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Sample records for accept patients marked

  1. The acceptability of ending a patient's life

    PubMed Central

    Guedj, M; Gibert, M; Maudet, A; Munoz, S; Mullet, E; Sorum, P

    2005-01-01

    Objectives: To clarify how lay people and health professionals judge the acceptability of ending the life of a terminally ill patient. Design: Participants judged this acceptability in a set of 16 scenarios that combined four factors: the identity of the actor (patient or physician), the patient's statement or not of a desire to have his life ended, the nature of the action as relatively active (injecting a toxin) or passive (disconnecting life support), and the type of suffering (intractable physical pain, complete dependence, or severe psychiatric illness). Participants: 115 lay people and 72 health professionals (22 nurse's aides, 44 nurses, six physicians) in Toulouse, France. Main measurements: Mean acceptability ratings for each scenario for each group. Results: Life ending interventions are more acceptable to lay people than to the health professionals. For both, acceptability is highest for intractable physical suffering; is higher when patients end their own lives than when physicians do so; and, when physicians are the actors, is higher when patients have expressed a desire to die (voluntary euthanasia) than when they have not (involuntary euthanasia). In contrast, when patients perform the action, acceptability for the lay people and nurse's aides does not depend on whether the patient has expressed a desire to die, while for the nurses and physicians unassisted suicide is more acceptable than physician assisted suicide. Conclusions: Lay participants judge the acceptability of life ending actions in largely the same way as do healthcare professionals. PMID:15923476

  2. The ethical and practical aspects of acceptance and universal patient acceptance.

    PubMed

    Corsino, Bruce V; Patthoff, Donald E

    2006-11-01

    "Acceptance" is an often presupposed, hidden core value and ethic focused on how dental and other health practitioners first accept people as possible patients. The three basic styles of patient acceptance are random, selective, and universal. Reduced public access to care results from the practice of random and selective acceptance. Only universal acceptance creates a potential pathway for improved access to care. The notion of Universal Patient Acceptance (UPA) is discussed here as one kind of applied ethical tool or clinical practice that allows for the ethic of acceptance to be more effectively pursued in daily practice. We suggest that health providers falsely surmise that they already understand and practice Universal Patient Acceptance. That myth and perspective are partly what keeps Acceptance hidden as an ethic and overlooked as a potential way to foster dialogue and indirectly promote better access to care. Without Universal Patient Acceptance, dental and health providers will continue to silently engage in practice patterns that adversely affect public access to care. The actual benefits of Universal Patient Acceptance are the subject of ongoing review and debate. Whatever those benefits might be will not likely be realized until Acceptance and Universal Patient Acceptance are included as part of dental and other health professional codes of ethics and training curricula. That is what we argue for here. PMID:17106034

  3. 19 CFR 134.44 - Location and other acceptable methods of marking.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... be marked) until it reaches the ultimate purchaser unless deliberately removed. (b) Articles marked... which assures that unless deliberately removed they will remain on the article until it reaches...

  4. Increasing Patient Acceptance and Adherence Toward Insulin.

    PubMed

    Riddle, Matthew; Peters, Anne; Funnell, Martha

    2016-10-01

    Because of the progressive nature of type 2 diabetes mellitus (T2DM), the majority of patients will need insulin to achieve and maintain glycemic control. By maintaining glycemic control, patients will avoid acute osmotic symptoms of hyperglycemia, instability in plasma glucose (PG) over time, and prevent or delay the development of diabetes complications without adversely affecting quality of life. Despite recommendations for initiating insulin therapy, both patient and health system barriers stand in the way. To develop confidence in individualizing patient therapy and maximize outcomes for patients with T2DM, healthcare practitioners (HCPs) were updated on recommendations and clinical evidence supporting when to initiate insulin therapy, strategies for overcoming provider and patient barriers for initiating insulin therapy, and the safety and efficacy of current and emerging insulin therapy and delivery technology for patients with T2DM. PMID:27109558

  5. Acceptable cost for the patient and society.

    PubMed

    Chambers, Georgina M; Adamson, G David; Eijkemans, Marinus J C

    2013-08-01

    Alongside the debate around clinical, scientific, and ethical aspects of assisted reproductive technology (ART), there exists a parallel debate around the economics of ART treatment and what is the most appropriate funding framework for providing safe, equitable, and cost-effective treatment. The cost of ART treatment from a patient perspective exhibits striking differences worldwide due to the costliness of underlying health care systems and the level of public and third-party subsidization. These relative cost differences affect not only who can afford to access ART treatment but how ART is practiced in terms of embryo transfer practices; in turn significantly impacting the health outcomes and costs of caring for ART conceived children. Although empirical evidence indicates that ART treatment is "good value money" from a societal and patient perspective, the challenge remains to communicate this to policy makers, primarily because fertility treatments are not easily accommodated by traditional health economic methods. Furthermore, with global demand for ART treatment likely to increase, it is important that future funding decisions are informed by what has been learned about how costs and economic incentives influence equity of access and clinical practice. In this review we provide an international perspective on the costs and consequences of ART and summarize key economic considerations from the perspective of ART patients, providers, and society as a whole in the coming decade. PMID:23905708

  6. Patient acceptance for CT colonography: what is the real issue?

    PubMed

    Thomeer, M; Bielen, D; Vanbeckevoort, D; Dymarkowski, S; Gevers, A; Rutgeerts, P; Hiele, M; Van Cutsem, E; Marchal, G

    2002-06-01

    The aim of this study was to evaluate the discomfort associated with CT colonography compared with colonoscopy and bowel purgation cleansing, and to evaluate patient preference between CT colonography and colonoscopy. In a total of 124 patients, scheduled for multidetector virtual CT colonography and diagnostic colonoscopy, patient acceptance and future preference were assessed during the different steps of the procedure (colon preparation, CT examination, and conventional colonoscopy). Patients who described contradictory findings between the degree of discomfort and their preference regarding follow-up examinations were retrospectively reinterviewed regarding the reason for this discrepancy. Colonoscopy was graded slightly more uncomfortable than virtual CT colonography, but the preparation was clearly the most uncomfortable part of the procedure. Concerning their preference regarding follow-up examinations, 71% of the patients preferred virtual CT colonography, 24% preferred colonoscopy, and 5% had no preference. Twenty-eight percent of the patients preferred virtual CT colonography despite that they thought it was equally or even more uncomfortable than colonoscopy. This was mainly due to the faster procedure (17 patients), the lower physical challenge (14 patients), and the lack of sedation (12 patients) of virtual CT colonography. Factors other than the discomfort related to the examinations play an important role in the patient's preference for virtual CT colonography, namely the faster procedure, the lower physical challenge, and the lack of sedation. Since the preparation plays a major decisive factor in the patient acceptance of virtual CT colonography, more attention should be given to fecal tagging. PMID:12042947

  7. Accept or divert ICU patients? A heated ethical debate.

    PubMed

    Angelucci, P A

    2000-01-01

    Stretching scarce resources is more than a managerial issue. Should an understaffed ICU accept the patient or divert him to another facility? The intense "medical utility" controversy focuses on a situation that critical care nurses now face every day. PMID:11998065

  8. Patients' Perception and Future Acceptance of an Artificial Pancreas

    PubMed Central

    van Bon, Arianne C.; Kohinor, Miriam J. E.; Hoekstra, Joost B. L.; von Basum, Golo; DeVries, J. Hans

    2010-01-01

    Background Little is known of patient acceptance of an artificial pancreas (AP). The purpose of this study was to investigate future acceptance of an AP and its determinants. Methods Patients with type 1 diabetes treated with insulin pump therapy were interviewed using questions based on the technology acceptance model and completed the diabetes treatment and satisfaction questionnaire (DTSQ). Results Twenty-two adults with type 1 diabetes participated. Half of the patients were followed in a university hospital, and the others were under treatment in an affiliated teaching hospital. Half of the patients were male. The mean DTSQ score was 29 (range 23–33). The AP was perceived as likely to be useful. Perceived advantages were a stable glucose regulation, less need for self-monitoring of blood glucose, relief of daily concerns, and time saving. Participants were confident in their capability to use the system. Although many participants (58%) had been reluctant to start continuous subcutaneous insulin infusion, the majority (79%) felt they would have no barriers to start using the AP. Trust in the AP was related to the quality of glucose control it would provide. Almost everyone expressed the intention to use the new system when available, even if it would initially not cover 24/24 hours. Conclusion The overall attitude on the AP was positive. Intention to use was dependent on trust in the AP, which was related to the quality of glucose control provided by the AP. PMID:20513325

  9. The Effects of Key Demographic Variables on Markers' Perceived Ease of Use and Acceptance of Onscreen Marking

    ERIC Educational Resources Information Center

    Yan, Zi; Coniam, David

    2014-01-01

    The current study aims to investigate the effects of three key demographic factors -- the language of marking, gender and age -- on markers' reactions to onscreen marking (OSM). A total of 1743 markers completed a post-marking questionnaire consisting of two previously validated scales, i.e. "Ease of Use in the OSM Environment" and…

  10. Assessing the acceptability of Norplant contraceptive in four patient populations.

    PubMed

    Dugoff, L; Jones, O W; Allen-Davis, J; Hurst, B S; Schlaff, W D

    1995-07-01

    The object of this study was to review the experience of Norplant implants insertion at the University of Colorado Health Sciences Center with specific attention to the potential impact of source of care and/or clinic site of of insertion. Norplant implants were inserted at four different office sites, namely, adolescent-teen, resident, certified nurse midwife, and faculty physician. The charts of all patients who had Norplant implants inserted between April 1991 and September 1992 were reviewed and we attempted to contact each patient by telephone to assess clinical course and acceptability of Norplant contraceptive. We were able to contact 254 of 414 women (61%) who had Norplant implants inserted. The average length of time since Norplant implants insertion was 13.2 months. The only significant demographic difference between groups was that the adolescent-teen patients were younger, of lower parity, less educated, and were more likely to be single than the other three groups. The overall removal proportion was 14.6%, and removal proportions were not significantly different between any of the four groups. The primary reason for removal was unacceptable bleeding (32% of removers). Only 59% of patients returned for follow-up care. Faculty physician patients were significantly more compliant with follow-up compared to adolescent-teen and resident patients (p < 0.01). Patient retention of Norplant contraceptive is unrelated to age or the clinic setting in which the device was inserted. Since similar side effects are experienced by retainers and removers, it is unclear what other factors prompt women to seek removal. Particularly in the teen and resident groups, follow-up is poor. PMID:8521714

  11. Current migraine management – patient acceptability and future approaches

    PubMed Central

    Fumal, Arnaud; Schoenen, Jean

    2008-01-01

    Despite its high prevalence and individual as well as societal burden, migraine remains underdiagnosed and undertreated. In recent years, the options for the management of migraine patients have greatly expanded. A number of drugs belonging to various pharmacological classes and deliverable by several routes are now available both for the acute and the preventive treatments of migraine. Nevertheless, disability and satisfaction remain low in many subjects because treatments are not accessible, not optimized, not effective, or simply not tolerated. There is thus still considerable room for better education, for more efficient therapies and for greater support from national health systems. In spite of useful internationally accepted guidelines, anti-migraine treatment has to be individually tailored to each patient taking into account the migraine subtype, the ensuing disability, the patient’s previous history and present expectations, and the co-morbid disorders. In this article we will summarize the phenotypic presentations of migraine and review recommendations for acute and preventive treatment, highlighting recent advances which are relevant for clinical practice in terms of both diagnosis and management. PMID:19337450

  12. Transvaginal retropubic sling systems: efficacy and patient acceptability

    PubMed Central

    Moldovan, Christina P; Marinone, Michelle E; Staack, Andrea

    2015-01-01

    Stress urinary incontinence is a common, disabling, and costly medical problem that affects approximately 50% of women with urinary incontinence. Suburethral retropubic slings have been developed as a minimally invasive and effective surgical option, and they have been used as a first-line treatment for stress urinary incontinence since 1995. However, complications including vaginal extrusion, erosion, pain, bleeding, infections, lower urinary tract symptoms, urinary retention, and incontinence have been reported with use of the slings. Several companies manufacture sling kits, and the sling kits vary with regard to the composition of the mesh and introducer needle. The aim of this review was to determine which sling kit was most effective for patients, had minimal reported side effects, and was best accepted by patients and surgeons. In a review of the literature, it was found that a total of 38 studies were published between 1995 and 2014 that reported on eight tension-free retropubic sling kits: SPARC, RetroArc, Align, Advantage, Lynx, Desara, Supris, and Gynecare TVT. The Gynecare TVT was the most cited sling kit; the second most cited was the SPARC. This review provides a summary of the studies that have examined positive and negative outcomes of the retropubic tension-free suburethral sling procedure using various sling kits. Overall, the results of the literature review indicated that data from comparisons of the available sling kits are insufficient to make an evidenced-based recommendation. Therefore, the decision regarding which sling kit is appropriate to use in surgery is determined by the medical provider’s preference, training, and past experience, and not by the patient. PMID:25733928

  13. Transvaginal retropubic sling systems: efficacy and patient acceptability.

    PubMed

    Moldovan, Christina P; Marinone, Michelle E; Staack, Andrea

    2015-01-01

    Stress urinary incontinence is a common, disabling, and costly medical problem that affects approximately 50% of women with urinary incontinence. Suburethral retropubic slings have been developed as a minimally invasive and effective surgical option, and they have been used as a first-line treatment for stress urinary incontinence since 1995. However, complications including vaginal extrusion, erosion, pain, bleeding, infections, lower urinary tract symptoms, urinary retention, and incontinence have been reported with use of the slings. Several companies manufacture sling kits, and the sling kits vary with regard to the composition of the mesh and introducer needle. The aim of this review was to determine which sling kit was most effective for patients, had minimal reported side effects, and was best accepted by patients and surgeons. In a review of the literature, it was found that a total of 38 studies were published between 1995 and 2014 that reported on eight tension-free retropubic sling kits: SPARC, RetroArc, Align, Advantage, Lynx, Desara, Supris, and Gynecare TVT. The Gynecare TVT was the most cited sling kit; the second most cited was the SPARC. This review provides a summary of the studies that have examined positive and negative outcomes of the retropubic tension-free suburethral sling procedure using various sling kits. Overall, the results of the literature review indicated that data from comparisons of the available sling kits are insufficient to make an evidenced-based recommendation. Therefore, the decision regarding which sling kit is appropriate to use in surgery is determined by the medical provider's preference, training, and past experience, and not by the patient. PMID:25733928

  14. Enteral feeding pumps: efficacy, safety, and patient acceptability

    PubMed Central

    White, Helen; King, Linsey

    2014-01-01

    Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump); and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field. PMID:25170284

  15. Virtual glaucoma clinics: patient acceptance and quality of patient education compared to standard clinics

    PubMed Central

    Court, Jennifer H; Austin, Michael W

    2015-01-01

    Purpose Virtual glaucoma clinics allow rapid, reliable patient assessment but the service should be acceptable to patients and concordance with treatment needs to be maintained with adequate patient education. This study compares experiences and understanding of patients reviewed via the virtual clinic versus the standard clinic by way of an extended patient satisfaction questionnaire (PSQ). Patients and methods One hundred PSQs were given to consecutive patients attending glaucoma clinics in October 2013. All 135 patients reviewed via the virtual clinic from April 2013 until August 2013 were sent postal PSQs in September 2013. Data were obtained for demographics, understanding of glaucoma, their condition, satisfaction with their experience, and quality of information. Responses were analyzed in conjunction with the clinical records. Results Eighty-five percent of clinic patients and 63% of virtual clinic patients responded to the PSQ. The mean satisfaction score was over 4.3/5 in all areas surveyed. Virtual clinic patients’ understanding of their condition was very good, with 95% correctly identifying their diagnosis as glaucoma, 83% as ocular hypertension and 78% as suspects. There was no evidence to support inferior knowledge or self-perceived understanding compared to standard clinic patients. Follow-up patients knew more about glaucoma than new patients. Over 95% of patients found our information leaflet useful. Forty percent of patients sought additional information but less than 20% used the internet for this. Conclusion A substantial proportion of glaucoma pathway patients may be seen by non-medical staff supervised by glaucoma specialists via virtual clinics. Patients are accepting of this format, reporting high levels of satisfaction and non-inferior knowledge to those seen in standard clinics. PMID:25987832

  16. Patient awareness and acceptability of antenatal perineal massage.

    PubMed

    Ismail, S I M F; Emery, S J

    2013-11-01

    Antenatal perineal massage is recommended to reduce perineal trauma at the time of delivery. The practice has been shown to be acceptable to pregnant women taking part in research studies. The aim of this study was to establish its acceptability to pregnant women in day-to-day clinical practice, as well as their awareness of its technique. An anonymous self-construct questionnaire was given to mothers after their first delivery. A total of 113 questionnaires were returned over a 4-month period. With regard to acceptability, 61.4% of respondents indicated that the practice was acceptable, only 25.7% felt the practice was embarrassing and 56.7% were happy for their husband/partner to perform it for them. With respect to awareness, 37.2% of the respondents had heard about the practice, 9.7% knew it should be practised from 34 weeks onwards, 11.5% knew it should be maintained for 5-10 min and 30.1% knew it ought to be performed daily. This showed first time mothers' awareness of antenatal perineal massage to be low, despite the idea being acceptable to them, which calls for action to improve awareness and provide more instruction and encouragement to take up the practice. PMID:24219726

  17. SU-E-T-502: Biometrically Accepted Patient Records

    SciTech Connect

    Basavatia, A; Kalnicki, S; Garg, M; Lukaj, A; Hong, L; Fret, J; Yaparpalvi, R; Tome, W

    2014-06-01

    Purpose: To implement a clinically useful palm vein pattern recognition biometric system to treat the correct treatment plan to the correct patient each and every time and to check-in the patient into the department to access the correct medical record. Methods: A commercially available hand vein scanning system was paired to Aria and utilized an ADT interface from the hospital electronic health system. Integration at two points in Aria, version 11 MR2, first at the appointment tracker screen for the front desk medical record access and second at the queue screen on the 4D treatment console took place for patient daily time-out. A test patient was utilized to check accuracy of identification as well as to check that no unintended interactions take place between the 4D treatment console and the hand vein scanning system. This system has been in clinical use since December 2013. Results: Since implementation, 445 patients have been enrolled into our biometric system. 95% of patients learn the correct methodology of hand placement on the scanner in the first try. We have had two instances of patient not found because of a bad initial scan. We simply erased the scanned metric and the patient enrolled again in those cases. The accuracy of the match is 100% for each patient, we have not had one patient misidentified. We can state this because we still use patient photo and date of birth as identifiers. A QA test patient is run monthly to check the integrity of the system. Conclusion: By utilizing palm vein scans along with the date of birth and patient photo, another means of patient identification now exits. This work indicates the successful implementation of technology in the area of patient safety by closing the gap of treating the wrong plan to a patient in radiation oncology. FOJP Service Corporation covered some of the costs of the hardware and software of the palm vein pattern recognition biometric system.

  18. The acceptability of ending a patient's life: a France-Portugal-Spain comparison.

    PubMed

    Mullet, Etienne; Neto, Félix; Pinto, Conceiçao; Raich, Rosa Maria; Sastre, Maria Teresa Munoz; Sorum, Paul C

    2014-01-01

    The views of French, Portuguese, and Spanish people on end-of-life decisions were compared. Two hundred seventy-seven adults from Barcelona, Oporto, and Toulouse judged the acceptability of life-ending procedures in 42 scenarios composed of all combinations of 3 factors: the patient's age (30 or 80 years), the patient's life expectancy (days, weeks, or months), and the type of procedure (suicide, suicide assisted by the physician, euthanasia by the physician at the request of a suffering patient, euthanasia of a comatose patient at the family's request, euthanasia of a comatose patient as stipulated in the patient's advance directives, euthanasia of a comatose patient without advance directions and without a request from the family, or euthanasia of a suffering patient without a request from the patient). In all 3 countries, the type of procedure had the major effect. The 4 procedures implemented by the patient or at the patient's request were, on average, considered acceptable. The 2 procedures not implemented at the patient's request were considered unacceptable. Euthanasia of a comatose patient at the request of the family was judged mildly acceptable. The attitudes of the people in Toulouse, Oporto, and Barcelona concerning the acceptability of ending a patient's life have now largely converged, although Spanish participants were statistically significantly more accepting than French and Portuguese participants. PMID:24521043

  19. Reliability of a Manual Procedure for Marking the EZ Endpoint Location in Patients with Retinitis Pigmentosa

    PubMed Central

    Ramachandran, Rithambara; X. Cai, Cindy; Lee, Dongwon; C. Epstein, Benjamin; Locke, Kirsten G.; G. Birch, David; C. Hood, Donald

    2016-01-01

    Purpose We developed and evaluated a training procedure for marking the endpoints of the ellipsoid zone (EZ), also known as the inner segment/outer segment (IS/OS) border, on frequency domain optical coherence tomography (fdOCT) scans from patients with retinitis pigmentosa (RP). Methods A manual for marking EZ endpoints was developed and used to train 2 inexperienced graders. After training, an experienced grader and the 2 trained graders marked the endpoints on fdOCT horizontal line scans through the macula from 45 patients with RP. They marked the endpoints on these same scans again 1 month later. Results Intragrader agreement was excellent. The intraclass correlation coefficient (ICC) was 0.99, the average difference of endpoint locations (19.6 μm) was close to 0 μm, and the 95% limits were between −284 and 323 μm, approximately ±1.1°. Intergrader agreement also was excellent. The ICC values were 0.98 (time 1) and 0.97 (time 2), the average difference among graders was close to zero, and the 95% limits of these differences was less than 350 μm, approximately 1.2°, for both test times. Conclusions While automated algorithms are becoming increasingly accurate, EZ endpoints still have to be verified manually and corrected when necessary. With training, the inter- and intragrader agreement of manually marked endpoints is excellent. Translational Relevance For clinical studies, the EZ endpoints can be marked by hand if a training procedure, including a manual, is used. The endpoint confidence intervals, well under ±2.0°, are considerably smaller than the 6° spacing for the typically used static visual field. PMID:27226930

  20. Patients' acceptance of Internet-based home asthma telemonitoring.

    PubMed

    Finkelstein, J; Hripcsak, G; Cabrera, M R

    1998-01-01

    We studied asthma patients from a low-income inner-city community without previous computer experience. The patients were given portable spirometers to perform spirometry tests and palmtop computers to enter symptoms in a diary, to exchange messages with physician and to review test results. The self-testing was performed at home on a daily basis. The results were transmitted to the hospital information system immediately after completion of each test. Physician could review results using an Internet Web browser from any location. A constantly active decision support server monitored all data traffic and dispatched alerts when certain clinical conditions were met. Seventeen patients, out of 19 invited, agreed to participate in the study and have been monitored for three weeks. They have been surveyed then using standardized questionnaire. Most of the patients (82.4%) characterized self-testing procedures as "not complicated at all." In 70.6% of cases self-testing did not interfere with usual activities, and 82.4% of patients felt the self-testing required a "very little" amount of their time. All patients stated that it is important for them to know that the results can be reviewed by professional staff in a timely manner. However, only 29.5% of patients reviewed their results at least once a week at home independently. The majority of the patients (94.1%) were strongly interested in using home asthma telemonitoring in the future. We concluded that Internet-based home asthma telemonitoring can be successfully implemented in the group of patients without previous computer background. PMID:9929237

  1. Utilizing the health belief model to assess vaccine acceptance of patients on hemodialysis.

    PubMed

    Adams, Angela; Hall, Mellisa; Fulghum, Janis

    2014-01-01

    Vaccine rates in patients on hemodialysis are substantially lower than the Healthy People 2020 targets. The purpose of this study is to utilize the perceptions and cues for action constructs of the Health Belief Model (HBM) to assess the attitudes of patients receiving outpatient hemodialysis regarding acceptance of the seasonal influenza, pneumococcal, and hepatitis B virus vaccines. Vaccine acceptance is defined as receiving the vaccine. Study findings suggest age, perceived susceptibility, and perceived severity increase the odds of getting some vaccines. Findings have implications for the development of patient education materials, interdisciplinary team assessments, and plan of care strategies to increase vaccine acceptance. PMID:25244894

  2. Acceptability of a Virtual Patient Educator for Hispanic Women.

    PubMed

    Wells, Kristen J; Vàzquez-Otero, Coralia; Bredice, Marissa; Meade, Cathy D; Chaet, Alexis; Rivera, Maria I; Arroyo, Gloria; Proctor, Sara K; Barnes, Laura E

    2015-01-01

    There are few Spanish language interactive, technology-driven health education programs. Objectives of this feasibility study were to (a) learn more about computer and technology usage among Hispanic women living in a rural community and (b) evaluate acceptability of the concept of using an embodied conversational agent (ECA) computer application among this population. A survey about computer usage history and interest in computers was administered to a convenience sample of 26 women. A sample video prototype of a hospital discharge ECA was administered followed by questions to gauge opinion about the ECA. Data indicate women exhibited both a high level of computer experience and enthusiasm for the ECA. Feedback from community is essential to ensure equity in state of the art dissemination of health information. PMID:26671558

  3. Markedly Reduced Thermal Pain Perception in a Schizoaffective Patient with Tardive Dyskinesia.

    PubMed

    Potvin, Stéphane; Stip, Emmanuel; Marchand, Serge

    2016-01-01

    Several case reports have described stories of schizophrenia patients reporting no discomfort in response to several medical conditions which normally elicit pain. Comparatively, experimental studies performed on pain perception in schizophrenia have not documented hypoalgesic responses that are as frank as those reported in these clinical cases. Here, we report the case of a female patient with schizoaffective disorder, who displayed markedly reduced pain perception during an experimental heat pain paradigm. Compared to a large group of healthy volunteers that we tested in 3 previous studies using the same psychophysical procedure, the experimental temperature required to induce moderate pain was radically increased in this patient (z-score = 3.6). The patient had mild psychiatric symptoms and had insight into her symptoms. She had drug-induced dyskinetic symptoms. This case report illustrates that it is possible to observe marked reductions in pain perception in schizophrenia patients tested in experimental settings but that the phenomenon is relatively rare. Regardless of the exact nature of pain indifference in schizophrenia, it can delay diagnosis and treatment of medical problems in these patients. Future studies in the field will need to pay attention to drug-induced extrapyramidal symptoms. PMID:27144045

  4. Markedly Reduced Thermal Pain Perception in a Schizoaffective Patient with Tardive Dyskinesia

    PubMed Central

    2016-01-01

    Several case reports have described stories of schizophrenia patients reporting no discomfort in response to several medical conditions which normally elicit pain. Comparatively, experimental studies performed on pain perception in schizophrenia have not documented hypoalgesic responses that are as frank as those reported in these clinical cases. Here, we report the case of a female patient with schizoaffective disorder, who displayed markedly reduced pain perception during an experimental heat pain paradigm. Compared to a large group of healthy volunteers that we tested in 3 previous studies using the same psychophysical procedure, the experimental temperature required to induce moderate pain was radically increased in this patient (z-score = 3.6). The patient had mild psychiatric symptoms and had insight into her symptoms. She had drug-induced dyskinetic symptoms. This case report illustrates that it is possible to observe marked reductions in pain perception in schizophrenia patients tested in experimental settings but that the phenomenon is relatively rare. Regardless of the exact nature of pain indifference in schizophrenia, it can delay diagnosis and treatment of medical problems in these patients. Future studies in the field will need to pay attention to drug-induced extrapyramidal symptoms. PMID:27144045

  5. The impact of social support on the acceptance process among RA patients: a qualitative study.

    PubMed

    Kostova, Zlatina; Caiata-Zufferey, Maria; Schulz, Peter J

    2014-01-01

    Acceptance is an important component of pain management, being associated with improved quality of life and lower levels of pain and depression. In enabling patients with chronic diseases to accept unpleasant consequences and to establish a new way of living, the support they receive from their social environment may play a decisive role. In this article, we identify the key sources and types of social support that are relevant for rheumatoid arthritis (RA) patients, and explore when and how those sources are important across the different stages of the acceptance process. We conducted a qualitative study involving 20 semi-structured interviews with RA patients in Switzerland. Analysis of the data followed the precepts of grounded theory. We found that, amid the complexity and variety of patients' struggles for acceptance, there were some common experiences or 'key moments' in which social support played an important role. While three sources of support - family, physicians and the external social context - are fundamental for RA patients, all three may inhibit as well as encourage acceptance, due to the invisible and unpredictable character of the disease. There is a pervasive risk either of underestimating patients' suffering or of over-supporting, both of which prevent patients accepting the disease and developing a new 'normal' life. We conclude that sources of social support need to find a middle way between scepticism and solicitousness. PMID:24841727

  6. The perils of nurses accepting gifts from their patients.

    PubMed

    2016-08-17

    There are few perks to being a nurse. The pay is poor, the working conditions often challenging and the pension is not what it once was. At the same time, patients have never been so demanding, with expectations sometimes being unreasonable. PMID:27533372

  7. A survey of user acceptance of electronic patient anesthesia records

    PubMed Central

    Jin, Hyun Seung; Lee, Suk Young; Jeong, Hui Yeon; Choi, Soo Joo; Lee, Hye Won

    2012-01-01

    Background An anesthesia information management system (AIMS), although not widely used in Korea, will eventually replace handwritten records. This hospital began using AIMS in April 2010. The purpose of this study was to evaluate users' attitudes concerning AIMS and to compare them with manual documentation in the operating room (OR). Methods A structured questionnaire focused on satisfaction with electronic anesthetic records and comparison with handwritten anesthesia records was administered to anesthesiologists, trainees, and nurses during February 2011 and the responses were collected anonymously during March 2011. Results A total of 28 anesthesiologists, 27 trainees, and 47 nurses responded to this survey. Most participants involved in this survey were satisfied with AIMS (96.3%, 82.2%, and 89.3% of trainees, anesthesiologists, and nurses, respectively) and preferred AIMS over handwritten anesthesia records in 96.3%, 71.4%, and 97.9% of trainees, anesthesiologists, and nurses, respectively. However, there were also criticisms of AIMS related to user-discomfort during short, simple or emergency surgeries, doubtful legal status, and inconvenient placement of the system. Conclusions Overall, most of the anesthetic practitioners in this hospital quickly accepted and prefer AIMS over the handwritten anesthetic records in the OR. PMID:22558502

  8. Safety, efficacy, and patient acceptability of rifaximin for hepatic encephalopathy.

    PubMed

    Kimer, Nina; Krag, Aleksander; Gluud, Lise L

    2014-01-01

    Hepatic encephalopathy is a complex disease entity ranging from mild cognitive dysfunction to deep coma. Traditionally, treatment has focused on a reduction of ammonia through a reduced production, absorption, or clearance. Rifaximin is a nonabsorbable antibiotic, which reduces the production of ammonia by gut bacteria and, to some extent, other toxic derivatives from the gut. Clinical trials show that these effects improve episodes of hepatic encephalopathy. A large randomized trial found that rifaximin prevents recurrent episodes of hepatic encephalopathy. Most patients were treated concurrently with lactulose. Trials have varied greatly in design, outcomes, and duration of treatment regimes. Although a number of retrospective studies have indicated that long-term treatment with rifaximin is safe and possibly beneficial, high quality trials are needed to further clarify efficacy and safety of long-term treatment with rifaximin and evaluate effects of combination therapy with lactulose and branched-chain amino acids for patients with liver cirrhosis and hepatic encephalopathy. PMID:24672227

  9. Safety, efficacy, and patient acceptability of rifaximin for hepatic encephalopathy

    PubMed Central

    Kimer, Nina; Krag, Aleksander; Gluud, Lise L

    2014-01-01

    Hepatic encephalopathy is a complex disease entity ranging from mild cognitive dysfunction to deep coma. Traditionally, treatment has focused on a reduction of ammonia through a reduced production, absorption, or clearance. Rifaximin is a nonabsorbable antibiotic, which reduces the production of ammonia by gut bacteria and, to some extent, other toxic derivatives from the gut. Clinical trials show that these effects improve episodes of hepatic encephalopathy. A large randomized trial found that rifaximin prevents recurrent episodes of hepatic encephalopathy. Most patients were treated concurrently with lactulose. Trials have varied greatly in design, outcomes, and duration of treatment regimes. Although a number of retrospective studies have indicated that long-term treatment with rifaximin is safe and possibly beneficial, high quality trials are needed to further clarify efficacy and safety of long-term treatment with rifaximin and evaluate effects of combination therapy with lactulose and branched-chain amino acids for patients with liver cirrhosis and hepatic encephalopathy. PMID:24672227

  10. A systematic review of patient acceptance of screening for oral cancer outside of dental care settings.

    PubMed

    Paudyal, Priyamvada; Flohr, Francesca D; Llewellyn, Carrie D

    2014-10-01

    This systematic review summarised the literature on patient acceptability of screening for oral cancer outside dental care settings. A comprehensive search of relevant literature was performed in EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, CINAHAL, psycINFO, CANCERLIT and BNI to identify relevant articles published between 1975 and Dec 2013. Studies reporting acceptability of oral cancer screening to undiagnosed individuals attending non-dental settings were eligible for inclusion. A total of 2935 references were initially identified from the computerised search but 2217 were excluded after screening the titles. From the abstracts of the remaining 178 articles, 47 full text articles were retrieved for further scrutiny, and 12 studies were found to be eligible for inclusion. In these studies, knowledge about oral cancer, anxiety related to the screening process, preference for care provision, and financial cost were influencing factors for the acceptance of screening. Written information provided to patients in primary care was reported to boost immediate knowledge levels of oral cancer, lessen anxiety, and increase intentions for screening. The majority of screening methods were entirely acceptable to patients; lack of acceptability from the patients' viewpoint was not a significant barrier to carrying out opportunistic screening of high-risk populations. In conclusion, the available evidence suggests that acceptance of, and satisfaction with oral cancer screening is high, particularly where patients have previously been educated about oral cancer. Further research focusing on patient's preferences would enable streamlining of the approach to oral cancer screening taken by any national programme. PMID:25127201

  11. Universal patient acceptance: ethics pipe dream or key to improved access in dentistry?

    PubMed

    Patthoff, D E; Corsino, B V

    2001-01-01

    The authors discuss ways that dentistry engages silently and sometimes unknowingly in practice patterns that adversely affect public access to dental care. The concept of acceptance is explained and contrasted with treatment and with access to care. The concept of Universal Patient Acceptance (UPA) is introduced, with a focus on how it underlies and precedes access, creating a pathway so that truer universal access to dental care can be realized. The authors argue that a commitment to Universal Patient Acceptance shows promise as an important starting point in the dental profession's concern to address society's unmet oral health needs. PMID:11887369

  12. A Systematic Review of Patient Acceptance of Consumer Health Information Technology

    PubMed Central

    Or, Calvin K.L.; Karsh, Ben-Tzion

    2009-01-01

    A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation. PMID:19390112

  13. A systematic review of patient acceptance of consumer health information technology.

    PubMed

    Or, Calvin K L; Karsh, Ben-Tzion

    2009-01-01

    A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation. PMID:19390112

  14. Efficacy, safety, and patient acceptability of the Essure™ procedure

    PubMed Central

    Lessard, Collette R; Hopkins, Matthew R

    2011-01-01

    The Essure™ system for permanent contraception was developed as a less invasive method of female sterilization. Placement of the Essure™ coil involves a hysteroscopic transcervical technique. This procedure can be done in a variety of settings and with a range of anesthetic options. More than eight years have passed since the US Food and Drug Administration approval of Essure™. Much research has been done to evaluate placement success, adverse outcomes, satisfaction, pain, and the contraceptive efficacy of the Essure™. The purpose of this review is to summarize the available literature regarding the efficacy, safety, and patient satisfaction with this new sterilization technique. PMID:21573052

  15. The recognition of gender-marked nouns and verbs in Polish-speaking aphasic patients.

    PubMed

    Perlak, Danuta; Jarema, Gonia

    2003-06-01

    In the present study, we investigated the on-line recognition of gender-marked lexical items by three aphasic patients and eighteen matched control participants, all native speakers of Polish. Polish is unique in that it allows investigating grammatical gender across the major categories of nouns and verbs. Patients and their controls were tested using a simple visual lexical decision paradigm in which gender, number and grammatical category were manipulated. Results show that, while response latencies were markedly slower for aphasic patients, gender did not yield differential results in either grammatical category, for both patients and control participants. Plural forms, on the other hand, showed significantly slower response latencies than singular forms in both brain-damaged and unimpaired participants, but only for nouns. We interpret these findings in terms of the inherent vs. contextual, i.e. underspecified, nature of gender and number in the two grammatical categories. This study suggests that while gender can be impaired in off-line performance in aphasia, on-line recognition patterns parallel the performance of non-brain-damaged individuals, confirming the preservation of access procedures in automatic word recognition. PMID:12870818

  16. Accepting or declining non-invasive ventilation or gastrostomy in amyotrophic lateral sclerosis: patients' perspectives.

    PubMed

    Greenaway, L P; Martin, N H; Lawrence, V; Janssen, A; Al-Chalabi, A; Leigh, P N; Goldstein, L H

    2015-01-01

    The objective was to identify factors associated with decisions made by patients with amyotrophic lateral sclerosis (ALS) to accept or decline non-invasive ventilation (NIV) and/or gastrostomy in a prospective population-based study. Twenty-one people with ALS, recruited from the South-East ALS Register who made an intervention decision during the study timeframe underwent a face-to-face in-depth interview, with or without their informal caregiver present. Sixteen had accepted an intervention (11 accepted gastrostomy, four accepted NIV and one accepted both interventions). Five patients had declined gastrostomy. Thematic analysis revealed three main themes: (1) patient-centric factors (including perceptions of control, acceptance and need, and aspects of fear); (2) external factors (including roles played by healthcare professionals, family, and information provision); and (3) the concept of time (including living in the moment and the notion of 'right thing, right time'). Many aspects of these factors were inter-related. Decision-making processes for the patients were found to be complex and multifaceted and reinforce arguments for individualised (rather than 'algorithm-based') approaches to facilitating decision-making by people with ALS who require palliative interventions. PMID:25683760

  17. The Prostate Care Questionnaire for Patients (PCQ-P): Reliability, validity and acceptability

    PubMed Central

    Tarrant, Carolyn; Baker, Richard; Colman, Andrew M; Sinfield, Paul; Agarwal, Shona; Mellon, John K; Steward, William; Kockelbergh, Roger

    2009-01-01

    Background In England, prostate cancer patients report worse experience of care than patients with other cancers. However, no standard measure of patient experience of prostate cancer care is currently available. This paper describes an evaluation of the reliability, validity and acceptability of the PCQ-P, a newly developed instrument designed to measure patient experience of prostate cancer care. Methods The reliability, acceptability and validity of the PCQ-P were tested through a postal survey and interviews with patients. The PCQ-P was posted to 1087 prostate cancer patients varying in age, occupation, and overall health status, sampled from five hospitals in England. Nonresponders received one reminder. To assess criterion validity, 935 patients were also sent sections of the National Centre for Social Research Shortened Questionnaire; and to assess test-retest reliability, 296 patients who responded to the questionnaire were resent it a second time three weeks later. A subsample of 20 prostate cancer patients from one hospital took part in qualitative interviews to assess validity and acceptability of the PCQ-P. Acceptability to service providers was evaluated based on four hospitals' experiences of running a survey using the PCQ-P. Results Questionnaires were returned by 865 patients (69.2%). Missing data was low across the sections, with the proportion of patients completing less than 50% of each section ranging from 4.5% to 6.9%. Across the sections of the questionnaire, internal consistency was moderate to high (Cronbach's alpha ranging from 0.63 to 0.80), and test-retest stability was acceptable (intraclass correlation coefficients ranging from 0.57 to 0.73). Findings on criterion validity were significant. Patient interviews indicated that the PCQ-P had high face validity and acceptability. Feedback from hospitals indicated that they found the questionnaire useful, and highlighted important considerations for its future use as part of quality

  18. The process of acceptance among rheumatoid arthritis patients in Switzerland: A qualitative study

    PubMed Central

    Kostova, Zlatina; Caiata-Zufferey, Maria; Schulz, Peter J

    2014-01-01

    BACKGROUND: Rheumatoid arthritis (RA) is a chronic, painful disease with many injurious psychological effects. Acceptance is an important component of pain management and is associated with improved quality of life, and lower levels of pain and depression. While studies have begun to identify the stages of acceptance, little is known about factors influencing the ease and speed with which patients pass through these stages. OBJECTIVE: To explore the main stages through which RA patients pass and the strategies they adopt to learn to live with the pain, and to identify factors shaping patients’ capacities to achieve acceptance. METHODS: A qualitative study involving 20 semistructured interviews with RA patients in the Italian-speaking region of Switzerland was conducted. Analysis of the data followed the precepts of grounded theory. RESULTS: Although the present study revealed that acceptance is not a smooth or linear process, five main stages in patients’ struggles to accommodate the newly imposed limitations were, nonetheless, identified: naming the illness; realizing the illness; resisting the illness; ‘hitting the bottom’; and integrating the illness. Diagnosis proved to be an especially tortuous stage in the case of RA, and the effects of delayed diagnosis continued to be felt during the subsequent stages. Patients’ understanding of the notion of acceptance and the strategies that they used to achieve it were also explored. CONCLUSIONS: Diagnosis of RA is notoriously difficult. Beyond the clinical difficulties, structural reasons for late diagnosis (symptoms being neglected by patients and medical professionals) were identifed. Delayed diagnosis hindered the acceptance process throughout, and led to more resistant behaviour and to a struggle to achieve the optimal formula for acceptanceaccepting the losses of prepain life while still pursuing personal goals. PMID:24527466

  19. Patients' perceptions of mortality risk for localized prostate cancer vary markedly depending on their treatment strategy.

    PubMed

    Kendel, Friederike; Helbig, Lukas; Neumann, Konrad; Herden, Jan; Stephan, Carsten; Schrader, Mark; Gaissmaier, Wolfgang

    2016-08-15

    Treatment choice for localized prostate cancer (PCa) is a controversial issue, and mortality risk is probably the most decisive factor in this regard. The study aimed to compare prostate-cancer-specific mortality risk estimates for different treatment options assigned by patients managed with active surveillance (AS), radical prostatectomy (RP) and patients who had discontinued AS (DAS). Patients initially managed with AS or RP (N = 370) were matched according to length of therapy. All patients completed mailed questionnaires assessing their mortality risk estimates (in %) and prostate-cancer-specific anxiety. Differences in risk estimates among the three treatment groups were analyzed using ANOVA, relationships of clinical and psychosocial variables with risk estimates using standard multiple regression. In all treatment groups, the prostate- cancer-specific mortality risk was overestimated. This applied whether it was the patient's own treatment or the alternative treatment option. RP patients assigned a mortality risk to AS that was almost three times higher than that assigned to RP (50.9 ± 25.0 vs. 17.8 ± 19.7, d = 1.48; p < 0.001). Anxiety was significantly associated with risk estimates for AS (p = 0.008) and RP (p = 0.001). Compared with clinical data that suggest that the prostate-cancer-specific mortality risk for AS is low and does not significantly differ from that for RP, patients strongly overestimated the mortality risk. This was most markedly so in RP patients, who drastically overestimated the benefits of RP compared to the risk of AS. This overestimation could increase overtreatment and should therefore be corrected by better patient education. PMID:27038059

  20. Factors affecting home care patients' acceptance of a web-based interactive self-management technology

    PubMed Central

    Karsh, Ben-Tzion; Severtson, Dolores J; Burke, Laura J; Brown, Roger L; Brennan, Patricia Flatley

    2010-01-01

    Objective With the advent of personal health records and other patient-focused health technologies, there is a growing need to better understand factors that contribute to acceptance and use of such innovations. In this study, we employed the Unified Theory of Acceptance and Use of Technology as the basis for determining what predicts patients' acceptance (measured by behavioral intention) and perceived effective use of a web-based, interactive self-management innovation among home care patients. Design Cross-sectional secondary analysis of data from a randomized field study evaluating a technology-assisted home care nursing practice with adults with chronic cardiac disease. Measurement and analysis A questionnaire was designed based on validated measurement scales from prior research and was completed by 101 participants for measuring the acceptance constructs as part of the parent study protocol. Latent variable modeling with item parceling guided assessment of patients' acceptance. Results Perceived usefulness accounted for 53.9% of the variability in behavioral intention, the measure of acceptance. Together, perceived usefulness, health care knowledge, and behavioral intention accounted for 68.5% of the variance in perceived effective use. Perceived ease of use and subjective norm indirectly influenced behavioral intention, through perceived usefulness. Perceived ease of use and subjective norm explained 48% of the total variance in perceived usefulness. Conclusion The study demonstrates that perceived usefulness, perceived ease of use, subjective norm, and healthcare knowledge together predict most of the variance in patients' acceptance and self-reported use of the web-based self-management technology. PMID:21131605

  1. Acceptability of Alternatives to Traditional Emergency Care: Patient Characteristics, Alternate Transport Modes, and Alternate Destinations.

