; Markowitz, Lauri; Deeks, Shelley; Tam, Theresa; Irwin, Kathleen; Garland, Suzanne M; Schuchat, Anne

    2008-08-19

    Successful incorporation of a new vaccine into a nation's vaccination program requires addressing a number of issues, including: 1) establishing national recommendations; 2) assuring education of and acceptance by the public and medical community; 3) establishing and maintaining an appropriate infrastructure for vaccine delivery; 4) financing the vaccine and the program, in addition to political will. This article reviews the early experience with implementation of human papillomavirus (HPV) vaccination programs. It focuses on the United States of America and Canada and provides a brief report on Australia, where introduction is underway.

  20. Spatial reversal learning in preclinical scrapie-inoculated mice.

    Science.gov (United States)

    Lysons, A M; Woollard, S J

    1996-04-10

    Acquisition and reversal of a two-choice spatial discrimination were tested in scrapie-inoculated mice. Both acquisition and reversal were normal in mice tested 138 and 103 days prior to the onset of clinical symptoms. At 65 days before onset of clinical symptoms, scrapie-inoculated mice required more trails to criterion in reversal learning, but this effect was not significant in a second experiment (68 days preclinical) and was transient: no effect was seen 33 days before symptoms. However, the course of reversal learning was abnormal in all three late preclinical groups (68, 65 and 33 days before symptoms). Reversal learning in these three groups was characterized by a rapid extinction of the original discrimination, followed by a period, absent in controls, during which performance showed no further improvement. This effect corresponds in time of onset to the appearance of characteristic neuropathological features.

  1. Planning for the next generation of proton-decay experiments in the United States

    International Nuclear Information System (INIS)

    Ayres, D.S.

    1982-01-01

    There are now three well-developed proposals for new proton decay detectors to be built in the United States. These are the 1000 to 5000-ton Soudan 2 tracking calorimeter, the 1400-ton Homestake II liquid scintillator Tracking Spectrometer, and the 2500-ton University of Pennsylvania liquid-scintillator - proportional-drift-cell calorimeter. These proposals were reviewed by the Department of Energy Technical Assessment Panel on Proton Decay in February 1982. I shall describe the Soudan and Pennsylvania proposals, present the latest results from the 31-ton Soudan 1 experiment, and discuss the recommendations of the DOE Panel. Following these recommendations, a one-week workshop, to be held at Argonne in June, will focus on the optimization of techniques for future experiments

  2. Nurses’ Experiences of Managing and Management in a Critical Care Unit

    Directory of Open Access Journals (Sweden)

    K. Robyn Ogle

    2014-05-01

    Full Text Available In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem.

  3. Nurses’ Experiences of Managing and Management in a Critical Care Unit

    Science.gov (United States)

    Ogle, K. Robyn; Glass, Nel

    2014-01-01

    In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem. PMID:28462287

  4. Commercial operation and outage experience of ABWR at Kashiwazaki-Kariwa units Nos. 6 and 7

    International Nuclear Information System (INIS)

    Anahara, N.; Yamada, M.; Kataoka, H.

    2000-01-01

    drums and that of unit No. 3. Overhaul and inspection of new designs components, such as reactor internal pumps (RIPs), advanced type control rod drive mechanism (FMCRD) and large-capacity and high-efficiency turbine system, were conducted as planned, verifying their integrity after the commercial operation period. Operability during annual outage through ABWR-type main control room panels, which have a very new man-machine interface with touch-screen CRTs and flat displays, was also confirmed. In this paper, the commercial operation and annual outage experience of Kashiwazaki-Kariwa Nuclear Power Station units Nos. 6 and 7 are reported. (author)

  5. Preclinical models for obesity research

    Directory of Open Access Journals (Sweden)

    Perry Barrett

    2016-11-01

    Full Text Available A multi-dimensional strategy to tackle the global obesity epidemic requires an in-depth understanding of the mechanisms that underlie this complex condition. Much of the current mechanistic knowledge has arisen from preclinical research performed mostly, but not exclusively, in laboratory mouse and rat strains. These experimental models mimic certain aspects of the human condition and its root causes, particularly the over-consumption of calories and unbalanced diets. As with human obesity, obesity in rodents is the result of complex gene–environment interactions. Here, we review the traditional monogenic models of obesity, their contemporary optogenetic and chemogenetic successors, and the use of dietary manipulations and meal-feeding regimes to recapitulate the complexity of human obesity. We critically appraise the strengths and weaknesses of these different models to explore the underlying mechanisms, including the neural circuits that drive behaviours such as appetite control. We also discuss the use of these models for testing and screening anti-obesity drugs, beneficial bio-actives, and nutritional strategies, with the goal of ultimately translating these findings for the treatment of human obesity.

  6. Ethical Considerations of Preclinical Testing

    Directory of Open Access Journals (Sweden)

    Allen Goldenthal

    2015-12-01

    Full Text Available The numbers of animal tests being conducted are on a sharp incline.  Much of this increase is directly due to our ability to generate transgenic models and knock-outs, thereby increasing the validity of the animal model but not necessarily correlating directly with any translational medical benefits to the human counterpart.  In spite of our best efforts, there still exist species differences that prevent the application directly from animal to human, and in some examples having a completely different and adverse effect from that seen in the animal model. There are several ways in which we can improve the opportunity for a positive test outcome and at the same time reduce the animal usage which is associated with our current animal testing practices. The benefit of the 3R’s is that they encourage us not only to avoid wastage of life but that they require us to provide considerable foresight and extrapolated thought before directly engaging in the preclinical testing phase.

  7. Preclinical studies of dendrimer prodrugs.

    Science.gov (United States)

    Kojima, Chie

    2015-01-01

    Dendrimers are synthetic macromolecules with well-defined structures bearing a wide variety of functional groups on their periphery. These groups can be used to conjugate bioactive molecules such as drugs, ligands and imaging agents. Dendrimer prodrugs can be used to improve the water solubility and pharmacokinetic properties of the corresponding free drugs. This article summarizes preclinical studies pertaining to the use of drug-dendrimer conjugates as dendrimer prodrugs for the treatments of various diseases, including cancer and inflammatory diseases. A wide range of anticancer drugs have been conjugated to dendrimers via biodegradable linkers. The side effects of the parent drugs can be markedly reduced using dendrimer prodrugs, with some drugs showing improved efficacy. Anti-inflammatory agents have also been conjugated to dendrimers and used to treat a number of inflammatory diseases. Drug-dendrimer conjugates are preferable to drug-dendrimer complexes, where the use of degradable linkers is critical to the release of the drug. Polyethylene glycol and/or ligands can be added to a dendrimer prodrug, which is useful for the targeting of affected tissues. Imaging probes can also be incorporated into dendrimer prodrugs for the simultaneous delivery of therapeutic and diagnostic agents as 'theranostics.'

  8. Supporting Solar Power in Renewables Portfolio Standards: Experience from the United States

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ryan; Barbose, Galen; Holt, Edward

    2010-10-01

    Among the available options for encouraging the increased deployment of renewable electricity, renewables portfolio standards (RPS) have become increasingly popular. The RPS is a relatively new policy mechanism, however, and experience with its use is only beginning to emerge. One key concern that has been voiced is whether RPS policies will offer adequate support to a wide range of renewable energy technologies and applications or whether, alternatively, RPS programs will favor a small number of the currently least-cost forms of renewable energy. This report documents the design of and early experience with state-level RPS programs in the United States that have been specifically tailored to encourage a wider diversity of renewable energy technologies, and solar energy in particular. As shown here, state-level RPS programs specifically designed to support solar have already proven to be an important, albeit somewhat modest, driver for solar energy deployment, and those impacts are projected to continue to build in the coming years. State experience in supporting solar energy with RPS programs is mixed, however, and full compliance with existing requirements has not been achieved. The comparative experiences described herein highlight the opportunities and challenges of applying an RPS to specifically support solar energy, as well as the importance of policy design details to ensuring that program goals are achieved.

  9. Physical and mechanical restraint in psychiatric units: Perceptions and experiences of nursing staff.

    Science.gov (United States)

    Vedana, Kelly Graziani Giacchero; da Silva, Danielle Maria; Ventura, Carla Aparecida Arena; Giacon, Bianca Cristina Ciccone; Zanetti, Ana Carolina Guidorizzi; Miasso, Adriana Inocenti; Borges, Tatiana Longo

    2018-06-01

    Physical restraint in psychiatric units is a common practice but extremely controversial and poorly evaluated by methodologically appropriate investigations. The cultural issues and professionals' perceptions and attitudes are substantial contributors to the frequency of restraint that tend to be elevated. Aim In this qualitative study, we aimed to understand the experiences and perceptions of nursing staff regarding physical restraint in psychiatric units. Through theoretical sampling, 29 nurses from two Brazilian psychiatric units participated in the study. Data were collected from 2014 to 2016 from individual interviews and analyzed through thematic analysis, employing theoretical presuppositions of symbolic interactionism. Physical restraint was considered unpleasant, challenging, risky, and associated with dilemmas and conflicts. The nursing staff was often exposed to the risks and injuries related to restraint. Professionals sought strategies to reduce restraint-related damages, but still considered it necessary due to the lack of effective options to control aggressive behavior. This study provides additional perspectives about physical restraint and reveals the need for safer, humanized and appropriate methods for the care of aggressive patients that consider the real needs and rights of these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Cell phone recycling experiences in the United States and potential recycling options in Brazil.

    Science.gov (United States)

    Silveira, Geraldo T R; Chang, Shoou-Yuh

    2010-11-01

    This paper presents an overview of cell phone recycling programs currently available in the United States. At the same time, it also provides analyses of the current recycling situation and possible recycling alternatives for Brazil. Although there are several recycling options in the United States, collection rates are still only 10% of all potential devices because customers are not aware of these possibilities. The whole system is financially based on reselling refurbished cell phones and recycled materials to developing countries which represent an effective and strong market. Several recyclers offer funds to collection partners who are either charities or who work with charities while obtaining the materials that they need in order to run their operations. A mobile phone recycling system for Brazil considering the United States experience and the Extended Producer Responsibility (EPR) principle is suggested. A deposit/refund/advance-recycling fee is proposed which might be implemented as a voluntary industrial initiative managed by PRO Brazil, a producer responsibility organization. One widespread public-private agreement will integrate all mobile phone stakeholders, and environmental education actions and promotional events will promote citizen's participation. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Korean immigrant women's lived experience of childbirth in the United States.

    Science.gov (United States)

    Seo, Jin Young; Kim, Wooksoo; Dickerson, Suzanne S

    2014-01-01

    To understand Korean immigrant women's common experiences and practices of utilizing health care services in the United States during childbirth. A qualitative interpretive phenomenological research design. Recruitment was conducted through advertisement on the MissyUSA.com website, which is the largest online community for married Korean women who live in North America. A purposive sample of 15 Korean immigrant women who experienced childbirth in the United States within the past 5 years was recruited. Data were collected using semistructured telephone interviews and were analyzed using the Heideggerian hermeneutical methodology. During childbirth in the United States, participants faced multifaceted barriers in unfamiliar sociocultural contexts yet maintained their own cultural heritages. They navigated the unfamiliar health care system and developed their own strategies to overcome barriers to health care access. Korean immigrant women actively sought health information on the Internet and through social networking during childbirth. Korean immigrant women selectively accepted new cultural beliefs with some modifications from their own cultural contexts and developed their own distinct birth cultures. Understanding a particular culture and respecting women's traditions, beliefs, and practices about their childbirth could help nurses to provide culturally sensitive care. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  12. Differential Family Experience of Palliative Sedation Therapy in Specialized Palliative or Critical Care Units.

    Science.gov (United States)

    Shen, Hui-Shan; Chen, Szu-Yin; Cheung, Denise Shuk Ting; Wang, Shu-Yi; Lee, Jung Jae; Lin, Chia-Chin

    2018-02-21

    No study has examined the varying family experience of palliative sedation therapy (PST) for terminally ill patients in different settings. To examine and compare family concerns about PST use and its effect on the grief suffered by terminally ill patients' families in palliative care units (PCUs) or intensive care units (ICUs). A total of 154 family members of such patients were recruited in Taiwan, of whom 143 completed the study, with 81 from the PCU and 62 from the ICU. Data were collected on their concerns regarding PST during recruitment. Grief levels were assessed at three days and one month after the patient's death with the Texas Revised Inventory of Grief. Families' major concern about sedated patients in the PCU was that "there might be other ways to relieve symptoms" (90.2%), whereas families of ICU sedated patients gave the highest ratings to "feeling they still had something more to do" (93.55%), and "the patient's sleeping condition was not dignified" (93.55%). Family members recruited from the ICU tended to experience more grief than those from the PCU (P = 0.005 at Day 3 and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  13. When East meets West: intensive care unit experiences among first-generation Chinese American parents.

    Science.gov (United States)

    Lee, Shih-Yu; Weiss, Sandra J

    2009-01-01

    To explore the experiences of first-generation Chinese American parents while their infants are cared for in intensive care units (ICUs). Because the study focus was on understanding the experiences of parents, a phenomenological approach was used, with open-ended questions that encouraged participants to describe events they perceived to be important. The data analysis procedure suggested by van Manen was used for the qualitative data analysis. A convenience sample of 25 first-generation Chinese American families, with infants hospitalized in the intensive care units of three teaching hospitals in the San Francisco area. Seven themes were identified: perceived incompetence, self-blame, blame from others, filial piety, lack of support in the US, communication issues, and cultural differences. Both fathers and mothers experienced stress related to all identified themes. Findings suggest the need for more resources to educate and support families as well as culturally competent care within pediatric ICUs. Further study is critical to understand how the Chinese American's personal and family characteristics may influence stress perceptions when coping with their children's hospitalization. This study can help healthcare providers to understand Chinese American parents' perceptions while their infants are hospitalized in the ICU, which can enhance cultural competence care services.

  14. [Nurses' perception, experience and knowledge of palliative care in intensive care units].

    Science.gov (United States)

    Piedrafita-Susín, A B; Yoldi-Arzoz, E; Sánchez-Fernández, M; Zuazua-Ros, E; Vázquez-Calatayud, M

    2015-01-01

    Adequate provision of palliative care by nursing in intensive care units is essential to facilitate a "good death" to critically ill patients. To determine the perceptions, experiences and knowledge of intensive care nurses in caring for terminal patients. A literature review was conducted on the bases of Pubmed, Cinahl and PsicINFO data using as search terms: cuidados paliativos, UCI, percepciones, experiencias, conocimientos y enfermería and their alternatives in English (palliative care, ICU, perceptions, experiences, knowledge and nursing), and combined with AND and OR Boolean. Also, 3 journals in intensive care were reviewed. Twenty seven articles for review were selected, most of them qualitative studies (n=16). After analysis of the literature it has been identified that even though nurses perceive the need to respect the dignity of the patient, to provide care aimed to comfort and to encourage the inclusion of the family in patient care, there is a lack of knowledge of the end of life care in intensive care units' nurses. This review reveals that to achieve quality care at the end of life, is necessary to encourage the training of nurses in palliative care and foster their emotional support, to conduct an effective multidisciplinary work and the inclusion of nurses in decision making. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  15. Large-scale, long-term silvicultural experiments in the United States: historical overview and contemporary examples.

    Science.gov (United States)

    R. S. Seymour; J. Guldin; D. Marshall; B. Palik

    2006-01-01

    This paper provides a synopsis of large-scale, long-term silviculture experiments in the United States. Large-scale in a silvicultural context means that experimental treatment units encompass entire stands (5 to 30 ha); long-term means that results are intended to be monitored over many cutting cycles or an entire rotation, typically for many decades. Such studies...

  16. The Lived Experience of Jordanian Parents in a Neonatal Intensive Care Unit: A Phenomenological Study.

    Science.gov (United States)

    Abuidhail, Jamila; Al-Motlaq, Mohammad; Mrayan, Lina; Salameh, Taghreed

    2017-04-01

    Many international studies in the field of neonatal nursing have identified parental stress, coping difficulties, support issues, and various other experiences that are related to the birth of a preterm infant. However, no studies have assessed the interrelated issues of parental stress, social support, satisfaction, and nursing support in neonatal intensive care units (NICUs) in Jordan. This study describes the lived experiences, needs in relation to care, and support systems of parents whose neonates were admitted to the NICU. A qualitative design using a phenomenological approach was used to explore the experiences of Jordanian parents who gave birth to neonates in the NICU setting. Participants were recruited from the NICUs of government, teaching, and private hospitals. Data were collected using semistructured interviews that were conducted with parents in a suitable place. Ten participants were interviewed: eight mothers and two fathers. After interviews were transcribed, the methodology suggested by van Manen (1990) was used to analyze the data. The shock, worry, and anxiety experienced by parents; the influences of NICU admission on the experiences of parents and families; the information and assistance required and received by parents from healthcare professionals; and the emotions and satisfaction of parents were the main themes that emerged from the study to reflect the lived experience of parents of neonates in the NICU. The parents in this study were satisfied with the healthcare process in the NICUs, even when this care did not fulfill their expectations or needs for their infants. Nurses in the NICUs must develop interventions and strategies that minimize the stress experienced by parents and that support the emotional capacity of parents to deal with this stressful situation.

  17. Perceived discrimination and psychotic experiences across multiple ethnic groups in the United States.

    Science.gov (United States)

    Oh, Hans; Yang, Lawrence H; Anglin, Deidre M; DeVylder, Jordan E

    2014-08-01

    The objective of this study was to examine the relationship between perceived discrimination and psychotic experiences (PE) using validated measures of discrimination and a racially/ethnically diverse population-level sample. Data were drawn from two population-level surveys (The National Latino and Asian American Survey and The National Survey of American Life), which were analyzed together using survey weights and stratification variables. The analytic sample (N=8990) consisted of Latino, Asian, African-American, and Afro-Caribbean adults living in the United States. Separate unadjusted and adjusted multivariable logistic regression models were used, first to examine the crude bivariate relationship between perceived discrimination and PE, and second to examine the relationship adjusting for demographic variables. Adjusted logistic regression models were also used to examine the relationships between perceived discrimination and specific sub-types of PE (auditory and visual hallucinatory experiences, and delusional ideation). When compared to individuals who did not report any discrimination, those who reported the highest levels of discrimination were significantly more likely to report both 12-month PE (Adjusted OR=4.590, pPerceived discrimination is associated with the increased probability of reporting psychotic experiences in a linear Fashion in the US general population. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Experiences of internationally educated nurses holding management positions in the United States: Descriptive phenomenological study.

    Science.gov (United States)

    Allen, Lilian A

    2018-02-12

    The purpose of this study was to explore the experiences of internationally educated nurses in management positions in United States health care organisations to understand the obstacles and support these individuals' experience when pursuing and working in managerial roles. Although internationally educated nurses are an integral part of the US health care industry, few work in managerial roles. Little is known about the experiences of internationally educated nurses who do obtain management positions. In this qualitative, phenomenological study, seven internationally educated nurses who were managers in Chicago, Illinois, responded to open-ended interview questions. Supervisors contributed to the participants' acceptance of management positions. The participants experienced challenges such as cultural differences, language, and communication. Despite these challenges, the participants had positive working relationships with staff and supervisors. Further, the participants had opportunities for education and professional growth. Internationally educated nurses benefit from participating in organisational committees. They face challenges related to work responsibilities, cultural differences and communication but can succeed in management roles through developing strategies to overcome the challenges and through receiving support from staff, colleagues and supervisors. More internationally educated nurses may obtain managerial positions if supervisors provide encouragement and support. © 2018 John Wiley & Sons Ltd.

  19. Quality assurance in a radiation oncology unit: the chart round experience

    International Nuclear Information System (INIS)

    Fogarty, G.B.; Peters, L.J.; Hornby, C.; Ferguson, H.M.

    2001-01-01

    Quality assurance ensures that planned treatments eventuate. Programmes must include feedback loops to promptly correct any shortfall in predetermined standards. In March 1999, a weekly Chart Round was introduced to verify that certain items relevant to quality care were being completed for patients of the Head and Neck Radiotherapy Unit at the Peter MacCallum Cancer Institute. The experience was reviewed after 1 year and it was found that the initiation of Chart Rounds has assisted in raising the level of item completion from 80% to 99% in similar groups of patients treated before and after the initiation of the Chart Round. Initiation of the Chart Round has also provided a useful forum for in-house peer-review, education and effective real-time communication between medical and allied health personnel, all of which has further added to the quality of patient care. Copyright (2001) Blackwell Science Pty Ltd

  20. Experience in verification regimes. United States On-Site Inspection Agency

    International Nuclear Information System (INIS)

    Reppert, J.

    1998-01-01

    Experiences are described of the United States On-site Inspection Agency in verification regimes all over the world where it has been applied in the last 30 years. The challenge for the future is to extend the benefits of the applied tools to all states in all regions to enhance stability and to create conditions for peace at lower levels of armaments than currently exist. The USA need to engage states currently caught in cycles of violence and arms escalation. They must examine technologies which together with on-site aspects of verification or transparency regimes can provide a comprehensive picture at affordable costs. They foresee a growth in combined training with new states entering for the first time into regime that include arms control and transparency measure

  1. Specific problems and practical experience of regulatory inspection during commissioning in the United Kingdom

    International Nuclear Information System (INIS)

    Lewis, G.

    1977-01-01

    The commissioning of nine Magnox and two Advanced Gas-cooled Reactor Nuclear Power Plants in the United Kingdom during the last sixteen years under the regulatory control of the Nuclear Installations Inspectorate of the Health and Safety Executive has been based on a Stage Approval Philosophy starting with proof-testing of the primary gas circuit and concluding with tests on the reactor at full power. The practical experience gained during this period has enabled the Nuclear Installations Inspectorate to rationalise the procedures and test requirements without comporomising safety standards. The Operating Rules and Maintenance Schedules are approved for commissioning and during this period are reviewed for their adequacy for future power operation of the plant. The organisation, documentation, test procedures and the commissioning programme used for the Advanced Gas-cooled Reactors are briefly explained. (author)

  2. Summary of the fourth conference on United States utility experience in reactor noise analysis

    International Nuclear Information System (INIS)

    Fry, D.N.

    1987-01-01

    The fourth informal conference on United States utility experience in reactor noise analysis and loose-part monitoring was held at the Northeast Utilities Service Company offices in Hartford, Connecticut, May 12-14, 1987. Host and general chairman for the meeting was J.V. Persio of Northeast Utilities. This conference provided a forum where utilities could share information on reactor noise analysis on an informal basis. There were about 60 attendees at the meeting representing 10 utilities, 3 reactor vendors, 8 consulting organizations, and 4 universities and research laboratories. Twenty-three papers were presented at the conference, dealing with various aspects of loose-part monitoring, neutron noise analysis, and standards activities

  3. Experience in the installation of a microprocessor system for controlling converter units of the Vyborg substation

    International Nuclear Information System (INIS)

    Gusakovskii, K. B.; Zmaznov, E. Yu.; Katantsev, S. V.; Mazurenko, A. K.; Mestergazi, V. A.; Prochan, G. G.; Funtikova, S. F.

    2006-01-01

    The experience in the installation of modern digital systems for controlling converter units at the Vyborg converter substation on the basis of advanced microprocessor devices is considered. It is shown that debugging of a control and protection system on mathematical and physical models does not guarantee optimum control of actual converter devices. Examples of advancing the control and protection system are described, the necessity for which has become obvious in tests of actual equipment. Comparison of oscillograms of processes before optimization of the control system and after its optimization and adjustment shows that the digital control system makes it possible to improve substantially the algorithms of control and protection in the short term and without changing the hardware component

  4. [A unit for the care of acute headache attacks. A new experience in our milieu].

    Science.gov (United States)

    Zukerman, E; Lima, J G; Hannuch, S N; Nothen, M R; Carvalho, D de S

    1989-01-01

    This paper presents the aims of the first unit for treatment of headache crisis in a Brazilian Medical School. The differences between this unit and a neurological emergency unit and the therapeutic schedules are discussed.

  5. Supporting solar power in renewables portfolio standards: Experience from the United States

    International Nuclear Information System (INIS)

    Wiser, Ryan; Barbose, Galen; Holt, Edward

    2011-01-01

    Renewables portfolio standards (RPS) have become an increasingly popular option for encouraging the deployment of renewable electricity. It is a relatively new policy mechanism, however, and experience with its use is only beginning to emerge. One key concern is whether RPS policies offer adequate support to a wide range of renewable energy technologies and applications or whether, alternatively, they will favor a small number of the currently least-cost forms of renewable energy. This article documents the design of and early experience with state-level RPS programs in the United States that have been specifically tailored to encourage a wider diversity of renewable energy technologies, and solar energy in particular. As shown here, state-level RPS programs specifically designed to support solar have already proven to be an important driver for solar energy deployment, and those impacts are projected to build in the coming years. State experience in supporting solar energy with RPS programs is mixed, however, and full compliance with existing requirements has not been achieved. The comparative experiences described herein highlight the opportunities and challenges of applying an RPS to specifically support solar energy, as well as the importance of policy design details to ensuring that program goals are achieved. - Research highlights: → Many states have adopted RPS policies with solar or DG set-asides. → Solar and DG set-asides have become a significant driver for solar growth. → Compliance with solar/DG set-aside targets has been mixed. → The estimated retail rate impacts have thus far been relatively modest. → Various emerging issues will affect the future impact of RPS policies on solar growth.

  6. Do Indonesian Children's Experiences with Large Currency Units Facilitate Magnitude Estimation of Long Temporal Periods?

    Science.gov (United States)

    Cheek, Kim A.

    2017-08-01

    Ideas about temporal (and spatial) scale impact students' understanding across science disciplines. Learners have difficulty comprehending the long time periods associated with natural processes because they have no referent for the magnitudes involved. When people have a good "feel" for quantity, they estimate cardinal number magnitude linearly. Magnitude estimation errors can be explained by confusion about the structure of the decimal number system, particularly in terms of how powers of ten are related to one another. Indonesian children regularly use large currency units. This study investigated if they estimate long time periods accurately and if they estimate those time periods the same way they estimate analogous currency units. Thirty-nine children from a private International Baccalaureate school estimated temporal magnitudes up to 10,000,000,000 years in a two-part study. Artifacts children created were compared to theoretical model predictions previously used in number magnitude estimation studies as reported by Landy et al. (Cognitive Science 37:775-799, 2013). Over one third estimated the magnitude of time periods up to 10,000,000,000 years linearly, exceeding what would be expected based upon prior research with children this age who lack daily experience with large quantities. About half treated successive powers of ten as a count sequence instead of multiplicatively related when estimating magnitudes of time periods. Children generally estimated the magnitudes of long time periods and familiar, analogous currency units the same way. Implications for ways to improve the teaching and learning of this crosscutting concept/overarching idea are discussed.

  7. Our experience in using the whole body computed tomography unit (GE CT/T)

    International Nuclear Information System (INIS)

    Murakawa, Yasuhiro; Morimoto, Mitsuo; Ishigaki, Naoya; Zaitsu, Hiroaki; Kawabata, Kohji

    1983-01-01

    Since our hospital installed the CT unit of the head and neck (SCT-100N) in April, 1979, we reported our experience in using this equipment in 1980 and 1982. After that, since the whole body CT unit (GE CT/T) was installed in our hospital in April, 1982, the total number of CT examination have reached approximately three thousand five handred till this August. Consequently, this CT image seemed to be superior in image quality to that obtained by other CT equipment. The most important characteristic of this equipment is that the retrospective and prospective reviews of the target image and the coronal and sagittal recontruction from contiguous transverse axial scans are possible. We show in this report two experimental CT photograms obtained by the reviews of the target image in using of microchart phantom and CT photograms of uterus myoma, metastatic thyroid and liver cancers and further, of contiguous transverse axial scans of cerebral embolism and the coronal recontruction. The important problems for the future of this equipment are those of absorbed X-ray dose of the patients and the scan time. (author)

  8. Ward nurses' experiences of the discharge process between intensive care unit and general ward.

    Science.gov (United States)

    Kauppi, Wivica; Proos, Matilda; Olausson, Sepideh

    2018-05-01

    Intensive care unit (ICU) discharges are challenging practices that carry risks for patients. Despite the existing body of knowledge, there are still difficulties in clinical practice concerning unplanned ICU discharges, specifically where there is no step-down unit. The aim of this study was to explore general ward nurses' experiences of caring for patients being discharged from an ICU. Data were collected from focus groups and in-depth interviews with a total of 16 nurses from three different hospitals in Sweden. An inductive qualitative design was chosen. The analysis revealed three themes that reflect the challenges in nursing former ICU patients: a vulnerable patient, nurses' powerlessness and organizational structure. The nurses described the challenge of nursing a fragile patient based on several aspects. They expressed feeling unrealistic demands when caring for a fragile former ICU patient. The demands were related to their own profession and knowledge regarding how to care for this group of patients. The organizational structure had an impact on how the nurses' caring practice could be realized. This evoked ethical concerns that the nurses had to cope with as the organization's care guidelines did not always favour the patients. The structure of the organization and its leadership appear to have a significant impact on the nurses' ability to offer patients the care they need. This study sheds light on the need for extended outreach services and intermediate care in order to meet the needs of patients after the intensive care period. © 2018 British Association of Critical Care Nurses.

  9. First practical and clinical experiences using the IBU (integrated brachytherapy unit): it works

    International Nuclear Information System (INIS)

    Loevey, GL.; Haker, H.; Koch, K

    1996-01-01

    A large number of modern HDR-AL treatments requires a three dimensional applicator reconstruction and dose optimization. Conventional Xray-film digitalization is time consuming, operation tables and the Xray units limit the possible radiography directions and therefore the optimal catheter reconstruction. The IBU concept and equipments offer new possibilities in applicator reconstruction and 3D isodoses display. Materials and methods: Since January 1994 1095 HDR applications have been performed on Nucletron's 1993 installed IBU. All treatments have been individually planned, in 151 (13, 78%) cases 3D applicator reconstruction were necessary. Total treatment time elapsed, reconstruction time, time interval from the start of the planning phase to the start of the irradiation were measured. Results: Total treatment time was reduced in comparison to treatments with conventional catheter reconstruction because: 1.) no time needed for Xray film processing, 2.) faster identification of catheters due to digital image processing, 3.) faster evaluation of isodoses due to 3D isodoses display. Examples of filmless reconstruction and planning in different gynaecologic and H and N localizations will be demonstrated. Conclusion: the first practical experiences show a good match to the theoretical advantages of the integrated brachytherapy unit: the system reduces total treatment time and thus patient distress

  10. Acting with dedication and expertise: Relatives' experience of nurses' provision of care in a palliative unit.

    Science.gov (United States)

    Grøthe, Å; Biong, Stian; Grov, E K

    2015-12-01

    Admission of a cancer patient to a palliative unit when near the final stage of their disease trajectory undoubtedly impacts their relatives. The aim of our study was to illuminate and interpret relatives' lived experiences of health personnel's provision of care in a palliative ward. A phenomenological/hermeneutic approach was employed that was inspired by the philosophical tradition of Heidegger and Ricoeur and further developed by Lindseth and Nordberg. The perspectives of the narrator and the text were interpreted by highlighting relatives' views on a situation in which they have to face existential challenges. The analysis was undertaken in three steps: naïve reading, structural analysis, and comprehensive understanding, including the authors' professional experiences and theoretical background. Six subthemes appeared: the dying person, the bubble, the sight, the cover, the provision for children's needs, and the availability of immediate help. These components were further constructed into three themes: the meaning of relating, the meaning of action, and the meaning of resources. Our comprehensive understanding of the results suggests that the most important theme is "acting with dedication and expertise." The following aspects are crucial for relatives of cancer patients hospitalized in a palliative ward: time and existence, family dynamics, and care adjusted to the situation. Our study results led to reflections on the impact of how nurses behave when providing care to patients during the palliative phase, and how they interact with relatives in this situation. We found that cancer patients in a palliative unit most appreciate nurses who act with dedication and expertise.

  11. Development of an X-ray delay unit for correlation spectroscopy and pump-probe experiments

    Energy Technology Data Exchange (ETDEWEB)

    Roseker, Wojciech

    2008-07-15

    Probing condensed matter on time scales ranging from femtoseconds to nanoseconds will be one of the key topics for future X-ray Free Electron Laser (XFEL) sources. The accessible time windows are, however, compromised by the intrinsic time structure of the sources. One way to overcome this limitation is the usage of a time delay unit. A prototype device capable of splitting an X-ray pulse into two adjustable fractions, delaying one of them with the aim to perform X-ray Photon Correlation Spectroscopy and pump-probe type studies was designed and manufactured. The device utilizes eight perfect crystals in vertical 90 scattering geometry. Its performance has been verified with 8.39 keV and 12.4 keV Xrays at various synchrotron sources. The measured throughput of the device with a Si(333) monochromator at 8.39 keV under ambient conditions is 0.6%. The stability was verified at 12.4 keV and operation without realignment and feedback was possible for more than 30 minutes. Time delays up to 2.95 ns have been achieved. The highest resolution achieved in an experiment was 15.4 ps, a value entirely determined by the diagnostics system. The influence of the delay unit optics on the coherence properties of the beam was investigated by means of Fraunhofer diffraction and static speckle analysis. The obtained high fringe visibility and contrast values larger than 23% indicate the feasibility of performing coherence based experiments with the delay line. (orig.)

  12. The Devil Is in the Details: Incomplete Reporting in Preclinical Animal Research.

    Science.gov (United States)

    Avey, Marc T; Moher, David; Sullivan, Katrina J; Fergusson, Dean; Griffin, Gilly; Grimshaw, Jeremy M; Hutton, Brian; Lalu, Manoj M; Macleod, Malcolm; Marshall, John; Mei, Shirley H J; Rudnicki, Michael; Stewart, Duncan J; Turgeon, Alexis F; McIntyre, Lauralyn

    2016-01-01

    Incomplete reporting of study methods and results has become a focal point for failures in the reproducibility and translation of findings from preclinical research. Here we demonstrate that incomplete reporting of preclinical research is not limited to a few elements of research design, but rather is a broader problem that extends to the reporting of the methods and results. We evaluated 47 preclinical research studies from a systematic review of acute lung injury that use mesenchymal stem cells (MSCs) as a treatment. We operationalized the ARRIVE (Animal Research: Reporting of In Vivo Experiments) reporting guidelines for pre-clinical studies into 109 discrete reporting sub-items and extracted 5,123 data elements. Overall, studies reported less than half (47%) of all sub-items (median 51 items; range 37-64). Across all studies, the Methods Section reported less than half (45%) and the Results Section reported less than a third (29%). There was no association between journal impact factor and completeness of reporting, which suggests that incomplete reporting of preclinical research occurs across all journals regardless of their perceived prestige. Incomplete reporting of methods and results will impede attempts to replicate research findings and maximize the value of preclinical studies.

  13. The Devil Is in the Details: Incomplete Reporting in Preclinical Animal Research.

    Directory of Open Access Journals (Sweden)

    Marc T Avey

    Full Text Available Incomplete reporting of study methods and results has become a focal point for failures in the reproducibility and translation of findings from preclinical research. Here we demonstrate that incomplete reporting of preclinical research is not limited to a few elements of research design, but rather is a broader problem that extends to the reporting of the methods and results. We evaluated 47 preclinical research studies from a systematic review of acute lung injury that use mesenchymal stem cells (MSCs as a treatment. We operationalized the ARRIVE (Animal Research: Reporting of In Vivo Experiments reporting guidelines for pre-clinical studies into 109 discrete reporting sub-items and extracted 5,123 data elements. Overall, studies reported less than half (47% of all sub-items (median 51 items; range 37-64. Across all studies, the Methods Section reported less than half (45% and the Results Section reported less than a third (29%. There was no association between journal impact factor and completeness of reporting, which suggests that incomplete reporting of preclinical research occurs across all journals regardless of their perceived prestige. Incomplete reporting of methods and results will impede attempts to replicate research findings and maximize the value of preclinical studies.

  14. Interventions during labor and birth in the United States: a qualitative analysis of women's experiences.

    Science.gov (United States)

    Bibeau, Alana M

    2014-12-01

    To explore and describe hospital-birthing women's understandings of and experiences with interventions during labor and birth. Qualitative data was collected as part of a larger ethnographic study of childbirth in the United States. The grounded theory method was employed to analyze interviews with 59 women from three states who had recently given birth in hospitals with physicians or certified nurse-midwives in attendance. Four themes emerged from the data. The themes safety/risk and provider match, described women's expectations regarding intervention and their interactions with providers. A third theme addressed how women experienced interventions and their perceptions of control over decision-making. A final theme characterized women's satisfaction with maternity care. Women who received interventions expressed varying levels of comfort or apprehension associated with both expectations of maternity care and provider match. Women whose expectations matched those of the provider reported more positive experiences. Regardless of provider match, women expressed ambivalence about the use of interventions and confusion over their appropriate place. Women's ability to make sense of interventions was related to how well they navigated a complicated and bureaucratic maternity system. Increasing attention needs to be paid to the impact of these factors on women's perceptions of care during pregnancy and childbirth. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Design and Testing of a Breadboard Electrical Power Control Unit for the Fluid Combustion Facility Experiment

    Science.gov (United States)

    Kimnach, Greg L.; Lebron, Ramon C.

    1999-01-01

    The Fluid Combustion Facility (FCF) Project and the Power Technology Division at the NASA Glenn Research Center (GRC) at Lewis Field in Cleveland, OH along with the Sundstrand Corporation in Rockford, IL are jointly developing an Electrical Power Converter Unit (EPCU) for the Fluid Combustion Facility to be flown on the International Space Station (ISS). The FCF facility experiment contains three racks: A core rack, a combustion rack, and a fluids rack. The EPCU will be used as the power interface to the ISS 120V(sub dc) power distribution system by each FCF experiment rack which requires 28V(sub dc). The EPCU is a modular design which contains three 120V(sub dc)-to-28V(sub dc) full-bridge, power converters rated at 1 kW(sub e) each bus transferring input relays and solid-state, current-limiting input switches, 48 current-limiting, solid-state, output switches; and control and telemetry hardware. The EPCU has all controls required to autonomously share load demand between the power feeds and--if absolutely necessary--shed loads. The EPCU, which maximizes the usage of allocated ISS power and minimizes loss of power to loads, can be paralleled with other EPCUs. This paper overviews the electrical design and operating characteristics of the EPCU and presents test data from the breadboard design.

  16. Designing Preclinical Instruction of Psychomotor Skills (IV)--Instructional Engineering: Evaluation Phase.

    Science.gov (United States)

    Guenzel, Pamela J.; And Others

    1995-01-01

    The fourth article in a four-part series on instructional design discusses evaluation of a psychomotor skills unit taught in preclinical dental education. Issues examined include piloting of instructional materials, analysis and revision of materials based on student performance, syllabus design and content, influence of faculty characteristics,…

  17. [Inpatient Dialectical Behavioral Therapy for Adolescents (DBT-A) - 10 years of experience on the psychiatric inpatient unit "wellenreiter"].

    Science.gov (United States)

    von Auer, Anne Kristin; Kleindienst, Nikolaus; Ludewig, Sonia; Soyka, Oliver; Bohus, Martin; Ludäscher, Petra

    2015-09-01

    In April 2004 the inpatient unit "Wellenreiter" at the Vorwerker Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Lubeck (Germany) opened its doors. Despite reservations by the therapeutic community, we implemented a specialized treatment for female adolescents with symptoms of borderline personality disorder - the I;>ialectical Behavior Therapy for Adolescents (DBT-A). In this article we present the concept, our experiences, and data from the past 10 years of clinical work in this specialized unit.

  18. Diet and caries experience among preschool children in Ajman, United Arab Emirates.

    Science.gov (United States)

    Hashim, Raghad; Williams, Sheila M; Murray Thomson, Williams

    2009-12-01

    The study investigated the association between food and drink consumption and the caries experience among young children in Ajman, United Arab Emirates. A one-stage cluster sample was used to select children who were 5 or 6 yr of age. Clinical examinations for caries were conducted. Parents completed questionnaires seeking information on dietary habits. Principal components analysis was used to derive a summary score for the dietary variables (designated 'snack consumption level') and thus overcome the multicollinearity problems associated with using multiple dietary variables. Dental examination and questionnaire data were obtained for 1,036 children (79.9% participation rate). The overall mean number of decayed, missing or filled teeth (dmft) was 4.5. Snacking three or more times per day was associated with a dmft score that was almost one-third higher than the dmft score for children who snacked only once daily. One-third of children had a low overall snack consumption level (41% moderate and 25% high). There was a consistent dmft gradient across those categories. The severity of Early Childhood Caries (ECC) in young Ajman children is high, with dietary habits being important determinants. Cariogenic snack consumption can be represented using a summary exposure variable that appears to be valid. Young children in Ajman would benefit from health-promotion strategies directed towards appropriate dietary practices.

  19. Westinghouse experience in Kozloduy NPP units 5 and 6 I and C modernization

    International Nuclear Information System (INIS)

    Sechensky, B.

    2005-01-01

    The paper presents the background, current implementation approach and experience on the largest ever modernization program on operating units WWER 1000 (PWR) at Kozloduy Nuclear Power Plant in Bulgaria. The Modernization Program itself includes more than 212 measures. Westinghouse is modernizing the major I and C systems at WWER 1000. The major topics of the modernization program and specific approach described in this paper are as follows: 1) Design Approach and Feature; 2) Installation Approach; 3) Test Strategy; 4) Licensing Strategy, applicable codes and standards. At the end author summarized that: 1) Specific design solutions were required and developed in order to address the specific plant features. At each stage, representatives of the Client are being involved in the process of designing and testing of the equipment and systems; 2) Phase-by-phase installation efforts were developed and extensive installation design documentation was prepared to fit in the limited outage window and to successfully complete the installation activities; 3) Well-prepared, multi-phase testing strategy was developed and is being implemented to assure the proper and adequate operation of the equipment at the factory and at the real plant

  20. Immigration and psychotic experiences in the United States: Another example of the epidemiological paradox?

    Science.gov (United States)

    Oh, Hans; Abe, Jennifer; Negi, Nalini; DeVylder, Jordan

    2015-10-30

    In Europe, it is widely established that immigration increases risk for psychotic disorder. However, research has yet to confirm this association in the United States, where immigrants paradoxically report better health status than their native-born counterparts. Further, few studies have examined this topic with respect to sub-threshold psychotic experiences, which are more common than psychotic disorders in the general population. This study analyzes the (1) National Comorbidity Survey-Replication, (2) the National Latino and Asian American Survey, and (3) the National Survey of American Life, in order to determine whether generation status had any impact on risk for lifetime and 12-month PE, and whether these associations vary across racial/ethnic groups, adjusting for demographic variables and socioeconomic status. We found an absence of an immigration effect on PE across various ethnic groups and across various geographic areas, and found that immigration is actually protective among Latinos, supporting the idea that the epidemiological paradox extends to the psychosis phenotype. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. First Operational Experience with the LHC Beam Dump Trigger Synchronisation Unit

    CERN Document Server

    Antoine, A; Magnin, N; Juteau, P; Voumard, N

    2011-01-01

    Two LHC Beam Dumping Systems (LBDS) remove the counter-rotating beams safely from the collider during setting up of the accelerator, at the end of a physics run and in case of emergencies. Dump requests can come from 3 different sources: the machine protection system in emergency cases, the machine timing system for scheduled dumps or the LBDS itself in case of internal failures. These dump requests are synchronized with the 3 μs beam abort gap in a fail-safe redundant Trigger Synchronization Unit (TSU) based on a Digital Phase Locked Loop (DPLL), locked onto the LHC beam revolution frequency with a maximum phase error of 40 ns. The synchronized trigger pulses coming out of the TSU are then distributed to the high voltage generators of the beam dump kickers through a redundant fault-tolerant trigger distribution system. This paper describes the operational experience gained with the TSU since its commissioning with beam in 2009, and highlights the improvements, which have been implemented f...

  2. Acute extradural haematomas in children: A single neurosurgery unit's 12-year experience.

    Science.gov (United States)

    Enicker, B; Louw, H; Madiba, T

    2016-11-01

    Acute extradural haematomas (AEDHs) occur infrequently in children. This study was undertaken to review our experience with management and outcomes of this condition in children treated in the Neurosurgery Unit at Inkosi Albert Luthuli Central Hospital. A retrospective review of medical records of all children (age less than or equal to (≤) 12 years) with a diagnosis of AEDH admitted from January 2003 to December 2014 was performed. Records were analyzed for demographics, mechanisms of injury, clinical presentation, neuroradiology findings, management and outcomes at discharge. A total of 150 children with AEDHs were admitted during this period. The mean age was 6.6 ± 3.8 years with a peak incidence in the 7-9 year age group. There were 84 (56%) males, (M: F= 1.3:1). Sixty AEDHs resulted from road traffic crashes (40%). On admission 104 (69.3%) children were Glasgow coma scale (GCS) 13-15, 26 (17.3%) GCS 9-12 and 20 (13.4%) GCS 3-8. Haemoglobin was less than (children and the mean hospital stay was 6.9 ± 6.1 days. Four children (2.7%) died during in-hospital stay period. One hundred and forty one (94%) children had a favourable Glasgow outcome scale (GOS) at discharge. AEDHs in children carry a good prognosis, but can be potentially fatal. A vigilant approach is required when assessing these children, as early diagnosis and treatment yields gratifying results.

  3. A synthesis of the literature on Asian nurses' work experiences in the United States.

    Science.gov (United States)

    Lin, Li-Chen

    2009-01-01

    Nursing shortages in the United States have underscored the need for foreign nurse recruitment. The major population of foreign nurse recruits has long been Asian. When employing foreign nurses, fair employment practices and quality of care must be ensured; however, few empirical studies were found on this topic. Thus, the purpose of this article is to synthesize the extant literature about Asian nurses' work experiences in and adaptation to the U.S. health care system. The author searched four major bibliographic databases, as well as the ProQuest Dissertation and Thesis Database and analyzed eight empirical studies based on four predetermined inclusion criteria. The major themes identified in the selected scholarly works were: (a) overcoming language barriers, (b) dealing with discrimination, (c) adopting U.S. nursing practices, (d) adjusting to U.S. social customs, (e) becoming accustomed to U.S. culture, and (f) reconciling work ethics. Additional research studies, using both quantitative and qualitative approaches, are necessary to gain in-depth knowledge related to this phenomenon.

  4. Recommendations for Benchmarking Preclinical Studies of Nanomedicines.

    Science.gov (United States)

    Dawidczyk, Charlene M; Russell, Luisa M; Searson, Peter C

    2015-10-01

    Nanoparticle-based delivery systems provide new opportunities to overcome the limitations associated with traditional small-molecule drug therapy for cancer and to achieve both therapeutic and diagnostic functions in the same platform. Preclinical trials are generally designed to assess therapeutic potential and not to optimize the design of the delivery platform. Consequently, progress in developing design rules for cancer nanomedicines has been slow, hindering progress in the field. Despite the large number of preclinical trials, several factors restrict comparison and benchmarking of different platforms, including variability in experimental design, reporting of results, and the lack of quantitative data. To solve this problem, we review the variables involved in the design of preclinical trials and propose a protocol for benchmarking that we recommend be included in in vivo preclinical studies of drug-delivery platforms for cancer therapy. This strategy will contribute to building the scientific knowledge base that enables development of design rules and accelerates the translation of new technologies. ©2015 American Association for Cancer Research.

  5. 'Renewables-Friendly' Grid Development Strategies: Experience in the United States, Potential Lessons for China (Chinese Translation)

    Energy Technology Data Exchange (ETDEWEB)

    Hurlbut, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Zhou, Ella [National Renewable Energy Lab. (NREL), Golden, CO (United States); Porter, Kevin [Exeter Associates, Columbia, MD (United States); Arent, Douglas J. [Joint Institute for Strategic Energy Analysis, Golden, CO (United States)

    2015-10-03

    This is a Chinese translation of NREL/TP-6A20-64940. This report aims to help China's reform effort by providing a concise summary of experience in the United States with 'renewables-friendly' grid management, focusing on experiences that might be applicable to China. It focuses on utility-scale renewables and sets aside issues related to distributed generation.

  6. Children’s experiences of acute hospitalisation to a paediatric emergency and assessment unit – A qualitative study

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Jackson, Karen; Kolbæk, Raymond

    2012-01-01

    Short-stay treatment has become a popular form of care as a strategy to cope with increased demands on health care. There is little research that considers children’s experiences of acute hospitalisation to a short-stay care facility such as a Paediatric Emergency and Assessment Unit (PEAU...... provided some limited insight into the child’s experiences of acute hospitalisation, which should inform nursing care....

  7. Acute intensive care unit management of mustard gas victims: the Turkish experience.

    Science.gov (United States)

    Kilic, Ertugrul; Ortatatli, Mesut; Sezigen, Sermet; Eyison, Rusen Koray; Kenar, Levent

    2018-05-07

    Sulphur mustard (SM) is an highly toxic and vesicant chemical weapon that was used in various military conflicts several times in the history. The severity of ocular, dermal, and pulmonary symptoms that may appear following a characteristic asymptomatic period are depending on the SM concentration and exposure duration. The aim of this study is to present the clinical features and share the intensive care unit (ICU) experiences for the medical management of mustard gas victims. Thirteen Free Syrian Army soldiers near Al-Bab region of North Syria were reportedly exposed to oily blackish smoke with garlic smell due to the explosion of a trapped bomb without causing any blast or thermal effect on 26th November 2016. None of them wore any chemical protective suits or gas masks during explosion. Since they observed skin lesions including bullous formation next day, they were admitted to the Turkish Field Hospital at the Turkish - Syrian border and then evacuated to the State Hospital of Gaziantep Province, Turkey for further management. Eight victims who were very close to point of explosion suffered burning eyes, sore throat, dry cough and dyspnoea after the chemical attack. On admission to hospital, all cases had conjunctivitis, hoarseness and bullae on various body areas. Blepharospasm and opacity were found in 8 patients and 5 of them had corneal erosions and periorbital oedema. Temporary loss of vision in 4 cases lasted for 24 h. Multiple fluid-filled blisters were observed especially on the scalp, neck, arms and hands, where direct skin exposure to the agent occurred. A definitive clinical care and infection prophylaxis measures along with the burn treatment and bronchodilators for respiratory effects were applied in ICU. Two patients received granulocyte-colony-stimulating factor due to the SM-mediated bone marrow suppression on the 16th day of exposure and one of them died because of necrotic bronchial pseudomembrane obstruction resulting in cardiopulmonary

  8. Critical experiments on single-unit spherical plutonium geometries reflected and moderated by oil

    International Nuclear Information System (INIS)

    Rothe, R.E.

    1997-05-01

    Experimental critical configurations are reported for several dozen spherical and hemispherical single-unit assemblies of plutonium metal. Most were solid but many were hollow-centered, thick, shell-like geometries. All were constructed of nested plutonium (mostly 2139 Pu) metal hemispherical shells. Three kinds of critical configurations are reported. Two required interpolation and/or extrapolation of data to obtain the critical mass because reflector conditions were essentially infinite. The first finds the plutonium essentially fully reflected by a hydrogen-rich oil; the second is essentially unreflected. The third kind reports the critical oil reflector height above a large plutonium metal assembly of accurately known mass (no interpolation required) when that mass was too great to permit full oil reflection. Some configurations had thicknesses of mild steel just outside the plutonium metal, separating it from the oil. These experiments were performed at the Rocky Flats Critical Mass Laboratory in the late 1960s. They have not been published in a form suitable for benchmark-quality comparisons against state-of-the-art computational techniques until this paper. The age of the data and other factors lead to some difficulty in reconstructing aspects of the program and may, in turn, decrease confidence in certain details. Whenever this is true, the point is acknowledged. The plutonium metal was alpha-phase 239 Pu containing 5.9 wt-% 240 Pu. All assemblies were formed by nesting 1.667-mm-thick (nominal) bare plutonium metal hemispherical shells, also called hemishells, until the desired configuration was achieved. Very small tolerance gaps machined into radial dimensions reduced the effective density a small amount in all cases. Steel components were also nested hemispherical shells; but these were nominally 3.333-mm thick. Oil was used as the reflector because of its chemical compatibility with plutonium metal

  9. Parents' experience of a follow-up meeting after a child's death in the Paediatric Intensive Care Unit

    DEFF Research Database (Denmark)

    Brink, Helle L; Thomsen, Anja K; Laerkner, Eva

    2017-01-01

    OBJECTIVE: 'To identify parents' experience of a follow up meeting and to explore whether the conversation was adequate to meet the needs of parents for a follow-up after their child's death in the Paediatric Intensive Care Unit (PICU). DESIGN AND SETTING: Qualitative method utilising semi...

  10. Cardiotocography interpretation skills and the association with size of maternity unit, years of obstetric work experience and healthcare professional background

    DEFF Research Database (Denmark)

    Thellesen, Line; Sorensen, Jette Led; Hedegaard, Morten

    2017-01-01

    less than 15 years of obstetric work experience. This might indicate a challenge in maintaining CTG skills in small units and among experienced staff but could also reflect different levels of motivation, test familiarity and learning culture. Whether the findings are transferable to the clinical...... setting was not examined. This article is protected by copyright. All rights reserved....

