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Sample records for clinically applied hydroxylapatite

  1. Calcium Hydroxylapatite

    PubMed Central

    Yutskovskaya, Yana Alexandrovna; Philip Werschler, WM.

    2015-01-01

    Background: Calcium hydroxylapatite is one of the most well-studied dermal fillers worldwide and has been extensively used for the correction of moderate-to-severe facial lines and folds and to replenish lost volume. Objectives: To mark the milestone of 10 years of use in the aesthetic field, this review will consider the evolution of calcium hydroxylapatite in aesthetic medicine, provide a detailed injection protocol for a global facial approach, and examine how the unique properties of calcium hydroxylapatite provide it with an important place in today’s market. Methods: This article is an up-to-date review of calcium hydroxylapatite in aesthetic medicine along with procedures for its use, including a detailed injection protocol for a global facial approach by three expert injectors. Conclusion: Calcium hydroxylapatite is a very effective agent for many areas of facial soft tissue augmentation and is associated with a high and well-established safety profile. Calcium hydroxylapatite combines high elasticity and viscosity with an ability to induce long-term collagen formation making it an ideal agent for a global facial approach. PMID:25610523

  2. Presentation of Ligands on Hydroxylapatite

    NASA Technical Reports Server (NTRS)

    Chu, Barbara C. F.; Orgel, Leslie E.

    1997-01-01

    Conjugates of biotin with the decamer of glutamic acid (glu(sub 10)) and the trimer of D,L-2-amino-5-phosphonovaleric acid (I) have been synthesized, and it has been shown that they mediate the binding of avidin to hydroxylapatite. In a similar way a conjugate of methotrexate with glu(sub 10) mediates the binding of dihydrofolate reductase to the mineral. The presentation of ligands on the hydroxylapatite component of bone may find applications in clinical medicine.

  3. Hydroxylapatite Otologic Implants

    SciTech Connect

    McMillan, A.D.; Lauf, R.J.; Beale, B.; Johnson, R.

    2000-01-01

    A Cooperative Research and Development Agreement (CRADA) between Lockheed Martin Energy Research Corporation (LMER) and Smith and Nephew Richards Inc. of Bartlett, TN, was initiated in March 1997. The original completion date for the Agreement was March 25, 1998. The purpose of this work is to develop and commercialize net shape forming methods for directly creating dense hydroxylapatite (HA) ceramic otologic implants. The project includes three tasks: (1) modification of existing gelcasting formulations to accommodate HA slurries; (2) demonstration of gelcasting to fabricate green HA ceramic components of a size and shape appropriate to otologic implants: and (3) sintering and evaluation of the HA components.

  4. Zinc Incorporation Into Hydroxylapatite

    SciTech Connect

    Tang, Y.; Chappell, H; Dove, M; Reeder, R; Lee, Y

    2009-01-01

    By theoretical modeling and X-ray absorption spectroscopy, the local coordination structure of Zn incorporated into hydroxylapatite was examined. Density function theory (DFT) calculations show that Zn favors the Ca2 site over the Ca1 site, and favors tetrahedral coordination. X-ray absorption near edge structure (XANES) spectroscopy results suggest one dominant coordination environment for the incorporated Zn, and no evidence was observed for other Zn-containing phases. Extended X-ray absorption fine structure (EXAFS) fitting of the synthetic samples confirms that Zn occurs in tetrahedral coordination, with two P shells at 2.85-3.07 {angstrom}, and two higher Ca shells at 3.71-4.02 {angstrom}. These fit results are consistent with the most favored DFT model for Zn substitution in the Ca2 site.

  5. Processing of hydroxylapatite coatings on titanium alloy bone prostheses

    DOEpatents

    Nastasi, M.A.; Levine, T.E.; Mayer, J.W.; Pizziconi, V.B.

    1998-10-06

    Processing of hydroxylapatite sol-gel films on titanium alloy bone prostheses. A method utilizing non-line-of-sight ion beam implantation and/or rapid thermal processing to provide improved bonding of layers of hydroxylapatite to titanium alloy substrates while encouraging bone ingrowth into the hydroxylapatite layers located away from the substrate, is described for the fabrication of prostheses. The first layer of hydroxylapatite is mixed into the substrate by the ions or rapidly thermally annealed, while subsequent layers are heat treated or densified using ion implantation to form layers of decreasing density and larger crystallization, with the outermost layers being suitable for bone ingrowth.

  6. Processing of hydroxylapatite coatings on titanium alloy bone prostheses

    DOEpatents

    Nastasi, Michael A.; Levine, Timothy E.; Mayer, James W.; Pizziconi, Vincent B.

    1998-01-01

    Processing of hydroxylapatite sol-gel films on titanium alloy bone prostheses. A method utilizing non-line-of-sight ion beam implantation and/or rapid thermal processing to provide improved bonding of layers of hydroxylapatite to titanium alloy substrates while encouraging bone ingrowth into the hydroxylapatite layers located away from the substrate, is described for the fabrication of prostheses. The first layer of hydroxylapatite is mixed into the substrate by the ions or rapidly thermally annealed, while subsequent layers are heat treated or densified using ion implantation to form layers of decreasing density and larger crystallization, with the outermost layers being suitable for bone ingrowth.

  7. Evaluation of hydroxylapatite particles in repair of alveolar clefts in dogs.

    PubMed

    Cullum, P E; Frost, D E; Newland, T B; Keane, T M; Ehler, W J

    1988-04-01

    Twelve adult mongrel dogs were used to evaluate the use of hydroxylapatite (HA) in the closure of alveolar clefts. Bilateral alveolar clefts were surgically created in each animal. After healing, they were implanted randomly with either HA or particulate cancellous bone and marrow (PCBM). The results were evaluated clinically, radiographically, and histologically for healing, acceptance of the implant, closure of the fistula, and bony ingrowth. The results show that HA was as successful in closure of the fistulas and re-establishing an intact maxilla as PCBM. Minimal osteoid and bone was interspersed in the HA implant sites. No complications resulted from the HA graft. PMID:2834525

  8. Hydroxylapatite nanoparticles obtained by fiber laser-induced fracture

    NASA Astrophysics Data System (ADS)

    Boutinguiza, M.; Lusquiños, F.; Riveiro, A.; Comesaña, R.; Pou, J.

    2009-03-01

    This work presents the results of laser-induced fragmentation of hydroxylapatite microparticles in water dissolution. Calcined fish bones in form of powder, which were previously milled to achieve microsized particles, were used as precursor material. Two different laser sources were employed to reduce the size of the suspended particles: a pulsed Nd:YAG laser and a Ytterbium doped fiber laser working in continuous wave mode. The morphology as well as the composition of the obtained particles was characterized by scanning electron microscopy (SEM), energy dispersive X-ray (EDX) spectroscopy and conventional and high resolution transmission electron microscopy (TEM, HRTEM). The results show that nanometric particles of hydroxylapatite and β-tricalcium phosphate as small as 10 nm diameter can be obtained.

  9. Positive coooperativity in the binding of Streptococcus sanguis to hydroxylapatite.

    PubMed

    Nesbitt, W E; Doyle, R J; Taylor, K G; Staat, R H; Arnold, R R

    1982-01-01

    The adherence of Streptococcus sanguis to hydroxylapatite beads has been analyzed by binding isotherms, Langmuir isotherms, and Scatchard plots. For saliva-coated beads, the Scatchard curves contained components with both positive and negative slopes. The results are interpreted as evidence for positive cooperativity in the binding process. Although all Scatchard curves were similar in shape, distinct differences were observed between saliva samples from different individuals. Salivary agglutinins against whole S. sanguis cells did not appear to influence the shapes of the curves or the extent of adherence. In addition, different strains of S. sanguis yielded similar Scatchard plots. When the binding of S. sanguis to buffer-coated hydroxylapatite beads was analyzed by Scatchard plots or binding isotherms, curves were generated which suggested that either direct ligand-ligand or nonspecific interactions were occurring. Hill plots of the adherence data yielded curves with slopes greater than unity for saliva-coated beads, providing additional support for the view that the interactions between S. sanguis and the pellicle involve cooperative phenomena. In contrast, a Hill plot for the binding data of S. sanguis to buffer-coated hydroxylapatite beads gave a curve with a slope of 0.91 +/- 0.07, suggesting negative cooperativity or limited specificity. When adherence data were plotted by the Langmuir method, curves were obtained which could not discriminate between the binding of the bacteria to the hydroxylapatite beads coated with either saliva or buffer. It was also observed that several different proteins and whole saliva tended to inhibit adherence. Scatchard plots, however, describing the binding of S. sanguis to the proteincoated beads were unique and revealed possible specific and nonspecific interactions. Scatchard analyses of binding data may be useful in understanding the mechanism(s) of adherence of streptococci to smooth surfaces. PMID:6172378

  10. Equation of State of Carbonated Hydroxylapatite at Ambient Temperature up to 10 GPa: Significance of Carbonate

    SciTech Connect

    X Liu; S Shieh; M Fleet; L Zhang; Q He

    2011-12-31

    The incorporation of the carbonate ion into the crystal structure of hydroxylapatite results in the creation of vacancies, oxygen-loss, and disorder, with consequent changes in physical and chemical properties. High-pressure experimental investigation up to 10 GPa of two synthetic carbonated hydroxylapatite samples with up to 11 wt% CO3, using a diamond-anvil cell and synchrotron powder X-ray diffraction, provides the first rigorous assessment of the mechanical behavior of the carbonated hydroxylapatite. The pressure-volume data suggest that the isothermal bulk modulus of these carbonated hydroxylapatites has been significantly decreased by the presence of the carbonate (up to about 15%), which in turn will affect all the carbonated apatite-related reactions in the geosystem. Since hydroxylapatite is one of the major components of the bones and teeth, the incorporation of the carbonate in the hydroxylapatite weakens teeth and bones not only chemically, but also physically.

  11. Nurses' intention to apply clinical practice guidelines.

    PubMed

    Kogan, Ella; Tabak, Nili

    2012-12-01

    Using Ajzen and Madden's Theory of Planned Behavior, this study investigates factors which influence nurses' intention to apply clinical practice guidelines in their daily ward work. A convenience sample of 91 nurses in internal medicine wards in three Israeli hospitals answered four questionnaires. Data were processed by Pearson correlation coefficients and multivariate regression. The main findings were that burnout was negatively correlated with the intention to work according to guidelines and that professionalism (in the sense of a tendency to follow taught procedure rather than personal judgment) was positively correlated with it. Furthermore, nurses who perceive their behavioral control and subjective norms to be positive will be the most determined to work according to guidelines, provided they personally command the necessary resources to do so. PMID:23447906

  12. Production of nanoparticles from natural hydroxylapatite by laser ablation

    PubMed Central

    2011-01-01

    Laser ablation of solids in liquids technique has been used to obtain colloidal nanoparticles from biological hydroxylapatite using pulsed as well as a continuous wave (CW) laser. Transmission electron microscopy (TEM) measurements revealed the formation of spherical particles with size distribution ranging from few nanometers to hundred nanometers and irregular submicronic particles. High resolution TEM showed that particles obtained by the use of pulsed laser were crystalline, while those obtained by the use of CW laser were amorphous. The shape and size of particles are consistent with the explosive ejection as formation mechanism. PMID:21711800

  13. Applying temporal joins to clinical databases.

    PubMed Central

    O'Connor, M. J.; Tu, S. W.; Musen, M. A.

    1999-01-01

    Clinical databases typically contain a significant amount of temporal information, information that is often crucial in medical decision-support systems. Most recent clinical information systems use the relational model when working with this information. Although these systems have reasonably well-defined semantics for temporal queries on a single relational table, many do not fully address the complex semantics of operations involving multiple temporal tables. Such operations can arise frequently in queries on clinical databases. This paper describes the issues encountered when joining a set of temporal tables, and outlines how such joins are far more complex than non-temporal ones. We describe the semantics of temporal joins in a query management system called Chronus II, a system we have developed to assist in evaluating patients for clinical trials. PMID:10566376

  14. Applying Statistical Process Control to Clinical Data: An Illustration.

    ERIC Educational Resources Information Center

    Pfadt, Al; And Others

    1992-01-01

    Principles of statistical process control are applied to a clinical setting through the use of control charts to detect changes, as part of treatment planning and clinical decision-making processes. The logic of control chart analysis is derived from principles of statistical inference. Sample charts offer examples of evaluating baselines and…

  15. Optimizing facial rejuvenation outcomes by combining poly-L-lactic acid, hyaluronic acid, calcium hydroxylapatite, and neurotoxins: two case studies.

    PubMed

    Lorenc, Z Paul; Daro-Kaftan, Elizabeth

    2014-02-01

    Reversal of the visible signs of facial aging with the use of injectable products as an alternative to surgery has become more popular, with nearly 5 million procedures performed in the United States in 2012. Volume augmentation products, such as hyaluronic acid (HA), calcium hydroxylapatite (CaHA), and poly-L-lactic acid (PLLA), are often used in combination with one another and with neurotoxins for facial rejuvenation because of the complementary modes of action. This article presents 2 case reports involving patientspecific combinations of 2 different HA products, injectable PLLA, and CaHA with incobotulinumtoxinA or abobotulinumtoxinA. The combination of HA, CaHA, PLLA, and neurotoxins has resulted in outstanding outcomes for many patients, with no clinical evidence of increased adverse events secondary to combination therapy. PMID:24509971

  16. Improvement of tear trough by monophasic hyaluronic Acid and calcium hydroxylapatite.

    PubMed

    Wollina, Uwe

    2014-10-01

    Tear trough deformities are a sign of facial aging. The anatomical base is well understood. In many patients, minimal invasive surgical procedures are useful to improve appearance. Here, the authors describe the use of monophasic hyaluronic acid dermal filler and calcium hydroxylapatite injection for correction. Forty female patients with a mean age of 50 years have been treated. On average, an improvement of one class of Hidman's severity score could be achieved by single treatment. Mean duration of the effect was 10.1 months for hyaluronic acid and 12.8 months for calcium hydroxylapatite. Adverse effects were mild and temporary. Patients satisfaction was high (95%). PMID:25371770

  17. Calcium Hydroxylapatite With Integral Lidocaine Provides Improved Pain Control for the Correction of Nasolabial Folds.

    PubMed

    Schachter, Daniel; Bertucci, Vince; Solish, Nowell

    2016-08-01

    Calcium hydroxylapatite microspheres in a carrier gel (CaHA; Radiesse®: Merz North America, Inc., Raleigh, NC) is approved by the United States Food and Drug Administration for subdermal implantation for the correction of moderate-to-severe facial wrinkles and folds, such as nasolabial folds (NLFs). Lidocaine is often mixed with injectable dermal fillers to reduce injection pain. A new formulation of CaHA has been developed with the convenience of integral 0.3% lidocaine, CaHA (+).
    This multicenter, split-face, double-blind study randomized subjects to receive treatment with CaHA (+) in one NLF and CaHA without lidocaine in the contralateral NLF. The pain level for each NLF was evaluated immediately following the injection using a 10-cm visual analog scale (VAS), and every 15 minutes for 60 minutes plus follow-up visits. Additional endpoints included aesthetic outcomes and subject preference. All subjects (N=102) received treatment.
    CaHA (+) treatment resulted in a statistically and clinically significant reduction in pain ratings immediately after injection compared with CaHA. The mean difference in VAS scores for pain was -4.41 (P<0.0001). In 90% of subjects, the VAS scores were ≥2.0 cm lower for the CaHA (+)-treated NLF. A significant reduction in pain ratings throughout the first hour after injection was observed with CaHA (+) compared with CaHA (P<0.0001). Both treatment groups achieved significant aesthetic improvement; however, the pain differential resulted in a subject-reported preference for CaHA (+). CaHA (+) with integral lidocaine significantly reduces pain and is as effective as CaHA.

    J Drugs Dermatol. 2016;15(8):1005-1010. PMID:27538003

  18. Natural enamel wear--a physiological source of hydroxylapatite nanoparticles for biofilm management and tooth repair?

    PubMed

    Hannig, C; Hannig, M

    2010-04-01

    Dental caries is a widespread chronic disease caused by glucolytic biofilms. Despite considerable success in prophylaxis, there is still a strong demand for biomimetic biofilm management. Reflections on the abraded, but mostly caries-free teeth observed in prehistoric sculls or omnivorous primates, respectively, offer perspectives for developing new approaches in preventive dentistry. It is hypothesized that nano-sized hydroxylapatite crystallites occur in the oral cavity during extensive physiological wear of the hierarchical structured enamel surface due to dental abrasion and attrition. These nano-scaled apatite enamel crystallites might promote re-mineralization and physiological biofilm management at the tooth surface. Indeed, modern bioinspired nanomaterials in preventive dentistry containing nano-sized hydroxylapatite particles have shown efficacy in reducing oral biofilm formation and yield re-mineralizing effects. Accordingly, they seem to mimic extensive abrasions which do not occur with modern diet. PMID:19962245

  19. Synthesis and characterization of phosphocitric acid, a potent inhibitor of hydroxylapatite crystal growth.

    PubMed

    Tew, W P; Mahle, C; Benavides, J; Howard, J E; Lehninger, A L

    1980-04-29

    Human urine and extracts of rat liver mitochondria contain apparently identical agents capable of inhibiting the precipitation or crystallization of calcium phosphate. Its general properties, as well as 1H NMR and mass spectra, have suggested that the agent is phosphocitric acid. This paper reports the synthesis of phosphocitric acid via the phosphorylation of triethyl citrate with o-phenylene phosphochloridate, hydrogenolysis of the product to yield triethyl phosphocitrate, hydrolytic removal of the blocking ethyl groups and also chromatographic purification. An enzymatic assay of phosphocitrate is described. Synthetic phosphocitrate was found to be an exceedingly potent inhibitor of the growth of hydroxylapatite seed crystals in a medium supersaturated with respect to Ca2+ and phosphate. Comparative assays showed phosphocitrate to be much more potent than the most active precipitation-crystallization inhibitors previously reported, which include pyrophosphate and ATP. 14C-Labeled phosphocitrate was bound very tightly to hydroxylapatite crystals. Such binding appeared to be essential for its inhibitory activity on crystal growth. Citrate added before but not after, phosphocitrate greatly enhanced the inhibitory potency of the latter. This enhancement effect was not given by other tricarboxylic acids. The monoethyl ester of phosphocitrate had no inhibitory effect on hydroxylapatite crystal growth. PMID:7378389

  20. Applying Organ Clearance Concepts in a Clinical Setting

    PubMed Central

    2008-01-01

    Objective To teach doctor of pharmacy (PharmD) students how to apply organ clearance concepts in a clinical setting in order to optimize dose management, select the right drug product, and promote better patient-centered care practices. Design A student-focused 5-hour topic entitled "Organ Clearance Concepts: Modeling and Clinical Applications" was developed and delivered to second-year PharmD students. Active-learning techniques, such as reading assignments and thought-provoking questions, and collaborative learning techniques, such as small groups, were used. Student learning was assessed using application cards and a minute paper. Assessment Overall student responses to topic presentation were overwhelmingly positive. The teaching strategies here discussed allowed students to play an active role in their own learning process and provided the necessary connection to keep them motivated, as mentioned in the application cards and minute paper assessments. Students scored an average of 88% on the examination given at the end of the course. Conclusion By incorporating active-learning and collaborative-learning techniques in presenting material on organ clearance concept, students gained a more thorough knowledge of dose management and drug-drug interactions than if the concepts had been presented using a traditional lecture format. This knowledge will help students in solving critical patient situations in a real-world context. PMID:19214275

  1. Investigation of xFe2O4 (x = Mn, Co) doped hydroxylapatite ferromagnetic biomaterials for the treatment of damaged bone and magnetically targeted drug delivery systems

    NASA Astrophysics Data System (ADS)

    Anand, Vikas; Singh, K. J.; Kaur, Kulwinder; Bhatia, Gaurav

    2016-05-01

    Magnetically attracted MnFe2O4 and CoFe2O4 doped hydroxylapatite samples have been prepared by using co-precipitation method in the laboratory. Bioactive nature of samples has been confirmed from XRD spectra. Ferromagnetic behavior of samples has been studied by using vibration sample magnetometer. Human osteoblast cell line MG63 has been used to explore the cell viability of samples. Drug carrier ability of samples has been checked with gentamycin as an antibiotic and results show that samples can be used as excellent drug carriers. Drug loaded samples can be easily targeted to specific area due to their attractive nature towards external magnetic field. Our results indicate that prepared samples possess good bioactive as well as ferromagnetic behavior with drug carrier ability and hence, our samples can be potential candidates for the clinical applications.

  2. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  3. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  4. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  5. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  6. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  7. Applying a presentation content manifest for signing clinical documents.

    PubMed

    Lien, Chung-Yueh; Hsiao, Chia-Hung; Huang, Lu-Chou; Kao, Tsair

    2010-04-01

    In this paper, we demonstrate how to digitally sign a content manifest of a presentable clinical document that contains multiple clinical data with presentations. Only one signature is needed for an entire clinical document with multiple data resources, which can reduce the computation time during signing and verifying processes. In the radiology field, a report may contain text descriptions, images, and annotations that are stored separately in different data resources. The manifest signature would be a proper means for integrity checking for all the clinical data within the manifest. The manifest signature can be extended with a trusted third party to add a digital time signature for long-term verifiability. The performance of the manifest signing compared with that of a traditional digital signing was evaluated. The new manifest signature can be used for signing different types of presentable clinical documents, such HL7 CDA documents and DICOM image reports. PMID:19290579

  8. Anticancer Drug Delivery: An Update on Clinically Applied Nanotherapeutics.

    PubMed

    Marchal, Sophie; El Hor, Amélie; Millard, Marie; Gillon, Véronique; Bezdetnaya, Lina

    2015-09-01

    The development of chemotherapy using conventional anticancer drugs has been hindered due to several drawbacks related to their poor water solubility and poor pharmacokinetics, leading to severe adverse side effects and multidrug resistance in patients. Nanocarriers were developed to palliate these problems by improving drug delivery, opening the era of nanomedicine in oncology. Liposomes have been by far the most used nanovectors for drug delivery, with liposomal doxorubicin receiving US FDA approval as early as 1995. Antibody drug conjugates and promising drug delivery systems based on a natural polymer, such as albumin, or a synthetic polymer, are currently undergoing advanced clinical trials or have received approval for clinical applications. However, despite attractive results being obtained in preclinical studies, many well-designed nanodrugs fell short of expectations when tested in patients, evidencing the gap between nanoparticle design and their clinical translation. The aim of this review is to evaluate the extent of nanotherapeutics used in oncology by providing an insight into the most successful concepts. The reasons that prevent nanodrugs from expanding to clinic are discussed, and the efforts that must be taken to take full advantage of the great potential of nanomedicine are highlighted. PMID:26323338

  9. When the FRAX® test is applied to controlled clinical trials

    PubMed Central

    Fiore, Carmelo Erio; Gaudio, Agostino

    2012-01-01

    Summary FRAX® is a computer-based algorithm developed by the World Health Organization Collaborating Centre for Metabolic Bone Diseases in Sheffield (UK). This algorithm calculates fracture probability from easily obtained clinical risk factors in men and women: age, sex, body mass index and dichotomized variables comprising prior fragility fracture, parental history of hip fracture, current tobacco smoking, use of long-term oral glucocorticoid, rheumatoid arthritis, other causes of secondary osteoporosis and high alcohol consumption (femoral neck bone mineral density can be optionally input to enhance fracture risk prediction). The output of FRAX® is the 10-year probability of a major osteoporotic fracture (hip, clinical spine, humerus or wrist fracture) and the 10-year probability of hip fracture. Recently various Authors have re-evaluated the effectiveness of drugs approved for postmenopausal osteoporosis to test whether they are more effective in women with higher FRAX® probabilities. PMID:23289024

  10. Synthesis and solubility of Pb-Ca and P-As hydroxylapatite solid solutions

    NASA Astrophysics Data System (ADS)

    Puzio, Bartosz; Młynarska, Maria; Motyka, Joanna; Oknińska, Joanna; Mandelt, Agnieszka; Chlebowska, Patrycja; Kwaśniak-Kominek, Monika; Manecki, Maciej

    2016-04-01

    The objective of the study are three solid solution series: - HPY hydroxylpyromorphite Pb5(PO4)3OH - HAP hydroxylapatite Ca5(PO4)3OH - HAP hydroxylapatite Ca5(PO4)3OH - JBM johnbaumite Ca5(AsO4)3OH - JBM johnbaumite Ca5(AsO4)3OH - HMI hydroxylmimetite Pb5(AsO4)3OH The phases were synthesized from aqueous solutions at high pH (over 8) at ambient temperature by dropwise mixing of chemical reagents: Pb(NO3)2, Ca(NO3)2.4H2O, (NH4)H2PO4, and Na2AsHO4.7H2O. The products of all syntheses are crystalline, monomineral fine powders (crystal size less than 1 μm). Their chemical composition is close to theoretical. Systematic shift of XRD peaks and FTIR or Raman bands is observed within the solid solution series. Dissolution experiments were run at 5oC, 25oC, 45oC, and 65oC. An aliquot of 0.5g of each phase was dissolved in 250 mL of 0.05M NH4NO3 (pH between 3 and 5) for about 3 months. In all cases dissolution resulted in increase of pH by about 1. The systems were considered in equilibrium when three consecutive samplings (ca. two weeks apart) resulted in similar concentrations (within 3 standard deviations). The dissolution of all phases in question is incongruent. The amount of precipitating secondary phases was too small for identification. The results of HPY - HAP dissolution experiments are inconclusive due to strongly incongruent dissolution. This is partially in contrary to recent report by Zhu et al. (2015). Systematic increase of solubility is observed in HAP - JBM series. Also, the solubility of these phases increases with the increase of temperature. This is more pronounced for HAP than for JBM. Systematic increase of solubility is also observed in HMI - JBM series. This work is partially funded by AGH research grant no 11.11.140.319 and partially by Polish NCN grant No 2014/01/M/ST10/00355. Zhu,Y., Zhu, Z., Zhao, X., Liang, Y., Huang, Y., 2015. Characterization, dissolution, and solubility of lead hydroxypyromorphite Pb5(PO4)3OH at 25-45oC. Journal of Chemistry

  11. Plasma-Sprayed Hydroxylapatite-Based Coatings: Chemical, Mechanical, Microstructural, and Biomedical Properties

    NASA Astrophysics Data System (ADS)

    Heimann, Robert B.

    2016-06-01

    This contribution discusses salient properties and functions of hydroxylapatite (HA)-based plasma-sprayed coatings, including the effect on biomedical efficacy of coating thickness, phase composition and distribution, amorphicity and crystallinity, porosity and surface roughness, cohesion and adhesion, micro- and nano-structured surface morphology, and residual coating stresses. In addition, it will provide details of the thermal alteration that HA particles undergo in the extremely hot plasma jet that leads to dehydroxylated phases such as oxyhydroxylapatite (OHA) and oxyapatite (OA) as well as thermal decomposition products such as tri-(TCP) and tetracalcium phosphates (TTCP), and quenched phases such as amorphous calcium phosphate (ACP). The contribution will further explain the role of ACP during the in vitro interaction of the as-deposited coatings with simulated body fluid resembling the composition of extracellular fluid (ECF) as well as the in vivo responses of coatings to the ECF and the host tissue, respectively. Finally, it will briefly describe performance profiles required to fulfill biological functions of osteoconductive bioceramic coatings designed to improve osseointegration of hip endoprostheses and dental root implants. In large parts, the content of this contribution is a targeted review of work done by the author and his students and coworkers over the last two decades. In addition, it is considered a stepping stone toward a standard operation procedure aimed at depositing plasma-sprayed bioceramic implant coatings with optimum properties.

  12. Calcium hydroxylapatite associated soft tissue necrosis: a case report and treatment guideline.

    PubMed

    Tracy, Lauren; Ridgway, James; Nelson, J Stuart; Lowe, Nelson; Wong, Brian

    2014-04-01

    We present an uncommon case of nasal alar and facial necrosis following calcium hydroxylapatite filler injection performed elsewhere without direct physician supervision. The patient developed severe full-thickness necrosis of cheek and nasal alar skin 24 h after injections into the melolabial folds. Management prior to referral included oral antibiotics, prednisone taper, and referral to a dermatologist (day 3) who prescribed valacyclovir for a presumptive herpes zoster reactivation induced by the injection. Referral to our institution was made on day 11, and after herpetic outbreak was ruled out by a negative Tzanck smear, debridement with aggressive local wound care was initiated. After re-epithelialization and the fashioning of a custom intranasal stent to prevent vestibular stenosis, pulsed dye laser therapy was performed for wound modification. The patient healed with an acceptable cosmetic outcome. This report underscores the importance of facial vasculature anatomy, injection techniques, and identification of adverse events when using fillers. A current treatment paradigm for such events is also presented. PMID:23993752

  13. Spectroscopic analyses on sonocatalytic damage to bovine serum albumin (BSA) induced by ZnO/hydroxylapatite (ZnO/HA) composite under ultrasonic irradiation.

    PubMed

    Wang, Zhiqiu; Li, Ying; Wang, Jun; Zou, Mingming; Gao, Jingqun; Kong, Yumei; Li, Kai; Han, Guangxi

    2012-08-01

    ZnO/hydroxylapatite (ZnO/HA) composite with HA molar content of 6.0% was prepared by the method of precipitation and heat-treated at 500°C for 40min and was characterized by powder X-ray diffraction (XRD). The sonocatalytic activities of ZnO/HA composite was carried out through the damage of bovine serum albumin (BSA) in aqueous solution. Furthermore, the effects of several factors on the damage of BSA molecules were evaluated by means of UV-vis and fluorescence spectra. Experimental results indicated that the damage degree of BSA aggravated with the increase of ultrasonic irradiation time, irradiation power and ZnO/HA addition amount, but weakened with the increase of solution acidity and ionic strength. In addition, the damage site to BSA was also studied by synchronous fluorescence technology and the damage site was mainly at tryptophan (Trp) residue. This paper provides a valuable reference for driving sonocatalytic method to treat tumor in clinic application. PMID:22522300

  14. Applying Chomsky's Linguistic Methodology to the Clinical Interpretation of Symbolic Play.

    ERIC Educational Resources Information Center

    Ariel, Shlomo

    This paper summarizes how Chomsky's methodological principles of linguistics may be applied to the clinical interpretation of children's play. Based on Chomsky's derivation of a "universal grammar" (the set of essential, formal, and substantive traits of any human language), a number of hypothesized formal universals of clinically-relevant…

  15. Complete biodegradable nature of calcium hydroxylapatite after injection for malar enhancement: an MRI study

    PubMed Central

    Pavicic, Tatjana

    2015-01-01

    Background Radiesse® (Calcium hydroxylapatite [CaHA]) is a biocompatible, injectable gel for facial soft tissue augmentation. It is a completely biodegradable filler and this is well documented, but objective imaging methods to confirm this property are scarce. Methods We present a case report in which CaHA was injected into the midface of a 50-year-old woman for volume restoration and shaping of the cheek region. On the right side of the face, 1.6 mL CaHA was injected as several (5−7) small depots (0.1−0.2 mL) using a 28G 3/4 inch needle and the vertical supraperiosteal depot technique. On the contralateral side of the face, the subject received 1.6 mL CaHA over three entry points using a 27G 1 1/2 inch blunt cannula and the fanning technique. CaHA location and degradation were assessed using magnetic resonance imaging (MRI). Results CaHA appears as low-to-intermediate signal intensity on MRI images taken immediately after injection for malar enhancement with a symmetrical distribution. On MRI images taken 2.5 years after injection, no CaHA was visible but tissue volume remained increased, indicating a collagen-stimulating effect. The treatment was well tolerated. Conclusion In addition to producing long-lasting aesthetic and collagen-stimulating effects, MRI images confirm that CaHA is completely biodegradable with no product remaining 2.5 years after injection. PMID:25709485

  16. Adsorption of arsenic with struvite and hydroxylapatite in phosphate-bearing solutions.

    PubMed

    Rouff, Ashaki A; Ma, Ning; Kustka, Adam B

    2016-03-01

    Arsenic sorption at above neutral pH is relevant when considering contaminant mobility in alkaline, phosphorus-bearing wastewaters, and may be viable in the presence phosphate minerals. Arsenic adsorption on struvite (MgNH4PO4 · 6H2O, MAP) and hydroxylapatite (Ca5(PO4)3OH, HAP) was evaluated at pH 8-11 from solutions with 2.7-0.125 mM phosphate and 0.05 mM As(III) or As(V). Over 7 d, As(III) removal from solution was minimal, but As(V) removal increased with pH, and was higher in the presence of MAP compared to HAP with a maximum of 74% removal in pH 11 MAP-bearing solutions. X-ray absorption fine structure spectroscopy (XAFS) analysis of solids recovered from pH 10-11 solutions revealed different mechanisms of As(V) sorption with MAP and HAP. Arsenic forms monodentate mononuclear surface complexes with MAP through the formation of a Mg-O-As bond, but is incorporated at the near-surface of HAP forming a johnbaumite-like (Ca5(AsO4)3OH) structure. Experiments using radioactive (33)P at pH 10-11 revealed faster exchange of P at the HAP surface, which could promote more facile As incorporation. Near-surface incorporated As in HAP may be less susceptible to remobilization compared to surface adsorbates formed with MAP. Overall, both MAP and HAP may sorb As at high pH in the presence of phosphate. This is relevant to the fate of As in alkaline contaminated waters in contact with phosphate mineral phases. PMID:26748335

  17. In vitro stability of a highly crystalline hydroxylapatite coating in a saturated citric acid solution.

    PubMed

    Story, B J; Burgess, A V; La, D; Wagner, W R

    1999-01-01

    A novel pressurized hydrothermal post-plasma-spray process has been developed to convert the crystalline non-HA and amorphous components of plasma-sprayed hydroxylapatite coatings back into crystalline HA. The process, known commercially as MP-1, was used to produce coatings comprising approximately 96% crystalline HA. The in vitro solubility of the coating in saturated citric acid solution has been measured to simulate the effect of implant detoxification procedures, which use citric acid as a cleaning medium. The MP-1 coating solubility in saturated citric acid solution (pH = 1) was compared to that of coatings with crystalline HA contents ranging from 37.5-82%. All coatings showed an initial sharp rise in coating dissolution, which correlated with crystalline HA content, followed by a steady state dissolution rate. After 60 s at 25 degrees C, the MP-1 coating showed a 65% decrease in solubility compared to a highly amorphous coating (AM-2). All coatings showed very similar steady state dissolution rates, except for AM-2, which was significantly higher. SEM analysis showed that the AM-2 coating surface was degraded substantially more than the other coatings, resulting in partial coating exfoliation. A mechanism of coating dissolution is proposed, in which the initial rapid leaching of soluble phases from the coating leaves behind a porous layer of highly crystalline HA at the coating surface. The stability of this porous crystalline layer leads to steady state, diffusion-limited dissolution of the remainder of the coating. The observed two-regime dissolution profile can be accurately represented by a 2-parameter model, which predicts the initial sharp rise in coating dissolution followed by a slower, steady state loss in coating mass. Model parameters were determined from experimental solubility data, and were shown to correlate with the percentage of crystalline HA in the coatings. The present data suggest that the treated coating is significantly more resistant

  18. Improving biological relevancy of transcriptional biomarkers experiments by applying the MIQE guidelines to pre-clinical and clinical trials.

    PubMed

    Dooms, M; Chango, A; Barbour, E; Pouillart, P; Abdel Nour, A M

    2013-01-01

    The "Minimum Information for the Publication of qPCR Experiments" (MIQE [3]) guidelines are very much targeted at basic research experiments and have to our knowledge not been applied to qPCR assays carried out in the context of clinical trials. This report details the use of the MIQE qPCR app for iPhone (App Store, Apple) to assess the MIQE compliance of one clinical and five pre-clinical trials. This resulted in the need to include 14 modifications that make the guidelines more relevant for the assessment of this special type of application. We also discuss the need for flexibility, since while some parameters increase experimental quality, they also require more reagents and more time, which is not always feasible in a clinical setting. PMID:22910527

  19. Applying the clinical adoption framework to evaluate the impact of an ambulatory electronic medical record.

    PubMed

    Lau, Francis; Partridge, Colin; Randhawa, Gurprit; Bowen, Mike

    2013-01-01

    This paper describes the application of the Clinical Adoption (CA) Framework to evaluate the impact of a recently deployed electronic medical record (EMR) in a Canadian healthcare organization. The CA Framework dimensions evaluated were EMR quality, use and net benefits at the micro level; and people, organization and implementation at the meso level. The study involved clinical and support staff from two ambulatory care clinics, and managers and technical staff from the organization. A number of issues were identified at both levels of the CA Framework that had affected EMR adoption in the two clinics. Some perceived benefits in care coordination and efficiency were reported despite challenges that arose from early deployment decisions. There were five lessons that could be applied to other ambulatory care settings. The CA Framework has proved useful in making sense of ways that EMR can add value to the organization. PMID:23388247

  20. Case Study: Applying OpenEHR Archetypes to a Clinical Data Repository in a Chinese Hospital.

    PubMed

    Min, Lingtong; Wang, Li; Lu, Xudong; Duan, Huilong

    2015-01-01

    openEHR is a flexible and scalable modeling methodology for clinical information and has been widely adopted in Europe and Australia. Due to the reasons of differences in clinical process and management, there are few research projects involving openEHR in China. To investigate the feasibility of openEHR methodology for clinical information modelling in China, this paper carries out a case study to apply openEHR archetypes to Clinical Data Repository (CDR) in a Chinese hospital. The results show that a set of 26 archetypes are found to cover all the concepts used in the CDR. Of all these, 9 (34.6%) are reused without change, 10 are modified and/or extended, and 7 are newly defined. The reasons for modification, extension and newly definition have been discussed, including granularity of archetype, metadata-level versus data-level modelling, and the representation of relationships between archetypes. PMID:26262040

  1. Femtosecond laser modification of titanium surfaces: direct imprinting of hydroxylapatite nanopowder and wettability tuning via surface microstructuring

    NASA Astrophysics Data System (ADS)

    Ionin, Andrey A.; Kudryashov, Sergey I.; Makarov, Sergey V.; Saltuganov, Pavel N.; Seleznev, Leonid V.; Sinitsyn, Dmitry V.; Golosov, Evgene V.; Goryainov, Artem A.; Kolobov, Yury R.; Kornieieva, Kateryna A.; Skomorokhov, Andrei N.; Ligachev, Alexander E.

    2013-04-01

    Femtosecond laser modification of titanium surfaces was performed to produce microstructured hydrophilic and biocompatible surface layers. Biocompatible nano/microcoatings were prepared for the first time by dry femtosecond laser imprinting of hydroxylapatite nano/micropowder onto VT6 titanium surfaces. In these experiments HAP was first deposited onto the titanium surfaces and then softly imprinted by multiple femtosecond laser pulses into the laser-melted surface metal layer. The surface relief was modified at the nano- and microscales depending on the incident laser fluence and sample scanning speed. Wetting tests demonstrated that the wetting properties of the pristine Ti surface can be tuned through its laser modification in both the hydrophobic and hydrophilic directions.

  2. From the galleries to the clinic: applying art museum lessons to patient care.

    PubMed

    Miller, Alexa; Grohe, Michelle; Khoshbin, Shahram; Katz, Joel T

    2013-12-01

    Increasingly, medical educators integrate art-viewing into curricular interventions that teach clinical observation-often with local art museum educators. How can cross-disciplinary collaborators explicitly connect the skills learned in the art museum with those used at the bedside? One approach is for educators to align their pedagogical approach using similar teaching methods in the separate contexts of the galleries and the clinic. We describe two linked pedagogical exercises--Visual Thinking Strategies (VTS) in the museum galleries and observation at the bedside--from "Training the Eye: Improving the Art of Physical Diagnosis," an elective museum-based course at Harvard Medical School. It is our opinion that while strategic interactions with the visual arts can improve skills, it is essential for students to apply them in a clinical context with faculty support-requiring educators across disciplines to learn from one another. PMID:24014232

  3. Sequential analysis applied to clinical trials in dentistry: a systematic review.

    PubMed

    Bogowicz, P; Flores-Mir, C; Major, P W; Heo, G

    2008-01-01

    Clinical trials employ sequential analysis for the ethical and economic benefits it brings. In dentistry, as in other fields, resources are scarce and efforts are made to ensure that patients are treated ethically. The objective of this systematic review was to characterise the use of sequential analysis for clinical trials in dentistry. We searched various databases from 1900 through to January 2008. Articles were selected for review if they were clinical trials in the field of dentistry that had applied some form of sequential analysis. Selection was carried out independently by two of the authors. We included 18 trials from various specialties, which involved many different interventions. We conclude that sequential analysis seems to be underused in this field but that there are sufficient methodological resources in place for future applications.Evidence-Based Dentistry (2008) 9, 55-62. doi:10.1038/sj.ebd.6400587. PMID:18584009

  4. Improving Patient Safety in Clinical Oncology: Applying Lessons From Normal Accident Theory.

    PubMed

    Chera, Bhishamjit S; Mazur, Lukasz; Buchanan, Ian; Kim, Hong Jin; Rockwell, John; Milowsky, Matthew I; Marks, Lawrence B

    2015-10-01

    Concerns for patient safety persist in clinical oncology. Within several nonmedical areas (eg, aviation, nuclear power), concepts from Normal Accident Theory (NAT), a framework for analyzing failure potential within and between systems, have been successfully applied to better understand system performance and improve system safety. Clinical oncology practice is interprofessional and interdisciplinary, and our therapies often have narrow therapeutic windows. Thus, many of our processes are, in NAT terms, interactively complex and tightly coupled within and across systems and are therefore prone to unexpected behaviors that can result in substantial patient harm. To improve safety at the University of North Carolina, we have applied the concepts of NAT to our practice to better understand our systems' behavior and adopted strategies to reduce complexity and coupling. Furthermore, recognizing that we cannot eliminate all risks, we have stressed safety mindfulness among our staff to further promote safety. Many specific examples are provided herein. The lessons from NAT are translatable to clinical oncology and may help to promote safety. PMID:26182183

  5. [Point on consideration of the clinical trial design and evaluation on the dressing applied to burn wound].

    PubMed

    Yang, Xiaodong

    2012-05-01

    The relevant keypoints needed to be considered in clinical trials of dressing applied to burn wound when claiming for registration is discussed combining with the characteristics of burn wound and the dressing applied to wound surface in order to provide reference for development & clinical evaluation of dressing. PMID:22916480

  6. Applying knowledge-anchored hypothesis discovery methods to advance clinical and translational research: the OAMiner project

    PubMed Central

    Jackson, Rebecca D; Best, Thomas M; Borlawsky, Tara B; Lai, Albert M; James, Stephen; Gurcan, Metin N

    2012-01-01

    The conduct of clinical and translational research regularly involves the use of a variety of heterogeneous and large-scale data resources. Scalable methods for the integrative analysis of such resources, particularly when attempting to leverage computable domain knowledge in order to generate actionable hypotheses in a high-throughput manner, remain an open area of research. In this report, we describe both a generalizable design pattern for such integrative knowledge-anchored hypothesis discovery operations and our experience in applying that design pattern in the experimental context of a set of driving research questions related to the publicly available Osteoarthritis Initiative data repository. We believe that this ‘test bed’ project and the lessons learned during its execution are both generalizable and representative of common clinical and translational research paradigms. PMID:22647689

  7. Method to integrate clinical guidelines into the electronic health record (EHR) by applying the archetypes approach.

    PubMed

    Garcia, Diego; Moro, Claudia Maria Cabral; Cicogna, Paulo Eduardo; Carvalho, Deborah Ribeiro

    2013-01-01

    Clinical guidelines are documents that assist healthcare professionals, facilitating and standardizing diagnosis, management, and treatment in specific areas. Computerized guidelines as decision support systems (DSS) attempt to increase the performance of tasks and facilitate the use of guidelines. Most DSS are not integrated into the electronic health record (EHR), ordering some degree of rework especially related to data collection. This study's objective was to present a method for integrating clinical guidelines into the EHR. The study developed first a way to identify data and rules contained in the guidelines, and then incorporate rules into an archetype-based EHR. The proposed method tested was anemia treatment in the Chronic Kidney Disease Guideline. The phases of the method are: data and rules identification; archetypes elaboration; rules definition and inclusion in inference engine; and DSS-EHR integration and validation. The main feature of the proposed method is that it is generic and can be applied toany type of guideline. PMID:23920682

  8. Constructivism applied to psychiatric-mental health nursing: an alternative to supplement traditional clinical education.

    PubMed

    DeCoux Hampton, Michelle

    2012-02-01

    With the popularity of accelerated pre-licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism-based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric-mental health nursing course. Students participated in a 10-week, multistage project that examined life histories, treatment resources, and evidence-based practice, as applied to a single individual with a mental illness. Students reported increased understanding of mental health and illness, developed personal relevance associated with the knowledge gained, and learned to problem solve with regard to nursing care of individuals diagnosed with mental illness. For many students, there also appeared to be a reduction in stigmatized attitudes towards mental illness. Constructivism-based learning is a promising alternative to supplement clinical hours, while effectively achieving learning outcomes. Future research is needed to further validate the use of this method for the learning of course content, as well as the reduction of stigma. PMID:21676137

  9. Adsorption of Cd(II) and Cu(II) from aqueous solution by carbonate hydroxylapatite derived from eggshell waste.

    PubMed

    Zheng, Wei; Li, Xiao-ming; Yang, Qi; Zeng, Guang-ming; Shen, Xiang-xin; Zhang, Ying; Liu, Jing-jin

    2007-08-17

    Carbonate hydroxylapatite (CHAP) synthesized by using eggshell waste as raw material has been investigated as metal adsorption for Cd(II) and Cu(II) from aqueous solutions. The effect of various parameters on adsorption process such as contact time, solution pH, amount of CHAP and initial concentration of metal ions was studied at room temperature to optimize the conditions for maximum adsorption. The results showed that the removal efficiency of Cd(II) and Cu(II) by CHAP could reach 94 and 93.17%, respectively, when the initial Cd(II) concentration 80 mg/L and Cu(II) 60 mg/L and the liquid/solid ratio was 2.5 g/L. The equilibrium sorption data for single metal systems at room temperature could be described by the Langmuir and Freundlich isotherm models. The highest value of Langmuir maximum uptake, (b), was found for cadmium (111.1mg/g) and copper (142.86 mg/g). Similar Freundlich empirical constants, K, were obtained for cadmium (2.224) and copper (7.925). Ion exchange and surface adsorption might be involved in the adsorption process of cadmium and copper. Desorption experiments showed that CaCl2, NaCl, acetic acid and ultrasonic were not efficient enough to desorb substantial amount of metal ions from the CHAP. The results obtained show that CHAP has a high affinity to cadmium and copper. PMID:17368932

  10. Rorschach scores in applied clinical practice: a survey of perceived validity by experienced clinicians.

    PubMed

    Meyer, Gregory J; Hsiao, Wei-Cheng; Viglione, Donald J; Mihura, Joni L; Abraham, Leah M

    2013-01-01

    We surveyed practicing clinicians who regularly used the Rorschach about the perceived clinical validity of specific Rorschach scores from many coding systems. The survey included quantitative feedback on the validity of specific variables as well as qualitative input in several areas, including the validity of specific variables, the potentially unique information that can be obtained from them, coding challenges associated with Comprehensive System (CS) codes, and recommendations for CS developments. Participants were recruited by applying a snowball sampling strategy. Based on responses from 246 experienced clinicians from 26 countries, composite judgments on rated variables were quite reliable (e.g., M α = .95 across 88 CS variables), despite limited agreement among any 2 judges. The aggregated judgments clearly differentiated among scores that were considered more and less clinically valid and the overall results aligned with recently obtained meta-analytic conclusions from the traditional validity literature (Mihura, Meyer, Dumitrascu, & Bombel, 2012). The judges also provided guidance concerning revisions and enhancements that would facilitate Rorschach-based assessment in the future. We discuss the implication of the quantitative and qualitative findings and provide suggestions for future directions based on the results. PMID:23452352

  11. Applying Automated MR-Based Diagnostic Methods to the Memory Clinic: A Prospective Study

    PubMed Central

    Klöppel, Stefan; Peter, Jessica; Ludl, Anna; Pilatus, Anne; Maier, Sabrina; Mader, Irina; Heimbach, Bernhard; Frings, Lars; Egger, Karl; Dukart, Juergen; Schroeter, Matthias L.; Perneczky, Robert; Häussermann, Peter; Vach, Werner; Urbach, Horst; Teipel, Stefan; Hüll, Michael; Abdulkadir, Ahmed

    2015-01-01

    Abstract Several studies have demonstrated that fully automated pattern recognition methods applied to structural magnetic resonance imaging (MRI) aid in the diagnosis of dementia, but these conclusions are based on highly preselected samples that significantly differ from that seen in a dementia clinic. At a single dementia clinic, we evaluated the ability of a linear support vector machine trained with completely unrelated data to differentiate between Alzheimer’s disease (AD), frontotemporal dementia (FTD), Lewy body dementia, and healthy aging based on 3D-T1 weighted MRI data sets. Furthermore, we predicted progression to AD in subjects with mild cognitive impairment (MCI) at baseline and automatically quantified white matter hyperintensities from FLAIR-images. Separating additionally recruited healthy elderly from those with dementia was accurate with an area under the curve (AUC) of 0.97 (according to Fig. 4). Multi-class separation of patients with either AD or FTD from other included groups was good on the training set (AUC >  0.9) but substantially less accurate (AUC = 0.76 for AD, AUC = 0.78 for FTD) on 134 cases from the local clinic. Longitudinal data from 28 cases with MCI at baseline and appropriate follow-up data were available. The computer tool discriminated progressive from stable MCI with AUC = 0.73, compared to AUC = 0.80 for the training set. A relatively low accuracy by clinicians (AUC = 0.81) illustrates the difficulties of predicting conversion in this heterogeneous cohort. This first application of a MRI-based pattern recognition method to a routine sample demonstrates feasibility, but also illustrates that automated multi-class differential diagnoses have to be the focus of future methodological developments and application studies PMID:26401773

  12. Applying Automated MR-Based Diagnostic Methods to the Memory Clinic: A Prospective Study.

    PubMed

    Klöppel, Stefan; Peter, Jessica; Ludl, Anna; Pilatus, Anne; Maier, Sabrina; Mader, Irina; Heimbach, Bernhard; Frings, Lars; Egger, Karl; Dukart, Juergen; Schroeter, Matthias L; Perneczky, Robert; Häussermann, Peter; Vach, Werner; Urbach, Horst; Teipel, Stefan; Hüll, Michael; Abdulkadir, Ahmed

    2015-01-01

    Several studies have demonstrated that fully automated pattern recognition methods applied to structural magnetic resonance imaging (MRI) aid in the diagnosis of dementia, but these conclusions are based on highly preselected samples that significantly differ from that seen in a dementia clinic. At a single dementia clinic, we evaluated the ability of a linear support vector machine trained with completely unrelated data to differentiate between Alzheimer's disease (AD), frontotemporal dementia (FTD), Lewy body dementia, and healthy aging based on 3D-T1 weighted MRI data sets. Furthermore, we predicted progression to AD in subjects with mild cognitive impairment (MCI) at baseline and automatically quantified white matter hyperintensities from FLAIR-images. Separating additionally recruited healthy elderly from those with dementia was accurate with an area under the curve (AUC) of 0.97 (according to Fig. 4). Multi-class separation of patients with either AD or FTD from other included groups was good on the training set (AUC >  0.9) but substantially less accurate (AUC = 0.76 for AD, AUC = 0.78 for FTD) on 134 cases from the local clinic. Longitudinal data from 28 cases with MCI at baseline and appropriate follow-up data were available. The computer tool discriminated progressive from stable MCI with AUC = 0.73, compared to AUC = 0.80 for the training set. A relatively low accuracy by clinicians (AUC = 0.81) illustrates the difficulties of predicting conversion in this heterogeneous cohort. This first application of a MRI-based pattern recognition method to a routine sample demonstrates feasibility, but also illustrates that automated multi-class differential diagnoses have to be the focus of future methodological developments and application studies. PMID:26401773

  13. Clinical usefulness of the clock drawing test applying rasch analysis in predicting of cognitive impairment

    PubMed Central

    Yoo, Doo Han; Lee, Jae Shin

    2016-01-01

    [Purpose] This study examined the clinical usefulness of the clock drawing test applying Rasch analysis for predicting the level of cognitive impairment. [Subjects and Methods] A total of 187 stroke patients with cognitive impairment were enrolled in this study. The 187 patients were evaluated by the clock drawing test developed through Rasch analysis along with the mini-mental state examination of cognitive evaluation tool. An analysis of the variance was performed to examine the significance of the mini-mental state examination and the clock drawing test according to the general characteristics of the subjects. Receiver operating characteristic analysis was performed to determine the cutoff point for cognitive impairment and to calculate the sensitivity and specificity values. [Results] The results of comparison of the clock drawing test with the mini-mental state showed significant differences in according to gender, age, education, and affected side. A total CDT of 10.5, which was selected as the cutoff point to identify cognitive impairement, showed a sensitivity, specificity, Youden index, positive predictive, and negative predicive values of 86.4%, 91.5%, 0.8, 95%, and 88.2%. [Conclusion] The clock drawing test is believed to be useful in assessments and interventions based on its excellent ability to identify cognitive disorders. PMID:27512283

  14. Developing a technology for the use of operant extinction in clinical settings: an examination of basic and applied research.