    PubMed

    Jones, Courtney Marie Cora; Wasserman, Erin B; Li, Timmy; Shah, Manish N

    2015-01-01

    To determine the acceptability of alternatives to traditional emergency care, we assessed the proportion of subjects willing to consider alternative modes of transportation and alternative destinations. We further identified patient characteristics associated with willingness to consider these alternatives. We conducted a cross-sectional survey study in the emergency department (ED) of an academic medical center. Research assistants screened all non-critically ill ED patients for eligibility and willingness to participate and administered an interview-based survey that included questions on demographic and clinical characteristics, perceived illness severity, and acceptability of alternatives to traditional emergency care for acute illness and injuries. We calculated the proportions and 95% confidence intervals for subjects who found alternative transport modes and destinations acceptable and developed a log-binomial regression model to identify patient characteristics associated with acceptability of alternative modes of transport and alternative destinations. Complete data were available on 1,058 subjects. Forty-two percent of the study sample arrived to the ED via emergency medical services (EMS). Over two-thirds of the study sample (68.2%) was willing to consider transport via either taxi or medical transport van and 69.0% was willing to consider either transportation to an urgent care center or their primary care physician's office. Other alternatives, including delayed EMS response time, were less frequently endorsed as acceptable alternatives. Subject characteristics associated with willingness to accept alternative modes of transportation included younger age, chief complaint, previous ED use, and place of residence (p < 0.05). Subject characteristics associated with willingness to accept alternative destinations included younger age, non-white race, lower patient acuity, and lower self-perceived illness severity (p < 0.05). In our ED, some patients found

  2. Unusual idiopathic normal pressure hydrocephalus patient with marked asymmetric and upper body parkinsonism

    PubMed Central

    Kang, Kyunghun; Choi, Dongho; Lee, Ho-Won

    2016-01-01

    Asymmetry of parkinsonian symptoms is strong evidence toward the diagnosis of Parkinson's disease (PD). Lower body parkinsonism is characteristic in idiopathic normal pressure hydrocephalus (INPH). We report an unusual INPH patient with marked asymmetric and upper body parkinsonism. An 83-year-old man presented with gait impairment and asymmetric clumsiness of movement. According to the Unified Parkinson's Disease Rating Scale (UPDRS), the motor subscore was 12 in the left limb and 8 in the right. The score was 14 for both the upper and lower body. After the cerebrospinal fluid tap test (CSFTT), he showed marked improvement in the upper body score. A loss of asymmetry of parkinsonian signs, with greater improvement in the left limb, was presented. Fluorinated N-3-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)-nortropane (F-18 FP-CIT) positron emission tomography (PET) imaging was normal. In the differential diagnosis of elderly patients presenting with parkinsonism compatible with PD, we might need to consider a diagnosis of INPH. PMID:27293338

  3. Unusual idiopathic normal pressure hydrocephalus patient with marked asymmetric and upper body parkinsonism.

    PubMed

    Kang, Kyunghun; Choi, Dongho; Lee, Ho-Won

    2016-01-01

    Asymmetry of parkinsonian symptoms is strong evidence toward the diagnosis of Parkinson's disease (PD). Lower body parkinsonism is characteristic in idiopathic normal pressure hydrocephalus (INPH). We report an unusual INPH patient with marked asymmetric and upper body parkinsonism. An 83-year-old man presented with gait impairment and asymmetric clumsiness of movement. According to the Unified Parkinson's Disease Rating Scale (UPDRS), the motor subscore was 12 in the left limb and 8 in the right. The score was 14 for both the upper and lower body. After the cerebrospinal fluid tap test (CSFTT), he showed marked improvement in the upper body score. A loss of asymmetry of parkinsonian signs, with greater improvement in the left limb, was presented. Fluorinated N-3-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)-nortropane (F-18 FP-CIT) positron emission tomography (PET) imaging was normal. In the differential diagnosis of elderly patients presenting with parkinsonism compatible with PD, we might need to consider a diagnosis of INPH. PMID:27293338

  4. Acceptance of illness and satisfaction with life among malaria patients in rivers state, Nigeria

    PubMed Central

    2014-01-01

    Background Health condition is one of the basic factors affecting satisfaction with life, and the level of illness acceptance. The purpose of the study was to analyse the level of illness acceptance, the level of satisfaction with life among malaria patients, and the level of trust placed in the physician and the nurse. Methods The study employs the method of diagnostic survey based on standardised AIS and SWLS scales, as well as Anderson and Dedrick’s PPTS and PNTS scales. Results The average AIS level was 12 points, while the average level of SwL at the SWLS scale was 16.5 points. The average level of trust in the physician and the nurse amounted to 50.6 points and 51.4 points, respectively. The correlation between the level of illness acceptance and self-evaluated satisfaction with life was statistically significant, with R = 0.56. The marital status influenced the level of illness acceptance with p < 0.05 and the level of satisfaction with life with p < 0.05. The employment status affected the level of satisfaction with life with p < 0.05 and the level of illness acceptance with p < 0.05. Conclusions The majority of malaria patients did not accept their illness, while the level of satisfaction with life was low. The majority of respondents trusted their physician and nurse. There is a statistically significant correlation between the level of illness acceptance and the self-evaluated satisfaction with life. The marital status had a statistically significant effect on the acceptance of illness and the satisfaction with life. The individuals who had a job demonstrated higher levels of quality of life and illness acceptance. PMID:24885562

  5. Marked increase of asymmetric dimethylarginine in patients with incipient primary chronic renal disease.

    PubMed

    Kielstein, Jan T; Böger, Rainer H; Bode-Böger, Stefanie M; Frölich, Jürgen C; Haller, Hermann; Ritz, Eberhard; Fliser, Danilo

    2002-01-01

    In patients with uremia, increased blood concentrations of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) have been linked to the severity of atherosclerosis and to excess cardiovascular mortality. The ADMA levels and several traditional cardiovascular risk factors were assessed in 44 untreated nonsmoking patients with confirmed primary chronic renal disease at different stages of renal disease. True GFR was assessed by means of the inulin-clearance technique. For comparison, nonsmoking subjects matched with respect to age, gender, and body-mass index were examined. Mean plasma ADMA concentration was markedly higher (P < 0.0001) in all patients combined (4.2 +/- 0.9 micromol/L) than in control subjects (n = 16; age 45 +/- 10 yr; serum creatinine 1.0 +/- 0.1 mg/dl; ADMA 1.4 +/- 0.7 micromol/L). However, mean ADMA levels were similar in patients with normal renal function (n = 16; age 41 +/- 9 yr; serum creatinine 1.1 +/- 0.1 mg/dl; GFR 120 +/- 14 ml x min(-1) x 1.73 m2; ADMA 4.0 +/- 0.7 micromol/L), in patients with moderate renal failure (n = 15; 47 +/- 7 yr; 1.8 +/- 0.3 mg/dl; 65 +/- 10 ml x min(-1) x 1.73 m2; 3.8 +/- 0.6 micromol/L) and in patients with advanced renal failure (n = 13; 46 +/- 9 yr; 4.2 +/- 0.9 mg/dl; 25 +/- 4 ml x min(-1) x 1.73 m2; 4.7 +/- 1.2 micromol/L). Furthermore, ADMA levels were increased to the same extent in normotensive (n = 17; 4.0 +/- 0.8 micromol/L) and in hypertensive (n = 27; 4.2 +/- 0.9 micromol/L) patients. In contrast to ADMA, mean total plasma homocysteine concentration were similar in control subjects (10.6 +/- 2.9 micromol/L) and in patients with normal GFR (11.0 +/- 2.9 micromol/L), but were significantly higher in patients with moderate renal failure (17.7 +/- 4.1 micromol/L) and particularly in patients with advanced renal failure (28.2 +/- 10.6 micromol/L). Finally, mean total serum cholesterol concentrations were comparable in the control group and in the three groups of patients with

  6. Acceptance of NCPAP in a sample of patients admitted for geriatric rehabilitation

    PubMed Central

    2009-01-01

    Objective Sleep apnea syndrome (SAS) is common in older people. Nasal continuous airway pressure (NCPAP) therapy is the treatment of choice for sleep apnea, but is not always accepted by patients. The rate of successful initiation of NCPAP is unknown in geriatric patients. Methods All patients admitted for geriatric rehabilitation were considered for sleep studies. Sleep apnea was assessed using an Edentrace (Nellcor, Hayward, CA) multi-channel recording system. SAS was defined as an apnea-hypopnea-index (AHI) of more than five events per hour plus excessive daytime sleepiness, or an AHI of more than fifteen events per hour regardless of reported sleepiness. Disability was assessed using the Barthel Index of Activities of Daily Living. Results Two hundred sixty nine of 322 consecutive patients (84%) had adequate sleep studies and gave informed consent. SAS was found in 169 subjects (68%). There was no gender difference in the prevalence of SAS. Six subjects (4%) accepted NCPAP therapy. Individuals who accepted NCPAP were younger and less disabled (p < 0.03). Multiple logistic regression analysis revealed disability as the only significant factor predicting NCPAP acceptance. Conclusion NCPAP should not be withheld in the elderly. However, initiation of treatment for SAS remains to be a great challenge in those patients. Geriatric assessment procedures may help better manage older subjects with sleep apnea syndrome. PMID:20156732

  7. Characteristics of patients with diabetes who accept referrals for care management services

    PubMed Central

    Holtz, Bree; Annis, Ann M; Morrish, Wendy; Davis Burns, Jennifer; Krein, Sarah L

    2016-01-01

    Introduction: Patients with chronic conditions can improve their health through participation in self-care programs. However, awareness of and enrollment in these programs are generally low. Objective: We sought to identify factors influencing patients’ receptiveness to a referral for programs and services supporting chronic disease management. Methods: We analyzed data from 541 high-risk diabetic patients who completed an assessment between 2010 and 2013 from a computer-based, nurse-led Navigator referral program within a large primary care clinic. We compared patients who accepted a referral to those who declined. Results: A total of 318 patients (75%) accepted 583 referrals, of which 52% were for self-care programs. Patients who accepted a referral had more primary care visits in the previous year, were more likely to be enrolled in another program, expressed more interest in using the phone and family or friends for support, and were more likely to report recent pain than those who declined a referral. Discussion: Understanding what factors influence patients’ decisions to consider and participate in self-care programs has important implications for program design and development of strategies to connect patients to programs. This work informs outreach efforts to identify and engage patients who are likely to benefit from self-care activities. PMID:26835018

  8. Immunohistochemical assessment of an asymptomatic glucagonoma in a patient with hypergastrinemia and marked antral angiodysplasia.

    PubMed

    Weitgasser, R; Sungler, P; Hauser-Kronberger, C; Dietze, O; Sattlegger, P; Hacker, G W

    2001-03-01

    A 58-year-old patient had been treated for recurrent gastritis. Numerous gastroscopies indicated hemorrhagic gastritis combined with increasingly severe anemia. The patient was admitted with a hemoglobin of 4.4 g/dL. Gastroscopy showed marked antral angiodysplasia. Serum samples for gastrin were taken and found to be elevated (170-250 U/mL). The search for a gastrin-producing tumor with abdominal ultrasound, computed tomography, octreotide scan, and secretin test was negative, but angiography detected a pancreas tumor with a 2-cm diameter. Partial pancreatectomy and partial gastrectomy were performed. Immunohistochemical examination of the tumor did not show a gastrinoma but did show glucagon-reactive tissue. Further tumors or elevated plasma hormone levels were not detected, and a multiple endocrine neoplasia type I syndrome could be excluded. We thus found antral angiodysplasia with hypergastrinemia leading to detection of a glucagonoma diagnosed by immunohistochemistry. After more than 4 years of follow-up, the patient is without any symptoms or signs of relapse or secondary hormone syndrome. PMID:11277423

  9. Guar gum--its acceptability to diabetic patients when incorporated into baked food products.

    PubMed

    Tredger, J; Ransley, J

    1978-12-01

    Guar gum was incorporated into 10 g carbohydrate portions of cheese biscuits and 20 g carbohydrate portions of pizza and egg and bacon flan. Their acceptability to diabetic patients was assessed by means of a taste panel. The results were favourable. Other diabetic patients were asked to judge three cheese biscuits of varying guar gum content. The biscuit with the lowest content was most favoured. PMID:731029

  10. Automated Remote Monitoring of Depression: Acceptance Among Low-Income Patients in Diabetes Disease Management

    PubMed Central

    Ramirez, Magaly; Jin, Haomiao; Ell, Kathleen; Gross-Schulman, Sandra; Myerchin Sklaroff, Laura; Guterman, Jeffrey

    2016-01-01

    Background Remote patient monitoring is increasingly integrated into health care delivery to expand access and increase effectiveness. Automation can add efficiency to remote monitoring, but patient acceptance of automated tools is critical for success. From 2010 to 2013, the Diabetes-Depression Care-management Adoption Trial (DCAT)–a quasi-experimental comparative effectiveness research trial aimed at accelerating the adoption of collaborative depression care in a safety-net health care system–tested a fully automated telephonic assessment (ATA) depression monitoring system serving low-income patients with diabetes. Objective The aim of this study was to determine patient acceptance of ATA calls over time, and to identify factors predicting long-term patient acceptance of ATA calls. Methods We conducted two analyses using data from the DCAT technology-facilitated care arm, in which for 12 months the ATA system periodically assessed depression symptoms, monitored treatment adherence, prompted self-care behaviors, and inquired about patients’ needs for provider contact. Patients received assessments at 6, 12, and 18 months using Likert-scale measures of willingness to use ATA calls, preferred mode of reach, perceived ease of use, usefulness, nonintrusiveness, privacy/security, and long-term usefulness. For the first analysis (patient acceptance over time), we computed descriptive statistics of these measures. In the second analysis (predictive factors), we collapsed patients into two groups: those reporting “high” versus “low” willingness to use ATA calls. To compare them, we used independent t tests for continuous variables and Pearson chi-square tests for categorical variables. Next, we jointly entered independent factors found to be significantly associated with 18-month willingness to use ATA calls at the univariate level into a logistic regression model with backward selection to identify predictive factors. We performed a final logistic

  11. 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

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Acceptance of patients... HEALTH SERVICES Administration § 484.18 Condition of participation: Acceptance of patients, plan of care... that the patient's medical, nursing, and social needs can be met adequately by the agency in...

  12. 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

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Acceptance of patients... HEALTH SERVICES Administration § 484.18 Condition of participation: Acceptance of patients, plan of care... that the patient's medical, nursing, and social needs can be met adequately by the agency in...

  13. 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

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Acceptance of patients... HEALTH SERVICES Administration § 484.18 Condition of participation: Acceptance of patients, plan of care... that the patient's medical, nursing, and social needs can be met adequately by the agency in...

  14. 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

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Acceptance of patients... HEALTH SERVICES Administration § 484.18 Condition of participation: Acceptance of patients, plan of care... that the patient's medical, nursing, and social needs can be met adequately by the agency in...

  15. Use and Acceptance of Electronic Communication by Patients With Multiple Sclerosis: A Multicenter Questionnaire Study

    PubMed Central

    Schultheiss, Thorsten; Kempcke, Raimar; Thomas, Katja; Ziemssen, Tjalf

    2012-01-01

    Background The number of multiple sclerosis (MS) information websites, online communities, and Web-based health education programs has been increasing. However, MS patients’ willingness to use new ways of communication, such as websites, mobile phone application, short message service, or email with their physician, remains unknown. Objectives We designed a questionnaire to evaluate the a priori use of electronic communication methods by MS patients and to assess their acceptance of such tools for communication with their health care providers. Methods We received complete data from 586 MS patients aged between 17 and 73 years. Respondents were surveyed in outpatient clinics across Germany using a novel paper-and-pencil questionnaire. In addition to demographics, the survey items queried frequency of use of, familiarity with, and comfort with using computers, websites, email, and mobile phones. Results About 90% of all MS patients used a personal computer (534/586) and the Internet (527/586) at least once a week, 87.0% (510/586) communicated by email, and 85.6% (488/570) communicated by mobile phone. When asked about their comfort with using electronic communication methods for communication with health care providers, 20.5% (120/586) accepted communication by mobile Internet application or short message service via mobile phone, 41.0% (240/586) by websites, 54.3% (318/586) by email service, and 67.8% (397/586) by at least one type of electronic communication. The level of a priori use was the best predictor for the acceptance of electronic communication with health care providers. Patients who reported already searching online for health information (odds ratio 2.4, P < .001) and who had already communicated with a physician through a website (odds ratio 3.3, P = .03) reported higher acceptance for Web-based communication. Patients who already scheduled appointments with their mobile phones (odds ratio 2.1, P = .002) were more likely to accept the use of mobile

  16. The influence of tinnitus acceptance on the quality of life and psychological distress in patients with chronic tinnitus

    PubMed Central

    Riedl, David; Rumpold, Gerhard; Schmidt, Annette; Zorowka, Patrick G.; Bliem, Harald R.; Moschen, Roland

    2015-01-01

    Recent findings show the importance of acceptance in the treatment of chronic tinnitus. So far, very limited research investigating the different levels of tinnitus acceptance has been conducted. The aim of this study was to investigate the quality of life (QoL) and psychological distress in patients with chronic tinnitus who reported different levels of tinnitus acceptance. The sample consisted of outpatients taking part in a tinnitus coping group (n = 97). Correlations between tinnitus acceptance, psychological distress, and QoL were calculated. Receiver operating characteristic (ROC) curves were used to calculate a cutoff score for the German “Tinnitus Acceptance Questionnaire” (CTAQ-G) and to evaluate the screening abilities of the CTAQ-G. Independent sample t-tests were conducted to compare QoL and psychological distress in patients with low tinnitus acceptance and high tinnitus acceptance. A cutoff point for CTAQ-G of 62.5 was defined, differentiating between patients with “low-to-mild tinnitus acceptance” and “moderate-to-high tinnitus acceptance.” Patients with higher levels of tinnitus acceptance reported a significantly higher QoL and lower psychological distress. Tinnitus acceptance plays an important role for patients with chronic tinnitus. Increased levels of acceptance are related to better QoL and less psychological distress. PMID:26356381

  17. On the Moral Acceptability of Physician-Assisted Dying for Non-Autonomous Psychiatric Patients.

    PubMed

    Varelius, Jukka

    2016-05-01

    Several authors have recently suggested that the suffering caused by mental illness could provide moral grounds for physician-assisted dying. Yet they typically require that psychiatric-assisted dying could come to question in the cases of autonomous, or rational, psychiatric patients only. Given that also non-autonomous psychiatric patients can sometimes suffer unbearably, this limitation appears questionable. In this article, I maintain that restricting psychiatric-assisted dying to autonomous, or rational, psychiatric patients would not be compatible with endorsing certain end-of-life practices commonly accepted in current medical ethics and law, practices often referred to as 'passive euthanasia'. PMID:26449985

  18. Is watch and wait still acceptable for patients with low-grade follicular lymphoma?

    PubMed

    Armitage, James O; Longo, Dan L

    2016-06-01

    Follicular lymphoma (FL) represents more than 20% of all non-Hodgkin lymphomas worldwide and approximately 30% of the non-Hodgkin lymphomas diagnosed in the United States. Although occasionally localized at the time of diagnosis, most patients have disseminated disease. However, patients are frequently asymptomatic, and this, in combination with a long median survival, led to the initial studies of observing asymptomatic patients without initial therapy, ie, "watch and wait." Since the initial report of watch and wait as a treatment strategy for patients with low-grade FL, our understanding of the biology of the disease has advanced; multiple active new agents have been introduced into practice, and the survival of patients with low-grade FL has improved. Given these changes, is watch and wait still an acceptable treatment recommendation for a newly diagnosed patient with low-grade FL? PMID:26994147

  19. The Acceptance of e-Health Solutions Among Patients with Chronic Respiratory Conditions

    PubMed Central

    2013-01-01

    Abstract Objective: The main objective of this study was to assess the acceptance of the use of e-health applications by patients suffering from bronchial asthma and other chronic respiratory conditions. Subjects and Methods: The questionnaire, consisting of 73 items, was distributed among 200 patients remaining under the care of a tertiary-care pulmonology center in Krakow, Poland (return rate, 82.5%; n=165). Results: The mean age (standard deviation) of respondents was 50.8 (14.9) years. Of the respondents, 48.5% (n=80) suffered from bronchial asthma, 29.1% (n=48) from chronic obstructive pulmonary disease, and 32.1% (n=53) from other respiratory diseases. The Internet was used by 58.2% (n=96) of respondents. The most frequent types of health-related information searched for online included diseases (59.4%) and treatments (medication, 54.2%; treatment options, 58.3%), as well as information about physicians and healthcare institutions (32.3% and 31.3%, respectively). The differences between acceptance scores for specific e-health applications were significant (analysis of variance, Friedman chi-squared=166.315, p<0.001). The respondents revealed the highest acceptance of e-health solutions allowing them to book appointments with physicians, access laboratory test results, view educational resources, and renew prescriptions. The acceptance of the most popular e-health applications depended on the duration of disease, respondent's age and education, and his or her use of computers and the Internet. Conclusions: Patients suffering from chronic respiratory conditions demonstrate higher levels of acceptance of e-health applications such as appointment booking, prescription renewal, and access to information (laboratory test results, educational resources) than of solutions directly related to medical care (communication with healthcare providers, disease monitoring). PMID:23734700

  20. Marked phenotypic variability in Pseudomonas cepacia isolated from a patient with cystic fibrosis.

    PubMed

    Larsen, G Y; Stull, T L; Burns, J L

    1993-04-01

    Characterization of the epidemiology of Pseudomonas cepacia colonization in cystic fibrosis is difficult because of the phenotypic variability of isolates. A single sputum culture may yield colonies which differ in morphology, antibiotic susceptibility, and pigment production. We examined serial P. cepacia isolates from a cystic fibrosis patient which the clinical laboratory identified as separate strains; these were selected on the basis of isolation date and culture site. An attempt was made to sample at multiple time points and, at a single time point, from three different culture sites. Ribotype analysis, using both the standard Southern blot technique and a recently reported method which uses the polymerase chain reaction, was used to distinguish unique P. cepacia strains. Characterization included comparison of antibiotic susceptibility, plasmid content, and outer membrane protein (OMP) patterns. rRNA analysis demonstrated that all isolates had the same ribotype, consistent with their being derivatives of the same strain. Antibiotic susceptibility testing revealed variability among both same-date and same-site isolates. Screening for plasmid DNA identified three groups of isolates; both same-date and same-site isolates demonstrated variability. OMP profiles were similar, but at least six distinct patterns were identified. For the six same-date isolates, five different OMP patterns were identified. For the 10 same-site isolates from different dates, five of the six OMP patterns were represented. We have demonstrated marked phenotypic variability in 14 strains of P. cepacia isolated from different sites and at different times from a single colonized patient. Ribotyping identified all the isolates as derivatives of a single strain; thus, the diversity of phenotypes appears to be the result of differential gene expression. PMID:7681845

  1. 3D-manufactured patient-specific models of congenital heart defects for communication in clinical practice: feasibility and acceptability

    PubMed Central

    Biglino, Giovanni; Capelli, Claudio; Wray, Jo; Schievano, Silvia; Leaver, Lindsay-Kay; Khambadkone, Sachin; Giardini, Alessandro; Derrick, Graham; Jones, Alexander; Taylor, Andrew M

    2015-01-01

    Objectives To assess the communication potential of three-dimensional (3D) patient-specific models of congenital heart defects and their acceptability in clinical practice for cardiology consultations. Design This was a questionnaire-based study in which participants were randomised into two groups: the ‘model group’ received a 3D model of the cardiac lesion(s) being discussed during their appointment, while the ‘control group’ had a routine visit. Setting Outpatient clinic, cardiology follow-up visits. Participants 103 parents of children with congenital heart disease were recruited (parental age: 43±8 years; patient age: 12±6 years). In order to have a 3D model made, patients needed to have a recent cardiac MRI examination; this was the crucial inclusion criterion. Interventions Questionnaires were administered to the participants before and after the visits and an additional questionnaire was administered to the attending cardiologist. Main outcome measures Rating (1–10) for the liking of the 3D model, its usefulness and the clarity of the explanation received were recorded, as well as rating (1–10) of the parental understanding and their engagement according to the cardiologist. Furthermore, parental knowledge was assessed by asking them to mark diagrams, tick keywords and provide free text answers. The duration of consultations was recorded and parent feedback collected. Results Parents and cardiologists both found the models to be very useful and helpful in engaging the parents in discussing congenital heart defects. Parental knowledge was not associated with their level of education (p=0.2) and did not improve following their visit. Consultations involving 3D models lasted on average 5 min longer (p=0.02). Conclusions Patient-specific models can enhance engagement with parents and improve communication between cardiologists and parents, potentially impacting on parent and patient psychological adjustment following treatment. However, in

  2. Financial Incentive Increases CPAP Acceptance in Patients from Low Socioeconomic Background

    PubMed Central

    Tarasiuk, Ariel; Reznor, Gally; Greenberg-Dotan, Sari; Reuveni, Haim

    2012-01-01

    Objective We explored whether financial incentives have a role in patients′ decisions to accept (purchase) a continuous positive airway pressure (CPAP) device in a healthcare system that requires cost sharing. Design Longitudinal interventional study. Patients The group receiving financial incentive (n = 137, 50.8±10.6 years, apnea/hypopnea index (AHI) 38.7±19.9 events/hr) and the control group (n = 121, 50.9±10.3 years, AHI 39.9±22) underwent attendant titration and a two-week adaptation to CPAP. Patients in the control group had a co-payment of $330–660; the financial incentive group paid a subsidized price of $55. Results CPAP acceptance was 43% greater (p = 0.02) in the financial incentive group. CPAP acceptance among the low socioeconomic strata (n = 113) (adjusting for age, gender, BMI, tobacco smoking) was enhanced by financial incentive (OR, 95% CI) (3.43, 1.09–10.85), age (1.1, 1.03–1.17), AHI (>30 vs. <30) (4.87, 1.56–15.2), and by family/friends who had positive experience with CPAP (4.29, 1.05–17.51). Among average/high-income patients (n = 145) CPAP acceptance was affected by AHI (>30 vs. <30) (3.16, 1.14–8.75), living with a partner (8.82, 1.03–75.8) but not by the financial incentive. At one-year follow-up CPAP adherence was similar in the financial incentive and control groups, 35% and 39%, respectively (p = 0.82). Adherence rate was sensitive to education (+yr) (1.28, 1.06–1.55) and AHI (>30 vs. <30) (5.25, 1.34–18.5). Conclusions Minimizing cost sharing reduces a barrier for CPAP acceptance among low socioeconomic status patients. Thus, financial incentive should be applied as a policy to encourage CPAP treatment, especially among low socioeconomic strata patients. PMID:22479368

  3. Acceptance Factors of Mobile Apps for Diabetes by Patients Aged 50 or Older: A Qualitative Study

    PubMed Central

    Reichelt, Julius; Bellmann, Maike; Kirch, Wilhelm

    2015-01-01

    Background Mobile apps for people with diabetes offer great potential to support therapy management, increase therapy adherence, and reduce the probability of the occurrence of accompanying and secondary diseases. However, they are rarely used by elderly patients due to a lack of acceptance. Objective We investigated the question “Which factors influence the acceptance of diabetes apps among patients aged 50 or older?” Particular emphasis was placed on the current use of mobile devices/apps, acceptance-promoting/-inhibiting factors, features of a helpful diabetes app, and contact persons for technical questions. This qualitative study was the third of three substudies investigating factors influencing acceptance of diabetes apps among patients aged 50 or older. Methods Guided interviews were chosen in order to get a comprehensive insight into the subjective perspective of elderly diabetes patients. At the end of each interview, the patients tested two existing diabetes apps to reveal obstacles in (first) use. Results Altogether, 32 patients with diabetes were interviewed. The mean age was 68.8 years (SD 8.2). Of 32 participants, 15 (47%) knew apps, however only 2 (6%) had already used a diabetes app within their therapy. The reasons reported for being against the use of apps were a lack of additional benefits (4/8, 50%) compared to current therapy management, a lack of interoperability with other devices/apps (1/8, 12%), and no joy of use (1/8, 12%). The app test revealed the following main difficulties in use: nonintuitive understanding of the functionality of the apps (26/29, 90%), nonintuitive understanding of the menu navigation/labeling (19/29, 66%), font sizes and representations that were too small (14/29, 48%), and difficulties in recognizing and pressing touch-sensitive areas (14/29, 48%). Furthermore, the patients felt the apps lacked individually important functions (11/29, 38%), or felt the functions that were offered were unnecessary for their own

  4. Cultural acceptance of robotic telestroke medicine among patients and healthcare providers in Saudi Arabia

    PubMed Central

    Al-Khathaami, Ali M.; Alshahrani, Saeed M.; Kojan, Suleiman M.; Al-Jumah, Mohammed A.; Alamry, Ahmed A.; El-Metwally, Ashraf A.

    2015-01-01

    Objectives: To determine the degree of satisfaction and acceptance of stroke patients, their relatives, and healthcare providers toward using telestroke technology in Saudi Arabia. Methods: A cross-sectional study was conducted between October and December 2012 at King Abdulaziz Medical City, Ministry of National Guard Affairs, Riyadh, Saudi Arabia. The Remote Presence Robot (RPR), the RP-7i® (FDA- cleared) provided by InTouch Health was used in the study. Patients and their relatives were informed that the physician would appear through a screen on top of a robotic device, as part of their clinical care. Stroke patients admitted through the emergency department, and their relatives, as well as healthcare providers completed a self-administered satisfaction questionnaire following the telestroke consultation sessions. Results: Fifty participants completed the questionnaire. Most subjects agreed that the remote consultant interview was useful and that the audiovisual component of the intervention was of high quality; 98% agreed that they did not feel shy or embarrassed during the remote interview, were able to understand the instruction of the consultant, and recommended its use in stroke management. Furthermore, 92% agreed or strongly agreed that the use of this technology can efficiently replace the physical presence of a neurologist. Conclusion: Results suggest that the use of telestroke medicine is culturally acceptable among stroke patients and their families in Saudi Arabia and favorably received by healthcare providers. PMID:25630777

  5. Acceptance of short course artesunate plus mefloquine drug combination by malaria patients in rural Myanmar.

    PubMed

    Win, L L; Shwe, T; Lwin, M; Aung, S; Zaw, A K; Mar, K K

    1999-09-01

    A cross sectional study was carried out in a rural area of Myanmar to identify malaria patients' acceptance of artesunate plus mefloquine drug combination and to determine the cost borne by patients. The majority (88.5%) preferred this new regimen rather than the other ones they had used before; conviction of drug efficacy was the reason given for the preference by most of them. Traveling on foot to rural health centers or a health assistant's residence for getting the drugs was found to be the main route. Average cost incurred by a patient to get the drug was found to be 274.22 Kyats. Among the cost items, drug cost was the highest item that they had used. PMID:10774645

  6. Patient Acceptance, Initiation, and Engagement in Tele-psychotherapy in Primary Care

    PubMed Central

    Deen, Tisha; Fortney, John; Schroeder, Gary

    2013-01-01

    Objective To examine factors associated with the utilization of psychotherapy offered in primary care over interactive video (tele-psychotherapy). Methods Primary care patients with depression (N=179) recruited from five Federally Qualified Health Centers were randomized to a telemedicine-based collaborative care intervention and offered free tele-psychotherapy in the primary care setting. Independent variables included measures of access and need for depression treatment. Logistic regression indentified variables associated with acceptability, initiation and engagement in tele-psychotherapy. Results 76% of patients reported that psychotherapy was acceptable, 38% scheduled a tele-psychology session, 17% attended a session and 8% engaged in treatment (≥8 sessions). Because the intervention was designed to minimize treatment barriers, access was not a significant predictor of utilization. However, use of tele-psychotherapy was significantly associated with measures of perceived need. Conclusions Even when psychotherapy is delivered in the primary care setting over interactive video to minimize barriers, few patients initiate or engage in tele-psychotherapy. PMID:23370530

  7. Whether or not to accept a deceased donor kidney offer for a pediatric patient.

    PubMed

    Chaudhuri, Abanti; James, Gerri; Grimm, Paul

    2015-09-01

    The expansion of the number of children on the deceased donor renal transplant waitlist has far outstripped the supply of organs in most countries, leading to numerous adjustments to increase supply and to maximize the utility of donor organs. The system for organ allocation varies by country based on local laws, priorities, and resources. Adjustments are made to optimize allocation, enhance post-transplant survival benefit, decrease unequal transplant access, and optimize utilization of donated kidneys. Allocation of deceased donor kidneys is based on several criteria; however, the final decision to accept or reject the offered kidney is made by the potential recipient's transplant team (surgeon/nephrologist). Several considerations including assessment of the donor quality, the human leukocyte antigen (HLA) match between the donor and the recipient, numerous recipient factors, the geographical location of the recipient, and the organ all affect the decision to accept the organ or not for a particular recipient. This decision must be made quickly, often on the spot. Maximizing the benefit from this scarce resource raises difficult ethical issues. The philosophies of equity and utility are often competing. In this manuscript, we highlight a representative case that helps to focus on important issues for the pediatric nephrologist to consider while making the decision to accept a deceased donor kidney offer for a particular pediatric patient. PMID:26130248

  8. Toward optimizing patient-specific IMRT QA techniques in the accurate detection of dosimetrically acceptable and unacceptable patient plans

    SciTech Connect

    McKenzie, Elizabeth M.; Balter, Peter A.; Stingo, Francesco C.; Jones, Jimmy; Followill, David S.; Kry, Stephen F.

    2014-12-15

    Purpose: The authors investigated the performance of several patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) dosimeters in terms of their ability to correctly identify dosimetrically acceptable and unacceptable IMRT patient plans, as determined by an in-house-designed multiple ion chamber phantom used as the gold standard. A further goal was to examine optimal threshold criteria that were consistent and based on the same criteria among the various dosimeters. Methods: The authors used receiver operating characteristic (ROC) curves to determine the sensitivity and specificity of (1) a 2D diode array undergoing anterior irradiation with field-by-field evaluation, (2) a 2D diode array undergoing anterior irradiation with composite evaluation, (3) a 2D diode array using planned irradiation angles with composite evaluation, (4) a helical diode array, (5) radiographic film, and (6) an ion chamber. This was done with a variety of evaluation criteria for a set of 15 dosimetrically unacceptable and 9 acceptable clinical IMRT patient plans, where acceptability was defined on the basis of multiple ion chamber measurements using independent ion chambers and a phantom. The area under the curve (AUC) on the ROC curves was used to compare dosimeter performance across all thresholds. Optimal threshold values were obtained from the ROC curves while incorporating considerations for cost and prevalence of unacceptable plans. Results: Using common clinical acceptance thresholds, most devices performed very poorly in terms of identifying unacceptable plans. Grouping the detector performance based on AUC showed two significantly different groups. The ion chamber, radiographic film, helical diode array, and anterior-delivered composite 2D diode array were in the better-performing group, whereas the anterior-delivered field-by-field and planned gantry angle delivery using the 2D diode array performed less well. Additionally, based on the AUCs, there

  9. Acceptability of Voluntary Medical Male Circumcision (VMMC) among Male Sexually Transmitted Diseases Patients (MSTDP) in China

    PubMed Central

    Lau, Joseph T. F.; Kim, Yoona

    2016-01-01

    Voluntary Medical Male circumcision (VMMC) is an evidence-based, yet under-utilized biomedical HIV intervention in China. No study has investigated acceptability of VMMC among male sexually transmitted diseases patients (MSTDP) who are at high risk of HIV transmission. A cross-sectional survey interviewed 350 HIV negative heterosexual MSTDP in Shenzhen, China; 12.0% (n = 42) of them were circumcised at the time of survey. When the uncircumcised participants (n = 308) were informed that VMMC could reduce the risk of HIV infection via heterosexual intercourse by 50%, the prevalence of acceptability of VMMC in the next six months was 46.1%. Adjusted for significant background variables, significant factors of acceptability of VMMC included: 1) emotional variables: the Emotional Representation Subscale (adjusted odds ratios, AOR = 1.13, 95%CI: 1.06–1.18), 2) cognitive variables derived from Health Belief Model (HBM): perceived some chance of having sex with HIV positive women in the next 12 months (AOR = 2.48, 95%CI: 1.15–5.33) (perceived susceptibility), perceived severity of STD infection (AOR = 1.06, 95%CI: 1.02–1.10), perceived benefit of VMMC in risk reduction (AOR = 1.29, 95%CI: 1.16–1.42) and sexual performance (AOR = 1.45, 95%CI: 1.26–1.71), perceived barriers against taking up VMMC (AOR = 0.88, 95%CI: 0.81–0.95), and perceived cue to action (AOR = 1.41, 95%CI: 1.23–1.61) and self-efficacy (AOR = 1.38, 95%CI: 1.26–1.35) related to taking up VMMC. The association between perceived severity of STD infection and acceptability was fully mediated by emotional representation of STD infection. The relatively low prevalence of circumcision and high acceptability suggested that the situation was favorable for implementing VMMC as a means of HIV intervention among MSTDP in China. HBM is a potential suitable framework to guide the design of future VMMC promotion. Future implementation programs should be conducted in STD clinic settings, taking the

  10. Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey

    PubMed Central

    2016-01-01

    Background The future of health care delivery is becoming more citizen centered, as today’s user is more active, better informed, and more demanding. Worldwide governments are promoting online health services, such as electronic health record (EHR) patient portals and, as a result, the deployment and use of these services. Overall, this makes the adoption of patient-accessible EHR portals an important field to study and understand. Objective The aim of this study is to understand the factors that drive individuals to adopt EHR portals. Methods We applied a new adoption model using, as a starting point, Ventkatesh's Unified Theory of Acceptance and Use of Technology in a consumer context (UTAUT2) by integrating a new construct specific to health care, a new moderator, and new relationships. To test the research model, we used the partial least squares (PLS) causal modelling approach. An online questionnaire was administrated. We collected 360 valid responses. Results The statistically significant drivers of behavioral intention are performance expectancy (beta=.200; t=3.619), effort expectancy (beta=.185; t=2.907), habit (beta=.388; t=7.320), and self-perception (beta=.098; t=2.285). The predictors of use behavior are habit (beta=0.206; t=2.752) and behavioral intention (beta=0.258; t=4.036). The model explained 49.7% of the variance in behavioral intention and 26.8% of the variance in use behavior. Conclusions Our research helps to understand the desired technology characteristics of EHR portals. By testing an information technology acceptance model, we are able to determine what is more valued by patients when it comes to deciding whether to adopt EHR portals or not. The inclusion of specific constructs and relationships related to the health care consumer area also had a significant impact on understanding the adoption of EHR portals. PMID:26935646

  11. Fasting during Ramadan: efficacy, safety, and patient acceptability of vildagliptin in diabetic patients

    PubMed Central

    Aziz, Kamran MA

    2015-01-01

    Diabetes management during Ramadan fasting is challenging to the physician in terms of minimizing the risk of hypoglycemia. As compared to oral hypoglycemic agents (OHAs) and sulfonylureas (SUs), which carry a higher and significant risk of hypoglycemia, newer antidiabetic agents such as dipeptidyl peptidase-4 (DPP-4) inhibitors have demonstrated lower risk of hypoglycemia during Ramadan fasting, with better patient compliance. In addition to diabetes education and pre-Ramadan assessments, the physician should also consider use of DPP-4 inhibitors (such as vildagliptin) during Ramadan fasting to minimize the risk of hypoglycemia in type 2 diabetic subjects. Severe episodes of hypoglycemia have been demonstrated in recent research and clinical trials with OHAs/SUs. Conversely, these research observations have also demonstrated comparative safety and efficacy with lower risk of hypoglycemia associated with vildagliptin. Current research review has collected evidence-based clinical trials and observations for the drug vildagliptin to minimize the risk of hypoglycemia during Ramadan fasting, while at the same time focusing the role of diabetes self-management education (DSME), pre-Ramadan assessments, and patient care. PMID:25931826

  12. Clinical utility, safety, acceptability and complications of transoesophageal echocardiography (TEE) in 901 patients.

    PubMed

    Chee, T S; Quek, S S; Ding, Z P; Chua, S M

    1995-10-01

    Transoesophageal echocardiography (TEE) has earned an important role in the evaluation of patients with cardiovascular diseases. We report our TEE experience in 901 patients who had suboptimal transthoracic echocardiographic studies performed between September 1989 and June 1993. The patient-population consisted of 459 females and 442 males, with an ethnic distribution of Chinese 76.5%, Malays 12.7%, Indians 8.5% and Others 2.3%. The mean age was 48 years. The main indications for TEE were: cardiac source of embolism (27.5%); native valve pathology (19.1%); atrial septal abnormality (9.7%); infective endocarditis (8.3%); intracardiac masses (7.0%); prosthetic valve dysfunction (6.3%); congenital heart diseases (4.6%); aortic diseases (3.4%) and miscellaneous (14.1%). The majority of the studies were done on in- and out-patients, with only 1.2% performed in the intensive care area and 1% intraoperatively. 82.6% of TEE intubation were accomplished within one minute and most of the TEE studies were completed within twenty minutes. There were ten failures (1.2%). Major complications occurred in 5 patients (0.6%) but there was no mortality. 90.5% of the studies were considered by the operators as additionally-informative or useful for clinical decision making. In a subgroup analysis, 90.6% of the patients who had undergone TEE indicated their willingness for repeat studies if required and TEE was able to increase the sensitivity of detecting a potential cardioembolic source from 10.3% to 29.5%. In conclusion, with increasing experience, TEE can be performed expeditiously and safely, with good acceptability by our local population. TEE provides useful or additional information that supplements standard transthoracic echocardiography in a wide-ranging spectrum of cardiac conditions. PMID:8882528

  13. Mobile Technologies: Expectancy, Usage, and Acceptance of Clinical Staff and Patients at a University Medical Center

    PubMed Central

    2014-01-01

    Background Despite their increasing popularity, little is known about how users perceive mobile devices such as smartphones and tablet PCs in medical contexts. Available studies are often restricted to evaluating the success of specific interventions and do not adequately cover the users’ basic attitudes, for example, their expectations or concerns toward using mobile devices in medical settings. Objective The objective of the study was to obtain a comprehensive picture, both from the perspective of the patients, as well as the doctors, regarding the use and acceptance of mobile devices within medical contexts in general well as the perceived challenges when introducing the technology. Methods Doctors working at Hannover Medical School (206/1151, response 17.90%), as well as patients being admitted to this facility (213/279, utilization 76.3%) were surveyed about their acceptance and use of mobile devices in medical settings. Regarding demographics, both samples were representative of the respective study population. GNU R (version 3.1.1) was used for statistical testing. Fisher’s exact test, two-sided, alpha=.05 with Monte Carlo approximation, 2000 replicates, was applied to determine dependencies between two variables. Results The majority of participants already own mobile devices (doctors, 168/206, 81.6%; patients, 110/213, 51.6%). For doctors, use in a professional context does not depend on age (P=.66), professional experience (P=.80), or function (P=.34); gender was a factor (P=.009), and use was more common among male (61/135, 45.2%) than female doctors (17/67, 25%). A correlation between use of mobile devices and age (P=.001) as well as education (P=.002) was seen for patients. Minor differences regarding how mobile devices are perceived in sensitive medical contexts mostly relate to data security, patients are more critical of the devices being used for storing and processing patient data; every fifth patient opposed this, but nevertheless, 4.8% of

  14. Shared Decision Aids: Increasing Patient Acceptance of Long-Acting Reversible Contraception

    PubMed Central

    George, Tracy P.; DeCristofaro, Claire; Dumas, Bonnie P.; Murphy, Pamela F.

    2015-01-01

    Unintended pregnancies are an important public health issue. Long-acting reversible contraceptive methods (LARCs) are reliable, safe, highly effective methods for most women; however they are underutilized in the United States. Shared decision aids were added to usual care in five public health family planning clinics in the Southeastern United States, staffed by advance practice nurses and registered nurses. All five sites showed an increase in the use of LARCs during the time period that shared decision aids were used (results statistically significant to p < 0.001). It is important for women to make informed choices about contraception, and shared decision aids can be utilized to support this decision making. This resource has been adopted for statewide use in all public health clinics, and implications for practice suggest that the use of shared decision aids is an effective method to support informed patient decision making and acceptance of LARC methods of contraception. PMID:27417757

  15. The levonorgestrel-releasing intrauterine system: Safety, efficacy, and patient acceptability

    PubMed Central

    Beatty, Megan N; Blumenthal, Paul D

    2009-01-01

    The levonorgestrel-releasing intrauterine system (LNG-IUS) is a safe, effective and acceptable form of contraception used by over 150 million women worldwide. It also has a variety of noncontraceptive benefits including treatment for menorrhagia, endometriosis, and endometrial hyperplasia. The LNG-IUS has also been used in combination with estrogen for hormone replacement therapy and as an alternative to hysterectomy. Overall, the system is very well tolerated and patient satisfaction is quite high when proper education regarding possible side effects is provided. However, despite all of the obvious benefits of the LNG-IUS, utilization rates remain quite low in the developed countries, especially in the United States. This is thought to be largely secondary to the persistent negative impressions from the Dalkon Shield intrauterine experience in the 1970s. This history continues to negatively influence the opinions of both patients and health care providers with regards to intrauterine devices. Providers should resolve to educate themselves and their patients on the current indications and uses for this device, as it, and intrauterine contraception in general, remains a largely underutilized approach to a variety of women’s health issues. PMID:19707273

  16. Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD

    PubMed Central

    Uchmanowicz, Izabella; Jankowska-Polanska, Beata; Motowidlo, Urszula; Uchmanowicz, Bartosz; Chabowski, Mariusz

    2016-01-01

    Background COPD is a civilization disease. It affects up to 8%–10% of population >30 years of age. Coexistence of depression occurs in 20%–40% of patients with COPD. Depression and anxiety reduce compliance and worsen prognosis. Objective The aims of this study were to determine the degree of illness acceptance among patients with COPD, to examine the relation between disease acceptance and perceived anxiety and depression, and to verify which of the sociodemographic and clinical factors are associated with illness acceptance, anxiety, and depression. Materials and methods The study included 102 patients with COPD (mean age 65.8 years), hospitalized due to exacerbations. Acceptance of Illness Scale and Hospital Anxiety and Depression Scale were used. For statistical analysis, Student’s t-test and Pearson’s r correlation coefficient were carried out. Results The overall illness acceptance level was moderate with a tendency toward lack of acceptance (mean 20.6, standard deviation [SD] 7.62). The overall scores were 10.2 (SD 3.32) for anxiety and 10.8 (SD 4.14) for depression, which indicate borderline or high intensity of these symptoms. Acceptance of illness was negatively correlated with the intensity of depression symptoms (r=−0.46, P<0.05). Intensity of depression was significantly associated with intensity of smoking, duration of the disease, severity of dyspnea, and living in a rural area. Conclusion Early identification and assessment of depression and anxiety symptoms allow health care providers to offer patients at risk of depression a special medical supervision. Rapid start of antidepressant therapy may increase illness acceptance and improve prognosis among patients with COPD. PMID:27274217

  17. Assessment of matrix metalloproteinase-1 for marking liver cirrhosis in chronic hepatitis C patients.

    PubMed

    Attallah, Abdelfattah M; Badr El-Din, Nariman K; Omran, Mohamed M; Farid, Khaled; El-Wahab, Ahmed H Abd; El-Bendary, Mohamed; El-Dosoky, Ibrahim

    2011-01-01

    Our objective in the present study was to observe the change in the serum MMP-1 concentration using ELISA in 129 chronic hepatitis C (CHC) (78 non-cirrhotic and 51 with cirrhotic liver) and 50 healthy controls. The values of MMP-1 concentration increased in patients with CHC according to the stage of liver fibrosis. An area under the ROC curves (AUC) of the MMP-1 was 0.98 for discriminating patients with cirrhotic liver from healthy individuals and was 0.78 for discriminating patients with cirrhotic liver from non cirrhotic patients. The diagnostic potential of MMP-1 for discriminating cirrhosis from healthy individuals was very high with 98% sensitivity and 97% efficiency. MMP-1 detected cirrhosis in CHC with 71% sensitivity and 73% efficiency. In Conclusion, measurement of serum MMP-1 is useful for diagnosing liver cirrhosis in CHC patients. PMID:23082478

  18. Marked increase of calcium uptake in the ATP-depleted red cells of patients with iron deficiency

    SciTech Connect

    Shimoda, M.; Yawata, Y.

    1985-05-01

    Calcium (Ca) uptake was markedly increased in ATP-depleted red cells of patients with iron deficiency anemia (IDA) compared to ATP- depleted normal red cells. The extent of increased Ca uptake was related to the severity of iron deficiency as judged by decreased mean cell volume. Moreover, the increased Ca uptake returned to normal levels after oral iron supplementation therapy. The net calcium content of fresh red cells from iron-deficient individuals was the same as in red cells from normal subjects. Sodium influx and ferric ion uptake appeared to be virtually unaffected in the iron deficient red cells.

  19. Marked shrinkage of amyloid lymphadenopathy after an intensive chemotherapy in a patient with IgM-associated AL amyloidosis.

    PubMed

    Tazawa, Ko-Ichi; Katoh, Nagaaki; Shimojima, Yasuhiro; Matsuda, Masayuki; Ikeda, Shu-Ichi

    2009-12-01

    A male patient with primary AL amyloidosis who had been suffering from systemic lymphadenopathy with IgMkappa-type M-proteinemia received two courses of VAD and high-dose melphalan with in vivo elimination of CD20(+) cells using rituximab followed by autologous peripheral blood stem cell transplantation. Four years after complete hematological remission he showed marked reduction in size of the amyloid-laden lymph nodes. Deposits of AL amyloid may regress from the tissue if the chemotherapy succeeds in persistent inhibition of the production of an amyloidogenic immunoglobulin light chain. PMID:19922338

  20. Marked shrinkage of amyloid lymphadenopathy after an intensive chemotherapy in a patient with IgM-associated AL amyloidosis.

    PubMed

    Tazawa, Ko-Ichi; Katoh, Nagaaki; Shimojima, Yasuhiro; Matsuda, Masayuki; Ikeda, Shu-Ichi

    2009-01-01

    A male patient with primary AL amyloidosis who had been suffering from systemic lymphadenopathy with IgMkappa-type M-proteinemia received two courses of VAD and high-dose melphalan with in vivo elimination of CD20(+) cells using rituximab followed by autologous peripheral blood stem cell transplantation. Four years after complete hematological remission he showed marked reduction in size of the amyloid-laden lymph nodes. Deposits of AL amyloid may regress from the tissue if the chemotherapy succeeds in persistent inhibition of the production of amyloidogenic immunoglobulin light chains. PMID:19590992

  1. Methadone Maintenance for HIV Positive and HIV Negative Patients in Kyiv: Acceptability and Treatment Response

    PubMed Central

    Dvoriak, Sergii; Karachevsky, Andrey; Chhatre, Sumedha; Booth, Robert; Metzger, David; Schumacher, Joseph; Chychula, Nina; Pecoraro, Anna; Woody, George

    2014-01-01

    Background With up to 40% of opioid injectors infected with HIV, Ukraine has one of the most concentrated HIV epidemics in the world, mainly due to unsterile injection practices and a historical absence of effective prevention services. Harm reduction programs, including syringe exchange and a small buprenorphine treatment program, were introduced in 2004 and methadone maintenance was allowed in 2007. Despite an initial expansion, by 2009, only 3221 injectors were receiving methadone treatment. A growing body of research on methadone maintenance has found high retention rates with reduction in opioid use and HIV risk behaviors. We report on the acceptability and initial outcome of methadone treatment as a function of HIV status, an issue that has not yet been reported for injectors in Ukraine. Methods Longitudinal observational study of a 12-week course of methadone treatment in 25 HIV+ and 25 HIV− opioid addicted individuals recruited from a harm reduction program and the city AIDS Center. Drug use and HIV risk were assessed at baseline and weeks 4, 8, 12 and 20; all patients were offered continued methadone maintenance in the Kyiv city program at the end of 12 weeks. Results Fifty-four individuals were asked if they were interested in the study and 50, demographically similar to other samples of opioid addicted Ukrainians, agreed to participate. Two died of non-study related causes; the other 48 completed assessments at weeks 4, 8 and 12, and 47 completed followups at week 20. Significant reductions were seen in use of heroin (p<. 0001), other opiates/analgesics (p< 0.0001), and HIV risk behaviors (drug, sex, total; all p <0.0001). All 48 patients chose to continue methadone after the 12-weeks of study medication ended. Unlike most opioid treatment studies, sexual risk was somewhat higher than injecting risk at study intake. Conclusions Methadone maintenance was well accepted by HIV+ and HIV− opioid dependent individuals and has the potential for significant

  2. Working memory in ALS patients: preserved performance but marked changes in underlying neuronal networks.

    PubMed

    Zaehle, Tino; Becke, Andreas; Naue, Nicole; Machts, Judith; Abdulla, Susanne; Petri, Susanne; Kollewe, Katja; Dengler, Reinhard; Heinze, Hans-Jochen; Vielhaber, Stefan; Müller, Notger G

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease which affects the motor system but also other frontal brain regions. In this study we investigated changes in functional neuronal networks including posterior brain regions that are not directly affected by the neurodegenerative process. To this end, we analyzed the contralateral delay activity (CDA), an ERP component considered an online marker of memory storage in posterior cortex, while 23 ALS patients and their controls performed a delayed-matching-to-sample working memory (WM) task. The task required encoding of stimuli in the cued hemifield whilst ignoring stimuli in the other hemifield. Despite their unimpaired behavioral performance patients displayed several changes in the neuronal markers of the memory processes. Their CDA amplitude was smaller; it showed less load-dependent modulation and lacked the reduction observed when controls performed the same task three months later. The smaller CDA in the patients could be attributed to more ipsilateral cortical activity which may indicate that ALS patients unnecessarily processed the irrelevant stimuli as well. The latter is presumably related to deterioration of the frontal cortex in the patient group which was indicated by slight deficits in tests of their executive functions that increased over time. The frontal pathology presumably affected their top-down control of memory storage in remote regions in the posterior brain. In sum, the present results demonstrate functional changes in neuronal networks, i.e. neuroplasticity, in ALS that go well beyond the known structural changes. They also show that at least in WM tasks, in which strategic top-down control demands are relatively low, the frontal deficit can be compensated for by intact low level processes in posterior brain regions. PMID:23951274

  3. Working Memory in ALS Patients: Preserved Performance but Marked Changes in Underlying Neuronal Networks

    PubMed Central

    Zaehle, Tino; Becke, Andreas; Naue, Nicole; Machts, Judith; Abdulla, Susanne; Petri, Susanne; Kollewe, Katja; Dengler, Reinhard; Heinze, Hans-Jochen; Vielhaber, Stefan; Müller, Notger G.

