Sample records for cases zaburzenia hemostazy

  1. How to use case studies: continuity cases vs. one-shot cases.

    PubMed

    Reeves, P N

    1992-01-01

    Cases are a widely used instructional technique in health services administration education. This article discusses the merits of using cases in graduate education and identifies two types of cases, one-shot cases and continuity cases. The continuity case has many advantages for professional education. In particular it requires the students to recognize and cope with the interactions among decisions. Continuity cases are good vehicles both for instruction and for evaluation of students' competence. The supply of good continuity cases, however, is very limited. Consequently, despite the advantages of this type of case, instructors must consider using a blend of continuity and one-shot cases. Suggestions for the mix of cases within a curriculum are presented.

  2. Case management: a case study.

    PubMed

    Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

    2000-01-01

    This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

  3. [The case-case-time-control study design].

    PubMed

    Wang, Jing; Zhuo, Lin; Zhan, Siyan

    2014-12-01

    Although the 'self-matched case-only studies' (such as the case-cross-over or self-controlled case-series method) can control the time-invariant confounders (measured or unmeasured) through design of the study, however, they can not control those confounders that vary with time. A bidirectional case-crossover design can be used to adjust the exposure-time trends. In the areas of pharmaco-epidemiology, illness often influence the future use of medications, making a bidirectional study design problematic. Suissa's case-time-control design combines the case-crossover and the case-control design which could adjust for exposure-trend bias, but the control group may reintroduce selection bias, if the matching does not go well. We propose a "case-case-time-control" design which is an extension of the case-time-control design. However, rather than using a sample of external controls, we choose those future cases as controls for current cases to counter the bias that arising from temporal trends caused by exposure to the target of interest. In the end of this article we will discuss the strength and limitations of this design based on an applied example.

  4. Case Study: Testing with Case Studies

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman

    2015-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  5. The case for case reports.

    PubMed

    Bhattacharrya, Shamik; Miller, Julie; Ropper, Allan H

    2014-10-01

    Case reports have seemingly fallen upon hard times. Once esteemed by William Osler and C. Miller Fisher, these reports are now considered anachronistic. Nonetheless, case reports remain valuable and formed the largest proportion of publications written last year by residents in our training program (the Partners Neurology Residency). Although they are easy to produce, it is reasonable to ask if these modern exercises are of equal significance to the narratives of migraine by John Graham in the 1950s or descriptions of Parkinson disease by James Parkinson in 1817. Even a brief reading of currently published case reports raises doubts about the value of many of them but also emphasizes their utility. We argue here that the case report format remains of considerable merit, especially to the aspiring academic clinician. © 2014 American Neurological Association.

  6. Case Study: Writing a Journal Case Study

    ERIC Educational Resources Information Center

    Prud'homme-Genereux, Annie

    2016-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.

  7. Case management.

    PubMed

    Woodward, Judy; Rice, Eve

    2015-03-01

    Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. [Case-non case studies: Principles, methods, bias and interpretation].

    PubMed

    Faillie, Jean-Luc

    2017-10-31

    Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  9. Statin-Associated Polymyalgia Rheumatica. An Analysis Using WHO Global Individual Case Safety Database: A Case/Non-Case Approach

    PubMed Central

    de Jong, Hilda J. I.; Saldi, Siti R. F.; Klungel, Olaf H.; Vandebriel, Rob J.; Souverein, Patrick C.; Meyboom, Ronald H. B.; Passier, J. L. M. (Anneke); van Loveren, Henk; Tervaert, Jan Willem Cohen

    2012-01-01

    Objective To assess whether there is an association between statin use and the occurrence of polymyalgia rheumatic (PMR) in the spontaneous reporting database of the World Health Organisation (WHO). Methods We conducted a case/non-case study based on individual case safety reports (ICSR) in the WHO global ICSR database (VigiBase). Case reports containing the adverse event term polymyalgia rheumatica (WHOART or MedDRA Preferred Term) were defined as cases. Non-cases were all case reports containing other adverse event terms. Each case was matched to five non-cases by age, gender, and time of reporting. Case reports regarding a statin as suspected or concomitant drug were identified using the Anatomical Therapeutic Chemical (ATC) classification. Multivariate logistic regression was used to calculate reporting odds ratios (RORs) with 95% confidence intervals (CI). Results We identified 327 reports of PMR as cases and 1635 reports of other ADRs as non-cases. Among cases, statins were more frequently reported as suspected agent (29.4%) compared to non-cases (2.9%). After adjustment for several covariates, statins were significantly associated with reports of PMR (ROR 14.21; 95% CI 9.89–20.85). Conclusion The results of this study lends support to previous anecdotal case reports in the literature suggesting that the use of a statin may be associated with the occurrence of PMR. Further studies are needed to study the strength of the association in more detail and to elucidate the underlying mechanism. PMID:22844450

  10. Case-based explanation of non-case-based learning methods.

    PubMed Central

    Caruana, R.; Kangarloo, H.; Dionisio, J. D.; Sinha, U.; Johnson, D.

    1999-01-01

    We show how to generate case-based explanations for non-case-based learning methods such as artificial neural nets or decision trees. The method uses the trained model (e.g., the neural net or the decision tree) as a distance metric to determine which cases in the training set are most similar to the case that needs to be explained. This approach is well suited to medical domains, where it is important to understand predictions made by complex machine learning models, and where training and clinical practice makes users adept at case interpretation. PMID:10566351

  11. Using existing case-mix methods to fund trauma cases.

    PubMed

    Monakova, Julia; Blais, Irene; Botz, Charles; Chechulin, Yuriy; Picciano, Gino; Basinski, Antoni

    2010-01-01

    Policymakers frequently face the need to increase funding in isolated and frequently heterogeneous (clinically and in terms of resource consumption) patient subpopulations. This article presents a methodologic solution for testing the appropriateness of using existing grouping and weighting methodologies for funding subsets of patients in the scenario where a case-mix approach is preferable to a flat-rate based payment system. Using as an example the subpopulation of trauma cases of Ontario lead trauma hospitals, the statistical techniques of linear and nonlinear regression models, regression trees, and spline models were applied to examine the fit of the existing case-mix groups and reference weights for the trauma cases. The analyses demonstrated that for funding Ontario trauma cases, the existing case-mix systems can form the basis for rational and equitable hospital funding, decreasing the need to develop a different grouper for this subset of patients. This study confirmed that Injury Severity Score is a poor predictor of costs for trauma patients. Although our analysis used the Canadian case-mix classification system and cost weights, the demonstrated concept of using existing case-mix systems to develop funding rates for specific subsets of patient populations may be applicable internationally.

  12. CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

    EPA Science Inventory

    Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

  13. Participative Case Studies: Integrating Case Writing and a Traditional Case Study Approach in a Marketing Context

    ERIC Educational Resources Information Center

    Forman, Howard

    2006-01-01

    Case-based pedagogy is a valuable tool for applying business concepts and theories to organizational contexts. Traditional case-based pedagogy offers such learning opportunities. What this pedagogy lacks, however, is an element of real-time experiential learning opportunities. This research focuses on the advantages of incorporating a case-writing…

  14. CaseWorld™: Interactive, media rich, multidisciplinary case based learning.

    PubMed

    Gillham, David; Tucker, Katie; Parker, Steve; Wright, Victoria; Kargillis, Christina

    2015-11-01

    Nurse educators are challenged to keep up with highly specialised clinical practice, emerging research evidence, regulation requirements and rapidly changing information technology while teaching very large numbers of diverse students in a resource constrained environment. This complex setting provides the context for the CaseWorld project, which aims to simulate those aspects of clinical practice that can be represented by e-learning. This paper describes the development, implementation and evaluation of CaseWorld, a simulated learning environment that supports case based learning. CaseWorld provides nursing students with the opportunity to view unfolding authentic cases presented in a rich multimedia context. The first round of comprehensive summative evaluation of CaseWorld is discussed in the context of earlier formative evaluation, reference group input and strategies for integration of CaseWorld with subject content. This discussion highlights the unique approach taken in this project that involved simultaneous prototype development and large scale implementation, thereby necessitating strong emphasis on staff development, uptake and engagement. The lessons learned provide an interesting basis for further discussion of broad content sharing across disciplines and universities, and the contribution that local innovations can make to global education advancement. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  15. Case reports and case series in prehospital emergency care research.

    PubMed

    Patterson, P Daniel; Weaver, Matthew; Clark, Sunday; Yealy, Donald M

    2010-11-01

    Research begins with a clearly stated question, problem or hypothesis. The selection of a study design appropriate to the task is the next key step. This paper provides guidance for the use of case report and case series designs by describing the 'what', 'when' and 'how' of both designs. Also described is the use of case reports and case series study designs in prehospital emergency research and the quality of published literature from 2000 to mid-2008.

  16. 24 CFR 252.3 - Case-by-case conversion to full insurance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Case-by-case conversion to full insurance. 252.3 Section 252.3 Housing and Urban Development Regulations Relating to Housing and Urban... HOMES § 252.3 Case-by-case conversion to full insurance. Cross Reference: The provisions of 24 CFR 251.3...

  17. In Case You Teach English: Case Studies in the English Classroom.

    ERIC Educational Resources Information Center

    Johannessen, Larry R.

    Case studies can be a powerful strategy to use for helping students learn critical thinking processes that are key to interpreting and responding to literature and writing. Some of the major benefits of applying case methods are: cases provide an environment for active learning; they encourage the creation of a community of learners; cases help…

  18. 24 CFR 251.3 - Case-by-case conversion to full insurance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Case-by-case conversion to full... § 251.3 Case-by-case conversion to full insurance. Upon the request of a coinsuring lender, the... conversion would be less costly to HUD than if the Mortgage remained coinsured; (d) The lender has paid HUD...

  19. The Case for CASES

    ERIC Educational Resources Information Center

    Powell, W. R.

    1978-01-01

    In this article the Community Annual Energy Storage System ( CASES), a "thermal utility" plan for heating and cooling communities by storing summer heat and winter cold for use in the opposite season, is described. (MDR)

  20. Case Study Teaching

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman

    2011-01-01

    This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)

  1. Case Resolution Manual

    EPA Pesticide Factsheets

    This Case Resolution Manual (CRM) is intended to provide procedural guidance to ECRCO case managers to ensure EPA’s prompt, effective, and efficient resolution of civil rights cases consistent with science and the civil rights laws.

  2. Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

    ERIC Educational Resources Information Center

    Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

    2017-01-01

    Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

  3. Working smarter on cold cases: identifying factors associated with successful cold case investigations.

    PubMed

    Davis, Robert C; Jensen, Carl J; Burgette, Lane; Burnett, Kathryn

    2014-03-01

    Cold case squads have garnered much attention; however, they have yet to undergo significant empirical scrutiny. In the present study, the authors interviewed investigators and reviewed 189 solved and unsolved cold cases in Washington, D.C., to determine whether there are factors that can predict cold case solvability. In the interviews, new information from witnesses or information from new witnesses was cited as the most prevalent reason for case clearance. The case reviews determined that there were factors in each of the following domains that predicted whether cases would be solved during cold case investigations: Crime Context, Initial Investigation Results, Basis for Opening Cold Case, and Cold Case Investigator Actions. The results suggest that it is possible to prioritize cold case work based on the likelihood of investigations leading to clearances. © 2014 American Academy of Forensic Sciences.

  4. [Bone hydatidosis. 12 cases].

    PubMed

    Jlidi, R; Yaakoubi, M T; Ladeb, M F; Ben Ayeche, M L; Ghannouchi, G; Moula, T

    1992-01-01

    The hydatic cyst is a parasitic disease caused by the development in man of the larval form of echinococcus granulosus. All parts of the body may be involved, but the liver and lungs are the main locations of the disease. The bone site is rare, accounting for 0.9 to 2% of all hydatic lesions. Between 1982 and 1988, we have compiled 12 cases of hydatic disease of bone. They were located in the skull (4 cases), the iliac bone (4 cases), the omoplate (1 case), the ribs (1 case), the femur (1 case) and the fibula (1 case). These lesions are generally considered as primary, but association with visceral locations was noted in 3 cases in our series.

  5. The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

    PubMed

    Hogan, Tierney D

    2005-01-01

    A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff.

  6. Case Studies.

    ERIC Educational Resources Information Center

    Emerson, Allen; And Others

    1994-01-01

    Three cases of use of collaborative learning techniques in the college classroom are described: a developmental mathematics course, a graduate-level writing project, and college science instruction. Each case includes description of specific class activities and assignments, results, and teacher concerns and comments. (MSE)

  7. Contemplating case mix: A primer on case mix classification and management.

    PubMed

    Costa, Andrew P; Poss, Jeffery W; McKillop, Ian

    2015-01-01

    Case mix classifications are the frameworks that underlie many healthcare funding schemes, including the so-called activity-based funding. Now more than ever, Canadian healthcare administrators are evaluating case mix-based funding and deciphering how they will influence their organization. Case mix is a topic fraught with technical jargon and largely relegated to government agencies or private industries. This article provides an abridged review of case mix classification as well as its implications for management in healthcare. © 2015 The Canadian College of Health Leaders.

  8. Impact of lens case hygiene guidelines on contact lens case contamination.

    PubMed

    Wu, Yvonne T; Teng, Yuu Juan; Nicholas, Mary; Harmis, Najat; Zhu, Hua; Willcox, Mark D P; Stapleton, Fiona

    2011-10-01

    Lens case contamination is a risk factor for microbial keratitis. The effectiveness of manufacturers' lens case cleaning guidelines in limiting microbial contamination has not been evaluated in vivo. This study compared the effectiveness of manufacturers' guidelines and an alternative cleaning regimen. A randomized cross-over clinical trial with two phases (n = 40) was performed. Participants used the lens types of their choice in conjunction with the provided multipurpose solution (containing polyhexamethylene biguanide) for daily wear. In the manufacturers' guideline phase, cases were rinsed with multipurpose solution and air dried. In the alternative regimen phase, cases were rubbed, rinsed with solution, tissue wiped, and air-dried face down. The duration of each phase was 1 month. Lens cases were collected at the end of each phase for microbiological investigation. The levels of microbial contamination were compared, and compliance to both regimens was assessed. The case contamination rate was 82% (32/39) in the manufacturers' guideline group, compared with 72% (28/39) in the alternative regimen group. There were significantly fewer (p = 0.004) colony forming units (CFU) of bacteria from cases used by following the alternative regimen (CFU range of 0 to 10, and median of 12 CFU per well) compared with that of the manufacturer's guidelines (CFU range of 0 to 10, and median of 28 CFU per well). The compliance level between both guidelines was not significantly different (p > 0.05). The alternative guidelines are more effective in eliminating microbial contamination from lens cases than that of the current manufacturer's guideline. Simply incorporating rubbing and tissue-wiping steps in daily case hygiene reduces viable organism contamination.

  9. 24 CFR 255.3 - Case-by-case conversion to full insurance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Case-by-case conversion to full insurance. 255.3 Section 255.3 Housing and Urban Development Regulations Relating to Housing and Urban...-by-case conversion to full insurance. Cross Reference: The provisions of 24 CFR 251.3 apply to this...

  10. [Case and studies].

    PubMed

    Schubert, András

    2015-11-15

    Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

  11. Case Study: Puttin' on the Ritz: How to Put Science into Cases

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman

    2017-01-01

    There are multiple ways to put science into a case. This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses different ways of presenting science in case studies.

  12. Teaching and the Case Method. Text, Cases, and Readings. Third Edition.

    ERIC Educational Resources Information Center

    Barnes, Louis B.; And Others

    This volume includes text, cases, and readings for a college faculty seminar to develop the knowledge, skills, and attitudes necessary for utilization of the case method approach to instruction. It builds on a long-term clinical research effort on the dynamics of the case method of teaching and application at Harvard Business School. In addition…

  13. Making a Case for Cases.

    ERIC Educational Resources Information Center

    Richmond, Gail; Neureither, Barbara

    1998-01-01

    Summarizes the process of a reform effort in biology instruction. Describes the use of a case study about cholera epidemics and explains how it enables critical objectives in the science curriculum to be addressed. (DDR)

  14. Teaching Business French through Case Studies: Presentation of a Marketing Case.

    ERIC Educational Resources Information Center

    Federico, Salvatore; Moore, Catherine

    The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

  15. Hierarchical Safety Cases

    NASA Technical Reports Server (NTRS)

    Denney, Ewen W.; Whiteside, Iain J.

    2012-01-01

    We introduce hierarchical safety cases (or hicases) as a technique to overcome some of the difficulties that arise creating and maintaining industrial-size safety cases. Our approach extends the existing Goal Structuring Notation with abstraction structures, which allow the safety case to be viewed at different levels of detail. We motivate hicases and give a mathematical account of them as well as an intuition, relating them to other related concepts. We give a second definition which corresponds closely to our implementation of hicases in the AdvoCATE Assurance Case Editor and prove the correspondence between the two. Finally, we suggest areas of future enhancement, both theoretically and practically.

  16. Assembling a Case Study Tool Kit: 10 Tools for Teaching with Cases

    ERIC Educational Resources Information Center

    Prud'homme-Généreux, Annie

    2017-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. The author shares the strategies and tools that teachers can use to manage a case study classroom effectively.

  17. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

    ERIC Educational Resources Information Center

    Pai, Aditi

    2014-01-01

    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  18. Case Studies Behavior Modification.

    ERIC Educational Resources Information Center

    Wark, David M.

    The case histories of five students enrolled in a university course in how to study are reported. The students ranged in age from 18 to 35, included two males and three females, and varied in school experience from no college in one case and some college in two cases to college degrees in two cases. Students were initially taught to chart their…

  19. Teaching Case: MiHotel--Applicant Processing System Design Case

    ERIC Educational Resources Information Center

    Miller, Robert E.; Dunn, Paul

    2018-01-01

    This teaching case describes the functionality of an applicant processing system designed for a fictitious hotel chain. The system detailed in the case includes a webform where applicants complete and submit job applications. The system also includes a desktop application used by hotel managers and Human Resources to track applications and process…

  20. Case report: protothecal tenosynovitis.

    PubMed

    Lee, Jin Seo; Moon, Goo Hyun; Lee, Nam Yong; Peck, Kyong Ran

    2008-12-01

    Protothecosis is a rare infection caused by achlorophyllic algae called Prototheca. Approximately 117 cases have been described in the literature world wide, the majority caused by the species P. wickerhamii. Cutaneous infection is the most common and cases of tenosynovitis are very rare. A local or systemic immunosuppressive factor is seen in half of the cases of protothecosis. We report a case of protothecal tenosynovitis in a middle-aged, immunocompetent woman that developed after she received sclerosing therapy of varicose veins. Administration of itraconazole with surgical débridement produced a good response. We also review the published cases of protothecal tenosynovitis.

  1. The Case for Case-Mix: A New Construct for Hospital Management

    PubMed Central

    Plomann, Marilyn Peacock; Garzino, Fred R.

    1981-01-01

    Case-mix is a useful methodology for health care management, planning and control. It provides managers with a powerful tool by providing a framework for relating resource consumption profiles with specific treatment patterns. In the long run, it will assist hospital planners in analyzing the demands which different classes of patients bring to the hospital. Decisions concerning capital financing, facilities planning, new services, and the medical and financial implications of physician activities are more efficiently analyzed within a case-mix framework. In the near term, inventory management, staffing policies and the on-going need for the astute management of cash flow will be postively and decisively affected by the use of case-mix measures. The benefits derived from a case-mix system are not limited to hospitals possessing sophisticated management information systems. The case-mix methodology also provides a useful tool for hospitals with less advanced data processing systems and management practices in applying a variety of management science techniques to their planning and control activities.

  2. Mining with Rare Cases

    NASA Astrophysics Data System (ADS)

    Weiss, Gary M.

    Rare cases are often the most interesting cases. For example, in medical diagnosis one is typically interested in identifying relatively rare diseases, such as cancer, rather than more frequently occurring ones, such as the common cold. In this chapter we discuss the role of rare cases in Data Mining. Specific problems associated with mining rare cases are discussed, followed by a description of methods for addressing these problems.

  3. Case series: Two cases of eyeball tattoos with short-term complications.

    PubMed

    Duarte, Gonzalo; Cheja, Rashel; Pachón, Diana; Ramírez, Carolina; Arellanes, Lourdes

    2017-04-01

    To report two cases of eyeball tattoos with short-term post procedural complications. Case 1 is a 26-year-old Mexican man that developed orbital cellulitis and posterior scleritis 2 h after an eyeball tattoo. Patient responded satisfactorily to systemic antibiotic and corticosteroid treatment. Case 2 is a 17-year-old Mexican man that developed two sub-episcleral nodules in the ink injection sites immediately after the procedure. Eyeball tattoos are performed by non-ophthalmic trained personnel. There are a substantial number of short-term risks associated with this procedure. Long-term effects on the eyes and vision are still unknown, but in a worst case scenario could include loss of vision or permanent damage to the eyes.

  4. Focused search of semantic cases: the effects of question form and case status.

    PubMed

    Singer, M; Jakobson, L S

    1989-05-01

    The present study was designed to identify and examine some of the variables that influence the focused search of semantic cases in question answering. Singer, Parbery, and Jakobson (1988) have previously reported that people can focus on the case interrogated by a question and can largely disregard irrelevant cases. In the present study, people learned facts, such as the pilot painted the garage with the roller, the spraygun, and the brush. One day later, they answered questions that focused on a particular case. For example, the question did the pilot paint with a spraygun? focuses on the instrument case. Experiment 1 revealed that people can focus on a particular case in response both to complete questions and to comparable word probes, such as "pilot spraygun." Therefore, the given-new structure of questions is not essential to focused search. Experiment 2 revealed that people have a difficult time ignoring the agent case, even when it is irrelevant to the question. This corroborates proposals that agent and action information are closely interrelated in the representation of a fact. These results help to delineate the phenomenon of the focused search of semantic cases.

  5. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

    PubMed

    Oh, Jinjoo; Oh, Seieun

    2017-12-01

    The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

  6. [Unusual cases of non-Hodgkin's lymphomas--case reports].

    PubMed

    Wach, M; Dmoszyńska, A; Wasik-Szczepanek, E; Skomra, D

    2000-01-01

    We describe 4 cases of non-Hodkin's lymphomas that were interesting because of their curiosal clinical courses and spontaneous complete remissions during the course of high malignancy lymphoma. We present three of them for the first time in Poland. Case 1: a 61-year old woman was admitted to the hospital because of the headache, lasting for 4 months before hospitalization and right hemiparesis. CT scans revealed the presence of tumor in the temporo-occipital region. The diagnosis of B-cell lymphoma was established at histopathological examination of the postoperative material. Co60--therapy of these region was applied after the operation with good response. Case 2: a 38-year woman was admitted to the hospital because of L5-S1 spondylolisthesis to operate it. During the hospitalization haemolytic anaemia of unknown origin, thrombocytopoenia, splenomegaly, fever and rising acute insufficiency of kidneys, heart, liver and CNS were occurred. The patient died, despite applying corticosteroidotherapy. The diagnosis of intravascular lymphoma was established at postmortem examination. Case 3: a 51-year old woman was admitted to the hospital with diagnosis: anaplastic non-Hodgkin lymphoma B-cell type high malignancy established after the double histopathological examination of lymph nodes and biopsy of the lung. At the admission to the Department of Haematology we stated absolute regression of these changes. The patient had been only observed in the Outpatient Department over 1 year. She died after 6 months since the beginning of the relapse despite intensive chemotherapy. Case 4: a 43-year old man was admitted to the hospital because of great hyperleukocytosis, hepatosplenomegaly and neurological symptoms. The diagnosis: chronic prolymphocytic leukaemia was established. The cerebrospinal fluid examination showed presence of mononuclears which infiltrated CNS. CT scans of the brain revealed leucaemic infiltrations of the hemispheres and cerebellum. The patient died despite

  7. Case Report: Protothecal Tenosynovitis

    PubMed Central

    Lee, Jin Seo; Moon, Goo Hyun; Lee, Nam Yong

    2008-01-01

    Protothecosis is a rare infection caused by achlorophyllic algae called Prototheca. Approximately 117 cases have been described in the literature world wide, the majority caused by the species P. wickerhamii. Cutaneous infection is the most common and cases of tenosynovitis are very rare. A local or systemic immunosuppressive factor is seen in half of the cases of protothecosis. We report a case of protothecal tenosynovitis in a middle-aged, immunocompetent woman that developed after she received sclerosing therapy of varicose veins. Administration of itraconazole with surgical débridement produced a good response. We also review the published cases of protothecal tenosynovitis. PMID:18791778

  8. Case vignettes of movement disorders.

    PubMed

    Yung, C Y

    1983-08-01

    This paper reports five movement disorders cases to serve as a basis for discussion of the problems encountered in the clinical management of these cases, and the pathophysiological mechanisms involved in these disorders as presented. Case 1 is a description of the subjective experience of a patient with acute orofacial dystonia from promethazine. Case 2 is the use of clonazepam is post-head injury tics. Case 3 is the complication from discontinuation of haloperidol and benztropine mesylate treatment. Case 4 is myoclonus in subacute sclerosing Panencephalitis, and Case 5 is rebound tremor from withdrawal of a beta-adrenergic blocker.

  9. CABINS: Case-based interactive scheduler

    NASA Technical Reports Server (NTRS)

    Miyashita, Kazuo; Sycara, Katia

    1992-01-01

    In this paper we discuss the need for interactive factory schedule repair and improvement, and we identify case-based reasoning (CBR) as an appropriate methodology. Case-based reasoning is the problem solving paradigm that relies on a memory for past problem solving experiences (cases) to guide current problem solving. Cases similar to the current case are retrieved from the case memory, and similarities and differences of the current case to past cases are identified. Then a best case is selected, and its repair plan is adapted to fit the current problem description. If a repair solution fails, an explanation for the failure is stored along with the case in memory, so that the user can avoid repeating similar failures in the future. So far we have identified a number of repair strategies and tactics for factory scheduling and have implemented a part of our approach in a prototype system, called CABINS. As a future work, we are going to scale up CABINS to evaluate its usefulness in a real manufacturing environment.

  10. The State's Case

    ERIC Educational Resources Information Center

    Calhoun, John W.

    1972-01-01

    Author is Assistant Attorney General in Wisconsin and represented the state in the Wisconsin vs. Yoder case. Cites other cases and decisions handed down by the United States Supreme Court in relation to compulsory education. (RB)

  11. Is case-chaos methodology an appropriate alternative to conventional case-control studies for investigating outbreaks?

    PubMed

    Edelstein, Michael; Wallensten, Anders; Kühlmann-Berenzon, Sharon

    2014-08-15

    Case-chaos methodology is a proposed alternative to case-control studies that simulates controls by randomly reshuffling the exposures of cases. We evaluated the method using data on outbreaks in Sweden. We identified 5 case-control studies from foodborne illness outbreaks that occurred between 2005 and 2012. Using case-chaos methodology, we calculated odds ratios 1,000 times for each exposure. We used the median as the point estimate and the 2.5th and 97.5th percentiles as the confidence interval. We compared case-chaos matched odds ratios with their respective case-control odds ratios in terms of statistical significance. Using Spearman's correlation, we estimated the correlation between matched odds ratios and the proportion of cases exposed to each exposure and quantified the relationship between the 2 using a normal linear mixed model. Each case-control study identified an outbreak vehicle (odds ratios = 4.9-45). Case-chaos methodology identified the outbreak vehicle 3 out of 5 times. It identified significant associations in 22 of 113 exposures that were not associated with outcome and 5 of 18 exposures that were significantly associated with outcome. Log matched odds ratios correlated with their respective proportion of cases exposed (Spearman ρ = 0.91) and increased significantly with the proportion of cases exposed (b = 0.054). Case-chaos methodology missed the outbreak source 2 of 5 times and identified spurious associations between a number of exposures and outcome. Measures of association correlated with the proportion of cases exposed. We recommended against using case-chaos analysis during outbreak investigations. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Case Management Directors

    PubMed Central

    Bankston-White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role. We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Findings/Conclusions: Case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. Implications for Case Management: As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time. To operate most effectively, case management directors must understand the full range of their

  13. Moral case deliberation.

    PubMed

    Tan, Daniel Y B; Ter Meulen, Bastiaan C; Molewijk, Albert; Widdershoven, Guy

    2018-06-01

    Ethical dilemmas in general are characterised by a choice between two mutually excluding options neither of which is satisfactory, because there always will be a form of moral damage. Within the context of medicine several ethics support services have been developed to support healthcare professionals in dealing with ethical dilemmas, including moral case deliberation. In this article, we describe how moral case deliberation works in daily practice, illustrated with a case example from the neurology ward. The article is meant as an introduction to moral case deliberation according to the dilemma method. We show its relevance to the clinic and the context needed to put it into practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Case Selection via Matching

    ERIC Educational Resources Information Center

    Nielsen, Richard A.

    2016-01-01

    This article shows how statistical matching methods can be used to select "most similar" cases for qualitative analysis. I first offer a methodological justification for research designs based on selecting most similar cases. I then discuss the applicability of existing matching methods to the task of selecting most similar cases and…

  15. Leveraging tuberculosis case relative locations to enhance case detection and linkage to care in Swaziland.

    PubMed

    Brunetti, Marie; Rajasekharan, Sathyanath; Ustero, Piluca; Ngo, Katherine; Sikhondze, Welile; Mzileni, Buli; Mandalakas, Anna; Kay, Alexander W

    2018-01-01

    In Swaziland, as in many high HIV/TB burden settings, there is not information available regarding the household location of TB cases for identifying areas of increased TB incidence, limiting the development of targeted interventions. Data from "Butimba", a TB REACH active case finding project, was re-analyzed to provide insight into the location of TB cases surrounding Mbabane, Swaziland. The project aimed to identify geographical areas with high TB burdens to inform active case finding efforts. Butimba implemented household contact tracing; obtaining landmark based, informal directions, to index case homes, defined here as relative locations. The relative locations were matched to census enumeration areas (known location reference areas) using the Microsoft Excel Fuzzy Lookup function. Of 403 relative locations, an enumeration area reference was detected in 388 (96%). TB cases in each census enumeration area and the active case finders in each Tinkhundla, a local governmental region, were mapped using the geographic information system, QGIS 2.16. Urban Tinkhundla predictably accounted for most cases; however, after adjusting for population, the highest density of cases was found in rural Tinkhundla. There was no correlation between the number of active case finders currently assigned to the 7 Tinkhundla surrounding Mbabane and the total number of TB cases (Spearman rho = -0.57, p  = 0.17) or the population adjusted TB cases (Spearman rho = 0.14, p  = 0.75) per Tinkhundla. Reducing TB incidence in high-burden settings demands novel analytic approaches to study TB case locations. We demonstrated the feasibility of linking relative locations to more precise geographical areas, enabling data-driven guidance for National Tuberculosis Programs' resource allocation. In collaboration with the Swazi National Tuberculosis Control Program, this analysis highlighted opportunities to better align the active case finding national strategy with the TB disease

  16. Case Management Directors

    PubMed Central

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations

  17. The First Case(s) of Botulism in Vienna in 21 Years: A Case Report.

    PubMed

    Vossen, Matthias Gerhard; Gattringer, Klaus-Bernhard; Wenisch, Judith; Khalifeh, Neda; Koreny, Maria; Spertini, Verena; Allerberger, Franz; Graninger, Wolfgang; Kornschober, Christian; Lagler, Heimo; Reitner, Andreas; Sycha, Thomas; Thalhammer, Florian

    2012-01-01

    We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how botulism cases may present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known. We review the available literature, the compiled clinical data, and observations. After a slow onset of clinical signs a married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool retention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in Austria. In the last 21 years there were only twelve reported cases. Both patients went to a general practitioner as well as several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between intoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin can produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of industrial food production.

  18. The First Case(s) of Botulism in Vienna in 21 Years: A Case Report

    PubMed Central

    Vossen, Matthias Gerhard; Gattringer, Klaus-Bernhard; Wenisch, Judith; Khalifeh, Neda; Koreny, Maria; Spertini, Verena; Allerberger, Franz; Graninger, Wolfgang; Kornschober, Christian; Lagler, Heimo; Reitner, Andreas; Sycha, Thomas; Thalhammer, Florian

    2012-01-01

    We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how botulism cases may present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known. Methods: We review the available literature, the compiled clinical data, and observations. Results: After a slow onset of clinical signs a married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool retention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in Austria. In the last 21 years there were only twelve reported cases. Conclusion: Both patients went to a general practitioner as well as several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between intoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin can produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of industrial food production. PMID:22779015

  19. High laboratory cost predicted per tuberculosis case diagnosed with increased case finding without a triage strategy.

    PubMed

    Dunbar, R; Naidoo, P; Beyers, N; Langley, I

    2017-09-01

    Cape Town, South Africa. To model the effects of increased case finding and triage strategies on laboratory costs per tuberculosis (TB) case diagnosed. We used a validated operational model and published laboratory cost data. We modelled the effect of varying the proportion with TB among presumptive cases and Xpert cartridge price reductions on cost per TB case and per additional TB case diagnosed in the Xpert-based vs. smear/culture-based algorithms. In our current scenario (18.3% with TB among presumptive cases), the proportion of cases diagnosed increased by 8.7% (16.7% vs. 15.0%), and the cost per case diagnosed increased by 142% (US$121 vs. US$50). The cost per additional case diagnosed was US$986. This would increase to US$1619 if the proportion with TB among presumptive cases was 10.6%. At 25.9-30.8% of TB prevalence among presumptive cases and a 50% reduction in Xpert cartridge price, the cost per TB case diagnosed would range from US$50 to US$59 (comparable to the US$48.77 found in routine practice with smear/culture). The operational model illustrates the effect of increased case finding on laboratory costs per TB case diagnosed. Unless triage strategies are identified, the approach will not be sustainable, even if Xpert cartridge prices are reduced.

  20. Lively Discussions vs. Discussions of Substance: Making the Case for Guided Case Study.

    ERIC Educational Resources Information Center

    Woloshin/Lerman, Phyllis

    1996-01-01

    Discusses the history and purpose of the case study method used to stimulate in-class discussion. Advocates the use of the guided case study method to ensure that substantive discussions take place and provides nine steps for using the method. Includes a sample case study worksheet. (11 citations) (BCY)

  1. Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

    PubMed

    Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

    2017-06-05

    Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

  2. [Case management process identified from experience of nurse case managers].

    PubMed

    Park, Eun-Jun; Kim, Chunmi

    2008-12-01

    The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

  3. [Methodology of psychiatric case histories].

    PubMed

    Scherbaum, N; Mirzaian, E

    1999-05-01

    This paper deals with the methodology of psychiatric case histories. Three types of case histories are differentiated. The didactic case history teaches about the typical aspects of a psychiatric disorder or treatment by using an individual patient as an example. In the heuristic case history the individual case gives rise to challenging established concepts or to generate new hypotheses. Such hypotheses drawn from inductive reasoning have then to be tested using representative samples. The focus of hermeneutic case histories is the significance of pathological behaviour and experience in the context of the biography of an individual patient. So-called psychopathographies of important historical figures can also be differentiated according to these types. Based on these methodological considerations, quality standards for the named types of case histories are stated.

  4. Case Study: Let's Get Personal--Putting Personality into Your Cases

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman

    2017-01-01

    In this case study, the subject for discussion is the need to use teaching notes in order to add personality to case studies. Personality, it is said, is more important than policy, than demographics, than finances, or amorous peccadillos. Personality is essential. It is the interaction of people that capture our interest, yet, the question is…

  5. FATAL HONEY POISONING IN SOUTHWEST CHINA: A CASE SERIES OF 31 CASES.

    PubMed

    Zhang, Qiang; Chen, Xinguang; Chen, Shunan; Ye, Yinlong; Luo, Jiancheng; Li, Juanjuan; Yu, Siyang; Liu, Hui; Liu, Zhitao

    2017-01-01

    Honey poisoning cases occur in southwestern China. In this case series, we attempted to determine the symptoms and causes of honey poisoning from 2007 to 2012 in southwestern China. We also conducted a quantitative melissopalynological analysis of honey samples. During the study period, 31 honey poisoning cases occurred in the study location, all during July to August. All the cases occurred after consuming at least 100 grams of honey. The most frequent symptoms were nausea and vomiting (100%), abdominal pain (90.3%), diarrhea (74.2%), palpitations (61.3%), dizziness (54.8%), chest congestion (48.4%) and dyspnea (48.4%). Severe cases developed oliguria/anuria, twitch, hematuria, ecchymosis or hematochezia. The median time from ingestion to onset of symptoms was 29 hours. Eight patients died (mortality rate: 25.8%). The pollen of Tripterygium hypoglaucum (a plant with poisonous nectar and pollen) was detected in 22 of 29 honey samples examined (75.9%). The results of pollen analysis were consistent with the clinical findings of previous cases. T. hypoglaucum appears to be the cause of honey poisoning in southwestern China. Honey poisoning should be included in the differential diagnosis of patients who consume honey in this region and develop symptoms of food poisoning.

  6. Case Studies in Wilderness Medicine.

    ERIC Educational Resources Information Center

    Gray, Melissa; Tarter, Shana Lee

    Five case studies explore issues in wilderness medicine, with emphasis on evacuation decision making. The cases describe medical problems encountered during wilderness trips involving college or high school students. In each case, the situation and facts of the case are outlined, including the patient's medical history and vital signs, and at…

  7. When case report became case series: 45 cases of late traumatic flap complications after laser-assisted in situ keratomileusis and review of Chinese literature.

    PubMed

    Xiao, Jianhe; Jiang, Caihui; Zhang, Maonian; Jiang, Hua; Li, Shiyang; Zhang, Ying

    2014-09-01

    To report 45 cases of late traumatic flap complications after laser-assisted in situ keratomileusis (LASIK) and discuss the continually increasing number of cases in China. A multicentre retrospective survey of eye injuries was carried in 31 military hospitals from January 2006 to December 2011. Detailed information from the medical records of all 92 cases with a history of prior LASIK treatment were collected and summarised, with respect to visual acuity (VA), flap condition, treatment and final outcome. All Chinese publications relevant to late traumatic flap complications in Chinese patients were retrieved and summarised. 92 inpatients (92 eyes) underwent LASIK surgery; 45 of these had traumatic LASIK flap complications. Flap dislocation was the commonest and most needed surgical repair. VA after treatment was good and no statistically significant difference was observed when compared with the 47 cases without flap complications. 109 articles related to late traumatic flap complications after LASIK were retrieved from four Chinese document databases. There were 550 cases of late traumatic flap complications. From 2004, case reports became more common; 10 or more cases were reported in some case series. VA of most cases was good and there was no remarkable vision loss after treatment. Late traumatic flap complications after LASIK have become more frequent in China, although the prognosis of most cases is good. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Case Study: What Makes a Good Case, Revisited: The Survey Monkey Tells All

    ERIC Educational Resources Information Center

    Herried, Clyde Freeman; Prud'homme-Genereux, Annie; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

    2016-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. In this month's issue the authors provide a more definitive answer to the "What Makes a Good Case?" question based on a just-completed Survey Monkey survey given to NCCSTS teachers.

  9. [Duodeno-pancreatic trauma. About 14 cases].

    PubMed

    Beyrouti, Mohamed Issam; Beyrouti, Ramez; Kchaou, Issam; Gharbi, Walid; Elleuch, Slim; Tafech, Issam; Frikha, Foued; Ben Amar, Mohamed; Ghorbel, Ali; Bouaziz, Mounir; Karoui, Abdelhamid; Sellami, Abdelhafidh

    2005-02-01

    Through a series of 14 cases brought over a period of 12 years, we realized a retrospective, analytical and descriptive study of these traumatisms. We aimed to release recommendations to improve their management. It was 2 women and 12 men, whom mean age was 24.4 years (extremes: 50 and 60 years), divided into 10 pancreatic injuries, 2 duodenal injuries and 2 duodeno-pancreatic injuries. Etiology was dominated by traffic accidents 7 cases (50%). Trauma was closed in 13 cases (92%). Associated lesions were present among 13 patients (92%). The traumatism appeared by an urgent surgical abdomen among 9 patients, secondarily in 3 cases, tardily in 2 cases: a case of deep suppuration 3 months after a traumatism treated into ambulatory and a case of persistent ascites after a past unperceived traumatism. Abdominal ultrasonography was made among 4 patients. It allowed diagnosing only a case. Scanner was made among 4 patients. It allowed diagnosing all the cases. Only a patient was treated medically, it was a post-traumatic acute pancreatitis. Surgical treatment was made in 13 cases: conservative in 7 cases and radical in 6 cases. Follow-up was complicated in 11 cases (78%) and non-complicated in 3 cases. Mortality rate was 7.1%.

  10. Are Victorian elective surgery cases still converting from overnight to same day cases?

    PubMed

    Hanning, Brian W T

    2005-05-01

    The conversion rate on a diagnosis related group (DRG)-standardised basis of Victorian private overnight (ON) elective surgery cases to same day (SD) cases declined from 4.7% per annum over 1996-97 to 1998-99 to 2.5% per annum over 1998-99 to 2002-03. Similar analysis within the Victorian public sector shows a decline from 3.8% per annum over 1996-97 to 1998-99 to 1.9% over 1998-99 to 2002-03. Comparison on a DRG-standardised basis shows while the public sector continued to show a higher incidence of elective surgery SD cases than the private sector in 2002-03 (by 1.6%). The difference has declined since 1998-99 when it was 2.4%. DRG-based analysis suggests the conversion rate in both sectors and the difference in SD surgery cases between the two sectors will continue to decline. Future savings in recurrent and capital cost due to ON surgery cases becoming SD cases are likely to be much lower than savings in recent years.

  11. Structural Case Assignment in Korean

    ERIC Educational Resources Information Center

    Koak, Heeshin

    2012-01-01

    In this dissertation, I aim to provide a theory on the distribution of structural Case in Korean. I propose the following Structural Case Assignment Hypothesis (SCAH) regarding the assignment of structural Case: "Structural Case is assigned by phase heads (C: nominative; v: accusative) to every argument in the c-command domain of the phase…

  12. Electronic measurement apparatus movable in a cased borehole and compensating for casing resistance differences

    DOEpatents

    Vail, W.B. III.

    1991-12-24

    Methods of operation are described for an apparatus having at least two pairs of voltage measurement electrodes vertically disposed in a cased well to measure the resistivity of adjacent geological formations from inside the cased well. During stationary measurements with the apparatus at a fixed vertical depth within the cased well, the invention herein discloses methods of operation which include a measurement step and subsequent first and second compensation steps respectively resulting in improved accuracy of measurement. The invention also discloses multiple frequency methods of operation resulting in improved accuracy of measurement while the apparatus is simultaneously moved vertically in the cased well. The multiple frequency methods of operation disclose a first A.C. current having a first frequency that is conducted from the casing into formation and a second A.C. current having a second frequency that is conducted along the casing. The multiple frequency methods of operation simultaneously provide the measurement step and two compensation steps necessary to acquire accurate results while the apparatus is moved vertically in the cased well. 6 figures.

  13. Electronic measurement apparatus movable in a cased borehole and compensating for casing resistance differences

    DOEpatents

    Vail, III, William B.

    1991-01-01

    Methods of operation of an apparatus having at least two pairs of voltage measurement electrodes vertically disposed in a cased well to measure the resistivity of adjacent geological formations from inside the cased well. During stationary measurements with the apparatus at a fixed vertical depth within the cased well, the invention herein discloses methods of operation which include a measurement step and subsequent first and second compensation steps respectively resulting in improved accuracy of measurement. The invention also discloses multiple frequency methods of operation resulting in improved accuracy of measurement while the apparatus is simultaneously moved vertically in the cased well. The multiple frequency methods of operation disclose a first A.C. current having a first frequency that is conducted from the casing into formation and a second A.C. current having a second frequency that is conducted along the casing. The multiple frequency methods of operation simultaneously provide the measurement step and two compensation steps necessary to acquire accurate results while the apparatus is moved vertically in the cased well.

  14. In Case You Are Interested: Results of a Survey of Case Study Teachers

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

    2011-01-01

    Case study teaching had a long tradition in law and business before it made the jump to medical school education in the form of Problem-Based Learning (PBL) in the 1970s. Today, both the University of Delaware's Clearinghouse and the University of Buffalo's National Center for Case Study Teaching in Science (NCCSTS) have hundreds of cases and…

  15. [Costal chondrosarcoma. 4 cases].

    PubMed

    Ben M'rad, S; el Hammami, S; Merai, S; Kamoun, N; Horchani, H; Ben Miled, K; Kilani, T; Djenayah, F

    1999-09-04

    Tumors of the rib cage are uncommon and malignant in 29% of the cases. Chondrosarcoma predominates, accounting for 40% of all cases of malignant costal tumors. Four patients (3 women, 1 man, mean age 28.2 years) were hospitalized for costal chondrosarcoma. Pain and tumefaction dominated the clinical presentation. Calcifications suggested the diagnosis in 3 cases. Curative surgery was performed in all cases. Postoperative radiotherapy was unable to improve prognosis in 2 patients. Chondrosarcoma of the ribs is characterized by a strong potential for invasive extension. Diagnosis is suspected on the basis of imaging findings and confirmed at pathology. Surgery is required. Chemotherapy and radiotherapy do not improve prognosis significantly.

  16. Building the Business Case

    DTIC Science & Technology

    2001-05-15

    Building the Business Case Dr Robin Miller Centre for Defence Analysis Report Documentation Page Report Date 15052001 Report Type N/A Dates Covered...from... to) - Title and Subtitle Building the Business Case Contract Number Grant Number Program Element Number Author(s) Miller, Robin...Trade-offs between men/materiel/process can be made coherent – auditable links to operational risk can be maintained Business Case Challenge for SBA

  17. Case Study: A Step-by-Step Guide to Students Writing Case Studies (and Tools for Novice Case Authors)

    ERIC Educational Resources Information Center

    Prud'homme-Genereux, Annie

    2015-01-01

    In experimenting with ways of structuring the assignment and providing guidance to students, the author developed a series of tools that may be of interest to instructors wishing to implement a case-writing assignment in their course. This assignment is more suited for instructors experienced in case writing, as their knowledge of how to design a…

  18. Trend in case detection rate for all tuberculosis cases notified in Ebonyi, Southeastern Nigeria during 1999-2009.

    PubMed

    Ukwaja, Kingsley Nnanna; Alobu, Isaac; Ifebunandu, Ngozi Appolonia; Osakwe, Chijioke; Igwenyi, Chika

    2013-01-01

    Unlike previous annual WHO tuberculosis reports that reported case detection rate for only smear-positive tuberculosis cases, the 2010 report presented case detection rate for all tuberculosis cases notified in line with the current Stop TB strategy. To help us understand how tuberculosis control programmes performed in terms of detecting tuberculosis, there is need to document the trend in case detection rate for all tuberculosis cases notified in high burden countries. This evidence is currently lacking from Nigeria. Therefore, this study aimed to assess the trend in case detection rate for all tuberculosis cases notified from Ebonyi state compared to Nigeria national figures. Reports of tuberculosis cases notified between 1999 and 2009 were reviewed from the Ebonyi State Ministry of Health tuberculosis quarterly reports. Tuberculosis case detection rates were computed according to WHO guidelines. 22, 508 patients with all forms of tuberculosis were notified during the study. Case detection rate for all tuberculosis rose from 27% in 1999 to gradually reach a peak of 40% during 2007 to 2008 before a slight decline in 2009 to 38%. However, the national case detection rate for all tuberculosis cases in Nigeria rose from 7% in 1999 and progressively increased to reach a peak of 19% during 2008 and 2009. Since the introduction of DOTS in Ebonyi, the programme has achieved 40% case detection rate for all tuberculosis cases - about 20% better than national figures. However, with the current low case detection rates, alternative mechanisms are needed to achieve the current global stop- TB targets in Nigeria.

