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Sample records for adult pectus excavatum

  1. Minimally invasive repair of pectus excavatum (MIRPE) in adults: is it a proper choice?

    PubMed Central

    Demirkaya, Ahmet; Kılıç, Burcu; Kara, Hasan Volkan; Yakşi, Osman; Alizade, Nurlan; Demirhan, Özkan; Sayılgan, Cem; Turna, Akif; Kaynak, Kamil

    2016-01-01

    Introduction The Nuss procedure is suitable for prepubertal and early pubertal patients but can also be used in adult patients. Aim To determine whether the minimally invasive technique (MIRPE) can also be performed successfully in adults. Material and methods Between July 2006 and January 2016, 836 patients (744 male, 92 female) underwent correction of pectus excavatum with the MIRPE technique at our institution. The mean age was 16.8 years (2–45 years). There were 236 adult patients (28.2%) (> 18 years) – 20 female, 216 male. The mean age among the adult patients was 23.2 years (18–45 years). The recorded data included length of hospital stay, postoperative complications, number of bars used, duration of the surgical procedure and signs of pneumothorax on the postoperative chest X-ray. Results The MIRPE was performed in 236 adult patients. The average operative time was 44.4 min (25–90 min). The median postoperative stay was 4.92 ±2.81 days (3–21 days) in adults and 4.64 ±1.58 (2–13) in younger patients. The difference was not statistically significant (p = 0.637). Two or more bars were used in 36 (15.8%) adult patients and in 44 (7.5%) younger patients. The difference was not statistically significant either (p = 0.068). Regarding the overall complications, complication rates among the adult patients and younger patients were 26.2% and 11.8% respectively. The difference was statistically significant (p = 0.007). Conclusions MIRPE is a feasible procedure that produces good long-term results in the treatment of pectus excavatum in adults. PMID:27458490

  2. Nuss procedure for repair of pectus excavatum after failed Ravitch procedure in adults: indications and caveats

    PubMed Central

    Kocher, Gregor J.; Gstrein, Nathalie; Jaroszewski, Dawn E.; Ewais, Mennatallah M.

    2016-01-01

    Background Recurrence of pectus excavatum (PE) is not an uncommon problem after open repair using the Ravitch technique. The optimal approach for redo surgery is still under debate, especially in adults with less chest wall pliability. Aim of this study was to investigate the usefulness and efficacy of the minimally invasive Nuss technique for repair of recurrent PE after conventional open repair. Methods We performed a retrospective multicentre review of 20 adult patients from University Hospital Bern (n=6) and the US Mayo Clinic (n=14) who underwent minimally invasive repair of recurrent PE after unsuccessful prior Ravitch procedure. Results Mean patient age at primary open correction was 21 years, with recurrence being evident after a mean duration of 10.5 years (range, 0.25–47 years). Mean age at redo surgery using the Nuss technique was 31 years, with a mean Haller index of 4.7 before and 2.5 after final correction. Main reason for redo surgery was recurrent or persistent deformity (100%), followed by chest pain (75%) and exercise intolerance (75%). No major intraoperative or postoperative complications occurred and successful correction was possible in all patients. Conclusions Although the procedure itself is more challenging, the minimally invasive Nuss technique can be safely and successfully used for repair of recurrent PE after failed open surgery. In our series final results were good to excellent in the majority of patients without major complications or recurrence. PMID:27621850

  3. Management of deep pectus excavatum (DPE)

    PubMed Central

    Tedde, Miguel Lia

    2016-01-01

    The correction of deep pectus excavatum, with the Nuss procedure, frequently require a series of maneuvers that is inherently dangerous. Herein we describe 10 technical modifications to prevent potential complications. These modified techniques have certain advantages and according to the authors, with these maneuvers the risk of pericardial sac, cardiac injury, bar displacement and complications during the removal of the bar could be markedly reduced. PMID:27747181

  4. Diminished pulmonary function in pectus excavatum: from denying the problem to finding the mechanism

    PubMed Central

    Obermeyer, Robert J.; Nuss, Donald

    2016-01-01

    Background Recently, technical improvement in the ability to measure lung function and the severity of chest deformity have enabled progress in understanding the mechanism of limitations of lung function in pectus excavatum. Methods After establishing that most patients with pectus excavatum do have symptoms of exercise intolerance, easy fatigability, and shortness of breath with exertion, lung function has been evaluated by a variety of methods in different centers. Spirometry, plethysmography, exercise testing, oculo electronic plethysmography, and imaging methods have been used to assess lung function in pectus excavatum and its response to surgery. Results Not all patients with pectus excavatum have subnormal static pulmonary function testing; some have above-average values. However, in more than 1500 adult and pediatric surgical patients with anatomically severe pectus excavatum at a single center, the bell curve of FVC, FEV1, and FEF 25-75 is shifted to significantly lower values in pectus excavatum. The curve is shifted to higher values after operation by approximately one standard deviation. Previous work has demonstrated that patients with more anatomically severe pectus excavatum are more likely to have diminished PFT’s. A mechanism for this effect is seen by oculo electronic plethysmography, which demonstrates that the depressed portion of the chest does not move on respiration. After Nuss procedure, the chest wall motion used to create suction to draw air into the lungs is indistinguishable from that of persons with a normal chest, and the intrathoracic volume is markedly increased. Conclusions Pectus excavatum is accompanied in most patients by diminished static pulmonary function. Correction by Nuss procedure results in improvement in chest wall motion; this improvement in the thoracic bellows action is accompanied by improvement in pulmonary function testing. PMID:27747180

  5. [Stanford type a acute aortic dissection with pectus excavatum].

    PubMed

    Kuwata, Toshiyuki; Fukuda, Hirotsugu; Yoshitatsu, Masao; Yamada, Yasuyuki; Shibasaki, Ikuko; Inoue, Yuho; Hori, Takayuki; Ogawa, Hironaga; Tsuchiya, Go; Shimizu, Riha; Takei, Yusuke

    2012-11-01

    Pectus excavatum is generally an isolated abnormality of the chest wall. However, some patients have a concomitant pectus deformity and cardiac & aortic disease. Decisions must be made regarding the operative approach and whether the pectus excavatum should be corrected during the same session. We report 2 patients with acute Stanford type A aortic dissection and pectus excavatum who underwent emergency operation. In case 1, median sternotomy is an unsuitable approach for open heart surgery, since the heart and great vessels are displace into the left hemithorax. But combined sternotomy and left anterior thoracotomy provided excellent surgical exposure. In case 2, we proceeded with a leftsided costotomy of four ribs and place a normal chest retractor providing as excellent exposure as combined sternotomy and left anterior thoracotomy. A left-sided costotomy of four ribs can be performed safely, eliminating the risks of median sternotomy in acute stanford type A aortic dissection with pectus excavatum.

  6. Pectus excavatum from a pediatric surgeon’s perspective

    PubMed Central

    Obermeyer, Robert J.; Kelly, Robert E.

    2016-01-01

    Historically, pectus excavatum (PE) was reported to be congenital, but in our experience only 22% are noticed in the first decade of life. Thus far, genetic studies support an autosomal recessive heritability, which coincides with only 40% of our patients having some positive family history, but is also contradictory given a constant sex ratio of 4:1 in favor of males. This inconsistency may be explained by the effect of more than one pectus disease-associated allele. Once the deformity is noticed, it tends to progress slowly until puberty, when rapid progression is often seen. We recommend surgical repair at around 12–14 years of age since the chest wall is still typically flexible and because this allows us to keep the bar in place as the patient progresses through puberty which may help decrease growth-related recurrences. Patients with mild to moderate PE are treated with therapeutic deep breathing, posturing, and aerobic exercises, and in appropriately selected patients, the vacuum bell may also be offered. Patients that have severe symptomatic PE are offered Minimally Invasive Repair of Pectus Excavatum (MIRPE). The surgical technique in children is similar to that of adults, except for the higher forces involved that often necessitate sternal elevation and more involved stabilization strategies. Postoperative management includes pain control, deep breathing, and early ambulation. Exercise restriction is mandatory for the first six weeks with slow resumption of normal activity after 12 weeks. PMID:27747183

  7. Pectus excavatum: echocardiographic, pathophysiologic, and surgical insights.

    PubMed

    Silbiger, Jeffrey J; Parikh, Aditya

    2016-08-01

    Patients with pectus excavatum (PEX) may be referred for echocardiographic examination for a variety of complaints including exercise intolerance, dyspnea, palpitations, or chest pain. It is therefore important for the echocardiographer to have an appreciation of the various abnormalities associated with this disorder. Echocardiographic imaging may reveal a number of structural alterations of the right ventricle as well as a reduction in right ventricular systolic function. Interestingly, a number of these abnormalities have also been described in patients with arrhythmogenic right ventricular dysplasia, although patients with PEX do not share a predilection for malignant ventricular arrhythmias. Additional echocardiographic abnormalities associated with PEX include prolapse of the mitral and/or tricuspid valves, Marfan's aortopathy, pericardial effusion, prominence of the crista terminalis, and possibly a number of congenital cardiac anomalies. This review discusses the echocardiographic abnormalities associated with PEX and their pathophysiologic significance. The effects of corrective orthopedic surgery on cardiac function are also discussed. PMID:27277386

  8. Pectus Excavatum and Heritable Disorders of the Connective Tissue

    PubMed Central

    Tocchioni, Francesca; Ghionzoli, Marco; Messineo, Antonio; Romagnoli, Paolo

    2013-01-01

    Pectus excavatum, the most frequent congenital chest wall deformity, may be rarely observed as a sole deformity or as a sign of an underlying connective tissue disorder. To date, only few studies have described correlations between this deformity and heritable connective tissue disorders such as Marfan, Ehlers-Danlos, Poland, MASS (Mitral valve prolapse, not progressive Aortic enlargement, Skeletal and Skin alterations) phenotype among others. When concurring with connective tissue disorder, cardiopulmonary and vascular involvement may be associated to the thoracic defect. Ruling out the concomitance of pectus excavatum and connective tissue disorders, therefore, may have a direct implication both on surgical outcome and long term prognosis. In this review we focused on biological bases of connective tissue disorders which may be relevant to the pathogenesis of pectus excavatum, portraying surgical and clinical implication of their concurrence. PMID:24198927

  9. Virtual simulation of the postsurgical cosmetic outcome in patients with Pectus Excavatum

    NASA Astrophysics Data System (ADS)

    Vilaça, João L.; Moreira, António H. J.; L-Rodrigues, Pedro; Rodrigues, Nuno; Fonseca, Jaime C.; Pinho, A. C. M.; Correia-Pinto, Jorge

    2011-03-01

    Pectus excavatum is the most common congenital deformity of the anterior chest wall, in which several ribs and the sternum grow abnormally. Nowadays, the surgical correction is carried out in children and adults through Nuss technic. This technic has been shown to be safe with major drivers as cosmesis and the prevention of psychological problems and social stress. Nowadays, no application is known to predict the cosmetic outcome of the pectus excavatum surgical correction. Such tool could be used to help the surgeon and the patient in the moment of deciding the need for surgery correction. This work is a first step to predict postsurgical outcome in pectus excavatum surgery correction. Facing this goal, it was firstly determined a point cloud of the skin surface along the thoracic wall using Computed Tomography (before surgical correction) and the Polhemus FastSCAN (after the surgical correction). Then, a surface mesh was reconstructed from the two point clouds using a Radial Basis Function algorithm for further affine registration between the meshes. After registration, one studied the surgical correction influence area (SCIA) of the thoracic wall. This SCIA was used to train, test and validate artificial neural networks in order to predict the surgical outcome of pectus excavatum correction and to determine the degree of convergence of SCIA in different patients. Often, ANN did not converge to a satisfactory solution (each patient had its own deformity characteristics), thus invalidating the creation of a mathematical model capable of estimating, with satisfactory results, the postsurgical outcome.

  10. The sandwich technique for repair of pectus carinatum and excavatum/carinatum complex

    PubMed Central

    Kim, Kyung Soo

    2016-01-01

    Background Simple external compression of pectus carinatum seems to have its limitations, particularly the repair of asymmetric pectus carinatum or excavatum/carinatum complex. We devised the sandwich technique (press-molding) to remodel the entire chest wall. The purpose of this study is to introduce the sandwich technique and appraise the early results. Methods Between January 2007 and January 2016, 523 consecutive patients with pectus carinatum and its variants were analyzed retrospectively. No patients were excluded during the study period. The sandwich 1 and 2 techniques using the internal and external pectus bars were for pectus carinatum repair. Modified techniques using the external string and the internal bar were to treat the lower costal flare (the flare-buster) and focal protuberances (the magic string) in pectus excavatum repair. Statistical analyses were carried out using paired and unpaired t-test or Wilcoxon signed rank tests. Results The sandwich repair with the external and internal bars was applied to 58 pectus carinatum patients: seven symmetric (12.1%), 14 asymmetric (24.1%), and 37 carinatum-excavatum complex (63.8%). After pectus excavatum repair, 426 patients had the flare-buster and 39 patients received the magic string. The sandwich 1 technique achieved near-complete resolution of carinatum in 52 patients (86.2%). The sandwich 2 technique accomplished almost symmetric configuration with no residual carinatum in all six cases. Conclusions The sandwich technique using the external and internal bars seems to be effective in treating asymmetric pectus carinatum and complex excavatum/carinatum deformities. The flare-buster and the magic string effectively relieve the costal flare and focal protuberances in pectus excavatum repair. PMID:27747176

  11. Pectus excavatum repair from a plastic surgeon’s perspective

    PubMed Central

    2016-01-01

    Minimally invasive repair of pectus excavatum (MIRPE) or similar procedures for pectus excavatum (PE) repair, nowadays no longer performed by one single speciality, may not always achieve sufficient aesthetic results, particularly in the infrapectoral or infraxiphoidal region. Reasons for this include the diaphragm inhibiting correct positioning of the bars, as well as asymmetric deformities which may still be present after remodelling attempts. Furthermore, some cases develop a mild recurrence or partial concavity once the correction bar is removed. However, any secondary re-do MIRPE procedure remains risky because of adhesions between the pleura, lung, pericardium, thoracic wall as residuals from the primary intervention. Treatment options as secondary correction for these deformities may include open access surgery, resection or reshaping of deformed costal cartilage. Moreover, augmentation of a residual concave area can be achieved by autologous transplantation of resected over-abundant cartilage, as well as by liposhifting or implantation of customized alloplastics. A physician dealing with PE corrections should be familiar with various shaping and complementary reconstructive techniques in order to provide the best options for a variety of expressions of anterior wall deformities. Among treating surgeons, there is an awareness that no single method can be applied for every kind of funnel chest deformity. An appropriate technique, either as a single approach for the ordinary deformities or in conjunction with ancillary procedures for the intricate cases, should be selected carefully based on the heterogeneity of symptoms, severity, expectations and surgical skill in addition to the available equipment. Out of a variety of such ancillary procedures available and based on experience within general plastic reconstructive surgery, some techniques for PE repair are explained and illustrated here with their advantages and disadvantages. PMID:27747184

  12. Is breast asymmetry caused by volume differences in women with pectus excavatum?

    PubMed

    Rha, Eun Young; Kim, Ji-Min; Yoo, Gyeol; Jeong, Jin Yong; Hwang, Duck Ki; Kim, Ki Jun

    2016-04-01

    This study determined the breast volumes of female patients with pectus excavatum that led to asymmetry and hypoplasia compared with normal women. This retrospective study enrolled 13 patients diagnosed with pectus excavatum and 13 normal women, randomly selected from a healthcare centre (n = 26), between January 2012 and December 2014. We measured breast volumes (n = 52) based on chest computed tomography (CT) of all patients using Image J software and divided them into four groups according to the side and presence of pectus excavatum. The mean volumes of the right and left breasts of patients with pectus excavatum were 209 ± 64 mL and 218 ± 67 mL, respectively, with no significant difference between the two groups (P = 0.736). The mean volumes of the right and left breasts of normal women were 415 ± 197 mL and 439 ± 197 mL, respectively, with no significant difference between the two groups (P = 0.754). The breasts of patients with pectus excavatum were significantly smaller than those of normal women (P < 0.001). Both breasts of patients with pectus excavatum were similar in size but were smaller than the breasts of normal women. Skeletal correction for breast asymmetry correction, followed by breast augmentation for breast hypoplasty correction, with a one- or two-step approach may be useful to improve the aesthetics of breast deformities in women with pectus excavatum.

  13. Metal allergy to titanium bars after the Nuss procedure for pectus excavatum.

    PubMed

    Sakamoto, Kazuhiro; Ando, Kohei; Noma, Daisuke

    2014-08-01

    The Nuss procedure requires the placement of metal bars in the chest cage to repair pectus excavatum. Metal allergies are one of the complications associated with this procedure. Given that titanium is a biocompatible metal, it induces few allergic symptoms. Therefore, titanium bars are recommended for patients with metal sensitivity. We report the case of a 17-year-old boy with pectus excavatum who had a metal allergy to titanium bars, which occurred after the Nuss procedure. The administration of oral steroids is useful for treating metal allergies. Metal allergies to titanium bars are very rare; however, they can still occur.

  14. CASE REPORT A Double Thoracodorsal Artery Perforator Flap Technique for the Treatment of Pectus Excavatum

    PubMed Central

    Sinna, Raphaël; Perignon, David; Qassemyar, Quentin; Benhaim, Thomas; Dodreanu, Codrin N.; Berna, Pascal; Delay, Emmanuel

    2010-01-01

    Background: Pectus excavatum is a common congenital deformity involving the anterior thoracic wall. It can be treated with several surgical approaches. Material and methods: To our best of knowledge, this is the first case of pectus excavatum repair via a 2-stage double thoracodorsal artery perforator flap procedure in a 37-year-old patient. Results: We obtained a satisfactory result in which the missing volume was correctly replaced in the absence of dorsal sequelae. The patient was very satisfied despite the dorsal scars. Conclusion: This new approach broadens the surgeon's options for the correction of thoracic deformities. PMID:20458352

  15. Management of severe asymmetric pectus excavatum complicating aortic repair in a patient with Marfan's syndrome.

    PubMed

    Yeung, Jonathan C; Marcuzzi, Danny; Peterson, Mark D; Ko, Michael A

    2016-05-01

    We describe the case of a 28-year old man with Marfan's syndrome and severe pectus excavatum who required an aortic root replacement for an ascending aortic aneurysm. There was a near-vertical angulation of the sternum that presented challenges with opening and exposure of the heart during aortic surgery. Furthermore, removal of the sternal retractor after aortic repair resulted in sudden loss of cardiac output. A Ravitch procedure was then performed to successfully close the chest without further cardiovascular compromise. We propose that patients with a severe pectus excavatum and mediastinal displacement seen on preoperative CT scanning should be considered for simultaneous, elective repair.

  16. Pectus excavatum in relief from Ancient Egypt (dating back to circa 2400 BC).

    PubMed

    Bialas, Adam J; Kaczmarski, Jacek; Kozak, Jozef; Kempinska-Miroslawska, Bogumila

    2015-04-01

    Pectus excavatum is one of the most common congenital deformities of the chest wall. The aim of the study was to analyse 621 artefacts (reliefs, sculptures, paintings) from Ancient Egypt in terms of anatomical defects of the chest. The team which analysed artefacts consisted of historians of medicine and thoracic surgeons. The researchers found a relief, depicting a man with an abnormal shape of the chest. The relief was from Niankhkhnum and Khnumhotep mastaba and dates back to circa 2400 BC. The authors think it is possible that the relief may represent a pectus excavatum deformity and believe the image will open up debate on the occurrence of this deformity in ancient times.