  11. Latino Immigrant Students' School Experiences in the United States: The Importance of Family- School-Community Collaborations

    Science.gov (United States)

    Sibley, Erin; Brabeck, Kalina

    2017-01-01

    This paper reviews the literature on the educational experiences of Latino immigrant students in the United States, from early childhood through postsecondary educational attainment. Utilizing a developmental-contextual perspective, we explain the various environmental, political, structural, and psychological challenges these students face, while…

  12. Post-Secondary Educational Experiences in the Acculturation of Resettled Refugees in the United States

    Science.gov (United States)

    Ross, Tara W.

    2013-01-01

    A global refugee crisis necessitates an understanding of policymaking governing the resettlement of refugees in the United States. Resettling more refugees than all other countries combined, the United States emphasizes rapid employment over post-secondary education for adult resettled refugees in order to compel their self-sufficiency. However,…

  13. Middle Level Preservice Teachers Experience a Natural History Arts-Integrated Interdisciplinary Thematic Unit

    Science.gov (United States)

    Weber, Carolyn A.; Rule, Audrey C.

    2017-01-01

    Curricular demands and best practices for middle school require interdisciplinary units. Arts integration can provide motivation and a new pathway to learning. This unit focused on inquiry into the natural history of artifacts and rocks recovered from the exposed subsoil of an area near Cedar Falls, Iowa that had been bulldozed as part of…

  14. Marker for the pre-clinical development of bone substitute materials

    Directory of Open Access Journals (Sweden)

    de Wild Michael

    2017-09-01

    Full Text Available Thin mechanically stable Ti-cages have been developed for the in-vivo application as X-ray and histology markers for the optimized evaluation of pre-clinical performance of bone graft materials. A metallic frame defines the region of interest during histological investigations and supports the identification of the defect site. This standardization of the procedure enhances the quality of pre-clinical experiments. Different models of thin metallic frameworks were designed and produced out of titanium by additive manufacturing (Selective Laser Melting. The productibility, the mechanical stability, the handling and suitability of several frame geometries were tested during surgery in artificial and in ex-vivo bone before a series of cages was preclinically investigated in the female Göttingen minipigs model. With our novel approach, a flexible process was established that can be adapted to the requirements of any specific animal model and bone graft testing.

  15. Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

    Science.gov (United States)

    Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

    2016-09-01

    The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P noise in single-patient rooms (33%) than in multipatient rooms (79%; P pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

  16. Similar alteration of motor unit recruitment strategies during the anticipation and experience of pain.

    Science.gov (United States)

    Tucker, Kylie; Larsson, Anna-Karin; Oknelid, Stina; Hodges, Paul

    2012-03-01

    A motor unit consists of a motoneurone and the multiple muscle fibres that it innervates, and forms the final neural pathway that influences movement. Discharge of motor units is altered (decreased discharge rate and/or cessation of firing; and increased discharge rate and/or recruitment of new units) during matched-force contractions with pain. This is thought to be mediated by nociceptive (pain) input on motoneurones, as demonstrated in animal studies. It is also possible that motoneurone excitability is altered by pain related descending inputs, that these changes persist after noxious stimuli cease, and that direct nociceptive input is not necessary to induce pain related changes in movement. We aimed to determine whether anticipation of pain (descending pain related inputs without nociceptor discharge) alters motor unit discharge, and to observe motor unit discharge recovery after pain has ceased. Motor unit discharge was recorded with fine-wire electrodes in the quadriceps of 9 volunteers. Subjects matched isometric knee-extension force during anticipation of pain (anticipation: electrical shocks randomly applied over the infrapatellar fat-pad); pain (hypertonic saline injected into the fat-pad); and 3 intervening control conditions. Discharge rate of motor units decreased during pain (Precruitment of 1 population of units and new recruitment of another population were observed during both anticipation and pain; some changes in motor unit recruitment persisted after pain ceased. This challenges the fundamental theory that pain-related changes in muscle activity result from direct nociceptor discharge, and provides a mechanism that may underlie long-term changes in movement/chronicity in some musculoskeletal conditions. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  17. [Learning from the experiences of an arbitration unit for medical liability questions].

    Science.gov (United States)

    Scheppokat, K D

    2005-03-01

    While other countries', e.g. the United States', experience with alternative dispute resolution (ADR) in medical malpractice has been disappointing, German physicians have instituted extrajudicial claims resolution as an alternative to civil litigation: Established by the Arztekammern (corporate bodies of professional self-governance) in the mid-1970s, the Schlichtungsstellen (SchlSt--claims resolution panels) offer patients and doctors, on a voluntary basis, proceedings directed toward achieving a settlement. The number of cases submitted to these panels has been constantly growing since. In 90% of cases decided upon by the panel, civil litigation was avoided. Doctors can, as exemplified by the operation of the SchlSt, tackle difficult and complex problems and solve them--without being funded or directed by outside agencies. What can be learnt from being, as a physician member, associated with a SchlSt for several years? (1) Physicians--as Eddy has pointed out--must make decisions about complex problems under difficult conditions on the basis of inadequate information. Expert testimony suffers from similar uncertainties. Decisions on individual cases cannot be improved by external and necessarily generalized ruling (disease management programs, other directives). (2) Errors and adverse events in medical care have to be accepted as principally unavoidable. Most claims heard by the panel have to do with operations and--in the non-surgical specialties--with invasive procedures. Medical tasks of high complexity, as many operative and invasive procedures indeed are, seem to have an inherent accident-proneness. Therefore decisions as to operations and invasive procedures should be weighed with utmost care. More is not always better (3) 25% of the patients filing claims with the SchlSt complain of deficient doctor-patient-communication. Failure of doctors and staff to communicate adequately with the patients and with their professional contacts plays an important role as

  18. Heat Transfer Reactor Experiment (HTRE)-3 Container Storage Unit Resource Conservation Recovery Act closure plan

    International Nuclear Information System (INIS)

    Spry, M.J.

    1992-11-01

    This document describes the closure of the HTRE-3 Container Storage Unit under the requirements of the Resource Conservation and Recovery Act. The unit's location, size, history, and current status are described. The document also summarizes the decontamination and decommissioning efforts performed in 1983 and provides an estimate of,waste residues remaining in the HTRE-3 assembly. A risk evaluation was performed that demonstrates that the residue does not pose a hazard to public health or the environment. Based on the risk evaluation, it is proposed that the HTRE-3 Container Storage Unit be closed in its present condition, without further decontamination or removal activities

  19. Operating experience with unit for sulfuric acid alkylation of isobutane by butylenes

    Energy Technology Data Exchange (ETDEWEB)

    Tagavov, I.T.; Sumanov, V.T.; Khadzhiev, S.N.

    1988-09-01

    The operation of units for the sulfuric acid alkylation of isobutanes by butylenes have been performed. The reaction was carried out in a KSG-3 horizontal sulfuric acid contractor. A butane-butylene fraction from catalytic cracking and an isobutane fraction from the central gas fractionating unit were used as a feedstock. The studies have shown that the unit will give a high-quality product under various conditions of operation. The specific consumption of sulfuric acid in processing different types of feed remains within acceptable limits.

  20. Experience in lifetime extension of the first generation WWER-440 power units

    International Nuclear Information System (INIS)

    Medvedev, P.

    2002-01-01

    In connection with the expiration of the lifetime for the first generation WWER-440 reactors in Russian Federation (Novo Voronezh and Kola NPP), the legal procedures and Life Time Extension (LTE) Program are discussed. The LTE Program includes: development of regulation basis; economic efficiency studies; power unit modernization; power unit comprehensive examination and justification od equipment resource; in-dept safety assessment; operational license acquisition. As a result from the LTE Program the safety level of the unit 3 of the Novo Voronezh NPP is significantly increases, the operational period has been justified and a 5-year license has been issued

  1. Utilization of blended learning to teach preclinical endodontics.

    Science.gov (United States)

    Maresca, Cristina; Barrero, Carlos; Duggan, Dereck; Platin, Enrique; Rivera, Eric; Hannum, Wallace; Petrola, Frank

    2014-08-01

    Blended learning (BL) is the integration of classroom learning with an online environment. The purpose of this study was to determine whether dental students who experienced BL in a preclinical endodontic course demonstrated better manual skills, conceptual knowledge, and learning experience compared to those experiencing traditional learning. All eighty-one students (100 percent) in a preclinical endodontics course agreed to participate and were assigned to either the traditional or BL group. A root canal procedure was used to determine the level of manual skills gained by each group. Pre- and post-intervention quizzes were given to all students to evaluate conceptual knowledge gained, and the students' perspectives on the methods were evaluated with a survey. The BL group scored better than the traditional group on the manual skills exercise at a statistically significant level (p=0.0067). There were no differences in the post-intervention quiz scores between the two groups, and the students' opinions were positive regarding BL. With BL, the students were able to learn and demonstrate dental skills at a high level.

  2. Left ventricular remodeling in preclinical experimental mitral regurgitation of dogs.

    Science.gov (United States)

    Dillon, A Ray; Dell'Italia, Louis J; Tillson, Michael; Killingsworth, Cheryl; Denney, Thomas; Hathcock, John; Botzman, Logan

    2012-03-01

    Dogs with experimental mitral regurgitation (MR) provide insights into the left ventricular remodeling in preclinical MR. The early preclinical left ventricular (LV) changes after mitral regurgitation represent progressive dysfunctional remodeling, in that no compensatory response returns the functional stroke volume (SV) to normal even as total SV increases. The gradual disease progression leads to mitral annulus stretch and enlargement of the regurgitant orifice, further increasing the regurgitant volume. Remodeling with loss of collagen weave and extracellular matrix (ECM) is accompanied by stretching and hypertrophy of the cross-sectional area and length of the cardiomyocyte. Isolated ventricular cardiomyocytes demonstrate dysfunction based on decreased cell shortening and reduced intracellular calcium transients before chamber enlargement or decreases in contractility in the whole heart can be clinically appreciated. The genetic response to increased end-diastolic pressure is down-regulation of genes associated with support of the collagen and ECM and up-regulation of genes associated with matrix remodeling. Experiments have not demonstrated any beneficial effects on remodeling from treatments that decrease afterload via blocking the renin-angiotensin system (RAS). Beta-1 receptor blockade and chymase inhibition have altered the progression of the LV remodeling and have supported cardiomyocyte function. The geometry of the LV during the remodeling provides insight into the importance of regional differences in responses to wall stress. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Operation experience of the advanced fuel assemblies at Unit 1 of Volgodonsk NPP within four fuel cycles

    International Nuclear Information System (INIS)

    Vasilchenko, I.; Kobelev, S.; Kushmanov, S.

    2006-01-01

    The first commissioning of Volgodonsk NPP Unit 1 with standard reactor WWER-1000 (project V-320) was in 2001. The reactor core, starting from the first fuel charge, was arranged completely with Advanced Fuel Assemblies (AFAs). In this way, it is possible to obtain the experience in startup and operation of the core, completely arranged with AFAs, and also to get a possibility of performing the comprehensive check for justification of newly commissioned units and justification of design solutions accepted in the design of reactor core for Taiwan NPP, Bushehr NPP and Kudankulam NPP. The first fuel charge of the Volgodonsk NPP Unit 1 is a reference and unified for Tiawan NPP (V-428), Bushehr NPP (V-446), Kudankulam NPP(V-412) with small differences caused by design features of RP V-320. The first core charge of Unit 1 of Volgodonsk NPP was arranged of 163 AFAs, comprising 61 CPS ARs and 42 BAR bundles. The subsequent fuel charges were arranged of AFAs with gadolinium oxide integrated into fuel instead of BAR. By 2005 the results of operation of the core at Unit 1 of Volgodonsk NPP during four fuel cycles showed that AFA is sufficiently reliable and serviceable. The activity of the primary coolant of the Volgodonsk NPP is at stable low level. During the whole time of the core operation of the Volgodonsk NPP Unit 1 no leaky AFAs were revealed. The modifications of the internals, made during pre-operational work, are reasonable and effective to provide for fuel mechanical stability in the course of operation. The modifications, made in AFA structure during operation of the Volgodonsk NPP Unit 1, are aimed at improving the service and operational reliability of its components. Correctness of the solutions taken is confirmed by AFAs operation experience both at the Volgodonsk NPP, and at other operating Russian NPPs

  4. Contributions at the Tripoli Monte Carlo code qualifying on critical experiences and at neutronic interaction study of fissile units

    International Nuclear Information System (INIS)

    Nouri, A.

    1994-01-01

    Criticality studies in nuclear fuel cycle are based on Monte Carlo method. These codes use multigroup cross sections which can verify by experimental configurations or by use of reference codes such Tripoli 2. In this Tripoli 2 code nuclear data are errors attached and asked for experimental studies with critical experiences. This is one of the aim of this thesis. To calculate the keff of interacted fissile units we have used the multigroup Monte Carlo code Moret with convergence problems. A new estimator of reactions rates permit to better approximate the neutrons exchange between units and a new importance function has been tested. 2 annexes

  5. Modeling the Western Diet for Preclinical Investigations.

    Science.gov (United States)

    Hintze, Korry J; Benninghoff, Abby D; Cho, Clara E; Ward, Robert E

    2018-05-01

    Rodent models have been invaluable for biomedical research. Preclinical investigations with rodents allow researchers to investigate diseases by using study designs that are not suitable for human subjects. The primary criticism of preclinical animal models is that results are not always translatable to humans. Some of this lack of translation is due to inherent differences between species. However, rodent models have been refined over time, and translatability to humans has improved. Transgenic animals have greatly aided our understanding of interactions between genes and disease and have narrowed the translation gap between humans and model animals. Despite the technological innovations of animal models through advances in genetics, relatively little attention has been given to animal diets. Namely, developing diets that replicate what humans eat will help make animal models more relevant to human populations. This review focuses on commonly used rodent diets that are used to emulate the Western dietary pattern in preclinical studies of obesity and type 2 diabetes, nonalcoholic liver disease, maternal nutrition, and colorectal cancer.

  6. Budget Surpluses: Experiences of Other Nations and Implications for the United States

    National Research Council Canada - National Science Library

    1999-01-01

    ... should be used. While balancing the budget has been the clear and generally accepted fiscal goal for many years in the United States, there is not yet agreement on the appropriate fiscal policy during a period of budget surpluses...

  7. PyMUS: Python-Based Simulation Software for Virtual Experiments on Motor Unit System

    Directory of Open Access Journals (Sweden)

    Hojeong Kim

    2018-04-01

    Full Text Available We constructed a physiologically plausible computationally efficient model of a motor unit and developed simulation software that allows for integrative investigations of the input–output processing in the motor unit system. The model motor unit was first built by coupling the motoneuron model and muscle unit model to a simplified axon model. To build the motoneuron model, we used a recently reported two-compartment modeling approach that accurately captures the key cell-type-related electrical properties under both passive conditions (somatic input resistance, membrane time constant, and signal attenuation properties between the soma and the dendrites and active conditions (rheobase current and afterhyperpolarization duration at the soma and plateau behavior at the dendrites. To construct the muscle unit, we used a recently developed muscle modeling approach that reflects the experimentally identified dependencies of muscle activation dynamics on isometric, isokinetic and dynamic variation in muscle length over a full range of stimulation frequencies. Then, we designed the simulation software based on the object-oriented programing paradigm and developed the software using open-source Python language to be fully operational using graphical user interfaces. Using the developed software, separate simulations could be performed for a single motoneuron, muscle unit and motor unit under a wide range of experimental input protocols, and a hierarchical analysis could be performed from a single channel to the entire system behavior. Our model motor unit and simulation software may represent efficient tools not only for researchers studying the neural control of force production from a cellular perspective but also for instructors and students in motor physiology classroom settings.

  8. PyMUS: Python-Based Simulation Software for Virtual Experiments on Motor Unit System.

    Science.gov (United States)

    Kim, Hojeong; Kim, Minjung

    2018-01-01

    We constructed a physiologically plausible computationally efficient model of a motor unit and developed simulation software that allows for integrative investigations of the input-output processing in the motor unit system. The model motor unit was first built by coupling the motoneuron model and muscle unit model to a simplified axon model. To build the motoneuron model, we used a recently reported two-compartment modeling approach that accurately captures the key cell-type-related electrical properties under both passive conditions (somatic input resistance, membrane time constant, and signal attenuation properties between the soma and the dendrites) and active conditions (rheobase current and afterhyperpolarization duration at the soma and plateau behavior at the dendrites). To construct the muscle unit, we used a recently developed muscle modeling approach that reflects the experimentally identified dependencies of muscle activation dynamics on isometric, isokinetic and dynamic variation in muscle length over a full range of stimulation frequencies. Then, we designed the simulation software based on the object-oriented programing paradigm and developed the software using open-source Python language to be fully operational using graphical user interfaces. Using the developed software, separate simulations could be performed for a single motoneuron, muscle unit and motor unit under a wide range of experimental input protocols, and a hierarchical analysis could be performed from a single channel to the entire system behavior. Our model motor unit and simulation software may represent efficient tools not only for researchers studying the neural control of force production from a cellular perspective but also for instructors and students in motor physiology classroom settings.

  9. Cold War Agency: The United States and the Failure of the DIEM Experiment

    Science.gov (United States)

    2017-03-01

    the United States by complying with Western norms of democratic leadership , only later developing into an autocratic tyrant; or was Diem’s...2000s to establish democratic regimes in Afghanistan and Iraq reflect an American foreign policy tradition that began at the end of World War II. The...would eventually serve in Vietnam in a failed effort to prevent the Democratic Republic of Vietnam from uniting the country under a communist regime

  10. Late Intensive Care Unit Admission in Liver Transplant Recipients: 10-Year Experience.

    Science.gov (United States)

    Atar, Funda; Gedik, Ender; Kaplan, Şerife; Zeyneloğlu, Pınar; Pirat, Arash; Haberal, Mehmet

    2015-11-01

    We evaluated late intensive care unit admission in liver transplant recipients to identify incidences and causes of acute respiratory failure in the postoperative period and to compare these results with results in patients who did not have acute respiratory failure. We retrospectively screened the data of 173 consecutive adult liver transplant recipients from January 2005 through March 2015 to identify patients with late admission (> 30 d posttransplant) to an intensive care unit. Patients were divided into 2 groups: patients with and without acute respiratory failure. Acute respiratory failure was defined as severe dyspnea, respiratory distress, decreased oxygen saturation, hypoxemia or hypercapnia on room air, or need for noninvasive or invasive mechanical ventilation. Demographic, laboratory, clinical, and respiratory data were collected. Model for End-Stage Liver Disease, Acute Physiology and Chronic Health Evaluation II, and Sequential Organ Failure Assessment scores; lengths of intensive care unit and hospital stays; and hospital mortality were assessed. Among 173 patients, 37 (21.4%) were admitted to an intensive care unit, including 22 (59.5%) with acute respiratory failure. The leading cause of acute respiratory failure was pneumonia (n = 19, 86.4%). Patients with acute respiratory failure had significantly lower levels of albumin before intensive care unit admission (P = .003). In patients with acute respiratory failure, severe sepsis and septic shock were more frequently observed and tracheotomy was more frequently performed (P = .041). Acute respiratory failure developed in 59.5% of liver transplant recipients with late intensive care unit admission. The leading cause was pneumonia, with this group of patients having higher requirements for invasive mechanical ventilation and tracheotomy, longer stays in an intensive care unit, and higher mortality.

  11. Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers.

    Science.gov (United States)

    Mmamma, Mogale L; Mothiba, Tebogo M; Nancy, Malema R

    2015-12-17

    Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9) and those working night duty (n = 3) who were at work on the anticipated days for data collection. The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

  12. Free Trade Agreements With The United States: 8 Lessons For Prospective Parties From Australia’s Experience

    OpenAIRE

    Tully Stephen R.

    2016-01-01

    This article identifies 8 key lessons for those States contemplating a free trade agreement with the United States (U.S.) arising from Australia’s experience. The standards of intellectual property protection under the Australia-U.S. Free Trade Agreement and their impact on pharmaceutical prices in Australia are a particular focus. Prospective parties must first conduct a national interest self-assessment which reviews the desired strength of intellectual property protection under national la...

  13. The supply and demand of wine-on-tap in the United States: An examination of perceptions and experiences

    OpenAIRE

    Nuebling, Michaela Andrea

    2015-01-01

    The purpose of the present study was to investigate the perceptions and early experiences associated with a recent trend in the United States' foodservice and wine industry: wine-on-tap. Three study populations were investigated: wine consumers, restaurant and winery professionals. Contrary to expectations driven by literature and the diffusion of other wine product innovations, American wine consumers showed interest in trying wine-on-tap, stating that the main reason for non-adoption was li...

  14. Elective courses for medical students during the preclinical curriculum: a systematic review and evaluation

    Directory of Open Access Journals (Sweden)

    Ankit Agarwal

    2015-05-01

    Full Text Available Objective: Preclinical medical student electives are prevalent at medical schools across the United States, but the range of electives available and their impact on medical student education are not well described in the literature. The objective of this article is to review the literature relating to preclinical medical student electives and their impact on medical student educational outcomes. Methods: We reviewed studies that met the following criteria: English-language articles describing preclinical US-based medical electives. We used PubMed journal databases and limited our search for the time period 1999–2014. We excluded electives based in other countries or electives designed for third or fourth year students. Data abstracted included the topic of the elective, qualitative descriptions of the electives, and any associated surveys or exam data associated with the electives. Data were synthesized using descriptive tables sorting electives by broad topic. Reported outcomes and statistical methods were analyzed to assess study quality. Results: We found a wide range of subjects taught in the form of preclinical medical school electives. We identified electives in clinical skills, the humanities, student lifestyle, specialty-specific electives, and an assortment of other miscellaneous electives. Surveys and exams administered to students showed that the electives were universally well received by students. Of the 37 electives identified, 15 electives used quantitative objective assessments, such as knowledge exams, while the remaining tended to use student self-reported results. Conclusions: Preclinical medical student electives are prevalent at medical schools across the United States and have a significant impact on medical student education.

  15. Experiences of Diagnosing Autism Spectrum Disorder: A Survey of Professionals in the United Kingdom

    Science.gov (United States)

    Rogers, Claire L.; Goddard, Lorna; Hill, Elisabeth L.; Henry, Lucy A.; Crane, Laura

    2016-01-01

    To date, research exploring experiences of diagnosing autism spectrum disorder has largely focused on parental perspectives. In order to obtain a more complete account of the autism spectrum disorder diagnostic process, it is essential that the views and experiences of professionals are heard. In this study, 116 multidisciplinary professionals…

  16. United State Collaboration working in the ATLAS hall experiment (B180).

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    It's a small world; at least you might think so after a visit to Building 180. Inside, about 30 engineers and physicists weld, measure and hammer away. They hail from Pakistan, Israel, Japan, China, Russia and the United States and they work toward one common goal: the completion of the ATLAS muon chamber endcaps.

  17. United State Collaboration working in the Atlas hall experiment (B180).

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    It's a small world; at least you might think so after a visit to Building 180. Inside, about 30 engineers and physicists weld, measure and hammer away. They hail from Pakistan, Israel, Japan, China, Russia and the United States and they work toward one common goal: the completion of the ATLAS muon chamber endcaps

  18. The Evolution of Computer Based Learning Software Design: Computer Assisted Teaching Unit Experience.

    Science.gov (United States)

    Blandford, A. E.; Smith, P. R.

    1986-01-01

    Describes the style of design of computer simulations developed by Computer Assisted Teaching Unit at Queen Mary College with reference to user interface, input and initialization, input data vetting, effective display screen use, graphical results presentation, and need for hard copy. Procedures and problems relating to academic involvement are…

  19. Nett Warrior C3Conflict Experiment: Measuring the Effect of Battlefield Awareness in Small Units

    Science.gov (United States)

    2011-01-01

    C3Conflict is a distributed, computer-based, multiplayer , small unit war game designed to elicit measures of leader performance focusing on command...has raised the specter of even more violence . While the level of violence has plunged from the carnage of 2006 and 2007, suicide bombers continue

  20. Introducing Blended Learning: An Experience of Uncertainty for Students in the United Arab Emirates

    Science.gov (United States)

    Kemp, Linzi J.

    2013-01-01

    The cultural dimension of Uncertainty Avoidance is analysed in this study of an introduction to blended learning for international students. Content analysis was conducted on the survey narratives collected from three cohorts of management undergraduates in the United Arab Emirates. Interpretation of certainty with blended learning was found in:…

  1. Safe intravenous administration in pediatrics: A 5-year Pediatric Intensive Care Unit experience with smart pumps.

    Science.gov (United States)

    Manrique-Rodríguez, S; Sánchez-Galindo, A C; Fernández-Llamazares, C M; Calvo-Calvo, M M; Carrillo-Álvarez, Á; Sanjurjo-Sáez, M

    2016-10-01

    To estimate the impact of smart pump implementation in a pediatric intensive care unit in terms of number and type of administration errors intercepted. Observational, prospective study carried out from January 2010 to March 2015 with syringe and great volumen infusion pumps available in the hospital. A tertiary level hospital pediatric intensive care unit. Infusions delivered with infusion pumps in all pediatric intensive care unit patients. Design of a drug library with safety limits for all intravenous drugs prescribed. Users' compliance with drug library as well as number and type of errors prevented were analyzed. Two hundred and eighty-three errors were intercepted during 62 months of study. A high risk drug was involved in 58% of prevented errors, such as adrenergic agonists and antagonists, sedatives, analgesics, neuromuscular blockers, opioids, potassium and insulin. Users' average compliance with the safety software was 84%. Smart pumps implementation has proven effective in intercepting high risk drugs programming errors. These results might be exportable to other critical care units, involving pediatric or adult patients. Interdisciplinary colaboration is key to succeed in this process. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  2. Sulphurfree diesel - modifications and experiences on a HDS-unit; Modifikationen und Betriebserfahrungen an einer Mitteldestillatentschwefelung

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, J. [Veba Oel-Verarbeitungs-GmbH, Gelsenkirchen (Germany); Balfanz, U. [Aral Forschung FDT, Gelsenkirchen (Germany); Dimmig, T. [TU Bergakademie Freiberg (Germany)

    2002-10-01

    Ruhr Oel GmbH, a joint venture between BP and PDVSA, is operating a HDS-unit at their facilities at Gelsenkirchen-Scholven. The product of this unit is a major blend component for Diesel fuel. Driven by ambitious German environmental policy and by an agreement between the German car and oil industry on the one side and the government on the other side, more stringent low sulphur fuels will be introduced in Germany much earlier than in the rest of the European Union. In view of this background a project was developed to realise the new product specifications with minimum investment. In cooperation between the refinery, company research facilities and the catalyst supplier (AKZO NOBEL), pilot plant test were performed to find out the best catalyst system and the new process conditions. Based on this, an existing HDS-unit was revamped. After the revamp, the unit produce Diesel fuel with 50 ppm sulphur content, test runs for 10 ppm were carried out successfully. These results were demonstrated in this article. (orig.)

  3. Lived Experiences of Diversity Visa Lottery Immigrants in the United States

    Science.gov (United States)

    Hailu, Tekleab Elos; Mendoza, Bernadette M.; Lahman, Maria K. E.; Richard, Veronica M.

    2012-01-01

    Every year approximately 50,000 people immigrate to the United States through the avenue referred to as the Diversity Visa (DV) Lottery. In this article, the authors present a literature review of immigration to the U.S. through the DV Lottery, reflect on their own immigration histories, and utilize phenomenology to investigate and describe…

  4. Experience and Satisfaction With a Multidisciplinary Care Unit for Patients With Psoriasis and Psoriatic Arthritis.

    Science.gov (United States)

    Urruticoechea-Arana, Ana; Serra Torres, Marta; Hergueta Diaz, Mercedes; González Guerrero, María Eugenia; Fariñas Padron, Leslie; Navarro Martín, Sara; Vargas Osorio, Kelly; Palacios Abufón, Andrés; García de Yébenes, María Jesús; Loza, Estíbaliz

    2017-08-24

    To describe patient's characteristics, the activity and patient's satisfaction with a multidisciplinary care unit in patients with psoriasis and psoriatic arthritis (PsA). A retrospective medical records review of patients with psoriasis or PsA attended in a multidisciplinary care unit was performed. Included patients were contacted to fulfill a satisfaction questionnaire. A specific electronic database was set up. Data regarding to patients and their baseline characteristics and the activity of the unit were collected. Descriptive analysis were performed. A total of 112 patients with 154 visits were included in almost 3 years, 54% women, with a mean age of 51 years, 43.7% presented hyperlipidemia and 30.4% arterial hypertension. Half of patients were referred due to diagnostic doubts and the other half for therapeutic problems. After the evaluation of the patients, 66 patients (58.9%) met diagnostic criteria for PsA, and 13 (11.6%) of an inflammatory disease other than PsA, and 95% came back to their usual physician. The most ordered test were laboratory tests (75.6% of patients), followed by X-rays in 57 patients (51.3%). In general the number of patients with different treatments increased, and 55.4% and 42% of patients changed their topic and systemic treatments respectively. The level of satisfaction was very high and all of patients considered that their disease was better controlled in this multidisciplinary care unit. This multidisciplinary care unit has improved the care and satisfaction of patients with psoriasis or PsA, and increased collaboration between rheumatology and dermatology departments. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  5. A comparative study of Japan and United States nuclear enterprise: Industry structure and construction experience

    International Nuclear Information System (INIS)

    Hinman, G.W.; Lowinger, T.C.

    1987-01-01

    Both Japan and the United States have undertaken major programs to utilize nuclear power for central station electricity generation. Over the past 20 years, the Japanese have developed their own construction and government regulatory institutions and now have an essentially independent domestic nuclear power program. Nuclear construction and government oversight of nuclear power have developed somewhat differently in Japan and the United States, reflecting to some extent the two countries' different business and social cultures. In the United States the vendor and utility industries are much more fragmented than those in Japan, and construction projects are carried out on a more competitive basis. The Japanese industry operates through a few well-established consortia while the U.S. industry does not. Relations among the national government, the vendors, and the electric utilities tend to be cooperative in Japan while they are more adversarial in the Untied States. This paper discusses these topics in a framework of a comparative study of the countries' nuclear industries. Whether because of the factors mentioned above or for other reasons the success of nuclear power in Japan and the United States has differed dramatically in recent years. This paper compares the performance of the nuclear enterprise in these two countries in terms of the physical attributes of the plants themselves, the labor required to build them, and the construction times required. It also discusses the relationship between initial estimates of costs and schedules and actual results achieved. On all counts, recent Japanese performance has been better than in the United States

  6. Experience of the United States in Hosting and Supporting IAEA Peer Review Missions

    International Nuclear Information System (INIS)

    Mamish, N.

    2016-01-01

    The International Atomic Energy Agency (IAEA) provides a number of peer review services to its Member States. The United States has strongly supported these peer reviews since their inception. In 2010, the United States hosted an Integrated Regulatory Review Service (IRRS) mission, with a follow-up mission completed in 2014. The missions provided valuable recommendations and suggestions, identified a number of best practices, and acknowledged the prompt and effective actions taken by the NRC following the Fukushima Daiichi accident. Through hosting an International Physical Protection Advisory Service (IPPAS) mission in 2013, the United States benefited both from the insights provided by the team, as well as the U.S. Government’s gap analyses and preparatory efforts in advance of the mission. The United States strongly supports the IAEA’s Operational Safety Review Team (OSART) program, inviting a peer review mission to a U.S. nuclear power plant every 3 years. Although OSART is an operational, not regulatory, peer review, the NRC provides funding for the mission and gives inspection credit to operators that host them. The United States also contributes significant technical expertise to IAEA peer review missions hosted by other Member States. With the IRRS and IPPAS reaching their 10th and 20th anniversaries respectively, these programs have improved as they have matured. However, it remains critical for Member States to continue to support these programs, and provide feedback to the IAEA Secretariat on their effectiveness and areas where IAEA might enhance them. Doing so will ensure peer reviews remain an effective tool for strengthening nuclear safety and security worldwide. (author)

  7. Three-dimensional ultrasound. Early personal experience with a dedicated unit and literature review

    International Nuclear Information System (INIS)

    Cesarani, F.; Isolato, G.; Capello, S.; Bianchi, S.D.

    1999-01-01

    The authors report our preliminary clinical experience with three-dimensional ultrasound (3D US) in abdominal and small parts imaging, comparing the yield of 3D versus 2D US and the through a literature review [it

  8. The effects of unit pricing system upon household solid waste management: The Korean experience

    Energy Technology Data Exchange (ETDEWEB)

    Hong, S.

    1999-09-01

    Initial effects of adoption of a unit pricing system paired with aggressive recycling programs appear to be substantial. This paper explores the impact of price incentives under the unit pricing system on household solid waste generation and recycling in Korea. The author employs a simultaneous equation model considering the feedback effects between total waste generation and recycling. Estimation results using 3017 Korean household survey data indicate that a rise in waste collection fee induces households to recycle more wastes. However, this effect is partially offset by decreases in source-reduction efforts due to the feedback effects, resulting in relatively lower price elasticity of demand for solid waste collection services. This implies that household demand for solid waste collection services will not decrease much with additional increases in the collection fee, unless further recycling incentives such as more frequent recyclable pickup services are accompanied.

  9. The United States Experience with the Exotic Cerambycid Anoplophora glabripennis: Detection, Quarantine, and Control

    Science.gov (United States)

    Robert A. Haack; Therese M. Poland; Rui-Tong Gao

    2000-01-01

    It is estimated that there are at least 4500 exotic (non-indigenous) organisms currently established in the United States(US) (US Congress 1993) and possibly as many as 50,000 (Pimentel et al. 2000). Of the many exotic organisms now in the US, more than 400 are insects that feed on trees and shrubs.(Haack and Byler 1993, Mattson et al. 1994, Niemela and Mattson 1996)....

  10. Monitoring the World Health Organization Global Target 2025 for Exclusive Breastfeeding: Experience From the United States.

    Science.gov (United States)

    Gupta, Priya M; Perrine, Cria G; Chen, Jian; Elam-Evans, Laurie D; Flores-Ayala, Rafael

    2017-08-01

    Exclusive breastfeeding under 6 months, calculated from a single 24-hour recall among mothers of children 0 to 5 months of age, is a World Health Organization (WHO) indicator used to monitor progress on the 2025 global breastfeeding target. Many upper-middle-income and high-income countries, including the United States, do not have estimates for this indicator. Research aim: To describe the prevalence of exclusive breastfeeding under 6 months in the United States. We used a single 24-hour dietary recall from the National Health and Nutrition Examination Survey 2009-2012 to calculate the prevalence of exclusive breastfeeding under 6 months. We discuss our results in the context of routine breastfeeding surveillance, which is reported from a national survey with different methodology. Among children younger than 6 months, 24.4%, 95% confidence interval [17.6, 31.1], were exclusively breastfed the previous day. To our knowledge, this is the first estimate of the WHO indicator of exclusive breastfeeding under 6 months for the United States. This study supports the global surveillance and data strategy for reporting to the WHO on the 2025 target for exclusive breastfeeding.

  11. Depleted ion exchange resins encapsulation with mobile unit: equipment and experience

    International Nuclear Information System (INIS)

    Cohen, S.; Faisantieu, D.

    1986-01-01

    Since 1981, STMI has been operating mobile units in EDF's PWR nuclear power plants, for spent resins encapsulation with polymer thermosetting matrices. Three mobile units are now in operation: COMET 1 and COMET 2, supplied by STMI, using polymerized styrene with proper additives as encapsulating material, and PRECED 1, on PEC-Engineering design, based on a DOW Chemical solidification process. On march 1986, more than 30 operations have been performed on EDF's PWR plants. More than 5000 liners containing encapsulated depleted ion exchange resins have been produced, while processing about 500 m 3 (i.e. 17.000 ft 3 ) of resins. During this period, those mobile units have shown their reliability and their efficiency. The produced processed waste, which have been accepted by ANDRA at the La Manche Storage Site (SSM) must meet the Fundamental Safety Rules (RFS) edicted by the Central Bureau for Nuclear Facilities Safety (SCSIN) of the French Department of Industry. The operations are carried out with excellent safety and radioprotection safety conditions, and following a very detailed Q.A. program [fr

  12. Integrating E-Learning and Classroom Learning for Engineering Quality Control unit - Curtin University Experience

    Directory of Open Access Journals (Sweden)

    Ali M. Darabi Golshani

    2011-08-01

    Full Text Available Engineering employers expect engineering graduates to possess a wide range of skills that goes beyond their technical knowledge. It is vital that graduates have skills which demonstrate that they are responsible for their own development and careers. Some of these skills include; communication abilities, organizational skills, self-promotion, the ability to work as part of a team, be an effective problem solver, be a critical thinker, have good negotiation skills, have the ability to be a leader and being able to network effectively. Department of Civil Engineering at Curtin University of Technology in Perth, Australia offers a Master of Engineering Management degree for Engineers from various disciplines. One of the units taught in this Master degree program is Engineering Quality Control. It was decided to incorporate these non-technical skills in this unit by using an e-learning platform (Blackboard together with an adaptation of the Seven Principles of Good Practice and Dr Meredith Belbin’s team role theory to divide participants into groups. At the end of the unit, most of the participants were showing improvements in their non-technical skills.

  13. Cultural affordances and emotional experience: socially engaging and disengaging emotions in Japan and the United States.

    Science.gov (United States)

    Kitayama, Shinobu; Mesquita, Batja; Karasawa, Mayumi

    2006-11-01

    The authors hypothesized that whereas Japanese culture encourages socially engaging emotions (e.g., friendly feelings and guilt), North American culture fosters socially disengaging emotions (e.g., pride and anger). In two cross-cultural studies, the authors measured engaging and disengaging emotions repeatedly over different social situations and found support for this hypothesis. As predicted, Japanese showed a pervasive tendency to reportedly experience engaging emotions more strongly than they experienced disengaging emotions, but Americans showed a reversed tendency. Moreover, as also predicted, Japanese subjective well-being (i.e., the experience of general positive feelings) was more closely associated with the experience of engaging positive emotions than with that of disengaging emotions. Americans tended to show the reversed pattern. The established cultural differences in the patterns of emotion suggest the consistent and systematic cultural shaping of emotion over time.

  14. Stroke care: Experiences and clinical research in stroke units in Chennai

    Directory of Open Access Journals (Sweden)

    Gobindram Arjundas

    2006-01-01

    Full Text Available Background: S troke is the second commonest cause of death in India with crude overall prevalence rate of 220 per 100,000. With an increasing aging population at risk, the stroke burden in India can be expected to reach epidemic proportions. Materials and Methods: The first protocol-based prospective studies, funded by private agencies was conducted in Madras Institute of Neurology in 1984-86. The results led to establishment of the first stroke unit in Tamil Nadu state, in the institute. The first all-India hospital-based studies in acute stroke was completed as INDIAN COOPERATIVE ACUTE STROKE STUDIES (ICASS I and ICASS II with WHO STEP ONE by members of the Indian Stroke Association between 2000-2005. This has generated very useful data for our country. Results: Mortality in 1984-86 was 40%. Stroke unit in the institute dropped it to 12%. About 10 years later, ICASS studies showed a further fall of mortality to 8%, which is the current international figure in the west. Morbidity pattern showed about half return to their original activities. But about one third are left totally disabled needing prolonged care, for which fiscal, social and rehab provisions have to be done on a national basis. Conclusions: The progress and success of care of Stroke in the last three decades, from treatment in medical and neurology wards to specialized stroke units is presented. The main risk factors are hypertension, diabetes and ischemic heart disease across the country. Hypertension alone or with the other two diseases was present in 72% of cases. Prevention and treatment of these factors will reduce the stroke burden, mortality and morbidity of strokes. The Stroke-team concept can be extended to the smallest hospitals in our country.

  15. Unheard Voices: Korean Immigrant Mothers' Experiences with the United States Special Education System

    Science.gov (United States)

    Kim, Jeanie

    2013-01-01

    The purpose of this study was to examine the experiences of Korean immigrant mothers of children with special needs in the New York metropolitan area in the special education process (e.g., referral, evaluation, meetings, services), and to better understand how these mothers perceive special education, disability, and their relationships with…

  16. Learning to Become Graduate Students: Japanese Women's Experience in the Research Unit in Engineering

    Science.gov (United States)

    Hosaka, Masako

    2010-01-01

    Based on the analysis of 16 interviews with women first-year master's students at two national engineering schools in Japan, this article examines the socialisation role of compulsory undergraduate research experience in Japanese women's decisions to pursue graduate education and choices of the programme. The findings suggest that research…

  17. Exploring the experiences of EU qualified doctors working in the United Kingdom: a qualitative study.

    Science.gov (United States)

    Legido-Quigley, Helena; Saliba, Vanessa; McKee, Martin

    2015-04-01

    This qualitative study of 23 doctors from other EU member states working in the UK highlights that, contrary to media reports, doctors from other member states working in the UK were well prepared and their main motivation to migrate was to learn new skills and experience a new health care system. Interviewees highlighted some aspects of their employment that work well and others that need improving. Some interviewees reported initially having language problems, but most noted that this was resolved after a few months. These doctors overwhelmingly reported having very positive experiences with patients, enjoying a NHS structure that was less hierarchical structure than in their home systems, and appreciating the emphasis on evidence-based medicine. Interviewees mostly complained about the lack of cleanliness of hospitals and gave some examples of risk to patient safety. Interviewees did not experience discrimination other than some instances of patronising and snobbish behaviour. However, a few believed that their nationality was a block to achieving senior positions. Overall, interviewees reported having enjoyable experiences with patients and appreciating what the NHS had to offer. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Nursing students’ experiences of professional patient care encounters in a hospital unit

    DEFF Research Database (Denmark)

    Kaldal, Maiken Holm; Kristiansen, Jette; Uhrenfeldt, Lisbeth

    2015-01-01

    experiences of professional patient care encounters where students engage with patients and provide nursing care within the basic principles of nursing care relating to the patients’ physiological and psychological needs. Studies that reflect nursing students’ comprehension of or attitudes towards nursing...

  19. Patients' experience of thirst while being conscious and mechanically ventilated in the intensive care unit

    DEFF Research Database (Denmark)

    Kjeldsen, Caroline L; Hansen, Mette S; Jensen, Kamilla

    2017-01-01

    associate feelings of desperation, anxiety and powerlessness with the experience of thirst. These feelings have a negative impact on their psychological well-being. A strategy in the ICU that includes no sedation for critically ill patients in need of MV introduces new demands on the nurses who must care...

  20. Experiences of Autism Diagnosis: A Survey of over 1000 Parents in the United Kingdom

    Science.gov (United States)

    Crane, Laura; Chester, James W; Goddard, Lorna; Henry, Lucy A; Hill, Elisabeth

    2016-01-01

    A sample of 1047 parents completed an online survey about their experiences and opinions regarding the process of attaining a diagnosis of autism spectrum disorder for their children. The results revealed that parents usually waited a year from when they first had concerns about their child's development before they sought professional help. On…

  1. Parents' experiences with neonatal home care following initial care in the neonatal intensive care unit: a phenomenological hermeneutical interview study.

    Science.gov (United States)

    Dellenmark-Blom, Michaela; Wigert, Helena

    2014-03-01

    A descriptive study of parents' experiences with neonatal home care following initial care in the neonatal intensive care unit. As survival rates improve among premature and critically ill infants with an increased risk of morbidity, parents' responsibilities for neonatal care grow in scope and degree under the banner of family-centred care. Concurrent with medical advances, new questions arise about the role of parents and the experience of being provided neonatal care at home. An interview study with a phenomenological hermeneutic approach. Parents from a Swedish neonatal (n = 22) home care setting were extensively interviewed within one year of discharge. Data were collected during 2011-2012. The main theme of the findings is that parents experience neonatal home care as an inner emotional journey, from having a child to being a parent. This finding derives from three themes: the parents' experience of leaving the hospital milieu in favour of establishing independent parenthood, maturing as a parent and processing experiences during the period of neonatal intensive care. This study suggests that neonatal home care is experienced as a care structure adjusted to incorporate parents' needs following discharge from a neonatal intensive care unit. Neonatal home care appears to bridge the gap between hospital and home, supporting the family's adaptation to life in the home setting. Parents become empowered to be primary caregivers, having nurse consultants serving the needs of the whole family. Neonatal home care may therefore be understood as the implementation of family-centred care during the transition from NICU to home. © 2013 John Wiley & Sons Ltd.

  2. Cernavoda NPP Unit 1: Operating experience program and plant specific performance indicators (level 2)

    International Nuclear Information System (INIS)

    Teodor, Vasile; Popa, Viorel

    1998-01-01

    The basis for the Operating Experience Program was set in place since early stages of the commissioning phase (1993), when a system based on the Canadian approach was implemented for reporting, reviewing, assessing and establishing of the necessary corrective action for unplanned events. This system provided excellent opportunity to train staff in unplanned event assessment methodology, and prepare the station for the formal reporting process following criticality in accordance with the licensing requirements. The formal process, set in place after criticality is described in Station Instruction Procedure SI-01365-P13 'Unplanned Event Report' and was developed under the supervision of Safety and Compliance Department. In parallel, a program for information exchange and trending of performance indicators was developed by Technical Services Department. The WANO recommendations following August 1997 Peer Review provided the opportunity for a better understanding and reconsideration of the Operating Experience Program. As a result, all the activities related to this topic were assigned to a new structure, within Safety and Compliance Department. As such an Operating Experience Group was created and a new program is now being developed in an integrated and centralized manner. The content of the paper is the following: - Overview; - Operating Experience Program; - Event Analysis (Unplanned Events Assessment System - UEIR Process- and Systematic Analysis of Operational Events - ACR Process); - Information Exchange Program; - Monitoring of Operating Experience - Plant Specific Performance Indicators; - Purpose; - Level 2 Performance Indicators. Four appendices are added containing: - A. Station performance indicators/targets (Level 2); - B. SPI (Station Performance Indicators - Level 2) - Graphics; - C. UEIR, LRS (Safety and Licensing Review Sheet), UEFR (Unplanned Event Follow-up Report), ACR and OPEX forms. (authors)

  3. Learning from 25 years of experience with the United States clean air act

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, R.H. [Trinity Consultants Incorporated, Dallas, TX (United States)

    1995-12-31

    Twenty-five years ago, the United States embarked on a quest to attain clean air. President Nixon, in signing the Clean Air Act of 1970, defined clean air as the objective for the `70s. Although enormous progress has been made, much remains to be done. Newly constructed industry is quite clean, but many older facilities continue to operate with antiquated controls. Significant advances have been made in cleaning up the emissions from new automobiles, but two factors have impaired progress. First, cars last longer than they did in 1970, so the average age of the fleet has increased. Second, travel has increased as people have moved to the suburbs. Thus, the emission decreases from clean cars have not been as great as expected. This presentation will address some of the lessons learned from the efforts in the United States to implement clean air programs. In a large number of countries, excessively elaborate studies have been substituted for action programs. Since much is now known about air quality, fairly brief studies can define programs that should be undertaken. What may take longer is developing public support and enthusiasm for improved air quality. In most cases, it is desirable to reduce spending on studies and increase spending on devising and implementing plans, as well as effectively communicating the necessary changes to the public. Balanced spending on studies- and action programs is essential to a sound air quality control program. (author)

  4. Improving patient care by making small sustainable changes: a cardiac telemetry unit's experience.

    Science.gov (United States)

    Braaten, Jane S; Bellhouse, Dorothy E

    2007-01-01

    With the introduction of each new drug, technology, and regulation, the processes of care become more complicated, creating an elaborate set of procedures connecting various hospital units and departments. Using methods of Adaptive Design and the Toyota Production System, a nursing unit redesigned work systems to achieve sustainable improvements in productivity, staff and patient satisfaction, and quality outcomes. The first hurdle of redesign was identifying problems, to which staff had become so accustomed with various work arounds that they had trouble seeing the process bottlenecks. Once the staff identified problems, they assumed they could solve the problem because they assumed they knew the causes. Utilizing root cause analysis, asking, "why, why, why," was essential to unearthing the true cause of a problem. Similarly, identifying solutions that were simple and low cost was an essential step in problem solving. Adopting new procedures and sustaining the commitment to identify and signal problems was a last and critical step toward realizing improvement, requiring a manager to function as "teacher/coach" rather than "fixer/firefighter".

  5. Learning from 25 years of experience with the United States clean air act

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, R H [Trinity Consultants Incorporated, Dallas, TX (United States)

    1996-12-31

    Twenty-five years ago, the United States embarked on a quest to attain clean air. President Nixon, in signing the Clean Air Act of 1970, defined clean air as the objective for the `70s. Although enormous progress has been made, much remains to be done. Newly constructed industry is quite clean, but many older facilities continue to operate with antiquated controls. Significant advances have been made in cleaning up the emissions from new automobiles, but two factors have impaired progress. First, cars last longer than they did in 1970, so the average age of the fleet has increased. Second, travel has increased as people have moved to the suburbs. Thus, the emission decreases from clean cars have not been as great as expected. This presentation will address some of the lessons learned from the efforts in the United States to implement clean air programs. In a large number of countries, excessively elaborate studies have been substituted for action programs. Since much is now known about air quality, fairly brief studies can define programs that should be undertaken. What may take longer is developing public support and enthusiasm for improved air quality. In most cases, it is desirable to reduce spending on studies and increase spending on devising and implementing plans, as well as effectively communicating the necessary changes to the public. Balanced spending on studies- and action programs is essential to a sound air quality control program. (author)

  6. Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit.

    Science.gov (United States)

    Venn, R M; Bradshaw, C J; Spencer, R; Brealey, D; Caudwell, E; Naughton, C; Vedio, A; Singer, M; Feneck, R; Treacher, D; Willatts, S M; Grounds, R M

    1999-12-01

    Dexmedetomidine, a highly selective and potent alpha2-adrenergic agonist, has a potentially useful role as a sedative agent in patients requiring intensive care. As part of a larger European multicentre trial, a total of 119 postoperative cardiac and general surgical patients requiring ventilation and sedation in an intensive care unit were enrolled in four centres in the United Kingdom. One hundred and five patients were randomly allocated to receive either dexmedetomidine or placebo with rescue sedation and analgesia provided by midazolam and morphine, respectively. Compared with the control group, intubated patients receiving dexmedetomidine required 80% less midazolam [mean 4.9 (5.8) microg.kg-1.h-1 vs. 23.7 (27.5) microg.kg-1.h-1, p < 0.0001], and 50% less morphine [11.2 (13.4) microg.kg-1.h-1 vs. 21.5 (19.4) microg.kg-1.h-1,p = 0.0006]. Cardiovascular effects and adverse events could be predicted from the known properties of alpha-2 agonists. In conclusion, dexmedetomidine is a useful agent for the provision of postoperative analgesia and sedation.

  7. Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers

    Directory of Open Access Journals (Sweden)

    Mogale L. Mmamma

    2015-12-01

    Full Text Available Background: Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. Objectives: The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. Method: A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9 and those working night duty (n = 3 who were at work on the anticipated days for data collection. Results: The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. Conclusion: It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

  8. METHODOLOGICAL APPROACHES TO EXPERT EVALUATION OF PRECLINICAL AND CLINICAL TRIALS OF HUMAN IMMUNOGLOBULIN PRODUCTS

    Directory of Open Access Journals (Sweden)

    V. B. Ivanov

    2017-01-01

    Full Text Available The article considers the experience of Russian and leading foreign regulatory agencies in organisation and conduction of preclinical and clinical trials of human immunoglobulin products. The authors suggest a classification of human immunoglobulins and provide updated information on authorization of these products in Russia. The article summarizes methodological approaches, basic scientific principles and criteria relating to expert evaluation of preclinical and clinical trials of blood products. The authors further define the expert body’s requirements for data on preclinical and clinical trials of human normal immuniglobulins and human specific immunoglobulins for the prevention and/or treatment of infectious and non-infectious diseases which are submitted as part of applications for marketing authorization or marketing authorization variation. The article suggests programs of preclinical and clinical trials for human normal immunoglobulins and human specific immunoglobulins for the prevention and/or treatment of infectious and non-infectious diseases that are aligned with the Russian legislation and Eurasian Economic Union’s regulations on medicines circulation, and have been elaborated with respect to the guidelines of the European Medicines Agency.

  9. Women's experiences of nurse case management on a gynaecological oncology unit in a Swiss tertiary hospital. A thematic analysis.