    PubMed Central

    Lerman, D C; Iwata, B A

    1996-01-01

    Extinction of operant behavior, which involves terminating the reinforcement contingency that maintains a response, is important to the development, generalization, and reduction of behavior in clinical settings. We review basic and applied research findings on variables that influence the direct and indirect effects of extinction and discuss the potential value of a general technology for the use of extinction. We suggest that current research findings are not sufficient for the development of a comprehensive, applied technology of extinction and provide extensive guidelines for further studies on factors that may affect the course of extinction in clinical settings. PMID:8926226

  15. Applying the benefits of the AwM study in the clinic.

    PubMed

    Dodick, D W

    2008-09-01

    The Act when Mild (AwM) Study has illustrated the benefits to migraineurs of taking triptan medication when their migraine pain is still mild and within 1 h of the onset of symptoms. Yet many patients wait until the attack has fully developed before taking their medication, with potentially inferior outcomes. In order to reproduce the benefits of early intervention using the AwM paradigm in daily practice, a number of key barriers need to be addressed at both the physician and patient level. Notable physician-related barriers to be overcome, particularly at the primary care level, include accuracy of an early diagnosis of migraine in newly presenting patients, communication skills that generate a therapeutic engagement with migraine patients and enhance patient confidence, the application of knowledge about up-to-date strategies to optimize treatment outcomes, and the setting of achievable goals to avoid unrealistic expectations. Patient-related obstacles that need to be identified and overcome encompass patient attitude, expectations, and behaviour. Migraine patients may be reluctant to consult their physician, and, of those who do, many stop consulting because they perceive that physicians can do little to improve their situation. For this reason, migraine patients need to be counselled about the most appropriate medication for their level of symptoms. Moreover, patients need to be confident before they will adhere routinely to the advice they receive, and high in the priority of advice is the use of medication, particularly triptans, at the first sign of a migraine attack, rather than waiting until their attack has progressed to moderate or severe intensity. Patients who adhere to this advice are likely to experience a notable reduction in the pain, disability and time lost that they would otherwise suffer. The beneficial effects of early triptan intervention illustrated in the AwM Study can therefore be best reproduced in the clinic if the correct advice given

  16. Venlafaxine versus applied relaxation for generalized anxiety disorder: a randomized controlled study on clinical and electrophysiological outcomes.

    PubMed

    Zullino, Daniele; Chatton, Anne; Fresard, Emmanuelle; Stankovic, Miroslava; Bondolfi, Guido; Borgeat, François; Khazaal, Yasser

    2015-03-01

    Some components of generalized anxiety disorder, such as physical symptoms, are thought to reflect autonomic nervous system arousal. This study primarily assessed the relationships between psychophysiological and clinical measures using venlafaxine extended release or applied relaxation, and secondarily, the impact of combination treatment in patients not remitting after 8 weeks. Fifty-eight patients were randomly assigned to 8 weeks of treatment with either venlafaxine or applied relaxation (Phase I). Non-remitted patients received combination treatment for an additional 8 weeks (Phase II). Assessments included the Hamilton Anxiety Scale (HAM-A), Beck Depression Inventory, Penn State Worry Questionnaire and the Stroop Color-Word Task coupled with electrophysiological measures (skin conductance and frontalis electromyography (EMG)). In Phase 1, a time effect was found for the clinical and skin conductance measures. Thirteen patients from each group were in remission. In Phase 2, seven additional patients remitted. Baseline psychophysiological measures were not associated with baseline clinical variables or with clinical outcomes. Independently of treatment allocation, a reduction in frontal EMG values at week 4 was significantly associated with a decrease in HAM-A scores at week 8. At week 4, responders from the applied relaxation group had lower electrophysiological activity than the venlafaxine group. Baseline psychophysiological measures were not linked with clinical measures at study inclusion or with treatment response. Frontal EMG response at week 4 is a possible predictor of treatment response. Treatment combination enhances treatment response after initial failure. PMID:25464934

  17. Applying active learning to assertion classification of concepts in clinical text.

    PubMed

    Chen, Yukun; Mani, Subramani; Xu, Hua

    2012-04-01

    Supervised machine learning methods for clinical natural language processing (NLP) research require a large number of annotated samples, which are very expensive to build because of the involvement of physicians. Active learning, an approach that actively samples from a large pool, provides an alternative solution. Its major goal in classification is to reduce the annotation effort while maintaining the quality of the predictive model. However, few studies have investigated its uses in clinical NLP. This paper reports an application of active learning to a clinical text classification task: to determine the assertion status of clinical concepts. The annotated corpus for the assertion classification task in the 2010 i2b2/VA Clinical NLP Challenge was used in this study. We implemented several existing and newly developed active learning algorithms and assessed their uses. The outcome is reported in the global ALC score, based on the Area under the average Learning Curve of the AUC (Area Under the Curve) score. Results showed that when the same number of annotated samples was used, active learning strategies could generate better classification models (best ALC-0.7715) than the passive learning method (random sampling) (ALC-0.7411). Moreover, to achieve the same classification performance, active learning strategies required fewer samples than the random sampling method. For example, to achieve an AUC of 0.79, the random sampling method used 32 samples, while our best active learning algorithm required only 12 samples, a reduction of 62.5% in manual annotation effort. PMID:22127105

  18. Applying extracellular vesicles based therapeutics in clinical trials – an ISEV position paper

    PubMed Central

    Lener, Thomas; Gimona, Mario; Aigner, Ludwig; Börger, Verena; Buzas, Edit; Camussi, Giovanni; Chaput, Nathalie; Chatterjee, Devasis; Court, Felipe A.; del Portillo, Hernando A.; O'Driscoll, Lorraine; Fais, Stefano; Falcon-Perez, Juan M.; Felderhoff-Mueser, Ursula; Fraile, Lorenzo; Gho, Yong Song; Görgens, André; Gupta, Ramesh C.; Hendrix, An; Hermann, Dirk M.; Hill, Andrew F.; Hochberg, Fred; Horn, Peter A.; de Kleijn, Dominique; Kordelas, Lambros; Kramer, Boris W.; Krämer-Albers, Eva-Maria; Laner-Plamberger, Sandra; Laitinen, Saara; Leonardi, Tommaso; Lorenowicz, Magdalena J.; Lim, Sai Kiang; Lötvall, Jan; Maguire, Casey A.; Marcilla, Antonio; Nazarenko, Irina; Ochiya, Takahiro; Patel, Tushar; Pedersen, Shona; Pocsfalvi, Gabriella; Pluchino, Stefano; Quesenberry, Peter; Reischl, Ilona G.; Rivera, Francisco J.; Sanzenbacher, Ralf; Schallmoser, Katharina; Slaper-Cortenbach, Ineke; Strunk, Dirk; Tonn, Torsten; Vader, Pieter; van Balkom, Bas W. M.; Wauben, Marca; Andaloussi, Samir El; Théry, Clotilde; Rohde, Eva; Giebel, Bernd

    2015-01-01

    Extracellular vesicles (EVs), such as exosomes and microvesicles, are released by different cell types and participate in physiological and pathophysiological processes. EVs mediate intercellular communication as cell-derived extracellular signalling organelles that transmit specific information from their cell of origin to their target cells. As a result of these properties, EVs of defined cell types may serve as novel tools for various therapeutic approaches, including (a) anti-tumour therapy, (b) pathogen vaccination, (c) immune-modulatory and regenerative therapies and (d) drug delivery. The translation of EVs into clinical therapies requires the categorization of EV-based therapeutics in compliance with existing regulatory frameworks. As the classification defines subsequent requirements for manufacturing, quality control and clinical investigation, it is of major importance to define whether EVs are considered the active drug components or primarily serve as drug delivery vehicles. For an effective and particularly safe translation of EV-based therapies into clinical practice, a high level of cooperation between researchers, clinicians and competent authorities is essential. In this position statement, basic and clinical scientists, as members of the International Society for Extracellular Vesicles (ISEV) and of the European Cooperation in Science and Technology (COST) program of the European Union, namely European Network on Microvesicles and Exosomes in Health and Disease (ME-HaD), summarize recent developments and the current knowledge of EV-based therapies. Aspects of safety and regulatory requirements that must be considered for pharmaceutical manufacturing and clinical application are highlighted. Production and quality control processes are discussed. Strategies to promote the therapeutic application of EVs in future clinical studies are addressed. PMID:26725829

  19. Applying extracellular vesicles based therapeutics in clinical trials - an ISEV position paper.

    PubMed

    Lener, Thomas; Gimona, Mario; Aigner, Ludwig; Börger, Verena; Buzas, Edit; Camussi, Giovanni; Chaput, Nathalie; Chatterjee, Devasis; Court, Felipe A; Del Portillo, Hernando A; O'Driscoll, Lorraine; Fais, Stefano; Falcon-Perez, Juan M; Felderhoff-Mueser, Ursula; Fraile, Lorenzo; Gho, Yong Song; Görgens, André; Gupta, Ramesh C; Hendrix, An; Hermann, Dirk M; Hill, Andrew F; Hochberg, Fred; Horn, Peter A; de Kleijn, Dominique; Kordelas, Lambros; Kramer, Boris W; Krämer-Albers, Eva-Maria; Laner-Plamberger, Sandra; Laitinen, Saara; Leonardi, Tommaso; Lorenowicz, Magdalena J; Lim, Sai Kiang; Lötvall, Jan; Maguire, Casey A; Marcilla, Antonio; Nazarenko, Irina; Ochiya, Takahiro; Patel, Tushar; Pedersen, Shona; Pocsfalvi, Gabriella; Pluchino, Stefano; Quesenberry, Peter; Reischl, Ilona G; Rivera, Francisco J; Sanzenbacher, Ralf; Schallmoser, Katharina; Slaper-Cortenbach, Ineke; Strunk, Dirk; Tonn, Torsten; Vader, Pieter; van Balkom, Bas W M; Wauben, Marca; Andaloussi, Samir El; Théry, Clotilde; Rohde, Eva; Giebel, Bernd

    2015-01-01

    Extracellular vesicles (EVs), such as exosomes and microvesicles, are released by different cell types and participate in physiological and pathophysiological processes. EVs mediate intercellular communication as cell-derived extracellular signalling organelles that transmit specific information from their cell of origin to their target cells. As a result of these properties, EVs of defined cell types may serve as novel tools for various therapeutic approaches, including (a) anti-tumour therapy, (b) pathogen vaccination, (c) immune-modulatory and regenerative therapies and (d) drug delivery. The translation of EVs into clinical therapies requires the categorization of EV-based therapeutics in compliance with existing regulatory frameworks. As the classification defines subsequent requirements for manufacturing, quality control and clinical investigation, it is of major importance to define whether EVs are considered the active drug components or primarily serve as drug delivery vehicles. For an effective and particularly safe translation of EV-based therapies into clinical practice, a high level of cooperation between researchers, clinicians and competent authorities is essential. In this position statement, basic and clinical scientists, as members of the International Society for Extracellular Vesicles (ISEV) and of the European Cooperation in Science and Technology (COST) program of the European Union, namely European Network on Microvesicles and Exosomes in Health and Disease (ME-HaD), summarize recent developments and the current knowledge of EV-based therapies. Aspects of safety and regulatory requirements that must be considered for pharmaceutical manufacturing and clinical application are highlighted. Production and quality control processes are discussed. Strategies to promote the therapeutic application of EVs in future clinical studies are addressed. PMID:26725829

  20. Dialectical Behavior Therapy (DBT) Applied to College Students: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Pistorello, Jacqueline; Fruzzetti, Alan E.; MacLane, Chelsea; Gallop, Robert; Iverson, Katherine M.

    2012-01-01

    Objective: College counseling centers (CCCs) are increasingly being called upon to treat highly distressed students with complex clinical presentations. This study compared the effectiveness of Dialectical Behavior Therapy (DBT) for suicidal college students with an optimized control condition and analyzed baseline global functioning as a…

  1. Critical action research applied in clinical placement development in aged care facilities.

    PubMed

    Xiao, Lily D; Kelton, Moira; Paterson, Jan

    2012-12-01

    The aim of this study was to develop quality clinical placements in residential aged care facilities for undergraduate nursing students undertaking their nursing practicum topics. The proportion of people aged over 65 years is expected to increase steadily from 13% in 2006 to 26% of the total population in Australia in 2051. However, when demand is increasing for a nursing workforce competent in the care of older people, studies have shown that nursing students generally lack interest in working with older people. The lack of exposure of nursing students to quality clinical placements is one of the key factors contributing to this situation. Critical action research built on a partnership between an Australian university and five aged care organisations was utilised. A theoretical framework informed by Habermas' communicative action theory was utilised to guide the action research. Multiple research activities were used to support collaborative critical reflection and inform actions throughout the action research. Clinical placements in eight residential aged care facilities were developed to support 179 nursing students across three year-levels to complete their practicum topics. Findings were presented in three categories described as structures developed to govern clinical placement, learning and teaching in residential aged care facilities. PMID:23134277

  2. Automatic Domain Adaptation of Word Sense Disambiguation Based on Sublanguage Semantic Schemata Applied to Clinical Narrative

    ERIC Educational Resources Information Center

    Patterson, Olga

    2012-01-01

    Domain adaptation of natural language processing systems is challenging because it requires human expertise. While manual effort is effective in creating a high quality knowledge base, it is expensive and time consuming. Clinical text adds another layer of complexity to the task due to privacy and confidentiality restrictions that hinder the…

  3. Considerations in Applying the Results of Randomized Controlled Clinical Trials to the Care of Older Adults With Kidney Disease in the Clinical Setting: The SHARP Trial.

    PubMed

    Butler, Catherine R; O'Hare, Ann M

    2016-01-01

    The Study of Heart and Renal Protection (SHARP) found that treatment with ezetemibe and low-dose simvastatin reduced the incidence of major atherosclerotic events in patients with kidney disease. Due to the paucity of evidence-based interventions that lower cardiovascular morbidity in this high-risk population, the SHARP trial will likely have a large impact on clinical practice. However, applying the results of clinical trials conducted in select populations to the care of individual patients in real-world settings can be fraught with difficulty. This is especially true when caring for older adults with complex comorbidity and limited life expectancy. These patients are often excluded from clinical trials, frequently have competing health priorities, and may be less likely to benefit and more likely to be harmed by medications. We discuss key considerations in applying the results of the SHARP trial to the care of older adults with CKD in real-world clinical settings using guiding principles set forth by the American Geriatrics Society's Expert Panel on the Care of Older Adults with Multimorbidity. Using this schema, we emphasize the importance of evaluating trial results in the unique context of each patient's goals, values, priorities, and circumstances. PMID:26709060

  4. Treatment of pediatric overweight: an examination of feasibility and effectiveness in an applied clinical setting

    Technology Transfer Automated Retrieval System (TEKTRAN)

    OBJECTIVE: To examine the effectiveness and feasibility of an evidence-based treatment for weight loss in children. METHODS: A total of 41 children who were overweight and their families were provided a modified version of the Traffic Light Diet (TLD) in an applied setting. Children who received tr...

  5. Biodegradable device applied in flatfoot surgery: comparative studies between clinical and technological aspects of removed screws.

    PubMed

    Ruozi, Barbara; Belletti, Daniela; Manfredini, Giuseppe; Tonelli, Massimo; Sena, Paola; Vandelli, Maria Angela; Forni, Flavio; Tosi, Giovanni

    2013-04-01

    Poly-L-lactide (PLLA) is one of the most used polymers for biomedical application; its use in sutures and other implants has been widely investigated. Although the knowledge of PLLA biodegradation and biocompatibility features is deep, PLLA screws used to correct the flat foot deformity have deserved attention since they are not degraded in most of cases after a long period of years (3-7) from the implantation. In this article, a clinical and radiological evaluation (NMR, histological and clinical outcomes) on patients was correlated with physico-chemical characterization (by SEM, DSC, GPC and XRD analysis at different temperatures) on both native and patient-recovered screws together with the theoretical degradation processes of PLLA-based implants. The data demonstrated the need for crossing the biodegradation and bioabsorption of the polymer with the characteristics of both the device (geometry, structure and fabrication process) and the implantation site. PMID:23827635

  6. A comparative study of supervised learning as applied to acronym expansion in clinical reports.

    PubMed

    Joshi, Mahesh; Pakhomov, Serguei; Pedersen, Ted; Chute, Christopher G

    2006-01-01

    Electronic medical records (EMR) constitute a valuable resource of patient specific information and are increasingly used for clinical practice and research. Acronyms present a challenge to retrieving information from the EMR because many acronyms are ambiguous with respect to their full form. In this paper we perform a comparative study of supervised acronym disambiguation in a corpus of clinical notes, using three machine learning algorithms: the naïve Bayes classifier, decision trees and Support Vector Machines (SVMs). Our training features include part-of-speech tags, unigrams and bigrams in the context of the ambiguous acronym. We find that the combination of these feature types results in consistently better accuracy than when they are used individually, regardless of the learning algorithm employed. The accuracy of all three methods when using all features consistently approaches or exceeds 90%, even when the baseline majority classifier is below 50%. PMID:17238371

  7. Interdisciplinary collaboration applied to clinical research: an example of remote monitoring in lung transplantation.

    PubMed

    VanWormer, Arin; Lindquist, Ruth; Robiner, William; Finkelstein, Stanley

    2012-01-01

    Collaboration across disciplines is vital in clinical practice. It is also needed to generate high-quality actionable research, yet few frameworks for interdisciplinary collaboration exit to promote effective communications among researchers with common goals, but varied backgrounds. A review of what has been learned about collaboration was undertaken to determine attributes of effective interdisciplinary collaboration and barriers to its realization in patients undergoing lung transplantation. PMID:22475710

  8. Interdisciplinary collaboration applied to clinical research: an example of remote monitoring in lung transplantation

    PubMed Central

    VanWormer, Arin; Robiner, William; Finkelstein, Stanley

    2012-01-01

    Collaboration across disciplines is vital in clinical practice. It is also needed to generate high-quality actionable research, yet few frameworks for interdisciplinary collaboration exit to promote effective communications among researchers with common boals, but varied backgrounds. A review of that has been learned about collaboration was undertaken to determine attributes of effective interdisciplinary collaboration and barriers to its realization in patients undergoing lung transplantation. PMID:22475710

  9. Clinical use of vaginal or rectally applied microbicides in patients suffering from HIV/AIDS

    PubMed Central

    Gupta, Satish Kumar; Nutan

    2013-01-01

    Microbicides, primarily used as topical pre-exposure prophylaxis, have been proposed to prevent sexual transmission of HIV. This review covers the trends and challenges in the development of safe and effective microbicides to prevent sexual transmission of HIV Initial phases of microbicide development used such surfactants as nonoxynol-9 (N-9), C13G, and sodium lauryl sulfate, aiming to inactivate the virus. Clinical trials of microbicides based on N-9 and C31G failed to inhibit sexual transmission of HIV. On the contrary, N-9 enhanced susceptibility to sexual transmission of HIV-1. Subsequently, microbicides based on polyanions and a variety of other compounds that inhibit the binding, fusion, or entry of virus to the host cells were evaluated for their efficacy in different clinical setups. Most of these trials failed to show either safety or efficacy for prevention of HIV transmission. The next phase of microbicide development involved antiretroviral drugs. Microbicide in the form of 1% tenofovir vaginal gel when tested in a Phase IIb trial (CAPRISA 004) in a coitally dependent manner revealed that tenofovir gel users were 39% less likely to become HIV-infected compared to placebo control. However, in another trial (VOICE MTN 003), tenofovir gel used once daily in a coitally independent mode failed to show any efficacy to prevent HIV infection. Tenofovir gel is currently in a Phase III safety and efficacy trial in South Africa (FACTS 001) employing a coitally dependent dosing regimen. Further, long-acting microbicide-delivery systems (vaginal ring) for slow release of such antiretroviral drugs as dapivirine are also undergoing clinical trials. Discovering new markers as correlates of protective efficacy, novel long-acting delivery systems with improved adherence in the use of microbicides, discovering new compounds effective against a broad spectrum of HIV strains, developing multipurpose technologies incorporating additional features of efficacy against other

  10. Clinical use of vaginal or rectally applied microbicides in patients suffering from HIV/AIDS.

    PubMed

    Gupta, Satish Kumar; Nutan

    2013-01-01

    Microbicides, primarily used as topical pre-exposure prophylaxis, have been proposed to prevent sexual transmission of HIV. This review covers the trends and challenges in the development of safe and effective microbicides to prevent sexual transmission of HIV Initial phases of microbicide development used such surfactants as nonoxynol-9 (N-9), C13G, and sodium lauryl sulfate, aiming to inactivate the virus. Clinical trials of microbicides based on N-9 and C31G failed to inhibit sexual transmission of HIV. On the contrary, N-9 enhanced susceptibility to sexual transmission of HIV-1. Subsequently, microbicides based on polyanions and a variety of other compounds that inhibit the binding, fusion, or entry of virus to the host cells were evaluated for their efficacy in different clinical setups. Most of these trials failed to show either safety or efficacy for prevention of HIV transmission. The next phase of microbicide development involved antiretroviral drugs. Microbicide in the form of 1% tenofovir vaginal gel when tested in a Phase IIb trial (CAPRISA 004) in a coitally dependent manner revealed that tenofovir gel users were 39% less likely to become HIV-infected compared to placebo control. However, in another trial (VOICE MTN 003), tenofovir gel used once daily in a coitally independent mode failed to show any efficacy to prevent HIV infection. Tenofovir gel is currently in a Phase III safety and efficacy trial in South Africa (FACTS 001) employing a coitally dependent dosing regimen. Further, long-acting microbicide-delivery systems (vaginal ring) for slow release of such antiretroviral drugs as dapivirine are also undergoing clinical trials. Discovering new markers as correlates of protective efficacy, novel long-acting delivery systems with improved adherence in the use of microbicides, discovering new compounds effective against a broad spectrum of HIV strains, developing multipurpose technologies incorporating additional features of efficacy against other

  11. Applying the results of large clinical trials in the management of acute myocardial infarction.

    PubMed Central

    Sweeney, J P; Schwartz, G G

    1996-01-01

    Mortality from acute myocardial infarction has declined in recent years, largely due to the widespread application of new pharmacologic and mechanical interventions that have been tested in large, prospective, randomized clinical trials. For practicing generalists, we review the key data from such trials that have shaped the current management of patients with acute myocardial infarction. We discuss the roles of thrombolytic therapy, coronary angioplasty, nitrates, beta- and calcium channel blockers, angiotensin-converting-enzyme inhibitors, magnesium, and antiarrhythmic and antithrombotic agents. In addition, we highlight critical unanswered questions in the management of this disorder. PMID:8775936

  12. Towards Implementing a Global Competency-Based Nursing and Clinical Informatics Curriculum: Applying the TIGER Initiative.

    PubMed

    Hübner, Ursula; Ball, Marion; de Fátima Marin, Heimar; Chang, Polun; Wilson, Marisa; Anderson, Christel

    2016-01-01

    This workshop will review the history of the TIGER initiative in order to set the framework for an understanding of international informatics competencies. We will include a description of clinical nursing informatics programs in 37 countries as well as the results of a recent survey of nursing competencies in order to further discussions of internationally agreed-upon competency definitions. These two surveys will provide the basis for developing a consensus regarding the integration of core competencies into informatics curriculum developments. Expected outcomes include building consensus on core competencies and developing plans toward implementing intra- and inter-professional informatics competencies across disciplines globally. PMID:27332333

  13. Interactive tele-education applied to a distant clinical microbiology specialization university course.

    PubMed

    Andreazzi, Denise B; Rossi, Flávia; Wen, Chao L

    2011-09-01

    The microbiology laboratory provides a strategic support for infectious disease diagnosis and also alerts the medical community about bacterial resistance to antibiotics. The microbiologists' training is a challenge in Brazil, a country with an extensive territory, a diverse population, and disparity of resource allocation. The aim of this study was to implement an interactive tele-educational course in clinical microbiology to reach distant laboratory workers and to improve their professional skills. The course scientific content was defined according to competences associated, distributed in 560 h, with laboratory practices (knowledge matrix-contextual education). The 11-module course structure comprised 70% distance learning, 22% on campus (integrated modules), and 8% monographs. The group included 7 physicians and 21 microbiologists from 20 different Brazilian cities. The time flexibility and location were the two main reasons for student participation, thus decreasing absences to the workplace, different from the traditional teaching methodologies. The group performance was measured by monthly evaluations, and 1 year postcourse, the researcher visited their workplace. There was significant improvement in microbiological practices performed before compared with after group participation. Therefore, 76.9% of laboratory practices were modified because of the knowledge acquired in the course. Students showed behavioral changes in relation to performance in infection control as well as on the dissemination of their knowledge. This specialization course using distance education did not compromise the quality. This educational methodology represents an alternative to teach clinical microbiology to laboratory workers from remote hospitals, as a nationwide continuing educational strategy. PMID:21749260

  14. The Palliative Outcome Scale (POS) applied to clinical practice and research: an integrative review

    PubMed Central

    Rugno, Fernanda Capella; Carlo, Marysia Mara Rodrigues do Prado De

    2016-01-01

    ABSTRACT Objective: to identify and evaluate the evidence found in the international scientific literature on the application of the Palliative Outcome Scale (POS) in clinical practice and research in Palliative Care (PC). Method: integrative literature review, through the search of publications in journals indexed in PubMed / MEDLINE, LILACS, SciELO and CINAHL databases, between the years 1999 and 2014. Results: the final sample consisted of 11 articles. In the data analysis, the articles were classified into 2 units of analysis (studies using the POS as a resource in research and studies using the POS in clinical practice), in which the information was presented in the form of sub-themes related to publications of the selected studies, highlighting the synthesis of the results. Conclusion: POS emerged as an important tool for measuring outcomes to assess the quality of life of patients and families, of the quality of care provided and the PC service organization. The international scientific literature on the application of POS proved to be relevant to the advancement and consolidation of the field of knowledge related to PC. PMID:27533273

  15. Applied Proteogenomics OrganizationaL Learning and Outcomes (APOLLO) Network - Office of Cancer Clinical Proteomics Research

    Cancer.gov

    In the spirit of collaboration inspired by the Vice President’s Cancer Moonshot, the Department of Veterans Affairs (VA), the Department of Defense (DoD), and the National Cancer Institute (NCI) are proud to announce a new tri-agency coalition (APOLLO Network — Applied Proteogenomics OrganizationaL Learning and Outcomes) that will help cancer patients by enabling their oncologists to more rapidly and accurately identify effective drugs to treat cancer based on a patient’s unique proteogenomic profile.

  16. Factors Associated with Success in Searching medline and Applying Evidence to Answer Clinical Questions

    PubMed Central

    Hersh, William R.; Crabtree, M. Katherine; Hickam, David H.; Sacherek, Lynetta; Friedman, Charles P.; Tidmarsh, Patricia; Mosbaek, Craig; Kraemer, Dale

    2002-01-01

    Objectives: This study sought to assess the ability of medical and nurse practitioner students to use medline to obtain evidence for answering clinical questions and to identify factors associated with the successful answering of questions. Methods: A convenience sample of medical and nurse practitioner students was recruited. After completing instruments measuring demographic variables, computer and searching attitudes and experience, and cognitive traits, the subjects were given a brief orientation to medline searching and the techniques of evidence-based medicine. The subjects were then given 5 questions (from a pool of 20) to answer in two sessions using the Ovid medline system and the Oregon Health & Science University library collection. Each question was answered using three possible responses that reflected the quality of the evidence. All actions capable of being logged by the Ovid system were captured. Statistical analysis was performed using a model based on generalized estimating equations. The relevance-based measures of recall and precision were measured by defining end queries and having relevance judgments made by physicians who were not associated with the study. Results: Forty-five medical and 21 nurse practitioner students provided usable answers to 324 questions. The rate of correctness increased from 32.3 to 51.6 percent for medical students and from 31.7 to 34.7 percent for nurse practitioner students. Ability to answer questions correctly was most strongly associated with correctness of the answer before searching, user experience with medline features, the evidence-based medicine question type, and the spatial visualization score. The spatial visualization score showed multi-collinearity with student type (medical vs. nurse practitioner). Medical and nurse practitioner students obtained comparable recall and precision, neither of which was associated with correctness of the answer. Conclusions: Medical and nurse practitioner students in this

  17. Parenting Coordination: Applying Clinical Thinking to the Management and Resolution of Post-Divorce Conflict.

    PubMed

    Demby, Steven L

    2016-05-01

    There is a small but significant number of parents who remain stuck in a high level of conflict with each other after the legal conclusion of their divorce. Exposure to chronically high levels of parental conflict is a strong risk factor negatively affecting both children's short- and long-term adjustment. Parenting coordination is a nonadversarial, child-focused dispute-resolution process designed to help divorced parents contain their conflict to protect children from its negative effect. Parenting coordination is a hybrid role combining different skills and conflict-resolution approaches. In high-conflict divorce, each parent's internalization of relationship patterns constructed from past experiences contributes to the intractable nature of the interparent conflict. A case presentation illustrates how this clinical perspective enhances the parenting coordinator's ability to work with parents to manage and contain their parenting conflicts with each other. PMID:26828998

  18. Structure and Measurement of Depression in Youth: Applying Item Response Theory to Clinical Data

    PubMed Central

    Cole, David A.; Cai, Li; Martin, Nina C.; Findling, Robert L; Youngstrom, Eric A.; Garber, Judy; Curry, John F.; Hyde, Janet S.; Essex, Marilyn J.; Compas, Bruce E.; Goodyer, Ian M.; Rohde, Paul; Stark, Kevin D.; Slattery, Marcia J.; Forehand, Rex

    2013-01-01

    Goals of the paper were to use item response theory (IRT) to assess the relation of depressive symptoms to the underlying dimension of depression and to demonstrate how IRT-based measurement strategies can yield more reliable data about depression severity than conventional symptom counts. Participants were 3403 clinic and nonclinic children and adolescents from 12 contributing samples, all of whom received the Kiddie Schedule of Affective Disorders and Schizophrenia for school-aged children. Results revealed that some symptoms reflected higher levels of depression and were more discriminating than others. Results further demonstrated that utilization of IRT-based information about symptom severity and discriminability in the measurement of depression severity can reduce measurement error and increase measurement fidelity. PMID:21534696

  19. The main challenges that remain in applying high-throughput sequencing to clinical diagnostics.

    PubMed

    Loeffelholz, Michael; Fofanov, Yuriy

    2015-01-01

    Over the last 10 years, the quality, price and availability of high-throughput sequencing instruments have improved to the point that this technology may be close to becoming a routine tool in the diagnostic microbiology laboratory. Two groups of challenges, however, have to be resolved in order to move this powerful research technology into routine use in the clinical microbiology laboratory. The computational/bioinformatics challenges include data storage cost and privacy concerns, requiring analysis to be performed without access to cloud storage or expensive computational infrastructure. The logistical challenges include interpretation of complex results and acceptance and understanding of the advantages and limitations of this technology by the medical community. This article focuses on the approaches to address these challenges, such as file formats, algorithms, data collection, reporting and good laboratory practices. PMID:26394651

  20. Clinical efficiency of applying low-intensity laser therapy in treating dyscirculatory encephalopathy

    NASA Astrophysics Data System (ADS)

    Putilina, M. V.; Kozlov, V. I.; Vakhtin, V. I.

    2001-04-01

    An investigation was made of applying laser therapy combined with drug preparations in treating 300 patients affected by dyscirculatory encephalopathy. Neurological and neuropsychological examinations together with electroencephalography, rheoencephalography, computerized tomography, and magnetic resonance imaging were used to assess the patients' states prior to and after the treatment. It was found that the combined application of laser therapy and drug preparations produced a more pronounced therapeutic effect as compared with that produced by the separate application of laser therapy and drug preparations. The results obtained allowed us to conclude that the 0.89 micrometers laser infrared radiation increased patients' susceptibility to drugs. Moreover, the combined laser therapy improved the cerebral bloodflow and activated the metabolic and plastic functions of neurons. This decreased or eliminated late complications provoked by the cerebral blood circulation insufficiency.

  1. A Cardiovascular Pharmacotherapy Elective Course to Enhance Pharmacy Students’ Literature Evaluation Skills and Ability to Apply Clinical Evidence

    PubMed Central

    2012-01-01

    Objectives. To design and implement a cardiovascular pharmacotherapy elective course to enhance pharmacy students’ ability to evaluate medical literature and apply clinical evidence. Design. In weekly class sessions, students were provided an overview of the important literature supporting therapeutic guidelines for the management of major cardiovascular diseases. Students worked in groups to complete outside-of-class assignments involving a patient case and then discussed the case in class. During the semester, each student also independently completed a literature search on an assigned topic, summarized the studies found in table format, and presented 1 of the studies to the class. Assessment. Students’ grades on weekly patient case assignments steadily increased over the semester. Also, the average grade on the final examination was higher than the grade on the midterm take-home examination. On the course evaluation, students rated the course favorably in terms of improvement of confidence in evaluating the primary literature and applying it to practice. Conclusion. Completion of the cardiovascular pharmacotherapy elective increased pharmacy students’ level of confidence in evaluating literature and applying clinical evidence in making patient care decisions. PMID:23049109

  2. Dogs'olfactory diagnostics applied on human species: state of the art and clinical perspectives.

    PubMed

    Palmieri, B; Nardo, B; Lippi, G; Palmieri, L; Vadalà, M; Laurino, C

    2016-01-01

    Dogs'smell ability is about 10000-100000 more developed than humans' one. Dogs smell is usually exploited in forensic medicine, to find missing people and specific substances showing peculiar sensorial features. In clinic, there is the possibility to take advantage of dogs smell, which are conveniently trained, for the screening of cancers and other diseases. The common feature is the presence of molecules in organic samples that may be considered as biomarkers of a specific pathology. In cancer, scientific evidences exist about screening of melanoma, lung, breast, rectum, ovarian, prostate and bladder cancer. Instead, other pathologies manifest the presence of organic volatile compounds in biologic materials, such as spit, faeces and urine that may be studied by dogs smell in order to identify the presence of a specific disease. This review shows the state of the art of actual dogs' olfactory ability based on scientific principles and the advantages and the disadvantages of this method. The authors also reveal some potential pathologies joined by the presence of organic volatile compounds, which may be investigated by dogs smell. PMID:27598027

  3. Biologic therapies in the metastatic colorectal cancer treatment continuum--applying current evidence to clinical practice.

    PubMed

    Peeters, Marc; Price, Timothy

    2012-08-01

    More therapeutic options are now available than ever before for patients with metastatic colorectal cancer (mCRC) and, as such, treatment decisions have become more complex. A multidisciplinary approach is, therefore, required to effectively manage these patients. In the past few years, many trials have reported on the value of combining biological agents, such as those targeting vascular endothelial growth factor A and epidermal growth factor receptors, with chemotherapy. However, despite the plethora of information now available, the optimal treatment strategy for patients with mCRC remains unclear. Indeed, the propensity of investigators to conduct clinical trials utilising a variety of chemotherapy backbones combined with the increased complexity of retrospectively incorporating analyses of genetic mutation status (e.g. KRAS and BRAF) have led to conflicting results for seemingly similar endpoints, particularly overall survival. As a result, guidelines that have been developed, whilst having some similarities, have distinct differences in terms of suggested therapeutic combinations. Therefore, here, we review and distil the currently available data reported from phase III trials of biologic agents in the first-, second- and third-line mCRC settings. PMID:21899955

  4. Health Technology Assessment of pathogen reduction technologies applied to plasma for clinical use

    PubMed Central

    Cicchetti, Americo; Berrino, Alexandra; Casini, Marina; Codella, Paola; Facco, Giuseppina; Fiore, Alessandra; Marano, Giuseppe; Marchetti, Marco; Midolo, Emanuela; Minacori, Roberta; Refolo, Pietro; Romano, Federica; Ruggeri, Matteo; Sacchini, Dario; Spagnolo, Antonio G.; Urbina, Irene; Vaglio, Stefania; Grazzini, Giuliano; Liumbruno, Giancarlo M.

    2016-01-01

    Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration between the Italian National Blood Centre and the Post-Graduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. A large, multidisciplinary team was created and divided into six groups, each of which addressed one or more HTA domains. Plasma treated with amotosalen + UV light, riboflavin + UV light, methylene blue or a solvent/detergent process was compared to fresh-frozen plasma with regards to current use, technical features, effectiveness, safety, economic and organisational impact, and ethical, social and legal implications. The available evidence is not sufficient to state which of the techniques compared is superior in terms of efficacy, safety and cost-effectiveness. Evidence on efficacy is only available for the solvent/detergent method, which proved to be non-inferior to untreated fresh-frozen plasma in the treatment of a wide range of congenital and acquired bleeding disorders. With regards to safety, the solvent/detergent technique apparently has the most favourable risk-benefit profile. Further research is needed to provide a comprehensive overview of the cost-effectiveness profile of the different pathogen-reduction techniques. The wide heterogeneity of results and the lack of comparative evidence are reasons why more comparative studies need to be performed. PMID:27403740

  5. Health Technology Assessment of pathogen reduction technologies applied to plasma for clinical use.

    PubMed

    Cicchetti, Americo; Berrino, Alexandra; Casini, Marina; Codella, Paola; Facco, Giuseppina; Fiore, Alessandra; Marano, Giuseppe; Marchetti, Marco; Midolo, Emanuela; Minacori, Roberta; Refolo, Pietro; Romano, Federica; Ruggeri, Matteo; Sacchini, Dario; Spagnolo, Antonio G; Urbina, Irene; Vaglio, Stefania; Grazzini, Giuliano; Liumbruno, Giancarlo M

    2016-07-01

    Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration between the Italian National Blood Centre and the Post-Graduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. A large, multidisciplinary team was created and divided into six groups, each of which addressed one or more HTA domains.Plasma treated with amotosalen + UV light, riboflavin + UV light, methylene blue or a solvent/detergent process was compared to fresh-frozen plasma with regards to current use, technical features, effectiveness, safety, economic and organisational impact, and ethical, social and legal implications. The available evidence is not sufficient to state which of the techniques compared is superior in terms of efficacy, safety and cost-effectiveness. Evidence on efficacy is only available for the solvent/detergent method, which proved to be non-inferior to untreated fresh-frozen plasma in the treatment of a wide range of congenital and acquired bleeding disorders. With regards to safety, the solvent/detergent technique apparently has the most favourable risk-benefit profile. Further research is needed to provide a comprehensive overview of the cost-effectiveness profile of the different pathogen-reduction techniques. The wide heterogeneity of results and the lack of comparative evidence are reasons why more comparative studies need to be performed. PMID:27403740

  6. Can Clinical Scenario Videos Improve Dental Students' Perceptions of the Basic Sciences and Ability to Apply Content Knowledge?

    PubMed

    Miller, Cynthia Jayne; Metz, Michael James

    2015-12-01

    Dental students often have difficulty understanding the importance of basic science classes, such as physiology, for their future careers. To help alleviate this problem, the aim of this study was to create and evaluate a series of video modules using simulated patients and custom-designed animations that showcase medical emergencies in the dental practice. First-year students in a dental physiology course formatively assessed their knowledge using embedded questions in each of the three videos; 108 to 114 of the total 120 first-year students answered the questions, for a 90-95% response rate. These responses indicated that while the students could initially recognize the cause of the medical emergency, they had difficulty in applying their knowledge of physiology to the scenario. In two of the three videos, students drastically improved their ability to answer high-level clinical questions at the conclusion of the video. Additionally, when compared to the previous year of the course, there was a significant improvement in unit exam scores on clinically related questions (6.2% increase). Surveys were administered to the first-year students who participated in the video modules and fourth-year students who had completed the course prior to implementation of any clinical material. The response rate for the first-year students was 96% (115/120) and for the fourth-year students was 57% (68/120). The first-year students indicated a more positive perception of the physiology course and its importance for success on board examinations and their dental career than the fourth-year students. The students perceived that the most positive aspects of the modules were the clear applications of physiology to real-life dental situations, the interactive nature of the videos, and the improved student comprehension of course concepts. These results suggest that online modules may be used successfully to improve students' perceptions of the basic sciences and enhance their ability to

  7. Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs.

    PubMed

    Bonetti, Debbie; Pitts, Nigel B; Eccles, Martin; Grimshaw, Jeremy; Johnston, Marie; Steen, Nick; Glidewell, Liz; Thomas, Ruth; Maclennan, Graeme; Clarkson, Jan E; Walker, Anne

    2006-10-01

    This study applies psychological theory to the implementation of evidence-based clinical practice. The first objective was to see if variables from psychological frameworks (developed to understand, predict and influence behaviour) could predict an evidence-based clinical behaviour. The second objective was to develop a scientific rationale to design or choose an implementation intervention. Variables from the Theory of Planned Behaviour, Social Cognitive Theory, Self-Regulation Model, Operant Conditioning, Implementation Intentions and the Precaution Adoption Process were measured, with data collection by postal survey. The primary outcome was the number of intra-oral radiographs taken per course of treatment collected from a central fee claims database. Participants were 214 Scottish General Dental Practitioners. At the theory level, the Theory of Planned Behaviour explained 13% variance in the number of radiographs taken, Social Cognitive Theory explained 7%, Operant Conditioning explained 8%, Implementation Intentions explained 11%. Self-Regulation and Stage Theory did not predict significant variance in radiographs taken. Perceived behavioural control, action planning and risk perception explained 16% of the variance in number of radiographs taken. Knowledge did not predict the number of radiographs taken. The results suggest an intervention targeting predictive psychological variables could increase the implementation of this evidence-based practice, while influencing knowledge is unlikely to do so. Measures which predicted number of radiographs taken also predicted intention to take radiographs, and intention accounted for significant variance in behaviour (adjusted R(2)=5%: F(1,166)=10.28, p<.01), suggesting intention may be a possible proxy for behavioural data when testing an intervention prior to a service-level trial. Since psychological frameworks incorporate methodologies to measure and change component variables, taking a theory-based approach

  8. Potential workload in applying clinical practice guidelines for patients with chronic conditions and multimorbidity: a systematic analysis

    PubMed Central

    Buffel du Vaure, Céline; Ravaud, Philippe; Baron, Gabriel; Barnes, Caroline; Gilberg, Serge; Boutron, Isabelle

    2016-01-01

    Objectives To describe the potential workload for patients with multimorbidity when applying existing clinical practice guidelines. Design Systematic analysis of clinical practice guidelines for chronic conditions and simulation modelling approach. Data sources National Guideline Clearinghouse index of US clinical practice guidelines. Study selection We identified the most recent guidelines for adults with 1 of 6 prevalent chronic conditions in primary care (ie hypertension, diabetes, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), osteoarthritis and depression). Data extraction From the guidelines, we extracted all recommended health-related activities (HRAs) such as drug management, self-monitoring, visits to the doctor, laboratory tests and changes of lifestyle for a patient aged 45–64 years with moderate severity of conditions. Simulation modelling approach For each HRA identified, we performed a literature review to determine the potential workload in terms of time spent on this HRA. Then, we used a simulation modelling approach to estimate the potential workload needed to comply with these recommended HRAs for patients with several of these chronic conditions. Results Depending on the concomitant chronic condition, patients with 3 chronic conditions complying with all the guidelines would have to take a minimum of 6 to a maximum of 13 medications per day, visit a health caregiver a minimum of 1.2 to a maximum of 5.9 times per month and spend a mean (SD) of 49.6 (27.3) to 71.0 (34.5) h/month in HRAs. The potential workload increased greatly with increasing number of concomitant conditions, rising to 18 medications per day, 6.6 visits per month and 80.7 (35.8) h/month in HRAs for patients with 6 chronic conditions. PMID:27006342

  9. Analyzing patients' values by applying cluster analysis and LRFM model in a pediatric dental clinic in Taiwan.

    PubMed

    Wu, Hsin-Hung; Lin, Shih-Yen; Liu, Chih-Wei

    2014-01-01

    This study combines cluster analysis and LRFM (length, recency, frequency, and monetary) model in a pediatric dental clinic in Taiwan to analyze patients' values. A two-stage approach by self-organizing maps and K-means method is applied to segment 1,462 patients into twelve clusters. The average values of L, R, and F excluding monetary covered by national health insurance program are computed for each cluster. In addition, customer value matrix is used to analyze customer values of twelve clusters in terms of frequency and monetary. Customer relationship matrix considering length and recency is also applied to classify different types of customers from these twelve clusters. The results show that three clusters can be classified into loyal patients with L, R, and F values greater than the respective average L, R, and F values, while three clusters can be viewed as lost patients without any variable above the average values of L, R, and F. When different types of patients are identified, marketing strategies can be designed to meet different patients' needs. PMID:25045741

  10. Analyzing Patients' Values by Applying Cluster Analysis and LRFM Model in a Pediatric Dental Clinic in Taiwan

    PubMed Central

    Lin, Shih-Yen; Liu, Chih-Wei

    2014-01-01

    This study combines cluster analysis and LRFM (length, recency, frequency, and monetary) model in a pediatric dental clinic in Taiwan to analyze patients' values. A two-stage approach by self-organizing maps and K-means method is applied to segment 1,462 patients into twelve clusters. The average values of L, R, and F excluding monetary covered by national health insurance program are computed for each cluster. In addition, customer value matrix is used to analyze customer values of twelve clusters in terms of frequency and monetary. Customer relationship matrix considering length and recency is also applied to classify different types of customers from these twelve clusters. The results show that three clusters can be classified into loyal patients with L, R, and F values greater than the respective average L, R, and F values, while three clusters can be viewed as lost patients without any variable above the average values of L, R, and F. When different types of patients are identified, marketing strategies can be designed to meet different patients' needs. PMID:25045741

  11. Making good theory practical: five lessons for an Applied Social Identity Approach to challenges of organizational, health, and clinical psychology.

    PubMed

    Haslam, S Alexander

    2014-03-01

    Social identity research was pioneered as a distinctive theoretical approach to the analysis of intergroup relations but over the last two decades it has increasingly been used to shed light on applied issues. One early application of insights from social identity and self-categorization theories was to the organizational domain (with a particular focus on leadership), but more recently there has been a surge of interest in applications to the realm of health and clinical topics. This article charts the development of this Applied Social Identity Approach, and abstracts five core lessons from the research that has taken this forward. (1) Groups and social identities matter because they have a critical role to play in organizational and health outcomes. (2) Self-categorizations matter because it is people's self-understandings in a given context that shape their psychology and behaviour. (3) The power of groups is unlocked by working with social identities not across or against them. (4) Social identities need to be made to matter in deed not just in word. (5) Psychological intervention is always political because it always involves some form of social identity management. Programmes that seek to incorporate these principles are reviewed and important challenges and opportunities for the future are identified. PMID:24627990

  12. Biosynthesis of calcium hydroxylapatite coating on sputtered Ti/TiN nano multilayers and their corrosion behavior in simulated body solution.

