Sample records for national inis centre

  1. "Getting Practical" and the National Network of Science Learning Centres

    ERIC Educational Resources Information Center

    Chapman, Georgina; Langley, Mark; Skilling, Gus; Walker, John

    2011-01-01

    The national network of Science Learning Centres is a co-ordinating partner in the Getting Practical--Improving Practical Work in Science programme. The principle of training provision for the "Getting Practical" programme is a cascade model. Regional trainers employed by the national network of Science Learning Centres trained the cohort of local…

  2. Addiction research centres and the nurturing of creativity: National Drug Dependence Treatment Centre, India--a profile.

    PubMed

    Ray, Rajat; Dhawan, Anju; Chopra, Anita

    2013-10-01

    The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  3. Multi-University Southeast INIE Consortium

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

    Ayman Hawari; Nolan Hertel; Mohamed Al-Sheikhly

    2 Project Summary: The Multi-University Southeast INIE Consortium (MUSIC) was established in response to the US Department of Energy’s (DOE) Innovations in Nuclear Infrastructure and Education (INIE) program. MUSIC was established as a consortium composed of academic members and national laboratory partners. The members of MUSIC are the nuclear engineering programs and research reactors of Georgia Institute of Technology (GIT), North Carolina State University (NCSU), University of Maryland (UMD), University of South Carolina (USC), and University of Tennessee (UTK). The University of Florida (UF), and South Carolina State University (SCSU) were added to the MUSIC membership in the second year.more » In addition, to ensure proper coordination between the academic community and the nation’s premier research and development centers in the fields of nuclear science and engineering, MUSIC created strategic partnerships with Oak Ridge National Laboratory (ORNL) including the Spallation Neutron Source (SNS) project and the Joint Institute for Neutron Scattering (JINS), and the National Institute of Standards and Technology (NIST). A partnership was also created with the Armed Forces Radiobiology Research Institute (AFRRI) with the aim of utilizing their reactor in research if funding becomes available. Consequently, there are three university research reactors (URRs) within MUSIC, which are located at NCSU (1-MW PULSTAR), UMD (0.25-MW TRIGA) and UF (0.10-MW Argonaut), and the AFRRI reactor (1-MW TRIGA MARK F). The overall objectives of MUSIC are: a) Demonstrate that University Research Reactors (URR) can be used as modern and innovative instruments of research in the basic and applied sciences, which include applications in fundamental physics, materials science and engineering, nondestructive examination, elemental analysis, and contributions to research in the health and medical sciences, b) Establish a strong technical collaboration between the nuclear

  4. Developing substance misuse services in United Arab Emirates: the National Rehabilitation Centre experience

    PubMed Central

    Al Ghaferi, Hamad A.; Ali, Ahmed Y.; Gawad, Tarek A.

    2017-01-01

    In 2001 a directive was issued to establish the National Rehabilitation Centre (NRC) to deal with the growing problem of substance misuse in the United Arab Emirates. The NRC has achieved many goals as a treatment and rehabilitation facility as well as a drug and alcohol demand reduction response centre. It is now working towards being an international centre of excellence. PMID:29093960

  5. SMARCB1/INI1 inactivation in renal medullary carcinoma.

    PubMed

    Calderaro, Julien; Moroch, Julien; Pierron, Gaelle; Pedeutour, Florence; Grison, Camille; Maillé, Pascale; Soyeux, Pascale; de la Taille, Alexandre; Couturier, Jérome; Vieillefond, Annick; Rousselet, Marie Christine; Delattre, Olivier; Allory, Yves

    2012-09-01

    Renal medullary carcinoma (RMC), a rare and highly aggressive tumour which occurs in patients with sickle-cell disease, shares many clinicopathological features with collecting duct carcinoma (CDC). The molecular mechanisms underlying RMC and CDC are mainly unknown, and there is ongoing debate about their status as distinct entities. Loss of expression of SMARCB1/INI1, a chromatin remodelling regulator and repressor of cyclin D1 transcription, has been reported recently in RMC. The aim of our study was to investigate if such loss of expression is specific for RMC. SMARCB1/INI1 genetic alterations and cyclin D1 expression were also studied. Using immunochemistry, neoplastic cells showed complete loss of SMARCB1/INI1 expression in all six cases of RMC but in only one of 22 cases of CDC. In two RMC cases investigated, comparative genomic hybridization demonstrated complete loss of one SMARCB1/INI1 allele, with no other genomic imbalances, and no mutations were found on the remaining allele. Cyclin D1 was expressed in all RMCs, suggesting that SMARCB1/INI1 inactivation may result in increased cyclin D1 transcription. The specific SMARCB1/INI1 inactivation observed in RMCs suggests that RMC and CDC are different entities. © 2012 Blackwell Publishing Ltd.

  6. Germline Mutation of INI1/SMARCB1 in Familial Schwannomatosis

    PubMed Central

    Hulsebos, Theo J. M.; Plomp, Astrid S.; Wolterman, Ruud A.; Robanus-Maandag, Els C.; Baas, Frank; Wesseling, Pieter

    2007-01-01

    Patients with schwannomatosis develop multiple schwannomas but no vestibular schwannomas diagnostic of neurofibromatosis type 2. We report an inactivating germline mutation in exon 1 of the tumor-suppressor gene INI1 in a father and daughter who both had schwannomatosis. Inactivation of the wild-type INI1 allele, by a second mutation in exon 5 or by clear loss, was found in two of four investigated schwannomas from these patients. All four schwannomas displayed complete loss of nuclear INI1 protein expression in part of the cells. Although the exact oncogenetic mechanism in these schwannomas remains to be elucidated, our findings suggest that INI1 is the predisposing gene in familial schwannomatosis. PMID:17357086

  7. Ethical dilemmas of a large national multi-centre study in Australia: time for some consistency.

    PubMed

    Driscoll, Andrea; Currey, Judy; Worrall-Carter, Linda; Stewart, Simon

    2008-08-01

    To examine the impact and obstacles that individual Institutional Research Ethics Committee (IRECs) had on a large-scale national multi-centre clinical audit called the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study. Multi-centre research is commonplace in the health care system. However, IRECs continue to fail to differentiate between research and quality audit projects. The National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes study used an investigator-developed questionnaire concerning a clinical audit for heart failure programmes throughout Australia. Ethical guidelines developed by the National governing body of health and medical research in Australia classified the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study as a low risk clinical audit not requiring ethical approval by IREC. Fifteen of 27 IRECs stipulated that the research proposal undergo full ethical review. None of the IRECs acknowledged: national quality assurance guidelines and recommendations nor ethics approval from other IRECs. Twelve of the 15 IRECs used different ethics application forms. Variability in the type of amendments was prolific. Lack of uniformity in ethical review processes resulted in a six- to eight-month delay in commencing the national study. Development of a national ethics application form with full ethical review by the first IREC and compulsory expedited review by subsequent IRECs would resolve issues raised in this paper. IRECs must change their ethics approval processes to one that enhances facilitation of multi-centre research which is now normative process for health services. The findings of this study highlight inconsistent ethical requirements between different IRECs. Also highlighted are the obstacles and delays that IRECs create when undertaking multi-centre clinical audits

  8. HIV-1 replication in cell lines harboring INI1/hSNF5 mutations.

    PubMed

    Sorin, Masha; Yung, Eric; Wu, Xuhong; Kalpana, Ganjam V

    2006-08-31

    INI1/hSNF5 is a cellular protein that directly interacts with HIV-1 integrase (IN). It is specifically incorporated into HIV-1 virions. A dominant negative mutant derived from INI1 inhibits HIV-1 replication. Recent studies indicate that INI1 is associated with pre-integration and reverse transcription complexes that are formed upon viral entry into the target cells. INI1 also is a tumor suppressor, biallelically deleted/mutated in malignant rhabdoid tumors. We have utilized cell lines derived from the rhabdoid tumors, MON and STA-WT1, that harbor either null or truncating mutations of INI1 respectively, to assess the effect of INI1 on HIV-1 replication. We found that while HIV-1 virions produced in 293T cells efficiently transduced MON and STA-WT1 cells, HIV-1 particle production was severely reduced in both of these cells. Reintroduction of INI1 into MON and STA-WT1 significantly enhanced the particle production in both cell lines. HIV-1 particles produced in MON cells were reduced for infectivity, while those produced in STA-WT1 were not. Further analysis indicated the presence of INI1 in those virions produced from STA-WT1 but not from those produced from MON cells. HIV-1 produced in MON cells were defective for synthesis of early and late reverse transcription products in the target cells. Furthermore, virions produced in MON cells were defective for exogenous reverse transcriptase activity carried out using exogenous template, primer and substrate. Our results suggest that INI1-deficient cells exhibit reduced particle production that can be partly enhanced by re-introduction of INI1. Infectivity of HIV-1 produced in some but not all INI1 defective cells, is affected and this defect may correlate to the lack of INI1 and/or some other proteins in these virions. The block in early events of virion produced from MON cells appears to be at the stage of reverse transcription. These studies suggest that presence of INI1 or some other host factor in virions and

  9. Introducing Mushroom Fruiting Patterns from the Swiss National Poisons Information Centre

    PubMed Central

    Schenk-Jäger, Katharina M.; Egli, Simon; Hanimann, David; Senn-Irlet, Beatrice; Kupferschmidt, Hugo; Büntgen, Ulf

    2016-01-01

    Changes in the ecology of macrofungi are poorly understood, not only because much of their life cycle is hidden belowground, but also because experiments often miss real-world complexity and most fruitbody inventories are limited in space and time. The National Poisons Information Centre ‘Tox Info Suisse’ provides countrywide 24hours/7days medical advice in case of poisonings since 1966. Here, we introduce a total of 12,126 mushroom-related phone calls that were received by Tox Info Suisse between 1966 and 2014. This indirect source of mycological information is dominated by the families of Boletaceae (11%), Agaricaceae (10%) and Amanitaceae (8%), which account for ~30% of all cases. Mushroom fruiting patterns revealed by the Poisons Centre inventory statistically resemble changes in fungal phenology, productivity and diversity as reflected by the Swiss National Data Centre ‘SwissFungi’. Although the newly developed Tox Info Suisse dataset provides an innovative basis for timely environmental research, caution is advised when interpreting some of the observed long-term changes and autumnal extremes. Uncertainty of the new record relates to possible data incompleteness, imprecise species description and/or identification, as well as the inclusion of cultivated and non-indigenous mushrooms. Nevertheless, we hope that the Tox Info Suisse inventory will stimulate and enable a variety of ecological-oriented follow-up studies. PMID:27648562

  10. Introducing Mushroom Fruiting Patterns from the Swiss National Poisons Information Centre.

    PubMed

    Schenk-Jäger, Katharina M; Egli, Simon; Hanimann, David; Senn-Irlet, Beatrice; Kupferschmidt, Hugo; Büntgen, Ulf

    2016-01-01

    Changes in the ecology of macrofungi are poorly understood, not only because much of their life cycle is hidden belowground, but also because experiments often miss real-world complexity and most fruitbody inventories are limited in space and time. The National Poisons Information Centre 'Tox Info Suisse' provides countrywide 24hours/7days medical advice in case of poisonings since 1966. Here, we introduce a total of 12,126 mushroom-related phone calls that were received by Tox Info Suisse between 1966 and 2014. This indirect source of mycological information is dominated by the families of Boletaceae (11%), Agaricaceae (10%) and Amanitaceae (8%), which account for ~30% of all cases. Mushroom fruiting patterns revealed by the Poisons Centre inventory statistically resemble changes in fungal phenology, productivity and diversity as reflected by the Swiss National Data Centre 'SwissFungi'. Although the newly developed Tox Info Suisse dataset provides an innovative basis for timely environmental research, caution is advised when interpreting some of the observed long-term changes and autumnal extremes. Uncertainty of the new record relates to possible data incompleteness, imprecise species description and/or identification, as well as the inclusion of cultivated and non-indigenous mushrooms. Nevertheless, we hope that the Tox Info Suisse inventory will stimulate and enable a variety of ecological-oriented follow-up studies.

  11. National data centre preparedness exercise 2015 (NPE2015): MY-NDC progress result and experience

    NASA Astrophysics Data System (ADS)

    Rashid, Faisal Izwan Abdul; Zolkaffly, Muhammed Zulfakar

    2017-01-01

    Malaysia has established the National Data Centre (MY-NDC) in December 2005. MY-NDC is tasked to perform the Comprehensive Nuclear-Test-Ban-Treaty (CTBT) data management as well as providing relevant information for Treaty related events to the Malaysian Nuclear Agency (Nuclear Malaysia) as the CTBT National Authority. In the late 2015, MY-NDC has participated in the National Data Centre Preparedness Exercise 2015 (NPE 2015) which aims to access the level of readiness at MY-NDC. This paper aims at presenting the progress result of NPE 2015 as well as highlighting MY-NDC experience in NPE 2015 compared to previous participation in NPE 2013. MY-NDC has utilised available resources for NPE 2015. In NPE 2015, MY-NDC has performed five type of analyses compared with only two analyses in NPE 2013. Participation in the NPE 2015 has enabled MY-NDC to assess its capability and identify rooms for improvement.

  12. Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

    PubMed Central

    Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

    2015-01-01

    Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients. PMID:26229680

  13. Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards.

    PubMed

    Manley, Stephen; Last, Andrew; Fu, Kenneth; Greenham, Stuart; Kovendy, Andrew; Shakespeare, Thomas P

    2015-06-01

    Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.

  14. MYC interaction with the tumor suppressive SWI/SNF complex member INI1 regulates transcription and cellular transformation

    PubMed Central

    Stojanova, Angelina; Tu, William B.; Ponzielli, Romina; Kotlyar, Max; Chan, Pak-Kei; Boutros, Paul C.; Khosravi, Fereshteh; Jurisica, Igor; Raught, Brian; Penn, Linda Z.

    2016-01-01

    ABSTRACT MYC is a key driver of cellular transformation and is deregulated in most human cancers. Studies of MYC and its interactors have provided mechanistic insight into its role as a regulator of gene transcription. MYC has been previously linked to chromatin regulation through its interaction with INI1 (SMARCB1/hSNF5/BAF47), a core member of the SWI/SNF chromatin remodeling complex. INI1 is a potent tumor suppressor that is inactivated in several types of cancers, most prominently as the hallmark alteration in pediatric malignant rhabdoid tumors. However, the molecular and functional interaction of MYC and INI1 remains unclear. Here, we characterize the MYC-INI1 interaction in mammalian cells, mapping their minimal binding domains to functionally significant regions of MYC (leucine zipper) and INI1 (repeat motifs), and demonstrating that the interaction does not interfere with MYC-MAX interaction. Protein-protein interaction network analysis expands the MYC-INI1 interaction to the SWI/SNF complex and a larger network of chromatin regulatory complexes. Genome-wide analysis reveals that the DNA-binding regions and target genes of INI1 significantly overlap with those of MYC. In an INI1-deficient rhabdoid tumor system, we observe that with re-expression of INI1, MYC and INI1 bind to common target genes and have opposing effects on gene expression. Functionally, INI1 re-expression suppresses cell proliferation and MYC-potentiated transformation. Our findings thus establish the antagonistic roles of the INI1 and MYC transcriptional regulators in mediating cellular and oncogenic functions. PMID:27267444

  15. Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards

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

    Manley, Stephen, E-mail: stephen.manley@ncahs.health.nsw.gov.au; Last, Andrew; Fu, Kenneth

    Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of ourmore » conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.« less

  16. Planetario Habana: A Cultural Centre For Science And Technology In A Developing Nation.

    NASA Astrophysics Data System (ADS)

    Alvarez, Oscar

    2006-08-01

    Astronomical education in Cuba is not widespread in the educational system; nevertheless the public interest in sciences in general but particularly in Astronomy issues is very high as it has become reflected by the attention paid to educational and scientific program broadcasts in the national television channels. The "Planetario Habana" Cultural Centre for Science and Technology under construction is aimed at guiding the interest towards basic sciences and astronomical formation of the people, in the most populated and frequented area of the country. A key objective of this project shall be serving as an instructive motivation and entertainment for the casual or habitual visitors to these facilities, offering them the possibility to enjoy vivid representations, play with interactive amusement equipments and listen to instructive presentations on astronomy and related sciences, all guided by qualified specialists. Another fundamental purpose shall be the establishment of a plan for educational complementation in coordination with schools in order to allow children and young people to participate in activities enabling them to get into the fascinating world of Astronomy, Exploration of Outer Space and Life as Cosmic Phenomenon. The setting up of the Planetario Habana Cultural Centre for Science and Technology under the general administration of the Office of the Historian of the City of Havana, and methodologically lead by the Ministry of Science Technology and Environment, showing in function the GOTO Planetarium G Cuba custom obtained under a Japanese Cultural Grant Aid, shall develop into a nonpareil pole in the national environment for the scientific outreach and education of these sciences. Surrounded by the attractiveness of the colonial "ambience", it shall become a centre for dissemination of information about new discoveries and scientific programs developed at national and international level. Here we present a general view of the project, its present and

  17. Therapeutically targeting cyclin D1 in primary tumors arising from loss of Ini1

    PubMed Central

    Smith, Melissa E.; Cimica, Velasco; Chinni, Srinivasa; Jana, Suman; Koba, Wade; Yang, Zhixia; Fine, Eugene; Zagzag, David; Montagna, Cristina; Kalpana, Ganjam V.

    2011-01-01

    Rhabdoid tumors (RTs) are rare, highly aggressive pediatric malignancies with poor prognosis and with no standard or effective treatment strategies. RTs are characterized by biallelic inactivation of the INI1 tumor suppressor gene. INI1 directly represses CCND1 and activates cyclin-dependent kinase (cdk) inhibitors p16Ink4a and p21CIP. RTs are exquisitely dependent on cyclin D1 for genesis and survival. To facilitate translation of unique therapeutic strategies, we have used genetically engineered, Ini1+/− mice for therapeutic testing. We found that PET can be used to noninvasively and accurately detect primary tumors in Ini1+/− mice. In a PET-guided longitudinal study, we found that treating Ini1+/− mice bearing primary tumors with the pan-cdk inhibitor flavopiridol resulted in complete and stable regression of some tumors. Other tumors showed resistance to flavopiridol, and one of the resistant tumors overexpressed cyclin D1, more than flavopiridol-sensitive cells. The concentration of flavopiridol used was not sufficient to down-modulate the high level of cyclin D1 and failed to induce cell death in the resistant cells. Furthermore, FISH and PCR analyses indicated that there is aneuploidy and increased CCND1 copy number in resistant cells. These studies indicate that resistance to flavopiridol may be correlated to elevated cyclin D1 levels. Our studies also indicate that Ini1+/− mice are valuable tools for testing unique therapeutic strategies and for understanding mechanisms of drug resistance in tumors that arise owing to loss of Ini1, which is essential for developing effective treatment strategies against these aggressive tumors. PMID:21173237

  18. Study of defects in TlBr, InI as potential semiconductor radiation detectors

    NASA Astrophysics Data System (ADS)

    Biswas, Koushik; Du, Mao-Hua

    2011-03-01

    Group III-halides such as TlBr and InI are receiving considerable attention for application in room temperature radiation detector devices. It is however, essential that these detector materials have favorable defect properties which enable good carrier transport when operating under an external bias voltage. We have studied the properties of native defects of InI and Tlbr and several important results emerge: (1) Schottky defects are the dominant low-energy defects in both materials that can potentially pin the Fermi level close to midgap, leading to high resistivity; (2) native defects in TlBr are benign in terms of electron trapping. However, anion-vacancy in InI induces a deep electron trap similar to the F -centers in alkali halides. This can reduce electron mobility-lifetime product in InI; (3) low diffusion barriers of vacancies and ionic conductivity could be responsible for the observed polarization phenomenon in both materials at room temperature. U.S. DOE Office of Nonproliferation Research and Development NA22.

  19. The National Poisons Information Centre in Sri Lanka: the first ten years.

    PubMed

    Fernando, Ravindra

    2002-01-01

    Poisoning is a major health concern in Sri Lanka, which has a very high morbidity and mortality from pesticide poisoning. Poisoning, which continues to be in the first five leading causes of death, accounts for about 80,000 hospitalizations and over 3,000 deaths per year. The National Poisons Information Centre in Sri Lanka, thefirst such centre to be established in South Asia, completed 10 years service in 1997. The 4,070 calls received in thefirst 10 years are analyzed and compared with the national hospitalization pattern. The recorded data sheets of all enquiries received from 1988 to 1997 were analyzed retrospectively to study (1) purpose of enquiry, (2) category of enquirer, (3) circumstances of poisoning, (4) gender of victim, (5) age of victim, (6) type of poison, and (7) outcome. Items (6) and (7) were compared with the national hospital statistics for 1998. Of the 4,070 enquiries, 92% concerned specific patients and 6% were for information on poisons. Almost 90% of the enquiries were from medical or paramedical personnel, 5% from relatives or friends, and 3% from the victims. Nearly 38% of enquiries concerned pesticides compared to 27% of poisoning hospitalizations. Medicinal agents were the subject of 20% of enquiries compared to 13% of hospitalizations. The major discrepancy was for snake bites, accounting for only 6% of enquiries but 42% of hospitalizations. Sex distribution of enquiries showed more males than females. Thirty-seven percent of the victims were young adults-15-29years age group. Nearly 49% of the enquiries were for suicidal attempts. Seventy-one percent of the victims recovered. Although enquiries to the NPIC averaged only 0.5% of poisoning hospitalizations, they were sufficiently representative of the national pattern to predict that increasing utilization of the NPIC would offer a much needed service, both for

  20. Computational modeling of Repeat1 region of INI1/hSNF5: An evolutionary link with ubiquitin

    PubMed Central

    Bhutoria, Savita

    2016-01-01

    Abstract The structure of a protein can be very informative of its function. However, determining protein structures experimentally can often be very challenging. Computational methods have been used successfully in modeling structures with sufficient accuracy. Here we have used computational tools to predict the structure of an evolutionarily conserved and functionally significant domain of Integrase interactor (INI)1/hSNF5 protein. INI1 is a component of the chromatin remodeling SWI/SNF complex, a tumor suppressor and is involved in many protein‐protein interactions. It belongs to SNF5 family of proteins that contain two conserved repeat (Rpt) domains. Rpt1 domain of INI1 binds to HIV‐1 Integrase, and acts as a dominant negative mutant to inhibit viral replication. Rpt1 domain also interacts with oncogene c‐MYC and modulates its transcriptional activity. We carried out an ab initio modeling of a segment of INI1 protein containing the Rpt1 domain. The structural model suggested the presence of a compact and well defined ββαα topology as core structure in the Rpt1 domain of INI1. This topology in Rpt1 was similar to PFU domain of Phospholipase A2 Activating Protein, PLAA. Interestingly, PFU domain shares similarity with Ubiquitin and has ubiquitin binding activity. Because of the structural similarity between Rpt1 domain of INI1 and PFU domain of PLAA, we propose that Rpt1 domain of INI1 may participate in ubiquitin recognition or binding with ubiquitin or ubiquitin related proteins. This modeling study may shed light on the mode of interactions of Rpt1 domain of INI1 and is likely to facilitate future functional studies of INI1. PMID:27261671

  1. Computational modeling of Repeat1 region of INI1/hSNF5: An evolutionary link with ubiquitin.

    PubMed

    Bhutoria, Savita; Kalpana, Ganjam V; Acharya, Seetharama A

    2016-09-01

    The structure of a protein can be very informative of its function. However, determining protein structures experimentally can often be very challenging. Computational methods have been used successfully in modeling structures with sufficient accuracy. Here we have used computational tools to predict the structure of an evolutionarily conserved and functionally significant domain of Integrase interactor (INI)1/hSNF5 protein. INI1 is a component of the chromatin remodeling SWI/SNF complex, a tumor suppressor and is involved in many protein-protein interactions. It belongs to SNF5 family of proteins that contain two conserved repeat (Rpt) domains. Rpt1 domain of INI1 binds to HIV-1 Integrase, and acts as a dominant negative mutant to inhibit viral replication. Rpt1 domain also interacts with oncogene c-MYC and modulates its transcriptional activity. We carried out an ab initio modeling of a segment of INI1 protein containing the Rpt1 domain. The structural model suggested the presence of a compact and well defined ββαα topology as core structure in the Rpt1 domain of INI1. This topology in Rpt1 was similar to PFU domain of Phospholipase A2 Activating Protein, PLAA. Interestingly, PFU domain shares similarity with Ubiquitin and has ubiquitin binding activity. Because of the structural similarity between Rpt1 domain of INI1 and PFU domain of PLAA, we propose that Rpt1 domain of INI1 may participate in ubiquitin recognition or binding with ubiquitin or ubiquitin related proteins. This modeling study may shed light on the mode of interactions of Rpt1 domain of INI1 and is likely to facilitate future functional studies of INI1. © 2016 The Protein Society.

  2. 'Smashed by the National Health'? A Closer Look at the Demise of the Pioneer Health Centre, Peckham.

    PubMed

    Conford, Philip

    2016-04-01

    The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre's directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre's directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre's experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed 'chemical triumphalism' was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times.

  3. Cell envelope stress in mycobacteria is regulated by the novel signal transduction ATPase IniR in response to trehalose

    PubMed Central

    van Winden, Vincent J. C.; Sparrius, Marion; van de Weerd, Robert; Speer, Alexander; Ummels, Roy; Sherman, David R.

    2017-01-01

    The cell envelope of mycobacteria is a highly unique and complex structure that is functionally equivalent to that of Gram-negative bacteria to protect the bacterial cell. Defects in the integrity or assembly of this cell envelope must be sensed to allow the induction of stress response systems. The promoter that is specifically and most strongly induced upon exposure to ethambutol and isoniazid, first line drugs that affect cell envelope biogenesis, is the iniBAC promoter. In this study, we set out to identify the regulator of the iniBAC operon in Mycobacterium marinum using an unbiased transposon mutagenesis screen in a constitutively iniBAC-expressing mutant background. We obtained multiple mutants in the mce1 locus as well as mutants in an uncharacterized putative transcriptional regulator (MMAR_0612). This latter gene was shown to function as the iniBAC regulator, as overexpression resulted in constitutive iniBAC induction, whereas a knockout mutant was unable to respond to the presence of ethambutol and isoniazid. Experiments with the M. tuberculosis homologue (Rv0339c) showed identical results. RNAseq experiments showed that this regulatory gene was exclusively involved in the regulation of the iniBAC operon. We therefore propose to name this dedicated regulator iniBAC Regulator (IniR). IniR belongs to the family of signal transduction ATPases with numerous domains, including a putative sugar-binding domain. Upon testing different sugars, we identified trehalose as an activator and metabolic cue for iniBAC activation, which could also explain the effect of the mce1 mutations. In conclusion, cell envelope stress in mycobacteria is regulated by IniR in a cascade that includes trehalose. PMID:29281637

  4. Automation and Networking of Public Libraries in India Using the E-Granthalaya Software from the National Informatics Centre

    ERIC Educational Resources Information Center

    Matoria, Ram Kumar; Upadhyay, P. K.; Moni, Madaswamy

    2007-01-01

    Purpose: To describe the development of the library management system, e-Granthalaya, for public libraries in India. This is an initiative of the Indian government's National Informatics Centre (NIC). The paper outlines the challenges and the potential of a full-scale deployment of this software at a national level. Design/methodology/approach:…

  5. [Tissue bank of the National Centre for Tumour Disease. An innovative platform for translational tumour].

    PubMed

    Herpel, E; Koleganova, N; Schirmacher, P

    2008-11-01

    The tissue bank of the National Centre for Tumour Diseases (NCT) in Heidelberg, Germany, was founded in 2005 by the University Hospital of Heidelberg and the German Cancer Research Centre as a section of the NCT. It is a nonprofit organization with a completely evaluated legal and ethical framework and supports the Comprehensive Cancer Centre concept. Its main aim is the acquisition and characterization of fresh-frozen and paraffin-embedded human tissues according to the standards of good scientific practice and the promotion of interdisciplinary tumour research of the comprehensive cancer centre and its cooperating partners. It also offers expert project assistance: a project leader can submit a short proposal, and the tissue collecting/preparing process will be performed in cooperation with a specialised pathologist and, if applicable, an experienced clinical researcher. The tissue bank is also a central platform for further developing of innovative technologies for tissue handling, e.g. multi-tissue-array and virtual microscopy, with links to digital image analysis and bioinformatics. Thus, the NCT tissue bank represents a model for innovative biobanking and for institutions with active interdisciplinary cancer research.

  6. Evolution and diversification of National Cleaner Production Centres (NCPCs).

    PubMed

    Van Berkel, Rene

    2010-07-01

    Since 1994 UNIDO and UNEP cooperate in a Programme to establish National Cleaner Production Centres (NCPCs) as a mechanism for delivery of Cleaner Production (CP) services to businesses, governments and other organisations. In 2007, 38 NCPCs were operational in 37 developing and transition countries. While initially set up in near-identical ways in each country, over time NCPCs evolved in response to both programme-internal and country-level factors. The resulting diversity among NCPCs is described and analysed here. Differentiation and specialisation had occurred in service areas or topics both within and between NCPCs, however without a clear strategy for integration and synergy. NCPCs were becoming part of expanding networks of business services providers nationally forcing some to focus on audit and training services (tier 1), and others on specialist services in CP technology and/or policy (tier 2) and/or networking services (tier 3). All NCPCs were on a trajectory from a project management organisation to a nationally-owned entity. The different management requirements were not proactively managed and technical aspects of CP service delivery overshadowed institutional and governance aspects of establishing and operating the NCPC institution. Differences in service delivery methods between NCPCs are most evident in three service areas: CP assessments; policy advice; and transfer of Environmentally Sound Technologies. It is argued here that understanding root causes and benefits of this presently-observed differentiation, could lay the foundation for capturing and advancing best practice CP concepts, methods and policies. This in turn would enable strategic planning for customised interventions and support at the national level. Copyright 2010 Elsevier Ltd. All rights reserved.

  7. A masked NES in INI1/hSNF5 mediates hCRM1-dependent nuclear export: implications for tumorigenesis

    PubMed Central

    Craig, Errol; Zhang, Zhi-Kai; Davies, Kelvin P.; Kalpana, Ganjam V.

    2002-01-01

    INI1 (integrase interactor 1)/hSNF5 is a component of the mammalian SWI/SNF complex and a tumor suppressor mutated in malignant rhabdoid tumors (MRT). We have identified a nuclear export signal (NES) in the highly conserved repeat 2 domain of INI1 that is unmasked upon deletion of a downstream sequence. Mutation of conserved hydrophobic residues within the NES, as well as leptomycin B treatment abrogated the nuclear export. Full-length INI1 specifically associated with hCRM1/exportin1 in vivo and in vitro. A mutant INI1 [INI1(1–319) delG950] found in MRT lacking the 66 C-terminal amino acids mislocalized to the cytoplasm. Full-length INI1 but not the INI1(1–319 delG950) mutant caused flat cell formation and cell cycle arrest in cell lines derived from MRT. Disruption of the NES in the delG950 mutant caused nuclear localization of the protein and restored its ability to cause cell cycle arrest. These observations demonstrate that INI1 has a masked NES that mediates regulated hCRM1/exportin1-dependent nuclear export and we propose that mutations that cause deregulated nuclear export of the protein could lead to tumorigenesis. PMID:11782423

  8. An Essential Role of INI1/hSNF5 Chromatin Remodeling Protein in HIV-1 Posttranscriptional Events and Gag/Gag-Pol Stability

    PubMed Central

    La Porte, Annalena; Cano, Jennifer; Wu, Xuhong; Mitra, Doyel

    2016-01-01

    ABSTRACT INI1/hSNF5/SMARCB1/BAF47 is an HIV-specific integrase (IN)-binding protein that influences HIV-1 transcription and particle production. INI1 binds to SAP18 (Sin3a-associated protein, 18 kDa), and both INI1 and SAP18 are incorporated into HIV-1 virions. To determine the significance of INI1 and the INI1-SAP18 interaction during HIV-1 replication, we isolated a panel of SAP18-interaction-defective (SID)-INI1 mutants using a yeast reverse two-hybrid screen. The SID-INI1 mutants, which retained the ability to bind to IN, cMYC, and INI1 but were impaired for binding to SAP18, were tested for their effects on HIV-1 particle production. SID-INI1 dramatically reduced the intracellular Gag/Gag-Pol protein levels and, in addition, decreased viral particle production. The SID-INI1-mediated effects were less dramatic in trans complementation assays using IN deletion mutant viruses with Vpr-reverse transcriptase (RT)-IN. SID-INI1 did not inhibit long-terminal-repeat (LTR)-mediated transcription, but it marginally decreased the steady-state gag RNA levels, suggesting a posttranscriptional effect. Pulse-chase analysis indicated that in SID-INI1-expressing cells, the pr55Gag levels decreased rapidly. RNA interference analysis indicated that small hairpin RNA (shRNA)-mediated knockdown of INI1 reduced the intracellular Gag/Gag-Pol levels and further inhibited HIV-1 particle production. These results suggest that SID-INI1 mutants inhibit multiple stages of posttranscriptional events of HIV-1 replication, including intracellular Gag/Gag-Pol RNA and protein levels, which in turn inhibits assembly and particle production. Interfering INI1 leads to a decrease in particle production and Gag/Gag-Pol protein levels. Understanding the role of INI1 and SAP18 in HIV-1 replication is likely to provide novel insight into the stability of Gag/Gag-Pol, which may lead to the development of novel therapeutic strategies to inhibit HIV-1 late events. IMPORTANCE Significant gaps exist in our

  9. Detached Melt and Vapor Growth of InI in SUBSA Furnace

    NASA Technical Reports Server (NTRS)

    Ostrogorsky, A. G.; Riabov, V.; Volz, M. P.; van den Berg, L.; Croll, A.

    2017-01-01

    Indium iodide (InI) is a promising wide energy band gap nuclear detector material. It is ideal for space experiments because it is non-toxic and has a relatively low melting point of only 351 degrees Centigrade. However, it has been established that melt-grown crystals contain a large amount of second phase inclusions/precipitates. The typical size of inclusions are 1 to 27 microns in diameter, while the volume fraction of all sizes is 300 to 600 parts per million. The SEM-EDS (Scanning Electron Microscopy / Energy Dispersive X-Ray Spectroscopy) analysis of the inclusions has revealed that they all contain oxygen and some contain carbon. At present, under sponsorship of NASA and CASIS (Center for the Advancement of Science in Space), we are conducting ground-based experiments with InI in preparation for the flight experiments to be conducted in the SUBSA (Solidification Using a Baffle in Sealed Ampoules) furnace in the Microgravity Science Glovebox at the International Space Station, planned for the summer/fall of 2017. Earth-based experiments include melt and vapor growth conducted in the SUBSA ground unit, measurements of the volumetric expansion coefficient of the melt, and measurements of the wetting angle of molten InI. Finite element modeling has been conducted to optimize the design of the flight ampoules. Alloying with Tl and Ga has given promising results.

  10. The Impact of the Mathematics Support Centre on the Grades of First Year Students at the National University of Ireland Maynooth

    ERIC Educational Resources Information Center

    Mac an Bhaird, Ciaran; Morgan, Tadhg; O'Shea, Ann

    2009-01-01

    In this article, we consider the mathematics grades of first year students at the National University of Ireland Maynooth and the influence that the Mathematics Support Centre (MSC) has on these grades. We will consider the evidence to suggest that the MSC has a positive effect on the grades of the students who attend the centre. It seems to be…

  11. Role of the "National Reference Centre for Genetically Modified Organisms (GMO) detection" in the official control of food and feed.

    PubMed

    Ciabatti, I; Marchesi, U; Froiio, A; Paternò, A; Ruggeri, M; Amaddeo, D

    2005-08-01

    The National Reference Centre for Genetically Modified Organisms (GMO) detection was established in 2002 within the Istituto Zooprofilattico Sperimentale Lazio e Toscana, with the aim of providing scientific and technical support to the National Health System and to the Ministry of Health within the scope of the regulation of GMO use in food and feed.The recently adopted EU legislation on GMOs (Regulation CE no. 1829/2003 and no. 1830/2003) introduced more rigorous procedures for the authorisation, labelling and analytical control of food and feed consisting, containing or derived from GMOs. The National Reference Centre, besides its institutional tasks as one of the laboratories of the Italian National Health System, collects and analyses data and results of the national official control of GMOs; carries out scientific research aimed at developing, improving, validating and harmonising detection and quantification methods, in cooperation with other scientific institutions, the Community Reference Laboratory and within the European Network of GMOs laboratories (ENGL); collaborates with the Ministry of Health in the definition of control programmes and promotes educational and training initiatives. Objectives defined for 2004-2006, activities in progress and goals already achieved are presented.

  12. ‘Smashed by the National Health’? A Closer Look at the Demise of the Pioneer Health Centre, Peckham

    PubMed Central

    Conford, Philip

    2016-01-01

    The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre’s directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre’s directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre’s experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed ‘chemical triumphalism’ was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times. PMID:26971599

  13. Seismological investigation of the National Data Centre Preparedness Exercise 2013

    NASA Astrophysics Data System (ADS)

    Gestermann, Nicolai; Hartmann, Gernot; Ross, J. Ole; Ceranna, Lars

    2015-04-01

    The Comprehensive Nuclear-Test-Ban Treaty (CTBT) prohibits all kinds of nuclear explosions conducted on Earth - underground, underwater or in the atmosphere. The verification regime of the CTBT is designed to detect any treaty violation. While the data of the International Monitoring System (IMS) is collected, processed and technically analyzed at the International Data Centre (IDC) of the CTBT-Organization, National Data Centres (NDC) of the member states provide interpretation and advice to their government concerning suspicious detections. The NDC Preparedness Exercises (NPE) are regularly performed dealing with fictitious treaty violations to practice the combined analysis of CTBT verification technologies. These exercises should help to evaluate the effectiveness of analysis procedures applied at NDCs and the quality, completeness and usefulness of IDC products for example. The exercise trigger of NPE2013 is a combination of a tempo-spatial indication pointing to a certain waveform event and simulated radionuclide concentrations generated by forward Atmospheric Transport Modelling based on a fictitious release. For the waveform event the date (4 Sept. 2013) is given and the region is communicated in a map showing the fictitious state of "Frisia" at the Coast of the North Sea in Central Europe. The potential connection between the waveform and radionuclide evidence remains unclear for exercise participants. The verification task was to identify the waveform event and to investigate potential sources of the radionuclide findings. The final question was whether the findings are CTBT relevant and justify a request for On-Site-Inspection in "Frisia". The seismic event was not included in the Reviewed Event Bulletin (REB) of the IDC. The available detections from the closest seismic IMS stations lead to a epicenter accuracy of about 24 km which is not sufficient to specify the 1000 km2 inspection area in case of an OSI. With use of data from local stations and

  14. Minister unveils new nanotech centres

    NASA Astrophysics Data System (ADS)

    Dumé, Belle

    2009-06-01

    Three new nanotechnology research centres are to be set up in France as part of a €70m government plan to help French companies in the sector. Researchers at the new centres, which will be located in Grenoble, Saclay (near Paris) and Toulouse, will be encouraged to collaborate with industry to develop new nanotech-based products. Dubbed NANO-INNOV, the new plan includes €46m for two new buildings at Saclay, with the rest being used to buy new equipment at the three centres and to fund grant proposals from staff to the French National Research Agency (ANR).

  15. Canadian Educational Development Centre Websites: More Ebb than Flow?

    ERIC Educational Resources Information Center

    Simmons, Nicola

    2010-01-01

    This paper examines information portrayed on Canadian educational development (ED) centre websites and, in particular, whether information that corresponds to questions compiled from a literature search of ED centre practices is readily available from centre websites. This study phase is part of a larger national study of Canadian educational…

  16. [The National Reference Centres and Reference Laboratories. Importance and tasks].

    PubMed

    Laude, G; Ammon, A

    2005-09-01

    Since 1995, the German Federal Ministry for Health and Social Security funds National Reference Centres (NRC) for the laboratory surveillance of important pathogens and syndromes. Which pathogens or syndromes are selected to be covered by a NRC depends on their epidemiological relevance, the special diagnostic tools, problems with antimicrobial resistance and necessary infection control measures. Currently, there are 15 NRC, which are appointed for a period of 3 years (currently from January 2005 through December 2007). Towards the end of their appointment all NRC are evaluated by a group of specialists. The assessment of their achievements is guided by a catalogue of tasks for the NRC. In addition to the NRC, a total of 50 laboratories are appointed which provide specialist expertise for additional pathogens in order to have a broad range of pathogens for which specialist laboratories are available. Their predominant task is to give advice and support for special diagnostic problems. Both NRC and the specialist laboratories are important parts of the network for infectious disease epidemiology.

  17. UK Renal Registry 16th annual report: chapter 13 clinical, haematological and biochemical parameters in patients receiving renal replacement therapy in paediatric centres in the uk in 2012: national and centre-specific analyses.

    PubMed

    Pruthi, Rishi; Maxwell, Heather; Casula, Anna; Braddon, Fiona; Lewis, Malcolm; O'Brien, Catherine; Stojanovic, Jelena; Tse, Yincent; Inward, Carol; Sinha, Manish D

    2013-01-01

    The British Association for Paediatric Nephrology Registry (BAPN) was established to analyse data related to renal replacement therapy (RRT) in children. The registry receives data from the 13 paediatric nephrology centres in the UK. This chapter aims to provide centre specific data so that individual centres can reflect on the contribution that their data makes to the national picture and to determine the extent to which their patient parameters meet nationally agreed audit standards for the management of children with established renal failure (ERF). Data returns included a mixture of electronic (92%) and paper (8%) returns. Data were analysed to calculate summary statistics and where applicable the percentage achieving an audit standard. The standards used were those set out by the Renal Association and the National Institute for Health and Clinical Excellence. Anthropometric data confirmed that children receiving RRT were short compared to healthy peers. Amongst patients with a height of <2SD between 2001 and 2012, 29.2%were receiving growth hormone if they were on dialysis compared to 11.9% if they had a functioning transplant. Prevalence rates of overweight and obese status in children with ERF remain concerningly high. Blood pressure control remained challenging with wide inter-centre variation although this was significantly better in children with a functioning transplant. Over a quarter of haemodialysis patients and 17.3% of peritoneal dialysis patients were anaemic, compared to only 8.3% of transplanted patients. ESA use in the dialysis population exceeded 90% amongst anaemic patients. The control of renal bone disease remained challenging. Optimising growth and reducing prevalent excess weight in children on RRT remains challenging. The likelihood of complete electronic reporting in the near future with plans for quarterly reporting in the format of the recently finalised NEW paediatric dataset will hopefully improve quality of data and their reporting

  18. Genome-wide identification and characterisation of human DNA replication origins by initiation site sequencing (ini-seq)

    PubMed Central

    Langley, Alexander R.; Gräf, Stefan; Smith, James C.; Krude, Torsten

    2016-01-01

    Next-generation sequencing has enabled the genome-wide identification of human DNA replication origins. However, different approaches to mapping replication origins, namely (i) sequencing isolated small nascent DNA strands (SNS-seq); (ii) sequencing replication bubbles (bubble-seq) and (iii) sequencing Okazaki fragments (OK-seq), show only limited concordance. To address this controversy, we describe here an independent high-resolution origin mapping technique that we call initiation site sequencing (ini-seq). In this approach, newly replicated DNA is directly labelled with digoxigenin-dUTP near the sites of its initiation in a cell-free system. The labelled DNA is then immunoprecipitated and genomic locations are determined by DNA sequencing. Using this technique we identify >25,000 discrete origin sites at sub-kilobase resolution on the human genome, with high concordance between biological replicates. Most activated origins identified by ini-seq are found at transcriptional start sites and contain G-quadruplex (G4) motifs. They tend to cluster in early-replicating domains, providing a correlation between early replication timing and local density of activated origins. Origins identified by ini-seq show highest concordance with sites identified by SNS-seq, followed by OK-seq and bubble-seq. Furthermore, germline origins identified by positive nucleotide distribution skew jumps overlap with origins identified by ini-seq and OK-seq more frequently and more specifically than do sites identified by either SNS-seq or bubble-seq. PMID:27587586

  19. Genome-wide identification and characterisation of human DNA replication origins by initiation site sequencing (ini-seq).

    PubMed

    Langley, Alexander R; Gräf, Stefan; Smith, James C; Krude, Torsten

    2016-12-01

    Next-generation sequencing has enabled the genome-wide identification of human DNA replication origins. However, different approaches to mapping replication origins, namely (i) sequencing isolated small nascent DNA strands (SNS-seq); (ii) sequencing replication bubbles (bubble-seq) and (iii) sequencing Okazaki fragments (OK-seq), show only limited concordance. To address this controversy, we describe here an independent high-resolution origin mapping technique that we call initiation site sequencing (ini-seq). In this approach, newly replicated DNA is directly labelled with digoxigenin-dUTP near the sites of its initiation in a cell-free system. The labelled DNA is then immunoprecipitated and genomic locations are determined by DNA sequencing. Using this technique we identify >25,000 discrete origin sites at sub-kilobase resolution on the human genome, with high concordance between biological replicates. Most activated origins identified by ini-seq are found at transcriptional start sites and contain G-quadruplex (G4) motifs. They tend to cluster in early-replicating domains, providing a correlation between early replication timing and local density of activated origins. Origins identified by ini-seq show highest concordance with sites identified by SNS-seq, followed by OK-seq and bubble-seq. Furthermore, germline origins identified by positive nucleotide distribution skew jumps overlap with origins identified by ini-seq and OK-seq more frequently and more specifically than do sites identified by either SNS-seq or bubble-seq. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  20. The Isis Centre: a counselling service within the National Health Service.

    PubMed Central

    Agulnik, P; Holroyd, P; Mandelbrote, B

    1976-01-01

    A new centre has been established to provide readily accessible counselling, consultation, and mental health information. People may refer themselves or are recommended to attend by general practitioners or other agencies. The counsellors have varied backgrounds in paramedical or counselling services, and they are supported by psychiatrists. Of a sample of 100 clients, four were referred to one of the team's psychiatrists and 33 visited the centre only once. The centre's staff aim to adopt a flexible approach to the client and his problems, and formal psychiatric categories have not been found useful. Provision is made for people who want to solve their problems by discussion rather than medication and those for whom the existing psychiatric services may have little time to spare. Consequently, the approach adopted by the Isis Centre, whereby many people benefit from psychotherapy yet the psychiatrist deals directly with only a few selected cases, contributes towards meeting the great need for psychiatric services and using the psychiatrist's skills more effectively. PMID:947421

  1. Immunohistochemical Analysis Supports a Role for INI1/SMARCB1 in Hereditary Forms of Schwannomas, But Not in Solitary, Sporadic Schwannomas

    PubMed Central

    Patil, Sushama; Perry, Arie; MacCollin, Mia; Dong, Shumin; Betensky, Rebecca A.; Yeh, Tu-Hsueh; Gutmann, David H.; Stemmer-Rachamimov, Anat O.

    2009-01-01

    The INI1/SMARCB1 protein product (INI1), a component of a transcription complex, was recently implicated in the pathogenesis of schwannomas in two members of a single family with familial schwannomatosis1. Tumors were found to have both constitutional and somatic mutations of the SMARCB1 gene and showed a mosaic pattern of loss of INI1 expression by immunohistochemistry, suggesting a tumor composition of mixed null and haploinsufficient cells. To determine if this finding could be extended to all tumors arising in familial schwannomatosis, and how it compares to other multiple schwannoma syndromes (sporadic schwannomatosis and neurofibromatosis 2) as well as to sporadic, solitary schwannomas, we performed an immunohistochemistry analysis on 45 schwannomas from patients with multiple schwannoma syndromes and on 38 solitary, sporadic schwannomas from non-syndromic patients. A mosaic pattern of INI1 expression was seen in 93% of tumors from familial schwannomatosis patients, 55% of tumors from sporadic schwannomatosis, 83% of NF2-associated tumors and only 5% of solitary, sporadic schwannomas. These results confirm a role for INI1/SMARCB1 in multiple schwannoma syndromes and suggest that a different pathway of tumorigenesis occurs in solitary, sporadic tumors. PMID:18422762

  2. [Definition of endometriosis expert centres].

    PubMed

    Chanavaz-Lacheray, I; Darai, E; Descamps, P; Agostini, A; Poilblanc, M; Rousset, P; Bolze, P-A; Panel, P; Collinet, P; Hebert, T; Graesslin, O; Martigny, H; Brun, J-L; Dechaud, H; Mezan De Malartic, C; Piechon, L; Wattiez, A; Chapron, C; Golfier, F

    2018-03-01

    The Collège national des gynécologues obstétriciens français (CNGOF), in agreement with the Société de chirurgie gynécologique et pelvienne (SCGP), has set up a commission in 2017 to define endometriosis expert centres, with the aim of optimizing endometriosis care in France. The committee included members from university and general hospitals as well as private facilities, representing medical, surgical and radiological aspects of endometriosis care. Opinion of endometriosis patients' associations was obtained prior to writing this work. The final text was presented and unanimously validated by the members of the CNGOF Board of Directors at its meeting of October 13, 2017. Based on analysis of current management of endometriosis and the last ten years opportunities in France, the committee has been able to define the contours of endometriosis expert centres. The objectives, production specifications, mode of operation, missions and funding for these centres were described. The following missions have been specifically defined: territorial organization, global and referral care, communication and teaching as well as research and evaluation. Because of its daily impact for women and its economic burden in France, endometriosis justifies launching of expert centres throughout the country with formal accreditation by health authorities, ideally as part of the National Health Plan. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  3. Birth centres and the national maternity services review: response to consumer demand or compromise?

    PubMed

    Dahlen, H; Jackson, M; Schmied, V; Tracy, S; Priddis, H

    2011-12-01

    In February 2009 the Improving Maternity Services in Australia - The Report of the Maternity Services Review (MSR) was released and recommended improving women's access to and availability of birth centres. It was unclear if this was in response to an overwhelming request for birth centres in the submissions received by the commonwealth or a compromise for excluding homebirth from the maternity service reforms. The aim of this paper was to examine what was said in the submissions to the MSR about birth centres. Data for this study comprised 832 submissions to the MSR that are publicly available on the Commonwealth of Australia Department of Health and Ageing website. All 832 submissions were downloaded, and read for any mention of the words 'birth centre', 'birth center'. Content analysis was used to categorise and report the data. Of the 832 submissions to the MSR 197 (24%) mentioned birth centres while 470 (60%) of the submissions mentioned homebirth. Only 31 (4%) of the submissions to the Maternity Review mentioned birth centres without mentioning home birth also. Most of the submissions emphasised that 'everything should be on the menu' when it came to place of birth and care provider. Reasons for choosing a birth centre were identified as: 'the best compromise available, 'the right and natural way' and 'the birth centre as safe'. Women had certain requirements of a birth centre that included: 'continuity of carer', 'midwife led', 'a sanctum from medicalised care', 'resources to cope with demand', 'close to home', and 'flexible guidelines and admission criteria'. Women weighed up a series of requirements when deciding whether to give birth in a birth centre. The recommendation by the MSR to expand birth centres and ignore home birth is at odds with the strong view expressed that 'everything should be on the menu'. The requirements women described of birth centre care are also at odds with current trends. If there is to be an expansion of birth centres, service

  4. Initiation of non-invasive ventilation in amyotrophic lateral sclerosis and clinical practice guidelines: Single-centre, retrospective, descriptive study in a national reference centre.

    PubMed

    Georges, Marjolaine; Golmard, Jean-Louis; Llontop, Claudia; Shoukri, Amr; Salachas, François; Similowski, Thomas; Morelot-Panzini, Capucine; Gonzalez-Bermejo, Jésus

    2017-02-01

    In amyotrophic lateral sclerosis (ALS), respiratory muscle weakness leads to respiratory failure. Non-invasive ventilation (NIV) maintains adequate ventilation in ALS patients. NIV alleviates symptoms and improves survival. In 2006, French guidelines established criteria for NIV initiation based on limited evidence. Their impact on clinical practice remains unknown. Our objective was to describe NIV initiation practices of the main French ALS tertiary referral centre with respect to guidelines. In this retrospective descriptive study, 624 patients followed in a single national reference centre began NIV between 2005 and 2013. We analysed criteria used to initiate NIV, including symptoms, PaCO 2 , forced vital capacity, maximal inspiratory pressures and time spent with SpO 2 <90% at night. At NIV initiation, 90% of patients were symptomatic. Median PaCO 2 was 48 mmHg. The main criterion to initiate NIV was 'symptoms' followed by 'hypercapnia' in 42% and 34% of cases, respectively. NIV was initiated on functional parameters in only 5% of cases. Guidelines were followed in 81% of cases. In conclusion, despite compliance with French guidelines, the majority of patients are treated at the stage of symptomatic daytime hypoventilation, which suggests that NIV is initiated late in the course of ALS. Whether this practice could be improved by changing guidelines or increasing respiratory-dedicated resources remains to be determined.

  5. Assuring optimal trauma care: the role of trauma centre accreditation

    PubMed Central

    Simons, Richard; Kirkpatrick, Andrew

    2002-01-01

    Optimal care of the injured patient requires the delivery of appropriate, definitive care shortly after injury. Over the last 30 to 40 years, civilian trauma systems and trauma centres have been developed in the United States based on experience gained in military conflicts, particularly in Korea and Vietnam. A similar process is evolving in Canada. National trauma committees in the US and Canada have defined optimal resources to meet the goal of rapid, appropriate care in trauma centres. They have introduced programs (verification or accreditation) to externally audit trauma centre performance based on these guidelines. It is generally accepted that implementing trauma systems results in decreased preventable death and improved survival after trauma. What is less clear is the degree to which each facet of trauma system development contributes to this improvement. The relative importance of national performance guidelines and trauma centre audit as integral steps toward improved outcomes following injury are reviewed. Current Trauma Association of Canada guidelines for trauma centres are presented and the process of trauma centre accreditation is discussed. PMID:12174987

  6. Sustaining the Leaders of Children's Centres: The Role of Leadership Mentoring

    ERIC Educational Resources Information Center

    John, Karen

    2008-01-01

    Leadership mentoring is a central component of the National Professional Qualification in Integrated Centre Leadership (NPQICL), which is designed to develop robust, creative and courageous children's centre leaders. Mentoring provides a safe, supportive and confidential space in which leaders can discuss the challenges of leading their centres.…

  7. The new policy of the Food and Agriculture Organization of the United Nations and its Reference Centres for the Animal Production and Health Division.

    PubMed

    Lubroth, J

    2007-01-01

    The article explains the current procedures to be followed for institutes that are, were or would like to become Reference Centres for the Food and Agriculture Organization (FAO) of the United Nations. Within the realm of animal health many of the Reference Laboratories and Reference Centres of the World Organisation for Animal Health (OIE) are the same as those of the Animal and Health Division of FAO, particularly for diseases that are transboundary in nature, but they also address other aspects concerning health, production, standard setting, agriculture, conservation, water, and biotechnology.

  8. The Hellenic National Tsunami Warning Centre (HL-NTWC): Recent updates and future developments

    NASA Astrophysics Data System (ADS)

    Melis, Nikolaos S.; Charalampakis, Marinos

    2014-05-01

    The Hellenic NTWC (HL-NTWC) was established officially by Greek Law in September 2010. HL-NTWC is hosted at the National Observatory of Athens, Institute of Geodynamics (NOA-IG), which also operates a 24/7 earthquake monitoring service in Greece and coordinates the newly established Hellenic Unified National Seismic Network. NOA-IG and HL-NTWC Operational Centre is linked to the Civil Protection Operational Centre and serves as the official alerting agency to the General Secretariat for Civil Protection in Greece, regarding earthquake events and tsunami watch. Since August 2012, HL-NTWC acts as Candidate Tsunami Watch Provider (CTWP) under the UNESCO IOC - ICG NEAMTWS tsunami warning system (NEAM: North-Eastern Atlantic, the Mediterranean and connected seas) and offers its services to the NEAMTWS system. HL-NTWC has participated in all Communication Test Exercises (CTE) under NEAMTWS and also it has provided tsunami scenarios for extended system testing exercises such as NEAMWAVE12. Some of the recent developments at HL-NTWC in Greece include: deployment of new tide gauge stations for tsunami watch purposes, computation of tsunami scenarios and extending the database in use, improving alerting response times, earthquake magnitude estimation and testing newly established software modules for tsunami and earthquake alerting (i.e. Early-Est, SeisComP3 etc.) in Greece and the Eastern Mediterranean. Although funding today is limited, an advantage of the participation in important EC funded research projects, i.e. NERIES, NERA, TRANSFER, NEAMTIC and ASTARTE, demonstrates that collaboration of top class Research Institutions that care to produce important and useful results in the research front in Europe, can facilitate towards developing and operating top class Operational Centers, useful for Civil Protection purposes in regions in need. Last, it is demonstrated that HL-NTWC collaboration with important key role Research Centers in the Security and Safety issues (e

  9. Genomic analysis using high density SNP based oligonucleotide arrays and MLPA provides a comprehensive analysis of INI1/SMARCB1 in malignant rhabdoid tumors

    PubMed Central

    Jackson, Eric M.; Sievert, Angela J.; Gai, Xiaowu; Hakonarson, Hakon; Judkins, Alexander R; Tooke, Laura; Perin, Juan Carlos; Xie, Hongbo; Shaikh, Tamim H.; Biegel, Jaclyn A.

    2009-01-01

    Translational Relevance Previous reports suggested that abnormalities of INI1 could be detected in 70–75% of malignant rhabdoid tumors. The mechanism of inactivation in the other 25% remained unclear. The goal of this study was to perform a high-resolution genomic analysis of a large series of rhabdoid tumors with the expectation of identifying additional loci related to the initiation or progression of these malignancies. We also developed a comprehensive set of assays, including a new MLPA assay, to interrogate the INI1 locus in 22q11.2. Intragenic deletions could be detected using the Illumina 550K Beadchip, whereas single exon deletions could be detected using MLPA. The current study demonstrates that with a multi-platform approach, alterations at the INI1 locus can be detected in almost all cases. Thus, appropriate molecular genetic testing can be used as an aid in the diagnosis and for treatment planning for most patients. Purpose A high-resolution genomic profiling and comprehensive targeted analysis of INI1/SMARCB1 of a large series of pediatric rhabdoid tumors was performed. The aim was to identify regions of copy number change and loss of heterozygosity that might pinpoint additional loci involved in the development or progression of rhabdoid tumors, and define the spectrum of genomic alterations of INI1 in this malignancy. Experimental Design A multi-platform approach, utilizing Illumina single nucleotide polymorphism (SNP) based oligonucleotide arrays, multiplex ligation dependent probe amplification (MLPA), fluorescence in situ hybridization (FISH), and coding sequence analysis was used to characterize genome wide copy number changes, loss of heterozygosity, and genomic alterations of INI1/SMARCB1 in a series of pediatric rhabdoid tumors. Results The bi-allelic alterations of INI1 that led to inactivation were elucidated in 50 of 51 tumors. INI1 inactivation was demonstrated by a variety of mechanisms, including deletions, mutations, and loss of

  10. Should money follow the patient: Financial implication for being the National Centre for the Treatment and Management of Pelvic and Acetabular Fractures in Ireland.

    PubMed

    Kelly, M E; Leonard, M; Green, C; Beggs, R; Cheung, C; McElwain, J; Morris, S

    2013-12-01

    Pelvic and acetabular fractures are complex injuries requiring specialist treatment. Our institution is the National Centre for Treatment and Management of these injuries. To audit all referrals to our institution over a 6-month period and calculate the cost incurred by being the national referral centre. Retrospective review of database, and subsequent allocation of Casemix points to assess total cost of treatment for each patient referred to our institution. 103 patients referred with pelvic or acetabular fracture for operative management. The furthest referral distance was 181miles. Over-all, the length of stay was 15.4 days. The average inclusive cost for a referral to our unit for operative management was €16,302. Pelvic and acetabular fractures are complex injuries that require specialist referral unit management. However for these units to remain sustainable money needs to "follow the patient". Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  11. Serbia National Poison Control Centre: organization and current activities.

    PubMed

    Jovanović, Dugan; Joksović, Dragan; Vucinić, Savica; Todorović, Veljko; Segrt, Zoran; Kilibarda, Vesna; Bokonjić, Dubravko

    2005-01-01

    Ministry of Health of the former Federal Republic of Yugoslavia established the National Poison Control Centre in 1995. However, that was only the formally solution since clinical, analytical and experimental services in toxicology had worked independently for at least 40 years. Besides the Headquarters, NPCC has currently 2 main units, the Clinic of Emergency and Clinical Toxicology and Pharmacology and the Institute of Toxicology and Pharmacology. The latter is consisted of Toxicological Information Department, Department of Analytical Toxicology and Department of Experimental Toxicology and Pharmacology. The Mobile Toxicological Chemical Unit is a separate department that is activated from personnel of the NPCC in a case of chemical accidents and/or disasters. Clinical, information and analytical parts of NPCC have a 365-day/24-hour working service. The Clinic of Emergency and Clinical Toxicology and Pharmacology is a place where the intoxicated patients are treated, including those that need the intensive care measures. Toxicological Information Department uses the data from a self-made computer Database for different information purposes. Department of Analytical Toxicology is equipped with a lot of contemporary analytical equipment that is giving the opportunity of identification and quantification of chemicals/metabolites/degradation products in biological material, food, water, air and soil. Basic pharmacological and toxicological research of chemicals and pre-clinical investigations of antidotes are realized in the Department of Experimental Toxicology and Pharmacology. In terms of medical prevention and rational treatment of human poison exposures in Serbia, the current organization of NPCC has so far proven to be effective.

  12. Evaluating the Effectiveness of Information Centres and Services

    DTIC Science & Technology

    1988-09-01

    THE EFFECTIVENESS OF INFORMATION CENTRES AND SERVICES Accession For ZTIS GRA&I DTIC TAB Unarnnounoed 0- Justilfication By Distribution/ Availability...Recommending effective ways for the member nations to use their research and development capabilities for the common benefit of the NATO community; - Providing...evaluation is done. It proposes various strategies for altering the centres and services so that effectiveness is improved; in so doing, it covers

  13. Byurakan Astrophysical Observatory as Cultural Centre

    NASA Astrophysics Data System (ADS)

    Mickaelian, A. M.; Farmanyan, S. V.

    2016-12-01

    NAS RA V. Ambartsumian Byurakan Astrophysical Observatory is presented as a cultural centre for Armenia and the Armenian nation in general. Besides being scientific and educational centre, the Observatory is famous for its unique architectural ensemble, rich botanical garden and world of birds, as well as it is one of the most frequently visited sightseeing of Armenia. In recent years, the Observatory has also taken the initiative of the coordination of the Cultural Astronomy in Armenia and in this field, unites the astronomers, historians, archaeologists, ethnographers, culturologists, literary critics, linguists, art historians and other experts.

  14. The DIY Digital Medical Centre.

    PubMed

    Timmis, James Kenneth; Timmis, Kenneth

    2017-09-01

    Healthcare systems worldwide are confronted with major economic, organizational and logistical challenges. Historic evolution of health care has led to significant healthcare sector fragmentation, resulting in systemic inefficiencies and suboptimal resource exploitation. To attain a sustainable healthcare model, fundamental, system-wide improvements that effectively network, and ensure fulfilment of potential synergies between sectors, and include and facilitate coherent strategic planning and organisation of healthcare infrastructure are needed. Critically, they must be specifically designed to sustainably achieve peak performance within the current policy environment for cost-control, and efficiency and quality improvement for service delivery. We propose creation of a new healthcare cluster, to be embedded in existing healthcare systems. It consists of (i) local 24/7 walk-in virtually autonomous do-it-yourself Digital Medical Centres performing routine diagnosis, monitoring, prevention, treatment and standardized documentation and health outcome assessment/reporting, which are online interfaced with (ii) regional 24/7 eClinician Centres providing on-demand clinical supervision/assistance to Digital Medical Centre patients. Both of these are, in turn, online interfaced with (iii) the National Clinical Informatics Centre, which houses the national patient data centre (cloud) and data analysis units that conduct patient- and population-level, personalized and predictive(-medicine) intervention optimization analyses. The National Clinical Informatics Centre also interfaces with biomedical research and prioritizes and accelerates the translation of new discoveries into clinical practice. The associated Health Policy Innovation and Evaluation Centre rapidly integrates new findings with health policy/regulatory discussions. This new cluster would synergistically link all health system components in a circular format, enable not only access by all arms of the health

  15. Problems and Prospects of Education Resource Centres in Nigeria

    ERIC Educational Resources Information Center

    Ekanem, Johnson Efiong

    2015-01-01

    Nigeria has good policies on Education and one of such policies is the establishment of Education Resource Centres in every State of the Federation, including the Federal Capital Territory, Abuja. The need is clearly articulated in the National Policy on Education. Despite the lofty plan, most of the centres are not fulfilling the need for their…

  16. Industry Restructuring: Extracts from Centre Publications.

    ERIC Educational Resources Information Center

    Hall, William C., Ed.

    This document contains excerpts from material previously published by Australia's TAFE (Technical and Further Education) National Centre for Research and Development on the subjects of industry restructuring, the reasons for restructuring, revising curricula, and providing a service to business and industry. Its contents are "Industry…

  17. Being prepared to verify the CTBT-Atmospheric Transport modeling and radionuclide analysis at the Austrian National Data Centre during the NDC Preparedness Exercise 2009

    NASA Astrophysics Data System (ADS)

    Wotawa, Gerhard; Schraick, Irene

    2010-05-01

    An explosion in the Kara-Zhyra mine in Eastern Kazakhstan on 28 November 2009 around 07:20 UTC was recorded by both the CTBTO seismic and infrasound networks. This event triggered a world-wide preparedness exercise among the CTBTO National Data Centres. Within an hour after the event was selected by the German NDC, a computer program developed by NDC Austria based on weather forecasts from the European Centre for Medium-Range Weather Forecasts (ECMWF) and from the U.S. National Centers for Environmental Prediction (NCEP) was started to analyse what Radionuclide Stations of the CTBTO International Monitoring System (IMS) would be potentially affected by the release from a nuclear explosion at this place in the course of the following 3-10 days. These calculations were daily updated to consider the observed state of the atmosphere instead of the predicted one. Based on these calculations, automated and reviewed radionuclide reports from the potentially affected stations as produced by the CTBTO International Data Centre (IDC) were looked at. An additional analysis of interesting spectra was provided by the Seibersdorf Laboratories. Based on all the results coming in, no evidence whatsoever was found that the explosion in Kazakhstan was nuclear. This is in accordance with ground truth information saying that the event was caused by the detonation of more than 53 Tons of explosives as part of mining operations. A number of conclusions can be drawn from this exercise. First, the international, bilateral as well as national mechanisms and procedures in place for such an event worked smoothly. Second, the products and services from the CTBTO IDC proved to be very useful to assist the member states in their verification efforts. Last but not least, issues with the availability of data from IMS radionuclide stations do remain.

  18. Seismological Investigations of the National Data Centre Preparedness Exercise 2015 (NPE2015)

    NASA Astrophysics Data System (ADS)

    Gestermann, Nicolai; Hartmann, Gernot; Ross, Jens-Ole

    2017-04-01

    The Comprehensive Nuclear-Test-Ban Treaty (CTBT) prohibits all kinds of nuclear explosions. For the detection of treaty violations the International Monitoring System (IMS) operates stations observing seismic, hydroacoustic, and infrasound signals as well as radioisotopes in the atmosphere. While the IMS data is collected, processed and technically analyzed in the International Data Center (IDC) of the CTBT-Organization, National Data Centers (NDC) provide interpretation and advice to their government concerning suspicious detections occurring in IMS data. The National Data Centre Preparedness Exercises (NPE) are regularly performed dealing with fictitious treaty violations to practice the combined analysis of CTBT verification technologies and national technical means. These exercises should help to evaluate the effectiveness of analysis procedures applied at NDCs and the quality, completeness and usefulness of IDC products. The NPE2015 is a combined radionuclide-waveform scenario. Fictitious particulate radionuclide and radioxenon measurements at stations of the IMS (International Monitoring System) of the CTBTO were reported to the international community. The type of isotopes and concentrations could arise from an underground nuclear explosion (UNE). The task of the exercise is to identify the scenario behind the provided data. The source region and time domain of a possible treaty violation activity was determined from ATM in backtracking mode with input data from the fictitious data. A time slot in October and a region around the mining area of Lubin could be identified as the possible source area of the fictitious measurements. The seismicity of the determined source region was investigated in detail to identify events which cannot be classified as natural or induced within the relevant time interval. The comparison of spectral characteristics and a cluster analysis was applied to search for a non-characteristic event within a number of known induced events

  19. Byurakan Astrophysical Observatory as Cultural Centre

    NASA Astrophysics Data System (ADS)

    Mickaelian, A. M.; Farmanyan, S. V.