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease which affects the motor system but also other frontal brain regions. In this study we investigated changes in functional neuronal networks including posterior brain regions that are not directly affected by the neurodegenerative process. To this end, we analyzed the contralateral delay activity (CDA), an ERP component considered an online marker of memory storage in posterior cortex, while 23 ALS patients and their controls performed a delayed-matching-to-sample working memory (WM) task. The task required encoding of stimuli in the cued hemifield whilst ignoring stimuli in the other hemifield. Despite their unimpaired behavioral performance patients displayed several changes in the neuronal markers of the memory processes. Their CDA amplitude was smaller; it showed less load-dependent modulation and lacked the reduction observed when controls performed the same task three months later. The smaller CDA in the patients could be attributed to more ipsilateral cortical activity which may indicate that ALS patients unnecessarily processed the irrelevant stimuli as well. The latter is presumably related to deterioration of the frontal cortex in the patient group which was indicated by slight deficits in tests of their executive functions that increased over time. The frontal pathology presumably affected their top-down control of memory storage in remote regions in the posterior brain. In sum, the present results demonstrate functional changes in neuronal networks, i.e. neuroplasticity, in ALS that go well beyond the known structural changes. They also show that at least in WM tasks, in which strategic top-down control demands are relatively low, the frontal deficit can be compensated for by intact low level processes in posterior brain regions. PMID:23951274

  4. Shared decision making in transplantation: how patients see their role in the decision process of accepting a donor liver.

    PubMed

    Op den Dries, Sanna; Annema, Coby; Berg, Aad P van den; Ranchor, Adelita V; Porte, Robert J

    2014-09-01

    At the time of the organ offer for transplantation, donor-related risks such as disease transmission and graft failure are weighed against the patient's risk of remaining on the waiting list. The patient's commonly inactive role in decision making and the timing and extent of donor-specific risk information have been discussed in the medical literature. This is the first study revealing the opinions of liver patients on these issues. Forty patients listed for liver transplantation and 179 liver transplant patients participated in an anonymous questionnaire-based survey. The majority of the patients wanted to be informed about donor-related risks (59.8%-74.8%). The preferred timing for being informed about donor-related risks was the time of the organ offer for 53.3% of the patients. Among these patients, 79.8% wished to be involved in making the decision to accept or not accept a liver for transplantation, 10.6% wished to make the final decision alone, and only 9.6% did not want to be involved in the decision-making process. Implementing this knowledge through the standardization of the content, the manner of transfer, and the amount of information that we provide to our patients will improve opportunities for shared decision making at different time points during the transplant allocation process. This will enable us to provide the same opportunities and care to every patient on the waiting list. PMID:24863055

  5. Microalbuminuria is related to marked end organ damage in previously untreated, elderly hypertensive patients.

    PubMed

    Terpstra, W F; May, J F; Smit, A J; de Graeff, P A; Crijns, H J G M

    2002-01-01

    We wondered whether, in an elderly hypertensive population in a primary prevention setting, free from diabetes mellitus and clinical atherosclerosis, differences between end organ damage and microalbuminuria (MA) could be found using a lower level of urinary albumin excretion than that of classically defined MA. From a population survey of 173 previously untreated hypertensive patients (4x blood pressure systolic > or = 160 and < or = 220 mmHg, and/or diastolic > or = 95 and < or = 115 mmHg), mean age 67 +/- 4 years, were screened for MA (defined as albumin excretion between 20 and 300 mg/24 h). End organ damage was determined by B-mode ultrasound scanning of carotid and femoral arteries and echocardiography. Out of 173 hypertensives, 14 showed MA (8%). These hypertensives had a significantly higher intima media thickness (IMT; 1.01 +/- 0.21 vs 0.88 +/- 0.6 mm, p < 0.05) and increased left ventricular mass index (118 +/- 31 vs 103 +/- 22 g/m2, p < 0.05) than hypertensives without MA. Linear regression analysis showed that MA, age, male gender and diastolic blood pressure were independently related to IMT, while systolic blood pressure, male gender and body mass index were independently related to left ventricular mass. Even using lower levels of urinary albumin excretion rate, patients with MA had significantly higher IMT and increased left ventricular mass. Moreover, MA was independently related to IMT in these elderly hypertensives. These results suggest that the threshold value for MA should be reconsidered in hypertension. PMID:12035876

  6. Feasibility and acceptability of a volunteer-mediated diversional therapy program for older patients with cognitive impairment.

    PubMed

    Wong Shee, Anna; Phillips, Bev; Hill, Keith; Dodd, Karen

    2014-01-01

    Understanding the perceptions of stakeholders is critical for determining acceptability and feasibility of volunteer-mediated programs. This study evaluated the feasibility and acceptability for staff, volunteers, patients and their carers, of a volunteer diversional therapy program for patients with cognitive impairment undergoing inpatient rehabilitation. Post-program structured interviews were conducted with the volunteers (n = 10), patients (n = 30) and their carers (n = 3); and nursing staff (n = 6) participated in a focus group. Thematic analysis identified five themes (values, attitudes, knowledge, purpose, support) in two dimensions (personal, team culture). Overall, patients, carers, staff and volunteers were satisfied with the volunteer program and perceived benefits for quality of care. Recommendations for improvements to the program related to staff engagement with the program and the volunteers' education and training. The volunteer diversional therapy pilot program for patients with cognitive impairment on a sub-acute ward was acceptable and feasible for patients, carers, staff and volunteers. PMID:24755195

  7. [Marked hyponatremia with consciousness disturbance probably caused by linezolid in a patient with acute myeloid leukemia].

    PubMed

    Suzuki, Kei; Ohishi, Kohshi; Ino, Kazuko; Sugawara, Yumiko; Sekine, Takao

    2008-01-01

    We report the case of a 75-year-old man with acute myeloid leukemia who developed hyponatremia after linezolid administration. Because induction therapy did not achieve complete remission for this man, we initiated re-induction therapy with enocitabin and daunomycin. Seven days after chemotherapy, the patient experienced a catheter-related blood stream infection (CRBSI) due to methicilin resistant staphylococcus aureus (MRSA). When treatment with albekacin and fosfomycin was in effective, linezolid was administrated intravenously and he became afebrile. On day 8 after linezolid administration, however, he reported general fatigue and slight consciousness disturbance. His serum sodium concentration was 119 mEq/L and his urinary sodium excretion rose to 143 mEq/day, although intravenous sodium intake was 98 mEq/day. Because of the sufficiency of urine volume and weight loss, we surmise that inappropriate ADH secretion (SIADH) syndrome was unlikely. We diagnosed renal salt wasting syndrome (RSWS) based on calculation of the amount of sodium intake and the amount of sodium excreted from the kidneys. After linezolid was discontinued and aggressive treatment with sodium supplement begun, his consciousness cleared as his low serum sodium level rose. This is, to the best of our knowledge, the first case reported on the development of RSWS after linezolid treatment. Although the process remains unclear, our case suggests that linezolid may induce RSWS after intensive chemotherapy. PMID:18306678

  8. The Influence of Alignment on Midterm Outcome after Total Knee Arthroplasty in Patients With Marked Coronal Femoral Bowing.

    PubMed

    Huang, Tsan-Wen; Lee, Ching-Yu; Lin, Shih-Jie; Lee, Mel S; Hsu, Robert Wen-Wei; Shen, Wun-Jer

    2015-09-01

    Whether the mechanical axis should be restored to neutral remains controversial when the patient has marked coronal femoral bowing. Eighty-four total knee arthroplasties were retrospectively reviewed. In the neutral-aligned group A the immediate postoperative mechanical axis of 179 ± 1° held stable (P = 0.841). The postoperative mechanical axis decreased from 176 ± 1° to 173 ± 1° (P = 0.024) in the outlier group. Progressive varus in the outlier group at follow-up was probably due implant instability and ligament imbalance as well as excessive polyethylene wear. At a mean follow-up of 75.8 months, no statistically significant difference was detected between the two groups. Long-term follow up will be needed to determine if the maintenance in radiographic results translates to better clinical outcomes. PMID:25891432

  9. Validation of a Chinese version of the Chronic Pain Acceptance Questionnaire (CAPQ) and CPAQ-8 in chronic pain patients.

    PubMed

    Liu, Yaqun; Wang, Lei; Wei, Yibo; Wang, Xiaolin; Xu, Tianming; Sun, Jinhai

    2016-08-01

    Acceptance of chronic pain has increasingly become a significant issue in the field of pain management. Many researchers have suggested that patients with better acceptance of pain are more likely to have better functioning both in physical and psychological status. In many countries, the Chronic Pain Acceptance Questionnaire (CPAQ) and CPAQ-8 have been validated and utilized frequently to measure the pain acceptance of patients with chronic pain. However, the CPAQ and CPAQ-8 yet have not been introduced and validated in Mainland China.In this study, we aimed to translate the English version of the CPAQ into simplified Chinese, make proper cross-cultural adaptations, and validate the psychometric properties of the Chinese version of the CPAQ and the CPAQ-8.The English version of the CPAQ was first linguistically translated and cross-culturally adapted to formulate a Chinese version. Then, we recruited 224 patients from a pain clinic and every participant was asked to finish a series of questionnaires. Finally, statistical analysis was performed to test the psychometric properties of the CPAQ and the CPAQ-8.Both confirmatory factor analysis (CFA) and principal component analysis (PCA) confirmed a 2-factor structure for the CPAQ and the CPAQ-8. Nine out of 10 of the hypotheses were validated for construct validity. The overall intraclass correlation coefficient (ICC) value for the CPAQ and CPAQ-8 were 0.92 and 0.89, respectively. In addition, the Cronbach α values for both the CPAQ and the CPAQ-8 showed excellent test-retest reliability.In conclusion, the original CPAQ was successfully developed into the Chinese version of the CPAQ and CPAQ-8 with excellent validity and reliability. The scores of the CPAQ or CPAQ-8 might be a strong predictor for the physical and psychological function of chronic pain patients. In addition, to improve the satisfaction of surgery patients, we recommend measuring patients' pain acceptance using the CPAQ or CPAQ-8 before and after the

  10. Evaluation of the Patient Acceptable Symptom State (PASS) in Italian Patients Affected by Systemic Lupus Erythematosus: Association with Disease Activity Indices

    PubMed Central

    Conti, Fabrizio; Ceccarelli, Fulvia; Massaro, Laura; Pacucci, Viviana A.; Miranda, Francesca; Truglia, Simona; Cipriano, Enrica; Martinelli, Francesco; Leccese, Ilaria; Spinelli, Francesca Romana; Alessandri, Cristiano; Perricone, Carlo; Valesini, Guido

    2013-01-01

    Objectives The aim of this study was to evaluate the discriminant capability of the patient acceptable symptom state (PASS) according to disease activity, in a cohort of Italian patients affected by systemic Lupus erythematosus (SLE). Methods Consecutive SLE patients were enrolled. At each visit, the patients underwent a complete physical examination and the clinical/laboratory data were collected in a standardized, computerized, and electronically-filled form. The evaluation of serum complement C3 and C4 levels and determination of autoantibodies was obtained. Disease activity was assessed with the SLEDAI-2K and ECLAM, while chronic damage was measured with the SLICC. Finally, PASS was assessed in all patients by asking to answer yes or no to a single question. Results One hundred sixty-five patients were enrolled (M/F 12/153; mean age 40.4±11.8 years, mean disease duration 109.1±96.2 months). No patients refused to answer, suggesting the acceptability of PASS. A total of 80% of patients rated their state as acceptable. The patients with an acceptable status had significantly lower mean SLEDAI-2K and ECLAM scores than the others [1.8±2.7 versus 3.4±2.3(P=0.004); 0.7±0.9 versus 1.4±1.1(P=0.0027)]. No significant differences were observed when considering chronic damage, evaluated with SLICC. Conclusions In the clinical practice, SLE patients assessment performed by using complex disease activity indices such as SLEDAI-2K and ECLAM, could be time consuming. In our study, for the first time, we used PASS, a quick and easily comprehensible tool, to evaluate the patients’ status, this single question seems to be able to discriminate patients with different disease activity, especially when this is determined by musculoskeletal involvement. PMID:24039971

  11. Polymyxin B-immobilized fiber hemoperfusion with low priming volume in an elderly septic shock patient with marked endotoxemia.

    PubMed

    Nakamura, Tsukasa; Kawagoe, Yasuhiro; Ueda, Yoshihiko; Koide, Hikaru

    2005-01-01

    An 84-year-old woman with septic shock caused by pyelonephritis is described herein. She was admitted for severe back pain and high fever. Her white blood cell (WBC) count and C-reactive protein (CRP) and endotoxin levels were elevated at 38,000/microl, 40.0 mg/dl, and 8,400 pg/ml, respectively. Her blood pressure was 80/34 mm Hg. Urinalysis revealed occult blood with innumerable WBCs. Plain abdominal radiography showed calcium stones in both kidneys. Septic shock with endotoxemia was diagnosed, and the patient was treated with antibiotics, gamma-globulin, and dopamine. However, her plasma endotoxin level remained high for 3 days. We performed direct hemoperfusion twice using a polymyxin B-immobilized fiber (PMX-F) column with a low priming volume. After PMX-F treatment, the patient's temperature decreased to 36.8 degrees C; her WBC count and CRP level decreased to 9,200/microl and 3.8 mg/dl, respectively. Her plasma endotoxin level decreased to 840 pg/ml after the first treatment and to 188 pg/ml after the second treatment. The next day, her blood endotoxin level further decreased to 32 pg/ml. Her blood pressure increased to 92/60 mm Hg after the first treatment and to 118/76 mm Hg after the second treatment. The patient was discharged on day 26 after admission. Our experience in this case suggests that PMX-F treatment with a low priming volume may be beneficial in elderly patients with septic shock and marked endotoxemia. PMID:16156319

  12. Emotional control, styles of coping with stress and acceptance of illness among patients suffering from chronic somatic diseases.

    PubMed

    Janowski, Konrad; Kurpas, Donata; Kusz, Joanna; Mroczek, Bożena; Jedynak, Tomasz

    2014-02-01

    The purpose of this study was to analyse the associations of emotional control with sociodemographic and clinical variables in a sample of patients with a range of chronic somatic diseases. The relationships between emotional control, coping styles and adjustment to the disease were investigated. The sample consisted of 300 patients with the mean age of 54.60 ± 17.57 years. Courtauld Emotional Control Scale was used to measure the patients' tendency to suppress negative emotions, Coping Inventory for Stressful Situations was used to measure coping styles and Acceptance of Illness Scale was applied to determine adjustment to the disease. Patients with neurological conditions showed significantly lower suppression of anger. Levels of emotional control were found to be related to gender, age and educational level but not to the place of residence. Task-oriented style of coping with stress correlated positively with suppression of depression and anxiety, whereas acceptance of illness correlated negatively with suppression of anger. Levels of emotional control are only weakly related to the type of diagnosis; however, some clinical samples may show lower suppression of anger. Suppression of negative emotions is weakly related to adjustment indicators such as certain coping styles and acceptance of illness. PMID:23653433

  13. Factors influencing insulin acceptance among type 2 diabetes mellitus patients in a primary care clinic: a qualitative exploration

    PubMed Central

    2013-01-01

    Background Many Type 2 Diabetes Mellitus (T2DM) patients refuse insulin therapy even when they require this modality of treatment. However, some eventually accept insulin. This study aimed to explore the T2DM patients’ reasons for accepting insulin therapy and their initial barriers to use insulin. Methods This qualitative study interviewed twenty-one T2DM patients at a primary care clinic who had been on insulin for more than a year through three in-depth interviews and three focus group discussions. A semi structured interview protocol was used and the sessions were audio-recorded. Subsequently, thematic analysis was conducted to identify major themes. Results The participants’ acceptance of insulin was influenced by their concerns and beliefs about diabetes and insulin. Concerns about complications of poorly controlled diabetes and side effects of other treatment regime had resulted in insulin acceptance among the participants. They also had a strong belief in insulin benefits and effectiveness. These concerns and beliefs were the results of having good knowledge about the diabetes and insulin, experiential learning, as well as doctors’ practical and emotional support that helped them to accept insulin therapy and become efficient in self-care management. These factors also allayed their negative concerns and beliefs towards diabetes and insulin, which were their barriers for insulin acceptance as it caused fear to use insulin. These negative concerns were related to injection (self-injection, needle phobia, injection pain), and insulin use (inconvenience, embarrassment, lifestyle restriction, negative social stigma, and poor self-efficacy), whereas the negative beliefs were 'insulin could cause organ damage’, 'their diabetes was not serious enough’, 'insulin is for life-long’, and 'insulin is for more severe disease only’. Conclusions Exploring patients’ concerns and beliefs about diabetes and insulin is crucial to assist physicians in

  14. Marking Time

    ERIC Educational Resources Information Center

    Foster, Colin

    2011-01-01

    Teachers say that they would gladly teach a day in the classroom if at the end of the day they could leave and have no marking. There is a common staffroom perception that mathematics teachers have it easy when it comes to marking. In arts subjects, setting an essay can be a fairly straightforward matter--a one-line question may suffice--but…

  15. Primary Care Patients with Depression Are Less Accepting of Treatment Than Those Seen by Mental Health Specialists

    PubMed Central

    Van Voorhees, Benjamin W; Cooper, Lisa A; Rost, Kathryn M; Nutting, Paul; Rubenstein, Lisa V; Meredith, Lisa; Wang, Nae-Yuh; Ford, Daniel E

    2003-01-01

    OBJECTIVE This study examined whether depressed patients treated exclusively in primary care report less need for care and less acceptability of treatment options than those depressed patients treated in the specialty mental health setting after up to 6 months of treatment. DESIGN Cross-sectional study. SETTING Forty-five community primary care practices. PARTICIPANTS A total of 881 persons with major depression who had received mental health services in the previous 6 months and who enrolled in 3 of the 4 Quality Improvement for Depression Collaboration Studies. MEASUREMENTS AND RESULTS Patients were categorized into 1 of 2 groups: 1) having received mental health services exclusively from a primary care provider (45%), or 2) having received any services from a mental health specialist (55%) in the previous 6 months. Compared with patients who received care from mental health specialists, patients who received mental health services exclusively from primary care providers had 2.7-fold the odds (95% confidence interval [CI], 1.6 to 4.4) of reporting that no treatment was definitely acceptable and had 2.4-fold the odds (95% CI, 1.5 to 3.9) of reporting that evidence-based treatment options (antidepressant medication) were definitely not acceptable. These results were adjusted for demographic, social/behavioral, depression severity, and economic factors using multiple logistic regression analysis. CONCLUSIONS Patients with depression treated exclusively by primary care providers have attitudes and beliefs more averse to care than those seen by mental health specialists. These differences in attitudes and beliefs may contribute to lower quality depression care observed in comparisons of primary care and specialty mental health providers. PMID:14687257

  16. Integrating Patient-Reported Outcome Measures into Routine Cancer Care: Cancer Patients’ and Clinicians’ Perceptions of Acceptability and Value

    PubMed Central

    Stover, Angela; Irwin, Debra E.; Chen, Ronald C.; Chera, Bhishamjit S.; Mayer, Deborah K.; Muss, Hyman B.; Rosenstein, Donald L.; Shea, Thomas C.; Wood, William A.; Lyons, Jessica C.; Reeve, Bryce B.

    2015-01-01

    Introduction: Despite growing interest in integrating patient-reported outcome (PRO) measures of symptoms and functional status into routine cancer care, little attention has been paid to patients’ and clinicians’ perceptions of acceptability and value. Methods: A two-phase qualitative study was conducted to develop a web-based PRO screening system with 21 items assessing symptoms (e.g., nausea) and functional status. Phase 1 involved cognitive interviews with 35 cancer outpatients (n=9 breast chemotherapy, radiation for prostate (n=8) or head and neck cancer (n=10), and n=8 bone marrow transplant [BMT]). In Phase 2, we evaluated the acceptability and perceived value of reviewing a PRO measure during real-time clinical encounters with 39 additional outpatients (n=10 breast, n=9 head and neck, n=10 prostate, n=10 BMT) and 12 clinicians (n=3 breast, n=2 head and neck, n=4 prostate, n=3 BMT). At least 20% of patients were ≥60 years, African American, or ≤ high school. Results: Patients felt that their PRO summary of symptoms and functional status was helpful in discussing health issues with clinicians (92%), wanted to review their results with clinicians during future visits (82%), and would recommend it to other patients (87%). Clinicians found the PRO summary to be easy to interpret (83%), most helpful for documenting the Review of Symptoms (92%), and would recommend it to future patients (92%). Over 90% of clinicians reported that consultation time did not increase. Conclusion: Both cancer patients and clinicians reported that discussing a PRO summary of symptoms and functional status during an outpatient visit was useful, acceptable, and feasible. PMID:26557724

  17. Attitudes towards acceptance of an innovative home-based and remote sensing rehabilitation protocol among cardiovascular patients in Shantou, China

    PubMed Central

    Fang, Jia-Ying; Li, Ji-Lin; Li, Zhong-Han; Xu, Duan-Min; Chen, Chang; Xie, Bin; Chen, Helen; Au, William W

    2016-01-01

    Background Cardiac rehabilitation (CR) protocols have diversified to include home-based cardiac tele-rehabilitation (HBCTR) as an alternative to hospital-based or center-based CR. To adopt the use of home-based cardiac tele-rehabilitation, it is necessary to assess cardiac patients' attitudes towards acceptance of such e-health technology, especially in China where knowledge of such technology is deficient. Methods Interviews were conducted in the First Affiliated Hospital of Shantou University Medical College, Shantou, China. After percutaneous coronary interventional (PCI) surgery, patients completed the survey. Results Among the 150 patients, only 13% had ever heard of HBCTR. After an introduction of our HBCTR program, 60% of patients were willing to participate in the program. From our multivariate analysis of questionnaire data, age (OR: 0.92, 95% CI: 0.86–0.98; P = 0.007), average family monthly income (OR: 0.13, 95% CI: 0.05–0.34; P < 0.001), education level (OR: 0.24, 95% CI: 0.10–0.59; P = 0.002) and physical exercise time (OR: 0.19, 95% CI: 0.06–0.56; P = 0.003) were independent predictors for acceptance of HBCTR. From the reasons for participation, patients selected: enhanced safety and independence (28.3%), ability to self-monitor physical conditions daily (25.4%), and having automatic and emergency alert (23.1%). Reasons for refusal were: too cumbersome operation (34.3%) and unnecessary protocol (19.4%). Conclusions Most patients lacked knowledge about HBCTR but volunteered to participate after they have learned about the program. Several personal and life-style factors influenced their acceptance of the program. These indicate that both improvement of technology and better understanding of the program will enhance active participation. PMID:27403142

  18. Can home care maintain an acceptable quality of life for patients with terminal cancer and their relatives?

    PubMed

    Hinton, J

    1994-01-01

    This prospective study was designed to assess whether patients with terminal cancer, and their relatives, find that competent home care sufficiently maintains comfort and helps adjustment. A random sample from a home care service with readily available beds comprised 77 adults and their relatives who were able and willing to be interviewed separately each week. They were asked the nature and degree of current problems and regular assessments were made of some qualities of life including mood, attitude to the condition, perceived help and preferred place of care. These patients had 90% of their care at home; 29% died at home but 30% were finally admitted for one to three days and 41% for longer. In the final eight weeks, tolerable physical symptoms were volunteered by a mean of 63% each week and psychological symptoms by 17%. Some distress was felt by 11% of patients; this was usually from pain, depression, dyspnoea, anxiety or weakness, and generally did not persist. Relatives suffered grief, strain or their own ill health. Patients' and relatives' reports generally matched except for the strain on carers. Regular assessments found that 64% of patients thought death certain or probable, and 27% thought it possible. Various proportions coped by optimism, fighting their disease, partial suppression or denial, but 50% reached positive acceptance. Relatives were more aware and accepting. About three-quarters of patients and half the relatives were composed, often enjoying life. Serious depression affected 5% of patients and anxiety 4%, but relatives' manifest depression in the later stages increased to 17% and anxiety to 14%. Many consciously disguised their feelings. Treatment was usually praised but realistic preference for home care fell steadily from 100% to 54% of patients and 45% of relatives. At follow-up most relatives approved of where patients had received care and died. PMID:7952369

  19. Neurophysiological mechanisms in acceptance and commitment therapy in opioid-addicted patients with chronic pain.

    PubMed

    Smallwood, Rachel F; Potter, Jennifer S; Robin, Donald A

    2016-04-30

    Acceptance and Commitment Therapy (ACT) has been effectively utilized to treat both chronic pain and substance use disorder independently. Given these results and the vital need to treat the comorbidity of the two disorders, a pilot ACT treatment was implemented in individuals with comorbid chronic pain and opioid addiction. This pilot study supported using neurophysiology to characterize treatment effects and revealed that, following ACT, participants with this comorbidity exhibited reductions in brain activation due to painful stimulus and in connectivity at rest. PMID:27107155

  20. Stretch Marks

    MedlinePlus

    ... changes that can go with bodybuilding. People who use steroid-containing skin creams or ointments (such as hydrocortisone) for more than a few weeks may also get stretch marks. So might people who have to ... surgeon. These doctors may use one of many types of treatments — from actual ...

  1. Feasibility and acceptability of advance care planning in elderly Italian and Greek speaking patients as compared to English-speaking patients: an Australian cross-sectional study

    PubMed Central

    Detering, Karen; Sutton, Elizabeth; Fraser, Scott; Wallis, Kasey; Silvester, William; Mawren, Daveena; Whiteside, Kathryn

    2015-01-01

    Objectives To assess the feasibility and acceptability of facilitated advance care planning (ACP) discussions in elderly Italian and Greek-speaking inpatients compared to English-speaking inpatients. Design, setting and participants This cross-sectional study with convenience sampling was conducted in Melbourne, Australia, and recruited hospital inpatients with medical decision-making capacity, aged 65 years or above, who spoke Greek (25 patients), Italian (24 patients) or English (63 patients). Intervention Facilitated ACP was offered, aiming to assists patients to consider and discuss their goals, values, beliefs and future treatment wishes with their family and doctor; to help them consider how they would like healthcare decisions made in the future if they become unable to do this for themselves; and to complete advance care directives. Main outcome measures The completion of ACP discussions, their duration, advance care directive completion and utilisation of interpreters. Results Of 112 patients, 109 (97%) had at least one discussion, 63 (54%) completed advance care directives, either nominating a substitute decision-maker, documenting their wishes or both, and 76 (68%) included family in discussions. The median duration of discussions for all patients was slightly more than 1 h, over two visits. There were no differences between the Greek-speaking and the Italian-speaking patients, or between the Non-English speaking and the English-speaking patients in any of these measures. Only 14 non-English speaking patients, (30%) utilised interpreters, but when utilised, patients were much more likely (p<0.005) to complete advance care directives. Conclusions Facilitated ACP in elderly Italian and Greek-speaking patients is feasible, acceptable and is similar to that for English-speaking patients. PMID:26319775

  2. The knowledge, awareness, and acceptability of renal transplantation among patients with end-stage renal disease in Ibadan, Nigeria.

    PubMed

    Takure, A O; Jinadu, Y O; Adebayo, S A; Shittu, O B; Salako, B L; Kadiri, S

    2016-01-01

    Renal transplantation is well established in the USA, Europe, India, and South Africa. However, it is still in its infancy in Nigeria. The objective of our study is to determine the knowledge, awareness, and acceptability of renal transplant among patients with end-stage renal disease (ESRD) and the factors which are responsible for the low level of transplantation in Ibadan, Nigeria. A 15-item pilot-tested questionnaire was administered to willing patients with ESRD seen at the medical outpatient clinic of the University Teaching Hospital, from January to December 2011. There was 81% participation rate of the respondents. Exactly 90.1% had formal education and 44% earned <50,000 naira per month. Seventy-nine percent of respondents was aware of renal transplantation, 70.4% would recommend it to others, and 66.7% accepted renal transplantation; 77.8% would maintain a close relationship with their donors. About 61.7% considered it very expensive, while 33.3% did not know the cost for transplantation. Of the reason for the low level of kidney transplantation in Nigeria, 39.5% had no idea and in 27.2% of the respondents, the fear of death by potential donors may be responsible. Eleven percent of responded that recipients had no money for kidney transplantation and another 11% thought the potential donors would like to be paid for donating their kidneys. Most of the respondents with ESRD were knowledgeable, aware of, and accepted renal transplantation as the next step to treat chronic renal failure. However, majority of these patients could not afford the cost for renal transplantation. PMID:27424696

  3. A Patient Survey Assessing the Awareness and Acceptability of the Emergency Care Summary and Its Consent Model in Scotland

    PubMed Central

    Johnstone, Chris; McCartney, Gerry

    2010-01-01

    Background The Emergency Care Summary (ECS) was introduced in 2006 to allow aspects of the general practitioner (GP; family doctor, equivalent to primary care physician) medical record to be viewed in hospitals and out-of-hours centers in Scotland. Records were automatically uploaded unless patients actively opted out. This study investigated patient awareness and acceptance of this process. Methods This was a questionnaire survey of patients in a GP surgery (office) in Paisley, Scotland. Results Survey results indicated that 42 percent of patients were aware of the ECS, and 16 percent said that they recognized the leaflet posted to households. Of those who recognized the leaflet, 92 percent said they were happy for their record to be part of the system, while the others did not realize their record was to be included. Having read the leaflet, 97 percent said that they were happy for their record to be included in the ECS. Conclusions This study shows that most patients were not aware of the Emergency Care Summary or did not remember seeing the leaflet posted to households. Having read the leaflet, the vast majority of patients were happy for their records to be included in the system. The low awareness of the ECS calls into question the validity of an implied consent model using an information leaflet distributed by post. PMID:20697469

  4. Knowledge, attitudes and acceptability to provider-initiated HIV testing and counseling: patients' perspectives in Moshi and Rombo Districts, Tanzania.

    PubMed

    Manongi, Rachel; Mahande, Michael; Njau, Bernard

    2014-10-01

    Provider-initiated HIV testing and counseling (PITC) is referred to as routine testing in a clinical setting as part of a standard programme of medical services. PITC is initiated in order to avoid missed opportunities for people to get tested for HIV. While advocated as a strategy, there is dearth of information on patients' views on PITC in a number of districts in Tanzania. The objective of this study was to assess the knowledge, attitude and acceptability to PITC services among patients attending health care facilities in rural and urban settings in Kilimanjaro region A total of 12 focus group discussions (FGDs) were conducted with 99 (73 female and 26 male) patients enrolled into out-patient clinics in 8 (2 hospitals and 6 primary care centers) health facilities in Moshi Urban and Rombo districts in northern Tanzania. The study explored on knowledge, attitudes and acceptability of PITC, perceived benefits and barriers of PITC, and ethical issues related to PITC. Interviews were audio taped, transcribed, translated, and analyzed using Non-numerical Unstructured Data Indexing and Theorizing (NUDIST) software. Knowledge about PITC services was generally low. Compared to men, women had a more positive attitude towards PITC services, because of its ability to identify and treat undiagnosed HIV cases. HIV stigma was regarded as a major barrier to patients' uptake of PITC. Institutional factors such as lack of supplies and human resources were identified as barriers to successful provision of PITC. In conclusion, the findings highlight both opportunities and potential barriers in the successful uptake of PITC, and underscore the importance of informed consent, counseling and confidentiality and the need for specific strategies on advocacy for the service. PMID:26891519

  5. Knowledge and acceptability of HAART among TB patients in Durban, South Africa.

    PubMed

    Gebrekristos, Hirut T; Lurie, Mark N; Mthethwa, Nkosinathi; Karim, Quarraisha Abdool

    2005-08-01

    From October 2002 to February 2003, we conducted semi-structured interviews on knowledge of HIV, antiretroviral treatment, and willingness to participate in voluntary counselling and testing and HAART with 54 consenting patients attending a tuberculosis (TB) clinic in Durban, South Africa. 74% of patients interviewed reported not knowing anything about antiretroviral treatment (HAART). Knowledge of antiretroviral drugs (ARVs) was restricted to use in preventing mother to child HIV transmission (MTCT). 57.4% of the patients reported having an HIV test in the past, but less than 10% were aware of their current HIV status. Patients who did not know their current HIV status expressed fear and hesitation about testing HIV positive. However, 91% of the patients expressed willingness to participate in HIV treatment given the opportunity. The findings from this study indicate that knowledge of HIV treatment is limited. As access to HAART is expanded, information about HIV treatment options will need to be disseminated. TB centres may present unique opportunities for disseminating HIV prevention, care, and treatment options. PMID:16036263

  6. Is billboard advertising beneficial for healthcare organizations? An investigation of efficacy and acceptability to patients.

    PubMed

    Fortenberry, John L; McGoldrick, Peter J

    2010-01-01

    The healthcare industry is increasingly turning to billboard advertising to promote various medical services, yet little attention has been directed toward understanding the performance and policy implications of billboard advertising from the perspective of the patients targeted. To shed light on this, we initiated a field experiment investigating the impact of an urgent care center's billboard advertising campaign, collecting primary data over a 32-day period at the center's two clinics. Over the course of the billboard campaign, perspectives from 1,640 patients were collected via questionnaire. Institutionally supplied business metrics were also monitored. Our principal findings indicate that billboard advertisements are noticed by patients, favorably viewed by patients, and effective across the sequence of steps leading to patient patronage. Enhancement of awareness exerts the most powerful influence on patronage, but the capacity to inform consumers is also highly significant. These effects are not limited to new patients, as many returning clients were made more aware of the clinics and were influenced by the campaign. The study offers insights for creative billboard treatments and campaign planning. Although effects remained strong throughout the campaign, some degree of "wearout" was evident after three weeks, which suggests the need to rotate billboards frequently and to consider digital billboards. Corner tabs--small announcements sometimes placed in the corners of billboard advertisements--proved largely ineffective as a promotional device and may clutter the central messages. Given these findings, we believe healthcare institutions are justified in using billboards, as they perform effectively and appear relatively free of controversy. Careful planning of creative billboard treatments and appropriate scheduling patterns are essential to maximize their communications potential. PMID:20402365

  7. Patient acceptability and satisfaction with Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension).

    PubMed

    Shulman, L P; Oleen-Burkey, M; Willke, R J

    1999-10-01

    The results from a User Satisfaction Questionnaire, Treatment Assessment Questionnaire, and Global Well-Being Schedule questionnaire administered to women participating in an open-labeled, nonrandomized, parallel, controlled study comparing a new monthly injectable contraceptive containing 25 mg of medroxyprogesterone acetate (MPA) and 5 mg of estradiol cypionate (E2C) (MPA/E2C) (Lunelle Monthly Contraceptive Injection) and a triphasic norethindrone (0.5, 0.75, 1.0 mg)/0.035 mg ethinyl estradiol (NET/EE) oral contraceptive (Ortho-Novum 7/7/7) are reviewed. Approximately 85% of all 1103 women enrolled in the comparative trial completed their initial and final questionnaires. To better assess the comparison of a new and extant method of contraception, outcome data were divided among MPA/E2C users and new and previous oral contraceptive (OC) users. Despite the inherent inequalities in comparing an injectable to an oral method of contraception, few treatment assessment and satisfaction outcomes were significantly different when comparing MPA/E2C users to new OC (NET/EE) users. More women in the MPA/E2C study group reported discomfort with their method than women in either NET/EE study group; however, only 19.4% of MPA/E2C users rated the administration of their contraceptive to be moderately uncomfortable or worse, compared to 11.7% of new NET/EE users and 13.4% of previous OC users. Among MPA/E2C users, 86.3% reported no interference with social activities compared with 90.4% of new NET/EE users. MPA/E2C and new NET/EE users were also similar in their responses recommending their respective contraceptive method to friends, with > 90% of both groups stating that they had a very favorable experience and would definitely recommend their method to a friend. In general, MPA/E2C was well accepted by women in the study group. Their attitudes and perceptions are similar to those of women who were starting OCs for the first time. These data support the premise that MPA/E2C may

  8. An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

    ERIC Educational Resources Information Center

    Eisner, Lori R.; Johnson, Sheri L.

    2008-01-01

    Expressed emotion (EE) is a robust predictor of outcome in bipolar disorder. Despite decades of research, interventions to reduce EE levels have had only modest effects. This study used an expanded model of EE to develop an intervention. Research has demonstrated a strong link between attributions and EE in families of patients with psychiatric…

  9. The relationship between hearing aid frequency response and acceptable noise level in patients with sensorineural hearing loss

    PubMed Central

    Jalilvand, Hamid; Pourbakht, Akram; Jalaee, Shohreh

    2015-01-01

    Background: When fitting hearing aid as a compensatory device for an impaired cochlea in a patient with sensorineural hearing loss (HL), it is needed to the effective and efficient frequency response would be selected regarding providing the patient's perfect speech perception. There is not any research about the effects of frequency modifications on speech perception in patients with HL regarding the cochlear desensitization. The effect (s) of modifications in frequency response of hearing aid amplification on the results of acceptable noise level (ANL) test is the main aim of this study. Materials and Methods: The amounts of ANL in two conditions of linear amplification (high frequency emphasis [HFE] and mid frequency emphasis [MFE]) were measured. Thirty-two male subjects who participated in this study had the moderate to severe sensorineural HL. Results: There was not any significant difference between ANL in linear amplification of hearing aid with HFE frequency response and ANL in linear amplification of hearing aid with MFE frequency response. Conclusion: The gain modification of frequency response not only does not affect the patient's performance of speech intelligibility in ANL test. This indicates that we need to note to the cochlear desensitization phenomenon when fitting hearing aid as a compensatory device for an impaired cochlea in a patient. The cochlear desensitization has not been considered properly in hearing aid fitting formula which is needed to be explored more about the bio-mechanisms of impaired cochlea. PMID:26918238

  10. Individual Factors of Social Acceptance in Patients Infected With Human Immunodeficiency Virus (HIV) at the Yazd Behavioral Consultation Center in Iran

    PubMed Central

    Bidaki, Reza; Mousavi, Seyed Mahdi; Bashardoust, Nasrollah; Sabouri Ghannad, Masoud; Dashti, Naser

    2016-01-01

    Background: A considerable number of patients infected with HIV also have mental health problems. Individual psychotherapy is an effective way to treat these issues. Lack of social acceptance is a barrier to patients receiving proper medication and emotional/psychological support. Objectives: The purpose of this study was to examine the individual factors of social acceptance in patients infected with human immunodeficiency virus. Patients and Methods: Fifty HIV-infected patients who were registered in the Behavioral Consultation Center entered the study. Each of them filled out a questionnaire based on the Crown-Marlow social acceptance scale. Their answers were evaluated according to the questionnaire key. Results: Forty-five patients (90%) were male and five (10%) were female. Their ages ranged between 28 and 52 years old. Other variables researched in this study include patients’ age, sex, education, occupation, place of living, marital status, family history of HIV, and family history of psychological disorders. Employed patients experienced more social acceptance than housewives and people who were unemployed or retired. Conclusions: This study showed that HIV-infected patients with jobs enjoy a great deal of acceptance from the people around them and a higher quality of life in general. It also led to suggestions for further study with the purpose of finding more effective solutions for HIV prevention and better strategies for dealing with psychological disorders. Such research could also help in providing an enhanced understanding of the potential psychological impact that AIDS has on patients in Iran. PMID:27218064

  11. Treating atopic dermatitis: safety, efficacy, and patient acceptability of a ceramide hyaluronic acid emollient foam

    PubMed Central

    Pacha, Omar; Hebert, Adelaide A

    2012-01-01

    Advances in current understanding of the pathophysiology of atopic dermatitis have led to improved targeting of the structural deficiencies in atopic skin. Ceramide deficiency appears to be one of the major alterations in atopic dermatitis and the replenishment of this epidermal component through topically applied ceramide based emollients appears to be safe, well tolerated, and effective. Recently a ceramide hyaluronic acid foam has become commercially available and increasing evidence supports its safety and efficacy in patients who suffer from atopic dermatitis. PMID:22690129

  12. Polar Markings

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Context image for PIA02155 Polar Markings

    These bright and dark markings occurred near the end of summer in the south polar region. The dark material is likely dust that has been freed of frost cover.

    Image information: VIS instrument. Latitude -76.3N, Longitude 84.9E. 17 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  13. Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability

    PubMed Central

    2013-01-01

    Background The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers. This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. Methods We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user’s own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Results Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising

  14. When and Why Placebo-Prescribing Is Acceptable and Unacceptable: A Focus Group Study of Patients' Views

    PubMed Central

    Bishop, Felicity L.; Aizlewood, Lizzi; Adams, Alison E. M.

    2014-01-01

    Background Surveys of doctors suggest that they use placebos and placebo effects clinically to help patients. However, patients' views are not well-understood. We aimed to identify when and why placebo-prescribing in primary care might be acceptable and unacceptable to patients. Methods A purposive diverse sample of 58 English-speaking adults (18 men; aged 19–80 years) participated in 11 focus groups. Vignettes describing doctors prescribing placebos in primary care were used to initiate discussions. Data were analyzed inductively. Results Participants discussed diverse harms and benefits of placebo-prescribing for individual patients, carers, healthcare providers, and society. Two perspectives on placebo-prescribing were identified. First, the “consequentialist” perspective focused on the potential for beneficial outcomes of placebo-prescribing. Here, some participants thought placebos are beneficial and should be used clinically; they often invoked the power of the mind or mind-body interactions. Others saw placebos as ineffective and therefore a waste of time and money. Second, the “respecting autonomy” perspective emphasized the harms caused by the deceptive processes thought necessary for placebo-prescribing. Here, participants judged placebo-prescribing unacceptable because placebo-prescribers deceive patients, thus a doctor who prescribes placebos cannot be trusted and patients' autonomy is compromised. They also saw placebo-responders as gullible, which deterred them from trying placebos themselves. Overall, the word “placebo” was often thought to imply “ineffective”; some participants suggested alternative carefully chosen language that could enable doctors to prescribe placebos without directly lying to patients. Conclusions Negative views of placebos derive from beliefs that placebos do not work and/or that they require deception by the doctor. Positive views are pragmatic in that if placebos work then any associated processes (e

  15. Feasibility and Patient Acceptance of Emergency Department-Based Influenza Vaccination in a Military Medical Center.

    PubMed

    Hilger, Keren Arkin; Hilger, James R; Putnam, Shannon D; Carstairs, Shaun D; Maves, Ryan C

    2016-08-01

    Influenza vaccination rates in the United States remain low. Many emergency department (ED) patients may not routinely seek care elsewhere. In a survey of ED visitors, 36.8% of unvaccinated respondents were willing to consider influenza vaccination during their visit. Participants at high risk for influenza complications were more likely to have been previously vaccinated, but unvaccinated participants at high risk were not significantly more likely to consider ED-based vaccination compared with other participants. ED-based influenza vaccination may be an effective method to expand vaccine coverage. PMID:27483528

  16. Clinical trials in cancer: the role of surrogate patients in defining what constitutes an ethically acceptable clinical experiment.

    PubMed Central

    Mackillop, W. J.; Palmer, M. J.; O'Sullivan, B.; Ward, G. K.; Steele, R.; Dotsikas, G.

    1989-01-01

    Doctors who treat lung cancer in Ontario were previously asked how they would wish to be managed if they developed non-small cell lung cancer and whether they would consent to participate in six clinical trials for which they might be eligible. The proportion of these expert surrogate patients who would consent to each clinical trial ranged from 11 to 64%. The results of this study were transmitted to the same group of doctors who were asked to comment on the ethical acceptability of each trial in the light of this information. The majority of physicians said that those trials to which less than 50% of expert surrogates consented should not have been opened to patients. Sixty-nine per cent of doctors thought that new trials should be evaluated in this way. We also present the results of a survey of 400 lay people in Ontario who were asked to imagine that they had lung cancer and whether they would consent to participate in two of these same clinical trials. Fifty per cent of lay people consented to a randomised trial of lobectomy versus segmentectomy in early, operable disease (LCSC-821) compared to 64% of expert surrogates, and 48% of lay people consented to a randomised trial of five different forms of chemotherapy in metastatic disease (SWOG-8241) compared to 19% of doctors. It was concluded that the lay people were unable to discern differences in the acceptability of clinical trials which were clear to experts in the field. Subsequently, respondents were told about the decisions which doctors would make in the same circumstances and asked if this information would modify their previous decisions. There is no net change in the proportion of patients consenting to the surgery trial but the proportion of people consenting to the chemotherapy trial decreased by 40%. The majority of lay people said that they would wish to have access to this type of information before consenting to participate in a clinical trial. PMID:2930704

  17. Patient tolerance and acceptance of colesevelam hydrochloride: focus on type-2 diabetes mellitus.

    PubMed

    Brunetti, Luigi; DeSantis, Evelyn Hermes

    2015-01-01

    Diabetes mellitus (DM) is a chronic disease with a U.S. prevalence of 25.8 million, and 90-95% of all cases are type-2 diabetes mellitus (T2DM). Despite the known mortality and morbidity associated with T2DM, the majority of patients do not achieve their hemoglobin A1c (HbA1c) goals. Nonadherence is one of the contributing factors to the lackluster attainment of treatment goals. Drug tolerability may impact medication nonadherence; therefore, strategies to improve tolerability are important. Colesevelam, a second-generation bile acid resin, was designed with greater specificity and affinity for bile acids. Its physiochemical attributes contribute to an improved tolerability profile. Colesevelam has demonstrated efficacy in lowering HbA1c in addition to low-density lipoprotein-cholesterol, although clinical outcomes data are lacking. Several mechanisms of colesevelam's effect in T2DM have been proposed, including effects on insulin sensitivity and secretion, incretin effects, changes in bile acid composition, and splanchnic sequestration of mealtime glucose. Colesevelam is associated with reductions in HbA1c in T2DM patients ranging from 0.32 to 1.1 percentage points. Colesevelam is generally well tolerated, and indirect comparisons with cholestyramine suggest that it is associated with fewer gastrointestinal symptoms. Reported adherence and persistence to colesevelam treatment in observational studies are 33.3% and 49%, respectively. PMID:25628509

  18. Orally disintegrating vardenafil tablets for the treatment of erectile dysfunction: efficacy, safety, and patient acceptability

    PubMed Central

    Green, Roger; Hicks, Rodney W

    2011-01-01

    Background: Erectile dysfunction (ED) is a well-documented medical condition that is expected to increase significantly over the next several decades, especially as men live longer and the prevalence of diabetes and cardiovascular diseases increase. Pharmacology agents are often the first line treatment approach. Newer solid dosage forms, known as orally disintegrating tablets (ODT), are now available as one treatment option. Objectives: To review the drug delivery mechanisms of ODTs in general and to review safety and efficacy of vardenafil ODT (a PDE-5 inhibitor) as a treatment option for management of ED. Method: Literature reviews were performed of pharmaceutical dosage forms and the POTENT I (n = 358 subjects) and POTENT II (n = 337 subjects) studies that investigated vardenafil ODT. Results: Vardenafil ODT has been successfully used in multiple age groups and in multiple settings with men from various ethnic backgrounds. Efficacy of vardenafil ODT, as measured using the International Index of Erectile Function (IIEF-EF) and from the Sexual Encounter Profile (SEP) was significantly greater than placebo (P < 0.0001) at 12 weeks. Safety profiles were similar to film-coated dosage forms with no patient deaths reported. Conclusion: Vardenafil ODT offers a convenient, ready-to-use approach for combating ED. Safety concerns are similar to other PDE-5 inhibitors and practitioners should counsel patients accordingly. PMID:21573049

  19. Acceptance and Efficacy of a Guided Internet Self-Help Treatment Program for Obese Patients with Binge Eating Disorder

    PubMed Central

    Isabelle, Carrard; Christelle, Crépin; Patrick, Rouget; Tony, Lam; der Linden Martial, Van; Alain, Golay

    2011-01-01

    Introduction: A significant percentage of obese patients suffer from binge eating disorder (BED), with negative consequences on psychological health, quality of life, weight loss treatment and maintenance. Cognitive behavioral therapy (CBT), delivered in traditional or self-help format, is effective in reducing BED symptoms. To improve dissemination, a self-help treatment program composed of eleven CBT based modules was implemented on the Internet and evaluated in a population of adult obese patients with BED. Method: Forty-two obese BED patients wait-listed for a multi-disciplinary obesity treatment took part in the study. Twenty-two patients completing the six-month online guided self-help treatment program were compared to a control group of twenty patients without intervention. Both groups were evaluated before and after six months of Internet self-help treatment or waiting list. A follow-up evaluation was carried out six months later. Results: Participants in the online self-help treatment program showed higher binge eating abstinence rates, lower EDE-Q shape and weight concerns, and improved TFEQ disinhibition of eating and hunger scores compared to the control group. They also scored better on psychological health and quality of life measures after intervention, and gains were maintained at follow-up. No effect was found regarding BMI. The number of modules completed was correlated with a better quality of life improvement at post evaluation. Participants rated the program as useful and easy to use. Conclusion: The Internet seems to be a valuable tool for disseminating CBT for BED obese patients. Acceptance of new technology was good in this population. Further research is needed with a larger sample to corroborate these results. PMID:21552482

  20. Explaining unexplained pain to fibromyalgia patients: finding a narrative that is acceptable to patients and provides a rationale for evidence based interventions

    PubMed Central

    Hyland, Michael E; Hinton, Claire; Hill, Charlotte; Whalley, Ben; Jones, Rupert CM; Davies, Anthony F

    2016-01-01

    As the cause of fibromyalgia is controversial, communicating with patients can be challenging, particularly if the patient adopts the narrative ‘I am damaged and so I need a more powerful pain killer’. Research shows that providing patients with alternative narratives can be helpful, but it remains unclear what particular narratives are most acceptable to patients and at the same time provide a rationale for evidence based psychological and exercise interventions. This article described the development of a new narrative and the written comments made about the narrative by fibromyalgia patients. The narrative derives from a complexity theory model and provides an alternative to biogenic and psychogenic models. The model was presented to 15 patients whose comments about comprehensibility led to the final format of the narrative. In the final form, the body is presented as ‘a very, very clever computer’ where fibromyalgia is caused by a software rather than a hardware problem. The software problem is caused by the body adapting when people have to ‘keep going’ despite ‘stop signals’, such as pain and fatigue. The narrative provides a rationale for engaging in psychological and exercise interventions as a way of correcting the body’s software. This way of explaining fibromyalgia was evaluated by a further 25 patients attending a 7-week ‘body reprogramming’ intervention, where the therapy was presented as correcting the body’s software, and included both exercise and psychological components. Attendance at the course was 85%. Thematic analysis of written patient feedback collected after each session showed that patients found the model believable and informative, it provided hope and was empowering. Patients also indicated that they had started to implement lifestyle change with perceived benefit. Fibromyalgia patients appear to respond positively to a technology-derived narrative based on the analogy of the body as a computer. PMID:27583142

  1. Explaining unexplained pain to fibromyalgia patients: finding a narrative that is acceptable to patients and provides a rationale for evidence based interventions.

