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Sample records for accept patients marked

  1. Mark.

    ERIC Educational Resources Information Center

    Lipman, Matthew; Smith, Theresa L., Ed.

    Mark is the central character in this story designed to help adolescents formulate a philosophy of values. The story is well suited for use in high school social studies courses and/or in philosophy or guidance units. Mark's thoughts and actions are reported as he interacts with his family, friends, acquaintances, and individuals of authority…

  2. A Comparative Picture of the Ease of Use and Acceptance of Onscreen Marking by Markers across Subject Areas

    ERIC Educational Resources Information Center

    Coniam, David; Yan, Zi

    2016-01-01

    Onscreen marking (OSM) has been used for the majority of Hong Kong public examinations since 2012. The current study compares marker reactions to OSM, ie, perceived ease of use and acceptance of OSM, against the backdrop of virtually all subject areas being marked on screen. The data were collected from three major sources: (1) survey data…

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY COUNTRY OF ORIGIN MARKING Method and Location of Marking Imported... Customs, any method of marking at any location insuring that country of origin will conspicuously...

  4. 19 CFR 134.44 - Location and other acceptable methods of marking.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY COUNTRY OF ORIGIN MARKING Method and Location of Marking Imported... Customs, any method of marking at any location insuring that country of origin will conspicuously...

  5. Preliminary Mark-18A (Mk-18A) Target Material Recovery Program Product Acceptance Criteria

    SciTech Connect

    Robinson, Sharon M.; Patton, Bradley D.

    2016-09-01

    The Mk-18A Target Material Recovery Program (MTMRP) was established in 2015 to preserve the unique materials, e.g. 244Pu, in 65 previously irradiated Mk-18A targets for future use. This program utilizes existing capabilities at SRS and Savannah River National Laboratory (SRNL) to process targets, recover materials from them, and to package the recovered materials for shipping to ORNL. It also utilizes existing capabilities at ORNL to receive and store the recovered materials, and to provide any additional processing of the recovered materials or residuals required to prepare them for future beneficial use. The MTMRP is presently preparing for the processing of these valuable targets which is expected to begin in ~2019. As part of the preparations for operations, this report documents the preliminary acceptance criteria for the plutonium and heavy curium materials to be recovered from the Mk-18A targets at SRNL for transport and storage at ORNL. These acceptance criteria were developed based on preliminary concepts developed for processing, transporting, and storing the recovered Mk-18A materials. They will need to be refined as these concepts are developed in more detail.

  6. 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.

  7. Codes and colleagues: Is there support for universal patient acceptance?

    PubMed

    Peltier, Bruce

    2006-11-01

    This article is a refinement of verbal reactions to O'Toole's and Corsino's remarks at a national conference on Access to Oral Health Care held at the headquarters of the American Dental Association in August 2005. The article consists of two parts, each part an answer to specific questions. The first is a reaction to Corsino's explanation of Patthoff's concept of Universal Patient Acceptance. Acceptance is supported and endorsed, and a case is made for the importance of a clear and accurate explanation of Universal Patient Acceptance, as it has a much greater likelihood of being embraced by dentists than "access" seems to have. A review of relevant codes of ethics in dentistry reveals mixed and uneven support for Universal Patient Acceptance. The second part of this article compares the way that the profession of psychology views access and acceptance with the way that dentistry seems to view them and concludes that, if dentistry is to remain a caring profession rather than a commercial enterprise, acceptance must be embraced.

  8. Cefotiam disposition in markedly obese athlete patients, Japanese sumo wrestlers.

    PubMed Central

    Chiba, K; Tsuchiya, M; Kato, J; Ochi, K; Kawa, Z; Ishizaki, T

    1989-01-01

    Markedly obese athletes like Japanese sumo wrestlers may frequently suffer various traumas which result in the prophylaxis or treatment of posttraumatic infection with antibiotics. However, appropriate dosage regimens in this group of patients have not been fully known for many antibiotics. Therefore, we studied the kinetic disposition of cefotiam, a parenteral, broad-spectrum cephalosporin with activity against gram-positive and -negative bacteria, after an intravenous dose (2 g) infused over 30 min into 15 sumo wrestler patients with an excess body weight (130 to 220% of ideal body weight) and 10 control patients with a normal weight (90 to 102% of ideal body weight). Mean (+/- standard deviation) clearance and steady-state volume of distribution were significantly greater in the sumo wrestler than in the control group (38.3 +/- 9.4 versus 23.5 +/- 6.0 liters/h, P less than 0.001, and 30.2 +/- 8.0 versus 17.9 +/- 6.1 liters, P less than 0.001). Mean elimination half-life was slightly but significantly longer in the sumo wrestler than in the control group (0.91 +/- 0.14 versus 0.74 +/- 0.20 h, P less than 0.05). However, mean residence time did not differ between the two groups (0.79 +/- 0.10 versus 0.75 +/- 0.14 h). The statistical differences in clearance and volume of distribution between the two groups disappeared when these kinetic parameters were corrected for body surface area, but not for total body weight or ideal body weight. The results suggest that the dosage calculation of cefotiam, a hydrophilic antibiotic, should be made on the basis of body surface area in morbidly obese athlete or sumo wrestler patients. However, whether this recommendation should extend to other nonathlete obese subjects remains to be determined. PMID:2802548

  9. Prophylaxis of migraine: general principles and patient acceptance

    PubMed Central

    D’Amico, Domenico; Tepper, Stewart J

    2008-01-01

    Migraine is a chronic neurological condition with episodic exacerbations. Migraine is highly prevalent, and associated with significant pain, disability, and diminished quality of life. Migraine management is an important health care issue. Migraine management includes avoidance of trigger factors, lifestyle modifications, non-pharmacological therapies, and medications. Pharmacological treatment is traditionally divided into acute or symptomatic treatment, and preventive treatment or prophylaxis. Many migraine patients can be treated using only acute treatment. Patients with severe and/or frequent migraines require long-term preventive therapy. Prophylaxis requires daily administration of anti-migraine compounds with potential adverse events or contraindications, and may also interfere with other concurrent conditions and treatments. These problems may induce patients to reject the idea of a preventive treatment, leading to poor patient adherence. This paper reviews the main factors influencing patient acceptance of anti-migraine prophylaxis, providing practical suggestions to enhance patient willingness to accept pharmacological anti-migraine preventive therapy. We also provide information about the main clinical characteristics of migraine, and their negative consequences. The circumstances warranting prophylaxis in migraine patients as well as the main characteristics of the compounds currently used in migraine prophylaxis will also be briefly discussed, focusing on those aspects which can enhance patient acceptance and adherence. PMID:19337456

  10. Risk Acceptance in Multiple Sclerosis Patients on Natalizumab Treatment

    PubMed Central

    Tur, Carmen; Tintoré, Mar; Vidal-Jordana, Ángela; Bichuetti, Denis; Nieto González, Pablo; Arévalo, María Jesús; Arrambide, Georgina; Anglada, Elisenda; Galán, Ingrid; Castilló, Joaquín; Nos, Carlos; Río, Jordi; Martín, María Isabel; Comabella, Manuel; Sastre-Garriga, Jaume; Montalban, Xavier

    2013-01-01

    Objective We aimed to investigate the ability of natalizumab (NTZ)-treated patients to assume treatment-associated risks and the factors involved in such risk acceptance. Methods From a total of 185 patients, 114 patients on NTZ as of July 2011 carried out a comprehensive survey. We obtained disease severity perception scores, personality traits’ scores, and risk-acceptance scores (RAS) so that higher RAS indicated higher risk acceptance. We recorded JC virus status (JCV+/-), prior immunosuppression, NTZ treatment duration, and clinical characteristics. NTZ patients were split into subgroups (A-E), depending on their individual PML risk. Some 22 MS patients on first-line drugs (DMD) acted as controls. Results No differences between treatment groups were observed in disease severity perception and personality traits. RAS were higher in NTZ than in DMD patients (p<0.01). Perception of the own disease as a more severe condition tended to predict higher RAS (p=0.07). Higher neuroticism scores predicted higher RAS in the NTZ group as a whole (p=0.04), and in high PML-risk subgroups (A-B) (p=0.02). In low PML-risk subgroups (C-E), higher RAS were associated with a JCV+ status (p=0.01). Neither disability scores nor pre-treatment relapse rate predicted RAS in either group. Conclusions Risk acceptance is a multifactorial phenomenon, which might be partly explained by an adaptive process, in light of the higher risk acceptance amongst NTZ-treated patients and, especially, amongst those who are JCV seropositive but still have low PML risk, but which seems also intimately related to personality traits. PMID:24340060

  11. 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…

  12. Acceptance and perception of Nigerian patients to medical photography.

    PubMed

    Adeyemo, W L; Mofikoya, B O; Akadiri, O A; James, O; Fashina, A A

    2013-12-01

    The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of

  13. Will patients accept randomization to psychoanalysis? A feasibility study.

    PubMed

    Caligor, Eve; Hilsenroth, Mark J; Devlin, Michael; Rutherford, Bret R; Terry, Madeleine; Roose, Steven P

    2012-04-01

    The feasibility of using a randomized design in a psychoanalytic outcome study was evaluated. Our hypothesis was that it would be feasible to randomize patients to psychoanalysis three or four times weekly on the couch for five years, supportive expressive therapy once or twice weekly for up to forty sessions, and cognitive behavior therapy once or twice weekly for up to forty sessions. Successful randomization was defined as a 30% recruitment rate among eligible patients. Recruitment began in September 2009 and closed in April 2010. A total of 132 subjects responded to study advertisements, 107 of whom (81%) were triaged out. The remaining 25 were scheduled for the first of two clinical interviews, and 21 of 25 (88%) completed the interview. Eleven of the 25 (44%) were determined to be eligible based on inclusion and exclusion criteria. Eight of the 11 accepted the idea of randomization and completed the diagnostic assessment phase. Calculated on the basis of 8 of 11 eligible patients accepting randomization, the 95% confidence interval was that 39% to 92% of eligible subjects would participate in a larger study of this design. Our findings support the feasibility of implementing an RCT comparing psychoanalysis as defined by the American Psychoanalytic Association (three or four times weekly on the couch for approximately five years) with shorter-term dynamic or cognitive behavioral therapy once or twice a week. Pre-treatment characteristics of these eight patients are presented, as are initial reliability data for the treatment adherence scales used in this trial.

  14. An Improved Colonoscopy Preparation Method and its Acceptability by Patients

    PubMed Central

    1995-01-01

    The author presents an improved method of preparation for colonoscopy that involved no dietary limitation on the patient until the day of the examination and that was shown by a randomized questionnaire evaluation to earn good patient tolerance and acceptance. Patients were given 10 mg of cisapride and 75 mg of sodium picosulfate before sleep on the day preceding the examination, and 50 g of magnesium citrate powder (MP) in 1,200 mL lukewarm water before the examination. It was divided into 600-mL portions and ingested slowly during two 30-minute periods. Ninety-five percent of patients classified the taste of a magnesium citrate powder laxative as palatable in the questionnaire given immediately after the procedure. Concerning the quantity, 79.4% replied that it was tolerable, 17.3% considered it somewhat excessive, and 3.3% replied that it was barely tolerable. No patient classified it as intolerable. Symptoms after taking laxatives and lukewarm water such as abdominal pain, nausea and abdominal fullness were observed in 3.8%, 4.4% and 5.6%, respectively, whereas there were no symptoms in 79% of patients. Body weight and serum K level showed a tendency to decrease, whereas the serum Mg level showed an increase before and after colonoscopy. The quality of colonic cleansing evaluated by colonoscopy was excellent, good, or fair in a total of 93.3%. No adverse effects were observed. It was concluded that this method is a clinically beneficial and well-tolerated preparation for colonic examinations. PMID:18493356

  15. [A case of Xanthinuria in a patient with marked hypouricemia].

    PubMed

    Martella, Vilma; Sozzo, Efisio; Montagna, Elio; Stefanizzi, Salvatore; Cito, Annarita; Marinello, Enrico; Terzuoli, Lucia; Micheli, Vanna; Napoli, Marcello

    2011-01-01

    Xanthinuria is a rare autosomal recessive disorder associated with a deficiency of xanthine oxidoreductase (XOR), which normally catalyzes the conversion of hypoxanthine to uric acid. The effects of this deficit are an elevated concentration of hypoxanthine and xanthine in the blood and urine, hypouricemia, and hypouricuria. The deficit in XOR can be isolated (type I xanthinuria) or associated with a deficit in aldehyde oxidase (type II xanthinuria) and sulfite oxidase (type III xanthinuria). While the first two variants have a benign course, are often asymptomatic (20%), and clinically indistinguishable, type III xanthinuria is a harmful form that leads to infant death due to neurological damage. The clinical symptoms (kidney stones, CKD, muscle and joint pain, peptic ulcer) are the result of the accumulation of xanthine, which is highly insoluble, in the body fluids. We describe a case of type I xanthinuria in a 52-year-old woman who presented with hypouricemia, hypouricuria and kidney stones. The diagnosis was based on purine catabolite levels in urine and serum measured by 3 nonroutine methods: high-pressure liquid chromatography, mass spectrometry, and magnetic resonance imaging. To identify the type of xanthinuria the allopurinol test was used. We believe that these tests will facilitate the diagnosis of xantinuria especially in asymptomatic patients without the need for a biopsy of the liver or intestines, which is useful only for scientific purposes.

  16. 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

  17. 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

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

    PubMed

    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.

  19. 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

  20. 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.

  1. 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.

  2. Patient-provider communication and human papillomavirus vaccine acceptance.

    PubMed

    Rand, Cynthia M; Schaffer, Stanley J; Humiston, Sharon G; Albertin, Christina S; Shone, Laura P; Heintz, Eric V; Blumkin, Aaron K; Stokley, Shannon; Szilagyi, Peter G

    2011-02-01

    The authors performed telephone interviews of parents of adolescents (n = 430) and their older adolescents (n = 208) in Monroe County, New York to measure parent and adolescent acceptance of human papillomavirus (HPV) vaccine, its association with ratings of provider communication, and vaccine-related topics discussed with the adolescent's provider. More than half of adolescent girls had already received an HPV vaccination, with fewer than one quarter refusing. Parent and teen ratings of provider communication was high, and not related to HPV vaccine refusal. Parents were more likely to refuse if they were Hispanic (odds ratio [OR] = 5.88, P = .05) or did not consider vaccines "very safe" (OR = 2.76, P = .04). Most parents of boys (85%) believed males should be given HPV vaccine if recommended. Few parents and teens recalled discussing that vaccination does not preclude future Pap smear testing. Providers should address cultural and vaccine safety concerns in discussions about HPV vaccine.

  3. 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.

  4. Acceptability of robotic technology in neuro-rehabilitation: preliminary results on chronic stroke patients.

    PubMed

    Mazzoleni, Stefano; Turchetti, Giuseppe; Palla, Ilaria; Posteraro, Federico; Dario, Paolo

    2014-09-01

    During the last decade, different robotic devices have been developed for motor rehabilitation of stroke survivors. These devices have been shown to improve motor impairment and contribute to the understanding of mechanisms underlying motor recovery after a stroke. The assessment of the robotic technology for rehabilitation assumes great importance. The aim of this study is to present preliminary results on the assessment of the acceptability of the robotic technology for rehabilitation on a group of thirty-four chronic stroke patients. The results from questionnaires on the patients' acceptability of two different robot-assisted rehabilitation scenarios show that the robotic approach was well accepted and tolerated by the patients.

  5. [Demonstrating patient safety requires acceptance of a broader scientific palette].

    PubMed

    Leistikow, I

    2017-01-01

    It is high time the medical community recognised that patient-safety research can be assessed using other scientific methods than the traditional medical ones. There is often a fundamental mismatch between the methodology of patient-safety research and the methodology used to assess the quality of this research. One example is research into the reliability and validity of record review as a method for detecting adverse events. This type of research is based on logical positivism, while record review itself is based on social constructivism. Record review does not lead to "one truth": adverse events are not measured on the basis of the records themselves, but by weighing the probability of certain situations being classifiable as adverse events. Healthcare should welcome behavioural and social sciences to its scientific palette. Restricting ourselves to the randomised control trial paradigm is short-sighted and dangerous; it deprives patients of much-needed improvements in safety.

  6. 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

  7. Health insurance does not guarantee access to primary care: a national study of physicians' acceptance of publicly insured patients.

    PubMed

    Cykert, S; Kissling, G; Layson, R; Hansen, C

    1995-06-01

    The roles of reimbursement and other predictors that affect physicians' willingness to accept publicly insured continuing care patients were examined in a national survey. The response rate was 47%. Eighty-eight percent of the respondents were accepting new patients. Forty-two percent of these physicians were willing to accept new continuing care patients insured by Medicaid, 70% reported accepting those paying by Medicare assignment, and 85% said they accept patients covered by Medicare plus balance-billing payments. Low reimbursement was the strongest predictor for lack of acceptance. The results suggest that systems of multitiered reimbursement are associated with diminished access for patients insured in the lower tiers.

  8. 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.

  9. 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

  10. Marked QTc Prolongation and Torsades de pointes in Patients with Chronic Inflammatory Arthritis

    PubMed Central

    Lazzerini, Pietro Enea; Capecchi, Pier Leopoldo; Bertolozzi, Iacopo; Morozzi, Gabriella; Lorenzini, Sauro; Simpatico, Antonella; Selvi, Enrico; Bacarelli, Maria Romana; Acampa, Maurizio; Lazaro, Deana; El-Sherif, Nabil; Boutjdir, Mohamed; Laghi-Pasini, Franco

    2016-01-01

    Mounting evidence indicates that in chronic inflammatory arthritis (CIA), QTc prolongation is frequent and correlates with systemic inflammatory activation. Notably, basic studies demonstrated that inflammatory cytokines induce profound changes in potassium and calcium channels resulting in a prolonging effect on cardiomyocyte action potential duration, thus on the QT interval on the electrocardiogram. Moreover, it has been demonstrated that in rheumatoid arthritis (RA) patients, the risk of sudden cardiac death is significantly increased when compared to non-RA subjects. Conversely, to date no data are available about torsades de pointes (TdP) prevalence in CIA, and the few cases reported considered CIA only an incidental concomitant disease, not contributing factor to TdP development. We report three patients with active CIA developing marked QTc prolongation, in two cases complicated with TdP degenerating to cardiac arrest. In these patients, a blood sample was obtained within 24 h from TdP/marked QTc prolongation occurrence, and levels of IL-6, TNFα, and IL-1 were evaluated. In all three cases, IL-6 was markedly elevated, ~10 to 100 times more than reference values. Moreover, one patient also showed high circulating levels of TNFα and IL-1. In conclusion, active CIA may represent a currently overlooked QT-prolonging risk factor, potentially contributing in the presence of other “classical” risk factors to TdP occurrence. In particular, a relevant role may be played by elevated circulating IL-6 levels via direct electrophysiological effects on the heart. This fact should be carefully kept in mind, particularly when recognizable risk factors are already present and/or the addition of QT-prolonging drugs is required. PMID:27703966

  11. Estrogen patient package insert: medication acceptance despite negative attitudes

    SciTech Connect

    Weintraub, M.; Glickstein, S.; Lasagna, L.

    1981-08-01

    We surveyed 100 women receiving short courses of estrogen post partum to suppress lactation. Thirty six had significant apprehension about estrogens, but took them. These women were significantly older and better educated and 92% of them were married. In contrast, only one third of the ''nonapprehensive'' women were married and they had significantly lower family incomes. More of the apprehensive women read the estrogen patient package insert (PPI) and almost 30% developed negative attitudes toward estrogens. The major concerns of these women reflected information in the PPI about cancer and thromboembolism. The reasons given for taking estrogens despite apprehension included the lower risk of short courses, assurance from physicians, nurses, or family members, and the desired therapeutic effect. These women should not be given the current estrogen PPI, which was designed to warn women of the risks of long-term estrogen use; a PPI should be written specifically for patients receiving short courses. Similar problems will arise with the PPIs for other medications that have different risks for different therapeutic indications.

  12. Relationship between behavioural coping strategies and acceptance in patients with fibromyalgia syndrome: Elucidating targets of interventions

    PubMed Central

    2011-01-01

    Background Previous research has found that acceptance of pain is more successful than cognitive coping variables for predicting adjustment to pain. This research has a limitation because measures of cognitive coping rely on observations and reports of thoughts or attempts to change thoughts rather than on overt behaviours. The purpose of the present study, therefore, is to compare the influence of acceptance measures and the influence of different behavioural coping strategies on the adjustment to chronic pain. Methods A sample of 167 individuals diagnosed with fibromyalgia syndrome completed the Chronic Pain Coping Inventory (CPCI) and the Chronic Pain Acceptance Questionnaire (CPAQ). Results Correlational analyses indicated that the acceptance variables were more related to distress and functioning than were behavioural coping variables. The average magnitudes of the coefficients for activity engagement and pain willingness (both subscales of pain acceptance) across the measures of distress and functioning were r = 0.42 and 0.25, respectively, meanwhile the average magnitude of the correlation between coping and functioning was r = 0.17. Regression analyses examined the independent, relative contributions of coping and acceptance to adjustment indicators and demonstrated that acceptance accounted for more variance than did coping variables. The variance contributed by acceptance scores ranged from 4.0 to 40%. The variance contributed by the coping variables ranged from 0 to 9%. Conclusions This study extends the findings of previous work in enhancing the adoption of acceptance-based interventions for maintaining accurate functioning in fibromyalgia patients. PMID:21714918

  13. Freeze-all embryo transfer awareness and acceptance of IVF-ET patients in China

    PubMed Central

    Guo, Yan-Xiu; Yin, Yan-Jing; Tian, Li

    2016-01-01

    Abstract The aim of the study was to determine the level of awareness and acceptance of in vitro fertilization pre-embryo transfer (IVF-ET) patients for freeze-all embryo transfer, improve relevant technical specifications, and optimize treatment results based on medical experience. Questionnaires were completed by women who received in vitro fertilization embryo transfer. A total of 377 valid samples were included into this study. Through focus group discussions and tablet assisted intercept interviews, we analyzed the basic situation, the awareness for frozen-all embryo transfer, and the need for frozen-all embryo transfer information for infertile patients. In this study, 60% of patients received IVF-ET for the first time, whereas the remaining patients received IVF-ET more than once. We investigated the current awareness and acceptance of IVF-ET patients for freeze-all embryo transfer quantificationally. Patients were grouped based on quantitative measurements, and the mainstream group of patients (72.7%) was precisely the patients who were worried and concerned of frozen-all embryo transfers. Although few of them could “rationally accept the comparative advantage of the technology,” this group was vulnerable to doctors’ guidance and education. Eventually, this group of patients accepted the frozen-all embryo transfer. Since there are no certain criteria for the kind of embryo transfer patients and reproductive centers should take, the choice should be taken individually according to the social economic situation and acceptance of patients for the frozen embryo transfer, as well as the technology of the reproductive center. PMID:27893658

  14. Freeze-all embryo transfer awareness and acceptance of IVF-ET patients in China.

    PubMed

    Guo, Yan-Xiu; Yin, Yan-Jing; Tian, Li

    2016-11-01

    The aim of the study was to determine the level of awareness and acceptance of in vitro fertilization pre-embryo transfer (IVF-ET) patients for freeze-all embryo transfer, improve relevant technical specifications, and optimize treatment results based on medical experience.Questionnaires were completed by women who received in vitro fertilization embryo transfer. A total of 377 valid samples were included into this study. Through focus group discussions and tablet assisted intercept interviews, we analyzed the basic situation, the awareness for frozen-all embryo transfer, and the need for frozen-all embryo transfer information for infertile patients.In this study, 60% of patients received IVF-ET for the first time, whereas the remaining patients received IVF-ET more than once. We investigated the current awareness and acceptance of IVF-ET patients for freeze-all embryo transfer quantificationally. Patients were grouped based on quantitative measurements, and the mainstream group of patients (72.7%) was precisely the patients who were worried and concerned of frozen-all embryo transfers. Although few of them could "rationally accept the comparative advantage of the technology," this group was vulnerable to doctors' guidance and education. Eventually, this group of patients accepted the frozen-all embryo transfer.Since there are no certain criteria for the kind of embryo transfer patients and reproductive centers should take, the choice should be taken individually according to the social economic situation and acceptance of patients for the frozen embryo transfer, as well as the technology of the reproductive center.

  15. 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

  16. 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

  17. Addressing patient safety through the use of 'criteria of acceptability' for medical radiation equipment.

    PubMed

    Gilley, Debbie Bray; Holmberg, Ola

    2013-02-01

    Patient safety should be considered in the use of ionising radiation equipment in medicine. The International Atomic Energy Agency (IAEA) establishes standards of safety and provides for the application of these standards, also in the area of medical use of radiation. Equipment acceptability, as it relates to radiation in medicine, is the need to satisfy the requirements or standards prior to the use of the device in patient imaging or treatment. Through IAEA activities in establishing and developing Safety Standards, Safety Reports and recommendations to regulatory authorities and end-users, it encourages the adoption of acceptability criteria that are relevant to the medical equipment and its use.

  18. The acceptability of waiting times for elective general surgery and the appropriateness of prioritising patients

    PubMed Central

    Oudhoff, Jurriaan P; Timmermans, Danielle RM; Rietberg, Martin; Knol, Dirk L; van der Wal, Gerrit

    2007-01-01

    Background Problematic waiting lists in public health care threaten the equity and timeliness of care provision in several countries. This study assesses different stakeholders' views on the acceptability of waiting lists in health care, their preferences for priority care of patients, and their judgements on acceptable waiting times for surgical patients. Methods A questionnaire survey was conducted among 257 former patients (82 with varicose veins, 86 with inguinal hernia, and 89 with gallstones), 101 surgeons, 95 occupational physicians, and 65 GPs. Judgements on acceptable waiting times were assessed using vignettes of patients with varicose veins, inguinal hernia, and gallstones. Results Participants endorsed the prioritisation of patients based on clinical need, but not on ability to benefit. The groups had significantly different opinions (p < 0.05) on the use of non-clinical priority criteria and on the need for uniformity in the prioritisation process. Acceptable waiting times ranged between 2 and 25 weeks depending on the type of disorder (p < 0.001) and the severity of physical and psychosocial problems of patients (p < 0.001). Judgements were similar between the survey groups (p = 0.3) but responses varied considerably within each group depending on the individual's attitude towards waiting lists in health care (p < 0.001). Conclusion The explicit prioritisation of patients seems an accepted means for reducing the overall burden from waiting lists. The disagreement about appropriate prioritisation criteria and the need for uniformity, however, raises concern about equity when implementing prioritisation in daily practice. Single factor waiting time thresholds seem insufficient for securing timely care provision in the presence of long waiting lists as they do not account for the different consequences of waiting between patients. PMID:17328816

  19. Hepatitis A virus genotype IA-infected patient with marked elevation of aspartate aminotransferase levels.

    PubMed

    Miura, Yoshifumi; Kanda, Tatsuo; Yasui, Shin; Takahashi, Koji; Haga, Yuki; Sasaki, Reina; Nakamura, Masato; Wu, Shuang; Nakamoto, Shingo; Arai, Makoto; Nishizawa, Tsutomu; Okamoto, Hiroaki; Yokosuka, Osamu

    2017-02-01

    We describe a case of acute liver failure (ALF) without hepatic encephalopathy with marked elevation of aminotransferase due to hepatitis A, according to the revised Japanese criteria of ALF. This liver biopsy of the patient showed compatible to acute viral hepatitis and she immediately recovered without intensive care. She had no comorbid disorders. Of interest, phylogenetic tree analysis using almost complete genomes of hepatitis A virus (HAV) demonstrated that the HAV isolate from her belonged to the HAV subgenotype IA strain and was similar to the HAJFF-Kan12 strain (99% nucleotide identity) or FH1 strain (98% nucleotide identity), which is associated with severe or fulminant hepatitis A. Careful interpretation of the association between HAV genome variations and severity of hepatitis A is needed and the mechanism of the severe hepatitis should be explored.

  20. 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

  1. Physician acceptance of new Medicare patients stabilizes in 2004-05.

    PubMed

    Cunningham, Peter; Staiti, Andrea; Ginsburg, Paul B

    2006-01-01

    Despite an earlier Medicare payment rate reduction, the proportion of U.S. physicians accepting Medicare patients stabilized in 2004-05, with nearly three-quarters saying their practices were open to all new Medicare patients, according to a new study by the Center for Studying Health System Change (HSC). In 2004-05, 72.9 percent of physicians reported accepting all new Medicare patients, statistically unchanged from 71.1 percent in 2000-01. Only 3.4 percent of physicians reported that their practices were completely closed to new Medicare patients in 2004-05, also statistically unchanged from 2000-01. These trends indicate the decline in Medicare physician access observed between 1996-97 and 2000-01 leveled off in 2004-05. In fact, Medicare beneficiaries' access to primary care physicians increased between 2000-01 and 2004-05, reversing an earlier decline. Among privately insured patients, trends in physician access are similar to those for Medicare patients, suggesting that overall health system dynamics have played a larger role in physician decisions about accepting Medicare patients than have Medicare payment policies.

  2. Popular or Unpopular? Therapists' Use of Structured Interviews and Their Estimation of Patient Acceptance

    ERIC Educational Resources Information Center

    Bruchmuller, Katrin; Margraf, Jurgen; Suppiger, Andrea; Schneider, Silvia

    2011-01-01

    An accurate diagnosis is an important precondition for effective psychotherapeutic treatment. The use of structured interviews provides the gold standard for reliable diagnosis. Suppiger et al. (2009) showed that structured interviews have a high acceptance among patients. On a scale from 0 ("not at all satisfied") to 100 ("totally…

  3. [The comparison of self-concept and self-acceptance in patients with paranoid schizophrenia and neurotic disorder].

    PubMed

    Spila, B; Grzywa, A; Karakuła, H; Kosińska, U; Makara, M

    1997-01-01

    Self-acceptance as a correlation between real and ideal self-concept distinguishes neurotic patients from paranoid schizophrenic patients. This fact may support the hypothesis that these groups of patients are characteristic of different personality traits.

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

    PubMed

    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.

  5. 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

  6. Problems, acceptance and social inequality: a study of the deformed leprosy patients and their families.

    PubMed

    Kopparty, S N

    1995-09-01

    Though the impact of social inequality on health conditions is widely known, its impact on the chronic and stigmatized disease, leprosy, has received little attention. Deformity sometimes leads to disabilities and to handicaps causing problems to the patient and his family. In this paper an attempt has been made to understand the impact of social inequality, prevalent in the form of the caste system in India on the deformed leprosy patients and on their families. This impact was examined in terms of the problems faced by the patients. A sample of 150 deformed patients and their families, drawn from two districts in Tamil Nadu, was selected for the study. About 57% of the deformed patients experienced their deformity as a handicap which caused social and economic problems while the rest did not. Of the three caste groups, the Lower Caste group experienced more severe economic problems while the Upper Caste group faced more social problems. The extent of acceptance of deformed patients in their family varied significantly among those facing and not facing problems due to their deformity. The deformed patients without any handicap were accepted in a large majority of their families (82%) regardless of their caste status. In contrast the deformed but handicapped patients were accepted differentially among the three caste groups with the Upper group accepting them in most of their families (80%) while in the Lower group much less number of families (54%) did. All the families of the deformed but not handicapped patients desired to keep their patients till their death irrespective of their caste status. On the contrary, while all the families in the Upper Caste group expressed their willingness to keep their handicapped patients in the family till their death, 10% in the Middle and 22% in the Lower Caste groups did not want to do so. This suggests the gradual marginalization, rejection and dehabilitation of the affected. Thus, one's caste status can be a broad indicator

  7. 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

  8. 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'.

  9. Open Trial of an Acceptance-Based Behavior Therapy Intervention to Engage Newly Diagnosed HIV Patients in Care: Rationale and Evidence of Feasibility and Acceptability.