  17. Pectus Excavatum and Pectus Carinatum: Associated Conditions, Family History, and Postoperative Patient Satisfaction

    PubMed Central

    Kuru, Pinar; Cakiroglu, Aylin; Er, Aynur; Ozbakir, Hincal; Cinel, Ali Emin; Cangut, Busra; Iris, Merve; Canbaz, Berkay; Pıçak, Ebru; Yuksel, Mustafa

    2016-01-01

    Background Pectus excavatum (PE) and pectus carinatum (PC) are the most common chest wall deformities. In this study, we aimed to characterize how patients obtained information about these deformities, as well as patients’ family history, associated medical problems, and postoperative satisfaction after the Nuss and Abramson procedures. Methods This cross-sectional retrospective study included patients who were operated by a single surgeon between 2006 and 2013. Follow-up calls were made after approval of our institution’s ethics committee. We reached 207 of the 336 PE patients (61.6%) and 73 of the 96 PC patients (76%). Results The majority of the patients were male (85% of the PE patients and 91.8% of the PC patients). The age of diagnosis of PE was 14.52±0.51 years and the age at the time of operation was 17.89±0.42 years; for PC patients, the corresponding ages were 15.23±0.55 years and 16.77±0.55 years, respectively. A total of 70% of the PE patients and 63.8% of the PC patients obtained information about pectus deformities through the Internet. In 27.1% of the PE patients with an associated anomaly, 57.1% (n=13) had scoliosis, while 41.1% of the PC patients with an associated anomaly had kyphosis (n=5). Postoperative satisfaction, as evaluated on a scale from 0 to 10, was 8.17±0.15 for PE patients and 8.37±0.26 for PC patients. The postoperative pain duration was 51.93±5.18 days for PE patients and 38.5±6.88 days for PC patients. Conclusion In this study, we found that most patients with pectus deformities were male. The Internet was an important resource for patients to learn about their deformities. Family history and associated anomalies were identified as important aspects for consideration in the clinical setting. The patients reported high levels of postoperative satisfaction, and pain management was found to be one of the most important elements of postoperative care. PMID:26889443

  18. Nuss technique in pectus excavatum: a mono-institutional experience

    PubMed Central

    2015-01-01

    Background Pectus excavatum (PE) is the most common anomaly of the anterior chest wall. Prior PE was corrected by a modified Ravitch operation, but since Nuss published his minimal technique in 1998, most surgeons have preferred this technique. Methods Since 2001 the modified Nuss procedure has routinely been used for correction of more than 1,500 patients at Aarhus University Hospital. In the time period between January 1, 2011 and January 31, 2015, 675 patients have been corrected. The median age was 16 years (range, 11-58 years). All patients had preoperatively an epidural catheter and the operations were done in general anaesthesia. The postoperative pain treatment was planned for 4-5 weeks and the patients were routinely seen in the outpatient clinic 6 weeks after surgery and the bars removed after 3 years. Results Four hundred-and-fifty patients had one bar, 216 patients with two bars and nine patients with three bars inserted. The median length of the bar was 10 inch. The median duration of the operation was 29 minutes. The median postoperative stay was 3 days. No death, cardiac perforation or deep infection occurred and only 5% of the patients experienced a complication. Conclusions The Nuss procedure should still be considered in the treatment of PE. To my opinion, it should be the choice for correction of PE. The short bar should be used to achieve the best stability of the system, to obtain a good cosmetic result, a reduced dysfunction motion of the chest wall and an increased cardiac performance. PMID:25984364

  19. Single centre experience on short bar technique for pectus excavatum

    PubMed Central

    2016-01-01

    Background Pectus excavatum (PE) is the most frequent anomaly of the anterior chest wall. Before 2001, all patients in Denmark were referred to the plastic and reconstructive surgeon for implantation of a subcutaneous silicone prosthesis, because the modified Ravitch procedure was not used. Since 2001, all patients have been treated with a modified Nuss procedure, which today has become the gold standard for correction of PE. Methods From September 2001 to March 2016, 1,713 patients have been operated by a modified Nuss procedure using the short bar at Aarhus University Hospital with a male-female ratio 6:1. The median age was 16 years (range 7–58 years). All operations were done in general anesthesia with epidural analgesia and all patients were operated by the same surgeon. All patients were seen routinely 6 weeks after surgery and the bars were removed after 3 years. Results Patients were younger than 18 years in 1,109 cases (65%). The number of bars needed for optimal correction was one in 1,209 patients, two in 486 patients and three in 18 patients. The median length of bar changed from 11 inches to 10 inches during the study period. The annual number of procedures continued to rise during the study period [833 patients during the first 10 years and 880 patients in the last 6 years, though more patients received two bars in the later period, (34%) versus (24%)] and the proportion of patients older than 30 years increased from 7.7% to 10%. The average duration of the operation was 36 minutes (range 12–270 minutes) and did not change significantly during the study period, change in operation time which was around half an hour. The median postoperative hospital stay decreased over time from 6 to 2 days. There was no mortality. Conclusions The modified Nuss procedure with the short bar technique is effective for the correction of PE. The results are stable with a low rate of bar malrotations, and in may most cases can be done in less than an hour in

  20. Early complications of the Nuss procedure for pectus excavatum: a prospective study.

    PubMed

    Castellani, Christoph; Schalamon, Johannes; Saxena, Amulya K; Höellwarth, Michael E

    2008-06-01

    The Nuss procedure is a minimally invasive method for the correction of pectus excavatum, with several centers reporting its successful application. Complications related to the Nuss procedure are not uncommon and life-threatening complications have been reported. This study focuses on the incidence and management of complications in a series of 167 children and adults with funnel chest corrected by Nuss procedure. Guidelines and strategies to avoid the most common and typical complications are proposed. All patients with funnel chest, operated between April 2000 and 2006 were evaluated prospectively. Our surgical approach involved the submuscular insertion of the pectus bar under right-sided thoracoscopic control. The bar was secured in most cases with one stabilizer on the right side on the underlying rib to prevent bar displacement. Postoperative pain was primarily managed by epidural catheters. All data in the patient report forms was prospectively entered in a database. All complications were documented and classified into major or minor complication. A major complication was noted, if an organ injury occurred or if a significant surgical intervention became necessary. A minor complication was documented, if either an endoscopy or an evacuation of fluid or gas from the thorax by puncture were necessary. One hundred and sixty seven patients (136 males and 31 females) with a mean age of 16.3 (range 5-40 years) were included in this study. Major complications occurred in seven patients (4.2%) and consisted of one intraoperative heart perforation, one piercing of the liver with the trocar, bar infections (n = 2) and significant bar displacement (n = 3). Minor complications were seen in 122 patients (73.1%) and consisted of breakage of wires used to secure the lateral stabilizer plate (n = 48), pleural effusions (n = 28), intraoperative rupture of the intercostal muscle (n = 15), pericardial tears without clinical significance (n = 7) and lung atelectasia (n = 4

  1. Advancing our understanding of the inheritance and transmission of pectus excavatum

    PubMed Central

    Horth, Lisa; Stacey, Michael W.; Proud, Virginia K.; Segna, Kara; Rutherford, Chelsea; Nuss, Donald; Kelly, Robert E.

    2012-01-01

    Pectus excavatum is the most common congenital chest wall abnormality expressed in children, yet its inheritance is poorly understood. Here we present the first comprehensive assessment of the inheritance of this disorder. After evaluating 48 pedigrees and 56 clinical traits of probands and family members, we find strong evidence of autosomal recessive, genetic control for this disorder. Additionally there is likely more than one pectus disease-associated allele, as well as a relatively large number of disease allele carriers in the human population. Some clinical traits appear important and may serve as reliable indicators for predicting the likelihood of pectus excavatum in children before severe symptoms present. Quantifying sex-ratio bias in probands demonstrates a highly significant male bias associated with pectus excavatum. When combined with pedigree data, sex-bias is indicative of sex-linked, sex-limited, and/or epigenetic control such as X-inactivation, reiterating a point made with pedigrees alone, which is that more than one mutation is likely responsible for this disorder.

  2. Late coronary artery and tricuspid valve injury post pectus excavatum surgery.

    PubMed

    Bibiloni Lage, Ignacio; Khan, Khalid; Kaabneh, Ahmed; Kendall, Simon

    2013-10-01

    We report the surgical case of a 25-year old man admitted because of progressive dyspnoea and stabbing chest pain, who had undergone a pectus excavatum correction using a retrosternal strut 8 years previously. The computerized tomography scan showed that the right tip of the pectus bar had migrated across his right ventricle and tricuspid valve into the right atrium. Intraoperatively, it was confirmed that in its path, the right coronary artery and the posterior leaflet of the tricuspid valve had been damaged. After removing the bar and repairing the tricuspid valve, the patient made a full recovery.

  3. Variation of the Anthropometric Index for pectus excavatum relative to age, race, and sex

    PubMed Central

    Rebeis, Eduardo Baldassari; de Campos, Jose Ribas Milanez; Moreira, Luis Felipe Pinho; Pastorino, Antonio Carlos; Pêgo-Fernandes, Paulo Manuel; Jatene, Fabio Biscegli

    2013-01-01

    OBJECTIVES: To determine possible variations in the Anthropometric Index for pectus excavatum relative to age, race, and sex in individuals free of thoracic wall deformities. METHODS: Between 2002 and 2012, 166 individuals with morphologically normal thoracic walls consented to have their chests and the perimeter of the lower third of the thorax measured according to the Anthropometric Index for pectus excavatum. The participant characteristics are presented (114 men and 52 women; 118 Caucasians and 48 people of African descent). RESULTS: Measurements of the Anthropometric Index for pectus excavatum were statistically significantly different between men and women (11–40 years old); however, no significant difference was found between Caucasians and people of African descent. For men, the index measurements were not significantly different across all of the age groups. For women, the index measurements were significantly lower for individuals aged 3 to 10 years old than for individuals aged 11 to 20 years old and 21 to 40 years old; however, no such difference was observed between women aged 11 to 20 years old and those aged 21 to 40 years old. CONCLUSION: In the sample, significant differences were observed between women aged 11 to 40 years old and the other age groups; however, there was no difference between Caucasian and people of African descent. PMID:24141837

  4. Medical photography: a reliable and objective method for documenting the results of reconstructive surgery of pectus excavatum.

    PubMed

    van Dijk, Hans; Höppener, Paul F; Siebenga, Jan; Kragten, Hans A

    2011-03-01

    Patients with a pectus excavatum frequently experience medical problems such as dyspnoea, fatigue and palpitations. After surgical intervention most patients are alleviated of their symptoms. Pectus excavatum can easily be diagnosed by a proper inspection of the chest. In the Atrium Medical Center photographic documentation of the deformation of the chest is part of the treatment protocol before and after surgical correction of a pectus excavatum. In addition to the normal photographic routine two special recording techniques are applied: measuring the depth of the excavation with a rule, and documenting the depth of the excavation in a 3-D grid-projection image. The applied 3-D technique (raster stereography) can also be an asset to other medical specialty areas in which changes in body shape and appearance play a major role.

  5. Pectus excavatum postsurgical outcome based on preoperative soft body dynamics simulation

    NASA Astrophysics Data System (ADS)

    Moreira, Antonio H. J.; Rodrigues, Pedro L.; Fonseca, Jaime; Pinho, A. C. M.; Rodrigues, Nuno F.; Correia-Pinto, Jorge; Vilaça, João L.

    2012-02-01

    Pectus excavatum is the most common congenital deformity of the anterior chest wall, in which an abnormal formation of the rib cage gives the chest a caved-in or sunken appearance. Today, the surgical correction of this deformity is carried out in children and adults through Nuss technic, which consists in the placement of a prosthetic bar under the sternum and over the ribs. Although this technique has been shown to be safe and reliable, not all patients have achieved adequate cosmetic outcome. This often leads to psychological problems and social stress, before and after the surgical correction. This paper targets this particular problem by presenting a method to predict the patient surgical outcome based on pre-surgical imagiologic information and chest skin dynamic modulation. The proposed approach uses the patient pre-surgical thoracic CT scan and anatomical-surgical references to perform a 3D segmentation of the left ribs, right ribs, sternum and skin. The technique encompasses three steps: a) approximation of the cartilages, between the ribs and the sternum, trough b-spline interpolation; b) a volumetric mass spring model that connects two layers - inner skin layer based on the outer pleura contour and the outer surface skin; and c) displacement of the sternum according to the prosthetic bar position. A dynamic model of the skin around the chest wall region was generated, capable of simulating the effect of the movement of the prosthetic bar along the sternum. The results were compared and validated with patient postsurgical skin surface acquired with Polhemus FastSCAN system.

  6. The use of soft silicone solid implant molded intraoperatively for pectus excavatum surgical repair

    PubMed Central

    Anger, Jaime; Alcalde, Raphael Francisco Vesterman; de Campos, Jose Ribas Milanez

    2014-01-01

    ABSTRACT Objective: To describe a new surgical technique to treat pectus excavatum utilizing low hardness solid silicone block that can be carved during the intraoperative period promoting a better aesthetic result. Methods: Between May 1994 and February 2013, 34 male patients presenting pectus excavatum were submitted to surgical repair with the use of low hardness solid silicone block, 10 to 30 Shore A. A block-shaped parallelepiped was used with height and base size coinciding with those of the bone defect. The block was carved intraoperatively according to the shape of the dissected space. The patients were followed for a minimum of 120 days postoperatively. The results and the complications were recorded. Results: From the 34 patients operated on, 28 were primary surgeries and 6 were secondary treatment, using other surgical techniques, bone or implant procedures. Postoperative complications included two case of hematomas and eight of seromas. It was necessary to remove the implant in one patient due to pain, and review surgery was performed in another to check prothesis dimensions. Two patients were submitted to fat grafting to improve the chest wall contour. The result was considered satisfactory in 33 patients. Conclusion: The procedure proved to be fast and effective. The results of carved silicone block were more effective for allowing a more refined contour as compared to custom made implants. PMID:25003924

  7. Numerical Simulation and Clinical Verification of the Minimally Invasive Repair of Pectus Excavatum

    PubMed Central

    Zhong, WeiHong; Ye, JinDuo; Liu, JiFu; Zhang, ChunQiu; Zhao, MeiJiao

    2014-01-01

    Objective: In this article we proposed a modeling method by building an assembled model to simulate the orthopedic process of minimally invasive surgery for pectus excavatum and got the clinical verification, which aims to provide some references for clinic diagnoses, treatment, and surgery planning. Methods: The anterior chest model of a 15-year-old patient was built based on his CT images; and his finite element model and the Nuss bar were created. Coupling of nodal displacement was used to connect bones with cartilages of the anterior chest. Turning the Nuss bar over is completed by rotating displacement of it. By comparing the numerical simulation outcomes with clinical surgery results, the numerical simulation results were verified Results: The orthopedic process of minimally invasive surgery of pectus excavatum was simulated by model construction and numerical analysis. The stress, displacement fields and distribution of the contact pressure between the Nuss bar and costal cartilages were analyzed. The relationship between correcting force and displacement was obtained. Compared with the of clinical results, the numerical simulation results were close to that of the actual clinical surgery in displacement field, and the final contact position of the Nuss bar and the costal cartilages. Conclusion: Compared with the rigid model, the assembled simulation model is in more conformity with the actual clinical practice. The larger curvature results in the maximum equivalent stress, which is the main reason for clinical pain. Soft tissues and muscles should be taken into account in the numerical simulation process. PMID:26312072

  8. Ravitch versus Nuss procedure for pectus excavatum: systematic review and meta-analysis

    PubMed Central

    Kanagaratnam, Aran; Phan, Steven; Tchantchaleishvilli, Vakhtang

    2016-01-01

    Background Pectus excavatum is the most common congenital chest wall deformity. The two most common surgical techniques for its correction are the modified Ravitch technique and the minimally invasive Nuss technique. Despite both procedures being used widely, data comparing them are scarce. Methods We conducted a systematic review and meta-analysis of comparative studies to evaluate these procedures. A systematic search of the literature was performed from six electronic databases. Pooled meta-analysis was conducted using odds ratio (OR) and weighted mean difference (WMD). Results A total of 13 studies comprising 1,432 pediatric (79.3%) and adult (20.7%) patients were identified, including 912 patients undergoing the Nuss procedure compared to 520 patients undergoing the Ravitch procedure. There was no significant difference found between the Nuss group versus Ravitch group in pediatric patients with regard to overall complications (OR =1.16; 95% CI: 0.61–2.19; I2=56%; P=0.65), reoperations (6.1% vs. 6.4%; OR =1.00; 95% CI: 0.40–2.50; I2=0%; P=1.00), wound infections (OR =0.58; 95% CI: 0.23–1.46; I2=0%; P=0.25), hemothorax (1.6% vs. 1.3%; OR =0.74; 95% CI: 0.21–2.65; I2=12%; P=0.64), pneumothorax (3.4% vs. 1.5%; OR =1.11; 95% CI: 0.42–2.93; I2=0%; P=0.83) or pneumonia (OR =0.15; 95% CI: 0.02–1.48; I2=0%; P=0.10). Adult patients undergoing the Nuss procedure had a higher incidence of overall complications (OR =3.26; 95% CI: 1.01–10.46; I2=0%; P=0.05), though there were far fewer studies that reported data. Conclusions These results suggest no difference between the Nuss and Ravitch procedures for pediatric patients, while in adults the Ravitch procedure resulted in fewer complications. PMID:27747174

  9. Descending aortic replacement after Nuss for pectus excavatum in a Marfan patient—Case report

    PubMed Central

    Jaroszewski, Dawn; Ewais, MennatAllah; DeValeria, Patrick; Gotway, Michael; Craig Miller, D.

    2016-01-01

    Introduction The Nuss procedure for pectus excavatum (PE) repair has been successfully performed in Marfan syndrome (MFS) patients however there is concern for future risk of aortic dilation/rupture and need for emergent access with support bars in place. Case presentation We present a 45 year-old male with MFS that required descending aortic replacement shortly after modified Nuss repair. Discussion The majority of MFS patients have severe PE and repair with the Nuss procedure is not uncommon. The risk for life threatening aortic dilation, dissection, or rupture in such patients is a concern when utilizing this technique. Our work has been reported in line with the CARE criteria. Conclusion Nuss repair should be considered in MFS patients with technique modifications and careful consideration of future risk of aortic dilation and rupture. PMID:26895112

  10. A prospective study on quality of life in youths after pectus excavatum correction

    PubMed Central

    Jacobsen, Elisabeth Brammer; Thastum, Mikael; Pilegaard, Hans

    2016-01-01

    Background The impact of correction of pectus excavatum (PE) on adolescents’ health-related quality of life (HRQL) has only been investigated in prospective designs using disease-specific measures and without controls. The aim of this prospective study was to evaluate the HRQL before and after surgical correction of PE using a generic HRQL measure, and to compare the reported level of HRQL before surgery with an age-comparable control group. Methods Patients (n=107) and one of their parents (n=106) completed the generic HRQL measure: the Child Health Questionnaire before, 3 months, and 6 months after correction for PE. A control group (n=183) consisting of school children comparable in age completed the same measure on one occasion. Results The patients’ level of HRQL before surgery was comparable to the level of the controls except for physical functioning; here boys reported impaired function compared to controls (P<0.0001, d=0.72). Both patients and parents reported improved emotional wellbeing and self-esteem, as well as an increase in physical and social activities from pre- to post-surgery. These improvements were statistically significant (P≤0.001–0.03) and yielded moderate to high effect sizes (ƞ2=0.04–0.22). Conclusions The improvement of physical and psychosocial HRQL reported by both patients and their parents as proxy indicates the psychological implications of the deformity. Patients reported impaired physical function compared to controls. Further, pre-surgery differences in HRQL between the patients and the controls were lacking. However, the improvement in the patients’ HRQL following surgery may justify the correction of pectus excavatum. The effect of the deformity on patients wellbeing compared with controls’ needs to be addressed in further studies. PMID:27747179

  11. A Sensorized Nuss Bar for Patient-Specific Treatment of Pectus Excavatum

    PubMed Central

    Betti, Stefano; Ciuti, Gastone; Ricotti, Leonardo; Ghionzoli, Marco; Cavallo, Filippo; Messineo, Antonio; Menciassi, Arianna

    2014-01-01

    Pectus Excavatum is an anatomical deformation characterized by a depression of the anterior chest wall. Nuss technique (representing the current clinical golden standard) consists in the introduction of a corrective metal bar, in order to raise the sternum in its anatomic natural position. Nowadays, the bar plays purely a mechanical/corrective action and is kept implanted for about three years, supporting up to a maximum force of 250 N. Our study aims at optimizing the procedure of correction, in terms of monitoring the bar effect, minimizing the body response, and facilitating the bar removal. The sensorized Nuss bar prototype inserted in a platform for telemedicine described in this article is able to monitor in vitro pressure data variations, with more than 150 discrete measurements during the operating period. This behavior is promising for future clinical applications, in which the device could be exploited to monitor the forces at work, thus, providing a customized therapeutic protocol, which in turn may optimize the period of implant. The sensorized bar was also provided with a polymeric coating, able to influence human dermal fibroblast behavior in vitro. This highlights the possibility to minimize, in future in vivo applications, tissue fibrotic responses. PMID:25268912

  12. Gpr126/Adgrg6 deletion in cartilage models idiopathic scoliosis and pectus excavatum in mice

    PubMed Central

    Karner, Courtney M.; Long, Fanxin; Solnica-Krezel, Lilianna; Monk, Kelly R.; Gray, Ryan S.

    2015-01-01

    Adolescent idiopathic scoliosis (AIS) and pectus excavatum (PE) are common pediatric musculoskeletal disorders. Little is known about the tissue of origin for either condition, or about their genetic bases. Common variants near GPR126/ADGRG6 (encoding the adhesion G protein-coupled receptor 126/adhesion G protein-coupled receptor G6, hereafter referred to as GPR126) were recently shown to be associated with AIS in humans. Here, we provide genetic evidence that loss of Gpr126 in osteochondroprogenitor cells alters cartilage biology and spinal column development. Microtomographic and x-ray studies revealed several hallmarks of AIS, including postnatal onset of scoliosis without malformations of vertebral units. The mutants also displayed a dorsal-ward deflection of the sternum akin to human PE. At the cellular level, these defects were accompanied by failure of midline fusion within the developing annulus fibrosis of the intervertebral discs and increased apoptosis of chondrocytes in the ribs and vertebrae. Molecularly, we found that loss of Gpr126 upregulated the expression of Gal3st4, a gene implicated in human PE, encoding Galactose-3-O-sulfotransferase 4. Together, these data uncover Gpr126 as a genetic cause for the pathogenesis of AIS and PE in a mouse model. PMID:25954032

  13. Semi-automatic 3D segmentation of costal cartilage in CT data from Pectus Excavatum patients

    NASA Astrophysics Data System (ADS)

    Barbosa, Daniel; Queirós, Sandro; Rodrigues, Nuno; Correia-Pinto, Jorge; Vilaça, J.

