Science.gov

Sample records for pre-existing medical conditions

  1. Travellers with pre-existing medical conditions.

    PubMed

    Ericsson, Charles D

    2003-02-01

    Medical conditions that influence travel include those that compromise the immunity of the traveller and chronic underlying diseases or infirmities. The former includes HIV, transplantation, malignancy and its treatment, IgA deficiency, asplenia and use of immunocompromising drugs like corticosteroids. Chronic conditions include diabetes mellitus, end stage renal disease, diseases associated with compromised cardiac or pulmonary function and certain gastrointestinal diseases including cirrhosis. This review includes practical approaches to each of these conditions with attention to risk assessment and avoidance, vaccination when appropriate and not a risk to the compromised host, and arming the traveller with self-therapy and chemoprophylaxis. Since travellers with underlying conditions are often taking various medications the travel health practitioner must be alert for possible drug/drug interactions and must adjust dosages depending on the level of compromised renal or hepatic function. Finally, education of such travellers is paramount; they must understand that risk avoidance is critical and preventative modalities such as vaccination and chemoprophylaxis are never 100% efficacious. PMID:12615384

  2. Sport climbing with pre-existing cardio-pulmonary medical conditions.

    PubMed

    Kuepper, T; Morrison, A; Gieseler, U; Schoeffl, V

    2009-06-01

    Over the past 25 years sport climbing has developed from an elite extreme sport subculture pursued by few into a mainstream recreational sport enjoyed globally by climbers of all ages, climbing abilities, and with pre-existing health conditions. As the demands and grades of climbing difficulty have increased over this period, most scientific literature on sport climbing focused on acute injuries and overuse syndromes, or performance physiology in healthy adult males. The physiological response to sport climbing is more similar to that of resistance training (i.e., body building) rather than a predominantly aerobic sport (i.e., running, cycling), so that heart rate and blood pressure during a climb will be disproportionately high relative to the 'exercise' of climbing, and breathing may be irregular. Therefore this review sought evidence-based recommendations for recreational sport climbing participation by those individuals with pre-existing cardiopulmonary medical conditions including coronary heart disease, chronic heart failure, cardiac dysrhythmia, pulmonary diseases (i.e., asthma) or hypertension. This review defines the criteria that must be fulfilled for safe sport climbing by those with pre-existing cardiopulmonary conditions or those with hypertension. PMID:19199210

  3. Pre-existing Conditions Genetic Testing, Causation, and the Justice of

    E-print Network

    Pennock, Robert T.

    modified organisms, gene therapy, and other biological technologies. Research on creating artificial cells407 Chapter 23 Pre-existing Conditions Genetic Testing, Causation, and the Justice of Medical debates complicate public policy decisions regarding the development, regulation and use of genetically

  4. Pre-existing condition insurance plan program. Amendment to interim final rule with request for comments.

    PubMed

    2012-08-30

    This document contains an amendment regarding program eligibility to the interim final regulation implementing the Pre-Existing Condition Plan program under provisions of the Patient Protection and Affordable Care Act. In light of a new process recently announced by the Department of Homeland Security, eligibility for the program is being amended so that the program does not inadvertently expand the scope of that process. PMID:22934326

  5. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....345 Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition... 45 Public Welfare 1 2013-10-01 2013-10-01 false Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition Insurance Plan. 155.345 Section 155.345 Public Welfare...

  6. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....345 Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition... 45 Public Welfare 1 2014-10-01 2014-10-01 false Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition Insurance Plan. 155.345 Section 155.345 Public Welfare...

  7. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....345 Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition... 45 Public Welfare 1 2012-10-01 2012-10-01 false Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition Insurance Plan. 155.345 Section 155.345 Public Welfare...

  8. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... If I have a pre-existing dental or vision condition, may I join FEDVIP? 894...CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and... If I have a pre-existing dental or vision condition, may I join FEDVIP?...

  9. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... If I have a pre-existing dental or vision condition, may I join FEDVIP? 894...CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and... If I have a pre-existing dental or vision condition, may I join FEDVIP?...

  10. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... If I have a pre-existing dental or vision condition, may I join FEDVIP? 894...CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and... If I have a pre-existing dental or vision condition, may I join FEDVIP?...

  11. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... If I have a pre-existing dental or vision condition, may I join FEDVIP? 894...CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and... If I have a pre-existing dental or vision condition, may I join FEDVIP?...

  12. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... If I have a pre-existing dental or vision condition, may I join FEDVIP? 894...CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and... If I have a pre-existing dental or vision condition, may I join FEDVIP?...

  13. Pre-existing cardiovascular conditions and high altitude travel. Consensus statement of the Medical Commission of the Union Internationale des Associations d'Alpinisme (UIAA MedCom) Travel Medicine and Infectious Disease.

    PubMed

    Donegani, Enrico; Hillebrandt, David; Windsor, Jeremy; Gieseler, Ulf; Rodway, George; Schöffl, Volker; Küpper, Thomas

    2014-01-01

    The number of persons visiting high altitude regions for various purposes (recreation, business etc.), and the age of people who do so, increases. Therefore there are more and more patients who need specific and individual advice to prevent emergency situations at altitude and to deal with emergencies if the safety strategy should fail. Since literature concerning cardiocirculatory diseases at altitude is scarce and studies with a controlled setting and high evidence level are missing, UIAA MedCom has checked all available literature for specific information to enable physicians who are active in travel or high altitude medicine to advise the patients at the highest possible level of evidence. It must be pointed out that there are several other medical fields where such information is mandatory, e.g. in occupational medicine, when employees depart to high altitude destinations for business purposes. The recommendations are based on a detailed literature research (databases, handbooks and the respective references). For easier use the paper has been structured as follows: general information, cardiocirculatory system and ECG at altitude, several cardiocirculatory diseases and their specific recommendations. The commission concludes, that a general "don't go!" is no state-of-the-art advice for the patients. With the information presented here a safe trip to altitude should be possible for many patients. PMID:24675141

  14. Sports Dermatology: Part 1 of 2 Traumatic or Mechanical Injuries, Inflammatory Conditions, and Exacerbations of Pre-existing Conditions

    PubMed Central

    Sivek, Rachel; Marciniak, Brian

    2015-01-01

    Competitive athletes endure extreme bodily stress when participating in sports-related activities. An athlete’s skin is particularly susceptible to a wide array of repetitive physical and environmental stressors that challenge the skin’s protective function. Many unique dermatoses are well-known to the serious athlete due to countless hours of intense physical training, but are frequently unrecognized by many healthcare professionals. Sports dermatology is a distinctive, budding field of dermatology that focuses on dermatoses frequently encountered in athletes. Athletic skin problems are notoriously infectious in nature due to the inherent environment of close-contact physical activity. Nonetheless, other skin conditions can manifest or worsen with recurring mechanical or traumatic injury or exposure to environmental hazards. Additionally, sports-related activities may exacerbate other pre-existing dermatological conditions that may possibly be unknown to the athlete or clinician. The objective of this two-part review is to arm the astute physician with the fundamental knowledge of the range of dermatological conditions distinct to the competitive athlete. Knowledge of these cutaneous conditions in the context of specific sporting events will permit the clinician to manage these unique patients most effectively. Part one will focus on traumatic or mechanical injuries, inflammatory conditions, and exacerbations of pre-existing conditions frequently seen in athletes. PMID:26060516

  15. Realizing Health Reform’s Potential Early Implementation of Pre-Existing Condition Insurance Plans: Providing an Interim Safety Net for the Uninsurable

    E-print Network

    Hall, Jean P.; Moore, Janice M.

    2011-06-01

    letter from a physician or evidence from medical records or an online personal health record — Subject to medical review, any other condition verified by doctor North Carolina X X X — — Ohio X From 2 carriers within 6 mos. X From 2 carriers...-Existing Condition Insurance Plans.pdf.txt Content-Encoding UTF-8 Content-Type text/plain; charset=UTF-8 Realizing Health Reform’s Potential Early Implementation of Pre-Existing Condition Insurance Plans: Providing an Interim Safety Net...

  16. Importance of pre-existing oceanic conditions to upper ocean response induced by Super Typhoon Hai-Tang

    NASA Astrophysics Data System (ADS)

    Zheng, Zhe-Wen; Ho, Chung-Ru; Kuo, Nan-Jung

    2008-10-01

    This study investigates upper ocean response to Super Typhoon Hai-Tang, the most intense typhoon in 2005, in the western North Pacific using multi-satellite microwave data, typhoon data and Argo profiles. Sequential merged microwave sea surface temperature (SST) images show that Hai-Tang induced four separately cooling responses after its trail in the western North Pacific during 11-18 July. Comparison between upper ocean responses of cooling SST and pre-typhoon sea surface height suggests that these cooling responses of the upper ocean to Hai-Tang are closely associated with pre-existing cyclonic circulation denoted by pre-existing negative sea surface features. Furthermore, applying Argo profiles, the physical mechanism is confirmed to be associated with pre-existing cyclonic circulations provide a relatively unstable thermodynamic structure, and therefore cold water would be brought up readily. This paper provides the rather convincing evidence that cyclonic flow and uplifted thermocline are the pre-existing conditions for intensive cooling following the typhoon passage.

  17. Comparison of maternal morbidity and medical costs during pregnancy and delivery between patients with gestational diabetes and patients with pre-existing diabetes

    PubMed Central

    Son, K H; Lim, N-K; Lee, J-W; Cho, M-C; Park, H-Y

    2015-01-01

    Aims To evaluate the effects of gestational diabetes and pre-existing diabetes on maternal morbidity and medical costs, using data from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Methods Delivery cases in 2010, 2011 and 2012 (459 842, 442 225 and 380 431 deliveries) were extracted from the Health Insurance Review and Assessment Service database. The complications and medical costs were compared among the following three pregnancy groups: normal, gestational diabetes and pre-existing diabetes. Results Although, the rates of pre-existing diabetes did not fluctuate (2.5, 2.4 and 2.7%) throughout the study, the rate of gestational diabetes steadily increased (4.6, 6.2 and 8.0%). Furthermore, the rates of pre-existing diabetes and gestational diabetes increased in conjunction with maternal age, pre-existing hypertension and cases of multiple pregnancy. The risk of pregnancy-induced hypertension, urinary tract infections, premature delivery, liver disease and chronic renal disease were greater in the gestational diabetes and pre-existing diabetes groups than in the normal group. The risk of venous thromboembolism, antepartum haemorrhage, shoulder dystocia and placenta disorder were greater in the pre-existing diabetes group, but not the gestational diabetes group, compared with the normal group. The medical costs associated with delivery, the costs during pregnancy and the number of in-hospital days for the subjects in the pre-existing diabetes group were the highest among the three groups. Conclusions The study showed that the rates of pre-existing diabetes and gestational diabetes increased with maternal age at pregnancy and were associated with increases in medical costs and pregnancy-related complications. PMID:25472691

  18. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  19. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  20. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  1. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  2. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  3. Clinical prognosis, pre-existing conditions and the use of reperfusion therapy for patients with ST segment elevation acute myocardial infarction

    PubMed Central

    Parker, Andrea B; Naylor, C David; Chong, Alice; Alter, David A

    2006-01-01

    BACKGROUND Some evidence-based therapies are underused in patients with a poor prognosis despite the fact that the survival gains would be highest among such patient subgroups. The extent to which this applies for acute, life-saving therapies is unknown. The impact of prognostic characteristics and pre-existing conditions on the use of reperfusion therapy among eligible patients with acute ST segment elevation myocardial infarction is examined. METHODS Of 2829 acute myocardial infarction patients prospectively identified in 53 acute care hospitals across Ontario, 987 presented with ST segment elevation within 12 h of symptom onset and without any absolute contraindications to reperfusion therapy. The baseline prognosis for each patient was derived from a validated risk-adjustment model of 30-day mortality. Multiple logistical regression was used to examine the relationships among reperfusion therapy, prognosis and the number of pre-existing chronic conditions after adjusting for factors such as age, sex, time since symptom onset and socioeconomic status. RESULTS Of the 987 appropriate candidates, 725 (73.5%) received reperfusion therapy (70.8% fibrinolysis, 2.6% primary angioplasty). The adjusted odds ratio of reperfusion therapy fell 4% with each 1% increase in baseline risk of death (adjusted OR 0.96, 95% CI 0.92 to 1.00, P=0.04) and fell 18% with each additional pre-existing condition (adjusted OR 0.82, 95% CI 0.76 to 0.90, P<0.001). The number rather than the type of pre-existing conditions inversely correlated with the use of reperfusion therapy. While the impact of baseline risk and pre-existing conditions was additive, pre-existing conditions exerted a greater impact on the nonuse of reperfusion therapy than did baseline risk. CONCLUSIONS A treatment-risk paradox is demonstrable even within a cohort of lower risk patients with ST segment elevation myocardial infarction. These findings are consistent with the view that these clinical decisions are more likely to be attributable to concerns about patient frailty or side effects than to a misunderstanding of treatment benefits. PMID:16485048

  4. Realizing Health Reform’s Potential The Affordable Care Act’s Pre-Existing Condition Insurance Plan: Enrollment, Costs, and Lessons for Reform

    E-print Network

    Hall, Jean P.; Moore, Janice M.

    2012-09-01

    in the individual market for a healthy person, cover only 53 percent of the cost of claims, on average.10 State high-risk pools therefore depend on external sources to break even, including assessments charged to health carriers and hospitals and, in a few cases... open enrollment periods and from imposing any waiting period for coverage of a preex- isting condition. These provisions have undoubtedly been life-saving for many individuals who enrolled in the program to address a health crisis. Indeed...

  5. Cardiopulmonary Bypass in Patients With Pre-existing Coagulopathy

    PubMed Central

    DeBois, William; Liu, Junli; Lee, Leonard; Girardi, Leonard; Ko, Wilson; Tortolani, Anthony; Krieger, Karl; Isom, O. Wayne

    2005-01-01

    Abstract: Patients with pre-existing coagulopathies who undergo surgical interventions are at increased risk for bleeding complications. This risk is especially true in cardiac surgical procedures with cardiopulmonary bypass (CPB) because of the necessity for heparinization and the use of the extracorporeal circuits, which have destructive effects on most of the blood components. In this review, cases of cardiac surgeries in patients with certain pre-existing coagulopathies are summarized, which could shed a light on future managements of such patients undergoing cardiac procedures with CPB. Pre-existing coagulopathies include antithrombin III deficiency, heparin-induced thrombocytopenia, cancer, factor XII deficiency, hemophilia, idiopathic thrombocytopenic purpura, protein S deficiency, and drug-induced platelet inhibition. In summary, pre-existing coagulopathy in patients undergoing open-heart surgeries, if not recognized and appropriately managed, can cause serious complications. Management of patients undergoing cardiac procedures should include a routine coagulation work-up and a thorough past medical history examination. If any of the foregoing is abnormal, further evaluation is warranted. Proper diagnosis and management of the pre-existing coagulopathy disorders is of crucial importance to the surgical outcome and long-term morbidity. PMID:15804152

  6. Depression in Pregnancy is Associated with Pre-existing but not Pregnancy-induced Hypertension

    PubMed Central

    Katon, Wayne J.; Russo, Joan E.; Melville, Jennifer L.; Katon, Jodie; Gavin, Amelia

    2011-01-01

    Background To examine whether depression is associated with pre-existing hypertension or pregnancy-induced hypertension in a large sample of women attending a university-based obstetrics clinic. Methods In this prospective study, participants were 2398 women receiving ongoing prenatal care at a university-based obstetrics clinic from January 2004 through January 2009. Prevalence of depression was measured using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria based on the Patient Health Questionnaire-9 as well as the self-reported use of antidepressant medication. Evidence of pre-existing hypertension, pregnancy-induced hypertension and preeclampsia/eclampsia was determined by obstetrician ICD-9 codes. Logistic regression was used to quantify the association between hypertension in pregnancy and antenatal depression. Results After adjusting for sociodemographic variables, chronic medical conditions, smoking and prior pregnancy complications, women with pre-existing hypertension had an increased risk of Any Depression (minor, major, use of antidepressants) (OR = 1.55, 95% CI 1.08, 2.23) and Major Depression and/or use of antidepressants) (OR = 1.65, 95% CI 1.10, 2.48) compared to women without hypertension. No differences were seen in risk of depression in women with pregnancy-induced hypertension or preeclampsia/eclampsia compared to those without hypertension. Conclusion Women with pre-existing hypertension, but not pregnancy induced hypertension are more likely to meet criteria for an antenatal depressive disorder and/or to be treated with antidepressants and could be targeted by obstetricians for screening for depression and enhanced treatment. PMID:22055108

  7. MEDICAL INSURANCE ConditionCare

    E-print Network

    - 21 - MEDICAL INSURANCE ConditionCare If you or one of your dependents have diabetes, coronary three medical insurance plans with Anthem Blue Cross and Blue Shield. Part of Anthem's mission decisions about their health and are included with your medical coverage. Included in the medical plans

  8. 17 CFR 151.9 - Pre-existing positions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Pre-existing positions. 151.9 Section 151.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION POSITION LIMITS FOR FUTURES AND SWAPS § 151.9 Pre-existing positions. (a) Non-spot-month position limits. The position...

  9. 17 CFR 151.9 - Pre-existing positions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Pre-existing positions. 151.9 Section 151.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION POSITION LIMITS FOR FUTURES AND SWAPS § 151.9 Pre-existing positions. (a) Non-spot-month position limits. The position...

  10. 17 CFR 151.9 - Pre-existing positions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 2 2014-04-01 2014-04-01 false Pre-existing positions. 151.9 Section 151.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION (CONTINUED) POSITION LIMITS FOR FUTURES AND SWAPS § 151.9 Pre-existing positions. (a) Non-spot-month position limits....

  11. The effect of pre-existing mental health comorbidities on the stage at diagnosis and timeliness of care of solid tumor malignances in a Veterans Affairs (VA) medical center

    PubMed Central

    Wadia, Roxanne J; Yao, Xiaopan; Deng, Yanhong; Li, Jia; Maron, Steven; Connery, Donna; Gunduz-Bruce, Handan; Rose, Michal G

    2015-01-01

    There are limited data on the impact of mental health comorbidities (MHC) on stage at diagnosis and timeliness of cancer care. Axis I MHC affect approximately 30% of Veterans receiving care within the Veterans Affairs (VA) system. The purpose of this study was to compare stage at diagnosis and timeliness of care of solid tumor malignancies among Veterans with and without MHC. We performed a retrospective analysis of 408 charts of Veterans with colorectal, urothelial, and head/neck cancer diagnosed and treated at VA Connecticut Health Care System (VACHS) between 2008 and 2011. We collected demographic data, stage at diagnosis, medical and mental health co-morbidities, treatments received, key time intervals, and number of appointments missed. The study was powered to assess for stage migration of 15–20% from Stage I/II to Stage III/IV. There was no significant change in stage distribution for patients with and without MHC in the entire study group (p = 0.9442) and in each individual tumor type. There were no significant differences in the time intervals from onset of symptoms to initiation of treatment between patients with and without MHC (p = 0.1135, 0.2042 and 0.2352, respectively). We conclude that at VACHS, stage at diagnosis for patients with colorectal, urothelial and head and neck cancers did not differ significantly between patients with and without MHC. Patients with MHC did not experience significant delays in care. Our study indicates that in a medical system in which mental health is integrated into routine care, patients with Axis I MHC do not experience delays in cancer care. PMID:26063243

  12. A Double Whammy: Health Promotion Among Cancer Survivors with Pre-Existing Functional Limitations

    PubMed Central

    Volker, Deborah L.; Becker, Heather; Kang, Sook Jung; Kullberg, Vicki

    2012-01-01

    Purpose/Objectives To explore the experience of living with a cancer diagnosis within the context of a pre-existing functional disability and to identify strategies to promote health in this growing population of cancer survivors. Research Approach Qualitative descriptive Setting Four sites in the United States Participants 19 female cancer survivors with pre-existing disabling conditions Methodologic Approach Four focus groups were conducted. The audiotapes were transcribed and analyzed using content analysis techniques. Main Research Variables cancer survivor, disability, health promotion Findings Analytic categories included living with a cancer diagnosis, health promotion strategies, and wellness program development for survivors with pre-existing functional limitations. Participants described many challenges associated with managing a cancer diagnosis on top of living with a chronic disabling functional limitation. They identified strategies they used to maintain their health and topics to be included in health promotion programs tailored for this unique group of cancer survivors. Conclusions The “double whammy” of a cancer diagnosis for persons with pre-existing functional limitations requires modification of health promotion strategies and programs to promote wellness in this group of cancer survivors. Interpretation Nurses and other health care providers must attend to patients’ pre-existing conditions as well as the challenges of the physical, emotional, social, and economic sequelae of a cancer diagnosis. PMID:23269771

  13. 75 FR 45013 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-30

    ...FEHBP. The subject of Federal funding of abortion services with respect to the Affordable...prohibit the use of Federal funds for abortion services, except in cases of rape or...by the PCIP program shall not include abortion services except in the case of rape...

  14. 77 FR 52614 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-30

    ...cost sharing. This is consistent with the policy under S. 3992, the Development, Relief, and Education for Alien Minors (DREAM) Act of 2010.'' See Consideration of Deferred Action for Childhood Arrivals,...

  15. 78 FR 30218 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ...Plan prescription drug benefit, the relative...for Medicare Part B drugs based on published...health and substance abuse facilities; (5...final rule goes into effect, HHS may opt, through...the prescription drug benefit in the federally-administered...furnished under the organ/tissue...

  16. 78 FR 30218 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ..., no later than 5 p.m. on July 22, 2013. Because of staff and resource limitations, we cannot accept.... Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You..., work, risk and resources of the service. (Hereafter, we generally refer to this pricing methodology...

  17. 75 FR 45013 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-30

    ... resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may submit comments in... 2719A (regarding patient protections), published in the Federal Register on June 28, 2010 (75 FR 37188... consumer information resources that each PCIP will establish) and incorporated into the final...

  18. 77 FR 52614 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-30

    ... staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may... 30, 2010 (75 FR 45014). For the reasons explained below, HHS is now issuing an amendment to this... Affordable Insurance Exchanges, 45 CFR 155.20 (77 FR 18310, March 27, 2012), and the premium tax credits,...

  19. 75 FR 45013 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-30

    ... 2719A (regarding patient protections), published in the Federal Register on June 28, 2010 (75 FR 37188... of rape or incest, or where the life of the woman would be endangered. Exec. Order No. 13,535, 75 FR... of Federal funding of abortion services with respect to the Affordable Care Act was addressed in...

  20. Travelers with Disabilities and Medical Conditions

    MedlinePLUS

    ... Travel Redress Claims Travel Tips FAQ Disabilities and Medical Conditions To ensure your security, all travelers are ... officer with the TSA notification card or other medical documentation to describe your condition. If you have ...

  1. The Magnetospheric Source of the Pre-existing Auroral Arc

    NASA Astrophysics Data System (ADS)

    Jiang, Feifei

    An auroral substorm commences when a discrete auroral arc brightens and subsequently expands poleward and azimuthally. The arc that brightens is usually the most equatorward of several quiescent auroral arcs present for a few to tens of minutes before the break-up commences. This arc is referred to as the "pre-existing auroral arc (PAA)" or the "growth-phase arc". Till now, the magnetospheric manifestation of the PAA during the growth phase and at substorm onset are not well understood. This dissertation addresses the magnetospheric location and source of the field-aligned current (FAC) of the PAA by analyzing measurements from magnetic and optical observatories on the ground and spacecraft at low and high altitudes. In order to understand the magnetospheric location of the PAA relative to the inner edge of the electron plasma sheet (IEEPS), 2 years of THEMIS plasma data are surveyed to characterize the location of IEEPS on the equatorial plane. The IEEPS is found to lie at 7˜8 RE in the pre-midnight sector and 6˜7 RE in the post-midnight sector at geomagnetically quiet times. Next, from 5 events obtained between 2007 and early 2009 in which FAST crosses the flux tube linking to a PAA imaged by THEMIS all-sky imagers before an auroral substorm, the PAA is found to be located 1˜2 degree poleward of the equatorward boundary of the 1 keV trapped electrons in the ionosphere. This latitudinal separation maps to a 2˜3 RE radial separation from the IEEPS at the equator by the T96 model, and it places the PAA at 8˜10 RE for typical growth phase conditions and further tailward for a very stretched magnetotail. In addition, the PAA is found to be located very close to the boundary between the Region 1 and Region 2 FACs but shifted into the upward FAC region. The source of the FAC of the PAA is examined from observations in the ionosphere and in the magnetosphere. ˜200 PAA events identified from the FAST measurements in 1998 show that an ionospheric flow shear is present in the vicinity of the PAA, where westward flow increases within 0.5 degree equatorward of the PAA in the premidnight sector and eastward flow increases within 0.5 degree poleward of the PAA in the postmidnight sector. Corresponding magnetospheric flow shear is observed by the THEMIS probes in a region estimated to be located near the PAA's source. Two events with THEMIS in-situ and ASI observations show that flow shear is the primary source of the FAC of the PAA during the growth phase and contributes significantly to the FAC system of the onset arc shortly before the auroral breakup.

  2. Gate dielectric degradation: Pre-existing vs. generated defects

    SciTech Connect

    Veksler, Dmitry E-mail: gennadi.bersuker@sematech.org; Bersuker, Gennadi E-mail: gennadi.bersuker@sematech.org

    2014-01-21

    We consider the possibility that degradation of the electrical characteristics of high-k gate stacks under low voltage stresses of practical interest is caused primarily by activation of pre-existing defects rather than generation of new ones. In nFETs in inversion, in particular, defect activation is suggested to be associated with the capture of an injected electron: in this charged state, defects can participate in a fast exchange of charge carriers with the carrier reservoir (substrate or gate electrode) that constitutes the physical process underlying a variety of electrical measurements. The degradation caused by the activation of pre-existing defects, as opposed to that of new defect generation, is both reversible and exhibits a tendency to saturate through the duration of stress. By using the multi-phonon assisted charge transport description, it is demonstrated that the trap activation concept allows reproducing a variety of experimental results including stress time dependency of the threshold voltage, leakage current, charge pumping current, and low frequency noise. Continuous, long-term degradation described by the power law time dependency is shown to be determined by the activation of defects located in the interfacial SiO{sub 2} layer of the high-k gate stacks. The findings of this study can direct process optimization efforts towards reduction of as-grown precursors of the charge trapping defects as the major factor affecting reliability.

  3. PRESENCE OF PRE-EXISTING ANTIBODIES MEDIATE SURVIVAL IN SEPSIS

    PubMed Central

    Moitra, Rituparna; Beal, Dominic R.; Belikoff, Bryan G.; Remick, Daniel G.

    2011-01-01

    Sepsis is one of the leading causes of death in hospitals worldwide. Even with optimal therapy, severe sepsis results in 50% mortality, indicating variability in the response of individuals towards treatment. We hypothesize that the presence of pre-existing antibodies present in the blood before the onset of sepsis induced by cecal ligation and puncture (CLP) in mice, accounts for the differences in their survival. A Plasma Enhanced Killing (PEK) assay was performed to calculate the PEK capacity of plasma i.e. the ability of plasma to augment PMN killing of bacteria. PEK was calculated as PEK= (1/log (N)) × 100; where N= number of surviving bacteria; a higher PEK indicated better bacterial killing. A range of PEK in plasma collected from mice prior to CLP was observed, documenting individual differences in bacterial killing capacity. Mortality was predicted based on plasma IL-6 levels at 24 hr post CLP. Mice predicted to die (Die-P) had a lower PEK (<14) and higher peritoneal bacterial counts 24 hr post sepsis compared to those predicted to live (Live-P) with a PEK>16. Mice with PEK<14 were 3.1 times more likely to die compared to the PEK>16 group. To understand the mechanism of defense conferred by the pre-existing antibodies, binding of IgM or IgG to enteric bacteria was documented by flow cytometry. To determine the relative contribution of IgM or IgG, the immunoglobulins were specifically immuno-depleted from the naïve plasma samples and the PEK of the depleted plasma measured. Compared to naïve plasma, depletion of IgM had no effect on the PEK. However, depletion of IgG increased PEK suggesting that an inhibitory IgG binds to antigenic sites on bacteria preventing optimal opsonization of the bacteria. These data demonstrate that prior to CLP; circulating inhibitory IgG antibodies exist that prevent bacterial killing by PMNs in a CLP model of sepsis. PMID:21921828

  4. The Near Earth Asteroid Medical Conditions List

    NASA Technical Reports Server (NTRS)

    Barr, Yael R.; Watkins, S. D.

    2011-01-01

    Purpose: The Exploration Medical Capability (ExMC) element is one of six elements within NASA s Human Research Program (HRP) and is responsible for addressing the risk of "the inability to adequately recognize or treat an ill or injured crewmember" for exploration-class missions. The Near Earth Asteroid (NEA) Medical Conditions List, constructed by ExMC, is the first step in addressing the above-mentioned risk for the 13-month long NEA mission. The NEA mission is being designed by NASA's Human Space Flight Architecture Team (HAT). The purpose of the conditions list is to serve as an evidence-based foundation for determining which medical conditions could affect a crewmember during the NEA mission, which of those conditions would be of concern and require treatment, and for which conditions a gap in knowledge or technology development exists. This information is used to focus research efforts and technology development to ensure that the appropriate medical capabilities are available for exploration-class missions. Scope and Approach: The NEA Medical Conditions List is part of a broader Space Medicine Exploration Medical Conditions List (SMEMCL), which incorporates various exploration-class design reference missions (DRMs). The conditions list contains 85 medical conditions which could occur during space flight and which are derived from several sources: Long-Term Surveillance of Astronaut Health (LSAH) in-flight occurrence data, The Space Shuttle (STS) Medical Checklist, The International Space Station (ISS) Medical Checklist, and subject matter expert opinion. Each medical condition listed has been assigned a clinical priority and a clinical priority rationale based on incidence, consequence, and mitigation capability. Implementation: The conditions list is a "living document" and as such, new conditions can be added to the list, and the priority of conditions on the list can be adjusted as the DRM changes, and as screening, diagnosis, or treatment capabilities change. The NEA medical conditions list was used recently as the basis for identifying gaps in in-flight medical evaluation (screening) capabilities. Learning Objectives: The audience will become familiar with the approach taken by NASA's Exploration Medical Capability element in addressing the risk of inability to recognize and treat medical conditions in the setting of a Near Earth Asteroid mission. Which one of the following statements is incorrect? a) The Near Earth Asteroid (NEA) medical conditions list includes 85 medical conditions which could occur during space flight. b) Each condition on the NEA medical conditions list has been assigned a clinical priority and a clinical priority rationale. c) The NEA medical conditions list targets a mission to Mars. d) The NEA medical conditions list should be viewed as a "living document" where new conditions can be added and clinical priorities adjusted to address changes in the design reference mission or medical capabilities. The incorrect answer is c). The NEA medical conditions list targets a mission to a Near Earth Asteroid.

  5. Ionospheric Current Closure of the Pre-existing Auroral Arc

    NASA Astrophysics Data System (ADS)

    Jiang, F.; Kivelson, M.; Strangeway, R. J.; Khurana, K. K.; Walker, R. J.; Weygand, J. M.

    2014-12-01

    An auroral substorm commences when a discrete auroral arc brightens and subsequently expands poleward and azimuthally. The arc that brightens is usually the most equatorward of several auroral arcs that remain quiescent for ~5 to ~60 minutes before the break-up commences. This arc is often referred to as the "pre-existing auroral arc (PAA)" or the "growth-phase arc". Till now, the ionospheric electrodynamics of the PAA has been studied extensively by ground radar, rockets and low-altitude spacecraft, and it is well established that the field-aligned currents (FAC) associated with the PAA in the ionosphere are current sheets that are narrow in latitude and elongated in longitude. However, it remains a question whether the ionospheric currents that connect the FAC pair of the PAA are meridional or azimuthal. In this study, we have identified ~180 PAA events from FAST measurements in 1998 and 1999 and used the statistics to investigate the ionospheric current closure of the PAA. We calculate the height-integrated Pedersen currents from the electric fields measured by FAST using an empirical ionospheric conductance model and infer the FAC density from the divergence of the Pedersen currents. We find that in the vicinity of the PAA, the FAC density inferred from the divergence of perpendicular currents mimics the trend of the FAC density inferred from magnetic perturbations seen on FAST, and that the boundaries between the upward and the downward FAC sheets inferred from two different approaches lie very close together. Additionally, the latitudinal gradient of the azimuthal component of the magnetic perturbation is much larger than the azimuthal gradient of the meridional component of the magnetic perturbation in the vicinity of the PAA, indicating that the density of a meridional current is much larger than that of an azimuthal current. Our observational analysis strongly suggests that the perpendicular current that closes the FAC pair of the PAA is a north-south Pedersen current in the ionosphere.

  6. Sleep Disturbances in Patients with Medical Conditions.

    PubMed

    Kamath, Jayesh; Prpich, Galina; Jillani, Sarah

    2015-12-01

    Sleep-wake cycle disturbances are prevalent in patients with medical conditions and frequently present as part of a symptom cluster. Sleep disturbances impair functioning and quality of life, decrease adherence to treatments of the primary medical condition, and increase morbidity and mortality. The pathophysiology of sleep disturbances in these patients involves alterations in immune and neuroendocrine function and shares common pathophysiologic pathways with comorbidities such as fatigue and depression. Emphasis is placed on the evaluation and management of medical and psychiatric comorbidities and other factors contributing to sleep problems. Primary treatments include cognitive-behavioral therapy and pharmacotherapy. PMID:26600111

  7. 14 CFR 67.113 - General medical condition.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.113 General medical condition. The general medical standards for a first-class airman medical certificate are: (a) No...

  8. 42 CFR 418.102 - Condition of participation: Medical director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Condition of participation: Medical director. 418.102 Section 418...Condition of participation: Medical director. The hospice must designate a physician to serve as medical director. The medical director...

  9. The Space Medicine Exploration Medical Condition List

    NASA Technical Reports Server (NTRS)

    Watkins, Sharmi; Barr, Yael; Kerstman, Eric

    2011-01-01

    Exploration Medical Capability (ExMC) is an element of NASA s Human Research Program (HRP). ExMC's goal is to address the risk of the "Inability to Adequately Recognize or Treat an Ill or Injured Crewmember." This poster highlights the approach ExMC has taken to address this risk. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to define the set of medical conditions that are most likely to occur during exploration space flight missions. The list was derived from the International Space Station Medical Checklist, the Shuttle Medical Checklist, in-flight occurrence data from the Lifetime Surveillance of Astronaut Health, and NASA subject matter experts. The list of conditions was further prioritized for eight specific design reference missions with the assistance of the ExMC Advisory Group. The purpose of the SMEMCL is to serve as an evidence-based foundation for the conditions that could affect a crewmember during flight. This information is used to ensure that the appropriate medical capabilities are available for exploration missions.

  10. Three-dimensional numerical analysis of magma transport through a pre-existing fracture in the crust

    NASA Astrophysics Data System (ADS)

    Chen, Zuan; Cheng, Xu; Huang, Xiaoge; Bai, Wuming; Jin, Zhi-He

    2014-05-01

    Magmas are transported through pre-existing fractures in many repeatedly erupting volcanoes. The study of this special process of magma transport is fundamentally important to understand the mechanisms and conditions of volcanic eruptions. In this paper, we numerically simulate the magma propagation process through a pre-existing vertical fracture in the crust by using the combined finite difference method (FDM), finite element method (FEM) and discontinuous deformation analysis (DDA) approach. FDM is used to analyze magma flow in the pre-existing fracture, FEM is used to calculate the opening of the fracture during magma intrusion, and DDA is used to deal with the contact of the closed fracture surfaces. Both two-dimensional (2D) and three-dimensional (3D) examples are presented. Parametric studies are carried out to investigate the influence of various physical and geometric parameters on the magma transport in the pre-existing fracture. We have considered magma chamber depth ranging from 7 km to 10 km under the crust surface, magma viscosity ranging from 2 × 10-2 to 2 × 10-7 MPa s, and the density difference between the magma and host rock ranging from 300 to 700 kg/m3. The numerical results indicate that (1) the fluid pressure p varies gradually along the depth, (2) the shape of the magma body during propagation is like a torch bar and its width ranges from 2 m to 4 m approximately in the 3D case and 10 m to 50 m in the 2D case for the same physical parameters used, (3) the crust surface around the pre-existing fracture begins to increase on both sides of the fracture, forms a trough between them, then gradually uplifts during the transport of the magma, and finally takes the shape of a crater when the magma reaches the surface. We have also examined the influence of physical and geometric parameters on the minimum overpressure for magma transport in the 3D case. The numerical results show that our numerical technique presented in this paper is an effective tool for simulating magma transport process through pre-existing fractures in the crust.

  11. 14 CFR 67.113 - General medical condition.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false General medical condition. 67.113 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.113 General medical condition. The general medical standards for a first-class airman medical certificate are: (a)...

  12. 14 CFR 67.313 - General medical condition.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false General medical condition. 67.313 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.313 General medical condition. The general medical standards for a third-class airman medical certificate are: (a)...

  13. 14 CFR 67.213 - General medical condition.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false General medical condition. 67.213 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.213 General medical condition. The general medical standards for a second-class airman medical certificate are: (a)...

  14. 14 CFR 67.313 - General medical condition.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false General medical condition. 67.313 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.313 General medical condition. The general medical standards for a third-class airman medical certificate are: (a)...

  15. 14 CFR 67.213 - General medical condition.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false General medical condition. 67.213 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.213 General medical condition. The general medical standards for a second-class airman medical certificate are: (a)...

  16. 14 CFR 67.113 - General medical condition.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false General medical condition. 67.113 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.113 General medical condition. The general medical standards for a first-class airman medical certificate are: (a)...

  17. Asperger Syndrome: Associated Psychiatric and Medical Conditions.

    ERIC Educational Resources Information Center

    Ghaziuddin, Mohammad

    2002-01-01

    This article explores the association of medical and psychiatric conditions with Asperger syndrome, based mainly on publications from the last two decades. It examines comorbidity of Asperger syndrome with mood disorders, schizophrenia, obsessive-compulsive disorder, attention deficit/hyperactivity disorder, tic disorders, violence and aggression,…

  18. Handbook for Students Disabilities / Medical Conditions

    E-print Network

    Pavlov, Ronnie

    and personal growth in students with disabilities. We partner with our community members to embrace disabilityHandbook for Students with Disabilities / Medical Conditions 2015-2016 Handbook also available Students with Disabilities 4 Confidentiality of Student Records & Documentation 4 Academic Accommodations

  19. Evolution and metamorphosis of pre-existent structures : lasting change, Lazarus' memory

    E-print Network

    Olson, Richard Keith

    1994-01-01

    As society perpetually evolves, retention of selected pre-existent building fragments (structure and inhabitation, form and use) provides necessary continuity to affirm cultural and individual identity. Within this framework ...

  20. Rapid selective sweep of pre-existing polymorphisms and slow fixation of new mutations in experimental evolution of Desulfovibrio vulgaris.

    PubMed

    Zhou, Aifen; Hillesland, Kristina L; He, Zhili; Schackwitz, Wendy; Tu, Qichao; Zane, Grant M; Ma, Qiao; Qu, Yuanyuan; Stahl, David A; Wall, Judy D; Hazen, Terry C; Fields, Matthew W; Arkin, Adam P; Zhou, Jizhong

    2015-11-01

    To investigate the genetic basis of microbial evolutionary adaptation to salt (NaCl) stress, populations of Desulfovibrio vulgaris Hildenborough (DvH), a sulfate-reducing bacterium important for the biogeochemical cycling of sulfur, carbon and nitrogen, and potentially the bioremediation of toxic heavy metals and radionuclides, were propagated under salt stress or non-stress conditions for 1200 generations. Whole-genome sequencing revealed 11 mutations in salt stress-evolved clone ES9-11 and 14 mutations in non-stress-evolved clone EC3-10. Whole-population sequencing data suggested the rapid selective sweep of the pre-existing polymorphisms under salt stress within the first 100 generations and the slow fixation of new mutations. Population genotyping data demonstrated that the rapid selective sweep of pre-existing polymorphisms was common in salt stress-evolved populations. In contrast, the selection of pre-existing polymorphisms was largely random in EC populations. Consistently, at 100 generations, stress-evolved population ES9 showed improved salt tolerance, namely increased growth rate (2.0-fold), higher biomass yield (1.8-fold) and shorter lag phase (0.7-fold) under higher salinity conditions. The beneficial nature of several mutations was confirmed by site-directed mutagenesis. All four tested mutations contributed to the shortened lag phases under higher salinity condition. In particular, compared with the salt tolerance improvement in ES9-11, a mutation in a histidine kinase protein gene lytS contributed 27% of the growth rate increase and 23% of the biomass yield increase while a mutation in hypothetical gene DVU2472 contributed 24% of the biomass yield increase. Our results suggested that a few beneficial mutations could lead to dramatic improvements in salt tolerance. PMID:25848870

  1. 14 CFR 67.213 - General medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 2010-01-01 false General medical condition. 67.213 Section 67.213...TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.213 General...

  2. 14 CFR 67.313 - General medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 2010-01-01 false General medical condition. 67.313 Section 67.313...TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.313 General...

  3. 14 CFR 67.113 - General medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 2010-01-01 false General medical condition. 67.113 Section 67.113...TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.113 General...

  4. 42 CFR 418.102 - Condition of participation: Medical director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition of participation: Medical director. 418... Environment § 418.102 Condition of participation: Medical director. The hospice must designate a physician to serve as medical director. The medical director must be a doctor of medicine or osteopathy who is...

  5. 42 CFR 418.102 - Condition of participation: Medical director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Condition of participation: Medical director. 418... Environment § 418.102 Condition of participation: Medical director. The hospice must designate a physician to serve as medical director. The medical director must be a doctor of medicine or osteopathy who is...

  6. 28 CFR 79.34 - Proof of medical condition.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Proof of medical condition. 79.34 Section... COMPENSATION ACT Eligibility Criteria for Claims by Onsite Participants § 79.34 Proof of medical condition. Proof of medical condition under this subpart will be made in the same manner and according to the...

  7. 28 CFR 79.34 - Proof of medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of medical condition. 79.34 Section... COMPENSATION ACT Eligibility Criteria for Claims by Onsite Participants § 79.34 Proof of medical condition. Proof of medical condition under this subpart will be made in the same manner and according to the...

  8. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  9. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 14 2012-04-01 2012-04-01 false Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  10. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 14 2014-04-01 2013-04-01 true Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  11. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 14 2011-04-01 2010-04-01 true Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  12. Surrogate-based optimization of hydraulic fracturing in pre-existing fracture networks

    E-print Network

    Lu, Zhiming

    Surrogate-based optimization of hydraulic fracturing in pre-existing fracture networks Mingjie Chen Keywords: Hydraulic fracturing Fractal dimension Surrogate model Optimization Global sensitivity a b s t r a c t Hydraulic fracturing has been used widely to stimulate production of oil, natural gas

  13. Are There Pre-Existing Neural, Cognitive, or Motoric Markers for Musical Ability?

    ERIC Educational Resources Information Center

    Norton, Andrea; Winner, Ellen; Cronin, Karl; Overy, Katie; Lee, Dennis J.; Schlaug, Gottfried

    2005-01-01

    Adult musician's brains show structural enlargements, but it is not known whether these are inborn or a consequence of long-term training. In addition, music training in childhood has been shown to have positive effects on visual-spatial and verbal outcomes. However, it is not known whether pre-existing advantages in these skills are found in…

  14. Mechanical and microstructural development of Carrara marble with pre-existing strain variation

    E-print Network

    Cattin, Rodolphe

    Mechanical and microstructural development of Carrara marble with pre-existing strain variation September 2010 Keywords: Carrara marble Torsion Strain variation Strain reversal Single-stage deformation Two-stage deformation A series of two-stage torsion experiments on Carrara marble were conducted

  15. Effect of pre-existing crystallographic preferred orientation on the rheology of Carrara marble

    E-print Network

    Skemer, Philip

    Effect of pre-existing crystallographic preferred orientation on the rheology of Carrara marble Available online 26 August 2014 Keywords: CPO Strain weakening Annealing Carrara marble Torsion experiments development to the strain weakening seen in Carrara marble samples during large strain torsion ex- periments

  16. Using an Electronic Highlighter to Eliminate the Negative Effects of Pre-Existing, Inappropriate Highlighting

    ERIC Educational Resources Information Center

    Gier, Vicki; Kreiner, David; Hudnell, Jason; Montoya, Jodi; Herring, Daniel

    2011-01-01

    The purpose of the present experiment was to determine whether using an active learning technique, electronic highlighting, can eliminate the negative effects of pre-existing, poor highlighting on reading comprehension. Participants read passages containing no highlighting, appropriate highlighting, or inappropriate highlighting. We hypothesized…

  17. Medical Conditions and Medication Use in Adults with Down Syndrome: A Descriptive Analysis

    ERIC Educational Resources Information Center

    Kerins, Gerard; Petrovic, Kimberly; Bruder, Mary Beth; Gruman, Cynthia

    2008-01-01

    Background: We examined the presence of medical conditions and medication use within a sample of adults with Down syndrome. Methods: Retrospective chart review using a sample of 141 adults with Down syndrome and age range of 30 to 65 years. Results: We identify 23 categories of commonly occurring medical conditions and 24 categories of medications

  18. 14 CFR 67.113 - General medical condition.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false General medical condition. 67.113 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.113...