    PubMed

    Hyland, Michael E; Hinton, Claire; Hill, Charlotte; Whalley, Ben; Jones, Rupert Cm; Davies, Anthony F

    2016-08-01

    As the cause of fibromyalgia is controversial, communicating with patients can be challenging, particularly if the patient adopts the narrative 'I am damaged and so I need a more powerful pain killer'. Research shows that providing patients with alternative narratives can be helpful, but it remains unclear what particular narratives are most acceptable to patients and at the same time provide a rationale for evidence based psychological and exercise interventions. This article described the development of a new narrative and the written comments made about the narrative by fibromyalgia patients. The narrative derives from a complexity theory model and provides an alternative to biogenic and psychogenic models. The model was presented to 15 patients whose comments about comprehensibility led to the final format of the narrative. In the final form, the body is presented as 'a very, very clever computer' where fibromyalgia is caused by a software rather than a hardware problem. The software problem is caused by the body adapting when people have to 'keep going' despite 'stop signals', such as pain and fatigue. The narrative provides a rationale for engaging in psychological and exercise interventions as a way of correcting the body's software. This way of explaining fibromyalgia was evaluated by a further 25 patients attending a 7-week 'body reprogramming' intervention, where the therapy was presented as correcting the body's software, and included both exercise and psychological components. Attendance at the course was 85%. Thematic analysis of written patient feedback collected after each session showed that patients found the model believable and informative, it provided hope and was empowering. Patients also indicated that they had started to implement lifestyle change with perceived benefit. Fibromyalgia patients appear to respond positively to a technology-derived narrative based on the analogy of the body as a computer. PMID:27583142

  2. Marked Multiple Tendinitis at the Onset of Rheumatoid Arthritis in a Patient with Heterozygous Familial Hypercholesterolemia: Ultrasonographic Observation

    PubMed Central

    Okamoto, Akiko

    2014-01-01

    A 59-year-old woman who had been diagnosed with heterozygous familial hypercholesterolemia developed rheumatoid arthritis (RA). She presented with marked tendinitis of the Achilles tendons, patellar tendons, and finger extensor tendons at the onset of RA. Ultrasonographic examination revealed that tendon lesions were predominantly tendinitis rather than paratenonitis, and that the tendinitis was of the noninsertional variety, rather than the insertional variety. Preexisting tendon xanthomas might have contributed to the unusually dominant noninsertional tendinitis of multiple tendons. PMID:25013736

  3. Feasibility, Safety, Acceptability, and Preliminary Efficacy of Measurement-Based Care Depression Treatment for HIV Patients in Bamenda, Cameroon

    PubMed Central

    Pence, Brian W.; Gaynes, Bradley N.; Atashili, Julius; O'Donnell, Julie K.; Kats, Dmitry; Whetten, Kathryn; Njamnshi, Alfred K.; Mbu, Tabenyang; Kefie, Charles; Asanji, Shantal; Ndumbe, Peter

    2014-01-01

    Background Depression affects 18-30% of HIV-infected patients in Africa and is associated with greater stigma, lower antiretroviral adherence, and faster disease progression. However, the region's health system capacity to effectively identify and treat depression is limited. Task-shifting models may help address this large mental health treatment gap. Methods Measurement-Based Care (MBC) is a task-shifting model in which a Depression Care Manager (DCM) guides a non-psychiatric (e.g., HIV) provider in prescribing and managing antidepressant treatment. We adapted MBC for depressed HIV-infected patients in Cameroon and completed a pilot study to assess feasibility, safety, acceptability, and preliminary efficacy. Results We enrolled 55 participants; all started amitriptyline 25-50mg daily at baseline. By 12 weeks, most remained at 50mg daily (range 25-125mg). Median (interquartile range) PHQ-9 depressive severity scores declined from 13 (12-16) (baseline) to 2 (0-3) (week 12); 87% achieved depression remission (PHQ9<5) by 12 weeks. Intervention fidelity was high: HIV providers followed MBC recommendations at 96% of encounters. Most divergences reflected a failure to increase dose when indicated. No serious and few bothersome side effects were reported. Most suicidality (prevalence: 62% at baseline; 8% at 12 weeks) was either passive or low-risk. Participant satisfaction was high (100%), and most participants (89%) indicated willingness to pay for medications if MBC were implemented in routine care. Conclusions The adapted MBC intervention demonstrated high feasibility, safety, acceptability, and preliminary efficacy in this uncontrolled pilot study. Further research should assess whether MBC could improve adherence and HIV outcomes in this setting. PMID:24558099

  4. Treatment acceptance and adherence in HIV disease: patient identity and the perceived impact of physician-patient communication.

    PubMed

    Laws, M Barton; Rose, Gary S; Bezreh, Tanya; Beach, Mary Catherine; Taubin, Tatiana; Kogelman, Laura; Gethers, Marcia; Wilson, Ira B

    2012-01-01

    Studies have found that physician-patient relationships and communication quality are related to medication adherence and outcomes in HIV care. Few qualitative studies exist of how people living with HIV experience clinical communication about their self-care behavior. Eight focus groups with people living with HIV in two US cities were conducted. Participants responded to a detailed discussion guide and to reenactments of actual physician-patient dialogue about antiretroviral adherence. The 82 participants were diverse in age, sex, and ethnicity. Most had been living with HIV for many years and had stable relationships with providers. They appreciated providers who knew and cared about their personal lives, who were clear and direct about instructions, and who were accessible. Most had struggled to overcome addiction, emotional turmoil, and/or denial before gaining control over their lives and becoming adherent to medications. They made little or no causal attribution for their transformation to any outside agency, including their providers. They generally saw medication adherence as a function of autonomous motivation. Successful coping with HIV with its prevalent behavioral comorbidities, stigma, and other challenges requires a transformation of identity and internalization of motivation to maintain health. Effective methods for clinicians to support such development are needed. PMID:23271898

  5. Effectiveness of Acceptance-Commitment Therapy on Anxiety and Depression among Patients on Methadone Treatment: A Pilot Study

    PubMed Central

    Saedy, Mozhgan; Kooshki, Shirin; Jamali Firouzabadi, Mahmoud; Emamipour, Susan; Rezaei Ardani, Amir

    2015-01-01

    Background: Substance dependence disorder is a psychiatric disorders with different factors that influence its nature, severity, outcome, and treatment options. Objectives: This study evaluates the effectiveness of Acceptance-Commitment Therapy (ACT) to decrease anxiety and depression in patients with opioid dependencies who are undergoing methadone maintenance treatment (MMT). Materials and Methods: The present study was done in Mashhad from 2011-2012. Twenty-eight patients (18-50 yr) with opioid dependency who were on MMT were selected using purposive sampling and were divided equally between case and control groups. The case group received 8 sessions of individual psychotherapy with ACT. The level of depression and anxiety of these patients were measured using the Beck Depression Inventory-II and Beck Anxiety Inventory before the initiation of ACT as a pretest, 2 weeks after the termination of ACT as the posttest, and 3-months after the termination as a follow-up. The collected data was analyzed with SPSS (ver. 20) using χ2, paired t-test, ANOVA, and MANOVA. Results: The pretest-posttest-follow up of anxiety showed no significant differences between the two groups (P = 0.05); however, the case group had lower depression scores in the posttest and follow-up than the control group (P = 0.04). Evaluating the results of the case group revealed that depression significantly decreased in the posttest group when compared to the pretest (P = 0.01) and there were no significant decreases in the follow up compared to the pretest (P = 0.34). Conclusion: Short-term ACT for opioid dependent patients on MMT are not associated with a significant decrease in the level of anxiety; however, it is associated with a significant decrease in the level of depression. Nonetheless, this reduction was not maintained long term. PMID:26251660

  6. Acceptance of direct physician access to a computer-based patient record in a managed care setting.

    PubMed

    Dewey, J B; Manning, P; Brandt, S

    1993-01-01

    Kaiser Permanente Mid-Atlantic States has developed a fully integrated outpatient information system which currently runs on an IBM ES9000 on a VM platform written in MUMPS. The applications include Lab, Radiology, Transcription, Appointments. Pharmacy, Encounter tracking, Hospitalizations, Referrals, Phone Advice, Pap tracking, Problem list, Immunization tracking, and Patient demographics. They are department specific and require input and output from a dumb terminal. We have developed a physician's work station to access this information using PC compatible computers running Microsoft Windows and a custom Microsoft Visual Basic 2.0 environment which draws from these 14 applications giving the physician a comprehensive view of all electronic medical records. Through rapid prototyping, voluntary participation, formal training and gradual implementation we have created an enthusiastic response. 95% of our physician PC users access the system each month. The use ranges from 0.2 to 3.0 screens of data viewed per patient visit. This response continues to drive the process toward still greater user acceptance and further practice enhancement. PMID:8130585

  7. Critical appraisal of the efficacy, safety, and patient acceptability of hydroxyprogesterone caproate injection to reduce the risk of preterm birth

    PubMed Central

    Vidaeff, Alex C; Belfort, Michael A

    2013-01-01

    Prevention of preterm delivery is a major desiderate in contemporary obstetrics and a societal necessity. The means to achieve this goal remain elusive. Progesterone has been used in an attempt to prevent preterm delivery since the 1970s, but the evidence initially accumulated was fraught by mixed results and was based on mostly underpowered studies with variable eligibility criteria, including history of spontaneous abortion as an indication for treatment. More recent randomized controlled clinical trials restimulated the interest in progesterone supplementation, suggesting that progesterone may favorably influence the rate of preterm delivery. Preterm delivery is a complex disorder and consequently it is unlikely that one generalized prevention strategy will be effective in all patients. Further, an additional impediment in accepting progesterone as the “magic bullet” in the prevention of preterm delivery is that its mechanism of action is not fully understood and the optimal formulations, route of administration, and dose have yet to be established. We have concerned ourselves in this review with the most recent status of 17 alpha-hydroxyprogesterone caproate (17OH-PC) supplementation for prevention of preterm delivery. Our intention is to emphasize the efficacy, safety, and patient acceptability of this intervention, based on a comprehensive and unbiased review of the available literature. Currently there are insufficient data to suggest that 17OH-PC is superior or inferior to natural progesterone. Based on available evidence, we suggest a differential approach giving preferential consideration to either 17OH-PC or other progestins based on obstetric history and cervical surveillance. Progestin therapy for risk factors other than a history of preterm birth and/or a short cervix in the current pregnancy is not currently supported by the published evidence. The experience to date with 17OH-PC indicates that there are population subgroups that may be harmed by

  8. Perceptions of adult trauma patients on the acceptability of text messaging as an aid to reduce harmful drinking behaviours

    PubMed Central

    2014-01-01

    Background Brief interventions (BIs) have been shown to be effective in modifying hazardous drinking behaviours in a range of settings. However, they are underutilised in hospitals due to resource constraints. We explored the perspectives of admitted trauma patients about the appeal, acceptability and content of a Brief Intervention (BI) delivered via text messages. Methods Thirty mobile phone users (≥16 years old) admitted to Auckland City Hospital as a result of injury were recruited (December 2010 – January 2011). Participants were interviewed face-to-face during their hospital stay using a semi-structured interview guide that explored topics including perceptions of the proposed intervention to reduce hazardous drinking and related harm, and perceived acceptability of an m-health program. Where issues relating to content of messages were raised by participants these were also captured. In addition, a brief survey captured information on demographic information, mobile phone usage and type of phone, along with the frequency of alcohol use. Results 22 of the 30 participants were male, and almost half were aged 20 to 39 years. The majority of participants identified as New Zealand Europeans, six as Māori (New Zealand's indigenous population) and of the remainder two each identified as Pacific and of Asian ethnicity. Most (28/30) participants used a mobile phone daily. 18 participants were deemed to be drinking in a non-hazardous manner, seven were hazardous drinkers, and three were non-drinkers. Most participants (21/30) indicated that text messages could be effective in reducing hazardous drinking and related harms, with more than half (17/30) signalling they would sign-up. Factors identified that would increase receptiveness included: awareness that the intervention was evidence-based; participants readiness-to-change; informative messages that include the consequences of drinking and practical advice; non-judgemental messages; and ease-of-use. Areas of

  9. [Marked 99mTc-PYP myocardial accumulation immediately after reperfusion in a patient with acute myocardial infarction].

    PubMed

    Adachi, Yoshihiko; Ito, Kazuki; Nishikawa, Susumu; Yuba, Tatsuya; Tsubakimoto, Yoshinori; Takata, Hiroki; Kato, Shuji; Azuma, Akihiro; Sugihara, Hiroki; Nakagawa, Masao

    2003-02-01

    We reported a case of a 72-year-old man with chest pain. An electrocardiogram showed ST segment elevation in I, II, III, aVL, aVF and V1-6 leads. 99mTc-tetrofosmin myocardial SPECT showed defect in the anterior, septal, apical and inferior walls. Coronary angiography showed 99% stenosis of the proximal right coronary artery and total occlusion of the midsegment of the left anterior descending coronary artery. Therefore, direct PTCA was performed for each lesion to achieve reperfusion. We didnt's see reperfusion injury during PTCA of the left coronary artery. On the other side, we saw severe reperfusion injury, such as slow-flow, arrhythmia and falling blood pressure during PTCA of the right coronary artery. After four hours, 99mTc-PYP myocardial SPECT showed marked uptake in the apical and inferior walls, and mild uptake in the anterior and posterior walls. After three days, severely-reduced uptake of 99mTc-PYP in the apex was noted, and mild uptake in the mid-portion of the anterior wall and the mid-portion of the inferior wall. Though reperfusion injury was seen, three was mild myocardial uptake of 99mTc-PYP in the area of the right coronary artery. On the other side, despite no reperfusion injury, there showed marked uptake during the acute phase and defect during the subacute phase in the area of the left coronary artery. Wall motion of the left ventricle was normal in the area of the right coronary artery and akinesis was seen on the left. These findings suggest that 99mTc-tetrofosmin and 99mTc-PYP myocardial SPECT are useful for visualization of reperfusion injury during the acute phase and for estimation of function during the chronic phase, better even than electrocardiogram or coronary angiography. PMID:12701202

  10. Patients' Perspectives on Wait Times and the Referral-Consultation Process While Attending a Tertiary Diabetes and Endocrinology Centre: Is Econsultation an Acceptable Option?

    PubMed

    Keely, Erin; Traczyk, Lara; Liddy, Clare

    2015-08-01

    The goal of this study was to establish patients' perspectives on the acceptability of wait times, the impact of wait times on their health and the possibility of using electronic consultations (eConsultations) to avoid visits to specialists. A 2-stage patient survey (self-administered and with a follow-up telephone call) and a chart audit was conducted on a sequential sample of patients attending their initial consultations in a tertiary diabetes and endocrinology centre. Patients' perspectives on actual and ideal wait times, the impact of waiting for access, the effectiveness of the referral-consultation process and attitudes toward eConsultations as an alternative to traditional referral-consultations were collected. The study involved 101 patients (22% for diabetes, 78% for endocrinologic conditions), whose comments were collated and categorized. Of the 101 patients who completed the survey, 61 also completed telephone interviews. The average wait time was 19 weeks; the median 10 weeks. More than 30% of patients waited longer than 6 months and 6% waited longer than 1 year. Overall, 90% of patients thought that the maximum wait time should be less than 3 months. While waiting, 58% of patients worried about a serious undiagnosed disease, 30% found their symptoms had affected their daily activities and 24% had to miss work or school due to symptoms. Of the patients, 46% considered eConsultation a viable alternative to face-to-face visits. Excessive wait times for specialist care remain barriers and have negative impacts on patients. Wait times significantly exceeded times patients considered acceptable. eConsultations provide acceptable alternatives for many patients, and they reduced the number of patients requiring traditional consultations. PMID:25797111

  11. Marked elevation of urinary β2-microglobulin in patients with reversible splenial lesions: A small case series.

    PubMed

    Azuma, Junji; Nabatame, Shin; Katsura, Toshiya; Yamamoto, Kyoko; Kaneno, Hiroshi; Kijima, Eri; Mizoguchi, Yoshimi; Shimotsuji, Tunesuke; Yamamoto, Takehisa; Ozono, Keiichi

    2016-09-15

    The magnetic resonance imaging findings of reversible isolated lesions with transiently reduced diffusion in the splenium of corpus callosum of patients with a wide spectrum of pathological conditions are referred to as reversible splenial lesion syndrome (RESLES). Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is probably included within the spectrum of RESLES; however, its exact pathophysiology is not known. Here, we describe three patients with MERS and one patient with RESLES, all of whom showed elevated urinary β2-microglobulin regardless of diagnosis and presence of pathogens. Elevated urinary β2-microglobulin suggested that an excessive immune response might play a role in the pathophysiology of reversible splenial lesions. PMID:27538611

  12. Acute renal failure induced by markedly decreased appetite secondary to a depressive episode after discontinuation of long-term lithium therapy in an elderly patient with bipolar disorder

    PubMed Central

    Okada, Akira

    2014-01-01

    Some elderly patients on chronic lithium therapy for bipolar disorder and their doctors may be faced with a therapeutic dilemma over whether or not to continue prescribing/taking lithium given their increased risk of reduced renal function. We present the case of a 78-year-old woman with bipolar disorder who discontinued lithium therapy due to increased risk factors for renal injury. After discontinuation, she experienced markedly decreased appetite secondary to a depressive episode, and developed acute renal failure, which subsequently progressed to a more advanced stage of chronic kidney disease. This case suggests that extreme care must be taken to prevent the recurrence of depression in elderly patients with bipolar disorder who discontinue lithium therapy, even when they had been emotionally stable for a long time while receiving lithium. Medications other than lithium for bipolar disorder may be needed at the time lithium therapy is discontinued. PMID:24835805

  13. Clozapine-treated Patients Have Marked Gastrointestinal Hypomotility, the Probable Basis of Life-threatening Gastrointestinal Complications: A Cross Sectional Study

    PubMed Central

    Every-Palmer, Susanna; Nowitz, Mike; Stanley, James; Grant, Eve; Huthwaite, Mark; Dunn, Helen; Ellis, Pete M.

    2016-01-01

    Background Gastrointestinal side effects are particularly common with clozapine and occur with other antipsychotics, ranging from mild constipation to fatal bowel obstruction and/or ischemia. While this adverse-effect spectrum has been attributed to ‘gastrointestinal hypomotility’, gastrointestinal transit times in antipsychotic-treated patients have not previously been measured, making this mechanism speculative. Methods Using standardized radiopaque marker (‘Metcalf’) methods we established colonic transit times of antipsychotic-treated psychiatric inpatients and compared them with population normative values. We analyzed results by antipsychotic type, antipsychotic dose equivalent, anticholinergic load, duration of treatment, gender, ethnicity, and age. Outcomes For patients not prescribed clozapine, median colonic transit time was 23 h. For patients prescribed clozapine, median transit time was 104.5 h, over four times longer than those on other antipsychotics or normative values (p < 0.0001). Eighty percent of clozapine-treated patients had colonic hypomotility, compared with none of those prescribed other antipsychotics (olanzapine, risperidone, paliperidone aripiprazole, zuclopenthixol or haloperidol). In the clozapine group, right colon, left colon and rectosigmoid transit times were all markedly abnormal suggesting pan-colonic pathology. Hypomotility occurred irrespective of gender, age, ethnicity, or length of clozapine treatment. Transit times were positively correlated with clozapine plasma level (rho = 0.451, p = 0.045), but not with duration of treatment, total antipsychotic load or demographic factors. Interpretation Clozapine, unlike the other antipsychotics examined, causes marked gastrointestinal hypomotility, as previously hypothesized. Pre-emptive laxative treatment is recommended when starting clozapine. PMID:27077119

  14. Acceptance of Combined Coronary CT Angiography and Myocardial CT Perfusion versus Conventional Coronary Angiography in Patients with Coronary Stents—Intraindividual Comparison

    PubMed Central

    Martus, Peter; Laule, Michael; Dewey, Marc; Schönenberger, Eva

    2015-01-01

    Objectives To evaluate how well patients with coronary stents accept combined coronary computed tomography angiography (CTA) and myocardial CT perfusion (CTP) compared with conventional coronary angiography (CCA). Background While combined CTA and CTP may improve diagnostic accuracy compared with CTA alone, patient acceptance of CTA/CTP remains to be defined. Methods A total of 90 patients with coronary stents prospectively underwent CTA/CTP (both with contrast agent, CTP with adenosine) and CCA as part of the CARS-320 study. In this group, an intraindividual comparison of patient acceptance of CTA, CTP, and CCA was performed. Results CTP was experienced to be significantly more painful than CTA (p<0.001) and was associated with a higher frequency of dyspnea (p<0.001). Comparison of CTA/CTP with CCA revealed no significant differences in terms of pain (p = 0.141) and comfort (p = 0.377). Concern before CTA/CTP and CCA and overall satisfaction were likewise not significantly different (p = 0.097 and p = 0.123, respectively). Nevertheless, about two thirds (n = 60, 68%) preferred CTA/CTP to CCA (p<0.001). Moreover, patients felt less helpless during CTA/CTP than during CCA (p = 0.026). Lack of invasiveness and absence of pain were the most frequently mentioned advantages of CTA/CTP over CCA in our patient population. Conclusions CCA and combined CTA/CTP are equally well accepted by patients; however, more patients prefer CTA/CTP. CTP was associated with more intense pain than CTA and more frequently caused dyspnea than CTA alone. Trial Registration ClinicalTrials.gov NCT00967876 PMID:26327127

  15. Access to chronic disease care in general practice: the acceptability of implementing systematic waiting-room screening using computer-based patient-reported risk status

    PubMed Central

    Paul, Christine L; Carey, Mariko; Yoong, Sze Lin; D’Este, Catherine; Makeham, Meredith; Henskens, Frans

    2013-01-01

    Background Routine screening and advice regarding risky lifestyle behaviours is appropriate in the primary care setting, but often not implemented. Routine electronic collection of patients’ self-reported data may streamline the collection of such information. Aim To explore the perceptions of GPs and their attending patients regarding the acceptability of waiting-room touchscreen computers for the collection of health behaviour information. Uptake, ease of operation, and the perceived likelihood of future implementation were studied. Design and setting Cross-sectional health-risk survey. General practices in metropolitan areas in Australia. Method Practices were randomly selected by postcode. Consecutive patients who were eligible to take part in the study were approached in the waiting room and invited to do so. Participants completed the touchscreen health survey. A subsample of patients and GPs completed additional items regarding acceptability. Results Twelve general practices participated in the study, with 4058 patients (86%) and 51 of 68 (75%) GPs consenting to complete the health-risk survey, 596 patients and 30 GPs were selected to complete the acceptability survey. A majority of the 30 GPs indicated that the operation of the survey was not disruptive to practice and more than 90% of patients responded positively to all items regarding its operation. More than three-quarters of the patient sample were willing to consider allowing their responses to be kept on file and complete such surveys in the future. Conclusion As waiting-room-based collection of this information appears to be both feasible and acceptable, practitioners should consider collecting and incorporating routine patient-reported health behaviours for inclusion in the medical record. PMID:23998842

  16. Comparison of acceptance, preference and efficacy between pressure anesthesia and classical needle infiltration anesthesia for dental restorative procedures in adult patients

    PubMed Central

    Makade, Chetana Sachin; Shenoi, Pratima R; Gunwal, Mohit K

    2014-01-01

    Introduction: Intraoral local anesthesia is essential for delivering dental care. Needless devices have been developed to provide anesthesia without injections. Little controlled research is available on its use in dental restorative procedures in adult patients. The aims of this study were to compare adult patients acceptability and preference for needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Materials and Methods: Twenty non fearful adults with no previous experience of dental anesthesia were studied using split-mouth design. The first procedure was performed with classical needle infiltration anesthesia. The same amount of anesthetic solution was administered using MADA jet needleless device in a second session one week later, during which a second dental restorative procedure was performed. Patients acceptance was assessed using Universal pain assessment tool while effectiveness was recorded using soft tissue anesthesia and pulpal anesthesia. Patients reported their preference for the anesthetic method at the third visit. The data was evaluated using chi square test and student's t-test. Results: Pressure anesthesia was more accepted and preferred by 70% of the patients than traditional needle anesthesia (20%). Both needle and pressure anesthesia was equally effective for carrying out the dental procedures. Conclusion: Patients experienced significantly less pain and fear (p<0.01) during anesthetic procedure with pressure anesthesia. However, for more invasive procedures needle anesthesia will be more effective. PMID:24778516

  17. Chronic synovitis with marked infiltration of granulocytes in a patient with an unusual development of systemic lupus erythematosus.

    PubMed

    Meijers, K A; Eulderink, F; van de Putte, L B; Wiersema-van Gogh, H; de Vries, E; Cats, A

    1979-01-01

    The case described concerns a patient initially presenting the clinical symptoms of rheumatoid arthritis, including the presence of nodules, and slowly developing into systemic lupus erythematosus (SLE). Besides the signs of chronic inflammation in the synovial tissue, many granulocytes and PAS-positive macrophages were present. At electronmicroscopy the basal membranes of the vessels were multilaminated and the endothelial cells enlarged while many macrophages contained large clumps of electrondense material which could easily be interpreted as rough endoplasmatic reticulum (RER) of plasma cells. Immunoflourescence studies showed deposition of immunoglobulins and complement in the vessel walls of the synovium, thus suggesting an immune-complex pathogenesis. PMID:506490

  18. Feasibility and Acceptability of Utilizing a Smartphone Based Application to Monitor Outpatient Discharge Instruction Compliance in Cardiac Disease Patients around Discharge from Hospitalization

    PubMed Central

    Layton, Aimee M.; Whitworth, James; Peacock, James; Bartels, Matthew N.; Jellen, Patricia A.; Thomashow, Byron M.

    2014-01-01

    The purpose of this study was to determine the feasibility and acceptability of utilizing a smartphone based application to monitor compliance in patients with cardiac disease around discharge. For 60 days after discharge, patients' medication compliance, physical activity, follow-up care, symptoms, and reading of education material were monitored daily with the application. 16 patients were enrolled in the study (12 males, 4 females, age 55 ± 18 years) during their hospital stay. Five participants were rehospitalized during the study and did not use the application once discharged. Seven participants completed 1–30 days and four patients completed >31 days. For those 11 patients, medication reminders were utilized 37% (1–30-day group) and 53% (>31-day group) of the time, education material was read 44% (1–30) and 53% (>31) of the time, and physical activity was reported 25% (1–30) and 42% (>31) of the time. Findings demonstrated that patients with stable health utilized the application, even if only minimally. Patients with decreased breath sounds by physical exam and who reported their health as fair to poor on the day of discharge were less likely to utilize the application. Acceptability of the application to report health status varied among the stable patients. PMID:25574165

  19. Acceptance of Anti-Retroviral Therapy among Patients Infected with HIV and Tuberculosis in Rural Malawi Is Low and Associated with Cost of Transport

    PubMed Central

    Zachariah, Rony; Harries, Anthony David; Manzi, Marcel; Gomani, Patrick; Teck, Roger; Phillips, Mit; Firmenich, Peter

    2006-01-01

    Background A study was conducted among newly registered HIV-positive tuberculosis (TB) patients systematically offered anti-retroviral treatment (ART) in a district hospital in rural Malawi in order to a) determine the acceptance of ART b) conduct a geographic mapping of those placed on ART and c) examine the association between “cost of transport” and ART acceptance. Methodology/Principal Findings A retrospective cross-sectional analysis was performed on routine program data for the period of February 2003 to July 2004. Standardized registers and patient cards were used to gather data. The place of residence was used to determine road distances to the Thyolo district hospital. Cost of transport from different parts of the district was based on the known cost for public transport to the road-stop closest to the patient's residence. Of 1,290 newly registered TB patients, 1,003(78%) underwent HIV-testing of whom 770 (77%) were HIV-positive. 742 of these individuals (pulmonary TB = 607; extra-pulmonary TB = 135) were considered eligible for ART of whom only 101(13.6%) accepted ART. Cost of transport to the hospital ART site was significantly associated with ART acceptance and there was a linear trend in association between cost and ART acceptance (X2 for trend = 25.4, P<0.001). Individuals who had to pay 50 Malawi Kwacha (1 United States Dollar = 100 Malawi Kwacha, MW) or less for a one-way trip to the Thyolo hospital were four times more likely to accept ART than those who had to pay over 100 MW (Adjusted Odds ratio = 4.0, 95% confidence interval: 2.0–8.1, P<0.001). Conclusions/Significance ART acceptance among TB patients in a rural district in Malawi is low and associated with cost of transport to the centralized hospital based ART site. Decentralizing the ART offer from the hospital to health centers that are closer to home communities would be an essential step towards reducing the overall cost and burden of travel. PMID:17205125

  20. Comparison of Accuracy in Calculation of Absorbed Dose to Patients Following Bone Scan with (99m)Tc-Marked Diphosphonates by Two Different Background Correction Methods.

    PubMed

    Shahbazi-Gahrouei, Daryoush; Damoori, Mehri; Tavakoli, Mohammad Bagher; Moslehi, Masoud

    2016-01-01

    To improve the accuracy of the activity quantification and the image quality in scintigraphy, scatter correction is a vital procedure. The aim of this study is to compare the accuracy in calculation of absorbed dose to patients following bone scan with (99m)Tc-marked diphosphonates ((99m)Tc-MDP) by two different methods of background correction in conjugate view method. This study involved 22 patients referring to the Nuclear Medicine Center of Shahid Chamran Hospital, Isfahan, Iran. After the injection of (99m)Tc-MDP, whole-body images from patients were acquired at 10, 60, 90, and 180 min. Organ activities were calculated using the conjugate view method by Buijs and conventional background correction. Finally, the absorbed dose was calculated using the Medical Internal Radiation Dosimetry (MIRD) technique. The results of this study showed that the absorbed dose per unit of injected activity (rad/mCi) ± standard deviation for pelvis bone, bladder, and kidneys by Buijs method was 0.19 ± 0.05, 0.08 ± 0.01, and 0.03 ± 0.01 and by conventional method was 0.13 ± 0.04, 0.08 ± 0.01, and 0.024 ± 0.01, respectively. This showed that Buijs background correction method had a high accuracy compared to conventional method for the estimated absorbed dose of bone and kidneys whereas, for the bladder, its accuracy was low. PMID:27014610

  1. Comparison of Accuracy in Calculation of Absorbed Dose to Patients Following Bone Scan with 99mTc-Marked Diphosphonates by Two Different Background Correction Methods

    PubMed Central

    Shahbazi-Gahrouei, Daryoush; Damoori, Mehri; Tavakoli, Mohammad Bagher; Moslehi, Masoud

    2016-01-01

    To improve the accuracy of the activity quantification and the image quality in scintigraphy, scatter correction is a vital procedure. The aim of this study is to compare the accuracy in calculation of absorbed dose to patients following bone scan with 99mTc-marked diphosphonates (99mTc-MDP) by two different methods of background correction in conjugate view method. This study involved 22 patients referring to the Nuclear Medicine Center of Shahid Chamran Hospital, Isfahan, Iran. After the injection of 99mTc-MDP, whole-body images from patients were acquired at 10, 60, 90, and 180 min. Organ activities were calculated using the conjugate view method by Buijs and conventional background correction. Finally, the absorbed dose was calculated using the Medical Internal Radiation Dosimetry (MIRD) technique. The results of this study showed that the absorbed dose per unit of injected activity (rad/mCi) ± standard deviation for pelvis bone, bladder, and kidneys by Buijs method was 0.19 ± 0.05, 0.08 ± 0.01, and 0.03 ± 0.01 and by conventional method was 0.13 ± 0.04, 0.08 ± 0.01, and 0.024 ± 0.01, respectively. This showed that Buijs background correction method had a high accuracy compared to conventional method for the estimated absorbed dose of bone and kidneys whereas, for the bladder, its accuracy was low. PMID:27014610

  2. Effectiveness and Patient Acceptance of Halcinonide 0.1% Cream in 216g Jars for Large-area Steroid-responsive Dermatoses

    PubMed Central

    2011-01-01

    When treating patients with extensive dermatitis, total body surface area affected must be considered when prescribing topical medication. Halcinonide 0.1% cream, a class 2 topical corticosteroid, is now available in a 216g jar. This large size is convenient and cost effective for patients with large-area dermatoses. Objectives: The objectives of this study were to determine the efficacy and patient acceptance of halcinonide in 216g jars for the treatment of large-area dermatoses. Design: This study was an open-label, noncomparator trial evaluating the clinical outcomes and acceptability of halcinonide in 216g jars. Halcinonide was prescribed twice daily for up to 28 days. Measurement: Severity of dermatoses was based on investigator observations at the baseline visit and again after 28 days. Patient satisfaction was evaluated based on a questionnaire completed at the conclusion of the study. Results: Total enrollment was 40 patients. Dermatoses affected an average of 12 percent body surface area. At baseline, all patients exhibited dermatoses rated as severe or moderate. Nearly half of patients were completely cleared or almost cleared by 28 days, with all patients noting at least some improvement. Most patients agreed that they liked the way the product spread on the skin (94.7%), and more than 80 percent found that it was neither sticky nor greasy. In more than 90 percent of cases, the investigator reported that halcinonide provided a shorter duration of therapy versus triamcinolone one-pound jars. Conclusion: Halcinonide 0.1% cream in 216g jars is effective and convenient for patients with large-area dermatoses. PMID:21532875

  3. Five Patients With Burning Mouth Syndrome in Whom an Antidepressant (Serotonin-Noradrenaline Reuptake Inhibitor) Was Not Effective, but Pregabalin Markedly Relieved Pain.

    PubMed

    Ito, Mikiko; Tokura, Tatsuya; Yoshida, Keizo; Nagashima, Wataru; Kimura, Hiroyuki; Umemura, Eri; Tachibana, Masako; Miyauchi, Tomoya; Kobayashi, Yuka; Arao, Munetaka; Ozaki, Norio; Kurita, Kenichi

    2015-01-01

    Burning mouth syndrome (BMS) causes idiopathic pain or a burning sensation in clinically normal oral mucosa. Burning mouth syndrome is a chronic disease with an unknown etiology. Burning mouth syndrome is also idiopathic, and a consensus regarding diagnosis/treatment has not been reached yet. Recent studies have supported the suggestion that BMS is a neuropathic pain disorder in which both the peripheral and central nervous systems are involved. Tricyclic antidepressants (nortriptyline and amitriptyline), serotonin-noradrenaline reuptake inhibitors (SNRIs) (duloxetine and milnacipran), and antiepileptic drugs, potential-dependent calcium channel α2δ subunit ligands (gabapentine and pregabalin), are currently recommended as the first-choice drugs for neuropathic pain. In this study, we report 5 patients with BMS in whom there was no response to SNRI (milnacipran or duloxetine), or administration was discontinued because of adverse reactions, but in whom pregabalin therapy markedly reduced or led to the disappearance of pain in a short period. Pregabalin, whose mechanism of action differs from that of SNRIs, may become a treatment option for BMS patients who are not responsive to or are resistant to SNRIs. PMID:26166242

  4. Introducing single dose liposomal amphotericin B for the treatment of visceral leishmaniasis in rural bangladesh: feasibility and acceptance to patients and health staff.

    PubMed

    Maintz, Eva-Maria; Hassan, Mahbub; Huda, M Mamun; Ghosh, Debashis; Hossain, Md Shakhawat; Alim, Abdul; Kroeger, Axel; Arana, Byron; Mondal, Dinesh

    2014-01-01

    Background. For the treatment of visceral leishmaniasis in Bangladesh, single dose liposomal amphotericin B (ambisome) is supposed to be the safest and most effective treatment. Specific needs for application and storage raise questions about feasibility of its implementation and acceptance by patients and health staff. Methods. The study was carried out in the most endemic district of Bangladesh. Study population includes patients treated with ambisome or miltefosine, hospital staff, and a director of the national visceral leishmaniasis program. Study methods include direct observation (subdistrict hospitals), open interviews (heath staff and program personnel), structured questionnaires, and focus group discussions (patients). Results. Politicalcommitment for ambisome is strong; the general hospital infrastructure favours implementation but further strengthening is required, particularly for drug storage below 25°C (refrigerators), back-up energy (fuel for generators), and supplies for ambisome administration (like 5% dextrose solution). Ambisome created high satisfaction in patients and hospital staff, less adverse events, and less income loss for patients compared to miltefosine. Conclusions. High political commitment, general capacities of subdistrict hospitals, and high acceptability favour the implementation of ambisome treatment in Bangladesh. However, strengthening of the infrastructure and uninterrupted supplies of essential accessories is mandatory before introducing sLAB in Bangladesh. PMID:24578710

  5. Testing the credibility, feasibility and acceptability of an optimised behavioural intervention (OBI) for avoidant chronic low back pain patients: protocol for a randomised feasibility study

    PubMed Central

    2013-01-01

    Background Chronic back pain continues to be a costly and prevalent condition. The latest NICE guidelines issued in 2009 state that for patients with persistent back pain (of between six weeks and twelve months duration), who are highly distressed and/or disabled and for whom exercise, manual therapy and acupuncture has not been beneficial, the evidence supports a combination of around 100 hours of combined physical and psychological treatment. This is costly, and may prove unacceptable to many patients. A key recommendation of these guidelines was for further randomised controlled trials (RCTs) of psychological treatment and to target treatment to specific sub-groups of patients. Recent trials that have included psychological interventions have shown only moderate improvement at best, and results are not maintained long term. There is therefore a need to test theoretically driven interventions that focus on specific high-risk sub-groups, in which the intervention is delivered at full integrity against a credible control. Methods/design A feasibility study of a pragmatic randomised controlled trial comparing psychologist-delivered Contextual Cognitive Behavioural Therapy (CCBT) against Treatment As Usual (TAU) physiotherapy delivered by physiotherapists for the treatment of chronic lower back pain in ‘avoidant’ patients. Ninety-two patients referred for physiotherapy will be recruited and randomised on a 1:1 basis to receive CCBT or TAU. Treatment groups will be balanced by centre and pain interference score. Primary outcomes include assessing the credibility and acceptability of the intervention, and to demonstrate proof of principle through a greater change in pain acceptance in the CCBT arm, measured by the Acceptance and Action –II and the Chronic Pain Acceptance questionnaires. In addition, the feasibility of carrying out a full trial will be explored with reference to recruitment and follow-up rates including the assessment of the burden of outcome

  6. Outpatient treatment of low-risk venous thromboembolism with monotherapy oral anticoagulation: patient quality of life outcomes and clinician acceptance

    PubMed Central

    Kline, Jeffrey A; Kahler, Zachary P; Beam, Daren M

    2016-01-01

    Background Oral monotherapy anticoagulation has facilitated home treatment of venous thromboembolism (VTE) in outpatients. Objectives The aim of this study was to measure efficacy, safety, as well as patient and physician perceptions produced by a protocol that selected VTE patients as low-risk patients by the Hestia criteria, and initiated home anticoagulation with an oral factor Xa antagonist. Methods Patients were administered the Venous Insufficiency Epidemiological and Economic Study Quality of life/Symptoms questionnaire [VEINEs QoL/Sym] and the physical component summary [PCS] from the Rand 36-Item Short Form Health Survey [SF36]). The primary outcomes were VTE recurrence and hemorrhage at 30 days. Secondary outcomes compared psychometric test scores between patients with deep vein thrombosis (DVT) to those with pulmonary embolism (PE). Patient perceptions were abstracted from written comments and physician perceptions specific to PE outpatient treatment obtained from structured survey. Results From April 2013 to September 2015, 253 patients were treated, including 67 with PE. Within 30 days, 2/253 patients had recurrent DVT and 2/253 had major hemorrhage; all four had DVT at enrollment. The initial PCS scores did not differ between DVT and PE patients (37.2±13.9 and 38.0±12.1, respectively) and both DVT and PE patients had similar improvement over the treatment period (42.2±12.9 and 43.4±12.7, respectively), consistent with prior literature. The most common adverse event was menorrhagia, present in 15% of women. Themes from patient-written responses reflected satisfaction with increased autonomy. Physicians’ (N=116) before-to-after protocol comfort level with home treatment of PE increased 48% on visual analog scale. Conclusion Hestia-negative VTE patients treated with oral monotherapy at home had low rates of VTE recurrence and bleeding, as well as quality of life measurements similar to prior reports. PMID:27143861

  7. Unexpected Acceptance? Patients with Social Anxiety Disorder Manifest their Social Expectancy in ERPs During Social Feedback Processing

    PubMed Central

    Cao, Jianqin; Gu, Ruolei; Bi, Xuejing; Zhu, Xiangru; Wu, Haiyan

    2015-01-01

    Previous studies on social anxiety have demonstrated negative-expectancy bias in social contexts. In this study, we used a paradigm that employed self-relevant positive or negative social feedback, in order to test whether this negative expectancy manifests in event-related potentials (ERPs) during social evaluation among socially anxious individuals. Behavioral data revealed that individuals with social anxiety disorder (SAD) showed more negative expectancy of peer acceptance both in the experiment and in daily life than did the healthy control participants. Regarding ERP results, we found a overally larger P2 for positive social feedback and also a group main effect, such that the P2 was smaller in SAD group. SAD participants demonstrated a larger feedback-related negativity (FRN) to positive feedback than to negative feedback. In addition, SAD participants showed a more positive ΔFRN (ΔFRN = negative – positive). Furthermore, acceptance expectancy in daily life correlated negatively with ΔFRN amplitude, while the Interaction Anxiousness Scale (IAS) score correlated positively with the ΔFRN amplitude. Finally, the acceptance expectancy in daily life fully mediated the relationship between the IAS and ΔFRN. These results indicated that both groups could differentiate between positive and negative social feedback in the early stage of social feedback processing (reflected on the P2). However, the SAD group exhibited a larger FRN to positive social feedback than to negative social feedback, demonstrating their dysfunction in the late stage of social feedback processing. In our opinion, such dysfunction is due to their greater negative social feedback expectancy. PMID:26635659

  8. The Mark 5C VLBI Data System

    NASA Technical Reports Server (NTRS)

    Whitney, Alan; Ruszczyk, Chester; Romney, Jon; Owens, Ken

    2010-01-01

    The Mark 5C disk-based VLBI data system is being developed as the third-generation Mark 5 disk-based system, increasing the sustained data-recording rate capability to 4 Gbps. It is built on the same basic platform as the Mark 5A, Mark 5B and Mark 5B+ systems and will use the same 8-disk modules as earlier Mark 5 systems, although two 8-disk modules will be necessary to support the 4 Gbps rate. Unlike its earlier brethren, which use proprietary data interfaces, the Mark 5C will accept data from a standard 10 Gigabit Ethernet connection and be compatible with the emerging VLBI Data Interchange Format (VDIF) standard. Data sources for the Mark 5C system will be based on new digital backends now being developed, specifically the RDBE in the U.S. and the dBBC in Europe, as well as others. The Mark 5C system is being planned for use with the VLBI2010 system and will also be used by NRAO as part of the VLBA sensitivity upgrade program; it will also be available to the global VLBI community from Conduant. Mark 5C system specification and development is supported by Haystack Observatory, NRAO, and Conduant Corporation. Prototype Mark 5C systems are expected in early 2010.

  9. The Mark 5C VLBI Data System

    NASA Astrophysics Data System (ADS)

    Whitney, Alan; Ruszczyk, Chet; Romney, Jon; Owens, Kenneth

    2010-12-01

    The Mark 5C disk-based VLBI data system is being developed as the third-generation Mark 5 disk-based system, increasing the sustained data-recording rate capability to 4 Gbps. It is built on the same basic platform as the Mark 5A, Mark 5B and Mark 5B+ systems and will use the same 8-disk modules as earlier Mark 5 systems, although two 8-disk modules will be necessary to support the 4 Gbps rate. Unlike its earlier brethren, which use proprietary data interfaces, the Mark 5C will accept data from a standard 10 Gigabit Ethernet connection and be compatible with the emerging VLBI Data Interchange Format (VDIF) standard. Data sources for the Mark 5C system will be based on new digital backends now being developed, specifically the RDBE in the U.S. and the dBBC in Europe, as well as others. The Mark 5C system is being planned for use with the VLBI2010 system and will also be used by NRAO as part of the VLBA sensitivity upgrade program; it will also be available to the global VLBI community from Conduant. Mark 5C system specification and development is supported by Haystack Observatory, NRAO, and Conduant Corporation. Prototype Mark 5C systems are expected in early 2010.

  10. The Mark 5 VLBI Data System

    NASA Astrophysics Data System (ADS)

    Whitney, A. R.

    2007-07-01

    The Mark 5 VLBI data system is a disk-based data-recording and playback system for high-data-rate VLBI observations, and has been adopted worldwide for VLBI observations. Approximately 150 Mark 5A systems, capable of recording/playback at 1024 Mbps, are now deployed around the world, directly replacing the Mark 4/VLBA tape-based systems which were prevalent for over 25 years. The Mark 5A system records to an 8-disk removable module which is normally transported to a central correlator facility for processing. The Mark 5B VLBI data system is designed to support the VSI-H international specification and is now being deployed. It is based on the same physical platform and uses the same disk-modules as the Mark 5A; it also supports the same maximum data rate of 1024 Mbps. Data formatting and timetagging is done internally within the Mark 5B, eliminating the need for external formatters. Backwards playback compatibility with Mark 5A is accomplished by an upgrade to the Mark 5A. An upgrade of the Mark 5B system, dubbed Mark 5B+, is now also available and capable of sustained recording at 2 Gbps. The Mark 5C system, currently in development, accepts sampled data through a standard 10 Gigabit Ethernet OSI Layer 2 interface and will support sustained recording up to 4 Gbps. The Mark 5C will support a recording mode which is backwards compatible with the Mark 5B system for playback; Mark 5C is expected to be available in early 2008.