    PubMed

    Moitra, Ethan; Chan, Philip A; Stein, Michael D

    2015-09-01

    Successful linkage and retention in care of newly diagnosed individuals in the United States remains a significant gap in the HIV care continuum. This study assessed the acceptability and feasibility of an acceptance-based behavior therapy (ABBT) intervention to engage patients newly diagnosed with HIV in medical care. Nine patients were recruited over 4 months for this brief ABBT intervention, which consisted of two brief sessions, each lasting less than 20 min. The intervention was developed to promote psychological acceptance of the HIV diagnosis, thereby increasing patients' willingness to make informed disclosure of their status. Eight patients completed a 1-month follow-up assessment, and all approved of the intervention and its components. Over the 1-month period, participants showed increased acceptance, reduced perceptions of HIV stigmatization, and increased disclosure of HIV status to social supports. This pilot study provided support for the continued investigation of ABBT as an adjunctive intervention for newly diagnosed HIV patients who are at high-risk of dropping out of HIV care.

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

    PubMed

    Armitage, James O; Longo, Dan L

    2016-06-09

    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?

  11. The Potential Utility of Acceptance and Commitment Therapy (ACT) for Reducing Stress and Improving Wellbeing in Cancer Patients in Kolkata.

    PubMed

    Datta, Arunima; Aditya, Chandana; Chakraborty, Abhijit; Das, Priyabrata; Mukhopadhyay, Ashis

    2016-12-01

    As soon as a patient comes to know that he/she has cancer, the stress starts and psychological intervention is required. The authors assessed how well a cancer patient can manage stress over the course of the psychological intervention. Data was collected among 107 patients during pre and post intervention and at 2 months follow-up. Intervention was required to measures include acceptance of the disease, managing stress, well -being, and meaning of life. Finally, effects of acceptance and commitment therapy (ACT) were defined in acceptance measured in terms of a significant difference between pre and post intervention scores in the meaning of life and the acceptance level. This acceptance and commitment therapy can be an effective intervention approach for cancer patients that increases acceptance regarding disease and simultaneously leads to improvement in the meaning of life.

  12. A review of cost communication in oncology: Patient attitude, provider acceptance, and outcome assessment.

    PubMed

    Shih, Ya-Chen Tina; Chien, Chun-Ru

    2017-05-15

    The American Society of Clinical Oncology released its first guidance statement on the cost of cancer care in August 2009, affirming that patient-physician cost communication is a critical component of high-quality care. This forward-thinking recommendation has grown increasingly important in oncology practice today as the high costs of cancer care impose tremendous financial burden to patients, their families, and the health care system. For the current review, a literature search was conducted using the PubMed and Web of Science databases to identify articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes; and 15 articles from 12 distinct studies were identified. Although most articles that addressed patient attitude suggested that cost communication is desired by >50% of patients in the respective study cohorts, only <33% of patients in those studies had actually discussed costs with their physicians. The literature on physician acceptance indicated that, although 75% of physicians considered discussions of out-of-pocket costs with patients their responsibility, <30% felt comfortable with such communication. When asked about whether cost communication actually took place in their practice, percentages reported by physicians varied widely from <10% to >60%. The data suggested that cost communication was associated with improved patient satisfaction, lower out-of-pocket expenses, and a higher likelihood of medication nonadherence; none of the studies established causality. Both patients and physicians expressed a strong need for accurate, accessible, and transparent information about the cost of cancer care. Cancer 2017;123:928-39. © 2016 American Cancer Society.

  13. Association of physicians' illness perception of fibromyalgia with frustration and resistance to accepting patients: a cross-sectional study.

    PubMed

    Homma, Mieko; Ishikawa, Hirono; Kiuchi, Takahiro

    2016-04-01

    The aim of this study was to elucidate whether physicians' illness perceptions correlate with their frustration or resistance to accepting patients with fibromyalgia (FM). In this cross-sectional postal survey, questionnaires were sent to member physicians of the Japan College of Rheumatology and Japan Rheumatism Foundation. Measures collected included the Brief Illness Perception Questionnaire with Causal Attribution, the Illness Invalidation Inventory, and the Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10). Multiple logistic regression was performed to examine associations between the DDPRQ-10 and resistance to accepting patients with FM for treatment. We analyzed data from 233 physicians who had experience in consulting with patients with FM. Only 44.2 % answered that they wanted to accept additional patients with FM. Physicians' frustration was associated with difficulty controlling symptoms, patients' emotional responses, and causal attribution of FM to patient internal factors. Conversely, lower levels of frustration were associated with causal attributions to biological factors and uncontrollable external factors. However, the "difficult patient" perception did not correlate with resistance to accepting patients with FM. Difficulty controlling symptoms with treatment was the one factor common to both physicians' frustration and resistance to accepting patients with FM. Physicians may hesitate to accept patients with FM not because of the stigmatic image of the "difficult patient," but instead because of the difficulty in controlling the symptoms of FM. Thus, to improve the quality of consultation, physicians must continuously receive new information about the treatments and causes of FM.

  14. Marked eosinophilia in a patient with history of severe atypical Kawasaki disease.

    PubMed

    O'Byrne, Michael L; Cohen, Meryl S

    2013-01-01

    An infant with recent atypical, treatment-refractory Kawasaki disease presented with marked eosinophilia. Workup failed to identify an etiology. The eosinophilia spontaneously resolved. Eosinophilia has been observed in the acute phase of Kawasaki disease, but has not been reported following recovery.

  15. Acceptability of an Electronic Self-Report Assessment Program for patients with cancer.

    PubMed

    Wolpin, Seth; Berry, Donna; Austin-Seymour, Mary; Bush, Nigel; Fann, Jesse R; Halpenny, Barbara; Lober, William B; McCorkle, Ruth

    2008-01-01

    Eliciting symptom and quality of life information from patients is an important component of medical and nursing care processes. Traditionally, this information has been collected with paper and pencil. However, this approach presents several barriers, including delays in receiving information, difficulty in integrating responses with electronic records, and the time required to manually score questionnaires for measurement purposes. One solution that addresses many of these barriers is the adoption of computerized screening for symptom and quality-of-life information. This research explored the acceptability of asking symptom and quality-of-life questions using the Electronic Self Report Assessment-Cancer program on wireless laptops equipped with touch-screen format. Acceptability data were explored with respect to whether any differences may be attributed to demographics and symptom and quality-of-life levels, such as depression and cognitive and emotional functioning. This evaluation used descriptive and univariate statistics to examine data from 342 participants from the ongoing ESRA-C randomized clinical trial. Research participants for the ESRA-C study were recruited from the Seattle Cancer Care Alliance, a consortium among the University of Washington Medical Center, Fred Hutchinson Cancer Research Center, and Children's Hospital and Regional Medical Center in Seattle, WA. The sample consisted of 342 adult participants who completed both baseline and follow-up survey sessions. Medical oncology represented the largest recruitment group (45.3%), followed by stem cell transplant (34.5%) and radiation oncology (20.2%). The primary finding was that patients were generally able to use ESRA-C quickly and without difficulty in a real-world clinical setting and that they were overall quite satisfied with the ESRA-C program. Significant differences were found in several acceptability areas with respect to demographics and quality of life measures such as age, sex, and

  16. Marked Body Shape Concerns in Female Patients Suffering from Eating Disorders: Relevance of a Clinical Sub-Group.

    PubMed

    Gailledrat, Lucie; Rousselet, Morgane; Venisse, Jean-Luc; Lambert, Sylvain; Rocher, Bruno; Remaud, Manon; Guilleux, Alice; Sauvaget, Anne; Eyzop, Emeline; Grall-Bronnec, Marie

    2016-01-01

    Concerns about body shape and weight are core diagnostic criteria for eating disorders although intensity varies between patients. Few studies have focused on the clinical differences relative to the intensity of these concerns. Nonetheless, they might have a prognostic value. This study was aimed at identifying the characteristics associated with marked body shape concerns in patients with an eating disorder. Data was collected from a systematic and standardized clinical assessment of outpatients seeking treatment in our department for eating disorders. Only female patients, suffering from anorexia nervosa or bulimia nervosa, and with "no / mild" or "marked" body shape concerns according to the Body Shape Questionnaire, were included for the present study. We focused on sociodemographic characteristics, eating disorder characteristics, axis 1 disorders, types of attachment, self-esteem and dissociation. A multiple logistic regression was performed to identify factors related to "marked" body shape concerns. In our sample (123 participants, with a mean age of 24.3 years [range 16-61]), 56.9% had marked concerns with body shape. Marked body shape concerns were associated with a major depressive episode (OR = 100.3), the use of laxatives (OR = 49.8), a high score on the item "body dissatisfaction" of the Eating Disorders Inventory scale (OR = 1.7), a higher minimum body mass index (OR = 1.73), and a high score on the item "loss of control over behavior, thoughts and emotions" from the dissociation questionnaire (OR = 10.74). These results are consistent with previous studies, and highlight the importance of denial.

  17. Investigation into the acceptability of door locking to staff, patients, and visitors on acute psychiatric wards.

    PubMed

    Muir-Cochrane, Eimear; van der Merwe, Marie; Nijman, Henk; Haglund, Kristina; Simpson, Alan; Bowers, Len

    2012-02-01

    There is disagreement among psychiatric professionals about whether the doors of acute psychiatric wards should be kept locked to prevent patients from leaving and harming themselves or others. This study explored patient, staff, and visitor perceptions about the acceptability of locking the ward door on acute psychiatric inpatient wards. Interviews were conducted with 14 registered nurses, 15 patients, and six visitors from three different acute wards. Findings revealed commonalities across all groups, with general agreement that locking the door reduced absconding. Staff expressed feelings of guilt, embarrassment, and fear of being blamed when a patient absconded. Staff also reported that open wards created anxious vigilance to prevent an abscond and increased workload in allocating staff to watch the door, whereas staff on partially-locked doors also perceived an increased workload in letting people in and out of the ward. Patients had mixed feelings about the status of the door, expressing depression, a sense of stigma, and low self-esteem when the door was locked. The issue of balancing safety and security on acute psychiatric wards against the autonomy of patients is not easily resolved, and requires focused research to develop innovative nursing practices.

  18. Design simplicity influences patient portal use: the role of aesthetic evaluations for technology acceptance

    PubMed Central

    Watkins, Ivan; Mackert, Michael S; Xie, Bo; Stephens, Keri K; Shalev, Heidi

    2016-01-01

    Objective This study focused on patient portal use and investigated whether aesthetic evaluations of patient portals function are antecedent variables to variables in the Technology Acceptance Model. Methods A cross-sectional survey of current patient portals users (N = 333) was conducted online. Participants completed the Visual Aesthetics of Website Inventory, along with items measuring perceived ease of use (PEU), perceived usefulness (PU), and behavioral intentions (BIs) to use the patient portal. Results The hypothesized model accounted for 29% of the variance in BIs to use the portal, 46% of the variance in the PU of the portal, and 29% of the variance in the portal’s PEU. Additionally, one dimension of the aesthetic evaluations functions as a predictor in the model – simplicity evaluations had a significant positive effect on PEU. Conclusion This study provides evidence that aesthetic evaluations – specifically regarding simplicity – function as a significant antecedent variable to patients’ use of patient portals and should influence patient portal design strategies. PMID:26635314

  19. Markedly elevated serum lactate dehydrogenase levels are a clue to the diagnosis of disseminated histoplasmosis in patients with AIDS.

    PubMed

    Corcoran, G R; Al-Abdely, H; Flanders, C D; Geimer, J; Patterson, T F

    1997-05-01

    Disseminated histoplasmosis is a common late manifestation of AIDS, but the diagnosis may be unsuspected in some patients because the clinical presentation of histoplasmosis may mimic other opportunistic infections. High serum lactate dehydrogenase (LDH) levels have been associated with disseminated histoplasmosis. We therefore evaluated whether markedly increased LDH levels were useful for making a diagnosis of disseminated histoplasmosis by comparing admission LDH levels for 15 patients with culture-proven disseminated histoplasmosis with those for 30 patients with advanced AIDS who were admitted to the hospital for evaluation of pulmonary infiltrates and fever. The mean admission LDH level in patients with disseminated histoplasmosis was 1,356 IU/L (range, 145-5,410 IU) whereas it was 332 (range, 77-832 IU) in the patients with other pulmonary processes. Admission LDH levels were >600 IU in 11 (73%) of the 15 patients with disseminated histoplasmosis vs. 3 (10%) of controls (P < .001). We conclude that markedly elevated admission LDH levels may be a clinical clue to the diagnosis of disseminated histoplasmosis in patients with AIDS.

  20. Safety, Efficacy, and Patient Acceptability of Everolimus in the Treatment of Breast Cancer

    PubMed Central

    Lousberg, Laurence; Jerusalem, Guy

    2016-01-01

    Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus–exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile. PMID:28096680

  1. Safety, Efficacy, and Patient Acceptability of Everolimus in the Treatment of Breast Cancer.

    PubMed

    Lousberg, Laurence; Jerusalem, Guy

    2016-01-01

    Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus-exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile.

  2. 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

  3. 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

  4. 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

  5. Body-Worn Sensors in Parkinson's Disease: Evaluating Their Acceptability to Patients

    PubMed Central

    Hammerla, Nils Y.; Rochester, Lynn; Andras, Peter; Walker, Richard W.

    2016-01-01

    Abstract Background: Remote monitoring of symptoms in Parkinson's disease (PD) using body-worn sensors would assist treatment decisions and evaluation of new treatments. To date, a rigorous, systematic evaluation of the acceptability of body-worn sensors in PD has not been undertaken. Materials and Methods: Thirty-four participants wore bilateral wrist-worn sensors for 4 h in a research facility and then for 1 week at home. Participants' experiences of wearing the sensors were evaluated using a Likert-style questionnaire after each phase. Qualitative data were collected through free-text responses. Differences in responses between phases were assessed by using the Wilcoxon rank-sum test. Content analysis of qualitative data was undertaken. “Non–wear time” was estimated via analysis of accelerometer data for periods when sensors were stationary. Results: After prolonged wearing there was a negative shift in participants' views on the comfort of the sensor; problems with the sensor's strap were highlighted. However, accelerometer data demonstrated high patient concordance with wearing of the sensors. There was no evidence that participants were less likely to wear the sensors in public. Most participants preferred wearing the sensors to completing symptom diaries. Conclusions: The finding that participants were not less likely to wear the sensors in public provides reassurance regarding the ecological validity of the data captured. The validity of our findings was strengthened by “triangulation” of data sources, enabling patients to express their agenda and repeated assessment after prolonged wearing. Long-term monitoring with wrist-worn sensors is acceptable to this cohort of PD patients. Evaluation of the wearer's experience is critical to the development of remote monitoring technology. PMID:26186307

  6. The influence of frailty syndrome on acceptance of illness in elderly patients with chronic obstructive pulmonary disease

    PubMed Central

    Uchmanowicz, Izabella; Jankowska-Polanska, Beata; Chabowski, Mariusz; Uchmanowicz, Bartosz; Fal, Andrzej M

    2016-01-01

    COPD is one of the most debilitating diseases. Frailty syndrome and advanced age may decrease the acceptance of illness, quality of life, and worsen health conditions in these patients, as well as lead to an increase in health care expenses. The aim of the study was to assess how the level of frailty affects the acceptance of illness in elderly patients with COPD. We also aimed to evaluate the associations between sociodemographic and clinical factors and the level of acceptance of illness, anxiety, and frailty in this group of patients. The study included 102 COPD patients with a mean age of 63.2 (standard deviation =6.5) years and grades I (3%), II (37%), III (52%), and IV (8%) by Global Initiative for Chronic Obstructive Lung Disease. The Polish versions of the Acceptance of Illness Scale and Tilburg frailty indicator were used. Frailty syndrome was found in 77 (75.5%) patients, with an average score of 7.42 (standard deviation =2.24). Coexisting diseases such as hypertension (46.07%), coronary artery disease (32.35%), heart failure (28.43%), diabetes (18.63%), and heart arrhythmia (9.8%) were found among the subjects. The overall level of acceptance of illness was 20.6 (standard deviation =7.62). A lower level of acceptance of illness was associated with a higher level of frailty, especially in the physical and social domain. Elderly patients with severe COPD are more prone to frailty and decreased acceptance of their disease in comparison to patients with other chronic diseases. Assessment and management of frailty in the care of older COPD patients are likely to improve risk stratification significantly and help personalize management, leading to better patient outcomes. PMID:27729781

  7. Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG) tube placement- patients' and care givers' perspectives

    PubMed Central

    Anis, Muhammad K; Abid, Shahab; Jafri, Wasim; Abbas, Zaigham; Shah, Hasnain A; Hamid, Saeed; Wasaya, Rozina

    2006-01-01

    Background Percutaneous endoscopic gastrostomy tube has now become a preferred option for the long-term nutritional support device for patients with dysphagia. There is a considerable debate about the health issues related to the quality of life of these patients. Our aim of the study was to assess the outcome and perspectives of patients/care givers, about the acceptability of percutaneous endoscopic gastrostomy tube placement. Methods This descriptive analytic study conducted in patients, who have undergone percutaneous endoscopic gastrostomy tube placement during January 1998 till December 2004. Medical records of these patients were evaluated for their demographic characteristics, underlying diagnosis, indications and complications. Telephonic interviews were conducted till March 2005, on a pre-tested questionnaire to address psychological, social and physical performance status, of the health related quality of life issues. Results A total of 191 patients' medical records were reviewed, 120 (63%) were males, and mean age was 63 years. Early complication was infection at PEG tube site in 6 (3%) patients. In follow up over 365 ± 149 days, late complications (occurring 72 hours later) were infection at PEG tube site in 29 (15 %) patient and dislodgment/blockage of the tube in 26 (13.6%). Interviews were possible with 126 patients/caretakers. Karnofsky Performance Score of 0, 1, 2, 3 and 4 was found in 13(10%), 18(14%), 21(17%), 29(23%) and 45(36%) with p-value < 0.001. Regarding the social and psychological aspects; 76(60%) would like to have the PEG tube again if required, 105(83 %) felt ease in feeding, and 76(60%) felt that PEG-tube helped in prolonging the survival. Regarding negative opinions; 49(39 %) felt that the feeding was too frequent, 45(36 %) felt apprehensive about dependency for feeding and 62(49%) were concerned about an increase in the cost of care. Conclusion PEG-tube placement was found to be relatively free from serious immediate and long

  8. Reluctance to Accept Alcohol Treatment by Alcoholic Liver Disease Transplant Patients: A Qualitative Study

    PubMed Central

    Heyes, Cathy M.; Schofield, Toni; Gribble, Robert; Day, Carolyn A.; Haber, Paul S.

    2016-01-01

    Background Liver transplantation (LT) is the optimum treatment for patients with end-stage alcoholic liver disease (ALD). However, despite a recognized risk of relapse to harmful drinking, ALD transplant patients are reluctant to use speciality alcohol treatment to support their abstinence, even when offered within the LT context. This study aimed to understand and identify factors contributing to alcohol treatment reluctance by ALD patients undergoing transplantation. Methods We conducted an in-depth qualitative study of ALD transplant patients. Minimally structured face-to-face interviews explored participants' alcohol-related experiences and their reasons for not using alcohol treatment during the course of their transplantation. Thematic analysis was used to analyze and interpret interview data to understand treatment reluctance based on participants' experiences. Results Five major themes were identified among 3 subgroups of patients (pretransplant and posttransplant abstainers and posttransplant relapsers): (i) the “contract” of mandatory abstinence, (ii) the “gap in the program” involving the lack of candour between patient and staff about alcohol-related matters and the lack of addiction services, (iii) a preference by participants to self-manage their alcohol use disorder, (iv) social support as a facilitator of abstinence and the risk of relapse when social support is diminished, and (v) the fear of stigmatization. Each of these factors were dynamically interrelated and differed slightly for each subgroup. Conclusions The LT services may benefit from the inclusion of integrated specialist addiction services in their model of care. Such an approach may enhance the acceptability of alcohol treatment and reduce the risk of relapse among ALD transplant participants, especially for those whose social supports have diminished. PMID:27795986

  9. 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

  10. 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

  11. [Markedly dilated cervical carotid arteries in a patient with a ruptured aneurysm of the anterior communicating artery: a case report].

    PubMed

    Nakai, H; Kawata, Y; Tomabechi, M; Aizawa, S; Ohgami, S; Yonemasu, Y; Muraoka, S

    1993-04-01

    We reported a case of ruptured aneurysm of the anterior communicating artery with marked dilatation of bilateral cervical carotid arteries. A 38 year old female suffered a subarachnoid hemorrhage. Angiography on admission revealed markedly dilated cervical carotid arteries with smooth lumen and a few segmental areas with mild constrictions in their entire course up to the carotid canals (their maximal sagittal diameters exceeded those of a cervical vertebral body). A saccular aneurysm was also seen at the junction of right A1, A2, and Acom. External carotid arteries were normal in size. Vertebral arteries were not examined because of failures of selective cannulation. The patient was operated upon and trapping of Acom was performed. During the operation, no definite arteriosclerotic changes were identified in the intracranial arteries. Histopathological examination of the surgical specimens revealed marked hyperplasia of the smooth muscle of the tunica media with intact internal elastic lamina both in a superficial temporal artery and a middle meningeal artery. During the operation, pneumothorax developed due to the rupture of bullae in the right lung. Past history of this patient disclosed hypertension noted a few years previously, and frequent severe bruises following minor trauma. Repeated angiography performed three months after the operation disclosed unchanged dilatation of the cervical carotid arteries as well as mild intraluminal irregularities in the proximal one third of the left renal artery. This patient died of pneumonia one year after the operation, but autopsy was not permitted. Possible diagnosis of this patient was discussed, with particular emphasis on fibromuscular dysplasia and Ehlers-Danlos type IV (arterial, ecchymotic, or Sack-Barabas type).(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Pain acceptance potentially mediates the relationship between pain catastrophizing and post-surgery outcomes among compensated lumbar fusion patients

    PubMed Central

    Dance, Cassie; DeBerard, M. Scott; Gundy Cuneo, Jessica

    2017-01-01

    Purpose Chronic low back pain is highly prevalent and often treatment recalcitrant condition, particularly among workers’ compensation patients. There is a need to identify psychological factors that may predispose such patients to pain chronicity. The primary aim of this study was to examine whether pain acceptance potentially mediated the relationship between pain catastrophizing and post-surgical outcomes in a sample of compensated lumbar fusion patients. Patients and methods Patients insured with the Workers Compensation Fund of Utah and who were at least 2 years post-lumbar fusion surgery completed an outcome survey. These data were obtained from a prior retrospective-cohort study that administered measures of pain catastrophizing, pain acceptance, mental and physical health, and disability. Results Of the 101 patients who completed the outcome survey, 75.2% were male with a mean age of 42.42 years and predominantly identified as White (97.0%). The majority of the participants had a posterior lumbar interbody fusion surgery. Pain acceptance, including activity engagement and pain willingness, was significantly correlated with better physical health and mental health, and lower disability rates. Pain catastrophizing was inversely correlated with measures of pain acceptance (activity engagement r=−0.67, p<0.01, pain willingness r=−0.73, p<0.01) as well as the outcome measures: mental health, physical health, and disability. Pain acceptance significantly mediated the relationship between pain catastrophizing and both mental and physical health and also the relationship between pain catastrophizing and disability. Conclusion This study demonstrated that the relationship between pain catastrophizing and negative patient outcomes was potentially mediated by pain acceptance. Understanding this mediating relationship offers insight into how pain acceptance may play a protective role in patients’ pain and disability and has potential implications for pain

  13. 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

  14. Marked Body Shape Concerns in Female Patients Suffering from Eating Disorders: Relevance of a Clinical Sub-Group

    PubMed Central

    Gailledrat, Lucie; Rousselet, Morgane; Venisse, Jean-Luc; Lambert, Sylvain; Rocher, Bruno; Remaud, Manon; Guilleux, Alice; Sauvaget, Anne; Eyzop, Emeline; Grall-Bronnec, Marie

    2016-01-01

    Concerns about body shape and weight are core diagnostic criteria for eating disorders although intensity varies between patients. Few studies have focused on the clinical differences relative to the intensity of these concerns. Nonetheless, they might have a prognostic value. This study was aimed at identifying the characteristics associated with marked body shape concerns in patients with an eating disorder. Data was collected from a systematic and standardized clinical assessment of outpatients seeking treatment in our department for eating disorders. Only female patients, suffering from anorexia nervosa or bulimia nervosa, and with “no / mild” or “marked” body shape concerns according to the Body Shape Questionnaire, were included for the present study. We focused on sociodemographic characteristics, eating disorder characteristics, axis 1 disorders, types of attachment, self-esteem and dissociation. A multiple logistic regression was performed to identify factors related to “marked” body shape concerns. In our sample (123 participants, with a mean age of 24.3 years [range 16–61]), 56.9% had marked concerns with body shape. Marked body shape concerns were associated with a major depressive episode (OR = 100.3), the use of laxatives (OR = 49.8), a high score on the item “body dissatisfaction” of the Eating Disorders Inventory scale (OR = 1.7), a higher minimum body mass index (OR = 1.73), and a high score on the item “loss of control over behavior, thoughts and emotions” from the dissociation questionnaire (OR = 10.74). These results are consistent with previous studies, and highlight the importance of denial. PMID:27776159

  15. Autoimmune pernicious anaemia as a cause of collapse, heart failure and marked panyctopaenia in a young patient.

    PubMed

    Carey, Justin; Hack, Ebru

    2012-05-08

    A 35-year-old woman with a history of vitiligo, hypothyroidism and amenorrhoea presented with collapse and clinical features of cardiac failure. Laboratory investigations revealed pancytopaenia, the cause of which was found to be vitamin B12 deficiency due to pernicious anaemia. Treatment with intramuscular hydroxycobalamin was commenced and the patient improved steadily with concomitant improvement in her haematological indices. Clinical features of pernicious anaemia which can include marked pancytopaenia, diagnostic approach, associated conditions and approach to treatment are discussed. The importance of surveillance for gastrointestinal malignancy is emphasised.

  16. The acceptability and feasibility of an anxiety reduction intervention for emergency department patients with non-cardiac chest pain

    PubMed Central

    Webster, Rosie; Thompson, Andrew Robert; Norman, Paul; Goodacre, Steve

    2017-01-01

    Abstract Despite good physical prognosis, patients who receive a diagnosis of non-cardiac chest pain (NCCP) may experience persistent pain and distress. While cognitive-behavioural interventions have been found to be effective for this group, they are difficult to deliver in busy emergency department (ED) settings. Addressing the acceptability and relevance of self-help interventions is an important initial step in addressing this need. This study sought to examine the acceptability and relevance of an evidence-based self-help intervention for ED patients with persistent NCCP and anxiety. Patient (interviews: N = 11) and specialist chest pain nurse (focus group: N = 4) views on acceptability and feasibility were examined. Data were analysed using thematic analysis. Patients and nurses reported that there was a need for the intervention, as stress and anxiety are common among patients with NCCP, and provision of psychosocial support is currently lacking. Both patients and nurses reported that the intervention was relevant, acceptable, and potentially useful. Some changes to the intervention were suggested. Nurses reported that the intervention could be used within the existing staff resources available in an ED setting. This study represents an important first step towards developing a brief self-help intervention for ED patients with NCCP and anxiety. Further research should seek to determine the efficacy of the intervention in a pilot trial. PMID:26924523

  17. 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.

  18. Stretch Marks

    MedlinePlus

    ... like during puberty), that person may get fine lines on the body called stretch marks. Stretch marks happen when the skin is pulled by rapid growth or stretching. Although the skin is usually fairly elastic, when it's overstretched, the normal production of collagen (the major protein that makes up ...

  19. Social network intervention in patients with schizophrenia and marked social withdrawal: a randomized controlled study.

    PubMed

    Terzian, Emanuela; Tognoni, Gianni; Bracco, Renata; De Ruggieri, Edoardo; Ficociello, Rita Angela; Mezzina, Roberto; Pillo, Giuseppe

    2013-11-01

    Objectif : Évaluer l’efficacité et la faisabilité de mesures destinées à mettre en œuvre ou à améliorer le réseau social des patients au sein des services de santé mentale du Service national de la santé communautaire italien. Méthodes : Nous avons mené un essai clinique randomisé dans un réseau de 47 services de santé mentale communautaires avec des patients ayant un diagnostic du spectre de la schizophrénie (F20 dans la Classification internationale des maladies, 10e révision), qui étaient jeunes (moins de 45 ans), et dont le réseau social était médiocre (moins de 5 relations). Outre les traitements réguliers, pour le groupe expérimental, le personnel a cerné des champs d’intérêt possibles pour les patients individuels et proposé des activités sociales qui avaient lieu en dehors des ressources des services, avec les membres de la communauté. Le résultat principal a été l’amélioration du réseau social des patients; les indicateurs de résultats secondaires étaient un résultat clinique, les aptitudes à la vie quotidienne et le travail. Résultats : Les résultats à 1 an et 2 ans, de 345 et 327 respectivement, sur les 357 patients randomisés ont été analysés selon le principe de vouloir traiter. Une amélioration du réseau social a été observée à l’an 1 chez 25 % des patients affectés au traitement régulier et chez 39,9 % de ceux affectés au volet expérimental (RC 2,0; IC à 95 % 1,3 à 3,1; RC corrigé 2,4; IC à 95 % 1,4 à 3,9). La différence demeurait statistiquement significative à l’an 2. Aucune différence significative n’est apparue pour aucun des autres indicateurs de résultats. Cependant, les patients ayant amélioré 1 ou plusieurs domaines à l’an 1 et 2 présentaient une amélioration statistiquement significative de leur réseau social. Conclusions : L’activation des réseaux sociaux comme activité intégrée dans des soins psychiatriques standards est réalisable, sans frais

  20. Chronic Oral L-Carnitine Supplementation Drives Marked Plasma TMAO Elevations in Patients with Organic Acidemias Despite Dietary Meat Restrictions.

    PubMed

    Miller, Marcus J; Bostwick, Bret L; Kennedy, Adam D; Donti, Taraka R; Sun, Qin; Sutton, V Reid; Elsea, Sarah H

    2016-01-01

    Recent studies have implicated trimethylamine N-oxide (TMAO) in atherosclerosis, raising concern about L-carnitine, a common supplement for patients with inborn errors of metabolism (IEMs) and a TMAO precursor metabolized, in part, by intestinal microbes. Dietary meat restriction attenuates carnitine-to-TMAO conversion, suggesting that TMAO production may not occur in meat-restricted individuals taking supplemental L-carnitine, but this has not been tested. Here, we mine a metabolomic dataset to assess TMAO levels in patients with diverse IEMs, including organic acidemias. These data were correlated with clinical information and confirmed using a quantitative TMAO assay. Marked plasma TMAO elevations were detected in patients treated with supplemental L-carnitine, including those on a meat-free diet. On average, patients with an organic acidemia had ~45-fold elevated [TMAO], as compared to the reference population. This effect was mitigated by metronidazole therapy lasting 7 days each month. Collectively, our data show that TMAO production occurs at high levels in patients with IEMs receiving oral L-carnitine. Further studies are needed to determine the long-term safety and efficacy of chronic oral L-carnitine supplementation and whether suppression or circumvention of intestinal bacteria may improve L-carnitine therapy.