    PubMed

    Subramanian, Balasubramanian; Dhandapani, Perumal; Maruthamuthu, Sundaram; Jayachandran, Muthirulandi

    2012-02-01

    Titanium/titanium nitride (Ti/TiN) nanoscale multilayered films were deposited onto 316L stainless steel substrates by reactive magnetron sputtering using a Ti target. Coatings characterized by X-ray diffraction showed that the stack possesses centered cubic structure. The X-ray photoelectron spectroscopy survey spectra on the etched surfaces of the stack film on steel exhibited the characteristic Ti2p, N1s, and O1s peaks at the corresponding binding energies 454.5, 397.0, and 530.6 eV, respectively. Platelet adhesion experiments were carried out to examine the interaction between blood and the materials in vitro. The results indicated that the smoothness and lower isoelectric point contribute to better hemocompatibility of the Ti/TiN nanoscale multilayered coating. The biomediated synthesis of calcium hydroxylapatite (HA) was carried out on coated substrates using calcium-depositing bacteria. The observation of low corrosion current density (I(corr)) for the calcium HA-coated Ti/TiN specimens in simulated body fluid confirmed their highly resistive nature under the testing condition. PMID:20819919

  13. Multicultural Training Applied in Clinical Practice: Reflections from a Euro-American Female Counselor-in-Training Working with Mexican Immigrants

    ERIC Educational Resources Information Center

    Paynter, Clara K.; Estrada, Diane

    2009-01-01

    The clinical experience of a Euro-American female counselor-in-training providing bilingual family therapy services to Mexican immigrants is described. Cultural themes encountered when applying academic discourse to clinical work are raised in the context of case studies in which the student therapist works from a postmodern client-as-expert…

  14. The mPED randomized controlled clinical trial: applying mobile persuasive technologies to increase physical activity in sedentary women protocol

    PubMed Central

    2011-01-01

    Background Despite the significant health benefits of regular physical activity, approximately half of American adults, particularly women and minorities, do not meet the current physical activity recommendations. Mobile phone technologies are readily available, easily accessible and may provide a potentially powerful tool for delivering physical activity interventions. However, we need to understand how to effectively apply these mobile technologies to increase and maintain physical activity in physically inactive women. The purpose of this paper is to describe the study design and protocol of the mPED (mobile phone based physical activity education) randomized controlled clinical trial that examines the efficacy of a 3-month mobile phone and pedometer based physical activity intervention and compares two different 6-month maintenance interventions. Methods A randomized controlled trial (RCT) with three arms; 1) PLUS (3-month mobile phone and pedometer based physical activity intervention and 6-month mobile phone diary maintenance intervention), 2) REGULAR (3-month mobile phone and pedometer based physical activity intervention and 6-month pedometer maintenance intervention), and 3) CONTROL (pedometer only, but no intervention will be conducted). A total of 192 physically inactive women who meet all inclusion criteria and successfully complete a 3-week run-in will be randomized into one of the three groups. The mobile phone serves as a means of delivering the physical activity intervention, setting individualized weekly physical activity goals, and providing self-monitoring (activity diary), immediate feedback and social support. The mobile phone also functions as a tool for communication and real-time data capture. The primary outcome is objectively measured physical activity. Discussion If efficacy of the intervention with a mobile phone is demonstrated, the results of this RCT will be able to provide new insights for current behavioral sciences and m

  15. Applying the RE-AIM Framework to Evaluate the Dissemination and Implementation of Clinical Practice Guidelines for Sexually Transmitted Infections.

    PubMed

    Jeong, Heon-Jae; Jo, Heui-Sug; Oh, Moo-Kyung; Oh, Hyung-Won

    2015-07-01

    Clinical practice guidelines (CPG) are one of the most effective ways to translate evidence of medical improvement into everyday practice. This study evaluated the dissemination and implementation of the Sexually Transmitted Infections-Korean Guidelines (STIKG) by applying the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. A survey questionnaire was administered to clinicians via the internet. Among the 332 respondents, 190 (57.2%) stated that they were aware of STIKG and 107 (33.2%) implemented STIKG in their practice. The odds that a physician was exposed to STIKG (dissemination) were 2.61 times greater among physicians with previous training or education for any CPG than those who did not. Clinicians who indicated that STIKG were easy to understand were 4.88 times more likely to implement STIKG in their practice than those who found them not so easy. When a clinician's workplace had a supporting system for CPG use, the odds of implementation was 3.76 times higher. Perceived level of effectiveness of STIKG did not significantly influence their implementation. The findings of this study suggest that, ultimately, knowing how to engage clinicians in CPG implementation is as important as how to disseminate such guidelines; moreover, easy-to-use guidelines and institutional support are key factors. PMID:26130944

  16. Clinical performance of a low cost near infrared sensor for continuous glucose monitoring applied with subcutaneous microdialysis.

    PubMed

    Ben Mohammadi, Lhoucine; Klotzbuecher, T; Sigloch, S; Welzel, K; Goeddel, M; Pieber, T R; Schaupp, L

    2015-08-01

    In this work we present a low cost, minimally invasive, and chip-based near infrared (NIR) sensor, combined with subcutaneous microdialysis, for continuous glucose monitoring (CGM). The sensor principle is based on difference absorption spectroscopy in the 1st overtone band known to be dominated by glucose-specific absorption features. The device comprises a multi-emitter LED and InGaAs-photodiodes, which are located on a single electronic board (non-disposable part), connected to a personal computer via Bluetooth. The disposable part consists of a chip containing the fluidic connections for microdialysis, two fluidic channels acting as optical transmission cells and total internally reflecting mirrors for in- and out-coupling of the light to the chip and to the detectors. The use of the sensor in conjunction with a subcutaneous microdialysis catheter to separate the glucose from the cells and proteins has been demonstrated to be extremely useful and advantageous for obtaining continuous glucose monitoring data and detecting glycemic levels in real time for a long period. Several in vitro and in vivo experiments were conducted to test the reliability of the device. In vitro measurements showed a linear relationship between glucose concentration and the integrated difference signal with a coefficient of determination of 99 % at the physiological concentration range. Clinical trial on 6 subjects with Type 1 diabetes showed that the NIR-CGM sensor data reflects the blood reference values adequately, if a proper calibration and signal drift compensation is applied. The MARD (mean absolute relative difference) value taken on retrospective data over all subjects is 8.5 % (range 6-11.5 %). PMID:26141039

  17. Applying psychological theories to evidence-based clinical practice: Identifying factors predictive of managing upper respiratory tract infections without antibiotics

    PubMed Central

    Eccles, Martin P; Grimshaw, Jeremy M; Johnston, Marie; Steen, Nick; Pitts, Nigel B; Thomas, Ruth; Glidewell, Elizabeth; Maclennan, Graeme; Bonetti, Debbie; Walker, Anne

    2007-01-01

    Background Psychological models can be used to understand and predict behaviour in a wide range of settings. However, they have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. The aim of this study was to explore the usefulness of a range of psychological theories to predict health professional behaviour relating to management of upper respiratory tract infections (URTIs) without antibiotics. Methods Psychological measures were collected by postal questionnaire survey from a random sample of general practitioners (GPs) in Scotland. The outcome measures were clinical behaviour (using antibiotic prescription rates as a proxy indicator), behavioural simulation (scenario-based decisions to managing URTI with or without antibiotics) and behavioural intention (general intention to managing URTI without antibiotics). Explanatory variables were the constructs within the following theories: Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Stage Model (SM), and knowledge (a non-theoretical construct). For each outcome measure, multiple regression analysis was used to examine the predictive value of each theoretical model individually. Following this 'theory level' analysis, a 'cross theory' analysis was conducted to investigate the combined predictive value of all significant individual constructs across theories. Results All theories were tested, but only significant results are presented. When predicting behaviour, at the theory level, OLT explained 6% of the variance and, in a cross theory analysis, OLT 'evidence of habitual behaviour' also explained 6%. When predicting behavioural simulation, at the theory level, the proportion of variance explained was: TPB, 31%; SCT, 26%; II, 6%; OLT, 24%. GPs who reported having already decided to change their management to try to avoid the

  18. Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients with Hypertension: Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study

    ERIC Educational Resources Information Center

    Karupaiah, Tilakavati; Wong, Kimberly; Chinna, Karuthan; Arasu, Kanimolli; Chee, Winnie Siew Swee

    2015-01-01

    The CORFIS ("Community-Based Cardiovascular Risk Factors Intervention Strategies") program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in…

  19. How to apply case reports in clinical practice using surrogate models via example of the trigeminocardiac reflex.

    PubMed

    Sandu, Nora; Chowdhury, Tumul; Schaller, Bernhard J

    2016-01-01

    Case reports are an increasing source of evidence in clinical medicine. Until a few years ago, such case reports were emerged into systematic reviews and nowadays they are often fitted to the development of clinical (thinking) models. We describe this modern progress of knowledge creation by the example of the trigeminocardiac reflex that was first described in 1999 by a case series and was developed over the cause-and-effect relationship, triangulation to systematic reviews and finally to thinking models. Therefore, this editorial not only underlines the increasing and outstanding importance of (unique) case reports in current science, but also in current clinical decision-making and therefore also that of specific journals like the Journal of Medical Case Reports. PMID:27048202

  20. Now or Later?: An Empirical Investigation of When and Why Students Apply to Clinical Psychology PhD Programs

    ERIC Educational Resources Information Center

    Zimak, Eric H.; Edwards, Katie M.; Johnson, Shannon M.; Suhr, Julie

    2011-01-01

    This study used a national sample of PhD students in clinical psychology (N = 1,034) to explore when students decided to pursue their graduate degree, reasons for their decisions, and associated satisfaction. Results indicated that immediately after completing their undergraduate degree, 57% of current graduate students reported postponing…

  1. Transcranial near-infrared laser therapy applied to promote clinical recovery in acute and chronic neurodegenerative diseases

    PubMed Central

    Lapchak, Paul A

    2012-01-01

    One of the most promising methods to treat neurodegeneration is noninvasive transcranial near-infrared laser therapy (NILT), which appears to promote acute neuroprotection by stimulating mitochondrial function, thereby increasing cellular energy production. NILT may also promote chronic neuronal function restoration via trophic factor-mediated plasticity changes or possibly neurogenesis. Clearly, NILT is a treatment that confers neuroprotection or neurorestoration using pleiotropic mechanisms. The most advanced application of NILT is for acute ischemic stroke based upon extensive preclinical and clinical studies. In laboratory settings, NILT is also being developed to treat traumatic brain injury, Alzheimer’s disease and Parkinson’s disease. There is some intriguing data in the literature that suggests that NILT may be a method to promote clinical improvement in neurodegenerative diseases where there is a common mechanistic component, mitochondrial dysfunction and energy impairment. This article will analyze and review data supporting the continued development of NILT to treat neurodegenerative diseases. PMID:22145842

  2. Routing cancer immunology and immunotherapy from the lab to the clinic 4–5 th March 2014, Center for Applied Medical Research and University Clinic, Pamplona, Spain

    PubMed Central

    2014-01-01

    New approaches to generate effective anticancer responses by either inducing immune responses or inhibiting immunosuppression are under development to improve efficacy in patients. On March 4-5th, 2014, a symposium was held in Pamplona, Spain, to report the new strategies showing preclinical and clinical results regarding translational research efforts on the topic. Participants interacted through oral presentations of 15 speakers and further discussions on topics that included novel therapeutic agents for cancer immunotherapy, viral vectors and interferon-based approaches, experimental tumor imaging and immunostimulatory monoclonal antibodies. Promising agents to target cancer cells and therapeutic approaches that are under translation from bench to patients were presented. PMID:25060862

  3. Clinical evaluation of a new NSAID applied topically (BPAA gel) vs. diclofenac emulgel in elderly osteoarthritic patients.

    PubMed

    Giacovazzo, M

    1992-01-01

    This study reports therapeutic results obtained with a group of elderly subjects suffering from osteoarthritis undergoing therapy with a new topically applied NSAID (BPAA gel). Excellent results, ease of use and absence of side effects are the essential characteristics of the anti-inflammatory drug in this preparation. Results were compared to those obtained in a homogeneous sample treated with diclofenac emulgel. No statistically significant differences were observed in therapeutic effectiveness. PMID:1490436

  4. Applying the wisdom of stepping down inhaled corticosteroids in patients with COPD: a proposed algorithm for clinical practice

    PubMed Central

    Kaplan, Alan G

    2015-01-01

    Current guidelines for the management of chronic obstructive pulmonary disease (COPD) recommend limiting the use of inhaled corticosteroids (ICS) to patients with more severe disease and/or increased exacerbation risk. However, there are discrepancies between guidelines and real-life practice, as ICS are being overprescribed. In light of the increasing concerns about the clinical benefit and long-term risks associated with ICS use, therapy needs to be carefully weighed on a case-by-case basis, including in patients already on ICS. Several studies sought out to determine the effects of withdrawing ICS in patients with COPD. Early studies have deterred clinicians from reducing ICS in patients with COPD as they reported that an abrupt withdrawal of ICS precipitates exacerbations, and results in a deterioration in lung function and symptoms. However, these studies were fraught with numerous methodological limitations. Recently, two randomized controlled trials and a real-life prospective study revealed that ICS can be safely withdrawn in certain patients. Of these, the WISDOM (Withdrawal of Inhaled Steroids During Optimized Bronchodilator Management) trial was the largest and first to examine stepwise withdrawal of ICS in patients with COPD receiving maintenance therapy of long-acting bronchodilators (ie, tiotropium and salmeterol). Even with therapy being in line with the current guidelines, the findings of the WISDOM trial indicate that not all patients benefit from including ICS in their treatment regimen. Indeed, only certain COPD phenotypes seem to benefit from ICS therapy, and validated markers that predict ICS response are urgently warranted in clinical practice. Furthermore, we are now better equipped with a larger armamentarium of novel and more effective long-acting β2-agonist/long-acting muscarinic antagonist combinations that can be considered by clinicians to optimize bronchodilation and allow for safer ICS withdrawal. In addition to providing a review of

  5. [Subtypes of cocaine addicts with and without associated problematic alcohol use: towards a neuropsychology of personality applied to clinical practice].

    PubMed

    Pedrero Pérez, Eduardo J; Ruiz Sánchez de León, José M

    2012-01-01

    It is important to know which personality factors are associated with addiction so to distinguish addicts that require specialized treatment from those who do not, and to identify those addicts who achieve abstinence from those who continue their substance use despite the negative consequences. Cloninger's model includes biological and psychosocial variables that can be characterized in neuropsychological terms. Two samples were analyzed: individuals who had begun cocaine addiction treatment (n=183) and a non-clinical population sample (n = 183), matched for sex, age and educational level. Alcohol abuse/dependence was monitored as an independent variable. Significant differences and large effect size were found between addicts and non-clinical population in Novelty Seeking and Self-Directedness, and to a lesser extent, in Harm Avoidance. These differences increase when problematic use of alcohol is added. According to the profile of traits, clusters of addicts were established and differences were obtained in variables such as functional/dysfunctional impulsivity, dysexecutive symptoms and perceived stress. Six clusters were identified, some of minor severity, the most severely problematic clusters being characterized by higher levels of dysfunctional impulsivity, more dysexecutive symptoms and higher levels of perceived stress. Self-Directedness seems to reflect the deficit of prefrontal systems in the regulation of behavior, as well as in emotion and impulse control. It is proposed that evaluation of the personality is more useful than the mere assessment of symptoms for classifying addicts, determining their needs and designing a therapeutic itinerary. PMID:23241716

  6. Stereoscopic three-dimensional visualization applied to multimodal brain images: clinical applications and a functional connectivity atlas

    PubMed Central

    Rojas, Gonzalo M.; Gálvez, Marcelo; Vega Potler, Natan; Craddock, R. Cameron; Margulies, Daniel S.; Castellanos, F. Xavier; Milham, Michael P.

    2014-01-01

    Effective visualization is central to the exploration and comprehension of brain imaging data. While MRI data are acquired in three-dimensional space, the methods for visualizing such data have rarely taken advantage of three-dimensional stereoscopic technologies. We present here results of stereoscopic visualization of clinical data, as well as an atlas of whole-brain functional connectivity. In comparison with traditional 3D rendering techniques, we demonstrate the utility of stereoscopic visualizations to provide an intuitive description of the exact location and the relative sizes of various brain landmarks, structures and lesions. In the case of resting state fMRI, stereoscopic 3D visualization facilitated comprehension of the anatomical position of complex large-scale functional connectivity patterns. Overall, stereoscopic visualization improves the intuitive visual comprehension of image contents, and brings increased dimensionality to visualization of traditional MRI data, as well as patterns of functional connectivity. PMID:25414626

  7. No More Fighting and Biting During Mouth Care: Applying the Theoretical Constructs of Threat Perception to Clinical Practice

    PubMed Central

    Jablonski, Rita A.; Therrien, Barbara; Kolanowski, Ann

    2012-01-01

    The purpose of this article is to describe how the neurobiological principles of threat perception and fear response can support clinical approaches to prevent and reduce care-resistant behaviors during mouth care. Nursing home residents who exhibit care-resistant behavior are at risk for poor oral health because daily oral hygiene may not be consistently provided. Poor oral health predisposes these older people to systemic problems such as pneumonia, cerebral vascular accidents, and hyperglycemia. Care-resistant behavior is a fear-evoked response to nurses’ unintentionally threatening behavior during mouth care. Nurses can safely and effectively provide mouth care to persons with dementia who resist care by using personalized combinations of 15 threat reduction strategies. PMID:22216691

  8. Applying PET to Broaden the Diagnostic Utility of the Clinically Validated CA19.9 Serum Biomarker for Oncology

    PubMed Central

    Viola-Villegas, Nerissa Therese; Rice, Samuel L.; Carlin, Sean; Wu, Xiaohong; Evans, Michael J.; Sevak, Kuntal K.; Drobjnak, Marija; Ragupathi, Govind; Sawada, Ritsuko; Scholz, Wolfgang W.; Livingston, Philip O.; Lewis, Jason S.

    2014-01-01

    Despite their considerable advantages, many circulating biomarkers have well-documented limitations. One prominent shortcoming in oncology is a high frequency of false-positive indications for malignant disease in upfront diagnosis. Because one common cause of false positivism is biomarker production from benign disorders in unrelated host tissues, we hypothesized that probing the sites of biomarker secretion with an imaging tool could be a broadly useful strategy to deconvolute the meaning of foreboding but inconclusive circulating biomarker levels. Methods In preparation to address this hypothesis clinically, we developed 89Zr-5B1, a fully human, antibody-based radiotracer targeting tumor-associated CA19.9 in the preclinical setting. Results 89Zr-5B1 localized to multiple tumor models representing diseases with undetectable and supraphysiologic serum CA19.9 levels. Among these, 89Zr-5B1 detected orthotopic models of pancreatic ductal adenocarcinoma, an elusive cancer for which the serum assay is measured in humans but with limited specificity in part because of the frequency of CA19.9 secretion from benign hepatic pathologies. Conclusion In this report, a general strategy to supplement some of the shortcomings of otherwise highly useful circulating biomarkers with immunoPET is described. To expedite the clinical validation of this model, a human monoclonal antibody to CA19.9 (a highly visible but partially flawed serum biomarker for several cancers) was radiolabeled and evaluated, and the compelling preclinical evidence suggests that the radiotracer may enhance the fidelity of diagnosis and staging of pancreatic ductal adenocarcinoma, a notoriously occult cancer. PMID:24029655

  9. The secret of the care of the patient is in knowing and applying the evidence about effective clinical communication.

    PubMed

    Frankel, R M; Sherman, H B

    2015-11-01

    American physicians and dentists conduct approximately 140 000-160 000 patient interviews in a practice lifetime, making the interview the most frequently performed medical procedure. Over the past 75 years, a steadily growing stream of scientific research has confirmed the fact that patient-clinician communication affects the course, direction, and both biomedical and functional outcomes of care. The field of clinical communication research has matured from anecdotes and aphorisms about 'bedside manner' to sophisticated randomized control trials and evidence-based outcomes that have been translated into reliable practice guidelines. Several key skills or habits of practice have been identified and studied in terms of their efficacy and effectiveness. These include the importance of agenda-setting, eliciting patients' perspectives about the nature of their ailments, communicating caring and concern, and testing for patient comprehension and agreement with proposed treatments. In addition to being effective, interpersonal communication can be deeply satisfying as well as offering a lower probability of law suits in the event of an adverse outcome. PMID:24725164

  10. Ball lens hollow fiber Raman probe and Fourier transform infrared applied for studying non-clinic samples colorectal tumor models

    NASA Astrophysics Data System (ADS)

    Andriana, Bibin B.; Miyoshi, N.; Limantara, L.; Soeratman, C. Linda R.; Ishigaki, M.; Maeda, Y.; Taketani, A.; Sato, Hidetoshi

    2013-02-01

    Ball-lens hollow fiber Raman Probe (BHRP) and FTIR spectroscopy were main tools in this study. Thus, both of equipments detected the alteration of antisymmetric and symmetric P=O stretching vibration within our mice colorectal tumor models. Some differences of spectra due to randomly the edge of each BHRP and FTIR attached the surface of tumor during measurements. Meanwhile, the application of FTIR potentially differentiates the grade levels of non-clinic samples colorectal tumor models at four different grades (normal, grade 1, grade 2 and grade 3). Detailed investigations were assignable to wave numbers that publicized to represent biochemical alteration. The whole of investigated spectra in the fingerprint region revealed some different peaks and shoulders, most of which were assignable to wave numbers that exposed to represent biochemical alteration within the tissue. Differences in peak heights and peak ratio indicated differences in biochemical composition of cancer from different grade level. However, all collected colorectal tumor model at different peak was distinguishable, where antisymmetric and symmetric P=O stretching vibration was imaged and mapped clearly by both equipments. Therefore, BHRP were comfortable for in vivo studies. Meanwhile FTIR spectral analysis in combination with calibration curve might be used to distinguish cancer grade within colorectal tumor model tissue for ex vivo study.

  11. Virtual reality, augmented reality, and robotics applied to digestive operative procedures: from in vivo animal preclinical studies to clinical use

    NASA Astrophysics Data System (ADS)

    Soler, Luc; Marescaux, Jacques

    2006-04-01

    Technological innovations of the 20 th century provided medicine and surgery with new tools, among which virtual reality and robotics belong to the most revolutionary ones. Our work aims at setting up new techniques for detection, 3D delineation and 4D time follow-up of small abdominal lesions from standard mecial images (CT scsan, MRI). It also aims at developing innovative systems making tumor resection or treatment easier with the use of augmented reality and robotized systems, increasing gesture precision. It also permits a realtime great distance connection between practitioners so they can share a same 3D reconstructed patient and interact on a same patient, virtually before the intervention and for real during the surgical procedure thanks to a telesurgical robot. In preclinical studies, our first results obtained from a micro-CT scanner show that these technologies provide an efficient and precise 3D modeling of anatomical and pathological structures of rats and mice. In clinical studies, our first results show the possibility to improve the therapeutic choice thanks to a better detection and and representation of the patient before performing the surgical gesture. They also show the efficiency of augmented reality that provides virtual transparency of the patient in real time during the operative procedure. In the near future, through the exploitation of these systems, surgeons will program and check on the virtual patient clone an optimal procedure without errors, which will be replayed on the real patient by the robot under surgeon control. This medical dream is today about to become reality.

  12. Applying clinically proven human techniques for contraception and fertility to endangered species and zoo animals: a review.

    PubMed

    Silber, Sherman J; Barbey, Natalie; Lenahan, Kathy; Silber, David Z

    2013-12-01

    Reversible contraception that does not alter natural behavior is a critical need for managing zoo populations. In addition to reversible contraception, other fertility techniques perfected in humans may be useful, such as in vitro fertilization (IVF) or oocyte and embryo banking for endangered species like amphibians and Mexican wolves (Canis lupus baileyi). Furthermore, the genetics of human fertility can give a better understanding of fertility in more exotic species. Collaborations were established to apply human fertility techniques to the captive population. Reversible vasectomy might be one solution for reversible contraception that does not alter behavior. Reversible approaches to vasectomy, avoiding secondary epididymal disruption, were attempted in South American bush dogs (Speothos venaticus), chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla), Przewalski's horse (Equus przewalski poliakov), and Sika deer (Cervus nippon) in a variety of zoos around the world. These techniques were first perfected in > 4,000 humans before attempting them in zoo animals. In vitro fertilization with gestational surrogacy was used to attempt to break the vicious cycle of hand rearing of purebred orangutans, and egg and ovary vitrification in humans have led to successful gamete banking for Mexican wolves and disappearing amphibians. The study of the human Y chromosome has even explained a mechanism of extinction related to global climate change. The best results with vasectomy reversal (normal sperm counts, pregnancy, and live offspring) were obtained when the original vasectomy was performed "open-ended," so as to avoid pressure-induced epididymal disruption. The attempt at gestational surrogacy for orangutans failed because of severe male infertility and the lack of success with human ovarian hyperstimulation protocols. Vitrification of oocytes is already being employed for the Amphibian Ark Project and for Mexican wolves. Vasectomy can be a reversible contraception

  13. Designing evidence-based medicine training to optimize the transfer of skills from the classroom to clinical practice: applying the four component instructional design model.

    PubMed

    Maggio, Lauren A; Cate, Olle Ten; Irby, David M; O'Brien, Bridget C

    2015-11-01

    Evidence-based medicine (EBM) skills, although taught in medical schools around the world, are not optimally practiced in clinical environments because of multiple barriers, including learners' difficulty transferring EBM skills learned in the classroom to clinical practice. This lack of skill transfer may be partially due to the design of EBM training. To facilitate the transfer of EBM skills from the classroom to clinical practice, the authors explore one instructional approach, called the Four Component Instructional Design (4C/ID) model, to guide the design of EBM training. On the basis of current cognitive psychology, including cognitive load theory, the premise of the 4C/ID model is that complex skills training, such as EBM training, should include four components: learning tasks, supportive information, procedural information, and part-task practice. The combination of these four components can inform the creation of complex skills training that is designed to avoid overloading learners' cognitive abilities; to facilitate the integration of the knowledge, skills, and attitudes needed to execute a complex task; and to increase the transfer of knowledge to new situations. The authors begin by introducing the 4C/ID model and describing the benefits of its four components to guide the design of EBM training. They include illustrative examples of educational practices that are consistent with each component and that can be applied to teaching EBM. They conclude by suggesting that medical educators consider adopting the 4C/ID model to design, modify, and/or implement EBM training in classroom and clinical settings. PMID:25993279

  14. Stopping a clinical trial early: frequentist and Bayesian approaches applied to a CALGB trial in non-small-cell lung cancer.

    PubMed

    George, S L; Li, C; Berry, D A; Green, M R

    In May 1984, the Cancer and Leukemia Group B (CALGB) opened a phase III clinical trial for patients with stage III non-small-cell lung cancer (NSCLC). The experimental design entailed randomization of 240 patients equally to one of two treatments: radiotherapy alone or chemotherapy followed by radiotherapy. The original design was a fixed sample size design with the intent to analyse the results after 190 deaths. Shortly after the trial began, it was decided to apply group sequential concepts by using a truncated O'Brien-Fleming stopping rule, implemented via a Lan-DeMets alpha-spending function. A study monitoring committee was established to review the analyses as they were produced. The study was stopped at the fifth interim analysis in May 1987 after 155 eligible patients had been entered. This paper reviews the statistical and other considerations leading to this decision and presents later follow-up information on these patients. Some Bayesian alternatives to the standard frequentist approaches are also explored and it is demonstrated how these alternatives provide a natural way to address many of the issues raised in monitoring clinical trials. PMID:7973212

  15. Long-term clinical evaluation of fracture and pulp injury following glass-ionomer cement or composite resin applied as a base filling in teeth restored with amalgam.

    PubMed

    De C Luz, M A; Ciaramicoli-Rodrigues, M T; Garone Netto, N; De Lima, A C

    2001-07-01

    The aim of this research was to analyse the long-term clinical behaviour of two dental materials applied as filling under silver amalgam restorations: glass-ionomer cement (GIC) and composite resin with adhesive system (CR). In this study, 117 posterior teeth (29 premolars and 88 molars) were selected with carious lesions which resulted in great loss of dentin and cusps with unsupported enamel. After caries removal, cavities were prepared and totally filled with GIC or with CR. In a following visit, new cavities were prepared, leaving the employed filling material as a base and support for the enamel, which were then restored with silver amalgam. Restorations were evaluated periodically after 6 months and up to 5 years. Both fracture and pulpal involvement rates were low. Although differences could be observed in the behaviour of the materials, statistical survival estimation showed that the performances of GIC and CR as filling material were similar. There was a significant association both between kind of tooth (molar or premolar) and long-term survival of the restorations; and between degree of unsupported enamel and the same long-term survival. Our results confirmed that the technique in which GIC or CR are used as filling under silver amalgam restorations is clinically acceptable. PMID:11422695

  16. Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients With Hypertension: Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study.

    PubMed

    Karupaiah, Tilakavati; Wong, Kimberly; Chinna, Karuthan; Arasu, Kanimolli; Chee, Winnie Siew Swee

    2015-06-01

    The CORFIS (Community-Based Cardiovascular Risk Factors Intervention Strategies) program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in CORFIS patients with hypertension. Based on submitted diet and exercise records (n = 209), adherence to sodium reduction, regular exercise, and increasing fruit and vegetable intake behaviors were quantified against weight, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) changes. Patients were categorized at 6 months into nonadherent/N-A (Precontemplation, Contemplation, and Preparation), newly adherent/NA (Action) and totally adherent/TA (Maintenance) groups. Self-reported adherence records did not meet recommended targets for healthful behaviors, but clinical benefits were achieved by adherent groups as indicated by effect size (Cohen's d) comparisons. SBP reduction was associated with adherence to sodium reduction in NA (d = 0.60, p < .001) and TA (d = 0.45, p < .001) compared to N-A (d = 0.13, p > .05). Marginally increasing fruit and vegetable consumption (Δ = 0.41 servings) resulted in sizeable reductions in weight for NA (d = 0.81, p < .001) > TA (d = 0.54, p < .001) > N-A (d = 0.21, p > .05) and in WC for NA (d = 0.68, p < .00) > TA (d = 0.53, p < .001) > N-A (d = 0.52, p > .05). Exercise behavior was least successful as pedometer counting was below 10,000 steps but sizeable weight and WC reductions were largest for NA (d = 0.71 and 0.79, respectively) > TA (d = 0.60 and 0.53, respectively) > N-A (d = 0.33 and 0.35, respectively). Patients reporting a shift to positive stages of change behaviors enjoyed clinically beneficial reductions in SBP, DBP, weight, and WC. PMID:25512075

  17. Medical students’ satisfaction with the Applied Basic Clinical Seminar with Scenarios for Students, a novel simulation-based learning method in Greece

    PubMed Central

    2016-01-01

    Purpose: The integration of simulation-based learning (SBL) methods holds promise for improving the medical education system in Greece. The Applied Basic Clinical Seminar with Scenarios for Students (ABCS3) is a novel two-day SBL course that was designed by the Scientific Society of Hellenic Medical Students. The ABCS3 targeted undergraduate medical students and consisted of three core components: the case-based lectures, the ABCDE hands-on station, and the simulation-based clinical scenarios. The purpose of this study was to evaluate the general educational environment of the course, as well as the skills and knowledge acquired by the participants. Methods: Two sets of questions were distributed to the participants: the Dundee Ready Educational Environment Measure (DREEM) questionnaire and an internally designed feedback questionnaire (InEv). A multiple-choice examination was also distributed prior to the course and following its completion. A total of 176 participants answered the DREEM questionnaire, 56 the InEv, and 60 the MCQs. Results: The overall DREEM score was 144.61 (±28.05) out of 200. Delegates who participated in both the case-based lectures and the interactive scenarios core components scored higher than those who only completed the case-based lecture session (P=0.038). The mean overall feedback score was 4.12 (±0.56) out of 5. Students scored significantly higher on the post-test than on the pre-test (P<0.001). Conclusion: The ABCS3 was found to be an effective SBL program, as medical students reported positive opinions about their experiences and exhibited improvements in their clinical knowledge and skills. PMID:27012313

  18. The Effect of Information About Gynecological Examination on the Anxiety Level of Women Applying to Gynecology Clinics: A Prospective, Randomized, Controlled Study

    PubMed Central

    Ulker, Kahraman; Kivrak, Yuksel

    2016-01-01

    Background: Crowded hospital outpatient clinics and endless waiting lines that make patients feel overlooked tend to exaggerate patients’ anxiety levels. In addition, fear of pain, shyness, religious and traditional thoughts, women’s sexual role in society, and previous information and experience also contribute to people’s anxiety levels with regard to gynecologic examination. Objectives: We aimed to analyze the effect of specific information about gynecologic examination on anxiety levels of women applying to gynecology clinics. Materials and Methods: In this randomized prospective study, the women applying for a gynecological examination were randomly allocated into control, intervention 1, and intervention 2 groups. Power analysis indicated that in order to achieve a one-point decrease from the previous anxiety score of 43.85 ± 5.41 at one side alpha 0.05 with a power of 80%, at least 79 women were needed in each group. Four medical school students interviewed 75 women (25 in control, 25 in intervention 1, and 25 in intervention 2). The data were collected using the demographic, social, and economic data form, and the Turkish version of the state-trait anxiety inventory (STAI). The women in the intervention 1 and 2 groups were instructed to read a paper that contained brief information about the gynecological examination procedure and the profits obtained from forests, respectively. All participants, including the women in the control group, filled the STAI by themselves. The three groups were compared appropriately. Results: The demographics pertaining to age, gravidity and parity, miscarriage, induced abortion, ectopic pregnancy, offspring number, place of residence, working status, education level and previous experience of gynecological examination did not differ among the groups (P > 0.05). According to the STAI scores, all groups had mild state (control: 40.20 ± 10.53, intervention 1: 42.00 ± 11.98, and intervention 2: 39.53 ± 10.32) and severe

  19. A clinical education program for speech-language pathologists applying reflective practice, evidence-based practice and case-based learning.

    PubMed

    Meilijson, Sara; Katzenberger, Irit

    2014-01-01

    This paper presents a comprehensive clinical education program for speech-language pathology students while considering the learning process and gradual acquisition of knowledge and skills for becoming a practicing speech-language pathologist. It describes the clinical speech and language education program for speech-language pathology students at Hadassah Academic College Jerusalem (HAC) based on three facets of learning: reflective practice, evidence-based practice and case-based learning. Also described are the choice of the model of learning and its implementation. The clinical education program presented reflects the professional development of the faculty at HAC as well as recent trends in clinical education methods. PMID:25790922

  20. Is the Information about a Test Important? Applying the Methods of Evidence-Based Medicine to the Clinical Examination of Swallowing

    ERIC Educational Resources Information Center

    Rosenbek, John C.; McCullough, Gary H.; Wertz, Robert T.

    2004-01-01

    A hotly debated topic in oropharyngeal dysphagia is the Clinical Swallowing Examination's (CSE) importance in clinical practice. That debate can profit from the application of evidence-based medicine's (EBM) principles and procedures. These can guide both appropriate data collection and interpretation as will be demonstrated in the present report.…

  1. An exploratory study on the efficacy of rat dedifferentiated fat cells (rDFATs) with a poly lactic-co-glycolic acid/hydroxylapatite (PLGA/HA) composite for bone formation in a rat calvarial defect model.

    PubMed

    Shirakata, Yoshinori; Nakamura, Toshiaki; Shinohara, Yukiya; Taniyama, Katsuyoshi; Sakoda, Kenji; Yoshimoto, Takehiko; Noguchi, Kazuyuki

    2014-03-01

    In the last two decades, tissue-engineering approaches using scaffolds, growth factors, and cells, or their combination, have been developed for the regeneration of periodontal tissue and bone. The aim of this study was to examine the effects of rat dedifferentiated fat cells (rDFATs) with a poly lactic-co-glycolic acid/hydroxylapatite (PLGA/HA) composite on bone formation in rat calvarial defects. Twenty animals surgically received two calvarial defects (diameter, 5 mm) bilaterally in each parietal bone. The defects were treated by one of the following procedures: PLGA/HA+osteo-differentiated rDFATs implantation (PLGA/HA+rDFATs (OD)); PLGA/HA+rDFATs implantation (PLGA/HA+rDFATs); PLGA/HA implantation (PLGA/HA); no implantation as a control. The animals were euthanized at 8 weeks after the surgery for histological evaluation. The PLGA/HA composite was remarkably resorbed and the amounts of residual PLGA/HA were very slight at 8 weeks after the surgery. The PLGA/HA-implanted groups (PLGA/HA+rDFATs (OD), PLGA/HA+rDFATs and PLGA/HA) showed recovery of the original volume and contour of the defects. The newly formed bone area was significantly larger in the PLGA/HA group (42.10 ± 9.16 %) compared with the PLGA/HA+rDFATs (21.35 ± 13.49 %) and control (22.17 ± 13.08 %) groups (P < 0.05). The percentage of defect closure (DC) by new bone in the PLGA/HA+rDFATs (OD) group (83.16 ± 13.87 %) was significantly greater than that in the control group (40.61 ± 29.62 %) (P < 0.05). Furthermore, the PLGA/HA+rDFATs (OD) group showed the highest level of DC among all the groups. The present results suggest that the PLGA/HA composite is a promising scaffold and that PLGA/HA+DFATs (OD) may be effective for bone formation. PMID:24363067

  2. Lost in Translation: Using Video Annotation Software to Examine How a Clinical Supervisor Interprets and Applies a State-Mandated Teacher Assessment Instrument

    ERIC Educational Resources Information Center

    Miller, Matthew James; Carney, Joanne

    2009-01-01

    This case study examines the reasoning of a clinical supervisor as she assesses preservice teacher candidates with a state-mandated performance assessment instrument. The supervisor's evaluations were recorded using video annotation software, which allowed her to record her observations in real-time. The study reveals some of the inherent…

  3. Comparison of Clinical Success of Applying a Kind of Fissure Sealant on the Lower Permanent Molar Teeth in Dry and Wet Conditions

    PubMed Central

    Eskandarian, Tahereh; Baghi, Saeid; Alipoor, Abbas

    2015-01-01

    Statement of the Problem Fissure sealant therapy is among the most effective methods of preventing dental caries. However, it is lengthy and isolation of the teeth is difficult in this procedure especially in young children. Using new hydrophilic fissure sealant may reduce such problems. Purpose This study aimed to evaluate the clinical success of a hydrophilic fissure sealant on the lower permanent molar teeth in dry and wet conditions. Materials and Method This clinical trial assessed 31 patients (mean age 8.13±1.77 years) who needed fissure sealant therapy on their first or second mandibular permanent molar. Having performed dental prophylaxis, the teeth were etched and rinsed. Then one of the two was randomly selected and sealed with smartseal & loc in isolated and dry conditions; while, the other was wetted on the etched enamel by using a saliva-contaminated micro brush, and was then sealed with the same fissure as the first tooth. Six and 12 months later, two independent observers examined the clinical success of sealant through checking the marginal integrity, marginal discoloration, and anatomical form. Data were analyzed by using SPSS software, version 16. The bivariate Chi-square and Exact Fisher tests were used to compare the clinical success of the two treatment methods. Results There was a high interpersonal reliability between the two examiners (K= 0.713). After 12 months, 90.3% clinical success was observed in dry conditions and 83.9% in wet conditions for smartseal & loc; however, the difference was not statistically significant (p= 0.0707). Conclusion According to the results of this study, it seems that using new hydrophilic fissure sealant can reduce technical sensitivities and consequently decreases the apprehensions on saliva contamination of etched enamel during treatment procedures. PMID:26331144

  4. A Randomized Clinical Trial Comparison between Pivotal Response Treatment (PRT) and Structured Applied Behavior Analysis (ABA) Intervention for Children with Autism

    ERIC Educational Resources Information Center

    Mohammadzaheri, Fereshteh; Koegel, Lynn Kern; Rezaee, Mohammad; Rafiee, Seyed Majid

    2014-01-01

    Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, can positively influence the effectiveness of interventions for children with autism spectrum disorder (ASD). The purpose of this study was to compare two applied behavior analysis (ABA) intervention procedures, a…

  5. Applied breath analysis: an overview of the challenges and opportunities in developing and testing sensor technology for human health monitoring in aerospace and clinical applications

    PubMed Central

    Hunter, Gary W; Dweik, Raed A

    2010-01-01

    The aerospace industry requires the development of a range of chemical sensor technologies for such applications as leak detection, emission monitoring, fuel leak detection, environmental monitoring, and fire detection. A family of chemical sensors are being developed based on micromachining and microfabrication technology to fabricate microsensors with minimal size, weight, and power consumption, and the use of nanomaterials and structures to develop sensors with improved stability combined with higher sensitivity. However, individual sensors are limited in the amount of information that they can provide in environments that contain multiple chemical species. Thus, sensor arrays are being developed to address detection needs in such multi-species environments. These technologies and technical approaches have direct relevance to breath monitoring for clinical applications. This paper gives an overview of developing cutting-edge sensor technology and possible barriers to new technology implementation. This includes lessons learned from previous microsensor development, recent work in development of a breath monitoring system, and future directions in the implementation of cutting edge sensor technology. Clinical applications and the potential impact to the biomedical field of miniaturized smart gas sensor technology are discussed. PMID:20622933

  6. A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Structured Applied Behavior Analysis (ABA) Intervention for Children with Autism

    PubMed Central

    Mohammadzaheri, Fereshteh; Koegel, Lynn Kern; Rezaee, Mohammad; Rafiee, Seyed Majid

    2014-01-01

    Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, can positively influence the effectiveness of interventions for children with autism spectrum disorder (ASD). The purpose of this study was to compare two ABA intervention procedures, a naturalistic approach, Pivotal Response Treatment (PRT) with a structured ABA approach in a school setting. A Randomized Clinical Trial design using two groups of children, matched according to age, sex and mean length of utterance was used to compare the interventions. The data showed that the PRT approach was significantly more effective in improving targeted and untargeted areas after three months of intervention. The results are discussed in terms of variables that produce more rapid improvements in communication for children with ASD. PMID:24840596

  7. A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Adult-Driven Applied Behavior Analysis (ABA) Intervention on Disruptive Behaviors in Public School Children with Autism.

    PubMed

    Mohammadzaheri, Fereshteh; Koegel, Lynn Kern; Rezaei, Mohammad; Bakhshi, Enayatolah

    2015-09-01

    Children with autism often demonstrate disruptive behaviors during demanding teaching tasks. Language intervention can be particularly difficult as it involves social and communicative areas, which are challenging for this population. The purpose of this study was to compare two intervention conditions, a naturalistic approach, Pivotal Response Treatment (PRT) with an adult-directed ABA approach on disruptive behavior during language intervention in the public schools. A randomized clinical trial design was used with two groups of children, matched according to age, sex and mean length of utterance. The data showed that the children demonstrated significantly lower levels of disruptive behavior during the PRT condition. The results are discussed with respect to antecedent manipulations that may be helpful in reducing disruptive behavior. PMID:25953148

  8. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice

    PubMed Central

    2011-01-01

    Background Psychological models predict behaviour in a wide range of settings. The aim of this study was to explore the usefulness of a range of psychological models to predict the health professional behaviour 'referral for lumbar spine x-ray in patients presenting with low back pain' by UK primary care physicians. Methods Psychological measures were collected by postal questionnaire survey from a random sample of primary care physicians in Scotland and north England. The outcome measures were clinical behaviour (referral rates for lumbar spine x-rays), behavioural simulation (lumbar spine x-ray referral decisions based upon scenarios), and behavioural intention (general intention to refer for lumbar spine x-rays in patients with low back pain). Explanatory variables were the constructs within the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Weinstein's Stage Model termed the Precaution Adoption Process (PAP), and knowledge. For each of the outcome measures, a generalised linear model was used to examine the predictive value of each theory individually. Linear regression was used for the intention and simulation outcomes, and negative binomial regression was used for the behaviour outcome. Following this 'theory level' analysis, a 'cross-theoretical construct' analysis was conducted to investigate the combined predictive value of all individual constructs across theories. Results Constructs from TPB, SCT, CS-SRM, and OLT predicted behaviour; however, the theoretical models did not fit the data well. When predicting behavioural simulation, the proportion of variance explained by individual theories was TPB 11.6%, SCT 12.1%, OLT 8.1%, and II 1.5% of the variance, and in the cross-theory analysis constructs from TPB, CS-SRM and II explained 16.5% of the variance in simulated behaviours. When predicting intention, the proportion of variance

  9. Applied Stratigraphy

    NASA Astrophysics Data System (ADS)

    Lucas, Spencer G.

    Stratigraphy is a cornerstone of the Earth sciences. The study of layered rocks, especially their age determination and correlation, which are integral parts of stratigraphy, are key to fields as diverse as geoarchaeology and tectonics. In the Anglophile history of geology, in the early 1800s, the untutored English surveyor William Smith was the first practical stratigrapher, constructing a geological map of England based on his own applied stratigraphy. Smith has, thus, been seen as the first “industrial stratigrapher,” and practical applications of stratigraphy have since been essential to most of the extractive industries from mining to petroleum. Indeed, gasoline is in your automobile because of a tremendous use of applied stratigraphy in oil exploration, especially during the latter half of the twentieth century. Applied stratigraphy, thus, is a subject of broad interest to Earth scientists.

  10. Tolerance to Dose Escalation in Minibeam Radiation Therapy Applied to Normal Rat Brain: Long-Term Clinical, Radiological and Histopathological Analysis.

    PubMed

    Prezado, Yolanda; Deman, Pierre; Varlet, Pascale; Jouvion, Gregory; Gil, Silvia; Le Clec'H, Céline; Bernard, Hélène; Le Duc, Géraldine; Sarun, Sukhena

    2015-09-01

    The major limitation to reaching a curative radiation dose in radioresistant tumors such as malignant gliomas is the high sensitivity to radiation and subsequent damage of the surrounding normal tissues. Novel dose delivery methods such as minibeam radiation therapy (MBRT) may help to overcome this limitation. MBRT utilizes a combination of spatial fractionation of the dose and submillimetric (600 μm) field sizes with an array ("comb") of parallel thin beams ("teeth"). The dose profiles in MBRT consist of peaks and valleys. In contrast, the seamless irradiations of the several squared centimeter field sizes employed in standard radiotherapy result in homogeneous dose distributions (and consequently, flat dose profiles). The innovative dose delivery methods employed in MBRT, unlike standard radiation therapy, have demonstrated remarkable normal tissue sparing. In this pilot work, we investigated the tolerance of the rat brain after whole-brain MBRT irradiation. A dose escalation was used to study the tissue response as a function of dose, so that a threshold could be established: doses as high as 100 Gy in one fraction were still well tolerated by the rat brain. This finding suggests that MBRT may be used to deliver higher and potentially curative radiation doses in clinical practice. PMID:26284420

  11. Acupoint-specific, frequency-dependent, and improved insulin sensitivity hypoglycemic effect of electroacupuncture applied to drug-combined therapy studied by a randomized control clinical trial.

    PubMed

    Lin, Rong-Tsung; Tzeng, Chung-Yuh; Lee, Yu-Chen; Chen, Ying-I; Hsu, Tai-Hao; Lin, Jaung-Geng; Chang, Shih-Liang

    2014-01-01

    The application of electroacupuncture (EA) to specific acupoints can induce a hypoglycemic effect in streptozotocin-induced rats, normal rats, and rats with steroid-induced insulin resistance. EA combined with the oral insulin sensitizer rosiglitazone improved insulin sensitivity in rats and humans with type II diabetes mellitus (DM). There are different hypoglycemic mechanisms between Zhongwan and Zusanli acupoints by EA stimulation. On low-frequency (2 Hz) stimulation at bilateral Zusanli acupoints, serotonin was involved in the hypoglycemic effect in normal rats. Moreover, after 15 Hz EA stimulation at the bilateral Zusanli acupoints, although enhanced insulin activity mainly acts on the insulin-sensitive target organs, the muscles must be considered. In addition, 15 Hz EA stimulation at the bilateral Zusanli acupoints has the combined effect of enhancing cholinergic nerve activity and increasing nitric oxide synthase (NOS) activity to enhance insulin activity. Despite the well-documented effect of pain control by EA in many systemic diseases, there are few high-quality long-term clinical trials on the hypoglycemic effect of EA in DM. Combination treatment with EA and other medications seems to be an alternative treatment to achieve better therapeutic goals that merit future investigation. PMID:25024728

  12. Applying an Open-Source Segmentation Algorithm to Different OCT Devices in Multiple Sclerosis Patients and Healthy Controls: Implications for Clinical Trials.