  19. 14 CFR 67.313 - General medical condition.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false General medical condition. 67.313 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.313...

  20. 14 CFR 67.113 - General medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false General medical condition. 67.113 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.113...

  1. 14 CFR 67.313 - General medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false General medical condition. 67.313 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.313...

  2. 14 CFR 67.213 - General medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false General medical condition. 67.213 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.213...

  3. 14 CFR 67.213 - General medical condition.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false General medical condition. 67.213 Section...) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.213...

  4. On Reactivation of a Pre-Existing Fracture by Fluid Injection into Subsurface

    NASA Astrophysics Data System (ADS)

    Sarvaramini, E.; Garagash, D.

    2012-12-01

    The reactivation of pre-existing mechanically-closed but hydraulically-open fractures may control injection of liquid waste (such as super critical CO2) into deep geological formations for storage. These fractures could be either of natural origin or man-made (e.g., hydraulic fractures used to stimulate production from a now depleted reservoir chosen for waste storage). The study of interactions between the fluid, fracture and surrounding porous rock plays a key role to understand the mechanical and hydraulical behavior of the fracture during initial stages of injection when initially mechanically-closed crack is pressurized. The knowledge of the pore fluid pressure evolution with time and space is crucial to observe the fracture transition from mechanically closed (positive effective confining stress) to mechanically open (negative effective confining stress) state, and to the eventual onset of propagation. This requires the accurate study of the crack behavior near zero effective confining stress. In one possible scenario, the crack can be assumed to be uniformly pressurized if hydraulic conductivity of the crack is sufficiently high and/or the fluid injection rate is sufficiently low. In this case the internal fluid pressure will increase with time uniformly along the crack during the transient pressurization until the condition of the crack opening is reached. In order to investigate the extent to which the assumption of uniform internal fluid pressure along the crack is valid, we consider the actual case where the internal fluid pressure may not be uniform along the crack. Adopting a relation between the local hydraulic aperture and the effective normal stress [Gangi 1978], the flow of the fluid inside the mechanically-closed but hydraulically-opened fracture can be described by a lubrication-like equation, and the flow of fluid in the porous rock adjacent to the fracture by the full diffusivity equation. We show that the validity of the uniformly pressurized crack assumption depends upon the representative values of crack properties, fluid properties and operating conditions such as the fluid injection rate, and establish the range of these parameters for which the assumption is justified. The obtained solution for transient pressurization of initially closed and subsequently opened crack allows to evaluate the time from the beginning of the injection to the onset of the fracture propagation and provides initial conditions to the propagation problem.

  5. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Medical records. 494.170 Section 494.170... Administration § 494.170 Condition: Medical records. The dialysis facility must maintain complete, accurate, and...: Completion of patient records and centralization of clinical information. (1) Current medical records...

  6. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Medical records. 494.170 Section 494.170... Administration § 494.170 Condition: Medical records. The dialysis facility must maintain complete, accurate, and...: Completion of patient records and centralization of clinical information. (1) Current medical records...

  7. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Condition: Medical records. 494.170 Section 494.170... Administration § 494.170 Condition: Medical records. The dialysis facility must maintain complete, accurate, and...: Completion of patient records and centralization of clinical information. (1) Current medical records...

  8. Travelers with Disabilities and Medical Conditions

    MedlinePLUS

    ... and other external medical devices to test for explosives using explosives trace detection technology. Individuals with disabilities and medical ... includes a visual/physical inspection as well as explosives trace detection testing of the footwear. Please choose ...

  9. U.S. Military Discharges and Pre-existing Personality Disorders: A Health Policy Review.

    PubMed

    Leroux, Todd C

    2015-11-01

    The Department of Defense (DoD) is facing allegations service members were wrongfully discharged for pre-existing personality disorders. From 2001 to 2007, 26,000 enlisted service members were discharged for a pre-existing personality disorder (2.6 % of total discharges). With national media attention of the issue, personality disorder discharges were reduced by 31 % in 2008 with new discharge procedures issued by the DoD. Even with the reduction, a government review found the DoD did not adhere to its discharge protocols. The objective of this paper is to explore personality disorders in the military, analyze various costs to stakeholders, and identify potential policy alternatives. PMID:25378127

  10. Effect of pre-existing disorder on surface amorphization in GaN

    SciTech Connect

    Azarov, A. Yu.; Titov, A. I.; Kucheyev, S. O.

    2010-08-15

    Single crystal GaN epilayers with pre-existing surface disordered layers are bombarded at room temperature with 40 and 100 keV P ions. Stable lattice defects are studied by Rutherford backscattering/channeling spectrometry. Results show that the rate of planar surface amorphization is independent of the concentration of pre-existing defects near the amorphous/crystalline (a/c) interface. In contrast, the formation of stable defects in the crystal bulk in the vicinity of an a/c interface is influenced by the presence of the interface. These experimental observations suggest that the a/c interface, as compared to stable bulk damage, is a more efficient sink for mobile point defects with respect to both processes of point defect recombination and trapping.

  11. A historical pyroclastic flow emplaced within a pre-existing Pleistocene lava tube: Silidong, Tianchi Volcano, Changbaishan, northeastern China

    NASA Astrophysics Data System (ADS)

    Chen, Zhengquan; Wei, Haiquan; Liu, Yongshun; Tilling, Robert I.; Xu, Jiandong; Wu, Chengzhi; Nie, Baofeng

    2015-06-01

    Pyroclastic flow deposits recently found within a pre-existing lava tube at Tianchi Volcano represent, to the best of our knowledge, the only such reported occurrence worldwide. In this case, pyroclastic flow of Tianchi's "Millennium eruption" (~1 ka) traveled about 18 km from the summit eruptive source and poured successively into the ~560-m-long accessible segment of Silidong lava tube. Mapping of tube morphology, combined with detailed characterization of the features associated with the pumice flow deposits (e.g., adhering of pyroclastic materials on tube walls, fumarole pipes, rootless vents, and flow fronts of the deposit surface) has enabled plausible inferences regarding the original within-tube conditions and dynamic flow regime during emplacement. We propose a model of an aggrading pyroclastic flow which locally varies its sedimentation rate. The pyroclastic deposit is thicker in locations of reduced flow mobility, and the resultant variations in deposit thickness appear to control the distribution of fumarole pipes and rootless vents.

  12. 28 CFR 79.16 - Proof of medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Program to contact the appropriate state cancer or tumor registry. The Program will accept as proof of medical condition verification from the state cancer or tumor registry that it possesses medical records... Cancer Institute can make a diagnosis of leukemia to a reasonable degree of medical certainty: (i)...

  13. 28 CFR 79.16 - Proof of medical condition.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Program to contact the appropriate state cancer or tumor registry. The Program will accept as proof of medical condition verification from the state cancer or tumor registry that it possesses medical records... Cancer Institute can make a diagnosis of leukemia to a reasonable degree of medical certainty: (i)...

  14. 28 CFR 79.16 - Proof of medical condition.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Program to contact the appropriate state cancer or tumor registry. The Program will accept as proof of medical condition verification from the state cancer or tumor registry that it possesses medical records... Cancer Institute can make a diagnosis of leukemia to a reasonable degree of medical certainty: (i)...

  15. 28 CFR 79.16 - Proof of medical condition.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Program to contact the appropriate state cancer or tumor registry. The Program will accept as proof of medical condition verification from the state cancer or tumor registry that it possesses medical records... Cancer Institute can make a diagnosis of leukemia to a reasonable degree of medical certainty: (i)...

  16. 28 CFR 79.16 - Proof of medical condition.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Program to contact the appropriate state cancer or tumor registry. The Program will accept as proof of medical condition verification from the state cancer or tumor registry that it possesses medical records... Cancer Institute can make a diagnosis of leukemia to a reasonable degree of medical certainty: (i)...

  17. Treating child obesity and associated medical conditions.

    PubMed

    Caprio, Sonia

    2006-01-01

    With American children on course to grow into the most obese generation of adults in history, Sonia Caprio argues that it is critical to develop more effective strategies for preventing childhood obesity and treating serious obesity-related health complications. She notes that although pediatricians are concerned about the obesity problem, most are ineffective in addressing it. Treatment should begin, Caprio explains, with a thorough medical exam, an assessment of nutrition and physical activity, an appraisal of the degree of obesity and associated health complications, a family history, and full information about current medications. Caprio also summarizes the current use of medications and surgery in treating child obesity and argues, that for severe forms of obesity, the future lies in developing new and more effective drugs. Caprio explains that today's most effective obesity treatment programs have been carried out in academic centers through an approach that combines a dietary component, behavioral modification, physical activity, and parental involvement. Such programs, however, have yet to be translated to primary pediatric care centers. Successfully treating obesity, she argues, will require a major shift in pediatric care that builds on the findings of these academic centers regarding structured intervention programs. To ensure that pediatricians are well trained in implementing such programs, the American Medical Association is working with federal agencies, medical specialty societies, and public health organizations to teach doctors how to prevent and manage obesity in both children and adults. Such training should be a part of undergraduate and graduate medical education and of continuing medical education programs. Caprio also addresses the problem of reimbursement for obesity treatment. Despite the health risks of obesity, patients get little support from health insurers, thus putting long-term weight-management programs beyond the reach of most. Caprio argues that obesity should be recognized as a disease and receive coverage for its treatment just as other diseases do. PMID:16532665

  18. Numerical modeling of the seismic response of a large pre-existing landslide in the Marmara region

    NASA Astrophysics Data System (ADS)

    Bourdeau, Céline; Lenti, Luca; Martino, Salvatore

    2015-04-01

    Turkey is one of the geologically most active regions of Europe prone to natural hazards in particular earthquakes and landslides. Detailed seismological studies show that a catastrophic event is now expected in the Marmara region along the North Anatolian Fault Zone (NAFZ). On the shores of the Marmara sea, about 30km East of Istanbul and 15km North from the NAFZ, urbanization is fastly growing despite the presence of pre-existing large landslides. Whether such landslides could be reactivated under seismic shaking is a key question. In the framework of the MARsite European project, we selected one of the most critical landslides namely the Büyükçekmece landslide in order to assess its local seismic response. Based on detailed geophysical and geotechnical field investigations, a high-resolution engineering-geological model of the landslide slope was reconstructed. A numerical modeling was carried out on a longitudinal cross section of this landslide with a 2D finite difference code FLAC in order to assess the local seismic response of the slope and to evaluate the consistency of conditions suitable for the earthquake-induced reactivation of the landslide. The obtained ground-motion amplification pattern along the slope surface is very complex and is strongly influenced by properties changes between the pre-existing landslide mass and the surrounding material. Further comparisons of 2D versus 1D ground-motion amplifications on the one hand and 2D versus topographic site effects on the other hand will shed light on the parameters controlling the spatial variations of ground-motion amplifications along the slope surface.

  19. [Development of forensic medical expertise of sexual conditions in men].

    PubMed

    Dmitrieva, O A

    2005-01-01

    The necessity of new methodological approaches in forensic medical examination of sexual male conditions are discussed basing on the analysis of questionnaire surveys of isolated groups of men and forensic medical examinations of male victims accused of sexual crimes. How to update expertise of sexual male conditions including investigations of anorectal and erectile dysfunctions in shown. PMID:16078542

  20. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Standard: Record retention and preservation. In accordance with 45 CFR § 164.530(j)(2), all patient records... 42 Public Health 5 2014-10-01 2014-10-01 false Condition: Medical records. 494.170 Section 494.170... Administration § 494.170 Condition: Medical records. The dialysis facility must maintain complete, accurate,...

  1. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Standard: Record retention and preservation. In accordance with 45 CFR § 164.530(j)(2), all patient records... 42 Public Health 5 2013-10-01 2013-10-01 false Condition: Medical records. 494.170 Section 494.170... Administration § 494.170 Condition: Medical records. The dialysis facility must maintain complete, accurate,...

  2. Ionization-induced annealing of pre-existing defects in silicon carbide

    PubMed Central

    Zhang, Yanwen; Sachan, Ritesh; Pakarinen, Olli H.; Chisholm, Matthew F.; Liu, Peng; Xue, Haizhou; Weber, William J.

    2015-01-01

    A long-standing objective in materials research is to effectively heal fabrication defects or to remove pre-existing or environmentally induced damage in materials. Silicon carbide (SiC) is a fascinating wide-band gap semiconductor for high-temperature, high-power and high-frequency applications. Its high corrosion and radiation resistance makes it a key refractory/structural material with great potential for extremely harsh radiation environments. Here we show that the energy transferred to the electron system of SiC by energetic ions via inelastic ionization can effectively anneal pre-existing defects and restore the structural order. The threshold determined for this recovery process reveals that it can be activated by 750 and 850?keV Si and C self-ions, respectively. The results conveyed here can contribute to SiC-based device fabrication by providing a room-temperature approach to repair atomic lattice structures, and to SiC performance prediction as either a functional material for device applications or a structural material for high-radiation environments. PMID:26264864

  3. Ionization-induced annealing of pre-existing defects in silicon carbide.

    PubMed

    Zhang, Yanwen; Sachan, Ritesh; Pakarinen, Olli H; Chisholm, Matthew F; Liu, Peng; Xue, Haizhou; Weber, William J

    2015-01-01

    A long-standing objective in materials research is to effectively heal fabrication defects or to remove pre-existing or environmentally induced damage in materials. Silicon carbide (SiC) is a fascinating wide-band gap semiconductor for high-temperature, high-power and high-frequency applications. Its high corrosion and radiation resistance makes it a key refractory/structural material with great potential for extremely harsh radiation environments. Here we show that the energy transferred to the electron system of SiC by energetic ions via inelastic ionization can effectively anneal pre-existing defects and restore the structural order. The threshold determined for this recovery process reveals that it can be activated by 750 and 850?keV Si and C self-ions, respectively. The results conveyed here can contribute to SiC-based device fabrication by providing a room-temperature approach to repair atomic lattice structures, and to SiC performance prediction as either a functional material for device applications or a structural material for high-radiation environments. PMID:26264864

  4. Instability of pre-existing resonances in the DC Stark effect vs. stability in the AC Stark effect

    E-print Network

    I. Herbst; J. Rama

    2014-03-29

    For atoms described by a 1-dimensional Friedrichs model we present the following result: pre-existing resonances, when subjected to a small constant electric field (DC Stark effect), are unstable in the weak field limit. In contrast, pre-existing resonances under the influence of a small time-periodic electric field (AC Stark effect) are stable in this limit. This article is a review of our results in "Instability of pre-existing resonances under a small constant electric field", arXiv:1310.4745.

  5. Caring for Kids With Medical Conditions

    MedlinePLUS

    ... becomes dizzy, call the parents immediately. Back Continue Cerebral Palsy Cerebral palsy (CP) is a long-term condition involving brain damage and muscle problems. CP can cause limitations in moving, learning, hearing, seeing, ...

  6. 40 CFR Appendix B to Part 434 - Baseline Determination and Compliance Monitoring for Pre-existing Discharges at Remining Operations

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS COAL MINING POINT... establishing effluent limitations for pre-existing discharges at coal remining operations, in accordance with the requirements set forth in Subpart G; Coal Remining. The requirements specify that...

  7. 42 CFR 418.102 - Condition of participation: Medical director.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Condition of participation: Medical director. 418.102 Section 418.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of participation: Organizational Environment § 418.102 Condition...

  8. Initiation of breakdown in bubbles immersed in liquids: pre-existed charges versus bubble size

    NASA Astrophysics Data System (ADS)

    Babaeva, Natalia Yu; Tereshonok, Dmitry V.; Naidis, George V.

    2015-09-01

    In this paper we report on results from a computational investigation of streamer evolution in bubbles immersed in liquids. We show that avalanche-to-streamer transition and streamer formation in the uniform electric field are determined by the applied external field, the parameter pR (pressure times bubble size), as well as by the location and amount of initial free charges inside the bubble. We found that streamers are not formed in bubbles with a rather small size, unless pre-existed or injected charges are large enough to initiate the breakdown. The present investigation relates the bubble size and the applied field to the minimal possible amount of charge in a bubble.

  9. Bayesian Hierarchical Rule Modeling for Predicting Medical Conditions

    E-print Network

    McCormick, Tyler H.

    2012-01-01

    We propose a statistical modeling technique, called the Hierarchical Association Rule Model (HARM), that predicts a patient’s possible future medical conditions given the patient’s current and past history of reported ...

  10. Severity of pre-existing psychiatric illness and response to the Great East Japan Earthquake.

    PubMed

    Funayama, Michitaka; Mizushima, Jin

    2013-10-01

    Reports have described how psychiatric patients respond to disasters. However, previous reports on the response depending on diagnostic categories have provided no clear consensus. Here we analyzed response to the Great East Japan Earthquake of March 11, 2011, among psychiatric patients in light of severity of pre-existing psychiatric illness. We studied psychiatric change among a population of psychiatric outpatients in Tochigi prefecture, located ~160 km (~100 miles) southeast of the Fukushima nuclear power plant, in an area that suffered moderate damage from the earthquake and radiation. A total of 294 psychiatric outpatients was assessed using the Global Assessment of Functioning (GAF-F). A change of ?10 points in the GAF-F score was counted as a change in symptoms. The data were stratified by disease category, gender, and GAF-F score and analyzed using the Fisher's exact test. In the 2 months after the earthquake, 5.4% of patients showed evidence of a change in symptoms, with 4.1% worsening and 1.4% improving. Compared with patients having a GAF-F score ?50, significantly more patients with a score >50 showed evidence of worsening symptoms. No significant difference was found with respect to gender or diagnostic category for patients with worsened or improved symptoms. Our findings reveal that a relatively small percent of patients with pre-existing psychiatric diseases showed evidence of a change in symptoms and that patients with mild-to-moderate psychiatric illness are potentially vulnerable to the impacts of a natural disaster. PMID:23820110

  11. A Model for Subglacial Flooding Along a Pre-Existing Hydrological Network during the Rapid Drainage of Supraglacial Lakes

    NASA Astrophysics Data System (ADS)

    Adhikari, S.; Tsai, V. C.

    2014-12-01

    Increasingly large numbers of supraglacial lakes form and drain every summer on the Greenland Ice Sheet. Presently, about 15% of the lakes drain rapidly within the timescale of a few hours, and the vertical discharge of water during these events may find a pre-existing subglacial hydrological network, particularly late in the melt season. Here, we present a model for subglacial flooding applied specifically to such circumstances. Given the short timescale of events, we treat ice and bed as purely elastic and assume that the fluid flow in the subglacial conduit is fully turbulent. We evaluate the effect of initial conduit opening, wi, on the rate of flood propagation and along-flow profiles of field variables. We find that floods propagate much faster, particularly in early times, for larger wi. For wi = 10 and 1 cm, for example, floods travel about 68% and 50% farther than in the fully coupled ice/bed scenario after 2 hours of drainage, respectively. Irrespective of the magnitude of wi, we also find that there exists a region of positive pressure gradient. This reversal of pressure gradient draws water in from the farfield and causes the conduit to narrow, respecting mass continuity. While the general shape of the profiles appears similar, greater conduit opening is found for larger wi. For wi = 10 and 1 cm, for example, the elastostatic conduit opening at the point of injection is about 1.39 and 1.26 times that of the fully coupled ice/bed scenario after 2 hours of drainage. The hypothesis of a pre-existing thin film of water is consistent with the spirit of contemporary state-of-the-art continuum models for subglacial hydrology. This also results in avoiding the pressure singularity, which is inherent in classical hydro-fracture models applied to fully coupled ice/bed scenarios, thus opening an avenue for integrating the likes of our model within continuum hydrological models. Furthermore, we foresee that the theory presented can be used to potentially infer subglacial hydrological conditions, particularly wi, given accurate observations of ice surface displacement during drainage events.

  12. Discovery of a pre-existing molecular filament associated with supernova remnant G127.1+0.5

    SciTech Connect

    Zhou, Xin; Yang, Ji; Fang, Min; Su, Yang

    2014-08-20

    We performed millimeter observations in CO lines toward the supernova remnant (SNR) G127.1+0.5. We found a molecular filament at 4-13 km s{sup –1} consisting of two distinct parts: a straight part coming out of the remnant region and a curved part in the remnant region. The curved part is coincides well with the bright SNR shell detected in 1420 MHz radio continuum and mid-infrared observations in the northeastern region. In addition, redshifted line wing broadening is found only in the curved part of the molecular filament, which indicates a physical interaction. These provide strong evidences, for the first time, to confirm the association between an SNR and a pre-existing long molecular filament. Multi-band observations in the northeastern remnant shell could be explained by the interaction between the remnant shock and the dense molecular filament. RADEX radiative transfer modeling of the quiet and shocked components yield physical conditions consistent with the passage of a non-dissociative J-type shock. We argue that the curved part of the filament is fully engulfed by the remnant's forward shock. A spatial correlation between aggregated young stellar objects (YSOs) and the adjacent molecular filament close to the SNR is also found, which could be related to the progenitor's activity.

  13. Interactions between X-ray induced transient defects and pre-existing damage precursors in DKDP crystals

    SciTech Connect

    Negres, R A; Saw, C K; Demos, S G

    2008-10-24

    Large-aperture laser systems, currently designed to achieve high energy densities at the target location (exceeding {approx} 10{sup 11} J/m{sup 3}), will enable studies of the physics of matter and radiation under extreme conditions. As a result, their optical components, such as the frequency conversion crystals (KDP/DKDP), may be exposed to X-rays and other ionizing radiation. This in turn may lead to a change in the damage performance of these materials as they may be affected by radiation-induced effects by either forming new damage initiation centers or interacting with the pre-existing damage initiating defects (so-called damage precursors). We present an experimental study on the laser-induced bulk damage performance at 355-nm of DKDP crystals following X-ray irradiation at room temperature. Results indicate that the damage performance of the material is affected by exposure to X-rays. We attribute this behavior to a change in the physical properties of the precursors which, in turn, affect their individual damage threshold.

  14. 42 CFR 418.102 - Condition of participation: Medical director.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Condition of participation: Medical director. 418.102 Section 418.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  15. Exact solutions for shells collapsing towards a pre-existing black hole

    NASA Astrophysics Data System (ADS)

    Liu, Yuan; Zhang, Shuang Nan

    2009-08-01

    The gravitational collapse of a star is an important issue both for general relativity and astrophysics, which is related to the well-known “frozen star” paradox. This paradox has been discussed intensively and seems to have been solved in the comoving-like coordinates. However, to a real astrophysical observer within a finite time, this problem should be discussed in the point of view of the distant rest-observer, which is the main purpose of this Letter. Following the seminal work of Oppenheimer and Snyder (1939), we present the exact solution for one or two dust shells collapsing towards a pre-existing black hole. We find that the metric of the inner region of the shell is time-dependent and the clock inside the shell becomes slower as the shell collapses towards the pre-existing black hole. This means the inner region of the shell is influenced by the property of the shell, which is contrary to the result in Newtonian theory. It does not contradict the Birkhoff's theorem, since in our case we cannot arbitrarily select the clock inside the shell in order to ensure the continuity of the metric. This result in principle may be tested experimentally if a beam of light travels across the shell, which will take a longer time than without the shell. It can be considered as the generalized Shapiro effect, because this effect is due to the mass outside, but not inside as the case of the standard Shapiro effect. We also found that in real astrophysical settings matter can indeed cross a black hole's horizon according to the clock of an external observer and will not accumulate around the event horizon of a black hole, i.e., no “frozen star” is formed for an external observer as matter falls towards a black hole. Therefore, we predict that only gravitational wave radiation can be produced in the final stage of the merging process of two coalescing black holes. Our results also indicate that for the clock of an external observer, matter, after crossing the event horizon, will never arrive at the “singularity” (i.e. the exact center of the black hole), i.e., for all black holes with finite lifetimes their masses are distributed within their event horizons, rather than concentrated at their centers. We also present a worked-out example of the Hawking's area theorem.

  16. Holistic approach of pre-existing flaws on the decay of two limestones.

    PubMed

    Dewanckele, J; Boone, M A; De Kock, T; De Boever, W; Brabant, L; Boone, M N; Fronteau, G; Dils, J; Van Hoorebeke, L; Jacobs, P; Cnudde, V

    2013-03-01

    This study aims to understand the influence of the microfacies and the determination of pre-existing flaws on the weathering behavior of two types of limestones. Therefore, both Lede and Noyant limestones were independently weathered by strong acid tests and freeze-thaw cycles. In order to characterize the weathering patterns inside the stones, a combination of high resolution X-ray CT, SEM-EDS and thin section microscopy was used. The advantage of high resolution X-ray CT is its non-destructive character and the obtained 3D structural information. By using this technique, a time-lapse sequence of the weathering patterns was obtained for both gypsum crust formation as well as crack formation due to freezing and thawing. This way, a clear link could be made with the initial non-weathered state. Thin section microscopy and SEM-EDS provided additional chemical information. The focus of this study lies in the processes that occur in the bioclast fragments in the stone and the influence of the surrounding cement or matrix. The results show that weathering patterns vary for both limestones although the causes of weathering were similar. In case of the Noyant stone, the weathering by crystallizing gypsum was mainly restricted to the microporous matrix of the stone, while in case of the Lede stone, several foraminifera and shell fragments were preferentially recrystallized. In general, the underlying microstructure determines the weathering pattern of the stone. PMID:23410862

  17. EVIDENCE FOR PRE-EXISTING DUST IN THE BRIGHT TYPE IIn SN 2010jl

    SciTech Connect

    Andrews, J. E.; Clayton, Geoffrey C.; Clem, J.; Landolt, A. E-mail: landolt@phys.lsu.edu E-mail: jclem@phys.lsu.edu

    2011-08-15

    SN 2010jl was an extremely bright, Type IIn supernova (SN) which showed a significant infrared (IR) excess no later than 90 days after explosion. We have obtained Spitzer 3.6 and 4.5 {mu}m and JHK observations of SN 2010jl {approx}90 days post-explosion. Little to no reddening in the host galaxy indicated that the circumstellar material lost from the progenitor must lie in a torus inclined out of the plane of the sky. The likely cause of the high mid-IR flux is the reprocessing of the initial flash of the SN by pre-existing circumstellar dust. Using a three-dimensional Monte Carlo radiative-transfer code, we have estimated that between 0.03 and 0.35 M{sub sun} of dust exists in a circumstellar torus around the SN located 6 x 10{sup 17} cm away from the SN and inclined between 60 deg. and 80 deg. to the plane of the sky. On day 90, we are only seeing the illumination of approximately 5% of this torus, and expect to see an elevated IR flux from this material up until day {approx} 450. It is likely this dust was created in a luminous blue variable (LBV) like mass-loss event of more than 3 M{sub sun}, which is large but consistent with other LBV progenitors such as {eta} Carinae.

  18. The Influence of Pre-existing Deformation on GMA Welding Distortion in Thin Steel Plates

    NASA Astrophysics Data System (ADS)

    Davies, C. M.; Ahn, J.; Tsunori, M.; Dye, D.; Nikbin, K. M.

    2015-01-01

    Weld distortion is particularly problematic for large thin structures that are used in the assembly of ships. The drive toward lighter ships and thinner plate is restricted by the significant increase in distortion as the plate thickness decreases. The influence of pre-existing deformation in the plates to be joined on the resultant distortion in gas metal arc welded structure has been studied. DH-36 steel plate surface profiles were measured before and after the butt welding of two plates 1000 × 500 × 4 mm in size. Three dimensional finite element models that incorporate the initial plate profile have been created to simulate the welding process and to examine the relationship between the final welded plate profiles and the initial deformation present in the plates. Both symmetric and asymmetric models were considered. A significant variation in the unwelded base plates' initial distortion was observed. Generally, it has been found that if an out-of-plane deformation exists in a plate prior to welding, the level of distortion further increases in the same direction following welding. The final distortions are strongly related to the initial plate profiles. The residual stress distributions in the plates are also to some extent affected by the level of distortion initially present.

  19. Psychological distress in an earthquake-devastated area with pre-existing high rate of suicide.

    PubMed

    Tachibana, Akira; Kitamura, Hideaki; Shindo, Masanobu; Honma, Hiroko; Someya, Toshiyuki

    2014-10-30

    On 12 March 2011 an earthquake devastated the Matsunoyama and Matsudai districts of T?kamachi City, Niigata, Japan. These areas had high pre-existing suicide rates, especially among the elderly. We investigated whether mental health status became worse among the sufferers 5 months after the earthquake, and what kind of factors were implicated in any changes. A 15-item questionnaire that tapped earthquake-related variables and the Kessler 10 Psychological Distress Scale to measure psychological distress were distributed to 1923 residents aged over 40 years. The mean age (S.D.) of the total 1731 respondents (male, 805; female, 926) was 68.2 (13.1) years. Of these, we assessed K10 scores from 1346 respondents. The mean scores (S.D.) for K10 and K6 (six selected items from the K10) were 5.8 (6.3) and 3.4 (3.9), respectively. Among the respondents, 9.1% and 3.2% obtained a score of K10 ?15 and K6 ?13, respectively. These scores showed slightly higher psychological distress, especially among the elderly, in comparison with existing community-based data. Categorical regression analysis revealed significant and relatively strong effects of initial psychological impact, decrease in sleep hours, advanced age, and decrease in interpersonal relationships within the community on the K10 score. The last item suggests the importance of socio-environmental factors in post-disaster mental health. PMID:24928758

  20. Flash-ionization of pre-existing circumstellar material around Nova Oph 2015

    NASA Astrophysics Data System (ADS)

    Munari, U.; Walter, F. M.

    2016-01-01

    We have obtained daily high-resolution Echelle spectroscopy of Nova Oph 2015 during its initial evolution. It reveals the presence of pre-existing circumstellar material around the nova, which can be interpreted as the wind of an evolved companion. On earliest observations, the emission line profiles of Nova Oph 2015 displayed a very narrow emission component (full width at half-maximum [FWHM] ˜ 60 km s-1), recombining over a time-scale of 5 days and showing constant low velocity (RV? = -4.5 km s-1), that we interpret as coming from the wind of the secondary recombining after the ionization from the initial UV-flash of the nova. The underlying broad component underwent a marked reduction in both FWHM and width at zero intensity (the latter declining from 4000 to 2000 km s-1 in 10 days) while increasing by six times in flux, that we believe is the result of the high-velocity ejecta of the nova being slowed down while trying to expand within the surrounding wind of the companion. Nova Oph 2015 is possibly unique among novae with evolved companions in having displayed a long rise to maximum brightness and a slow decline from it, an Fe II-type classification, and a probable sub-giant luminosity class for the secondary.

  1. Dendritic spine dynamics in synaptogenesis after repeated LTP inductions: Dependence on pre-existing spine density

    PubMed Central

    Oe, Yuki; Tominaga-Yoshino, Keiko; Hasegawa, Sho; Ogura, Akihiko

    2013-01-01

    Not only from our daily experience but from learning experiments in animals, we know that the establishment of long-lasting memory requires repeated practice. However, cellular backgrounds underlying this repetition-dependent consolidation of memory remain largely unclear. We reported previously using organotypic slice cultures of rodent hippocampus that the repeated inductions of LTP (long-term potentiation) lead to a slowly developing long-lasting synaptic enhancement accompanied by synaptogenesis distinct from LTP itself, and proposed this phenomenon as a model system suitable for the analysis of the repetition-dependent consolidation of memory. Here we examined the dynamics of individual dendritic spines after repeated LTP-inductions and found the existence of two phases in the spines' stochastic behavior that eventually lead to the increase in spine density. This spine dynamics occurred preferentially in the dendritic segments having low pre-existing spine density. Our results may provide clues for understanding the cellular bases underlying the repetition-dependent consolidation of memory. PMID:23739837

  2. Plasticity induced by pre-existing defects during high strain-rate loading

    NASA Astrophysics Data System (ADS)

    Bringa, Eduardo

    2014-03-01

    High strain-rate deformation of metals has been typically studied for perfect monocrystals. Computational advances now allow more realistic simulations of materials including defects, which lower the Hugoniot Elastic Limit, and lead to microstructures differing from the ones from perfect monocrystals. As pre-existing defects one can consider vacancy clusters, dislocation loops, grain boundaries, etc. New analysis tools allow analysis of dislocation densities and twin fractions, for both f.c.c. and b.c.c. metals. Recent results for defective single crystal Ta [Tramontina et al.., High Energy Den. Phys. 10, 9 (2014), and Ruestes et al., Scripta Mat. 68, 818 (2013)], and for polycrystalline b.c.c metals [Tang et al., Mat. Sci. Eng. A 580, 414 (2013), and Gunkelmann et al., Phys. Rev. B 86, 144111 (2012)] will be highlighted, alongside new results for nanocrystalline Cu, Ta, Fe, and Zr [Ruestes et al., Scripta Mat. 71, 9 (2014)]. This work has been carried out in collaboration with D. Tramontina, C. Ruestes, E. Millan, J. Rodriguez-Nieva, M.A. Meyers, Y. Tang, H. Urbassek, N. Gunkelmann, A. Stukowski, M. Ruda, G. Bertolino, D. Farkas, A. Caro, J. Hawreliak, B. Remington, R. Rudd, P. Erhart, R. Ravelo, T. Germann, N. Park, M. Suggit, S. Michalik, A. Higginbotham and J. Wark. Funding by PICT2008-1325 and SeCTyP U.N. Cuyo.

  3. Differentiation of pre-existing trapped methane from thermogenic methane in an igneous-intruded coal by hydrous pyrolysis

    USGS Publications Warehouse

    Dias, Robert F.; Lewan, Michael D.; Birdwell, Justin E.; Kotarba, Maciej J.

    2014-01-01

    So as to better understand how the gas generation potential of coal changes with increasing rank, same-seam samples of bituminous coal from the Illinois Basin that were naturally matured to varying degrees by the intrusion of an igneous dike were subjected to hydrous pyrolysis (HP) conditions of 360 °C for 72 h. The accumulated methane in the reactor headspace was analyzed for ?13C and ?2H, and mol percent composition. Maximum methane production (9.7 mg/g TOC) occurred in the most immature samples (0.5 %Ro), waning to minimal methane values at 2.44 %Ro (0.67 mg/g TOC), and rebounding to 3.6 mg/g TOC methane in the most mature sample (6.76 %Ro). Methane from coal with the highest initial thermal maturity (6.76 %Ro) shows no isotopic dependence on the reactor water and has a microbial ?13C value of ?61‰. However, methane from coal of minimal initial thermal maturity (0.5 %Ro) shows hydrogen isotopic dependence on the reaction water and has a ?13C value of ?37‰. The gas released from coals under hydrous pyrolysis conditions represents a quantifiable mixture of ancient (270 Ma) methane (likely microbial) that was generated in situ and trapped within the rock during the rapid heating by the dike, and modern (laboratory) thermogenic methane that was generated from the indigenous organic matter due to thermal maturation induced by hydrous pyrolysis conditions. These findings provide an analytical framework for better assessment of natural gas sources and for differentiating generated gas from pre-existing trapped gas in coals of various ranks.

  4. Guidelines for Documentation of Medical Disorders This broad category includes substantially limiting, permanent medical conditions that can range

    E-print Network

    Hamburger, Peter

    Guidelines for Documentation of Medical Disorders This broad category includes substantially to broad systemic conditions. Additionally, students with these disorders may be prescribed medications environment. Examples of medical disorders include, but are not limited to: diabetes, Crohn's disease

  5. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Condition: Medical records. The dialysis facility must maintain complete, accurate...including home patients who elect to receive dialysis supplies and equipment from a supplier...provider of ESRD services and all other home dialysis patients whose care is under the...

  6. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Condition: Medical records. The dialysis facility must maintain complete, accurate...including home patients who elect to receive dialysis supplies and equipment from a supplier...provider of ESRD services and all other home dialysis patients whose care is under the...

  7. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Condition: Medical records. The dialysis facility must maintain complete, accurate...including home patients who elect to receive dialysis supplies and equipment from a supplier...provider of ESRD services and all other home dialysis patients whose care is under the...

  8. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Condition: Medical records. The dialysis facility must maintain complete, accurate...including home patients who elect to receive dialysis supplies and equipment from a supplier...provider of ESRD services and all other home dialysis patients whose care is under the...

  9. 42 CFR 494.170 - Condition: Medical records.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Condition: Medical records. The dialysis facility must maintain complete, accurate...including home patients who elect to receive dialysis supplies and equipment from a supplier...provider of ESRD services and all other home dialysis patients whose care is under the...

  10. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and...'s condition, be completed and documented within 24 hours after admission or registration, but prior... examination are completed within 30 days before admission or registration. The updated examination of...

  11. 28 CFR 79.26 - Proof of medical condition.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... required in paragraph (c) of this section. (For claims relating to primary cancer of the liver, the... diagnosis, that authorizes the Program to contact the appropriate state cancer or tumor registry. The Program will accept as proof of medical condition verification from the state cancer or tumor...

  12. Proteasome Inhibition Is Partially Effective in Attenuating Pre-Existing Immunity against Recombinant Adeno-Associated Viral Vectors

    PubMed Central

    Karman, Jozsef; Gumlaw, Nathan K.; Zhang, Jinhua; Jiang, Ji-Lei; Cheng, Seng H.; Zhu, Yunxiang

    2012-01-01

    Pre-existing immunity against adeno-associated virus (AAV) remains a major challenge facing the clinical use of systemic administration of recombinant AAV vectors for the treatment of genetic and acquired diseases using gene therapy. In this study, we evaluated the potential of bortezomib (marketed under trade name Velcade) to abrogate a pre-existing immunity to AAV in mice, thereby allowing subsequent transduction by a recombinant AAV vector of the same serotype. We demonstrate that bortezomib efficiently reduces AAV-specific IgG titres and moderates the cytotoxic T cell response in mice that have a pre-existing immunity to AAV2/8. Significant depletion of AAV2/8-specific IgG-producing plasma cells in secondary lymphoid organs and bone marrow was observed. However, this inhibition of the immune response by bortezomib was insufficient to allow subsequent re-infection with a recombinant AAV vector of a similar serotype. We show that this shortcoming is probably due to the combination of residual antibody levels and the inability of bortezomib to completely deplete the memory B cells that are re-activated in response to a repeated infection with a recombinant AAV vector. Taken together, the results of this study argue for the use of immunosuppressive therapies that target both plasma and memory B cells for the efficient elimination of pre-existing immunity against AAV2/8 vectors. PMID:22514654

  13. DNase I and proteinase K impair Listeria monocytogenes biofilm formation and induce dispersal of pre-existing biofilms

    E-print Network

    Burrows, Lori

    DNase I and proteinase K impair Listeria monocytogenes biofilm formation and induce dispersal of pre-existing biofilms Uyen T. Nguyen, Lori L. Burrows Department of Biochemistry and Biomedical monocytogenes Biofilm Inhibition Dispersal Protease DNase Current sanitation methods in the food industry

  14. Fitness Conferred by BCR-ABL Kinase Domain Mutations Determines the Risk of Pre-Existing Resistance in Chronic

    E-print Network

    a mutant oncoprotein (BCR-ABL). Despite its successes, acquired resistance to imatinib leads to reducedFitness Conferred by BCR-ABL Kinase Domain Mutations Determines the Risk of Pre-Existing Resistance) is the first human malignancy to be successfully treated with a small molecule inhibitor, imatinib, targeting

  15. 40 CFR Appendix B to Part 434 - Baseline Determination and Compliance Monitoring for Pre-existing Discharges at Remining Operations

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS COAL MINING POINT... loadings of total iron, total manganese, total suspended solids, and net acidity in pre-existing discharges shall not exceed baseline pollutant loadings. The procedures described in this appendix shall be...

  16. 42 CFR 484.34 - Condition of participation: Medical social services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Condition of participation: Medical social services. 484...Condition of participation: Medical social services. If the agency furnishes medical social services, those...a qualified social work assistant under the supervision...

  17. 42 CFR 484.34 - Condition of participation: Medical social services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Condition of participation: Medical social services. 484...Condition of participation: Medical social services. If the agency furnishes medical social services, those...a qualified social work assistant under the supervision...

  18. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Conditions for payment: Medically directed anesthesia services. 415.110 Section 415...Conditions for payment: Medically directed anesthesia services. (a) General payment rule...the physician's medical direction of anesthesia services for one service or two...

  19. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Conditions for payment: Medically directed anesthesia services. 415.110 Section 415...Conditions for payment: Medically directed anesthesia services. (a) General payment rule...the physician's medical direction of anesthesia services for one service or two...

  20. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Conditions for payment: Medically directed anesthesia services. 415.110 Section 415...Conditions for payment: Medically directed anesthesia services. (a) General payment rule...the physician's medical direction of anesthesia services for one service or two...

  1. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Conditions for payment: Medically directed anesthesia services. 415.110 Section 415...Conditions for payment: Medically directed anesthesia services. (a) General payment rule...the physician's medical direction of anesthesia services for one service or two...

  2. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Conditions for payment: Medically directed anesthesia services. 415.110 Section 415...Conditions for payment: Medically directed anesthesia services. (a) General payment rule...the physician's medical direction of anesthesia services for one service or two...

  3. The Prescribed Pediatric Center: A Medical Day Treatment Program for Children with Complex Medical Conditions.

    ERIC Educational Resources Information Center

    Ruppert, Elizabeth S.; Karst, Thomas O.; Brogan, Mark G.

    1998-01-01

    The Prescribed Pediatric Center (Toledo, Ohio) is a community-based, multidisciplinary program for infants and children with chronic, complex medical conditions. This article describes program beginnings; the planning process; and the program's growth, development, and components. Initial program evaluation indicates positive effects on some…

  4. Avoiding the requirement for pre-existing optical contact during picosecond laser glass-to-glass welding.

    PubMed

    Chen, Jianyong; Carter, Richard M; Thomson, Robert R; Hand, Duncan P

    2015-07-13

    Previous reports of ultrafast laser welding of glass-to-glass have indicated that a pre-existing optical contact (or very close to) between the parts to be joined is essential. In this paper, the capability of picosecond laser welding to bridge micron-scale gaps is investigated, and successful welding, without cracking, of two glasses with a pre-existing gap of 3 µm is demonstrated. It is shown that the maximum gap that can be welded is not significantly affected by welding speeds, but is strongly dependent on the laser power and focal position relative to the interface between the materials. Five distinct types of material modification were observed over a range of different powers and surface separations, and a mechanism is proposed to explain the observations. PMID:26191923

  5. The experience of altered states of consciousness in shamanic ritual: the role of pre-existing beliefs and affective factors.

    PubMed

    Polito, Vince; Langdon, Robyn; Brown, Jac

    2010-12-01

    Much attention has been paid recently to the role of anomalous experiences in the aetiology of certain types of psychopathology, e.g. in the formation of delusions. We examine, instead, the top-down influence of pre-existing beliefs and affective factors in shaping an individual's characterisation of anomalous sensory experiences. Specifically we investigated the effects of paranormal beliefs and alexithymia in determining the intensity and quality of an altered state of consciousness (ASC). Fifty five participants took part in a sweat lodge ceremony, a traditional shamanic ritual which was unfamiliar to them. Participants reported significant alterations in their state of consciousness, quantified using the 'APZ' questionnaire, a standardized measure of ASC experience. Participants endorsing paranormal beliefs compatible with shamanic mythology, and those showing difficulty identifying feelings scored higher on positive dimensions of ASC experience. Our findings demonstrate that variation in an individual's characterisation of anomalous experiences is nuanced by pre-existing beliefs and affective factors. PMID:20558090

  6. Impact of Acute Malaria on Pre-Existing Antibodies to Viral and Vaccine Antigens in Mice and Humans

    PubMed Central

    Banga, Simran; Coursen, Jill D.; Portugal, Silvia; Tran, Tuan M.; Hancox, Lisa; Ongoiba, Aissata; Traore, Boubacar; Doumbo, Ogobara K.; Huang, Chiung-Yu; Harty, John T.; Crompton, Peter D.

    2015-01-01

    Vaccine-induced immunity depends on long-lived plasma cells (LLPCs) that maintain antibody levels. A recent mouse study showed that Plasmodium chaubaudi infection reduced pre-existing influenza-specific antibodies—raising concerns that malaria may compromise pre-existing vaccine responses. We extended these findings to P. yoelii infection, observing decreases in antibodies to model antigens in inbred mice and to influenza in outbred mice, associated with LLPC depletion and increased susceptibility to influenza rechallenge. We investigated the implications of these findings in Malian children by measuring vaccine-specific IgG (tetanus, measles, hepatitis B) before and after the malaria-free 6-month dry season, 10 days after the first malaria episode of the malaria season, and after the subsequent dry season. On average, vaccine-specific IgG did not decrease following acute malaria. However, in some children malaria was associated with an accelerated decline in vaccine-specific IgG, underscoring the need to further investigate the impact of malaria on pre-existing vaccine-specific antibodies. PMID:25919588

  7. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2 2010-10-01 2010-10-01 false Medical and other health services: Basic conditions...HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.12...