  1. 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…

  2. Radix Astragali Stimulates p38 MARK Phosphorylation in Pediatric Patients with β-Thalassemia

    PubMed Central

    Qian, Xinhua; Zhang, Chunhong; Chen, Zhiwen; Du, Guangliang

    2016-01-01

    A previous study conducted by our group demonstrated that Radix Astragali compounded with Codonopsis pilosula and Plastrum testudinis was effective in treating pediatric β-thalassemia in a randomized, controlled clinical trial. However, the mechanism of action that underpins this treatment remains to be elucidated. Blood was collected from patients participating in this clinical trial and nucleated red blood cell-enriched mononuclear cells were isolated to facilitate the extraction of RNA and protein. RT-PCR was used to monitor the expression of globin genes and p38 MAPK, and total and phosphorylated p38 MAPK expression was assessed using Western blot analysis. Expression of α-, β-, and Aγ-globin mRNAs was not significantly affected following treatment with R. Astragali or the compounded formulation. However, Gγ-globin mRNA levels increased significantly in both treatment groups (when compared with pretreatment levels) following 12 weeks of treatment. Moreover, posttreatment Gγ-globin expression was significantly higher in both treatment groups compared with the control group. Although neither p38 MAPK mRNA nor protein levels were affected by the treatments, posttreatment phosphorylation of p38 MAPK was significantly increased in the R. Astragali and compounded formulation groups compared with the control group. These data suggest that the molecular mechanisms that underpin the efficacious use of R. Astragali (and its compounded formulation) in pediatric β-thalassemia treatment facilitate the induction of Gγ-globin expression following activation of p38 MAPK. PMID:27882072

  3. Marked Reduction in Length of Stay for Patients with Psychiatric Emergencies after Implementation of a Co-Management Model

    PubMed Central

    Polevoi, Steven K.; Shim, J. Jewel; McCulloch, Charles E.; Grimes, Barbara; Govindarajan, Prasanthi

    2013-01-01

    = -60 to 5.9 visits per month) in the post-intervention phase. Conclusions A co-management model was associated with a marked reduction in the length of stay for this patient population. PMID:23701340

  4. The contribution of chronic illness to acceptance of death in hospitalized patients.

    PubMed

    Nichols, Joyce; Riegel, Barbara

    2002-02-01

    This pilot study explored acceptance of death in the chronically ill. It was hypothesized that chronic illness would be a positive predictor of premature acceptance of death. Acceptance of death, if premature, may lead to untimely acquiescence to death, making people less likely to seek medical care and practice preventive health behaviors. A correlational design was used to explore the relationship between chronic illness and acceptance of death, controlling for age. Data were collected on death acceptance using the revised version of the Life Attitude Profile. Number of chronic illnesses was obtained from self-report and a review of the medical record in a sample of 76 hospitalized individuals. The number of chronic illnesses was significantly and positively associated with death acceptance, but age was not. The model explained only 5.2% of the variance in death acceptance, however. Chronic illness is clearly only one of many factors stimulating individuals to ponder death earlier than expected. Nurses need to be alert to the possibility that individuals with multiple chronic illnesses may be prematurely acquiescing to death. If acquiescence causes failure to participate in care, it could potentially exacerbate chronic conditions unnecessarily.

  5. [Marked weight loss in two female patients with prader-willi syndrome by behavioral modification and improvement of the environment].

    PubMed

    Nishida, Keiko; Okada, Yosuke; Mori, Hiroko; Hirose, Akiko; Tanikawa, Takahisa; Arao, Tadashi; Morita, Emiko; Tanaka, Yoshiya

    2006-03-01

    Prader-Willi Syndrome (PWS) is a complex neurogenetic disorder with considerable clinical variability, and is considered to be mainly the result of a hypothalamic defect. PWS is characterized by hyperphagia, obesity, mental retardation and hypogonadism from a young age. Hyperphagia is one of the most serious problems, which is organic in origin, inducing morbid obesity and leading to respiratory failure. Most studies attempting to control obesity in children with PWS by dietary management reported limited success due to difficulty in controlling foraging and food stealing. Here we report 16- and 20-year-old female patients with PWS who showed marked weight loss and improvement of respiratory failure by behavior modification and improvement of the environment.

  6. [A report on attempted suicide cases involving patients accepted by public health care institutions].

    PubMed

    Tsujimoto, Tetsushi; Tsuji, Motohiro; Yamada, Naoto

    2011-01-01

    We investigated attempted suicide cases, both successful and failed involving patients, accepted by public health care institutions in Shiga Prefecture, whose population is about 1. 4 million, from the 12th January 2010 to 14th February 2010. Prefectural emergency hospitals, fire stations, and pathologists cooperated in the investigation, and the cases were reported with the age and sex as well as the means and results of the attempts. How these institutions cooperated in the cases was also reported. A total number of 104 people attempted suicide, in which 40 people (38.5%) succeeded, 54 people (51.9%) failed, and the outcome was unknown in 10 people (9.6%). Forty-one people (39.4%) were in their 30s, being the most common age group. Successful suicides were most prominent among elderly males, and failed attempts were most prominent among young females. Hanging and poisonous gassing were the common means of suicide among the successful cases, and overdose, drinking, and wrist -cutting were the common means among the failed attempts. Sixty-four people (61.5%) were admitted to public emergency hospitals, 51 people (49.0%) were rescued by fire workers, and 34 people (32.7%) were sent for autopsy following police reports on fatal cases as suicide. Successful suicides and males were mostly sent for pathological examination without any coordinated care from different medical institutions, whereas, failed cases and females were often taken care of by several institutions. Five people (4.8%) were referred for psychiatric help. Suicide intervention needs to take account of differences in the sex, age, means, and other characteristics of those who attempt suicide. Each institution plays an important role, and they need to cooperate in order to establish an effective intervention.

  7. 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.

  8. Adalimumab markedly improves enthesitis in patients with psoriatic arthritis: Evaluation with a magnetic resonance imaging scoring system.

    PubMed

    Yanaba, Koichi; Sadaoka, Akari; Yonenaga, Takenori; Saeki, Hidehisa; Umezawa, Yoshinori; Tojo, Shinjiro; Ito, Toshihiro; Kikuchi, Sota; Fukuda, Kunihiko; Nakagawa, Hidemi

    2015-12-01

    Psoriatic arthritis (PsA), a seronegative arthropathy, may often result in progressive joint damage without treatment, leading to disability and impaired quality of life. Early therapeutic intervention of PsA is therefore crucial before the development of irreversible joint damage. Because psoriatic skin lesions generally precede the onset of PsA, dermatologists occupy an important position in treating patients with early PsA. This study aimed to evaluate the efficacy of adalimumab in treating joint disease in patients with PsA, using the PsA magnetic resonance imaging scoring system (PsAMRIS). Five adult Japanese male patients with active PsA were treated with adalimumab. Magnetic resonance imaging was obtained at baseline and 8-32 weeks with 2-3 time points following adalimumab treatment and assessed using PsAMRIS. Adalimumab treatment markedly improved clinical symptoms and disease activities of joint disease, which was confirmed by the reduction of PsAMRIS scores in all patients. Bone marrow edema and periarticular inflammation, reflecting the presence of enthesitis, were dramatically improved at week 8, while improvement of synovitis and flexor tenosynovitis was observed later, at week 24 or 32. However, bone erosion was not improved by adalimumab treatment during the follow-up period. These results indicate that adalimumab treatment is associated with dramatic improvement of enthesitis in patients with PsA, whereas bone erosion may be resistant to such treatment. PsAMRIS appears to be useful for the evaluation of treatment efficacy in PsA.

  9. Pain related catastrophizing on physical limitation in rheumatoid arthritis patients. Is acceptance important?

    PubMed

    Costa, Joana; Pinto-Gouveia, José; Marôco, João

    2014-01-01

    The experience of Rheumatoid Arthritis (RA) includes significant suffering and life disruption. This cross-sectional study examined the associations between pain, catastrophizing, acceptance and physical limitation in 55 individuals (11 males and 44 female; Mean age = 54.37; SD = 18.346), from the Portuguese population with (RA) 2 years after the diagnosis; also explored the role of acceptance as a mediator process between pain, catastrophizing and physical limitation. Results showed positive correlation between pain and catastrophizing (r = .544; p ≤ .001), and also between pain and 2-years' physical limitation (r = .531; p ≤ .001) Results also showed that acceptance was negatively correlated with physical limitation 2 years after the diagnosis (r = -.476; p ≤ .001). Path-analysis was performed to explore the direct effect of pain (ß = -.393; SD = .044; Z = 3.180; p ≤ .001) and catastrophizing (n.sig.) on physical limitation and also to explore the buffer effect of acceptance in this relationship (indirect effect ß = -.080). Results showed that physical limitation is not necessarily a direct product of pain and catastrophizing but acceptance was also involved. Pain and catastrophizing are associated but the influence of catastrophizing on physical limitation is promoted by low levels of acceptance. Results emphasize the relevance of acceptance as the emotional regulation process by which pain and catastrophizing influence physical functioning and establish the basic mechanism by which pain and catastrophizing operate in a contextual-based perspective. Also the study results offer a novel approach that may help behavioral health and medical providers prevent and treat these conditions.

  10. 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

  11. Assessing physician and patient acceptance of infliximab biosimilars in rheumatoid arthritis, ankylosing spondyloarthritis and psoriatic arthritis across Germany

    PubMed Central

    Waller, John; Sullivan, Emma; Piercy, James; Black, Christopher M; Kachroo, Sumesh

    2017-01-01

    Objectives We examined rheumatologists’ motivation for prescribing biosimilars, assessed their treatment preferences in relation to prescribing behavior and explored patient attitudes to biosimilars. Methods Data were taken from the Adelphi Real World Biosimilars Programme, a real-world, cross-sectional study undertaken with German rheumatologists and patients with rheumatoid arthritis, ankylosing spondyloarthritis or psoriatic arthritis in 2015–2016. Rheumatologists provided data on their prescribing behavior and attitudes toward biosimilars and invited the next eight eligible consecutive consulting patients to complete a questionnaire. Rheumatologists were split into “investigative”, “conservative” and “other” groups. Results Overall, 50 rheumatologists and 261 patients participated. Biosimilars accounted for <10% of all biologic therapy prescriptions, and >95% of rheumatologists would prescribe a biooriginator rather than biosimilar as the first- or second-line therapy if unrestricted. Patients showed some reluctance to accept biosimilars, and a small proportion of patients were unhappy when switched from a biooriginator to a biosimilar. Satisfaction with treatment was highest in patients who started treatment with a biooriginator prior to biosimilar availability. Patient concerns when starting treatment with a biooriginator or a biosimilar included not knowing enough about the drug (25%–41%), potential side effects (26%–32%) and potential long-term problems (19%–30%). Conclusion Study results demonstrate that there is some reluctance from patients to accept biosimilars and the need to educate patients who are unsure to allow them to be involved in decision making, highlighting the importance of patient and physician communication. There remains a need for further research into nonclinical switching and the long-term impact of prescribing biosimilars. PMID:28331299

  12. Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of Posttraumatic Stress Disorder (PTSD) Symptoms Among Active Duty Military Members

    DTIC Science & Technology

    2016-03-01

    Page 1 of 63 AWARD NUMBER: W81XWH-15-2-0015 TITLE: Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of...SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-2-0015 Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment...study seeks to evaluate the effectiveness and acceptability of stellate ganglion block (SGB) for treatment of Posttraumatic Stress Disorder (PTSD

  13. Acceptability of an Alimentary Supplement of Whey-Protein Concentrate and TGF- β in Patients with Crohn's Disease.

    PubMed

    Davanço, Taciana; Silva, Luciano Bruno de Carvalho; Sampaio, Karina de Lemos; Coy, Cláudio Saddy Rodrigues; Vilela, Maria Marluce Dos Santos; Pinto, Elizete Aparecida Lomazi da Costa

    2013-01-01

    The objective of this study was to evaluate the acceptability of an alimentary supplement of bovine whey-protein concentrate (WPC) and TGF- β , unavailable commercially, by patients with Crohn's disease (CD) and determine the chemical composition, solubility, and total amino acids content. The supplement was diluted in water, and an acceptance test was done to evaluate the aroma, flavour, and viscosity of the product using facial hedonic scale (nine-point scale), applied on 54 CD patients. The supplement composition indicated 73.3% protein, 10.5% fat, 2.2% ash, 6.3% water, and 7.7% carbohydrate. The supplement is presented as a good protein source and high content of essential amino acids. The average acceptance for all the attributes was between 5.0 and 6.0, and the flavour was mainly associated with soybean/grain, sour milk, and sweet/vanilla flavour. The results indicated that the supplement provided important nutritional properties for CD patients; however, for a large number of individuals to be encouraged to perform supplementation, it is essential to improve the sensory quality of the product. In order to do so, additional research is necessary to prevent the formation of volatiles which cause off-flavours or to mask undesirable aromas/flavours found in it.

  14. Acceptability of an Alimentary Supplement of Whey-Protein Concentrate and TGF-β in Patients with Crohn's Disease

    PubMed Central

    Davanço, Taciana; Silva, Luciano Bruno de Carvalho; Sampaio, Karina de Lemos; Coy, Cláudio Saddy Rodrigues; Vilela, Maria Marluce dos Santos; Pinto, Elizete Aparecida Lomazi da Costa

    2013-01-01

    The objective of this study was to evaluate the acceptability of an alimentary supplement of bovine whey-protein concentrate (WPC) and TGF-β, unavailable commercially, by patients with Crohn's disease (CD) and determine the chemical composition, solubility, and total amino acids content. The supplement was diluted in water, and an acceptance test was done to evaluate the aroma, flavour, and viscosity of the product using facial hedonic scale (nine-point scale), applied on 54 CD patients. The supplement composition indicated 73.3% protein, 10.5% fat, 2.2% ash, 6.3% water, and 7.7% carbohydrate. The supplement is presented as a good protein source and high content of essential amino acids. The average acceptance for all the attributes was between 5.0 and 6.0, and the flavour was mainly associated with soybean/grain, sour milk, and sweet/vanilla flavour. The results indicated that the supplement provided important nutritional properties for CD patients; however, for a large number of individuals to be encouraged to perform supplementation, it is essential to improve the sensory quality of the product. In order to do so, additional research is necessary to prevent the formation of volatiles which cause off-flavours or to mask undesirable aromas/flavours found in it. PMID:24967262

  15. 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

  16. 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

  17. 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

  18. Patients' appropriateness, acceptability, usability and preferences for pharmaceutical preparations: Results from a literature review on clinical evidence.

    PubMed

    Drumond, Nélio; van Riet-Nales, Diana A; Karapinar-Çarkit, Fatma; Stegemann, Sven

    2017-04-15

    Patients play an important role in achieving the desired therapeutic outcomes, as they are frequently responsible for their own medication management. To facilitate drug administration and overcome medication issues, the patients' needs and preferences should be considered in the pharmaceutical drug product design. With the aim to evaluate the current state of evidence for patient appropriateness, acceptability, usability and preference for aspects of this design, a literature search was performed. Comparative clinical studies that assessed such endpoints for different patient populations were included and summarized descriptively. The search identified 45 publications that met the inclusion criteria. A detailed analysis of the studies identified two main areas investigating either packaging design (n=10) or dosage form design (n=35). Studies on packaging design showed preferences for wing top and screw cap openings, push-through blisters and suppositories with slide system. Additionally, child-resistant containers should be avoided concerning specific patient populations. Regarding dosage form design, sprinkles and minitablets were the most preferred in studies involving young patients, while preferences varied considerably depending on route of administration and geographical region in studies with adult patients. Review of the methodology used in the studies revealed that ten studies had used well-defined protocols and observational endpoints to investigate patient appropriateness. Studies focusing on methodology for testing the appropriateness and usability of drug products by patients were not found. In conclusion, more interdisciplinary scientific efforts are required to develop and increase research in understanding patient needs and preferences.

  19. Prejudices and perceptions: patient acceptance of mobile technology use in health care.

    PubMed

    Alexander, S M; Nerminathan, A; Harrison, A; Phelps, M; Scott, K M

    2015-11-01

    mHealth is transforming health care, yet few studies have evaluated patient and carer perceptions of the use of smartphones at the patient bedside. In this study, 70 patients and carers answered a short survey on health professionals' use of mobile devices. Half the participants were tolerant of doctors using such devices if it was work-related; others believed it was a distraction and not beneficial to patient care. Changes in practice and patient education may be needed to enable effective use of mobile devices in health.

  20. The differential effect of compensation structures on the likelihood that firms accept new patients by insurance type.

    PubMed

    Bullock, Justin B; Bradford, W David

    2016-03-01

    Adequate access to primary care is not universally achieved in many countries, including the United States, particularly for vulnerable populations. In this paper we use multiple years of the U.S.-based Community Tracking Survey to examine whether a variety of physician compensation structures chosen by practices influence the likelihood that the practice takes new patients from a variety of different types of insurance. Specifically, we examine the roles of customer satisfaction and quality measures on the one hand, and individual physician productivity measures on the other hand, in determining whether or not firms are more likely to accept patients who have private insurance, Medicare, or Medicaid. In the United States these different types of insurance mechanisms cover populations with different levels of vulnerability. Medicare (elderly and disabled individuals) and Medicaid (low income households) enrollees commonly have lower ability to pay any cost sharing associated with care, are more likely to have multiple comorbidities (and so be more costly to treat), and may be more sensitive to poor access. Further, these two insurers also generally reimburse less generously than private payors. Thus, if lower reimbursements interact with compensation mechanisms to discourage physician practices from accepting new patients, highly vulnerable populations may be at even greater risk than generally appreciated. We control for the potential endogeneity of incentive choice using a multi-level propensity score method. We find that the compensation incentives chosen by practices are statistically and economically significant predictors for the types of new patients that practices accept. These findings have important implications for both policy makers and private health care systems.

  1. A multicentre study to determine the efficacy and patient acceptability of the Paxman Scalp Cooler to prevent hair loss in patients receiving chemotherapy.

    PubMed

    Massey, Carolyn S

    2004-06-01

    Alopecia is a distressing and common side-effect of chemotherapy, especially anthracycline- and taxane-containing regimen. A series of studies and reviews have considered scalp cooling as a means of reducing this side-effect without a definitive result. The aim of the study was to determine the efficacy and patient acceptability of scalp cooling using the Paxman Scalp Cooler. This was an open, non-randomised, observational study conducted at eight sites involving 94 patients. Alopecia was assessed using the World Health Organisation (WHO) grading system. Patient acceptability was assessed by questionnaire. Results were compiled by Scalp Cooling Assessment Groups using data from eight centres in the UK collected between 1997 and 2000. Use of the Paxman Scalp Cooler was adjudged a success for 89% of all patients using the WHO grading system for alopecia and for 87% of patients being specifically administered the commonly used 5-fluorouracil, epirubicin and cyclophosphamide (FEC) regimen. When asked about degrees of comfort during the scalp-cooling process, 85% of patients described it as very comfortable, reasonably comfortable or comfortable, with only 15% of patients reporting a description of uncomfortable or very uncomfortable. Scalp cooling using the Paxman Scalp Cooler was found to be an effective technique with minimal side-effects for patients treated with commonly prescribed alopecia-inducing chemotherapy drugs.

  2. Feasibility and acceptance of a home telemanagement system in patients with inflammatory bowel disease: a 6-month pilot study.

    PubMed

    Cross, Raymond K; Finkelstein, Joseph

    2007-02-01

    Our purpose was to assess the acceptance and feasibility of a home telemanagement system (HAT) in inflammatory bowel disease (IBD). The HAT consists of a laptop and a scale. Subjects were required to complete weekly self-testing for 6 months. Disease activity, quality of life, and knowledge were assessed at baseline and 6 months. Attitudinal surveys were completed at 6 months. Twenty-five subjects completed the study. Ninety-one percent of patients thought that self-testing was not complicated. Eighty-six percent said that self-testing did not interfere with their usual activities. Ninety-one percent of patients would consider using a HAT in the future. Adherence with self-testing was 91%. Improvements in disease activity and quality of life, and significant improvements in knowledge, were observed after implementation of the HAT. The HAT is feasible and accepted in IBD. We predict that the HAT will positively affect adherence, monitoring, and patient education, resulting in improved disease activity and quality of life.

  3. When an indigent patient needs a helicopter: a case report and an accepted institutional policy.

    PubMed

    La Puma, J; Balskus, M

    1988-01-01

    Emergency aeromedical systems have become an integral part of the practice of critical care medicine. These systems provide specialized care to the severely injured, including transport to the nearest trauma center with the highest level. Aeromedical physicians and nurses called to care for injured indigent patients, however, may be placed at odds with the financial interests of their institution. "Patient dumping" in aeromedicine may lead to ethical, legal, professional, and regulatory dilemmas for emergency professionals and health care institutions. Institutional policy for aeromedical transport of severely injured patients must be instituted, regardless of their ability to pay.

  4. Integrating the patient portal into the health management work ecosystem: user acceptance of a novel prototype

    PubMed Central

    Eschler, Jordan; Meas, Perry Lin; Lozano, Paula; McClure, Jennifer B.; Ralston, James D.; Pratt, Wanda

    2016-01-01

    People with a chronic illness must manage a myriad of tasks to support their health. Online patient portals can provide vital information and support in managing health tasks through notification and reminder features. However, little is known about the efficacy of these features in managing health tasks via the portal. To elicit feedback about reminder and notification features in patient portals, we employed a patient-centered approach to design new features for managing health tasks within an existing portal tool. We tested three iteratively designed prototypes with 19 patients and caregivers. Our findings provide insights into users’ attitudes, behavior, and motivations in portal use. Design implications based on these insights include: (1) building on positive aspects of clinician relationships to enhance engagement with the portal; (2) using face-to-face visits to promote clinician collaboration in portal use; and (3) allowing customization of portal modules to support tasks based on user roles. PMID:28269850

  5. Integrating the patient portal into the health management work ecosystem: user acceptance of a novel prototype.

    PubMed

    Eschler, Jordan; Meas, Perry Lin; Lozano, Paula; McClure, Jennifer B; Ralston, James D; Pratt, Wanda

    2016-01-01

    People with a chronic illness must manage a myriad of tasks to support their health. Online patient portals can provide vital information and support in managing health tasks through notification and reminder features. However, little is known about the efficacy of these features in managing health tasks via the portal. To elicit feedback about reminder and notification features in patient portals, we employed a patient-centered approach to design new features for managing health tasks within an existing portal tool. We tested three iteratively designed prototypes with 19 patients and caregivers. Our findings provide insights into users' attitudes, behavior, and motivations in portal use. Design implications based on these insights include: (1) building on positive aspects of clinician relationships to enhance engagement with the portal; (2) using face-to-face visits to promote clinician collaboration in portal use; and (3) allowing customization of portal modules to support tasks based on user roles.

  6. Validity testing of patient objections to acceptance of tamper-resistant opioid formulations

    PubMed Central

    Argoff, Charles E; Stanos, Steven P; Wieman, Matthew S

    2013-01-01

    Background Tamper-resistant formulations (TRFs) of oral opioid drugs are intended to prevent certain types of abuse (eg, intranasal, intravenous). Patients raising objections to receiving a TRF may have valid concerns or may be seeking a formulation that can be more easily misused. Methods US clinicians experienced in pain management met in October 2011 to discuss common patient objections to being switched from a non-TRF opioid to a TRF of the same opioid. Retail pharmacy, health insurance, and scientific data were used to assess the potential validity of these patient objections. Results Clinical experience switching patients from a non-TRF to a TRF opioid was limited to oxycodone controlled release (CR), as it was the only TRF available at that time; knowledge of other TRFs was limited to the scientific literature. Common objections from patients included “costs more,” “not covered by insurance,” “can’t feel it working,” and “causes adverse events.” Objective retail pharmacy and insurance coverage information for oxycodone CR was accessible and indicated that patient objections were based on cost and coverage varied by insurer. Unpublished trial results (ClinicalTrials.gov) revealed that TRF oxycodone CR has a slower initial release than the non-TRF formulation, which may reduce positive subjective effects. The complaint “I can’t feel it working” may reflect lessened positive subjective effects rather than reduced analgesic efficacy. Most tolerability complaints lacked objective support. Conclusion The general process used to assess the validity of patient objections to TRF oxycodone CR may be applied to other TRFs once they become available. Publication of clinical data on TRFs would help clinicians to appropriately weigh patient concerns. PMID:23696714

  7. Assessment of pain, acceptance of illness, adjustment to life with cancer, and coping strategies in colorectal cancer patients

    PubMed Central

    Religioni, Urszula; Deptała, Andrzej; Walewska-Zielecka, Bożena

    2015-01-01

    Introduction Every year more than 15,000 newly diagnosed cases of colorectal carcinoma are recorded in Poland. Aim The objective of the study was an assessment of coping strategies and pain management, acceptance of illness, and adjustment to cancer in patients diagnosed with colorectal carcinoma. The analysis was extended to include the effect of socioeconomic variables on the above-mentioned issues. Material and methods The study included 238 colorectal cancer patients treated on an outpatient basis at the Centre of Oncology, the Maria Skłodowska-Curie Institute in Warsaw in the year 2013. The questionnaire interview comprised demographic questions (socioeconomic variables) and the following four psychometric tests: BPCQ (Beliefs about Pain Control Questionnaire), CSQ (Coping Strategies Questionnaire), AIS questionnaire (Acceptance of Illness Scale), and the Mini-Mac scale (Mental Adjustment to Cancer). Results The source of pain control depends on the respondent's level of education. An increase in patient income was associated with a lower mean result in the “power of doctors” subscale. The coping self-statements and increased behavioural activity are the two most frequently selected strategies of coping with pain. The most commonly followed ways of mental adjustment to cancer in the study group were a fighting spirit (23.42) and positive re-evaluation (22.31). Conclusions Colorectal cancer patients believe that the greatest role in pain management is played by internal factors. The locus of pain control depends on the level of education. The study patients feature a constructive way of struggling with disease differentiated by the place of residence, professional status, and income. PMID:27350836

  8. 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.

  9. Comparison of articulating paper markings and T Scan III recordings to evaluate occlusal force in normal and rehabilitated maxillofacial trauma patients

    PubMed Central

    Majithia, I.P.; Arora, Vimal; Anil Kumar, S.; Saxena, Vivek; Mittal, Manish

    2015-01-01

    Background Prosthodontic Rehabilitation of Treated Maxillofacial Trauma Cases by Evaluating Occlusal Force Distribution Using Computerized Occlusal Analysis. Method 30 patients were selected for the study. 15 normal and 15 treated trauma patients were subjected to T Scan analysis and evaluated for the occlusal force distribution. Results The results take into consideration the two parameters. Firstly the largest articulating paper mark (photographed) and secondly the T scan of the same patient. Comparison was made between the largest articulating paper mark and highest force tooth in the quadrant using T Scan. The matches and no matches were then tabulated for statistical analysis assessing the frequency of the matches to the no matches. Conclusion The ultimate advantage of a T Scan III analysis is that it can detect the amount of force as well as location of the highest intensity contacts of a single tooth which is very specific. PMID:26843754

  10. 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.

  11. Inadvertent prescription of gelatin-containing oral medication: its acceptability to patients.

    PubMed

    Vissamsetti, Bharat; Payne, Mark; Payne, Stephen

    2012-09-01

    When prescribing, doctors usually only consider the 'active' component of any drug's formulation ignoring the majority of the agents which make up the bulk of the tablet or capsule, collectively known as excipients. Many urological drugs contain the excipient gelatin which is, universally, of animal origin; this may conflict with the dietetic ideals of patients. A questionnaire-based study, undertaken between January and June 2010 in a mixed ethnicity inner-city population presenting with urological symptoms, asked which patients preferred not to ingest animal-based products, who would ask about the content of their prescribed treatment and who would refuse to take that medication if alternatives were available. Ultimately, the authors sought to find out how many patients had been inadvertently prescribed gelatin-containing oral medications and to suggest ways in which prescriptions might be more congruous with an individual patient's dietetic wishes. This study demonstrated that 43.2% of the study population would prefer not to take animal product-containing medication even if no alternative were available. 51% of men with lower urinary tract symptoms were also found to have inadvertently been prescribed gelatin-containing products against their preferred dietary restriction. Education of healthcare professionals about excipients and getting them to ask about a patient's dietetic preferences may help avoid inadvertent prescription of the excipient gelatin in oral medications. Substitution of gelatin with vegetable-based alternatives and clearer labelling on drug packaging are alternative strategies to help minimise the risks of inadvertently contravening a patient's dietetic beliefs when prescribing oral medication.

  12. 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…

  13. 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

  14. 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

  15. 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

  16. 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

  17. Accept or Refuse? A Pilot Study of Patients' Perspective on Participating as Imaginary Research Subjects in Schizophrenia

    PubMed Central

    Kim, Jin Hun; Kim, Daeho; Park, Sung-Hyouk

    2009-01-01

    Objective The goal of the present study was to evaluate demographic and clinical factors that affect the intention to participate in commonly-conducted research in patients with schizophrenia. Methods Thirty-four outpatients with a diagnosis of schizophrenia were enrolled in this study. They were asked whether they would have any intention to participate in four imaginary studies: a simple questionnaire, a genetic study, a study of complex tasks and a risky study. We analyzed the differences in general psychopathology, insight and demographic characteristics of the participants according to their responses (acceptance or refusal) to the four proposed studies. Results Younger and better-educated patients tended to decline participation in a risky study. Patients with a longer duration of regular psychiatric follow-ups tended to willingly participate in the simple questionnaire. There were no overall statistical differences in general psychopathology and insight between patients who agreed or declined to participate in studies. Conclusion Age and education level may be factors that influence decisions to participate in schizophrenia studies. Further research is needed to confirm and expand on the current findings. PMID:20046377

  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. An alternative percutaneous interventional approach for post-anastomatic left anterior descending artery stenosis in patients with markedly tortuous LIMA graft.

    PubMed

    Tengiz, Istemihan; Aliyev, Emil; Ercan, Ertugrul

    2005-10-01

    Percutaneous coronary intervention through a tortuous left internal mammary artery (LIMA) graft, especially with redundancy in length is a challenge in spite of availability of different types of coated guidewires and low-profile balloons. Various modifications of the interventional technique are required in order to negotiate the tortuosity of the LIMA graft. We describe an alternative technique that overcomes this problem in patient with a markedly tortuous LIMA graft.

  20. Pilot assessment of HIV gene therapy-hematopoietic stem cell clinical trial acceptability among minority patients and their advisors.

    PubMed

    King, William Douglas; Wyatt, Gail E; Liu, Honghu; Williams, John K; DiNardo, Anthony D; Mitsuyasu, Ronald T

    2010-12-01

    Clinical trials involving technologically involved novel treatments such as gene therapy delivered through hematopoietic stem cells as human immunodeficiency virus (HIV) treatment will need to recruit ethnically diverse patients to ensure the acceptance among broad groups of individuals and generalizability of research findings. Five focus groups of 47 HIV-positive men and women, religious and community leaders and health providers, mostly from African American and low-income communities, were conducted to examine knowledge about gene therapy and stem cell research and to assess the moral and ethical beliefs that might influence participation in clinical trials. Three themes emerged from these groups: (1) the need for clarification of terminology and the ethics of understanding gene therapy-stem cell research, (2) strategies to avoid mistrust of medical procedures and provider mistrust, and (3) the conflict between science and religious beliefs as it pertains to gene therapy-stem cell research.

  1. Psychological interventions for patients with cancer: psychological flexibility and the potential utility of Acceptance and Commitment Therapy.

    PubMed

    Hulbert-Williams, N J; Storey, L; Wilson, K G

    2015-01-01

    Cancer is an illness affecting patients' physical and psychosocial well-being: high numbers report problematic levels of distress at many points through diagnosis, treatment and survivorship. Conclusive evidence for the long-term benefits of psychological interventions is lacking and this may be because (1) they employ a too limited scope of underlying therapeutic model; or (2) that they are too focused on improving psychopathological outcomes. Acceptance and Commitment Therapy (ACT) may add components not emphasised elsewhere and may provide a more suitable model of adjustment and coping. Following a comprehensive literature search a theoretical and conceptual discussion of the potential for ACT-based oncology interventions is presented. Only a small number of studies have purposively studied the application of ACT within the cancer setting, but this nonetheless presents useful pilot data. The data demonstrate potential clinical- and cost-effectiveness for a range of patients, including those with psychological comorbidity. Within the context of wider cancer adjustment, ACT offers an intervention framework to appropriately build upon the strong empirical base already established for Mindfulness within this specific patient population. The evidence available suggests that the underlying framework of ACT offers an intervention model that is potentially more suited to the individualistic nature of cancer adjustment.