    Science.gov (United States)

    Grob, Silvia; Bläuer, Cornelia; Frei, Irena Anna

    2017-12-01

    Women with gynaecological cancer face various physical, social and emotional challenges concerning their health. Existing research shows that case management can improve patient satisfaction and reduce readmission rates. Although nurse case management was introduced on a gynaecological oncology unit in a Swiss university hospital in 2013, little is known about the experiences of female patients on a unit that uses this model of care. The aims were to explore women's experiences and to gain deeper understanding about hospital-based nurse case management on a gynaecological oncology unit and to qualitatively evaluate the concept of nurse case management. Sound research knowledge suggests that experiences are best explored with a qualitative research design. Ten participant interviews were conducted and inductively analysed between September 2014 and May 2015 as described by the thematic analysis method. Ethical approval was obtained, and the women signed a consent form. The first theme was named continuous relationship, with the nurse case manager as contact person and trusted partner. Study participants explained that friendliness and being present were essential qualities of nurse case management. Secondly, an essential support for women dealing with the situation of gynaecological cancer was described in the theme sharing information. The organisation of rehabilitation and other services by the nurse case management defined the third theme coordinating care. Trust was seen as the basis of the continuous relationship, marked by friendliness and presence of the nurse case manager. The helpful approach of persons practicing nurse case management made dealing with the situation of illness easier for women with gynaecological cancer. Coordination of information between the nurse case management and other healthcare services could be improved. Further evaluation is suggested to explore effects of the concept on family members. © 2017 Nordic College of Caring Science.

  10. Learning style preferences among pre-clinical medical students

    Directory of Open Access Journals (Sweden)

    Aye Aye Mon

    2014-02-01

    Full Text Available Generally, different students employ different learning styles dur-ing their studies and medical students are exposed to diverse methods of teaching. Therefore, understanding students’ learning style preference is an important consideration for a high quality and effective teaching and learning process.The aim of the study was to study the variation of learning styles among pre-clinical medical students of SEGi University, Malaysia. A cross-sectional study was performed by using VARK (Visual, Audio, Reading and Kinaesthetic questionnaire version 7.2 to assess the learning style preference of 98 (n=98 pre-clinical medical students in SEGi University. The questionnaire consists of 16 items which identify four different learning styles: visual, aural, reading/writing and kin-esthetic. Descriptive statistics were used to identify the learning styles of students. 61 students preferred multimodal as their learning style, out of which 43 (70% of them were female stu-dents and 18 (30% were male students. 37 students preferred unimodal as their learning style out of which 22 (59% of them were female students and 15 (41% were male students. In addi-tion, female students had more diverse preferences than male students by having 10 out of the other 11 possible combinations in multimodal learning style of preference, whereas the male stu-dents only had 5 out of the 11 combinations. In this study, there was no significant gender difference in the percentages of males and female students who preferred unimodal and multimodal styles of information presentation (P= 0.263; α=0.05. To con-clude, the majority of students of both genders had chosen quad-modal as their learning style preference. The results of this study can provide useful information for improving the quality of the teaching and learning experiences of students.

  11. The experiences of parents with infants in Neonatal Intensive Care Unit

    OpenAIRE

    Heidari, Haydeh; Hasanpour, Marzieh; Fooladi, Marjan

    2013-01-01

    Background: In recent years significant medical science advances have been made in the field midwifery and infant care. The premature, low birth weight and ill infants are admitted to the technologically advanced NICU for care and they often require long-term stay. This study addresses parental experiences with the infant care in NICU, explores their concerns regarding nursing supports for parents and offers nurses? perspectives on performing duties. Materials and Methods: A qualitative induc...

  12. Wind and Solar Energy Curtailment: Experience and Practices in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cochran, Jaquelin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Wang, Xi [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-03-01

    This report examines U.S. curtailment practices, with a particular emphasis on utilities in the Western states. The information presented here is based on a series of interviews conducted with utilities, system operators, wind energy developers, and non-governmental organizations. The report provides case studies of curtailment experience and examines the reasons for curtailment, curtailment procedures, compensation, and practices that can minimize curtailment.

  13. Report of the first United States conference on utility experience with neutron noise analysis

    International Nuclear Information System (INIS)

    Fry, D.N.; Horne, G.P.; Mayo, C.W.

    1984-01-01

    An informal meeting was held in Washington, D.C. on April 3 and 4, 1984, to discuss the current state of the art and experiences with neutron noise analysis in US pressurized water reactors (PWRs). The meeting was attended by 33 persons representing 11 utilities and 3 PWR reactor vendors as well as consultants, universities, and research laboratories. Presentations at the meeting covered several applications of neutron noise for diagnosing such things as vibrations induced by baffle jetting, detection of mechanical degradation of thermal shield supports, and electrical degradation of nuclear instrumentation channels. Twenty-one responses were obtained from a questionnaire circulated to all participants requesting their viewpoints and experiences regarding neutron noise analysis. The meeting participants concluded that a working group on neutron noise analysis should be formed to (1) establish a baseline library of neutron noise data, (2) provide a forum for communicating experiences with neutron noise surveillance, and (3) develop good practices and quality assurance procedures for neutron noise measurement and interpretation

  14. Competition in the electricity supply industry. Experiences from Europe and the United States

    International Nuclear Information System (INIS)

    Olsen, O.J.

    1995-01-01

    Introducing competition in the electricity industry is a major social experiment. Historically, the industry has been heavily regulated, however, this is no longer the case. Production and sales are being opened for competition and separated from the network services, transmission and distribution. This book includes papers from a Nordic Conference held in September 1994 in Copenhagen. The conference was planned as a part of the Energy Research Programme under the Nordic Council of Ministers and the object was to discuss the Nordic experience of competition in the electricity industry in comparison with other Western countries. The U.K. was the first European country to introduce competition in its electricity industry. Norway came next and two other Nordic countries - Sweden and Finland - have decided to follow suit. The U.S. started earlier than the European countries opening for limited competition in power production. However, the background of the reforms and its approach in the U.S. is different from Europe and far less radical. The experience of two Central European countries - Germany and The Netherlands - is also included in this book. Both countries have many institutional similarities to the Nordic countries, but they are - together with Denmark - more hesitant about introducing competition in their electricity industries. (au)

  15. Computer programs for unit-cell determination in electron diffraction experiments

    International Nuclear Information System (INIS)

    Li, X.Z.

    2005-01-01

    A set of computer programs for unit-cell determination from an electron diffraction tilt series and pattern indexing has been developed on the basis of several well-established algorithms. In this approach, a reduced direct primitive cell is first determined from experimental data, in the means time, the measurement errors of the tilt angles are checked and minimized. The derived primitive cell is then checked for possible higher lattice symmetry and transformed into a proper conventional cell. Finally a least-squares refinement procedure is adopted to generate optimum lattice parameters on the basis of the lengths of basic reflections in each diffraction pattern and the indices of these reflections. Examples are given to show the usage of the programs

  16. Intersectionality at Work: South Asian Muslim Women's Experiences of Employment and Leadership in the United Kingdom.

    Science.gov (United States)

    Tariq, Memoona; Syed, Jawad

    2017-01-01

    Drawing on qualitative interviews with 20 South Asian heritage, Muslim, female leaders, managers, and supervisors in the United Kingdom, we examine the multi-layered issues and challenges they face in pursuit of employment and leadership positions. The paper offers an intersectional perspective taking into account interconnected and overlapping factors (gender, ethnicity, religion, and family status) that affect not only the issues and challenges these women face in the labour market but also the individual agency and strategies they use to overcome any obstacles in the way of their employment and career. The results show that although Muslim women continue to face a myriad of challenges in the workplace, they are also able to tackle some of these issues through their individual strategies and networks, such as personal networks and further education. The study highlights the need for policymakers and employers to consider intersectionality to enable ethnic minority women's inclusion and leadership within and outside the workplace.

  17. [From empowerment to customer satisfaction: experience of a medical oncology unit].

    Science.gov (United States)

    Cifaldi, L; Gareri, R; Cristina, G; Felicetti, V; Gremigni, U

    2009-01-01

    The purpose of the study was the objective assessment of the outpatients satisfaction of the Medical Oncology Unit in Colleferro (USL Roma G), Italy. A retrospective survey conducted on 584 patients using a closed questionnaire focusing on nine items assess the degree of satisfaction expressed by patients relating to the different aspects of the service. The main aspects object of analysis were the accommodation, the relationship with the staff, the comfort of the structure and the health assistance received. The survey showed a high percentage of overall satisfaction for each of the nine parameters evaluated. There were no significant differences appreciated on a personal variables. The evaluation of customer satisfaction is a useful tool to measure patients approval and to meet their needs.

  18. Reliability research based experience with systems and events at the Kozloduy NPP units 1-4

    Energy Technology Data Exchange (ETDEWEB)

    Khristova, R; Kaltchev, B; Dimitrov, B [Energoproekt, Sofia (Bulgaria); Nedyalkova, D; Sonev, A [Kombinat Atomna Energetika, Kozloduj (Bulgaria)

    1996-12-31

    An overview of equipment reliability based on operational data of selected safety systems at the Kozloduy NPP is presented. Conclusions are drawn on reliability of the service water system, feed water system, emergency power supply - category 2, emergency high pressure ejection system and spray system. For the units 1-4 all recorded accident protocols in the period 1974-1993 have been processed and the main initiators identified. A list with 39 most frequent initiators of accidents/incidents is compiled. The human-caused errors account for 27% of all events. The reliability characteristics and frequencies have been calculated for all initiating events. It is concluded that there have not been any accidents with consequences for fuel integrity or radioactive release. 14 refs.

  19. Digital scrapbooking as a standard of care in neonatal intensive care units: initial experience.

    Science.gov (United States)

    Subhani, Muhammad T; Kanwal, Ifrah

    2012-01-01

    In this article, we describe a digital photo scrapbooking project as a standard of care for the parents of infants admitted in a neonatal intensive care unit (NICU). Photographs were taken from birth until discharge or expiry at special moments during the infant's hospitalization and used to create a digital scrapbook with daily notes by the parents. The scrapbook and original photos were provided on a CD at discharge or at expiry. Parents and their families unanimously appreciated the photos and the opportunity to record their thoughts, and considered the CDs as a lifetime treasure. Digital photo journaling could be implemented as a standard of care at other institutions with a commitment from the nursing and ancillary staff of the NICU and labor and delivery department, with possible support from volunteers.

  20. Natality Decline and Miscarriages Associated With the 1918 Influenza Pandemic: The Scandinavian and United States Experiences

    DEFF Research Database (Denmark)

    Bloom-Feshbach, Kimberly; Simonsen, Lone; Viboud, Cecile

    2011-01-01

    Background. Although pregnancy is a recognized risk factor for severe influenza infection, the effect of influenza on miscarriages and births remains unclear. We examined the relationship between influenza and birth rates during the 1918 pandemic in the United States, Denmark, Sweden, and Norway...... of peak pandemic exposure and depressions in birth rates, and identified pregnancy stages at risk of influenza-related miscarriage. Results. Birth rates declined in all study populations in spring 1919 by a mean of 2.2 births per 1000 persons, representing a 5%–15% drop below baseline levels (P ...). The 1919 natality depression reached its trough 6.1–6.8 months after the autumn pandemic peak, suggesting that missing births were attributable to excess first trimester miscarriages in ∼1 in 10 women who were pregnant during the peak of the pandemic. Pandemic-related mortality was insufficient to explain...

  1. Radiation Tolerance Qualification Tests of the Final Source Interface Unit for the ALICE Experiment

    CERN Document Server

    Dénes, E; Futó, E; Kerék, A; Kiss, T; Molnár, J; Novák, D; Soós, C; Tölyhi, T; Van de Vyvre, P

    2007-01-01

    The ALICE Detector Data Link (DDL) is a high-speed optical link designed to interface the readout electronics of ALICE sub-detectors to the DAQ computers. The Source Interface Unit (SIU) of the DDL will operate in radiation environment. Previous tests showed that a configuration loss of SRAM-based FPGA devices may happen and the frequency of undetected data errors in the FPGA user memory area is also not acceptable. Therefore, we redesigned the SIU card using another FPGA based on flash technology. In order to detect bit errors in the user memory we added parity check logic to the design. The new SIU has been extensively tested using neutron and proton irradiation to verify its radiation tolerance. In this paper we summarize the design changes, introduce the final design, and the results of the radiation tolerance measurements on the final card.

  2. Reliability research based experience with systems and events at the Kozloduy NPP units 1-4

    International Nuclear Information System (INIS)

    Khristova, R.; Kaltchev, B.; Dimitrov, B.; Nedyalkova, D.; Sonev, A.

    1995-01-01

    An overview of equipment reliability based on operational data of selected safety systems at the Kozloduy NPP is presented. Conclusions are drawn on reliability of the service water system, feed water system, emergency power supply - category 2, emergency high pressure ejection system and spray system. For the units 1-4 all recorded accident protocols in the period 1974-1993 have been processed and the main initiators identified. A list with 39 most frequent initiators of accidents/incidents is compiled. The human-caused errors account for 27% of all events. The reliability characteristics and frequencies have been calculated for all initiating events. It is concluded that there have not been any accidents with consequences for fuel integrity or radioactive release. 14 refs

  3. [Clinical use of virally inactived plasma. The experience of Blood Transfusion Unit in Mantova, Italy].

    Science.gov (United States)

    Lepri, Debora; Capuzzo, Enrico; Mattioli, Anna Vittoria; Dall'Oglio, Daniela; Sgarioto, Vincenzo; Terenziani, Isabella; Caramaschi, Giacomo; Manzato, Franco; Franchini, Massimo

    2013-03-01

    Fresh Frozen Plasma (FFP) is a blood component whose clinical use is widespread worldwide. Transfusion safety of this product is ensured by legally obligatory tests. Although these tests are carried out on each plasma donation, safety levels can be further improved by using some technical procedures, such as, among others, methylene blue (MB) and solvent-detergent (SD) viral inactivation methods. The DMTE (Blood Transfusion Unit) in Mantova has used the pharmaceutical-like SD virally inactivated plasma since 2007 (Plasmasafe, Kedrion) as replacement of the PFC by each single donor. Guidelines for the usage of both products are the same. With the main aim of assessing the therapeutic effectiveness and safety of Plasmasafe, we decided to clinically monitor transfusions performed with this product on patients of the Intensive Care Unit at the city hospital in Mantova. In addition, we controlled some coagulation parameters (PT, aPTT, ATIII, Fibrinogen, PC, PS, FV, FVII, FVIII) before and 24 hours after the Plasmasafe infusion. From a clinical point of view, the use of Plasmasafe always led to a significant reduction, or complete stop, of the bleeding. No transfusion-related adverse events were recorded. As regards, the most relevant laboratory results, a marked increase in the above mentioned hemostatic parameters was detected. Furthermore, patients transfused with this product received a mean volume significantly lower than an historical cohort of patients treated with FFP (503 mL with Plasmasafe versus 1549 mL with FFP, Pcost-effective treatment, able to rapidly correct hemostatic abnormalities, for critical patients.

  4. Cross-cultural medical education in the United States: key principles and experiences.

    Science.gov (United States)

    Betancourt, Joseph R; Cervantes, Marina C

    2009-09-01

    The field of cross-cultural care focuses on the ability to communicate effectively and provide quality health care to patients from diverse sociocultural backgrounds. In recent years, medical schools in the United States have increasingly recognized the growing importance of incorporating cross-cultural curricula into medical education. Cross-cultural medical education in the United States has emerged for four reasons: (1) the need for providers to have the skills to care for a diverse patient population; (2) the link between effective communication and health outcomes; (3) the presence of racial/ethnic disparities that are, in part, due to poor communication across cultures; and (4) medical school accreditation requirements. There are three major approaches to cross-cultural education: (1) the cultural sensitivity/awareness approach that focuses on attitudes; (2) the multicultural/categorical approach that focuses on knowledge; and (3) the cross-cultural approach that focuses on skills. The patient-based approach to cross-cultural care combines these three concepts into a framework that can be used to care for any patient, anytime, anywhere. Ultimately, if cross-cultural medical education is to evolve, students must believe it is important and understand that the categorical approach can lead to stereotyping; it should be taught using patient cases and highlighting clinical applications; it should be embedded in a longitudinal, developmentally appropriate fashion; and it should be integrated into the larger curriculum whenever possible. At the Harvard Medical School, we have tried to apply all of these lessons to our work, and we have started to develop a strategic integration process where we try to raise awareness, impart knowledge, and teach cross-cultural skills over the 4 years of schooling.

  5. Historical Origins of the Tuskegee Experiment: The Dilemma of Public Health in the United States

    Directory of Open Access Journals (Sweden)

    Jinbin PARK

    2017-12-01

    Full Text Available The Tuskegee Study of Untreated Syphilis in the Negro Male was an observational study on African-American males in Tuskegee, Alabama between 1932 and 1972. The U. S. Public Health Service ran this study on more than 300 people without notifying the participants about their disease nor treating them even after the introduction of penicillin. The study included recording the progress of disease and performing an autopsy on the deaths. This paper explores historical backgrounds enabled this infamous study, and discusses three driving forces behind the Tuskegee Study. First, it is important to understand that the Public Health Service was established in the U. S. Surgeon General’s office and was operated as a military organization. Amidst the development of an imperial agenda of the U.S. in the late 19th and early 20th centuries, the PHS was responsible for protecting hygiene and the superiority of “the American race” against infectious foreign elements from the borders. The U.S. Army’s experience of medical experiments in colonies and abroad was imported back to the country and formed a crucial part of the attitude and philosophy on public health. Secondly, the growing influence of eugenics and racial pathology at the time reinforced discriminative views on minorities. Progressivism was realized in the form of domestic reform and imperial pursuit at the same time. Major medical journals argued that blacks were inclined to have certain defects, especially sexually transmitted diseases like syphilis, because of their prodigal behavior and lack of hygiene. This kind of racial ideas were shared by the PHS officials who were in charge of the Tuskegee Study. Lastly, the PHS officials believed in continuing the experiment regardless of various social changes. They considered that black participants were not only poor but also ignorant of and even unwilling to undergo the treatment. When the exposure of the experiment led to the Senate

  6. Normative cultural values and the experiences of Mexican-American mothers in the neonatal intensive care unit.

    Science.gov (United States)

    Cleveland, Lisa M; Horner, Sharon D

    2012-04-01

    To explore the experiences of Mexican-American mothers who have had infants in the neonatal intensive care unit (NICU). A convenience sample of 15 English-speaking, Mexican-American women was interviewed. The study used an exploratory qualitative approach. Data collection was conducted through audiotaped, transcribed, semistructured, individual interviews and field notes. The 5 normative cultural values for Latino families-(1) simpatia, (2) personalismo, (3) respeto, (4) familismo, and (5) fatalismo-were used as a sensitizing framework to guide data interpretation. The women's discussions of their NICU experiences clearly reflect the 5 normative Latino cultural values. Positive and negative exemplars of these values are provided as evidence. These findings can be used to inform nursing care provided for Mexican-American mothers and their infants by assisting nurses to customize care to meet the cultural needs of this population.

  7. Experience and development of on-line BWR surveillance system at Onagawa nuclear power station unit-1

    International Nuclear Information System (INIS)

    Kishi, A.; Chiba, K.; Kato, K.; Ebata, S.; Ando, Y.; Sakamoto, H.

    1986-01-01

    ONAGAWA nuclear power station Unit-1 (Tohoku Electric Power Co.) is a BWR-4 nuclear power station of 524 MW electric power which started commercial operation in June 1984. To attain high reliability and applicability for ONAGAWA-1, Tohoku Electric Power Co. and Toshiba started a Research and Development project on plant surveillance and diagnosis from April 1982. Main purposes of this project are to: (1) Develop an on-line surveillance system and acquire its operating experience at a commercial BWR, (2) Assist in plant operation and maintenance by data acquisition and analysis, (3) Develop a new technique for plant surveillance and diagnosis. An outline of the project, operating experience gained from the on-line surveillance system and an introduction to new diagnosis techniques are reported in this paper. (author)

  8. Pre-clinical research in small animals using radiotherapy technology. A bidirectional translational approach

    International Nuclear Information System (INIS)

    Tillner, Falk; Buetof, Rebecca; Krause, Mechthild; Enghardt, Wolfgang; Helmholtz-Zentrum Dresden-Rossendorf, Dresden; Technische Univ. Dresden; Helmholtz-Zentrum Dresden-Rossendorf, Dresden

    2014-01-01

    For translational cancer research, pre-clinical in-vivo studies using small animals have become indispensable in bridging the gap between in-vitro cell experiments and clinical implementation. When setting up such small animal experiments, various biological, technical and methodical aspects have to be considered. In this work we present a comprehensive topical review based on relevant publications on irradiation techniques used for pre-clinical cancer research in mice and rats. Clinical radiotherapy treatment devices for the application of external beam radiotherapy and brachytherapy as well as dedicated research irradiation devices are feasible for small animal irradiation depending on the animal model and the experimental goals. In this work, appropriate solutions for the technological transfer of human radiation oncology to small animal radiation research are summarised. Additionally, important information concerning the experimental design is provided such that reliable and clinically relevant results can be attained.

  9. Pre-clinical research in small animals using radiotherapy technology--a bidirectional translational approach.

    Science.gov (United States)

    Tillner, Falk; Thute, Prasad; Bütof, Rebecca; Krause, Mechthild; Enghardt, Wolfgang

    2014-12-01

    For translational cancer research, pre-clinical in-vivo studies using small animals have become indispensable in bridging the gap between in-vitro cell experiments and clinical implementation. When setting up such small animal experiments, various biological, technical and methodical aspects have to be considered. In this work we present a comprehensive topical review based on relevant publications on irradiation techniques used for pre-clinical cancer research in mice and rats. Clinical radiotherapy treatment devices for the application of external beam radiotherapy and brachytherapy as well as dedicated research irradiation devices are feasible for small animal irradiation depending on the animal model and the experimental goals. In this work, appropriate solutions for the technological transfer of human radiation oncology to small animal radiation research are summarised. Additionally, important information concerning the experimental design is provided such that reliable and clinically relevant results can be attained. Copyright © 2014. Published by Elsevier GmbH.

  10. Pre-clinical research in small animals using radiotherapy technology. A bidirectional translational approach

    Energy Technology Data Exchange (ETDEWEB)

    Tillner, Falk; Buetof, Rebecca [Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; Thute, Prasad [Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Krause, Mechthild [Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; German Cancer Consortium (DKTK), Dresden (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); Enghardt, Wolfgang [Technische Univ. Dresden (Germany). OncoRay - National Center for Radiation Research in Oncology; Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Technische Univ. Dresden (Germany). Dept. of Radiation Oncology; Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany). Inst. of Radiooncology

    2014-07-01

    For translational cancer research, pre-clinical in-vivo studies using small animals have become indispensable in bridging the gap between in-vitro cell experiments and clinical implementation. When setting up such small animal experiments, various biological, technical and methodical aspects have to be considered. In this work we present a comprehensive topical review based on relevant publications on irradiation techniques used for pre-clinical cancer research in mice and rats. Clinical radiotherapy treatment devices for the application of external beam radiotherapy and brachytherapy as well as dedicated research irradiation devices are feasible for small animal irradiation depending on the animal model and the experimental goals. In this work, appropriate solutions for the technological transfer of human radiation oncology to small animal radiation research are summarised. Additionally, important information concerning the experimental design is provided such that reliable and clinically relevant results can be attained.

  11. Preclinical and clinical safety studies on DNA vaccines.

    NARCIS (Netherlands)

    Schalk, Johanna A C; Mooi, Frits R; Berbers, Guy A M; Aerts, Leon A G J M van; Ovelgönne, Hans; Kimman, Tjeerd G

    2007-01-01

    DNA vaccines are based on the transfer of genetic material, encoding an antigen, to the cells of the vaccine recipient. Despite high expectations of DNA vaccines as a result of promising preclinical data their clinical utility remains unproven. However, much data is gathered in preclinical and

  12. Upper Gastrointestinal Bleeding in Children: A Tertiary United Kingdom Children’s Hospital Experience

    Directory of Open Access Journals (Sweden)

    Omar Nasher

    2017-11-01

    Full Text Available The aim of this study was to review the aetiology, presentation and management of these patients with upper gastrointestinal bleeding (UGIB at a tertiary children’s unit in the United Kingdom. This was a retrospective single-institution study on children (<16 years who presented with acute UGIB over a period of 5 years using known International Classification of Diseases (ICD codes. A total of 32 children (17 males, 15 females were identified with a total median age at presentation of 5.5 years. The majority (24/32 of patients presented as an emergency. A total of 19/32 presented with isolated haematemesis, 8/32 with isolated melaena and 5/32 with a combination of melaena and haematemesis. On admission, the mean haemoglobin of patients who presented with isolated haematemesis was 11 g/dL, those with isolated melaena 9.3 g/dL and those with a combination 7.8 g/dL. Blood transfusion was required in 3/19 with haematemesis and 3/5 with haematemesis and melaena. A total of 19/32 underwent upper gastrointestinal endoscopy. Endoscopic findings were oesophageal varices (5/19 of which 4 required banding; bleeding gastric ulcer (1/19 requiring clips, haemospray and adrenaline; gastric vascular malformation (1/19 treated with Argon plasma coagulation therapy; duodenal ulcer (3/19 which required surgery in two cases; oesophagitis (5/19; and gastritis +/− duodenitis (3/19. A total of 13/32 patients did not undergo endoscopy and the presumed aetiology was a Mallory–Weiss tear (4/13; ingestion of foreign body (2/13; gastritis (3/13; viral illness (1/13; unknown (2/13. While UGIB is uncommon in children, the morbidity associated with it is very significant. Melaena, dropping haemoglobin, and requirement for a blood transfusion appear to be significant markers of an underlying cause of UGIB that requires therapeutic intervention. A multi-disciplinary team comprising gastroenterologists and surgeons is essential.

  13. Developing Potential Candidates of Preclinical Preeclampsia

    Directory of Open Access Journals (Sweden)

    Sandra Founds

    2015-11-01

    Full Text Available The potential for developing molecules of interest in preclinical preeclampsia from candidate genes that were discovered on gene expression microarray analysis has been challenged by limited access to additional first trimester trophoblast and decidual tissues. The question of whether these candidates encode secreted proteins that may be detected in maternal circulation early in pregnancy has been investigated using various proteomic methods. Pilot studies utilizing mass spectrometry based proteomic assays, along with enzyme linked immunosorbent assays (ELISAs, and Western immunoblotting in first trimester samples are reported. The novel targeted mass spectrometry methods led to robust multiple reaction monitoring assays. Despite detection of several candidates in early gestation, challenges persist. Future antibody-based studies may lead to a novel multiplex protein panel for screening or detection to prevent or mitigate preeclampsia.

  14. Common pitfalls in preclinical cancer target validation.

    Science.gov (United States)

    Kaelin, William G

    2017-07-01

    An alarming number of papers from laboratories nominating new cancer drug targets contain findings that cannot be reproduced by others or are simply not robust enough to justify drug discovery efforts. This problem probably has many causes, including an underappreciation of the danger of being misled by off-target effects when using pharmacological or genetic perturbants in complex biological assays. This danger is particularly acute when, as is often the case in cancer pharmacology, the biological phenotype being measured is a 'down' readout (such as decreased proliferation, decreased viability or decreased tumour growth) that could simply reflect a nonspecific loss of cellular fitness. These problems are compounded by multiple hypothesis testing, such as when candidate targets emerge from high-throughput screens that interrogate multiple targets in parallel, and by a publication and promotion system that preferentially rewards positive findings. In this Perspective, I outline some of the common pitfalls in preclinical cancer target identification and some potential approaches to mitigate them.

  15. Multi-processor developments in the United States for future high energy physics experiments and accelerators

    International Nuclear Information System (INIS)

    Gaines, I.

    1988-03-01

    The use of multi-processors for analysis and high-level triggering in High Energy Physics experiments, pioneered by the early emulator systems, has reached maturity, in particular with the multiple microprocessor systems in use at Fermilab. It is widely acknowledged that such systems will fulfill the major portion of the computing needs of future large experiments. Recent developments at Fermilab's Advanced Computer Program will make such systems even more powerful, cost-effective, and easier to use than they are at present. The next generation of microprocessors, already available, will provide CPU power of about one VAX 780 equivalent/$300, while supporting most VMS FORTRAN extensions and large (>8MB) amounts of memory. Low cost high density mass storage devices (based on video tape cartridge technology) will allow parallel I/O to remove potential I/O bottlenecks in systems of over 1000 VAX equipment processors. New interconnection schemes and system software will allow more flexible topologies and extremely high data bandwidth, especially for on-line systems. This talk will summarize the work at the Advanced Computer Program and the rest of the US in this field. 3 refs., 4 figs

  16. Differential reporting of discriminatory experiences in Brazil and the United States

    Directory of Open Access Journals (Sweden)

    Sarah Burgard

    Full Text Available Abstract: There has been little cross-national comparison of perceived discrimination, and few studies have considered how intersectional identities shape perception of discriminatory treatment in different societies. Using data from the ELSA-Brasil, a study of Brazilian civil servants, and the Americans’ Changing Lives Study, a nationally-representative sample of U.S. adults, we compare reports of lifetime discrimination among race-by-gender groups in each society. We also consider whether educational attainment explains any group differences, or if differences across groups vary by level of education. Results reveal higher lifetime discrimination experiences among Black respondents in both countries, especially Black men, than among Whites, and lower reports among White women than White men. Brown men and women also reported higher levels than White men in Brazil. For all race-by-gender groups in both countries, except Brazilian White men, reports of discrimination were higher among the more educated, though adjusting for educational differences across groups did not explain group differences. In Brazil, we found the greatest racial disparities among the college educated, while U.S. Black men were more likely to report discrimination than White men at all levels of education. Results reveal broad similarities across countries, despite important differences in their histories, and an intersectional approach contributed to identification of these similarities and some differences in discrimination experiences. These findings have implications for social and public health surveillance and intervention to address the harmful consequences of discrimination.

  17. Deserving citizenship? Exploring migrants' experiences of the 'citizenship test' process in the United Kingdom.

    Science.gov (United States)

    Monforte, Pierre; Bassel, Leah; Khan, Kamran

    2018-02-21

    Since the early 2000s several European countries have introduced language and citizenship tests as new requirements for access to long-term residence or naturalization. The content of citizenship tests has been often presented as exclusionary in nature, in particular as it is based on the idea that access to citizenship has to be 'deserved'. In this paper, we aim to explore the citizenship tests 'from below', through the focus on the experience of migrants who prepare and take the 'Life in the UK' test, and with particular reference to how they relate to the idea of 'deservingness'. Through a set of in-depth interviews with migrants in two different cities (Leicester and London), we show that many of them use narratives in which they distinguish between the 'deserving citizens' and the 'undeserving Others' when they reflect upon their experience of becoming citizens. In so doing, they negotiate new hierarchies of inclusion into and exclusion from citizenship, which reflect broader neo-liberal and ethos-based conceptions of citizenship. © London School of Economics and Political Science 2018.

  18. Westinghouse power distribution monitoring experience at Duke Power's McGuire Unit 1

    International Nuclear Information System (INIS)

    Grobmyer, L.R.; Cash, M.T.; Kitlan, M.S.; Impink, A.J. Jr.

    1987-01-01

    In the evolution of the Westinghouse methodology of assuring safe core power distributions, emphasis was placed on analysis and not on continuous detailed core monitoring. Power distribution monitoring is currently achieved by periodic surveillances using the movable in-core detector system (MIDS) and by continuous observations of the two-section excore power range detectors. Control of the power distribution is regulated by limits on the indications from these systems, by limits on control rod insertion, and by operational constraints on the position indication systems. As more plants come on line and as more utilities take over the fuel design function for themselves, the desire for better core monitoring becomes evident. Also, the need and desire by the utilities to have more control over their operating margin has motivated the industry to offer and/or upgrade core monitoring systems. Westinghouse and Duke Power are participants in a joint development program to finalize the development of the core on-line surveillance monitoring and operations system (COSMOS). This final stage of development consists of prototype field trials at the McGuire Nuclear Plant. The purpose of the prototype program is to determine how well the design objectives are met and how to improve the system based on the operating experience at McGuire. Another purpose of this prototype program is to generate the necessary experience and information to develop a topical report for the US Nuclear Regulatory Commission to obtain a licensing basis for technical specification relaxation

  19. Operational experience of decommissioning techniques for research reactors in the United Kingdom

    International Nuclear Information System (INIS)

    England, M.R.; McCool, T.M.

    2002-01-01

    In previous co-ordinated research projects (CRP) conducted by the IAEA no distinction was made between decommissioning activities carried out at nuclear power plants, research reactors or nuclear fuel cycle facilities. As experience was gained and technology advanced it became clear that decommissioning of research reactors had certain specific characteristics which needed a dedicated approach. It was within this context that a CRP on Decommissioning Techniques for Research Reactors was launched and conducted by the IAEA from 1997 to 2001. This paper considers the experience gained from the decommissioning of two research reactors during the course of the CRP namely: (a) the ICI Triga Mk I reactor at Billingham UK which was largely complete by the end of the research project and (b) the Argonaut 100 reactor at the Scottish Universities Research and Reactor centre at East Kilbride in Scotland which is currently is the early stages of dismantling/site operations. It is the intention of this paper with reference to the two case studies outlined above to compare the actual implementation of these works against the original proposals and identify areas that were found to be problematical and/or identify any lessons learnt. (author)

  20. The Experiences of Specialist Nurses Working Within the Uro-oncology Multidisciplinary Team in the United Kingdom.

    Science.gov (United States)

    Punshon, Geoffrey; Endacott, Ruth; Aslett, Phillippa; Brocksom, Jane; Fleure, Louisa; Howdle, Felicity; Masterton, Morven; O'Connor, Anita; Swift, Adrian; Trevatt, Paul; Leary, Alison

    United Kingdom prostate cancer nursing care is provided by a variety of urology and uro-oncology nurses. The experience of working in multidisciplinary teams (MDT) was investigated in a national study. The study consisted of a national survey with descriptive statistics and thematic analysis. A secondary analysis of a data subset from a UK whole population survey was undertaken (n = 285) of the specialist nursing workforce and the services they provide. Data were collected on the experience of working in the MDT. Forty-five percent of the respondents felt that they worked in a functional MDT, 12% felt that they worked in a dysfunctional MDT, and 3.5% found the MDT meeting intimidating. Furthermore, 34% of the nurses felt that they could constructively challenge all members of the MDT in meetings. Themes emerging from open-ended questions were lack of interest in nonmedical concerns by other team members, ability to constructively challenge decisions or views within the meeting, and little opportunity for patients' wishes to be expressed. Despite expertise and experience, nurses had a variable, often negative, experience of the MDT. It is necessary to ensure that all participants can contribute and are heard and valued. More emphasis should be given to patients' nonmedical needs.

  1. Patients' experiences and satisfaction about care provided by male nurses in medical surgical units in Islamabad, Pakistan: A pilot study.

    Science.gov (United States)

    Younas, Ahtisham; Sundus, Amara

    2018-01-01

    Nursing is predominantly a female profession and caring has been considered an attribute of female nurses, which could imply a noncaring image of male nurses. To determine patients' experiences and satisfaction from care provided by male nurses in a private hospital in Islamabad, Pakistan. This cross-sectional study included a purposive sample of 50 patients admitted to medical surgical units for at least 2 days and who had at least three professional interactions with a male nurse. The Newcastle Satisfaction with Nursing Scale was used for data collection. Descriptive statistics were used for data analysis. The total score for experience and satisfaction was 81 and 51, respectively. A statistically significant difference existed between experience and satisfaction scores of male and female participants, indicating that males were more pleased and satisfied with their experience of receiving care from male nurses compared to the female participants. The male nurses were concerned for their patients, they were knowledgeable about the patients' condition and care, and provided them with clear explanations of the medical and nursing procedures. However, they seem to lack interpersonal relationship with patients and did not take initiative in understanding their patients. © 2017 Wiley Periodicals, Inc.

  2. Experience in start-up of the South-Ukrainian-2 power unit with the WWER-1000 reactor

    International Nuclear Information System (INIS)

    Belov, Yu.V.; Kazakov, V.A.; Kirilov, V.V.; Kryakvin, L.V.

    1987-01-01

    The volume, sequence and dates of works fulfilled during hot testing, physical and power start-ups and while bringing output of the South-Ukranian-2 power unit with the WWER-1000 reactor to the design figure are described. The works were fulfilled according to the standard schedules from October in 1984 till April in 1985. Combination of the stages and intensification of works before the physical start-up have allowed to shorten the dates by 90 days as compared to the schedule. The physical and power start-ups, including bringing reactor output to the design figure, were performed during 140 days, that permits to shorten the dates by 20 days more. The results of physical experiments carried out at the South-Ukranian-2 power unit, are in good agreement with the data obtained at the first power units of the given and Kalinin NPPs. Besides, during physical and power start-ups additional measures ensuring nuclear safety are developed

  3. The Attachment Imperative: Parental Experiences of Relation-making in a Danish Neonatal Intensive Care Unit.

    Science.gov (United States)

    Navne, Laura E; Svendsen, Mette N; Gammeltoft, Tine M

    2018-03-01

    In this article, we explore how parents establish relations with extremely premature infants whose lives and futures are uncertain. Drawing on ethnographic fieldwork in a Danish Neonatal Intensive Care Unit (NICU), we engage recent discussions of the limits of conventional anthropological thinking on social relations and point to the productive aspects of practices of distance and detachment. We show that while the NICU upholds an imperative of attachment independently of the infant's chances of survival, for parents, attachment is contingent on certain hesitations in relation to their infant. We argue that there are nuances in practices of relationmaking in need of more attention (i.e., the nexus of attachment and detachment). Refraining from touching, holding, and feeding their infants during critical periods, the parents enact detachment as integral to their practices of attachment. Such "cuts" in parent-infant relations become steps on the way to securing the infant's survival and making kin(ship). We conclude that although infants may be articulated as "maybe-lives" by staff, in the NICU as well as in Danish society, the ideal of attachment appears to leave little room for "maybe-parents." © 2017 by the American Anthropological Association.

  4. Haematological parameters in different african populations: an experience from united nations level 3 hospital

    International Nuclear Information System (INIS)

    Iftikhar, R.; Khan, N.U.; Iqbal, Z.; Anwar, M.I.

    2017-01-01

    To evaluate hematological parameters in African population to estimate normal reference intervals for these tests. Study Design: Cross sectional observational study. Place and Duration of Study: Department of Pathology, United Nations level 3 hospital, Nyala, Darfur from 1st Mar to 30th Dec 2014. Material and Methods: There were 396 healthy African male and female volunteers selected between 18-65 years of age, belonging to different countries. Fresh whole blood was used to measure haemoglobin (Hb) concentration, haematocrit (Hct), total red blood cell (TRBC) count, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), platelet count, total leucocyte count (TLC) and differential white blood cells count. Data were analysed using SPSS version 19. Results: Mean Hb of study group was 13.81 +- 1.99 g/dl. Mean TLC was 5.50 +- 1.96 x 103/ul. Mean lymphocyte count was 2.58 +- 0.95. Mean platelet count was 234 +- 92 x103 /ul. Mean values for Hb Concentration, TRBC, Hct Ratio, MCV, MCH and MCHC were all higher for African Males than Females; this difference was statistically significant (p<0.05). Conclusion: This multi-national African population based study confirms the variations in haematological parameters previously described in single nation African studies. The commonly observed variations in normal adults are low RBC indices, relative neutropenia and lymphocytosis. (author)

  5. Family members' experiences with intensive care unit diaries when the patient does not survive.

    Science.gov (United States)

    Johansson, Maria; Wåhlin, Ingrid; Magnusson, Lennart; Runeson, Ingrid; Hanson, Elizabeth

    2018-03-01

    The aim of the study was to explore how family members experienced the use of a diary when a relative does not survive the stay in the intensive care unit (ICU). A qualitative method with a hermeneutic approach was used. Nine participants who read/wrote eight diaries in total were interviewed. The collected data were analysed using a hermeneutic technique inspired by Geanellos. The analysis revealed an overall theme 'the diary was experienced as a bridge connecting the past with the future', which was a metaphor referring to the temporal aspect where there was the period with the diary up until the patient's death and then the postbereavement period. The diary contributed to both a rational and emotional understanding of the death of the patient and disclosed glimmers of light that still existed before the illness deteriorated. Further, the diary bridged the space between family members themselves and between family and nursing staff. It helped to maintain a feeling of togetherness and engagement in the care of the patient which family members found comforting. Family members of nonsurvivors had a need to have the ICU time explained and expressed. The diary might work as a form of 'survival kit' to gain coherence and understanding; to meet their needs during the hospital stay; and, finally, to act as a bereavement support by processing the death of the patient. © 2017 Nordic College of Caring Science.

  6. [Evolution and follow-up of hunger strikers: experience from an interregional hospital secured unit].

    Science.gov (United States)

    Dubois, F; Sudre, E; Porte, A; Bédry, R; Gromb, S

    2011-11-01

    A hunger strike is a voluntary fast, performed to protest publicly against an issue deemed unfair. In the case of French prisoners, hospitalization in an interregional hospital secured units (UHSI) may be necessary. A retrospective epidemiological study based on one UHSI medical records was performed on the period of May, 2006 to December, 2008, and focused on symptoms, outcomes and ethical problems encountered. Seven men and one woman with a mean age of 32.6 years were hospitalized in an UHSI, with nine episodes of hunger strike of a median duration of 57 days. Clinical symptoms began after two weeks of voluntary deprivation in the form of dizziness, weakness, muscle pain and headache. Laboratory tests showed hypoglycemia (hunger strikes. All hunger strikes were respected by medical staff, and treatment was based upon surveillance of symptoms, vitamin B and sweetened drinks administration and explanations of the clinical hazards on a daily basis. The special problem encountered in the medical management of these strikers was to convince them to accept treatments in order to avoid a coercive life-saving treatment as requested by French law. Copyright © 2011 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  7. [Community vegetable gardens as a health promotion activity: an experience in Primary Healthcare Units].

    Science.gov (United States)

    Costa, Christiane Gasparini Araújo; Garcia, Mariana Tarricone; Ribeiro, Silvana Maria; Salandini, Marcia Fernanda de Sousa; Bógus, Cláudia Maria

    2015-10-01

    Urban and peri-urban agriculture (UPA) is being practiced in different settings, contributing to the improvement of health in communities and healthier environments. In order to identify the meanings and implications of the practice of UPA in Primary Healthcare Units (PHU) as an activity of health promotion (HP), and to what extent its therapeutic dimension characterizes it as an activity aligned with complementary and integrative practices (CIP), a qualitative cross-sectional study was performed in Embu das Artes, State of São Paulo. From the analysis, the following main themes arose: health concept, health outcomes, the return to traditional practices and habits and the reorientation of health services. It was possible to identify the close link between the cultivation of vegetable gardens and HP guidelines and fields of action, such as creating healthier environments, boosting community actions, developing personal skills, stimulating autonomy and empowerment and demands for the reorientation of services. The garden activities, set up in PHU areas, proved to be an implementation strategy of CIP. The conclusion reached is that vegetable gardening activities in community gardens are seen to be health promotion practices that integrate key elements of CIP.

  8. Firewater Storage, Treatment, Recycling and Management: New Perspectives Based on Experiences from the United Kingdom

    Directory of Open Access Journals (Sweden)

    Miklas Scholz

    2014-02-01

    Full Text Available Smart firewater management and recycling helps reduce water use and protect the environment from pollution. However, contamination of recycled water may pose a health risk to fire fighters. This review assesses international literature to identify best practices, and to recommend new technologies and methods on firewater management and recycling. The literature assessment indicates that this is a new research area where insufficient findings have been published in Web of Science-referenced journals. Therefore, informally published materials (a.k.a. grey literature were also assessed. Findings indicate the need for practical decision support tools to estimate consumption rates, predict “bottlenecks” and bund capacity, assess water quality and determine pump requirements. This article recommends that cost-efficient and rapid on-site treatment methods, such as compact and mobile filtration units for firewater recycling should be researched in the future. The filters should be based on compartments with different media. The empty pore space should decrease from inflow to outflow. A light plastic media should be positioned near the inflow to retain large particles, such as a grid. Activated carbon media could be placed near the outlet to remove fine suspended solids and dissolved contaminants. This should address concerns by fire fighters dealing with contaminated water, spray and foam.

  9. Fusarium spp infections in a pediatric burn unit: nine years of experience.

    Science.gov (United States)

    Rosanova, María Teresa; Brizuela, Martín; Villasboas, Mabel; Guarracino, Fabian; Alvarez, Veronica; Santos, Patricia; Finquelievich, Jorge

    2016-01-01

    Fusarium spp are ubiquitous fungi recognized as opportunistic agents of human infections, and can produce severe infections in burn patients. The literature on Fusarium spp infections in pediatric burn patients is scarce. To describe the clinical and epidemiological features as well as outcome of Fusarium spp infections in pediatric burn patients. Retrospective, descriptive study of Fusarium spp infections in a specialized intensive care burn unit. In 15 patients Fusarium spp infections were diagnosed. Median age was 48 months. Direct fire injury was observed in ten patients. The median affected burn surface area was 45%. Twelve patients had a full thickness burn. Fourteen patients had a Garces Index ≥3. Fungal infection developed at a median of 11 days after burn injury. Fungi were isolated from burn wound in 14 patients and from the bone in one patient. Amphotericin B was the drug of choice for treatment followed by voriconazole. Median time of treatment completion was 23 days. One patient (7%) died of fungal infection-related causes. In our series Fusarium spp was an uncommon pathogen in severely burnt patients. The burn wound was the most common site of infection and mortality was low. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  10. Introducing blended learning: An experience of uncertainty for students in the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Linzi J. Kemp

    2013-05-01

    Full Text Available The cultural dimension of Uncertainty Avoidance is analysed in this study of an introduction to blended learning for international students. Content analysis was conducted on the survey narratives collected from three cohorts of management undergraduates in the United Arab Emirates. Interpretation of certainty with blended learning was found in: student skills with technology; student acknowledgement of course organisation; and student appreciation of online feedback. Uncertainty with the introduction of blended learning was found: when membership was assigned for group work, higher quality research methods were introduced; where course structure lacked detail, increased time was required for new and different online activities. These international students, from countries with a high score on Uncertainty Avoidance, exhibited that dimension when introduced to blended learning. The implications of these findings are discussed, and strategies suggested for introducing blended learning to international students. The limitations of the study are considered, and a direction for future research is suggested. This is the first study on undergraduates in the Middle East for the effects of a cultural dimension when introducing blended learning. The findings increase the body of knowledge that relates to learning technology in the international business classroom.

  11. Investment in epilepsy monitoring units improves epilepsy care—experience in a regional neuroscience centre

    LENUS (Irish Health Repository)

    McGinty, RN

    2017-08-01

    An evaluation of the clinical yield of inpatient long-term video-EEG (vEEG) in a new epilepsy monitoring unit (EMU) was undertaken, with findings compared to the centre’s prior method of bedside vEEG recording in a standard neurology ward, as reported in 2004. A retrospective analysis of neurophysiology reports for all adults who underwent elective vEEG monitoring in the EMU at Cork University Hospital between January 2015 and July 2016 was conducted. Of 115 vEEG studies in the EMU, 100 (87.0%) were deemed diagnostically conclusive, 14 (12.2%) failed to catch any clinical events and showed normal EEG throughout, and one (0.9%) captured spells of unclear clinical significance—the corresponding figures reported in 2004 for bedside vEEGs were 21.3%, 77% and 1.6%, respectively. The EMU offers a more effective method of recording inpatient vEEG, which aids decision-making and improves clinical outcomes. Some evidence-based measures which could further enhance diagnostic yield are discussed.

  12. More than half the families of mobile intensive care unit patients experience inadequate communication with physicians.

    Science.gov (United States)

    Debaty, Guillaume; Ageron, François-Xavier; Minguet, Laetitia; Courtiol, Guillaume; Escallier, Christophe; Henniche, Adeline; Maignan, Maxime; Briot, Raphaël; Carpentier, Françoise; Savary, Dominique; Labarere, José; Danel, Vincent

    2015-07-01

    This study aimed to assess comprehension by family members of the patient's severity in the prehospital setting. We conducted a cross-sectional study in four mobile intensive care units (ICUs, medicalized ambulances) in France from June to October 2012. Nurses collected data on patients, patient's relatives, and mobile ICU physicians. For each patient, one relative and one physician independently rated the patient's severity using a simplified version of the Clinical Classification of Out-of-Hospital Emergency Patients scale (CCMS). Relatives were also asked to assess their interview with the physician. The primary outcome was agreement between the relative's and physician's ratings of the patient's severity. Data were available for 184 patients, their relatives, and mobile ICU physicians. Full and partial agreement between relatives and physicians regarding the patient's severity was found for 79 (43%) and 121 (66%) cases, respectively [weighted kappa = 0.32 (95% confidence interval, CI, 0.23-0.42)]. Relatives overestimated the patient's severity assessed by the physician [6 (5-8) vs. 4 (3-7), p communicated by mobile ICU physicians.

  13. Neonatal pain and preventive strategies: an experience in a tertiary care unit

    International Nuclear Information System (INIS)

    Mahmud, S.

    2017-01-01

    Little is known about neonatal pain in Pakistan. So, to know about neonatal pain, its scoring and the effectiveness of oral dextrose in neonatal pain management we carried this study in neonatal intensive care unit (NICU) of military hospital (MH) Rawalpindi. Methods: This randomized control trial was carried out in NICU of MH, Rawalpindi from to Jan 2013 to Dec 2013. Total of 252 babies were enrolled in the study. We assessed neonatal pain by using Modified Behavioural Pain Scale (MBPS). Babies were given 10% dextrose and sterile water two minutes before a painful procedure and pain assessment was done after the procedure. The different painful procedures included, heel prick, nasogastric (NG) tube insertion, cannulation, catheterization and venepuncture for blood sampling. Results: A total of 252 babies were enrolled in the study. Of these 139(55%) were male and 113(45%) were female babies. Painful procedures included heel lancing 120(48%), I/V cannulations 60(24%), venepuncture 40 (16%), NG insertion 26 (10%) and Foley catheterization 6 (2%). Mean MBPS score with 10% dextrose and sterile water were 4.31 and 6.26 respectively and the difference between two was significant statically. Conclusion: Oral dextrose is a cheap and easily available solution and can be used in neonatal pain management during various painful procedures. (author)

  14. Positive experiences in physical education through teacher intervention in the teaching unit futsal.

    Directory of Open Access Journals (Sweden)

    Ángel Abós Catalán

    2015-09-01

    Full Text Available The interpersonal style used by the teacher of Physical Education (PE in their classes can trigger consequences for students inside and outside the classroom. Grounded in self-determination theory and achievement goal theory, the aim of the study was to analyze the relationship between motivational climate and support of the basic psychological needs (BPN generated by the PE teacher in the teaching unit (TU of futsal, with consequences of enjoyment and boredom, as well as the predisposition toward EF experienced by students. The sample was composed of 70 students (32 men and 38 women year 4th of compulsory Secondary Education, aged 15 to 17 years (M age = 15.31, SD = 0.49. The variables measured at the end of the TU were: motivational climate (EPCM, support of the BPN (CANPB and affective consequences (SSI the content of futsal and the predisposition towards PE (PEPS. The results of correlation analysis showed that the task climate and support of the BPN in the TU futsal, correlated positively and significantly with enjoyment and some predisposing factors toward PE, while doing it in reverse with boredom. Therefore, given the relationship between what happens in the classroom and outside it, seems necessary that teachers of PE generates a task climate and support of the BPN in each of curricular content, to students adopt life-styles more active and healthy. 

  15. Early versus late tracheostomy in pediatric intensive care unit: does it matter? A 6-year experience.

    Science.gov (United States)

    Pizza, Alessandro; Picconi, Enzo; Piastra, Marco; Genovese, Orazio; Biasucci, Daniele G; Conti, Giorgio

    2017-08-01

    The aim of this study is to examine the clinical data of children who underwent tracheostomy during their stay in Pediatric Intensive Care Unit (PICU), in order to describe the relationship between the timing of tracheostomy, the length of PICU stay and the occurrence of ventilator-associated pneumonia (VAP). This is a retrospective cohort study that collects all patients undergoing tracheostomy during their PICU stay over a six-year period. Data collection included PICU length of stay, days of intubation, days of mechanical ventilation, primary indication for tracheostomy, information about VAP and decannulations. The early tracheostomy group was defined as patients who had ten or fewer days of continuous ventilation, whereas the late tracheostomy group had more than ten days of continuous ventilation. A significant decrease in the rate of VAP incidence was noticed in the early tracheostomy group vs. late group (P=0.004, OR=0.39, 95% CI: 0.18-0.85). No differences were observed about decannulation, need of long-term ventilation and death rate. Significant decreases of days of mechanical ventilation and PICU stay were found in subgroup of patients who underwent early tracheostomy and were decannulated within 18 months. No standard timing for tracheostomy placement has been established in the pediatric population. Early tracheostomy can shorten the days of ventilation and hospitalization in PICU and reduce the incidence of VAP, but further studies are needed to identify patient categories in which it can be of benefit.

  16. [Medullary carcinoma experience in breast oncology unit of Hospital Juarez Mexico].