    2017-07-01

    NAS RA V. Ambartsumian Byurakan Astrophysical Observatory is presented as a cultural centre for Armenia and the Armenian nation in general. Besides being scientific and educational centre, the Observatory is famous for its unique architectural ensemble, rich botanical garden and world of birds, as well as it is one of the most frequently visited sightseeing of Armenia. In recent years, the Observatory has also taken the initiative of the coordination of the Cultural Astronomy in Armenia and in this field, unites the astronomers, historians, archaeologists, ethnographers, culturologists, literary critics, linguists, art historians and other experts. Keywords: Byurakan Astrophysical Observatory, architecture, botanic garden, tourism, Cultural Astronomy.

  20. Multiple schwannomatosis caused by the recently described INI1 gene--molecular pathology, and implications for prognosis.

    PubMed

    Brennan, Paul M; Barlow, Antonio; Geraghty, Alistair; Summers, David; Fitzpatrick, Michael M

    2011-06-01

    The most common genetic predisposition to multiple schwannoma growth is mutation of the neurofibromatosis type 2 gene. We describe a patient with multiple schwannomas and mutation in the recently described INI1 gene, which also predisposes to the disease. We explore the implications for prognosis and outcome.

  1. In Pursuit of a Multi-lateral Dialogue - the Swiss National Centre for Climate Services (NCCS)

    NASA Astrophysics Data System (ADS)

    Michiko Hama, Angela; Croci-Maspoli, Mischa; Liniger, Mark; Schwierz, Cornelia; Stöckli, Reto; Fischer, Andreas; Gubler, Stefanie; Kotlarski, Sven; Rossa, Andrea; Zubler, Elias; Appenzeller, Christof

    2017-04-01

    Kick-starting, fostering and maintaining a dialogue between primarily public and academic actors involved in the co-design, co-delivery and use of climate services is at the core of Switzerland's National Centre for Climate Services (NCCS), which was founded in late 2015 in recognition of the Global Framework for Climate Services (GFCS). This coordination and innovation mechanism is a concerted national effort comprised of seven Federal Agencies and Institutes and further partners from academia committed to implementing the Framework at national to subnational level and creating synergies the world over. The NCCS is to be regarded as vital alongside the Swiss National Adaptation Strategy, and it also contributes to putting words into action with respect to the UN's Sustainable Development Goals, the UNFCCC and the Sendai Framework for Disaster Risk Reduction. The services of the Centre provide information to support policy-makers from national to local level as well as the private sector and society at large in minimising their risks, maximising opportunities and optimising costs in the context of climate change and variability. They are indispensable for setting effective mitigation and adaptation measures and for instigating societal transformation. Hence, the goals of the NCCS are to bundle the existing climate services of the Swiss Federation, co-create new tailored solutions with users, act as a network agent and knowledge broker - to boost climate literacy and enable climate-sensitive decision-making leading to increased resilience. The services reflect the specificities and requirements of the Alpine region and its particular challenges and vulnerabilities. Pursuing a participatory approach, the NCCS has brought together essential key players, acted as a sounding board for governmental stakeholders and their needs, and accordingly defined and populated six priority themes in line with the priority areas of the GFCS. These themes are: natural hazards, health

  2. Reframing the focus from a family-centred to a child-centred care approach for children's healthcare.

    PubMed

    Coyne, Imelda; Hallström, Inger; Söderbäck, Maja

    2016-05-01

    In this article, we argue for a conceptual move from family-centred care (FCC) to a child-centred care approach and the implications for clinical nursing practice. Firstly, we argue that the parents and professional dominance constructs an asymmetric relationship towards the child, which may take away the focus from the child; Secondly, we need to renew efforts to promote the fundamental principles of protection, promotion and participation rights for children and young people according to the United Nations Convention on the Rights of the Child declaration and thirdly, we need to strengthen the child's perspective and to view the child as an agent representing own experiences and wishes to be respected and negotiated. © The Author(s) 2016.

  3. Addiction research centres and the nurturing of creativity. Monitoring the European drug situation: the ongoing challenge for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

    PubMed

    Griffiths, Paul; Mounteney, Jane; Lopez, Dominique; Zobel, Frank; Götz, Wolfgang

    2012-02-01

    The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the designated hub for drug-related information in the European Union. The organization's role is to provide the European Union (EU) and its Member States with a factual overview of European drug problems and a common information framework to support the drugs debate. In order to achieve its mission, the EMCDDA coordinates and relies on a network of 30 national monitoring centres, the Reitox National Focal Points. The Centre publishes on a wide range of drug-related topics, across epidemiology, interventions, laws and policies. Every November, the EMCDDA publishes its Annual Report, providing a yearly update on the European drug situation, translated into 23 EU languages. In line with its founding regulation, the EMCDDA has a role acting as an interface between the worlds of science and policy. While not a research centre in the formal sense, the results the Centre generates serve as catalysts for new research questions and help to identify priorities. Current challenges facing the agency include continuing to increase scientific standards while maintaining a strong institutional role, as well as supporting European efforts to identify, share and codify best practice in the drugs field. © 2011 EMCDDA.

  4. From gene to structure: The protein factory of the NBICS Centre of Kurchatov Institute

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

    Boyko, K. M.; Lipkin, A. V.; Popov, V. O., E-mail: vpopov@inbi.ras.ru

    2013-05-15

    The Protein Factory was established at the Centre for Nano, Bio, Info, Cognitive, and Social Sciences and Technologies (NBICS Centre) of the National Research Centre 'Kurchatov Institute' in 2010. The Protein Factory, together with the Centre for Synchrotron Radiation and Nanotechnology, promote research on structural biology. This paper presents the technology platforms developed at the Protein Factory and the facilities available for researchers. The main projects currently being performed at the Protein Factory are briefly described.

  5. Addiction research centres and the nurturing of creativity: Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Sweden.

    PubMed

    Stenius, Kerstin; Ramstedt, Mats; Olsson, Börje

    2010-03-01

    The Centre for Social Research on Alcohol and Drugs (SoRAD) was established as a national research centre and department within the Faculty of Social Science at Stockholm University in 1997, following a Government Report and with the aim to strengthen social alcohol and drug research. Initially, core funding came from the Swedish Council for Working Life and Social Research and from the Ministry of Health and Social Affairs for several long-term projects. Today, SoRAD, with 25 senior and junior researchers, has core funding from the university but most of its funding comes from external national and international grants. Research is organized under three themes: consumption, problems and norms, alcohol and drug policy and societal reactions, treatment and recovery processes. SoRADs scientific approach, multi-disciplinarity, a mix of qualitative and quantitative methods and international comparisons was established by the centre's first leader, Robin Room. Regular internal seminars are held and young researchers are encouraged to attend scientific meetings and take part in collaborative projects. SoRAD researchers produce government-funded monthly statistics on alcohol consumption and purchase, and take part in various national government committees, but SoRADs research has no clear political or bureaucratic constraints. One of the future challenges for SoRAD will be the proposed system for university grants allocation, where applied social science will have difficulties competing with basic biomedical research if decisions are based on publication and citation measures.

  6. UK National Data Centre archive of seismic recordings of (presumed) underground nuclear tests 1964-1996

    NASA Astrophysics Data System (ADS)

    Young, John; Peacock, Sheila

    2016-04-01

    The year 1996 has particular significance for forensic seismologists. This was the year when the Comprehensive Test Ban Treaty (CTBT) was signed in September at the United Nations, setting an international norm against nuclear testing. Blacknest, as a long time seismic centre for research into detecting and identifying underground explosions using seismology, provided significant technical advice during the CTBT negotiations. Since 1962 seismic recordings of both presumed nuclear explosions and earthquakes from the four seismometer arrays Eskdalemuir, Scotland (EKA), Yellowknife, Canada (YKA), Gauribidanur, India (GBA), and Warramunga, Australia (WRA) have been copied, digitised, and saved. There was a possibility this archive would be lost. It was decided to process the records and catalogue them for distribution to other groups and institutions. This work continues at Blacknest but the archive is no longer under threat. In addition much of the archive of analogue tape recordings has been re-digitised with modern equipment, allowing sampling rates of 100 rather than 20 Hz.

  7. Missed Opportunities to Keep Children Safe? National Survey of Injury Prevention Activities of Children's Centres

    ERIC Educational Resources Information Center

    Watson, Michael Craig; Mulvaney, Caroline; Timblin, Clare; Stewart, Jane; Coupland, Carol A.; Deave, Toity; Hayes, Mike; Kendrick, Denise

    2016-01-01

    Objective: To ascertain the activities undertaken by children's centres to prevent unintentional injuries in the under-fives and, in particular, the prevention of falls, poisoning and scalds. Design: A questionnaire was posted to managers of 851 children's centres, using stratified cluster sampling. The questionnaire included questions on injury…

  8. The epidemiology and type of medication errors reported to the National Poisons Information Centre of Ireland.

    PubMed

    Cassidy, Nicola; Duggan, Edel; Williams, David J P; Tracey, Joseph A

    2011-07-01

    Medication errors are widely reported for hospitalised patients, but limited data are available for medication errors that occur in community-based and clinical settings. Epidemiological data from poisons information centres enable characterisation of trends in medication errors occurring across the healthcare spectrum. The objective of this study was to characterise the epidemiology and type of medication errors reported to the National Poisons Information Centre (NPIC) of Ireland. A 3-year prospective study on medication errors reported to the NPIC was conducted from 1 January 2007 to 31 December 2009 inclusive. Data on patient demographics, enquiry source, location, pharmaceutical agent(s), type of medication error, and treatment advice were collated from standardised call report forms. Medication errors were categorised as (i) prescribing error (i.e. physician error), (ii) dispensing error (i.e. pharmacy error), and (iii) administration error involving the wrong medication, the wrong dose, wrong route, or the wrong time. Medication errors were reported for 2348 individuals, representing 9.56% of total enquiries to the NPIC over 3 years. In total, 1220 children and adolescents under 18 years of age and 1128 adults (≥ 18 years old) experienced a medication error. The majority of enquiries were received from healthcare professionals, but members of the public accounted for 31.3% (n = 736) of enquiries. Most medication errors occurred in a domestic setting (n = 2135), but a small number occurred in healthcare facilities: nursing homes (n = 110, 4.68%), hospitals (n = 53, 2.26%), and general practitioner surgeries (n = 32, 1.36%). In children, medication errors with non-prescription pharmaceuticals predominated (n = 722) and anti-pyretics and non-opioid analgesics, anti-bacterials, and cough and cold preparations were the main pharmaceutical classes involved. Medication errors with prescription medication predominated for adults (n = 866) and the major medication

  9. Ion Beam Facilities at the National Centre for Accelerator based Research using a 3 MV Pelletron Accelerator

    NASA Astrophysics Data System (ADS)

    Trivedi, T.; Patel, Shiv P.; Chandra, P.; Bajpai, P. K.

    A 3.0 MV (Pelletron 9 SDH 4, NEC, USA) low energy ion accelerator has been recently installed as the National Centre for Accelerator based Research (NCAR) at the Department of Pure & Applied Physics, Guru Ghasidas Vishwavidyalaya, Bilaspur, India. The facility is aimed to carried out interdisciplinary researches using ion beams with high current TORVIS (for H, He ions) and SNICS (for heavy ions) ion sources. The facility includes two dedicated beam lines, one for ion beam analysis (IBA) and other for ion implantation/ irradiation corresponding to switching magnet at +20 and -10 degree, respectively. Ions with 60 kV energy are injected into the accelerator tank where after stripping positively charged ions are accelerated up to 29 MeV for Au. The installed ion beam analysis techniques include RBS, PIXE, ERDA and channelling.

  10. Development and implementation of a nurse-led walk-in centre: evidence lost in translation?

    PubMed

    Desborough, Jane; Parker, Rhian; Forrest, Laura

    2013-07-01

    The design of the first Australian public nurse-led primary care walk-in centre was modelled on those established in the English National Health Service (NHS). An independent evaluation of the first 12 months of operation of the Australian Capital Territory (ACT) Health walk-in centre, in 2011, analysed the translation of evidence from the national evaluation of the NHS walk-in centres to the policy development and implementation of the ACT walk-in centre. Whilst in a number of ways the evidence was used well, our interest for this paper was to examine three areas identified as problematic and to identify the points at which the evidence was lost or diluted. In addition to data obtained through nurse and key stakeholder interviews for the evaluation, an analysis was undertaken of documents on the planning and establishment of the ACT walk-in centre, either provided to the evaluation team or made publicly available. Three areas were identified as problematic in the way that evidence from the NHS evaluation was translated: the use of clinical decision support software (CDSS); the marketing of the walk-in centre; and its location. Our examination indicates that despite seeking evidence to inform the development of the ACT walk-in centre, the evidence was not fully used and some clear lessons ignored, resulting in much of the evidence being lost in translation.

  11. The changing interface between district hospital cardiology and the major cardiac centres

    PubMed Central

    1997-01-01

    The national priority for reducing mortality and morbidity from cardiovascular disease, the resulting expansion in the number of consultant cardiologists, and the reforms of the National Health Service have produced significant changes in delivery of care for cardiac patients and in the relations between district general hospitals (DGH) and the old regional cardiac centres. 1.2 The British Cardiac Society, the Medical Royal Colleges of Physicians of London and Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow established a working group to make recommendations on the most appropriate evolution of these changes to secure high quality care in a cost-effective and professionally rewarding environment. The principal conclusions of the working group were: i) The establishment of new cardiac catheterisation laboratories in DGHs remote from a major cardiac centre should be encouraged provided the workload is adequate to ensure efficient use of the facility. ii) Cardiologists working in districts close to a major centre should be encouraged to catheterise their patients at the centre. iii) Close liaison of the district cardiologist with a cardiac surgeon and interventionist is vitally important. iv) The centres will be required to provide tertiary care for emergency and urgent cases from their traditional catchment area, specialised expertise for the management of rare and difficult cases, and angioplasty. Some centres will also offer complex electrophysiology, and ablation techniques. v) The centres must also provide routine cardiology services for their local district, facilities for cardiac catheterisation for DGH cardiologists, and training for doctors, nurses, technicians, and radiographers. vi) Some centres will be linked with paediatric cardiology and paediatric cardiac surgical units. vii) District cardiac centres will be required to provide a full non-invasive diagnostic service and emergency care for patients referred by general practitioners

  12. Centre for Research Infrastructure of Polish GNSS Data - response and possible contribution to EPOS

    NASA Astrophysics Data System (ADS)

    Araszkiewicz, Andrzej; Rohm, Witold; Bosy, Jaroslaw; Szolucha, Marcin; Kaplon, Jan; Kroszczynski, Krzysztof

    2017-04-01

    In the frame of the first call under Action 4.2: Development of modern research infrastructure of the science sector in the Smart Growth Operational Programme 2014-2020 in the late of 2016 the "EPOS-PL" project has launched. Following institutes are responsible for the implementation of this project: Institute of Geophysics, Polish Academy of Sciences - Project Leader, Academic Computer Centre Cyfronet AGH University of Science and Technology, Central Mining Institute, the Institute of Geodesy and Cartography, Wrocław University of Environmental and Life Sciences, Military University of Technology. In addition, resources constituting entrepreneur's own contribution will come from the Polish Mining Group. Research Infrastructure EPOS-PL will integrate both existing and newly built National Research Infrastructures (Theme Centre for Research Infrastructures), which, under the premise of the program EPOS, are financed exclusively by the national founds. In addition, the e-science platform will be developed. The Centre for Research Infrastructure of GNSS Data (CIBDG - Task 5) will be built based on the experience and facilities of two institutions: Military University of Technology and Wrocław University of Environmental and Life Sciences. The project includes the construction of the National GNNS Repository with data QC procedures and adaptation of two Regional GNNS Analysis Centres for rapid and long-term geodynamical monitoring.

  13. Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre.

    PubMed

    Lane, Thirusha; Pinney, Jennifer H; Gilbertson, Janet A; Hutt, David F; Rowczenio, Dorota M; Mahmood, Shameem; Sachchithanantham, Sajitha; Fontana, Marianna; Youngstein, Taryn; Quarta, Candida C; Wechalekar, Ashutosh D; Gillmore, Julian D; Hawkins, Philip N; Lachmann, Helen J

    2017-09-01

    Systemic AA amyloidosis is a serious complication of chronic inflammation; however, there are relatively few published data on its incidence. We investigated the changing epidemiology of AA amyloidosis over a 25-year period at a single national referral centre. We conducted a retrospective study of all patients diagnosed with AA amyloidosis who had attended the centre between 1990 and 2014 inclusive. Six hundred and twenty-five patients were studied in three cohorts: C1: 1990-1997; C2: 1998-2006; C3: 2007-2014. Mean age at presentation increased from 46 in C1 to 56 in C3 (p < .0001). The proportion of South Asian patients increased from 4% in C1 to 17% in C3 (p = .0006). Comparison of underlying diseases between C1 and C3 revealed a reduction in patients with juvenile idiopathic arthritis from 25% to 2% (p < .0001), but an increase in patients with chronic infection due to intravenous recreational drug use from 1% to 13% (p < .0001), and uncharacterized inflammatory disorders from 10% to 27% (p <.0001). More patients were in end-stage renal failure at presentation in C3 (29%) than C1 (15%) (p = .0028). Median age at death was later in C3 (62 years) than C1 (54 years) (p = .0012). These data suggest both falling incidence and better outcome in AA amyloidosis over a quarter of a century, reflecting advances in therapeutics and overall management of complex chronic disease in an ageing population. AA amyloidosis of uncertain aetiology presents an emerging major problem. Newer techniques such as next-generation sequencing may aid diagnosis and effective treatment, thereby improving overall survival.

  14. Cooperative Research Centres: The Concept and Its Implementation.

    ERIC Educational Resources Information Center

    Slatyer, Ralph O.

    1994-01-01

    Australia's Cooperative Research Centres Program, a system of 52 research and development (R&D) units, links researchers from public and private sectors, helping industry and scientific community coordinate research efforts. The program represents 6% of the national R&D effort and spans six major R&D and industry sectors. (MSE)

  15. The Role of National Adult Education Centre in Curriculum Development in Somalia in Selected Government Primary Adult Schools of Mogadisho. African Studies in Curriculum Development and Evaluation, No. 109.

    ERIC Educational Resources Information Center

    Bahar, Ismail F. S.

    A study of curriculum development in Somalia focused on the role of the National Adult Education Centre (NAEC) and involvement of teachers and inspectors. The sample consisted of 80 Mogadisho primary adult school teachers. Information sources were related literature, teacher questionnaires, and unstructured interviews with school inspectors,…

  16. A knowledge translation project on community-centred approaches in public health.

    PubMed

    Stansfield, J; South, J

    2018-03-01

    This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

  17. CADC and CANFAR: Extending the role of the data centre

    NASA Astrophysics Data System (ADS)

    Gaudet, Severin

    2015-12-01

    Over the past six years, the CADC has moved beyond the astronomy archive data centre to a multi-service system for the community. This evolution is based on two major initiatives. The first is the adoption of International Virtual Observatory Alliance (IVOA) standards in both the system and data architecture of the CADC, including a common characterization data model. The second is the Canadian Advanced Network for Astronomical Research (CANFAR), a digital infrastructure combining the Canadian national research network (CANARIE), cloud processing and storage resources (Compute Canada) and a data centre (Canadian Astronomy Data Centre) into a unified ecosystem for storage and processing for the astronomy community. This talk will describe the architecture and integration of IVOA and CANFAR services into CADC operations, the operational experiences, the lessons learned and future directions

  18. Interdisciplinary Study of Egyptian Mummies from the Pushkin State Museum of Fine Arts Collection at the National Research Centre ``Kurchatov Institute''

    NASA Astrophysics Data System (ADS)

    Yatsishina, E. B.; Kovalchuk, M. V.; Loshak, M. D.; Vasilyev, S. V.; Vasilieva, O. A.; Dyuzheva, O. P.; Pojidaev, V. M.; Ushakov, V. L.

    2018-05-01

    Nine ancient Egyptian mummies (dated preliminarily to the period from the 1st mill. BCE to the first centuries CE) from the collection of the State Pushkin Museum of Fine Arts have been studied at the National Research Centre "Kurchatov Institute" (NRC KI) on the base of the complex of NBICS technologies. Tomographic scanning is performed using a magneto-resonance tomograph (3 T) and a hybrid positron emission tomography/computed tomography (PET-CT) scanner. Three-dimensional reconstructions of mummies and their anthropological measurements are carried out. Some medical conclusions are drawn based on the tomographic data. In addition, the embalming composition and tissue of one of the mummies are preliminarily analyzed.

  19. University-Industry Interaction in the Ontario Centres of Excellence.

    ERIC Educational Resources Information Center

    Bell, Stephen

    1996-01-01

    The development and enhancement of alliances among universities, industry, and government is widely seen as a prescription for strengthening the competitiveness of regional and national economies. The interaction of university and industrial scientists is examined, and whether the creation of Ontario's Centres of Excellence should serve as a model…

  20. Estimation of content of anti-TB drugs supplied at centres of the Revised National TB Control Programme in Tamil Nadu, India.

    PubMed

    Ramachandran, Geetha; Chandrasekaran, Vedachalam; Hemanth Kumar, Agibothu Kupparam; Dewan, Puneet; Swaminathan, Soumya; Thomas, Aleyamma

    2013-09-01

    To determine the content of certain antituberculosis (TB) drugs supplied at TB treatment centres of the Revised National TB Control Programme (RNTCP) in the state of Tamil Nadu, India. Eight districts across the state were selected, and the following drugs were collected from five settings (District TB centre, TB unit, designated microscopy centres, DOT providers) in each district: rifampicin (150 and 450 mg), isoniazid (300 mg), pyrazinamide (500 and 750 mg), ethambutol (400 and 600 mg), ethionamide (250 mg), levofloxacin (500 mg) and cycloserine (250 mg). A maximum of 10 tablets/capsules were collected from each setting. The drugs were coded prior to analysis. All drugs were assayed by validated spectrophotometric methods. The acceptable limits for drug content were taken as 90-110% of the stated content. More than 90% of tablets of rifampicin 450 mg, isoniazid 300 mg, pyrazinamide 500 and 750 mg, ethambutol 400 and 600 mg and ethionamide 250 mg were within acceptable limits. Eighty per cent of rifampicin 150 mg, 21% of cycloserine 250 mg and 87% of levofloxacin 500 mg were within acceptable limits. The mean cycloserine content was below the acceptable limit in all districts, the mean drug content being 200 mg (range: 108-245 mg). This systematic study showed that the stated drug content of cycloserine was not reached in all districts. Deterioration of cycloserine could be minimised by storing the drug in refrigerators. The geographical location of the districts had no influence on the drug content. © 2013 John Wiley & Sons Ltd.

  1. Antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from peripheral health centres and STD clinic attendees of a tertiary care centre in India.

    PubMed

    Bala, M; Ray, K; Gupta, S M

    2008-06-01

    The aim of the study was to compare the antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from urban and rural peripheral health centres and from sexually transmitted disease (STD) clinic attendees. Antimicrobial susceptibility testing of 191 N. gonorrhoeae isolates (165 isolates from STD clinic attendees and 26 from peripheral health centres) was carried out in Delhi, India, using the calibrated dichotomous sensitivity technique for penicillin, tetracycline, ceftriaxone, ciprofloxacin, spectinomycin and nalidixic acid, and minimum inhibitory concentrations were determined using E-test. Penicillin-resistant, ciprofloxacin-resistant, penicillinase-producing N. gonorrhoeae and tetracycline-resistant N. gonorrhoeae strains were higher in STD clinic attendees than in peripheral health centres, probably because of less antibiotic pressure in the peripheral areas. High-level resistance to ciprofloxacin and multiresistant strains were also higher in STD clinic attendees. The present study emphasizes the importance of surveillance of antimicrobial resistance of N. gonorrhoeae in different population subgroups in order to monitor the spread of multiresistant strains and to update the national treatment recommendations.

  2. Singapore National Medical Image Resource Centre (SN.MIRC): a world wide web resource for radiology education.

    PubMed

    Yang, Guo-Liang; Lim, C C Tchoyoson

    2006-08-01

    Radiology education is heavily dependent on visual images, and case-based teaching files comprising medical images can be an important tool for teaching diagnostic radiology. Currently, hardcopy film is being rapidly replaced by digital radiological images in teaching hospitals, and an electronic teaching file (ETF) library would be desirable. Furthermore, a repository of ETFs deployed on the World Wide Web has the potential for e-learning applications to benefit a larger community of learners. In this paper, we describe a Singapore National Medical Image Resource Centre (SN.MIRC) that can serve as a World Wide Web resource for teaching diagnostic radiology. On SN.MIRC, ETFs can be created using a variety of mechanisms including file upload and online form-filling, and users can search for cases using the Medical Image Resource Center (MIRC) query schema developed by the Radiological Society of North America (RSNA). The system can be improved with future enhancements, including multimedia interactive teaching files and distance learning for continuing professional development. However, significant challenges exist when exploring the potential of using the World Wide Web for radiology education.

  3. Development and piloting the Woman Centred Care Scale (WCCS).

    PubMed

    Brady, Susannah; Bogossian, Fiona; Gibbons, Kristen

    2017-06-01

    In midwifery we espouse a woman centred care approach to practice, yet in midwifery education no valid instrument exists with which to measure the performance of these behaviours in midwifery students. To develop and validate an instrument to measure woman centred care behaviours in midwifery students. We identified four core concepts; woman's sphere, holism, self-determination and the shared power relationship. We mapped 18 individual descriptive care behaviours (from the Australian National Competency Standards for the Midwife) to these concepts to create an instrument to articulate and measure care behaviours that are specifically woman centred. Review by expert midwifery clinicians ensured face, content and construct validity of the scale and predictive validity and reliability were tested in a simulated learning environment. Midwifery students were video recorded performing a clinical skill and the videos were reviewed and rated by two expert clinicians who assessed the woman centred care behaviours demonstrated by the students (n=69). Test and re-test reliability of the instrument was high for each of the individual raters (Kappa 0.946 and 0.849 respectively p<0.001). However, when raters were compared there were differences between their scores suggesting variation in their expectations of woman centred care behaviours (Kappa 0.470, p<0.001). Midwifery students who had repeated exposures to higher levels of simulation fidelity demonstrated higher levels of woman centred care behaviours. The WCCS has implications for education and the wider midwifery profession in recognising and maintaining practice consistent with the underlying philosophy of woman centred care. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  4. A guide to multi-centre ethics for surgical research in Australia and New Zealand.

    PubMed

    Boult, Maggi; Fitzpatrick, Kate; Maddern, Guy; Fitridge, Robert

    2011-03-01

    This paper describes existing inconsistencies as well as the disparate processes and logistics required when obtaining ethics approval in Australia and New Zealand in order to initiate a multi-centre bi-national surgical trial. The endovascular aortic aneurysm repair trial is a large multi-centre trial that aims to obtain pre- and post-operative data from patients in hospitals across Australia and New Zealand. As the trial was research based, ethics applications were submitted to all hospitals where surgeons wished to be involved in the trial. Few ethics committees have embraced attempts to simplify the application process for multi-centre trials. There was limited mutual review between Human Research Ethics Committees necessitating the submission of multiple applications. Though the use of the National Ethics Application Form in ethical review is increasing, some Human Research Ethics Committees do not accept it in its entirety; many require site-specific applications or sections of the Common Application Form modules. Queensland, New South Wales and New Zealand were the easiest systems to prepare, submit and lodge ethics applications because of their understanding and accommodation of reviewing multi-centred trials. The time, expense and complexity of obtaining ethics approval for multi-centre research projects are impediments to their establishment and reduce the time available for research. Australia is working to implement a system named the Harmonisation of Multi-centre Ethical Review to ease the process of obtaining multi-centre ethics clearance. Our experience suggests there will be some teething problems with implementation and acceptance. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

  5. Interaction of In(I) and Tl(I) cations with 2,6-diaryl pyridine ligands: cation encapsulation within a very weakly interacting N/arene host environment.

    PubMed

    Mansaray, Hassanatu B; Tang, Christina Y; Vidovic, Dragoslav; Thompson, Amber L; Aldridge, Simon

    2012-12-03

    The interaction of 2,6-dimesitylpyridine with Tl(I) and In(I) cations has been investigated with a view to developing tractable molecular M(I) compounds which are soluble in organic media. In stark contrast to isosteric and isoelectronic terphenyl systems, complexes featuring the [(2,6-Mes(2)py)M](+) fragment feature very weak metal-ligand interactions in the solid state, as revealed by M-N distances of the order of 2.45 Å (M = In) and 2.64 Å (M = Tl). While additional weak π interactions are observed with arene solvate molecules in these systems, the related 2:1 complex [(2,6-Mes(2)py)(2)In][BAr(f)(4)] features an In(I) center wholly encapsulated by the bulky Mes(2)py donors, and even longer In-N distances [2.586(6) and 2.662(5) Å]. These contacts are about 0.5 Å greater than the sum of the respective covalent radii (2.13 Å) and provide evidence for an effectively "naked" In(I) cation stabilized to a minor extent by orbital interactions.

  6. Resource variation in colorectal surgery: a national centre level analysis.

    PubMed

    Drake, T M; Lee, M J; Senapati, A; Brown, S R

    2017-07-01

    Delivery of quality colorectal surgery requires adequate resources. We set out to assess the relationship between resources and outcomes in English colorectal units. Data were extracted from the Association of Coloproctology of Great Britain and Ireland resource questionnaire to profile resources. This was correlated with Hospital Episode Statistics outcome data including 90-day mortality and readmissions. Patient satisfaction measures were extracted from the Cancer Experience Patient Survey and compared at unit level. Centres were divided by workload into low, middle and top tertile. Completed questionnaires were received from 75 centres in England. Service resources were similar between low and top tertiles in access to Confidential Enquiry into Patient Outcome and Death (CEPOD) theatre, level two or three beds per 250 000 population or the likelihood of having a dedicated colorectal ward. There was no difference in staffing levels per 250 000 unit of population. Each 10% increase in the proportion of cases attempted laparoscopically was associated with reduced 90-day unplanned readmission (relative risk 0.94, 95% CI 0.91-0.97, P < 0.001). The presence of a dedicated colorectal ward (relative risk 0.85, 95% CI 0.73-0.99, P = 0.040) was also associated with a significant reduction in unplanned readmissions. There was no association between staffing or service factors and patient satisfaction. Resource levels do not vary based on unit of population. There is benefit associated with increased use of laparoscopy and a dedicated surgical ward. Alternative measures to assess the relationship between resources and outcome, such as failure to rescue, should be explored in UK practice. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  7. Paraquat poisoning calls to the Malaysia National Poison Centre following its ban and subsequent restriction of the herbicide from 2004 to 2015.

    PubMed

    Leong, Yin-Hui; Ariff, Adilah Mohamed; Khan, Halilol Rahman Mohamed; Rani, Noor Afiza Abdul; Majid, Mohamed Isa Abdul

    2018-05-01

    This study analyses the incidences and patterns of paraquat poisoning from calls received at the Malaysia National Poison Centre (NPC) since 2004 following the ban of the herbicide (2004-2006) and subsequent restriction up to year 2015. Related reported cases to the centre over twelve years (2004-2015) were retrieved and studied in respect to socio-demographic characteristics, mode and type of poisonings, exposure routes and location of incident. Ages of poisoned victims range from 10 months old to 98 years with males being intoxicated more frequently than females (ratio male to female = 2.7). The age group mainly involved in the poisoning was 20-39 years. The most common mode was intentional (62.8%) followed by unintentional (36.9%). Among the 1232 reported cases, suicidal poisoning was the highest (57.2%); accidental poisoning (30.8%) and occupational poisoning (3.3%). The findings showed an upward trend of suicidal poisoning over the years, clearly emphasizing the need for more stringent and effective enforcement to ensure the safe use of paraquat. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  8. First results of the Nordic and Baltic GNSS Analysis Centre

    NASA Astrophysics Data System (ADS)

    Lahtinen, Sonja; Pasi, Häkli; Jivall, Lotti; Kempe, Christina; Kollo, Karin; Kosenko, Ksenija; Pihlak, Priit; Prizginiene, Dalia; Tangen, Oddvar; Weber, Mette; Paršeliūnas, Eimuntas; Baniulis, Rimvydas; Galinauskas, Karolis

    2018-03-01

    The Nordic Geodetic Commission (NKG) has launched a joint NKG GNSS Analysis Centre that aims to routinely produce high qualityGNSS solutions for the common needs of the NKG and the Nordic and Baltic countries. A consistent and densified velocity field is needed for the constraining of the gla-cial isostatic adjustment (GIA) modelling that is a key component of maintaining the national reference frame realisations in the area. We described the methods of the NKG GNSS Analysis Centre including the defined processing setup for the local analysis centres (LAC) and for the combination centres.We analysed the results of the first 2.5 years (2014.5-2016). The results showed that different subnets were consistent with the combined solution within 1-2 mm level. We observed the so called network effect affecting our reference frame alignment. However, the accuracy of the reference frame alignment was on a few millimetre level in the area of the main interest (Nordic and Baltic Countries). TheNKGGNSS AC was declared fully operational in April 2017.

  9. What specifications for a centre or network of excellence in clinical research?

    PubMed

    Diebolt, Vincent; Lang, Marie; Thoby, Frédérique

    2016-02-01

    The Giens 2015 Workshop Round Table entitled "What specifications for a centre or network of excellence in clinical research?" took a viewpoint distinct from earlier work and studies on changes in clinical research activities in France. The purpose of the present work was to identify, starting from concrete examples, the main strengths and advantages of clinical research activity in France related, in part, to the background environment and also to the specific characteristics of the investigation centres considered to be among the most high-performance units in activity. The criteria retained were grouped into a set of specifications that could be used to establish a "label of excellence" upon which the different teams and clinical research centres could model themselves. It was thus considered that belonging to a centre or structured network with at least a national configuration, when this is possible for the medial topic in question, constitutes a real advantage. Four benchmarks were identified: the scientific and clinical expertise of the head investigator, as well as the qualification and operational capacity of the centre's team; definition and measurement of performance using clearly displayed indicators and evaluation procedures; the quality of the overall trial "process" and of each of its component steps; communication, because know-how and promotion go hand in hand, with the main objective of informing the professional and general public about the value of the research centre meeting the above-mentioned criteria, about its networks of competencies, and more generally, about the important assets of the background of clinical research in France. This sector of research is funded by the public authorities via calls for public grants, financial aids for structures supporting clinical research in the University Hospital Centres and other healthcare institutions allowing for a professionalization of the research occupations, and the national public health

  10. Impact of national smokefree environments laws on teachers, schools and early childhood centres.

    PubMed

    Watson, Donna; Glover, Marewa; McCool, Judith; Bullen, Chris; Adams, Brian; Min, Sandar

    2011-12-01

    New Zealand's (NZ) smokefree legislation, implemented on 1 January 2004, requires that all school and early childhood centre buildings and grounds are 100% smokefree; one aim being to prevent young people being influenced by seeing people (including teachers) smoke there. This study, conducted in 2008, investigated teachers'smoking behaviour and perceived adherence to the legislation. A national NZ cross-sectional survey of 2,004 teachers (oversampling Māori), who were randomly selected from the electoral roll of registered voters and sent postal invitations to complete an anonymous survey. The response rate was 70%. Current smokers numbered 7%, and proportionately more Maori and Pacific Island teachers (12% each) smoked than European/Other teachers (7%). Of current smokers, 37% smoked non-daily. Smokers smoked less on work than non-work days. Introducing smokefree legislation was associated with teachers changing when they smoked, cutting down, quitting or trying to quit. Perceived compliance with the legislation was high, although 30% of teachers reported seeing staff smoking. Proportionately, significantly more teachers from low than from high socioeconomic schools perceived poor compliance and staff visibly smoking. Smokefree legislation affects people's smoking behaviour. Smoking in NZ is becoming confined to population subgroups defined by socioeconomic status and ethnicity. Our findings argue for supporting cessation among those who work with children and young people, and for targeting support at school communities in areas of low socioeconomic status or with large populations of Māori or Pacific peoples.

  11. The joint cardiovascular research profile of the university medical centres in the Netherlands.

    PubMed

    van Welie, S D; van Leeuwen, T N; Bouma, C J; Klaassen, A B M

    2016-05-01

    Biomedical scientific research in the Netherlands has a good reputation worldwide. Quantitatively, the university medical centres (UMCs) deliver about 40 % of the total number of scientific publications of this research. Analysis of the bibliometric output data of the UMCs shows that their research is highly cited. These output-based analyses also indicate the high impact of cardiovascular scientific research in these centres, illustrating the strength of this research in the Netherlands. A set of six joint national cardiovascular research topics selected by the UMCs can be recognised. At the top are heart failure, rhythm disorder research and atherosclerosis. National collaboration of top scientists in consortia in these three areas is successful in acquiring funding of large-scale programs. Our observations suggest that funding national consortia of experts focused on a few selected research topics may increase the international competitiveness of cardiovascular research in the Netherlands.

  12. Ninety day mortality following pancreatoduodenectomy in England: has the optimum centre volume been identified?

    PubMed

    Liu, Z; Peneva, I S; Evison, F; Sahdra, S; Mirza, D F; Charnley, R M; Savage, R; Moss, P A; Roberts, K J

    2018-06-09

    Mortality following pancreatoduodenectomy is related to centre volume although the optimal volume is not defined. Patients undergoing PD between 2001 and 2016 were identified from UK national databases. The effects of patient variables, centre volume and time period upon 90 day mortality were studied. 90 day mortality (970/14,935, 6.5%) was related to advanced age, comorbidity, diagnosis, ethnicity, deprivation, centre volume and time period. Mortality rates fell markedly from 10.0% in 2001-4 to 4.1% in 2013-16. There was no difference in 90 day mortality between high (36 -60 PD per year) and very high volume (>60) centres. However, patients operated upon at very high volume centres were more elderly (66, 58 -73 vs 65, 56 -72; median, IQR; p = 0.006), deprived (38.7 vs 34.6%; p < 0.001) and co morbid (48.9 vs 46.1%; p = 0.027). Although a plateau in the centre volume and mortality relationship appears to have been demonstrated those patients treated at the highest volume centres were at higher risk of mortality. This data suggests therefore that to further understand outcomes from specialist centres characteristics of the patient population should be defined, not just centre volume. Copyright © 2018. Published by Elsevier Ltd.

  13. European guidelines for the accreditation of Sleep Medicine Centres.

    PubMed

    Pevernagie, Dirk

    2006-06-01

    This document describes guidelines for accreditation of Sleep Medicine Centres in Europe. These guidelines are the result of a consensus procedure, in which representatives of the European Sleep Research Society (ESRS) and representatives of different European National Sleep Societies (ENSS) were involved. The information obtained during different rounds of consultation was gathered and processed by the members of the Steering Committee of the ESRS. The scope of the guidelines is to define the characteristics of multidisciplinary Sleep Medicine Centres (SMCs), in terms of requirements regarding staff, operational procedures and logistic facilities. Accreditation of SMCs is proposed to be the responsibility of the individual ENSS. The Accreditation Guidelines may thus be considered an instrument for the national societies to develop new or standardize existing accreditation questionnaires, as well as procedures for visiting the site, drafting the accreditation report, and finally, granting the accreditation. The Accreditation Guidelines are meant to be a line of action, that ideally should be followed as close as possible, but that may be subject to certain exceptions, depending on local customs or regulations.

  14. Chapter 9 Biochemical variables amongst UK adult dialysis patients in 2010: national and centre-specific analyses.

    PubMed

    Pruthi, Rishi; Pitcher, David; Dawnay, Anne

    2012-01-01

    The UK Renal Association clinical practice guidelines include clinical performance measures for biochemical variables in dialysis patients. The UK Renal Registry (UKRR) annually audits dialysis centre performance against these measures as part of its role in promoting continuous quality improvement. Cross sectional performance analyses were undertaken to compare dialysis centre achievement of clinical audit measures for prevalent haemodialysis (HD) and peritoneal dialysis (PD) cohorts in 2010. The biochemical variables studied were phosphate, adjusted calcium, parathyroid hormone, bicarbonate and total cholesterol. In addition longitudinal analyses were performed (2000-2010) to show changes in achievement of clinical performance measures over time. Fifty-six percent of HD and 69% of PD patients achieved a phosphate within the range recommended by the RA clinical practice guidelines. Seventy-five percent of HD and 76% of PD patients had adjusted calcium between 2.2-2.5 mmol/L. Twenty-eight percent of HD and 31% of PD patients had parathyroid hormone between 16- 32 pmol/L. Sixty percent of HD and 80% of PD patients achieved the audit measure for bicarbonate. There was significant inter-centre variation for all variables studied. The UKRR consistently demonstrates significant inter-centre variation in achievement of biochemical clinical audit measures. Understanding the causes of this variation is an important part of improving the care of dialysis patients in the UK. Copyright © 2012 S. Karger AG, Basel.

  15. The "Conservatoire National des Arts et Metiers"

    ERIC Educational Resources Information Center

    Kuhn, Gerard

    2004-01-01

    The overall mission of the Conservatoire national des arts et metiers--(CNAM) [National Conservatory of Industrial Arts and Trades] is outlined. One of its centers, the "Centre national de l'entrepreneuriat"--(CNE) [National Center for Entrepreneurship] is described in greater detail. In particular, this center offers various services, notably…

  16. Indigenous Cultural Self-Representation and Its Internal Critiques: A Case Study of the Woodland Cultural Centre, Canada

    ERIC Educational Resources Information Center

    Nakamura, Naohiro

    2014-01-01

    This research report discusses Indigenous cultural representation and its internal critiques, based on the case study of an Indigenous-run museum, the Woodland Cultural Centre, in Canada. Since its establishment in 1972, the Woodland Cultural Centre has strived to promote Indigenous culture, especially First Nations art, and has challenged the…

  17. Audit of sweat testing: a first report from Italian Cystic Fibrosis Centres.

    PubMed

    Cirilli, Natalia; Padoan, Rita; Raia, Valeria

    2008-09-01

    Cystic Fibrosis diagnosis is confirmed using sweat test. The aim of our study was to evaluate current techniques and methodologies in use at Italian CF Care Centres. A series of questions related to the performance of the sweat test was collected by all CF Care Centres in Italy. Answers were compared with UK and NCCLS guidelines. 39/41 Centres replied to the questionnaire. A good adherence to guidelines was registered for storing samples before analysis in 90.9%, while performing CF diagnosis by at least two sweat tests, and chloride analysis were reported respectively in 100% and 75.7% of Centres. Some inconsistencies were registered for minimum acceptable sweat quantity and time to collect sweat inadequate in respectively 42.5% and 24.2% of Centres, while performing quality control procedures and referring to an external quality assessment scheme were found inadequate in respectively 54.6% and 100%. 57.6% didn't provide any appropriate analytical ranges and only 15.1% of Centres offered proper information to patients/parents. A report form, including sweat quantity, reference ranges and interpretation, was adequate only for 9.4 up to 41.4% of CF Centres. Our study showed areas of inconsistencies in sweat testing current practices in Italy and highlights the need for evidence based national guidelines to improve practice and management strategies.

  18. A trans-cultural comparison of the organisation of care at headache centres world-wide.

    PubMed

    Bhola, Ria; Goadsby, Peter J

    2011-02-01

    The need to provide better outcomes for patients with headache, and to minimise the costs involved in doing so, has prompted the search for new modes of service delivery by exploring the service organisation and nursing role from various cultural, economic and global perspectives. This study was based on comparisons with the UK headache service up to 2007, the point at which this study was set up. This UK service was based at the National Hospital for Neurology and Neurosurgery (NHNN, UCLH Trust). Data were obtained from US headache centres in 2008 and from centres in Copenhagen, Bangkok, Sydney and Porto Alegre in 2009. A comparison shows the key components of services at all centres showing the team structure and size of service. Prominent features at the centres included: team-working, regular meetings, educational input, good access and communication among team members, headache-trained neurologists, specialist nursing at most centres, and the input of psychological and physical therapists at some centres. The problems of tertiary headache care are very similar throughout the world and seem to transcend ethnic, cultural and economic considerations.

  19. Provision of Vocational Skills Education to Orphans: Lessons from Orphanage Centres in Dar es Salaam City, Tanzania

    ERIC Educational Resources Information Center

    Meli, Benjamin Mbeba

    2015-01-01

    This paper utilises data from a study that investigated the efficacy of vocational skills training provided to orphans from three orphanages in Temeke District, Dar es Salaam. The three orphanage centres that were studied are Kurasini National Children Home, Saudia and Don Bosco Vocational Centre. The sample comprised of 45 orphans, an official…

  20. Inhibition of Early Stages of HIV-1 Assembly by INI1/hSNF5 Transdominant Negative Mutant S6 ▿

    PubMed Central

    Cano, Jennifer; Kalpana, Ganjam V.

    2011-01-01

    INI1/hSNF5 is an HIV-1 integrase (IN) binding protein specifically incorporated into virions. A truncated mutant of INI1 (S6, amino acids 183 to 294) harboring the minimal IN binding Rpt1 domain potently inhibits HIV-1 particle production in a transdominant manner. The inhibition requires interaction of S6 with IN within Gag-Pol. While INI1 is a nuclear protein and harbors a masked nuclear export signal (NES), the transdominant negative mutant S6 is cytoplasmic, due to the unmasking of NES. Here, we examined the effects of subcellular localization of S6 on HIV-1 inhibition and further investigated the stages of assembly that are affected. We found that targeting a nuclear localization signal-containing S6 variant [NLS-S6(Rpt1)] to the nucleoplasm (but not to the nucleolus) resulted in complete reversal of inhibition of particle production. Electron microscopy indicated that although no electron-dense particles at any stage of assembly were seen in cells expressing S6, virions were produced in cells expressing the rescue mutant NLS-S6(Rpt1) to wild-type levels. Immunofluorescence analysis revealed that p24 exhibited a diffuse pattern of localization within the cytoplasm in cells expressing S6 in contrast to accumulation along the membrane in controls. Pulse-chase analysis indicated that in S6-expressing cells, although Gag(Pr55gag) protein translation was unaffected, processing and release of p24 were defective. Together, these results indicate that expression of S6 in the cytoplasm interferes with trafficking of Gag-Pol/Gag to the membrane and causes a defective processing leading to inhibition of assembly at an early stage prior to particle formation and budding. PMID:21159874

  1. The impact of distance and duration of travel on participation rates and participants’ satisfaction: results from a pilot study at one study centre in Pretest 2 of the German National Cohort

    PubMed Central

    Schweitzer, Aparna; Akmatov, Manas K; Kindler, Florentina; Kemmling, Yvonne; Kreienbrock, Lothar; Krause, Gérard; Pessler, Frank

    2015-01-01

    Objectives In this pilot study within the Pretest 2 phase of the German National Cohort, we aimed to (1) test the hypothesis that distance and duration of travel to a study centre may affect participation rates and participants’ satisfaction and (2) to obtain data that would help to select recruitment areas around the study centre Hannover with the greatest projected participation rate for the main study. Setting Mixed urban/suburban environment in Northern Germany with approximately 600 000 inhabitants. 4 recruitment areas with divergent estimated mean distances (range, 7–40 km) and duration of travel to the study centre Hannover were selected. Participants 1050 men and women (ratio, 1:1), aged 20–69 years, were randomly selected from the population registries of the 4 recruitment areas and invited by mail to participate in the Pretest 2 study programme at the study centre Hannover, covering a variety of questionnaire-based and physical assessments. 166 individuals participated (16%). Interventions All 166 participants completed a travel questionnaire containing 5 items relating to travel duration and satisfaction, amounting to a participation rate of 100% in the questionnaire-based part of the study. Results Participation rates in the Pretest 2 programme at the study centre Hannover by area ranged from 11% (area farthest from the study centre, estimated median distance 38 km) to 18% (nearest area, 2 km). The odds of non-participation were highest in the area farthest from the study centre (adjusted OR 2.06; p=0.01; CI 1.28 to 3.32). Nonetheless, 97% of participants were satisfied with travel duration. Conclusions Increasing distance was associated with a lower participation rate. However, acceptance of duration of travel was high, irrespective of distance or duration. Thus, recruiting in farther away locations may select individuals with a greater frustration tolerance for travel to the study centre, perhaps due to a greater interest in

  2. RTEMS Centre - Support and Maintenance Centre to RTEMS Operating System

    NASA Astrophysics Data System (ADS)

    Silva, H.; Constantino, A.; Freitas, D.; Coutinho, M.; Faustino, S.; Mota, M.; Colaço, P.; Sousa, J.; Dias, L.; Damjanovic, B.; Zulianello, M.; Rufino, J.

    2009-05-01

    RTEMS CENTRE - Support and Maintenance Centre to RTEMS Operating System is a joint ESA/Portuguese Task Force initiative to develop a support and maintenance centre to the Real-Time Executive for Multiprocessor Systems (RTEMS). This paper gives a high level visibility of the progress, the results obtained and the future work in the RTEMS CENTRE [6] and in the RTEMS Improvement [7] projects. RTEMS CENTRE started officially in November 2006, with the RTEMS 4.6.99.2 version. A full analysis of RTEMS operating system was produced. The architecture was analysed in terms of conceptual, organizational and operational concepts. The original objectives [1] of the centre were primarily to create and maintain technical expertise and competences in this RTOS, to develop a website to provide the European Space Community an entry point for obtaining support (http://rtemscentre.edisoft.pt), to design, develop, maintain and integrate some RTEMS support tools (Timeline Tool, Configuration and Management Tools), to maintain flight libraries and Board Support Packages, to develop a strong relationship with the World RTEMS Community and finally to produce some considerations in ARINC-653, DO-178B and ECSS E-40 standards. RTEMS Improvement is the continuation of the RTEMS CENTRE. Currently the RTEMS, version 4.8.0, is being facilitated for a future qualification. In this work, the validation material is being produced following the Galileo Software Standards Development Assurance Level B [5]. RTEMS is being completely tested, errors analysed, dead and deactivated code removed and tests produced to achieve 100% statement and decision coverage of source code [2]. The SW to exploit the LEON Memory Management Unit (MMU) hardware will be also added. A brief description of the expected implementations will be given.

  3. Diabetic retinopathy screening in New Zealand requires improvement: results from a multi-centre audit.

    PubMed

    Hutchins, Edward; Coppell, Kirsten J; Morris, Ainsley; Sanderson, Gordon

    2012-06-01

    To determine whether diabetic retinal screening services and retinopathy referral centres in New Zealand meet the national guidelines for referral and assessment of screen detected moderate retinal and mild macular diabetic eye disease. Diabetic retinal screening pathways and the data collected at four main centre retinal screening services were described and compared with recommendations in the national diabetes retinal screening guidelines. A retrospective audit of photoscreen detected moderate retinopathy (grade R3), and mild maculopathy (grades M2B and M3) during May to August 2008 was undertaken. Data collected by retinopathy referral centres were used to examine the follow-up of screen detected cases and to make comparisons with the national recommendations. All four screening services used the guidelines for grading, but the recommended dataset was incomplete. Not all recorded data were readily accessible. The retinal photos of 157 (2.4%) patients were graded as R3, M2B, M3 or a combination. The proportion of those screened with these grades varied across the four centres from 1.2% to 3.4%. Follow-up of the 157 screen positive patients did not always comply with guideline recommendations. Seventy five (48%) were referred for review by an ophthalmologist as recommended, 45 (60% of referred) were seen within the recommended six months. Nine patients (15% of the 60 with a documented assessment) were referred for or received laser treatment at 12-months follow-up. Quality diabetic retinal screening data systems and quality assurance programs are required to improve the monitoring and quality of retinal screening in New Zealand. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  4. SMARCB1/INI1 germline mutations contribute to 10% of sporadic schwannomatosis.

    PubMed

    Rousseau, Guillaume; Noguchi, Tetsuro; Bourdon, Violaine; Sobol, Hagay; Olschwang, Sylviane

    2011-01-24

    Schwannomatosis is a disease characterized by multiple non-vestibular schwannomas. Although biallelic NF2 mutations are found in schwannomas, no germ line event is detected in schwannomatosis patients. In contrast, germline mutations of the SMARCB1 (INI1) tumor suppressor gene were described in familial and sporadic schwannomatosis patients. To delineate the SMARCB1 gene contribution, the nine coding exons were sequenced in a series of 56 patients affected with a variable number of non-vestibular schwannomas. Nine variants scattered along the sequence of SMARCB1 were identified. Five of them were classified as deleterious. All five patients carrying a SMARCB1 mutation had more multiple schwannomas, corresponding to 10.2% of patients with schwannomatosis. They were also diagnosed before 35 years of age. These results suggest that patients with schwannomas have a significant probability of carrying a SMARCB1 mutation. Combined with data available from other studies, they confirm the clinical indications for genetic screening of the SMARCB1 gene.

  5. SMARCB1/INI1 germline mutations contribute to 10% of sporadic schwannomatosis

    PubMed Central

    2011-01-01

    Background Schwannomatosis is a disease characterized by multiple non-vestibular schwannomas. Although biallelic NF2 mutations are found in schwannomas, no germ line event is detected in schwannomatosis patients. In contrast, germline mutations of the SMARCB1 (INI1) tumor suppressor gene were described in familial and sporadic schwannomatosis patients. Methods To delineate the SMARCB1 gene contribution, the nine coding exons were sequenced in a series of 56 patients affected with a variable number of non-vestibular schwannomas. Results Nine variants scattered along the sequence of SMARCB1 were identified. Five of them were classified as deleterious. All five patients carrying a SMARCB1 mutation had more multiple schwannomas, corresponding to 10.2% of patients with schwannomatosis. They were also diagnosed before 35 years of age. Conclusions These results suggest that patients with schwannomas have a significant probability of carrying a SMARCB1 mutation. Combined with data available from other studies, they confirm the clinical indications for genetic screening of the SMARCB1 gene. PMID:21255467

  6. The SWI/SNF Subunit INI1 Contains an N-Terminal Winged Helix DNA Binding Domain that Is a Target for Mutations in Schwannomatosis

    PubMed Central

    Allen, Mark D.; Freund, Stefan M.V.; Zinzalla, Giovanna; Bycroft, Mark

    2015-01-01

    Summary SWI/SNF complexes use the energy of ATP hydrolysis to remodel chromatin. In mammals they play a central role in regulating gene expression during differentiation and proliferation. Mutations in SWI/SNF subunits are among the most frequent gene alterations in cancer. The INI1/hSNF5/SMARCB1 subunit is mutated in both malignant rhabdoid tumor, a highly aggressive childhood cancer, and schwannomatosis, a tumor-predisposing syndrome characterized by mostly benign tumors of the CNS. Here, we show that mutations in INI1 that cause schwannomatosis target a hitherto unidentified N-terminal winged helix DNA binding domain that is also present in the BAF45a/PHF10 subunit of the SWI/SNF complex. The domain is structurally related to the SKI/SNO/DAC domain, which is found in a number of metazoan chromatin-associated proteins. PMID:26073604

  7. SMARCB1/INI1 maternal germ line mosaicism in schwannomatosis.

    PubMed

    Hulsebos, T J M; Kenter, S B; Jakobs, M E; Baas, F; Chong, B; Delatycki, M B

    2010-01-01

    Schwannomatosis is characterized by the development of multiple schwannomas of the nervous system, but without the occurrence of vestibular schwannomas. Most cases of schwannomatosis are thought to be sporadic, representing the first case in a family due to a new mutation in the causative gene. We recently identified SMARCB1/INI1 as a schwannomatosis-predisposing gene. Here, we analyzed this gene in a schwannomatosis family with two affected children, but with clinically unaffected parents. Both affected individuals carried a constitutional SMARCB1 mutation, c.1118+ 1G>A, that changes the donor splice site sequence of intron 8, causing skipping of exon 8 and resulting in the in-frame deletion of 132 nucleotides in the transcript. The mutation was not evident in constitutional DNA of the parents. Haplotyping revealed that the chromosome 22 segment that carries the mutant SMARCB1 allele originated from the mother. She transferred the same chromosome 22 segment, however, with a wild-type SMARCB1 copy, to a third unaffected child. Our findings indicate that the mother is germ line mosaic for the SMARCB1 mutation. In conclusion, our study shows for the first time that germ line mosaicism may occur in schwannomatosis, which has implications for genetic counseling in this disease.

  8. Saskatchewan's (Canada) Regional Centre of Expertise on Education for Sustainable Development

    ERIC Educational Resources Information Center

    Dahms, Tanya; McMartin, Dena; Petry, Roger

    2008-01-01

    Purpose: The purpose of this paper is to describe the unique collaborative process initiated at the University of Regina in Saskatchewan, Canada, to develop a Regional Centre of Expertise (RCE) on Education for Sustainable Development (ESD) through the United Nations University-Institute of Advanced Studies (UNU-IAS). Design/methodology/approach:…

  9. Birth centre confinement at the Queen Victoria Medical Centre. I. Obstetric and neonatal outcome.

    PubMed

    Campbell, J; Hudson, H; Lumley, J; Morris, N; Rao, J; Spensley, J

    1981-10-03

    A review of hte first 175 confinements at the Queen Victoria Medical Centre Birth Centre is presented. The design, structure and function of hte Birth Centre is described and the safety of the programme demonstrated. Seventy-four pregnancies (42%) accepted for Birth Centre confinement required transfer because of antepartum or intrapartum complications. There were satisfactory obstetric and neonatal outcomes in all pregnancies. The first year's experience has allowed a reassessment of the risk factors, which will permit greater use of the Birth Centre without any increases risk to mothers or babies.

  10. Case reports of lead poisoning in dogs from the National Animal Poison Control Center and the Centre National D'Informations Toxicologiques, Veterinaires: anecdotes or reality?

    PubMed

    Berny, P J; Cote, L M; Buck, W B

    1992-02-01

    This paper presents case reports of lead toxicoses from 2 major animal poison control centers in Europe and North America, gathered from 1985 through 1989. All results examined here involved cases assessed as "toxicosis" or "suspected toxicosis" by the National Animal Poison Control Center (NAPCC) or the Centre National d'Informations Toxicologiques Veterinaries (CNITV). 537 cases were reported to the NAPCC, most of them concerning dogs (59%). In France, most of the 362 cases involved cattle (57.2%). There was an increased number of cases reported during late summer and early fall, and a decreased number of cases in November and December, in both centers. Dogs intoxicated were predominantly young animals (60% were less than 2 years old). No sex difference was noted. Pure bred dogs appeared more often involved than mixed-breed ones, but the breed distribution closely resembles dog breed distribution in the US. The source of lead was usually unknown and, when information was available, paint seemed to be the most common cause of poisoning. Clinical signs reported to the animal poison control centers involved the CNS and GI tract. Results from the French and the American database showed similar trends. They are compared to data from veterinary clinics and veterinary colleges in the US and Australia. In each case, data are very similar to what was reported to the CNITV and the NAPCC. It is concluded that animal poison control centers databases can provide a useful tool for better knowledge of animal poisoning. They can also help identify unexpected toxicologic problems related to drug administration or pesticide use.

  11. A mosaic pattern of INI1/SMARCB1 protein expression distinguishes Schwannomatosis and NF2-associated peripheral schwannomas from solitary peripheral schwannomas and NF2-associated vestibular schwannomas.

    PubMed

    Caltabiano, Rosario; Magro, Gaetano; Polizzi, Agata; Praticò, Andrea Domenico; Ortensi, Andrea; D'Orazi, Valerio; Panunzi, Andrea; Milone, Pietro; Maiolino, Luigi; Nicita, Francesco; Capone, Gabriele Lorenzo; Sestini, Roberta; Paganini, Irene; Muglia, Mariella; Cavallaro, Sebastiano; Lanzafame, Salvatore; Papi, Laura; Ruggieri, Martino

    2017-06-01

    The INI1/SMARCB1 gene protein product has been implicated in the direct pathogenesis of schwannomas from patients with one form of schwannomatosis [SWNTS1; MIM # 162091] showing a mosaic pattern of loss of protein expression by immunohistochemistry [93% in familial vs. 55% in sporadic cases]. To verify whether such INI1/SMARCB1 mosaic pattern could be extended to all schwannomas arising in the sporadic and familial schwannomatoses [i.e. to SMARCB1-related (SWNTS1) or LZTR1-related (SWNTS2) schwannomatosis or to SMARCB1/LZTR1-negative schwannomatosis] and whether it could be involved in classical NF2 or solitary peripheral schwannomas METHODS: We blindly analysed schwannoma samples obtained from a total of 22 patients including (a) 2 patients (2 males; aged 38 and 55 years) affected by non-familial SMARCB1-associated schwannomatosis (SWTNS1); (b) 1 patient (1 female; aged 33 years) affected by familial schwannomatosis (SWTNS1/ SMARCB1 germ line mutations); (c) 5 patients (3 males, 2 females; aged 33 to 35 years) affected by non-familial (sporadic) LZTR1-associated schwannomatosis (SWNTS2); (d) 3 patients (3 males; aged 35 to 47 years) affected by familial schwannomatosis (SWTNS2/ LZTR1 germ line mutations); (e) 2 patients (1 male, 1 female; aged 63 and 49 years, respectively) affected by non-familial schwannomatosis (SWTNS, negative for SMARCB1, LZTR1 and NF2 gene mutations); (f) 4 patients (3 males, 1 females; aged 15 to 24 years) affected by classical NF2 (NF2: harbouring NF2 germ line mutations; and (g) 5 patients (3 males, 2 females; aged 33 to 68 years) who had solitary schwannomas. [follow-up = 15-30 years; negative for constitutional/somatic mutation analysis for the SMARCB1, LZTR1 and NF2 genes] were (blindly) analyzed. The INI1/SMARCB1 immunostaining pattern was regarded as (1) diffuse positive nuclear staining [= retained expression] or (2) mosaic pattern [mixed positive/negative nuclei = loss of expression in a subset of tumour cells]. All

  12. The Search for Centre

    ERIC Educational Resources Information Center

    Nunes, April

    2006-01-01

    This paper acknowledges the importance of a dancer's centre but likewise highlights the problematic nature of the communication of this concept from dance teacher to student. After a brief introduction of orthodox approaches in finding centre, this paper suggests a method of locating centre through the ancient somatic technique.

  13. Contribution of cerebrovascular disease in autopsy confirmed neurodegenerative disease cases in the National Alzheimer’s Coordinating Centre

    PubMed Central

    Toledo, Jon B.; Arnold, Steven E.; Raible, Kevin; Brettschneider, Johannes; Xie, Sharon X.; Grossman, Murray; Monsell, Sarah E.; Kukull, Walter A.

    2013-01-01

    Cerebrovascular disease and vascular risk factors are associated with Alzheimer’s disease, but the evidence for their association with other neurodegenerative disorders is limited. Therefore, we compared the prevalence of cerebrovascular disease, vascular pathology and vascular risk factors in a wide range of neurodegenerative diseases and correlate them with dementia severity. Presence of cerebrovascular disease, vascular pathology and vascular risk factors was studied in 5715 cases of the National Alzheimer’s Coordinating Centre database with a single neurodegenerative disease diagnosis (Alzheimer’s disease, frontotemporal lobar degeneration due to tau, and TAR DNA-binding protein 43 immunoreactive deposits, α-synucleinopathies, hippocampal sclerosis and prion disease) based on a neuropathological examination with or without cerebrovascular disease, defined neuropathologically. In addition, 210 ‘unremarkable brain’ cases without cognitive impairment, and 280 cases with pure cerebrovascular disease were included for comparison. Cases with cerebrovascular disease were older than those without cerebrovascular disease in all the groups except for those with hippocampal sclerosis. After controlling for age and gender as fixed effects and centre as a random effect, we observed that α-synucleinopathies, frontotemporal lobar degeneration due to tau and TAR DNA-binding protein 43, and prion disease showed a lower prevalence of coincident cerebrovascular disease than patients with Alzheimer’s disease, and this was more significant in younger subjects. When cerebrovascular disease was also present, patients with Alzheimer’s disease and patients with α-synucleinopathy showed relatively lower burdens of their respective lesions than those without cerebrovascular disease in the context of comparable severity of dementia at time of death. Concurrent cerebrovascular disease is a common neuropathological finding in aged subjects with dementia, is more common in

  14. The SWI/SNF Subunit INI1 Contains an N-Terminal Winged Helix DNA Binding Domain that Is a Target for Mutations in Schwannomatosis.

    PubMed

    Allen, Mark D; Freund, Stefan M V; Zinzalla, Giovanna; Bycroft, Mark

    2015-07-07

    SWI/SNF complexes use the energy of ATP hydrolysis to remodel chromatin. In mammals they play a central role in regulating gene expression during differentiation and proliferation. Mutations in SWI/SNF subunits are among the most frequent gene alterations in cancer. The INI1/hSNF5/SMARCB1 subunit is mutated in both malignant rhabdoid tumor, a highly aggressive childhood cancer, and schwannomatosis, a tumor-predisposing syndrome characterized by mostly benign tumors of the CNS. Here, we show that mutations in INI1 that cause schwannomatosis target a hitherto unidentified N-terminal winged helix DNA binding domain that is also present in the BAF45a/PHF10 subunit of the SWI/SNF complex. The domain is structurally related to the SKI/SNO/DAC domain, which is found in a number of metazoan chromatin-associated proteins. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. The impact of distance and duration of travel on participation rates and participants' satisfaction: results from a pilot study at one study centre in Pretest 2 of the German National Cohort.

    PubMed

    Schweitzer, Aparna; Akmatov, Manas K; Kindler, Florentina; Kemmling, Yvonne; Kreienbrock, Lothar; Krause, Gérard; Pessler, Frank

    2015-08-21

    In this pilot study within the Pretest 2 phase of the German National Cohort, we aimed to (1) test the hypothesis that distance and duration of travel to a study centre may affect participation rates and participants' satisfaction and (2) to obtain data that would help to select recruitment areas around the study centre Hannover with the greatest projected participation rate for the main study. Mixed urban/suburban environment in Northern Germany with approximately 600,000 inhabitants. 4 recruitment areas with divergent estimated mean distances (range, 7-40 km) and duration of travel to the study centre Hannover were selected. 1050 men and women (ratio, 1:1), aged 20-69 years, were randomly selected from the population registries of the 4 recruitment areas and invited by mail to participate in the Pretest 2 study programme at the study centre Hannover, covering a variety of questionnaire-based and physical assessments. 166 individuals participated (16%). All 166 participants completed a travel questionnaire containing 5 items relating to travel duration and satisfaction, amounting to a participation rate of 100% in the questionnaire-based part of the study. Participation rates in the Pretest 2 programme at the study centre Hannover by area ranged from 11% (area farthest from the study centre, estimated median distance 38 km) to 18% (nearest area, 2 km). The odds of non-participation were highest in the area farthest from the study centre (adjusted OR 2.06; p=0.01; CI 1.28 to 3.32). Nonetheless, 97% of participants were satisfied with travel duration. Increasing distance was associated with a lower participation rate. However, acceptance of duration of travel was high, irrespective of distance or duration. Thus, recruiting in farther away locations may select individuals with a greater frustration tolerance for travel to the study centre, perhaps due to a greater interest in participating in health-oriented studies and thus different health-related behaviour

  16. [The design and development of a quality system for the diagnosis of exotic animal diseases at the National Centre for Animal and Plant Health in Cuba].