  2. Marked increase in bone formation markers after cinacalcet treatment by mechanisms distinct from hungry bone syndrome in a haemodialysis patient

    PubMed Central

    Goto, Shunsuke; Fujii, Hideki; Matsui, Yutaka; Fukagawa, Masafumi

    2010-01-01

    A 59-year-old female who was on dialysis due to diabetic nephropathy was referred to our hospital for severe hyperparathyroidism refractory to intravenous vitamin D receptor activator treatment. With subsequent cinacalcet hydrochloride treatment, parathyroid hormone (PTH) levels were only slightly suppressed. However, progressive increases were observed in serum alkaline phosphatase (ALP) and bone-specific alkaline phosphatase (BAP) levels with mild hypocalcaemia. A bone biopsy, obtained immediately before surgical parathyroidectomy after 3 months of cinacalcet treatment, revealed no disappearance of osteoclasts. These data suggest that cinacalcet hydrochloride treatment may induce a marked promotion of bone formation by mechanisms distinct from hungry bone syndrome that usually develops after parathyroidectomy. PMID:25949410

  3. 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

  4. 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.

  5. Drivers and Barriers to Acceptance of Web-Based Aftercare of Patients in Inpatient Routine Care: A Cross-Sectional Survey

    PubMed Central

    Hennemann, Severin; Beutel, Manfred E

    2016-01-01

    Background Web-based aftercare can help to stabilize treatment effects and support transition after inpatient treatment, yet uptake by patients seems limited in routine care and little is known about the mechanisms of adoption and implementation. Objective The aim of this study was to (1) determine acceptance of Web-based aftercare and (2) explore its drivers and barriers in different subgroups of a mixed inpatient sample. Method In a cross-sectional design, 38.3% (374/977) of the inpatients from a broad spectrum of diagnostic groups (psychosomatic, cardiologic, orthopedic, pediatric, and substance-related disorders) filled out a self-administered questionnaire prior to discharge. Drivers and barriers to patients’ acceptance of Web-based aftercare were examined based on an extension to the “unified theory of acceptance and use of technology” (UTAUT). In total, 16.7% (59/353) of the participants indicated prior use of eHealth interventions. Results Acceptance (min 1, max 5) was low (mean 2.56, SD 1.22) and differed between diagnostic groups (Welch F4,133.10 =7.77, P<.001), with highest acceptance in adolescent patients (mean 3.46, SD 1.42). Acceptance was significantly predicted by 3 UTAUT predictors: social influence (beta=.39, P<.001), performance expectancy (beta=.31, P<.001), and effort expectancy (beta=.22, P<.001). Furthermore, stress due to permanent availability (beta=−.09, P=.01) was negatively associated with acceptance. Conclusion This study demonstrated a limited acceptance of Web-based aftercare in inpatients. Expectations, social environment’s attitude, and negative experience with permanent availability influence eHealth acceptance. Improving implementation, therefore, means increasing eHealth experience and literacy and facilitating positive attitudes in patients and health professionals through education and reduction of misconceptions about effectiveness or usability. PMID:28011445

  6. Recruiting the Social Contacts of STI Patients for HIV Screening in Lilongwe, Malawi: Process Evaluation and Assessment of Acceptability

    PubMed Central

    Rosenberg, Nora E.; Stanley, Christopher; Rutstein, Sarah E.; Bonongwe, Naomi; Kamanga, Gift; Pettifor, Audrey; Mpanje, Clement; Martinson, Francis; Hoffman, Irving F.; Miller, William C.

    2017-01-01

    Objectives To explore acceptability of recruiting social contacts for HIV and STI screening in Lilongwe, Malawi. Methods In this observational study, three groups of “seed” patients were enrolled: 45 HIV-infected STI patients, 45 HIV-uninfected STI patients, and 45 community controls, who were also tested for HIV as part of the study. Each seed was given five coupons and asked to recruit up to five social contacts to the STI clinic. Seeds were told the programme for contacts would include HIV testing, STI screening, and general health promotion. Seeds were asked to return after one month to report on the contact recruitment process. Seeds received $2 for each successfully recruited contact. Results Eighty-nine seeds (66%) returned for one-month follow-up with no difference between the three seed groups (p=0.9). Returning seeds reported distributing most of their coupons (mean=4.1) and discussing each feature of the programme with most contacts—HIV testing (90%), STI screening (87%), and health promotion (91%). Seeds reported discussing their own HIV status with most contacts (52%), with a lower proportion of HIV-infected seeds discussing their HIV status (22%) than HIV-uninfected seeds (81%) or community seeds (64%) (p<0.001). Contact recruitment did not vary with socioeconomic status. Conclusions Most seeds distributed all coupons and reported describing all aspects of the programme to most contacts. STI patients are able to act as health promoters within their social networks and may be a critical link to increasing STI and HIV status awareness among high risk groups. PMID:27177775

  7. 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.

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

    PubMed Central

    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

  9. 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

  10. Delay in diagnosis affects the clinical outcome in a cohort of cvid patients with marked reduction of iga serum levels.

    PubMed

    Graziano, Vincenzo; Pecoraro, Antonio; Mormile, Ilaria; Quaremba, Giuseppe; Genovese, Arturo; Buccelli, Claudio; Paternoster, Mariano; Spadaro, Giuseppe

    2017-03-25

    Common variable immunodeficiency disorders (CVID) represent a collection of diseases leading to an absent or strongly impaired antibody production. CVID presents a wide range of immunological abnormalities and clinical manifestations, including infections, inflammatory and autoimmune diseases, and malignancies. The aim of this observational study was to analyze the epidemiological and clinical features of a cohort of 75 Italian CVID patients, and evaluate the correlation with comorbidity and mortality. Clinical data were retrospectively collected: the cohort was followed-up for a maximum of 30years (mean time of 10.24years, median of 9years). An higher age at the diagnosis of CVID and an higher age at onset of symptoms were significantly associated with a reduction of patients survival if stratified per median of IgA (less than or >8.00mg/dl). Thus IgA levels at diagnosis are correlated with patients survival contributing to identify a subset with a worse prognostic outcome.

  11. 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.

  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

    Okada, Akira

    2014-05-16

    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.

  13. Project (inverted exclamation mark)EXITO!: success through diversity and universality for outcomes improvement among Hispanic home care patients.

    PubMed

    Woerner, Louise; Espinosa, Javier; Bourne, Susan; O'Toole, Marie; Ingersoll, Gail L

    2009-01-01

    The National Health Disparities Report notes that Hispanics have poorer quality of care in 23 of 38 core measures. The result of this disparity is great personal and health system costs, which could be reduced. Prior studies have focused on access and language. We studied outcomes improvement. The purpose of this project was to develop a replicable theory-based outcomes improvement model for delivery of nursing care to Hispanic patients. The Leininger Sunrise Enabler approach was used to design a program specific to the cultural needs of a home care population. Outcome and Assessment Information Set (OASIS) data from 125 unduplicated home care patients were tracked. Nursing care delivery was analyzed using ethnographic research techniques. Delivery of nursing care using a culturally congruent approach reduced acute hospitalization and emergent care visits. Medication management and customer and nursing satisfaction also improved. National standards for culturally and linguistically appropriate services in health care help reduce healthcare disparities, but improving Hispanic outcomes requires moving beyond symptoms and symptom management to transcultural care. The estimated savings to the health care system are significant.

  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. 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

  16. Feasibility and Acceptability of an Audio Computer-Assisted Self-Interview Version of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) in Primary Care Patients

    PubMed Central

    Spear, Suzanne E.; Shedlin, Michele; Gilberti, Brian; Fiellin, Maya; McNeely, Jennifer

    2016-01-01

    Background This study explores the feasibility and acceptability of a computer self-administered approach to substance use screening from the perspective of primary care patients. Methods Forty-eight patients from a large safety net hospital in New York City completed an audio computer-assisted self-interview (ACASI) version of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and a qualitative interview to assess feasibility and acceptability; comprehension; comfort with screening questions; and preferences for screening mode (interviewer or computer). Qualitative data analysis organized the participants’ feedback into major themes. Results Participants overwhelmingly reported being comfortable with the ACASI ASSIST. Mean administration time was 5.2 minutes (range 1.6 – 14.8). The major themes from the qualitative interviews were 1) ACASI ASSIST is feasible and acceptable to patients, 2) Social stigma around substance use is a barrier to patient disclosure, and 3) ACASI screening should not preclude personal interaction with providers. Conclusions The ACASI ASSIST is an appropriate and feasible approach to substance use screening in primary care. Because of the highly sensitive nature of substance use, screening tools must explain the purpose of screening, assure patients that their privacy is protected, and inform patients of the opportunity to discuss their screening results with their provider. PMID:26158798

  17. Marked Elevation of Excitatory Amino Acids in Cerebrospinal Fluid Obtained From Patients With Rotavirus-Associated Encephalopathy.

    PubMed

    Kashiwagi, Yasuyo; Kawashima, Hisashi; Suzuki, Shunsuke; Nishimata, Shigeo; Takekuma, Koji; Hoshika, Akinori

    2015-07-01

    Rotavirus is the most common cause of severe gastroenteritis in young children; however, its pathogenesis and immunity are not completely understood. Even less well recognized is rotavirus-induced central nervous system (CNS) involvement, which has been associated with seizure, encephalopathy and death, among others. To elucidate the host response to rotavirus infection, we retrospectively examined neurotransmitter amino acids in the cerebrospinal fluid (CSF) of 19 children with CNS involvement associated with rotavirus infection. Subjects were classified into two groups: those with encephalopathy followed by prolonged seizure (encephalopathy group) and those who had experienced afebrile, brief cluster of seizures without encephalopathy (cluster group). The levels of glutamate, glycine, and taurine in the encephalopathy group were significantly higher than those in the cluster group. Increased levels of excitatory amino acids in the CSF may induce neurological disorders and be related to disorder severity. To the best of our knowledge, this is the first report regarding amino acids in the CSF obtained from patients with rotavirus-induced CNS involvement. Further study is necessary to elucidate the role of CSF amino acid levels in rotavirus-induced CNS involvement.

  18. Very Late Antigen-1 Marks Functional Tumor-Resident CD8 T Cells and Correlates with Survival of Melanoma Patients

    PubMed Central

    Murray, Timothy; Fuertes Marraco, Silvia A.; Baumgaertner, Petra; Bordry, Natacha; Cagnon, Laurène; Donda, Alena; Romero, Pedro; Verdeil, Grégory; Speiser, Daniel E.

    2016-01-01

    A major limiting factor in the success of immunotherapy is tumor infiltration by CD8+ T cells, a process that remains poorly understood. In the present study, we characterized homing receptors expressed by human melanoma-specific CD8+ T cells. Our data reveal that P-selectin binding and expression of the retention integrin, very late antigen (VLA)-1, by vaccine-induced T cells correlate with longer patient survival. Furthermore, we demonstrate that CD8+VLA-1+ tumor-infiltrating lymphocytes (TILs) are highly enriched in melanoma metastases in diverse tissues. VLA-1-expressing TIL frequently co-express CD69 and CD103, indicating tissue-resident memory T cells (TRM) differentiation. We employed a mouse model of melanoma to further characterize VLA-1-expressing TIL. Our data show that VLA-1+ TRM develop in murine tumors within 2 weeks, where they exhibit increased activation status, as well as superior effector functions. In addition, in vivo blockade of either VLA-1 or CD103 significantly impaired control of subcutaneous tumors. Together, our data indicate that VLA-1+ TRM develop in tumors and play an important role in tumor immunity, presenting novel targets for the optimization of cancer immunotherapy. PMID:28018343

  19. Markedly improved outcomes and acceptable toxicity in adolescents and young adults with acute lymphoblastic leukemia following treatment with a pediatric protocol: a phase II study by the Japan Adult Leukemia Study Group.

    PubMed

    Hayakawa, F; Sakura, T; Yujiri, T; Kondo, E; Fujimaki, K; Sasaki, O; Miyatake, J; Handa, H; Ueda, Y; Aoyama, Y; Takada, S; Tanaka, Y; Usui, N; Miyawaki, S; Suenobu, S; Horibe, K; Kiyoi, H; Ohnishi, K; Miyazaki, Y; Ohtake, S; Kobayashi, Y; Matsuo, K; Naoe, T

    2014-10-17

    The superiority of the pediatric protocol for adolescents with acute lymphoblastic leukemia (ALL) has already been demonstrated, however, its efficacy in young adults remains unclear. The ALL202-U protocol was conducted to examine the efficacy and feasibility of a pediatric protocol in adolescents and young adults (AYAs) with BCR-ABL-negative ALL. Patients aged 15-24 years (n=139) were treated with the same protocol used for pediatric B-ALL. The primary objective of this study was to assess the disease-free survival (DFS) rate and its secondary aims were to assess toxicity, the complete remission (CR) rate and the overall survival (OS) rate. The CR rate was 94%. The 5-year DFS and OS rates were 67% (95% confidence interval (CI) 58-75%) and 73% (95% CI 64-80%), respectively. Severe adverse events were observed at a frequency that was similar to or lower than that in children treated with the same protocol. Only insufficient maintenance therapy significantly worsened the DFS (hazard ratio 5.60, P<0.001). These results indicate that this protocol may be a feasible and highly effective treatment for AYA with BCR-ABL-negative ALL.

  20. A randomized controlled pilot study of CBT-I Coach: Feasibility, acceptability, and potential impact of a mobile phone application for patients in cognitive behavioral therapy for insomnia.

    PubMed

    Koffel, Erin; Kuhn, Eric; Petsoulis, Napoleon; Erbes, Christopher R; Anders, Samantha; Hoffman, Julia E; Ruzek, Josef I; Polusny, Melissa A

    2016-06-27

    There has been growing interest in utilizing mobile phone applications (apps) to enhance traditional psychotherapy. Previous research has suggested that apps may facilitate patients' completion of cognitive behavioral therapy for insomnia (CBT-I) tasks and potentially increase adherence. This randomized clinical trial pilot study (n = 18) sought to examine the feasibility, acceptability, and potential impact on adherence and sleep outcomes related to CBT-I Coach use. All participants were engaged in CBT-I, with one group receiving the app as a supplement and one non-app group. We found that patients consistently used the app as intended, particularly the sleep diary and reminder functions. They reported that it was highly acceptable to use. Importantly, the app did not compromise or undermine benefits of cognitive behavioral therapy for insomnia and patients in both groups had significantly improved sleep outcomes following treatment.

  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. 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.

  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.

  4. Feasibility and Acceptability of Screening and Brief Interventions to Address Alcohol and Other Drug Use among Patients Presenting for Emergency Services in Cape Town, South Africa

    PubMed Central

    Myers, Bronwyn; Stein, Dan J.; Mtukushe, Bulelwa; Sorsdahl, Katherine

    2012-01-01

    Despite evidence from high income countries, it is not known whether screening and brief interventions (SBI) for alcohol and other drug (AOD) use are feasible to implement in low and middle income countries. This paper describes the feasibility and acceptability of a peer-led SBI for AOD-using patients presenting with injuries at emergency services in Cape Town, South Africa. Data were extracted from program records on the number of eligible patients screened and the number of program refusals. A questionnaire examined preliminary responses to the intervention for 30 patients who had completed the program and 10 emergency personnel. Peer counselors were also interviewed to identify barriers to implementation. Of the 1458 patients screened, 21% (305) met inclusion criteria, of which 74% (225) were enrolled in the intervention. Of the 30 patients interviewed, most (83%) found the program useful. Emergency personnel were supportive of the program but felt that visibility and reach could improve. Peer counselors identified the need for better integration of the program into emergency services and for additional training and support. In conclusion, with limited additional resources, peer-led SBIs for AOD use are feasible to conduct in South African emergency services and are acceptable to patients and emergency personnel. PMID:23198159

  5. 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

  6. Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias.

    PubMed

    Garcia-Palacios, A; Botella, C; Hoffman, H; Fabregat, S

    2007-10-01

    The present survey explored the acceptability of virtual reality (VR) exposure and in vivo exposure in 150 participants suffering from specific phobias. Seventy-six percent chose VR over in vivo exposure, and the refusal rate for in vivo exposure (27%) was higher than the refusal rate for VR exposure (3%). Results suggest that VR exposure could help increase the number of people who seek exposure therapy for phobias.

  7. Impact of a New Nasal Pillows Mask on Patients' Acceptance, Compliance, and Willingness to Remain on CPAP Therapy.

    PubMed

    Wimms, Alison; Ketheeswaran, Sahisha; Ziegenbein, Claus; Jennings, Laura; Woehrle, Holger

    2016-01-01

    Aim. Continuous positive airway pressure (CPAP) masks are a key factor in patient compliance. This program assessed the performance of a new nasal pillows mask (NPM) on a variety of new and established obstructive sleep apnea (OSA) patients using CPAP therapy. Methods. Five programs were developed to assess the new NPM [AirFit P10, ResMed] on naïve patients; patients established on another NPM; patients using a nasal mask; patients with low CPAP compliance; and patients who wished to stop using CPAP therapy. Results. A total of 212 patients were included. In naïve patients, CPAP usage after 3 months was 5.9 ± 1.7 hours/night, compared with the control group at 4.6 ± 2.4 hours/night (p < 0.05). In patients established on another NPM, usage improved to 7.4 ± 1.1 hours/night versus 6.7 ± 1.4 (p = 0.001). 78% of nasal mask users wished to continue using the new NPM. Low compliance patients improved with an average of 0.87 hours/night (p = 0.001) when using the new NPM. In patients at the point of quitting CPAP, 60% continued with therapy using the new NPM. Conclusion. The new NPM mask performed well in a variety of clinical groups of OSA patients receiving CPAP therapy and shows that technical advances in CPAP masks can improve patient compliance.

  8. Impact of a New Nasal Pillows Mask on Patients' Acceptance, Compliance, and Willingness to Remain on CPAP Therapy

    PubMed Central

    Ketheeswaran, Sahisha; Jennings, Laura; Woehrle, Holger

    2016-01-01

    Aim. Continuous positive airway pressure (CPAP) masks are a key factor in patient compliance. This program assessed the performance of a new nasal pillows mask (NPM) on a variety of new and established obstructive sleep apnea (OSA) patients using CPAP therapy. Methods. Five programs were developed to assess the new NPM [AirFit P10, ResMed] on naïve patients; patients established on another NPM; patients using a nasal mask; patients with low CPAP compliance; and patients who wished to stop using CPAP therapy. Results. A total of 212 patients were included. In naïve patients, CPAP usage after 3 months was 5.9 ± 1.7 hours/night, compared with the control group at 4.6 ± 2.4 hours/night (p < 0.05). In patients established on another NPM, usage improved to 7.4 ± 1.1 hours/night versus 6.7 ± 1.4 (p = 0.001). 78% of nasal mask users wished to continue using the new NPM. Low compliance patients improved with an average of 0.87 hours/night (p = 0.001) when using the new NPM. In patients at the point of quitting CPAP, 60% continued with therapy using the new NPM. Conclusion. The new NPM mask performed well in a variety of clinical groups of OSA patients receiving CPAP therapy and shows that technical advances in CPAP masks can improve patient compliance. PMID:27648308

  9. The influence of depression, level of functioning in everyday life, and illness acceptance on quality of life in patients with Parkinson’s disease: a preliminary study

    PubMed Central

    Rosińczuk, Joanna; Kołtuniuk, Aleksandra

    2017-01-01

    Background Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease, and its incidence will increase as the global population ages. Due to the multitude of symptoms, this disease clearly has a significant impact on decreasing quality of life for those with PD. We aimed to evaluate the effect of selected variables on quality of life in people with idiopathic PD treated pharmacologically. Materials and methods This study was conducted among 50 patients with PD aged 47–85 years. The diagnostic survey method was applied to collect data with the use of the authors’ questionnaire and standardized questionnaires, including, Parkinson’s Disease Questionnaire (PDQ), Beck Depression Inventory, Instrumental Activities of Daily Living Scale, and Acceptance of Illness Scale. The results were statistically analyzed. Results Analysis of the study material showed that people who were more self-reliant were characterized by lower intensity of depressive symptoms (ρ=−0.567, P=0), were more likely to accept their illness (ρ=0.611, P=0), and assessed quality of life better in each of the studied domains of the PDQ. Illness acceptance correlated with the occurrence of depressive symptoms (ρ=−0.567, P=0) and significantly affected quality of life. Conclusion Factors such as depression, disease acceptance, and functional capacity have a significant impact on the subjective assessment of quality of life in patients with PD. Evaluation of these factors should be taken into account in the therapeutic process, to minimize their negative impact on quality of life in patients with PD. PMID:28356744

  10. Marked increase of procalcitonin after the administration of anti-thymocyte globulin in patients before hematopoietic stem cell transplantation does not indicate sepsis: a prospective study

    PubMed Central

    Brodska, Helena; Drabek, Tomas; Malickova, Karin; Kazda, Antonin; Vitek, Antonin; Zima, Tomas; Markova, Marketa

    2009-01-01

    Introduction Procalcitonin (PCT) and C-reactive protein (CRP) are established markers of infection in the general population. In contrast, several studies reported falsely increased PCT levels in patients receiving T-cell antibodies. We evaluated the validity of these markers in patients scheduled for hemopoietic stem cell transplantation receiving anti-thymocyte globulin (ATG) during conditioning. We also assessed renal and liver functions and their relationship to PCT and CRP changes. Methods Twenty-six patients without clinical signs of infection were prospectively studied. ATG was administered in up to three doses over the course of 5 days. PCT, CRP, white blood cell (WBC) count, urea, creatinine, glomerular filtration rate, bilirubin, alanin amino-transferase (ALT), and gamma-glutamyl transferase (GGT) were assessed daily during ATG administration. Pharyngeal, nose, and rectal swabs and urine samples were cultured twice weekly. Blood cultures were obtained if clinical symptoms of infection were present. Results Baseline (BL) levels of both PCT and CRP before ATG administration were normal. WBC count decreased after ATG administration (P = 0.005). One day after ATG administration, both PCT and CRP levels increased significantly, returning to BL levels on day 4. Microbiological results were clinically unremarkable. There was no interrelationship between PCT levels and BL markers of renal or liver functions (P > 0.05 for all comparisons). Bilirubin and GGT were increased on days 2 to 5 and ALT was increased on day 3 (P < 0.05 versus BL). No difference in renal functions was observed. Three patients developed bacterial infection on days 7 to 11 with different dynamics of PCT and CRP. There was no association between the number of ATG doses and PCT levels or between the risk of developing infection and previous PCT levels. Conclusions ATG triggered a marked early surge in PCT and CRP followed by a steady decrease over the course of 3 days. The dynamics of both PCT

  11. [Intelligence quotient levels, aspiration and self-acceptance in patients with restricting and binge-eating type of anorexia nervosa].

    PubMed

    Rajewski, A; Talarczyk-Wieckowska, M

    1996-01-01

    A group of 50 patients aged from 12 to 20 with anorexia nervosa was examined: 40 persons with a diagnosis of restricting type and 10 with binge-eating type according to DSM IV. The level of intelligence quotient (IQ) was estimated by using Wechsler Test, selfacceptation by SQ and aspiration by TAT and test of unfinished sentences. In the majority of patients IQ was stated on the average level. Independently of intellectual level all patients presented a high aspiration degree. In their own estimation the emotional motivation sphere was significantly more important in the patients with binge-eating type and intellectual in the patients with restricting type of anorexia nervosa.

  12. 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

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

    PubMed

    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.

  14. 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.

  15. 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.

  16. 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

  17. Feasibility, acceptability and findings from a pilot randomized controlled intervention study on the impact of a book designed to inform patients about cancer clinical trials.

    PubMed

    Carney, Patricia A; Tucker, Erin K; Newby, Timothy A; Beer, Tomasz M

    2014-03-01

    This study was conducted to assess the feasibility, acceptability, and changes in knowledge among cancer patients assigned to receive a 160-page book on experimental cancer therapies and clinical trials. We enrolled 20 patients with cancer who had never participated in a clinical trial and randomly assigned them to receive the book either during week 1 or week 4 of the study. We collected baseline patient demographic and cancer-related information as well as knowledge about cancer clinical trials at week 0. Follow-up surveys were administered at weeks 3 and 6 for both study groups. Comparisons were made within and between groups randomized to receive the book early (at week 1) to those who received it later (at week 4). One hundred percent of data were captured in both groups at baseline, which decreased to 77.8% by week 6. The vast majority of participants found the book moderately or very useful (89% in the Early Group at week 3 and 95.5% in the Late Group at week 6). Within group pairwise comparisons found significant difference between baseline and week 6 in content-specific knowledge scores among participants in the Late Group [79% versus 92.1%, p = 0.01). Global knowledge scores increased significantly for variables reflecting knowledge that promotes decisions to participate in clinical trials. Providing published reading material to patients with cancer is both feasible and acceptable. Offering information to patients about cancer clinical trials, using a book designed for patients with cancer may influence knowledge related to decision to participate in clinical trials.

  18. Identification of cut-points in commonly used hip osteoarthritis-related outcome measures that define the patient acceptable symptom state (PASS).

    PubMed

    Emerson Kavchak, Alicia J; Cook, Chad; Hegedus, Eric J; Wright, Alexis A

    2013-11-01

    To determine patient acceptable symptom state (PASS) estimates in outcome measures commonly used in hip osteoarthritis (OA). Identification of cut-points on commonly used outcome measures associated with patient satisfaction with their current state of health. As part of a randomized controlled trial, 70 patients with a clinical diagnosis of hip OA undergoing a 9-session physiotherapy treatment program completed four physical performance measures and three self-report measures at 9 weeks and 1 year. Upon completion of treatment, patients assessed their current health status according to the PASS question. Cut-points were estimated using receiver operating characteristic curves (anchor-based method), based on the patient's response to the PASS question. At 9 weeks and 1 year, identified cut-points were, respectively, ≤10 and ≤11 for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale; ≤35 and ≤40 on the WOMAC physical function subscale; ≥+5 and ≥+6 on the global rating of change score; ≤6.05 and ≤5.30 s for the timed-up-and-go; ≤28.3 and ≤24.9 for the 40-m self-paced walk test; ≥11 and ≥12 repetitions for the 30-s chair stand test; and ≥46 repetitions for the 20-cm step test. Initial target cut-points signaling patient satisfaction with their current symptom state following physiotherapy in patients with hip osteoarthritis were determined for seven outcome measures over 1 year.

  19. 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

  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.

  1. Use, perceptions, and acceptability of a ready-to-use supplementary food among adult HIV patients initiating antiretroviral treatment: a qualitative study in Ethiopia

    PubMed Central

    Olsen, Mette Frahm; Tesfaye, Markos; Kaestel, Pernille; Friis, Henrik; Holm, Lotte

    2013-01-01

    Objectives Ready-to-use supplementary foods (RUSF) are used increasingly in human immunodeficiency virus (HIV) programs, but little is known about how it is used and viewed by patients. We used qualitative methods to explore the use, perceptions, and acceptability of RUSF among adult HIV patients in Jimma, Ethiopia. Methods The study obtained data from direct observations and 24 in-depth interviews with HIV patients receiving RUSF. Results Participants were generally very motivated to take RUSF and viewed it as beneficial. RUSF was described as a means to fill a nutritional gap, to “rebuild the body,” and protect it from harmful effects of antiretroviral treatment (ART). Many experienced nausea and vomiting when starting the supplement. This caused some to stop supplementation, but the majority adapted to RUSF. The supplement was eaten separately from meal situations and only had a little influence on household food practices. RUSF was described as food with “medicinal qualities,” which meant that many social and religious conventions related to food did not apply to it. The main concerns about RUSF related to the risk of HIV disclosure and its social consequences. Conclusion HIV patients view RUSF in a context of competing livelihood needs. RUSF intake was motivated by a strong wish to get well, while the risk of HIV disclosure caused concerns. Despite the motivation for improving health, the preservation of social networks was prioritized, and nondisclosure was often a necessary strategy. Food sharing and religious fasting practices were not barriers to the acceptability of RUSF. This study highlights the importance of ensuring that supplementation strategies, like other HIV services, are compatible with the sociocultural context of patients. PMID:23766634

  2. Vandetanib induces a marked anti-tumor effect and amelioration of ectopic Cushing’s syndrome in a medullary thyroid carcinoma patient

    PubMed Central

    Bseiso, Hashem; Lev-Cohain, Naama; Gross, David J

    2016-01-01

    Summary A 55-year-old woman diagnosed with sporadic MTC underwent total thyroidectomy 20 years ago. After the first surgery, elevated calcitonin levels in parallel with local disease persistence were noted and therefore she underwent repeated neck dissections. During follow-up, multiple foci of metastatic disease were noted in the neck and mediastinal lymph nodes, lungs and bones; however, the disease had an indolent course for a number of years, in parallel with a calcitonin doubling time of more than two years and without significant symptoms. During a routine follow-up visit 2 years ago, findings suggestive of Cushing’s syndrome were observed on physical examination. The biochemical evaluation demonstrated markedly elevated serum calcitonin level, in parallel with lack of cortisol suppression after an overnight 1 mg dexamethasone suppression test, lack of cortisol and ACTH suppression after high-dose IV dexamethasone 8 mg, elevated plasma ACTH up to 79 pg/mL (normal <46 pg/mL) and elevated 24-h urinary free cortisol up to 501 µg/24 h (normal 9–90 µg/24 h). After a negative pituitary MRI, she underwent IPSS, which was compatible with EAS. Whole-body CT demonstrated progressive disease at most of the tumor sites. Treatment with vandetanib at a dosage of 200 mg/day was commenced. The patient showed a significant, rapid and consistent clinical improvement already after two months of treatment, in parallel with biochemical improvement, whereas a decrease in tumor size was demonstrated on follow-up CT. Learning points: Ectopic Cushing’s syndrome due to ectopic ACTH secretion (EAS) by MTC is an uncommon and a poor prognostic event, being associated with significant morbidity and mortality. We demonstrate that vandetanib is effective in controlling the signs and symptoms related to the EAS in patients with advanced progressive MTC. We demonstrate that vandetanib is effective in decreasing tumor size and in inducing tumor control. PMID:27855236

  3. Noninherited maternal antigens identify acceptable HLA mismatches: benefit to patients and cost-effectiveness for cord blood banks.

    PubMed

    Van der Zanden, Henk G M; Van Rood, Jon J; Oudshoorn, Machteld; Bakker, Jack N A; Melis, Angelo; Brand, Anneke; Scaradavou, Andromachi; Rubinstein, Pablo

    2014-11-01

    Cord blood unit (CBU) transplantations to patients mismatched for only 1 HLA antigen, which is identical to the CBU noninherited maternal antigen (NIMA), are designated as having a 6/6 "virtual" NIMA-matched phenotype and have a prognosis similar to 6/6 inherited HLA-matched CBUs. Such virtual HLA phenotypes of CBUs can be created by replacing the inherited alleles with 1 or more NIMAs. Phenotypes of Dutch patients (n = 2020) were matched against the inherited and virtual HLA phenotypes of the National Cord Blood Program CBU file (with known NIMA, n = 6827). Inherited 6/6 matches were found for 11% of the patients. Including virtual phenotypes resulted in, overall, 19-fold more different phenotypes than were inherited, conferring 6/6 virtual matches for an additional 20% of the patients, whereas another 17% might benefit from CBUs with a 4/6 HLA match and 1 NIMA match (4/6 + 1NIMA or 5/6 virtual match). The elucidation of donors' maternal HLA phenotypes can provide significant numbers of 6/6 and 5/6 virtually matched CBUs to patients and is potentially cost effective.