  19. Case management after long-term absence from work in China: a case report.

    PubMed

    Tang, Dan; Yu, Ignatius Tak Sun; Luo, Xiaoyuan; Liang, Youxin; He, Yonghua

    2011-03-01

    Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.

  20. Measles cases among adolescents in southern Pakistan 2012-2015: The case for revisiting vaccination strategies.

    PubMed

    Shakoor, Sadia; Khan, Erum; Rajput, Muhammad Imran; Rahimoon, Wali Muhammad

    2017-07-03

    Surveillance of adult measles in Pakistan is a challenge as it does not enjoy the status of a reportable disease unlike childhood cases and therefore cases remain undetected and unreported or misdiagnosed. Consequently no data or estimates of young adult cases, seroprevalence, or estimates of susceptible preadolescent or young adult population exist. We have presented both laboratory conformed and clinically suspected cases of measles occurring in adolescents and adults in the southern province of Sindh in Pakistan. Through an examination of 2 independent databases, i.e. a laboratory database of measles IgM positive cases and clinically detected cases on surveillance performed by the Disease Early Warning System, we have analyzed and reported age-specific positivity rates from 2012 to 2015 in Sindh, Pakistan. High rates of laboratory confirmed measles were observed in those aged 9 y and younger. Among adolescents and adults, significantly higher positivity rates were observed among those aged 10-19 y. Clinically detected cases from Sindh showed similar distribution of cases. High burden of cases among children <9 y of age confirm that supplementary immunization activities (SIAs) among this age group are inadequate and need to be strengthened. Cases among those 10-19 y further demonstrate the need for consolidating SIAs with an additional strategy to vaccinate those who remain non-immune at college entry and in institutions where outbreaks can be prevented. Such measures are essential to achieving the goal of measles elimination in the country and region.

  1. Casing Out Evaluation: Expanding Student Interest in Program Evaluation through Case Competitions.

    ERIC Educational Resources Information Center

    Obrecht, Michael; Porteous, Nancy; Haddock, Blair

    1998-01-01

    Describes the authors' experiences in organizing bilingual evaluation case competitions for the National Capital Chapter of the Canadian Evaluation Society for three years. Competition structure, eligibility, judging, contestant recruiting, and preparing cases are outlined. (SLD)

  2. Querying Safety Cases

    NASA Technical Reports Server (NTRS)

    Denney, Ewen W.; Naylor, Dwight; Pai, Ganesh

    2014-01-01

    Querying a safety case to show how the various stakeholders' concerns about system safety are addressed has been put forth as one of the benefits of argument-based assurance (in a recent study by the Health Foundation, UK, which reviewed the use of safety cases in safety-critical industries). However, neither the literature nor current practice offer much guidance on querying mechanisms appropriate for, or available within, a safety case paradigm. This paper presents a preliminary approach that uses a formal basis for querying safety cases, specifically Goal Structuring Notation (GSN) argument structures. Our approach semantically enriches GSN arguments with domain-specific metadata that the query language leverages, along with its inherent structure, to produce views. We have implemented the approach in our toolset AdvoCATE, and illustrate it by application to a fragment of the safety argument for an Unmanned Aircraft System (UAS) being developed at NASA Ames. We also discuss the potential practical utility of our query mechanism within the context of the existing framework for UAS safety assurance.

  3. Teaching with Cases: Learning to Question.

    ERIC Educational Resources Information Center

    Boehrer, John; Linsky, Marty

    1990-01-01

    This chapter discusses the origins of the case method, looks at the question of what is a case, gives ideas about learning in case teaching, the purposes it can serve in the classroom, the ground rules for case discussion, including the role of questions, and new directions for case teaching. (MLW)

  4. The Case for Decision-Forcing Cases: Preparing Teachers for EFL Settings.

    ERIC Educational Resources Information Center

    Jackson, Jane

    2000-01-01

    Focuses on the role that cases can play in preparing English-as-a-foreign-language teachers for the linguistic, cultural, and pedagogical realities of teaching English in an unfamiliar sociocultural setting. Describes some of the benefits of a case-based approach in TEFL teacher development programs. Offers a definition of decision-forcing cases…

  5. Non-ferromagnetic overburden casing

    DOEpatents

    Vinegar, Harold J.; Harris, Christopher Kelvin; Mason, Stanley Leroy

    2010-09-14

    Systems, methods, and heaters for treating a subsurface formation are described herein. At least one system for electrically insulating an overburden portion of a heater wellbore is described. The system may include a heater wellbore located in a subsurface formation and an electrically insulating casing located in the overburden portion of the heater wellbore. The casing may include at least one non-ferromagnetic material such that ferromagnetic effects are inhibited in the casing.

  6. "Since I have my case manager, I am back to life" case management in Croatia.

    PubMed

    Gruber, Ema N; Ivezić-Strkalj, Sladana; Agius, Mark; Martić-Biocina, Sanja

    2008-03-01

    The authors present a case report of a patient who was treated by a case manager, a member of a Croatian Community Mental Health (CMH) Team, following the recommendations of WHO 2004 as well as the IRIS guidelines and the Basic Standards for Management of Patients with Serious Mental Illness in the Community (Agius 2005) and using the elements of Clinical case management (Muser 1998), Assertive community treatment model (Burns 1995, Scott 1995, Wolfsan 1990), the personal strength model (Rapp 1988) and Rehabilitation model (Anthony 1993). In order to emphasize the importance of the therapist-patient relationship in the treatment of chronic schizophrenic patients (Ivezic 2001) and creating the group atmosphere a Croatian model of case management is created where the patient's needs and risks are assessed by a multidisciplinary team which also conducts the recommended psychosocial interventions plan. The majority of interventions are conducted in groups. The case manager develops a confident relationship with a patient, nourishes the positive transference and aids the delivery of the treatment. The main goals of the interventions are empowerment of the patient, improvement of his abilities and decreasing of disabilities. The case manager also carries out a full assessment of the needs of the patient's family so that the family or carers are also included in the treatment or support if necessary (Gruber 2006). A case report of a patient and the work of her case manager as well as the case manager's diary (Gruber 2007) and the Croatian model of case management is presented in this article.

  7. Generic health/safety/environment cases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kelland, A.N.; Primrose, M.; Pickles, J.C.

    1996-12-31

    A desire to implement HSE Management Systems including HSE Cases in all Shell companies operations prompted the development of a relational data base software package (THESIS) to provide a structured way of preparing an HSE Case. The software includes features which facilitate the management of {open_quotes}Keeping the Case Alive{close_quotes}, enabling the dissemination of tasks and hazard information to the workplace. During the software development it was recognized that a significant reduction could be made in the resources which would be required to prepare an HSE Case for each and every operation by the building of {open_quotes}Generic HSE Cases{close_quotes} addressing specificmore » activities which were repeated across the Company`s operations. This was recognized to be particularly valid for the smaller Single String Venture type of operations. The activities selected for the initial Generic HSE Case development include Land Drilling Operations, Land Seismic Acquisition, and Land Transport. To establish the Generic HSE Case, the THESIS data base is populated with data for a generic operation, identifying all the hazards and activities associated with that operation including all the associated controls, with established formats for the textual sections. In effect, the Generic Case defines the standards required for that type of operation. To generate an operation specific HSE Case, the Generic Case thereafter requires to be modified/adapted so that it represents the actual situation in the operation which it defines. This process includes itemization of all the operation specific details, and may involve the inclusion/deletion of any additional/existing activities or hazards together with their associated controls.« less

  8. [Tuberculous pyopneumothorax: about 18 cases].

    PubMed

    Hicham, Souhi; Hanane, El Ouazzani; Hicham, Janah; Ismaïl, Rhorfi; Ahmed, Abid

    2016-01-01

    Tuberculous pyopneumothorax is a rare but serious complication of evolutive pulmonary tuberculosis. We report a series of 18 cases with tuberculous pyopneumothorax admitted to the Pneumo-Phthisiology Department of the Mohammed V Military Teaching Hospital in Rabat between January 2005 and December 2009. Our study included 15 men and 3 women, the average age was 35 ± 7 years. 4 patients were diabetic. Smoking was found in 9 cases. Right-sided pneumothorax was found in 13 cases. Chest radiograph showed cavitary lesions in 15 patients and extensive bilateral lesions in 8 cases. The search for Mycobacterium tuberculosis in the fluid from the gastric tube was positive in 16 cases. Chest drainage associated with antituberculosis treatment according to the 2SRHZ/7RH regimen and respiratory kinesitherapy were performed in all cases. The average duration of pleural drainage was 4 weeks. In 3 cases we noted persistent pleural suppuration requiring pleural toilet using thoracoscopy with pleurectomy and limited pulmonary resection to eliminate tuberculous parenchymal lesions and the persistence of a large pleural pocket with restrictive ventilatory defect that required surgery for pleural decortication in two cases. The outcome was favorable with minimal pachypleuritis as sequelae in the remaining cases. Tuberculous pyopneumothorax is a severe form, which is often associated with active cavitary tuberculosis. Evolution is generally progressive despite antituberculosis treatment and thoracic drainage, hence the need for early diagnosis and treatment of all forms of tuberculosis.

  9. Approximation of Engine Casing Temperature Constraints for Casing Mounted Electronics

    NASA Technical Reports Server (NTRS)

    Kratz, Jonathan L.; Culley, Dennis E.; Chapman, Jeffryes W.

    2017-01-01

    The performance of propulsion engine systems is sensitive to weight and volume considerations. This can severely constrain the configuration and complexity of the control system hardware. Distributed Engine Control technology is a response to these concerns by providing more flexibility in designing the control system, and by extension, more functionality leading to higher performing engine systems. Consequently, there can be a weight benefit to mounting modular electronic hardware on the engine core casing in a high temperature environment. This paper attempts to quantify the in-flight temperature constraints for engine casing mounted electronics. In addition, an attempt is made at studying heat soak back effects. The Commercial Modular Aero Propulsion System Simulation 40k (C-MAPSS40k) software is leveraged with real flight data as the inputs to the simulation. A two-dimensional (2-D) heat transfer model is integrated with the engine simulation to approximate the temperature along the length of the engine casing. This modification to the existing C-MAPSS40k software will provide tools and methodologies to develop a better understanding of the requirements for the embedded electronics hardware in future engine systems. Results of the simulations are presented and their implications on temperature constraints for engine casing mounted electronics is discussed.

  10. Approximation of Engine Casing Temperature Constraints for Casing Mounted Electronics

    NASA Technical Reports Server (NTRS)

    Kratz, Jonathan; Culley, Dennis; Chapman, Jeffryes

    2016-01-01

    The performance of propulsion engine systems is sensitive to weight and volume considerations. This can severely constrain the configuration and complexity of the control system hardware. Distributed Engine Control technology is a response to these concerns by providing more flexibility in designing the control system, and by extension, more functionality leading to higher performing engine systems. Consequently, there can be a weight benefit to mounting modular electronic hardware on the engine core casing in a high temperature environment. This paper attempts to quantify the in-flight temperature constraints for engine casing mounted electronics. In addition, an attempt is made at studying heat soak back effects. The Commercial Modular Aero Propulsion System Simulation 40k (C-MAPSS40k) software is leveraged with real flight data as the inputs to the simulation. A two-dimensional (2-D) heat transfer model is integrated with the engine simulation to approximate the temperature along the length of the engine casing. This modification to the existing C-MAPSS40k software will provide tools and methodologies to develop a better understanding of the requirements for the embedded electronics hardware in future engine systems. Results of the simulations are presented and their implications on temperature constraints for engine casing mounted electronics is discussed.

  11. Case Managers on the Front Lines of Ethical Dilemmas: Advocacy, Autonomy, and Preventing Case Manager Burnout.

    PubMed

    Sortedahl, Charlotte; Mottern, Nina; Campagna, Vivian

    The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.

  12. Case-control studies in neurosurgery.

    PubMed

    Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

    2014-08-01

    Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure

  13. Case-control studies in diabetes. Do they really use a case-control design?

    PubMed

    Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

    2017-07-01

    Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

  14. Case Reports, Case Series - From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education.

    PubMed

    Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven

    2017-08-07

    Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.

  15. Compatible poliomyelitis cases in India during 2000.

    PubMed Central

    Kohler, Kathryn A.; Hlady, W. Gary; Banerjee, Kaushik; Gupta, Dhananjoy; Francis, Paul; Durrani, Sunita; Zuber, Patrick L. F.; Sutter, Roland W.

    2003-01-01

    OBJECTIVE: To describe the characteristics of compatible poliomyelitis cases and to assess the programmatic implications of clusters of such cases in India. METHODS: We described the characteristics of compatible poliomyelitis cases, identified clusters of compatible cases (two or more in the same district or neighbouring districts within two months), and examined their relationship to wild poliovirus cases. FINDINGS: There were 362 compatible cases in 2000. The incidence of compatible cases was higher in districts with laboratory-confirmed poliomyelitis cases than in districts without laboratory-confirmed cases. Of 580 districts, 96 reported one compatible case and 72 reported two or more compatible cases. Among these 168 districts with at least one compatible case, 123 had internal or cross- border clusters of compatible cases. In 27 districts with clusters of compatible cases, no wild poliovirus was isolated either in the same district or in neighbouring districts. Three of these 27 districts presented laboratory-confirmed poliomyelitis cases during 2001. CONCLUSION: Most clusters of compatible cases occurred in districts identified as areas with continuing wild poliovirus transmission and where mopping-up vaccination campaigns were carried out. As certification nears, areas with compatible poliomyelitis cases should be investigated and deficiencies in surveillance should be corrected in order to ensure that certification is justified. PMID:12640469

  16. 12 CFR 585.110 - How do I apply for a case-by-case exemption?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false How do I apply for a case-by-case exemption? 585.110 Section 585.110 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY PROHIBITED SERVICE AT SAVINGS AND LOAN HOLDING COMPANIES Exemptions § 585.110 How do I apply for a case-by...

  17. Case Study: Mini-Case Studies: Small Infusions of Active Learning for Large-Lecture Courses

    ERIC Educational Resources Information Center

    Carloye, Lisa

    2017-01-01

    In this article, the author introduces the usage of case studies to be an excellent method for engaging students through stories. The author notes she developed a series of mini-case studies that can be implemented, with a little advance preparation, within a 10- to 15-minute window during lecture. What makes them "mini" case studies?…

  18. Case-based ethics instruction: the influence of contextual and individual factors in case content on ethical decision-making.

    PubMed

    Bagdasarov, Zhanna; Thiel, Chase E; Johnson, James F; Connelly, Shane; Harkrider, Lauren N; Devenport, Lynn D; Mumford, Michael D

    2013-09-01

    Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sense making processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed.

  19. Brief: Field measurements of casing tension forces

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Quigley, M.S.; Lewis, D.B.; Boswell, R.S.

    1995-02-01

    Tension forces acting on individual casing joints were accurately measured during installation of 10,158 ft of 9 5/8-in. {times} 47-lbm/ft casing and 11,960 ft of 11 7/8-in. {times} 71.8-lbm/ft casing. A unique casing load table (CLT) weighed the casing string after the addition of each casing joint. Strain gauges attached inside the pin ends of instrumented casing joints (ICJ`s) directly measured tension force on those joints. A high-speed computer data-acquisition system (DAS) automatically recorded data from all the sensors. Several casing joints were intentionally subjected to extreme deceleration to determine upper limits for dynamic tension forces. Data from these testsmore » clearly show effects of wellbore friction and casing handling conditions. In every case, tension forces in the casing during maximum deceleration were considerably less than expected. In some cases, the highest tension forces occurred when the casing lifted out of the slips. Peak tension forces caused by setting the casing slips were typically no more than 5% greater than tension forces in the casing at rest. This dynamic amplification was far less than the 60% value used in the previous casing design method. Reducing the safety factor for installation loads has permitted use of lighter, less-expensive casing than dictated by older design criteria.« less

  20. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS General Construction Requirements for Transmission Lines and Mains § 192.323 Casing. Each casing used on a transmission line or main under a railroad or highway must comply with the following: (a) The casing must be designed to withstand the superimposed...

  1. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS General Construction Requirements for Transmission Lines and Mains § 192.323 Casing. Each casing used on a transmission line or main under a railroad or highway must comply with the following: (a) The casing must be designed to withstand the superimposed...

  2. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS General Construction Requirements for Transmission Lines and Mains § 192.323 Casing. Each casing used on a transmission line or main under a railroad or highway must comply with the following: (a) The casing must be designed to withstand the superimposed...

  3. Membranous Dysmenorrhea: A Case Series

    PubMed Central

    Omar, Hatim A.; Smith, Shawn J.

    2007-01-01

    The purpose was to illustrate the variability of hormonal contraception of patients that presented with membranous dysmenorrheal. A case analysis chart review was completed on six patients referred to a Pediatric Gynecologist in an academic setting. In each case the patient underwent a thorough pelvic and bimanual exam. Following the initial presentation, each patient continued to be followed on a regular visits. Cases: Two were using the transdermal contraceptive patch and oral contraceptive, but following the expulsion of decidual cast, they were both placed on depot medroxyprogesterone acetate (DMPA) without further complications. Three of the six cases were on DMPA prior to the similar occurrence of membranous dysmenorrheal and following this incident, continued on DMPA without further problems. The final case was on the transdermal patch prior to decidual cast expulsion and remained on this form of hormonal contraception without further complications. These cases indicate that membranous dysmenorrheal is not limited to the use of DMPA. PMID:18060329

  4. A report on case reports

    PubMed Central

    Gopikrishna, Velayutham

    2010-01-01

    Case reports are defined as the scientific documentation of a single clinical observation and have a time-honored and rich tradition in medicine and scientific publication. This article discusses the role and relevance of case reports in the current evidence-based medical literature. It also seeks to help and guide authors to understand how to prepare a reasonable and well-written case report and how they may anticipate concerns that peer reviewers may express when scrutinizing their manuscript. An overview of the Journal of Conservative Dentistry’s review process of a manuscript submission is provided for the benefit of future authors. It is important to be able to read a case report critically and to use the information they contain appropriately. This article also discusses the factors to consider in evaluating individual case reports, and discusses a practical conceptual scheme for evaluating the potential value and educational content of a case report. PMID:21217956

  5. Case Citations 1991. Eleventh Series.

    ERIC Educational Resources Information Center

    Sharp, Linda A., Ed.

    Case citations from five legal areas--college students, liability on campus, sport law, employment, and employment discrimination--are presented in this document. Each section offers brief summaries of cases and concludes with a table of cases. The first section on college students examines litigation involving student finances, disciplinary…

  6. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... loads. (b) If there is a possibility of water entering the casing, the ends must be sealed. (c) If the... operating pressure of the pipe, the casing must be designed to hold this pressure at a stress level of not... the weather to prevent water from entering the casing. ...

  7. 49 CFR 192.323 - Casing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... loads. (b) If there is a possibility of water entering the casing, the ends must be sealed. (c) If the... operating pressure of the pipe, the casing must be designed to hold this pressure at a stress level of not... the weather to prevent water from entering the casing. ...

  8. Teaching Cases on Family Involvement

    ERIC Educational Resources Information Center

    Harvard Family Research Project, 2010

    2010-01-01

    Teaching cases are a valuable tool in preparing teachers and school administrators to engage effectively with families. Because the case method presents a story in practice, it offers students an active learning opportunity. Teaching cases involve real world situations and consider the perspectives of various stakeholders, including teachers,…

  9. [Aspergillus spondylodiscitis. Apropos of 5 cases].

    PubMed

    Cortet, B; Deprez, X; Triki, R; Savage, C; Flipo, R M; Duquesnoy, B; Delcambre, B

    1993-01-01

    Five cases of Aspergillus discitis in male patients are reported. Three patients had impaired immune responses as a result of immunosuppressive therapy following a heart transplant (two cases) or hairy cell leukemia (one case). Two patients had a recent history of mycobacterial infection. All five patients were hospitalized for severe spinal pain suggestive of an inflammatory disease with no neurological abnormalities. Erythrocyte sedimentation rate was elevated in every case. The diagnosis of discitis was suspected on spinal roentgenograms and established by computed tomography and/or magnetic resonance imaging. In three patients the spine was the only site of Aspergillus infection (lumbar discitis in two cases and thoracic discitis in one case). One patient developed Aspergillus infection of several disks (L1-L2, L2-L3, and L4-L5) after Aspergillus endocarditis with embolization to the left lower limb. Another patient developed discitis after an Aspergillus lung infection. In every case, Aspergillus fumigatus was recovered in cultures of specimens harvested by a percutaneous needle biopsy of the intervertebral disk. All five patients were treated by itraconazole which was given as single drug therapy in one case and in combination with 5-flucytosine and amphotericin B in four cases. Recovery was achieved in every case after four to six months of this drug therapy. In contrast to most previously reported cases, none of the five patients reported herein required surgical treatment. Efficacy of conservative treatment in this study may be related to the use of itraconazole in every case.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Comparing colon cancer outcomes: The impact of low hospital case volume and case-mix adjustment.

    PubMed

    Fischer, C; Lingsma, H F; van Leersum, N; Tollenaar, R A E M; Wouters, M W; Steyerberg, E W

    2015-08-01

    When comparing performance across hospitals it is essential to consider the noise caused by low hospital case volume and to perform adequate case-mix adjustment. We aimed to quantify the role of noise and case-mix adjustment on standardized postoperative mortality and anastomotic leakage (AL) rates. We studied 13,120 patients who underwent colon cancer resection in 85 Dutch hospitals. We addressed differences between hospitals in postoperative mortality and AL, using fixed (ignoring noise) and random effects (incorporating noise) logistic regression models with general and additional, disease specific, case-mix adjustment. Adding disease specific variables improved the performance of the case-mix adjustment models for postoperative mortality (c-statistic increased from 0.77 to 0.81). The overall variation in standardized mortality ratios was similar, but some individual hospitals changed considerably. For the standardized AL rates the performance of the adjustment models was poor (c-statistic 0.59 and 0.60) and overall variation was small. Most of the observed variation between hospitals was actually noise. Noise had a larger effect on hospital performance than extended case-mix adjustment, although some individual hospital outcome rates were affected by more detailed case-mix adjustment. To compare outcomes between hospitals it is crucial to consider noise due to low hospital case volume with a random effects model. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Female genital tuberculosis cases with distinct clinical symptoms: Four case reports

    PubMed Central

    Aslan, Gonul; Ulger, Mahmut; Ulger, Seda Tezcan; Durukan, Huseyin; Yazici, Faik Gurkan; Emekdas, Gurol

    2018-01-01

    Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Genital TB (GTB) is a form of extrapulmonary TB that occurs more frequently in women, in whom it classically presents in association with menstrual irregularity, pregnancy loss and short and long-term sequelae especially infertility in infected women. Patients with GTB are usually young women diagnosed during workup for infertility. GTB is rare in postmenopausal women and responsible for only approximately 1% of postmenopausal bleeding. In this study, we aimed to evaluate the laboratory, clinical and demographic characteristics of female GTB cases. Case: We presented four female GTB cases with distinct clinical symptoms. All patients have no history of TB, and no acid-fast bacilli were seen in smears prepared from the clinical materials of the patients. Histopathological examinations revealed granulomatous inflammation in all patients. Conclusion: In the light of the clinical features of these cases we aimed to emphasize that, female GTB must be taken into account in the patients with different clinical symptoms like postmenopausal bleeding, menometrorrhagia, infertility, and menstrual irregularities. We believe that these symptoms will be helpful for the diagnosis and treatment of female GTB. PMID:29675489

  12. Structured Case Analysis: Developing Critical Thinking Skills in a Marketing Case Course

    ERIC Educational Resources Information Center

    Klebba, Joanne M.; Hamilton, Janet G.

    2007-01-01

    Structured case analysis is a hybrid pedagogy that flexibly combines diverse instructional methods with comprehensive case analysis as a mechanism to develop critical thinking skills. An incremental learning framework is proposed that allows instructors to develop and monitor content-specific theory and the corresponding critical thinking skills.…

  13. The Self-Actualizing Case Method.

    ERIC Educational Resources Information Center

    Gunn, Bruce

    1980-01-01

    Presents a case procedure designed to assist trainees in perfecting their problem-solving skills. Elements of that procedure are the rationale behind this "self-actualizing" case method; the role that the instructor, case leaders, and participants play in its execution; and the closed-loop grading system used for peer evaluation. (CT)

  14. Natural Learning Case Study Archives

    ERIC Educational Resources Information Center

    Lawler, Robert W.

    2015-01-01

    Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…

  15. Detailed validation of the bidirectional effect in various Case I and Case II waters.

    PubMed

    Gleason, Arthur C R; Voss, Kenneth J; Gordon, Howard R; Twardowski, Michael; Sullivan, James; Trees, Charles; Weidemann, Alan; Berthon, Jean-François; Clark, Dennis; Lee, Zhong-Ping

    2012-03-26

    Simulated bidirectional reflectance distribution functions (BRDF) were compared with measurements made just beneath the water's surface. In Case I water, the set of simulations that varied the particle scattering phase function depending on chlorophyll concentration agreed more closely with the data than other models. In Case II water, however, the simulations using fixed phase functions agreed well with the data and were nearly indistinguishable from each other, on average. The results suggest that BRDF corrections in Case II water are feasible using single, average, particle scattering phase functions, but that the existing approach using variable particle scattering phase functions is still warranted in Case I water.

  16. BOS MOrth cases prize 2011.

    PubMed

    Patel, Jigar Vipinchandra

    2013-12-01

    This paper describes the orthodontic treatment of two cases awarded the prize by the British Orthodontic Society for best treated cases submitted for the Membership in Orthodontics. The first case reports on the treatment of a class III malocclusion with increased vertical lower anterior facial proportions and dentoalveolar compensation that was treated with orthodontic camouflage. The second case reports on the treatment of a class II division II malocclusion with reduced vertical lower anterior facial proportions and an overbite complete to the palate, which was treated with orthodontic camouflage.

  17. A challenging case of invasive pulmonary aspergillosis after near-drowning: a case report and literature review

    PubMed Central

    Jenks, Jeffrey D.; Preziosi, Michael

    2015-01-01

    Near-drowning, a relatively common event, is often complicated by subsequent pneumonia. While endogenous and exogenous bacteria are typical pathogens, rarely fungi are as well. We report a complicated case of invasive pulmonary aspergillosis in a 30-year-old man after a near-drowning event. We also review the medical literature for similar cases. All cases of invasive pulmonary aspergillosis after near-drowning reported in the literature involve Aspergillus fumigatus. The majority of cases involved submersion in stagnant water after a motor vehicle accident (MVA). Treatment varied considerably, with amphotericin B used in the majority of cases. Morbidity was considerable with prolonged hospitalization occurring in every case, and mortality occurring in fifty percent of the reported cases. Although a rare complication of near-drowning, invasive pulmonary aspergillosis can occur and lead to significant morbidity and mortality. After near-drowning A. fumigatus isolated from the respiratory tract should be assumed to be a true pathogen and treated accordingly. PMID:26392737

  18. Exchangeability in the case-crossover design

    PubMed Central

    Mittleman, Murray A; Mostofsky, Elizabeth

    2014-01-01

    In cohort and case-control studies, confounding that arises as a result of differences in the distribution of determinants of the outcome between exposure groups leading to non-exchangeability are addressed by restriction, matching or with statistical models. In case-only studies, this issue is addressed by comparing each individual with his/herself. Although case-only designs use self-matching and only include individuals who develop the outcome of interest, issues of non-exchangeability are identical to those that arise in traditional case-control and cohort studies. In this review, we describe one type of case-only design, the case-crossover design, and discuss how the concept of exchangeability can be used to understand issues of confounding, carryover effects, period effects and selection bias in case-crossover studies. PMID:24756878

  19. Case II: Conflict recognition--the case of the misdirected faculty.

    PubMed

    Hoelscher, Diane C; Comer, Robert W

    2002-04-01

    Early recognition is fundamental to managing conflict. Successful leaders rely upon their ability to recognize conflict before it escalates into crisis. This article reviews the signs and sources of conflict along with related management theories. Conflict management includes understanding the sources and types of conflict as well as the impact potential; in the case presented, the leaders were unaware of conflict. Dr. Forester, the faculty member "in the middle," was in a precarious position. Her performance evaluation reflected unacceptable accomplishments. However, her self-assessment, based on the hiring agreement, was successful. Her requests for guidance and clarification were unproductive. What does she do now? The management theories that apply to the case of "the misdirected faculty" include analysis and discussion of communication, feedback, and expectancy theory. Action alternatives are presented to explore some of the options available to stimulate discussion and to provide readers with an eclectic approach to applying a case analysis.

  20. Emotion, Engagement, and Case Studies

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

    2014-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  1. Making a Case for a Blended Approach: The Need for The Design-Based Case Study

    ERIC Educational Resources Information Center

    Deaton, Cynthia C. M.; Malloy, Jacquelynn A.

    2017-01-01

    Design-based case studies address research questions that involve instructional innovations within a bounded system. This blend of case study and design-based research provides a systematic approach to examining instructional innovations that are bounded by perspective, context, and time. Design-based case studies provide a framework for engaging…

  2. "Tuberculosis Case Management" Training.

    ERIC Educational Resources Information Center

    Knebel, Elisa; Kolodner, Jennifer

    2001-01-01

    The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to…

  3. Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

    PubMed

    Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

    2016-01-05

    Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

  4. Factors associated with tuberculosis cases in Semarang District, Indonesia: case-control study performed in the area where case detection rate was extremely low.

    PubMed

    Rahayu, Sri Ratna; Katsuyama, Hironobu; Demura, Masashi; Katsuyama, Midori; Ota, Yoko; Tanii, Hideji; Higashi, Tomomi; Semadi, Ngakan Putu Djaja; Saijoh, Kiyofumi

    2015-07-01

    Indonesia is ranked as the 4th highest contributor to tuberculosis (TB) in the world. Semarang District in Central Java displays extremely low case detection rate (CDR), possibly contributing to the local prevalence of TB. A case-control study was performed to explore the factors that cause such low CDR. We recruited 129 TB cases and 83 controls that visited the same centers and were not diagnosed with TB. The cases had 7.5 ± 2.3 symptoms/person on average, indicating the delay in diagnosis because the controls only displayed 1.0 ± 1.7. The multiple logistic regression analysis comparing the cases/controls extracted following factors as a risk to have TB: farmer, close contact with TB patients, ignorance of whether Bacillus Calmette-Guérin (BCG) was accepted or no, smoking, low income, a lot of people living in the same room, irregular hand wash before meals, not wash hands after blow, soil floor, and no sunlight and no ventilation in the house. Neither the cases nor the controls knew the symptoms and how to avoid TB infection, which probably caused the delay in diagnosis. It is difficult to change the current living conditions. Thus, the amendment of the community-based education program of TB seems to be required.

  5. Case and Administrative Support Tools

    EPA Pesticide Factsheets

    Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help reduce office administrative labor costs while increasing employee effectiveness. CAST supports business functions which rely on and store Privacy Act sensitive data (PII). Specific business processes included in CAST (and respective PII) are: -Civil Rights Cast Tracking (name, partial medical history, summary of case, and case correspondance). -Employment Law Case Tracking (name, summary of case). -Federal Tort Claims Act Incident Tracking (name, summary of incidents). -Ethics Program Support Tools and Tracking (name, partial financial history). -Summer Honors Application Tracking (name, home address, telephone number, employment history). -Workforce Flexibility Initiative Support Tools (name, alternative workplace phone number). -Resource and Personnel Management Support Tools (name, partial employment and financial history).

  6. Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

    PubMed

    King, Robert

    2009-05-01

    In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace

  7. Shared written case formulations and weight change in outpatient therapy for anorexia nervosa: a naturalistic single case series.

    PubMed

    Gladwin, Alice M; Evangeli, Michael

    2013-01-01

    The therapeutic effects of written shared case formulations are underexplored and have not been examined in anorexia nervosa. This study explored the relationship between (a) the delivery (b) the quality of a shared written case formulation and weight in outpatient psychological therapy for anorexia nervosa. A naturalistic single case series approach was used to examine the case notes of women who had attended a specialist eating disorders service over a 2-year period. The case notes of 15 adult women who had undergone outpatient psychological therapy for anorexia nervosa with a shared written case formulation component were reviewed. The impact of the quality of the case formulation on weekly weight was examined for 14 of the clients where the case formulation was available. The nature of the relationship between the delivery of the written shared case formulation and weight was examined for all 15 clients. There was some evidence to support an association between delivery of the shared written case formulation and weight changes (both weight gain [five out of 15 clients] and weight loss [three out of 15 clients]) in individual cases. Higher case formulation quality was related to cases where weight change did not occur. The delivery of case formulations can be associated with important therapeutic change (both beneficial and potentially harmful) in anorexia nervosa. Future research into the causal mechanisms associated with sharing formulations will face the challenge of adopting strategies that allow for an in-depth exploration of complex therapy variables whilst overcoming methodological challenges. Copyright © 2012 John Wiley & Sons, Ltd.

  8. Case-based medical informatics

    PubMed Central

    Pantazi, Stefan V; Arocha, José F; Moehr, Jochen R

    2004-01-01

    Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning) and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences of problem-solving and

  9. Effect of the new standards for case logging on resident operative volume: doing better cases or better numbers?

    PubMed

    Murthy, Raghav; Shepard, Alex; Swartz, Andrew; Woodward, Ann; Reickert, Craig; Horst, Mathilda; Rubinfeld, Ilan

    2012-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) modified the designation of major (index) operative cases to include those previously considered "minor." This study assessed the potential effect of these changes on resident operative experience. With Institutional Review Board approval, we analyzed National Surgical Quality Improvement Program participant use files for 2005-2008 for general and vascular surgery cases. Primary CPT case coding was mapped to the ACGME major case category using both the old and new classification schemes. The variables were analyzed using χ(2) analysis in SPSS IBM 19 (IBM, Armonk, New York). A total of 576,019 cases were reviewed. Major cases as defined by the new classification represented an increasing proportion of the cases each year, rising from 88.3% in 2005 to 95% by 2008 (p < 0.001). Major cases as defined by the old scheme decreased from 71% in 2005 to 62% by 2008 (p < 0.001). The cases covered by a resident dropped from 82% in 2005 to 61% in 2008 (p < 0.001). When comparing the new to the old scheme, 364,366 (63.3%) cases were considered major and 30,587 (5.3%) were minor by both standards; 7089 (1.2%) cases previously classified as major were changed to minor, whereas 173,977 (30.2%) (p < 0.001) previously classified as minor were now major. This latter group showed top procedures to include excision of breast lesion (22,175 [12.7%]), laparoscopic gastric bypass (18,825 [10.8%]), ventral hernia repair (14,732 [8.5%]), and appendectomy (10,190 [5.9%]). Of these newly designated major cases, the proportion not covered by residents increased from 22% in 2005 to 44% in 2007 and 2008 (p < 0.001). Although some operative cases newly classified as major are technically advanced procedures (eg, Roux-en-Y gastric bypass), other cases are not (eg, breast lesion excision), which raises the issue as to whether the major case category has been diluted by less demanding case types. The implications of these findings may

  10. Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis.

    PubMed

    Sayed, Shahin; Lester, Susan C; Wilson, Michael; Berney, Daniel; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela; Guarner, Jeannette

    2017-01-01

    Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45-90 min to complete.Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging.New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers' feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice.

  11. Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis

    PubMed Central

    Wilson, Michael; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela

    2017-01-01

    Background Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. Objectives We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Methods Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Results Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45–90 min to complete. Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging. New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers’ feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Conclusion Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice. PMID:29147646

  12. Dioctophymiasis: A Rare Case Report

    PubMed Central

    Kaval, Sunil; Tewari, Swati

    2016-01-01

    Dioctophyma renale commonly known as “giant kidney worm’ is found in the kidney of carnivorous mammals. Human infestation is rare, but results in destruction of the kidneys. Very few cases have been reported worldwide. We are here reporting a case of Dioctophymiasis in a 35-year-old male patient who presented with retention of urine and subsequent passage of worm and blood in urine. The worm was confirmed as Dioctophyma renale based on its morphology and clinical presentation. This is a very rare case report and to best of our knowledge only two cases have been reported from India. PMID:27042466

  13. Dioctophymiasis: A Rare Case Report.

    PubMed

    Chauhan, Sapna; Kaval, Sunil; Tewari, Swati

    2016-02-01

    Dioctophyma renale commonly known as "giant kidney worm' is found in the kidney of carnivorous mammals. Human infestation is rare, but results in destruction of the kidneys. Very few cases have been reported worldwide. We are here reporting a case of Dioctophymiasis in a 35-year-old male patient who presented with retention of urine and subsequent passage of worm and blood in urine. The worm was confirmed as Dioctophyma renale based on its morphology and clinical presentation. This is a very rare case report and to best of our knowledge only two cases have been reported from India.

  14. Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

    PubMed Central

    Jewkes, Rachel; Christofides, Nicola; Vetten, Lisa; Jina, Ruxana; Sigsworth, Romi; Loots, Lizle

    2009-01-01

    Background Health services for victims of rape are recognised as a particularly neglected area of the health sector internationally. Efforts to strengthen these services need to be guided by clinical research. Expert medical evidence is widely used in rape cases, but its contribution to the progress of legal cases is unclear. Only three studies have found an association between documented bodily injuries and convictions in rape cases. This article aims to describe the processing of rape cases by South African police and courts, and the association between documented injuries and DNA and case progression through the criminal justice system. Methods and Findings We analysed a provincially representative sample of 2,068 attempted and completed rape cases reported to 70 randomly selected Gauteng province police stations in 2003. Data sheets were completed from the police dockets and available medical examination forms were copied. 1,547 cases of rape had medical examinations and available forms and were analysed, which was at least 85% of the proportion of the sample having a medical examination. We present logistic regression models of the association between whether a trial started and whether the accused was found guilty and the medico-legal findings for adult and child rapes. Half the suspects were arrested (n = 771), 14% (209) of cases went to trial, and in 3% (31) of adults and 7% (44) of children there was a conviction. A report on DNA was available in 1.4% (22) of cases, but the presence or absence of injuries were documented in all cases. Documented injuries were not associated with arrest, but they were associated with children's cases (but not adult's) going to trial (adjusted odds ratio [AOR] for having genital and nongenital injuries 5.83, 95% confidence interval [CI] 1.87–18.13, p = 0.003). In adult cases a conviction was more likely if there were documented injuries, whether nongenital injuries alone AOR 6.25 (95% CI 1.14–34.3, p = 0

  15. Cases for the Net Generation: An Empirical Examination of Students' Attitude toward Multimedia Case Studies

    ERIC Educational Resources Information Center

    Sheppard, Michael; Vibert, Conor

    2016-01-01

    Case studies have been an important tool in business, legal, and medical education for generations of students. Traditional text-based cases tend to be self-contained and structured in such a way as to teach a particular concept. The multimedia cases introduced in this study feature unscripted web-hosted video interviews with business owners and…

  16. The Elements of a Good Case

    ERIC Educational Resources Information Center

    Fossey, Richard; Crow, Gary M.

    2011-01-01

    In the broad sense, case teaching is an ancient pedagogy. Since time began, teachers have taught other people by drawing on stories from real-life experiences. In a way, then, telling stories taken from real life can be seen as case teaching. Case writing and case teaching in a college or university setting, however, require specific research and…

  17. Understanding and Evaluating Assurance Cases

    NASA Technical Reports Server (NTRS)

    Rushby, John; Xu, Xidong; Rangarajan, Murali; Weaver, Thomas L.

    2015-01-01

    Assurance cases are a method for providing assurance for a system by giving an argument to justify a claim about the system, based on evidence about its design, development, and tested behavior. In comparison with assurance based on guidelines or standards (which essentially specify only the evidence to be produced), the chief novelty in assurance cases is provision of an explicit argument. In principle, this can allow assurance cases to be more finely tuned to the specific circumstances of the system, and more agile than guidelines in adapting to new techniques and applications. The first part of this report (Sections 1-4) provides an introduction to assurance cases. Although this material should be accessible to all those with an interest in these topics, the examples focus on software for airborne systems, traditionally assured using the DO-178C guidelines and its predecessors. A brief survey of some existing assurance cases is provided in Section 5. The second part (Section 6) considers the criteria, methods, and tools that may be used to evaluate whether an assurance case provides sufficient confidence that a particular system or service is fit for its intended use. An assurance case cannot provide unequivocal "proof" for its claim, so much of the discussion focuses on the interpretation of such less-than-definitive arguments, and on methods to counteract confirmation bias and other fallibilities in human reasoning.

  18. Legal consequences for torture in children cases: the Gomez Paquiyauri Brothers vs Peru case.

    PubMed

    Tinta, Monica Feria

    2009-01-01

    The Gomez Paquiyauri Brothers case, before the Inter-American Court of Human Rights, was the first international case concerning the protection of children in the context of armed conflict where an international court stated the law concerning the duties of States towards children even in the context of war, and provided for reparations. As such it represents a landmark decision. The case arose from the illegal detention, torture and extrajudicial execution of two minors, Emilio and Rafael Gomez Paquiyauri, at the hands of Peruvian Police in 1991, under the Fujimori Administration at a time when the internal war in Peru was at its peak. Unlike most cases coming to the jurisdiction of the Inter-American Court, the case had been subject to domestic criminal investigations that had led to the convictions of two low ranking policemen. Yet a more subtle pattern of impunity lied at the root of the case. Torture had been denied by the State, and the prosecutions of low ranking policemen had intended to cover up the responsibility of those who ordered a policy of torture and executions (including the existence of secret codes for the torture and elimination of suspects of "terrorism") during the years of the internal armed conflict in Peru. The joint work of legal and medical expertise in the litigation of the case permitted the establishment of the facts and the law, obtaining an award of 740,500 dollars for the victims and a number of measures of reparation including guarantees of non-repetition and satisfaction, such as the naming of a school after the victims.

  19. Scholarship improved by case report curriculum.

    PubMed

    Stephens, John; Wardrop, Richard

    2016-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) requires that residents participate in scholarly activity. Case reports are an accessible form of resident scholarship, given the time required relative to other forms of research. Our paediatric residency lacked a curriculum for writing and presenting case reports. We created and implemented a brief curriculum for writing case reports and scientific posters. The curriculum consisted of two 1-hour didactic sessions, followed by mentoring during the writing process. The impact of the curriculum was measured via resident surveys about the material presented and by the rate of presentations of case reports made by residents at our departmental research day, before and after implementation. In the year of curriculum implementation, there were 15 case reports presented at the departmental research day, compared with an average of 4.7 per year in the three prior years. The resident (n = 85) participation rate increased from an average of 0.06 case reports per resident per year before implementation to 0.18 case reports per resident per year after implementation (p = 0.0023). Implementation of a case report curriculum with subsequent mentoring was associated with a marked increase in resident case report presentations at the departmental research day. These results suggest that even brief instruction and subsequent faculty mentorship in preparation of case reports can significantly improve resident participation in scholarly activity. © 2016 John Wiley & Sons Ltd.

  20. Using full-cohort data in nested case-control and case-cohort studies by multiple imputation.

    PubMed

    Keogh, Ruth H; White, Ian R

    2013-10-15

    In many large prospective cohorts, expensive exposure measurements cannot be obtained for all individuals. Exposure-disease association studies are therefore often based on nested case-control or case-cohort studies in which complete information is obtained only for sampled individuals. However, in the full cohort, there may be a large amount of information on cheaply available covariates and possibly a surrogate of the main exposure(s), which typically goes unused. We view the nested case-control or case-cohort study plus the remainder of the cohort as a full-cohort study with missing data. Hence, we propose using multiple imputation (MI) to utilise information in the full cohort when data from the sub-studies are analysed. We use the fully observed data to fit the imputation models. We consider using approximate imputation models and also using rejection sampling to draw imputed values from the true distribution of the missing values given the observed data. Simulation studies show that using MI to utilise full-cohort information in the analysis of nested case-control and case-cohort studies can result in important gains in efficiency, particularly when a surrogate of the main exposure is available in the full cohort. In simulations, this method outperforms counter-matching in nested case-control studies and a weighted analysis for case-cohort studies, both of which use some full-cohort information. Approximate imputation models perform well except when there are interactions or non-linear terms in the outcome model, where imputation using rejection sampling works well. Copyright © 2013 John Wiley & Sons, Ltd.

  1. How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

    ERIC Educational Resources Information Center

    Fallek, Max

    This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

  2. Analysis of Restricted Natural Gas Supply Cases

    EIA Publications

    2004-01-01

    The four cases examined in this study have progressively greater impacts on overall natural gas consumption, prices, and supply. Compared to the Annual Energy Outlook 2004 reference case, the no Alaska pipeline case has the least impact; the low liquefied natural gas case has more impact; the low unconventional gas recovery case has even more impact; and the combined case has the most impact.

  3. Rhetorical Structure and Linguistic Features of Case Presentations in Case Reports in Taiwanese and International Medical Journals

    ERIC Educational Resources Information Center

    Hung, Hsuan; Chen, Pi-Ching; Tsai, Jing-Jane

    2012-01-01

    The case presentation is the core section of a medical case report. Issues in the teaching of case report writing have recently been the subject of great interest in medical education, especially in the era of globalization. Given that Taiwanese medical students, residents and junior physicians are requested to write case reports in English and…

  4. [The case manager--from words to deeds?].

    PubMed

    Lindegaard, Birthe Rosenkrantz; Qvist, Peter

    2010-04-19

    Allocation of a case manager is now mandatory for both in- and outpatients in Denmark. Case manager allocation is reported quarterly to the regions and results are generally satisfying. Knowledge about fulfillment of the case manager role is, however, sparse. This study aims to examine the degree of fulfillment of the case manager role for a sample of inpatients. Two medical and two surgical wards participated. Patients were interviewed in relation to discharge while staff assigned as case managers completed a survey. Both patients and case managers answered questions regarding the defined roles as case managers: Planning/coordination, continuous information and discharge planning. 107 of 125 eligible patients were interviewed. Only 25 declared themselves informed about the allocation of a case manager. The patients' assessment of the service provided by the staff in relation to case manager tasks was generally good, but the services were seldom provided by the named case manager. 22% of patients did not experience continuous information, while only 13% did not experience a generally coherent stay in hospital. 110 case managers completed the survey. Less than half felt themselves well informed about the case manager role. Only a few case managers feel that they succeed in fulfilling the role, particularly regarding the participation in discharge planning. There seems to be a need for a targeted effort to improve the conditions for case managers in Danish hospitals in order to meet the intentions of this initiative.