    2015-03-01

    One of the current frontiers in the clinical management of Pectus Excavatum (PE) patients is the prediction of the surgical outcome prior to the intervention. This can be done through computerized simulation of the Nuss procedure, which requires an anatomically correct representation of the costal cartilage. To this end, we take advantage of the costal cartilage tubular structure to detect it through multi-scale vesselness filtering. This information is then used in an interactive 2D initialization procedure which uses anatomical maximum intensity projections of 3D vesselness feature images to efficiently initialize the 3D segmentation process. We identify the cartilage tissue centerlines in these projected 2D images using a livewire approach. We finally refine the 3D cartilage surface through region-based sparse field level-sets. We have tested the proposed algorithm in 6 noncontrast CT datasets from PE patients. A good segmentation performance was found against reference manual contouring, with an average Dice coefficient of 0.75±0.04 and an average mean surface distance of 1.69+/-0.30mm. The proposed method requires roughly 1 minute for the interactive initialization step, which can positively contribute to an extended use of this tool in clinical practice, since current manual delineation of the costal cartilage can take up to an hour.

  14. Surgical correction of 639 pectus excavatum cases via the Nuss procedure

    PubMed Central

    Zhang, Dong-Kun; Tang, Ji-Ming; Ben, Xiao-Song; Xie, Liang; Zhou, Hai-Yu; Ye, Xiong; Zhou, Zi-Hao; Shi, Rui-Qing; Xiao, Pu

    2015-01-01

    Background To review the clinical experience and short- to middle-term effects of the Nuss procedure for correction of pectus excavatum (PE). Methods From September 2006 to August 2014, 639 patients with PE were treated using the Nuss procedure. Of these, 546 were male and 93 were female. The mean age was 15.3±5.8 years (2.5-49 years). Preoperative chest CT scans Haller index (HI) was 4.3±1.7 (2.9-17.4), with 75 cases of mild PE (HI <3.2), 114 cases of moderate PE (HI 3.2-3.5), 393 cases of severe PE (HI 3.6-6.0), and 57 cases of extremely severe PE (HI >6.0). Results A total of 638 patients successfully completed the surgery, an 11-year-old male patient who died after the surgery had undergone ventricular septal defect closure surgery through a sternal incision 7 years ago. The mean operative time was 64.3±41.7 min (40-310 min). Excluding the patient who died, the average blood loss was 24.5±17.8 mL (10-160 mL). The average length of postoperative hospital stay was 5.2±2.9 days (4-36 days). A total of 484 cases (75.7%) required 1 steel bar insertion, 153 cases (24.0%) required 2 steel bars, and 2 cases (0.3%) required 3 bars. Postoperative evaluation of the surgery outcomes revealed the following: excellent in 504 cases, good in 105, fair in 28 and poor in 2, good quality rate was 95.3%. Conclusions Correction of PE via the Nuss procedure is minimally invasive and simple to perform with good short and mid-term effects, while long-term efficacy remains to be determined. PMID:26543607

  15. Combined mitral valve replacement associated with the Bentall procedure, diaphragmatic hernia repair and reconstruction of the pectus excavatum in a 26-year-old patient with Marfan syndrome

    PubMed Central

    Stępiński, Piotr; Aboul-Hassan, Sleiman Sebastian; Szymańska, Anna; Marczak, Jakub; Cichoń, Romuald

    2016-01-01

    A 26-year-old man with Marfan syndrome was admitted as an emergency patient with ascending aorta aneurysm, severe mitral and aortic regurgitation, diaphragmatic hernia and pectus excavatum. After completion of diagnostics a combined surgical procedure was performed. PMID:27516786

  16. The study of physicochemical properties of stabilizing plates removed from the body after treatment of pectus excavatum.

    PubMed

    Kajzer, Anita; Kajzer, Wojciech; Dzielicki, Józef; Matejczyk, Dawid

    2015-01-01

    This paper presents the results of a physicochemical surface study and clinical observation of a new generation of plates for the treatment of pectus excavatum. Analysis of the data allowed us to investigate the effect of implant design and condition of their surface on the results of treatment of pectus excavatum. In the study, we performed an analysis of clinical data, obtained after a suitable period of treatment with the use of implants, as well as a study of physicochemical properties of stabilizing plates after their removal from the body. Surface roughness, the surface wettability and corrosion resistance were measured, and the results were compared with clinical observations. When removing the plates we found only slight inflammatory-periosteal reactions around the wire fixing transverse stabilizing plates to the ribs and locking the base plate correcting the distortion. The corrective plates did not shift or rotate during the entire treatment period, giving an optimal, oval and natural shape of the chest. The obtained values of the parameters investigated indicate that the reduction in resistance to pitting corrosion occurred in the areas where laser marking was made to identify the plate. The remaining plates, in spite of mechanical damage of the surface, were characterized by good corrosion resistance, a fact which is confirmed by the results of clinical evaluation.

  17. Pectus excavatum and carinatum: new concepts in the correction of congenital chest wall deformities in the pediatric age group.

    PubMed

    Mavanur, Arun; Hight, Donald W

    2008-01-01

    A wide range of congenital chest wall deformities have been described over the years. The spectrum of severity may range from life threatening deformities such as cordis ectopia to those which pose functional limitations as growth and maturity approach adulthood. Until recently, pectus excavatum (PE) and carinatum(PC) malformations have generally been considered as primarily cosmetic abnormalities. "Open" surgical procedures to correct PE and PC involved extensive resection of cartilage and bone to remove the bony deformity often with lasting growth restriction of the chest wall. Minimally invasive surgery has recently been reported as an effective technique in correcting PE without removing healthy chest wall structures. Nonoperative bracing has been effectively applied to PC eliminating traditional surgical methods. This report presents the experience at the Connecticut Children's Medical Center (CCMC) in the treatment of these two common deformities using new, less invasive methods with excellent long-term results. PMID:18286876

  18. Postoperative epidural analgesia for patients undergoing pectus excavatum corrective surgery: a 10-year retrospective analysis

    PubMed Central

    Siddiqui, Asad; Tse, Andrew; Paul, James E; Fitzgerald, Peter; Teh, Bernice

    2016-01-01

    Introduction Managing postoperative pain in patients undergoing minimally invasive pectus excavatum repair (Nuss procedure) is challenging but essential in facilitating ambulation and minimizing the length of stay. Although multiple epidural regimens with varying opioids are presently used for pain management, there is currently no clinical consensus regarding which epidural regimen provides the best analgesia outcomes with the fewest side effects. This 10-year retrospective cohort study was performed to compare the quality of analgesia and the incidence of side effects associated with the three most common epidural regimens used at a tertiary care children’s hospital, in patients undergoing the Nuss procedure. Methods Seventy-two pediatric patients were identified as having been treated with one of three epidural regimens for postoperative pain management following the Nuss procedure: Group A (n=12) received 0.125% bupivacaine and 5 µg/mL fentanyl, Group B (n=21) received 0.125% bupivacaine and 10 µg/mL hydromorphone, and Group C (n=39) received 0.1% ropivacaine and 20 µg/mL hydromorphone. Our primary outcome was maximal daily pain scores (numerical rating scale 0–10), with an analytical focus on postoperative day 1 scores. The primary outcome was analyzed using linear regression. The secondary outcomes included the length of stay, side-effect profiles as reflected by the number of treatments for nausea and pruritus, pain scores according to epidural site insertion, occurrence of breakthrough pain, and presence of severe pain throughout their hospital stay. Secondary outcomes were analyzed using linear or logistic regression adjusted for pain scores at baseline. The criterion for statistical significance was set a priori at alpha =0.05. Results Group A had significantly higher day-1 pain scores (score 5.42/10) than Group B (4.52/10; P=0.030) and Group C (4.49/10; P=0.015) after adjusting for baseline pain and age. No significant difference in maximum daily

  19. Use of laryngeal mask airway for non-endotracheal intubated anesthesia for patients with pectus excavatum undergoing thoracoscopic Nuss procedure

    PubMed Central

    Du, Xiaojun; Mao, Songsong; Cui, Jianxiu; Ma, Jue; Zhang, Guangyan; Zheng, Yong; Zhou, Haiyu; Xie, Liang; Zhang, Dongkun; Shi, Ruiqing

    2016-01-01

    Background The aim of the present study was to determine the safety and feasibility of the use of laryngeal mask airway (LMA) for non-endotracheal intubated anesthesia for patients with pectus excavatum (PE) undergoing thoracoscopic Nuss procedure. Methods Between July 2015 and December 2015, 30 selected patients with PE were planned to undergo a thoracoscopic Nuss procedure using LMA for non-endotracheal intubated anesthesia in the Guangdong General Hospital. The clinical data were analyzed to evaluate the safety and feasibility of this technique. Results Of the 30 selected patients, two were female, the mean age was 16.04±5.09 years and the average Haller index was 3.37±0.88. A total of 27 cases (90%) succeeded at the first attempt, one patient required conversion to an endotracheal tube (ETT) because of continuous air leak. The peripheral O2 saturation (SpO2), end-tidal carbon dioxide (EtCO2) values, heart rate (HR), and mean arterial blood pressure (MAP) remained stable throughout the procedure in all cases. All of the 30 patients were successfully corrected without requiring conversion to an open surgery. Two patients experienced postoperative nausea and one reported a sore throat. Neither gastro-esophageal reflux nor in-hospital mortality occurred. Conclusions The use of LMA for non-endotracheal intubated anesthesia for selected patients with PE undergoing thoracoscopic Nuss procedure is clinically safe and technically feasible. PMID:27621860

  20. Use of laryngeal mask airway for non-endotracheal intubated anesthesia for patients with pectus excavatum undergoing thoracoscopic Nuss procedure

    PubMed Central

    Du, Xiaojun; Mao, Songsong; Cui, Jianxiu; Ma, Jue; Zhang, Guangyan; Zheng, Yong; Zhou, Haiyu; Xie, Liang; Zhang, Dongkun; Shi, Ruiqing

    2016-01-01

    Background The aim of the present study was to determine the safety and feasibility of the use of laryngeal mask airway (LMA) for non-endotracheal intubated anesthesia for patients with pectus excavatum (PE) undergoing thoracoscopic Nuss procedure. Methods Between July 2015 and December 2015, 30 selected patients with PE were planned to undergo a thoracoscopic Nuss procedure using LMA for non-endotracheal intubated anesthesia in the Guangdong General Hospital. The clinical data were analyzed to evaluate the safety and feasibility of this technique. Results Of the 30 selected patients, two were female, the mean age was 16.04±5.09 years and the average Haller index was 3.37±0.88. A total of 27 cases (90%) succeeded at the first attempt, one patient required conversion to an endotracheal tube (ETT) because of continuous air leak. The peripheral O2 saturation (SpO2), end-tidal carbon dioxide (EtCO2) values, heart rate (HR), and mean arterial blood pressure (MAP) remained stable throughout the procedure in all cases. All of the 30 patients were successfully corrected without requiring conversion to an open surgery. Two patients experienced postoperative nausea and one reported a sore throat. Neither gastro-esophageal reflux nor in-hospital mortality occurred. Conclusions The use of LMA for non-endotracheal intubated anesthesia for selected patients with PE undergoing thoracoscopic Nuss procedure is clinically safe and technically feasible.

  1. Pectus excavatum repair

    MedlinePlus

    Funnel chest repair; Chest deformity repair; Sunken chest repair; Cobbler's chest repair; Nuss repair; Ravitch repair ... There are two types of surgery to repair this condition -- open surgery ... surgery is done while the child is in a deep sleep and pain- ...

  2. ORTHOPEDIC APPROACH TO PECTUS DEFORMITIES: 32 YEARS OF STUDIES

    PubMed Central

    Haje, Sydney Abrão; de Podestá Haje, Davi

    2015-01-01

    The authors summarize a 32-year experience in the study and in the non-operative approach of pectus carinatum and pectus excavatum. Data of 4,012 patients with pectus deformities were collected from 1977 to January 2009, allowing evaluation on the etiology, pathogenesis and treatment of these deformities. Growth disturbances of anterior chest wall bones and cartilages were detected in imaging studies. Heredity, and biomechanical factors, like respiratory disturbances and scoliosis were noticed in more than 40% of the patients. The method of dynamic remodeling of the thorax – compressive orthoses simultaneously to exercises practice – was indicated in 2453 patients. Concomitant treatment with bending brace was provided in patients with 20° to 52° scoliosis. Of pectus patients with treatment indication, 1717 returned for re-evaluation: 1632 children and adolescents and 85 adults. Good results were seen in 60.6% of children and adolescents and in 27% of adults treated. No scoliosis patient presented curve worsening, and a case of 52° presented an improvement of 20° in the scoliosis with the treatment. Disturbances in the growth of the sternum and costal arches, as well as biomechanical factors related to the pathogenesis of pectus deformities, demonstrate how these deformities are correlated to orthopaedics. Appropriate evaluation of the anterior chest wall and concomitant treatment with bending brace are recommended in the presence of scoliosis. The dynamic remodeling method of the thorax requires a protocol of medical actions for a successful treatment. PMID:27004171

  3. Overcorrection during treatment of pectus deformities with DCC orthoses: experience in 17 cases.

    PubMed

    Haje, S A; Haje, D P

    2006-08-01

    Treatment of pectus carinatum and pectus excavatum with dynamic chest compressor (DCC) orthoses have been reported by Haje and others. The goal of this study was to demonstrate that overcorrection during orthotic treatment of children and adolescents with pectus deformities can occur and requires medical attention. Of 3,028 children and adolescents with pectus deformities, observed between 1977 and October 2005, 1,824 were prescribed treatment with DCC orthoses and, after a few months of treatment, some overcorrection was noted in 30 patients. Of the patients who received orthoses, 738 had a minimum follow-up of 1 year and 17 of these, 2 with pectus excavatum and 15 with pectus carinatum, presented overcorrection and were studied. The dynamic remodeling method (DCC orthoses + exercises) was applied. The procedures, adopted according to each patient's needs, were: decreasing the time of orthosis wear and/or the tightening of the screws, introducing a second orthosis, and improving the prescribed exercises and/or encouraging the patient to perform them more intensively. The therapy was successful in all patients, and the result was maintained in one case of pectus excavatum followed up until adulthood. It was concluded that overcorrection during DCC orthosis wear can occur and that careful medical follow-up is necessary if this complication is to be successfully reversed. PMID:16474937

  4. [Children severe OSAHS with pectus excavatum: a case report].

    PubMed

    Ma, Wei; Wang, Jinfeng; Xie, Yuping

    2016-03-01

    The primary etiopathology of pediatric OSAHS includes tonsil or adenoid hypertrophy. Severe OSAHS contributes to or aggravates thoracic deformity, which is rarely reported. In the current report, This children sleep snoring more than 4 years, increasing with thoracic severe depression during sleep 2 days. Clinical examination indicated tonsil and adenoid hypertrophy, and polysomnography revealed OSAHS . The symptoms of OSAHS and severe inhalation-related sternum depression disappeared rapidly after tonsillectomy. Our findings indicated that OSAHS were the major causes underlying funnel chest in children. The rarity of the incidence may result in missed diagnosis or misdiagnosis. Polysomnography was recommended for the child diagnosed with funnel chest accompanied by upper airway stenosis. PMID:27382691

  5. In vitro acaricidal effect of plant extract of neem seed oil (Azadirachta indica) on egg, immature, and adult stages of Hyalomma anatolicum excavatum (Ixodoidea: Ixodidae).

    PubMed

    Abdel-Shafy, S; Zayed, A A

    2002-05-30

    Effects of the plant extract of neem seed (Azadirachta indica) on eggs, immature, and adult stages of Hyalomma anatolicum excavatum was studied at concentrations of 1.6, 3.2, 6.4, and 12.8%. The extract was found to have a significant effect on the hatching rate of eggs. It significantly increased the hatching rate during the first 7 days post-treatment (DPT) giving incompletely developed and dead larvae; however, it cause hatching failure at DPT 15. Neem Azal F induced a significant increased in mortality rates of newly hatched larvae, unfed larvae, and unfed adults reaching 100% on 15th, 3rd, and 15th DPT, respectively. The mortality rates increased with the extract concentrations. Although, it had no significant effect on the moulting rates of fed nymphs, it caused malformation or deformities in 4% of adults moulted. It was concluded that the concentration of Neem Azal F which may be used for commercial control of this tick species were 1.6 and 3.2%. PMID:11992715

  6. Minimally Invasive Repair of Pectus Carinatum in Patients Unsuited to Bracing Therapy

    PubMed Central

    Suh, Jee-Won; Joo, Seok; Lee, Geun Dong; Haam, Seok Jin; Lee, Sungsoo

    2016-01-01

    Background We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. Methods Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. Results The mean age of the patients was 24.35±13.20 years (range, 14–57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were 2.01±0.19 (range, 1.60–2.31), and 2.22±0.19 (range, 1.87–2.50), respectively (p-value=0.01), and the median hospital stay was 7.09±2.91 days (range, 5–15 days). Only one patient experienced postoperative complications. Conclusion Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients. PMID:27066432

  7. A mother and daughter with a novel phenotype of hand and foot abnormalities and severe pectus excavatum.

    PubMed

    Low, Karen; Smith, James; Lee, Simon; Newbury-Ecob, Ruth

    2013-08-01

    A mother and daughter with an overlapping Catel-Manzke and Temtamy preaxial brachydactyly hyperphalangism syndrome phenotype are reported. We describe a phenotype with a previously undescribed genetic basis. .

  8. Dynamic compression system for the correction of pectus carinatum.

    PubMed

    Martinez-Ferro, Marcelo; Fraire, Carlos; Bernard, Silvia

    2008-08-01

    Between April 2001 and 2007, we treated 208 patients with pectus carinatum by using a specially designed dynamic compression system (DCS) that uses a custom-made aluminum brace. Recently, an electronic pressure measuring device was added to the brace. Results were evaluated by using a double-blinded subjective scale (1 to 10). A total of 208 patients were treated over 6 years; 154 were males (74%) and the mean age was 12.5 years (range 3 to 18 years). Mean utilization time was 7.2 hours daily for 7 months (range 3 to 20 months). A total of 28 (13.4%) patients abandoned treatment and were not evaluated for final results. Of the 180 remaining patients, 112 completed treatment. A total of 99 of 112 (88.4%) had good to excellent results scoring between 7 and 10 points, and 13 (11.6%) patients scored 1 to 6 points and were judged as poor or failed results. The "Pressure for Initial Correction" (PIC) in pounds per square inch (PSI) proved that starting treatment with less than 2.5 PSI avoids skin lesions. Patients who require pressures higher than 7.5 PSI should not be treated with this method. We found a good correlation between PIC versus treatment duration and outcome. DCS is an effective treatment for pectus carinatum with minimal morbidity. We suggest that patients with pectus carinatum have a trial of compression therapy before recommending surgical resection. The use of pressure measurement avoids complications such as skin lesions, partial or poor results, and patient noncompliance.

  9. Randomized trial of epidural vs. subcutaneous catheters for managing pain after modified Nuss in adults

    PubMed Central

    Temkit, M’hamed; Ewais, MennatAllah M.; Luckritz, Todd C.; Stearns, Joshua D.; Craner, Ryan C.; Gaitan, Brantley D.; Ramakrishna, Harish; Thunberg, Christopher A.; Weis, Ricardo A.; Myers, Kelly M.; Merritt, Marianne V.; Rosenfeld, David M.