  4. DiAlert: a prevention program for overweight first degree relatives of type 2 diabetes patients: results of a pilot study to test feasibility and acceptability

    PubMed Central

    2012-01-01

    Background Prevalence of type 2 diabetes mellitus is increasing due to lifestyle changes, particularly affecting those genetically at risk. We developed DiAlert as a targeted group-based intervention aimed to promote intrinsic motivation and action planning for lifestyle changes and weight loss in first degree relatives of patients with type 2 diabetes mellitus. The main objective of the pilot of the DiAlert intervention was to assess fidelity, feasibility and acceptability prior to starting the randomized controlled trial. Methods Individuals with a family history of type 2 diabetes mellitus were self-identified and screened for eligibility. DiAlert consists of two group sessions. Feasibility, fidelity, acceptability and self-reported perceptions and behavioral determinants were evaluated in a pre-post study using questionnaires and observations. Determinants of behavior change were analyzed using paired-samples t tests and Wilcoxon signed rank tests. Results DiAlert was delivered to two groups of first degree relatives of patients with type 2 diabetes mellitus (N = 9 and N = 12). Feasibility and fidelity were confirmed. Overall, the DiAlert group sessions were positively evaluated (8.0 on a scale of 1 to 10) by participants. The intervention did not impact perceived susceptibility or worry about personal diabetes risk. Action planning with regard to changing diet and physical activity increased. Conclusions DiAlert proved feasible and was well-accepted by participants. Positive trends in action planning indicate increased likelihood of actual behavior change following DiAlert. Testing the effectiveness in a randomized controlled trial is imperative. Trial registration Netherlands National Trial Register (NTR): NTR2036 PMID:23013843

  5. Therapeutic efficacy, secondary effects, and patient acceptability of 10% sulfur in either pork fat or cold cream for the treatment of scabies.

    PubMed

    Avila-Romay, A; Alvarez-Franco, M; Ruiz-Maldonado, R

    1991-03-01

    Twenty-six children with scabies and 32 contacts were treated with 10% sulfur in cold cream. A 100% clinical cure rate was observed, although 56.8% of patients experienced some kind of mild, transient cutaneous reaction. An additional 25 children with scabies and 28 contacts were treated with 10% sulfur and 1% salicylic acid in pork fat. Of these, 88% were clinically cured and 73.5% had some cutaneous adverse effects. In both groups, most adverse effects were related to skin dryness or postscabetic reaction. The cold cream base was more acceptable to patients than the pork fat base. However, the pork fat base was significantly cheaper and easier to obtain than the cold cream base, and 238 times less expensive than the cheapest commercial scabicidal medication available in the United States.

  6. Sentinel lymph node biopsy after neo-adjuvant chemotherapy in patients with breast cancer: Are the current false negative rates acceptable?

    PubMed

    Patten, D K; Zacharioudakis, K E; Chauhan, H; Cleator, S J; Hadjiminas, D J

    2015-08-01

    The advent of sentinel lymph node biopsy has revolutionised surgical management of axillary nodal disease in patients with breast cancer. Patients undergoing neo-adjuvant chemotherapy for large breast primary tumours may experience complete pathological response on a previously positive sentinel node whilst not eliminating the tumour from the other lymph nodes. Results from 2 large prospective cohort studies investigating sentinel lymph node biopsy after neo-adjuvant chemotherapy demonstrate a combined false negative rate of 12.6-14.2% and identification rate of 80-89% with the minimal acceptable false negative rate and identification rate being set at 10% and 90%, respectively. A false negative rate of 14% would have been classified as unacceptable when compared to the figures obtained by the pioneers of sentinel lymph node biopsy which was 5% or less.

  7. "They just come, pick and go." The Acceptability of Integrated Medication Adherence Clubs for HIV and Non Communicable Disease (NCD) Patients in Kibera, Kenya

    PubMed Central

    Venables, Emilie; Edwards, Jeffrey K.; Baert, Saar; Etienne, William; Khabala, Kelly; Bygrave, Helen

    2016-01-01

    Introduction The number of people on antiretroviral therapy (ART) for the long-term management of HIV in low- and middle-income countries (LMICs) is continuing to increase, along with the prevalence of Non-Communicable Diseases (NCDs). The need to provide large volumes of HIV patients with ART has led to significant adaptations in how medication is delivered, but access to NCD care remains limited in many contexts. Medication Adherence Clubs (MACs) were established in Kibera, Kenya to address the large numbers of patients requiring chronic HIV and/or NCD care. Stable NCD and HIV patients can now collect their chronic medication every three months through a club, rather than through individual clinic appointments. Methodology We conducted a qualitative research study to assess patient and health-care worker perceptions and experiences of MACs in the urban informal settlement of Kibera, Kenya. A total of 106 patients (with HIV and/or other NCDs) and health-care workers were purposively sampled and included in the study. Ten focus groups and 19 in-depth interviews were conducted and 15 sessions of participant observation were carried out at the clinic where the MACs took place. Thematic data analysis was conducted using NVivo software, and coding focussed on people’s experiences of MACs, the challenges they faced and their perceptions about models of care for chronic conditions. Results MACs were considered acceptable to patients and health-care workers because they saved time, prevented unnecessary queues in the clinic and provided people with health education and group support whilst they collected their medication. Some patients and health-care workers felt that MACs reduced stigma for HIV positive patients by treating HIV as any other chronic condition. Staff and patients reported challenges recruiting patients into MACs, including patients not fully understanding the eligibility criteria for the clubs. There were also some practical challenges during the

  8. A qualitative study of patients' knowledge and views of about oral health and acceptability of related intervention in an Australian inpatient alcohol and drug treatment facility.

    PubMed

    Cheah, Alison Li Sun; Pandey, Ram; Daglish, Mark; Ford, Pauline J; Patterson, Sue

    2017-01-20

    Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients' views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted 'good teeth' but few diligently attended to oral healthcare; most sought assistance only in emergencies. Participants' knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research.

  9. Perceptions and Acceptability of Short Message Services Technology to Improve Treatment Adherence amongst Tuberculosis Patients in Peru: A Focus Group Study

    PubMed Central

    Albino, Sandra; Tabb, Karen M.; Requena, David; Egoavil, Miguel; Pineros-Leano, Maria F.; Zunt, Joseph R.; García, Patricia J.

    2014-01-01

    Background Tuberculosis (TB) is global health concern and a leading infectious cause of mortality. Reversing TB incidence and disease-related mortality is a major global health priority. Infectious disease mortality is directly linked to failure to adhere to treatments. Using technology to send reminders by short message services have been shown to improve treatment adherence. However, few studies have examined tuberculosis patient perceptions and attitudes towards using SMS technology to increase treatment adherence. In this study, we sought to investigate perceptions related to feasibility and acceptability of using text messaging to improve treatment adherence among adults who were receiving treatment for TB in Callao, Peru. Methods We conducted focus group qualitative interviews with current TB positive and non-contagious participants to understand the attitudes, perceptions, and feasibility of using short message service (SMS) reminders to improve TB treatment adherence. Subjects receiving care through the National TB Program were recruited through public health centers in Ventanilla, Callao, Peru. In four focus groups, we interviewed 16 patients. All interviews were recorded and transcribed verbatim. Thematic network analysis and codebook techniques were used to analyze data. Results Three major themes emerged from the data: limits on health literacy and information posed challenges to successful TB treatment adherence, treatment motivation at times facilitated adherence to TB treatment, and acceptability of SMS including positive perceptions of SMS to improve TB treatment adherence. The majority of patients shared considerations about how to effectively and confidentially administer an SMS intervention with TB positive participants. Conclusion The overall perceptions of the use of SMS were positive and indicated that SMS technology may be an efficient way to transmit motivational texts on treatment, health education information, and simple reminders to

  10. Marking: A Critical Alternative.

    ERIC Educational Resources Information Center

    Hull, Charles

    1984-01-01

    Having pupils critique their own work is an alternative to marking that is worthy of consideration. Pupil critique fosters in students a willingness to take responsibility for the quality of their work products. (RM)

  11. 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...

  12. Mark IVA microprocessor support

    NASA Technical Reports Server (NTRS)

    Burford, A. L.

    1982-01-01

    The requirements and plans for the maintenance support of microprocessor-based controllers in the Deep Space Network Mark IVA System are discussed. Additional new interfaces and 16-bit processors have introduced problems not present in the Mark III System. The need for continuous training of maintenance personnel to maintain a level of expertise consistent with the sophistication of the required tools is also emphasized.

  13. Keele Aches and Pains Study protocol: validity, acceptability, and feasibility of the Keele STarT MSK tool for subgrouping musculoskeletal patients in primary care

    PubMed Central

    Campbell, Paul; Hill, Jonathan C; Protheroe, Joanne; Afolabi, Ebenezer K; Lewis, Martyn; Beardmore, Ruth; Hay, Elaine M; Mallen, Christian D; Bartlam, Bernadette; Saunders, Benjamin; van der Windt, Danielle A; Jowett, Sue; Foster, Nadine E; Dunn, Kate M

    2016-01-01

    Musculoskeletal conditions represent a considerable burden worldwide, and are predominantly managed in primary care. Evidence suggests that many musculoskeletal conditions share similar prognostic factors. Systematically assessing patient’s prognosis and matching treatments based on prognostic subgroups (stratified care) has been shown to be both clinically effective and cost-effective. This study (Keele Aches and Pains Study) aims to refine and examine the validity of a brief questionnaire (Keele STarT MSK tool) designed to enable risk stratification of primary care patients with the five most common musculoskeletal pain presentations. We also describe the subgroups of patients, and explore the acceptability and feasibility of using the tool and how the tool is best implemented in clinical practice. The study design is mixed methods: a prospective, quantitative observational cohort study with a linked qualitative focus group and interview study. Patients who have consulted their GP or health care practitioner about a relevant musculoskeletal condition will be recruited from general practice. Participating patients will complete a baseline questionnaire (shortly after consultation), plus questionnaires 2 and 6 months later. A subsample of patients, along with participating GPs and health care practitioners, will be invited to take part in qualitative focus groups and interviews. The Keele STarT MSK tool will be refined based on face, discriminant, construct, and predictive validity at baseline and 2 months, and validated using data from 6-month follow-up. Patient and clinician perspectives about using the tool will be explored. This study will provide a validated prognostic tool (Keele STarT MSK) with established cutoff points to stratify patients with the five most common musculoskeletal presentations into low-, medium-, and high-risk subgroups. The qualitative analysis of patient and health care perspectives will inform practitioners on how to embed the tool

  14. Patients' experience of a telephone booster intervention to support weight management in Type 2 diabetes and its acceptability.

    PubMed

    Wu, Lihua; Forbes, Angus; While, Alison

    2010-01-01

    We studied the patient experience of a telephone booster intervention, i.e. weekly reinforcement of the clinic advice regarding lifestyle modification advice to support weight loss. Forty six adults with Type 2 diabetes and a body mass index >28 kg/m(2) were randomised into either intervention (n = 25) or control (n = 21) groups. Semi-structured interviews were conducted with the intervention group participants to explore their views and experiences. The patients were satisfied or very satisfied with the telephone calls and most would recommend the intervention to others in a similar situation. The content of the telephone follow-up met their need for on-going support. The benefits arising from the telephone calls included: being reminded to comply with their regimen; prompting and motivating adherence to diabetes self-care behaviours; improved self-esteem; and feeling 'worthy of interest'. The convenience and low cost of telephone support has much potential in chronic disease management.

  15. Microscopic saw mark analysis: an empirical approach.

    PubMed

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

    2015-01-01

    Microscopic saw mark analysis is a well published and generally accepted qualitative analytical method. However, little research has focused on identifying and mitigating potential sources of error associated with the method. The presented study proposes the use of classification trees and random forest classifiers as an optimal, statistically sound approach to mitigate the potential for error of variability and outcome error in microscopic saw mark analysis. The statistical model was applied to 58 experimental saw marks created with four types of saws. The saw marks were made in fresh human femurs obtained through anatomical gift and were analyzed using a Keyence digital microscope. The statistical approach weighed the variables based on discriminatory value and produced decision trees with an associated outcome error rate of 8.62-17.82%.

  16. 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.

  17. 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.

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

    PubMed

    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.

  19. Efficacy, Tolerability, and Acceptability of Iron Hydroxide Polymaltose Complex versus Ferrous Sulfate: A Randomized Trial in Pediatric Patients with Iron Deficiency Anemia.

    PubMed

    Yasa, Beril; Agaoglu, Leyla; Unuvar, Emin

    2011-01-01

    Iron polymaltose complex (IPC) offers similar efficacy with superior tolerability to ferrous sulfate in adults, but randomized trials in children are rare. In a prospective, open-label, 4-month study, 103 children aged >6 months with iron deficiency anemia (IDA) were randomized to IPC once daily or ferrous sulfate twice daily, (both 5 mg iron/kg/day). Mean increases in Hb to months 1 and 4 with IPC were 1.2 ± 0.9 g/dL and 2.3 ± 1.3 g/dL, respectively, (both P = 0.001 versus baseline) and 1.8 ± 1.7 g/dL and 3.0 ± 2.3 g/dL with ferrous sulfate (both P = 0.001 versus baseline) (n.s. between groups). Gastrointestinal adverse events occurred in 26.9% and 50.9% of IPC and ferrous sulfate patients, respectively (P = 0.012). Mean acceptability score at month 4 was superior with IPC versus ferrous sulfate (1.63 ± 0.56 versus 2.14 ± 0.75, P = 0.001). Efficacy was comparable with IPC and ferrous sulfate over a four-month period in children with IDA, but IPC was associated with fewer gastrointestinal adverse events and better treatment acceptability.

  20. 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.

  1. Acceptance of tinnitus: validation of the tinnitus acceptance questionnaire.

    PubMed

    Weise, Cornelia; Kleinstäuber, Maria; Hesser, Hugo; Westin, Vendela Zetterqvist; Andersson, Gerhard

    2013-01-01

    The concept of acceptance has recently received growing attention within tinnitus research due to the fact that tinnitus acceptance is one of the major targets of psychotherapeutic treatments. Accordingly, acceptance-based treatments will most likely be increasingly offered to tinnitus patients and assessments of acceptance-related behaviours will thus be needed. The current study investigated the factorial structure of the Tinnitus Acceptance Questionnaire (TAQ) and the role of tinnitus acceptance as mediating link between sound perception (i.e. subjective loudness of tinnitus) and tinnitus distress. In total, 424 patients with chronic tinnitus completed the TAQ and validated measures of tinnitus distress, anxiety, and depression online. Confirmatory factor analysis provided support to a good fit of the data to the hypothesised bifactor model (root-mean-square-error of approximation = .065; Comparative Fit Index = .974; Tucker-Lewis Index = .958; standardised root mean square residual = .032). In addition, mediation analysis, using a non-parametric joint coefficient approach, revealed that tinnitus-specific acceptance partially mediated the relation between subjective tinnitus loudness and tinnitus distress (path ab = 5.96; 95% CI: 4.49, 7.69). In a multiple mediator model, tinnitus acceptance had a significantly stronger indirect effect than anxiety. The results confirm the factorial structure of the TAQ and suggest the importance of a general acceptance factor that contributes important unique variance beyond that of the first-order factors activity engagement and tinnitus suppression. Tinnitus acceptance as measured with the TAQ is proposed to be a key construct in tinnitus research and should be further implemented into treatment concepts to reduce tinnitus distress.

  2. 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.

  3. 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

  4. Self-administered C1 esterase inhibitor concentrates for the management of hereditary angioedema: usability and patient acceptance

    PubMed Central

    Li, Huamin Henry

    2016-01-01

    Hereditary angioedema (HAE) is a rare genetic disease characterized by episodic subcutaneous or submucosal swelling. The primary cause for the most common form of HAE is a deficiency in functional C1 esterase inhibitor (C1-INH). The swelling caused by HAE can be painful, disfiguring, and life-threatening. It reduces daily function and compromises the quality of life of affected individuals and their caregivers. Among different treatment strategies, replacement with C1-INH concentrates is employed for on-demand treatment of acute attacks and long-term prophylaxis. Three human plasma-derived C1-INH preparations are approved for HAE treatment in the US, the European Union, or both regions: Cinryze®, Berinert®, and Cetor®; however, only Cinryze is approved for long-term prophylaxis. Postmarketing studies have shown that home therapy (self-administered or administered by a caregiver) is a convenient and safe option preferred by many HAE patients. In this review, we summarize the role of self-administered plasma-derived C1-INH concentrate therapy with Cinryze at home in the prophylaxis of HAE. PMID:27660422

  5. 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.

  6. 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…

  7. 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)

  8. 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).

  9. Little Jiffy, Mark IV

    ERIC Educational Resources Information Center

    Kaiser, Henry F.; Rice, John

    1974-01-01

    In this paper three changes and one new development for the method of exploratory factor analysis (a second generation Little Jiffy) developed by Kaiser are described. Following this short description a step-by-step computer algorithm of the revised method, dubbed Little Jiffy, Mark IV is presented. (MP)

  10. Rehab Mark. Participant's Workbook.

    ERIC Educational Resources Information Center

    Greenwood, Reed; And Others

    This manual is the employer-focused component workbook of a vocational rehabilitation program. Goals of the RehabMark approach include increased exposure of the rehabilitation agency in the local community, expanded contributions by the agency to community members, and services benefiting numerous clients simultaneously. The first half of the…

  11. 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…

  12. Development and Pilot Evaluation of an Online Relapse-Prevention Program Based on Acceptance and Commitment Therapy for Chronic Pain Patients

    PubMed Central

    2015-01-01

    Background A significant number of chronic pain patients experience a decline in therapeutic effects after rehabilitation. As face-to-face contacts with health care professionals are not always feasible after treatment, new, innovative, fully automated relapse-prevention programs are highly needed. Objective In this study an online, automated relapse-prevention program based on acceptance and commitment therapy (ACT)—both as a website and as a mobile app—was developed and evaluated. At each step of the development, end users (ie, chronic pain patients) were consulted in order to fully address their needs. Methods In a step-by-step process, a contextual inquiry, requirement specification, and design were executed with chronic pain patients by conducting, respectively, a focus group (n=10), interviews with rapid prototyping (n=28), and a user- and expert-based usability evaluation (n=14). Furthermore, a pilot evaluation was conducted with 14 chronic pain or fatigue patients who had received the online relapse-prevention program following a multidisciplinary ACT treatment. They were interviewed about their usage and the usefulness of the program in supporting them to maintain changed behaviors and prevent relapses in avoidance and pain control behaviors. Results The three stages provided information about the expected needs of end users, comments about the usefulness of the proposed features, and feedback about the design and usability of the program. This resulted in a fully operational, online relapse-prevention program. Results from the pilot evaluation showed that 9 patients used the online program after treatment, 5 of whom indicated that the program supported them after treatment. Of all the patients, 4 of them indicated that the program did not support them because they wanted more social interaction with other users. Conclusions This study showed that an innovative, automated, online program that is user friendly can be developed by involving the end users

  13. 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.

  14. A comparison between two lingual orthodontic brackets in terms of speech performance and patients' acceptance in correcting Class II, Division 1 malocclusion: a randomized controlled trial

    PubMed Central

    Haj-Younis, Samiha; Khattab, Tarek Z.; Hajeer, Mohammad Y.; Farah, Hassan

    2016-01-01

    ABSTRACT Objective: To compare speech performance and levels of oral impairment between two types of lingual brackets. Methods: A parallel-group randomized controlled trial was carried out on patients with Class II, Division 1 malocclusion treated at the University of Hama School of Dentistry in Hama, Syria. A total of 46 participants (mean age: 22.3 ± 2.3 years) with maxillary dentoalveolar protrusion were randomly distributed into two groups with 23 patients each (1:1 allocation ratio). Either STb (Ormco) or 7th Generation (Ormco) lingual brackets were applied. Fricative sound/s/ spectrograms were analyzed directly before intervention (T0), one week following premolar extraction prior to bracket placement (T1), within 24 hours of bracket bonding (T2), one month after (T3), and three months after (T4) bracket placement. Patients′ acceptance was assessed by means of standardized questionnaires. Results: After bracket placement, significant deterioration in articulation was recorded at all assessment times in the 7th Generation group, and up to T3 in the STb group. Significant intergroup differences were detected at T2 and T3. No statistically significant differences were found between the two groups in reported tongue irritation levels, whereas chewing difficulty was significantly higher in the 7th Generation group one month after bracket placement. Conclusions: 7th Generation brackets have more interaction with sound production than STb ones. Although patients in both groups complained of some degree of oral impairment, STb appliances appeared to be more comfortable than the 7th Generation ones, particularly within the first month of treatment. PMID:27653268

  15. Perceptions and acceptability of mHealth interventions for improving patient care at a community-based HIV/AIDS clinic in Uganda: a mixed methods study.

    PubMed

    Chang, Larry W; Njie-Carr, Veronica; Kalenge, Sheila; Kelly, Jack F; Bollinger, Robert C; Alamo-Talisuna, Stella

    2013-01-01

    Mobile technologies for health (mHealth) represents a growing array of tools being applied in diverse health care settings. mHealth interventions for improving HIV/AIDS care is a promising strategy, but its evidence base is limited. We conducted a formative research evaluation to inform the development of novel mHealth HIV/AIDS care interventions to be used by community health workers (CHWs) in Kampala, Uganda. A mixed methods formative research approach was utilized. Qualitative methods included 20 in-depth interviews (IDIs) and six focus groups with CHWs, clinic staff, and patients. Thematic analysis was performed and selected quotations used to illustrate themes. Quantitative methods consisted of a survey administered to CHWs and clinic staff, using categorical and Likert scale questions regarding current mobile phone and internet access and perceptions on the potential use of smartphones by CHWs. Qualitative results included themes on significant current care challenges, multiple perceived mHealth benefits, and general intervention acceptability. Key mHealth features desired included tools to verify CHWs' task completions, clinical decision support tools, and simple access to voice calling. Inhibiting factors identified included concerns about CHWs' job security and unrealistic expectations of mHealth capabilities. Quantitative results from 27 staff participants found that 26 (96%) did not have internet access at home, yet only 2 (7.4%) did not own a mobile phone. Likert scale survey responses (1-5, 1 = Strongly Disagree, 5 = Strongly Agree) indicated general agreement that smartphones would improve efficiency (Mean = 4.35) and patient care (4.31) but might be harmful to patient confidentiality (3.88) and training was needed (4.63). Qualitative and quantitative results were generally consistent, and, overall, there was enthusiasm for mHealth technology. However, a number of potential inhibiting factors were also discovered. Findings from this study may help

  16. 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…

  17. 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…

  18. Mark 3 system overview

    NASA Technical Reports Server (NTRS)

    Clark, T. A.

    1980-01-01

    The Mark 3 very long baseline interferometry (VLBI) system, comprising a complete end to end VLBI system optimized for both high accuracy geodesy and radio astronomy, is described. The data flow, the data base handler system, and the field station component and configurations are briefly discussed. The use of mobile and transportable stations allows measurements to be taken from a large number of sites with relatively few sets of equipment. Fixed stations form a long term reference network for tying together the measurements with the mobile and transportable stations.

  19. Forensic surface metrology: tool mark evidence.

    PubMed

    Gambino, Carol; McLaughlin, Patrick; Kuo, Loretta; Kammerman, Frani; Shenkin, Peter; Diaczuk, Peter; Petraco, Nicholas; Hamby, James; Petraco, Nicholas D K

    2011-01-01

    Over the last several decades, forensic examiners of impression evidence have come under scrutiny in the courtroom due to analysis methods that rely heavily on subjective morphological comparisons. Currently, there is no universally accepted system that generates numerical data to independently corroborate visual comparisons. Our research attempts to develop such a system for tool mark evidence, proposing a methodology that objectively evaluates the association of striated tool marks with the tools that generated them. In our study, 58 primer shear marks on 9 mm cartridge cases, fired from four Glock model 19 pistols, were collected using high-resolution white light confocal microscopy. The resulting three-dimensional surface topographies were filtered to extract all "waviness surfaces"-the essential "line" information that firearm and tool mark examiners view under a microscope. Extracted waviness profiles were processed with principal component analysis (PCA) for dimension reduction. Support vector machines (SVM) were used to make the profile-gun associations, and conformal prediction theory (CPT) for establishing confidence levels. At the 95% confidence level, CPT coupled with PCA-SVM yielded an empirical error rate of 3.5%. Complementary, bootstrap-based computations for estimated error rates were 0%, indicating that the error rate for the algorithmic procedure is likely to remain low on larger data sets. Finally, suggestions are made for practical courtroom application of CPT for assigning levels of confidence to SVM identifications of tool marks recorded with confocal microscopy.

  20. 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.

  1. 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.

  2. Heavy metal, religiosity, and suicide acceptability.

    PubMed

    Stack, S

    1998-01-01

    There has been little work at the national level on the subject of musical subcultures and suicide acceptability. The present work explores the link between "heavy metal" rock fanship and suicide acceptability. Metal fanship is thought to elevate suicide acceptability through such means as exposure to a culture of personal and societal chaos marked by hopelessness, and through its associations with demographic risk factors such as gender, socioeconomic status, and education. Data are taken from the General Social Survey. A link between heavy metal fanship and suicide acceptability is found. However, this relationship becomes nonsignificant once level of religiosity is controlled. Metal fans are low in religiosity, which contributes, in turn, to greater suicide acceptability.

  3. Omega 3 fatty acids induce a marked reduction of apolipoprotein B48 when added to fluvastatin in patients with type 2 diabetes and mixed hyperlipidemia: a preliminary report

    PubMed Central

    Valdivielso, Pedro; Rioja, José; García-Arias, Carlota; Sánchez-Chaparro, Miguel Angel; González-Santos, Pedro

    2009-01-01

    Backgorund Mixed hyperlipidemia is common in patients with diabetes. Statins, the choice drugs, are effective at reducing lipoproteins that contain apolipoprotein B100, but they fail to exert good control over intestinal lipoproteins, which have an atherogenic potential. We describe the effect of prescription omega 3 fatty acids on the intestinal lipoproteins in patients with type 2 diabetes who were already receiving fluvastatin 80 mg per day. Methods Patients with type 2 diabetes and mixed hyperlipidemia were recruited. Fasting lipid profile was taken when patients were treated with diet, diet plus 80 mg of fluvastatin and diet plus fluvastatin 80 mg and 4 g of prescription omega 3 fatty acids. The intestinal lipoproteins were quantified by the fasting concentration of apolipoprotein B48 using a commercial ELISA. Results The addition of 4 g of prescription omega 3 was followed by significant reductions in the levels of triglycerides, VLDL triglycerides and the triglyceride/HDL cholesterol ratio, and an increase in HDL cholesterol (P < 0.05). Fluvastatin induced a reduction of 26% in B100 (P < 0.05) and 14% in B48 (NS). However, the addition of omega 3 fatty acids enhanced this reduction to 32% in B100 (NS) and up to 36% in B48 (P < 0.05). Conclusion Our preliminary findings therefore suggest an additional benefit on postprandial atherogenic particles when omega 3 fatty acids are added to standard treatment with fluvastatin. PMID:19133114

  4. Offer/Acceptance Ratio.

    ERIC Educational Resources Information Center

    Collins, Mimi

    1997-01-01

    Explores how human resource professionals, with above average offer/acceptance ratios, streamline their recruitment efforts. Profiles company strategies with internships, internal promotion, cooperative education programs, and how to get candidates to accept offers. Also discusses how to use the offer/acceptance ratio as a measure of program…

  5. 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

  6. Marked attenuation of shock burden by the use of antitachycardia pacing therapy in a patient with an implanted cardioverter-defibrillator.

    PubMed

    Ganjehei, Leila; Nazeri, Alireza; Massumi, Ali; Razavi, Mehdi

    2012-01-01

    A 76-year-old man was admitted to our institution for elective exchange of his implanted cardioverter-defibrillator generator. Nine years earlier, he had been diagnosed with nonischemic cardiomyopathy and nonsustainable ventricular tachycardia. At that time, he had received a single-chamber implanted cardioverter-defibrillator, which was upgraded to a dual-chamber implanted cardioverter-defibrillator 3 years later. In the course of the current admission, routine device interrogation during exchange of the patient's implanted cardioverter-defibrillator generator revealed 150 episodes of ventricular tachycardia in the preceding 7 months, 137 of which had been successfully treated by antitachycardia pacing therapy without shock. These findings show the remarkable effectiveness of antitachycardia pacing in terminating ventricular tachycardia while preventing the delivery of shocks, minimizing patient discomfort, and avoiding implanted cardioverter-defibrillator battery depletion.

  7. 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

  8. Feasibility and acceptability to patients of a longitudinal system for evaluating cancer-related symptoms and quality of life: pilot study of an e/Tablet data-collection system in academic oncology.

    PubMed

    Abernethy, Amy P; Herndon, James E; Wheeler, Jane L; Day, Jeannette M; Hood, Linda; Patwardhan, Meenal; Shaw, Heather; Lyerly, Herbert Kim

    2009-06-01

    Programmed, notebook-style, personal computers ("e/Tablets") can collect symptom and quality-of-life (QOL) data at the point of care. Patients use an e/Tablet in the clinic waiting area to complete electronic surveys. Information then travels wirelessly to a server, which generates a real-time report for use during the clinical visit. The objective of this study was to determine whether academic oncology patients find e/Tablets logistically acceptable and a satisfactory means of communicating symptoms to providers during repeated clinic visits. Sixty-six metastatic breast cancer patients at Duke Breast Cancer Clinic participated. E/Tablets were customized to electronically administer a satisfaction/acceptability survey, several validated questionnaires, and the Patient Care Monitor (PCM) review of symptoms survey. At each of the four visits within six months, participants completed the patient satisfaction/acceptability survey, which furnished data for the current analysis. Participant demographics were: mean age of 54 years, 77% Caucasian, and 47% with less than a college education. Participants reported that e/Tablets were easy to read (94%), easy to navigate (99%), and had a comfortable weight (90%); they found it easy to respond to questions using the e/Tablet (98%). Seventy-five percent initially indicated satisfaction with PCM for reporting symptoms; this proportion increased over time. By the last visit, 88% of participants indicated that they would recommend the PCM to other patients; 74% felt that the e/Tablet helped them remember symptoms to report to their clinician. E/Tablets offered a feasible and acceptable method for collecting longitudinal patient-reported symptom and QOL data within an academic, tertiary care, breast cancer clinic.

  9. Marked biochemical difference in amyloid proportion between intra- and extraocular tissues in a liver-transplanted patient with hereditary ATTR amyloidosis.

    PubMed

    Yoshinaga, Tsuneaki; Yazaki, Masahide; Kametani, Fuyuki; Sekijima, Yoshiki; Iesato, Yasuhiro; Miyahara, Teruyoshi; Tsuchiya-Suzuki, Ayako; Sano, Kenji; Higuchi, Keiichi; Ikeda, Shu-Ichi

    2017-01-13

    In order to elucidate the pathomechanism of ocular amyloid formation in a liver-transplanted patient with hereditary ATTR amyloidosis, we investigated detailed biochemical features of ocular amyloid. The patient was a 49-year-old woman with V30M transthyretin (TTR) variant (p.TTRV50M), who underwent ophthalmectomy due to corneal rupture 10 years after liver transplantation (LT). The amyloid was selectively isolated from several portions in intra- and extraocular tissues using a laser microdissection (LMD) system and analyzed by liquid chromatography-tandem mass spectrometry to determine the composition percentage of wild-type and variant TTR in the isolated amyloid. Biochemical analysis revealed that the amyloid consisted mainly of variant TTR in intraocular tissues with a percentage > 80%. On the contrary in the extraocular muscles, wild-type TTR was the main component of the amyloid with a percentage of ∼70%. Our data indicate that intraocular amyloid formation strongly depends on locally synthesized variant TTR and the contribution of wild-type TTR to amyloid formation is quite limited.