  8. 42 CFR 410.38 - Durable medical equipment: Scope and conditions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Durable medical equipment: Scope and conditions... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.38 Durable medical equipment: Scope and conditions. (a) Medicare Part B pays for the...

  9. 42 CFR 410.38 - Durable medical equipment: Scope and conditions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Durable medical equipment: Scope and conditions... HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.38 Durable medical equipment: Scope and conditions. (a) Medicare Part B pays for the...

  10. Framework for preventing accidental falls in hospitals - management plan for ADL, medication and medical conditions.

    PubMed

    Kato, Shogo; Tsuru, Satoko; Iizuka, Yoshinori

    2009-01-01

    Prevention and reduction of medical accidents is essential. Among medical accidents, accidental falls remain a serious problem. While "assessment score sheets" have already been used in hospitals to prevent accidental falls, satisfactory results have not actually been achieved. In this study, we aim to establish a methodology for preventing accidental falls. We consider that the 'management plan' for each patient includes three factors. A plan of instructions for patients on actions they can take for safety in their ADL (Activities of Daily Living) is essential as a base. Second, a plan to keep up with any short term change in a patient's state is needed, because the state of a hospitalized patient will usually be temporarily affected by medication and changing medical conditions. We develop a model for preventing accidental falls, which enable us to design appropriate management plan for each patient. Then, we develop a prototype system based on the designed model. Finally, we address the result of verification of the model, by applying the prototype system into actual cases in hospitals. PMID:19592884

  11. Pre-existing differences in motivation for food and sensitivity to cocaine-induced locomotion in obesity-prone rats.

    PubMed

    Vollbrecht, Peter J; Nobile, Cameron W; Chadderdon, Aaron M; Jutkiewicz, Emily M; Ferrario, Carrie R

    2015-12-01

    Obesity is a significant problem in the United States, with roughly one third of adults having a body mass index (BMI) over thirty. Recent evidence from human studies suggests that pre-existing differences in the function of mesolimbic circuits that mediate motivational processes may promote obesity and hamper weight loss. However, few preclinical studies have examined pre-existing neurobehavioral differences related to the function of mesolimbic systems in models of individual susceptibility to obesity. Here, we used selectively bred obesity-prone and obesity-resistant rats to examine 1) the effect of a novel "junk-food" diet on the development of obesity and metabolic dysfunction, 2) over-consumption of "junk-food" in a free access procedure, 3) motivation for food using instrumental procedures, and 4) cocaine-induced locomotor activity as an index of general mesolimbic function. As expected, eating a sugary, fatty, "junk-food" diet exacerbated weight gain and increased fasted insulin levels only in obesity-prone rats. In addition, obesity-prone rats continued to over-consume junk-food during discrete access testing, even when this same food was freely available in the home cage. Furthermore, when asked to press a lever to obtain food in an instrumental task, rates of responding were enhanced in obesity-prone versus obesity-resistant rats. Finally, obesity-prone rats showed a stronger locomotor response to 15mg/kg cocaine compared to obesity-resistant rats prior to any diet manipulation. This enhanced sensitivity to this dose of cocaine is indicative of basal differences in the function of mesolimbic circuits in obesity-prone rats. We speculate that pre-existing differences in motivational systems may contribute to over-consumption and enhanced motivation in susceptible individuals. PMID:26423787

  12. 42 CFR 418.106 - Condition of participation: Drugs and biologicals, medical supplies, and durable medical equipment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Condition of participation: Drugs and biologicals, medical supplies, and durable medical equipment. 418.106 Section 418.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HOSPICE CARE Conditions of...

  13. Roots of Mold Problems and Humidity Control Measures in Institutional Buildings with Pre-Existing Mold Condition 

    E-print Network

    Chen, H.; Deng, S.; Bruner, H.; Garcia, J.

    2004-01-01

    Humidity control and mold in buildings has become an increasingly important problem. Once a building has experience mold growth on walls, ceilings, and other surfaces, it does not take longterm exposure to moisture for mold to re...

  14. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...and CHIP. The Exchange and the Exchange appeals entity must...CHIP made by the State Medicaid or CHIP...Standards for sharing information between the Exchange and the agencies...are no lapses in health coverage....

  15. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...and CHIP. The Exchange and the Exchange appeals entity must...CHIP made by the State Medicaid or CHIP...Standards for sharing information between the Exchange and the agencies...are no lapses in health coverage....

  16. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...AFFORDABLE CARE ACT Exchange Functions in the...Determinations for Exchange Participation and...CHIP, the Basic Health Program, and the...Agreements. The Exchange must enter into...Medicaid based on other information or through other...of applicant and State Medicaid...

  17. Indium-111-labeled white blood cells in the detection of osteomyelitis complicated by a pre-existing condition

    SciTech Connect

    McCarthy, K.; Velchik, M.G.; Alavi, A.; Mandell, G.A.; Esterhai, J.L.; Goll, S.

    1988-06-01

    Forty-six patients (23M, 23F) ranging in age from 19 to 79 yr with a clinical history of a nonunion fracture, surgery, diabetes or a soft-tissue infection were studied with (/sup 111/In)oxine WBCs to detect osteomyelitis. There were 27 true-positive, nine true-negative, two false-positive and one false-negative. The false-positives and the false-negative occurred in patients with soft-tissue infections overlying the area of interest. All diagnoses were confirmed by intraoperative bone biopsies and cultures. Bone biopsy and scan were performed within 2 days of each other in 39 patients. The overall sensitivity was 97% (27/28), specificity, 82% (9/11) and the diagnostic accuracy, 92% (36/39). The remaining seven patients had negative (/sup 111/In)WBC scans several months after positive bone biopsies and definite antibiotic treatment. This suggests that (In)WBC scans become negative after appropriate therapy is undertaken. Interobserver data was obtained from four nuclear physicians of varying experience blinded to clinical information. A high degree of agreement was found in over 90% of the cases. This study demonstrates the utility of (/sup 111/In)WBC scans in the diagnosis and follow-up of complicated osteomyelitis and a high level of interobserver agreement in scan interpretation.

  18. Medical Signal-Conditioning and Data-Interface System

    NASA Technical Reports Server (NTRS)

    Braun, Jeffrey; Jacobus, charles; Booth, Scott; Suarez, Michael; Smith, Derek; Hartnagle, Jeffrey; LePrell, Glenn

    2006-01-01

    A general-purpose portable, wearable electronic signal-conditioning and data-interface system is being developed for medical applications. The system can acquire multiple physiological signals (e.g., electrocardiographic, electroencephalographic, and electromyographic signals) from sensors on the wearer s body, digitize those signals that are received in analog form, preprocess the resulting data, and transmit the data to one or more remote location(s) via a radiocommunication link and/or the Internet. The system includes a computer running data-object-oriented software that can be programmed to configure the system to accept almost any analog or digital input signals from medical devices. The computing hardware and software implement a general-purpose data-routing-and-encapsulation architecture that supports tagging of input data and routing the data in a standardized way through the Internet and other modern packet-switching networks to one or more computer(s) for review by physicians. The architecture supports multiple-site buffering of data for redundancy and reliability, and supports both real-time and slower-than-real-time collection, routing, and viewing of signal data. Routing and viewing stations support insertion of automated analysis routines to aid in encoding, analysis, viewing, and diagnosis.

  19. Dioxins from medical waste incineration: Normal operation and transient conditions.

    PubMed

    Chen, Tong; Zhan, Ming-xiu; Yan, Mi; Fu, Jian-ying; Lu, Sheng-yong; Li, Xiao-dong; Yan, Jian-hua; Buekens, Alfons

    2015-07-01

    Polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) are key pollutants in waste incineration. At present, incinerator managers and official supervisors focus only on emissions evolving during steady-state operation. Yet, these emissions may considerably be raised during periods of poor combustion, plant shutdown, and especially when starting-up from cold. Until now there were no data on transient emissions from medical (or hospital) waste incineration (MWI). However, MWI is reputed to engender higher emissions than those from municipal solid waste incineration (MSWI). The emission levels in this study recorded for shutdown and start-up, however, were significantly higher: 483 ± 184 ng Nm(-3) (1.47 ± 0.17 ng I-TEQ Nm(-3)) for shutdown and 735 ng Nm(-3) (7.73 ng I-TEQ Nm(-3)) for start-up conditions, respectively. Thus, the average (I-TEQ) concentration during shutdown is 2.6 (3.8) times higher than the average concentration during normal operation, and the average (I-TEQ) concentration during start-up is 4.0 (almost 20) times higher. So monitoring should cover the entire incineration cycle, including start-up, operation and shutdown, rather than optimised operation only. This suggestion is important for medical waste incinerators, as these facilities frequently start up and shut down, because of their small size, or of lacking waste supply. Forthcoming operation should shift towards much longer operating cycles, i.e., a single weekly start-up and shutdown. PMID:26159561

  20. Investigation on the Automatic Geo-Referencing of Archaeological UAV Photographs by Correlation with Pre-Existing Ortho-Photos

    NASA Astrophysics Data System (ADS)

    Karel, W.; Doneus, M.; Briese, C.; Verhoeven, G.; Pfeifer, N.

    2014-06-01

    We present a method for the automatic geo-referencing of archaeological photographs captured aboard unmanned aerial vehicles (UAVs), termed UPs. We do so by help of pre-existing ortho-photo maps (OPMs) and digital surface models (DSMs). Typically, these pre-existing data sets are based on data that were captured at a widely different point in time. This renders the detection (and hence the matching) of homologous feature points in the UPs and OPMs infeasible mainly due to temporal variations of vegetation and illumination. Facing this difficulty, we opt for the normalized cross correlation coefficient of perspectively transformed image patches as the measure of image similarity. Applying a threshold to this measure, we detect candidates for homologous image points, resulting in a distinctive, but computationally intensive method. In order to lower computation times, we reduce the dimensionality and extents of the search space by making use of a priori knowledge of the data sets. By assigning terrain heights interpolated in the DSM to the image points found in the OPM, we generate control points. We introduce respective observations into a bundle block, from which gross errors i.e. false matches are eliminated during its robust adjustment. A test of our approach on a UAV image data set demonstrates its potential and raises hope to successfully process large image archives.

  1. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... medical record requirements for psychiatric hospitals. The medical records maintained by a psychiatric.... Medical records must stress the psychiatric components of the record, including history of findings and... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Special medical...

  2. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... medical record requirements for psychiatric hospitals. The medical records maintained by a psychiatric.... Medical records must stress the psychiatric components of the record, including history of findings and... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Special medical...

  3. 41 CFR 105-64.208 - What special conditions apply to release of medical records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... apply to release of medical records? 105-64.208 Section 105-64.208 Public Contracts and Property....208 What special conditions apply to release of medical records? Medical records containing... writing by you, or by your guardian or conservator. Medical records in an Official Personnel Folder...

  4. 41 CFR 105-64.208 - What special conditions apply to release of medical records?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... apply to release of medical records? 105-64.208 Section 105-64.208 Public Contracts and Property....208 What special conditions apply to release of medical records? Medical records containing... writing by you, or by your guardian or conservator. Medical records in an Official Personnel Folder...

  5. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... medical record requirements for psychiatric hospitals. The medical records maintained by a psychiatric.... Medical records must stress the psychiatric components of the record, including history of findings and... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Special medical...

  6. 41 CFR 105-64.208 - What special conditions apply to release of medical records?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... apply to release of medical records? 105-64.208 Section 105-64.208 Public Contracts and Property....208 What special conditions apply to release of medical records? Medical records containing... writing by you, or by your guardian or conservator. Medical records in an Official Personnel Folder...

  7. 41 CFR 105-64.208 - What special conditions apply to release of medical records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... apply to release of medical records? 105-64.208 Section 105-64.208 Public Contracts and Property....208 What special conditions apply to release of medical records? Medical records containing... writing by you, or by your guardian or conservator. Medical records in an Official Personnel Folder...

  8. 41 CFR 105-64.208 - What special conditions apply to release of medical records?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... apply to release of medical records? 105-64.208 Section 105-64.208 Public Contracts and Property....208 What special conditions apply to release of medical records? Medical records containing... writing by you, or by your guardian or conservator. Medical records in an Official Personnel Folder...

  9. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Special medical record... medical record requirements for psychiatric hospitals. The medical records maintained by a psychiatric.... Medical records must stress the psychiatric components of the record, including history of findings...

  10. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Special medical record... medical record requirements for psychiatric hospitals. The medical records maintained by a psychiatric.... Medical records must stress the psychiatric components of the record, including history of findings...

  11. 42 CFR 416.47 - Condition for coverage-Medical records.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Condition for coverage-Medical records. 416.47... Coverage § 416.47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient care. (a) Standard: Organization. The ASC...

  12. 42 CFR 416.47 - Condition for coverage-Medical records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Condition for coverage-Medical records. 416.47... Coverage § 416.47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient care. (a) Standard: Organization. The ASC...

  13. 42 CFR 416.47 - Condition for coverage-Medical records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Condition for coverage-Medical records. 416.47... Coverage § 416.47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient care. (a) Standard: Organization. The ASC...

  14. 42 CFR 484.34 - Condition of participation: Medical social services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Medical social services....34 Condition of participation: Medical social services. If the agency furnishes medical social services, those services are given by a qualified social worker or by a qualified social work...

  15. 42 CFR 484.34 - Condition of participation: Medical social services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Medical social services....34 Condition of participation: Medical social services. If the agency furnishes medical social services, those services are given by a qualified social worker or by a qualified social work...

  16. 42 CFR 484.34 - Condition of participation: Medical social services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Medical social services....34 Condition of participation: Medical social services. If the agency furnishes medical social services, those services are given by a qualified social worker or by a qualified social work...

  17. 42 CFR 484.34 - Condition of participation: Medical social services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Medical social services....34 Condition of participation: Medical social services. If the agency furnishes medical social services, those services are given by a qualified social worker or by a qualified social work...

  18. 42 CFR 484.34 - Condition of participation: Medical social services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Medical social services....34 Condition of participation: Medical social services. If the agency furnishes medical social services, those services are given by a qualified social worker or by a qualified social work...

  19. 42 CFR 416.47 - Condition for coverage-Medical records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Medical records. 416.47....47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient care. (a) Standard: Organization. The ASC must...

  20. 42 CFR 416.47 - Condition for coverage-Medical records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Condition for coverage-Medical records. 416.47....47 Condition for coverage—Medical records. The ASC must maintain complete, comprehensive, and accurate medical records to ensure adequate patient care. (a) Standard: Organization. The ASC must...

  1. 14 CFR 67.313 - General medical condition.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...standards for a third-class airman medical certificate are: (a) No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or...

  2. 14 CFR 67.113 - General medical condition.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...standards for a first-class airman medical certificate are: (a) No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or...

  3. 14 CFR 67.113 - General medical condition.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...standards for a first-class airman medical certificate are: (a) No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or...

  4. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and physical examination must...registration, but prior to surgery or a procedure requiring anesthesia services, when the medical history and physical...

  5. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and physical examination must...registration, but prior to surgery or a procedure requiring anesthesia services, when the medical history and physical...

  6. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and physical examination must...registration, but prior to surgery or a procedure requiring anesthesia services, when the medical history and physical...

  7. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...registration, but prior to surgery or a procedure requiring anesthesia services. The medical history and physical examination must...registration, but prior to surgery or a procedure requiring anesthesia services, when the medical history and physical...

  8. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...END-STAGE RENAL DISEASE FACILITIES Administration § 494.150 Condition: Responsibilities of the medical director. The dialysis facility must have a medical director who meets the qualifications of § 494.140(a) to be responsible for the...

  9. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...END-STAGE RENAL DISEASE FACILITIES Administration § 494.150 Condition: Responsibilities of the medical director. The dialysis facility must have a medical director who meets the qualifications of § 494.140(a) to be responsible for the...

  10. The Association between Pre-existing Diabetes Mellitus and Pressure Ulcers in Patients Following Surgery: A Meta-analysis

    PubMed Central

    Kang, Zhou-Qing; Zhai, Xiao-Jie

    2015-01-01

    Uncertainty exists about the role of diabetes in the development of surgery-related pressure ulcers. Therefore, we conducted a meta-analysis to explore the association between pre-existing diabetes mellitus and pressure ulcers among patients after surgery. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random effects models. Thirteen eligible studies of 2367 patients in total and 12053 controls were included in the final analysis. Compared with patients without diabetes, the pooled odds ratio (OR) of the incidence of pressure ulcers in diabetic patients was 1.74 [95% confidence interval (CI)?=?1.40–2.15, I2?=?51.1%]. Estimates by type of surgery suggested similar results in cardiac surgery [OR?=?2.00, 95% CI?=?1.42–2.82, I2?=?0%], in general surgery [OR?=?1.75, 95% CI?=?1.42–2.15, I2?=?0%], and in major lower limb amputations [OR?=?1.65, 95% CI?=?1.01–2.68, I2?=?0%] for diabetic patients versus non-diabetic controls. We did not find an increased incidence of pressure ulcers in diabetic patients undergoing hip surgery compared with non-diabetic controls [OR?=?1.46, 95% CI?=?0.62–3.47, I2?=?93.1%]. The excess risk of pressure ulcers associated with pre-existing diabetes was significantly higher in patients undergoing surgery, specifically in patients receiving cardiac surgery. Further studies should be conducted to examine these associations in other types of surgery. PMID:26260124

  11. The effects of aerobic- versus strength-training on body image among young women with pre-existing body image concerns.

    PubMed

    Martin Ginis, Kathleen A; Strong, Heather A; Arent, Shawn M; Bray, Steven R; Bassett-Gunter, Rebecca L

    2014-06-01

    This experiment compared the effects of aerobic-training (AT) versus strength-training (ST) on body image among young women with pre-existing body image concerns. Theory-based correlates of body image change were also examined. Participants were 46 women (M age=21.5 years), randomly assigned to an 8-week AT or ST intervention consisting of supervised exercise 3 days/week. Multidimensional measures of body image were administered pre- and post-intervention, along with measures of physical fitness, perceived fitness, and exercise self-efficacy. Women in the AT condition reported greater reductions in social physique anxiety (p=.001) and tended to report greater improvements in appearance evaluation (p=.06) than women in the ST condition. Changes in perceived fatness, perceived aerobic endurance and aerobic self-efficacy were significantly correlated with body image change (ps<.003). Results provide direction for prescribing exercise to improve body image and advancing theory to account for the effects of exercise. PMID:24958656

  12. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... requiring anesthesia services. The medical history and physical examination must be completed and documented... 24 hours after admission or registration, but prior to surgery or a procedure requiring...

  13. Secondary organic aerosol formation from alpha-pinene and toluene: Laboratory studies examining the role of pre-existing particles, relative humidity and oxidant type

    NASA Astrophysics Data System (ADS)

    Cui, Tianqu

    Secondary organic aerosol (SOA) is a major fraction of fine particulate matter (PM2.5), thus impacting air quality and climate. In the first section of this thesis, experiments were performed to investigate SOA formation from both ozonolysis and hydroxyl radical (OH)-initiated oxidation (so-called photooxidation) of alpha-pinene under conditions with varying relative humidity (RH) and seed aerosol acidity at the UNC dual outdoor smog chamber facility. Formation of dimer esters was observed only in SOA derived from alpha-pinene ozonolysis with increased concentrations at high RH, indicating these compounds could serve as tracers for SOA enhanced by anthropogenic pollution. In the second section of this thesis, toluene photooxidation experiments in presence of nitric oxide were conducted to examine the effect of the pre-existing titanium dioxide (TiO2) seed aerosol, as an instance of engineered metal oxide nanomaterials, considering their unique photocatalytic properties. Results indicate that TiO2 aerosol enhanced and accelerated SOA formation from toluene.

  14. The role of pre-existing tectonic structures and magma chamber shape on the geometry of resurgent blocks: Analogue models

    NASA Astrophysics Data System (ADS)

    Marotta, Enrica; de Vita, Sandro

    2014-02-01

    A set of analogue models has been carried out to understand the role of an asymmetric magma chamber on the resurgence-related deformation of a previously deformed crustal sector. The results are then compared with those of similar experiments, previously performed using a symmetric magma chamber. Two lines of experiments were performed to simulate resurgence in an area with a simple graben-like structure and resurgence in a caldera that collapsed within the previously generated graben-like structure. On the basis of commonly accepted scaling laws, we used dry-quartz sand to simulate the brittle behaviour of the crust and Newtonian silicone to simulate the ductile behaviour of the intruding magma. An asymmetric shape of the magma chamber was simulated by moulding the upper surface of the silicone. The resulting empty space was then filled with sand. The results of the asymmetric-resurgence experiments are similar to those obtained with symmetrically shaped silicone. In the sample with a simple graben-like structure, resurgence occurs through the formation of a discrete number of differentially displaced blocks. The most uplifted portion of the deformed depression floor is affected by newly formed, high-angle, inward-dipping reverse ring-faults. The least uplifted portion of the caldera is affected by normal faults with similar orientation, either newly formed or resulting from reactivation of the pre-existing graben faults. This asymmetric block resurgence is also observed in experiments performed with a previous caldera collapse. In this case, the caldera-collapse-related reverse ring-fault is completely erased along the shortened side, and enhances the effect of the extensional faults on the opposite side, so facilitating the intrusion of the silicone. The most uplifted sector, due to an asymmetrically shaped intrusion, is always in correspondence of the thickest overburden. These results suggest that the stress field induced by resurgence is likely dictated by the geometry of the intruding magma body, and the related deformation is partially controlled by pre-existing tectonic and/or volcano-tectonic structures.

  15. 42 CFR 410.38 - Durable medical equipment: Scope and conditions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...rental or purchase of durable medical equipment, including iron...means a covered item of durable medical equipment that is in a...practitioner means a physician assistant, nurse practitioner, or...beneficiary for his or her medical condition and determining...

  16. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...State in which the hospital is located, a doctor of dental surgery or dental medicine. (c) Standard: Medical staff bylaws...hours after admission or registration, but prior to surgery or a procedure requiring anesthesia...

  17. The effect of pre-existing affect on the sexual responses of women with and without a history of childhood sexual abuse.

    PubMed

    Rellini, Alessandra H; Elinson, Samantha; Janssen, Erick; Meston, Cindy M

    2012-04-01

    Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives. Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on genital responses, subjective sexual arousal, and affect elicited during the presentation of erotic film excerpts in a community sample of 25 women with and 25 women without a history of CSA. The CSA group showed greater pre-existing negative affect and smaller genital responses to the erotic film stimuli compared to the NSA group. Findings support a moderating effect of CSA, in that pre-existing negative affect was associated with strength of genital responses in the NSA but not in the CSA group. The results did not support a mediation model of pre-existing negative affect as an explanation for smaller physiological sexual responses in the CSA group. Taken together, the findings suggest that pre-existing affect may be more relevant for women with no history of CSA and call for more research on factors implicated in impaired sexual responses in women with a history of CSA. PMID:21667233

  18. Combinatorial RNA Interference Therapy Prevents Selection of Pre-existing HBV Variants in Human Liver Chimeric Mice

    PubMed Central

    Shih, Yao-Ming; Sun, Cheng-Pu; Chou, Hui-Hsien; Wu, Tzu-Hui; Chen, Chun-Chi; Wu, Ping-Yi; Enya Chen, Yu-Chen; Bissig, Karl-Dimiter; Tao, Mi-Hua

    2015-01-01

    Selection of escape mutants with mutations within the target sequence could abolish the antiviral RNA interference activity. Here, we investigated the impact of a pre-existing shRNA-resistant HBV variant on the efficacy of shRNA therapy. We previously identified a highly potent shRNA, S1, which, when delivered by an adeno-associated viral vector, effectively inhibits HBV replication in HBV transgenic mice. We applied the “PICKY” software to systemically screen the HBV genome, then used hydrodynamic transfection and HBV transgenic mice to identify additional six highly potent shRNAs. Human liver chimeric mice were infected with a mixture of wild-type and T472C HBV, a S1-resistant HBV variant, and then treated with a single or combined shRNAs. The presence of T472C mutant compromised the therapeutic efficacy of S1 and resulted in replacement of serum wild-type HBV by T472C HBV. In contrast, combinatorial therapy using S1 and P28, one of six potent shRNAs, markedly reduced titers for both wild-type and T472C HBV. Interestingly, treatment with P28 alone led to the emergence of escape mutants with mutations in the P28 target region. Our results demonstrate that combinatorial RNAi therapy can minimize the escape of resistant viral mutants in chronic HBV patients. PMID:26482836

  19. A critical shock mach number for particle acceleration in the absence of pre-existing cosmic rays: M=?5

    SciTech Connect

    Vink, Jacco

    2014-01-10

    It is shown that, under some generic assumptions, shocks cannot accelerate particles unless the overall shock Mach number exceeds a critical value M>?5. The reason is that for M??5 the work done to compress the flow in a particle precursor requires more enthalpy flux than the system can sustain. This lower limit applies to situations without significant magnetic field pressure. In case that the magnetic field pressure dominates the pressure in the unshocked medium, i.e., for low plasma beta, the resistivity of the magnetic field makes it even more difficult to fulfill the energetic requirements for the formation of shock with an accelerated particle precursor and associated compression of the upstream plasma. We illustrate the effects of magnetic fields for the extreme situation of a purely perpendicular magnetic field configuration with plasma beta ? = 0, which gives a minimum Mach number of M = 5/2. The situation becomes more complex, if we incorporate the effects of pre-existing cosmic rays, indicating that the additional degree of freedom allows for less strict Mach number limits on acceleration. We discuss the implications of this result for low Mach number shock acceleration as found in solar system shocks, and shocks in clusters of galaxies.

  20. The Role of Pre-Existing Disturbances in the Effect of Marine Reserves on Coastal Ecosystems: A Modelling Approach

    PubMed Central

    Savina, Marie; Condie, Scott A.; Fulton, Elizabeth A.

    2013-01-01

    We have used an end-to-end ecosystem model to explore responses over 30 years to coastal no-take reserves covering up to 6% of the fifty thousand square kilometres of continental shelf and slope off the coast of New South Wales (Australia). The model is based on the Atlantis framework, which includes a deterministic, spatially resolved three-dimensional biophysical model that tracks nutrient flows through key biological groups, as well as extraction by a range of fisheries. The model results support previous empirical studies in finding clear benefits of reserves to top predators such as sharks and rays throughout the region, while also showing how many of their major prey groups (including commercial species) experienced significant declines. It was found that the net impact of marine reserves was dependent on the pre-existing levels of disturbance (i.e. fishing pressure), and to a lesser extent on the size of the marine reserves. The high fishing scenario resulted in a strongly perturbed system, where the introduction of marine reserves had clear and mostly direct effects on biomass and functional biodiversity. However, under the lower fishing pressure scenario, the introduction of marine reserves caused both direct positive effects, mainly on shark groups, and indirect negative effects through trophic cascades. Our study illustrates the need to carefully align the design and implementation of marine reserves with policy and management objectives. Trade-offs may exist not only between fisheries and conservation objectives, but also among conservation objectives. PMID:23593432

  1. Automatic Detection Of Vaccine Adverse Reactions By Incorporating Historical Medical Conditions

    E-print Network

    Karypis, George

    Automatic Detection Of Vaccine Adverse Reactions By Incorporating Historical Medical Conditions This paper extends the state of art by bringing the historical medical conditions into the vaccine adverse with certain vaccines. We propose a novel measure called dual-lift for this task. It is shown that the dual

  2. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... limitations. (a) Basic conditions. The medical and other health services specified in § 410.10 are covered by... 42 Public Health 2 2010-10-01 2010-10-01 false Medical and other health services: Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID...

  3. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... limitations. (a) Basic conditions. The medical and other health services specified in § 410.10 are covered by... 42 Public Health 2 2011-10-01 2011-10-01 false Medical and other health services: Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID...

  4. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... limitations. (a) Basic conditions. The medical and other health services specified in § 410.10 are covered by... 42 Public Health 2 2013-10-01 2013-10-01 false Medical and other health services: Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID...

  5. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... limitations. (a) Basic conditions. The medical and other health services specified in § 410.10 are covered by... 42 Public Health 2 2014-10-01 2014-10-01 false Medical and other health services: Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID...

  6. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... limitations. (a) Basic conditions. The medical and other health services specified in § 410.10 are covered by... 42 Public Health 2 2012-10-01 2012-10-01 false Medical and other health services: Basic conditions and limitations. 410.12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID...

  7. Risk of Acute Lung Injury/Acute Respiratory Distress Syndrome in Critically Ill Adult Patients with Pre-Existing Diabetes: A Meta-Analysis

    PubMed Central

    Kan, Quan-Cheng; Sun, Tong-Wen

    2014-01-01

    Background The impact of pre-existing diabetes on the development of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in critically ill patients remains unclear. We performed a meta-analysis of cohort studies to evaluate the risk of ALI/ARDS in critically ill patients with and without pre-existing diabetes. Materials and Methods We searched PubMed and Embase from the inception to September 2013 for cohort studies assessing the effect of pre-existing diabetes on ALI/ARDS occurrence. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using random- or fixed-effect models when appropriate. Results Seven cohort studies with a total of 12,794 participants and 2,937 cases of pre-existing diabetes, and 2,457 cases of ALI/ARDS were included in the meta-analysis. A fixed-effects model meta-analysis showed that pre-existing diabetes was associated with a reduced risk of ALI/ARDS (OR 0.66; 95% CI, 0.55–0.80; p<0.001), with low heterogeneity among the studies (I2?=?18.9%; p?=?0.286). However, the asymmetric funnel plot and Egger's test (p?=?0.007) suggested publication bias may exist. Conclusions Our meta-analysis suggests that pre-existing diabetes was associated with a decreased risk of ALI/ARDS in critically ill adult patients. However, the result should be interpreted with caution because of the potential bias and confounding in the included studies. PMID:24587357

  8. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... State law of the State in which the hospital is located. (4) If a hospital is part of a hospital system consisting of multiple separately certified hospitals and the system elects to have a unified and integrated... staff members of each separately certified hospital in the system (that is, all medical staff...

  9. Schoolchildren with Dysphagia Associated with Medically Complex Conditions

    ERIC Educational Resources Information Center

    Lefton-Greif, Maureen A.; Arvedson, Joan C.

    2008-01-01

    Purpose: This article reviews population trends and general characteristics of children with dysphagia in schools, provides an overview of dysphagia teams and the roles of the speech-language pathologist (SLP) in school and hospital settings, and describes assessment and treatment of swallowing and feeding problems in children with complex medical

  10. Modification of Ad5 Hexon Hypervariable Regions Circumvents Pre-Existing Ad5 Neutralizing Antibodies and Induces Protective Immune Responses

    PubMed Central

    Bruder, Joseph T.; Semenova, Elena; Chen, Ping; Limbach, Keith; Patterson, Noelle B.; Stefaniak, Maureen E.; Konovalova, Svetlana; Thomas, Charlie; Hamilton, Melissa; King, C. Richter; Richie, Thomas L.; Doolan, Denise L.

    2012-01-01

    The development of an effective malaria vaccine is a high global health priority. Vaccine vectors based on adenovirus type 5 are capable of generating robust and protective T cell and antibody responses in animal models and are currently being evaluated in clinical trials for HIV and malaria. They appear to be more effective in terms of inducing antigen-specific immune responses as compared with non-Ad5 serotype vectors. However, the high prevalence of neutralizing antibodies to Ad5 in the human population, particularly in the developing world, has the potential to limit the effectiveness of Ad5-based vaccines. We have generated novel Ad5-based vectors that precisely replace the hexon hypervariable regions with those derived from Ad43, a subgroup D serotype with low prevalence of neutralizing antibody in humans. We have demonstrated that these hexon-modified adenovectors are not neutralized efficiently by Ad5 neutralizing antibodies in vitro using sera from mice, rabbits and human volunteers. We have also generated hexon-modified adenovectors that express a rodent malaria parasite antigen, PyCSP, and demonstrated that they are as immunogenic as an unmodified vector. Furthermore, in contrast to the unmodified vector, the hexon-modified adenovectors induced robust T cell responses in mice with high levels of Ad5 neutralizing antibody. We also show that the hexon-modified vector can be combined with unmodified Ad5 vector in prime-boost regimens to induce protective responses in mice. Our data establish that these hexon-modified vectors are highly immunogenic even in the presence of pre-existing anti-adenovirus antibodies. These hexon-modified adenovectors may have advantages in sub-Saharan Africa where there is a high prevalence of Ad5 neutralizing antibody in the population. PMID:22496772

  11. Estimating the Reactivation Potential of Pre-Existing Fractures in Subsurface Granitoids from Outcrop Analogues and in-Situ Stress Modeling: Implications for EGS Reservoir Stimulation with an Example from Thuringia (Central Germany)

    NASA Astrophysics Data System (ADS)

    Kasch, N.; Ustaszewski, K. M.; Siegburg, M.; Navabpour, P.; Hesse, G.

    2014-12-01

    The Mid-German Crystalline Rise (MGCR) in Thuringia (central Germany) is part of the European Variscan orogen and hosts large extents of Visean granites (c. 350 Ma), locally overlain by up to 3 km of Early Permian to Mid-Triassic volcanic and sedimentary rocks. A geothermal gradient of 36°C km-1 suggests that such subsurface granites form an economically viable hot dry rock reservoir at > 4 km depth. In order to assess the likelihood of reactivating any pre-existing fractures during hydraulic reservoir stimulation, slip and dilation tendency analyses (Morris et al. 1996) were carried out. For this purpose, we determined orientations of pre-existing fractures in 14 granite exposures along the southern border fault of an MGCR basement high. Additionally, the strike of 192 Permian magmatic dikes affecting the granite was considered. This analysis revealed a prevalence of NW-SE-striking fractures (mainly joints, extension veins, dikes and subordinately brittle faults) with a maximum at 030/70 (dip azimuth/dip). Borehole data and earthquake focal mechanisms reveal a maximum horizontal stress SHmax trending N150°E and a strike-slip regime. Effective in-situ stress magnitudes at 4.5 km depth, assuming hydrostatic conditions and frictional equilibrium along pre-existing fractures with a friction coefficient of 0.85 yielded 230 and 110 MPa for SHmax and Shmin, respectively. In this stress field, fractures with the prevailing orientations show a high tendency of becoming reactivated as dextral strike-slip faults if stimulated hydraulically. To ensure that a stimulation well creates fluid connectivity on a reservoir volume as large as possible rather than dissipating fluids along existing fractures, it should follow a trajectory at the highest possible angle to the orientation of prevailing fractures, i.e. subhorizontal and NE-SW-oriented. References: Morris, A., D. A. Ferrill, and D. B. Henderson (1996), Slip-tendency analysis and fault reactivation, Geology, 24, 275-278.

  12. [Future breakthroughs in medical treatment of age-related conditions].

    PubMed

    Vaag, Allan; Petersen, Jacob Sten

    2009-03-01

    Significant progress in our understanding of age-related diseases including the metabolic syndrome, type 2 diabetes, arteriosclerosis and cancer have been achieved in recent years. Novel disease-causing mechanisms and, therefore, drug targets, include epigenetics, inflammation, telomeres, mitochondrial function, oxidative stress and sirtuins. There is a need for individualized treatments, and future medical interventions may be initiated in a primary preventive setting by targeting mechanisms similar to those influenced by calorie restriction and physical exercise. PMID:19265603

  13. Adherence to medication regimens among low-income patients with multiple comorbid chronic conditions.

    PubMed

    Mishra, Shiraz I; Gioia, Deborah; Childress, Saltanat; Barnet, Beth; Webster, Ramothea L

    2011-11-01

    This qualitative study sought to explore facilitators and barriers to adherence to multiple medications among low-income patients with comorbid chronic physical and mental health conditions. The 50 focus group participants identified personal/contextual and health system factors as major impediments to adherence to multiple medications. These factors included medication side effects, fear of harm from medication, fear of dependence on medication, complex instructions, suboptimal communications with doctor, suspicion about doctors' and pharmaceutical companies' motives in prescribing medication, and the high cost ofmedications. Participants also identified motivators, both internal (self-initiated) and external (initiated by family, doctor, support groups),to ensure adherence to multiple medications. These motivators included self-discipline, sense of personal responsibility, faith, support from family members and doctors, and focused health education and self-management support. Three themes emerged that enhanced understanding of the complexity of adherence to multiple medications: (1) reaching one's own threshold for medication adherence, (2) lack of shared information and decision making, and (3) taking less than the prescribed medication. Further analysis of the data revealed that the patients perceived a lack of shared decision making in the management of their comorbid chronic conditions and their medication regimen. PMID:22308877

  14. A dairy-based high calcium diet improves glucose homeostasis and reduces steatosis in the context of pre-existing obesity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    High dietary calcium (Ca) in the context of a dairy food matrix has been shown to reduce obesity development and associated inflammation in diet-induced obese (DIO) rodents. The influence of Ca and dairy on these phenotypes in the context of pre-existing obesity is not known. Furthermore, interpre...

  15. A dairy-based high calcium diet improves glucose homeostasis and reduces further weight gain in high fat fed mice in the context of pre-existing obesity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: High dietary calcium (Ca) in the context of a dairy food matrix has been shown to reduce obesity development and associated inflammation in diet-induced obese (DIO) mice. However, the influence of Ca and dairy on these phenotypes in the context of pre-existing obesity is not known. Met...

  16. Effect of the pre-existing carbides on the grain boundary network during grain boundary engineering in a nickel based alloy

    SciTech Connect

    Liu, Tingguang; Xia, Shuang; Li, Hui; Zhou, Bangxin; Bai, Qin

    2014-05-01

    Grain boundary engineering was carried out on an aging-treated nickel based Alloy 690, which has precipitated carbides at grain boundaries. Electron backscatter diffraction technique was used to investigate the grain boundary networks. Results show that, compared with the solution-annealed samples, the aging-treated samples with pre-existing carbides at grain boundaries need longer duration or higher temperature during annealing after low-strain tensile deformation for forming high proportion of low-? coincidence site lattice grain boundaries (more than 75%). The reason is that the primary recrystallization is inhibited or retarded owing to that the pre-existing carbides are barriers to grain boundaries migration. - Highlights: • Study of GBE as function of pre-existing GB carbides, tensile strain and annealing • Recrystallization of GBE is inhibited or retarded by the pre-existing carbides. • Retained carbides after annealing show the original GB positions. • More than 80% of special GBs were formed after the modification of GBE processing. • Multiple twinning during recrystallization is the key process of GBE.

  17. A Comparison of Expedition Medical Condition List Treatment Directives with Integrated Medical Model Simulation Data Presentation and Briefing Report

    NASA Technical Reports Server (NTRS)

    Lewis, Robert

    2013-01-01

    This aerospace medicine clerkship project is under the direction of Dr. Sharmila Watkins and is in cooperation with Dr. Eric Kerstman and Dr. Ronak Shah. The questions of the research project are: 1. What are the main drivers of evacuation and loss of crew life (LOCL) on three Design Reference Missions (DRMs): Near Earth Asteroid (NEA), Lunar Sortie and Lunar Outpost using an inexhaustible International Space Station medical kit 2. What are the treatment designations for these driving medical conditions as listed in Expedition Medical Condition List (EMCL) 3. Do the drivers make sense in the context of the given Design Reference Mission (DRM) 4. Do any EMCL treatment designations need re-assessing.

  18. Effects of Mining-Induced Stress Perturbations on Pre-Existing Faults Near a Deep South African Gold Mine

    NASA Astrophysics Data System (ADS)

    Lucier, A. M.; Heesakkers, V.; Zoback, M. D.; Reches, Z.

    2007-12-01

    For over a century, mining-induced earthquakes have been recorded in the deep underground mining region of Witwatersrand Basin in South Africa. The TauTona gold mine experiences an appreciable number of mining- induced earthquakes and is the site of the Natural Earthquake Laboratory in South African Mines (NELSAM) project. In this work, we constrain the virgin (i.e. unperturbed) state of stress near the TauTona gold mine using an iterative forward modeling approach that combines observations of drilling induced borehole failures in borehole images, boundary element modeling of the mining-induced stress perturbations, and forward modeling of borehole failures based on the results of the boundary element modeling. We find that the state of stress is a normal faulting regime with principal stress orientations that are slightly deviated from vertical and horizontal and therefore denoted with a (*). The maximum principal stress, Sv*, is deviated 0° to 20° from vertical towards the NNW and has a magnitude gradient of 27 ± 0.3 MPa/km. The intermediate principal stress, SHmax*, is inclined 0° to 20° from horizontal with an azimuth of 145° to 168° and has a magnitude gradient of 21.5 to 26 MPa/km. The least principal stress, Shmin*, is inclined 0° to 10° from horizontal with an azimuth of 235° to 258° and has a magnitude gradient of 13 to 15.5 MPa/km. Using this constrained stress state, we investigate the likelihood of faulting to occur both on pre-existing fault planes that are optimally-oriented to the virgin stress state and on faults affected by the mining-perturbed stress field, the latter of which is calculated with boundary element modeling. The far-field stress state indicates that the crust is in a state of frictional faulting equilibrium, such that normal faulting is likely to occur on faults striking SSE and NNW and have a dip angle of approximately 45° to 80°. The mining-induced stress perturbation affects faults relatively closer to the mining excavation. We analyze active faults observed in borehole image log data and mapped in the TauTona access tunnels. In the borehole image logs, we find evidence of recent slip on faults that have become critically stressed due to the mining-induced stress perturbation. In our investigation of the Pretorius Fault Zone (PFZ), an ancient (Pre-Cambrian) fault system, we find that stress perturbations due to recent mining advances may be responsible for reactivating segments of the PFZ that were observed to slip during a M2.2 event recorded in December 2004.

  19. The role of pre-existing Precambrian structures in rift evolution: The Albertine and Rhino grabens, Uganda

    NASA Astrophysics Data System (ADS)

    Katumwehe, Andrew B.; Abdelsalam, Mohamed G.; Atekwana, Estella A.

    2015-04-01

    We integrated Shuttle Radar Topography Mission (SRTM) Digital Elevation Models (DEM), airborne magnetic, radiometric and three-dimensional Full Tensor Gravity Gradiometry (3D-FTG) data to investigate the role of Precambrian structures in the evolution of the largely amagmatic Miocene-Recent aged Albertine and Rhino grabens in Uganda. These grabens represent the northern segment of the Western Branch of the East African Rift System (EARS). The two NE-trending grabens are connected by a right-stepping transfer zone and they extend within the Archean-Paleoproterozoic Northeast Congo block which represents the northeastern extension of the Congo craton. Our results show the following and highlight the importance of pre-existing structures in the evolution of continental rift systems: (1) The NE-extent of the Albertine full-graben is controlled by NE-trending Precambrian fabric and the graben terminates at its northeastern end when it encounters a multiply folded Precambrian basement terrain with poorly-developed NW-trending structural grain. Additionally, the northeastern termination of the Albertine graben coincides with the presence of NW-trending right-stepping high-density bodies within the Precambrian terrain. (2) The transfer zone between the Albertine and Rhino grabens is controlled by NE-trending Precambrian structures which might have facilitated the development of relay ramp faults. (3) Strain localization within the better-developed southeastern border fault of the Rhino half-graben is facilitated by the presence of Precambrian structures better aligned in a NE-direction in the southeastern part of the basin compared to its northwestern part. (4) Further to the northeast, the Rhino graben is segmented and transitions into a narrower ENE-trending half-graben with a better-developed border fault on its northwestern side. This segmentation coincides with the presence of N-trending Precambrian structures. (5) The Rhino graben terminates farther northeast against the NW-trending Precambrian Aswa shear zone; a prominent structure with complex, but generally NW-trending fabric.

  20. Advancing medical-surgical nursing practice: improving management of the changing patient condition.

    PubMed

    Monroe, Heidi; Plylar, Peggy; Krugman, Mary

    2014-01-01

    Higher patient acuities and more novice nurses on medical-surgical units have Educators focused on achieving positive outcomes with changes in patient condition. An educational program was developed to enhance nurses' knowledge, skill, and confidence in assessing hemodynamics, recognizing early signs of instability, and administering vasoactive medications. The program was successful with significant knowledge improvement as well as an increased use of the Medical Emergency Team while maintaining a low number of code calls. PMID:25407973

  1. Adherence to Medication Regimens among Low-Income Patients with Multiple Comorbid Chronic Conditions

    ERIC Educational Resources Information Center

    Mishra, Shiraz I.; Gioia, Deborah; Childress, Saltanat; Barnet, Beth; Webster, Ramothea L.