    Science.gov (United States)

    Jiménez-Villanueva, Xicoténcatl; Hernández-Rubio, Angela; García-Rodríguez, Francisco Mario; García, Rebeca Gil; Moreno-Eutimio, Mario; Herrera-Torre, Analy

    2014-01-01

    Medullary breast cancer is a rare type, considered of good prognosis. To know the epidemiological and clinical characteristics of the population attended in the Hospital Juarez de Mexico, to know if they are alike to described worldwide and if the treatments proposed internationally are applicable for this hospitable center. We performed a retrospective analysis. Reviewing the records with histopathologic diagnosis of medullary breast cancer from February 1993 to February 2011. Finding 41 patients in the oncology unit of the institution. We report an incidence of 3.04%, originating in 11 Mexican States, with a low to middle socioeconomic level in 39.02%. The average age at the time of diagnosis was 50 years. No family history was reported but some patients had medical history for type 2 diabetes, hypertension and previous breast cancer. 63.41% were menopausal. The average clinical size of the tumor was 58 mm. The 63% of the cases were located in the left breast. The 53.1% were clinical stages I and II, 46.3% were clinical stages III and in 9.6% of the cases primary tumor could not be assessed. Only 47% of the patients had positive axillary lynph nodes at diagnosis. The inmunohistochemestry was only reported in 14 of the 41 patients, according to the molecular classification of breast cancer: 8 were triple negative, 2 luminal A, 1 luminal B and 3 Her2neu. The Mexican population presents epidemiological and clinical characteristics similar to those patients described in other studies worldwide.

  17. Central venous catheter placement by an interventional radiology unit: an australian experience

    International Nuclear Information System (INIS)

    Lee, M. K. S.; Mossop, P. J.; Vrazas, J. I.

    2007-01-01

    The aim of this retrospective study was to analyse the outcomes of central venous catheter (CVC) placement carried out by an interventional radiology unit. A review of our hospital records identified 331 consecutive patients who underwent insertion of a tunnelled or non-tunnelled CVC between January 2000 and December 2004. Key outcome measures included the technical success rate of CVC insertion and the percentage of immediate ( 30 days) complications. A total of 462 CVCs were placed under radiological guidance, with an overall success rate of 98.9%. Immediate complications included one pneumothorax, which was diagnosed 7 days after subclavian CVC insertion, and eight episodes of significant haematoma or bleeding within 24 h of CVC insertion. No cases were complicated by arterial puncture or air embolus. Catheter-related sepsis occurred in 2% of non-tunnelled CVC and 8.9% of tunnelled CVC. The overall incidence of catheter-related sepsis was 0.17 per 100 catheter days. As the demand for chemotherapy and haemodialysis grows with our ageing population, interventional radiology suites are well placed to provide a safe and reliable service for the placement of central venous access devices

  18. Family participation during intensive care unit rounds: attitudes and experiences of parents and healthcare providers in a tertiary pediatric intensive care unit.

    Science.gov (United States)

    Stickney, Carolyn A; Ziniel, Sonja I; Brett, Molly S; Truog, Robert D

    2014-02-01

    To compare the experiences and attitudes of healthcare providers and parents regarding parental participation in morning rounds, in particular to evaluate for differences in perception of parental comprehension of rounds content and parental comfort with attendance, and to identify subgroups of parents who are more likely to report comfort with attending rounds. Cross-sectional survey of 100 parents and 131 healthcare providers in a tertiary care pediatric medical/surgical intensive care unit. Descriptive statistics were used to analyze survey responses; univariate and multivariate analyses were performed to compare parent and healthcare provider responses. Of parents, 92% reported a desire to attend rounds, and 54% of healthcare providers reported a preference for parental presence. There were significant discrepancies in perception of understanding between the 2 groups, with healthcare providers much less likely to perceive that parents understood both the format (30% vs 73%, P parents. Analysis of parent surveys did not reveal characteristics correlated with increased comfort or desire to attend rounds. A majority of parents wish to participate in morning rounds, whereas healthcare provider opinions are mixed. Important discrepancies exist between parent and healthcare provider perceptions of parental comfort and comprehension on rounds, which may be important in facilitating parental presence. Copyright © 2014 Mosby, Inc. All rights reserved.

  19. Organisation and experience of the regulatory review in the United Kingdom

    International Nuclear Information System (INIS)

    Gausden, R.; Woods, P.B.

    1979-01-01

    Regulatory requirements and stages of the review in the UK are outlined. The organisation, management and working procedures of the Inspectorate are described and the effort and timescale which have been found necessary for a satisfactory safety review is discussed. A number of problem areas in the review situation have been identified from experience and these are discussed and possible solutions proposed. They include the importance of early review of generic aspects of systems which are being considered for licensing, the place of safety principles and of detailed engineering assessment in the review process, the independence of the regulatory group's activities in its study of major technical issues and the use which should be made of outside expertise. (auth.)

  20. Finding a path through the health unit: practical experience of Ugandan patients.

    Science.gov (United States)

    Mogensen, Hanne O

    2005-01-01

    Finding one's way through a health facility is not necessarily an easy task for Ugandan patients. Our understanding of how people succeed in doing so, and of the obstacles they encounter on their way, is incomplete if we focus only on the cognitive level of the clinical encounter. Much research in public health and medical anthropology implicitly works with the notion that agency is located in the mind and that cognitive understanding is a precondition for practice. Based on material from eastern Uganda, this article explores the practical experience of Ugandan patients and their relatives and reflects upon the ways in which this notion of agency has often caused us to confuse the spectator's point of view with the actor's point of view. Thus, as Pierre Bourdieu has argued, we are made to look for answers to "questions that practice never asks because it has no need to ask them."

  1. [A unit for emergency psychiatry and crisis intervention--concepts, structure and initial experiences].

    Science.gov (United States)

    Feuerlein, W; Bronisch, T; Fürmaier, A

    1983-03-01

    The article reports on a ward with 12 beds which has been set up for emergency cases in psychiatry or for immediate intervention in case of a crisis experienced by a patient. In the theoretical part of this article, it is explained that crisis situations are present in most of the psychiatric emergency patients. The article then goes briefly into the fundamentals of therapeutic strategy in such patients: A therapy which helps to uncover hidden conflicts, the pros and cons of therapy focussed on conflict and on supportive measures; as well as a therapy which supports and promotes the ego. This is followed by a comparison of the ward with corresponding facilities in Germany and abroad and a description of their structure, their patients and their function within a psychiatric care system. The concluding part of the article is devoted to a description of the authors' initial experiences and impressions gained during their work with the ward patients, quoting several examples.

  2. Experiences with mobile units for liquid raw management in slovak and czech nuclear power plants

    International Nuclear Information System (INIS)

    Rapant, T.; Tatransky, P.; Vasko, M.; Hlavacka, R.

    2015-01-01

    Text describes the experience from multiple projects of retrieval, pre-treatment and final treatment of liquid radioactive waste in Slovak and Czech NPPs during last 20 years. The purpose of these projects was to retrieve RAW (sludge, used resins, crystalline sediments, other types of liquid RAW) from operational tanks or technological systems, its pre-treatment and its solidification into 200 l or 60 l drums. Slovak and Czech NPPs are WWER 440 type (except Bohunice A1 NPP) where operational liquid RAW should be stored in large capacity tanks during the whole operational period. Volume of tanks placed in auxiliary buildings is from 460 to 550 m 3 , usually they are situated in rooms with limited access and minimal handling space. The liquid RAW management process is described. (authors)

  3. [Care of mothers of newborns in intensive care units: experiences, feelings and expectations of the mothers].

    Science.gov (United States)

    Belli, M A

    1995-08-01

    The purpose of the study was to examine the experiences, feelings and expectation of mothers of high risk newborns. The population was a group of 20 mothers of high risk newborns of three hospitals in the City of São Paulo. Interview with the mothers was the method of data collection containing opened and structured questions. It was verified that most of the mothers had none or only a little interaction with the newborn after delivery; the eye contact was the most referred during the staying of the newborn in the Intensive Care Unity; all of them demonstrated interest in participating in the care of the newborn and expressed the need of information concerning to the health status of the newborn, the Intensive Care Unity environment and the hospital team. Several were the feelings expressed and the motives that indicated the needs of the mothers.

  4. The experiences of internationally educated nurses in the southeastern United States of America.

    Science.gov (United States)

    Wheeler, R M; Foster, J W; Hepburn, K W

    2013-09-01

    US healthcare facilities have addressed nursing shortages in part by recruiting internationally educated nurses (IENs), and studies suggest IENs may make up a significant percentage of the nursing workforce in urban hospitals. Despite the economic recession of 2008-2012, international nurse migration is expected to continue. Little is known about IENs in the southeastern USA, and no studies have compared their perspectives to those of their US counterparts. The purpose of this study was to gain a deeper understanding about the experiences of IENs compared to those of US registered nurses (RNs) practising in two urban hospitals in southeastern USA. This study involved two rounds of semi-structured interviews of 82 IENs and US RNs. Interviews focused on themes relating to education, barriers to practice, intent to stay in nursing and IENs' migration experiences. Most IENs interviewed migrated to the USA after 1990 to join their family and do not plan to return to their home countries to practise. Most IENs initially received their Associate Degree in Nursing; many have obtained their Bachelor of Science in Nursing degree. IENs and newly licensed US RNs faced similar barriers when they began practising in the USA, but IENs faced additional challenges adjusting to the attitudes of US patients, the perceived lack of respect for nurses and delivering total patient care. IENs would benefit from orientation regarding the cultural differences in the USA. In other ways, their challenges are similar to those of US RNs; policies regarding education, recruitment and retention could target both groups together. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.

  5. Free Trade Agreements With The United States: 8 Lessons For Prospective Parties From Australia’s Experience

    Directory of Open Access Journals (Sweden)

    Tully Stephen R.

    2016-12-01

    Full Text Available This article identifies 8 key lessons for those States contemplating a free trade agreement with the United States (U.S. arising from Australia’s experience. The standards of intellectual property protection under the Australia-U.S. Free Trade Agreement and their impact on pharmaceutical prices in Australia are a particular focus. Prospective parties must first conduct a national interest self-assessment which reviews the desired strength of intellectual property protection under national law and their preference for using flexibilities available to them under the existing international intellectual property rights framework. The United States negotiates free trade agreements in light of previous ones, negotiating outcomes obtained in other fora and the decisions of international trade tribunals. Negotiations typically occur behind closed doors, which is a process having adverse implications for transparent decision-making, public consultation periods and contributions from interested non-governmental actors. A concluded agreement will build on prior treaties and influence the course of future international arrangements. But the impact of a United States free trade agreement is not always clear, including because of a lack of reliable data, and the extent of national legal change is a contested issue given existing reform agendas and external influences. The United States seek to redesign national health care systems in its own image and had little success in Australia’s case. National legal systems need not be harmonised: although there can be some convergence in intellectual property rights regimes, significant differences may also remain. Negotiators must reconcile competing cultures, philosophies and perspectives between States for a free trade agreement to be worthwhile.

  6. Twenty-five years of transient counting experience in French PWR units

    Energy Technology Data Exchange (ETDEWEB)

    Barthelet, B. [Electricite de France (EDF DPN), 93 - Saint-Denis (France); Savoldelli, D.; Fritz, R. [Electricite de France (EDF DPN), 93 - Noisy le Grand (France)

    2001-07-01

    For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

  7. The 1951-98 experience of the Paris Institut Curie Radiopathology Unit: a preliminary report

    International Nuclear Information System (INIS)

    Cosset, J.M.; Perdereau, B.; Dubray, B.; Helfre, S.; Brixy, F.; Gongora, R.; Fourquet, A.

    1999-01-01

    From 1 January 1951 to 30 June 1998, 696 patients presented spontaneously or were referred to the French Institut Curie Radiopathology Unit following a more or less severe accidental irradiation. Of these, 568 patients came from France, while 128 were sent by various foreign countries. The very great majority of irradiation accidents occurred in the workplace, particularly in industry. Interestingly, 'non-nuclear' industry was responsible for three times more events than the nuclear industry. While incidental irradiation of the public by lost radioactive sources was exceedingly rare in France, it seemed to be more frequent in our cohort of foreign patients. Radiation phobia accounted for about 10% of cases in the French cohort, but the number of cases did not seem to increase with time. Overall, the accrual of patients over time appears to be stable, with 10 to 25 new cases consulting each year. Fortunately, a majority of cases corresponded to low-level irradiation (and even no irradiation at all). In the French cohort, only 21.6% of patients, showing deterministic effects, required some form of treatment, with 4.9% considered as 'severe' cases. Not unexpectedly, more patients required treatment in the foreign cohort (35.2%), with 24.2% of severe cases, including four deaths. The main features of this database are consistent with the data previously reported by the IAEA, UNSCEAR and REAC/TS. Although the number of severe cases is small, it should still be considered to be too high, especially as most of these accidents could have been easily avoided if a few basic radioprotection rules had been fully respected. (abstract)

  8. Radiation litigation and the nuclear industry--the experience in the United Kingdom.

    Science.gov (United States)

    Leigh, W J; Wakeford, R

    2001-12-01

    In the United Kingdom, the Nuclear Installations Act 1965 places a "strict" statutory duty on the operators of nuclear facilities to ensure that any exposure to radiation resulting from operations does not cause injury or damage. A claimant does not have to prove fault to receive compensation under the Act, only causation. The 1965 Act has been fundamental in shaping litigation involving the nuclear industry in the UK. Civil law cases brought under the Act will be heard before a single judge (with no jury or technical assessor) who must present his or her decision in a reasoned judgment. This process leads to a considerable volume of expert evidence being presented to the court and extensive cross-examination of witnesses. The expense and uncertain outcome of cases involving claims by nuclear workers that occupational exposure to radiation had caused the development of cancer has led to employers and trade unions setting up the voluntary Compensation Scheme for Radiation-linked Diseases as an alternative to litigation. This Scheme has worked well and is held up as a model of alternative dispute resolution. However, a few cases concerning personal injury or damage to property have come before the courts when the defendant nuclear operator considered that the claims were technically unjustified and where settlement was not a policy option. As anticipated, these cases were lengthy, complex, and expensive. The radiation doses assessed to have been received by the individuals who were the subject of claims, whether workers or members of the public, have been crucial to the outcome. The technical expertise of health physicists and allied specialists has been vital in establishing defensible estimates of dose, and this contribution can be expected to remain of high importance in radiation litigation in the UK.

  9. Summary of failed reactor coolant pump rotating assembly experience at Crystal River Unit 3

    International Nuclear Information System (INIS)

    Hayner, G.O.; Clary, M.D.

    1992-01-01

    Four reactor coolant pump (RCP) rotating assemblies (shafts) have failed or have severely cracked during operation at the Crystal River Unit 3 (CR-3) Nuclear Power Plant. The two failed shafts removed from RCP-1A have been extensively examined. All of the RCP shafts (except the D shaft) were fabricated from UNS S66286 superalloy (Alloy A-286). The D shaft was fabricated from UNS S20910 (Alloy XM-19/Nitronic 50). Torsional strain gauge analysis was performed on the RCP-1A shaft during the 1990 refueling outage. This type of analysis has not been performed previously on an operating RCP. Several results were found including: (1) the primary components of alternating torsional stress during normal RCP operation are impeller vane pass and a sub-2X torsional resonance with maximum components of ∼±0.8 ksi; (2) a typical vane pass cycle is initiated by an abrupt unloading of the shaft followed by a reload past equilibrium and a damped return to equilibrium; (3) a higher (compared to normal four pump operation) alternating torsional stress range resulted from solo operation of RCP-1A at low temperature and pressure (normal startup conditions); (4) the 2/0 combination produced the highest mean torsional stresses and the lowest alternating stresses and (5) a startup of a secured RCP with three operating pumps results in significantly higher alternating stress than a cold startup. The root cause RCP failure mechanism appears to involve RCP startup sequence at CR-3, peculiarities that necessitate this sequence and complex shaft stresses just above or under the journal bearing. The 1986 impeller bolt failure is not considered to be a root cause effect. It was also determined that fatigue cracking has always been responsible for both shaft initiation and propagation mechanisms and cracking can occur independent of shaft material

  10. Hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral®) as allergen: experience from a contact dermatitis unit.

    Science.gov (United States)

    Carvalho, Rodrigo; Maio, Paula; Amaro, Cristina; Santos, Raquel; Cardoso, Jorge

    2011-09-01

    Hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC)-Lyral® is a widely used synthetic fragrance found in personal care and household products. It is an aldehyde, lipophilic enough to penetrate the skin and is a frequent cause of contact sensitization. Describe the frequency of contact allergy to HICC in a Contact Dermatitis Unit, after its inclusion in baseline patch test series. A retrospective study including all patients submitted to patch test, from January 2007 to December 2009. Over a 3-year period, 629 consecutive patients were patch tested. The frequency of positive reactions to HICC was 2.7% (17/629). Of the positive patients, 35% (6/17) gave a history of atopy, 58.8% (10/17) had eczema on the face and neck, 23.5% (4/17) on the hands, 23.5% (4/17) in the axillae, 17.6% (3/17) on the trunk and 6% (3/17) had generalized eczema. All patients were patch positive for more than one allergen: all (17/17) positive to fragrance Mix 2 (FM2); 47% of the patients (8/17) positive to fragrance Mix 1 (FM1); and 23.5% of the patients (4/17) positive to Balsam of Peru. In 94% (16/17) of cases, the reaction was judged to be of current relevance. The frequency of positive reactions to HICC of 2.7% found in our population is according to what is described in several European reports, where HICC is still widely used as a fragrance ingredient. In contrast, in North America, the prevalence is lower. All the patients were positive also to FM2. The association found between reactions to FM1 and HICC is also commonly reported and could represent a concomitant sensitization following increased exposure to fragrance allergens. These data confirm the importance of HICC introduction in the baseline patch test series.

  11. The 1951-98 experience of the Paris Institut Curie Radiopathology Unit: a preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Cosset, J.M.; Perdereau, B.; Dubray, B.; Helfre, S.; Brixy, F.; Gongora, R.; Fourquet, A. [Institut Curie, 26 rue d' Ulm, 75005 Paris (France)

    1999-12-01

    From 1 January 1951 to 30 June 1998, 696 patients presented spontaneously or were referred to the French Institut Curie Radiopathology Unit following a more or less severe accidental irradiation. Of these, 568 patients came from France, while 128 were sent by various foreign countries. The very great majority of irradiation accidents occurred in the workplace, particularly in industry. Interestingly, 'non-nuclear' industry was responsible for three times more events than the nuclear industry. While incidental irradiation of the public by lost radioactive sources was exceedingly rare in France, it seemed to be more frequent in our cohort of foreign patients. Radiation phobia accounted for about 10% of cases in the French cohort, but the number of cases did not seem to increase with time. Overall, the accrual of patients over time appears to be stable, with 10 to 25 new cases consulting each year. Fortunately, a majority of cases corresponded to low-level irradiation (and even no irradiation at all). In the French cohort, only 21.6% of patients, showing deterministic effects, required some form of treatment, with 4.9% considered as 'severe' cases. Not unexpectedly, more patients required treatment in the foreign cohort (35.2%), with 24.2% of severe cases, including four deaths. The main features of this database are consistent with the data previously reported by the IAEA, UNSCEAR and REAC/TS. Although the number of severe cases is small, it should still be considered to be too high, especially as most of these accidents could have been easily avoided if a few basic radioprotection rules had been fully respected. (abstract)

  12. The Syrian civil war: The experience of the Surgical Intensive Care Units.

    Science.gov (United States)

    Ozdogan, Hatice Kaya; Karateke, Faruk; Ozdogan, Mehmet; Cetinalp, Sibel; Ozyazici, Sefa; Gezercan, Yurdal; Okten, Ali Ihsan; Celik, Muge; Satar, Salim

    2016-01-01

    Since the civilian war in Syria began, thousands of seriously injured trauma patients from Syria were brought to Turkey for emergency operations and/or postoperative intensive care. The aim of this study was to present the demographics and clinical features of the wounded patients in Syrian civil war admitted to the surgical intensive care units in a tertiary care centre. The records of 80 trauma patients admitted to the Anaesthesia, General Surgery and Neurosurgery ICUs between June 1, 2012 and July 15, 2014 were included in the study. The data were reviewed regarding the demographics, time of presentation, place of reference, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Injury Severity Score (ISS), surgical procedures, complications, length of stay and mortality. A total of 80 wounded patients (70 males and 10 females) with a mean age of 28.7 years were admitted to surgical ICUs. The most frequent cause of injury was gunshot injury. The mean time interval between the occurrence of injury and time of admission was 2.87 days. Mean ISS score on admission was 21, and mean APACHE II score was 15.7. APACHE II scores of non-survivors were significantly increased compared with those of survivors (P=0.001). No significant differences was found in the age, ISS, time interval before admission, length of stay in ICU, rate of surgery before or after admission. The most important factor affecting mortality in this particular trauma-ICU patient population from Syrian civil war was the physiological condition of patients on admission. Rapid transport and effective initial and on-road resuscitation are critical in decreasing the mortality rate in civil wars and military conflicts.

  13. Ethical challenges in the neonatal intensive care units: perceptions of physicians and nurses; an Iranian experience.

    Science.gov (United States)

    Kadivar, Maliheh; Mosayebi, Ziba; Asghari, Fariba; Zarrini, Pari

    2015-01-01

    The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of Iran. In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians' and nurses' perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations. The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22. Respecting patients' rights and interactions with parents were perceived as the most challenging aspects of neonatal care. There were significant differences between sexes in the domains of the perceived challenges. According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job. The results of our study showed that the most challenging issues were related to patients' rights, interactions with parents, communication and cooperation, and end of life considerations respectively. It can be concluded, therefore, that more attention should be paid to these issues in educational programs and ethics committees of hospitals.

  14. Twenty-five years of transient counting experience in French PWR units

    International Nuclear Information System (INIS)

    Barthelet, B.; Savoldelli, D.; Fritz, R.

    2001-01-01

    For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

  15. Look at Me!! I'm a Tree!: A Literacy-Based Integrated Thematic Unit on Forestry and Conservation Designed for Field Experiences in Early Childhood Education.

    Science.gov (United States)

    Mayo, Karen E.

    This paper describes a literacy-based thematic unit on forestry and conservation designed for field experiences in early childhood education. This unit responds to national and state initiatives and serves as a model for enacting reform of science instruction by equipping preservice teachers with the necessary strategies to foster science process…

  16. Tinnitus services in the United Kingdom: a survey of patient experiences.

    Science.gov (United States)

    McFerran, Don; Hoare, Derek J; Carr, Simon; Ray, Jaydip; Stockdale, David

    2018-02-13

    Tinnitus service provision in the United Kingdom has been investigated from the healthcare provider's perspective demonstrating considerable regional variation particularly regarding availability of psychological treatments. An audiological-based tinnitus service, however, was reportedly available for all tinnitus patients in the UK. The aim of the current study was to define and evaluate nationwide tinnitus healthcare services from the patients' viewpoint. Secondary analyses were performed on data from a 33-item questionnaire provided by the British Tinnitus Association. The questionnaire had been distributed via email and social media. Responses from 937 participants who had or had previously experienced tinnitus were analysed. All but one person had at some time consulted their GP. About one in five received medication in primary care. The majority were referred to secondary care, generally an ENT surgeon or audiovestibular physician; some were referred directly to audiological services. In secondary care the majority underwent audiometric testing and over half underwent MRI scanning. Drugs were prescribed less frequently in secondary care. About one third of patients were referred onwards from diagnostic services in secondary care to receive therapeutic interventions for tinnitus. Therapy was generally delivered by an audiologist or hearing therapist. Just under two fifths of people discharged from secondary care returned to their GP, with most returning within one year. Over a third of this group were re-referred to secondary care. Few patients saw a psychologist (2.6%) though some psychological treatments were delivered by appropriately trained audiologists. Negative counselling from healthcare professionals in both primary and secondary care settings was reported. Although the UK has developed a national service for patients with tinnitus many people find it difficult to access, being blocked at the primary care level or after secondary care diagnostic

  17. Experience with using second life for medical education in a family and community medicine education unit

    Directory of Open Access Journals (Sweden)

    Melús-Palazón Elena

    2012-05-01

    Full Text Available Abstract Background The application of new technologies to the education of health professionals is both a challenge and a necessity. Virtual worlds are increasingly being explored as a support for education. Aim: The aim of this work is to study the suitability of Second Life (SL as an educational tool for primary healthcare professionals. Methods Design: Qualitative study of accredited clinical sessions in SL included in a continuing professional development (CPD programme for primary healthcare professionals. Location: Zaragoza I Zone Family and Community Medicine Education Unit (EU and 9 health centres operated by the Aragonese Health Service, Aragon, Spain. Method: The EU held two training workshops in SL for 16 healthcare professionals from 9 health centres by means of two workshops, and requested them to facilitate clinical sessions in SL. Attendance was open to all personnel from the EU and the 9 health centres. After a trail period of clinical sessions held at 5 health centres between May and November 2010, the CPD-accredited clinical sessions were held at 9 health centres between February and April 2011. Participants: 76 healthcare professionals attended the CPD-accredited clinical sessions in SL. Main measurements: Questionnaire on completion of the clinical sessions. Results Response rate: 42-100%. Questionnaire completed by each health centre on completion of the CPD-accredited clinical sessions: Access to SL: 2 centres were unable to gain access. Sound problems: 0% (0/9. Image problems: 0% (0/9. Voice/text chat: used in 100% (10/9; 0 incidents. Questionnaire completed by participants in the CPD-accredited clinical sessions: Preference for SL as a tool: 100% (76/76. Strengths of this method: 74% (56/76 considered it eliminated the need to travel; 68% (52/76 believed it made more effective use of educational resources; and 47% (36/76 considered it improved accessibility. Weaknesses: 91% (69/76 experienced technical problems, while; 9

  18. Experience with using second life for medical education in a family and community medicine education unit.

    Science.gov (United States)

    Melús-Palazón, Elena; Bartolomé-Moreno, Cruz; Palacín-Arbués, Juan Carlos; Lafuente-Lafuente, Antonio; García, Inmaculada García; Guillen, Sara; Esteban, Ana B; Clemente, Silvia; Marco, Angeles M; Gargallo, Pilar M; López, Carlos; Magallón-Botaya, Rosa

    2012-05-15

    The application of new technologies to the education of health professionals is both a challenge and a necessity. Virtual worlds are increasingly being explored as a support for education. The aim of this work is to study the suitability of Second Life (SL) as an educational tool for primary healthcare professionals. Qualitative study of accredited clinical sessions in SL included in a continuing professional development (CPD) programme for primary healthcare professionals. Zaragoza I Zone Family and Community Medicine Education Unit (EU) and 9 health centres operated by the Aragonese Health Service, Aragon, Spain. The EU held two training workshops in SL for 16 healthcare professionals from 9 health centres by means of two workshops, and requested them to facilitate clinical sessions in SL. Attendance was open to all personnel from the EU and the 9 health centres. After a trail period of clinical sessions held at 5 health centres between May and November 2010, the CPD-accredited clinical sessions were held at 9 health centres between February and April 2011. 76 healthcare professionals attended the CPD-accredited clinical sessions in SL. Questionnaire on completion of the clinical sessions. Response rate: 42-100%. Questionnaire completed by each health centre on completion of the CPD-accredited clinical sessions: Access to SL: 2 centres were unable to gain access. Sound problems: 0% (0/9). Image problems: 0% (0/9). Voice/text chat: used in 100% (10/9); 0 incidents. Questionnaire completed by participants in the CPD-accredited clinical sessions: Preference for SL as a tool: 100% (76/76). Strengths of this method: 74% (56/76) considered it eliminated the need to travel; 68% (52/76) believed it made more effective use of educational resources; and 47% (36/76) considered it improved accessibility. Weaknesses: 91% (69/76) experienced technical problems, while; 9% (7/76) thought it was impersonal and with little interaction. 65.79% (50/76) believed it was better than

  19. Operational accidents and radiation exposure experience within the United States Atomic Energy Commission, 1943--1975

    International Nuclear Information System (INIS)

    1975-01-01

    The occupational injury and fatality experience during 32 years of the development of the atomic energy industry under the direction of the Atomic Energy Commission (AEC) and its predecessor, the Manhattan Engineering District, is reviewed. Data are included on the cause of all accidents, including fires and transportation accidents, and the cost of AEC property damage. Fatalities of AEC and contractor personnel from all causes during the 32-year period totaled 321, of which 184 occurred in construction; 121 in AEC operations such as production, research, and services; and 16 in Government functions. There were 19,225 lost-time injuries attributable to all accidental causes, or a 32-year frequency rate of 2.75 based on the number of injuries per million man-hours. There were six deaths attributable to nuclear causes, thee of which were due to blast and flying missiles and three caused by whole-body radiation exposure. Forty-one workers were involved in lost-time radiation accidents, of whom 26 showed clinical manifestations attributable to radiation, resulting in permanent partial-disability of three workers and the loss of a digit by four workers, while the others did not develop evidence of radiation injury

  20. Control and management unit for a computation platform at the PANDA experiment

    Energy Technology Data Exchange (ETDEWEB)

    Galuska, Martin; Gessler, Thomas; Kuehn, Wolfgang; Lang, Johannes; Lange, Jens Soeren; Liang, Yutie; Liu, Ming; Spruck, Bjoern; Wang, Qiang [II. Physikalisches Institut, Justus-Liebig-Universitaet Giessen (Germany)

    2010-07-01

    The FAIR facility will provide high intensity antiproton and heavy ion beams for the PANDA and HADES experiments, leading to very high reaction rates. PANDA is expected to run at 10-20 MHz with a raw data output rate of up to 200 GB/s. A sophisticated data acquisition system is needed in order to select physically relevant events online. For this purpose a network of interconnected compute nodes can be used. Each compute node can be programmed to run various algorithms, such as online particle track recognition for high level triggering. An ATCA communication shelf provides power, cooling and high-speed interconnections to up to 14 nodes. A single shelf manager supervises and regulates the power distribution and temperature inside the shelf. The shelf manager relies on a local control chip on each node to relay sensor read-outs, provide hardware adresses and power requirements etc. An IPM controller based on an Atmel microcontroller was designed for this purpose, and a prototype was produced. The neccessary software is being developed to allow local communication with the components of the compute node and remote communication with the shelf manager conform to the ATCA specification.

  1. Lived experiences of parents of premature babies in the intensive care unit in a private hospital in Johannesburg, South Africa

    Directory of Open Access Journals (Sweden)

    Erika Steyn

    2017-02-01

    Full Text Available Background: Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU, and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. Objectives: The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. Method: Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, nonmaleficence and justice were adhered to throughout the research process. Results: Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences. Recommendations: Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU. Conclusion: Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents’ relationships.

  2. Lived experiences of parents of premature babies in the intensive care unit in a private hospital in Johannesburg, South Africa.

    Science.gov (United States)

    Steyn, Erika; Poggenpoel, Marie; Myburgh, Chris

    2017-02-28

    Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU), and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, nonmaleficence and justice were adhered to throughout the research process. Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences. Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU. Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents' relationships.

  3. Can cancer researchers accurately judge whether preclinical reports will reproduce?

    Directory of Open Access Journals (Sweden)

    Daniel Benjamin

    2017-06-01

    Full Text Available There is vigorous debate about the reproducibility of research findings in cancer biology. Whether scientists can accurately assess which experiments will reproduce original findings is important to determining the pace at which science self-corrects. We collected forecasts from basic and preclinical cancer researchers on the first 6 replication studies conducted by the Reproducibility Project: Cancer Biology (RP:CB to assess the accuracy of expert judgments on specific replication outcomes. On average, researchers forecasted a 75% probability of replicating the statistical significance and a 50% probability of replicating the effect size, yet none of these studies successfully replicated on either criterion (for the 5 studies with results reported. Accuracy was related to expertise: experts with higher h-indices were more accurate, whereas experts with more topic-specific expertise were less accurate. Our findings suggest that experts, especially those with specialized knowledge, were overconfident about the RP:CB replicating individual experiments within published reports; researcher optimism likely reflects a combination of overestimating the validity of original studies and underestimating the difficulties of repeating their methodologies.

  4. [Towards a safety culture in the neonatal unit: Six years experience].

    Science.gov (United States)

    Esqué Ruiz, M T; Moretones Suñol, M G; Rodríguez Miguélez, J M; Parés Tercero, S; Cortés Albuixech, R; Varón Ramírez, E M; Figueras Aloy, J

    2015-10-01

    A safety culture is the collective effort of an institution to direct its resources toward the goal of safety. An analysis is performed on the six years of experience of the Committee on the Safety of Neonatal Patient. A mailbox was created for the declaration of adverse events, and measures for their correction were devised, such as case studies, continuous education, prevention of nosocomial infections, as well as information on the work done and its assessment. A total of 1287 reports of adverse events were received during the six years, of which 600 (50.8%) occurred in the neonatal ICU, with 15 (1.2%) contributing to death, and 1282 (99.6%) considered preventable. Simple corrective measures (notification, security alerts, etc.) were applied in 559 (43.4%), intermediate measures (protocols, monthly newsletter, etc.) in 692 (53.8%), and more complex measures (causal analysis, scripts, continuous education seminars, prospective studies, etc.) in 66 (5.1%). As regards nosocomial infections, the prevention strategies implemented (hand washing, insertion and maintenance of catheters) directly affected their improvement. Two surveys were conducted to determine the level of satisfaction with the Committee on the Safety of Neonatal Patient. A rating 7.5/10 was obtained in the local survey, while using the Spanish version of the Hospital Survey on Patient Safety Culture the rate was 7.26/10. A path to a culture of safety has been successfully started and carried out. Reporting the adverse events is the key to obtaining information on their nature, etiology and evolution, and to undertake possible prevention strategies. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  5. Experience with Stabilization of SGHWR Sludge in a Commercial Plant in the United Kingdom

    International Nuclear Information System (INIS)

    Hagan, M.; Cornell, R.M.; Riley, B.; Ware, B.

    2009-01-01

    buffer store to hold the completed drums. After completion, drums are moved in a shielded overpack to the Treated Radwaste Store located on a different part of the Winfrith site. More than 300 m 3 of active sludge, held in four adjacent concrete tanks, has now been stabilised into 978 drums that have been placed into the dedicated store. The process of recovery and homogenization of the residual sludge in the bottom of each tank to the required specification will be described together with the means of recovery and disposal options for a quantity of unexpected materials found at the bottom of each unit. The means of dealing with the final quantities of sludge and water from the last two concrete tanks by recovering it into a tall steel filtration vessel located within one concrete tank will also be described. The final aspects of the paper will briefly describe the approach to be adopted for the final decontamination and demolition of both the EAST facility and WETP plant. The WETP plant is now in the latter stages of commercial operation leading to a second programme of stabilisation of a quantity of thorium metal for UKAEA ahead of its final decommissioning and demolition. (authors)

  6. Computerized Virtual Reality Simulation in Preclinical Dentistry: Can a Computerized Simulator Replace the Conventional Phantom Heads and Human Instruction?

    Science.gov (United States)

    Plessas, Anastasios

    2017-10-01

    In preclinical dental education, the acquisition of clinical, technical skills, and the transfer of these skills to the clinic are paramount. Phantom heads provide an efficient way to teach preclinical students dental procedures safely while increasing their dexterity skills considerably. Modern computerized phantom head training units incorporate features of virtual reality technology and the ability to offer concurrent augmented feedback. The aims of this review were to examine and evaluate the dental literature for evidence supporting their use and to discuss the role of augmented feedback versus the facilitator's instruction. Adjunctive training in these units seems to enhance student's learning and skill acquisition and reduce the required faculty supervision time. However, the virtual augmented feedback cannot be used as the sole method of feedback, and the facilitator's input is still critical. Well-powered longitudinal randomized trials exploring the impact of these units on student's clinical performance and issues of cost-effectiveness are warranted.

  7. Patient with giant upper limb melanoma presenting to a UK plastic surgery unit: differentials and experience of management.

    Science.gov (United States)

    Honeyman, Calum Sinclair; Wilson, Paul

    2016-02-02

    A 57-year-old woman was referred to our regional sarcoma unit following a 2-year history of a progressively enlarging mass on her right forearm. At 14 × 7 × 12 cm, this mass turned out to be one of the largest upper limb cutaneous malignant melanomas ever described, and, to the best of our knowledge, the first documented in the UK. Remarkably, despite having a T4 malignant tumour with a Breslow thickness of 70 mm, this patient is still alive over 4 years later with no locoregional or distant metastatic spread. We present our experience in the management of this giant malignant melanoma of the upper limb and consider important differentials. 2016 BMJ Publishing Group Ltd.

  8. [Pilot-experience in home care: bedridden aged patients of a basic health unit, Porto Alegre, Brazil].

    Science.gov (United States)

    Marques, Giselda Quintana; Freitas, Ivani Bueno de Almeida

    2009-12-01

    The objectives of this study were to describe the development of a pilot-project in home care to bedridden aged patients at a Basic Health Unit, and identify demographic, social and health aspects of these patients, as well as relevant aspects reported by the health team that implemented the home care. The study had descriptive and evaluative characteristics. The patients' enrollment forms and health records and the project's records were analyzed. The pilot-experience permitted to develop the team's skills, in addition to being enriching and of great responsibility for the professionals and caregivers involved. The results indicated the need for continuous home care and adjustments in its organization with the purpose of increasing the areas for health care and improving the population's quality of life.

  9. Traumatic brain injury rehabilitation, the programs applied in French UEROS units, and the specificity of the Limoges experience.

    Science.gov (United States)

    Hamonet-Torny, J; Fayol, P; Faure, P; Carrière, H; Dumond, J-J

    2013-04-01

    First created in 1996, the French evaluation, retraining, social and vocational orientation units (UEROS) now play a fundamental role in the social and vocational rehabilitation of patients with brain injury. As of today, there exist 30 UEROS centers in France. While their care and treatment objectives are shared, their means of assessment and retraining differ according to the experience of each one. The objective of this article is to describe the specific programs and the different tools put to work in the UEROS of Limoges. The UEROS of Limoges would appear to offer a form of holistic rehabilitation management characterized by the importance of psycho-education and its type of approach towards vocational reintegration. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  10. Review of operational experience with the gas-cooled Magnox reactors of the United Kingdom Central Electricity Generating Board

    International Nuclear Information System (INIS)

    Cave, L.; Clarke, A.W.

    1984-01-01

    The paper provides a review, which is mainly of a statistical nature, of 260 reactor years of operating experience which the (United Kingdom) Central Electricity Generating Board (CEGB) has obtained with its gas-cooled, graphite moderated Magnox reactors. The main emphasis in the review is on safety rather than on availability. Data are provided on the overall incidence and frequencies of faults and it is shown that the plant items which are predominantly responsible for recorded faults are the gas circulators and the turbo-alternators. Analysis of the reactor trip experience shows that the incidence of events which necessitate an automatic shutdown of the reactor has been about one per reactor year and that of other events leading to a reactor trip has not been much higher (1.4 per reactor year). As would be expected from the length of the operating experience, some relatively rare events have occurred (expected frequency 10 -2 per reactor year, or less) but on each occasion the reactor shutdown system and decay heat removal systems functioned satisfactorily. No overheating of, or damage to, the fuel occurred as a result of these rare events or of other, more frequent, faults. Analysis of the trend of failure rates has shown an improvement with time in nearly all safety-related items and external inspection of the primary coolant circuits has shown no significant deterioration with time. However, some derating of the reactors has been necessary to reduce the effects of oxidation of mild steel in CO 2 , in order to obtain optimum service lives. In spite of major differences between the systems, a comparison of the failure rates of analogous systems and plant items in PWRs and the Magnox reactors show a considerable similarity. Overall, the review of CEGB's operational experience with its Magnos reactors has shown that the frequencies of faults in systems and plant items has been satisfyingly low. (author)

  11. AN EXPERIENCE OF HANDLING MICROBIAL CONTAMINATION OF PRODUCT WATER AT A HAEMODIALYSIS UNIT IN NORTH KARNATAKA OF INDIA

    Directory of Open Access Journals (Sweden)

    Archana Aravindrao Dambal

    2017-09-01

    Full Text Available BACKGROUND Dialysis units need regular prophylactic disinfection of the dialysis water production and distribution circuit without which there can be chronic inflammation among patients using the facility. The aim of the study is to present here our experience in containing an episode of microbial contamination of dialysis water. MATERIALS AND METHODS Our haemodialysis unit had a single pass reverse osmosis plant with facility for pretreatment of raw water and a distribution loop of medical grade PVC (polyvinyl chloride feeding haemodialysis machines, bicarbonate preparation and dialyser reprocessing areas. After installation, the Reverse Osmosis (RO membranes and distribution loop were disinfected every fortnight using formalin. Cultures of product water were sent from various sites in the product water loop every month. RESULTS From January to April 2011, 15 water samples out of 52 water samples grew Pseudomonas aeruginosa with a colony count over 200 Colony-Forming Units (CFU. The average monthly number of haemodialysis was reduced from 84.75 to 65. Two patients had intradialytic pyrexia and two others had mild lower respiratory infection. So, the reverse osmosis plant and product water distribution system were repeatedly disinfected using 2% formalin and 1% bleach ensuring contact time and thorough rinsing to address persistent cultures. When these measures could not eradicate microbial growth, the system was sanitised with Gramicid (48% w/w H2O2 + 500 ppm Ag and all traces of the disinfectant were rinsed away before resuming haemodialysis. CONCLUSION The microbial contamination of dialysis water was eradicated by Gramicid and not by bleach or formalin without any adverse effects after thorough rinsing.

  12. Taiwanese parents' experience of making a "do not resuscitate" decision for their child in pediatric intensive care unit.

    Science.gov (United States)

    Liu, Shu-Mei; Lin, Hung-Ru; Lu, Frank L; Lee, Tzu-Ying

    2014-03-01

    The purpose of this project was to explore the parental experience of making a "do not resuscitate" (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. Three major themes were identified: (a) "convincing points to sign", (b) "feelings immediately after signing", and (c) "post-signing relief or regret". Feelings following signing the DNR form were mixed and included "frustration", "guilt", and "conflicting hope". Parents adjusted their attitudes to thoughts such as "I have done my best," and "the child's life is beyond my control." Some parents whose child had died before the time of the interview expressed among other things "regret not having enough time to be with and talk to my child". Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process. Copyright © 2013. Published by Elsevier B.V.

  13. United States experience in environmental cost-benefit analysis for nuclear power plants with implications for developing countries

    International Nuclear Information System (INIS)

    Spangler, M.B.

    1980-08-01

    Environmental cost-benefit analysis in the United States involves a comparison of diverse societal impacts of the proposed developments and its alternatives. Regarding nuclear power plant licensing actions, such analyses include the need for base-load electrical generating capacity versus the no-action alternative; alternative sources of energy; alternative sites for the proposed nuclear plants; and alternative technologies for mitigating environmental impacts. Many U.S. experiences and environmental assessment practices and comparative resource requirements presented in this report will not provide a wholly reliable reflection of the precise situation of each country. Nevertheless, the procedural and substantive issues encountered by the United States in nuclear power plant licensing may exhibit a number of important, if rough, parallelisms for other countries. Procedural issues dealt with include: the scoping of alternatives and impact issues; the problem of balancing incommensurable impacts; and treating uncertainty in measuring or forecasting certain kinds of environmental impacts. Although substantive environmental impact issues will vary appreciably among nations, it is to be expected that many of the substantive impact issues such as impacts on biota, community-related effects, and aesthetic impacts will also have some measure of universal interest to other countries

  14. Kidney Paired Donation and the "Valuable Consideration" Problem: The Experiences of Australia, Canada, and the United States.

    Science.gov (United States)

    Toews, Maeghan; Giancaspro, Mark; Richards, Bernadette; Ferrari, Paolo

    2017-09-01

    As organ donation rates remain unable to meet the needs of individuals waiting for transplants, it is necessary to identify reasons for this shortage and develop solutions to address it. The introduction of kidney paired donation (KPD) programs represents one such innovation that has become a valuable tool in donation systems around the world. Although KPD has been successful in increasing kidney donation and transplantation, there are lingering questions about its legality. Donation through KPD is done in exchange for-and with the expectation of-a reciprocal kidney donation and transplantation. It is this reciprocity that has caused concern about whether KPD complies with existing law. Organ donation systems around the world are almost universally structured to legally prohibit the commercial exchange of organs. Australia, Canada, and the United States have accomplished this goal by prohibiting the exchange of an organ for "valuable consideration," which is a legal term that has not historically been limited to monetary exchange. Whether or not KPD programs violate this legislative prohibition will depend on the specific legislative provision being considered, and the legal system and case law of the particular jurisdiction in question. This article compares the experiences of Australia, Canada, and the United States in determining the legality of KPD and highlights the need for legal clarity and flexibility as donation and transplantation systems continue to evolve.

  15. Experiences of patients with cancer and their nurses on the conditions of spiritual care and spiritual interventions in oncology units.

    Science.gov (United States)

    Rassouli, Maryam; Zamanzadeh, Vahid; Ghahramanian, Akram; Abbaszadeh, Abbas; Alavi-Majd, Hamid; Nikanfar, Alireza

    2015-01-01

    Although nurses acknowledge that spiritual care is part of their role, in reality, it is performed to a lesser extent. The purpose of the present study was to explore nurses' and patients' experiences about the conditions of spiritual care and spiritual interventions in the oncology units of Tabriz. This study was conducted with a qualitative conventional content analysis approach in the oncology units of hospitals in Tabriz. Data were collected through purposive sampling by conducting unstructured interviews with 10 patients and 7 nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control. Three categories emerged from the study: (1) "perceived barriers for providing spiritual care" including "lack of preparation for spiritual care," "time and space constraints," "unprofessional view," and "lack of support"; (2) "communication: A way for Strengthening spirituality despite the limitations" including "manifestation of spirituality in the appearances and communicative behaviors of nurses" and "communication: Transmission of spiritual energy"; and (3) "religion-related spiritual experiences" including "life events as divine will and divine exam," "death as reincarnation," "trust in God," "prayer/recourse to Holy Imams," and "acceptance of divine providence." Although nurses had little skills in assessing and responding to the patients' spiritual needs and did not have the organizational and clergymen's support in dealing with the spiritual distress of patients, they were the source of energy, joy, hope, and power for patients by showing empathy and compassion. The patients and nurses were using religious beliefs mentioned in Islam to strengthen the patients' spiritual dimension. According to the results, integration of spiritual care in the curriculum of nursing is recommended. Patients and nurses can benefit from organizational and clergymen's support to cope with spiritual distress. Researchers should

  16. Promoting evidence based medicine in preclinical medical students via a federated literature search tool.

    Science.gov (United States)

    Keim, Samuel Mark; Howse, David; Bracke, Paul; Mendoza, Kathryn

    2008-01-01

    Medical educators are increasingly faced with directives to teach Evidence Based Medicine (EBM) skills. Because of its nature, integrating fundamental EBM educational content is a challenge in the preclinical years. To analyse preclinical medical student user satisfaction and feedback regarding a clinical EBM search strategy. The authors introduced a custom EBM search option with a self-contained education structure to first-year medical students. The implementation took advantage of a major curricular change towards case-based instruction. Medical student views and experiences were studied regarding the tool's convenience, problems and the degree to which they used it to answer questions raised by case-based instruction. Surveys were completed by 70% of the available first-year students. Student satisfaction and experiences were strongly positive towards the EBM strategy, especially of the tool's convenience and utility for answering issues raised during case-based learning sessions. About 90% of the students responded that the tool was easy to use, productive and accessed for half or more of their search needs. This study provides evidence that the integration of an educational EBM search tool can be positively received by preclinical medical students.

  17. A student-initiated and student-facilitated international health elective for preclinical medical students

    Directory of Open Access Journals (Sweden)

    Nirali Vora

    2010-02-01

    Full Text Available Introduction: Global health education is becoming more important for developing well-rounded physicians and may encourage students toward a career in primary care. Many medical schools, however, lack adequate and structured opportunities for students beginning the curriculum. Methods: Second-year medical students initiated, designed, and facilitated a pass–fail international health elective, providing a curricular framework for preclinical medical students wishing to gain exposure to the clinical and cultural practices of a developing country. Results: All course participants (N=30 completed a post-travel questionnaire within one week of sharing their experiences. Screening reflection essays for common themes that fulfill university core competencies yielded specific global health learning outcomes, including analysis of health care determinants. Conclusion: Medical students successfully implemented a sustainable global health curriculum for preclinical student peers. Financial constraints, language, and organizational burdens limit student participation. In future, long-term studies should analyze career impact and benefits to the host country.

  18. A student-initiated and student-facilitated international health elective for preclinical medical students.

    Science.gov (United States)

    Vora, Nirali; Chang, Mina; Pandya, Hemang; Hasham, Aliya; Lazarus, Cathy

    2010-02-15

    Global health education is becoming more important for developing well-rounded physicians and may encourage students toward a career in primary care. Many medical schools, however, lack adequate and structured opportunities for students beginning the curriculum. Second-year medical students initiated, designed, and facilitated a pass-fail international health elective, providing a curricular framework for preclinical medical students wishing to gain exposure to the clinical and cultural practices of a developing country. All course participants (N=30) completed a post-travel questionnaire within one week of sharing their experiences. Screening reflection essays for common themes that fulfill university core competencies yielded specific global health learning outcomes, including analysis of health care determinants. Medical students successfully implemented a sustainable global health curriculum for preclinical student peers. Financial constraints, language, and organizational burdens limit student participation. In future, long-term studies should analyze career impact and benefits to the host country.

  19. Preclinical Alzheimer disease and risk of falls.

    Science.gov (United States)

    Stark, Susan L; Roe, Catherine M; Grant, Elizabeth A; Hollingsworth, Holly; Benzinger, Tammie L; Fagan, Anne M; Buckles, Virginia D; Morris, John C

    2013-07-30

    We determined the rate of falls among cognitively normal, community-dwelling older adults, some of whom had presumptive preclinical Alzheimer disease (AD) as detected by in vivo imaging of fibrillar amyloid plaques using Pittsburgh compound B (PiB) and PET and/or by assays of CSF to identify Aβ₄₂, tau, and phosphorylated tau. We conducted a 12-month prospective cohort study to examine the cumulative incidence of falls. Participants were evaluated clinically and underwent PiB PET imaging and lumbar puncture. Falls were reported monthly using an individualized calendar journal returned by mail. A Cox proportional hazards model was used to test whether time to first fall was associated with each biomarker and the ratio of CSF tau/Aβ₄₂ and CSF phosphorylated tau/Aβ₄₂, after adjustment for common fall risk factors. The sample (n = 125) was predominately female (62.4%) and white (96%) with a mean age of 74.4 years. When controlled for ability to perform activities of daily living, higher levels of PiB retention (hazard ratio = 2.95 [95% confidence interval 1.01-6.45], p = 0.05) and of CSF biomarker ratios (p risk factor for falls in older adults. This study suggests that subtle noncognitive changes that predispose older adults to falls are associated with AD and may precede detectable cognitive changes.

  20. Time management for preclinical safety professionals.

    Science.gov (United States)

    Wells, Monique Y

    2010-08-01

    A survey about time management in the workplace was distributed to obtain a sense of the level of job satisfaction among preclinical safety professionals in the current economic climate, and to encourage reflection upon how we manage time in our work environment. Roughly equal numbers of respondents (approximately 32%) identified themselves as management or staff, and approximately 27% indicated that they are consultants. Though 45.2% of respondents indicated that time management is very challenging for the profession in general, only 36.7% find it very challenging for themselves. Ten percent of respondents view time management to be exceedingly challenging for themselves. Approximately 34% of respondents indicated that prioritization of tasks was the most challenging aspect of time management for them. Focusing on an individual task was the second most challenging aspect (26%), followed equally by procrastination and delegation of tasks (12.4%). Almost equal numbers of respondents said that they would (35.2%) or might (33.3%) undertake training to improve their time management skills. Almost equal numbers of participants responded "perhaps" (44.6%) or "yes" (44.2%) to the question of whether management personnel should be trained in time management.

  1. Detection of preclinical Parkinson's disease with PET

    International Nuclear Information System (INIS)

    Brooks, D.J.