    2016-01-01

    Background Minimally invasive repair of pectus excavatum (MIRPE) is now performed in adults. Managing adult patients’ pain postoperatively has been challenging due to increased chest wall rigidity and the pressure required for supporting the elevated sternum. The optimal pain management regimen has not been determined. We designed this prospective, randomized trial to compare postoperative pain management and outcomes between thoracic epidural analgesia (TEA) and bilateral subcutaneous infusion pump catheters (On-Q). Methods Patients undergoing MIRPE (modified Nuss) underwent random assignment to TEA or On-Q group. Both groups received intravenous, patient-controlled opioid analgesia, with concomitant delivery of local anesthetic. Primary outcomes were length of stay (LOS), opioid use, and pain scores. Results Of 85 randomly assigned patients, 68 completed the study [52 men, 76.5%; mean (range) age, 32.2 (20.0–58.0) years; Haller index, 5.9 (range, 3.0-26.7)]. The groups were equally matched for preoperative variables; however, the On-Q arm had more patients (60.3%). No significant differences were found between groups in mean daily pain scores (P=0.52), morphine-equivalent opioid usage (P=0.28), or hospital stay 3.5 vs. 3.3 days (TEA vs. On-Q; P=0.55). Thirteen patients randomized to TEA refused the epidural and withdrew from the study because they perceived greater benefit of the On-Q system. Conclusions Postoperative pain management in adults after MIRPE can be difficult. Both continuous local anesthetic delivery by TEA and On-Q catheters with concomitant, intravenous, patient-controlled anesthesia maintained acceptable analgesia with a reasonable LOS. In our cohort, there was preference for the On-Q system for pain management. PMID:27621865

  10. Randomized trial of epidural vs. subcutaneous catheters for managing pain after modified Nuss in adults

    PubMed Central

    Temkit, M’hamed; Ewais, MennatAllah M.; Luckritz, Todd C.; Stearns, Joshua D.; Craner, Ryan C.; Gaitan, Brantley D.; Ramakrishna, Harish; Thunberg, Christopher A.; Weis, Ricardo A.; Myers, Kelly M.; Merritt, Marianne V.; Rosenfeld, David M.

    2016-01-01

    Background Minimally invasive repair of pectus excavatum (MIRPE) is now performed in adults. Managing adult patients’ pain postoperatively has been challenging due to increased chest wall rigidity and the pressure required for supporting the elevated sternum. The optimal pain management regimen has not been determined. We designed this prospective, randomized trial to compare postoperative pain management and outcomes between thoracic epidural analgesia (TEA) and bilateral subcutaneous infusion pump catheters (On-Q). Methods Patients undergoing MIRPE (modified Nuss) underwent random assignment to TEA or On-Q group. Both groups received intravenous, patient-controlled opioid analgesia, with concomitant delivery of local anesthetic. Primary outcomes were length of stay (LOS), opioid use, and pain scores. Results Of 85 randomly assigned patients, 68 completed the study [52 men, 76.5%; mean (range) age, 32.2 (20.0–58.0) years; Haller index, 5.9 (range, 3.0-26.7)]. The groups were equally matched for preoperative variables; however, the On-Q arm had more patients (60.3%). No significant differences were found between groups in mean daily pain scores (P=0.52), morphine-equivalent opioid usage (P=0.28), or hospital stay 3.5 vs. 3.3 days (TEA vs. On-Q; P=0.55). Thirteen patients randomized to TEA refused the epidural and withdrew from the study because they perceived greater benefit of the On-Q system. Conclusions Postoperative pain management in adults after MIRPE can be difficult. Both continuous local anesthetic delivery by TEA and On-Q catheters with concomitant, intravenous, patient-controlled anesthesia maintained acceptable analgesia with a reasonable LOS. In our cohort, there was preference for the On-Q system for pain management.

  11. Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review

    PubMed Central

    2009-01-01

    Background Some patients with mild or moderate thoracic scoliosis (Cobb angle <50-60 degrees) suffer disproportionate impairment of pulmonary function associated with deformities in the sagittal plane and reduced flexibility of the spine and chest cage. Long-term improvement in the clinical signs and symptoms of childhood onset scoliosis in an adult, without surgical intervention, has not been documented previously. Case presentation A diagnosis of thoracic scoliosis (Cobb angle 45 degrees) with pectus excavatum and thoracic hypokyphosis in a female patient (DOB 9/17/52) was made in June 1964. Immediate spinal fusion was strongly recommended, but the patient elected a daily home exercise program taught during a 6-week period of training by a physical therapist. This regime was carried out through 1992, with daily aerobic exercise added in 1974. The Cobb angle of the primary thoracic curvature remained unchanged. Ongoing clinical symptoms included dyspnea at rest and recurrent respiratory infections. A period of multimodal treatment with clinical monitoring and treatment by an osteopathic physician was initiated when the patient was 40 years old. This included deep tissue massage (1992-1996); outpatient psychological therapy (1992-1993); a daily home exercise program focused on mobilization of the chest wall (1992-2005); and manipulative medicine (1994-1995, 1999-2000). Progressive improvement in chest wall excursion, increased thoracic kyphosis, and resolution of long-standing respiratory symptoms occurred concomitant with a >10 degree decrease in Cobb angle magnitude of the primary thoracic curvature. Conclusion This report documents improved chest wall function and resolution of respiratory symptoms in response to nonsurgical approaches in an adult female, diagnosed at age eleven years with idiopathic scoliosis. PMID:20003501

  12. A Case of Successful Surgical Repair for Pectus Arcuatum Using Chondrosternoplasty

    PubMed Central

    Kim, Sang Yoon; Park, Samina; Kim, Eung Rae; Park, In Kyu; Kim, Young Tae; Kang, Chang Hyun

    2016-01-01

    Pectus arcuatum is a rare complex chest wall deformity. A 31-year-old female presented with a severely protruding upper sternum combined with a concave lower sternum. We planned a modified Ravitch-type operation. Through vertical mid-sternal incision, chondrectomies were performed from the second to fifth costal cartilages, saving the perichondrium. Horizontal osteotomy was performed in a wedge shape on the most protruding point, and followed by an additional partial osteotomy at the most concaved point. The harvested wedge-shape bone fragments were minced and re-implanted to the latter osteotomy site. The osteotomized sternum was fixed with multiple wirings. With chondrosternoplasty, a complex chest wall deformity can be corrected successfully. PMID:27298803

  13. Flail chest stabilization with Nuss operation in presence of multiple myeloma.

    PubMed

    Lee, Song Am; Hwang, Jae Joon; Chee, Hyun Keun; Kim, Yo Han; Lee, Woo Surng

    2014-05-01

    Nowadays the Nuss operation has been widely adopted as a minimally invasive procedure and standard surgical choice in pectus excavatum. However, much debate and concern have been raised regarding its applicability in adults with pectus excavatum flail chest and other thoratic wall deformities, as compared with younger patients, in terms of complications after surgery. To stabilize the segment of paradoxical chest wall movement we performed the Nuss operation on a patient with multiple myeloma who sustained blunt thoracic trauma. The patient presented with paradoxical movement of the thoracic wall and sternum instability due to multiple myeloma, which led to severe dyspnea, hypoxemia, hypercapnea, and bedridden state. His condition progressed to acute respiratory distress syndrome and did not respond to conservative treatment. We performed the Nuss operation on the patient, and his clinical symptoms were relieved after surgery. The patient regained the ability to walk unassisted and was discharged from the hospital without any specific events.

  14. Plummer-Vinson syndrome with pectus carinatum mitral valve prolapsus and exotropia in an 18-year-old boy.

    PubMed

    Sahin, Cem; Ozseker, Burak; Rencuzogullari, Ibrahim; Zeybek, Arife

    2014-01-22

    The Plummer-Vinson syndrome is a clinical syndrome characterised by dysphagia, web or webs in upper oesophagus and iron-deficiency anaemia. The syndrome is often seen in women of age 40-70 years and rarely in adolescents. Plummer-Vinson syndrome might be associated with malignancy, myeloproliferative disorder and autoimmune diseases including coeliac disease, rheumatoid arthritis and Sjögren syndrome. However, according to our literature search, there are no reports of such case associated with thorax deformity, cardiac pathology and ocular findings. We present a case of an 18-year-old boy with a rare presentation of this syndrome including pectus carinatum, exotropia and mitral valve prolapsus.

  15. Plummer-Vinson syndrome with pectus carinatum mitral valve prolapsus and exotropia in an 18-year-old boy

    PubMed Central

    Sahin, Cem; Ozseker, Burak; Rencuzogullari, Ibrahim; Zeybek, Arife

    2014-01-01

    The Plummer-Vinson syndrome is a clinical syndrome characterised by dysphagia, web or webs in upper oesophagus and iron-deficiency anaemia. The syndrome is often seen in women of age 40–70 years and rarely in adolescents. Plummer-Vinson syndrome might be associated with malignancy, myeloproliferative disorder and autoimmune diseases including coeliac disease, rheumatoid arthritis and Sjögren syndrome. However, according to our literature search, there are no reports of such case associated with thorax deformity, cardiac pathology and ocular findings. We present a case of an 18-year-old boy with a rare presentation of this syndrome including pectus carinatum, exotropia and mitral valve prolapsus. PMID:24451233

  16. Anaesthetic Management of Laparoscopic Morgagni Hernia Repair in a Patient with Coexisting Down Syndrome, Patent Foramen Ovale and Pectus Carinatum

    PubMed Central

    Kozanhan, Betül; Başaran, Betül; Aygın, Feride; Akkoyun, İbrahim; Özmen, Sadık

    2016-01-01

    Laparoscopic repair has several advantages with a minimally invasive surgical option for children with Morgagni hernias; however, a number of physiological sequelae results from pneumoperitoneum and insufflation. These physiological changes may be more significant in patients with a congenital heart disease. Perioperative detailed evaluation, meticulous monitorization and cooperation with a surgical team are important in cases with patent foramen ovale for the possible risk of the paradoxical gas embolism. We present the anaesthetic management of a patient with patent foramen ovale, Down syndrome and pectus carinatus who successfully underwent laparoscopic Morgagni hernia repair. Under a well-managed anaesthesia that prevented complications because of pneumoperitoneum, laparoscopic surgery would be safe enough for patients with Morgagni hernia having an associated congenital heart disease. PMID:27366555

  17. [Correction of the congenital malformations of the front chest wall by the modelling technique of sternochondroplasty: technique and results on a series of 14 cases].

    PubMed

    Duhamel, P; Brunel, C; Le Pimpec, F; Pons, F; Jancovici, R

    2003-04-01

    In the congenital malformations of the front chest wall showing depression or protrusion, the cardiorespiratory disorders are inconstant and often not linked with the distortion. On the other hand psychoaffective repercussions are major in adolescents and young adults justifying recourse to surgery with morphological and aesthetic aiming. The authors present the technique of modelling sternochondroplasty by raising with osteosynthesis by slide fastener-handle of Martin-Borrelly, applied to the correction of congenital malformation of the front chest wall in young adult, both of protrusion (pectus carinatum), of thoraxes in funnel (pectus excavatum) types or of mixed types (pectus arcuatum). This surgical replanning intervention is carried out by under-mammary way and aims at reestablishing a normal anatomy of the front chest wall. It leads to a genuine wide sternochondrocostal volet, which is stabilised by a specific, multipurpose, adaptable and reliable osteosynthesis equipment. The results obtained on a series of 14 cases are good or excellent in 86% of the cases and stable over time in the absence of major complications. A good cooperation of the patient is essential to obtain a good result in particular via the continuation of musculation exercises after assembly consolidation, possibly associated with remote mammary plastic surgery in the event of hypoplasia or of associated mammary agenesia. PMID:12801547

  18. Successful Singleton and Twin Pregnancies With the Nuss Bars in Place.

    PubMed

    Jaroszewski, Dawn E; Ewais, MennatAllah M; Gotway, Michael B; McMahon, Lisa E; Notrica, David M

    2015-11-01

    Pectus excavatum (PE) occurs less commonly in women, and the implications on a pregnancy after repair during the period when support bars are in place are unknown. We present 2 cases: 1 with a successful twin gestation and another with a successful singleton gestation. These women carried the pregnancies to term and delivered their infants with the Nuss bars in place.

  19. Usefulness of Kent retractor and lifting hook for Nuss procedure.

    PubMed

    Takahashi, Tsubasa; Okazaki, Tadaharu; Yamataka, Atsuyuki; Uchida, Eiji

    2015-11-01

    Although the Nuss procedure for pectus excavatum has been widely employed, a variety of complications have been reported. The most dangerous complication is cardiac injury from the insertion of the introducer. To eliminate these complications, we present a sternum elevating technique using a Kent retractor and a lifting hook.

  20. Usefulness of infrared thermal imaging camera for screening of postoperative surgical site infection after the nuss procedure.

    PubMed

    Fujita, Kenya; Noguchi, Masahiko; Yuzuriha, Shunsuke; Yanagisawa, Daisuke; Matsuo, Kiyoshi

    2013-01-01

    Introduction and Objective. The Nuss procedure is widely used in the treatment of pectus excavatum worldwide. Postoperative pectus bar infection is one of the most serious complications associated with this procedure. Therefore, early detection of signs of implant infection is very important. However, this is difficult, and effective methods have yet to be established. Methods. We use a handheld infrared thermal imaging camera to screen patients for postoperative infection following the Nuss procedure. Here, we report a 28-year-old man with recurrent postoperative (Ravitch procedure) pectus excavatum. Results. Infrared thermography camera clearly indicated slight cellulitis in the right chest. Conclusion. Our technique may assist in preventing postoperative bar infection and removal caused by severe bar infection. Furthermore, this camera is potentially suitable for many situations in infection monitoring following subcutaneous implant surgery.

  1. Adult Books for Young Adults.

    ERIC Educational Resources Information Center

    Carter, Betty

    1997-01-01

    Considers the differences between young adult and adult books and maintains that teachers must be familiar with young adults' tastes for both. Suggests that traffic between these publishing divisions is a two-way street, with young adults reading adult books and adults reading young adult books. (TB)

  2. Distraction Osteogenesis of Multiple Ribs for the Treatment of Acquired Thoracic Dystrophy.

    PubMed

    Piper, Merisa L; Delrosario, Lawrence; Hoffman, William Y

    2016-03-01

    Acquired thoracic dystrophy is a complication associated with early open repair of pectus excavatum resulting from extensive cartilage resection. The condition can cause serious functional and physiologic impairments, including cardiac compression and restrictive pulmonary function. We describe a 17-year-old boy with acquired thoracic dystrophy after Ravitch repair of pectus excavatum during infancy, whom we treated with distraction osteogenesis. The patient had a marked deformity of the chest wall and general hypoplasia of the central portion of the ribcage, with resultant symptomatic dyspnea on exertion and reduced pulmonary function. After osteotomies and distraction osteogenesis of bilateral ribs 4-8 using customized distraction devices, he had improved thoracic contour, resolution of dyspnea, and decreased restrictive pulmonary symptoms. This case suggests that distraction osteogenesis, already used extensively in craniomaxillofacial and orthopedic surgery, may be a novel method for management of this condition.

  3. Distraction Osteogenesis of Multiple Ribs for the Treatment of Acquired Thoracic Dystrophy.

    PubMed

    Piper, Merisa L; Delrosario, Lawrence; Hoffman, William Y

    2016-03-01

    Acquired thoracic dystrophy is a complication associated with early open repair of pectus excavatum resulting from extensive cartilage resection. The condition can cause serious functional and physiologic impairments, including cardiac compression and restrictive pulmonary function. We describe a 17-year-old boy with acquired thoracic dystrophy after Ravitch repair of pectus excavatum during infancy, whom we treated with distraction osteogenesis. The patient had a marked deformity of the chest wall and general hypoplasia of the central portion of the ribcage, with resultant symptomatic dyspnea on exertion and reduced pulmonary function. After osteotomies and distraction osteogenesis of bilateral ribs 4-8 using customized distraction devices, he had improved thoracic contour, resolution of dyspnea, and decreased restrictive pulmonary symptoms. This case suggests that distraction osteogenesis, already used extensively in craniomaxillofacial and orthopedic surgery, may be a novel method for management of this condition. PMID:26908658

  4. Adult immunization

    PubMed Central

    Mehta, Bharti; Chawla, Sumit; Kumar Dharma, Vijay; Jindal, Harashish; Bhatt, Bhumika

    2014-01-01

    Vaccination is recommended throughout life to prevent vaccine-preventable diseases and their sequel. The primary focus of vaccination programs has historically been directed to childhood immunizations. For adults, chronic diseases have been the primary focus of preventive and medical health care, though there has been increased emphasis on preventing infectious diseases. Adult vaccination coverage, however, remains low for most of the routinely recommended vaccines. Though adults are less susceptible to fall prey to traditional infectious agents, the probability of exposure to infectious agents has increased manifold owing to globalization and increasing travel opportunities both within and across the countries. Thus, there is an urgent need to address the problem of adult immunization. The adult immunization enterprise is more complex, encompassing a wide variety of vaccines and a very diverse target population. There is no coordinated public health infrastructure to support an adult immunization program as there is for children. Moreover, there is little coordination among adult healthcare providers in terms of vaccine provision. Substantial improvement in adult vaccination is needed to reduce the health consequences of vaccine-preventable diseases among adults. Routine assessment of adult patient vaccination needs, recommendation, and offer of needed vaccines for adults should be incorporated into routine clinical care of adults. PMID:24128707

  5. Moyamoya disease associated with asymptomatic mosaic Turner syndrome: a rare cause of hemorrhagic stroke.

    PubMed

    Manjila, Sunil; Miller, Benjamin R; Rao-Frisch, Anitha; Otvos, Balint; Mitchell, Anna; Bambakidis, Nicholas C; De Georgia, Michael A

    2014-01-01

    Moyamoya disease is a rare cerebrovascular anomaly involving the intracranial carotid arteries that can present clinically with either ischemic or hemorrhagic disease. Moyamoya syndrome, indistinguishable from moyamoya disease at presentation, is associated with multiple clinical conditions including neurofibromatosis type 1, autoimmune disease, prior radiation therapy, Down syndrome, and Turner syndrome. We present the first reported case of an adult patient with previously unrecognized mosaic Turner syndrome with acute subarachnoid and intracerebral hemorrhage as the initial manifestation of moyamoya syndrome. A 52-year-old woman was admitted with a subarachnoid hemorrhage with associated flame-shaped intracerebral hemorrhage in the left frontal lobe. Physical examination revealed short stature, pectus excavatum, small fingers, micrognathia, and mild facial dysmorphism. Cerebral angiography showed features consistent with bilateral moyamoya disease, aberrant intrathoracic vessels, and an unruptured 4-mm right superior hypophyseal aneurysm. Genetic analysis confirmed a diagnosis of mosaic Turner syndrome. Our case report is the first documented presentation of adult moyamoya syndrome with subarachnoid and intracerebral hemorrhage as the initial presentation of mosaic Turner syndrome. It illustrates the utility of genetic evaluation in patients with cerebrovascular disease and dysmorphism.

  6. Urinary tract infection - adults

    MedlinePlus

    Bladder infection - adults; UTI - adults; Cystitis - bacterial - adults; Pyelonephritis - adults; Kidney infection - adults ... to the hospital if you: Are an older adult Have kidney stones or changes in the anatomy ...

  7. Adult intussusception.

    PubMed Central

    Azar, T; Berger, D L

    1997-01-01

    OBJECTIVE: The objectives were to review adult intussusception, its diagnosis, and its treatment. SUMMARY BACKGROUND DATA: Adult intussusception represents 1% of all bowel obstructions, 5% of all intussusceptions, and 0.003%-0.02% of all hospital admissions. Intussusception is a different entity in adults than it is in children. METHODS: The records of all patients 18 years and older with the postoperative diagnosis of intussusception at the Massachusetts General Hospital during the years 1964 through 1993 were reviewed retrospectively. The 58 patients were divided into those with benign enteric, malignant enteric, benign colonic, and malignant colonic lesions associated with their intussusception. The diagnosis and treatment of each were reviewed. RESULTS: In 30 years at the Massachusetts General Hospital, there are 58 cases of surgically proven adult intussusception. The patients' mean age was 54.4 years. Most patients presented with symptoms consistent with bowel obstruction. There were 44 enteric and 14 colonic intussusceptions. Ninety-three percent of the intussusceptions were associated with a pathologic lesion. Forty-eight percent of the enteric lesions were malignant and 52% were benign. Forty-three percent of the colonic lesions were malignant and 57% were benign. CONCLUSIONS: Intussusception occurs rarely in adults. It presents with a variety of acute, intermittent, and chronic symptoms, thus making its preoperative diagnosis difficult. Computed tomography scanning proved to be the most useful diagnostic radiologic method. The diagnosis and treatment of adult intussusception are surgical. Surgical resection of the intussusception without reduction is the preferred treatment in adults, as almost half of both colonic and enteric intussusceptions are associated with malignancy. PMID:9296505

  8. Adult Children.

    ERIC Educational Resources Information Center

    Frazier, Billie H.

    This document contains a brief bibliography of peer-reviewed literature, with abstracts, on adult children. It is one of 12 bibliographies on aging prepared by the National Agricultural Library for its "Pathfinders" series of publications. Topics covered by the other 11 bibliographies include aging parents, dementia and Alzheimer's disease in the…

  9. Adult Psychology.

    ERIC Educational Resources Information Center

    Bischof, Ledford J.