    2011-01-01

    This qualitative study sought to explore facilitators and barriers to adherence to multiple medications among low-income patients with comorbid chronic physical and mental health conditions. The 50 focus group participants identified personal/contextual and health system factors as major impediments to adherence to multiple medications. These…

  2. The Impact of Medical Conditions on the Support of Children with Profound Intellectual and Multiple Disabilities

    ERIC Educational Resources Information Center

    Zijlstra, H. P.; Vlaskamp, C.

    2005-01-01

    Background: The aim of this study was to analyse the impact of medical conditions of children with profound intellectual and multiple disabilities on the professional support they receive in centres for special education. Method: The medical files, the daily records and daily communication records between parents and professionals were reviewed…

  3. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... before or 24 hours after admission or registration, but prior to surgery or a procedure requiring... after admission or registration, but prior to surgery or a procedure requiring anesthesia services, when... registration. The updated examination of the patient, including any changes in the patient's condition, must...

  4. 42 CFR 482.22 - Condition of participation: Medical staff.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... before or 24 hours after admission or registration, but prior to surgery or a procedure requiring... after admission or registration, but prior to surgery or a procedure requiring anesthesia services, when... registration. The updated examination of the patient, including any changes in the patient's condition, must...

  5. Tests and Medical Conditions Associated with Dementia Diagnosis

    ERIC Educational Resources Information Center

    Burt, Diana B.; Primeaux-Hart, Sharon; Loveland, Katherine A.; Cleveland, Lynne A.; Lewis, Kay R.; Lesser, Jary; Pearson, Pamela L.

    2005-01-01

    Diagnosis of dementia in adults with intellectual disabilities requires documentation of clinically significant declines in memory and other cognitive skills, as well as changes in everyday and emotional functioning. To improve diagnostic accuracy in adults with Down syndrome, the authors examined conditions often associated with dementia, as well…

  6. Parental perspectives on influenza vaccination of children with chronic medical conditions.

    PubMed Central

    Lin, Chyongchiou J.; Zimmerman, Richard K.; Nowalk, Mary Patricia; Ko, Feng-Shou; Raymund, Mahlon; Hoberman, Alejandro; Kearney, Diana H.; Block, Bruce

    2006-01-01

    BACKGROUND: Minorities and those living in the inner city have a higher respiratory disease burden than other groups. Yet, influenza vaccination rates among all children with chronic medical conditions remain low. METHODS: Parents of 2-13-year-old children with high-risk medical conditions from health centers in low-income urban neighborhoods completed a mailed survey. Immunization status from medical records was used to calculate validity measures. Survey data are presented for those whose vaccination status was concordant between parental report and the medical record (n=183). RESULTS: Parent-reported influenza vaccination versus medical record review showed 84.9% sensitivity, 68.7% specificity, 49.1% positive predictive value and 92.7% negative predictive value, with a kappa of 0.43. Vaccination rate was 30.6%. Medical record-verified influenza vaccination was associated with parental beliefs that the doctor recommends a flu shot (OR, 40.9; 95% Cl, 9.0-184.9) and that relatives recommend a flu shot (OR, 4.3; 95% Cl, 1.7-10.5), and was less likely if the parent believed that the child will get the flu if a household member is infected (OR, 0.2; 95% Cl, 0.1-0.6). CONCLUSIONS: The message that influenza vaccination is important to protect children with chronic medical conditions may be relayed through physician recommendation or a relative's suggestion and may be more effective if it addresses vaccine efficacy issues. PMID:16708499

  7. 42 CFR 416.45 - Condition for coverage-Medical staff.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Medical staff. 416.45 Section 416.45 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM AMBULATORY SURGICAL SERVICES Specific Conditions for Coverage §...

  8. 42 CFR 416.45 - Condition for coverage-Medical staff.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Condition for coverage-Medical staff. 416.45 Section 416.45 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) AMBULATORY SURGICAL SERVICES Specific Conditions...

  9. Self-Medication of Somatic and Psychiatric Conditions Using Botanical Marijuana.

    PubMed

    Osborn, Lawrence A; Lauritsen, Kirstin J; Cross, Nicole; Davis, Alan K; Rosenberg, Harold; Bonadio, Francis; Lang, Brent

    2015-01-01

    As a complement to research evaluating botanical marijuana as a medical therapy for various somatic and psychiatric conditions, there is a growing body of research assessing marijuana users' self-reports of the symptoms and conditions for which they use marijuana without a physician's recommendation. As part of two larger web-based surveys and one in-situ survey at an outdoor marijuana festival, we asked regular marijuana users if they consumed the drug without a physician's recommendation and, if so, to describe (or select from a checklist) the conditions for which they used marijuana as a medication. Participants reported using marijuana to self-medicate a wide variety of both somatic conditions (such as pain, diabetes, and irritable bowel syndrome) and psychiatric conditions (such as depression, anxiety, and insomnia). Because fewer than half of the American states, and only a few countries, allow physicians to recommend medicinal marijuana, these findings may be of interest to clinicians as they treat patients, to lawmakers and policymakers as they consider legislation allowing physicians to recommend botanical marijuana for somatic and psychiatric conditions, and to researchers evaluating conditions that individuals elect to self-medicate using botanical marijuana. PMID:26595140

  10. Temporary Increases in Problem Behavior and Sleep Disruption Following Decreases in Medication: A Descriptive Analysis of Conditional Rates

    ERIC Educational Resources Information Center

    Rapp, John T.; Swanson, Greg; Dornbusch, Kaitlin

    2007-01-01

    Conditional rates of problem behavior for weeks that followed medication decreases and no medication changes were compared for 12 individuals who exhibited severe problem behavior (e.g., self-injury, aggression). The results indicate that conditional rates of problem behavior were higher following medication decreases than following no changes in…

  11. Reprinted from: TECTONICS, VOL. 29, TC6004, doi:10.1029/2010TC002744, 2010 Influence of pre-existing fault fabric on inversion-related deformation: A case study

    E-print Network

    -existing fault fabric on inversion-related deformation: A case study of the inverted Fundy rift basin. The pre-existing fabric, con- sisting of NE-striking faults with gentle dips and E-striking faults orogenic activity. During Mesozoic rifting, the pre-existing fabric was reactivated, creating a border

  12. Effects of pre-existing ice crystals on cirrus clouds and comparison between different ice nucleation parameterizations with the Community Atmosphere Model (CAM5)

    NASA Astrophysics Data System (ADS)

    Shi, X.; Liu, X.; Zhang, K.

    2015-02-01

    In order to improve the treatment of ice nucleation in a more realistic manner in the Community Atmosphere Model version 5.3 (CAM5.3), the effects of pre-existing ice crystals on ice nucleation in cirrus clouds are considered. In addition, by considering the in-cloud variability in ice saturation ratio, homogeneous nucleation takes place spatially only in a portion of the cirrus cloud rather than in the whole area of the cirrus cloud. Compared to observations, the ice number concentrations and the probability distributions of ice number concentration are both improved with the updated treatment. The pre-existing ice crystals significantly reduce ice number concentrations in cirrus clouds, especially at mid- to high latitudes in the upper troposphere (by a factor of ~10). Furthermore, the contribution of heterogeneous ice nucleation to cirrus ice crystal number increases considerably. Besides the default ice nucleation parameterization of Liu and Penner (2005, hereafter LP) in CAM5.3, two other ice nucleation parameterizations of Barahona and Nenes (2009, hereafter BN) and Kärcher et al. (2006, hereafter KL) are implemented in CAM5.3 for the comparison. In-cloud ice crystal number concentration, percentage contribution from heterogeneous ice nucleation to total ice crystal number, and pre-existing ice effects simulated by the three ice nucleation parameterizations have similar patterns in the simulations with present-day aerosol emissions. However, the change (present-day minus pre-industrial times) in global annual mean column ice number concentration from the KL parameterization (3.24 × 106 m-2) is less than that from the LP (8.46 × 106 m-2) and BN (5.62 × 106 m-2) parameterizations. As a result, the experiment using the KL parameterization predicts a much smaller anthropogenic aerosol long-wave indirect forcing (0.24 W m-2) than that using the LP (0.46 W m-2) and BN (0.39 W m-2) parameterizations.

  13. Medical laboratory scientists are key members of the medical team, detecting diseases and other conditions by performing chemical,

    E-print Network

    , medical terminology, microbiology, and anatomy and physiology. Medical Laboratory Science--BS wwwMedical laboratory scientists are key members of the medical team, detecting diseases and other on blood, tissues, and bodily fluids.They are some of the most versatile medical professionals

  14. HealthDoc: Customizing patient information and health education by medical condition and personal characteristics

    E-print Network

    DiMarco, Chrysanne

    HealthDoc: Customizing patient information and health education by medical condition and personal a comprehensive approach to the customization of patient-information and health-education materials through the development of so- phisticated natural language generation systems. We adopt a model of patient education

  15. Coping and Depressive Symptoms in Adolescents with a Chronic Medical Condition: A Search for Intervention Targets

    ERIC Educational Resources Information Center

    Kraaij, Vivian; Garnefski, Nadia

    2012-01-01

    The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for adolescents with a chronic medical condition. A wide range of coping techniques were studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 176 adolescents participated. They were…

  16. Epidemiology of Autism Spectrum Disorder in Portugal: Prevalence, Clinical Characterization, and Medical Conditions

    ERIC Educational Resources Information Center

    Oliveira, Guiomar; Ataide, Assuncao; Marques, Carla; Miguel, Teresa S.; Coutinho, Ana Margarida; Mota-Vieira, Luisa; Goncalves, Esmeralda; Lopes, Nazare Mendes; Rodrigues, Vitor; Carmona da Mota, Henrique; Vicente, Astrid Moura

    2007-01-01

    The objective of this study was to estimate the prevalence of autistic spectrum disorder (ASD) and identify its clinical characterization, and medical conditions in a paediatric population in Portugal. A school survey was conducted in elementary schools, targeting 332 808 school-aged children in the mainland and 10 910 in the Azores islands.…

  17. Academic and Family Conditions Associated with Intrinsic Academic Motivation in Japanese Medical Students: A Pilot Study

    ERIC Educational Resources Information Center

    Tanaka, Masaaki; Watanabea, Yasuyoshi

    2012-01-01

    Objective: Intrinsic academic motivation is one of the most important psychological concepts in education, and it is related to academic outcomes in medical students. This study examined the relationships between academic and family conditions and intrinsic academic motivation. Design: Cross-sectional design. Setting: The study group consisted of…

  18. Patient perception versus medical record entry of health-related conditions among patients with heart failure.

    PubMed

    Malik, Adnan S; Giamouzis, Grigorios; Georgiopoulou, Vasiliki V; Fike, Lucy V; Kalogeropoulos, Andreas P; Norton, Catherine R; Sorescu, Dan; Azim, Sidra; Laskar, Sonjoy R; Smith, Andrew L; Dunbar, Sandra B; Butler, Javed

    2011-02-15

    A shared understanding of medical conditions between patients and their health care providers may improve self-care and outcomes. In this study, the concordance between responses to a medical history self-report (MHSR) form and the corresponding provider documentation in electronic health records (EHRs) of 19 select co-morbidities and habits in 230 patients with heart failure were evaluated. Overall concordance was assessed using the ? statistic, and crude, positive, and negative agreement were determined for each condition. Concordance between MHSR and EHR varied widely for cardiovascular conditions (? = 0.37 to 0.96), noncardiovascular conditions (? = 0.06 to 1.00), and habits (? = 0.26 to 0.69). Less than 80% crude agreement was seen for history of arrhythmias (72%), dyslipidemia (74%), and hypertension (79%) among cardiovascular conditions and lung disease (70%) and peripheral arterial disease (78%) for noncardiovascular conditions. Perfect agreement was observed for only 1 of the 19 conditions (human immunodeficiency virus status). Negative agreement >80% was more frequent than >80% positive agreement for a condition (15 of 19 [79%] vs 8 of 19 [42%], respectively, p = 0.02). Only 20% of patients had concordant MSHRs and EHRs for all 7 cardiovascular conditions; in 40% of patients, concordance was observed for ?5 conditions. For noncardiovascular conditions, only 28% of MSHR-EHR pairs agreed for all 9 conditions; 37% agreed for ?7 conditions. Cumulatively, 39% of the pairs matched for ?15 of 19 conditions. In conclusion, there is significant variation in the perceptions of patients with heart failure compared to providers' records of co-morbidities and habits. The root causes of this variation and its impact on outcomes need further study. PMID:21185003

  19. Patient Perception Versus Medical Record Entry of Health-Related Conditions Among Patients With Heart Failure

    PubMed Central

    Malik, Adnan S.; Giamouzis, Grigorios; Georgiopoulou, Vasiliki V.; Fike, Lucy V.; Kalogeropoulos, Andreas P.; Norton, Catherine R.; Sorescu, Dan; Azim, Sidra; Laskar, Sonjoy R.; Smith, Andrew L.; Dunbar, Sandra B.; Butler, Javed

    2013-01-01

    A shared understanding of medical conditions between patients and their health care providers may improve self-care and outcomes. In this study, the concordance between responses to a medical history self-report (MHSR) form and the corresponding provider documentation in electronic health records (EHRs) of 19 select co-morbidities and habits in 230 patients with heart failure were evaluated. Overall concordance was assessed using the ? statistic, and crude, positive, and negative agreement were determined for each condition. Concordance between MHSR and EHR varied widely for cardiovascular conditions (? = 0.37 to 0.96), noncardiovascular conditions (? = 0.06 to 1.00), and habits (? = 0.26 to 0.69). Less than 80% crude agreement was seen for history of arrhythmias (72%), dyslipidemia (74%), and hypertension (79%) among cardiovascular conditions and lung disease (70%) and peripheral arterial disease (78%) for noncardiovascular conditions. Perfect agreement was observed for only 1 of the 19 conditions (human immunodeficiency virus status). Negative agreement >80% was more frequent than >80% positive agreement for a condition (15 of 19 [79%] vs 8 of 19 [42%], respectively, p = 0.02). Only 20% of patients had concordant MSHRs and EHRs for all 7 cardiovascular conditions; in 40% of patients, concordance was observed for ?5 conditions. For noncardiovascular conditions, only 28% of MSHR-EHR pairs agreed for all 9 conditions; 37% agreed for ?7 conditions. Cumulatively, 39% of the pairs matched for ?15 of 19 conditions. In conclusion, there is significant variation in the perceptions of patients with heart failure compared to providers’ records of co-morbidities and habits. The root causes of this variation and its impact on outcomes need further study. PMID:21185003

  20. C/EBP? Activates Pre-existing and De Novo Macrophage Enhancers during Induced Pre-B Cell Transdifferentiation and Myelopoiesis

    PubMed Central

    van Oevelen, Chris; Collombet, Samuel; Vicent, Guillermo; Hoogenkamp, Maarten; Lepoivre, Cyrille; Badeaux, Aimee; Bussmann, Lars; Sardina, Jose Luis; Thieffry, Denis; Beato, Miguel; Shi, Yang; Bonifer, Constanze; Graf, Thomas

    2015-01-01

    Summary Transcription-factor-induced somatic cell conversions are highly relevant for both basic and clinical research yet their mechanism is not fully understood and it is unclear whether they reflect normal differentiation processes. Here we show that during pre-B-cell-to-macrophage transdifferentiation, C/EBP? binds to two types of myeloid enhancers in B cells: pre-existing enhancers that are bound by PU.1, providing a platform for incoming C/EBP?; and de novo enhancers that are targeted by C/EBP?, acting as a pioneer factor for subsequent binding by PU.1. The order of factor binding dictates the upregulation kinetics of nearby genes. Pre-existing enhancers are broadly active throughout the hematopoietic lineage tree, including B cells. In contrast, de novo enhancers are silent in most cell types except in myeloid cells where they become activated by C/EBP factors. Our data suggest that C/EBP? recapitulates physiological developmental processes by short-circuiting two macrophage enhancer pathways in pre-B cells. PMID:26235892

  1. Method Issues in Epidemiological Studies of Medically Unexplained Symptom-based Conditions in Veterans.

    PubMed

    Coughlin, Steven S; McNeil, Rebecca B; Provenzale, Dawn T; Dursa, Erin K; Thomas, Catherine M

    2013-05-01

    Symptom-based conditions such as chronic fatigue syndrome (CFS) and medically unexplained multi-symptom illness (MSI) are fairly common in the general population and are also important veteran's health concerns due to their higher frequency among U.S. veterans who served during the 1990-1991 Gulf War. CFS, MSI, and other symptom-based conditions are often associated with considerable morbidity due to fatigue, chronic pain, neurologic symptoms, and other symptoms that can impair the quality of life. This article discusses several important issues of methodology that arise in population studies of CFS and MSI. These include the exclusion criteria that have been used in population studies to define CFS-like illness and unexplained MSI, the potential for false positive and false negative assessments of illness status, the potential for sex differences, and the poorly understood natural history of these symptom-based conditions across the life span. As an empirical example of these methodology issues, we examined existing data from a 2005 follow-up survey. We found that 64.9% (762 of 1,175) of female Gulf War veterans and 53.4% (2,530 of 4,739) of male Gulf War veterans had 1 or more exclusionary medical conditions. The prevalence among veterans with one or more exclusionary medical conditions increased markedly by age among females and those with a low income. PMID:24683425

  2. Working with Students in the Medication Era: Do We All Have to Know How to Diagnose and Treat Mental Conditions?

    ERIC Educational Resources Information Center

    Alishio, Kip

    2005-01-01

    A marked increase in the number of college students on medications for depression, attention deficit disorder, and other conditions may have intimidated counselors and educators into believing that they all need to be medical experts. The widespread practice of medicalizing behavior and experience contrasts dramatically with the approach in which…

  3. College Health Service Capacity to Support Youth With Chronic Medical Conditions

    PubMed Central

    Lawlor, Katherine; Scherer, Emily A.; Kelemen, Skyler; Weitzman, Elissa R.

    2014-01-01

    BACKGROUND AND OBJECTIVE: Twenty percent of US youth have a chronic medical condition and many attend college. Guidelines for transition from pediatric to adult care do not address college health services, and little is known about their capacity to identify, support, and provide care for these youth. The objective of this study was to describe college health center policies, practices, and resources for youth with chronic medical conditions (YCMC). METHODS: Survey of medical directors from health centers of a representative sample of 200 4-year US colleges with ?400 enrolled undergraduate students. Patterns of identification, management, and support for youth with a general chronic medical condition and with asthma, diabetes, and depression, were investigated; ?2 and Fisher exact tests were used to ascertain differences by institutional demographics. RESULTS: Directors at 153 institutions completed the survey (76.5% response rate). Overall, 42% of schools had no system to identify YCMC. However, almost a third (31%) did identify and add to a registry of incoming YCMC on review of medical history, more likely in private (P < .001) and small (<5000 students, P = .002) colleges; 24% of health centers contacted YCMC to check-in/make initial appointments. Most institutions could manage asthma and depression (83% and 69%, respectively); 51% could manage diabetes on campus. CONCLUSIONS: Relatively few US colleges have health systems to identify and contact YCMC, although many centers have capacity to provide primary care and management of some conditions. Guidelines for transition should address policy and practices for pediatricians and colleges to enhance comanagement of affected youth. PMID:25349315

  4. Phenological asynchrony between herbivorous insects and their hosts: signal of climate change or pre-existing adaptive strategy?

    PubMed Central

    Singer, Michael C.; Parmesan, Camille

    2010-01-01

    Climate change alters phenological relations between interacting species. We might expect the historical baseline, or starting-point, for such effects to be precise synchrony between the season at which a consumer most requires food and the time when its resources are most available. We synthesize evidence that synchrony was not the historical condition in two insect–plant interactions involving Edith's checkerspot butterfly (Euphydryas editha), the winter moth (Operophtera brumata) and their host plants. Initial observations of phenological mismatch in both systems were made prior to the onset of anthropogenically driven climate change. Neither species can detect the phenology of its host plants with precision. In both species, evolution of life history has involved compromise between maximizing fecundity and minimizing mortality, with the outcome being superficially maladaptive strategies in which many, or even most, individuals die of starvation through poor synchrony with their host plants. Where phenological asynchrony or mismatch with resources forms the starting point for effects of anthropogenic global warming, consumers are particularly vulnerable to impacts that exacerbate the mismatch. This vulnerability likely contributed to extinction of a well-studied metapopulation of Edith's checkerspot, and to the skewed geographical pattern of population extinctions underlying a northward and upward range shift in this species. PMID:20819810

  5. DNase I and proteinase K impair Listeria monocytogenes biofilm formation and induce dispersal of pre-existing biofilms.

    PubMed

    Nguyen, Uyen T; Burrows, Lori L

    2014-09-18

    Current sanitation methods in the food industry are not always sufficient for prevention or dispersal of Listeria monocytogenes biofilms. Here, we determined if prevention of adherence or dispersal of existing biofilms could occur if biofilm matrix components were disrupted enzymatically. Addition of DNase during biofilm formation reduced attachment (<50% of control) to polystyrene. Treatment of established 72h biofilms with 100?g/ml of DNase for 24h induced incomplete biofilm dispersal, with <25% biofilm remaining compared to control. In contrast, addition of proteinase K completely inhibited biofilm formation, and 72h biofilms-including those grown under stimulatory conditions-were completely dispersed with 100?g/ml proteinase K. Generally-regarded-as-safe proteases bromelain and papain were less effective dispersants than proteinase K. In a time course assay, complete dispersal of L. monocytogenes biofilms from both polystyrene and type 304H food-grade stainless steel occurred within 5min at proteinase K concentrations above 25?g/ml. These data confirm that both DNA and proteins are required for L. monocytogenes biofilm development and maintenance, and that these components of the biofilm matrix can be targeted for effective prevention and removal of biofilms. PMID:25043896

  6. A Review of Therapeutic Uses of Mirtazapine in Psychiatric and Medical Conditions

    PubMed Central

    Voronovich, Zoya; Carley, Joseph A.

    2013-01-01

    Objective: To review the literature examining the use of mirtazapine with an emphasis on its therapeutic benefits for psychiatric patients with comorbid medical conditions. Data Sources: MEDLINE, PsycINFO, Global Health, and AGRICOLA were searched using the terms mirtazapine OR Remeron. Limits were English language, human, year 1980–2012, treatment and prevention, and therapy. Study Selection: Two hundred ninety-three articles were identified. Data Extraction: Identified articles were reviewed with a focus on indications and therapeutic benefits in patients with medical comorbidities. Results: Mirtazapine is an effective antidepressant with unique mechanisms of action. It is characterized by a relatively rapid onset of action, high response and remission rates, a favorable side-effect profile, and several unique therapeutic benefits over other antidepressants. Mirtazapine has also shown promise in treating some medical disorders, including neurologic conditions, and ameliorating some of the associated debilitating symptoms of weight loss, insomnia, and postoperative nausea and vomiting. Conclusions: Mirtazapine offers clinicians multiple therapeutic advantages especially when treating patients with comorbid medical illness. PMID:24511451

  7. Decline in annual lung function in workers exposed to asbestos with and without pre-existing fibrotic changes on chest radiography.

    PubMed Central

    Nakadate, T

    1995-01-01

    OBJECTIVES--To examine whether or not workers with pre-existing mild pulmonary fibrosis have accelerated decline in forced expiratory volume in one second (FEV1) or forced vital capacity (FVC), under low level exposure to chrysotile asbestos. METHODS--All male workers in two asbestos manufacturing factories were followed up annually for six years to compare their declines in FEV1 and FVC. The values of FEV1 and FVC were divided by the square of the person's height to adjust for body size differences (FEV1/Ht2 and FVC/Ht2, respectively). Annual change was calculated for each subject as a slope of the simple linear regression with FEV1/Ht2 or FVC/Ht2 regressed according to age. Analysis was conducted on 242 middle aged workers who had normal routine spirometry values, normal chest radiographs or mild pneumoconiosis up to 1/2 grade, without changes either in smoking habit or severity of pneumoconiosis during the study period, and with acceptable spirograms in three or more surveys. The occupational environment, in terms of chrysotile asbestos, had been well controlled below the threshold limit value of Japan at that time--namely, 2 fibres/micromilligrams. RESULTS-There was no significant effect from the interaction between pre-existing mild pulmonary fibrosis and low level of exposure to chrysotile asbestos on the accelerated annual decline of FEV1/Ht2, or FVC/Ht2. Fibrosis significantly contributed to annual changes in FEV1/Ht2, even after adjustment for mean FEV1 and smoking. The point estimate of the contribution was - 4.9 ml/m2/y. No significant independent contribution of exposure was found in decline of either FEV1/Ht2 or FVC/Ht2. CONCLUSIONS--Pre-existing pulmonary fibrosis is an independent risk factor for accelerated annual decline of FEV1, even when mild and stable. Additional decline due to exposure to chrysotile asbestos is less probable if it is well controlled under the current threshold limit value. PMID:7627312

  8. Receipt of Prescription Contraception by Commercially Insured Women With Chronic Medical Conditions

    PubMed Central

    DeNoble, Anna E.; Hall, Kelli S.; Xu, Xiao; Zochowski, Melissa K.; Piehl, Kenneth; Dalton, Vanessa K.

    2014-01-01

    Objective To assess differences in receipt of prescription contraception among women with and without chronic medical conditions. Methods This observational study used 3 years of administrative claims records for insured women aged 21–45 years who were enrolled in a commercial insurance company in Michigan between 2004 and 2009. Women were considered to have a chronic medical condition if they had at least two claims for one of the following conditions, in order of prevalence in our study population: hypertension, asthma, hypothyroidism, diabetes, obesity, rheumatoid arthritis, inflammatory bowel disease, or systemic lupus erythematosus. Our primary outcome was receipt of prescription contraception, defined by a pharmacy claim or diagnostic or procedural code. We used multivariable logistic regression to estimate the association of chronic condition status with the odds of receiving prescription contraception within 3 years, adjusting for age, community-level socioeconomic status, total outpatient visits, and cervical cancer screening. Results Of 11,649 women studied, 16.0% (n=1,862) had at least one of the chronic conditions we considered. Of those with a chronic condition, 33.5% (n=623) received prescription contraception during the 3-year study period compared to 41.1% (n=4,018) of those without a chronic condition (p<0.001). After adjusting for covariates, women with a chronic condition remained less likely than women without a chronic condition to have received prescription contraception (adjusted odds ratio=0.85; 95% CI 0.76, 0.96; p=0.010). Conclusion Despite a greater risk for adverse outcomes with an unplanned pregnancy, women with these chronic conditions were less likely to receive prescription contraception. PMID:24807345

  9. The elephant in the room: ethical issues associated with rare and expensive medical conditions.

    PubMed

    Mavroudis, Constantine D; Mavroudis, Constantine; Jacobs, Jeffrey P

    2015-12-01

    The treatment of rare and expensive medical conditions is one of the defining qualities of paediatric cardiology and congenital heart surgery. Increasing concerns over healthcare resource allocation are challenging the merits of treating more expensive forms of congenital heart disease, and this trend will almost certainly continue. In this manuscript, the problems of resource allocation for rare and expensive medical conditions are described from philosophical and economic perspectives. The argument is made that current economic models are limited in the ability to assess the value of treating expensive and rare forms of congenital heart disease. Further, multi-disciplinary approaches are necessary to best determine the merits of treating a patient population such as those with significant congenital heart disease that sometimes requires enormous healthcare resources. PMID:26675614

  10. Estimating the Impact of Workplace Bullying: Humanistic and Economic Burden among Workers with Chronic Medical Conditions

    PubMed Central

    Fattori, A.; Neri, L.; Aguglia, E.; Bellomo, A.; Bisogno, A.; Camerino, D.; Carpiniello, B.; Cassin, A.; Costa, G.; De Fazio, P.; Di Sciascio, G.; Favaretto, G.; Fraticelli, C.; Giannelli, R.; Leone, S.; Maniscalco, T.; Marchesi, C.; Mauri, M.; Mencacci, C.; Polselli, G.; Quartesan, R.; Risso, F.; Sciaretta, A.; Vaggi, M.; Vender, S.; Viora, U.

    2015-01-01

    Background. Although the prevalence of work-limiting diseases is increasing, the interplay between occupational exposures and chronic medical conditions remains largely uncharacterized. Research has shown the detrimental effects of workplace bullying but very little is known about the humanistic and productivity cost in victims with chronic illnesses. We sought to assess work productivity losses and health disutility associated with bullying among subjects with chronic medical conditions. Methods. Participants (N = 1717) with chronic diseases answered a self-administered survey including sociodemographic and clinical data, workplace bullying experience, the SF-12 questionnaire, and the Work Productivity Activity Impairment questionnaire. Results. The prevalence of significant impairment was higher among victims of workplace bullying as compared to nonvictims (SF-12 PCS: 55.5% versus 67.9%, p < 0.01; SF-12 MCS: 59.4% versus 74.3%, p < 0.01). The adjusted marginal overall productivity cost of workplace bullying ranged from 13.9% to 17.4%, corresponding to Italian Purchase Power Parity (PPP) 2010 US$ 4182–5236 yearly. Association estimates were independent and not moderated by concurrent medical conditions. Conclusions. Our findings demonstrate that the burden on workers' quality of life and productivity associated with workplace bullying is substantial. This study provides key data to inform policy-making and prioritize occupational health interventions. PMID:26557692

  11. Estimating the Impact of Workplace Bullying: Humanistic and Economic Burden among Workers with Chronic Medical Conditions.

    PubMed

    Fattori, A; Neri, L; Aguglia, E; Bellomo, A; Bisogno, A; Camerino, D; Carpiniello, B; Cassin, A; Costa, G; De Fazio, P; Di Sciascio, G; Favaretto, G; Fraticelli, C; Giannelli, R; Leone, S; Maniscalco, T; Marchesi, C; Mauri, M; Mencacci, C; Polselli, G; Quartesan, R; Risso, F; Sciaretta, A; Vaggi, M; Vender, S; Viora, U

    2015-01-01

    Background. Although the prevalence of work-limiting diseases is increasing, the interplay between occupational exposures and chronic medical conditions remains largely uncharacterized. Research has shown the detrimental effects of workplace bullying but very little is known about the humanistic and productivity cost in victims with chronic illnesses. We sought to assess work productivity losses and health disutility associated with bullying among subjects with chronic medical conditions. Methods. Participants (N = 1717) with chronic diseases answered a self-administered survey including sociodemographic and clinical data, workplace bullying experience, the SF-12 questionnaire, and the Work Productivity Activity Impairment questionnaire. Results. The prevalence of significant impairment was higher among victims of workplace bullying as compared to nonvictims (SF-12 PCS: 55.5% versus 67.9%, p < 0.01; SF-12 MCS: 59.4% versus 74.3%, p < 0.01). The adjusted marginal overall productivity cost of workplace bullying ranged from 13.9% to 17.4%, corresponding to Italian Purchase Power Parity (PPP) 2010 US$ 4182-5236 yearly. Association estimates were independent and not moderated by concurrent medical conditions. Conclusions. Our findings demonstrate that the burden on workers' quality of life and productivity associated with workplace bullying is substantial. This study provides key data to inform policy-making and prioritize occupational health interventions. PMID:26557692

  12. Effects of pre-existing hearing loss and gender on proposed ANSI S12.13 outcomes for characterizing hearing conservation program effectiveness: preliminary investigation.

    PubMed

    Amos, N E; Simpson, T H

    1995-11-01

    Draft American National Standard "Evaluating the Effectiveness of Hearing Conservation Programs" identifies potentially important links between audiometric threshold variability outcomes and occupational hearing conservation program (HCP) practices. Unacceptable threshold variability in annual audiograms may identify poor testing practices and temporary threshold shifts. This preliminary investigation reveals pre-existing hearing loss to be a potentially important confounding viable to interpreting ANSI S12.13 outcomes. Poor hearing groups in this study consistently yielded greater threshold variability (i.e., "poorer" HCP performance) than better hearing groups. Gender may also be a confounding variable, however, to a far lesser degree. HCP managers should exercise caution when interpreting relative ANSI S12.13 outcomes among HCPs differing in baseline hearing sensitivity. Potential causes for these findings are discussed, and implications for future research are identified. PMID:8580500

  13. Manganese [III] Tetrakis [5,10,15,20]-Benzoic Acid Porphyrin Reduces Adiposity and Improves Insulin Action in Mice with Pre-Existing Obesity

    PubMed Central

    Brestoff, Jonathan R.; Brodsky, Tim; Sosinsky, Alexandra Z.; McLoughlin, Ryan; Stansky, Elena; Fussell, Leila; Sheppard, Aaron; DiSanto-Rose, Maria; Kershaw, Erin E.; Reynolds, Thomas H.

    2015-01-01

    The superoxide dismutase mimetic manganese [III] tetrakis [5,10,15,20]-benzoic acid porphyrin (MnTBAP) is a potent antioxidant compound that has been shown to limit weight gain during short-term high fat feeding without preventing insulin resistance. However, whether MnTBAP has therapeutic potential to treat pre-existing obesity and insulin resistance remains unknown. To investigate this, mice were treated with MnTBAP or vehicle during the last five weeks of a 24-week high fat diet (HFD) regimen. MnTBAP treatment significantly decreased body weight and reduced white adipose tissue (WAT) mass in mice fed a HFD and a low fat diet (LFD). The reduction in adiposity was associated with decreased caloric intake without significantly altering energy expenditure, indicating that MnTBAP decreases adiposity in part by modulating energy balance. MnTBAP treatment also improved insulin action in HFD-fed mice, a physiologic response that was associated with increased protein kinase B (PKB) phosphorylation and expression in muscle and WAT. Since MnTBAP is a metalloporphyrin molecule, we hypothesized that its ability to promote weight loss and improve insulin sensitivity was regulated by heme oxygenase-1 (HO-1), in a similar fashion as cobalt protoporphyrins. Despite MnTBAP treatment increasing HO-1 expression, administration of the potent HO-1 inhibitor tin mesoporphyrin (SnMP) did not block the ability of MnTBAP to alter caloric intake, adiposity, or insulin action, suggesting that MnTBAP influences these metabolic processes independent of HO-1. These data demonstrate that MnTBAP can ameliorate pre-existing obesity and improve insulin action by reducing caloric intake and increasing PKB phosphorylation and expression. PMID:26397111

  14. Ectopic expression of select innexins in individual central neurons couples them to pre-existing neuronal or glial networks that express the same innexin.

    PubMed

    Firme, Constantine P; Natan, Ryan G; Yazdani, Neema; Macagno, Eduardo R; Baker, Michael W

    2012-10-10

    Fifteen of the 21 innexin (Inx) genes (Hve-inx) found in the genome of the medicinal leech, Hirudo verbana, are expressed in the CNS (Kandarian et al., 2012). Two are expressed pan-neuronally, while the others are restricted in their expression to small numbers of cells, in some cases reflecting the membership of known networks of electrically coupled and dye-coupled neurons or glial cells. We report here that when Hve-inx genes characteristic of discrete coupled networks were expressed ectopically in neurons known not to express them, the experimental cells were found to become dye coupled with the other cells in that network. Hve-inx6 is normally expressed by only three neurons in each ganglion, which form strongly dye-coupled electrical connections with each other [Shortening-Coupling interneuron (S-CI) network] (Muller and Scott, 1981; Dykes and Macagno, 2006). But when Hve-inx6 was ectopically expressed in a variety of central embryonic neurons, those cells became dye coupled with the S-CI network. Similarly, Hve-inx2 is normally uniquely expressed by the ganglion's large glial cells, but when it was ectopically expressed in different central neurons, they became dye coupled to the glial cells. In contrast, overexpression of the pan-neuronal Inx genes Hve-inx1 and Hve-inx14 did not yield any novel instances of dye coupling to pre-existent neuronal networks. These results reveal that expression of certain innexins is sufficient to couple individual neurons to pre-existing networks in the CNS. We propose that a primary determinant of selective neuronal connectivity and circuit formation in the leech is the surface expression of unique subsets of gap junctional proteins. PMID:23055495

  15. Ectopic Expression of Select Innexins in Individual Central Neurons Couples Them to Pre-Existing Neuronal or Glial Networks That Express the Same Innexin

    PubMed Central

    Firme, Constantine P.; Natan, Ryan G.; Yazdani, Neema

    2012-01-01

    Fifteen of the 21 innexin (Inx) genes (Hve-inx) found in the genome of the medicinal leech, Hirudo verbana, are expressed in the CNS (Kandarian et al., 2012). Two are expressed pan-neuronally, while the others are restricted in their expression to small numbers of cells, in some cases reflecting the membership of known networks of electrically coupled and dye-coupled neurons or glial cells. We report here that when Hve-inx genes characteristic of discrete coupled networks were expressed ectopically in neurons known not to express them, the experimental cells were found to become dye coupled with the other cells in that network. Hve-inx6 is normally expressed by only three neurons in each ganglion, which form strongly dye-coupled electrical connections with each other [Shortening-Coupling interneuron (S-CI) network] (Muller and Scott, 1981; Dykes and Macagno, 2006). But when Hve-inx6 was ectopically expressed in a variety of central embryonic neurons, those cells became dye coupled with the S-CI network. Similarly, Hve-inx2 is normally uniquely expressed by the ganglion's large glial cells, but when it was ectopically expressed in different central neurons, they became dye coupled to the glial cells. In contrast, overexpression of the pan-neuronal Inx genes Hve-inx1 and Hve-inx14 did not yield any novel instances of dye coupling to pre-existent neuronal networks. These results reveal that expression of certain innexins is sufficient to couple individual neurons to pre-existing networks in the CNS. We propose that a primary determinant of selective neuronal connectivity and circuit formation in the leech is the surface expression of unique subsets of gap junctional proteins. PMID:23055495

  16. Medical costs and lost productivity from health conditions at volatile organic compound-contaminated Superfund sites

    SciTech Connect

    Lybarger, J.A.; Spengler, R.F.; Brown, D.R.; Lee, R.; Vogt, D.P.; Perhac, R.M. Jr.

    1998-10-01

    This paper estimates the health costs at Superfund sites for conditions associated with volatile organic compounds (VOCs) in drinking water. Health conditions were identified from published literature and registry information as occurring at excess rates in VOC-exposed populations. These health conditions were: (1) some categories of birth defects, (2) urinary tract disorders, (3) diabetes, (4) eczema and skin conditions, (5) anemia, (6) speech and hearing impairments in children under 10 years of age, and (7) stroke. Excess rates were used to estimate the excess number of cases occurring among the total population living within one-half mile of 258 Superfund sites. These sites had evidence of completed human exposure pathways for VOCs in drinking water. For each type of medical condition, an individual`s expected medical costs, long-term care costs, and lost work time due to illness or premature mortality were estimated. Costs were calculated to be approximately $330 million per year, in the absence of any remediation or public health intervention programs. The results indicate the general magnitude of the economic burden associated with a limited number of contaminants at a portion of all Superfund sites, thus suggesting that the burden would be greater than that estimated in this study if all contaminants at all Superfund sites could be taken into account.

  17. Influence of Dopaminergic Medication on Conditioned Pain Modulation in Parkinson's Disease Patients

    PubMed Central

    Buhmann, Carsten; Forkmann, Katarina; Diedrich, Sabrina; Wesemann, Katharina; Bingel, Ulrike

    2015-01-01

    Background Pain is highly prevalent in patients with Parkinson’s disease (PD), but little is known about the underlying pathophysiological mechanisms. The susceptibility to pain is known to depend on ascending and descending pathways. Because parts of the descending pain inhibitory system involve dopaminergic pathways, dysregulations in dopaminergic transmission might contribute to altered pain processing in PD. Deficits in endogenous pain inhibition can be assessed using conditioned pain modulation (CPM) paradigms. Methods Applying such a paradigm, we investigated i) whether CPM responses differ between PD patients and healthy controls, ii) whether they are influenced by dopaminergic medication and iii) whether there are effects of disease-specific factors. 25 patients with idiopathic PD and 30 healthy age- and gender-matched controls underwent an established CPM paradigm combining heat pain test stimuli at the forearm and the cold pressor task on the contralateral foot as the conditioning stimulus. PD patients were tested under dopaminergic medication and after at least 12 hours of medication withdrawal. Results No significant differences between CPM responses of PD patients and healthy controls or between PD patients “on” and “off” medication were found. These findings suggest (i) that CPM is insensitive to dopaminergic modulations and (ii) that PD is not related to general deficits in descending pain inhibition beyond the known age-related decline. However, at a trend level, we found differences between PD subtypes (akinetic-rigid, tremor-dominant, mixed) with the strongest impairment of pain inhibition in the akinetic-rigid subtype. Conclusions There were no significant differences between CPM responses of patients compared to healthy controls or between patients “on” and “off” medication. Differences between PD subtypes at a trend level point towards different pathophysiological mechanisms underlying the three PD subtypes which warrant further investigation and potentially differential therapeutic strategies in the future. PMID:26270817

  18. Medical Conditions of Hazardous Drinkers and Drug Users in Primary Care Clinics in Cape Town, South Africa

    PubMed Central

    Mertens, Jennifer R.; Flisher, Alan J.; Ward, Catherine L.; Bresick, Graham F.; Sterling, Stacy A.; Weisner, Constance M.

    2010-01-01

    Research has identified a wide range of health conditions related to alcohol and drug use in studies conducted primarily in developed countries and in populations with severe alcohol and drug problems. Little is known about medical conditions in those with less severe alcohol and drug use in developing countries. We used WHO AUDIT and ASSIST screeners to identify hazardous drinking or drug use in public health clinics in Cape Town, South Africa, and included questions about doctor-diagnosed medical conditions. Using logistic regression we examined the relationship of medical conditions to hazardous alcohol, drug and tobacco use. Those with hazardous substance use had higher prevalence of many health conditions including tuberculosis. Hepatitis B, migraine, chronic bronchitis, and liver cirrhosis. Optimal treatment for some medical conditions may include treatment of underlying hazardous substance use, particularly use of drugs other than alcohol. In these populations, access to substance use treatment is limited and even brief interventions or advice may be useful. PMID:21197147

  19. Use of an emergency medical pictorial communication book during simulated disaster conditions.

    PubMed

    Behar, Solomon; Benson Ii, Richard; Kurzweil, Ami; Azen, Colleen; Nager, Alan L

    2013-10-01

    During disasters, the needs of victims outstrip available resources. Rapid assessment of patients must be performed; however, language barriers can be an impediment to efficient patient assessment, especially if interpreter resources are limited. Dependency on interpretive services requiring technology such a telephones, cell phones, and video conferencing may be inefficient, as they may be unavailable during disaster conditions. A low-tech, portable tool that aids in communication with non-English speakers would be beneficial. The medical emergency communication (MEC) book, developed at Children's Hospital Los Angeles, has the potential to be a useful tool in this capacity. The goal of this pilot study was to compare the accuracy of a newly developed disaster-focused medical history obtained from Spanish-speaking patients or caregivers using the MEC book, compared to a control group with whom no book was used. Our hypothesis was that use of the MEC book improves accuracy of medical history taking between English-only speaking health care workers and Spanish-speaking patients better than a monolingual clinician trying to take a medical history without it. We anticipated a higher overall score in the group of subjects whose histories were taken using the MEC book than in the control group. Patient satisfaction with the MEC book also was measured. PMID:24274127

  20. Leisure Engagement: Medical Conditions, Mobility Difficulties, and Activity Limitations—A Later Life Perspective

    PubMed Central

    Nilsson, Ingeborg; Nyqvist, Fredrica; Gustafson, Yngve; Nygård, Mikael

    2015-01-01

    Objectives. This study aims to investigate the impact of medical conditions, mobility difficulties, and activity limitations on older people's engagement in leisure activities. Methods. The analyses are based on a cross regional survey carried out in 2010 in the Bothnia region (Northern Sweden and Western Finland). A posted questionnaire, which included questions on different aspects of leisure engagement, medical history, and health, was sent out to older persons in the region. The final sample consisted of 5435 persons aged 65, 70, 75, and 80 years. The data was analyzed by using ordinary least squares (OLS) multivariate regression. Results. The most important predictor of leisure engagement abstention among older people is the prevalence of activity limitations, whereas mobility difficulties and medical conditions play less important roles. The strong negative association between activity limitations and leisure engagement remains significant even after we control for individual, sociodemographic characteristics, and country. Discussion. This study provides a window into leisure engagement in later life and factors influencing the magnitude of engagement in leisure activities. PMID:26346706

  1. Leisure Engagement: Medical Conditions, Mobility Difficulties, and Activity Limitations-A Later Life Perspective.

    PubMed

    Nilsson, Ingeborg; Nyqvist, Fredrica; Gustafson, Yngve; Nygård, Mikael

    2015-01-01

    Objectives. This study aims to investigate the impact of medical conditions, mobility difficulties, and activity limitations on older people's engagement in leisure activities. Methods. The analyses are based on a cross regional survey carried out in 2010 in the Bothnia region (Northern Sweden and Western Finland). A posted questionnaire, which included questions on different aspects of leisure engagement, medical history, and health, was sent out to older persons in the region. The final sample consisted of 5435 persons aged 65, 70, 75, and 80 years. The data was analyzed by using ordinary least squares (OLS) multivariate regression. Results. The most important predictor of leisure engagement abstention among older people is the prevalence of activity limitations, whereas mobility difficulties and medical conditions play less important roles. The strong negative association between activity limitations and leisure engagement remains significant even after we control for individual, sociodemographic characteristics, and country. Discussion. This study provides a window into leisure engagement in later life and factors influencing the magnitude of engagement in leisure activities. PMID:26346706

  2. Gains in medication affordability following Medicare Part D are eroding among elderly with multiple chronic conditions

    PubMed Central

    Naci, Huseyin; Soumerai, Stephen B; Ross-Degnan, Dennis; Zhang, Fang; Briesacher, Becky A; Gurwitz, Jerry H; Madden, Jeanne M

    2014-01-01

    Elderly Americans, especially those with multiple chronic conditions, face difficulties paying for prescriptions, resulting in worse adherence and discontinuation of therapy (“cost-related medication nonadherence” or CRN). We investigated whether the gains in medication affordability attributable to Medicare Part D implementation in January 2006 persisted during the six years that followed. Overall, we found continued incremental improvements in medication affordability in the early years of Part D (2007–2009), which then eroded during more recent years (2009–2011). Among elderly beneficiaries with four or more chronic conditions, we observed an increase in the prevalence of CRN from 14.4% in 2009 to 17.0% in 2011, reversing previous downward trends. Similarly, the prevalence of forgoing basic needs in order to purchase medicines among the sickest elderly decreased from 8.7% in 2007 to 6.8% in 2009, then rose to 10.2% in 2011. Our findings highlight the need for targeted policy efforts to alleviate the persistent burden of drug treatment costs in this vulnerable population. PMID:25092846

  3. The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

    NASA Technical Reports Server (NTRS)

    Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G., Jr.