    1991-01-01

    Putamen 18F-dopa uptake of patients with Parkinson's disease (PD) is reduced by at least 35% at onset of symptoms; therefore, positron-emission tomography (PET) can be used to detect preclinical disease in clinically unaffected twins and relatives of patients with PD. Three out of 6 monozygotic and 2 out of 3 dizygotic unaffected PD co-twins have shown reduced putamen 18F-dopa uptake to date. In addition, an intact sibling and a daughter of 1 of 4 siblings with PD both had low putamen 18F-dopa uptake. These preliminary findings suggest there may be a familial component to the etiology of PD. PET can also be used to detect underlying nigral pathology in patients with isolated tremor and patients who become rigid taking dopamine-receptor blocking agents (DRBAs). Patients with familial essential tremor have normal, and those with isolated rest tremor have consistently low, putamen 18F-dopa uptake. Drug-induced parkinsonism is infrequently associated with underlying nigral pathology

  2. Quetiapine: recent developments in preclinical research

    Directory of Open Access Journals (Sweden)

    Marco Orsetti

    2010-03-01

    Full Text Available Quetiapine (QTP is an atypical antipsychotic labelled for the treatment of patients with schizophrenia, bipolar mania and bipolar depression. Nevertheless, QTP has been tried across multiple diagnosis categories and seems to be used, among other atypical antipsychotics, in clinical practice for an expanding range of disorders such as major depression, substance abuse disorders, anxiety disorders, and borderline personality disorders. The present review focuses on papers which investigated the molecular mechanism(s of QTP antidepressant effect. In particular, preclinical studies performed by coupling the chronic mild stress, an animal model of human depression with Affymetrix microarray technology, revealed that chronic QTP administration prevented the stress-induced up- or down-regulation of 42 genes involved in the central nervous system development or having a crucial role for viability of neural cells, like regulation of signal transduction, inorganic ion transport, membrane organisation, and neurite morphogenesis. Among these, Ptgs2, Hes5, Plcb1, Senp2, Gad1, and Marcks are presumably the effectors of the QTP clinical efficacy.

  3. Preclinical animal anxiety research - flaws and prejudices.

    Science.gov (United States)

    Ennaceur, Abdelkader; Chazot, Paul L

    2016-04-01

    The current tests of anxiety in mice and rats used in preclinical research include the elevated plus-maze (EPM) or zero-maze (EZM), the light/dark box (LDB), and the open-field (OF). They are currently very popular, and despite their poor achievements, they continue to exert considerable constraints on the development of novel approaches. Hence, a novel anxiety test needs to be compared with these traditional tests, and assessed against various factors that were identified as a source of their inconsistent and contradictory results. These constraints are very costly, and they are in most cases useless as they originate from flawed methodologies. In the present report, we argue that the EPM or EZM, LDB, and OF do not provide unequivocal measures of anxiety; that there is no evidence of motivation conflict involved in these tests. They can be considered at best, tests of natural preference for unlit and/or enclosed spaces. We also argued that pharmacological validation of a behavioral test is an inappropriate approach; it stems from the confusion of animal models of human behavior with animal models of pathophysiology. A behavioral test is developed to detect not to produce symptoms, and a drug is used to validate an identified physiological target. In order to overcome the major methodological flaws in animal anxiety studies, we proposed an open space anxiety test, a 3D maze, which is described here with highlights of its various advantages over to the traditional tests.

  4. Experience in connecting the power generating units of thermal power plants to automatic secondary frequency regulation within the united power system of Russia

    International Nuclear Information System (INIS)

    Zhukov, A. V.; Komarov, A. N.; Safronov, A. N.; Barsukov, I. V.

    2009-01-01

    The principles of central control of the power generating units of thermal power plants by automatic secondary frequency and active power overcurrent regulation systems, and the algorithms for interactions between automatic power control systems for the power production units in thermal power plants and centralized systems for automatic frequency and power regulation, are discussed. The order of switching the power generating units of thermal power plants over to control by a centralized system for automatic frequency and power regulation and by the Central Coordinating System for automatic frequency and power regulation is presented. The results of full-scale system tests of the control of power generating units of the Kirishskaya, Stavropol, and Perm GRES (State Regional Electric Power Plants) by the Central Coordinating System for automatic frequency and power regulation at the United Power System of Russia on September 23-25, 2008, are reported.

  5. Early bedside care during preclinical medical education: can technology-enhanced patient simulation advance the Flexnerian ideal?

    Science.gov (United States)

    Gordon, James A; Hayden, Emily M; Ahmed, Rami A; Pawlowski, John B; Khoury, Kimberly N; Oriol, Nancy E

    2010-02-01

    Flexner wanted medical students to study at the patient bedside-a remarkable innovation in his time-so that they could apply science to clinical care under the watchful eye of senior physicians. Ever since his report, medical schools have reserved the latter years of their curricula for such an "advanced" apprenticeship, providing clinical clerkship experiences only after an initial period of instruction in basic medical sciences. Although Flexner codified the segregation of preclinical and clinical instruction, he was committed to ensuring that both domains were integrated into a modern medical education. The aspiration to fully integrate preclinical and clinical instruction continues to drive medical education reform even to this day. In this article, the authors revisit the original justification for sequential preclinical-clinical instruction and argue that modern, technology-enhanced patient simulation platforms are uniquely powerful for fostering simultaneous integration of preclinical-clinical content in a way that Flexner would have applauded. To date, medical educators tend to focus on using technology-enhanced medical simulation in clinical and postgraduate medical education; few have devoted significant attention to using immersive clinical simulation among preclinical students. The authors present an argument for the use of dynamic robot-mannequins in teaching basic medical science, and describe their experience with simulator-based preclinical instruction at Harvard Medical School. They discuss common misconceptions and barriers to the approach, describe their curricular responses to the technique, and articulate a unifying theory of cognitive and emotional learning that broadens the view of what is possible, feasible, and desirable with simulator-based medical education.

  6. Using drawings to understand the child's experience of child-centred care on admission to a paediatric high dependency unit.

    Science.gov (United States)

    Foster, Mandie; Whitehead, Lisa

    2018-01-01

    Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.

  7. Faculty and Students’ Perceptions of Student Experiences in a Medical School Undergoing Curricular Transition in the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Syed I Shehnaz

    2012-02-01

    Full Text Available Objectives: In 2008, the Gulf Medical College in the United Arab Emirates underwent a curricular change from a discipline-based to an organ-system-based integrated curriculum. In this context, this study aimed to compare the faculty and students’ perceptions of the student experiences with the new curriculum. Methods: Data were collected from faculty and second-year students in the integrated curriculum using the Dundee Ready Education Environment Measure (DREEM. Data collected were transferred to Predictive Analytics Software, Version 18. Global and domain scores were assessed with the Wilcoxon Rank-Sum Test. Percentage agreement, disagreement and uncertainty were assessed by the z-test for proportion. Results: There were no significant differences between the total DREEM scores of faculty (139/200 and students (135/200. The faculty perceived that the students were experiencing significantly more positive learning as indicated by the domain score of “Students' Perceptions of Learning”. Proportions of agreement between faculty and students showed that more faculty members than students perceived the need for increased feedback to students and a greater emphasis on long term learning. Conclusion: The study showed that the faculty and students had similar perceptions about the student experiences in the integrated curriculum. Areas necessitating remedial measures were the need for faculty to learn constructive feedback techniques and an emphasis on long term learning in the new curriculum.

  8. Pre-clinical cognitive phenotypes for Alzheimer disease: a latent profile approach.

    Science.gov (United States)

    Hayden, Kathleen M; Kuchibhatla, Maragatha; Romero, Heather R; Plassman, Brenda L; Burke, James R; Browndyke, Jeffrey N; Welsh-Bohmer, Kathleen A

    2014-11-01

    Cognitive profiles for pre-clinical Alzheimer disease (AD) can be used to identify groups of individuals at risk for disease and better characterize pre-clinical disease. Profiles or patterns of performance as pre-clinical phenotypes may be more useful than individual test scores or measures of global decline. To evaluate patterns of cognitive performance in cognitively normal individuals to derive latent profiles associated with later onset of disease using a combination of factor analysis and latent profile analysis. The National Alzheimer Coordinating Centers collect data, including a battery of neuropsychological tests, from participants at 29 National Institute on Aging-funded Alzheimer Disease Centers across the United States. Prior factor analyses of this battery demonstrated a four-factor structure comprising memory, attention, language, and executive function. Factor scores from these analyses were used in a latent profile approach to characterize cognition among a group of cognitively normal participants (N = 3,911). Associations between latent profiles and disease outcomes an average of 3 years later were evaluated with multinomial regression models. Similar analyses were used to determine predictors of profile membership. Four groups were identified; each with distinct characteristics and significantly associated with later disease outcomes. Two groups were significantly associated with development of cognitive impairment. In post hoc analyses, both the Trail Making Test Part B, and a contrast score (Delayed Recall - Trails B), significantly predicted group membership and later cognitive impairment. Latent profile analysis is a useful method to evaluate patterns of cognition in large samples for the identification of preclinical AD phenotypes; comparable results, however, can be achieved with very sensitive tests and contrast scores. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  9. Preclinical efficacy and safety of herbal formulation for management ...

    African Journals Online (AJOL)

    Preclinical efficacy and safety of herbal formulation for management of wounds. ... The effects of the treatments on rate of wound closure, epithelialisation time ... inflammation and better tissue remodeling for rats treated with herbal product.

  10. The role of radiolabelled compounds in preclinical drug development

    International Nuclear Information System (INIS)

    Hawkins, D.R.

    1988-01-01

    The role of radiolabelled compounds in the development of new drugs is discussed, with particular reference to their use in toxicological, metabolic and pharmacokinetic studies for the pre-clinical safety evaluation of new drugs. (U.K.)

  11. Does student performance on preclinical OSCEs relate to clerkship grades?

    Directory of Open Access Journals (Sweden)

    Margot Chima

    2016-06-01

    Full Text Available Background: Objective structured clinical examinations (OSCEs have been used to assess the clinical competence and interpersonal skills of healthcare professional students for decades. However, the relationship between preclinical (second year or M2 OSCE grades and clerkship performance had never been evaluated, until it was explored to provide information to educators at the University of Nebraska Medical Center (UNMC. In addition, the relationship between M2 OSCE communication scores (which is a portion of the total score and third-year (M3 Internal Medicine (IM clerkship OSCE scores was also explored. Lastly, conflicting evidence exists about the relationship between the amount of previous clinical experience and OSCE performance. Therefore, the relationship between M3 IM clerkship OSCE scores and the timing of the clerkship in the academic year was explored. Methods: Data from UNMC M2 OSCEs and M3 IM clerkship OSCEs were obtained for graduates of the 2013 and 2014 classes. Specifically, the following data points were collected: M2 fall OSCE total, M2 fall OSCE communication; M2 spring OSCE total, M2 spring OSCE communication; and M3 IM clerkship OSCE total percentages. Data were organized by class, M3 IM clerkship OSCE performance, and timing of the clerkship. Microsoft Excel and SPSS were used for data organization and analysis. Results: Of the 245 records, 229 (93.5% had data points for all metrics of interest. Significant differences between the classes of 2013 and 2014 existed for average M2 spring total, M2 spring communication, and M3 IM clerkship OSCEs. Retrospectively, there were no differences in M2 OSCE performances based on how students scored on the M3 IM clerkship OSCE. M3 IM clerkship OSCE performance improved for those students who completed the clerkship last in the academic year. Conclusions: There were inconsistencies in OSCE performances between the classes of 2013 and 2014, but more information is needed to determine if

  12. Does student performance on preclinical OSCEs relate to clerkship grades?

    Science.gov (United States)

    Chima, Margot; Dallaghan, Gary Beck

    2016-01-01

    Objective structured clinical examinations (OSCEs) have been used to assess the clinical competence and interpersonal skills of healthcare professional students for decades. However, the relationship between preclinical (second year or M2) OSCE grades and clerkship performance had never been evaluated, until it was explored to provide information to educators at the University of Nebraska Medical Center (UNMC). In addition, the relationship between M2 OSCE communication scores (which is a portion of the total score) and third-year (M3) Internal Medicine (IM) clerkship OSCE scores was also explored. Lastly, conflicting evidence exists about the relationship between the amount of previous clinical experience and OSCE performance. Therefore, the relationship between M3 IM clerkship OSCE scores and the timing of the clerkship in the academic year was explored. Data from UNMC M2 OSCEs and M3 IM clerkship OSCEs were obtained for graduates of the 2013 and 2014 classes. Specifically, the following data points were collected: M2 fall OSCE total, M2 fall OSCE communication; M2 spring OSCE total, M2 spring OSCE communication; and M3 IM clerkship OSCE total percentages. Data were organized by class, M3 IM clerkship OSCE performance, and timing of the clerkship. Microsoft Excel and SPSS were used for data organization and analysis. Of the 245 records, 229 (93.5%) had data points for all metrics of interest. Significant differences between the classes of 2013 and 2014 existed for average M2 spring total, M2 spring communication, and M3 IM clerkship OSCEs. Retrospectively, there were no differences in M2 OSCE performances based on how students scored on the M3 IM clerkship OSCE. M3 IM clerkship OSCE performance improved for those students who completed the clerkship last in the academic year. There were inconsistencies in OSCE performances between the classes of 2013 and 2014, but more information is needed to determine if this is because of testing variability or heterogeneity

  13. Preclinical and Clinical Effects of Mistletoe against Breast Cancer

    Directory of Open Access Journals (Sweden)

    Mohsen Marvibaigi

    2014-01-01

    Full Text Available Breast cancer is among the most frequent types of cancer in women worldwide. Current conventional treatment options are accompanied by side effects. Mistletoe is amongst the important herbal medicines traditionally used as complementary remedies. An increasing number of studies have reported anticancer activity of mistletoe extracts on breast cancer cells and animal models. Some recent evidence suggests that cytotoxic activity of mistletoe may be mediated through different mechanisms. These findings provide a good base for clinical trials. Various studies on mistletoe therapy for breast cancer patients revealed similar findings concerning possible benefits on survival time, health-related quality of life (HRQoL, remission rate, and alleviating adverse reactions to conventional therapy. This review provides an overview of the recent findings on preclinical experiments and clinical trials of mistletoe for its cytotoxic and antitumor activity and its effect on HRQoL in breast cancer patients. Moreover, studies investigating molecular and cellular mechanisms underlying antitumor activity of mistletoe are discussed in this paper. The analyzed trials provided evidence that there might be a combination of pharmacological and motivational aspects mediated by the mistletoe extract application which may contribute to the clinical benefit and positive outcome such as improved HRQoL and self-regulation in breast cancer patients.

  14. Novel technology to prepare oral formulations for preclinical safety studies.

    Science.gov (United States)

    Niwa, Toshiyuki; Hashimoto, Naofumi

    2008-02-28

    A novel method to prepare oral formulations, normally suspended dosage form, for preclinical safety studies in animals has been developed using a rotation/revolution mixer. Small hard balls made of zirconia were added to the mixing process to evaluate effectiveness in making a high quality suspension. The driving with balls loaded in the cylindrical container (vessel) of the mixer was quite efficient in dispersing and milling the particles of the active pharmaceutical ingredient (API) in an aqueous medium. The API powder and a small amount of oral aqueous medium (vehicle) were successfully mixed by the spinning motion of the balls in the vessel as though the paste-like suspension was kneaded with a mortar and pestle. It was found that the milled suspension with the mean size of 10-20microm could be prepared, in addition finer milling of less than 10microm could be achieved by selecting the material of vessel. Optimum driving conditions including mixing time, size and quantity of balls, and the standard operational procedure was established using compounds varying in physicochemical properties. The particle size and quantitative analysis by HPLC showed that the resultant suspension was well-milled and highly homogeneous with the nearly intended concentration of API. The proposed method established by this experiment could be applied to the actual safety studies in the real preparation scale of oral suspension.

  15. Robotic Anterior and Midline Skull Base Surgery: Preclinical Investigations

    International Nuclear Information System (INIS)

    O'Malley, Bert W.; Weinstein, Gregory S.

    2007-01-01

    Purpose: To develop a minimally invasive surgical technique to access the midline and anterior skull base using the optical and technical advantages of robotic surgical instrumentation. Methods and Materials: Ten experimental procedures focusing on approaches to the nasopharynx, clivus, sphenoid, pituitary sella, and suprasellar regions were performed on one cadaver and one live mongrel dog. Both the cadaver and canine procedures were performed in an approved training facility using the da Vinci Surgical Robot. For the canine experiments, a transoral robotic surgery (TORS) approach was used, and for the cadaver a newly developed combined cervical-transoral robotic surgery (C-TORS) approach was investigated and compared with standard TORS. The ability to access and dissect tissues within the various areas of the midline and anterior skull base were evaluated, and techniques to enhance visualization and instrumentation were developed. Results: Standard TORS approaches did not provide adequate access to the midline and anterior skull base; however, the newly developed C-TORS approach was successful in providing the surgical access to these regions of the skull base. Conclusion: Robotic surgery is an exciting minimally invasive approach to the skull base that warrants continued preclinical investigation and development

  16. Rigor or mortis: best practices for preclinical research in neuroscience.

    Science.gov (United States)

    Steward, Oswald; Balice-Gordon, Rita

    2014-11-05

    Numerous recent reports document a lack of reproducibility of preclinical studies, raising concerns about potential lack of rigor. Examples of lack of rigor have been extensively documented and proposals for practices to improve rigor are appearing. Here, we discuss some of the details and implications of previously proposed best practices and consider some new ones, focusing on preclinical studies relevant to human neurological and psychiatric disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Study partners should be required in preclinical Alzheimer's disease trials.

    Science.gov (United States)

    Grill, Joshua D; Karlawish, Jason

    2017-12-06

    In an effort to intervene earlier in Alzheimer's disease (AD), clinical trials are testing promising candidate therapies in preclinical disease. Preclinical AD trial participants are cognitively normal, functionally independent, and autonomous decision-makers. Yet, like AD dementia trials, preclinical trials require dual enrollment of a participant and a knowledgeable informant, or study partner. The requirement of dyadic enrollment is a barrier to recruitment and may present unique ethical challenges. Despite these limitations, the requirement should continue. Study partners may be essential to ensure participant safety and wellbeing, including overcoming distress related to biomarker disclosure and minimizing risk for catastrophic reactions and suicide. The requirement may maximize participant retention and ensure data integrity, including that study partners are the source of data that will ultimately instruct whether a new treatment has a clinical benefit and meaningful impact on the population health burden associated with AD. Finally, study partners are needed to ensure the scientific and clinical value of trials. Preclinical AD will represent a new model of care, in which persons with no symptoms are informed of probable cognitive decline and eventual dementia. The rationale for early diagnosis in symptomatic AD is equally applicable in preclinical AD-to minimize risk, maximize quality of life, and ensure optimal planning and communication. Family members and other sources of support will likely be essential to the goals of this new model of care for preclinical AD patients and trials must instruct this clinical practice.

  18. Radiation exposure reduction technologies for a Japanese Advanced BWR (Dose Rate Reduction Experience in Shika Unit 2)

    International Nuclear Information System (INIS)

    Saito, Takeshi; Ichikawa, Koji; Ishimaru, Hiroshi; Aizawa, Motohiro; Sato, Yoshiteru; Morita, Shoichi

    2012-09-01

    Operating experiences of the advanced boiling water reactor (ABWR) have been accumulated in Japan since the first ABWRs Kashiwazaki-Kariwa NPS unit 6 and 7 came into service. Shika NPS unit 2 (Shika-2) of Hokuriku Electric Power Co. is the fourth ABWR plant in Japan. Since ABWRs have no piping of the reactor recirculation system (RRS), which is the largest source of radiation in conventional BWRs, carbon steel piping of the reactor water cleanup system (RWCU) and residual heat removal system (RHR) are the largest source in ABWRs. Therefore we have focused on reduction methods of radioactive material on carbon steel surface in order to reduce the quantity of occupational exposure in Shika-2. In Shika-2 the following methods have been adopted. Before fuel loading, alkaline pre-filming process was applied to the RWCU piping during plant startup testing. After start of operation, the feed water iron concentration control (or nickel/iron ratio control) method was applied. Furthermore, during shutdown operation the RHR system was operated when the reactor water temperature was dropped to 120 degree C with the use of condenser heat sink cooling operation. These dose rate reduction methods worked well in Shika-2 as expected. The quantity of occupational exposure at the 3 rd outage in Shika-2 was approximately 0.35 person-Sv. On the basis of the results obtained thus far, the occupational dose expected at the outage after deposition amount of radioactivity reaching the equilibrium state has been estimated to be around 0.5 person-Sv. This value is considered to be in low level compared with the worldwide statistics. (authors)

  19. EGFR-targeted anti-cancer drugs in radiotherapy: Preclinical evaluation of mechanisms

    International Nuclear Information System (INIS)

    Baumann, Michael; Krause, Mechthild; Dikomey, Ekkehard; Dittmann, Klaus; Doerr, Wolfgang; Kasten-Pisula, Ulla; Rodemann, H. Peter

    2007-01-01

    Preclinical and clinical results indicate that the EGFR can mediate radioresistance in different solid human tumours. Combination of radiotherapy and EGFR inhibitors can improve local tumour control compared to irradiation alone and has been introduced into clinical radiotherapy practice. So far several mechanisms have been identified in preclinical studies to contribute to improved local tumour control after radiation combined with EGFR inhibitors. These include direct kill of cancer stem cells by EGFR inhibitors, cellular radiosensitization through modified signal transduction, inhibition of repair of DNA damage, reduced repopulation and improved reoxygenation during fractionated radiotherapy. Effects and mechanisms may differ for different classes of EGFR inhibitors, for different tumours and for normal tissues. The mechanisms underlying this heterogeneity are currently poorly understood, and predictive assays are not available yet. Importantly, mechanisms and predictors for the combined effects of radiation with EGFR inhibitors appear to be considerably different to those for application of EGFR inhibitors alone or in combination with chemotherapy. Therefore to further evaluate the efficacy and mechanisms of EGFR-inhibition in combined treatments, radiotherapy-specific preclinical research strategies, which include in vivo experiments using local tumour control as an endpoint, as well as animal studies on normal tissue toxicity are needed

  20. Factors influencing the approaches to studying of preclinical and clinical students and postgraduate trainees

    Directory of Open Access Journals (Sweden)

    Samarasekera Dharmabandu N

    2011-05-01

    Full Text Available Abstract Background Students can be classified into three categories depending on their approaches to studying; namely, deep approach (DA, strategic approach (SA and surface apathetic or superficial approach (SAA. The aim of this study was to identify factors affecting the approaches to studying among Sri Lankan medical undergraduates and post graduate trainees and to analyze the change in the pattern of study skills with time and experience. Method Pre-clinical and clinical students of the Faculty of Medicine, University of Colombo and postgraduate trainees in Surgery at the National Hospital of Sri Lanka were invited to complete the Approaches and Study Skills Inventory for Students (ASSIST questionnaire. Results A total of 187 pre clinical (M: F = 96:91, 124 clinical (M: F = 61:63 and 53 post graduate trainees (M: F = 50:3 participated in the study. Approaches of male and female students were similar. SA was significantly affected by age among the preclinical students (p = 0.01, but not in other groups. Among pre-clinical students, males preferred a teacher who supported understanding (p = 0.04 but females preferred a passive transmission of information (p Conclusion Different factors affect the approach to studying in different groups but these explain only a small fraction of the variance observed.

  1. Experiences Using Pre-Exposure Prophylaxis for Safer Conception Among HIV Serodiscordant Heterosexual Couples in the United States.

    Science.gov (United States)

    Bazzi, Angela R; Leech, Ashley A; Biancarelli, Dea L; Sullivan, Meg; Drainoni, Mari-Lynn

    2017-08-01

    Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast. In-depth interview guides explored couple relationships and contextual factors and attitudes, perceptions, and decision-making processes surrounding PrEP for safer conception. Thematic analyses focused on identifying the following emergent themes. We found that couple relationships were situated within broader social and cultural contexts of immigration, family, and community that shaped their experiences with HIV and serodiscordant relationship status. Despite strong partner support within relationships, HIV stigma and disapproval of serodiscordant relationships contributed to couples' feelings of social isolation and subsequent aspirations to have "normal" families. By enabling "natural" conception through condomless sex, PrEP for safer conception provided a sense of enhanced relationship intimacy. Couples called for increasing public awareness of PrEP through positive messaging as a way to combat HIV stigma. Findings suggest that relationship dynamics and broader social contexts appear to shape HIV serodiscordant couples' fertility desires and motivations to use PrEP. However, increased public awareness of PrEP for safer conception may be needed to combat HIV stigma at the community level.

  2. Perspectives for utilization of the experience from the electrical equipment modernization of Kozloduy NPP units 5 and 6 in case of construction of new NPP

    International Nuclear Information System (INIS)

    Bogdanov, D.

    2005-01-01

    In 2005 a governmental decision for continue the project for construction of Belene NPP was adopted. In case of start of this significant project in short terms, a good option will be to utilize the already achieved experience by the modernization program of units 5 and 6 of Kozloduy NPP. The process of construction of new NPP is associated with significant amount of engineering, civil construction works, equipment order and delivery, installation works, testing and commissioning activities. It is vital necessity to have optimal technology, strict organization for project implementation and excellent documentation. From technical point of view the experience from the modernization of units 5 and 6 of Kozloduy NPP will be very important in case of utilization of similar types of WWER 1000 units. According to the 'Feasibility study for construction of Belene NPP', the most favorable option is to accomplish the already partially constructed Unit 1 on the basis of upgraded WWER B-320 design - WWER 1000 B-392, in order to fulfill IEC 331-3A, IEC 332-3A, and of US NRC Regulatory Guide 1.70 and to construct the second unit on the basis of ASE WWER/1000 B-466. However, for any type of unit selected, the achieved experience will be an important basis. This article is focused mostly on the modernization aspects of some electrical systems of Kozloduy NPP

  3. Preclinical Medical Student Hematology/Oncology Education Environment.

    Science.gov (United States)

    Zumberg, Marc S; Broudy, Virginia C; Bengtson, Elizabeth M; Gitlin, Scott D

    2015-12-01

    To better prepare medical students to care for patients in today's changing health-care environment as they transition to continuing their education as residents, many US medical schools have been reviewing and modifying their curricula and are considering integration of newer adult learning techniques, including team-based learning, flipped classrooms, and other active learning approaches (Assoc Am Med Coll. 2014). Directors of hematology/oncology (H/O) courses requested an assessment of today's H/O education environment to help them respond to the ongoing changes in the education content and environment that will be necessary to meet this goal. Several recommendations for the improvement of cancer education resulted from American Association for Cancer Education's (ACCE's) "Cancer Education Survey II" including a call for medical schools to evaluate the effectiveness of current teaching methods in achieving cancer education objectives (Chamberlain et al. J Cancer Educ 7(2):105-114.2014). To understand the current environment and resources used in medical student preclinical H/O courses, an Internet-based, Survey Monkey®-formatted, questionnaire focusing on nine topic areas was distributed to 130 United States Hematology/Oncology Course Directors (HOCDs). HOCDs represent a diverse group of individuals who work in variably supportive environments and who are variably satisfied with their position. Several aspects of these courses remain relatively unchanged from previous assessments, including a predominance of traditional lectures, small group sessions, and examinations that are either written or computer-based. Newer technology, including web-based reproduction of lectures, virtual microscopes, and availability of additional web-based content has been introduced into these courses. A variety of learner evaluation and course assessment approaches are used. The ultimate effectiveness and impact of these changes needs to be determined.

  4. Reflections on attitudes, experiences, and vulnerability of intimate partner violence among Southeast Asian college women living in United States.

    Science.gov (United States)

    Thongpriwan, Vipavee; Buseh, Aaron; Arunothong, Wachiraporn

    2015-12-01

    To provide culturally sensitive intimate partner violence (IPV) prevention programs for ethnic groups, a basic foundational understanding of Southeast Asian (SEA) women living in the United States is vital. The purpose of this study was to describe SEA college women's perceptions of IPV and how the women recognize their vulnerability to such violent situations. Qualitative methods using focus group discussions were employed to elicit participants' perceptions. Participants included 18 SEA college women, ages 18-34 (Mean=22; SD=7.22). Transcriptions were analyzed using a content analysis approach. Five themes emerged: recognition of IPV; perception of individual vulnerability to IPV; experience and responses to IPV; help seeking and support system; and strategies used for prevention of IPV. Findings yielded an understanding of intertwined issues of cultural norms associated with IPV, social and economic disparities, and challenges for IPV prevention in SEA communities. Culturally sensitive prevention programs will be more effective by reforming cultural values, while at the same time promoting non-violent relationships and increasing access to services. Published by Elsevier B.V.

  5. Experience with respect to dose limitation in nuclear fuel service operations in the United Kingdom supporting civil nuclear power programmes

    International Nuclear Information System (INIS)

    Kennedy, J.W.

    1983-01-01

    Within the United Kingdom, the nuclear power generation programme is supported by nuclear fuel services including uranium enrichment, fuel fabrication and reprocessing, operated by British Nuclear Fuels Limited (BNFL). These have entailed the processing of large quantities of uranium and of plutonium and fission products arising in the course of irradiation of fuel in nuclear power stations and have necessitated substantial programmes for the radiological protection of the public and of the workers employed in the industry. This paper presents and reviews the statistics of doses recorded in the various sectors of nuclear fuel services operations against the background of the standards to which the industry is required to operate. A description is given of the development of BNFL policy in keeping with the objective of being recognized as among those industries regarded as safe and the resource implications of measures to reduce doses received by workers are reviewed in the light of experience. Finally, the paper reviews the epidemiological data which have been, and continue to be, collected for workers who have been employed in these nuclear fuel services. (author)

  6. Experiences and needs of families regarding prognostic communication in an intensive care unit: supporting families at the end of life.

    Science.gov (United States)

    Gutierrez, Karen M

    2012-01-01

    This article reports the results of a study designed to explore the experiences and needs of family members for prognostic communication at end of life in an intensive care unit (ICU). Subjects in this qualitative study included 20 family members of patients at high risk for death in 1 adult medical/surgical ICU. All subjects were interviewed once utilizing a semistructured interview format, with approximately half interviewed multiple times during the ICU stay. Families described 5 themes of information-related "work": (1) hearing and recalling, (2) accessing, (3) interpreting, (4) retaining, and (5) utilizing information for decision making. Barriers, including accessing physicians and cognitive issues from high levels of stress, made this work difficult. Families described a need for prognostic information, especially if the prognosis was poor. Because hearing this news was difficult, they needed it communicated with respect, sensitivity, and compassion. Suggestions for clinical practice to support families in their information-related work are presented. Overall, the importance of providers approaching communication from a holistic perspective, extending beyond simply passing on information, is emphasized. Viewing communication as a therapeutic modality, and communicating with compassion, sensitivity, and a genuine sense of caring, can help provide both the information and the emotional support and comfort families desperately need.

  7. Lost in the present but confident of the past: experiences of being in a psycho-geriatric unit as narrated by persons with dementia.

    Science.gov (United States)

    Edvardsson, David; Nordvall, Karin

    2008-02-01

    To illuminate meanings of being in a psycho-geriatric unit. Background. There are known risks associated with moving persons with dementia from home to an institution, but little is known about how they experience being in psycho-geriatric units. Using open-ended research interviews, six persons with mild to severe dementia were asked to narrate about their experiences in the hospital. The interviews were interpreted using a phenomenological hermeneutical method of analysis. The comprehensive understanding of being in a psycho-geriatric unit points towards an understanding of being lost in the present but confident of the past. The analysis showed that the participants appeared lost as they could not narrate where they were and why, but that they became confident when narrating about their previous life. The analysis also showed that being in the hospital meant sharing living space with strangers, invasions of private space and establishing new acquaintances. Being in the unit could also mean boredom and devaluation for participants. The interviews were interpreted in the light of narrative theory of identity: persons with dementia narrating about previous life experiences as to make claims of how to be interpreted by others; as persons instead of merely as 'demented' patients. Experiences of care narrated by persons with dementia present meaningful and useful information that can provide feedback to inform care practice. Experiences of care from persons with dementia provide meaningful information about care and the doing and being of staff. Creating time for conversations with these persons may facilitate well-being.

  8. Challenges for Preclinical Investigations of Human Biofield Modalities

    Science.gov (United States)

    Gronowicz, Gloria; Bengston, William

    2015-01-01

    Preclinical models for studying the effects of the human biofield have great potential to advance our understanding of human biofield modalities, which include external qigong, Johrei, Reiki, therapeutic touch, healing touch, polarity therapy, pranic healing, and other practices. A short history of Western biofield studies using preclinical models is presented and demonstrates numerous and consistent examples of human biofields significantly affecting biological systems both in vitro and in vivo. Methodological issues arising from these studies and practical solutions in experimental design are presented. Important questions still left unanswered with preclinical models include variable reproducibility, dosing, intentionality of the practitioner, best preclinical systems, and mechanisms. Input from the biofield practitioners in the experimental design is critical to improving experimental outcomes; however, the development of standard criteria for uniformity of practice and for inclusion of multiple practitioners is needed. Research in human biofield studies involving preclinical models promises a better understanding of the mechanisms underlying the efficacy of biofield therapies and will be important in guiding clinical protocols and integrating treatments with conventional medical therapies. PMID:26665042

  9. Neuropsychiatric symptoms predict hypometabolism in preclinical Alzheimer disease.

    Science.gov (United States)

    Ng, Kok Pin; Pascoal, Tharick A; Mathotaarachchi, Sulantha; Chung, Chang-Oh; Benedet, Andréa L; Shin, Monica; Kang, Min Su; Li, Xiaofeng; Ba, Maowen; Kandiah, Nagaendran; Rosa-Neto, Pedro; Gauthier, Serge

    2017-05-09

    To identify regional brain metabolic dysfunctions associated with neuropsychiatric symptoms (NPS) in preclinical Alzheimer disease (AD). We stratified 115 cognitively normal individuals into preclinical AD (both amyloid and tau pathologies present), asymptomatic at risk for AD (either amyloid or tau pathology present), or healthy controls (no amyloid or tau pathology present) using [ 18 F]florbetapir PET and CSF phosphorylated tau biomarkers. Regression and voxel-based regression models evaluated the relationships between baseline NPS measured by the Neuropsychiatric Inventory (NPI) and baseline and 2-year change in metabolism measured by [ 18 F]fluorodeoxyglucose (FDG) PET. Individuals with preclinical AD with higher NPI scores had higher [ 18 F]FDG uptake in the posterior cingulate cortex (PCC), ventromedial prefrontal cortex, and right anterior insula at baseline. High NPI scores predicted subsequent hypometabolism in the PCC over 2 years only in individuals with preclinical AD. Sleep/nighttime behavior disorders and irritability and lability were the components of the NPI that drove this metabolic dysfunction. The magnitude of NPS in preclinical cases, driven by sleep behavior and irritability domains, is linked to transitory metabolic dysfunctions within limbic networks vulnerable to the AD process and predicts subsequent PCC hypometabolism. These findings support an emerging conceptual framework in which NPS constitute an early clinical manifestation of AD pathophysiology. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  10. Gas transport during in vitro and in vivo preclinical testing of inert gas therapies

    Directory of Open Access Journals (Sweden)

    Ira Katz

    2016-01-01

    Full Text Available New gas therapies using inert gases such as xenon and argon are being studied, which require in vitro and in vivo preclinical experiments. Examples of the kinetics of gas transport during such experiments are analyzed in this paper. Using analytical and numerical models, we analyze an in vitro experiment for gas transport to a 96 cell well plate and an in vivo delivery to a small animal chamber, where the key processes considered are the wash-in of test gas into an apparatus dead volume, the diffusion of test gas through the liquid media in a well of a cell test plate, and the pharmacokinetics in a rat. In the case of small animals in a chamber, the key variable controlling the kinetics is the chamber wash-in time constant that is a function of the chamber volume and the gas flow rate. For cells covered by a liquid media the diffusion of gas through the liquid media is the dominant mechanism, such that liquid depth and the gas diffusion constant are the key parameters. The key message from these analyses is that the transport of gas during preclinical experiments can be important in determining the true dose as experienced at the site of action in an animal or to a cell.

  11. Time-of-flight data acquisition unit (DAU) for neutron scattering experiments. Specification of the requirements and design concept. Version 3.1

    International Nuclear Information System (INIS)

    Herdam, G.; Klessmann, H.; Wawer, W.; Adebayo, J.; David, G.; Szatmari, F.

    1989-12-01

    This specification describes the requirements for the Data Acquisition Unit (DAU) and defines the design concept for the functional units involved. The Data Acquisition Unit will be used in the following neutron scattering experiments: Time-of-Flight Spectrometer NEAT, Time-of-Flight Spectrometer SPAN. In addition, the data of the SPAN spectrometer in Spin Echo experiments will be accumulated. The Data Acquisition Unit can be characterised by the following requirements: Time-of-flight measurement with high time resolution (125 ns), sorting the time-of-flight in up to 4096 time channels (channel width ≥ 1 μs), selection of different time channel widths for peak and background, on-line time-of-flight correction for neutron flight paths of different lengths, sorting the detector position information in up to 4096 position channels, accumulation of two-dimensional spectra in a 32 Mbyte RAM memory (4 K time channels*4 K position channels*16 bits). Because of the stringent timing requirements the functional units of the DAU are hardware controlled via tables. The DAU is part of a process control system which has access to the functional units via the VMEbus in order to initialise, to load tables and control information, and to read status information and spectra. (orig.) With 18 figs

  12. iPad experience during clinical rotations from seven medical schools in the United States: Lessons learned.

    Science.gov (United States)

    Deutsch, Kalie; Gaines, Julie K; Hill, Janette R; Nuss, Michelle A

    2016-11-01

    Since 2010, many US medical schools have introduced the use of mobile technology into their curriculum. Preclinical use of mobile technologies has been well studied, but use in the clinical years has been less explored. Our objective was to identify the clinical uses and limitations of mobile technology in the clinical curriculum. Interviews were conducted with key personnel at seven U. S. medical schools who introduced iPad programs during the clinical years. Interviews were qualitatively analyzed using a constant comparison technique. Eight "best practices" for introducing mobile technology in the clinical years were identified: (1) plan before implementation, (2) define focused goals, (3) establish a tablet "culture," (4) recruit appropriate implementation team, (5) invest in training, (6) involve students in mentoring, (7) accept variable use, and (8) encourage innovation. There is growing interest in using mobile technology for teaching and learning in the clinical curriculum. Following the identified best practices may assist schools with the integration of the technology into the curriculum and better prepare medical students to handle the increasing use of technology.

  13. Reflections on two years after establishing an orthogeriatric unit: a focus group study of healthcare professionals' expectations and experiences.

    Science.gov (United States)

    Abrahamsen, C; Nørgaard, B; Draborg, E; Nielsen, D

    2017-08-25

    For decades hospitals have been "vertically" organized, with the risk that specialization leads to fragmented and one-sided views of patient care and treatment that may cause poor communication and coordination of care and treatment. Two years after the introduction of an orthogeriatric unit for elderly patients admitted with fragility fractures, we studied the involved healthcare professionals' perspectives and experiences with working in an interprofessional organization. We performed four focus groups interviews with 19 healthcare workers representing different professions. The interviews were analysed using systematic text condensation (STC). Three themes were identified: 1) A patient-centred approach, 2) An opportunity for professional growth and 3) The benefits of interprofessional collaboration. The interviewees emphasized in particular the systematic and frequent face-to-face communication enabled by the interprofessional team meetings as essential to their feeling of enhanced collegial solidarity. All groups expressed their respect for other groups' competences and their vital contributions to good orthogeriatric care. However, collaboration was challenged by the groups' divergent views of the patients and of the relevance of the information given in the weekly meetings. Heavy workloads were also mentioned. The opportunity for professional growth was also felt to be imperilled by some professionals. All participants indicated their view that the orthogeriatric organization had improved the quality of care and treatment. Furthermore, good communication, mutual respect for other professional competences and shared goals were found to have enhanced interprofessional collaboration and improved the sense of having a shared mission. However, differences in approaches and expectations continued to challenge the orthogeriatric model after 2 years. Neither did all professionals find orthogeriatric care professionally challenging.

  14. Developing an Inclusive Learning Environment for Students with Visual Impairment in Higher Education: Progressive Mutual Accommodation and Learner Experiences in the United Kingdom

    Science.gov (United States)

    Hewett, Rachel; Douglas, Graeme; McLinden, Michael; Keil, Sue

    2017-01-01

    Drawing on the findings of a unique longitudinal qualitative study, this article investigates the experiences of 32 young people with visual impairment (VI) in higher education (HE) in the United Kingdom (UK) to explore how well they were able to participate on their courses. We propose and apply a Bioecological Model of Inclusive HE to interpret…

  15. BOOK REVIEW - The Experience of Face Veil Wearers in Europe and the Law (Cambridge University Press United Kingdom 2014. ISBN 978-1-107-05830-9.

    Directory of Open Access Journals (Sweden)

    Jacques L Matthee

    2017-03-01

    Full Text Available This contribution published by Cambridge University Press provides a short overview of the book by Eva Brems "The Experience of Face Veil Wearers in Europe and the Law" published by Cambridge University Press, United Kingdom, in 2014. See ISBN 978-1-107-05830-9.

  16. Language Anxiety: A Case Study of the Perceptions and Experiences of Students of English as a Foreign Language in a Higher Education Institution in the United Arab Emirates

    Science.gov (United States)

    Lababidi, Rola Ahmed

    2016-01-01

    This case study explores and investigates the perceptions and experiences of foreign language anxiety (FLA) among students of English as a Foreign Language in a Higher Education Institution in the United Arab Emirates. The first phase explored the scope and severity of language anxiety among all Foundation level male students at a college in the…

  17. Bioluminescence Tomography–Guided Radiation Therapy for Preclinical Research

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Bin [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland (United States); Wang, Ken Kang-Hsin, E-mail: kwang27@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland (United States); Yu, Jingjing [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland (United States); School of Physics and Information Technology, Shaanxi Normal University, Shaanxi (China); Eslami, Sohrab; Iordachita, Iulian [Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, Maryland (United States); Reyes, Juvenal; Malek, Reem [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland (United States); Tran, Phuoc T. [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland (United States); Department of Oncology and Urology, Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland (United States); Patterson, Michael S. [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario (Canada); Wong, John W. [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland (United States)

    2016-04-01

    Purpose: In preclinical radiation research, it is challenging to localize soft tissue targets based on cone beam computed tomography (CBCT) guidance. As a more effective method to localize soft tissue targets, we developed an online bioluminescence tomography (BLT) system for small-animal radiation research platform (SARRP). We demonstrated BLT-guided radiation therapy and validated targeting accuracy based on a newly developed reconstruction algorithm. Methods and Materials: The BLT system was designed to dock with the SARRP for image acquisition and to be detached before radiation delivery. A 3-mirror system was devised to reflect the bioluminescence emitted from the subject to a stationary charge-coupled device (CCD) camera. Multispectral BLT and the incomplete variables truncated conjugate gradient method with a permissible region shrinking strategy were used as the optimization scheme to reconstruct bioluminescent source distributions. To validate BLT targeting accuracy, a small cylindrical light source with high CBCT contrast was placed in a phantom and also in the abdomen of a mouse carcass. The center of mass (CoM) of the source was recovered from BLT and used to guide radiation delivery. The accuracy of the BLT-guided targeting was validated with films and compared with the CBCT-guided delivery. In vivo experiments were conducted to demonstrate BLT localization capability for various source geometries. Results: Online BLT was able to recover the CoM of the embedded light source with an average accuracy of 1 mm compared to that with CBCT localization. Differences between BLT- and CBCT-guided irradiation shown on the films were consistent with the source localization revealed in the BLT and CBCT images. In vivo results demonstrated that our BLT system could potentially be applied for multiple targets and tumors. Conclusions: The online BLT/CBCT/SARRP system provides an effective solution for soft tissue targeting, particularly for small, nonpalpable, or

  18. Bioluminescence Tomography–Guided Radiation Therapy for Preclinical Research

    International Nuclear Information System (INIS)

    Zhang, Bin; Wang, Ken Kang-Hsin; Yu, Jingjing; Eslami, Sohrab; Iordachita, Iulian; Reyes, Juvenal; Malek, Reem; Tran, Phuoc T.; Patterson, Michael S.; Wong, John W.

    2016-01-01

    Purpose: In preclinical radiation research, it is challenging to localize soft tissue targets based on cone beam computed tomography (CBCT) guidance. As a more effective method to localize soft tissue targets, we developed an online bioluminescence tomography (BLT) system for small-animal radiation research platform (SARRP). We demonstrated BLT-guided radiation therapy and validated targeting accuracy based on a newly developed reconstruction algorithm. Methods and Materials: The BLT system was designed to dock with the SARRP for image acquisition and to be detached before radiation delivery. A 3-mirror system was devised to reflect the bioluminescence emitted from the subject to a stationary charge-coupled device (CCD) camera. Multispectral BLT and the incomplete variables truncated conjugate gradient method with a permissible region shrinking strategy were used as the optimization scheme to reconstruct bioluminescent source distributions. To validate BLT targeting accuracy, a small cylindrical light source with high CBCT contrast was placed in a phantom and also in the abdomen of a mouse carcass. The center of mass (CoM) of the source was recovered from BLT and used to guide radiation delivery. The accuracy of the BLT-guided targeting was validated with films and compared with the CBCT-guided delivery. In vivo experiments were conducted to demonstrate BLT localization capability for various source geometries. Results: Online BLT was able to recover the CoM of the embedded light source with an average accuracy of 1 mm compared to that with CBCT localization. Differences between BLT- and CBCT-guided irradiation shown on the films were consistent with the source localization revealed in the BLT and CBCT images. In vivo results demonstrated that our BLT system could potentially be applied for multiple targets and tumors. Conclusions: The online BLT/CBCT/SARRP system provides an effective solution for soft tissue targeting, particularly for small, nonpalpable, or

  19. Characterization of novel preclinical dose distributions for micro irradiator

    International Nuclear Information System (INIS)

    Kodra, J; Miles, D; Yoon, S W; Kirsch, D G; Oldham, M

    2017-01-01

    This work explores and demonstrates the feasibility of utilizing new 3D printing techniques to implement advanced micro radiation therapy for pre-clinical small animal studies. 3D printed blocks and compensators were designed and printed from a strong x-ray attenuating material at sub-millimeter resolution. These techniques enable a powerful range of new preclinical treatment capabilities including grid therapy, lattice therapy, and IMRT treatment. At small scales, verification of these treatments is exceptionally challenging, and high resolution 3D dosimetry (0.5mm 3 ) is an essential capability to characterize and verify these capabilities, Here, investigate the 2D and 3D dosimetry of several novel pre-clinical treatments using a combination of EBT film and Presage/optical-CT 3D dosimetry in rodent-morphic dosimeters. (paper)

  20. Characterization of novel preclinical dose distributions for micro irradiator

    Science.gov (United States)

    Kodra, J.; Miles, D.; Yoon, S. W.; Kirsch, D. G.; Oldham, M.

    2017-05-01

    This work explores and demonstrates the feasibility of utilizing new 3D printing techniques to implement advanced micro radiation therapy for pre-clinical small animal studies. 3D printed blocks and compensators were designed and printed from a strong x-ray attenuating material at sub-millimeter resolution. These techniques enable a powerful range of new preclinical treatment capabilities including grid therapy, lattice therapy, and IMRT treatment. At small scales, verification of these treatments is exceptionally challenging, and high resolution 3D dosimetry (0.5mm3) is an essential capability to characterize and verify these capabilities, Here, investigate the 2D and 3D dosimetry of several novel pre-clinical treatments using a combination of EBT film and Presage/optical-CT 3D dosimetry in rodent-morphic dosimeters.

  1. An economic evaluation of preclinical testing strategies compared to the compulsory scrapie flock scheme in the control of classical scrapie.

    Directory of Open Access Journals (Sweden)

    Lisa Boden

    Full Text Available Cost-benefit is rarely combined with nonlinear dynamic models when evaluating control options for infectious diseases. The current strategy for scrapie in Great Britain requires that all genetically susceptible livestock in affected flocks be culled (Compulsory Scrapie Flock Scheme or CSFS. However, this results in the removal of many healthy sheep, and a recently developed pre-clinical test for scrapie now offers a strategy based on disease detection. We explore the flock level cost-effectiveness of scrapie control using a deterministic transmission model and industry estimates of costs associated with genotype testing, pre-clinical tests and the value of a sheep culled. Benefit was measured in terms of the reduction in the number of infected sheep sold on, compared to a baseline strategy of doing nothing, using Incremental Cost Effectiveness analysis to compare across strategies. As market data was not available for pre-clinical testing, a threshold analysis was used to set a unit-cost giving equal costs for CSFS and multiple pre-clinical testing (MT, one test each year for three consecutive years. Assuming a 40% within-flock proportion of susceptible genotypes and a test sensitivity of 90%, a single test (ST was cheaper but less effective than either the CSFS or MT strategies (30 infected-sales-averted over the lifetime of the average epidemic. The MT strategy was slightly less effective than the CSFS and would be a dominated strategy unless preclinical testing was cheaper than the threshold price of £6.28, but may be appropriate for flocks with particularly valuable livestock. Though the ST is not currently recommended, the proportion of susceptible genotypes in the national flock is likely to continue to decrease; this may eventually make it a cost-effective alternative to the MT or CSFS.

  2. Kinetic modeling in pre-clinical positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kuntner, Claudia [AIT Austrian Institute of Technology GmbH, Seibersdorf (Austria). Biomedical Systems, Health and Environment Dept.

    2014-07-01

    Pre-clinical positron emission tomography (PET) has evolved in the last few years from pure visualization of radiotracer uptake and distribution towards quantification of the physiological parameters. For reliable and reproducible quantification the kinetic modeling methods used to obtain relevant parameters of radiotracer tissue interaction are important. Here we present different kinetic modeling techniques with a focus on compartmental models including plasma input models and reference tissue input models. The experimental challenges of deriving the plasma input function in rodents and the effect of anesthesia are discussed. Finally, in vivo application of kinetic modeling in various areas of pre-clinical research is presented and compared to human data.

  3. The basics of preclinical drug development for neurodegenerative disease indications.

    Science.gov (United States)

    Steinmetz, Karen L; Spack, Edward G

    2009-06-12

    Preclinical development encompasses the activities that link drug discovery in the laboratory to initiation of human clinical trials. Preclinical studies can be designed to identify a lead candidate from several hits; develop the best procedure for new drug scale-up; select the best formulation; determine the route, frequency, and duration of exposure; and ultimately support the intended clinical trial design. The details of each preclinical development package can vary, but all have some common features. Rodent and nonrodent mammalian models are used to delineate the pharmacokinetic profile and general safety, as well as to identify toxicity patterns. One or more species may be used to determine the drug's mean residence time in the body, which depends on inherent absorption, distribution, metabolism, and excretion properties. For drugs intended to treat Alzheimer's disease or other brain-targeted diseases, the ability of a drug to cross the blood brain barrier may be a key issue. Toxicology and safety studies identify potential target organs for adverse effects and define the Therapeutic Index to set the initial starting doses in clinical trials. Pivotal preclinical safety studies generally require regulatory oversight as defined by US Food and Drug Administration (FDA) Good Laboratory Practices and international guidelines, including the International Conference on Harmonization. Concurrent preclinical development activities include developing the Clinical Plan and preparing the new drug product, including the associated documentation to meet stringent FDA Good Manufacturing Practices regulatory guidelines. A wide range of commercial and government contract options are available for investigators seeking to advance their candidate(s). Government programs such as the Small Business Innovative Research and Small Business Technology Transfer grants and the National Institutes of Health Rapid Access to Interventional Development Pilot Program provide funding and

  4. The basics of preclinical drug development for neurodegenerative disease indications

    Directory of Open Access Journals (Sweden)

    Spack Edward G

    2009-06-01

    Full Text Available Abstract Preclinical development encompasses the activities that link drug discovery in the laboratory to initiation of human clinical trials. Preclinical studies can be designed to identify a lead candidate from several hits; develop the best procedure for new drug scale-up; select the best formulation; determine the route, frequency, and duration of exposure; and ultimately support the intended clinical trial design. The details of each preclinical development package can vary, but all have some common features. Rodent and nonrodent mammalian models are used to delineate the pharmacokinetic profile and general safety, as well as to identify toxicity patterns. One or more species may be used to determine the drug's mean residence time in the body, which depends on inherent absorption, distribution, metabolism, and excretion properties. For drugs intended to treat Alzheimer's disease or other brain-targeted diseases, the ability of a drug to cross the blood brain barrier may be a key issue. Toxicology and safety studies identify potential target organs for adverse effects and define the Therapeutic Index to set the initial starting doses in clinical trials. Pivotal preclinical safety studies generally require regulatory oversight as defined by US Food and Drug Administration (FDA Good Laboratory Practices and international guidelines, including the International Conference on Harmonisation. Concurrent preclinical development activities include developing the Clinical Plan and preparing the new drug product, including the associated documentation to meet stringent FDA Good Manufacturing Practices regulatory guidelines. A wide range of commercial and government contract options are available for investigators seeking to advance their candidate(s. Government programs such as the Small Business Innovative Research and Small Business Technology Transfer grants and the National Institutes of Health Rapid Access to Interventional Development Pilot

  5. Comparison of USDA Forest Service and stakeholder motivations and experiences in collaborative federal forest governance in the Western United States

    Science.gov (United States)

    Emily Jane Davis; Eric M. White; Lee K. Cerveny; David Seesholtz; Meagan L. Nuss; Donald R. Ulrich

    2017-01-01

    In the United States, over 191 million acres of land is managed by the United States Department of Agriculture Forest Service, a federal government agency. In several western U.S. states, organized collaborative groups have become a de facto governance approach to providing sustained input on management decisions on much public land. This is most extensive in Oregon,...