    This volume comprehensively reviews the research on the psychology of the middle aged (ages 40-65). Topics include the concept of maturity and maturation models, the measurement and influences of adult self image; marriage and sexual patterns; intergenerational relationships between and children; vocations and avocations (work, retirement, play,…

  10. ADULT EDUCATION OF MIGRANT ADULTS.

    ERIC Educational Resources Information Center

    BEAL, CATHERINE; AND OTHERS

    UNITS ON MIGRANT ADULT EDUCATION, AND A UNIT ON ORGANIZING INFORMAL GROUPS OF MIGRANT WOMEN TO DISCUSS MAINTAINING AND IMPROVING THEIR TEMPORARY HOMES, ARE PRESENTED. THE GOALS OF THE UNIT ON EDUCATION FOR MIGRANT MEN ARE ECONOMIC INDEPENDENCE, BETTER HEALTH AND WELL-BEING, AND BETTER HANDLING OF RESPONSIBILITIES. THE MAIN DIVISIONS OF THE…

  11. [Adult twins].

    PubMed

    Charlemaine, Christiane

    2006-12-31

    This paper explores the deep roots of closeness that twins share in their youngest age and their effect on their destiny at the adult age. Psychologists believe the bond between twins begins in utero and develops throughout the twins' lives. The four patterns of twinship described show that the twin bond is determined by the quality of parenting that twins receive in their infancy and early childhood. Common problems of adult twins bring about difficulties to adapt in a non-twin world. The nature versus nurture controversy has taken on new life focusing on inter-twin differences and the importance of parent-child interaction as fundamental to the growth and development of personality. PMID:17352324

  12. Obstructive sleep apnea - adults

    MedlinePlus

    Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults ... When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your ...

  13. Teaching Adults. Third Edition.

    ERIC Educational Resources Information Center

    Rogers, Alan

    The question of how adult educators can make their teaching of adults more effective is explored in the context of recent work on adult lifelong learning. The following are among the topics discussed: (1) modes of adult education and the shift in focus from adult education to lifelong learning; (2) the contract between adult student and adult…

  14. Chronic obstructive pulmonary disease - adults - discharge

    MedlinePlus

    ... adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; Chronic bronchitis - adults - discharge; Emphysema - adults - ...

  15. Adult flatfoot.

    PubMed

    Toullec, E

    2015-02-01

    Adult flatfoot is defined as a flattening of the medial arch of the foot in weight-bearing and lack of a propulsive gait. The 3 lesion levels are the talonavicular, tibiotarsal and midfoot joints. The subtalar joint is damaged by the consequent rotational defects. Clinical examination determines deformity and reducibility, and assesses any posterior tibialis muscle deficit, the posterior tibialis tendon and spring ligament being frequently subject to degenerative lesions. Radiographic examination in 3 incidences in weight-bearing is essential, to determine the principal level of deformity. Tendon (posterior tibialis tendon) and ligamentous lesions (spring ligament and interosseous ligament) are analyzed on MRI or ultrasound. In fixed deformities, CT explores for arthritic evolution or specific etiologies. 3D CT reconstruction can analyze bone and joint morphology and contribute to the planning of any osteotomy. Medical management associates insoles and physiotherapy. Acute painful flatfoot requires strict cast immobilization. Surgical treatment associates numerous combinations of procedures, currently under assessment for supple flatfoot: for the hindfoot: medial slide calcaneal osteotomy, calcaneal lengthening osteotomy, or arthroereisis; for the midfoot: arthrodesis on one or several rays, or first cuneiform or first metatarsal osteotomy; for the ankle: medial collateral ligament repair with tendon transfer. Fixed deformities require arthrodesis of one or several joint-lines in the hindfoot; for the ankle, total replacement after realignment of the foot, or tibiotalocalcaneal fusion or ankle and hindfoot fusion; and, for the midfoot, cuneonavicular or cuneometatarsal fusion. Tendinous procedures are often associated. Specific etiologies may need individualized procedures. In conclusion, adult flatfoot tends to be diagnosed and managed too late, with consequent impact on the ankle, the management of which is complex and poorly codified.

  16. Adult flatfoot.

    PubMed

    Toullec, E

    2015-02-01

    Adult flatfoot is defined as a flattening of the medial arch of the foot in weight-bearing and lack of a propulsive gait. The 3 lesion levels are the talonavicular, tibiotarsal and midfoot joints. The subtalar joint is damaged by the consequent rotational defects. Clinical examination determines deformity and reducibility, and assesses any posterior tibialis muscle deficit, the posterior tibialis tendon and spring ligament being frequently subject to degenerative lesions. Radiographic examination in 3 incidences in weight-bearing is essential, to determine the principal level of deformity. Tendon (posterior tibialis tendon) and ligamentous lesions (spring ligament and interosseous ligament) are analyzed on MRI or ultrasound. In fixed deformities, CT explores for arthritic evolution or specific etiologies. 3D CT reconstruction can analyze bone and joint morphology and contribute to the planning of any osteotomy. Medical management associates insoles and physiotherapy. Acute painful flatfoot requires strict cast immobilization. Surgical treatment associates numerous combinations of procedures, currently under assessment for supple flatfoot: for the hindfoot: medial slide calcaneal osteotomy, calcaneal lengthening osteotomy, or arthroereisis; for the midfoot: arthrodesis on one or several rays, or first cuneiform or first metatarsal osteotomy; for the ankle: medial collateral ligament repair with tendon transfer. Fixed deformities require arthrodesis of one or several joint-lines in the hindfoot; for the ankle, total replacement after realignment of the foot, or tibiotalocalcaneal fusion or ankle and hindfoot fusion; and, for the midfoot, cuneonavicular or cuneometatarsal fusion. Tendinous procedures are often associated. Specific etiologies may need individualized procedures. In conclusion, adult flatfoot tends to be diagnosed and managed too late, with consequent impact on the ankle, the management of which is complex and poorly codified. PMID:25595429

  17. An ectodermal dysplasia syndrome of alopecia, onychodysplasia, hypohidrosis, hyperkeratosis, deafness and other manifestations.

    PubMed

    Freire-Maia, N; Cat, I; Raponegaidzinski, R

    1977-01-01

    A girl is reported with a hitherto apparently undescribed ectodermal dysplasia syndrome. The main findings include: alopecia, onychodysplasia, hypohidrosis, sensorineural deafness, skin with a tan color and hyperkeratosis (involving also plams and soles), unusual facies (with slight auricle and nose abnormalities), pectus excavatum, severe hyperopia, EEG abnormalities, and retarded bone age. The patient also presents mongoloid palpebral slanting, narrow palpebral fissures, bilateral esotropia, photophobia and dermatoglyphics with extensive ridge dissociation. The etiology is unknown but presumed to be genetic, possibly due to the homozygous state of an autosomal recessive mutation.

  18. A simple idea for approximating the volume of filler needed for chest-wall contour-defects.

    PubMed

    Sivathasan, Niroshan; Chakrabarty, Kaushik H

    2012-09-01

    Fillers can be used to correct contour-defects. Due to the irregularities of defects, estimating the volume of filler required can be difficult. This frequently results in surgeons taking a step-wise approach to filler-injection, usually occurring over different appointments. Using a patient with pectus excavatum as an example, we provide a simple tip as to estimating the volume of filler required. In this case, normal saline was poured into the chest-wall defect until the adequate level was reached (from the lateral aspect), while noting how much liquid was used. The patient then had a comparable volume of filler injected.

  19. Adult Still's disease

    MedlinePlus

    Still's disease - adult; AOSD ... than 1 out of 100,000 people develop adult-onset Still's disease each year. It affects women more often than men. The cause of adult Still's disease is unknown. No risk factors for ...

  20. Panic Disorder among Adults

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  1. Bipolar Disorder Among Adults

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  2. Major Depression Among Adults

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  3. Adult Recruitment Practices.

    ERIC Educational Resources Information Center

    Kaufman, Juliet, Ed.; And Others

    Findings of an American College Testing Program 1981 survey on college recruitment of adult students are summarized, and 12 articles on adult recruitment are presented. Titles and authors are as follows: "Adult Recruitment Practices: A Report of a National Survey" (Patricia Spratt, Juliet Kaufmann, Lee Noel); "Three Programs for Adults in Shopping…

  4. Adult Cancers in Adolescents and Young Adults.

    PubMed

    Laurence, Valérie; Marples, Maria; Stark, Daniel P

    2016-01-01

    The pattern of cancer seen in young people changes with increasing age, transitioning from childhood- to adult-type cancer in adolescence and the third decade. The risk factors, presentation and biology of cancer in young adults differ from those in the older adult population. Factors of particular significance in adolescents and young adults (AYAs) include genetic predisposition to adult-type cancer, diagnostic uncertainty, long-term morbidity and considerations of fertility. New systemic therapies are being introduced that can prolong life and even increase the chance of cure, but the impact on AYAs is uncertain, as these patients are often under-represented in clinical trials. Here, we discuss the management of AYAs with 3 of the most common cancers affecting adults, when they emerge in the AYA populations, and therefore are currently met by medical oncologists - breast cancer, colorectal cancer and melanoma. PMID:27595357

  5. Adult Congenital Heart Association

    MedlinePlus

    ... survivable, manageable, yet in the routine years between infancy and adulthood, sometimes forgettable. The Adult Congenital Heart ... understand the continuum of the disease from its infancy. The Adult Congential Heart Association brings together valuable ...

  6. Immunization Schedules for Adults

    MedlinePlus

    ... ACIP Vaccination Recommendations Why Immunize? Vaccines: The Basics Immunization Schedules for Adults in Easy-to-read Formats ... previous immunizations. View or Print a Schedule Recommended Immunizations for Adults (19 Years and Older) by Age ...

  7. Liberal Adult Education.

    ERIC Educational Resources Information Center

    Toiviainen, Timo

    1988-01-01

    Discusses providers of and the concept of liberal adult education in Finland. Providers include (1) folk high schools, (2) adult education centers, (3) voluntary popular organizations, (4) public libraries, (5) evening schools, (6) cooperative groups formed of universities and other adult education providers, (7) summer universities, and (8)…

  8. Comparing Adult Education Worldwide.

    ERIC Educational Resources Information Center

    Charters, Alexander N.; And Others

    Comparative international adult education, defined as that field in which adult educators from various countries compare their own institutions and practices with those of their counterparts in other nations, is examined. Provided is an account of adult education in nine European socialist countries (including the Soviet Union), as well as…

  9. Adult Numeracy Core Curriculum.

    ERIC Educational Resources Information Center

    Steeds, Andrew, Ed.

    Designed primarily for adult literacy teachers and tutors, this curriculum describes the content of what should be taught in numeracy programs in order to meet the individual needs of adults through the selection and teaching of skills appropriate to those adults' needs. An introduction describes national standards and qualifications, learners,…

  10. Adult Educators' Core Competences

    ERIC Educational Resources Information Center

    Wahlgren, Bjarne

    2016-01-01

    Which competences do professional adult educators need? This research note discusses the topic from a comparative perspective, finding that adult educators' required competences are wide-ranging, heterogeneous and complex. They are subject to context in terms of national and cultural environment as well as the kind of adult education concerned…

  11. Adults Learning. Fourth Edition.

    ERIC Educational Resources Information Center

    Rogers, Jenny

    Aimed at anyone who wants to know how to teach adults, this guide aims to build confidence, offer practical advice, and give the real-life flavor of helping fellow adults develop. Chapter 1 addresses adult learners: mindsets, motivation, and learning (learning cycle, learning styles, relevance, reinforcement and practice, experience, learning to…

  12. Adult Education in Hungary.

    ERIC Educational Resources Information Center

    Csoma, Gyula; And Others

    Beginning with a brief survey of the national system, this work covers provisions since 1945 for adult education in Hungary. Educational objectives and other theoretical aspects of adult education in Hungarian society are described, together with the eight year elementary program, technical and vocational adult schools, general and professional…

  13. An Adult ESL Curriculum.

    ERIC Educational Resources Information Center

    South Carolina Literacy Resource Center, Columbia.

    This curriculum framework for adult literacy was written by 21 South Carolina adult English-as-a-Second-Language (ESL) instructors, as submitted to the South Carolina Literacy Resource Center. It is based on current theories in the fields of adult education and second language acquisition and is designed to be flexible so that it may be adapted to…

  14. Dimensions of Adult Learning

    ERIC Educational Resources Information Center

    Foley, Griff, Ed.

    2004-01-01

    This broad introduction to adult and postcompulsory education offers an overview of the field for students, adult educators and workplace trainers. The book establishes an analytical framework to emphasize the nature of learning and agency of learners; examines the core knowledge and skills that adult educators need; discusses policy, research and…

  15. Canadian Adult Basic Education.

    ERIC Educational Resources Information Center

    Brooke, W. Michael, Comp.

    "Trends," a publication of the Canadian Association for Adult Education, is a collection of abstracts on selected subjects affecting adult education; this issue is on adult basic education (ABE). It covers teachers and teacher training, psychological factors relating to the ABE teacher and students, manuals for teachers, instructional materials,…

  16. Adult Learning Assumptions

    ERIC Educational Resources Information Center

    Baskas, Richard S.

    2011-01-01

    The purpose of this study is to examine Knowles' theory of andragogy and his six assumptions of how adults learn while providing evidence to support two of his assumptions based on the theory of andragogy. As no single theory explains how adults learn, it can best be assumed that adults learn through the accumulation of formal and informal…

  17. Adult Education in Greece

    ERIC Educational Resources Information Center

    Kokkos, Alexios

    2008-01-01

    The central aim of this article is to analyse the current situation of adult education in Greece. The article focuses on the following points: (a) the degree of participation in programmes of continuing professional training and general adult education courses, (b) the quality and the outcomes of the adult education provision in Greece, and (c)…

  18. Adults Role in Bullying

    ERIC Educational Resources Information Center

    Notar, Charles E.; Padgett, Sharon

    2013-01-01

    Do adults play a role in bullying? Do parents, teachers, school staff, and community adult leaders influence bullying behavior in children and teenagers? This article will focus on research regarding all adults who have almost daily contact with children and teens and their part in how bullying is identified, addressed, and prevented. This article…

  19. Adult Survival Skills Assessment.

    ERIC Educational Resources Information Center

    Walsko, Gregory M.

    The purpose of this instrument is to supplement data from the Adult Basic Learning Examination in assessing the functional level of adults in daily situations. It may also be used as a teaching tool for adults requesting tutoring in specific concepts and skills presented in the instrument. This instrument is an informal assessment instrument and…

  20. Adult Learning: A Reader.

    ERIC Educational Resources Information Center

    Sutherland, Peter, Ed.

    This book on adult learning is divided into six sections. Section 1, Cognitive Processes, includes the following chapters: "Cognitive Processes: Contemporary Paradigms of Learning" (Jack Mezirow); "Information Processing, Memory, Age and Adult Learning" (Gillian Boulton-Lewis); "Adult Learners' Metacognitive Behaviour in Higher Education" (Barry…

  1. Kids Who Outwit Adults.

    ERIC Educational Resources Information Center

    Seita, John R.; Brendtro, Larry K.

    Kids who distrust adults are highly skilled at hiding their real nature and resisting change. Most adults shun such youths or get mired in conflict with them. Punitive get tough practices as well as traditional flaw-fixing treatment are reactive strategies that often drive these youths further from adult bonds and reinforce oppositional and…

  2. Adults Learning for Development.

    ERIC Educational Resources Information Center

    Rogers, Alan

    This book, drawing on 30 years of adult education experience in England, Ireland, India, and other countries, contrasts the individualistic approach to adult education in the West with the social responsibility view of adult education in the developing world. The book's thesis is that the gulf between the approach of the West and that of…

  3. Young Adult Services Manual.

    ERIC Educational Resources Information Center

    Boegen, Anne, Ed.

    Designed to offer guidelines, ideas and help to those who provide library service to young adults, this manual includes information about the provision of young adult (YA) services in six sections. The first section, which addresses planning and administration, includes a definition of a young adult and a checklist for determining community needs…

  4. The Adult Experience.

    ERIC Educational Resources Information Center

    Belsky, Janet

    The 14 chapters of this textbook chronicle adult development from youth through old age, emphasizing both research and interviews with adults at various stages in their lives. Topics covered include the following: (1) the academic field of adult development; (2) theories and research methods; (3) aging and disease prevention; (4) sexuality and…

  5. Adult Education in Turkey

    ERIC Educational Resources Information Center

    Miser, Rifat; Ural, Ozana; Ünlühisarýklý, Özlem

    2013-01-01

    This study investigates the situation and practices of adult education in Turkey in terms of (a) participants, (b) providers, and (c) program areas. The data were derived from published statistical data and one-to-one interaction with adult education providers when such data are unavailable. Turkey has a long tradition of adult education with…

  6. New material for Nuss procedure.

    PubMed

    Osawa, Hisayoshi; Mawatari, Tohru; Watanabe, Atsushi; Abe, Tomio

    2004-10-01

    The Nuss procedure for pectus excavatum repair has been considered an acceptable method in terms of its decreased invasiveness and excellent cosmetic results. Although a steel bar is usually used for elevating the sternum, we used a titanium alloy plate for pectus excavatum repair for the first time. The characteristics of this plate are that 1) it comes out translucently on X-rays, 2) MRI examination is possible because titanium will not be magnetized, and 3) it is possible to go through the security checkpoint at the airport without setting off the metal detector. Furthermore, the titanium alloy is highly elastic, which reduces complications such as dislocation, and it excels in the conformity to organization. Patients who have received the Nuss operation are forced to somewhat limit their daily life for two or three years until the bar is removed. A plate made from titanium alloy resolves this problem because of its material and it is thought to be an ideal candidate for elevating the sternum during the Nuss operation. PMID:15563267

  7. Estimation of cartilaginous region in noncontrast CT of the chest

    NASA Astrophysics Data System (ADS)

    Zhao, Qian; Safdar, Nabile; Yu, Glenna; Myers, Emmarie; Sandler, Anthony; Linguraru, Marius George

    2014-03-01

    Pectus excavatum is a posterior depression of the sternum and adjacent costal cartilages and is the most common congenital deformity of the anterior chest wall. Its surgical repair can be performed via minimally invasive procedures that involve sternum and cartilage relocation and benefit from adequate surgical planning. In this study, we propose a method to estimate the cartilage regions in thoracic CT scans, which is the first step of statistical modeling of the osseous and cartilaginous structures for the rib cage. The ribs and sternum are first segmented by using interactive region growing and removing the vertebral column with morphological operations. The entire chest wall is also segmented to estimate the skin surface. After the segmentation, surface meshes are generated from the volumetric data and the skeleton of the ribs is extracted using surface contraction method. Then the cartilage surface is approximated via contracting the skin surface to the osseous structure. The ribs' skeleton is projected to the cartilage surface and the cartilages are estimated using cubic interpolation given the joints with the sternum. The final cartilage regions are formed by the cartilage surface inside the convex hull of the estimated cartilages. The method was validated with the CT scans of two pectus excavatum patients and three healthy subjects. The average distance between the estimated cartilage surface and the ground truth is 2.89 mm. The promising results indicate the effectiveness of cartilage surface estimation using the skin surface.

  8. Recruiting Adult Education Students.

    ERIC Educational Resources Information Center

    Learning Resources Network, Manhattan, KS.

    This document is the first nationwide compilation of successful recruiting techniques for students in adult basic education, literacy, General Educational Development classes, and adult high school degree programs. Information for the publication was gathered from a literature search and other sources, especially "Reaching the Least Educated," a…

  9. Provision for Adult Education

    ERIC Educational Resources Information Center

    Hutchinson, Edward

    1970-01-01

    Comments on the report recently issued by the National Institute of Adult Education as a result of inquiries made into provision for adult education in six areas in England and one in Wales between the years 1967 and 1969. (Author/EB)

  10. Counseling Adult Adoptees

    ERIC Educational Resources Information Center

    Corder, Kate

    2012-01-01

    This review presents various resources about working with adult adoptees in order to inform counselors in their practice. Topics covered include basics of adoption, including types of adoption and adoption statistics; possible issues adult adoptees may face; and suggestions and implications for counselors. The article addresses some of the serious…

  11. Adult Counseling Project.

    ERIC Educational Resources Information Center

    Perrone, Phil; Davis, Sandy A.

    In order to determine the specific counseling needs of the adult learner, staff of the Adult Counseling Project began by conducting a literature search pertaining to the problems of returning students and those considering a return to school. The review revealed that little is known about the educational and vocational needs of the returning…

  12. Adult Day Services

    MedlinePlus

    A Smart Choice Adult Day Services Comparison At-a-Glance 1 Adult Day Services Assisted Living Home Care Nursing Homes Live at home with family ... supervision Nursing care available as needed during the day Flexibility to receive care only on days when ...