    PubMed

    Bhargava, Pavan; Lang, Andrew; Al-Louzi, Omar; Carass, Aaron; Prince, Jerry; Calabresi, Peter A; Saidha, Shiv

    2015-01-01

    Background. The lack of segmentation algorithms operative across optical coherence tomography (OCT) platforms hinders utility of retinal layer measures in MS trials. Objective. To determine cross-sectional and longitudinal agreement of retinal layer thicknesses derived from an open-source, fully-automated, segmentation algorithm, applied to two spectral-domain OCT devices. Methods. Cirrus HD-OCT and Spectralis OCT macular scans from 68 MS patients and 22 healthy controls were segmented. A longitudinal cohort comprising 51 subjects (mean follow-up: 1.4 ± 0.9 years) was also examined. Bland-Altman analyses and interscanner agreement indices were utilized to assess agreement between scanners. Results. Low mean differences (-2.16 to 0.26 μm) and narrow limits of agreement (LOA) were noted for ganglion cell and inner and outer nuclear layer thicknesses cross-sectionally. Longitudinally we found low mean differences (-0.195 to 0.21 μm) for changes in all layers, with wider LOA. Comparisons of rate of change in layer thicknesses over time revealed consistent results between the platforms. Conclusions. Retinal thickness measures for the majority of the retinal layers agree well cross-sectionally and longitudinally between the two scanners at the cohort level, with greater variability at the individual level. This open-source segmentation algorithm enables combining data from different OCT platforms, broadening utilization of OCT as an outcome measure in MS trials. PMID:26090228

  13. Applying an Open-Source Segmentation Algorithm to Different OCT Devices in Multiple Sclerosis Patients and Healthy Controls: Implications for Clinical Trials

    PubMed Central

    Lang, Andrew; Al-Louzi, Omar; Carass, Aaron; Prince, Jerry; Calabresi, Peter A.; Saidha, Shiv

    2015-01-01

    Background. The lack of segmentation algorithms operative across optical coherence tomography (OCT) platforms hinders utility of retinal layer measures in MS trials. Objective. To determine cross-sectional and longitudinal agreement of retinal layer thicknesses derived from an open-source, fully-automated, segmentation algorithm, applied to two spectral-domain OCT devices. Methods. Cirrus HD-OCT and Spectralis OCT macular scans from 68 MS patients and 22 healthy controls were segmented. A longitudinal cohort comprising 51 subjects (mean follow-up: 1.4 ± 0.9 years) was also examined. Bland-Altman analyses and interscanner agreement indices were utilized to assess agreement between scanners. Results. Low mean differences (−2.16 to 0.26 μm) and narrow limits of agreement (LOA) were noted for ganglion cell and inner and outer nuclear layer thicknesses cross-sectionally. Longitudinally we found low mean differences (−0.195 to 0.21 μm) for changes in all layers, with wider LOA. Comparisons of rate of change in layer thicknesses over time revealed consistent results between the platforms. Conclusions. Retinal thickness measures for the majority of the retinal layers agree well cross-sectionally and longitudinally between the two scanners at the cohort level, with greater variability at the individual level. This open-source segmentation algorithm enables combining data from different OCT platforms, broadening utilization of OCT as an outcome measure in MS trials. PMID:26090228

  14. Applied oceanography

    SciTech Connect

    Bishop, J.M.

    1984-01-01

    This book combines oceanography principles and applications such as marine pollution, resources, and transportation. It is divided into two main parts treating the basic principles of physical oceanography, and presenting a unique systems framework showing how physical oceanography, marine ecology, economics, and government policy may be combined to define the newly developing field of applied oceanography.

  15. Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC)

    PubMed Central

    2011-01-01

    Background The English National Health Service has made a major investment in nine partnerships between higher education institutions and local health services called Collaborations for Leadership in Applied Health Research and Care (CLAHRC). They have been funded to increase capacity and capability to produce and implement research through sustained interactions between academics and health services. CLAHRCs provide a natural 'test bed' for exploring questions about research implementation within a partnership model of delivery. This protocol describes an externally funded evaluation that focuses on implementation mechanisms and processes within three CLAHRCs. It seeks to uncover what works, for whom, how, and in what circumstances. Design and methods This study is a longitudinal three-phase, multi-method realistic evaluation, which deliberately aims to explore the boundaries around knowledge use in context. The evaluation funder wishes to see it conducted for the process of learning, not for judging performance. The study is underpinned by a conceptual framework that combines the Promoting Action on Research Implementation in Health Services and Knowledge to Action frameworks to reflect the complexities of implementation. Three participating CLARHCS will provide in-depth comparative case studies of research implementation using multiple data collection methods including interviews, observation, documents, and publicly available data to test and refine hypotheses over four rounds of data collection. We will test the wider applicability of emerging findings with a wider community using an interpretative forum. Discussion The idea that collaboration between academics and services might lead to more applicable health research that is actually used in practice is theoretically and intuitively appealing; however the evidence for it is limited. Our evaluation is designed to capture the processes and impacts of collaborative approaches for implementing research, and

  16. Clinical update: transendoscopic laser surgery for treatment of epiglottic entrapment: Nd:YAG and 808-nm diode laser applied individually and in combination

    NASA Astrophysics Data System (ADS)

    Tate, Lloyd P.; Tudor, R. A.

    1999-06-01

    Hospital records reviewed from 1986-1998 determined that 18 horses were presented for correction of epiglottic entrapment by the aryepiglottic fold. All horses had a history of an abnormal respiratory noise and/or exercise intolerance. In conjunction with epiglottic entrapment, 10 horses had dorsal displacement of the soft palate. Initial confirmation of the epiglottic entrapment was made by endoscopic examination. In addition, 3 horses had radiographs taken of the larynx and pharyngeal region to determine the length of the epiglottis.Laser surgical treatment was performed on the horses in a standing position under sedation. The treatment consisted of axially dividing the aryepiglottic fold from the base of the epiglottis to the tip or beyond by means of a laser fiber introduced through the biopsy channel of an endoscope. The Nd:YAG laser was applied transendoscopically to 11 horses using free fiber technique. Three horses received transendoscopic laser correction using the 808-nm diode laser with the fiber in contact configuration. A combination of both 808-nm diode laser and Nd:YAG lasers were used to facilitate correction in the last 4 horses. Partial re-entrapment occurred in 2 out of the 3 cases in which the 808-nm diode laser was used as a single modality for correction. This did not occur in the horses that received either the Nd:YAG laser treatment or Nd:YAG laser treatment in combination with the 808-nm diode laser. Horses that received either 808-nm diode laser irradiation alone or 808-nm diode laser irradiation in combination with Nd:YAG laser appeared to have less swelling than those that received only Nd:YAG irradiation.

  17. MO-G-BRE-05: Clinical Process Improvement and Billing in Radiation Oncology: A Case Study of Applying FMEA for CPT Code 77336 (continuing Medical Physics Consultation)

    SciTech Connect

    Spirydovich, S; Huq, M

    2014-06-15

    Purpose: The improvement of quality in healthcare can be assessed by Failure Mode and Effects Analysis (FMEA). In radiation oncology, FMEA, as applied to the billing CPT code 77336, can improve both charge capture and, most importantly, quality of the performed services. Methods: We created an FMEA table for the process performed under CPT code 77336. For a given process step, each member of the assembled team (physicist, dosimetrist, and therapist) independently assigned numerical values for: probability of occurrence (O, 1–10), severity (S, 1–10), and probability of detection (D, 1–10) for every failure mode cause and effect combination. The risk priority number, RPN, was then calculated as a product of O, S and D from which an average RPN was calculated for each combination mentioned above. A fault tree diagram, with each process sorted into 6 categories, was created with linked RPN. For processes with high RPN recommended actions were assigned. 2 separate R and V systems (Lantis and EMR-based ARIA) were considered. Results: We identified 9 potential failure modes and corresponding 19 potential causes of these failure modes all resulting in unjustified 77336 charge and compromised quality of care. In Lantis, the range of RPN was 24.5–110.8, and of S values – 2–10. The highest ranking RPN of 110.8 came from the failure mode described as “end-of-treatment check not done before the completion of treatment”, and the highest S value of 10 (RPN=105) from “overrides not checked”. For the same failure modes, within ARIA electronic environment with its additional controls, RPN values were significantly lower (44.3 for end-of-treatment missing check and 20.0 for overrides not checked). Conclusion: Our work has shown that when charge capture was missed that also resulted in some services not being performed. Absence of such necessary services may result in sub-optimal quality of care rendered to patients.

  18. Applied Nanotoxicology.

    PubMed

    Hobson, David W; Roberts, Stephen M; Shvedova, Anna A; Warheit, David B; Hinkley, Georgia K; Guy, Robin C

    2016-01-01

    Nanomaterials, including nanoparticles and nanoobjects, are being incorporated into everyday products at an increasing rate. These products include consumer products of interest to toxicologists such as pharmaceuticals, cosmetics, food, food packaging, household products, and so on. The manufacturing of products containing or utilizing nanomaterials in their composition may also present potential toxicologic concerns in the workplace. The molecular complexity and composition of these nanomaterials are ever increasing, and the means and methods being applied to characterize and perform useful toxicologic assessments are rapidly advancing. This article includes presentations by experienced toxicologists in the nanotoxicology community who are focused on the applied aspect of the discipline toward supporting state of the art toxicologic assessments for food products and packaging, pharmaceuticals and medical devices, inhaled nanoparticle and gastrointestinal exposures, and addressing occupational safety and health issues and concerns. This symposium overview article summarizes 5 talks that were presented at the 35th Annual meeting of the American College of Toxicology on the subject of "Applied Nanotechnology." PMID:26957538

  19. International Federation of Clinical Chemistry and International Union of Pure and Applied Chemistry 2. Properties and Units in the Clinical Laboratory Sciences. VI. Properties and Units in IOC Prohibited Drugs (IFCC-IUPAC Recommendations 1997).

    PubMed

    Olesen, H; Cowan, D; Bruunshuus, I; Klempel, K; Hill, G

    1997-12-10

    The term designating a substance being an active ingredient of a drug may be a generic name, a nonproprietary name, a registered trade name, a fantasy name or other. This causes difficulties in the transmission of request and report on such substances to and from the clinical laboratories, and in the collating of this information from different sources. The document comprises a list of properties of drugs of abuse in biological fluids as defined by the International Olympic Committee Medical Code for use in electronic transmission systems. Standard systematic names are presented with a code value for each. The coding schemes thus prepared are accessible on Internet from C-NPU Home page address: http://inet.uni-c.dk/ qukb7642. PMID:9495577

  20. Applied Koopmanisma)

    NASA Astrophysics Data System (ADS)

    Budišić, Marko; Mohr, Ryan; Mezić, Igor

    2012-12-01

    A majority of methods from dynamical system analysis, especially those in applied settings, rely on Poincaré's geometric picture that focuses on "dynamics of states." While this picture has fueled our field for a century, it has shown difficulties in handling high-dimensional, ill-described, and uncertain systems, which are more and more common in engineered systems design and analysis of "big data" measurements. This overview article presents an alternative framework for dynamical systems, based on the "dynamics of observables" picture. The central object is the Koopman operator: an infinite-dimensional, linear operator that is nonetheless capable of capturing the full nonlinear dynamics. The first goal of this paper is to make it clear how methods that appeared in different papers and contexts all relate to each other through spectral properties of the Koopman operator. The second goal is to present these methods in a concise manner in an effort to make the framework accessible to researchers who would like to apply them, but also, expand and improve them. Finally, we aim to provide a road map through the literature where each of the topics was described in detail. We describe three main concepts: Koopman mode analysis, Koopman eigenquotients, and continuous indicators of ergodicity. For each concept, we provide a summary of theoretical concepts required to define and study them, numerical methods that have been developed for their analysis, and, when possible, applications that made use of them. The Koopman framework is showing potential for crossing over from academic and theoretical use to industrial practice. Therefore, the paper highlights its strengths in applied and numerical contexts. Additionally, we point out areas where an additional research push is needed before the approach is adopted as an off-the-shelf framework for analysis and design.

  1. Applied Koopmanism.

    PubMed

    Budisić, Marko; Mohr, Ryan; Mezić, Igor

    2012-12-01

    A majority of methods from dynamical system analysis, especially those in applied settings, rely on Poincaré's geometric picture that focuses on "dynamics of states." While this picture has fueled our field for a century, it has shown difficulties in handling high-dimensional, ill-described, and uncertain systems, which are more and more common in engineered systems design and analysis of "big data" measurements. This overview article presents an alternative framework for dynamical systems, based on the "dynamics of observables" picture. The central object is the Koopman operator: an infinite-dimensional, linear operator that is nonetheless capable of capturing the full nonlinear dynamics. The first goal of this paper is to make it clear how methods that appeared in different papers and contexts all relate to each other through spectral properties of the Koopman operator. The second goal is to present these methods in a concise manner in an effort to make the framework accessible to researchers who would like to apply them, but also, expand and improve them. Finally, we aim to provide a road map through the literature where each of the topics was described in detail. We describe three main concepts: Koopman mode analysis, Koopman eigenquotients, and continuous indicators of ergodicity. For each concept, we provide a summary of theoretical concepts required to define and study them, numerical methods that have been developed for their analysis, and, when possible, applications that made use of them. The Koopman framework is showing potential for crossing over from academic and theoretical use to industrial practice. Therefore, the paper highlights its strengths in applied and numerical contexts. Additionally, we point out areas where an additional research push is needed before the approach is adopted as an off-the-shelf framework for analysis and design. PMID:23278096

  2. Applied geodesy

    SciTech Connect

    Turner, S.

    1987-01-01

    This volume is based on the proceedings of the CERN Accelerator School's course on Applied Geodesy for Particle Accelerators held in April 1986. The purpose was to record and disseminate the knowledge gained in recent years on the geodesy of accelerators and other large systems. The latest methods for positioning equipment to sub-millimetric accuracy in deep underground tunnels several tens of kilometers long are described, as well as such sophisticated techniques as the Navstar Global Positioning System and the Terrameter. Automation of better known instruments such as the gyroscope and Distinvar is also treated along with the highly evolved treatment of components in a modern accelerator. Use of the methods described can be of great benefit in many areas of research and industrial geodesy such as surveying, nautical and aeronautical engineering, astronomical radio-interferometry, metrology of large components, deformation studies, etc.

  3. Applying Clinical Neuropsychology in the Public Schools.

    ERIC Educational Resources Information Center

    Federhar, David B.

    Neuropsychology is an area in which the functioning or integrity of the brain is linked to measurable human behavior. This paper describes the use of the Reitan batteries (Reitan and Davison; 1974) in public school settings for documenting and prescribing appropriate academic programs. Three individual case studies are presented. Case 1 is a 16…

  4. PSYCHOANALYSIS AS APPLIED AESTHETICS.

    PubMed

    Richmond, Stephen H

    2016-07-01

    The question of how to place psychoanalysis in relation to science has been debated since the beginning of psychoanalysis and continues to this day. The author argues that psychoanalysis is best viewed as a form of applied art (also termed applied aesthetics) in parallel to medicine as applied science. This postulate draws on a functional definition of modernity as involving the differentiation of the value spheres of science, art, and religion. The validity criteria for each of the value spheres are discussed. Freud is examined, drawing on Habermas, and seen to have erred by claiming that the psychoanalytic method is a form of science. Implications for clinical and metapsychological issues in psychoanalysis are discussed. PMID:27428582

  5. Following the Rules Set by Accreditation Agencies and Governing Bodies to Maintain In-Compliance Status: Applying Critical Thinking Skills When Evaluating the Need for Change in the Clinical Laboratory.

    PubMed

    Byrne, Karen M; Levy, Kimberly Y; Reese, Erika M

    2016-05-01

    Maintaining an in-compliance clinical laboratory takes continuous awareness and review of standards, regulations, and best practices. A strong quality assurance program and well informed leaders who maintain professional networks can aid in this necessary task. This article will discuss a process that laboratories can follow to interpret, understand, and comply with the rules and standards set by laboratory accreditation bodies. PMID:26945880

  6. Clinical neuroimaging

    SciTech Connect

    Gilman, S.; Mazziotta, J.C.

    1989-01-01

    Designed for practicing neurologists and neurosurgeons, this reference focuses on the newest techniques in computed assisted tomography. Text material covers basic principles of computed tomography, as well as the clinical advantages and disadvantages of each modality. The anatomical and/or physiological processes measured by XCT, PET, SPECT and MRI are first discussed in terms of the normal patient, and then applied to the diagnosis and treatment of patients with neurological disease (primarily of the brain). Emphasis is placed on areas of difficult diagnosis, such as differentiating recurrent tumor from radiation necrosis, early diagnosis of dementia, selection of patients for extracranial-intracranial bypass procedures, and localization of epileptic foci.

  7. A multi-center randomized proof-of-concept clinical trial applying [¹⁸F]FDG-PET for evaluation of metabolic therapy with rosiglitazone XR in mild to moderate Alzheimer's disease.

    PubMed

    Tzimopoulou, Sofia; Cunningham, Vincent J; Nichols, Thomas E; Searle, Graham; Bird, Nick P; Mistry, Prafull; Dixon, Ian J; Hallett, William A; Whitcher, Brandon; Brown, Andrew P; Zvartau-Hind, Marina; Lotay, Narinder; Lai, Robert Y K; Castiglia, Mary; Jeter, Barbara; Matthews, Julian C; Chen, Kewei; Bandy, Dan; Reiman, Eric M; Gold, Michael; Rabiner, Eugenii A; Matthews, Paul M

    2010-01-01

    Here we report the first multi-center clinical trial in Alzheimer's disease (AD) using fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) measures of brain glucose metabolism as the primary outcome. We contrasted effects of 12 months treatment with the PPARγ agonist Rosiglitazone XR versus placebo in 80 mild to moderate AD patients. Secondary objectives included testing for reduction in the progression of brain atrophy and improvement in cognition. Active treatment was associated with a sustained but not statistically significant trend from the first month for higher mean values in Kiindex and CMRgluindex, novel quantitative indices related to the combined forward rate constant for [18F]FDG uptake and to the rate of cerebral glucose utilization, respectively. However, neither these nor another analytical approach recently validated using data from the Alzheimer's Disease Neuroimaging Initiative indicated that active treatment decreased the progression of decline in brain glucose metabolism. Rates of brain atrophy were similar between active and placebo groups and measures of cognition also did not suggest clear group differences. Our study demonstrates the feasibility of using [18F]FDG-PET as part of a multi-center therapeutics trial. It suggests that Rosiglitazone is associated with an early increase in whole brain glucose metabolism, but not with any biological or clinical evidence for slowing progression over a 1 year follow up in the symptomatic stages of AD. PMID:20930300

  8. Clinical professional governance for detailed clinical models.

    PubMed

    Goossen, William; Goossen-Baremans, Anneke

    2013-01-01

    This chapter describes the need for Detailed Clinical Models for contemporary Electronic Health Systems, data exchange and data reuse. It starts with an explanation of the components related to Detailed Clinical Models with a brief summary of knowledge representation, including terminologies representing clinic relevant "things" in the real world, and information models that abstract these in order to let computers process data about these things. Next, Detailed Clinical Models are defined and their purpose is described. It builds on existing developments around the world and accumulates in current work to create a technical specification at the level of the International Standards Organization. The core components of properly expressed Detailed Clinical Models are illustrated, including clinical knowledge and context, data element specification, code bindings to terminologies and meta-information about authors, versioning among others. Detailed Clinical Models to date are heavily based on user requirements and specify the conceptual and logical levels of modelling. It is not precise enough for specific implementations, which requires an additional step. However, this allows Detailed Clinical Models to serve as specifications for many different kinds of implementations. Examples of Detailed Clinical Models are presented both in text and in Unified Modelling Language. Detailed Clinical Models can be positioned in health information architectures, where they serve at the most detailed granular level. The chapter ends with examples of projects that create and deploy Detailed Clinical Models. All have in common that they can often reuse materials from earlier projects, and that strict governance of these models is essential to use them safely in health care information and communication technology. Clinical validation is one point of such governance, and model testing another. The Plan Do Check Act cycle can be applied for governance of Detailed Clinical Models

  9. The Applied Mathematics Laboratory.

    ERIC Educational Resources Information Center

    Siegel, Martha J.

    This report describes the Applied Mathematics Laboratory (AML) operated by the Department of Mathematics at Towson State University, Maryland. AML is actually a course offered to selected undergraduates who are given the opportunity to apply their skills in investigating industrial and governmental problems. By agreement with sponsoring…

  10. Applied Linguistics: Brazilian Perspectives

    ERIC Educational Resources Information Center

    Cavalcanti, Marilda C.

    2004-01-01

    The aim of this paper is to present perspectives in Applied Linguistics (AL) against the background of a historical overview of the field in Brazil. I take the stance of looking at AL as a field of knowledge and as a professional area of research. This point of view directs my reflections towards research-based Applied Linguistics carried out from…

  11. Science: Pure or Applied?

    ERIC Educational Resources Information Center

    Evans, Peter

    1980-01-01

    Through a description of some of the activities which take place in his science classroom, the author makes a strong case for the inclusion of technology, or applied science, rather than pure science in the primary curriculum. (KC)

  12. Mesothelioma Applied Research Foundation

    MedlinePlus

    ... Percentage Donations Tribute Wall Other Giving/Fundraising Opportunities Bitcoin Donation Form FAQs Help us raise awareness and ... Percentage Donations Tribute Wall Other Giving/Fundraising Opportunities Bitcoin Donation Form FAQs © 2013 Mesothelioma Applied Research Foundation, ...

  13. Applied Physics at Strathclyde.

    ERIC Educational Resources Information Center

    Patterson, H.; Twidell, J. W.

    1979-01-01

    Outlines and describes the content of an applied physics course offered for the four year honors and the three year pass degrees. The course stresses three components: principal subjects, industrial projects, and subsidiary subjects. (GA)

  14. Geomorphology: Pure and applied

    SciTech Connect

    Hart, M.G.

    1986-01-01

    The book summarizes the history of intellectual debate in geomorphology and describes modern developments both ''pure'' and ''applied.'' The history begins well before W.M. Davis and follows through to such debates as those concerned with the Pleistocene. Modern developments in pure geomorphology are cast in terms of chapters on form, process, materials, and methods analysis. The applied chapters concentrate on environmental hazards and resources, and their management.

  15. CLINICAL BIOCHEMISTRY

    EPA Science Inventory

    Assessment of the health status of animals through measurement of cellular, biochemical, and macromolecular constituents in blood, secretions, and excretions has been variously referred to as clinical chemistry, clinical biochemistry, or clinical pathology. he genesis of this dis...

  16. [Implantation of collagen coated hydroxyapatite particles. A clinical-histological study in humans].

    PubMed

    Sanz, M; Bascones, A; Kessler, A; García Nuñez, J; Newman, M G; Robertson, M A; Carranza, F A

    1989-05-01

    In this study, histologic behaviour of collagen coated hydroxylapatite particles implanted in human periodontal osseous defects has been analyzed. This material was surgically implanted in four patients, and reentry and block biopsies were carried out 4 and 6 months later. The histologic results demonstrate that this material is well tolerated by surrounding tissues, not eliciting an inflammatory reaction. At four months, the hydroxylapatite particles appear encapsulated by a very cellular connective tissue and at 6 months are found in direct contact with osteoid and mature bone. This material acts as a filler material, being fully biocompatible and stimulating an osseoconductive reaction of the adjacent alveolar bone. PMID:2637052

  17. Applied Astronomy: Asteroid Prospecting

    NASA Astrophysics Data System (ADS)

    Elvis, M.

    2013-09-01

    In the age of asteroid mining the ability to find promising ore-bearing bodies will be valuable. This will give rise to a new discipline- "Applied Astronomy". Just as most geologists work in industry, not in academia, the same will be true of astronomers. Just how rare or common ore-rich asteroids are likely to be, and the skills needed to assay their value, are discussed here, with an emphasis on remote - telescopic - methods. Also considered are the resources needed to conduct extensive surveys of asteroids for prospecting purposes, and the cost and timescale involved. The longer-term need for applied astronomers is also covered.

  18. Clinical Research and Clinical Trials

    MedlinePlus

    ... you can get involved. Doing your own clinical research project? Then select the Guidance for Clinical Researchers link to learn more about the NICHD's clinical research processes and policies. Last Reviewed: 03/06/2012 ...

  19. Applying to College

    ERIC Educational Resources Information Center

    Tierney, William G.

    2009-01-01

    This article suggests that unlike their well-off counterparts who apply to college in the fall and know they will go somewhere when the applications have been sent, low-income students face unique challenges that extend the process in a manner entirely different from the wealthy. The notion that college-going is a cultural interpretation is…

  20. Applied Music (Individual Study).

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    Background information and resources to help students in grades 9-12 in Texas pursue an individual study contract in applied music is presented. To fulfill a contract students must publicly perform from memory, with accompaniment as specified, three selections from a list of approved music for their chosen field (instrument or voice). Material…

  1. Applying Mathematical Processes (AMP)

    ERIC Educational Resources Information Center

    Kathotia, Vinay

    2011-01-01

    This article provides insights into the "Applying Mathematical Processes" resources, developed by the Nuffield Foundation. It features Nuffield AMP activities--and related ones from Bowland Maths--that were designed to support the teaching and assessment of key processes in mathematics--representing a situation mathematically, analysing,…

  2. Applied research on glucansucrases

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Although glycansucrases have been known for over 70 years, they remain relatively unknown except to a small group of researchers. Practical, applied research on glycansucrases has been focused on certain key areas. The earliest of these was the development of blood plasma extenders from dextran, d...

  3. Applied Linguistics in Europe

    ERIC Educational Resources Information Center

    de Bot, Kees

    2004-01-01

    In this contribution developments in Applied Linguistics in Europe are linked to major social changes that have taken place over the last decades. These include: The decline of the USSR and the end of the cold war; The development of the EEC and the EU and fading of borders; The economic growth of Western Europe; Labor migration from the south to…

  4. Applied Statistics with SPSS

    ERIC Educational Resources Information Center

    Huizingh, Eelko K. R. E.

    2007-01-01

    Accessibly written and easy to use, "Applied Statistics Using SPSS" is an all-in-one self-study guide to SPSS and do-it-yourself guide to statistics. What is unique about Eelko Huizingh's approach is that this book is based around the needs of undergraduate students embarking on their own research project, and its self-help style is designed to…

  5. Africa and Applied Linguistics.

    ERIC Educational Resources Information Center

    Makoni, Sinfree, Ed.; Meinhof, Ulrike H., Ed.

    2003-01-01

    This collection of articles includes: "Introducing Applied Linguistics in Africa" (Sinfree Makoni and Ulrike H. Meinhof); "Language Ideology and Politics: A Critical Appraisal of French as Second Official Language in Nigeria" (Tope Omoniyi); "The Democratisation of Indigenous Languages: The Case of Malawi" (Themba Moyo); "Classroom Code-Switching…

  6. Essays on Applied Microeconomics

    ERIC Educational Resources Information Center

    Mejia Mantilla, Carolina

    2013-01-01

    Each chapter of this dissertation studies a different question within the field of Applied Microeconomics. The first chapter examines the mid- and long-term effects of the 1998 Asian Crisis on the educational attainment of Indonesian children ages 6 to 18, at the time of the crisis. The effects are identified as deviations from a linear trend for…

  7. Applied Vocational Mathematics.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Vocational Education.

    Developed for use in teaching a two-semester, one-unit course, this course guide is intended to aid the high school instructor in teaching mathematical problem-solving and computational skills to vocational education students. The state-adopted textbook for general mathematics III, "Applied General Mathematics" serves as the major resource…

  8. Applied Algebra Curriculum Modules.

    ERIC Educational Resources Information Center

    Texas State Technical Coll., Marshall.

    This collection of 11 applied algebra curriculum modules can be used independently as supplemental modules for an existing algebra curriculum. They represent diverse curriculum styles that should stimulate the teacher's creativity to adapt them to other algebra concepts. The selected topics have been determined to be those most needed by students…

  9. Applied Behavior Analysis

    ERIC Educational Resources Information Center

    Szapacs, Cindy

    2006-01-01

    Teaching strategies that work for typically developing children often do not work for those diagnosed with an autism spectrum disorder. However, teaching strategies that work for children with autism do work for typically developing children. In this article, the author explains how the principles and concepts of Applied Behavior Analysis can be…

  10. Signals: Applying Academic Analytics

    ERIC Educational Resources Information Center

    Arnold, Kimberly E.

    2010-01-01

    Academic analytics helps address the public's desire for institutional accountability with regard to student success, given the widespread concern over the cost of higher education and the difficult economic and budgetary conditions prevailing worldwide. Purdue University's Signals project applies the principles of analytics widely used in…

  11. Clinical Preceptor.

    ERIC Educational Resources Information Center

    Gardipee, Sheila; Clemens, Glenna

    A clinical preceptor is an employed registered nurse in a clinical facility who supervises and evaluates a student's performance independent of a clinical instructor. This manual is intended to assist the clinical preceptor, especially the preceptor dealing with re-entry nursing students. It encompasses a practical approach with actual situations…

  12. Clinical Laboratory Science: Applied Biology with Great Potential.

    ERIC Educational Resources Information Center

    Stanley, Melissa

    1990-01-01

    Described are a variety of careers under the umbrella of medical technology. The status of medical technology and medical technology education are discussed. Different curricula for medical technology are compared. (CW)

  13. Quality in applied science

    NASA Astrophysics Data System (ADS)

    Sten, T.

    1993-12-01

    Science is in many senses a special kind of craft and only skilled craftsmen are able to distinguish good work from bad. Due to the variation in approaches, methods and even philosophical basis, it is nearly impossible to derive a general set of quality criteria for scientific work outside specific research traditions. Applied science introduces a new set of quality criteria having to do with the application of results in practical situations and policy making. A scientist doing basic research relates mainly to the scientific community of which he is a member, while in applied contract research the scientist has to consider the impact of his results both for the immediate users and upon interest groups possibly being affected. Application thus raises a whole new set of requirements having to do with business ethics, policy consequences and societal ethics in general.

  14. Applied Meteorology Unit (AMU)

    NASA Technical Reports Server (NTRS)

    Bauman, William; Lambert, Winifred; Wheeler, Mark; Barrett, Joe; Watson, Leela

    2007-01-01

    This report summarizes the Applied Meteorology Unit (AMU) activities for the second quarter of Fiscal Year 2007 (January - March 2007). Tasks reported on are: Obiective Lightning Probability Tool, Peak Wind Tool for General Forecasting, Situational Lightning Climatologies for Central Florida, Anvil Threat Corridor Forecast Tool in AWIPS, Volume Averaqed Heiqht lnteq rated Radar Reflectivity (VAHIRR), Tower Data Skew-t Tool, and Weather Research and Forecastini (WRF) Model Sensitivity Study

  15. Applied Biotechnology in Nematology

    PubMed Central

    Caswell-Chen, E. P.; Williamson, V. M.; Westerdahl, B. B.

    1993-01-01

    During the past two decades, rapid advances in biotechnology and molecular biology have affected the understanding and treatment of human and plant diseases. The human and Caenorhabditis elegans genome-sequencing projects promise further techniques and results useful to applied nematology. Of course, biotechnology is not a panacea for nematological problems, but it provides many powerful tools that have potential use in applied biology and nematode management. The tools will facilitate research on a range of previously intractable problems in nematology, from identification of species and pathotypes to the development of resistant cultivars that have been inaccessible because of technical limitations. However, to those unfamiliar or not directly involved with the new technologies and their extensive terminology, the benefits of the advances in biotechnology may not be readily discerned. The sustainable agriculture of the future will require ecology-based management, and successful integrated nematode management will depend on combinations of control tactics to reduce nematode numbers. In this review we discuss how biotechnology may influence nematode management, define terminology relative to potential applications, and present current and future avenues of research in applied nematology, including species identification, race and pathotype identification, development of resistant cultivars, definition of nematode-host interactions, nematode population dynamics, establishment of optimal rotations, the ecology of biological control and development of useful biological control agents, and the design of novel nematicides. PMID:19279831

  16. Development of clinical sites.

    PubMed

    O'Brien, Mary

    2015-02-01

    Clinical experiences are vital to all types of healthcare educational programs. Supervised clinical experiences provide the opportunity for the learner to apply didactic knowledge and theory to real world situations and hone skills necessary for entry into practice. Nurse anesthesia programs utilize a wide variety of clinical sites to expose student registered nurse anesthetists to experiences that will prepare them clinically, academically and professionally to enter practice as a Certified Registered Nurse Anesthetist. This article describes the process of developing a clinical site. A thorough evaluation will determine the types of experiences meant to be offered at the site, the resources available to house and educate the students, and how to evaluate the effectiveness of the clinical site. Open communication between the clinical coordinator and the program director or designee is essential to ensure success of the clinical site. The Council on Accreditation of Nurse Anesthesia Educational Programs has resources available to guide those interested in becoming a clinical site, as well as for program administrators who seek to add new experiences to their programs. PMID:25842629

  17. Applied ALARA techniques

    SciTech Connect

    Waggoner, L.O.

    1998-02-05

    The presentation focuses on some of the time-proven and new technologies being used to accomplish radiological work. These techniques can be applied at nuclear facilities to reduce radiation doses and protect the environment. The last reactor plants and processing facilities were shutdown and Hanford was given a new mission to put the facilities in a safe condition, decontaminate, and prepare them for decommissioning. The skills that were necessary to operate these facilities were different than the skills needed today to clean up Hanford. Workers were not familiar with many of the tools, equipment, and materials needed to accomplish:the new mission, which includes clean up of contaminated areas in and around all the facilities, recovery of reactor fuel from spent fuel pools, and the removal of millions of gallons of highly radioactive waste from 177 underground tanks. In addition, this work has to be done with a reduced number of workers and a smaller budget. At Hanford, facilities contain a myriad of radioactive isotopes that are 2048 located inside plant systems, underground tanks, and the soil. As cleanup work at Hanford began, it became obvious early that in order to get workers to apply ALARA and use hew tools and equipment to accomplish the radiological work it was necessary to plan the work in advance and get radiological control and/or ALARA committee personnel involved early in the planning process. Emphasis was placed on applying,ALARA techniques to reduce dose, limit contamination spread and minimize the amount of radioactive waste generated. Progress on the cleanup has,b6en steady and Hanford workers have learned to use different types of engineered controls and ALARA techniques to perform radiological work. The purpose of this presentation is to share the lessons learned on how Hanford is accomplishing radiological work.

  18. Applied Meteorology Unit (AMU)

    NASA Technical Reports Server (NTRS)

    Bauman, William H., Jr.; Crawford, Winifred; Short, David; Barrett, Joe; Watson, Leela

    2008-01-01

    This report summarizes the Applied Meteorology Unit (AMU) activities for the second quarter of Fiscal Year 2008 (January - March 2008). Projects described are: (1) Peak Wind Tool for User Launch Commit Criteria (LCC), (2) Peak Wind Tool for General Forecasting, (3) Situational Lightning Climatologies for Central Florida. Phase III, (4) Volume Averaged Height Integrated Radar Reflectivity (VAHIRR), (5) Impact of Local Sensors, (6) Radar Scan Strategies for the PAFB WSR-74C Replacement and (7) WRF Wind Sensitivity Study at Edwards Air Force Base.

  19. Applied Meteorology Unit (AMU)

    NASA Technical Reports Server (NTRS)

    Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Wheeler, Mark

    2010-01-01

    This report summarizes the Applied Meteorology Unit (AMU) activities for the first quarter of Fiscal Year 2010 (October - December 2009). A detailed project schedule is included in the Appendix. Included tasks are: (1) Peak Wind Tool for User Launch Commit Criteria (LCC), (2) Objective Lightning Probability Tool, Phase III, (3) Peak Wind Tool for General Forecasting, Phase II, (4) Upgrade Summer Severe Weather Tool in Meteorological Interactive Data Display System (MIDDS), (5) Advanced Regional Prediction System (ARPS) Data Analysis System (ADAS) Update and Maintainability, (5) Verify 12-km resolution North American Model (MesoNAM) Performance, and (5) Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) Graphical User Interface.

  20. NASA Applied Sciences Program

    NASA Technical Reports Server (NTRS)

    Frederick, Martin

    2006-01-01

    This presentation highlights the NASA Applied Sciences Program. The goal of the program is to extend the results of scientific research and knowledge beyond the science community to contribute to NASA's partners' applications of national priority, such as agricultural efficiency, energy management and Homeland Security. Another purpose of the program's scientific research is to increase knowledge of the Earth-Sun system to enable improved predictions of climate, weather, and natural hazards. The program primarily optimizes benefits for citizens by contributing to partnering on applications that are used by state, local and tribal governments.

  1. Leadership Theory Lets Clinical Instructors Guide Students toward Autonomy.

    ERIC Educational Resources Information Center

    Keenan, Mary J.; And Others

    1988-01-01

    Discusses situational leadership theories and suggests that clinical instructors should apply them within clinical learning settings to help students participate more responsibly in their learning experiences. (JOW)

  2. Clinical Trials

    MedlinePlus

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  3. Clinical Trials

    MedlinePlus

    Clinical trials are research studies that test how well new medical approaches work in people. Each study ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to ...

  4. [Echinocandins: Applied pharmacology].

    PubMed

    Azanza Perea, José Ramón

    2016-01-01

    The echinocandins share pharmacodynamic properties, although there are some interesting differences in their pharmacokinetic behaviour in the clinical practice. They are not absorbed by the oral route. They have a somewhat special distribution in the organism, as some of them can reach high intracellular concentrations while, with some others, the concentration is reduced. They are highly bound to plasma proteins, thus it is recommended to administer a loading dose for anidulafungin and caspofungin, although this procedure is not yet clear with micafungin. Echinocandins are excreted via a non-microsomal metabolism, so the urinary concentration is very low. Some carrier proteins that take part in the biliary clearance process are probably involved in the interactions described with caspofungin and micafungin. These two drugs must be used with caution in patients with severely impaired hepatic function, while all of them can be used without special precautions when there is renal impairment or the patient requires renal replacement therapy. PMID:27395024

  5. Instructions for Applying | Division of Cancer Prevention

    Cancer.gov

    This is NOT a grant application - if successful, funds will not be transferred to your institution to support your project. Rather, this is an application to access the scientific capabilities and resources of the NCI with the goal of moving promising cancer chemopreventive agents into clinical testing. If successful, you will partner with the NCI in developing a drug development pipeline. | Apply to access the scientific capabilities and resources of the NCI with the goal of moving promising cancer chemopreventive agents into clinical testing.

  6. Applied computational aerodynamics

    SciTech Connect

    Henne, P.A.

    1990-01-01

    The present volume discusses the original development of the panel method, the mapping solutions and singularity distributions of linear potential schemes, the capabilities of full-potential, Euler, and Navier-Stokes schemes, the use of the grid-generation methodology in applied aerodynamics, subsonic airfoil design, inverse airfoil design for transonic applications, the divergent trailing-edge airfoil innovation in CFD, Euler and potential computational results for selected aerodynamic configurations, and the application of CFD to wing high-lift systems. Also discussed are high-lift wing modifications for an advanced-capability EA-6B aircraft, Navier-Stokes methods for internal and integrated propulsion system flow predictions, the use of zonal techniques for analysis of rotor-stator interaction, CFD applications to complex configurations, CFD applications in component aerodynamic design of the V-22, Navier-Stokes computations of a complete F-16, CFD at supersonic/hypersonic speeds, and future CFD developments.

  7. Applying robotics to HAZMAT

    NASA Technical Reports Server (NTRS)

    Welch, Richard V.; Edmonds, Gary O.

    1994-01-01

    The use of robotics in situations involving hazardous materials can significantly reduce the risk of human injuries. The Emergency Response Robotics Project, which began in October 1990 at the Jet Propulsion Laboratory, is developing a teleoperated mobile robot allowing HAZMAT (hazardous materials) teams to remotely respond to incidents involving hazardous materials. The current robot, called HAZBOT III, can assist in locating characterizing, identifying, and mitigating hazardous material incidents without risking entry team personnel. The active involvement of the JPL Fire Department HAZMAT team has been vital in developing a robotic system which enables them to perform remote reconnaissance of a HAZMAT incident site. This paper provides a brief review of the history of the project, discusses the current system in detail, and presents other areas in which robotics can be applied removing people from hazardous environments/operations.

  8. Applying robotics to HAZMAT

    NASA Astrophysics Data System (ADS)

    Welch, Richard V.; Edmonds, Gary O.

    1994-02-01

    The use of robotics in situations involving hazardous materials can significantly reduce the risk of human injuries. The Emergency Response Robotics Project, which began in October 1990 at the Jet Propulsion Laboratory, is developing a teleoperated mobile robot allowing HAZMAT (hazardous materials) teams to remotely respond to incidents involving hazardous materials. The current robot, called HAZBOT III, can assist in locating characterizing, identifying, and mitigating hazardous material incidents without risking entry team personnel. The active involvement of the JPL Fire Department HAZMAT team has been vital in developing a robotic system which enables them to perform remote reconnaissance of a HAZMAT incident site. This paper provides a brief review of the history of the project, discusses the current system in detail, and presents other areas in which robotics can be applied removing people from hazardous environments/operations.

  9. Applied Healthspan engineering.

    PubMed

    Larrick, James W; Mendelsohn, Andrew

    2010-01-01

    According to the Homeric Hymn to Aphrodite, when Eos asked Zeus for Tithonus to be granted immortality, she forgot to ask for eternal youth. Applied Healthspan Engineering (AHE) seeks to address this problem. All organisms have a minimal level of functional reserve required to sustain life that eventually declines to a point incompatible with survival at death. AHE seeks to maintain or restore optimal functional reserve of critical tissues and organs. Tissue reserve correlates with well being. Diet, physical exercise, and currently available small-molecule-based therapeutics may attenuate the rate of decline of specific organs or organ systems, but are unlikely to restore lost reserve. Inherent evolutionary-derived limitations in tissue homeostasis and cell maintenance necessitate the development of therapies to enhance regenerative processes and possibly replace whole organs or tissues. AHE supports the study of cell, tissue, and organ homeostatic mechanisms to derive new regenerative and tissue replacement therapies to extend the period of human health. PMID:20462384

  10. Methods of applied dynamics

    NASA Technical Reports Server (NTRS)

    Rheinfurth, M. H.; Wilson, H. B.

    1991-01-01

    The monograph was prepared to give the practicing engineer a clear understanding of dynamics with special consideration given to the dynamic analysis of aerospace systems. It is conceived to be both a desk-top reference and a refresher for aerospace engineers in government and industry. It could also be used as a supplement to standard texts for in-house training courses on the subject. Beginning with the basic concepts of kinematics and dynamics, the discussion proceeds to treat the dynamics of a system of particles. Both classical and modern formulations of the Lagrange equations, including constraints, are discussed and applied to the dynamic modeling of aerospace structures using the modal synthesis technique.

  11. NASA Applied Sciences Program

    NASA Technical Reports Server (NTRS)

    Estes, Sue M.; Haynes, J. A.

    2009-01-01

    NASA's strategic Goals: a) Develop a balanced overall program of science, exploration, and aeronautics consistent with the redirection of human spaceflight program to focus on exploration. b) Study Earth from space to advance scientific understanding and meet societal needs. NASA's partnership efforts in global modeling and data assimilation over the next decade will shorten the distance from observations to answers for important, leading-edge science questions. NASA's Applied Sciences program will continue the Agency's efforts in benchmarking the assimilation of NASA research results into policy and management decision-support tools that are vital for the Nation's environment, economy, safety, and security. NASA also is working with NOAH and inter-agency forums to transition mature research capabilities to operational systems, primarily the polar and geostationary operational environmental satellites, and to utilize fully those assets for research purposes.

  12. Applied antineutrino physics workshop.

    SciTech Connect

    Lund, James C.

    2008-01-01

    This workshop is the fourth one of a series that includes the Neutrino Geophysics Conference at Honolulu, Hawaii, which I attended in 2005. This workshop was organized by the Astro-Particle and Cosmology laboratory in the recently opened Condoret building of the University of Paris. More information, including copies of the presentations, on the workshop is available on the website: www.apc.univ-paris7.fr/AAP2007/. The workshop aims at opening neutrino physics to various fields such that it can be applied in geosciences, nuclear industry (reactor and spent fuel monitoring) and non-proliferation. The workshop was attended by over 60 people from Europe, USA, Asia and Brazil. The meeting was also attended by representatives of the Comprehensive nuclear-Test Ban Treaty (CTBT) and the International Atomic Energy Agency (IAEA). The workshop also included a workshop dinner on board of a river boat sailing the Seine river.

  13. Starting a job as adjunct clinical instructor.

    PubMed

    Koharchik, Linda; Jakub, Karen

    2014-08-01

    This article is the second in a new quarterly series on the roles of adjunct clinical faculty and preceptors, who teach nursing students to apply knowledge in clinical settings. Topics will include the preparation of clinical instructors and preceptors for these roles, the student evaluation process, and overcoming challenges that can come with teaching in the clinical field and with adjunct teaching. PMID:25075704

  14. Situational Supervision for Athletic Training Clinical Education

    ERIC Educational Resources Information Center

    Levy, Linda S.; Gardner, Greg; Barnum, Mary G.; Willeford, K. Sean; Sexton, Patrick; Guyer, M. Susan; Fincher, A. Louise

    2009-01-01

    Introduction: The medical education model provides the basis for athletic training students to learn theoretical and practical skills. Clinical rotations are completed where they apply what they have learned under the direct supervision of a clinical instructor (CI) or approved clinical instructor (ACI). Approved clinical instructors are taught…

  15. Basic and applied research on choice responding.

    PubMed Central

    Fisher, W W; Mazur, J E

    1997-01-01

    Choice responding refers to the manner in which individuals allocate their time or responding among available response options. In this article, we first review basic investigations that have identified and examined variables that influence choice responding, such as response effort and reinforcement rate, immediacy, and quality. We then describe recent bridge and applied studies that illustrate how the results of basic research on choice responding can help to account for human behavior in natural environments and improve clinical assessments and interventions. PMID:9316255

  16. Applied equine genetics

    PubMed Central

    FINNO, C. J.; BANNASCH, D. L.

    2015-01-01

    Summary Genome sequencing of the domestic horse and subsequent advancements in the field of equine genomics have led to an explosion in the development of tools for mapping traits and diseases and evaluating gene expression. The objective of this review is to discuss the current progress in the field of equine genomics, with specific emphasis on assembly and analysis of the reference sequence and subsequent sequencing of a Quarter Horse mare; the genomic tools currently available to researchers and their implications in genomic investigations in the horse; the genomics of Mendelian and non-Mendelian traits; the genomics of performance traits and considerations regarding genetic testing in the horse. The whole-genome sequencing of a Quarter Horse mare has provided additional variants within the equine genome that extend past single nucleotide polymorphisms to include insertions/deletions and copy number variants. Equine single nucleotide polymorphism arrays have allowed for the investigation of both simple and complex genetic traits while DNA microarrays have provided a tool for examining gene expression across various tissues and with certain disease conditions. Recently, next-generation sequencing has become more affordable and both whole-genome DNA sequencing and transcriptome-wide RNA sequencing are methodologies that are being applied to equine genomic research. Research in the field of equine genomics continues to expand rapidly as the cost of genotyping and sequencing decreases, resulting in a need for quality bioinformatics software and expertise to appropriately handle both the size and complexity of these data. PMID:24802051

  17. Applying Evolutionary Anthropology

    PubMed Central

    Gibson, Mhairi A; Lawson, David W

    2015-01-01

    Evolutionary anthropology provides a powerful theoretical framework for understanding how both current environments and legacies of past selection shape human behavioral diversity. This integrative and pluralistic field, combining ethnographic, demographic, and sociological methods, has provided new insights into the ultimate forces and proximate pathways that guide human adaptation and variation. Here, we present the argument that evolutionary anthropological studies of human behavior also hold great, largely untapped, potential to guide the design, implementation, and evaluation of social and public health policy. Focusing on the key anthropological themes of reproduction, production, and distribution we highlight classic and recent research demonstrating the value of an evolutionary perspective to improving human well-being. The challenge now comes in transforming relevance into action and, for that, evolutionary behavioral anthropologists will need to forge deeper connections with other applied social scientists and policy-makers. We are hopeful that these developments are underway and that, with the current tide of enthusiasm for evidence-based approaches to policy, evolutionary anthropology is well positioned to make a strong contribution. PMID:25684561

  18. Applied model validation

    NASA Astrophysics Data System (ADS)

    Davies, A. D.

    1985-07-01

    The NBS Center for Fire Research (CFR) conducts scientific research bearing on the fire safety of buildings, vehicles, tunnels and other inhabited structures. Data from controlled fire experiments are collected, analyzed and reduced to the analytical formulas that appear to underly the observed phenomena. These results and more general physical principles are then combined into models to predict the development of environments that may be hostile to humans. This is a progress report of an applied model validation case study. The subject model is Transport of Fire, Smoke and Gases (FAST). Products from a fire in a burn room exit through a connected corridor to outdoors. Cooler counterflow air in a lower layer feeds the fire. The model predicts corridor layer temperatures and thicknesses vs. time, given enclosure, fire and ambient specifications. Data have been collected from 38 tests using several fire sizes, but have not been reduced. Corresponding model results, and model and test documentation are yet to come. Considerable modeling and calculation is needed to convert instrument readings to test results comparable with model outputs so that residual differences may be determined.