  11. Accept or divert?

    PubMed

    Angelucci, P A

    1999-09-01

    Stretching scarce resources is more than a managerial issue. Should you accept the patient to an understaffed ICU or divert him to another facility? The intense "medical utility" controversy focuses on a situation that critical care nurses now face every day. PMID:10614370

  12. Evaluation of specialists' outreach clinics in general practice in England: process and acceptability to patients, specialists, and general practitioners.

    PubMed Central

    Bowling, A; Stramer, K; Dickinson, E; Windsor, J; Bond, M

    1997-01-01

    OBJECTIVES: The wider study aimed to evaluate specialists' outreach clinics in relation to their costs, processes, and effectiveness, including patients' and professionals' attitudes. The data on processes and attitudes are presented here. DESIGN: Self administered questionnaires were drawn up for patients, their general practitioners (GPs) and specialists, and managers in the practice. Information was sought from hospital trusts. The study formed a pilot phase prior to a wider evaluation. SETTING: Nine outreach clinics in general practices in England, each with a hospital outpatient department as a control clinic were studied. SUBJECTS: The specialties included were ear, nose, and throat surgery; rheumatology; and gynaecology. The subjects were the patients who attended either the outreach clinics or hospital outpatients clinics during the study period, the outreach patients' GPs, the outreach patients' and outpatients' specialists, the managers in the practices, and the NHS trusts which employed the specialists. MAIN OUTCOME MEASURES: Process items included waiting lists, waiting times in clinics, number of follow up visits, investigations and procedures performed, treatment, health status, patients' and specialists' travelling times, and patients' and doctors' attitudes to, and satisfaction with, the clinic. RESULTS: There was no difference in the health status of patients in relation to the clinic site (ie, outreach and hospital outpatients' clinics) at baseline, and all but one of the specialists said there were no differences in casemix between their outreach and outpatients' clinics. Patients preferred, and were more satisfied with, care in specialists' outreach clinics in general practice, in comparison with outpatients' clinics. The outreach clinics were rated as more convenient than outpatients' clinics in relation to journey times; those outreach patients in work lost less time away from work than outpatients' clinic patients due to the clinic attendance

  13. Do Ask, Do Tell: High Levels of Acceptability by Patients of Routine Collection of Sexual Orientation and Gender Identity Data in Four Diverse American Community Health Centers

    PubMed Central

    Cahill, Sean; Singal, Robbie; Grasso, Chris; King, Dana; Mayer, Kenneth; Baker, Kellan; Makadon, Harvey

    2014-01-01

    Background The Institute of Medicine and The Joint Commission have recommended asking sexual orientation and gender identity (SOGI) questions in clinical settings and including such data in Electronic Health Records (EHRs). This is increasingly viewed as a critical step toward systematically documenting and addressing health disparities affecting lesbian, gay, bisexual, and transgender (LGBT) people. The U.S. government is currently considering whether to include SOGI data collection in the Stage 3 guidelines for the incentive program promoting meaningful use of EHR. However, some have questioned whether acceptable standard measures to collect SOGI data in clinical settings exist. Methods In order to better understand how a diverse group of patients would respond if SOGI questions were asked in primary care settings, 301 randomly selected patients receiving primary care at four health centers across the U.S. were asked SOGI questions and then asked follow-up questions. This sample was mainly heterosexual, racially diverse, and geographically and regionally broad. Results There was a strong consensus among patients surveyed about the importance of asking SOGI questions. Most of the LGBT respondents thought that the questions presented on the survey allowed them to accurately document their SOGI. Most respondents—heterosexual and LGBT—answered the questions, and said that they would answer such questions in the future. While there were some age-related differences, respondents of all ages overwhelmingly expressed support for asking SOGI questions and understood the importance of providers' knowing their patients' SOGI. Conclusions Given current deliberations within national health care regulatory bodies and the government's increased attention to LGBT health disparities, the finding that patients can and will answer SOGI questions has important implications for public policy. This study provides evidence that integrating SOGI data collection into the meaningful

  14. Human Immunodeficiency Virus (HIV)-Infected Patients Accept Finger Stick Blood Collection for Point-Of-Care CD4 Testing

    PubMed Central

    Scott, Lesley; Potgieter, Joachim; Kestens, Luc; Stevens, Wendy

    2016-01-01

    Introduction HIV-infected patients require antiretroviral treatment for life. To improve access to care, CD4 enumeration and viral load tests have been redesigned to be used as point-of-care techniques using finger-stick blood. Accurate CD4 counting in capillary blood requires a free flowing blood drop that is achieved by blade incision. The aim of this study was to assess the attitude of the patients toward blade-based finger-stick blood donation. Methods Four hundred and ninety-nine patients were included (299 patients from South Africa and 200 from Belgium). They completed a questionnaire to express their preference for finger stick or venipuncture, after undergoing both. The South African patient cohort was divided in two groups, receiving either single or multiple finger stick for CD4 and other HIV-related tests. The Belgian patients received a single finger stick for CD4 testing, and were asked to respond directly and again after two days. Results The majority of the patients preferred the finger stick to the venipuncture. The perceived pain using the blade was superior to a small needle, but similar to a large needle. They preferred up to three finger sticks over one venipuncture. Up to 30% of the patients changed their mind over two days. The main reason for choosing a finger stick was continued bleeding after venipuncture. The most cited objection to finger stick was pain/soreness. Conclusion Patient perceptions support the implementation of donating capillary blood with blade-based finger stick during CD4 point-of-care testing. PMID:27556894

  15. Enhancing the management of deteriorating patients with Australian on line e-simulation software: Acceptability, transferability, and impact in Hong Kong.

    PubMed

    Sparkes, Louise; Chan, Maggie Mee Kie; Cooper, Simon; Pang, Michelle Tsz Ha; Tiwari, Agnes

    2016-09-01

    International concerns relating to healthcare professionals' failure to rescue deteriorating patients exist. Web-based training programs have been developed and evaluated in Western settings but further testing is required before application in non-Western countries, as traditional modalities of learning may differ between cultures. We trialed an Australian English language online simulation program for the management of deteriorating patients, Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST(2) ACTWeb), to test cultural acceptability, transferability, and educational impact. The study was designed as a quasi-experimental evaluation of the FIRST(2) ACTWeb program with final year nursing students from a Bachelor of Nursing program at the University of Hong Kong. Participants completed pre-course and post-course tests, three interactive scenarios, and program evaluations. The program was positively evaluated, with significant improvements in knowledge, skills, self-rating of performance, confidence, and competence. Outcomes were comparable to earlier evaluations with Australian students, demonstrating that an interactive simulation-based program of patient deterioration management has cultural and language acceptability and transferability across communities with significant educational impact. PMID:27103595

  16. On Your Marks.

    ERIC Educational Resources Information Center

    Steinbach, Paul

    2000-01-01

    Examines the application of field, rink, track, and court markings and explains why the use of proper materials and some knowledge of science is important. Specific issues when using marking paints and dyes are addressed. (GR)

  17. Marking nut anaphylaxis

    PubMed Central

    Kral, Anita Christine; Hayball, John; Smith, William B

    2016-01-01

    Marking nut Semecarpus anacardium, so-called because it contains a pigment that has been used in the past to mark fabrics, is a known cause of contact hypersensitivity. It may be ingested as an ingredient of some traditional Hindi foods. We describe the first reported case of anaphylaxis to marking nut. PMID:27489793

  18. Marking nut anaphylaxis.

    PubMed

    Fok, Jie Shen; Kral, Anita Christine; Hayball, John; Smith, William B

    2016-07-01

    Marking nut Semecarpus anacardium, so-called because it contains a pigment that has been used in the past to mark fabrics, is a known cause of contact hypersensitivity. It may be ingested as an ingredient of some traditional Hindi foods. We describe the first reported case of anaphylaxis to marking nut. PMID:27489793

  19. [Double ricochet marks].

    PubMed

    Sellier, K

    1987-01-01

    When bullets are flying stably and ricochet on a surface, only one mark is produced. In contrast yawing bullets can produce a double mark if the angle of incidence is sufficiently small (less than or equal to 5 degrees). Distances up to 15 cm were seen between the two marks. PMID:3660953

  20. Acceptance and Efficacy of Metacognitive Training (MCT) on Positive Symptoms and Delusions in Patients With Schizophrenia: A Meta-analysis Taking Into Account Important Moderators.

    PubMed

    Eichner, Carolin; Berna, Fabrice

    2016-07-01

    Metacognitive training (MCT) is a new, widely used intervention for psychosis. The present meta-analysis examines the efficacy of MCT in schizophrenia. Fifteen studies comparing effects of MCT on positive symptoms, delusions or acceptance of MCT with a control group were included in this meta-analysis. These studies comprised a total of 408 patients in the MCT condition and 399 in the control condition. The moderating effects of masking of outcome assessment, randomization, incomplete outcome data, use of an active control intervention, and individual vs group MCT were investigated. Possible effects of sensitivity analyses and publication bias were also examined. The results show a significant overall effect of MCT for positive symptoms (g = -0.34, 95% CI [-0.53, -0.15]), delusions (g = -0.41, 95% CI [-0.74, -0.07]) and acceptance of the intervention (g = -0.84, 95% CI [-1.37, -0.31]). Using only studies being at low risk for bias regarding randomization, masking and incomplete outcome data reduced effect sizes for positive symptoms and delusions (g = -0.28, 95% CI [-0.50, -0.06] and g = -0.18, 95% CI [-0.43, 0.06]), respectively. This meta-analysis demonstrates that MCT exerts a small to moderate effect on delusions and positive symptoms and a large effect on acceptance of the intervention. The effect on delusions is reduced, but remains significant when potential biases are considered. PMID:26748396

  1. Comparison of daily megavoltage electronic portal imaging or kilovoltage imaging with marker seeds to ultrasound imaging or skin marks for prostate localization and treatment positioning in patients with prostate cancer

    SciTech Connect

    Serago, Christopher F. . E-mail: serago.christopher@mayo.edu; Buskirk, Steven J.; Igel, Todd C.; Gale, Ashley A.; Serago, Nicole E.; Earle, John D.

    2006-08-01

    Purpose: To compare the accuracy of imaging modalities, immobilization, localization, and positioning techniques in patients with prostate cancer. Methods and Materials: Thirty-five patients with prostate cancer had gold marker seeds implanted transrectally and were treated with fractionated radiotherapy. Twenty of the 35 patients had limited immobilization; the remaining had a vacuum-based immobilization. Patient positioning consisted of alignment with lasers to skin marks, ultrasound or kilovoltage X-ray imaging, optical guidance using infrared reflectors, and megavoltage electronic portal imaging (EPI). The variance of each positioning technique was compared to the patient position determined from the pretreatment EPI. Results: With limited immobilization, the average difference between the skin marks' laser position and EPI pretreatment position is 9.1 {+-} 5.3 mm, the average difference between the skin marks' infrared position and EPI pretreatment position is 11.8 {+-} 7.2 mm, the average difference between the ultrasound position and EPI pretreatment position is 7.0 {+-} 4.6 mm, the average difference between kV imaging and EPI pretreatment position is 3.5 {+-} 3.1 mm, and the average intrafraction movement during treatment is 3.4 {+-} 2.7 mm. For the patients with the vacuum-style immobilization, the average difference between the skin marks' laser position and EPI pretreatment position is 10.7 {+-} 4.6 mm, the average difference between kV imaging and EPI pretreatment position is 1.9 {+-} 1.5 mm, and the average intrafraction movement during treatment is 2.1 {+-} 1.5 mm. Conclusions: Compared with use of skin marks, ultrasound imaging for positioning provides an increased degree of agreement to EPI-based positioning, though not as favorable as kV imaging fiducial seeds. Intrafraction movement during treatment decreases with improved immobilization.

  2. Safety and Patient Acceptability of Stellate Ganglion Blockade as a Treatment Adjunct for Combat-Related Post-Traumatic Stress Disorder: A Quality Assurance Initiative

    PubMed Central

    2015-01-01

    OBJECTIVE: To perform a quality assurance and performance improvement project through review of our single center data on the safety and patient acceptability of the stellate ganglion blockade (SGB) procedure for the relief of symptoms related to chronic post-traumatic stress disorder. BACKGROUND: Our interventional pain management service has been offering trials of SGB therapy to assist with the management of the sympathetically mediated anxiety and hyperarousal symptoms of severe and treatment-refractory combat-related PTSD. There have been multiple case series in the literature describing the potential impact of this procedure for PTSD symptom management as well as the safety of image-guided procedures. We wished to ensure that we were performing this procedure safely and that patients were tolerating and accepting of this adjunctive treatment option. METHODS: We conducted a review of our quality assurance and performance improvement data over the past 18 months during which we performed 250 stellate ganglion blocks for the management of PTSD symptoms to detect any potential complications or unanticipated side effects.  We also analyzed responses from an anonymous patient de-identified survey collected regarding the comfort and satisfaction associated with the procedure. RESULTS: We did not identify any immediate post-procedural complications or delayed complications from any of the 250 procedures performed from November 2013 to April 2015. Of the 110 surveys that were returned and tabulated, 100% of the patients surveyed were overall satisfied with our process and with the procedure, 100% said they would recommend the procedure to a friend, and 95% stated that they would be willing to undergo as many repeat procedures as necessary based on little discomfort and tolerable side effects. CONCLUSION: Our quality assurance assessment suggests that in our center the SGB procedure for PTSD is a safe, well-tolerated, and acceptable

  3. A case series investigating acceptance and commitment therapy as a treatment for previously treated, unremitted patients with anorexia nervosa.

    PubMed

    Berman, M I; Boutelle, K N; Crow, S J

    2009-11-01

    The aim of the present study was to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) for treatment of anorexia nervosa (AN) using a case series methodology among participants with a history of prior treatment for AN. Three participants enrolled; all completed the study. All participants had a history of 1-20 years of intensive eating disorder treatment prior to enrollment. Participants were seen for 17-19 twice-weekly sessions of manualized ACT. Symptoms were assessed at baseline, post-treatment and 1-year follow-up. All participants experienced clinically significant improvement on at least some measures; no participants worsened or lost weight even at 1-year follow-up. Simulation modelling analysis (SMA) revealed for some participants an increase in weight gain and a decrease in eating disorder symptoms during the treatment phase as compared to a baseline assessment phase. These data, although preliminary, suggest that ACT could be a promising treatment for subthreshold or clinical cases of AN, even with chronic participants or those with medical complications. PMID:19760625

  4. Perampanel in the management of partial-onset seizures: a review of safety, efficacy, and patient acceptability

    PubMed Central

    Schulze-Bonhage, Andreas; Hintz, Mandy

    2015-01-01

    Perampanel (PER) is a novel antiepileptic drug recently introduced for the adjunctive treatment in epilepsy patients aged 12 years or older with partial-onset seizures with or without secondary generalization in the US and Europe. Its antiepileptic action is based on noncompetitive inhibition of postsynaptic AMPA receptors, decreasing excitatory synaptic transmission. Evaluation of efficacy in three placebo-controlled randomized Phase III studies showed that add-on therapy of PER decreased seizure frequencies significantly compared to placebo at daily doses between 4 mg/day and 12 mg/day. PER’s long half-life of 105 hours allows for once-daily dosing that is favorable for patient compliance with intake. Long-term extension studies showed a 62.5%–69.6% adherence of patients after 1 year of treatment, comparing favorably with other second-generation antiepileptic drugs. Whereas these trials demonstrated an overall favorable tolerability profile of PER, nonspecific central nervous system adverse effects like somnolence, dizziness, headache, and fatigue may occur. In addition, neuropsychiatric disturbances ranging from irritability to suicidality were reported in several case reports; both placebo-controlled and prospective long-term extension trials showed a low incidence of such behavioral and psychiatric complaints. For early recognition of neuropsychiatric symptoms like depression, anxiety, and aggression, slow titration and close monitoring during drug introduction are mandatory. This allows on the one hand to recognize patients particularly susceptible to adverse effects of the drug, and on the other hand to render the drug’s full potential of seizure control available for the vast majority of patient groups tolerating the drug well. PMID:26316718

  5. Patient Acceptable Symptom State in Self-Report Questionnaires and Composite Clinical Disease Index for Assessing Rheumatoid Arthritis Activity: Identification of Cut-Off Points for Routine Care

    PubMed Central

    Salaffi, Fausto; Carotti, Marina; Gutierrez, Marwin; Di Carlo, Marco; De Angelis, Rossella

    2015-01-01

    Objective. To provide information on the value of Patient Acceptable Symptom State (PASS) in rheumatoid arthritis (RA) by the identification of PASS thresholds for patient-reported outcomes (PROs) composite scores. Methods. The characteristics of RA patients with affirmative and negative assignment to PASS were compared. Contributors to physician response were estimated by logistic regression models and PASS thresholds by the 75th percentile and receiver-operating characteristic (ROC) curve methods. Results. 303 RA patients completed the study. All PROs were different between the PASS (+) and PASS (−) groups (p < 0.0001). The thresholds with the 75th percentile approach were 2.0 for the RA Impact of Disease (RAID) score, 2.5 for the PRO-CLinical ARthritis Activity (PRO-CLARA) index, and 1.0 for the Recent-Onset Arthritis Disability (ROAD) questionnaire. The cut-off values for Clinical Disease Activity Index (CDAI) were in the moderate range of disease activity. Assessing the size of the logistic regression coefficients, the strongest predictors of PASS were the disease activity (p = 0.0007) and functional state level (0.006). Conclusion. PASS thresholds were relatively high and many patients in PASS had moderate disease activity states according to CDAI. Factors such as disease activity and physical function may influence a negative PASS. PMID:26167506

  6. Acceptance and commitment therapy (ACT): the foundation of the therapeutic model and an overview of its contribution to the treatment of patients with chronic physical diseases.

    PubMed

    Prevedini, Anna Bianca; Presti, Giovambattista; Rabitti, Elisa; Miselli, Giovanni; Moderato, Paolo

    2011-01-01

    Nowadays, treatment of chronic illnesses, such as stroke, cancer, chronic heart and respiratory diseases, osteoarthritis, diabetes, and so forth, account for the largest part of expenses in western countries national health systems. Moreover, these diseases are by far the leading causes of mortality in the world, representing 60% of all deaths. Any treatment aimed at targeting them might engage an individual for a large portion of his/her life so that personal and environmental factors can play a crucial role in modulating the person's quality of life and functioning, on top of any medical cure. Anxiety, depression, and distress for examples are not rare in patients with chronic diseases. Therefore, Cognitive and Behavior Therapy research has largely contributed in the last decades in identifying and programming interventions on such aspects as real and perceived social and family support, coping abilities, locus of control, self-efficacy that might help patients living with their chronic disease. More recently, third generation Cognitive-Behavior-Therapies, such as Dialectical Behavioral Therapy (DBT), Mindfulness Based Cognitive Therapy (MBCT), Functional Analytic Psychotherapy (FAP) and Acceptance, and Commitment Therapy (ACT) focused their attention and research efforts on developing intervention models targeting the needs of patients with a chronic disease. This paper has three aims. First is to briefly introduce ACT epistemological (Functional Contextualism) and theoretical (Relational Frame Theory) foundations as a stand point for understanding the peculiarity of ACT as a modern form of Clinical Behavior Analysis. The second aim is to introduce ACT clinical model and its six core processes (acceptance, defusion, present moment, self as a context, values and committed action) as both accountable, in their continuum, for psychological flexibility and inflexibility. Third, to present a brief overview of studies and outcomes of ACT intervention protocols and

  7. Efficacy, safety, and patient acceptability of elvitegravir/cobicistat/emtricitabine/tenofovir in the treatment of HIV/AIDS.

    PubMed

    Prinapori, Roberta; Di Biagio, Antonio

    2015-01-01

    The fixed-dose combination (FDC) elvitegravir/cobicistat/emtricitabine/tenofovir (EVG/c/FTC/TDF) is a once-daily, single-tablet regimen containing an integrase strand transfer inhibitor and a pharmacoenhancer (cobicistat) associated with two nucleos(t)ide reverse transcriptase inhibitors. It is approved as the preferred regimen and as the first-line combined antiretroviral therapy in treatment-naïve patients with HIV infection. Two large trials, 102-Study and 103-Study, demonstrated that EVG/c/FTC/TDF was not inferior to efavirenz/FTC/TDF and ritonavir-boosted atazanavir in association with FTC/TDF, in terms of virological suppression and immunological reconstitution through week 144. Also, simplification arms containing EVG/c/FTC/TDF reached noninferiority in comparison with a nonnucleoside reverse transcriptase inhibitor, or a protease inhibitor, or a raltegravir-based regimen. Furthermore, EVG/c/FTC/TDF exhibited an excellent tolerability profile, with a safer lipid profile, and despite the indication of its use in subjects with an estimated creatinine clearance >70 mL/min, recent data demonstrated that EVG/c/FTC/TDF determined a reduction in estimated glomerular filtration rate (GFR) but not a reduction of actual GFR. Moreover, in a cohort of naïve patients with pretreatment mild-to-moderate renal impairment, GFR decrease was noted as early at week 2, after which it generally stabilized and was nonprogressive through week 48. The FDC's efficacy and good tolerability enable EVG/c/FTC/TDF to meet the patients' needs, improving adherence and quality of life, which are among the most important factors affecting the therapeutic efficacy of an antiretroviral regimen. This paper describes the evidence making EVG/c/FTC/TDF a new therapeutic opportunity for different HIV-infected patients. PMID:26345643

  8. Acceptance speech.

    PubMed

    Carpenter, M

    1994-01-01

    In Bangladesh, the assistant administrator of USAID gave an acceptance speech at an awards ceremony on the occasion of the 25th anniversary of oral rehydration solution (ORS). The ceremony celebrated the key role of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) in the discovery of ORS. Its research activities over the last 25 years have brought ORS to every village in the world, preventing more than a million deaths each year. ORS is the most important medical advance of the 20th century. It is affordable and client-oriented, a true appropriate technology. USAID has provided more than US$ 40 million to ICDDR,B for diarrheal disease and measles research, urban and rural applied family planning and maternal and child health research, and vaccine development. ICDDR,B began as the relatively small Cholera Research Laboratory and has grown into an acclaimed international center for health, family planning, and population research. It leads the world in diarrheal disease research. ICDDR,B is the leading center for applied health research in South Asia. It trains public health specialists from around the world. The government of Bangladesh and the international donor community have actively joined in support of ICDDR,B. The government applies the results of ICDDR,B research to its programs to improve the health and well-being of Bangladeshis. ICDDR,B now also studies acute respiratory diseases and measles. Population and health comprise 1 of USAID's 4 strategic priorities, the others being economic growth, environment, and democracy, USAID promotes people's participation in these 4 areas and in the design and implementation of development projects. USAID is committed to the use and improvement of ORS and to complementary strategies that further reduce diarrhea-related deaths. Continued collaboration with a strong user perspective and integrated services will lead to sustainable development. PMID:12345470

  9. Acceptance speech.

    PubMed

    Yusuf, C K

    1994-01-01

    I am proud and honored to accept this award on behalf of the Government of Bangladesh, and the millions of Bangladeshi children saved by oral rehydration solution. The Government of Bangladesh is grateful for this recognition of its commitment to international health and population research and cost-effective health care for all. The Government of Bangladesh has already made remarkable strides forward in the health and population sector, and this was recognized in UNICEF's 1993 "State of the World's Children". The national contraceptive prevalence rate, at 40%, is higher than that of many developed countries. It is appropriate that Bangladesh, where ORS was discovered, has the largest ORS production capacity in the world. It was remarkable that after the devastating cyclone in 1991, the country was able to produce enough ORS to meet the needs and remain self-sufficient. Similarly, Bangladesh has one of the most effective, flexible and efficient control of diarrheal disease and epidemic response program in the world. Through the country, doctors have been trained in diarrheal disease management, and stores of ORS are maintained ready for any outbreak. Despite grim predictions after the 1991 cyclone and the 1993 floods, relatively few people died from diarrheal disease. This is indicative of the strength of the national program. I want to take this opportunity to acknowledge the contribution of ICDDR, B and the important role it plays in supporting the Government's efforts in the health and population sector. The partnership between the Government of Bangladesh and ICDDR, B has already borne great fruit, and I hope and believe that it will continue to do so for many years in the future. Thank you. PMID:12345479

  10. Enzyme Reactions and Acceptability of Plant Foods.

    ERIC Educational Resources Information Center

    Palmer, James K.

    1984-01-01

    Provides an overview of enzyme reactions which contribute to the character and acceptability of plant foods. A detailed discussion of polyphenoloxidase is also provided as an example of an enzyme which can markedly affect the character and acceptability of such foods. (JN)

  11. Efficacy, safety, and patient acceptability of elvitegravir/cobicistat/emtricitabine/tenofovir in the treatment of HIV/AIDS

    PubMed Central

    Prinapori, Roberta; Di Biagio, Antonio

    2015-01-01

    The fixed-dose combination (FDC) elvitegravir/cobicistat/emtricitabine/tenofovir (EVG/c/FTC/TDF) is a once-daily, single-tablet regimen containing an integrase strand transfer inhibitor and a pharmacoenhancer (cobicistat) associated with two nucleos(t)ide reverse transcriptase inhibitors. It is approved as the preferred regimen and as the first-line combined antiretroviral therapy in treatment-naïve patients with HIV infection. Two large trials, 102-Study and 103-Study, demonstrated that EVG/c/FTC/TDF was not inferior to efavirenz/FTC/TDF and ritonavir-boosted atazanavir in association with FTC/TDF, in terms of virological suppression and immunological reconstitution through week 144. Also, simplification arms containing EVG/c/FTC/TDF reached noninferiority in comparison with a nonnucleoside reverse transcriptase inhibitor, or a protease inhibitor, or a raltegravir-based regimen. Furthermore, EVG/c/FTC/TDF exhibited an excellent tolerability profile, with a safer lipid profile, and despite the indication of its use in subjects with an estimated creatinine clearance >70 mL/min, recent data demonstrated that EVG/c/FTC/TDF determined a reduction in estimated glomerular filtration rate (GFR) but not a reduction of actual GFR. Moreover, in a cohort of naïve patients with pretreatment mild-to-moderate renal impairment, GFR decrease was noted as early at week 2, after which it generally stabilized and was nonprogressive through week 48. The FDC’s efficacy and good tolerability enable EVG/c/FTC/TDF to meet the patients’ needs, improving adherence and quality of life, which are among the most important factors affecting the therapeutic efficacy of an antiretroviral regimen. This paper describes the evidence making EVG/c/FTC/TDF a new therapeutic opportunity for different HIV-infected patients. PMID:26345643

  12. A technology-enabled adherence enhancement system for people with bipolar disorder: results from a feasibility and patient acceptance analysis

    PubMed Central

    Sajatovic, Martha; Davis, Michael S; Cassidy, Kristin A; Nestor, Joseph; Sams, Johnny; Fuentes-Casiano, Edna

    2015-01-01

    Objective As poor medication adherence is common in bipolar disorder (BD), technology-assisted approaches may help to monitor and enhance adherence. This study evaluated preliminary feasibility, patient satisfaction and effects on adherence, BD knowledge, and BD symptoms associated with the use of a multicomponent technology-assisted adherence enhancement system. Methods This prospective study tested the system in five BD patients over a 15-day period. System components included: 1) an automated pill cap with remote monitoring sensor; 2) a multimedia adherence enhancement program; and 3) a treatment incentive program. This study evaluated system usability, patient satisfaction and effects on adherence (Morisky scale), knowledge (treatment knowledge test [TKT]), and symptoms (internal state scale [ISS]). Results Mean age of the sample was 62 years, 4/5 (80%) Caucasian, and 4/5 (80%) single/divorced or widowed. Most participants (4/5, 80%) were on a single BD medication. Participants had BD for an average of 21 years. Challenges included attaching the pill sensor to standard pharmacy bottles for individuals using very large pill containers or those with multiday pill boxes. Three of five (60%) individuals completed the full 15-day period. Usability scores were high overall. Mean Morisky scores improved. Means on all four subscales of the ISS were all in the direction of improvement. On the TKT, there was a 40% increase in mean scores. Conclusion A multicomponent technology-assisted BD adherence enhancement system is feasible. Challenges include accommodating multiple types of pill containers and monitoring multiple drugs simultaneously. The system can also generate adherence information that is potentially useful for treatment planning. PMID:26089652

  13. GCF Mark IV development

    NASA Technical Reports Server (NTRS)

    Mortensen, L. O.

    1982-01-01

    The Mark IV ground communication facility (GCF) as it is implemented to support the network consolidation program is reviewed. Changes in the GCF are made in the area of increased capacity. Common carrier circuits are the medium for data transfer. The message multiplexing in the Mark IV era differs from the Mark III era, in that all multiplexing is done in a GCF computer under GCF software control, which is similar to the multiplexing currently done in the high speed data subsystem.

  14. 'The waiting game': are current chlamydia and gonorrhoea near-patient/point-of-care tests acceptable to service users and will they impact on treatment?

    PubMed

    Atkinson, Lindsay M; Vijeratnam, Dayan; Mani, Reena; Patel, Raj

    2016-07-01

    The objective of this study was to assess the length of time service users were prepared to wait for chlamydia and gonorrhoea (CT/GC) near-patient/point-of-care test (NP-POCT) results and to determine the possible effect on management. Individuals attending two UK clinics from November 2013 to February 2014 were surveyed asking the maximum length of time they would wait for CT/GC NP-POCT results after consultation. Linked CT/GC prevalence and treatment rates were analysed. A total of 1817 participants were surveyed, and 1356 provided CT/GC NAAT samples, in which it was found that 115 (8.5%) could wait over 90 minutes in clinic for their result. 115 received treatment at consultation, of which 50 were CT/GC negative and 12 were treated for urethritis or cervicitis; 38 attended as CT/GC contacts. Six of this population would have waited over 90 minutes were NP-POCTs available. A total of 129 tested CT/GC positive, of whom 65 were treated at their consultation, 61 at a later date, and three were untreated. Twelve of these 129 patients would also have waited over 90 minutes for a NP-POCT result. We conclude that 90-minute NP-POCTs are not acceptable to most clinic attendees and would not have impacted on treatment rates or inappropriate prescribing, and 20-minute NP-POCTs show a marginal benefit in treating CT/GC. While NP-POCTs for CT/GC are promising, they must meet client expectations and enhance disease management in order to be accepted by patients and clinicians. PMID:26092579

  15. Comparison of the antibacterial efficacy and acceptability of an alcohol-based hand rinse with two alcohol-based hand gels during routine patient care.

    PubMed

    Barbut, Frédéric; Maury, Eric; Goldwirt, Laurianne; Boëlle, Piérre-Yves; Neyme, Denis; Aman, Rubina; Rossi, Beatrice; Offenstadt, Georges

    2007-06-01

    The aims of this study were to compare the antibacterial efficacy of handrubbing with an alcoholic rinse (AHRR) and two different alcoholic gels (AHRG) in reducing hand contamination under practical use conditions. We wanted to assess the acceptability of the three products and to determine the effect of each product on overall hand hygiene compliance. A prospective alternating time-series clinical trial was performed in a medical intensive care unit. The study was divided into three six-week periods (P1, P2, P3). Handrubbing was achieved with Sterillium rinse (AHRR) during P1, sterillium gel(AHRG-1) during P2 and Manugel Plus (AHRG-2) during P3. Pre- and post-rubbing hand contaminations were assessed immediately after a direct contact with a patient, using the glove juice technique. Health care workers (HCWs) evaluated the acceptability of the products through a self-administered anonymous questionnaire. Compliance of HCWs with hand hygiene was assessed during the three periods. We studied 242 handrubbing opportunities. The mean reduction factor (expressed as the Log(10) CFU/mL) of the AHRR, AHRG-1 and AHRG-2 were 1.28+/-0.95, 1.29+/-0.84 and 0.51+/-0.73, respectively (p<0.001). Assessment of the three products by HCWs indicated that AHRR and AHRG-1 were significantly better accepted than AHRG-2. The overall compliance of HCWs to hand hygiene was better when gel was available. Under practical use conditions, AHRG-1 and AHRR were more effective than AHRG-2, although all were claimed to pass the European standard EN1500. In vivo trials are essential to compare the antimicrobial efficacy of products for handrubbing. PMID:17513011

  16. Acceptability of Mobile Phone Technology for Medication Adherence Interventions among HIV-Positive Patients at an Urban Clinic

    PubMed Central

    Miller, Christopher W. T.; Himelhoch, Seth

    2013-01-01

    Mobile phone technology is increasingly used to overcome traditional barriers limiting access to care. The goal of this study was to evaluate access and willingness to use smart and mobile phone technology for promoting adherence among people attending an urban HIV clinic. One hundred consecutive HIV-positive patients attending an urban HIV outpatient clinic were surveyed. The questionnaire evaluated access to and utilization of mobile phones and willingness to use them to enhance adherence to HIV medication. The survey also included the CASE adherence index as a measure of adherence. The average age was 46.4 (SD = 9.2). The majority of participants were males (63%), black (93%), and Hispanic (11.4%) and reported earning less than $10,000 per year (67.3%). Most identified themselves as being current smokers (57%). The vast majority reported currently taking HAART (83.5%). Approximately half of the participants reported some difficulty with adherence (CASE < 10). Ninety-six percent reported owning a mobile phone. Among owners of mobile phones 47.4% reported currently owning more than one device. Over a quarter reported owning a smartphone. About 60% used their phones for texting and 1/3 used their phone to search the Internet. Nearly 70% reported that they would use a mobile device to help with HIV adherence. Those who reported being very likely or likely to use a mobile device to improve adherence were significantly more likely to use their phone daily (P = 0.03) and use their phone for text messages (P = 0.002). The vast majority of patients in an urban HIV clinic own mobile phones and would use them to enhance adherence interventions to HIV medication. PMID:23997948

  17. Marking as Judgment

    ERIC Educational Resources Information Center

    Brooks, Val

    2012-01-01

    An aspect of assessment which has received little attention compared with perennial concerns, such as standards or reliability, is the role of judgment in marking. This paper explores marking as an act of judgment, paying particular attention to the nature of judgment and the processes involved. It brings together studies which have explored…

  18. Safety, efficacy, actions, and patient acceptability of drospirenone/ethinyl estradiol contraceptive pills in the treatment of premenstrual dysphoric disorder.

    PubMed

    Breech, Lesley L; Braverman, Paula K

    2010-01-01

    Premenstrual dysphoric disorder (PMDD) is estimated to affect 3%-8% of reproductive age women. Multiple therapeutic modalities have been evaluated with varying efficacy for the associated somatic and mood symptoms. The majority of older studies had shown that oral contraceptive pills (OCs) were most effective for the physical symptoms. However, newer OCs containing a novel progestin, drospirenone, have shown promise in alleviating both the somatic and affective/behavioral symptoms. This progestin, which is a derivative of spironolactone, has both antimineralocorticoid and antiandrogenic activity. A 24/4 formulation containing 20 μg of ethinyl estradiol has been found effective in randomized double-blind placebo-controlled trials utilizing established scales documenting symptoms associated with PMDD. Multiple studies have shown that drospirenone-containing OCs are safe without evidence of clinically adverse effects on carbohydrate metabolism, lipids, blood pressure, weight, serum potassium or increased thrombotic events compared to other low dose OCs. In addition, significant improvements have been demonstrated in acne, hirsutism, and fluid retention symptoms. Several open label studies demonstrated good patient compliance and reported satisfaction with the method. Because of the significant placebo effect demonstrated in the blinded placebo-controlled trials, additional large randomized placebo-controlled trials are needed to confirm the efficacy of the drospirenone OCs in the treatment of PMDD. However, this OC formulation appears to be a promising therapeutic modality. PMID:21072278

  19. Safety, efficacy, actions, and patient acceptability of drospirenone/ethinyl estradiol contraceptive pills in the treatment of premenstrual dysphoric disorder

    PubMed Central

    Breech, Lesley L; Braverman, Paula K

    2010-01-01

    Premenstrual dysphoric disorder (PMDD) is estimated to affect 3%–8% of reproductive age women. Multiple therapeutic modalities have been evaluated with varying efficacy for the associated somatic and mood symptoms. The majority of older studies had shown that oral contraceptive pills (OCs) were most effective for the physical symptoms. However, newer OCs containing a novel progestin, drospirenone, have shown promise in alleviating both the somatic and affective/behavioral symptoms. This progestin, which is a derivative of spironolactone, has both antimineralocorticoid and antiandrogenic activity. A 24/4 formulation containing 20 μg of ethinyl estradiol has been found effective in randomized double-blind placebo-controlled trials utilizing established scales documenting symptoms associated with PMDD. Multiple studies have shown that drospirenone-containing OCs are safe without evidence of clinically adverse effects on carbohydrate metabolism, lipids, blood pressure, weight, serum potassium or increased thrombotic events compared to other low dose OCs. In addition, significant improvements have been demonstrated in acne, hirsutism, and fluid retention symptoms. Several open label studies demonstrated good patient compliance and reported satisfaction with the method. Because of the significant placebo effect demonstrated in the blinded placebo-controlled trials, additional large randomized placebo-controlled trials are needed to confirm the efficacy of the drospirenone OCs in the treatment of PMDD. However, this OC formulation appears to be a promising therapeutic modality. PMID:21072278

  20. Development and initial validation of the Cardiovascular Disease Acceptance and Action Questionnaire (CVD-AAQ) in an Italian sample of cardiac patients

    PubMed Central

    Spatola, Chiara A. M.; Cappella, Emanuele A. M.; Goodwin, Christina L.; Baruffi, Matteo; Malfatto, Gabriella; Facchini, Mario; Castelnuovo, Gianluca; Manzoni, Gian Mauro; Molinari, Enrico

    2014-01-01

    Psychological inflexibility refers to the attempt to decrease internal distress even when doing so is inconsistent with life values, and has been identified as a potential barrier to making and maintaining health behavior changes that are consistent with a heart-healthy lifestyle. Disease- and behavior-specific measures of psychological inflexibility have been developed and utilized in treatment research. However, no specific measure has been created for patients with heart disease. Thus, the CardioVascular Disease Acceptance and Action Questionnaire (CVD-AAQ) was developed. The present study is aimed to evaluate the psychometric properties of the CVD-AAQ and to explore its association with measures of psychological adjustment and cardiovascular risk factors in an Italian sample of 275 cardiac patients. Exploratory factor analysis showed a structural one-factor solution with satisfactory internal consistency and test–retest reliability. The relation with other measures was in the expected direction with stronger correlations for the theoretically consistent variables, supporting convergent and divergent validity. CVD-AAQ scores were associated with general psychological inflexibility, anxiety and depression and inversely correlated with psychological well-being. Moreover, the results showed that CVD-AAQ scores are associated with two relevant risk factors for cardiac patients, namely low adherence to medication and being overweight. In sum, results suggest that the CVD-AAQ is a reliable and valid measure of heart disease-specific psychological inflexibility with interesting clinical applications for secondary prevention care. PMID:25452737

  1. 46 CFR 108.661 - Unit markings: Draft marks.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Unit markings: Draft marks. 108.661 Section 108.661... AND EQUIPMENT Equipment Markings and Instructions § 108.661 Unit markings: Draft marks. (a) Each unit must have draft marks for each foot of immersion— (1) If the unit is a surface unit, on both the...

  2. 46 CFR 108.661 - Unit markings: Draft marks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Unit markings: Draft marks. 108.661 Section 108.661... AND EQUIPMENT Equipment Markings and Instructions § 108.661 Unit markings: Draft marks. (a) Each unit must have draft marks for each foot of immersion— (1) If the unit is a surface unit, on both the...

  3. 46 CFR 108.661 - Unit markings: Draft marks.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Unit markings: Draft marks. 108.661 Section 108.661... AND EQUIPMENT Equipment Markings and Instructions § 108.661 Unit markings: Draft marks. (a) Each unit must have draft marks for each foot of immersion— (1) If the unit is a surface unit, on both the...

  4. 46 CFR 108.661 - Unit markings: Draft marks.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Unit markings: Draft marks. 108.661 Section 108.661... AND EQUIPMENT Equipment Markings and Instructions § 108.661 Unit markings: Draft marks. (a) Each unit must have draft marks for each foot of immersion— (1) If the unit is a surface unit, on both the...

  5. 46 CFR 108.661 - Unit markings: Draft marks.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Unit markings: Draft marks. 108.661 Section 108.661... AND EQUIPMENT Equipment Markings and Instructions § 108.661 Unit markings: Draft marks. (a) Each unit must have draft marks for each foot of immersion— (1) If the unit is a surface unit, on both the...

  6. Evaluation of safety and patient subjective efficacy of using radiofrequency and pulsed magnetic fields for the treatment of striae (stretch marks).

    PubMed

    Dover, Jeffrey S; Rothaus, Kenneth; Gold, Michael H

    2014-09-01

    Stretch marks are common skin disorders that are dermal scars with associated epidermal atrophy. They are of significant concern or psychological concern to many. This manuscript describes the use of multipolar radiofrequency with pulsed magnetic fields that was successfully used to diminish these lesions in 16 subjects undergoing a series of treatments. The improvements noted were statistically significant and no serious adverse events were noted. PMID:25276274

  7. Evaluation of Safety and Patient Subjective Efficacy of Using Radiofrequency and Pulsed Magnetic Fields for the Treatment of Striae (Stretch Marks)

    PubMed Central

    Dover, Jeffrey S.; Rothaus, Kenneth

    2014-01-01

    Stretch marks are common skin disorders that are dermal scars with associated epidermal atrophy. They are of significant concern or psychological concern to many. This manuscript describes the use of multipolar radiofrequency with pulsed magnetic fields that was successfully used to diminish these lesions in 16 subjects undergoing a series of treatments. The improvements noted were statistically significant and no serious adverse events were noted. PMID:25276274

  8. Ames Fellows Award - Mark

    NASA Video Gallery

    Dr. Hans Mark is a leading expert in the fields of aerospace design and national defense policy. From 1969 to 1977, he served as Director of the NASA Ames Research Center. During his tenure, Ames b...

  9. Part Marking and Identification Materials' for MISSE

    NASA Technical Reports Server (NTRS)

    Roxby, Donald; Finckenor, Miria M.

    2008-01-01

    The Materials on International Space Station Experiment (MISSE) is being conducted with funding from NASA and the U.S. Department of Defense, in order to evaluate candidate materials and processes for flight hardware. MISSE modules include test specimens used to validate NASA technical standards for part markings exposed to harsh environments in low-Earth orbit and space, including: atomic oxygen, ultraviolet radiation, thermal vacuum cycling, and meteoroid and orbital debris impact. Marked test specimens are evaluated and then mounted in a passive experiment container (PEC) that is affixed to an exterior surface on the International Space Station (ISS). They are exposed to atomic oxygen and/or ultraviolet radiation for a year or more before being retrieved and reevaluated. Criteria include percent contrast, axial uniformity, print growth, error correction, and overall grade. MISSE 1 and 2 (2001-2005), MISSE 3 and 4 (2006-2007), and MISSE 5 (2005-2006) have been completed to date. Acceptable results were found for test specimens marked with Data Matrix(TradeMark) symbols by Intermec Inc. and Robotic Vision Systems Inc using: laser bonding, vacuum arc vapor deposition, gas assisted laser etch, chemical etch, mechanical dot peening, laser shot peening, laser etching, and laser induced surface improvement. MISSE 6 (2008-2009) is exposing specimens marked by DataLase(Registed TradeMark), Chemico technologies Inc., Intermec Inc., and tesa with laser-markable paint, nanocode tags, DataLase and tesa laser markings, and anodized metal labels.

  10. Is chronic hypoxemia in patients with chronic obstructive pulmonary disease associated with more marked nutritional deficiency? A study of the fat-free mass evaluated by anthropometry and bioelectrical impedance methods.

    PubMed

    Godoy, I; Castro E Silva, M H; Togashi, R H; Geraldo, R R; Campana, A O

    2000-01-01

    In order to determine wheter blood gases abnormalities, specially hypoxemia, are associated with more marked changes in fat-free mass in patients with chronic obstructive pulmonary disease (CPOD), nutritional assessment was performed on 16 normoxemic (PaO2 > 55 mm Hg) and 16 hypoxemic (PaO2 < 55 mm Hg) COPD patients in stable clinical condition. Body weight was expressed as percentage of the ideal body weight. Fat-free mass was estimated by anthropometry (FFM-Anthr) and by bioelectrical impedance (FFM-BI). Handgrip-strength was assessed as a measure of peripheral skeletal muscle strength. Patients were age-matched and presented similar degree of airway obstruction. Malnutrition, defined as body weight less than 90% of the ideal, was observed in 19% of the normoxemic patients and in 25% of the hypoxemic patients (p>0,05). FFM values in hypoxemic patients, estimated by both methods, were not different from those observed in normoxemic patients. No significant difference was observed on handgrip values between the two groups. No correlation was found between nutritional indices and pulmonary function and gases exchange parameters. FFM correlated positively with values of peripheral muscle function in normoxemic and hypoxemic patients. These data add further evidence to the hypothesis that hypoxemia is not a primary cause of the nutritional deficiency observed in COPD patients. PMID:10842422

  11. Review of dutasteride/tamsulosin fixed-dose combination for the treatment of benign prostatic hyperplasia: efficacy, safety, and patient acceptability

    PubMed Central

    Barkin, Jack

    2011-01-01

    Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) will usually affect older men, of whom 50% over the age 60 years and almost 90% in their nineties will be bothered enough by their symptoms that they request some type of treatment. However, symptomatic bother may also affect men in their forties with a prevalence rate of almost 18%. The International Prostate Symptom Score (IPSS) has become the most widely used and best validated questionnaire to allow the patient to quantify the severity of his LUTS/BPH symptoms. This score has become the cornerstone in demonstrating the “rate of symptom response” for the patient who has been exposed to any type BPH management. Question 8 on the IPSS score is what is defined as the “Quality of Life” question or what is also termed the “Bothersome Index.” The score out of 6 as declared by the patient will reflect the degree of concern that the patient is feeling about his symptoms and the reduction of the score after treatment is a statement of their improved quality of life. There are 2 families of accepted medical therapy to treat the symptoms of BPH and potentially prevent the most worrisome long-term sequelae of progression of BPH: urinary retention or the need for surgery. When defining the impact of the main types of medical therapy, the alpha blockers have been termed the “openers” and the 5 alpha-reductase inhibitors are described as the “shrinkers.” Since they each offer a different mechanism of effect, the concept of combination therapy was raised and trialed many times over recent years. The final aspect of any medical therapy is the patient’s satisfaction with the treatment and the side effects. In the CombAT (Combination of Avodart and Tamsulosin) trial a new assessment was developed and tested called the Patient’s Perception of Study Medication (PPSM) which told the investigators if the patients, given free choice, would choose to take that combination of

  12. Meetings with Mark Vishik

    NASA Astrophysics Data System (ADS)

    Kalikinskaya, E. I.

    2014-12-01

    Mark Iosifovich Vishik was my husband Vladimir Chepyzhov's advisor during his years as a student in the Faculty of Mechanics and Mathematics at Moscow State University, and afterwards they worked together for almost 30 years. This is why I knew him personally while not being a mathematician myself: we sometimes talked on the phone, and met during common trips and a few holidays. In his last years, after the death of his devoted wife who was also his best friend, my husband and I decided to visit Mark regularly in order to comfort him in his loneliness, and many other of his friends did the same. I can say without exaggeration that Mark loved to talk with me about everyday matters, to reminisce about his wife Asya Moiseevna, their friends and relatives, to tell stories of his youth and the wonderful encounters that had so enriched his life. We had the idea to write down our conversations and publish them as a book. Unfortunately, few such conversations lay ahead. The last one took place in January 2010. We did not write a book, but we did write an article [1], which was published in English in the form of an interview with Mark. The present article is based on our conversations with Mark. Here I will try to recount his memories about people who played an important role in his life.

  13. UID.. .Now That's Gonna Leave A Mark

    NASA Technical Reports Server (NTRS)

    Schramm, Fred

    2006-01-01

    Since 1975 bar codes on products at the retail counter have been accepted as the standard for entering product identity for price determination. Since the beginning of the 21st century, the Data Matrix symbol has become accepted as the bar code format that is marked directly on a part, assembly or product that is durable enough to identify that item for its lifetime. NASA began the studies for direct part marking Data Matrix symbols on parts during the Return to Flight activities after the Challenger Accident. Over the 20 year period that has elapsed since Challenger, a mountain of studies, analyses and focused problem solutions developed by and for NASA have brought about world changing results. NASA Technical Standard 6002 and NASA Handbook 6003 for Direct Part Marking Data Matrix Symbols on Aerospace Parts have formed the basis for most other standards on part marking internationally. NASA and its commercial partners have developed numerous products and methods that addressed the difficulties of collecting part identification in aerospace operations. These products enabled the marking of Data Matrix symbols in virtually every situation and the reading of symbols at great distances, severe angles, under paint and in the dark without a light. Even unmarkable delicate parts now have a process to apply a chemical mixture, recently trademarked as Nanocodes, that can be converted to Data Matrix information through software. The accompanying intellectual property is protected by ten patents, several of which are licensed. Direct marking Data Matrix on NASA parts dramatically decreases data entry errors and the number of parts that go through their life cycle marked, two major threats to sound configuration management and flight safety. NASA is said to only have people and stuff with information connecting them. Data Matrix is one of the most significant improvements since Challenger to the safety and reliability of that connection.