  10. HOXB7 overexpression promotes cell proliferation and correlates with poor prognosis in gastric cancer patients by inducing expression of both AKT and MARKs

    PubMed Central

    He, Xujun; Liu, Zhengchuang; Xia, Yingjie; Xu, Ji; Lv, Guocai; Wang, Lu; Ma, Tonghui; Jiang, Liping; Mou, Yiping; Jiang, Xiaoting; Ma, Jie; Zhao, Zhongkuo; Ni, Haibin; Xu, Wenjuan; Ru, Guoqing; Huang, Dongsheng; Tao, Houquan

    2017-01-01

    Increased expression of HOXB7 has been reported to correlate with the progression in many cancers. However, the specific mechanism by which it promotes the evolution of gastric cancer (GC) is poorly understood. In this study, we sought to investigate the role of HOXB7 in GC by assessing HOXB7 expression in patient tissue and its correlation to clinical characteristics. We found that GC tissues showed increased expression of HOXB7 and that the HOXB7 expression was significantly associated with Lauren classification, invasion depth, lymphatic metastasis and poor prognosis, and could serve as an independent prognostic factor. To further investigate the role of HOXB7 in GC, we generated stable GC cell lines and both over-expressed and knocked down HOXB7 expression. Over-expression of HOXB7 in GC cell lines enhanced cell proliferation, colony formation, migration and invasion ability, whereas the opposite trends were observed upon reduction of HOXB7 expression by knockdown. These findings were further supported by our in vivo studies which show that HOXB7 expression can affect the GC cells' subcutaneous growth and lung metastases. A Phospho-MAPK Array Kit was used to explore the possible mechanism of HOXB7-induced cell proliferation and invasion. We found that the AKT signaling pathway and the two members of the MAPK pathway, were involved in those promoting effects. In conclusion, our results showed that increased expression of HOXB7 might play an important role in promoting GC proliferation, migration and invasion by inducing both AKT and MAPK pathways, thus resulting in progression of, and poor prognosis in GC patients. PMID:27901487

  11. Bilateral Severe Sterile Inflammation with Hypopyon after Simultaneous Intravitreal Triamcinolone Acetonide and Aflibercept Injection in a Patient with Bilateral Marked Rubeosis Associated with Ocular Ischemic Syndrome

    PubMed Central

    Durmaz Engin, Ceren; Ayhan, Ziya; Men, Süleyman

    2017-01-01

    We report the clinical course of a diabetic patient with bilateral cataract and rubeosis in association with ocular ischemic syndrome and initially treated him with simultaneous intravitreal 2 mg aflibercept and 2 mg triamcinolone acetonide injection at the same setting prior to planned cataract surgery and further photocoagulation. However, sterile anterior segment inflammation characterized by hypopyon occurred four days apart in OU. Right eye developed the sterile inflammation at the third postinjection day and the left eye developed the sterile inflammation at the seventh postinjection day (two days after the uneventful cataract surgery with intraocular lens implantation) without any pain or significant redness. Vitreous biopsy taken during the right phacovitrectomy was negative for any microbial contamination. Both eyes were treated successfully with intensive topical prednisolone acetate with a relatively good visual outcome. It is likely that underlying ocular ischemic syndrome might have facilitated the formation of sterile inflammation as blood-aqueous barrier disruption and flare have already been present. PMID:28386497

  12. Nodular mesangial lesions, marked mesangiolysis, and fingerprint deposits of unknown origin in a patient with nephrotic syndrome: a unique combination of glomerular lesions.

    PubMed

    Ohtani, Hiroshi; Wakui, Hideki; Komatsuda, Atsushi; Okuyama, Shin; Masai, Rie; Maki, Nobuki; Kigawa, Akihiko; Sawada, Ken-Ichi

    2006-06-01

    A 46-year-old woman developed nephrotic syndrome at the age of 16 in 1973. On the basis of the histological findings of the first renal biopsy, she was diagnosed as having minimal change nephrotic syndrome. Initial treatment with steroid was effective, but she had several relapses during tapering of the daily dose of steroid. The second renal biopsy, performed in 1997, disclosed glomerular lobulation, mesangial proliferation, nodular mesangial lesions, and mesangiolysis. From 2001, the degree of proteinuria increased, with urinary protein being 5 g/day in January 2003, when a third renal biopsy was performed. On light microscopy, the glomerular lesions were similar to those observed in 1997. Immunofluorescence microscopy revealed coarse granular stainings for IgG, IgA, IgM, kappa, lambda, and C3 in the mesangial area and along the capillary walls. On electron microscopy, fingerprint structures were observed in the mesangial and subendothelial deposits. There were no characteristic fibers in the nodular lesions. On the basis of clinical and laboratory findings in this patient, we excluded disease entities in which nodular mesangial lesions, mesangiolysis, and fingerprint deposits had been reported. To our knowledge, such a unique combination of glomerular lesions has not been described previously in the literature.

  13. LIMS user acceptance testing.

    PubMed

    Klein, Corbett S

    2003-01-01

    Laboratory Information Management Systems (LIMS) play a key role in the pharmaceutical industry. Thorough and accurate validation of such systems is critical and is a regulatory requirement. LIMS user acceptance testing is one aspect of this testing and enables the user to make a decision to accept or reject implementation of the system. This paper discusses key elements in facilitating the development and execution of a LIMS User Acceptance Test Plan (UATP).

  14. On Maximum FODO Acceptance

    SciTech Connect

    Batygin, Yuri Konstantinovich

    2014-12-24

    This note illustrates maximum acceptance of FODO quadrupole focusing channel. Acceptance is the largest Floquet ellipse of a matched beam: A = $\\frac{a^2}{β}$$_{max}$ where a is the aperture of the channel and βmax is the largest value of beta-function in the channel. If aperture of the channel is restricted by a circle of radius a, the s-s acceptance is available for particles oscillating at median plane, y=0. Particles outside median plane will occupy smaller phase space area. In x-y plane, cross section of the accepted beam has a shape of ellipse with truncated boundaries.

  15. Varicella infection complicated by marked thrombocytopenia.

    PubMed

    Shibusawa, Motoharu; Motomura, Sayuri; Hidai, Hiroko; Tsutsumi, Hisasi; Fujita, Akira

    2014-01-01

    We report a rare case of adult varicella complicated by marked thrombocytopenia. A 49-year-old woman presented with fever and rash for 3 days. Blood examination revealed marked thrombocytopenia (2.7 × 10(4)/μL). Varicella infection was diagnosed after elevated levels of varicella zoster virus IgM and IgG antibodies were observed 2 weeks later. In this case, thrombocytopenia was due to varicella infection, and the mechanism was estimated to be non-immunological. Because varicella infection complicated by thrombocytopenia may result in fatal bleeding, thrombocytopenia in patients with varicella warrants close attention.

  16. The Mark III VLBI System

    NASA Technical Reports Server (NTRS)

    Rogers, A. E. E.; Whitney, A. R.; Levine, J. I.; Nesman, E. F.; Webber, J. C.; Hinteregger, H. F.

    1988-01-01

    Geodetic measurements have errors in centimeter range. Collection of three reports describes both equipment and results of some measurements taken with Mark III very-long-baseline interferometry (VLBI) system. Has demonstrated high accuracy over short baselines, where phase-delay measurements used. Advanced hardware, called Mark III A, developed to improve system performance and efficiency. Original Mark III hardware and III A subsystem upgrades developed as part of NASA Crustal Dynamics Project at Haystack Observatory.

  17. 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...

  18. 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…

  19. Swash mark and grain flow

    USGS Publications Warehouse

    Sallenger,, Asbury H.

    1981-01-01

    Swash marks composed entirely of coarse sand are commonly found on coarse-sand beaches. These swash marks are 10 to 30 centimeters in width and a few millimeters to one centimeter in height. Previous observations, mostly on finer-sand beaches, indicate swash marks are seldom over a few millimeters in height and are commonly composed of material readily floated by surface tension (e.g., mica flakes and shell fragments). Swash marks composed of coarse sand have both fining seaward and fining with depth trends in grain size. Apparently, the leading margin of a wave upwash drives a highly concentrated flow of grains in which both grain size and grain velocity decrease with depth. Therefore, large grains are transported at greater velocities than are smaller grains. Thus, at the maximum advance of an upwash, a swash mark is deposited which has the observed fining seaward and fining with depth trends in grain size.

  20. 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)

  1. Mark-specific hazard ratio model with missing multivariate marks.

    PubMed

    Juraska, Michal; Gilbert, Peter B

    2016-10-01

    An objective of randomized placebo-controlled preventive HIV vaccine efficacy (VE) trials is to assess the relationship between vaccine effects to prevent HIV acquisition and continuous genetic distances of the exposing HIVs to multiple HIV strains represented in the vaccine. The set of genetic distances, only observed in failures, is collectively termed the 'mark.' The objective has motivated a recent study of a multivariate mark-specific hazard ratio model in the competing risks failure time analysis framework. Marks of interest, however, are commonly subject to substantial missingness, largely due to rapid post-acquisition viral evolution. In this article, we investigate the mark-specific hazard ratio model with missing multivariate marks and develop two inferential procedures based on (i) inverse probability weighting (IPW) of the complete cases, and (ii) augmentation of the IPW estimating functions by leveraging auxiliary data predictive of the mark. Asymptotic properties and finite-sample performance of the inferential procedures are presented. This research also provides general inferential methods for semiparametric density ratio/biased sampling models with missing data. We apply the developed procedures to data from the HVTN 502 'Step' HIV VE trial.

  2. 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.

  3. 49 CFR 172.304 - Marking requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SECURITY PLANS Marking § 172.304 Marking requirements. (a) The marking required in this subpart— (1) Must... labels or attachments; and (4) Must be located away from any other marking (such as advertising)...

  4. 19 CFR 134.21 - Special marking.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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,...

  5. Inflectional marking in Hungarian aphasics.

    PubMed

    MacWhinney, B; Osmán-Sági, J

    1991-08-01

    How do aphasics deal with the rich inflectional marking available in agglutinative languages like Hungarian? For the Hungarian noun alone, aphasics have to deal with over 15 basic case markings and dozens of possible combinations of these basic markings. Using the picture description task of MacWhinney and Bates (1978), this study examined the use of inflectional markings in nine Broca's and five Wernicke's aphasic speakers of Hungarian. The analysis focused on subject, direct object, indirect object, and locative nominal arguments. Compared to normals, both groups had a much higher rate of omission of all argument types. Subject ellipsis was particularly strong, as it is in normal Hungarian. There was a tendency for Broca's to omit the indirect object and for Wernicke's to omit the direct object. Across argument types, Wernicke's had a much higher level of pronoun usage than did Broca's. Broca's also showed a very high level of article omission. Compared to similar data reported by Slobin (this issue) for Turkish, the Hungarian aphasics showed an elevated level of omission of case markings. Addition errors were quite rare, but there were 14 substitutions of one case marking for another. These errors all involved the substitution of some close semantic competitor. There were no errors in the basic rules for vowel harmony or morpheme order. Overall the results paint a picture of a group of individuals whose grammatical abilities are damaged and noisy, but still largely functional. Neither the view of Broca's as agrammatic nor the view of Wernicke's as paragrammatic was strongly supported.

  6. Acceptable outcome following resection of bilateral large popliteal space heterotopic ossification masses in a spinal cord injured patient: a case report.

    PubMed

    Espandar, Ramin; Haghpanah, Babak

    2010-06-22

    Spinal cord injury is a well-known predisposing factor for development of heterotopic ossification around the joints especially hip and elbow. Heterotopic ossification about the knee is usually located medially, laterally or anteriorly; besides, the knee is generally fixed in flexion. There are only a few reports of heterotopic bone formation at the posterior aspect of the knee (popliteal space) and fixation of both knees in extension; so, there is little experience in operative management of such a problem.Here, we present a 39-years old paraplegic man who was referred to us five years after trauma with a request of above knee amputation due to sever impairment of his life style and adaptive capacity for daily living because of difficulties in using wheelchair. The principle reason for the impairment was fixed full extension of both knees as the result of bilateral large heterotopic ossification masses in popliteal fossae. The bony masses were surgically resected with acceptable outcome. The anatomic position of the ossified masses as well as ankylosis of both knees in full extension, and the acceptable functional outcome of surgery which was done after a long period of five years following injury makes this case unique.

  7. Acceptable outcome following resection of bilateral large popliteal space heterotopic ossification masses in a spinal cord injured patient: a case report

    PubMed Central

    2010-01-01

    Spinal cord injury is a well-known predisposing factor for development of heterotopic ossification around the joints especially hip and elbow. Heterotopic ossification about the knee is usually located medially, laterally or anteriorly; besides, the knee is generally fixed in flexion. There are only a few reports of heterotopic bone formation at the posterior aspect of the knee (popliteal space) and fixation of both knees in extension; so, there is little experience in operative management of such a problem. Here, we present a 39-years old paraplegic man who was referred to us five years after trauma with a request of above knee amputation due to sever impairment of his life style and adaptive capacity for daily living because of difficulties in using wheelchair. The principle reason for the impairment was fixed full extension of both knees as the result of bilateral large heterotopic ossification masses in popliteal fossae. The bony masses were surgically resected with acceptable outcome. The anatomic position of the ossified masses as well as ankylosis of both knees in full extension, and the acceptable functional outcome of surgery which was done after a long period of five years following injury makes this case unique. PMID:20569483

  8. 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

  9. Enforced dismissal of Dutch patients who are not motivated to leave forensic psychiatric settings and treatment--is it ethically acceptable?

    PubMed

    Martens, W H J

    2009-09-01

    The ethical issues surrounding enforced release of forensic psychiatric patients are discussed in this article. Some patients disagree with their discharge because they are convinced that they need the continued structure of the hospital setting and the social relationships with fellow patients and therapists. They fear that without this structure they will unable to cope with the challenges of life in society and the consequence could be relapse and recidivism. Suggestions for guidelines on a practical approach to this category of forensic patients are presented.

  10. Accepting space radiation risks.

    PubMed

    Schimmerling, Walter

    2010-08-01

    The human exploration of space inevitably involves exposure to radiation. Associated with this exposure are multiple risks, i.e., probabilities that certain aspects of an astronaut's health or performance will be degraded. The management of these risks requires that such probabilities be accurately predicted, that the actual exposures be verified, and that comprehensive records be maintained. Implicit in these actions is the fact that, at some point, a decision has been made to accept a certain level of risk. This paper examines ethical and practical considerations involved in arriving at a determination that risks are acceptable, roles that the parties involved may play, and obligations arising out of reliance on the informed consent paradigm seen as the basis for ethical radiation risk acceptance in space.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. Buparlisib, a PI3K inhibitor, demonstrates acceptable tolerability and preliminary activity in a phase I trial of patients with advanced leukemias

    PubMed Central

    Ragon, Brittany Knick; Kantarjian, Hagop; Jabbour, Elias; Ravandi, Farhad; Cortes, Jorge; Borthakur, Gautam; DeBose, LaKiesha; Zeng, Zhihong; Schneider, Heather; Pemmaraju, Naveen; Garcia-Manero, Guillermo; Kornblau, Steven; Wierda, William; Burger, Jan; DiNardo, Courtney D; Andreeff, Michael; Konopleva, Marina; Daver, Naval

    2017-01-01

    Phosphatidylinositol-3-kinase (PI3K) signaling plays a crucial role in oncogene-mediated tumor growth and proliferation. Buparlisib (BKM120) is an oral pan-class I PI3K inhibitor. This phase I study was conducted to determine the dose limiting toxicity (DLT) and maximum tolerated dose (MTD) of BKM120 in patients (pts) with relapsed/refractory acute leukemias. Fourteen pts (12 acute myeloid leukemia, 1 acute lymphoblastic leukemia, and 1 mixed phenotype leukemia) were enrolled. Twelve pts received BKM-120 80 mg/day and two 100 mg/day. The MTD was 80 mg/day. Of the 14 patients treated, the best response was stable disease in one patient that lasted 82 days. The median survival for all patients was 75 days (range 10–568). Three patients with a 3q26 chromosome abnormality had a significantly improved median survival of 360 days (range 278–568) as compared to a median survival of 57 days (range, 10–125) among the 11 other patients. The most frequent drug-related toxicities included confusion, mucositis, dysphagia, and fatigue. Western blot profiling revealed a decrease in p-pS6K/total pS6K in 5/7 (71%) available patient samples with a mean quantitative inhibition of 65% (range, 32–100%) and a decrease in p-FOXO3/total FOXO3 in 4/6 (67%) samples with a mean quantitative inhibition of 93% (range, 89–100%). BKM120 administered at 80 mg/day showed modest efficacy and was tolerable in advanced acute leukemias. PMID:27673440

  19. 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

  20. 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…

  1. 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…

  2. 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…

  3. Acceptability of human risk.

    PubMed

    Kasperson, R E

    1983-10-01

    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.

  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. Should sulfonylureas remain an acceptable first-line add-on to metformin therapy in patients with type 2 diabetes? No, it's time to move on!

    PubMed

    Genuth, Saul

    2015-01-01

    Since their introduction to clinical practice in the 1950s, sulfonylureas have been widely prescribed for use in patients with type 2 diabetes. Of all the other medications currently available for clinical use, only metformin has been used more frequently. However, several new drug classes have emerged that are reported to have equal glucose-lowering efficacy and greater safety when added to treatment of patients in whom metformin monotherapy is no longer sufficient. Moreover, current arguments also suggest that the alternative drugs may be superior to sulfonylureas with regard to the risk of cardiovascular complications. Thus, while there is universal agreement that metformin should remain the first-line pharmacologic therapy for those in whom lifestyle modification is insufficient to control hyperglycemia, there is no consensus as to which drug should be added to metformin. Therefore, given the current controversy, we provide a Point-Counterpoint on this issue. In the preceding point narrative, Dr. Abrahamson provides his argument suggesting that avoiding use of sulfonylureas as a class of medication as an add-on to metformin is not appropriate as there are many patients whose glycemic control would improve with use of these drugs with minimal risk of adverse events. In the counterpoint narrative below, Dr. Genuth suggests there is no longer a need for sulfonylureas to remain a first-line addition to metformin for those patients whose clinical characteristics are appropriate and whose health insurance and/or financial resources make an alternative drug affordable.

  6. Should sulfonylureas remain an acceptable first-line add-on to metformin therapy in patients with type 2 diabetes? Yes, they continue to serve us well!

    PubMed

    Abrahamson, Martin J

    2015-01-01

    Since their introduction to clinical practice in the 1950s, sulfonylureas have been widely prescribed for use in patients with type 2 diabetes. Of all the other medications currently available for clinical use, only metformin has been used more frequently. However, several new drug classes have emerged that are reported to have equal glucose-lowering efficacy and greater safety when added to treatment of patients in whom metformin monotherapy is no longer sufficient. Moreover, current arguments also suggest that the alternative drugs may be superior to sulfonylureas with regard to the risk of cardiovascular complications. Thus, while there is universal agreement that metformin should remain the first-line pharmacologic therapy for those in whom lifestyle modification is insufficient to control hyperglycemia, there is no consensus as to which drug should be added to metformin. Therefore, given the current controversy, we provide a Point-Counterpoint on this issue. In the point narrative presented below, Dr. Abrahamson provides his argument suggesting that avoiding use of sulfonylureas as a class of medication as an add-on to metformin is not appropriate as there are many patients whose glycemic control would improve with use of these drugs with minimal risk of adverse events. In the following counterpoint narrative, Dr. Genuth suggests there is no longer a need for sulfonylureas to remain a first-line addition to metformin for those patients whose clinical characteristics are appropriate and whose health insurance and/or financial resources make an alternative drug affordable.

  7. Acceptance Test Plan.

    DTIC Science & Technology

    2014-09-26

    7 RD-Ai507 154 CCEPTANCE TEST PLN(U) WESTINGHOUSE DEFENSE ND i/i ELECTRO ICS CENTER BALTIMORE MD DEVELOPMENT AND OPERATIONS DIY D C KRRiJS 28 JUN...Ln ACCEPTANCE TEST PLAN FOR SPECIAL RELIABILITY TESTS FOR BROADBAND MICROWAVE AMPLIFIER PANEL David C. Kraus, Reliability Engineer WESTINGHOUSE ...ORGANIZATION b. OFFICE SYMBOL 7g& NAME OF MONITORING ORGANIZATION tIf appdeg ble) WESTINGHOUSE ELECTRIC CORP. - NAVAL RESEARCH LABORATORY e. AOORES$ (Ci7t

  8. 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.

  9. 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

  10. 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)

  11. 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

  12. 40 CFR 761.45 - Marking formats.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... POLYCHLORINATED BIPHENYLS (PCBs) MANUFACTURING, PROCESSING, DISTRIBUTION IN COMMERCE, AND USE PROHIBITIONS Marking of PCBs and PCB Items § 761.45 Marking formats. The following formats shall be used for marking:...

  13. Acceptability of identification bracelets for hospital inpatients

    PubMed Central

    Cleopas, A; Kolly, V; Bovier, P; Garnerin, P; Perneger, T

    2004-01-01

    Objective: To evaluate whether hospitalised patients would agree to wear an identification bracelet and whether patient acceptability is improved by more detailed explanations or by using a code instead of a name on the bracelet. Design: Patient survey that tested two variables in a randomised factorial design. Explanations about identification bracelets were given (a) with or without examples of situations where patient identification may be important, and (b) with the patient name or an anonymous code appearing on the bracelet. Setting: Swiss teaching hospital where wearing of identification bracelets was not systematic. Participants: Adult patients discharged from hospital (n = 1411). Main outcome measures: Patients' responses to the questions: (a) should the hospital introduce a compulsory identification bracelet? and (b) would the patient agree to wear such a bracelet? Results: Globally, 83.9% of patients thought that the hospital should introduce bracelets and 90.2% stated that they would agree to wear one. Providing examples increased support for both the hospital policy (87.9% v 79.2%, p<0.001) and personal acceptance (92.2% v 88.1%, p = 0.015). Whether or not the bracelet carried the patient's name or an anonymous code did not influence patient choice. Conclusions: The majority of patients were in favour of wearing an identification bracelet during their hospital stay. This proportion increased significantly when an explanation based on examples of the consequences of incorrect patient identification had been provided. PMID:15465937

  14. Laser marking of component parts

    SciTech Connect

    Gress, A.V. Jr.

    1983-01-01

    Permanent identification of components and subassemblies for traceability and historical purposes is essential for assemblies subject to long term storage. Marketing requirements run the gamut from simple functional alphanumerics for terminal or wire numbers to complex component identification involving program nomenclature, part number, manufacturer's code, serial number, data code, and lot or batch number. The wide range of opaque materials marked includes both ferrous and nonferrous materials, plastics, composites, and ceramics.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Determining a relationship between applied occlusal load and articulating paper mark area.

    PubMed

    Carey, Jason P; Craig, Mark; Kerstein, Robert B; Radke, John

    2007-01-01

    Articulating paper mark size has been widely accepted in the dental community to be descriptive of occlusal load. The objective of this study is to determine if any direct relationship exists between articulating paper mark area and applied occlusal load. A uniaxial testing machine repeatedly applied a compressive load, beginning at 25N and incrementally continuing up to 450N, to a pair of epoxy dental casts with articulating paper interposed. The resultant paper markings (n = 600) were photographed, and analyzed the mark area using a photographic image analysis and sketching program. A two-tailed Student's t-test for unequal variances compared the measured size of the mark area between twelve different teeth (p < 0.05). Graphical interpretation of the data indicated that the mark area increased non-linearly with increasing load. When the data was grouped to compare consistency of the mark area between teeth, a high variability of mark area was observed between different teeth at the same applied load. The Student's t-test found significant differences in the size of the mark area approximately 80% of the time. No direct relationship between paper mark area and applied load could be found, although the trend showed increasing mark area with elevating load. When selecting teeth to adjust, an operator should not assume the size of paper markings, accurately describing the markings' occlusal contact force content.

  3. Changes in liver acceptance patterns after implementation of Share 35.

    PubMed

    Washburn, Kenneth; Harper, Ann; Baker, Timothy; Edwards, Erick

    2016-02-01

    The Share 35 policy was implemented June 2013. We sought to evaluate liver offer acceptance patterns of centers under this policy. We compared three 1-year eras (1, 2, and 3) before and 1 era (4) after the implementation date of the Share 35 policy (June 18, 2013). We evaluated all offers for liver-only recipients including only those offers for livers that were ultimately transplanted. Logistic regression was used to develop a liver acceptance model. In era 3, there were 4809 offers for Model for End-Stage Liver Disease (MELD) score ≥ 35 patients with 1071 acceptances (22.3%) and 10,141 offers and 1652 acceptances (16.3%) in era 4 (P < 0.001). In era 3, there were 42,954 offers for MELD score < 35 patients with 4181 acceptances (9.7%) and 44,137 offers and 3882 acceptances (8.8%) in era 4 (P < 0.001). The lower acceptance rate persisted across all United Network for Organ Sharing regions and was significantly less in regions 2, 3, 4, 5, and 7. Mean donor risk index was the same (1.3) for all eras for MELD scores ≥ 35 acceptances and the same (1.4) for MELD score < 35 acceptances. Refusal reasons did not vary throughout the eras. The adjusted odds ratio of accepting a liver for a MELD score of 35 + compared to a MELD score < 35 patient was 1.289 before the policy and 0.960 after policy implementation. In conclusion, the Share 35 policy has resulted in more offers to patients with MELD scores ≥ 35. Overall acceptance rates were significantly less compared to the same patient group before the policy implementation. Centers are less likely to accept a liver for a patient with a MELD score of 35 + after the policy change. Decreased donor acceptance rates could reflect more programmatic selectivity and ongoing donor and recipient matching.

  4. Profile of the capsaicin 8% patch for the management of neuropathic pain associated with postherpetic neuralgia: safety, efficacy, and patient acceptability

    PubMed Central

    Laklouk, Muhammad; Baranidharan, Ganesan

    2016-01-01

    Capsaicin is a naturally occurring irritant active ingredient found in hot peppers. It is a ligand for transient receptor potential channel vanilloid receptors, which are found in nociceptive nerve terminals in the skin. Initial exposure to topical capsaicin leads to excitation of these receptors, release of vasoactive mediators, erythema, intense burning, pain, and thereafter desensitization of sensory neurons resulting in inhibition of pain transmission. Capsaicin 8% has been licensed for the treatment of postherpetic neuralgia pain in recent years. A single application of high-concentration capsaicin for 60 minutes for postherpetic neuralgia has been robustly evaluated. Capsaicin 8% patches are applied to the most painful areas of healthy skin and allowed to remain for 60 minutes. Treatment can be repeated every 90 days if the pain persists or returns. The patches are usually applied in specialist pain clinics where patients can be pretreated and monitored. Health care staff need to take certain precautions before administering these patches to avoid unintentional contact. Common adverse effects of the capsaicin 8% patch are transient mild-to-moderate self-limiting application-site burning, pain, erythema, pruritus, papules, swelling, dryness, and hypertension. To manage local pain from capsaicin application, the skin is pretreated with a local anesthetic such as topical lidocaine or an oral analgesic such as oxycodone for up to 5 days. A transient increase in pain is usually seen within 48 hours of patch application before the pain-relieving effect starts. Systemic absorption is minimal and clinically insignificant. The nature of administration and relatively high cost of capsaicin patches can significantly limit their use to a small number of patients with severe refractory symptoms. This review highlights recent evidence related to the use and effectiveness of the 8% capsaicin patch for Postherpetic Neuralgia and discusses its safety and side-effect profiles

  5. Profile of the capsaicin 8% patch for the management of neuropathic pain associated with postherpetic neuralgia: safety, efficacy, and patient acceptability.

    PubMed

    Laklouk, Muhammad; Baranidharan, Ganesan

    2016-01-01

    Capsaicin is a naturally occurring irritant active ingredient found in hot peppers. It is a ligand for transient receptor potential channel vanilloid receptors, which are found in nociceptive nerve terminals in the skin. Initial exposure to topical capsaicin leads to excitation of these receptors, release of vasoactive mediators, erythema, intense burning, pain, and thereafter desensitization of sensory neurons resulting in inhibition of pain transmission. Capsaicin 8% has been licensed for the treatment of postherpetic neuralgia pain in recent years. A single application of high-concentration capsaicin for 60 minutes for postherpetic neuralgia has been robustly evaluated. Capsaicin 8% patches are applied to the most painful areas of healthy skin and allowed to remain for 60 minutes. Treatment can be repeated every 90 days if the pain persists or returns. The patches are usually applied in specialist pain clinics where patients can be pretreated and monitored. Health care staff need to take certain precautions before administering these patches to avoid unintentional contact. Common adverse effects of the capsaicin 8% patch are transient mild-to-moderate self-limiting application-site burning, pain, erythema, pruritus, papules, swelling, dryness, and hypertension. To manage local pain from capsaicin application, the skin is pretreated with a local anesthetic such as topical lidocaine or an oral analgesic such as oxycodone for up to 5 days. A transient increase in pain is usually seen within 48 hours of patch application before the pain-relieving effect starts. Systemic absorption is minimal and clinically insignificant. The nature of administration and relatively high cost of capsaicin patches can significantly limit their use to a small number of patients with severe refractory symptoms. This review highlights recent evidence related to the use and effectiveness of the 8% capsaicin patch for Postherpetic Neuralgia and discusses its safety and side-effect profiles.

  6. 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

  7. 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.

  8. 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...

  9. 27 CFR 28.144 - 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. 28.144... § 28.144 Export marks. (a) General Requirement. In addition to the marks and brands required to be... brewer shall mark the word “Export” on each container or case of beer, or the words “Beer concentrate...

  10. 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...

  11. 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...

  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. A unique solar marking construct.

    PubMed

    Sofaer, A; Zinser, V; Sinclair, R M

    1979-10-19

    An assembly of stone slabs on an isolated butte in New Mexico collimates sunlight onto spiral petroglyphs carved on a cliff face. The light illuminates the spirals in a changing pattern throughout the year and marks the solstices and equinoxes with particular images. The assembly can also be used to observe lunar phenomena. It is unique in archeoastronomy in utilizing the changing height of the midday sun throughout the year rather than its rising and setting points. The construct appears to be the result of deliberate work of the Anasazi Indians, the builders of the great pueblos in the area.

  14. Social Acceptance of Adolescent Mainstreamed Students with Visual Impairments.

    ERIC Educational Resources Information Center

    Peavey, Katherine Owen; Leff, Debra

    2002-01-01

    Five adolescents with visual impairments participated in trust engendering activities in five separate peer focus groups. At the completion of the intervention, four of the students with visual impairments showed marked improvement in their social acceptance and had higher scores on the Social Skills Assessment Tool for Children with Visual…

  15. 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

    Bennett, Sarah D; Otieno, Ronald; Ayers, Tracy L; Odhiambo, Aloyce; Faith, Sitnah H; Quick, Robert

    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.

  16. 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

  17. Mark 3 interactive data analysis system

    NASA Technical Reports Server (NTRS)

    Ryan, J. W.; Ma, C.; Schupler, B. P.

    1980-01-01

    The interactive data analysis system, a major subset of the total Mark 3 very long baseline interferometry (VLBI) software system is described. The system consists of two major and a number of small programs. These programs provide for the scientific analysis of the observed values of delay and delay rate generated by the VLBI data reduction programs and product the geophysical and astrometric parameters which are among the ultimate products of VLBI. The two major programs are CALC and SOLVE. CALC generates the theoretical values of VLBI delay rate as well as partial derivatives based on apriori values of the geophysical and astronometric parameters. SOLVE is a least squares parameters estimation program which yields the geophysical and astrometric parameters using the observed values by the data processing system and theoretical values and partial derivatives provided by CALC. SOLVE is a highly interactive program in which the user selects the exact form of the recovered parameters and the data to be accepted into the solution.

  18. 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).