  19. Evaluating Nursing Students' Clinical Performance.

    PubMed

    Koharchik, Linda; Weideman, Yvonne L; Walters, Cynthia A; Hardy, Elaine

    2015-10-01

    This article is one in a series on the roles of adjunct clinical faculty and preceptors, who teach nursing students to apply knowledge in clinical settings. This article describes aspects of the student evaluation process, which should involve regular feedback and clearly stated performance expectations. PMID:26402292

  20. Applied Historical Astronomy

    NASA Astrophysics Data System (ADS)

    Stephenson, F. Richard

    2014-01-01

    F. Richard Stephenson has spent most of his research career -- spanning more than 45 years -- studying various aspects of Applied Historical Astronomy. The aim of this interdisciplinary subject is the application of historical astronomical records to the investigation of problems in modern astronomy and geophysics. Stephenson has almost exclusively concentrated on pre-telescopic records, especially those preserved from ancient and medieval times -- the earliest reliable observations dating from around 700 BC. The records which have mainly interested him are of eclipses (both solar and lunar), supernovae, sunspots and aurorae, and Halley's Comet. The main sources of early astronomical data are fourfold: records from ancient and medieval East Asia (China, together with Korea and Japan); ancient Babylon; ancient and medieval Europe; and the medieval Arab world. A feature of Stephenson's research is the direct consultation of early astronomical texts in their original language -- either working unaided or with the help of colleagues. He has also developed a variety of techniques to help interpret the various observations. Most pre-telescopic observations are very crude by present-day standards. In addition, early motives for skywatching were more often astrological rather than scientific. Despite these drawbacks, ancient and medieval astronomical records have two remarkable advantages over modern data. Firstly, they can enable the investigation of long-term trends (e.g. in the terrestrial rate of rotation), which in the relatively short period covered by telescopic observations are obscured by short-term fluctuations. Secondly, over the lengthy time-scale which they cover, significant numbers of very rare events (such as Galactic supernovae) were reported, which have few -- if any-- counterparts in the telescopic record. In his various researches, Stephenson has mainly focused his attention on two specific topics. These are: (i) long-term changes in the Earth's rate of

  1. Essays in applied microeconomics

    NASA Astrophysics Data System (ADS)

    Wang, Xiaoting

    In this dissertation I use Microeconomic theory to study firms' behavior. Chapter One introduces the motivations and main findings of this dissertation. Chapter Two studies the issue of information provision through advertisement when markets are segmented and consumers' price information is incomplete. Firms compete in prices and advertising strategies for consumers with transportation costs. High advertising costs contribute to market segmentation. Low advertising costs promote price competition among firms and improves consumer welfare. Chapter Three also investigates market power as a result of consumers' switching costs. A potential entrant can offer a new product bundled with an existing product to compensate consumers for their switching cost. If the primary market is competitive, bundling simply plays the role of price discrimination, and it does not dominate unbundled sales in the process of entry. If the entrant has market power in the primary market, then bundling also plays the role of leveraging market power and it dominates unbundled sales. The market for electric power generation has been opened to competition in recent years. Chapter Four looks at issues involved in the deregulated electricity market. By comparing the performance of the competitive market with the social optimum, we identify the conditions under which market equilibrium generates socially efficient levels of electric power. Chapter Two to Four investigate the strategic behavior among firms. Chapter Five studies the interaction between firms and unemployed workers in a frictional labor market. We set up an asymmetric job auction model, where two types of workers apply for two types of job openings by bidding in auctions and firms hire the applicant offering them the most profits. The job auction model internalizes the determination of the share of surplus from a match, therefore endogenously generates incentives for an efficient division of the matching surplus. Microeconomic

  2. Applied large eddy simulation.

    PubMed

    Tucker, Paul G; Lardeau, Sylvain

    2009-07-28

    Large eddy simulation (LES) is now seen more and more as a viable alternative to current industrial practice, usually based on problem-specific Reynolds-averaged Navier-Stokes (RANS) methods. Access to detailed flow physics is attractive to industry, especially in an environment in which computer modelling is bound to play an ever increasing role. However, the improvement in accuracy and flow detail has substantial cost. This has so far prevented wider industrial use of LES. The purpose of the applied LES discussion meeting was to address questions regarding what is achievable and what is not, given the current technology and knowledge, for an industrial practitioner who is interested in using LES. The use of LES was explored in an application-centred context between diverse fields. The general flow-governing equation form was explored along with various LES models. The errors occurring in LES were analysed. Also, the hybridization of RANS and LES was considered. The importance of modelling relative to boundary conditions, problem definition and other more mundane aspects were examined. It was to an extent concluded that for LES to make most rapid industrial impact, pragmatic hybrid use of LES, implicit LES and RANS elements will probably be needed. Added to this further, highly industrial sector model parametrizations will be required with clear thought on the key target design parameter(s). The combination of good numerical modelling expertise, a sound understanding of turbulence, along with artistry, pragmatism and the use of recent developments in computer science should dramatically add impetus to the industrial uptake of LES. In the light of the numerous technical challenges that remain it appears that for some time to come LES will have echoes of the high levels of technical knowledge required for safe use of RANS but with much greater fidelity. PMID:19531503

  3. Clinical challenge.

    PubMed

    2016-09-01

    Questions for this month's clinical challenge are based on articles in this issue. The clinical challenge is endorsed by the RACGP Quality Improvement and Continuing Professional Development (QI&CPD) program and has been allocated four Category 2 points (Activity ID:59922). Answers to this clinical challenge are available immediately following successful completion online at http://gplearning.racgp.org.au. Clinical challenge quizzes may be completed at any time throughout the 2014-16 triennium; therefore, the previous months' answers are not published. Each of the questions or incomplete statements below is followed by four suggested answers or completions. Select the most appropriate statement as your answer. PMID:27606376

  4. Essays in applied economics

    NASA Astrophysics Data System (ADS)

    Arano, Kathleen

    Three independent studies in applied economics are presented. The first essay looks at the US natural gas industrial sector and estimates welfare effects associated with the changes in natural gas regulatory policy over the past three decades. Using a disequilibrium model suited to the natural gas industry, welfare transfers and deadweight losses are calculated. Results indicate that deregulation policies, beginning with the NGPA of 1978, have caused the industry to become more responsive to market conditions. Over time, regulated prices converge toward the estimated equilibrium prices. As a result of this convergence, deadweight losses associated with regulation are also diminished. The second essay examines the discounted utility model (DU), the standard model used for intertemporal decision-making. Prior empirical studies challenge the descriptive validity of the model. This essay addresses the four main inconsistencies that have been raised: domain dependence, magnitude effects, time effects, and gain/loss asymmetries. These inconsistencies, however, may be the result of the implicit assumption of linear utility and not a failure of the DU model itself. In order to test this hypothesis, data was collected from in-class surveys of economics classes at Mississippi State University. A random effects model for panel data estimation which accounts for individual specific effects was then used to impute discount rates measured in terms of dollars and utility. All four inconsistencies were found to be present when the dollar measures were used. Using utility measures of the discount rate resolved the inconsistencies in some cases. The third essay brings together two perspectives in the study of religion and economics: modeling religious behavior using economic tools and variables, and modeling economic behavior using religious variables. A system of ordered probit equations is developed to simultaneously model religious activities and economic outcomes. Using data

  5. Applied Behavior Analysis in Education.

    ERIC Educational Resources Information Center

    Cooper, John O.

    1982-01-01

    Applied behavioral analysis in education is expanding rapidly. This article describes the dimensions of applied behavior analysis and the contributions this technology offers teachers in the area of systematic applications, direct and daily measurement, and experimental methodology. (CJ)

  6. The Routledge Applied Linguistics Reader

    ERIC Educational Resources Information Center

    Wei, Li, Ed.

    2011-01-01

    "The Routledge Applied Linguistics Reader" is an essential collection of readings for students of Applied Linguistics. Divided into five sections: Language Teaching and Learning, Second Language Acquisition, Applied Linguistics, Identity and Power and Language Use in Professional Contexts, the "Reader" takes a broad interpretation of the subject…

  7. Clinical Trials

    MedlinePlus

    ... of visits, and any adjustments to treatment. (back) Requirements for Participation Admission into a clinical trial is based on a rigid set of requirements. You must be diagnosed with the illness that ...

  8. Clinical neuroimaging

    SciTech Connect

    Theodore, W.H.

    1988-01-01

    This book contains chapters on neuroimaging. Included are the following chapters: diagnostic neuroimaging in stroke, position emission tomography in cerebrovascular disease: clinical applications, and neuroradiologic work-up of brain tumors.

  9. Applying comprehensive geriatric assessment to investigate falls.

    PubMed

    Rodgers, Geraldine

    2016-04-01

    This is the second article in a short series that presents case study examples of the use of comprehensive geriatric assessment (CGA) in different clinical settings. CGA is a holistic assessment model designed to determine frail older people's medical and mental health status, as well as functional, social and environmental issues. When applied by nurses, it can enable individualised planning for health, safety and wellbeing. This article presents the case of an older man who had a three-month history of falls. After his most recent fall he was admitted to an emergency department, where examination identified no significant abnormal pathology, and subsequently to a nurse-led older person's clinic. The article describes how a CGA approach was adopted to assess the man, establish an underlying diagnosis of Parkinson's disease, and develop a personalised care plan to address immediate falls risk and long-term planning. PMID:27029990

  10. Motivating employees. Applying motivational theories to nursing.

    PubMed

    Pustai, I

    1989-12-01

    Managers provide the critical link between the delivery of nursing care and the administration. It is vital for nurse managers to provide a work environment that supports professional nursing practices. Staff nurses are taught how to carry out clinical functions. For them to develop and practice advanced clinical skills, managers have to buffer the pressures of daily operations. They must ask themselves, "Am I committed to my employees?" "Am I an enthusiastic role model for my employees?" "Do I use positive motivating techniques?" "Do I know each of my employees personally as a unique individual?" "What can I do to create an environment that supports my employees?" and "How can I make each of my employees feel respected and worthy?" If the manager, whether experienced or not, can answer these questions honestly and apply motivational techniques differently, he or she will be the best kind of manager: a true leader. PMID:2619295

  11. HEAVY-ION IMAGING APPLIED TO MEDICINE

    SciTech Connect

    Fabrikant, J.I.; Tobias, C.A.; Capp, M.P.; Benton, E.V.; Holley, W.R.

    1980-02-01

    Heavy particle radiography is a newly developed noninvasive low dose imaging procedure with increased resolution of minute density differences in soft tissues of the body. The method utilizes accelerated high energy ions, primarily carbon and neon, at the BEVALAC accelerator at the Lawrence Berkeley Laboratory. The research program applied to medicine utilizes heavy-ion radiography for low dose mammography, for treatment planning for cancer patients, and for imaging and accurate densitometry of skeletal structures and brain and spinal neoplasms. The presentation will be illustrated with clinical cases under study. Discussion will include the potential of heavy-ion imaging, and particularly reconstruction tomography, as an adjunct to existing diagnostic imaging procedures in medicine, both for the applications to the diagnosis, management and treatment of clinical cancer in man, but also for the early detection of small soft tissue tumors at low radiation dose.

  12. Implementing Peer Evaluation of Clinical Teaching

    ERIC Educational Resources Information Center

    Laske, Rita Ann

    2013-01-01

    Clinical education provides the nursing student opportunities to learn the practice of nursing. In the clinical setting, the nursing student applies classroom knowledge to the real patient care situation. The clinical instructor facilitates this important process by assisting students to integrate knowledge into their practice, improve their…

  13. Effective Mentoring in the Clinical Setting.

    PubMed

    Shellenbarger, Teresa; Robb, Meigan

    2016-04-01

    This article is one in a series on the roles of adjunct clinical faculty and preceptors, who teach nursing students and new graduates to apply knowledge in clinical settings. This article describes mentoring strategies clinical instructors and preceptors can use to help ease novice nurses' transition to practice. PMID:27011145

  14. Applied Academics. Applied Mathematics: Drafting. Curriculum Bulletin VE-53.

    ERIC Educational Resources Information Center

    Cincinnati Public Schools, OH. Div. of Student Services.

    This publication contains the Applied Mathematics Curriculum (Drafting) for grades 11 and 12 for the Cincinnati (Ohio) Public Schools. The curriculum is part of a larger program (the Applied Academics Program), which emphasizes the integration of mathematics and the language arts with vocational content. Included in the document is a description…

  15. CLINICAL PEARL

    PubMed Central

    Mazefsky, Carla A.; Minshew, Nancy J.

    2013-01-01

    Autism spectrum disorders are defined behaviorally by the Diagnostic and Statistical Manual (DSM) IV-TR based on abnormal development in social interaction and communication and restricted, repetitive, and stereotyped patterns of behaviors and interests that are evident before the age of 3. After decades of debate, research has demonstrated that the distinctions among autism, Asperger disorder, and pervasive developmental disorder not otherwise specified are neither clinically reliable nor based on valid neurobiological or genetic differences. The fifth edition of the DSM therefore proposes to collapse all of the clinical syndromes under the single diagnosis of autism spectrum disorder (ASD). PMID:23186793

  16. Clinical cytomics

    NASA Astrophysics Data System (ADS)

    Tárnok, Attila; Mittag, Anja; Lenz, Dominik

    2006-02-01

    The goal of predictive medicine is the detection of changes in patient's state prior to the clinical manifestation of the deterioration of the patients current status. Therefore, both the diagnostic of diseases like cancer, coronary atherosclerosis or congenital heart failure and the prognosis of the effect specific therapeutics on patients outcome are the main fields of predictive medicine. Clinical Cytomcs is based on the analysis of specimens from the patient by Cytomic technologies that are mainly imaging based techniques and their combinations with other assays. Predictive medicine aims at the recognition of the "fate" of each individual patients in order to yield unequivocal indications for decision making (i.e. how does the patient respond to therapy, react to medication etc.). This individualized prediction is based on the Predictive Medicine by Clinical Cytomics concept. These considerations have recently stimulated the idea of the Human Cytome Project. A major focus of the Human Cytome Project is multiplexed cy-tomic analysis of individual cells of the patient, extraction of predictive information and individual prediction that merges into individualized therapy. Although still at the beginning, Clinical Cytomics is a promising new field that may change therapy in the near future for the benefit of the patients.

  17. Applied Linguistics in Society. Papers from the Annual Meeting of the British Association for Applied Linguistics (20th, Nottingham, England, United Kingdom, September 1987). British Studies in Applied Linguistics, 3.

    ERIC Educational Resources Information Center

    Grunwell, Pamela, Ed.

    A selection of papers from the 1987 meeting of the applied linguistics association includes the following: "Applied Linguistics in Society" (John Trim); "European Developments in Applied Linguistics" (Theo van Els); "Translation and Interpretation: Retrospect and Prospect" (Peter Newmark); "Clinical Linguistics: Retrospect and Prospect" (Pamela…

  18. The Fleming Applied Projects Program

    ERIC Educational Resources Information Center

    Spasov, Peter

    2004-01-01

    Applied Projects is a program where every technology student engages in an intensive team project full time during the final academic semester. A wide range of enterprises provide the real-world problems that form the basis of student projects. This article describes the program and how Fleming College uses this program for applied research. To…

  19. Writing, Literacy, and Applied Linguistics.

    ERIC Educational Resources Information Center

    Leki, Ilona

    2000-01-01

    Discusses writing and literacy in the domain of applied linguistics. Focus is on needs analysis for literacy acquisition; second language learner identity; longitudinal studies as extensions of identity work; and applied linguistics contributions to second language literacy research. (Author/VWL)

  20. Clinical biochemistry

    NASA Technical Reports Server (NTRS)

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.

    1975-01-01

    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  1. Applied photonic therapy in veterinary medicine

    NASA Astrophysics Data System (ADS)

    Wood, Terry R.; McLaren, Brian C.

    2005-04-01

    There can be no question that specific systemic physiological results occur, when red light (660nm) is applied to the skin, it is now more a question of detailed mechanisms. Before gathering statistically signifcant clinical trial data, it is important to first enumerate the type of results observed in practice. Case histories are presented highlighting the use of photonic therapy in veterinary medicine. Over 900 surgical procedures have been performed and documented, utilizing the principles of photonic therapy, and while hemostasis, pain relief, and nausea relief, were the primary goals, the peri-operative death rate, the post-operative seroma, and post-operative infection were reduced to almost zero, and there was a noticeable increase in the healing rate. Scientifically applied photonic therapy, rather than supplanting conventional veterinary medicine, compliments and increases the veterinarian's set of skills. This paper proposes a hypothesis of how 660 nm light applied to specific points on the skin, produces various physiological changes in animals. By using animals, there can be no placebo, hypnotic or psychosomatic confounding effects.

  2. Towards open applied Earth sciences

    EPA Science Inventory

    Concepts of open science -- in the context of cyber/digital technology and culture -- could greatly benefit applied and secondary Earth science efforts. However, international organizations (e.g., environmental agencies, conservation groups and sustainable development organizatio...

  3. An Excursion in Applied Mathematics.

    ERIC Educational Resources Information Center

    von Kaenel, Pierre A.

    1981-01-01

    An excursion in applied mathematics is detailed in a lesson deemed well-suited for the high school student or undergraduate. The problem focuses on an experimental missile guidance system simulated in the laboratory. (MP)

  4. Memory clinics

    PubMed Central

    Jolley, D; Benbow, S M; Grizzell, M

    2006-01-01

    Memory clinics were first described in the 1980s. They have become accepted worldwide as useful vehicles for improving practice in the identification, investigation, and treatment of memory disorders, including dementia. They are provided in various settings, the setting determining clientele and practice. All aim to facilitate referral from GPs, other specialists, or by self referral, in the early stages of impairment, and to avoid the stigma associated with psychiatric services. They bring together professionals with a range of skills for the benefit of patients, carers, and colleagues, and contribute to health promotion, health education, audit, and research, as well as service to patients. PMID:16517802

  5. Clinical arthrography

    SciTech Connect

    Arndt, R.; Horns, J.W.; Gold, R.H.; Blaschke, D.D.

    1985-01-01

    This book deals with the method and interpretation of arthrography of the shoulder, knee, ankle, elbow, hip, wrist, and metacarpophalangeal, interphalangeal, and temporomandibular joints. The emphasis is on orthopaedic disorders, usually of traumatic origin, which is in keeping with the application of arthrography in clinical practice. Other conditions, such as inflammatory and degenerative diseases, congenital disorders and, in the case of the hip, arthrography of reconstructive joint surgery, are included. Each chapter is devoted to one joint and provides a comprehensive discussion on the method of arthrography, including single and double contrast techniques where applicable, normal radiographic anatomy, and finally, the interpretation of the normal and the abnormal arthrogram.

  6. Integrated clinical information system.

    PubMed

    Brousseau, G

    1995-01-01

    contains personalized profiles: questionnaires based on the predetermined choices of the information most relevant to the specific user. The SIDOCI clinical dictionary also includes the hospital's suggested or mandatory interventions, clinical guidelines, and protocols. These clinical guidelines are customized at the hospital, service, and professional levels. Common interventions have been regrouped so that health professionals may apply the appropriate diagnostic, therapeutic, educational, or other intervention plans. The clinical dictionary also serves as a teaching and continuing education tool. The patient profile is a permanent record containing information on allergies, blood type, primary and secondary diagnoses, ongoing treatments, and prior hospitalizations. The problem list dealing with the current hospitalization includes symptoms, signs, and diagnoses. This standard clinical record facilitates communication between the services and provides a quick overview of the patient's history should emergency treatment be required. This health information system integrates Requests and Results, Progress Notes, and Analysis of the results. In addition, functions inherent to a patient's clinical cycle such as Administrative Management of episodes, Adaptation to physical and professional structures of the hospital, Messages between health professionals, and Electronic signature constitute the basis of SIDOCI. The most exciting aspect of this research project is its social impact: a more efficient health care system will improve the lives of all citizens. Moreover this applied research project involves the information industry and directly calls for the input of users such as doctors, nurses and hospital support staff. PMID:8591228

  7. Applied Remote Sensing Program (ARSP)

    NASA Technical Reports Server (NTRS)

    Johnson, J. D.; Foster, K. E.; Mouat, D. A.; Miller, D. A.; Conn, J. S.

    1976-01-01

    The activities and accomplishments of the Applied Remote Sensing Program during FY 1975-1976 are reported. The principal objective of the Applied Remote Sensing Program continues to be designed projects having specific decision-making impacts as a principal goal. These projects are carried out in cooperation and collaboration with local, state and federal agencies whose responsibilities lie with planning, zoning and environmental monitoring and/or assessment in the application of remote sensing techniques. The end result of the projects is the use by the involved agencies of remote sensing techniques in problem solving.

  8. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  9. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  10. Defining and Applying a Functionality Approach to Intellectual Disability

    ERIC Educational Resources Information Center

    Luckasson, R.; Schalock, R. L.

    2013-01-01

    Background: The current functional models of disability do not adequately incorporate significant changes of the last three decades in our understanding of human functioning, and how the human functioning construct can be applied to clinical functions, professional practices and outcomes evaluation. Methods: The authors synthesise current…

  11. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  12. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  13. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  14. Topical and Applied Interests of Introductory Psychology Students

    ERIC Educational Resources Information Center

    Stalder, Daniel R.; Stec, Deborah A.

    2007-01-01

    Using forced-choice and continuous measures, introductory psychology students reported highest interest for the topical areas of clinical and social psychology (over biological, cognitive, and developmental) and for the applied areas of education and health (over business, environment, and law) at both the beginning and end of semesters. Among…

  15. The Representation of Applied Psychology Areas in Introductory Psychology Textbooks

    ERIC Educational Resources Information Center

    Haselhuhn, Charlotte W.; Clopton, Kerri L.

    2008-01-01

    Many psychology majors indicate helping others as a reason for majoring in psychology, yet many enter positions not closely related to the field. This discrepancy may be due to a lack of student knowledge of the applied areas of psychology. The purpose of this study was to investigate the coverage of clinical, counseling,…

  16. 42 CFR 68a.3 - Who is eligible to apply?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Who is eligible to apply? 68a.3 Section 68a.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM FOR INDIVIDUALS...

  17. 42 CFR 68a.3 - Who is eligible to apply?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Who is eligible to apply? 68a.3 Section 68a.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM FOR INDIVIDUALS...

  18. CURRENT TRENDS IN APPLIED LINGUISTICS.

    ERIC Educational Resources Information Center

    KACHRU, BRAJ B.

    WITH PROGRESS IN THEORETICAL AND APPLIED LINGUISTICS, THE APPLICATION OF LINGUISTICS TO LANGUAGE TEACHING HAS COME UNDER INCREASING SCRUTINY. WHILE THE STRUCTURALISTS HAVE FOUND COMPETITION IN THE MORE RECENT CONCEPTS OF THE COMPETENCE-ORIENTED AND THE PERFORMANCE-ORIENTED APPROACHES, AND MENTALISTIC THEORIES SEEM TO PROVIDE MORE EXPLANATIONS THAN…

  19. Applied aerodynamics: Challenges and expectations

    NASA Technical Reports Server (NTRS)

    Peterson, Victor L.; Smith, Charles A.

    1993-01-01

    Aerospace is the leading positive contributor to this country's balance of trade, derived largely from the sale of U.S. commercial aircraft around the world. This powerfully favorable economic situation is being threatened in two ways: (1) the U.S. portion of the commercial transport market is decreasing, even though the worldwide market is projected to increase substantially; and (2) expenditures are decreasing for military aircraft, which often serve as proving grounds for advanced aircraft technology. To retain a major share of the world market for commercial aircraft and continue to provide military aircraft with unsurpassed performance, the U.S. aerospace industry faces many technological challenges. The field of applied aerodynamics is necessarily a major contributor to efforts aimed at meeting these technological challenges. A number of emerging research results that will provide new opportunities for applied aerodynamicists are discussed. Some of these have great potential for maintaining the high value of contributions from applied aerodynamics in the relatively near future. Over time, however, the value of these contributions will diminish greatly unless substantial investments continue to be made in basic and applied research efforts. The focus: to increase understanding of fluid dynamic phenomena, identify new aerodynamic concepts, and provide validated advanced technology for future aircraft.

  20. Applied Linguistics Research on Asianness

    ERIC Educational Resources Information Center

    Kobayashi, Yoko

    2011-01-01

    As China is increasingly occupying the world's attention, its explosively expanding economical and political clout has also been felt in the applied linguistics domain, with the discussion on China's/Chinese language issues growing by leaps and bounds (e.g. China's English education policies, Chinese language classes in the West). Amid the world's…

  1. Conditional Independence in Applied Probability.

    ERIC Educational Resources Information Center

    Pfeiffer, Paul E.

    This material assumes the user has the background provided by a good undergraduate course in applied probability. It is felt that introductory courses in calculus, linear algebra, and perhaps some differential equations should provide the requisite experience and proficiency with mathematical concepts, notation, and argument. The document is…

  2. Applied Mathematics for Earth Scientists

    NASA Astrophysics Data System (ADS)

    Merrill, Ronald T.

    Writing an applied mathematics book can be hazardous to one's ego. First, there typically are strong and incompatible opinions on what should go into such a book, and second, there are already many excellent applied mathematics books on the market. Nevertheless, three prestigious geophysicists from Toyko University, Rikitake, Sato, and Hagiwara, have correctly identified a niche to be filled in this competitive market, and they have attempted to fill it with the publication of Applied Mathematics for Earth Sciences.A more appropriate title for this book might be “Applied Mathematics for Geophysicists” it is at geophysicists and not at, say, stratigraphers that the book is aimed. The book is divided into Part I, Fundamentals (164 pages) and Part II, Applications (271 pages). The main subtitles of Part I are, in order, Fourier transform, Laplace transform, Heaviside operator, spectral analysis, special functions, Laplace equation, wave equation, and relaxation method. As separate books have been written on virtually all of these topics, one can correctly anticipate that the material presented here will be very condensed. The applications part consists of 10 chapters of examples that draw strongly on papers published by the authors. Seismology constitutes roughly a third of the applications part, with the remainder going to selected topics on Earth's gravity, rotation and tides, heat conduction, magnetic and electrical potentials, electromagnetic induction, and magnetohydrodynamics. Emphasis throughout the book is placed on selected analytical theory, as opposed to methods of numerical analysis.

  3. Toward an Applied Administrative Science.

    ERIC Educational Resources Information Center

    Dunbar, Roger L. M.

    1983-01-01

    A study of 65 articles from the 1981 volumes of "Administrative Science Quarterly" and "Harvard Business Review," using smallest space analysis, found that the few studies adopting subjective (instead of objective) approaches to analyzing organizational change were most likely to provide a basis for an applied administrative science. (Author/RW)

  4. Applied Remote Sensing Program (ARSP)

    NASA Technical Reports Server (NTRS)

    Mouat, D. A.; Johnson, J. D.; Foster, K. E.

    1977-01-01

    Descriptions of projects engaged by the Applied Remote Sensors Program in the state of Arizona are contained in an annual report for the fiscal year 1976-1977. Remote sensing techniques included thermal infrared imagery in analog and digital form and conversion of data into thermograms. Delineation of geologic areas, surveys of vegetation and inventory of resources were also presented.

  5. Applied Mathematics. Florida Teaching Supplement.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.

    The information in this supplementary notebook is intended to provide teachers with additional materials, ideas and suggestions, and activities to help in implementing the first 21 units of the Applied Mathematics modules that help develop and refine job-related mathematics skills. An introduction lists the 36 units of the complete Applied…

  6. Case Studies in Applied Mathematics.

    ERIC Educational Resources Information Center

    Mathematical Association of America, Washington, DC.

    This collection of nine case studies in applied mathematics was written primarily for the use of the instructor by a Conference sponsored by the Committee on the Undergraduate Program in Mathematics (CUPM). Each chapter contains exercises of varying degrees of difficulty and several include student projects. The materials were used on a trial…

  7. Applied Economics. Curriculum Review Project.

    ERIC Educational Resources Information Center

    Butler, Judy D.

    This paper provides a review of "Applied Economics," a curriculum package developed by Junior Achievement, Inc. (Colorado Springs, Colorado). The materials are used in high schools across the nation and provide students an opportunity to study economics, learn about the U.S. free enterprise system, and explore their roles as citizens, producers,…

  8. Clinical research in allied health.

    PubMed

    Selker, L G

    1994-01-01

    Allied health professionals in nutrition and medical dietetics, occupational therapy, physical therapy, and speech-language pathology and audiology play both unique and key cross-cutting roles in the furtherance of clinical research. Clinical research in nutrition and medical dietetics uniquely focuses on food nutrient intake and the metabolic utilization of nutrients. Clinical research in occupational therapy has a special focus on the relationship of impairment to disability, the adaptation to disability and the maximization of function. Physical therapy clinical research uniquely targets movement dysfunction and its evaluation and treatment within the context of quality and effective care. Clinical research in speech-language pathology and audiology is singular in its focus on deafness and hearing disorders, voice, speech, language and related disorders, and intersections among these and other neurological and physical conditions. Thus, all of these disciplines are making unique contributions to clinical research. Clinical research in these allied health professions is much more than the above specific foci. Inasmuch as these disciplines are rooted in practice, their contributions to research are inherently clinical. Many, if not most, of these contributions represent further validations of clinical practice or its underlying knowledge base. This means that, at a macro level, clinical research in allied health is very much "applied" research. Within allied health clinical research, this emphasis is redoubled at the "person," or individual level, where considerable attention is given to concepts of function and effectiveness. Clinical research in allied health has played a key cross-cutting role through its emphasis on collaboration. Possibly due to their professional maturation within multidisciplinary academic units, allied health professionals have demonstrated a level of comfort with multidisciplinary and interdisciplinary collaborations unique within many

  9. Applied physiology at the bedside to drive resuscitation algorithms

    PubMed Central

    Holder, Andre L.; Pinsky, Michael R.

    2014-01-01

    Hemodynamic instability is associated with significant morbidity and mortality. Goal-directed therapeutic algorithms have been used in various clinical settings to reverse or prevent organ damage and death that could occur with a low oxygen delivery state. Most current resuscitative algorithms use static physiologic measures to determine if a patient will respond to proven therapies. While static parameters are useful in identifying the potential for clinical instability, they cannot tell us how patients will respond to an intervention. Applied physiology, through the use of functional hemodynamic monitoring can predict the body's reaction to therapy because they are based on cardiovascular dynamics. A growing body of evidence supports the use of applied physiologic principles in goal directed therapeutic algorithms for appropriate and effective resuscitation/optimization. Over time, applied physiology should be incorporated into standardized protocol-driven care to improve outcomes in patients experiencing, or at risk for hemodynamic instability. PMID:25479921

  10. Enhancing clinical evidence by proactively building quality into clinical trials

    PubMed Central

    Meeker-O’Connell, Ann; Glessner, Coleen; Behm, Mark; Mulinde, Jean; Roach, Nancy; Sweeney, Fergus; Tenaerts, Pamela; Landray, Martin J

    2016-01-01

    Background: Stakeholders across the clinical trial enterprise have expressed concern that the current clinical trial enterprise is unsustainable. The cost and complexity of trials have continued to increase, threatening our ability to generate reliable evidence essential for making appropriate decisions concerning the benefits and harms associated with clinical interventions. Overcoming this inefficiency rests on improving protocol design, trial planning, and quality oversight. Methods: The Clinical Trials Transformation Initiative convened a project to evaluate methods to prospectively build quality into the scientific and operational design of clinical trials (“quality-by-design”), such that trials are feasible to conduct and important errors are prevented rather than remediated. A working group evaluated aspects of trial design and oversight and developed the Clinical Trials Transformation Initiative quality-by-design principles document, outlining a series of factors generally relevant to the reliability of trial conclusions and to patient safety. These principles were then applied and further refined during a series of hands-on workshops to evaluate their utility in facilitating proactive, cross-functional dialogue, and decision-making about trial design and planning. Following these workshops, independent qualitative interviews were conducted with 19 workshop attendees to explore the potential challenges for implementing a quality-by-design approach to clinical trials. The Clinical Trials Transformation Initiative project team subsequently developed recommendations and an online resource guide to support implementation of this approach. Conclusion: The Clinical Trials Transformation Initiative quality-by-design principles provide a framework for assuring that clinical trials adequately safeguard participants and provide reliable information on which to make decisions on the effects of treatments. The quality-by-design workshops highlighted the value of

  11. Towards clinical bioethics (or a return to clinical ethics?).

    PubMed

    Petrini, C

    2013-01-01

    Medical ethics has traditionally been oriented towards the clinical setting. Since the middle of the last century, however, various circumstances (associated mainly, though not exclusively, with rapid advances in technology and knowledge) have considerably broadened both the field of enquiry and the scope of this discipline. This is due partly to the overlap between medical ethics and bioethics, which in recent decades has acquired its own identity and concerns a multitude of ethical aspects in the biomedical field. Clinical ethics taps into the vast wealth of deontology, so that it has no need for additional criteria or principles, or for the definition of new values: rather, it recognizes the need to apply existing criteria, principles and values to contingent circumstances and contexts. A special role is reserved for ethics committees and, above all, for clinical ethics consultants, although in some countries the former are concerned mainly with authorisations for clinical trials. Clinical ethics consultants, however, may have a more incisive influence in clinical decisions: the special requisites and skills they need have been defined and discussed in various documents which are mentioned briefly in the present article. The presence of these consultants does not exonerate clinical physicians from their responsibilities or from liability for their decisions, in the formation of which they must refer constantly to codes of professional ethics. PMID:24424236

  12. METHOD OF APPLYING METALLIC COATINGS

    DOEpatents

    Robinson, J.W.; Eubank, L.D.

    1961-08-01

    A method for applying a protective coating to a uranium rod is described. The steps include preheating the unanium rod to the coating temperature, placement of the rod between two rotating rollers, pouring a coating metal such as aluminum-silicon in molten form between one of the rotating rollers and the uranium rod, and rotating the rollers continually until the coating is built up to the desired thickness. (AEC)

  13. An Applied Physicist Does Econometrics

    NASA Astrophysics Data System (ADS)

    Taff, L. G.

    2010-02-01

    The biggest problem those attempting to understand econometric data, via modeling, have is that economics has no F = ma. Without a theoretical underpinning, econometricians have no way to build a good model to fit observations to. Physicists do, and when F = ma failed, we knew it. Still desiring to comprehend econometric data, applied economists turn to mis-applying probability theory---especially with regard to the assumptions concerning random errors---and choosing extremely simplistic analytical formulations of inter-relationships. This introduces model bias to an unknown degree. An applied physicist, used to having to match observations to a numerical or analytical model with a firm theoretical basis, modify the model, re-perform the analysis, and then know why, and when, to delete ``outliers'', is at a considerable advantage when quantitatively analyzing econometric data. I treat two cases. One is to determine the household density distribution of total assets, annual income, age, level of education, race, and marital status. Each of these ``independent'' variables is highly correlated with every other but only current annual income and level of education follow a linear relationship. The other is to discover the functional dependence of total assets on the distribution of assets: total assets has an amazingly tight power law dependence on a quadratic function of portfolio composition. Who knew? )

  14. Towards "open applied" Earth sciences

    NASA Astrophysics Data System (ADS)

    Ziegler, C. R.; Schildhauer, M.

    2014-12-01

    Concepts of open science -- in the context of cyber/digital technology and culture -- could greatly benefit applied and secondary Earth science efforts. However, international organizations (e.g., environmental agencies, conservation groups and sustainable development organizations) that are focused on applied science have been slow to incorporate open practices across the spectrum of scientific activities, from data to decisions. Myriad benefits include transparency, reproducibility, efficiency (timeliness and cost savings), stakeholder engagement, direct linkages between research and environmental outcomes, reduction in bias and corruption, improved simulation of Earth systems and improved availability of science in general. We map out where and how open science can play a role, providing next steps, with specific emphasis on applied science efforts and processes such as environmental assessment, synthesis and systematic reviews, meta-analyses, decision support and emerging cyber technologies. Disclaimer: The views expressed in this paper are those of the authors and do not necessarily reflect the views or policies of the organizations for which they work and/or represent.

  15. Applied Pharmacogenomics in Cardiovascular Medicine

    PubMed Central

    Weeke, Peter; Roden, Dan M.

    2014-01-01

    Interindividual heterogeneity in drug response is a central feature of all drug therapies. Studies in individual patients, families, and populations over the past several decades have identified variants in genes encoding drug elimination or drug target pathways that in some cases contribute substantially to variable efficacy and toxicity. Important associations of pharmacogenomics in cardiovascular medicine include clopidogrel and risk for in-stent thrombosis, steady-state warfarin dose, myotoxicity with simvastatin, and certain drug-induced arrhythmias. This review describes methods used to accumulate and validate these findings and points to approaches—now being put in place at some centers—to implementing them in clinical care. PMID:24111889

  16. Nose: Applied Aspects in Dermatology.

    PubMed

    Lakshmi, Dammaningala Venkataramaiah; Shilpa, Kanathur; Nataraja, Holavanahally Veerabhadrappa; Divya, Kallapa Gorur

    2016-01-01

    Nose is the most prominent part of the mid-face and has important physiological, aesthetic and psychological functions. Skin diseases on the nose are commonly seen by dermatologists, otorhinolaryngologists, and plastic surgeons. Because of its exposed, highly visible localization, lesions on the skin of the nose are often noticed by patients themselves, typically very early in the course of the disease. Similarly, the dermatological lexicon is well known with descriptive terminologies, synonyms, acronyms, eponyms, toponyms, misnomers. We have tried to compile the anatomical applications of nose in cosmetology and dermatosurgery subspecialities with nasal eponyms and signs encountered in clinical dermatology that would be helpful for residents. PMID:27057038

  17. Nose: Applied Aspects in Dermatology

    PubMed Central

    Lakshmi, Dammaningala Venkataramaiah; Shilpa, Kanathur; Nataraja, Holavanahally Veerabhadrappa; Divya, Kallapa Gorur

    2016-01-01

    Nose is the most prominent part of the mid-face and has important physiological, aesthetic and psychological functions. Skin diseases on the nose are commonly seen by dermatologists, otorhinolaryngologists, and plastic surgeons. Because of its exposed, highly visible localization, lesions on the skin of the nose are often noticed by patients themselves, typically very early in the course of the disease. Similarly, the dermatological lexicon is well known with descriptive terminologies, synonyms, acronyms, eponyms, toponyms, misnomers. We have tried to compile the anatomical applications of nose in cosmetology and dermatosurgery subspecialities with nasal eponyms and signs encountered in clinical dermatology that would be helpful for residents. PMID:27057038

  18. Applying critical thinking to nursing.

    PubMed

    Price, Bob

    2015-08-19

    Critical thinking and writing are skills that are not easy to acquire. The term 'critical' is used differently in social and clinical contexts. Nursing students need time to master the inquisitive and ruminative aspects of critical thinking that are required in academic environments. This article outlines what is meant by critical thinking in academic settings, in relation to both theory and reflective practice. It explains how the focus of a question affects the sort of critical thinking required and offers two taxonomies of learning, to which students can refer when analysing essay requirements. The article concludes with examples of analytical writing in reference to theory and reflective practice. PMID:26285997

  19. Talk in Interaction in the Speech-Language Pathology Clinic: Bringing Theory to Practice through Discourse

    ERIC Educational Resources Information Center

    Leaby, Margaret M.; Walsh, Irene P.

    2008-01-01

    The importance of learning about and applying clinical discourse analysis to enhance the talk in interaction in the speech-language pathology clinic is discussed. The benefits of analyzing clinical discourse to explicate therapy dynamics are described.

  20. Electrochemical Sensors for Clinic Analysis

    PubMed Central

    Wang, You; Xu, Hui; Zhang, Jianming; Li, Guang

    2008-01-01

    Demanded by modern medical diagnosis, advances in microfabrication technology have led to the development of fast, sensitive and selective electrochemical sensors for clinic analysis. This review addresses the principles behind electrochemical sensor design and fabrication, and introduces recent progress in the application of electrochemical sensors to analysis of clinical chemicals such as blood gases, electrolytes, metabolites, DNA and antibodies, including basic and applied research. Miniaturized commercial electrochemical biosensors will form the basis of inexpensive and easy to use devices for acquiring chemical information to bring sophisticated analytical capabilities to the non-specialist and general public alike in the future.

  1. Fire retardancy using applied materials

    NASA Technical Reports Server (NTRS)

    Feldman, R.

    1971-01-01

    An example of advanced technology transfer from the Little Joe, Surveyor, Comsat, re-entry and Apollo age to everyday fire protection needs is presented. Utilizing the principle of sublimation cooling for thermostatic temperature control, the material meets a wide range of fire retardancy and heat transmission control requirements. Properties vary from flexible tape for conduits and electrical cables to rigid coatings for column protection, with a broad spectrum of sublimation temperatures available. The material can be applied in the field or in the factory, utilizing mass production techniques, yielding a product that is reliable, effective, widely available and low in cost.

  2. Applying quantum principles to psychology

    NASA Astrophysics Data System (ADS)

    Busemeyer, Jerome R.; Wang, Zheng; Khrennikov, Andrei; Basieva, Irina

    2014-12-01

    This article starts out with a detailed example illustrating the utility of applying quantum probability to psychology. Then it describes several alternative mathematical methods for mapping fundamental quantum concepts (such as state preparation, measurement, state evolution) to fundamental psychological concepts (such as stimulus, response, information processing). For state preparation, we consider both pure states and densities with mixtures. For measurement, we consider projective measurements and positive operator valued measurements. The advantages and disadvantages of each method with respect to applications in psychology are discussed.

  3. Applying STAMP in Accident Analysis

    NASA Technical Reports Server (NTRS)

    Leveson, Nancy; Daouk, Mirna; Dulac, Nicolas; Marais, Karen

    2003-01-01

    Accident models play a critical role in accident investigation and analysis. Most traditional models are based on an underlying chain of events. These models, however, have serious limitations when used for complex, socio-technical systems. Previously, Leveson proposed a new accident model (STAMP) based on system theory. In STAMP, the basic concept is not an event but a constraint. This paper shows how STAMP can be applied to accident analysis using three different views or models of the accident process and proposes a notation for describing this process.

  4. Hypothermia as a clinical neuroprotectant.

    PubMed

    Sherman, Andrew L; Wang, Michael Y

    2014-08-01

    Applying therapeutic hypothermia (TH) for the purposes of neuroprotection, originally termed "hibernation," started nearly 100 years ago. Because TH cooling systems have improved to the point where it is practical and safe for general application, interest in providing such treatment in conditions such as spinal cord injury, traumatic brain injury, stroke, and cardiac arrest has increased. This article reviews the mechanisms by which TH mitigates secondary neurologic injury, the clinical scenarios where TH is being applied, and reviews selected published studies using TH for central nervous system neuroprotection. PMID:25064786

  5. Implementing an Applied Science Program

    NASA Technical Reports Server (NTRS)

    Rickman, Doug; Presson, Joan

    2007-01-01

    The work implied in the NASA Applied Science Program requires a delicate balancing act for the those doing it. At the implementation level there are multiple tensions intrinsic to the program. For example each application of an existing product to a decision support process requires deep knowledge about the data and deep knowledge about the decision making process. It is highly probable no one person has this range of knowledge. Otherwise the decision making process would already be using the data. Therefore, a team is required. But building a team usually requires time, especially across agencies. Yet the program mandates efforts of relatively short duration. Further, those who know the data are scientists, which makes them essential to the program. But scientists are evaluated on their publication record. Anything which diverts a scientist from the research for his next publication is an anathema to him and potential death to their career. Trying to get another agency to use NASA data does not strike most scientists as material inherently suitable for publication. Also, NASA wishes to rapidly implement often substantial changes to another agency's process. For many reasons, such as budget and program constraints, speed is important. But the owner of a decision making process is tightly constrained, usually by law, regulation, organization and custom. Changes when made are slow, cautious, even hesitant, and always done according a process specific to the situation. To manage this work MSFC must balance these and other tensions. Some things we have relatively little control over, such as budget. These we try to handle by structural techniques. For example by insisting all of our people work on multiple projects simultaneously we inherently have diversification of funding for all of our people. In many cases we explicitly use some elements of tension to be productive. For example the need for the scientists to constantly publish is motivation to keep tasks short and

  6. An Introduction to Applied Biogeography

    NASA Astrophysics Data System (ADS)

    Spellerberg, Ian F.; Sawyer, John W. D.

    1999-03-01

    Biogeography is about the geographical distribution, both past and present, of plants, animals and other organisms. In this undergraduate textbook, Spellerberg and Sawyer bring a modern approach to a developing subject, writing in a lively and sometimes provocative manner. Throughout the text, the authors emphasize the applications of biogeography to conservation management, economic production, environmental assessment, sustainable use of resources, landscape planning, and public health. They discuss applications of island biogeography in conservation, the concept of wildlife corridors, the analysis of biogeographical data, and the role of humans and their cultures in biogeography. The applied approach of this textbook, along with its numerous illustrative examples and figures, make it a unique introduction to the field for many geography, biology and environmental science students.

  7. Data Understanding Applied to Optimization

    NASA Technical Reports Server (NTRS)

    Buntine, Wray; Shilman, Michael

    1998-01-01

    The goal of this research is to explore and develop software for supporting visualization and data analysis of search and optimization. Optimization is an ever-present problem in science. The theory of NP-completeness implies that the problems can only be resolved by increasingly smarter problem specific knowledge, possibly for use in some general purpose algorithms. Visualization and data analysis offers an opportunity to accelerate our understanding of key computational bottlenecks in optimization and to automatically tune aspects of the computation for specific problems. We will prototype systems to demonstrate how data understanding can be successfully applied to problems characteristic of NASA's key science optimization tasks, such as central tasks for parallel processing, spacecraft scheduling, and data transmission from a remote satellite.

  8. Ubiquitous Multicriteria Clinic Recommendation System.

    PubMed

    Chen, Toly

    2016-05-01

    Advancements in information, communication, and sensor technologies have led to new opportunities in medical care and education. Patients in general prefer visiting the nearest clinic, attempt to avoid waiting for treatment, and have unequal preferences for different clinics and doctors. Therefore, to enable patients to compare multiple clinics, this study proposes a ubiquitous multicriteria clinic recommendation system. In this system, patients can send requests through their cell phones to the system server to obtain a clinic recommendation. Once the patient sends this information to the system, the system server first estimates the patient's speed according to the detection results of a global positioning system. It then applies a fuzzy integer nonlinear programming-ordered weighted average approach to assess four criteria and finally recommends a clinic with maximal utility to the patient. The proposed methodology was tested in a field experiment, and the experimental results showed that it is advantageous over two existing methods in elevating the utilities of recommendations. In addition, such an advantage was shown to be statistically significant. PMID:26984357

  9. Applying adult learning practices in medical education.

    PubMed

    Reed, Suzanne; Shell, Richard; Kassis, Karyn; Tartaglia, Kimberly; Wallihan, Rebecca; Smith, Keely; Hurtubise, Larry; Martin, Bryan; Ledford, Cynthia; Bradbury, Scott; Bernstein, Henry Hank; Mahan, John D

    2014-07-01

    The application of the best practices of teaching adults to the education of adults in medical education settings is important in the process of transforming learners to become and remain effective physicians. Medical education at all levels should be designed to equip physicians with the knowledge, clinical skills, and professionalism that are required to deliver quality patient care. The ultimate outcome is the health of the patient and the health status of the society. In the translational science of medical education, improved patient outcomes linked directly to educational events are the ultimate goal and are best defined by rigorous medical education research efforts. To best develop faculty, the same principles of adult education and teaching adults apply. In a systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education, the use of experiential learning, feedback, effective relationships with peers, and diverse educational methods were found to be most important in the success of these programs. In this article, we present 5 examples of applying the best practices in teaching adults and utilizing the emerging understanding of the neurobiology of learning in teaching students, trainees, and practitioners. These include (1) use of standardized patients to develop communication skills, (2) use of online quizzes to assess knowledge and aid self-directed learning, (3) use of practice sessions and video clips to enhance significant learning of teaching skills, (4) use of case-based discussions to develop professionalism concepts and skills, and (5) use of the American Academy of Pediatrics PediaLink as a model for individualized learner-directed online learning. These examples highlight how experiential leaning, providing valuable feedback, opportunities for practice, and stimulation of self-directed learning can be utilized as medical education continues its dynamic transformation in the years ahead. PMID

  10. Five practices of efficient factories applied to dental education.

    PubMed

    Nalliah, Romesh P

    2015-05-01

    Efficient factories, such as dental school clinics (DSC), are trying to improve the quality of their product by reducing inefficiencies, error rates, and wastage. Dental education is an expensive business for the student and the institution. Dental materials and equipment are costly, and students are novice providers who work slowly and inefficiently compared to an experienced dentist; this is not a good business model. The objective of this article was to present and apply five practices of efficient factories that could be applied to the DSC setting. I propose that this will lead to improved educational outcomes and improved patient outcomes in DSC. PMID:25891379

  11. Writing clinical scenarios for clinical science questions.

    PubMed

    Smith, Phil Em; Mucklow, John C

    2016-04-01

    Written knowledge assessments for physicians in training typically involve multiple-choice questions that use a clinical scenario in a single-best-answer format. The Royal College of Physicians Part 1 MRCP(UK) examination includes basic sciences themes that are challenging to assess through a clinical scenario. A realistic clinical setting based on everyday clinical practice and integral to the question is the clearest demonstration that the knowledge being assessed is clinically relevant. However, without special attention to detail, the scenario in a clinical science question can appear redundant or artificial. Reading unnecessary material frustrates candidates and threatens the reputation of the assessment. In this paper we discuss why a clinical scenario is important for basic science questions and offer advice on setting realistic and plausible clinical scenarios for such questions. PMID:27037383

  12. Hypothyroidism in Clinical Practice

    PubMed Central

    Qari, Faiza

    2014-01-01

    Background: Hypothyroidism is the most common endocrine disease that was seen in the clinical practice especially for family physicians. Methods: This review article covered the important practical clinical issues for managing overt hypothyroidism, subclinical hypothyroidism and hypothyroidism during pregnancy. Conclusions: The clinical issues were addressed by clinical scenario followed by questions and stressed on the important clinical points. PMID:25161963

  13. Anaphylaxis to topically applied sodium fusidate.

    PubMed

    Park, Mi-Ran; Kim, Do-Soo; Kim, Jihyun; Ahn, Kangmo

    2013-03-01

    Fusidic acid is a bacteriostatic antibiotic that is effective primarily on gram-positive bacteria, such as Staphylococcus and Corynebacterium species. It is often topically applied to the skin, but is also given systemically as a tablet or injection. Allergic contact dermatitis, or urticaria, has been reported as a side effect of fusidic acid treatment, whereas anaphylaxis to topically administered fusidic acid has not been reported previously. A 16-year-old boy visited an outpatient clinic for further evaluation of anaphylaxis. He suffered abrasions on his arms during exercise, which were treated with a topical ointment containing sodium fusidate. Within 30 minutes, he developed urticaria and eyelid swelling, followed by a cough and respiratory difficulty. His symptoms were relieved by emergency treatment in a nearby hospital. To investigate the etiology, oral provocation with fusidate was performed. After 125 mg (1/2 tablet) of sodium fusidate was administered, he developed a cough and itching of the throat within 30 minutes, which was followed by chest discomfort and urticaria. Forced expiratory volume in 1 second (FEV1) dropped from 4.09 L at baseline to 3.50 L after challenge, although wheezing was not heard in his chest. After management with an inhaled bronchodilator using a nebulizer, chest discomfort was relieved and FEV1 rose to 3.86 L. The patient was directed not to use fusidate, especially on abrasions. Here we report the first case of anaphylaxis resulting from topical fusidic acid application to abrasions. PMID:23450038

  14. Clinical Physiology: A Successful Academic and Clinical Discipline is Threatened in Sweden

    ERIC Educational Resources Information Center

    Arheden, Hakan

    2009-01-01

    Clinical physiologists in Sweden are physicians (the majority with a PhD degree) with thorough training in system physiology and pathophysiology. They investigate patients in a functional approach and are engaged in basic and applied physiology teaching and research. In 1954, clinical physiology was founded as an independent academic and clinical…

  15. Virtual reality applied to teletesting

    NASA Astrophysics Data System (ADS)

    van den Berg, Thomas J.; Smeenk, Roland J. M.; Mazy, Alain; Jacques, Patrick; Arguello, Luis; Mills, Simon

    2003-05-01

    The activity "Virtual Reality applied to Teletesting" is related to a wider European Space Agency (ESA) initiative of cost reduction, in particular the reduction of test costs. Reduction of costs of space related projects have to be performed on test centre operating costs and customer company costs. This can accomplished by increasing the automation and remote testing ("teletesting") capabilities of the test centre. Main problems related to teletesting are a lack of situational awareness and the separation of control over the test environment. The objective of the activity is to evaluate the use of distributed computing and Virtual Reality technology to support the teletesting of a payload under vacuum conditions, and to provide a unified man-machine interface for the monitoring and control of payload, vacuum chamber and robotics equipment. The activity includes the development and testing of a "Virtual Reality Teletesting System" (VRTS). The VRTS is deployed at one of the ESA certified test centres to perform an evaluation and test campaign using a real payload. The VRTS is entirely written in the Java programming language, using the J2EE application model. The Graphical User Interface runs as an applet in a Web browser, enabling easy access from virtually any place.