    2015-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting mass and volume constraints.

  4. The Integrated Medical Model: A Probabilistic Simulation Model for Predicting In-Flight Medical Risks

    NASA Technical Reports Server (NTRS)

    Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G.

    2015-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting mass and volume constraints.

  5. Novel application of stereotactic ablative radiotherapy using CyberKnife® for early-stage renal cell carcinoma in patients with pre-existing chronic kidney disease: Initial clinical experiences

    PubMed Central

    LO, CHENG-HSIANG; HUANG, WEN-YEN; CHAO, HSING-LUNG; LIN, KUEN-TZE; JEN, YEE-MIN

    2014-01-01

    The treatment of renal cell carcinoma (RCC) in patients diagnosed with chronic kidney disease (CKD) requires particular care in order to preserve the remaining renal function. The present study aimed to investigate the potential of a novel nephron-sparing treatment, which is capable of targeting tumors embedded deep within tissues. The present study analyzed three patients, with pre-existing CKD and multiple comorbidities, who were successfully treated for stage I RCC using the CyberKnife® stereotactic ablative radiotherapy (SABR) system. The total prescribed dose was 40 Gy in five fractions administered over five consecutive days. Treatment efficiency was determined using computed tomography scans of the tumors and periodic measurements of the glomerular filtration rate over a period of 12–40 months. Local control, defined as a radiologically stable condition, was achieved in all patients. Lung metastasis was observed in one patient nine months after SABR; however, the side-effects were generally mild and self-limiting. One patient developed renal failure 26 months after SABR, while the severity of CKD was only marginally altered in the other two patients and renal failure did not occur. In conclusion, in the present study, SABR with CyberKnife® was observed to be well tolerated in the patients, with an acceptable acute toxicity effect. Therefore, it may represent a potential therapeutic option for patients with early-stage RCC who have previously been diagnosed with CKD, but for whom other nephron-sparing treatments are contraindicated. PMID:24959276

  6. Factors Associated with Perceived Uncertainty among Parents of Children with Undiagnosed Medical Conditions

    PubMed Central

    Madeo, Anne C.; O'Brien, Kathleen E.; Bernhardt, Barbara A.; Biesecker, Barbara B.

    2012-01-01

    Uncertainty is a pervasive characteristic of illness. Yet little is known about the individual or situational factors that contribute to perceptions of uncertainty. The present study aims to examine the factors that contribute to perceived uncertainty among parents of a child with an undiagnosed condition. Two hundred sixty-six parents of a child, or children, affected by an undiagnosed medical condition for at least two years completed an electronically administered mixed-methods survey assessing theoretical predictors of perceived uncertainty. Multivariate linear regression analyses were used to identify the relationship of key variables to perceived uncertainty. Parents' perceived control and optimism were negatively associated with uncertainty (B = ?4.044, p ? 0.001, B = ?0.477, p ? 0.05). Subjective disease severity was positively associated with perceived uncertainty (B = 1.797, p ? 0.05). Our findings suggest that parents who experience greater uncertainty feel less control over their child's medical condition, which may lead to less effective coping and poorer adaptation. Parents who are less optimistic or who perceive their child's disease as more severe may benefit most from interventions that target situations where parents perceive the least control, thereby enhancing coping and ultimately, adaptation. PMID:22711240

  7. An Integral Effects Test in a zion-like geometry to investigate the effects of pre-existing hydrogen on direct containment heating in the Surtsey Test Facility

    SciTech Connect

    Allen, M.D.; Blanchat, T.K.; Pilch, M. ); Nichols, R.T. )

    1993-01-01

    The sixth experiment of the Integral Effects Test (IET-6) series was conducted to investigate the effects of high pressure melt ejection on direct containment heating. Scale models of the Zion reactor pressure vessel (RPV), cavity, instrument tunnel, and subcompartment structures were constructed in the Surtsey Test Facility at Sandia National Laboratories. The RPV was modeled with a melt generator that consisted of a steel pressure barrier, a cast MgO crucible, and a thin steel inner liner. The melt generator/crucible had a hemispherical bottom head containing a graphite limitor plate with a 4-cm exit hole to simulate the ablated hole in the RPV bottom head that would be formed by ejection of an instrument guide tube in a severe nuclear power plant accident. The cavity contained 3.48 kg of water, which corresponds to condensate levels in the Zion plant, and the containment basement floor was dry. A 43-kg initial charge of iron oxide/aluminum/chromium thermite was used to simulate corium debris on the bottom head of the RPV. Molten thermite was ejected by steam at an initial pressure of 6.3 MPa into the reactor cavity. The Surtsey vessel atmosphere contained pre-existing hydrogen to represent partial oxidation of the zirconium in the Zion core. The initial composition of the vessel atmosphere was 87.1 mol.% N[sub 2], 9.79 mol.% O[sub 2], and 2.59 mol.% H[sub 2], and the initial absolute pressure was 198 kPa. A partial hydrogen burn occurred in the Surtsey vessel. The peak vessel pressure increase was 279 kPa in IET-6, compared to 246 kPa in the IET-3 test. The total debris mass ejected into the Surtsey vessel in IET-6 was 42.5 kg. The gas grab sample analysis indicated that there were 180 g[center dot] moles of pre-existing hydrogen, and that 308[center dot]moles of hydrogen were produced by steam/metal reactions. About 335 g[center dot]moles of hydrogen burned, and 153 g[center dot]moles remained unreacted.

  8. Concomitant Medical Conditions and Therapies Preclude Accurate Classification of Children With Severe or Severe Complicated Clostridium difficile Infection.

    PubMed

    Kociolek, Larry K; Patel, Sameer J; Shulman, Stanford T; Gerding, Dale N

    2015-12-01

    Severe and severe complicated Clostridium difficile infections (SCDI/SCCDI) were retrospectively assessed in a pediatric cohort. Underlying medical conditions and concomitant medical therapy preclude accurate classification of children with SCDI/SCCDI, using current CDI severity definitions. Revised CDI definitions in children should focus on more objective, age-appropriate, and CDI-specific markers of severity. PMID:26582882

  9. The State of Health in Older Adults in Japan: Trends in Disability, Chronic Medical Conditions and Mortality

    PubMed Central

    Ishii, Shinya; Ogawa, Sumito; Akishita, Masahiro

    2015-01-01

    Both life expectancy and healthy life expectancy in Japan have been increasing and are among the highest in the world, but the gap between them has also been widening. To examine the recent trends in old age disability, chronic medical conditions and mortality in Japan, we retrospectively analyzed three nationally representative datasets: Comprehensive Survey of Living Conditions (2001–2013), Patient Survey (1996–2011) and Vital Statistics (1995–2010). We obtained the sex- and age-stratified trends in disability rate, treatment rates of nine selected chronic medical conditions (cerebrovascular diseases, joint disorders, fractures, osteoporosis, ischemic heart disease, diabetes mellitus, hypertension, pneumonia and malignant neoplasms), total mortality rate and mortality rates from specific causes (cerebrovascular diseases, heart diseases, pneumonia and malignant neoplasms) in both sexes in four age strata (65–69, 70–74, 75–79, 80–84 years). Disability rates declined significantly in both sexes. Treatment rates of all selected medical conditions also decreased significantly, except for fractures in women and pneumonia. Both total mortality rate and cause-specific mortality rates decreased in both sexes. We concluded that the recent decline in disability rates, treatment rates of chronic medical conditions and mortality rates points toward overall improvement in health conditions in adults over the age of 65 years in Japan. Nonetheless, considering the increase in the number of older adults, the absolute number of older adults with disability or chronic medical conditions will continue to increase and challenge medical and long-term care systems. PMID:26431468

  10. Effects of pre-existing hearing loss on proposed ANSI S12.13 outcomes for characterizing hearing conservation program effectiveness: follow-up investigation.

    PubMed

    Simpson, T H; Amos, N; Rintelmann, W F

    1998-04-01

    Draft ANSI S12.13 1991 Standard Evaluating the Effectiveness of Hearing Conservation Programs presents statistical protocols purportedly sensitive to temporary threshold shift (TTS) in occupational hearing conservation program (HCP) audiometric databases. Because it is well established that less TTS is found in humans with hearing loss than in those with essentially normal hearing, one might predict baseline hearing level to be a confounding variable in interpreting ANSI S12.13 outcomes, with better-hearing industrial populations tending to demonstrate greater year-to-year audiometric variability than poorer-hearing groups. However, in a large industrial sample from the public domain audiometric database, poorer-hearing groups systematically demonstrated greater audiometric threshold variability than better-hearing groups, and ANSI S12.13 outcome magnitudes were highly positively correlated to baseline hearing levels. These findings generally do not support notions that ANSI S12.13 outcomes clearly provide indirect measures of TTS. HCP managers should exercise extreme caution in interpreting ANSI S12.13 outcomes to rate overall program performance. In particular, HCP managers should not rely upon these outcomes for decisions regarding hearing protection policies without careful consideration of pre-existing hearing loss in the populations involved. PMID:9564673

  11. Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System

    PubMed Central

    Carone, Marco; Al-Saedy, Huda; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Black, Robert E

    2012-01-01

    Abstract Objective To determine the range and burden of health services utilization among Iraqi refugees receiving health assistance in Jordan, a country of first asylum. Methods Medical conditions, diagnosed in accordance with the tenth revision of the International classification of diseases, were actively monitored from 1January to 31December 2010 using a pilot centralized database in Jordan called the Refugee Assistance Information System. Findings There were 27?166 medical visits by 7642 Iraqi refugees (mean age: 37.4 years; 49% male; 70% from Baghdad; 6% disabled; 3% with a history of torture). Chronic diseases were common, including essential hypertension (22% of refugees), visual disturbances (12%), joint disorders (11%) and type II diabetes mellitus (11%). The most common reasons for seeking acute care were upper respiratory tract infection (11%), supervision of normal pregnancy (4%) and urinary disorders (3%). The conditions requiring the highest number of visits per refugee were cerebrovascular disease (1.46 visits), senile cataract (1.46) and glaucoma (1.44). Sponsored care included 31?747 referrals or consultations to a specialty service, 18?432 drug dispensations, 2307 laboratory studies and 1090 X-rays. The specialties most commonly required were ophthalmology, dentistry, gynaecology and orthopaedic surgery. Conclusion Iraqi refugees in countries of first asylum and resettlement require targeted health services, health education and sustainable prevention and control strategies for predominantly chronic diseases. PMID:22690034

  12. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...governing body for the quality of medical care provided to patients. Medical director responsibilities...improvement program. (b) Staff education, training, and performance...Policies and procedures. The medical director must— (1)...

  13. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...governing body for the quality of medical care provided to patients. Medical director responsibilities...improvement program. (b) Staff education, training, and performance...Policies and procedures. The medical director must— (1)...

  14. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...governing body for the quality of medical care provided to patients. Medical director responsibilities...improvement program. (b) Staff education, training, and performance...Policies and procedures. The medical director must— (1)...

  15. 20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... more than one wound or medical condition, can the refundable disbursements paid on a single FECA claim... received for more than one wound or medical condition, can the refundable disbursements paid on a single... to the United States? (a) All wounds, diseases or other medical conditions accepted by OWCP...

  16. 20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... more than one wound or medical condition, can the refundable disbursements paid on a single FECA claim... received for more than one wound or medical condition, can the refundable disbursements paid on a single... to the United States? (a) All wounds, diseases or other medical conditions accepted by OWCP...

  17. 20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... more than one wound or medical condition, can the refundable disbursements paid on a single FECA claim... received for more than one wound or medical condition, can the refundable disbursements paid on a single... to the United States? (a) All wounds, diseases or other medical conditions accepted by OWCP...

  18. 20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... more than one wound or medical condition, can the refundable disbursements paid on a single FECA claim... received for more than one wound or medical condition, can the refundable disbursements paid on a single... to the United States? (a) All wounds, diseases or other medical conditions accepted by OWCP...

  19. 20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... more than one wound or medical condition, can the refundable disbursements paid on a single FECA claim... received for more than one wound or medical condition, can the refundable disbursements paid on a single... to the United States? (a) All wounds, diseases or other medical conditions accepted by OWCP...

  20. Assessment of medical students’ proficiency in dermatology: Are medical students adequately prepared to diagnose and treat common dermatologic conditions in the United States?

    PubMed Central

    Ulman, Catherine A.; Binder, Stephen Bruce; Borges, Nicole J.

    2015-01-01

    This study assessed whether a current medical school curriculum is adequately preparing medical students to diagnose and treat common dermatologic conditions. A 15-item anonymous multiple choice quiz covering fifteen diseases was developed to test students’ ability to diagnose and treat common dermatologic conditions. The quiz also contained five items that assessed students’ confidence in their ability to diagnose common dermatologic conditions, their perception of whether they were receiving adequate training in dermatology, and their preferences for additional training in dermatology. The survey was performed in 2014, and was completed by 85 students (79.4%). Many students (87.6%) felt that they received inadequate training in dermatology during medical school. On average, students scored 46.6% on the 15-item quiz. Proficiency at the medical school where the study was performed is considered an overall score of greater than or equal to 70.0%. Students received an average score of 49.9% on the diagnostic items and an average score of 43.2% on the treatment items. The findings of this study suggest that United States medical schools should consider testing their students and assessing whether they are being adequately trained in dermatology. Then schools can decide if they need to re-evaluate the timing and delivery of their current dermatology curriculum, or whether additional curriculum hours or clinical rotations should be assigned for dermatologic training. PMID:25989840

  1. Sensitive Detection of Pre-Existing BCR-ABL Kinase Domain Mutations in CD34+ Cells of Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia Patients Is Associated with Imatinib Resistance: Implications in the Post-Imatinib Era

    PubMed Central

    Iqbal, Mudassar; Naqvi, Mubashar Iqbal; Gill, Ammara; Taj, Abid Sohail; Qayyum, Abdul; ur-Rehman, Najeeb; Khalid, Ahmad Mukhtar; Shah, Ijaz Hussain; Khalid, Muhammad; Haq, Riazul; Khan, Mahwish; Baig, Shahid Mahmood; Jamil, Abid; Abbas, Muhammad Naeem; Absar, Muhammad; Mahmood, Amer; Rasool, Mahmood; Akhtar, Tanveer

    2013-01-01

    Background BCR-ABL kinase domain mutations are infrequently detected in newly diagnosed chronic-phase chronic myeloid leukemia (CML) patients. Recent studies indicate the presence of pre-existing BCR-ABL mutations in a higher percentage of CML patients when CD34+ stem/progenitor cells are investigated using sensitive techniques, and these mutations are associated with imatinib resistance and disease progression. However, such studies were limited to smaller number of patients. Methods We investigated BCR-ABL kinase domain mutations in CD34+ cells from 100 chronic-phase CML patients by multiplex allele-specific PCR and sequencing at diagnosis. Mutations were re-investigated upon manifestation of imatinib resistance using allele-specific PCR and direct sequencing of BCR-ABL kinase domain. Results Pre-existing BCR-ABL mutations were detected in 32/100 patients and included F311L, M351T, and T315I. After a median follow-up of 30 months (range 8–48), all patients with pre-existing BCR-ABL mutations exhibited imatinib resistance. Of the 68 patients without pre-existing BCR-ABL mutations, 24 developed imatinib resistance; allele-specific PCR and BCR-ABL kinase domain sequencing detected mutations in 22 of these patients. All 32 patients with pre-existing BCR-ABL mutations had the same mutations after manifestation of imatinib-resistance. In imatinib-resistant patients without pre-existing BCR-ABL mutations, we detected F311L, M351T, Y253F, and T315I mutations. All imatinib-resistant patients except T315I and Y253F mutations responded to imatinib dose escalation. Conclusion Pre-existing BCR-ABL mutations can be detected in a substantial number of chronic-phase CML patients by sensitive allele-specific PCR technique using CD34+ cells. These mutations are associated with imatinib resistance if affecting drug binding directly or indirectly. After the recent approval of nilotinib, dasatinib, bosutinib and ponatinib for treatment of chronic myeloid leukemia along with imatinib, all of which vary in their effectiveness against mutated BCR-ABL forms, detection of pre-existing BCR-ABL mutations can help in selection of appropriate first-line drug therapy. Thus, mutation testing using CD34+ cells may facilitate improved, patient-tailored treatment. PMID:23409026

  2. General Medical Considerations for the Wilderness Adventurer: Medical Conditions That May Worsen With or Present Challenges to Coping With Wilderness Exposure.

    PubMed

    Cushing, Tracy A; Roberts, William O; Hackett, Peter; Dexter, William W; Brent, Jeff S; Young, Craig C; Fudge, Jessie R; Hawkins, Seth C; DeLoughery, Thomas G; Thomas, Benjamin J; Tabin, Geoffrey C; Jacoby, Leah E; Asplund, Chad A

    2015-09-01

    Participation in wilderness and adventure sports is on the rise, and as such, practitioners will see more athletes seeking clearance to participate in these events. The purpose of this article is to describe specific medical conditions that may worsen or present challenges to the athlete in a wilderness environment. PMID:26340731

  3. The efficacy of sodium bicarbonate in preventing contrast-induced nephropathy in patients with pre-existing renal insufficiency: a meta-analysis

    PubMed Central

    Zhang, Bin; Liang, Long; Chen, Wenbo; Liang, Changhong; Zhang, Shuixing

    2015-01-01

    Objective The aim of this meta-analysis was to explore the efficacy of sodium bicarbonate in preventing contrast-induced nephropathy (CIN). Methods We searched PubMed, Medline and the Cochrane Library from 1 January 2004 to 1 August 2014. The effect estimate was expressed as a pooled OR with 95% CI, using the fixed-effects or random-effects model. Results 20 randomised controlled trials (n=4280) were identified. Hydration with sodium bicarbonate was associated with a significant decrease in CIN among patients with pre-existing renal insufficiency (OR 0.67, 95% CI 0.47 to 0.96; p=0.027). However, moderate heterogeneity was noted across trials (I2=48%; p=0.008). Subgroup analyses indicated a better effect of sodium bicarbonate in studies using low-osmolar (OR 0.59, 95% CI 0.37 to 0.93; p=0.024) compared with iso-osmolar contrast agents (OR 0.76, 95% CI 0.43 to 1.34; p=0.351). The odds of CIN with sodium bicarbonate were lower in studies including only patients undergoing emergency (OR 0.16, 95% CI 0.05 to 0.51; p=0.002) compared with elective procedures (OR 0.76, 95% CI 0.54 to 1.06; p=0.105). Sodium bicarbonate was more beneficial in patients given a bolus injection before procedures (OR 0.15, 95% CI 0.04 to 0.54; p=0.004) compared with continuous infusion (OR 0.75, 95% CI 0.53 to 1.05; p=0.091). Sodium bicarbonate plus N-acetylcysteine (OR 0.17, 95% CI 0.04 to 0.79; p=0.024) was better than sodium bicarbonate alone (OR 0.71, 95% CI 0.48 to 1.03; p=0.071). The effect of sodium bicarbonate was considered greater in papers published before (OR 0.19, 95% CI 0.09 to 0.41; p=0.000) compared with after 2008 (OR 0.85, 95% CI 0.62 to 1.16; p=0.302). However, no significant differences were found in mortality (OR 0.69, 95% CI 0.36 to 1.32; p=0.263) or requirement for dialysis (OR 1.08, 95% CI 0.52 to 2.25; p=0.841). Conclusions Sodium bicarbonate is effective in preventing CIN among patients with pre-existing renal insufficiency. However, it fails to lower the risks of dialysis and mortality and therefore cannot improve the clinical prognosis of patients with CIN. PMID:25783425

  4. Influence of pre-existing basement faults on the structural evolution of the Zagros Simply Folded belt: 3D numerical modelling

    NASA Astrophysics Data System (ADS)

    Ruh, Jonas B.; Gerya, Taras

    2015-04-01

    The Simply Folded Belt of the Zagros orogen is characterized by elongated fold trains symptomatically defining the geomorphology along this mountain range. The Zagros orogen results from the collision of the Arabian and the Eurasian plates. The Simply Folded Belt is located southwest of the Zagros suture zone. An up to 2 km thick salt horizon below the sedimentary sequence enables mechanical and structural detachment from the underlying Arabian basement. Nevertheless, deformation within the basement influences the structural evolution of the Simply Folded Belt. It has been shown that thrusts in form of reactivated normal faults can trigger out-of-sequence deformation within the sedimentary stratigraphy. Furthermore, deeply rooted strike-slip faults, such as the Kazerun faults between the Fars zone in the southeast and the Dezful embayment and the Izeh zone, are largely dispersing into the overlying stratigraphy, strongly influencing the tectonic evolution and mechanical behaviour. The aim of this study is to reveal the influence of basement thrusts and strike-slip faults on the structural evolution of the Simply Folded Belt depending on the occurrence of intercrustal weak horizons (Hormuz salt) and the rheology and thermal structure of the basement. Therefore, we present high-resolution 3D thermo-mechnical models with pre-existing, inversively reactivated normal faults or strike-slip faults within the basement. Numerical models are based on finite difference, marker-in-cell technique with (power-law) visco-plastic rheology accounting for brittle deformation. Preliminary results show that deep tectonic structures present in the basement may have crucial effects on the morphology and evolution of a fold-and-thrust belt above a major detachment horizon.

  5. Dental Erosion and Medical Conditions An Overview of Aetiology, Diagnosis and Management

    PubMed Central

    Paryag, A; Rafeek, R

    2014-01-01

    ABSTRACT Tooth wear or tooth surface loss is a normal physiological process and occurs throughout life but is considered pathological when the degree of destruction is excessive or the rate of loss is rapid, causing functional, aesthetic or sensitivity problems. The importance of tooth wear as a dental problem has been increasingly recognized. The findings of a study in Trinidad indicate that the prevalence of tooth wear in a Trinidadian population is comparable to the United Kingdom (UK) and, indeed, that the level of moderate and severe wear is nearly twice as high. The aetiology of tooth wear is attributed to four causes: erosion, attrition, abrasion and abfraction. Erosion is generally considered to be the most prevalent cause of tooth wear in the UK and Europe. Acids that cause dental erosion originate mainly from the diet or the stomach and, to a lesser extent, the environment. Underlying medical problems can contribute to influence the progress of tooth wear due to erosion and the patient may not be aware of these conditions. Moderate to severe tooth wear poses a significant clinical challenge to dental practitioners and may result in treatment that is more complex and costly to the patient, both in terms of finances and time spent in the dental chair. This paper provides an overview of aetiology and diagnosis of tooth wear, in particular tooth wear due to erosion, so that medical and dental practitioners may recognize tooth wear early, institute preventive measures and manage patients appropriately. PMID:25781289

  6. Comorbid Medical Conditions in Vascular Dementia: A Matched Case-Control Study.

    PubMed

    Habeych, Miguel E; Castilla-Puentes, Ruby

    2015-08-01

    The objective of the study was to compare the presence of comorbid medical conditions between patients with a vascular dementia (VaD) and a control group, from the Integrated Healthcare Information Services (IHCIS) database. VaD was defined by the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 290.40, 290.4, 290.41, 290.42, and, 290.43. An individual matching method was used to select the controls, which were matched to cases on a 15:1 ratio by age, gender, type of health plan, and pharmacy benefits. Alzheimer's disease, any other dementia or cognitive deficits associated were considered exclusion criteria. Among the IHCIS patients 60 years of age or older and full year of eligibility during 2010, there were 898 VaD patients, from which 63.6% were women. Concurrent presence of cerebrovascular disease, atherosclerosis, heart failure, and atrial fibrillation were found at 12.6, 4.6, 2.8, and 1.7 times higher in VaD patients, respectively. Compared to controls, VaD patients had more septicemia, injuries, lung diseases including chronic obstructive pulmonary disease, and urinary diseases (all with df = 897,1; p < 0.0001). The present study confirms that these four medical comorbidities are frequent complications of VaD and physicians should be alert to the presence of them in patients with VaD. PMID:26230648

  7. Factors associated with geographic variation in cost per episode of care for three medical conditions

    PubMed Central

    2014-01-01

    Objective To identify associations between market factors, especially relative reimbursement rates, and the probability of surgery and cost per episode for three medical conditions (cataract, benign prostatic neoplasm, and knee degeneration) with multiple treatment options. Methods We use 2004–2006 Medicare claims data for elderly beneficiaries from sixty nationally representative communities to estimate multivariate models for the probability of surgery and cost per episode of care as a function local market factors, including Medicare physician reimbursement for surgical versus non-surgical treatment and the availability of primary care and specialty physicians. We used Symmetry’s Episode Treatment Groups (ETG) software to group claims into episodes for the three conditions (n?=?540,874 episodes). Results Higher Medicare reimbursement for surgical episodes and greater availability of the relevant specialists are significantly associated with more surgery and higher cost per episode for all three conditions, while greater availability of primary care physicians is significantly associated with less frequent surgery and lower cost per episode. Conclusion Relative Medicare reimbursement rates for surgical vs. non-surgical treatments and the availability of both primary care physicians and relevant specialists are associated with the likelihood of surgery and cost per episode. PMID:24949281

  8. Hurricane Katrina’s Impact on the Care of Survivors with Chronic Medical Conditions

    PubMed Central

    2007-01-01

    BACKGROUND Hurricane Katrina affected a population with significant levels of chronic disease. OBJECTIVE The extent to which Hurricane Katrina disrupted treatments is not known but would be useful information for future disaster planning. PARTICIPANTS 1,043 displaced and nondisplaced English-speaking Katrina survivors ages 18 and older who resided in affected areas before the hurricane. DESIGN AND SETTING A geographically representative telephone survey conducted between January 19 and March 31, 2006. MEASUREMENTS AND MAIN RESULTS The proportions of survivors with chronic illnesses in the 12 months before the hurricane and the extent to which those with chronic illnesses cut back or terminated treatments because of the disaster. Correlates and reasons given by survivors for disrupted treatment were identified. Most (73.9%) Katrina survivors had 1 or more chronic conditions in the year before the hurricane; of these, 20.6% cut back or terminated their treatment because of the disaster. Disruptions in treatment were significantly more common among the non-elderly, uninsured, socially isolated, those with housing needs, or for conditions remaining relatively asymptomatic but still dangerous if untreated. Frequent reasons for disrupted care included problems accessing physicians (41.1%), medications (32.5%), insurance/financial means (29.3%), transportation (23.2%), or competing demands on time (10.9%). CONCLUSIONS Many Katrina survivors burdened by chronic disease had their treatments disrupted by the disaster. Future disaster management plans should anticipate and address such chronic care needs, with timely reestablishment of primary care services, access to medications, and means to address financial and structural barriers to treatment. PMID:17657545

  9. Invasive pneumococcal infections among persons with and without underlying medical conditions: Implications for prevention strategies

    PubMed Central

    2008-01-01

    Background The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for persons aged < 65 years with chronic medical conditions. We evaluated the risk and mortality from invasive pneumococcal disease (IPD) among persons with and without the underlying medical conditions which are considered PPV23 indications. Methods Population-based data on all episodes of IPD (positive blood or cerebrospinal fluid culture) reported by Finnish clinical microbiology laboratories during 1995–2002 were linked to data in national health care registries and vital statistics to obtain information on the patient's preceding hospitalisations, co-morbidities, and outcome of illness. Results Overall, 4357 first episodes of IPD were identified in all age groups (average annual incidence, 10.6/100,000). Patients aged 18–49 and 50–64 years accounted for 1282 (29%) and 934 (21%) of IPD cases, of which 372 (29%) and 427 (46%) had a current PPV23 indication, respectively. Overall, 536 (12%) IPD patients died within one month of first positive culture. Persons aged 18–64 years accounted for 254 (47%) of all deaths (case-fatality proportion, 12%). Of those who died 117 (46%) did not have a vaccine indication. In a survival model, patients with alcohol-related diseases, non-haematological malignancies, and those aged 50–64 years were most likely to die. Conclusion In the general population of non-elderly adults, almost two-thirds of IPD and half of fatal cases occurred in persons without a recognised PPV23 indication. Policymakers should consider additional prevention strategies such as lowering the age of universal PPV23 vaccination and introducing routine childhood pneumococcal conjugate immunisation which could provide substantial health benefits to this population through indirect vaccine effects. PMID:18647385

  10. [The Russian Armed Forces Military Medical Service: condition and ways of improvement].

    PubMed

    Fisun, A Ia

    2014-01-01

    In 2013 the main efforts of the Medical Service were aimed at the following tasks: optimization of management system of military medical service, improvement of medical evacuation system, medical service security for military contingents, assigned according to territory principle to military-medical facilities of the Ministry of Defence of the Russian Federation, implementation of innovations at all stages of medical evacuation in peace- and wartime, security of combat and mobilization readiness of regulatory bodies of the Medical Service, medical military units and military medical facilities, medical service of troops battle training, improvement of material and technical resources, security of regular pharmacy and equipment supply, activation of research work in the Medical Service interests. Lines of military medicine development in 2014 are: transfer of treatment facilities that are not used by the Ministry of Defence into the Federal Biomedical Agency till the end of 2014, prevention of pneumonia and meningitis in military personnel, improvement of early diagnosis system, medical service for military contingents according to territory principle, improvement of diagnostic and treatment work in military-medical units and subunits and military-medical facilities by means of development of material and technical resources, monitor the implementation of innovative diagnostic and treatment technologies, completion of construction projects of central military hospitals and etc. PMID:24734429

  11. The Relation Between Smoking Status and Medical Conditions Among Incarcerated Adults

    PubMed Central

    Parker, Donna R.; Fallone, Diandra; Martin, Rosemarie A.; Stein, L. A. R.; Bock, Beth; Martin, Stephen A.; Roberts, Mary B.; Lopes, Cheryl E.; Clarke, Jennifer J.

    2013-01-01

    Objectives The rate of smoking among incarcerated adults is over three times that of the general population. Negative health consequences of smoking have prompted many correctional facilities to become tobacco-free. This presents a unique opportunity to examine health conditions associated with motivation to remain tobacco-free following release from prison. We examined this association among individuals who participated in the WISE randomized clinical trial. Methods 247 participants completed a baseline questionnaire asking about illnesses (both smoking-related and non-smoking related), family history of smoking-related illnesses, demographics and smoking history. Smoking status was assessed 3 weeks post release. Results 38.1% of participants reported having an illness caused by or worsened by smoking and 53.0% reported having “moderate” to “a lot” of concern about their health due to smoking. 22.9% reported having asthma and 26.8% reported hypertension. The adjusted odds of remaining tobacco-free at 3 weeks post-release from a tobacco-free prison was significant only for individuals with a family history of smoking-related illnesses (OR=0.28;95% CI: 0.12–0.68). For individuals with smoking-related conditions, the adjusted odds of remaining tobacco-free was non-significant (OR=1.91;95% CI: 0.85–4.27). Similarly, the adjusted odds of remaining tobacco-free for participants with non-smoking related medical conditions was non-significant (OR=0.27;95% CI: 0.06–1.22) Conclusions These results offer a first look at understanding health conditions as a motivator to remain tobacco-free following release from prison. While these findings require additional investigation, these results suggest that providing treatment to prisoners with chronic disease and specifically targeting smoking related illnesses might be beneficial with regard to smoking cessation success. PMID:24503925

  12. [About development of medical maintenance of military air forces in modern conditions].

    PubMed

    Radchenko, S N; Arsen'ev, Iu G

    2010-10-01

    The authors prove the necessity of transformation of medical service of Air Force of all levels within the framework of the realization of program "Development of medical supply of Armed Forces of Russian Federation 2008-2012". Goals, functions of different elements of medical service, responsibilities of performers are developed. These goals have fundamental differences from previous one. New organizational structure of medical service of Air Forces and criteria of the estimation of its effectiveness are suggested. Offers of further optimization of organizational medical structure and improvement of medical supply of Air Forces are developed. PMID:21254586

  13. Perceptions of the impact of depression and anxiety and the medication for these conditions on safety in the workplace

    PubMed Central

    Haslam, C; Atkinson, S; Brown, S; Haslam, R

    2005-01-01

    Background: The number of people taking prescribed medication for anxiety and depression has increased greatly, but little is known of how this medication impacts on safety at work. Aims: To examine the relation between anxiety and depression, prescribed medication, performance, and safety in the workplace. Methods: The research involved nine focus groups with sufferers of anxiety and depression to investigate experiences of mental health problems and the impact of psychotropic drugs. A further three focus groups were conducted with staff in human resources, personnel, occupational health, and health and safety departments, to explore organisational perspectives. The sample comprised 74 individuals drawn from a wide range of occupational sectors. Finally, the results were presented to a panel of experts from occupational medicine, general practice, psychology, health and safety, and psychiatry, to consider the implications for practice. Results: Workers reported that both the symptoms and the medication impaired work performance. Participants described accidents which they attributed to their condition or to the medication. Workers with responsibilities for others, such as teachers, healthcare workers, and managers appeared to present a particular safety risk. Healthcare workers believed that they placed themselves and their patients at risk when carrying out medical procedures. Conclusions: Respondents in this study felt that their symptoms of anxiety and depression and the medication they took to treat these conditions placed them at risk with respect to safety in the workplace. Drawing on the results, the authors outline areas for improvement in the management of mental health problems at work. PMID:16046606

  14. Testing the influence of vertical, pre-existing joints on normal faulting using analogue and 3D discrete element models (DEM)

    NASA Astrophysics Data System (ADS)

    Kettermann, Michael; von Hagke, Christoph; Virgo, Simon; Urai, Janos L.

    2015-04-01

    Brittle rocks are often affected by different generations of fractures that influence each other. We study pre-existing vertical joints followed by a faulting event. Understanding the effect of these interactions on fracture/fault geometries as well as the development of dilatancy and the formation of cavities as potential fluid pathways is crucial for reservoir quality prediction and production. Our approach combines scaled analogue and numerical modeling. Using cohesive hemihydrate powder allows us to create open fractures prior to faulting. The physical models are reproduced using the ESyS-Particle discrete element Modeling Software (DEM), and different parameters are investigated. Analogue models were carried out in a manually driven deformation box (30x28x20 cm) with a 60° dipping pre-defined basement fault and 4.5 cm of displacement. To produce open joints prior to faulting, sheets of paper were mounted in the box to a depth of 5 cm at a spacing of 2.5 cm. Powder was then sieved into the box, embedding the paper almost entirely (column height of 19 cm), and the paper was removed. We tested the influence of different angles between the strike of the basement fault and the joint set (0°, 4°, 8°, 12°, 16°, 20°, and 25°). During deformation we captured structural information by time-lapse photography that allows particle imaging velocimetry analyses (PIV) to detect localized deformation at every increment of displacement. Post-mortem photogrammetry preserves the final 3-dimensional structure of the fault zone. We observe that no faults or fractures occur parallel to basement-fault strike. Secondary fractures are mostly oriented normal to primary joints. At the final stage of the experiments we analyzed semi-quantitatively the number of connected joints, number of secondary fractures, degree of segmentation (i.e. number of joints accommodating strain), damage zone width, and the map-view area fraction of open gaps. Whereas the area fraction does not change distinctly, the number of secondary fractures and connected joints increases strongly with increasing angles between basement fault and joint strike. Integrating these models with a 3-dimensional DEM code using the ESyS-Particle software allows for retrieving 4D information from the models, as well as for testing other parameters such as joint spacing or joint depth. Our DEM models are capable of robustly reproducing all characteristic features observed in the analogue models, and will provide a quantitative measure of the influence of joint-fault angle on permeability of cohesive rocks that have experienced more than one brittle deformation phase.

  15. 3-D numerical modelling of the influence of reactivated pre-existing faults on the distribution of deformation: example of North-Western Ghana around 2.15-2.00 Ga

    NASA Astrophysics Data System (ADS)

    FENG, Xiaojun; Gerbault, Muriel; Martin, Roland; Ganne, Jérôme; Jessell, Mark

    2015-04-01

    High strain zones appear to play a significant role in feeding the upper crust with fluids and partially molten material from lower crust sources. The Bole-Bulenga terrain (North-Western Ghana) is located in between two subvertical shear zones, and mainly consists of high-grade orthogneisses, paragneisses and metabasites intruded by partially molten lower crustal material with monzogranites and orthogneisses (Eburnean orogeny, around 2.1 Ga). In order to understand the location of these high grade rocks at the edges and in between these two shear zones, a three dimensional numerical model was built to test the influence of different orientations of a system of branched strike-slip faults on visco-plastic deformation, under compressional and simple shear boundary conditions. Our models indicate domains of tensile vs. compressional strain as well as shear zones, and show that not only internal fault zones but also the host rock in between the faults behave relatively softer than external regions. Under both applied compressive and simple shear boundary conditions, these softened domains constitute preferential zones of tensile strain accommodation (dilation) in the upper crust, which may favor infilling by deeper partially molten rocks. Our modeled pre-existing faults zones are assumed to have formed during an early D1 stage of deformation, and they are shown to passively migrate and rotate together with the solid matrix under applied external boundary conditions (corresponding to a post D1 - early D2 phase of deformation). We suggest that in the Bole-Bulenga terrain, fluids or partially molten material stored in deeper crustal domains, preferentially intruded the upper crust within these highly (shear and tensile) strained domains, thanks to this D2 shearing deformation phase. Building relief at the surface is primarily controlled by fault orientations, together with mechanical parameters and external boundary conditions. In particular, greatest magnitudes of relief are obtained when faults dip in parallel one with the other and when they are inclined at depth, as they thus facilitate stress rotation and material transfer from depth. The host rock density does not play a primary role in producing relief compared to variations in friction angle at the crustal scale (30km thick). Relief increases by 200 - 300 m when the host rock density is increased by 200 kg/m3 , whereas relief drops by about 1200 m when decreasing the host rock friction from ? = 20° to 10°.

  16. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... to the governing body for the quality of medical care provided to patients. Medical director responsibilities include, but are not limited to, the following: (a) Quality assessment and performance improvement program. (b) Staff education, training, and performance. (c) Policies and procedures. The medical...

  17. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... to the governing body for the quality of medical care provided to patients. Medical director responsibilities include, but are not limited to, the following: (a) Quality assessment and performance improvement program. (b) Staff education, training, and performance. (c) Policies and procedures. The medical...

  18. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... to the governing body for the quality of medical care provided to patients. Medical director responsibilities include, but are not limited to, the following: (a) Quality assessment and performance improvement program. (b) Staff education, training, and performance. (c) Policies and procedures. The medical...

  19. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... to the governing body for the quality of medical care provided to patients. Medical director responsibilities include, but are not limited to, the following: (a) Quality assessment and performance improvement program. (b) Staff education, training, and performance. (c) Policies and procedures. The medical...

  20. 42 CFR 494.150 - Condition: Responsibilities of the medical director.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... to the governing body for the quality of medical care provided to patients. Medical director responsibilities include, but are not limited to, the following: (a) Quality assessment and performance improvement program. (b) Staff education, training, and performance. (c) Policies and procedures. The medical...

  1. Critical Illness in Pregnancy: Part II: Common Medical Conditions Complicating Pregnancy and Puerperium.

    PubMed

    Guntupalli, Kalpalatha K; Karnad, Dilip R; Bandi, Venkata; Hall, Nicole; Belfort, Michael

    2015-11-01

    The first of this two-part series on critical illness in pregnancy dealt with obstetric disorders. In Part II, medical conditions that commonly affect pregnant women or worsen during pregnancy are discussed. ARDS occurs more frequently in pregnancy. Strategies commonly used in nonpregnant patients, including permissive hypercapnia, limits for plateau pressure, and prone positioning, may not be acceptable, especially in late pregnancy. Genital tract infections unique to pregnancy include chorioamnionitis, group A streptococcal infection causing toxic shock syndrome, and polymicrobial infection with streptococci, staphylococci, and Clostridium perfringens causing necrotizing vulvitis or fasciitis. Pregnancy predisposes to VTE; D-dimer levels have low specificity in pregnancy. A ventilation-perfusion scan is preferred over CT pulmonary angiography in some situations to reduce radiation to the mother's breasts. Low-molecular-weight or unfractionated heparins form the mainstay of treatment; vitamin K antagonists, oral factor Xa inhibitors, and direct thrombin inhibitors are not recommended in pregnancy. The physiologic hyperdynamic circulation in pregnancy worsens many cardiovascular disorders. It increases risk of pulmonary edema or arrhythmias in mitral stenosis, heart failure in pulmonary hypertension or aortic stenosis, aortic dissection in Marfan syndrome, or valve thrombosis in mechanical heart valves. Common neurologic problems in pregnancy include seizures, altered mental status, visual symptoms, and strokes. Other common conditions discussed are aspiration of gastric contents, OSA, thyroid disorders, diabetic ketoacidosis, and cardiopulmonary arrest in pregnancy. Studies confined to pregnant women are available for only a few of these conditions. We have, therefore, reviewed pregnancy-specific adjustments in the management of these disorders. PMID:26020727

  2. Urgent carotid endarterectomy is safe in patients with few comorbid medical conditions.

    PubMed

    Bazan, Hernan A; Pradhan, Sanjeev; Westvik, Tormod S; Sumpio, Bauer E; Gusberg, Richard J; Dardik, Alan

    2008-01-01

    Recent reports from single institutions have confirmed the efficacy of carotid endarterectomy (CEA) performed in the urgent or emergent setting, although with higher perioperative mortality and morbidity. We determined the results of urgently performed CEA in academic and community hospitals and whether patient or hospital factors affected outcome. The records of patients undergoing CEA in all nonfederal hospitals in the state of Connecticut between 1992 and 2002 were reviewed, and symptomatic patients who presented in an urgent or emergent fashion were compared to patients treated electively. Multivariable logistic regression was used to determine the effect of patient risk factors on perioperative mortality, stroke, and cardiac complications. Patients undergoing urgent CEA (n = 764, 6.3%) had higher perioperative mortality (2.0% vs. 0.3%, p < 0.0001) and stroke (2.9% vs. 1.1%, p < 0.0001) but not cardiac complications (3.0% vs. 2.2%, p = 0.14) compared to patients undergoing elective CEA (n = 11,312). Patients undergoing urgent CEA and with high rates of associated comorbidity had a higher risk of perioperative mortality (7.8% vs. 0.4, p = 0.001), stroke (10.9% vs. 0.8%, p = 0.0002), and cardiac complications (14.1% vs. 0.8%, p < 0.0001) compared to patients presenting urgently but with little comorbidity. Perioperative mortality was associated with performance of the procedure in hospitals with low bed capacity (odds ratio [OR] = 4.6, p = 0.01). Perioperative stroke was associated with renal insufficiency (OR = 5.3, p = 0.04). Perioperative cardiac complications were associated with diabetes (OR = 2.6, p = 0.03) and performance in hospitals with low bed capacity (OR = 5.0, p < 0.01). Urgent admission was associated with age >/=80 (OR = 1.2, p = 0.04), renal disease (OR = 1.8, p = 0.05), and cardiac disease (OR = 1.3, p < 0.01). Urgently performed CEA has higher perioperative mortality and stroke compared with electively performed cases. However, the subset of patients with low rates of associated comorbid medical conditions but urgently needing CEA is associated with low rates of perioperative complications. Patients with severe associated comorbid medical conditions who present urgently for CEA may form a high-risk group of patients to be considered for referral to large treatment centers or possibly alternative therapy. PMID:18462920

  3. [Towards the problem of necessity to reduce the medical evacuation stages in conditions of local wars and armed conflicts].