  19. Determining a Relationship Between Applied Occlusal Load and Articulating Paper Mark Area

    PubMed Central

    Carey, Jason P; Craig, Mark; Kerstein, Robert B; Radke, John

    2007-01-01

    Articulating paper mark size has been widely accepted in the dental community to be descriptive of occlusal load. The objective of this study is to determine if any direct relationship exists between articulating paper mark area and applied occlusal load. A uniaxial testing machine repeatedly applied a compressive load, beginning at 25N and incrementally continuing up to 450N, to a pair of epoxy dental casts with articulating paper interposed. The resultant paper markings (n = 600) were photographed, and analyzed the mark area using a photographic image analysis and sketching program. A two-tailed Student’s t-test for unequal variances compared the measured size of the mark area between twelve different teeth (p < 0.05). Graphical interpretation of the data indicated that the mark area increased non-linearly with increasing load. When the data was grouped to compare consistency of the mark area between teeth, a high variability of mark area was observed between different teeth at the same applied load. The Student’s t-test found significant differences in the size of the mark area approximately 80% of the time. No direct relationship between paper mark area and applied load could be found, although the trend showed increasing mark area with elevating load. When selecting teeth to adjust, an operator should not assume the size of paper markings, accurately describing the markings’ occlusal contact force content. PMID:19088874

  20. 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.

  1. 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...

  2. When should conscientious objection be accepted?

    PubMed

    Magelssen, Morten

    2012-01-01

    This paper makes two main claims: first, that the need to protect health professionals' moral integrity is what grounds the right to conscientious objection in health care; and second, that for a given claim of conscientious objection to be acceptable to society, a certain set of criteria should be fulfilled. The importance of moral integrity for individuals and society, including its special role in health care, is advocated. Criteria for evaluating the acceptability of claims to conscientious objection are outlined. The precise content of the criteria is dictated by the two main interests that are at stake in the dilemma of conscientious objection: the patient's interests and the health professional's moral integrity. Alternative criteria proposed by other authors are challenged. The bold claim is made that conscientious objection should be recognised by society as acceptable whenever the five main criteria of the proposed set are met.

  3. A survey of physicians' acceptance of telemedicine.

    PubMed

    Sheng, O R; Hu, P J; Chau, P Y; Hjelm, N M; Tam, K Y; Wei, C P; Tse, J

    1998-01-01

    Physicians' acceptance of telemedicine is an important managerial issue facing health-care organizations that have adopted, or are about to adopt, telemedicine. Most previous investigations of the acceptance of telemedicine have lacked theoretical foundation and been of limited scope. We examined technology acceptance and usage among physicians and specialists from 49 clinical departments at eight public tertiary hospitals in Hong Kong. Out of the 1021 questionnaires distributed, 310 were completed and returned, a 30% response rate. The preliminary findings suggested that use of telemedicine among clinicians in Hong Kong was moderate. While 18% of the respondents were using some form of telemedicine for patient care and management, it accounted for only 6.3% of the services provided. The intensity of their technology usage was also low, accounting for only 6.8% of a typical telemedicine-assisted service. These preliminary findings have managerial implications.

  4. 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.

  5. 30 CFR 7.29 - Approval marking.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth and Ventilation Tubing § 7.29 Approval marking. (a) Approved brattice cloth shall be legibly and permanently marked with the assigned...

  6. 30 CFR 7.29 - Approval marking.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth and Ventilation Tubing § 7.29 Approval marking. (a) Approved brattice cloth shall be legibly and permanently marked with the assigned...

  7. 30 CFR 7.29 - Approval marking.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth and Ventilation Tubing § 7.29 Approval marking. (a) Approved brattice cloth shall be legibly and permanently marked with the assigned...

  8. 30 CFR 7.29 - Approval marking.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth and Ventilation Tubing § 7.29 Approval marking. (a) Approved brattice cloth shall be legibly and permanently marked with the assigned...

  9. 30 CFR 7.29 - Approval marking.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth and Ventilation Tubing § 7.29 Approval marking. (a) Approved brattice cloth shall be legibly and permanently marked with the assigned...

  10. 46 CFR 160.016-4 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Lamps, Safety, Flame, for Merchant Vessels § 160.016-4 Marking. (a) Flame safety lamps shall be permanently and legibly marked with the name and address of...

  11. 46 CFR 160.016-4 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Lamps, Safety, Flame, for Merchant Vessels § 160.016-4 Marking. (a) Flame safety lamps shall be permanently and legibly marked with the name and address of...

  12. 46 CFR 160.016-4 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Lamps, Safety, Flame, for Merchant Vessels § 160.016-4 Marking. (a) Flame safety lamps shall be permanently and legibly marked with the name and address of...

  13. 46 CFR 160.016-4 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Lamps, Safety, Flame, for Merchant Vessels § 160.016-4 Marking. (a) Flame safety lamps shall be permanently and legibly marked with the name and address of...

  14. 46 CFR 160.016-4 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Lamps, Safety, Flame, for Merchant Vessels § 160.016-4 Marking. (a) Flame safety lamps shall be permanently and legibly marked with the name and address of...

  15. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Operating Limitations and Information Markings and Placards § 29... fuel controls— (1) Each fuel tank selector valve control must be marked to indicate the...

  16. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Operating Limitations and Information Markings and Placards § 29... fuel controls— (1) Each fuel tank selector valve control must be marked to indicate the...

  17. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Operating Limitations and Information Markings and Placards § 29... fuel controls— (1) Each fuel tank selector valve control must be marked to indicate the...

  18. Acceptance criteria for method equivalency assessments.

    PubMed

    Chatfield, Marion J; Borman, Phil J

    2009-12-15

    Quality by design (ICH-Topic Q8) requires that process control strategy requirements are met and maintained. The challenging task of setting appropriate acceptance criteria for assessment of method equivalence is a critical component of satisfying these requirements. The use of these criteria will support changes made to methods across the product lifecycle. A method equivalence assessment is required when a change is made to a method which may pose a risk to its ability to monitor the quality of the process. Establishing appropriate acceptance criteria are a vital, but not clearly understood, prerequisite to deciding the appropriate design/sample size of the equivalency study. A number of approaches are proposed in the literature for setting acceptance criteria for equivalence which address different purposes. This perspective discusses those purposes and then provides more details on setting acceptance criteria based on patient and producer risk, e.g., tolerance interval approach and the consideration of method or process capability. Applying these to a drug substance assay method for batch release illustrates that, for the equivalence assessment to be meaningful, a clear understanding and appraisal of the control requirements of the method is needed. Rather than a single exact algorithm, the analyst's judgment on a number of aspects is required in deciding the appropriate acceptance criteria.

  19. Mark III results from SPEAR

    SciTech Connect

    Toki, W.

    1983-11-01

    First results from the MARK III detector at SPEAR are presented based on 2.7 million J/psi decays. The eta/sub c/ is observed in three modes, J/psi ..-->.. ..gamma..eta/sub c/, (eta/sub c/ ..-->.. rho anti rho, eta..pi../sup +/..pi../sup -/, and phi phi). Using the phi phi mode, the eta/sub c/ spin-parity is determined to be 0/sup -/. The known radiative J/psi decays J/psi ..-->.. ..gamma..f(f ..-->.. ..pi../sup +/..pi../sup -/), ..gamma..eta'(eta' ..-->.. ..gamma..rho/sup 0/, eta..pi../sup +/..pi../sup -/), ..gamma..f'(f' ..-->.. kappa/sup +/kappa/sup -/), ..gamma..theta(theta ..-->.. kappa anti kappa), and ..gamma..iota(iota ..-->.. ..pi..kappa anti kappa) are observed and their branching ratios found to be in agreement with previous measurements. In the J/psi ..-->.. ..gamma..kappa/sup +/kappa/sup -/ mode a new state is observed at 2.22 GeV and in the J/psi ..-->.. ..gamma gamma..rho/sup 0/ and ..gamma..eta..pi../sup +/..pi../sup -/ modes evidence for new structures near 1.4 GeV is presented. 29 references.

  20. Degradation Modeling of Polyurea Pavement Markings

    DTIC Science & Technology

    2011-03-01

    DEGRADATION MODELING OF POLYUREA PAVEMENT MARKINGS THESIS Jonathan D. Needham, Captain, USAF AFIT/GEM/ENV/11-M05 DEPARTMENT OF THE...DEGRADATION MODELING OF POLYUREA PAVEMENT MARKINGS THESIS Presented to the Faculty Department of Engineering Management Graduates School of...DEGRADATION MODELING OF POLYUREA PAVEMENT MARKINGS Jonathan D. Needham, BS Captain, USAF Approved

  1. 49 CFR 221.14 - Marking devices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., DEPARTMENT OF TRANSPORTATION REAR END MARKING DEVICE-PASSENGER, COMMUTER AND FREIGHT TRAINS Marking Devices § 221.14 Marking devices. (a) As prescribed in § 221.13, passenger, commuter and freight trains shall be... and commuter trains in compliance with paragraph (a) of this section shall be lighted under...

  2. 49 CFR 221.14 - Marking devices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., DEPARTMENT OF TRANSPORTATION REAR END MARKING DEVICE-PASSENGER, COMMUTER AND FREIGHT TRAINS Marking Devices § 221.14 Marking devices. (a) As prescribed in § 221.13, passenger, commuter and freight trains shall be... and commuter trains in compliance with paragraph (a) of this section shall be lighted under...

  3. 49 CFR 221.14 - Marking devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., DEPARTMENT OF TRANSPORTATION REAR END MARKING DEVICE-PASSENGER, COMMUTER AND FREIGHT TRAINS Marking Devices § 221.14 Marking devices. (a) As prescribed in § 221.13, passenger, commuter and freight trains shall be... and commuter trains in compliance with paragraph (a) of this section shall be lighted under...

  4. 49 CFR 221.14 - Marking devices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., DEPARTMENT OF TRANSPORTATION REAR END MARKING DEVICE-PASSENGER, COMMUTER AND FREIGHT TRAINS Marking Devices § 221.14 Marking devices. (a) As prescribed in § 221.13, passenger, commuter and freight trains shall be... and commuter trains in compliance with paragraph (a) of this section shall be lighted under...

  5. 49 CFR 178.318-3 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Marking. 178.318-3 Section 178.318-3 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.318-3 Marking. Each container must be marked as...

  6. 49 CFR 178.318-3 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Marking. 178.318-3 Section 178.318-3 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.318-3 Marking. Each container must be marked as...

  7. 49 CFR 178.318-3 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Marking. 178.318-3 Section 178.318-3 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.318-3 Marking. Each container must be marked as...

  8. 49 CFR 178.318-3 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Marking. 178.318-3 Section 178.318-3 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.318-3 Marking. Each container must be marked as...

  9. 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…

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 48 CFR 752.7009 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Marking. 752.7009 Section... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of USAID Contract Clauses 752.7009 Marking. The following clause is for use in all USAID contracts performed in whole or in part overseas. Marking (JAN 1993)...

  16. 48 CFR 752.7009 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Marking. 752.7009 Section... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of USAID Contract Clauses 752.7009 Marking. The following clause is for use in all USAID contracts performed in whole or in part overseas. Marking (JAN 1993)...

  17. 14 CFR 25.1555 - Control markings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 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...

  18. 14 CFR 23.1555 - Control markings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Control markings. 23.1555 Section 23.1555... Markings and Placards § 23.1555 Control markings. Link to an amendment published at 76 FR 75763, December 2, 2011. (a) Each cockpit control, other than primary flight controls and simple push button type...

  19. 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...

  20. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Control markings. 27.1555 Section 27.1555... Control markings. (a) Each cockpit control, other than primary flight controls or control whose function... fuel controls— (1) Each fuel tank selector control must be marked to indicate the...

  1. 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...

  2. 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…

  3. 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... filled under the provisions of part 24 of this chapter, the proprietor shall mark the word “Export”...

  4. 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... “Export” on each container or case before removal for export, for use on vessels or aircraft, or...

  5. 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... “Export” on the Government side of each case or Government head of each container before removal...

  6. 46 CFR 111.25-5 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Marking. 111.25-5 Section 111.25-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motors § 111.25-5 Marking. (a) Each motor must have a marking or nameplate that meets either Section...

  7. 46 CFR 111.25-5 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Marking. 111.25-5 Section 111.25-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motors § 111.25-5 Marking. (a) Each motor must have a marking or nameplate that meets either Section...

  8. 46 CFR 111.25-5 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Marking. 111.25-5 Section 111.25-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motors § 111.25-5 Marking. (a) Each motor must have a marking or nameplate that meets either Section...

  9. 46 CFR 111.25-5 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Marking. 111.25-5 Section 111.25-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motors § 111.25-5 Marking. (a) Each motor must have a marking or nameplate that meets either Section...

  10. 46 CFR 111.25-5 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Marking. 111.25-5 Section 111.25-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motors § 111.25-5 Marking. (a) Each motor must have a marking or nameplate that meets either Section...

  11. 49 CFR 221.14 - Marking devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Marking devices. 221.14 Section 221.14 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REAR END MARKING DEVICE-PASSENGER, COMMUTER AND FREIGHT TRAINS Marking...

  12. 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)

  13. 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... Identification and Markings § 2001.25 Declassification markings. (a) General. A uniform security...

  14. 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... Identification and Markings § 2001.25 Declassification markings. (a) General. A uniform security...

  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... Identification and Markings § 2001.25 Declassification markings. (a) General. A uniform security...

  16. 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... Identification and Markings § 2001.25 Declassification markings. (a) General. A uniform security...

  17. 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... Identification and Markings § 2001.25 Declassification markings. (a) General. A uniform security...

  18. 40 CFR 262.32 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Pre-Transport Requirements § 262.32 Marking. (a) Before transporting or offering hazardous waste for transportation off-site, a generator must mark each package of... transportation off-site, a generator must mark each container of 119 gallons or less used in such...

  19. 40 CFR 262.32 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Pre-Transport Requirements § 262.32 Marking. (a) Before transporting or offering hazardous waste for transportation off-site, a generator must mark each package of... transportation off-site, a generator must mark each container of 119 gallons or less used in such...

  20. 40 CFR 262.32 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Pre-Transport Requirements § 262.32 Marking. (a) Before transporting or offering hazardous waste for transportation off-site, a generator must mark each package of... transportation off-site, a generator must mark each container of 119 gallons or less used in such...

  1. 40 CFR 262.32 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Pre-Transport Requirements § 262.32 Marking. (a) Before transporting or offering hazardous waste for transportation off-site, a generator must mark each package of... transportation off-site, a generator must mark each container of 119 gallons or less used in such...

  2. 40 CFR 262.32 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... APPLICABLE TO GENERATORS OF HAZARDOUS WASTE Pre-Transport Requirements § 262.32 Marking. (a) Before transporting or offering hazardous waste for transportation off-site, a generator must mark each package of... transportation off-site, a generator must mark each container of 119 gallons or less used in such...

  3. 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

  4. "Denture marking" as an aid to forensic identification.

    PubMed

    Mohan, Jayashree; Kumar, C Dhinesh; Simon, Paul

    2012-09-01

    "Identification through forensic science is an art of giving the corpse a name A real life detective work that would put even Sherlock Homes to shame." Forensic dentistry deals with proper handling and examination of dental evidence and proper evaluation and presentation of dental findings in interest of justice. Denture marking or labeling is not a new concept in either Prosthetic or Forensic dentistry and its routine practice has been urged by Forensic dentists internationally for many years. Denture marking is accepted as a means of identifying dentures and persons in geriatric institutions or post mortem during war, crimes, and civil unrest, natural and mass disasters. Prosthodontists are playing very important role in forensic dentistry as they are concerned with fabrication of various prostheses which can serve as an important tool for identification. Identification is essential requirement of any medico-legal investigation because a wrong identity may pose a problem in delivering justice. The main objective of this article is to discuss the various methods of denture marking and to emphasize the importance of denture marking for person identification in medico legal investigations.

  5. 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…

  6. 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...

  7. 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...

  8. 42 CFR 35.62 - Acceptance of contributions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 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...

  9. Suicide and the Standard of Care: Optimal vs. Acceptable.

    ERIC Educational Resources Information Center

    Berman, Alan L.; Cohen-Sandler, Roni

    1982-01-01

    Discusses accepted standards of care for suicidal patients from the perspectives of the law, malpractice insurance claims, the mental health professions, and the ideal. A review of decisions of professional liability provides guidelines for what the court considers to be adequate care, suggesting an acceptance of minimal standards. (JAC)

  10. 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.

  11. 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.

  12. 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

  13. When is physician assisted suicide or euthanasia acceptable?

    PubMed Central

    Frileux, S; Lelievre, C; Munoz, S; Mullet, E; Sorum, P

    2003-01-01

    Objectives: To discover what factors affect lay people's judgments of the acceptability of physician assisted suicide and euthanasia and how these factors interact. Design: Participants rated the acceptability of either physician assisted suicide or euthanasia for 72 patient vignettes with a five factor design—that is, all combinations of patient's age (three levels); curability of illness (two levels); degree of suffering (two levels); patient's mental status (two levels), and extent of patient's requests for the procedure (three levels). Participants: Convenience sample of 66 young adults, 62 middle aged adults, and 66 older adults living in western France. Main measurements: In accordance with the functional theory of cognition of N H Anderson, main effects, and interactions among patient factors and participants' characteristics were investigated by means of both graphs and ANOVA. Results: Patient requests were the most potent determinant of acceptability. Euthanasia was generally less acceptable than physician assisted suicide, but this difference disappeared when requests were repetitive. As their own age increased, participants placed more weight on patient age as a criterion of acceptability. Conclusions: People's judgments concur with legislation to require a repetition of patients' requests for a life ending act. Younger people, who frequently are decision makers for elderly relatives, place less emphasis on patient's age itself than do older people. PMID:14662811

  14. 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

  15. 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.

  16. Extending the Technology Acceptance Model: Policy Acceptance Model (PAM)

    NASA Astrophysics Data System (ADS)

    Pierce, Tamra

    There has been extensive research on how new ideas and technologies are accepted in society. This has resulted in the creation of many models that are used to discover and assess the contributing factors. The Technology Acceptance Model (TAM) is one that is a widely accepted model. This model examines people's acceptance of new technologies based on variables that directly correlate to how the end user views the product. This paper introduces the Policy Acceptance Model (PAM), an expansion of TAM, which is designed for the analysis and evaluation of acceptance of new policy implementation. PAM includes the traditional constructs of TAM and adds the variables of age, ethnicity, and family. The model is demonstrated using a survey of people's attitude toward the upcoming healthcare reform in the United States (US) from 72 survey respondents. The aim is that the theory behind this model can be used as a framework that will be applicable to studies looking at the introduction of any new or modified policies.

  17. Market Acceptance of Smart Growth

    EPA Pesticide Factsheets

    This report finds that smart growth developments enjoy market acceptance because of stability in prices over time. Housing resales in smart growth developments often have greater appreciation than their conventional suburban counterparts.

  18. 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

  19. 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…

  20. 7 CFR 51.311 - Marking requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STANDARDS) United States Standards for Grades of Apples Marking Requirements § 51.311 Marking requirements... minimum diameter of apples packed in a closed container shall be indicated on the container. For apple... varieties, the minimum diameter and minimum weight of apples packed in a closed container shall be...

  1. 7 CFR 51.311 - Marking requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STANDARDS) United States Standards for Grades of Apples Marking Requirements § 51.311 Marking requirements... minimum diameter of apples packed in a closed container shall be indicated on the container. For apple... varieties, the minimum diameter and minimum weight of apples packed in a closed container shall be...

  2. 7 CFR 51.311 - Marking requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STANDARDS) United States Standards for Grades of Apples Marking Requirements § 51.311 Marking requirements... minimum diameter of apples packed in a closed container shall be indicated on the container. For apple... varieties, the minimum diameter and minimum weight of apples packed in a closed container shall be...

  3. 46 CFR 160.031-6 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Line-Throwing Appliance, Shoulder Gun Type (and Equipment) § 160.031-6 Marking. (a) Gun. The gun shall be permanently and legibly marked on the barrel with the manufacturer's model or type designation of the gun, the serial number for the gun, the official Coast...

  4. 46 CFR 160.031-6 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Line-Throwing Appliance, Shoulder Gun Type (and Equipment) § 160.031-6 Marking. (a) Gun. The gun shall be permanently and legibly marked on the barrel with the manufacturer's model or type designation of the gun, the serial number for the gun, the official Coast...

  5. 46 CFR 160.031-6 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Line-Throwing Appliance, Shoulder Gun Type (and Equipment) § 160.031-6 Marking. (a) Gun. The gun shall be permanently and legibly marked on the barrel with the manufacturer's model or type designation of the gun, the serial number for the gun, the official Coast...

  6. 46 CFR 160.031-6 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Line-Throwing Appliance, Shoulder Gun Type (and Equipment) § 160.031-6 Marking. (a) Gun. The gun shall be permanently and legibly marked on the barrel with the manufacturer's model or type designation of the gun, the serial number for the gun, the official Coast...

  7. 46 CFR 160.031-6 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Line-Throwing Appliance, Shoulder Gun Type (and Equipment) § 160.031-6 Marking. (a) Gun. The gun shall be permanently and legibly marked on the barrel with the manufacturer's model or type designation of the gun, the serial number for the gun, the official Coast...

  8. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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....

  9. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 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. 46 CFR 160.053-5 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 6 2012-10-01 2012-10-01 false Marking. 160.053-5 Section 160.053-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Work Vests, Unicellular Plastic Foam § 160.053-5 Marking....

  11. 46 CFR 160.053-5 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Marking. 160.053-5 Section 160.053-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Work Vests, Unicellular Plastic Foam § 160.053-5 Marking....

  12. Credit Documentation and the Mark 15 Subroutine

    SciTech Connect

    McAllister, J.E.

    2001-08-16

    This report documents the rewrite of the heat transfer subroutine. Part of the process of preparing the Mark 15 assembly for production operation is the development of thermal-hydraulic limits for the assembly. These limits require, among other items, the development of a Mark 15 assembly subroutine for the CREDIT code.

  13. 46 CFR 160.026-5 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... number shall be embossed on the top of the container. The container shall also be lithographed on one side in accordance with § 160.026-3(b) with the following: “U. S. Coast Guard Approval No. __” (Not...) (b) Other marking. In addition to any other marking placed on the smallest packing carton or box...

  14. 33 CFR 175.128 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Marking. 175.128 Section 175.128 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.128 Marking. No person may use a boat unless...

  15. 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 19.752 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE... Marks. (a) Fuel alcohol. A proprietor of an alcohol fuel plant must place a conspicuous and...

  16. Fantasy and Reality in Mark Twain's Aggression.

    ERIC Educational Resources Information Center

    Sears, Robert R.

    Psychoanalysis, a favorite method for studying personality and motivation, cannot be used on the dead. Instead, biographical analysis must be employed. This study examines Mark Twain's aggression by analyzing his writings, social behavior, and environmental aspects of his life. In viewing Mark Twain's novels as representing fantasy, 17 categories…

  17. 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...

  18. 46 CFR 161.012-15 - Markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 6 2013-10-01 2013-10-01 false Markings. 161.012-15 Section 161.012-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ELECTRICAL EQUIPMENT Personal Flotation Device Lights § 161.012-15 Markings. (a)...

  19. 46 CFR 164.023-15 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 6 2014-10-01 2014-10-01 false Marking. 164.023-15 Section 164.023-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL MATERIALS Thread for Personal Flotation Devices § 164.023-15 Marking. (a)...

  20. 46 CFR 169.545 - Markings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Firefighting Equipment Personal Flotation Devices § 169.545 Markings. (a) Each personal flotation device must... persons onboard, the containers in which they are stowed must be marked “adult personal flotation devices” or “child personal flotation devices”, as appropriate, and with the number contained therein, in...

  1. 46 CFR 169.545 - Markings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Firefighting Equipment Personal Flotation Devices § 169.545 Markings. (a) Each personal flotation device must... persons onboard, the containers in which they are stowed must be marked “adult personal flotation devices” or “child personal flotation devices”, as appropriate, and with the number contained therein, in...

  2. 46 CFR 169.545 - Markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Firefighting Equipment Personal Flotation Devices § 169.545 Markings. (a) Each personal flotation device must... persons onboard, the containers in which they are stowed must be marked “adult personal flotation devices” or “child personal flotation devices”, as appropriate, and with the number contained therein, in...

  3. 46 CFR 161.012-15 - Markings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 6 2012-10-01 2012-10-01 false Markings. 161.012-15 Section 161.012-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ELECTRICAL EQUIPMENT Personal Flotation Device Lights § 161.012-15 Markings. (a)...

  4. 46 CFR 164.023-15 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 6 2013-10-01 2013-10-01 false Marking. 164.023-15 Section 164.023-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL MATERIALS Thread for Personal Flotation Devices § 164.023-15 Marking. (a)...

  5. 46 CFR 161.012-15 - Markings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 6 2014-10-01 2014-10-01 false Markings. 161.012-15 Section 161.012-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ELECTRICAL EQUIPMENT Personal Flotation Device Lights § 161.012-15 Markings. (a)...

  6. 46 CFR 161.012-15 - Markings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Markings. 161.012-15 Section 161.012-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ELECTRICAL EQUIPMENT Personal Flotation Device Lights § 161.012-15 Markings. (a)...

  7. 46 CFR 169.545 - Markings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Firefighting Equipment Personal Flotation Devices § 169.545 Markings. (a) Each personal flotation device must... persons onboard, the containers in which they are stowed must be marked “adult personal flotation devices” or “child personal flotation devices”, as appropriate, and with the number contained therein, in...

  8. 46 CFR 160.036-5 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals § 160.036-5 Marking. (a) General. Each hand-held rocket-propelled parachute red flare distress signal shall be legibly marked or labeled as follows: (Company brand or style designation) Hand-Held...

  9. 46 CFR 160.036-5 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals § 160.036-5 Marking. (a) General. Each hand-held rocket-propelled parachute red flare distress signal shall be legibly marked or labeled as follows: (Company brand or style designation) Hand-Held...

  10. 46 CFR 160.036-5 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals § 160.036-5 Marking. (a) General. Each hand-held rocket-propelled parachute red flare distress signal shall be legibly marked or labeled as follows: (Company brand or style designation) Hand-Held...

  11. 46 CFR 160.036-5 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals § 160.036-5 Marking. (a) General. Each hand-held rocket-propelled parachute red flare distress signal shall be legibly marked or labeled as follows: (Company brand or style designation) Hand-Held...

  12. 46 CFR 160.036-5 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Hand-Held Rocket-Propelled Parachute Red Flare Distress Signals § 160.036-5 Marking. (a) General. Each hand-held rocket-propelled parachute red flare distress signal shall be legibly marked or labeled as follows: (Company brand or style designation) Hand-Held...

  13. 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)...

  14. 30 CFR 7.90 - Approval marking.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 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)...

  15. 30 CFR 7.90 - Approval marking.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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)...

  16. 30 CFR 7.90 - Approval marking.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 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)...

  17. 30 CFR 7.90 - Approval marking.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 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)...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 46 CFR 160.053-5 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 6 2014-10-01 2014-10-01 false Marking. 160.053-5 Section 160.053-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Work Vests, Unicellular Plastic Foam § 160.053-5 Marking....

  3. 10 CFR 1045.40 - Marking requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Marking requirements. 1045.40 Section 1045.40 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Generation and Review of Documents Containing Restricted Data and Formerly Restricted Data § 1045.40 Marking...

  4. 10 CFR 1045.40 - Marking requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Marking requirements. 1045.40 Section 1045.40 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Generation and Review of Documents Containing Restricted Data and Formerly Restricted Data § 1045.40 Marking...

  5. 10 CFR 1045.40 - Marking requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Marking requirements. 1045.40 Section 1045.40 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Generation and Review of Documents Containing Restricted Data and Formerly Restricted Data § 1045.40 Marking...

  6. 10 CFR 1045.40 - Marking requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Marking requirements. 1045.40 Section 1045.40 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Generation and Review of Documents Containing Restricted Data and Formerly Restricted Data § 1045.40 Marking...

  7. 49 CFR 450.7 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... construction begins on or after January 1, 1984, all maximum gross weight markings on the container must be consistent with the maximum gross weight information on the safety approval plate. (b) On each container that construction begins before January 1, 1984, all maximum gross weight markings on the container must...

  8. 49 CFR 450.7 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... construction begins on or after January 1, 1984, all maximum gross weight markings on the container must be consistent with the maximum gross weight information on the safety approval plate. (b) On each container that construction begins before January 1, 1984, all maximum gross weight markings on the container must...

  9. 46 CFR 160.076-39 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... section. (b) PFD Type. Based on its approval certificate, each PFD must be marked as follows— (l) “Type I... of the inflation mechanism approved for use on the PFD. (2) (e) Inflation mechanisms. Each manual, automatic, or manual-auto inflation mechanism must be permanently marked with its unique model number....

  10. 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...

  11. 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...

  12. 10 CFR 1045.40 - Marking requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Marking requirements. 1045.40 Section 1045.40 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Generation and Review of Documents Containing Restricted Data and Formerly Restricted Data § 1045.40 Marking...

  13. 49 CFR 179.500-17 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500-17 Marking. (a) Each tank shall be plainly and permanently marked, thus certifying that tank complies with all...

  14. 49 CFR 179.500-17 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500-17 Marking. (a) Each tank shall be plainly and permanently marked, thus certifying that tank complies with all...

  15. 49 CFR 179.500-17 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500-17 Marking. (a) Each tank shall be plainly and permanently marked, thus certifying that tank complies with all...

  16. 49 CFR 179.500-17 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specification for Cryogenic Liquid Tank Car Tanks and Seamless Steel Tanks (Classes DOT-113 and 107A) § 179.500-17 Marking. (a) Each tank shall be plainly and permanently marked, thus certifying that tank complies with all...

  17. 46 CFR 160.054-6 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Inflatable Liferafts § 160.054-6 Marking. (a) Each approved first-aid kit shall be plainly and permanently marked with the following... kit, the Coast Guard approval number, and the words “First-Aid Kit—For Inflatable Life Rafts”. If...

  18. 46 CFR 160.041-6 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Merchant Vessels § 160.041-6 Marking. (a) Each approved first-aid kit shall be permanently marked with the following information: name of... Guard Approval Number, and the words “FIRST-AID KIT.” This information may be embossed on the...

  19. 46 CFR 160.041-6 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Merchant Vessels § 160.041-6 Marking. (a) Each approved first-aid kit shall be permanently marked with the following information: name of... Guard Approval Number, and the words “FIRST-AID KIT.” This information may be embossed on the...

  20. 46 CFR 160.054-6 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Inflatable Liferafts § 160.054-6 Marking. (a) Each approved first-aid kit shall be plainly and permanently marked with the following... kit, the Coast Guard approval number, and the words “First-Aid Kit—For Inflatable Life Rafts”. If...

  1. 46 CFR 160.041-6 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Merchant Vessels § 160.041-6 Marking. (a) Each approved first-aid kit shall be permanently marked with the following information: name of... Guard Approval Number, and the words “FIRST-AID KIT.” This information may be embossed on the...

  2. 46 CFR 160.054-6 - Marking.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Inflatable Liferafts § 160.054-6 Marking. (a) Each approved first-aid kit shall be plainly and permanently marked with the following... kit, the Coast Guard approval number, and the words “First-Aid Kit—For Inflatable Life Rafts”. If...

  3. 46 CFR 160.054-6 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Inflatable Liferafts § 160.054-6 Marking. (a) Each approved first-aid kit shall be plainly and permanently marked with the following... kit, the Coast Guard approval number, and the words “First-Aid Kit—For Inflatable Life Rafts”. If...

  4. 46 CFR 160.041-6 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Merchant Vessels § 160.041-6 Marking. (a) Each approved first-aid kit shall be permanently marked with the following information: name of... Guard Approval Number, and the words “FIRST-AID KIT.” This information may be embossed on the...

  5. 46 CFR 160.041-6 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Merchant Vessels § 160.041-6 Marking. (a) Each approved first-aid kit shall be permanently marked with the following information: name of... Guard Approval Number, and the words “FIRST-AID KIT.” This information may be embossed on the...