  13. Today's Adult Students

    ERIC Educational Resources Information Center

    Reese, Susan

    2012-01-01

    Who are the adult students in career and technical education (CTE) today? There is not one simple answer to that question. Some are young with little life experience, while others are returning to the workforce and learning new skills to reinvent themselves. Whatever the case, educating adult students is an integral part of ACTE's mission, and the…

  14. Toward Transpersonal Adult Development

    ERIC Educational Resources Information Center

    Boucouvalas, Marcie

    2016-01-01

    As a foundation for discussing transpersonal adult development, the author traces her trajectory, involvement in, and contribution to the modern transpersonal movement and her introduction of it to the adult learning literature, beginning during the early 1980s. Highlighted are the transpersonal domain and a differentiation between transpersonal…

  15. Adult Education Regional Planning

    ERIC Educational Resources Information Center

    California Community Colleges, Chancellor's Office, 2015

    2015-01-01

    For more than one hundred and fifty years, until 2008, California was an undisputed national leader in its commitment to adult education. The state's investment in adult learners topped $750 million, a sum greater than the combined total of every other state in the nation. However, for the past several years recession and fiscal crisis have left…

  16. Adult Education in Thailand.

    ERIC Educational Resources Information Center

    Miller, Harry G.; Torricelli, James

    To develop background for examining the past, present, and future of adult education in Thailand, the author initially sketches an economic and geographic profile of the country. In the second of five sections, Thailand's adult education movement is traced by examining the influences of kings, the Buddhist religion, various governments, and the…

  17. Authenticity in Adult Learning

    ERIC Educational Resources Information Center

    Ashton, Sam

    2010-01-01

    This paper is concerned with the relationship between authenticity and adult learning and prompted by some studies in which adult "authentic learning" is a central concept. The implication revealed by them is that real-worldness of learning contexts, learning content and learning tasks is perceived as conferring authenticity on learning. Here,…

  18. Nutrition in older adults.

    PubMed

    DiMaria-Ghalili, Rose Ann; Amella, Elaine

    2005-03-01

    Both physiologic and psychosocial changes affect the nutritional status of adults over the age of 65. Malnutrition is, in fact, a greater threat to this population than obesity. This article reviews the intake requirements of older adults and discusses the risk factors that can lead to malnutrition, including diet, limited income, isolation, chronic illness, and physiologic changes. Assessment and nursing interventions are also addressed.

  19. Young Adult Literature.

    ERIC Educational Resources Information Center

    Sewell, Ernestine P., Ed.

    1981-01-01

    The major articles in this journal issue deal with various aspects of young adult literature. Specific topics covered in the articles are (1) questions worth asking students about young adult novels, (2) the five major functions of adolescent literature in high school literature programs, (3) Southwestern literature for adolescents, (4) teaching…

  20. Career Advising for Adults.

    ERIC Educational Resources Information Center

    Miles, Johnnie H., Ed.; Clouse, James, Ed.

    This manual is designed to provide information and structural exercises for teachers who assist adults in career advising and career development. The materials, which can be shared with students individually or in small groups, are based on needs of adult students identified from the literature and from local needs assessment surveys. Topics…

  1. Libraries and Adult Learners.

    ERIC Educational Resources Information Center

    Josey, E. J., Ed.

    1982-01-01

    Of the 13 essays presented in this special issue on libraries and adult education, 8 focus on programs and services from the public library for adult learners. These essays provide information on: (1) an Education Information Centers Program (EIC) designed to complement employment skills training provided under the Comprehensive Employment and…

  2. Constructing Adult Identities.

    ERIC Educational Resources Information Center

    Baxter Magolda, Marcia B.

    1999-01-01

    Stories from a longitudinal study of 39 adults illuminate the complex journey from external to internal self-definition. Explores the dynamics of constructing an internal adult identity from age 22 to 30 and translates into recommendations for effective student affairs practice. (Contains 22 references.) (Author/GCP)

  3. Adult Learning and Education

    ERIC Educational Resources Information Center

    Rubenson, Kjell, Ed.

    2011-01-01

    As individuals and societies try to respond to fundamental economic and social transformation, the field of adult learning and education is rapidly getting increased attention and new topics for research on adult learning have emerged. This collection of articles from the International Encyclopedia of Education 3e offers practitioners and…

  4. Adult Education and Development.

    ERIC Educational Resources Information Center

    Hinzen, Heribert, Ed.

    2002-01-01

    This document contains 19 papers on adult education and development worldwide. The following papers are included: "Editorial" (Heribert Hinzen); "Lifelong Learning in Europe: Moving towards EFA (Dakar Framework for Action on Education for All) Goals and the CONFINTEA V Agenda" (Sofia Conference on Adult Education); "Poverty and Schooling in the…

  5. Adult Tech Prep.

    ERIC Educational Resources Information Center

    Schaad, Donna

    For over 2 years, Blak Hawk College (Illinois) has provided high school equivalency (GED) candidates and recipients, older returning students, and underprepared high school graduates with a Tech Prep curriculum to give them the skills to make the transition from adult basic education to college or work. The Adult Tech Prep (ATP) core curriculum…

  6. Gender Dysphoria in Adults.

    PubMed

    Zucker, Kenneth J; Lawrence, Anne A; Kreukels, Baudewijntje P C

    2016-01-01

    Gender dysphoria (GD), a term that denotes persistent discomfort with one's biologic sex or assigned gender, replaced the diagnosis of gender identity disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. Subtypes of GD in adults, defined by sexual orientation and age of onset, have been described; these display different developmental trajectories and prognoses. Prevalence studies conclude that fewer than 1 in 10,000 adult natal males and 1 in 30,000 adult natal females experience GD, but such estimates vary widely. GD in adults is associated with an elevated prevalence of comorbid psychopathology, especially mood disorders, anxiety disorders, and suicidality. Causal mechanisms in GD are incompletely understood, but genetic, neurodevelopmental, and psychosocial factors probably all contribute. Treatment of GD in adults, although largely standardized, is likely to evolve in response to the increasing diversity of persons seeking treatment, demands for greater client autonomy, and improved understanding of the benefits and limitations of current treatment modalities. PMID:26788901

  7. Schizophrenia in older adults.

    PubMed

    Collier, Elizabeth; Sorrell, Jeanne M

    2011-11-01

    Although the number of people older than 55 with schizophrenia is expected to double during the next 20 years, the research data on older adults with schizophrenia are limited. This appears to be because until the middle of the 20th century, it was assumed that mental illness in older adults was a part of the aging process and because older adults are often excluded from research investigations. Nursing research is needed to explore how people with schizophrenia learn to manage their problems as they age, as well as how those who are first diagnosed with schizophrenia in later life adapt to their illness. Mental health nurses need to be cautious in assigning premature labels to older adults with mental illness that may lead to unsubstantiated assumptions about levels of disability. Instead, nurses should realize individual potential regarding undiscovered strengths and should attempt to create interventions that recognize and foster personal development for older adults with schizophrenia.

  8. Adult Education in the Seventies.

    ERIC Educational Resources Information Center

    Indian Adult Education Association, New Delhi.

    The proceedings of the 24th All India Adult Education Conference highlight two symposia, "Adult Education and Urban Development" and "Adult Education and Green Revolution." Commission Reports on the two symposia are given. (DB)

  9. Young Adult Smoking Behavior

    PubMed Central

    Ling, Pamela M.; Neilands, Torsten B.; Glantz, Stanton A.

    2009-01-01

    Background Young adults have the highest smoking rate of any age group in the U.S., and new strategies to decrease young adult smoking are needed. The objective of the current study was to identify psychographic and demographic factors associated with current smoking and quitting behaviors among young adults. Methods Attitudes, social groups, and self-descriptors, including supporting action against the tobacco industry, advertising receptivity, depression, alcohol use, and other factors associated with smoking were tested for associations with smoking behaviors in a 2005 cross-sectional survey of 1528 young adults (aged 18–25 years) from a web-enabled panel. Analyses were conducted in 2007. Results Being older was associated with current smoking, whereas having some higher education and being African American or Hispanic were negatively associated with smoking. Supporting action against the tobacco industry was negatively associated with smoking (AOR=0.34 [95% CI=0.22, 0.52]). Perceived usefulness of smoking, exposure to smokers, increased perceived smoking prevalence, receptivity to tobacco advertising, binge drinking, and exposure to tobacco advertising in bars and clubs were associated with smoking. Supporting action against the tobacco industry was associated with intentions to quit smoking (AOR= 4.43 [95% CI=2.18, 8.60]). Conclusions Young adults are vulnerable to tobacco-industry advertising. Media campaigns that denormalize the tobacco industry and appeal to young adults appear to be a powerful intervention to decrease young adult smoking. PMID:19269128

  10. Depression in Older Adults

    PubMed Central

    Fiske, Amy; Wetherell, Julie Loebach; Gatz, Margaret

    2010-01-01

    Depression is less prevalent among older adults than among younger adults but can have serious consequences. Over half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults. Risk factors leading to the development of late life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support. PMID:19327033

  11. Obsessive Compulsive Disorder among Adults

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  12. Brainstem Glioma in Adults

    PubMed Central

    Hu, Jethro; Western, Stephen; Kesari, Santosh

    2016-01-01

    Brainstem gliomas are not nearly as common in adults as they are in children. They are likely the final common consequence not of a single disease process but of several. They can be difficult to diagnose, and are challenging to treat. Clinical studies of this diagnosis are few and generally small. Because of these factors, our understanding of the biology of adult brainstem glioma is incomplete. However, the knowledge base is growing and progress is being made. In this article, we review the current state of knowledge for brainstem glioma in adults and identify key areas for which additional information is required. PMID:27556016

  13. Motivation and Adult Education

    ERIC Educational Resources Information Center

    Veeraraghavan, J.

    1974-01-01

    The paper examines the role of adult education and the contribution it can make to the solution of current problems in developing countries, particularly the problems of economic under-development and over-population. (Author/AG)

  14. About BMI for Adults

    MedlinePlus

    ... Physical Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs About Adult BMI Language: ... Physical Activity Overweight & Obesity Healthy Weight Breastfeeding Micronutrient Malnutrition State and Local Programs Language: English Español (Spanish) ...

  15. Mosquito, adult (image)

    MedlinePlus

    This illustration shows an adult southern house mosquito. This mosquito feeds on blood and is the carrier of many diseases, such as encephalitis, West Nile, dengue fever, yellow fever, and others. ( ...

  16. Motivation and Adult Education.

    ERIC Educational Resources Information Center

    Taylor, J. Rodney

    1982-01-01

    The author reviews theories of human motivation: Lewin's force field analysis, Skinner's operant reinforcement theory, and Maslow's hierarchy of needs. He then extracts the implications of these theories for adult learning. SK)

  17. Education for Older Adults.

    ERIC Educational Resources Information Center

    Glendenning, Frank

    2001-01-01

    Examines ways in which discussion of education for older adults has been enlarged and expanded since 1973. Discusses developments in third-age learning, educational gerontology, and preretirement education. (Contains 33 references.) (SK)

  18. Cardiac imaging in adults

    SciTech Connect

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  19. Adult educators' core competences

    NASA Astrophysics Data System (ADS)

    Wahlgren, Bjarne

    2016-06-01

    Which competences do professional adult educators need? This research note discusses the topic from a comparative perspective, finding that adult educators' required competences are wide-ranging, heterogeneous and complex. They are subject to context in terms of national and cultural environment as well as the kind of adult education concerned (e.g. basic education, work-related education etc.). However, it seems that it is possible to identify certain competence requirements which transcend national, cultural and functional boundaries. This research note summarises these common or "core" requirements, organising them into four thematic subcategories: (1) communicating subject knowledge; (2) taking students' prior learning into account; (3) supporting a learning environment; and (4) the adult educator's reflection on his or her own performance. At the end of his analysis of different competence profiles, the author notes that adult educators' ability to train adult learners in a way which then enables them to apply and use what they have learned in practice (thus performing knowledge transfer) still seems to be overlooked.

  20. Adult Education through World Collaboration.

    ERIC Educational Resources Information Center

    Cassara, Beverly Benner, Ed.

    This book contains the following papers about development/delivery of adult education through the efforts of multinational and bilateral government donors and the International Council for Adult Education (ICAE): "Preface" (Beverly Benner Cassara); "Introduction: Adult Education and Democracy" (Francisco Vio Grossi); "Adult Education and the…

  1. The ABC's of Adult Ed

    ERIC Educational Resources Information Center

    Roehrig, Lucy

    2010-01-01

    According to the 2003 National Assessment of Adult Literacy, it is estimated that 93 million adults in the United States have basic or below basic literacy skills. Those individuals found most lacking in literacy skills were adults living in poverty, adults lacking a high school diploma, seniors and the elderly aged 65 and older, the more than one…

  2. Rich Environments for Adult Learners

    ERIC Educational Resources Information Center

    Bentham, Renee

    2008-01-01

    Unaware of the messages a bare adult learning environment sends and its effect on adult learners, a trainer attends an intensive Reggio Emilia course and learns that the physical environment is the "third teacher"--for adults as well as for children. Using principles of Reggio, she offers suggestions for enhancing adult learning spaces and…

  3. Adult Education in Croatian Society.

    ERIC Educational Resources Information Center

    Pongrac, Silvije, Ed.

    This document contains eight papers on adult education in Croatian society. "Basic Characteristics of Croatian Adult Education up to These Days" (Silvije Pongrac, Ilija Lavrnja) highlights key trends in the development of Croatian adult education. "Adult Education in Croatia Based on Social Changes" (Anita Klapan) discusses Croatian adult…

  4. Adult Seborrheic Dermatitis

    PubMed Central

    2011-01-01

    Seborrheic dermatitis is a common chronic-recurrent inflammatory disorder that most commonly affects adults; however, a more transient infantile form also occurs. The definitive cause of seborrheic dermatitis is unknown. However, proliferation of Malassezia species has been described as a contributing factor. The adult form of seborrheic dermatitis affects up to approximately five percent of the general population. The disorder commonly affects the scalp, face, and periauricular region, with the central chest, axillae, and genital region also involved in some cases. Pruritus is not always present and is relatively common, especially with scalp disease. A variety of treatments are available including topical corticosteroids, topical antifungal agents, topical calcineurin inhibitors, and more recently, a nonsteroidal “device ”cream. This article reviews the practical topical management of seborrheic dermatitis in the United States, focusing on the adult population. PMID:21607192

  5. Adult onset retinoblastoma.

    PubMed

    Sengupta, Sabyasachi; Pan, Utsab; Khetan, Vikas

    2016-07-01

    Retinoblastoma (RB) is the most common primary malignant intraocular tumor of childhood presenting usually before 5 years of age. RB in adults older than 20 years is extremely rare. A literature search using PubMed/PubMed Central, Scopus, Google Scholar, EMBASE, and Cochrane databases revealed only 45 cases till date. Over the past decade, there has been a significant increase in the number of such reports, indicating heightened level of suspicion among ophthalmologists. Compared to its pediatric counterpart, adult onset RB poses unique challenges in diagnosis and treatment. This article summarizes available literature on adult onset RB and its clinical and pathologic profile, genetics, association with retinocytoma, diagnostics, treatment, and outcomes. PMID:27609158

  6. Hypertension in young adults.

    PubMed

    De Venecia, Toni; Lu, Marvin; Figueredo, Vincent M

    2016-01-01

    Hypertension remains a major societal problem affecting 76 million, or approximately one third, of US adults. While more prevalent in the older population, an increasing incidence in the younger population, including athletes, is being observed. Active individuals, like the young and athletes, are viewed as free of diseases such as hypertension. However, the increased prevalence of traditional risk factors in the young, including obesity, diabetes mellitus, and renal disease, increase the risk of developing hypertension in younger adults. Psychosocial factors may also be contributing factors to the increasing incidence of hypertension in the younger population. Increased left ventricular wall thickness and mass are increasingly found in young adults on routine echocardiograms and predict future cardiovascular events. This increasing incidence of hypertension in the young calls for early surveillance and prompt treatment to prevent future cardiac events. In this review we present the current epidemiological data, potential mechanisms, clinical implications, and treatment of hypertension in young patients and athletes.

  7. Adult onset retinoblastoma

    PubMed Central

    Sengupta, Sabyasachi; Pan, Utsab; Khetan, Vikas

    2016-01-01

    Retinoblastoma (RB) is the most common primary malignant intraocular tumor of childhood presenting usually before 5 years of age. RB in adults older than 20 years is extremely rare. A literature search using PubMed/PubMed Central, Scopus, Google Scholar, EMBASE, and Cochrane databases revealed only 45 cases till date. Over the past decade, there has been a significant increase in the number of such reports, indicating heightened level of suspicion among ophthalmologists. Compared to its pediatric counterpart, adult onset RB poses unique challenges in diagnosis and treatment. This article summarizes available literature on adult onset RB and its clinical and pathologic profile, genetics, association with retinocytoma, diagnostics, treatment, and outcomes. PMID:27609158

  8. Nuss bar procedure: past, present and future

    PubMed Central

    Obermeyer, Robert J.; Kelly, Robert E.

    2016-01-01

    Repair of pectus excavatum began at the beginning of the 20th century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support. The wide resection resulted in a very rigid anterior chest wall, and in some instances, the development of asphyxiating chondrodystrophy. The primary care physicians therefore became reluctant to refer the patients for repair. In 1987, Nuss developed a minimally invasive technique that required no cartilage or sternal resection and relied only on internal bracing by means of a sub-sternal bar, which is inserted into the chest through two lateral thoracic incisions and guided across the mediastinum with the help of thoracoscopy. After publication of the procedure in 1998, it became widely accepted and a flood of new patients suddenly started to appear, which allowed for rapid improvements and modifications of the technique. New instruments were developed specifically for the procedure, complications were recognized, and the steps taken to prevent them included the development of a stabilizer and the use of pericostal sutures to prevent bar displacement. Various options were developed for sternal elevation prior to mediastinal dissection to prevent injury to the mediastinal structures, allergy testing was implemented, and pain management improved. The increased number of patients coming for repair permitted studies of cardiopulmonary

  9. Adult Religious Education

    ERIC Educational Resources Information Center

    Elias, John L.

    2012-01-01

    Most religious organizations exert their greatest effort in the religious education of children. This makes sense in terms of handing on the faith to the next generation. Historically, however, religious education of adults is the first endeavor of religious groups. Conducting education of children requires the previous religious education of…

  10. Adult Education in Australia.

    ERIC Educational Resources Information Center

    Whitelock, Derek A., Ed.

    This evaluative national survey begins with a brief historical review of Australian adult education, followed by its current (1968) profile and features of the overall educational system. The next six chapters consider the role played by universities, Federal and state governments, the Workers' Educational Association and other voluntary…

  11. Adult Literacy Perspectives.

    ERIC Educational Resources Information Center

    Taylor, Maurice C., Ed.; Draper, James A., Ed.

    This book, intended to serve as a professional reference work, proposes to define the field of Adult Basic Education in its evolution, its contribution to professional education, and the principal problems and issues. The volume contains the following treatises: "Definitions and Evolution of the Concepts" (Thomas); "Selected Chronology of Literacy…

  12. Bereavement in Older Adults.

    ERIC Educational Resources Information Center

    Morgan, James P.

    1994-01-01

    Factors that place older adults at risk for problems associated with the bereavement process are identified and discussed. Provides guidelines for distinguishing between normal bereavement depression and clinical depression, discusses the impact of different types of loss, describes three types of intervention, and explores countertransference.…

  13. Helping Adults Learn

    ERIC Educational Resources Information Center

    Edmundson, Phyllis J.

    2007-01-01

    Increased attention to preparing addictions counselors and related professionals to use evidence-based practices has brought new attention to the preparation programs for addictions counselors. Research and theory about adult learning emphasizes the importance of students as active participants in problem and experience based learning. This paper…

  14. Simulation in Adult Education.

    ERIC Educational Resources Information Center

    Knolle, Lawrence M.; Nicely, Robert F., Jr.

    Various simulations designed for adult learning experiences are described. A simulation is defined as "an operating model that displays processes over time and thus may develop dynamically." It is stated that this definition implies that the teacher can design a simulation that he can manage and then can increase its complexity. One simulation…

  15. Profiles of Adult Learners.

    ERIC Educational Resources Information Center

    Illinois State Library, Springfield.

    Since January 1986, when the Illinois Secretary of State Literacy Grant Program began funding a wide variety of adult literacy programs, more than 30,000 students have sought help with reading. They have been matched with 25,000 tutors who have provided more than 2 million hours of volunteer instruction. The profiles in this booklet are stories of…

  16. Hearing Loss in Adults.

    ERIC Educational Resources Information Center

    House, John W.

    1997-01-01

    This article discusses hearing loss in adults. It begins with an explanation of the anatomy of the ear and then explains the three types of hearing loss: conductive hearing loss, sensorineural hearing loss, and mixed conductive-sensorineural hearing loss. Tinnitus, hearing aids, and cochlear implants are also addressed. (CR)

  17. Intelligence and Adult Learning.

    ERIC Educational Resources Information Center

    Fellenz, Robert A., Ed.; Conti, Gary J., Ed.

    "Understanding Adult Intelligence" (Robert Sternberg) focuses on the nature of intelligence. It explains Sternberg's triarchic theory, in which he posits three main aspects of intelligence: its relation to the internal or mental world of the learner, its relation to experience, and its relation to the surrounding world. "Strategies and Learning"…

  18. ADULTS IN TRANSITION.

    ERIC Educational Resources Information Center

    SCHLOSSBERG, NANCY K.