  5. A guide to writing case reports for the Journal of Medical Case Reports and BioMed Central Research Notes

    PubMed Central

    2013-01-01

    Case reports are a time-honored, important, integral, and accepted part of the medical literature. Both the Journal of Medical Case Reports and the Case Report section of BioMed Central Research Notes are committed to case report publication, and each have different criteria. Journal of Medical Case Reports was the world’s first international, PubMed-listed medical journal devoted to publishing case reports from all clinical disciplines and was launched in 2007. The Case Report section of BioMed Central Research Notes was created and began publishing case reports in 2012. Between the two of them, thousands of peer-reviewed case reports have now been published with a worldwide audience. Authors now also have Cases Database, a continually updated, freely accessible database of thousands of medical case reports from multiple publishers. This informal editorial outlines the process and mechanics of how and when to write a case report, and provides a brief look into the editorial process behind each of these complementary journals along with the author’s anecdotes in the hope of inspiring all authors (both novice and experienced) to write and continue writing case reports of all specialties. Useful hyperlinks are embedded throughout for easy and quick reference to style guidelines for both journals. PMID:24283456

  6. Endodontic cellulitis 'flare-up'. Case report.

    PubMed

    Matusow, R J

    1995-02-01

    Endodontic cellulitis involves facial swelling which can vary from mild to severe and can occur as a primary case or a flare-up following initial treatment of asymptomatic teeth with periapical lesions. The microbial spectrum in primary cases involves a significant mixture of anaerobic and facultative aerobic microbes, chiefly streptococci. In a previous study, cultures from flare-up cases, utilizing the same anaerobic techniques as in primary cases, revealed an absence of obligate anaerobes and an 80 per cent incidence of facultative aerobic streptococci. These cases also revealed a significant time lapse from onset of symptoms to the cellulitis phase. No sex or age factors were noted in the primary or flare-up cases. The purpose of this case report is to restate a traditional theory, namely, the alteration of the oxidation/reduction potential (Eh), as a major factor for endodontic cellulitis flare-ups; to confirm the pathogenic potential of oral facultative streptococci; and that asymptomatic endodontic lesions tend to exist with mixed aerobic/anaerobic microbial flora.

  7. Fuzzy-Set Case Studies

    ERIC Educational Resources Information Center

    Mikkelsen, Kim Sass

    2017-01-01

    Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

  8. SETDA Case Studies 2012

    ERIC Educational Resources Information Center

    State Educational Technology Directors Association, 2012

    2012-01-01

    The State Educational Technology Directors Association (SETDA) published a series of case studies from 28 states to showcase examples of how ARRA EETT ("American Recovery and Reinvestment Act of 2009 Enhancing Education Through Technology") grant funds have impacted teaching and learning. SETDA collected data for the case studies through…

  9. The cost of an Ebola case.

    PubMed

    Bartsch, Sarah M; Gorham, Katrin; Lee, Bruce Y

    2015-02-01

    As the most recent outbreak of Ebola virus disease (EVD) in West Africa continues to grow since its initial recognition as a Public Health Emergency of International Concern, an unanswered question is what is the cost of a case of Ebola? Understanding this cost will help decision makers better understand the impact of each case of EVD, benchmark this against that of other diseases, prioritize which cases may require response, and begin to estimate the cost of Ebola outbreaks. To date, the scientific literature has not characterized this cost per case. Therefore, we developed a mathematical model to estimate the cost of an EVD case from the provider and societal perspectives in the three most affected countries of Guinea, Liberia, and Sierra Leone. Our model estimates the total societal cost of an EVD case with full recovery ranges from $480 to $912, while that of an EVD case not surviving ranges from $5929 to $18 929, varying by age and country. Therefore, as of 10 December 2014, the estimated total societal costs of all reported EVD cases in these three countries range from $82 to potentially over $356 million.

  10. The tantalum-cased tantalum capacitor

    NASA Technical Reports Server (NTRS)

    Moynihan, J. D.

    1977-01-01

    Tantalum-cased tantalum capacitors were tested with regard to temperature stability, capacitance ratio, surge current capabilities, shock, vibration, and thermal shock. They were found to be superior to the conventional wet slug tantalum capacitor cased in silver, since they are more resistant to sulfuric acid. The tantalum-cased tantalum capacitors are widely accepted for use in critical electronic equipment because of their excellent performance and reliability.

  11. 38 CFR 21.180 - Case status system.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., treatment, and other related services, the VR&E case manager will coordinate with Veterans Health... process have been completed. The case status system will: (1) Assist VR&E staff to fulfill its case... case status at each point in the rehabilitation process. (c) Case manager. The VR&E (Vocational...

  12. 38 CFR 21.180 - Case status system.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., treatment, and other related services, the VR&E case manager will coordinate with Veterans Health... process have been completed. The case status system will: (1) Assist VR&E staff to fulfill its case... case status at each point in the rehabilitation process. (c) Case manager. The VR&E (Vocational...

  13. 40 CFR 148.4 - Procedures for case-by-case extensions to an effective date.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) WATER PROGRAMS (CONTINUED) HAZARDOUS WASTE INJECTION RESTRICTIONS General § 148.4 Procedures for case-by-case extensions to an effective date. The owner or operator of a Class I hazardous waste...

  14. Characteristics of sick-listing cases that physicians consider problematic--analyses of written case reports.

    PubMed

    Engblom, Monika; Alexanderson, Kristina; Rudebeck, Carl Edvard

    2009-01-01

    The aim was to discern common characteristics in the sick-listing cases that physicians in general practice and occupational health services find problematic. Descriptive categorization within a narrative theoretical framework. Sickness-insurance course for physicians in general practice and occupational health services. A total of 195 case reports written by 195 physicians. Main outcome measures. Categories of features regarding medical, work, and social situation as well as medical interventions. Beside age and sex, the following information was often provided: family situation, stressful life events, occupation, problem at work, considerations concerning diagnoses, medical investigations, treatments, and vocational rehabilitation measures. Two-thirds of the patients had been sickness absent for more than a year. The most common type of case reports concerned women, employed in non-qualified nursing occupations, and sick listed due to mental disorders. The most common measures taken by the physicians were referrals to psychotherapy and/or physiotherapy, and prescribing antidepressants (SSRI). Facts about alcohol habits were rarely provided in the cases. Some of the circumstances, such as prolonged sick-listing, are likely to be more or less inevitable in problematic sick-listing cases. Other circumstances, such as stress-full life events, more closely reflect what the reporting physicians find problematic. The categories identified can be regarded as markers of problematic sick-listing cases in general practice and occupational health service.

  15. Ulnar nerve lesion at the wrist and sport: A report of 8 cases compared with 45 non-sport cases.

    PubMed

    Seror, P

    2015-04-01

    Reporting clinical and electrodiagnostic characteristics of sport-related ulnar neuropathies at the wrist. Eight sport-related and 45 non-sport-related cases from 53 ulnar neuropathies at the wrist cases over 14 years. Sport-related ulnar neuropathies at the wrist cases were due to cycling (5 cases), kayaking (2 cases), and big-game fishing (1 case). No patient had sensory complaints in ulnar digits, and all had motor impairment. Conduction across the wrist with recording on the first dorsal interosseous muscle was impaired in all cases, with conduction block in 5. Two cyclists showed bilateral ulnar neuropathies at the wrist. All cases recovered within 2 to 6 months with sport discontinuation. Distal lesions of the deep motor branch were more frequent in sport- than non-sport-related cases. The 8 sport-related ulnar neuropathies at the wrist cases involved the deep motor branch. Conduction study to the first dorsal interosseous muscle across the wrist is the key to electrodiagnostics. Bilateral cases in cyclists does not require wrist imaging. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. [Ectopic breast fibroadenoma. Case report].

    PubMed

    Senatore, G; Zanotti, S; Cambrini, P; Montroni, I; Pellegrini, A; Montanari, E; Santini, D; Taffurelli, M

    2010-03-01

    Among the rare anomalies of the breast development, polythelia is the most common, between 1% and 5% of women and men present supernumerary nipples. Polymastia, usually presenting as ectopic breast tissue without areola-nipple complex, is seen mostly along the milk line, extending from the axilla to the pubic region. Ectopic breast tissue is functionally analogous to mammary gland and it is subjected to the same alterations and diseases, whether benign or malignant, that affect normal breast tissue. We report the case of a 21 years-old female evaluated by the medical staff after founding a solid nodular mass by suspect axillary lymphadenopathy. Differential diagnosis with lymphoma is the major problem in these cases. The mass was removed and the intraoperative histological examination showed fibroadenoma in axillary supernumerary breast. Presence of ectopic breast tissue is a rare condition; development of benign mass or malignant degeneration is possible, but it is very unusual. In case of polymastia diagnosis is simple; in case of isolated nodule, without local inflammation or infection, there are greater difficulties. Ultrasonography is diagnostic in case of breast fibroadenoma, but it might be inadequate in ectopic localizations owing to the shortage of mammary tissue around the mass. Preoperative diagnosis is important to plan an adequate surgical treatment; lumpectomy is indicated in case of benign tissue; in case of malignancy, therapy is based on the standard treatment used for breast cancer (surgery, chemotherapy and radiation therapy).

  17. Lunar drill footplate and casing

    NASA Technical Reports Server (NTRS)

    Maassen, Erik C.; Hendrix, Thomas H.; Morrison, Eddie W.; Phillips, Rodrick B.; Le, Vu Quang; Works, Bruce A.

    1989-01-01

    To prevent hole collapse during lunar drilling operations, a casing has been devised of a graphite reinforced polyimide composite which will be able to withstand the lunar environment. Additionally, this casing will be inserted into the ground in segments two meters long which will penetrate the regolith simultaneously with the auger. The vertical action of the mobile platform will provide a downward force to the casing string through a special adaptor, giving the casing the needed impetus to sink the anticipated depth of ten meters. Casing segments will be connected with a simple snap arrangement. Excess casing will be cut off by a cylindrical cutting tool which will also transport the excess casing away from the hole. A footplate will be incorporated to grasp the auger rod string during rod segment additions or removals. The footplate grasping mechanism will consist of a set of vice-like arms, one end of each bearing threaded to a common power screw. The power screw will be threaded such that one end's thread pitch opposes that of the other end. The weight of the auger and rod string will be transmitted through the arms to the power screw and absorbed by a set of three ball bearing assemblies. The power screw will be driven by a one-half horsepower brushless motor actuated by radio control. The footplate will rest on four short legs and be anchored with pins that are an integral part of each leg.

  18. A Framework to Improve Surgeon Communication in High-Stakes Surgical Decisions: Best Case/Worst Case.

    PubMed

    Taylor, Lauren J; Nabozny, Michael J; Steffens, Nicole M; Tucholka, Jennifer L; Brasel, Karen J; Johnson, Sara K; Zelenski, Amy; Rathouz, Paul J; Zhao, Qianqian; Kwekkeboom, Kristine L; Campbell, Toby C; Schwarze, Margaret L

    2017-06-01

    Although many older adults prefer to avoid burdensome interventions with limited ability to preserve their functional status, aggressive treatments, including surgery, are common near the end of life. Shared decision making is critical to achieve value-concordant treatment decisions and minimize unwanted care. However, communication in the acute inpatient setting is challenging. To evaluate the proof of concept of an intervention to teach surgeons to use the Best Case/Worst Case framework as a strategy to change surgeon communication and promote shared decision making during high-stakes surgical decisions. Our prospective pre-post study was conducted from June 2014 to August 2015, and data were analyzed using a mixed methods approach. The data were drawn from decision-making conversations between 32 older inpatients with an acute nonemergent surgical problem, 30 family members, and 25 surgeons at 1 tertiary care hospital in Madison, Wisconsin. A 2-hour training session to teach each study-enrolled surgeon to use the Best Case/Worst Case communication framework. We scored conversation transcripts using OPTION 5, an observer measure of shared decision making, and used qualitative content analysis to characterize patterns in conversation structure, description of outcomes, and deliberation over treatment alternatives. The study participants were patients aged 68 to 95 years (n = 32), 44% of whom had 5 or more comorbid conditions; family members of patients (n = 30); and surgeons (n = 17). The median OPTION 5 score improved from 41 preintervention (interquartile range, 26-66) to 74 after Best Case/Worst Case training (interquartile range, 60-81). Before training, surgeons described the patient's problem in conjunction with an operative solution, directed deliberation over options, listed discrete procedural risks, and did not integrate preferences into a treatment recommendation. After training, surgeons using Best Case/Worst Case clearly presented a choice between

  19. The input ambiguity hypothesis and case blindness: an account of cross-linguistic and intra-linguistic differences in case errors.

    PubMed

    Pelham, Sabra D

    2011-03-01

    English-acquiring children frequently make pronoun case errors, while German-acquiring children rarely do. Nonetheless, German-acquiring children frequently make article case errors. It is proposed that when child-directed speech contains a high percentage of case-ambiguous forms, case errors are common in child language; when percentages are low, case errors are rare. Input to English and German children was analyzed for percentage of case-ambiguous personal pronouns on adult tiers of corpora from 24 English-acquiring and 24 German-acquiring children. Also analyzed for German was the percentage of case-ambiguous articles. Case-ambiguous pronouns averaged 63·3% in English, compared with 7·6% in German. The percentage of case-ambiguous articles in German was 77·0%. These percentages align with the children's errors reported in the literature. It appears children may be sensitive to levels of ambiguity such that low ambiguity may aid error-free acquisition, while high ambiguity may blind children to case distinctions, resulting in errors.

  20. Four Cases of Autochthonous Dengue Infection in Japan and 46 Imported Cases: Characteristics of Japanese Dengue.

    PubMed

    Yoshimura, Yukihiro; Sakamoto, Yohei; Amano, Yuichiro; Nakaharai, Kazuhiko; Yaita, Kenichiro; Hoshina, Tokio; Kurai, Hanako; Usuku, Shuzo; Tachikawa, Natsuo

    2015-01-01

    A dengue outbreak occurred in Japan 2014. We investigated the characteristics of dengue infection among Japanese. We investigated the medical charts retrospectively. Patients The study participants are patients who came to our clinic between 2008 and 2014. We investigated 4 domestic cases and 46 imported cases of Japanese with laboratory confirmation of dengue. Major symptoms were fever (100%), rash (86%), fatigue (84%), headache (81%), joint pain (66%), muscle pain (49%), and bleeding (6%). A late rash that appeared near the time of fever resolution was observed in 37 cases (74%). A total of 38/43 (88%) cases had low WBC count (<3,500 /μL) during the febrile period, 42/48 (88%) cases had a low platelet (PLT) count (<130×10(3)/μL), and 44/50 (88%) cases had a C-reactive protein (CRP) <2.0 mg/dL. Patients with a high fever, late rash, fever-associated leukopenia, low PLT count, low CRP, and elevated aminotransferases are generally suspected of having a dengue infection.

  1. Case Studies in Science Ethics

    NASA Astrophysics Data System (ADS)

    Williams, Karen

    2010-03-01

    Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case

  2. [Cases of strangulated obturator hernia].

    PubMed

    Chakhvadze, B; Nakashidze, D; Kashibadze, K; Beridze, A

    2010-02-01

    Obturator hernias are extremely rare in surgical practice. Only about 600 cases are described in the world medical literature. To diagnose obturator hernia is very complicated. Hernial protrusion is not often observed. The strangulation of obturator hernia is accompanied by rapidly developing symptoms of intestinal obstruction, which is usually an indication for emergency surgery. The article analyzes two clinical cases of strangulated obturator hernia and one traumatic eventration and strangulation of small intestine in the obturator ring ruined by trauma. In all cases the indication of surgery was clinical picture of a growing intestinal obstruction or acute abdomen. Only in one case, despite the prevailing clinical picture of acute intestinal obstruction in the light of anamnesis and the accompanying neurological symptoms before the operation could be suspected strangulated obturator hernia, which was confirmed during surgery. As it was mentioned above, in doubtful cases to clarify the diagnosis should be applied other methods of examination of patients, including computed tomography.

  3. Work Sharing Case Studies.

    ERIC Educational Resources Information Center

    McCarthy, Maureen E.; And Others

    Designed to provide private sector employers with the practical information necessary to select and then to design and implement work sharing arrangements, this book presents case studies of some 36 work sharing programs. Topics covered in the case studies include the circumstances leading to adoption of the program, details of compensation and…

  4. Learning the Lessons of Leadership: Case Method Teaching with Interactive Computer-Based Tools and Film-Based Cases

    DTIC Science & Technology

    2008-03-01

    report describes how the AXL system capitalizes on the best practices of traditional case method instruction and addresses some of the limitations of...system were addressed in the AXL system, producing an innovative technology solution for delivering case method instruction. Several case method best ...approaches for addressing such problems. The report also documents how case method best practices in traditional classroom environments can be translated into

  5. ASRM case insulation design and development

    NASA Astrophysics Data System (ADS)

    Bell, Matthew S.; Tam, William F. S.

    1992-10-01

    This paper describes the achievements made on the Advanced Solid Rocket Motor (ASRM) case insulation design and development program. The ASRM case insulation system described herein protects the metal case and joints from direct radiation and hot gas impingement. Critical failure of solid rocket systems is often traceable to failure of the insulation design. The wide ranging accomplishments included the development of a nonasbestos insulation material for ASRM that replaced the existing Redesigned Solid Rocket Motor (RSRM) asbestos-filled nitrile butadiene rubber (NBR) along with a performance gain of 300 pounds, and improved reliability of all the insulation joint designs, i.e., segmented case joint, case-to-nozzle and case-to-igniter joint. The insulation process development program included the internal stripwinding process. This process advancement allowed Aerojet to match to exceed the capability of other propulsion companies.

  6. ASRM case insulation design and development

    NASA Technical Reports Server (NTRS)

    Bell, Matthew S.; Tam, William F. S.

    1992-01-01

    This paper describes the achievements made on the Advanced Solid Rocket Motor (ASRM) case insulation design and development program. The ASRM case insulation system described herein protects the metal case and joints from direct radiation and hot gas impingement. Critical failure of solid rocket systems is often traceable to failure of the insulation design. The wide ranging accomplishments included the development of a nonasbestos insulation material for ASRM that replaced the existing Redesigned Solid Rocket Motor (RSRM) asbestos-filled nitrile butadiene rubber (NBR) along with a performance gain of 300 pounds, and improved reliability of all the insulation joint designs, i.e., segmented case joint, case-to-nozzle and case-to-igniter joint. The insulation process development program included the internal stripwinding process. This process advancement allowed Aerojet to match to exceed the capability of other propulsion companies.

  7. 30 CFR 250.421 - What are the casing and cementing requirements by type of casing string?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... hazards, and water depthsSet casing immediately before drilling into formations known to contain oil or..., DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations Casing and Cementing Requirements § 250.421 What are the casing and cementing...

  8. Case Report

    PubMed Central

    Naran, Sanjay; Imbriglia, Joseph E.

    2016-01-01

    Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment. Results: We document growth of the transplanted phalanges, despite surgery occurring after the reported optimum age of before 18 months, and the patient not undergoing distraction. The patient reported no donor site morbidity in regards to function or psychosocial impact. Furthermore, we observed active function at the metacarpophalangeal joints of all operated digits. Conclusions: We report the longest follow-up (35 years) following nonvascularized proximal toe phalangeal transfer for short finger type symbrachydactyly. We highlight the long-term functional outcome of nonvascularized toe phalangeal transfers, and present an overview of the current outcome literature for this type of procedure, advocating that nonvascularized toe phalangeal transfers remain a viable treatment option for select cases of symbrachydactyly. PMID:28149225

  9. Case acceptance: no random acts allowed.

    PubMed

    McAnally, James

    2009-12-01

    Consider implementing a case acceptance system in your office to fully utilize your hard-earned clinical skills, and to experience the professional rewards that come with serving more patients at a higher level. Doctors who are willing to commit the time and resources necessary to improving case acceptance will increase the number of implant cases entering the treatment phase--cases that run the gamut of complexity and support fees commensurate with their skills!

  10. Teaching Case: Enterprise Architecture Specification Case Study

    ERIC Educational Resources Information Center

    Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy

    2013-01-01

    A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…

  11. An unexpected tetanus case.

    PubMed

    Ergonul, Onder; Egeli, Demet; Kahyaoglu, Bulent; Bahar, Mois; Etienne, Mill; Bleck, Thomas

    2016-06-01

    1 million cases of tetanus are estimated to occur worldwide each year, with more than 200 000 deaths. Tetanus is a life-threatening but preventable disease caused by a toxin produced by Clostridium tetani-a Gram-positive bacillus found in high concentrations in soil and animal excrement. Tetanus is almost completely preventable by active immunisation, but very rarely unexpected cases can occur in individuals who have been previously vaccinated. We report a case of generalised tetanus in a 22-year-old woman that arose despite the protective antitoxin antibody in her serum. The patient received all her vaccinations in the USA; her last vaccination was 6 years ago. The case was unusual because the patient had received all standard vaccinations, had no defined port of entry at disease onset, and had symptoms lasting for 6 months. Tetanus can present with unusual clinical forms; therefore, the diagnosis and management of this rare but difficult disease should be updated. In this Grand Round, we review the clinical features, epidemiology, treatment, and prognosis of C tetani infections. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Vitamin B6 in Health Supplements and Neuropathy: Case Series Assessment of Spontaneously Reported Cases.

    PubMed

    van Hunsel, Florence; van de Koppel, Sonja; van Puijenbroek, Eugène; Kant, Agnes

    2018-05-08

    In the literature, vitamin B 6 has been linked to the development of polyneuropathy. Most often, these complaints were seen when taking high doses of vitamin B 6 for a long time. Evidence as to whether a lower dosage range of vitamin B 6 (< 50 mg/day) can also induce neuropathy is scarce. We aim to comprehensively describe the cases of neuropathy associated with vitamin B 6 received by the Netherlands Pharmacovigilance Centre Lareb and to assess the case series concerning the use of vitamin B 6 and neuropathic complaints. We describe the number and nature of the reported cases, including suspect product, dosage, duration of use, and vitamin B 6 serum levels. In addition, we describe the causality for the individual cases (Naranjo Probability Scale) and for the entire case series (Bradford Hill criteria). In total, 90 reports on products containing vitamin B 6 included at least one adverse drug reaction in the standardized Medical Dictionary for Regulatory Activities (MedDRA ® ) query (SMQ; broad) 'peripheral neuropathy'. The amount of vitamin B 6 in the products varied between 1.4 and 100 mg per tablet. The serum vitamin B 6 level was known in 36 cases (88-4338 nmol/l), and the mean serum vitamin B 6 level was 907 nmol/l. However, no statistical correlation between dosage and vitamin B 6 blood levels was found. Causality assessment of the case series of 90 reports to Lareb shows it is plausible for the vitamin B 6 supplements to have caused complaints such as neuropathies. This is especially the case with higher dosages and prolonged use, but dosages < 50 mg/day also cannot be excluded.

  13. The CASE Project: Evaluation of Case-Based Approaches to Learning and Teaching in Statistics Service Courses

    ERIC Educational Resources Information Center

    Fawcett, Lee

    2017-01-01

    The CASE project (Case-based Approaches to Statistics Education; see www.mas.ncl.ac.uk/~nlf8/innovation) was established to investigate how the use of real-life, discipline-specific case study material in Statistics service courses could improve student engagement, motivation, and confidence. Ultimately, the project aims to promote deep learning…

  14. Pulmonary tularaemia: all that looks like cancer is not necessarily cancer - case report of four consecutive cases.

    PubMed

    Fachinger, Patrick; Tini, Gabrielo Mauro; Grobholz, Rainer; Gambazzi, Franco; Fankhauser, Hans; Irani, Sarosh

    2015-03-26

    Pulmonary tularaemia is a very rare disease with only a small number of cases described in the literature. So far, to our knowledge, there exists no case report of pulmonary tularaemia where PET-CT scans and follow up CT scans are available. We present four consecutive cases of pulmonary tularaemia. All patients suffered from non-specific symptoms. All patients were referred to our institution with strong suspicions of malignancy, particularly lung cancer. Diagnosis of tularaemia was made by typical findings in the aspirate of EBUS guided fine needle aspiration (necrosis, epithelioid cell aggregation) and surgical biopsy respectively, and a positive serology. In three of the four cases, the diagnosis was confirmed by positive PCR results of the tissue. PET-CT scans obtained in all four cases were indistinguishable from lesions typically seen in patients suffering from lung cancer. One of the four patients suffered from recurrence of the disease after antibiotic treatment; also this patient finally recovered after initiation of a second antibiotic regimen. One case became asymptomatic spontaneously, but this patient still received an antibiotic treatment. In one case, a follow up CT scan was unchanged compared to the initial PET-CT scan; in all other cases, the lesions disappeared almost completely. Symptoms of patients suffering from pulmonary tularaemia are non-specific and can be of prolonged character. PET-CT scans in these cases are indistinguishable from lung cancer. The diagnosis can be established when typical findings in EBUS guided fine needle aspirates or surgical biopsies are found in combination with a positive serology. In most cases the lesions disappear in follow up CT scans after clinically successful treatment.

  15. Aims and harvest of moral case deliberation.

    PubMed

    Weidema, Froukje C; Molewijk, Bert A C; Kamsteeg, Frans; Widdershoven, Guy A M

    2013-09-01

    Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.

  16. [Research and control of relapse tuberculosis cases].

    PubMed

    Yamagishi, Fumio; Toyota, Makoto

    2009-12-01

    With this symposium, we focused on the relapse of tuberculosis in Japan. Out of 19,893 tuberculosis patients registered in 2007 in Japan, 7.48% were classified as relapse cases. Relapse cases have the risk of acquired drug resistance. But we have few analyses of the proportion of relapse tuberculosis cases with standard short course regimens for six months, factors contributing to tuberculosis relapse and the proportion of drug resistance among relapse TB cases in Japan. Therefore we analyzed the relapse tuberculosis cases in two rural areas and three urban areas. We also analyzed the proportion of drug resistance among relapse cases with the data of drug susceptibility survey of Ryoken. 1. Research of relapse tuberculosis cases: Makoto TOYOTA (Kochi City Public Health Center). To clarify the relapse rate and factors contributing to tuberculosis relapse, we investigated the relapse tuberculosis cases in the municipality where the proportion of elderly tuberculosis patients was high. Out of 902 tuberculosis patients registered in Kochi City Public Health Center during 10 years, 20 pulmonary tuberculosis patients were confirmed relapse cases with initial registered records. Pretreatment cavitations, sputum culture positivity at 2 months, medical miss-management (e.g. number of doses, duration of therapy) and poor adherence were considered to be factors contributing to tuberculosis relapse. Out of 20 relapse cases, 12 cases were detected with symptoms, while only 3 cases were detected by examination in law. 2. A clinical study on relapse cases of pulmonary tuberculosis: Shuichi TAKIKAWA (National Hospital Organization Nishibeppu National Hospital). The relapse of pulmonary tuberculosis was investigated. In the cases with a treatment history before short course chemotherapy, drug resistance rate was high, and thus it needs to be cautious of drug resistance at the time of the retreatment. In the cases with a treatment history of short course chemotherapy, relapse cases

  17. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series

    PubMed Central

    Patil, Shankargouda; Sarode, Gargi S.; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

    2017-01-01

    Background Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. Method A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of ‘Oral submucous fibrosis’, ‘prosthesis’, ‘dentures’ and/or ‘restricted mouth opening’. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. Results A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Conclusion Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results. PMID:28877246

  18. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

    PubMed

    Patil, Shankargouda; Sarode, Sachin Chakradhar; Sarode, Gargi S; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

    2017-01-01

    Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

  19. Qualification of the RSRM case membrane case-to-insulation bondline inspection using the Thiokol Corporation ultrasonic RSRM bondline inspection system

    NASA Technical Reports Server (NTRS)

    Cook, M.

    1990-01-01

    Qualification testing of Combustion Engineering's AMDATA Intraspect/98 Data Acquisition and Imaging System that applies to the redesigned solid rocket motor (RSRM) case membrane case-to-insulation bondline inspection was performed. Testing was performed at M-67, the Thiokol Corp. RSRM Assembly Facility. The purpose of the inspection was to verify the integrity of the case membrane case-to-insulation bondline. The case membrane scanner was calibrated on the redesigned solid rocket motor case segment calibration standard, which had an intentional 1.0 by 1.0 in. case-to-insulation unbond. The case membrane scanner was then used to scan a 20 by 20 in. membrane area of the case segment. Calibration of the scanner was then rechecked on the calibration standard to ensure that the calibration settings did not change during the case membrane scan. This procedure was successfully performed five times to qualify the unbond detection capability of the case membrane scanner.

  20. Writing a case report: polishing a gem?

    PubMed

    Papanas, N; Lazarides, M K

    2008-08-01

    Case reports describe patient cases which are of particular interest due to their novelty and their potential message for clinical practice. While there are several types of case reports, originality and clinical implications constitute the main virtues by which case reports are judged. Defining the educational message and choosing the right audience are vital steps in the process of writing. Generally, a case report is structured, its main components being the abstract, the introduction, the case description and the discussion. Guidelines and tips for writing case reports are not enough for making a successful author, but they help, especially less experienced doctors, to exercise and improve their writing. If properly prepared, case reports can still communicate new observations in an interesting and pleasant way, thereby enriching our knowledge, even in the era of evidence-based medicine.

  1. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    PubMed

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

  2. Birth outcomes of cases with conotruncal defects of heart - a population-based case-control study.

    PubMed

    Vereczkey, Attila; Kósa, Zsolt; Csáky-Szunyogh, Melinda; Gerencsér, Balázs; Czeizel, Andrew E

    2015-03-01

    The aim of this study was to evaluate the birth outcomes of cases with four types of conotruncal defects (CTDs), i.e. common truncus, transposition of great arteries, tetralogy of Fallot and double-outlet right ventricle. Birth outcomes of 597 live-born cases with CTD and 38,151 population controls without any defects were compared in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities completed by socio-demographic variables of their mothers. There was a male excess in cases with CTD (56.8%) with the same mean gestational age (39.4 versus 39.4 weeks) and preterm birth rate (8.2 versus 9.2%), but their mean birth weight was smaller (3077 versus 3276 g) with a high rate of low birthweight (14.6 versus 5.7%) compared to the birth outcomes of population controls. These data indicate intrauterine growth restriction of fetuses affected with transposition of great arteries, tetralogy of Fallot and double-outlet right ventricle particularly in females, while there were a shorter mean gestational age and smaller mean birth weigh in cases with common truncus. In general CTD, except common truncus, had no effect for gestational age but associated with a high risk for intrauterine fetal growth restriction particularly in female cases.

  3. Teaching astronomy with case studies

    NASA Astrophysics Data System (ADS)

    Slater, Timothy F.

    2015-11-01

    Breaking the students into small, collaborative learning groups to solve a meaningful task together is one of the most successful and fully evaluated teaching techniques implemented over the last century. Although there are many ways to accomplish small group learning, a long-standing and consistently successful collaborative class activity is to use the case study teaching strategy. The use of case studies is common in medical schools and law schools, but not so common in the teaching of astronomy. Case studies create meaningful conversations among students and with the professor by focusing on life-like dilemmas to be solved. Case study tasks ask audience members to synthesize several ideas or evaluate scenarios that have not been explicitly presented to them in the lecture or in available readings.

  4. Corruption case.

    PubMed

    1999-07-23

    A Federal jury in Puerto Rico found three defendants guilty of participating in the theft of $2.2 million in Federal funds from the San Juan AIDS Institute. The key figure in the case is [name removed], a consultant to the institute. He was convicted of 12 counts of money laundering and faces up to 25 years in prison. Two other administrative officials were also convicted in the case. Four others have pleaded guilty, and three more await trial. Rep. Jose Granados Navado was among those implicated; he received $100,000 for his campaign for mayor of San Juan in 1988 from the institute=s medical director. U.S. Rep. Tom Coburn (R-Okla.) has called for an audit of all Ryan White CARE Act funds since this scandal was uncovered.

  5. [Two cases of apiaceae spice allergy].

    PubMed

    Harada, Susumu; Matsunaga, Akiko; Miyachi, Rieko; Masaki, Taro; Moriyama, Tatsuya

    2007-12-01

    Many cases of spice allergy have been reported especially from Scandinavian countries, but in contrast there are few reports in Japan. This time we experienced two cases of apiaceae spice allergy and practiced some kinds of examinations. We report here these two cases with the consideration concerning mechanism of spice allergy. We practiced 1) specific IgE of pollens and foods, 2) prick tests of spices and apiaceae vesitables, 3) immunoblot of spices, against two cases suspected spice allergy from their clinical courses. Clinically Case 1 32 y.o. male had been no history of pollinosis, in contrast Case 2 46 y.o. female had been suffered from pollinosis during spring and autumn seasons. In Case 1 the scores of specific IgE of pollens were almost negative and immunoblot examination of spices revealed positive reaction at the site of 10 approximately 12 kDa and 60 kDa. In Case 2 the scores of specific IgE of pollens were positive in many species and immunoblot examination of spices reacted positively at the site of 14 kDa and 60 kDa. Both of them showed positive reactions against many kinds of apiaceae spices in prick tests, so we diagnosed them as apiaceae spice allergy. According to these results we suspected Case 1 as class 1 allergy induced by the sensitization of spices themselves and Case 2 as class 2 allergy caused by the cross reactions with pollinosis. So there may be some different mechanisms in the occurrence of spice allergy. In the future the occurrence of spice allergy will be supposed to increase and it will be necessary for us to pay much more attention to spice allergy even in Japan.

  6. Trichotillomania in a dementia case

    PubMed Central

    Caixeta, Leonardo; Lopes, Danielly Bandeira

    2011-01-01

    We report an 87-year-old male case of hair pulling associated with a white-matter vascular dementia (Binswanger’s disease). Trichotillomania in our case did not resolve using mirtazapine or anticholinesterasic medication. Trichotillomania seems to be related to a form of perseveration associated with dementia. The findings in this case suggest the abnormality involving white matter in the pathogenesis of trichotillomania, may constitute a defect in connectivity in the right frontal-subcortical circuit. PMID:29213722

  7. Chronic Tuberculous Otomastoiditis: A Case Report.

    PubMed

    Bruschini, Luca; Ciabotti, Annalisa; Berrettini, Stefano

    2016-08-01

    Worldwide, tuberculosis is a widespread disease, with 8.7 million new cases occurring annually. Its etiologic agent, Mycobacterium tuberculosis, essentially causes pneumonia. However, this organism affects the middle ear in rare cases, accounting for 0.04-0.09% of all chronic middle ear otitis cases in Western countries. In this report, we describe the case of a young woman affected by tuberculosis of the middle ear. In our experience, empiric therapy was not beneficial. Adequate treatment was possible only after obtaining a specific diagnosis through a difficult process requiring surgical sampling for culture examination. We consider surgical sampling to be mandatory in all cases of chronic otitis media that do not respond to prolonged systemic and local therapies.

  8. Boron epoxy rocket motor case program

    NASA Technical Reports Server (NTRS)

    Stang, D. A.

    1971-01-01

    Three 28-inch-diameter solid rocket motor cases were fabricated using 1/8 inch wide boron/epoxy tape. The cases had unequal end closures (4-1/8-inch-diameter forward flanges and 13-inch-diameter aft flanges) and metal attachment skirts. The flanges and skirts were titanium 6Al-4V alloy. The original design for the first case was patterned after the requirements of the Applications Technology Satellite apogee kick motor. The second and third cases were designed and fabricated to approximate the requirements of a small Applications Technology Satellite apogee kick motor. The program demonstrated the feasibility of designing and fabricating large-scale filament-wound solid propellant rocket motor cases with boron/epoxy tape.

  9. The "Reverse Case Study:" Enhancing Creativity in Case-Based Instruction in Leadership Studies

    ERIC Educational Resources Information Center

    Atkinson, Timothy N.

    2014-01-01

    In this application brief I share a case study assignment I used in my "Leadership in Complex Organizations" classes to promote creativity in problem solving. I sorted Ph.D. students into two teams and trained them to use creative writing techniques to "encode" theory into their own cases. A sense of competition emerged. Later,…

  10. Neuroblastoma-like schwannoma in a case of schwannomatosis: Report of a rare case.

    PubMed

    Sulhyan, Kalpana R; Deshmukh, Bhakti D; Gosavi, Alka V; Ramteerthakar, Nayan A

    2015-10-01

    Schwannomatosis is a term used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF2). Neuroblastoma-like schwannoma is a rare subtype of schwannoma, with histological features resembling a neuroblastoma. This case is probabaly the second case of very uncommon neuroblastoma-like schwannoma, in a patient of schwannomatosis.

  11. Four cases of vertebrobasilar insufficiency.

    PubMed

    Inui, H; Yoneyama, K; Kitaoku, Y; Nakane, M; Ohue, S; Yamanaka, T; Ueda, T; Fujita, N; Miyahara, H; Matsunaga, T

    1998-01-01

    Four cases of vertebrobasilar insufficiency are reported. Case 1 was a 38-year-old man who felt a sudden onset of dizziness when he turned his head to the back. An abnormal positional nystagmus was observed when he rotated his head to the left. A magnetic resonance angiogram (MRA) demonstrated total occlusion of the left vertebral artery (VA). Case 2 was a 31-year-old woman who had a total occlusion of her left VA as observed in the MRA. Case 3 was a 68-year-old man who noted dizziness. The systolic blood pressure change on his Schellong test was 28 mmHg. On his MRA, severe displacement of the basilar and the vertebral arteries was visible. Case 4 was a 76-year-old woman who noted a blackout-like sensation. Optokinetic nystagmus was noted with a hyponystagmus pattern, and an eye tracking test showed a saccadic pattern. On her MRA, the vertebrobasilar system was narrowed. The arterial architecture and any stenosis of the blood vessels could be detected non-invasively by MRA.

  12. Theoretical pluralism in psychoanalytic case studies.

    PubMed

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

  13. Theoretical pluralism in psychoanalytic case studies

    PubMed Central

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

  14. Variation in day-case nasal surgery - why cannot we improve our day-case rates?

    PubMed

    Hopkins, C; Browne, J; Slack, R; Brown, P

    2007-02-01

    The NHS plan states that 75% of all elective operations should be performed as day-cases. We set out to evaluate day surgery rates in sinonasal surgery and to identify factors limiting current practice. Prospective multicentre cohort study. 3128 patients undergoing sinonasal surgery during 2000 and 2001. Same day discharge, complication and readmission rates. There is potential selection bias due to the non-random selection of NHS Trusts and patients in this study. However, as results are similar to Hospital Episode Statistics data such bias is probably small. Only 15.5% of all procedures are performed as day surgery. We are achieving day-case rates of 18, 20 and 6% for nasal polypectomy, intranasal antrostomy and extensive FESS respectively, compared with recently published targets of 90%, 80% and 50%. Factors significantly associated with overnight admission were use of packs, extensive surgery, excess post-operative bleeding and high ASA grade. There was considerable unexplained variation in day-case rates and the use of packs between different surgeons. A third of consultants pack all patients post-operatively. More than 51% of consultants admit all patients, while 5% discharge all patients on the day of surgery. There were no excess adverse events or readmissions amongst the day surgery patients. However, only 17% of in-patients would have liked to be discharged on the day of surgery. Both patient and surgeon must overcome resistance to day case surgery before targets can be reached. Strategies for improving day-case rates in sinonasal surgery. All ASA grade 1 and 2 patients could be considered for day-case surgery, but particularly those with less extensive disease on radiography, and those planned to undergo less extensive procedures. Excess peri-operative bleeding was reported in 6% of patients. There must therefore be provision for overnight admission if required. Greater utilisation of day-case units, selective use of packs, and earlier removal may

  15. Real-Life Case Studies for Teachers.

    ERIC Educational Resources Information Center

    Hayes, William

    Case studies described in this book reflect conditions present in today's public schools. Situations described in these case studies are intended to introduce education students to the variety of problems existing in today's schools. The 38 case studies highlight: student cheating; teacher's observation by administrator; inclusion; contract…

  16. Comparison of sporadic cases of Salmonella Typhimurium with other Salmonella serotypes in Castellon (Spain): case-case study.

    PubMed

    Arnedo-Pena, Alberto; Vivas-Fornas, Iraya; Meseguer-Ferrer, Noemi; Tirado-Balaguer, María Dolores; Yagüe-Muñoz, Alberto; Herrera-León, Silvia; Sabater-Vidal, Susana; Romeu-García, María Ángeles; Vizcaino Batllés, Ana; Bellido-Blasco, Juan Bautista; Moreno-Muñoz, Rosario

    2017-10-07

    Salmonella infections (SI) are common in Spain. The aim of this study was to appraise risk factors and the clinical characteristics of sporadic Salmonella Typhimurium infections compared with other sporadic salmonella serotype infections (OSI). From September 2014 to August 2015, a case-case study was carried out by the Epidemiology Division of the Public Health Centre of Castellon. Case 1 consisted of patients with sporadic S. Typhimurium infections, while case 2 comprised OSI patients, assessed according to the stool cultures analyzed by the Microbiology Laboratories of Hospital General de Castellon and Hospital de La Plana in Vila-real. Patients from detected outbreaks were not included. The salmonella serotype was identified by the National Centre of Microbiology (Madrid). The total number of SI patients reported was 327, 242 of whom were studied (74.0%). 148 patients had sporadic S. Typhimurium infection and 64 had OSI, with median ages of 4 and 8.5 years, respectively. Sporadic S. Typhimurium infection patients presented more blood in feces and diarrhea episodes. Consumption of pork meat (OR=2.22; 95% CI 1.12-4.43), cold pork meats (OR=2.49; 95% CI 1.32-4.68) and playing in the dirt (OR=3.02; 95% CI 1.55-5.88), were associated with sporadic S. Typhimurium infection. In the 0-4 year-old group, the associated factors were consumption of cold pork meats, omelets and female gender. In the 5-year-old and over group, only playing in soil was associated with sporadic S. Typhimurium infection. The consumption of pork and omelets, as well as playing in the dirt, were the main factors associated with infection. Children were most affected by sporadic S. Typhimurium infection. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  17. Neuroblastoma-like schwannoma in a case of schwannomatosis: Report of a rare case

    PubMed Central

    Sulhyan, Kalpana R; Deshmukh, Bhakti D; Gosavi, Alka V; Ramteerthakar, Nayan A

    2015-01-01

    Schwannomatosis is a term used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF2). Neuroblastoma-like schwannoma is a rare subtype of schwannoma, with histological features resembling a neuroblastoma. This case is probabaly the second case of very uncommon neuroblastoma-like schwannoma, in a patient of schwannomatosis. PMID:26715928

  18. Does Case-Study Methodology Lack Rigour? The Need for Quality Criteria for Sound Case-Study Research, as Illustrated by a Recent Case in Secondary and Higher Education

    ERIC Educational Resources Information Center

    Kyburz-Graber, Regula

    2004-01-01

    There is a tendency to use case-study research methodology for research issues aiming at simply describing a complex situation, and to draw conclusions with insufficient rigour. Sound case-study research, however, follows discriminate rules which can be described in all the dimensions of a full case-study research process. This paper examines…

  19. IVHS institutional issues and case studies : ADVANCE case study

    DOT National Transportation Integrated Search

    1994-04-01

    This operational test case study is one of six performed in response to a Volpe National Transportation Systems Center technical task directive (TTD) to Science Applications International Corporation (SAIC) entitled, IVHS Institutional Issues and ...

  20. Multiple imputation of missing data in nested case-control and case-cohort studies.

    PubMed

    Keogh, Ruth H; Seaman, Shaun R; Bartlett, Jonathan W; Wood, Angela M

    2018-06-05

    The nested case-control and case-cohort designs are two main approaches for carrying out a substudy within a prospective cohort. This article adapts multiple imputation (MI) methods for handling missing covariates in full-cohort studies for nested case-control and case-cohort studies. We consider data missing by design and data missing by chance. MI analyses that make use of full-cohort data and MI analyses based on substudy data only are described, alongside an intermediate approach in which the imputation uses full-cohort data but the analysis uses only the substudy. We describe adaptations to two imputation methods: the approximate method (MI-approx) of White and Royston () and the "substantive model compatible" (MI-SMC) method of Bartlett et al. (). We also apply the "MI matched set" approach of Seaman and Keogh () to nested case-control studies, which does not require any full-cohort information. The methods are investigated using simulation studies and all perform well when their assumptions hold. Substantial gains in efficiency can be made by imputing data missing by design using the full-cohort approach or by imputing data missing by chance in analyses using the substudy only. The intermediate approach brings greater gains in efficiency relative to the substudy approach and is more robust to imputation model misspecification than the full-cohort approach. The methods are illustrated using the ARIC Study cohort. Supplementary Materials provide R and Stata code. © 2018, The International Biometric Society.

  1. Temporal Visualization for Legal Case Histories.

    ERIC Educational Resources Information Center

    Harris, Chanda; Allen, Robert B.; Plaisant, Catherine; Shneiderman, Ben

    1999-01-01

    Discusses visualization of legal information using a tool for temporal information called "LifeLines." Explores ways "LifeLines" could aid in viewing the links between original case and direct and indirect case histories. Uses the case of Apple Computer, Inc. versus Microsoft Corporation and Hewlett Packard Company to…

  2. Education for Effective Case Management Practice.

    ERIC Educational Resources Information Center

    Dickerson, Pamela S.; Mansfield, Jerry A.

    2003-01-01

    Managed care organization employees (n=115) attended case management training that included case studies, problem solving and communication skills, and focus on internal capability. Three-month follow-up showed that case managers now ask more questions, have more confidence, mentor new employees, and work with greater accuracy. (SK)

  3. 40 CFR 155.42 - Registration review cases.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

  4. 40 CFR 155.42 - Registration review cases.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

  5. 40 CFR 155.42 - Registration review cases.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

  6. 40 CFR 155.42 - Registration review cases.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

  7. 40 CFR 155.42 - Registration review cases.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Registration review cases. 155.42... REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.42 Registration review cases. (a) Establishing registration review cases. A registration review case will be composed of one or...

  8. [Surrogacy, yes or no? Case report].

    PubMed

    Pektorová, M; Ventruba, P

    2015-08-01

    Case study of surrogacy which did not come up to client-couple´s expectation. Case report. Department of Gynaecology and Obstetrics, Uherske Hradiste Hospital a. s., Uherske Hradiste. Description of the case, case study. In the Czech Republic, missing legislation when subject matter is surrogacy does not allow to make a complex legal contract. This fact causes legal uncertainty to all participants. Irresponsible approach of doctors, surrogate mother, client-couple, and in the upshot care of disabled child at government expense can be results.