  6. 46 CFR 160.054-6 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Kits, First-Aid, for Inflatable Liferafts § 160.054-6 Marking. (a) Each approved first-aid kit shall be plainly and permanently marked with the following... kit, the Coast Guard approval number, and the words “First-Aid Kit—For Inflatable Life Rafts”. If...

  7. 14 CFR 27.1555 - Control markings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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....

  8. 14 CFR 29.1555 - Control markings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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....

  9. 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....

  10. 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....

  11. 14 CFR 25.1555 - Control markings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Operating Limitations and Information Markings and Placards § 25... aerodynamic control must be marked under the requirements of §§ 25.677 and 25.699. (c) For powerplant...

  12. 14 CFR 25.1555 - Control markings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Operating Limitations and Information Markings and Placards § 25... aerodynamic control must be marked under the requirements of §§ 25.677 and 25.699. (c) For powerplant...

  13. 46 CFR 169.545 - Markings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Firefighting Equipment Personal Flotation Devices § 169.545 Markings. (a) Each personal flotation device must... persons onboard, the containers in which they are stowed must be marked “adult personal flotation devices” or “child personal flotation devices”, as appropriate, and with the number contained therein, in...

  14. 46 CFR 161.012-15 - Markings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Markings. 161.012-15 Section 161.012-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL ELECTRICAL EQUIPMENT Personal Flotation Device Lights § 161.012-15 Markings. (a)...

  15. Effects of heat on cut mark characteristics.

    PubMed

    Waltenberger, Lukas; Schutkowski, Holger

    2017-02-01

    Cut marks on bones provide crucial information about tools used and their mode of application, both in archaeological and forensic contexts. Despite a substantial amount of research on cut mark analysis and the influence of fire on bones (shrinkage, fracture pattern, recrystallisation), there is still a lack of knowledge in cut mark analysis on burnt remains. This study provides information about heat alteration of cut marks and whether consistent features can be observed that allow direct interpretation of the implemented tools used. In a controlled experiment, cut marks (n=25) were inflicted on pig ribs (n=7) with a kitchen knife and examined using micro-CT and digital microscopy. The methods were compared in terms of their efficacy in recording cut marks on native and heat-treated bones. Statistical analysis demonstrates that floor angles and the maximum slope height of cuts undergo significant alteration, whereas width, depth, floor radius, slope, and opening angle remain stable. Micro-CT and digital microscopy are both suitable methods for cut mark analysis. However, significant differences in measurements were detected between both methods, as micro-CT is less accurate due to the lower resolution. Moreover, stabbing led to micro-fissures surrounding the cuts, which might also influence the alteration of cut marks.

  16. 46 CFR 160.064-4 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Marine Buoyant Devices § 160.064-4 Marking. (a) Each water safety buoyant device must have the following information clearly marked in waterproof lettering: (1) For... recreational boats and on uninspected commercial vessels less than 40 feet in length not carrying...

  17. RANDOM PULSE GENERATOR PRODUCING FIDUCIAL MARKS

    DOEpatents

    Nielsen, W.F.

    1960-02-01

    The apparatus for automatically applying a fiducial marking, having a nonrepetitive pattern, to a plurality of simultaneously made records comprises, in series, a bypass filter, a trigger circuit, and a pulse generator, with printing means connected to and controlled by the pulse generator for simultaneously making the visible fiducial marks on a plurality of simultaneously produced records.

  18. 40 CFR 761.45 - Marking formats.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Large PCB Mark—M L. Mark ML shall be as shown in Figure 1, letters and striping on a white or yellow background and shall be sufficiently durable to equal or exceed the life (including storage for disposal) of... PCB Mark—M s. Mark Ms shall be as shown in Figure 2, letters and striping on a white or...

  19. 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....

  20. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Lateral marks. 62.25 Section 62.25 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 § 62.25 Lateral marks....

  1. 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....

  2. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Lateral marks. 62.25 Section 62.25 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 § 62.25 Lateral marks....

  3. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Lateral marks. 62.25 Section 62.25 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 § 62.25 Lateral marks....

  4. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Lateral marks. 62.25 Section 62.25 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 § 62.25 Lateral marks....

  5. 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....

  6. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Lateral marks. 62.25 Section 62.25 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 § 62.25 Lateral marks....

  7. 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....

  8. 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....

  9. 9 CFR 316.9 - Products to be marked with official marks.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... liver, beef tongue, and beef heart which has been inspected and passed shall be marked with the official..., brisket, chuck, and shank. (c) Beef livers shall be marked with the official inspection legend...

  10. 9 CFR 316.9 - Products to be marked with official marks.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... liver, beef tongue, and beef heart which has been inspected and passed shall be marked with the official..., brisket, chuck, and shank. (c) Beef livers shall be marked with the official inspection legend...

  11. IgM+IgD+CD27+ B cells are markedly reduced in IRAK-4-, MyD88-, and TIRAP- but not UNC-93B-deficient patients.

    PubMed

    Weller, Sandra; Bonnet, Mélanie; Delagreverie, Héloïse; Israel, Laura; Chrabieh, Maya; Maródi, László; Rodriguez-Gallego, Carlos; Garty, Ben-Zion; Roifman, Chaim; Issekutz, Andrew C; Zitnik, Simona Eva; Hoarau, Cyrille; Camcioglu, Yildiz; Vasconcelos, Júlia; Rodrigo, Carlos; Arkwright, Peter D; Cerutti, Andrea; Meffre, Eric; Zhang, Shen-Ying; Alcais, Alexandre; Puel, Anne; Casanova, Jean-Laurent; Picard, Capucine; Weill, Jean-Claude; Reynaud, Claude-Agnès

    2012-12-13

    We studied the distribution of peripheral B-cell subsets in patients deficient for key factors of the TLR-signaling pathways (MyD88, TIRAP/MAL, IL-1 receptor-associated kinase 4 [IRAK-4], TLR3, UNC-93B, TRIF). All TLRs, except TLR3, which signals through the TRIF adaptor, require MyD88 and IRAK-4 to mediate their function. TLR4 and the TLR2 heterodimers (with TLR1, TLR6, and possibly TLR10) require in addition the adaptor TIRAP, whereas UNC-93B is needed for the proper localization of intracellular TLR3, TLR7, TLR8, and TLR9. We found that IgM(+)IgD(+)CD27(+) but not switched B cells were strongly reduced in MyD88-, IRAK-4-, and TIRAP-deficient patients. This defect did not appear to be compensated with age. However, somatic hypermutation of Ig genes and heavy-chain CDR3 size distribution of IgM(+)IgD(+)CD27(+) B cells were not affected in these patients. In contrast, the numbers of IgM(+)IgD(+)CD27(+) B cells were normal in the absence of TLR3, TRIF, and UNC-93B, suggesting that UNC-93B-dependent TLRs, and notably TLR9, are dispensable for the presence of this subset in peripheral blood. Interestingly, TLR10 was found to be expressed at greater levels in IgM(+)IgD(+)CD27(+) compared with switched B cells in healthy patients. Hence, we propose a role for TIRAP-dependent TLRs, possibly TLR10 in particular, in the development and/or maintenance of IgM(+)IgD(+)CD27(+) B cells in humans.

  12. High contrast laser marking of alumina

    NASA Astrophysics Data System (ADS)

    Penide, J.; Quintero, F.; Riveiro, A.; Fernández, A.; del Val, J.; Comesaña, R.; Lusquiños, F.; Pou, J.

    2015-05-01

    Alumina serves as raw material for a broad range of advanced ceramic products. These elements should usually be identified by some characters or symbols printed directly on them. In this sense, laser marking is an efficient, reliable and widely implemented process in industry. However, laser marking of alumina still leads to poor results since the process is not able to produce a dark mark, yielding bad contrast. In this paper, we present an experimental study on the process of marking alumina by three different lasers working in two wavelengths: 1064 nm (Near-infrared) and 532 nm (visible, green radiation). A colorimetric analysis has been carried out in order to compare the resulting marks and its contrast. The most suitable laser operating conditions were also defined and are reported here. Moreover, the physical process of marking by NIR lasers is discussed in detail. Field Emission Scanning Electron Microscopy, High Resolution Transmission Electron Microscopy and X-ray Photoelectron Spectroscopy were also employed to analyze the results. Finally, we propose an explanation for the differences of the coloration induced under different atmospheres and laser parameters. We concluded that the atmosphere is the key parameter, being the inert one the best choice to produce the darkest marks.

  13. From requirements to acceptance tests

    NASA Technical Reports Server (NTRS)

    Baize, Lionel; Pasquier, Helene

    1993-01-01

    From user requirements definition to accepted software system, the software project management wants to be sure that the system will meet the requirements. For the development of a telecommunication satellites Control Centre, C.N.E.S. has used new rules to make the use of tracing matrix easier. From Requirements to Acceptance Tests, each item of a document must have an identifier. A unique matrix traces the system and allows the tracking of the consequences of a change in the requirements. A tool has been developed, to import documents into a relational data base. Each record of the data base corresponds to an item of a document, the access key is the item identifier. Tracing matrix is also processed, providing automatically links between the different documents. It enables the reading on the same screen of traced items. For example one can read simultaneously the User Requirements items, the corresponding Software Requirements items and the Acceptance Tests.

  14. Defining acceptable conditions in wilderness

    NASA Astrophysics Data System (ADS)

    Roggenbuck, J. W.; Williams, D. R.; Watson, A. E.

    1993-03-01

    The limits of acceptable change (LAC) planning framework recognizes that forest managers must decide what indicators of wilderness conditions best represent resource naturalness and high-quality visitor experiences and how much change from the pristine is acceptable for each indicator. Visitor opinions on the aspects of the wilderness that have great impact on their experience can provide valuable input to selection of indicators. Cohutta, Georgia; Caney Creek, Arkansas; Upland Island, Texas; and Rattlesnake, Montana, wilderness visitors have high shared agreement that littering and damage to trees in campsites, noise, and seeing wildlife are very important influences on wilderness experiences. Camping within sight or sound of other people influences experience quality more than do encounters on the trails. Visitors’ standards of acceptable conditions within wilderness vary considerably, suggesting a potential need to manage different zones within wilderness for different clientele groups and experiences. Standards across wildernesses, however, are remarkably similar.

  15. The Effectiveness, cost-effectiveness and acceptability of Community versus Hospital Eye Service follow-up for patients with neovascular age-related macular degeneration with quiescent disease (ECHoES): a virtual randomised balanced incomplete block trial.

    PubMed Central

    Reeves, Barnaby C; Scott, Lauren J; Taylor, Jodi; Hogg, Ruth; Rogers, Chris A; Wordsworth, Sarah; Townsend, Daisy; Muldrew, Alyson; Peto, Tunde; Violato, Mara; Dakin, Helen; Cappel-Porter, Heike; Mills, Nicola; O'Reilly, Dermot; Harding, Simon P; Chakravarthy, Usha

    2016-01-01

    -effectiveness and acceptability of Community versus Hospital Eye Service follow-up for patients with neovascular age-related macular degeneration with quiescent disease (ECHoES) study web application was robust and could be used for future training or research. The benefit of reducing HES workload was not considered in the economic evaluation. A framework of programme budgeting and marginal analysis could explicitly explore the resource implications of shifting resources within a given health service area, as the benefit of reducing HES workload was not considered in the economic evaluation. Future qualitative research could investigate professional differences of opinion that were identified in multidisciplinary focus groups. TRIAL REGISTRATION Current Controlled Trials ISRCTN07479761. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 80. See the NIHR Journals Library website for further project information. PMID:27809956

  16. A Robust Approach for Mapping Group Marks to Individual Marks Using Peer Assessment

    ERIC Educational Resources Information Center

    Spatar, Ciprian; Penna, Nigel; Mills, Henny; Kutija, Vedrana; Cooke, Martin

    2015-01-01

    Group work can form a substantial component of degree programme assessments. To satisfy institutional and student expectations, students must often be assigned individual marks for their contributions to the group project, typically by mapping a single holistic group mark to individual marks using peer assessment scores. Since the early 1990s,…

  17. Evaluation and differential diagnosis of marked, persistent eosinophilia

    PubMed Central

    Mejia, Rojelio; Nutman, Thomas B.

    2012-01-01

    High grade eosinophilia in patients can be a diagnostic dilemma, as the etiologies are extensive and varied. Hypereosinophilic syndromes (HES) are a group of heterogeneous disorders, many of which remain ill-defined. By definition, HES must be distinguished from other disorders with persistently elevated eosinophilia with a defined cause. Although marked eosinophilia worldwide is most commonly caused by helminth (worm) infections, non-infectious causes must be sought including drug reactions, malignancies, and immunologic, inflammatory and allergic diseases. PMID:22449625

  18. 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

  19. 19 CFR 134.52 - Certificate of marking.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TREASURY COUNTRY OF ORIGIN MARKING Articles Found Not Legally Marked § 134.52 Certificate of marking. (a... provision of § 141.20 of this chapter, to certify that marking of the country of origin on imported...

  20. 19 CFR 134.52 - Certificate of marking.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TREASURY COUNTRY OF ORIGIN MARKING Articles Found Not Legally Marked § 134.52 Certificate of marking. (a... provision of § 141.20 of this chapter, to certify that marking of the country of origin on imported...

  1. Mark-Recapture Experiments with Freshwater Organisms.

    ERIC Educational Resources Information Center

    Dussart, Georges

    1991-01-01

    The population of Gyrinus, the whirligig beetle, is assessed using the Lincoln mark-recapture index. This technique has the advantage of helping the student to understand simple proportion as well as other concepts. (Author)

  2. 49 CFR 178.318-3 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS SPECIFICATIONS FOR PACKAGINGS Specifications for Containers for Motor Vehicle Transportation § 178.318-3 Marking. Each container must be...

  3. 27 CFR 24.259 - Marks.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... the bottlers wine premises; (3) The kind (class and type) and the alcohol content of the wine. The... removed in cases, the cases may be marked to show the number and size of bottles or other containers...

  4. 46 CFR 162.050-11 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Pollution Prevention Equipment § 162.050-11 Marking. (a) Each... other chemical compounds that do not impair operation of the item. (8) If the item is an oil...

  5. 46 CFR 160.076-39 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of the inflation mechanism approved for use on the PFD. (2) (e) Inflation mechanisms. Each manual, automatic, or manual-auto inflation mechanism must be permanently marked with its unique model number....

  6. 46 CFR 162.161-8 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Fixed Clean Agent Fire Extinguishing Systems § 162.161-8 Marking. The following information must be displayed on a permanent metal or pressure-sensitive...

  7. 46 CFR 162.161-8 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Fixed Clean Agent Fire Extinguishing Systems § 162.161-8 Marking. The following information must be displayed on a permanent metal or pressure-sensitive...

  8. 22 CFR 226.91 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., reports, papers, publications, audio-visual productions, public service announcements, Web sites/Internet... items too small or other otherwise unsuited for individual marking, such as food in bulk. (vi)...

  9. 46 CFR 164.023-15 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... The manufacturer must ensure that each shipping label, and each spool or individual unit of put-up, is... markings specified in paragraph (a) of this section, each unit of put-up of non-standard thread must...

  10. Mark Twain, Fenimore Cooper, and Batman.

    ERIC Educational Resources Information Center

    Crick, Robert Alan

    1992-01-01

    Describes how Mark Twain's essay "Fenimore Cooper's Literary Offenses" helped students to get interested in writing and inspired them to write a similar essay critiquing the movie "Batman." Provides excerpts from students' essays. (PRA)

  11. 46 CFR 98.25-15 - Markings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., AND OTHER PROVISIONS FOR CERTAIN DANGEROUS CARGOES IN BULK Anhydrous Ammonia in Bulk § 98.25-15..., the legend, “Anhydrous Ammonia” shall be conspicuously and legibly marked upon the dome or...

  12. 46 CFR 98.25-15 - Markings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., AND OTHER PROVISIONS FOR CERTAIN DANGEROUS CARGOES IN BULK Anhydrous Ammonia in Bulk § 98.25-15..., the legend, “Anhydrous Ammonia” shall be conspicuously and legibly marked upon the dome or...

  13. 46 CFR 98.25-15 - Markings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., AND OTHER PROVISIONS FOR CERTAIN DANGEROUS CARGOES IN BULK Anhydrous Ammonia in Bulk § 98.25-15..., the legend, “Anhydrous Ammonia” shall be conspicuously and legibly marked upon the dome or...

  14. 46 CFR 98.25-15 - Markings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., AND OTHER PROVISIONS FOR CERTAIN DANGEROUS CARGOES IN BULK Anhydrous Ammonia in Bulk § 98.25-15..., the legend, “Anhydrous Ammonia” shall be conspicuously and legibly marked upon the dome or...

  15. 46 CFR 98.25-15 - Markings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., AND OTHER PROVISIONS FOR CERTAIN DANGEROUS CARGOES IN BULK Anhydrous Ammonia in Bulk § 98.25-15..., the legend, “Anhydrous Ammonia” shall be conspicuously and legibly marked upon the dome or...

  16. 30 CFR 7.105 - Approval marking.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Diesel Power Packages Intended for Use in Areas of Underground Coal Mines Where Permissible Electric Equipment is Required § 7.105 Approval marking....

  17. 46 CFR 162.050-11 - Marking.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Pollution Prevention Equipment § 162.050-11 Marking. (a) Each... other chemical compounds that do not impair operation of the item. (8) If the item is an oil...

  18. 46 CFR 162.050-11 - Marking.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: SPECIFICATIONS AND APPROVAL ENGINEERING EQUIPMENT Pollution Prevention Equipment § 162.050-11 Marking. (a) Each... other chemical compounds that do not impair operation of the item. (8) If the item is an oil...

  19. 46 CFR 162.018-6 - Marking.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... valve or stamped or cast on a plate securely fastened to the valve. The marking shall include the following data: (1) The name or identifying trademark of the manufacturer. (2) Manufacturer's design or...

  20. 46 CFR 162.018-6 - Marking.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... valve or stamped or cast on a plate securely fastened to the valve. The marking shall include the following data: (1) The name or identifying trademark of the manufacturer. (2) Manufacturer's design or...

  1. 30 CFR 7.409 - Approval marking.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... approval number in addition to the number and size (gauge) of conductors and cable type. For cables containing electric conductors, the marking shall also include the voltage rating. For splices, the...

  2. 7 CFR 160.32 - Marking containers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) NAVAL STORES REGULATIONS AND... interested person shall provide any labor necessary for marking the containers, after the contents have...

  3. On Optical Mark-Sense Scanning

    NASA Astrophysics Data System (ADS)

    Jones, Douglas W.

    Optical mark-sense scanning has lead to a resurgence in the use of paper ballots in the United States, despite a century of strong competition from paperless direct-recording voting systems. By the time mark-sense technology emerged, procedural measures had been developed to counter most of the vulnerabilities of paper ballots. Automatic counting of paper ballots poses technical and legal problems, but by counting the paper ballots automatically in the presence of the voter, mark-sense systems address some of the remaining problems with paper ballots. The best current technology uses precinct-count optical scanners to capture pixelized images of each ballot and then process the marks on that image. While this technology may be among the best voting technologies available today for the conduct of complex general elections, it faces one significant problem, access to voters with disabilities. There are promising solutions to this problem, but work remains to be done.

  4. 33 CFR 401.6 - Markings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... markings. (c) Where a vessel's bulbous bow extends forward beyond her stem head, a symbol of a bulbous bow... number indicating the total length in meters by which the bulbous bow projects beyond the stem. (68...

  5. 33 CFR 401.6 - Markings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... markings. (c) Where a vessel's bulbous bow extends forward beyond her stem head, a symbol of a bulbous bow... number indicating the total length in meters by which the bulbous bow projects beyond the stem. (68...

  6. 33 CFR 401.6 - Markings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... markings. (c) Where a vessel's bulbous bow extends forward beyond her stem head, a symbol of a bulbous bow... number indicating the total length in meters by which the bulbous bow projects beyond the stem. (68...

  7. Further Conceptualization of Treatment Acceptability

    ERIC Educational Resources Information Center

    Carter, Stacy L.

    2008-01-01

    A review and extension of previous conceptualizations of treatment acceptability is provided in light of progress within the area of behavior treatment development and implementation. Factors including legislation, advances in research, and service delivery models are examined as to their relationship with a comprehensive conceptualization of…

  8. Acceptance and Commitment Therapy: Introduction

    ERIC Educational Resources Information Center

    Twohig, Michael P.

    2012-01-01

    This is the introductory article to a special series in Cognitive and Behavioral Practice on Acceptance and Commitment Therapy (ACT). Instead of each article herein reviewing the basics of ACT, this article contains that review. This article provides a description of where ACT fits within the larger category of cognitive behavior therapy (CBT):…

  9. Nitrogen trailer acceptance test report

    SciTech Connect

    Kostelnik, A.J.

    1996-02-12

    This Acceptance Test Report documents compliance with the requirements of specification WHC-S-0249. The equipment was tested according to WHC-SD-WM-ATP-108 Rev.0. The equipment being tested is a portable contained nitrogen supply. The test was conducted at Norco`s facility.

  10. Imaginary Companions and Peer Acceptance

    ERIC Educational Resources Information Center

    Gleason, Tracy R.

    2004-01-01

    Early research on imaginary companions suggests that children who create them do so to compensate for poor social relationships. Consequently, the peer acceptance of children with imaginary companions was compared to that of their peers. Sociometrics were conducted on 88 preschool-aged children; 11 had invisible companions, 16 had personified…

  11. Euthanasia Acceptance: An Attitudinal Inquiry.

    ERIC Educational Resources Information Center

    Klopfer, Fredrick J.; Price, William F.

    The study presented was conducted to examine potential relationships between attitudes regarding the dying process, including acceptance of euthanasia, and other attitudinal or demographic attributes. The data of the survey was comprised of responses given by 331 respondents to a door-to-door interview. Results are discussed in terms of preferred…

  12. Helping Our Children Accept Themselves.

    ERIC Educational Resources Information Center

    Gamble, Mae

    1984-01-01

    Parents of a child with muscular dystrophy recount their reactions to learning of the diagnosis, their gradual acceptance, and their son's resistance, which was gradually lessened when he was provided with more information and treated more normally as a member of the family. (CL)

  13. Enamel-based mark performance for marking Chinese mystery snail Bellamya chinensis

    USGS Publications Warehouse

    Wong, Alec; Allen, Craig R.; Hart, Noelle M.; Haak, Danielle M.; Pope, Kevin L.; Smeenk, Nicholas A.; Stephen, Bruce J.; Uden, Daniel R.

    2013-01-01

    The exoskeleton of gastropods provides a convenient surface for carrying marks, and i the interest of improving future marking methods our laboratory assessed the performance of an enamel paint. The endurance of the paint was also compared to other marking methods assessed in the past. We marked the shells of 30 adult Chinese mystery snails Bellamya chinensis and held them in an aquarium for 181 days. We observed no complete degradation of any enamel-paint mark during the 181 days. The enamel-paint mark was superior to a nai;-polish mark, which lasted a median of 100 days. Enamel-paint marks also have a lower rate of loss (0.00 month-1 181 days) than plastic bee tags (0.01 month-1, 57 days), gouache paint (0.07 month-1, 18.5 days), or car body paint from studies found in scientific literature. Legibility of enamel-paint marks had a median lifetime of 102 days. The use of enamel paint on the shells of gastropods is a viable option for studies lasting up to 6 months. Furthermore, visits to capture-mark-recapture site 1 year after application of enamel-paint marks on B. chinesnis shells produced several individuals on which the enamel paint was still visible, although further testing is required to clarify durability over longer periods.

  14. Preliminary results of thoracoscopic Belsey Mark IV antireflux procedure.

    PubMed

    Nguyen, N T; Schauer, P R; Hutson, W; Landreneau, R; Weigel, T; Ferson, P F; Keenan, R J; Luketich, J D

    1998-06-01

    Laparoscopic Nissen fundoplication has replaced open approaches for refractory gastroesophageal reflux disease (GERD) in many major medical centers. Here we report our preliminary results of the Belsey Mark IV antireflux procedure performed by video-assisted thoracoscopy (VATS-Belsey). Fifteen patients underwent VATS-Belsey. The indications for surgery included GERD refractory to medical therapy (n=10), achalasia (n=2), diffuse esophageal spasms (n=1), epiphrenic esophageal diverticulum (n=1), and paraesophageal hernia (n=1). The median operative time was 235 min. There were three conversions to open minithoracotomy (8-10 cm) necessitated by severe adhesions (n=2) and repair of a gastric perforation (n=1). The median hospital stay was 4 days. Postoperative complications included persistent air leaks, requiring discharge with a Heimlich valve in one patient. There were no perioperative deaths. At a median follow-up of 19 months, ten patients (66%) were asymptomatic and were not taking any antacids. One patient who had taken proton pump inhibitors preoperatively required postoperative H2 blockers for mild heartburn. In three patients, recurrent GERD symptoms (mean follow-up 6 months) led to laparoscopic takedown of the Belsey and Nissen fundoplication. One patient with achalasia, who had recurrent dysphagia after 1 year of relief following VATS myotomy and Belsey, underwent esophagectomy. The Belsey Mark IV antireflux procedure is technically feasible by VATS with minimal morbidity. However, our preliminary results suggest that open thoracotomy for Belsey Mark IV should remain the standard operation for GERD with poor esophageal motility when a thoracic approach is desired. We have modified our approach to laparoscopic partial fundoplications (Toupet or Dor) for severe GERD and poor esophageal motility when an abdominal approach is possible.

  15. Marking cabbage looper (Lepidoptera: Noctuidae) with cesium

    SciTech Connect

    Moss, J.I.; Van Steenwyk, R.A.

    1984-04-01

    Cabbage loopers (CL), Trichoplusia ni (Huebner), adults reared on artificial diet containing 1 x 10/sup -2/ M and 1 x 10/sup -3/ M CsCl were marked with cesium (Cs) which could be detected by atomic absorption spectrophotometry. The cesium marks from the 10/sup -2/ M CsCl diet were sufficient to last the expected lifetime of the insects. CL reared on diet containing 1 x 10/sup -1/ M CsCl did not survive. Unmarked females mated to males reared on artificial diet containing 1 x 10/sup -2/ M and 1 x 10/sup -3/ M CsCl were marked. CL reared on cotton plants sprayed with Cs solutions of 1000, 5000, and 10,000 ..mu..g/ml were marked sufficiently to last the expected lifetime of the insect. CL adults exposed for 72 h to cotton plants sprayed with Cs solutions of 1000, 5000, and 10,000 ..mu..g/ml were marked sufficiently to last the expected lifetime of the insect. CL adults reared from field cotton plants sprayed with CsCl solutions at rates of 1.24, 2.47, and 4.94 kg of CsCl per ha were marked. 12 references, 1 figure, 5 tables.

  16. When accepting a gift can be professional misconduct and theft.

    PubMed

    Griffith, Richard

    2016-07-01

    Gifts are often given as tokens of gratitude by grateful patients to district nurses. However, there are circumstances where the Nursing and Midwifery Council (NMC), as the professional regulator, and the courts, have held that accepting gifts, large or small, from vulnerable adults is dishonest and amounts to professional misconduct and even theft. Richard Griffith discusses the circumstances where a district nurse who accepts a gift can face a fitness-to-practise investigation and an allegation of theft.

  17. Noninvasive computed tomography-guided marking technique for peripheral pulmonary nodules

    PubMed Central

    Matsuura, Yosuke; Nakao, Masayuki; Ichinose, Junji; Nakagawa, Ken; Okumura, Sakae

    2016-01-01

    Background Identification of the exact location of small peripheral pulmonary nodules during thoracoscopic wedge resection (TWR) is crucial. We describe a new method of computed tomography (CT)-guided marking without puncturing the visceral pleura (VP) for minimally palpable pulmonary nodules. Methods Preoperative CT scans were performed 1 day before TWR with the patient in the lateral decubitus position. Under CT guidance, we marked the skin over the pulmonary nodule. During TS, an indwelling catheter was inserted perpendicular to the marked skin surface and put a mark with gentian violet (Pyoktanin blue®, Wako Pure Chemical Industries, Osaka, Japan) onto the VP. We palpated the nodules near the mark(s) and performed TWR. Results Between October 2012 and April 2016, we performed CT-guided marking in 54 patients (24 males and 30 females, median age 65 years). Cases included 39 primary lung cancers, 10 metastatic lung tumors, and 5 benign tumors. The mean diameter of the nodules was 10 mm (range, 3–26 mm), and the mean distance of the nodule from the VP was 4 mm (range, 0–17 mm). The mean time of intraoperative marking was 3.5 min (range, 1–4.5 min). The mean distance from the nodule to the marking point was 7.0 mm (range, 0–30 mm). We were able to identify the location of the nodule using this procedure in 53 patients (98%). Hematoma of the chest wall after marking was observed in one patient. There were no other complications. Conclusions This marking technique is a simple, economic, and effective procedure to locate small peripheral pulmonary nodules during TWR. PMID:28066668

  18. Share 35 Changes Center Level Liver Acceptance Practices.

    PubMed

    Goldberg, David S; Levine, Matthew; Karp, Seth; Gilroy, Richard; Abt, Peter L

    2017-02-27

    Share 35 was implemented to provide improved access to organs for patients with MELD scores ≥35. However, little is known about the impact of Share 35 on organ offer acceptance rates. We evaluated all liver offers to adult patients that were ultimately transplanted between 1/1/2011-12/31/2015. The analyses focused on patients ranked in the top five positions of a given match run, and used multi-level mixed-effects models, clustering on individual waitlist candidate and transplant center. There was a significant interaction between Share 35 era and MELD category (p<0.001). Comparing offers to MELD score ≥35 patients, offers post-Share 35 were 36% less likely to be accepted compared to offers to MELD score ≥35 patients pre-Share 35 (adjusted OR: 0.64). There was no clinically meaningful difference in the DRI of livers that were declined for patients with an allocation MELD score ≥35 in the pre- vs post-Share 35 era. Organ offer acceptance rates for patients with an allocation MELD≥35 decreased in every region post-Share 35; the magnitude of these changes was bigger in regions 2, 3, 4, 5, 6, 7, and 11, compared to regions 8 and 9 that had regional sharing in place pre-Share 35. There were significant changes in organ offer acceptance rates at the center level pre- vs post-Share 35, and these changes varied across centers (p<0.001).

  19. 78 FR 35990 - All Operating Boiling-Water Reactor Licensees With Mark I And Mark II Containments; Docket Nos...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-14

    ... COMMISSION All Operating Boiling-Water Reactor Licensees With Mark I And Mark II Containments; Docket Nos... Licensees operate boiling-water reactors (BWRs) with Mark I and Mark II containment designs. II. The events... Boiling Water Reactors with Mark I and Mark II Containments'' (November 26, 2012). Option 2 in...

  20. [The ideographic iteration mark in Senkinho].

    PubMed

    Matsuoka, Takanori; Yamashita, Koichi; Murasaki, Toru

    2006-06-01

    In the 7th century, Senkinho was written by Sonshibaku in the Tang dynasty China. This book that was altered in 1066 in the north Sung dynasty China has become known in the world now. However four series of books remained intact, as they were not modified. The names of each book were Senkinho Kentoushi-syouraibon, the Shincho-sonshinjin senkinho, Stein book, and the Kozlov book. Senkinho Kentoushi-syouraibon and Shincho-sonshinjin Senkinho are in Japan, while Stein and the Kozlov books are in the United Kingdom and Russia respectively. We researched the ideographic iteration marks in these books. In Senkinho Kentoushi-syouraibon, several ideographic iteration marks were used. But in Shincho-sonshinjin senkinho and the Kozlov book, only one ideographic iteration mark was used. Furthermore, there were two types of ideographic iteration marks in the Chinese character text of Senkinho Kentoushi-syouraibon. We estimated that the ideographic iteration marks in the Katakana character were transcribed between the middle era of Kamakura Japan and the early era of Muromachi Japan.