  6. A survey on the knowledge and attitudes of anaesthesia providers in the United States of America, United Kingdom and Singapore on visual experiences during cataract surgery.

    Science.gov (United States)

    Tan, C S H; Kumar, C M; Fanning, G L; Lai, Y C; Au Eong, K G

    2006-04-01

    To assess the knowledge, beliefs and attitudes of anaesthesia providers on the patients' possible intraoperative visual experiences during cataract surgery under local anaesthesia. Anaesthesia providers from the Ophthalmic Anaesthesia Society (USA); British Ophthalmic Anaesthesia Society (UK); Alexandra Hospital, National University Hospital, Tan Tock Seng Hospital, Singapore General Hospital and Changi General Hospital (Singapore) were surveyed using a structured questionnaire. A total of 146 anaesthesiologists (81.6%), 10 ophthalmologists (5.6%) and 23 nurse anaesthetists (12.8%) responded to the survey. Most respondents believed that patients would experience light perception and many also felt that patients might encounter other visual sensations such as movements, flashes, colours, surgical instruments, hands/fingers and the surgeon during the surgery. A significantly higher proportion of anaesthesia providers with previous experience of monitoring patients under topical anaesthesia believed that patients might experience the various visual sensations compared to those who have not previously monitored. For both topical and regional anaesthesia, anaesthesia providers who routinely counsel their patients are (1) more likely to believe that preoperative counselling helps or (2) were previously told by patients that they could see intraoperatively and/or that they were frightened by their visual sensations. These findings were statistically significant. The majority of anaesthesia providers in the USA, UK and Singapore are aware that patients may experience a variety of visual sensations during cataract surgery under regional or topical anaesthesia. Those who have previously managed patients undergoing cataract surgery under topical anaesthesia are more likely to believe this compared to those who have not.

  7. Parents' experiences of transition when their infants are discharged from the Neonatal Intensive Care Unit: a systematic review protocol.

    Science.gov (United States)

    Aagaard, Hanne; Uhrenfeldt, Lisbeth; Spliid, Mette; Fegran, Liv

    2015-10-01

    The objective of this review is to identify, appraise and synthesize the best available studies exploring parents' experiences of transition when their infants are discharged from the Neonatal Intensive Care Unit (NICU).The review questions are: Giving birth to a premature or sick infant is a stressful event for parents. The parents' presence and participation in the care of the infant is fundamental to reduce this stress and to provide optimal care for both the premature or sick infant and family. A full term pregnancy is estimated to last between 37 and 40 weeks. Preterm infants born before 28 week (5.1%) are defined as extremely preterm, while those who are born between 28 to 31 weeks (10.3%) are defined as very preterm. The majority of the preterm (84.1%) are born between 32 to 37 week and may have significant medical problems requiring prolonged hospitalization.The prevalence of preterm birth is increasing worldwide. More than one in ten babies are born preterm annually. This is equal to 15 million preterm infants born globally and the second largest direct cause of deaths in children below five. The highest rates of preterm birth are in Sub-Saharan Africa and South Asia (more than 60%) and the lowest rates are in Northern Africa, Western Asia, Latin America and the Caribbean. The preterm birth rates in the developing countries vary widely and follow a different pattern than in high income countries.The preterm birth rate has increased between 1990 and 2010 with an average of 0.8% annually in almost all countries. Morbidity among critically ill newborn and preterm infants vary widely from no late effects to severe complications, such as visual or hearing impairment, chronic lung disease, growth failure in infancy and specific learning impairments, dyslexia and reduced academic achievement. Full term infants may also experience significant health problems requiring neonatal intensive care. The most common reasons for a full term infant to be admitted to a NICU

  8. Maternity care for trafficked women: Survivor experiences and clinicians' perspectives in the United Kingdom's National Health Service.

    Science.gov (United States)

    Bick, Debra; Howard, Louise M; Oram, Sian; Zimmerman, Cathy

    2017-01-01

    Although trafficked women and adolescents are at risk of unprotected or forced sex, there is little research on maternity care among trafficking survivors. We explored health care needs, service use and challenges among women who became pregnant while in the trafficking situation in the United Kingdom (UK) and clinicians' perspectives of maternity care for trafficked persons. Cross-sectional survey and qualitative interviews with trafficking survivors recruited from statutory and voluntary sector organisations in England and qualitative interviews with maternity clinicians and family doctors undertaken to offer further insight into experiences reported by these women. Twenty-eight (29%) of 98 women who took part in a large study of trafficking survivors reported one or more pregnancies while trafficked, whose data are reported here. Twelve (42.8%) of these women reported at least one termination of pregnancy while in the trafficking situation and 25 (89.3%) experienced some form of mental health disorder. Nineteen (67.9%) women experienced pre-trafficking physical abuse and 9 (32.%) sexual abuse. A quarter of women were trafficked for sexual exploitation, six for domestic servitude and two for manual labour. Survivors and clinicians described service challenges, including restrictions placed on women's movements by traffickers, poor knowledge on how to access maternity care, poor understanding of healthcare entitlements and concerns about confidentiality. Maternity care clinicians recognised potential indicators of trafficking, but considered training would help them identify and respond to victims. Main limitations include that findings reflect women who had exited the trafficking situation, however as some had only recently exited the trafficking situation, difficulties with recall were likely to be low. More than one in four women became pregnant while trafficked, indicating that maternity services offer an important contact point for identification and care

  9. The National School Lunch Program: Ideas, proposals, policies, and politics shaping students' experiences with school lunch in the United States, 1946 - present

    OpenAIRE

    Gosliner, Wendi Anne

    2013-01-01

    AbstractThe National School Lunch Program:Ideas, proposals, policies, and politics shaping students' experiences with school lunch in the United States, 1946 - presentBy Wendi Anne GoslinerDoctor of Public HealthUniversity of California, BerkeleyProfessor Ann Keller, ChairOn an average school day in 2012, The National School Lunch Program (NSLP) supported the provision of lunch meals to almost 2/3 of school-age youth in the United States. Recent spikes in childhood obesity rates and the emerg...

  10. Preclinical and clinical studies of photodynamic action on some pathogenic micro-organisms of the oral cavity

    Science.gov (United States)

    Ovchinnikov, Ilya S.; Tuchin, Valery V.; Ivanov, Krill I.; Titorenko, Vladimir A.

    2001-10-01

    The work is devoted to an analysis of pre-clinical and clinical experiments on photodynamic action of HeNe laser radiation in aggregate with a cation thiazinium dye Methylene Blue (MB) on a mix of pathogenic and conditionally pathogenic aerobic bacteria being activators of pyoinflammatory diseases of oral cavity. Concentration of photosensitizes at which there is no own bactericidal influence on dying microflora, and parameters of influence at which the efficiency of irradiated microflora defeat reaches 99% are determined.

  11. Development of a unit suitable for corrosion monitoring in district heating systems. Experiences with the LOCOR-cell test method

    DEFF Research Database (Denmark)

    Andersen, Asbjørn; Hilbert, Lisbeth Rischel

    2004-01-01

    A by-pass unit suitable for placement of a number of different probes for corrosion monitoring has been designed. Also measurements of water parameters are allowed in a side stream from the unit. The project is a part of the Nordic Innovation Fund project KORMOF. The by-pass unit has been installed...... in 6 pressurised circulating heating systems and in one cooling system. 7 different corrosion monitoring methods have been used to study corrosion rates and types in dependency of water chemistry. This paper describes the design of the by-pass unit including water analysis methods. It also describes...... the purpose, background and gained results of one of the used monitoring techniques, the crevice corrosion measurements obtained by the LOCOR-Cell„§. The crevice corrosion cell was developed by FORCE Technology in a previous district heating project financed by Nordic Industrial Fund (1)(2). Results from...

  12. Stress, Burnout and Coping Strategies in Preclinical Medical Students

    Science.gov (United States)

    Fares, Jawad; Al Tabosh, Hayat; Saadeddin, Zein; El Mouhayyar, Christopher; Aridi, Hussam

    2016-01-01

    It is acknowledged that physicians do not seek the same expert aid for themselves as they would offer their patients. In their preclinical years, medical students appear to espouse comparable behavior. To many, medicine is described as a never-ending path that places the student under heavy stress and burnout from the beginning, leaving him/her vulnerable and with insufficient coping methods. Hence, the objective of this study is to 1) explore the prevalence of stress and burnout among preclinical medical students, and 2) propose solutions to decrease stress and burnout and improve medical education in the preclinical years. A detailed scholarly research strategy using Google Scholar, Scopus, Embase, MEDLINE and PubMed was implemented to highlight key themes that are relevant to preclinical medical students’ stress and burnout. Stress varied among different samples of medical students and ranged between 20.9% and 90%. Conversely, burnout ranged between 27% and 75%. Methods that help in reducing the incidence of stress and burnout by promoting strategies that focus on personal engagement, extracurricular activities, positive reinterpretation and expression of emotion, student-led mentorship programs, evaluation systems, career counseling and life coaching should be adopted. PMID:27042604

  13. Perspective: Recommendations for benchmarking pre-clinical studies of nanomedicines

    Science.gov (United States)

    Dawidczyk, Charlene M.; Russell, Luisa M.; Searson, Peter C.

    2015-01-01

    Nanoparticle-based delivery systems provide new opportunities to overcome the limitations associated with traditional small molecule drug therapy for cancer, and to achieve both therapeutic and diagnostic functions in the same platform. Pre-clinical trials are generally designed to assess therapeutic potential and not to optimize the design of the delivery platform. Consequently, progress in developing design rules for cancer nanomedicines has been slow, hindering progress in the field. Despite the large number of pre-clinical trials, several factors restrict comparison and benchmarking of different platforms, including variability in experimental design, reporting of results, and the lack of quantitative data. To solve this problem, we review the variables involved in the design of pre-clinical trials and propose a protocol for benchmarking that we recommend be included in in vivo pre-clinical studies of drug delivery platforms for cancer therapy. This strategy will contribute to building the scientific knowledge base that enables development of design rules and accelerates the translation of new technologies. PMID:26249177

  14. Preclinical animal research on therapy dosimetry with dual isotopes

    NARCIS (Netherlands)

    M.W. Konijnenberg (Mark); M. de Jong (Marion)

    2011-01-01

    textabstractPreclinical research into radionuclide therapies based on radiation dosimetry will enable the use of any LET-equivalent radionuclide. Radiation dose and dose rate have significant influence on dose effects in the tumour depending on its radiation sensitivity, possibilities for repair of

  15. A preclinical mouse model of invasive lobular breast cancer metastasis

    NARCIS (Netherlands)

    Doornebal, Chris W.; Klarenbeek, Sjoerd; Braumuller, Tanya M.; Klijn, Christiaan N.; Ciampricotti, Metamia; Hau, Cheei-Sing; Hollmann, Markus W.; Jonkers, Jos; de Visser, Karin E.

    2013-01-01

    Metastatic disease accounts for more than 90% of cancer-related deaths, but the development of effective antimetastatic agents has been hampered by the paucity of clinically relevant preclinical models of human metastatic disease. Here, we report the development of a mouse model of spontaneous

  16. Stress, Burnout and Coping Strategies in Preclinical Medical Students.

    Science.gov (United States)

    Fares, Jawad; Al Tabosh, Hayat; Saadeddin, Zein; El Mouhayyar, Christopher; Aridi, Hussam

    2016-02-01

    It is acknowledged that physicians do not seek the same expert aid for themselves as they would offer their patients. In their preclinical years, medical students appear to espouse comparable behavior. To many, medicine is described as a never-ending path that places the student under heavy stress and burnout from the beginning, leaving him/her vulnerable and with insufficient coping methods. Hence, the objective of this study is to 1) explore the prevalence of stress and burnout among preclinical medical students, and 2) propose solutions to decrease stress and burnout and improve medical education in the preclinical years. A detailed scholarly research strategy using Google Scholar, Scopus, Embase, MEDLINE and PubMed was implemented to highlight key themes that are relevant to preclinical medical students' stress and burnout. Stress varied among different samples of medical students and ranged between 20.9% and 90%. Conversely, burnout ranged between 27% and 75%. Methods that help in reducing the incidence of stress and burnout by promoting strategies that focus on personal engagement, extracurricular activities, positive reinterpretation and expression of emotion, student-led mentorship programs, evaluation systems, career counseling and life coaching should be adopted.

  17. Nanotechnology and nuclear medicine; research and preclinical applications.

    Science.gov (United States)

    Assadi, Majid; Afrasiabi, Kolsoom; Nabipour, Iraj; Seyedabadi, Mohammad

    2011-01-01

    The birth of nanotechnology in human society was around 2000 years ago and soon found applications in various fields. In this article, we highlight the current status of research and preclinical applications and also future prospects of nanotechnology in medicine and in nuclear medicine. The most important field is cancer. A regular nanotechnology training program for nuclear medicine physicians may be welcome.

  18. USHERING IN THE STUDY AND TREATMENT OF PRECLINICAL ALZHEIMER DISEASE

    Science.gov (United States)

    Langbaum, Jessica B.S.; Fleisher, Adam S.; Chen, Kewei; Ayutyanont, Napatkamon; Lopera, Francisco; Quiroz, Yakeel T.; Caselli, Richard J.; Tariot, Pierre N.; Reiman, Eric M.

    2014-01-01

    Researchers have begun to characterize the subtle biological and cognitive processes that precede the clinical onset of Alzheimer disease (AD), and to set the stage for accelerated evaluation of experimental treatments to delay the onset, reduce the risk of or completely prevent clinical decline. Here, we provide an overview of the experimental strategies, and brain imaging and cerebrospinal fluid biomarker measures that are used in early detection and tracking of AD, highlighting at-risk individuals who could be suitable for preclinical monitoring. We discuss how these advances have contributed to reconceptualization of AD as a sequence of biological changes that occur during progression from preclinical AD, to mild cognitive impairment and finally dementia, and we review recently proposed research criteria for preclinical AD. Advances in the study of preclinical AD have driven the recognition that efficacy of at least some AD therapies may depend on initiation of treatment before clinical manifestation of disease, leading to a new era of AD prevention research. PMID:23752908

  19. Subjective and Objective Evaluation of PBL Outcomes in Preclinical ...

    African Journals Online (AJOL)

    Subjective and Objective Evaluation of PBL Outcomes in Preclinical Medical Students. ... ABSTRACT: Problem based learning curriculum is widely recognized as a progressive, learner-centered, active learning approach and is currently used in the entire medical curriculum in over 10% of medical schools worldwide.

  20. Image-guided drug delivery: preclinical applications and clinical translation

    NARCIS (Netherlands)

    Ojha, Tarun; Rizzo, Larissa; Storm, Gerrit; Kiessling, Fabian; Lammers, Twan Gerardus Gertudis Maria

    2015-01-01

    Image-guided drug delivery refers to the combination of drug targeting and imaging. Preclinically, image-guided drug delivery can be used for several different purposes, including for monitoring biodistribution, target site accumulation, off-target localization, drug release and drug efficacy.

  1. Using peer-assisted learning to teach basic surgical skills: medical students’ experiences

    Directory of Open Access Journals (Sweden)

    Mahdi Saleh

    2013-08-01

    Full Text Available Standard medical curricula in the United Kingdom (UK typically provide basic surgical-skills teaching before medical students are introduced into the clinical environment. However, these sessions are often led by clinical teaching fellows and/or consultants. Depending on the roles undertaken (e.g., session organizers, peer tutors, a peer-assisted learning (PAL approach may afford many benefits to teaching surgical skills. At the University of Keele's School of Medicine, informal PAL is used by the Surgical Society to teach basic surgical skills to pre-clinical students. As medical students who assumed different roles within this peer-assisted model, we present our experiences and discuss the possible implications of incorporating such sessions into UK medical curricula. Our anecdotal evidence suggests that a combination of PAL sessions – used as an adjunct to faculty-led sessions – may provide optimal learning opportunities in delivering a basic surgical skills session for pre-clinical students.

  2. Development of computational small animal models and their applications in preclinical imaging and therapy research

    NARCIS (Netherlands)

    Xie, Tianwu; Zaidi, Habib

    The development of multimodality preclinical imaging techniques and the rapid growth of realistic computer simulation tools have promoted the construction and application of computational laboratory animal models in preclinical research. Since the early 1990s, over 120 realistic computational animal

  3. 77 FR 71194 - Draft Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy...

    Science.gov (United States)

    2012-11-29

    ...] Draft Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy... Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy Products,'' dated November... Evaluation (CBER), Office of Cellular, Tissue, and Gene Therapies (OCTGT). The product areas covered by this...

  4. A Novel Telemanipulated Robotic Assistant for Surgical Endoscopy: Preclinical Application to ESD.

    Science.gov (United States)

    Zorn, Lucile; Nageotte, Florent; Zanne, Philippe; Legner, Andras; Dallemagne, Bernard; Marescaux, Jacques; de Mathelin, Michel

    2018-04-01

    Minimally invasive surgical interventions in the gastrointestinal tract, such as endoscopic submucosal dissection (ESD), are very difficult for surgeons when performed with standard flexible endoscopes. Robotic flexible systems have been identified as a solution to improve manipulation. However, only a few such systems have been brought to preclinical trials as of now. As a result, novel robotic tools are required. We developed a telemanipulated robotic device, called STRAS, which aims to assist surgeons during intraluminal surgical endoscopy. This is a modular system, based on a flexible endoscope and flexible instruments, which provides 10 degrees of freedom (DoFs). The modularity allows the user to easily set up the robot and to navigate toward the operating area. The robot can then be teleoperated using master interfaces specifically designed to intuitively control all available DoFs. STRAS capabilities have been tested in laboratory conditions and during preclinical experiments. We report 12 colorectal ESDs performed in pigs, in which large lesions were successfully removed. Dissection speeds are compared with those obtained in similar conditions with the manual Anubiscope platform from Karl Storz. We show significant improvements ( ). These experiments show that STRAS (v2) provides sufficient DoFs, workspace, and force to perform ESD, that it allows a single surgeon to perform all the surgical tasks and those performances are improved with respect to manual systems. The concepts developed for STRAS are validated and could bring new tools for surgeons to improve comfort, ease, and performances for intraluminal surgical endoscopy.

  5. Comparative Study on Subjective Experience of Elder Abuse Between Older Korean Immigrants in the United States and Older Koreans in Korea.

    Science.gov (United States)

    Chang, Miya

    2018-01-01

    This study examines the prevalence of elder abuse and the relationship between sociodemographic factors and elder abuse among older Koreans in the United States and Korea. Survey data from older Koreans aged between 60 and 79 years from the two countries ( n = 480) were analyzed descriptively and in binary logistic regressions. This study found a similar prevalence of elder abuse in the two samples, with 26% of older Korean immigrants in the United States reporting abuse and 23% of older Koreans in Korea reporting abuse. However, there were significant differences in the types of emotional abuse experienced by older Koreans in both countries. Reports of some types of emotional abuse, such as 'name calling' and 'silent treatment,' were significantly higher in the United States than in Korea. These findings expand our knowledge of the experience of elder abuse among older Koreans in both countries.

  6. Assessment of the Relationship between Recurrent High-risk Pregnancy and Mothers’ Previous Experience of Having an Infant Admitted to a Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Sedigheh Hantoosh Zadeh

    2015-01-01

    Full Text Available Background & aim:  High-risk pregnancies increase the risk of Intensive Care Unit (ICU and Neonatal Intensive Care Unit (NICU admission in mothers and their newborns. In this study, we aimed to identify the association between the recurrence of high-risk pregnancy and mothers’ previous experience of having an infant admitted to NICU. Methods:We performed a cohort, retrospective study to compare subsequent pregnancy outcomes among 232 control subjects and 200 female cases with a previous experience of having a newborn requiring NICU admission due to intrauterine growth retardation, preeclampsia, preterm birth, premature rupture of membranes, and asphyxia. The information about the prevalence of subsequent high-risk pregnancies was gathered via phone calls. Results: As the results indicated, heparin, progesterone, and aspirin were more frequently administered in the case group during subsequent pregnancies, compared to the control group (P

  7. Otolaryngology in the medical school curriculum: Current trends in the United States.

    Science.gov (United States)

    Boscoe, Elizabeth F; Cabrera-Muffly, Cristina

    2017-02-01

    To identify trends in medical school otolaryngology curriculum requirements. Survey of United States allopathic medical schools. A survey was sent to deans of curriculum at allopathic medical schools. We identified opportunities for medical students to learn basic concepts in otolaryngology during their undergraduate medical training. The opportunities were classified into preclinical and clinical as well as elective and mandatory rotations. Of the schools surveyed, 60% responded. Mean class size was 149 students. Sixty-eight percent of surveyed schools noted that 75% to 100% of their students participated in preclinical otolaryngology experiences, with 59% reporting a mandatory preclinical otolaryngology module for all students. Eighty-nine percent of schools offered otolaryngology as a clinical elective rotation, with a mean of 12 students participating yearly. Only 7% of schools required a mandatory otolaryngology clinical rotation. Our data suggest that medical students do not receive sufficient exposure to otolaryngology during medical school. Increased requirements for otolaryngology curriculum may be beneficial to all medical students, regardless of their specialty choice. NA. Laryngoscope, 00:000-000, 2016 127:346-348, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Peer-mentoring Program during the Preclinical Years of Medical School at Bonn University: a Project Description.

    Science.gov (United States)

    Lapp, Hendrik; Makowka, Philipp; Recker, Florian

    2018-01-01

    Introduction: To better prepare young medical students in a thorough and competent manner for the ever increasing clinical, scientific, as well as psychosocial requirements, universities should enable a close, personal transfer of experience and knowledge. Structured mentoring programs are a promising approach to incorporate clinical subjects earlier into the preclinical training. Such a mentoring program facilitates the prioritization of concepts from a broad, theory-heavy syllabus. Here we report the experiences and results of the preclinical mentoring program of Bonn University, which was introduced in the winter semester of 2012/2013. Project desciption: The program is characterized by the concept of peer-to-peer teaching during the preclinical semesters of medical school. Regular, voluntary course meetings with different clinical case examples provide students the opportunity to apply knowledge acquired from the basic science curricula; furthermore, a personal contact for advice and support is ensured. Thus, an informal exchange of experiences is made possible, which provides to the students motivational and learning aids, in particular for the oral examination at the end of the premedical semesters as well as for other examinations during medical school. Results: Over the course of the preceding three years the number of participants and the interest in the program grew steadily. The analysis of collected evaluations confirms very good communication between mentors and students (>80%), as well as consistently good to very good quality and usefulness in terms of the mentors' subject-specific and other advice. The overall final evaluation of the mentoring program was always good to very good (winter semester: very good 64.8±5.0%, good 35.2±5.0%, summer semester: very good 83.9±7.5%, good 16.1±7.5%) Summary: In summary, it has been shown that the mentoring program had a positive impact on the development, education and satisfaction of students beginning

  9. 5-year operation experience with the 1.8 K refrigeration units of the LHC cryogenic system

    CERN Document Server

    Ferlin, G; Claudet, S; Pezzetti, M

    2015-01-01

    Since 2009, the Large Hadron Collider (LHC) is in operation at CERN. The LHC superconducting magnets distributed over eight sectors of 3.3-km long are cooled at 1.9 K in pressurized superfluid helium. The nominal operating temperature of 1.9 K is produced by eight 1.8-K refrigeration units based on centrifugal cold compressors (3 or 4 stages depending to the vendor) combined with warm volumetric screw compressors with sub-atmospheric suction. After about 5 years of continuous operation, we will present the results concerning the availability for the final user of these refrigeration units and the impact of the design choice on the recovery time after a system trip. We will also present the individual results for each rotating machinery in terms of failure origin and of Mean Time between Failure (MTBF), as well as the consolidations and upgrades applied to these refrigeration units.

  10. 5-year operation experience with the 1.8 K refrigeration units of the LHC cryogenic system

    Science.gov (United States)

    Ferlin, G.; Tavian, L.; Claudet, S.; Pezzetti, M.

    2015-12-01

    Since 2009, the Large Hadron Collider (LHC) is in operation at CERN. The LHC superconducting magnets distributed over eight sectors of 3.3-km long are cooled at 1.9 K in pressurized superfluid helium. The nominal operating temperature of 1.9 K is produced by eight 1.8-K refrigeration units based on centrifugal cold compressors (3 or 4 stages depending to the vendor) combined with warm volumetric screw compressors with sub-atmospheric suction. After about 5 years of continuous operation, we will present the results concerning the availability for the final user of these refrigeration units and the impact of the design choice on the recovery time after a system trip. We will also present the individual results for each rotating machinery in terms of failure origin and of Mean Time between Failure (MTBF), as well as the consolidations and upgrades applied to these refrigeration units.

  11. The experience in the Cernavoda Unit 1 operation - a stimulating argument for future nuclear power development in Romania

    International Nuclear Information System (INIS)

    Rotaru, I.; Bucur, I.; Galeriu, A.C.; Budan, O.

    1999-01-01

    The Romanian nuclear program has been developed based on the option for CANDU type reactors. At the beginning, this program was unrealistically conceived and its management was inappropriate. The program was reconsidered in 1990 and the management policy and organization structure were also adapted accordingly. The paper presents, in the first part, the actual organization structure, adapted for the execution of the current and future activities, related to the nuclear power program. The performance achieved by Cernavoda Unit 1 constitutes the main part of the paper. The performances described demonstrate that the Cernavoda Unit 1 is a success and the Romania's electricity needs are satisfied in a proportion of about 12% by the nuclear power. The paper also presents a general view on Cernavoda Unit 2 perspectives. The essential conclusion of the paper is that the continuation of the nuclear program appears to be a logical option, generally accepted in Romania, limited only by financial restraints. (author)

  12. Regulation of Say on Pay: Engineering Incentives for Executives and Directors – Experiences from the United States and Implications for Regulation in Switzerland

    OpenAIRE

    Müller, Lukas

    2011-01-01

    The debate about the compensation of executives and directors is a discussion about incentives and agency costs. This article analyzes basic tools to reduce agency costs and also assesses the ongoing debate about the future regulation of the compensation of executives and directors. It draws upon legislative experience from the United States. Recently proposed legislation in Switzerland attempts to empower shareholders with the draft of the Swiss Code of Obligations (CO). The main motivation ...

  13. Cross-cultural comparison of long-term care in the United States and Finland: Research done through a short-term study-abroad experience.

    Science.gov (United States)

    Kruger, Tina M; Gilland, Sarah; Frank, Jacquelyn B; Murphy, Bridget C; English, Courtney; Meade, Jana; Morrow, Kaylee; Rush, Evan

    2017-01-01

    In May 2014, a short-term study-abroad experience was conducted in Finland through a course offered at Indiana State University (ISU). Students and faculty from ISU and Eastern Illinois University participated in the experience, which was created to facilitate a cross-cultural comparison of long-term-care settings in the United States and Finland. With its outstanding system of caring for the health and social needs of its aging populace, Finland is a logical model to examine when considering ways to improve the quality of life for older adults who require care in the United States . Those participating in the course visited a series of long-term-care facilities in the region surrounding Terre Haute, Indiana, then travelled to Lappeenranta, Finland to visit parallel sites. Through limited-participation observation and semistructured interviews, similarities and differences in experiences, educations, and policies affecting long-term care workers in the United States and Finland were identified and are described here.

  14. The relevance of preclinical research models for the development of antimigraine drugs: Focus on 5-HT1B/1D and CGRP receptors

    DEFF Research Database (Denmark)

    Gupta, S.; Villalon, C.M.

    2010-01-01

    to the relief of migraineurs. Pathophysiological factors culminating into migraine headaches have not yet been completely deciphered and, thus, pose an additional challenge for preclinical research in the absence of any direct experimental marker. Migraine provocation experiments in humans use a head......-score to evaluate migraine, as articulated by the volunteer, which cannot be applied to laboratory animals. Therefore, basic research focuses on different symptoms and putative mechanisms, one at a time or in combination, to validate the hypotheses. Studies in several species, utilizing different preclinical...... incorporating the newer ideas/techniques in order to get better insights into migraine pathophysiology. (C) 2010 Elsevier Inc. All rights reserved...

  15. Teaching Mass Transfer and Filtration Using Crossflow Reverse Osmosis and Nanofiltration: An Experiment for the Undergraduate Unit Operations Lab

    Science.gov (United States)

    Anastasio, Daniel; McCutcheon, Jeffrey

    2012-01-01

    A crossflow reverse osmosis (RO) system was built for a senior-level chemical engineering unit operations laboratory course. Intended to teach students mass transfer fundamentals related to membrane separations, students tested several commercial desalination membranes, measuring water flux and salt rejections at various pressures, flow rates, and…

  16. Experience with the selection method in pine stands in the southern United States, with implications for future application

    Science.gov (United States)

    James M. Guldin

    2011-01-01

    The selection method applied in shade-intolerant pine stands in the southern United States has been shown to be an effective method of uneven-aged silviculture, but it is becoming less frequently practiced for a variety of reasons. Economically, the high value of standing timber puts fully stocked uneven-aged pine stands at risk of liquidation if the timberland is sold...

  17. Quantifying the multi-scale response of avifauna to prescribed fire experiments in the southwest United States

    Science.gov (United States)

    Brett G. Dickson; Barry R. Noon; Curtis H. Flather; Stephanie Jentsch; William M. Block

    2009-01-01

    Landscape-scale disturbance events, including ecological restoration and fuel reduction activities, can modify habitat and affect relationships between species and their environment. To reduce the risk of uncharacteristic stand-replacing fires in the southwestern United States, land managers are implementing restoration and fuels treatments (e.g., mechanical thinning,...

  18. Expatriate Academic Staff in the United Arab Emirates: The Nature of Their Work Experiences in Higher Education Institutions

    Science.gov (United States)

    Austin, Ann E.; Chapman, David W.; Farah, Samar; Wilson, Elisabeth; Ridge, Natasha

    2014-01-01

    As many countries expand their higher education systems, they must attract, support, and retain qualified academic staff. This paper focuses on the United Arab Emirates (UAE) as a case study of a nation drawing on large numbers of mostly expatriate faculty working in short-term academic appointments. The paper begins by considering the national…

  19. Taiwanese Parents' Experience of Making a “Do Not Resuscitate” Decision for Their Child in Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Shu-Mei Liu, RN, MN

    2014-03-01

    Conclusion: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process.

  20. Collaborative Disaster Preparedness: Vietnam, the United States, and Regional Experiences (Proceedings from Da Nang, Vietnam, August 1820, 2015)

    Science.gov (United States)

    2016-05-19

    Children, and Catholic Relief Services work to build capacity for communities to respond to disasters 4. incident command system (ICS) (U.S. Forest Service...including Australia, Fiji, France , New Zealand, and the United Kingdom) offered military support to the government’s response. The civilian

  1. SU-E-T-606: Performance of MR-Based 3D FXG Dosimetry for Preclinical Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Welch, M [Department of Medical Biophysics, University of Toronto, Toronto, ON (Canada); Jaffray, D [Department of Medical Biophysics, University of Toronto, Toronto, ON (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON (Canada); Department of Radiation Oncology, University of Toronto, Toronto, ON (Canada); TECHNA Institute for the Advancement of Technology for Health, Toronto, ON (Canada)

    2015-06-15

    Purpose: Technological advances have revolutionized preclinical radiation research to enable precise radiation delivery in preclinical models. Kilovoltage x-rays and complex geometries in preclinical radiation studies challenge conventional dosimetry methods. Previously developed gel-based dosimetry provides a viable means of accommodating complex geometries and accurately reporting dose at kV energies. This paper will describe the development and evaluation of gel-based ferrous xylenol-orange (FXG) dosimetry using a 7T preclinical imaging system. Methods: To confirm water equivalence, Zeff values were calculated for the FXG material, water and ICRU defined soft tissue. Proton T1 relaxivity response in FXG was measured using a preclinical 7T MR and a small animal irradiator for a dose range of 1–22 Gy. FXG was contained in 50 ml centrifuge tubes and irradiated with a 225 kVp x-ray beam at a nominal dose rate of 2.3 Gy/min. Pre and post irradiation maps of the T1 relaxivity were collected using variable TR spin-echo imaging (TE 6.65 ms; TR 500, 750, 1000, 1500, 2000, 3000 and 5000 ms) with 2 mm thick slices, 0.325 mm/pixel, 3 averages and an acquisition time of 26 minutes. A linear fit to the change in relaxation rate (1/T1) for the delivered doses reported the gel sensitivity in units of ms{sup -1}Gy{sup -1}. Irradiation and imaging studies were repeated using three batches of gel over 72 hrs. Results: FXG has a Zeff of 3.8 for the 225 kVp spectrum used; differing from water and ICRU defined soft tissue by 0.5% and 2.5%, respectively. The average sensitivity for the FXG dosimeter was 31.5 ± 0.7 ms{sup -1}Gy{sup -1} (R{sup 2} = 0.9957) with a y-intercept of −29.4 ± 9.0 ms{sup -1}. Conclusion: Preliminary results for the FXG dosimeter properties, sensitivity, and dose linearity at preclinical energies is promising. Future work will explore anatomically relevant tissue inclusions to test MR performance. Student funding provided by The Terry Fox Foundation

  2. Dr Julia King CBE FREng, Chief Executive Designate, Institute of Physics (United Kingdom), visiting the NA48 experiment.

    CERN Multimedia

    Patrice Loïez

    2002-01-01

    Photo 02: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (right) with A. Ceccucci and K. Peach. Photo 05: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (centre) with A. Ceccucci and C. Lazzeroni. Photo 08: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (second from left) with (left to right) R. Barlow, J. Wood, N. McCubbin, K. Peach, A. Ceccucci, C. Lazzeroni, M. Patel and D. Munday.

  3. A comparison of the education and work experiences of immigrant and the United States of America-trained nurses.

    Science.gov (United States)

    Mazurenko, O; Gupte, G; Shan, G

    2014-12-01

    This study examined the education and work experience of immigrant and American-trained registered nurses from 1988 to 2008. The USA increasingly relies on immigrant nurses to fill a significant nursing shortage. These nurses receive their training overseas, but can obtain licenses to practice in different countries. Although immigrant nurses have been in the USA workforce for several decades, little is known about how their education and work experience compares with USA-trained nurses. Yet much is presumed by policy makers and administrators who perpetuate the stereotype that immigrant nurses are not as qualified. We analysed the National Sample Survey of Registered Nurses datasets from 1988 to 2008 using the Cochran-Armitage trend tests. Our findings showed similar work experience and upward trends in education among both groups of nurses. However, American-trained nurses were more likely to further advance their education, whereas immigrant nurses were more likely to have more work experience and practice in a wider range of healthcare settings. Although we discovered differences between nurses trained in the USA and abroad, we theorize that these differences even out, as education and work experience each have their own distinct caregiving advantages. Immigrant nurses are not less qualified than their American-trained counterparts. However, healthcare providers should encourage them to further pursue their education and certifications. Even though immigrant nurses' education and work experience are comparable with their American counterparts, workforce development policies may be particularly beneficial for this group. © 2014 International Council of Nurses.

  4. Preclinical diagnosis of Alzheimer's disease: Prevention or prediction?

    Directory of Open Access Journals (Sweden)

    Ricardo Nitrini

    Full Text Available Abstract The diagnosis of Alzheimer's disease (AD for cases with dementia may be too late to allow effective treatment. Criteria for diagnosis of preclinical AD suggested by the Alzheimer's Association include the use of molecular and structural biomarkers. Preclinical diagnosis will enable testing of new drugs and forms of treatment toward achieving successful preventive treatment. But what are the advantages for the individual? To know that someone who is cognitively normal is probably going to develop AD's dementia when there is no effective preventive treatment is definitely not good news. A research method whereby volunteers are assigned to receive treatment or placebo without knowing whether they are in the control or at-risk arm of a trial would overcome this potential problem. If these new criteria are used wisely they may represent a relevant milestone in the search for a definitive treatment for AD.

  5. Prediction of antibiotic resistance: time for a new preclinical paradigm?

    DEFF Research Database (Denmark)

    Sommer, Morten Otto Alexander; Munck, Christian; Toft-Kehler, Rasmus Vendler

    2017-01-01

    Predicting the future is difficult, especially for evolutionary processes that are influenced by numerous unknown factors. Still, this is what is required of drug developers when they assess the risk of resistance arising against a new antibiotic candidate during preclinical development. In this ......Predicting the future is difficult, especially for evolutionary processes that are influenced by numerous unknown factors. Still, this is what is required of drug developers when they assess the risk of resistance arising against a new antibiotic candidate during preclinical development....... In this Opinion article, we argue that the traditional procedures that are used for the prediction of antibiotic resistance today could be markedly improved by including a broader analysis of bacterial fitness, infection dynamics, horizontal gene transfer and other factors. This will lead to more informed...

  6. Preclinical Alzheimer's disease: Definition, natural history, and diagnostic criteria.

    Science.gov (United States)

    Dubois, Bruno; Hampel, Harald; Feldman, Howard H; Scheltens, Philip; Aisen, Paul; Andrieu, Sandrine; Bakardjian, Hovagim; Benali, Habib; Bertram, Lars; Blennow, Kaj; Broich, Karl; Cavedo, Enrica; Crutch, Sebastian; Dartigues, Jean-François; Duyckaerts, Charles; Epelbaum, Stéphane; Frisoni, Giovanni B; Gauthier, Serge; Genthon, Remy; Gouw, Alida A; Habert, Marie-Odile; Holtzman, David M; Kivipelto, Miia; Lista, Simone; Molinuevo, José-Luis; O'Bryant, Sid E; Rabinovici, Gil D; Rowe, Christopher; Salloway, Stephen; Schneider, Lon S; Sperling, Reisa; Teichmann, Marc; Carrillo, Maria C; Cummings, Jeffrey; Jack, Cliff R

    2016-03-01

    During the past decade, a conceptual shift occurred in the field of Alzheimer's disease (AD) considering the disease as a continuum. Thanks to evolving biomarker research and substantial discoveries, it is now possible to identify the disease even at the preclinical stage before the occurrence of the first clinical symptoms. This preclinical stage of AD has become a major research focus as the field postulates that early intervention may offer the best chance of therapeutic success. To date, very little evidence is established on this "silent" stage of the disease. A clarification is needed about the definitions and lexicon, the limits, the natural history, the markers of progression, and the ethical consequence of detecting the disease at this asymptomatic stage. This article is aimed at addressing all the different issues by providing for each of them an updated review of the literature and evidence, with practical recommendations. Copyright © 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  7. Lifelong Learning Experience and Level of Social Exclusion or Inclusion of Asian Communities Living in Denmark and the United Kingdom

    DEFF Research Database (Denmark)

    Singla, Rashmi; Klein, Sonia; Panesar, Jasbir

    2005-01-01

    This article reflects the situation of Asian communities in Denmark and the United Kingdom which is influenced by global trends, the patterns of differing learning they participate in which are influenced by the concept of LifeLong Learning within each country, educational opportunities, socio......-economic positions of this target group and entrepreneurship activities taking place. Global trends influence disadvantaged learners level of participation in learning within Europe. The Asian communities in Denmark and the United Kingdom, despite the differences in migration period, have made the decision to live......, including Asian communities, have been negatively affected in the recent years due to the increased political restrictions and media coverage. In comparison, despite the recent immigration policies in the UK, many members of the Asian communities have embraced the opportunities LifeLong Learning has...

  8. Risks of serious complications and death from smallpox vaccination: A systematic review of the United States experience, 1963–1968

    OpenAIRE

    Aragón, Tomás J; Ulrich, Skylar; Fernyak, Susan; Rutherford, George W

    2003-01-01

    Abstract Background The United States (US) has re-instituted smallpox vaccinations to prepare for an intentional release of the smallpox virus into the civilian population. In an outbreak, people of all ages will be vaccinated. To prepare for the impact of large-scale ring and mass vaccinations, we conducted a systematic review of the complication and mortality risks of smallpox vaccination. We summarized these risks for post-vaccinial encephalitis, vaccinia necrosum (progressive vaccinia), e...

  9. Confidential donation confirmation as an alternative to confidential unit exclusion: 15 months experience of the HEMOMINAS foundation

    Directory of Open Access Journals (Sweden)

    Flávia Cristine Martineli Loureiro

    2011-01-01

    Full Text Available BACKGROUND: Confidential unit exclusion remains a controversial strategy to reduce the residual risk of transfusion-transmitted infections. OBJECTIVE: This study aimed to analyze confidential unit exclusion from its development in a large institution in light of confidential donation confirmation. METHODS: Data of individuals who donated from October 1, 2008 to December 31, 2009 were analyzed in a case-control study. The serological results and sociodemographic characteristics of donors who did not confirm their donations were compared to those who did. Variables with p-values < 0.20 in univariate analysis were included in a logistic multivariate analysis. RESULTS: In the univariate analysis there was a statically significant association between positive serological results and response to confidential donation confirmation of "No". Donation type, (firsttime or return donor - OR 1.69, CI 1.37-2.09, gender (OR 1.66, CI 1.35-2.04, education level (OR 2.82, CI 2.30-3.47 and ethnic background (OR 0.67, CI 0.55-0.82 were included in the final logistic regression model. In all logistic regression models analyzed, the serological suitability and confidential donation confirmation were not found to be statistically associated. The adoption of new measures of clinical classification such as audiovisual touch-screen computer-assisted self-administered interviews might be more effective than confidential unit exclusion in the identification of donor risk behavior. The requirement that transfusion services continue to use confidential unit exclusion needs to be debated in countries where more specific and sensitive clinical and serological screening methods are available. CONCLUSION: Our findings suggest that there are not enough benefits to justify continued use of confidential donation confirmation in the analyzed institution.

  10. Pre-clinical functional magnetic resonance imaging. Pt. I. The kidney

    Energy Technology Data Exchange (ETDEWEB)

    Zoellner, Frank G.; Kalayciyan, Raffi; Chacon-Caldera, Jorge; Zimmer, Fabian; Schad, Lothar R. [Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine

    2014-07-01

    The prevalence of chronic kidney disease (CKD) is increasing worldwide. In Europe alone, at least 8% of the population currently has some degree of CKD. CKD is associated with serious comorbidity, reduced life expectancy, and high economic costs; hence, the early detection and adequate treatment of kidney disease is important. Pre-clinical research can not only give insights into the mechanisms of the various kidney diseases but it also allows for investigating the outcome of new drugs developed to treat kidney disease. Functional magnetic resonance imaging provides non-invasive access to tissue and organ function in animal models. Advantages over classical animal research approaches are numerous: the same animal might be repeatedly imaged to investigate a progress or a treatment of disease over time. This has also a direct impact on animal welfare and the refinement of classical animal experiments as the number of animals in the studies might be reduced. In this paper, we review current state of the art in functional magnetic resonance imaging with a focus on pre-clinical kidney imaging.

  11. Neurosurgery Elective for Preclinical Medical Students: Early Exposure and Changing Attitudes.

    Science.gov (United States)

    Zuckerman, Scott L; Mistry, Akshitkumar M; Hanif, Rimal; Chambless, Lola B; Neimat, Joseph S; Wellons, John C; Mocco, J; Sills, Allen K; McGirt, Matthew J; Thompson, Reid C

    2016-02-01

    Exposure to surgical subspecialties is limited during the preclinical years of medical school. To offset this limitation, the authors created a neurosurgery elective for first- and second-year medical students. The objective was to provide each student with early exposure to neurosurgery by combining clinical experience with faculty discussions about the academic and personal realities of a career in neurosurgery. From 2012 to 2013, the authors offered a neurosurgery elective course to first- and second-year medical students. Each class consisted of the following: 1) peer-reviewed article analysis; 2) student presentation; 3) faculty academic lecture; 4) faculty personal lecture with question and answer period. Thirty-five students were enrolled over a 2-year period. After completing the elective, students were more likely to: consider neurosurgery as a future career (P life to be higher (P life, and family-work balance, while not altering the students' views about the difficulty of training. Adopting a neurosurgery elective geared towards preclinical medical students can significantly change attitudes about the field of neurosurgery and has potential to increase interest in pursuing a career in neurosurgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Preclinical assessment of HIV vaccines and microbicides by repeated low-dose virus challenges.

    Directory of Open Access Journals (Sweden)

    Roland R Regoes

    2005-08-01

    Full Text Available Trials in macaque models play an essential role in the evaluation of biomedical interventions that aim to prevent HIV infection, such as vaccines, microbicides, and systemic chemoprophylaxis. These trials are usually conducted with very high virus challenge doses that result in infection with certainty. However, these high challenge doses do not realistically reflect the low probability of HIV transmission in humans, and thus may rule out preventive interventions that could protect against "real life" exposures. The belief that experiments involving realistically low challenge doses require large numbers of animals has so far prevented the development of alternatives to using high challenge doses.Using statistical power analysis, we investigate how many animals would be needed to conduct preclinical trials using low virus challenge doses. We show that experimental designs in which animals are repeatedly challenged with low doses do not require unfeasibly large numbers of animals to assess vaccine or microbicide success.Preclinical trials using repeated low-dose challenges represent a promising alternative approach to identify potential preventive interventions.

  13. Near-peers improve patient safety training in the preclinical curriculum.

    Science.gov (United States)

    Raty, Sally R; Teal, Cayla R; Nelson, Elizabeth A; Gill, Anne C

    2017-01-01

    Accrediting bodies require medical schools to teach patient safety and residents to develop teaching skills in patient safety. We created a patient safety course in the preclinical curriculum and used continuous quality improvement to make changes over time. To assess the impact of resident teaching on student perceptions of a Patient Safety course. Using the Institute for Healthcare Improvement patient safety curriculum as a frame, the course included the seven IHI modules, large group lectures and small group facilitated discussions. Applying a social action methodology, we evaluated the course for four years (Y1-Y4). In Y1, Y2, Y3 and Y4, we distributed a course evaluation to each student (n = 184, 189, 191, and 184, respectively) and the response rate was 96, 97, 95 and 100%, respectively. Overall course quality, clarity of course goals and value of small group discussions increased in Y2 after the introduction of residents as small group facilitators. The value of residents and the overall value of the course increased in Y3 after we provided residents with small group facilitation training. Preclinical students value the interaction with residents and may perceive the overall value of a course to be improved based on near-peer involvement. Residents gain valuable experience in small group facilitation and leadership.

  14. Sexuality and gender identity teaching within preclinical medical training in New Zealand: content, attitudes and barriers.

    Science.gov (United States)

    Taylor, Oscar; Rapsey, Charlene M; Treharne, Gareth J

    2018-06-22

    To investigate inclusion of sexuality and gender identity content, attitudes and barriers to inclusion of content in preclinical curricula of New Zealand medical schools from the perspective of key teaching staff. Staff responsible for curriculum oversight at New Zealand's two medical schools were invited to complete a mixed-methods survey about sexuality and gender identity content in their modules. Of 24 respondents, the majority included very little content relating to sexuality or gender identity (33%) or none at all (54%). This content was deemed important by most participants (69%), and none believed there should be less such content in their curriculum. Time was reported to be the main barrier limiting inclusion of such content. Our finding of limited content is consistent with international literature. Our findings extend the literature by revealing that barriers to greater inclusion of content are not due to overt negative attitudes. Staff responsible for preclinical medical curriculum oversight have positive attitudes about content relating to sexuality and gender identity but perceive curriculum space to be a limiting barrier. This is important as it informs approaches to change. Future interventions with medical schools should focus on methods to increase diverse content as part of existing teaching, education to increase knowledge of LGBTQI relevant material and potentially incorporate strategies used to address unconscious bias. Addressing the perceived barriers of time constraints and lack of relevance is required to ensure medical students receive training to develop the competencies to provide positive healthcare experiences for all patients regardless of sexuality and gender identity.

  15. Feasibility of spatial frequency domain imaging (SFDI) for optically characterizing a preclinical oncology model.

    Science.gov (United States)

    Tabassum, Syeda; Zhao, Yanyu; Istfan, Raeef; Wu, Junjie; Waxman, David J; Roblyer, Darren

    2016-10-01

    Determination of chemotherapy efficacy early during treatment would provide more opportunities for physicians to alter and adapt treatment plans. Diffuse optical technologies may be ideally suited to track early biological events following chemotherapy administration due to low cost and high information content. We evaluated the use of spatial frequency domain imaging (SFDI) to characterize a small animal tumor model in order to move towards the goal of endogenous optical monitoring of cancer therapy in a controlled preclinical setting. The effects of key measurement parameters including the choice of imaging spatial frequency and the repeatability of measurements were evaluated. The precision of SFDI optical property extractions over repeat mouse measurements was determined to be within 3.52% for move and replace experiments. Baseline optical properties and chromophore values as well as intratumor heterogeneity were evaluated over 25 tumors. Additionally, tumor growth and chemotherapy response were monitored over a 45 day longitudinal study in a small number of mice to demonstrate the ability of SFDI to track treatment effects. Optical scattering and oxygen saturation increased as much as 70% and 25% respectively in treated tumors, suggesting SFDI may be useful for preclinical tracking of cancer therapies.

  16. Pre-clinical functional magnetic resonance imaging. Pt. I. The kidney

    International Nuclear Information System (INIS)

    Zoellner, Frank G.; Kalayciyan, Raffi; Chacon-Caldera, Jorge; Zimmer, Fabian; Schad, Lothar R.

    2014-01-01

    The prevalence of chronic kidney disease (CKD) is increasing worldwide. In Europe alone, at least 8% of the population currently has some degree of CKD. CKD is associated with serious comorbidity, reduced life expectancy, and high economic costs; hence, the early detection and adequate treatment of kidney disease is important. Pre-clinical research can not only give insights into the mechanisms of the various kidney diseases but it also allows for investigating the outcome of new drugs developed to treat kidney disease. Functional magnetic resonance imaging provides non-invasive access to tissue and organ function in animal models. Advantages over classical animal research approaches are numerous: the same animal might be repeatedly imaged to investigate a progress or a treatment of disease over time. This has also a direct impact on animal welfare and the refinement of classical animal experiments as the number of animals in the studies might be reduced. In this paper, we review current state of the art in functional magnetic resonance imaging with a focus on pre-clinical kidney imaging.

  17. Drug release, preclinical and clinical pharmacokinetics relationships of alginate pellets prepared by melt technology.

    Science.gov (United States)

    Bose, Anirbandeep; Harjoh, Nurulaini; Pal, Tapan Kumar; Dan, Shubhasis; Wong, Tin Wui

    2016-01-01

    Alginate pellets prepared by the aqueous agglomeration technique experience fast drug dissolution due to the porous pre-formed calcium alginate microstructure. This study investigated in vitro drug release, preclinical and clinical pharmacokinetics relationships of intestinal-specific calcium acetate-alginate pellets against calcium-free and calcium carbonate-alginate pellets. Alginate pellets were prepared by solvent-free melt pelletization instead of aqueous agglomeration technique using chlorpheniramine maleate as model drug. A fast in situ calcium acetate dissolution in pellets resulted in rapid pellet breakup, soluble Ca(2+) crosslinking of alginate fragments and drug dissolution retardation at pH 1.2, which were not found in other pellet types. The preclinical drug absorption rate was lower with calcium acetate loaded than calcium-free alginate pellets. In human subjects, however, the extent and the rate of drug absorption were higher from calcium acetate-loaded pellets than calcium-free alginate pellets. The fine, dispersible and weakly gastric mucoadhesive calcium alginate pellets underwent fast human gastrointestinal transit. They released the drug at a greater rate than calcium-free pellets in the intestine, thereby promoting drug bioavailability. Calcium acetate was required as a disintegrant more than as a crosslinking agent clinically to promote pellet fragmentation, fast gastrointestinal transit and drug release in intestinal medium, and intestinal-specific drug bioavailability.

  18. Applications of the Preclinical Molecular Imaging in Biomedicine: Gene Therapy

    International Nuclear Information System (INIS)

    Collantes, M.; Peñuelas, I.

    2014-01-01

    Gene therapy constitutes a promising option for efficient and targeted treatment of several inherited disorders. Imaging techniques using ionizing radiation as PET or SPECT are used for non-invasive monitoring of the distribution and kinetics of vector-mediated gene expression. In this review the main reporter gene/reporter probe strategies are summarized, as well as the contribution of preclinical models to the development of this new imaging modality previously to its application in clinical arena. [es

  19. Multimodal imaging of bone metastases: From preclinical to clinical applications

    Directory of Open Access Journals (Sweden)

    Stephan Ellmann

    2015-10-01

    Full Text Available Metastases to the skeletal system are commonly observed in cancer patients, highly affecting the patients' quality of life. Imaging plays a major role in detection, follow-up, and molecular characterisation of metastatic disease. Thus, imaging techniques have been optimised and combined in a multimodal and multiparametric manner for assessment of complementary aspects in osseous metastases. This review summarises both application of the most relevant imaging techniques for bone metastasis in preclinical models and the clinical setting.