  16. Applied extreme-value statistics

    SciTech Connect

    Kinnison, R.R.

    1983-05-01

    The statistical theory of extreme values is a well established part of theoretical statistics. Unfortunately, it is seldom part of applied statistics and is infrequently a part of statistical curricula except in advanced studies programs. This has resulted in the impression that it is difficult to understand and not of practical value. In recent environmental and pollution literature, several short articles have appeared with the purpose of documenting all that is necessary for the practical application of extreme value theory to field problems (for example, Roberts, 1979). These articles are so concise that only a statistician can recognise all the subtleties and assumptions necessary for the correct use of the material presented. The intent of this text is to expand upon several recent articles, and to provide the necessary statistical background so that the non-statistician scientist can recognize and extreme value problem when it occurs in his work, be confident in handling simple extreme value problems himself, and know when the problem is statistically beyond his capabilities and requires consultation.

  17. Modeling Applied to Problem Solving

    NASA Astrophysics Data System (ADS)

    Pawl, Andrew; Barrantes, Analia; Pritchard, David E.

    2009-11-01

    We describe a modeling approach to help students learn expert problem solving. Models are used to present and hierarchically organize the syllabus content and apply it to problem solving, but students do not develop and validate their own Models through guided discovery. Instead, students classify problems under the appropriate instructor-generated Model by selecting a system to consider and describing the interactions that are relevant to that system. We believe that this explicit System, Interactions and Model (S.I.M.) problem modeling strategy represents a key simplification and clarification of the widely disseminated modeling approach originated by Hestenes and collaborators. Our narrower focus allows modeling physics to be integrated into (as opposed to replacing) a typical introductory college mechanics course, while preserving the emphasis on understanding systems and interactions that is the essence of modeling. We have employed the approach in a three-week review course for MIT freshmen who received a D in the fall mechanics course with very encouraging results.

  18. Intelligence Applied to Air Vehicles

    NASA Technical Reports Server (NTRS)

    Rosen, Robert; Gross, Anthony R.; Fletcher, L. Skip; Zornetzer, Steven (Technical Monitor)

    2000-01-01

    The exponential growth in information technology has provided the potential for air vehicle capabilities that were previously unavailable to mission and vehicle designers. The increasing capabilities of computer hardware and software, including new developments such as neural networks, provide a new balance of work between humans and machines. This paper will describe several NASA projects, and review results and conclusions from ground and flight investigations where vehicle intelligence was developed and applied to aeronautical and space systems. In the first example, flight results from a neural network flight control demonstration will be reviewed. Using, a highly-modified F-15 aircraft, a NASA/Dryden experimental flight test program has demonstrated how the neural network software can correctly identify and respond to changes in aircraft stability and control characteristics. Using its on-line learning capability, the neural net software would identify that something in the vehicle has changed, then reconfigure the flight control computer system to adapt to those changes. The results of the Remote Agent software project will be presented. This capability will reduce the cost of future spacecraft operations as computers become "thinking" partners along with humans. In addition, the paper will describe the objectives and plans for the autonomous airplane program and the autonomous rotorcraft project. Technologies will also be developed.

  19. Tissue engineering and regenerative medicine in applied research: a year in review of 2014.

    PubMed

    Lin, Xunxun; Huang, Jia; Shi, Yuan; Liu, Wei

    2015-04-01

    Tissue engineering and regenerative medicine (TERM) remains to be one of the fastest growing fields, which covers a wide scope of topics of both basic and applied biological researches. This overview article summarized the advancements in applied researches of TERM area, including stem cell-mediated tissue regeneration, material science, and TERM clinical trial. These achievements demonstrated the great potential of clinical regenerative therapy of tissue/organ disease or defect through stem cells and tissue engineering approaches. PMID:25588683

  20. Accreditation Stimuli and Evaluation Responses in a Clinical Training Program.

    ERIC Educational Resources Information Center

    Wood, David; And Others

    Assessment and evaluation skills are significant goals of clinical training, yet many clinical and counseling students lack personal experiences with applied program evaluation. Clinical psychology graduate students responded to successive impending accreditation visits by conducting in-house evaluations. Students in 1977 (N=38) and 1980 (N=35)…

  1. Rationale for Clinical Supervision

    ERIC Educational Resources Information Center

    Cogan, Morris L.

    1976-01-01

    The author, one of the originators and developers of the clinical supervision process, offered a cogent rationale for clinical supervision. He defined clinical supervision and discussed the psychological-sociological basis for its practice. (Editor)

  2. ClinicalTrials.gov

    MedlinePlus

    ... Health ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of ... This Site ClinicalTrials.gov Background About the Results Database History, Policies, and Laws Media/Press Resources Linking ...

  3. Governance of clinical research.

    PubMed

    Camilleri, Michael; Tremaine, William J

    2012-03-01

    We review the principal methods and issues in the governance of clinical research: oversight of human research by federal offices, certification of clinical trial centers, management of conflict of interest in clinical research, and trial registration and reporting. PMID:22388015

  4. THE OUTLOOK FOR APPLIED ENTOMOLOGY.

    PubMed

    1891-01-16

    I have thus touched, gentlemen, upon a few of the many subjects that crowd upon the mind for consideration on an occasion like this, - a few gleanings from a field which is passing rich in promise and possibility. It is a field that some of us have cultivated for many years, and yet have only scratched the surface ; and, if I have ventured to suggest or admonish, it is with the feeling that my own labors in this field are ere long about to end, and that I may not have another occasion. At no time in the history of the world has there, I trow, been gathered together such a body of devoted and capable workers in applied entomology. It marks an era in our calling, and, looking back at the progress of the past fifteen years, we may well ponder the possibilities of the next fifteen. They will be fruitful of grand results in proportion as we persistently and combinedly pursue the yet unsolved problems, and are not tempted to the immediate presentation of separate facts, which are so innumerable and so easily observed that their very wealth becomes an element of weakness. Epoch-making discoveries result only from this power of following up unswervingly any given problem or any fixed ideal. The kerosene emulsion ; the cyclone nozzle ; the history of Phylloxera vastatrix, of Phorodon humuli, of Vedalia cardinalis,- are illustrations in point: and, while we may not expect frequent results as striking or of as wide application as these, there is no end of important problems yet to be solved, and from the solution of which we may look for similar beneficial results. Applied entomology is often considered a sordid pursuit ; but it only becomes so when the object is sordid. When pursued with unselfish enthusiasm born of the love of investigation and the delight in benefiting our fellow-men, it is inspiring ; and there are few pursuits more deservedly so, considering the vast losses to our farmers from insect injury and the pressing need that the distressed husbandman has for

  5. Earthquake Prognosis With Applied Microseism.

    NASA Astrophysics Data System (ADS)

    Ahmedov, N.; Nagiyev, A.

    Earthquakes are the most dangerous natural catastrophy in terms of numerous casualties, amount of damages, areal coverage and difficulties associated with a need to provide secure measures. Inability to forecast these events makes the situation worse due to the following circumstances:-their buried focuses are invisible in the subsurface, they occur suddenly as a thunder, and some tens of the seconds later they leave devastated areas and casualties of tens of thousands of people. Currently earthquake forecausting is actually absolutely inefficient. Microseism application is one of the possible ways to forecast earthquakes. These small oscillation of up-going low-ampitude, irregular wawes observed on seismograms are refered to as microseism. Having been different from earhquakes itself, they are continuous, that is, have no origin coordinate on time axis. Their occurence is associated with breakers observed along shorelines, strong wind and hurricane patterns and so on. J.J.Linch has discovered a new tool to monitor hurricane motion trend over the seas with applied microseism recorded at ad hocstations. Similar to these observations it became possible to monitor the formation of the earthquake focuses based on correlation between low-frequency horizontal ahannels'N-S and E-W components. Microseism field and preceding abnormal variations monitoring data derived from "Cherepaha" 3M and 6/12 device enable to draw out some systematic trend in amplitude/frecuency domain. This relationship observed in a certain frequency range made it possible to define the generation of earthquake focuses with regard to the monitoring station. This variation trend was observed while Turkish and Iranian events happened during 1990,1992, and 1997. It is suggested to be useful to verify these effects in other regions to further correlate available data and work out common forecausting criteria.

  6. A Multiple Approach to Evaluating Applied Academics.

    ERIC Educational Resources Information Center

    Wang, Changhua; Owens, Thomas

    The Boeing Company is involved in partnerships with Washington state schools in the area of applied academics. Over the past 3 years, Boeing offered grants to 57 high schools to implement applied mathematics, applied communication, and principles of technology courses. Part 1 of this paper gives an overview of applied academics by examining what…

  7. Clinical utility of quantitative imaging.

    PubMed

    Rosenkrantz, Andrew B; Mendiratta-Lala, Mishal; Bartholmai, Brian J; Ganeshan, Dhakshinamoorthy; Abramson, Richard G; Burton, Kirsteen R; Yu, John-Paul J; Scalzetti, Ernest M; Yankeelov, Thomas E; Subramaniam, Rathan M; Lenchik, Leon

    2015-01-01

    Quantitative imaging (QI) is increasingly applied in modern radiology practice, assisting in the clinical assessment of many patients and providing a source of biomarkers for a spectrum of diseases. QI is commonly used to inform patient diagnosis or prognosis, determine the choice of therapy, or monitor therapy response. Because most radiologists will likely implement some QI tools to meet the patient care needs of their referring clinicians, it is important for all radiologists to become familiar with the strengths and limitations of QI. The Association of University Radiologists Radiology Research Alliance Quantitative Imaging Task Force has explored the clinical application of QI and summarizes its work in this review. We provide an overview of the clinical use of QI by discussing QI tools that are currently used in clinical practice, clinical applications of these tools, approaches to reporting of QI, and challenges to implementing QI. It is hoped that these insights will help radiologists recognize the tangible benefits of QI to their patients, their referring clinicians, and their own radiology practice. PMID:25442800

  8. Clinical Utility of Quantitative Imaging

    PubMed Central

    Rosenkrantz, Andrew B; Mendiratta-Lala, Mishal; Bartholmai, Brian J.; Ganeshan, Dhakshinamoorthy; Abramson, Richard G.; Burton, Kirsteen R.; Yu, John-Paul J.; Scalzetti, Ernest M.; Yankeelov, Thomas E.; Subramaniam, Rathan M.; Lenchik, Leon

    2014-01-01

    Quantitative imaging (QI) is increasingly applied in modern radiology practice, assisting in the clinical assessment of many patients and providing a source of biomarkers for a spectrum of diseases. QI is commonly used to inform patient diagnosis or prognosis, determine the choice of therapy, or monitor therapy response. Because most radiologists will likely implement some QI tools to meet the patient care needs of their referring clinicians, it is important for all radiologists to become familiar with the strengths and limitations of QI. The Association of University Radiologists Radiology Research Alliance Quantitative Imaging Task Force has explored the clinical application of QI and summarizes its work in this review. We provide an overview of the clinical use of QI by discussing QI tools that are currently employed in clinical practice, clinical applications of these tools, approaches to reporting of QI, and challenges to implementing QI. It is hoped that these insights will help radiologists recognize the tangible benefits of QI to their patients, their referring clinicians, and their own radiology practice. PMID:25442800

  9. Sorption of cadmium and copper ions on natural and synthetic hydroxylapatite particles

    SciTech Connect

    Fernane, F.; Mecherri, M.O.; Sharrock, P. Hadioui, M.; Lounici, H.; Fedoroff, M.

    2008-05-15

    The sorption of divalent cadmium and copper ions from aqueous solutions on natural and synthetic hydroxyapatite was investigated by the batch method and under dynamic conditions in columns at 22 deg. C and pH 5. The effect of cadmium and copper concentration on sorption was studied. Both types of apatites are efficient, despite their different composition and morphology. The sorption mechanism involves an ion exchange for Cd(II), while Cu(II) leads to precipitation of a newly formed solid. Thus, the sorption efficiency depends on the experimental conditions and the specific physicochemical properties of the apatites used. The sorption isotherms were fitted to the Langmuir equation.

  10. Developing Cross Cultural Competence: Applying Development and Prevention Ideals to Counseling Young Children

    ERIC Educational Resources Information Center

    Wolfgang, Jeff; Frazier, Kimberly; West-Olatunji, Cirecie; Barrett, Joe

    2011-01-01

    As counselors turn their attention to child-based counseling, there is a need to apply the core tenets of the discipline of counseling to young children and incorporate cross-cultural issues into clinical competence. Using Multicultural Counseling Theory (MCT), the authors discuss conventional approaches to providing clinical interventions for…

  11. Distinguishing between applied research and practice

    PubMed Central

    Johnston, James M.

    1996-01-01

    Behavior-analytic research is often viewed along a basic—applied continuum of research goals and methods. The applied portion of this continuum has evolved in ways that combine applied research and service delivery. Although these two facets of applied behavior analysis should be closely related, more clearly distinguishing between them, particularly in how we conceptualize and conduct applied research, may enhance the continuing development of each. This differentiation may improve the recruitment and training of graduate students. PMID:22478238

  12. A Prospective, Comparative, Evaluator-blind Clinical Study Investigating Efficacy and Safety of Two Injection Techniques with Radiesse® for the Correction of Skin Changes in Aging Hands

    PubMed Central

    Gubanova, Elena I; Starovatova, Polina A

    2015-01-01

    Background: Dermal fillers are used to correct age-related changes in hands. Aims: Assess efficacy and safety of two injection techniques to treat age-related changes in the hands using calcium hydroxylapatite filler, Radiesse®. Settings and Design: This was a prospective, comparative, evaluator-blind, single-center study. Materials and Methods: Radiesse® (0.8 mL/0.2 mL 2% lidocaine) was injected subdermally on Day (D)01, using a needle multipoint technique in one hand (N) and a fan-like cannula technique in the other (C). Assessments were made pre-injection, on D14, Month (M)02, M03 and M05 using the Merz Aesthetics Hand Grading Scale (MAS) and Global Aesthetic Improvement Scale (GAIS). Participants completed questionnaires on satisfaction, pain and adverse events (AEs). Statistical Analysis Used: Data distribution was tested with the Shapiro-Wilk and Levene's tests. The Wilcoxon signed-rank and Chi-square tests were employed to evaluate quantitative and qualitative data, respectively. Results: All 10 participants completed the study, four opted for a M03 touch-up (0.8 mL Radiesse®). Evaluator-assessed mean GAIS scores were between 2 (significant improvement but not complete correction) and 3 (optimal cosmetic result) at each time point. The MAS score improved from D01 to M05 (N: 2.60 to 1.40; C: 2.20 to 1.30). Following treatment, participants reported skin was softer, more elastic, more youthful and less wrinkled. Other than less noticeable veins and tendons on the C hand, no differences in participant satisfaction were noted. All AEs were mild, with no serious AEs reported. Conclusions: Both injection techniques (needle and cannula) demonstrated equivalent clinical efficacy with a comparable safety profile for the correction of age-related changes in hands with Radiesse®. PMID:26644738

  13. Unsupervised mining of frequent tags for clinical eligibility text indexing.

    PubMed

    Miotto, Riccardo; Weng, Chunhua

    2013-12-01

    Clinical text, such as clinical trial eligibility criteria, is largely underused in state-of-the-art medical search engines due to difficulties of accurate parsing. This paper proposes a novel methodology to derive a semantic index for clinical eligibility documents based on a controlled vocabulary of frequent tags, which are automatically mined from the text. We applied this method to eligibility criteria on ClinicalTrials.gov and report that frequent tags (1) define an effective and efficient index of clinical trials and (2) are unlikely to grow radically when the repository increases. We proposed to apply the semantic index to filter clinical trial search results and we concluded that frequent tags reduce the result space more efficiently than an uncontrolled set of UMLS concepts. Overall, unsupervised mining of frequent tags from clinical text leads to an effective semantic index for the clinical eligibility documents and promotes their computational reuse. PMID:24036004

  14. Unsupervised Mining of Frequent Tags for Clinical Eligibility Text Indexing

    PubMed Central

    Miotto, Riccardo; Weng, Chunhua

    2013-01-01

    Clinical text, such as clinical trial eligibility criteria, is largely underused in state-of-the-art medical search engines due to difficulties of accurate parsing. This paper proposes a novel methodology to derive a semantic index for clinical eligibility documents based on a controlled vocabulary of frequent tags, which are automatically mined from the text. We applied this method to eligibility criteria on ClinicalTrials.gov and report that frequent tags (1) define an effective and efficient index of clinical trials and (2) are unlikely to grow radically when the repository increases. We proposed to apply the semantic index to filter clinical trial search results and we concluded that frequent tags reduce the result space more efficiently than an uncontrolled set of UMLS concepts. Overall, unsupervised mining of frequent tags from clinical text leads to an effective semantic index for the clinical eligibility documents and promotes their computational reuse. PMID:24036004

  15. Evidence and Clinical Trials.

    NASA Astrophysics Data System (ADS)

    Goodman, Steven N.

    1989-11-01

    This dissertation explores the use of a mathematical measure of statistical evidence, the log likelihood ratio, in clinical trials. The methods and thinking behind the use of an evidential measure are contrasted with traditional methods of analyzing data, which depend primarily on a p-value as an estimate of the statistical strength of an observed data pattern. It is contended that neither the behavioral dictates of Neyman-Pearson hypothesis testing methods, nor the coherency dictates of Bayesian methods are realistic models on which to base inference. The use of the likelihood alone is applied to four aspects of trial design or conduct: the calculation of sample size, the monitoring of data, testing for the equivalence of two treatments, and meta-analysis--the combining of results from different trials. Finally, a more general model of statistical inference, using belief functions, is used to see if it is possible to separate the assessment of evidence from our background knowledge. It is shown that traditional and Bayesian methods can be modeled as two ends of a continuum of structured background knowledge, methods which summarize evidence at the point of maximum likelihood assuming no structure, and Bayesian methods assuming complete knowledge. Both schools are seen to be missing a concept of ignorance- -uncommitted belief. This concept provides the key to understanding the problem of sampling to a foregone conclusion and the role of frequency properties in statistical inference. The conclusion is that statistical evidence cannot be defined independently of background knowledge, and that frequency properties of an estimator are an indirect measure of uncommitted belief. Several likelihood summaries need to be used in clinical trials, with the quantitative disparity between summaries being an indirect measure of our ignorance. This conclusion is linked with parallel ideas in the philosophy of science and cognitive psychology.

  16. Efficiency Improvement of Dentistry Clinics: Introducing an Intervening Package for Dentistry Clinics, Isfahan, Iran

    PubMed Central

    Alaghemandan, Hamed; Yarmohammadian, Mohammad H.; Khorasani, Elahe; Rezaee, Sobhan

    2014-01-01

    Background: In Isfahan, the second metropolitan in Iran, there are 1448 dentistry treatment centers that most of them are inefficient. Today, efficiency is the most important issue in health care centers as well as dentistry clinics. The goal of this research is to investigate the affordability and efficiency of dentistry clinics in Isfahan province, Iran. Methods: The current work is a quantitative research, designed in three methodological steps, including two surveys and experimental studies, for understanding current deficiencies of Iranian dentistry clinics. First, we ran a survey. Then, we analyzed the results of the questionnaires which guided us to find a particular intervening package to improve the efficiency of the clinics. At the second step, we chose an inefficient clinic named Mohtasham (Iran, Isfahan) to evaluate our intervening package. Results: Based on what the interviewees answered, we mention the most important issues to be considered for improving the efficiency of dental clinics in Isfahan. By considering mentioned problematic issues, an intervening package was designed. This intervening package was applied in Mohtasham clinic, since June 2010. It improved the clinic's income from 16328 US$ with 4125 clients in 2010, to 420,000 US$ with 14784 patients in 2012. Conclusions: The proposed intervening package changed this clinic to an efficient and economic one. Its income increased 5.08 times and its patient's numbers grew 4.01 times simultaneously. In other words, Mohtasham's experience demonstrates the reliability of the package and its potentiality to be applied in macro level to improve other dentistry clinics. PMID:24627744

  17. Award for Distinguished Professional Contributions to Applied Research: Luciano L'Abate

    ERIC Educational Resources Information Center

    American Psychologist, 2009

    2009-01-01

    Luciano L'Abate, recipient of the Award for Distinguished Professional Contributions to Applied Research, contributed to applied research through the introduction of the laboratory method in clinical psychology assessment and intervention, leading to the development of the first automated playroom, linking play therapy with research in child…

  18. Being a Clinical Educator

    ERIC Educational Resources Information Center

    Higgs, Joy; Mcallister, Lindy

    2007-01-01

    What is it like to be a clinical educator? How do clinical educators experience and describe their continuing journey of becoming a clinical educator? Within the model developed in this research, dimensions of being a clinical educator were identified. These dimensions include (a) having a sense of self (and the impact of bringing self into the…

  19. Applied technology section. Monthly report, December 1993

    SciTech Connect

    Buckner, M.R.

    1994-01-28

    This monthly report contains abstracts of the progress made in various projects from the applied technology section at the Savannah River Plant. Research areas include engineering modeling and simulation, applied physics, experimental thermal hydraulics, and packaging and transportation.

  20. Applied Psycholinguistics--Amphibian or Phantom?

    ERIC Educational Resources Information Center

    Titone, Renzo

    1975-01-01

    A tentative classification of internal departments of psycholinguistics is suggested and a list of applied fields is presented. Applied psycholinguistics is not seen here to have a right to scientific independence. (SCC)

  1. Gatekeepers for pragmatic clinical trials.

    PubMed

    Whicher, Danielle M; Miller, Jennifer E; Dunham, Kelly M; Joffe, Steven

    2015-10-01

    To successfully implement a pragmatic clinical trial, investigators need access to numerous resources, including financial support, institutional infrastructure (e.g. clinics, facilities, staff), eligible patients, and patient data. Gatekeepers are people or entities who have the ability to allow or deny access to the resources required to support the conduct of clinical research. Based on this definition, gatekeepers relevant to the US clinical research enterprise include research sponsors, regulatory agencies, payers, health system and other organizational leadership, research team leadership, human research protections programs, advocacy and community groups, and clinicians. This article provides a framework to help guide gatekeepers' decision-making related to the use of resources for pragmatic clinical trials. Relevant ethical considerations for gatekeepers include (1) concern for the interests of individuals, groups, and communities affected by the gatekeepers' decisions, including protection from harm and maximization of benefits; (2) advancement of organizational mission and values; and (3) stewardship of financial, human, and other organizational resources. Separate from these ethical considerations, gatekeepers' actions will be guided by relevant federal, state, and local regulations. This framework also suggests that to further enhance the legitimacy of their decision-making, gatekeepers should adopt transparent processes that engage relevant stakeholders when feasible and appropriate. We apply this framework to the set of gatekeepers responsible for making decisions about resources necessary for pragmatic clinical trials in the United States, describing the relevance of the criteria in different situations and pointing out where conflicts among the criteria and relevant regulations may affect decision-making. Recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding

  2. Ultrasound imaging in research and clinical medicine.

    PubMed

    Schellpfeffer, Michael A

    2013-06-01

    The use of ultrasound imaging in clinical obstetrics continues to grow at an almost exponential rate. Ultrasound imaging in developmental biology has only begun to be used to enhance the traditional methodologies to study the developing embryo/fetus. The various modalities of ultrasound imaging are reviewed as they apply to current uses in clinical obstetrics and developmental biologic research. New modalities are also discussed in both clinical obstetrics and developmental biologic research as well as the current limitations of ultrasound imaging faced in both of these fields. PMID:23897593

  3. Western Perspectives in Applied Linguistics in Africa

    ERIC Educational Resources Information Center

    Makoni, Sinfree; Meinhof, Ulrike H.

    2004-01-01

    The aim of this article is to analyze the nature of the historical and contemporary social contexts within which applied linguistics in Africa emerged, and is currently practiced. The article examines the challenges "local" applied Linguistics in Africa is confronted with as it tries to amplify applied linguistic programs emanating from…

  4. Critical and Alternative Directions in Applied Linguistics

    ERIC Educational Resources Information Center

    Pennycook, Alastair

    2010-01-01

    Critical directions in applied linguistics can be understood in various ways. The term "critical" as it has been used in "critical applied linguistics," "critical discourse analysis," "critical literacy" and so forth, is now embedded as part of applied linguistic work, adding an overt focus on questions of power and inequality to discourse…

  5. Clinical competence in pain assessment.

    PubMed

    Sjöström, B; Jakobsson, E; Haljamäe, H

    2000-10-01

    Our knowledge about the content of the clinical knowledge used by nurses in a surgical recovery unit for assessment of postoperative pain is fairly limited. The aim of the present study was to analyse and describe the variations of nurses' conceptions of the impact of clinical experience on competence in post-operative pain assessment. The informants consist of critical care nurses. A phenomenographical approach has been applied to tape-recorded interview data. The results reveal that clinical competence in pain assessment was described in three categories: (a) to be able to see; (b) to be able to differentiate; (c) to be able to give. The observations articulate what nurses perceive that they have learnt from experience in performing many clinical pain assessments and point to some difficulties in using a single-data source for the development of valid and truthful professional knowledge. In the development of professional experience, it is of the utmost importance to be able to change perspective from what is most frequent and general to what is special and unique, to base one's standpoint on the individual patient's experience and integrate this with previous professional experience. PMID:11000601

  6. Evaluating Language. Papers from the Annual Meeting of the British Association for Applied Linguistics (Essex, England, United Kingdom, September 1992).

    ERIC Educational Resources Information Center

    Graddol, David, Ed.; Swann, Joan, Ed.

    Papers from a British conference on applied linguistics address various aspects of evaluation and language. Articles include: "Grammar and Language Impairment: Clinical Linguistics as Applied Linguistics" (Paul Fletcher); "Putting Our Practice Into Theory" (Deborah Cameron); "Applied Linguistics as Evaluation of Theory and Practice:…

  7. Genes, Race, and Culture in Clinical Care

    PubMed Central

    Hunt, Linda M.; Truesdell, Nicole D.; Kreiner, Meta J.

    2015-01-01

    Race, although an unscientific concept, remains prominent in health research and clinical guidelines, and is routinely invoked in clinical practice. In interviews with 58 primary care clinicians we explored how they understand and apply concepts of racial difference. We found wide agreement that race is important to consider in clinical care. They explained the effect of race on health, drawing on common assumptions about the biological, class, and cultural characteristics of racial minorities. They identified specific race-based clinical strategies for only a handful of conditions and were inconsistent in the details of what they said should be done for minority patients. We conclude that using race in clinical medicine promotes and maintains the illusion of inherent racial differences and may result in minority patients receiving care aimed at presumed racial group characteristics, rather than care selected as specifically appropriate for them as individuals. [race and genetics, primary care, health disparities, racial profiling] PMID:23804331

  8. Phenotypic mapping and clinical ideology

    SciTech Connect

    Lurie, I.W.; Opitz, J.M.

    1995-07-17

    Scientists have been trying to determine whether the main clinical findings in the 4p deletion syndrome are due to a deletion of one small critical segment, or whether deletions of some particular segments of 4p are responsible for different phenotypic manifestations. This is the basic issue for the whole group of autosomal deletion syndromes, as well as for our understanding of mechanisms of the origin of the abnormal phenotype. All circumstances need to be taken into consideration when trying to apply molecular methods for the mapping of phenotypic findings in the 4p deletion or in any other autosomal deletion syndrome. 8 refs.

  9. Clinical applications of skin substitutes.

    PubMed

    Nyame, Theodore T; Chiang, H Abraham; Orgill, Dennis P

    2014-08-01

    A unique understanding of the components of mammalian skin has led to the development of numerous skin substitutes. These skin substitutes attempt to compensate for functional and physiologic deficits present in damaged tissue. Skin substitutes, when appropriately applied in optimized settings, offer a promising solution to difficult wound management. The body of literature on skin substitutes increases as the understanding of tissue engineering and molecular biology expands. Given the high cost of these products, future randomized large prospective studies are needed to guide the clinical applications of skin substitutes. PMID:25085091

  10. Managing clinical grant costs.

    PubMed

    Glass, Harold E; Hollander, Karen

    2009-05-01

    The rapidly increasing cost of pharmaceutical R&D presents a major challenge for the industry. This paper examines one aspect of that spending, clinical grants, and presents ways that pharmaceutical companies can best manage those expenditures. The first part of the paper examines the role of clinical grant payments as a motivation for clinical trial participation. The second part outlines a number of current management practices for controlling clinical grant costs. Financial compensation is an important matter for many physicians conducting clinical trials, especially those in office-based practices and those conducting phase 4 clinical trials. Since financial considerations are important to most types of investigators, and there is no compelling evidence that paying at high rates insures timely performance or quality data, companies engaging clinical investigators must manage their clinical grant funds as effectively as possible. Sound financial management requires that clinical development professionals appreciate the complex relationship between the pharmaceutical company and the physicians who serve as clinical investigators on that company's clinical trials. Sensible financial management of clinical grants also demands that sponsor companies get the most value for their clinical grant spending. Ultimately, good clinical grant management requires an attitude that combines good business sense with an understanding that pharmaceutical R&D strives to bring to market new drugs that can help patient populations around the world. Investigators are medical contractors in clinical trials, and while they are engaged in their vital research, they are a part of the research process that must be carefully budgeted and managed. Society, pharmaceutical companies, clinical investigators, and patients will reap the benefits of adequately budgeted, and well managed clinical grants. PMID:19470309

  11. Finite Element Analysis Applied to Dentoalveolar Trauma: Methodology Description

    PubMed Central

    da Silva, B. R.; Moreira Neto, J. J. S.; da Silva, F. I.; de Aguiar, A. S. W.

    2011-01-01

    Dentoalveolar traumatic injuries are among the clinical conditions most frequently treated in dental practice. However, few studies so far have addressed the biomechanical aspects of these events, probably as a result of difficulties in carrying out satisfactory experimental and clinical studies as well as the unavailability of truly scientific methodologies. The aim of this paper was to describe the use of finite element analysis applied to the biomechanical evaluation of dentoalveolar trauma. For didactic purposes, the methodological process was divided into steps that go from the creation of a geometric model to the evaluation of final results, always with a focus on methodological characteristics, advantages, and disadvantages, so as to allow the reader to customize the methodology according to specific needs. Our description shows that the finite element method can faithfully reproduce dentoalveolar trauma, provided the methodology is closely followed and thoroughly evaluated. PMID:21991463

  12. Good clinical practice: a nuisance, a help or a necessity for clinical pharmacology?

    PubMed Central

    Sweatman, John

    2003-01-01

    This article reviews the impact of good clinical practice (GCP) on clinical pharmacology with particular reference to the new European Union Clinical Trial Directive. The Directive will be applied to both commercial and noncommercial studies on medicinal products for human use. The Directive requires that GCP should be used in all clinical trials except noninterventional studies. GCP is likely to follow the International Conference on Harmonization GCP guidelines in many aspects. GCP will enforce tighter guidelines on ethical aspects of a clinical study. Higher standards will be required in terms of comprehensive documentation for the clinical protocol, record keeping, training, and facilities including computers. Quality assurance and inspections will ensure that these standards are achieved. The additional requirements of GCP are discussed and any advantage to the study subject. The impact of the new Directive within the Research Governance Framework of the UK Department of Health is reviewed. PMID:12534634

  13. Clinical Trials in Vision Research

    MedlinePlus

    ... Clinical Trials in Vision Research Clinical Trials in Vision Research Clinical studies depend on people who volunteer. ... about the treatment. How are clinical trials in vision different from other clinical trials? Eyes are one ...

  14. Spina Bifida Clinic Directory

    MedlinePlus

    ... genitourinary-reconstruction Cleveland Clinic (pediatric) 9500 Euclid Avenue S-60 Cleveland, OH 44195 Phone: 216-445-5579 Fax: ... for Adults Adult Spina Bifida Clinic (adult only) 60 Township Line Rd. Elkins Park, PA 19027 (215) ...

  15. Fertility Clinic Success Rates

    MedlinePlus

    ... 2013 Assisted Reproductive Technology Fertility Clinic Success Rates Report Recommend on Facebook Tweet Share Compartir 2013 ART Fertility Clinic Success Rates Report [PDF - 1MB] Bookmarks and thumbnails are available within ...

  16. Research Areas: Clinical Trials

    Cancer.gov

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  17. Clinical nuclear medicine. [Handbook

    SciTech Connect

    Matin, P.

    1981-01-01

    ''Clinical Nuclear Medicine'' is an update to the author's ''Handbook of Clinical Nuclear Medicine.'' Sections on placental imaging, bone marrow imaging, biliary tract imaging and scintigraphy are included in the volume. (JMT)

  18. Research Areas - Clinical Trials

    Cancer.gov

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  19. Clinical governance and pathology

    PubMed Central

    Crook, M

    2002-01-01

    This article looks at clinical governance and pathology. Clinical governance should be an important tool in seeking quality improvement within the Natinal Health Service. But how as pathologists should we go about it? PMID:11896066

  20. International Conference on Applied Sciences (ICAS2013)

    NASA Astrophysics Data System (ADS)

    Lemle, Ludovic Dan; Jiang, Yiwen

    2014-03-01

    The International Conference on Applied Sciences (ICAS2013) took place in Wuhan, P R China from 26-27 October 2013 at the Military Economics Academy. The conference is regularly organized, alternately in Romania and in P R China, by ''Politehnica'' University of Timişoara, Romania, and Military Economics Academy of Wuhan, P R China, with the aim to serve as a platform for the exchange of information between various areas of applied sciences, and to promote the communication between the scientists of different nations, countries and continents. The conference has been organized for the first time in 15-16 June 2012 at the Engineering Faculty of Hunedoara, Romania. The topics of the conference covered a comprehensive spectrum of issues: Economical sciences Engineering sciences Fundamental sciences Medical sciences The conference gathered qualified researchers whose expertise can be used to develop new engineering knowledge that has applicability potential in economics, defense, medicine, etc. The number of registered participants was nearly 90 from 5 countries. During the two days of the conference 4 invited and 36 oral talks were delivered. A few of the speakers deserve a special mention: Mircea Octavian Popoviciu, Academy of Romanian Scientist — Timişoara Branch, Correlations between mechanical properties and cavitation erosion resistance for stainless steels with 12% chromium and variable contents of nickel; Carmen Eleonora Hărău, ''Politehnica'' University of Timişoara, SWOT analysis of Romania's integration in EU; Ding Hui, Military Economics Academy of Wuhan, Design and engineering analysis of material procurement mobile operation platform; Serban Rosu, University of Medicine and Pharmacy ''Victor Babeş'' Timişoara, Cervical and facial infections — a real life threat, among others. Based on the work presented at the conference, 14 selected papers are included in this volume of IOP Conference Series: Materials Science and Engineering. These papers

  1. Applying XDS for sharing CDA-based medical records

    NASA Astrophysics Data System (ADS)

    Kim, Joong Il; Jang, Bong Mun; Han, Dong Hoon; Yang, Keon Ho; Kang, Won-Suk; Jung, Haijo; Kim, Hee-Joung

    2006-03-01

    Many countries have set long-term objectives for establishing an Electronic Healthcare Records system(EHRs). Various IT Strategies note that integration of EHR systems has a high priority. Because the EHR systems are based on different information models and different technology platforms, one of the key integration problems in the realization of the EHRs for the continuity of patient care, is the inability to share patient records between various institutions. Integrating the Healthcare Enterprise (IHE) committee has defined the detailed implementations of existing standards such as DICOM, HL7, in a publicly available document called the IHE technical framework (IHE-TF). Cross-enterprise document sharing (XDS), one of IHE technical frameworks, is describing how to apply the standards into the information systems for the sharing of medical documents among hospitals. This study aims to design Clinical Document Architecture (CDA) schema based on HL7, and to apply implementation strategies of XDS using this CDA schema.

  2. Boston Society's 11th Annual Applied Pharmaceutical Analysis conference.

    PubMed

    Lee, Violet; Liu, Ang; Groeber, Elizabeth; Moghaddam, Mehran; Schiller, James; Tweed, Joseph A; Walker, Gregory S

    2016-02-01

    Boston Society's 11th Annual Applied Pharmaceutical Analysis conference, Hyatt Regency Hotel, Cambridge, MA, USA, 14-16 September 2015 The Boston Society's 11th Annual Applied Pharmaceutical Analysis (APA) conference took place at the Hyatt Regency hotel in Cambridge, MA, on 14-16 September 2015. The 3-day conference affords pharmaceutical professionals, academic researchers and industry regulators the opportunity to collectively participate in meaningful and relevant discussions impacting the areas of pharmaceutical drug development. The APA conference was organized in three workshops encompassing the disciplines of regulated bioanalysis, discovery bioanalysis (encompassing new and emerging technologies) and biotransformation. The conference included a short course titled 'Bioanalytical considerations for the clinical development of antibody-drug conjugates (ADCs)', an engaging poster session, several panel and round table discussions and over 50 diverse talks from leading industry and academic scientists. PMID:26853375

  3. Exploring Continuous Clinical Placement for Undergraduate Students

    ERIC Educational Resources Information Center

    McKenna, Lisa G.; Wray, Natalie; McCall, Louise

    2009-01-01

    Clinical placements are integral to health professional preparatory courses. These placements allow for the application of classroom-based learning into real patient care situations. In doing so, they provide opportunities for applying theoretical knowledge into practice contexts, skills development and socialisation into the chosen profession.…

  4. Preceptor Handbook: Rural Clinical Nurse Placement Center.

    ERIC Educational Resources Information Center

    Stuart-Siddall, Sandra; Haberlin, Jean

    This handbook provides Rural Clinical Nurse Placement Program (RCNP) preceptors with a program overview and practical suggestions to apply during student placement. An introductory section describes how the program addresses the maldistribution of nurses by raising awareness about the rural experience, adding a needed perspective to the urban bias…

  5. The Effective Clinical Conference.

    ERIC Educational Resources Information Center

    Wink, Diane M.

    1995-01-01

    Examines the common problems with clinical conferences and suggests approaches to maximize student learning. Suggests that an effective clinical conference has three characteristics: (1) it is a group event; (2) it contributes to the achievement of course and clinical objectives; and (3) it provides a setting for students to explore personal…

  6. Clinical document architecture.

    PubMed

    Heitmann, Kai

    2003-01-01

    The Clinical Document Architecture (CDA), a standard developed by the Health Level Seven organisation (HL7), is an ANSI approved document architecture for exchange of clinical information using XML. A CDA document is comprised of a header with associated vocabularies and a body containing the structural clinical information. PMID:15061557

  7. Applying professional values: the perspective of nurses of Isfahan hospitals.

    PubMed

    Shahriari, Mohsen; Baloochestani, Elahe

    2014-01-01

    Applying professional values is an important issue in nursing practice. It is also crucial to find out nurses' perspectives toward ethical and professional values in the clinical environment. For this purpose, we aimed to utilize a standard tool to survey perspectives on applying these values in nursing care in hospitals of Isfahan, Iran. This is a descriptive-analytical study in which 150 nurses working in hospitals of Isfahan, Iran in 2010 were recruited by quota convenience sampling, and their perspectives on professional values were assessed. Data were collected by the Nurses Professional Values Scale (NPVS) and analyzed using SPSS Software version 16 applying descriptive and interpretive statistics. In the present study, 84% of the participants were female and 88% had bachelor's degree in nursing. The average age was 34.2 (SD=7.3), and the average years of working in a hospital were 11 (SD=7.3). No significant association was present between demographic characteristics such as age, sex, educational level or work records and applying professional and ethical values. Results also demonstrated that respect for professional values is similar among nurses of different employment types. In this study, we addressed the most and the less important professional values specified by nurses with different types of employment and also different experiences. Iranian nurses believe in respecting the legal and ethical rights of patients as the most prominent value in the nursing profession. We suggest that these professional values be specified and assessed based on Iranian culture. PMID:25512822

  8. Applying professional values: the perspective of nurses of Isfahan hospitals

    PubMed Central

    Shahriari, Mohsen; Baloochestani, Elahe

    2014-01-01

    Applying professional values is an important issue in nursing practice. It is also crucial to find out nurses’ perspectives toward ethical and professional values in the clinical environment. For this purpose, we aimed to utilize a standard tool to survey perspectives on applying these values in nursing care in hospitals of Isfahan, Iran. This is a descriptive-analytical study in which 150 nurses working in hospitals of Isfahan, Iran in 2010 were recruited by quota convenience sampling, and their perspectives on professional values were assessed. Data were collected by the Nurses Professional Values Scale (NPVS) and analyzed using SPSS Software version 16 applying descriptive and interpretive statistics. In the present study, 84% of the participants were female and 88% had bachelor’s degree in nursing. The average age was 34.2 (SD=7.3), and the average years of working in a hospital were 11 (SD=7.3). No significant association was present between demographic characteristics such as age, sex, educational level or work records and applying professional and ethical values. Results also demonstrated that respect for professional values is similar among nurses of different employment types. In this study, we addressed the most and the less important professional values specified by nurses with different types of employment and also different experiences. Iranian nurses believe in respecting the legal and ethical rights of patients as the most prominent value in the nursing profession. We suggest that these professional values be specified and assessed based on Iranian culture. PMID:25512822

  9. How to apply vacuum-assisted closure therapy.

    PubMed

    Ellis, Georgina

    2016-03-01

    RATIONALE AND KEY POINTS: This article aims to provide an overview of the technique for applying vacuum-assisted closure therapy (V.A.C. therapy), using the example of one of the most basic dressing types: V.A.C. GranuFoam, a black polyurethane foam. Practitioners should refer to the manufacturer's instructions for application of other dressing types. ▶ V.A.C. therapy is used to apply negative pressure to the wound bed to promote wound healing. ▶ V.A.C therapy promotes perfusion, reduces oedema, draws the wound edges together and stimulates the formation of granulation tissue. ▶ The correct technique for applying V.A.C. therapy is essential to ensure patient safety and optimum wound healing outcomes. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How you think this article will change your practice. 2. How the use of V.A.C. therapy might affect the patient's experience. PMID:26932648

  10. University cardiology clinic.

    PubMed

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  11. Mentoring in the Clinical Setting to Improve Student Decision-Making Competence

    ERIC Educational Resources Information Center

    Stick-Mueller, Misty; Boesch, Ron; Silverman, Steven; Carpenter, Scott; Illingworth, Robert; Countryman, James

    2010-01-01

    Introduction: The physician-intern relationship can be difficult to develop. A new chiropractic intern in a teaching clinic undergoes a major transition from classroom to clinical practice and must learn to turn classroom knowledge into clinical application. The ability to start formulating clinical techniques and apply them on a patient is…

  12. Assessing clinical pragmatism.

    PubMed

    Jansen, Lynn A

    1998-03-01

    "Clinical pragmatism" is an important new method of moral problem-solving in clinical practice. This method draws on the pragmatic philosophy of John Dewey and recommends an experimental approach to solving moral problems in clinical practice. Although the method may shed some light on how clinicians and their patients ought to interact when moral problems are at hand, it nonetheless is deficient in a number of respects. Clinical pragmatism fails to explain adequately how moral poblems can be solved experimentally, it underestimates the relevance and importance of judgment in clinical ethics, and it presents a questionable account of the role that moral principles should play in moral problem solving. PMID:11656751

  13. Clinical ecology. American College of Physicians

    SciTech Connect

    Not Available

    1989-07-15

    Clinical ecologists propose the existence of a unique illness in which multiple environmental chemicals, foods, drugs, and endogenous C. albicans have a toxic effect on the immune system, thereby adversely affecting other bodily functions. The proposal uses some concepts that superficially resemble those that apply to clinical allergy and toxicology and others that are novel. Review of the clinical ecology literature provides inadequate support for the beliefs and practices of clinical ecology. The existence of an environmental illness as presented in clinical ecology theory must be questioned because of the lack of a clinical definition. Diagnoses and treatments involve procedures of no proven efficacy. Case reports by clinical ecologists and evaluation of these patients by other physicians indicate that this diagnosis is applied most frequently to persons with symptoms of physiologic (somatic) or psychologic dysfunction, or both. Proof of cause-effect relations between environmental factors and symptoms of environmental illness is particularly difficult because clinical ecologists implicate such a broad range of agents, including chemicals, foods, hormones, and microorganisms. Most patients are believed to react to multiple environmental substances by any route of exposure, and some are said to be intolerant to the entire environment, the so-called total allergy syndrome. The principal method of proof cited by clinical ecologists for the existence of environmental illness is the symptom-provocation test used in diagnosis of individual cases after the condition is suspected because of a history of symptoms and suspected causes. Published studies on the provocation test employed widely different subject-selection methods and outcome-measurement criteria. 91 references.

  14. How to Establish Clinical Prediction Models

    PubMed Central

    Bang, Heejung

    2016-01-01

    A clinical prediction model can be applied to several challenging clinical scenarios: screening high-risk individuals for asymptomatic disease, predicting future events such as disease or death, and assisting medical decision-making and health education. Despite the impact of clinical prediction models on practice, prediction modeling is a complex process requiring careful statistical analyses and sound clinical judgement. Although there is no definite consensus on the best methodology for model development and validation, a few recommendations and checklists have been proposed. In this review, we summarize five steps for developing and validating a clinical prediction model: preparation for establishing clinical prediction models; dataset selection; handling variables; model generation; and model evaluation and validation. We also review several studies that detail methods for developing clinical prediction models with comparable examples from real practice. After model development and vigorous validation in relevant settings, possibly with evaluation of utility/usability and fine-tuning, good models can be ready for the use in practice. We anticipate that this framework will revitalize the use of predictive or prognostic research in endocrinology, leading to active applications in real clinical practice. PMID:26996421

  15. Teaching and Assessing Clinical Reasoning Skills.

    PubMed

    Modi, Jyoti Nath; Anshu; Gupta, Piyush; Singh, Tejinder

    2015-09-01

    Clinical reasoning is a core competency expected to be acquired by all clinicians. It is the ability to integrate and apply different types of knowledge, weigh evidence critically and reflect upon the process used to arrive at a diagnosis. Problems with clinical reasoning often occur because of inadequate knowledge, flaws in data gathering and improper approach to information processing. Some of the educational strategies which can be used to encourage acquisition of clinical reasoning skills are: exposure to a wide variety of clinical cases, activation of previous knowledge, development of illness scripts, sharing expert strategies to arrive at a diagnosis, forcing students to prioritize differential diagnoses; and encouraging reflection, metacognition, deliberate practice and availability of formative feedback. Assessment of clinical reasoning abilities should be done throughout the training course in diverse settings. Use of scenario based multiple choice questions, key feature test and script concordance test are some ways of theoretically assessing clinical reasoning ability. In the clinical setting, these skills can be tested in most forms of workplace based assessment. We recommend that clinical reasoning must be taught at all levels of medical training as it improves clinician performance and reduces cognitive errors. PMID:26519715

  16. Perspectives on clinical possibility: elements of analysis.

    PubMed

    Chiffi, Daniele; Zanotti, Renzo

    2016-08-01

    Possibility is one of the most common modalities in reasoning and argumentation. Various kinds of modal concepts have been identified in philosophical and logical discussion of the metaphysics of modality. We focus here on the concept of clinical possibility. A critical analysis of what is intended as clinical possibility has not yet received sufficient examination, although the concept is extensively used in clinical reasoning. We present arguments to emphasize some desirable features associated with the concept of clinical possibility. We argue that almost all clinical possibilities are potentialities, that is, possibilities that may be actualized by effective, appropriate and feasible interventions. However, in some limited cases, even mere possibilities - which may or may not be actualized, since we do not have the required knowledge - may be involved in clinical reasoning, and we present some examples in this paper. We then introduce some basic views on the nature of possibility showing their validity and limitations when applied to the concept of clinical possibility. Lastly, we conjecture that clinical possibility is a normative modality that can be formalized in a multimodal system with epistemic and deontic logical operators. PMID:26314392

  17. How to Establish Clinical Prediction Models.

    PubMed

    Lee, Yong Ho; Bang, Heejung; Kim, Dae Jung

    2016-03-01

    A clinical prediction model can be applied to several challenging clinical scenarios: screening high-risk individuals for asymptomatic disease, predicting future events such as disease or death, and assisting medical decision-making and health education. Despite the impact of clinical prediction models on practice, prediction modeling is a complex process requiring careful statistical analyses and sound clinical judgement. Although there is no definite consensus on the best methodology for model development and validation, a few recommendations and checklists have been proposed. In this review, we summarize five steps for developing and validating a clinical prediction model: preparation for establishing clinical prediction models; dataset selection; handling variables; model generation; and model evaluation and validation. We also review several studies that detail methods for developing clinical prediction models with comparable examples from real practice. After model development and vigorous validation in relevant settings, possibly with evaluation of utility/usability and fine-tuning, good models can be ready for the use in practice. We anticipate that this framework will revitalize the use of predictive or prognostic research in endocrinology, leading to active applications in real clinical practice. PMID:26996421

  18. On the relation between applied behavior analysis and positive behavioral support

    PubMed Central

    Carr, James E.; Sidener, Tina M.