  9. OMC Compressor Case

    NASA Technical Reports Server (NTRS)

    Humphrey, W. Donald

    1997-01-01

    This report summarizes efforts expended in the development of an all-composite compressor case. Two pre-production units have been built, one utilizing V-CAP and one utilizing AFR-700B resin systems. Both units have been rig tested at elevated temperatures well above design limit loads. This report discusses the manufacturing processes, test results, and Finite Element Analysis performed. The V-CAP unit was funded by NASA-Lewis Research Center in 1994 under contract number NAS3- 27442 for Development of an All-Composite OMC Compressor Case. This contract was followed by an Air Force study in 1996 to build and identical unit using the AFR-700B resin system in place of the V-CAP system. The second compressor case was funded under U.S. Air Force contract F33615-93-D-5326, Advanced Materials for Aerospace Structures Special Studies (AMAS3), Delivery Order 0021 entitled "Advanced Polymeric Composite Materials and Structures Technology for Advanced High Temperature Gas Turbine Engines.' Initial studies using the V-CAP resin system were undertaken in 1993 under a NASA Lewis contract (NAS3-26829). A first prototype unit was developed in a joint program between Textron-Lycoming (now Allied Signal) and Brunswick (now Lincoln Composites). This unit included composite end closures using low density, high temperature molded end closures. The units was similar in size and shape to a titanium case currently used on the PT-21 0 engine and was funded as part of the integrated High Performance Turbine Engine Technology (EHPTET) initiative of DOD and NASA.

  10. 45 CFR 1644.4 - Case disclosure requirement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Case disclosure requirement. 1644.4 Section 1644.4 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION DISCLOSURE OF CASE INFORMATION § 1644.4 Case disclosure requirement. (a) For each case filed in court by its...

  11. 28 CFR 2.17 - Original jurisdiction cases.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Original jurisdiction cases. 2.17 Section... Original jurisdiction cases. (a) Following any hearing conducted pursuant to these rules, the Regional Commissioner may designate that a case should be decided as an original jurisdiction case. If the Regional...

  12. An unusual case of priapism.

    PubMed Central

    Jam, M.; Datta, N. S.; Askari, A.

    1993-01-01

    A case of sickle cell disease with 63 documented episodes of priapism that were managed medically is presented. The case is very unusual because of the fact that despite so many episodes of priapism, he did not lose sexual potency. On the contrary, over a period of time, his penis hypertrophied. To the best of our knowledge, this is the first such case with so many episodes of priapism reported in the English literature. We present a hypothesis for such unusual occurrence. PMID:8366540

  13. A rare case of multiple schwannomas presenting with scrotal mass: a probable case of schwannomatosis.

    PubMed

    Ikari, Ryo; Okamoto, Keisei; Yoshida, Tetsuya; Johnin, Kazuyoshi; Okabe, Hidetoshi; Okada, Yusaku

    2010-08-01

    We report a rare case of multiple schwannomas presenting with scrotal mass. In the present case, a scrotal schwannoma developed in a 66-year-old man with a history of brain tumor surgery. Investigating the patient's past history lead to the diagnosis as probable schwannomatosis. Patients with schwannomatosis are at increased risk of developing multiple schwannomas and these patients need regular surveillance. In this regard, the present case highlights the importance of thorough history taking in patients with scrotal schwannoma.

  14. 29 CFR 1614.302 - Mixed case complaints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 4 2012-07-01 2012-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

  15. 29 CFR 1614.302 - Mixed case complaints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 4 2014-07-01 2014-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

  16. 29 CFR 1614.302 - Mixed case complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 4 2013-07-01 2013-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

  17. 29 CFR 1614.302 - Mixed case complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 4 2011-07-01 2011-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

  18. 29 CFR 1614.302 - Mixed case complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

  19. Autoerotic deaths: four cases.

    PubMed

    Cooke, C T; Cadden, G A; Margolius, K A

    1994-07-01

    We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died of ischemic heart disease, apparently whilst masturbating with a vacuum cleaner and a hair dryer.

  20. Unusual Case of Calculus in Floor of Mouth: A Case Report

    PubMed Central

    Thosar, Nilima; Jain, Eesha S

    2012-01-01

    Abstract Calculus consists of mineralized bacterial plaque that forms on the surfaces of natural teeth. It is supragingival or subgingival depending upon its relation with gingival margin. The two most common locations for supragingival calculus are the buccal surfaces of maxillary molars and lingual surfaces of mandibular anterior teeth. It is very important to rule out the predisposing factor for calculus formation. In the present case of an 11-year- old female child, 1.2 × 1.5 cm large indurated mass suggestive of calculus in the left side of floor of mouth was observed. After surgical removal, along with indurated mass, an embedded root fragment was seen. Biochemical analysis of the specimen detected the calcium and phosphate ions approximately equals to the level in calculus. Thus, we diagnosed it as a calculus. Oral hygiene instructions and regular follow-up was advised. How to cite this article: Bahadure RN, Thosar N, Jain ES. Unusual Case of Calculus in Floor of Mouth: A Case Report. Int J Clin Pediatr Dent 2012;5(3):223-225. PMID:25206174

  1. Formal Foundations for Hierarchical Safety Cases

    NASA Technical Reports Server (NTRS)

    Denney, Ewen; Pai, Ganesh; Whiteside, Iain

    2015-01-01

    Safety cases are increasingly being required in many safety-critical domains to assure, using structured argumentation and evidence, that a system is acceptably safe. However, comprehensive system-wide safety arguments present appreciable challenges to develop, understand, evaluate, and manage, partly due to the volume of information that they aggregate, such as the results of hazard analysis, requirements analysis, testing, formal verification, and other engineering activities. Previously, we have proposed hierarchical safety cases, hicases, to aid the comprehension of safety case argument structures. In this paper, we build on a formal notion of safety case to formalise the use of hierarchy as a structuring technique, and show that hicases satisfy several desirable properties. Our aim is to provide a formal, theoretical foundation for safety cases. In particular, we believe that tools for high assurance systems should be granted similar assurance to the systems to which they are applied. To this end, we formally specify and prove the correctness of key operations for constructing and managing hicases, which gives the specification for implementing hicases in AdvoCATE, our toolset for safety case automation. We motivate and explain the theory with the help of a simple running example, extracted from a real safety case and developed using AdvoCATE.

  2. Business and Consumer Education Case Studies.

    ERIC Educational Resources Information Center

    Delta Pi Epsilon, Minneapolis, Minn. Phi Chapter.

    This publication contains 58 case studies for classroom use in teaching various business and consumer education subjects at the high school level. A supplement to a previous Phi Chapter publication, "Office Education Case Studies" (1973), the case studies are intended to create class discussions and help students acquire the ability to analyze…

  3. A rare case of supraventricular tachycardia induced by Infliximab: a case report

    PubMed Central

    2009-01-01

    Background Infliximab, a chimeric monoclonal immunoglobulin antibody to tumor necrosis factor-α, has been established as a safe and effective treatment of rheumatoid arthritis, active and fistulising crohn's disease. Infliximab is generally well tolerated drug. The commonly reported cardiac side effects of Infliximab include exacerbation of congestive heart failure, hypotension and syncope. Symptomatic disorders of cardiac rhythm have been reported only rarely in few case reports and to the best of our knowledge, no tachyarrhythmia has been reported in past. Case report We report the case of a supraventricular tachycardia that occurred within three hours of Infliximab infusion in a patient with rheumatoid arthritis. Conclusion It is interesting to note that prior infusions in this patient did not precipitate similar consequences, thus, emphasising the importance of careful monitoring of patients on Infliximab therapy for possible reactions, even if prior exposures have been uneventful. PMID:19946518

  4. Construction of integrated case environments.

    PubMed

    Losavio, Francisca; Matteo, Alfredo; Pérez, María

    2003-01-01

    The main goal of Computer-Aided Software Engineering (CASE) technology is to improve the entire software system development process. The CASE approach is not merely a technology; it involves a fundamental change in the process of software development. The tendency of the CASE approach, technically speaking, is the integration of tools that assist in the application of specific methods. In this sense, the environment architecture, which includes the platform and the system's hardware and software, constitutes the base of the CASE environment. The problem of tools integration has been proposed for two decades. Current integration efforts emphasize the interoperability of tools, especially in distributed environments. In this work we use the Brown approach. The environment resulting from the application of this model is called a federative environment, focusing on the fact that this architecture pays special attention to the connections among the components of the environment. This approach is now being used in component-based design. This paper describes a concrete experience in civil engineering and architecture fields, for the construction of an integrated CASE environment. A generic architectural framework based on an intermediary architectural pattern is applied to achieve the integration of the different tools. This intermediary represents the control perspective of the PAC (Presentation-Abstraction-Control) style, which has been implemented as a Mediator pattern and it has been used in the interactive systems domain. In addition, a process is given to construct the integrated CASE.

  5. Dissecting malpractice in pancreaticoduodenectomy cases.

    PubMed

    Anandalwar, Seema P; Scholer, Anthony J; Ninan, Gigio; Oliver, Joseph B; Christian, Derick; Eloy, Jean Anderson; Chokshi, Ravi J

    2017-05-15

    Medical malpractice is a growing concern for physicians in all fields. Surgical fields have some of the highest malpractice premiums and litigation rates. Pancreaticoduodenectomy (PD) has become a popular procedure; however, it is still associated with significant morbidity and mortality. This study is the first to analyze factors involved in litigation regarding PD cases. The Westlaw database was searched for jury verdicts and settlements using the terms "medical malpractice" and "pancreaticoduodenectomy". Twenty-nine cases from 1991 to 2012 were initially collected. Seven entries not involving PD and three duplicate cases were excluded. Nineteen cases were included for analysis. Of the 19 cases included in the analysis, three (15.8%) reached a settlement, three (15.8%) were ruled in favor of the plaintiff, and 13 (68.4%) were ruled in favor of the physician. The average settlement award was $398,333 (range, $195,000-500,000), and the average plaintiff award was $4,288,869 (range, $1,066,608-10,300,000). The most common factors raised in litigation included PD being allegedly unnecessary (47.4%), followed by postoperative negligence and misdiagnosis (36.8% each). The most common factors present in litigation included the allegation that PD was unnecessarily performed. The cases that are awarded large monetary sums are those that involve continued medical care. Ways to improve patient safety and limit litigation include increasing transparency and communication with a thorough discussion between surgeon and patient of the most common topics of litigation discussed. Published by Elsevier Inc.

  6. The impact of CMSA's case management adherence guidelines and guidelines training on case manager-reported behavior change.

    PubMed

    Aliotta, Sherry L; Boling, Jeanne; Commander, Connie; Day, David; Greenberg, Liza; Lattimer, Cheri; Marshall, Danielle; Rogers, Susan A

    2007-01-01

    The Case Management Society of America (CMSA) developed evidence-based guidelines (Case Management Adherence Guidelines, CMAG) for case managers to support increased efficacy of case managers in helping patients become more adherent to medication regimens. The effort was in response to documented high levels of nonadherence, and evidence demonstrating that lack of adherence negatively impacts patient health status. The CMSA engaged in a massive training program to support case manager adoption of the CMAG tools and approaches to improve patient knowledge and motivation. This article reports on findings of a follow-up survey that evaluated case manager's use of the tools and strategies discussed in the CMAG. Seven hundred fifty case managers from all settings were trained in the use of the CMAG. In a follow-up survey, 42% of respondents reported that there has been a very, or fairly, significant impact of using their new skills to increase their effectiveness in helping patients reach their outcome improvement goals. In addition, 43% reported that there has been a very, or fairly, big improvement in patient adherence since they took the training, while 39% did not see a major impact. At the time of the survey (up to 1 year after training), 43% of respondents indicated that the training was very valuable; another 39% reported that it was fairly valuable. Participants continue to use the skills and information adopted in the training sessions: 26% report that they currently use at least some of the information and skills very often, while another 49% use them fairly often. Sixty-six percent of respondents indicated that they specifically use motivational interviewing to help address patient knowledge and motivation regarding medication adherence. Medication adherence is a key issue in case management practice; efforts to positively impact low patient knowledge and motivation can be frustration for case managers. The CMAG offer evidence-based assessment tools to

  7. 12 CFR 268.302 - Mixed case complaints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Mixed case complaints. 268.302 Section 268.302... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...

  8. 12 CFR 268.302 - Mixed case complaints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Mixed case complaints. 268.302 Section 268.302... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...

  9. 12 CFR 268.302 - Mixed case complaints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 4 2012-01-01 2012-01-01 false Mixed case complaints. 268.302 Section 268.302... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...

  10. Mesothelioma in Mongolia: case report

    PubMed Central

    Damiran, Naransukh; Davaajav, Khishigtogtokh; Erdenebayar, Erdenechimeg; Gomboloi, Burmaa; Frank, Arthur L

    2015-01-01

    Background: More than 80% of cases of mesothelioma worldwide have a history of asbestos exposure. In Mongolia, workers in coal burning thermal power plants (TPP) have widely utilized asbestos as an insulation material. Methods: We describe the case of a 47-year-old woman diagnosed with a malignant pleural mesothelioma. She worked in a TPP in Ulaanbaatar, Mongolia for 28 years. Results: A computer tomography (CT) scan showed a circumferential ring around her left lung, and tissues’ samples had a biphasic variant of mesothelioma with epithelioid and sarcomatoid components. Discussion: This is the first reported case of mesothelioma in Mongolia. We expect additional cases of mesothelioma, as well as other asbestos related diseases, will be identified in the future. In order to properly track asbestos related diseases in the country, we recommend the creation of an asbestos related disease registry. PMID:25582747

  11. ASRM Case Insulation development

    NASA Technical Reports Server (NTRS)

    Tam, W. F. S.; Bell, M.

    1993-01-01

    The ASRM Case Insulation Program used design of experiments to develop a high performance case insulation. The program traded-off more than thirty properties in areas of ablation performance, material properties, processibility, bonding/aging. Kevlar pulp was found to be the most significant factor. The low-molecular weight ethylene propylene diene monomer, EPDM was the second most significant factor. The curative was the third most significant factor. The tackifier was the fourth most significant factor. The stripwinding process for applying the insulation onto the case inner surfaces was also studied. The parameters selected for experiment were extruder speed, upper roller temperature and extruder nozzle temperature. The extrudability results showed that non-Kevlar filled formulations displayed optimum edges but poor thickness continuity. High Kevlar filled formulations displayed optimum thickness continuity but poor strip edge ratings.

  12. ASRM Case Insulation development

    NASA Astrophysics Data System (ADS)

    Tam, W. F. S.; Bell, M.

    1993-06-01

    The ASRM Case Insulation Program used design of experiments to develop a high performance case insulation. The program traded-off more than thirty properties in areas of ablation performance, material properties, processibility, bonding/aging. Kevlar pulp was found to be the most significant factor. The low-molecular weight ethylene propylene diene monomer, EPDM was the second most significant factor. The curative was the third most significant factor. The tackifier was the fourth most significant factor. The stripwinding process for applying the insulation onto the case inner surfaces was also studied. The parameters selected for experiment were extruder speed, upper roller temperature and extruder nozzle temperature. The extrudability results showed that non-Kevlar filled formulations displayed optimum edges but poor thickness continuity. High Kevlar filled formulations displayed optimum thickness continuity but poor strip edge ratings.

  13. Case Management and the Integration of Services: How Service Delivery Systems Shape Case Management.

    ERIC Educational Resources Information Center

    Moore, Stephen

    1992-01-01

    Notes that primary role that case management plays in coordination of services is determined by level of service integration and by level of resources in service delivery system. Describes conditions under which case management serves as mechanism for rationing services, marketing function, brokering function, or development role. Discusses…

  14. Mobile phone use and location of glioma: a case-case analysis.

    PubMed

    Hartikka, Hanna; Heinävaara, Sirpa; Mäntylä, Riitta; Kähärä, Veikko; Kurttio, Päivi; Auvinen, Anssi

    2009-04-01

    We assessed a new approach for evaluating the glioma risk among users of mobile phones to focus on the part of the brain most heavily exposed to radiofrequency electromagnetic fields from mobile phones. The tumor midpoint was defined from radiological imaging. A case-case analysis with 99 gliomas was performed using logistic regression. The exposed cases were those with the tumor mid-point within 4.6 cm from the line between the mouth and the external meatus of the ear, representing the most likely location of the mobile phone (the source of exposure). Alternative analyses based on various indicators of mobile phone use as the outcome were also carried out. The majority of cases were regular mobile phone users. A slightly higher proportion of gliomas among mobile phone users than non-users occurred within 4.6 cm from the presumed location of the mobile phone (28% vs. 14%). Modestly elevated odds ratios were observed for several indicators of mobile phone use, but without an exposure gradient. The highest odds ratios were found for contralateral and short-term use. Our results, though limited by the small sample size, demonstrate that detailed information on tumor location allows evaluation of the risk related to the most heavily exposed part of the brain, representing direct evaluation of the possible local carcinogenic effects of the radiofrequency fields. However, field strength varies between users and over time also within a given anatomic site, due to the output power of the phone. Collaborative analysis of a larger sample is planned. (c) 2009 Wiley-Liss, Inc.

  15. [Amyand's hernia--a clinical case].

    PubMed

    Savlovschi, C; Brănescu, C; Serban, D; Tudor, C; Găvan, C; Shanabli, A; Comandaşu, M; Vasilescu, L; Borcan, R; Dumitrescu, D; Sandolache, B; Sajin, M; Grădinaru, S; Munteanu, R; Kraft, A; Oprescu, S

    2010-01-01

    Amyand's hernia, a rare entity in the surgical pathology, presupposes the presence of the vermiform appendix inside a inguinal hernia sac (1). The hernia sac peritonitis by appendix swelling is even more rare, very few cases being presented in the surgical literature (1). The preoperatory diagnosis of Amyand's hernia is therefore very difficult. We herein present the case of a 71-year old male patient, operated on an emergency basis for hernia, which eventually turned out to be Amyand's hernia, a case which determined us to research the literature dedicated to this topic.

  16. Case Studies for Effective Business Instruction.

    ERIC Educational Resources Information Center

    McAlister-Kizzier, Donna

    This book is designed as a resource for educators who teach business content in a variety of instructional settings. It contains case studies representing all functional areas of business, including corporate training, for grades 7 through graduate education. Chapter 1 provides an overview of the case study method. The history of the case method,…

  17. [Clinal analysis of 202 nasal bone fractures cases].

    PubMed

    Zhong, Zhenhua; Fan, Xihui; Lian, Zhuang; Cheng, Zexing; Zhuang, Yuanling

    2014-12-01

    To evaluate the age, sex, etiology, diagnosis and treatment time of nasal bone fractures. Clinical data of 202 cases with nasal bone fractures treated in the hospital were retrospectively analysed. A total of 202 cases,163 men (80. 7%) and 39 women (19. 3%). Fifty-two patients had a relationship with alcohol consumption, and all of them were males. The most frequent reasons of the injury were fight 46. 5% (94 cases) followed by falling-down 21. 3% (43 cases), traffic accidents 19. 3% (39 cases), works related 6. 5% (13 cases), sport injuries 5. 9% (12 cases) and others 0. 5% (1 cases). Patients distribution in seasons were: spring 54 cases (26.7%), summer 42 cases (20.8%), autumn 58 cases (28.7%), winter 48 cases (23. 8%). Diagnosis of nasal bone fractures were made positively by x-ray films in 79. 7% of cases, but 100% by CT. Positive predictive value of CT was superior to that of X-ray films in the diagnosis of nasal bone fracture. High morbidity of nasal bone fracture was seen in the age group of 20-29 years, and predominantly in male. Fight was found to be the main etiologic factor. We think that CT is necessary for diagnosing nasal bone fracture.

  18. Teaching Business Demography Using Case Studies.

    PubMed

    Swanson, David A; Morrison, Peter A

    2010-02-01

    Many faculty members consider using case studies but not all end up using them. We provide a brief review of what cases are intended to do and identify three ways in which they can be used. We then use an example to illustrate how we have used the case study method in teaching business demography. Among other benefits, we note that the case studies method not only encourages the acquisition of skills by students, but can be used to promote "deep structure learning," an approach naturally accommodates other features associated with the case studies method-the development of critical thinking skills, the use of real world problems, the emphasis of concepts over mechanics, writing and presentation skills, active cooperative learning and the "worthwhileness" of a course. As noted by others, we understand the limitations of the case study method. However, given its strengths, we believe it has a place in the instructional toolbox for courses in business demography. The fact that courses we teach is a testament to our perceived efficacy of this tool.

  19. Qualitative Case Study Research as Empirical Inquiry

    ERIC Educational Resources Information Center

    Ellinger, Andrea D.; McWhorter, Rochell

    2016-01-01

    This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

  20. Case Study: The Chemistry of Cocaine

    ERIC Educational Resources Information Center

    Dewprashad, Brahmadeo

    2011-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

  1. Discursive Hierarchical Patterning in Economics Cases

    ERIC Educational Resources Information Center

    Lung, Jane

    2011-01-01

    This paper attempts to apply Lung's (2008) model of the discursive hierarchical patterning of cases to a closer and more specific study of Economics cases and proposes a model of the distinct discursive hierarchical patterning of the same. It examines a corpus of 150 Economics cases with a view to uncovering the patterns of discourse construction.…

  2. Avoidable costs of comprehensive case management.

    PubMed

    Issel, L M; Anderson, R A

    1999-01-01

    Comprehensive case management has become an industry standard and its pervasiveness raises questions about the ubiquitous need for this service. Analyzed from the perspective of transaction cost analysis and access, we argue that in some cases comprehensive case management is an avoidable cost incurred because of system problems that limit access to otherwise eligible clients. Implications are discussed.

  3. CASE Thriving on the Sunshine Coast

    ERIC Educational Resources Information Center

    Gordon, Neil

    2016-01-01

    Cognitive Acceleration through Science Education (CASE) on the Sunshine Coast is growing rapidly. It has expanded from one inaugural Year 8 class in 2012 to the current state of play with the involvement of over 3,000 CASE students from eleven Sunshine Coast State High Schools. It is being taught by more than seventy CASE teachers with…

  4. A Review of Case-Based Learning Practices in an Online MBA Program: A Program-Level Case Study

    ERIC Educational Resources Information Center

    Lee, Seung-hee; Lee, Jieun; Liu, Xiaojing; Bonk, Curt J.; Magjuka, Richard J.

    2009-01-01

    This study examines how a case-based learning approach was used and facilitated in online business education. Perceptions of students and instructors regarding the practices of case-based learning in online environments are explored in terms of instructional design, facilitation, and technology support. This study finds case-based learning to be a…

  5. Responding to the Increased Needs of College Students: A Case Study of Case Management

    ERIC Educational Resources Information Center

    Shelesky, Kristin; Weatherford, Ryan D.; Silbert, Janelle

    2016-01-01

    The psychological needs of college students lead to overwhelming demand on college counseling centers' resources. In this article, we review models of case management in Higher Education including the administrative, behavioral intervention, and counseling center models. We also present a case study of the 3-year development of a counseling center…

  6. [Anti-NMDA receptor encephalitis: two paediatric cases].

    PubMed

    González-Toro, M Cristina; Jadraque-Rodríguez, Rocío; Sempere-Pérez, Ángela; Martínez-Pastor, Pedro; Jover-Cerdá, Jenaro; Gómez-Gosálvez, Francisco

    2013-12-01

    Encephalitis associated to anti-N-methyl D-aspartate (NMDA) receptor antibodies is an autoimmune neurological pathology that has been reported increasingly more frequently in the paediatric population in recent years. We report two cases from our own experience with similar clinical pictures. Case 1: a 5-year-old girl who began with clinical signs and symptoms of convulsions and altered consciousness, associated to movement disorders and regression of previously acquired abilities that developed into autism. Case 2: a 13-year-old girl who presented left-side hemiparesis, abnormal movements, conduct disorder and dysautonomia. In both cases positive anti-NMDA receptor antibodies were obtained in cerebrospinal fluid and they were diagnosed with anti-NMDA receptor encephalitis. In the first case, treatment was established with intravenous perfusion of corticoids and immunoglobulins, and rituximab also had to be associated. In the second case, treatment consisted in corticoids and immunoglobulins. Progress was favourable in both cases, with a slight language disorder as a sequela in the first case and a relapse in the second case, with full resolution. Anti-NMDA receptor encephalitis is a treatable disorder and early diagnosis and treatment are crucial, since this improves the prognosis and diminishes the chances of relapses.

  7. The importance of laboratory re-evaluation in cases of suspected child abuse - A case report.

    PubMed

    Woydt, L; König, C; Bernhard, M K; Nickel, P; Dreßler, J; Ondruschka, B

    2017-09-01

    In order to accurately diagnose child abuse or neglect, a physician needs to be familiar with diseases and medical conditions that can simulate maltreatment. Unrecognized cases of abuse may lead to insufficient child protection, whereas, on the other hand, over-diagnosis could be the cause of various problems for the family and their potentially accused members. Regarding child abuse, numerous cases of false diagnoses with undetected causes of bleeding are described in the scientific literature, but, specifically concerning leukemia in childhood, only very few case reports exist. Here, for the first time, we report a case of a 2-year-old boy who got hospitalized twice because of suspicious injuries and psychosocial conspicuities, in a family situation known for repeated endangerment of the child's well-being. After his first hospitalization with injuries typical for child abuse, but without paraclinical abnormalities, medical inspections were arranged periodically. The child was hospitalized with signs of repeated child abuse again five months later. During second admission, an acute lymphoblastic leukemia was revealed by intermittent laboratory examination, ordered due to new bruises with changes in morphology, identifiable as petechial hemorrhages. This case elucidates the discussion of known cases of leukemia in childhood associated with suspected child abuse in order to provide an overview of possible diseases mimicking maltreatment. To arrange necessary supportive examinations, a skillful interaction between pediatrician and forensic pathologist is crucial in the differentiation between accidental and non-accidental injury. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Casing pipe damage detection with optical fiber sensors: a case study in oil well constructions

    NASA Astrophysics Data System (ADS)

    Zhou, Zhi; He, Jianping; Huang, Minghua; He, Jun; Ou, Jinping; Chen, Genda

    2010-04-01

    Casing pipes in oil well constructions may suddenly buckle inward as their inside and outside hydrostatic pressure difference increases. For the safety of construction workers and the steady development of oil industries, it is critically important to measure the stress state of a casing pipe. This study develops a rugged, real-time monitoring, and warning system that combines the distributed Brillouin Scattering Time Domain Reflectometry (BOTDR) and the discrete fiber Bragg grating (FBG) measurement. The BOTDR optical fiber sensors were embedded with no optical fiber splice joints in a fiber reinforced polymer (FRP) rebar and the FBG sensors were wrapped in epoxy resins and glass clothes, both installed during the segmental construction of casing pipes. In-situ tests indicate that the proposed sensing system and installation technique can survive the downhole driving process of casing pipes, withstand a harsh service environment, and remain in tact with the casing pipes for compatible strain measurements. The relative error of the measured strains between the distributed and discrete sensors is less than 12%. The FBG sensors successfully measured the maximum horizontal principal stress with a relative error of 6.7% in comparison with a cross multi-pole array acoustic instrument.

  9. [Case managers experience improved trajectories for cancer patients after implementation of the case manager function].

    PubMed

    Axelsen, Karina Rahbek; Nafei, Hanne; Jakobsen, Stine Finne; Gandrup, Per; Knudsen, Janne Lehmann

    2014-10-13

    Case managers are increasingly used to optimize trajectories for patients. This study is based on a questionnaire among case managers in cancer care, aiming at the clarification of the function and its impact on especially patient safety, when handing over the responsibility. The results show a major variation in how the function is organized, the level of competence and the task to be handled. The responsibility has in general been narrowed to department level. Overall, the case managers believe that the function has optimized pathways for cancer patients and improved safety, but barriers persist.

  10. Student-generated case reports.

    PubMed

    Good, Christopher J

    2009-01-01

    When students create teaching materials, learning can be enhanced. Therefore, a project was designed based on the traditional clinical case report and the chiropractic technique and principles curriculum at the University of Bridgeport College of Chiropractic. The objectives were to increase mastery in a clinical topic, increase awareness of different patient presentations and management options, and enhance information technology skills. Following lectures about the components of a case report and neurological reflexes related to visceral comorbidities and subluxation and joint dysfunction, students created a case report based on a template provided by the instructor. A survey gathered student perspectives on the exercise. More than 70% of the surveyed students felt the project was at least moderately helpful in improving understanding of a case report, the condition investigated, their clinical reasoning, and the ability to integrate information. Most felt that they improved their understanding of neurological reflexes, use of the literature, and the practice of evidence-based care. The majority believed that they identified weakness in knowledge, improved self-learning skills, and increased confidence in managing patients. Most enjoyed it at least somewhat and 70% agreed that the project should be continued. Many believed that they were better prepared for national boards and had improved their writing skills.

  11. Case-based fracture image retrieval.

    PubMed

    Zhou, Xin; Stern, Richard; Müller, Henning

    2012-05-01

    Case-based fracture image retrieval can assist surgeons in decisions regarding new cases by supplying visually similar past cases. This tool may guide fracture fixation and management through comparison of long-term outcomes in similar cases. A fracture image database collected over 10 years at the orthopedic service of the University Hospitals of Geneva was used. This database contains 2,690 fracture cases associated with 43 classes (based on the AO/OTA classification). A case-based retrieval engine was developed and evaluated using retrieval precision as a performance metric. Only cases in the same class as the query case are considered as relevant. The scale-invariant feature transform (SIFT) is used for image analysis. Performance evaluation was computed in terms of mean average precision (MAP) and early precision (P10, P30). Retrieval results produced with the GNU image finding tool (GIFT) were used as a baseline. Two sampling strategies were evaluated. One used a dense 40 × 40 pixel grid sampling, and the second one used the standard SIFT features. Based on dense pixel grid sampling, three unsupervised feature selection strategies were introduced to further improve retrieval performance. With dense pixel grid sampling, the image is divided into 1,600 (40 × 40) square blocks. The goal is to emphasize the salient regions (blocks) and ignore irrelevant regions. Regions are considered as important when a high variance of the visual features is found. The first strategy is to calculate the variance of all descriptors on the global database. The second strategy is to calculate the variance of all descriptors for each case. A third strategy is to perform a thumbnail image clustering in a first step and then to calculate the variance for each cluster. Finally, a fusion between a SIFT-based system and GIFT is performed. A first comparison on the selection of sampling strategies using SIFT features shows that dense sampling using a pixel grid (MAP = 0

  12. Building Physics Test Cases | Buildings | NREL

    Science.gov Websites

    building physics test cases in BESTEST-EX. In these cases, the model inputs that describe the house are programs. This diagram provides an overview of the BESTEST-EX physics case process. On the left side of the diagram is a box labeled "BESTEST-EX Document" with a list that contains two bulleted items. The

  13. An Arizona Border Wall Case Study

    DTIC Science & Technology

    2017-12-01

    WALL CASE STUDY by Justin Alexander Bristow December 2017 Thesis Advisor: Erik Dahl Second Reader: Jorge Gonzalez THIS PAGE...4. TITLE AND SUBTITLE AN ARIZONA BORDER WALL CASE STUDY 5. FUNDING NUMBERS 6. AUTHOR(S) Justin Alexander Bristow 7. PERFORMING ORGANIZATION...PAGE INTENTIONALLY LEFT BLANK iii Approved for public release. Distribution is unlimited. AN ARIZONA BORDER WALL CASE STUDY Justin Alexander

  14. Associative visual agnosia: a case study.

    PubMed

    Charnallet, A; Carbonnel, S; David, D; Moreaud, O

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

  15. [Lobular idiopathic granulomatos mastitis. About 10 cases].

    PubMed

    Hmissa, Sihem; Sahraoui, Wassila; Missaoui, Nabiha; Stita, Wided; Mokni, Moncef; Yacoubi, Mohamed T; Khairi, Hedi; Korbi, Sadok

    2006-06-01

    Our retrospective study was performed on 10 cases of granulomatous mastitis registered in Obstetric Gynaecology Department and Pathology Department of CHU F. Hached, Sousse, during 8 years period. The mean age was 36.4 years (range 32-59). Among these 10 cases. 8 were observed in reproductive-age women and 2 were noted in menopausal women. Clinical findings showed unilateral breast nodule associated with inflammatory signs in 4 cases, mammelonary retraction in 2 cases and serous or sero-purulent mamelonnary flow in 4 cases. Mamnmographic examination suggested a malignant tumor in 5 patients. In all cases, the diagnosis is made by histopathology. Surgical treatment consisted in wide excision with drainage or radical mastectomy, eventually with combination with antibiotic therapy and non steroid anti-inflammatory drugs. Prognostic features showed a good cicatrization in 4 cases, local recurrence and cutaneous fistulization in one patient. Granulomatous mastitis aetiology is still unclear, auto-immune aetio-pathogenesis appears more interesting and should be clarified.

  16. [Retrospective Analysis of 17 Family Homicide Cases].

    PubMed

    Xu, W J; Ji, P

    2016-12-01

    To summarize the characteristics of family homicide cases and to provide reference for the analysis and prevention of such cases. Seventeen solved family homicide cases in Liyang from 2004 to 2014 were investigated. The original registration information, record of scene investigation, corpse inspection report and case situation were analyzed statistically. The characteristics of the 17 family homicides cases showed that most victims were female and most suspects were male, and spouse infidelity and suspected spouse infidelity have higher proportion in the motives for the killings. Murders by patients with psychosis, camouflage murders and murder-suicides occupied a certain proportion in the family homicide cases. The family homicide cases are correlated with the family factors such as extramarital sexual intercourse and murder by patients with psychosis. Some suspects suicided after murder. The tools for committing crimes have the features of simplicity, randomness and easy source availability. Copyright© by the Editorial Department of Journal of Forensic Medicine

  17. [A case of lingual agenesis].

    PubMed

    Carinci, F; Felisatti, P; Curioni, C

    1996-01-01

    Lingual agenesis is a rare anomaly caused by failed morphogenesis of the lateral lingual swellings during embriogenesis. Most reported cases have been part of oromandibular limb hypogenesis syndrome (OLHS). A case of lingual agenesis associated with micrognathia and alteration of the hands is reported.

  18. 30 CFR 250.1608 - Well casing and cementing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... rock casing, (iv) Bobtail cap rock casing (required when the cap rock casing does not penetrate into the cap rock), (v) Second cap rock casing (brine wells), and (vi) Production liner. (2) The lessee... lessee shall initiate remedial action as approved by the District Manager. For cap rock casing, the test...

  19. 30 CFR 250.1608 - Well casing and cementing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... rock casing, (iv) Bobtail cap rock casing (required when the cap rock casing does not penetrate into the cap rock), (v) Second cap rock casing (brine wells), and (vi) Production liner. (2) The lessee... lessee shall initiate remedial action as approved by the District Manager. For cap rock casing, the test...

  20. 30 CFR 250.1608 - Well casing and cementing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... rock casing, (iv) Bobtail cap rock casing (required when the cap rock casing does not penetrate into the cap rock), (v) Second cap rock casing (brine wells), and (vi) Production liner. (2) The lessee... lessee shall initiate remedial action as approved by the District Manager. For cap rock casing, the test...

  1. A case-case study of mobile phone use and acoustic neuroma risk in Japan.

    PubMed

    Sato, Yasuto; Akiba, Suminori; Kubo, Osami; Yamaguchi, Naohito

    2011-02-01

    Results of case-control studies of mobile phone use and acoustic neuroma have been inconsistent. We conducted a case-case study of mobile phone use and acoustic neuroma using a self-administered postal questionnaire. A total of 1589 cases identified in 22 hospitals throughout Japan were invited to participate, and 787 cases (51%) actually participated. Associations between laterality of mobile phone use prior to the reference dates (1 and 5 years before diagnosis) and tumor location were analyzed. The overall risk ratio was 1.08 (95% confidence interval (CI), 0.93-1.28) for regular mobile phone use until 1 year before diagnosis and 1.14 (95% CI, 0.96-1.40) for regular mobile phone use until 5 years before diagnosis. A significantly increased risk was identified for mobile phone use for >20 min/day on average, with risk ratios of 2.74 at 1 year before diagnosis, and 3.08 at 5 years before diagnosis. Cases with ipsilateral combination of tumor location and more frequently used ear were found to have tumors with smaller diameters, suggesting an effect of detection bias. Furthermore, analysis of the distribution of left and right tumors suggested an effect of tumor-side-related recall bias for recall of mobile phone use at 5 years before diagnosis. The increased risk identified for mobile phone users with average call duration >20 min/day should be interpreted with caution, taking into account the possibilities of detection and recall biases. However, we could not conclude that the increased risk was entirely explicable by these biases, leaving open the possibility that mobile phone use increased the risk of acoustic neuroma. Copyright © 2010 Wiley-Liss, Inc.

  2. Two cases of scimitar variant.

    PubMed

    Takeda, S; Imachi, T; Arimitsu, K; Minami, M; Hayakawa, M

    1994-01-01

    The scimitar sign is characteristic of partial anomalous pulmonary venous drainage into the inferior vena cava (IVC). We encountered two variant cases of scimitar sign. In one case, the scimitar vein entered both the IVC and the left atrium (LA) without any intracardiac shunts. Surgical repair was made by simple ligation of the scimitar vein to correct the left to right shunt. Retrograde balloon occlusion angiography of the scimitar vein was diagnostic. In the other case, the scimitar vein showed a meandering course, and then drained into the LA without any connection with the IVC, and surgical intervention was not required.

  3. Literary Precocity: An Exceptional Case among Exceptional Cases.

    ERIC Educational Resources Information Center

    Edmunds, Alan L.; Noel, Kathryn A.

    2003-01-01

    This article presents the case of Geoffrey, a prolific 5-year-old writer. It examines his writing and how his intrapersonal factors and propitious environment contribute to his prodigious output. Childhood precocity is presented as an age-based comparable rather than as an adult-based predictor. A developmental theory of precocity is considered.…

  4. Performable Case Studies in Ethics Education.

    PubMed

    Robeson, Richard; King, Nancy M P

    2017-09-12

    Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

  5. [Pediatric lung lesions: a clinicopathological study of 215 cases].

    PubMed

    Niu, Huilin; Wang, Fenghua; Liu, Wei; Wang, Yong; Chen, Zhengrong; Gao, Qiu; Yi, Peng; Li, Liping; Zeng, Rongxin

    2015-09-01

    To investigate clinical and pathological features of lung lesions in children. Clinical manifestations, radiologic imaging, histopathological features and immunohistochemical results were analyzed in 215 cases of lung lesions in children. A total of 215 cases of lung lesions in children aged 0 day to 13 years (average age of 27.2 months and the median age of 18.0 months) were selected, including 137 male and 78 female patients with a male to female ratio of 1.76:1.00. The incidence of congenital lung disease was higher in patients of less than 1 year old than those of over 1 year old age, and the difference of the two groups was statistically significant (P = 0.004). 142 cases had acquired lung diseases, and 73 cases had congenital bronchopulmonary dysplasia. Lung abscess was the most common lesion seen in 86 cases (40.0%), including 1 case of fungal abscess. Congenital pulmonary airway malformation (CPAM) was the second most common, seen in 44 patients (20.5%), including 20 cases of type 1, 18 cases of type 2 and 6 cases of type 4 CPAM. Pulmonary sequestration was found in 25 cases (11.6%) including 14 cases of intralobar type and 11 cases of extralobar type. Two cases of extralobar pulmonary sequestration showed simultaneous CPAM2 type 2 lesion. Other lesions included tuberculosis (13 cases, 6.0%), emphysema (12 cases, 5.6%), interstitial pneumonia (7 cases, 3.2%), pulmonary hemorrhage (6 cases, 2.8%), bronchogenic cyst (4 cases, 1.9%), bronchiolitis obliterans (2 cases, 0.9%), idiopathic pulmonary hemosiderin deposition disease (2 cases, 0.9%) and 1 cases of lung non-specific changes. 13 cases of neoplastic lesions (6.0%) were found, of which 11 cases were primary tumors (5.1%), including inflammatory myofibroblastic tumor in 5 patients (2.3%), pleuropulmonary blastoma in 5 cases (1 case of type I, 2 type II and 2 type III) and 1 case of mucoepidermoid carcinoma (0.5%) and 2 cases of metastatic tumors (hepatoblastoma and Wilm's tumor, 0.9%). Infectious diseases

  6. Imported human rabies cases worldwide, 1990-2012.

    PubMed

    Carrara, Philippe; Parola, Phillipe; Brouqui, Phillipe; Gautret, Philippe

    2013-01-01

    Sixty cases of human rabies in international travelers were reviewed from 1990-2012. A significant proportion of the cases were observed in migrants or their descendants when emigrating from their country of origin or after a trip to visit friends and relatives or for other reasons (43.3%). The cases were not necessarily associated with long-term travel or expatriation to endemic countries; moreover, cases were observed in travelers after short trips of two weeks or less. A predominance of male patients was observed (75.0%). The proportion of children was low (11.7%). Cases from India and Philippines were frequent (16 cases/60). In a significant proportion of cases (51.1%), diagnosis was challenging, with multiple missed diagnoses and transfers from ward to ward before the final diagnosis of rabies. Among the 28 patients whose confirmed diagnosis was obtained ante-mortem, the mean time between hospitalization and diagnosis was 7.7 days (median time: 6.0 days, range 2-30) including four cases with a diagnosis delayed by 15 or more days. In five cases, a patient traveled through one or more countries before ultimately being hospitalized. Three factors played a role in delaying the diagnosis of rabies in a number of cases: (i) a low index of suspicion for rabies in countries where the disease has been eradicated for a long time or is now rare, (ii) a negative history of animal bites or exposure to rabies, and (iii) atypical clinical presentation of the disease. Clinical symptomatology of rabies is complex and commonly confuses physicians. Furthermore, failure in diagnosing imported cases in more developed countries is most likely related to the lack of medical familiarity with even the typical clinical features of the disease.

  7. Case Management: Service or Symptom?

    ERIC Educational Resources Information Center

    Netting, F. Ellen

    1992-01-01

    Provides overview of case management, its history, and contemporary models. Examines challenges that case management poses for social work profession: covering up issue that health and human services delivery system is nonsystem; maintaining client-centered perspective in cost-obsessed environment; dealing with quality control; coping with…

  8. Case Report Writing in a Doctor of Physical Therapy Education Program: A Case Study

    ERIC Educational Resources Information Center

    Fillyaw, Michael J.

    2011-01-01

    Case reports are an established form of scholarship used for teaching and learning in medicine and health care, but there are few examples of the teaching and learning activities used to prepare students to write a case report. This report describes the implementation of two courses that prepare physical therapy students to write and disseminate a…

  9. Associative Visual Agnosia: A Case Study

    PubMed Central

    Charnallet, A.; Carbonnel, S.; David, D.; Moreaud, O.

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4]. PMID:18413915

  10. Corporate Information Management: A Case Study

    DTIC Science & Technology

    1991-03-01

    SUBJECT TERMS ( FIELD GROUP SUB-GROUP ICorporate Information Management (CIM), Case study, Strategic level decision making, Department Of Defense. 19...ABSTRACT ( This thesis documents in a case format the events, environment and decisions in the genesis and evolution of the Department of Defense’s...case format the events, environment and decisions in the genesis and evolution of the Department of Defense’s Corporate Information Management

  11. [Sexual offences--selected cases].

    PubMed

    Łabecka, Marzena; Jarzabek-Bielecka, Grazyna; Lorkiewicz-Muszyńska, Dorota

    2013-04-01

    Expert testimony on violence victims also includes victims of sexual assault. The role of an expert is to classify the injuries by their severity as defined in art. 157 156 or 217 of the Criminal Code pertaining to crimes against health and life. Also, the role of an expert opinion is to determine whether the injuries identified during the exam occurred at the time and under the circumstances stated in medical history. The examination of sexual assault victims is conducted by two experts: a gynecologist and a forensic physician. Most examinations are performed at different times and various medical centers. The conclusions are presented in an official report. Regardless of victim age, all sexual crimes are investigated ex officio by the Police Department and the Prosecutor's Office. Further legal classification of criminal offenses is the task of an appropriate legal body and the offenses are codified in accordance with the provisions of chapter XXV of the Criminal Code, articles 197 - 205. In controversial cases, i.e. when two different expert opinions appear on the same case, or if, according to the law enforcement, a medical opinion is insufficient for some reason, an appropriate expert or team of experts is appointed to resolve the problem. To present selected cases of sexual violence victims treated at the Department of Gynecology and assessed at the Department of Forensic Medicine with reference to the challenges regarding qualification of the sustained injuries and clinical diagnoses. Research material included selected forensic opinions developed for law enforcement offices that involved victims of sexual violence. The expert opinions were prepared either on the basis of submitted evidence, or both, submitted evidence and examination of the victim at the Department of Forensic Medicine. Moreover the article presents a case of a patient examined and treated at the Department of Gynecology in Poznan. Based on the selected cases, the authors conclude that a

  12. Graphite oral tattoo: case report.

    PubMed

    Moraes, Renata Mendonça; Gouvêa Lima, Gabriela de Morais; Guilhermino, Marinaldo; Vieira, Mayana Soares; Carvalho, Yasmin Rodarte; Anbinder, Ana Lia

    2015-10-16

    Pigmented oral lesions compose a large number of pathological entities, including exogenous pigmentat oral tattoos, such as amalgam and graphite tattoos. We report a rare case of a graphite tattoo on the palate of a 62-year-old patient with a history of pencil injury, compare it with amalgam tattoos, and determine the prevalence of oral tattoos in our Oral Pathology Service. We also compare the clinical and histological findings of grafite and amalgam tattoos. Oral tattoos affect women more frequently in the region of the alveolar ridge. Graphite tattoos occur in younger patients when compared with the amalgam type. Histologically, amalgam lesions represent impregnation of the reticular fibers of vessels and nerves with silver, whereas in cases of graphite tattoos, this impregnation is not observed, but it is common to observe a granulomatous inflammatory response, less evident in cases of amalgam tattoos. Both types of lesions require no treatment, but in some cases a biopsy may be done to rule out melanocytic lesions.

  13. Making a Case for Case-Based Teaching in Data Literacy

    ERIC Educational Resources Information Center

    Riddle, Derek R.; Beck, Jori S.; Morgan, Joseph John; Brown, Nancy; Whitesides, Heather

    2017-01-01

    Building on a study conducted by the authors, this article provides strategies for teaching data literacy and outlines the case-based teaching method as an effective way of developing data-literate teachers.