  20. [Impact of microdose clinical trials in the preclinical stage].

    Science.gov (United States)

    Kim, Soonih

    2014-01-01

    A microdose clinical trial may be useful as a safe early-phase exploratory study using doses as low as 100 μg or less for determination of the disposition of a candidate compound in humans in a short period of time. This may increase confidence in candidate compounds, especially those for which it is difficult to predict disposition based on the results of in vitro or preclinical studies. In this study, we examined microdose trials performed in the preclinical stage for two first-in-class compounds with a new mechanism of action. These compounds showed species difference in first pass metabolism in the digestive tract and liver, causing uncertainty in prediction of disposition in humans. For this reason, first-in-human microdose clinical trials were performed. The results showed that the two compounds had effective blood concentrations after oral administration at a dose of 100 mg qd. Administration of an extremely small dose of one (14)C-labeled compound permitted identification of major metabolites. No toxic metabolites were detected. The preclinical toxic dose was determined based on prediction of blood exposure at the estimated maximum clinical dose. For the other candidate compound, the findings of the microdose trial indicated a high bioavailability after oral administration and low hepatic clearance after intravenous administration. These results suggested only a small risk of a change in disposition in patients with hepatic disorder. The data obtained for the two compounds suggest that microdose clinical trials can be useful for improving the process of candidate selection in the preclinical stage.

  1. Format of medical order sheet improves security of antibiotics prescription: The experience of an intensive care unit.

    Science.gov (United States)

    Wasserfallen, Jean-Blaise; Bütschi, Anne-Joëlle; Muff, Patrik; Biollaz, Jérôme; Schaller, Marie-Denise; Pannatier, André; Revelly, Jean-Pierre; Chiolero, René

    2004-03-01

    To assess whether formatting the medical order sheet has an effect on the accuracy and security of antibiotics prescription. Prospective assessment of antibiotics prescription over time, before and after the intervention, in comparison with a control ward. The medical and surgical intensive care unit (ICU) of a university hospital. All patients hospitalized in the medical or surgical ICU between February 1 and April 30, 1997, and July 1 and August 31, 2000, for whom antibiotics were prescribed. Formatting of the medical order sheet in the surgical ICU in 1998. Compliance with the American Society of Hospital Pharmacists' criteria for prescription safety was measured. The proportion of safe orders increased in both units, but the increase was 4.6 times greater in the surgical ICU (66% vs. 74% in the medical ICU and 48% vs. 74% in the surgical ICU). For unsafe orders, the proportion of ambiguous orders decreased by half in the medical ICU (9% vs. 17%) and nearly disappeared in the surgical ICU (1% vs. 30%). The only missing criterion remaining in the surgical ICU was the drug dose unit, which could not be preformatted. The aim of antibiotics prescription (either prophylactic or therapeutic) was indicated only in 51% of the order sheets. Formatting of the order sheet markedly increased security of antibiotics prescription. These findings must be confirmed in other settings and with different drug classes. Formatting the medical order sheet decreases the potential for prescribing errors before full computerized prescription is available.

  2. Nasal Bubble CPAP: One Year Experience in a Neonatal Unit of a Tertiary Health Facility in Northwestern Nigeria.

    Science.gov (United States)

    Abdulkadir, I; Hassan, L; Abdullahi, F; Purdue, S; Ogala, W N

    2015-03-01

    Nasal bubble continuous positive airway pressure (NBCPAP) respiratory support, though decades old, is beginning to gain popularity in developing countries including Nigeria. We reviewed neonates who benefitted from NBCPAP, to describe the demographics and outcome of NBCPAP respiratory support in newborns admitted to the neonatal unit of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, over a one year period. The study is a descriptive observational review of all neonates who required NBCPAP respiratory support in the neonatal unit of ABUTH Zaria. Data was extracted from a specifically designed proforma used to obtain information on each neonate throughout the period of admission. Twenty babies received NBCPAP respiratory support during the period of study. Seventeen (85%) of the neonates were successfully weaned off CPAP while three (15%) failed CPAP. Three neonates developed complications with two having CPAP belly syndrome and the third had facial swelling which resolved spontaneously after 6 hours. Overall, seven (41%) of the neonates who were successfully weaned off CPAP were discharged home. MajorityofnewbornswhorequirerespiratorysupportwillbenefitfromNBCPAP therefore, this method of respiratory support should be popularized and neonatal units in the country should be supported to efficiently offer the service.

  3. Experiences of four parents with physical therapy and early mobility of their children in a pediatric critical care unit: A case series.

    Science.gov (United States)

    Parisien, Rachel B; Gillanders, Kirstie; Hennessy, Erin K; Herterich, Lisa; Saunders, Kendra; Lati, Jamil; Dos Santos, Stephanie; Hassall, Alison; O'Brien, Kelly K

    2016-05-31

    The aim of this study was to conduct a preliminary investigation into parents' experiences of physical therapy and early mobility (EM) for their children in a pediatric critical care unit (PCCU). We conducted a series of four qualitative case studies using in-depth semi-structured face-to-face interviews. We recruited parents of children who had undergone surgery and received at least one EM physical therapy intervention while intubated. We conducted a thematic analysis of transcribed interviews to illuminate the factors that influenced EM experiences. Four parents participated in the study. We developed an overview of Parental Experiences with Physical Therapy and Early Mobility in a PCCU, which includes four themes that parents believed influenced their experiences: (1) environmental factors; (2) awareness of physical therapist and health care professional (HCP) roles; (3) communication among parents and HCPs; and (4) parental participation in their child's EM, within the overarching parental experiences in the PCCU. This study affords a preliminary understanding of parents' experiences with physical therapy and EM in a PCCU setting. Results provide an important foundation for future research on mobility in the context of pediatric critical care research and practice.

  4. Identification of new treatments for epilepsy: issues in preclinical methodology

    Science.gov (United States)

    Galanopoulou, Aristea S.; Buckmaster, Paul S.; Staley, Kevin J.; Moshé, Solomon L.; Perucca, Emilio; Engel, Jerome; Löscher, Wolfgang; Noebels, Jeffrey L.; Pitkänen, Asla; Stables, James; White, Steve H.; O’Brien, Terence J.; Simonato, Michele

    2013-01-01

    Summary Preclinical research has facilitated the discovery of valuable drugs for the symptomatic treatment of epilepsy. Yet, despite these therapies, seizures are not adequately controlled in a third of all affected individuals, and comorbidities still impose a major burden on quality of life. The introduction of multiple new therapies into clinical use over the past two decades has done little to change this. There is an urgent demand to address the unmet clinical needs for: (a) new symptomatic anti-seizure treatments for drug-resistant seizures with improved efficacy/tolerability profiles, (b) disease modifying treatments that prevent or ameliorate the epileptogenic state, and (c) treatments for the common comorbidities that contribute to disability in people with epilepsy. New therapies also need to address the special needs of certain subpopulations, i.e. age- or gender-specific treatments. Preclinical development in these treatment areas is complex due to heterogeneity in presentation and etiology, and may need to be formulated with a specific seizure, epilepsy syndrome or comorbidity in mind. The aim of this report is to provide a framework that will help define future guidelines that improve and standardize the design, reporting, and validation of data across preclinical anti-epilepsy therapy development studies targeting drug-resistant seizures, epileptogenesis and comorbidities. PMID:22292566

  5. Identification of new epilepsy treatments: issues in preclinical methodology.

    Science.gov (United States)

    Galanopoulou, Aristea S; Buckmaster, Paul S; Staley, Kevin J; Moshé, Solomon L; Perucca, Emilio; Engel, Jerome; Löscher, Wolfgang; Noebels, Jeffrey L; Pitkänen, Asla; Stables, James; White, H Steve; O'Brien, Terence J; Simonato, Michele

    2012-03-01

    Preclinical research has facilitated the discovery of valuable drugs for the symptomatic treatment of epilepsy. Yet, despite these therapies, seizures are not adequately controlled in a third of all affected individuals, and comorbidities still impose a major burden on quality of life. The introduction of multiple new therapies into clinical use over the past two decades has done little to change this. There is an urgent demand to address the unmet clinical needs for: (1) new symptomatic antiseizure treatments for drug-resistant seizures with improved efficacy/tolerability profiles, (2) disease-modifying treatments that prevent or ameliorate the process of epileptogenesis, and (3) treatments for the common comorbidities that contribute to disability in people with epilepsy. New therapies also need to address the special needs of certain subpopulations, that is, age- or gender-specific treatments. Preclinical development in these treatment areas is complex due to heterogeneity in presentation and etiology, and may need to be formulated with a specific seizure, epilepsy syndrome, or comorbidity in mind. The aim of this report is to provide a framework that will help define future guidelines that improve and standardize the design, reporting, and validation of data across preclinical antiepilepsy therapy development studies targeting drug-resistant seizures, epileptogenesis, and comorbidities. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

  6. A cost-effective simulation curriculum for preclinical endodontics.

    Science.gov (United States)

    Pileggi, Roberta; Glickman, Gerald N

    2004-02-01

    A challenge in contemporary dental education is to achieve a smooth transition from preclinical teaching environments to patient-care clinics in a cost-effective manner. The preclinical endodontic courses at The University of Texas, Dental Branch at Houston provide a unique learning environment that enables the student to perform endodontic treatment on extracted teeth in a typodont, and be involved in diagnosis and treatment-planning discussions. The specially designed stone typodont used has built-in radiographic capability, and is mounted at each chair in the clinic. During each preclinical session, students are assigned clinical cubicles and proper aseptic protocol is followed. Students are required to wear gloves, masks and eyewear, and place a rubber dam during treatment. Written self-assessment evaluations based upon prescribed criteria are utilised; feedback is given by faculty composed of both full-time endodontists and graduate students who periodically rotate and are calibrated on a regular basis. In the lecture phase, clinical case scenarios are presented to reinforce concepts of diagnosis and emergency care and to help integrate endodontics with other disciplines; a Socratic-like teaching style is established by the faculty facilitator to create an environment for developing critical-thinking and problem-solving skills. The overall feedback from graduating students has been very positive. Advantages of this format are an easier transition to patient management, a more keen interest in specialsation and a perceived increase in levels of confidence.

  7. Preclinical experimental stress studies: protocols, assessment and comparison.

    Science.gov (United States)

    Bali, Anjana; Jaggi, Amteshwar Singh

    2015-01-05

    Stress is a state of threatened homeostasis during which a variety of adaptive processes are activated to produce physiological and behavioral changes. Preclinical models are pivotal for understanding these physiological or pathophysiological changes in the body in response to stress. Furthermore, these models are also important for the development of novel pharmacological agents for stress management. The well described preclinical stress models include immobilization, restraint, electric foot shock and social isolation stress. Stress assessment in animals is done at the behavioral level using open field, social interaction, hole board test; at the biochemical level by measuring plasma corticosterone and ACTH; at the physiological level by measuring food intake, body weight, adrenal gland weight and gastric ulceration. Furthermore the comparison between different stressors including electric foot shock, immobilization and cold stressor is described in terms of intensity, hormonal release, protein changes in brain, adaptation and sleep pattern. This present review describes these preclinical stress protocols, and stress assessment at different levels. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Is medical students' moral orientation changeable after preclinical medical education?

    Science.gov (United States)

    Lin, Chaou-Shune; Tsou, Kuo-Inn; Cho, Shu-Ling; Hsieh, Ming-Shium; Wu, Hsi-Chin; Lin, Chyi-Her

    2012-03-01

    Moral orientation can affect ethical decision-making. Very few studies have focused on whether medical education can change the moral orientation of the students. The purpose of the present study was to document the types of moral orientation exhibited by medical students, and to study if their moral orientation was changed after preclinical education. From 2007 to 2009, the Mojac scale was used to measure the moral orientation of Taiwan medical students. The students included 271 first-year and 109 third-year students. They were rated as a communitarian, dual, or libertarian group and followed for 2 years to monitor the changes in their Mojac scores. In both first and third-year students, the dual group after 2 years of preclinical medical education did not show any significant change. In the libertarian group, first and third-year students showed a statistically significant increase from a score of 99.4 and 101.3 to 103.0 and 105.7, respectively. In the communitarian group, first and third-year students showed a significant decline from 122.8 and 126.1 to 116.0 and 121.5, respectively. During the preclinical medical education years, students with communitarian orientation and libertarian orientation had changed in their moral orientation to become closer to dual orientation. These findings provide valuable hints to medical educators regarding bioethics education and the selection criteria of medical students for admission.

  9. Patient with giant upper limb melanoma presenting to a UK plastic surgery unit: differentials and experience of management

    OpenAIRE

    Honeyman, Calum Sinclair; Wilson, Paul

    2016-01-01

    A 57-year-old woman was referred to our regional sarcoma unit following a 2-year history of a progressively enlarging mass on her right forearm. At 14×7×12 cm, this mass turned out to be one of the largest upper limb cutaneous malignant melanomas ever described, and, to the best of our knowledge, the first documented in the UK. Remarkably, despite having a T4 malignant tumour with a Breslow thickness of 70 mm, this patient is still alive over 4 years later with no locoregional or distant meta...

  10. Experience in the United States with a secondary resource curriculum on ''Science, society and America's nuclear waste''

    International Nuclear Information System (INIS)

    King, G.P.

    1994-01-01

    The nuclear power and nuclear waste situation in the Usa, is first reviewed. In order to enhance information concerning these topics among pupils and teachers, a resource curriculum, 'Science, society, and America's Nuclear Waste', was developed by teachers for teachers; it consists of four units: nuclear waste, ionizing radiation, the nuclear waste policy act, and the waste management system. It has been well received by teachers. Within nine months after its national introduction, 350000 teacher and student curriculum documents were requested by teachers from all 50 states. Requests have been also received from 250 foreign colleges and universities

  11. My American Dream: The Interplay Between Structure and Agency in West African Immigrants' Educational Experiences in the United States

    Science.gov (United States)

    Knight, Michelle G.; Roegman, Rachel; Edstrom, Lisa

    2016-01-01

    This article presents findings of a qualitative, interpretive case study of the experiences of 1.5- and 2nd-generation West African immigrants who self-identify as pursuing the American Dream, defined by them as academic attainment and career success. Employing structuration theory, the authors examine the interplay between structures and agency…

  12. The Tactical Games Model Sport Experience: An Examination of Student Motivation and Game Performance during an Ultimate Frisbee Unit

    Science.gov (United States)

    Carpenter, Eric J.

    2010-01-01

    Students benefit from positive sport experiences in physical education. If designed well, sport provides a social avenue for physical activity and strengthens student achievement in psychomotor (e.g., motor skill), cognitive (e.g., decision-making), and affective (e.g., personal and social responsibility) learning domains. Unfortunately, not all…

  13. The experience of an United Nations Military Observer in Western Sahara / A experiência de observador militar da ONU no Saara Ocidental

    Directory of Open Access Journals (Sweden)

    Sylvio de Souza Ferreira

    2017-03-01

    Full Text Available The Western Sahara issue is the most recent, lasting and unresolved case of decolonization in African continent, in the midst of the 21st Century. It is a non- governed territory, located in the northwest portion of Saharan Africa and it has been under UN custody since 1991, when MINURSO had been established. In this regard, this article has as main motivation to communicate the experience of an UN Military Observer, emphasizing peculiar and practical aspects, as well as perceptions in the performance of this appointment. It is an internal vision of the reality of the Peace Operation, the individual and the professional of the UN. In order to do so, this article uses a qualitative approach deploying methodologies such as participant observation and the descriptive case study. It comprises an introduction, which aims to enlighten the reader to the question, a characterization of the area, a historical review of the case, a section of exposure of the methodology and the experience of one of the authors as a UN Military Observer in the Western Sahara itself. Finally, considerations are made at the conclusion. A questão do Saara Ocidental constitui o caso de descolonização mais recente, duradouro e não-resolvido do continente africano, em pleno século XXI. Trata-se de um território não-governado, localizado na porção noroeste da África Saariana e encontra-se sob custódia da ONU desde 1991, quando da implantação da MINURSO. Nesse contexto, o presente artigo tem como principal motivação comunicar a experiência no exercício da função de observador militar da ONU, sublinhando aspectos peculiares e práticos, bem como percepções no desempenho dessa função. É uma visão interna da realidade de uma Operação de Paz, do indivíduo e do profissional da Organização. Para tanto, o artigo utiliza abordagem qualitativa na metodologia empregada e aspectos da observação participante e do estudo de caso descritivo. É composto por uma

  14. The Elixir of Visiting: A Qualitative Study on the Experiences of Conscious Mechanically Ventilated Patients in Intensive Care Units Regarding Visiting Family Members

    Directory of Open Access Journals (Sweden)

    Fatemeh Hajiabadi

    2017-07-01

    Full Text Available Background: Visiting family members is one of the basic human needs; however, there is contradictory evidence about the advantages and disadvantages of the existing visiting systems.  Therefore, the investigation of patients’ preferences for the visiting strategies, and achievement of their authentic experiences can significantly contribute to decision-making about the type of acceptable and approved policies in this domain. Aim: The aim of this study was to explain the experiences of conscious patients undergoing mechanical ventilation in Intensive Care Units regarding their visits with their family members. Method: This qualitative study was conducted on 15 conscious mechanically ventilated patients admitted to the Intensive Care Unit in Iran in 2017. The data were collected using semi-structured interviews and observations. The sampling was performed through purposive sampling technique, which was continued until data saturation to select the individuals with rich experiences about the subject under investigation. The data were analyzed through the conventional type of qualitative content analysis. Results: Out of the initial 385 codes, 11 subthemes and 5 main themes were extracted during the analysis process, all of which were placed under the general concept of “the elixir of visiting”. The five main themes included visiting as a healing agent, visiting as an agent for the enhancement of perceived support, visiting as an agent for gaining hope, visiting as the patient’s urgent need, and preference for planed visiting. Implications for Practice: The results of the present study showed that visiting was like an elixir for the conscious patients undergoing mechanical ventilation in the Intensive Care Units. This practice could allay lots of their pains and lead to numerous valuable effects, such as elimination of loneliness and sadness, increased hope for survival and recovery, and enhancement of a sense of support. Therefore, nursing

  15. Thinking through postoperative cognitive dysfunction: How to bridge the gap between clinical and pre-clinical perspectives.

    Science.gov (United States)

    Hovens, Iris B; Schoemaker, Regien G; van der Zee, Eddy A; Heineman, Erik; Izaks, Gerbrand J; van Leeuwen, Barbara L

    2012-10-01

    Following surgery, patients may experience cognitive decline, which can seriously reduce quality of life. This postoperative cognitive dysfunction (POCD) is mainly seen in the elderly and is thought to be mediated by surgery-induced inflammatory reactions. Clinical studies tend to define POCD as a persisting, generalised decline in cognition, without specifying which cognitive functions are impaired. Pre-clinical research mainly describes early hippocampal dysfunction as a consequence of surgery-induced neuroinflammation. These different approaches to study POCD impede translation between clinical and pre-clinical research outcomes and may hamper the development of appropriate interventions. This article analyses which cognitive domains deteriorate after surgery and which brain areas might be involved. The most important outcomes are: (1) POCD encompasses a wide range of cognitive impairments; (2) POCD affects larger areas of the brain; and (3) individual variation in the vulnerability of neuronal networks to neuroinflammatory mechanisms may determine if and how POCD manifests itself. We argue that, for pre-clinical and clinical research of POCD to advance, the effects of surgery on various cognitive functions and brain areas should be studied. Moreover, in addition to general characteristics, research should take inter-relationships between cognitive complaints and physical and mental characteristics into account. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Lessons Learned: Insights into One Teacher’s Experience Working with Karen Refugee Students in the United States

    Directory of Open Access Journals (Sweden)

    Daniel J. Gilhooly

    2015-01-01

    Full Text Available This study is informed by funds of knowledge and culturally responsive teaching studies that aim to explore and legitimize the cultural knowledge immigrant children bring to their communities and schools. Consequently, this paper specifically addresses issues related to the educational experiences of Karen children and their parents from one American teacher/researcher who has worked with the Karen for the past four years. In aggregate, this paper addresses issues germane to Karen education including; (1 background information on Karen educational experiences prior to resettlement, including a review of their journey from Thailand to the U.S.; (2 important characteristics of Karen culture; (3 Karen names; (4 Sgaw Karen language characteristics; (5 the language divide between parents and children; (6 parental involvement in their children’s schooling; (7 American teacher perceptions of Karen students; (8 issues over grading and, finally; (9 gender issues.

  17. Survey of core medical trainees in the United Kingdom 2013 - inconsistencies in training experience and competing with service demands.

    Science.gov (United States)

    Tasker, Fiona; Newbery, Nina; Burr, Bill; Goddard, Andrew F

    2014-04-01

    There is currently considerable concern about the attractiveness of hospital medicine as a career and experiences in core medical training (CMT) are a key determinant of whether trainees continue in the medical specialties. Little is understood about the quality and impact of the current CMT programme and this survey was designed to assess this. Three key themes emerged. Firstly, the demands of providing service have led to considerable loss of training opportunities, particularly in outpatients and formal teaching sessions. Trainees spend a lot of this service time doing menial tasks and over 90% report that service takes up 80-100% of their time. Secondly, clinical and educational supervision is variable, with trainees sometimes getting little consultant feedback on their clinical performance. Finally, 44% of trainees report that CMT has not prepared them to be a medical registrar and many trainees are put off acute medical specialties by their experiences in CMT.

  18. Contribution of the microprocessors in the study and development of a pre-processing unit involved in a nuclear physics experiment

    International Nuclear Information System (INIS)

    Pichot, G.

    1980-01-01

    The pre-processing unit has its place between the electronic output of the detector and the experiment control system, its role is 3-fold: a real-time role to provide adequate data to the control system allowing feedback, a basic role of selecting and reducing the volume of data and a role of managing the programs necessary to the first 2 roles. This work can be divided in 3 parts. First the analysis of the needs and limitations of the present system, secondly the meeting of the needs with on-the-shelf equipment, and thirdly validation and future improvements [fr

  19. Emotion experience and regulation in China and the United States: How do culture and gender shape emotion responding?

    OpenAIRE

    Davis, E; Greenberger, E; Charles, S; Chen, C; Zhao, L; Dong, Q

    2012-01-01

    Culture and gender shape emotion experience and regulation, in part because the value placed on emotions and the manner of their expression is thought to vary across these groups. This study tested the hypothesis that culture and gender would interact to predict people's emotion responding (emotion intensity and regulatory strategies). Chinese (n = 220; 52% female) and American undergraduates (n = 241; 62% female) viewed photos intended to elicit negative emotions after receiving instructions...

  20. Space Station Biological Research Project (SSBRP) Cell Culture Unit (CCU) and incubator for International Space Station (ISS) cell culture experiments

    Science.gov (United States)

    Vandendriesche, Donald; Parrish, Joseph; Kirven-Brooks, Melissa; Fahlen, Thomas; Larenas, Patricia; Havens, Cindy; Nakamura, Gail; Sun, Liping; Krebs, Chris; de Luis, Javier; hide

    2004-01-01

    The CCU and Incubator are habitats under development by SSBRP for gravitational biology research on ISS. They will accommodate multiple specimen types and reside in either Habitat Holding Racks, or the Centrifuge Rotor, which provides selectable gravity levels of up to 2 g. The CCU can support multiple Cell Specimen Chambers, CSCs (18, 9 or 6 CSCs; 3, 10 or 30 mL in volume, respectively). CSCs are temperature controlled from 4-39 degrees C, with heat shock to 45 degrees C. CCU provides automated nutrient supply, magnetic stirring, pH/O2 monitoring, gas supply, specimen lighting, and video microscopy. Sixty sample containers holding up to 2 mL each, stored at 4-39 degrees C, are available for automated cell sampling, subculture, and injection of additives and fixatives. CSCs, sample containers, and fresh/spent media bags are crew-replaceable for long-term experiments. The Incubator provides a 4-45 degrees C controlled environment for life science experiments or storage of experimental reagents. Specimen containers and experiment unique equipment are experimenter-provided. The Specimen Chamber exchanges air with ISS cabin and has 18.8 liters of usable volume that can accommodate six trays and the following instrumentation: five relocatable thermometers, two 60 W power outlets, four analog ports, and one each relative humidity sensor, video port, ethernet port and digital input/output port.

  1. Emotion experience and regulation in China and the United States: how do culture and gender shape emotion responding?

    Science.gov (United States)

    Davis, Elizabeth; Greenberger, Ellen; Charles, Susan; Chen, Chuansheng; Zhao, Libo; Dong, Qi

    2012-01-01

    Culture and gender shape emotion experience and regulation, in part because the value placed on emotions and the manner of their expression is thought to vary across these groups. This study tested the hypothesis that culture and gender would interact to predict people's emotion responding (emotion intensity and regulatory strategies). Chinese (n=220; 52% female) and American undergraduates (n=241; 62% female) viewed photos intended to elicit negative emotions after receiving instructions to either "just feel" any emotions that arose (Just Feel), or to "do something" so that they would not experience any emotion while viewing the photos (Regulate). All participants then rated the intensity of their experienced emotions and described any emotion-regulation strategies that they used while viewing the photos. Consistent with predictions, culture and gender interacted with experimental condition to predict intensity: Chinese men reported relatively low levels of emotion, whereas American women reported relatively high levels of emotion. Disengagement strategies (especially distancing) were related to lower emotional intensity and were reported most often by Chinese men. Taken together, findings suggest that emotion-regulation strategies may contribute to differences in emotional experience across Western and East Asian cultures.

  2. The value of integrating pre-clinical data to predict nausea and vomiting risk in humans as illustrated by AZD3514, a novel androgen receptor modulator

    Energy Technology Data Exchange (ETDEWEB)

    Grant, Claire, E-mail: claire.grant@astrazeneca.com [Drug Safety and Metabolism, AstraZeneca, Alderley Park, Macclesfield SK10 4TG (United Kingdom); Ewart, Lorna [Drug Safety and Metabolism, AstraZeneca, Da Vinci Building, Melbourn Science Park, Cambridge Road, Melbourn, Royston SG8 6HB (United Kingdom); Muthas, Daniel [Respiratory, Inflammation and Autoimmunity iMED, AstraZeneca, Pepparedsleden 1, 431 83 Mölndal (Sweden); Deavall, Damian [Drug Safety and Metabolism, AstraZeneca, Alderley Park, Macclesfield SK10 4TG (United Kingdom); Smith, Simon A. [Oncology Translational Medicine Unit, Early Clinical Development, AstraZeneca, Da Vinci Building, Melbourn Science Park, Melbourn, Royston SG8 6HB (United Kingdom); Clack, Glen [Translational Medicine Unit, Early Clinical Development, AstraZeneca, Alderley Park, Macclesfield SK10 4TG (United Kingdom); Newham, Pete [Drug Safety and Metabolism, AstraZeneca, Darwin Building, Cambridge Science Park, Milton Road, Cambridge CB4 0WG (United Kingdom)

    2016-04-01

    Nausea and vomiting are components of a complex mechanism that signals food avoidance and protection of the body against the absorption of ingested toxins. This response can also be triggered by pharmaceuticals. Predicting clinical nausea and vomiting liability for pharmaceutical agents based on pre-clinical data can be problematic as no single animal model is a universal predictor. Moreover, efforts to improve models are hampered by the lack of translational animal and human data in the public domain. AZD3514 is a novel, orally-administered compound that inhibits androgen receptor signaling and down-regulates androgen receptor expression. Here we have explored the utility of integrating data from several pre-clinical models to predict nausea and vomiting in the clinic. Single and repeat doses of AZD3514 resulted in emesis, salivation and gastrointestinal disturbances in the dog, and inhibited gastric emptying in rats after a single dose. AZD3514, at clinically relevant exposures, induced dose-responsive “pica” behaviour in rats after single and multiple daily doses, and induced retching and vomiting behaviour in ferrets after a single dose. We compare these data with the clinical manifestation of nausea and vomiting encountered in patients with castration-resistant prostate cancer receiving AZD3514. Our data reveal a striking relationship between the pre-clinical observations described and the experience of nausea and vomiting in the clinic. In conclusion, the emetic nature of AZD3514 was predicted across a range of pre-clinical models, and the approach presented provides a valuable framework for predicition of clinical nausea and vomiting. - Highlights: • Integrated pre-clinical data can be used to predict clinical nausea and vomiting. • Data integrated from standard toxicology studies is sufficient to make a prediction. • The use of the nausea algorithm developed by Parkinson (2012) aids the prediction. • Additional pre-clinical studies can be used

  3. Training, their influence on the quality of services. An experience in the unit "Coffee Express" of Fomento.

    Directory of Open Access Journals (Sweden)

    Tania Ivón Sosa Ibarra

    2012-03-01

    Full Text Available Achieving quality of service is a necessity in this highly competitive and turbulent world, one of the elements that influence it is training. This research was designed and implemented a training procedure to improve the quality of services in a cafeteria of Development, were detected with the training needs of their staff to plan and implement actions that will raise the skills of workers. Surveys were conducted to determine the state of opinion of internal and external clients implemented before and after the procedure and to evaluate the quality of service received from the selected attributes to the application of Delphi method experts. The unit has made progress recognized and improved economic indicators becoming a reference center in the municipality, which shows that is possible to provide quality services from training workers.

  4. Beliefs about power and its relation to emotional experience: a comparison of Japan, France, Germany, and the United States.

    Science.gov (United States)

    Mondillon, Laurie; Niedenthal, Paula M; Brauer, Markus; Rohmann, Anette; Dalle, Nathalie; Uchida, Yukiko

    2005-08-01

    This research examined the concept of power in Japan, France, Germany, and the United States, as well as beliefs about the emotions persons in power tend to elicit in others and about powerful people's regulation (specifically, inhibition) of certain emotions. Definitions of power were assessed by examining the importance of two main components: control over self versus other and freedom of action vis-à-vis social norms. Beliefs about both positive (pride, admiration) and negative (jealousy, contempt) emotions were measured. Analyses revealed that the concept of power differed across countries and that the definitions of power as well as country of origin significantly predicted beliefs about the emotions that are elicited in others by powerful people and also the regulation of expression of emotion by powerful people.

  5. Comparison of USDA Forest Service and Stakeholder Motivations and Experiences in Collaborative Federal Forest Governance in the Western United States.

    Science.gov (United States)

    Davis, Emily Jane; White, Eric M; Cerveny, Lee K; Seesholtz, David; Nuss, Meagan L; Ulrich, Donald R

    2017-11-01

    In the United States, over 191 million acres of land is managed by the United States Department of Agriculture Forest Service, a federal government agency. In several western U.S. states, organized collaborative groups have become a de facto governance approach to providing sustained input on management decisions on much public land. This is most extensive in Oregon, where at least 25 "forest collaboratives" currently exist. This affords excellent opportunities for studies of many common themes in collaborative governance, including trust, shared values, and perceptions of success. We undertook a statewide survey of participants in Oregon forest collaboratives to examine differences in motivations, perceptions of success, and satisfaction among Forest Service participants ("agency participants"), who made up 31% of the sample, and other respondents ("non-agency") who represent nonfederal agencies, interest groups, citizens, and non-governmental groups. We found that agency participants differed from non-agency participants. They typically had higher annual incomes, and were primarily motivated to participate to build trust. However, a majority of all respondents were similar in not indicating any other social or economic motivations as their primary reason for collaborating. A majority also reported satisfaction with their collaborative-despite not ranking collaborative performance on a number of specific potential outcomes highly. Together, this suggests that collaboration in Oregon is currently perceived as successful despite not achieving many specific outcomes. Yet there were significant differences in socioeconomic status and motivation that could affect the ability of agency and nonagency participants to develop and achieve mutually-desired goals.

  6. Comparison of USDA Forest Service and Stakeholder Motivations and Experiences in Collaborative Federal Forest Governance in the Western United States

    Science.gov (United States)

    Davis, Emily Jane; White, Eric M.; Cerveny, Lee K.; Seesholtz, David; Nuss, Meagan L.; Ulrich, Donald R.

    2017-11-01

    In the United States, over 191 million acres of land is managed by the United States Department of Agriculture Forest Service, a federal government agency. In several western U.S. states, organized collaborative groups have become a de facto governance approach to providing sustained input on management decisions on much public land. This is most extensive in Oregon, where at least 25 "forest collaboratives" currently exist. This affords excellent opportunities for studies of many common themes in collaborative governance, including trust, shared values, and perceptions of success. We undertook a statewide survey of participants in Oregon forest collaboratives to examine differences in motivations, perceptions of success, and satisfaction among Forest Service participants ("agency participants"), who made up 31% of the sample, and other respondents ("non-agency") who represent nonfederal agencies, interest groups, citizens, and non-governmental groups. We found that agency participants differed from non-agency participants. They typically had higher annual incomes, and were primarily motivated to participate to build trust. However, a majority of all respondents were similar in not indicating any other social or economic motivations as their primary reason for collaborating. A majority also reported satisfaction with their collaborative—despite not ranking collaborative performance on a number of specific potential outcomes highly. Together, this suggests that collaboration in Oregon is currently perceived as successful despite not achieving many specific outcomes. Yet there were significant differences in socioeconomic status and motivation that could affect the ability of agency and nonagency participants to develop and achieve mutually-desired goals.

  7. Project Experience of MMIS for Shin-Hanul units 1 and 2 (Component Design, Manufacturing and Testing)

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Seo-ryong; Kim, Kook-hun [Doosan Heavy Industries and Construction Co. Ltd., Hwaseong (Korea, Republic of)

    2015-10-15

    Doosan is uniquely positioned in the field of nuclear power plant in the world-wide. Doosan has secured the first step to nuclear technology field through the development of the nuclear power plant (NPP) man machine interface system (MMIS), which is one of the three major core technologies of non-independence. In the nuclear power plant, MMIS takes a function as the brain and nerve system in the human body. Korean MMIS was selected for the Shin-Hanul units 1 and 2 for the first time and Doosan is charge of a component design and equipment supply. At the end of successful completion of MMIS for Shin-Hanul units 1 and 2, Doosan will be a total provider of the MMIS from development, validation, and manufacturing to delivery in Korea. Man Machine Interface System (MMIS) is equivalent to the brain and nerve system of a nuclear power plant. It monitors and controls the operating conditions to prevent accidents proactively. Doosan achieved a complete development of MMIS which is core part of nuclear technology that was relied on oversea's companies in the past by an accomplishment of RnD in cooperation with domestic utility, KHNP and research institutions. Doosan's MMIS is very user-friendly, easy to understand, transparent to audits, and guarantees maximum reliability, availability, maintainability, and safety. Doosan proved safety and reliability through test and inspection of integrated function of nuclear safety and non-safety control system. Doosan MMIS was evaluated a one of the best system through IAEA IERIC's review via safety guide from IAEA specialist's group in 2010. Doosan also achieved the improvements of quality through the KINS audits in 2014.

  8. Preclinical animal acute toxicity studies of new developed MRI contrast agent based on gadolinium

    Science.gov (United States)

    Nam, I. F.; Zhuk, V. V.

    2015-04-01

    Acute toxicity test of new developed MRI contrast agent based on disodium salt of gadopentetic acid complex were carried out on Mus musculus and Sprague Dawley rats according to guidelines of preclinical studies [1]. Groups of six animals each were selected for experiment. Death and clinical symptoms of animals were recorded during 14 days. As a result the maximum tolerated dose (MTD) for female mice is 2.8 mM/kg of body weight, male mice - 1.4 mM/kg, female rats - 2.8 mM/kg, male rats - 5.6 mM/kg of body weight. No Observed Adverse Effect Dose (NOAEL) for female mice is 1.4 mM/kg, male mice - 0.7 mM/kg, male and female rats - 0.7 mM/kg. According to experimental data new developed MRI contrast agent based on Gd-DTPA complex is low-toxic.

  9. Steady natural convection heat transfer experiments in a horizontal annulus for the United States Spent Fuel Shipping Cask Technology Program

    International Nuclear Information System (INIS)

    Boyd, R.D.

    1981-04-01

    This experimental study deals with the measurement of the heat transfer across a horizontal annulus which is formed by an inner hexagonal cylinder and an outer concentric circular cylinder. The geometry simulates, in two dimensions, a liquid metal fast breeder reactor radioactive fuel subassembly inside a shipping container. This geometry is also similar to a radioactive fuel pin inside a horizontal reactor subassembly. The objective of the experiments is to measure the local and mean heat transfer at the surface of the inner hexagonal cylinder

  10. Assessment of preclinical students’ academic motivation before and after a three-day academic affair program

    Directory of Open Access Journals (Sweden)

    Aung MN

    2015-12-01

    Full Text Available Myo Nyein Aung,1 Juraiporn Somboonwong,2 Vorapol Jaroonvanichkul,1 Pongsak Wannakrairot3 1Medical Education Unit, 2Quality Management Division and Department of Physiology, 3Academic Affairs Division, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandBackground: Medical students’ motivation is an important driving factor for academic performance, and therefore medical teachers and educators are often highly interested in this topic. This study evaluated the impact of an academic affair program upon preclinical year medical students’ motivation to study.Design and methods: An intervention study was conducted using a pretest-posttest study design. A total of 296 preclinical year medical students who had just passed their first year and were about to attend their second year at the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, participated in the study. The intervention comprised of dialogues for personality development, pictorial expression in groups, as well as small group lectures delivered by senior students giving information on how to prepare for the forthcoming classes. Students’ academic motivation was measured before and after the intervention program, applying the transculturally translated Academic Motivation Scale (AMS. Cronbach’s alpha of Thai version AMS was 0.8992. The average scores in seven scales of AMS were compared between the pre- and posttest results, using the Wilcoxon signed-rank test. The differences were confirmed by using the multivariate analysis of variance.Results: Students’ academic motivation increased after participation in the three-day academic program. There was also a significant increase in introjected extrinsic motivation, which can enhance the students’ self-esteem and feeling of self-worth (P<0.001. Moreover, intrinsic motivation toward accomplishment increased significantly (P<0.001. This is related to the enjoyment of passing academic milestones, and a step

  11. Patient perceptions of environmental control units: experiences of Veterans with spinal cord injuries and disorders receiving inpatient VA healthcare.

    Science.gov (United States)

    Etingen, Bella; Martinez, Rachael N; Vallette, Marissa A; Dendinger, Ryan; Bidassie, Balmatee; Miskevics, Scott; Khan, Hira T; Cozart, Huberta T; Locatelli, Sara M; Weaver, Frances M

    2018-05-01

    To assess patients' perceptions of environmental control units (ECUs) at Veterans Affairs Spinal Cord Injury Centers. A brief questionnaire was conducted with patients in real-time while they were hospitalised ("on-the-spot questionnaire"); a survey was mailed to patients who had recently been discharged from a hospital stay ("discharge survey"). Data were analysed using descriptive statistics. Seventy on-the-spot questionnaires and 80 discharge surveys were collected. ECU features used most frequently were comparable in responses from both surveys: watching TV/movies (81%, 85%), calling the nurse (68%, 61%), turning lights on/off (63%, 52%), adjusting the bed (53%, 33%), and playing games (39%, 24%). Many on-the-spot questionnaire respondents felt the ECU met their need for independence a great deal (42%). Most respondents to both surveys were satisfied with the ECU (71%, 57%). Areas for improvement included user training, improved functionality of the device and its features, and device design. ECUs were well-accepted by persons with spinal cord injuries/disorders (SCI/D) in the inpatient setting, and increased patients' perceptions of independence. To maximise usability and satisfaction, facilities should ensure that comprehensive training on ECU use and features available is offered to all patients, and resources are available for timely troubleshooting and maintenance. Implications for rehabilitation An environmental control unit (ECU) is a form of assistive technology that allows individuals with disabilities (such as spinal cord injuries and disorders [SCI/D]) to control functional and entertainment-related aspects of their environment. ECU use can increase functioning, independence and psychosocial well-being among individuals with SCI/D, by allowing users to reclaim control over day-to-day activities that are otherwise limited by their disability. Our study results indicate that, among persons with SCI/D, ECUs are well-accepted and increase perceptions of

  12. [DIFFERENCE IN THE PREVALENCE OF BURNOUT SYNDROME IN PRECLINICAL AND CLINICAL TEACHING DOCTORS OF MOSTAR SCHOOL OF MEDICINE].

    Science.gov (United States)

    Vukojevič, Mladenka; Antunovič, Andelka; Petrov, Božo

    2015-01-01

    The aim of this study was to determine the difference in the prevalence of burnout syndrome in preclinical and clinical teaching doctors of Mostar School of Medicine in the academic year 2011/2012. Special attention was also focused on finding out the possible difference between the syndrome incidence that was correlated to gender and years of service. The main hypothesis was that the probability of burnout syndrome incidence was higher in the group of female clinical teaching doctors having more years of service. The study involved 62 people with high academic education employed at Mostar School of Medicine who were surveyed during a randomly selected consecutive 3-month period (February to May) of the academic year 2011/2012. The data were prospectively collected through a standardized questionnaire survey. The studied parameters were gender, years of work experience and the engagement in preclinical or clinical departments of the Medical School. The survey showed that 43 out of 62 (69.4%) respondents did not suffer the burnout syndrome, while moderate syndrome was recodred in 19 (30.6%) of them. No person had serious symptoms of the syndrome. The difference between the respondents who suffered the syndrome and those who did not was not statistically significant (P=0.002). Considering the gender of respondents, statistically significant differences were not confirmed (P=0.444). Considering the years of service, the highest incidence of the syndrome was found in people with more work experience (in the group of 21-25 years), but the difference between the groups was not statistically significant (P=0.271). Observing the work in preclinical and clinical departments, because of the limited number of patients we could not confirm the hypothesis. The syndrome had affected 13 (21%) clinical teaching doctors and 6 (9,7%) preclinical doctors, while the differenece between them was not statistically significant (P=0.054). Considering the results of this research, it has

  13. Real-time subsystem in nuclear physics. Use of a terminal unit for automatical control of experiments

    International Nuclear Information System (INIS)

    Chatain, Dominique.

    1975-01-01

    A data processing system allowing data acquisition and the automatic control of spectrometry experiments, has been designed and installed at the Institut de Physique Nucleaire of Lyon. This system consists of a CDC 1700 computer used by the computing center as a terminal of the IN2P3 CDC 6600 computer and to which a remote station located near the experiment has been connected. Peripherals for spectrometer control and a display are connected to the remote station. This display makes it possible for users to converse with the computer and to visualize the spectra processing under a graphic or alphanumerical form. The software consists of a real time subsystem of the standard CDC system: ''Mass Storage Operating System''. This real time subsystem is meant to achieve data transfers between the computer and its remote station. A dynamic store allocation simulating a virtual memory is attached to the system. It allows the parallel running of many programs, no matter how long they are. Moreover a disk file supervisor allows experimenters to store experimental results for delayed processing [fr

  14. Creating beauty: the experience of a fashion collection prepared by adolescent patients at a pediatric oncology unit.

    Science.gov (United States)

    Veneroni, Laura; Clerici, Carlo Alfredo; Proserpio, Tullio; Magni, Chiara; Sironi, Giovanna; Chiaravalli, Stefano; Roncari, Luisa; Casanova, Michela; Gandola, Lorenza; Massimino, Maura; Ferrari, Andrea

    2015-01-01

    Adolescent patients with cancer need psychological support in order to face the traumatic event of cancer diagnosis and to preserve continuity with their normal lives. Creative projects or laboratories may help young patients express their thoughts and feelings. The Youth Project developed activities dedicated to adolescents to give them a chance to vent their creative spirit and express themselves freely. In the first project, the teenagers designed their own fashion collection in all its various stages under the artistic direction of a well-known fashion designer, creating their own brand name (B.Live), and organized a fashion show. In all, 24 patients from 15 to 20 years old took part in the project. The fashion project proved a fundamental resource in helping the young patients involved to regain a positive self-image and the feeling that they could take action, both on themselves and in their relations with others. Facilitating the experience of beauty may enable hope to withstand the anguish caused by disease. This experience integrated the usual forms of psychological support to offer patients a form of expression and support during the course of their treatment.

  15. A life uncertain – My baby’s vulnerability: Mothers’ lived experience of connection with their preterm infants in a Botswana neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Rosinah K. Ncube

    2016-08-01

    Full Text Available Background: Preterm and low–birth weight infants are often separated from their mothers when admitted to neonatal units for stabilisation of body temperature and technological support. Objectives: The aim of the study was to explore and describe the lived experiences of mothers regarding care of their hospitalised preterm infants in a neonatal unit in a public hospital in Gaborone, Botswana. Method: This study utilised a qualitative exploratory and descriptive phenomenological study design. Mothers of hospitalised preterm infants were purposefully selected, with whom there was extensive engagement. Two in-depth interviews were conducted with each participant (P. Results: Mothers were shocked by the sudden birth of a preterm infant and found the neonatal environment intimidating. This increased their fear and anxiety and delayed development of a relationship with their infants. Support from staff, other mothers in the neonatal unit and family members enabled the mothers to overcome their fear and to develop an emotional connection with their infants. Conclusion: On-going supportive communication with the mothers by healthcare professionals promotes their confidence and competence in caring for their preterm infants, which in turn promotes mother–infant attachment.

  16. A life uncertain - My baby's vulnerability: Mothers' lived experience of connection with their preterm infants in a Botswana neonatal intensive care unit.

    Science.gov (United States)

    Ncube, Rosinah K; Barlow, Hilary; Mayers, Pat M

    2016-08-30

    Preterm and low-birth weight infants are often separated from their mothers when admitted to neonatal units for stabilisation of body temperature and technological support. The aim of the study was to explore and describe the lived experiences of mothers regarding care of their hospitalised preterm infants in a neonatal unit in a public hospital in Gaborone, Botswana. This study utilised a qualitative exploratory and descriptive phenomenological study design. Mothers of hospitalised preterm infants were purposefully selected, with whom there was extensive engagement. Two in-depth interviews were conducted with each participant (P). Mothers were shocked by the sudden birth of a preterm infant and found the neonatal environment intimidating. This increased their fear and anxiety and delayed development of a relationship with their infants. Support from staff, other mothers in the neonatal unit and family members enabled the mothers to overcome their fear and to develop an emotional connection with their infants. On-going supportive communication with the mothers by healthcare professionals promotes their confidence and competence in caring for their preterm infants, which in turn promotes mother-infant attachment.

  17. DESIGN AND EXPERIENCE WITH THE WS/HS ASSEMBLY MOVEMENT USING LABVIEW VIS, NATIONAL INSTRUMENT MOTION CONTROLLERS, AND COMPUMOTOR ELECTRONIC DRIVE UNITS AND MOTORS

    International Nuclear Information System (INIS)

    Barr, D.S.; Day, L.A.

    2001-01-01

    The Low-Energy Demonstration Accelerator (LEDA), designed and built at the Los Alamos National Laboratory, is part of the Accelerator Production of Tritium (APT) program and provides a platform for measuring high-power proton beam-halo formation. The technique used for measuring the beam halo employs nine combination Wire Scanner and Halo Scraper (WS/HS) devices. This paper will focus on the experience gained in the use of National Instrument (NI) LabVIEW VIs and motion controllers, and Compumotor electronic drive units and motors. The base configuration couples a Compumotor motor driven by a Parker-Hannifin Gemini GT Drive unit. The drive unit is controlled by a NI PXI-7344 controller card, which in turn is controlled by a PC running custom built NI LabVIEW VIs. The function of the control VI's is to interpret instructions from the main control system, the Experimental Physics and Industrial Control System (EPICS), and carry out the corresponding motion commands. The main control VI has to run all nineteen WS/HS motor axes used in the accelerator. A basic discussion of the main accelerator control system, EPICs which is hosted on a VXI platform, and its interface with the PC based LabVIEW motion control software will be included

  18. Judges in the Formation of the Nation- State: Professional Experiences, Academic Background and Geographic Circulation of Members of the Supreme Courts of Brazil and the United States

    Directory of Open Access Journals (Sweden)

    Luciano Da Ros

    2010-06-01

    Full Text Available This article compares the career profiles of judges from the highest bodies of the Judiciary in Brazil and the United States of America, examining the biographies of all the ministros of the Supreme Court of Justice (Empire and of the Supreme Federal Tribunal (Republic in Brazil, and of all the justices of the Supreme Court of the United States, appointed until 2008 in both cases. Based on the sociology of political elites perspective, the article examines data concerning academic background, geographic circulation and the different professional experiences — legal, political and linked to the administration of the State’s coercive activity (police or military — lived through by future members of the Supreme Courts of Brazil and the United States so as to identify the types of individuals recommended to join the top bodies of the Judiciary in the two countries. In this sense, different State-building processes are identified on the basis of the examination of Brazilian and US judicial elites, suggesting a more fragmented and diverse trajectory in the case of US justices, and greater homogeneity and centralization in the case of their Brazilian counterparts.

  19. Preclinical evaluation of strontium-containing bioactive bone cement

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zhaoyang, E-mail: lizy@hku.hk [School of Materials Science and Engineering, Tianjin University, Tianjin 300072 (China); Tianjin Key Laboratory of Composite and Functional Materials, Tianjin 300072 (China); Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong (China); Yuan, Ning [Department of Laboratory Medicine, Tianjin Chest Hospital, Tianjin 300051 (China); Lam, Raymond Wing Moon [Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong (China); Cui, Zhenduo; Yang, Xianjin [School of Materials Science and Engineering, Tianjin University, Tianjin 300072 (China); Tianjin Key Laboratory of Composite and Functional Materials, Tianjin 300072 (China); Lu, William Weijia, E-mail: wwlu@hku.hk [Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong (China)

    2013-12-01

    Strontium (Sr) has become more attractive for orthopaedic applications as they can simultaneously stimulate bone formation and prevent bone loss. A Sr-containing bioactive bone cement (Sr-BC) has been designed to fix osteoporotic bone fracture. Sr is a trace element, so the safety of containing Sr is concerned when Sr-BC is implanted in human body. The preclinical assessment of biocompatibility of Sr-BC was conducted according to ISO 10993 standards. MTT assay showed that this bioactive bone cement was non-toxic to mouse fibroblasts, and it met the basic requirement for the orthopaedic implant. The three independent genetic toxicity studies including Ames, chromosome aberration and bone marrow micronucleus assays demonstrated absence of genotoxic components in Sr-BC, which reassured the safety concerns of this novel bone cement. The muscle implantation results in present study were also encouraging. The acute inflammation around the cement was observed at 1 week post-implantation; however, no significant difference was observed between control and Sr-BC groups. These responses may be attributed to the presence of the foreign body, but the tissue healed after 12 weeks implantation. In summary, the above preclinical results provide additional assurance for the safety of this implant. Sr-BC can be used as a potential alternative to the traditional bone cement. - Highlights: • Strontium-containing bioactive bone cement (Sr-BC) was designed. • The biocompatibility of Sr-BC was evaluated according ISO 10993 standards. • Preclinical results provide additional assurance for the safety of Sr-BC.

  20. Preclinical evaluation of strontium-containing bioactive bone cement

    International Nuclear Information System (INIS)

    Li, Zhaoyang; Yuan, Ning; Lam, Raymond Wing Moon; Cui, Zhenduo; Yang, Xianjin; Lu, William Weijia

    2013-01-01

    Strontium (Sr) has become more attractive for orthopaedic applications as they can simultaneously stimulate bone formation and prevent bone loss. A Sr-containing bioactive bone cement (Sr-BC) has been designed to fix osteoporotic bone fracture. Sr is a trace element, so the safety of containing Sr is concerned when Sr-BC is implanted in human body. The preclinical assessment of biocompatibility of Sr-BC was conducted according to ISO 10993 standards. MTT assay showed that this bioactive bone cement was non-toxic to mouse fibroblasts, and it met the basic requirement for the orthopaedic implant. The three independent genetic toxicity studies including Ames, chromosome aberration and bone marrow micronucleus assays demonstrated absence of genotoxic components in Sr-BC, which reassured the safety concerns of this novel bone cement. The muscle implantation results in present study were also encouraging. The acute inflammation around the cement was observed at 1 week post-implantation; however, no significant difference was observed between control and Sr-BC groups. These responses may be attributed to the presence of the foreign body, but the tissue healed after 12 weeks implantation. In summary, the above preclinical results provide additional assurance for the safety of this implant. Sr-BC can be used as a potential alternative to the traditional bone cement. - Highlights: • Strontium-containing bioactive bone cement (Sr-BC) was designed. • The biocompatibility of Sr-BC was evaluated according ISO 10993 standards. • Preclinical results provide additional assurance for the safety of Sr-BC

  1. Collaborative learning in pre-clinical dental hygiene education.

    Science.gov (United States)

    Mueller-Joseph, Laura J; Nappo-Dattoma, Luisa

    2013-04-01

    Dental hygiene education continues to move beyond mastery of content material and skill development to learning concepts that promote critical-thinking and problem-solving skills. The purpose of this research was to evaluate the effectiveness of collaborative learning and determine the growth in intellectual development of 54 first-year dental hygiene students. The control group used traditional pre-clinical teaching and the experimental group used collaborative pedagogy for instrument introduction. All students were subjected to a post-test evaluating their ability to apply the principles of instrumentation. Intellectual development was determined using pre- and post-tests based on the Perry Scheme of Intellectual Development. Student attitudes were assessed using daily Classroom Assessment Activities and an end-of-semester departmental course evaluation. Findings indicated no significant difference between collaborative learning and traditional learning in achieving pre-clinical competence as evidenced by the students' ability to apply the principles of instrumentation. Advancement in intellectual development did not differ significantly between groups. Value added benefits of a collaborative learning environment as identified by the evaluation of student attitudes included decreased student reliance on authority, recognition of peers as legitimate sources of learning and increased self-confidence. A significant difference in student responses to daily classroom assessments was evident on the 5 days a collaborative learning environment was employed. Dental hygiene students involved in a pre-clinical collaborative learning environment are more responsible for their own learning and tend to have a more positive attitude toward the subject matter. Future studies evaluating collaborative learning in clinical dental hygiene education need to investigate the cost/benefit ratio of the value added outcomes of collaborative learning.