    PubMed

    de Oca, N Montes; Villoch, A; Pérez Ruano, M

    2004-12-01

    A quality system for the diagnosis of exotic animal diseases was developed at the national centre for animal and plant health (CENSA), responsible for coordinating the clinical, epizootiological and laboratory diagnosis of causal agents of exotic animal diseases in Cuba. A model was designed on the basis of standard ISO 9001:2000 of the International Organization for Standardization (ISO), standard ISO/IEC 17025:1999 of ISO and the International Electrotechnical Commission, recommendations of the World Organisation for Animal Health (OIE) and other regulatory documents from international and national organisations that deal specifically with the treatment of emerging diseases. Twenty-nine standardised operating procedures were developed, plus 13 registers and a checklist to facilitate the evaluation of the system. The effectiveness of the quality system was confirmed in the differential diagnosis of classical swine fever at an animal virology laboratory in Cuba.

  17. Pertussis diagnosis in Belgium: results of the National Reference Centre for Bordetella anno 2015.

    PubMed

    Martini, H; Rodeghiero, C; VAN DEN Poel, C; Vincent, M; Pierard, D; Huygen, K

    2017-08-01

    In 2015, the Belgian National Reference Centre for Bordetella analyzed 4110 respiratory samples by qPCR and 4877 serum samples by serology. Whereas about 50% of respiratory samples were from infants and children below the age of five, serum samples were distributed among all age categories. A total of 394 (9·6%) cases was diagnosed as positive for Bordetella pertussis by qPCR and 844 (17·3%) cases were diagnosed as acute infection by serology (anti-pertussis toxin (PT) IgG > 125 IU/ml). Another 1042 (21·4%) sera had anti-PT IgG between 55 and 125 IU/ml reflecting a vaccination or pertussis infection during the last 1-2 years. Seventy per cent of the pertussis cases diagnosed by qPRC were in infants and children younger than 14 years old, whereas the highest number of sera with anti-PT levels >125 IU/ml was in the age group of 10-14 years old. Based on the limited data of the last vaccination (reported for only 15% of the samples), recent booster vaccination in the teenager group may have contributed only minimally to these elevated anti-PT levels. The highest number of sera with anti-PT titers between 55 and 125 IU/ml was found in the age category 50-59 years old. It is clear that pertussis continues to be a problem in Belgium and that other vaccination strategies (maternal vaccination, cocoon vaccination) and ultimately better vaccines will be needed to control this highly infectious respiratory disease.

  18. Translating change: the development of a person-centred triage training programme for emergency nurses.

    PubMed

    McBrien, Barry

    2009-01-01

    Within health care, there has been a change in practice from an illness-orientated service to one that is more health-focused and person-centred. The concept of person-centredness is frequently espoused by practitioners as being not only a desirable, but a necessary element of health care provision. Indeed, nationally and internationally, person-centred care has underpinned many healthcare documents and policies. Person-centred practice focuses on providing care, utilising a variety of processes that operationalise person-centred nursing and include working with patients' beliefs and values, engagement, presence, sharing decision-making and providing for physical needs. In the field of emergency nursing, the incorporation of person-centred care and its holistic foundation may require a significant shift in practice. There is evidence to suggest that emergency nurses view their role as one, which is predominantly concerned with providing urgent physical care, rather than one, which espouses the theories of holistic healthcare. To this extent, being person-centred in the context of emergency care, requires the nurse to move beyond the traditional notions of his/her role and to embrace the more holistic aspects of patient care. The aim of this article is to critically analyse how a change in nurse-led triage training in one Irish Emergency Department facilitated an improved person-centred approach in practice.

  19. UK Renal Registry 16th annual report: chapter 10 haemoglobin, ferritin and erythropoietin amongst UK adult dialysis patients in 2012: national and centre-specific analyses.

    PubMed

    Rao, Anirudh; Gilg, Julie; Williams, Andrew

    2013-01-01

    Anaemia treatment in chronic kidney disease (CKD) patients has changed dramatically since the implementation of erythropoietin stimulating agents (ESAs) and has shifted the emphasis from treating severe anaemia in dialysis patients to preventing anaemia. The aim of this chapter is to determine the extent to which the UK Renal Association (RA) and National Institute for Health and Care Excellence (NICE) guidelines for anaemia management are met in the UK. Quarterly data were obtained for haemoglobin (Hb) and factors that influence Hb from UK renal centres for the incident and prevalent renal replacement therapy (RRT) cohorts for 2012. In the UK, in 2012, 51% of patients commenced dialysis therapy with Hb 100 g/L (median Hb 100 g/L). Of patients in the early presentation group, 54% started dialysis with Hb 100 g/L whilst 34% of patients presenting late started dialysis with Hb 100 g/L. The UK median Hb of haemodialysis (HD) patients was 112 g/L, with 82% of patients having Hb 100 g/L. The median Hb of peritoneal dialysis (PD) patients in the UK was 114 g/L, with 85% of patients having Hb 100 g/L. The median ferritin in HD patients in the UK was 431 µg/L and 95% of HD patients had a ferritin 100 µg/L. In EW&NI the median ferritin in PD patients was 285 µg/L (IQR 164-466) with 88% of PD patients having a ferritin 100 µg/L. In EW&NI the median ESA dose was higher for HD than PD patients (7,248 vs. 4,250 IU/week). The percentage of patients treated with an ESA and having Hb >120 g/L ranged between centres from 7-39% for HD and from 0-33% for PD. There was poor correlation between median Hb achieved and median ferritin and ESA usage across the EW&NI centres. There was also a significant variation between centres in the percentages of patients treated with an ESA and having Hb >120 g/L. © 2014 S. Karger AG, Basel.

  20. From Comfort Zone to Contact Zone Lessons from a Belfast Writing Centre

    ERIC Educational Resources Information Center

    Cain, Kathleen Shine

    2011-01-01

    American writing center director Kathleen Shine Cain analyzes the transformative experience of spending a year in a Belfast writing centre, resulting in a renewed appreciation of cross-national and cross-cultural partnerships. Although American writing center theory and pedagogy have informed the development of centers in Europe, Asia, and Africa,…

  1. After-School Centres: Statistical Information and Monitoring of the Economics of Education

    ERIC Educational Resources Information Center

    Kupriyanov, B. V.; Kosaretsky, S. G.; Mertsalova, T. A.; Semenova, T. V.

    2015-01-01

    This article presents results of a survey of after-school centre directors concerning the extracurricular activities of children. It was conducted within the framework of the Monitoring of the Economics of Education at the National Research University--Higher School of Economics (HSE). The demographics of students at children's after-school…

  2. Effects of unstratified and centre-stratified randomization in multi-centre clinical trials.

    PubMed

    Anisimov, Vladimir V

    2011-01-01

    This paper deals with the analysis of randomization effects in multi-centre clinical trials. The two randomization schemes most often used in clinical trials are considered: unstratified and centre-stratified block-permuted randomization. The prediction of the number of patients randomized to different treatment arms in different regions during the recruitment period accounting for the stochastic nature of the recruitment and effects of multiple centres is investigated. A new analytic approach using a Poisson-gamma patient recruitment model (patients arrive at different centres according to Poisson processes with rates sampled from a gamma distributed population) and its further extensions is proposed. Closed-form expressions for corresponding distributions of the predicted number of the patients randomized in different regions are derived. In the case of two treatments, the properties of the total imbalance in the number of patients on treatment arms caused by using centre-stratified randomization are investigated and for a large number of centres a normal approximation of imbalance is proved. The impact of imbalance on the power of the study is considered. It is shown that the loss of statistical power is practically negligible and can be compensated by a minor increase in sample size. The influence of patient dropout is also investigated. The impact of randomization on predicted drug supply overage is discussed. Copyright © 2010 John Wiley & Sons, Ltd.

  3. UK Renal Registry 16th annual report: chapter 9 adequacy of haemodialysis in UK adult patients in 2012: national and centre-specific analyses.

    PubMed

    Shaw, Catriona; Steenkamp, Retha; Davenport, Andrew

    2013-01-01

    Outcomes in patients treated with haemodialysis (HD) are influenced by the delivered dose of dialysis. The UK Renal Association (RA) publishes clinical practice guidelines which include recommendations for dialysis dose. The urea reduction ratio (URR) is a widely used measure of dialysis dose and has historically been the measure of adequacy reported by the UKRR. This chapter aims to determine the extent to which patients achieved the recommended UK target. All 71 UK renal centres submitted data to the UK Renal Registry (UKRR). Two groups of patients were included in the analyses: the prevalent HD patient population on 30st September 2012 and the incident HD patient population for 2011. Centres returning data on <50% of their patient population or centres with <20 patients were excluded from centrespecific comparisons. Data regarding URR were available from 63 renal centres in the UK. Forty nine centres provided URR data on more than 90% of prevalent HD patients. The proportion of patients in the UK who met the UK clinical practice guideline for URR (>65%) increased from 69% in 2000 to 88% in 2012. There was persistent variation observed between centres, with 21 centres attaining the RA clinical practice guideline in >90% of patients, 38 centres attaining the guideline in 70-90% of patients and one centre in less than 70% of patients. The overall proportion of prevalent HD patients with a URR >65% has continued to improve over time. The delivered dose of HD, as measured by URR for patients with established renal failure, has increased over the last decade. Whilst the majority of UK patients achieved the target URR there was considerable variation between centres in the percentage of patients achieving the current guideline. © 2014 S. Karger AG, Basel.

  4. Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

    PubMed

    Hermus, M A A; Boesveld, I C; Hitzert, M; Franx, A; de Graaf, J P; Steegers, E A P; Wiegers, T A; van der Pal-de Bruin, K M

    2017-07-03

    During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics. International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care. From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all

  5. Centre for Education, Training, & Research in Renewable Energy and Energy Efficiency (CETREE) of Malaysia: Educating the Nation

    NASA Astrophysics Data System (ADS)

    Ibrahim, Kamarulazizi; Hilme, Khairur Rahim Ahmad

    2007-10-01

    Centre for Education, Training, and Research in Renewable Energy and Energy Efficiency (CETREE), was established in the year 2000, in Universiti Sains Malaysia (USM). CETREE is a not-for-profit organization that was part of the Malaysian Government's continuous effort in promoting sustainable development. The centre's main task is to tackle issues and problems that are slowing the potential growth of RE & EE utilizations in Malaysia. CETREE and the Government of Malaysia, with funding and supports from Danish International Development Assistance (DANIDA) and USM, has been working together closely in applying trans-disciplinary educational methods and approaches for the teaching of RE & EE that are compatible with Malaysian. Through association with various entities such as Energy Centre of Malaysia (PTM), Energy Commission of Malaysia (ST), Malaysia Electricity Supply Industry Trust Account (MESITA); CETREE was able to successfully promote sustainable development through education and training. Significant accomplishments made by CETREE include introducing RE and EE as part of Malaysian secondary schools and universities education; conducting energy related courses for professionals; and generating awareness via campaign in the mass media and CETREE's mobile-exhibition-unit road-tour.

  6. Integrating public health and medical intelligence gathering into homeland security fusion centres.

    PubMed

    Lenart, Brienne; Albanese, Joseph; Halstead, William; Schlegelmilch, Jeffrey; Paturas, James

    Homeland security fusion centres serve to gather, analyse and share threat-related information among all levels of governments and law enforcement agencies. In order to function effectively, fusion centres must employ people with the necessary competencies to understand the nature of the threat facing a community, discriminate between important information and irrelevant or merely interesting facts and apply domain knowledge to interpret the results to obviate or reduce the existing danger. Public health and medical sector personnel routinely gather, analyse and relay health-related inform-ation, including health security risks, associated with the detection of suspicious biological or chemical agents within a community to law enforcement agencies. This paper provides a rationale for the integration of public health and medical personnel in fusion centres and describes their role in assisting law enforcement agencies, public health organisations and the medical sector to respond to natural or intentional threats against local communities, states or the nation as a whole.

  7. Informing Policy and Practice in Australia's Vocational Education and Training Sector: Reflections and Futures. Proceedings of the 25th Anniversary Forum of the National Centre for Vocational Education Research (Adelaide, South Australia, Australia, March 21, 2007)

    ERIC Educational Resources Information Center

    Curtin, Penelope, Ed.; Loveder, Phil, Ed.

    2007-01-01

    To mark the occasion of its 25th anniversary, the National Centre for Vocational Education Research (NCVER) brought together policy, industry and academic leaders to reflect on the role that research and statistics have played in the development of Australia's vocational education and training (VET) sector. This publication includes the original…

  8. Innovation and the English National Health Service: a qualitative study of the independent sector treatment centre programme.

    PubMed

    Turner, Simon; Allen, Pauline; Bartlett, Will; Pérotin, Virginie

    2011-08-01

    Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.

    PubMed

    Morris, N; Campbell, J; Biro, M A; Lumley, J; Rao, J; Spensley, J

    1986-06-09

    A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.

  10. Showing Your Pride: A National Survey of Queer Student Centres in Canadian Colleges and Universities

    ERIC Educational Resources Information Center

    Ecker, John; Rae, Jennifer; Bassi, Amandeep

    2015-01-01

    The presence of queer student centres (QSCs) across Canadian universities and colleges is largely unknown. It is an important area of investigation since queer-identified students have previously identified several benefits of these services, including receiving support from other queer individuals. The focus of the current study was to determine…

  11. Out-of-pocket expenditure and catastrophic health spending on maternal care in public and private health centres in India: a comparative study of pre and post national health mission period.

    PubMed

    Mohanty, Sanjay K; Kastor, Anshul

    2017-09-18

    The National Health Mission (NHM), one of the largest publicly funded maternal health programs worldwide was initiated in 2005 to reduce maternal, neo-natal and infant mortality and out-of-pocket expenditure (OOPE) on maternal care in India. Though evidence suggests improvement in maternal and child health, little is known on the change in OOPE and catastrophic health spending (CHS) since the launch of NHM. The aim of this paper is to provide a comprehensive estimate of OOPE and CHS on maternal care by public and private health providers in pre and post NHM periods. The unit data from the 60th and 71st rounds of National Sample Survey (NSS) is used in the analyses. Descriptive statistics is used to understand the differentials in OOPE and CHS. The CHS is estimated based on capacity to pay, derived from household consumption expenditure, the subsistence expenditure (based on state specific poverty line) and household OOPE on maternal care. Data of both rounds are pooled to understand the impact of NHM on OOPE and CHS. The log-linear regression model and the logit regression models adjusted for state fixed effect, clustering and socio-economic and demographic correlates are used in the analyses. Women availing themselves of ante natal, natal and post natal care (all three maternal care services) from public health centres have increased from 11% in 2004 to 31% by 2014 while that from private health centres had increased from 12% to 20% during the same period. The mean OOPE on all three maternal care services from public health centres was US$60 in pre-NHM and US$86 in post-NHM periods while that from private health center was US$170 and US$300 during the same period. Controlling for socioeconomic and demographic correlates, the OOPE on delivery care from public health center had not shown any significant increase in post NHM period. The OOPE on delivery care in private health center had increased by 5.6 times compared to that from public health centers in pre NHM

  12. Transforming Readers: Teachers and Children in the Centre for Literacy in Primary Education Power of Reading Project

    ERIC Educational Resources Information Center

    O'Sullivan, Olivia; McGonigle, Sue

    2010-01-01

    This paper presents findings from a national project in England, The Power of Reading (Centre for Literacy in Primary Education), which has involved to date 41 projects over 5 years, in 16 Local Authorities nationally, with 900 schools and 1,350 teachers. The paper presents findings for the first 4 years. Our data demonstrate how professional…

  13. Operational flood forecasting system of Umbria Region "Functional Centre

    NASA Astrophysics Data System (ADS)

    Berni, N.; Pandolfo, C.; Stelluti, M.; Ponziani, F.; Viterbo, A.

    2009-04-01

    The hydrometeorological alert office (called "Decentrate Functional Centre" - CFD) of Umbria Region, in central Italy, is the office that provides technical tools able to support decisions when significant flood/landslide events occur, furnishing 24h support for the whole duration of the emergency period, according to the national directive DPCM 27 February 2004 concerning the "Operating concepts for functional management of national and regional alert system during flooding and landslide events for civil protection activities purposes" that designs, within the Italian Civil Defence Emergency Management System, a network of 21 regional Functional Centres coordinated by a central office at the National Civil Protection Department in Rome. Due to its "linking" role between Civil Protection "real time" activities and environmental/planning "deferred time" ones, the Centre is in charge to acquire and collect both real time and quasi-static data: quantitative data from monitoring networks (hydrometeorological stations, meteo radar, ...), meteorological forecasting models output, Earth Observation data, hydraulic and hydrological simulation models, cartographic and thematic GIS data (vectorial and raster type), planning studies related to flooding areas mapping, dam managing plans during flood events, non instrumental information from direct control of "territorial presidium". A detailed procedure for the management of critical events was planned, also in order to define the different role of various authorities and institutions involved. Tiber River catchment, of which Umbria region represents the main upper-medium portion, includes also regional trans-boundary issues very important to cope with, especially for what concerns large dam behavior and management during heavy rainfall. The alert system is referred to 6 different warning areas in which the territory has been divided into and based on a threshold system of three different increasing critical levels according

  14. Addiction research centres and the nurturing of creativity. The Chinese National Institute on Drug Dependence, Peking University: past, present and future.

    PubMed

    Wang, Xi; Zhao, Dong; Shi, Jie; Zhao, Chengzheng; Liu, Zhimin; Lu, Lin

    2010-09-01

    In the 25 years since drug abuse re-emerged in China in the 1980s, the National Institute of Drug Dependence (NIDD) has made many contributions to China's antidrug campaign. This present paper offers an account of the history, current status and future of drug dependence research at NIDD. NIDD was originally a research centre at Beijing Medical University, founded by the Chinese Ministry of Health to address the rapid spread of drug abuse in China. Originally, the main task of NIDD was to complete the commissions assigned by the government and university. Further developments transformed NIDD into a national research institute in the field of drug addiction that began to conduct its own research. NIDD has now created a professional team spread across several independent departments involved in neurobiological mechanisms, epidemiological surveys and monitoring, pre-clinical and clinical evaluation of new drugs (mainly analgesic drugs and detoxification drugs) and informatics and data analysis. As a university-based research institute, NIDD's funding derives mainly from grants provided by the government and financial support from international organizations. Its past and present research has a gained NIDD a reputation with both practitioners and policy makers in the field of drug addiction. In the future, NIDD will continue to engage in various aspects of drug addiction research and will enter the field of brain function.

  15. Research and Development Digest--5. A Summary of Published Research by the Centre for the Period 1 July, 1989--30 June, 1990.

    ERIC Educational Resources Information Center

    Hall, William C., Ed.

    This publication summarizes 50 research studies published by the TAFE (Technical and Further Education) National Centre for Research and Development Ltd., Australia. The document is presented in 10 sections. The first section provides an overview of the Centre's work and its publications, describing how best to use them. Sections 2-6 consist of…

  16. An introduction to family-centred services for children affected by HIV and AIDS.

    PubMed

    Richter, Linda

    2010-06-23

    Family-centred services in the context of HIV/AIDS acknowledge a broad view of a "family system" and ideally include comprehensive treatment and care, community agencies and coordinated case management. The importance of family-centred care for children affected by HIV/AIDS has been recognized for some time. There is a clear confluence of changing social realities and the needs of children in families affected by HIV and AIDS, but a change of paradigm in rendering services to children through families, in both high-prevalence and concentrated epidemic settings, has been slow to emerge.Despite a wide variety of model approaches, interventions, whether medical or psychosocial, still tend to target individuals rather than families. It has become clear that an individualistic approach to children affected by HIV and AIDS leads to confusion and misdirection of the global, national and local response. The almost exclusive focus on orphans, defined initially as a child who had lost one or both parents to AIDS, has occluded appreciation of the broader impact on children exposed to risk in other ways and the impact of the epidemic on families, communities and services for children. In addition, it led to narrowly focused, small-scale social welfare and case management approaches with little impact on government action, global and national policy, integration with health and education interventions, and increased funding.National social protection programmes that strengthen families are now established in several countries hard hit by AIDS, and large-scale pilots are underway in others. These efforts are supported by international and national development agencies, increasingly by governments and, more recently, by UNAIDS and the global AIDS community.There is no doubt that this is the beginning of a road and that there is still a long way to go, including basic research on families, family interventions, and effectiveness and costs of family-centred approaches. It is also

  17. Perceptual centres in speech - an acoustic analysis

    NASA Astrophysics Data System (ADS)

    Scott, Sophie Kerttu

    Perceptual centres, or P-centres, represent the perceptual moments of occurrence of acoustic signals - the 'beat' of a sound. P-centres underlie the perception and production of rhythm in perceptually regular speech sequences. P-centres have been modelled both in speech and non speech (music) domains. The three aims of this thesis were toatest out current P-centre models to determine which best accounted for the experimental data bto identify a candidate parameter to map P-centres onto (a local approach) as opposed to the previous global models which rely upon the whole signal to determine the P-centre the final aim was to develop a model of P-centre location which could be applied to speech and non speech signals. The first aim was investigated by a series of experiments in which a) speech from different speakers was investigated to determine whether different models could account for variation between speakers b) whether rendering the amplitude time plot of a speech signal affects the P-centre of the signal c) whether increasing the amplitude at the offset of a speech signal alters P-centres in the production and perception of speech. The second aim was carried out by a) manipulating the rise time of different speech signals to determine whether the P-centre was affected, and whether the type of speech sound ramped affected the P-centre shift b) manipulating the rise time and decay time of a synthetic vowel to determine whether the onset alteration was had more affect on P-centre than the offset manipulation c) and whether the duration of a vowel affected the P-centre, if other attributes (amplitude, spectral contents) were held constant. The third aim - modelling P-centres - was based on these results. The Frequency dependent Amplitude Increase Model of P-centre location (FAIM) was developed using a modelling protocol, the APU GammaTone Filterbank and the speech from different speakers. The P-centres of the stimuli corpus were highly predicted by attributes of

  18. CCS-MIP: Low cost Customizable Control Centre

    NASA Technical Reports Server (NTRS)

    Labezin, Christian; Vielcanet, Pierre

    1994-01-01

    The positioning and station keeping of French national satellites are among the main missions of CNES French Space Agency CNES. The related experience and skills of the Toulouse Space Centre are reknown and often required at international level for a wide range of missions. CISI, a software engineering company, has been contributing during the last 20 years to the development of the French space programs, particularly in the field of space missions ground control segments. The CCS-MIP system, presented here, is a satellite positioning and station-keeping system designed to answer the CNES multi-mission needs, easily adaptable for a wide range of applications.

  19. A French network of bipolar expert centres: a model to close the gap between evidence-based medicine and routine practice.

    PubMed

    Henry, Chantal; Etain, Bruno; Mathieu, Flavie; Raust, Aurélie; Vibert, Jean-Francois; Scott, Jan; Leboyer, Marion

    2011-06-01

    Bipolar disorders are a major public health concern. Efforts to provide optimal care by general practitioners and psychiatrists are undermined by the complexity of the disorder and difficulties in applying clinical practice guidelines and new research findings to the spectrum of cases seen in day to day practice. A national network of bipolar expert centres was established. Each centre has established strong links to local health services and provides support to clinicians in delivering personalized care plans derived from systematic case assessments undertaken at the centre. A common set of diagnostic and clinical assessment tools has been adopted at eight centres. Evaluations are undertaken by trained assessors and cross-centre reliability is monitored. A web application, e-bipolar© is used to record data in a common computerized medical file. Anonymized data is entered into a shared national database for use in multi-centre audit and research. Instead of offering treatment advice based on clinical practice guidelines recommendations for selected sub-populations of patients (a 'top-down' approach), the French bipolar network offers systematic, comprehensive, longitudinal, and multi-dimensional assessments of cases representative of general bipolar populations. This 'bottom-up' strategy may offer a more efficient and effective way to transfer knowledge and share expertise as the referrer can appreciate the rationale underpinning suggested treatment protocols and more readily apply such principles and approaches to other cases. The network also builds an infrastructure for clinical cohort and comparative-effectiveness research on more representative patient populations. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Real time monitoring of risk-adjusted paediatric cardiac surgery outcomes using variable life-adjusted display: implementation in three UK centres

    PubMed Central

    Pagel, Christina; Utley, Martin; Crowe, Sonya; Witter, Thomas; Anderson, David; Samson, Ray; McLean, Andrew; Banks, Victoria; Tsang, Victor; Brown, Katherine

    2013-01-01

    Objective To implement routine in-house monitoring of risk-adjusted 30-day mortality following paediatric cardiac surgery. Design Collaborative monitoring software development and implementation in three specialist centres. Patients and methods Analyses incorporated 2 years of data routinely audited by the National Institute of Cardiac Outcomes Research (NICOR). Exclusion criteria were patients over 16 or undergoing non-cardiac or only catheter procedures. We applied the partial risk adjustment in surgery (PRAiS) risk model for death within 30 days following surgery and generated variable life-adjusted display (VLAD) charts for each centre. These were shared with each clinical team and feedback was sought. Results Participating centres were Great Ormond Street Hospital, Evelina Children's Hospital and The Royal Hospital for Sick Children in Glasgow. Data captured all procedures performed between 1 January 2010 and 31 December 2011. This incorporated 2490 30-day episodes of care, 66 of which were associated with a death within 30 days.The VLAD charts generated for each centre displayed trends in outcomes benchmarked to recent national outcomes. All centres ended the 2-year period within four deaths from what would be expected. The VLAD charts were shared in multidisciplinary meetings and clinical teams reported that they were a useful addition to existing quality assurance initiatives. Each centre is continuing to use the prototype software to monitor their in-house surgical outcomes. Conclusions Timely and routine monitoring of risk-adjusted mortality following paediatric cardiac surgery is feasible. Close liaison with hospital data managers as well as clinicians was crucial to the success of the project. PMID:23564473

  1. RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System

    NASA Astrophysics Data System (ADS)

    Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.

    2008-08-01

    RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

  2. Politics, policy and payment--facilitators or barriers to person-centred rehabilitation?

    PubMed

    Turner-Stokes, Lynne

    This paper explores the tensions between politics and payment in providing affordable services that satisfy the public demand for patient-centred care. The two main approaches taken by the UK Government to curtail the spiralling costs of healthcare have been to focus development in priority areas and to cap spending through the introduction of a fixed-tariff episode-based funding system. The National Service Framework for Long Term Neurological Conditions embraces many laudable principles of person-centred management, but the 'one-size-fits all' approach to reimbursement potentially cuts right across these. A series of tools have been developed to determine complexity of rehabilitation needs that will support the development of banded tariffs. A practical approach is also offered to demonstrate the cost-efficiency of rehabilitation services for people with complex needs, and help to ensure that they are not excluded from treatment because of their higher treatment costs. Whilst responding to public demand for person-centred care, we must recognize the current financial pressure on healthcare systems. Clinicians will have greater credibility if they routinely collect and share outcomes that demonstrate the economic benefits of intervention, as well the impact on health, function and quality of life.

  3. The application of Firefly algorithm in an Adaptive Emergency Evacuation Centre Management (AEECM) for dynamic relocation of flood victims

    NASA Astrophysics Data System (ADS)

    ChePa, Noraziah; Hashim, Nor Laily; Yusof, Yuhanis; Hussain, Azham

    2016-08-01

    Flood evacuation centre is defined as a temporary location or area of people from disaster particularly flood as a rescue or precautionary measure. Gazetted evacuation centres are normally located at secure places which have small chances from being drowned by flood. However, due to extreme flood several evacuation centres in Kelantan were unexpectedly drowned. Currently, there is no study done on proposing a decision support aid to reallocate victims and resources of the evacuation centre when the situation getting worsens. Therefore, this study proposes a decision aid model to be utilized in realizing an adaptive emergency evacuation centre management system. This study undergoes two main phases; development of algorithm and models, and development of a web-based and mobile app. The proposed model operates using Firefly multi-objective optimization algorithm that creates an optimal schedule for the relocation of victims and resources for an evacuation centre. The proposed decision aid model and the adaptive system can be applied in supporting the National Security Council's respond mechanisms for handling disaster management level II (State level) especially in providing better management of the flood evacuating centres.

  4. A Phase II, Multicenter Study of the EZH2 Inhibitor Tazemetostat in Adult Subjects With INI1-Negative Tumors or Relapsed/Refractory Synovial Sarcoma

    ClinicalTrials.gov

    2018-05-18

    Malignant Rhabdoid Tumors (MRT); Rhabdoid Tumors of the Kidney (RTK); Atypical Teratoid Rhabdoid Tumors (ATRT); Selected Tumors With Rhabdoid Features; Synovial Sarcoma; INI1-negative Tumors; Malignant Rhabdoid Tumor of Ovary; Renal Medullary Carcinoma; Epithelioid Sarcoma; Poorly Differentiated Chordoma (or Other Chordoma With Sponsor Approval); Any Solid Tumor With an EZH2 GOF Mutation

  5. Roles of Regional Centres of Expertise on Education for Sustainable Development: Lessons Learnt in the First Half of the UNDESD

    ERIC Educational Resources Information Center

    Fadeeva, Zinaida; Mochizuki, Yoko

    2010-01-01

    As its major contribution to the United Nations Decade of Education for Sustainable Development (UN DESD, 2005-2014), the United Nations University (UNU) has promoted the establishment of Regional Centres of Expertise on education for sustainable development (RCEs) and their net-working to build innovative multistakeholder platforms for ESD…

  6. A Canadian model for building university and community partnerships: centre for research & education on violence against women and children.

    PubMed

    Jaffe, Peter G; Berman, Helene; MacQuarrie, Barb

    2011-09-01

    The importance of Canadian research on violence against women became a national focus after the 1989 murder of 14 women at École Polytechnique in Montreal. This tragedy led to several federal government studies that identified a need to develop centers for applied research and community-university alliances on violence against women. One such center is the Centre for Research & Education on Violence against Women and Children. The Centre was founded in London, Canada in 1992 out of a partnership of a university, a community college, and community services. The centre's history and current activities are summarized as a model for the development and sustainability of similar centers.

  7. The politics of patient-centred care.

    PubMed

    Kreindler, Sara A

    2015-10-01

    Despite widespread belief in the importance of patient-centred care, it remains difficult to create a system in which all groups work together for the good of the patient. Part of the problem may be that the issue of patient-centred care itself can be used to prosecute intergroup conflict. This qualitative study of texts examined the presence and nature of intergroup language within the discourse on patient-centred care. A systematic SCOPUS and Google search identified 85 peer-reviewed and grey literature reports that engaged with the concept of patient-centred care. Discourse analysis, informed by the social identity approach, examined how writers defined and portrayed various groups. Managers, physicians and nurses all used the discourse of patient-centred care to imply that their own group was patient centred while other group(s) were not. Patient organizations tended to downplay or even deny the role of managers and providers in promoting patient centredness, and some used the concept to advocate for controversial health policies. Intergroup themes were even more obvious in the rhetoric of political groups across the ideological spectrum. In contrast to accounts that juxtaposed in-groups and out-groups, those from reportedly patient-centred organizations defined a 'mosaic' in-group that encompassed managers, providers and patients. The seemingly benign concept of patient-centred care can easily become a weapon on an intergroup battlefield. Understanding this dimension may help organizations resolve the intergroup tensions that prevent collective achievement of a patient-centred system. © 2013 John Wiley & Sons Ltd.

  8. Developing person-centred practice in hip fracture care for older people.

    PubMed

    Christie, Jane; Macmillan, Maureen; Currie, Colin; Matthews-Smith, Gerardine

    2016-12-14

    To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people. Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers. Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole. To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.

  9. Spherical tokamaks with plasma centre-post

    NASA Astrophysics Data System (ADS)

    Ribeiro, Celso

    2013-10-01

    The metal centre-post (MCP) in tokamaks is a structure which carries the total toroidal field current and also houses the Ohmic heating solenoid in conventional or low aspect ratio (Spherical)(ST) tokamaks. The MCP and solenoid are critical components for producing the toroidal field and for the limited Ohmic flux in STs. Constraints for a ST reactor related to these limitations lead to a minimum plasma aspect ratio of 1.4 which reduces the benefit of operation at higher betas in a more compact ST reactor. Replacing the MCP is of great interest for reactor-based ST studies since the device is simplified, compactness increased, and maintenance reduced. An experiment to show the feasibility of using a plasma centre-post (PCP) is being currently under construction and involves a high level of complexity. A preliminary study of a very simple PCP, which is ECR(Electron Cyclotron Resonance)-assisted and which includes an innovative fuelling system based on pellet injection, has recently been reported. This is highly suitable for an ultra-low aspect ratio tokamak (ULART) device. Advances on this PCP ECR-assisted concept within a ULART and the associated fuelling system are presented here, and will include the field topology for the PCP ECR-assisted scheme, pellet ablation modeling, and a possible global equilibrium simulation. VIE-ITCR, IAEA-CRP contr.17592, National Instruments-Costa Rica.

  10. Claims for fertility interventions: a systematic assessment of statements on UK fertility centre websites

    PubMed Central

    Spencer, E A; Mahtani, K R; Goldacre, B; Heneghan, C

    2016-01-01

    Objectives Fertility services in the UK are offered by over 200 Human Fertilisation and Embryology Authority (HFEA)-registered NHS and private clinics. While in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) form part of the National Institute for Health and Care Excellence (NICE) guidance, many further interventions are offered. We aimed to record claims of benefit for interventions offered by fertility centres via information on the centres' websites and record what evidence was cited for these claims. Methods We obtained from HFEA a list of all UK centres providing fertility treatments and examined their websites. We listed fertility interventions offered in addition to standard IVF and ICSI and recorded statements about interventions that claimed or implied improvements in fertility in healthy women. We recorded which claims were quantified, and the evidence cited in support of the claims. Two reviewers extracted data from websites. We accessed websites from 21 December 2015 to 31 March 2016. Results We found 233 websites for HFEA-registered fertility treatment centres, of which 152 (65%) were excluded as duplicates or satellite centres, 2 were andrology clinics and 5 were unavailable or under construction websites. In total, 74 fertility centre websites, incorporating 1401 web pages, were examined for claims. We found 276 claims of benefit relating to 41 different fertility interventions made by 60 of the 74 centres (median 3 per website; range 0 to 10). Quantification was given for 79 (29%) of the claims. 16 published references were cited 21 times on 13 of the 74 websites. Conclusions Many fertility centres in the UK offer a range of treatments in addition to standard IVF procedures, and for many of these interventions claims of benefit are made. In most cases, the claims are not quantified and evidence is not cited to support the claims. There is a need for more information on interventions to be made available by fertility centres

  11. National VET Research Priorities: 2010 and beyond. Discussion Paper

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2009

    2009-01-01

    National Centre for Vocational Education Research (NCVER) is undertaking a consultation process to determine the next set of National Research Priorities which will guide research activities in the post-compulsory education and training arena, particularly in relation to vocational education and training. This discussion paper, and the…

  12. Definitive care in level 3 trauma centres after severe injury: A comparison of clinical characteristics and outcomes.

    PubMed

    Gomez, David; Alali, Aziz S; Xiong, Wei; Zarzaur, Ben L; Mann, N Clay; Nathens, Avery B

    2015-09-01

    The role of level 3 trauma centres (TC) in inclusive trauma systems has not been well defined. The absence of nationally recognised inter-facility transfer criteria for inclusive systems has often left individual level 3 TCs to decide upon their own what their spectrum of care is and particularly which severely injured patients to admit for definitive care. Retrospective cohort study in which the principal objective was to compare the characteristics and outcomes of severely injured (injury severity score>15) adult patients (≥18 years) who received definitive care at level 3 centres with severely injured adult patients who were transferred to level 1-2 TCs during the same time period. Data were derived from the National Trauma Data Bank (2010-2011). First, we utilised hierarchical logistic regression models to evaluate the risk-adjusted mortality of patients admitted at level 3 TCs compared to those who were transferred to level 1-2 TCs. Subgroup analysis was carried out for patients with isolated traumatic brain injury (iTBI). Finally, we explored the extent of variation in risk-adjusted mortality across level 3 TCs. We identified 6433 severely injured patients who received definitive care across 150 level 3 TCs and 41,165 severely injured patients transferred to level 1-2 centres. Patients who received definitive care at level 3 TCs had a lower comorbidity burden and different injury profiles compared to those transferred to level 1-2 centres. There was no difference in crude mortality (10% vs. 11%, standardised difference 0.04); however, after risk-adjustment, the odds of death for patients who received definitive care at level 3 TCs were 1.24-fold higher (95%CI 1.08-1.43) when compared to those transferred to level 1-2 centres. A trend towards a higher likelihood of death at level 3 centres was observed when analysis was limited to patients with iTBI. Risk-adjusted mortality across level 3 TCs was with few exceptions, homogeneous (<10% of level 3 TCs were

  13. Person-centred web-based support--development through a Swedish multi-case study.

    PubMed

    Josefsson, Ulrika; Berg, Marie; Koinberg, Ingalill; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt; Ranerup, Agneta; Lundin, Carina Sparud; Skärsäter, Ingela

    2013-10-19

    Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In

  14. Person-centred web-based support - development through a Swedish multi-case study

    PubMed Central

    2013-01-01

    Background Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons’ needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. Methods/Design The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. Discussion To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people’s experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the

  15. The digital eczema centre utrecht.

    PubMed

    van Os-Medendorp, Harmieke; van Veelen, Carien; Hover, Maaike; Eland-de Kok, Petra; Bruijnzeel-Koomen, Carla; Sonnevelt, Gert-Jan; Mensing, Geert; Pasmans, Suzanne

    2010-01-01

    The University Medical Centre Utrecht (UMC Utrecht) has developed an eczema portal that combines e-consulting, monitoring and self-management training by a dermatology nurse online for patients and parents of young children with atopic dermatitis (AD). Patient satisfaction with the portal was high. It could be extended to become a Digital Eczema Centre for multidisciplinary collaboration between health-care providers from different locations and the patient. Before starting the construction of the Digital Eczema Centre, the feasibility was examined by carrying out a business case analysis. The purposes, strength and weaknesses showed that the Digital Eczema Centre offered opportunities to improve care for patients with AD. The financial analysis resulted in a medium/best case scenario with a positive result of euro50-240,000 over a period of five years. We expect that the Digital Eczema Centre will increase the accessibility and quality of care. The web-based patient record and the digital chain-of-care promote the involvement of patients, parents and multidisciplinary teams as well as the continuity and coordination of care.

  16. Teaching and Learning Centres: Towards Maturation

    ERIC Educational Resources Information Center

    Challis, Di; Holt, Dale; Palmer, Stuart

    2009-01-01

    Approximately 70% of Australian Teaching and Learning Centres have been restructured and/or have undergone leadership changes in the last three years. The volatility of this environment reflects the number of significant challenges faced by Teaching and Learning Centres. In determining what makes Centres successful, the issues that are likely to…

  17. Theory-based practice in a major medical centre.

    PubMed

    Alligood, Martha Raile

    2011-11-01

    This project was designed to improve care quality and nursing staff satisfaction. Nursing theory structures thought and action as demonstrated by evidence of improvement in complex health-care settings. Nursing administrators selected Modelling and Role-Modelling (MRM) for the theory-based practice goal in their strategic plan. An action research approach structured implementation of MRM in a 1-year consultation project in 2001-2002. Quality of health care improved according to national quality assessment ratings, as well as patient satisfaction and nurse satisfaction. Modelling and Role-Modelling demonstrated capacity to structure nursing thought and action in patient care in a major medical centre. Uniformity of patient care language was valued by nurses as well as by allied health providers who wished to learn the holistic MRM style of practice. The processes of MRM and action research contributed to project success. A positive health-care change project was carried out in a large medical centre with action research. Introducing MRM theory-based practice was a beneficial decision by nursing administration that improved care and nurse satisfaction. Attention to nursing practice stimulated career development among the nurses to pursue bachelors, masters, and doctoral degrees. © 2011 Blackwell Publishing Ltd.

  18. Small Steps towards Student-Centred Learning

    ERIC Educational Resources Information Center

    Jacobs, George M.; Toh-Heng, Hwee Leng

    2013-01-01

    Student centred learning classroom practices are contrasted with those in teacher centred learning classrooms. The discussion focuses on the theoretical underpinnings of the former, and provides nine steps and tips on how to implement student centred learning strategies, with the aim of developing the 21st century skills of self-directed and…

  19. Towards the Implementation of an Assessment-Centred Blended Learning Framework at the Course Level: A Case Study in a Vietnamese National University

    ERIC Educational Resources Information Center

    Nguyen, Viet Anh

    2017-01-01

    Purpose: The purpose of this paper is to build an assessment-centred blended learning (BL) framework to assess learners, to analyse and to evaluate the impact of the technology support in the form of formative assessment in students' positive learning. Design/methodology/approach: This research proposed an assessment-centred BL framework at the…

  20. A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol

    PubMed Central

    Hafskjold, Linda; Sundler, Annelie J; Holmström, Inger K; Sundling, Vibeke; van Dulmen, Sandra

    2015-01-01

    Introduction This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice. Methods and analysis This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers’ self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments. Ethics and dissemination Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and

  1. A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol.

    PubMed

    Hafskjold, Linda; Sundler, Annelie J; Holmström, Inger K; Sundling, Vibeke; van Dulmen, Sandra; Eide, Hilde

    2015-04-15

    This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice. This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments. Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people

  2. A Healing Space: The Experiences of First Nations and Inuit Youth with Equine-Assisted Learning (EAL)

    ERIC Educational Resources Information Center

    Dell, Colleen Anne; Chalmers, Darlene; Bresette, Nora; Swain, Sue; Rankin, Deb; Hopkins, Carol

    2011-01-01

    The Nimkee NupiGawagan Healing Centre (NNHC) in Muncey, ON provides residential treatment to First Nations and Inuit youth who abuse solvents. As a complement to its culture-based programming, in 2008 the centre began offering weekly equine-assisted learning (EAL) curriculum to its clients in partnership with the Keystone Equine Centre and the…

  3. Can Chemistry Teachers' Centres Survive?

    ERIC Educational Resources Information Center

    Garforth, F. M.

    1972-01-01

    The difficulties faced by the Hull Chemistry Teachers' Centre in England are discussed. The lack of finances and time, as well as organizational difficulties in relationship with Science Centres and universities are among the problems. (TS)

  4. A new risk prediction model for critical care: the Intensive Care National Audit & Research Centre (ICNARC) model.

    PubMed

    Harrison, David A; Parry, Gareth J; Carpenter, James R; Short, Alasdair; Rowan, Kathy

    2007-04-01

    To develop a new model to improve risk prediction for admissions to adult critical care units in the UK. Prospective cohort study. The setting was 163 adult, general critical care units in England, Wales, and Northern Ireland, December 1995 to August 2003. Patients were 216,626 critical care admissions. None. The performance of different approaches to modeling physiologic measurements was evaluated, and the best methods were selected to produce a new physiology score. This physiology score was combined with other information relating to the critical care admission-age, diagnostic category, source of admission, and cardiopulmonary resuscitation before admission-to develop a risk prediction model. Modeling interactions between diagnostic category and physiology score enabled the inclusion of groups of admissions that are frequently excluded from risk prediction models. The new model showed good discrimination (mean c index 0.870) and fit (mean Shapiro's R 0.665, mean Brier's score 0.132) in 200 repeated validation samples and performed well when compared with recalibrated versions of existing published risk prediction models in the cohort of patients eligible for all models. The hypothesis of perfect fit was rejected for all models, including the Intensive Care National Audit & Research Centre (ICNARC) model, as is to be expected in such a large cohort. The ICNARC model demonstrated better discrimination and overall fit than existing risk prediction models, even following recalibration of these models. We recommend it be used to replace previously published models for risk adjustment in the UK.

  5. Global National Qualifications Framework Inventory

    ERIC Educational Resources Information Center

    Bjornavold, Jens; Pevec-Grm, Slava; Graham, Michael; Deij, Arjen; Singh, Madhu; Charkoun, Borhène; Agrawal, Shivani

    2013-01-01

    This publication is a global, country-by-country, inventory of National Qualifications Frameworks (NQFs). It is a copublication, prepared by two EU agencies, the European Training Foundation (ETF) and the Centre for the Development of Vocational Training (Cedefop); and UNESCO's Institute for Lifelong Learning (UIL) and the Section for TVET at…

  6. Managing the technological edge: the UNESCO International Computation Centre and the limits to the transfer of computer technology, 1946-61.

    PubMed

    Nofre, David

    2014-07-01

    The spread of the modern computer is assumed to have been a smooth process of technology transfer. This view relies on an assessment of the open circulation of knowledge ensured by the US and British governments in the early post-war years. This article presents new historical evidence that question this view. At the centre of the article lies the ill-fated establishment of the UNESCO International Computation Centre. The project was initially conceived in 1946 to provide advanced computation capabilities to scientists of all nations. It soon became a prize sought by Western European countries like The Netherlands and Italy seeking to speed up their own national research programs. Nonetheless, as the article explains, the US government's limitations on the research function of the future centre resulted in the withdrawal of European support for the project. These limitations illustrate the extent to which US foreign science policy could operate as (stealth) industrial policy to secure a competitive technological advantage and the prospects of US manufacturers in a future European market.

  7. Saskatchewan Forest Fire Control Centre Surface Meteorological Data

    NASA Technical Reports Server (NTRS)

    Hall, Forrest G. (Editor); Newcomer, Jeffrey A. (Editor); Funk, Barry; Strub, Richard

    2000-01-01

    The Saskatchewan Forest Fire Control Centre (SFFCC) provided surface meteorological data to BOREAS from its archive. This data set contains hourly surface meteorological data from 18 of the Meteorological stations located across Saskatchewan. Included in these data are parameters of date, time, temperature, relative humidity, wind direction, wind speed, and precipitation. Temporally, the data cover the period of May through September of 1994 and 1995. The data are provided in comma-delimited ASCII files, and are classified as AFM-Staff data. The data files are available on a CD-ROM (see document number 20010000884), or from the Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC).

  8. University of Victoria Genome British Columbia Proteomics Centre Partners with CPTAC | Office of Cancer Clinical Proteomics Research

    Cancer.gov

    University of Victoria Genome British Columbia Proteomics Centre, a leader in proteomic technology development, has partnered with the U.S. National Cancer Institute (NCI) to make targeted proteomic assays accessible to the community through NCI’s CPTAC Assay Portal (https://assays.cancer.gov).

  9. Experiences with the implementation of a national teaching qualification in university medical centres and veterinary medicine in the Netherlands.

    PubMed

    Molenaar, Willemina M Ineke; Zanting, Anneke

    2015-02-01

    In 2008, a compulsory national basic teaching qualification was introduced for all university teachers in the Netherlands. At that time all eight University Medical Centres (UMCs) and the only Faculty of Veterinary Medicine had adopted or were setting up teacher development programmes. This study explores how these programmes relate to each other and to the basic teaching qualification. To gather information on teacher development programmes in the UMCs and the Veterinary Medicine Faculty an online survey was filled out by teacher development representatives from each of them. The programmes had main features in common (e.g. competency based and portfolio assessment), but differed somewhat in contents according to the local situation. Importantly, they had all been formally accepted as equivalent to the basic teaching qualification. We consider the freedom to tailor the qualifications to the medical context as well as to the local situation of the UMCs and the Veterinary Medicine Faculty one of the major success factors and the well-established collaboration between teacher development representatives of the UMCs and the Faculty of Veterinary Medicine as another. Challenges for the future include embedding the teacher development programmes in the institutional organizations and maintaining and further developing the programmes and the competencies of the qualified teachers, e.g. in a senior qualification.

  10. The paediatric cardiac centre for Africa--proceedings of the March 2012 symposium.

    PubMed

    Kinsley, Robin H; Edwin, Frank; Entsua-Mensah, Kow

    2013-04-01

    The Pediatric Cardiac Centre for Africa (PCCA) was opened by national patron Mr Nelson Mandela on November 7, 2003. In 2008, the Centre's international pediatric cardiac symposium was introduced as a learning forum for pediatric cardiac surgeons and cardiologists in the continent. The symposium has consistently grown in attendance and attracted distinguished leaders in the field. The 2012 symposium featured Dr. Thomas Spray of Children's Hospital of Philadelphia, Dr. David Barron of Birmingham Children's Hospital, and Dr. John Brown of Indiana University School of Medicine as guest speakers. Experience of the Fontan procedure, the small aortic root, hypoplastic left heart syndrome, right ventricular outflow tract reconstruction, transposition of the great arteries, and interrupted aortic arch were the highlights of the symposium. In the "African Corner," centers in South Africa, Ghana, and Angola presented work done from across the African continent.

  11. Claims for fertility interventions: a systematic assessment of statements on UK fertility centre websites.

    PubMed

    Spencer, E A; Mahtani, K R; Goldacre, B; Heneghan, C

    2016-11-27

    Fertility services in the UK are offered by over 200 Human Fertilisation and Embryology Authority (HFEA)-registered NHS and private clinics. While in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) form part of the National Institute for Health and Care Excellence (NICE) guidance, many further interventions are offered. We aimed to record claims of benefit for interventions offered by fertility centres via information on the centres' websites and record what evidence was cited for these claims. We obtained from HFEA a list of all UK centres providing fertility treatments and examined their websites. We listed fertility interventions offered in addition to standard IVF and ICSI and recorded statements about interventions that claimed or implied improvements in fertility in healthy women. We recorded which claims were quantified, and the evidence cited in support of the claims. Two reviewers extracted data from websites. We accessed websites from 21 December 2015 to 31 March 2016. We found 233 websites for HFEA-registered fertility treatment centres, of which 152 (65%) were excluded as duplicates or satellite centres, 2 were andrology clinics and 5 were unavailable or under construction websites. In total, 74 fertility centre websites, incorporating 1401 web pages, were examined for claims. We found 276 claims of benefit relating to 41 different fertility interventions made by 60 of the 74 centres (median 3 per website; range 0 to 10). Quantification was given for 79 (29%) of the claims. 16 published references were cited 21 times on 13 of the 74 websites. Many fertility centres in the UK offer a range of treatments in addition to standard IVF procedures, and for many of these interventions claims of benefit are made. In most cases, the claims are not quantified and evidence is not cited to support the claims. There is a need for more information on interventions to be made available by fertility centres, to support well-informed treatment

  12. The GNSS-based component for the new Indonesian tsunami early warning centre provided by GITEWS

    NASA Astrophysics Data System (ADS)

    Falck, C.; Ramatschi, M.; Bartsch, M.; Merx, A.; Hoeberechts, J.; Rothacher, M.

    2009-04-01

    sensors on land the processing system delivers deviations from their normal, mean coordinates. The deviations or so called displacements are indicators for land mass movements which can occur, e.g., due to strong earthquakes. The ground motion information is a valuable source for a fast understanding of an earthquake's mechanism with possible relevance for a potentially following tsunami. By this means the GNSS system supports the decision finding process whether most probably a tsunami has been generated or not. For buoy based GNSS data the processing (differential, with GNSS reference station on land) delivers coordinates as well. Only the vertical component is of interest as it corresponds to the instant sea level height. Deviations to the mean sea level height are an indicator for a possibly passing tsunami wave. The graphical user interface (GUI) of the GNSS system supports both, a quick view for all staff members at the warning centre (24h/7d shifts) and deeper analysis by GNSS experts. The GNSS GUI system is implemented as a web-based application and allows all views to be displayed on different screens at the same time, even at remote locations. This is part of the concept, as it can support the dialogue between warning centre staff on duty or on standby and sensor station maintenance staff. Acknowledgements The GITEWS project (German Indonesian Tsunami Early Warning System) is carried out by a large group of scientists and engineers from (GFZ) German Research Centre for Geosciences and its partners from the German Aerospace Centre (DLR), the Alfred Wegener Institute for Polar and Marine Research (AWI), the GKSS Research Centre, the Konsortium Deutsche Meeresforschung (KDM), the Leibniz Institute for Marine Sciences (IFM-GEOMAR), the United Nations University (UNU), the Federal Institute for Geosciences and Natural Resources (BGR), the German Agency for Technical Cooperation (GTZ) and other international partners. Most relevant partners in Indonesia with respect

  13. Towards a National Plan in Applied Education and Training.

    ERIC Educational Resources Information Center

    Adderley, John

    The National Computing Centre Limited (NCC), established by the British Government to extend and improve the use of computers in the United Kingdom, is a major force in computer science education. As part of the overall national plan, training course packages consisting of lecturer's materials, visual aids and student notes have been prepared for…

  14. A short history of the Science and Mathematics Education Centre at Curtin University

    NASA Astrophysics Data System (ADS)

    Treagust, David F.

    2011-09-01

    This article is presented in four parts. In the first part, I describe the foundation of the Science and Mathematics Education Centre (SMEC) at Curtin University. In the second part, I explain the development of SMEC's teaching and research capacity under its three directors. In the third section, I describe how federal government support of SMEC as a national Key Centre for Teaching and Research in School Science and Mathematics provided enhanced postgraduate study opportunities for science and mathematics teachers throughout Australia by offering degree programs through distance education and face-to-face contact, short courses, and seminars. At the same time, research and teaching capacity of the academic staff was enhanced through the internationalisation of the programs being offered. In the final section, I describe current and future developments at SMEC.

  15. Typology of birth centres in the Netherlands using the Rainbow model of integrated care: results of the Dutch Birth Centre Study.

    PubMed

    Boesveld, Inge C; Bruijnzeels, Marc A; Hitzert, Marit; Hermus, Marieke A A; van der Pal-de Bruin, Karin M; van den Akker-van Marle, M E; Steegers, Eric A P; Franx, Arie; de Vries, Raymond G; Wiegers, Therese A

    2017-06-21

    The goal of integrated care is to offer a continuum of care that crosses the boundaries of public health, primary, secondary, and tertiary care. Integrated care is increasingly promoted for people with complex needs and has also recently been promoted in maternity care systems to improve the quality of care. Especially when located near an obstetric unit, birth centres are considered to be ideal settings for the realization of integrated care. At present, however, we know very little about the degree of integration in these centres and we do not know if increased levels of integration improve the quality of the care delivered. The Dutch Birth Centre Study is designed to evaluate birth centres and their contribution to the Dutch maternity care system. The aim of this particular sub-study is to classify birth centres in clusters with similar characteristics based on integration profiles, to support the evaluation of birth centre care. This study is based on the Rainbow Model of Integrated Care. We used a survey followed by qualitative interviews in 23 birth centres in the Netherlands to determine which integration profiles can be distinguished and to describe their discriminating characteristics. Cluster analysis was used to classify the birth centres. Birth centres were classified into three clusters: 1)"Mono-disciplinary-oriented birth centres" (n = 10): which are mainly owned by primary care organizations and established as physical facilities to provide an alternative birthplace for low risk births; 2) "Multi-disciplinary-oriented birth centres" (n = 6): which are mainly multi-disciplinary oriented and can be regarded as facilities to give birth, with a focus on integrated birth care; 3) "Mixed Cluster of birth centres" (n = 7): which have a range of organizational forms that differentiate them from centres in the other clusters. We identified a recognizable classification, with similar characteristics between birth centres in the clusters. The results of

  16. The murine SNF5/INI1 chromatin remodeling factor is essential for embryonic development and tumor suppression.

    PubMed

    Klochendler-Yeivin, A; Fiette, L; Barra, J; Muchardt, C; Babinet, C; Yaniv, M

    2000-12-01

    The assembly of eukaryotic DNA into nucleosomes and derived higher order structures constitutes a barrier for transcription, replication and repair. A number of chromatin remodeling complexes, as well as histone acetylation, were shown to facilitate gene activation. To investigate the function of two closely related mammalian SWI/SNF complexes in vivo, we inactivated the murine SNF5/INI1 gene, a common subunit of these two complexes. Mice lacking SNF5 protein stop developing at the peri-implantation stage, showing that the SWI/SNF complex is essential for early development and viability of early embryonic cells. Furthermore, heterozygous mice develop nervous system and soft tissue sarcomas. In these tumors the wild-type allele was lost, providing further evidence that SNF5 functions as a tumor suppressor gene in certain cell types.

  17. The murine SNF5/INI1 chromatin remodeling factor is essential for embryonic development and tumor suppression

    PubMed Central

    Klochendler-Yeivin, Agnes; Fiette, Laurence; Barra, Jaqueline; Muchardt, Christian; Babinet, Charles; Yaniv, Moshe

    2000-01-01

    The assembly of eukaryotic DNA into nucleosomes and derived higher order structures constitutes a barrier for transcription, replication and repair. A number of chromatin remodeling complexes, as well as histone acetylation, were shown to facilitate gene activation. To investigate the function of two closely related mammalian SWI/SNF complexes in vivo, we inactivated the murine SNF5/INI1 gene, a common subunit of these two complexes. Mice lacking SNF5 protein stop developing at the peri-implantation stage, showing that the SWI/SNF complex is essential for early development and viability of early embryonic cells. Furthermore, heterozygous mice develop nervous system and soft tissue sarcomas. In these tumors the wild-type allele was lost, providing further evidence that SNF5 functions as a tumor suppressor gene in certain cell types. PMID:11263494

  18. Patient-centred outcomes research: perspectives of patient stakeholders.

    PubMed

    Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Schwartz, J Sanford; Jayadevappa, Ravishankar

    2017-11-01

    To elicit patient stakeholders' experience and perspectives about patient-centred care. Qualitative. A large urban healthcare system. Four patient stakeholders who are prostate cancer survivors. Experience and perspectives of patient stakeholders regarding patient-centred care and treatment decisions. Our patient stakeholders represented a diverse socio-demographic group. The patient stakeholders identified engagement and dialogue with physicians as crucial elements of patient-centred care model. The degree of patient-centred care was observed to be dependent on the situations. High severity conditions warranted a higher level of patient involvement, compared to mild conditions. They agreed that patient-centred care should not mean that patients can demand inappropriate treatments. An important attribute of patient-centred outcomes research model is the involvement of stakeholders. However, we have limited knowledge about the experience of patient stakeholders in patient-centred outcomes research. Our study indicates that patient stakeholders offer a unique perspective as researchers and policy-makers aim to precisely define patient-centred research and care.

  19. Military Airlift: DOD Plans to Participate in Multi-National Program to Exchange Air Services with European Nations

    DTIC Science & Technology

    2013-10-30

    Air Transport, Air-to-Air Refueling and Other Exchange of Services ( ATARES ) program.1 ATARES is a European program through which member nations use a... ATARES is managed by the Movement Coordination Centre Europe (MCCE), a multi-national organization established in July 2007 to coordinate and optimize...of ATARES but is seeking to join the program. DOD is a member of MCCE and pays a fee for this membership; there is no additional fee to become a

  20. The foundation of NCVD PCI Registry: the Malaysia's first multi-centre interventional cardiology project.

    PubMed

    Liew, H B; Rosli, M A; Wan Azman, W A; Robaayah, Z; Sim, K H

    2008-09-01

    The National Cardiovascular Database for Percutaneous Coronary Intervention (NCVD PCI) Registry is the first multicentre interventional cardiology project, involving the main cardiac centres in the country. The ultimate goal of NCVD PCI is to provide a contemporary appraisal of PCI in Malaysia. This article introduces the foundation, the aims, methodology, database collection and preliminary results of the first six-month database.

  1. Responses to a questionnaire on networking between OIE Reference Laboratories and OIE Collaborating Centres.

    PubMed

    Brückner, G K; Linnane, S; Diaz, F; Vallat, B

    2007-01-01

    Two separate questionnaires were distributed to 20 OIE Collaborating Centres and 160 OIE Reference Laboratories to assess the current status of networking and collaboration among OIE Reference Laboratories and between OIE Reference Laboratories and OIE Collaborating Centres. The questionnaire for the OIE Reference Laboratories contained 7 sections with questions on networking between laboratories, reporting of information, biosecurity quality control, and financing. Emphasis was placed in obtaining information on inter-laboratory relationships and exchange of expertise, training needs and sharing of data and information. The questionnaire for the OIE Collaborating Centres contained six sections with the emphasis on aspects related to awareness of services that can be provided, expertise that could be made available, sharing of information and the relationship with the national veterinary services of the countries concerned. The responses to the questionnaires were collated, categorised and statistically evaluated to allow for tentative inferences on the data provided. Valuable information emanated from the data identifying the current status of networking and indicating possible shortcomings that could be addressed to improve networking.

  2. Communicating astronomy by the Unizul Science Centre

    NASA Astrophysics Data System (ADS)

    Beesham, A.; Beesham, N.

    2015-03-01

    The University of Zululand, situated along the east coast of KwaZulu-Natal, has a thriving Science Centre (USC) situated in the developing port city of Richards Bay. Over 30 000 learners visit the centre annually, and it consists of an exhibition area, an auditorium, lecture areas and offices. The shows consist of interactive games, science shows, competitions, quizzes and matriculation workshops. Outreach activities take place through a mobile science centre for schools and communities that cannot visit the centre.

  3. Growth of InSb and InI Crystals on Earth and in Microgravity

    NASA Technical Reports Server (NTRS)

    Ostrogorsky, A. G.; Churilov, A.; Volz, M. P.; Riabov, V.; Van den Berg, L.

    2015-01-01

    During the past 40 years, dozens of semiconductor crystal growth experiments have been conducted in space laboratories. The subsequent analysis of the space-grown crystals revealed (i) that weak convection existed in virtually all melt-growth experiments, (ii) de-wetting significantly reduced the level of stress-induced defects, and (iii) particularly encouraging results were obtained in vapor-growth experiments. In 2002, following a decade of ground based research in growing doped Ge and GaSb crystals, a series of crystal growth experiments was performed at the ISS, within the SUBSA (Solidification Using a Baffle in Sealed Ampoules) investigation. Te- and Zn-doped InSb crystals were grown from the melt. The specially designed furnace provided a side-view of the melt and precise seeding measurement of the growth rate. At present, under sponsorship of CASIS (Center for the Advancement of Science in Space, www.iss-casis.org), we are conducting ground-based experiments with indium mono-iodide (InI) in preparation for the "SUBSA II" ISS investigation, planned for 2017. The experiments include: i) Horizontal Bridgman (HB) growth and ii) Vapor Transport (VT) growth. Finite element modeling will also be conducted, to optimize the design of the flight ampoules, for vapor and melt growth.

  4. The "magic" of tutorial centres in Hong Kong: An analysis of media marketing and pedagogy in a tutorial centre

    NASA Astrophysics Data System (ADS)

    Koh, Aaron

    2014-12-01

    Why do more than three-quarters of Hong Kong's senior secondary students flock to tutorial centres like moths to light? What is the "magic" that is driving the popularity of the tutorial centre enterprise? Indeed, looking at the ongoing boom of tutorial centres in Hong Kong (there are almost 1,000 of them), it is difficult not to ask these questions. This paper examines the phenomenon of tutorial centres in Hong Kong and seeks to understand what draws students to these centres. Combining theories of marketing semiotics and emotion studies, the author investigates the pivotal role of media marketing in generating the "magic" of tutorial centres, whose advertising strategy includes, for example, a display of billboard posters featuring stylishly-dressed "celebrity teachers". The author reviews some of the literature available on the subject of tutorial centres. In a case study approach, he then maps out the pedagogy he observed in an English tutorial class, seeking heuristic insights into the kind of teaching students in the study were looking for. He argues that part of the "magical" attraction of what are essentially "cram schools" is their formulaic pedagogy of teaching and reinforcing exam skills. Finally, the paper considers the social implications of the tutorial centre industry in terms of media marketing of education and unequal access to tutorial services.

  5. The Australian Prevention Partnership Centre: systems thinking to prevent lifestyle-related chronic illness.

    PubMed

    Wilson, Andrew; Wutzke, Sonia; Overs, Marge

    2014-11-28

    Chronic diseases are the major cause of death in Australia and the biggest contributor to premature death and disability. Although prevention of chronic disease can be effective and cost-effective, it has proven difficult to systematically implement interventions that target important lifestyle-related risk factors for chronic disease such as poor nutrition, physical inactivity and harmful alcohol use. Prevention efforts targeting these lifestyle-related risk factors have had mixed success due to issues around designing and implementing effective interventions that address the complexity of risk factors, and incorporating evidence and implementing interventions at a scale, duration, intensity and quality required to achieve population effects. There is increasing recognition that multilevel, multisector approaches are required for the effective and sustained prevention of complex chronic disease. The Australian Prevention Partnership Centre, one of two National Health and Medical Research Council Partnership Centres established in 2013, is researching and developing systems perspectives to prevent lifestyle-related chronic disease in Australia. The Centre's collaborative approach is providing opportunities for researchers to work with policy makers and practitioners to develop research questions, conduct research, and analyse, interpret and disseminate the findings. As such, it is the model of interaction that is being tested as much as the specific projects. With its funding partners, the Centre has developed plans for more than 30 projects. It has also established four capacity units that will improve the gathering, sharing and use of evidence to build a prevention system in Australia. The Centre is exploring new ways to advance prevention by bringing together researchers, policy makers and practitioners to determine the information and actions needed for an effective prevention system for Australia.

  6. Global Inventory of Regional and National Qualifications Frameworks. Volume I: Thematic Chapters

    ERIC Educational Resources Information Center

    Deij, Arjen; Graham, Michael; Bjornavold, Jens; Grm, Slava Pevec; Villalba, Ernesto; Christensen, Hanne; Chakroun, Borhene; Daelman, Katrien; Carlsen, Arne; Singh, Madhu

    2015-01-01

    The "Global Inventory of Regional and National Qualifications Frameworks," the result of collaborative work between the European Training Foundation (ETF), the European Centre for the Development of Vocational Training (Cedefop), UNESCO [United Nations Educational, Scientific and Cultural Organization] and UIL [UNESCO Institute for…

  7. Indian Institute of Technology Bombay and Tata Memorial Centre Join the International Efforts in Clinical Proteogenomics Cancer Research | Office of Cancer Clinical Proteomics Research

    Cancer.gov

    The National Cancer Institute’s (NCI) Office of Cancer Clinical Proteomics Research, part of the National Institutes of Health, along with the Indian Institute of Technology Bombay (IITB) and Tata Memorial Centre (TMC) have signed a Memorandum of Understanding (MOU) on clinical proteogenomics cancer research. The MOU between NCI, IITB, and Tata Memorial Centre represents the thirtieth and thirty-first institutions and the twelfth country to join the International Cancer Proteogenome Consortium (ICPC). The purpose of the MOU is to facilitate scientific and programmatic collaborations between NCI, IITB, and TMC in basic and clinical proteogenomic studies leading to patient care and public dissemination and information sharing to the research community.

  8. The German national registry for primary immunodeficiencies (PID)

    PubMed Central

    Gathmann, B; Goldacker, S; Klima, M; Belohradsky, B H; Notheis, G; Ehl, S; Ritterbusch, H; Baumann, U; Meyer-Bahlburg, A; Witte, T; Schmidt, R; Borte, M; Borte, S; Linde, R; Schubert, R; Bienemann, K; Laws, H-J; Dueckers, G; Roesler, J; Rothoeft, T; Krüger, R; Scharbatke, E C; Masjosthusmann, K; Wasmuth, J-C; Moser, O; Kaiser, P; Groß-Wieltsch, U; Classen, C F; Horneff, G; Reiser, V; Binder, N; El-Helou, S M; Klein, C; Grimbacher, B; Kindle, G

    2013-01-01

    In 2009, a federally funded clinical and research consortium (PID–NET, http://www.pid-net.org) established the first national registry for primary immunodeficiencies (PID) in Germany. The registry contains clinical and genetic information on PID patients and is set up within the framework of the existing European Database for Primary Immunodeficiencies, run by the European Society for Primary Immunodeficiencies. Following the example of other national registries, a central data entry clerk has been employed to support data entry at the participating centres. Regulations for ethics approvals have presented a major challenge for participation of individual centres and have led to a delay in data entry in some cases. Data on 630 patients, entered into the European registry between 2004 and 2009, were incorporated into the national registry. From April 2009 to March 2012, the number of contributing centres increased from seven to 21 and 738 additional patients were reported, leading to a total number of 1368 patients, of whom 1232 were alive. The age distribution of living patients differs significantly by gender, with twice as many males than females among children, but 15% more women than men in the age group 30 years and older. The diagnostic delay between onset of symptoms and diagnosis has decreased for some PID over the past 20 years, but remains particularly high at a median of 4 years in common variable immunodeficiency (CVID), the most prevalent PID. PMID:23607573

  9. Incorporation of National Universities in Japan

    ERIC Educational Resources Information Center

    Oba, Jun

    2007-01-01

    In April 2004, Japanese national universities were incorporated and became much more autonomous from the government in their operations. Their managerial structure was realigned--placing the president at the centre of the decision-making process, and with the participation of external persons--to be more responsive to the changing needs of…

  10. Major chemical incidents--a response, the role of the Consultant in Communicable Disease Control and the case of need for a national surveillance-resource centre.