  14. Approaches to child protection case management for cases involving people with disabilities.

    PubMed

    Lightfoot, Elizabeth B; LaLiberte, Traci L

    2006-04-01

    This exploratory study examines the delivery of child protection services by county child protection agencies involving cases with a family member with a disability. Telephone surveys were conducted with the directors or their designees of 89% of the child protection agencies in a Midwestern state. Respondents were asked about the policies and/or procedures for approaching cases involving a person with a disability and the barriers and strengths agencies have in serving people with disabilities. Only 6.7% of respondents reported their agency had a written policy related to serving persons with a disability. There were 18 different approaches to serving clients with a disability within child protection, with the most common being informally teaming for information, dual case assignment, and teaming with an outside consultant. Five counties had specialty workers who were experts in both child protection and disability. Barriers reported varied between rural and non-rural counties, with the most important barriers being lack of resources, lack of knowledge regarding disabilities, systems conflicts, and rural issues, such as lack of providers and lack of transportation. Strengths included accessing and coordinating services, individualizing services, good collaboration and creativity. While few county agencies had any written policies, both formal and informal collaboration is happening at the individual level. The lack of standardization in providing services indicates a need for more attention to issues regarding disability within child protection, including more training for workers, the development of models of collaborative case management and the removal of systemic barriers.

  15. Investigation of Energy-Efficient Supermarket Display Cases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Walker, D.H.

    Supermarkets represent one of the largest energy-intensive building groups in the commercial sector, consuming 2 to 3 million kWh/yr per store (ES-1). Over half of this energy use is for the refrigeration of food display cases and storage coolers. Display cases are used throughout a supermarket for the merchandising of perishable food products. The cases are maintained at air temperatures ranging from -10 to 35 F, depending upon the type of product stored. The operating characteristics and energy requirements of the refrigeration system are directly related to the refrigeration load. The sources of the display case refrigeration load consist of:more » (1) Moist and warm air infiltration through the open front of the case--air curtains are employed to inhibit this infiltration, but some ambient air is entrained, which adds a substantial portion to the refrigeration load. (2) Heat conduction through case panels and walls. (3) Thermal radiation from the ambient to the product and display case interior. (4) Internal thermal loads--the use of lights, evaporator fans, periodic defrosts, and antisweat heaters adds to the refrigeration load of the display case as well as directly consuming electric energy. The impact of each of these elements on the refrigeration load is very dependent upon case type (Figure ES-1). For example, air infiltration is the most significant portion of the refrigeration load for open, multi-deck cases, while radiation is the largest part of the load for tub-type cases. The door anti-sweat heaters represent a major share of the refrigeration load for frozen food door reach-in cases. Figure ES-2 shows the distribution of display cases in a typical supermarket (ES-2). Open, multi-deck, medium temperature display cases typically comprise about half of the refrigerated fixtures in a store (ES-3). In addition, medium temperature fixtures and storage coolers account for roughly 70 to 75 percent of the total store refrigeration load with open, multi

  16. Case formulation and management using pattern-based formulation (PBF) methodology: clinical case 1.

    PubMed

    Fernando, Irosh; Cohen, Martin

    2014-02-01

    A tool for psychiatric case formulation known as pattern-based formulation (PBF) has been recently introduced. This paper presents an application of this methodology in formulating and managing complex clinical cases. The symptomatology of the clinical presentation has been parsed into individual clinical phenomena and interpreted by selecting explanatory models. The clinical presentation demonstrates how PBF has been used as a clinical tool to guide clinicians' thinking, that takes a structured approach to manage multiple issues using a broad range of management strategies. In doing so, the paper also introduces a number of patterns related to the observed clinical phenomena that can be re-used as explanatory models when formulating other clinical cases. It is expected that this paper will assist clinicians, and particularly trainees, to better understand PBF methodology and apply it to improve their formulation skills.

  17. Rare case of malignant craniopharyngioma reactive to adjunctive stereotactic radiotherapy and chemotherapy; Case report and review.

    PubMed

    Nomura, Shunsunke; Aihara, Yasuo; Amano, Kosaku; Eguchi, Seiichiro; Chiba, Kentaro; Komori, Takashi; Kawamata, Takakazu

    2018-06-19

    Malignant craniopharyngioma or anaplastic craniopharyngioma was first reported in 1987 by Akachi. It has a malignant clinical and histological feature; remarkably rapid progression, atypical pathology like squamous cell carcinoma and poor prognosis. To date seventeen cases of malignant craniopharyngioma have been reported and of these cases, most were of secondary malignant tumor in nature. With respect to traditional benign craniopharyngioma, adjunctive treatment after gross total removal is not necessary, but in the case of malignant types of the tumor, adjunctive treatment is important. This paper presents the first case of malignant craniopharyngioma reactive to adjunctive Gamma knife stereotactic radiosurgery and chemotherapy. Malignant craniopharyngioma is very rare, and we report Gamma knife stereotactic radiosurgery and chemotherapy (Carboplatine and etoposide chemotherapy), as well as Temozolomide chemotherapy were effective and could control progression of the tumor temporarily. Since adjunctive Gamma knife stereotactic radiosurgery and chemotherapy of malignant craniopharyngioma cases affects follow-up strategies, we propose supporting the need to a revision to the WHO classification regarding malignancy evaluation of craniopharyngioma. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals.

    PubMed

    Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

    2017-01-01

    Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation.

  19. Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

    PubMed Central

    Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

    2017-01-01

    Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation. PMID:29046660

  20. Bakke's Case vs. the Case for Affirmative Action

    ERIC Educational Resources Information Center

    Smith, Ralph R.

    1978-01-01

    Before the Supreme Court is Allan Bakke's claim that he was denied medical school admission because 16 reserved places were granted to minority applicants. Professor Smith believes the case is weak, that admissions are best left to university discretion, and that whatever the Court renders, the questions raised by Bakke will not be put to rest.…

  1. [Case managers experience improved trajectories for cancer patients after implementation of the case manager function].

    PubMed

    Axelsen, Karina Rahbek; Nafei, Hanne; Jakobsen, Stine Finne; Gandrup, Per; Knudsen, Janne Lehmann

    2015-06-08

    Case managers are increasingly used to optimize trajectories for patients. This study is based on a questionnaire among case managers in cancer care, aiming at the clarification of the func­tion and its impact on especially patient safety, when handing over the responsibility. The results show a major variation in how the function is organized, the level of competence and the task to be handled. The responsibility has in general been nar­rowed to department level. Overall, the case managers believe that the function has optimized pathways for cancer patients and improved safety, but barriers persist.

  2. Cheilitis Glandularis: Two Case Reports of Asian-Japanese Men and Literature Review of Japanese Cases

    PubMed Central

    Yanagawa, Toru; Yamaguchi, Akira; Harada, Hiroyuki; Yamagata, Kenji; Ishibashi, Naomi; Noguchi, Masayuki; Onizawa, Kojiro; Bukawa, Hiroki

    2011-01-01

    Cheilitis glandularis (CG) is a rare disorder characterized by swelling of the lip with hyperplasia of the labial salivary glands. CG is most frequently encountered in the lower lip, in middle-aged to older Caucasian men; however Asian cases were rarely reported. In this paper we present two cases of CG in Asian-Japanese men. One was a 23-year-old male with CG of the superficial suppurative type. The other was a 54-year-old male with deep suppurative type. We also reviewed the Japanese cases of CG in the literature and discussed about clinical feature of Japanese CG. PMID:21991474

  3. Mandibular molar uprighting using mini-implants: different approaches for different clinical cases--two case reports.

    PubMed

    Derton, Nicola; Perini, Alessandro; Mutinelli, Sabrina; Gracco, Antonio

    2012-01-01

    To detail two different clinical protocols and case studies using mini-implant anchorage developed to respond to certain clinical conditions. Two clinical protocols are described to upright mesially tilted mandibular molars. In the first protocol, a single mini-implant is inserted distally to the molar to be uprighted, and an elastic traction chain is applied to the tooth. In the second clinical approach, two mini-implants are inserted mesially. A screw-suspended TMA sectional archwire is applied (Derton-Perini technique). Two cases, descriptive of the two different treatment protocols, are described. In the first case, the mandibular right second premolar was missing and the adjacent first molar needed to be uprighted. A single screw was inserted distally to the first molar, and an elastic chain was applied. In the second case, the mandibular left second molar was missing and the third molar needed to be uprighted. Two mini-implants were inserted mesially and a fully screw-supported sectional archwire was used to upright and bodily mesialize the third molar. Both uprighting approaches uprighted the molar axis without loss of anchorage. The two approaches to mandibular molar uprighting, developed as rational responses to different clinical cases, were both found to be effective.

  4. Qualitative Case Study Guidelines

    DTIC Science & Technology

    2013-11-01

    Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

  5. Dissection of the aorta in Turner syndrome: two cases and review of 85 cases in the literature

    PubMed Central

    Carlson, M; Silberbach, M

    2009-01-01

    Patients with Turner syndrome (TS) are at risk for aortic dissection, but the clinical profile for those at risk is not well described. In addition to reporting two new cases, we performed an electronic search to identify all reported cases of aortic dissection associated with TS. In total, 85 cases of aortic dissection in TS were reported between 1961 and 2006. Dissection occurred at a young age, 30.7 (range 4–64) years, which is significantly earlier than its occurrence in the general female population (68 years). Importantly, in 11% of the cases, neither hypertension nor congenital heart disease were identified, suggesting that TS alone is an independent risk factor for aortic dissection; however, the cases where no risk factors were identified were very poorly documented. A TS aortic dissection registry has been established to determine the natural history and risk factors better (http://www.turnersyndrome.org/). PMID:21731587

  6. [Management of spontaneous pneumothorax: about 138 cases].

    PubMed

    Habibi, Bouchra; Achachi, Leila; Hayoun, Sohaib; Raoufi, Mohammed; Herrak, Laila; Ftouh, Mustapha El

    2017-01-01

    Pneumothorax is a collection of air in the pleural cavity. We conducted a retrospective study of patients with spontaneous pneumothorax in the Department of Pneumology at the Ibn Sina Hospital in Rabat (2009-2011) with the aim to determine the epidemiological, clinical, radiological, therapeutic and evolutionary manifestation of spontaneous pneumothorax. The study involved 138 patients: 128 men and 10 women (17-83 years), with an average age of 44.5 +/- 17.4 years and sex ratio of 12/8. 81.2% of patients were smokers. Clinical symptomatology was chest pain (92%), dyspnea (60%). Chest radiograph showed total unilateral (110 cases); partial (10 cases); localized (6 cases); bilateral (4 cases); right (51.4%) or left (45.7%) PNO (pneumothorax). During our study period we found that 70% of patients had spontaneous primitive pneumothorax and 30% had PNO secondary to Chronic obstructive pulmonary disease (COPD) (44%) and pulmonary tuberculosis (TB) (39%). Initial management included patients hospitalization, chest drainage (95%), needle exsufflation (1%), rest and O 2 (4%). It enables the lung to stick to the chest wall within 10 days in 63% of patients. Evolution was favorable in 89% of patients. Immediate complications included: subcutaneous emphysema (5 cases); infection (6 cases) and 3 deaths (cardiorespiratory arrest). Late complications included: recurrences in 11.6%; the first recurrence occurred in 13 cases (chest drainage in 11 cases and oxygen therapy in 2 cases) while the second recurrence occurred in 3 cases (surgery). This study shows the role of chest drainage and monitoring in the management of pneumothorax to avoid complications and especially to prevent recurrences, with a possible need to resort to surgery.

  7. PathCase-SB architecture and database design

    PubMed Central

    2011-01-01

    Background Integration of metabolic pathways resources and regulatory metabolic network models, and deploying new tools on the integrated platform can help perform more effective and more efficient systems biology research on understanding the regulation in metabolic networks. Therefore, the tasks of (a) integrating under a single database environment regulatory metabolic networks and existing models, and (b) building tools to help with modeling and analysis are desirable and intellectually challenging computational tasks. Description PathCase Systems Biology (PathCase-SB) is built and released. The PathCase-SB database provides data and API for multiple user interfaces and software tools. The current PathCase-SB system provides a database-enabled framework and web-based computational tools towards facilitating the development of kinetic models for biological systems. PathCase-SB aims to integrate data of selected biological data sources on the web (currently, BioModels database and KEGG), and to provide more powerful and/or new capabilities via the new web-based integrative framework. This paper describes architecture and database design issues encountered in PathCase-SB's design and implementation, and presents the current design of PathCase-SB's architecture and database. Conclusions PathCase-SB architecture and database provide a highly extensible and scalable environment with easy and fast (real-time) access to the data in the database. PathCase-SB itself is already being used by researchers across the world. PMID:22070889

  8. Blood creatinine level in postmortem cases.

    PubMed

    Nishida, Atsushi; Funaki, Hironao; Kobayashi, Masaki; Tanaka, Yuka; Akasaka, Yoshihisa; Kubo, Toshikazu; Ikegaya, Hiroshi

    2015-05-01

    Blood chemical analysis for the diagnosis of diseases in forensic cases should be conducted in the same way as for clinical cases. However, it is sometimes difficult to obtain serum samples in forensic cases because of postmortem changes such as hemolysis and putrefaction. This study aimed to evaluate renal function in postmortem cases by blood creatinine analysis. The blood creatinine level was measured by high performance liquid chromatography (HPLC) using whole blood samples taken from 77 postmortem cases, and the relationships between blood creatinine level, postmortem interval, and cause of death were examined. The median blood creatinine level was found to be 1.15 mg/dL, with no significant differences between blood samples taken from different parts of the body. The blood creatinine level was stable for 3 days after death and gradually increased after that period, in line with a previous study using enzymatic analysis that found the serum creatinine level was stable in the early postmortem period. The blood creatinine level was high in the cases of blunt injury, intoxication, and in deaths caused by fire. This was considered to reflect acute renal dysfunction. However, the postmortem blood creatinine level remained higher than the clinical normal value despite omitting cases with renal dysfunction from the analysis. Therefore, we next investigated the change in postmortem creatinine levels in mice and found that the blood creatinine level increased with the emergence of rigor mortis. Our findings indicate that HPLC is useful in the postmortem evaluation of renal function even in the cases where serum cannot be obtained. However, the presence of rigor mortis should be considered in the evaluation of blood creatinine values. Copyright © 2014 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Rhabdomyolysis case based on hypothyroidism

    PubMed Central

    Katipoglu, Bilal; Acehan, Fatih; Meteris, Ayşenur; Yılmaz, Nisbet

    2016-01-01

    Summary Hypothyroidism is a wide clinical spectrum disorder and only a few cases in literature show this. Rhabdomyolysis and acute renal impairment can be seen concurrently in a hypothyroid state. We report a case of severe hypothyroidism with poor drug compliance leading to rhabdomyolysis and acute kidney injury. Learning points: Hypothyroidism is a rare cause of acute kidney injury. In this case report, we studied a rare occurrence of acute renal impairment due to hypothyroidism with poor drug compliance, which induced rhabdomyolysis. Our report emphasized that thyroid status should be evaluated in patients with unexplained acute renal impairment or presenting with the symptoms of muscle involvement. PMID:27855234

  10. [Extra skeletal Ewing's sarcoma. Report of two cases. Ultrastructural study of one case (author's transl)].

    PubMed

    Krulik, M; Brechot, J M; de Saint-Maur, P; Lecomte, D; Mougeot-Martin, M; Audebert, A A; Zylberait, D; Debray, J

    The authors report two cases of extra skeletal Ewing's sarcoma. The first case concerns a 26 years old woman presenting a tumor at the level of the sacrum area, locally recurrent, metastazing to the lungs and the lumbar column, despite of radiotherapy and chemotherapy and leading to death after a course of 18 months. The second one is that of a 30 years old man bearing a tumor of the shoulder area probably already metastazed to bones, rapidly recurrent and metastazing to the lungs and cause of death after 9 months in spite of intensive therapy. About these 2 observations a review of the literature of the cases of extra skeletal Ewing's sarcoma is done. Whatever nosologic discussion it seems that Ewing's sarcoma may present essentially as a tumor of soft tissues. An ultrastructural study has been performed in the second case. The findings are similar to those reported in Ewing's sarcoma.

  11. Case Report: A Case of Plasmodium falciparum hrp2 and hrp3 Gene Mutation in Bangladesh.

    PubMed

    Nima, Maisha Khair; Hougard, Thomas; Hossain, Mohammad Enayet; Kibria, Mohammad Golam; Mohon, Abu Naser; Johora, Fatema Tuj; Rahman, Rajibur; Haque, Rashidul; Alam, Mohammad Shafiul

    2017-10-01

    Several species of Plasmodium are responsible for causing malaria in humans. Proper diagnoses are crucial to case management, because severity and treatment varies between species. Diagnoses can be made using rapid diagnostic tests (RDTs), which detect Plasmodium proteins. Plasmodium falciparum causes the most virulent cases of malaria, and P. falciparum histidine-rich protein 2 (PfHRP2) is a common target of falciparum malaria RDTs. Here we report a case in which a falciparum malaria patient in Bangladesh tested negative on PfHRP2-based RDTs. The negative results can be attributed to a deletion of part of the pfhrp2 gene and frameshift mutations in both pfhrp2 and pfhrp3 gene. This finding may have implications for malaria diagnostics and case management in Bangladesh and other regions of South Asia.

  12. Measuring resistivity changes from within a first cased well to monitor fluids injected into oil bearing geological formations from a second cased well while passing electrical current between the two cased wells

    DOEpatents

    Vail, III, William B.

    1993-01-01

    A.C. current is conducted through geological formations separating two cased wells in an oil field undergoing enhanced oil recovery operations such as water flooding operations. Methods and apparatus are disclosed to measure the current leakage conducted into a geological formation from within a first cased well that is responsive to fluids injected into formation from a second cased well during the enhanced oil production activities. The current leakage and apparent resistivity measured within the first cased well are responsive to fluids injected into formation from the second cased well provided the distance of separation between the two cased wells is less than, or on the order of, a Characteristic Length appropriate for the problem.

  13. Measuring resistivity changes from within a first cased well to monitor fluids injected into oil bearing geological formations from a second cased well while passing electrical current between the two cased wells

    DOEpatents

    Vail, W.B. III.

    1993-02-16

    A.C. current is conducted through geological formations separating two cased wells in an oil field undergoing enhanced oil recovery operations such as water flooding operations. Methods and apparatus are disclosed to measure the current leakage conducted into a geological formation from within a first cased well that is responsive to fluids injected into formation from a second cased well during the enhanced oil production activities. The current leakage and apparent resistivity measured within the first cased well are responsive to fluids injected into formation from the second cased well provided the distance of separation between the two cased wells is less than, or on the order of, a Characteristic Length appropriate for the problem.

  14. Enhanced Web-Based Otitis Study Case vs Simple Paper-Case: Impact on Medical Student Objective Structured Clinical Exam (OSCE) Performance.

    PubMed

    Malloy, Michael H

    2002-12-01

    Distance education methods have taken on greater importance as medical student education has moved off campus into the community. What the best methods are for conveying information to students at distant sites has not been determined. To determine if students at distant community sites who received an otitis media study case by e-mail that was enhanced with a referral to a web-based otitis study case, performed better on otitis OSCE stations than students who received the same case not enhanced with visuals or referrals to a web-based otitis case. Students were randomized by community site to receive either the enhanced (E) or simple otitis study case (S). Students were e-mailed an otitis media study case during the 5th week of the rotation. Those randomized to the E-case received a case that started with a case scenario followed by a "Task" that instructed them to go to this web address: http://www.aap.org/otitismedia/www/vc/ear/index.cfm (American Academy of Pediatrics Otitis Web Site). They were then to select "Case 1" which was a continuation of the case scenario present on their e-mail. A list of learning objectives was also printed on the e-mail. Students receiving the S-case viewed the same case scenario and objectives, but were not instructed to go to the web-page. All students rotated through two OSCE otitis stations. In the first station they interviewed a simulated patient(OSCE-SP) and counseled her on the management of her 12 month old with otitis. Within that station they viewed a video of a pneumoscopic exam of two ears, one ear with otitis and the other ear normal. At the 2 nd otitis station the student presented the case to a faculty and was asked a series of questions about otitis media(OSCE-PR). Scores on the two stations were compared by group. There were 198 students who took the OSCE. 178 (90%) responded to a survey that indicated they had opened and read the e-mailed case. There were 87 students in the E-group and 91 in the S-group. The mean

  15. Performable Case Studies in Ethics Education

    PubMed Central

    Robeson, Richard; King, Nancy M. P.

    2017-01-01

    Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry—the creation and performance of short case studies designed specifically to raise bioethics issues for discussion—represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio. PMID:28895903

  16. [Rectovaginal endometriosis--analysis of 160 cases].

    PubMed

    Wilczyński, Miłosz; Wiecka-Płusa, Monika; Antosiak, Beata; Maciołek-Blewniewska, Grazyna; Majchrzak-Baczmańska, Dominika; Malinowski, Andrzej

    2015-12-01

    The aim of the study was a retrospective analysis of the medical records of patients who underwent surgery due to deep infiltrating rectovaginal endometriosis (mainly with the use of the 'shaving' technique). We analysed 160 cases of patients who underwent surgery due to the deep infiltrating rectovaginal endometriosis in our ward between 2003-2014. Depending on lesion localization, disease severity and clinical characteristics, three possible ways of operation were proposed: laparoscopic, vaginal or a combined vagino-laparoscopic approach. A total of 120 patients underwent laparoscopic removal of the endometrial lesions, whereas 17 were operated vaginally and 23 with the use of the combined approach. Nodule resection was successfully performed in all cases. The combined vagino-laparoscopic operations were characterized by the longest operating time. The rate of perioperative complications was low in the group of patients who underwent laparoscopic or combined operations. The necessity of bowel wall suturing occurred in 15 cases. This procedure was performed in order to strengthen the bowel wall (in cases when no perforation occurred) or due to bowel resection during surgery. Unexpected bowel perforation occurred in only 5 cases. Conclusions: Vaginal, laparoscopic and the combined vagino-laparoscopic surgeries can be safely performed in cases of deep rectovaginal endometriosis.

  17. The Case of James Leininger: An American Case of the Reincarnation Type.

    PubMed

    Tucker, Jim B

    2016-01-01

    Numerous cases of young children who report memories of previous lives have been studied over the last 50 years. Though such cases are more easily found in cultures that have a general belief in reincarnation, they occur in the West as well. This article describes the case of James Leininger, an American child who at age two began having intense nightmares of a plane crash. He then described being an American pilot who was killed when his plane was shot down by the Japanese. He gave details that included the name of an American aircraft carrier, the first and last name of a friend who was on the ship with him, and a location and other specifics about the fatal crash. His parents eventually discovered a close correspondence between James׳s statements and the death of a World War II pilot named James Huston. Documentation of James׳s statements that was made before Huston was identified includes a television interview with his parents that never aired but which the author has been able to review. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Case series: toxicity from 25B-NBOMe--a cluster of N-bomb cases.

    PubMed

    Gee, Paul; Schep, Leo J; Jensen, Berit P; Moore, Grant; Barrington, Stuart

    2016-01-01

    Background A new class of hallucinogens called NBOMes has emerged. This class includes analogues 25I-NBOMe, 25C-NBOMe and 25B-NBOMe. Case reports and judicial seizures indicate that 25I-NBOMe and 25C-NBOMe are more prevalently abused. There have been a few confirmed reports of 25B-NBOMe use or toxicity. Report Observational case series. This report describes a series of 10 patients who suffered adverse effects from 25B-NBOMe. Hallucinations and violent agitation predominate along with serotonergic/stimulant signs such as mydriasis, tachycardia, hypertension and hyperthermia. The majority (7/10) required sedation with benzodiazepines. Analytical method 25B-NBOMe concentrations in plasma and urine were quantified in all patients using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Peak plasma levels were measured between 0.7-10.1 ng/ml. Discussion The NBOMes are desired by users because of their hallucinogenic and stimulant effects. They are often sold as LSD or synthetic LSD. Reported cases of 25B- NBOMe toxicity are reviewed and compared to our series. Seizures and one pharmacological death have been described but neither were observed in our series. Based on our experience with cases of mild to moderate toxicity, we suggest that management should be supportive and focused on preventing further (self) harm. High doses of benzodiazepines may be required to control agitation. Patients who develop significant hyperthermia need to be actively managed. Conclusions Effects from 25B-NBOMe in our series were similar to previous individual case reports. The clinical features were also similar to effects from other analogues in the class (25I-NBOMe, 25C-NBOMe). Violent agitation frequently present along with signs of serotonergic stimulation. Hyperthermia, rhabdomyolysis and kidney injury were also observed.

  19. Online Learning and Teaching with Technology: Case Studies, Experience and Practice. Case Studies of Teaching in Higher Education.

    ERIC Educational Resources Information Center

    Murphy, David, Ed.; Walker, Rob, Ed.; Webb, Graham, Ed.

    This book contains case studies that look at using technology in a wide range of situations, from fully online courses to more traditional face-to-face settings. The case studies deal with issues related to student interaction, teaching and assessment, planning and development, and policy. The following case studies are included: (1) "Flame…

  20. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

    PubMed

    Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

    2017-06-01

    Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

  1. Library-ABE Projects. Case Studies.

    ERIC Educational Resources Information Center

    MacVicar, Phyllis

    This document contains 41 case studies submitted to the Appalachian Adult Education Center by the staffs of four projects demonstrating library services to disadvantaged adults, in cooperation with adult basic education programs. Included in each case study is the coping skill area in which an individual need was recognized and met through the…

  2. The Economic Case for Education

    ERIC Educational Resources Information Center

    Woessmann, Ludger

    2016-01-01

    The case for education can be made from many perspectives. This paper makes the case for education based on economic outcomes. Surveying the most recent empirical evidence, it shows the crucial role of education for individual and societal prosperity. Education is a leading determinant of economic growth, employment, and earnings in modern…

  3. 27 CFR 25.143 - Cases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Cases. 25.143 Section 25.143 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Marks, Brands, and Labels § 25.143 Cases. (a) Brewer's name. The brewer's name or...

  4. Teaching Diversity through Case Competition

    ERIC Educational Resources Information Center

    Phillips, T. Nichole; Wood, Lynette I.

    2017-01-01

    This paper shares the process and outcomes of utilizing case competitions as an approach to diversity education. A university-wide case competition was held for two consecutive years. We detail the procedure for facilitating the competition, the role of internal and external stakeholders, and student performance and feedback. It is our position…

  5. A Case Study of Engineering Ethics

    NASA Astrophysics Data System (ADS)

    Shimizu, Kazuo

    In Engineering Ethics Class at Shizuoka University, the Code of Ethics and Cases for Electrical Engineers by IEEJ Ethics committee is used to promote for high education effect to correspond large number of students (140students). In this paper, a case study in the class, and survey results for ethics value of students are presented. In addition, some comments for role playing act on the case of virtual experiences by students are described.

  6. Using the journal BMJ Case Reports to promote the publication of clinical case reports

    PubMed Central

    Montano, Blanca San José

    2016-01-01

    Objective The study updates and enhances clinicians' knowledge about clinical case reports (CCRs) and encourages publication of such articles. Methods The author developed and offered a session about BMJ Case Reports to medical and surgical departments in the University Hospital of Móstoles. The session reviewed the contents and add-on services of the journal, conventional and alternative indicators of journal quality, use of CCRs to share valuable clinical lessons, and manuscript preparation and submission. Results The main result of these sessions was submission of eight CCRs to BMJ Case Reports, of which four were accepted. One submitting author was invited to serve as peer reviewer for the journal. Other clinicians are preparing five new CCRs for submission to BMJ Case Reports or other journals. Conclusions The learning sessions were successful in promoting writing and publication of CCRs. Young staff and postgraduate residents seemed especially encouraged to publish CCRs that had already been presented in their departmental sessions. As a librarian, I gained experience in CCR publication and reinforced my position as an essential supporter of the hospital's teaching and publishing activity. PMID:27822158

  7. Case Citations 1996. Eighteenth Series (School Administrators).

    ERIC Educational Resources Information Center

    Evans, William J., Jr., Ed.

    This document contains case citations for 1996 in areas pertaining to school administration. The cases are categorized according to the topics of negligence, workers' compensation, administrator due process, discrimination against school administrators, and discrimination in hiring teachers for administrative positions. Negligence cases cover…

  8. Multiple orthokeratinized odontogenic cysts: a case report.

    PubMed

    Cheng, Yi-Shing Lisa; Liang, Hui; Wright, John; Teenier, Tom

    2015-03-01

    The purpose of this report is to document the clinical, radiographic, pathological and molecular findings of the first case of multiple orthokeratinized odontogenic cysts (OOCs). Multiple odontogenic keratocysts are one of the major features of nevoid basal cell carcinoma syndrome (NBCCS), and loss of heterozygosity in the PTCH gene, the culprit gene for NBCCS, has recently been found in sporadic OOC cases. Therefore, in this presenting case, we also investigated the possibility that this patient might also have NBCCS, by comparing the available clinical information and the molecular findings of this case to the diagnostic criteria for NBCCS (as proposed by the First International Colloquium on NBCCS in 2011). However, this patient with multiple OOCs showed no evidence of having NBCCS. This conclusion supports the findings from previous case series based on sporadic cases that OOC does not appear to be associated with NBCCS.

  9. [Writing and publication of a clinical case report].

    PubMed

    Târcoveanu, E; Roca, M; Mihăescu, T

    2011-01-01

    A case report represents a collection of detailed information about an individual patient, written with the purpose to disseminate clinical outcomes, not previously reported. Case reports provide a rich resource for teaching and research in medicine. Despite the limitation of case reports, these are useful to generate new hypothesis for future large scale clinical trials. A clinical case report should be well structured and convey a clear message. Elements of a case report are similar to all forms of medical scientific articles: title, structured abstract, introduction, case report, discussion, conclusion and references. A well written case report with literature support and a detailed description of management of the case has the greatest chances to be published. "Uniform Requirements for Manuscripts to Biomedical Journals" form the basis for most journal instructions regarding content and formatting and should be consulted when journal's instructions don't answer to author's questions. In this paper we present a case report check sheet to use as a form of self-evaluation, prior to submitting the articles.

  10. Lesions Associated With Calcium Gluconate Extravasation: Presentation of 5 Clinical Cases and Analysis of Cases Published.

    PubMed

    Pacheco Compaña, Francisco Javier; Midón Míguez, José; de Toro Santos, Francisco Javier

    2017-11-01

    Calcium gluconate extravasation is a process, which, while not common, occurs more frequently in neonatal intensive care units. The aim of this study is to present a number of cases of calcium gluconate extravasation, which have occurred in our hospital, and to carry out a review of those clinical cases published in the literature to obtain relevant epidemiological data. Data were gathered on the medical histories of 5 patients who presented lesions secondary to calcium gluconate extravasation in our center. A review of the literature was also performed to include clinical cases of calcium gluconate extravasation already published. Data were collected on 60 cases published in 37 articles. Most patients (55%) were neonates. The average age of these neonates was 8 days. The commonest location of injuries was the back of the hand and wrist (42%). The 2 most frequent symptoms were the appearance of erythema (65%) and swelling/edema (48%) followed by the appearance of skin necrosis (47%), indurated skin (33%), and yellow-white plaques or papules (33%). Most cases are cured within a period of 3 to 6 months. Fifty percent of patients required surgery, and in 13% of cases, skin grafts were performed. The most frequent histological finding was the presence of calcium deposits. Other histological findings described were the presence of necrosis, lymphohistiocytic infíltrate, and granulomas. Most histological findings were located in the dermis. Most x-rays showing calcium deposits had been performed at 3 to 4 weeks. Calcium gluconate extravasation is a process, which, although infrequent, is associated with serious skin and soft-tissue lesions, mainly affecting infants. Further studies are needed to determine possible specific procedures to be carried out in these cases.

  11. 40 CFR 260.41 - Procedures for case-by-case regulation of hazardous waste recycling activities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of hazardous waste recycling activities. 260.41 Section 260.41 Protection of Environment... Rulemaking Petitions § 260.41 Procedures for case-by-case regulation of hazardous waste recycling activities... hazardous waste recycling activities described in § 261.6(a)(2)(iii) under the provisions of § 261.6 (b) and...

  12. 40 CFR 260.41 - Procedures for case-by-case regulation of hazardous waste recycling activities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of hazardous waste recycling activities. 260.41 Section 260.41 Protection of Environment... Rulemaking Petitions § 260.41 Procedures for case-by-case regulation of hazardous waste recycling activities... hazardous waste recycling activities described in § 261.6(a)(2)(iii) under the provisions of § 261.6 (b) and...

  13. 40 CFR 260.41 - Procedures for case-by-case regulation of hazardous waste recycling activities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of hazardous waste recycling activities. 260.41 Section 260.41 Protection of Environment... Rulemaking Petitions § 260.41 Procedures for case-by-case regulation of hazardous waste recycling activities... hazardous waste recycling activities described in § 261.6(a)(2)(iii) under the provisions of § 261.6 (b) and...

  14. 40 CFR 260.41 - Procedures for case-by-case regulation of hazardous waste recycling activities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of hazardous waste recycling activities. 260.41 Section 260.41 Protection of Environment... Rulemaking Petitions § 260.41 Procedures for case-by-case regulation of hazardous waste recycling activities... hazardous waste recycling activities described in § 261.6(a)(2)(iii) under the provisions of § 261.6 (b) and...

  15. 40 CFR 260.41 - Procedures for case-by-case regulation of hazardous waste recycling activities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of hazardous waste recycling activities. 260.41 Section 260.41 Protection of Environment... Rulemaking Petitions § 260.41 Procedures for case-by-case regulation of hazardous waste recycling activities... hazardous waste recycling activities described in § 261.6(a)(2)(iii) under the provisions of § 261.6 (b) and...

  16. Putting the Learning in Case Learning? The Effects of Case-Based Approaches on Student Knowledge, Attitudes, and Engagement

    ERIC Educational Resources Information Center

    Krain, Matthew

    2016-01-01

    This study revisits case learning's effects on student engagement and assesses student learning as a result of the use of case studies and problem-based learning. The author replicates a previous study that used indirect assessment techniques to get at case learning's impact, and then extends the analysis using a pre- and post-test experimental…

  17. CASE Annual Fund Ideas. The Best of CASE Currents.

    ERIC Educational Resources Information Center

    Carter, Virginia L., Ed.

    Fund raising ideas for colleges and universities are compiled in a handbook of articles from "CASE Currents." The first section discusses the annual fund drive in such articles as: "Start that Habit Early--Senior Giving '5X'" (Lynn Segall); "Join Hands with Lost Friends" (Jeanne Knoerle); "Match Those…

  18. A rare case of dedifferentiated liposarcoma of the sinonasal cavity: A case report.

    PubMed

    Miyazaki, Masaru; Aoki, Mikiko; Oba, Satoru; Sakata, Toshifumi; Nakagawa, Takashi; Nabeshima, Kazuki

    2017-10-01

    Sarcoma is an uncommon histopathological presentation of sinonasal tumors, comprising ~15% of all cases; liposarcoma is particularly uncommon. An analysis of the available medical literature revealed no prior reports of dedifferentiated liposarcoma (DDLPS) of the sinonasal cavity. This case report presents a rare case of DDLPS of the sinonasal cavity. A 40-year old six-week pregnant female was admitted with a left nasal obstruction. Endoscopic evaluation of the left nasal cavity revealed a polypoid lesion. A computed tomography scan indicated a mass invading the left nasal cavity, maxillary sinus and anterior ethmoid sinus with focal destruction of the surrounding bone. A biopsy of the tumor was performed and hematoxylin and eosin staining of the tissue sections revealed proliferation of atypical and pleomorphic spindle cells with enlarged or elongated hyperchromatic nuclei and occasional vacuolated cytoplasm arranged in short interlacing fascicles or storiform structures, accompanied by tumor necrosis. These findings were consistent with undifferentiated pleomorphic sarcoma. Immunohistochemically, the tumor cells were positive for cyclin dependent kinase 4, mouse double minute 2 homolog (MDM2) and adipophilin. Fluorescence in situ hybridization (FISH) analysis revealed amplification of the MDM2 gene. Recently, undifferentiated pleomorphic sarcoma without areas of well-differentiated liposarcoma but with MDM2 amplification is regarded as conventional DDLPS. In the present case, the tumor was diagnosed as a DDLPS due to the results of histopathological, immunohistochemical and FISH analysis.

  19. Triazolam blood concentrations in forensic cases in Canada.

    PubMed

    Joynt, B P

    1993-01-01

    Triazolam has been a controversial drug since its appearance on world markets as a hypnotic more than ten years ago. Whole blood concentrations of triazolam as found in forensic cases are cited in several categories; that is, impaired driving: 17 cases; sexual assault: four cases; death due to drugs: 45 cases; drug-related death (drugs contributed to the death but were not the ultimate cause): 20 cases; drug-involved death (drugs were present but were not felt to be a contributing factor): six cases; miscellaneous: one case. The data was gleaned from a forensic toxicology database designed and used by the Forensic Toxicology Sections of the Royal Canadian Mounted Police (RCMP) laboratories in Canada. Triazolam concentrations from selected references are included for comparison.

  20. The wavefield of acoustic logging in a cased-hole with a single casing - Part I: a monopole tool

    NASA Astrophysics Data System (ADS)

    Wang, Hua; Fehler, Michael

    2018-01-01

    The bonding quality of the seal formed by the cement or collapse material between casing and formation rock is critical for the hydraulic isolation of reservoir layers with shallow aquifers, production and environmental safety, and plug and abandonment issues. Acoustic logging is a very good tool for evaluating the condition of the bond between different interfaces. The understanding of the acoustic logging wavefields in wells with single casing is still incomplete. We use a 3-D finite difference method to simulate wireline monopole wavefields in a single cased borehole with different bonding conditions at two locations: (1) between the cement and casing and (2) between the cement and formation. Pressure snapshots and waveforms for different models are shown, which allow us to better understand the wave propagation. Modal dispersion curves and data processing methods such as velocity-time semblance and dispersion analysis facilitate the identification of propagation modes in the different models. We find that the P wave is submerged in the casing modes and the S wave has poor coherency when the cement is replaced with fluid. The casing modes are strong when cement next to the casing is partially or fully replaced with fluid. The amplitude of these casing modes can be used to determine the bonding condition of the interface between casing and cement. However, the limited variation of the amplitude with fluid thickness means that amplitude measurements may lead to an ambiguous interpretation. When the cement next to the formation is partially replaced with fluid, the modes propagate in the combination of steel casing and cement and the velocities are highly dependent on the cement thickness. However, if the cement thickness is large (more than 2/3 of the annulus between casing and rock), the arrival time of the first arrival approximates that of the formation compressional wave when cement is good. It would highly likely that an analyst could misjudge cement quality

  1. Methodology Series Module 2: Case-control Studies.

    PubMed

    Setia, Maninder Singh

    2016-01-01

    Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

  2. Methodology Series Module 2: Case-control Studies

    PubMed Central

    Setia, Maninder Singh

    2016-01-01

    Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias. PMID:27057012

  3. Defining travel-associated cases of enteric fever.

    PubMed

    Freedman, Joanne; Lighton, Lorraine; Jones, Jane

    2014-01-01

    There is no internationally recognized case-definition for travel-associated enteric fever in non-endemic countries. This study describes the patterns of case reporting between 2007 and 2011 as travel-associated or not from the surveillance data in England, Wales and Northern Ireland (EWNI), before and after a change in the time component of the case-definition in January 2011. It examines in particular the role of a time frame based on the reported typical incubation period in defining a case of travel-associated enteric fever. The results showed no significant differences in the distribution of cases of enteric fever in regards to the interval between the onset and UK arrival in 2011 compared to 2007-2010 (p=0.98 for typhoid and paratyphoid A); the distribution for paratyphoid B was also similar in both time periods. During 2007-2010, 93% (1730/1853) of all of the cases were classified as travel-associated compared to 94% (448/477) in 2011. This difference was not statistically significant. Changing the time component of the definition of travel-associated enteric fever did not make a significant difference to the proportion of travel-associated cases reported by investigators. Our analysis suggests that time might be subordinate to other considerations when investigators classify a case as travel-associated. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  4. Hearing impairment associated with oral terbinafine use: a case series and case/non-case analysis in the Netherlands Pharmacovigilance Centre Lareb database and VigiBase™.

    PubMed

    Scholl, Joep H G; van Puijenbroek, Eugene P

    2012-08-01

    The Netherlands Pharmacovigilance Centre Lareb received reports of six cases of hearing impairment in association with oral terbinafine use. This study describes these cases and provides support for this association from the Lareb database for spontaneous adverse drug reaction (ADR) reporting and from Vigibase™, the ADR database of the WHO Collaborating Centre for International Drug Monitoring, the Uppsala Monitoring Centre. The objective of the current study was to identify whether the observed association between oral terbinafine use and hearing impairment, based on cases received by Lareb, constitutes a safety signal. Cases of hearing impairment in oral terbinafine users are described. In a case/non-case analysis, the strength of the association in Vigibase™ and the Lareb database was determined (date of analysis August 2011) by calculating the reporting odds ratios (RORs), adjusted for possible confounding by age, sex and ototoxic concomitant medication. For the purpose of this study, RORs were calculated for deafness, hypoacusis and the combination of both, defined as hearing impairment. In the Lareb database, six reports concerning individuals aged 31-82 years, who developed hearing impairment after starting oral terbinafine, were present. The use of oral terbinafine was disproportionally associated with hypoacusis in both the Lareb database (adjusted ROR 3.9; 95% CI 1.7, 9.0) and in Vigibase™ (adjusted ROR 1.7; 95% CI 1.0, 2.8). Deafness was not disproportionally present in either of the databases. Based on the described cases and the statistical analyses from both databases, a causal relationship between the use of oral terbinafine and hearing impairment is possible. The mechanism by which terbinafine could cause hearing impairment has not been elucidated yet. The pharmacological action of terbinafine is based on the inhibition of squalene epoxidase, an enzyme present in both fungal and human cells. This inhibition might result in a decrease in

  5. Analyzing self-controlled case series data when case confirmation rates are estimated from an internal validation sample.

    PubMed

    Xu, Stanley; Clarke, Christina L; Newcomer, Sophia R; Daley, Matthew F; Glanz, Jason M

    2018-05-16

    Vaccine safety studies are often electronic health record (EHR)-based observational studies. These studies often face significant methodological challenges, including confounding and misclassification of adverse event. Vaccine safety researchers use self-controlled case series (SCCS) study design to handle confounding effect and employ medical chart review to ascertain cases that are identified using EHR data. However, for common adverse events, limited resources often make it impossible to adjudicate all adverse events observed in electronic data. In this paper, we considered four approaches for analyzing SCCS data with confirmation rates estimated from an internal validation sample: (1) observed cases, (2) confirmed cases only, (3) known confirmation rate, and (4) multiple imputation (MI). We conducted a simulation study to evaluate these four approaches using type I error rates, percent bias, and empirical power. Our simulation results suggest that when misclassification of adverse events is present, approaches such as observed cases, confirmed case only, and known confirmation rate may inflate the type I error, yield biased point estimates, and affect statistical power. The multiple imputation approach considers the uncertainty of estimated confirmation rates from an internal validation sample, yields a proper type I error rate, largely unbiased point estimate, proper variance estimate, and statistical power. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. [Listeriosis in pregnancy--case report].

    PubMed

    Barlik, Magdalena; Seremak-Mrozikiewicz, Agnieszka; Drews, Krzysztof

    2014-04-01

    Listeriosis is a rather rare infectious disease but its incidence in pregnancy is over 20 times higher than in the general population. Pregnant women with listeriosis comprise one-third of all listeriosis cases. Listeriosis is a foodborne disease. Sporadic as well as epidemic cases of listeriosis are usually related to contaminated processed food, especially meat dishes served in fast-food restaurants and dairy products. Pregnant women are at an increased risk for listeriosis infection. Unfortunately the symptoms are not specific and the diagnosis presents a considerable challenge. Although the literature offers some case reports on a complicated course of listeriosis during pregnancy the infection usually runs a mild course in pregnant women. Regardless, fetal or neonatal infection is related to very high risk of lethal complications in the newborn, among others: sepsis, meningitis or pneumonia. In this paper we present a case of a 28-year-old gravida with listeriosis. We described the course of the infection, diagnostic process and treatment in both, the mother and the newborn.

  7. The Strange Case of Emil Rupp

    NASA Astrophysics Data System (ADS)

    French, A. P.

    1999-03-01

    Physics has seldom had to deal with claims of alteration or fabrication of data, such as have troubled biological and medical research in recent years. The case of Emil Rupp in the 1930s was, however, a notable exception. The present paper revisits this case, adding in certain areas to earlier accounts of Rupp and his work. The case is not without significance, because Rupp's publications carried considerable weight during a historically important era of 20th-century physics.

  8. Research misconduct oversight: defining case costs.

    PubMed

    Gammon, Elizabeth; Franzini, Luisa

    2013-01-01

    This study uses a sequential mixed method study design to define cost elements of research misconduct among faculty at academic medical centers. Using time driven activity based costing, the model estimates a per case cost for 17 cases of research misconduct reported by the Office of Research Integrity for the period of 2000-2005. Per case cost of research misconduct was found to range from $116,160 to $2,192,620. Research misconduct cost drivers are identified.

  9. Using Design Thinking to Write and Publish Novel Teaching Cases: Tips from Experienced Case Authors

    ERIC Educational Resources Information Center

    Sheehan, Norman T.; Gujarathi, Mahendra R.; Jones, Joanne C.; Phillips, Fred

    2018-01-01

    With increasing calls for a greater connection between management education and practice, teaching cases play a vital role in the business curriculum. Cases not only allow instructors to expose students to practical problems but also let educators contribute to the scholarship of teaching and learning. An important reason why faculty members may…

  10. Case Studies Nested in Fuzzy-Set QCA on Sufficiency: Formalizing Case Selection and Causal Inference

    ERIC Educational Resources Information Center

    Schneider, Carsten Q.; Rohlfing, Ingo

    2016-01-01

    Qualitative Comparative Analysis (QCA) is a method for cross-case analyses that works best when complemented with follow-up case studies focusing on the causal quality of the solution and its constitutive terms, the underlying causal mechanisms, and potentially omitted conditions. The anchorage of QCA in set theory demands criteria for follow-up…

  11. Case-Based Instruction: Improving Students' Conceptual Understanding through Cases in a Mechanical Engineering Course

    ERIC Educational Resources Information Center

    Yadav, Aman; Vinh, Megan; Shaver, Gregory M.; Meckl, Peter; Firebaugh, Stephanie

    2014-01-01

    Recently, there has been a push within engineering curricula to adopt more learner-centered pedagogies, such as case-based instruction. Case-based instruction has been hypothesized to make the curriculum more relevant and motivating for students by pushing them to integrate the concepts they have learned with other experiences. The current study…

  12. The Barnes case: taking difficult futility cases public.

    PubMed

    Mickelsen, Ruth A; Bernstein, Daniel S; Marshall, Mary Faith; Miles, Steven H

    2013-01-01

    Futility disputes are increasing and courts are slowly abandoning their historical reluctance to engage these contentious issues, particularly when confronted with inappropriate surrogate demands for aggressive treatment. Use of the judicial system to resolve futility disputes inevitably brings media attention and requires clinicians, hospitals, and families to debate these deep moral conflicts in the public eye. A recent case in Minnesota, In re Emergency Guardianship of Albert Barnes, explores this emerging trend and the complex responsibilities of clinicians and hospital administrators seeking to replace an unfaithful surrogate demanding aggressive therapy. Use of the courts requires the coordinated commitment of significant institutional resources, management of intense media scrutiny and individual and organizational courage to enter the unpredictable world of litigation. Given the dearth of legislative guidance on medical futility, individual clinicians and institutions will continue to bear the difficult responsibility for resolution of individual futility disputes. The Barnes case illustrates how one institution successfully used the judicial system to replace an unfaithful surrogate, cease the provision of inappropriate aggressive care, and stimulate a community dialogue about appropriate care at the end of life. © 2013 American Society of Law, Medicine & Ethics, Inc.