  2. Post-SSRI Sexual Dysfunction: Preclinical to Clinical. Is It Fact or Fiction?

    Science.gov (United States)

    Coskuner, Enis Rauf; Culha, Mehmet Gokhan; Ozkan, Burak; Kaleagasi, Elcin Orhan

    2018-04-01

    Selective serotonin reuptake inhibitors (SSRIs) are a widely used class of drug for various psychiatric disorders during the lifespan, including pregnancy, lactation, childhood, and adolescence. Deterioration in sexual functioning is a major and serious adverse effect of SSRIs. There is emerging evidence that SSRIs can have long-lasting effects on sexuality. To summarize the long-lasting effects of SSRIs on sexuality, starting with animal models and continuing with the clinical experience of different investigators. A literature review of relevant publications in PubMed. To assess the long-lasting effects of SSRIs on sexuality. Although the persistent effects of SSRIs on sexuality have been little studied in humans, animal studies suggest that SSRIs might cause permanent sexual dysfunction after ending SSRI exposure at a young age but not in adulthood in rats. There are no prospective randomized controlled trials in humans and the present evidence is derived from case reports, incidental research findings, and experiences of some internet communities. There is some preclinical evidence from animal studies for enduring SSRI-induced sexual dysfunction, but the available clinical information could prevent a clear decision about the existence of post-SSRI sexual dysfunction, its pathophysiology, and its management. We need more research to fill in the gaps in our knowledge. Coskuner ER, Culha MG, Ozkan B, Kaleagasi EO. Post-SSRI Sexual Dysfunction: Preclinical to Clinical. Is It Fact or Fiction? Sex Med Rev 2018;6:217-223. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  3. Impact of a Comprehensive Early Clinical Exposure Program for Preclinical Year Medical Students

    Directory of Open Access Journals (Sweden)

    Sumitra Govindarajan

    2018-06-01

    Full Text Available Purpose: To study the impact of an early clinical exposure program designed to provide a wide variety (cognitive, affective and psychomotor of learning experiences for the preclinical year students. Method: One hundred and fifty preclinical students were posted in small groups to selected departments – Transfusion medicine, Catheterization lab, Simulation lab, Radiology, Neurology, Nephrology, Respiratory medicine and General surgery. Each student had atleast ten hours  of clinical exposure under this program. The program was evaluated through a series of pre and post-test questionnaires, which were designed based on the learning objectives of each session. Students who wished to participate in the program evaluation gave informed consent, took up the pre / post test and were also asked to give their written open comments about the program. Results: There was a significant increase in the post-test scores (ranging from 9.14±2.67 to 36.65±6.62 when compared to the pre-test scores (ranging from 7.94±2.31 to 28.69±6.11 for all the sessions (p value <0.001, n=144. Analysis of the open feedback showed that the program had significant impact on the cognitive, psychomotor and affective domains. “Application of basic sciences in clinical practice”, “motivation to learn”, “got familiar with various specialties”, “insight about what the patient undergoes” were the themes identified from the open comments. Conclusion: The innovative use of early clinical exposure program to teach/learn clinical skills like phlebotomy and Basic Life Support had been well appreciated by the students. The present design involving a variety of learning experiences has been successful in introducing the various dimensions of medical profession like scientific, ethical, interpersonal, professional and social to the new entrants in addition to enhancing their motivation to learn. Keywords: Attitude, Learning, Simulation lab, Medical education, Curriculum

  4. Women In The United States Experience High Rates Of Coverage 'Churn' In Months Before And After Childbirth.

    Science.gov (United States)

    Daw, Jamie R; Hatfield, Laura A; Swartz, Katherine; Sommers, Benjamin D

    2017-04-01

    Insurance transitions-sometimes referred to as "churn"-before and after childbirth can adversely affect the continuity and quality of care. Yet little is known about coverage patterns and changes for women giving birth in the United States. Using nationally representative survey data for the period 2005-13, we found high rates of insurance transitions before and after delivery. Half of women who were uninsured nine months before delivery had acquired Medicaid or CHIP coverage by the month of delivery, but 55 percent of women with that coverage at delivery experienced a coverage gap in the ensuing six months. Risk factors associated with insurance loss after delivery include not speaking English at home, being unmarried, having Medicaid or CHIP coverage at delivery, living in the South, and having a family income of 100-185 percent of the poverty level. To minimize the adverse effects of coverage disruptions, states should consider policies that promote the continuity of coverage for childbearing women, particularly those with pregnancy-related Medicaid eligibility. Project HOPE—The People-to-People Health Foundation, Inc.

  5. Why Not Wait? Eight Institutions Share Their Experiences Moving United States Medical Licensing Examination Step 1 After Core Clinical Clerkships.

    Science.gov (United States)

    Daniel, Michelle; Fleming, Amy; Grochowski, Colleen O'Conner; Harnik, Vicky; Klimstra, Sibel; Morrison, Gail; Pock, Arnyce; Schwartz, Michael L; Santen, Sally

    2017-11-01

    The majority of medical students complete the United States Medical Licensing Examination Step 1 after their foundational sciences; however, there are compelling reasons to examine this practice. This article provides the perspectives of eight MD-granting medical schools that have moved Step 1 after the core clerkships, describing their rationale, logistics of the change, outcomes, and lessons learned. The primary reasons these institutions cite for moving Step 1 after clerkships are to foster more enduring and integrated basic science learning connected to clinical care and to better prepare students for the increasingly clinical focus of Step 1. Each school provides key features of the preclerkship and clinical curricula and details concerning taking Steps 1 and 2, to allow other schools contemplating change to understand the landscape. Most schools report an increase in aggregate Step 1 scores after the change. Despite early positive outcomes, there may be unintended consequences to later scheduling of Step 1, including relatively late student reevaluations of their career choice if Step 1 scores are not competitive in the specialty area of their choice. The score increases should be interpreted with caution: These schools may not be representative with regard to mean Step 1 scores and failure rates. Other aspects of curricular transformation and rising national Step 1 scores confound the data. Although the optimal timing of Step 1 has yet to be determined, this article summarizes the perspectives of eight schools that changed Step 1 timing, filling a gap in the literature on this important topic.

  6. Zero Health Worker Infection: Experiences From the China Ebola Treatment Unit During the Ebola Epidemic in Liberia.

    Science.gov (United States)

    Liu, Lei; Yin, Huahua; Liu, Ding

    2017-04-01

    In November 2014, a total of 164 health care workers were dispatched by the Chinese government as the first medical assistance team to Liberia. The tasks of this team were to establish a China Ebola treatment unit (ETU), to commence the initial admission and treatment of suspected and confirmed Ebola patients, and to provide public health and infection control training for relevant local personnel. Overall, during the 2-month stay of this first medical assistance team in Liberia, 112 Ebola-suspected patients presented to the ETU, 65 patients were admitted, including 5 confirmed cases, and 3 confirmed cases were cured. Furthermore, 1520 local people were trained, including health care workers, military health care workers, staff members employed by the ETU, and community residents. Most importantly, as the first Chinese medical assistance team deployed to Liberia fighting the Ebola virus on the frontline, not a single member of this team or the hired local staff were infected by Ebola virus. This highly successful outcome was due to the meticulous infection control initiatives developed by the team, thereby making a significant contribution to China's ETU "zero infection" of health workers in Liberia. The major infection control initiatives conducted in the China ETU that contributed to achieving "zero infection" of all health workers in the ETU are introduced in this report. (Disaster Med Public Health Preparedness. 2017;11:262-266).

  7. Predictive Factors for Delayed Extubation in the Intensive Care Unit after Coronary Artery Bypass Grafting; A Southern Iranian Experience

    Directory of Open Access Journals (Sweden)

    Shahrbanoo Shahbazi

    2012-12-01

    Full Text Available Background: Early extubation is implemented in cardiothoracic units worldwide for its advantages such as decreased mortality, morbidity, and hospitalization costs. We conducted a retrospective study to evaluate potential factors which may affect extubation time. Methods: The records of 334 eligible patients who underwent elective coronary artery bypass grafting (CABG in 2008 in Kowsar Hospital in Shiraz, southern Iran were evaluated to find the factors that can affect the extubation time. The patients were divided to early (equal or less than 6 hours and late extubation groups. The patients’ demographic data and operative variables were extracted from the records. We excluded patients with difficult intubation, severe acid base disturbance, neurological problems, and cardiovascular instability; and those who used intra-aortic balloon pump, had underwent emergency operation, or had another concomitant surgery. Results: Multiple logistic regressions comparing age, sex, number of grafts, ejection fraction, pump time, hematocrit, number of risk factors, and number of inotropic drugs, identified only age as a predictor of delayed extubation (odds ratio=1.07, CI 95%=1.04-1.10, P<0.001. Also, in both studied groups the men to women ratio was higher (P<0.05.Conclusion: Although in our study age was the only predictive factor for delayed extubation, a comprehensive study including preoperative, perioperative, and postoperative factors is recommended in our area.

  8. Characteristics features and factors influencing early death in Acute promyelocytic leukemia; Experience from United Arab Emirates (UAE).

    Science.gov (United States)

    Hassan, Inaam Bashir; Zaabi, Mariam R Al; Alam, Arif; Hashim, Mohammed Jawad; Tallman, Martin S; Kristensen, Jorgen

    2017-07-01

    Although acute promyelocytic leukemia (APL) is a curable hematologic malignancy, early death (ED) remains a significant cause of treatment failure especially in developing countries. In a retrospective data analysis of 67 adult APL patients diagnosed in United Arab Emirates we report an ED rate of 11.9% which is comparable to that reported from more developed countries. We identified the following parameters at presentation as significant predictor of increased ED: Age >40 years (P = 0.015), fever (P = 0.030), WBC count >20 × 10 9 /L (P = 0.010), the breakpoints other than bcr1 (P = 0.043) and fibrinogen level 10 × 10 9 /L and expression of HLA-DR (P = 0.018) or CD2 (P = 0.017) were significant predictors for differentiation syndrome (DS) which was found to be a predictor of ED (P = 0.002). Reducing the APL related ED rate in centers with limited resources is feasible provided early initiation of ATRA administration and early correction of coagulopathy in high-risk patients in addition to prompt treatment of DS. To our knowledge this is the first report from the Arabian Gulf describing ED in APL.

  9. Advanced scale conditioning agent (ASCA) planning, application experience, and results at Seabrook and D.C. Cook unit 2

    Energy Technology Data Exchange (ETDEWEB)

    Ramaley, D.; Forney, M. [Westinghouse Electric Company LLC, Cranberry Township, Pennsylvania (United States); Rocheleau, M. [Next Era Energy, Seabrook Nuclear Plant, Seabrook, New Hampshire (United States); Shimunek, C.; Monk, P [American Electric Power, Cook Nuclear Plant, Bridgman, Michigan (United States)

    2012-07-01

    ASCA technology has been applied more than thirty-five times worldwide since its inception in 2000. This technology has continually grown in popularity since its development as a result of the many process benefits while maintaining minimal outage impacts. Utilities have applied ASCAs for a variety of reasons including: • Partial removal of secondary side deposit inventory • Improvement in sludge removal quantity over traditional mechanical cleaning processes • Reduction of tube support plate (TSP) blockage • Improvement in steam generator thermal performance • Partial dissolution and softening of consolidated top of tubesheet (TTS) collars In addition to several international ASCA applications, two U.S. ASCA applications were performed in 2011 and 2012. In 2011, a TTS ASCA application was performed at Seabrook Station Nuclear Plant. The TTS application was the third ASCA to be executed at the plant; Seabrook performed full bundle ASCAs in 2008 and 2009. In 2012, a full bundle maintenance cleaning ASCA was implemented at D.C. Cook Unit 2. This was the first ASCA application to be executed by the utility. This paper will discuss both the Westinghouse and utility perspective on ASCA application planning, site execution, and process results for TTS and full bundle applications. (author)

  10. Applying an Ecohealth Perspective in a State of the Environment Report: Experiences of a Local Public Health Unit in Canada

    Directory of Open Access Journals (Sweden)

    Steven Lam

    2014-12-01

    Full Text Available We applied an Ecohealth perspective into a State of the Environment report for Grey Bruce Health Unit and summarized environmental and health data relevant for public health practice. We aimed for comprehensiveness in our data compilation, including: standard media categories (e.g., air, water, land; and ecological indicators (e.g., vectors, forests, wetlands. Data sources included both primary (collected by an organization and secondary (assembled by others. We organized indicators with the Driving forces-Pressure-State-Exposure-Effect-Action (DPSEEA framework created by the World Health Organization. Indicators of air, water and land quality generally appeared to point towards a healthy state. Vector-borne diseases remained low. Forests and wetlands appeared to be in good condition, however more monitoring data was needed to determine trends in their ecological indicators. Data were not available on biodiversity and fish conditions. The results of our application of the DPSEEA framework suggest that routinely collected environmental and health data can be structured into the framework, though challenges arose due to gaps in data availability, particularly for social and gender analyses. Ecohealth approaches had legitimacy with broader healthy community partners but applying such approaches was a complex undertaking.

  11. Preclinical Science Regarding Cannabinoids as Analgesics: An Overview

    Directory of Open Access Journals (Sweden)

    ME Lynch

    2005-01-01

    Full Text Available Modern pharmacology of cannabinoids began in 1964 with the isolation and partial synthesis of delta-9-tetrahydrocannabinol, the main psychoactive agent in herbal cannabis. Since then, potent antinociceptive and antihyperalgesic effects of cannabinoid agonists in animal models of acute and chronic pain; the presence of cannabinoid receptors in pain-processing areas of the brain, spinal cord and periphery; and evidence supporting endogenous modulation of pain systems by cannabinoids has provided support that cannabinoids exhibit significant potential as analgesics. The present article presents an overview of the preclinical science.

  12. Preclinical investigations towards the first spacer gel application in prostate cancer treatment during particle therapy at HIT

    International Nuclear Information System (INIS)

    Ruciński, Antoni; Parodi, Katia; Jäkel, Oliver; Haberer, Thomas; Bauer, Julia; Campbell, Patrick; Brons, Stephan; Unholtz, Daniel; Habl, Gregor; Herfarth, Klaus; Debus, Jürgen; Bert, Christoph

    2013-01-01

    The application of spacer gel represents a promising approach to reliably spare the rectal frontal wall during particle therapy (IJROBP 76:1251-1258, 2010). In order to qualify the spacer gel for the clinical use in particle therapy, a variety of measurements were performed in order to ensure the biological compatibility of the gel, its physical stability during and after the irradiation, and a proper definition of the gel in terms of the Hounsfield Unit (HU) values for the treatment planning system. The potential for the use of the spacer gel for particle therapy monitoring with off-line Positron Emission Tomography (PET) was also investigated. The spacer gel implanted to the prostate patient in direct neighbourhood to the clinical target volume does not interfere with the particle therapy treatment planning procedure applied at Heidelberg Ion Beam Therapy Centre (HIT). The performed measurements show that Bragg-peak position of the particles can be properly predicted on the basis of computed tomography imaging with the treatment planning system used at HIT (measured water equivalent path length of 1.011 ±0.011 (2σ), measured Hounsfield Unit of 28.9 ±6.1 (2σ)). The spacer gel samples remain physically unchanged after irradiation with a dose exceeding the therapeutic dose level. The independently measured Bragg-Peak position does not change within the time interval of 10 weeks. As a result of the presented experiments, the first clinical application of spacer gel implant during prostate cancer treatment with carbon ions and protons was possible at HIT in 2012. The reported pre-clinical investigations demonstrate that use of spacer gel is safe in particle therapy in presence of therapy target motion and patient positioning induced particle range variations. The spacer gel injected between prostate and rectum enlarge the distance between both organs, which is expected to clinically significantly decrease the undesirable exposure of the most critical organ at risk

  13. Preclinical evaluation of a Haemophilus influenzae type b conjugate vaccine process intended for technology transfer.

    Science.gov (United States)

    Hamidi, Ahd; Verdijk, Pauline; Kreeftenberg, Hans

    2014-01-01

    Introduction of Haemophilus influenzae type b (Hib) vaccine in low- and middle-income countries has been limited by cost and availability of Hib conjugate vaccines for a long time. It was previously recognized by the Institute for Translational Vaccinology (Intravacc, originating from the former Vaccinology Unit of the National Institute of Public Health [RIVM] and the Netherlands Vaccine Institute [NVI]) that local production of a Hib conjugate vaccine would increase the affordability and sustainability of the vaccine and thereby help to speed up Hib introduction in these countries. A new affordable and a non-infringing production process for a Hib conjugate vaccine was developed, including relevant quality control tests, and the technology was transferred to a number of vaccine manufacturers in India, Indonesia, and China. As part of the Hib technology transfer project managed by Intravacc, a preclinical toxicity study was conducted in the Netherlands to test the safety and immunogenicity of this new Hib conjugate vaccine. The data generated by this study were used by the technology transfer partners to accelerate the clinical development of the new Hib conjugate vaccine. A repeated dose toxicity and local tolerance study in rats was performed to assess the reactogenicity and immunogenicity of a new Hib conjugate vaccine compared to a licensed vaccine. The results showed that the vaccine was well tolerated and immunogenic in rats, no major differences in both safety and immunogenicity in rats were found between the vaccine produced according to the production process developed by Intravacc and the licensed one. Rats may be useful to verify the immunogenicity of Hib conjugate vaccines and for preclinical evaluation. In general, nonclinical evaluation of the new Hib conjugate vaccine, including this proof of concept (safety and immunogenicity study in rats), made it possible for technology transfer partners, having implemented the original process with no changes

  14. A qualitative study of the experiences and expectations of women receiving in-patient postnatal care in one English maternity unit

    Directory of Open Access Journals (Sweden)

    Bick Debra

    2010-10-01

    Full Text Available Abstract Background Studies consistently highlight in-patient postnatal care as the area of maternity care women are least satisfied with. As part of a quality improvement study to promote a continuum of care from the birthing room to discharge home from hospital, we explored women's expectations and experiences of current in-patient care. Methods For this part of the study, qualitative data from semi-structured interviews were transcribed and analysed using content analyses to identify issues and concepts. Women were recruited from two postnatal wards in one large maternity unit in the South of England, with around 6,000 births a year. Results Twenty women, who had a vaginal or caesarean birth, were interviewed on the postnatal ward. Identified themes included; the impact of the ward environment; the impact of the attitude of staff; quality and level of support for breastfeeding; unmet information needs; and women's low expectations of hospital based postnatal care. Findings informed revision to the content and planning of in-patient postnatal care, results of which will be reported elsewhere. Conclusions Women's responses highlighted several areas where changes could be implemented. Staff should be aware that how they inter-act with women could make a difference to care as a positive or negative experience. The lack of support and inconsistent advice on breastfeeding highlights that units need to consider how individual staff communicate information to women. Units need to address how and when information on practical aspects of infant care is provided if women and their partners are to feel confident on the woman's transfer home from hospital.

  15. Preclinical QSP Modeling in the Pharmaceutical Industry: An IQ Consortium Survey Examining the Current Landscape

    Science.gov (United States)

    Wu, Fan; Bansal, Loveleena; Bradshaw‐Pierce, Erica; Chan, Jason R.; Liederer, Bianca M.; Mettetal, Jerome T.; Schroeder, Patricia; Schuck, Edgar; Tsai, Alice; Xu, Christine; Chimalakonda, Anjaneya; Le, Kha; Penney, Mark; Topp, Brian; Yamada, Akihiro

    2018-01-01

    A cross‐industry survey was conducted to assess the landscape of preclinical quantitative systems pharmacology (QSP) modeling within pharmaceutical companies. This article presents the survey results, which provide insights on the current state of preclinical QSP modeling in addition to future opportunities. Our results call attention to the need for an aligned definition and consistent terminology around QSP, yet highlight the broad applicability and benefits preclinical QSP modeling is currently delivering. PMID:29349875

  16. Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK

    Directory of Open Access Journals (Sweden)

    Pearson Mark

    2012-10-01

    Full Text Available Abstract Background School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evidence of school-based interventions tend to be highly problem- or intervention- specific, thereby missing potential generic insights into implementation and effectiveness of such programmes across problems. Methods/design A realist systematic review will be undertaken to explain how, why and in what circumstances schools can provide feasible settings for effective health promotion programmes in the United Kingdom (UK. The review will be conducted in two phases. Phase 1 will identify programme theories about implementation (ideas about what enables or inhibits effective health promotion to be delivered in a school setting. Phase 2 will test the programme theories so that they can be challenged, endorsed and/or refined. A Review Advisory Group of education and health professionals will be convened to help identify and choose potential programme theories, provide a ‘reality check’ on the clarity and explanatory strength of the mechanisms to be tested, and help shape the presentation of findings to be usable by practitioners and decision-makers. Review findings will be disseminated through liaison with decision-makers, and voluntary and professional groups in the fields of education and health.

  17. Risks of serious complications and death from smallpox vaccination: A systematic review of the United States experience, 1963–1968

    Directory of Open Access Journals (Sweden)

    Aragón Tomás J

    2003-08-01

    Full Text Available Abstract Background The United States (US has re-instituted smallpox vaccinations to prepare for an intentional release of the smallpox virus into the civilian population. In an outbreak, people of all ages will be vaccinated. To prepare for the impact of large-scale ring and mass vaccinations, we conducted a systematic review of the complication and mortality risks of smallpox vaccination. We summarized these risks for post-vaccinial encephalitis, vaccinia necrosum (progressive vaccinia, eczema vaccinatum, generalized vaccinia, and accidental infection (inadvertant autoinoculation. Methods Using a MEDLINE search strategy, we identified 348 articles, of which seven studies met our inclusion criteria (the number of primary vaccinations and re-vaccinations were reported, sufficient data were provided to calculate complication or case-fatality risks, and comparable case definitions were used. For each complication, we estimated of the complication, death, and case-fatality risks. Results The life-threatening complications of post-vaccinial encephalitis and vaccinia necrosum were at least 3 and 1 per million primary vaccinations, respectively. Twenty-nine percent of vaccinees with post-vaccinial encephalitis died and 15% with vaccinia necrosum died. There were no deaths among vaccinees that developed eczema vaccinatum; however, 2.3% of non-vaccinated contacts with eczema vaccinatum died. Among re-vaccinees, the risk of post-vaccinial encephalitis was reduced 26-fold, the risk of generalized vaccinia was reduced 29-fold, and the risk of eczema vaccinatum was reduced 12-fold. However, the risk reductions of accidental infection and vaccinia necrosum were modest (3.8 and 1.5 fold respectively.

  18. Experiences with integrated concepts for the control of Haemonchus contortus in sheep and goats in the United States.

    Science.gov (United States)

    Terrill, Thomas H; Miller, James E; Burke, Joan M; Mosjidis, Jorge A; Kaplan, Ray M

    2012-05-04

    The generally warm, moist environmental conditions in the southern United States (U.S.) are ideal for survival and growth of the egg and larval stages of Haemonchus contortus and other gastrointestinal nematodes (GIN) of sheep and goats. Consequently, infection with GIN is the greatest threat to economic small ruminant production in this region. With anthelmintic resistance now reaching epidemic proportions in small ruminants in the U.S., non-chemical control alternatives are critically needed. The Southern Consortium for Small Ruminant Parasite Control (SCSRPC) was formed in response to this crisis and over the last decade has successfully validated the use of several novel control technologies, including FAMACHA(©) for the implementation of targeted selective treatments (TST), copper oxide wire particles (COWP), nematode-trapping fungi, and grazing or feeding hay of the high-tannin perennial legume sericea lespedeza [Lespedeza cuneata (Dum.-Cours. G. Don)]. Producer attitudes toward GIN control in the U.S. have been shifting away from exclusive dependence upon anthelmintics toward more sustainable, integrated systems of parasite control. Some novel control technologies have been readily adopted by producers in combination with appropriate diagnostic tools, such as FAMACHA(©). Others techniques are still being developed, and will be available for producer use as they are validated. Although new drugs will likely be available to U.S. goat and sheep producers in the future, these will also be subject to development of anthelmintic resistance. Therefore, the adoption and implementation of sustainable GIN control principles will remain important. With emerging markets for grass-fed or organic livestock, there will continue to be a critical need for research and outreach on development and on-farm application of integrated GIN control systems for small ruminants in the U.S. for the foreseeable future. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. [Manual handling of loads in the hotel trade: the experience of the ASL (Local Health Unit) Milan].

    Science.gov (United States)

    Fontani, S; Mercuri, Irene; Salicco, R; Veratti, Silvia; Sorrentino, L

    2010-01-01

    There are over 400 hotels in Milan with a guest capacity of about 62,000 and employing more than 10,000 workers. In 2008/09 the Occupational Health and Safety Service of A.S.L. Milano (Local Health Unit) carried out research into the hotel trade to ascertain the development of this commercial sector, also in view of EXPO 2015. The aim of the project was to improve hygiene and safety conditions and carry out preventive measures. A specific purpose was to study manual handling of loads and repetitive movements risk. The study covered 30 hotels and 7 temporary staff cooperatives. We acquired the Risk Evaluation Document, the Health Surveillance Programme and Registers of Labour Accidents to analyze manual handling of loads and repetitive movements. In the investigations and assessments on hotels we used currently available scientific tools--NIOSH Lifting Index, Push and Pulling Analysis, OC.R.A. Check-List--to study risks related to handling loads and upper limb mechanical overload, which revealed a specific occupational risk that requires a fresh approach to prevention and safety in the entire sector. Chambermaid: LI (Range): 0.57-2.75; Push and Pulling Actions: Fi 0.66-Fm 1.5 and Fi 0.76-Fm 1.33 respectively; OC.R.A. Check-List: 21. Porter: LI (Range): 0.77-3.75. Maintenance staff LI (Range): 0.57-2.75. The study highlighted the presence of risk due to manual handling of loads and repetitive movements in porters, maintenance personnel and particularly in chambermaids that up to now have been poorly assessed by safety experts. Analysis of the information contained in the registers of labour accidents suggests that a significant number of accidents can be related to muscular-skeletal disorders that affect especially cleaning, portering and kitchen staff

  20. Experience of nasal continuous positive airway pressure (cpap) by infant flow driver in a neonatal unit of a developing country

    International Nuclear Information System (INIS)

    Iqbal, A.; Waqar, T.; Safdar, C.A.; Iqbal, T.

    2014-01-01

    Objective: To study the safety and efficacy of nasal continuous positive airways pressure by infant flow drivers in neonates admitted with respiratory problems. Study Design: Quasi-experimental study. Place and Duration of Study: This study was conducted at CMH Lahore from April 2012 to March 2013. Subjects and Methods: All infants who were treated with nasal continuous positive airway pressure (nCPAP) for various indications at neonatal intensive care unit (NICU) of CMH Lahore were evaluated for gestational, age, weight, gender, indications and duration on nCPAP, pre-defined outcomes, complications and length of hospital stay. Efficacy was defined as the ability to manage an infant on nCPAP alone thus avoiding the need for mechanical ventilation. Results: During the study period, 343 neonates were admitted in NICU, forty five neonates were placed on nCPAP. Mean gestational age was 33.85+ 3 weeks. Mean weight was 2043 + 770 grams. Main indications for applying nCPAP were respiratory distress syndrome (48.9%) and neonatal pneumonia (17.8%). Most common complication was abdominal distension (6.7%). Out of 45 infants placed on nCPAP, 32 (71.1%) were managed on nCPAP alone while 13 (28.9%) needed mechanical ventilation after nCPAP failure. Conclusion: Nasal CPAP by an infant flow driver is a useful method to manage respiratory distress in neonates. It reduces the need for mechanical ventilation and can be used as first line respiratory support before mechanical ventilation. (author)

  1. Multidisciplinary interventions and continuous quality improvement to reduce unplanned extubation in adult intensive care units: A 15-year experience.

    Science.gov (United States)

    Chao, Chien-Ming; Lai, Chih-Cheng; Chan, Khee-Siang; Cheng, Kuo-Chen; Ho, Chung-Han; Chen, Chin-Ming; Chou, Willy

    2017-07-01

    We conduct a retrospective study of patients with unplanned extubation (UE) in adult intensive care units (ICU) at a medical center. In 2001, a multidisciplinary team of intensivists, senior residents, nurses, and respiratory therapists was established at Chi Mei Medical Center. The improvement interventions, implemented between 2001 and 2015, were organized around 8 key areas: standardizing procedures, improving communication skills, revising sedation and weaning protocols, changing strategies for restraints, establishing a task force for identifying and managing high-risk patients, using new quality-improvement models as breakthrough series and team resource management, using the strategy of accountability without assigning blame, and changing a new method to secure endotracheal tube. We measured the outcome as the annual event and the rate of UE. During this 15-year period, there were 1404 episodes of UE, with 44,015 episodes of mechanical ventilation (MV) (319,158 ventilator-days). The overall rate of UE was 3.19/100 ventilated patients (4.40/1000 ventilator-days). In 2001, there were 188 episodes of UE and the rate of UE was 6.82/100 ventilated patients or 9.0/1000 ventilator-days. After this continue quality improvement project had been implemented, the annual number of episodes of UE declined to 27, and the rate fell to 0.95/100 ventilated patients or 1.36/1000 ventilator-days in 2015. Overall, the trend analysis showed the change was significant with P continuously and effectively reduced using multidisciplinary and sequential quality improvement interventions.

  2. [Medication reconciliation: an innovative experience in an internal medicine unit to decrease errors due to inacurrate medication histories].

    Science.gov (United States)

    Pérennes, Maud; Carde, Axel; Nicolas, Xavier; Dolz, Manuel; Bihannic, René; Grimont, Pauline; Chapot, Thierry; Granier, Hervé

    2012-03-01

    An inaccurate medication history may prevent the discovery of a pre-admission iatrogenic event or lead to interrupted drug therapy during hospitalization. Medication reconciliation is a process that ensures the transfer of medication information at admission to the hospital. The aims of this prospective study were to evaluate the interest in clinical practice of this concept and the resources needed for its implementation. We chose to include patients aged 65 years or over admitted in the internal medicine unit between June and October 2010. We obtained an accurate list of each patient's home medications. This list was then compared with medication orders. All medication variances were classified as intended or unintended. An internist and a pharmacist classified the clinical importance of each unintended variance. Sixty-one patients (mean age: 78 ± 7.4 years) were included in our study. We identified 38 unintended discrepancies. The average number of unintended discrepancies was 0.62 per patient. Twenty-five patients (41%) had one or more unintended discrepancies at admission. The contact with the community pharmacist permitted us to identify 21 (55%) unintended discrepancies. The most common errors were the omission of a regularly used medication (76%) and an incorrect dosage (16%). Our intervention resulted in order changes by the physician for 30 (79%) unintended discrepancies. Fifty percent of the unintended variances were judged by the internist and 76% by the pharmacist to be clinically significant. The admission to the hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  3. Challenges in setting up a potable water supply system in a United Nations peacekeeping mission: the South Sudan experience.

    Science.gov (United States)

    Hazra, Aniruddha

    2013-01-01

    A United Nations peacekeeping contingent was deployed in the conflict affected areas of South Sudan with inadequate environmental sanitation, lack of clean drinking water and a heightened risk of water-borne diseases. In the immediate post-deployment phase, the contingent-owned water purification system was pressed into service. However, laboratory analyses of processed water revealed its unsuitability for human consumption. A systematic, sanitary survey was conducted to identify the shortcomings in the water supply system's ability to provide potable water. Under field conditions, the 'H2S method' was used to detect faecal contamination of drinking water. The raw water from the only available source, the White Nile River, was highly turbid and contaminated by intestinal and other pathogens due to an unprotected watershed. Water sterilizing powder was not readily available in the local area to replenish the existing stocks that had deteriorated during the long transit period from the troop contributing country. The water pipelines that had been laid along the ground, under water-logged conditions, were prone to microbial recontamination due to leakages in the network. The critical evaluation of the water supply system and necessary modifications in the purification process, based upon locally available options, yielded safe drinking water. Provision of safe drinking water in the mission area requires an in-depth analysis of prevailing conditions and appropriate planning in the pre-deployment phase. The chemicals for water purification should be procured through UN sources via a 'letter of assist' request from the troop contributor. Copyright © 2012 Elsevier GmbH. All rights reserved.

  4. Dr Kathryn Beers, Assistant Director Physical Sciences and Engineering, Office of Science and Technology Policy Executive Office of the President United States of America visit the CMS experiment at point 5.

    CERN Multimedia

    Maximilien Brice

    2007-01-01

    Dr Kathryn Beers, Assistant Director Physical Sciences and Engineering, Office of Science and Technology Policy Executive Office of the President United States of America visit the CMS experiment at point 5.

  5. Professor Tony F. Chan Assistant Director for Mathematics and Physical Sciences National Science Foundation United States of America on 23rd May 2007. Here visiting ATLAS experiment with P. Jenni and M. Tuts.

    CERN Multimedia

    Maximilien Brice

    2007-01-01

    Professor Tony F. Chan Assistant Director for Mathematics and Physical Sciences National Science Foundation United States of America on 23rd May 2007. Here visiting ATLAS experiment with P. Jenni and M. Tuts.

  6. H.E. Mr Ichiro Fujisaki Ambassador Extraordinary and Plenipotentiary Permanent Representative of Japan to the Office of the United Nations and the other international organisations in Geneva visit the LHCb Experiment at point 8.

    CERN Multimedia

    Maximilien Brice

    2007-01-01

    H.E. Mr Ichiro Fujisaki Ambassador Extraordinary and Plenipotentiary Permanent Representative of Japan to the Office of the United Nations and the other international organisations in Geneva visit the LHCb Experiment at point 8.

  7. Lived Experience of Caregivers of Family-Centered Care in the Neonatal Intensive Care Unit: “Evocation of Being at Home”

    Science.gov (United States)

    Hadian Shirazi, Zahra; Sharif, Farkhondeh; Rakhshan, Mahnaz; Pishva, Narjes; Jahanpour, Faezeh

    2016-01-01

    Background In recent decades, family-centered care (FCC) has come to be known, accepted, and reported as the best care strategy for admitted children and their families. However, in spite of the increasing application of this approach, the experiences of the caregivers have not yet been studied. Objectives The present study aimed at the description and interpretation of the FCC experience in two neonatal intensive care units (NICU) at Shiraz University of Medical Sciences. Methods This study was conducted through the hermeneutic phenomenological approach. Semi-structured interviews were conducted with 17 professional and familial caregivers, and their interactions were observed in three work shifts. The interviews were audiotaped and transcribed verbatim. After observations, field notes were also written. Finally, the data were analyzed through van Manen’s methodology. Results One of the essential themes that emerged in this study was the “evocation of being at home” among familial and even professional caregivers. This theme had three subthemes: i.e., “meta-family interaction,” “comprehensive support,” and “reconstruction of a normal family.” Accordingly, FCC eliminated borders between professional and non-professional caregivers and built close relationships among them in the NICU. It also provided for the needs of neonates, their families, and even professional caregivers through perceived and received support. Conclusions Parents of the neonates admitted to the NICU experience hard moments. They not only play the role of primary caregivers, but they also receive the care. Focusing on the different meanings of this care from the caregivers’ points of view and having managers provide certain requirements can guarantee the establishment of comprehensive care for clients and proper support for the staff in this unit. PMID:28203324

  8. Transferable skills of incoming medical students and their development over the first academic year: The United Arab Emirates experience.

    Science.gov (United States)

    McLean, Michelle; Shaban, Sami; Murdoch-Eaton, Deborah

    2011-01-01

    Increasingly, it is being recognised in higher and medical education that learners should be adequately prepared for the unpredictable nature of professional practice. Several generic or transferable skills or capabilities (e.g., communication, information handling) that will enable graduates to function in an ever-changing professional world have been identified. Using a validated inventory comprising six categories of transferable skills, three cohorts of incoming male and female medical students at a Gulf university documented their level of practice and confidence for 31 skills. The exercise was repeated a year later. New medical students identified computer and organisational skills and the ability to manage their learning as strengths, but scores for technical and numeracy, information handling and presentation and communication skills suggested that learners generally required guidance. A year later, despite considerable self-reported information handling and communication skills development, learners generally did not consider themselves self-sufficient. A significant gender difference emerged, with incoming males reporting less experience and confidence in many skills. This gap was reduced but did not disappear over the first academic year. An audit such as this may be useful for identifying individual skills levels as well as providing insight into shortcomings in the academic programme in terms of opportunities for transferable skills development.

  9. 22q11 deletion syndrome: Parents' and children's experiences of educational and healthcare provision in the United Kingdom.

    Science.gov (United States)

    Cohen, Wendy; McCartney, Elspeth; Crampin, Lisa

    2017-06-01

    22q11 deletion syndrome (22q11DS) is a genetic syndrome, prevalence around 1:4000-1:6000 live births, with a complex array of associated features, impacting on healthcare and educational support. This study reports the perceptions of families and individuals with 22q11DS in relation to these needs. Individuals and families of those with 22q11DS were approached though two national charities - the Max Appeal and 22Crew. An initial observational survey design was used to gather views via questions probing access to healthcare and educational experiences. Thirty-four responses were received and the data subjected to descriptive analysis. Over half of the respondents were diagnosed before the age of 1. Ninety-one percent reported ongoing difficulties with learning at school, compounded by school attendance being compromised as a result of medical interventions. Individuals reported engaging heavily with educational support and a high number of health professions (mean 9.5; mode 10). Age of diagnosis of 22q11DS ranged from birth to nine years. Families had ongoing concerns about aspects of education and healthcare services, and lack of knowledge and awareness of the difficulties faced by individuals with 22q11DS was raised. Healthcare and education providers should be aware of the range of services individuals required on a regular basis so as to provide a more holistic approach to care.

  10. Effect of warning statements in e-cigarette advertisements: an experiment with young adults in the United States.

    Science.gov (United States)

    Sanders-Jackson, Ashley; Schleicher, Nina C; Fortmann, Stephen P; Henriksen, Lisa

    2015-12-01

    This on-line experiment examined whether the addition of ingredient- or industry-themed warning statements in television advertisements for e-cigarettes would affect young adults' craving for and risk perceptions of e-cigarettes and combustible cigarettes, as well as intent to purchase e-cigarettes. Advertisements for two leading e-cigarette brands were edited to contain a warning statement about product ingredients or about the tobacco industry. Participants were assigned randomly to one of eight treatments or one of two brand-specific control conditions without any warning statement. Young adults (n=900, aged 18-34 years) in a web panel were recruited from three groups: recent e-cigarette users, current smokers who used combustible cigarettes exclusively and non-users of either product. Craving and risk perceptions (addictiveness, harmful to health in general, harmful to others) were measured separately for e-cigarettes and combustible cigarettes. The Juster scale measured intention to purchase e-cigarettes. Exposure to both types of warnings was associated with lower craving for e-cigarettes among e-cigarette users and smokers who experienced any craving (Paddictive than the control conditions (Pe-cigarette television advertising similarly reduces craving and purchase intent for e-cigarettes, but has inconsistent effects on perceived risks. © 2015 Society for the Study of Addiction.

  11. Experience of the posterior lip augmentation device in a regional hip arthroplasty unit as a treatment for recurrent dislocation.

    Science.gov (United States)

    Hoggett, L; Cross, C; Helm, T

    2017-12-01

    Dislocation after total hip arthroplasty (THA) remains a significant complication of the procedure and is the third leading cause for revision THA. One technique for treatment of this complication is the use of the posterior lip augmentation device (PLAD). We describe our experience using the PLAD including complication rates. A retrospective review of 55 PLADs (54 patients) was carried out following identification from electronic theatre records. Basic patient demographics, operative records and radiographs were collected and reviewed and data was analysed using Microsoft Excel. Failure of the PLAD was defined as further operative intervention after PLAD insertion and included: dislocation, implant breakage, infection and revision of the THA for loosening of either component. 55 PLADs were implanted in 54 patients with an average age of 77 years. There was a significant preponderance of females and a variety of surgical approaches had been used for the original hip replacement, including trochanteric osteotomy, posterior and antero-lateral. 9 (16%) patients had recurrent dislocations,1 (2%) failed secondary to screw breakage, 3 (5%) had and infection requiring intervention and 2 (4%) underwent further revision for aseptic loosening of the femoral component. The overall failure rate was 25% with 14 patients requiring intervention post PLAD. Our results are inferior to other published results and indicate that the PLAD should be used with caution for recurrent dislocations of the Charnley hip replacement.

  12. The patient experience of services for thyroid eye disease in the United Kingdom: results of a nationwide survey.

    Science.gov (United States)

    Estcourt, Stephanie; Hickey, Janis; Perros, Petros; Dayan, Colin; Vaidya, Bijay

    2009-09-01

    A recent consensus statement from the European Group on Graves' Orbitopathy recommends referring all patients with thyroid eye disease (TED), except the mildest cases, to a specialist multidisciplinary clinic. To study the patients' experiences of accessing services for the treatment of TED in the UK. A postal questionnaire survey of 395 members of two patients support organisations for TED in the UK, the TED Charitable Trust and the British Thyroid Foundation. The response rate was 67%. The majority of responders were females (91%) and aged above 45 (74%). There were delays in the diagnosis and referral. In 26% of responders, the time lapsed from the first symptoms to the diagnosis of TED for over 12 months. There was a wide variation in the type of clinic and healthcare professionals involved in the treatment of TED. Only 25% of the responders attended a specialist TED clinic. Out of these, 33% waited over 6 months from the first consultation with a doctor to being seen at a specialist TED clinic. Only 56% of responders were satisfied with the treatment they received for TED. More responders who had attended a specialist TED clinic were satisfied with the treatment than those who had not attended a specialist clinic (67 vs 52%, P<0.05). Only a minority of patients with TED are treated at a specialist TED clinic in the UK. Those patients who are treated at a specialist TED clinic are more likely to be satisfied with the treatment.

  13. IMPLEMENTATION OF RISK CLASSIFICATION IN A EMERGENCY UNIT OF A PUBLIC HOSPITAL IN RIO DE JANEIRO - AN EXPERIENCE REPORT

    Directory of Open Access Journals (Sweden)

    Eugenio Fuentes Pérez Júnior

    2012-01-01

    Full Text Available Objetivo:. identificar critérios de gravidade dos clientes, previamente estabelecidos pelo corpo clínico do hospital e institucionalizados pela Direção na forma de Protocolo clínico, de uma forma objetiva e sistematizada; indicar a prioridade clínica com que o paciente deve ser atendido e o respectivo tempo alvo recomendado até o atendimento médico. Método:. Pesquisa quantitativa do tipo Relato de experiência com descrição do processo de implementação do projeto Triagem de Manchester em uma unidade hospitalar pública. Resultados: A avaliação da implementação, após 50.996 classificações, revelaram mudanças no perfil de atendimento e na rotina do serviço. Conclusão:. A implementação do projeto de Classificação de Risco na emergência contribuiu para proporcionar um gestão do serviço de emergência de forma mais humana. A priorização da assistência pelo método sistematizado pré definido tem assegurado aos clientes uma assistência segura e justa evitando a ocorrência de agravamentos ou óbitos nas filas de espera das emergências. Descritores: Enfermagem; Triagem; Acolhimento.

  14. What am I going to say here? The experiences of doctors and nurses communicating with patients in a cancer unit

    Directory of Open Access Journals (Sweden)

    Margaret eMcLean

    2011-11-01

    Full Text Available This paper describes a study investigating the provider-patient communication perceptions, experiences, needs and strategies of doctors and nurses working together in a UK cancer setting. This was a qualitative study using individual interviews and focus group discussions. Interpretative Phenomenological analysis (IPA was used to underpin data collection and analysis. Twenty-six staff participated in the project (18 nurses and 8 doctors. Both professional groups identified an inherent emotional strain in their daily interactions with patients. The strategies they adopted to reduce this strain fell into two main categories: 1 Handling or managing the patient to keep negative emotion at bay; and 2 Managing self to keep negative emotion at bay. These strategies allowed staff to maintain a sense of control in an emotionally-stressful environment. Most believed that their communication skills were sufficient. In conclusion, communicating with and caring for cancer patients causes considerable psycho-social burden for doctors and nurses. Managing this burden influences their communication with patients. Without recognition of the need for staff to protect their own emotional well-being, communication skills training programmes, emphasised in current UK cancer care guidelines, may have little impact on practice.

  15. General Practitioner (GP) trainees' experience of a '1-h protected supervision model' given during psychiatry placements in the United Kingdom.

    Science.gov (United States)

    Thomas, Gareth; McNeill, Helen

    2018-01-05

    Background A '1-hour protected supervision model' is well established for Psychiatry trainees. This model is also extended to GP trainees who are on placement in psychiatry. To explore the experiences of the '1-hour protected supervision model' for GP trainees in psychiatry placements in the UK. Methods Using a mixed methods approach, an anonymous online questionnaire was sent to GP trainees in the North West of England who had completed a placement in Psychiatry between February and August 2015. Results Discussing clinical cases whilst using the e-portfolio was the most useful learning event in this model. Patient care can potentially improve if a positive relationship develops between trainee/supervisor, which is impacted by the knowledge of this model at the start of the placement. Trainees found that clinical pressures were impacting on the occurrence of supervision. Conclusion The model works best when both GP trainees and their supervisors understand the model. The most frequently used and educationally beneficial aspect for GP trainees in psychiatry is the exploration of clinical cases using the learning portfolio as an educational tool. For effective delivery of this model of supervision, organisations must reflect on the balance between service delivery and allowing the supervisor and trainee adequate time for it to occur.

  16. Melatonin and breast cancer: Evidences from preclinical and human studies.

    Science.gov (United States)

    Kubatka, Peter; Zubor, Pavol; Busselberg, Dietrich; Kwon, Taeg Kyu; Adamek, Mariusz; Petrovic, Daniel; Opatrilova, Radka; Gazdikova, Katarina; Caprnda, Martin; Rodrigo, Luis; Danko, Jan; Kruzliak, Peter

    2018-02-01

    The breast cancer affects women with high mortality and morbidity worldwide. The risk is highest in the most developed world but also is markedly rising in the developing countries. It is well documented that melatonin has a significant anti-tumor activities demonstrated on various cancer types in a plethora of preclinical studies. In breast cancer, melatonin is capable to disrupt estrogen-dependent cell signaling, resulting in a reduction of estrogen-stimulated cells, moreover, it's obvious neuro-immunomodulatory effect in organism was described. Several prospective studies have demonstrated the inverse correlation between melatonin metabolites and the risk of breast cancer. This correlation was confirmed by observational studies that found lower melatonin levels in breast cancer patients. Moreover, clinical studies have showed that circadian disruption of melatonin synthesis, specifically night shift work, is linked to increased breast cancer risk. In this regard, proper light/dark exposure with more selective use of light at night along with oral supplementation of melatonin may have benefits for high-risk women. The results of current preclinical studies, the mechanism of action, and clinical efficacy of melatonin in breast cancer are reviewed in this paper. Melatonin alone or in combined administration seems to be appropriate drug for the treatment of early stages of breast cancer with documented low toxicity over a wide range of doses. These and other issues are also discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Subjective memory complaints in preclinical autosomal dominant Alzheimer disease.

    Science.gov (United States)

    Norton, Daniel J; Amariglio, Rebecca; Protas, Hillary; Chen, Kewei; Aguirre-Acevedo, Daniel C; Pulsifer, Brendan; Castrillon, Gabriel; Tirado, Victoria; Munoz, Claudia; Tariot, Pierre; Langbaum, Jessica B; Reiman, Eric M; Lopera, Francisco; Sperling, Reisa A; Quiroz, Yakeel T

    2017-10-03

    To cross-sectionally study subjective memory complaints (SMC) in autosomal dominant Alzheimer disease (ADAD). We examined self-reported and study partner-based SMC in 52 young, cognitively unimpaired individuals from a Colombian kindred with early-onset ADAD. Twenty-six carried the PSEN-1 E280A mutation, averaging 7 years of age younger than the kindred's expected clinical onset. Twenty-six were age-matched noncarriers. Participants also underwent structural MRI and cognitive testing. Self-reported SMC were greater in carriers than noncarriers ( p = 0.02). Study partner-based SMC did not differ between groups ( p = 0.21), but in carriers increased with age ( r = 0.66, p < 0.001) and decreased with hippocampal volume ( r = -0.35, p = 0.08). Cognitively unimpaired PSEN-1 carriers have elevated SMC. Self-reported SMC may be a relatively early indicator of preclinical AD, while partner- reported SMC increases later in preclinical AD, closer to clinical onset. © 2017 American Academy of Neurology.

  18. Contribution of student involvement in production/service unit and experience of industry practices to entrepreneurial attitude and the impact entrepeneurship readiness of vocational high school students of great Malang

    Science.gov (United States)

    Mukminna, Halimahtus; Isnandar, Muladi

    2017-09-01

    Purpose of this research was to determine the contribution of student involvement in production/ service unit (X1), experience of industry practices (X2), and entrepreneurial attitude (Y) towards readiness entrepreneurship (Z) of vocational student regional Malang. The design of the study using a quantitative approach. The samples used as many as 130 respondents. Instruments used for collecting data in the form of questionnaires. Data analysis included descriptive and test of hypothesis. The result showed: that the description of data on the level of student involvement in production/ service unit, experience of industry practices, entrepreneurial attitude and entrepreneurship readiness in the high category. The contribution student involvement in production/ service unit of entrepreneurial attitude of 10.6%. The contribution experience of industry practices of entrepreneurial attitude of 17.4%. The contribution student involvement in production/ service unit and experience of industry practices simultaneously to entrepreneurial attitude of 44.1%. The contribution student involvement in production/ service unit of readiness entrepreneurship of 4%. The contribution experience of industry practices of readiness entrepreneurship of 5%. The contribution entrepreneurial attitude of readiness entrepreneurship of 16%. Finally, the contribution student involvement in production/ service unit, experience of industry practices, and entrepreneurial attitude simultaneously to readiness entrepreneurship of 50.3%.

  19. Implementing the CASPiE course-based research experience at the United States Military Academy: Affective responses and effects on critical thinking

    Science.gov (United States)

    Chase, Anthony Michael

    The Center for Authentic Science Practices in Education (CASPiE) pioneered a course-based research experience approach to teaching chemistry laboratory courses. The method had previously been studied in a variety of institutional settings. Recently, the United States Military Academy at West Point decided to develop CASPiE-style modules for the introductory honors chemistry course. This research setting presents clean experimental-control comparisons and a group of faculty who were completely new to the method. Equipping students with authentic research experiences early in their education is important regardless of the institution. However, cadets at a military academy must make decisions relatively early (the outset of their second year) as to what their career trajectory will be as eventual officers. In the new CASPiE-based experience, cadets are given the opportunity to select from one of three different modules (analytical chemistry, toxicology, and chemical engineering) in which to participate during the course. These three modules represent subsections of an overall Army waste-to-energy research project. Cadets generate unique hypotheses, real data, and research posters towards the advancement of the project. Posters are then presented in a session. that includes an audience of project stakeholders, course instructors, and other academy faculty and staff. Here, I will present my research methods, evaluative procedures, and findings in the affective domain, critical thinking, and laboratory content comprehension.

  20. Preclinical Testing of an Oncolytic Parvovirus: Standard Protoparvovirus H-1PV Efficiently Induces Osteosarcoma Cell Lysis In Vitro

    OpenAIRE

    Carsten Geiss; Zoltán Kis; Barbara Leuchs; Monika Frank-Stöhr; Jörg R. Schlehofer; Jean Rommelaere; Christiane Dinsart; Jeannine Lacroix

    2017-01-01

    Osteosarcoma is the most frequent malignant disease of the bone. On the basis of early clinical experience in the 1960s with H-1 protoparvovirus (H-1PV) in osteosarcoma patients, this effective oncolytic virus was selected for systematic preclinical testing on various osteosarcoma cell cultures. A panel of five human osteosarcoma cell lines (CAL 72, H-OS, MG-63, SaOS-2, U-2OS) was tested. Virus oncoselectivity was confirmed by infecting non-malignant human neonatal fibroblasts and osteoblasts...