    PubMed

    Ayres, P J

    1995-06-01

    The aim of this study is to discuss the adequacy of current arrangements for dealing with major chemical incidents through the offices of the Consultant in Communicable Disease Control (CCDC). This paper describes the public health response to an explosion at a chemical works which was followed by illnesses of unknown aetiology in emergency service workers and other people. An outline of the circumstances as they presented themselves and a description of the lessons learned from the management of this disaster are presented alongside an overview of the prevailing infrastructure of advice, support and training available to CsCDC. Key issues relevant to these areas are discussed. A total of 181 potential cases were notified to the investigating team, of whom 115 had an illness possibly associated with the explosion. Of these, 93 suffered a gastrointestinal illness and 68 had so-called 'toxic' symptoms (eye, skin and bronchopulmonary irritation). Forty-six people had both sets of symptoms at the same time. Current arrangements dictate that public health physicians have a role in incidents such as this, whether they seek such a position or not. The specialty would do well to consider developing formal disaster training schemes for those likely to have to manage major incidents (usually the CCDC), and would benefit from the setting up of a chemical-environmental incident surveillance-resource centre. Such a centre should have a remit for teaching and training, information support, incident recording, coordination of expert resources, and liaison between interested bodies both nationally and internationally.

  11. Metrics for Success in the Preservation of Scientific Data at the STFC Centre for Environmental Data Archival (CEDA).

    NASA Astrophysics Data System (ADS)

    Lawrence, B.; Pepler, S.

    2009-04-01

    CEDA (http://www.ceda.ac.uk) hosts three main data centres: the British Atmospheric Data Centre (http://badc.nerc.ac.uk), the NERC Earth Observation Data Centre (http://neodc.nerc.ac.uk), and the Intergovernmental Panel for Climate Change Dedicated Data Centre (http://ipcc-data.org) as well as components of many national and international projects. CEDA recieves both core funding (from the UK Natural Environment Research Council) and per project funding (from a variety of sources). However, all funders require metrics assessing success. In the case of preservation it is hard to measure success - usage alone is not enough, since next year someone may use currently unused data if it is well preserved, and so it is the act of preservation which in this case marks success. Even where data is accessed, it is not necessarily used. Hence at CEDA we have three key focii in our approach to metrics: measuring direct website access, benchmarking procedures against best practice, and hopefully soon, recording data citation. In this presentation we cover how we are addressing each of these three areas.

  12. Perspectives on recycling centres and future developments.

    PubMed

    Engkvist, I-L; Eklund, J; Krook, J; Björkman, M; Sundin, E

    2016-11-01

    The overall aim of this paper is to draw combined, all-embracing conclusions based on a long-term multidisciplinary research programme on recycling centres in Sweden, focussing on working conditions, environment and system performance. A second aim is to give recommendations for their development of new and existing recycling centres and to discuss implications for the future design and organisation. Several opportunities for improvement of recycling centres were identified, such as design, layout, ease with which users could sort their waste, the work environment, conflicting needs and goals within the industry, and industrialisation. Combining all results from the research, which consisted of different disciplinary aspects, made it possible to analyse and elucidate their interrelations. Waste sorting quality was recognized as the most prominent improvement field in the recycling centre system. The research identified the importance of involving stakeholders with different perspectives when planning a recycling centre in order to get functionality and high performance. Practical proposals of how to plan and build recycling centres are given in a detailed checklist. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Patient-centred care: a review for rehabilitative audiologists.

    PubMed

    Grenness, Caitlin; Hickson, Louise; Laplante-Lévesque, Ariane; Davidson, Bronwyn

    2014-02-01

    This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Literature review and synthesis. Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

  14. Review of CERN Data Centre Infrastructure

    NASA Astrophysics Data System (ADS)

    Andrade, P.; Bell, T.; van Eldik, J.; McCance, G.; Panzer-Steindel, B.; Coelho dos Santos, M.; Traylen and, S.; Schwickerath, U.

    2012-12-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project's motivations, current status and areas for future investigation.

  15. WHO Collaborating Centre for Acquired Immunodeficiency Syndrome for the Eastern Mediterranean Regional Office, Faculty of Medicine, Kuwait University, Kuwait.

    PubMed

    Altawalah, Haya; Al-Nakib, Widad

    2014-01-01

    In the early 1980s, the World Health Organization (WHO) designated the Virology Unit of the Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait, a collaborating centre for AIDS for the Eastern Mediterranean Regional Office (EMRO), recognizing it to be in compliance with WHO guidelines. In this centre, research integral to the efforts of WHO to combat AIDS is conducted. In addition to annual workshops and symposia, the centre is constantly updating and renewing its facilities and capabilities in keeping with current and latest advances in virology. As an example of the activities of the centre, the HIV-1 RNA viral load in plasma samples of HIV-1 patients is determined by real-time PCR using the AmpliPrep TaqMan HIV-1 test v2.0. HIV-1 drug resistance is determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene, using the TRUGENE HIV-1 Genotyping Assay on the OpenGene® DNA Sequencing System. HIV-1 subtypes are determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene using the genotyping assays described above. A fundamental program of Kuwait's WHO AIDS collaboration centre is the national project on the surveillance of drug resistance in human deficiency virus in Kuwait, which illustrates how the centre and its activities in Kuwait can serve the EMRO region of WHO. © 2014 S. Karger AG, Basel.

  16. 78 FR 24154 - Notice of Availability of a National Animal Health Laboratory Network Reorganization Concept Paper

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ...] Notice of Availability of a National Animal Health Laboratory Network Reorganization Concept Paper AGENCY... Network (NAHLN) for public review and comment. The NAHLN is a nationally coordinated network and... Coordinator, National Animal Health Laboratory Network, Veterinary Services, APHIS, 2140 Centre Avenue...

  17. The "Magic" of Tutorial Centres in Hong Kong: An Analysis of Media Marketing and Pedagogy in a Tutorial Centre

    ERIC Educational Resources Information Center

    Koh, Aaron

    2014-01-01

    Why do more than three-quarters of Hong Kong's senior secondary students flock to tutorial centres like moths to light? What is the "magic" that is driving the popularity of the tutorial centre enterprise? Indeed, looking at the ongoing boom of tutorial centres in Hong Kong (there are almost 1,000 of them), it is difficult not to ask…

  18. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres.

    PubMed

    Breck, Andrew; Dixon, L Beth; Kettel Khan, Laura

    2016-10-01

    The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Child-care centres were located in low-income neighbourhoods in NYC. Overall, 87 % of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by >60 %. Sweets and water had lower match percentages (40 and 32 %, respectively), but water was served 68 % of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day.

  19. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres

    PubMed Central

    Breck, Andrew; Dixon, L Beth; Khan, Laura Kettel

    2016-01-01

    Objective The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Design Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Setting Child-care centres were located in low-income neighbourhoods in NYC. Results Overall, 87% of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by > 60%. Sweets and water had lower match percentages (40 and 32%, respectively), but water was served 68% of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. Conclusions In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day. PMID:27280341

  20. International Energy Agency's Heat Pump Centre (IEA-HPC) Annual National Team Working Group Meeting

    NASA Astrophysics Data System (ADS)

    Broders, M. A.

    1992-09-01

    The traveler, serving as Delegate from the United States Advanced Heat Pump National Team, participated in the activities of the fourth IEA-HPC National Team Working Group meeting. Highlights of this meeting included review and discussion of 1992 IEA-HPC activities and accomplishments, introduction of the Switzerland National Team, and development of the 1993 IEA-HPC work program. The traveler also gave a formal presentation about the Development and Activities of the IEA Advanced Heat Pump U.S. National Team.

  1. The illusion of client-centred practice.

    PubMed

    Gupta, Jyothi; Taff, Steven D

    2015-07-01

    A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession's philosophical basis and espoused commitment to client-centred practice. The current practice of occupational therapy in the reimbursement-driven practice arena in the United States is incongruent with the profession's espoused philosophy and values of client-centred practice. Occupational therapy differentiates itself from medicine's expert model aimed at curing disease and remediating impairment, by its claim to client-centred practice focused on restoring health through occupational enablement. Practice focused on impairment and function is at odds with the profession's core tenet, occupation, and minimizes the lasting impact of interventions on health and well-being. The profession cannot unleash the therapeutic power of human occupation in settings where body systems and body functions are not occupation-ready at the requisite levels for occupational participation. Client-centred practice is best embodied by occupation-focused interventions in the natural environment of everyday living. Providing services that are impairment-focused in unfamiliar settings is not a good fit for client-centred practice, which is the unique, authentic, and sustainable orientation for the profession.

  2. Mental health in Sexual Assault Referral Centres: A survey of forensic physicians.

    PubMed

    Brooker, Charlie; Paul, Sheila; Sirdifield, Coral

    2018-05-22

    A national survey of Forensic Physicians (FPs) working in Sexual Assault Referral Centres was undertaken. The survey was advertised in the weekly bulletin sent out by the Faculty of Forensic and Legal Medicine. Response was relatively low (n = 45). It is estimated that this figures represents about 12% of the workforce. The aim of the survey was to investigate FPs experience of accessing mental health pathways out of a SARC for complainants of all ages. The results concurred with a previous survey of SARC clinical managers with mental health services proving unresponsive. Informed co-commissioning between NHS England and Clinical Commissioning groups can only improve if aspects of complainant's mental health are routinely assessed within SARCs using structured outcome measures. Structured outcomes should be integrated into NHS England's Sexual Assault Referral Centres Indicators of Performance (SARCIP). Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  3. The obtaining relative position of lunar centre masses and centre of the figure in selenocentric catalogues

    NASA Astrophysics Data System (ADS)

    Nefedjev, Yu. A.; Valeev, S. G.; Rizvanov, N. G.; Mikeev, R. R.; Varaksina, N. Yu.

    2010-05-01

    The relative position of lunar center masses relative to center of the figure in Kazan and Kiev selenocentric catalogues was customized. The expansions by spherical harmonics N=5 degree and order of the lunar function h(λ, β) with using the package ASNI USTU were executed. Module of the expansion of the local area to surfaces to full sphere was used. The parameters of cosmic missions are given for comparison (SAI; Bills, Ferrari). The normalized coefficients from expansions for eight sources hypsometric information are obtained: - Clementine (N=40), - Kazan (N=5), - Kiev (N=5), - SAI (N=10; Chuikova (1975)), - Bills, Ferrari, - Каguуа (Selena, Japan mission), - ULCN (The Uuified Lunaz Control Network 2005). The displacements of the lunar centre figure relative to lunar centre of the masses were defined from equations (Chuikova (1975)). The results of the obtaining relative position of the lunar centre masses and centre of the figure in Kazan selenocentric catalogue give good agreement with modern cosmic mission data.

  4. A Foreign Model of Teacher Education and Its Local Appropriation: The English Teachers' Centres in Spain

    ERIC Educational Resources Information Center

    Groves, Tamar

    2015-01-01

    This article explores the implementation of the English model of teachers' centres in the context of 1980s Spain. Originally it was a top-down plan initiated by a national government. However, from the very beginning its fate was dependent on a bottom-up educational project carried out by pedagogical social movements. The first part of the article…

  5. A new model of collaborative research: experiences from one of Australia's NHMRC Partnership Centres for Better Health.

    PubMed

    Wutzke, Sonia; Redman, Sally; Bauman, Adrian; Hawe, Penelope; Shiell, Alan; Thackway, Sarah; Wilson, Andrew

    2017-02-15

    There is often a disconnection between the creation of evidence and its use in policy and practice. Cross-sectoral, multidisciplinary partnership research, founded on shared governance and coproduction, is considered to be one of the most effective means of overcoming this research-policy-practice disconnect. Similar to a number of funding bodies internationally, Australia's National Health and Medical Research Council has introduced Partnership Centres for Better Health: a scheme explicitly designed to encourage coproduced partnership research. In this paper, we describe our experiences of The Australian Prevention Partnership Centre, established in June 2013 to explore the systems, strategies and structures that inform decisions about how to prevent lifestyle-related chronic disease. We present our view on how the Partnership Centre model is working in practice. We comment on the unique features of the Partnership Centre funding model, how these features enable ways of working that are different from both investigator-initiated and commissioned research, and how these ways of working can result in unique outcomes that would otherwise not have been possible. Although not without challenges, the Partnership Centre approach addresses a major gap in the Australian research environment, whereby large-scale, research-policy-practice partnerships are established with sufficient time, resources and flexibility to deliver highly innovative, timely and accessible research that is of use to policy and practice.

  6. The Imperial College Thermophysical Properties Data Centre

    NASA Astrophysics Data System (ADS)

    Angus, S.; Cole, W. A.; Craven, R.; de Reuck, K. M.; Trengove, R. D.; Wakeham, W. A.

    1986-07-01

    The IUPAC Thermodynamic Tables Project Centre in London has at its disposal considerable expertise on the production and utilization of high-accuracy equations of state which represent the thermodynamic properties of substances. For some years they have been content to propagate this information by the traditional method of book production, but the increasing use of the computer in industry for process design has shown that an additional method was needed. The setting up of the IUPAC Transport Properties Project Centre, also at Imperial College, whose products would also be in demand by industry, afforded the occasion for a new look at the problem. The solution has been to set up the Imperial College Thermophysical Properties Data Centre, which embraces the two IUPAC Project Centres, and for it to establish a link with the existing Physical Properties Data Service of the Institution of Chemical Engineers, thus providing for the dissemination of the available information without involving the Centres in problems such as those of marketing and advertising. This paper outlines the activities of the Centres and discusses the problems in bringing their products to the attention of industry in suitable form.

  7. Investigating the job satisfaction of healthcare providers at primary healthcare centres in Lebanon: A national cross-sectional study.

    PubMed

    Alameddine, Mohamad; Baroud, Maysa; Kharroubi, Samer; Hamadeh, Randa; Ammar, Walid; Shoaib, Hikma; Khodr, Hiba

    2017-11-01

    Low job satisfaction is linked to higher staff turnover and intensified shortages in healthcare providers (HCP). This study investigates the level of, and factors associated with, HCP job satisfaction in the national primary healthcare (PHC) network in Lebanon. The study adopts a cross-sectional design to survey HCP at 99 PHC centres distributed across the country between October 2013 and May 2014. The study questionnaire consisted of four sections: socio-demographics/professional background, employment characteristics, level of job satisfaction (Measure of Job Satisfaction scale) and level of professional burnout (Maslach Burnout Inventory-HSS scale). A total of 1,000 providers completed the questionnaire (75.8% response rate). Bivariate and multivariate regression analyses were used to identify factors significantly associated with job satisfaction. Findings of the study highlight an overall mean job satisfaction score of 3.59 (SD 0.54) indicating that HCP are partially satisfied. Upon further examination, HCP were least satisfied with pay, training and job prospects. Gender, age, career plans, salary, exposure to violence, and level of burnout were significantly associated with the overall level of job satisfaction which was also associated with increased likelihood to quit. Overall, the study highlights how compensation, development and protection of PHC HCP can influence their job satisfaction. Recommendations include the necessity of developing a nationally representative committee, led by the Ministry of Public Health, to examine the policies and remuneration scales within the PHC sector and suggest mechanisms to bridge the pay differential with other sectors. The effective engagement of key stakeholders with the development, organisation and evaluation of professional development programmes offered to HCP in the PHC sector remains crucial. Concerned stakeholders should assess and formulate initiatives and programmes that enrich the physical, psychological

  8. The Dutch Birth Centre Study: study design of a programmatic evaluation of the effect of birth centre care in the Netherlands.

    PubMed

    Hermus, Marieke A A; Wiegers, Therese A; Hitzert, Marit F; Boesveld, Inge C; van den Akker-van Marle, M Elske; Akkermans, Henk A; Bruijnzeels, Marc A; Franx, Arie; de Graaf, Johanna P; Rijnders, Marlies E B; Steegers, Eric A P; van der Pal-de Bruin, Karin M

    2015-07-16

    Birth centres are regarded as settings where women with uncomplicated pregnancies can give birth, assisted by a midwife and a maternity care assistant. In case of (threatening) complications referral to a maternity unit of a hospital is necessary. In the last decade up to 20 different birth centres have been instituted in the Netherlands. This increase in birth centres is attributed to various reasons such as a safe and easy accessible place of birth, organizational efficiency in integration of care and direct access to obstetric hospital care if needed, and better use of maternity care assistance. Birth centres are assumed to offer increased integration and quality of care and thus to contribute to better perinatal and maternal outcomes. So far there is no evidence for this assumption as no previous studies of birth centres have been carried out in the Netherlands. The aims are 1) Identification of birth centres and measuring integration of organization and care 2) Measuring the quality of birth centre care 3) Effects of introducing a birth centre on regional quality and provision of care 4) Cost-effectiveness analysis 5) In depth longitudinal analysis of the organization and processes in birth centres. Different qualitative and quantitative methods will be used in the different sub studies. The design is a multi-centre, multi-method study, including surveys, interviews, observations, and analysis of registration data and documents. The results of this study will enable users of maternity care, professionals, policy makers and health care financers to make an informed choice about the kind of birth location that is appropriate for their needs and wishes.

  9. Women's questions about medicines in pregnancy - An analysis of calls to an Australian national medicines call centre.

    PubMed

    Pijpers, Eva L; Kreijkamp-Kaspers, Sanne; McGuire, Treasure M; Deckx, Laura; Brodribb, Wendy; van Driel, Mieke L

    2017-06-01

    For many medicines, safe use during pregnancy is not established and adherence is often poor due to safety concerns. Therefore, it is important to identify consumers' medicines information needs during pregnancy. A retrospective, mixed methods analysis was conducted on eight years of pregnancy-related calls to an Australian national medicines call centre. The call profile of pregnancy and non-pregnancy-related questions were compared. Medicines involved in pregnancy calls were categorised by class (Anatomical Therapeutic Chemical (ATC)3 level), and Therapeutic Goods Administration pregnancy category. Questions in these calls were also themed by pregnancy stage. We identified 4573 pregnancy-related and 118 547 non-pregnancy-related calls. The caller profile for pregnancy-related calls was female (93.7%), asking for herself (83.0%), and while 70.1% of questions involved one medicine, 9.6% involved three or more medicines. Pregnancy enquiries were prompted more often by conflicting information, inadequate information or desire for a second opinion. For 1166 calls, where the stage of pregnancy was available, most questions concerned safety. Medication classified as 'safe' during pregnancy accounted for 34% of these questions. After antidepressants, most calls were made about over-the-counter (OTC) medicines (paracetamol, dexchlorpheniramine, codeine). Safe treatment for everyday conditions was of increasing concern as the pregnancy progressed. Pregnant women are concerned about the safety of medication use in pregnancy and a significant proportion overestimate risk. Psychotropic medication and fertility are strong drivers to seek information during preconception. Everyday illnesses and self-medication with OTC medication are a common concern throughout pregnancy, even though many medicines are safe to use. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. The nitrogen-vacancy colour centre in diamond

    NASA Astrophysics Data System (ADS)

    Doherty, Marcus W.; Manson, Neil B.; Delaney, Paul; Jelezko, Fedor; Wrachtrup, Jörg; Hollenberg, Lloyd C. L.

    2013-07-01

    The nitrogen-vacancy (NV) colour centre in diamond is an important physical system for emergent quantum technologies, including quantum metrology, information processing and communications, as well as for various nanotechnologies, such as biological and sub-diffraction limit imaging, and for tests of entanglement in quantum mechanics. Given this array of existing and potential applications and the almost 50 years of NV research, one would expect that the physics of the centre is well understood, however, the study of the NV centre has proved challenging, with many early assertions now believed false and many remaining issues yet to be resolved. This review represents the first time that the key empirical and ab initio results have been extracted from the extensive NV literature and assembled into one consistent picture of the current understanding of the centre. As a result, the key unresolved issues concerning the NV centre are identified and the possible avenues for their resolution are examined.

  11. Student-Centred and Teacher-Centred Learning Environment in Pre-Vocational Secondary Education: Psychological Needs, and Motivation

    ERIC Educational Resources Information Center

    Smit, Karin; de Brabander, Cornelis J.; Martens, Rob L.

    2014-01-01

    In this study the perception of psychological needs and motivation in a student-centred and a teacher-centred learning environment are compared, using Self Determination Theory as a framework. The self-report Intrinsic Motivation Inventory was completed by 230 students (mean age 16.1 years) in pre-vocational secondary education. School records on…

  12. Barriers to ART adherence & follow ups among patients attending ART centres in Maharashtra, India.

    PubMed

    Joglekar, N; Paranjape, R; Jain, R; Rahane, G; Potdar, R; Reddy, K S; Sahay, S

    2011-12-01

    Adherence to ART is a patient specific issue influenced by a variety of situations that a patient may encounter, especially in resource-limited settings. A study was conducted to understand factors and influencers of adherence to ART and their follow ups among patients attending ART centres in Maharashtra, India. Between January and March 2009, barriers to ART adherence among 32 patients at three selected ART centres functioning under national ART roll-out programme in Maharashtra, India, were studied using qualitative methods. Consenting patients were interviewed to assess barriers to ART adherence. Constant comparison method was used to identify grounded codes. Patients reported multiple barriers to ART adherence and follow up as (i) Financial barriers where the contributing factors were unemployment, economic dependency, and debt, (ii) social norm of attending family rituals, and fulfilling social obligations emerged as socio-cultural barriers, (iii) patients' belief, attitude and behaviour towards medication and self-perceived stigma were the reasons for sub-optimal adherence, and (iv) long waiting period, doctor-patient relationship and less time devoted in counselling at the center contributed to missed visits. Mainstreaming ART can facilitate access and address 'missed doses' due to travel and migration. A 'morning' and 'evening' ART centre/s hours may reduce work absenteeism and help in time management. Proactive 'adherence probing' and probing on internalized stigma might optimize adherence. Adherence probing to prevent transitioning to suboptimal adherence among patients stable on ART is recommended.

  13. The Centre of High-Performance Scientific Computing, Geoverbund, ABC/J - Geosciences enabled by HPSC

    NASA Astrophysics Data System (ADS)

    Kollet, Stefan; Görgen, Klaus; Vereecken, Harry; Gasper, Fabian; Hendricks-Franssen, Harrie-Jan; Keune, Jessica; Kulkarni, Ketan; Kurtz, Wolfgang; Sharples, Wendy; Shrestha, Prabhakar; Simmer, Clemens; Sulis, Mauro; Vanderborght, Jan

    2016-04-01

    The Centre of High-Performance Scientific Computing (HPSC TerrSys) was founded 2011 to establish a centre of competence in high-performance scientific computing in terrestrial systems and the geosciences enabling fundamental and applied geoscientific research in the Geoverbund ABC/J (geoscientfic research alliance of the Universities of Aachen, Cologne, Bonn and the Research Centre Jülich, Germany). The specific goals of HPSC TerrSys are to achieve relevance at the national and international level in (i) the development and application of HPSC technologies in the geoscientific community; (ii) student education; (iii) HPSC services and support also to the wider geoscientific community; and in (iv) the industry and public sectors via e.g., useful applications and data products. A key feature of HPSC TerrSys is the Simulation Laboratory Terrestrial Systems, which is located at the Jülich Supercomputing Centre (JSC) and provides extensive capabilities with respect to porting, profiling, tuning and performance monitoring of geoscientific software in JSC's supercomputing environment. We will present a summary of success stories of HPSC applications including integrated terrestrial model development, parallel profiling and its application from watersheds to the continent; massively parallel data assimilation using physics-based models and ensemble methods; quasi-operational terrestrial water and energy monitoring; and convection permitting climate simulations over Europe. The success stories stress the need for a formalized education of students in the application of HPSC technologies in future.

  14. Deformation-induced structural transition in body-centred cubic molybdenum

    PubMed Central

    Wang, S. J.; Wang, H.; Du, K.; Zhang, W.; Sui, M. L.; Mao, S. X.

    2014-01-01

    Molybdenum is a refractory metal that is stable in a body-centred cubic structure at all temperatures before melting. Plastic deformation via structural transitions has never been reported for pure molybdenum, while transformation coupled with plasticity is well known for many alloys and ceramics. Here we demonstrate a structural transformation accompanied by shear deformation from an original <001>-oriented body-centred cubic structure to a <110>-oriented face-centred cubic lattice, captured at crack tips during the straining of molybdenum inside a transmission electron microscope at room temperature. The face-centred cubic domains then revert into <111>-oriented body-centred cubic domains, equivalent to a lattice rotation of 54.7°, and ~15.4% tensile strain is reached. The face-centred cubic structure appears to be a well-defined metastable state, as evidenced by scanning transmission electron microscopy and nanodiffraction, the Nishiyama–Wassermann and Kurdjumov–Sachs relationships between the face-centred cubic and body-centred cubic structures and molecular dynamics simulations. Our findings reveal a deformation mechanism for elemental metals under high-stress deformation conditions. PMID:24603655

  15. Centre-Based Child Care Quality in Urban Australia

    ERIC Educational Resources Information Center

    Ishimine, Karin; Wilson, Rachel

    2009-01-01

    This study investigates the quality of childcare centres in urban Australian communities designated according to different bands of Centre Location Demographics (CLD). Childcare centres were assessed using the Early Childhood Environment Rating Scale- Revised Edition (ECERS-R) and the Early Childhood Environment Rating Scale-Extension (ECERS-E).…

  16. Student-Centred Learning (SCL): Roles Changed?

    ERIC Educational Resources Information Center

    Onurkan Aliusta, Gülen; Özer, Bekir

    2017-01-01

    This paper addresses the espoused and enacted practices of high school teachers with regard to student-centred learning (SCL). Explanatory mixed-method design, where quantitative strand is followed by qualitative one, is employed. While the quantitative strand aims to explore teachers' perceptions regarding the extent student-centred teacher and…

  17. Elderly Care Centre

    NASA Astrophysics Data System (ADS)

    Wagiman, Aliani; Haja Bava Mohidin, Hazrina; Ismail, Alice Sabrina

    2016-02-01

    The demand for elderly centre has increased tremendously abreast with the world demographic change as the number of senior citizens rose in the 21st century. This has become one of the most crucial problems of today's era. As the world progress into modernity, more and more people are occupied with daily work causing the senior citizens to lose the care that they actually need. This paper seeks to elucidate the best possible design of an elderly care centre with new approach in order to provide the best service for them by analysing their needs and suitable activities that could elevate their quality of life. All these findings will then be incorporated into design solutions so as to enhance the living environment for the elderly especially in Malaysian context.

  18. The Irish Centre for Talented Youth

    ERIC Educational Resources Information Center

    Gilheany, Sheila

    2005-01-01

    Conducting potency tests on penicillin, discussing rocket technology with a NASA astronaut, analysing animal bone fragments from medieval times, these are just some of the activities which occupy the time of students at The Irish Centre for Talented Youth. The Centre identifies young students with exceptional academic ability and then provides…

  19. Documentation Centre of the Association of African Universities.

    ERIC Educational Resources Information Center

    Chateh, Peter

    This report presents the results of a study of the Documentation Centre of the Association of African Universities (AAU) undertaken to work out proposals for the rational organization of the Centre, and to explore the possibility of computerizing the Centre and linking it with other centers which provide automated documentation services. The…

  20. UK Renal Registry 16th annual report: chapter 12 biochemical variables amongst UK adult dialysis patients in 2012: national and centre-specific analyses.

    PubMed

    Nicholas, Johann; Shaw, Catriona; Pitcher, David; Dawnay, Anne

    2013-01-01

    The UK Renal Association clinical practice guidelines include clinical performance measures for biochemical variables in dialysis patients. The UK Renal Registry (UKRR) annually audits dialysis centre performance against these measures as part of its role in promoting continuous quality improvement. Cross sectional performance analyses were undertaken to compare dialysis centre achievement of clinical audit measures for prevalent haemodialysis (HD) and peritoneal dialysis (PD) cohorts in 2012. The biochemical variables studied were phosphate, adjusted calcium, parathyroid hormone, bicarbonate and total cholesterol. In addition, longitudinal analyses were performed (2002-2012) to show changes in achievement of clinical performance measures over time. Fifty-six percent of HD and 61% of PD patients achieved a phosphate within the range recommended by the RA clinical practice guidelines. Seventy-seven percent of HD and 78% of PD patients had adjusted calcium between 2.2-2.5 mmol/L. Fifty-eight percent of HD and 65% of PD patients had parathyroid hormone between 16-72 pmol/L. Fifty-nine percent of HD and 80% of PD patients achieved the audit measure for bicarbonate. There was significant inter-centre variation for all variables studied. The UKRR consistently demonstrates significant inter-centre variation in achievement of biochemical clinical audit measures. Understanding the causes of this variation is an important part of improving the care of dialysis patients in the UK.

  1. The haemtrack home therapy reporting system: Design, implementation, strengths and weaknesses: A report from UK Haemophilia Centre Doctors Organisation.

    PubMed

    Hay, C R M; Xiang, H; Scott, M; Collins, P W; Liesner, R; Dolan, G; Hollingsworth, R

    2017-09-01

    Haemtrack is an electronic home treatment diary for patients with inherited bleeding disorders, introduced in 2008. It aimed to improve the timeliness and completeness of patient-reported treatment records, to facilitate analysis of treatment and outcome trends. The system is easy to use, responsive and accessible. The software uses Microsoft technologies with a SQL Server database and an ASP.net website front-end, running on personal computers, android and I-phones. Haemtrack interfaces with the UK Haemophilia Centre Information System and the National Haemophilia Database (NHD). Data are validated locally by Haemophilia Centres and centrally by NHD. Data collected include as follows: treatment brand, dose and batch number, time/date of bleed onset and drug administration, reasons for treatment (prophylaxis, bleed, follow-up), bleed site, severity, pain-score and outcome. Haemtrack was used by 90% of haemophilia treatment centres (HTCs) in 2015, registering 2683 patients using home therapy of whom 1923 used Haemtrack, entering >17 000 treatments per month. This included 68% of all UK patients with severe haemophilia A. Reporting compliance varied and 55% of patients reported ≥75% of potential usage. Centres had a median 78% compliance overall. A strategy for progressively improving compliance is in place. Age distribution and treatment intensity were similar in Haemtrack users/non-users with severe haemophilia treated prophylactically. The Haemtrack system is a valuable tool that may improve treatment compliance and optimize treatment regimen. Analysis of national treatment trends and large-scale longitudinal, within-patient analysis of changes in regimen and/or product will provide valuable insights that will guide future clinical practice. © 2017 John Wiley & Sons Ltd.

  2. [The Adamant, an unusual care centre].

    PubMed

    Khidichian, Frédéric

    2011-01-01

    The day care centre of the central Paris area has established itself in an unusual location--a 650 m2 floating building moored on the right bank of the Seine. Patients and caregivers were involved in the design of this original and ecological care centre, which places the emphasis on comfort and safety.

  3. Centre of the Cell: Science Comes to Life.

    PubMed

    Balkwill, Frances; Chambers, Katie

    2015-01-01

    Centre of the Cell is a unique biomedical science education centre, a widening participation and outreach project in London's East End. This article describes Centre of the Cell's first five years of operation, the evolution of the project in response to audience demand, and the impact of siting a major public engagement project within a research laboratory.

  4. Assessing Learners' Satisfication towards Support Services Delivery in National Open University Nigeria: Implications for Counselling Services

    ERIC Educational Resources Information Center

    Okopi, Fidel; Ofole, Ndidi

    2013-01-01

    This study aims at determining the level of students' satisfaction of learner support services in the study centres of NOUN--National Open University of Nigeria and whether the support services offered at the study centres have significant influence on the level of students' satisfaction. A descriptive survey of ex-post facto research design was…

  5. Access to yellow fever travel vaccination centres in England, Wales, and Northern Ireland: A geographical study.

    PubMed

    Petersen, Jakob; Simons, Hilary; Patel, Dipti

    More than 700,000 trips were made by residents in England, Wales, and Northern Ireland (EWNI) in 2015 to tropical countries endemic for yellow fever, a potentially deadly, yet vaccine-preventable disease transmitted by mosquitoes. The aim of this study was to map the geographical accessibility of yellow fever vaccination centres (YFVC) in EWNI. The location of 3208 YFVC were geocoded and the average geodetic distance to nearest YFVC was calculated for each population unit. Data on trips abroad and centres were obtained regionally for EWNI and nationally for the World Top20 countries in terms of travel. The mean distance to nearest YFVC was 2.4 km and only 1% of the population had to travel more than 16.1 km to their nearest centre. The number of vaccines administered regionally in EWNI was found correlated with the number of trips to yellow fever countries. The number of centres per 100,000 trips was 6.1 in EWNI, which was below United States (12.1) and above the rest of Top20 countries. The service availability was in line with demand regionally. With the exception of remote, rural areas, yellow fever vaccination services were widely available with only short distances to cover for the travelling public. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  6. Waste management in primary healthcare centres of Iran.

    PubMed

    Mesdaghinia, Alireza; Naddafi, Kazem; Mahvi, Amir Hossein; Saeedi, Reza

    2009-06-01

    The waste management practices in primary healthcare centres of Iran were investigated in the present study. A total of 120 primary healthcare centres located across the country were selected using the cluster sampling method and the current situation of healthcare waste management was determined through field investigation. The quantities of solid waste and wastewater generation per outpatient were found to be 60 g outpatient(-1) day(-1) and 26 L outpatient(-1) day(-1), respectively. In all of the facilities, sharp objects were separated almost completely, but separation of other types of hazardous healthcare solid waste was only done in 25% of the centres. The separated hazardous solid waste materials were treated by incineration, temporary incineration and open burning methods in 32.5, 8.3 and 42.5% of the healthcare centres, respectively. In 16.7% of the centres the hazardous solid wastes were disposed of without any treatment. These results indicate that the management of waste materials in primary healthcare centres in Iran faced some problems. Staff training and awareness, separation of healthcare solid waste, establishment of the autoclave method for healthcare solid waste treatment and construction of septic tanks and disinfection units in the centres that were without access to a sewer system are the major measures that are suggested for improvement of the waste management practices.

  7. Learner-centred teaching in a non-learner-centred world: An interpretive phenomenological study of the lived experience of clinical nursing faculty.

    PubMed

    Oyelana, Olabisi; Martin, Donna; Scanlan, Judith; Temple, Beverley

    2018-08-01

    With the growing complexities in the contemporary health care system, there is a challenge of preparing nurses for the practice demands. To this end, learner-centred teaching has emerged in many nursing curricula in Canada and evidence indicates its effectiveness in developing the essential practice skills in nursing students. It is important to examine the experience of the clinical faculty members who implement learner-centred teaching, as doing so would provide an insight to the factors that may hinder the implementation of learner-centred teaching in the practice settings. This phenomenological study aimed to address two research questions: what does learner-centred teaching mean to clinical nurse faculty? What is the lived experience of clinical nursing faculty who incorporate learner-centred teaching? Ten clinical nurse faculty members who had at least two years of clinical teaching experience volunteered to participate in the study. Data were collected using a semi-structured interview guide and audio recorder. Additional data sources included a demographic survey and a reflective journal. Multiple sub-themes emerged from this study from which three significant themes were consolidated: diversity of meanings, facilitators of LCT, and barriers to LCT. However, an overarching theme of "learner-centred teaching in a non-learner-centred world" was coined from participants' accounts of their experiences of barriers in incorporating LCT in the practice settings. A collaborative effort between faculty and the stakeholders is paramount to a successful implementation of learner-centred teaching in practice settings. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Person-centred rehabilitation: what exactly does it mean? Protocol for a scoping review with thematic analysis towards framing the concept and practice of person-centred rehabilitation.

    PubMed

    Jesus, Tiago S; Bright, Felicity; Kayes, Nicola; Cott, Cheryl A

    2016-07-19

    Person-centredness is a philosophy for organising and delivering healthcare based on patients' needs, preferences and experiences. Although widely endorsed, the concept suffers from a lack of detail and clarification, in turn accounting for ambiguous implementation and outcomes. While a conceptual framework based on a systematic review defines person/patient-centred care components (Scholl et al, 2014), it applies across healthcare contexts and may not be sensitive to the nuances of the rehabilitation of adults with physical impairments. Accordingly, this study aims to build a conceptual framework, based on existing literature, of what person-centredness means in the rehabilitation of adults with physical impairments in the clinical encounter and broader health service delivery. We will use a scoping review methodology. Searches on relevant databases will be conducted first, combining keywords for 'rehabilitation', 'person-centered' and associated terms (including patient preferences/experiences). Next, snowball searches (citation tracking, references lists) will be performed. Papers will be included if they fall within predefined selection categories (seen as most likely informative on elements pertaining to person-centred rehabilitation) and are written in English, regardless of design (conceptual, qualitative, quantitative). Two reviewers will independently screen titles and abstracts, followed by screening of the full text to determine inclusion. Experts will then be consulted to identify relevant missing papers. This can include elements other than the peer-reviewed literature (eg, book chapters, policy/legal papers). Finally, information that helps to build the concept and practice of person-centred rehabilitation will be abstracted independently by two reviewers and analysed by inductive thematic analysis to build the conceptual framework. The resulting framework will aid clarification regarding person-centred rehabilitation, which in turn is expected to

  9. Person-centred rehabilitation: what exactly does it mean? Protocol for a scoping review with thematic analysis towards framing the concept and practice of person-centred rehabilitation

    PubMed Central

    Bright, Felicity; Kayes, Nicola; Cott, Cheryl A

    2016-01-01

    person-centred rehabilitation, which in turn is expected to conceptually ground and inform its operationalisation (eg, measurement, implementation, improvement). Findings will be disseminated through local, national and international stakeholders, both at the clinical and service organisation levels. PMID:27436670

  10. Reconciling evidence‐based medicine and patient‐centred care: defining evidence‐based inputs to patient‐centred decisions

    PubMed Central

    2015-01-01

    Abstract Evidence‐based and patient‐centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards ‘cookbook’ medicine undermine the view of patients as unique particulars, and diminish what might be considered patient‐centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence‐based and person‐centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients’ uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner–patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence‐based and patient‐centred approaches. PMID:26456314

  11. Reconciling evidence-based medicine and patient-centred care: defining evidence-based inputs to patient-centred decisions.

    PubMed

    Weaver, Robert R

    2015-12-01

    Evidence-based and patient-centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards 'cookbook' medicine undermine the view of patients as unique particulars, and diminish what might be considered patient-centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence-based and person-centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients' uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner-patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence-based and patient-centred approaches. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  12. The Role of Parents' Educational Level and Centre Type in Parent Satisfaction with Early Childhood Care Centres: A Study in Greece

    ERIC Educational Resources Information Center

    Kelesidou, Sofia; Chatzikou, Maria; Tsiamagka, Evmorfia; Koutra, Evangelia; Abakoumkin, Georgios; Tseliou, Eleftheria

    2017-01-01

    This research examines specific facets of parent satisfaction with childcare centres, namely satisfaction with parent-centre communication and the educational services they provide, as well as respective parent beliefs. These were investigated in relation to centre type (private vs public) and parents' education. Parents of different educational…

  13. The GNSS data processing component within the Indonesian tsunami early warning centre provided by GITEWS

    NASA Astrophysics Data System (ADS)

    Bartsch, M.; Merx, A.; Falck, C.; Ramatschi, M.

    2010-05-01

    movements which can occur, e.g., due to strong earthquakes. The ground motion information is a valuable source for a fast understanding of an earthquake's mechanism and consequences with possible relevance for a potentially following tsunami. Regarding kinematic coordinates of a buoy only the vertical component is of interest as it corresponds to the instant sea level. The kinematic coordinates are delivered to an oceanographic post-processing unit which applies dipping-, tilting- and tidal-corrections to the data. Deviations to the mean sea level are an indicator for a possibly passing tsunami wave. By this means the GNSS system supports the decision finding process whether a tsunami has been released or not. A graphical user interface (GUI) was developed which monitors the whole processing chain from data transmission and GNSS data processing to the displaying of the kinematic coordinate time series. It supports both, a quick view for all staff members at the warning centre (24h/7d shifts) and deeper analysis by GNSS experts. The GNSS GUI system is web-based and allows all views to be displayed on different screens at the same time, even at remote locations. This is part of the concept, as it can support the dialogue between warning centre staff on duty or on standby and sensor station maintenance staff. Acknowledgements The GITEWS project (German Indonesian Tsunami Early Warning System) is carried out by a large group of scientists and engineers from (GFZ) German Research Centre for Geosciences and its partners from the German Aerospace Centre (DLR), the Alfred Wegener Institute for Polar and Marine Research (AWI), the GKSS Research Centre, the Konsortium Deutsche Meeresforschung (KDM), the Leibniz Institute for Marine Sciences (IFM-GEOMAR), the United Nations University (UNU), the Federal Institute for Geosciences and Natural Resources (BGR), the German Agency for Technical Cooperation (GTZ) and other international partners. Most relevant partners in Indonesia with

  14. Psychiatric intervention and repeated admission to emergency centres due to drug overdose.

    PubMed

    Kanehara, Akiko; Yamana, Hayato; Yasunaga, Hideo; Matsui, Hiroki; Ando, Shuntaro; Okamura, Tsuyoshi; Kumakura, Yousuke; Fushimi, Kiyohide; Kasai, Kiyoto

    2015-10-01

    Repeated drug overdose is a major risk factor for suicide. Data are lacking on the effect of psychiatric intervention on preventing repeated drug overdose. To investigate whether psychiatric intervention was associated with reduced readmission to emergency centres due to drug overdose. Using a Japanese national in-patient database, we identified patients who were first admitted to emergency centres for drug overdose in 2010-2012. We used propensity score matching for patient and hospital factors to compare readmission rates between intervention (patients undergoing psychosocial assessment) and unexposed groups. Of 29 564 eligible patients, 13 035 underwent psychiatric intervention. In the propensity-matched 7938 pairs, 1304 patients were readmitted because of drug overdose. Readmission rate was lower in the intervention than in the unexposed group (7.3% v . 9.1% respectively, P <0.001). Psychiatric intervention was associated with reduced readmission in patients who had taken a drug overdose. None. © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

  15. Socioeconomic predictors of referral to a diagnostic centre on suspected adverse events following HPV vaccination.

    PubMed

    Weye, Nanna; Fonager, Kirsten; Lützen, Tina; Rytter, Dorte

    2018-05-25

    In Denmark, the human papillomavirus (HPV) vaccines have been suspected of adverse events since 2014. However, as no causal associations between the HPV vaccines and numerous diseases have been demonstrated, factors prior to vaccination may influence the risk of suspecting the HPV vaccines of causing symptoms. We studied the associations between individual and parental socioeconomic characteristics and the risk of referral to a diagnostic centre in a female population aged 11-29 years with a first HPV vaccination in January 2008 to June 2015. Individual and parental data from national registries were linked using the unique personal identification number. Logistic regression analyses were used to estimate crude and adjusted odds ratio's according to each individual and parental socioeconomic factor with two-sided 95% 95% CI. The cohort consisted of 453 216 individuals of which 1316 (0.29%) were referred to a diagnostic centre in 2015. Having a mother outside the workforce or an unemployed mother was associated with an increased risk of referral, while girls and women who had fathers with a higher educational level were less likely to be referred. In addition, women aged 20-29 years who were unemployed or outside the workforce prior to vaccination had increased odds of being referred to a diagnostic centre. We found social inequality in the referral to a diagnostic centre following HPV vaccination. This might be explained by an increased morbidity in girls and women of lower socioeconomic status.

  16. Addiction research centres and the nurturing of creativity The Norwegian Centre for Addiction Research (SERAF).

    PubMed

    Bramness, Jørgen G; Clausen, Thomas; Duckert, Fanny; Ravndal, Edle; Waal, Helge

    2011-08-01

    The Norwegian Centre for Addiction Research (SERAF) at the University of Oslo is a newly established, clinical addiction research centre. It is located at the Oslo University Hospital and has a major focus on opioid dependency, investigating Norwegian opioid maintenance treatment (OMT), with special interest in OMT during pregnancy, mortality, morbidity and criminality before, during and after OMT and alternatives to OMT, such as the use of naltrexone implants. The well-developed health registries of Norway are core assets that also allow the opportunity for other types of substance abuse research. This research includes health services, abuse of prescription drugs and drugs of abuse in connection with traffic. The centre also focuses upon comorbidity, investigating the usefulness and limitations of psychometric instruments, drug abuse in different psychiatric treatment settings and internet-based interventions for hazardous alcohol consumption. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  17. Addiction research centres and the nurturing of creativity: the Department of Alcohol, Drugs and Addiction at the National Institute for Health and Welfare in Finland: diverse problems, diverse perspectives.

    PubMed

    Hakkarainen, Pekka; Kiianmaa, Kalervo; Kuoppasalmi, Kimmo; Tigerstedt, Christoffer

    2012-10-01

    The Department of Alcohol, Drugs and Addiction started operations on 1 January 2009, when the National Institute of Public Health (KTL) and the National Research and Development Centre for Welfare and Health (STAKES) were merged. The newly formed institute, called the National Institute for Health and Welfare (THL), operates under the Finnish Ministry of Social Affairs and Health. The scope of the research and preventive work conducted in the Department covers alcohol, drugs, tobacco and gambling issues. The two main tasks of the Department are (i) to research, produce and disseminate information on alcohol and drugs, substance use, addictions and their social and health-related effects and (ii) to develop prevention and good practices with a view to counteracting the onset and development of alcohol and drug problems and the damaging effects of smoking and other addictions. The number of staff hovers at approximately 60 people. The Department is organized into three units, one specialized in social sciences (the Alcohol and Drug Research Unit), another in laboratory analytics (the Alcohol and Drug Analytics Unit) and the third primarily in preventive work (the Addiction Prevention Unit). These units incorporate a rich variety and long traditions of both research and preventive work. The mixture of different disciplines creates good opportunities for interdisciplinary research projects and collaboration within the Department. Also, the fact that in the same administrative context there are both researchers and people specialized in preventive work opens up interesting possibilities for combining efforts from these two branches. Nationally, the Department is a key player in all its fields of interest. It engages in a great deal of cooperation both nationally and internationally, and among its strengths are the high-quality, regularly collected long-term data sets. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  18. The Albanian National Question and the Myth of Greater Albania

    DTIC Science & Technology

    2013-03-01

    This manuscript is submitted in partial fulfillment of the requirements of the Master of Strategic Studies Degree. The views expressed in this student ...accrediting agency recognized by the U.S. Secretary of Education and the Council for Higher Education Accreditation. The views expressed in this student ...school students , conducted by the Greek National Centre of Social Research, who were asked to rank nations according to their preferences showed

  19. Anatomy of ridge discontinuities, transform fault and overlapping spreading centre, at the slow spreading sedimented Andaman Sea Spreading Centre

    NASA Astrophysics Data System (ADS)

    Jourdain, A.; Singh, S. C.; Klinger, Y.

    2013-12-01

    Transform faults are the major discontinuities and define the main segment boundaries along spreading centres but their anatomy is poorly understood because of their complex seafloor morphology, even though they are observed at all types of spreading centres. Here, we present high-resolution seismic reflection images across the sedimented Andaman Sea Transform Fault where the sediments record the faulting and allow studying the evolution of the transform fault both in space and time. Furthermore, sediments allow the imaging of the faults down to the Moho depth that provides insight on the interplay between tectonic and magmatic processes. On the other hand, overlapping spreading centres (OSC) are small-scale discontinuities, possibly transient, and are observed only along fast or intermediate spreading centres. Exceptionally, an overlapping spreading centre is present at the slow spreading Andaman Sea Spreading Centre, which, we suggest, is due to the presence of thick sediments that hamper the efficient hydrothermal circulation allowing magma to stay much longer in the crust at different depths, and up to close to the segment ends, leading to the development of an overlapping spreading. The seismic reflection images across the OSC indicate the presence of large magma bodies in the crust. Seismic images also provide images of active faults allowing to study the link between faulting and magmatism. Interestingly, an earthquake swarm occurred at propagating limb of the OSC in 2006, after the great 2004 Andaman-Sumatra earthquake of Mw=9.3, highlighting the migration of the OSC westward. In this paper, we will show seismic reflection images and interpret these images in the light of bathymetry and earthquake data, and provide the anatomy of the ridge discontinuities along the slow spreading sedimented Andaman Sea Spreading Centre.

  20. Addiction research centres and the nurturing of creativity: The Centre for Addictions Research of British Columbia, Canada

    PubMed Central

    Stockwell, Tim; Reist, Dan; Macdonald, Scott; Benoit, Cecilia; Jansson, Mikael

    2015-01-01

    The Centre for Addictions Research of British Columbia (CARBC) was established as a multi-campus and multi-disciplinary research centre administered by the University of Victoria (UVic) in late 2003. Its core funding is provided from interest payments on an endowment of CAD$10.55 million. It is supported by a commitment to seven faculty appointments in various departments at UVic. The Centre has two offices, an administration and research office in Victoria and a knowledge exchange unit in Vancouver. The two offices are collaborating on the implementation of CARBC’s first 5-year plan which seeks to build capacity in British Columbia for integrated multi-disciplinary research and knowledge exchange in the areas substance use, addictions and harm reduction. Present challenges include losses to the endowment caused by the 2008/2009 economic crisis and difficulties negotiating faculty positions with the university administration. Despite these hurdles, to date each year has seen increased capacity for the Centre in terms of affiliated scientists, funding and staffing as well as output in terms of published reports, electronic resources and impacts on policy and practice. Areas of special research interest include: drug testing in the work-place, epidemiological monitoring, substance use and injury, pricing and taxation policies, privatization of liquor monopolies, poly-substance use, health determinants of indigenous peoples, street-involved youth and other vulnerable populations at risk of substance use problems. Further information about the Centre and its activities can be found on http://www.carbc.ca. PMID:20078479

  1. Delivery of antiretroviral treatment services in India: Estimated costs incurred under the National AIDS Control Programme.

    PubMed

    Agarwal, Reshu; Rewari, Bharat Bhushan; Shastri, Suresh; Nagaraja, Sharath Burugina; Rathore, Abhilakh Singh

    2017-04-01

    Competing domestic health priorities and shrinking financial support from external agencies necessitates that India's National AIDS Control Programme (NACP) brings in cost efficiencies to sustain the programme. In addition, current plans to expand the criteria for eligibility for antiretroviral therapy (ART) in India will have significant financial implications in the near future. ART centres in India provide comprehensive services to people living with HIV (PLHIV): those fulfilling national eligibility criteria and receiving ART and those on pre-ART care, i.e. not on ART. ART centres are financially supported (i) directly by the NACP; and (ii) indirectly by general health systems. This study was conducted to determine (i) the cost incurred per patient per year of pre-ART and ART services at ART centres; and (ii) the proportion of this cost incurred by the NACP and by general health systems. The study used national data from April 2013 to March 2014, on ART costs and non-ART costs (human resources, laboratory tests, training, prophylaxis and management of opportunistic infections, hospitalization, operational, and programme management). Data were extracted from procurement records and reports, statements of expenditure at national and state level, records and reports from ART centres, databases of the National AIDS Control Organisation, and reports on use of antiretroviral drugs. The analysis estimates the cost for ART services as US$ 133.89 (?8032) per patient per year, of which 66% (US$ 88.66, ?5320) is for antiretroviral drugs and 34% (US$ 45.23, ?2712) is for non-ART recurrent expenditure, while the cost for pre-ART care is US$ 33.05 (?1983) per patient per year. The low costs incurred for patients in ART and pre-ART care services can be attributed mainly to the low costs of generic drugs. However, further integration with general health systems may facilitate additional cost saving, such as in human resources.

  2. Energy efficiency in U.K. shopping centres

    NASA Astrophysics Data System (ADS)

    Mangiarotti, Michela

    Energy efficiency in shopping centres means providing comfortable internal environment and services to the occupants with minimum energy use in a cost-effective and environmentally sensitive manner. This research considers the interaction of three factors affecting the energy efficiency of shopping centres: i) performance of the building fabric and services ii) management of the building in terms of operation, control, maintenance and replacement of the building fabric and services, and company's energy policy iii) occupants' expectation for comfort and awareness of energy efficiency. The aim of the investigation is to determine the role of the above factors in the energy consumption and carbon emissions of shopping centres and the scope for reducing this energy usage by changing one or all the three factors. The study also attempts to prioritize the changes in the above factors that are more cost-effective at reducing that energy consumption and identify the benefits and main economic and legal drivers for energy efficiency in shopping centres. To achieve these targets, three case studies have been analysed. Using energy data from bills, the performance of the selected case studies has been assessed to establish trends and current energy consumption and carbon emissions of shopping centres and their related causes. A regression analysis has attempted to break down the energy consumption of the landlords' area by end-use to identify the main sources of energy usage and consequently introduce cost-effective measures for saving energy. A monitoring and occupants' survey in both landlords' and tenants' areas have been carried out at the same time to compare the objective data of the environmental conditions with the subjective impressions of shoppers and shopkeepers. In particular, the monitoring aimed at assessing the internal environment to identify possible causes of discomfort and opportunities for introducing energy saving measures. The survey looked at

  3. SPOT4 Management Centre

    NASA Technical Reports Server (NTRS)

    Labrune, Yves; Labbe, X.; Roussel, A.; Vielcanet, P.

    1994-01-01

    In the context of the CNES SPOT4 program CISI is particularly responsible for the development of the SPOT4 Management Centre, part of the SPOT4 ground control system located at CNES Toulouse (France) designed to provide simultaneous control over two satellites. The main operational activities are timed to synchronize with satellite visibilities (ten usable passes per day). The automatic capability of this system is achieved through agenda services (sequence of operations as defined and planned by operator). Therefore, the SPOT4 Management Centre offers limited, efficient and secure human interventions for supervision and decision making. This paper emphasizes the main system characteristics as degree of automation, level of dependability and system parameterization.

  4. The British society for gynaecological endoscopy endometriosis centres project.

    PubMed

    Saridogan, Ertan; Byrne, Dominic

    2013-01-01

    Management of advanced endometriosis frequently requires a multidisciplinary team approach and international guidelines suggest treatment in centres of expertise. Due to variability of published outcome data, prospective data collection and standardisation of reporting systems have been suggested to improve our understanding of surgical outcomes. The British Society for Gynaecological Endoscopy (BSGE) Endometriosis Centres were established to manage rectovaginal endometriosis, to collect treatment and outcome data, and to provide these data to patients, clinicians and healthcare commissioners. The BSGE Endometriosis Centres Project works on the principle of voluntary participation. Centres that would like to be recognised or accredited as a BSGE Endometriosis Centre need to fulfil a number of basic requirements including working in appropriate multidisciplinary clinical teams, auditing their outcome and having sufficient workload to maintain their surgical skills. The project has already had an impact on where the patients with advanced endometriosis are treated in the United Kingdom. Patients and healthcare professionals are becoming aware of their presence and more patients with the condition are being referred to these centres. It is also expected that the accredited centre status would be required for funding by healthcare commissioners for this type endometriosis. Copyright © 2013 S. Karger AG, Basel.

  5. Taiwanese maternal health in the postpartum nursing centre.

    PubMed

    Hung, Chich-Hsiu; Yu, Ching-Yun; Ou, Chu-Chun; Liang, Wei-Wen

    2010-04-01

    To investigate the association between postpartum stress as well as social support and the general health status of women recently discharged from postpartum nursing centres where the ritual of Tso-Yueh-Tzu is followed. Taiwanese women stay in postpartum nursing centres to take care of their newborn babies and perform the traditional Chinese ritual of Tso-Yueh-Tzu, the custom of a postpartum month-long rest. A non-experimental research design was used in the study. Two hundred and fifty-eight postpartum women who had stayed in postpartum nursing centres for at least 20 days were recruited at eight postpartum nursing centres in the Kaohsiung metropolitan area of southern Taiwan. They were administered the Hung Postpartum Stress Scale, the Social Support Scale and the Chinese Health Questionnaire. Women without minor psychiatric morbidity had higher social support, lower postpartum stress and longer length-of-stays in the postpartum care centre than women with minor psychiatric morbidity. Postpartum stress revolved around changes in body shape. A one-point increase in postpartum stress increased the likelihood that a mother would suffer minor psychiatric morbidity by 1.04 times; while giving birth to a boy decreased that likelihood by 0.51 times. This study found Tso-Yueh-Tzu as practised in postpartum nursing centres gave the postpartum women the opportunity to receive tangible support and, therefore, helped decrease postpartum stress and improved their general health. The greatest source of postpartum stress was concern over negative body changes. The postpartum nursing centre plays an important role in helping postpartum Taiwanese women observe the traditional ritual of Tso-Yueh-Tzu and in improving these women's general health. These centres may want to pay more attention to providing exercise that promotes body toning and relaxation.

  6. Dosimetric inter-institutional comparison in European radiotherapy centres: Results of IAEA supported treatment planning system audit.

    PubMed

    Gershkevitsh, Eduard; Pesznyak, Csilla; Petrovic, Borislava; Grezdo, Joseph; Chelminski, Krzysztof; do Carmo Lopes, Maria; Izewska, Joanna; Van Dyk, Jacob

    2014-05-01

    One of the newer audit modalities operated by the International Atomic Energy Agency (IAEA) involves audits of treatment planning systems (TPS) in radiotherapy. The main focus of the audit is the dosimetry verification of the delivery of a radiation treatment plan for three-dimensional (3D) conformal radiotherapy using high energy photon beams. The audit has been carried out in eight European countries - Estonia, Hungary, Latvia, Lithuania, Serbia, Slovakia, Poland and Portugal. The corresponding results are presented. The TPS audit reviews the dosimetry, treatment planning and radiotherapy delivery processes using the 'end-to-end' approach, i.e. following the pathway similar to that of the patient, through imaging, treatment planning and dose delivery. The audit is implemented at the national level with IAEA assistance. The national counterparts conduct the TPS audit at local radiotherapy centres through on-site visits. TPS calculated doses are compared with ion chamber measurements performed in an anthropomorphic phantom for eight test cases per algorithm/beam. A set of pre-defined agreement criteria is used to analyse the performance of TPSs. TPS audit was carried out in 60 radiotherapy centres. In total, 190 data sets (combination of algorithm and beam quality) have been collected and reviewed. Dosimetry problems requiring interventions were discovered in about 10% of datasets. In addition, suboptimal beam modelling in TPSs was discovered in a number of cases. The TPS audit project using the IAEA methodology has verified the treatment planning system calculations for 3D conformal radiotherapy in a group of radiotherapy centres in Europe. It contributed to achieving better understanding of the performance of TPSs and helped to resolve issues related to imaging, dosimetry and treatment planning.

  7. Causes of death in hospitalised HIV-infected patients at a National Referral Centre in Singapore: a retrospective review from 2008 to 2010.

    PubMed

    Wong, Chen Seong; Lo, Francis A; Cavailler, Philippe; Ng, Oon Tek; Lee, Cheng Chuan; Leo, Yee Sin; Chua, Arlene C

    2012-12-01

    Highly active antiretroviral therapy (HAART) has improved outcomes for individuals infected with human immunodeficiency virus (HIV). This study describes the causes of death in hospitalised HIV-positive patients from 2008 to 2010 in Tan Tock Seng Hospital, the national referral centre for HIV management in Singapore. Data were retrospectively collected from HIV-positive patients who died in Tan Tock Seng Hospital from January 2008 to December 2010. Sixty-seven deaths occurred in the study period. A majority of patients died of non-acquired immune deficiency syndrome (AIDS)-defining illnesses (54.7%). The median CD4 count was 39.5 (range, 20.0 to 97.0), and 7 patients had HIV viral loads of <200 copies/mL. There were 27 deaths due to opportunistic infections, 27 due to non AIDS-defining infections, 4 due to non AIDS-associated malignancies. This study also describes 3 deaths due to cardiovascular events, and 1 due to hepatic failure. Patients who had virologic suppression were more likely to die from non AIDS-defining causes. Causes of death in HIV-positive patients have changed in the HAART era. More research is required to further understand and address barriers to testing and treatment to further improve outcomes in HIV/AIDS.

  8. Critiquing Child-Centred Pedagogy to Bring Children and Early Childhood Educators into the Centre of a Democratic Pedagogy

    ERIC Educational Resources Information Center

    Langford, Rachel

    2010-01-01

    Child-centred pedagogy is both an enduring approach and a revered concept in Western-based teacher preparation. This article weaves together major critiques of child-centred pedagogy that draw on critical feminist, postmodernist and post-structural theories. These critiques have particular relevance for conceptualizing what it can mean to be, and…

  9. Are all metal-on-metal hip revision operations contributing to the National Joint Registry implant survival curves? : a study comparing the London Implant Retrieval Centre and National Joint Registry datasets.

    PubMed

    Sabah, S A; Henckel, J; Koutsouris, S; Rajani, R; Hothi, H; Skinner, J A; Hart, A J

    2016-01-01

    The National Joint Registry for England, Wales and Northern Ireland (NJR) has extended its scope to report on hospital, surgeon and implant performance. Data linkage of the NJR to the London Implant Retrieval Centre (LIRC) has previously evaluated data quality for hip primary procedures, but did not assess revision records. We analysed metal-on-metal hip revision procedures performed between 2003 and 2013. A total of 69 929 revision procedures from the NJR and 929 revised pairs of components from the LIRC were included. We were able to link 716 (77.1%) revision procedures on the NJR to the LIRC. This meant that 213 (22.9%) revision procedures at the LIRC could not be identified on the NJR. We found that 349 (37.6%) explants at the LIRC completed the full linkage process to both NJR primary and revision databases. Data completion was excellent (> 99.9%) for revision procedures reported to the NJR. This study has shown that only approximately one third of retrieved components at the LIRC, contributed to survival curves on the NJR. We recommend prospective registry-retrieval linkage as a tool to feedback missing and erroneous data to the NJR and improve data quality. Prospective Registry - retrieval linkage is a simple tool to evaluate and improve data quality on the NJR. ©2016 Sabah et al.

  10. Reducing cooling energy consumption in data centres and critical facilities

    NASA Astrophysics Data System (ADS)

    Cross, Gareth

    Given the rise of our everyday reliance on computers in all walks of life, from checking the train times to paying our credit card bills online, the need for computational power is ever increasing. Other than the ever-increasing performance of home Personal Computers (PC's) this reliance has given rise to a new phenomenon in the last 10 years ago. The data centre. Data centres contain vast arrays of IT cabinets loaded with servers that perform millions of computational equations every second. It is these data centres that allow us to continue with our reliance on the internet and the PC. As more and more data centres become necessary due to the increase in computing processing power required for the everyday activities we all take for granted so the energy consumed by these data centres rises. Not only are more and more data centres being constructed daily, but operators are also looking at ways to squeeze more processing from their existing data centres. This in turn leads to greater heat outputs and therefore requires more cooling. Cooling data centres requires a sizeable energy input, indeed to many megawatts per data centre site. Given the large amounts of money dependant on the successful operation of data centres, in particular for data centres operated by financial institutions, the onus is predominantly on ensuring the data centres operate with no technical glitches rather than in an energy conscious fashion. This report aims to investigate the ways and means of reducing energy consumption within data centres without compromising the technology the data centres are designed to house. As well as discussing the individual merits of the technologies and their implementation technical calculations will be undertaken where necessary to determine the levels of energy saving, if any, from each proposal. To enable comparison between each proposal any design calculations within this report will be undertaken against a notional data facility. This data facility will

  11. The value of testing multiple anatomic sites for gonorrhoea and chlamydia in sexually transmitted infection centres in the Netherlands, 2006-2010.

    PubMed

    Koedijk, F D H; van Bergen, J E A M; Dukers-Muijrers, N H T M; van Leeuwen, A P; Hoebe, C J P A; van der Sande, M A B

    2012-09-01

    National surveillance data from 2006 to 2010 of the Dutch sexually transmitted infection (STI) centres were used to analyse current practices on testing extragenital sites for chlamydia and gonorrhoea in men who have sex with men (MSM) and women. In MSM, 76.0% and 88.9% were tested at least at one extragenital site (pharyngeal and/or anorectal) for chlamydia and gonorrhoea, respectively; for women this was 20.5% and 30.2%. Testing more than one anatomic site differed by STI centre, ranging from 2% to 100%. In MSM tested at multiple sites, 63.0% and 66.5% of chlamydia and gonorrhoea diagnoses, respectively, would have been missed if screened at the urogenital site only, mainly anorectal infections. For women tested at multiple sites, the proportions of missed chlamydia and gonorrhoea diagnoses would have been 12.9% and 30.0%, respectively. Testing extragenital sites appears warranted, due to the numerous infections that would have been missed. Adding anorectal screening to urogenital screening for all MSM visiting an STI centre should be recommended. Since actual testing practices differ by centre, there is a need for clearer guidelines. Routine gonorrhoea and chlamydia screening at multiple sites in STI centres should be investigated further as this might be a more effective approach to reduce transmission than current practice.

  12. How children's rights are constructed in family-centred care: a review of the literature.

    PubMed

    Kelly, Margaret; Jones, Susan; Wilson, Val; Lewis, Peter

    2012-06-01

    It appears that the acceptance of children's rights within the acute care setting is treated as a given but such a given requires a more systematic analysis. This has been undertaken here in the form of a review of the literature. The purpose of the review is to explore how children's rights, defined by the United Nations Convention on the Rights of the Child (UNCRC) are recognized in family-centred care in the acute care paediatric setting as reported in the literature. Reports that were available from 1989 to 2010 were reviewed. Children's rights are not mentioned frequently in the literature of interest to children's nurses. What is revealed are the ethical tensions in the challenge to act at all times in children's best interests (in the spirit of Article 3) while giving due weight to their views (in the spirit of Article 12) (OHCHR, 1989). The continuing failure to address these tensions undermines the spirit and practice of family-centred care.

  13. Need and feasibility of telemedicine in non-urban day care centres.

    PubMed

    Setia, Monika; DelliFraine, Jami L

    2010-01-01

    There appear to have been no studies of telemedicine in rural day care centres. We have assessed the feasibility of using telemedicine in eight rural day care centres in Pennsylvania, from the day care centres' perspective. The average number of children in these centres was 76 (range 20-150). The centres sent an average of 4.7 children home each month because of illness. Using telephone and face-to-face interviews, we assessed their perceived need for and familiarity with telemedicine, as well as their openness and preparedness for implementing telemedicine. Most day care centres reported a need for telemedicine and were open to learning how to use it. Some centres were concerned about adequate space for the equipment, but overall, the centres felt that their resources were adequate. Telemedicine in rural day care centres appears to be feasible, and would have the potential to save time and money for parents, as well as perhaps improving health care for children in rural areas.

  14. The WMO RA VI Regional Climate Centre Network - a support to users in Europe

    NASA Astrophysics Data System (ADS)

    Rösner, S.