  14. Aircraft vortex marking program

    NASA Technical Reports Server (NTRS)

    Pompa, M. F.

    1979-01-01

    A simple, reliable device for identifying atmospheric vortices, principally as generated by in-flight aircraft and with emphasis on the use of nonpolluting aerosols for marking by injection into such vortex (-ices) is presented. The refractive index and droplet size were determined from an analysis of aerosol optical and transport properties as the most significant parameters in effecting vortex optimum light scattering (for visual sighting) and visual persistency of at least 300 sec. The analysis also showed that a steam-ejected tetraethylene glycol aerosol with droplet size near 1 micron and refractive index of approximately 1.45 could be a promising candidate for vortex marking. A marking aerosol was successfully generated with the steam-tetraethylene glycol mixture from breadboard system hardware. A compact 25 lb/f thrust (nominal) H2O2 rocket chamber was the key component of the system which produced the required steam by catalytic decomposition of the supplied H2O2.

  15. The PCB mark

    SciTech Connect

    1994-12-01

    Polychlorinated biphenyls (PCBs) are a class of organic chemicals that had become widely used in industrial applications due to their practical physical and chemical properties. Historical uses of PCBs include dielectric fluids (used in utility transformers, capacitors, etc.), hydraulic fluids, and other applications requiring stable, fire-retardant materials. Due to findings that PCBs may cause adverse health effects and due to their persistence and accumulation in the environment. The Toxic Substances Control Act (TSCA), enacted on October 11, 1976, banned the manufacture of PCBs after 1978 [Section 6(e)]. The first PCB regulations, promulgated at 40 CFR Part 761, were finalized on February 17, 1978. These PCB regulations include requirements specifying disposal methods and marking (labeling) procedures, and controlling PCB use. To assist the Department of Energy (DOE) in its efforts to comply with the TSCA statute and implementing regulations, the Office of Environmental Guidance has prepared the document ``Guidance on the Management of Polychlorinated Biphenyls (PCBs).`` That document explains the requirements specified in the statute and regulations for managing PCBs including PCB use, storage, transport, and disposal. The requirements outlined at 40 CFR 761.40 through 761.45 specify marking requirements for most PCB items (i.e., any PCB Article, PCB Container, PCB Article Container, or PCB Equipment that contains PCBs). Most PCB items require PCB marks, which are defined as a descriptive name, instructions, cautions, or other information applied to PCB Items or other objects subject to these regulations. The marking regulations include requirements for PCB marks on PCB Items, storage areas, and temporary storage areas. This Information Brief supplements the PCB guidance document by responding to common questions concerning marking requirements for PCBs. It is one of a series of Information Briefs pertinent to PCB management issues.

  16. The need for dental ethicists and the promise of universal patient acceptance: response to Richard Masella's "Renewing professionalism in dental education".

    PubMed

    Patthoff, Donald E

    2007-02-01

    Richard Masella's "Renewing Professionalism in Dental Education: Overcoming the Market Environment" reveals why professionalism is nearly dead in America; it also shows the good of commerce and the excesses of commercialism in the market. More importantly, it collects and summarizes most of the relevant forms of education currently available to teach professionalism and professional ethics in dentistry; it then briefly examines whether those forms of education are used and if they are effective. Masella also asks some key challenging questions. His select and limited references lead to deeper studies about the nature and definition of professionalism and how it might be learned and presented. His suggestions for renewing professionalism are minimal; this sets the stage for proposing and selecting other ideas that need attention and development. Some of those ideas and suggestions, such as competition and collaboration, four types of dentistry, understanding two conflicting meanings of desire and need, and universal patient acceptance were recently explored in a workshop, "Professional Promises: Hopes and Gaps in Access to Oral Health Care" (procedings published in the November 2006 Journal of Dental Education), and were not yet available to Masella when his article was authored. His article, though, stimulates good discussion and action. Its data and substance show why, for example, dentistry needs to develop a core cadre of full-time practicing professional dental ethicists. Currently, there is only a small but very dedicated group of volunteers trying to meet our society's need to bring new life to professionalism in dentistry and our market. PMID:17314383

  17. Digitally Marking RSA Moduli

    SciTech Connect

    Johnston, A.M.

    2000-10-09

    The moduli used in RSA (see [5]) can be generated by many different sources. The generator of that modulus (assuming a single entity generates the modulus) knows its factorization. They would have the ability to forge signatures or break any system based on this moduli. If a moduli and the RSA parameters associated with it were generated by a reputable source, the system would have higher value than if the parameters were generated by an unknown entity. So for tracking, security, confidence and financial reasons it would be beneficial to know who the generator of the RSA modulus was. This is where digital marking comes in. An RSA modulus ia digitally marked, or digitally trade marked, if the generator and other identifying features of the modulus (such as its intended user, the version number, etc.) can be identified and possibly verified by the modulus itself. The basic concept of digitally marking an RSA modulus would be to fix the upper bits of the modulus to this tag. Thus anyone who sees the public modulus can tell who generated the modulus and who the generator believes the intended user/owner of the modulus is.

  18. Interview with Mark Ashwill

    ERIC Educational Resources Information Center

    Landsberger, Joe

    2006-01-01

    This article presents an interview with Mark Ashwill, Director of the Institute of International Education-Vietnam in Ha Noi, Vietnam, a branch of the Institute of International Education (IIE). In this interview, Ashwill talks about his work as Director of the Institute of International Education-Vietnam, the role that communications technology…

  19. Marking Advanced Essays

    ERIC Educational Resources Information Center

    Donley, Michael

    1978-01-01

    A list of points to aid essay writers is suggested as the basis of a marking system for the teacher of English as a foreign language. The checklist, obtained from a book on higher education by Ruth Beard, can be adapted to the English as a foreign language situation. (SW)

  20. Airbag bounce marks

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Looking east from the lander, the last few bounce marks as Pathfinder rolled to a stop on July 4 are visible in the soil in this image, taken by the Imager for Mars Pathfinder (IMP). The two most distant marks, identified by pointers in the image, consist of dark patches of disturbed soil. The three closest marks are clearly visible in the foreground, with one easily identifiable behind the Atmospheric Structure Instrument/Meteorology Package (ASI/MET) mast, is at right. The most distant positively identified bounce mark, indicated by the pointer at right, is approximately 11.3 meters (37 feet) from the lander.

    Mars Pathfinder is the second in NASA's Discovery program of low-cost spacecraft with highly focused science goals. The Jet Propulsion Laboratory, Pasadena, CA, developed and manages the Mars Pathfinder mission for NASA's Office of Space Science, Washington, D.C. The Imager for Mars Pathfinder (IMP) was developed by the University of Arizona Lunar and Planetary Laboratory under contract to JPL. Peter Smith is the Principal Investigator. JPL is an operating division of the California Institute of Technology (Caltech).

  1. Fathoming Mark Twain.

    ERIC Educational Resources Information Center

    Biggar, Joanna

    1988-01-01

    Relates the efforts of completing two collections of the works and papers of Mark Twain. Describes the combined efforts of the University of Iowa and the University of California to publish both a scholarly edition and a reader's edition devoted to Twain. (KO)

  2. Teaching with Mark Dion

    ERIC Educational Resources Information Center

    Fusaro, Joe

    2011-01-01

    Mark Dion creates sculptures, installations, and interactive environments that sometimes seem contrary to what one expects from visual artists. Remarkable curiosity cabinets and carefully arranged artifacts from specific places and time periods make up a large part of his work. His work does not neatly fit into traditional lessons about elements…

  3. Double Marking Revisited

    ERIC Educational Resources Information Center

    Brooks, Val

    2004-01-01

    In 2002, the Qualifications and Curriculum Authority (QCA) published the report of an independent panel of experts into maintaining standards at Advanced Level (A-Level). One of its recommendations was for: limited experimental double marking of scripts in subjects such as English to determine whether the strategy would significantly reduce errors…

  4. Neuromuscular electrical stimulation and dietary interventions to reduce oxidative stress in a secondary progressive multiple sclerosis patient leads to marked gains in function: a case report.

    PubMed

    Reese, David; Shivapour, Ezzatolah T; Wahls, Terry L; Dudley-Javoroski, Shauna D; Shields, Richard

    2009-01-01

    Neuromuscular electrical stimulation has been used to aid musculoskeletal recovery. Excessive oxidative stress and excitoxicity are implicated in secondary progressive multiple sclerosis. A 52-year-old white female with SPMS had been scooter- and cane-dependent for 4 years. She requested and received a trial of neuromuscular electrical stimulation. Two months after initiating NMES the patient adopted several nutritional interventions to lower oxidative stress and excito-toxicity. During the first 2 months of neuromuscular electrical stimulation, the therapist observed modest gait improvements. Following the addition of nutritional interventions, more rapids gains in strength and endurance, including muscle groups not receiving neuromuscular electrical stimulation were observed by both the therapist and the patient. After 8 months of neuromuscular electrical stimulation (6 months of nutritional intervention) the patient's function had improved sufficiently that she no longer used a scooter or cane and rode her bicycle routinely 8 miles, including hills. PMID:19918474

  5. Mark Twain on phrenology.

    PubMed

    Stone, James L

    2003-12-01

    Mark Twain was a noted 19th century American writer and humorist. He often elaborated upon the personalities of his characters, and his observational skills reflected a strong interest in psychology. Similarly, he found an interest in phrenology, a pseudoscience that purported to characterize personality traits according to elevations or depressions on the head. Twain's style is clearly reflected in the interesting essay he wrote regarding his personal experience with phrenology. PMID:14633308

  6. Acceptability of Couples’ Voluntary HIV Testing Among HIV-infected Patients in Care and Their HIV-negative Partners in the United States

    PubMed Central

    Wall, Kristin M.; Canary, Lauren; Workowski, Kimberly; Lockard, Annie; Jones, Jeb; Sullivan, Patrick; Hills, Katherine; Fofana, Kadija; Stephenson, Rob; Allen, Susan

    2016-01-01

    Introduction: Couples’ voluntary HIV counseling and testing (CHTC) is an HIV risk reduction strategy not widely available in the US. Methods: We assessed willingness to participate in CHTC among US HIV-infected clinic patients via tablet-based survey and among HIV-negative persons with HIV-infected partners in care via mixed-method phone interviews. Results: Most of the N=64 HIV-infected partners surveyed were men (89%), on antiretroviral treatment (ART) (92%), and many self-identified homosexual (62%). We observed high levels of willingness to participate in CHTC (64%) among HIV-infected partners. Reasons for not wanting to participate included perceived lack of need (26%), desire to self-disclose their status (26%), and fear of being asked sensitive questions with their partner present (17%). HIV-infected partners were interested in discussing ART (48%), other sexually transmitted infections (STIs) (44%), and relationship agreements like monogamy (31%) during CHTC sessions. All N=15 HIV-negative partners interviewed were men, most identified as homosexual (73%), and about half (54%) reported consistent condom use with HIV-infected partners. We observed high levels of willingness to participate in CHTC (87%) among HIV-negative partners, who were also interested in discussing ART (47%), other STIs (47%), mental health services (40%), and relationship agreements (33%). Most negative partners (93%) indicated that they believed their HIV-infected partner was virally suppressed, but in the event that they were not, many (73%) were willing to take pre-exposure prophylaxis (PrEP). Conclusion: These results indicate that CHTC for serodiscordant couples is acceptable and should emphasize aspects most pertinent to these couples, such as discussion of ART/PrEP, STIs, and relationship agreements. PMID:27014393

  7. Case Marking Strategies in Kope.

    ERIC Educational Resources Information Center

    Clifton, John

    Case marking strategies in Kope, a Papuan language of Papua New Guinea, are analyzed in light of previous claims that most Papuan languages have one strategy for marking core relations and another for marking peripheral relations. A brief grammatical overview illustrates how core and peripheral relations are marked in Kope, including nominal case…

  8. Minimal Marking: A Success Story

    ERIC Educational Resources Information Center

    McNeilly, Anne

    2014-01-01

    The minimal-marking project conducted in Ryerson's School of Journalism throughout 2012 and early 2013 resulted in significantly higher grammar scores in two first-year classes of minimally marked university students when compared to two traditionally marked classes. The "minimal-marking" concept (Haswell, 1983), which requires…

  9. Delayed radiation-induced inflammation accompanying a marked carbohydrate antigen 19-9 elevation in a patient with resected pancreatic cancer

    PubMed Central

    Mattes, Malcolm D.; Cardinal, Jon S.; Jacobson, Geraldine M.

    2016-01-01

    Although carbohydrate antigen (CA) 19-9 is a useful tumor marker for pancreatic cancer, it can also become elevated from a variety of benign and malignant conditions. Herein we describe an unusual presentation of elevated CA 19-9 in an asymptomatic patient who had previously undergone adjuvant chemotherapy and radiation therapy for resected early stage pancreatic cancer. The rise in CA 19-9 might be due to delayed radiation-induced inflammation related to previous intra-abdominal radiation therapy with or without radiation recall induced by gemcitabine. After treatment with corticosteroids the CA 19-9 level decreased to normal, and the patient has not developed any evidence of recurrent cancer to date. PMID:27306770

  10. Extended Essay Marking on Screen: Is Examiner Marking Accuracy Influenced by Marking Mode?

    ERIC Educational Resources Information Center

    Johnson, Martin; Hopkin, Rebecca; Shiell, Hannah; Bell, John F.

    2012-01-01

    In the UK and elsewhere, large-scale educational assessment agencies are shifting the mode of school examination marking towards having examiners mark examination scripts on screen rather than on paper. This shift has prompted questions about whether the mode of marking might influence examiner marking accuracy, particularly in relation to…

  11. [Transcatheter arterial chemo-embolization using degradable starch microspheres (DSM) markedly effective for post-hepatectomy intra-hepatic recurrence in a patient with cholangioma].

    PubMed

    Niinobu, T; Shibata, T; Fukushima, Y; Kitada, M; Tukahara, Y; Hata, S; Ikeda, K; Hayashida, H; Fuzita, J; Takahashi, Y; Nakamura, T; Suzuki, R; Shimano, T; Takami, M; Ishida, T

    2000-10-01

    Transcatheter arterial chemo-embolization (TACE) using degradable starch microspheres (DSM) was performed for multiple recurrence after hepatectomy in a patient with cholangiocarcinoma. The patient was a 68-year-man. He received treatment for hepatitis type C starting in 1996 at a nearby hospital. In November 1997, an increased AFP level was noted and a CT scan of the abdomen revealed an abnormal shadow in the liver. On May 21, 1998, imaging results led to the diagnosis of cholangiocarcinoma or a mixed type of hepatocellular carcinoma with cholangioma. Hepatic S7 sub-sequential resection was performed. The lesion was found to be a tumor-forming type, measuring 2.2 x 2.0 cm in diameter, diagnosed histopathologically as cholangiocarcinoma, tw (-), but Stage III since a nodule suggesting intrahepatic metastasis was noted in the cut surface of the resected liver. CT scan after a month revealed multiple metastatic lesions in the liver. TACE was performed by administering 450 mg of DSM, 10 mg of MMC and 30 mg of FARM, given in three divided doses on October 30, 1998, and February 9, 1999, according to Seldinger's method. A CT scan on January 31, 2000 revealed nearly complete remission of the hepatic SOL. Accordingly, TACE was considered to be useful therapy in combination with DSM, MMC and FARM for intrahepatic recurrence of cholangiocarcinoma. PMID:11086448

  12. Treatment adherence with the easypod™ growth hormone electronic auto-injector and patient acceptance: survey results from 824 children and their parents

    PubMed Central

    2011-01-01

    Background Accurately monitoring adherence to treatment with recombinant human growth hormone (r-hGH) enables appropriate intervention in cases of poor adherence. The electronic r-hGH auto-injector, easypod™, automatically records the patient's adherence to treatment. This study evaluated adherence to treatment of children who started using the auto-injector and assessed opinions about the device. Methods A multicentre, multinational, observational 3-month survey in which children received r-hGH as part of their normal care. Physicians reviewed the recorded dose history and children (with or without parental assistance) completed a questionnaire-based survey. Children missing ≤2 injections per month (92% of injections given) were considered adherent to treatment. Adherence was compared between GH treatment-naïve and treatment-experienced children. Results Of 834 recruited participants, 824 were evaluated. The median (range) age was 11 (1-18) years. From the recorded dose history, 87.5% of children were adherent to treatment over the 3-month period. Recorded adherence was higher in treatment-naïve (89.7%, n = 445/496) than in treatment-experienced children (81.7%, n = 152/186) [Fisher's exact test FI(X) = 7.577; p = 0.0062]. According to self-reported data, 90.2% (607/673) of children were adherent over 3 months; 51.5% (421/817) missed ≥1 injection over this period (mainly due to forgetfulness). Concordance between reported and recorded adherence was 84.3%, with a trend towards self-reported adherence being higher than recorded adherence. Most children liked the auto-injector: over 80% gave the top two responses from five options for ease of use (720/779), speed (684/805) and comfort (716/804). Although 38.5% (300/780) of children reported pain on injection, over half of children (210/363) considered the pain to be less or much less than expected. Given the choice, 91.8% (732/797) of children/parents would continue using the device. Conclusions easypod

  13. 16 CFR 1505.8 - Maximum acceptable material temperatures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Association, 155 East 44th Street, New York, NY 10017. Material Degrees C. Degrees F. Capacitors (1) (1) Class... capacitor has no marked temperature limit, the maximum acceptable temperature will be assumed to be 65...

  14. 16 CFR 1505.8 - Maximum acceptable material temperatures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Association, 155 East 44th Street, New York, NY 10017. Material Degrees C. Degrees F. Capacitors (1) (1) Class... capacitor has no marked temperature limit, the maximum acceptable temperature will be assumed to be 65...

  15. 16 CFR 1505.8 - Maximum acceptable material temperatures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Association, 155 East 44th Street, New York, NY 10017. Material Degrees C. Degrees F. Capacitors (1) (1) Class... capacitor has no marked temperature limit, the maximum acceptable temperature will be assumed to be 65...

  16. 16 CFR 1505.8 - Maximum acceptable material temperatures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Association, 155 East 44th Street, New York, NY 10017. Material Degrees C. Degrees F. Capacitors (1) (1) Class... capacitor has no marked temperature limit, the maximum acceptable temperature will be assumed to be 65...

  17. 16 CFR 1505.8 - Maximum acceptable material temperatures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Association, 155 East 44th Street, New York, NY 10017. Material Degrees C. Degrees F. Capacitors (1) (1) Class... capacitor has no marked temperature limit, the maximum acceptable temperature will be assumed to be 65...

  18. The Mark 3 Haploscope

    NASA Technical Reports Server (NTRS)

    Decker, T. A.; Williams, R. E.; Kuether, C. L.; Logar, N. D.; Wyman-Cornsweet, D.

    1975-01-01

    A computer-operated binocular vision testing device was developed as one part of a system designed for NASA to evaluate the visual function of astronauts during spaceflight. This particular device, called the Mark 3 Haploscope, employs semi-automated psychophysical test procedures to measure visual acuity, stereopsis, phoria, fixation disparity, refractive state and accommodation/convergence relationships. Test procedures are self-administered and can be used repeatedly without subject memorization. The Haploscope was designed as one module of the complete NASA Vision Testing System. However, it is capable of stand-alone operation. Moreover, the compactness and portability of the Haploscope make possible its use in a broad variety of testing environments.

  19. Does the use of Nintendo Wii Sports™ improve arm function and is it acceptable to patients after stroke? Publication of the Protocol of the Trial of Wii™ in Stroke – TWIST

    PubMed Central

    Adie, Katja; Schofield, Christine; Berrow, Margie; Wingham, Jennifer; Freeman, Janet; Humfryes, John; Pritchard, Colin

    2014-01-01

    Introduction Many stroke patients experience loss of arm function requiring rehabilitation, which is expensive, repetitive, and does not always translate into “real life.” Nintendo Wii Sports™ (Wii™) may offer task-specific training that is repetitive and motivating. The Trial of Wii™ in Stroke (TWIST) is designed to investigate feasibility, efficacy, and acceptability using Wii™ to improve affected arm function for patients after stroke. Method This is a randomized controlled trial (RCT), incorporating a qualitative study and health economics analysis that compares playing Wii™ versus arm exercises in patients receiving standard rehabilitation in a home setting within 6 months of stroke with a motor deficit of less than 5 on the MRC (Medical Research Council) scale (arm). In this study, we expect to randomize 240 participants. Outcome measures Primary outcome is change in affected arm function at 6 weeks follow-up in intervention and control group using the Action Research Arm Test. Secondary outcomes include occupational performance using the Canadian Occupational Performance Measure, quality of life using the Stroke Impact Scale, cost effectiveness analysis, and a qualitative study investigating factors that influence use of Wii™ for patients and carers. Conclusion TWIST is the first UK RCT assessing the feasibility, cost effectiveness, and acceptability of Wii™ in stroke rehabilitation. The trial has been registered with ISRCTN 06807619 and UK CRN 11030. Results of the study will be published after completion of study in August 2014. PMID:25336985

  20. ATLAS ACCEPTANCE TEST

    SciTech Connect

    J.C. COCHRANE; J.V. PARKER; ET AL

    2001-06-01

    The acceptance test program for Atlas, a 23 MJ pulsed power facility for use in the Los Alamos High Energy Density Hydrodynamics program, has been completed. Completion of this program officially releases Atlas from the construction phase and readies it for experiments. Details of the acceptance test program results and of machine capabilities for experiments will be presented.

  1. Improving Marking Quality through a Taxonomy of Mark Schemes

    ERIC Educational Resources Information Center

    Ahmed, Ayesha; Pollitt, Alastair

    2011-01-01

    At the heart of most assessments lies a set of questions, and those who write them must achieve "two" things. Not only must they ensure that each question elicits the kind of performance that shows how "good" pupils are at the subject, but they must also ensure that each mark scheme gives more marks to those who are "better" at it. We outline a…

  2. An Approach to Mark Arthropods for Mark Capture Type Research

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A series of studies were conducted to validate methods for marking a wide variety of arthropods with inexpensive proteins for mark-capture dispersal research. The markers tested included egg albumin protein in chicken egg whites and casein protein in bovine milk. The first study qualified the effec...

  3. Leaving A Mark: A Comparison Arthropod Protein Marking Protocols

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Knowledge of arthropod pest and natural enemy disperal patterns is needed for effective and environmentally benign pest control. The most common tactics used to monitor arthropod dispersal patterns include mark-release-recapture (MRR) and mark-capture methodologies. Both methods require the applica...

  4. Impact of a "TED-Style" presentation on potential patients' willingness to accept dental implant therapy: a one-group, pre-test post-test study

    PubMed Central

    Ghanem, Henry; Abi-Nader, Samer

    2015-01-01

    PURPOSE A survey was conducted to assess the impact of a TED-like educational session on participants' willingness to accept dental implant therapy. MATERIALS AND METHODS Volunteers interested in having information about dental implant therapies were recruited and asked to complete a two-part survey before and after an educational session. The initial survey elicited demographic information, self-perceived knowledge on dental implants and willingness to this kind of treatment. A "TED-style" presentation that provided information about dental implant treatments was conducted before asking the participants to complete a second set of questions assessing the impact of the session. RESULTS The survey was completed by 104 individuals, 78.8% were women and the mean age was 66.5±10.8. Before the educational session, 76.0% of the participants refused dental implants mainly due to lack of knowledge. After the educational session, the rejection of dental implants decreased by almost four folds to 20.2%. CONCLUSION This study proved that an educational intervention can significantly increase willingness to accept treatment with dental implants in a segment of the population who is interested in having information about dental implant therapy. Furthermore, educational interventions, such as TED-like talks, might be useful to increase popular awareness on dental implant therapy. PMID:26816573

  5. Assessment of Gastric Accommodation in Patients with Functional Dyspepsia by 99mTc-Pertechtenate Single Photon Emission Computed Tomography Imaging: Practical but not Widely Accepted

    PubMed Central

    Amiriani, Taghi; Javadi, Hamid; Raiatnavaz, Tahereh; Pashazadeh, Ali Mahmoud; Semnani, Shahriar; Tabib, Seyed Masoud; Assadi, Majid

    2015-01-01

    Objective: Impaired gastric accommodation is one of the main symptoms in patients with functional dyspepsia. The aim of the present study was to assess gastric accommodation in patients with functional dyspepsia using single photon emission computed tomography (SPECT) imaging. Methods: Twenty-four patients with functional dyspepsia and 50 healthy volunteers as control group were enrolled in this study. All participants were given 5 mCi 99mTc-pertechtenate intravenously, served with a low fat meal, and underwent SPECT scanning 20 minutes after the meal. Results: Based on the scintigraphic data, gastric volumes were found to be significantly increased after food ingestion in both patient and control groups. We also found that while there was no significant difference between patient and control groups in terms of fasting gastric volumes, postprandial gastric volume was significantly lower in patients as compared to healthy individuals (p<0.05). Conclusion: Measuring gastric volume by using SPECT can be a valuable method in the detection of functional dyspepsia and in differentiation of this entity from other organic disorders. PMID:27529885

  6. Characterization of overlay mark fidelity

    NASA Astrophysics Data System (ADS)

    Adel, Mike; Ghinovker, Mark; Poplawski, Jorge M.; Kassel, Elyakim; Izikson, Pavel; Pollentier, Ivan K.; Leray, Philippe; Laidler, David W.

    2003-05-01

    In this publication we introduce a new metric for process robustness of overlay metrology in microelectronic manufacturing. By straightforward statistical analysis of overlay metrology measurements on an array of adjacent, nominally identical overlay targets the Overlay Mark Fidelity (OMF) can be estimated. We present the results of such measurements and analysis on various marks, which were patterned using a DUV scanner. The same reticle set was used to pattern wafers on different process layers and process conditions. By appropriate statistical analysis, the breakdown of the total OMF into a reticle-induced OMF component and a process induced OMF component was facilitated. We compare the OMF of traditional box-in-box overlay marks with that of new gratingbased overlay marks and show that in all cases the grating marks are superior. The reticle related OMF showed an improvement of 30 % when using the new grating-based overlay mark. Furthermore, in a series of wafers run through an STI-process with different Chemical Mechanical Polish (CMP) times, the random component of the OMF of the new grating-based overlay mark was observed to be 40% lower and 50% less sensitive to process variation compared with Box in Box marks. These two observations are interpreted as improved process robustness of the grating mark over box in box, specifically in terms of reduced site by site variations and reduced wafer to wafer variations as process conditions change over time. Overlay Mark Fidelity, as defined in this publication, is a source of overlay metrology uncertainty, which is statistically independent of the standard error contributors, i.e. precision, TIS variability, and tool to tool matching. Current overlay metrology budgeting practices do not take this into consideration when calculating total measurement uncertainty (TMU). It is proposed that this be reconsidered, given the tightness of overlay and overlay metrology budgets at the 70 nm design rule node and below.

  7. Development of a Weight Loss Mobile App Linked With an Accelerometer for Use in the Clinic: Usability, Acceptability, and Early Testing of its Impact on the Patient-Doctor Relationship

    PubMed Central

    Choo, Seryung; Jung, Se Young; Kim, Sarah; Kim, Jeong Eun; Han, Jong Soo; Kim, Sohye; Kim, Jeong Hyun; Kim, Jeehye; Kim, Yongseok; Kim, Dongouk; Steinhubl, Steve

    2016-01-01

    Background Although complications of obesity are well acknowledged and managed by clinicians, management of obesity itself is often difficult, which leads to its underdiagnosis and undertreatment in hospital settings. However, tools that could improve the management of obesity, including self-monitoring, engagement with a social network, and open channels of communication between the patient and doctor, are limited in a clinic-based setting. Objective The objective of our study was to evaluate the usability and acceptability of a newly developed mobile app linked with an accelerometer and its early effects on patient-doctor relationships. Methods From September 2013 to February 2014, we developed a mobile app linked with an accelerometer as a supportive tool for a clinic-based weight loss program. The app used information from electronic health records and delivered tailored educational material. Personal goal setting, as well as monitoring of weight changes and physical activity combined with feedback, are key features of the app. We also incorporated an interactive message board for patients and doctors. During the period of March 2014 to May 2014, we tested our mobile app for 1 month in participants in a hospital clinic setting. We assessed the app’s usability and acceptability, as well as the patient-doctor relationship, via questionnaires and analysis of app usage data. Results We recruited 30 individuals (18 male and 12 female) for the study. The median number of log-ins per day was 1.21, with the most frequently requested item being setting goals, followed by track physical activities and view personal health status. Scales of the depth of the patient-doctor relationship decreased from 27.6 (SD 4.8) to 25.1 (SD 4.5) by a Wilcoxon signed rank test (P=.02). Conclusions A mobile phone app linked with an accelerometer for a clinic-based weight loss program is useful and acceptable for weight management but exhibited less favorable early effects on patient

  8. The PACT study protocol: a time series study investigating the impact, acceptability and cost of an integrated model for psychosocial screening, care and treatment of patients with urological and head and neck cancers

    PubMed Central

    Girgis, Afaf; Kelly, Brian; Boyes, Allison; Haas, Marion; Viney, Rosalie; Descallar, Joseph; Candler, Hayley; Bellamy, Douglas; Proietto, Anthony

    2014-01-01

    Introduction While there is good evidence of the effectiveness of a variety of interventions and services to prevent and/or relieve distress experienced by people affected by cancer, much of this psychosocial morbidity is undetected and untreated, with consequent exacerbated suffering, decreased satisfaction with care, impaired adherence to treatment regimens and poorer morbidity and mortality outcomes. The objective of this study is to develop, implement and assess the impact, acceptability and cost of an integrated, patient-centred Psychosocial Assessment, Care and Treatment (PACT) model of care for patients with urological and head and neck cancers. Methods and analysis A time series research design will be used to test the PACT model of care, newly introduced in an Australian tertiary hospital. The primary outcome is system-level impact, assessed through audit of patients’ medical records and Medicare claims for follow-up care. The secondary outcomes are impact of the model on patients' experience and healthcare professionals’ (HCPs) knowledge and confidence, assessed via patient and HCP surveys at baseline and at follow-up. Acceptability of the intervention will be assessed through HCP interviews at follow-up, and cost will be assessed from Medicare and Pharmaceutical Benefits Scheme claims information and information logged pertaining to intervention activities (eg, time spent by the newly appointed psycho-oncology staff in direct patient contact, providing training sessions, engaging in case review) and their associated costs (eg, salaries, training materials and videoconferencing). Ethics and dissemination Ethics approval was obtained from the Human Research Ethics Committees of Hunter New England Local Health District and the University of NSW. Results The results will be widely disseminated to the funding body and through peer-reviewed publications, HCP and consumer publications, oncology conferences and meetings. Trial registration The study is

  9. Acceptance, values, and probability.

    PubMed

    Steel, Daniel

    2015-10-01

    This essay makes a case for regarding personal probabilities used in Bayesian analyses of confirmation as objects of acceptance and rejection. That in turn entails that personal probabilities are subject to the argument from inductive risk, which aims to show non-epistemic values can legitimately influence scientific decisions about which hypotheses to accept. In a Bayesian context, the argument from inductive risk suggests that value judgments can influence decisions about which probability models to accept for likelihoods and priors. As a consequence, if the argument from inductive risk is sound, then non-epistemic values can affect not only the level of evidence deemed necessary to accept a hypothesis but also degrees of confirmation themselves. PMID:26386533

  10. Newbery Medal Acceptance.

    ERIC Educational Resources Information Center

    Freedman, Russell

    1988-01-01

    Presents the Newbery Medal acceptance speech of Russell Freedman, writer of children's nonfiction. Discusses the place of nonfiction in the world of children's literature, the evolution of children's biographies, and the author's work on "Lincoln." (ARH)

  11. Newbery Medal Acceptance.

    ERIC Educational Resources Information Center

    Cleary, Beverly

    1984-01-01

    Reprints the text of Ms. Cleary's Newbery medal acceptance speech in which she gives personal history concerning her development as a writer and her response to the letters she receives from children. (CRH)

  12. Caldecott Medal Acceptance.

    ERIC Educational Resources Information Center

    Provensen, Alice; Provensen, Martin

    1984-01-01

    Reprints the text of the Provensens' Caldecott medal acceptance speech in which they describe their early interest in libraries and literature, the collaborative aspect of their work, and their current interest in aviation. (CRH)

  13. Profile of paliperidone palmitate once-monthly long-acting injectable in the management of schizophrenia: long-term safety, efficacy, and patient acceptability – a review

    PubMed Central

    González-Rodríguez, Alexandre; Catalán, Rosa; Penadés, Rafael; Garcia-Rizo, Clemente; Bioque, Miquel; Parellada, Eduard; Bernardo, Miquel

    2015-01-01

    Background and objectives Short-term studies focused on once-monthly paliperidone palmitate (PP) at doses of 25 mg eq, 50 mg eq, 75 mg eq, 100 mg eq, or 150 mg eq have shown its efficacy and tolerability in the treatment of schizophrenia patients. However, few open-label and long-term studies are available regarding this new pharmacological formulation. Thus, our main aim was to review the scientific evidence on efficacy, safety, tolerability, and preference of PP in these populations. Method Electronic searches were conducted by using PubMed and ISI Web of Knowledge databases. All relevant studies published from 2009 until January 2015 were included without any language restriction if patients met diagnostic criteria for schizophrenia, and adequate information on efficacy, safety, and tolerability of once-monthly PP was available. Results Nineteen studies were identified irrespective of the study design and duration of the follow-up period. Randomized, double-blind, placebo-controlled trials found that schizophrenia patients receiving PP showed a significant improvement in psychotic symptoms and similar adverse events compared to placebo and suggested that all doses of PP were efficacious and well tolerated. Other studies demonstrated noninferiority of PP compared to risperidone long-acting injectable in recently diagnosed schizophrenia patients, chronically ill patients, as well as in acute and nonacute symptomatic schizophrenia patients, and a similar proportion of treatment-emergent adverse events between both groups were also noted. Conclusion Several studies have demonstrated that schizophrenia patients treated with PP show higher rates of improvement of psychotic symptoms compared to placebo, and similar efficacy and tolerability outcomes were noted when comparing PP to risperidone long-acting injectable or oral, paliperidone extended release. PMID:26082620

  14. 19 CFR 134.21 - Special marking.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... COUNTRY OF ORIGIN MARKING Marking of Containers or Holders § 134.21 Special marking. This subpart includes only country of origin marking requirements and exceptions under section 304(b), Tariff Act of 1930,...

  15. CE Marking - the Essential Requirements

    NASA Astrophysics Data System (ADS)

    Playle, Mervyn

    The European Union (EU) harmonisation project introduced the CE marking of products to enable the free, unhindered movement of goods throughout the European market. The CE mark replaced the EC mark in the mid 1990s and is fundamental to the New Approach Directives. When a product falls within the scope of a New Approach Directive the manufacturer must comply with the 'goal setting' essential requirements of the directive, to follow one of the conformity assessment procedures provided for, and to draw up the technical documentation specified. Although not mandatory, a manufacturer can choose to satisfy the essential requirements through the application of European harmonised standards.

  16. Preoperative surgical marking: a case of seeing double.

    PubMed

    Rughani, Milap; Kokkinakis, Michail; Davison, Marc

    2010-01-01

    Preoperative marking is an integral part of the care of patients undergoing surgical procedures. It occurs on a daily basis in hospitals and involves all members of the healthcare staff and the patient. Incorrect marking or errors can lead to devastating consequences for the patient and staff involved. We present an unusual case of seeing double arrows on a patient undergoing emergency orthopaedic surgery, despite standard preoperative marking procedures. This was recognised in the anaesthetic room and the correct site was confirmed. We aim to highlight this specific problem and remind all involved in preoperative marking of the dangers of a mirror imprint, thereby avoiding seeing double in the anaesthetic or operating room. PMID:22315636

  17. An integrated technique for the analysis of skin bite marks.

    PubMed

    Bernitz, Herman; Owen, Johanna H; van Heerden, Willie F P; Solheim, Tore

    2008-01-01

    The high number of murder, rape, and child abuse cases in South Africa has led to increased numbers of bite mark cases being heard in high courts. Objective analysis to match perpetrators to bite marks at crime scenes must be able to withstand vigorous cross-examination to be of value in conviction of perpetrators. An analysis technique is described in four stages, namely determination of the mark to be a human bite mark, pattern association analysis, metric analysis and comparison with the population data, and illustrated by a real case study. New and accepted techniques are combined to determine the likelihood ratio of guilt expressed as one of a range of conclusions described in the paper. Each stage of the analysis adds to the confirmation (or rejection) of concordance between the dental features present on the victim and the dentition of the suspect. The results illustrate identification to a high degree of certainty. PMID:18279256

  18. The Brustkrebs-Studien.de website for breast cancer patients: User acceptance of a German internet portal offering information on the disease and treatment options, and a clinical trials matching service

    PubMed Central

    2010-01-01

    Background The internet portal http://www.brustkrebs-studien.de (BKS) was launched in 2000 by the German Society of Senology (DGS) and the Baden-Württemberg Institute for Women's Health (IFG) to provide expert-written information on breast cancer online and to encourage and facilitate the participation of breast cancer patients in clinical trials. We describe the development of BKS and its applications, and report on website statistics and user acceptance. Methods Existing registries, including ClinicalTrials.gov, were analysed before we designed BKS, which combines a trial registry, a knowledge portal, and an online second opinion service. An advisory board guided the process. Log files and patient enquiries for trial participation and second opinions were analysed. A two-week user satisfaction survey was conducted online. Results During 10/2005-06/2010, the portal attracted 702,655 visitors, generating 15,507,454 page views. By 06/2010, the website's active scientific community consisted of 189 investigators and physicians, and the registry covered 163 clinical trial protocols. In 2009, 143 patients requested trial enrolment and 119 sought second opinions or individual treatment advice from the expert panel. During the two-week survey in 2008, 5,702 BKS visitors submitted 507 evaluable questionnaires. Portal acceptance was high. Respondents trusted information correctness (80%), welcomed self-matching to clinical trials (79%) and planned to use the portal in the future (76%) and recommend it to others (81%). Conclusions BKS is an established and trusted breast cancer information platform offering up-to-date resources and protocols to the growing physician and patient community to encourage participation in clinical trials. Further studies are needed to assess potential increases in trial enrolment by eligibility matching services. PMID:21126358

  19. Feasibility and acceptability of mobile phone short message service as a support for patients receiving antiretroviral therapy in rural Uganda: a cross-sectional study

    PubMed Central

    Kim, Jiho; Zhang, Wendy; Nyonyitono, Maureen; Lourenco, Lillian; Nanfuka, Mastula; Okoboi, Stephen; Birungi, Josephine; Lester, Richard T; Kaleebu, Pontiano; Munderi, Paula; Moore, David M

    2015-01-01

    Introduction Mobile phone technologies have been promoted to improve adherence to antiretroviral therapy (ART). We studied the receptiveness of patients in a rural Ugandan setting to the use of short messaging service (SMS) communication for such purposes. Methods We performed a cross-sectional analysis measuring mobile phone ownership and literacy amongst patients of The AIDS Support Organisation (TASO) in Jinja, Uganda. We performed bivariate and multivariate logistic regression analyses to examine associations between explanatory variables and a composite outcome of being literate and having a mobile phone. Results From June 2012 to August 2013, we enrolled 895 participants, of whom 684 (76%) were female. The median age was 44 years. A total of 576 (63%) were both literate and mobile phone users. Of these, 91% (527/ 576) responded favourably to the potential use of SMS for health communication, while only 38.9% (124/319) of others were favourable to the idea (p<0.001). A lower proportion of literate mobile phone users reported optimal adherence to ART (86.4% vs. 90.6%; p=0.007). Male participants (AOR=2.81; 95% CI 1.83–4.30), sub-optimal adherence (AOR=1.76; 95% CI 1.12–2.77), those with waged or salaried employment (AOR=2.35; 95% CI 1.23–4.49), crafts/trade work (AOR=2.38; 95% CI 1.11–5.12), or involved in petty trade (AOR=1.85; 95% CI 1.09–3.13) (in comparison to those with no income) were more likely to report mobile phone ownership and literacy. Conclusions In a rural Ugandan setting, we found that over 60% of patients could potentially benefit from a mobile phone-based ART adherence support. However, support for such an intervention was lower for other patients. PMID:26654029

  20. Mark Chaffin (1952-2015).

    PubMed

    Lutzker, John R; Bonner, Barbara L

    2016-04-01

    Presents an obituary for Mark Chaffin, who passed away unexpectedly on August 23, 2015, in Atlanta, Georgia, while riding his bike on the Atlanta Beltline, a joy and passion for him. Mark was a leader in the field of child maltreatment research. He dedicated his career to helping at-risk children and families. His distinguished career belied his self-proclaimed, self-effacing lack of accomplishment. (PsycINFO Database Record PMID:27042891

  1. Acceptance of dying: a discourse analysis of palliative care literature.

    PubMed

    Zimmermann, Camilla

    2012-07-01

    The subject of death denial in the West has been examined extensively in the sociological literature. However, there has not been a similar examination of its "opposite", the acceptance of death. In this study, I use the qualitative method of discourse analysis to examine the use of the term "acceptance" of dying in the palliative care literature from 1970 to 2001. A Medline search was performed by combining the text words "accept or acceptance" with the subject headings "terminal care or palliative care or hospice care", and restricting the search to English language articles in clinical journals discussing acceptance of death in adults. The 40 articles were coded and analysed using a critical discourse analysis method. This paper focuses on the theme of acceptance as integral to palliative care, which had subthemes of acceptance as a goal of care, personal acceptance of healthcare workers, and acceptance as a facilitator of care. For patients and families, death acceptance is a goal that they can be helped to attain; for palliative care staff, acceptance of dying is a personal quality that is a precondition for effective practice. Acceptance not only facilitates the dying process for the patient and family, but also renders care easier. The analysis investigates the intertextuality of these themes with each other and with previous texts. From a Foucauldian perspective, I suggest that the discourse on acceptance of dying represents a productive power, which disciplines patients through apparent psychological and spiritual gratification, and encourages participation in a certain way to die. PMID:22513246

  2. Simplicity, safety, and acceptability of insulin pen use versus the conventional vial/syringe device in patients with type 1 and type 2 diabetes mellitus in Lebanon

    PubMed Central

    Ramadan, Wijdan H; Khreis, Noura A; Kabbara, Wissam K

    2015-01-01

    Background The aim of the study was to evaluate the simplicity, safety, patients’ preference, and convenience of the administration of insulin using the pen device versus the conventional vial/syringe in patients with diabetes. Methods This observational study was conducted in multiple community pharmacies in Lebanon. The investigators interviewed patients with diabetes using an insulin pen or conventional vial/syringe. A total of 74 questionnaires were filled over a period of 6 months. Answers were entered into the Statistical Package for Social Sciences (SPSS) software and Excel spreadsheet. t-test, logistic regression analysis, and correlation analysis were used in order to analyze the results. Results A higher percentage of patients from the insulin pen users group (95.2%) found the method easy to use as compared to only 46.7% of the insulin conventional users group (P 0.001, relative risk [RR]: 2.041, 95% confidence interval [CI]: 1.178–3.535). Moreover, 61.9% and 26.7% of pen users and conventional users, respectively, could read the scale easily (P 0.037, RR 2.321, 95% CI: 0.940–5.731), while 85.7% of pen users found it more convenient shifting to pen and 86.7% of the conventional users would want to shift to pen if it had the same cost. Pain perception was statistically different between the groups. A much higher percentage (76.2%) of pen users showed no pain during injection compared to only 26.7% of conventional users (P 0.003, RR 2.857, 95% CI: 1.194–6.838). Conclusion The insulin pen was significantly much easier to use and less painful than the conventional vial/syringe. Proper education on the methods of administration/storage and disposal of needles/syringes is needed in both groups. PMID:25848231

  3. Four therapeutic diets: adherence and acceptability.

    PubMed

    Berkow, Susan E; Barnard, Neal; Eckart, Jill; Katcher, Heather

    2010-01-01

    Many health conditions are treated, at least in part, by therapeutic diets. Although the success of any intervention depends on its acceptability to the patient, the acceptability of therapeutic diets and factors that influence it have been largely neglected in nutrition research. A working definition of acceptability is proposed and an examination and summary are provided of available data on the acceptability of common diet regimens used for medical conditions. The goal is to suggest ways to improve the success of therapeutic diets. The proposed working definition of "acceptability" refers to the user's judgment of the advantages and disadvantages of a therapeutic diet-in relation to palatability, costs, and effects on eating behaviour and health-that influence the likelihood of adherence. Very low-calorie, reduced-fat omnivorous, vegetarian and vegan, and low-carbohydrate diets all achieve acceptability among the majority of users in studies of up to one year, in terms of attrition and adherence rates and results of questionnaires assessing eating behaviours. Longer studies are fewer, but they suggest that vegetarian, vegan, and reduced-fat diets are acceptable, as indicated by sustained changes in nutrient intake. Few studies of this length have been published for very low-calorie or low-carbohydrate diets. Long-term studies of adherence and acceptability of these and other therapeutic diets are warranted. PMID:21144137

  4. Do clinicians use more question marks?

    PubMed Central

    Otte, Willem M; van’t Klooster, Maryse A; van Diessen, Eric; Leijten, Frans SS; Sander, Josemir W

    2015-01-01

    Objective To quantify the use of question marks in titles of published studies. Design and setting Literature review. Participants All Pubmed publications between 1 January 2013 and 31 December 2013 with an available abstract. Papers were classified as being clinical when the search terms clin*, med* or patient* were found anywhere in the paper’s title, abstract or the journal’s name. Other papers were considered controls. As a verification, clinical journals were compared to non-clinical journals in two different approaches. Also, 50 highest impact journals were explored for publisher group dependent differences. Main outcome measure Total number of question marks in titles. Results A total of 368,362 papers were classified as clinical and 596,889 as controls. Clinical papers had question marks in 3.9% (95% confidence interval 3.8–4.0%) of titles and other papers in 2.3% (confidence interval 2.3–2.3%; p < 0.001). These findings could be verified for clinical journals compared to non-clinical journals. Different percentages between four publisher groups were found (p < 0.01). Conclusion We found more question marks in titles of clinical papers than in other papers. This could suggest that clinicians often have a question-driven approach to research and scientists in more fundamental research a hypothesis-driven approach. An alternative explanation is that clinicians like catchy titles. Publishing groups might have pro- and anti-question mark policies. PMID:26085937

  5. A new method of marking dentures using microchips.

    PubMed

    Rajan, M; Julian, R

    2002-06-01

    Over the years various methods of denture marking have been reported in the literature. They include surface marking and inclusion techniques using metallic or non-metallic materials, microchips and microlabels. The microchips are preferred because of their small size and aesthetic acceptability. They are not however widely used due to the high cost of manufacture and data incorporation. This article details the procedures involved in inscribing a microchip using the photochemical etching process used in the electronics industry. The resulting microchip was cosmetically appealing, cost effective and was able to satisfy all the forensic requirements for a suitable denture marker. PMID:12085521

  6. Approaches to acceptable risk

    SciTech Connect

    Whipple, C.

    1997-04-30

    Several alternative approaches to address the question {open_quotes}How safe is safe enough?{close_quotes} are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, in a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made.

  7. 1984 Newbery Acceptance Speech.

    ERIC Educational Resources Information Center

    Cleary, Beverly

    1984-01-01

    This acceptance speech for an award honoring "Dear Mr. Henshaw," a book about feelings of a lonely child of divorce intended for eight-, nine-, and ten-year-olds, highlights children's letters to author. Changes in society that affect children, the inception of "Dear Mr. Henshaw," and children's reactions to books are highlighted. (EJS)

  8. Why was Relativity Accepted?

    NASA Astrophysics Data System (ADS)

    Brush, S. G.

    Historians of science have published many studies of the reception of Einstein's special and general theories of relativity. Based on a review of these studies, and my own research on the role of the light-bending prediction in the reception of general relativity, I discuss the role of three kinds of reasons for accepting relativity (1) empirical predictions and explanations; (2) social-psychological factors; and (3) aesthetic-mathematical factors. According to the historical studies, acceptance was a three-stage process. First, a few leading scientists adopted the special theory for aesthetic-mathematical reasons. In the second stage, their enthusiastic advocacy persuaded other scientists to work on the theory and apply it to problems currently of interest in atomic physics. The special theory was accepted by many German physicists by 1910 and had begun to attract some interest in other countries. In the third stage, the confirmation of Einstein's light-bending prediction attracted much public attention and forced all physicists to take the general theory of relativity seriously. In addition to light-bending, the explanation of the advance of Mercury's perihelion was considered strong evidence by theoretical physicists. The American astronomers who conducted successful tests of general relativity became defenders of the theory. There is little evidence that relativity was `socially constructed' but its initial acceptance was facilitated by the prestige and resources of its advocates.

  9. UGV acceptance testing

    NASA Astrophysics Data System (ADS)

    Kramer, Jeffrey A.; Murphy, Robin R.