    2002-01-01

    Anderson and Freeman (2000) recently defined positive behavioral support (PBS) as a systematic approach to the delivery of clinical and educational services that is rooted in behavior analysis. However, the recent literature contains varied definitions of PBS as well as discrepant notions regarding the relation between applied behavior analysis and PBS. After summarizing common definitional characteristics of PBS from the literature, we conclude that PBS is comprised almost exclusively of techniques and values originating in applied behavior analysis. We then discuss the relations between applied behavior analysis and PBS that have been proposed in the literature. Finally, we discuss possible implications of considering PBS a field separate from applied behavior analysis. PMID:22478389

  19. Good Clinical Practice Guidance and Pragmatic Clinical Trials: Balancing the Best of Both Worlds.

    PubMed

    Mentz, Robert J; Hernandez, Adrian F; Berdan, Lisa G; Rorick, Tyrus; O'Brien, Emily C; Ibarra, Jenny C; Curtis, Lesley H; Peterson, Eric D

    2016-03-01

    Randomized, clinical trials are commonly regarded as the highest level of evidence to support clinical decisions. Good Clinical Practice guidelines have been constructed to provide an ethical and scientific quality standard for trials that involve human subjects in a manner aligned with the Declaration of Helsinki. Originally designed to provide a unified standard of trial data to support submission to regulatory authorities, the principles may also be applied to other studies of human subjects. Although the application of Good Clinical Practice principles generally led to improvements in the quality and consistency of trial operations, these principles have also contributed to increasing trial complexity and costs. Alternatively, the growing availability of electronic health record data has facilitated the possibility for streamlined pragmatic clinical trials. The central tenets of Good Clinical Practice and pragmatic clinical trials represent potential tensions in trial design (stringent quality and highly efficient operations). In the present article, we highlight potential areas of discordance between Good Clinical Practice guidelines and the principles of pragmatic clinical trials and suggest strategies to streamline study conduct in an ethical manner to optimally perform clinical trials in the electronic age. PMID:26927005

  20. Outcome Prediction in Clinical Treatment Processes.

    PubMed

    Huang, Zhengxing; Dong, Wei; Ji, Lei; Duan, Huilong

    2016-01-01

    Clinical outcome prediction, as strong implications for health service delivery of clinical treatment processes (CTPs), is important for both patients and healthcare providers. Prior studies typically use a priori knowledge, such as demographics or patient physical factors, to estimate clinical outcomes at early stages of CTPs (e.g., admission). They lack the ability to deal with temporal evolution of CTPs. In addition, most of the existing studies employ data mining or machine learning methods to generate a prediction model for a specific type of clinical outcome, however, a mathematical model that predicts multiple clinical outcomes simultaneously, has not yet been established. In this study, a hybrid approach is proposed to provide a continuous predictive monitoring service on multiple clinical outcomes. More specifically, a probabilistic topic model is applied to discover underlying treatment patterns of CTPs from electronic medical records. Then, the learned treatment patterns, as low-dimensional features of CTPs, are exploited for clinical outcome prediction across various stages of CTPs based on multi-label classification. The proposal is evaluated to predict three typical classes of clinical outcomes, i.e., length of stay, readmission time, and the type of discharge, using 3492 pieces of patients' medical records of the unstable angina CTP, extracted from a Chinese hospital. The stable model was characterized by 84.9% accuracy and 6.4% hamming-loss with 3 latent treatment patterns discovered from data, which outperforms the benchmark multi-label classification algorithms for clinical outcome prediction. Our study indicates the proposed approach can potentially improve the quality of clinical outcome prediction, and assist physicians to understand the patient conditions, treatment inventions, and clinical outcomes in an integrated view. PMID:26573645

  1. [Randomized clinical trials and real clinical practice].

    PubMed

    Heerlein, Andrés

    2009-01-01

    One of the emerging problems in modern medicine is that part of its highly efficacious treatments do not show significant effectiveness in real world systems of care. Efficacy studies address the appropriate dosages, short term response and feasibility of treatments in carefully selected populations, but they do not necessarily provide information for decisions in clinical practice. This review aims to present strengths and limitations of different methodological types of trials and to offer an overview of how knowledge from clinical trials can be used for clinical practice. The important effect of funding source on the outcome of randomized controlled trials is discussed. Some key questions in the treatment assessment of depression, schizophrenia and different medical conditions are discussed, with a focus on the possibilities and restrictions of translating clinical trial results into real-world settings. Empirical evidence shows that although randomized controlled trials are the gold standard for proving efficacy of a therapeutic procedure they often suffer from funding source bias and from lack of generalizability. Effectiveness studies evaluate effects of treatments under conditions approximating usual care. Another key area that can be addressed by effectiveness studies is the impact on important health policy measures such as disability days, days of work or medical costs, etc. Conclusions show that the future assessment of treatment regimes for clinical utility requires less biased efficacy studies and more effectiveness studies addressing major issues from all relevant perspectives. PMID:19543562

  2. Can research influence clinical practice?

    PubMed

    Jiménez, Juan Pablo

    2007-06-01

    After briefly reviewing the unfavourable reception accorded empirical research by parts of the psychoanalytic community, as well as some of the benefits to clinical practice of analysts being involved in research activities, the author examines whether the findings of process and outcome research in psychotherapy and psychoanalysis can help identify the most appropriate forms of intervention for producing therapeutic change, given the specific condition of the patient and the relationship that the individual establishes with the analyst. He argues that research findings can influence clinical practice on various levels and in different areas, and goes on to examine a number of related issues: the specificity of therapeutic interventions versus the relevance of common curative factors; the dyadic conception of technique and ways of understanding the therapeutic action of the treatment alliance; and the strategic or heuristic conception in psychoanalytic therapy. Finally, the author presents clinical material with the aim of illustrating how the knowledge acquired through research can be applied to psychoanalytic treatment. PMID:17537698

  3. Child Participant Roles in Applied Linguistics Research

    ERIC Educational Resources Information Center

    Pinter, Annamaria

    2014-01-01

    Children's status as research participants in applied linguistics has been largely overlooked even though unique methodological and ethical concerns arise in projects where children, rather than adults, are involved. This article examines the role of children as research participants in applied linguistics and discusses the limitations of…

  4. Applied Implications of Reinforcement History Effects

    ERIC Educational Resources Information Center

    Pipkin, Claire St. Peter; Vollmer, Timothy R.

    2009-01-01

    Although the influence of reinforcement history is a theoretical focus of behavior analysis, the specific behavioral effects of reinforcement history have received relatively little attention in applied research and practice. We examined the potential effects of reinforcement history by reviewing nonhuman, human operant, and applied research and…

  5. Applying Psychological Theories to Educational Practice

    ERIC Educational Resources Information Center

    Sternberg, Robert

    2008-01-01

    Two approaches to the application of psychological theories to education might be referred to as domain-general and domain-specific. The domain-general approach seeks a general theory of cognitive and other skills that apply across subject-matter areas. The domain-specific approach seeks to apply specific theories within given domains, such as…

  6. 32 CFR 37.1220 - Applied research.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Applied research. 37.1220 Section 37.1220 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1220 Applied research. Efforts that attempt to determine and...

  7. The Contextual Interference Effect in Applied Settings

    ERIC Educational Resources Information Center

    Barreiros, Joao; Figueiredo, Teresa; Godinho, Mario

    2007-01-01

    This paper analyses the research literature that approaches the contextual interference effect in applied settings. In contrast to the laboratory settings, in which high interference conditions depress acquisition and promote learning evaluated in retention and transfer tests, in applied settings most of the studies (60%) fail to observe positive…

  8. Applied Linguistics in Its Disciplinary Context

    ERIC Educational Resources Information Center

    Liddicoat, Anthony J.

    2010-01-01

    Australia's current attempt to develop a process to evaluate the quality of research (Excellence in Research for Australia--ERA) places a central emphasis on the disciplinary organisation of academic work. This disciplinary focus poses particular problems for Applied Linguistics in Australia. This paper will examine Applied Linguistics in relation…

  9. Autobiographic Narratives as Data in Applied Linguistics

    ERIC Educational Resources Information Center

    Pavlenko, Aneta

    2007-01-01

    In the past decade, language memoirs, linguistic autobiographies, and learners' journals and diaries have become a popular means of data collection in applied linguistics. It is not always clear however how one should go about analyzing these data. The aim of this paper is to offer a critical review of analytical frameworks applied to second…

  10. Why They Didn't Apply.

    ERIC Educational Resources Information Center

    Baker, Michael E.; Meganathan, Ami

    Prospective students who received application materials for Carnegie-Mellon University (CMU), Pennsylvania, in 1976 and 1978 but did not apply for admission were surveyed to determine student background factors or attitudes that may have influenced their choice of colleges to which they applied. Findings include the following: nonapplicants…

  11. ISAE- The International Society for Applied Ethology

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The International Society for Applied Ethology (ISAE) was created in 1966 as the Society for Veterinary Ethology, with a primary membership of U.K.-based veterinarians. It quickly expanded to encompass researchers and clinicians working in all areas of applied animal behavior and all over the world....

  12. 32 CFR 37.1220 - Applied research.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false Applied research. 37.1220 Section 37.1220... REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1220 Applied research... technology such as new materials, devices, methods and processes. It typically is funded in...

  13. Applied Linguistics: The Challenge of Theory

    ERIC Educational Resources Information Center

    McNamara, Tim

    2015-01-01

    Language has featured prominently in contemporary social theory, but the relevance of this fact to the concerns of Applied Linguistics, with its necessary orientation to practical issues of language in context, represents an ongoing challenge. This article supports the need for a greater engagement with theory in Applied Linguistics. It considers…

  14. Edinburgh Working Papers in Applied Linguistics, 1996.

    ERIC Educational Resources Information Center

    Parkinson, Brian, Ed.; Mitchell, Keith

    1996-01-01

    This monograph contains papers on research work in progress at the Department of Applied Linguistics and Institute for Applied Language Studies at the University of Edinburgh (Scotland). Topics addressed include general English teaching, English for Academic Purposes teaching, Modern Language teaching, and teacher education. Papers are: "Cultural…

  15. Applied Indigenous Studies at Northern Arizona University.

    ERIC Educational Resources Information Center

    Trosper, Ronald L.

    2001-01-01

    The Applied Indigenous Studies program at Northern Arizona University aims to prepare American Indian students to assume tribal leadership roles. Its location in the College of Ecosystem Science and Management emphasizes its land-oriented and applied focus. The program's development, core courses, and academic requirements for bachelors degrees…

  16. 32 CFR 37.1220 - Applied research.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Applied research. 37.1220 Section 37.1220... REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1220 Applied research... technology such as new materials, devices, methods and processes. It typically is funded in...

  17. 32 CFR 37.1220 - Applied research.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false Applied research. 37.1220 Section 37.1220... REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1220 Applied research... technology such as new materials, devices, methods and processes. It typically is funded in...

  18. Nuclear Facilities and Applied Technologies at Sandia

    SciTech Connect

    Wheeler, Dave; Kaiser, Krista; Martin, Lonnie; Hanson, Don; Harms, Gary; Quirk, Tom

    2014-11-28

    The Nuclear Facilities and Applied Technologies organization at Sandia National Laboratories’ Technical Area Five (TA-V) is the leader in advancing nuclear technologies through applied radiation science and unique nuclear environments. This video describes the organization’s capabilities, facilities, and culture.

  19. Applied Behavior Analysis and Statistical Process Control?

    ERIC Educational Resources Information Center

    Hopkins, B. L.

    1995-01-01

    Incorporating statistical process control (SPC) methods into applied behavior analysis is discussed. It is claimed that SPC methods would likely reduce applied behavior analysts' intimate contacts with problems and would likely yield poor treatment and research decisions. Cases and data presented by Pfadt and Wheeler (1995) are cited as examples.…

  20. 32 CFR 37.1220 - Applied research.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1220 Applied research. Efforts that attempt to determine and exploit the potential of scientific discoveries or improvements in... 32 National Defense 1 2010-07-01 2010-07-01 false Applied research. 37.1220 Section...

  1. Applying Cultural Competency in Clinical Practice: Findings from Multicultural Experts' Experience

    ERIC Educational Resources Information Center

    Kwong, Miu Ha

    2009-01-01

    This study employed a qualitative (grounded theory) method to achieve a better understanding, conceptualization, and operationalization of how cultural competency translated into practice could be observed and evaluated in social work students and practitioners. The research findings presented in this study were organized into three overarching…

  2. On the evolution of statistical methods as applied to clinical trials.

    PubMed

    Machin, D

    2004-05-01

    This paper describes how statistical methods have evolved in parallel with activities associated with randomized control trials. In particular we emphasize the pivotal role of two papers published in British Journal of Cancer, and the paper describing the Cox proportional hazards model. In addition, the importance of early papers on estimating the sample size required for trials is highlighted. Later developments including the increasing roles for competing risks, multilevel modelling and Bayesian methodologies are described. The interplay between computer software and statistical methodological developments is stressed. Finally some future directions are indicated. PMID:15078495

  3. Clinical Evaluation of Direct Aperture Optimization When Applied to Head-And-Neck IMRT

    SciTech Connect

    Jones, Stephen Williams, Matthew

    2008-04-01

    Direct Machine Parameter Optimization (DMPO) is a leaf segmentation program released as an optional item of the Pinnacle planning system (Philips Radiation Oncology Systems, Milpitas, CA); it is based on the principles of direct aperture optimization where the size, shape, and weight of individual segments are optimized to produce an intensity modulated radiation treatment (IMRT) plan. In this study, we compare DMPO to the traditional method of IMRT planning, in which intensity maps are optimized prior to conversion into deliverable multileaf collimator (MLC) apertures, and we determine if there was any dosimetric improvement, treatment efficiency gain, or planning advantage provided by the use of DMPO. Eleven head-and-neck patients treated with IMRT had treatment plans generated using each optimization method. For each patient, the same planning parameters were used for each optimization method. All calculations were performed using Pinnacle version 7.6c software and treatments were delivered using a step-and-shoot IMRT method on a Varian 2100EX linear accelerator equipped with a 120-leaf Millennium MLC (Varian Medical Systems, Palo Alto, CA). Each plan was assessed based on the calculation time, a conformity index, the composite objective value used in the optimization, the number of segments, monitor units (MUs), and treatment time. The results showed DMPO to be superior to the traditional optimization method in all areas. Considerable advantages were observed in the dosimetric quality of DMPO plans, which also required 32% less time to calculate, 42% fewer MUs, and 35% fewer segments than the conventional optimization method. These reductions translated directly into a 29% decrease in treatment times. While considerable gains were observed in planning and treatment efficiency, they were specific to our institution, and the impact of direct aperture optimization on plan quality and workflow will be dependent on the planning parameters, planning system, and linear accelerators used by a particular institution.

  4. Reliability Realized! Year Two of Clinical Practice Candidates Applying Action Research

    ERIC Educational Resources Information Center

    Moffett, David W.; Zhou, Yunfang; Reid, Barbara K.

    2009-01-01

    The Investigators studied effects of Candidates' 10 day unit plans of instruction through prescribed action research projects, across academic years 2007-2008 and 2008-2009. Results of the spring term '07-'08 Action Research projects informed the Unit in such a way that modifications were possible and made across programs. This resulted in…

  5. Applying behavior analysis to clinical problems: review and analysis of habit reversal.

    PubMed Central

    Miltenberger, R G; Fuqua, R W; Woods, D W

    1998-01-01

    This article provides a review and analysis of habit reversal, a multicomponent procedure developed by Azrin and Nunn (1973, 1974) for the treatment of nervous habits, tics, and stuttering. The article starts with a discussion of the behaviors treated with habit reversal, behavioral covariation among habits, and functional analysis and assessment of habits. Research on habit reversal and simplified versions of the procedure is then described. Next the article discusses the limitations of habit reversal and the evidence for its generality. The article concludes with an analysis of the behavioral processes involved in habit reversal and suggestions for future research. PMID:9757583

  6. Social Psychological Concepts Applied to Clinical Processes: On the Need for Precision.

    ERIC Educational Resources Information Center

    Harris, Ben; Harvey, John H.

    1978-01-01

    Analyzes and critiques an attempted application of cognitive dissonance and reactance concepts to a therapy analogue. An experiment by R. M. Gordon is discussed. Key prerequisites for dissonance arousal and for reactance induction were not present. Self-selection of volunteers for treatment is an unreported factor. Gordon replies to this critique.…

  7. Helping patients make better decisions: how to apply behavioral economics in clinical practice

    PubMed Central

    Courtney, Maureen Reni; Spivey, Christy; Daniel, Kathy M

    2014-01-01

    Clinicians are committed to effectively educating patients and helping them to make sound decisions concerning their own health care. However, how do clinicians determine what is effective education? How do they present information clearly and in a manner that patients understand and can use to make informed decisions? Behavioral economics (BE) is a subfield of economics that can assist clinicians to better understand how individuals actually make decisions. BE research can help guide interactions with patients so that information is presented and discussed in a more deliberate and impactful way. We can be more effective providers of care when we understand the factors that influence how our patients make decisions, factors of which we may have been largely unaware. BE research that focuses on health care and medical decision making is becoming more widely known, and what has been reported suggests that BE interventions can be effective in the medical realm. The purpose of this article is to provide clinicians with an overview of BE decision science and derived practice strategies to promote more effective behavior change in patients. PMID:25378915

  8. Applying the Concept of Trustworthiness to the Evaluation of a Clinical Program.

    ERIC Educational Resources Information Center

    Barzansky, Barbara; And Others

    An attending tutor program designed to increase faculty-student contact within an Obstetrics and Gynecology clerkship was evaluated. Sessions were observed, written documents were reviewed, and faculty and students were interviewed in order to determine if the program was meeting its goals. Based on the evaluation data, the program was…

  9. Applying mixed reality to simulate vulnerable populations for practicing clinical communication skills.

    PubMed

    Chuah, Joon Hao; Lok, Benjamin; Black, Erik

    2013-04-01

    Health sciences students often practice and are evaluated on interview and exam skills by working with standardized patients (people that role play having a disease or condition). However, standardized patients do not exist for certain vulnerable populations such as children and the intellectually disabled. As a result, students receive little to no exposure to vulnerable populations before becoming working professionals. To address this problem and thereby increase exposure to vulnerable populations, we propose using virtual humans to simulate members of vulnerable populations. We created a mixed reality pediatric patient that allowed students to practice pediatric developmental exams. Practicing several exams is necessary for students to understand how to properly interact with and correctly assess a variety of children. Practice also increases a student's confidence in performing the exam. Effective practice requires students to treat the virtual child realistically. Treating the child realistically might be affected by how the student and virtual child physically interact, so we created two object interaction interfaces - a natural interface and a mouse-based interface. We tested the complete mixed reality exam and also compared the two object interaction interfaces in a within-subjects user study with 22 participants. Our results showed that the participants accepted the virtual child as a child and treated it realistically. Participants also preferred the natural interface, but the interface did not affect how realistically participants treated the virtual child. PMID:23428437

  10. Structure and Measurement of Depression in Youths: Applying Item Response Theory to Clinical Data

    ERIC Educational Resources Information Center

    Cole, David A.; Cai, Li; Martin, Nina C.; Findling, Robert L.; Youngstrom, Eric A.; Garber, Judy; Curry, John F.; Hyde, Janet S.; Essex, Marilyn J.; Compas, Bruce E.; Goodyer, Ian M.; Rohde, Paul; Stark, Kevin D.; Slattery, Marcia J.; Forehand, Rex

    2011-01-01

    Our goals in this article were to use item response theory (IRT) to assess the relation of depressive symptoms to the underlying dimension of depression and to demonstrate how IRT-based measurement strategies can yield more reliable data about depression severity than conventional symptom counts. Participants were 3,403 children and adolescents…

  11. Understanding Girls with Attention-Deficit/Hyperactivity Disorder (ADHD): Applying Research to Clinical Practice

    ERIC Educational Resources Information Center

    Soffer, Stephen L.; Mautone, Jennifer A.; Power, Thomas J.

    2008-01-01

    To date, the majority of research on Attention-Deficit/Hyperactivity Disorder (ADHD) has been completed with boys as the predominate participants in study samples. Over the past decade there has been increased attention focused on the characteristics and needs of girls with ADHD. Although much of the research comparing boys and girls with ADHD…

  12. Novel insights in basic and applied stem cell therapy.

    PubMed

    Siniscalco, Dario; Giordano, Antonio; Galderisi, Umberto

    2012-05-01

    The achievement of novel findings in stem cell research were the subject of the meeting organized by Stem Cell Research Italy (SCR Italy) and by the International Society for Cellular Therapy-Europe (ISCT). Stem cell therapy represents great promise for the future of molecular and regenerative medicine. The use of several types of stem cells is a real opportunity to provide a valid approach to curing several untreatable human diseases. Before it is suitable for clinical applications, stem cell biology needs to be investigated further and in greater detail. Basic stem cell research could provide exact knowledge regarding stem cell action mechanisms, and pre-clinical research on stem cells on an in vivo model of disease provides scientific evidence for future human applications. Applied stem cell research is a promising new approach to handling several diseases. Along with tissue engineering, it offers a new and promising discipline that can help to manage human pathologies through stem cell therapy. All of these themes were discussed in this meeting, covering stem cell subtypes with their newest basic and applied research. PMID:21780112

  13. Applied behavior analysis at West Virginia University: A brief history.

    PubMed

    Hawkins, R P; Chase, P N; Scotti, J R

    1993-01-01

    The development of an emphasis on applied behavior analysis in the Department of Psychology at West Virginia University is traced. The emphasis began primarily in the early 1970s, under the leadership of Roger Maley and Jon Krapfl, and has continued to expand and evolve with the participation of numerous behavior analysts and behavior therapists, both inside and outside the department. The development has been facilitated by several factors: establishment of a strong behavioral emphasis in the three Clinical graduate programs; change of the graduate program in Experimental Psychology to a program in basic Behavior Analysis; development of nonclinical applied behavior analysis within the Behavior Analysis program; establishment of a joint graduate program with Educational Psychology; establishment of a Community/Systems graduate program; and organization of numerous conferences. Several factors are described that seem to assure a stable role for behavior analysis in the department: a stable and supportive "culture" within the department; American Psychological Association accreditation of the clinical training; a good reputation both within the university and in psychology; and a broader community of behavior analysts and behavior therapists. PMID:16795816

  14. The basic importance of applied behavior analysis

    PubMed Central

    Epling, W. Frank; Pierce, W. David

    1986-01-01

    We argue that applied behavior analysis is relevant to basic research. Modification studies, and a broad range of investigations that focus on the precipitating and maintaining conditions of socially significant human behavior, have basic importance. Applied behavior analysis may aid basic researchers in the design of externally valid experiments and thereby enhance the theoretical significance of basic research for understanding human behavior. Applied research with humans, directed at culturally-important problems, will help to propagate the science of human behavior. Such a science will also be furthered by analogue experiments that model socially important behavior. Analytical-applied studies and analogue experiments are forms of applied behavior analysis that could suggest new environment-behavior relationships. These relationships could lead to basic research and principles that further the prediction, control, and understanding of behavior. PMID:22478650

  15. Defining Clinical Excellence in Adult Infectious Disease Practice

    PubMed Central

    Chida, Natasha M.; Ghanem, Khalil G.; Auwaerter, Paul G.; Wright, Scott M.; Melia, Michael T.

    2016-01-01

    Clinical excellence should be recognized, particularly in the current climate that appropriately prioritizes relationship-centered care. In order to develop a recognition model, a definition of clinical excellence must be created and agreed upon. A paradigm recently suggested by C. Christmas describes clinical excellence through the following domains: diagnostic acumen, professionalism and humanism, communication and interpersonal skills, skillful negotiation of the healthcare system, knowledge, taking a scholarly approach to clinical practice, and having passion for clinical medicine. This work references examples of infectious disease (ID) clinical excellence across Christmas' domains and, in doing so, both examines how the definition of clinical excellence applies to ID practice and highlights the importance of ID physicians. Emphasizing such aspirational standards may not only inspire trainees and practicing physicians to pursue their own fulfilling clinical ID careers, it may also encourage health systems to fully value outstanding ID physicians who labor tirelessly to provide patients with exceptional care. PMID:27419186

  16. Defining Clinical Excellence in Adult Infectious Disease Practice.

    PubMed

    Chida, Natasha M; Ghanem, Khalil G; Auwaerter, Paul G; Wright, Scott M; Melia, Michael T

    2016-09-01

    Clinical excellence should be recognized, particularly in the current climate that appropriately prioritizes relationship-centered care. In order to develop a recognition model, a definition of clinical excellence must be created and agreed upon. A paradigm recently suggested by C. Christmas describes clinical excellence through the following domains: diagnostic acumen, professionalism and humanism, communication and interpersonal skills, skillful negotiation of the healthcare system, knowledge, taking a scholarly approach to clinical practice, and having passion for clinical medicine. This work references examples of infectious disease (ID) clinical excellence across Christmas' domains and, in doing so, both examines how the definition of clinical excellence applies to ID practice and highlights the importance of ID physicians. Emphasizing such aspirational standards may not only inspire trainees and practicing physicians to pursue their own fulfilling clinical ID careers, it may also encourage health systems to fully value outstanding ID physicians who labor tirelessly to provide patients with exceptional care. PMID:27419186

  17. Statistics in clinical research: Important considerations

    PubMed Central

    Barkan, Howard

    2015-01-01

    Statistical analysis is one of the foundations of evidence-based clinical practice, a key in conducting new clinical research and in evaluating and applying prior research. In this paper, we review the choice of statistical procedures, analyses of the associations among variables and techniques used when the clinical processes being examined are still in process. We discuss methods for building predictive models in clinical situations, and ways to assess the stability of these models and other quantitative conclusions. Techniques for comparing independent events are distinguished from those used with events in a causal chain or otherwise linked. Attention then turns to study design, to the determination of the sample size needed to make a given comparison, and to statistically negative studies. PMID:25566715

  18. Making Diabetes Clinic Records Computer-Compatible

    PubMed Central

    McKendry, J. B. Ralph; Braaten, Jan T.

    1985-01-01

    Efficient paper records are prerequisites for success in computerizing clinical data on chronic, multi-system diseases such as diabetes. Clinic/office charts can be made more efficient manual records and computer-compatible by use of formats and procedures facilitating collection, selective abstraction, coding and entry of data-to-be-saved. A dated Health Events List is essential. A clinical status profiling process to represent salient features in concise, comprehensible and computer-digestible codes is useful, as is a subsystem to capture and apply patient-generated data. An IBM PC/KnowledgeMan-based diabetes information system subserved by formatted paper records incorporating these devices is in use for clinical care and research purposes.

  19. Smart Technology in Lung Disease Clinical Trials.

    PubMed

    Geller, Nancy L; Kim, Dong-Yun; Tian, Xin

    2016-01-01

    This article describes the use of smart technology by investigators and patients to facilitate lung disease clinical trials and make them less costly and more efficient. By "smart technology" we include various electronic media, such as computer databases, the Internet, and mobile devices. We first describe the use of electronic health records for identifying potential subjects and then discuss electronic informed consent. We give several examples of using the Internet and mobile technology in clinical trials. Interventions have been delivered via the World Wide Web or via mobile devices, and both have been used to collect outcome data. We discuss examples of new electronic devices that recently have been introduced to collect health data. While use of smart technology in clinical trials is an exciting development, comparison with similar interventions applied in a conventional manner is still in its infancy. We discuss advantages and disadvantages of using this omnipresent, powerful tool in clinical trials, as well as directions for future research. PMID:26135330

  20. Clinical application of MRI in ophthalmology

    PubMed Central

    Townsend, Kelly A.; Wollstein, Gadi; Schuman, Joel S.

    2010-01-01

    MRI has long been applied to clinical medical and neurological cases for the structural assessment of tissues as well as their physiological and functional needs and processes. These uses are at a variety of developmental stages in ophthalmology, from common use of clinical structural assessment for neuro-ophthalmology and evaluation of space-occupying lesions to the beginning stages of experimentally measuring functional activation of specific layers within the retina and measurement of physiological oxygen responses. New MRI methodologies, such as the use of orbital coils and Gd-DTPA image enhancement, have been researched, developed, and validated in the eye, opening new possibilities for this technology to enter the clinic. This review aims to summarize the clinical ophthalmological uses of MRI, focusing on the current use of the technology and future applications. PMID:18384176

  1. The tacit dimension of clinical judgment.

    PubMed Central

    Goldman, G. M.

    1990-01-01

    Two distinct views of the nature of clinical judgment are identified and contrasted. The dominant view that clinical judgment is a fully explicit process is compared to the relatively neglected view that tacit knowledge plays a substantial role in the clinician's mental operations. The tacit dimension of medical thinking is explored at length. The discussion suggests severe limits when applying decision analysis, expert systems, and computer-aided cost-benefit review to medicine. The goals and practices of postgraduate medical education are also examined from this perspective, as are various other implications for the clinician. The paper concludes that it is valuable to explore the nature of medical thinking in order to improve clinical practice and education. Such explorations should, however, take cognizance of the often overlooked tacit dimension of clinical judgment. Possible constraints on the medical applicability of both formal expert systems and heavily didactic instructional programs are considered. PMID:2356625

  2. Perceptions of Anatomy: Critical Components in the Clinical Setting

    ERIC Educational Resources Information Center

    Lazarus, Michelle D.; Chinchilli, Vernon M.; Leong, Shou Ling; Kauffman, Gordon L., Jr.

    2012-01-01

    The evolution in undergraduate medical school curricula has significantly impacted anatomy education. This study investigated the perceived role of clinical anatomy and evaluated perceptions of medical students' ability to apply anatomical knowledge in the clinic. The aim of this study was to develop a framework to enhance anatomical educational…

  3. Temporal Relation Extraction in Outcome Variances of Clinical Pathways.

    PubMed

    Yamashita, Takanori; Wakata, Yoshifumi; Hamai, Satoshi; Nakashima, Yasuharu; Iwamoto, Yukihide; Franagan, Brendan; Nakashima, Naoki; Hirokawa, Sachio

    2015-01-01

    Recently the clinical pathway has progressed with digitalization and the analysis of activity. There are many previous studies on the clinical pathway but not many feed directly into medical practice. We constructed a mind map system that applies the spanning tree. This system can visualize temporal relations in outcome variances, and indicate outcomes that affect long-term hospitalization. PMID:26262376

  4. Reflection-in-Action: Case Study of a Clinical Supervisor.

    ERIC Educational Resources Information Center

    Turner-Muecke, Lee A.

    1986-01-01

    Applies Donald Schon's concept of the "reflective practitioner" to Robert Goldhammer's clinical supervision cycle (pre-observation conference, observation, analysis and strategy, supervision conference, and postconference analysis), stressing personal growth purposes for teacher and supervisor alike. Explores a clinical supervisor's reflection on…

  5. A value analysis model applied to the management of amblyopia.

    PubMed Central

    Beauchamp, G R; Bane, M C; Stager, D R; Berry, P M; Wright, W W

    1999-01-01

    PURPOSE: To assess the value of amblyopia-related services by utilizing a health value model (HVM). Cost and quality criteria are evaluated in accordance with the interests of patients, physicians, and purchasers. METHODS: We applied an HVM to a hypothetical statistical ("median") child with amblyopia whose visual acuity is 20/80 and to a group of children with amblyopia who are managed by our practice. We applied the model to calculate the value of these services by evaluating the responses of patients and physicians and relating these responses to clinical outcomes. RESULTS: The consensus value of care for the hypothetical median child was calculated to be 0.406 (of 1.000). For those children managed in our practice, the calculated value is 0.682. Clinically, 79% achieved 20/40 or better visual acuity, and the mean final visual acuity was 0.2 logMAR (20/32). Value appraisals revealed significant concerns about the financial aspects of amblyopia-related services, particularly among physicians. Patients rated services more positively than did physicians. CONCLUSIONS: Amblyopia care is difficult, sustained, and important work that requires substantial sensitivity to and support of children and families. Compliance and early detection are essential to success. The value of amblyopia services is rated significantly higher by patients than by physicians. Relative to the measured value, amblyopia care is undercompensated. The HVM is useful to appraise clinical service delivery and its variation. The costs of failure and the benefits of success are high; high-value amblyopia care yields substantial dividends and should be commensurately compensated in the marketplace. PMID:10703133

  6. Model-driven CDA Clinical Document Development Framework.

    PubMed

    Li, Jingdong; Lincoln, Michael J

    2007-01-01

    The Health Level 7 (HL7) Clinical Document Architecture, Release 2 (CDA R2) standardizes the structure and semantics of clinical documents in order to permit interchange. We have applied this standard to generate a platform independent CDA model and write a toolset that permits model specialization, generation of XML implementation artifacts, and provides an interface for clinical data managers. The resulting work was tested using US Department of Veterans Affairs Operative Note templates. PMID:18694129

  7. Personalizing Drug Selection Using Advanced Clinical Decision Support

    PubMed Central

    Pestian, John; Spencer, Malik; Matykiewicz, Pawel; Zhang, Kejian; Vinks, Alexander A.; Glauser, Tracy

    2009-01-01

    This article describes the process of developing an advanced pharmacogenetics clinical decision support at one of the United States’ leading pediatric academic medical centers. This system, called CHRISTINE, combines clinical and genetic data to identify the optimal drug therapy when treating patients with epilepsy or Attention Deficit Hyperactivity Disorder. In the discussion a description of clinical decision support systems is provided, along with an overview of neurocognitive computing and how it is applied in this setting. PMID:19898682

  8. Good clinical practice is now obligatory in academic clinical drug research in the European Union.

    PubMed

    Jørgensen, Annette; Bach, Karin Friis; Friis, Karen

    2004-02-01

    By May 2004, all clinical trials in the European Union (EU) on medicinal products have to be initiated and conducted in compliance with the principles in the new directive on Good Clinical Practice (GCP). This requirement will also apply to non-commercial trials involving registered drugs and may therefore restrain the academic clinical drug research. In Denmark, three public GCP units connected in a national network and associated with the university hospitals in Copenhagen, Odense and Aarhus have been established. The GCP units offer academic researchers the necessary quality assurance and quality control systems to ensure that clinical drug research can be performed according to GCP. The Danish initiative is presented here as a contribution to the future work with implementation of the principles of GCP in academic clinical drug research in the European Union. PMID:14748847

  9. Improving clinical practice guidelines for practicing cardiologists.

    PubMed

    Benhorin, Jesaia; Bodenheimer, Monty; Brown, Mary; Case, Robert; Dwyer, Edward M; Eberly, Shirley; Francis, Charles; Gillespie, John A; Goldstein, Robert E; Greenberg, Henry; Haigney, Mark; Krone, Ronald J; Klein, Helmut; Lichstein, Edgar; Locati, Emanuela; Marcus, Frank I; Moss, Arthur J; Oakes, David; Ryan, Daniel H; Bloch Thomsen, Poul E; Zareba, Wojciech

    2015-06-15

    Cardiac-related clinical practice guidelines have become an integral part of the practice of cardiology. Unfortunately, these guidelines are often long, complex, and difficult for practicing cardiologists to use. Guidelines should be condensed and their format upgraded, so that the key messages are easier to comprehend and can be applied more readily by those involved in patient care. After presenting the historical background and describing the guideline structure, we make several recommendations to make clinical practice guidelines more user-friendly for clinical cardiologists. Our most important recommendations are that the clinical cardiology guidelines should focus exclusively on (1) class I recommendations with established benefits that are supported by randomized clinical trials and (2) class III recommendations for diagnostic or therapeutic approaches in which quality studies show no benefit or possible harm. Class II recommendations are not evidence based but reflect expert opinions related to published clinical studies, with potential for personal bias by members of the guideline committee. Class II recommendations should be published separately as "Expert Consensus Statements" or "Task Force Committee Opinions," so that both majority and minority expert opinions can be presented in a less dogmatic form than the way these recommendations currently appear in clinical practice guidelines. PMID:25918027

  10. The Clinical Trials Transformation Initiative (CTTI).

    PubMed

    Grignolo, Alberto

    2011-01-01

    The Clinical Trials Transformation Initiative (CTTI) is a public-private partnership created in 2007 between the United States Food and Drug Administration (FDA) and Duke University for the purpose of identifying practices that will increase the quality and efficiency of clinical trials. The initiative was generated from the realization that the clinical trials system in the United States has been suffering as a result of increasingly longer study start-up times, slowing enrollment of patients into trials, increasing clinical trial costs, and declining investigator interest in participating in clinical trials. Although CTTI was created to address a crisis for US clinical research, it seeks to identify practice improvements that can be applied internationally, and is therefore engaging international collaborators with international efforts that have similar objectives. CTTI's approach is to involve all sectors in the selection, conduct, and interpretation of its projects; to keep the dialogue open across sectors; to provide evidence that can influence regulatory guidance, and to attempt to create a "level playing field" when recommending change. The hope is that a broad and diverse data-driven discussion of the important issues in clinical trials will lead to meaningful change for the benefit of all concerned, and importantly for patients. PMID:21430332

  11. Operating Outpatient Clinics in 1990.

    ERIC Educational Resources Information Center

    Bohannan, Harry M.

    1984-01-01

    The future of dental school clinic operations is discussed including change within dental education, factors influencing change, and some predicted changes. Fundamental change can be predicted in educational philosophy, responsibility for clinical care, clinic facilities, clinic operation, and faculty. (MLW)

  12. American Association for Clinical Chemistry

    MedlinePlus

    ... indispensable patient care tool. Learn more IN CLINICAL CHEMISTRY ddPCR Quantification of Lymphoma Mutations Researchers have developed ... Online Harmonization.net Commission on Accreditation in Clinical Chemistry American Board of Clinical Chemistry Clinical Chemistry Trainee ...

  13. Applied Pharmacokinetics: Course Description and Retrospective Evaluation.

    ERIC Educational Resources Information Center

    Beck, Diane E.

    1984-01-01

    An applied course designed to allow students to formulate pharmacokinetic recommendations individually for actual patient data and compare their recommendations to those of a pharmacokinetic consulting service is described and evaluated, and an objective student evaluation method is outlined. (MSE)

  14. Applied Physics at Heriot-Watt.

    ERIC Educational Resources Information Center

    Colles, M. J.

    1979-01-01

    Describes a course in applied physics with solid state electronics, aimed at providing a continuing broad background in general physics while allowing for the gradual development of an emphasis on applications, engineering expertise, and relevant industrial experience. (Author/GA)

  15. Applied Aeroscience and CFD Branch Overview

    NASA Technical Reports Server (NTRS)

    LeBeau, Gerald J.; Kirk, Benjamin S.

    2014-01-01

    The principal mission of NASA Johnson Space Center is Human Spaceflight. In support of the mission the Applied Aeroscience and CFD Branch has several technical competencies that include aerodynamic characterization, aerothermodynamic heating, rarefied gas dynamics, and decelerator (parachute) systems.

  16. Security Science as an Applied Science?

    ERIC Educational Resources Information Center

    Smith, Clifton

    2001-01-01

    Describes the development of a security science degree as the emerging applied science of the protection of individuals and assets. Proposes the themes of physical, electronic, information security and facility management as scientific applications for the course. (Author/MM)

  17. Applying Change of Variable to Calculus Problems

    ERIC Educational Resources Information Center

    Kachapova, Farida; Kachapov, Ilias

    2011-01-01

    This article describes the technique of introducing a new variable in some calculus problems to help students master the skills of integration and evaluation of limits. This technique is algorithmic and easy to apply.

  18. Current Psychotherapy Research Methodology Applied to Psychoanalysis

    PubMed Central

    VAUGHAN, SUSAN C.; MARSHALL, RANDALL D.; MACKINNON, ROGER A.; ROOSE, STEVEN P.

    1994-01-01

    This paper describes a study to assess the feasibility of applying the methodology and instruments used in brief-term psychotherapy outcome research to long-term psychodynamic psychotherapy and psychoanalysis. PMID:22700201

  19. Applied-field MPD thruster geometry effects

    NASA Technical Reports Server (NTRS)

    Myers, Roger M.

    1991-01-01

    Eight MPD thruster configurations were used to study the effects of applied field strength, propellant, and facility pressure on thruster performance. Vacuum facility background pressures higher than approx. 0.12 Pa were found to greatly influence thruster performance and electrode power deposition. Thrust efficiency and specific impulse increased monotonically with increasing applied field strength. Both cathode and anode radii fundamentally influenced the efficiency specific impulse relationship, while their lengths influence only the magnitude of the applied magnetic field required to reach a given performance level. At a given specific impulse, large electrode radii result in lower efficiencies for the operating conditions studied. For all test conditions, anode power deposition was the largest efficiency loss, and represented between 50 and 80 pct. of the input power. The fraction of the input power deposited into the anode decreased with increasing applied field and anode radii. The highest performance measured, 20 pct. efficiency at 3700 seconds specific impulse, was obtained using hydrogen propellant.

  20. Introductory Applied Quantum and Statistical Mechanics

    NASA Astrophysics Data System (ADS)

    Hagelstein, Peter L.; Senturia, Stephen D.; Orlando, Terry P.

    2004-03-01

    * An applied focus for electrical engineers and materials scientists. * Theoretical results supported with real-world systems and applications. * Includes worked examples and self-study questions. * Solutions manual available.

  1. Applied andrology in chickens and turkeys

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The theories and practices of applied andrology in commercial poultry species (turkey, layer chicken and broiler chicken) are reviewed. Poultry male reproductive biology, including reproductive anatomy and spermatogenesis, is compared with mammalian livestock species. A detailed description of pou...

  2. Applied Mathematical Sciences research at Argonne, October 1, 1978-March 31, 1980

    SciTech Connect

    Pieper, G. W.

    1980-01-01

    This report reviews the research activities of the Applied Mathematical Sciences Section for the period October 1, 1978, through March 31, 1980. The body of the report discusses various projects carried out in four major areas of research: applied analysis, computational mathematics, software engineering, and software clinics. Information on section staff, visitors, workshops, and seminars is found in the appendices. Descriptions of individual research topics are very brief.

  3. [What did bachelard mean by "applied rationalism" ?].

    PubMed

    Tiles, Mary

    2013-01-01

    Bachelard was concerned with the processes whereby scientific knowledge is acquired, including the activity of knowing subjects. He did not equate reasoning with logic but rather argued that reasoning resulted from the use of mathematics in organizing both thought and experimental practices, which is why he conceived science as applied mathematics. This had material and technical implications, for Bachelard was concerned with the element of reason inherent in technical materialism as well as the concrete reality inherent in applied rationalism. PMID:24091650

  4. Applied optics in the automotive industry.

    PubMed

    Preston, B W

    1969-09-01

    A general discussion of the interrelated subjects of vision, illumination, marking systems, signaling devices, materials, and components as found in the automotive industry is included in this article. Optics as applied in supporting industries, such as the lighting, metal, glass, paint, plastics, and fabrics industries are also discussed. A few examples of optics in these industries as applied to product development and productioncontrol are presented and illustrated. PMID:20072517

  5. Clinical management of hypophosphatasia

    PubMed Central

    Bishop, Nick

    2015-01-01

    Summary HPP is a rare disease that manifests in different ways across the life course. Accurate diagnosis depends upon the use of appropriate age-related normative data. A new therapy is undergoing clinical trials; the preliminary published data is encouraging, but the scope of clinical application remains to be determined. PMID:26604944

  6. CLINICAL TRIALS.GOV

    EPA Science Inventory

    ClinicalTrials.gov provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases and conditions. The U.S. National Institutes of Health (NIH), through its National Library of Medi...

  7. Multispecialty Clinic Practice

    PubMed Central

    Margolin, David A.; Beck, David E.

    2011-01-01

    A multispecialty clinic practice is a common practice arrangement for colorectal surgeons. This type of practice has a variety of features, both positive and negative. The authors explore location, practice patterns, lifestyles, compensation, and academic opportunities associated with a multispecialty clinic practice. This information can assist younger surgeons in choosing a practice opportunity and guide experienced surgeons through their career progression. PMID:22654568

  8. The NASA Clinic System

    NASA Technical Reports Server (NTRS)

    Scarpa, Philip J.; Williams, Richard

    2009-01-01

    NASA maintains on site occupational health clinics at all Centers and major facilities NASA maintains an on-site clinic that offers comprehensive health care to astronauts at the Johnson Space Center NASA deploys limited health care capability to space and extreme environments Focus is always on preventive health care

  9. Clinical coding. Code breakers.

    PubMed

    Mathieson, Steve

    2005-02-24

    --The advent of payment by results has seen the role of the clinical coder pushed to the fore in England. --Examinations for a clinical coding qualification began in 1999. In 2004, approximately 200 people took the qualification. --Trusts are attracting people to the role by offering training from scratch or through modern apprenticeships. PMID:15768716

  10. Clinical Application of Electrocardiography.

    ERIC Educational Resources Information Center

    Brammell, H. L.; Orr, William

    The scalar electrocardiogram (ECG) is one of the most important and commonly used clinical tools in medicine. A detailed description of the recordings of cardiac electrical activity made by the ECG is presented, and the vast numbers of uses made with the data provided by this diagnostic tool are cited. Clinical applications of the ECG are listed.…

  11. Advances in clinical study of curcumin.

    PubMed

    Yang, Chunfen; Su, Xun; Liu, Anchang; Zhang, Lin; Yu, Aihua; Xi, Yanwei; Zhai, Guangxi

    2013-01-01

    Curcumin has been estimated as a potential agent for many diseases and attracted great attention owing to its various pharmacological activities, including anti-cancer, and anti-inflammatory. Now curcumin is being applied to a number of patients with breast cancer, rheumatoid arthritis, Alzheimer's disease, colorectal cancer, psoriatic, etc. Several clinical trials have stated that curcumin is safe enough and effective. The objective of this article was to summarize the clinical studies of curcumin, and give a reference for future studies. PMID:23116307

  12. High-Resolution Manometry in Clinical Practice

    PubMed Central

    Pandolfino, John E.

    2015-01-01

    High-resolution manometry (HRM) is the primary method used to evaluate esophageal motor function. Displayed and interpreted by esophageal pressure topography (EPT), HRM/ EPT provides a detailed assessment of esophageal function that is useful in the evaluation of patients with nonobstructive dysphagia and before foregut surgery. Esophageal motility diagnoses are determined systematically by applying objective metrics of esophageal sphincter and peristaltic function to the Chicago Classification of esophageal motility disorders. This article discusses HRM study, EPT interpretation, and the translation of EPT findings into clinical practice. Examples are provided to illustrate several clinical challenges. PMID:27118931

  13. The Contextualization of Archetypes: Clinical Template Governance.

    PubMed

    Pedersen, Rune; Ulriksen, Gro-Hilde; Ellingsen, Gunnar

    2015-01-01

    This paper is a status report from a large-scale openEHR-based EPR project from the North Norway Regional Health Authority. It concerns the standardization of a regional ICT portfolio and the ongoing development of a new process oriented EPR systems encouraged by the unfolding of a national repository for openEHR archetypes. Subject of interest; the contextualization of clinical templates is governed over multiple national boundaries which is complex due to the dependency of clinical resources. From the outset of this, we are interested in how local, regional, and national organizers maneuver to standardize while applying OpenEHR technology. PMID:26262546

  14. In the clinic. Perimenopause.

    PubMed

    McNamara, Megan; Batur, Pelin; DeSapri, Kristi Tough

    2015-02-01

    This issue provides a clinical overview of Perimenopause focusing on prevention, diagnosis, treatment, practice improvement, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic. PMID:25643316

  15. [Bioethics in clinical practice].

    PubMed

    Sánchez-Gonzaléz, Miguel; Herreros, Benjamín

    2015-01-01

    Bioethics has grown exponentially in recent decades. Its most important schools include principlism, casuistry, virtue ethics and the ethics of care. These schools are not exclusive. Within bioethics, clinical ethics addresses the inherent clinical practice ethical problems, problems which are many and very varied. Bioethics training is essential for clinicians to address these bioethics' problems. But even the professionals are trained, there are problems that cannot be solved individually and require advisory groups in clinical ethics: clinical ethics committees. These committees are also responsible for education in bioethics in health institutions. Clinical bioethics is a practical discipline, oriented to address specific problems, so its development is necessary to improve the decision making in such complex problems, inevitable problems in healthcare. PMID:25680645

  16. In the Clinic. Dementia.

    PubMed

    Rabins, Peter V; Blass, David M

    2014-08-01

    This issue provides a clinical overview of dementia, focusing on prevention, diagnosis, treatment, practice improvement, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, https://mksap.acponline.org/, and other resources referenced in each issue of In the Clinic. PMID:25089871

  17. In the clinic: hypertension.

    PubMed

    Weir, Matthew R

    2014-12-01

    This issue provides a clinical overview of Hypertension focusing on prevention, diagnosis, treatment, practice improvement, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic. PMID:25437425

  18. In the clinic. Insomnia.

    PubMed

    Masters, Philip A

    2014-10-01

    This issue provides a clinical overview of Insomnia focusing on prevention, diagnosis, treatment, practice improvement, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic. PMID:25285559

  19. In the clinic. Constipation.

    PubMed

    Shah, Brijen J; Rughwani, Nisha; Rose, Suzanne

    2015-04-01

    This issue provides a clinical overview of constipation, focusing on prevention, diagnosis, treatment, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic. PMID:25845017

  20. Clinical Pathway for Thyroidectomy.

    PubMed

    Villar del Moral, Jesús María; Soria Aledo, Víctor; Colina Alonso, Alberto; Flores Pastor, Benito; Gutiérrez Rodríguez, María Teresa; Ortega Serrano, Joaquín; Parra Hidalgo, Pedro; Ros López, Susana

    2015-05-01

    Clinical pathways are care plans applicable to patient care procedures that present variations in practice and a predictable clinical course. They are designed not as a substitute for clinical judgment, but rather as a means to improve the effectiveness and efficiency of the procedures. This clinical pathway is the result of a collaborative work of the Sections of Endocrine Surgery and Quality Management of the Spanish Association of Surgeons. It attempts to provide a framework for standardizing the performance of thyroidectomy, the most frequently performed operation in endocrine surgery. Along with the usual documents of clinical pathways (temporary matrix, variance tracking and information sheets, assessment indicators and a satisfaction questionnaire) it includes a review of the scientific evidence around different aspects of pre, intra and postoperative management. Among others, antibiotic and antithrombotic prophylaxis, preoperative preparation in hyperthyroidism, intraoperative neuromonitoring and systems for obtaining hemostasis are included, along with management of postoperative hypocalcemia. PMID:25732107

  1. Applied Physics. Course Materials: Physics 111, 112, 113. Seattle Tech Prep Applied Academics Project.

    ERIC Educational Resources Information Center

    South Seattle Community Coll., Washington.