    2012-04-01

    Climate, like weather, has no limits. Therefore the World Meteorological Organization (WMO), a specialized United Nations organization, has established a three-level infrastructure to better serve its member countries. This structure comprises Global Producing Centres for Long-range Forecasts (GPCs), Regional Climate Centres (RCCs) and National Meteorological or Hydrometeorological Services (NMHSs), in most cases representing their countries in WMO governance bodies. The elements of this infrastructure are also part of and contribute to the Global Framework for Climate Services (GFCS) agreed to be established by World Climate Conference 3 (WCC-3) and last year's Sixteenth World Meteorological Congress (WMO Cg-XVI). RCCs are the core element of this infrastructure at the regional level and are being establish in all WMO Regional Associations (RAs), i.e. Africa (RA I); Asia (II); South America (III); North America, Central America and the Caribbean (IV); South-West Pacific (V); Europe (VI). Addressing inter-regional areas of common interest like the Mediterranean or the Polar Regions may require inter-regional RCCs. For each region the RCCs follow a user driven approach with regard to governance and structure as well as products generated for the users in the respective region. However, there are common guidelines all RCCs do have to follow. This is to make sure that services are provided based on best scientific standards, are routinely and reliably generated and made available in an operational mode. These guidelines are being developed within WMO and make use of decade-long experience gained in the business of operational weather forecast. Based on the requirements of the 50 member countries of WMO RA VI it was agreed to establish the WMO RCC as a network of centres of excellence that create regional products including long-range forecasts that support regional and national climate activities, and thereby strengthen the capacity of WMO Members in the region to

  15. The validity of a behavioural multiple-mini-interview within an assessment centre for selection into specialty training

    PubMed Central

    2014-01-01

    Background Entry into specialty training was determined by a National Assessment Centre (NAC) approach using a combination of a behavioural Multiple-Mini-Interview (MMI) and a written Situational Judgement Test (SJT). We wanted to know if interviewers could make reliable and valid decisions about the non-cognitive characteristics of candidates with the purpose of selecting them into general practice specialty training using the MMI. Second, we explored the concurrent validity of the MMI with the SJT. Methods A variance components analysis estimated the reliability and sources of measurement error. Further modelling estimated the optimal configurations for future MMI iterations. We calculated the relationship of the MMI with the SJT. Results Data were available from 1382 candidates, 254 interviewers, six MMI questions, five alternate forms of a 50-item SJT, and 11 assessment centres. For a single MMI question and one assessor, 28% of the variance between scores was due to candidate-to-candidate variation. Interviewer subjectivity, in particular the varying views that interviewer had for particular candidates accounted for 40% of the variance in scores. The generalisability co-efficient for a six question MMI was 0.7; to achieve 0.8 would require ten questions. A disattenuated correlation with the SJT (r = 0.35), and in particular a raw score correlation with the subdomain related to clinical knowledge (r = 0.25) demonstrated evidence for construct and concurrent validity. Less than two per cent of candidates would have failed the MMI. Conclusion The MMI is a moderately reliable method of assessment in the context of a National Assessment Centre approach. The largest source of error relates to aspects of interviewer subjectivity, suggesting enhanced interviewer training would be beneficial. MMIs need to be sufficiently long for precise comparison for ranking purposes. In order to justify long term sustainable use of the MMI in a postgraduate assessment centre

  16. [Cost of treatment and follow up of breast cancer: a retrospective assessment in a comprehensive cancer centre].

    PubMed

    Lilliu, Hervé; Stevens, Denise; Brun, Catherine; Morel, Julie; Pen, Claude Le; Bonastre, Julia; Bachelot, Florence; Davesne, Christian; Gentile, Annie; Hirlimann, Eric; Sabourin, Jean-Christophe; Berlie, Jacques; Rouëssé, Jacques

    2002-06-01

    Breast cancer is one of the major causes of premature death for women. Its cost management is important for both the national health insurance and the individual health care providers. The objective of this study was to assess the global medical cost of breast cancer from diagnosis to follow up in one French medical centre: centre René-Huguenin, Saint-Cloud (92). Duration of medical activities and other medical resources utilisations were collected from a retrospective cohort of 120 patients followed from January 1995 to February 2000. Unit costs were obtained from cost accounts of the Centre. The mean medical cost per patient was FF 66,067 [60,318-7,815] (USD $ 10,744 [9,809-11,679]). The mean cost varied from FF 41,875 (UDS $ 6,810) to FF 81,020 (UDS $ 13,175) depending on choice of type of therapy. The initial treatment phase was the most expensive, costing FF 48,397 [46,176-50,617] (USD $ 7,870 [7,509-8,231]) which represented 73.3% of the global cost. This study has provided an estimate of the real global cost of managing patients with breast cancer in a single French Comprehensive Cancer Centre (CLCC). The study method used is readily transposable to other treatment contexts and to other types of cancer.

  17. Spectrum of SMARCB1/INI1 Mutations in Familial and Sporadic Rhabdoid Tumors

    PubMed Central

    Eaton, Katherine W.; Tooke, Laura S.; Wainwright, Luanne M.; Judkins, Alexander R.; Biegel, Jaclyn A.

    2011-01-01

    Background Germline mutations and deletions of SMARCB1/INI1 in chromosome band 22q11.2 predispose patients to rhabdoid tumor and schwannomatosis. Previous estimates suggested that 15–20% of rhabdoid tumors were caused by an underlying germline abnormality of SMARCB1. However, these studies were limited by case selection and an inability to detect intragenic deletions and duplications. Procedure One hundred matched tumor and blood samples from patients with rhabdoid tumors of the brain, kidney, or soft tissues were analyzed for mutations and deletions of SMARCB1 by FISH, multiplex ligation-dependent probe amplification (MLPA), sequence analysis and high resolution Illumina 610K SNP based oligonucleotide array studies. Results Thirty-five of 100 patients were found to have a germline SMARCB1 abnormality. These abnormalities included point and frameshift mutations, intragenic deletions and duplications, and larger deletions including regions both proximal and distal to SMARCB1. There were 9 cases that demonstrated parent to child transmission of a mutated copy of SMARCB1. In 8 of the 9 cases, one or more family members were also diagnosed with rhabdoid tumor or schwannoma, and 2 of the 8 families presented with multiple affected children in a manner consistent with gonadal mosaicism. Conclusions Approximately one third of newly diagnosed patients with rhabdoid tumor have an underlying genetic predisposition to tumors due to a germline SMARCB1 alteration. Families may demonstrate incomplete penetrance and gonadal mosaicism, which must be considered when counseling families of patients with rhabdoid tumor. PMID:21108436

  18. A certification/accreditation model for Haemophilia Centres in Italy

    PubMed Central

    Mannucci, Pier Mannuccio; Menichini, Ivana

    2014-01-01

    Background The Italian Association of Haemophilia Centres has developed a voluntary programme of professional accreditation of Haemophilia Centres, run by its members. Participation in the programme, which aims to foster staff involvement in clinical governance, includes both medical personnel and nurses. Materials and methods Accreditation is awarded provided the candidate Haemophilia Centre is able to adhere to a pre-established set of quality standards and meet a number of clinical and organisational requirements, previously defined on the basis of evidence-based medicine. Self-evaluation is the first step in the programme, followed by a site visit by a team of peer professionals experienced in quality auditing. Results The programme has so far involved 21 Italian Haemophilia Centres. The comparison between self- and peer-evaluation revealed less discrepancies for disease-related than for organisational requirements, the latter being met to a lesser degree by most Haemophilia Centres. Discussion This programme of professional accreditation developed by the Italian Association of Haemophilia Centres has the potential to describe, monitor and improve clinical and organisational performances in the management of patients with haemophilia and allied inherited coagulation disorders. It should also be seen as a contribution to the implementation of the strategy for improving professional governance in Haemophilia Centres. PMID:24922289

  19. Reaching the Students that Student-Centred Learning Cannot Reach

    ERIC Educational Resources Information Center

    Hockings, Christine

    2009-01-01

    Student-centred learning has the potential to engage a more academically diverse student body than the more conventional teacher-centred approaches. In spite of the evidence in favour of student-centred learning, a recent study showed that it was ineffective for around 30% of undergraduates in a large and diverse group studying business operations…

  20. The effect of the National Essential Medicines Policy on health expenditures and service delivery in Chinese township health centres: evidence from a longitudinal study.

    PubMed

    Zhang, Xin; Wu, Qunhong; Liu, Guoxiang; Li, Ye; Gao, Lijun; Guo, Bin; Fu, Wenqi; Hao, Yanhua; Cui, Yu; Huang, Weidong; Coyte, Peter C

    2014-12-22

    The government of China has introduced a National Essential Medicines Policy (NEMP) in the new round of health system reform. The objective of this paper is to analyse whether the NEMP can play a role in curbing the rise of medical expenditures without disrupting the availability of healthcare services at township hospitals in China. This study adopted a pre-post treatment-control study design. A difference-in-differences method and fixed-effects model for panel data were employed to estimate the effect of the NEMP. Chongqing, Jiangsu and Henan Province, in China, in 2009 and 2010. 296 township health centres. Outcomes for health expenditures were average outpatient drug expenses per visit, average inpatient drug expenses per discharged patient, average outpatient expenses per visit and average inpatient expenses per discharged patient. Outcomes for care delivery were the numbers of visits per certified doctor per day and the numbers of hospitalised patients per certified doctor per day. The township health centres that were enrolled in the NEMP reported 26% (p<0.01) lower drug expenditures for inpatient care. An 11% (p<0.05) decrease in average inpatient expenditures per discharged patient was found following the implementation of the NEMP. The impacts of the NEMP on average outpatient expenditures and outpatient drug expenditures were not statistically significant at the 5% level. No statistically significant associations were found between the NEMP and reduction in quantity of health service delivery. The NEMP was significant in its effect in reducing inpatient medication and health service expenditures. This study shows no evidence that the quantity of healthcare service declined significantly after introduction of the NEMP over the study period, which suggests that if appropriate matching policies are introduced, the side effects of the NEMP can be counteracted to some degree. Further research including a long-term follow-up study is needed. Published by the

  1. The effect of the National Essential Medicines Policy on health expenditures and service delivery in Chinese township health centres: evidence from a longitudinal study

    PubMed Central

    Zhang, Xin; Wu, Qunhong; Liu, Guoxiang; Li, Ye; Gao, Lijun; Guo, Bin; Fu, Wenqi; Hao, Yanhua; Cui, Yu; Huang, Weidong; Coyte, Peter C

    2014-01-01

    Objectives The government of China has introduced a National Essential Medicines Policy (NEMP) in the new round of health system reform. The objective of this paper is to analyse whether the NEMP can play a role in curbing the rise of medical expenditures without disrupting the availability of healthcare services at township hospitals in China. Design This study adopted a pre–post treatment-control study design. A difference-in-differences method and fixed-effects model for panel data were employed to estimate the effect of the NEMP. Setting Chongqing, Jiangsu and Henan Province, in China, in 2009 and 2010. Participants 296 township health centres. Outcome measures Outcomes for health expenditures were average outpatient drug expenses per visit, average inpatient drug expenses per discharged patient, average outpatient expenses per visit and average inpatient expenses per discharged patient. Outcomes for care delivery were the numbers of visits per certified doctor per day and the numbers of hospitalised patients per certified doctor per day. Results The township health centres that were enrolled in the NEMP reported 26% (p<0.01) lower drug expenditures for inpatient care. An 11% (p<0.05) decrease in average inpatient expenditures per discharged patient was found following the implementation of the NEMP. The impacts of the NEMP on average outpatient expenditures and outpatient drug expenditures were not statistically significant at the 5% level. No statistically significant associations were found between the NEMP and reduction in quantity of health service delivery. Conclusions The NEMP was significant in its effect in reducing inpatient medication and health service expenditures. This study shows no evidence that the quantity of healthcare service declined significantly after introduction of the NEMP over the study period, which suggests that if appropriate matching policies are introduced, the side effects of the NEMP can be counteracted to some degree

  2. Chapter 8 Haemoglobin, ferritin and erythropoietin amongst UK adult dialysis patients in 2010: national and centre-specific analyses.

    PubMed

    Webb, Lynsey; Gilg, Julie; Wilkie, Martin

    2012-01-01

    The UK Renal Association (RA) and National Institute for Health and Clinical Excellence (NICE) have published clinical practice guidelines which include recommendations for management of anaemia in established renal failure. To determine the extent to which the guidelines for anaemia management are met in the UK. Quarterly data were obtained regarding haemoglobin (Hb) and factors that influence Hb from renal centres in England, Wales, Northern Ireland (EWNI) and the Scottish Renal Registry for the incident and prevalent renal replacement therapy (RRT) cohorts for 2010. In the UK, in 2010 53.6% of patients commenced dialysis therapy with Hb ≥ 10.0 g/dl (median Hb 10.1 g/dl). The median Hb of haemodialysis (HD) patients was 11.5 g/dl with an interquartile range (IQR) of 10.5-12.3 g/dl. Of HD patients 84.6% had Hb ≥ 10.0 g/dl. The median Hb of peritoneal dialysis (PD) patients in the UK was 11.6 g/dl (IQR 10.6-12.5 g/dl). Of UK PD patients, 87.2% had Hb ≥ 10.0 g/dl. The median ferritin in HD patients in EWNI was 444 µg/L (IQR 299-635) and 96% of HD patients had a ferritin ≥ 100 µg/L. The median ferritin in PD patients was 264 µg/L (IQR 148-426) with 86% of PD patients having a ferritin ≥ 100 µg/L. In EWNI the mean Erythropoietin Stimulating Agent (ESA) dose was higher for HD than PD patients (9,020 vs. 6,202 IU/week). Of prevalent HD patients, 52.7% had Hb ≥ 10 and ≤ 12 g/dl. Of prevalent PD patients, 54.3% had Hb 10.5-12.5 g/dl. Copyright © 2012 S. Karger AG, Basel.

  3. The United Nations Basic Space Science Initiative

    NASA Astrophysics Data System (ADS)

    Haubold, Hans; Balogh, Werner

    2014-05-01

    were held in Egypt in 2010 for Western Asia, Nigeria in 2011 for Africa, and Ecuador in 2012 for Latin America and the Caribbean. The International Center for Space Weather Science and Education at Kyushu University, Fukuoka, Japan 9www.serc.kyushu-u.ac.jp/index_e.html), was established through the basic space science initiative in 2012. Similar research and education centres were also established in Nigeria(www.cbssonline.com/aboutus.html) and India (www.cmsintl.org). Activities of basic space science initiative were also coordinated with the Regional Centres for Space Science and Technology Education, affiliated to the United Nations (www.unoosa.org/oosa/en/SAP/centres/index.html). Prospective future directions of the initiative will be discussed in this paper.

  4. European hospital managers' perceptions of patient-centred care.

    PubMed

    Taylor, Angelina; Groene, Oliver

    2015-01-01

    The spotlight has recently been placed on managers' responsibility for patient-centred care as a result of Mid Staffordshire NHS Foundation Trust failings. In previous research, clinicians reported that managers do not have an adequate structured plan for implementing patient-centred care. The purpose of this paper is to assess the perceptions of European hospital management with respect to factors affecting the implementation of a patient-centred approach. In total, 15 semi-structured interviews were conducted with hospital managers (n=10), expert country informants (n=2), patient organisations (n=2) and a user representative (n=1) from around Europe. Participants were purposively and snowball sampled. Interviews were analysed using framework analysis. Most participants felt that current levels of patient-centred care are inadequate, but accounted that there were a number of macro, meso and micro challenges they faced in implementing this approach. These included budget constraints, political and historical factors, the resistance of clinicians and other frontline staff. Organisational culture emerged as a central theme, shaped by these multi-level factors and influencing the way in which patient-centred care was borne out in the hospital. Participants proposed that the needs of patients might be better met through increasing advocacy by patient organisations and greater staff contact with patients. This study is the first of its kind to obtain management views from around Europe. It offers an insight into different models of how patient-centred care is realised by management. It indicates that managers see the value of a patient-centred approach but that they feel restricted by a number of factors at multiple levels.

  5. Policy recommendations for rare disease centres of expertise.

    PubMed

    Syed, Ahmed M; Camp, Rob; Mischorr-Boch, Christina; Houÿez, Francois; Aro, Arja R

    2015-10-01

    Rare diseases are a serious public health concern and are a priority in the EU. This study aims to develop policy recommendations for rare disease centres of expertise (CoEs) in order to improve standards and quality of care. A modified 3-round Delphi technique was used. Participants included rare diseases patients, carers, patient representatives and healthcare professionals (HCPs) from CoEs in two countries-Denmark and the UK. The results suggest the need to make improvements within current CoE environments, access to CoEs and the need for coordination and cooperation of services within and outside CoEs. It is recommended that CoEs are not overly 'medicalised', while at the same time they should be established as research facilities. The importance of including patient representatives in CoE performance management was also highlighted. Raising awareness and provision of appropriate training amongst non-specialist HCPs is seen as a priority for early and correct diagnosis and ensuring high quality care. Similarly, provision of targeted information about patients' illness and care was considered essential along with access to social assistance within CoEs. Policy recommendations were developed in areas previously recognised as having gaps. Their implementation is expected to strengthen and improve current care provision for rare disease patients. In member states where national plans and strategies are being developed, it is recommended to replicate the methodological approach used in this study as it has proven to be a helpful tool in rare disease centres of expertise policy development. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Promotion in Call Centres: Opportunities and Determinants

    ERIC Educational Resources Information Center

    Gorjup, Maria Tatiana; Valverde, Mireia; Ryan, Gerard

    2008-01-01

    Purpose: The purpose of this paper is to examine the quality of jobs in call centres by focusing on the opportunities for promotion in this sector. More specifically, the research questions focus on discovering whether promotion is common practise in the call centre sector and on identifying the factors that affect this.…

  7. Triangles with Given Distances from a Centre

    ERIC Educational Resources Information Center

    Maloo, Alok K.; Lal, Arbind K.; Singh, Arindama

    2002-01-01

    There are four Euclidean centres of a triangle--the circumcentre, the centroid, the incentre and the orthocentre. In this article, the authors prove the following: if the centre is the incentre (resp. orthocentre) then there exists a triangle with given distances of its vertices from its incentre (resp. orthocentre). They also consider uniqueness…

  8. Professional relationships between general practitioners and pharmacists in health centres.

    PubMed Central

    Harding, G; Taylor, K M

    1990-01-01

    The inclusion of pharmacies in health centres has created opportunities for general practitioners to become better acquainted with the potential contribution of pharmacists to health care. A qualitative study has been made to explore the extent to which this potential has been realized. Ten health centres with an integral pharmacy were selected, one from each of the regional health authorities in England which had at least one such health centre. Interviews were conducted with 13 general practitioners and 10 pharmacists working in the health centres. Nine general practitioners working in health centres without pharmacies and 10 community pharmacists were also interviewed. General practitioners' attitudes towards health centre pharmacists appeared to differ markedly from the attitudes of colleagues working in relative isolation from pharmacists. It appears that general practitioners working closely with the pharmacist develop a collaborative approach to health care. PMID:2271280

  9. Is a family-centred initiative a family-centred service? A case of a Conductive Education setting for children with cerebral palsy.

    PubMed

    Schenker, R; Parush, S; Rosenbaum, P; Rigbi, A; Yochman, A

    2016-11-01

    From the moment a child is diagnosed as having cerebral palsy, families have to cope on a daily basis with the multifaceted challenges of life-long disability management. Family-centred service is embraced as a 'best practice' model because of accumulating evidence supporting its positive influence on parents and children's outcomes. Nevertheless, research comparing parent and provider perspectives on family-centred practices of educational service providers in education settings is scarce. The aims of this study were to compare the extent to which parents and conductors experience the service delivery in Tsad Kadima, the Association for Conductive Education in Israel, as being family-centred, as well as comparing parents' perception of different educational settings as being family-centred. Measurements of family-centeredness, the Israeli Measure of Processes of Care for families (MPOC-20) and for service providers (MPOC-SP), were administrated to 38 teacher conductors and 83 families of children with cerebral palsy (aged 1-14), from different conductive educational settings. Parents and conductors perceive Conductive Education service as being highly family centred in most domains, rating respectful and supportive care the highest and providing general information the lowest, thus indicating an area where improvements should be made. Parents perceived the service they receive to be more family-centred than conductor's perception about their own activities. In addition, educational setting (day care, pre-school and school) was found to be associated with parent's scores. The current study, which is the first to examine family-centred service provision in a conductive special education setting, from the perspectives of both parents and conductors, provides significant evidence for high-quality services in these settings. © 2016 John Wiley & Sons Ltd.

  10. [Role of Institutional Review Boards for multi-centre studies in national health services research - a cross-sectional study of the effort to obtain secondary ethical approvals for the DACAPO study].

    PubMed

    Blecha, Sebastian; Thomann-Hackner, Kathrin; Brandstetter, Susanne; Dodoo-Schittko, Frank; Seboek, Philipp; Apfelbacher, Christian; Graf, Bernhard M; Bein, Thomas

    2015-09-01

    Health services research (HSR) is of fundamental importance for the continuous improvement of preventive, diagnostic or therapeutic measures. The conduct of multi-centre HSR studies requires that ethical approval by Institutional review boards (IRB's) is obtained. We documented the effort, the complexity and the man power necessary to obtain secondary ethical approval for a national HSR in Germany ("Surviving the Acute Respiratory Distress Syndrome" [DACAPO-study]). Having obtained a primary ethical approval by the IRB of Regensburg University, the time, correspondence, necessity for amendments, corrections, or additional costs by 34 IRB's for 64 participating study centers was documented. The complete obtainment was found to be time consuming and associated with a high workload and man power. A time span of seven month was needed to receive votes from all IRB's. The median time span was 25,5 days (25 %/75 % percentile 13 and 42 days, respectively). Requirements in terms of corrections or amendments were inhomogeneous and frequent changes were necessary. There were additional fees for secondary votes of 4328,40 €. Total costs for the study center Regensburg were 21.193,40 € (2,6 % of the grant volume). Obtaining all ethical approvals for a multi-centre observational HSR study in Germany is complex and time consuming. Various and inhomogeneous formalities may delay the plan and realization of HSR. A Homogenization and simplification of the procedure of ethics votes should be discussed. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Is "Object-Centred Neglect" a Homogeneous Entity?

    ERIC Educational Resources Information Center

    Gainotti, Guido; Ciaraffa, Francesca

    2013-01-01

    The nature of object-centred (allocentric) neglect and the possibility of dissociating it from egocentric (subject-centred) forms of neglect are controversial. Originally, allocentric neglect was described by and in patients who reproduced all the elements of a multi-object scene, but left unfinished the left side of one or more of them. More…

  12. UV LED lighting for automated crystal centring

    PubMed Central

    Chavas, Leonard M. G.; Yamada, Yusuke; Hiraki, Masahiko; Igarashi, Noriyuki; Matsugaki, Naohiro; Wakatsuki, Soichi

    2011-01-01

    A direct outcome of the exponential growth of macromolecular crystallography is the continuously increasing demand for synchrotron beam time, both from academic and industrial users. As more and more projects entail screening a profusion of sample crystals, fully automated procedures at every level of the experiments are being implemented at all synchrotron facilities. One of the major obstacles to achieving such automation lies in the sample recognition and centring in the X-ray beam. The capacity of UV light to specifically react with aromatic residues present in proteins or with DNA base pairs is at the basis of UV-assisted crystal centring. Although very efficient, a well known side effect of illuminating biological samples with strong UV sources is the damage induced on the irradiated samples. In the present study the effectiveness of a softer UV light for crystal centring by taking advantage of low-power light-emitting diode (LED) sources has been investigated. The use of UV LEDs represents a low-cost solution for crystal centring with high specificity. PMID:21169682

  13. Use of dolutegravir in two INI-experienced patients with multiclass resistance resulted in excellent virological and immunological responses

    PubMed Central

    Marije Hofstra, Laura; Nijhuis, Monique; Mudrikova, Tania; Fun, Axel; Schipper, Pauline; Schneider, Margriet; Wensing, Annemarie

    2014-01-01

    Introduction Dolutegravir is a second generation integrase inhibitor with a proposed high genetic barrier to resistance. However, in clinical trials, decreased virological response was seen in a subset of patients with prior exposure to raltegravir and multiple integrase resistance mutations. Methods We describe two cases of HIV subtype B-infected patients starting dolutegravir after previous failure on a raltegravir-containing regimen with extensive resistance. Genotypic analysis was performed using population sequencing and 454 ultradeep sequencing of integrase at time of raltegravir exposure. Results Both patients were diagnosed in early 1990s and received mono- and dual therapy, followed by several cART-regimens. Due to presence of extensive resistance, the genotypic susceptibility score of these regimens never reached a score >2 and never resulted in sustained virological suppression despite good adherence. Early 2012, the clinical condition of patient 1 worsened during persistent failure of a mega-cART regimen despite excellent drug levels. Six major PI, six minor PI, seven NRTI, six NNRTI and two INI mutations plus DM-virus were detected (Table 1). Ultra-deep sequencing of integrase showed the selection of Q148R, E138K+Q148K, and N155H variants and phenotypic raltegravir resistance was demonstrated. After addition of dolutegravir and enfuvirtide to the failing regimen (zidovudine, lamivudine, tenofovir, etravirine, darunavir/ritonavir, maraviroc), viral load (VL) decreased from 244,000 to <20 cps/mL within five months, CD4-count increased (33 to 272 mm3) and the clinical condition improved substantially. In patient 2, similar worsening of the clinical condition was observed late 2012 during persistent failure on mega-cART. Five major PI, six minor PI, nine NRTI, seven NNRTI and one INI mutation plus DM-virus were detected. Ultra-deep sequencing showed selection of N155H, followed by Q95K and V151I variants and phenotypic raltegravir resistance was

  14. Paediatric type 1 diabetes in Ireland--results of the first national audit.

    PubMed

    Hawkes, C P; Murphy, N P

    2014-04-01

    The aim of this study was to describe the services provided for children with type 1 diabetes in the Republic of Ireland, and to identify a baseline from which services and outcomes might be improved. Lead clinicians in 17 of the 19 centres providing paediatric type 1 diabetes care responded to requests for information from 2012 regarding demographics, patient numbers, diagnostics, outpatient management, multidisciplinary team resources, comorbidity screening, transition policy, clinical guidelines, and use of insulin pumps. The total number of patients attending these centres was 2518. Eight centres initiate insulin pump therapy. Insulin pump usage ranged from 0 to 42% of patients attending each centre. Self reported clinic mean haemoglobin A1c ranged from 8.2 to 9.4% (66.1 to 79.2 mmol/mol). Variation existed in guideline availability, frequency of clinic appointments, age of transition and insulin types used. We recommend a national approach to standardising and improving care for these patients.

  15. A single-centre cohort study of National Early Warning Score (NEWS) and near patient testing in acute medical admissions.

    PubMed

    Abbott, Tom E F; Torrance, Hew D T; Cron, Nicholas; Vaid, Nidhi; Emmanuel, Julian

    2016-11-01

    The utility of an early warning score may be improved when used with near patient testing. However, this has not yet been investigated for National Early Warning Score (NEWS). We hypothesised that the combination of NEWS and blood gas variables (lactate, glucose or base-excess) was more strongly associated with clinical outcome compared to NEWS alone. This was a prospective cohort study of adult medical admissions to a single-centre over 20days. Blood gas results and physiological observations were recorded at admission. NEWS was calculated retrospectively and combined with the biomarkers in multivariable logistic regression models. The primary outcome was a composite of mortality or critical care escalation within 2days of hospital admission. The secondary outcome was hospital length of stay. After accounting for missing data, 15 patients out of 322 (4.7%) died or were escalated to the critical care unit. The median length of stay was 4 (IQR 7) days. When combined with lactate or base excess, NEWS was associated with the primary outcome (OR 1.18, p=0.01 and OR 1.13, p=0.03). However, NEWS alone was more strongly associated with the primary outcome measure (OR 1.46, p<0.01). The combination of NEWS with glucose was not associated with the primary outcome. Neither NEWS nor any combination of NEWS and a biomarker were associated with hospital length of stay. Admission NEWS is more strongly associated with death or critical care unit admission within 2days of hospital admission, compared to combinations of NEWS and blood-gas derived biomarkers. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  16. Educational reform in Britain: Beyond the National Curriculum

    NASA Astrophysics Data System (ADS)

    White, John

    1990-06-01

    The essay begins with an account of why Britain introduced a National Curriculum for English and Welsh schools in 1988 in place of its previously more autonomous system. It goes on to analyse the content and aims of the National Curriculum and includes a comparison with Stalin's curriculum for schools in the USSR. An alternative to the National Curriculum is sketched out, centring around the aim of promoting personal autonomy for all. In the last part of the paper recent British experience of greater centralization and vocational orientation of the curriculum is contrasted with recent moves by the USSR State Committee on Education towards the democratization and humanization of the Soviet school system.

  17. Automatic centring and bonding of lenses

    NASA Astrophysics Data System (ADS)

    Krey, Stefan; Heinisch, J.; Dumitrescu, E.

    2007-05-01

    We present an automatic bonding station which is able to center and bond individual lenses or doublets to a barrel with sub micron centring accuracy. The complete manufacturing cycle includes the glue dispensing and UV curing. During the process the state of centring is continuously controlled by the vision software, and the final result is recorded to a file for process statistics. Simple pass or fail results are displayed to the operator at the end of the process.

  18. Centre vortex removal restores chiral symmetry

    NASA Astrophysics Data System (ADS)

    Trewartha, Daniel; Kamleh, Waseem; Leinweber, Derek B.

    2017-12-01

    The influence of centre vortices on dynamical chiral symmetry breaking is investigated through the light hadron spectrum on the lattice. Recent studies of the quark propagator and other quantities have provided evidence that centre vortices are the fundamental objects underpinning dynamical chiral symmetry breaking in {SU}(3) gauge theory. For the first time, we use the chiral overlap fermion action to study the low-lying hadron spectrum on lattice ensembles consisting of Monte Carlo, vortex-removed, and vortex-projected gauge fields. We find that gauge field configurations consisting solely of smoothed centre vortices are capable of reproducing all the salient features of the hadron spectrum, including dynamical chiral symmetry breaking. The hadron spectrum on vortex-removed fields shows clear signals of chiral symmetry restoration at light values of the bare quark mass, while at heavy masses the spectrum is consistent with a theory of weakly interacting constituent quarks.

  19. Assessment of ART centres in India: client perspectives.

    PubMed

    Sogarwal, Ruchi; Bachani, Damodar

    2009-05-01

    Drug adherence and quality of antiretroviral therapy (ART) services are the keys for the successful ART programme. Hence, an attempt has been made to assess ART centres in India from client perspectives that are receiving services from the centres. Data were gathered through exit interviews with 1366 clients from 27 ART centres that were selected on the basis of drug adherence and client load. Analyses revealed that more than 80 per cent of the clients reported overall satisfaction with the services availed from the centre and 60 per cent reported that the quality of life has improved to a great extent after getting ART. Most of the clients strongly demanded to open ART centre in each district for better access as that will increase drug adherence and eventually control the HIV progression. It has been found that as many as 14% of respondents, ever been on ART, reported non-adherence and 70% of them cited distance and economic factors as the reasons for non-adherence. Study concludes that while majority of the clients were satisfied with ART services, shortage of staff, high level of non-drug adherence, long distances and poor referring system are the weak areas requiring attention.

  20. Pushing the Child Centred Approach in Myanmar: The Role of Cross National Policy Networks and the Effects in the Classroom

    ERIC Educational Resources Information Center

    Lall, Marie

    2011-01-01

    In Myanmar schools, rote learning is the norm. International aid and education organisations based in the country have been trying to promote the child centred approach (CCA) as a much more progressive form of teaching and learning. The CCA is being rolled out principally through monastic school networks aided by international and national…

  1. Conceptual Framework for Educational Disaster Centre "save the Children Life"

    NASA Astrophysics Data System (ADS)

    Bandrova, T.; Kouteva, M.; Pashova, L.; Savova, D.; Marinova, S.

    2015-08-01

    Millions of people are affected by natural and man-made disasters each year, among which women, children, elderly persons, people with disabilities or special needs, prisoners, certain members of ethnic minorities, people with language barriers, and the impoverished are the most vulnerable population groups in case of emergencies. Many national and international organizations are involved in Early Warning and Crisis Management training, particularly focused on the special target to safe children and improve their knowledge about disasters. The success of these efforts is based on providing the specific information about disaster preparedness and emergency in adapted for children educational materials, accompanied with simple illustrative explanations for easy and fast understanding of the disasters. The active participation of the children in the educational activities through appropriate presenting the information, short training seminars and entertaining games will increase their resilience and will contribute significantly to their preparedness and adequate response in emergency situations. This paper aims to present the conceptual framework of a project for establishing an Educational Disaster Centre (EDC) "Save the children life" at University of Architecture, Civil Engineering and Geodesy (UACEG), providing relevant justification of the necessity to organize such centre in Bulgaria and discussing good practices in Europe and worldwide for children' education and training in case of disastrous event. General concepts for educational materials and children training are shared. Appropriate equipment for the EDC is shortly described.

  2. A Generic Ground Framework for Image Expertise Centres and Small-Sized Production Centres

    NASA Astrophysics Data System (ADS)

    Sellé, A.

    2009-05-01

    Initiated by the Pleiadas Earth Observation Program, the CNES (French Space Agency) has developed a generic collaborative framework for its image quality centre, highly customisable for any upcoming expertise centre. This collaborative framework has been design to be used by a group of experts or scientists that want to share data and processings and manage interfaces with external entities. Its flexible and scalable architecture complies with the core requirements: defining a user data model with no impact on the software (generic access data), integrating user processings with a GUI builder and built-in APIs, and offering a scalable architecture to fit any preformance requirement and accompany growing projects. The CNES jas given licensing grants for two software companies that will be able to redistribute this framework to any customer.

  3. External validation of the Intensive Care National Audit & Research Centre (ICNARC) risk prediction model in critical care units in Scotland.

    PubMed

    Harrison, David A; Lone, Nazir I; Haddow, Catriona; MacGillivray, Moranne; Khan, Angela; Cook, Brian; Rowan, Kathryn M

    2014-01-01

    Risk prediction models are used in critical care for risk stratification, summarising and communicating risk, supporting clinical decision-making and benchmarking performance. However, they require validation before they can be used with confidence, ideally using independently collected data from a different source to that used to develop the model. The aim of this study was to validate the Intensive Care National Audit & Research Centre (ICNARC) model using independently collected data from critical care units in Scotland. Data were extracted from the Scottish Intensive Care Society Audit Group (SICSAG) database for the years 2007 to 2009. Recoding and mapping of variables was performed, as required, to apply the ICNARC model (2009 recalibration) to the SICSAG data using standard computer algorithms. The performance of the ICNARC model was assessed for discrimination, calibration and overall fit and compared with that of the Acute Physiology And Chronic Health Evaluation (APACHE) II model. There were 29,626 admissions to 24 adult, general critical care units in Scotland between 1 January 2007 and 31 December 2009. After exclusions, 23,269 admissions were included in the analysis. The ICNARC model outperformed APACHE II on measures of discrimination (c index 0.848 versus 0.806), calibration (Hosmer-Lemeshow chi-squared statistic 18.8 versus 214) and overall fit (Brier's score 0.140 versus 0.157; Shapiro's R 0.652 versus 0.621). Model performance was consistent across the three years studied. The ICNARC model performed well when validated in an external population to that in which it was developed, using independently collected data.

  4. Psychiatric rehabilitation in community-based day centres: motivation and satisfaction.

    PubMed

    Eklund, Mona; Tjörnstrand, Carina

    2013-11-01

    This study investigated attendees' motivation and motives for participation in day centres and their satisfaction with the rehabilitation, while also addressing the influence of day centre orientation (work- or meeting-place orientation), gender and age. Ninety-three Swedish day centre attendees participated in a cross-sectional study and completed questionnaires about motivation, motives, and satisfaction with the rehabilitation. Data were analysed with non-parametric statistics. The participants were highly motivated for going to the day centre and set clear goals for their rehabilitation. Female gender, but not age, was associated with stronger motivation. The strongest motives for going to the day centre were getting structure to the day and socializing. Attendees at work-oriented day centres more often expressed that they went there to get structure to the day and gain social status. Satisfaction with the rehabilitation was high, and the most common wishes for further opportunities concerned earning money and learning new things. The rehabilitation largely seemed to meet the attendees' needs, but the findings indicated that further developments were desired, such as participation in work on the open market and more work-like occupations in the day centre, accompanied by some kind of remuneration.

  5. The cataract national data set electronic multi-centre audit of 55,567 operations: case-mix adjusted surgeon's outcomes for posterior capsule rupture.

    PubMed

    Sparrow, J M; Taylor, H; Qureshi, K; Smith, R; Johnston, R L

    2011-08-01

    To develop a methodology for case-mix adjustment of surgical outcomes for individual cataract surgeons using electronically collected multi-centre data conforming to the cataract national data set (CND). Routinely collected anonymised data were remotely extracted from electronic patient record (EPR) systems in 12 participating NHS Trusts undertaking cataract surgery. Following data checks and cleaning, analyses were carried out to risk adjust outcomes for posterior capsule rupture rates for individual surgeons, with stratification by surgical grade. A total of 406 surgeons from 12 NHS Trusts submitted data on 55,567 cataract operations between November 2001 and July 2006 (86% from January 2004). In all, 283 surgeons contributed data on >25 cases, providing 54,319 operations suitable for detailed analysis. Case-mix adjusted results of individual surgeons are presented as funnel plots for all surgeons together, and separately for three different grades of surgeon. Plots include 95 and 99.8% confidence limits around the case-mix adjusted outcomes for detection of surgical outliers. Routinely collected electronic data conforming to the CND provides sufficient detail for case-mix adjustment of cataract surgical outcomes. The validation of these risk indicators should be carried out using fresh data to confirm the validity of the risk model. Once validated this model should provide an equitable approach for peer-to-peer comparisons in the context of revalidation.

  6. Pioneering better science through the 3Rs: an introduction to the national centre for the replacement, refinement, and reduction of animals in research (NC3Rs).

    PubMed

    Burden, Natalie; Chapman, Kathryn; Sewell, Fiona; Robinson, Vicky

    2015-03-01

    The National Centre for the Replacement, Refinement, and Reduction of Animals in Research (NC3Rs) is an independent scientific organization that is based in the United Kingdom, which was set up by the government to lead the discovery and application of new technologies and approaches that minimize the use of animals in research and improve animal welfare. The NC3Rs uses a range of strategies to improve and advance science through application of the 3Rs. These include funding basic research, open innovation (CRACK IT), and programs run by inhouse scientists. We present several case studies from the NC3Rs portfolio, featuring asthma research, the use of nonhuman primates in monoclonal antibody development, and CRACK IT. Finally, we anticipate the future, as we use our experience to move into new research fields and expand toward international collaboration. Here we highlight how equipping scientists with relevant and emerging 3Rs tools can help overcome the challenges and limitations of the use of animals in research to the benefit of the whole bioscience community.

  7. Pioneering Better Science through the 3Rs: An Introduction to the National Centre for the Replacement, Refinement, and Reduction of Animals in Research (NC3Rs)

    PubMed Central

    Burden, Natalie; Chapman, Kathryn; Sewell, Fiona; Robinson, Vicky

    2015-01-01

    The National Centre for the Replacement, Refinement, and Reduction of Animals in Research (NC3Rs) is an independent scientific organization that is based in the United Kingdom, which was set up by the government to lead the discovery and application of new technologies and approaches that minimize the use of animals in research and improve animal welfare. The NC3Rs uses a range of strategies to improve and advance science through application of the 3Rs. These include funding basic research, open innovation (CRACK IT), and programs run by inhouse scientists. We present several case studies from the NC3Rs portfolio, featuring asthma research, the use of nonhuman primates in monoclonal antibody development, and CRACK IT. Finally, we anticipate the future, as we use our experience to move into new research fields and expand toward international collaboration. Here we highlight how equipping scientists with relevant and emerging 3Rs tools can help overcome the challenges and limitations of the use of animals in research to the benefit of the whole bioscience community. PMID:25836967

  8. White-centred retinal haemorrhages (Roth spots).

    PubMed

    Ling, R; James, B

    1998-10-01

    Roth spots (white-centred retinal haemorrhages) were classically described as septic emboli lodged in the retina of patients with subacute bacterial endocarditis. Indeed many have considered Roth spots pathognomonic for this condition. More recent histological evidence suggests, however, that they are not foci of bacterial abscess. Instead, they are nonspecific and may be found in many other diseases. A review of the histology and the pathogenesis of these white-centred haemorrhages will be provided, along with the work-up of the differential diagnosis.

  9. Profil épidémio-clinique des dermatoses chez les enfants vus en consultation dermatologique dans le service de dermatologie du centre national d’appui à la lutte contre la maladie à Bamako (Mali)

    PubMed Central

    Fofana, Youssouf; Traore, Bekaye; Dicko, Adama; Faye, Ousmane; Berthe, Siritio; Cisse, Lamissa; Keita, Alimata; Tall, Koureissi; Kone, Mamadou Bakary; Keita, Somita

    2016-01-01

    Introduction Les maladies de peau constituent un problème majeur de santé publique dans les pays en voie développement. En pratique courante les enfants représentent la couche sociale la plus touchée. Le but de notre travail était de décrire les aspects épidémio- cliniques des dermatoses chez les enfants de 0-15 ans dans le service de dermatologie du centre national d’appui à la lutte contre la maladie à Bamako, Mali. Méthodes Il s’agissait d’une étude transversale effectuée au cours de la période allant du premier janvier 2009 au 31 Décembre 2009 dans le service de Dermato-vénérologie du centre national d’appui à la lutte contre la maladie. Sur un total de 16339 patients ayant fait une consultation dermatologique 5149 enfants ont été inclus. Résultats La fréquence hospitalière des dermatoses infantiles était de 31,51%. Les malades se répartissaient en 2838 garçons (55,10%) et 2311 filles (44,90%) soit un sex-ratio de 1,22. L’âge des malades variait de 03 jours à 15 ans avec une moyenne d’âge de 8±5,7 ans. Parmi les affections retrouvées les dermatoses infectieuses représentaient 55,10% de l’ensemble des dermatoses, les dermatoses immuno-allergiques (32,5%), les dermatoses inflammatoires (11,85%). Conclusion Notre étude a révélé l’importance des pathologies infectieuses et immuno-allergiques et la nécessité de mener des actions de prévention simple comme l’hygiène, l’achat d’une tondeuse pour chaque enfant. PMID:28293354

  10. Family-centred care delivery

    PubMed Central

    Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

    2013-01-01

    Abstract Objective To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Design Cross-sectional study. Setting Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. Participants A total of 137 practices, 363 providers, and 5144 patients. Main outcome measures Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Results Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Conclusion Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC. PMID:24235195

  11. Subjective experience or objective process: understanding the gap between values and practice for involving patients in designing patient-centred care.

    PubMed

    Lord, Laura; Gale, Nicola

    2014-01-01

    Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve "patient-centred" care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK. Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method. While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organizational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system. Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice. The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

  12. Pesticide poisoning trend analysis of 13 years: a retrospective study based on telephone calls at the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi.

    PubMed

    Peshin, Sharda Shah; Srivastava, Amita; Halder, Nabanita; Gupta, Yogendra Kumar

    2014-02-01

    The study was designed to analyze the incidence and pattern of pesticide poisoning calls reported to the National Poisons Information Centre (NPIC), AIIMS, New Delhi and highlight the common classes of pesticides involved in poisoning. The telephone calls received by the Centre during the thirteen year period (1999-2012) were entered into a preset proforma and then into a retrievable database. A total of 4929 calls of pesticide poisoning were recorded. The data was analyzed with respect to age, gender, mode and type of poisoning. The age ranged from 1 to 65 years with the preponderance of males (M = 62.19%, F = 37.80%). The age group mainly involved in poisoning was 18-35 years. While 59.38% calls pertained to household pesticides, 40.61% calls related to agricultural pesticides. The common mode of poisoning was intentional (64.60%) followed by accidental (34.40%) and unknown (1%). Amongst the household pesticides, the highest number of calls were due to pyrethroids (26.23%) followed by rodenticides (17.06%), organophosphates (6.26%), carbamates (4.95%) and others (4.86%). In agricultural pesticides group, the organophosphates (9.79%) ranked the first followed by, aluminium phosphide (9.65%), organochlorines (9.31%), pyrethroids (3.87%), herbicides, weedicides and fungicides (3.20%), ethylene dibromide (2.82%), and others (1.70%). The data analysis shows a high incidence of poisoning due to household pesticides as compared to agricultural pesticides, clearly emphasizing the need for creating awareness and education about proper use and implementation of prevention programmes. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  13. Centre vortex removal restores chiral symmetry

    DOE PAGES

    Trewartha, Daniel; Kamleh, Waseem; Leinweber, Derek B.

    2017-11-15

    The influence of centre vortices on dynamical chiral symmetry breaking is investigated through the light hadron spectrum on the lattice. Recent studies of the quark propagator and other quantities have provided evidence that centre vortices are the fundamental objects underpinning dynamical chiral symmetry breaking in SU(3) gauge theory. For the first time, we use the chiral overlap fermion action to study the low-lying hadron spectrum on lattice ensembles consisting of Monte Carlo, vortex-removed, and vortex-projected gauge fields. We find that gauge field configurations consisting solely of smoothed centre vortices are capable of reproducing all the salient features of the hadronmore » spectrum, including dynamical chiral symmetry breaking. In conclusion, the hadron spectrum on vortex-removed fields shows clear signals of chiral symmetry restoration at light values of the bare quark mass, while at heavy masses the spectrum is consistent with a theory of weakly-interacting constituent quarks.« less

  14. Cold chain status at immunisation centres in Ethiopia.

    PubMed

    Berhane, Y; Demissie, M

    2000-09-01

    Child immunisation is among the most cost-effective ways of preventing premature child deaths, and the potency of vaccines, crucial for vaccine efficacy, is dependent on effective management of the cold chain at all levels of vaccine handling. To assess the status of the cold chain at peripheral vaccine stores in Ethiopia. Institution based cross-sectional survey in two rural and one urban administrative areas were included in the study. Sixty seven health institutions providing static vaccination services were included in the study but cold chain system was assessed fully in only sixty four. Data were collected by interviewing health workers and by directly observing the cold chain equipment and records using structured forms. Conditions of the cold chain system were described based on 64 of the 67 centres visited, three were excluded because of non-functioning cold chain. Complete temperature record was observed in 37 (57.8%) of the centres. Thermometer was not available in four (6.3%) and thermometer reading was found to be outside the optimal range in another seven (10.9%) centres. Vaccine storage in the refrigerator was not proper in 47 (73.4%) centres. Majority of the centres had neither trained personnel nor budget for maintenance of the cold chain. There is a real danger of vaccines losing their potency at these centres even if they were potent on arrival. Relevant training for those handling the cold chain, improving the maintenance conditions of refrigerators and introduction of cold chain monitoring devises are recommended.

  15. Effect of patient choice and hospital competition on service configuration and technology adoption within cancer surgery: a national, population-based study.

    PubMed

    Aggarwal, Ajay; Lewis, Daniel; Mason, Malcolm; Purushotham, Arnie; Sullivan, Richard; van der Meulen, Jan

    2017-11-01

    There is a scarcity of evidence about the role of patient choice and hospital competition policies on surgical cancer services. Previous evidence has shown that patients are prepared to bypass their nearest cancer centre to receive surgery at more distant centres that better meet their needs. In this national, population-based study we investigated the effect of patient mobility and hospital competition on service configuration and technology adoption in the National Health Service (NHS) in England, using prostate cancer surgery as a model. We mapped all patients in England who underwent radical prostatectomy between Jan 1, 2010, and Dec 31, 2014, according to place of residence and treatment location. For each radical prostatectomy centre we analysed the effect of hospital competition (measured by use of a spatial competition index [SCI], with a score of 0 indicating weakest competition and 1 indicating strongest competition) and the effect of being an established robotic radical prostatectomy centre at the start of 2010 on net gains or losses of patients (difference between number of patients treated in a centre and number expected based on their residence), and the likelihood of closing their radical prostatectomy service. Between Jan 1, 2010, and Dec 31, 2014, 19 256 patients underwent radical prostatectomy at an NHS provider in England. Of the 65 radical prostatectomy centres open at the start of the study period, 23 (35%) had a statistically significant net gain of patients during 2010-14. Ten (40%) of these 23 were established robotic centres. 37 (57%) of the 65 centres had a significant net loss of patients, of which two (5%) were established robotic centres and ten (27%) closed their radical prostatectomy service during the study period. Radical prostatectomy centres that closed were more likely to be located in areas with stronger competition (highest SCI quartile [0·87-0·92]; p=0·0081) than in areas with weaker competition. No robotic surgery centre

  16. The Role of Science Centres and Planetariums

    NASA Astrophysics Data System (ADS)

    Lomb, Nick

    Science centres planetariums and similar places such as visitor centres and public observatories have an essential role to play in school education. Even in states where astronomy is in the curriculum teachers often have a limited knowledge of the subject. Consequently they are happy to bring their students to a place where they can be instructed by professional astronomy educators. Where astronomy is not on the curriculum the centres provide teachers with the opportunity of using the appeal of astronomy to excite students about science. In this paper we will look at a number of examples of what science centres and planetariums provide to school students. Sydney Observatory is open for school visits throughout each school term. Visits are highly structured making use of all the facilities of the observatory in informing the students and exciting them about astronomy. Facilities available include a new interactive 3-D theatre a very small planetarium modern and historic telescopes an exhibition and a lecture room. A planetarium is an invaluable resource for teaching and stimulating the interest of students. Australian planetariums include ones in Melbourne Canberra and Launceston. Some of their experiences in reaching school audiences will be discussed.

  17. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

    ERIC Educational Resources Information Center

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2012-01-01

    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  18. Using drama to improve person-centred dementia care.

    PubMed

    Kontos, Pia C; Mitchell, Gail J; Mistry, Bhavnita; Ballon, Bruce

    2010-06-01

    We implemented a 12-week drama-based educational intervention to introduce to dementia practitioners person-centred care that emphasizes the notion of embodied selfhood (defined as non-verbal self-expression). Person-centred dementia care guidelines emphasize the assessment of individual needs, and where appropriate, the use of non-pharmacological interventions before resorting to pharmacological management. However, dementia care is not consistent with these guidelines suggesting conceptual limitations and reliance on passive knowledge translation strategies. Focus groups and semi-structured interviews with practitioners (n = 24) in two nursing homes in central Canada were undertaken to assess the effectiveness of the drama-based components of the intervention. Our findings suggest that drama was effective as an educational modality, and helped implement the person-centred approach into practice. Significant practice outcomes included: new awareness that residents' body movements and dispositions can convey meaning; seeking biographical information from families; increased time efficiency; and supporting residents' independence. Our findings make an important contribution to person-centred dementia care by broadening the notion of personhood, and by facilitating implementation using drama. As an enhancement of person-centred care, the support of embodied selfhood may significantly improve residents' quality of life, quality of care, and practitioners' care-giving experience. © 2010 Blackwell Publishing Ltd.

  19. Tests for qualitative treatment-by-centre interaction using a 'pushback' procedure.

    PubMed

    Ciminera, J L; Heyse, J F; Nguyen, H H; Tukey, J W

    1993-06-15

    In multicentre clinical trials using a common protocol, the centres are usually regarded as being a fixed factor, thus allowing any treatment-by-centre interaction to be omitted from the error term for the effect of treatment. However, we feel it necessary to use the treatment-by-centre interaction as the error term if there is substantial evidence that the interaction with centres is qualitative instead of quantitative. To make allowance for the estimated uncertainties of the centre means, we propose choosing a reference value (for example, the median of the ordered array of centre means) and converting the individual centre results into standardized deviations from the reference value. The deviations are then reordered, and the results 'pushed back' by amounts appropriate for the corresponding order statistics in a sample from the relevant distribution. The pushed-back standardized deviations are then restored to the original scale. The appearance of opposite signs among the destandardized values for the various centres is then taken as 'substantial evidence' of qualitative interaction. Procedures are presented using, in any combination: (i) Gaussian, or Student's t-distribution; (ii) order-statistic medians or outward 90 per cent points of the corresponding order statistic distributions; (iii) pooling or grouping and pooling the internally estimated standard deviations of the centre means. The use of the least conservative combination--Student's t, outward 90 per cent points, grouping and pooling--is recommended.

  20. The oral food desensitization in the Italian allergy centres.

    PubMed

    Meglio, P; Caminiti, L; Pajno, G B; Dello Iacono, I; Tripodi, S; Verga, M C; Martelli, A

    2015-05-01

    Attempts aimed at inducing food tolerance through oral food desensitization (OFD) for the treatment of IgE-mediated food allergies are increasing. In Italy, a number of allergy centres offer this procedure. To collect information on how these centres are organized, how patients are selected, the methods used to administer OFD and how adverse reactions are managed. A questionnaire was e-mailed to all the Italian allergy centres offering OFD. The survey shows a high degree of variability between centres. A correct diagnosis of food allergy is crucial for selecting patients for OFD. In the Italian allergy centres, oral food challenges are mostly open label (84%), but in 16% of cases they are single-blind (8%) or double-blind (8%). A high proportion of allergy centres (83%) offer OFD to children presenting forms of anaphylaxis triggered by traces--or very low doses--of food allergen. The majority of allergy centres (76%) enroll patients over 3 years of age, with 44% enrolling patients above the age of 5. Not-controlled asthma, unreliability of parents in the management of OFD and/or risk of adverse events, are the main reasons for exclusion from the procedure. Although OFD may sometimes be successful and may be considered a valid alternative to an elimination diet, further randomized controlled trials are needed, in order to clarify some controversial points, such as the characteristics of the child undergoing OFD, and the methods of food preparation and administration. Moreover, further studies should further investigate OFD safety, efficacy and costs.

  1. The National Blood Service. Supporting better blood transfusion.

    PubMed

    Gerrard, Rebecca

    2004-05-01

    The National Blood Service (NBS) is an integral part of the National Health Service that provides blood, blood components, blood products and tissues from fifteen blood centres to England and North Wales. Each year, the NBS collects tests, processes, stores and issues approximately 2.3 million blood donations. The service also undertakes research into blood safety, provides clinical advice to hospital staff and supports hospital transfusion practitioners. Rebecca Gerrard describes some of the initiatives to improve blood transfusion practices, including monitoring of the serious hazards of transfusion, bench marking schemes and the roles of blood transfusion liaison (BTL) nurses.

  2. Molecular cloning, expression analysis and functional characterization of interleukin-22 in So-iny mullet, Liza haematocheila.

    PubMed

    Qi, Zhitao; Zhang, Qihuan; Wang, Zisheng; Zhao, Weihong; Chen, Shannan; Gao, Qian

    2015-02-01

    In the present study, interleukin-22 (IL-22) from So-iny mullet (Liza haematocheila) was identified, and its tissue expression in both healthy and Streptococcus dysgalactiae-infected fish was examined. The full length cDNA sequence of mullet IL-22 was 1070bp, containing an open reading frame of 555bp. The deduced amino acid sequence shared high similarity (45.1-67.9%) with IL-22 from other fish species. Mullet IL-22 also contained an IL-10 family signature and four cysteine residues that were well conserved in other vertebrate IL-22 molecules. Mullet IL-22 mRNA was highly expressed in kidney, moderately expressed in liver and gut, and relatively weakly expressed in spleen, and its expression was significantly up-regulated in all the examined tissues following S. dysgalactiae infection. Furthermore, recombinant mullet IL-22 protein was shown to promote the expression of β-defensin in the four tissues and to increase the survival rate of the fish infected with S. dysgalactiae. Our results suggest mullet IL-22 plays an important role in the immune defense against bacterial infection and has the potential to be used to treat bacterial diseases in fish. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Optimizing Data Centre Energy and Environmental Costs

    NASA Astrophysics Data System (ADS)

    Aikema, David Hendrik

    Data centres use an estimated 2% of US electrical power which accounts for much of their total cost of ownership. This consumption continues to grow, further straining power grids attempting to integrate more renewable energy. This dissertation focuses on assessing and reducing data centre environmental and financial costs. Emissions of projects undertaken to lower the data centre environmental footprints can be assessed and the emission reduction projects compared using an ISO-14064-2-compliant greenhouse gas reduction protocol outlined herein. I was closely involved with the development of the protocol. Full lifecycle analysis and verifying that projects exceed business-as-usual expectations are addressed, and a test project is described. Consuming power when it is low cost or when renewable energy is available can be used to reduce the financial and environmental costs of computing. Adaptation based on the power price showed 10--50% potential savings in typical cases, and local renewable energy use could be increased by 10--80%. Allowing a fraction of high-priority tasks to proceed unimpeded still allows significant savings. Power grid operators use mechanisms called ancillary services to address variation and system failures, paying organizations to alter power consumption on request. By bidding to offer these services, data centres may be able to lower their energy costs while reducing their environmental impact. If providing contingency reserves which require only infrequent action, savings of up to 12% were seen in simulations. Greater power cost savings are possible for those ceding more control to the power grid operator. Coordinating multiple data centres adds overhead, and altering at which data centre requests are processed based on changes in the financial or environmental costs of power is likely to increase this overhead. Tests of virtual machine migrations showed that in some cases there was no visible increase in power use while in others power use

  4. The development of integrated service centre system for professional teachers empowerment in North Sumatera

    NASA Astrophysics Data System (ADS)

    Gultom, S.; Simanjorang, M. M.; Muchtar, Z.; Mansyur, A.

    2018-03-01

    Based on Act number 12 in year 2012 the function of higher education is related to individual, social community, knowledge and technology development. Hence, higher education providers need to think and develop policies in order to improve their service and fulfil the higher education function. As part of the effort to fulfil its function Universitas Negeri Medan (Unimed), which historically was a pre-service teacher training institute, should has a special interest on improving teachers’ professionalism. The Act number 14 in year 2005 described requirements for professional teacher, including academic qualification and set of competencies possessed by the teacher. The Act also guaranties teachers’ right to have opportunities for improving their competencies and academic qualification through training and other professionalism development programme. The question is how this guarantee can be implemented. In order to answer this question a developmental study has been done which aimed on developing an integrated service centre system for professional teachers empowerment. As the name implies, this integrated service centre system is expected to be a real manifestation of Unimed’s support towards the improvement of professional teachers quality, which in the end will boils down to the improvement of national education services quality. The result of this study is an integrated service centre system for professional teachers empowerment that fulfils the professionalism principles described in the Act number 14 in year 2005, which has been developed by considering problems faced by and also supports needed by teachers post certification programme.

  5. Power, empowerment, and person-centred care: using ethnography to examine the everyday practice of unregistered dementia care staff.

    PubMed

    Scales, Kezia; Bailey, Simon; Middleton, Joanne; Schneider, Justine

    2017-02-01

    The social positioning and treatment of persons with dementia reflects dominant biomedical discourses of progressive and inevitable loss of insight, capacity, and personality. Proponents of person-centred care, by contrast, suggest that such loss can be mitigated within environments that preserve rather than undermine personhood. In formal organisational settings, person-centred approaches place particular responsibility on 'empowered' direct-care staff to translate these principles into practice. These staff provide the majority of hands-on care, but with limited training, recognition, or remuneration. Working within a Foucauldian understanding of power, this paper examines the complex ways that dementia care staff engage with their own 'dis/empowerment' in everyday practice. The findings, which are drawn from ethnographic studies of three National Health Service (NHS) wards and one private care home in England, are presented as a narrative exploration of carers' general experience of powerlessness, their inversion of this marginalised subject positioning, and the related possibilities for action. The paper concludes with a discussion of how Foucault's understanding of power may help define and enhance efforts to empower direct-care staff to provide person-centred care in formal dementia care settings. © 2016 Foundation for the Sociology of Health & Illness.

  6. The National Ignition Facility: the path to a carbon-free energy future.

    PubMed

    Stolz, Christopher J

    2012-08-28

    The National Ignition Facility (NIF), the world's largest and most energetic laser system, is now operational at Lawrence Livermore National Laboratory. The NIF will enable exploration of scientific problems in national strategic security, basic science and fusion energy. One of the early NIF goals centres on achieving laboratory-scale thermonuclear ignition and energy gain, demonstrating the feasibility of laser fusion as a viable source of clean, carbon-free energy. This talk will discuss the precision technology and engineering challenges of building the NIF and those we must overcome to make fusion energy a commercial reality.

  7. The difference in centre position in the ACL femoral footprint inclusive and exclusive of the fan-like extension fibres.

    PubMed

    Iriuchishima, Takanori; Ryu, Keinosuke; Aizawa, Shin; Fu, Freddie H

    2016-01-01

    The purpose of this study was to compare the centre position of each anterior cruciate ligament bundle in its femoral footprint in measurements including and excluding the fan-like extension fibres. Fourteen non-paired human cadaver knees were used. All soft tissues around the knee were resected except the ligaments. The ACL was divided into antero-medial (AM) and postero-lateral (PL) bundles according to the difference in tension patterns. The ACL was carefully dissected, and two outlines were made of the periphery of each bundle insertion site: those which included and those which excluded the fan-like extension fibres. An accurate lateral view of the femoral condyle was photographed with a digital camera, and the images were downloaded to a personal computer. The centre position of each bundle, including and excluding the fan-like extension fibres, was measured with ImageJ software (National Institution of Health). Evaluation of the centre position was performed using the modified quadrant method. The centre of the femoral AM bundle including the fan-like extension was located at 28.8% in a shallow-deep direction and 37.2% in a high-low direction. When the AM bundle was evaluated without the fan-like extension, the centre was significantly different at 34.6% in a shallow-deep direction (p = 0.000) and 36% in a high-low direction. The centre of the PL bundle including the fan-like extension was found at 37.1% in a shallow-deep direction and 73.4% in a high-low direction. When the PL bundle was evaluated without the fan-like extension, the centre was significantly different at 42.7% in a shallow-deep direction (p = 0.000) and 69.3% in a high-low direction (p = 0.000). The centre position of the AM and PL bundles in the femoral ACL footprint was significantly different depending on the inclusion or exclusion of the fan-like extension fibres. For the clinical relevance, to reproduce the direct femoral insertion in the anatomical ACL reconstruction, tunnels should be

  8. White-centred retinal haemorrhages (Roth spots).

    PubMed Central

    Ling, R.; James, B.

    1998-01-01

    Roth spots (white-centred retinal haemorrhages) were classically described as septic emboli lodged in the retina of patients with subacute bacterial endocarditis. Indeed many have considered Roth spots pathognomonic for this condition. More recent histological evidence suggests, however, that they are not foci of bacterial abscess. Instead, they are nonspecific and may be found in many other diseases. A review of the histology and the pathogenesis of these white-centred haemorrhages will be provided, along with the work-up of the differential diagnosis. Images Figure 1 Figure 2 PMID:10211348

  9. Design Considerations for an Intensive Autism Treatment Centre

    ERIC Educational Resources Information Center

    Deochand, Neil; Conway, Alissa A.; Fuqua, R. Wayne

    2015-01-01

    Individuals with autistic spectrum disorder (ASD) who display severe and challenging behaviour sometimes require centre-based intensive applied behaviour analysis (ABA) therapy to meet their health, safety and educational needs. Unfortunately, despite the need for centre-based treatment, there is a paucity of empirical research on building and…

  10. A Survey on Evaluation Practices in Teaching and Learning Centres

    ERIC Educational Resources Information Center

    Kolomitro, Klodiana; Anstey, Lauren M.

    2017-01-01

    There is general consensus that teaching and learning centres have a positive impact on promoting and supporting a culture that values teaching and learning, yet there is limited evidence on how centres evaluate their work. For this purpose, a survey was developed and administered to the directors of 88 Canadian centres; 46 of which completed the…

  11. Six essential roles of health promotion research centres: the Atlantic Canada experience

    PubMed Central

    Langille, Lynn L.; Crowell, Sandra J.; Lyons, Renée F.

    2009-01-01

    SUMMARY Over the past 20 years, the federal government and universities across Canada have directed resources towards the development of university-based health promotion research centres. Researchers at health promotion research centres in Canada have produced peer-reviewed papers and policy documents based on their work, but no publications have emerged that focus on the specific roles of the health promotion research centres themselves. The purpose of this paper is to propose a framework, based on an in-depth examination of one centre, to help identify the unique roles of health promotion research centres and to clarify the value they add to promoting health and advancing university goals. Considering the shifting federal discourse on health promotion over time and the vulnerability of social and health sciences to changes in research funding priorities, health promotion research centres in Canada and elsewhere may need to articulate their unique roles and contributions in order to maintain a critical focus on health promotion research. The authors briefly describe the Atlantic Health Promotion Research Centre (AHPRC), propose a framework that illustrates six essential roles of health promotion research centres and describe the policy contexts and challenges of health promotion research centres. The analysis of research and knowledge translation activities over 15 years at AHPRC sheds light on the roles that health promotion research centres play in applied research. The conclusion raises questions regarding the value of university-based research centres and challenges to their sustainability. PMID:19171668

  12. Clarifying the role of mean centring in multicollinearity of interaction effects.

    PubMed

    Shieh, Gwowen

    2011-11-01

    Moderated multiple regression (MMR) is frequently employed to analyse interaction effects between continuous predictor variables. The procedure of mean centring is commonly recommended to mitigate the potential threat of multicollinearity between predictor variables and the constructed cross-product term. Also, centring does typically provide more straightforward interpretation of the lower-order terms. This paper attempts to clarify two methodological issues of potential confusion. First, the positive and negative effects of mean centring on multicollinearity diagnostics are explored. It is illustrated that the mean centring method is, depending on the characteristics of the data, capable of either increasing or decreasing various measures of multicollinearity. Second, the exact reason why mean centring does not affect the detection of interaction effects is given. The explication shows the symmetrical influence of mean centring on the corrected sum of squares and variance inflation factor of the product variable while maintaining the equivalence between the two residual sums of squares for the regression of the product term on the two predictor variables. Thus the resulting test statistic remains unchanged regardless of the obvious modification of multicollinearity with mean centring. These findings provide a clear understanding and demonstration on the diverse impact of mean centring in MMR applications. ©2011 The British Psychological Society.

  13. Regionally acquired intestinal failure data suggest an underestimate in national service requirements.

    PubMed

    Barclay, A R; Paxton, C E; Gillett, P; Hoole, D; Livingstone, J; Young, D; Menon, G; Munro, F; Wilson, D C

    2009-12-01

    OBJECTIVES, SETTING AND PATIENTS: With complete case referral for prolonged parenteral nutrition (PN) beyond term equivalent, serving a stable population of 1.25 million people, we describe the long-term outcome and survival of patients referred to an intestinal failure (IF) nutrition support team over the first 8 years of existence at a regional paediatric centre, and extrapolate to potential numbers of national home parenteral nutrition (HPN) cases and intestinal transplantation data. Retrospective analysis detailing patient demographics, interventions, use of HPN, occurrence of intestinal failure-associated liver disease (IFALD), and outcomes of enteral adaptation, survival, and referral for and receipt of organ transplantation. 23 patients were referred over 8 years, 20 being PN dependent within the neonatal period. Diagnoses included short bowel syndrome (SBS) (18), neuromuscular abnormalities (4) and congenital enterocyte disorder (1). 12 696 days of PN were delivered with 314 confirmed episodes of sepsis at a median of 12 episodes per patient. 144 central venous catheters (CVCs) were required at a median of four per patient. IFALD occurred in 17 (73%) patients, with 10 (44%) referred for transplant assessment. Thirteen (56%) children received HPN. Overall mortality was 44%. A significant predictor for survival in the SBS group was residual bowel >40 cm (82% vs 28%, p = 0.049). Survival for IF at 56% was lower than reported from non-UK supra-regional centres, and nationally collected data, possibly reflecting pre-selected referral populations. Data from regional centres with complete ascertainment may be important both when counselling parents and when planning regional and national HPN and IF specialist services.

  14. Implementing Responsibility Centre Budgeting

    ERIC Educational Resources Information Center

    Vonasek, Joseph

    2011-01-01

    Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

  15. Vocational Centres in Fiji Schools: A Needs Analysis

    ERIC Educational Resources Information Center

    McBeath, Clare

    2005-01-01

    A needs analysis was conducted into the issues facing the Technical and Vocational Education sector in Fiji. Vocational Centre teachers, Principals and an Education Officer were interviewed, and their responses analysed. The survey pointed to the difficulties currently experienced by the Vocational Centres in the face of poor facilities and…

  16. Recognizing a Centre of Excellence in Ontario's Colleges

    ERIC Educational Resources Information Center

    Litwin, Jeffrey M.