    PubMed

    Ga?dar, B V; Ivantsov, V A; Sidel'nikov, V O; Rusev, I T; Mada?, D Iu; Kokoev, V G; Zinov'ev, E V; Mutalibov, M M

    2004-06-01

    The article is devoted to the review of modern opinions concerning the experience of military operation medical support in conditions of local wars and military conflicts. On the base of analysis of medical assistance rendered to the wounded and casualties in Republic of Chechnya the advantages and defects of different approaches are discussed. The experience in rendering assistance to the casualties in the Armed Forces of NATO countries during the local wars for the last decades is discussed. It is shown that the optimal variant of organization of treatment-and-evacuation measures during the local armed conflicts and wars is the two-stage scheme of evacuation: the first medical aid--the qualified (specialized) medical aid. PMID:15327132

  4. Chronic kidney disease is associated with a higher 90-day mortality than other chronic medical conditions in patients with sepsis

    PubMed Central

    Mansur, Ashham; Mulwande, Evelyn; Steinau, Maximilian; Bergmann, Ingo; Frederik Popov, Aron; Ghadimi, Michael; Beissbarth, Tim; Bauer, Martin; Hinz, José

    2015-01-01

    According to previous studies, the clinical course of sepsis could be affected by preexisting medical conditions, which are very common among patients with sepsis. This observational study aimed at investigating whether common chronic medical conditions affect the 90-day mortality risk in adult Caucasian patients with sepsis. A total of 482 patients with sepsis were enrolled in this study. The ninety-day mortality was the primary outcome; organ failure was the secondary outcome. Sepsis-related organ failure assessment (SOFA) scores and the requirements for organ support were evaluated to assess organ failure. A multivariate Cox regression model for the association between the 90-day mortality risk and chronic preexisting medical conditions adjusted for all relevant confounders and mortality predictors revealed the highest hazard ratio for patients with chronic kidney disease (CKD) (hazard ratio, 2.25; 95% CI, 1.46-3.46; p?=?0.0002). Patients with CKD had higher SOFA scores than patients without CKD (8.9?±?4.0 and 6.5?±?3.4, respectively; p?medical conditions. PMID:25995131

  5. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... anesthesia services. The medical history and physical examination must be placed in the patient's medical... anesthesia services. (B) An updated examination of the patient, including any changes in the patient's... anesthesia services. (ii) Admitting diagnosis. (iii) Results of all consultative evaluations of the...

  6. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... payment: Medically directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent...

  7. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... payment: Medically directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent...

  8. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... payment: Medically directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent...

  9. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... anesthesia services. The medical history and physical examination must be placed in the patient's medical... anesthesia services. (B) An updated examination of the patient, including any changes in the patient's... anesthesia services. (ii) Admitting diagnosis. (iii) Results of all consultative evaluations of the...

  10. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY...SMI) BENEFITS Medical and Other Health Services § 410.12...

  11. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY...SMI) BENEFITS Medical and Other Health Services § 410.12...

  12. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY...SMI) BENEFITS Medical and Other Health Services § 410.12...

  13. 42 CFR 410.12 - Medical and other health services: Basic conditions and limitations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...12 Section 410.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY...SMI) BENEFITS Medical and Other Health Services § 410.12...

  14. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    42 Public Health 5 2013-10-01 2013-10-01... Section 482.61 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...data. Medical records must stress the psychiatric...

  15. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    42 Public Health 5 2014-10-01 2014-10-01... Section 482.61 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...data. Medical records must stress the psychiatric...

  16. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    42 Public Health 5 2012-10-01 2012-10-01... Section 482.61 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...data. Medical records must stress the psychiatric...

  17. 42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...involved. (4) The social service records, including...contacts as well as a social history. (5) When...admission; (2) Include a medical history; (3) Contain...12(c), nurse, social worker and, when...

  18. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...and procedure, in order to support medical care evaluation studies. (3) The hospital must have a procedure for ensuring... (iv) Documentation of complications, hospital acquired infections, and unfavorable reactions to drugs and anesthesia....

  19. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...to surgery or a procedure requiring anesthesia services. The medical history and...to surgery or a procedure requiring anesthesia services. (B) An updated examination...to surgery or a procedure requiring anesthesia services. (ii) Admitting...

  20. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...to surgery or a procedure requiring anesthesia services. The medical history and...to surgery or a procedure requiring anesthesia services. (B) An updated examination...to surgery or a procedure requiring anesthesia services. (ii) Admitting...

  1. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...to surgery or a procedure requiring anesthesia services. The medical history and...to surgery or a procedure requiring anesthesia services. (B) An updated examination...to surgery or a procedure requiring anesthesia services. (ii) Admitting...

  2. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...to surgery or a procedure requiring anesthesia services. The medical history and...to surgery or a procedure requiring anesthesia services. (B) An updated examination...to surgery or a procedure requiring anesthesia services. (ii) Admitting...

  3. Potential Therapeutic Competition in Community-Living Older Adults in the U.S.: Use of Medications That May Adversely Affect a Coexisting Condition

    PubMed Central

    Lorgunpai, Songprod Jonathan; Grammas, Marianthe; Lee, David S. H.; McAvay, Gail; Charpentier, Peter; Tinetti, Mary E.

    2014-01-01

    Objective The 75% of older adults with multiple chronic conditions are at risk of therapeutic competition (i.e. treatment for one condition may adversely affect a coexisting condition). The objective was to determine the prevalence of potential therapeutic competition in community-living older adults. Methods Cross-sectional descriptive study of a representative sample of 5,815 community-living adults 65 and older in the U.S, enrolled 2007–2009. The 14 most common chronic conditions treated with at least one medication were ascertained from Medicare claims. Medication classes recommended in national disease guidelines for these conditions and used by ?2% of participants were identified from in-person interviews conducted 2008–2010. Criteria for potential therapeutic competition included: 1), well-acknowledged adverse medication effect; 2) mention in disease guidelines; or 3) report in a systematic review or two studies published since 2000. Outcomes included prevalence of situations of potential therapeutic competition and frequency of use of the medication in individuals with and without the competing condition. Results Of 27 medication classes, 15 (55.5%) recommended for one study condition may adversely affect other study conditions. Among 91 possible pairs of study chronic conditions, 25 (27.5%) have at least one potential therapeutic competition. Among participants, 1,313 (22.6%) received at least one medication that may worsen a coexisting condition; 753 (13%) had multiple pairs of such competing conditions. For example, among 846 participants with hypertension and COPD, 16.2% used a nonselective beta-blocker. In only 6 of 37 cases (16.2%) of potential therapeutic competition were those with the competing condition less likely to receive the medication than those without the competing condition. Conclusions One fifth of older Americans receive medications that may adversely affect coexisting conditions. Determining clinical outcomes in these situations is a research and clinical priority. Effects on coexisting conditions should be considered when prescribing medications. PMID:24586786

  4. Neutralizing Antibody Response after Intramuscular Purified Vero Cell Rabies Vaccination (PVRV) in Iranian Patients with Specific Medical Conditions

    PubMed Central

    Rahimi, Pooneh; Vahabpour, RouhAllah; Aghasadeghi, Mohammad Reza; Sadat, Syed Mehdi; Howaizi, Nader; Mostafavi, Ehsan; Eslamifar, Ali; Fallahian, Vida

    2015-01-01

    Objective Post exposure prophylaxis using one of the WHO-approved vaccines is the method of choice for preventing rabies. Abnormal immune function in patients with some specific medical conditions, such as pregnancy, chronic hepatitis B virus infection, different types of cancers like lymphoma, diabetes I and II, corticosteroid consumption by patients with rheumatoid arthritis and lupus erythematosus, could impair the immunologic response to various vaccines. The immune response to rabies vaccination has never been examined in patients with any of these described medical conditions. This study purposed to evaluate the neutralyzing antibody response after vaccination with purified Vero cell rabies vaccine (PVRV) according to the WHO-recommended Post–Exposure Prophylaxis (PEP) "ESSEN" regimen. Methods Thirty healthy volunteers and 50 volunteers with different medical conditions who were exposed to a suspected rabid animal in the 2nd or 3rd category of exposure received 5 doses of PVRV under the ESSEN protocol. Three blood samples were collected on days 0 (before the first dose), 14, and 35. The anti-rabies antibody titer was measured using the Rapid Fluorescent Foci Inhibition Test (RFFIT) and an ELISA Bio-Rad, Platelia, Rabies II kit. Results All subjects reached NAb titers above 0.5 IU/ml by day 14 after vaccination. On day 35 (1 week after receiving the last rabies vaccine), anti-rabies antibodies were in the protective level (>0.5 IU/ml) in both groups. There was no statistically significant difference in anti-rabies antibody response due to the type of exposure (category 2 or 3), and successful seroconversion was confirmed in both groups. Conclusion In conclusion, the ESSEN protocol using the PVRV vaccine is sufficient for rabies prophylaxis in patients with specific medical conditions. PMID:26440665

  5. Perception of stress-related working conditions in hospitals (iCept-study): a comparison between physicians and medical students

    PubMed Central

    2013-01-01

    Background The students’ perception of working conditions in hospitals hasn’t been subject of research in Germany so far. However the perception plays an important role talking about the sustainability of working conditions. The iCept Study wants to examine the perception of medical students compared to the perception of practicing physicians. Methods/design The perception will be investigated with a redesigned questionnaire based upon two established and validated questionnaires. The two samples built for this study (students and physician) will be chosen from members of the labor union Marburger Bund. The iCept-Study is designed as an anonymized online-survey. Discussion The iCept-Study is thought to be the basis of ongoing further investigations regarding the perception of working conditions in hospitals. The results shall serve the facilitation of improving working conditions. PMID:23442606

  6. 76 FR 15798 - Special Conditions: Boeing 747-468, Installation of a Medical Lift

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ...replaced with an electrically powered medical lift using the opening in the...formerly occupied by the stairs. When the lift is not in operation, the...shafts and gear boxes is powered on the front and rear of the lift platform. The...

  7. Prevalence of Chronic Medical Conditions in Adults with Mental Retardation: Comparison with the General Population.

    ERIC Educational Resources Information Center

    Kapell, Deborah; Nightingale, Beryle; Rodriguez, Ana; Lee, Joseph H.; Zigman, Warren B.; Schupf, Nicole

    1998-01-01

    A study interviewed caregivers and reviewed medical records of 278 adults with mental retardation with and without Down syndrome. The adults with mental retardation had age-related disorders comparable to those in the general population, but there was an increased frequency of thyroid disorders, nonischemic heart disorders, and sensory impairment.…

  8. 75 FR 27662 - Special Conditions: Boeing 747-468, Installation of a Medical Lift

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... displacement of the center of gravity from the airplane centerline. The following optional requirements, which... with an electrically powered medical lift using the opening in the upper deck formerly occupied by the... powered on the front and rear of the lift platform. The spindles are supported at the lifting gear on...

  9. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... to surgery or a procedure requiring anesthesia services. The medical history and physical examination... prior to surgery or a procedure requiring anesthesia services. (B) An updated examination of the patient... surgery or a procedure requiring anesthesia services. (ii) Admitting diagnosis. (iii) Results of...

  10. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent anesthesia services...

  11. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... to surgery or a procedure requiring anesthesia services. The medical history and physical examination... prior to surgery or a procedure requiring anesthesia services. (B) An updated examination of the patient... surgery or a procedure requiring anesthesia services. (ii) Admitting diagnosis. (iii) Results of...

  12. 42 CFR 482.24 - Condition of participation: Medical record services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... to surgery or a procedure requiring anesthesia services. The medical history and physical examination... prior to surgery or a procedure requiring anesthesia services. (B) An updated examination of the patient... surgery or a procedure requiring anesthesia services. (ii) Admitting diagnosis. (iii) Results of...

  13. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent anesthesia services...

  14. Spiritually Competent Practice with Individuals and Families Dealing with Medical Conditions

    ERIC Educational Resources Information Center

    Sperry, Len

    2011-01-01

    Counselors and psychotherapists are increasingly expected to provide services that are spiritually competent. Those counseling individuals and families where medical concerns are a focus would do well to consider the implications of spiritual competence in their work. The article defines spiritual competence, describes spiritual competencies, and…

  15. A Survey of Injuries and Medical Conditions Affecting Competitive Adult Outrigger Canoe Paddlers on O`ahu

    PubMed Central

    Haley, Amanda; Nichols, Andrew

    2009-01-01

    Outrigger canoe paddling is a very popular competitive sport in the Hawaiian Islands and Polynesia. The sport is growing rapidly in Australia and the mainland US. Purpose To assess the types and severity of musculoskeletal injuries and medical conditions that affect adult outrigger canoe paddlers on (O`ahu, Hawai`i. Methods and Study Design A survey was designed to assess outrigger canoe paddling injuries and medical conditions based upon a literature review of medical conditions that affect other paddling sport athletes (e.g., rowers, kayakers, and canoeists). The data were compiled and analyzed using statistical software. Results Surveys were completed by 278 (142 women, 145 men) (9.5%) of the 3,068 registered (O`ahu adult paddlers during the summer of 2006. The subjects’ mean age was 39 years (range=18–72 years). Sixty-two percent of respondents had experienced paddling-related musculoskeletal injuries. The most common sites of involvement were shoulder (40%), and back (26%), followed by wrist/hand (10%), elbow (9%), and neck (9%). Forty-nine percent of participants experienced skin lacerations, 33% developed heat illness, 32% sustained injuries from exposure to coral or sea creatures, and 24% developed skin infections. Ten percent of subjects reported prior histories of skin cancer or precancerous lesions. There was no statistically significant increase in injuries when comparing age groups, sex, or boat position. There was a statistically significant increase in the number of injuries in those that paddled in the long and short distance seasons over those that paddled only short distance. Short distance races are sprints less than 2000 meters and long distance races are endurance events usually 20 to 30 kilometers with some more than 40 kilometers. There were also more injuries reported in the first season compared with the second season and in the third or later season as compared with the second, although this may be due to limitations of the survey design. Conclusions Outrigger canoe paddlers report a high prevalence of musculoskeletal injuries and illnesses related to their sport. The shoulder and back were the most common sites of injury. The rib was the most commonly fractured bone. Paddling may also predispose to such environmentally related conditions as heat illness, injury from sea creatures, and perhaps skin cancers. Significance of Findings To the authors’ knowledge, this is the first study to identify the medical conditions that affect adult competitive outrigger canoe paddlers on (O`ahu. The findings will help paddlers, coaches, and medical practitioners to better identify and understand paddling-related injuries and illnesses. PMID:19653418

  16. Detection of antibody responses against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis proteins in children with community-acquired pneumonia: effects of combining pneumococcal antigens, pre-existing antibody levels, sampling interval, age, and duration of illness.

    PubMed

    Borges, I C; Andrade, D C; Vilas-Boas, A-L; Fontoura, M-S H; Laitinen, H; Ekström, N; Adrian, P V; Meinke, A; Cardoso, M-R A; Barral, A; Ruuskanen, O; Käyhty, H; Nascimento-Carvalho, C M

    2015-08-01

    We evaluated the effects of combining different numbers of pneumococcal antigens, pre-existing antibody levels, sampling interval, age, and duration of illness on the detection of IgG responses against eight Streptococcus pneumoniae proteins, three Haemophilus influenzae proteins, and five Moraxella catarrhalis proteins in 690 children aged <5 years with pneumonia. Serological tests were performed on acute and convalescent serum samples with a multiplexed bead-based immunoassay. The median sampling interval was 19 days, the median age was 26.7 months, and the median duration of illness was 5 days. The rate of antibody responses was 15.4 % for at least one pneumococcal antigen, 5.8 % for H. influenzae, and 2.3 % for M. catarrhalis. The rate of antibody responses against each pneumococcal antigen varied from 3.5 to 7.1 %. By multivariate analysis, pre-existing antibody levels showed a negative association with the detection of antibody responses against pneumococcal and H. influenzae antigens; the sampling interval was positively associated with the detection of antibody responses against pneumococcal and H. influenzae antigens. A sampling interval of 3 weeks was the optimal cut-off for the detection of antibody responses against pneumococcal and H. influenzae proteins. Duration of illness was negatively associated with antibody responses against PspA. Age did not influence antibody responses against the investigated antigens. In conclusion, serological assays using combinations of different pneumococcal proteins detect a higher rate of antibody responses against S. pneumoniae compared to assays using a single pneumococcal protein. Pre-existing antibody levels and sampling interval influence the detection of antibody responses against pneumococcal and H. influenzae proteins. These factors should be considered when determining pneumonia etiology by serological methods in children. PMID:25894988

  17. The prevalence of the pre-existing hepatitis C viral variants and the evolution of drug resistance in patients treated with the NS3-4a serine protease inhibitor telaprevir

    SciTech Connect

    Rong, Libin; Ribeiro, Ruy M; Perelson, Alan S

    2008-01-01

    Telaprevir (VX-950), a novel hepatitis C virus (HCV) NS3-4A serine protease inhibitor, has demonstrated substantial antiviral activity in patients infected with HCV genotype 1. Some patients experience viral breakthrough, which has been shown to be associated with emergence of telaprevir-resistant HCV variants during treatment. The exact mechanisms underlying the rapid selection of drug resistant viral variants during dosing are not fully understood. In this paper, we develop a two-strain model to study the pre-treatment prevalence of the mutant virus and derive an analytical solution of the mutant frequency after administration of the protease inhibitor. Our analysis suggests that the rapid increase of the mutant frequency during therapy is not due to mutant growth but rather due to the rapid and profound loss of wild-type virus, which uncovers the pre-existing mutant variants. We examine the effects of backward mutation and hepatocyte proliferation on the pre-existence of the mutant virus and the competition between wild-type and drug resistant virus during therapy. We then extend the simple model to a general model with multiple viral strains. Mutations during therapy do not play a significant role in the dynamics of various viral strains, although they are capable of generating low levels of HCV variants that would otherwise be completely suppressed because of fitness disadvantages. Hepatocyte proliferation may not affect the pretreatment frequency of mutant variants, but is able to influence the quasispecies dynamics during therapy. It is the relative fitness of each mutant strain compared with wild-type that determines which strain(s) will dominate the virus population. The study provides a theoretical framework for exploring the prevalence of pre-existing mutant variants and the evolution of drug resistance during treatment with other protease inhibitors or HCV polymerase inhibitors.

  18. Associations between Medical Conditions and Breast Cancer Risk in Asians: A Nationwide Population-Based Study in Taiwan

    PubMed Central

    Chuang, Shu-Chun; Wu, Guo-Jie; Lu, Yen-Shen; Lin, Ching-Hung; Hsiung, Chao Agnes

    2015-01-01

    Background The breast cancer incidence in Asia is rising. To explore whether the etiology of breast cancer is different from the known risk factors from studies in Western countries, we conducted a nested case-control study using data from the Taiwan National Health Insurance Research Database (NHIRD). Methods All medical conditions based on the first three digits of the ICD-9 and a list of medical conditions based on literature review were retrieved for each case and control. The odds ratios (OR) and 95% confidence intervals (CI) of the associations between medical conditions and breast cancer risks were estimated using conditional logistic regression and adjusted for occupation, number of breast cancer screening, and the average number of outpatient visits prior the diagnosis. The associations were also estimated for younger (<50 years old) and older subjects separately. Results The analyses included 4,884 breast cancer cases and 19,536 age-matched controls. Prior breast diseases (OR, 95% CI: 2.47, 2.26–2.71), obesity (1.43, 1.04–1.96), endometriosis (1.44, 1.15–1.80), uterine leiomyoma (1.20, 1.03–1.40), hypertensive diseases (1.14, 1.05–1.25), and disorders in lipid metabolism (1.13, 1.04–1.24) were associated with increased breast cancer risk. No heterogeneity was observed between age groups (<50 and ?50 years old). Conclusions In addition to benign breast diseases, obesity, endometriosis, uterine leiomyoma, hypertensive diseases, and disorders of lipid metabolism were associated with a subsequent breast cancer risk. Impacts Our results suggest that estrogen related factors may play an important role in breast cancer risks in the Taiwanese female population. PMID:26605792

  19. Photon doses at the entrance of 60Co and low-energy medical accelerator rooms under unusual irradiation conditions.

    PubMed

    Facure, A; Cardoso, S C; da Rosa, L A R; da Silva, A X

    2010-03-01

    In this paper, the general-purpose Monte Carlo code MCNP5 was used to study the dose variance due to the position of medical linear accelerators, under unusual conditions, for shielding design of radiotherapy facilities. It was found that the computational methods generally used to estimate the scattered photon doses at the entrance of radiotherapy unit vaults provide conservative results when compared with the MCNP results, considering the standard condition. On the other hand, for the situations where the axis of gantry rotation is redirected at, for example, 45 degrees with respect to the walls of the room, the photon doses at the entrance can reach values up to seven times higher than those obtained under the standard condition, depending on the energy of the primary beam. PMID:19965909

  20. Apparatus for detecting at least one predetermined condition and providing an informational signal in response thereto in a medication infusion system

    NASA Technical Reports Server (NTRS)

    Fischell, Robert E. (Inventor)

    1986-01-01

    A medication infusion system provides redundant safety and includes condition detecting and informational alarm signal generating apparatus for indicating if (1) a fluid leak occurs in different portions of the system; (2) a programmable input from a patient or physician would result in exceeding a safe dosage limit; (3) the reservoir containing medication has been filled; (4) the intended medication pumping does not correlate with the pumping actually effected; (5) battery voltage is low; (6) the medication reserve is low; and (7) the system has been switched off. The apparatus may provide subcutaneous electrical, thermal, or audible stimulation to the patient and also provides a signal which a physician may monitor. The stimulation may be coded to separately identify each above-listed deviation in nominal system performance. In addition, the number of medication requests are correlated with actual medication dispensing to assure proper operation. An identification scheme is provided which matches the patient with his or her corresponding medication.

  1. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... other imaging reports, lymphocyte proliferation testings, beryllium patch tests, pulmonary function or... medical condition. (1) For covered beryllium illnesses, additional medical evidence, as set forth in § 30.207, is required to establish a beryllium illness. (2) For chronic silicosis, additional...

  2. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... other imaging reports, lymphocyte proliferation testings, beryllium patch tests, pulmonary function or... medical condition. (1) For covered beryllium illnesses, additional medical evidence, as set forth in § 30.207, is required to establish a beryllium illness. (2) For chronic silicosis, additional...

  3. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... other imaging reports, lymphocyte proliferation testings, beryllium patch tests, pulmonary function or... medical condition. (1) For covered beryllium illnesses, additional medical evidence, as set forth in § 30.207, is required to establish a beryllium illness. (2) For chronic silicosis, additional...

  4. Predictors of all-cause mortality in patients with stable COPD: medical co-morbid conditions or high depressive symptoms.

    PubMed

    Maters, Gemma A; de Voogd, Jacob N; Sanderman, Robbert; Wempe, Johan B

    2014-08-01

    Co-morbid conditions are frequently found in patients with COPD. We evaluate the association of co-morbidities with mortality, in stable COPD. 224 patients, mean age 61.2 (± 10.00), 48.2% female, mean FEV1 1.1 (± 0.5) liters, median follow-up time 4.2 years, participated. Medical co-morbidities were scored according to the Charlson Co-morbidity Index (CCI). Depressive symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS) and Symptom Checklist-90 (SCL-90). The Cox proportional hazard model was used for survival analyses. In our sample, 70% of all patients have a co-morbid medical condition or high depressive symptoms. During follow-up 51% of all patients died, and those with heart failure have the highest mortality rate (75%). Age, fat-free mass and exercise capacity were predictive factors, contrary to CCI-scores and high depressive symptoms. An unadjusted association between heart failure and survival was found. Although the presence of co-morbidities, using the CCI-score, is not related to survival, heart failure seems to have a detrimental effect on survival. Higher age and lower exercise capacity or fat-free mass predict mortality. PMID:24831411

  5. Interventions to Address Medical Conditions and Health-Risk Behaviors Among Persons With Serious Mental Illness: A Comprehensive Review.

    PubMed

    McGinty, Emma E; Baller, Julia; Azrin, Susan T; Juliano-Bult, Denise; Daumit, Gail L

    2016-01-01

    People with serious mental illness (SMI) have mortality rates 2 to 3 times higher than the overall US population, largely due to cardiovascular disease. The prevalence of cardiovascular risk factors such as obesity and diabetes mellitus and other conditions, such as HIV/AIDS, is heightened in this group. Based on the recommendations of a National Institute of Mental Health stakeholder meeting, we conducted a comprehensive review examining the strength of the evidence surrounding interventions to address major medical conditions and health-risk behaviors among persons with SMI. Peer-reviewed studies were identified using 4 major research databases. Randomized controlled trials and observational studies testing interventions to address medical conditions and risk behaviors among persons with schizophrenia and bipolar disorder between January 2000 and June 2014 were included. Information was abstracted from each study by 2 trained reviewers, who also rated study quality using a standard tool. Following individual study review, the quality of the evidence (high, medium, low) and the effectiveness of various interventions were synthesized. 108 studies were included. The majority of studies examined interventions to address overweight/obesity (n = 80). The strength of the evidence was high for 4 interventions: metformin and behavioral interventions had beneficial effects on weight loss; and bupropion and varenicline reduced tobacco smoking. The strength of the evidence was low for most other interventions reviewed. Future studies should test long-term interventions to cardiovascular risk factors and health-risk behaviors. In addition, future research should study implementation strategies to effectively translate efficacious interventions into real-world settings. PMID:26221050

  6. The Tumor Antigen Cyclin B1 Hosts Multiple CD4 T Cell Epitopes Differently Recognized by Pre-Existing Naive and Memory Cells in Both Healthy and Cancer Donors.

    PubMed

    Chevaleyre, Claire; Benhamouda, Nadine; Favry, Emmanuel; Fabre, Elizabeth; Mhoumadi, Anais; Nozach, Hervé; Marcon, Elodie; Cosler, Guillaume; Vinatier, Emeline; Oudard, Stephane; Hans, Stephane; Le Pimpec-Barthes, Françoise; Bats, Anne-Sophie; Castelli, Florence A; Tartour, Eric; Maillère, Bernard

    2015-08-15

    Cyclin B1 (CCNB1) is considered as a potential target for a cancer vaccine, as it is overexpressed in many malignant cells, while being transiently expressed in normal cells. To evaluate the CD4 T cell response to CCNB1, we derived T cell lines by multiple weekly rounds of stimulation with recombinant CCNB1 of T cells collected in healthy donors (long-term T cell assays). T cell lines were specific for 15 immunodominant peptides and derived preferentially from naive T cells. From 74 overlapping peptides, 20 peptides were selected for their broad specificity of binding to HLA class II molecules and included most of the immunodominant epitopes. They primed in vitro a large number of specific CD4 T cell lines in all the donors. Immunodominant epitopes were the most efficacious in long-term T cell assays, both in terms of number of specific T cell lines and number of responding donors. The 20 peptides were also submitted to short-term T cell assays using cells collected in healthy and cancer patients with the aim to evaluate the memory response. The recognized peptides differed from the immunodominant peptides and were part of the best promiscuous peptides. We also observed pre-existing CCNB1-specifc IgG Abs in both healthy and cancer donors. Long- and short-term T cell assays revealed that CCNB1 contained many CD4 T cell epitopes, which are differentially recognized by pre-existing naive and memory CD4 T cells. These observations are of value for the design of cancer vaccines. PMID:26136431

  7. Pharmacological modulation of caspase-8 in thymus-related medical conditions.

    PubMed

    Pozzesi, Nicola; Fierabracci, Alessandra; Thuy, Trinh Thy; Martelli, Maria Paola; Liberati, Anna Marina; Ayroldi, Emira; Riccardi, Carlo; Delfino, Domenico V

    2014-10-01

    The thymus is a lymphoid organ that governs the development of a diverse T-cell repertoire capable of defending against nonself-antigens and avoiding autoimmunity. However, the thymus can also succumb to different diseases. Hypertrophic diseases, such as thymomas, are typically associated with impairment of negative selection, which leads to autoimmune disease, or disruption of positive selection, which results in immunodeficiency. Hypotrophic diseases of the thymus can manifest during acute infections, cancer, allogeneic bone marrow transplantation, or with aging. This condition leads to decreased immune function and can be treated by either replacing lost thymic tissue or by preventing thymic tissue death. Studies have demonstrated the critical role of caspase-8 in regulating apoptosis in the thymus. In this review, we discuss how pharmacological activation and inhibition of caspase-8 can be used to treat hypertrophic and hypotrophic diseases of the thymus, respectively, to improve its function. PMID:25060674

  8. Special Medical Conditions Associated with Catatonia in the Internal Medicine Setting: Hyponatremia-Inducing Psychosis and Subsequent Catatonia

    PubMed Central

    Novac, Andrei A; Bota, Daniela; Witkowski, Joanne; Lipiz, Jorge; Bota, Robert G

    2014-01-01

    Diagnosis and treatment of catatonia in the psychiatry consultation service is not infrequent. Usually, the patient either presents to the Emergency Department or develops catatonia on the medical floor. This condition manifests with significant behavioral changes (from mildly decreased speech output to complete mutism) that interfere with the ability to communicate. After structural brain disorders are excluded, one of the diagnoses that always should be considered is catatonia. However, the causes of catatonia are numerous, ranging from psychiatric causes to a plethora of medical illnesses. Therefore, it is not surprising that there are many proposed underlying mechanisms of catatonia and that controversy persists about the etiology of specific cases. There are only 6 reports of hyponatremia-induced catatonia and psychosis in the literature. Here, we present the case of a 30-year-old woman with catatonia and psychosis induced by hyponatremia, and we use this report to exemplify the multitude of biologic causes of catatonia and to propose a new way to look at the neuroanatomical basis of processing, particularly the vertical processing systems we believe are involved in catatonia. PMID:25102520

  9. Medication/Drug Allergy

    MedlinePLUS

    ... Information > Condition Information > Allergens > Medication/Drug Allergy Medication/Drug Allergy Allergies to medications/drugs are complicated because ... allergy symptoms. Learn more. Doctors Who Treat Medication/Drug Allergy Rohit K. Katial Harold S. Nelson Richard W. ...

  10. Assessing the Representativeness of Medical Expenditure Panel Survey Inpatient Utilization Data for Individuals With Psychiatric and Nonpsychiatric Conditions.

    PubMed

    Slade, Eric P; Goldman, Howard H; Dixon, Lisa B; Gibbons, Brent; Stuart, Elizabeth A

    2015-12-01

    Sampling and reporting biases in the Medical Expenditure Panel Survey (MEPS) survey could render data on inpatient utilization that are not representative for individuals with severe psychiatric conditions. The authors assessed the representativeness of MEPS data on psychiatric inpatient utilization, by comparing MEPS estimates of total annual psychiatric and nonpsychiatric inpatient admissions and bed days, and mean length of stay, for nonelderly U.S. adults in calendar years 2005 to 2010 (N = 9,288) to estimates from the Nationwide Inpatient Sample (NIS), a nationally representative inpatient care database derived from hospitals' administrative records (N = 21,934,378). Compared with the NIS, the MEPS indicated 34% as many psychiatric admissions and 86% as many nonpsychiatric admissions, while mean psychiatric length of stay was greater in MEPS than in NIS. In MEPS data, underrepresentation of psychiatric inpatient utilization at community hospitals may result in measurement distortions for commonly used statistics on psychiatric inpatient utilization and costs. PMID:26149973

  11. The quality of life in acne: a comparison with general medical conditions using generic questionnaires.

    PubMed

    Mallon, E; Newton, J N; Klassen, A; Stewart-Brown, S L; Ryan, T J; Finlay, A Y

    1999-04-01

    Skin diseases such as acne are sometimes thought of as unimportant, even trivial, when compared with diseases of other organ systems. To address this point directly, validated generic questionnaires were used to assess morbidity in acne patients and compare it with morbidity in patients with other chronic diseases. For 111 acne patients referred to a dermatologist, quality of life was measured using the Dermatology Life Quality Index, Rosenberg's measure of self-esteem, a version of the General Health Questionnaire (GHQ-28) and the Short Form 36 (SF-36). Clinical severity was measured using the Leeds Acne Grade. Population quality of life data for the SF-36 instrument were available from a random sample of adult local residents (n = 9334) some of whom reported a variety of long-standing disabling diseases. All quality of life instruments showed substantial deficits for acne patients that correlated with each other but not with clinically assessed acne severity. The acne patients (a relatively severely affected group) reported levels of social, psychological and emotional problems that were as great as those reported by patients with chronic disabling asthma, epilepsy, diabetes, back pain or arthritis. Acne is not a trivial disease in comparison with other chronic conditions. This should be recognized in the allocation of health care resources. PMID:10233319

  12. Conditionals

    E-print Network

    von Fintel, Kai

    2011-01-01

    This article introduces the classic accounts of the meaning of conditionals (material implication, strict implication, variably strict conditional) and discusses the difference between indicative and subjunctive/counterfactual ...

  13. [Experience of medical assistance in the hosital of Plesetsk Cosmodrome under conditions of large patient load after explosion of a launch vehicle].

    PubMed

    Plekhanov, V N; Mel'nikov, O N; Shut', A D

    2013-11-01

    Military hospital of Plesetsk Cosmodrome was founded on 20 December 1958. The aims of the hospital were always connected with medical support of the cosmodrome, including emergency situations. On 18 March 1980 a Vostok-2M rocket exploded on its launch pad during a fuelling operation. Experience of medical assistance under conditions of large patient load showed the necessity of constant readiness to medical assistance to patients with combined pathology (burn injury, orthopedic trauma and thermochemical injury of the upper respiratory tract), expediency of compact patient accommodation along with the modern anaesthetic machine and readiness to frequent suction bronchoscopy. PMID:24611312

  14. Frontal White Matter Alterations in Short-Term Medicated Panic Disorder Patients without Comorbid Conditions: A Diffusion Tensor Imaging Study

    PubMed Central

    Kim, Borah; Kim, Jeong Hoon; Kim, Min-Kyoung; Lee, Kang Soo; Kim, Youngki; Choi, Tai Kiu; Kim, Yun Tai; Lee, Sang-Hyuk

    2014-01-01

    The frontal cortex might play an important role in the fear network, and white matter (WM) integrity could be related to the pathophysiology of panic disorder (PD). A few studies have investigated alterations of WM integrity in PD. The aim of this study was to determine frontal WM integrity differences between patients with PD without comorbid conditions and healthy control (HC) subjects by using diffusion tensor imaging. Thirty-six patients with PD who had used medication within 1 week and 27 age- and sex-matched HC subjects participated in this study. Structural brain magnetic resonance imaging was performed on all participants. Panic Disorder Severity Scale and Beck Anxiety Inventory (BAI) scores were assessed. Tract-based spatial statistics (TBSS) was used for image analysis. TBSS analysis showed decreased fractional anisotropy (FA) in frontal WM and WM around the frontal lobe, including the corpus callosum of both hemispheres, in patients with PD compared to HC subjects. Moreover, voxel-wise correlation analysis revealed that the BAI scores for patients with PD were positively correlated with their FA values for regions showing group differences in the FA of frontal WM of both hemispheres. Altered integrity in frontal WM of patients with PD without comorbid conditions might represent the structural pathophysiology in these patients, and these changes could be related to clinical symptoms of PD. PMID:24788587

  15. An Integral Effects Test in a zion-like geometry to investigate the effects of pre-existing hydrogen on direct containment heating in the Surtsey Test Facility. The IET-6 experiment

    SciTech Connect

    Allen, M.D.; Blanchat, T.K.; Pilch, M.; Nichols, R.T.

    1993-01-01

    The sixth experiment of the Integral Effects Test (IET-6) series was conducted to investigate the effects of high pressure melt ejection on direct containment heating. Scale models of the Zion reactor pressure vessel (RPV), cavity, instrument tunnel, and subcompartment structures were constructed in the Surtsey Test Facility at Sandia National Laboratories. The RPV was modeled with a melt generator that consisted of a steel pressure barrier, a cast MgO crucible, and a thin steel inner liner. The melt generator/crucible had a hemispherical bottom head containing a graphite limitor plate with a 4-cm exit hole to simulate the ablated hole in the RPV bottom head that would be formed by ejection of an instrument guide tube in a severe nuclear power plant accident. The cavity contained 3.48 kg of water, which corresponds to condensate levels in the Zion plant, and the containment basement floor was dry. A 43-kg initial charge of iron oxide/aluminum/chromium thermite was used to simulate corium debris on the bottom head of the RPV. Molten thermite was ejected by steam at an initial pressure of 6.3 MPa into the reactor cavity. The Surtsey vessel atmosphere contained pre-existing hydrogen to represent partial oxidation of the zirconium in the Zion core. The initial composition of the vessel atmosphere was 87.1 mol.% N{sub 2}, 9.79 mol.% O{sub 2}, and 2.59 mol.% H{sub 2}, and the initial absolute pressure was 198 kPa. A partial hydrogen burn occurred in the Surtsey vessel. The peak vessel pressure increase was 279 kPa in IET-6, compared to 246 kPa in the IET-3 test. The total debris mass ejected into the Surtsey vessel in IET-6 was 42.5 kg. The gas grab sample analysis indicated that there were 180 g{center_dot} moles of pre-existing hydrogen, and that 308{center_dot}moles of hydrogen were produced by steam/metal reactions. About 335 g{center_dot}moles of hydrogen burned, and 153 g{center_dot}moles remained unreacted.

  16. Apparatus for detecting a condition of a medication infusion system and providing an informational signal in response thereto

    NASA Technical Reports Server (NTRS)

    Fischell, Robert E. (Inventor)

    1988-01-01

    A medication infusion system having a means for providing an informational signal when (1) medication in the reservoir falls below a threshold level; (2) a fluid leak occurs in different portions of the system; and (3) the intended medication pumping does not correlate with the pumping actually affected.

  17. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., plan of care, and medical supervision. 484.18 Section 484.18 Public Health CENTERS FOR MEDICARE..., and medical supervision. Patients are accepted for treatment on the basis of a reasonable expectation that the patient's medical, nursing, and social needs can be met adequately by the agency in...

  18. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., plan of care, and medical supervision. 484.18 Section 484.18 Public Health CENTERS FOR MEDICARE..., and medical supervision. Patients are accepted for treatment on the basis of a reasonable expectation that the patient's medical, nursing, and social needs can be met adequately by the agency in...

  19. Magnetic resonance imaging in patients with cardiac pacemakers: era of "MR Conditional" designs

    PubMed Central

    2011-01-01

    Advances in cardiac device technology have led to the first generation of magnetic resonance imaging (MRI) conditional devices, providing more diagnostic imaging options for patients with these devices, but also new controversies. Prior studies of pacemakers in patients undergoing MRI procedures have provided groundwork for design improvements. Factors related to magnetic field interactions and transfer of electromagnetic energy led to specific design changes. Ferromagnetic content was minimized. Reed switches were modified. Leads were redesigned to reduce induced currents/heating. Circuitry filters and shielding were implemented to impede or limit the transfer of certain unwanted electromagnetic effects. Prospective multicenter clinical trials to assess the safety and efficacy of the first generation of MR conditional cardiac pacemakers demonstrated no significant alterations in pacing parameters compared to controls. There were no reported complications through the one month visit including no arrhythmias, electrical reset, inhibition of generator output, or adverse sensations. The safe implementation of these new technologies requires an understanding of the well-defined patient and MR system conditions. Although scanning a patient with an MR conditional device following the strictly defined patient and MR system conditions appears straightforward, issues related to patients with pre-existing devices remain complex. Until MR conditional devices are the routine platform for all of these devices, there will still be challenging decisions regarding imaging patients with pre-existing devices where MRI is required to diagnose and manage a potentially life threatening or serious scenario. A range of other devices including ICDs, biventricular devices, and implantable physiologic monitors as well as guidance of medical procedures using MRI technology will require further biomedical device design changes and testing. The development and implementation of cardiac MR conditional devices will continue to require the expertise and collaboration of multiple disciplines and will need to prove safety, effectiveness, and cost effectiveness in patient care. PMID:22032338

  20. Automatic de-identification of electronic medical records using token-level and character-level conditional random fields.

    PubMed

    Liu, Zengjian; Chen, Yangxin; Tang, Buzhou; Wang, Xiaolong; Chen, Qingcai; Li, Haodi; Wang, Jingfeng; Deng, Qiwen; Zhu, Suisong

    2015-12-01

    De-identification, identifying and removing all protected health information (PHI) present in clinical data including electronic medical records (EMRs), is a critical step in making clinical data publicly available. The 2014 i2b2 (Center of Informatics for Integrating Biology and Bedside) clinical natural language processing (NLP) challenge sets up a track for de-identification (track 1). In this study, we propose a hybrid system based on both machine learning and rule approaches for the de-identification track. In our system, PHI instances are first identified by two (token-level and character-level) conditional random fields (CRFs) and a rule-based classifier, and then are merged by some rules. Experiments conducted on the i2b2 corpus show that our system submitted for the challenge achieves the highest micro F-scores of 94.64%, 91.24% and 91.63% under the "token", "strict" and "relaxed" criteria respectively, which is among top-ranked systems of the 2014 i2b2 challenge. After integrating some refined localization dictionaries, our system is further improved with F-scores of 94.83%, 91.57% and 91.95% under the "token", "strict" and "relaxed" criteria respectively. PMID:26122526

  1. Concurrent Medical Conditions and Health Care Use and Needs among Children with Learning and Behavioral Developmental Disabilities, National Health Interview Survey, 2006-2010

    ERIC Educational Resources Information Center

    Schieve, Laura A.; Gonzalez, Vanessa; Boulet, Sheree L.; Visser, Susanna N.; Rice, Catherine E.; Braun, Kim Van Naarden; Boyle, Coleen A.

    2012-01-01

    Studies document various associated health risks for children with developmental disabilities (DDs). Further study is needed by disability type. Using the 2006-2010 National Health Interview Surveys, we assessed the prevalence of numerous medical conditions (e.g. asthma, frequent diarrhea/colitis, seizures), health care use measures (e.g. seeing a…

  2. Trends in self-medication for dental conditions among patients attending oral health outreach programs in coastal Karnataka, India

    PubMed Central

    Simon, Arun K.; Rao, Ashwini; Rajesh, Gururaghavendran; Shenoy, Ramya; Pai, Mithun B. H.

    2015-01-01

    Objectives: To determine the prevalence, pattern, and awareness of self-medication practices among patients presenting at oral health outreach programs in coastal Karnataka, India. Materials and Methods: The cross-sectional study, based on an interview conducted in randomly selected 400 study subjects from the patients presenting at these oral health outreach programs. Data were collected regarding demographic information and the interview schedule consisting of 14 questions was administered. Results: Prevalence of self-medication was 30%. Respondents’ gender (?2 = 5.095, P < 0.05), occupation (?2 = 10.215, P < 0.05), the time from the last dental visit (?2 = 8.108, P < 0.05), recommendation of drug(s) to family members or friends (?2 = 75.565, P < 0.001), and the likelihood of self-medication in the next 6 months (?2 = 80.999, P < 0.001) were significantly associated with self-medication. Male respondents were less likely to have undertaken self-medication (odds ratio = 0.581 [0.361, 0.933]). The frequently self-medicated drug was analgesics (42.5%) for toothache (69.2%). The regression model explained 39.4% (Nagelkerke R2) of the variance in self-medication practices. Conclusions: Prevalence of self-medication was 30% with demographic influence. Hence, this study highlights the policy implications for drug control by government agencies and stresses on the need for dental health education to discourage irrational drug use. PMID:26600642

  3. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...medications and treatments, any safety measures to protect against injury, instructions for timely discharge or referral...the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per agency policy developed...

  4. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...medications and treatments, any safety measures to protect against injury, instructions for timely discharge or referral...the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per agency policy developed...

  5. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...medications and treatments, any safety measures to protect against injury, instructions for timely discharge or referral...the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per agency policy developed...

  6. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...medications and treatments, any safety measures to protect against injury, instructions for timely discharge or referral...the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per agency policy developed...

  7. 42 CFR 484.18 - Condition of participation: Acceptance of patients, plan of care, and medical supervision.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...medications and treatments, any safety measures to protect against injury, instructions for timely discharge or referral...the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per agency policy developed...

  8. Adaptive multi-level conditional random fields for detection and segmentation of small enhanced pathology in medical images.