    This publication contains materials for three courses in Applied Physics in the Applied Academics program at South Seattle Community College. It begins with the article, "Community College Applied Academics: The State of the Art?" (George B. Neff), which describes the characteristics, model, courses, and coordination activity that make up this…

  2. Applied Math. Course Materials: Math 111, 112, 113. Seattle Tech Prep Applied Academics Project.

    ERIC Educational Resources Information Center

    South Seattle Community Coll., Washington.

    This publication contains materials for three courses in Applied Math in the Applied Academics program at South Seattle Community College. It begins with the article, "Community College Applied Academics: The State of the Art?" (George B. Neff), which describes the characteristics, model, courses, and coordination activity that make up this…

  3. Community vs. Clinic-Based Modular Treatment of Children with Early-Onset ODD or CD: A Clinical Trial with 3-Year Follow-Up

    ERIC Educational Resources Information Center

    Kolko, David J.; Dorn, Lorah D.; Bukstein, Oscar G.; Pardini, Dustin; Holden, Elizabeth A.; Hart, Jonathan

    2009-01-01

    This study examines the treatment outcomes of 139, 6-11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC).…

  4. Remote ischemic conditioning: a clinical trial's update.

    PubMed

    Candilio, Luciano; Hausenloy, Derek J; Yellon, Derek M

    2011-01-01

    Coronary artery disease (CAD) is the leading cause of death and disability worldwide, and early and successful restoration of myocardial reperfusion following an ischemic event is the most effective strategy to reduce final infarct size and improve clinical outcome. This process can, however, induce further myocardial damage, namely acute myocardial ischemia-reperfusion injury (IRI) and worsen clinical outcome. Therefore, novel therapeutic strategies are required to protect the myocardium against IRI in patients with CAD. In this regard, the endogenous cardioprotective phenomenon of "ischemic conditioning," in which the heart is put into a protected state by subjecting it to one or more brief nonlethal episodes of ischemia and reperfusion, has the potential to attenuate myocardial injury during acute IRI. Intriguingly, the heart can be protected in this manner by applying the "ischemic conditioning" stimulus to an organ or tissue remote from the heart (termed remote ischemic conditioning or RIC). Furthermore, the discovery that RIC can be noninvasively applied using a blood pressure cuff on the upper arm to induce brief episodes of nonlethal ischemia and reperfusion in the forearm has greatly facilitated the translation of RIC into the clinical arena. Several recently published proof-of-concept clinical studies have reported encouraging results with RIC, and large multicenter randomized clinical trials are now underway to investigate whether this simple noninvasive and virtually cost-free intervention has the potential to improve clinical outcomes in patients with CAD. In this review article, we provide an update of recently published and ongoing clinical trials in the field of RIC. PMID:21821533

  5. [Clinical management. Clinical management units. Management agreements].

    PubMed

    Ortega Moreno, A

    2003-12-01

    Clinical management (CM) as a concept includes different innovating experiences in health care services management among developed countries, which were initiated during the late eighties and the first nineties. They were mostly due to the concern that political leaders had about their financial viability. CM, as far as it is understood in Spain, is an organizing model which considers the patient as the centre of the health system. It is guided towards disease, looking for continuous assistance and facilitates an autonomous management together with decentralization at the time of taking decisions. It involves professionals whose clinical practice, based on guides, medical records and care planning, incorporate the knowledge and methodology of "evidence based medicine". Clinical management units (CMU) are organizational types of CM, which implantation is spreading rapidly in the different national health care systems. They include a person who assumes responsibility for them, who act as the hospital directorship interlocutor and are autonomous at the time of managing the allocated resources related to their medical programmes and services. They have an information system adapted to their own needs and an outcome evaluation system which allows them "process" re-engineering. CMU's strengths and weaknesses are highly dependent on the professionals that integrate them. The CMU responsible carries out a management contract with the hospital directorship in which CMU competences, directorship's obligations, essential aspects to meet agreed goals, an outcome evaluation system and an incentives scheme are included. PMID:15206333

  6. Visual Impairment/lntracranial Pressure Risk Clinical Care Data Tools

    NASA Technical Reports Server (NTRS)

    Van Baalen, Mary; Mason, Sara S.; Taiym, Wafa; Wear, Mary L.; Moynihan, Shannan; Alexander, David; Hart, Steve; Tarver, William

    2014-01-01

    Prior to 2010, several ISS crewmembers returned from spaceflight with changes to their vision, ranging from a mild hyperopic shift to frank disc edema. As a result, NASA expanded clinical vision testing to include more comprehensive medical imaging, including Optical Coherence Tomography and 3 Tesla Brain and Orbit MRIs. The Space and Clinical Operations (SCO) Division developed a clinical practice guideline that classified individuals based on their symptoms and diagnoses to facilitate clinical care. For the purposes of clinical surveillance, this classification was applied retrospectively to all crewmembers who had sufficient testing for classification. This classification is also a tool that has been leveraged for researchers to identify potential risk factors. In March 2014, driven in part by a more comprehensive understanding of the imaging data and increased imaging capability on orbit, the SCO Division revised their clinical care guidance to outline in-flight care and increase post-flight follow up. The new clinical guidance does not include a classification scheme

  7. APPLIED AUDIOLOGY FOR CHILDREN. SECOND EDITION.

    ERIC Educational Resources Information Center

    DALE, D.M.C.

    THE PURPOSE OF THE BOOK IS TO HELP TEACHERS, PARENTS, DOCTORS, AND WORKERS IN AUDIOLOGY CLINICS MAKE THE MOST OF SOUND IN THE EDUCATIONAL AND SOCIAL TREATMENT OF DEAFNESS. ASPECTS OF SOUND AMPLIFICATION CONSIDERED ARE THE NATURE OF SOUND, ELECTRICAL AMPLIFICATION, AND VARIOUS TYPES OF HEARING AIDS (INDIVIDUAL, GROUP, INDUCTION LOOP, SPEECH…

  8. Can ILP Be Applied to Large Datasets?

    NASA Astrophysics Data System (ADS)

    Watanabe, Hiroaki; Muggleton, Stephen

    There exist large data in science and business. Existing ILP systems cannot be applied effectively for data sets with 10000 data points. In this paper, we consider a technique which can be used to apply for more than 10000 data by simplifying it. Our approach is called Approximative Generalisation and can compress several data points into one example. In case that the original examples are mixture of positive and negative examples, the resulting example is ascribed in probability values representing proportion of positiveness. Our longer term aim is to apply on large Chess endgame database to allow well controlled evaluations of the technique. In this paper we start by choosing a simple game of Noughts and Crosses and we apply mini-max backup algorithm to obtain database of examples. These outcomes are compacted using our approach and empirical results show this has advantage both in accuracy and speed. In further work we hope to apply the approach to large database of both natural and artificial domains.

  9. Clinical Microbiology Informatics

    PubMed Central

    Sintchenko, Vitali; Rauch, Carol A.; Pantanowitz, Liron

    2014-01-01

    SUMMARY The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future. PMID:25278581

  10. The Ontology of Clinical Research (OCRe): An Informatics Foundation for the Science of Clinical Research

    PubMed Central

    Sim, Ida; Tu, Samson W.; Carini, Simona; Lehmann, Harold P.; Pollock, Brad H.; Peleg, Mor; Wittkowski, Knut M.

    2013-01-01

    To date, the scientific process for generating, interpreting, and applying knowledge has received less informatics attention than operational processes for conducting clinical studies. The activities of these scientific processes — the science of clinical research — are centered on the study protocol, which is the abstract representation of the scientific design of a clinical study. The Ontology of Clinical Research (OCRe) is an OWL 2 model of the entities and relationships of study design protocols for the purpose of computationally supporting the design and analysis of human studies. OCRe’s modeling is independent of any specific study design or clinical domain. It includes a study design typology and a specialized module called ERGO Annotation for capturing the meaning of eligibility criteria. In this paper, we describe the key informatics use cases of each phase of a study’s scientific lifecycle, present OCRe and the principles behind its modeling, and describe applications of OCRe and associated technologies to a range of clinical research use cases. OCRe captures the central semantics that underlies the scientific processes of clinical research and can serve as an informatics foundation for supporting the entire range of knowledge activities that constitute the science of clinical research. PMID:24239612

  11. Design of clinical trials.

    PubMed

    Rollo, David; Machado, Sanjay; Ceschin, Mauro

    2010-09-01

    Clinical trial design for nuclear medicine diagnostic imaging radiopharmaceuticals must include a design for preclinical safety studies. These studies should establish that the investigational product (IP) does not have a toxic effect. As a further requirement, radiopharmaceutical clinical trials include a human study (phase 1) that provides biodistribution, pharmacokinetics, and radiation dosimetry information. These studies demonstrate to the Food and Drug Administration that the IP either meets or exceeds the toxicology and radiation exposure safety limits. Satisfying this requirement can result in the Food and Drug Administration approving the performance of late-phase (phase 2/3) clinical trials that are designed to validate the clinical efficacy of the diagnostic imaging agent in patients who have a confirmed diagnosis for the intended application. Emphasis is placed on the most typical trial design for diagnostic imaging agents that use a comparator to demonstrate that the new IP is similar in efficacy to an established standard comparator. Such trials are called equivalence, or noninferiority, trials that attempt to show that the new IP is not less effective than the comparator by more than a statistically defined amount. Importantly, the trial design must not inappropriately favor one diagnostic imaging agent over the other. Bias is avoided by the use of a core laboratory with expert physicians who are not involved in the trial for interpreting and objectively scoring the image sets obtained at the clinical trial sites. Clinical trial design must also follow Good Clinical Practice (GCP) guidelines. GCP stipulates the clinical trial process, including protocol and Case Report Form design, analyses planning, as well as analyzing and preparing interim and final clinical trial/study reports. PMID:20674592

  12. Applied behavior analysis and statistical process control?

    PubMed Central

    Hopkins, B L

    1995-01-01

    This paper examines Pfadt and Wheeler's (1995) suggestions that the methods of statistical process control (SPC) be incorporated into applied behavior analysis. The research strategies of SPC are examined and compared to those of applied behavior analysis. I argue that the statistical methods that are a part of SPC would likely reduce applied behavior analysts' intimate contacts with the problems with which they deal and would, therefore, likely yield poor treatment and research decisions. Examples of these kinds of results and decisions are drawn from the cases and data Pfadt and Wheeler present. This paper also describes and clarifies many common misconceptions about SPC, including W. Edwards Deming's involvement in its development, its relationship to total quality management, and its confusion with various other methods designed to detect sources of unwanted variability. PMID:7592156

  13. Alagille syndrome: clinical perspectives.

    PubMed

    Saleh, Maha; Kamath, Binita M; Chitayat, David

    2016-01-01

    Alagille syndrome is an autosomal dominant, complex multisystem disorder characterized by the presence of three out of five major clinical criteria: cholestasis with bile duct paucity on liver biopsy, congenital cardiac defects (with particular involvement of the pulmonary arteries), posterior embryotoxon in the eye, characteristic facial features, and butterfly vertebrae. Renal and vascular abnormalities can also occur. Inter- and intrafamilial variabilities in the clinical manifestations are common. We reviewed the clinical features and management as well as the molecular basis of Alagille syndrome. PMID:27418850

  14. Alagille syndrome: clinical perspectives

    PubMed Central

    Saleh, Maha; Kamath, Binita M; Chitayat, David

    2016-01-01

    Alagille syndrome is an autosomal dominant, complex multisystem disorder characterized by the presence of three out of five major clinical criteria: cholestasis with bile duct paucity on liver biopsy, congenital cardiac defects (with particular involvement of the pulmonary arteries), posterior embryotoxon in the eye, characteristic facial features, and butterfly vertebrae. Renal and vascular abnormalities can also occur. Inter- and intrafamilial variabilities in the clinical manifestations are common. We reviewed the clinical features and management as well as the molecular basis of Alagille syndrome. PMID:27418850

  15. Automation in Clinical Microbiology

    PubMed Central

    Ledeboer, Nathan A.

    2013-01-01

    Historically, the trend toward automation in clinical pathology laboratories has largely bypassed the clinical microbiology laboratory. In this article, we review the historical impediments to automation in the microbiology laboratory and offer insight into the reasons why we believe that we are on the cusp of a dramatic change that will sweep a wave of automation into clinical microbiology laboratories. We review the currently available specimen-processing instruments as well as the total laboratory automation solutions. Lastly, we outline the types of studies that will need to be performed to fully assess the benefits of automation in microbiology laboratories. PMID:23515547

  16. Symbolic Interaction and Applied Social Research

    PubMed Central

    Kotarba, Joseph A.

    2014-01-01

    In symbolic interaction, a traditional yet unfortunate and unnecessary distinction has been made between basic and applied research. The argument has been made that basic research is intended to generate new knowledge, whereas applied research is intended to apply knowledge to the solution of practical (social and organizational) problems. I will argue that the distinction between basic and applied research in symbolic interaction is outdated and dysfunctional. The masters of symbolic interactionist thought have left us a proud legacy of shaping their scholarly thinking and inquiry in response to and in light of practical issues of the day (e.g., Znaniecki, and Blumer). Current interactionist work continues this tradition in topical areas such as social justice studies. Applied research, especially in term of evaluation and needs assessment studies, can be designed to serve both basic and applied goals. Symbolic interaction provides three great resources to do this. The first is its orientation to dynamic sensitizing concepts that direct research and ask questions instead of supplying a priori and often impractical answers. The second is its orientation to qualitative methods, and appreciation for the logic of grounded theory. The third is interactionism’s overall holistic approach to interfacing with the everyday life world. The primary illustrative case here is the qualitative component of the evaluation of an NIH-funded, translational medical research program. The qualitative component has provided interactionist-inspired insights into translational research, such as examining cultural change in medical research in terms of changes in the form and content of formal and informal discourse among scientists; delineating the impact of significant symbols such as "my lab" on the social organization of science; and appreciating the essence of the self-concept "scientist" on the increasingly bureaucratic and administrative identities of medical researchers. This

  17. Doing clinical research: the challenges and benefits.

    PubMed

    Higgins, Isabel; Parker, Vicki; Keatinge, Diana; Giles, Michelle; Winskill, Rhonda; Guest, Eileen; Kepreotes, Elizabeth; Phelan, Caroline

    2010-06-01

    The need for research in practice is well documented within nursing and other health care disciplines. This acceptance is predicated on the belief that clinically applied research will inform and improve practice and health service delivery resulting in better outcomes for consumers and their families. Nurses, however, find doing clinical research challenging. This paper describes nurses' experiences of doing clinical research. The main challenges of doing clinical research arise from a culture that prioritises practice where nursing work is core business and there is the need to address immediate and short term goals. There are also problems associated with the use of research language amongst clinical nurses and ambiguity in relation to research role expectations. Lack of support and resources for doing research along with keeping up the momentum for a research project also pose significant challenges. The benefits of doing clinical nursing research include experiential learning that has the potential to lead to practice change and improved patient outcomes that are evidence based. PMID:20950198

  18. Exploring continuous clinical placement for undergraduate students.

    PubMed

    McKenna, Lisa G; Wray, Natalie; McCall, Louise

    2009-08-01

    Clinical placements are integral to health professional preparatory courses. These placements allow for the application of classroom-based learning into real patient care situations. In doing so, they provide opportunities for applying theoretical knowledge into practice contexts, skills development and socialisation into the chosen profession. However, despite its recognised importance across health professions, little has been written about optimal structures for supporting clinical learning. This paper presents one group of findings from a larger qualitative study aimed at exploring health professional student's clinical experiences and their impact on career intentions. Findings reported here present a group of undergraduate midwifery student's perspectives on a "home" hospital clinical placement model where continuous clinical placements were taken in the same agency (or hospital group) for 2 days per week over the final 2 years of their course. Two main themes emerged from the data analysis, these being, 'familiarity' and 'continuity'. It is concluded that continuous placements in the same clinical setting have the potential to offer greater opportunities for learning and early professional socialisation than traditional block (Monday to Friday) placements. They can offer a more integrated approach to classroom theory and its application into practice. PMID:18427942

  19. Exploring how nurse lecturers maintain clinical credibility.

    PubMed

    Fisher, Melanie T

    2005-01-01

    The role of the nurse lecturer is changing. There is growing pressure from the government and professionals alike to recruit nurse teachers who posses both practical and recent experience of nursing [Department of Health, 1999. Making a Difference: Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Health Care. DOH, London; UKCC, 2000. Standards for the Preparation of Teachers of Nursing, Midwifery and Health Visiting. UKCC, London]. Whilst much of the literature available suggests a growing concern amongst practitioners, students and nurse educationalists themselves about the importance of being ;clinically credible', what is not clear is how tangible it is to maintain currency and clinical credibility. In addition, the term ;clinical credibility' is in itself ill-defined. An exploratory study was undertaken within one higher education institution which sought to seek the views of nurse lecturers. The principles of ethnography were applied to this research. The sample included six of the most recently appointed nurse lecturers within one academic faculty who taught predominantly on pre-registration programmes. Data from individual and focus group interviews was analysed using a thematic content analysis approach. The findings are discussed which embrace the concepts of: working ;hands on' in the clinical area, clinical currency, transferability of skills, clinical visibility and role development. Recommendations for the development of professional practice are offered. PMID:19038175

  20. Hazardous waste disposal and the clinical laboratory.

    PubMed

    Armbruster, D A

    1990-01-01

    Negligent, unregulated hazardous waste management has resulted in real and potential threats to public health and safety. The federal government has responded with laws and regulations aimed at the producers of hazardous waste, including clinical laboratories. Clinical laboratory managers must understand how the requirements apply to their facilities and how to comply with them, or risk violating the law. The Resources Conservation and Recovery Act (RCRA) imposes controls on hazardous waste management through the Code of Federal Regulations (CFR). The Environmental Protection Agency (EPA) and the Department of Transportation (DOT) regulate these activities through 40 CFR and 49 CFR, respectively. 49 CFR specifies the characteristics of hazardous waste and lists more than 400 toxic chemicals, including several commonly used in clinical laboratories. Laboratories must conduct chemical inventories to determine if they should obtain an EPA identification number as a hazardous waste generator. Most clinical laboratories can operate satellite accumulation points and accumulate, store, transport, and dispose of waste in accordance with EPA and DOT regulations. Regulations pertaining to infectious waste, sure to affect many clinical laboratories, are being developed now by the EPA. The tracking system mandated by the federal government can be supplemented by state and local authorities and poses a significant regulatory challenge to clinical laboratory managers. PMID:10104718

  1. Clinical pathology services: remapping our strategic itinerary.

    PubMed

    Blanckaert, Norbert

    2010-07-01

    Both technological advances and economic drivers have led to major changes in clinical laboratories across the world, with vastly improved testing productivity. However, the production process capability advances have far outpaced the clinical pathologists' success in assuring optimal test utilization and interpretation. While productivity of 'commodity' testing increases, our healthcare value productivity decreases. Such developments constitute a serious threat to our clinical pathology specialty, not only because pathologists may lose direct control of the commodity testing production activities, but also because the present evolution exposes a failure of our core clinical activities, the pathologist's knowledge processes that translate 'commodity' results into medical outcomes optimization. At a time when a revolution in health care organization is inescapable in the years ahead, clinical pathology must proceed from a merely reactive strategy (to fulfill the 'more with less' demands) to a proactive strategy where we build excellence and visibility in knowledge services on a strong foothold of operational excellence. Based on a Strengths-Weaknesses-Opportunities-Threats analysis, we argue that clinical pathology should safeguard and expand its healthcare value productivity by assuming leadership in building integrated laboratory services networks. We also suggest that the core knowledge processes deserve a system approach, for example, by applying a risk-based quality management system. PMID:20491600

  2. Lectins and their application to clinical microbiology.

    PubMed Central

    Slifkin, M; Doyle, R J

    1990-01-01

    Lectins are generally associated with plant or animal components, selectively bind carbohydrates, and interact with procaryotic and eucaryotic cells. Lectins have various specificities that are associated with their ability to interact with acetylaminocarbohydrates, aminocarbohydrates, sialic acids, hexoses, pentoses, and as other carbohydrates. Microbial surfaces generally contain many of the sugar residues that react with lectins. Lectins are presently used in the clinical laboratory to type blood cells and are used in a wide spectrum of applications, including, in part, as carriers of chemotherapeutic agents, as mitogens, for fractionation of animal cells, and for investigations of cellular surfaces. Numerous studies have shown that lectins can be used to identify rapidly certain microorganisms isolated from a clinical specimen or directly in a clinical specimen. Lectins have been demonstrated to be important diagnostic reagents in the major realms of clinical microbiology. Thus, they have been applied in bacteriology, mycology, mycobacteriology, and virology for the identification and/or differentiation of various microorganisms. Lectins have been used successfully as epidemiologic as well as taxonomic markers of specific microorganisms. Lectins provide the clinical microbiologist with cost-effective and potential diagnostic reagents. This review describes the applications of lectins in clinical microbiology. Images PMID:2200603

  3. Dynamic programming in applied optimization problems

    NASA Astrophysics Data System (ADS)

    Zavalishchin, Dmitry

    2015-11-01

    Features of the use dynamic programming in applied problems are investigated. In practice such problems as finding the critical paths in network planning and control, finding the optimal supply plan in transportation problem, objects territorial distribution are traditionally solved by special methods of operations research. It should be noted that the dynamic programming is not provided computational advantages, but facilitates changes and modifications of tasks. This follows from the Bellman's optimality principle. The features of the multistage decision processes construction in applied problems are provided.

  4. Velocity filtering applied to optical flow calculations

    NASA Technical Reports Server (NTRS)

    Barniv, Yair

    1990-01-01

    Optical flow is a method by which a stream of two-dimensional images obtained from a forward-looking passive sensor is used to map the three-dimensional volume in front of a moving vehicle. Passive ranging via optical flow is applied here to the helicopter obstacle-avoidance problem. Velocity filtering is used as a field-based method to determine range to all pixels in the initial image. The theoretical understanding and performance analysis of velocity filtering as applied to optical flow is expanded and experimental results are presented.

  5. System Applies Polymer Powder To Filament Tow

    NASA Technical Reports Server (NTRS)

    Baucom, Robert M.; Snoha, John J.; Marchello, Joseph M.

    1993-01-01

    Polymer powder applied uniformly and in continuous manner. Powder-coating system applies dry polymer powder to continuous fiber tow. Unique filament-spreading technique, combined with precise control of tension on fibers in system, ensures uniform application of polymer powder to web of spread filaments. Fiber tows impregnated with dry polymer powders ("towpregs") produced for preform-weaving and composite-material-molding applications. System and process valuable to prepreg industry, for production of flexible filament-windable tows and high-temperature polymer prepregs.

  6. Defining applied behavior analysis: An historical analogy

    PubMed Central

    Deitz, Samuel M.

    1982-01-01

    This article examines two criteria for a definition of applied behavior analysis. The criteria are derived from a 19th century attempt to establish medicine as a scientific field. The first criterion, experimental determinism, specifies the methodological boundaries of an experimental science. The second criterion, philosophic doubt, clarifies the tentative nature of facts and theories derived from those facts. Practices which will advance the science of behavior are commented upon within each criteria. To conclude, the problems of a 19th century form of empiricism in medicine are related to current practices in applied behavior analysis. PMID:22478557

  7. Applying a Genetic Algorithm to Reconfigurable Hardware

    NASA Technical Reports Server (NTRS)

    Wells, B. Earl; Weir, John; Trevino, Luis; Patrick, Clint; Steincamp, Jim

    2004-01-01

    This paper investigates the feasibility of applying genetic algorithms to solve optimization problems that are implemented entirely in reconfgurable hardware. The paper highlights the pe$ormance/design space trade-offs that must be understood to effectively implement a standard genetic algorithm within a modem Field Programmable Gate Array, FPGA, reconfgurable hardware environment and presents a case-study where this stochastic search technique is applied to standard test-case problems taken from the technical literature. In this research, the targeted FPGA-based platform and high-level design environment was the Starbridge Hypercomputing platform, which incorporates multiple Xilinx Virtex II FPGAs, and the Viva TM graphical hardware description language.

  8. Applying Physics: Opportunities in Semiconductor Technology Companies

    NASA Astrophysics Data System (ADS)

    Redinbo, Greg

    2011-03-01

    While many physicists practice in university settings, physics skills can also be applied outside the traditional academic track. ~Identifying these opportunities requires a clear understanding of how your physics training can be used in an industrial setting, understanding what challenges technology companies face, and identifying how your problem solving skills can be broadly applied in technology companies. ~In this talk I will highlight the common features of such companies, discuss what specific skills are useful for an industrial physicist, and explain roles (possibly unfamiliar) that may be available to you.

  9. Clinical Neurophysiology of Hepatic Encephalopathy

    PubMed Central

    Amodio, Piero; Montagnese, Sara

    2015-01-01

    Background/Objectives Hepatic encephalopathy (HE) has relevant impact on the quality of life of patients and their caregivers and causes relevant costs because of hospitalizations and work days lost. Its quantification is important to perform adequate clinical trials on this relevant complication of cirrhosis and portal-systemic shunting. Clinical neurophysiology, which detects functional alterations of the nervous system, has been applied to the study of HE for over 60 years. This review aims at summarizing and clarifying the role of neurophysiologic techniques in the study of HE. Methods A narrative review was performed aiming at interpreting the cited papers and the techniques on the basis of their physiological and pathophysiological meaning. Results The potential role of EEG, quantified EEG, evoked potentials—both exogenous, endogenous and motor—have been clarified to the reader that may be unfamiliar with neurophysiology. Conclusions The EEG, reflecting the oscillatory changes of neural network is the preferable tool to detect and monitor HE, with the exception of its most severe stage, when EEG flattens. SSEP and MEP have indication to detect and monitor transmission alterations that are likely related to myelin changes and microedema. PMID:26041960

  10. CULTURAL COMPETENCE AND PSYCHOTHERAPY: APPLYING ANTHROPOLOGICALLY INFORMED CONCEPTIONS OF CULTURE

    PubMed Central

    Lakes, Kimberley; López, Steven R.; Garro, Linda C.

    2013-01-01

    The authors apply two contemporary notions of culture to advance the conceptual basis of cultural competence in psychotherapy: Kleinman’s (1995) definition of culture as what is at stake in local, social worlds, and Mattingly and Lawlor’s (2001) concept of shared narratives between practitioners and patients. The authors examine these cultural constructs within a clinical case of an immigrant family caring for a young boy with an autism-spectrum disorder. Their analysis suggests that the socially based model of culture and the concept of shared narratives have the potential to broaden and enrich the definition of cultural competence beyond its current emphasis on the presumed cultural differences of specific racial and ethnic minority groups. PMID:22122131

  11. The Ising Model Applied on Chronification of Pain

    PubMed Central

    2016-01-01

    This is a hypothesis-article suggesting an entirely new framework for understanding and treating longstanding pain. Most medical and psychological models are described with boxes and arrows. Such models are of little clinical and explanatory use when describing the phenomenon of chronification of pain due to unknown causes. To date no models that have been provided - and tested in a scientific satisfactory way - lays out a plan for specific assessment due to a specific causal explanation, and in the end serves the clinicians, patients and researcher with tools on how to address the specific pain condition to every individual pain patient's condition. By applying the Ising model (from physics) on the phenomenon of chronification of pain, one is able to detangle all these factors, and thus have a model that both suggests an explanation of the condition and outlines how one might target the treatment of chronic pain patients with the use of network science. PMID:26398917

  12. Applied Behavior Analysis in the Treatment of Severe Psychiatric Disorders: A Bibliography.

    ERIC Educational Resources Information Center

    Scotti, Joseph R.; And Others

    Clinical research in the area of severe psychiatric disorders constituted the major focus for the discipline of applied behavior analysis during the early 1960s. Recently, however, there appears to be a notable lack of a behavioral focus within many inpatient psychiatric settings and a relative dearth of published behavioral treatment studies with…

  13. 42 CFR 68a.16 - What other regulations and statutes apply?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What other regulations and statutes apply? 68a.16 Section 68a.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM...

  14. 42 CFR 68a.16 - What other regulations and statutes apply?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false What other regulations and statutes apply? 68a.16 Section 68a.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM...

  15. 42 CFR 68a.16 - What other regulations and statutes apply?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false What other regulations and statutes apply? 68a.16 Section 68a.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM...

  16. Implementing clinical pharmacy within undergraduate teaching in Namibia.

    PubMed

    Rudall, Nicola; Kalemeera, Francis; Rennie, Timothy

    2015-06-01

    Clinical pharmacy is currently not practised in Namibia. To introduce the concept and skills pertinent to this area of practice, pharmacy undergraduates at Namibia's new School of Pharmacy are introduced to clinical pharmacy from their second year, and progress from theory to practical application on the wards. This approach has led to students having a greater understanding of clinical pharmacy and how it can be applied in practice. Introducing clinical pharmacy progressively at an undergraduate level may help to stimulate interest in the speciality for future career progression. PMID:25854309

  17. Applying Convergent Immunity to Innovative Vaccines Targeting Staphylococcus aureus

    PubMed Central

    Yeaman, Michael R.; Filler, Scott G.; Schmidt, Clint S.; Ibrahim, Ashraf S.; Edwards, John E.; Hennessey, John P.

    2014-01-01

    Recent perspectives forecast a new paradigm for future “third generation” vaccines based on commonalities found in diverse pathogens or convergent immune defenses to such pathogens. For Staphylococcus aureus, recurring infections and a limited success of vaccines containing S. aureus antigens imply that native antigens induce immune responses insufficient for optimal efficacy. These perspectives exemplify the need to apply novel vaccine strategies to high-priority pathogens. One such approach can be termed convergent immunity, where antigens from non-target organisms that contain epitope homologs found in the target organism are applied in vaccines. This approach aims to evoke atypical immune defenses via synergistic processes that (1) afford protective efficacy; (2) target an epitope from one organism that contributes to protective immunity against another; (3) cross-protect against multiple pathogens occupying a common anatomic or immunological niche; and/or (4) overcome immune subversion or avoidance strategies of target pathogens. Thus, convergent immunity has a potential to promote protective efficacy not usually elicited by native antigens from a target pathogen. Variations of this concept have been mainstays in the history of viral and bacterial vaccine development. A more far-reaching example is the pre-clinical evidence that specific fungal antigens can induce cross-kingdom protection against bacterial pathogens. This trans-kingdom protection has been demonstrated in pre-clinical studies of the recombinant Candida albicans agglutinin-like sequence 3 protein (rAls3) where it was shown that a vaccine containing rAls3 provides homologous protection against C. albicans, heterologous protection against several other Candida species, and convergent protection against several strains of S. aureus. Convergent immunity reflects an intriguing new approach to designing and developing vaccine antigens and is considered here in the context of vaccines to target S

  18. Applying Convergent Immunity to Innovative Vaccines Targeting Staphylococcus aureus.

    PubMed

    Yeaman, Michael R; Filler, Scott G; Schmidt, Clint S; Ibrahim, Ashraf S; Edwards, John E; Hennessey, John P

    2014-01-01

    Recent perspectives forecast a new paradigm for future "third generation" vaccines based on commonalities found in diverse pathogens or convergent immune defenses to such pathogens. For Staphylococcus aureus, recurring infections and a limited success of vaccines containing S. aureus antigens imply that native antigens induce immune responses insufficient for optimal efficacy. These perspectives exemplify the need to apply novel vaccine strategies to high-priority pathogens. One such approach can be termed convergent immunity, where antigens from non-target organisms that contain epitope homologs found in the target organism are applied in vaccines. This approach aims to evoke atypical immune defenses via synergistic processes that (1) afford protective efficacy; (2) target an epitope from one organism that contributes to protective immunity against another; (3) cross-protect against multiple pathogens occupying a common anatomic or immunological niche; and/or (4) overcome immune subversion or avoidance strategies of target pathogens. Thus, convergent immunity has a potential to promote protective efficacy not usually elicited by native antigens from a target pathogen. Variations of this concept have been mainstays in the history of viral and bacterial vaccine development. A more far-reaching example is the pre-clinical evidence that specific fungal antigens can induce cross-kingdom protection against bacterial pathogens. This trans-kingdom protection has been demonstrated in pre-clinical studies of the recombinant Candida albicans agglutinin-like sequence 3 protein (rAls3) where it was shown that a vaccine containing rAls3 provides homologous protection against C. albicans, heterologous protection against several other Candida species, and convergent protection against several strains of S. aureus. Convergent immunity reflects an intriguing new approach to designing and developing vaccine antigens and is considered here in the context of vaccines to target S

  19. Clinical specular microscopy

    SciTech Connect

    Hirst, L.W.; Laing, R.A.

    1987-01-01

    This book provides the general ophthalmologist with a guide to the clinical applications of specular microscopy. Important material is included on laser injury, cataract surgery, corneal transplants, glaucoma, uveitis, and trauma.

  20. The Perfect Clinical Trial.

    PubMed

    Bril, V

    2016-01-01

    Multiple phase III clinical trials have failed to show disease-modifying benefits for diabetic sensorimotor polyneuropathy (DSP) and this may be due to the design of the clinical trials. The perfect clinical trial in DSP would enroll sufficiently large numbers of patients having early or minimal disease, as demonstrated by nerve conduction studies (NCS). These patients would be treated with an intervention given at an effective and well-tolerated dose for a sufficient duration of time to show change in the end points selected. For objective or surrogate measures such as NCS and for some small fiber measures, the duration needed to show positive change may be as brief as 6-12 months, but subsequently, trials lasting 5-8 years will be required to demonstrate clinical benefits. PMID:27133143

  1. Clinically based implant selection.

    PubMed

    Fugazzotto, P A

    1999-01-01

    A hierarchy of implant selection is presented, based on overcoming specific clinical challenges in a variety of situations, including maximization of the esthetic, comfort, and functional potentials of therapy. PMID:10709488

  2. Clinical Trials - Participants

    MedlinePlus

    ... participating in was reviewed by an IRB. Further Reading For more information about research protections, see: Office ... data and decide whether the results have medical importance. Results from clinical trials are often published in ...

  3. Learn about Clinical Studies

    MedlinePlus

    ... in the care of future patients by providing information about the benefits and risks of therapeutic, preventative, or diagnostic products or interventions. Clinical trials provide the basis for the development and marketing of new drugs, biological products, and medical devices. ...

  4. Participating in Clinical Trials

    MedlinePlus Videos and Cool Tools

    ... experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. A clinical trial may compare experimental products or tests to those already available or may compare existing ...

  5. Find a Free Clinic

    MedlinePlus

    ... Dental, Medical, Rx's www.amissionofmercy.org A Storehouse Free. Medical Ministries 675 E Lexington Rd Mocksville , NC ... E-mail: Info@nafcclinics.org National Association of Free & Charitable Clinics © 2016

  6. Hepatitis C: Clinical Trials

    MedlinePlus

    ... and Public Home » Hepatitis C » Treatment Decisions Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... can I find out about participating in a hepatitis C clinical trial? Many trials are being conducted ...

  7. Clinically Oriented Physiology Teaching: Strategy for Developing Critical-Thinking Skills in Undergraduate Medical Students

    ERIC Educational Resources Information Center

    Abraham, Reem Rachel; Upadhya, Subramanya; Torke, Sharmila; Ramnarayan, K.

    2004-01-01

    Medicine is an applied science, interpreting evidence and applying it to real life by using clinical reasoning skills and experience. COPT (clinically oriented physiology teaching) was incorporated in physiology instruction aiming to relate the study of physiology to real-life problems, to generate enthusiasm and motivation for learning, and to…

  8. Outpatient preanaesthesia evaluation clinics.

    PubMed

    Lew, E; Pavlin, D J; Amundsen, L

    2004-11-01

    In recent years, there has been a paradigm shift from an inpatient to outpatient preanaesthesia evaluation. This has been driven by rising healthcare costs and the increasing popularity of ambulatory and same-day admission surgery. These outpatient preanaesthesia clinics play an important role in enhancing the cost-effectiveness of the perioperative process. This review describes the structure of modern outpatient preanaesthesia evaluation clinics, and the associated benefits, limitations and controversies. PMID:15510321

  9. Lacaziosis - unusual clinical presentation.

    PubMed

    Sousa, Pétra Pereira de; Schettini, Antonio Pedro Mendes; Rodrigues, Carlos Alberto Chirano; Westphal, Danielle Cristine

    2015-01-01

    Lacaziosis or Jorge Lobo's disease is a fungal, granulomatous, chronic infectious disease caused by Lacazia loboi, which usually affects the skin and subcutaneous tissue. It is characterized by slow evolution and a variety of cutaneous manifestations with the most common clinical expression being nodular keloid lesions that predominate in exposed areas. We report the case of a patient who had an unusual clinical presentation, with a single-plated lesion on the back. Histopathological examination confirmed the diagnosis of Lacaziosis. PMID:25831004

  10. Clinical careers film.

    PubMed

    2015-09-01

    Those interested in developing clinical academic careers might be interested in a short animated film by Health Education England (HEE) and the National Institute for Health Research. The three-minute film, a frame from which is shown below, describes the sort of opportunities that are on offer to all professionals as part of the HEE's clinical academic careers framework. You can view the film on YouTube at tinyurl.com/pelb95c. PMID:26309005

  11. The Calgary Youth Clinic

    PubMed Central

    Sohn, Arthur H.

    1971-01-01

    This is a report of the findings gathered from the study of youthful patients presenting at a clinic set up in response to the need felt after a rock festival was held in Calgary. The clinic was staffed by volunteers, and the response was so good that some volunteers had to be turned away. One night per week was found to be sufficient time to meet the demand. Findings were assessed according to age and place of residence. PMID:20468673

  12. Considering retail health clinics.

    PubMed

    Mullin, Kathy

    2009-12-01

    By gaining increasing acceptance from consumers and traditional providers, retail-based convenient care clinics have moved from the innovative fringe into the mainstream of healthcare delivery. Nationwide, resourceful administrators are experimenting with retail-based delivery systems, using the clinic's unique attributes to promote wellness, expand accessibility, reduce delivery costs, and enhance brand recognition. This article takes an in-depth look at the convenient care business model, pertinent regulatory issues, and some of the associated benefits and concerns. PMID:19955967

  13. MTA: A Clinical Review

    PubMed Central

    Tawil, Peter Z; Duggan, Derek J.; Galicia, Johnah C.

    2016-01-01

    MTA has been a revolutionary material in endodontics. Since it’s introduction in the 1990’s several studies have demonstrated its use in several clinical applications. MTA has been extensively studied and is currently used for perforation repairs, apexifications, regenerative procedures, apexogenesis, pulpotomies & pulp capping. This article will review the history, composition, research findings and clinical applications of this versatile material. PMID:25821936

  14. Learning for Life: Applying the AASL Standards

    ERIC Educational Resources Information Center

    Franklin, Pat; Stephens, Claire Gatrell

    2010-01-01

    When the American Association of School Librarians (AASL) first released the new Standards for the 21st-Century Learner, controversy arose because many school librarians thought that they were vague and de-emphasized information skill instruction. Many school librarians had trouble visualizing how the program would be applied in their school and…

  15. The Master's Thesis in Applied Psychology Training.

    ERIC Educational Resources Information Center

    Shultz, Kenneth S.; Kottke, Janet L.

    1996-01-01

    Recommends the inclusion of a master's thesis in industrial and organizational psychology programs. Argues that the thesis serves several critical educational purposes and is relevant to applied psychology. Offers suggestions for increasing the relationship between the educational requirement and the professional tasks. (MJP)

  16. Applying Servant Leadership in Today's Schools

    ERIC Educational Resources Information Center

    Culver, Mary K.

    2009-01-01

    This book illustrates how the ideal of servant leadership can be applied in your school today. With real-life scenarios, discussions, and self assessments, this book gives practical suggestions to help you develop into a caring and effective servant leader. There are 52 scenarios in this book, focusing on situations as varied as: (1) Dealing with…

  17. Applied Science for the Over 16s

    ERIC Educational Resources Information Center

    Browning, D. R.

    1975-01-01

    Urges that more applied science and technology be included in college science curricula. Reviews courses which are working toward this end, such as an engineering course which requires the student to spend a week in an industrial environment and to produce a report on his visit. (MLH)

  18. Positive Behavior Support and Applied Behavior Analysis

    ERIC Educational Resources Information Center

    Johnston, J. M.; Foxx, R. M.; Jacobson, J. W.; Green, G.; Mulick, J. A.

    2006-01-01

    This article reviews the origins and characteristics of the positive behavior support (PBS) movement and examines those features in the context of the field of applied behavior analysis (ABA). We raise a number of concerns about PBS as an approach to delivery of behavioral services and its impact on how ABA is viewed by those in human services. We…

  19. Applied Linguists and Institutions of Opinion

    ERIC Educational Resources Information Center

    Myers, Greg

    2005-01-01

    Public opinion research is not an area that has received much attention from applied linguists. But language lies at the heart of the procedures used to define, elicit, and report opinions, whether through such methods as polling, interviews, and focus groups, or through the less obvious channels of vox pop interviews, letters to the editor, radio…

  20. Applied programs at Brookhaven National Laboratory

    SciTech Connect

    Not Available

    1991-09-01

    This document overviews the areas of current research at Brookhaven National Laboratory. Technology transfer and the user facilities are discussed. Current topics are presented in the areas of applied physics, chemical science, material science, energy efficiency and conservation, environmental health and mathematics, biosystems and process science, oceanography, and nuclear energy. (GHH)

  1. Uniform insulation applied-B ion diode

    DOEpatents

    Seidel, David B.; Slutz, Stephen A.

    1988-01-01

    An applied-B field extraction ion diode has uniform insulation over an anode surface for increased efficiency. When the uniform insulation is accomplished with anode coils, and a charge-exchange foil is properly placed, the ions may be focused at a point on the z axis.

  2. Applying Negligence Doctrine to the Teaching Profession.

    ERIC Educational Resources Information Center

    Collingsworth, Terrence P.

    1982-01-01

    The author first reviews the current cases on teacher negligence and attempts to isolate the reasoning behind the courts' refusal to recognize a cause of action for educational malpractice, then develops a hypothetical case to illustrate that ordinary principles of negligence can be applied to an educational malpractice case. (Author/MLF)

  3. The Moral Self: Applying Identity Theory

    ERIC Educational Resources Information Center

    Stets, Jan E.; Carter, Michael J.

    2011-01-01

    This research applies identity theory to understand the moral self. In identity theory, individuals act on the basis of their identity meanings, and they regulate the meanings of their behavior so that those meanings are consistent with their identity meanings. An inconsistency produces negative emotions and motivates individuals to behave…

  4. Applied fluvial geomorphology. Report No. 31

    SciTech Connect

    MacBroom, J.G.

    1981-03-01

    The first portion of this report discusses the geologic properties and characteristics of natural rivers and floodplains. The second part outlines the influence of man on fluvial geomorphology, ecological considerations, and the natural characteristics of rivers that should be applied in the design of river and bridge projects.

  5. Applied fluvial geomorphology. Report No. 31

    SciTech Connect

    MacBroom, J.G.

    1981-03-01

    The first portion of this report discusse the geologic properties and characteristics of natural rivers and floodplains. The second part outlines the influence of man on fluvial geomorphology, ecological considerations, and the natural characteristics of rivers that should be applied in the design of river and bridge projects.

  6. Center for Applied Linguistics, Washington DC, USA

    ERIC Educational Resources Information Center

    Sugarman, Julie; Fee, Molly; Donovan, Anne

    2015-01-01

    The Center for Applied Linguistics (CAL) is a private, nonprofit organization with over 50 years' experience in the application of research on language and culture to educational and societal concerns. CAL carries out its mission to improve communication through better understanding of language and culture by engaging in a variety of projects in…

  7. Promoting Rigorous Validation Practice: An Applied Perspective

    ERIC Educational Resources Information Center

    Mattern, Krista D.; Kobrin, Jennifer L.; Camara, Wayne J.

    2012-01-01

    As researchers at a testing organization concerned with the appropriate uses and validity evidence for our assessments, we provide an applied perspective related to the issues raised in the focus article. Newton's proposal for elaborating the consensus definition of validity is offered with the intention to reduce the risks of inadequate…

  8. Degree Program in Applied Sociology/Anthropology.

    ERIC Educational Resources Information Center

    Northern Kentucky Univ., Highland Heights.

    The Northern Kentucky University Bachelor of Science in Applied Sociology and Anthropology (ASAN), which is described in this report, involves a strong liberal arts background combined with a thorough preparation in social science research skills. ASAN students take introductory and basic methods courses in sociology and anthropology, applied…

  9. Applied Information Systems Research Program Workshop

    NASA Technical Reports Server (NTRS)

    Bredekamp, Joe

    1991-01-01

    Viewgraphs on Applied Information Systems Research Program Workshop are presented. Topics covered include: the Earth Observing System Data and Information System; the planetary data system; Astrophysics Data System project review; OAET Computer Science and Data Systems Programs; the Center of Excellence in Space Data and Information Sciences; and CASIS background.

  10. Problems Portraying Migrants in Applied Linguistics Research

    ERIC Educational Resources Information Center

    Block, David

    2010-01-01

    This paper is a very personal attempt to explore the problematics of portraying migrants in Applied Linguistics research. I begin with a discussion of identity, in particular what we might mean when we use the term, and from there I go on to explore its fundamental imprecision through an analysis of a census question about ethnicity. I then…

  11. Ideology in Applied Linguistics for Language Teaching

    ERIC Educational Resources Information Center

    Waters, Alan

    2009-01-01

    It is contended that much of present-day applied linguistics for language teaching (ALLT) fails to mediate effectively, primarily because an ideological construction, emanating from a critical theory perspective, is too often imposed on everyday pedagogical practices. This has resulted in an exaggerated level of concern about the power imbalances…

  12. Introduction: Conversation Analysis in Applied Linguistics

    ERIC Educational Resources Information Center

    Sert, Olcay; Seedhouse, Paul

    2011-01-01

    This short, introductory paper presents an up-to-date account of works within the field of Applied Linguistics which have been influenced by a Conversation Analytic paradigm. The article reviews recent studies in classroom interaction, materials development, proficiency assessment and language teacher education. We believe that the publication of…

  13. Applying Brain-Friendly Instructional Practices

    ERIC Educational Resources Information Center

    Erlauer-Myrah, Laura

    2006-01-01

    In this article, the author offers advice for principals on working with teachers to change the instructional climate and on how to apply brain-friendly instructions to improve the effectiveness of one's teaching. To lead an entire district toward the use of brain-compatible instruction, the author suggests to start with a group of motivated…

  14. Applied Welding Technology. Technical Committee Report.

    ERIC Educational Resources Information Center

    Idaho State Dept. of Education, Boise. Div. of Vocational Education.

    This Technical Committee Report prepared by industry representatives in Idaho lists the skills currently necessary for an employee in that state to obtain a job in applied welding technology, retain a job once hired, and advance in that occupational field. (Task lists are grouped according to duty areas generally used in industry settings, and are…

  15. Applied Research as Academic Public Relations.

    ERIC Educational Resources Information Center

    Leichty, Greg

    Applied communication research should be used by communication professors, communication departments, and colleges as an important tool for strengthening their relationships with their communities, students, and communication practitioners. Professors spend a great deal of time doing research and teaching people about research. Public…

  16. Applied Literature and Composition Curriculum Guide.

    ERIC Educational Resources Information Center

    Georgia State Dept. of Education, Atlanta.

    Redesigned to reflect a more standards-driven as opposed to course-driven approach, the Applied Literature and Composition courses (I and II) described in this paper not only prepare the two-year college/technical school students for entering the real world of work, but also for post-secondary and college level work. It notes that the course is…

  17. Applying Social Psychological Concepts Outside the Classroom

    ERIC Educational Resources Information Center

    Lakin, Jessica L.; Wichman, Aaron L.

    2005-01-01

    This article evaluates a writing assignment in which social psychology students gathered examples from outside the classroom (e.g., cartoons, movies) and analyzed them with course material. Compared to a control group, students who completed the assignment learned that it was easier to apply social psychology to the real world. A follow-up survey…

  18. Thermodynamic Laws Applied to Economic Systems

    ERIC Educational Resources Information Center

    González, José Villacís

    2009-01-01

    Economic activity in its different manifestations--production, exchange, consumption and, particularly, information on quantities and prices--generates and transfers energy. As a result, we can apply to it the basic laws of thermodynamics. These laws are applicable within a system, i.e., in a country or between systems and countries. To these…

  19. Applying Cryopreservation Techniques to Diverse Biological Materials

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Developing new cryopreservation protocols for each new plant or tissue is time consuming and often unnecessary. Existing standard protocols can be applied to many plants resulting in moderate to excellent results or protocols may require only a few changes for optimum recovery of plants. Protocols ...

  20. Applied Biomechanics in an Instructional Setting

    ERIC Educational Resources Information Center

    Hudson, Jackie L.

    2006-01-01

    Biomechanics is the science of how people move better, meaning more skillfully and more safely. This article places more emphasis on skill rather than safety, though there are many parallels between them. It shares a few features of the author's paradigm of applied biomechanics and discusses an integrated approach toward a middle school football…