  13. Using Case Studies to Enrich Field Experience.

    ERIC Educational Resources Information Center

    Florio-Ruane, Susan; Clark, Christopher M.

    1990-01-01

    This paper discusses the use of field experience in teacher education and how it can be augmented by phenomenological case studies. It summarizes a particular case study involving three teacher education classes, noting that reflective analysis of cases can prepare students to observe in the field. (SM)

  14. Obsessional Slowness in College Students: Case Studies

    ERIC Educational Resources Information Center

    Johnson, Aleta

    2014-01-01

    Cases of obsessional slowness, a variant of obsessive compulsive disorder, have been documented in case literature regarding relatively low functioning populations. However, obsessional slowness can also present in higher functioning populations, including college and graduate students, as illustrated here by three case examples from a competitive…

  15. Testicular tumours in prepubertal children: About eight cases.

    PubMed

    Khemakhem, Rachid; Ahmed, Yosra Ben; Jlidi, Said; Nouira, Faouzi; Fdhila, Faten; Charieg, Awatef; Ghorbel, Sofiene; Barsaoui, Sihem; Chaouachi, Béji

    2013-01-01

    To analyze the spectrum of testicular tumors in prepubertal children and the therapeutic resultants in an unselected population. Our hospital database was analyzed for testicular tumors from January 1995 to December 2010 concerning clinical presentation, treatment and therapeutic results. Eight patients were operated on because of testicular tumors. In six cases (75%) the tumor was benign: benign teratoma (four cases), epidermoid cyst (one case) and immature teratoma (one case). Two patients (25%) had a malignant tumour: yolk-sac tumour (two cases). All this children underwent surgery. Radical inguinal orchidectomy was performed in six cases and conservative surgery was performed in two cases. One patient has received adjuvant chemotherapy. Follow-up was uneventfully three years after primary surgery. In prepubertal children, most testicular tumours are benign. If tumour markers were negative testis-preserving surgery can be proposed, complete excision of the tumour should be ascertained. In the case of testicular teratoma, the possibility of contralateral tumour should be considered in the follow-up.

  16. Grindability of alpha-case formed on cast titanium.

    PubMed

    Koike, Marie; Jacobson, David; Chan, Kwai S; Okabe, Toru

    2009-09-01

    The hardened alpha-case (alpha-case) layer inevitably forms on the surface of titanium castings when prepared by investment casting. Because the hardness of the alpha-case is incomparable to that of the interior structure, the perception exists that the alpha-case is difficult to remove during cutting, grinding and polishing. Grindability (ease of grinding) of cast cpTi and cast Ti-6Al-4V was evaluated by grinding cast specimens incrementally using a SiC abrasive wheel. The present study revealed that the presence of the brittle alpha-case with lower fracture toughness is beneficial in grinding titanium. The alpha-case on the ductile cpTi can be ground much easier than its bulk interior structure. In less ductile Ti-6Al-4V, the grinding rate is much higher than that of cpTi, and the alpha-case and its interior structure are at similar levels since the fracture toughness of its alpha-case and the bulk material is not large enough.

  17. [Early congenital syphilis: a case report].

    PubMed

    Cavagnaro S M, Felipe; Pereira R, Teresita; Pérez P, Carla; Vargas Del V, Fernanda; Sandoval C, Carmen

    2014-02-01

    Congenital syphilis (CS) is a multisystemic infection of the newborn (NB) which can produce severe symptoms, and in some cases, even be fatal. In recent years, the incidence of syphilis has increased worldwide and similarly, the cases of CS in neonates have increased. To report two cases of early and severe presentation of CS, focusing on the importance of prevention of vertical transmission and monitoring of treated mothers. The diagnostic difficulties are discussed. Two premature newborns that were diagnosed with probable CS present in the newborn period are presented. In the first case, due to a high index of suspicion, but without confirmatory testing, treatment was started with good clinical response. In the second case, CS was confirmed through positive serology and the specific treatment was given. CS has significant diagnostic challenges as there is no test for early confirmation, therefore, a high index of suspicion might be key in the treatment and consequent prognosis. Due to the current epidemiology of the condition, it is also important to focus on preventive measures.

  18. Rethinking Case Study Methodology in Poststructural Research.

    PubMed

    Mohammed, Shan; Peter, Elizabeth; Gastaldo, Denise; Howell, Doris

    2015-03-01

    Little consideration has been given to how case study might be used in poststructural research to explore power relations that constitute a phenomenon. Many case study scholars, most notably Robert Yin, adopt a postpositivist perspective that assumes the "truth" can be accessed through applying prescriptive and rigid research techniques. Using a discussion of Michel Foucault's key theoretical ideas and the insights gained through a Foucauldian case study of people with advanced cancer who continue to receive curative treatment, the authors argue for the expansion of case study in poststructural inquiry. They propose that the use of poststructuralist case study is valuable because of the flexibility and comprehensiveness of the methodology, which allows for the exploration of a deeper understanding of the broader discourses that shape a phenomenon, as well as how power/knowledge relations shape the behaviours and perceptions of people. They also introduce the reflexive implications of poststructural case study research. Copyright© by Ingram School of Nursing, McGill University.

  19. Exploring role confusion in nurse case management.

    PubMed

    Gray, Frances C; White, Ann; Brooks-Buck, Judith

    2013-01-01

    This is a report of the results of a pilot project conducted to identify the areas where role confusion/ambiguity exists in the practice of nurse case management. A convenience sample of 25 registered nurses practicing as case managers in a small east coast medical treatment facility's outpatient clinics. Participants responded to 2 Likert-type surveys designed to evaluate role confusion from an individual and a team membership perspective. Analysis indicated that nurse case managers experience role confusion in the specific areas of conflicts between time resources, capabilities, and multiple individual roles. There was no identified role confusion associated with membership on multidisciplinary teams. The application of the Synergy Model as a theoretical framework for nurse case management serves as a benchmark for the implementation of evidence-based practices. This project could serve as the starting point for the development of a skill set for nurse case managers, for the standardization of the practice, and for the recognition of nurse case management as a legitimate nursing subspecialty.

  20. A case of triple volvulus

    PubMed Central

    Basu, I; Phillips, D

    2012-01-01

    Situs inversus is a rare congenital anomaly that has reportedly been associated with caecal volvulus. We describe a case of partial situs inversus complicated by intestinal obstruction secondary to three simultaneously occurring volvuli of the stomach, caecum and sigmoid colon. To our knowledge, this is the first documented case in the literature of multiple, simultaneously occurring volvuli. PMID:22391352

  1. A case of triple volvulus.

    PubMed

    Elsharif, M; Basu, I; Phillips, D

    2012-03-01

    Situs inversus is a rare congenital anomaly that has reportedly been associated with caecal volvulus. We describe a case of partial situs inversus complicated by intestinal obstruction secondary to three simultaneously occurring volvuli of the stomach, caecum and sigmoid colon. To our knowledge, this is the first documented case in the literature of multiple, simultaneously occurring volvuli.

  2. The Big Read: Case Studies

    ERIC Educational Resources Information Center

    National Endowment for the Arts, 2009

    2009-01-01

    The Big Read evaluation included a series of 35 case studies designed to gather more in-depth information on the program's implementation and impact. The case studies gave readers a valuable first-hand look at The Big Read in context. Both formal and informal interviews, focus groups, attendance at a wide range of events--all showed how…

  3. The effect of compliance on contact lens case contamination.

    PubMed

    Tilia, Daniel; Lazon de la Jara, Percy; Zhu, Hua; Naduvilath, Thomas J; Holden, Brien A

    2014-03-01

    To determine the efficacy of written instructions on contact lens case hygiene and to quantify the effect of noncompliance on contact lens case contamination. Data were retrospectively analyzed from 16 prospective, 3-month daily-wear studies during which six commercially available silicone hydrogel contact lenses and seven lens care solutions (LCS) were tested following a similar protocol. Verbal instructions regarding case hygiene (rinse case with LCS, not tap water) were given in nine studies, while the same instructions were given verbally and in written format in seven studies. A survey on contact lens, LCS, and lens case hygiene was completed at 1- and 3-month visits and compliance with case hygiene instructions was determined. Regular contact lens cases were used for 1 month and collected for microbial analysis at the 1- and 3-month visits. The rate of case contamination and the types of microbes contaminating cases were evaluated. Participants given verbal and written instructions were more likely to be compliant with case hygiene instructions than those just given verbal instructions (odds ratio [OR]: 2.19, p < 0.001, 95% confidence interval [CI]: 1.40-3.44). The overall case contamination rate was 79%. Use of tap water to rinse contact lens cases was associated with significantly more cases contaminated with Gram-negative bacteria (GNB) (30% vs. 10%, p < 0.001), a greater risk of GNB case contamination (OR: 2.91, p < 0.001. 95% CI: 1.72-4.92), and a higher quantity of GNB in cases (mean colony-forming unit/case ± SD: 28,286 ± 131,935 vs. 6477 ± 60,447, p < 0.001). Lens case hygiene can be improved by effective communication of instructions. Contact lens wearers should be actively discouraged from rinsing contact lens cases with tap water because of the increased risk of GNB contamination.

  4. Leadership development and succession planning in case management.

    PubMed

    Miodonski, Kathleen; Hines, Patricia

    2013-01-01

    The director of case management is one of health care's leadership positions most frequently in demand. The lack of qualified and effective case management leaders will continue to be an issue for organizations for years to come, influenced by increasing pressures on health care reimbursement and the aging case management workforce. Organizations have an opportunity to create a program to develop future case management leaders from their internal talent. The proposed strategies are designed for the acute care hospital but also have applicability in other health care settings where there are case managers and a need for case management leadership. The business community offers leadership research and leadership development models with relevance to case management. Identifying and developing internal talent for leadership roles has been proven to be effective in preparation for advanced responsibilities, has a positive effect on staff morale, and minimizes the impact of vacant leadership positions during recruitment and onboarding activities. Creating a case management leadership development program for an organization can be an alternative to the process of external recruitment for case management department leaders. Such a program can be undertaken even in today's budget conscious environment by accessing existing resources in an organization in a creative and organized manner. The authors outline an approach for case management leaders to accept responsibility for succession planning and for case managers to accept responsibility for promoting their own career development through creation of a leadership development program.

  5. Removal of biofilm from contact lens storage cases.

    PubMed

    Wu, Yvonne T; Zhu, Hua; Willcox, Mark; Stapleton, Fiona

    2010-12-01

    Lens case hygiene practices are important in maintaining safe contact lens wear. However, the effectiveness of various lens case cleaning practices have not been evaluated and compared. This in vitro study aimed to evaluate and compare the efficacy of cleaning practices that are most commonly carried out by lens wearers and recommended by practitioners. Pseudomonas aeruginosa 122, Serratia marcescens ATCC 13880, and Staphylococcus aureus ATCC 6538 were the challenge bacteria for biofilm formation on unused lens cases from two different manufacturers. After establishment of the biofilm, each lens case was subjected to one of the six cleaning regimens: "rinsed," "rubbed and rinsed," "air-dried," "soaked in a multipurpose contact lens solution," "tissue-wiped," and "lids recapped." The level of residual biofilm was quantified at the end of each cleaning regimen. The efficacy of each cleaning regimen was then compared. Mechanical rubbing and wiping of lens cases were the most effective cleaning regimen tested in reducing biofilm. Soaking lenses in disinfecting solution for 6 hours removed the majority of biofilm from lens cases. Rinsing lens cases alone provided only minimal efficacy in reducing biofilm. Air-drying or recapping the cases with the lid without any other additional cleaning methods were the least efficient at removing biofilm. Based on this study, digital rubbing and rinsing and/or wiping the lens cases with tissue is recommended. Air-drying or recapping the lens case lids after use without any additional cleaning methods should be discouraged with non-antimicrobial lens cases.

  6. Oral mite anaphylaxis caused by mite-contaminated okonomiyaki/ pancake-mix in Japan: 8 case reports and a review of 28 reported cases.

    PubMed

    Takahashi, Kentaro; Taniguchi, Masami; Fukutomi, Yuma; Sekiya, Kiyoshi; Watai, Kentaro; Mitsui, Chihiro; Tanimoto, Hidenori; Oshikata, Chiyako; Tsuburai, Takahiro; Tsurikisawa, Naomi; Minoguchi, Kenji; Nakajima, Hiroshi; Akiyama, Kazuo

    2014-03-01

    Anaphylaxis after the ingestion of foods contaminated with mites has recently been recognized. Case series and case reports thus far have shown that mite-contaminated wheat flour is the major cause of oral mite anaphylaxis. However, we have found 8 cases of oral mite anaphylaxis which were caused by mite-contaminated okonomiyaki-mix, a savory Japanese style pancake mix, in our hospital. In addition to our 8 cases, the databases of MEDLINE and ICHUSHI were systematically searched for patients with oral mite anaphylaxis in Japan. Thirty-six patients including our 8 cases with oral mite anaphylaxis were identified. Thirty-four out of 36 cases (94%) ingested okonomiyaki or takoyaki, prepared at home using okonomiyaki-mix or takoyaki-mix which was previously opened and stored for months at ambient temperature. Microscopic examination of culprit mixes of 16 cases including our 1 case revealed contamination of mites such as Dermatophagoides farina (Der f) (5 cases), Tyrophagus putrescentiae (Tyr p) (4 cases), and Dermatophagoides pteronyssinus (Der p) (3 cases). The specific IgE to each mite is generally upregulated in these patients. Especially, the titers of specific IgE to Der p and Der f were more than class 2 in all cases. Mite-contaminated flavored flour is the major cause of oral mite anaphylaxis in Japan.

  7. Cloacal Prolapse in Raptors: Review of 16 Cases.

    PubMed

    Dutton, Thomas A G; Forbes, Neil A; Carrasco, Daniel Calvo

    2016-06-01

    Sixteen cases of cloacal prolapse in raptors were reviewed in this study. Colonic prolapse was the most common presentation (56% of cases). Red-tailed hawks ( Buteo jamaicensis ) were overrepresented, comprising 66% of colonic prolapse cases. In cases of colonic prolapse, postsurgical stricture formation was a commonly identified complication after resection and anastomosis of the colon. A novel technique was used in 2 cases of colonic prolapse, in which sterile, semirigid rubber tubing was placed in the distal colon and removed per-cloaca at the end of the procedure; this facilitated a secure, fluid-tight anastomosis while maintaining sufficient intestinal lumen. Oviductal prolapse (31% of cases) was associated with the most guarded prognosis (40% treatment success). Cloacoliths were treated successfully in 2 birds (13% of cases) by minimally invasive per-cloacal manual removal.

  8. [Paranasal sinus mucoceles: About 32 cases].

    PubMed

    Hssaine, K; Belhoucha, B; Rochdi, Y; Nouri, H; Aderdour, L; Raji, A

    2016-02-01

    Mucocele is a pseudo-cystic tumor of the paranasal sinuses. Despite its benign histological nature, it is aggressive towards neighboring structures (orbit and brain). Our aim was to study the epidemiological, clinical, therapeutic, and evolution aspects of this pathology. We conducted a retrospective study over a period of 9 years on 32 patients operated on and followed for mucocele in our department. Mean age was 43.28 years with a sex ratio to 1. Mucoceles were located in the fronto-ethmoid sinus (27 cases), the maxillary sinus (3 cases) and the sphenoid sinus (2 cases). The most common symptoms were periorbital swelling and exophthalmia. CT scan confirmed the diagnosis in the majority of cases. MRI was performed in 3 patients. Surgery consisted in a large marsupialization by endonasal approach in 30 cases, and by a combined approach in two cases. A recurrence was observed in two patients after a mean period of 18 months. Mucocele is a benign and expansive pseudo-cystic tumor, affecting mostly adults and developing in the paranasal sinuses. Clinical symptoms are not specific. It may reveal itself by ophthalmic or intracranial complications. Diagnosis is based on imaging (CT and MRI). Endonasal surgery has become the gold standard for the treatment of mucoceles and is endowed with low morbidity. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Teaching Agricultural Policy with the Case Method.

    ERIC Educational Resources Information Center

    Stuhler, E. A.

    1994-01-01

    Two groups of agriculture students were taught with case studies and one group without (about 30 students in each group). Case-method groups had greater gains in cognitive performance and changed motivation and attitudes. Case studies had a positive effect on the development of problem-solving skills. (SK)

  10. 46 CFR 160.174-13 - Storage case.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 6 2014-10-01 2014-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

  11. 46 CFR 160.174-13 - Storage case.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

  12. 46 CFR 160.174-13 - Storage case.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 6 2012-10-01 2012-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

  13. 46 CFR 160.174-13 - Storage case.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

  14. 46 CFR 160.174-13 - Storage case.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 6 2013-10-01 2013-10-01 false Storage case. 160.174-13 Section 160.174-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-13 Storage case. Each thermal protective aid must be provided with a ziplock bag or equivalent storage case. ...

  15. Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default.

    PubMed

    Belchior, Aylana de Souza; Arcêncio, Ricardo Alexandre; Mainbourg, Evelyne Marie Therese

    2016-01-01

    To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases. Comparative study with 126 patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System. Comparative analysis between the two groups. The new cases differ from retreatment cases regarding educational level. The clinical-epidemiological profile shows a significant difference in relation to performance of the tuberculin skin test, and the HIV test result (positive) in favor of new cases. In relation to performance of sputum culture and the result (positive) of the first sputum smear of the first and second samples, in favor of retreatment cases. The two groups are significantly different in clinical and epidemiological characteristics that show the access to exams. Identificar fatores socioeconômicos e clínico-epidemiológicos associados à tuberculose em casos novos e em casos em retratamento. Estudo comparativo de 126 pacientes, sendo 42 casos em retratamento por abandono atendidos num Centro de Referência e 84 casos novos concluindo o primeiro tratamento, atendidos em Unidades Básicas de Saúde. Levantamento de dados primários por entrevista e dados secundários pela Ficha de Informação de Agravos de Notificação. Análise comparativa entre os dois grupos. Os casos novos diferem dos em retratamento quanto à escolaridade. O perfil clínico-epidemiológico mostra que há diferença significativa quanto à realização do teste tuberculínico e o resultado do teste HIV (positivo) a favor dos casos novos. Quanto à realização da cultura de escarro e o resultado (positivo) da baciloscopia de escarro da primeira e da segunda amostras, a favor dos casos em retratamento. Os dois grupos

  16. Interventional cardiology live case presentations: regulatory considerations.

    PubMed

    Farb, Andrew; Brown, Sheila A; Wolf, Deborah A; Zuckerman, Bram

    2010-10-01

    Live case presentations are increasingly common at interventional cardiology conferences. Taking advantage of significant advances in communication technology, broadcasts of procedures can be viewed as an extension of traditional medical education targeted to large groups of practitioners. However, there are important ethical, commercial, and patient safety issues associated with live cases that deserve attention. Use of investigational devices in live case demonstrations is subject to review and approval by FDA's Center for Devices and Radiological Health (CDRH), and the outcomes of patients participating in live cases are considered in the overall clinical study results. This article discusses CDRH's regulatory view of live case presentations with a focus on patient safety, clinical trial integrity, and concerns regarding improper medical device promotion. © 2010 Wiley-Liss, Inc.

  17. Interventional cardiology live case presentations regulatory considerations.

    PubMed

    Farb, Andrew; Brown, Sheila A; Wolf, Deborah A; Zuckerman, Bram

    2010-10-01

    Live case presentations are increasingly common at interventional cardiology conferences. Taking advantage of significant advances in communication technology, broadcasts of procedures can be viewed as an extension of traditional medical education targeted to large groups of practitioners. However, there are important ethical, commercial, and patient safety issues associated with live cases that deserve attention. Use of investigational devices in live case demonstrations is subject to review and approval by FDA's Center for Devices and Radiological Health (CDRH), and the outcomes of patients participating in live cases are considered in the overall clinical study results. This article discusses CDRH's regulatory view of live case presentations with a focus on patient safety, clinical trial integrity, and concerns regarding improper medical device promotion. Copyright © 2010. Published by Elsevier Inc.

  18. Case management: developing practice through action research.

    PubMed

    Smith, Annetta; Mackay, Seonaid; McCulloch, Kathleen

    2013-09-01

    This article is a report of an action research study carried out with community nurses to help develop case management within their practice. Using action research principles, nurses reviewed and analysed their current practice and developed recommendations for further embedding case management as a means of supporting patients with complex care needs in their own homes. Findings indicate that a number of factors can influence the community nurse's ability to implement case management. These factors include approaches to case finding, availability of resources and interprofessional working. Important considerations for nurses were the influence of the context of care, the geographical location and the health needs of the local patient population, which meant that case management may need to be adapted to meet local circumstances.

  19. Double pituitary adenomas: six surgical cases.

    PubMed

    Sano, T; Horiguchi, H; Xu, B; Li, C; Hino, A; Sakaki, M; Kannuki, S; Yamada, S

    1999-05-01

    While double pituitary adenomas have been found in approximately 1% of autopsy pituitaries, those in surgically resected material have been only rarely reported. We report herein 6 cases of double pituitary adenomas, which consisted of two histologically and/or immunohistochemically different areas among approximately 450 surgical specimens. Five out of 6 patients were men and the age was ranged between 18 and 61 years old. All these 6 patients presented acromegaly or acrogigantism and hyperprolactinemia was noted in 3 patients. In 2 patients (cases 1 and 2) the two adenomas belonged to different adenoma groups (GH-PRL-TSH group and FSH/LH group), while in the remaining 4 patients (cases 3-6) the two adenomas belonged to the same group (GH-PRL-TSH group). Thus, in all patients at least one of the two adenomas was GH-producing adenoma. Reasons for a high incidence of GH-producing adenomas in surgically resected double pituitary adenomas may include the presence of a variety of histologic subtypes among GH-producing adenomas and the advantage of cytokeratin immunostaining to distinguish these subtypes. In regard to pathogenesis of double pituitary adenomas, adenomas in cases 1 and 2 may be of multicentric occurrence, while those in cases 3-6 may occur through different clonal proliferation within originally one adenoma, resulting in diverse phenotypic expressions. Since there were patients with familial MEN 1 (case 2) and familial pituitary adenoma unrelated MEN 1 (case 3), genetic background should be also considered. Double pituitary adenomas in surgically resected material may not be so infrequent. Further molecular analysis will provide new insights into understanding the pathogenesis of pituitary adenomas and their mechanisms of multidirectional phenotypic diffrentiation.

  20. Impact of the Dayton Tire case.

    PubMed

    Hart, D L; Isernhagen, S J; Matheson, L N

    1998-01-01

    Three of the more pertinent legal cases in the United States concerning the performance of ergonomists are summarized. The results of the cited cases have impact on the validity of the NIOSH lifting formulae, the lack of scientific evidence relating performance of jobs with alleged ergonomic stressors with specific medical pathology, and the gold standard for expert witness testimony. The cases, taken together, should act as a catalyst for ergonomists to improve their level of scientific justification for their work and conclusions.

  1. ACHP | Federal Historic Preservation Case Law, 1966-2000

    Science.gov Websites

    of cases from 1996 to 2000. Federal Historic Preservation Case Law, 1966-2000 features an essay on authorities, and procedural issues in litigating preservation cases. It continues with 158 chronologically arranged digests of cases decided in Federal courts since 1966. Extensive footnotes, tables, and a

  2. 12 CFR 268.302 - Mixed case complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Mixed case complaints. 268.302 Section 268.302... RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case complaint is a complaint of employment discrimination filed with the Board based on race, color, religion...

  3. 12 CFR 268.302 - Mixed case complaints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Mixed case complaints. 268.302 Section 268.302... RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case complaint is a complaint of employment discrimination filed with the Board based on race, color, religion...

  4. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

  5. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

  6. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

  7. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

  8. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

  9. 32 CFR 644.70 - Closing of cases.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Closing of cases. 644.70 Section 644.70 National... HANDBOOK Acquisition Procurement of Title Evidence, Title Clearance, and Closings § 644.70 Closing of cases. (a) Closing and Settlement Officers. Payment and closing of cases will be initiated immediately upon...

  10. Science and the art of case reporting in medicine.

    PubMed

    Pramono, Laurentius A

    2013-10-01

    The case report is one type of article published in medical journals. Not all case reports can be published. Case reports worth publishing are case reports that have good teaching points and good clinical messages. Writing case reports need academic and clinical skills, along with a taste of art to interest readers to read and study about the case we report. Case reports are expected to be a good tool to all clinicians to build their clinical reasoning and sharpen their clinical instincts.

  11. Failures in Hybrid Microcircuits During Environmental Testing. History Cases

    NASA Technical Reports Server (NTRS)

    Teverovsky, Alexander

    2008-01-01

    This purpose of this viewgraph presentation is to discuss failures in hermetic hybrids observed at the GSFC PA Lab during environmental stress testing. The cases discussed are: Case I. Substrate metallization failures during Thermal cycling (TC). Case II. Flex lid-induced failure. Case Ill. Hermeticity failures during TC. Case IV. Die metallization cracking during TC. and how many test cycles and parts is necessary? Case V. Wire Bond failures after life test. Case VI. Failures caused by Au/In IMC growth.

  12. Impact of case-relevant and case-irrelevant communication within the surgical team on surgical-site infection.

    PubMed

    Tschan, F; Seelandt, J C; Keller, S; Semmer, N K; Kurmann, A; Candinas, D; Beldi, G

    2015-12-01

    Surgical-site infections (SSIs) are the most common complications after surgery. An influence from talking and distractions during surgery on patient outcomes has been suggested, but there is limited evidence. The aim of this prospective observational study was to assess the relationship between intraoperative communication within the surgical team and SSI, and between intraoperative distractions and SSI. This prospective observational study included patients undergoing elective, open abdominal procedures. For each procedure, intraoperative case-relevant and case-irrelevant communication, and intraoperative distractions were observed continuously on site. The influence of communication and distractions on SSI after surgery was assessed using logistic regressions, adjusting for risk factors. A total of 167 observed procedures were analysed; their mean(s.d.) duration was 4·6(2·1) h. A total of 24 SSIs (14·4 per cent) were diagnosed. Case-relevant communication during the procedure was independently associated with a reduced incidence of organ/space SSI (propensity score-adjusted odds ratio 0·86, 95 per cent c.i. 0·77 to 0·97; P = 0·014). Case-irrelevant communication during the closing phase of the procedure was independently associated with increased incidence of incisional SSI (propensity score-adjusted odds ratio 1·29, 1·08 to 1·55; P = 0·006). Distractions had no association with SSI. More case-relevant communication was associated with fewer organ/space SSIs, and more case-irrelevant communication during wound closure was associated with incisional SSI. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  13. Case Studies in the Field of Marketing Education: Learner Impact, Case Performance, and Cost Efficiency

    ERIC Educational Resources Information Center

    Spais, George S.

    2005-01-01

    The major objective of this study is to identify a methodology that will help educators in marketing to efficiently manage the design, impact, and cost of case studies. It is my intention is to examine the impact of case study characteristics in relation to the degree of learner involvement in the learning process. The author proposes that…

  14. A Careful Look at Modern Case Selection Methods

    ERIC Educational Resources Information Center

    Herron, Michael C.; Quinn, Kevin M.

    2016-01-01

    Case studies appear prominently in political science, sociology, and other social science fields. A scholar employing a case study research design in an effort to estimate causal effects must confront the question, how should cases be selected for analysis? This question is important because the results derived from a case study research program…

  15. A Case-Based Reasoning Method with Rank Aggregation

    NASA Astrophysics Data System (ADS)

    Sun, Jinhua; Du, Jiao; Hu, Jian

    2018-03-01

    In order to improve the accuracy of case-based reasoning (CBR), this paper addresses a new CBR framework with the basic principle of rank aggregation. First, the ranking methods are put forward in each attribute subspace of case. The ordering relation between cases on each attribute is got between cases. Then, a sorting matrix is got. Second, the similar case retrieval process from ranking matrix is transformed into a rank aggregation optimal problem, which uses the Kemeny optimal. On the basis, a rank aggregation case-based reasoning algorithm, named RA-CBR, is designed. The experiment result on UCI data sets shows that case retrieval accuracy of RA-CBR algorithm is higher than euclidean distance CBR and mahalanobis distance CBR testing.So we can get the conclusion that RA-CBR method can increase the performance and efficiency of CBR.

  16. [Drug-induced acute pancreatitis: about 10 cases].

    PubMed

    Maghrebi, Houcine; Rhaeim, Rami; Haddad, Anis; Makni, Amin; Mohamed, Jouini; Montasser, Kacem; Zoubeir, Ben Safta

    2017-01-01

    Drug-induced acute pancreatitis (AP) accounts for approximately 2% of acute pancreatitis. Its incidence is increasing, with more than 260 incriminated drugs. However, very few cases have been described in the literature due to accountability problem. We report our experience with 10 cases whose data were collected over a period of 7 years. Clinical presentation of AP was often equivocal. Ranson's score ranged from 0 to 5. We recorded 5 cases of edematous pancreatitis and 5 cases of necro-bleeding pancreatitis. These pancreatitis were often successfully treated without recurrence after discontinuation of the incriminated drug.

  17. Transvestism as a Symptom: A Case Series.

    PubMed

    Anupama, M; Gangadhar, K H; Shetty, Vandana B; Dip, P Bhadja

    2016-01-01

    Transvestism, commonly termed as cross-dressing, means to dress in the clothing of opposite sex. We describe a series of three cases with transvestism as one of their primary complaints. The discussion sheds light on the various ways in which transvestism as a symptom can present in Psychiatry. In the first two cases, there was lower intelligence. In first and third case, there were other paraphilia along with transvestism. Second case had co-morbid obsessive-compulsive disorder (OCD) and had good response to selective serotonin reuptake inhibitor (SSRI).

  18. Transvestism as a Symptom: A Case Series

    PubMed Central

    Anupama, M.; Gangadhar, K. H.; Shetty, Vandana B.; Dip, P. Bhadja

    2016-01-01

    Transvestism, commonly termed as cross-dressing, means to dress in the clothing of opposite sex. We describe a series of three cases with transvestism as one of their primary complaints. The discussion sheds light on the various ways in which transvestism as a symptom can present in Psychiatry. In the first two cases, there was lower intelligence. In first and third case, there were other paraphilia along with transvestism. Second case had co-morbid obsessive-compulsive disorder (OCD) and had good response to selective serotonin reuptake inhibitor (SSRI). PMID:27011411

  19. The virtual-casing principle and Helmholtz's theorem

    DOE PAGES

    Hanson, J. D.

    2015-09-10

    The virtual-casing principle is used in plasma physics to convert a Biot–Savart integration over a current distribution into a surface integral over a surface that encloses the current. In many circumstances, use of virtual casing can significantly speed up the computation of magnetic fields. In this paper, a virtual-casing principle is derived for a general vector field with arbitrary divergence and curl. This form of the virtual-casing principle is thus applicable to both magnetostatic fields and electrostatic fields. The result is then related to Helmholtz's theorem.

  20. Oral Mite Anaphylaxis Caused by Mite-Contaminated Okonomiyaki/Pancake-Mix in Japan: 8 Case Reports and a Review of 28 Reported Cases.

    PubMed

    Takahashi, Kentaro; Taniguchi, Masami; Fukutomi, Yuma; Sekiya, Kiyoshi; Watai, Kentaro; Mitsui, Chihiro; Tanimoto, Hidenori; Oshikata, Chiyako; Tsuburai, Takahiro; Tsurikisawa, Naomi; Minoguchi, Kenji; Nakajima, Hiroshi; Akiyama, Kazuo

    2014-01-01

    Anaphylaxis after the ingestion of foods contaminated with mites has recently been recognized. Case series and case reports thus far have shown that mite-contaminated wheat flour is the major cause of oral mite anaphylaxis. However, we have found 8 cases of oral mite anaphylaxis which were caused by mitecontaminated okonomiyaki-mix, a savory Japanese style pancake mix, in our hospital. In addition to our 8 cases, the databases of MEDLINE and ICHUSHI were systematically searched for patients with oral mite anaphylaxis in Japan. Thirty-six patients including our 8 cases with oral mite anaphylaxis were identified. Thirty-four out of 36 cases (94%) ingested okonomiyaki or takoyaki, prepared at home using okonomiyaki-mix or takoyaki-mix which was previously opened and stored for months at ambient temperature. Microscopic examination of culprit mixes of 16 cases including our 1 case revealed contamination of mites such as Dermatophagoides farina (Der f) (5 cases), Tyrophagus putrescentiae (Tyr p) (4 cases), and Dermatophagoides pteronyssinus (Der p) (3 cases). The specific IgE to each mite is generally upregulated in these patients. Especially, the titers of specific IgE to Der p and Der f were more than class 2 in all cases. Mite-contaminated flavored flour is the major cause of oral mite anaphylaxis in Japan. © 2014 Japanese Society of Allergology.

  1. Oral Mite Anaphylaxis Caused by Mite-Contaminated Okonomiyaki/Pancake-Mix in Japan: 8 Case Reports and a Review of 28 Reported Cases.

    PubMed

    Takahashi, Kentaro; Taniguchi, Masami; Fukutomi, Yuma; Sekiya, Kiyoshi; Watai, Kentaro; Mitsui, Chihiro; Tanimoto, Hidenori; Oshikata, Chiyako; Tsuburai, Takahiro; Tsurikisawa, Naomi; Minoguchi, Kenji; Nakajima, Hiroshi; Akiyama, Kazuo

    2013-12-25

    Background: Anaphylaxis after the ingestion of foods contaminated with mites has recently been recognized. Case series and case reports thus far have shown that mite-contaminated wheat flour is the major cause of oral mite anaphylaxis. However, we have found 8 cases of oral mite anaphylaxis which were caused by mite-contaminated okonomiyaki-mix, a savory Japanese style pancake mix, in our hospital. Methods: In addition to our 8 cases, the databases of MEDLINE and ICHUSHI were systematically searched for patients with oral mite anaphylaxis in Japan. Results: Thirty-six patients including our 8 cases with oral mite anaphylaxis were identified. Thirty-four out of 36 cases (94%) ingested okonomiyaki or takoyaki, prepared at home using okonomiyaki-mix or takoyaki-mix which was previously opened and stored for months at ambient temperature. Microscopic examination of culprit mixes of 16 cases including our 1 case revealed contamination of mites such as Dermatophagoides farina (Der f) (5 cases), Tyrophagus putrescentiae (Tyr p) (4 cases), and Dermatophagoides pteronyssinus (Der p) (3 cases). The specific IgE to each mite is generally upregulated in these patients. Especially, the titers of specific IgE to Der p and Der f were more than class 2 in all cases. Conclusions: Mite-contaminated flavored flour is the major cause of oral mite anaphylaxis in Japan.

  2. Case Studies

    ERIC Educational Resources Information Center

    Ritter, Lois A., Ed.; Sue, Valerie M., Ed.

    2007-01-01

    This article presents two case studies using online surveys for evaluation. The authors begin with an example of a needs assessment survey designed to measure the amount of help new students at a university require in their first year. They then discuss the follow-up survey conducted by the same university to measure the effectiveness of the…

  3. Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases.

    PubMed

    Caram, L B; Linefsky, J P; Read, K M; Murdoch, D R; Lalani, T; Woods, C W; Reller, L B; Kanj, S S; Premru, M M; Ryan, S; Al-Hegelan, M; Donnio, P Y; Orezzi, C; Paiva, M G; Tribouilloy, C; Watkin, R; Harris, O; Eisen, D P; Corey, G R; Cabell, C H; Petti, C A

    2008-02-01

    Leptotrichia species typically colonize the oral cavity and genitourinary tract. We report the first two cases of endocarditis secondary to L. goodfellowii sp. nov. Both cases were identified using 16S rRNA gene sequencing. Review of the English literature revealed only two other cases of Leptotrichia sp. endocarditis.

  4. Signal Analysis of Automotive Engine Spark Ignition System using Case-Based Reasoning (CBR) and Case-based Maintenance (CBM)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huang, H.; Vong, C. M.; Wong, P. K.

    2010-05-21

    With the development of modern technology, modern vehicles adopt electronic control system for injection and ignition. In traditional way, whenever there is any malfunctioning in an automotive engine, an automotive mechanic usually performs a diagnosis in the ignition system of the engine to check any exceptional symptoms. In this paper, we present a case-based reasoning (CBR) approach to help solve human diagnosis problem. Nevertheless, one drawback of CBR system is that the case library will be expanded gradually after repeatedly running the system, which may cause inaccuracy and longer time for the CBR retrieval. To tackle this problem, case-based maintenancemore » (CBM) framework is employed so that the case library of the CBR system will be compressed by clustering to produce a set of representative cases. As a result, the performance (in retrieval accuracy and time) of the whole CBR system can be improved.« less

  5. Signal Analysis of Automotive Engine Spark Ignition System using Case-Based Reasoning (CBR) and Case-based Maintenance (CBM)

    NASA Astrophysics Data System (ADS)

    Huang, H.; Vong, C. M.; Wong, P. K.

    2010-05-01

    With the development of modern technology, modern vehicles adopt electronic control system for injection and ignition. In traditional way, whenever there is any malfunctioning in an automotive engine, an automotive mechanic usually performs a diagnosis in the ignition system of the engine to check any exceptional symptoms. In this paper, we present a case-based reasoning (CBR) approach to help solve human diagnosis problem. Nevertheless, one drawback of CBR system is that the case library will be expanded gradually after repeatedly running the system, which may cause inaccuracy and longer time for the CBR retrieval. To tackle this problem, case-based maintenance (CBM) framework is employed so that the case library of the CBR system will be compressed by clustering to produce a set of representative cases. As a result, the performance (in retrieval accuracy and time) of the whole CBR system can be improved.

  6. Crouzon's Syndrome: A Case Report

    PubMed Central

    Jyothsna, M; Ahmed, Syed Basheer; Lakshmi, K Sree

    2013-01-01

    ABSTRACT Crouzon's syndrome (CS) is a rare autosomal dominant condition with multiple mutations of the fibroblast growth factor receptor (FGFR2) gene, which accounts for 4.8% of all cases of craniosynostosis. It is characterized by premature closure of cranial sutures, cranial deformities, midface hypoplasia, relative mandibular prognathism, hypertelorism, proptosis, strabismus and short upper lip, crowding of teeth, pseudocleft or sometimes cleft palate and other associated abnormalities. The CS can vary in severity from mild presentation to severe forms involving multiple cranial sutures. We report a case of CS in 11-year-old boy. How to cite this article: Kumar GR, Jyothsna M, Ahmed SB, Lakshmi KS, Crouzon's Syndrome: A Case Report. Int J Clin Pediatr Dent 2013;6(1):33-37. PMID:25206185

  7. Crouzon's Syndrome: A Case Report.

    PubMed

    Kumar, G Ravi; Jyothsna, M; Ahmed, Syed Basheer; Lakshmi, K Sree

    2013-01-01

    Crouzon's syndrome (CS) is a rare autosomal dominant condition with multiple mutations of the fibroblast growth factor receptor (FGFR2) gene, which accounts for 4.8% of all cases of craniosynostosis. It is characterized by premature closure of cranial sutures, cranial deformities, midface hypoplasia, relative mandibular prognathism, hypertelorism, proptosis, strabismus and short upper lip, crowding of teeth, pseudocleft or sometimes cleft palate and other associated abnormalities. The CS can vary in severity from mild presentation to severe forms involving multiple cranial sutures. We report a case of CS in 11-year-old boy. How to cite this article: Kumar GR, Jyothsna M, Ahmed SB, Lakshmi KS, Crouzon's Syndrome: A Case Report. Int J Clin Pediatr Dent 2013;6(1):33-37.

  8. A Case of Lymphomatoid Keratosis

    PubMed Central

    Choi, Min Jee; Kim, Hei Sung; Kim, Hyung Ok; Song, Kye Yong

    2010-01-01

    Lymphomatoid keratosis (LK) is considered to be a rare variant of cutaneous lymphoid hyperplasia, with epidermotropism. We herein report a case of LK which developed on the abdomen of an elderly Korean woman. A 60-year-old woman presented with a 10-year history of a pruritic, solitary, brown to black plaque on the abdomen. Histopathologically, the specimen showed hyperkeratosis, parakeratosis, acanthosis and Pautrier's micro-abscess in the epidermis, and a lichenoid infiltration of lymphocytes in the dermis, which expressed both B cell and T cell lineage on the immune-histochemical staining. Based on these clinical and histopathological findings, our case was diagnosed as LK. To our knowledge, this is the first case report of LK in the Korean dermatologic literature. PMID:20548920

  9. Using rhetorical theory in medical ethics cases.

    PubMed

    Heifferon, B

    2000-01-01

    In this paper I argue that rhetorical theory is a valuable tool in medical ethics cases. The case I use as an example is one in which traditional, philosophy-based medical ethics are applied. In this case the traditional ethical approach is not adequate to the task. Key issues and problems are not addressed, resulting in a problem that seems to be solved on the surface, but, when rhetorically analyzed, it's obvious that none of the issues have been resolved in any satisfactory way. By using rhetorical theory, such as that Michel Foucault uses in Power/Knowledge, we discover that the reason this case has not been solved is that the power issues have not been addressed. Using Foucault's concepts of "subjugated knowledge", "local knowledge", "situated knowledge", and "docile bodies", we can tease out the real issues that surface in this ethics case and solve them. Foucault also recommends we use theory as a "toolkit". I propose a model that is a further iteration of this idea. My model uses numerous rhetorical and literary theories, depending on the issues that need to be addressed in each individual medical ethics case. I briefly describe the various theories and include a handout of what the new model of using rhetorical theory in such cases would look like.

  10. Schematic representation of case study research designs.

    PubMed

    Rosenberg, John P; Yates, Patsy M

    2007-11-01

    The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Case study research is a methodologically flexible approach to research design that focuses on a particular case - whether an individual, a collective or a phenomenon of interest. It is known as the 'study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods.

  11. Study on Case Teaching of Financial Management

    ERIC Educational Resources Information Center

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  12. Case analysis online: a strategic management case model for the health industry.

    PubMed

    Walsh, Anne; Bearden, Eithne

    2004-01-01

    Despite the plethora of methods and tools available to support strategic management, the challenge for health executives in the next century will relate to their ability to access and interpret data from multiple and intricate communication networks. Integrated digital networks and satellite systems will expand the scope and ease of sharing information between business divisions, and networked systems will facilitate the use of virtual case discussions across universities. While the internet is frequently used to support clinical decisions in the healthcare industry, few executives rely upon the internetfor strategic analysis. Although electronic technologies can easily synthesize data from multiple information channels, research as well as technical issues may deter their application in strategic analysis. As digital models transform access to information, online models may become increasingly relevant in designing strategic solutions. While there are various pedagogical models available to support the strategic management process, this framework was designed to enhance strategic analysis through the application of technology and electronic research. A strategic analysis framework, which incorporated internet research and case analysis in a strategic managementcourse, is described alongwith design and application issues that emerged during the case analysis process.

  13. Censored Hurdle Negative Binomial Regression (Case Study: Neonatorum Tetanus Case in Indonesia)

    NASA Astrophysics Data System (ADS)

    Yuli Rusdiana, Riza; Zain, Ismaini; Wulan Purnami, Santi

    2017-06-01

    Hurdle negative binomial model regression is a method that can be used for discreate dependent variable, excess zero and under- and overdispersion. It uses two parts approach. The first part estimates zero elements from dependent variable is zero hurdle model and the second part estimates not zero elements (non-negative integer) from dependent variable is called truncated negative binomial models. The discrete dependent variable in such cases is censored for some values. The type of censor that will be studied in this research is right censored. This study aims to obtain the parameter estimator hurdle negative binomial regression for right censored dependent variable. In the assessment of parameter estimation methods used Maximum Likelihood Estimator (MLE). Hurdle negative binomial model regression for right censored dependent variable is applied on the number of neonatorum tetanus cases in Indonesia. The type data is count data which contains zero values in some observations and other variety value. This study also aims to obtain the parameter estimator and test statistic censored hurdle negative binomial model. Based on the regression results, the factors that influence neonatorum tetanus case in Indonesia is the percentage of baby health care coverage and neonatal visits.

  14. Birth outcomes of cases with isolated atrial septal defect type II--a population-based case-control study.

    PubMed

    Vereczkey, Attila; Kósa, Zsolt; Csáky-Szunyogh, Melinda; Urbán, Róbert; Czeizel, Andrew E

    2013-07-01

    In general, epidemiological studies have evaluated cases with congenital cardiovascular abnormalities together. The aim of this study is to describe the birth outcomes of cases with isolated/single atrial septal defect type II (ASD-II, i.e. only a fossa ovalis defect) after surgical correction or lethal outcome in the light of maternal sociodemographic data. Comparison of birth outcomes and maternal characteristics of cases with ASD-II and controls without defect. The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities. Hungarian newborn infants with or without ASD-II. Medically recorded birth outcomes, maternal age and birth order were evaluated. Marital and employment status was based on maternal information. The lifestyle factors were analyzed in a subsample of mothers visited at home based on a personal interview with mothers and their close relatives, and the family consensus was accepted. Mean gestational age at delivery and birthweight, rate of preterm birth and low birthweight, maternal age, birth order, marital and employment status. The evaluation of 471 cases with ASD-II and 38,151 controls without any defects showed a female excess in cases with ASD-II, having shorter gestational age and lower mean birthweight, and thus a higher rate of preterm births and low birthweight. Intrauterine growth restriction and shorter gestational age were found in cases with ASD-II, particularly in female children. These factors may have a general developmental process in which there was not closure of the foramen ovale, thus echocardiographic screening of these babies might be of value. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Social Vulnerability in Congenital Syphilis Case Mothers: Qualitative Assessment of Cases in Indiana, 2014-2016.