    PubMed

    Karimaghaloo, Zahra; Arnold, Douglas L; Arbel, Tal

    2016-01-01

    Detection and segmentation of large structures in an image or within a region of interest have received great attention in the medical image processing domains. However, the problem of small pathology detection and segmentation still remains an unresolved challenge due to the small size of these pathologies, their low contrast and variable position, shape and texture. In many contexts, early detection of these pathologies is critical in diagnosis and assessing the outcome of treatment. In this paper, we propose a probabilistic Adaptive Multi-level Conditional Random Fields (AMCRF) with the incorporation of higher order cliques for detecting and segmenting such pathologies. In the first level of our graphical model, a voxel-based CRF is used to identify candidate lesions. In the second level, in order to further remove falsely detected regions, a new CRF is developed that incorporates higher order textural features, which are invariant to rotation and local intensity distortions. At this level, higher order textures are considered together with the voxel-wise cliques to refine boundaries and is therefore adaptive. The proposed algorithm is tested in the context of detecting enhancing Multiple Sclerosis (MS) lesions in brain MRI, where the problem is further complicated as many of the enhancing voxels are associated with normal structures (i.e. blood vessels) or noise in the MRI. The algorithm is trained and tested on large multi-center clinical trials from Relapsing-Remitting MS patients. The effect of several different parameter learning and inference techniques is further investigated. When tested on 120 cases, the proposed method reaches a lesion detection rate of 90%, with very few false positive lesion counts on average, ranging from 0.17 for very small (3-5 voxels) to 0 for very large (50+ voxels) regions. The proposed model is further tested on a very large clinical trial containing 2770 scans where a high sensitivity of 91% with an average false positive count of 0.5 is achieved. Incorporation of contextual information at different scales is also explored. Finally, superior performance is shown upon comparing with Support Vector Machine (SVM), Random Forest and variant of an MRF. PMID:26211811

  9. Parent & Educators' Drug Reference: A Guide to Common Medical Conditions & Drugs Used in School-Aged Children.

    ERIC Educational Resources Information Center

    Agins, Alan P.

    This book provides a guide to more than 180 drugs used for children. An introduction precedes the four major sections of the guide. Section 1 provides an overview of pharmacology and therapeutics in chapters on the basics of pharmacology, the language of pharmacology and therapeutics, compliance, side effects, medications in school, and drug…

  10. Teachers' Drug Reference: A Guide to Medical Conditions and Drugs Commonly Used in School-Aged Children.

    ERIC Educational Resources Information Center

    Agins, Alan P.

    This book provides a guide to approximately 175 drugs used with children. An introduction precedes the three major sections of the guide. Section 1 provides an overview of pharmacology and therapeutics in chapters on the basics of pharmacology, the language of pharmacology and therapeutics, compliance, side effects, and medications in school.…

  11. IIT CRD Handbook Chronic Med & Other Cond Documentation Guidelines Page 1 of 1 Chronic Medical and Other Conditions

    E-print Network

    Heller, Barbara

    to all chronic health conditions (asthma, diabetes, sickle cell anemia, etc.), orthopedic injuries to the history, expected course of treatment, and limitations resulting from the condition or treatments. 2

  12. Alternative Breaks Emergency Contact & Verification of Medical

    E-print Network

    Tipple, Brett

    Alternative Breaks Emergency Contact & Verification of Medical Insurance Form Participant Name: ___________________________ Emergency Contact/Medical Info Please list any allergies, medical conditions or medications you of Utah policy. Do you have personal medical health insurance? Yes No If Yes: I

  13. Medical Marijuana.

    PubMed

    Capriotti, Teri

    2016-01-01

    The use of medicinal marijuana is increasing. Marijuana has been shown to have therapeutic effects in certain patients, but further research is needed regarding the safety and efficacy of marijuana as a medical treatment for various conditions. A growing body of research validates the use of marijuana for a variety of healthcare problems, but there are many issues surrounding the use of this substance. This article discusses the use of medical marijuana and provides implications for home care clinicians. PMID:26645838

  14. Astronomy for Special Needs Children (Low-income and/or Serious Medical Conditions) and Their Families

    NASA Astrophysics Data System (ADS)

    Lubowich, Donald

    2015-08-01

    I present the results of two NASA-IDEAS/STScI* sponsored and one IAU OAD grant for astronomy outreach programs for seriously ill or traumatically injured children and their families staying at the Ronald McDonald Houses of Long Island (New Hyde Park, NY) and Chicago or for children hospitalized at the Winthrop University Hospital Children’s Medical Center, (Mineola, NY). An astronomy program was also created for the five Fresh Air Fund Charity summer camps (low-income and special needs) and for a Hofstra summer camp for developmentally challenged youths.These programs are designed for children of all ages include” STSCi’s “Tonight’s Sky” (monthly guide to the sky); telescope observations of the Moon, Sun, planets, nebulae, and stars; and hands-on activities. During cloudy weather remote/robotic telescope observations are shown to the children.The staff and volunteers at the Ronald McDonald House and Children’s Medical Center are trained to use the telescope and to do astronony demonstrations. I created an Activity Book for the staff with demonstrations, participatory hands-on activities, and edible demonstrations using chocolate, marshmallows, and popcorn are to stimulate interest.These educational activities help children and their families learn about astronomy while providing a diversion to take their minds off their illness during a stressful time. The RMHs provide free or low-cost housing in a comfortable, supportive alternative atmosphere where family members sleep, eat, relax and find support from other families in similar situations. Families are kept united when mutual support is as critical as the medical treatment itself. The ill children and their families may stay for a few days or months because of chemotherapy, dialysis, or rehabilitative therapy. Children from 50 states and 50 countries stay the Chicago RMHs and there are 260 RMHs in the US and 65 worldwide.

  15. A cross-sectional assessment of the prevalence of multiple chronic conditions and medication use in a sample of community-dwelling adults with fibromyalgia in Olmsted County, Minnesota

    PubMed Central

    Vincent, Ann; Whipple, Mary O; McAllister, Samantha J; Aleman, Katherine M; St Sauver, Jennifer L

    2015-01-01

    Objectives The objective of this study was to evaluate the problem of multiple chronic conditions and polypharmacy in patients with fibromyalgia. Design Retrospective medical record review. Setting Olmsted County, Minnesota. Participants 1111 adults with fibromyalgia. Primary and secondary outcome measures Number and type of chronic medical and psychiatric conditions, medication use. Results Medical record review demonstrated that greater than 50% of the sample had seven or more chronic conditions. Chronic joint pain/degenerative arthritis was the most frequent comorbidity (88.7%), followed by depression (75.1%), migraines/chronic headaches (62.4%) and anxiety (56.5%). Approximately, 40% of patients were taking three or more medications for symptoms of fibromyalgia. Sleep aids were the most commonly prescribed medications in our sample (33.3%) followed by selective serotonin reuptake inhibitors (28.7%), opioids (22.4%) and serotonin norepinephrine reuptake inhibitors (21.0%). Conclusions The results of our study highlight the problem of multiple chronic conditions and high prevalence of polypharmacy in fibromyalgia. Clinicians who care for patients with fibromyalgia should take into consideration the presence of multiple chronic conditions when recommending medications. PMID:25735301

  16. Imagining life with an ostomy: Does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust??

    PubMed Central

    Angott, Andrea M.; Comerford, David A.; Ubel, Peter A.

    2014-01-01

    Objective To test a video intervention as a way to improve predictions of mood and quality-of-life with an emotionally evocative medical condition. Such predictions are typically inaccurate, which can be consequential for decision making. Method In Part 1, people presently or formerly living with ostomies predicted how watching a video depicting a person changing his ostomy pouch would affect mood and quality-of-life forecasts for life with an ostomy. In Part 2, participants from the general public read a description about life with an ostomy; half also watched a video depicting a person changing his ostomy pouch. Participants’ quality-of-life and mood forecasts for life with an ostomy were assessed. Results Contrary to our expectations, and the expectations of people presently or formerly living with ostomies, the video did not reduce mood or quality-of-life estimates, even among participants high in trait disgust sensitivity. Among low-disgust participants, watching the video increased quality-of-life predictions for ostomy. Conclusion Video interventions may improve mood and quality-of-life forecasts for medical conditions, including those that may elicit disgust, such as ostomy. Practice implications Video interventions focusing on patients’ experience of illness continue to show promise as components of decision aids, even for emotionally charged health states such as ostomy. PMID:23177398

  17. Cytokine-induced changes in mood and behaviour: implications for 'depression due to a general medical condition', immunotherapy and antidepressive treatment.

    PubMed

    Pollak, Yehuda; Yirmiya, Raz

    2002-12-01

    Several lines of evidence indicate that cytokine-mediated communication pathways between the immune system and the brain are involved in the pathophysiology of depression: (1) . Depression is highly prevalent in various medical conditions, including infectious, autoimmune and neurodegenerative diseases. This clinical association cannot be attributed solely to psychological distress, and it probably reflects direct activation of illness-induced physiological processes. (2). Experiments in humans and in animals demonstrate that exposure to cytokines induces depressive-like mood and behavioural alterations. (3). Cytokine immunotherapy in cancer and hepatitis patients elicits a major depressive episode in a large percentage of the patients. (4). Several types of depression that are not directly associated with a physical disease (e.g. major depression, melancholia, dysthymia) were also associated with cytokine hypersecretion. (5). Antidepressant drugs possess anti-inflammatory characteristics, which may partly account for their therapeutic effect. Congruently, antidepressants were found to reverse cytokine-induced major depression in humans and depressive-like behaviours in animals. (6). Cytokines affect brain systems that were implicated in the aetiology of depression, including the hypothalamus-pituitary-adrenal axis and monoaminergic systems. These conclusions strongly suggest that during medical conditions elevated levels of cytokines directly contribute to the induction of depression. Therefore, illness-associated depression should not be underestimated (in terms of prevalence and severity), and should be treated with antidepressant drugs, which may act on the specific physiological mechanisms of this disorder. PMID:12466037

  18. Quality in health care. Medical or managerial?

    PubMed

    Hansson, J

    2000-01-01

    Explores the notion that the introduction of total quality management (TQM) in the public health-care sector indicates a conceptual break with a tradition in which the authority to define and interpret the meaning of medical practice has been located solely within the medical profession. It also serves to shift the focus of medical practice away from its contextual and interactional character towards numerical representations and codification in monetary terms. Further, it is argued that the realization of management ideals in everyday practice is dependent more on the availability of pre-existing technologies and standard procedures than on the ingenuity of particular organizational and institutional actors. These arguments are illustrated with the reutilization for TQM purposes of "local incident reports" in a Swedish hospital organization. PMID:11200301

  19. Diagnosis and treatment of cancer in medical textbooks of ancient Iran.

    PubMed

    Tabatabaei, Seyed Mahmoud; Ali Tabatabaei, Seyed Mohammad

    2014-01-01

    Research shows that ancient Iranians were among the pioneers of medical science, and are therefore admired and praised by non-Iranian scholars for their efforts and accomplishments in this field. Investigations of medical and historical texts indicate that between the 10(th) and the 18(th) century A.D., ancient Iran experienced a golden age of medicine. Great physicians such as Rhazes, al-Ahwazi, Avicenna and others reviewed the medical textbooks of civilizations such as Greece and India, Theories were scientifically criticized, superstitious beliefs were discarded, valuable innovations were added to pre-existing knowledge and the ultimate achievements were compiled as precious textbooks. Alhawi by Rhazes, Cannon by Avicenna, and Kamil al-Sina'ah by al-Ahwazi are among the works that were treasured by domestic and foreign scientists alike, as well as future generations who continued to appreciate them for centuries. The above-mentioned textbooks discuss diseases and conditions related to neurosurgery, ophthalmology, ear, nose and throat, gastroenterology, urology, skeletomuscular system and other specialties, as well as cancer and similar subjects. One of the richest texts on the description, diagnosis, differential diagnosis, and prognosis of cancer and therapeutic approaches is Alhawi by Mohammad ibn Zakarya al Razi (Rhazes). This article presents a brief summary of Rhazes' views about the definition of cancer, types, signs and symptoms, prevalence, complications, medical care, treatment and even surgical indications and contraindications. Moreover, his opinions are compared against the views of other physicians and theories of modern medicine. It is also recommended to review the medical heritage of Iran and evaluate the proposed treatments based on modern methodologies and scientific approaches. PMID:25512835

  20. Medical Device Safety

    MedlinePLUS

    A medical device is any product used to diagnose, cure, or treat a condition, or to prevent disease. They ... may need one in a hospital. To use medical devices safely Know how your device works. Keep ...

  1. Impact of cardiovascular risk factors and medication use on the efficacy of remote ischaemic conditioning: post hoc subgroup analysis of a randomised controlled trial

    PubMed Central

    Sloth, Astrid Drivsholm; Schmidt, Michael Rahbek; Munk, Kim; Schmidt, Morten; Pedersen, Lars; Toft Sørensen, Henrik; Bøtker, Hans Erik; Bøttcher, M

    2015-01-01

    Objectives Remote ischaemic conditioning (RIC) promotes cardioprotection in patients undergoing primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI). The effect of RIC may be modified by cardiovascular risk factors and their medications. We examined whether cardiovascular risk factors, lipid and glucose levels, and medication use influenced the efficacy of RIC in patients with STEMI treated with pPCI. Design Post hoc subgroup analysis of a single-centre randomised controlled trial. Participants A total of 139 patients with STEMI, randomised during ambulance transport to hospital for pPCI with (n=71) or without (n=68) RIC, met the trial criteria and achieved data for a myocardial salvage index (MSI). Interventions RIC was administered through intermittent arm ischaemia with four cycles of 5?min inflation and 5?min deflation of a blood pressure cuff. Primary outcome measures MSI, estimated by single-photon emission CT. We evaluated the efficacy of RIC on the MSI in patient subgroups of cardiovascular risk factors, lipid and glucose levels, and medication use. Results We found no significant difference in the efficacy of RIC in subgroups of cardiovascular risk factors, lipid and glucose levels, and medication use. However, point estimates indicated a reduced effect of RIC among smokers (median difference in MSI between RIC and control groups: ?0.02 (95% CI ?0.32 to 0.28) in smokers vs 0.25 (95% CI 0.08 to 0.42) in non-smokers, p value for interaction=0.13) and an increased effect of RIC in statin users (median difference in MSI between RIC and control groups: 0.34 (95% CI 0.03 to 0.65) in statin users vs 0.09 (95% CI ?0.11 to 0.29) in non-statin users, p value for interaction=0.19). Conclusions RIC as an adjunct to pPCI seems to improve MSI in our trial population of patients with STEMI regardless of most cardiovascular risk factors and their medications. Our post hoc finding on a limited sample size calls for further investigation in large-scale multicentre trials. Trial registration number NCT00435266. PMID:25838505

  2. Effect of Hot-Attribute Aged Ginger Tea on Chinese Medical Pulse Condition of Healthy Young Humans

    PubMed Central

    Chao, Dan-Ping; Tyan, Chu-Chang; Chen, Jian-Jung; Hsieh, Ching-Liang; Sheen, Lee-Yan

    2011-01-01

    Young individuals typically have a dry-heat (?? zào rè) constitution and feel overly stimulated. This study observes specialties on the right-bar (?? yòu gu?n) section of the radial-arterial pulse of healthy young subjects, and investigates pulse variations induced by different attribute foods. Chinese medical doctors grouped thirty subjects into heat and non-heat constitutions. Each subject took water, aged ginger tea, and coconut water, well recognized as neutral, hot, and cold drinks, on different visits. The current study observed physiological signals induced by the samples using novel noninvasive sphygmography and a blood pressure monitor. As the baseline bigger percussion wave, dicrotic wave, and area in the sphygmogram of the non-heat constitution subjects, this work suggests that blood vessels of these subjects may be more relaxed than that of the heat constitution ones. Stroke volume increased and pulse pressure decreased in the non-heat constitution subjects after taking aged ginger tea, which may elevate arterial compliance corresponding to maintaining an estimated radial-arterial diameter in our study. However, the percussion wave widened and the valley increased in the heat constitution subjects after taking aged ginger tea. This corresponds to the markedly reduced radial-arterial diameter, indicating tighter blood vessels than the baseline status. Accordingly, this study confirms that selecting foods with attributes opposite to personal constitutions is important for reestablishing a healthy cold-heat balance within the human body. Moreover, novel noninvasive sphygmography may be a useful instrument to classify scientifically the heat personal constitution and the responses to different attribute foods. PMID:24716108

  3. Nonequilibrium structural condition in the medical TiNi-based alloy surface layer treated by electron beam

    SciTech Connect

    Neiman, Aleksei A. Lotkov, Aleksandr I.; Meisner, Ludmila L. Semin, Viktor O.; Koval, Nikolai N.; Teresov, Anton D.

    2014-11-14

    The research is devoted to study the structural condition and their evolution from the surface to the depth of TiNi specimens treated by low-energy high-current electron beams with surface melting at a beam energy density E = 10 J/cm{sup 2}, number of pulses N = 10, and pulse duration ? = 50 ?s. Determined thickness of the remelted layer, found that it has a layered structure in which each layer differs in phase composition and structural phase state. Refinement B2 phase lattice parameters in local areas showed the presence of strong inhomogeneous lattice strain.

  4. The Effect of Different Storage Conditions on the Physical Properties of Pigmented Medical Grade I Silicone Maxillofacial Material

    PubMed Central

    Al-Dharrab, Ayman A.; Tayel, Seham B.; Abodaya, Mona H.

    2013-01-01

    Objective. This study aimed to evaluate the effect of different storage solutions that simulate acidic, alkaline, and sebum conditiions on the physical properties of pigmented (colorant elastomer) cosmesil M511 maxillofacial prosthetic material. Materials and Methods. Sixty specimens were prepared according to the manufacturer's instructions and were tested before and after immersion of different storage conditions for six months at 37?°C. The following tests were performed: color changes (group I), solution absorption (group II), surface roughness (group III), and scanning electron microscopy (group IV). Results. There were no significant changes observed in the color and solution absorption tests while surface roughness revealed significant difference between control group and other testing storage medium groups, and this result was supported by SEM analysis that revealed limited surface changes. Conclusions. Cosmaseil material is an acceptable cross-linked formulation that withstands storage in different solutions with variable pH. The addition of pigment cannot vary the physical properties of these materials. Surface roughness test as well as SEM microscopic study showed moderate changes indicating a limited effect on the surface of the material. PMID:23606978

  5. Diurnal and twenty-four hour patterning of human diseases: acute and chronic common and uncommon medical conditions.

    PubMed

    Smolensky, Michael H; Portaluppi, Francesco; Manfredini, Roberto; Hermida, Ramon C; Tiseo, Ruana; Sackett-Lundeen, Linda L; Haus, Erhard L

    2015-06-01

    The symptom intensity and mortality of human diseases, conditions, and syndromes exhibit diurnal or 24 h patterning, e.g., skin: atopic dermatitis, urticaria, psoriasis, and palmar hyperhidrosis; gastrointestinal: esophageal reflux, peptic ulcer (including perforation and hemorrhage), cyclic vomiting syndrome, biliary colic, hepatic variceal hemorrhage, and proctalgia fugax; infection: susceptibility, fever, and mortality; neural: frontal, parietal, temporal, and occipital lobe seizures, Parkinson's and Alzheimer's disease, hereditary progressive dystonia, and pain (cancer, post-surgical, diabetic neuropathic and foot ulcer, tooth caries, burning mouth and temporomandibular syndromes, fibromyalgia, sciatica, intervertebral vacuum phenomenon, multiple sclerosis muscle spasm, and migraine, tension, cluster, hypnic, and paroxysmal hemicranial headache); renal: colic and nocturnal enuresis and polyuria; ocular: bulbar conjunctival redness, keratoconjunctivitis sicca, intraocular pressure and anterior ischemic optic neuropathy, and recurrent corneal erosion syndrome; psychiatric/behavioral: major and seasonal affective depressive disorders, bipolar disorder, parasuicide and suicide, dementia-associated agitation, and addictive alcohol, tobacco, and heroin cravings and withdrawal phenomena; plus autoimmune and musculoskeletal: rheumatoid arthritis, osteoarthritis, axial spondylarthritis, gout, Sjögren's syndrome, and systemic lupus erythematosus. Knowledge of these and other 24 h patterns of human pathophysiology informs research of their underlying circadian and other endogenous mechanisms, external temporal triggers, and more effective patient care entailing clinical chronopreventive and chronotherapeutic strategies. PMID:25129839

  6. Managing work–family conflict in the medical profession: working conditions and individual resources as related factors

    PubMed Central

    Mache, Stefanie; Bernburg, Monika; Vitzthum, Karin; Groneberg, David A; Klapp, Burghard F; Danzer, Gerhard

    2015-01-01

    Objectives This study developed and tested a research model that examined the effects of working conditions and individual resources on work–family conflict (WFC) using data collected from physicians working at German clinics. Material and methods This is a cross-sectional study of 727 physicians working in German hospitals. The work environment, WFC and individual resources were measured by the Copenhagen Psychosocial Questionnaire, the WFC Scale, the Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism and Pessimism. Descriptive, correlation and linear regression analyses were applied. Results Clinical doctors working in German hospitals perceived high levels of WFC (mean=76). Sociodemographic differences were found for age, marital status and presence of children with regard to WFC. No significant gender differences were found. WFCs were positively related to high workloads and quantitative job demands. Job resources (eg, influence at work, social support) and personal resources (eg, resilient coping behaviour and self-efficacy) were negatively associated with physicians’ WFCs. Interaction terms suggest that job and personal resources buffer the effects of job demands on WFC. Conclusions In this study, WFC was prevalent among German clinicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WFC. Our results give a strong indication that both individual and organisational factors are related to WFC. Results may play an important role in optimising clinical care. Practical implications for physicians’ career planning and recommendations for future research are discussed. PMID:25941177

  7. Clinical implications and validity of nursing assessments: a longitudinal measure of patient condition from analysis of the Electronic Medical Record

    PubMed Central

    Rothman, Michael J; Solinger, Alan B; Rothman, Steven I; Finlay, G Duncan

    2012-01-01

    Objectives This study investigates risk of mortality associated with nurses’ assessments of patients by physiological system. We hypothesise that nursing assessments of in-patients performed at entry correlate with in-hospital mortality, and those performed just before discharge correlate with postdischarge mortality. Design Cohort study of in-hospital and postdischarge mortality of patients over two 1-year periods. Setting An 805-bed community hospital in Sarasota, Florida, USA. Subjects 42?302 inpatients admitted for any reason, excluding obstetrics, paediatric and psychiatric patients. Outcome measures All-cause mortalities and mortality OR. Results Patients whose entry nursing assessments, other than pain, did not meet minimum standards had significantly higher in-hospital mortality than patients meeting minimums; and final nursing assessments before discharge had large OR for postdischarge mortality. In-hospital mortality OR were found to be: food, 7.0; neurological, 9.4; musculoskeletal, 6.9; safety, 5.6; psychosocial, 6.7; respiratory, 8.1; skin, 5.2; genitourinary, 3.0; gastrointestinal, 2.3; peripheral-vascular, 3.9; cardiac, 2.8; and pain, 1.1. CI at 95% are within ±20% of these values, with p<0.001 (except for pain). Similar results applied to postdischarge mortality. All results were comparable across the two 1-year periods, with 0.85 intraclass correlation coefficient. Conclusions Nursing assessments are strongly correlated with in-hospital and postdischarge mortality. No multivariate analysis has yet been performed, and will be the subject of a future study, thus there may be confounding factors. Nonetheless, we conclude that these assessments are clinically meaningful and valid. Nursing assessment data, which are currently unused, may allow physicians to improve patient care. The mortality OR and the dynamic nature of nursing assessments suggest that nursing assessments are sensitive indicators of a patient's condition. While these conclusions must remain qualified, pending future multivariate analyses, nursing assessment data ought to be incorporated in risk-related health research, and changes in record-keeping software are needed to make this information more accessible. PMID:22874626

  8. Medical marijuana.

    PubMed Central

    Marmor, J B

    1998-01-01

    Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several conditions for which there may be therapeutic benefit from marijuana use and that merit further research. Marijuana should be held to the same evaluation standards of safety and efficacy as other drugs (a major flaw in Proposition 215) but should not have to be proved better than current medications for its use to be adopted. The therapeutic window for marijuana and THC between desired effect and unpleasant side effects is narrow and is a major reason for discontinuing use. Although the inhaled route of administration has the benefit of allowing patients to self-titrate the dose, the smoking of crude plant material is problematic. The NIH panel recommended that a high priority be given to the development of a controlled inhaled form of THC. The presence of a naturally occurring cannabinoid-receptor system in the brain suggests that research on selective analogues of THC may be useful to enhance its therapeutic effects and minimize adverse effects. PMID:9656007

  9. Potential interactions of prescription and over-the-counter medications having antioxidant capabilities with radiation and chemotherapy.

    PubMed

    Lemmo, Walter

    2015-12-01

    Oncology patients undergoing radiation treatment and chemotherapy routinely use prescription and/or over-the counter medications either as part of pre-existing comorbid conditions or in the context of conventional treatment management. A growing amount of data suggest that commonly used pharmaceuticals possess antioxidant properties, which may also partially explain some of their therapeutic efficacy. Clinical research is continuing on how such agents interact during chemotherapy and radiation when oxidative mechanisms of action are involved. Historically, such discussions centered on the category of dietary supplements, natural health products, fruits and vegetables, along with established protectant medications. Evidence confirms that some pharmaceutical agents exhibit antioxidant properties similar to dietary supplements, protectants, and may hence hinder the efficacy of chemotherapy and radiation treatment. Awareness by both healthcare providers and patients in this area is often lacking. After reviewing some of the more common and well-established pharmaceuticals, which include those prescribed during cancer treatment, caution needs to be advised especially in regards to the use of corticosteroids, as long-term randomized outcome studies ensuring safety in this area are still outstanding. PMID:25220632

  10. Increased IgG4 responses to multiple food and animal antigens indicate a polyclonal expansion and differentiation of pre-existing B cells in IgG4-related disease

    PubMed Central

    Culver, Emma L; Vermeulen, Ellen; Makuch, Mateusz; van Leeuwen, Astrid; Sadler, Ross; Cargill, Tamsin; Klenerman, Paul; Aalberse, Rob C; van Ham, S Marieke; Barnes, Eleanor; Rispens, Theo

    2015-01-01

    Background IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory condition, characterised by an elevated serum IgG4 concentration and abundant IgG4-positive plasma cells in the involved organs. An important question is whether the elevated IgG4 response is causal or a reflection of immune-regulatory mechanisms of the disease. Objectives To investigate if the IgG4 response in IgG4-RD represents a generalised polyclonal amplification by examining the response to common environmental antigens. Methods Serum from 24 patients with IgG4-RD (14 treatment-naive, 10 treatment-experienced), 9 patients with primary sclerosing cholangitis and an elevated serum IgG4 (PSC-high IgG4), and 18 healthy controls were tested against egg white and yolk, milk, banana, cat, peanut, rice and wheat antigens by radioimmunoassay. Results We demonstrated an elevated polyclonal IgG4 response to multiple antigens in patients with IgG4-RD and in PSC-high IgG4, compared with healthy controls. There was a strong correlation between serum IgG4 and antigen-specific responses. Responses to antigens were higher in treatment-naive compared with treatment-experienced patients with IgG4-RD. Serum electrophoresis and immunofixation demonstrated polyclonality. Conclusions This is the first study to show enhanced levels of polyclonal IgG4 to multiple antigens in IgG4-RD. This supports that elevated IgG4 levels reflect an aberrant immunological regulation of the overall IgG4 response, but does not exclude that causality of disease could be antigen-driven. PMID:25646372

  11. Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement.

    PubMed

    Guinchat, Vincent; Cravero, Cora; Diaz, Lautaro; Périsse, Didier; Xavier, Jean; Amiet, Claire; Gourfinkel-An, Isabelle; Bodeau, Nicolas; Wachtel, Lee; Cohen, David; Consoli, Angèle

    2015-03-01

    During adolescence, some individuals with autism spectrum disorder (ASD) engage in severe challenging behaviors, such as aggression, self-injury, disruption, agitation and tantrums. We aimed to assess risk factors associated with very acute behavioral crises in adolescents with ASD admitted to a dedicated neurobehavioral unit. We included retrospectively in 2008 and 2009 29 adolescents and young adults with ASD hospitalized for severe challenging behaviors and proposed a guideline (Perisse et al., 2010) that we applied prospectively for 29 patients recruited for the same indications between 2010 and 2012. In total, 58 patients were admitted (n=70 hospitalizations, mean age=15.66 (±4.07) years, 76% male). We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), comorbid organic conditions, etiologic diagnosis of the episode, and treatments. We explored predictors of Global Assessment Functioning Scale (GAFS) score and duration of hospitalization at discharge. All but 2 patients exhibited severe autistic symptoms and intellectual disability (ID), and two-thirds had no functional verbal language. During the inpatient stay (mean=84.3 (±94.9) days), patients doubled on average their GAFS scores (mean=17.66 (±9.05) at admission vs. mean=31.4 (±9.48) at discharge). Most common etiologies for acute behavioral crises were organic causes [n=20 (28%), including epilepsy: n=10 (14%) and painful medical conditions: n=10 (14%)], environmental causes [n=17 (25%) including lack of treatment: n=11 (16%) and adjustment disorder: n=6 (9%)], and non-ASD psychiatric condition [n=33 (48%) including catatonia: n=5 (7%), major depressive episode: n=6 (9%), bipolar disorder: n=4 (6%), schizophrenia: n=6 (9%), other/unknown diagnosis: n=12 (17%)]. We found no influence of age, gender, socio-economic status, migration, level of ID, or history of seizure on improvement of GAFS score at discharge. Severity of autism at admission was the only negative predictor (p<.001). Painful medical conditions (p=.04), non-ASD psychiatric diagnoses (p=.001), prior usage of specialized ASD care programs (p=.004), functional language (p=.007), as well as a higher number of challenging behaviors upon admission (p=.001) were associated with higher GAFS scores at discharge. Clinical severity at admission, based on the number of challenging behaviors (r=.35, p=.003) and GAFS score (r=-.32, p=.008) was correlated with a longer inpatient stay. Longer hospitalization was however correlated (r=.27, p=.03) with higher GAFS score at discharge even after adjustment for confounding factors. Challenging behaviors among adolescents with ASD may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic illness such as epilepsy or acute pain. The management of these behavioral challenges requires a unified, multidisciplinary approach. PMID:25575287

  12. Beyond accreditation: excellence in medical education.

    PubMed

    Ahn, Eusang; Ahn, Ducksun

    2014-01-01

    Medical school accreditation is a relatively new phenomenon in Korea. The development of an accreditation body and standards for a two-tiered "Must" and "Should" system in 1997 eventually led to the implementation of a third "Excellence" level of attainment. These standards were conceived out of a desire to be able to first recognize and promote outstanding performance of medical schools, second to provide role models in medical education, and furthermore to preview the third level as potential components of the pre-existing second level for the next accreditation cycle. It is a quality-assurance mechanism that, while not required for accreditation itself, pushes medical schools to go beyond the traditional requirements of mere pass-or-fail accreditation adequacy, and encourages schools to deliver an unprecedented level of medical education. The Association for Medical Education in Europe developed its own third-tier system of evaluation under the ASPIRE project, with many similar goals. Due to its advanced nature and global scope, the Korean accreditation body has decided to implement the ASPIRE system in Korea as well. PMID:24050749

  13. Mitigating Circumstances Guide September 2014 Leicester Medical School

    E-print Network

    Banaji,. Murad

    Mitigating Circumstances Guide September 2014 Leicester Medical School Department of Medical and mitigating circumstances The medical school has produced the guidance below to allow the mitigating environments and the safety implications for future patients. Chronic medical conditions The medical school

  14. October 2014 LEICESTER MEDICAL SCHOOL

    E-print Network

    Banaji,. Murad

    mitigation may have had on the assessment in question The temporal relationship between the proposed qualified doctor #12;October 2014 Medical students and mitigating circumstances The medical school implications for future patients. Chronic medical conditions The medical school accepts that students

  15. Action Rules Discovery without pre-existing classification rules

    E-print Network

    Ras, Zbigniew W.

    from a low-income to a high-income. Another example in business area is when an owner would like to improve his or her company's profits by going from a high-cost, low-income business to a low-cost, high-income Dardzi´nska3,1 1 Univ. of North Carolina, Dept. of Computer Science, Charlotte, NC, 28223, USA 2 Polish

  16. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., lymphocyte proliferation testings, beryllium patch tests, pulmonary function or exercise testing results.... (1) For covered beryllium illnesses, additional medical evidence, as set forth in § 30.207, is required to establish a beryllium illness. (2) For chronic silicosis, additional medical evidence, as...

  17. 20 CFR 30.114 - What kind of evidence is needed to establish a compensable medical condition and how will that...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., lymphocyte proliferation testings, beryllium patch tests, pulmonary function or exercise testing results.... (1) For covered beryllium illnesses, additional medical evidence, as set forth in § 30.207, is required to establish a beryllium illness. (2) For chronic silicosis, additional medical evidence, as...

  18. Ototoxic Medications (Medication Effects)

    MedlinePLUS

    ... topic can be found in our Audiology Information Series [PDF]. What Is Ototoxicity? Certain medications can damage ... the course of your treatment, you should have periodic hearing tests as part of the monitoring process. ...

  19. [French physicians in independent practice: opinions on their conditions of work and the issue of over/under staffing of medical workforce in their areas].

    PubMed

    Doan, Bui Dang Ha; Lévy, Danièle

    2006-01-01

    In France, ambulatory care is provided to patients mostly by independent physicians, GPs and specialists, paid on a fee-for-service basis. A national agreement between the Sickness Insurance Fund and the medical associations sets the price of different medical services. Due to the numerus clausus imposed upon the medical schools since the 70's, the yearly number of new graduates has sharply decreased and a feeling of manpower shortage has spread throughout the health system, in the public hospitals and the ambulatory care sector as well. Moreover increased dissatisfaction has been perceived among independent practitioners (they were 56 % of all the medical profession in early 2004). In this context, an opinion survey was undertaken among a sample of 3000 independent doctors whose one thousand have answered to the postal questionnaire. PMID:16739775

  20. Diagnostic recognition of facial changes associated with chronic conditions: use of an e-learning tool to enhance medical student education.

    PubMed

    McKenna, Danielle; Wilkinson, Caroline; Ker, Jean

    2010-06-16

    Facial characteristics serve as reliable indicators of numerous diseases, and their recognition can assist junior medical students in making an accurate diagnosis. At present, however, there is little data to support the incorporation of physiognomy in medical education. This pilot study involved the design, implementation and evaluation of e-learning tutorials as a means of teaching students to appreciate how careful observation of facial characteristics can enhance diagnosis. PMID:20557153

  1. Medical Assistants

    MedlinePLUS

    ... and help podiatrists in surgery. <- Summary Work Environment -> Work Environment About this section Medical assistants perform administrative ... of all medical assistants worked in physicians’ offices. Work Schedules Most medical assistants work full time. Some ...

  2. Abortion - medical

    MedlinePLUS

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  3. Medication Guide

    MedlinePLUS

    ... Yes No Send Us Feedback Donate Today Related Articles Glaucoma Medication Manufacturers Brand Names and Generic Medications Preservative-free Glaucoma Medications Glaucoma and the Brain Recent research has shown that the complex connection ...

  4. Medical geography in Charaka Samhita

    PubMed Central

    Bhavana, K.R.; Shreevathsa

    2014-01-01

    Charaka Samhita is the oldest and the most authentic treatise on Ayurveda and is the ancient medical science of India. Apart from giving information on medical conditions and their treatment; it also gives valuable information on geographical, social, and economic conditions of India. This article is an attempt to explore geographical conditions of the ancient India, its geographical position in present India and its medical significance. PMID:26195898

  5. Medical applications of artificial olfactometry

    NASA Technical Reports Server (NTRS)

    Lewis, Nathan S. (Inventor); Severin, Erik J. (Inventor); Wong, Bernard (Inventor); Kelso, David M. (Inventor); Munoz, Beth C. (Inventor)

    2005-01-01

    The present invention provides methods for detecting the presence of an analyte indicative of various medical conditions, including halitosis, periodontal disease and other diseases are also disclosed.

  6. Exploration Medical Capability

    NASA Technical Reports Server (NTRS)

    Watkins, Sharmila; Baumann, David; Wu, Jimmy; Barsten, Kristina

    2010-01-01

    Exploration Medical Capability (ExMC) is an element of NASA's Human Research Program (HRP). ExMC's goal is to address the risk of the Inability to Adequately Recognize or Treat an Ill or Injured Crewmember. This poster highlights the approach ExMC has taken to address this goal and our current areas of interest. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to identify medical conditions of concern during exploration missions. The list was derived from space flight medical incidents, the shuttle medical checklist, the International Space Station medical checklist, and expert opinion. The conditions on the list were prioritized according to mission type by a panel comprised of flight surgeons, physician astronauts, engineers, and scientists. From the prioritized list, the ExMC element determined the capabilities needed to address the medical conditions of concern. Where such capabilities were not currently available, a gap was identified. The element s research plan outlines these gaps and the tasks identified to achieve the desired capabilities for exploration missions. This poster is being presented to inform the audience of the gaps and tasks being investigated by ExMC and to encourage discussions of shared interests and possible future collaborations.

  7. Medical Scenarios Relevant to Spaceflight

    NASA Technical Reports Server (NTRS)

    Bacal, Kira; Hurs, Victor; Doerr, Harold

    2004-01-01

    The Medical Operational Support Team (MOST) was tasked by the JSC Space Medicine and Life Sciences Directorate (SLSD) to incorporate medical simulation into 1) medical training for astronaut-crew medical officers (CMO) and medical flight control teams and 2) evaluations of procedures and resources required for medical care aboard the International Space Station (ISS). Development of evidence-based medical scenarios that mimic the physiology observed during spaceflight will be needed for the MOST to complete these two tasks. The MOST used a human patient simulator, the ISS-like resources in the Medical Simulation Laboratory (MSL), and evidence from space operations, military operations and medical literature to develop space relevant medical scenarios. These scenarios include conditions concerning airway management, Advanced Cardiac Life Support (ACLS) and mitigating anaphylactic symptoms. The MOST has used these space relevant medical scenarios to develop a preliminary space medical training regimen for NASA flight surgeons, Biomedical Flight Controllers (Biomedical Engineers; BME) and CMO-analogs. This regimen is conducted by the MOST in the MSL. The MOST has the capability to develop evidence-based space-relevant medical scenarios that can help SLSD I) demonstrate the proficiency of medical flight control teams to mitigate space-relevant medical events and 2) validate nextgeneration medical equipment and procedures for space medicine applications.

  8. SPIE Medical Imaging Medical Imaging

    E-print Network

    Miga, Michael I.

    1 SPIE Medical Imaging 2006 1 Medical Imaging Fundamentals Kenneth H. Wong, Ph.D. Division of Computer Assisted Interventions and Medical Robotics (CAIMR) Imaging Science and Information Systems (ISIS) Center Department of Radiology Georgetown University SPIE Medical Imaging 2006 2 Main Themes · Describe

  9. MEDICAL SCHOOL Medical School Communications

    E-print Network

    Minnesota, University of

    MEDICAL SCHOOL Medical School Communications Strategic Plan © 2015 Regents of the University of Minnesota Medical School is a large institution made up of 27 departments and over 3000 faculty members. It is the faculty's role to achieve the overall goals of the Medical School through research, patient care

  10. Supporting Medical Decision Making with Argumentation Tools

    ERIC Educational Resources Information Center

    Lu, Jingyan; Lajoie, Susanne P.

    2008-01-01

    This study investigated the collaborative decision-making and communicative discourse of groups of learners engaged in a simulated medical emergency in two conditions. In one condition subgroups used a traditional whiteboard (TW group) to document medical arguments on how to solve a medical emergency. In the other condition subgroups used…

  11. Medical Scientists

    MedlinePLUS

    ... by investigating safe dosage limits. <- Summary Work Environment -> Work Environment About this section Medical scientists usually work ... they take precautions that ensure a safe environment. Work Schedules Most medical scientists work full time. <- What ...

  12. Medical Management

    MedlinePLUS

    ... Search form Search Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there ... an individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, ...

  13. Medical devices; pediatric uses of devices; requirement for submission of information on pediatric subpopulations that suffer from a disease or condition that a device is intended to treat, diagnose, or cure; direct final rule. Direct final rule.

    PubMed

    2010-04-01

    The Food and Drug Administration (FDA) is amending the regulations on premarket approval of medical devices to include requirements relating to the submission of information on pediatric subpopulations that suffer from the disease or condition that a device is intended to treat, diagnose, or cure. Elsewhere in this issue of the Federal Register, we are publishing a companion proposed rule under FDA's usual procedure for notice and comment to provide a procedural framework to finalize the rule in the event we receive significant adverse comment and withdraw this direct final rule. PMID:20383921

  14. Insight: implantable medical devices.

    PubMed

    Meng, E; Sheybani, R

    2014-09-01

    Implantable electronic medical devices have achieved remarkable medical advances in the treatment of the most challenging conditions, starting with the introduction of the first implantable pacemaker in 1958. Increasing demand for innovation in existing and novel implantable devices is fuelled by the growing aging population and the increased prevalence of chronic diseases. This perspective article provides an overview of the implantable medical device ecosystem, highlights recent developments, and discusses challenges and opportunities for translation of new innovative implants enabled by microtechnologies and microfabrication. PMID:24903337

  15. Medical marijuana and children.

    PubMed

    Stubblefield, Sam

    2014-11-01

    Medical marijuana is legal for use by minors in many states, but not Delaware. Anecdotes have accumulated suggesting efficacy in managing seizures in children and several other conditions in adults. Currently well-designed studies in children are lacking. Challenges to effective pediatric medical marijuana use remain at the level of biochemistry, the individual patient, and society. Appropriate and effective use of medical marijuana in children will require significant legislative changes at the state and federal level, as well as high-quality research and standardization of marijuana strains. PMID:25647865

  16. 20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...person, other than the United States, to pay damages, OWCP or SOL will determine whether recoveries received from one or more...is both practicable and equitable, as determined by OWCP or SOL, in its discretion, the conditions will be treated as...

  17. 20 CFR 10.719 - If a settlement or judgment is received for more than one wound or medical condition, can the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...person, other than the United States, to pay damages, OWCP or SOL will determine whether recoveries received from one or more...is both practicable and equitable, as determined by OWCP or SOL, in its discretion, the conditions will be treated as...

  18. Mycobacterial bone marrow infections at a medical centre in Taiwan, 2001-2009.

    PubMed

    Lin, S-H; Lai, C-C; Huang, S-H; Hung, C-C; Hsueh, P-R

    2014-07-01

    Mycobacterial bone marrow (BM) infection is the most common diagnosis established by BM examinations for fever of unknown origin. In this study, clinical features and outcomes of patients who fulfilled the criteria for BM infection due to Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) at a medical centre in Taiwan from 2001 to 2009 were investigated. The BM histopathological findings were also analysed. A total of 24 patients (16 men, eight women) with mycobacterial BM infections were found. Of these, nine (38%) were positive for human immunodeficiency virus (HIV) and six (25%) had no pre-existing immunocompromised conditions. MTB isolates were obtained from 11 (46%) patients and NTM species were isolated from 10 (42%) patients, including M. avium complex (MAC, n = 7) and M. kansasii (n = 3). Patients with MTB infections were significantly older than those with NTM infections (60·5 vs. 47·7 years, P = 0·043) and were less likely to have a positive BM culture (45% vs. 100%, P = 0·012). The 90-day survival rates for MTB and NTM BM infections were 68% and 60%, respectively (P = 0·61). In addition, the presence of BM granulomas was significantly more common in patients with MTB BM infections than in those with NTM infections (82% vs. 30%, P = 0·030). In Taiwan, the importance of NTM was not inferior to MTB and besides MAC, M. kansasii might be an important pathogen in non-HIV-infected patients. The presence of BM granulomas and caseation provides valuable information regarding early treatment pending culture results. PMID:24168831

  19. MECHANISMS IN ENDOCRINOLOGY: Medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions.

    PubMed

    Nieschlag, Eberhard; Vorona, Elena

    2015-08-01

    Anabolic androgenic steroids (AASs) are appearance and performance-enhancing drugs (APEDs) used in competitive athletics, in recreational sports, and by body-builders. The global lifetime prevalence of AASs abuse is 6.4% for males and 1.6% for women. Many AASs, often obtained from the internet and dubious sources, have not undergone proper testing and are consumed at extremely high doses and in irrational combinations, also along with other drugs. Controlled clinical trials investigating undesired side effects are lacking because ethical restrictions prevent exposing volunteers to potentially toxic regimens, obscuring a causal relationship between AASs abuse and possible sequelae. Because of the negative feedback in the regulation of the hypothalamic-pituitary-gonadal axis, in men AASs cause reversible suppression of spermatogenesis, testicular atrophy, infertility, and erectile dysfunction (anabolic steroid-induced hypogonadism). Should spermatogenesis not recover after AASs abuse, a pre-existing fertility disorder may have resurfaced. AASs frequently cause gynecomastia and acne. In women, AASs may disrupt ovarian function. Chronic strenuous physical activity leads to menstrual irregularities and, in severe cases, to the female athlete triad (low energy intake, menstrual disorders and low bone mass), making it difficult to disentangle the effects of sports and AASs. Acne, hirsutism and (irreversible) deepening of the voice are further consequences of AASs misuse. There is no evidence that AASs cause breast carcinoma. Detecting AASs misuse through the control network of the World Anti-Doping Agency (WADA) not only aims to guarantee fair conditions for athletes, but also to protect them from medical sequelae of AASs abuse. PMID:25805894

  20. Immune-related conditions and immune-modulating medications as risk factors for non-Hodgkin's lymphoma: a case-control study.