    2006-05-01

    With over 100 models of unmanned vehicles now available for military and civilian safety, security or rescue applications, it is important to for agencies to establish acceptance testing. However, there appears to be no general guidelines for what constitutes a reasonable acceptance test. This paper describes i) a preliminary method for acceptance testing by a customer of the mechanical and electrical components of an unmanned ground vehicle system, ii) how it has been applied to a man-packable micro-robot, and iii) discusses the value of testing both to ensure that the customer has a workable system and to improve design. The test method automated the operation of the robot to repeatedly exercise all aspects and combinations of components on the robot for 6 hours. The acceptance testing process uncovered many failures consistent with those shown to occur in the field, showing that testing by the user does predict failures. The process also demonstrated that the testing by the manufacturer can provide important design data that can be used to identify, diagnose, and prevent long-term problems. Also, the structured testing environment showed that sensor systems can be used to predict errors and changes in performance, as well as uncovering unmodeled behavior in subsystems.

  10. 29 CFR 1917.29 - Retention of DOT markings, placards and labels.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Transportation's Hazardous Materials Regulations (49 CFR parts 171 through 180) shall retain those markings... acceptable marking is affixed in accordance with the Hazard Communication Standard (29 CFR 1910.1200). (e... this section have the same definition as in the Hazardous Materials Regulations (49 CFR parts...

  11. Virtual Patients in continuing medical education and residency training: a pilot project for acceptance analysis in the framework of a residency revision course in pediatrics

    PubMed Central

    Lehmann, Ronny; Hanebeck, Benjamin; Oberle, Stephan; Simon, Anke; Choukair, Daniela; Tönshoff, Burkhard; Huwendiek, Sören

    2015-01-01

    Aim: Virtual patients (VPs) are a one-of-a-kind e-learning resource, fostering clinical reasoning skills through clinical case examples. The combination with face-to-face teaching is important for their successful integration, which is referred to as “blended learning”. So far little is known about the use of VPs in the field of continuing medical education and residency training. The pilot study presented here inquired the application of VPs in the framework of a pediatric residency revision course. Methods: Around 200 participants of a pediatric nephology lecture (‘nephrotic and nephritic syndrome in children’) were offered two VPs as a wrap-up session at the revision course of the German Society for Pediatrics and Adolescent Medicine (DGKJ) 2009 in Heidelberg, Germany. Using a web-based survey form, different aspects were evaluated concerning the learning experiences with VPs, the combination with the lecture, and the use of VPs for residency training in general. Results: N=40 evaluable survey forms were returned (approximately 21%). The return rate was impaired by a technical problem with the local Wi-Fi firewall. The participants perceived the work-up of the VPs as a worthwhile learning experience, with proper preparation for diagnosing and treating real patients with similar complaints. Case presentations, interactivity, and locally and timely independent repetitive practices were, in particular, pointed out. On being asked about the use of VPs in general for residency training, there was a distinct demand for more such offers. Conclusion: VPs may reasonably complement existing learning activities in residency training. PMID:26604993

  12. The use of intraoperative grid pattern markings in lipoplasty.

    PubMed

    Chang, K Ning

    2004-10-01

    Intraoperative grid pattern markings have been used in the performance of liposuction. Grid pattern markings include series of longitudinal and transverse lines to delineate various anatomical boundaries and landmarks, including the midline, lateral line, and medial line. The markings are superimposed on the customary preoperative markings and divide broad or circumferential body surfaces into smaller subunits for liposuction. Grid pattern markings are applied to areas such as the anterior thighs, medial thighs, entire abdomen, flanks, back, arms, buttocks, calves, and ankles; they are not applied to smaller, less curved areas. Eighty-two consecutive patients underwent lipoplasty in 562 areas of the body. The revision rate for postliposuction contour irregularities was 4.0 percent (nine of 224 areas) where grid pattern markings were used; one area had an indentation type of contour irregularity and required autologous fat grafting. The revision rate was 1.5 percent (five of 328 areas) where grid pattern markings were not used; two areas in one patient had indentation-type contour irregularities and required autologous fat grafting. All remaining areas requiring revision had protuberant-type contour irregularities and responded to additional liposuction only. The use of grid pattern markings is associated with a low incidence of serious contour-related complications. PMID:15457052

  13. Children acceptance of laser dental treatment

    NASA Astrophysics Data System (ADS)

    Lazea, Andreea; Todea, Carmen

    2016-03-01

    Objectives: To evaluate the dental anxiety level and the degree of acceptance of laser assisted pedodontic treatments from the children part. Also, we want to underline the advantages of laser use in pediatric dentistry, to make this technology widely used in treating dental problems of our children patients. Methods: Thirty pediatric dental patients presented in the Department of Pedodontics, University of Medicine and Pharmacy "Victor Babeş", Timişoara were evaluated using the Wong-Baker pain rating scale, wich was administered postoperatory to all patients, to assess their level of laser therapy acceptance. Results: Wong-Baker faces pain rating scale (WBFPS) has good validity and high specificity; generally it's easy for children to use, easy to compare and has good feasibility. Laser treatment has been accepted and tolerated by pediatric patients for its ability to reduce or eliminate pain. Around 70% of the total sample showed an excellent acceptance of laser dental treatment. Conclusions: Laser technology is useful and effective in many clinical situations encountered in pediatric dentistry and a good level of pacient acceptance is reported during all laser procedures on hard and soft tissues.

  14. 27 CFR 24.259 - Marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Marks. 24.259 Section 24....259 Marks. (a) Required marks. Each container larger than four liters or each case used to remove wine... shipment. (b) Application of marks. Required marks may be cut, printed, or otherwise legibly and...

  15. 19 CFR 18.27 - Port marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Port marks. 18.27 Section 18.27 Customs Duties U.S... Port marks. Port marks may be added by authority of the port director and under the supervision of a Customs officer. The original marks and the port marks shall appear in all papers pertaining to...

  16. 19 CFR 18.27 - Port marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Port marks. 18.27 Section 18.27 Customs Duties U.S... Port marks. Port marks may be added by authority of the port director and under the supervision of a Customs officer. The original marks and the port marks shall appear in all papers pertaining to...

  17. 19 CFR 18.27 - Port marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Port marks. 18.27 Section 18.27 Customs Duties U.S... Port marks. Port marks may be added by authority of the port director and under the supervision of a Customs officer. The original marks and the port marks shall appear in all papers pertaining to...

  18. 19 CFR 18.27 - Port marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Port marks. 18.27 Section 18.27 Customs Duties U.S... Port marks. Port marks may be added by authority of the port director and under the supervision of a Customs officer. The original marks and the port marks shall appear in all papers pertaining to...

  19. 27 CFR 24.259 - Marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Marks. 24.259 Section 24....259 Marks. (a) Required marks. Each container larger than four liters or each case used to remove wine... shipment. (b) Application of marks. Required marks may be cut, printed, or otherwise legibly and...

  20. 27 CFR 24.259 - Marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Marks. 24.259 Section 24....259 Marks. (a) Required marks. Each container larger than four liters or each case used to remove wine... shipment. (b) Application of marks. Required marks may be cut, printed, or otherwise legibly and...

  1. 27 CFR 24.259 - Marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Marks. 24.259 Section 24....259 Marks. (a) Required marks. Each container larger than four liters or each case used to remove wine... shipment. (b) Application of marks. Required marks may be cut, printed, or otherwise legibly and...

  2. 19 CFR 18.27 - Port marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Port marks. 18.27 Section 18.27 Customs Duties U.S... Port marks. Port marks may be added by authority of the port director and under the supervision of a Customs officer. The original marks and the port marks shall appear in all papers pertaining to...

  3. Acceptability and Use of Portable Drinking Water and Hand Washing Stations in Health Care Facilities and Their Impact on Patient Hygiene Practices, Western Kenya

    PubMed Central

    Otieno, Ronald; Odhiambo, Aloyce; Faith, Sitnah H.

    2015-01-01

    Many health care facilities (HCF) in developing countries lack access to reliable hand washing stations and safe drinking water. To address this problem, we installed portable, low-cost hand washing stations (HWS) and drinking water stations (DWS), and trained healthcare workers (HCW) on hand hygiene, safe drinking water, and patient education techniques at 200 rural HCFs lacking a reliable water supply in western Kenya. We performed a survey at baseline and a follow-up evaluation at 15 months to assess the impact of the intervention at a random sample of 40 HCFs and 391 households nearest to these HCFs. From baseline to follow-up, there was a statistically significant increase in the percentage of dispensaries with access to HWSs with soap (42% vs. 77%, p<0.01) and access to safe drinking water (6% vs. 55%, p<0.01). Female heads of household in the HCF catchment area exhibited statistically significant increases from baseline to follow-up in the ability to state target times for hand washing (10% vs. 35%, p<0.01), perform all four hand washing steps correctly (32% vs. 43%, p = 0.01), and report treatment of stored drinking water using any method (73% vs. 92%, p<0.01); the percentage of households with detectable free residual chlorine in stored drinking water did not change (6%, vs. 8%, p = 0.14). The installation of low-cost, low-maintenance, locally-available, portable hand washing and drinking water stations in rural HCFs without access to 24-hour piped water helped assure that health workers had a place to wash their hands and provide safe drinking water. This HCF intervention may have also contributed to the improvement of hand hygiene and reported safe drinking water behaviors among households nearest to HCFs. PMID:25961293

  4. Acceptability of human risk.

    PubMed Central

    Kasperson, R E

    1983-01-01

    This paper has three objectives: to explore the nature of the problem implicit in the term "risk acceptability," to examine the possible contributions of scientific information to risk standard-setting, and to argue that societal response is best guided by considerations of process rather than formal methods of analysis. Most technological risks are not accepted but are imposed. There is also little reason to expect consensus among individuals on their tolerance of risk. Moreover, debates about risk levels are often at base debates over the adequacy of the institutions which manage the risks. Scientific information can contribute three broad types of analyses to risk-setting deliberations: contextual analysis, equity assessment, and public preference analysis. More effective risk-setting decisions will involve attention to the process used, particularly in regard to the requirements of procedural justice and democratic responsibility. PMID:6418541

  5. Age and Acceptance of Euthanasia.

    ERIC Educational Resources Information Center

    Ward, Russell A.

    1980-01-01

    Study explores relationship between age (and sex and race) and acceptance of euthanasia. Women and non-Whites were less accepting because of religiosity. Among older people less acceptance was attributable to their lesser education and greater religiosity. Results suggest that quality of life in old age affects acceptability of euthanasia. (Author)

  6. Keynote Address: Rev. Mark Massa

    ERIC Educational Resources Information Center

    Massa, Mark S.

    2011-01-01

    Rev. Mark S. Massa, S.J., is the dean and professor of Church history at the School of Theology and Ministry at Boston College. He was invited to give a keynote to begin the third Catholic Higher Education Collaborative Conference (CHEC), cosponsored by Boston College and Fordham University. Fr. Massa's address posed critical questions about…

  7. Early-Modern "Speech" Marks

    ERIC Educational Resources Information Center

    Blackburn, Nick

    2011-01-01

    This essay presents a revised history of the punctuation mark ["], drawn from the earliest communities who made it their own. By situating the development of ["] in its historical context, from first uses of the diple [diple] by the Greek scholar Aristarchus, it explains how it was the general applications which persisted into the sixteenth…

  8. EP Profiles Inventor Mark Sherron

    ERIC Educational Resources Information Center

    Williams, John M.

    2006-01-01

    This article profiles Mark Jerome Sherron, inventor of the ALLIES Line of electronic sensors for blind and visually-impaired people. Featuring the American Liquid Level Indicator electronic sensor (ALLI), Sherron's ALLIES product line also includes the Light Intensity Level Indicator (LILI), a multi-function electronic light sensor for electronic…

  9. 14 CFR 23.1555 - Control markings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Markings and Placards § 23.1555 Control markings. (a) Each cockpit control, other than primary flight... specific sequence, that sequence must be marked on or near the selector for those tanks; (3) The...

  10. 14 CFR 23.1555 - Control markings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Markings and Placards § 23.1555 Control markings. (a) Each cockpit control, other than primary flight... specific sequence, that sequence must be marked on or near the selector for those tanks; (3) The...

  11. Validation of tool mark analysis of cut costal cartilage.

    PubMed

    Love, Jennifer C; Derrick, Sharon M; Wiersema, Jason M; Peters, Charles

    2012-03-01

    This study was designed to establish the potential error rate associated with the generally accepted method of tool mark analysis of cut marks in costal cartilage. Three knives with different blade types were used to make experimental cut marks in costal cartilage of pigs. Each cut surface was cast, and each cast was examined by three analysts working independently. The presence of striations, regularity of striations, and presence of a primary and secondary striation pattern were recorded for each cast. The distance between each striation was measured. The results showed that striations were not consistently impressed on the cut surface by the blade's cutting edge. Also, blade type classification by the presence or absence of striations led to a 65% misclassification rate. Use of the classification tree and cross-validation methods and inclusion of the mean interstriation distance decreased the error rate to c. 50%. PMID:22081951

  12. Classifying sea lamprey marks on Great Lakes lake trout: observer agreement, evidence on healing times between classes and recommendations for reporting of marking statistics

    USGS Publications Warehouse

    Ebener, Mark P.; Bence, James R.; Bergstedt, Roger A.; Mullet, Katherine M.

    2003-01-01

    In 1997 and 1998 two workshops were held to evaluate how consistent observers were at classifying sea lamprey (Petromyzon marinus) marks on Great Lakes lake trout (Salvelinus namaycush) as described in the King classification system. Two trials were held at each workshop, with group discussion between trials. Variation in counting and classifying marks was considerable, such that reporting rates for A1–A3 marks varied two to three-fold among observers of the same lake trout. Observer variation was greater for classification of healing or healed marks than for fresh marks. The workshops highlighted, as causes for inconsistent mark classification, both departures from the accepted protocol for classifying marks by some agencies, and differences in how sliding and multiple marks were interpreted. Group discussions led to greater agreement in classifying marks. We recommend ways to improve the reliability of marking statistics, including the use of a dichotomous key to classify marks. Laboratory data show that healing times of marks on lake trout were much longer at 4°C and 1°C than at 10°C and varied greatly among individuals. Reported A1–A3 and B1–B3 marks observed in late summer and fall collections likely result from a mixture of attacks by two year classes of sea lamprey. It is likely that a substantial but highly uncertain proportion of attacks that occur in late summer and fall lead to marks that are classified as A1–A3 the next spring. We recommend additional research on mark stage duration.

  13. [The acceptability of different oral contraceptive methods].

    PubMed

    Klinger, G; Fritzsche, H; Hempel, E; Carol, W; Böhme, W; Scholz, B; Grass, M; Chemnitius, K H

    1975-05-01

    Results of a survey of contraceptive acceptability are reported. In formation on oral and depot hormonal contraceptives was distributed to 1064 Ovosiston or Nonovlon users, 110 women using depot contraceptives, and 609 women who had never used hormonal contraception. The women's preferences with regard to administration schedule, and their perceptions of effectiveness and safety were noted. Non-users considered daily, weekly, or monthly administration acceptable, while only 2/3 of those taking oral contraceptives thought daily administration convenient. 90.2% of Deposiston patients did not care for daily administration. Deposiston patients also had the greatest confidence in their method. The authors believe on the basis of this survey that weekly administration may be highly acceptable alternative t o conventional oral contraception. PMID:1140078

  14. UID....Now That's Gonna Leave A Mark

    NASA Technical Reports Server (NTRS)

    Schramm, Harry F., Jr.

    2008-01-01

    Since 1975 bar codes on products at the retail counter have been accepted as the standard for entering product identity for price determination. Since the beginning of the 21 st century, the Data Matrix symbol has become accepted as the bar code format that is marked directly on a part, assembly or product that is durable enough to identify that item for its lifetime. NASA began the studies for direct part marking Data Matrix symbols on parts during the Return to Flight activities after the Challenger Accident. Over the 20 year period that has elapsed since Challenger, a mountain of studies, analyses and focused problem solutions developed by and for NASA have brought about world changing results. NASA Technical Standard 6002 and NASA Handbook 6003 for Direct Part Marking Data Matrix Symbols on Aerospace Parts have formed the basis for most other standards on part marking internationally. NASA and its commercial partners have developed numerous products and methods that addressed the difficulties of collecting part identification in aerospace operations. These products enabled the marking of Data Matrix symbols in virtually every situation and the reading of symbols at great distances, severe angles, under paint and in the dark without a light. Even unmarkable delicate parts now have a process to apply a chemical mixture, recently trademarked as Nanocodes, that can be converted to Data Matrix information through software. The accompanying intellectual property is protected by ten patents, several of which are licensed. Direct marking Data Matrix on NASA parts dramatically decreases data entry errors and the number of parts that go through their life cycle unmarked, two major threats to sound configuration management and flight safety. NASA is said to only have people and stuff with information connecting them. Data Matrix is one of the most significant improvements since Challenger to the safety and reliability of that connection.

  15. UID...Leaving Its Mark on the Universe

    NASA Technical Reports Server (NTRS)

    Schramm, Harry F., Jr.

    2008-01-01

    Since 1975 bar codes on products at the retail counter have been accepted as the standard for entering product identity for price determination. Since the beginning of the 21 st century, the Data Matrix symbol has become accepted as the bar code format that is marked directly on a part, assembly or product that is durable enough to identify that item for its lifetime. NASA began the studies for direct part marking Data Matrix symbols on parts during the Return to Flight activities after the Challenger Accident. Over the 20 year period that has elapsed since Challenger, a mountain of studies, analyses and focused problem solutions developed by and for NASA have brought about world changing results. NASA Technical Standard 6002 and NASA Handbook 6003 for Direct Part Marking Data Matrix Symbols on Aerospace Parts have formed the basis for most other standards on part marking internationally. NASA and its commercial partners have developed numerous products and methods that addressed the difficulties of collecting part identification in aerospace operations. These products enabled the marking of Data Matrix symbols in virtually every situation and the reading of symbols at great distances, severe angles, under paint and in the dark without a light. Even unmarkable delicate parts now have a process to apply a chemical mixture, recently trademarked as Nanocodes, that can be converted to Data Matrix information through software. The accompanying intellectual property is protected by ten patents, several of which are licensed. Direct marking Data Matrix on NASA parts dramatically decreases data entry errors and the number of parts that go through their life cycle unmarked, two major threats to sound configuration management and flight safety. NASA is said to only have people and stuff with information connecting them. Data Matrix is one of the most significant improvements since Challenger to the safety and reliability of that connection.

  16. UID...Now That's Gonna Leave a Mark

    NASA Technical Reports Server (NTRS)

    Schramm, Harry F.

    2008-01-01

    Since 1975 bar codes on products at the retail counter have been accepted as the standard for entering product identity for price determination. Since the beginning of the 21st century, the Data Matrix symbol has become accepted as the bar code format that is marked directly on a part, assembly or product that is durable enough to identify that item for its lifetime. NASA began the studies for direct part marking Data Matrix symbols on parts during the Return to Flight activities after the Challenger Accident. Over the 20 year period that has elapsed since Challenger, a mountain of studies, analyses and focused problem solutions developed by and for NASA have brought about world changing results. NASA Technical Standard 6002 and NASA Handbook 6003 for Direct Part Marking Data Matrix Symbols on Aerospace Parts have formed the basis for most other standards on part marking internationally. NASA and its commercial partners have developed numerous products and methods that addressed the difficulties of collecting part identification in aerospace operations. These products enabled the marking of Data Matrix symbols in virtually every situation and the reading of symbols at great distances, severe angles, under paint and in the dark without a light. Even unmarkable delicate parts now have a process to apply a chemical mixture, recently trademarked as Nanocodes, that can be converted to Data Matrix information through software. The accompanying intellectual property is protected by ten patents, several of which are licensed. Direct marking Data Matrix on NASA parts dramatically decreases data entry errors and the number of parts that go through their life cycle unmarked, two major threats to sound configuration management and flight safety. NASA is said to only have people and stuff with information connecting them. Data Matrix is one of the most significant improvements since Challenger to the safety and reliability of that connection.

  17. UID...Now That's Gonna Leave A Mark

    NASA Technical Reports Server (NTRS)

    Schramm, Harry F., Jr.

    2007-01-01

    Since 1975 bar codes on products at the retail counter have been accepted as the standard for entering product identity for price determination. Since the beginning of the 21st century, the Data Matrix symbol has become accepted as the bar code format that is marked directly on a part, assembly or product that is durable enough to identify that item for its lifetime. NASA began the studies for direct part marking Data Matrix symbols on parts during the Return to Flight activities after the Challenger Accident. Over the 20 year period that has elapsed since Challenger, a mountain of studies, analyses and focused problem solutions developed by and for NASA have brought about world changing results. NASA Technical Standard 6002 and NASA Handbook 6003 for Direct Part Marking Data Matrix Symbols on Aerospace Parts have formed the basis for most other standards on part marking internationally. NASA and its commercial partners have developed numerous products and methods that addressed the difficulties of collecting part identification in aerospace operations. These products enabled the marking of Data Matrix symbols in virtually every situation and the reading of symbols at great distances, severe angles, under paint and in the dark without a light. Even unmarkable delicate parts now have a process to apply a chemical mixture, recently trademarked as Nanocodes, that can be converted to Data Matrix information through software. The accompanying intellectual property is protected by ten patents, several of which are licensed. Direct marking Data Matrix on NASA parts dramatically decreases data entry errors and the number ofparts that go through their life cycle unmarked, two major threats to sound configuration management and flight safety. NASA is said to only have people and stuff with information connecting them. Data Matrix is one of the most significant improvements since Challenger to the safety and reliability of that connection.

  18. Baby-Crying Acceptance

    NASA Astrophysics Data System (ADS)

    Martins, Tiago; de Magalhães, Sérgio Tenreiro

    The baby's crying is his most important mean of communication. The crying monitoring performed by devices that have been developed doesn't ensure the complete safety of the child. It is necessary to join, to these technological resources, means of communicating the results to the responsible, which would involve the digital processing of information available from crying. The survey carried out, enabled to understand the level of adoption, in the continental territory of Portugal, of a technology that will be able to do such a digital processing. It was used the TAM as the theoretical referential. The statistical analysis showed that there is a good probability of acceptance of such a system.

  19. High acceptance recoil polarimeter

    SciTech Connect

    The HARP Collaboration

    1992-12-05

    In order to detect neutrons and protons in the 50 to 600 MeV energy range and measure their polarization, an efficient, low-noise, self-calibrating device is being designed. This detector, known as the High Acceptance Recoil Polarimeter (HARP), is based on the recoil principle of proton detection from np[r arrow]n[prime]p[prime] or pp[r arrow]p[prime]p[prime] scattering (detected particles are underlined) which intrinsically yields polarization information on the incoming particle. HARP will be commissioned to carry out experiments in 1994.

  20. Development of a clinical trial to determine whether watchful waiting is an acceptable alternative to surgical repair for patients with oligosymptomatic incisional hernia: study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Incisional hernia is a frequent complication in abdominal surgery. This article describes the development of a prospective randomized clinical trial designed to determine whether watchful waiting is an acceptable alternative to surgical repair for patients with oligosymptomatic incisional hernia. Methods/Design This clinical multicenter trial has been designed to compare watchful waiting and surgical repair for patients with oligosymptomatic incisional hernia. Participants are randomized to watchful waiting or surgery and followed up for two years. The primary efficacy endpoint is pain/discomfort during normal activities as a result of the hernia or hernia repair two years after enrolment, as measured by the hernia-specific Surgical Pain Scales (SPS). The target sample size of six hundred thirty-six patients was calculated to detect non-inferiority of the experimental intervention (watchful waiting) in the primary endpoint. Sixteen surgical centers will take part in the study and have submitted their declaration of commitment giving the estimated number of participating patients per year. A three-person data safety monitoring board will meet annually to monitor and supervise the trial. Discussion To date, we could find no published data on the natural course of incisional hernias. To our knowledge, watchful waiting has never been compared to standard surgical repair as a treatment option for incisional hernias. A trial to compare the outcome of the two approaches in patients with oligosymptomatic incisional hernias is urgently needed to provide data that can facilitate the choice between treatment options. If watchful waiting was equal to surgical repair, the high costs of surgical repair could be saved. The design for such a trial is described here. This multicenter trial will be funded by the German Research Foundation (DFG). The ethics committee of the Charité has approved the study protocol. Approval has been obtained from ten study sites at time of

  1. 40 CFR 761.45 - Marking formats.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of PCBs and PCB Items § 761.45 Marking formats. The following formats shall be used for marking: (a) Large PCB Mark—M L. Mark ML shall be as shown in Figure 1, letters and striping on a white or yellow... the PCB Article, PCB Equipment, or PCB Container. The size of the mark shall be at least 15.25 cm...

  2. 40 CFR 761.45 - Marking formats.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of PCBs and PCB Items § 761.45 Marking formats. The following formats shall be used for marking: (a) Large PCB Mark—M L. Mark ML shall be as shown in Figure 1, letters and striping on a white or yellow... the PCB Article, PCB Equipment, or PCB Container. The size of the mark shall be at least 15.25 cm...

  3. 40 CFR 761.45 - Marking formats.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of PCBs and PCB Items § 761.45 Marking formats. The following formats shall be used for marking: (a) Large PCB Mark—M L. Mark ML shall be as shown in Figure 1, letters and striping on a white or yellow... the PCB Article, PCB Equipment, or PCB Container. The size of the mark shall be at least 15.25 cm...

  4. 40 CFR 761.45 - Marking formats.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of PCBs and PCB Items § 761.45 Marking formats. The following formats shall be used for marking: (a) Large PCB Mark—M L. Mark ML shall be as shown in Figure 1, letters and striping on a white or yellow... the PCB Article, PCB Equipment, or PCB Container. The size of the mark shall be at least 15.25 cm...

  5. 40 CFR 761.45 - Marking formats.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of PCBs and PCB Items § 761.45 Marking formats. The following formats shall be used for marking: (a) Large PCB Mark—M L. Mark ML shall be as shown in Figure 1, letters and striping on a white or yellow... the PCB Article, PCB Equipment, or PCB Container. The size of the mark shall be at least 15.25 cm...

  6. 46 CFR 185.602 - Hull markings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Hull markings. 185.602 Section 185.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Markings Required § 185.602 Hull markings. (a) Each vessel must be marked as required by part...

  7. 46 CFR 185.602 - Hull markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Hull markings. 185.602 Section 185.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Markings Required § 185.602 Hull markings. (a) Each vessel must be marked as required by part...

  8. 46 CFR 185.602 - Hull markings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Hull markings. 185.602 Section 185.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Markings Required § 185.602 Hull markings. (a) Each vessel must be marked as required by part...

  9. 46 CFR 185.602 - Hull markings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Hull markings. 185.602 Section 185.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Markings Required § 185.602 Hull markings. (a) Each vessel must be marked as required by part...

  10. 46 CFR 185.602 - Hull markings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Hull markings. 185.602 Section 185.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Markings Required § 185.602 Hull markings. (a) Each vessel must be marked as required by part...

  11. 46 CFR 160.171-23 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Immersion Suits § 160.171-23 Marking. (a) Each immersion suit must be marked with the words “IMMERSION SUIT—COMPLIES WITH SOLAS 74/83,” the name of the manufacturer... case must be marked with the words “immersion suit” and the size. (c) The markings for the child...

  12. 27 CFR 28.216 - Export marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Export marks. 28.216... Export marks. In addition to the marks and brands required to be placed on packages or other bulk containers and cases under the provisions of parts 24 of this chapter, the exporter shall mark the...

  13. 27 CFR 40.212 - Mark.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Mark. 40.212 Section 40... TOBACCO Operations by Manufacturers of Tobacco Products Packages § 40.212 Mark. Every package of tobacco... thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark may...

  14. 27 CFR 28.103 - Export marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Export marks. 28.103... Manufacturing Bonded Warehouse § 28.103 Export marks. (a) General. In addition to the marks and brands required... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  15. Reading Skill, Textbook Marking, and Course Performance

    ERIC Educational Resources Information Center

    Bell, Kenneth E.; Limber, John E.

    2010-01-01

    We surveyed students enrolled in Introductory Psychology courses about their text marking preferences and analyzed the marking in their textbooks. Low-skill readers report more reliance on highlighting strategies and actually mark their texts more than better readers. In addition, low-skilled readers prefer to buy used, previously marked texts…

  16. 27 CFR 44.184 - Mark.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Mark. 44.184 Section 44... Tubes by Manufacturers and Export Warehouse Proprietors Packaging Requirements § 44.184 Mark. Every... imprinted thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark...

  17. 27 CFR 28.154 - Export marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Export marks. 28.154..., for Exportation or Transfer to a Foreign-Trade Zone § 28.154 Export marks. In addition to the marks... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  18. 27 CFR 28.216 - Export marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Export marks. 28.216... Export marks. In addition to the marks and brands required to be placed on packages or other bulk containers and cases under the provisions of parts 24 of this chapter, the exporter shall mark the...

  19. 27 CFR 28.193 - Export marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.193... Drawback Filing of Notice and Removal § 28.193 Export marks. In addition to the marks and brands required... chapter, the exporter shall mark the word “Export” on the Government side of each case or Government...

  20. 27 CFR 28.216 - Export marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Export marks. 28.216... Export marks. In addition to the marks and brands required to be placed on packages or other bulk containers and cases under the provisions of parts 24 of this chapter, the exporter shall mark the...

  1. 27 CFR 28.223 - Export marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Export marks. 28.223... Export marks. In addition to the marks and brands required to be placed on kegs, barrels, cases, crates or other packages under the provisions of part 25 of this chapter, the exporter shall mark the...

  2. 27 CFR 28.154 - Export marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Export marks. 28.154..., for Exportation or Transfer to a Foreign-Trade Zone § 28.154 Export marks. In addition to the marks... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  3. 27 CFR 28.223 - Export marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.223... Export marks. In addition to the marks and brands required to be placed on kegs, barrels, cases, crates or other packages under the provisions of part 25 of this chapter, the exporter shall mark the...

  4. 27 CFR 28.223 - Export marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Export marks. 28.223... Export marks. In addition to the marks and brands required to be placed on kegs, barrels, cases, crates or other packages under the provisions of part 25 of this chapter, the exporter shall mark the...

  5. 27 CFR 44.184 - Mark.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Mark. 44.184 Section 44.184... Tubes by Manufacturers and Export Warehouse Proprietors Packaging Requirements § 44.184 Mark. Every... imprinted thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark...

  6. 27 CFR 45.42 - Mark.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Mark. 45.42 Section 45.42... TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.42 Mark. Every package of tobacco... label securely affixed thereto, a mark as specified in this section. The mark may consist of the name...

  7. 27 CFR 44.184 - Mark.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Mark. 44.184 Section 44... Tubes by Manufacturers and Export Warehouse Proprietors Packaging Requirements § 44.184 Mark. Every... imprinted thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark...

  8. 27 CFR 28.103 - Export marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Export marks. 28.103... Manufacturing Bonded Warehouse § 28.103 Export marks. (a) General. In addition to the marks and brands required... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  9. 27 CFR 44.184 - Mark.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Mark. 44.184 Section 44... Tubes by Manufacturers and Export Warehouse Proprietors Packaging Requirements § 44.184 Mark. Every... imprinted thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark...

  10. 27 CFR 28.193 - Export marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Export marks. 28.193... Drawback Filing of Notice and Removal § 28.193 Export marks. In addition to the marks and brands required... chapter, the exporter shall mark the word “Export” on the Government side of each case or Government...

  11. 27 CFR 45.42 - Mark.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Mark. 45.42 Section 45.42... TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.42 Mark. Every package of tobacco... label securely affixed thereto, a mark as specified in this section. The mark may consist of the name...

  12. 27 CFR 28.154 - Export marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.154..., for Exportation or Transfer to a Foreign-Trade Zone § 28.154 Export marks. In addition to the marks... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  13. 27 CFR 19.1008 - Marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Marks. 19.1008 Section 19... TREASURY LIQUORS DISTILLED SPIRITS PLANTS Distilled Spirits For Fuel Use Marks § 19.1008 Marks. (a) Fuel alcohol. The proprietor shall conspicuously and permanently mark or securely label each container of...

  14. 27 CFR 45.42 - Mark.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Mark. 45.42 Section 45.42... TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.42 Mark. Every package of tobacco... label securely affixed thereto, a mark as specified in this section. The mark may consist of the name...

  15. 27 CFR 28.193 - Export marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Export marks. 28.193... Drawback Filing of Notice and Removal § 28.193 Export marks. In addition to the marks and brands required... chapter, the exporter shall mark the word “Export” on the Government side of each case or Government...

  16. 27 CFR 40.212 - Mark.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Mark. 40.212 Section 40.212... TOBACCO Operations by Manufacturers of Tobacco Products Packages § 40.212 Mark. Every package of tobacco... thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark may...

  17. 27 CFR 28.223 - Export marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Export marks. 28.223... Export marks. In addition to the marks and brands required to be placed on kegs, barrels, cases, crates or other packages under the provisions of part 25 of this chapter, the exporter shall mark the...

  18. 27 CFR 28.103 - Export marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Export marks. 28.103... Manufacturing Bonded Warehouse § 28.103 Export marks. (a) General. In addition to the marks and brands required... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  19. 27 CFR 28.154 - Export marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Export marks. 28.154..., for Exportation or Transfer to a Foreign-Trade Zone § 28.154 Export marks. In addition to the marks... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  20. 27 CFR 44.184 - Mark.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Mark. 44.184 Section 44... Tubes by Manufacturers and Export Warehouse Proprietors Packaging Requirements § 44.184 Mark. Every... imprinted thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark...

  1. 27 CFR 28.193 - Export marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Export marks. 28.193... Drawback Filing of Notice and Removal § 28.193 Export marks. In addition to the marks and brands required... chapter, the exporter shall mark the word “Export” on the Government side of each case or Government...

  2. 27 CFR 28.216 - Export marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Export marks. 28.216... Export marks. In addition to the marks and brands required to be placed on packages or other bulk containers and cases under the provisions of parts 24 of this chapter, the exporter shall mark the...

  3. 27 CFR 28.154 - Export marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Export marks. 28.154..., for Exportation or Transfer to a Foreign-Trade Zone § 28.154 Export marks. In addition to the marks... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  4. 27 CFR 40.212 - Mark.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Mark. 40.212 Section 40... TOBACCO Operations by Manufacturers of Tobacco Products Packages § 40.212 Mark. Every package of tobacco... thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark may...

  5. 27 CFR 45.42 - Mark.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Mark. 45.42 Section 45.42... TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.42 Mark. Every package of tobacco... label securely affixed thereto, a mark as specified in this section. The mark may consist of the name...

  6. 27 CFR 28.103 - Export marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.103... Manufacturing Bonded Warehouse § 28.103 Export marks. (a) General. In addition to the marks and brands required... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  7. 27 CFR 28.103 - Export marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Export marks. 28.103... Manufacturing Bonded Warehouse § 28.103 Export marks. (a) General. In addition to the marks and brands required... provisions of part 19 of this chapter, the proprietor shall mark the word “Export” on the Government side...

  8. 27 CFR 28.223 - Export marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Export marks. 28.223... Export marks. In addition to the marks and brands required to be placed on kegs, barrels, cases, crates or other packages under the provisions of part 25 of this chapter, the exporter shall mark the...

  9. 27 CFR 28.216 - Export marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.216... Export marks. In addition to the marks and brands required to be placed on packages or other bulk containers and cases under the provisions of parts 24 of this chapter, the exporter shall mark the...

  10. 27 CFR 45.42 - Mark.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Mark. 45.42 Section 45.42... TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.42 Mark. Every package of tobacco... label securely affixed thereto, a mark as specified in this section. The mark may consist of the name...

  11. 27 CFR 28.193 - Export marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Export marks. 28.193... Drawback Filing of Notice and Removal § 28.193 Export marks. In addition to the marks and brands required... chapter, the exporter shall mark the word “Export” on the Government side of each case or Government...

  12. 27 CFR 40.212 - Mark.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Mark. 40.212 Section 40... TOBACCO Operations by Manufacturers of Tobacco Products Packages § 40.212 Mark. Every package of tobacco... thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark may...

  13. 27 CFR 40.212 - Mark.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Mark. 40.212 Section 40... TOBACCO Operations by Manufacturers of Tobacco Products Packages § 40.212 Mark. Every package of tobacco... thereon, or on a label securely affixed thereto, a mark as specified in this section. The mark may...

  14. 14 CFR 23.1555 - Control markings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Control markings. 23.1555 Section 23.1555... Markings and Placards § 23.1555 Control markings. (a) Each cockpit control, other than primary flight controls and simple push button type starter switches, must be plainly marked as to its function and...

  15. 14 CFR 45.10 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Marking. 45.10 Section 45.10 Aeronautics..., § 45.10 was added, effective Apr. 14, 2010. The effective date of this addition was subsequently... REGISTRATION MARKING Identification of Aircraft and Related Products § 45.10 Marking. No person may mark...

  16. Marked Initial Pitch in Questions Signals Marked Communicative Function.

    PubMed

    Sicoli, Mark A; Stivers, Tanya; Enfield, N J; Levinson, Stephen C

    2015-06-01

    In conversation, the initial pitch of an utterance can provide an early phonetic cue of the communicative function, the speech act, or the social action being implemented. We conducted quantitative acoustic measurements and statistical analyses of pitch in over 10,000 utterances, including 2512 questions, their responses, and about 5000 other utterances by 180 total speakers from a corpus of 70 natural conversations in 10 languages. We measured pitch at first prominence in a speaker's utterance and discriminated utterances by language, speaker, gender, question form, and what social action is achieved by the speaker's turn. Through applying multivariate logistic regression we found that initial pitch that significantly deviated from the speaker's median pitch level was predictive of the social action of the question. In questions designed to solicit agreement with an evaluation rather than information, pitch was divergent from a speaker's median predictably in the top 10% of a speakers range. This latter finding reveals a kind of iconicity in the relationship between prosody and social action in which a marked pitch correlates with a marked social action. Thus, we argue that speakers rely on pitch to provide an early signal for recipients that the question is not to be interpreted through its literal semantics but rather through an inference. PMID:26677643

  17. Black anneal marking with pulsed fiber lasers

    NASA Astrophysics Data System (ADS)

    Murphy, T.; Harrison, P.; Norman, S.

    2015-07-01

    High contrast marking of metals is used in a wide range of industries. Fiber laser marking of these metals provides non-contact marking with no consumables, offering many advantages over traditional methods of metal marking. The laser creates a permanent mark on the material surface combining heat and oxygen with no noticeable ablation. The focussed beam of the fiber laser in combination with precision control of the heat input is able to treat small areas of the material surface evenly and consistently, which is critical for producing black anneal marks. The marks are highly legible which is ideal for marking serial numbers or small data matrices where traceability is required. This paper reports the experimental study for producing black anneal marks on various grades of stainless steel using fiber lasers. The influence of metal surface finish, beam quality, spot size diameter and pulse duration are investigated for producing both smooth and decorative anneal marks.

  18. The Mark III vertex chamber

    SciTech Connect

    Adler, J.; Bolton, T.; Bunnell, K.; Cassell, R.; Cheu, E.; Freese, T.; Grab, C.; Mazaheri, G.; Mir, R.; Odian, A.

    1987-07-01

    The design and construction of the new Mark III vertex chamber is described. Initial tests with cosmic rays prove the ability of track reconstruction and yield triplet resolutions below 50 ..mu..m at 3 atm using argon/ethane (50:50). Also performed are studies using a prototype of a pressurized wire vertex chamber with 8 mm diameter straw geometry. Spatial resolution of 35mm was obtained using dimethyl ether (DME) at 1 atm and 30 ..mu..m using argon/ethane (50/50 mixture) at 4 atm. Preliminary studies indicate the DME to adversely affect such materials as aluminized Mylar and Delrin.

  19. Interventions for the treatment of stretch marks: a systematic review.

    PubMed

    Liu, Liping; Ma, Hong; Li, Yumei

    2014-08-01

    Stretch marks are a common disfiguring skin condition that can have a deep psychological impact on affected patients. Although there are a variety of treatments available, no consistently effective therapies have been established. In this systematic review, we evaluate 8 randomized controlled trials (RCTs) to assess the efficacy and safety of currently available therapies for the treatment of stretch marks. Due to the limited number of patients and high or unclear risk of bias in the studies included in this assessment, the evidence from this review is insufficient to provide clear guidelines for practice. Therefore, more high-quality RCTs are needed. PMID:25184641

  20. Interview with Professor Mark Wilcox.

    PubMed

    Wilcox, Mark

    2016-08-01

    Mark Wilcox speaks to Georgia Patey, Commissioning Editor: Professor Mark Wilcox is a Consultant Microbiologist and Head of Microbiology at the Leeds Teaching Hospitals (Leeds, UK), the Professor of Medical Microbiology at the University of Leeds (Leeds, UK), and is the Lead on Clostridium difficile and the Head of the UK C. difficile Reference Laboratory for Public Health England (PHE). He was the Director of Infection Prevention (4 years), Infection Control Doctor (8 years) and Clinical Director of Pathology (6 years) at the Leeds Teaching Hospitals. He is Chair of PHE's Rapid Review Panel (reviews utility of infection prevention and control products for National Health Service), Deputy Chair of the UK Department of Health's Antimicrobial Resistance and Healthcare Associated Infection Committee and a member of PHE's HCAI/AR Programme Board. He is a member of UK/European/US working groups on C. difficile infection. He has provided clinical advice as part of the FDA/EMA submissions for the approval of multiple novel antimicrobial agents. He heads a healthcare-associated infection research team at University of Leeds, comprising approximately 30 doctors, scientists and nurses; projects include multiple aspects of C. difficile infection, diagnostics, antimicrobial resistance and the clinical development of new antimicrobial agents. He has authored more than 400 publications, and is the coeditor of Antimicrobial Chemotherapy (5th/6th/7th Editions, 15 December 2007). PMID:27494150

  1. Sonic boom acceptability studies

    NASA Astrophysics Data System (ADS)

    Shepherd, Kevin P.; Sullivan, Brenda M.; Leatherwood, Jack D.; McCurdy, David A.

    1992-04-01

    The determination of the magnitude of sonic boom exposure which would be acceptable to the general population requires, as a starting point, a method to assess and compare individual sonic booms. There is no consensus within the scientific and regulatory communities regarding an appropriate sonic boom assessment metric. Loudness, being a fundamental and well-understood attribute of human hearing was chosen as a means of comparing sonic booms of differing shapes and amplitudes. The figure illustrates the basic steps which yield a calculated value of loudness. Based upon the aircraft configuration and its operating conditions, the sonic boom pressure signature which reaches the ground is calculated. This pressure-time history is transformed to the frequency domain and converted into a one-third octave band spectrum. The essence of the loudness method is to account for the frequency response and integration characteristics of the auditory system. The result of the calculation procedure is a numerical description (perceived level, dB) which represents the loudness of the sonic boom waveform.

  2. Sonic boom acceptability studies

    NASA Technical Reports Server (NTRS)

    Shepherd, Kevin P.; Sullivan, Brenda M.; Leatherwood, Jack D.; Mccurdy, David A.

    1992-01-01

    The determination of the magnitude of sonic boom exposure which would be acceptable to the general population requires, as a starting point, a method to assess and compare individual sonic booms. There is no consensus within the scientific and regulatory communities regarding an appropriate sonic boom assessment metric. Loudness, being a fundamental and well-understood attribute of human hearing was chosen as a means of comparing sonic booms of differing shapes and amplitudes. The figure illustrates the basic steps which yield a calculated value of loudness. Based upon the aircraft configuration and its operating conditions, the sonic boom pressure signature which reaches the ground is calculated. This pressure-time history is transformed to the frequency domain and converted into a one-third octave band spectrum. The essence of the loudness method is to account for the frequency response and integration characteristics of the auditory system. The result of the calculation procedure is a numerical description (perceived level, dB) which represents the loudness of the sonic boom waveform.

  3. "Feeling better" or "feeling well" in usual care of hip and knee osteoarthritis pain: determination of cutoff points for patient acceptable symptom state (PASS) and minimal clinically important improvement (MCII) at rest and on movement in a national multicenter cohort study of 2414 patients with painful osteoarthritis.

    PubMed

    Perrot, Serge; Bertin, Philippe

    2013-02-01

    Patient-reported outcome measures are being developed for more relevant assessments of pain management. The patient acceptable symptom state (PASS) ("feeling well") and the minimal clinically important improvement (MCII) ("feeling better") have been determined in clinical trials, but not in daily pain management. We carried out a national multicenter cohort study of patients over the age of 50years with painful knee osteoarthritis (KOA) or hip osteoarthritis (HOA) who had visited their general practitioner and required treatment for more than 7days. Overall, 2414 patients (50.2% men, mean age 67.3years, body mass index 27.9kg/m(2), 33.5% with HOA) were enrolled by 1116 general practitioners. After 7days of treatment, PASS was estimated on a numerical rating scale as 4 at rest and 5 on movement, for both HOA and KOA, above the PASS threshold in clinical trials. In KOA, PASS was more frequently reached in men and younger people with less pain at rest and on movement, and in patients specifically seeking an improvement during sport activities. In HOA, PASS was most frequently reached in patients with low levels of pain at risk and in nonobese patients. MCII was -1 numerical rating scale point after 7days of usual treatment. This improvement is smaller than that recorded in randomized controlled trials, and was the same for both sites, both at rest and on movement. In conclusion, patient-reported outcome values in daily practice differ from those in clinical trials, and their determinant factors may depend on the site of osteoarthritis. Assessments of the treatment of painful osteoarthritis should be adapted to the characteristics and daily life of the patient, to personalize patient management. PMID:23265687

  4. The acceptability of cochlear implants and vibrotactile aids.

    PubMed

    Thornton, A R

    1988-05-01

    To obtain data on the likely acceptability of cochlear implants (and of vibrotactile aids), a questionnaire was sent to profoundly/totally hearing-impaired patients. The patients were asked how they felt about their current communication problems and possible benefits to be obtained from such devices. Of the 153 replies obtained, the combined 'yes' or 'maybe' responses indicated that 58% would accept an implant. The corresponding figure for vibrotactile aids was 73%. The statistically significant factors correlating with cochlear implant acceptance were the patient's expectation of the benefit it would give, the time needed for rehabilitation and the degree of communication difficulty that they suffer. The only significant factor in acceptance of a vibrotactile aid was whether the patient had attended the IHR clinic. This implies that the underlying factor is the patient's knowledge about these devices. PMID:2968826

  5. Methods to Mark Termites with Protein for Mark-Release-Recapture and Mark-Capture Type Studies.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Studies were conducted to investigate the feasibility of marking the southwestern desert subterranean termite, Heterotermes aureus (Snyder), with rabbit immunoglobulin G (IgG) protein for mark-release-recapture (MRR) and mark-capture type studies. Qualitative laboratory studies were conducted to de...

  6. Use of tetracycline hydrochloride and alizarin complexone for immersion marking black rockfish Sebastes schlegelii

    NASA Astrophysics Data System (ADS)

    Lü, Hongjian; Zhang, Xiumei; Fu, Mei; Xi, Dan; Gao, Tianxiang

    2014-07-01

    We tested the utility of chemical marking techniques in the juvenile black rockfish Sebastes schlegelii. Juveniles (30-40 mm total length) were immersed in a range of tetracycline hydrochloride (TC) solutions at concentrations ranging from 300 to 500 mg/L, and alizarin complexone (ALC) solutions at concentrations ranging from 200 to 400 mg/L in filtered sea water (salinity of 30) for 24 h, respectively. Otoliths (sagittae, asteriscus), scales, fin rays (dorsal, pectoral, ventral, anal, and caudal fin rays), and fin spines (dorsal, ventral, and anal fin spines) were sampled and used to detect fluorescent marks after a 60-day growth experiment. With the exception of 300 mg/L TC, acceptable marks were produced in the otoliths and fin spines by all concentrations of TC and ALC. In particular, we observed clearly visible marks in the sagittae, asteriscus, and fin spines under normal light at concentrations of 200-400 mg/L, 250-400 mg/L, and 250-400 mg/L ALC, respectively. Scales and fin rays had acceptable marks at much higher concentrations (≥350 mg/L TC, ≥250 mg/L ALC for scales and ≥350 mg/L TC, ≥300 mg/L ALC for fin rays). The best mark quality (i.e., acceptable marks were observed in all sampled structures after immersion marking) were obtained following immersion in TC at between 350-500 mg/L, and ALC between 300-400 mg/L. In addition, there was no significant difference in survival and growth of TC and ALC marked fish compared to their controls up to 60 days post-marking ( P > 0.05).