    PubMed

    DiOrio, Dawne; Kroeger, Karen; Ross, Amara

    2018-01-04

    Congenital syphilis occurs when a pregnant woman with syphilis is not diagnosed or treated and the infection is passed in utero, causing severe infant morbidity and mortality. Congenital syphilis is easily prevented if women receive timely and adequate prenatal care. Cases of congenital syphilis are considered indicators of problems in the safety net. However, maternal social and behavioral factors can impede women's care, even when providers follow guidelines. We reviewed case interviews and maternal records for 23 congenital syphilis cases reported to CDC from Indiana between 2014 and 2016. We used qualitative methods to analyze narrative notes from maternal interviews to learn more about factors that potentially contributed to CS cases. All providers followed CDC and state recommendations for screening and treatment of pregnant women with syphilis. Twenty-one of 23 women had health insurance. The number of prenatal care visits women had was suboptimal; more than one third of women had no prenatal care. Nearly one third of women's only risk factor was sex with a primary male sex partner. The majority of women suffered social vulnerabilities, including homelessness, substance abuse, and incarceration. Despite provider adherence to guidelines and health insurance availability, some pregnant women with syphilis are unlikely to receive timely diagnosis and treatment. Pregnant women at high risk for syphilis may need additional social and material support to prevent a CS case. Additional efforts are needed to reach the male partners of vulnerable females with syphilis.

  16. Breast cancer risk factor associations differ for pure versus invasive carcinoma with an in situ component in case-control and case-case analyses

    PubMed Central

    Ruszczyk, Melanie; Zirpoli, Gary; Kumar, Shicha; Bandera, Elisa V.; Bovbjerg, Dana H.; Jandorf, Lina; Khoury, Thaer; Hwang, Helena; Ciupak, Gregory; Pawlish, Karen; Schedin, Pepper; Masso-Welch, Patricia; Ambrosone, Christine B.; Hong, Chi-Chen

    2015-01-01

    Purpose Invasive ductal carcinoma (IDC) is diagnosed with or without a ductal carcinoma in situ (DCIS) component. Previous analyses have found significant differences in tumor characteristics between pure IDC lacking DCIS and mixed IDC with DCIS. We will test our hypothesis that pure IDC represents a form of breast cancer with etiology and risk factors distinct from mixed IDC/DCIS. Methods We compared reproductive risk factors for breast cancer risk, as well as family and smoking history between 831 women with mixed IDC/DCIS (n=650) or pure IDC (n=181), and 1,620 controls, in the context of the Women's Circle of Health Study (WCHS), a case-control study of breast cancer in African-American and European-American women. Data on reproductive and lifestyle factors were collected during interviews, and tumor characteristics were abstracted from pathology reports. Case-control and case-case analyses were conducted using unconditional logistic regression. Results Most risk factors were similarly associated with pure IDC and mixed IDC/DCIS. However, among postmenopausal women, risk for pure IDC was lower in women with body mass index (BMI) 25 to <30 kg/m2 (Odds Ratio (OR)=0.66; 95% confidence interval (CI), 0.35-1.23) and BMI≥30 kg/m2 (OR=0.33; 95% CI, 0.18-0.67) compared to women with BMI<25 kg/m2, with no associations with mixed IDC/DCIS. In case-case analyses, women who breastfed up to 12 months (OR=0.55; 95% CI, 0.32-0.94) or longer (OR=0.47; 95% CI, 0.26-0.87) showed decreased odds of pure IDC than mixed IDC/DCIS compared to those who did not breastfeed. Conclusions Associations with some breast cancer risk factors differed between mixed IDC/DCIS and pure IDC, potentially suggesting differential developmental pathways. These findings, if confirmed in a larger study, will provide a better understanding of the development patterns of breast cancer and the influence of modifiable risk factors, which in turn could lead to better preventive measures for pure IDC, which

  17. New journals for publishing medical case reports.

    PubMed

    Akers, Katherine G

    2016-04-01

    Because they do not rank highly in the hierarchy of evidence and are not frequently cited, case reports describing the clinical circumstances of single patients are seldom published by medical journals. However, many clinicians argue that case reports have significant educational value, advance medical knowledge, and complement evidence-based medicine. Over the last several years, a vast number (∼160) of new peer-reviewed journals have emerged that focus on publishing case reports. These journals are typically open access and have relatively high acceptance rates. However, approximately half of the publishers of case reports journals engage in questionable or "predatory" publishing practices. Authors of case reports may benefit from greater awareness of these new publication venues as well as an ability to discriminate between reputable and non-reputable journal publishers.

  18. Advance modern medicine with clinical case reports.

    PubMed

    Wáng, Yì-Xiáng J

    2014-12-01

    Randomized clinical trial (RCT) can fail to demonstrate the richness of individual patient characteristics. Given the unpredictable nature of medicine, a patient may present in an unusual way, have a strange new pathology, or react to a medical intervention in a manner not seen before. The publication of these novelties as case reports is a fundamental way of conveying medical knowledge. Throughout history there have been famous case studies that shaped the way we view health and disease. Case reports can have the following functions: (I) descriptions of new diseases; (II) study of mechanisms; (III) discovery new therapies; (IV) recognition of side effects; and (V) education. Before submitting a case report, it is worthwhile to refer to the Case Report Check Sheet described by Green and Johnson [2006].

  19. A case-based assistant for clinical psychiatry expertise.

    PubMed

    Bichindaritz, I

    1994-01-01

    Case-based reasoning is an artificial intelligence methodology for the processing of empirical knowledge. Recent case-based reasoning systems also use theoretic knowledge about the domain to constrain the case-based reasoning. The organization of the memory is the key issue in case-based reasoning. The case-based assistant presented here has two structures in memory: cases and concepts. These memory structures permit it to be as skilled in problem-solving tasks, such as diagnosis and treatment planning, as in interpretive tasks, such as clinical research. A prototype applied to clinical work about eating disorders in psychiatry, reasoning from the alimentary questionnaires of these patients, is presented as an example of the system abilities.

  20. Origin of malaria cases: a 7-year audit of global trends in indigenous and imported cases in relation to malaria elimination.

    PubMed

    Velarde-Rodríguez, Mar; Van den Bergh, Rafael; Fergus, Cristin; Casellas, Aina; Sanz, Sergi; Cibulskis, Richard; Ramsay, Andrew R; Bissell, Karen; Zachariah, Rony

    2015-01-01

    Countries in the different stages of pre-elimination, elimination, and prevention of reintroduction are required to report the number of indigenous and imported malaria cases to the World Health Organization (WHO). However, these data have not been systematically analysed at the global level. For the period 2007 to 2013, we aimed to report on 1) the proportion of countries providing data on the origin of malaria cases and 2) the origin of malaria cases in countries classified as being in the stages of pre-elimination, elimination and prevention of reintroduction. An observational study using annual data reported through routine health information systems to the WHO Global Malaria Programme between 2007 and 2013. For all countries classified as being in pre-elimination, elimination, and prevention of reintroduction in the year 2013, there has been a substantial decrease in the total number of indigenous malaria cases, from more than 15,000 cases reported in 2007 to less than 4,000 cases reported in 2013. However, the total number of imported malaria cases has increased over that time period, from 5,600 imported cases in 2007 to approximately 6,800 in 2013. Vigilant monitoring of the numbers of imported and indigenous malaria cases at national and global levels as well as appropriate strategies to target these cases will be critical to achieve malaria eradication.

  1. Origin of malaria cases: a 7-year audit of global trends in indigenous and imported cases in relation to malaria elimination

    PubMed Central

    Velarde-Rodríguez, Mar; Van den Bergh, Rafael; Fergus, Cristin; Casellas, Aina; Sanz, Sergi; Cibulskis, Richard; Ramsay, Andrew R.; Bissell, Karen; Zachariah, Rony

    2015-01-01

    Background Countries in the different stages of pre-elimination, elimination, and prevention of reintroduction are required to report the number of indigenous and imported malaria cases to the World Health Organization (WHO). However, these data have not been systematically analysed at the global level. Objective For the period 2007 to 2013, we aimed to report on 1) the proportion of countries providing data on the origin of malaria cases and 2) the origin of malaria cases in countries classified as being in the stages of pre-elimination, elimination and prevention of reintroduction. Design An observational study using annual data reported through routine health information systems to the WHO Global Malaria Programme between 2007 and 2013. Results For all countries classified as being in pre-elimination, elimination, and prevention of reintroduction in the year 2013, there has been a substantial decrease in the total number of indigenous malaria cases, from more than 15,000 cases reported in 2007 to less than 4,000 cases reported in 2013. However, the total number of imported malaria cases has increased over that time period, from 5,600 imported cases in 2007 to approximately 6,800 in 2013. Conclusions Vigilant monitoring of the numbers of imported and indigenous malaria cases at national and global levels as well as appropriate strategies to target these cases will be critical to achieve malaria eradication. PMID:26449205

  2. A case study on the successful management of Cotard's syndrome in pregnancy: Case Reports.

    PubMed

    Howe, G; Srinivasan, M

    1999-01-01

    Cotard's Syndrome is rare and no cases have been reported in pregnancy. We describe a case of a woman in the third trimester who attempted suicide by jumping out of a window, sustaining multiple fractures. Delivery of her baby by Caesarean section and orthopaedic intervention was necessary before electroconvulsive therapy (ECT) could be administered, resulting in a successful outcome for both mother and child. (Int J Psych Clin Pract 1999; 3: 293-295).

  3. Associated anomalies in cases with esophageal atresia.

    PubMed

    Stoll, Claude; Alembik, Yves; Dott, Beatrice; Roth, Marie-Paule

    2017-08-01

    Esophageal atresia (EA) is a common type of congenital anomaly. The etiology of esophageal atresia is unclear and its pathogenesis is controversial. Infants with esophageal atresia often have other non-EA associated congenital anomalies. The purpose of this investigation was to assess the prevalence and the types of these associated anomalies in a defined population. The associated anomalies in cases with EA were collected in all livebirths, stillbirths, and terminations of pregnancy during 29 years in 387,067 consecutive births in the area covered by our population-based registry of congenital malformations. Of the 116 cases with esophageal atresia, representing a prevalence of 2.99 per 10,000, 54 (46.6%) had associated anomalies. There were 9 (7.8%) cases with chromosomal abnormalities including 6 trisomies 18, and 20 (17.2%) nonchromosomal recognized dysmorphic conditions including 12 cases with VACTERL association and 2 cases with CHARGE syndrome. Twenty five (21.6%) of the cases had multiple congenital anomalies (MCA). Anomalies in the cardiovascular, the digestive, the urogenital, the musculoskeletal, and the central nervous systems were the most common other anomalies. The anomalies associated with esophageal atresia could be classified into a recognizable malformation syndrome or pattern in 29 out of 54 cases (53.7%). This study included special strengths: each affected child was examined by a geneticist, all elective terminations were ascertained, and the surveillance for anomalies was continued until 2 years of age. In conclusion the overall prevalence of associated anomalies, which was close to one in two cases, emphasizes the need for a thorough investigation of cases with EA. A routine screening for other anomalies may be considered in infants and in fetuses with EA. © 2017 Wiley Periodicals, Inc.

  4. Case Management: Let Us Count the Ways.

    ERIC Educational Resources Information Center

    Austin, Carol D.

    Case management as implemented in programs for the elderly, has focused on interactions between the client and case manager in the areas of assessment, care planning, service plan implementation, and follow-up. Variation in these case management tasks suggests that no single model can be implemented in all local delivery systems. This emphasis on…

  5. 46 CFR 160.171-13 - Storage case.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

  6. 46 CFR 160.171-13 - Storage case.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

  7. 46 CFR 160.171-13 - Storage case.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 6 2014-10-01 2014-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

  8. 46 CFR 160.171-13 - Storage case.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 6 2013-10-01 2013-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

  9. 46 CFR 160.171-13 - Storage case.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 6 2012-10-01 2012-10-01 false Storage case. 160.171-13 Section 160.171-13 Shipping...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-13 Storage case. (a) Each suit must have a storage case made of vinyl coated cloth or material that provides an equivalent measure of...

  10. 45 CFR 303.11 - Case closure criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the best interests of the child to establish paternity in a case involving incest or forcible rape, or... 45 Public Welfare 2 2011-10-01 2011-10-01 false Case closure criteria. 303.11 Section 303.11... STANDARDS FOR PROGRAM OPERATIONS § 303.11 Case closure criteria. (a) The IV-D agency shall establish a...

  11. Peace Corps Water/Sanitation Case Studies and Analyses. Appropriate Technologies for Development. Case Study CS-4.

    ERIC Educational Resources Information Center

    Talbert, Diana E., Comp.

    This document provides an overview of Peace Corps water and sanitation activities, five case studies (Thailand, Yemen, Paraguay, Sierra Leone, and Togo), programming guidelines, and training information. Each case study includes: (1) background information on the country's geography, population, and economics; (2) information on the country's…

  12. Results of the 2013 CASE Europe Salary Survey

    ERIC Educational Resources Information Center

    Paradise, Andrew

    2013-01-01

    CASE has conducted salary surveys to track trends in the profession and to help members benchmark salaries since 1982. Following CASE's major overhaul of the survey instrument and data collection system, CASE Europe fielded a European version of the salary survey for the second time in October 2012. All individual CASE Europe members at colleges,…

  13. Entanglement Evolution of Jaynes-Cummings Model in Resonance Case and Non-resonance Case

    NASA Astrophysics Data System (ADS)

    Cheng, Jing; Chen, Xi; Shan, Chuan-Jia

    2018-06-01

    We investigate the entanglement evolution of a two-level atom and a quantized single model electromagnetic filed in the resonance and non-resonance cases. The effects of the initial state, detuning degree, photon number on the entanglement are shown in detail. The results show that the atom-cavity entanglement state appears with periodicity. The increasing of the photon number can make the period of quantum entanglement be shorter. In the non-resonant case, if we choose the suitable initial state the entanglement of atom-cavity can be 1.0

  14. Acceptance of medical training cases as supplement to lectures

    PubMed Central

    Hörnlein, Alexander; Mandel, Alexander; Ifland, Marianus; Lüneberg, Edeltraud; Deckert, Jürgen; Puppe, Frank

    2011-01-01

    Introduction: Medical training cases (virtual patients) are in widespread use for student education. Most publications report about development and experiences in one course with training cases. In this paper we compare the acceptance of different training case courses with different usages deployed as supplement to lectures of the medical faculty of Wuerzburg university during a period of three semesters. Methods: The training cases were developed with the authoring tool CaseTrain and are available for students via the Moodle-based eLearning platform WueCampus at Wuerzburg university. Various data about usage and acceptance is automatically collected. Results: From WS (winter semester) 08/09 till WS 09/10 19 courses with about 200 cases were available. In each semester, about 550 different medical students from Würzburg and 50 students from other universities processed about 12000 training cases and filled in about 2000 evaluation forms. In different courses, the usage varied between less than 50 and more than 5000 processed cases. Discussion: Although students demand training cases as supplement to all lectures, the data show that the usage does not primarily depend on the quality of the available training cases. Instead, the training cases of nearly all case collections were processed extremely often shortly before the examination. It shows that the degree of usage depends primarily on the perceived relevance of the training cases for the examination. PMID:21866244

  15. Safety Case Development as an Information Modelling Problem

    NASA Astrophysics Data System (ADS)

    Lewis, Robert

    This paper considers the benefits from applying information modelling as the basis for creating an electronically-based safety case. It highlights the current difficulties of developing and managing large document-based safety cases for complex systems such as those found in Air Traffic Control systems. After a review of current tools and related literature on this subject, the paper proceeds to examine the many relationships between entities that can exist within a large safety case. The paper considers the benefits to both safety case writers and readers from the future development of an ideal safety case tool that is able to exploit these information models. The paper also introduces the idea that the safety case has formal relationships between entities that directly support the safety case argument using a methodology such as GSN, and informal relationships that provide links to direct and backing evidence and to supporting information.

  16. Complicated infective endocarditis: a case series.

    PubMed

    Kim, Joo Seop; Kang, Min-Kyung; Cho, A Jin; Seo, Yu Bin; Kim, Kun Il

    2017-05-08

    Infective endocarditis is associated with not only cardiac complications but also neurologic, renal, musculoskeletal, and systemic complications related to the infection, such as embolization, metastatic infection, and mycotic aneurysm. We report three cases (the first patient is Chinese and the other two are Koreans) of complicated infective endocarditis; two of the cases were associated with a mycotic aneurysm, and one case was associated with a splenic abscess. One case of a patient with prosthetic valve endocarditis was complicated by intracerebral hemorrhage caused by mycotic aneurysm rupture. A second case of a patient with right-sided valve endocarditis associated with a central catheter was complicated by an abdominal aortic mycotic aneurysm. The third patient had a splenic infarction and abscess associated with infected cardiac thrombi. Complicated infective endocarditis is rare and is associated with cardiac, neurologic, renal, musculoskeletal, and systemic complications related to infection, such as embolization, metastatic infection, and mycotic aneurysm. Infective endocarditis caused by Staphylococcus aureus is more frequently associated with complications. Because the mortality rate increases when complications develop, aggressive antibiotic therapy and surgery, combined with specific treatments for the complications, are necessary.

  17. Morphological changes in carotid arteries in stroke cases.

    PubMed

    Thapa, Guna Bahadur; Sundas, Alin; Rauniyar, Raj Kumar

    2013-01-01

    Majority of stroke is due to ischemic infarction and occurs in carotid artery territory. The extra cranial parts of carotid arteries are the common sites for the atherosclerotic plaque formation. Ultrasonography is the first line of investigation for screening of the carotid artery diseases to localize and characterize the plaques. Objective was to study the morphological changes in extra cranial part of carotid arteries in cases of ischemic infarction using Ultrasonography. It was an institution based prospective study and convenience sampling method was used. Computed Tomography proven ischemic infarct, lacunar infarction and transient ischemic infarction cases were included in the study. Fifty four cases were included in the study. Mean of Intimo-medial Complex Thickness was 0.89 mm and 0.88 mm in right and left side respectively. Sixty five percent cases had plaque in extra cranial part of carotid artery. Ninety three percent of plaque was found in and adjacent to the carotid bulb region. Ipsilateral plaque was found in 76% and 65% cases on right and left side respectively. Fifty three percent of cases had soft plaque. Majority of cases had less than 50% narrowing of the lumen diameter in term of cross-sectional area due to plaque. Thirteen (24%) cases had plaque in internal carotid artery. Carotid ultrasound can be used for screening of the asymptomatic but high-risk cases and following up of the symptomatic cases to plan for necessary management as required.

  18. Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015

    PubMed Central

    Alhamlan, F S; Majumder, M S; Brownstein, J S; Hawkins, J; Al-Abdely, H M; Alzahrani, A; Obaid, D A; Al-Ahdal, M N; BinSaeed, A

    2017-01-01

    Objectives As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia. Design Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined. Results A total of 1250 patients (aged 0–109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001). Conclusions To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed. PMID:28082362

  19. Utility Bill Calibration Test Cases | Buildings | NREL

    Science.gov Websites

    illustrates the utility bill calibration test cases in BESTEST-EX. In these cases, participants are given software results have been generated. This diagram provides an overview of the BESTEST-EX utility bill calibration case process. On the left side of the diagram is a box labeled "BESTEST-EX Document"

  20. Case Studies for Management Development in Bangladesh.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    Eight case studies appropriate for use in a course in management development were prepared and are provided in this document. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision. Questions for…

  1. Dandy-Walker malformation: analysis of 38 cases.

    PubMed

    Pascual-Castroviejo, I; Velez, A; Pascual-Pascual, S I; Roche, M C; Villarejo, F

    1991-04-01

    Thirty-eight cases of Dandy-Walker malformation (DWM) are presented. A female predominance of 3:1 was found. Thirty-two cases (84%) were diagnosed within the 1st year of life. Of these, 17 cases (44.7%) were diagnosed at birth. Ten (26%) were delivered by cesarean section. Thirteen infants (34%) had a birth weight below 3000 g. Several associated malformations were observed, the most frequent being capillary angioma (6 cases); cardiac malformations, ophthalmic anomalies, agenesis of the corpus callosum, malformed limbs, and occipital meningocele were also seen. These observations indicate that DWM represents a disorder of the midline central nervous system indicative of marked genetic and etiologic heterogeneity with the possibility of showing clinical and pathological alterations intra- and extracranially. Macrocephaly was the most frequent physical finding, appearing in 31 cases (82%). Seventeen (44.7%) patients died, 11 before 6 months of age, 3 between 6 and 12 months, and 3 after 1 year. Postmortem studies were performed in 13 patients. Three cases have been lost to follow-up. Mental retardation (IQ below 70) was found in 11 cases (58% of survivors), low intellect (IQ between 70 and 85) in 4, and only 2 patients showed normal intellectual development (IQ more than 85). The high incidence of malformations having several genetic and environmental origins, as well as the high early mortality of patients with DWM, indicate the complexity of this syndrome, which involves the midline developmental field structures. It is not an isolated malformation of the posterior fossa in most cases.

  2. Air Blasts from Cased and Uncased Explosives

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Glenn, L. A.

    2016-04-12

    The problem of a spherical blast in air is solved using the STUN code. For bare charges, the calculations are shown to be in excellent agreement with previous published results. It is demonstrated that, for an unconfined (uncased) chemical explosive, both range and time to effect scale inversely as the cube root of the yield and directly as the cube root of the ambient air density. It is shown that the peak overpressure decays to roughly 1/10 of ambient pressure in a scaled range of roughly 10 m/kg 1/3 at sea level. At a height of 30 km, where themore » ambient density is a factor of 64 less, the range to the same decay increases to 40 m/kg 1/3 . As a direct result of the scaling a single calculation suffices for all charge sizes and altitudes. Although the close-in results are sensitive to the nature of the explosive source and the equation of state of the air, this sensitivity is shown to virtually disappear at scaled ranges > 0.5 m/kg 1/3 . For cased explosives the case thickness introduces an additional scale factor. Moreover, when the blast wave arrives at the inner case radius the case begins to expand. Fracture occurs when a critical value of the resulting hoop strain is reached, causing the case to shatter into fragments. A model is proposed to describe the size distribution of the fragments and their subsequent motion via drag interaction with the explosion products and ambient air. It is shown that a significant fraction of the charge energy is initially transmitted to the case fragments in the form of kinetic energy; for example, a 1 kg spherical charge with a 5 mm thick steel case has almost 29% of the total charge energy as initial kinetic energy of case fragments. This percentage increases with increasing case thickness and decreases with increasing charge size. The peak overpressure at a given range is 70-85% for cased explosives as compared with uncased and the peak impulse per unit area is 90-95%. The peak overpressure and impulse also decrease

  3. Improving adolescent pregnancy outcomes and maternal health:a case study of comprehensive case managed services.

    PubMed

    Bowman, Elizabeth K; Palley, Howard A

    2003-01-01

    Our findings indicate how health outcomes regarding adolescent pregnancy and maternal and infant health care are intertwined with a case management process that fosters measures that are social in nature-the provision of direct services, as well as the encouragement of informal social supports systems. They also show how case managed services in a small, nongovernmental organization (NGO) with a strong commitment to its clients may provide the spontaneity and caring which results in a "match" between client needs and the delivery of services-and positive outcomes for pregnant women, early maternal health and infant health. The delivery of such case managed services in a manner which is intensive, comprehensive, flexible and integrated contributes significantly to such improved health outcomes.

  4. Intramedullary spindle cell hemangioma: case report.

    PubMed

    Nasser, Rani; Ashayeri, Kimberly; Legatt, Alan D; Houten, John K

    2016-09-01

    The authors describe the case of a 48-year-old man found to have the first reported intramedullary spinal cord spindle cell hemangioma. Previous research indicates that spindle cell hemangiomas are rarely found in the spine. Only 3 previous cases exist, all in the intradural, extramedullary space. In the present case, gross-total resection of the tumor was possible with no loss of function from baseline. This report presents the successful resection of the first reported intramedullary spindle cell hemangioma and reports 4-month follow-up, demonstrating the biological behavior of this rare tumor.

  5. Transportation planning effectiveness: twenty case studies

    DOT National Transportation Integrated Search

    1977-12-31

    This document consists of 20 site-specific case studies of urban area experience with the Technical Study Grant Program of the Urban Mass Transportation Administration (UMTA). The objective of the case studies is to determine how the Technical Study ...

  6. Organizational Effectiveness Case Development Manual

    DTIC Science & Technology

    1980-10-01

    Target audience Legal issues UAmographic information Sanctions Write-up format L eaching case Pay-off s The manual is a guide for developing...most efficient and effective way. The manual is divided into three main sections: (1) on the issues of client system sanction, confidentiality, and...CASE DEVELOPMENT MANUAL James Bedoian, Larry E. Greiner, Charles P. Schaefer, Warren H. Schmidt, Stanley R. Weingart System Development Corporation

  7. Using Case Studies in Calculus-based Physics

    NASA Astrophysics Data System (ADS)

    Katz, Debora M.

    2006-12-01

    Do your students believe that the physics only works in your classroom or laboratory? Or do they see that physics underlies their everyday experience? Case studies in physics help students connect physics principles to their everyday experience. For decades, case studies have been used to teach law, medicine and biology, but they are rarely used in physics. I am working on a calculus-based physics textbook for scientists and engineers. Case studies are woven into each chapter. Stop by and get a case study to test out in your classroom. I would love to get your feedback.

  8. The Association Between Urban Tree Cover and Gun Assault: A Case-Control and Case-Crossover Study.

    PubMed

    Kondo, Michelle C; South, Eugenia C; Branas, Charles C; Richmond, Therese S; Wiebe, Douglas J

    2017-08-01

    Green space and vegetation may play a protective role against urban violence. We investigated whether being near urban tree cover during outdoor activities was related to being assaulted with a gun. We conducted geographic information systems-assisted interviews with boys and men aged 10-24 years in Philadelphia, Pennsylvania, including 135 patients who had been shot with a firearm and 274 community controls, during 2008-2011. Each subject reported a step-by-step mapped account of where and with whom they traveled over a full day from waking until being assaulted or going to bed. Geocoded path points were overlaid on mapped layers representing tree locations and place-specific characteristics. Conditional logistic regressions were used to compare case subjects versus controls (case-control) and case subjects at the time of injury versus times earlier that day (case-crossover). When comparing cases at the time of assault to controls matched at the same time of day, being under tree cover was inversely associated with gunshot assault (odds ratio (OR) = 0.70, 95% confidence interval (CI): 0.55, 0.88), especially in low-income areas (OR = 0.69, 95% CI: 0.54, 0.87). Case-crossover models confirmed this inverse association overall (OR = 0.55, 95% CI: 0.34, 0.89) and in low-income areas (OR = 0.54, 95% CI: 0.33, 0.88). Urban greening and tree cover may hold promise as proactive strategies to decrease urban violence. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  9. Identification and medical utilization of incident cases of alcohol dependence: A population-based case-control study.

    PubMed

    Pan, Chun-Hung; Li, Min-Shan; Yang, Tien-Wey; Huang, Ming-Chyi; Su, Sheng-Shiang; Hung, Yen-Ni; Chen, Chiao-Chicy; Kuo, Chian-Jue

    2018-05-05

    Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010. For this nested case-control study, four controls were matched for age and sex with each case based on risk-set sampling. We measured various dimensions of medical utilization before AD was diagnosed, including department visited, physical comorbidity, and medication used. Conditional logistic regression was used for estimating the variables associated with AD. Patients living in less urbanized areas who were unemployed were more likely to develop AD. The highest proportions (34.2%) of AD cases were identified in the internal medicine department, followed by the emergency (22.3%) and psychiatry (18.7%) departments. AD patients had a higher risk of comorbid chronic hepatic disease (adjusted RR = 2.72, p < 0.001) before identification of AD than controls. AD patients also had greater numbers of hospital admissions than controls, including non-psychiatric and psychiatric hospitalizations. Outpatient visit numbers were similar for AD patients and controls. The findings indicate that clinicians providing care in diverse medical settings should be prepared to screen for unhealthy alcohol use and to mitigate its detrimental effects. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Analysis of Clinical Cohort Data Using Nested Case-control and Case-cohort Sampling Designs. A Powerful and Economical Tool.

    PubMed

    Ohneberg, K; Wolkewitz, M; Beyersmann, J; Palomar-Martinez, M; Olaechea-Astigarraga, P; Alvarez-Lerma, F; Schumacher, M

    2015-01-01

    Sampling from a large cohort in order to derive a subsample that would be sufficient for statistical analysis is a frequently used method for handling large data sets in epidemiological studies with limited resources for exposure measurement. For clinical studies however, when interest is in the influence of a potential risk factor, cohort studies are often the first choice with all individuals entering the analysis. Our aim is to close the gap between epidemiological and clinical studies with respect to design and power considerations. Schoenfeld's formula for the number of events required for a Cox' proportional hazards model is fundamental. Our objective is to compare the power of analyzing the full cohort and the power of a nested case-control and a case-cohort design. We compare formulas for power for sampling designs and cohort studies. In our data example we simultaneously apply a nested case-control design with a varying number of controls matched to each case, a case cohort design with varying subcohort size, a random subsample and a full cohort analysis. For each design we calculate the standard error for estimated regression coefficients and the mean number of distinct persons, for whom covariate information is required. The formula for the power of a nested case-control design and the power of a case-cohort design is directly connected to the power of a cohort study using the well known Schoenfeld formula. The loss in precision of parameter estimates is relatively small compared to the saving in resources. Nested case-control and case-cohort studies, but not random subsamples yield an attractive alternative for analyzing clinical studies in the situation of a low event rate. Power calculations can be conducted straightforwardly to quantify the loss of power compared to the savings in the num-ber of patients using a sampling design instead of analyzing the full cohort.

  11. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  12. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  13. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  14. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  15. 7 CFR 29.2287 - Order (case).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Order (case). 29.2287 Section 29.2287 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... (case). The state of tobacco with respect to its moisture content. ...

  16. The FIDELIS initiative: innovative strategies for increased case finding.

    PubMed

    Hinderaker, S G; Rusen, I D; Chiang, C-Y; Yan, L; Heldal, E; Enarson, D A

    2011-01-01

    Low-income, high tuberculosis (TB) burden countries. To compare case finding of new smear-positive pulmonary TB patients in projects funded to apply innovative approaches. Prospective application of innovative approaches to case finding within routine services to determine the numbers of additional cases detected and the cost per additional case detected, according to the type of approach applied. Between 2003 and 2007, 51 FIDELIS projects were implemented in 18 countries; 273,239 cases were reported, of which 85,267 were additional to the number reported in the previous year. The median cost per additional case was US$103. The interventions employed were: 1) social mobilisation and information, education and communication; 2) engagement of the private sector; 3) innovative approaches for microscopy services; 4) enhanced or semi-active case finding; 5) health systems strengthening; and 6) use of incentives. None of these was significantly more likely to detect additional cases or to have a lower cost per additional case than any of the others. While there was a substantial increase in cases detected, at a moderate cost per additional case, we were unable to show that any single intervention had an advantage over the others.

  17. Knowledge acquisition for case-based reasoning systems

    NASA Technical Reports Server (NTRS)

    Riesbeck, Christopher K.

    1988-01-01

    Case-based reasoning (CBR) is a simple idea: solve new problems by adapting old solutions to similar problems. The CBR approach offers several potential advantages over rule-based reasoning: rules are not combined blindly in a search for solutions, solutions can be explained in terms of concrete examples, and performance can improve automatically as new problems are solved and added to the case library. Moving CBR for the university research environment to the real world requires smooth interfaces for getting knowledge from experts. Described are the basic elements of an interface for acquiring three basic bodies of knowledge that any case-based reasoner requires: the case library of problems and their solutions, the analysis rules that flesh out input problem specifications so that relevant cases can be retrieved, and the adaptation rules that adjust old solutions to fit new problems.

  18. Testicular calculus: A rare case.

    PubMed

    Sen, Volkan; Bozkurt, Ozan; Demır, Omer; Tuna, Burcin; Yorukoglu, Kutsal; Esen, Adil

    2015-01-01

    Testicular calculus is an extremely rare case with unknown etiology and pathogenesis. To our knowledge, here we report the third case of testicular calculus. A 31-year-old man was admitted to our clinic with painful solid mass in left testis. After diagnostic work-up for a possible testicular tumour, he underwent inguinal orchiectomy and histopathologic examination showed a testicular calculus. Case hypothesis: Solid testicular lesions in young adults generally correspond to testicular cancer. Differential diagnosis should be done carefully. Future implications: In young adults with painful and solid testicular mass with hyperechogenic appearance on scrotal ultrasonography, testicular calculus must be kept in mind in differential diagnosis. Further reports on this topic may let us do more clear recommendations about the etiology and treatment of this rare disease.

  19. Menstruation angina: a case report

    PubMed Central

    2009-01-01

    Introduction Menstruation is commonly associated with migraine and irritable bowel but is rarely correlated with angina or myocardial ischaemia. Only a small number of cases have been reported suggesting a link between menstruation and myocardial ischaemic events. Case presentation A case of menstruation angina is reported in order to raise awareness of this association. A 47-year-old South Asian woman presented with recurrent chest pains in a monthly fashion coinciding with her menstruations. Each presentation was associated with troponin elevation. Angioplasty failed to resolve her symptoms but she eventually responded to hormonal therapy. Conclusions The possibility of menstruation angina should always be taken into account in any female patients from puberty to menopause presenting with recurrent chest pains. This can allow an earlier introduction of hormonal therapy to arrest further myocardial damage. PMID:19830114

  20. International or national publication of case reports.

    PubMed

    Lundh, Andreas; Christensen, Mikkel; Jørgensen, Anders W

    2011-02-01

    Case reports are often regarded as second-class research, but are an important part of medical science as they often present first evidence of new discoveries. We here describe the type of case reports published in a Danish general medical journal. We included all case reports published in Ugeskrift for Laeger in 2009. For each report, two authors extracted information on study characteristics and classified the relevance and the role of the report. We included 139 case reports written in Danish. Thirty-nine (28%) were of general relevance and 100 (72%) of speciality relevance. The median number of authors was three (range: 1-7). The first author was a non-specialist physician in 119 (86%) of the reports and the last author a specialist in 103 (78%). A total of 124 (89%) reports had an educational role, six (4%) dealt with new diseases, two (1%) with new side effects, three (2%) with new mechanisms and four (3%) were curiosities. A total of 59 (42%) reports were surgical, 64 (46%) non-surgical and 16 (12%) paraclinical. We found that most case reports published in Ugeskrift for Laeger were of speciality relevance and had an educational perspective. The journal may consider focusing on cases of more general educational relevance and should also consider whether the current form and language suit the aim and role of the various types of case reports.

  1. Principles for funding on a case mix basis: construction of case weights (RIWs).

    PubMed

    Botz, C K

    1991-01-01

    The construct of Resource Intensity Weights (RIWs) contains implicit financial incentives if they are used for hospital funding purposes. This paper compares the RIW (funding) credit to the expected average per diem cost for each of the new subcategories (typicals, deaths, transfers, signouts and outliers) of Case Mix Groups (CMGs). RIW construction, and inherent incentives for a hospital to reduce costs or length of stay (LOS), differ significantly for each subcategory. At some point or points in a patient's LOS, when RIW credit equals case cost, RIWs are incentive neutral. However, it can also be demonstrated that RIW credit is not generally congruent with average costs on each day of a patient's stay. Financial incentives (both positive and negative) arise when RIW credit and costs differ. Only by being fully aware of these differences can hospitals determine how to respond to the introduction of case mix funding to maintain financial viability. Funding agencies, too, need to appreciate the sometimes subtle policy implications that come with the adoption of RIWs for funding purposes.

  2. A Tale of Three Cases: Examining Accuracy, Efficiency, and Process Differences in Diagnosing Virtual Patient Cases

    ERIC Educational Resources Information Center

    Doleck, Tenzin; Jarrell, Amanda; Poitras, Eric G.; Chaouachi, Maher; Lajoie, Susanne P.

    2016-01-01

    Clinical reasoning is a central skill in diagnosing cases. However, diagnosing a clinical case poses several challenges that are inherent to solving multifaceted ill-structured problems. In particular, when solving such problems, the complexity stems from the existence of multiple paths to arriving at the correct solution (Lajoie, 2003). Moreover,…

  3. Case Management for Individuals with Mental Retardation. ARC Facts.

    ERIC Educational Resources Information Center

    Association for Retarded Citizens, Arlington, TX.

    A question-and-answer format is used in this fact sheet to provide information on case management for individuals with mental retardation. The fact sheet describes the major components of a case management system, the role of the case manager, the individual's or family's role in case management, providers of case management services and systems…

  4. Case report: a rare case of attempted homicide with Gloriosa superba seeds.

    PubMed

    Kande Vidanalage, Chaminda J; Ekanayeka, Rohan; Wijewardane, Deepthi K

    2016-06-21

    Gloriosa superba, well known as the glory lily or superb lily, is a tropical climbing plant that features an exotic red flower. The plant is poisonous because of high concentrations of colchicine in all parts of the plant. It is commercially grown for use in Ayurveda medicine and as a cash crop for extracting colchicine in India and Africa. It is a wild plant in Sri Lanka and commercial cultivation is rare. Accidental and suicidal poisonings with Gloriosa tubers are well known and reported. There are no case reports of poisoning by Gloriosa seeds in Sri Lanka. Google and PubMed searches showed no reported cases of poisoning with seeds or their use with homicidal intent in other parts of the world. A 27-year-old man was brought to hospital with profuse vomiting and diarrhea after drinking coriander tea, which is a common traditional treatment for common cold. The family members suspected poisoning by Gloriosa because they had seeds at home and the victim's sister-in-law who had made the herbal tea went missing from home. They were able to identify Gloriosa seeds, which looked similar to coriander, in the pot. The patient developed shock and respiratory distress and needed ventilation and intensive care. He also developed mild renal impairment, and thrombocytopenia. He developed massive generalized alopecia while recovering from acute illness. Full recovery was achieved after 15 days of hospital care. There are many poisonous plants in Asian countries. This case highlights the possibility of accidental or intentional use of Gloriosa seeds or its extracts to cause potentially fatal poisoning. It would be difficult to identify Gloriosa as the cause of poisoning without any background information because of multiple complications that can mimic a systemic infection. This case is a good example of the use of plants as biological weapons.

  5. Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015.

    PubMed

    Alhamlan, F S; Majumder, M S; Brownstein, J S; Hawkins, J; Al-Abdely, H M; Alzahrani, A; Obaid, D A; Al-Ahdal, M N; BinSaeed, A

    2017-01-12

    As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia. Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined. A total of 1250 patients (aged 0-109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001). To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Insulin Pump Malfunction During Hospitalization: Two Case Reports.

    PubMed

    Faulds, Eileen R; Wyne, Kathleen L; Buschur, Elizabeth O; McDaniel, Jodi; Dungan, Kathleen

    2016-06-01

    Insulin pump malfunctions and failures continue to occur; however, more severe malfunctions such as the "runaway pump" phenomenon are rarely reported. This article describes two cases of pump malfunction in which pump users appear to have received an unsolicited bolus of insulin resulting in severe episodes of hypoglycemia during hospitalization. Both cases of insulin pump malfunction occurred in the inpatient setting at a large academic medical center in the United States. An analysis of the corresponding insulin pump downloads was performed. The Food and Drug Administration's (FDA's) Manufacturer and User Facility Device Experience (MAUDE) database was searched for similar cases involving Medtronic (Northridge, CA) insulin pumps using the terms "pump," "infusion," "insulin AND malfunction AND Medtronic." The two cases described show remarkable similarities, each demonstrating a severe hypoglycemic event preceded by an infusion site change followed by an alarm. In both cases a rapid spraying of insulin was reported. The insulin pump downloads validated much of the patients' and medical staff's descriptions of events. The FDA's MAUDE database search revealed 425 cases meeting our search term criteria. All cases were reviewed. Seven cases were identified involving independent movement of the reservoir piston. The cases detailed are the first to describe an insulin pump malfunction of this nature in the hospital setting involving unsolicited insulin boluses leading to severe hypoglycemia. The cases are particularly compelling in that they were witnessed by medical personnel. Providers and patients should receive instruction education on the recognition and management of insulin pump malfunction.

  7. Canine ocular protothecosis: A review of 14 cases.

    PubMed

    Shank, Alba Maria M; Dubielzig, Richard D; Teixeira, Leandro B C

    2015-09-01

    To examine a series of 14 cases of canine ocular protothecosis from archived cases from the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW), and compare gross and histologic findings. Archival records from COPLOW were searched for canine cases of ocular protothecosis. Fourteen cases that contained matching criteria were identified, and gross and histologic findings, and clinical records for each case were tabulated, examined, and compared (2001-2013). Of the 14 cases identified, six had evidence of systemic disease, as per clinical history. Two of the 14 cases had Prototheca identified via cytology of ocular fluid or retinal exudate; in the remainder of cases, Prototheca identified via cytology of ocular fluid or retinal exudate in the remaining 12 cases, Prototheca was identified upon histologic examination of the submitted globe(s). Presenting ocular clinical signs were variable and nonspecific. Duration of ocular clinical signs varied from days to months. Fundoscopically, white membranes or plaques were identified on or around the retina in five cases. Retinal detachment was identified in 13 of the 14 submitted globes on gross examination following fixation and sectioning. The predominant histologic finding was granulomatous chorioretinitis with retinal detachment, with variable numbers of Prototheca within the inflammatory infiltrate. Due to the nonspecific nature of the ocular signs, a diagnosis of protothecosis generally is not made until enucleation and histopathologic examination of the globe(s). Retinal detachment and blindness were common. Cytologic sampling of retinal plaques and exudate may provide a rapid way to identify Prototheca. © 2014 American College of Veterinary Ophthalmologists.

  8. Evaluating performance of local case-mix system by international comparison: a case study in Beijing, China.

    PubMed

    Jian, Wei-Yan; Lu, Ming; Cui, Tao; Hu, Mu

    2011-01-01

    Case-mix is an important tool for health planning and management in many countries. As a major developing country, China is considering the introduction of the case-mix system in the health reform. Beijing, the capital of China, developed a local case-mix version whose performance needs to be evaluated before utilization. The objective of this study was to evaluate the performance of the case-mix system developed in Beijing by comparing it with those used in Australia and the U.S.A. A total of 1.3 million inpatient records from 154 hospitals in Beijing in 2008 were grouped respectively using three case-mix systems: (i) Beijing Diagnosis Related Groups (BJ-DRGs); (ii) US-based All Patient DRGs; and (iii) Australian Refined DRGs. Coefficient of variation (CV) and reduction in variance (RIV) were used to measure the performance of DRGs system. The BJ-DRGs produced the best CV and RIV results for expenditure. However, at the level of Major Diagnostic Category (MDC), three MDCs of BJ-DRGs gave the poorest RIVs for both expenditure and length of stay. Although the performance of BJ-DRGs was acceptable, further revision and improvement is needed. Comparisons with other mature DRGs versions can assist in identifying the improvement priorities of the local version. Copyright © 2011 John Wiley & Sons, Ltd.

  9. HYDROGEOLOGIC CASE STUDIES

    EPA Science Inventory

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  10. CASE Recognition Awards.

    ERIC Educational Resources Information Center

    Currents, 1985

    1985-01-01

    A total of 294 schools, colleges, and universities received prizes in this year's CASE Recognition program. Awards were given in: public relations programs, student recruitment, marketing, program pulications, news writing, fund raising, radio programming, school periodicals, etc. (MLW)

  11. Predicting U.S. tuberculosis case counts through 2020.

    PubMed

    Woodruff, Rachel S Y E L K; Winston, Carla A; Miramontes, Roque

    2013-01-01

    In 2010, foreign-born persons accounted for 60% of all tuberculosis (TB) cases in the United States. Understanding which national groups make up the highest proportion of TB cases will assist TB control programs in concentrating limited resources where they can provide the greatest impact on preventing transmission of TB disease. The objective of our study was to predict through 2020 the numbers of U.S. TB cases among U.S.-born, foreign-born and foreign-born persons from selected countries of birth. TB case counts reported through the National Tuberculosis Surveillance System from 2000-2010 were log-transformed, and linear regression was performed to calculate predicted annual case counts and 95% prediction intervals for 2011-2020. Data were analyzed in 2011 before 2011 case counts were known. Decreases were predicted between 2010 observed and 2020 predicted counts for total TB cases (11,182 to 8,117 [95% prediction interval 7,262-9,073]) as well as TB cases among foreign-born persons from Mexico (1,541 to 1,420 [1,066-1,892]), the Philippines (740 to 724 [569-922]), India (578 to 553 [455-672]), Vietnam (532 to 429 [367-502]) and China (364 to 328 [249-433]). TB cases among persons who are U.S.-born and foreign-born were predicted to decline 47% (4,393 to 2,338 [2,113-2,586]) and 6% (6,720 to 6,343 [5,382-7,476]), respectively. Assuming rates of declines observed from 2000-2010 continue until 2020, a widening gap between the numbers of U.S.-born and foreign-born TB cases was predicted. TB case count predictions will help TB control programs identify needs for cultural competency, such as languages and interpreters needed for translating materials or engaging in appropriate community outreach.

  12. Reflective practice: a framework for case manager development.

    PubMed

    Brubakken, Karen; Grant, Sara; Johnson, Mary K; Kollauf, Cynthia

    2011-01-01

    The role of a nurse case manager (NCM) incorporates practice that is built upon knowledge gained in other roles as well as components unique to case management. The concept of reflective practice was used in creating a framework to recognize the developmental stages that occur within community based case management practice. The formation of this framework and its uses are described in this article. The practice setting is a community based case management department in a large midwestern metropolitan health care system with Magnet recognition. Advanced practice nurses provide care for clients with chronic health conditions. Twenty-four narratives were used to identify behaviors of community based case managers and to distinguish stages of practice. The behaviors of advanced practice found within the narratives were labeled and analyzed for similarities. Related behaviors were grouped and descriptor statements were written. These statements grouped into 3 domains of practice: relationship/partnership, coordination/collaboration, and clinical knowledge/decision making. The statements in each domain showed practice variations from competent to expert, and 3 stages were determined. Reliability and validity of the framework involved analysis of additional narratives. The reflective practice process, used for monthly case review presentations, provides opportunity for professional development and group learning focused on improving case manager practice. The framework is also being used in orientation as new case managers acclimate to the role. Reflective writing has unveiled the richness and depth of nurse case manager practice. The depth of knowledge and skills involved in community-based case management is captured within this reflective practice framework. This framework provides a format for describing community based case manager practice development over the course of time and has been used as a tool for orientation and peer review.