    2012-01-01

    The term "Centre of Excellence" is increasingly used by Ontario's colleges with the expectation of portraying a superior level of proficiency, expertise, or investment in a particular academic discipline or program cluster. This paper proposes that the term Centre of Excellence should have a clearer definition so that when one of…

  17. Determining requirements for patient-centred care: a participatory concept mapping study.

    PubMed

    Ogden, Kathryn; Barr, Jennifer; Greenfield, David

    2017-11-28

    Recognition of a need for patient-centred care is not new, however making patient-centred care a reality remains a challenge to organisations. We need empirical studies to extend current understandings, create new representations of the complexity of patient-centred care, and guide collective action toward patient-centred health care. To achieve these ends, the research aim was to empirically determine what organisational actions are required for patient-centred care to be achieved. We used an established participatory concept mapping methodology. Cross-sector stakeholders contributed to the development of statements for patient-centred care requirements, sorting statements into groupings according to similarity, and rating each statement according to importance, feasibility, and achievement. The resultant data were analysed to produce a visual concept map representing participants' conceptualisation of patient-centred care requirements. Analysis included the development of a similarity matrix, multidimensional scaling, hierarchical cluster analysis, selection of the number of clusters and their labels, identifying overarching domains and quantitative representation of rating data. The outcome was the development of a conceptual map for the Requirements of Patient-Centred Care Systems (ROPCCS). ROPCCS incorporates 123 statements sorted into 13 clusters. Cluster labels were: shared responsibility for personalised health literacy; patient provider dynamic for care partnership; collaboration; shared power and responsibility; resources for coordination of care; recognition of humanity - skills and attributes; knowing and valuing the patient; relationship building; system review evaluation and new models; commitment to supportive structures and processes; elements to facilitate change; professional identity and capability development; and explicit education and learning. The clusters were grouped into three overarching domains, representing a cross-sectoral approach

  18. Paediatric ECMO at low-volume paediatric cardiac centres in the Nordic countries.

    PubMed

    Veien, M; Lindberg, L; Tynkkynen, P; Ravn, H B

    2015-03-01

    Extracorporeal membrane oxygenation (ECMO) is a life-saving resource-intensive technology for patients with respiratory and/or circulatory failure. We aimed to evaluate outcome data from three Nordic paediatric centres comparing with data from the International Registry of the Extracorporeal Life Support Organization (ELSO) and selected high-volume single-centre studies. One-hundred nineteen patients < 19 years from 2002 to 2012 were enrolled. Data on demographics and outcome were collected using a standardised registration form. Outcome data were compared with the ELSO registry and high-volume single-centre studies. Demographics, indications and diagnosis were similar to the ELSO register. Survival after ECMO was similar to outcome data from the ELSO register, apart from paediatric cardiac ECMO, where a significantly better survival to discharge was seen in the Nordic centres (68% vs. 49%; P = 0.03). Comparison with high-volume centres in the period after 2005 demonstrated a significantly better survival after cardiac ECMO in a single high-volume centre study, whereas four studies had significantly lower survival after cardiac ECMO. No significant difference was seen in children receiving respiratory ECMO in the Nordic centres and high-volume centres. Survival after ECMO in three low-volume Nordic centres demonstrated comparable outcome data with ELSO data and data from high-volume centres. We believe regular quality assurance surveys, as the present study, should be performed in order to maintain excellent therapy within the individual ECMO centres. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. Low-Income Parents' Adult Interactions at Childcare Centres

    ERIC Educational Resources Information Center

    Reid, Jeanne L.; Martin, Anne; Brooks-Gunn, Jeanne

    2017-01-01

    Little is known about the extent and nature of low-income parents' interactions with other parents and staff at childcare centres, despite the potential for these interactions to provide emotional, informational, and instrumental support. This study interviewed 51 parents at three childcare centres in low-income neighbourhoods in New York City.…

  20. Investigating Teachers' Views of Student-Centred Learning Approach

    ERIC Educational Resources Information Center

    Seng, Ernest Lim Kok

    2014-01-01

    Conventional learning is based on low levels of students' participation where students are rarely expected to ask questions or to challenge the theories of the academic. A paradigm shift in curriculum has resulted in implementing student-centred learning (SCL) approach, putting students as the centre of the learning process. This mode of…

  1. Centre-related variability in hospital admissions of patients with spondyloarthritis.

    PubMed

    Andrés, Mariano; Sivera, Francisca; Pérez-Vicente, Sabina; Carmona, Loreto; Vela, Paloma

    2016-09-01

    The aim of this study was to explore the variability in hospital admissions of patients with spondyloarthritis (SpA) in Spain, and the centre factors that may influence that variability. Descriptive cross-sectional study, part of the emAR II study, performed in Spain (2009-2010). Health records of patients with a diagnosis of SpA and at least one visit to the rheumatology units within the previous 2 years were reviewed. Variables related to hospital admissions, to the SpA, and to the patient and centre were collected. A multilevel logistic regression analysis of random intercept with non-random slopes was performed to assess variability between centres. From 45 centres, 1168 patients' health records were reviewed. Main SpA forms were ankylosing spondylitis (55.2 %) and psoriatic arthritis (22.2 %). A total of 248 admissions were registered for 196 patients (19.2 %, n = 1020). An adjusted variability of 17.6 % in hospitalizations between centres was noted. The following hospital-related factors showed a significant association with admissions: the total number of admissions of the centre, the existence of electronic admission, and the availability of ultrasound in rheumatology. However, these factors only explained 42.9 % of the inter-centre variability. The risk of a patient with SpA of being admitted could double (median OR 2.09), depending on the hospital where the patient was being managed. Hospital admissions of patients with SpA varied between hospitals due to centre characteristics. Further studies are needed to ascertain which specific factors may be causing the variation, as studied variables explained less than half of the variability.

  2. Tackling Work Related Stress in a National Health Service Trust

    ERIC Educational Resources Information Center

    Vick, Donna; Whyatt, Hilary

    2004-01-01

    The challenge of tackling the problem of coping with work related stress in a National Health Service (NHS) Trust was undertaken. Ideas were developed within the context of two different action learning sets and led to actions resulting in a large therapy Taster Session event and the establishment of a centre offering alternative therapies and…

  3. Colour centre recovery in yttria-stabilised zirconia: photo-induced versus thermal processes

    NASA Astrophysics Data System (ADS)

    Costantini, Jean-Marc; Touati, Nadia; Binet, Laurent; Lelong, Gérald; Guillaumet, Maxime; Beuneu, François

    2018-05-01

    The photo-annealing of colour centres in yttria-stabilised zirconia (YSZ) was studied by electron paramagnetic resonance spectroscopy upon UV-ray or laser light illumination, and compared to thermal annealing. Stable hole centres (HCs) were produced in as-grown YSZ single crystals by UV-ray irradiation at room temperature (RT). The HCs produced by 200-MeV Au ion irradiation, as well as the F+-type centres (? centres involving oxygen vacancies) were left unchanged upon UV illumination. In contrast, a significant photo-annealing of the latter point defects was achieved in 1.4-MeV electron-irradiated YSZ by 553-nm laser light irradiation at RT. Almost complete photo-bleaching was achieved by laser irradiation inside the absorption band of ? centres centred at a wavelength 550 nm. Thermal annealing of these colour centres was also followed by UV-visible absorption spectroscopy showing full bleaching at 523 K. Colour-centre evolutions by photo-induced and thermally activated processes are discussed on the basis of charge exchange processes between point defects.

  4. Science Centres: A Resource for School and Community

    ERIC Educational Resources Information Center

    Pilo, Miranda; Mantero, Alfonso; Marasco, Antonella

    2011-01-01

    We present a science centre established in Genoa on an agreement between Municipality of Genoa and Department of Physics of University of Genoa. The aim is to offer children, young people and community an opportunity to approach science in a playful way. The centre staffs guide the visitors through the exhibits, attracting their interests towards…

  5. Components of treatment delay in rheumatoid arthritis differ according to autoantibody status: validation of a single-centre observation using national audit data.

    PubMed

    Pratt, Arthur G; Lendrem, Dennis; Hargreaves, Ben; Aslam, Osman; Galloway, James B; Isaacs, John D

    2016-10-01

    To determine whether time to treatment following symptom onset differs between RA patients according to autoantibody status. A single-centre retrospective analysis of a UK early RA inception cohort was first undertaken to identify those components of the patient journey that differed by serological subtype. Data from a UK national audit of early inflammatory arthritis patients was accessed to replicate the key finding. A total of 173 RA patients were diagnosed over a 31-month period, of whom 80 (46%) were ACPA/RF double-seropositive (ACPA(+)/RF(+)), 53 (31%) ACPA(-)/RF(-), 17 (10%) ACPA(+)/RF(-) and 23 (13%) RF(+)/ACPA(-) Overall, ACPA(+)/RF(+) patients experienced significantly longer symptom duration before DMARD initiation. This was accounted for by delays in their presentation to primary care following symptom onset-a finding that was robustly confirmed in an independent dataset of 2192 UK early RA patients. In contrast, ACPA(-)/RF(-) patients were significantly more likely to experience delays in DMARD initiation after presenting to secondary care. Causes of treatment delays in early RA differ according to patients' autoantibody status. More insidious symptom onset and/or distinct health-seeking behaviours among ACPA(+)/RF(+) patients may contribute to late presentations in primary care, whereas ACPA(-)/RF(-) patients experience delayed diagnosis and treatment in secondary care. These observations inform the research agenda, potentially influencing the design of service delivery for early arthritis patients. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  6. From serenity to halcyon birth centre.

    PubMed

    Gutteridge, Kathryn

    2013-01-01

    This article follows the journey of Sandwell and West Birmingham Hospitals NHS Trust quest for improving normal birth outcomes for a complex and diverse population. The opportunities that led to commissioning a colocated and freestanding birth centre are explored and how the design was influenced by less clinical beliefs about birth. Through the story of both birth centre developments, Kathryn Gutteridge shows the changes that have been seen in both clinical outcomes and families'comments. From a failing maternity service to a beacon of light where midwifery care and a belief that 'your birth in our home' really matters.

  7. An Effective School Improvement Framework: Using the National School Improvement Tool

    ERIC Educational Resources Information Center

    Seifert, Deborah; Hartnell-Young, Elizabeth

    2015-01-01

    This occasional paper of the Centre for Education Policy and Practice outlines how the National School Improvement Tool, developed by the Australian Council for Educational Research (ACER) in collaboration with the Queensland Department of Education, Training and Employment is being used in Australian schools. The Tool is grounded in international…

  8. ERATOSTHENES: excellence research Centre for Earth surveillance and space-based monitoring of the environment, the EXCELSIOR Horizon 2020 teaming project

    NASA Astrophysics Data System (ADS)

    Hadjimitsis, Diofantos G.; Kontoes, Haris; Schreier, Gunter; Ansmann, Albert; Komodromos, George; Themistocleous, Kyriacos; Mamouri, Rodanthi; Michaelides, Silas; Nisantzi, Argyro; Papoutsa, Christiana; Neocleous, Kyriacos; Mettas, Christodoulos; Tzouvaras, Marios; Evagorou, Evagoras; Christofe, Andreas; Melillos, George; Papoutsis, Ioannis

    2017-10-01

    The aim of this paper is to present the strategy and vision to upgrade the existing ERATOSTHENES Research Centre (ERC) established within the Cyprus University of Technology (CUT) into a sustainable, viable and autonomous Centre of Excellence (CoE) for Earth Surveillance and Space-Based Monitoring of the Environment, which will provide the highest quality of related services on the National, European and International levels. EXCELSIOR is a Horizon 2020 Teaming project which addresses a specific challenge defined by the work program, namely, the reduction of substantial disparities in the European Union by supporting research and innovation activities and systems in low performing countries. It also aims at establishing long-term and strategic partnerships between the Teaming partners, thus reducing internal research and innovation disparities within European Research and Innovation landscape. The proposed CoE envisions the upgrading of the existing ERC into an inspiring environment for conducting basic and applied research and innovation in the areas of the integrated use of remote sensing and space-based techniques for monitoring the environment. Environment has been recognized by the Smart Specialization Strategy of Cyprus as the first horizontal priority for future growth of the island. The foreseen upgrade will regard the expansion of this vision to systematic monitoring of the environment using Earth Observation, space and ground based integrated technologies. Such an approach will lead to the systematic monitoring of all three domains of the Environment (Air, Land, Water). Five partners have united to upgrade the existing ERC into a CoE, with the common vision to become a world-class innovation, research and education centre, actively contributing to the European Research Area (ERA). More specifically, the Teaming project is a team effort between the Cyprus University of Technology (CUT, acting as the coordinator), the German Aerospace Centre (DLR), the

  9. Simultaneity of centres in ℤ q -equivariant systems.

    PubMed

    Giné, Jaume; Llibre, Jaume; Valls, Claudia

    2018-05-01

    We study the simultaneous existence of centres for two families of planar Z q -equivariant systems. First, we give a short review about Z q -equivariant systems. Next, we present the necessary and sufficient conditions for the simultaneous existence of centres for a Z 2 -equivariant cubic system and for a Z 2 -equivariant quintic system.

  10. Different Images of Science at Nordic Science Centres

    ERIC Educational Resources Information Center

    Davidsson, Eva; Jakobsson, Anders

    2007-01-01

    Science centres aim to present science in ways that will attract visitors and enhance public interest in, and knowledge of, science. But what images and different aspects of science are visitors confronted with at Nordic science centres? This study aims to explore the different aspects of science that are displayed and the ways in which these…

  11. UK Renal Registry 17th Annual Report: Chapter 10 2013 Multisite Dialysis Access Audit in England, Northern Ireland and Wales and 2012 PD One Year Follow-up: National and Centre-specific Analyses.

    PubMed

    Rao, Anirudh; Pitcher, David; Fluck, Richard; Kumwenda, Mick

    2015-01-01

    Dialysis access should be timely, minimize complications and maintain functionality. The aim of the second combined vascular and peritoneal dialysis access audit was to examine practice patterns with respect to dialysis access and highlight variations in practice between renal centres. The UK Renal Registry collected centre-specific information on incident vascular and peritoneal dialysis access outcome measures in patients from England, Wales and Northern Ireland (EW&NI), including patient demographics, dialysis access type (at start of dialysis and three months after start of dialysis), surgical assessment and access functionality. Centres who had reported data on incident PD patients for the previous 2012 audit were additionally asked to provide one year follow up data for this group. The findings were compared to the audit measures stated in Renal Association clinical practice guidelines for dialysis access. Fifty-seven centres in EW&NI (representing 92% of all centres) returned data on first access from 3,663 incident HD patients and 1,022 incident PD patients. A strong relationship was seen between surgical assessment and the likelihood of starting HD with an arteriovenous fistula (AVF). Twenty-four centres were at least two standard deviations below the 65% target for incident patients starting haemodialysis on AVF and only eight centres (14%) were within two standard deviations of the 85% target for prevalent haemodialysis patients on AVF. There was wide practice variation across the UK in provision of both HD and PD access which requires further exploration.

  12. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: results of the Dutch Birth Centre study

    PubMed Central

    Hermus, Marieke, MAA; Boesveld, Inge, IC; Franx, Arie; van der Pal-de Bruin, Karin, KM; Steegers, Eric, EAP; van den Akker-van Marle, EIske, ME

    2017-01-01

    Objectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design Economic evaluation based on a prospective cohort study. Setting 21 Dutch birth centres, 46 hospital locations where midwife-led birth was possible and 110 midwifery practices where home birth was possible. Participants 3455 low-risk women under the care of a community midwife at the start of labour in the Netherlands within the study period 1 July 2013 to 31 December 2013. Main outcome measures Costs and health outcomes of birth for different planned places of birth. Healthcare costs were measured from start of labour until 7 days after birth. The health outcomes were assessed by the Optimality Index-NL2015 (OI) and a composite adverse outcomes score. Results The total adjusted mean costs for births planned in a birth centre, in a hospital and at home under the care of a community midwife were €3327, €3330 and €2998, respectively. There was no difference between the score on the OI for women who planned to give birth in a birth centre and that of women who planned to give birth in a hospital. Women who planned to give birth at home had better outcomes on the OI (higher score on the OI). Conclusions We found no differences in costs and health outcomes for low-risk women under the care of a community midwife with a planned birth in a birth centre and in a hospital. For nulliparous and multiparous low-risk women, planned birth at home was the most cost-effective option compared with planned birth in a birth centre. PMID:28893750

  13. International Seismological Centre

    USGS Publications Warehouse

    Spall, H.; Hughes, A.

    1979-01-01

    The International Seismological Centre had its origins when the British seismologist Professor John Milne returned to England from Japan in 1895 to retire at Shide on the Isle of Eight. In cooperation with the British Association for the Advancement of Science, Milne had set up a number of seismographic stations around the world and, while Tokyo, had published a Catalogue of 8,33 Earthquakes Recorded in Japan, 1885-1892. 

  14. F-actin mechanics control spindle centring in the mouse zygote

    NASA Astrophysics Data System (ADS)

    Chaigne, Agathe; Campillo, Clément; Voituriez, Raphaël; Gov, Nir S.; Sykes, Cécile; Verlhac, Marie-Hélène; Terret, Marie-Emilie

    2016-01-01

    Mitotic spindle position relies on interactions between astral microtubules nucleated by centrosomes and a rigid cortex. Some cells, such as mouse oocytes, do not possess centrosomes and astral microtubules. These cells rely only on actin and on a soft cortex to position their spindle off-centre and undergo asymmetric divisions. While the first mouse embryonic division also occurs in the absence of centrosomes, it is symmetric and not much is known on how the spindle is positioned at the exact cell centre. Using interdisciplinary approaches, we demonstrate that zygotic spindle positioning follows a three-step process: (1) coarse centring of pronuclei relying on the dynamics of an F-actin/Myosin-Vb meshwork; (2) fine centring of the metaphase plate depending on a high cortical tension; (3) passive maintenance at the cell centre. Altogether, we show that F-actin-dependent mechanics operate the switch between asymmetric to symmetric division required at the oocyte to embryo transition.

  15. Capturing Reality at Centre Block

    NASA Astrophysics Data System (ADS)

    Boulanger, C.; Ouimet, C.; Yeomans, N.

    2017-08-01

    The Centre Block of Canada's Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS) of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  16. Educational Alliance for a Sustainable Toronto: The University of Toronto and the City's United Nations University (UNU) Regional Centre of Expertise

    ERIC Educational Resources Information Center

    Stefanovic, Ingrid Leman

    2008-01-01

    Purpose: The purpose of this paper is to describe the role that the University of Toronto has had in helping to establish a Regional Centre of Expertise (RCE) on Education for Sustainable Development in Toronto, Canada. The way in which the RCE initiative has helped to move forward the university's own five-year plan will also be discussed.…

  17. Stakeholder perceptions of a nurse led walk-in centre.

    PubMed

    Parker, Rhian M; Desborough, Jane L; Forrest, Laura E

    2012-11-05

    As many countries face primary care medical workforce shortages and find it difficult to provide timely and affordable care they seek to find new ways of delivering first point of contact health care through developing new service models. In common with other areas of rural and regional Australia, the Australian Capital Territory (ACT) is currently experiencing a general practitioner (GP) workforce shortage which impacts significantly on the ability of patients to access GP led primary care services. The introduction of a nurse led primary care Walk-in Centre in the ACT aimed to fulfill an unmet health care need in the community and meet projected demand for health care services as well as relieve pressure on the hospital system. Stakeholders have the potential to influence health service planning and policy, to advise on the potential of services to meet population health needs and to assess how acceptable health service innovation is to key stakeholder groups. This study aimed to ascertain the views of key stakeholders about the Walk-in Centre. Stakeholders were purposively selected through the identification of individuals and organisations which had organisational or professional contact with the Walk-in Centre. Semi structured interviews around key themes were conducted with seventeen stakeholders. Stakeholders were generally supportive of the Walk-in Centre but identified key areas which they considered needed to be addressed. These included the service's systems, full utilisation of the nurse practitioner role and adequate education and training. It was also suggested that a doctor could be available to the Centre as a source of referral for patients who fall outside the nurses' scope of practice. The location of the Centre was seen to impact on patient flows to the Emergency Department. Nurse led Walk-in Centres are one response to addressing primary health care medical workforce shortages. Whilst some stakeholders have reservations about the model others

  18. Are severely injured trauma victims in Norway offered advanced pre-hospital care? National, retrospective, observational cohort.

    PubMed

    Wisborg, T; Ellensen, E N; Svege, I; Dehli, T

    2017-08-01

    Studies of severely injured patients suggest that advanced pre-hospital care and/or rapid transportation provides a survival benefit. This benefit depends on the disposition of resources to patients with the greatest need. Norway has 19 Emergency Helicopters (HEMS) staffed by anaesthesiologists on duty 24/7/365. National regulations describe indications for their use, and the use of the national emergency medical dispatch guideline is recommended. We assessed whether severely injured patients had been treated or transported by advanced resources on a national scale. A national survey was conducted collecting data for 2013 from local trauma registries at all hospitals caring for severely injured patients. Patients were analysed according to hospital level; trauma centres or acute care hospitals with trauma functions. Patients with an Injury Severity Score (ISS) > 15 were considered severely injured. Three trauma centres (75%) and 17 acute care hospitals (53%) had data for trauma patients from 2013, a total of 3535 trauma registry entries (primary admissions only), including 604 victims with an ISS > 15. Of these 604 victims, advanced resources were treating and/or transporting 51%. Sixty percent of the severely injured admitted directly to trauma centres received advanced services, while only 37% of the severely injured admitted primarily to acute care hospitals received these services. A highly developed and widely distributed HEMS system reached only half of severely injured trauma victims in Norway in 2013. © 2017 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

  19. The Climate Data Centre of Deutscher Wetterdienst (DWD)

    NASA Astrophysics Data System (ADS)

    Kaspar, F.; Schreiber, K.-J.; Behrendt, J.

    2010-09-01

    In 2009 the German meteorological service (Deutscher Wetterdienst, DWD) has started to set up a Climate Data Centre (CDC) in order to provide unified access to its variety of climate data especially to users from research, educational and public institutions. CDC acts as a central point of contact to various data collections of DWD. These include observations from German weather stations and DWD's observatories, special data as e.g. from hydroclimatology, agro-climatology and medical climatology, but also from international activities of DWD, such as the Global Precipitation Climatology Center (GPCC), EUMETSAT's Satellite Application Facility on Climate Monitoring (CM-SAF) or marine climatological data (ship and buoy observations) of the Global Collecting Centre for Marine Climatological Data. Data are based on conventional surface observations over land and ocean as well as on various remote sensing methods, such as satellite observation. The major part consists of climate data from the past, but CDC will also include results from scenario calculations and projections for the future. In addition to pure observational data, CDC offers derived statistical parameters and spatial analyses as gridded datasets. As first step, a central data catalogue provides standardised descriptions and information on data access. It follows national and international rules for the description of geo-referenced data (GDI-DE; INSPIRE). The individual data providers of DWD can use the catalogue to easily edit and publish their metadata in a unified way. These metadata contain information on data access, data policy, data quality, spatial and temporal coverage, responsible persons, etc. The catalogue is based on an open source software product (geonetwork-opensource) that is also used by a large number of international organizations. Metadata can be exchanged (harvested) between these catalogues. This will allow implementing a structure that provides search capabilities over institutions

  20. Australasian disasters of national significance: an epidemiological analysis, 1900-2012.

    PubMed

    Bradt, David A; Bartley, Bruce; Hibble, Belinda A; Varshney, Kavita

    2015-04-01

    A regional epidemiological analysis of Australasian disasters in the 20th century to present was undertaken to examine trends in disaster epidemiology; to characterise the impacts on civil society through disaster policy, practice and legislation; and to consider future potential limitations in national disaster resilience. A surveillance definition of disaster was developed conforming to the Centre for Research on the Epidemiology of Disasters (CRED) criteria (≥10 deaths, ≥100 affected, or declaration of state emergency or appeal for international assistance). The authors then applied economic and legislative inclusion criteria to identify additional disasters of national significance. The surveillance definition yielded 165 disasters in the period, from which 65 emerged as disasters of national significance. There were 38 natural disasters, 22 technological disasters, three offshore terrorist attacks and two domestic mass shootings. Geographic analysis revealed that states with major population centres experienced the vast majority of disasters of national significance. Timeline analysis revealed an increasing incidence of disasters since the 1980s, which peaked in the period 2005-2009. Recent seasonal bushfires and floods have incurred the highest death toll and economic losses in Australasian history. Reactive hazard-specific legislation emerged after all terrorist acts and after most disasters of national significance. Timeline analysis reveals an increasing incidence in natural disasters over the past 15 years, with the most lethal and costly disasters occurring in the past 3 years. Vulnerability to disaster in Australasia appears to be increasing. Reactive legislation is a recurrent feature of Australasian disaster response that suggests legislative shortsightedness and a need for comprehensive all-hazards model legislation in the future. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  1. Studying and Working: A National Study of Student Finances and Student Engagement

    ERIC Educational Resources Information Center

    Devlin, Marcia; James, Richard; Grigg, Gabrielle

    2008-01-01

    A key determinant of the new relationship between students and universities in Australia is the changing nature of higher education funding arrangements and the shift towards "user-pays". In 2007, the Centre for the Study of Higher Education (CSHE) completed a commissioned national study, "Australian University Student Finances…

  2. The structural requirements for immunoglobulin aggregates to localize in germinal centres.

    PubMed Central

    Embling, P H; Evans, H; Guttierez, C; Holborow, E J; Johns, P; Johnson, P M; Papamichail, M; Stanworth, D R

    1978-01-01

    The capacity of non-heat-aggregated monoclonal human immunoglobulins of different classes, to localize in murine splenic germinal centres within 24 h of intravenous injection has been investigated. It has been shown that at least trimerization of polyclonal IgG must occur before any germinal centre trapping is manifest. Studies of complement fixation by these IgG preparations in vivo, together with studies of the germinal centre trapping of various monoclonal immunoglobulins, have indicated that the sole structural requirement for germinal centre localization of immunoglobulin aggregates is the ability to fix complement. Results suggest that immunoglobulin aggregates are transported to germinal centres via membrane C3 receptors of mobile cells, and then are released with loss of complement to become fixed to dendritic macrophages by a separate mechanism. PMID:363602

  3. Mathematics in Student-­Centred Inquiry Learning: Student Engagement

    ERIC Educational Resources Information Center

    Calder, Nigel

    2013-01-01

    This paper examines how mathematical understandings might be facilitated through student-centred inquiry. Data is drawn from a research project on student-centred inquiry learning that situated mathematics within authentic problem-solving contexts and involved students in a collaboratively constructed curriculum. A contemporary interpretive frame…

  4. Thermal Properties of the ESR Centres in Speleothem Samples

    NASA Astrophysics Data System (ADS)

    Ulusoy, Ü.; Anbar, Gül

    2007-04-01

    The paramagnetic centres used for ESR (Electron Spin Resonance) dating method should be thermally stable which is the main factor limiting the range of this method. In this work, thermal stabilities of the ESR centres in the cave deposites from the Aladaǧlar Massive and Alanya in Turkey has been investigated. The life times of the dating signal were calculated as about 4.0 and 3.7 years for G06 and G08 samples at the 10 °C depositing temperature. The activation energies of the centres are obtained the same, 0.7eV for both samples.

  5. Relevance of Health Economics in Breast Cancer Treatment – the View of Certified Breast Centres and Their Patients

    PubMed Central

    Lux, Michael; Hildebrandt, Thomas; Beyer-Finkler, Elke; Bani, Mayada; Loehberg, Christian; Jud, Sebastian; Rauh, Claudia; Schrauder, Michael; Fasching, Peter; Beckmann, Matthias

    2013-01-01

    Summary Breast cancer centres – certified in accordance with the criteria of the German Cancer Association and the German Mastology Association – are established throughout Germany. Although the setting up of centres and the subsequent need for certification are associated with a marked increase in costs, initial data show positive effects on quality. Certified centres are cost-effective from the point of view of health economics – they lead to improved quality in processes and results without creating any increase in costs for the funding bodies. However, the organization of the necessary structures, with interdisciplinary treatment, documentation and quality-assurance measures, requires considerable resources. Increasing consolidation of inpatient services is also involved, while shortening of the patients’ hospitalization periods is leading to reduced remuneration from the funding bodies. The current cost deficits, which have resulted from the increased resources required, need to be recouped through additional charges. It will only be possible to maintain the high quality achieved if additional charges become available to cover the centres’ added costs. Good data are increasingly becoming available as a basis for negotiations on charges – e.g., with regard to the quality of results and the National Cancer Plan – as well as clear support from patients. PMID:24715838

  6. [First-aid training at work on interpersonal development: exploratory study on employees in integration into the workplace centres].

    PubMed

    Lafitte, Pascale; Bridot, Michel; Semedo, Luis; Gagnayre, Rémi

    2016-01-01

    The National Institute of Research and Security and the “CHANTIER Ecole” network have developed first-aid training for employees of integration into the workplace centres. Specifically geared towards workplace safety, but similar in its content to home first-aid and rescue training, this training is also designed to enhance individual and collective responsibility and citizenship. The purpose of this study was to evaluate the personal and interpersonal effects of first-aid training of these employees by considering their social and professional difficulties in terms of psychosocial skills, such as empowerment, stress and emotions management, and decision-making capacity. A descriptive-inductive study was conducted over 18 months based on the grounded theory approach. Five integration into the work-place centres participated in the study and 34 interviews were conducted. These results raise several questions concerning: a) the characteristics of this public targeted by this training and their perception of integration into the workplace; b) the suitability of this training to working conditions and the link with other types of training such as family health education; c) the relationship between citizenship training and first-aid training at work, as it is more applicable to family training than workplace training. A quantitative study is considered to confirm these observations in other integration into the workplace centres.

  7. Bioelectromagnetics Research within an Australian Context: The Australian Centre for Electromagnetic Bioeffects Research (ACEBR).

    PubMed

    Loughran, Sarah P; Al Hossain, Md Shahriar; Bentvelzen, Alan; Elwood, Mark; Finnie, John; Horvat, Joseph; Iskra, Steve; Ivanova, Elena P; Manavis, Jim; Mudiyanselage, Chathuranga Keerawella; Lajevardipour, Alireza; Martinac, Boris; McIntosh, Robert; McKenzie, Raymond; Mustapic, Mislav; Nakayama, Yoshitaka; Pirogova, Elena; Rashid, M Harunur; Taylor, Nigel A; Todorova, Nevena; Wiedemann, Peter M; Vink, Robert; Wood, Andrew; Yarovsky, Irene; Croft, Rodney J

    2016-09-29

    Mobile phone subscriptions continue to increase across the world, with the electromagnetic fields (EMF) emitted by these devices, as well as by related technologies such as Wi-Fi and smart meters, now ubiquitous. This increase in use and consequent exposure to mobile communication (MC)-related EMF has led to concern about possible health effects that could arise from this exposure. Although much research has been conducted since the introduction of these technologies, uncertainty about the impact on health remains. The Australian Centre for Electromagnetic Bioeffects Research (ACEBR) is a National Health and Medical Research Council Centre of Research Excellence that is undertaking research addressing the most important aspects of the MC-EMF health debate, with a strong focus on mechanisms, neurodegenerative diseases, cancer, and exposure dosimetry. This research takes as its starting point the current scientific status quo, but also addresses the adequacy of the evidence for the status quo. Risk communication research complements the above, and aims to ensure that whatever is found, it is communicated effectively and appropriately. This paper provides a summary of this ACEBR research (both completed and ongoing), and discusses the rationale for conducting it in light of the prevailing science.

  8. Bioelectromagnetics Research within an Australian Context: The Australian Centre for Electromagnetic Bioeffects Research (ACEBR)

    PubMed Central

    Loughran, Sarah P.; Al Hossain, Md Shahriar; Bentvelzen, Alan; Elwood, Mark; Finnie, John; Horvat, Joseph; Iskra, Steve; Ivanova, Elena P.; Manavis, Jim; Mudiyanselage, Chathuranga Keerawella; Lajevardipour, Alireza; Martinac, Boris; McIntosh, Robert; McKenzie, Raymond; Mustapic, Mislav; Nakayama, Yoshitaka; Pirogova, Elena; Rashid, M. Harunur; Taylor, Nigel A.; Todorova, Nevena; Wiedemann, Peter M.; Vink, Robert; Wood, Andrew; Yarovsky, Irene; Croft, Rodney J.

    2016-01-01

    Mobile phone subscriptions continue to increase across the world, with the electromagnetic fields (EMF) emitted by these devices, as well as by related technologies such as Wi-Fi and smart meters, now ubiquitous. This increase in use and consequent exposure to mobile communication (MC)-related EMF has led to concern about possible health effects that could arise from this exposure. Although much research has been conducted since the introduction of these technologies, uncertainty about the impact on health remains. The Australian Centre for Electromagnetic Bioeffects Research (ACEBR) is a National Health and Medical Research Council Centre of Research Excellence that is undertaking research addressing the most important aspects of the MC-EMF health debate, with a strong focus on mechanisms, neurodegenerative diseases, cancer, and exposure dosimetry. This research takes as its starting point the current scientific status quo, but also addresses the adequacy of the evidence for the status quo. Risk communication research complements the above, and aims to ensure that whatever is found, it is communicated effectively and appropriately. This paper provides a summary of this ACEBR research (both completed and ongoing), and discusses the rationale for conducting it in light of the prevailing science. PMID:27690076

  9. Face-centred cubic to body-centred cubic phase transformation under [1 0 0] tensile loading

    NASA Astrophysics Data System (ADS)

    Xie, Hongxian; Yu, Jiayun; Yu, Tao; Yin, Fuxing

    2018-06-01

    Molecular dynamics simulation was used to verify a speculation of the existence of a certain face-centred cubic (FCC) to body-centred cubic (BCC) phase transformation pathway. Four FCC metals, Ni, Cu, Au and Ag, were stretched along the [1 0 0] direction at various strain rates and temperatures. Under high strain rate and low temperature, and beyond the elastic limit, the bifurcation of the FCC phase occurred with sudden contraction along one lateral direction and expansion along the other lateral direction. When the lattice constant along the expansion direction converged with that of the stretched direction, the FCC phase transformed into an unstressed BCC phase. By reducing the strain rate or increasing the temperature, dislocation or 'momentum-induced melting' mechanisms began to control the plastic deformation of the FCC metals, respectively.

  10. Rational use of medicines: assessing progress using primary health centres in Shomolu local government area of Lagos, Nigeria.

    PubMed

    Oyeyemi, A S; Ogunleye, O A

    2013-01-01

    Medicines (drugs) are a critical component in the prevention and treatment of diseases. Their rational use is important to maximize their benefits and prevent undesirable effects. This study was conducted to assess progress with rational use of medicines at primary care level using recommended indicators. The cross-sectional descriptive study was conducted in four primary health centres in Somolu Local Government Area (LGA) of Lagos State, Nigeria. It employed retrospective and prospective data collection methods. From the four centres, prescription notes of 600 clinical encounters spanning one year were analyzed for prescribing indicators and a checklist was administered for facility indicators. For the 600 clinical encounters studied, 2802 drugs were prescribed. The mean number of drugs per encounter was 4.7 ± 2.1; 75.6% of drugs were prescribed by generic name; prescriptions containing at least an antibiotic averaged 48.5%, while those with at least an injection prescribed were 21%. Of all the drugs prescribed, 83.2% were from the National Essential Drugs List (NEDL). On the average, 86.5% of key essential drugs were available in the health centres but none of the centres had a copy of the NEDL or drug formulary. There were wide variations in some of the indicators across the four facilities. The study showed progress in some indicators when compared with previous studies but gaps still exist. We recommend training on rational use of medicines for health workers in the facilities and distribution of copies of NEDL to all the facilities.

  11. Improving accountability through alignment: the role of academic health science centres and networks in England.

    PubMed

    Ovseiko, Pavel V; Heitmueller, Axel; Allen, Pauline; Davies, Stephen M; Wells, Glenn; Ford, Gary A; Darzi, Ara; Buchan, Alastair M

    2014-01-20

    seen which alignment mechanisms are most effective, and whether they are strong enough to counter the separation of accountabilities for the tripartite mission at the national level, the on-going structural fragmentation of the health system in England, and the unprecedented financial challenges that it faces. Future research should focus on determining the comparative effectiveness of different alignment mechanisms, developing standardised metrics and key performance indicators, evaluating and assessing academic health science centres and networks, and empirically addressing leadership issues.

  12. Improving accountability through alignment: the role of academic health science centres and networks in England

    PubMed Central

    2014-01-01

    the bottom up. It remains to be seen which alignment mechanisms are most effective, and whether they are strong enough to counter the separation of accountabilities for the tripartite mission at the national level, the on-going structural fragmentation of the health system in England, and the unprecedented financial challenges that it faces. Future research should focus on determining the comparative effectiveness of different alignment mechanisms, developing standardised metrics and key performance indicators, evaluating and assessing academic health science centres and networks, and empirically addressing leadership issues. PMID:24438592

  13. 100% of the World Ocean Floor Mapped by 2030 - Contribution of the South and West Pacific Regional Data Assembly and Coordination Centre to the Seabed 2030 Initiative

    NASA Astrophysics Data System (ADS)

    Lamarche, G.; Neil, H.; Stagpoole, V. M.; Greenland, A.; Mackay, K.; Black, J.; Griffin, E.

    2017-12-01

    The Seabed 2030 SaWPac Centre (South and West Pacific Ocean Regional Data Assembly and Coordination Centre) has been formed to generate new high resolution ocean floor maps of the western and southern Pacific Ocean. The centre is part of the joint Nippon Foundation and the General Bathymetric Chart of the Oceans (GEBCO) initiative to produce a definitive map of the World Ocean floor by 2030, empowering the world to make policy decisions, use the ocean sustainability and undertake scientific research based on detailed bathymetric information of the Earth's seabed. The SaWPac Centre is based at NIWA Wellington (New Zealand) and includes a collaborative partnership with GNS Science and Land Information New Zealand. It is responsible for the region from South America to Australia, north of latitude 50°S to 10° north of the Equator and the western part of the Northern Pacific Ocean to Russia. The region includes the world's deepest trenches and also covers some of the remotest oceans where bathymetric data form existing ship tracks is spaced up to 100 km apart. The challenge for the SaWPac Centre is to collate and combine all the available bathymetric data from the numerous nations that have surveyed in the region. The centre will also promote efforts to collect new data and contribute to map products generated by the Seabed 2030 global mapping project.

  14. Inquiry-Based Learning: An Educational Reform Based upon Content-Centred Teaching

    ERIC Educational Resources Information Center

    McLoughlin, M. Padraig M. M.

    2009-01-01

    The author of this paper posits that inquiry-based learning (IBL) enacted via a modified Moore method (MMM) is a content-driven pedagogy; as such it is content-centred not instructor-centred or student-centred. The MMM is a philosophy of education where student must master material by doing; not simply discussing, reading, or seeing it and that…

  15. Design and internal validation of an obstetric early warning score: secondary analysis of the Intensive Care National Audit and Research Centre Case Mix Programme database.

    PubMed

    Carle, C; Alexander, P; Columb, M; Johal, J

    2013-04-01

    We designed and internally validated an aggregate weighted early warning scoring system specific to the obstetric population that has the potential for use in the ward environment. Direct obstetric admissions from the Intensive Care National Audit and Research Centre's Case Mix Programme Database were randomly allocated to model development (n = 2240) or validation (n = 2200) sets. Physiological variables collected during the first 24 h of critical care admission were analysed. Logistic regression analysis for mortality in the model development set was initially used to create a statistically based early warning score. The statistical score was then modified to create a clinically acceptable early warning score. Important features of this clinical obstetric early warning score are that the variables are weighted according to their statistical importance, a surrogate for the FI O2 /Pa O2 relationship is included, conscious level is assessed using a simplified alert/not alert variable, and the score, trigger thresholds and response are consistent with the new non-obstetric National Early Warning Score system. The statistical and clinical early warning scores were internally validated using the validation set. The area under the receiver operating characteristic curve was 0.995 (95% CI 0.992-0.998) for the statistical score and 0.957 (95% CI 0.923-0.991) for the clinical score. Pre-existing empirically designed early warning scores were also validated in the same way for comparison. The area under the receiver operating characteristic curve was 0.955 (95% CI 0.922-0.988) for Swanton et al.'s Modified Early Obstetric Warning System, 0.937 (95% CI 0.884-0.991) for the obstetric early warning score suggested in the 2003-2005 Report on Confidential Enquiries into Maternal Deaths in the UK, and 0.973 (95% CI 0.957-0.989) for the non-obstetric National Early Warning Score. This highlights that the new clinical obstetric early warning score has an excellent ability to

  16. A new AMS facility at Inter University Accelerator Centre, New Delhi

    NASA Astrophysics Data System (ADS)

    Kumar, Pankaj; Chopra, S.; Pattanaik, J. K.; Ojha, S.; Gargari, S.; Joshi, R.; Kanjilal, D.

    2015-10-01

    Inter University Accelerator Centre (IUAC), a national facility of government of India, is having a 15UD Pelletron accelerator for multidisciplinary ion beam based research programs. Recently, a new accelerator mass spectrometry (AMS) facility has been developed after incorporating many changes in the existing 15UD Pelletron accelerator. A clean chemistry laboratory for 10Be and 26Al with all the modern facilities has also been developed for the chemical processing of samples. 10Be measurements on sediment samples, inter laboratory comparison results and 26Al measurements on standard samples are presented in this paper. In addition to the 10Be and 26Al AMS facilities, a new 14C AMS facility based on a dedicated 500 kV tandem ion accelerator with two cesium sputter ion sources, is also being setup at IUAC.

  17. Student centred teaching methods in a Chinese setting.

    PubMed

    Clarke, Janice

    2010-01-01

    This paper offers a discussion about using Western, student centred teaching methods with Chinese student nurses. There is increasing interest from Chinese nurse educators in student centred learning and an increase in partnerships between Chinese and Western universities. This paper suggests that the assumption that Western teaching methods are superior is now questioned and transferring Western style teaching to China requires a high degree of cultural sensitivity.

  18. Off-Centre Effects in the Triplet Relaxed Excited State of Ga+ Centres in CsBr:Ga Crystal

    NASA Astrophysics Data System (ADS)

    Kalder, K.; Korrovits, V.; Nagirnyi, V.; Stolovits, A.; Zazubovich, S.; Babin, V.

    1997-06-01

    Spectra, polarization and decay kinetics of the triplet and singlet emission of Ga+ centres in CsBr:Ga crystals have been studied in the temperature range of 0.1 to 400 K. It has been found that the triplet AX and AT emission bands coincide. Two slow components have been observed in the decay kinetics of each emission at T < 1.5 K and explained by the tunnel splitting of the metastable minima of the corresponding triplet relaxed excited state. It points to the off-centre displacement of a Ga+ ion from a crystal lattice site both in the tetragonal (T) and in the trigonal (X) Jahn-Teller minima.

  19. Meeting the Privacy Requirements for the Development of a Multi-Centre Patient Registry in Canada: The Rick Hansen Spinal Cord Injury Registry

    PubMed Central

    Noonan, Vanessa K.; Thorogood, Nancy P.; Joshi, Phalgun B.; Fehlings, Michael G.; Craven, B. Catharine; Linassi, Gary; Fourney, Daryl R.; Kwon, Brian K.; Bailey, Christopher S.; Tsai, Eve C.; Drew, Brian M.; Ahn, Henry; Tsui, Deborah; Dvorak, Marcel F.

    2013-01-01

    Privacy legislation addresses concerns regarding the privacy of personal information; however, its interpretation by research ethics boards has resulted in significant challenges to the collection, management, use and disclosure of personal health information for multi-centre research studies. This paper describes the strategy used to develop the national Rick Hansen Spinal Cord Injury Registry (RHSCIR) in accordance with privacy statutes and benchmarked against best practices. An analysis of the regional and national privacy legislation was conducted to determine the requirements for each of the 31 local RHSCIR sites and the national RHSCIR office. A national privacy and security framework was created for RHSCIR that includes a governance structure, standard operating procedures, training processes, physical and technical security and privacy impact assessments. The framework meets a high-water mark in ensuring privacy and security of personal health information nationally and may assist in the development of other national or international research initiatives. PMID:23968640

  20. Meeting the privacy requirements for the development of a multi-centre patient registry in Canada: the Rick Hansen Spinal Cord Injury Registry.

    PubMed

    Noonan, Vanessa K; Thorogood, Nancy P; Joshi, Phalgun B; Fehlings, Michael G; Craven, B Catharine; Linassi, Gary; Fourney, Daryl R; Kwon, Brian K; Bailey, Christopher S; Tsai, Eve C; Drew, Brian M; Ahn, Henry; Tsui, Deborah; Dvorak, Marcel F

    2013-05-01

    Privacy legislation addresses concerns regarding the privacy of personal information; however, its interpretation by research ethics boards has resulted in significant challenges to the collection, management, use and disclosure of personal health information for multi-centre research studies. This paper describes the strategy used to develop the national Rick Hansen Spinal Cord Injury Registry (RHSCIR) in accordance with privacy statutes and benchmarked against best practices. An analysis of the regional and national privacy legislation was conducted to determine the requirements for each of the 31 local RHSCIR sites and the national RHSCIR office. A national privacy and security framework was created for RHSCIR that includes a governance structure, standard operating procedures, training processes, physical and technical security and privacy impact assessments. The framework meets a high-water mark in ensuring privacy and security of personal health information nationally and may assist in the development of other national or international research initiatives. Copyright © 2013 Longwoods Publishing.

  1. Organizational and operational capabilities of specialist centres for children with psychomotor disability in Abidjan.

    PubMed

    Alloh, D; Nandjui, B; Bombo, J; Manou, B; Twoolys, A; Alloukou, R; Ake, N; Konate-Konan, E; Pillah, L; Coulibaly, A

    2009-06-01

    To describe the organizational and operational capabilities of specialized centres for children with psychomotor disability in Abidjan, Republic of Côte d'Ivoire. This descriptive study was carried out from February to May, 2006 at the various specialized centres for children with psychomotor disability that exist in the district of Abidjan. The procedure comprised a clinical description of the disabled children admitted to these centres and an assessment of the centres' organization and operational capabilities. Six specialist centres for children with psychomotor disability were identified, namely the Infant Guidance Centre, the Awakening and Stimulation Centre for disabled Children, the "Sainte-Magdeleine" Centre, the Medical and Training Institute, the "Page Blanche" institute and the "Colombes Notre Dame de la Paix" Centre. Among the children, 97.15% were day patients, 66.37% were mentally challenged, 30.96% had psychomotor impairment and 2.66% had motor impairments. The level of organization varied but the centres nevertheless had operational administrative, medical and paramedical staff, despite the absence of certain specialties. However, the lack of personnel, equipment and infrastructure is hindering the delivery of adequate services to the children. In Abidjan District, reception centres for children with psychomotor impairments are essentially privately run. Organizational and operational performances were suboptimal, with a low carer-to-patient ratio. Reinforcement of the centres' operational capabilities appears to be necessary.

  2. The Development of National Occupational Standards for Intercultural Working in the UK

    ERIC Educational Resources Information Center

    MacDonald, Malcolm N.; O'Regan, John P.; Witana, Julie

    2009-01-01

    From 2007 to 2008, CILT (Centre for Information for Language Teachers) developed a set of National Occupational Standards for Intercultural Working in the UK. This paper reports on three questions arising from the development project: how these standards are distinctive from others, how they realise intercultural competence and how they meet…

  3. Developing and testing the patient-centred innovation questionnaire for hospital nurses.

    PubMed

    Huang, Ching-Yuan; Weng, Rhay-Hung; Wu, Tsung-Chin; Lin, Tzu-En; Hsu, Ching-Tai; Hung, Chiu-Hsia; Tsai, Yu-Chen

    2018-03-01

    Develop the patient-centred innovation questionnaire for hospital nurses and establish its validity and reliability. Patient-centred care has been adopted by health care managers in their efforts to improve health care quality. It is regarded as a core concept for developing innovation. A cross-sectional study was employed to collect data from hospital nurses in Taiwan. This study was divided into two stages: pilot study and main study. In the main study, 596 valid responses were collected. This study adopted reliability analysis, exploratory factor analysis, confirmatory factor analysis and selected nurse innovation scale as a criterion to test criterion-related validity. Five-dimension patient-centred innovation questionnaire was proposed: access and practicability, co-ordination and communication, sharing power and responsibility, care continuity, family and person focus. Each dimension demonstrated a reliability of 0.89-0.98. All dimensions had acceptable convergent and discriminate validity. The patient-centred innovation questionnaire and nurse innovation scale exhibited a significantly positive correlation. Patient-centred innovation questionnaire not only had a good theoretical basis but also had sufficient reliability and construct validity, and criterion-related validity. Patient-centred innovation questionnaire could give a measure for evaluating the implementation of patient-centred care and could be used as a management tool during the process of nurse innovation. © 2017 John Wiley & Sons Ltd.

  4. The NERC Data Assimilation Research Centre and Envisat

    NASA Astrophysics Data System (ADS)

    LAHOZ, W. A.

    2001-12-01

    The NERC Data Assimilation Research Centre (DARC), a Centre of Excellence in Earth Observation, has been recently set up in the UK. DARC is a distributed centre, with participation from the universities of Reading, Oxford, Cambridge and Edinburgh, and the Rutherford Appleton Laboratory. It has strong links with the UK Met Office, and with European data assimilation groups. One of the remits of DARC is the exploitation of research satellite data (e.g. from ESA's Envisat, due to be launched in November 2001). This presentation will describe the participation of DARC in the Envisat programme. This participation involves: (1) the calibration/validation of Envisat data using an NWP assimilation system, and (2) the production of 4-d quality-controlled datasets of temperature, ozone and water vapour from Envisat using an NWP assimilation system.

  5. A Compton Gamma Imager for Criminal and National Security Investigation

    DTIC Science & Technology

    2014-05-01

    which is led by Defence Research and Development Canada’s Centre for Security Science, in partnership with Public Safety Canada. Partners in the...project include National Research Council, McGill University, Royal Canadian Mounted Police, Public Safety Canada, Toronto Police, and Canada Border...16  6.2.1  Follow-on Research ...................................................................................... 16  6.2.2  Follow-on

  6. Reference centres for adults with rare and complex cancers - Policy recommendations to improve the organisation of care in Belgium.

    PubMed

    Stordeur, S; Vrijens, F; Leroy, R

    2016-02-01

    Rare and/or complex cancers call for a very specific expertise and adequate infrastructure. In Belgium, every hospital with a programme in oncology can deliver care for adults with rare and/or complex cancer types, without having demonstrated a specific know-how to adequately manage these patients. Therefore, the Minister of Health ordered a scenario for the organisation of care for adults with rare and/or complex cancers, taking into account the current Belgian situation and relevant foreign experience. Combined methods were used in this study: a literature review, the consultation of stakeholders, in depth discussions in 14 multidisciplinary groups leading to concrete proposals for several rare/complex cancers and the consultation of a panel of expert pathologists. The core recommendation is the set-up of shared care networks around reference centres, with multidisciplinary teams of recognised expertise in specific rare/complex cancers. The definition of minimum caseloads for hospitals and medical specialists, the evaluation of the quality of care, a model of diagnostic confirmation and the set-up of a national portal website which provides information on rare and/or complex cancers and reference centres are highly recommended. It is no longer practicable, efficient or ethical that every hospital or every practitioner continues to offer care for every rare/complex cancer. Improving the quality of rare/complex cancer care requires to concentrate expertise and sophisticated infrastructure in reference centres. Furthermore, the formation of networks between reference centres and peripheral centres will allow a delivery of care combining expertise and proximity. The next step is the translation of the recommendations into policy decisions. It is very well realised that this will take some courage and that a certain degree of resistance will have to be surmounted, but eventually, the best interest of the patient should prevail. Copyright © 2015 Elsevier Masson SAS

  7. A Brief History of the J.P. Das Developmental Disabilities Centre

    ERIC Educational Resources Information Center

    Sobsey, Dick

    2008-01-01

    The J.P. Das Developmental Disabilities Centre celebrated its 40th anniversary on September 1, 2007, followed by The University of Alberta's 100th anniversary in 2008. The year 2008 also brought the appointment of a new Director for the Centre. As the immediate past Director of the Centre, the author recounts some of the history of the J.P. Das…

  8. Capacity of the national influenza surveillance system in Afghanistan, a chronic conflict setting.

    PubMed

    Rasooly, M H; Sahak, M N; Saeed, K I; Krishnan, S K; Khan, W; Hassounah, S

    2016-10-02

    Influenza surveillance is needed to monitor potential public health threats from the emergence of novel influenza viruses. This study assessed the capacity and performance of the national influenza surveillance system in Afghanistan from 2007 to 2014. Data were collected by review of hospital registers and the National Influenza Centre (NIC) database, interviews with influenza focal points at 9 influenza sentinel surveillance sites and the Centre staff, and observation of the sites. Out of 6900 specimens collected, influenza virus was detected in 253 (3.6%), predominantly H1N1 (63%); most of these cases were detected during the 2009 pandemic. The NIC had the capacity for virus isolation and PCR identification and performed reasonably until 2011 when support of the Naval American Medical Research Unit 3 was withdrawn. The limitations identified in the system indicated the need for: more complete data, improved technical competence and trained human resources, updating of the infrastructure/facilities, and the presence of standard operating procedures throughout surveillance.

  9. Work experiences among attendees of day centres for people with psychiatric disabilities.

    PubMed

    Eklund, Mona; Sandlund, Mikael

    2015-01-01

    It is possible that people with psychiatric disabilities who visit day centres have previous work experiences that may be seen as resources for their current engagement in day centre activities. Research in this respect seems to lack, however. To investigate work experiences among attendees at day centres for people with psychiatric disabilities and relationships with current type of day centre (work-oriented, meeting place-oriented or mixed), engagement in day centre activities, motivation and socio-demographic and health-related factors. Seventy-seven attendees responded to questionnaires. Global Assessment of Functioning, GAF, was also used. Work was categorised into Group I (professionals, semi-professionals), Group II (clerical support, services workers) and Group III (e.g. craft workers, elementary occupations). Almost everyone had previously had open-market employment; more than half for ≥ 10 years. Group I was more common in mixed centres, Group II in meeting place-oriented ones and Group III in work-oriented ones. Group I more frequently had college degree and was rated high on GAF functioning. Women were over-represented in Group II, and men in Group III and in meeting place-oriented centres. Attending mixed centres was more likely when having a college degree, scoring high on GAF functioning and being highly engaged in activities. Attendees at work-oriented day centres were characterised by being motivated for spending time alone and reporting a diagnosis of psychosis. The participants had unused working capacity. No clear-cut relationships were found between work experiences and the investigated correlates.

  10. Cyclic strain rate effects in fatigued face-centred and body-centred cubic metals

    NASA Astrophysics Data System (ADS)

    Mughrabi, Haël

    2013-09-01

    The present work deals mainly with the effect and the use of strain rate and temperature changes during cyclic deformation as a means to obtain valuable information on the thermally activated dislocation glide processes, based on the assessment of reversible changes of the thermal effective stress and of transient changes of the athermal stress. The importance of closed-loop testing in true plastic strain control with constant cyclic plastic strain rate throughout the cycle is explained and emphasized, especially with respect to the case of strain rate sensitive materials. Stress responses of face-centred cubic and body-centred cubic (bcc) metals to cyclic strain rate changes are presented to illustrate that the deformation modes of these two classes of materials differ characteristically at temperatures below that the so-called knee temperature of bcc metals. When such tests are performed in cyclic saturation, the temperature and strain rate dependence of bcc metals can be measured very accurately on one and the same specimen, permitting a thorough analysis of thermal activation.

  11. Bureaucracy, professionalization and school centred innovation strategies

    NASA Astrophysics Data System (ADS)

    Morris, Paul

    1990-03-01

    This paper examines an attempt to promote a school centred innovation strategy within a highly centralized educational system. The School Based Curriculum Project Scheme, which was introduced into Hong Kong in 1988, is analysed in terms of a professional-bureaucratic dichotomy. It is argued that the operational details of the scheme are designed to satisfy a range of bureaucratic concerns and these are not conducive to promoting the professional work ethic which is required for school centred innovation. Finally the paper identifies the implications which arise for policies designed to promote curriculum innovation.

  12. Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

    PubMed

    Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats

    2017-01-06

    Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises

  13. Organisational culture and post-merger integration in an academic health centre: a mixed-methods study.

    PubMed

    Ovseiko, Pavel V; Melham, Karen; Fowler, Jan; Buchan, Alastair M

    2015-01-22

    Around the world, the last two decades have been characterised by an increase in the numbers of mergers between healthcare providers, including some of the most prestigious university hospitals and academic health centres. However, many mergers fail to bring the anticipated benefits, and successful post-merger integration in university hospitals and academic health centres is even harder to achieve. An increasing body of literature suggests that organisational culture affects the success of post-merger integration and academic-clinical collaboration. This paper reports findings from a mixed-methods single-site study to examine 1) the perceptions of organisational culture in academic and clinical enterprises at one National Health Service (NHS) trust, and 2) the major cultural issues for its post-merger integration with another NHS trust and strategic partnership with a university. From the entire population of 72 clinician-scientists at one of the legacy NHS trusts, 38 (53%) completed a quantitative Competing Values Framework survey and 24 (33%) also provided qualitative responses. The survey was followed up by semi-structured interviews with six clinician-scientists and a group discussion including five senior managers. The cultures of two legacy NHS trusts differed and were primarily distinct from the culture of the academic enterprise. Major cultural issues were related to the relative size, influence, and history of the legacy NHS trusts, and the implications of these for respective identities, clinical services, and finances. Strategic partnership with a university served as an important ameliorating consideration in reaching trust merger. However, some aspects of university entrepreneurial culture are difficult to reconcile with the NHS service delivery model and may create tension. There are challenges in preserving a more desirable culture at one of the legacy NHS trusts, enhancing cultures in both legacy NHS trusts during their post-merger integration, and

  14. A Cross-Sectional Study of Indoor Tanning in Fitness Centres.

    PubMed

    Huang, Christina M; Kirchhof, Mark G

    Ultraviolet (UV) radiation is a human carcinogen and is associated with the development of skin cancer. The promotion of indoor tanning (IT) at fitness centres is of particular concern as it reinforces the idea that a tan is associated with health and fitness. The purpose of this study was to investigate the prevalence of IT in fitness centres, with an emphasis on determining the financial costs, adherence to regulations, and safety precautions. Ten cities, representing 9 different Canadian provinces, were chosen for the study. From each province, a minimum of 20 and a maximum of 30 fitness centres were randomly selected from the Yellow Pages website. Each fitness centre was contacted by the principal investigator and inquiries were made from a consumer's perspective. Of the 203 gyms surveyed, 43% (88/203) offered tanning facilities. Of these, 10.23% (9/88) were found to be noncompliant with the provincial IT regulations for age and/or time between tanning sessions. Despite the known risks of IT, not all fitness centres are compliant with provincial legislations regarding IT, and some continue to promote tanning access to minors.

  15. Hands-On versus Teacher-Centred Experiments in Soil Ecology

    ERIC Educational Resources Information Center

    Randler, Christoph; Hulde, Madeleine

    2007-01-01

    This study focused on differences between teacher-centred and learner-centred experiments in soil ecology. After a pilot study, we selected three experiments simple enough to be carried out by pupils even with little experience in self-determined learning and hands-on practice. The sample comprised 123 fifth and sixth graders from a middle school…

  16. A student-centred electronic health record system for clinical education.

    PubMed

    Elliott, Kristine; Judd, Terry; McColl, Geoff

    2011-01-01

    Electronic Health Record (EHR) systems are an increasingly important feature of the national healthcare system [1]. However, little research has investigated the impact this will have on medical students' learning. As part of an innovative technology platform for a new masters level program in medicine, we are developing a student-centred EHR system for clinical education. A prototype was trialed with medical students over several weeks during 2010. This paper reports on the findings of the trial, which had the overall aim of assisting our understanding of how trainee doctors might use an EHR system for learning and communication in a clinical setting. In primary care and hospital settings, EHR systems offer potential benefits to medical students' learning: Longitudinal tracking of clinical progress towards established learning objectives [2]; Capacity to search across a substantial body of records [3]; Integration with online medical databases [3]; Development of expertise in creating, accessing and managing high quality EHRs [4]. While concerns have been raised that EHR systems may alter the interaction between teachers and students [3], and may negatively influence physician-patient communication [6], there is general consensus that the EHR is changing the current practice environment and teaching practice needs to respond. Final year medical students on clinical placement at a large university teaching hospital were recruited for the trial. Following a four-week period of use, semi-structured interviews were conducted with 10 participants. Audio-recorded interviews were transcribed and data analysed for emerging themes. Study participants were also surveyed about the importance of EHR systems in general, their familiarity with them, and general perceptions of sharing patient records. Medical students in this pilot study identified a number of educational, practical and administrative advantages that the student-centred EHR system offered over their existing ad

  17. Children's Centre "3 in 1 - together"

    NASA Astrophysics Data System (ADS)

    Gancheva, Hristina

    2013-04-01

    "There are only two ways to life your live. One is as though nothing is a miracle. The other is as though everything is a miracle." Albert Einstein Children's Centre "3 in 1" is an extracurricular unit linked to the High School of Zlatartitsa, St. Cyril and St. Methodius, accomplished with the help of the municipality and many volunteers from the local community. With its activity it forms in children patriotic spirit, love for nature, active citizenship, and an impulse for a healthy life through communication with nature, saving the traditions and history, insurance of equality of the kids of the local five ethnicities and participation in activities in the sphere of science, art, sport and tourism. The educational work is mainly directed towards kids with difficulties with communication, hyperactivity, aggression, problems in their families, or those deprived of parental care. For a few years in the Children's Centre there have been clubs of interests: "Gardeners" - kids cultivate a garden. They plow, dig, plant, put in, irrigate and weed under the watch of Ms Stafka Nikolova, parents, and volunteers of the local community. The ecologically clean products - vegetables and fruits, kids use to cook delicious meals, sell, or give away. Weeds are also utilized; they are making herbarium out of them. "Cooks" - "What to have for lunch, when mom is out?". One can learn a lot of wonderful recipes from the club "Cooks". Products are own made, raised with love. In 2010, on the on the annual traditional holiday of the garden soup in Zlataritsa, the little cooks won third prize for making a delicious vegetable soup. On the same day, the 26 years old Nadezhda Savova, Cultural and Social Anthropology PhD in Princeton, founded the second community bakery in Bulgaria in Children's Centre "3 in1". Nadezhda Savova was declared traveler of 2012 by National Geographic. After the baking house in Gabrovo and Zlataritsa, Nadezhda also founded such projects in Sofia, Varna and Ruse

  18. System-centred tobacco management: from 'whole-person' to 'whole-system' change.

    PubMed

    Bonevski, Billie

    2014-01-01

    Patient-centred tobacco management is a pragmatic approach for helping smokers achieve their goals in terms of either cessation or harm reduction. However, the success of the approach is dependent on clinicians embracing and delivering it as intended. There are a number of structural and systemic organisational barriers which are limiting clinician-delivered patient-centred tobacco dependence. In response, 'whole system' approaches which help support clinicians in the delivery of patient-centred tobacco management are required. Health system changes to support clinicians and facilitate the delivery of patient-centred tobacco management are worth further investigation, particularly in settings where tobacco smoking rates are high. © 2013 Australasian Professional Society on Alcohol and other Drugs.

  19. Evaluation of a mobile screening service for abdominal aortic aneurysm in Broken Hill, a remote regional centre in far western NSW.

    PubMed

    Lesjak, Margaret S; Flecknoe-Brown, Stephen C; Sidford, Jan R; Payne, Kerryn; Fletcher, John P; Lyle, David M

    2010-04-01

    To evaluate the feasibility of a mobile screening service model for abdominal aortic aneurysm (AAA) in a remote population centre in Australia. Screening test evaluation. A remote regional centre (population: 20 000) in far western NSW. Men aged 65-74 years, identified from the Australian Electoral roll. A mobile screening service using directed ultrasonography, a basic health check and post-screening consultation. Attendance at the screening program, occurrence of AAA in the target population and effectiveness of screening processes. A total of 516 men without a previous diagnosis of AAA were screened, an estimated response rate of 60%. Of these, 463 (89.7%) had a normal aortic diameter, 28 (5.4%) ectatic and 25 (4.9%) a small, moderate or significant aneurysm. Two men with AAA were recommended for surgery. Feedback from participants indicated that the use of a personalised letter of invitation helped with recruitment, that the screening process was acceptable and the service valued. It is feasible to organise and operate a mobile AAA screening service from moderate sized rural and remote population centres. This model could be scaled up to provide national coverage for rural and remote residents.

  20. Nurse middle managers contributions to patient-centred care: A 'managerial work' analysis.

    PubMed

    Lalleman, Pcb; Smid, Gac; Dikken, J; Lagerwey, M D; Schuurmans, M J

    2017-10-01

    Nurse middle managers are in an ideal position to facilitate patient-centred care. However, their contribution is underexposed in literature due to difficulties to articulate this in practice. This paper explores how nurse middle managers contribute to patient-centred care in hospitals. A combination of time-use analysis and ethnographic work was used to disclose their contribution to patient-centred care at a micro level. Sixteen nurse managers were shadowed for over 560 hours in four hospitals. Some nurse middle managers seldom contribute to patient-centred care. Others are involved in direct patient care, but this does not result in patient-centred practices. At one hospital, the nurse middle managers did contribute to patient-centred care. Here balancing between "organizing work" and "caring work" is seen as a precondition for their patient-centeredness. Other important themes are feedback mechanisms; place matters; with whom to talk and how to frame the issues at stake; and behavioral style. Both "hands-on" and "heads-on" caring work of nurse middle managers enhances their patient-centeredness. This study is the first of its kind to obtain insight in the often difficult to articulate "doings" of nurse middle managers with regard to patient-centred care through combining time-use analysis with ethnographic work. © 2017 John Wiley & Sons Ltd.

  1. Re-Engaging 'Youth at Risk' of Disengaging from Schooling through Rugby League Club Partnership: Unpacking the Pedagogic Practices of the Titans Learning Centre

    ERIC Educational Resources Information Center

    Whatman, Susan L.; Main, Katherine

    2018-01-01

    The youth learning re-engagement program known as the Titans Learning Centre (or TLC) is an approved alternative schooling program, developed in partnership with state education and a local National Rugby League (NRL) club, the 'Titans'. Students typically in Grade Three or Four complete a 10 week program, interacting with professional A grade NRL…

  2. A macro perspective for client-centred practice in curricula: Critique and teaching methods.

    PubMed

    Fleming-Castaldy, Rita P

    2015-07-01

    Client-centred practice is often eclipsed by social, economic, and political inequities. Ignoring these realities obstructs clients' goal attainment. The author advocates for the integration of a macro perspective inclusive of participation barriers and supports in occupational therapy curricula and seeks to motivate educators to adopt teaching approaches that develop students' abilities to address the complexities of client-centred practice. This article integrates a critical analysis of the literature on client-centred practice with reflexivity on disability studies and autoethnography. Educational standards require students to learn about the social, economic, and political contexts that impact on client-centred practice and the need for advocacy to enable participation. Theoretical support of a macro perspective for client-centred practice is strongly evident in the literature. Information on methods for teaching students how to actualize these concepts in practice is scant. Thus, strategies to inform the integration of a macro perspective into curricula and concrete activities to develop students' competencies for empowered client-centred practice are required. Educators have an ethical responsibility to critique their pedagogy to determine whether they are adequately preparing students for client-centred practice. The focus must move from teaching a micro perspective of client-centred practice to a macro perspective that enables occupational justice and empowerment.

  3. Suicides in the Centre of Portugal: seven years analysis.

    PubMed

    Dias, Daniel; Mendonça, M Cristina; Real, Francisco Corte; Vieira, Duarte Nuno; Teixeira, Helena M

    2014-01-01

    As one of the more specific and distinctive problems of human beings, suicide has been investigated with increasing attention all over the world. Several risk factors have been described as well as limitations arising from their study. The World Health Organization estimates that this scourge affects one million people annually, which corresponds to one death every 40s worldwide. According to recent studies, Portugal, despite the good rates (10 suicide deaths per 100,000 inhabitants), had shown an increasing trend among younger people. This work aims to characterize the evolution of the suicidal profile autopsied at the Forensic Pathology Department of the Centre Branch of the National Institute of Legal Medicine and Forensic Sciences of Portugal, analyzing several variables: age, gender, marital status, employment status, suicidal methodology, toxicological analysis and some conditions/behaviors regarding personal history (alcoholism, suicidal ideation, suicide attempts, physical illness, psychiatric disorder). All the autopsies from the 1 January, 2003 to 31 December, 2009 were analyzed. The suicide profile achieved corresponded to a man (77%), aged between 65 and 74 years old (20.4%), married (54.5%), employed, who committed suicide by hanging, in September, May or February. Clinical records include an organic health problem or psychiatric one, in addition to risk behaviors such as alcoholism, suicidal thoughts or suicide attempts. The number of suicides autopsied at the Centre Branch has increased, resembling the profile to the result of many other authors. However, new medical and social developments place hanging as the favorite suicide method in our study. Many barriers remain to overthrow but several prevention programs begin to be designed and implemented. Future evaluations and interventions at the social and medical level, including the death certification process, will be fundamental to a better realistic understanding of this phenomenon. Copyright

  4. The impact of standalone call centres and GP cooperatives on access to after hours GP care: a before and after study adjusted for secular trend.