    PubMed

    Engels, Eric A; Cerhan, James R; Linet, Martha S; Cozen, Wendy; Colt, Joanne S; Davis, Scott; Gridley, Gloria; Severson, Richard K; Hartge, Patricia

    2005-12-15

    In immunosuppressed or autoimmune disease states, disordered immune responses may lead to non-Hodgkin's lymphoma (NHL). In a US population-based case-control study of NHL (1998-2000), the authors collected personal histories of immune-related conditions and use of immune-modulating therapies as well as family histories of autoimmune conditions. The study included 1,321 NHL cases and 1,057 controls; only half received some questionnaire components. NHL was associated with Sjögren's syndrome (odds ratio (OR) = 13, 95% confidence interval (CI): 1.7, 100) and lupus (OR = 4.2, 95% CI: 1.2, 15). Two specific NHL subtypes were strongly associated with Sjögren's syndrome: salivary gland (OR = 290, 95% CI: 33, 2600) and marginal zone (OR = 75, 95% CI: 9.1, 610). NHL was less convincingly associated with receipt of an organ transplant (OR = 2.0, 95% CI: 0.4, 11). Other autoimmune conditions were too rare to evaluate or not associated with NHL. Corticosteroid use was unrelated to NHL (OR = 1.0, 95% CI: 0.8, 1.2), but methotrexate use was marginally associated (OR = 2.3, 95% CI: 0.7, 7.5). Family history of dermatomyositis was associated with NHL (7 cases vs. 0 controls, OR = infinite; two-sided p = 0.02), but dermatomyositis was absent in cases themselves. Family history of remaining conditions was unrelated to NHL. Results suggest that disordered immunity in some immune-related conditions can lead to NHL. PMID:16251389

  1. Medication Errors

    MedlinePLUS

    ... broader product safety issues. Relevant FDA Drug Safety Communications for Drug Products Associated with Medication Errors FDA Drug Safety Communication: FDA cautions about dosing errors when switching between ...

  2. Exploration Medical System Demonstration Project

    NASA Technical Reports Server (NTRS)

    Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

    2011-01-01

    A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide better crew health via the reduction in crew errors, crew time, and ground time.

  3. Medical syncretism with reference to malaria in a Tanzanian community.

    PubMed

    Muela, Susanna Hausmann; Ribera, Joan Muela; Mushi, Adiel K; Tanner, Marcel

    2002-08-01

    What happens when new health information is introduced into a community? We have explored this question in a semi-rural community of Southeastern Tanzania whose population has been in contact with biomedicine for many decades. With the example of malaria, we illustrate how biomedical knowledge transmitted in health messages coexists, interacts and merges with local pre-existing ideas and logics. The results are syncretic models, which may deviate considerably from what health promoters intended to transmit. Some of those may have implications for treatment of malaria, which may include delay in seeking treatment and non-compliance with therapy. Analysing this medical syncretism clearly demonstrates that even if comprehension of health messages is accurate, the way in which people interpret these messages may not be. Disentangling syncretic processes permits us to understand the dynamics of how information is processed by the recipients, and provides orientations for health promoters for adapting messages to the local context. PMID:12144148

  4. Exploration Medical System Demonstration

    NASA Technical Reports Server (NTRS)

    Rubin, D. A.; Watkins, S. D.

    2014-01-01

    BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that allows for scalability, extensibility, and interoperability of data sources and data users. f. Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management. g. Provide a better standard of healthcare for crew members through reductions in the time required by crew and ground personnel to provide medical treatment and the number of crew errors experienced during treatment.

  5. Medical Terminology.

    ERIC Educational Resources Information Center

    Mercer County Community Coll., Trenton, NJ.

    This document is one of a series of student workbooks developed for workplace skill development courses or workshops by Mercer County Community College (New Jersey) and its partners. Designed to help employees of medical establishments learn medical terminology, this course provides information on basic word structure, body parts, suffixes and…

  6. Stability Analysis of ISS Medications

    NASA Technical Reports Server (NTRS)

    Wotring, V. E.

    2014-01-01

    It is known that medications degrade over time, and that extreme storage conditions will hasten their degradation. The temperature and humidity conditions of the ISS have been shown to be within the ideal ranges for medication storage, but the effects of other environmental factors, like elevated exposure to radiation, have not yet been evaluated. Current operational procedures ensure that ISS medications are re-stocked before expiration, but this may not be possible on long duration exploration missions. For this reason, medications that have experienced long duration storage on the ISS were returned to JSC for analysis to determine any unusual effects of aging in the low- Earth orbit environment. METHODS Medications were obtained by the JSC Pharmacy from commercial distributors and were re-packaged by JSC pharmacists to conserve up mass and volume. All medication doses were part of the ISS crew medical kit and were transported to the International Space Station (ISS) via NASA's Shuttle Transportation System (Space Shuttle). After 568 days of storage, the medications were removed from the supply chain and returned to Earth on a Dragon (SpaceX) capsule. Upon return to Earth, medications were transferred to temperature and humidity controlled environmental chambers until analysis. Nine medications were chosen on the basis of their availability for study. The medications included several of the most heavily used by US crewmembers: 2 sleep aids, 2 antihistamines/decongestants, 3 pain relievers, an antidiarrheal and an alertness medication. Each medication was available at a single time point; analysis of the same medication at multiple time points was not possible. Because the samples examined in this study were obtained opportunistically from medical supplies, there were no control samples available (i.e. samples aged for a similar period of time on the ground); a significant limitation of this study. Medications were analyzed using the HPLC/MS methods described in the United States Pharmacopeia (USP) to measure the amount of intact active ingredient, identify degradation products and measure their amounts. Some analyses were conducted by an independent analytical laboratory, but certain (Schedule) medications could not be shipped to their facility and were analyzed at JSC. RESULTS Nine medications were analyzed with respect to active pharmaceutical ingredient (API) and degradant amounts. Results were compared to the USP requirements for API and degradants/impurities content for every FDA-approved medication. One medication met USP requirements at 5 months after its expiration date. Four of the nine (44% of those tested) medications tested met USP requirements up to 8 months post-expiration. Another 3 medications (33% of those tested) met USP guidelines 2-3 months before expiration. One medication, a compound classed by the FDA as a dietary supplement and sometimes used as a sleep aid, failed to meet USP requirements at 11 months post-expiration. CONCLUSION Analysis of each medication at a single time point provides limited information on the stability of a medication stored in particular conditions; it is not possible to predict how long a medication may be safe and effective from these data. Notwithstanding, five of the nine medications tested (56%) met USP requirements for API and degradants/impurities at least 5 months past expiration dates. The single compound that failed to meet USP requirements is not regulated as strictly as prescription medications are during manufacture; it is unknown if this medication would have met the requirements prior to flight. Notably, it was the furthest beyond its expiration date. Only more comprehensive analysis of flight-aged samples compared to appropriate ground controls will permit determination of spaceflight effects on medication stability.

  7. 77 FR 51039 - Merchant Mariner Medical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-23

    ...Task Statement 5, Creating medical expert panels for the top medical conditions. (e) Task Statement 6, Developing designated medical examiner program. Day 2...Admiral, U.S. Coast Guard, Assistant Commandant for Prevention...

  8. Visiting Medical Student Immunization Requirements Entering medical students are required to show

    E-print Network

    He, Chuan

    Visiting Medical Student Immunization Requirements Entering medical students are required to show, Mumps, Rubella or Diphtheria outbreak in accordance with public health law. o MEDICAL CONTRAINDICATIONS, the nature, and duration of the medical condition that contraindicates the vaccine(s). This statement

  9. Immunization Requirement (Medical Exemption Form)

    E-print Network

    Stuart, Steven J.

    , nurse practitioner, or physician assistant stating that you have a medical condition and vaccinations. Please mail or fax this form to Redfern Health Center along with documentation from a physician

  10. Medical Transcriptionists

    MedlinePLUS

    ... answering phones and greeting patients. <- Summary Work Environment -> Work Environment About this section Many transcriptionists receive dictation ... home offices, receiving dictation and submitting drafts electronically. Work Schedules Most medical transcriptionists work full time, although ...

  11. Medical Imaging.

    ERIC Educational Resources Information Center

    Barker, M. C. J.

    1996-01-01

    Discusses four main types of medical imaging (x-ray, radionuclide, ultrasound, and magnetic resonance) and considers their relative merits. Describes important recent and possible future developments in image processing. (Author/MKR)

  12. Medication Treatment

    MedlinePLUS

    ... behavior, such as to reduce self-injury or aggression. Once a symptom is no longer a problem, ... of repetitive behaviors; decrease anxiety, irritability, tantrums, and aggressive behavior; and improve eye contact. Tricyclics These medications ...

  13. Taking Medication

    MedlinePLUS Videos and Cool Tools

    ... Tracker App Tip Sheets and Handouts AADE7 Self-Care Behaviors Healthy Eating Being Active Monitoring Taking Medication ... Legislative Action Center Federal Legislation State Legislation Affordable Care Act Information Advocacy Tools and Resources Cart Search ...

  14. Medical decisions.

    PubMed

    Black, D

    1980-04-01

    In relation to the application of decision theory to medical problems, a description is given of the terms 'probability', 'utility' and 'coherence'. The use of utilities is illustrated by comparing the outcomes of various methods of palliating terminal renal failure. The use of Bayes' theorem in incorporating additional information is described. Reference is made to specific clinical applications of mathematical methods. Some general comments are made on the way in which clinical and other medical decisions are reached. PMID:7006081

  15. Medical Products Research

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Ventrex Laboratories, Inc. develops, manufactures and markets a line of medical diagnostic assays based on biochemical techniques, in particular immunochemical techniques. Their products are sold worldwide to hospitals and medical laboratories for use in testing blood samples and other biological fluids. Analysis of a patient's body fluids, compared with normal values, aids a physician in confirming or otherwise diagnosing a suspected disease condition. NERAC's rapid information retrieval has provided Ventrex invaluable up-to-date information, and has permitted large scale savings. NERAC's service was particularly important in the development of a new product in the company's Ventre/Sep line, which is used in radioimmunoassays.

  16. BOISE STATE UNIVERSITY AUTHORIZATION FOR LIMITED RELEASE OF MEDICAL INFORMATION

    E-print Network

    Barrash, Warren

    medical information (including pertinent medical records), and to discuss my medical condition providers.) 1. 2. 3. I understand that the forgoing records and medical information are limited onlyBOISE STATE UNIVERSITY AUTHORIZATION FOR LIMITED RELEASE OF MEDICAL INFORMATION ("Release") I

  17. Medical Coding Classification by Leveraging Inter-Code Relationships

    E-print Network

    Dy, Jennifer G.

    medical records into standard prede- fined medical codes. There are several worldwide accepted medical the Ninth Revision of ICD (ICD-9) provides the standard for coding clinical records. Accu- rate medical coding to record medical services (procedures) and associated causes or conditions (diagnoses

  18. Common Childhood Orthopedic Conditions

    MedlinePLUS

    ... might be linked to other conditions, such as cerebral palsy, muscle weakness disorders, autism, or other nervous system ... be related to existing medical problems such as cerebral palsy. Doctors rarely have to treat pigeon-toed feet. ...

  19. AIR CONDITIONER REQUEST EXTREME MEDICAL CIRCUMSTANCES

    E-print Network

    ? _____________________________________________ _______________________________________________________________________________________________________________________________________________________ Type of allergy or significant medical condition: __________________________________________________________ _______________________________________________________________________________________________________________________________________________________ Are allergy injections given No OR essential Yes No to the management of allergy? Is the use of an air conditioner

  20. [Future trend medical apps. From the apps store directly into medical practice?].

    PubMed

    Gehring, H; Pramann, O; Imhoff, M; Albrecht, U-V

    2014-12-01

    In day to day medical care, patients, nursing staff and doctors currently face a bewildering and rapidly growing number of health-related apps running on various "smart" devices and there are also uncountable possibilities for the use of such technology. Concerning regulation, a risk-based approach is applied for development and use (including safety and security considerations) of medical and health-related apps. Considering safety-related issues as well as organizational matters, this is a sensible approach but requires honest self-assessment as well as a high degree of responsibility, networking and good quality management by all those involved. This cannot be taken for granted. Apart from regulatory aspects it is important to not only consider what is reasonable, helpful or profitable. Quality aspects, safety matters, data protection and privacy as well as liability issues must also be considered but are often not adequately respected. If software quality is compromised, this endangers patient safety as well as data protection, privacy and data integrity. This can for example result in unwanted advertising or unauthorized access to the stored data by third parties; therefore, local, regional and international regulatory measures need to be applied in order to ensure safe use of medical apps in all possible areas, including the operating room (OR) with its highly specialized demands. Lawmakers need to include impulses from all stakeholders in their considerations and this should include input from existing private initiatives that already deal with the use and evaluation of apps in a medical context. Of course, this process needs to respect pre-existing national, European as well as international (harmonized) standards. PMID:25388438

  1. Medical migration.

    PubMed

    Loefler, I J

    2001-10-01

    The issue of professional migration, however emotional it may have become, ought not to be regarded in moralizing terms. The history of western medicine is the history of migrating physicians. A doctor who moves from a locality to another to take up a new assignment there cannot be said to have "abandoned his patients". This emotional bond has become the victim of specialization and of depersonalization of medical services and not of medical migration, brain drain or otherwise. The primary reason for medical migration is not financial; the desire to migrate usually begins with the desire to learn. Professionals crave in the first line for professional satisfaction. The migration of medical manpower cannot be stopped with administrative measures and will not be stopped by exhortations and appeals, moralization and condemnations. Brain drain is a global phenomenon and has always been so. A country which loses its professionals, its doctors, should examine the social relationships within the profession and should investigate whether the opportunities for deriving professional satisfaction from everyday work exist or whether these have been thwarted by the hierarchy, conservatism, cronyism and the general lack of comprehension of what good medical care is about. PMID:11593497

  2. Medical Renaissance.

    PubMed

    Toledo-Pereyra, Luis H

    2015-06-01

    The Medical Renaissance started as the regular Renaissance did in the early 1400s and ended in the late 1600s. During this time great medical personalities and scholar humanists made unique advances to medicine and surgery. Linacre, Erasmus, Leonicello and Sylvius will be considered first, because they fit the early classic Renaissance period. Andreas Vesalius and Ambroise Paré followed thereafter, making outstanding anatomical contributions with the publication of the "Human Factory" (1543) by Vesalius, and describing unique surgical developments with the publication of the "The Apologie and Treatise of Ambroise Paré." At the end of the Renaissance and beginning of the New Science, William Harvey, noted British medical doctor and cardiovascular researcher, discovered the general circulation. He published his findings in "The Motu Cordis" in 1628 (Figure 1). The Medical Renaissance, in summary, included a great number of accomplished physicians and surgeons who made especial contributions to human anatomy; Vesalius assembled detailed anatomical information; Paré advanced surgical techniques; and Harvey, a medical genius, detailed the circulatory anatomy and physiology. PMID:26065591

  3. Commercial Driver Medical Examinations

    PubMed Central

    Moffitt, Gary; Hanowski, Richard J.; Kales, Stefanos N.; Porter, Richard J.; Hegmann, Kurt T.

    2015-01-01

    Objective: The objective of this study was to assess relationships between body mass index (BMI) and comorbid conditions within a large sample of truck drivers. Methods: Commercial driver medical examination data from 88,246 commercial drivers between 2005 and 2012 were analyzed for associations between BMI, medical disorders, and driver certification. Results: Most drivers were obese (53.3%, BMI >30.0 kg/m2) and morbidly obese (26.6%, BMI >35.0 kg/m2), higher than prior reports. Obese drivers were less likely to be certified for 2 years and more likely to report heart disease, hypertension, diabetes mellitus, nervous disorders, sleep disorders, and chronic low back pain (all P < 0.0001). There are relationships between multiple potentially disqualifying conditions and increasing obesity (P < 0.0001). Morbid obesity prevalence increased 8.9% and prevalence of three or more multiple conditions increased fourfold between 2005 and 2012. Conclusions: Obesity is related to multiple medical factors as well as increasing numbers of conditions that limit driving certification. PMID:25710607

  4. 28 CFR 2.77 - Medical parole.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Medical parole. 2.77 Section 2.77... Medical parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that... medical condition that is not terminal, the Commission shall determine whether or not to release...

  5. 28 CFR 2.77 - Medical parole.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Medical parole. 2.77 Section 2.77... Medical parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that... medical condition that is not terminal, the Commission shall determine whether or not to release...

  6. 28 CFR 2.77 - Medical parole.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Medical parole. 2.77 Section 2.77... Medical parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that... medical condition that is not terminal, the Commission shall determine whether or not to release...

  7. 28 CFR 2.77 - Medical parole.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Medical parole. 2.77 Section 2.77... Medical parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that... medical condition that is not terminal, the Commission shall determine whether or not to release...

  8. 28 CFR 2.77 - Medical parole.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Medical parole. 2.77 Section 2.77... Medical parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that... medical condition that is not terminal, the Commission shall determine whether or not to release...

  9. Medical marijuana.

    PubMed

    1999-04-30

    The Florida Supreme Court heard oral arguments in April regarding a glaucoma patient's request for a medical exception to the State prohibition on use of marijuana. [Name removed] was convicted on possession and cultivation charges, and a trial judge refused to allow a medical necessity defense. A State appeals court subsequently overturned [name removed]'s conviction. The case focuses on whether the legislature intended to prohibit such a defense when it declared in 1993 that the substance had no medicinal benefits. PMID:11366533

  10. Medical genetics

    SciTech Connect

    Jorde, L.B.; Carey, J.C.; White, R.L.

    1995-10-01

    This book on the subject of medical genetics is a textbook aimed at a very broad audience: principally, medical students, nursing students, graduate, and undergraduate students. The book is actually a primer of general genetics as applied to humans and provides a well-balanced introduction to the scientific and clinical basis of human genetics. The twelve chapters include: Introduction, Basic Cell Biology, Genetic Variation, Autosomal Dominant and Recessive Inheritance, Sex-linked and Mitochondrial Inheritance, Clinical Cytogenetics, Gene Mapping, Immunogenetics, Cancer Genetics, Multifactorial Inheritance and Common Disease, Genetic Screening, Genetic Diagnosis and Gene Therapy, and Clinical Genetics and Genetic Counseling.

  11. Treating Child Obesity and Associated Medical Conditions

    ERIC Educational Resources Information Center

    Caprio, Sonia

    2006-01-01

    With American children on course to grow into the most obese generation of adults in history, Sonia Caprio argues that it is critical to develop more effective strategies for preventing childhood obesity and treating serious obesity-related health complications. She notes that although pediatricians are concerned about the obesity problem, most…

  12. MEDICAL EDUCATION Professional Organizations

    E-print Network

    Acton, Scott

    MEDICAL EDUCATION Professional Organizations: Accreditation Council for Graduate Medical Education (ACGME) Association of American Medical Colleges (AAMC) Association for Hospital Medical Education (AHME) Alliance for Continuing Education in the Health Professions (ACEHP) Society for Academic Continuing Medical

  13. Integrated Medical Model Overview

    NASA Technical Reports Server (NTRS)

    Myers, J.; Boley, L.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; Saile, L.; Shah, R.; Garcia, Y.; Sirmons. B.; Walton, M.; Reyes, D.

    2015-01-01

    The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project.

  14. Medical genetics

    SciTech Connect

    Nora, J.J.; Fraser, F.C.

    1989-01-01

    This book presents a discussion of medical genetics for the practitioner treating or counseling patients with genetic disease. It includes a discussion of the relationship of heredity and diseases, the chromosomal basis for heredity, gene frequencies, and genetics of development and maldevelopment. The authors also focus on teratology, somatic cell genetics, genetics and cancer, genetics of behavior.

  15. Medical imaging.

    PubMed Central

    Kreel, L.

    1991-01-01

    There is now a wide choice of medical imaging to show both focal and diffuse pathologies in various organs. Conventional radiology with plain films, fluoroscopy and contrast medium have many advantages, being readily available with low-cost apparatus and a familiarity that almost leads to contempt. The use of plain films in chest disease and in trauma does not need emphasizing, yet there are still too many occasions when the answer obtainable from a plain radiograph has not been available. The film may have been mislaid, or the examination was not requested, or the radiograph had been misinterpreted. The converse is also quite common. Examinations are performed that add nothing to patient management, such as skull films when CT will in any case be requested or views of the internal auditory meatus and heal pad thickness in acromegaly, to quote some examples. Other issues are more complicated. Should the patient who clinically has gall-bladder disease have more than a plain film that shows gall-stones? If the answer is yes, then why request a plain film if sonography will in any case be required to 'exclude' other pathologies especially of the liver or pancreas? But then should cholecystography, CT or scintigraphy be added for confirmation? Quite clearly there will be individual circumstances to indicate further imaging after sonography but in the vast majority of patients little or no extra information will be added. Statistics on accuracy and specificity will, in the case of gall-bladder pathology, vary widely if adenomyomatosis is considered by some to be a cause of symptoms or if sonographic examinations 'after fatty meals' are performed. The arguments for or against routine contrast urography rather than sonography are similar but the possibility of contrast reactions and the need to limit ionizing radiation must be borne in mind. These diagnostic strategies are also being influenced by their cost and availability; purely pragmatic considerations are not infrequently the overriding factor. Non-invasive methods will be preferred, particularly sonography as it is far more acceptable by not being claustrophobic and totally free of any known untoward effects. There is another quite different but unrelated aspect. The imaging methods, apart from limited exceptions, cannot characterize tissues as benign or malignant, granulomatous or neoplastic; cytology or histology usually provides the answer. Sonography is most commonly used to locate the needle tip correctly for percutaneous sampling of tissues. Frequently sonography with fine needle aspiration cytology or biopsy is the least expensive, safest and most direct route to a definitive diagnosis. Abscesses can be similarly diagnosed but with needles or catheters through which the pus can be drained. The versatility and mobility of sonography has spawned other uses, particularly for the very ill and immobile, for the intensive therapy units and for the operating theatre, as well in endosonography. The appointment of more skilled sonographers to the National Health Service could make a substantial contribution to cost-effective management of hospital services. Just when contrast agents and angiography have become safe and are performed rapidly, they are being supplanted by scanning methods. They are now mainly used for interventional procedures or of pre-operative 'road maps' and may be required even less in the future as MRI angiography and Doppler techniques progress. MRI will almost certainly extent its role beyond the central nervous system (CNS) should the equipment become more freely available, especially to orthopaedics. Until then plain films, sonography or CT will have to suffice. Even in the CNS there are conditions where CT is more diagnostic, as in showing calculations in cerebral cysticercosis. Then, too, in most cases CT produces results comparable to MRI apart from areas close to bone, structures at the base of the brain, in the posterior fossa and in the spinal cord. Scintigraphy for pulmonary infarcts and bone metastases and in renal disease in children plays

  16. Effectiveness of a quality improvement curriculum for medical students

    PubMed Central

    Tartaglia, Kimberly M.; Walker, Curt

    2015-01-01

    Introduction As health systems find ways to improve quality of care, medical training programs are finding opportunities to prepare learners on principles of quality improvement (QI). The impact of QI curricula for medical students as measured by student learning is not well delineated. The aim of this study is to evaluate the effectiveness of a QI curriculum for senior medical students as measured by student knowledge and skills. Methods This study was an observational study that involved a self-assessment and post-test Quality Improvement Knowledge Application Tool (QIKAT) for intervention and control students. A QI curriculum consisting of online modules, live discussions, independent readings and reflective writing, and participation in a mentored QI project was offered to fourth-year medical students completing an honor's elective (intervention group). Senior medical students who received the standard QI curriculum only were recruited as controls. Results A total of 22 intervention students and 12 control students completed the self-assessment and QIKAT. At baseline, there was no difference between groups in self-reported prior exposure to QI principles. Students in the intervention group reported more comfort with their skills in QI overall and in 9 of the 12 domains (p<0.05). Additionally, intervention students performed better in each of the three case scenarios (p<0.01). Discussion A brief QI curriculum for senior medical students results in improved comfort and knowledge with QI principles. The strengths of our curriculum include effective use of classroom time and faculty mentorship with reliance on pre-existing online modules and written resources. Additionally, the curriculum is easily expandable to larger groups of students and transferable to other institutions. PMID:25960052

  17. Maternal medication, drug use, and breastfeeding.

    PubMed

    Rowe, Hilary; Baker, Teresa; Hale, Thomas W

    2013-02-01

    This article reviews the necessary skills required for clinicians to make informed decisions about the use of medications in women who are breastfeeding. Even without specific data on certain medications, this review of kinetic principles, mechanisms of medication entry into breast milk, and important infant factors can aid in clinical decision making. In addition, common medical conditions and suitable treatments of depression, hypertension, infections and so forth for women who are breastfeeding are also reviewed. PMID:23178070

  18. 20 CFR 220.110 - Medically disabled.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

  19. 20 CFR 220.110 - Medically disabled.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

  20. 20 CFR 220.110 - Medically disabled.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

  1. 20 CFR 220.110 - Medically disabled.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

  2. 20 CFR 220.110 - Medically disabled.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...

  3. Medical problems of surgical patients. Hypertension and ischaemic heart disease.

    PubMed Central

    Prys-Roberts, C.

    1976-01-01

    Pre-existing disease in the form of hypertension or ischaemic heart disease may increase morbidity and mortality in patients presenting for anaesthesia and surgery. The interaction of these two cardiovascular conditions in relation to anaesthesia has been studied in a series of 115 patients. The results did not support the view that antihypertensive drugs and beta-receptor blocking agents should be withdrawn before anaesthesia and surgery. The main cause for concern in providing anaesthesia for these patients is that sympathetic nervous activation induced either by anaesthetic manoeuvres or by surgical stimulation may lead to reflex cardiovascular responses which, by increasing myocardial oxygen demand, lead to episodes of myocardial ischaemia. In this respect beta-receptor blocking drugs appear to have a protective effect on the ischaemic myocardium. PMID:10825

  4. Medical Applications

    NASA Astrophysics Data System (ADS)

    Boccara, A. Claude; Mordon, Serge

    2015-10-01

    In re-listening to the lectures of Charles Townes shortly after the invention of the laser (e.g., in the Boston Science Museum), one can already have a realistic vision of the potentialities of this new tool in the field of medical therapy, as evidenced by the use of the laser in ophthalmology to cure retinal detachment in the 1960's. Since then, applications have flourished in the domain of therapy. We will thus illustrate here only some of the main fields of application of medical lasers. On the opposite, the use of lasers in medical imaging is, with one exception in ophthalmology, still at the development level. It is becoming a diagnostic tool in addition to high performance imaging facilities that are often very expensive (such as CT scan, Magnetic Resonance Imaging (MRI) and nuclear imaging). Even if progress is sometimes slow, one can now image with light inside the human body, in spite of the strong scattering of light by tissues, in the same way as a pathologist sees surgical specimens.

  5. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

  6. Smoking cessation medications

    MedlinePLUS

    Smoking cessation - medications; Smokeless tobacco - medications; Medications for stopping tobacco ... quit tobacco use. These medicines do not contain nicotine. They work in a different way than nicotine ...

  7. Evaluation of the medical history.

    PubMed

    Jolly, D E

    1994-07-01

    Medical and dental interdisciplinary cooperation is critical in appropriate assessment of the medical history and the subsequent management of the medically compromised dental patient. This interdisciplinary, rather than multidisciplinary, cooperation must extend beyond the physician and include the patient, family, caregivers, therapists, and anyone else involved in the life of the particular individual. This article has discussed numerous medically compromising conditions that require cooperative efforts between dental health professionals and other health care professionals. Specific recommendations were made regarding certain medical problems that affect dental care. The patient with a medical condition has a significant disability affecting many facets of life, essentially no different than a person with a physical or mental disability. The critical activity on the part of the dentist in managing the medically compromised dental patient is the cognitive skill ability. Cognitive skills permit appropriate use of the proper technique and behavioral skills. Proper oral health care can contribute significantly to a person's quantity and quality of life. The concept of optimum dental treatment planning differs from ideal dental treatment planning but should not be considered compromised dental treatment planning. Finally, an evaluation tool, the DRAPE Scale, is a means to aid dental treatment planning for the medically compromised dental patient. Remember that optimum care may not be ideal and is influenced by patient-specific and situation-specific circumstances. When this approach to treatment is followed in the appropriate interdisciplinary fashion, the patient benefits, and an individual's quantity and quality of life should benefit. Dental care for the patient with medically compromising conditions can be difficult and infinitely challenging but ultimately rewarding. PMID:7926193

  8. Inflight Medical Events in the Shuttle Program

    NASA Technical Reports Server (NTRS)

    Baisden, Denise L.; Effenhauser, R. K.; Wear, Mary L.

    1999-01-01

    Since the first launch of the Space Shuttle in 1981, the astronauts and their flight surgeons have dealt with a variety of inflight medical issues. A review will be provided of these issues as well as medications used in the treatment of these medical problems. Detailed medical debriefs are conducted by the flight ,surgeon with the individual crewmembers three days after landing. These debriefs were review for Shuttle flights from 1988 through 1999 to determine the frequency of inflight medical events. Medical events were grouped by ICD category and the frequency of medical events within those categories were reviewed. The ICD category of Symptoms, Signs and Ill-defined Conditions had the most medical events. Facial fullness and headache were the most common complaints within this category. The ICD category of Respiratory System had the next most common medical events with sinus congestion being the most common complaint. This was followed by Digestive System complaints and Nervous System/Sense Organ complaints. A variety of inflight medical events have occurred throughout the Shuttle program. Fortunately, the majority of these problems have been minor and have been well within the capability of the medical equipment flown and the skills of the Crew Medical Officers. Medical ,problems/procedures that are routine on the ground often present unique problems in the space flight environment. It is important that the flight surgeon understand the common medical problems encountered.

  9. Medical electromechatronics

    NASA Astrophysics Data System (ADS)

    Osipov, Y. M.; Syryamkin, V. I.; Osipov, O. Y.

    2015-11-01

    The first part of the article presentsdevices of rehabilitation electromechatronics.As a research work, the author's team has performed sketch and technical developments on this subject, which are protected by patents of the Russian Federation. The second part providesan overview of medical robotic surgery, which is ideal for imperfections removing.It also describes capabilities of the author's team in development of active driveline based "iron" hands.Scalpels never tremble in the iron hands, which are not afraid of the aftershocks and never get tired.They can perform operations during not less than 48 consecutive hours.

  10. Medical clip

    NASA Technical Reports Server (NTRS)

    Baucom, R. M. (inventor)

    1983-01-01

    An X-ray transparent and biological inert medical clip for treating aneurisms and the like is described. A graphite reinforced composite film is molded into a unitary structure having a pair of hourglass-like cavities hinged together with a pair of jaws for grasping the aneurism extending from the wall of one cavity. A silicone rubber pellet is disposed in the other cavity to exert a spring force through the hinge area to normally bias the jaws into contact with each other.

  11. Medical alert bracelet (image)

    MedlinePLUS

    People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will ... People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will ...

  12. Your Medical Records

    MedlinePLUS

    ... Best Self Smart Snacking Losing Weight Safely Your Medical Records KidsHealth > Teens > Body > Health Basics > Your Medical ... I Keep My Own Medical Records? What Are Medical Records? Each time you climb up on a ...

  13. 38 CFR 17.240 - Sharing specialized medical resources.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... medical resources. 17.240 Section 17.240 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.240 Sharing specialized medical resources. Subject to such terms and conditions as the Under Secretary for Health shall...

  14. 38 CFR 17.240 - Sharing specialized medical resources.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... medical resources. 17.240 Section 17.240 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.240 Sharing specialized medical resources. Subject to such terms and conditions as the Under Secretary for Health shall...

  15. 32 CFR 564.39 - Medical care benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Medical care benefits. 564.39 Section 564.39... REGULATIONS Medical Attendance and Burial § 564.39 Medical care benefits. (a) A member of the ARNG who incurs a disease or injury under the conditions enumerated herein is entitled to medical care, in...

  16. 32 CFR 564.39 - Medical care benefits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Medical care benefits. 564.39 Section 564.39... REGULATIONS Medical Attendance and Burial § 564.39 Medical care benefits. (a) A member of the ARNG who incurs a disease or injury under the conditions enumerated herein is entitled to medical care, in...

  17. 38 CFR 17.240 - Sharing specialized medical resources.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... medical resources. 17.240 Section 17.240 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.240 Sharing specialized medical resources. Subject to such terms and conditions as the Under Secretary for Health shall...

  18. Medical Need Special Parking Request Instructions Page 1 of 2

    E-print Network

    Medical Need Special Parking Request Instructions Page 1 of 2: Students may request special parking for a qualified medical condition. Special parking requests of greater than 90 days are routed through Duke by the student and medical provider. The medical provider (MD, DO, PA, and NP) cannot be someone with whom you

  19. 38 CFR 17.240 - Sharing specialized medical resources.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... medical resources. 17.240 Section 17.240 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.240 Sharing specialized medical resources. Subject to such terms and conditions as the Under Secretary for Health shall...

  20. FAMILY AND MEDICAL LEAVE ACT (FMLA) CERTIFICATION FORM Employee's Section

    E-print Network

    Lewis, Robert Michael

    FAMILY AND MEDICAL LEAVE ACT (FMLA) CERTIFICATION FORM Employee's Section Employee's Name): ______________________________________________________________ Medical Release-My signature authorizes the release of any medical information needed by the College __________________ (if patient is not employee): Reason for FMLA Leave: a. Employee's (your) own medical condition. b

  1. 38 CFR 17.240 - Sharing specialized medical resources.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... medical resources. 17.240 Section 17.240 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.240 Sharing specialized medical resources. Subject to such terms and conditions as the Under Secretary for Health shall...

  2. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT...

  3. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT...

  4. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT...

  5. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT...

  6. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Medical nutrition therapy. 410.132 Section 410.132... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.132 Medical nutrition therapy. (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT...

  7. Medical Misuse of Controlled Medications Among Adolescents

    PubMed Central

    McCabe, Sean Esteban; West, Brady T.; Cranford, James A.; Ross-Durow, Paula; Young, Amy; Teter, Christian J.; Boyd, Carol J.

    2011-01-01

    Objectives To determine the past-year medical misuse prevalence for 4 controlled medication classes (pain, stimulant, sleeping, and antianxiety) among adolescents, and to assess substance use outcomes among adolescents who report medical misuse. Design A Web-based survey was self-administered by 2744 secondary school students in 2009-2010. Setting Two southeastern Michigan school districts. Participants The sample had a mean age of 14.8 years and was 51.1% female. The racial/ethnic distribution was 65.0% white, 29.5% African American, 3.7% Asian, 1.3% Hispanic, and 0.5% other. Main Outcome Measures Past-year medical use and misuse of 4 controlled medication classes. Results Eighteen percent of the sample reported past-year medical use of at least 1 prescribed controlled medication. Among past-year medical users, 22.0% reported misuse of their controlled medications, including taking too much, intentionally getting high, or using to increase alcohol or other drug effects. Medical misusers were more likely than nonmisusers to divert their controlled medications and to abuse other substances. The odds of a positive screening result for drug abuse were substantially higher among medical misusers (adjusted odds ratio, 7.8; 95% confidence interval, 4.3-14.2) compared with medical users who used their controlled medications appropriately. The odds of drug abuse did not differ between medical users who used their controlled medications appropriately and nonusers. Conclusions Most adolescents who used controlled medications took their medications appropriately. Substance use and diversion of controlled medications were more prevalent among adolescents who misused their controlled medications. Careful therapeutic monitoring could reduce medical misuse and diversion of controlled medications among adolescents. PMID:21810634

  8. Medical robotics.

    PubMed

    Ferrigno, Giancarlo; Baroni, Guido; Casolo, Federico; De Momi, Elena; Gini, Giuseppina; Matteucci, Matteo; Pedrocchi, Alessandra

    2011-01-01

    Information and communication technology (ICT) and mechatronics play a basic role in medical robotics and computer-aided therapy. In the last three decades, in fact, ICT technology has strongly entered the health-care field, bringing in new techniques to support therapy and rehabilitation. In this frame, medical robotics is an expansion of the service and professional robotics as well as other technologies, as surgical navigation has been introduced especially in minimally invasive surgery. Localization systems also provide treatments in radiotherapy and radiosurgery with high precision. Virtual or augmented reality plays a role for both surgical training and planning and for safe rehabilitation in the first stage of the recovery from neurological diseases. Also, in the chronic phase of motor diseases, robotics helps with special assistive devices and prostheses. Although, in the past, the actual need and advantage of navigation, localization, and robotics in surgery and therapy has been in doubt, today, the availability of better hardware (e.g., microrobots) and more sophisticated algorithms(e.g., machine learning and other cognitive approaches)has largely increased the field of applications of these technologies,making it more likely that, in the near future, their presence will be dramatically increased, taking advantage of the generational change of the end users and the increasing request of quality in health-care delivery and management. PMID:21642033

  9. MEDICAL IMAGE PROCESSINGNegin Nahoomi

    E-print Network

    Matsakis, Pascal

    MEDICAL IMAGE PROCESSINGNegin Nahoomi Prof. Pascal Matsakis Fall 2015 INTRODUCTION Medical Image Processing goal is to effectively process and analyze the medical images in order to extract information medical image processing system ·Medical imaging tools ·Processing of medical images ·Some other

  10. 041 (a) 1-WH 06/2012 MEDICAL HISTORY--WOMEN'S HEALTH Page 1 of 1 MEDICAL HISTORY WOMEN'S HEALTH

    E-print Network

    Maroncelli, Mark

    041 (a) 1-WH 06/2012 MEDICAL HISTORY--WOMEN'S HEALTH Page 1 of 1 MEDICAL HISTORY ­ WOMEN'S HEALTH [ ]. Do you currently or have you ever had any of the following conditions? PAST MEDICAL HISTORY: Yes: _____________________________ ____________________________________________________ ____________________________________________________ OTHER SIGNIFICANT PAST MEDICAL HISTORY: Have you ever been pregnant? If yes, # of times

  11. Prioritizing Medical Resources for Exploration Missions

    NASA Technical Reports Server (NTRS)

    Shah, R. V.; Kerstman, E. L.

    2015-01-01

    Long duration missions beyond low Earth orbit introduce new constraints to the medical system. Factors such as the inability to evacuate to Earth in a timely manner, communication delay, limitations in available medical equipment, and the clinical background of the crew will all have an impact on the assessment and treatment of medical conditions. The Exploration Medical Capability (ExMC) Element of NASAs Human Research Program seeks to improve the way the element derives its mitigation strategies for the risk of "Unacceptable Health and Mission Outcomes Due to Limitation of In-flight Medical Capabilities."

  12. Medical expertise, existential suffering and ending life.

    PubMed

    Varelius, Jukka

    2014-02-01

    In this article, I assess the position that voluntary euthanasia (VE) and physician-assisted suicide (PAS) ought not to be accepted in the cases of persons who suffer existentially but who have no medical condition, because existential questions do not fall within the domain of physicians' professional expertise. I maintain that VE and PAS based on suffering arising from medical conditions involves existential issues relevantly similar to those confronted in connection with existential suffering. On that basis I conclude that if VE and PAS based on suffering arising from medical conditions is taken to fall within the domain of medical expertise, it is not consistent to use the view that physicians' professional expertise does not extend to existential questions as a reason for denying requests for VE and PAS from persons who suffer existentially but have no medical condition. PMID:23869046

  13. FIRST AID & SPECIAL MEDICAL Emergency Medical Plan*

    E-print Network

    Tullos, Desiree

    155 FIRST AID & SPECIAL MEDICAL SERVICE Emergency Medical Plan* Oregon Safety Codes state that every place of employment having more than one employee must have an emergency medical plan. If a physician or an ambulance with an emergency medical technician is available to the place of employment

  14. PRE-MEDICAL PROFESSIONS Medical professional schools

    E-print Network

    PRE-MEDICAL PROFESSIONS Medical professional schools encourage students to develop the broadest requirements required for application to the following medical professional schools include: chiropractic medicine programs, as well as other programs in the medical field. A Bachelor's degree is required

  15. Stanford University Medical Center Lane Medical Library

    E-print Network

    Kay, Mark A.

    Stanford University Medical Center Lane Medical Library 300 Pasteur Drive Room L109 Stanford, CA 94305-5126 Circulation: (650) 723-6691 LANE MEDICAL LIBRARY REGISTRATION FORM Print legibly and complete: ________________________________ The undersigned agrees to abide by Lane Medical Library regulations and acknowledge that the proxy's use

  16. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... made when the treating physician determines that there is a change of diagnosis, medical condition, or... any additional assessments or interventions required by a change of diagnosis, medical condition, or... 42 Public Health 2 2011-10-01 2011-10-01 false Medical nutrition therapy. 410.132 Section...

  17. 42 CFR 410.132 - Medical nutrition therapy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... made when the treating physician determines that there is a change of diagnosis, medical condition, or... any additional assessments or interventions required by a change of diagnosis, medical condition, or... 42 Public Health 2 2010-10-01 2010-10-01 false Medical nutrition therapy. 410.132 Section...

  18. How can we make smartphones smarter, solar energy less expensive and medical

    E-print Network

    Toronto, University of

    CHALLENGE: How can we make smartphones smarter, solar energy less expensive and medical conditions of applications, including medical diagnostics. "Most engineers design with materials; our business is design

  19. Medical responsibility.

    PubMed

    Hamowy, Ronald

    2012-01-01

    These comments seek to take issue with the contention that society has a responsibility to provide its members with any needed health care. In order to deal with this claim we must first make clear exactly what it meant by the proposition. I take it that those who embrace this view mean considerably more than that each of us has a moral obligation to contribute to those in need of medical attention who are unable, for one reason or another, to afford the necessary care. This is a moral proposition and is traditionally dealt with under the heading of charity. But the contention, as here used, means considerably more since its main implications are not moral but primarily political. PMID:23061581

  20. International Space Station Medical Operations

    NASA Technical Reports Server (NTRS)

    Jones, Jeffrey A.

    2008-01-01

    NASA is currently the leader, in conjunction with our Russian counterpart co-leads, of the Multilateral Medical Policy Board (MMPB), the Multilateral Medical Operations Panel (MMOP), which coordinates medical system support for International Space Station (ISS) crews, and the Multilateral Space Medicine Board (MSMB), which medically certifies all crewmembers for space flight on-board the ISS. These three organizations have representatives from NASA, RSA-IMBP (Russian Space Agency- Institute for Biomedical Problems), GCTC (Gagarin Cosmonaut Training Center), ESA (European Space Agency), JAXA (Japanese Space Agency), and CSA (Canadian Space Agency). The policy and strategic coordination of ISS medical operations occurs at this level, and includes interactions with MMOP working groups in Radiation Health, Countermeasures, Extra Vehicular Activity (EVA), Informatics, Environmental Health, Behavioral Health and Performance, Nutrition, Clinical Medicine, Standards, Post-flight Activities and Rehabilitation, and Training. Each ISS Expedition has a lead Crew Surgeon from NASA and a Russian Crew Surgeon from GCTC assigned to the mission. Day-to-day issues are worked real-time by the flight surgeons and biomedical engineers (also called the Integrated Medical Group) on consoles at the MCC (Mission Control Center) in Houston and the TsUP (Center for Flight Control) in Moscow/Korolev. In the future, this may also include mission control centers in Europe and Japan, when their modules are added onto the ISS. Private medical conferences (PMCs) are conducted regularly and upon crew request with the ISS crew via private audio and video communication links from the biomedical MPSR (multipurpose support room) at MCC Houston. When issues arise in the day-to-day medical support of ISS crews, they are discussed and resolved at the SMOT (space medical operations team) meetings, which occur weekly among the International Partners. Any medical or life science issue that is not resolved at the SMOT can be taken to the Mission Management Team meeting, which occurs biweekly from MCC-Houston. This meeting includes the other International Partners and all flight support and console position representatives via teleconference. ISS Crew Surgeons have handled many medical conditions on orbit; including skin rashes, dental abscesses, lacerations, and STT segment EKG changes. Fortunately to date, there have not been any forced medical evacuations from the ISS. This speaks well for the implementation of the primary, secondary and even tertiary prevention strategies invoked by the Integrated Medical Group, as there were several medical evacuations during the previous Russian space stations.