  13. Primary Spinal Intramedullary Neurocysticercosis: A Report of 3 Cases.

    PubMed

    Datta, Subramanya G S; Mehta, Ritu; Macha, Shrikant; Tripathi, Sanjog

    2017-09-01

    We describe a series of 3 cases of the rare intramedullary form of primary spinal neurocysticercosis. The cases were seen in varied age groups and showed different profiles at presentation. All the cases were thoroughly evaluated clinically and radiologically. Serologic tests were not conducted. In all cases, magnetic resonance imaging showed a large intramedullary lesion in the thoracic spinal cord consisting of a cystic lesion with a well-defined intramural nodule. One case was managed with steroids and cysticidal therapy, a second case was managed with steroids and surgery (2 emergency procedures), while the third case was managed without any medical or surgical intervention, as the patient was unwilling for either. All cases showed good neurologic recovery. In the second case where surgery was done, histologic examination of the resected specimen demonstrated the cysticercal parasite surrounded by mixed inflammatory infiltrate. As there were no intracranial lesions in all 3 cases, the final diagnosis was primary isolated intramedullary neurocysticercosis. Primary isolated intramedullary-neurocysticercosis remains a rare condition afflicting the spinal cord. It forms a small subset of cysticercal infestation of the neuraxis. Such evidence is rare, and only anecdotal reports are available. Our case series captures the wide spectrum of presentations, as well as the management options, and highlights the varied ways in which these cases were managed. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Sporotrichosis as an unusual case of osteomyelitis: A case report and review of the literature.

    PubMed

    Lederer, Henry T; Sullivan, Eva; Crum-Cianflone, Nancy F

    2016-03-01

    Sporotrichosis is an infection of worldwide distribution caused by the dimorphic fungus, Sporothrix schenckii. Acquisition typically occurs via cutaneous inoculation with development of a localized cutaneous and/or lymphocutaneous infection. We present a rare case of osteoarticular sporotrichosis in a 39-year-old man and review the literature noting only 20 published cases since 1980. Recommendations on the diagnosis and management of this unusual infection are provided.

  15. Case reports: Should we do away with them?

    PubMed

    Firat, Aynur Camkiran; Araz, Coskun; Kayhan, Zeynep

    2017-02-01

    There has been a gradual decline in the number of case reports published in leading medical journals in recent years. Since case reports are not highly cited they have an adverse effect on the journal impact factor. On the other hand sharing new experiences, challenges, or discoveries with colleagues is essential for medical community. Should case reports be eliminated from the journals or published only in journals devoted to case reports? Observational study. Web of Science database was searched, between 2005 and 2009, with terms: "anesthesia", "anesthesiology" and "case report" yielding 25 969, 9532, and 661 publications, respectively. Since some reports contained large number of cases, only those involving up to three cases (n = 425) were evaluated by the authors with respect to their type, contribution to knowledge and/or practice (Likert scale) and times they were cited. Distribution of answers to the statement "Case has added to my knowledge and/or improved my practice" was; 3% (strongly disagree), 10.5% (disagree), 33.2% (neither agree nor disagree), 39.3% (agree) and 13.7% (strongly agree). Average citations per item was 4.43 (1883/425), 7.32 (4838/661), and 7.82 (74 529/9532). As to the types of the reports; 50% unexpected event in the course of anesthesia, 31% unusual and instructive cases, 9.6% novel/unique anesthetic techniques, 6% novel use of equipment, 1.6% new information on diseases of importance to anesthesiology and 1% scientific observations. Case reports have been an important source of clinical guidance and scientific insight, and play an important role in medical education. They can be published quickly, providing publication opportunity for juniors and for clinicians who may not have the time or finance to conduct large-scale research. On the other hand some argue, that case reports are irrelevant in current medical practice and education, being at the bottom of the hierarchical ladder of medical evidence. We conclude that case reports

  16. Diversity in case management modalities: the Summit model.

    PubMed

    Peterson, G A; Drone, I D; Munetz, M R

    1997-06-01

    Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect to the needs of specific populations. The authors describe a highly differentiated and prescriptive system of case management involving the application of more than one model of service delivery. Such a diversified and targeted system offers an opportunity to study the technology of case management in a more meaningful manner.

  17. [Two cases of Costello syndrome].

    PubMed

    Masuyama, Tatsuo; Matsuo, Muneaki; Kuno, Tateo; Kitsuki, Kyoko; Kan, Yuka; Ishii, Kiyohisa; Ohtani, Yoshinobu

    2003-01-01

    We report two unrelated cases of Costello syndrome, presenting with poor postnatal growth, mild mental retardation, poor feeding, curly hair, coarse characteristic face, loose skin, hypotonia, and cardiac involvement. Nasal papilloma and acanthosis nigricans were the most characteristic features of this syndrome. Both cases had atrial fibrilation from infancy to early childhood. One patient had hypertonia in the lower extremities and pes equinovarus, while the other had hypotonia and pes planovalgus.

  18. General practice performance in referral for suspected cancer: influence of number of cases and case-mix on publicly reported data.

    PubMed

    Murchie, P; Chowdhury, A; Smith, S; Campbell, N C; Lee, A J; Linden, D; Burton, C D

    2015-05-26

    Publicly available data show variation in GPs' use of urgent suspected cancer (USC) referral pathways. We investigated whether this could be due to small numbers of cancer cases and random case-mix, rather than due to true variation in performance. We analysed individual GP practice USC referral detection rates (proportion of the practice's cancer cases that are detected via USC) and conversion rates (proportion of the practice's USC referrals that prove to be cancer) in routinely collected data from GP practices in all of England (over 4 years) and northeast Scotland (over 7 years). We explored the effect of pooling data. We then modelled the effects of adding random case-mix to practice variation. Correlations between practice detection rate and conversion rate became less positive when data were aggregated over several years. Adding random case-mix to between-practice variation indicated that the median proportion of poorly performing practices correctly identified after 25 cancer cases were examined was 20% (IQR 17 to 24) and after 100 cases was 44% (IQR 40 to 47). Much apparent variation in GPs' use of suspected cancer referral pathways can be attributed to random case-mix. The methods currently used to assess the quality of GP-suspected cancer referral performance, and to compare individual practices, are misleading. These should no longer be used, and more appropriate and robust methods should be developed.

  19. Primary retroperitoneal mucinous cystadenocarcinoma: report of two cases

    PubMed Central

    de León, David Cantú; Pérez-Montiel, Delia; Chanona-Vilchis, José; Dueñas-González, Alfonso; Villavicencio-Valencia, Verónica; Zavala-Casas, Gladys

    2007-01-01

    Background Retroperitoneal cystadenocarcinomas are rare lesions, the majority of cases presented as one-patient reports. Methods We present two cases of retroperitoneal cystadenocarcinoma, both in women of reproductive age: one with aggressive behavior, and the remaining case, with a more indolent clinical evolution. Results One case presented as pelvic tumor, was treated with surgical resection of the disease, but manifested with recurrent disease a few months later despite use of chemotherapy. The second case involved a patient with diagnosis of abdominal tumor; during laparotomy, a retroperitoneal tumor was found and was totally removed. At follow-up, the patient is disease-free with no other treatment. Conclusion The behavior and treatment of retroperitoneal cystadenocarcinoma are controversial. We suggest aggressive surgery including radical hysterectomy and bilateral salpingoopherectomy with adjuvant chemotherapy in these cases. PMID:17224073

  20. An ontological case base engineering methodology for diabetes management.

    PubMed

    El-Sappagh, Shaker H; El-Masri, Samir; Elmogy, Mohammed; Riad, A M; Saddik, Basema

    2014-08-01

    Ontology engineering covers issues related to ontology development and use. In Case Based Reasoning (CBR) system, ontology plays two main roles; the first as case base and the second as domain ontology. However, the ontology engineering literature does not provide adequate guidance on how to build, evaluate, and maintain ontologies. This paper proposes an ontology engineering methodology to generate case bases in the medical domain. It mainly focuses on the research of case representation in the form of ontology to support the case semantic retrieval and enhance all knowledge intensive CBR processes. A case study on diabetes diagnosis case base will be provided to evaluate the proposed methodology.

  1. Hepatic inflammatory pseudotumor: A case series

    PubMed Central

    Calomeni, Guilherme D.; Ataíde, Elaine B.; Machado, Ricardo R.; Escanhoela, Cecília A.F.; Costa, Larissa B.E.; Boin, Ilka F.F.

    2013-01-01

    INTRODUCTION Inflammatory pseudotumor (IPT) is a rare lesion consisted of inflammatory and myofibroblastic cells. These lesions may be found in different organs. There are less than 300 described cases. PRESENTATION OF CASE Case 1. 64-year-old cirrhotic male with a palpable epigastric mass. CT showed a lesion in liver segments 2 and 3 and left hepatic artery aneurism. Percutaneous embolization and wide spectrum antibiotics were tried, however the lesion grew. Left lateral hepatectomy was performed, and HIPT diagnosed. The patient died due to multiple organ dysfunction. Case 2. 30-year-old male with abdominal pain and fever. CT showed a hepatic hilar lesion. Surgical resection was performed after an ineffectual antibiotic trial, and HIPT was confirmed. The patient is doing well. Case 3. 73-year-old female with abdominal pain and fever. CT showed a 7 cm lesion in the left liver lobe. Unrewarding cancerous screening was performed, and unsuccessful antibiotic course was tried. Resection was performed, and HIPT diagnosed. The patient is doing well. Case 4. 50-year-old cirrhotic male with abdominal pain. CT showed a segment 6 lesion and portal vein thrombosis. Considering cancer as the first hypothesis and the MELD score of 9, segmentectomy was performed. HIPT was the final diagnosis. The patient died due to abdominal sepsis. DISCUSSION HIPT is a lesion with a vast list of differential diagnosis. Antibiotics are the first line of therapy, although surgery is often necessary. Overall prognosis is good, although comorbidities may worsen it. CONCLUSION HIPT is a rare and misleading entity. PMID:23399515

  2. Modalities of Generalization Through Single Case Studies.

    PubMed

    Zittoun, Tania

    2017-06-01

    The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

  3. Renal involvement in fatal cases of chikungunya virus infection.

    PubMed

    Mercado, Marcela; Acosta-Reyes, Jorge; Parra, Edgar; Guzmán, Luis; Beltrán, Mauricio; Gasque, Philippe; Mejía-García, Carlos; Viasus, Diego

    2018-06-01

    Information regarding physiopathology and complications in fatal cases of chikungunya virus (CHIKV) is scarce. The aim of this study was to describe the frequency and severity of renal complications in fatal cases associated with CHIKV infection based on the clinical and histopathological features from post-mortem tissue biopsies. This retrospective study included fatal cases associated with CHIKV infection occurring from September 2014 through October 2015, reported to National System for Public Health Surveillance (SIVIGILA) and laboratory-confirmed by the National Institute of Health of Colombia. Medical records from 13 patients were available. Information was collected on history, physical examination, and haematological, biochemical, radiological, and virologic investigation reports. Diagnosis of CHIKV infection was performed by positive CHIKV-PCR on post-mortem tissue in 10 cases, positive CHIKV-PCR in serum in 6 cases and anti-CHIKV virus IgM in 2 cases. Only 3 cases were children (≤5 years old). Four cases had underlying diseases, mainly systemic arterial hypertension. The median value of creatinine at admission was 2.8 mg/dL (interquartile range 1.52-4.51). During hospitalization, 9 cases required ICU admission, 8 vasopressor support and 6 mechanical ventilation. Kidney histopathological findings were mainly acute interstitial nephritis (11 cases), congestion/oedema glomerular (10 cases) and acute tubular necrosis (5 cases). Renal impairment in fatal cases of CHIKV infection is frequent and related mainly to acute interstitial nephritis. These data demonstrate evidence of acquired kidney injuries during CHIKV infection. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Pinpointing clusters of apparently sporadic cases of Legionnaires' disease.

    PubMed Central

    Bhopal, R. S.; Diggle, P.; Rowlingson, B.

    1992-01-01

    OBJECTIVES--To test the hypothesis that many non-outbreak cases of legionnaires' disease are not sporadic and to attempt to pinpoint cases clustering in space and time. DESIGN--Descriptive study of a case series, 1978-86. SETTING--15 health boards in Scotland. PATIENTS--203 probable cases of non-outbreak, non-travel, community acquired legionnaires' disease in patients resident in Scotland. MAIN MEASURES--Date of onset of disease and postcode and health board of residence of cases. RESULTS--Space-time clustering was present and numerous groups of cases were identified, all but two being newly recognised. Nine cases occurred during three months within two postcodes in Edinburgh, and an outbreak was probably missed. In several places cases occurred in one area over a prolonged period--for example, nine cases in postcode districts G11.5 and G12.8 in Glasgow during five years (estimated mean annual incidence of community acquired, non-outbreak, non-travel legionnaires' disease of 146 per million residents v 4.8 per million for Scotland). Statistical analysis showed that the space time clustering of cases in the Glasgow and Edinburgh areas was unusual (p = 0.036, p = 0.068 respectively). CONCLUSION--Future surveillance requires greater awareness that clusters can be overlooked; case searching whenever a case is identified; collection of complete information particularly of date of onset of the disease and address or postcode; ongoing analysis for space-time clustering; and an accurate yet workable definition of sporadic cases. Other researchers should re-examine their data on apparently sporadic infection. PMID:1586784

  5. 76 FR 6381 - Fee-Generating Cases

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-04

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services...) proposes to amend the Legal Services Corporation's regulation on fee-generating cases to clarify that it... Counsel, Office of Legal Affairs, Legal Services Corporation, 3333 K Street, NW., Washington, DC 20007...

  6. 14 CFR 1203.409 - Exceptional cases.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Original Classification § 1203.409 Exceptional cases. (a) In those cases where a person not authorized to classify information orginates or develops information which is believed to require classification, that... decision made by an appropriate classifying authority. For NASA employees the classifying authority is...

  7. Case Series Investigations in Cognitive Neuropsychology

    PubMed Central

    Schwartz, Myrna F.; Dell, Gary S.

    2011-01-01

    Case series methodology involves the systematic assessment of a sample of related patients, with the goal of understanding how and why they differ from one another. This method has become increasingly important in cognitive neuropsychology, which has long been identified with single-subject research. We review case series studies dealing with impaired semantic memory, reading, and language production, and draw attention to the affinity of this methodology for testing theories that are expressed as computational models and for addressing questions about neuroanatomy. It is concluded that case series methods usefully complement single-subject techniques. PMID:21714756

  8. [Clinical study of 12 cases with obstetric mirror syndrome].

    PubMed

    Wu, Lin-lin; Wang, Chen-hong; Li, Zhi-quan

    2012-03-01

    To discuss the clinical features, management, pregnancy outcome and prognosis of obstetric mirror syndrome. The clinical data of 12 cases with obstetric mirror syndrome at Shenzhen Maternity and Child Healthcare Hospital from April 2008 to December 2010 were collected to retrospectively analyze the clinical features, management, pregnancy outcome and prognosis. (1) ETIOLOGY: 12 cases with obstetric mirror syndrome included 9 cases of Bart's hydrops fetalis, 2 cases with fetal complicated congenital cardiac anomalies, and 1 case of unknown etiology. (2) Gestational age at diagnosis and at delivery: gestational age at diagnosis ranged from 28 to 36 weeks [mean (31.5 ± 4.7) weeks], and gestational age at delivery ranged from 28(+3) to 38 weeks [mean (32.9 ± 2.9) weeks]. There were no significant differences between the gestational age at diagnosis and at delivery in consistence with severe preeclampsia group and mild preeclampsia group [(31.8 ± 2.3) weeks vs. (30.9 ± 7.2) weeks, (32.5 ± 2.3) weeks vs. (33.5 ± 3.9) weeks, P > 0.05]. (3) The patients with obstetric mirror syndrome can present a preeclampsia-like syndrome: maternal extremity edema in 12 cases, headache and visual disturbance in 1 case, proteinuria in 11 cases, elevated blood pressure in 5 cases, elevated uric acid in 9 cases, hypoproteinemia in 12 cases, elevated creatinine in 3 case, elevated liver enzyme in 1 case, thrombocytopenia in 2 cases. The major complications included 1 case of HELLP syndrome, acute pulmonary edema, placental abruption, amnionic fluid embolism, DIC respectively, 3 cases of acute kidney failure and 6 cases of postpartum hemorrhage. (4) Sonographic findings: 1) Hydrops fetalis: fetal ultrasound revealed pleural fluid, fetal ascites, skin edema, scalp edema, encephalocolele enlargement, hydropericardium and increased cardio-chest ratio. 2) Placenta megaly: the placental pathological examination revealed edematous and large in 12 cases. Placental thickness was beyond 4 cm in

  9. The economic case for precision medicine.

    PubMed

    Gavan, Sean P; Thompson, Alexander J; Payne, Katherine

    2018-01-01

    Introduction : The advancement of precision medicine into routine clinical practice has been highlighted as an agenda for national and international health care policy. A principle barrier to this advancement is in meeting requirements of the payer or reimbursement agency for health care. This special report aims to explain the economic case for precision medicine, by accounting for the explicit objectives defined by decision-makers responsible for the allocation of limited health care resources. Areas covered : The framework of cost-effectiveness analysis, a method of economic evaluation, is used to describe how precision medicine can, in theory, exploit identifiable patient-level heterogeneity to improve population health outcomes and the relative cost-effectiveness of health care. Four case studies are used to illustrate potential challenges when demonstrating the economic case for a precision medicine in practice. Expert commentary : The economic case for a precision medicine should be considered at an early stage during its research and development phase. Clinical and economic evidence can be generated iteratively and should be in alignment with the objectives and requirements of decision-makers. Programmes of further research, to demonstrate the economic case of a precision medicine, can be prioritized by the extent that they reduce the uncertainty expressed by decision-makers.

  10. The economic case for precision medicine

    PubMed Central

    Gavan, Sean P.; Thompson, Alexander J.; Payne, Katherine

    2018-01-01

    ABSTRACT Introduction: The advancement of precision medicine into routine clinical practice has been highlighted as an agenda for national and international health care policy. A principle barrier to this advancement is in meeting requirements of the payer or reimbursement agency for health care. This special report aims to explain the economic case for precision medicine, by accounting for the explicit objectives defined by decision-makers responsible for the allocation of limited health care resources. Areas covered: The framework of cost-effectiveness analysis, a method of economic evaluation, is used to describe how precision medicine can, in theory, exploit identifiable patient-level heterogeneity to improve population health outcomes and the relative cost-effectiveness of health care. Four case studies are used to illustrate potential challenges when demonstrating the economic case for a precision medicine in practice. Expert commentary: The economic case for a precision medicine should be considered at an early stage during its research and development phase. Clinical and economic evidence can be generated iteratively and should be in alignment with the objectives and requirements of decision-makers. Programmes of further research, to demonstrate the economic case of a precision medicine, can be prioritized by the extent that they reduce the uncertainty expressed by decision-makers. PMID:29682615

  11. Colombia - A Case Study in Smart Power

    DTIC Science & Technology

    2014-05-22

    COLOMBIA–A CASE STUDY IN SMART POWER A Monograph by John P. Brady Foreign Service Officer United States Agency for...Colombia–A Case Study in Smart Power 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) John P. Brady...of Candidate: John P. Brady Monograph Title: Colombia–A Case Study in Smart Power Approved by: , Monograph Director Robert W

  12. Vibrio parahemolyticus bacteremia: case report.

    PubMed

    Ng, T C; Chiang, P C; Wu, T L; Leu, H S

    1999-09-01

    Vibrio parahemolyticus (V. parahemolyticus) is a halophilic gram-negative bacillus that lives in the ocean. It is the leading cause of infectious diarrhea in Taiwan and sometimes produces soft tissue infections, but it is rarely a cause of bacteremia. There have been only 11 cases reported in the literature. Most of the cases involved a history of ingestion of seafood or exposure to seawater. In addition, those patients were all immunosuppressed, especially with leukemia and cirrhosis. We report a 60-year-old male patient with chronic hepatitis C and adrenal insufficiency. He developed V. parahemolyticus bacteremia following ingestion of seafood one week prior to admission. His condition was complicated with neck and right lower leg soft tissue infection, as well as multiple organ failure. The patient survived after intravenous ceftazidime, oral doxycycline, and surgical debridement. To our knowledge, this is the 12th reported cases on Medline, and the second bacteremic case in Taiwan. After reviewing the literature, we suggest that all patients with immunosuppressed conditions or adrenal insufficiency should eat foods that are well cooked and avoid raw seafood. Moreover, when patients who are at risk to develop fever, diarrhea, and soft tissue infection after ingestion of seafood, V. parahemolyticus infection should be suspected. All culture specimens should be inoculated on Vibrios selective media.

  13. Pleural mesothelioma – case report

    PubMed Central

    Klawiter, Anna; Damaszke, Tomasz

    2010-01-01

    Summary Background: Pleural mesothelioma is a very rare neoplasm; especially the local form. The diagnostics is difficult and the prognosis unfavourable. Case Report: We presented a case of a man with dyspnoea and cough. His chest radiogram showed hydrothorax on the left side. Neither the examinations of the pleural liquid, nor the CT-guided fine needle biopsy established the diagnosis. CT showed features suggestive of pleural mesothelioma. The diagnosis was confirmed by thoracoscopy. Although no neoplastic cells were found in the thoracoscopic specimen from the supradiaphragmatic tumor, we assumed that to be a case of a diffuse, primarily local form of mesothelioma. Conclusions: Diagnostics of pleural mesothelioma is very difficult. CT and thoracoscopy seem to be very valuable diagnostic methods. It is worth remembering that pleural mesothelioma can have a local form which may transform into a diffuse one. PMID:22802809

  14. Predicate Argument Structure Analysis for Use Case Description Modeling

    NASA Astrophysics Data System (ADS)

    Takeuchi, Hironori; Nakamura, Taiga; Yamaguchi, Takahira

    In a large software system development project, many documents are prepared and updated frequently. In such a situation, support is needed for looking through these documents easily to identify inconsistencies and to maintain traceability. In this research, we focus on the requirements documents such as use cases and consider how to create models from the use case descriptions in unformatted text. In the model construction, we propose a few semantic constraints based on the features of the use cases and use them for a predicate argument structure analysis to assign semantic labels to actors and actions. With this approach, we show that we can assign semantic labels without enhancing any existing general lexical resources such as case frame dictionaries and design a less language-dependent model construction architecture. By using the constructed model, we consider a system for quality analysis of the use cases and automated test case generation to keep the traceability between document sets. We evaluated the reuse of the existing use cases and generated test case steps automatically with the proposed prototype system from real-world use cases in the development of a system using a packaged application. Based on the evaluation, we show how to construct models with high precision from English and Japanese use case data. Also, we could generate good test cases for about 90% of the real use cases through the manual improvement of the descriptions based on the feedback from the quality analysis system.

  15. [Cerebral gliosarcoma: clinico-pathologic study of 8 cases].

    PubMed

    Ayadi, Lobna; Charfi, Slim; Khabir, Abdemajid; Kalle, Rim; Sellami, Ahmed; Makni, Saloua; Boudawara, Zaher; Sellami-Boudawara, Tahya

    2010-03-01

    Gliosarcomas are biphasic neoplasms composed of a glioblastoma admixed to a sarcomatous component with different lines of differentiation. Histogenesis of these tumors is still discussed. Our objective is to specify clinical and pathological characteristics of this rare neoplasm and to discuss its histogenesis. Retrospective study of eight cases of gliosarcomas diagnosed between January 1998 and December 2004. Clinical, radiological, therapeutic and follow-up data were reviewed. Histological features and immunohistochemical results were also included in this review. Five patients were male, three women with a median age of 50.7 (range 31-74 years). Symptoms were dominated by intracranial hypertension and paralysis. The most common location was parietal or temporo-parietal (5 cases: 62.5%). Pathological exam including histochemical and immunohistochemical study confirmed the diagnosis of gliosarcoma in all cases. Sarcomatous component had features of fibrosarcoma in 5 cases, osteosarcoma in 2 cases and malignant fibrous histiocytoma in 1 case. All patients were treated by surgical excision (complete in five cases and partial in three cases). Adjuvant radiotherapy was received in three cases. One patient was lost on follow-up. Two patients died from postoperative. complications and the five remaining patients died with a medium follow up of 9 months (extremes: 2-24 months). Clinical, radiological and follow-up features of gliosarcomas share great similarities with glioblastomas. Histopathological, histochemical and immunohistochemical studies are helpful in accuracy diagnosis. Recent cytogenetic and molecular data support a monoclonal origin for these tumors.

  16. 25-hydroxyvitamin D and breast cancer, colorectal cancer, and colorectal adenomas: case-control versus nested case-control studies.

    PubMed

    Grant, William B

    2015-02-01

    Existing literature includes concerns regarding reliability of case-control studies of breast cancer incidence with respect to 25-hydroxyvitamin D (25(OH)D) concentrations. For breast cancer, only case-control studies consistently find inverse correlations between 25(OH)D and breast cancer. However, for colorectal cancer, nested case-control studies find significant inverse correlations with respect to 25(OH)D concentrations at baseline for mean follow-up times of 7 years. This is a review of results currently existing in literature. I provide evidence that 25(OH)D concentration values are only useful for short follow-up times for breast cancer since it develops rapidly. To support the robust nature of breast cancer case-control studies, I show that results from 11 studies from seven countries align in a robust power-law fit to the odds ratio versus mean 25(OH)D concentrations. Case-control studies of breast cancer incidence rates provide reliable results. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  17. Dedifferentiated endometrial cancer: an atypical case diagnosed from cerebellar and adrenal metastasis: case presentation and review of literature

    PubMed Central

    Berretta, Roberto; Patrelli, Tito Silvio; Faioli, Raffaele; Mautone, Daniele; Gizzo, Salvatore; Mezzogiorno, Antonio; Giordano, Giovanna; Modena, Alberto Bacchi

    2013-01-01

    Dedifferentiated endometrial cancer (DEC) is microscopically characterized by the presence of high-grade areas emerging from low-grade tumour. DEC is an aggressive tumour even when the dedifferentiated component represents only 20% of the entire neoplasm. A proper histological diagnosis is essential to define the most appropriate therapeutic approach for these tumors, since they are characterized by a particularly aggressive trend and by an extremely poor prognosis. We report a single case of DEC associated with dedifferentiated and adrenal metastasis, for which the patient underwent both abdominal-pelvic and cerebellar surgery. Dedifferentiated carcinoma of the endometrium is a poorly recognized neoplasm since they have not been clearly defined the histological features discriminating this neoplasm from high-grade endometrioid adenocarcinoma. Revising existing literature we found 79 described cases of central nervous system secondary involvement and 13 cases where the onset of the disease was characterized by neurological signs and symptoms. We could only find two reported cases of adrenal metastases originating from endometrial neoplasia but in no case of dedifferentiated endometrial carcinoma previously described has been reported the concomitant adrenal-cerebellar involvement. PMID:23923084

  18. Dedifferentiated endometrial cancer: an atypical case diagnosed from cerebellar and adrenal metastasis: case presentation and review of literature.

    PubMed

    Berretta, Roberto; Patrelli, Tito Silvio; Faioli, Raffaele; Mautone, Daniele; Gizzo, Salvatore; Mezzogiorno, Antonio; Giordano, Giovanna; Modena, Alberto Bacchi

    2013-01-01

    Dedifferentiated endometrial cancer (DEC) is microscopically characterized by the presence of high-grade areas emerging from low-grade tumour. DEC is an aggressive tumour even when the dedifferentiated component represents only 20% of the entire neoplasm. A proper histological diagnosis is essential to define the most appropriate therapeutic approach for these tumors, since they are characterized by a particularly aggressive trend and by an extremely poor prognosis. We report a single case of DEC associated with dedifferentiated and adrenal metastasis, for which the patient underwent both abdominal-pelvic and cerebellar surgery. Dedifferentiated carcinoma of the endometrium is a poorly recognized neoplasm since they have not been clearly defined the histological features discriminating this neoplasm from high-grade endometrioid adenocarcinoma. Revising existing literature we found 79 described cases of central nervous system secondary involvement and 13 cases where the onset of the disease was characterized by neurological signs and symptoms. We could only find two reported cases of adrenal metastases originating from endometrial neoplasia but in no case of dedifferentiated endometrial carcinoma previously described has been reported the concomitant adrenal-cerebellar involvement.

  19. Imported brucellosis: A case series and literature review.

    PubMed

    Norman, Francesca F; Monge-Maillo, Begoña; Chamorro-Tojeiro, Sandra; Pérez-Molina, Jose-Antonio; López-Vélez, Rogelio

    2016-01-01

    Brucellosis is one of the main neglected zoonotic diseases. Several factors may contribute to the epidemiology of brucellosis. Imported cases, mainly in travellers but also in recently arrived immigrants, and cases associated with imported products, appear to be infrequently reported. Cases of brucellosis diagnosed at a referral unit for imported diseases in Europe were described and a review of the literature on imported cases and cases associated with contaminated imported products was performed. Most imported cases were associated with traditional risk factors such as travel/consumption of unpasteurized dairy products in endemic countries. Cases associated with importation of food products or infected animals also occurred. Although a lower disease incidence of brucellosis has been reported in developed countries, a higher incidence may still occur in specific populations, as illustrated by cases in Hispanic patients in the USA and in Turkish immigrants in Germany. Imported brucellosis appears to present with similar protean manifestations and both classical and infrequent modes of acquisition are described, leading on occasions to mis-diagnoses and diagnostic delays. Importation of Brucella spp. especially into non-endemic areas, or areas which have achieved recent control of both animal and human brucellosis, may have public health repercussions and timely recognition is essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Human Cases of Tularemia in Armenia, 1996-2012.

    PubMed

    Melikjanyan, Syuzanna; Palayan, Karo; Vanyan, Artavazd; Avetisyan, Lilit; Bakunts, Nune; Kotanyan, Marine; Guerra, Marta

    2017-09-01

    A retrospective analysis was conducted of human cases and outbreaks of tularemia in the Republic of Armenia from 1996 to 2012 utilizing geographic information system software. A total of 266 human cases of tularemia were recorded in Armenia from 1996 to 2012, with yearly incidence ranging from 0 to 5.5 cases per 100,000 people. Cases predominantly affected the male population (62.8%), 11-20 year age group (37.2%), agricultural workers (49.6%), and persons residing in rural areas (93.6%). In 2003, a waterborne outbreak involving 158 cases occurred in Kotayk Marz, and in 2007, a foodborne outbreak with 17 cases occurred in Gegharkunik Marz, attributed to exposure of food products to contaminated hay. Geospatial analysis of all cases showed that the majority were associated with the steppe vegetation zone, elevations between 1,400 and 2,300 m, and the climate zone associated with dry, warm summers, and cold winters. Characterization of these environmental factors were used to develop a predictive risk model to improve surveillance and outbreak response for tularemia in Armenia.

  1. Performance of casings in Cerro Prieto production wells

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dominguez A, B.; Vital B, F.; Bermejo M, F.

    A careful evaluation of different production casings used at Cerro Prieto from 1964 to date has shown that the following casings have yielded particularly impressive results: 7 5/8-in. diameter, J-55, 26 lb/ft; 7 5/8-in. diameter, K-55, 45.3 lb/ft; and 5-in. diameter, K-55, 23.2 lb/ft. These casings differ from others of the same diameter but lighter weight which were also used at the field. The results are favorable in spite of severe construction problems, especially the loss of circulation during cementing operations, which we encountered in some of the wells where these casings were used. The use of gravity-fed fine sandmore » as packing material and the arrangement of the production and intermediate casings were important in avoiding damage due to tension-compression stresses and, above all, damage due to internal or external corrosion over time. This situation is clearly evidenced if we compare the damage to the above casings with that experienced by grade N-80 production casings, especially in a corrosive environment.« less

  2. Cases, Simulacra, and Semantic Web Technologies

    ERIC Educational Resources Information Center

    Carmichael, P.; Tscholl, M.

    2013-01-01

    "Ensemble" is an interdisciplinary research and development project exploring the potential role of emerging Semantic Web technologies in case-based learning across learning environments in higher education. Empirical findings have challenged the claim that cases "bring reality into the classroom" and that this, in turn, might…

  3. Multiple Personality Disorder: Concepts and Cases.

    ERIC Educational Resources Information Center

    Lindsley, Hope L.

    1992-01-01

    Presents two case examples illustrating nature and etiology of multiple personality disorder in two clients and describing their entry into counseling and progress through treatment. Compares and contrasts cases in areas of diagnosis, symptoms, history, and treatment. Suggests that mental health counselors combine firmness with flexibility in…

  4. 36 CFR 254.16 - Case closing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Case closing. 254.16 Section 254.16 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LANDOWNERSHIP ADJUSTMENTS Land Exchanges § 254.16 Case closing. (a) Title transfers. Unless otherwise agreed, and...

  5. Case for real-time systems development - Quo vadis?

    NASA Technical Reports Server (NTRS)

    Erb, Dona M.

    1991-01-01

    The paper focuses on the distinctive issues of computer-aided software engineering (CASE) products for the development of real-time systems. CASE technologies and associated standardization efforts are evolving from sets of conflicting interests. The majority of case products are intended for use in the development of management information systems. CASE products to support the development of large, complex real-time systems must provide additional capabilities. Generic concerns include the quality of the implementation of the required method for the phase of the system's development and whether the vendor is stable and committed to evolving the products in parallel with nonproprietary standards. The CASE market is undergoing considerable consolidation. The paper describes the major forces, cooperating entities, and remaining uncertainties that need to be weighed in near-term CASE procurements to limit risk of loss of investment in project time, trianing, and money.

  6. [MR myelography: analysis of 126 cases].

    PubMed

    Wang, W; Zhang, X; Lu, Y

    2000-03-01

    To investigate the value and limitation of MR myelography (MRM) in depicting the spinal canal obstruction. Heavily T2-weighted coronal MR myelography was performed with 3D fast-spin-echo (FSE) and fat-suppression sequence in 126 cases, including 6 cerebellomedullary cistern, 18 cervical, 19 thoracic and 83 lumbar cases. The resulting slice were then projected into a composite image using a standard maxium intensity projection (MIP) algorithm. 90.5% (114/126) of MRM yielded reproducible high-quality image of the spinal thecal sac. 106 lesions (extradural, intradural, intramedullary) were detected in 101 cases (80.2%). The level and degree of spinal canal obstruction were visualized and confirmed by operation in 66 cases with a high sensitivity of 100%, and a diagnostic accuracy of 91.3%. Heavily T2 FSE MR myelography is a noninvasive and reliable method. MRM surpasses conventional and CT myelography and could replace them in some degree.

  7. Acquired hepatocerebral degeneration: A case report

    PubMed Central

    Chen, Wei-Xing; Wang, Ping; Yan, Sen-Xiang; Li, You-Ming; Yu, Chao-Hui; Jiang, Ling-Ling

    2005-01-01

    AIM: Acquired hepatocerebral degeneration (AHD) is an exceptional type of hepatic encephalopathies (HE). It is characterized by neuropsychiatric and extrapyramidal symptomathology similar to that seen in hepatolenticular degeneration (Wilson’s disease). In this paper, we report a case of AHD with unusual presenting features. METHODS: A 28-year-old man with AHD was described and the literature was reviewed. RESULTS: The man had a history of HBV-related liver cirrhosis. He was admitted to our hospital with apathy, dysarthria, mild consciousness impairment and extrapyramidal symptoms after hematemesis. By review of the literature, cases with AHD often did not present consciousness impairment. So our case was once diagnosed incorrectly as Wilson’s disease. CONCLUSION: AHD is a rare syndrome and its variable clinical manifestations make it difficult to be diagnosed. But we believe that extensive examination and thorough understanding of the disease are beneficial to a correct diagnosis. Moreover, biocoene is effective in treating the case. PMID:15655841

  8. A Review of Melioidosis Cases in the Americas.

    PubMed

    Benoit, Tina J; Blaney, David D; Doker, Thomas J; Gee, Jay E; Elrod, Mindy G; Rolim, Dionne B; Inglis, Timothy J J; Hoffmaster, Alex R; Bower, William A; Walke, Henry T

    2015-12-01

    Melioidosis is a bacterial infection caused by Burkholderia pseudomallei, a gram-negative saprophytic bacillus. Cases occur sporadically in the Americas with an increasing number of cases observed among people with no travel history to endemic countries. To better understand the incidence of the disease in the Americas, we reviewed the literature, including unpublished cases reported to the Centers for Disease Control and Prevention. Of 120 identified human cases, occurring between 1947 and June 2015, 95 cases (79%) were likely acquired in the Americas; the mortality rate was 39%. Burkholderia pseudomallei appears to be widespread in South, Central, and North America. © The American Society of Tropical Medicine and Hygiene.

  9. Increase of cases of legionellosis in Latvia, 2011.

    PubMed

    Rozentale, B; Bormane, A; Perevosčikovs, J; Lucenko, I; Brila, A

    2011-11-10

    An increased number of legionellosis cases in 2011 has been reported in Latvia, compared to the ten previous years. A total of 30 legionellosis cases (1.35 per 100,000 inhabitants), including 19 females, have been confirmed until the end of September 2011. The majority of cases (n=23) were inhabitants of the capital city Riga. The reason for the increase in legionellosis is unclear. Twenty-six of the 30 cases are not travel-related.

  10. Duodenal gangliocytic paraganglioma with lymph node metastases: A case report and comparative review of 31 cases

    PubMed Central

    Cathcart, Sahara J; Sasson, Aaron R; Kozel, Jessica A; Oliveto, Jennifer M; Ly, Quan P

    2017-01-01

    Gangliocytic paraganglioma (GP) is a rare tumor of uncertain origin most often located in the second portion of the duodenum. It is composed of three cellular components: Epithelioid endocrine cells, spindle-like/sustentacular cells, and ganglion-like cells. While this tumor most often behaves in a benign manner, cases with metastasis are reported. We describe the case of a 62-year-old male with a periampullary GP with metastases to two regional lymph nodes who was successfully treated with pancreaticoduodenectomy. Using PubMed, EMBASE, EBSCOhost MEDLINE and CINAHL, and Google Scholar, we searched the literature for cases of GP with regional lymph node metastasis and evaluated the varying presentations, diagnostic workup, and disease management of identified cases. Thirty-one cases of GP with metastasis were compiled (30 with at least lymph node metastases and one with only distant metastasis to bone), with age at diagnosis ranging from 16 to 74 years. Ratio of males to females was 19:12. The most common presenting symptoms were abdominal pain (55%) and gastrointestinal bleeding or sequelae (42%). Twenty-five patients underwent pancreaticoduodenectomy. Five patients were treated with local resection alone. One patient died secondary to metastatic disease, and one died secondary to perioperative decompensation. The remainder did well, with no evidence of disease at follow-up from the most recent procedure (except two in which residual disease was deliberately left behind). Of the 26 cases with sufficient histological description, 16 described a primary tumor that infiltrated deep to the submucosa, and 3 described lymphovascular invasion. Of the specific immunohistochemistry staining patterns studied, synaptophysin (SYN) stained all epithelioid endocrine cells (18/18). Neuron specific enolase (NSE) and SYN stained most ganglion-like cells (7/8 and 13/18 respectively), and S-100 stained all spindle-like/sustentacular cells (21/21). Our literature review of published

  11. Duodenal gangliocytic paraganglioma with lymph node metastases: A case report and comparative review of 31 cases.

    PubMed

    Cathcart, Sahara J; Sasson, Aaron R; Kozel, Jessica A; Oliveto, Jennifer M; Ly, Quan P

    2017-06-16

    Gangliocytic paraganglioma (GP) is a rare tumor of uncertain origin most often located in the second portion of the duodenum. It is composed of three cellular components: Epithelioid endocrine cells, spindle-like/sustentacular cells, and ganglion-like cells. While this tumor most often behaves in a benign manner, cases with metastasis are reported. We describe the case of a 62-year-old male with a periampullary GP with metastases to two regional lymph nodes who was successfully treated with pancreaticoduodenectomy. Using PubMed, EMBASE, EBSCOhost MEDLINE and CINAHL, and Google Scholar, we searched the literature for cases of GP with regional lymph node metastasis and evaluated the varying presentations, diagnostic workup, and disease management of identified cases. Thirty-one cases of GP with metastasis were compiled (30 with at least lymph node metastases and one with only distant metastasis to bone), with age at diagnosis ranging from 16 to 74 years. Ratio of males to females was 19:12. The most common presenting symptoms were abdominal pain (55%) and gastrointestinal bleeding or sequelae (42%). Twenty-five patients underwent pancreaticoduodenectomy. Five patients were treated with local resection alone. One patient died secondary to metastatic disease, and one died secondary to perioperative decompensation. The remainder did well, with no evidence of disease at follow-up from the most recent procedure (except two in which residual disease was deliberately left behind). Of the 26 cases with sufficient histological description, 16 described a primary tumor that infiltrated deep to the submucosa, and 3 described lymphovascular invasion. Of the specific immunohistochemistry staining patterns studied, synaptophysin (SYN) stained all epithelioid endocrine cells (18/18). Neuron specific enolase (NSE) and SYN stained most ganglion-like cells (7/8 and 13/18 respectively), and S-100 stained all spindle-like/sustentacular cells (21/21). Our literature review of published

  12. THE RESERVE MINING CASE: SCIENTIFIC ISSUES THAT CREATED AND TRANSFORMED THE LANDMARK CASE AND STILL PERSIST TODAY

    EPA Science Inventory

    The Reserve Mining Case is regarded as the first landmark environmental and public health case and originated from Lake Superior Enforcement Conferences conducted under the Federal Water Pollution Control Act before U.S. EPA was formed. In 1973 just before the federal trial bega...

  13. Draugen HSE-case - occupational health risk management

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to workmore » environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.« less

  14. Building Language Educators: The Implications of Case-Based Pedagogy Using Practicum-Based Student-Teacher-Generated Cases for Pre-Service Language Teacher Education

    ERIC Educational Resources Information Center

    Cournoyer, Amy Beth

    2014-01-01

    This case study investigated case-based pedagogy using student-teacher-generated cases as an instructional tool in the preparation of 12 pre-service ESL, Bilingual, and Modern Foreign Language teachers enrolled in a Student Teaching Seminar at a post-secondary institution. In the fall methods course, each participant generated a case study based…

  15. Trends in child sexual abuse cases referred for forensic examination in Southern Denmark from 2000 to 2011 - Did the 'Tønder-case' have an impact?

    PubMed

    Skovmand, Sofie; Astrup, Birgitte Schmidt

    2015-11-01

    In 2005 a serious case of child sexual abuse from the region of Southern Denmark was revealed to the Danish public. The case became known as the 'Tønder-case'. It was the first in a series of 4-5 serious cases of child maltreatment in Denmark, cases which spurred heavy public debate. In this study all the cases of child sexual abuse referred for forensic examination in a 12 year period, a total of 368 cases, were systematically evaluated. In order to identify any trends that could be correlated to an impact of the 'Tønder-case', cases from 2000 to 2002 and cases from 2009 to 2011 underwent an in-depth analysis. In the 12 year period there was a significant increase in numbers of cases. In the subgroups, comprised of 113 cases meeting the inclusion criteria, we found a significant increase in the frequency of cases involving incest and systematic abuse, as well as an uncorrelated increase in the frequency of cases where children were placed in foster care prior to the examination. These results were countered by a significant decrease in the number cases police reported child sexual abuse in the same period. The possible impact that cases like the 'Tønder-case' and the following press coverage may have on disclosure and the handling of this type of case by authorities is discussed, as well as further perspectives of extensive press coverage. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  16. Case Management Takes Hold in Long-Term Care.

    ERIC Educational Resources Information Center

    Rose, Stephen M.; And Others

    1992-01-01

    Includes "Empowering Case Management Clients" (Rose); "Case Management in Rural Japan" (Maeda, Takahashi); "Coordinated-Care Teams" (Brodsky, Sobol); "Comparing Practice in the United States and the United Kingdom" (Sturges); "Business of Case Management Flourishing in the U.S." (Cress); and…

  17. The Use of Case Studies in Teaching Undergraduate Neuroscience

    PubMed Central

    Meil, William M.

    2007-01-01

    Case studies have been the cornerstone of many discoveries in neurology and continue to be an indispensable source of knowledge. Attaching a name, face, and story to the study of neurological disorders makes them more “real” and memorable. This article describes the value of the case study methodology and its advantages as a pedagogical approach. It also illustrates how the seminal case of H.M. can be used to highlight the advantages and disadvantages of the case study methodology. Three exercises are described for incorporating case studies into neuroscience courses. The first exercise requires students to conduct a literature review regarding their assigned case and then design an experiment to address a lingering question regarding that neurological disorder. Survey results of 90 students provide quantitative and qualitative support for this approach. The vast majority of students indicated this exercise was a valuable learning experience; sparked interest in the topic and in biopsychology; increased their knowledge and stimulated critical thinking. The second exercise discusses how students might conduct their own case studies. The third exercise emphasizes the use of case studies as a platform to examine competing hypotheses regarding neurological conditions and their treatment. A table listing case studies appropriate for undergraduate neuroscience courses is included. Cases are categorized by the type of neurological disorder and notes regarding the nature of and content of each case are provided. PMID:23493154

  18. Candida-induced prosthetic joint infection. A literature review including 72 cases and a case report.

    PubMed

    Cobo, Fernando; Rodríguez-Granger, Javier; López, Enrique M; Jiménez, Gemma; Sampedro, Antonio; Aliaga-Martínez, Luis; Navarro-Marí, José María

    2017-02-01

    The clinical and microbiological characteristics of prosthetic joint infection (PJI) caused by Candida species is described, including 72 cases in the literature and a case of Candida glabrata infection handled at the present centre. We describe one patient and using the key words 'fungal prosthetic joint infection' and 'candida prosthetic joint infection' we searched MEDLINE (National Library of Medicine, Bethesda, MD), Web of Science, CINAHL and Cochrane systematic review databases for case reports of this condition. Out of the 73 patients, 38 were female; mean age at diagnosis was 65.7 (± SD 18) yrs; 50 had risk factors for candidal infection such as systemic disease (e.g. rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus) and/or immunosuppressive therapy in 18 (24.6%) cases, diabetes mellitus in 14 (19.1%), immunosuppression due to malignant or chronic disease in 24 (32.8%) and long-term antibiotic use in four (5.4%) patients. Infection site was the knee in 36 patients and hip in 35; pain was present in 43 patients and swelling in 23 and the mean surgery-diagnosis interval was 32 months. The most frequent species was C. albicans, followed by C. parapsilosis. The diagnosis was obtained from joint fluid aspirate in 33 cases and intra-operative samples in 16. Susceptibility to antifungals was tested in only 21 isolates. The most frequently used antifungals were fluconazole and amphotericin B. Two-stage exchange arthroplasty was performed in 30 patients and resection arthroplasty in 31; 56 patients were cured with a combination of medical and surgical treatment; one patient died from the infection. PJI caused by Candida requires a high index of suspicion; surgery with long-term antifungal therapy is recommended.

  19. Consumerism--Student: Legal Issues and Cases.

    ERIC Educational Resources Information Center

    Zabetakis, Steve

    The facts, issues, and final judgements of 53 court cases are presented in this compilation focusing on the legal aspects of the student consumerism movement. The first 18 cases cited deal with issues related to admissions, such as reverse discrimination, admission fees, residency, fraudulent misrepresentation, employment promise, contractual…

  20. 7 CFR 29.1045 - Order (case).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Order (case). 29.1045 Section 29.1045 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1045 Order (case). The state of tobacco with respect to its moisture content. [42 FR...