  7. The research of laser marking control technology

    NASA Astrophysics Data System (ADS)

    Zhang, Qiue; Zhang, Rong

    2009-08-01

    In the area of Laser marking, the general control method is insert control card to computer's mother board, it can not support hot swap, it is difficult to assemble or it. Moreover, the one marking system must to equip one computer. In the system marking, the computer can not to do the other things except to transmit marking digital information. Otherwise it can affect marking precision. Based on traditional control methods existed some problems, introduced marking graphic editing and digital processing by the computer finish, high-speed digital signal processor (DSP) control marking the whole process. The laser marking controller is mainly contain DSP2812, digital memorizer, DAC (digital analog converting) transform unit circuit, USB interface control circuit, man-machine interface circuit, and other logic control circuit. Download the marking information which is processed by computer to U disk, DSP read the information by USB interface on time, then processing it, adopt the DSP inter timer control the marking time sequence, output the scanner control signal by D/A parts. Apply the technology can realize marking offline, thereby reduce the product cost, increase the product efficiency. The system have good effect in actual unit markings, the marking speed is more quickly than PCI control card to 20 percent. It has application value in practicality.

  8. Patients’ acceptance of corticotomy-assisted orthodontics

    PubMed Central

    Zawawi, Khalid H

    2015-01-01

    Objective To study patients’ acceptance of corticotomy-assisted orthodontics as a treatment option. Methods Adult patients seeking orthodontic treatment were asked to complete two sets of questionnaires; the first set included questions about age, sex, and level of education and general questions about orthodontic treatment; and the second set was related to the corticotomy-assisted orthodontics. Before answering the corticotomy questions, a brief description of the clinical procedure was explained and photographs of an actual procedure were shown. Results A total of 150 subjects were approached and 129 (86%) agreed to answer the questionnaires (72 male and 57 female patients). Of these, only 3.1% did hear about corticotomy and 7.8% selected corticotomy instead of extraction. Fear from the surgery (53.2%) was the most frequent reason for not selecting corticotomy followed by fear from pain (36.9%). The acceptance of corticotomy between males and females was similar. No relationship was found between the level of education and prior knowledge of the procedure, P=0.857. Prior knowledge about corticotomy was not a factor in selecting it as a treatment option (P=0.556) to reduce the treatment time (P=0.427). Conclusion The acceptance of corticotomy-assisted orthodontics as a treatment option was low. Fear from the surgery was the main reason for not selecting it. The acceptance of corticotomy-assisted orthodontics was not related to patient’s level of education or sex. PMID:26316719

  9. 42 CFR 35.62 - Acceptance of contributions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Acceptance of contributions. 35.62 Section 35.62 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.62 Acceptance...

  10. 42 CFR 35.62 - Acceptance of contributions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Acceptance of contributions. 35.62 Section 35.62 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.62 Acceptance...

  11. 42 CFR 35.62 - Acceptance of contributions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Acceptance of contributions. 35.62 Section 35.62 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.62 Acceptance...

  12. 42 CFR 35.62 - Acceptance of contributions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Acceptance of contributions. 35.62 Section 35.62 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.62 Acceptance...

  13. Acceptability for French People of Physician-Assisted Suicide

    ERIC Educational Resources Information Center

    Frileux, Stephanie; Sastre, Maria Teresa Munoz; Antonini, Sophie; Mullet, Etienne; Sorum, Paul Clay

    2004-01-01

    Our aim was to understand better how people judge the acceptability of physician-assisted suicide (PAS). We found that, for people in France of all ages and for elderly people with life-threatening illnesses, acceptability is an additive combination of the number of requests for PAS, the patient's age, the amount of physical suffering, and the…

  14. 14 CFR 25.1555 - Control markings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....1555 Control markings. (a) Each cockpit control, other than primary flight controls and controls whose... specific sequence, that sequence must be marked on, or adjacent to, the selector for those tanks; and...

  15. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Control markings. (a) Each cockpit control, other than primary flight controls or control whose function... any tanks in a specific sequence, that sequence must be marked on, or adjacent to, the selector...

  16. 14 CFR 25.1555 - Control markings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....1555 Control markings. (a) Each cockpit control, other than primary flight controls and controls whose... specific sequence, that sequence must be marked on, or adjacent to, the selector for those tanks; and...

  17. 14 CFR 25.1555 - Control markings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....1555 Control markings. (a) Each cockpit control, other than primary flight controls and controls whose... specific sequence, that sequence must be marked on, or adjacent to, the selector for those tanks; and...

  18. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Control markings. (a) Each cockpit control, other than primary flight controls or control whose function... any tanks in a specific sequence, that sequence must be marked on, or adjacent to, the selector...

  19. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Control markings. (a) Each cockpit control, other than primary flight controls or control whose function... any tanks in a specific sequence, that sequence must be marked on, or adjacent to, the selector...

  20. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....1555 Control markings. (a) Each cockpit control, other than primary flight controls or control whose... any tanks in a specific sequence, that sequence must be marked on, or adjacent to, the selector...

  1. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....1555 Control markings. (a) Each cockpit control, other than primary flight controls or control whose... any tanks in a specific sequence, that sequence must be marked on, or adjacent to, the selector...

  2. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....1555 Control markings. (a) Each cockpit control, other than primary flight controls or control whose... any tanks in a specific sequence, that sequence must be marked on, or adjacent to, the selector...

  3. DSN tracking system: Mark III-77

    NASA Technical Reports Server (NTRS)

    Chaney, W. D.

    1977-01-01

    The Deep Space Network tracking system is described. Revisions of subsystem Mark III-75 are briefly outlined, and the currently used multimission support subsystem Mark III-77 is described. Tracking functions performed are given as well.

  4. 46 CFR 160.028-5 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Signal Pistols for Red Flare Distress Signals § 160.028-5 Marking. (a) General. Each signal pistol shall be permanently and legibly marked with its serial...

  5. 46 CFR 160.049-6 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Marking. (a) Each buoyant cushion must have the following information clearly marked in waterproof... cushions shall be sufficiently waterproof so that after 72 hours submergence in water, it will...

  6. 46 CFR 160.048-6 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Marking. (a) Each buoyant cushion must have the following information clearly marked in waterproof... waterproof so that after 72 hours submergence in water, it will withstand vigorous rubbing by hand while...

  7. 46 CFR 160.049-6 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Marking. (a) Each buoyant cushion must have the following information clearly marked in waterproof... cushions shall be sufficiently waterproof so that after 72 hours submergence in water, it will...

  8. 46 CFR 160.048-6 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Marking. (a) Each buoyant cushion must have the following information clearly marked in waterproof... waterproof so that after 72 hours submergence in water, it will withstand vigorous rubbing by hand while...

  9. 46 CFR 160.048-6 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Marking. (a) Each buoyant cushion must have the following information clearly marked in waterproof... waterproof so that after 72 hours submergence in water, it will withstand vigorous rubbing by hand while...

  10. 46 CFR 160.048-6 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Marking. (a) Each buoyant cushion must have the following information clearly marked in waterproof... waterproof so that after 72 hours submergence in water, it will withstand vigorous rubbing by hand while...

  11. 46 CFR 160.048-6 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Marking. (a) Each buoyant cushion must have the following information clearly marked in waterproof... waterproof so that after 72 hours submergence in water, it will withstand vigorous rubbing by hand while...

  12. Absence of canonical active chromatin marks in developmentally regulated genes

    PubMed Central

    Ruiz-Romero, Marina; Corominas, Montserrat; Guigó, Roderic

    2015-01-01

    The interplay of active and repressive histone modifications is assumed to play a key role in the regulation of gene expression. In contrast to this generally accepted view, we show that transcription of genes temporally regulated during fly and worm development occurs in the absence of canonically active histone modifications. Conversely, strong chromatin marking is related to transcriptional and post-transcriptional stability, an association that we also observe in mammals. Our results support a model in which chromatin marking is associated to stable production of RNA, while unmarked chromatin would permit rapid gene activation and de-activation during development. In this case, regulation by transcription factors would play a comparatively more important regulatory role. PMID:26280901

  13. 7 CFR 160.32 - Marking containers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Marking containers. 160.32 Section 160.32 Agriculture... STANDARDS FOR NAVAL STORES Analysis, Inspection, and Grading on Request § 160.32 Marking containers. The interested person shall provide any labor necessary for marking the containers, after the contents have...

  14. 46 CFR 122.602 - Hull markings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Hull markings. 122.602 Section 122.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150....602 Hull markings. (a) Each vessel must be marked as required by part 67, subpart I, of this...

  15. 46 CFR 122.602 - Hull markings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Hull markings. 122.602 Section 122.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150....602 Hull markings. (a) Each vessel must be marked as required by part 67, subpart I, of this...

  16. 46 CFR 122.602 - Hull markings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Hull markings. 122.602 Section 122.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150....602 Hull markings. (a) Each vessel must be marked as required by part 67, subpart I, of this...

  17. 46 CFR 122.602 - Hull markings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Hull markings. 122.602 Section 122.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150....602 Hull markings. (a) Each vessel must be marked as required by part 67, subpart I, of this...

  18. 46 CFR 122.602 - Hull markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Hull markings. 122.602 Section 122.602 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150....602 Hull markings. (a) Each vessel must be marked as required by part 67, subpart I, of this...

  19. 27 CFR 28.123 - Export marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Export marks. 28.123..., or Transportation to a Manufacturing Bonded Warehouse § 28.123 Export marks. (a) General. In addition to the marks and brands required to be placed on packages or cases of wine at the time they...

  20. 27 CFR 19.752 - Marks.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Marks. 19.752 Section 19... Marks. (a) Fuel alcohol. A proprietor of an alcohol fuel plant must place a conspicuous and permanent warning mark or label on each container of 55 gallons or less of fuel alcohol that the proprietor...

  1. 37 CFR 2.45 - Certification mark.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Certification mark. 2.45... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.45 Certification mark. (a) In an application to register a certification mark under section 1(a) of the Act, the application shall include...

  2. 27 CFR 19.752 - Marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Marks. 19.752 Section 19... Marks. (a) Fuel alcohol. A proprietor of an alcohol fuel plant must place a conspicuous and permanent warning mark or label on each container of 55 gallons or less of fuel alcohol that the proprietor...

  3. 14 CFR 29.871 - Leveling marks.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Leveling marks. 29.871 Section 29.871... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 29.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  4. 37 CFR 2.44 - Collective mark.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Collective mark. 2.44 Section... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.44 Collective mark. (a) In an application to register a collective mark under section 1(a) of the Act, the application shall specify...

  5. 37 CFR 2.45 - Certification mark.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Certification mark. 2.45... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.45 Certification mark. (a) In an application to register a certification mark under section 1(a) of the Act, the application shall include...

  6. 37 CFR 2.43 - Service mark.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Service mark. 2.43 Section 2... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.43 Service mark. In an application to register a service mark, the application shall specify and contain all the elements required...

  7. 37 CFR 2.43 - Service mark.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Service mark. 2.43 Section 2... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.43 Service mark. In an application to register a service mark, the application shall specify and contain all the elements required...

  8. 37 CFR 2.45 - Certification mark.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Certification mark. 2.45... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.45 Certification mark. (a) In an application to register a certification mark under section 1(a) of the Act, the application shall include...

  9. 27 CFR 28.123 - Export marks.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export marks. 28.123..., or Transportation to a Manufacturing Bonded Warehouse § 28.123 Export marks. (a) General. In addition to the marks and brands required to be placed on packages or cases of wine at the time they...

  10. 14 CFR 29.871 - Leveling marks.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Leveling marks. 29.871 Section 29.871... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 29.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  11. 37 CFR 2.43 - Service mark.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Service mark. 2.43 Section 2... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.43 Service mark. In an application to register a service mark, the application shall specify and contain all the elements required...

  12. 37 CFR 2.44 - Collective mark.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Collective mark. 2.44 Section... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.44 Collective mark. (a) In an application to register a collective mark under section 1(a) of the Act, the application shall specify...

  13. 14 CFR 29.871 - Leveling marks.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Leveling marks. 29.871 Section 29.871... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 29.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  14. 37 CFR 2.45 - Certification mark.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Certification mark. 2.45... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.45 Certification mark. (a) In an application to register a certification mark under section 1(a) of the Act, the application shall include...

  15. 14 CFR 27.871 - Leveling marks.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Leveling marks. 27.871 Section 27.871... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 27.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  16. 14 CFR 27.871 - Leveling marks.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Leveling marks. 27.871 Section 27.871... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 27.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  17. 27 CFR 19.752 - Marks.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Marks. 19.752 Section 19... Marks. (a) Fuel alcohol. A proprietor of an alcohol fuel plant must place a conspicuous and permanent warning mark or label on each container of 55 gallons or less of fuel alcohol that the proprietor...

  18. 14 CFR 29.871 - Leveling marks.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Leveling marks. 29.871 Section 29.871... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 29.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  19. Marking Student Programs Using Graph Similarity

    ERIC Educational Resources Information Center

    Naude, Kevin A.; Greyling, Jean H.; Vogts, Dieter

    2010-01-01

    We present a novel approach to the automated marking of student programming assignments. Our technique quantifies the structural similarity between unmarked student submissions and marked solutions, and is the basis by which we assign marks. This is accomplished through an efficient novel graph similarity measure ("AssignSim"). Our experiments…

  20. 37 CFR 2.44 - Collective mark.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Collective mark. 2.44 Section... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.44 Collective mark. (a) In an application to register a collective mark under section 1(a) of the Act, the application shall specify...

  1. 27 CFR 28.123 - Export marks.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Export marks. 28.123..., or Transportation to a Manufacturing Bonded Warehouse § 28.123 Export marks. (a) General. In addition to the marks and brands required to be placed on packages or cases of wine at the time they...

  2. 27 CFR 28.123 - Export marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Export marks. 28.123..., or Transportation to a Manufacturing Bonded Warehouse § 28.123 Export marks. (a) General. In addition to the marks and brands required to be placed on packages or cases of wine at the time they...

  3. 27 CFR 19.752 - Marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Marks. 19.752 Section 19... Marks. (a) Fuel alcohol. A proprietor of an alcohol fuel plant must place a conspicuous and permanent warning mark or label on each container of 55 gallons or less of fuel alcohol that the proprietor...

  4. 37 CFR 2.43 - Service mark.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Service mark. 2.43 Section 2... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.43 Service mark. In an application to register a service mark, the application shall specify and contain all the elements required...

  5. 37 CFR 2.44 - Collective mark.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Collective mark. 2.44 Section... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.44 Collective mark. (a) In an application to register a collective mark under section 1(a) of the Act, the application shall specify...

  6. 14 CFR 27.871 - Leveling marks.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Leveling marks. 27.871 Section 27.871... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 27.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  7. 14 CFR 29.871 - Leveling marks.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Leveling marks. 29.871 Section 29.871... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 29.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  8. 37 CFR 2.45 - Certification mark.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Certification mark. 2.45... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.45 Certification mark. (a) In an application to register a certification mark under section 1(a) of the Act, the application shall include...

  9. 37 CFR 2.43 - Service mark.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Service mark. 2.43 Section 2... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.43 Service mark. In an application to register a service mark, the application shall specify and contain all the elements required...

  10. 14 CFR 27.871 - Leveling marks.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Leveling marks. 27.871 Section 27.871... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 27.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  11. 37 CFR 2.44 - Collective mark.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Collective mark. 2.44 Section... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.44 Collective mark. (a) In an application to register a collective mark under section 1(a) of the Act, the application shall specify...

  12. 14 CFR 27.871 - Leveling marks.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Leveling marks. 27.871 Section 27.871... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Miscellaneous § 27.871 Leveling marks. There must be reference marks for leveling the rotorcraft on the ground....

  13. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Control markings. 27.1555 Section 27.1555 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Operating Limitations and Information Markings and Placards § 27.1555 Control markings. (a) Each...

  14. 14 CFR 25.1555 - Control markings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Control markings. 25.1555 Section 25.1555 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Operating Limitations and Information Markings and Placards § 25.1555 Control markings. (a) Each...

  15. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Control markings. 29.1555 Section 29.1555 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Operating Limitations and Information Markings and Placards § 29.1555 Control markings. (a)...

  16. 46 CFR 160.174-23 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the Coast Guard approval number. (b) Each storage case must be marked with the words “Thermal...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Thermal Protective Aids § 160.174-23 Marking. (a) Each thermal protective aid must be marked with the words “Thermal Protective Aid,” the name of the manufacturer,...

  17. 46 CFR 162.018-6 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Safety Relief Valves, Liquefied Compressed Gas § 162.018-6 Marking. (a) Each safety relief valve shall be plainly marked by the manufacturer with the required data... valve or stamped or cast on a plate securely fastened to the valve. The marking shall include...

  18. 22 CFR 9a.6 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Marking. 9a.6 Section 9a.6 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS APPLICABLE TO CERTAIN INTERNATIONAL ENERGY PROGRAMS; RELATED MATERIAL § 9a.6 Marking. (a) The provisions of 22 CFR 9.15 through 9.19 shall govern the marking of information or...

  19. 49 CFR 180.213 - Requalification markings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... be marked on the external surface of the footring. (c) Requalification marking method. The depth of..., securely affixed in a manner prescribed by the cylinder manufacturer, near the original manufacturer's label. Stamping of the composite surface is not authorized. (d) Requalification markings. Each...

  20. 46 CFR 134.160 - Freeboard markings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Freeboard markings. 134.160 Section 134.160 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS ADDED PROVISIONS FOR LIFTBOATS § 134.160 Freeboard markings. Freeboard markings required by § 174.260 of this subchapter must...

  1. 46 CFR 134.160 - Freeboard markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Freeboard markings. 134.160 Section 134.160 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS ADDED PROVISIONS FOR LIFTBOATS § 134.160 Freeboard markings. Freeboard markings required by § 174.260 of this subchapter must...

  2. 46 CFR 134.160 - Freeboard markings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Freeboard markings. 134.160 Section 134.160 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS ADDED PROVISIONS FOR LIFTBOATS § 134.160 Freeboard markings. Freeboard markings required by § 174.260 of this subchapter must...

  3. 46 CFR 134.160 - Freeboard markings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Freeboard markings. 134.160 Section 134.160 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS ADDED PROVISIONS FOR LIFTBOATS § 134.160 Freeboard markings. Freeboard markings required by § 174.260 of this subchapter must...

  4. 46 CFR 134.160 - Freeboard markings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Freeboard markings. 134.160 Section 134.160 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS ADDED PROVISIONS FOR LIFTBOATS § 134.160 Freeboard markings. Freeboard markings required by § 174.260 of this subchapter must...

  5. The Text Marking Patterns of College Students.

    ERIC Educational Resources Information Center

    Nist, Sherrie L.; Kirby, Katie

    1989-01-01

    Examines patterns in college students' text markings using texts from three content areas: history, political science, and sociology. Indicates little differential marking between various text-types. Concludes that students seem to have little idea how to mark text efficiently. (MG)

  6. 46 CFR 160.047-6 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... marked in waterproof lettering that can be read at a distance of 2 feet: Type II Personal Flotation....). (Name and address of manufacturer or distributor.). (Lot No.). (b) Waterproof marking tags. Marking for buoyant vests shall be sufficiently waterproof so that after 72 hours submergence in water, it...

  7. 46 CFR 160.047-6 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... marked in waterproof lettering that can be read at a distance of 2 feet: Type II Personal Flotation....). (Name and address of manufacturer or distributor.). (Lot No.). (b) Waterproof marking tags. Marking for buoyant vests shall be sufficiently waterproof so that after 72 hours submergence in water, it...

  8. 46 CFR 160.047-6 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... marked in waterproof lettering that can be read at a distance of 2 feet: Type II Personal Flotation....). (Name and address of manufacturer or distributor.). (Lot No.). (b) Waterproof marking tags. Marking for buoyant vests shall be sufficiently waterproof so that after 72 hours submergence in water, it...

  9. 46 CFR 160.047-6 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... marked in waterproof lettering that can be read at a distance of 2 feet: Type II Personal Flotation....). (Name and address of manufacturer or distributor.). (Lot No.). (b) Waterproof marking tags. Marking for buoyant vests shall be sufficiently waterproof so that after 72 hours submergence in water, it...

  10. 46 CFR 160.047-6 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... marked in waterproof lettering that can be read at a distance of 2 feet: Type II Personal Flotation....). (Name and address of manufacturer or distributor.). (Lot No.). (b) Waterproof marking tags. Marking for buoyant vests shall be sufficiently waterproof so that after 72 hours submergence in water, it...

  11. 14 CFR 25.1555 - Control markings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Control markings. 25.1555 Section 25.1555....1555 Control markings. (a) Each cockpit control, other than primary flight controls and controls whose... aerodynamic control must be marked under the requirements of §§ 25.677 and 25.699. (c) For powerplant...

  12. 49 CFR 15.13 - Marking SSI.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Sensitive Security Information that is controlled under 49 CFR parts 15 and 1520. No part of this record may... Office of the Secretary of Transportation PROTECTION OF SENSITIVE SECURITY INFORMATION § 15.13 Marking... document. (b) Protective marking. The protective marking is: SENSITIVE SECURITY INFORMATION....

  13. 49 CFR 15.13 - Marking SSI.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Sensitive Security Information that is controlled under 49 CFR parts 15 and 1520. No part of this record may... Office of the Secretary of Transportation PROTECTION OF SENSITIVE SECURITY INFORMATION § 15.13 Marking... document. (b) Protective marking. The protective marking is: SENSITIVE SECURITY INFORMATION....

  14. 49 CFR 15.13 - Marking SSI.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Sensitive Security Information that is controlled under 49 CFR parts 15 and 1520. No part of this record may... Office of the Secretary of Transportation PROTECTION OF SENSITIVE SECURITY INFORMATION § 15.13 Marking... document. (b) Protective marking. The protective marking is: SENSITIVE SECURITY INFORMATION....

  15. 49 CFR 15.13 - Marking SSI.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Sensitive Security Information that is controlled under 49 CFR parts 15 and 1520. No part of this record may... Office of the Secretary of Transportation PROTECTION OF SENSITIVE SECURITY INFORMATION § 15.13 Marking... document. (b) Protective marking. The protective marking is: SENSITIVE SECURITY INFORMATION....

  16. 46 CFR 69.177 - Markings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Markings. 69.177 Section 69.177 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS Dual Measurement System § 69.177 Markings. (a) Tonnage mark. (1) All vessels with a second deck that are measured under the Dual...

  17. 46 CFR 69.177 - Markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Markings. 69.177 Section 69.177 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS Dual Measurement System § 69.177 Markings. (a) Tonnage mark. (1) All vessels with a second deck that are measured under the Dual...

  18. 46 CFR 69.177 - Markings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Markings. 69.177 Section 69.177 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS Dual Measurement System § 69.177 Markings. (a) Tonnage mark. (1) All vessels with a second deck that are measured under the Dual...

  19. Classroom Mark-Recapture with Crickets

    ERIC Educational Resources Information Center

    Whiteley, Andrew R.; Woolfe, Jennifer; Kennedy, Kathleen; Oberbillig, David; Brewer, Carol

    2007-01-01

    Mark-recapture techniques are commonly used by ecologists to estimate abundance of naturally occurring animals and are an important component of ecology curricula. This investigation teaches a mark-recapture technique using store-bought crickets in 10-gallon aquaria and provides an inexpensive way to teach students about mark-recapture in a real…

  20. 27 CFR 19.485 - Marks on containers of Puerto Rican and Virgin Islands spirits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... subpart, the markings prescribed by 27 CFR 26.40, modified to show the serial number of the Form 5110.31 prefixed by “Form 5110.31”, rather than the serial number and identification of the Form 487-B, shall be... subpart, the markings prescribed by 27 CFR 26.206 that are on such packages shall be accepted in lieu...

  1. Analysis of detected signal performance in multi-tracks of optical disk memory using convex-shaped recording mark

    NASA Astrophysics Data System (ADS)

    Otani, Yousuke; Nitta, Kouichi; Matoba, Osamu

    2014-09-01

    The possibility of multi-valued optical disk memory by using a convex-shaped recording mark fabricated by two-photon absorption is investigated. We fabricate a numerical model for convex-shaped recording marks and evaluate the signal characteristics in terms of the signal-to-noise ratio (SNR). The numerical results show that 6 bit data can be realized when the acceptable average SNR is 2 and a length of the mark is 4T.

  2. Phase II-I-II Study of Two Different Doses and Schedules of Pralatrexate, a High-Affinity Substrate for the Reduced Folate Carrier, in Patients With Relapsed or Refractory Lymphoma Reveals Marked Activity in T-Cell Malignancies

    PubMed Central

    O'Connor, Owen A.; Horwitz, Steven; Hamlin, Paul; Portlock, Carol; Moskowitz, Craig H.; Sarasohn, Debra; Neylon, Ellen; Mastrella, Jill; Hamelers, Rachel; MacGregor-Cortelli, Barbara; Patterson, Molly; Seshan, Venkatraman E.; Sirotnak, Frank; Fleisher, Martin; Mould, Diane R.; Saunders, Mike; Zelenetz, Andrew D.

    2009-01-01

    Purpose To determine the maximum-tolerated dose (MTD) and efficacy of pralatrexate in patients with lymphoma. Patients and Methods Pralatrexate, initially given at a dose of 135 mg/m2 on an every-other-week basis, was associated with stomatitis. A redesigned, weekly phase I/II study established an MTD of 30 mg/m2 weekly for six weeks every 7 weeks. Patients were required to have relapsed/refractory disease, an absolute neutrophil greater than 1,000/μL, and a platelet count greater than 50,000/μL for the first dose of any cycle. Results The every-other-week, phase II experience was associated with an increased risk of stomatitis and hematologic toxicity. On a weekly schedule, the MTD was 30 mg/m2 weekly for 6 weeks every 7 weeks. This schedule modification resulted in a 50% reduction in the major hematologic toxicities and abrogation of the grades 3 to 4 stomatitis. Stomatitis was associated with elevated homocysteine and methylmalonic acid, which were reduced by folate and vitamin B12 supplementation. Of 48 assessable patients, the overall response rate was 31% (26% by intention to treat), including 17% who experienced complete remission (CR). When analyzed by lineage, the overall response rates were 10% and 54% in patients with B- and T-cell lymphomas, respectively. All eight patients who experienced CR had T-cell lymphoma, and four of the six patients with a partial remission were positron emission tomography negative. The duration of responses ranged from 3 to 26 months. Conclusion Pralatrexate has significant single-agent activity in patients with relapsed/refractory T-cell lymphoma. PMID:19652067

  3. Standards and practices for bite mark photography.

    PubMed

    Golden, G S

    2011-12-01

    In most crimes where bite marks are discovered, photographic accuracy is crucial to the investigative process since in many instances the bite mark(s) may be the only evidence linking a particular suspect to the crime. Therefore, the rationale for employing superior photographic principles is mandatory for the investigation team. This paper will discuss current standards, best practice, and armamentaria for digital photography of bite mark injuries on skin. Full spectrum protocols will be described including Alternate Light Imaging, Reflective Ultra-violet, and Infrared techniques for photo-documentation of images of bite marks and other bruise patterns that have been inflicted on human skin. PMID:22717911

  4. Staff Acceptance of Tele-ICU Coverage

    PubMed Central

    Chan, Paul S.; Cram, Peter

    2011-01-01

    Background: Remote coverage of ICUs is increasing, but staff acceptance of this new technology is incompletely characterized. We conducted a systematic review to summarize existing research on acceptance of tele-ICU coverage among ICU staff. Methods: We searched for published articles pertaining to critical care telemedicine systems (aka, tele-ICU) between January 1950 and March 2010 using PubMed, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Library and abstracts and presentations delivered at national conferences. Studies were included if they provided original qualitative or quantitative data on staff perceptions of tele-ICU coverage. Studies were imported into content analysis software and coded by tele-ICU configuration, methodology, participants, and findings (eg, positive and negative staff evaluations). Results: Review of 3,086 citations yielded 23 eligible studies. Findings were grouped into four categories of staff evaluation: overall acceptance level of tele-ICU coverage (measured in 70% of studies), impact on patient care (measured in 96%), impact on staff (measured in 100%), and organizational impact (measured in 48%). Overall acceptance was high, despite initial ambivalence. Favorable impact on patient care was perceived by > 82% of participants. Staff impact referenced enhanced collaboration, autonomy, and training, although scrutiny, malfunctions, and contradictory advice were cited as potential barriers. Staff perceived the organizational impact to vary. An important limitation of available studies was a lack of rigorous methodology and validated survey instruments in many studies. Conclusions: Initial reports suggest high levels of staff acceptance of tele-ICU coverage, but more rigorous methodologic study is required. PMID:21051386

  5. Accepters and Rejecters of Counseling.

    ERIC Educational Resources Information Center

    Rose, Harriett A.; Elton, Charles F.

    Personality differences between students who accept or reject proffered counseling assistance were investigated by comparing personality traits of 116 male students at the University of Kentucky who accepted or rejected letters of invitation to group counseling. Factor analysis of Omnibus Personality Inventory (OPI) scores to two groups of 60 and…

  6. Cone penetrometer acceptance test report

    SciTech Connect

    Boechler, G.N.

    1996-09-19

    This Acceptance Test Report (ATR) documents the results of acceptance test procedure WHC-SD-WM-ATR-151. Included in this report is a summary of the tests, the results and issues, the signature and sign- off ATP pages, and a summarized table of the specification vs. ATP section that satisfied the specification.

  7. Feasibility and acceptability of remotely monitored pedometer-guided physical activity.

    PubMed

    Darvall, J N; Parker, A; Story, D A

    2016-07-01

    Nearly 70% of the Australian adult population are either sedentary, or have low levels of physical activity. There has been interest in addressing this problem by the 'mHealth', or mobile Health, arena, which is concerned with the confluence of mobile technology and health promotion. The newer generation of activity pedometers has the ability to automatically upload information, to enable aggregation and meta-data analysis of individual patient data. We conducted a ten-week pilot trial of the Fitbit Zip® pedometer using a validated tool in ten volunteers, finding it highly acceptable to both participants and investigators. Data synching was ranked as 'very easy' or 'easy' by all participants, and investigators could successfully monitor activity levels remotely. Median (interquartile range) daily step counts of participants over the ten-week trial ranged from 5471 (4591-7026) to 18779 (15031-21505) steps. Sedentary time over the study period ranged from 1.4% to 33.3% of study days. Percentage of days reaching the target activity level of >10,000 steps/day varied markedly between participants from 4.5% to 95.7%. This study demonstrates the feasibility and acceptability of a remotely monitored pedometer-guided physical activity intervention. This technology may be useful to encourage increased exercise as a form of 'prehabilitation' of adequately screened at-risk surgical or obstetric patients. PMID:27456182

  8. 2013 SYR Accepted Poster Abstracts.

    PubMed

    2013-01-01

    Promote Health and Well-being Among Middle School Educators. 20. A Systematic Review of Yoga-based Interventions for Objective and Subjective Balance Measures. 21. Disparities in Yoga Use: A Multivariate Analysis of 2007 National Health Interview Survey Data. 22. Implementing Yoga Therapy Adapted for Older Veterans Who Are Cancer Survivors. 23. Randomized, Controlled Trial of Yoga for Women With Major Depressive Disorder: Decreased Ruminations as Potential Mechanism for Effects on Depression? 24. Yoga Beyond the Metropolis: A Yoga Telehealth Program for Veterans. 25. Yoga Practice Frequency, Relationship Maintenance Behaviors, and the Potential Mediating Role of Relationally Interdependent Cognition. 26. Effects of Medical Yoga in Quality of Life, Blood Pressure, and Heart Rate in Patients With Paroxysmal Atrial Fibrillation. 27. Yoga During School May Promote Emotion Regulation Capacity in Adolescents: A Group Randomized, Controlled Study. 28. Integrated Yoga Therapy in a Single Session as a Stress Management Technique in Comparison With Other Techniques. 29. Effects of a Classroom-based Yoga Intervention on Stress and Attention in Second and Third Grade Students. 30. Improving Memory, Attention, and Executive Function in Older Adults with Yoga Therapy. 31. Reasons for Starting and Continuing Yoga. 32. Yoga and Stress Management May Buffer Against Sexual Risk-Taking Behavior Increases in College Freshmen. 33. Whole-systems Ayurveda and Yoga Therapy for Obesity: Outcomes of a Pilot Study. 34. Women�s Phenomenological Experiences of Exercise, Breathing, and the Body During Yoga for Smoking Cessation Treatment. 35. Mindfulness as a Tool for Trauma Recovery: Examination of a Gender-responsive Trauma-informed Integrative Mindfulness Program for Female Inmates. 36. Yoga After Stroke Leads to Multiple Physical Improvements. 37. Tele-Yoga in Patients With Chronic Obstructive Pulmonary Disease and Heart Failure: A Mixed-methods Study of Feasibility, Acceptability, and Safety

  9. Interferon-α induces marked alterations in circulating regulatory T cells, NK cell subsets, and dendritic cells in patients with JAK2V617F-positive essential thrombocythemia and polycythemia vera.

    PubMed

    Riley, Caroline H; Brimnes, Marie K; Hansen, Morten; Jensen, Morten Krogh; Hasselbalch, Hans C; Kjaer, Lasse; Straten, Per Thor; Svane, Inge Marie

    2016-07-01

    Long-term therapy with IFN-α2 is associated with sustained major molecular remissions in JAK2-positive ET and PV. The efficacy of IFN-α2 may be partly mediated by modulation of immune cells, which was investigated in twenty patients with ET (n = 6) and PV (n = 14). The frequency of CD4(+) CD25(+) Foxp3(+) T cells was significantly increased during IFN-α2 treatment in all patients (P < 0.0001). A significant expansion of the CD56(bright) NK cells (P = 0.0002) and a concomitant decrease in the frequency of CD56(dim) NK cells (P < 0.0001) were also detected. Myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) were studied in nine patients, and decreased frequencies of both cell types were observed during the course of treatment. On both mDCs and pDCs, HLA-ABC expression was upregulated (P = 0.003), but decreasing expression levels of HLA-DR was detected on mDCs. The expression of CD40 (P = 0.002), CD83 (P = 0.03), and CD86 (P = 0.01) increased, but was confined to pDCs. Furthermore, PD-L1 expression was reduced on mDC (P = 0.003) and increased on pDCs (P = 0.02). No significant correlations were found between the changes in immune cells and hematological or molecular responses achieved in our cohort of patients. So forth, it remains to be revealed whether the profound changes in circulating immune cells contribute to the beneficial effects of long-term IFN-α2 treatment in some patients. PMID:26385526

  10. Extending prayer marks as a sign of worsening chronic disease.

    PubMed

    Cangiano, M; Chisti, Mohammod J; Pietroni, Mark A C; Smith, Jonathan H

    2011-06-01

    A 60-year-old Muslim man was admitted to the Dhaka Hospital of ICDDR,B with an exacerbation of his chronic obstructive pulmonary disease. Incidental hyperpigmented skin lesions were noticed overlying the dorsum of his ankles, knees, and elbows. Such asymptomatic areas of thickened, lichenified and hyperpigmented skin are called 'prayer marks' and are well-imprinted on the knees, ankles, and forehead. These are secondary to prolonged periods of pressure over bony prominences during prayer. The patient's wife stated that the appearance of the elbow marks had coincided with an increase in his breathlessness and subsequent use of his elbows to rise from daily prayers. Prayer marks extending to the elbows could be a sign of worsening chronic disease. PMID:21766565

  11. An interview with Mark G. Hans

    PubMed Central

    Bolognese, Ana Maria; Palomo, Juan Martin; Miyashita, Kunihiko; Nojima, Lincoln Issamu; Nojima, Matilde da Cunha Gonçalves

    2014-01-01

    Medicine and residents in the Department of Orthodontics at CWRU. Part of his clinical practice at the university is devoted to the treatment of craniofacial anomalies and to special needs patients. Prof. Mark Hans has been wisely conducting the Joint Cephalometric Experts Group (JCEG) since 2008, held at the School of Dental Medicine (CWRU). He coordinates a team composed of American, Asian, Brazilian and European researchers and clinicians, working on the transition from 2D cephalometrics to 3D cone beam imaging as well as 3D models for diagnosis, treatment planning and assessment of orthodontic outcomes. Dr. Hans travels to different countries to give lectures on his fields of interest. Besides, he still maintains a clinical orthodontic practice at his private office. In every respect, Dr. Hans coordinates all activities with particular skill and performance. Married to Susan, they have two sons, Thomas and Jack and one daughter, Sarah and he enjoys playing jazz guitar for family and friends. Matilde da Cunha Gonçalves Nojima PMID:25162563

  12. An interview with Mark G. Hans.

    PubMed

    Hans, Mark G; Nojima, Matilde da Cunha Gonçalves

    2014-01-01

    Dental Medicine and residents in the Department of Orthodontics at CWRU. Part of his clinical practice at the university is devoted to the treatment of craniofacial anomalies and to special needs patients. Prof. Mark Hans has been wisely conducting the Joint Cephalometric Experts Group (JCEG) since 2008, held at the School of Dental Medicine (CWRU). He coordinates a team composed of American, Asian, Brazilian and European researchers and clinicians, working on the transition from 2D cephalometrics to 3D cone beam imaging as well as 3D models for diagnosis, treatment planning and assessment of orthodontic outcomes. Dr. Hans travels to different countries to give lectures on his fields of interest. Besides, he still maintains a clinical orthodontic practice at his private office. In every respect, Dr. Hans coordinates all activities with particular skill and performance. Married to Susan, they have two sons Thomas and Jack, and one daughter Sarah, and he enjoys playing jazz guitar for family and friends. PMID:25162563

  13. An analysis of hospital brand mark clusters.

    PubMed

    Vollmers, Stacy M; Miller, Darryl W; Kilic, Ozcan

    2010-07-01

    This study analyzed brand mark clusters (i.e., various types of brand marks displayed in combination) used by hospitals in the United States. The brand marks were assessed against several normative criteria for creating brand marks that are memorable and that elicit positive affect. Overall, results show a reasonably high level of adherence to many of these normative criteria. Many of the clusters exhibited pictorial elements that reflected benefits and that were conceptually consistent with the verbal content of the cluster. Also, many clusters featured icons that were balanced and moderately complex. However, only a few contained interactive imagery or taglines communicating benefits. PMID:20582849

  14. Accepted scientific research works (abstracts).

    PubMed

    2014-01-01

    These are the 39 accepted abstracts for IAYT's Symposium on Yoga Research (SYR) September 24-24, 2014 at the Kripalu Center for Yoga & Health and published in the Final Program Guide and Abstracts. PMID:25645134

  15. L-286 Acceptance Test Record

    SciTech Connect

    HARMON, B.C.

    2000-01-14

    This document provides a detailed account of how the acceptance testing was conducted for Project L-286, ''200E Area Sanitary Water Plant Effluent Stream Reduction''. The testing of the L-286 instrumentation system was conducted under the direct supervision

  16. Should Educators Accommodate Intolerance? Mark Halstead, Homosexuality, and the Islamic Case

    ERIC Educational Resources Information Center

    Merry, Michael S.

    2005-01-01

    The ideological interface between Muslims and liberal educators undoubtedly is strained in the realm of sex education, and perhaps on no topic more so than homosexuality. Mark Halstead argues that schools should not try to "undermine the faith" of Muslims, who object to teaching homosexuality as an "acceptable alternative lifestyle." In this…

  17. 33 CFR 62.31 - Special marks.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Special marks. 62.31 Section 62.31 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.31 Special marks....

  18. 33 CFR 62.31 - Special marks.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Special marks. 62.31 Section 62.31 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.31 Special marks....

  19. 33 CFR 62.31 - Special marks.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Special marks. 62.31 Section 62.31 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.31 Special marks....

  20. 33 CFR 62.31 - Special marks.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Special marks. 62.31 Section 62.31 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.31 Special marks....

  1. 33 CFR 62.31 - Special marks.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Special marks. 62.31 Section 62.31 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.31 Special marks....

  2. 25 CFR 141.16 - Price marking.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Price marking. 141.16 Section 141.16 Indians BUREAU OF... AND ZUNI RESERVATIONS General Business Practices § 141.16 Price marking. The price of each article... visible to the customer and that affords the customer a reasonable opportunity to learn the price of...

  3. 7 CFR 956.162 - Container markings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Container markings. 956.162 Section 956.162... WALLA VALLEY OF SOUTHEAST WASHINGTON AND NORTHEAST OREGON Rules and Regulations § 956.162 Container markings. Effective April 15, 1997, no handler shall ship any container of Walla Walla Sweet Onions...

  4. 30 CFR 7.90 - Approval marking.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Diesel Engines Intended for Use in Underground Coal Mines § 7.90 Approval marking. Each approved diesel engine shall be identified by a legible and... diesel engine. The marking shall also contain the following information: (a) Ventilation rate. (b)...

  5. 22 CFR 226.91 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... funded public communications and program materials for compliance with the approved Marking Plan. (3... packaging, must be marked with the USAID Identity. (f) After technical evaluation of applications for USAID... award. (g) After technical evaluation of applications for USAID funding, USAID Agreement Officers...

  6. 22 CFR 226.91 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... funded public communications and program materials for compliance with the approved Marking Plan. (3... packaging, must be marked with the USAID Identity. (f) After technical evaluation of applications for USAID... award. (g) After technical evaluation of applications for USAID funding, USAID Agreement Officers...

  7. 22 CFR 226.91 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... funded public communications and program materials for compliance with the approved Marking Plan. (3... packaging, must be marked with the USAID Identity. (f) After technical evaluation of applications for USAID... award. (g) After technical evaluation of applications for USAID funding, USAID Agreement Officers...

  8. Validating Onscreen Marking in Hong Kong

    ERIC Educational Resources Information Center

    Coniam, David

    2010-01-01

    This paper details an investigation into onscreen marking (OSM) in Hong Kong--where paper-based marking is being phased out, being completely superseded by OSM. The study described involved 30 raters who had previously rated English language essay scripts on screen in the 2007 Hong Kong Certificate of Education examination. In the current study,…

  9. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... showing rotor pitch or landing gear position, must be marked so that each crewmember can determine at any... be marked as to method of operation. (e) For rotorcraft incorporating retractable landing gear, the maximum landing gear operating speed must be displayed in clear view of the pilot....

  10. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... showing rotor pitch or landing gear position, must be marked so that each crewmember can determine at any... be marked as to method of operation. (e) For rotorcraft incorporating retractable landing gear, the maximum landing gear operating speed must be displayed in clear view of the pilot....

  11. 46 CFR 58.16-35 - Markings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Markings. 58.16-35 Section 58.16-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MAIN AND AUXILIARY MACHINERY AND RELATED SYSTEMS Liquefied Petroleum Gases for Cooking and Heating § 58.16-35 Markings. (a) The outside of...

  12. 46 CFR 58.16-35 - Markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Markings. 58.16-35 Section 58.16-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MAIN AND AUXILIARY MACHINERY AND RELATED SYSTEMS Liquefied Petroleum Gases for Cooking and Heating § 58.16-35 Markings. (a) The outside of...

  13. 46 CFR 58.16-35 - Markings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Markings. 58.16-35 Section 58.16-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MAIN AND AUXILIARY MACHINERY AND RELATED SYSTEMS Liquefied Petroleum Gases for Cooking and Heating § 58.16-35 Markings. (a) The outside of...

  14. 46 CFR 58.16-35 - Markings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Markings. 58.16-35 Section 58.16-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MAIN AND AUXILIARY MACHINERY AND RELATED SYSTEMS Liquefied Petroleum Gases for Cooking and Heating § 58.16-35 Markings. (a) The outside of...

  15. 46 CFR 58.16-35 - Markings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Markings. 58.16-35 Section 58.16-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MAIN AND AUXILIARY MACHINERY AND RELATED SYSTEMS Liquefied Petroleum Gases for Cooking and Heating § 58.16-35 Markings. (a) The outside of...

  16. 25 CFR 141.16 - Price marking.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Price marking. 141.16 Section 141.16 Indians BUREAU OF... AND ZUNI RESERVATIONS General Business Practices § 141.16 Price marking. The price of each article... visible to the customer and that affords the customer a reasonable opportunity to learn the price of...

  17. 25 CFR 141.16 - Price marking.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Price marking. 141.16 Section 141.16 Indians BUREAU OF... AND ZUNI RESERVATIONS General Business Practices § 141.16 Price marking. The price of each article... visible to the customer and that affords the customer a reasonable opportunity to learn the price of...

  18. 25 CFR 141.16 - Price marking.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Price marking. 141.16 Section 141.16 Indians BUREAU OF... AND ZUNI RESERVATIONS General Business Practices § 141.16 Price marking. The price of each article... visible to the customer and that affords the customer a reasonable opportunity to learn the price of...

  19. 25 CFR 141.16 - Price marking.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Price marking. 141.16 Section 141.16 Indians BUREAU OF... AND ZUNI RESERVATIONS General Business Practices § 141.16 Price marking. The price of each article... visible to the customer and that affords the customer a reasonable opportunity to learn the price of...

  20. 27 CFR 44.251 - Mark.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Mark. 44.251 Section 44.251 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE... Requirements § 44.251 Mark. Every package of cigars shall, before withdrawal from the customs warehouse...

  1. 27 CFR 44.251 - Mark.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Mark. 44.251 Section 44.251 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE... Requirements § 44.251 Mark. Every package of cigars shall, before withdrawal from the customs warehouse...

  2. 27 CFR 44.251 - Mark.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Mark. 44.251 Section 44.251 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE... Requirements § 44.251 Mark. Every package of cigars shall, before withdrawal from the customs warehouse...

  3. 27 CFR 44.251 - Mark.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Mark. 44.251 Section 44.251 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE... Requirements § 44.251 Mark. Every package of cigars shall, before withdrawal from the customs warehouse...

  4. 27 CFR 44.251 - Mark.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Mark. 44.251 Section 44.251 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE... Requirements § 44.251 Mark. Every package of cigars shall, before withdrawal from the customs warehouse...

  5. 46 CFR 162.050-11 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Marking. 162.050-11 Section 162.050-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Pollution Prevention Equipment § 162.050-11 Marking. (a) Each separator, oil content meter, and bilge...

  6. Pseudomonas septicaemia following tribal tatoo marks.

    PubMed

    Mathur, D R; Sahoo, A

    1984-09-01

    It is tradition in Northern Nigeria to make tribal tatoo marks on the face of a newborn, commonly on both sides of the angle of the mouth. A case of fatal septicaemia due to Pseudomonas aeruginosa following such tribal tatoo marks is reported. PMID:6506210

  7. 46 CFR 162.161-8 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 6 2012-10-01 2012-10-01 false Marking. 162.161-8 Section 162.161-8 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Fixed Clean Agent Fire Extinguishing Systems § 162.161-8 Marking. The following information must be displayed...

  8. 49 CFR 179.22 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... requires a tank-head puncture-resistance system must have the letter “S” substituted for the letter “A” in the specification marking. (c) Each tank car that requires a tank-head puncture-resistance system, a... “S” in the specification marking. (d) Each tank car that requires a tank-head...

  9. 49 CFR 179.22 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... puncture-resistance system must have the letter “S” substituted for the letter “A” in the specification marking. (c) Each tank car that requires a tank-head puncture-resistance system, a thermal protection... specification marking. (d) Each tank car that requires a tank-head puncture-resistance system, a...

  10. 49 CFR 179.22 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... puncture-resistance system must have the letter “S” substituted for the letter “A” in the specification marking. (c) Each tank car that requires a tank-head puncture-resistance system, a thermal protection... specification marking. (d) Each tank car that requires a tank-head puncture-resistance system, a...

  11. 49 CFR 179.22 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... puncture-resistance system must have the letter “S” substituted for the letter “A” in the specification marking. (c) Each tank car that requires a tank-head puncture-resistance system, a thermal protection... specification marking. (d) Each tank car that requires a tank-head puncture-resistance system, a...

  12. 14 CFR 23.1555 - Control markings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Control markings. 23.1555 Section 23.1555 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Operating Limitations and Information Markings and Placards §...

  13. 32 CFR 2001.25 - Declassification markings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Declassification markings. 2001.25 Section 2001.25 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.25...

  14. 32 CFR 2001.25 - Declassification markings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false Declassification markings. 2001.25 Section 2001.25 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.25...

  15. 32 CFR 2001.25 - Declassification markings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Declassification markings. 2001.25 Section 2001.25 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.25...

  16. 32 CFR 2001.25 - Declassification markings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Declassification markings. 2001.25 Section 2001.25 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.25...

  17. 32 CFR 2001.25 - Declassification markings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Declassification markings. 2001.25 Section 2001.25 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.25...

  18. 46 CFR 160.062-5 - Markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 6 2013-10-01 2013-10-01 false Markings. 160.062-5 Section 160.062-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Releases. Lifesaving Equipment, Hydraulic and Manual § 160.062-5 Markings. (a) Hydraulic releases...

  19. 46 CFR 160.062-5 - Markings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 6 2014-10-01 2014-10-01 false Markings. 160.062-5 Section 160.062-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Releases. Lifesaving Equipment, Hydraulic and Manual § 160.062-5 Markings. (a) Hydraulic releases...

  20. 76 FR 36983 - Marking Meteorological Evaluation Towers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... voluntary marking of METs less than 200 feet AGL (76 FR 1326). The FAA agrees that marking these structures... conspicuity of the towers for low level agricultural operations in the vicinity of these towers. FOR FURTHER... operators, associations representing agricultural operators, and state governments concerning the...