    PubMed

    Dunt, David; Day, Susan E; Kelaher, Margaret; Montalto, Michael

    2006-08-01

    The After Hours Primary Medical Trials were initiated by the Australian government to redress difficulties in after hours (AH) GP care in areas of high need. The study's objective is to study the impact of two standalone call centres and one GP cooperative offering comprehensive services, in improving consumer access to services for residents of a defined geographic area. A pre-post design was used to evaluate their impact after adjusting for secular trend at a national level. Access was considered in terms of availability, accessibility, affordability, acceptability and responsiveness of care. Unmet need and ease of obtaining AH telephone professional medical advice were also considered. Pre-trial and post-trial telephone surveys of two separate random samples of approximately 350 households using AH services in each trial area as well as in a national sample outside the trial areas. Consumer acceptability and affordability increased in residents in the area served by the GP cooperative. Access, however measured, did not improve in either of the standalone call centre areas. Reduction in unmet need approached but did not achieve statistical significance in most but not all trial areas. Improvements in access in the GP cooperative conformed to expectations based on current and pre-existing AH care arrangements put in place. Absence of improvements in access in the standalone call centres did not conform to expectations but may be partly explained by the reductions in consumer acceptability, following introduction of telephone triage systems reported elsewhere.

  5. Duality Centre - Suburbs: Origins by the Re-use of Religious Buildings

    NASA Astrophysics Data System (ADS)

    Virtudes, Ana

    2017-12-01

    The nationalization of religious properties; churches, convents and monasteries, signifying the decline and the end of the religious orders and a selling-off (by auction) of their properties was a universal phenomenon that took place in several countries in different times. In Portugal, this process occurred in 1834 and has contributed greatly to urban transformations. The changing of European cities in the transition to the twenty century has some aspects in common, such as is the resultant transformation of the compact urban fabric to a city with the duality between centre and suburbs, but there are others which are unique and Santarém is one such case. This uniqueness lies not in the result but in the cause of the change: this process means the re-using, transforming and rebuilding of religious spaces and their functions in order to meet new demands for the city. If on the one hand a bullfighting arena, some military buildings or even a prison were the new facilities of the suburbs, a theatre, an archaeological museum, a bank agency, a high school or a housing area for the bourgeoisie on the other hand were to become the new architecture of the city centre in the religious spaces. All the examples mentioned above were to lead to the adjustment of city limits. The city limits ceased to be identified in relation to the city-walls and the concept of a new city was formed by an internal dualism between city centre and suburbs. This process made the example of this city unique and caused a series of unique urban changes. During this peculiar socio-political process in Santarém, the new commercial bourgeoisie arose and its strong desire for land-ownership and buying-up the religious spaces. There were a large number of convents and their location was both inside and outside the city-walls. The city geography was this: it lay on a platform on top of the hill above the Tagus River and this brought in turn some unexpected beauty and quality to the urban design. The

  6. Audit of tumour histopathology reviewed by a regional oncology centre.

    PubMed Central

    Prescott, R J; Wells, S; Bisset, D L; Banerjee, S S; Harris, M

    1995-01-01

    AIMS--To analyse the diagnostic differences in reporting tumour histopathology between a district general hospital and a regional oncology centre. METHODS--Tumour histopathology reports (n = 227) extracted from Bolton General Hospital files between 1988 and 1992 were compared with the corresponding Christie Hospital (oncology centre) reports, the same material having been seen at both hospitals. RESULTS--Diagnostic agreement existed in 77% of all cases. The incidence of major discrepancies was 8.37%. Of the diagnoses, 19 (36%) cases involved major discrepancies and 34 (64%) cases minor discrepancies. Most discrepancies occurred in the lymphoma group and involved subclassification of Hodgkin's and non-Hodgkin's lymphoma. Ki1 anaplastic large cell lymphoma and T cell rich B cell lymphoma were problematic diagnoses. The correct grading of follicle centre cell lymphomas using the Kiel classification was another problem area. In 19 cases certain aspects of immunohistochemistry produced discrepancies. In one case an incorrect diagnosis was made at the oncology centre and in another both centres gave an incorrect diagnosis. CONCLUSIONS--Areas of diagnostic difficulty mainly involve the subclassification of lymphomas. Review of tumour pathology by experts is recommended, at least in certain categories, to ensure correct diagnosis and uniformity in subclassification of tumours. PMID:7730487

  7. Educational inequalities in patient-centred care: patients' preferences and experiences

    PubMed Central

    2012-01-01

    Background Educational attainment is strongly related to specific health outcomes. The pathway in which individual patient-provider interactions contribute to (re)producing these inequalities has yet to be studied. In this article, the focus is on differences between less and more highly educated patients in their preferences for and experiences with patient-centred care., e.g. shared decision making, receiving understandable explanations and being able to ask questions. Methods Data are derived from several Consumer Quality-index (CQ-index) studies. The CQ-index is a family of standardized instruments which are used in the Netherlands to measure quality of care from the patient’s perspective. Results The educational level of patients is directly related to the degree of importance patients attribute to specific aspects of patient-centred care. It has a minor influence on the experienced level of shared decision making, but not on experiences regarding other aspects of patient-centred care. Conclusions All patients regard patient-centred care as important and report positive experiences. However, there is a discrepancy between patient preferences for patient-centred care on one hand and the care received on the other. Less educated patients might receive ‘too much’, and more highly educated patients ‘too little’ in the domains of communication, information and shared decision making. PMID:22900589

  8. The effect of nitisinone on homogentisic acid and tyrosine: a two-year survey of patients attending the National Alkaptonuria Centre, Liverpool.

    PubMed

    Milan, Anna M; Hughes, Andrew T; Davison, Andrew S; Devine, Jean; Usher, Jeannette; Curtis, Sarah; Khedr, Milad; Gallagher, James A; Ranganath, Lakshminarayan R

    2017-05-01

    Background Alkaptonuria is a rare, debilitating autosomal recessive disorder affecting tyrosine metabolism. Deficiency of homogentisate 1,2-dioxygenase leads to increased homogentisic acid which is deposited as ochronotic pigment. Clinical sequelae include severe early onset osteoarthritis, increased renal and prostate stone formation and cardiac complications. Treatment has been largely based on analgaesia and arthroplasty. The National Alkaptonuria Centre in Liverpool has been using 2 mg nitisinone (NTBC) off-license for all patients in the United Kingdom with alkaptonuria and monitoring the tyrosine metabolite profiles. Methods Patients with confirmed alkaptonuria are commenced on 2 mg dose (alternative days) of NTBC for three months with daily dose thereafter. Metabolite measurement by LC-MS/MS is performed at baseline, day 4, three-months, six-months and one-year post-commencing NTBC. Thereafter, monitoring and clinical assessments are performed annually. Results Urine homogentisic acid concentration decreased from a mean baseline 20,557 µmol/24 h (95th percentile confidence interval 18,446-22,669 µmol/24 h) by on average 95.4% by six months, 94.8% at one year and 94.1% at two year monitoring. A concurrent reduction in serum homogentisic acid concentration of 83.2% compared to baseline was also measured. Serum tyrosine increased from normal adult reference interval to a mean ± SD of 594 ± 184 µmol /L at year-two monitoring with an increased urinary excretion from 103 ± 81 µmol /24 h at baseline to 1071 ± 726 µmol /24 h two years from therapy. Conclusions The data presented represent the first longitudinal survey of NTBC use in an NHS service setting and demonstrate the sustained effect of NTBC on the tyrosine metabolite profile.

  9. The Participation of Our Schools in the Defense and Diffusion of National Culture

    ERIC Educational Resources Information Center

    Cassanova, Manuel Gonzales

    1977-01-01

    Recounts a paper presented to the 18th Congress of the Centre International De Liaison Des Ecoles De Cinema et Television (CILECT) in 1976. Contends that American interests are infiltrating countries which are unable to defend against such threats to their national identity and analyzes "Sesame Street" to illustrate this contention. (MH)

  10. Psychometric evaluation of the Arabic language person-centred climate questionnaire-staff version.

    PubMed

    Aljuaid, Mohammed; Elmontsri, Mustafa; Edvardsson, David; Rawaf, Salman; Majeed, Azeem

    2018-05-01

    To evaluate the psychometric properties of the Arabic language person-centred climate questionnaire-staff version. There have been increasing calls for a person-centred rather than a disease-centred approach to health care. A limited number of tools measure the extent to which care is delivered in a person-centred manner, and none of these tools have been validated for us in Arab settings. The validated form of the person-centred climate questionnaire-staff version was translated into Arabic and distributed to 152 health care staff in teaching and non-teaching hospitals in Saudi Arabia. Statistical estimates of validity and reliability were used for psychometric evaluation. Items on the Arabic form of the person-centred climate questionnaire-staff version had high reliability (Cronbach's alpha .98). Cronbach's alpha values for the three sub-scales (safety, everydayness and community), were .96, .97 and .95 respectively. Internal consistency was also high and measures of validity were very good. Arabic form of the person-centred climate questionnaire-staff version provides a valid and reliable way to measure the degree of perceived person-centredness. The tool can be used for comparing levels of person-centredness between wards, units, and public and private hospitals. The tool can also be used to measure the extent of person-centredness in health care settings in other Arab countries. © 2017 John Wiley & Sons Ltd.

  11. A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial.

    PubMed

    Edvardsson, David; Sjögren, Karin; Lood, Qarin; Bergland, Ådel; Kirkevold, Marit; Sandman, Per-Olof

    2017-01-17

    The literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this. The study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents' thriving, relatives' satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives' experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention. The study is expected to provide evidence that can inform further research, policy and practice development on if and how

  12. Laser writing of coherent colour centres in diamond

    NASA Astrophysics Data System (ADS)

    Chen, Yu-Chen; Salter, Patrick S.; Knauer, Sebastian; Weng, Laiyi; Frangeskou, Angelo C.; Stephen, Colin J.; Ishmael, Shazeaa N.; Dolan, Philip R.; Johnson, Sam; Green, Ben L.; Morley, Gavin W.; Newton, Mark E.; Rarity, John G.; Booth, Martin J.; Smith, Jason M.

    2017-02-01

    Optically active point defects in crystals have gained widespread attention as photonic systems that could be applied in quantum information technologies. However, challenges remain in the placing of individual defects at desired locations, an essential element of device fabrication. Here we report the controlled generation of single negatively charged nitrogen-vacancy (NV-) centres in diamond using laser writing. Aberration correction in the writing optics allows precise positioning of the vacancies within the diamond crystal, and subsequent annealing produces single NV- centres with a probability of success of up to 45 ± 15%, located within about 200 nm of the desired position in the transverse plane. Selected NV- centres display stable, coherent optical transitions at cryogenic temperatures, a prerequisite for the creation of distributed quantum networks of solid-state qubits. The results illustrate the potential of laser writing as a new tool for defect engineering in quantum technologies, and extend laser processing to the single-defect domain.

  13. On the impact of RN network coverage on event selection and data fusion during the 2009 National Data Centres Preparedness Exercise

    NASA Astrophysics Data System (ADS)

    Becker, Andreas; Krysta, Monika; Auer, Matthias; Brachet, Nicolas; Ceranna, Lars; Gestermann, Nicolai; Nikkinen, Mika; Zähringer, Matthias

    2010-05-01

    The so-called National Data Centres (NDCs) to the Provisional Technical Secretariat of the Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty (CTBT) Organization are in charge to provide for the final judgement on the CTBT relevance of explosion events encountered in the PTS International Monitoring System (IMS). The latter is a 321 stations network set-up by the PTS (to date completion level: 80%) in order to globally monitor for occurrence of CTBT relevant seismo-acoustic and radionuclide signals. In doing so, NDCs learn about any seismo-acoustic or radionuclide event by active retrieval or subscription to corresponding event lists and products provided by the International Data Centre (IDC) to the PTS. To prepare for their instrumental role in case of a CTBT relevant event, the NDCs jointly conduct annually so-called NDC Preparedness Exercises. In 2009, NDC Germany was in charge to lead the exercise and to choose a seismo-acoustic event out of the list of events provided by the PTS (Gestermann et al., EGU2010-13067). The novelty in this procedure was that also the infrasound readings and the monitoring coverage of existing (certified) radionuclide stations into the area of consideration were taken into account during the event selection process (Coyne et al., EGU2010-12660). Hence, the event finally chosen and examined took place near Kara-Zhyra mine in Eastern Kazakhstan on 28 November 2009 around 07:20:31 UTC (Event-ID 5727516). NDC Austria performed forward atmospheric transport modelling in order to predict RN measurements that should have occurred in the radionuclide IMS. In doing so the fictitious case that there would have been a release of radionuclides taking place at the same location (Wotawa and Schraik, 2010; EGU2010-4907) in a strength being typical for a non-contained nuclear explosion is examined. The stations indicated should then be analysed for their actual radionuclide readings in order to confirm the non nuclear character of

  14. Building up careers in translational neuroscience and mental health research: Education and training in the Centre for Biomedical Research in Mental Health.

    PubMed

    Rapado-Castro, Marta; Pazos, Ángel; Fañanás, Lourdes; Bernardo, Miquel; Ayuso-Mateos, Jose Luis; Leza, Juan Carlos; Berrocoso, Esther; de Arriba, Jose; Roldán, Laura; Sanjuán, Julio; Pérez, Victor; Haro, Josep M; Palomo, Tomás; Valdizan, Elsa M; Micó, Juan Antonio; Sánchez, Manuel; Arango, Celso

    2015-01-01

    The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  15. Cardiac patients' perception of patient-centred care: a qualitative study.

    PubMed

    Esmaeili, Maryam; Cheraghi, Mohammad A; Salsali, Mahvash

    2016-03-01

    The aim of this study was to explore cardiac patients' perception of patient-centred care. Despite patient's importance in the process of care, less attention has been paid to experiences and expectations of patients in definitions of patient-centred care. As patients are an important element in process of patient-centred care, organizing care programs according to their perceptions and expectations will lead to enhanced quality of care and greater patient satisfaction. This study is a descriptive qualitative study. Content analysis approach was performed for data analysis. Participants were 18 cardiac patients (10 women and 8 men) hospitalized in coronary care units of teaching hospitals affiliated to Tehran University of Medical Sciences. We collected the study data through conducting personal face-to-face semi-structured interviews. The participants' perceptions of patient-centred care fell into three main themes including managing patients uncertainty, providing care with more flexibility and establishing a therapeutic communication. The second theme consisted of two sub-themes: empathizing with patients and having the right to make independent decisions. Receiving patient-centred care is essential for cardiac patients. Attention to priorities and preferences of cardiac patients and making decisions accordingly is among effective strategies for achieving patient-centred care. Cardiac care unit nurses ought to be aware that in spite of technological developments and advances, it is still important to pay attention to patients' needs and expectations in order to achieve patient satisfaction. In planning care programs, they should consider accountability towards patients' needs, flexibility in process of care and establishing medical interactions as an effective strategy for improving quality of care. © 2014 British Association of Critical Care Nurses.

  16. The availability, condition and employability of automated external defibrillators in large city centres in the Netherlands.

    PubMed

    Huig, Isabelle C; Boonstra, Linda; Gerritsen, Patricia C; Hoeks, Sanne E

    2014-10-01

    In the Netherlands there are, at the time of writing, no clear guidelines about the implementation of automated external defibrillators (AEDs). An observational study was conducted to investigate the current status of AEDs in city centres in the Netherlands looking specifically at the availability, condition and employability of the AEDs. The shopping areas in the old city centres of the six largest cities in the Netherlands were included in the study. After the AEDs had been identified, a questionnaire was used to determine the availability, condition and employability of the AED. In total 130 AEDs were found and 122 included in the study. The following results were found: 40% of the AEDs were not visible (range 21-64), 29% were not indicated with a sign (range 19-41), 7% had an empty battery (range 0-23), 16% of the defipads had expired (range 0-31) and in 98% of the AEDs a trained employee was present (range 96-100). After combining these results, 71% of the AEDs were available for use (range 61-93), 70% were in a good condition (range 46-82) and 70% were employable (range 58-93). The results show a major variability between cities. Our study demonstrates that although national guidelines have not been implemented, a reasonable amount of AEDs can be found. However there is certainly room for improvement in the current availability, condition and employability of AEDs in city centres in the Netherlands. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. ESA SSA Space Radiation Expert Service Centre: the Importance of Community Feedback

    NASA Astrophysics Data System (ADS)

    Crosby, Norma; Dierckxsens, Mark; Kruglanski, Michel; De Donder, Erwin; Calders, Stijn; Messios, Neophytos; Glover, Alexi

    2017-04-01

    End-users in a wide range of sectors both in space and on the ground are affected by space weather. In the frame of its Space Situational Awareness (SSA) programme (http://swe.ssa.esa.int/) the European Space Agency (ESA) is establishing a Space Weather (SWE) Service Network to support end-users in three ways: mitigate the effects of space weather on their systems, reduce costs, and improve reliability. Almost 40 expert groups from institutes and organisations across Europe contribute to this Network organised in five Expert Service Centres (ESCs) - Solar Weather, Heliospheric Weather, Space Radiation, Ionospheric Weather, Geomagnetic Conditions. To understand the end-user needs, the ESCs are supported by the SSCC (SSA Space Weather Coordination Centre) that offers first line support to the end-users. Here we present the mission of the Space Radiation ESC (R-ESC) (http://swe.ssa.esa.int/space-radiation) and the space domain services it supports. Furthermore, we describe how the R-ESC project complements past and ongoing projects both on national level as well as international (e.g. EU projects), emphasizing the importance of inter-disciplinary communication between different communities ranging from scientists, engineers to end-users. Such collaboration is needed if basic science is to be used most efficiently for the development of products and tools that provide end-users with what they actually need. Additionally, feedback from the various communities (projects) is also essential when defining future projects.

  18. The CTBTO Link to the database of the International Seismological Centre (ISC)

    NASA Astrophysics Data System (ADS)

    Bondar, I.; Storchak, D. A.; Dando, B.; Harris, J.; Di Giacomo, D.

    2011-12-01

    The CTBTO Link to the database of the International Seismological Centre (ISC) is a project to provide access to seismological data sets maintained by the ISC using specially designed interactive tools. The Link is open to National Data Centres and to the CTBTO. By means of graphical interfaces and database queries tailored to the needs of the monitoring community, the users are given access to a multitude of products. These include the ISC and ISS bulletins, covering the seismicity of the Earth since 1904; nuclear and chemical explosions; the EHB bulletin; the IASPEI Reference Event list (ground truth database); and the IDC Reviewed Event Bulletin. The searches are divided into three main categories: The Area Based Search (a spatio-temporal search based on the ISC Bulletin), the REB search (a spatio-temporal search based on specific events in the REB) and the IMS Station Based Search (a search for historical patterns in the reports of seismic stations close to a particular IMS seismic station). The outputs are HTML based web-pages with a simplified version of the ISC Bulletin showing the most relevant parameters with access to ISC, GT, EHB and REB Bulletins in IMS1.0 format for single or multiple events. The CTBTO Link offers a tool to view REB events in context within the historical seismicity, look at observations reported by non-IMS networks, and investigate station histories and residual patterns for stations registered in the International Seismographic Station Registry.

  19. Force-induced chemical reactions on the metal centre in a single metalloprotein molecule.

    PubMed

    Zheng, Peng; Arantes, Guilherme M; Field, Martin J; Li, Hongbin

    2015-06-25

    Metalloproteins play indispensable roles in biology owing to the versatile chemical reactivity of metal centres. However, studying their reactivity in many metalloproteins is challenging, as protein three-dimensional structure encloses labile metal centres, thus limiting their access to reactants and impeding direct measurements. Here we demonstrate the use of single-molecule atomic force microscopy to induce partial unfolding to expose metal centres in metalloproteins to aqueous solution, thus allowing for studying their chemical reactivity in aqueous solution for the first time. As a proof-of-principle, we demonstrate two chemical reactions for the FeS4 centre in rubredoxin: electrophilic protonation and nucleophilic ligand substitution. Our results show that protonation and ligand substitution result in mechanical destabilization of the FeS4 centre. Quantum chemical calculations corroborated experimental results and revealed detailed reaction mechanisms. We anticipate that this novel approach will provide insights into chemical reactivity of metal centres in metalloproteins under biologically more relevant conditions.

  20. Force-induced chemical reactions on the metal centre in a single metalloprotein molecule

    PubMed Central

    Zheng, Peng; Arantes, Guilherme M.; Field, Martin J.; Li, Hongbin

    2015-01-01

    Metalloproteins play indispensable roles in biology owing to the versatile chemical reactivity of metal centres. However, studying their reactivity in many metalloproteins is challenging, as protein three-dimensional structure encloses labile metal centres, thus limiting their access to reactants and impeding direct measurements. Here we demonstrate the use of single-molecule atomic force microscopy to induce partial unfolding to expose metal centres in metalloproteins to aqueous solution, thus allowing for studying their chemical reactivity in aqueous solution for the first time. As a proof-of-principle, we demonstrate two chemical reactions for the FeS4 centre in rubredoxin: electrophilic protonation and nucleophilic ligand substitution. Our results show that protonation and ligand substitution result in mechanical destabilization of the FeS4 centre. Quantum chemical calculations corroborated experimental results and revealed detailed reaction mechanisms. We anticipate that this novel approach will provide insights into chemical reactivity of metal centres in metalloproteins under biologically more relevant conditions. PMID:26108369

  1. Transitional and Transformational Spaces: Mentoring Young Academics through Writing Centres

    ERIC Educational Resources Information Center

    Archer, Arlene; Parker, Shabnam

    2016-01-01

    The effectiveness of writing centre interventions on student writing in higher education has been well-documented in academic literacies studies. This paper changes the focus of investigation from student to consultant and, consequently, explores the way in which an academic writing centre can function as a mentoring environment for young…

  2. Leading an Effective Improvement and Development Programme for Children's Centres

    ERIC Educational Resources Information Center

    Weston, Gill; Tyler, Mary

    2015-01-01

    This article reviews the process and achievements of leadership of an improvement and development programme for children's centres in the context of public value and Ofsted inspection. It analyses how the capacity has been developed of children's centre managers to work more strategically and collectively. Distributed leadership theory is applied…

  3. Research Informed Science Enrichment Programs at the Gravity Discovery Centre

    ERIC Educational Resources Information Center

    Venville, Grady; Blair, David; Coward, David; Deshon, Fred; Gargano, Mark; Gondwe, Mzamose; Heary, Auriol; Longnecker, Nancy; Pitts, Marina; Zadnik, Marjan

    2012-01-01

    Excursions to museums and science centres generally are great fun for students and teachers. The potential educational benefits beyond enjoyment, however, are rarely realised or analysed for their efficacy. The purpose of this paper is to describe four educational enrichment programs delivered at the Gravity Discovery Centre (GDC), near Gingin,…

  4. Barriers and opportunities for enhancing patient recruitment and retention in clinical research: findings from an interview study in an NHS academic health science centre.

    PubMed

    Adams, Mary; Caffrey, Louise; McKevitt, Christopher

    2015-03-12

    In the UK, the recruitment of patients into clinical research is a national health research and development policy priority. There has been limited investigation of how national level factors operate as barriers or facilitators to recruitment work, particularly from the perspective of staff undertaking patient recruitment work. The aim of this study is to identify and examine staff views of the key organisational barriers and facilitators to patient recruitment work in one clinical research group located in an NHS Academic Health Science Centre. A qualitative study utilizing in-depth, one-to-one semi-structured interviews with 11 purposively selected staff with particular responsibilities to recruit and retain patients as clinical research subjects. Thematic analysis classified interview data by recurring themes, concepts, and emergent categories for the purposes of establishing explanatory accounts. The findings highlight four key factors that staff perceived to be most significant for the successful recruitment and retention of patients in research and identify how staff located these factors within patients, studies, the research centre, the trust, and beyond the trust. Firstly, competition for research participants at an organisational and national level was perceived to undermine recruitment success. Secondly, the tension between clinical and clinical research workloads was seen to interrupt patient recruitment into studies, despite national funding arrangements to manage excess treatment costs. Thirdly, staff perceived an imbalance between personal patient burden and benefit. Ethical committee regulation, designed to protect patients, was perceived by some staff to detract from clarification and systematisation of incentivisation strategies. Finally, the structure and relationships within clinical research teams, in particular the low tacit status of recruitment skills, was seen as influential. The results of this case-study, conducted in an exemplary NHS

  5. Comparison of three models of ownership of community health centres in China: a qualitative study.

    PubMed

    Wei, Xiaolin; Yang, Nan; Gao, Yang; Wong, Samuel Y S; Wong, Martin C S; Wang, Jiaji; Wang, Harry H X; Li, Donald K T; Tang, Jinling; Griffiths, Sian M

    2015-07-01

    Community health centres are the main form of provision of primary care in China. There are three models: government managed, hospital managed and private. Our aim was to describe and compare primary care under the three ownership models. Four aspects of primary care were studied: services, organization, financing and human resources. Interviews were undertaken with 60 managerial and professional staff in 13 community health centres in the Pearl River Delta region in 2010. Three community health centres were selected in the capital city and two were selected from each of the other five cities. Thematic framework analysis was conducted. Government-managed community health centres received the largest public funding, followed by hospital-managed community health centres, while private community health centres received the least. Private community health centres were the smallest in scale and provided lower quality public health services compared with the other two models. Patient out-of-pocket costs accounted for the majority of the revenue in all models of community health centres despite improved government funding for preventive services. General challenges such as the shortage of public funding, the exclusion of migrants in the funding for preventive services, low capacity in human resources and the separation of clinical and preventive care in community health centres were identified in all three models of community health centres. The ownership and management of a community health centre greatly influence the service it provides. Private community health centres are in a disadvantaged position to deliver high quality clinical and preventive care. © The Author(s) 2015.

  6. Improving the layout of recycling centres by use of lean production principles.

    PubMed

    Sundin, Erik; Björkman, Mats; Eklund, Mats; Eklund, Jörgen; Engkvist, Inga-Lill

    2011-06-01

    There has been increased focus on recycling in Sweden during recent years. This focus can be attributed to external environmental factors such as tougher legislation, but also to the potential gains for raw materials suppliers. Recycling centres are important components in the Swedish total recycling system. Recycling centres are manned facilities for waste collection where visitors can bring, sort and discard worn products as well as large-sized, hazardous, and electrical waste. The aim of this paper was to identify and describe the main flows and layout types at Swedish recycling centres. The aim was also to adapt and apply production theory for designing and managing recycling centre operations. More specifically, this means using lean production principles to help develop guidelines for recycling centre design and efficient control. Empirical data for this research was primarily collected through interviews and questionnaires among both visitors and employees at 16 Swedish recycling centres. Furthermore, adapted observation protocols have been used in order to explore visitor activities. There was also close collaboration with a local recycling centre company, which shared their layout experiences with the researchers in this project. The recycling centres studied had a variety of problems such as queues of visitors, overloading of material and improper sorting. The study shows that in order to decrease the problems, the recycling centres should be designed and managed according to lean production principles, i.e. through choosing more suitable layout choices with visible and linear flows, providing better visitor information, and providing suitable technical equipment. Improvements can be achieved through proper planning of the layout and control of the flow of vehicles, with the result of increased efficiency and capacity, shorter visits, and cleaner waste fractions. The benefits of a lean production mindset include increased visitor capacity, waste

  7. The Tehran Book Processing Centre.

    ERIC Educational Resources Information Center

    Harvey, John F.

    Establishment of the Tehran Book Processing Centre (Tebroc) was proposed in the Spring of 1968. This document is a descriptive and historical account of the center, and a description of its contributions to Iranian processing development. The center was modeled, to a certain extent, after Bro-Dart's Alanar in Williamsport, Pennsylvania. Tebroc was…

  8. Knowledge and perceptions of physicians from private medical centres towards generic medicines: a nationwide survey from Malaysia.

    PubMed

    Kumar, Rohit; Hassali, Mohamed Azmi; Saleem, Fahad; Alrasheedy, Alian A; Kaur, Navneet; Wong, Zhi Yen; Kader, Muhamad Ali Sk Abdul

    2015-01-01

    Generic medicine prescribing has become a common practice in public hospitals. However, the trend in private medical centres seems to be different. The objective of this study was to investigate knowledge, perceptions and behavior of physicians from private medical centres in Malaysia regarding generic medicines. This study was a cross-sectional nationwide survey targeting physicians from private medical centres in Malaysia. The survey was conducted using questionnaire having (i) background and demographic data of the physicians, volume of prescription in a day, stock of generic medicines in their hospital pharmacy etc. (ii) their knowledge about bioequivalence (iii) prescribing behavior (iv) physicians' knowledge of quality, safety and efficacy of generic medicines, and their cost (v) perceptions of physicians towards issues pertaining to generic medicines utilization. A total of 263 questionnaires out of 735 were received, giving a response rate of 35.8%. Of the respondents, 214 (81.4%) were male and 49 (18.6%) were females. The majority of the participants were in the age range of 41-50 years and comprised 49.0% of the respondents. Only 2.3% of physicians were aware of the regulatory limits of bioequivalence standards in Malaysia. Of the respondents, 23.2% agreed that they 'always' write their prescriptions using originator product name whereas 50.2% do it 'usually'. A number of significant associations were found between their knowledge, perceptions about generic medicines and their demographic characteristics. The majority of the physicians from private medical centres in Malaysia had negative perceptions about safety, quality and the efficacy of generic medicines. These negative perceptions could be the cause of the limited use of generic medicines in the private medical centres. Therefore, in order to facilitate their use, it is recommended that the physicians need to be reassured and educated about the drug regulatory authority approval system of generic

  9. Motivation for orthognathic treatment and anticipated satisfaction levels-a two-centre cross-national audit.

    PubMed

    Patcas, Raphael; Cunningham, Susan J; Shute, Justin; Lloyd, Timothy; Obwegeser, Joachim A; Arjomand, Lida; Sharma, Sujata

    2017-06-01

    This audit investigated factors which motivate patients to seek orthognathic treatment, assessed how confident patients were that they would be satisfied with the outcome of treatment, and explored possible influencing factors. Questionnaires were distributed to pre-surgical patients at two centres (United Kingdom and Switzerland); questions asked what patients wished to gain from orthognathic treatment and how confident they were that they would be satisfied with treatment outcome. Gender, age and location were recorded as demographic variables, and type of malocclusion was also recorded. A total of 202 questionnaires were returned (UK, n = 149; Switzerland, n = 53). Reported motivating factors focused on improvements in aesthetics (specified and unspecified) (UK vs. Switzerland: 91.3% vs. 83.0%), function (72.5% vs. 66.0%), psychosocial health (51.7% vs. 20.8%), speech (4.0% vs. 7.5%), alleviation of pain (5.4% vs. 17%) and normalization of breathing (1.3% vs. 7.5%). No significant relationships were observed relative to patient age, gender or malocclusion. The anticipated satisfaction levels were generally high (86.5% vs. 89.9%). Although the distribution of motivational factors varied between the two sites, it did not affect the anticipated satisfaction level. Patients were generally confident that they would be satisfied with their treatment outcome and that their reasons for seeking treatment would be addressed. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.

  10. Examination and Evaluation of Websites of Science Centres in Turkey

    ERIC Educational Resources Information Center

    Bozdogan, Aykut Emre; Bozdogan, Kerem

    2016-01-01

    Science centres which have a considerable importance and functions in developed countries are intended to be popularized in Turkey. At this point considering the fact that the first contact between science centres and visitors is usually provided with websites, it is quite important that the content of these websites should be designed and…

  11. Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project.

    PubMed

    Egner, W; Cook, T; Harper, N; Garcez, T; Marinho, S; Kong, K L; Nasser, S; Thomas, M; Warner, A; Hitchman, J; Floss, K

    2017-10-01

    Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6 th National Audit Project. We compare self-declared UK practice in specialist perioperative allergy services with national recommendations. A SurveyMonkey™ questionnaire was distributed to providers of allergy services in the UK. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (NICE) Guidance on Drug Allergy-CG183. Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait >13 weeks) in contrast to adult centres (most wait <12 weeks). Service leads are allergists/immunologists (91%) or anaesthetists (7%). Potentially important differences were seen in: testing repertoire [10/44 (23%) lacked BSACI compliant neuromuscular blocking agent (NMBA) panels and 17/44 (39%) lacked a NAP6-defined extended panel; many failed to screen all cases for chlorhexidine 19/44 (43%) or latex 21/44 (48%)], staffing [only 26/44 (59%) had specialist nurses and 18/44 (41%) an anaesthetist] and provision of information [18/44 (41%) gave immediate information in clinic and 5/44 (11%) sign-posted support groups]. Most centres were able to provide diagnostic challenges to antibiotics [40/44 (91%]) and local anaesthetics [41/44 (93%)]. Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of

  12. UK Renal Registry 18th Annual Report: Chapter 11 2014 Multisite Dialysis Access Audit in England, Northern Ireland and Wales and 2013 PD One Year Follow-up: National and Centre-specific Analyses.

    PubMed

    Rao, Anirudh; Evans, Rebecca; Wilkie, Martin; Fluck, Richard; Kumwenda, Mick

    2016-01-01

    Data are presented from the third combined vascular and peritoneal dialysis access audit. In 2014, 53 centres in England, Wales and Northern Ireland (out of 62) returned data on first access from 4,339 incident haemodialysis (HD) patients and 1,090 incident peritoneal dialysis (PD) patients. Of the 5,429 incident patients, 20.1% started dialysis on PD, 27.8% started with an arteriovenous fistula (AVF), 1.0% with an arteriovenous graft (AVG), 27.1% on a tunnelled line (TL) and 24.0% on a non-tunnelled line (NTL). Older patients (565 years) were more likely to start haemodialysis using AVF compared to their younger counterparts (36.2% vs. 32.8%). Thirteen of the nineteen centres (68%) using the physician led percutaneous insertion technique had over 20% of their incident patients starting on PD when compared to only seven out of fourteen centres (50%) which used single technique (open surgical or laparoscopic) for their PD catheter insertion. Wide variations were apparent between centres for use of AVF as the first haemodialysis access ranging from 10–54%. Eight of the 49 centres were achieving close to the 65% target for AV fistula in their incident patients. Length of time known to nephrology services and likelihood of commencing dialysis using either an AVF or a PD catheter are strongly associated. Patients who were known to a nephrologist for over one year were more likely to start dialysis with AVF, as compared to those who were referred between 90–365 days (39.2% vs. 24.6%). Similarly, patients who were known to a nephrologist between 90 days and one year were more likely to start on PD when compared to patients who were referred <90 days prior to dialysis start (26.9% vs. 9.1%). By comparison, amongst the late presenters, only 3.5% had first access documented as an AVF and 87.3% started dialysis on either a tunnelled line or a non-tunnelled line. Initial surgical assessment was a key determinant of the likelihood of AVF formation. Of the incident patients

  13. Developing a Partnership between the Riverina Environmental Education Centre and Charles Sturt University

    ERIC Educational Resources Information Center

    Boylan, Colin; Collin, Keith

    2006-01-01

    A collaborative partnership has evolved between the Riverina Environmental Education Centre (REEC) and Charles Sturt University in Wagga Wagga. The Riverina Environmental Education Centre (REEC) is one of 24 Department of Education and Training environmental education centres in New South Wales (see www.reec.nsw.edu.au). As part of this…

  14. A comparative concept analysis of centring vs. opening meditation processes in health care.

    PubMed

    Birx, Ellen

    2013-08-01

    To report an analysis and comparison of the concepts centring and opening meditation processes in health care. Centring and opening meditation processes are included in nursing theories and frequently recommended in health care for stress management. These meditation processes are integrated into emerging psychotherapy approaches and there is a rapidly expanding body of neuroscience research distinguishing brain activity associated with different types of meditation. Currently, there is a lack of theoretical and conceptual clarity needed to guide meditation research in health care. A search of healthcare literature between 2006-2011 was conducted using Alt HealthWatch, CINAHL, PsychNET and PubMed databases using the keywords 'centring' and 'opening' alone and in combination with the term 'meditation.' For the concept centring, 10 articles and 11 books and for the concept opening 13 articles and 10 books were included as data sources. Rodgers' evolutionary method of concept analysis was used. Centring and opening are similar in that they both involve awareness in the present moment; both use a gentle, effortless approach; and both have a calming effect. Key differences include centring's focus on the individual's inner experience compared with the non-dual, spacious awareness of opening. Centring and opening are overlapping, yet distinct meditation processes. The term meditation cannot be used in a generic way in health care. The differences between centring and opening have important implications for the further development of unitary-transformative nursing theories. © 2012 Blackwell Publishing Ltd.

  15. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study.

    PubMed

    Hitzert, Marit; Hermus, Marieke A A; Scheerhagen, Marisja; Boesveld, Inge C; Wiegers, Therese A; van den Akker-van Marle, M Elske; van Dommelen, Paula; van der Pal-de Bruin, Karin M; de Graaf, Johanna P

    2016-09-01

    to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. this study is a cross-sectional study using the ReproQ questionnaire filled out eight to ten weeks after birth. The primary outcome was responsiveness of birth care. Secondary outcomes included overall grades for birth care and experiences with the birth centre services. Regression analyses were performed to compare experiences among the planned places of birth. The study is part of the Dutch Birth Centre Study. the women were recruited by 82 midwifery practices in the Netherlands, within the study period 1 August 2013 and 31 December 2013. a total of 2162 women gave written consent to receive the questionnaire and 1181 (54.6%) women completed the questionnaire. women who planned to give birth at a birth centre: (1) had similar experiences as the women who planned to give birth in a hospital receiving care of a community midwife. (2) had significantly less favourable experiences than the women who planned to give birth at home. Differences during birth were seen on the domains dignity (OR=1.58, 95% CI=1.09-2.27) and autonomy (OR=1.77, 95% CI=1.25-2.51), during the postpartum period on the domains social considerations (OR=1.54, 95% CI=1.06-2.25) and choice and continuity (OR=1.43, 95% CI=1.00-2.03). (3) had significantly better experiences than the women who planned to give birth in a hospital under supervision of an obstetrician. Differences during birth were seen on the domains dignity (OR=0.51, 95% CI=0.31-0.81), autonomy (OR=0.59, 95% CI=0.35-1.00), confidentiality (OR=0.57, 95% CI=0.36-0.92) and social considerations (OR=0.47, 95% CI=0.28-0.79). During the postpartum period differences were seen on the domains dignity (OR=0.61, 95% CI=0.38-0.98), autonomy (OR=0.52, 95% CI=0.31-0.85) and basic amenities (OR=0.52, 95% CI=0.30-0.88). More than 80

  16. Assuring measurement quality in person-centred healthcare

    NASA Astrophysics Data System (ADS)

    Pendrill, L. R.

    2018-03-01

    Is it realistic to aspire to the same kind of quality-assurance of measurement in person-centred care, currently being implemented in healthcare globally, as is established in the physical sciences and engineering? Ensuring metrological comparability (‘traceability’) and reliably declaring measurement uncertainty when assessing patient ability or increased social capital are however challenging for subjective measurements often characterised by large dispersion. Drawing simple analogies between ‘instruments’ in the social sciences—questionnaires, ability tests, etc—and engineering instruments such as thermometers does not go far enough. A possible way forward, apparently equally applicable to both physical and social measurement, seems to be to model inferences in terms of performance metrics of a measurement system. Person-centred care needs person-centred measurement and a full picture of the measurement process when man acts as a measurement instrument is given in the present paper. This complements previous work by presenting the process, step by step, from the observed indication (e.g. probability of success, P success, of achieving a task), through restitution with Rasch measurement theory, to the measurand (e.g. task difficulty). Rasch invariant measure theory can yield quantities—‘latent’ (or ‘explanatory’) variables such as task challenge or person ability—with characteristics akin to those of physical quantities. Metrological references for comparability via traceability and reliable estimates of uncertainty and decision risks are then in reach even for perceptive measurements (and other qualitative properties). As a case study, the person-centred measurement of cognitive ability is examined, as part of the EU project EMPIR 15HLT04 NeuroMet, for Alzheimer’s, where better analysis of correlations with brain atrophy is enabled thanks to the Rasch metrological approach.

  17. The Operational Role of the Belgian User Support and Operations Centre for the Atmosphere-Space Interactions Monitor (ASIM) on-board the International Space Station.

    NASA Astrophysics Data System (ADS)

    Muller, C.; Moreau, D., Sr.; Pandey, P. K.; Crosby, N. B.

    2014-12-01

    The Belgian User Support and Operations Centre (B.USOC) is an operational centre managing technological and scientific payloads on the International Space Station (ISS). B.USOC is the Facility Responsible Centre (FRC) for the European Space Agency's (ESA) Atmosphere-Space Interactions Monitor (ASIM) payload and also manages the Scientific Mission Centre of the Centre National d'Etudes Spatiales (CNES) PICARD satellite that monitors solar activity, among various other space missions. In this respect, B.USOC is ideally positioned to manage possible synergies between ASIM, the satellite TARANIS (Tool for the Analysis of RAdiation from lightNIng and Sprites), other space missions and ground-based networks. The ASIM mission (Neubert, 2009) consists of a package of two nadir instruments: one for the visible spectrum and another for X-ray and gamma-ray frequencies. In the normal operating mode "trigger mode" both instruments continuously measure, but, do not record data below certain thresholds. Another mode is a "timed mode", where, during a certain time the observations are recorded even in the absence of triggers. The "timed mode" demands a lot of flexibility from both scientific teams and B.USOC, as, ASIM's main targets of investigation (sprites and elves) are related to intense thunderstorms and thus, require reliable meteorological forecasts in the entire range of ISS latitudes. Moreover, ASIM is sensitive to a large number of phenomena of which most have a direct relationship with solar activity and therefore would probably need support from the ESA SSA (Space Situational Awareness) Space Weather Coordination Centre (SSCC) that shares the same campus with B.USOC. Local cooperation between the two centres, together with other space payloads such as TARANIS and ground-based networks will greatly optimize ASIM payload operations as well as scientific return. Neubert, T., and the ASIM Team, ASIM - an Instrument Suite for the International Space Station, Corte Workshop

  18. ESCAP/POPIN Expert Working Group on Development of Population Information Centres and Networks, 20-23 June 1984, Bangkok, Thailand.

    PubMed

    1984-07-01

    An overview of current population information programs at the regional, national, and global level was presented at a meeting of the Expert Working Group on Development of Population Information Centres and Networks. On the global level, the decentralized Population Information Network (POPIN) was established, consisting of population libraries, clearinghouses, information systems, and documentation centers. The Economic and Social Commission for Asia and the Pacific (ESCAP) Regional Population Information Centre (PIC) has actively promoted the standardization of methodologies for the collection and processing of data, the use of compatible terminology, adoption of classification systems, computer-assisted data and information handling, and improved programs of publication and infomration dissemination, within and among national centers. Among the national PICs, 83% are attached to the primary national family planning/fertility control unit and 17% are attached to demographic data, research, and analysis units. Lack of access to specialized information handling equipment such as microcomputers, word processors, and computer terminals remains a problem for PICs. Recommendations were made by the Expert Working Group to improve the functions of PICs: 1) the mandate and resoponsibilities of the PIC should be explicilty stated; 2) PICs should collect, process, and disseminate population information in the most effective format to workers in the population feild; 3) PICs should be given flexibility in the performance of activitites by their governing bodies; 4) short-term training should be provided in computerization and dissemination of information; 5) research and evaluation mechanisms for PIC activities should be developed; 6) PIC staff should prepare policy briefs for decision makers; 7) access to parent organizations should be given to nongovernment PICs; 8) study tours to foreign PICs should be organized for PIC staff; and 9) on-the-job training in indexing and

  19. Bubble propagation in Hele-Shaw channels with centred constrictions

    NASA Astrophysics Data System (ADS)

    Franco-Gómez, Andrés; Thompson, Alice B.; Hazel, Andrew L.; Juel, Anne

    2018-04-01

    We study the propagation of finite bubbles in a Hele-Shaw channel, where a centred occlusion (termed a rail) is introduced to provide a small axially uniform depth constriction. For bubbles wide enough to span the channel, the system’s behaviour is similar to that of semi-infinite fingers and a symmetric static solution is stable. Here, we focus on smaller bubbles, in which case the symmetric static solution is unstable and the static bubble is displaced towards one of the deeper regions of the channel on either side of the rail. Using a combination of experiments and numerical simulations of a depth-averaged model, we show that a bubble propagating axially due to a small imposed flow rate can be stabilised in a steady symmetric mode centred on the rail through a subtle interaction between stabilising viscous forces and destabilising surface tension forces. However, for sufficiently large capillary numbers Ca, the ratio of viscous to surface tension forces, viscous forces in turn become destabilising thus returning the bubble to an off-centred propagation regime. With decreasing bubble size, the range of Ca for which steady centred propagation is stable decreases, and eventually vanishes through the coalescence of two supercritical pitchfork bifurcations. The depth-averaged model is found to accurately predict all the steady modes of propagation observed experimentally, and provides a comprehensive picture of the underlying steady bifurcation structure. However, for sufficiently large imposed flow rates, we find that initially centred bubbles do not converge onto a steady mode of propagation. Instead they transiently explore weakly unstable steady modes, an evolution which results in their break-up and eventual settling into a steady propagating state of changed topology.

  20. Active mode-locked operation of a diode pumped colour-centre laser

    NASA Astrophysics Data System (ADS)

    Mazighi, K.; Doualan, J. L.; Hamel, J.; Margerie, J.; Mounier, D.; Ostrovsky, A.

    1991-09-01

    The cw laser diode pumping of an (F +2) ∗ colour centre laser has been recently demonstrated in our laboratory. The intensity of the pumping diode can easily be hf modulated. We present here the first experiments in which the colour centre laser is synchronously pumped at the mode spacing frequency, resulting in the emission of clean, regularly spaced pulses. The opto-electronic feedback is a very promising method of obtaining such a pulsed operation of a diode pumped colour centre laser without the use of an external hf oscillator.

  1. Identifying Centres of Plant Biodiversity in South Australia

    PubMed Central

    Guerin, Greg R.; Biffin, Ed; Baruch, Zdravko; Lowe, Andrew J.

    2016-01-01

    We aimed to identify regional centres of plant biodiversity in South Australia, a sub-continental land area of 983,482 km2, by mapping a suite of metrics. Broad-brush conservation issues associated with the centres were mapped, specifically climate sensitivity, exposure to habitat fragmentation, introduced species and altered fire regimes. We compiled 727,417 plant species records from plot-based field surveys and herbarium records and mapped the following: species richness (all species; South Australian endemics; conservation-dependent species; introduced species); georeferenced weighted endemism, phylogenetic diversity, georeferenced phylogenetic endemism; and measures of beta diversity at local and state-wide scales. Associated conservation issues mapped were: climate sensitivity measured via ordination and non-linear modelling; habitat fragmentation represented by the proportion of remnant vegetation within a moving window; fire prone landscapes assessed using fire history records; invasive species assessed through diversity metrics, species distribution and literature. Compared to plots, herbarium data had higher spatial and taxonomic coverage but records were more biased towards major transport corridors. Beta diversity was influenced by sampling intensity and scale of comparison. We identified six centres of high plant biodiversity for South Australia: Western Kangaroo Island; Southern Mount Lofty Ranges; Anangu Pitjantjatjara Yankunytjatjara lands; Southern Flinders Ranges; Southern Eyre Peninsula; Lower South East. Species composition in the arid-mediterranean ecotone was the most climate sensitive. Fragmentation mapping highlighted the dichotomy between extensive land-use and high remnancy in the north and intensive land-use and low remnancy in the south. Invasive species were most species rich in agricultural areas close to population centres. Fire mapping revealed large variation in frequency across the state. Biodiversity scores were not always

  2. Evaluation of telemedicine centres in Madhya Pradesh, Central India.

    PubMed

    Bali, Surya; Gupta, Arti; Khan, Asif; Pakhare, Abhijit

    2016-04-01

    In a developing country such as India, there is substantial inequality in health care distribution. Telemedicine facilities were established in Madhya Pradesh in 2007-2008. The purpose of this study was to evaluate the infrastructure, equipment, manpower, and functional status of Indian Space and Research Organisation (ISRO) telemedicine nodes in Madhya Pradesh. All district hospitals and medical colleges with nodes were visited by a team of three members. The study was conducted from December 2013-January 2014. The team recorded the structural facility situation and physical conditions on a predesigned pro forma. The team also conducted interviews with the nodal officers, data entry operator and other relevant people at these centres. Of the six specialist nodes, four were functional and two were non-functional. Of 10 patient nodes, two nodes were functional, four were semi-functional and four were non-functional. Most of the centres were not working due to a problem with their satellite modem. The overall condition of ISRO run telemedicine centres in Madhya Pradesh was found to be poor. Most of these centres failed to provide telemedicine consultations. We recommend replacing this system with another cost effective system available in the state wide area network (SWAN). We suggest the concept of the virtual out-patient department. © The Author(s) 2015.

  3. Evaluation of the Training Centre Infrastructure Fund (TCIF). Final Report

    ERIC Educational Resources Information Center

    Human Resources and Skills Development Canada, 2009

    2009-01-01

    The Training Centre Infrastructure Fund (TCIF) was initially announced in Budget 2004 and represented an immediate measure of the broader Workplace Skills Strategy. TCIF was a three-year $25 million pilot project, designed to address the growing need for union-employer training centres to replace aging equipment and simulators that were not up to…

  4. Malformations congénitales à Lubumbashi (République Démocratique du Congo): à propos de 72 cas observés et plaidoyer en faveur du développement d'un Registre National des Malformations Congénitales et d'un Centre National de Référence de Génétique Humaine

    PubMed Central

    Lubala, Toni Kasole; Shongo, Mick Yapongombo; Munkana, Arthur Ndundula; Mutombo, Augustin Mulangu; Mbuyi, Sébastien Musanzayi; wa Momat, Félix Kitenge

    2012-01-01

    En République Démocratique du Congo, les malformations congénitales constituent un véritable problème de santé publique. En effet, elles relancent le débat sur les effets de l'intensification de l'activité minière sur la santé de la reproduction. De 2009 à 2010, nous avons calculé une prévalence de 5.84 pour 1000 naissances. Les malformations du système nerveux central étaient les plus fréquentes (2.029 pour 1000) suivies des malformations des membres (1.055 pour 1000), et des fentes oro-faciales (0.811 pour 1000). Ces données sont certainement largement sous-estimées et les causes y relatives en République Démocratique du Congo ne sont ni surveillées, ni prévenues dans le cadre d'une politique gouvernementale. La mise en place d'un registre national et d'un centre national de génétique humaine de référence pourrait constituer un cadre rigoureux, organisé et structuré de surveillance et de prévention des malformations congénitales. PMID:23396951

  5. The UK Haemophilia Doctors Organisation triennial audit of UK Comprehensive Care Haemophilia Centres.

    PubMed

    Wilde, J T

    2012-07-01

    Under the auspices of the United Kingdom Haemophilia Doctors Organisation (UKHCDO) the UK Comprehensive Care Haemophilia Centres (CCCs) have undergone a three yearly formal audit assessment since 1993. This report describes the evolution of the audit process and details the findings of the most recent audit round, the sixth since inception. The audit reports from the 2009 audit round were reviewed by the audit organizing group and a structured analysis of the data was compiled. CCCs in the UK offer a high standard of comprehensive care services. The main areas of concern were the state of the premises (seven centres), lack of dental services (seven centres), physiotherapy (seven centres) and social work support (11 centres). Major concerns were identified at eight centres requiring a formal letter from the chairman of UKHCDO to the chief executive of the host trust. Since inception of the triennial audit process centre report recommendations have resulted in major improvements in the services available at UK CCCs. The audit process is considered to be a highly effective means of improving the quality of care for patients with bleeding disorders and can be used as a model for the introduction of a similar process in other countries. © 2012 Blackwell Publishing Ltd.

  6. A SDMS Model: Early Warning Coordination Centres

    NASA Astrophysics Data System (ADS)

    Santos-Reyes, Jaime

    2010-05-01

    Following the tsunami disaster in 2004, the General Secretary of the United Nations (UN) Kofi Annan called for a global early warning system for all hazards and for all communities. He also requested the ISDR (International Strategy fort Disaster Reduction) and its UN partners to conduct a global survey of capacities, gaps and opportunities in relation to early warning systems. The produced report, "Global survey of Early Warning Systems", concluded that there are many gaps and shortcomings and that much progress has been made on early warning systems and great capabilities are available around the world. However, it may be argued that an early warning system (EWS) may not be enough to prevent fatalities due to a natural hazard; i.e., it should be seen as part of a ‘wider' or total system. Furthermore, an EWS may work very well when assessed individually but it is not clear whether it will contribute to accomplish the purpose of the ‘total disaster management system'; i.e., to prevent fatalities. For instance, a regional EWS may only work if it is well co-ordinated with the local warning and emergency response systems that ensure that the warning is received, communicated and acted upon by the potentially affected communities. It may be argued that without these local measures being in place, a regional EWS will have little impact in saving lives. Researchers argued that unless people are warned in remote areas, the technology is useless; for instance McGuire [5] argues that: "I have no doubt that the technical element of the warning system will work very well,"…"But there has to be an effective and efficient communications cascade from the warning centre to the fisherman on the beach and his family and the bar owners." Similarly, McFadden [6] states that: "There's no point in spending all the money on a fancy monitoring and a fancy analysis system unless we can make sure the infrastructure for the broadcast system is there,"… "That's going to require a lot

  7. Person-centred Leadership: a relational approach to leadership derived through action research.

    PubMed

    Cardiff, Shaun; McCormack, Brendan; McCance, Tanya

    2018-04-21

    How does person-centred leadership manifest in clinical nursing. Person-centred practice fosters healthful relationships and is gaining increasing attention in nursing and healthcare, but nothing is known about the influence of a person-centred approach to leadership practice. Most leadership models used in nursing were originally developed outside of nursing. A three year participatory action research study where participant leaders planned, researched and learned from their practice development. After an orientation phase, four action spirals focused on: critical and creative reflective inquiries into leadership practice change; leading the implementation and evaluation of a new nursing system; facilitating storytelling sessions with staff and annually reflecting on personal leadership change. Multiple data gathering methods offered insight into leadership development from several perspectives. Critical and creative thematic data analysis revealed a set of attributes, relational processes and contextual factors that influenced the being and becoming of a person-centred leader. Comparing the findings with nursing leadership literature supports a conceptual framework for person-centred leadership. Person-centred leadership is a complex, dynamic, relational and contextualised practice that aims to enable associates and leaders achieve self-actualisation, empowerment and wellbeing. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. [Exposure to biological agents used in Polish enterprises: analysis of data derived from the National Register of Biological Agent].

    PubMed

    Kozajda, Anna; Szadkowska-Stańczyk, Irena

    2011-01-01

    The National Register of Biological Agents at Work and the National Information Centre for Biological Agents Present at Workplaces were established in the Nofer Institute of Occupational Medicine in 2005. The National Information Centre carries out consultation and education activities concerning occupational exposure and risk assessment, development and implementation of preventive programs and accurate registration of reliable information about the use of biological agents. Educational materials on biological exposure are published on the website. The National Register of Biological Agents (database) collects and periodically analyzes the information obtained from employers about the use of biological agents for research, diagnostic or industrial purposes. As of 10 December 2010 there were 240 notifications from companies, which use biological agents for the following purposes: research--69, industrial--30 and diagnostic--321. Near 75% of all notifications were obtained from different diagnostic laboratories (public and private). In total, 3226 workers, including 2967 (92%) women and 256 (8%) men were exposed to biological agents. In general, occupational exposure to 209 biological agents (186 of risk group 2 and 23 of risk group 3, of which 16 are additionally marked by 3**) were registered in the data base.

  9. Status report on the activities of National Balloon Facility at Hyderabad

    NASA Astrophysics Data System (ADS)

    Shankarnarayan, Sreenivasan; S, Sreenivasan; Shankarnarayan, Sreenivasan; Manchanda, R. K.; Subba Rao Jonnalagadda, Venkata; Buduru, Suneelkumar

    National balloon facility at Hyderabad has been mandated to provide launch support for Indian and International scientific balloon experiments and also perform the necessary research and development in the design and fabrication of plastic balloons. In the last 4 years, since our last report, NBF has launched many successful balloon flights for the astronomy payloads and a large number of high altitude GPS Sonde flights at different places in the country. We have also continued our efforts on qualification of raw materials for zero-failure performance of our balloons and major focus on upgrading of various facilities and load-line instrumentation for launching from remote sites. We foresee a surge of balloon based experimental activity for in-situ measurements in atmospheric sciences and concept validation payloads for future space based instruments. A new centre for research in Environmental Sciences and Payload Engineering (ESPE) has also been set up at the National Balloon Facility campus to develop and conduct research in various aspects of Environmental sciences in collaboration with other groups, with a specific goal to identify, development of advanced technologies leading to an improved understanding of the earth system. The Payload Engineering facility is geared to the Design and Fabrication of Micro and Nano Satellites and will act as Inter -University Centre for payload fabrication. In this paper we present an overview of the present and planned activities in scientific ballooning at National Balloon Facility Hyderabad.

  10. Differences in care burden of patients undergoing dialysis in different centres in the netherlands.

    PubMed

    de Kleijn, Ria; Uyl-de Groot, Carin; Hagen, Chris; Diepenbroek, Adry; Pasker-de Jong, Pieternel; Ter Wee, Piet

    2017-06-01

    A classification model was developed to simplify planning of personnel at dialysis centres. This model predicted the care burden based on dialysis characteristics. However, patient characteristics and different dialysis centre categories might also influence the amount of care time required. To determine if there is a difference in care burden between different categories of dialysis centres and if specific patient characteristics predict nursing time needed for patient treatment. An observational study. Two hundred and forty-two patients from 12 dialysis centres. In 12 dialysis centres, nurses filled out the classification list per patient and completed a form with patient characteristics. Nephrologists filled out the Charlson Comorbidity Index. Independent observers clocked the time nurses spent on separate steps of the dialysis for each patient. Dialysis centres were categorised into four types. Data were analysed using regression models. In contrast to other dialysis centres, academic centres needed 14 minutes more care time per patient per dialysis treatment than predicted in the classification model. No patient characteristics were found that influenced this difference. The only patient characteristic that predicted the time required was gender, with more time required to treat women. Gender did not affect the difference between measured and predicted care time. Differences in care burden were observed between academic and other centres, with more time required for treatment in academic centres. Contribution of patient characteristics to the time difference was minimal. The only patient characteristics that predicted care time were previous transplantation, which reduced the time required, and gender, with women requiring more care time. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  11. Girls' Groups and Boys' Groups at a Municipal Technology Centre

    ERIC Educational Resources Information Center

    Salminen-Karlsson, Minna

    2007-01-01

    This article describes the Swedish initiative of municipal technology centres from a gender point of view. These centres provide after-school technology education for children aged 6-16. By means of an ethnographic study, the effects of the use of single-sex groups in increasing the interest of girls and boys in technical activities have been…

  12. Is trauma centre care helpful for less severely injured patients?

    PubMed

    Helling, Thomas S; Nelson, Paul W; Moore, B Todd; Kintigh, Denise; Lainhart, Kathy

    2005-11-01

    Trauma centres have been shown to reduce the number of preventable deaths from serious injuries. This is due largely to the rapid response of surgeons and health care teams to resuscitate, evaluate, and operate if necessary. Less is known about the effectiveness of trauma centre care on those patients who have not incurred immediate life-threatening problems and may not be as critically injured. The purpose of this study was to review the use of physician and hospital resources for this patient population to determine whether trauma team and trauma centre care is helpful or even needed. This was a retrospective study of consecutive trauma patients (n=1592) admitted from 1998 to 2002 to the trauma service of an urban level I trauma centre and recorded in the hospital trauma registry. Patients were triaged in a tiered response to more or less severely injured. All patients' care was directed by trauma surgeons. Of the 1592 patients, 398 (25%) received a full trauma team response (Class I), 1194 were less seriously injured (Class II). The ISS for the Class I patients was 19+/-18 and for Class II patients 10+/-10. Nineteen percent of Class II patients had an ISS>15. Overall mortality in Class II patients was 2% including 20 unexpected deaths. Four hundred and three Class II patients (34%) had multisystem injuries. Of the Class II patients 423 (35%) were sent to the ICU or OR from the ED, 106 of whom required an immediate operation and 345 required an operation prior to discharge. Complications developed in 129 patients (11%), the majority of which were pulmonary. A large proportion of those patients thought initially to be less severely injured required resources available in a trauma centre, including specialty care, intensive care, and operating room accessibility. Over one-third of these patients had multisystem injuries and almost 20% were considered major trauma, needing prioritisation of care and expertise ideally found in a trauma centre environment

  13. Ancient deuterostome origins of vertebrate brain signalling centres.

    PubMed

    Pani, Ariel M; Mullarkey, Erin E; Aronowicz, Jochanan; Assimacopoulos, Stavroula; Grove, Elizabeth A; Lowe, Christopher J

    2012-03-14

    Neuroectodermal signalling centres induce and pattern many novel vertebrate brain structures but are absent, or divergent, in invertebrate chordates. This has led to the idea that signalling-centre genetic programs were first assembled in stem vertebrates and potentially drove morphological innovations of the brain. However, this scenario presumes that extant cephalochordates accurately represent ancestral chordate characters, which has not been tested using close chordate outgroups. Here we report that genetic programs homologous to three vertebrate signalling centres-the anterior neural ridge, zona limitans intrathalamica and isthmic organizer-are present in the hemichordate Saccoglossus kowalevskii. Fgf8/17/18 (a single gene homologous to vertebrate Fgf8, Fgf17 and Fgf18), sfrp1/5, hh and wnt1 are expressed in vertebrate-like arrangements in hemichordate ectoderm, and homologous genetic mechanisms regulate ectodermal patterning in both animals. We propose that these genetic programs were components of an unexpectedly complex, ancient genetic regulatory scaffold for deuterostome body patterning that degenerated in amphioxus and ascidians, but was retained to pattern divergent structures in hemichordates and vertebrates. © 2012 Macmillan Publishers Limited. All rights reserved

  14. Teaching clinical skills in developing countries: are clinical skills centres the answer?

    PubMed

    Stark, Patsy; Fortune, F

    2003-11-01

    There is growing international interest in teaching clinical skills in a variety of contexts, one of which is Clinical Skills Centres. The drivers for change making Skills Centres an important adjunct to ward and ambulatory teaching come both from within and outside medical education. Educationally, self-directed learning is becoming the accepted norm, encouraging students to seek and maximize learning opportunities. There are global changes in health care practice, increased consumerism and increasing student numbers. In some countries, professional recommendations influence what is taught. Increasingly, core skills curricula and outcome objectives are being defined. This explicit definition encourages assessment of the core skills. In turn, all students require equal opportunities to learn how to practise the skills safely and competently. The moves towards interprofessional education make joint learning in a"neutral" setting, like a Clinical Skills Centre, appear particularly attractive. To discuss the potential role of Clinical Skills Centres in skills training in developing countries and to consider alternative options. Many developing countries seek to establish Clinical Skills Centres to ensure effective and reliable skills teaching. However, the model may not be appropriate,because fully equipped Clinical Skills Centres are expensive to set up, staff; and run. They are not the only way to achieve high quality clinical teaching. Suggested options are based on the philosophy and teaching methods successfully developed in Clinical Skills Centres that may fulfil the local needs to achieve low cost and high quality clinical teaching which is reflective of the local health needs and cultural expectations.

  15. UK Renal Registry 17th Annual Report: Chapter 9 Clinical, Haematological and Biochemical Parameters in Patients Receiving Renal Replacement Therapy in Paediatric Centres in the UK in 2013: National and Centre-specific Analyses.

    PubMed

    Hamilton, Alexander J; Pruthi, Rishi; Maxwell, Heather; Casula, Anna; Braddon, Fiona; Inward, Carol; Lewis, Malcolm; O'Brien, Catherine; Stojanovic, Jelena; Tse, Yincent; Sinha, Manish D

    2015-01-01

    The Paediatric Registry analyses renal replacement therapy (RRT) data in children. All 13 UK paediatric nephrology centres submit electronic data. To provide centre specific data and to determine adherence to relevant audit standards. Data analysis to calculate summary statistics and achievement of an audit standard. The median height z-score for children on dialysis was -2.0 and for children with a functioning transplant -1.3. Children transplanted before age 11 years improved their height z score subsequently, whereas those >11 maintained their height z-score, with all transplanted patients having a similar height z-score after 3 years of starting RRT.The median weight z-score for children on dialysis was -1.2, and for children with a functioning transplant -0.2.Of those with data, 75% of the prevalent paediatric RRT population had .1 risk factors for cardiovascular disease, with 1 in 10 having all three risk factors evaluated. For transplant patients, 76% achieved the systolic blood pressure (SBP)standard and 91% achieved the haemoglobin standard. For haemodialysis patients, 53% achieved the SBP standard,66% the haemoglobin standard, 84% the calcium standard,43% the phosphate standard and 43% achieved the parathyroid hormone (PTH) standard. For peritoneal dialysis patients, 61% achieved the SBP standard, 83% the haemoglobin standard, 71% the calcium standard, 56% the phosphate standard and 36% achieved the PTH standard. Quarterly data collection will improve quality and reporting. Continued focus on improving height and avoiding obesity is needed. Awareness and management of cardiovascular risk is an important long term strategy.