    THERE IS A LACK OF THEORY AND EMPIRICAL KNOWLEDGE CONCERNING ADULT DEVELOPMENT BETWEEN THE AGES OF 30 TO 60. THE POSTULATE THAT THIS PERIOD IS CHARACTERIZED BY STABILITY IS QUESTIONED. EXPLORATION TAKES PLACE ALL THROUGH LIFE. ITS QUALITY AND FOCUS MIGHT CHANGE, BUT THE PROCESS IS THE SAME. DEVELOPMENTAL MODELS COULD PROVIDE A MORE COMPREHENSIVE…

  19. Adult Learning Matters

    ERIC Educational Resources Information Center

    Adults Learning, 2009

    2009-01-01

    The Campaigning Alliance for Lifelong Learning is to lobby parliament for the restoration of the 1.5 million adult learning places lost over the past two years. The campaign has attracted supporters from an astonishingly wide range of backgrounds. In this article, Gordon Marsden, Caroline Biggins, Beth Walker, Mike Chaney, Peter Davies, Sian…

  20. ADHD in Adults. [DVD

    ERIC Educational Resources Information Center

    Barkley, Russell A.

    2006-01-01

    From leading ADHD authority Dr. Russell A. Barkley, this instructive program integrates information about ADHD with the experiences of adults from different walks of life who suffer from the disorder. Including interviews with these individuals, their family members, and the clinicians who treat them, the program addresses such important topics as…

  1. Migration and Adult Education

    ERIC Educational Resources Information Center

    Gois, William

    2007-01-01

    The objective of this paper is to highlight the role of adult education as a tool in addressing labour migration issues, specifically those concerning the protection of migrant workers' rights and the transformation of the impact of migration into positive holistic developmental gains. The view of labour migration as a means to forge the economic…

  2. Facilitation of Adult Development

    ERIC Educational Resources Information Center

    Boydell, Tom

    2016-01-01

    Taking an autobiographical approach, I tell the story of my experiences facilitating adult development, in a polytechnic and as a management consultant. I relate these to a developmental framework of Modes of Being and Learning that I created and elaborated with colleagues. I connect this picture with a number of related models, theories,…

  3. No Adult Left Behind

    ERIC Educational Resources Information Center

    Arndt, Jason

    2010-01-01

    Left out of the conversation for education reform, at least on the level of grade school, secondary school, and college are the adult education programs provided across the country. These programs receive a fraction of the funds and respect as mainstream programs do. However, they are sorely needed in Northwest Indiana. The region's early 21st…

  4. Adult Basic Education Curriculum.

    ERIC Educational Resources Information Center

    Massachusetts Career Development Inst., Springfield.

    This booklet, aimed at adult basic education students, pinpoints and summarizes a few common spelling rules to help make spelling easier, and includes a component on using the dictionary. In the text, each rule is presented with many examples. Exercises follow each spelling rule, allowing students the opportunity to apply the rule to specific…

  5. Adult Children of Alcoholics.

    ERIC Educational Resources Information Center

    Goodman, Ronald W.

    1987-01-01

    Presents analysis of adult children of alcoholics, their experience and adjustment in relation to the severity and type of alcoholism, age considerations and perceptions as a child, and existence and nature of significant others. Discusses alcoholics' and others' family issues, focusing on roles taken, and personality characteristics. Emphasizes…

  6. Adult Education in Brazil.

    ERIC Educational Resources Information Center

    Ministerio da Educacao e Cultura, Rio de Janeiro (Brazil).

    The status and goals of adult education programs in Brazil are discussed in this report. Supplemental systems such as the Brazilian Literacy Movement (Mobral) and their results are described and evaluated. Charts detailing the evolution of literacy are shown and priorities in education are suggested. The progress of other educational entities is…

  7. Protein and older adults.

    PubMed

    Chernoff, Ronni

    2004-12-01

    Body composition changes as people get older. One of the noteworthy alterations is the reduction in total body protein. A decrease in skeletal muscle is the most noticeable manifestation of this change but there is also a reduction in other physiologic proteins such as organ tissue, blood components, and immune bodies as well as declines in total body potassium and water. This contributes to impaired wound healing, loss of skin elasticity, and an inability to fight infection. The recommended dietary allowance (RDA) for adults for protein is 0.8 grams of protein per kilogram of body weight. Protein tissue accounts for 30% of whole-body protein turnover but that rate declines to 20% or less by age 70. The result of this phenomenon is that older adults require more protein/kilogram body weight than do younger adults. Recently, it has become clear that the requirement for exogenous protein is at least 1.0 gram/kilogram body weight. Adequate dietary intake of protein may be more difficult for older adults to obtain. Dietary animal protein is the primary source of high biological value protein, iron, vitamin B(12), folic acid, biotin and other essential nutrients. In fact, egg protein is the standard against which all other proteins are compared. Compared to other high-quality protein sources like meat, poultry and seafood, eggs are the least expensive. The importance of dietary protein cannot be underestimated in the diets of older adults; inadequate protein intake contributes to a decrease in reserve capacity, increased skin fragility, decreased immune function, poorer healing, and longer recuperation from illness.

  8. Utah Adult Education Services. Adult Education Report 1968-69.

    ERIC Educational Resources Information Center

    Utah State Board of Education, Salt Lake City.

    Major purposes for the preparation of this report on public school adult education in Utah were: to provide the public with a description of achievements, trends, and needs, and with meaningful cost accounting information; to make comparisons and analyses of adult education by program, school district, and year; and to provide the adult education…

  9. Adult Education for Limited English Proficient Adults. Fact Sheet 3.

    ERIC Educational Resources Information Center

    Office of Vocational and Adult Education (ED), Washington, DC. Adult Learning and Literacy Clearinghouse.

    An overview of adult education programs and services for limited-English-proficient adults is offered. The population targeted by these programs and services is estimated at 4 to 6.5 million United States residents, refugees, and immigrants. Adults and out-of-school youth 16 years and older are eligible for federal adult…

  10. Adult Development. What do Teachers of Adults Need To Know?

    ERIC Educational Resources Information Center

    Whiting, Susan; And Others

    The first part of this two-part paper provides a general review of adult development and is premised on an understanding of andragogy. Andragogy is the art and science of helping adults learn. It is based on the following four assumptions about adults: (1) as people mature they become less dependent and more self-directed; (2) experiences serve as…

  11. Teaching Nontraditional Adult Students: Adult Learning Theories in Practice

    ERIC Educational Resources Information Center

    Chen, Joseph C.

    2014-01-01

    As the USA experiences rapid growth of nontraditional adult students in higher education, educators and institutions will increasingly need to look beyond the traditional youth-centric educational models to better address adult learning needs. To date, no research has been conducted examining the learning experiences of adult students enrolled in…

  12. Hearing Loss and Older Adults

    MedlinePlus

    ... Home » Health Info » Hearing, Ear Infections, and Deafness Hearing Loss and Older Adults On this page: What is ... about hearing loss and older adults? What is hearing loss? Hearing loss is a sudden or gradual decrease ...

  13. Alcohol Use and Older Adults

    MedlinePlus

    ... version of this page please turn Javascript on. Alcohol Use and Older Adults Alcohol and Aging Adults of any age can have ... Escape (Esc) button on your keyboard.) What Is Alcohol? Alcohol, also known as ethanol, is a chemical ...

  14. Adults with Congenital Heart Defects

    MedlinePlus

    ... Pressure High Blood Pressure Tools & Resources Stroke More Web Booklet: Adults With Congenital Heart Defects Updated:Apr ... topic from the list below to learn more. Web Booklet: Adults With Congenital Heart Defects Introduction Introduction: ...

  15. Facts about Measles for Adults

    MedlinePlus

    ... as part of a combination vaccine, called the MMR vaccine that protects against measles, mumps, and rubella. Which adults should get vaccinated against measles with MMR vaccine? Adults born in 1957 or later who do ...

  16. Renal Disease and Adult Vaccination

    MedlinePlus

    ... Resources for Healthcare Professionals Renal Disease and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... have immunity to this disease Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  17. Liver Disease and Adult Vaccination

    MedlinePlus

    ... Resources for Healthcare Professionals Liver Disease and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... have immunity to this disease Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  18. Finding Your Adult Vaccination Record

    MedlinePlus

    ... Button Past Emails CDC Features Is Your Adult Vaccination Record Up-To-Date? Language: English Español (Spanish) ... next medical appointment. Staying Up-to-date on Vaccination is Important Every year thousands of adults in ...

  19. HIV Infection and Adult Vaccination

    MedlinePlus

    ... Resources for Healthcare Professionals HIV Infection and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... percentage is less than 15%. Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  20. Transformative Dimensions of Adult Learning.

    ERIC Educational Resources Information Center

    Mezirow, Jack

    This book presents a theory of how adults learn by making meaning of their experiences. Chapter 1 gives an overview of an emerging transformation theory of adult learning, compares it with other theories of adult learning, and describes the dynamics of the process through which one makes meaning of one's experience. Chapter 2 examines the way…

  1. Rural Education for Older Adults

    ERIC Educational Resources Information Center

    Mott, Vivian W.

    2008-01-01

    Meeting the learning needs of older adults in rural areas is a critical and growing concern for adult and continuing education. This chapter addresses learning in a rural context for older adults by examining several constructs. These include the definitions of "rural," the issues of the learners' ages, and the various structures and purposes…

  2. Adult Education and Development, 1994.

    ERIC Educational Resources Information Center

    Adult Education and Development, 1994

    1994-01-01

    The publication is a half-yearly journal for adult education in Africa, Asia, and Latin America. Issue 42 includes the following: "Adult Education for Self-Reliance in Community Health Education Programmes" (Kweka); "Promoting Good Nutrition" (Mangvwat); "Incorporating Health-Improvement Activities in Adult Education Programmes in Nigeria"…

  3. Adult Learning and Numeracy: Introduction

    ERIC Educational Resources Information Center

    Kantner, M. Joanne

    2009-01-01

    The purpose of this article was to explore the marginalization of adult mathematics learning within education. The problem is adult education subsumes adult mathematics learning under the umbrella of literacy. Literacy and numeracy compared in terms of their quantities of funding, directed projects, ERIC submissions, and published dissertations.…

  4. Adult Multiple Intelligences and Math.

    ERIC Educational Resources Information Center

    Costanzo, Meg Ryback

    In the Adult Multiple Intelligences (AMI) study, 10 teachers of adults from the northeastern region of the United States explored for 18 months the ways that multiple intelligences (MI) theory could support instruction and assessment in various adult learning contexts. The results of this research were published in a book by Julie Viens called MI…

  5. Facilitating Creativity in Adult Learners

    ERIC Educational Resources Information Center

    Tsai, Kuan Chen

    2013-01-01

    Creativity in education research has received increasing attention, although the major focus of this research has been on children. Despite pleas by several adult educators for promoting creativity, very few studies have focused on adult learners, leaving to it to be explored what approaches are useful for adult educators to facilitate creativity…

  6. Adult Development and the Workplace.

    ERIC Educational Resources Information Center

    Heffernan, James M.

    Little attention has been given to how adults develop through their lifetimes and what roles their workplace environments play in that development. Research and theory regarding adult psychosocial development have confirmed the developmental life-cycle phases of adulthood. These are: leaving the family (ages 16-22), getting into the adult world…

  7. Assessment Tools for Adult Education.

    ERIC Educational Resources Information Center

    Shefrin, Carol; Shafer, Dehra; Forlizzi, Lori

    The Assessment Tools for Adult Education project was designed to provide training and support to staff of the Pennsylvania Bureau of Adult Basic and Literacy Education (ABLE) funded programs to help them use assessment tools and procedures to document the learning gains of the adult students they serve. The following candidate assessment…

  8. Adult Education in Western Germany.

    ERIC Educational Resources Information Center

    Knoll, Joachim H.; And Others

    Here are abstracts of three books on adult education in Western Germany, where the institutions and methods of continuing education have been nearly unknown. The first, ERWACHSENENBILDUNG IN DER BUNDESREPUBLIK (ADULT EDUCATION IN THE FEDERAL REPUBLIC), 167 pages, justifies regarding adult education today as a complete changeover from its forms in…

  9. The Future of Adult Education

    ERIC Educational Resources Information Center

    Schmidt, Steven W.

    2013-01-01

    It is an interesting assignment to think about the future of adult education. In fact, it is an assignment the author has the graduate students in his "Introduction to Adult Education" class at East Carolina University consider during one of their course units. As a member of the Board of Directors for the American Association for Adult and…

  10. Rural Adult Education: Current Status

    ERIC Educational Resources Information Center

    Ritchey, Jeffrey A.

    2008-01-01

    "Context". The word pervades the literature on adult and continuing education. For adult education practitioners and researchers alike, understanding the beliefs and actions of their educational place continues to be of significant concern, and rightfully so. That adults wish to have their histories, experiences, and abilities appreciated and…

  11. Infantile autism: adult outcome.

    PubMed

    Korkmaz, B

    2000-07-01

    Although the core features of autism do not change qualitatively, a gradual overall symptomatic improvement including an increase in adaptive skills is observed in most cases with age. Follow-up studies show that the diagnostic features, the differential diagnosis, and clinical problems of adult autistics differ substantially from that of autistic children. The differential diagnosis of older autistics include personality disorders, learning disabilities, and mood disorder. Depression, epilepsy, and behavioral problems such as aggression and agitation may be major clinical problems during adolescence. The early indicators of a better outcome include a higher level of IQ and language. Among the neuropsychological variables, measures of flexibility and cognitive shift are important as prognostic factors. Early behavioral and educational intervention may especially increase the adaptive skills of the patients and promote the in-family communication. The outcome studies of autism are particularly helpful in addressing the appropriate and most effective programs of remediation for adult autistics.

  12. Adult orbital trapdoor fracture.

    PubMed

    Kum, Clarissa; McCulley, Timothy J; Yoon, Michael K; Hwang, Thomas N

    2009-01-01

    Trapdoor fractures occur almost exclusively in the pediatric population. The authors describe an adult with an entrapped inferior rectus muscle sheath in a trapdoor fracture. A 37-year-old man presented with persistent diplopia 3 weeks after blunt right orbital trauma. The only abnormal findings on clinical examination were limited vertical ductions. No bony defect or displacement was evident on CT. However, several small pockets of air were visible adjacent to the inferior rectus muscle. On surgical exploration, a linear nondisplaced orbital floor fracture was confirmed, and the entrapped inferior rectus muscle was released. One month postoperatively, extraocular motility had improved with no diplopia in primary or reading positions. This case demonstrates that trapdoor fractures can occur in adults and should be considered when suggestive findings are encountered. Clinicians should be aware of this because timely diagnosis and treatment might achieve more favorable outcomes.

  13. Diarrhoea in adults (acute)

    PubMed Central

    2008-01-01

    Introduction An estimated 4000 million cases of diarrhoea occurred worldwide in 1996, resulting in 2.5 million deaths. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute diarrhoea in adults living in resource-rich countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults from resource-rich countries traveling to resource-poor countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults living in resource-poor countries? What are the effects of treatments for acute severe diarrhoea in adults living in resource-poor countries? We searched: Medline, Embase, The Cochrane Library and other important databases up to January 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 71 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet, intravenous rehydration, nasogastric tube rehydration, and oral rehydration solutions (amino acid oral rehydration solution, bicarbonate oral rehydration solution, reduced osmolarity oral rehydration solution, rice-based oral rehydration solution, standard oral rehydration solution). PMID:19450323

  14. Diarrhoea in adults (acute)

    PubMed Central

    2011-01-01

    Introduction An estimated 4.6 billion cases of diarrhoea occurred worldwide in 2004, resulting in 2.2 million deaths. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute diarrhoea in adults living in resource-rich countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults from resource-rich countries travelling to resource-poor countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults living in resource-poor countries? What are the effects of treatments for acute severe diarrhoea in adults living in resource-poor countries? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 72 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet, intravenous rehydration, nasogastric tube rehydration, oral rehydration solutions (amino acid oral rehydration solution, bicarbonate oral rehydration solution, reduced osmolarity oral rehydration solution, rice-based oral rehydration solution, standard oral rehydration solution), vitamin A supplementation, and zinc supplementation. PMID:21718555

  15. Rhinitis in older adults.

    PubMed

    Nyenhuis, Sharmilee M; Mathur, Sameer K

    2013-04-01

    Rhinitis symptoms of rhinorrhea, congestion, sneezing, nasal/ocular pruritis, and postnasal drainage can significantly affect the quality of life for older adults. As the US population ages, it will be increasingly important for health-care providers to effectively diagnose and manage rhinitis. Rhinitis is categorized broadly into allergic rhinitis and non-allergic rhinitis. Environmental changes and avoidance measures are a primary means of intervention. In addition, there are several topical therapies (nasal sprays) that can be effective for symptom control.

  16. An Undergraduate Course in Adult Development: When the Virtual Adult Is an Adult

    ERIC Educational Resources Information Center

    Williams, Robert B.

    2014-01-01

    An aspect of an undergraduate psychology course on adult development was the preparation of case records on adults who consented to be studied. Participants (1) developed their abilities to observe and accurately record adult behavior across a variety of ages and contexts; (2) withheld judgments about behavior when evidence was lacking; (3)…

  17. Immigration and adult transitions.

    PubMed

    Rumbaut, Rubén G; Komaie, Golnaz

    2010-01-01

    Almost 30 percent of the more than 68 million young adults aged eighteen to thirty-four in the United States today are either foreign born or of foreign parentage. As these newcomers make their transitions to adulthood, say Rubén Rumbaut and Golnaz Komaie, they differ significantly not only from one another but also from their native-parentage counterparts, including blacks and whites. The authors document the demographic changes in the United States over the past forty years and describe the ways in which generation and national origin shape the experiences of these newcomers as they become adults. Rumbaut and Komaie point out that immigrant groups experience gaps in social, economic, and legal status that are even greater than the gaps between native whites and blacks. By far the most-educated (Indians) and the least-educated (Mexicans) groups in the United States today are first-generation immigrants, as are the groups with the lowest poverty rate (Filipinos) and the highest poverty rate (Dominicans). These social and economic divides reflect three very different ways immigrants enter the country: through regular immigration channels, without legal authorization, or as state-sponsored refugees. For many ethnic groups, significant progress takes place from the first to the second generation. But, say the authors, for millions of young immigrants, a lack of legal permanent residency status blocks their prospects for social mobility. Having an undocumented status has become all the more consequential with the failure of Congress to pass comprehensive federal immigration reforms. In the coming two decades, as the U.S. native-parentage labor force continues to shrink, immigrants and their children are expected to account for most of the growth of the nation's labor force, with the fastest-growing occupations requiring college degrees. Rumbaut and Komaie stress that one key to the nation's future will be how it incorporates young adults of immigrant origin in its

  18. Unilateral pulmonary edema following acute subglottic edema.

    PubMed

    Morisaki, H; Ochiai, R; Takeda, J; Nagano, M

    1990-01-01

    Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal of the endotracheal tube, he showed dyspnea and cyanosis and was later found to have acute subglottic edema. After reintubation of the trachea, frothy pink fluid was discharged from the tube, and chest roentgenogram showed a right-sided alveolar infiltrate. Many factors may cause unilateral pulmonary edema, but it is suggested that acute subglottic edema and unilateral bronchial fragility strongly affected this episode.