  16. A national survey of antimicrobial prophylaxis in adult cardiac surgery across Canada

    PubMed Central

    Paradiso-Hardy, Fran L; Cornish, Patti; Pharand, Chantal; Fremes, Stephen E

    2002-01-01

    OBJECTIVE: To characterize national and regional patterns of antimicrobial prophylaxis in adult cardiac surgery across Canada. DESIGN: Retrospective, cross-sectional analysis. SETTING: Thirty-three adult cardiac surgical centres across Canada. INTERVENTIONS: A one-page questionnaire collecting information regarding institutional demographics and antimicrobial prophylaxis regimens for adult cardiac surgical procedures was mailed to all adult surgical centres across Canada. If a response was not received within one month, a second survey was mailed, followed by a telephone reminder within two weeks of the second mailing. MAIN RESULTS: The Overall response rate was 100%. Prophylactic antimicrobials were used in all the adult cardiac centres; single-agent prophylaxis was used in 97% (32 of 33) of centres; Single-dose antimicrobial prophylaxis was used in only 3% (one of 33) of centres. Preoperative and postoperative antimicrobial prophylaxis regimens varied both between provinces and within provinces across Canada. Cefazolin was the antimicrobial used in 88% (38 of 43) and 87% (33 of 38) of the reported pre-operative and post-operative prophylaxis regimens, respectively. Antimicrobial prophylaxis was initiated in the operating room 72% (26 of 36) of the time and intra-operative supplemental antimicrobial doses were administered for cardiac procedures longer than a median of 4 hours (range 4 to 8 hr). Overall, the median duration of antimicrobial prophylaxis was 36 hours (range 8 to 96 hr). CONCLUSIONS: Despite the availability of various published guidelines, our survey identified several areas for improvement with respect to antimicrobial prophylaxis in adult cardiac surgery across Canada. PMID:18159370

  17. Discrepancies Between Prototype International Data Centre, International Seismological Centre & USGS Seismic Magnitudes

    DTIC Science & Technology

    2007-03-01

    International Seismological C -DTRA 01-00-C-0074 Centre & USGS Seismic Magnitudes PE - 462D PR- AE TA - EJ 6. AUTHOR(S) WU - DH0203 9 Paul G. Richards, John P...Defense Threat Reduction Agency 8725 John J. Kingman Road, MS 6201 "a Fort Belvoir, VA 22060-6201 ’ DTRA-TR-06-15 Discrepancies Between Prototype...0 Z March 2007 "I 20070420395 Li DTRA 01 -00-C-0074 M Paul G. Richards, et al. Prepared by: Columbia University Lamont-Doherty Earth Observatory 61

  18. Long-term Field Experiments as Important Source of Knowledge - Aims of the BonaRes Data Centre

    NASA Astrophysics Data System (ADS)

    Grosse, Meike; Hierold, Wilfried

    2017-04-01

    BonaRes is short for "soil as a sustainable resource for the bioeconomy". It is funded by the German Federal Ministry of Education and Research (BMBF) under the umbrella of the National Research Strategy BioEconomy 2030. BonaRes consists of ten interdisciplinary research project consortia and the 'BonaRes - Centre for Soil Research' (see also Wollschläger et al 2016). It is one task of the BonaRes Data Centre as part of the 'BonaRes - Centre for Soil Research', to collect data and meta-data of agricultural long-term field experiments (LTFE) in Germany. The definition of LTFE in the context of BonaRes is a minimum duration of twenty years and a static design. LTFE are essential research infrastructures for agricultural sciences and soil sciences amongst other disciplines. Some LTFE run since a very long time; the start of the oldest one in Germany was 1878. Therefore, in many cases valuable time series exist. Data sets of LTFE shall be compiled and made publicly available by the BonaRes Data Centre. The public availability together with an easy access will lead to an enhanced usability of the data. This probably makes the LTFE itself more valuable through an improved visibility and may also help to maintain the LTFE. Beyond the data compilation there is the possibility for every data owner to make a data publication, which offers an additional value for the data owner after his first right of use. A first step towards a joint database is a compilation of all existing LTFE in Germany with meta information to each trial. This information is shown in an interactive web map, what is completely new in that context. Besides the exact position of the LTFE the following metadata are shown: name of the LTFE, website (if available), institution, land use category, participation in existing networks, research theme, start (and maybe end) of the trial, and research parameters. Details on the meta information will be presented in the speech. Literature Wollschläger, U; Helming

  19. Barriers and facilitators to the implementation of person-centred care in different healthcare contexts.

    PubMed

    Moore, Lucy; Britten, Nicky; Lydahl, Doris; Naldemirci, Öncel; Elam, Mark; Wolf, Axel

    2017-12-01

    To empower patients and improve the quality of care, policy-makers increasingly adopt systems to enhance person-centred care. Although models of person-centredness and patient-centredness vary, respecting the needs and preferences of individuals receiving care is paramount. In Sweden, as in other countries, healthcare providers seek to improve person-centred principles and address gaps in practice. Consequently, researchers at the University of Gothenburg Centre for Person-Centred Care are currently delivering person-centred interventions employing a framework that incorporates three routines. These include eliciting the patient's narrative, agreeing a partnership with shared goals between patient and professional, and safeguarding this through documentation. To explore the barriers and facilitators to the delivery of person-centred care interventions, in different contexts. Qualitative interviews were conducted with a purposeful sample of 18 researchers from seven research studies across contrasting healthcare settings. Interviews were transcribed, translated and thematically analysed, adopting some basic features of grounded theory. The ethical code of conduct was followed and conformed to the ethical guidelines adopted by the Swedish Research Council. Barriers to the implementation of person-centred care covered three themes: traditional practices and structures; sceptical, stereotypical attitudes from professionals; and factors related to the development of person-centred interventions. Facilitators included organisational factors, leadership and training and an enabling attitude and approach by professionals. Trained project managers, patients taking an active role in research and adaptive strategies by researchers all helped person-centred care delivery. At the University of Gothenburg, a model of person-centred care is being initiated and integrated into practice through research. Knowledgeable, well-trained professionals facilitate the routines of narrative

  20. Observation and control of blinking nitrogen-vacancy centres in discrete nanodiamonds.

    PubMed

    Bradac, C; Gaebel, T; Naidoo, N; Sellars, M J; Twamley, J; Brown, L J; Barnard, A S; Plakhotnik, T; Zvyagin, A V; Rabeau, J R

    2010-05-01

    Nitrogen-vacancy colour centres in diamond can undergo strong, spin-sensitive optical transitions under ambient conditions, which makes them attractive for applications in quantum optics, nanoscale magnetometry and biolabelling. Although nitrogen-vacancy centres have been observed in aggregated detonation nanodiamonds and milled nanodiamonds, they have not been observed in very small isolated nanodiamonds. Here, we report the first direct observation of nitrogen-vacancy centres in discrete 5-nm nanodiamonds at room temperature, including evidence for intermittency in the luminescence (blinking) from the nanodiamonds. We also show that it is possible to control this blinking by modifying the surface of the nanodiamonds.

  1. Polish forensic medicine A.D. 2016 - report of the National Consultant.

    PubMed

    Teresiński, Grzegorz

    2016-01-01

    The aim of the study was to present the current state and basis of functioning of an academic model of forensic expert activities in Poland and perspectives of their further development. The study material included information obtained from a preliminary survey among regional consultants within the ongoing activities of the national consultant team. The recently completed period of research infrastructure support within the policy of coherence of the European Union contributed to significant advances in scientific-educational potential of the majority of university forensic medicine centres. However, the improved educational base and purchases of new diagnostic devices were not associated with a considerable increase in staff resources of individual units, which finally decides about the renown of the entire discipline. It is necessary to undertake initiatives to highlight the importance of forensic medicine as a separate medical field and to increase the number of physicians starting specialist trainings. A highly profiled nature of the speciality necessitates cooperation with other centres and receptiveness to clinical fields. The establishment of various forms of cooperation is a measure of optimal use of equipment and stimulation of multi-centre research.

  2. Human-centred approaches in slipperiness measurement

    PubMed Central

    Grönqvist, Raoul; Abeysekera, John; Gard, Gunvor; Hsiang, Simon M.; Leamon, Tom B.; Newman, Dava J.; Gielo-Perczak, Krystyna; Lockhart, Thurmon E.; Pai, Clive Y.-C.

    2010-01-01

    A number of human-centred methodologies—subjective, objective, and combined—are used for slipperiness measurement. They comprise a variety of approaches from biomechanically-oriented experiments to psychophysical tests and subjective evaluations. The objective of this paper is to review some of the research done in the field, including such topics as awareness and perception of slipperiness, postural and balance control, rating scales for balance, adaptation to slippery conditions, measurement of unexpected movements, kinematics of slipping, and protective movements during falling. The role of human factors in slips and falls will be discussed. Strengths and weaknesses of human-centred approaches in relation to mechanical slip test methodologies are considered. Current friction-based criteria and thresholds for walking without slipping are reviewed for a number of work tasks. These include activities such as walking on a level or an inclined surface, running, stopping and jumping, as well as stair ascent and descent, manual exertion (pushing and pulling, load carrying, lifting) and particular concerns of the elderly and mobility disabled persons. Some future directions for slipperiness measurement and research in the field of slips and falls are outlined. Human-centred approaches for slipperiness measurement do have many applications. First, they are utilized to develop research hypotheses and models to predict workplace risks caused by slipping. Second, they are important alternatives to apparatus-based friction measurements and are used to validate such methodologies. Third, they are used as practical tools for evaluating and monitoring slip resistance properties of foot wear, anti-skid devices and floor surfaces. PMID:11794763

  3. Ascertainment bias in dementias: a secondary to tertiary centre analysis in Central Italy and conceptual review.

    PubMed

    Bonanni, L; Bontempo, G; Borrelli, I; Bifolchetti, S; Buongarzone, M P; Carlesi, N; Carolei, A; Ciccocioppo, F; Colangelo, U; Colonna, G; Desiderio, M; Ferretti, S; Fiorelli, L; D'Alessio, O; D'Amico, A; D'Amico, M C; De Lucia, R; Del Re, L; Di Blasio, F; Di Giacomo, R; Di Iorio, A; Di Santo, E; Di Giuseppe, M; Felice, N; Litterio, P; Gabriele, A; Mancino, E; Manzoli, L; Maruotti, V; Mearelli, S; Molino, G; Monaco, D; Nuccetelli, F; Onofrj, M; Perfetti, B; Sacchet, C; Sensi, F; Sensi, S; Sucapane, P; Taylor, J P; Thomas, A; Viola, P; Viola, S; Zito, M; Zhuzhuni, H

    2013-06-01

    Ascertainment bias (AB) indicates a bias of an evaluation centre in estimating the prevalence/incidence of a disease due to the specific expertise of the centre. The aim of our study was to evaluate classification of different types of dementia in new cases appearing in secondary and tertiary centres, in order to evidence possible occurrence of AB in the various (secondary to tertiary) dementia centres. To assess the mechanism of AB, the rates of new cases of the different forms of dementia reported by different centres were compared. The centres involved in the study were 11 hospital-based centres including a tertiary centre, located in the University Department of Clinical Neurology. The tertiary centre is endowed with state-of-the-art diagnostic facilities and its scientific production is prominently focused on dementia with Lewy bodies (DLB) thus suggesting the possible occurrence of a bias. Four main categories of dementia were identified: Alzheimer's disease (AD), DLB, fronto-temporal dementia (FTD), vascular dementia (VaD), with other forms in a category apart. The classification rate of new cases of dementia in the tertiary centre was compared with rates reported by secondary centres and rates of recoding were calculated during a follow-up of 2 years. The study classified 2,042 newly diagnosed cases of dementia in a population of 1,370,000 inhabitants of which 315,000 were older than 65. AD was categorized in 48-52 % of cases, DLB in 25-28 %, FTD in 2-4 % and VaD in 17-28 %. During the 2-year follow-up the diagnosis was re-classified in 40 patients (3 %). The rate of recoding was 5 % in the tertiary centre, 2-8 % in referrals from secondary to tertiary centre, 2-10 % in recodings performed in secondary centres and addressed to tertiary centre. Recoding or percentages of new cases of AD or DLB were not different in the comparison between secondary or between secondary and tertiary centres. FTD and VaD were instead significantly recoded. The results

  4. Institutional profile: the London Centre for Nanotechnology.

    PubMed

    Weston, David; Bontoux, Thierry

    2009-12-01

    Located in the London neighborhoods of Bloomsbury and South Kensington, the London Centre for Nanotechnology is a UK-based multidisciplinary research center that operates at the forefront of science and technology. It is a joint venture between two of the world's leading institutions, UCL and Imperial College London, uniting their strong capabilities in the disciplines that underpin nanotechnology: engineering, the physical sciences and biomedicine. The London Centre for Nanotechnology has a unique operating model that accesses and focuses the combined skills of the Departments of Chemistry, Physics, Materials, Medicine, Electrical and Electronic Engineering, Mechanical Engineering, Chemical Engineering, Biochemical Engineering and Earth Sciences across the two universities. It aims to provide the nanoscience and nanotechnology required to solve major problems in healthcare, information processing, energy and the environment.

  5. Characteristics of keratoconic patients at two main eye centres in Palestine: a cross-sectional study.

    PubMed

    Shanti, Yousef; Beshtawi, Ithar; Zyoud, Sa'ed H; Abu-Samra, Ahlam; Abu-Qamar, Areen; Barakat, Reem; Shehada, Reham

    2018-04-16

    Keratoconus (KC) is a multifactorial, degenerative ectatic condition of the cornea. It usually manifests during late adolescence or the early twenties. A painless disease, KC may end with severe visual loss. The prevalence of KC in middle-eastern countries is much higher than in other regions of the world. This may be due to genetic and environmental risk factors and consanguinity. The goal of this study is to explore the demographic profile of Palestinian keratoconic patients. A retrospective study was conducted in two ophthalmology centres (Tertiary Ophthalmic Centre of An-Najah National University Hospital and An-Noor Centre at the Specialized Arab Hospital). All medical charts of keratoconic patients attending both centres over the period from 2009 to 2016 were reviewed. These patients were diagnosed by ophthalmologists depending on history, examination and Pentacam. Severity was determined using the k median index from the Pentacam map. Data analysis was carried out using SPSS Version 22. The medical files of 936 keratoconic eyes of 505 keratoconic patients were reviewed. Their mean age at the time of diagnosis was 23.3 ranging from 8 to 62 years. Approximately 70.1% of them presented after the age of 20 years, and younger age groups were more likely to develop a severe disease stage than older ones (P = 0.001, r = - 0.108). There was a nearly equal distribution of patients between the two sexes (49.5% male, 50.5% female). On initial evaluation, the best-corrected visual acuity (BCVA) was recorded as ≥6/12 in most affected eyes (71.5%). Regarding severity, 62% presented in a mild form, while 9.9% were at a severe stage. About 88.2% presented with bilateralism. Most of the patients in their twenties presented with a mild bilateral form of the disease. This result is compatible with published international reports. It is recommended that the results of this study be considered when establishing a screening program in Palestine. Subsequently

  6. Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study.

    PubMed

    Cederwall, Carl-Johan; Olausson, Sepideh; Rose, Louise; Naredi, Silvana; Ringdal, Mona

    2018-06-01

    To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Child abuse and neglect in Turkey: professional, governmental and non-governmental achievements in improving the national child protection system.

    PubMed

    Akco, Seda; Dagli, Tolga; Inanici, Mehmet Akif; Kaynak, Hatice; Oral, Resmiye; Sahin, Figen; Sofuoglu, Zeynep; Ulukol, Betul

    2013-11-01

    Since ratification of the United Nations Convention on the Rights of the Child in 1995, significant efforts were made in Turkey to improve protection of children from abuse and neglect. The government took steps to amend relevant laws. Several state departments recognized the need for professional in-service training of relevant governmental agency staff. University hospitals established numerous hospital-based multidisciplinary child protection centres. The government established an Interministerial Higher Council, which has been overseeing the foundation of 13 child advocacy centres for a multidisciplinary and interagency response to child sexual abuse. In addition to undertaking research, non-governmental organizations contributed to this process by instituting professional and public education. These ground-breaking developments in the last decade give promise of even further improvement in the national child protection system from investigative, child protective and rehabilitative perspectives.

  8. Prevalence of maternal anaemia and its predictors: a multi-centre study.

    PubMed

    Barroso, Filipa; Allard, Shubha; Kahan, Brennan C; Connolly, Catriona; Smethurst, Heather; Choo, Louise; Khan, Khalid; Stanworth, Simon

    2011-11-01

    To investigate the prevalence, predictors, and management of anaemia in pregnancy. A multi centre study across 11 maternity units in the UK. Data were collected over a two week study period in 2008 on maternal history, haemoglobin (Hb) and ferritin concentrations, iron therapy during pregnancy and in the postpartum period. Logistic regression models were used to explore factors associated with anaemia during pregnancy. Main outcomes included anaemia, defined as Hb<11 g/dl at booking, Hb<10.5 g/dl in subsequent antenatal visits, and Hb<10 g/dl postnatally. Completed data were received on 2103 of 2155 women (97% completion rate). Of these, 24.4% (502) (95% CI 22.5-26.2%) were anaemic at some stage during the antenatal period. Predictors for having anaemia by 32 weeks gestation included young maternal age (odds ratio 1.96, 95% CI 1.38-2.79), non-white ethnic origin (odds ratios varied 1.37-2.89 depending on ethnic origin) and increasing parity (odds ratio 1.24, 95% CI 1.08-1.41). Of women who had postnatal Hb levels checked, 30% (309/1031) were anaemic and, depending on centre, 16% to 86% of these received iron therapy. Anaemia was reported in nearly one in four women in the antenatal period, and nearly one in three of the women who had a postpartum Hb checked. Despite national guidelines, there was considerable variation in administration of iron including low utilisation of parenteral iron therapy. Future research needs to focus on the consequences of iron deficiency anaemia for maternal and infant health outcomes and effectiveness of implementation strategies to reduce anaemia. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. Generation of (F+2)_AH Centres in Sodium Ion Doped KCl:CO^{2-3}

    NASA Astrophysics Data System (ADS)

    Diaf, M.; Chihi, I.; Hamaïdia, A.; Akrmi, El.

    1996-01-01

    We demonstrate that (F+2)AH centres of KCl may be obtained from crystals doped with K{2}CO{3} and NaCl, grown by the Czochralski method in open atmosphere. The optical properties of (F+2)AH centres thus produced are exactly the same as those of (F+2)AH centres prepared by the usual technique, which involves superoxide doping and a controlled atmosphere. Nous montrons que les centres (F+2)AH de KCl peuvent être obtenus à partir de cristaux dopés par K{2}CO{3} et NaCl, fabriqués par la méthode de Czochralski à l'air libre. Les propriétés optiques des centres (F+2)AH ainsi produits sont exactement les mêmes que celles des centres (F+2)AH préparés par la technique habituelle, qui comporte le dopage par un superoxyde et l'emploi d'une atmosphère contrôlée.

  10. [Creation of centres in high-volume hospitals -- promotor of communication].

    PubMed

    Möbius, C; Schumacher, G

    2013-02-01

    The number of patients with a diagnosis of cancer is alarming: according to new figures from the Robert Koch Institute about 435 000 patients are diagnosed annually in Germany. 210 000 patients die annually of this diagnosis. Even if no significant progress in prevention has been achieved, in 2020 about 25 % more cases will be diagnosed. In the last two decades it has become established that an interdisciplinary treatment of tumour patients is necessary because the variety of different treatment options depending on an individual person cannot be mastered by one physician. The goal of the centres and certification is to establish a very concentrated expertise in large case numbers and quality-assured transparent treatment. The central requirement of a maximum-care centre is thus to enable communication under appropriate conditions. Promoting not only the space requirements, centre must also develop a treatment corridor and is responsible for further education. Additionally an oncology centre has a goal in communications, namely, to offer a treatment option for all patients in each stage of the disease, and to incorporate cancer patients in clinical trials. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Mental health and addictions capacity building for community health centres in Ontario.

    PubMed

    Khenti, Akwatu; Thomas, Fiona C; Mohamoud, Sirad; Diaz, Pablo; Vaccarino, Oriana; Dunbar, Kate; Sapag, Jaime C

    2017-10-01

    In recent years, there has been increased recognition in Canada of the need to strengthen mental health services in primary health care (PHC). Collaborative models, including partnerships between PHC and specialized mental health care providers, have emerged as effective ways for improving access to mental health care and strengthening clinical capacity. Primary health care physicians and other health professionals are well positioned to facilitate the early detection of mental disorders and provide appropriate treatment and follow-up care, helping to tackle stigma toward mental health problems in the process. This 4-year mental health and addiction capacity-building initiative for PHC addressed competency needs at the individual, interprofessional, and organizational levels. The program included 5 key components: a needs assessment; interprofessional education; mentoring; development of organizational mental health and addiction action plans for each participating community health centre; and creation of an advanced resource manual to support holistic and culturally competent collaborative mental health care. A comprehensive evaluation framework using a mixed-methods approach was applied from the initiation of the program. A total of 184 health workers in 10 community health centres in Ontario participated in the program, including physicians, nurses, social workers, and administrative staff. Evaluation findings demonstrated high satisfaction with the training, improved competencies, and individual behavioural and organizational changes. By building capacity to integrate holistic and culturally appropriate care, this competency-based program is a promising model with strong potential to be adapted and scaled up for PHC organizations nationally and internationally. Copyright© the College of Family Physicians of Canada.

  12. Examining the nutritional quality of food and beverage consumed at Melbourne aquatic and recreation centres.

    PubMed

    Boelsen-Robinson, Tara; Chung, Alexandra; Khalil, Marianne; Wong, Evelyn; Kurzeme, Ariana; Peeters, Anna

    2017-04-01

    Examine the nutritional quality of food and beverages consumed across a sample of community aquatic and recreation centres in metropolitan Melbourne, Australia. Interviewer-administered surveys of randomly selected patrons attending four aquatic and recreation centres were conducted to ascertain food and beverage items consumed over two data collection periods (May-June 2014, January-February 2015). We selected centres in and around metropolitan Melbourne with a sit-down cafeteria and children's swimming classes. We classified items by government nutrient profiling guidelines; 'green' (best choice), 'amber' (choose carefully) or 'red' (limit). A total of 2,326 surveys were conducted (response rate 63%). Thirty-five per cent of surveyed patrons consumed food or beverages while at the centre; 54% of patrons purchased from the café and 61% brought items to the centre. More than half the food consumed from the café was 'red', increasing to 92% for children. One in five children visiting the centre consumed a 'red' item bought from the centre café. The nutritional quality of food and beverages consumed at recreation centres was generally poor, with the on-site cafés providing the majority of discretionary items consumed. Implications for public health: Community aquatic and recreation centres provide an opportunity to promote healthy eating by increasing the provision of healthy options and limiting discretionary food and drink items. © 2017 The Authors.

  13. The methodology for defining the European Standards for the certification of Haemophilia Centres in Europe

    PubMed Central

    Candura, Fabio; Menichini, Ivana; Calizzani, Gabriele; Giangrande, Paul; Mannucci, Pier Mannuccio; Makris, Michael

    2014-01-01

    Introduction Work Package 4 Development of the standardisation criteria of the European Haemophilia Network project has the main objective of implementing a common and shared European strategy for a certification system for two levels of Haemophilia Centres: European Haemophilia Treatment Centres and European Haemophilia Comprehensive Care Centres in the Member States of the European Union. Materials and methods An inclusive and participatory process for developing shared standards and criteria for the management of patients with inherited bleeding disorders has been carried out. The process has been implemented through four different consultation events involving the entire European community of stakeholders that significantly contributed in the drafting of the European Guidelines for the certification of Haemophilia Centres. Results The Guidelines set the standards for the designation of centres that provide specialised and multidisciplinary care (Haemophilia Comprehensive Care Centres) as well as local routine care (Haemophilia Treatment Centres). Standards cover several issues such as: general requirements; patient care; advisory services; laboratory; networking of clinical and specialised services. Conclusions The drafting of the European Guidelines for the certification of Haemophilia Centres was performed adopting a rigorous methodological approach. In order to build the widest possible consensus to the quality standards, the main institutional and scientific stakeholders have been involved. The resulting document will significantly contribute in promoting standardisation in the quality of diagnosis and treatment in European Haemophilia Centres. PMID:24922292

  14. NAROM- a national Laboratory for space education

    NASA Astrophysics Data System (ADS)

    Hansen, Arne Hjalmar; Østbø, Morten

    2002-07-01

    Despite a considerable growth in space related industry and scientific research over the past few decades, space related education has largely been neglected in our country. NAROM - the National Centre for Space Related Education - was formed last year to organize space related educational activities, to promote recruitment, to promote appreciation for the benefits of space activities, and to stimulate interest for science in general. This year, nine students from Narvik Engineering College have participated in the Hotel Payload Project (HPP) at Andøya Rocket Range. They have thus played an active and essential role in an ongoing engineering project.

  15. Multi-centre audit of VMAT planning and pre-treatment verification.

    PubMed

    Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

    2017-08-01

    We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. The Factors and Features of Museum Fatigue in Science Centres Felt by Korean Students

    NASA Astrophysics Data System (ADS)

    Kim, Minchul; Dillon, Justin; Song, Jinwoong

    2018-03-01

    One of the objectives of science education in science centres has been the enhancement of interest in science. However, museum fatigue has a negative impact on interest. Museum fatigue has been described as physical tiredness or a decrease in visitors' interest in a museum. The learning experience of students in science centres is also influenced by museum fatigue. The purpose of this study is to identify the phenomena of museum fatigue in science centres and to identity how it is manifested. First, we identified the factors causing museum fatigue in science centres using the data from an open-ended questionnaire which was given to 597 primary, middle and high school students in South Korea. From the responses to the questionnaire, 50 factors causing museum fatigue in science centres were identified. A second Likert-type questionnaire with the 50 factors of museum fatigue in science centres was administered to 610 primary, middle and high school students in South Korea. Using reliability and factor analyses, we developed a framework of the factors causing museum fatigue in science centres, which consists of three contexts, 12 categories and 50 factors. Secondly, through statistical analyses including T test and ANOVA analysis, the features of students' museum fatigue in science centres were analysed and compared regarding student gender, school level, interest in science, grade of school science, the number of visits, and type of visit. The results, which were found to be statistically significant, are reported and discussed. The findings of this study are intended to serve for a deeper understanding and practical improvement of science learning in science centres.

  17. Crystallographic Data Centre Services and Publications.

    ERIC Educational Resources Information Center

    Cambridge Univ. (England). Chemical Lab.

    The Cambridge Crystallographic Data Centre is concerned with the retrieval, evaluation, synthesis, and dissemination of structural data based on diffraction methods. The source of input is almost entirely primary journals. Bibliographic information and numeric data on crystal and molecular structures are on magnetic tapes. The bibliographic file…

  18. Centre of Excellence For Simulation Education and Innovation (CESEI).

    PubMed

    Qayumi, A Karim

    2010-01-01

    Simulation is becoming an integral part of medical education. The American College of Surgeons (ACS) was the first organization to recognize the value of simulation-based learning, and to award accreditation for educational institutions that aim to provide simulation as part of the experiential learning opportunity. Centre of Excellence for Simulation Education and Innovation (CESEI) is a multidisciplinary and interprofessional educational facility that is based at the University of British Columbia (UBC) and Vancouver Costal Health Authority (VCH). Centre of Excellence for Simulation Education and Innovation's goal is to provide excellence in education, research, and healthcare delivery by providing a technologically advanced environment and learning opportunity using simulation for various groups of learners including undergraduate, postgraduate, nursing, and allied health professionals. This article is an attempt to describe the infrastructure, services, and uniqueness of the Centre of Excellence for Simulation Education and Innovation. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. An operational centre for managing major chemical industrial accidents.

    PubMed

    Kiranoudis, C T; Kourniotis, S P; Christolis, M; Markatos, N C; Zografos, K G; Giannouli, I M; Androutsopoulos, K N; Ziomas, I; Kosmidis, E; Simeonidis, P; Poupkou, N

    2002-01-28

    The most important characteristic of major chemical accidents, from a societal perspective, is their tendency to produce off-site effects. The extent and severity of the accident may significantly affect the population and the environment of the adjacent areas. Following an accident event, effort should be made to limit such effects. Management decisions should be based on rational and quantitative information based on the site specific circumstances and the possible consequences. To produce such information we have developed an operational centre for managing large-scale industrial accidents. Its architecture involves an integrated framework of geographical information system (GIS) and RDBMS technology systems equipped with interactive communication capabilities. The operational centre was developed for Windows 98 platforms, for the region of Thriasion Pedion of West Attica, where the concentration of industrial activity and storage of toxic chemical is immense within areas of high population density. An appropriate case study is given in order to illuminate the use and necessity of the operational centre.

  20. [What illegal substances are used by sportsmen? a study in Midi-Pyrénées Doping Preventing Medical Centre (AMPD-MP)].

    PubMed

    Senard-Ojero, Ana; Durrieu, Geneviève; Depiesse, Frédéric; Schmitt, Laurent; Riviere, Daniel; Montastruc, Jean-Louis

    2010-01-01

    Doping Preventing Medical Centres (Antennes Médicales de Prévention du Dopage) were established in France in 2000 in order to help sportsmen using illegal substances. These services are also information centres on illegal substances (drugs or others) used in sport. The aim of the study was to analyze the characteristics of sportsmen outpatient clinics in Antenne Médicale de Prevention du Dopage Midi-Pyrénées (AMPD-MP). We present the results of outpatient clinics in AMPD-MP from 2002 to 2008. A descriptive analysis of demographic data, substances used and sports practised were performed. During this 7 year-period, 35 outpatient clinics were performed [32 men, 3 women, mean age: 28 years (extreme values: 18-47; 10 patients ≥ 30 years)]. They were mainly involved in national (16), international (8) or regional (7) competitions. The main sports involved were rugby (9) followed by cycling (5), athletics (3) and body-building (3). The most frequently used illegal substances were cannabis (15) followed by glucocorticoïds (9), androgens (4), indirect sympathomimetics amphetaminics (4), beta 2 adrenergic agonists (2) and NSAIDs (2). Two veterinary substances (clenbuterol, boldone-veterinaire) were also found in body-builders. This study shows a clear under use of Doping Preventing Medical Centres by sportsmen and practitioners. It also indicates a relative high age for sportsmen referred to the centre. The main sports involved were rugby and cycling. Cannabis and glucocorticoïds were the drugs more often involved in doping behaviours.

  1. Bright optical centre in diamond with narrow, highly polarised and nearly phonon-free fluorescence at room temperature

    NASA Astrophysics Data System (ADS)

    John, Roger; Lehnert, Jan; Mensing, Michael; Spemann, Daniel; Pezzagna, Sébastien; Meijer, Jan

    2017-05-01

    Using shallow implantation of ions and molecules with masses centred at 27 atomic mass units (amu) in diamond, a new artificial optical centre with unique properties has been created. The centre shows a linearly polarised fluorescence with a main narrow emission line mostly found at 582 nm, together with a weak vibronic sideband at room temperature. The fluorescence lifetime is ∼2 ns and the brightest centres are more than three times brighter than the nitrogen-vacancy centres. A majority of the centres shows stable fluorescence whereas some others present a blinking behaviour, at faster or slower rates. Furthermore, a second kind of optical centre has been simultaneously created in the same diamond sample, within the same ion implantation run. This centre has a narrow zero-phonon line (ZPL) at ∼546 nm and a broad phonon sideband at room temperature. Interestingly, optically detected magnetic resonance (ODMR) has been measured on several single 546 nm centres and two resonance peaks are found at 0.99 and 1.27 GHz. In view of their very similar ODMR and optical spectra, the 546 nm centre is likely to coincide with the ST1 centre, reported once (with a ZPL at 550 nm), but of still unknown nature. These new kinds of centres are promising for quantum information processing, sub-diffraction optical imaging or use as single-photon sources.

  2. What a Difference a Writing Centre Makes: A Small Scale Study

    ERIC Educational Resources Information Center

    Yeats, Rowena; Reddy, Peter; Wheeler, Anne; Senior, Carl; Murray, John

    2010-01-01

    Purpose: Academic writing is often considered to be a weakness in contemporary students, while good reporting and writing skills are highly valued by graduate employers. A number of universities have introduced writing centres aimed at addressing this problem; however, the evaluation of such centres is usually qualitative. The paper seeks to…

  3. Daily Welcoming in Childcare Centre as a Microtransition: An Exploratory Study

    ERIC Educational Resources Information Center

    Venturelli, Elena; Cigala, Ada

    2016-01-01

    This study focuses on the everyday morning microtransition in childcare centres that involves child-parent separation. This moment involves the contemporary presence of the child, caregiver and parent in the day-care centre. This coexistence is considered extremely relevant and full of important meanings for the interactive patterns they will…

  4. Understanding Challenges Physics Teachers Come Across as They Implement Learner-Centred Approaches in Lesotho

    ERIC Educational Resources Information Center

    Qhobela, Makomosela; Moru, Eunice Kolitsoe

    2014-01-01

    Teacher-centred strategies have dominated most physics lessons in Lesotho. This study attempted to understand the contributing factors for the choice of teacher-centred teaching instead of learner-centred teaching with the goal of informing a professional development programme designed to address this problem. The paper responds to the research…

  5. National Cancer Center Singapore: the way forward.

    PubMed

    Teo, Melissa; Soo, Khee Chee

    2016-02-01

    Cancer is the leading cause of death in Singapore, comprising almost 30% of annual deaths. The incidence and prevalence continue to rise, resulting in Singapore having the highest age-standardized rate of cancer in southeast Asia. A review of national health policies in 1992 resulted in the creation of a National Cancer Centre Singapore (NCCS) in 1999. The current NCCS, with its three pillars of clinical service, research and education, manages about 70% of all new cancer cases in the countries public healthcare system. As it outgrows its current outfit and looks to the new NCCS building in 2020, the goal must be for strategic planning to attract and retain the best minds and heart in the field of cancer if it were to continue to be successful in achieving its vision and mission. This article chronicles the NCCS's history and details the foundation of its strategic plans.

  6. Pharmacotherapy follow-up: Role in active malaria surveillance in a travel medicine centre outside the transmission area in Brazil.

    PubMed

    Pedro, R S; Brasil, P; Pina-Costa, A; Machado, C R; Damasceno, L S; Daniel-Ribeiro, C T; Guaraldo, L

    2017-12-01

    Malaria is a potentially severe disease, widespread in tropical and subtropical areas. Apart from parasite drug resistance, which receives the largest share of attention, several factors directly influence the response to antimalarial treatment such as incorrect doses, adverse drug events, lack of adherence to treatment, drug quality and drug-drug interactions. Pharmacotherapy follow-up can be used to monitor and improve the effectiveness of treatment, prevent drug-related problems and ensure patient safety. The aim of this study was to describe the results of the implementation of pharmacotherapy follow-up of patients with malaria seen at a reference centre for malaria diagnosis and treatment (CPD-Mal) located in the city of Rio de Janeiro, an area without malaria transmission. A descriptive study was conducted from January 2009 to September 2013 at the Instituto Nacional de Infectologia Evandro Chagas (INI) of the Fundação Oswaldo Cruz (Fiocruz). All malaria patients enrolled in the study were treated according to the Brazilian Malaria Therapy Guidelines. Data collected during pharmacotherapy follow-up were recorded in a standardized form. The variables included were age, gender, comorbidities, antimalarials and concomitant medications used, adverse drug reactions (ADR), clinical and parasitological cure times, and treatment outcomes classified as success, recurrence (recrudescence or relapse); and lost to follow-up. The ADR were classified by severity (DAIDS-NIH), organ system affected (WHO-ART) and likelihood to be caused by drugs (Naranjo scale). One hundred thirteen cases of malaria were included. Patients were aged between 13 and 66 years and the majority of them (75.2%) were male. Ninety-four ADR were observed, most classified as mild (85.1%), related to disorders of the gastrointestinal system (63.8%), such as nausea and vomiting, and assessed as "possibly" caused by the antimalarial drugs (91.5%). The majority of clinical (90.9%) and parasitological

  7. Choosing an out-of-hospital birth centre: Exploring women's decision-making experiences.

    PubMed

    Wood, Rebecca J; Mignone, Javier; Heaman, Maureen I; Robinson, Kristine J; Roger, Kerstin Stieber

    2016-08-01

    the primary objective for this study was to explore women's experiences of choosing to plan a birth at an out-of-hospital birth centre. We sought to understand how women make the choice to plan for an out-of-hospital birth and the meaning that women ascribe to this decision-making process. a qualitative phenomenological study was conducted in Winnipeg, Canada with a sample of seventeen post partum women who represent the socio-demographic characteristics of the actual users of the Birth Centre in Winnipeg. The women participated in semistructured interviews. Through a feminist perspective and using interpretative phenomenological analysis (IPA), each participant's experience of birthplace decision-making was explored. six themes emerged through the analysis: (1) Making the decision in the context of relationships; (2) Exercising personal agency; (3) An expression of one's ideology; (4) Really thinking it through; (5) Fitting into the eligibility criteria; and (6) The psychology of the space. The findings suggested that a woman's sense of safety was related to each of these themes. the birth centre decision-making experience has many similarities to the homebirth decision-making process. The visceral impact of the physical design of the facility plays an important role and differentiates the birth centre decision from other birth setting options. The concept of relational autonomy was emphasised in this study, in that women make the decision in the context of their relationships with their midwives and partners. The study has implications for midwifery practice and health-care policy related to: client education on birth settings, design of birth environments, validation of the birth centre concept, and upholding the women-centred midwifery model of care. The study highlighted the importance of increasing access to out-of-hospital birth centres. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Learner-Centred Education and "Cultural Translation"

    ERIC Educational Resources Information Center

    Thompson, Paul

    2013-01-01

    This paper contests the proposal that learner-centred education (LCE) may simply be a western construct, irrelevant to the current educational needs of developing countries, by arguing that its specific forms will be more effective when introduced through small-scale institutional relationships than through large-scale contracts with national…

  9. Strategic Leadership of Teaching and Learning Centres: From Reality to Ideal

    ERIC Educational Resources Information Center

    Palmer, Stuart; Holt, Dale; Challis, Di

    2011-01-01

    This paper reports on the third phase of a study of Australian Teaching and Learning Centres to identify factors that contribute to the effective strategic leadership of Centres. Focus groups at 10 Australian universities included 66 respondents, providing a diverse range of perspectives, from students to members of the university executive.…

  10. Sneeze related area in the medulla: localisation of the human sneezing centre?

    PubMed

    Seijo-Martínez, M; Varela-Freijanes, A; Grandes, J; Vázquez, F

    2006-04-01

    Sneezing is a rarely explored symptom in neurological practice. In the cat, a sneeze evoking centre is located in the medulla. The existence of a sneezing centre has not been confirmed in humans. A case with abnormal sneezing secondary to a strategic infarct in the right latero-medullary region is presented. A 66 year old man suddenly presented paroxysmal sneezing followed by ataxia, right sided motor and sensory symptoms, and hoarseness. The application of stimuli to the right nasal fossa did not evoke sneezing nor the wish to sneeze. The same stimuli to the contralateral nasal fossa evoked normal sneezing. The preservation of the superficial sensitivity of the nasal fossa indicates that the lesion was localised in the hypothetical human sneezing centre, very close to the spinal trigeminal tract and nucleus. This centre appears to be bilateral and functionally independent on both sides.

  11. Early childhood development: the role of community based childcare centres in Malawi.

    PubMed

    Munthali, Alister C; Mvula, Peter M; Silo, Lois

    2014-01-01

    Somatic changes including growth and development of the brain of a human being occur very early in life. Programmes that enhance early childhood development (ECD) therefore should be part of the national agenda. Cognizant of this fact, the Malawi Government together with development partners facilitated the establishment of community-based child care centres (CBCCs) which are owned and managed by community members. This study was aimed at understanding how CBCCs operated and their core functions. Using information from databases kept by the District Social Welfare Officers from all the 28 districts in Malawi, coupled with snowballing, all functioning CBCCs were enumerated. A questionnaire was administered to the head of the CBCC or a care giver. Highly trained Research Assistants also carried our observations of the structures around the centres and the activities that actually happened. Data was analysed using a Statistical Package for Social Sciences. Communities provide structures, support for care givers, food, utensils, labour and play materials for the children in CBCCs. The first ECD centre was established in 1966 but the real surge in establishing these happened towards the end of the 1990s and by 2007 there were 5,665 CBCCs in Malawi caring for 407,468 children aged between 3 and 5 years. CBCCs were established to provide pre-primary school learning, and in some cases provide special care to orphans and other vulnerable. Despite the fact that most CBCC premises and structures fell short of the standards laid down by the CBCC profile, the activities and services provided were mostly to the book. Children were provided with nutritious foods and subjected to play that stimulated their cognitive and mental development. Despite the fact that some members of the community do not realize the value of the CBCCs, the existence of these institutions is an opportunity for the community to take care of their children communally, a task that has become imperative as a

  12. The UK Centre for Astrobiology: A Virtual Astrobiology Centre. Accomplishments and Lessons Learned, 2011-2016.

    PubMed

    Cockell, Charles S; Biller, Beth; Bryce, Casey; Cousins, Claire; Direito, Susana; Forgan, Duncan; Fox-Powell, Mark; Harrison, Jesse; Landenmark, Hanna; Nixon, Sophie; Payler, Samuel J; Rice, Ken; Samuels, Toby; Schwendner, Petra; Stevens, Adam; Nicholson, Natasha; Wadsworth, Jennifer

    2018-02-01

    The UK Centre for Astrobiology (UKCA) was set up in 2011 as a virtual center to contribute to astrobiology research, education, and outreach. After 5 years, we describe this center and its work in each of these areas. Its research has focused on studying life in extreme environments, the limits of life on Earth, and implications for habitability elsewhere. Among its research infrastructure projects, UKCA has assembled an underground astrobiology laboratory that has hosted a deep subsurface planetary analog program, and it has developed new flow-through systems to study extraterrestrial aqueous environments. UKCA has used this research backdrop to develop education programs in astrobiology, including a massive open online course in astrobiology that has attracted over 120,000 students, a teacher training program, and an initiative to take astrobiology into prisons. In this paper, we review these activities and others with a particular focus on providing lessons to others who may consider setting up an astrobiology center, institute, or science facility. We discuss experience in integrating astrobiology research into teaching and education activities. Key Words: Astrobiology-Centre-Education-Subsurface-Analog research. Astrobiology 18, 224-243.

  13. Quarterly Reporting of Government-Funded Activity to the 2015 National VET Provider Collection. Technical Paper

    ERIC Educational Resources Information Center

    Foley, Paul

    2016-01-01

    The topic of more frequent and timely vocational education and training (VET) data has been an issue of interest for a number of years. Since 2015, the National Centre for Vocational Education Research (NCVER) has collected and reported data on government-funded students and courses on a quarterly basis. These quarterly data submissions are…

  14. National Identity and Its Relationship with Teachers' Historical Knowledge and Pedagogy: The Case of Taiwan

    ERIC Educational Resources Information Center

    Sung, Pei-Fen; Yang, Meng-Li

    2009-01-01

    National identity is one of the most important forms of ideology that affects human behaviours. Yet, the issue of whether it influences history teachers' subject matter knowledge or teaching practice is overlooked most of the time. With regime change in Taiwan, history curriculum and textbooks are no longer dominated by a China-centred narrative;…

  15. Implementation science: the laboratory as a command centre.

    PubMed

    Boeras, Debrah I; Nkengasong, John N; Peeling, Rosanna W

    2017-03-01

    Recent advances in point-of-care technologies to ensure universal access to affordable quality-assured diagnostics have the potential to transform patient management, surveillance programmes, and control of infectious diseases. Decentralization of testing can put tremendous stresses on fragile health systems if the laboratory is not involved in the planning, introduction, and scale-up strategies. The impact of investments in novel technologies can only be realized if these tests are evaluated, adopted, and scaled up within the healthcare system with appropriate planning and understanding of the local contexts in which these technologies will be used. In this digital age, the laboratory needs to take on the role of the Command Centre for technology introduction and implementation. Implementation science is needed to understand the political, cultural, economic, and behavioural context for technology introduction. The new paradigm should include: building a comprehensive system of laboratories and point-of-care testing sites to provide quality-assured diagnostic services with good laboratory-clinic interface to build trust in test results and linkage to care; building and coordinating a comprehensive national surveillance and communication system for disease control and global health emergencies; conducting research to monitor the impact of new tools and interventions on improving patient care.

  16. Medical students' and patients' perceptions of patient-centred attitude.

    PubMed

    Hur, Yera; Cho, A Ra; Choi, Chang Jin

    2017-03-01

    Patient-centred care can increase patient satisfaction and lead to better clinical outcomes for them, such as improved physical status and higher health-related quality of life. However, doctors' and patients' views on patient-centred attitude might differ and could be affected by culture and the community environment. To clarify the differences in primary care patients' and senior medical students' perceptions of medical students' patient-centred attitude. A total of 1,025 subjects-827 patients from primary care institutions and 198 fourth-year medical students from a medical college in South Korea-completed the Patient Practitioner Orientation Scale (PPOS). The students completed the self-reported questionnaire at the end of their clinical clerkship. Descriptive statistics, t-tests, and one-way analysis of variances were conducted in SPSS version 21.0. Firstly, sharing subscale scores were higher among patients than among medical students (students, 3.61 vs. patients, 3.76; p<0.001), but secondly, caring subscale scores were higher among medical students (students, 4.18 vs. patients, 3.82; p<0.001). Thirdly, PPOS total scores were higher among medical students (students, 3.90 vs. patients, 3.79; p=0.001). Finally, male students had the lowest sharing scores (F=6.811, p<0.001) and female students showed the highest PPOS total scores (F=5.805, p=0.001). Significant differences between medical students' and patients' perceptions of medical students' patient-centred attitudes suggest the necessity of educational efforts to overcome the gap between the groups.

  17. Elaboration of the Gothenburg model of person-centred care.

    PubMed

    Britten, Nicky; Moore, Lucy; Lydahl, Doris; Naldemirci, Oncel; Elam, Mark; Wolf, Axel

    2017-06-01

    Person-centred care (PCC) is increasingly advocated as a new way of delivering health care, but there is little evidence that it is widely practised. The University of Gothenburg Centre for Person-Centred Care (GPCC) was set up in 2010 to develop and implement person-centred care in clinical practice on the basis of three routines. These routines are based on eliciting the patient's narrative to initiate a partnership; working the partnership to achieve commonly agreed goals; and using documentation to safeguard the partnership and record the person's narrative and shared goals. In this paper, we aimed to explore professionals' understanding of PCC routines as they implement the GPCC model in a range of different settings. We conducted a qualitative study and interviewed 18 clinician-researchers from five health-care professions who were working in seven diverse GPCC projects. Interviewees' accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships. This study illustrates what is needed for health-care professionals to implement PCC in everyday practice: the recognition of the person is as important as the specific practical routines. Interviewees described the need to change the clinical mindset and to develop the ways of integrating people's narratives with clinical practice. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  18. An Evaluation of a Self-Access Centre through EFL Learners' Eyes

    ERIC Educational Resources Information Center

    Balcikanli, Cem

    2017-01-01

    Learner autonomy has become a central concern in the recent history of language learning. Self-Access Centres (SACs) play a critical role in fostering learner autonomy specifically in EFL (English as a Foreign Language) settings. As SACs aim at enabling learning to occur independent of teaching, in these centres, language learners are given more…

  19. Staff Morale in Day Care Centres for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Mascha, Katerina

    2007-01-01

    Background: Levels of burnout, job satisfaction and intended turnover of staff working in day care centres for adults with intellectual disabilities are investigated in relation to role clarity, staff support and supervision, and coping strategies used by staff. Materials and methods: Thirty six direct-care staff of four day care centres in the UK…

  20. The Child at the Centre: Self-Evaluation in the Early Years

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2007

    2007-01-01

    This revised edition of "The Child at the Centre" replaces all previous versions. Along with a revised edition of "How good is our school?," this document forms the third part of "How good is our school? The Journey to Excellence." Early education centres are now part of a wider partnership of professionals, all of…

  1. Safety assessment in primary Mycobacterium tuberculosis smear microscopy centres in Blantyre Malawi: a facility based cross sectional survey.

    PubMed

    Majamanda, J; Ndhlovu, P; Shawa, I T

    2013-12-01

    Tuberculosis (TB) is caused by Mycobacterium tuberculosis and is transmitted mainly through aerosolization of infected sputum which puts laboratory workers at risk in spite of the laboratory workers' risk of infection being at 3 to 9 times higher than the general public. Laboratory safety should therefore be prioritized and optimized to provide sufficient safety to laboratory workers. To assess the safety for the laboratory workers in TB primary microscopy centres in Blantyre urban. TB primary microscopy centers in Blantyre urban were assessed in aspects of equipment availability, facility layout, and work practice, using a standardized WHO/AFRO ISO 15189 checklist for the developing countries which sets the minimum safety score at ≥80%. Each center was graded according to the score it earned upon assessment. Only one (1) microscopy center out nine (9) reached the minimum safety requirement. Four (4) centers were awarded 1 star level, four (4) centers were awarded 2 star level and only one (1) center was awarded 3 star level. In Blantyre urban, 89% of the Tuberculosis microscopy centers are failing to provide the minimum safety to the laboratory workers. Government and other stake holders should be committed in addressing the safety challenges of TB microscopy centres in the country to ensure safety for the laboratory workers. It is recommended that the study be conducted at the regional or national level for both public and private laboratories in order to have a general picture of safety in Tb microscopy centres possibly across the country.

  2. Oo-Za-We-Kwun Centre Incorporated

    ERIC Educational Resources Information Center

    Findlay, P. R.; And Others

    1976-01-01

    The Centre is described as being designed to help native people participate more effectively in a modern Canadian environment. The residential family program includes a five-week Life Skills course followed by a two-year transfer of learning period during which counseling, paid employment, and community activities are available. (Author/MS)

  3. Special Issue: Using Drama to Improve Person-Centred Dementia Care

    PubMed Central

    Mitchell, Gail J.; Mistry, Bhavnita; Ballon, Bruce

    2013-01-01

    Background Person-centred dementia care guidelines emphasize the assessment of individual needs, and, where appropriate, the use of non-pharmacological interventions before resorting to pharmacological management. Yet dementia care is not consistent with these guidelines suggesting conceptual limitations and reliance on passive knowledge translation strategies. Aims and Objectives We implemented a 12-week drama-based educational intervention to introduce to dementia practitioners person-centred care that emphasizes the notion of embodied selfhood (defined as non-verbal self-expression). Design and Methods Focus groups and semi-structured interviews with practitioners (n=24) in two nursing homes in central Canada were undertaken to assess the effectiveness of the drama-based components of the intervention. Results Our findings suggest that drama was effective as an educational modality, and helped implement the person-centred approach into practice. Significant practice outcomes included: new awareness that residents’ body movements and dispositions convey meaning; seeking biographical information from families; increased time efficiency; and supporting residents’ independence. Conclusions Our findings make an important contribution to person-centred dementia care by broadening the notion of personhood, and by facilitating implementation using drama. Implications for Practice As an enhancement of person-centered care, the support of embodied selfhood may significantly improve residents’ quality of life, quality of care, and practitioners’ caregiving experience. PMID:20925717

  4. [Medical waste management in healthcare centres in the occupied Palestinian territory].

    PubMed

    Al-Khatib, Issam A

    2007-01-01

    Medical waste management in primary and secondary healthcare centres in the occupied Palestinian territory was assessed. The overall monthly quantity of solid healthcare waste was estimated to be 512.6 tons. Only 10.8% of the centres completely segregated the different kinds of healthcare waste and only 15.7% treated their medical waste. In the centres that treated waste, open burning was the main method of treatment. The results indicate that Palestinians are exposed to health and environmental risks because of improper disposal of medical waste and steps are needed to improve the situation through the establishment and enforcement of laws, provision of the necessary infrastructure for proper waste management and training of healthcare workers and cleaners.

  5. An Interactive Logistics Centre Information Integration System Using Virtual Reality

    NASA Astrophysics Data System (ADS)

    Hong, S.; Mao, B.

    2018-04-01

    The logistics industry plays a very important role in the operation of modern cities. Meanwhile, the development of logistics industry has derived various problems that are urgent to be solved, such as the safety of logistics products. This paper combines the study of logistics industry traceability and logistics centre environment safety supervision with virtual reality technology, creates an interactive logistics centre information integration system. The proposed system utilizes the immerse characteristic of virtual reality, to simulate the real logistics centre scene distinctly, which can make operation staff conduct safety supervision training at any time without regional restrictions. On the one hand, a large number of sensor data can be used to simulate a variety of disaster emergency situations. On the other hand, collecting personnel operation data, to analyse the improper operation, which can improve the training efficiency greatly.

  6. Outcomes of Cryoballoon Ablation in High- and Low-Volume Atrial Fibrillation Ablation Centres: A Russian Pilot Survey

    PubMed Central

    Mikhaylov, Evgeny N.; Lebedev, Dmitry S.; Pokushalov, Evgeny A.; Davtyan, Karapet V.; Ivanitskii, Eduard A.; Nechepurenko, Anatoly A.; Kosonogov, Alexey Ya.; Kolunin, Grigory V.; Morozov, Igor A.; Termosesov, Sergey A.; Maykov, Evgeny B.; Khomutinin, Dmitry N.; Eremin, Sergey A.; Mayorov, Igor M.; Romanov, Alexander B.; Shabanov, Vitaliy V.; Shatakhtsyan, Victoria; Tsivkovskii, Viktor; Revishvili, Amiran Sh.; Shlyakhto, Evgeny V.

    2015-01-01

    Purpose. The results of cryoballoon ablation (CBA) procedure have been mainly derived from studies conducted in experienced atrial fibrillation (AF) ablation centres. Here, we report on CBA efficacy and complications resulting from real practice of this procedure at both high- and low-volume centres. Methods. Among 62 Russian centres performing AF ablation, 15 (24%) used CBA technology for pulmonary vein isolation. The centres were asked to provide a detailed description of all CBA procedures performed and complications, if encountered. Results. Thirteen sites completed interviews on all CBAs in their centres (>95% of CBAs in Russia). Six sites were high-volume AF ablation (>100 AF cases/year) centres, and 7 were low-volume AF ablation. There was no statistical difference in arrhythmia-free rates between high- and low-volume centres (64.6 versus 60.8% at 6 months). Major complications developed in 1.5% of patients and were equally distributed between high- and low-volume centres. Minor procedure-related events were encountered in 8% of patients and were more prevalent in high-volume centres. Total event and vascular access site event rates were higher in women than in men. Conclusions. CBA has an acceptable efficacy profile in real practice. In less experienced AF ablation centres, the major complication rate is equal to that in high-volume centres. PMID:26640789

  7. Addiction research centres and the nurturing of creativity. The Centre for Alcohol and Drug Research: social science alcohol and drug research in Denmark.

    PubMed

    Pedersen, Mads U; Elmeland, Karen; Frank, Vibeke A

    2011-12-01

    The purpose of this paper is to introduce the social science alcohol and drug research undertaken by the Centre for Alcohol and Drug Research (CRF) and at the same time offer an insight into the development in Danish alcohol and drug research throughout the past 15-20 years. A review of articles, books and reports published by researcher from CRF from the mid-1990s until today and an analysis of the policy-making in the Danish substance use and misuse area. CRF is a result of the discussions surrounding social, health and allocation policy questions since the mid-1980s. Among other things, these discussions led to the formal establishment of the Centre in 1991 under the Aarhus University, the Faculty of Social Science. Since 2001 the Centre has received a permanent basic allocation, which has made it possible to appoint tenured senior researchers; to work under a more long-term research strategy; to function as a milieu for educating PhD students; and to diversify from commissioned research tasks to initiating projects involving more fundamental research. Research at the Centre is today pivoted around four core areas: consumption, policy, prevention and treatment. The emergence, continuation, financing and character of the research taking place at CRF can be linked closely to the specific Danish drug and alcohol discourse and to the division of the responsibility for alcohol and drug research into separate Ministries. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  8. Survey of prenatal counselling practices regarding aneuploidy risk modification, invasive diagnostic procedure risks, and procedure eligibility criteria in Canadian centres.

    PubMed

    Hull, Danna; Davies, Gregory; Armour, Christine M

    2012-07-01

    To explore prenatal practices related to aneuploidy screening, risk modification, and invasive diagnostic procedures across Canadian centres. We conducted a survey of members of the Canadian Association of Genetic Counsellors, the Canadian College of Medical Genetics, and the Canadian Society of Maternal Fetal Medicine, who provide direct counselling or management of prenatal patients in Canada. Eighty-two of 157 respondents indicated that their centre's definition of advanced maternal age was ≥ 35 years, with 33/157 respondents reporting an advanced maternal age definition of ≥ 40 years. The majority of respondents reported that prenatal serum screening for aneuploidy is provincially funded in their province or territory (121/147). The majority of respondents who reported that prenatal screening is not provincially funded (17/147) were from Quebec (14/17). Thirty-nine of 123 respondents reported that their centre defines increased nuchal translucency as ≥ 3.0 mm, whereas 49/123 reported a definition of ≥ 3.5 mm. Sixty-four of 150 respondents reported that the aneuploidy risk provided by serum screening is modified by a soft marker likelihood ratio, whereas 46/150 respondents reported that both age-related and serum screening risks are modified. Fifty-nine of 124 respondents reported that their centre will modify aneuploidy risk after a normal ultrasound; the most commonly cited negative likelihood ratio was 0.5. The most commonly reported procedure-related risk for chorionic villus sampling was 1/100 (123/147) and for amniocentesis was 1/200 (73/142). This study demonstrates inconsistencies in prenatal practices and access to screening programs across Canada. The information gained from this study will inform policy advisors developing prenatal practice guidelines at both the provincial and national levels.

  9. Slovak Flood Forecasting Service at the National and International Level

    NASA Astrophysics Data System (ADS)

    Leskova, Danica; Mikuličková, Michaela

    2017-04-01

    National Flood Forecasting Service is based on national legislation /Slovak legislation/ so that it could deal with the flood situation at the local level. Information about international rivers, e.g.: Danube, March (Morava), Uh, and Latorica are received on the basis of bilateral agreements. An important supplementary information is the European Flood Awareness System (EFAS). In this presentation a forecasting system POVAPSYS, which has been in Slovakia in use since 2016, is also shown. The Slovak Hydrometeorological Institute (SHMI) is a partner of EFAS, but simultaneously is a part of consortium of the EFAS Dissemination Centre, and its role is to analyze results of models, to analyze hydrometeorological situation, to disseminate information, and to send flood notifications to the EFAS partners. Both systems will be presented.

  10. Learner-Centred Education Reforms in India: The Missing Piece of Teachers' Beliefs

    ERIC Educational Resources Information Center

    Brinkmann, Suzana

    2015-01-01

    Recent international education trends have witnessed a widespread push for promoting Western-originating "learner-centred" approaches, often without adequately considering the challenges involved in crossing cultures. Like many developing countries, India has been attempting to bring a paradigm shift from "teacher-centred" to…

  11. The Nature of Exhibits about Acoustics in Science and Technology Centres

    ERIC Educational Resources Information Center

    Afonso, Ana S.; Gilbert, John K.

    2008-01-01

    This is a study of the opportunities currently provided by interactive science and technology centres for visitors' engagement in the field of acoustics. E-mails, requesting a description of exhibits on acoustics (sound and hearing) in use, were sent to members of staff of interactive science and technology centres around the world as well as to…

  12. Dedicated Space Science Education Centres Provide the Model for Effective Outreach

    NASA Astrophysics Data System (ADS)

    Brumfitt, A.

    Planetaria and science centres are traditionally successful players in engaging all levels and ages of society. They have long played a supportive role to and within education. Their value in teacher circles has always been recognised as an effective resource. Given the decline in career choices in traditional Science Technology Engineering and Mathematics (STEM) and astronomy and planetary sciences, they are now more important than ever. Since their inception the role and function of Planetaria has been required to evolve to meet the changing demands of society. They are now faced with the challenge of meeting new requirements and the need for new and different resources, techniques, support and funding models to meet and effectively deliver to new target groups. To face these challenges these pivotal centres require new methodology in their development of programs to be effective in their support to education. New directions specifically tailored for teacher professional development and for student studies. The changing requirements have resulted in a new kind of science centre one dedicated and specially designed using space science and dedicated to formal education across stem activities. The space scientist forms an integral and key role in this type of centre by providing the science, the passion of discovery and the relevance of the science to the community. These programs need to be carefully aligned to flexible course requirements and objectives to ensure relevancy to the education and outreach sector. They need access to and the support and input from the scientist and research institutions. They need real and appropriate material and resources. Scientists need effective channels through which to inform and share their work. Here is the potential for enormously effective symbiosis. This paper describes how new multi million dollar state-of-the-art space science centres are working with cutting edge science, research institutes, universities, government

  13. [Establishing an Ambulatory Health-Care Centre (AHCC) at a University Hospital].

    PubMed

    Krüll, A; Debatin, J F

    2013-02-01

    Since January 2004 hospitals have the opportunity to establish an ambulatory health-care centre (Medizinisches Versorgungszentrum - MVZ) as a result of the introduction of the Health-care Modernisation Act (Gesetz zur Modernisierung der gesetzlichen Krankenversicherung - GMG). After about a half-year preparatory phase, the UKE, in September 2004, began operation of the "Ambulanzzentrum des UKE GmbH" (a limited liability company) as the first MVZ at a university hospital in Germany. We report here on the establishment of the MVZ and the experience made. In the initial phase, only the medical fields of radiation therapy and nuclear medicine were represented. Both disciplines, especially radiation therapy, were existentially threatened by the extensive loss of ambulatory patients. The central motive for the establishment of the ambulatory health-care centre was to secure the survival of both disciplines and to preserve existing jobs. After it was put into operation, the referrals from practice-based colleagues to both radiation therapy and nuclear medicine increased quickly. The positive developments caused other departments of the UKE to express their interest in supplementing their outpatient activities with facilities in the MVZ. Over the following years, the ambulance centre grew steadily. Now 24 departments are represented in the MVZ, and the centre has a total of 49 positions for physicians contracted by and registered within the German public health insurance system. The number of salaried doctors has risen to 85, although many of these only work part time in the MVZ. Also more than 83 non-medical staff members were hired over the years. These were mostly physiotherapists, radiographers, and medical assistants. With the growing number of departments in the MVZ, the number of treated cases grew steadily. Currently approximately 20 000 cases are treated in each quarter of a year. The experience made while establishing an ambulatory health-care centre is very

  14. Sneeze related area in the medulla: localisation of the human sneezing centre?

    PubMed Central

    Seijo‐Martínez, M; Varela‐Freijanes, A; Grandes, J; Vázquez, F

    2006-01-01

    Sneezing is a rarely explored symptom in neurological practice. In the cat, a sneeze evoking centre is located in the medulla. The existence of a sneezing centre has not been confirmed in humans. A case with abnormal sneezing secondary to a strategic infarct in the right latero‐medullary region is presented. A 66 year old man suddenly presented paroxysmal sneezing followed by ataxia, right sided motor and sensory symptoms, and hoarseness. The application of stimuli to the right nasal fossa did not evoke sneezing nor the wish to sneeze. The same stimuli to the contralateral nasal fossa evoked normal sneezing. The preservation of the superficial sensitivity of the nasal fossa indicates that the lesion was localised in the hypothetical human sneezing centre, very close to the spinal trigeminal tract and nucleus. This centre appears to be bilateral and functionally independent on both sides. PMID:16354739

  15. Optical detection of paramagnetic centres: From crystals to glass-ceramics

    NASA Astrophysics Data System (ADS)

    Rogulis, Uldis

    2016-07-01

    An unambiguous attribution of the absorption spectra to definite paramagnetic centres identified by the EPR techniques in the most cases is problematic. This problem may be solved by applying of a direct measurement techniques—the EPR detected via the magnetic circular dichroism, or briefly MCD-EPR. The present survey reports on the advantages and disadvantages applying the MCD-EPR techniques to simple and complex paramagnetic centres in crystals as well as glasses and glass-ceramics.

  16. A student-centred feedback model for educators.

    PubMed

    Rudland, Joy; Wilkinson, Tim; Wearn, Andy; Nicol, Pam; Tunny, Terry; Owen, Cathy; O'Keefe, Maree

    2013-04-01

    Effective feedback is instrumental to effective learning. Current feedback models tend to be educator driven rather than learner-centred, with the focus on how the supervisor should give feedback rather than on the role of the learner in requesting and responding to feedback. An alternative approach emphasising the theoretical principles of student-centred and self-regulated learning is offered, drawing upon the literature and also upon the experience of the authors. The proposed feedback model places the student in the centre of the feedback process, and stresses that the attainment of student learning outcomes is influenced by the students themselves. This model emphasises the attributes of the student, particularly responsiveness, receptiveness and reflection, whilst acknowledging the important role that the context and attributes of the supervisor have in influencing the quality of feedback. Educational institutions should consider strategies to encourage and enable students to maximise the many feedback opportunities available to them. As a minimum, educators should remind students about their central role in the feedback process, and support them to develop confidence in meeting this role. In addition, supervisors may need support to develop the skills to shift the balance of responsibility and support students in precipitating feedback moments. Research is also required to validate the proposed model and to determine how to support students to adopt self-regulatory learning, with feedback as a central platform. © Blackwell Publishing Ltd 2013.

  17. Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

    PubMed

    Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil; Jensen, Rigmor; Siva, Aksel; Uygunoglu, Ugur; Gvantsa, Giorgadze; Mania, Maka; Braschinsky, Mark; Filatova, Elena; Latysheva, Nina; Osipova, Vera; Skorobogatykh, Kirill; Azimova, Julia; Straube, Andreas; Eren, Ozan Emre; Martelletti, Paolo; De Angelis, Valerio; Negro, Andrea; Linde, Mattias; Hagen, Knut; Radojicic, Aleksandra; Zidverc-Trajkovic, Jasna; Podgorac, Ana; Paemeleire, Koen; De Pue, Annelien; Lampl, Christian; Steiner, Timothy J; Katsarava, Zaza

    2016-12-01

    The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).

  18. Poisonous plants in New Zealand: a review of those that are most commonly enquired about to the National Poisons Centre.

    PubMed

    Slaughter, Robin J; Beasley, D Michael G; Lambie, Bruce S; Wilkins, Gerard T; Schep, Leo J

    2012-12-14

    New Zealand has a number of plants, both native and introduced, contact with which can lead to poisoning. The New Zealand National Poisons Centre (NZNPC) frequently receives enquiries regarding exposures to poisonous plants. Poisonous plants can cause harm following inadvertent ingestion, via skin contact, eye exposures or inhalation of sawdust or smoked plant matter. The purpose of this article is to determine the 15 most common poisonous plant enquiries to the NZNPC and provide a review of current literature, discussing the symptoms that might arise upon exposure to these poisonous plants and the recommended medical management of such poisonings. Call data from the NZNPC telephone collection databases regarding human plant exposures between 2003 and 2010 were analysed retrospectively. The most common plants causing human poisoning were selected as the basis for this review. An extensive literature review was also performed by systematically searching OVID MEDLINE, ISI Web of Science, Scopus and Google Scholar. Further information was obtained from book chapters, relevant news reports and web material. For the years 2003-2010 inclusive, a total of 256,969 enquiries were received by the NZNPC. Of these enquiries, 11,049 involved exposures to plants and fungi. The most common poisonous plant enquiries, in decreasing order of frequency, were: black nightshade (Solanum nigrum), arum lily (Zantedeschia aethiopica), kowhai (Sophora spp.), euphorbia (Euphorbia spp.), peace lily (Spathiphyllum spp.), agapanthus (Agapanthus spp.), stinking iris (Iris foetidissima), rhubarb (Rheum rhabarbarum), taro (Colocasia esculentum), oleander (Nerium oleander), daffodil (Narcissus spp.), hemlock (Conium maculatum), karaka (Corynocarpus laevigatus), foxglove (Digitalis purpurea) and ongaonga/New Zealand tree nettle (Urtica ferox). The combined total of enquiries for these 15 species was 2754 calls (representing approximately 25% of all enquiries regarding plant exposures). The signs

  19. Different centre of pressure patterns within the golf stroke II: group-based analysis.

    PubMed

    Ball, K A; Best, R J

    2007-05-01

    Although the golf coaching literature stresses the importance of weight transfer during the swing, research has been conflicting or lacking statistical support. A potential problem with previous studies is that no attempt was made to account for different movement strategies in the golf swing. This study evaluated the relationship between centre of pressure measures and club head velocity within two previously identified swing styles, the "Front Foot" and "Reverse" styles. Thirty-nine Front Foot golfers and 19 Reverse golfers performed swings with a driver while standing on two force plates. From the force plate data, centre of pressure displacement, velocity, range, and timing parameters were calculated. Correlation and regression analysis indicated that a larger range of centre of pressure and a more rapid centre of pressure movement in the downswing was associated with a larger club head velocity at ball contact for the Front Foot group. For the Reverse golfers, positioning the centre of pressure further from the back foot at late backswing and a more rapid centre of pressure transfer towards the back foot at ball contact was associated with a larger club head velocity at ball contact. This study has highlighted the importance of identifying different movement strategies before evaluating performance measures, as different parameters were found to be important for the Front Foot and Reverse styles.

  20. Does user-centred design affect the efficiency, usability and safety of CPOE order sets?

    PubMed

    Chan, Julie; Shojania, Kaveh G; Easty, Anthony C; Etchells, Edward E

    2011-05-01

    Application of user-centred design principles to Computerized provider order entry (CPOE) systems may improve task efficiency, usability or safety, but there is limited evaluative research of its impact on CPOE systems. We evaluated the task efficiency, usability, and safety of three order set formats: our hospital's planned CPOE order sets (CPOE Test), computer order sets based on user-centred design principles (User Centred Design), and existing pre-printed paper order sets (Paper). 27 staff physicians, residents and medical students. Sunnybrook Health Sciences Centre, an academic hospital in Toronto, Canada. Methods Participants completed four simulated order set tasks with three order set formats (two CPOE Test tasks, one User Centred Design, and one Paper). Order of presentation of order set formats and tasks was randomized. Users received individual training for the CPOE Test format only. Completion time (efficiency), requests for assistance (usability), and errors in the submitted orders (safety). 27 study participants completed 108 order sets. Mean task times were: User Centred Design format 273 s, Paper format 293 s (p=0.73 compared to UCD format), and CPOE Test format 637 s (p<0.0001 compared to UCD format). Users requested assistance in 31% of the CPOE Test format tasks, whereas no assistance was needed for the other formats (p<0.01). There were no significant differences in number of errors between formats. The User Centred Design format was more efficient and usable than the CPOE Test format even though training was provided for the latter. We conclude that application of user-centred design principles can enhance task efficiency and usability, increasing the likelihood of successful implementation.