  19. Ellis van Creveld syndome.

    PubMed

    Ghanekar, Jaishree; Sangrampurkar, Sujata; Hulinaykar, Raman; Ahmer, Tariq

    2009-07-01

    Ellis-van Creveld syndrome (EVC) or chondroectodermal dysplasia is a rare autosomal recessive disorder. It is a tetrad of chondrodysplasia, ectodermal dysplasia, polydactyly, and congenital heart disease. In several case reports, dysplasia involving other organs has also been identified. The exact prevalence is unknown, but the syndrome seems more common among the Amish community. Many Indian cases have also been reported. This report describes a classical case of EVC syndrome in a 22 year old woman of Indian origin born of a consanginous marriage. The patient had chondrodysplasia of tubular bones resulting in disproportionate dwarfism, postaxial polydactyly, severely dystrophic nails, partially absent teeth, pectus excavatum with narrow chest, knock knees and AV canal defect. PMID:20329417

  20. Gorlin syndrome and bilateral ovarian fibroma

    PubMed Central

    Pirschner, Fernanda; Bastos, Pollyana Marçal; Contarato, George Luiz; Bimbato, Anna Carolina Bon Lima; Filho, Antônio Chambô

    2012-01-01

    INTRODUCTION Gorlin syndrome (GS), also known as nevoid basal cell carcinoma syndrome (NBCCS), is a rare hereditary, autosomal dominant disease that affects various systems. Its prevalence is estimated at 1/57,000 to 1/256,000 of the population. It is characterized by basal cell carcinomas, multiple odontogenic keratocysts, skeletal abnormalities and ovarian fibroma, among other disorders. PRESENTATION OF CASE To report the case of a young patient with Gorlin syndrome and bilateral ovarian fibroma. DISCUSSION A 20-year old patient with Gorlin syndrome presented with facial asymmetry, broad nasal root, dental abnormalities, micrognathism, convergent strabismus, multiple pigmented lesions on the trunk and face, pectus excavatum, kyphoscoliosis and a palpable mass in the abdomen occupying the entire pelvic region. CONCLUSION Gorlin–Goltz syndrome is a hereditary pathology that includes numerous clinical manifestations. Diagnosis is clinical and genetic confirmation is unnecessary. PMID:22771908

  1. Short Nuss bar procedure

    PubMed Central

    2016-01-01

    The Nuss procedure is now the preferred operation for surgical correction of pectus excavatum (PE). It is a minimally invasive technique, whereby one to three curved metal bars are inserted behind the sternum in order to push it into a normal position. The bars are left in situ for three years and then removed. This procedure significantly improves quality of life and, in most cases, also improves cardiac performance. Previously, the modified Ravitch procedure was used with resection of cartilage and the use of posterior support. This article details the new modified Nuss procedure, which requires the use of shorter bars than specified by the original technique. This technique facilitates the operation as the bar may be guided manually through the chest wall and no additional stabilizing sutures are necessary. PMID:27747185

  2. Evaluation of the effects of rehabilitation after surgery using the Ravitch and Nuss methods: a case study

    PubMed Central

    2016-01-01

    Rehabilitation may be helpful in the prevention of complications associated with the treatment of patients with pectus excavatum who are subjected to surgery using the Ravitch and Nuss methods. This paper presents the case of a patient who underwent successful physical rehabilitation after 8 weeks from the surgery using the combined method. As part of the Nuss procedure, two plates were implanted to form a scaffolding for the patient's chest, which had previously been corrected with the Ravitch method. The plates were to be removed after 24 months of treatment. After the procedure, in spite of the favorable cosmetic effect of the repair, there was a significant decrease in the spirometric values and physical fitness of the patient. He underwent an individual physiotherapy program, which lasted four weeks. The streamlining of the respiratory system has significantly improved the spirometric values and raised the overall performance of the patient's organism. PMID:27212987

  3. Evaluation of the effects of rehabilitation after surgery using the Ravitch and Nuss methods: a case study.

    PubMed

    Bal-Bocheńska, Monika Anna

    2016-03-01

    Rehabilitation may be helpful in the prevention of complications associated with the treatment of patients with pectus excavatum who are subjected to surgery using the Ravitch and Nuss methods. This paper presents the case of a patient who underwent successful physical rehabilitation after 8 weeks from the surgery using the combined method. As part of the Nuss procedure, two plates were implanted to form a scaffolding for the patient's chest, which had previously been corrected with the Ravitch method. The plates were to be removed after 24 months of treatment. After the procedure, in spite of the favorable cosmetic effect of the repair, there was a significant decrease in the spirometric values and physical fitness of the patient. He underwent an individual physiotherapy program, which lasted four weeks. The streamlining of the respiratory system has significantly improved the spirometric values and raised the overall performance of the patient's organism. PMID:27212987

  4. A case of simultaneous bilateral spontaneous pneumothorax after the Nuss procedure.

    PubMed

    Matsuoka, Shunichiro; Miyazawa, Masahisa; Kashimoto, Kentaro; Kobayashi, Hiroaki; Mitsui, Fumihiko; Tsunoda, Hajime; Kunitomo, Kazuyoshi; Chisuwa, Hisanao; Haba, Yoshiaki

    2016-06-01

    We present a case of simultaneous bilateral spontaneous pneumothorax caused by a pleuro-pleural communication formed from Nuss procedure for pectus excavatum. A 17-year-old man with a history of Nuss operation complained chest pain and dyspnea. A chest roentgenogram demonstrated a tiny bilateral pneumothorax and two metallic bars inserted at the Nuss procedure. Computed tomography revealed furthermore a bulla in the apex of the left lung. The bilateral pneumothorax critically deteriorated after 4 days from onset and urgent bilateral chest drainages were performed. Nevertheless the drainages the full expansion of both lungs was not obtained and air leakage only from left side was continued. A video-assisted left bullectomy was performed 9 days after the tube insertion. The two bars penetrating anterior mediastinal pleura were thought to be a cause of the simultaneous bilateral spontaneous pneumothorax.

  5. Manifestations in four males with and an obligate carrier of the Lenz microphthalmia syndrome.

    PubMed

    Forrester, S; Kovach, M J; Reynolds, N M; Urban, R; Kimonis, V

    2001-01-01

    Lenz microphthalmia syndrome is a rare X-linked recessive condition first described by Lenz in 1955 and comprises of anophthalmia, microcephaly, mental retardation, external ear, digital, cardiac, skeletal, and urogenital anomalies. We present three brothers (ages 15 years, 9 years, and 18 months) and a maternal uncle (age 27 years) with congenital anophthalmia, delayed motor development, hypotonia, and moderate to severe mental retardation. They also have abnormally modeled ears, high-arched palate, pectus excavatum, finger and toe syndactyly, clinodactyly, fetal pads, scoliosis, cardiac, and renal abnormalities. An obligate carrier had abnormally modeled ears and syndactyly of the 2nd to 3rd toes bilaterally. Linkage and haplotype analysis in this family indicates that the gene is located in a 17.65-cM region on chromosome region Xq27-Xq28.

  6. Robinow Syndrome: A Rare Diagnosis

    PubMed Central

    Agarwalla, Sunil Kumar; Pradhan, Swayanprava

    2015-01-01

    Robinow syndrome is a rare entity characterized by short stature and abnormalities of the head, face and external genitalia. It is otherwise called ‘fetal face syndrome’ due to its resemblance with fetal face. We present an eight-year-old female child who came with mesomelic short stature, abnormal facial features, multiple sets of teeth (both deciduous and permanent), pectus excavatum, umbilical hernia, limb abnormalities like shortening of fore arm, simian crease, broad thumbs and other fingers, clinodactyly, abnormal carrying angle, absent labia minora, absent clitoris. Apart from physical appearance she was having diversification of recti and umbilical hernia. Due to the several physical presentation mild systemic involvement it was diagnosed as autosomal dominant robinow syndrome. She is now on follow up and planned for a cosmetic surgery to repair facial defects. PMID:26816964

  7. [Resection of a Subclavian Artery Aneurysm without Dividing the Clavicle;Report of a Case].

    PubMed

    Suzuki, Shuhei; Sogawa, Masakazu; Wakabayashi, Takashi; Nakamura, Norihito

    2016-09-01

    A 57-year-old woman with Marfan syndrome had undergone the surgical treatment for pectus excavatum at 15 years of age. She had since been screened regularly by computed tomography(CT) to detect any vascular diseases. CT demonstrated a left subclavian arterial aneurysm at 55 years of age. It enlarged to a diameter of 32 mm, and surgical treatment was performed. The subclavian artery and the aneurysm were identified by echography in order to locate the exact sites of supraclavicular and subclavicular skin incisions. The subclavian artery aneurysm was resected without dividing the clavicle, and replaced by a vascular graft. Echography is useful for precisely locating a subclavian artery aneurysm, which enables feasible resection without dividing the clavicle. PMID:27586322

  8. [Intraosseous infusion for adults].

    PubMed

    Leidel, B A; Kirchhoff, C

    2008-04-01

    Intraosseous (IO) infusion methods have been common for emergency treatment in infants and children for years. The role of IO access in adults is however much less clear, but its importance in this patient group is increasing, and different devices are available today. Each device has strengths and weaknesses, but all achieve rapid vascular access even in challenging situations. The potential of IO access regarding both therapeutic and diagnostic options has been shown in several operational studies in and out of hospital. Insertion times require between 1 and 2 min in most cases, while insertion and handling of the IO access devices seem to be easy and reliable. The flow rates of IO access devices for adults are lower than those of large-bore peripheral intravenous catheters, but fluid resuscitation is possible in most cases at least with pressure bag infusion systems. Most drugs administered intravenously can be given intraosseously in equivalent dosages and with the same effects. Nevertheless the limitations and risks of IO access routes need to be considered for each application. Rapid IO access is now possible in all age groups, and the 2005 AHA Guidelines favor it over drug administration via the endotracheal tube. PMID:18250995

  9. Sexting among young adults

    PubMed Central

    Gordon-Messer, Deborah; Bauermeister, Jose Arturo; Grodzinski, Alison; Zimmerman, Marc

    2012-01-01

    Purpose Sexting has stirred debate over its legality and safety, but few researchers have documented the relationship between sexting and health. We describe the sexting behavior of young adults in the United States, and examine its association with sexual behavior and psychological well-being. Methods Using an adapted web version of Respondent-Driven Sampling (webRDS) we recruited a sample of U.S. young adults (ages 18 to 24; N=3447). We examined participant sexting behavior using 4 categories of sexting: 1) Non-Sexters, 2) Receivers, 3) Senders, and 4) Two-way Sexters. We then assessed the relationships between sexting categories and sociodemographic characteristics, sexual behavior and psychological well-being. Results Over half (57%) of respondents were Non-Sexters, 28.2% of the sample were Two-way Sexters, 12.6% were Receivers, and 2% were Senders. Males were more likely to be Receivers than females. Sexually active respondents were more likely to be Two-way Sexters than non-sexually active respondents. Among participants who were sexually active in the past 30 days, we found no differences across sexting groups in number of sexual partners, or number of unprotected sex partners in the past 30 days. We also found no relationship between sexting and psychological well-being. Conclusions Our results suggest that sexting is not related to sexual risk behavior or psychological well-being. We discuss the findings of this study and propose directions for further research on sexting. PMID:23299018

  10. Near Vision Test for Adults

    MedlinePlus

    ... Eyes Education Series Online Training and Certification Patient Education Materials Star Pupils ... Test for Adults Testing Near Vision and Distance Vision Prevent Blindness does NOT recommend that you ...

  11. Facts about Rubella for Adults

    MedlinePlus

    ... A Hepatitis B HPV (Human Papillomavirus) Influenza (Flu) Measles Meningococcal Disease Mumps Pertussis (Whooping Cough) Pneumococcal Disease Rubella (German Measles) Shingles (Herpes Zoster) Tetanus (Lockjaw) Professional Resources Adult ...

  12. Facts about Mumps for Adults

    MedlinePlus

    ... A Hepatitis B HPV (Human Papillomavirus) Influenza (Flu) Measles Meningococcal Disease Mumps Pertussis (Whooping Cough) Pneumococcal Disease Rubella (German Measles) Shingles (Herpes Zoster) Tetanus (Lockjaw) Professional Resources Adult ...

  13. Oakland Adult Reading Lab. Building Comprehension in Adult Education Students.

    ERIC Educational Resources Information Center

    Johnston, Suzanne

    Many adult poor readers do not organize what they read in a way that best facilitates good comprehension. To help students overcome this problem, the Adult Day and Evening School in Oakland, California, organized a reading laboratory for their mostly low-income, educationally disadvantaged students with a diverse range of needs. Instruction in the…

  14. Responding to Young Adult Literature. Young Adult Literature Series.

    ERIC Educational Resources Information Center

    Monseau, Virginia R.

    This book focuses on how readers respond to the power of young adult literature--negating the assumption that because such literature appeals to adolescents it cannot possibly be worthy of a place in the language arts curriculum. The book serves two purposes: it describes and discusses the oral and written response of adolescents and adults to…

  15. Adult Literacy and Numeracy: Assessing Change. Adult Literacy Research Network.

    ERIC Educational Resources Information Center

    Cumming, J. Joy, Ed.; van Kraayenoord, Christina E., Ed.

    This document contains eight papers from an action research program to foster good practice in adult literacy provision and policy. "Introduction" (J. Joy Cumming, Christina E. van Kraayenoord) presents an overview of the action research project and individual reports. "Assessment: Making a Difference in Adult Literacy and Numeracy Learning" (J.…

  16. Literacy of Older Adults in America. Adult Literacy Fact Sheet.

    ERIC Educational Resources Information Center

    Kent State Univ., OH. Ohio Literacy Resource Center.

    As part of the National Adult Literacy Survey (NALS) of 1992, the National Center for Education Statistics published a separate study that focuses on the literacy skills of older adults (aged 60 years and older) from a variety of perspectives, such as age, sex, amount of education, race or ethnic background, income, and geographic region. Some of…

  17. Evaluation of Adult Education Programs. California Adult Education.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    To assist adult educators in finding meaningful ways to measure the effectiveness of instruction, this monograph provides selected illustrations of specific methods used by adult education instructors to verify student learning. Obtained from teachers in the field, the examples are from programs in (1) dental assisting, (2) instrument pilot ground…

  18. The Varieties of Adult Civic Engagement in Adult Learning

    ERIC Educational Resources Information Center

    Munoz, Linda; Wrigley, Heide Spruck

    2012-01-01

    Civic engagement, or the practice of democratic deliberation in adult education and learning, asks that adults use their experiences to cooperatively build solutions to the difficult social, economic, and political problems that affect their lives and communities now and into the future. The articles presented in this issue look at the…

  19. Atomoxetine Treatment for ADHD: Younger Adults Compared with Older Adults

    ERIC Educational Resources Information Center

    Durell, Todd; Adler, Lenard; Wilens, Timothy; Paczkowski, Martin; Schuh, Kory

    2010-01-01

    Objective: Atomoxetine is a nonstimulant medication for treating child, adolescent, and adult ADHD. This meta-analysis compared the effects in younger and older adults. Method: A post hoc analysis was conducted using data from two double-blind, placebo-controlled clinical trials. Data from patients aged 18-25 years were compared with data from…

  20. [Degenerative adult scoliosis].

    PubMed

    García-Ramos, C L; Obil-Chavarría, C A; Zárate-Kalfópulos, B; Rosales-Olivares, L M; Alpizar-Aguirre, A; Reyes-Sánchez, A A

    2015-01-01

    Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10° in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and/ or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance. PMID:27012088

  1. [Degenerative adult scoliosis].

    PubMed

    García-Ramos, C L; Obil-Chavarría, C A; Zárate-Kalfópulos, B; Rosales-Olivares, L M; Alpizar-Aguirre, A; Reyes-Sánchez, A A

    2015-01-01

    Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10° in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and/ or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance.

  2. Secondary hypertension in adults

    PubMed Central

    Puar, Troy Hai Kiat; Mok, Yingjuan; Debajyoti, Roy; Khoo, Joan; How, Choon How; Ng, Alvin Kok Heong

    2016-01-01

    Secondary hypertension occurs in a significant proportion of adult patients (~10%). In young patients, renal causes (glomerulonephritis) and coarctation of the aorta should be considered. In older patients, primary aldosteronism, obstructive sleep apnoea and renal artery stenosis are more prevalent than previously thought. Primary aldosteronism can be screened by taking morning aldosterone and renin levels, and should be considered in patients with severe, resistant or hypokalaemia-associated hypertension. Symptoms of obstructive sleep apnoea should be sought. Worsening of renal function after starting an angiotensin-converting enzyme inhibitor suggests the possibility of renal artery stenosis. Recognition, diagnosis and treatment of secondary causes of hypertension lead to good clinical outcomes and the possible reversal of end-organ damage, in addition to blood pressure control. As most patients with hypertension are managed at the primary care level, it is important for primary care physicians to recognise these conditions and refer patients appropriately. PMID:27211205

  3. Adult medulloblastoma: multiagent chemotherapy.

    PubMed Central

    Greenberg, H. S.; Chamberlain, M. C.; Glantz, M. J.; Wang, S.

    2001-01-01

    In this study, the records of 17 adult patients with medulloblastoma treated with craniospinal radiation and 1 of 2 multiagent chemotherapy protocols were reviewed for progression-free survival, overall survival, and toxicity, and the patients were compared with each other and with similarly treated children and adults. Records of patients treated at 3 institutions were reviewed. Seventeen medulloblastoma patients (11 female, 6 male) with a median age of 23 years (range, 18-47 years) were treated with surgery, craniospinal radiation (CSRT) plus local boost, and 1 of 2 adjuvant chemotherapy regimens. All tumors were infratentorial (10 in 4th ventricle and 7 in left or right hemisphere). Ten patients presented with hydrocephalus, and 7 of them were shunted. Eight patients had gross total resection, 7 had subtotal resection (>50% removed), and 2 had partial resection (<50% removed). Postoperatively, 3 patients had positive cytology and 3 had positive spinal MRI. Five patients were classified as good risk and 12 were classified as poor risk (Chang staging system). Ten patients were treated with the "Packer protocol," consisting of CSRT plus weekly vincristine followed by 8 cycles of cisplatin, lomustine, and vincristine. Seven patients were treated with the Pediatric Oncology Group (POG) protocol, consisting of alternating courses of cisplatin/etoposide and cyclophosphamide/vincristine, followed by CSRT. Eight of 17 patients relapsed, with all 8 relapsing at the primary site. Other relapse sites included the leptomeninges (5), bone (1), and brain (1). The estimated median relapse-free survival (Kaplan-Meier) for all patients was 48 months (95% confidence interval, >26 months to infinity). Median relapse-free survival for patients on the Packer protocol was 26 months, and for those on the POG regimen was 48 months (P = 0.410). Five of 10 on the Packer protocol were relapse-free, while 4 of 7 were relapse-free on the POG regimen. Two patients relapsed during chemotherapy

  4. [Modified Takeuchi in adults].

    PubMed

    Jaurena, J M; Subirana, M; Montiel, J; Ruyra, X; Blasco, E; Torner, M; Caralps, J M

    1996-02-01

    Anomalous origin of left coronary artery from pulmonary artery is a rare congenital anomaly (0.25-0.46%). Mortality is high in the first months (65%). Paradoxically, some patients reach adulthood because of a net made of collaterals from the right coronary artery. Thus, we classify the entity in two ways of clinical onset: childhood and adulthood. Ideally, the best surgical approach is the arrangement of a double coronary system. The most well-known technique is the one described by Takeuchi, that links the aorta and the left coronary artery by a tunnel through the pulmonary artery, made from a pulmonary artery frontal wall flap (closing the defect with a pericardial patch). We present a case of anomalous origin of the left coronary artery in an adult, treated in our institution using a modified Takeuchi technique.

  5. Extravasation Injuries in Adults

    PubMed Central

    Al-Benna, S.; O'Boyle, C.; Holley, J.

    2013-01-01

    Insertion of an intravascular catheter is one of the most common invasive procedures in hospitals worldwide. These intravascular lines are crucial in resuscitation, allow vital medication to be administered, and can be used to monitor the patients' real-time vital parameters. There is, however, growing recognition of potential risks to life and limb associated with their use. Medical literature is now replete with isolated case reports of complications succinctly described by Garden and Laussen (2004) as “An unending supply of “unusual” complications from central venous catheters.” This paper reviews complications of venous and arterial catheters and discusses treatment approaches and methods to prevent complications, based on current evidence and endeavours to provide information and guidance that will enable practitioners to prevent, recognise, and successfully treat extravasation injuries in adults. PMID:23738141

  6. The older adult driver.

    PubMed

    Carr, D B

    2000-01-01

    More adults aged 65 and older will be driving in the next few decades. Many older drivers are safe behind the wheel and do not need intensive testing for license renewal. Others, however, have physiologic or cognitive impairments that can affect their mobility and driving safety. When an older patient's driving competency is questioned, a comprehensive, step-by-step assessment is recommended. Many diseases that impair driving ability can be detected and treated effectively by family physicians. Physicians should take an active role in assessing and reducing the risk for injury in a motor vehicle and, when possible, prevent or delay driving cessation in their patients. Referral to other health care professionals, such as an occupational or physical therapist, may be helpful for evaluation and treatment. When an older patient is no longer permitted or able to drive, the physician should counsel the patient about using alternative methods of transportation. PMID:10643955

  7. Adult cervicothoracic lipomyelomeningocele.

    PubMed

    Abu-Bonsrah, Nancy; Purvis, Taylor E; Rory Goodwin, C; Petteys, Rory J; De la Garza-Ramos, Rafael; Sciubba, Daniel M

    2016-10-01

    Lipomyelomeningocele (LMM) as a cause of tethered cord syndrome (TCS) commonly presents in childhood in the lumbosacral spine. Patients frequently present with cutaneous manifestations, progressive neurological deterioration, bladder dysfunction, and intractable pain. Early surgical intervention with untethering is recommended for symptomatic patients. We report an unusual case of a woman who presented with a subcutaneous lump, pain, and neurological decline found to have a cervicothoracic LMM. The patient underwent laminectomy and subtotal resection of the mass; seventeen years later she was confined to a wheelchair with severe neurological decline ultimately requiring three additional attempts at surgical excision and repair. This case emphasizes the need for early recognition of and intervention in adult patients with LMM. PMID:27430413

  8. [Allergies in adults].

    PubMed

    Schäfer, T; Heinrich, J; Böhler, E; Klemm, E; Merkl, J; Ruhdorfer, S; Weigl, L; Wessner, D; Wichmann, H E; Ring, J

    2005-08-01

    Only few epidemiological studies have assessed allergic diseases in adults. In a follow-up study of the MONICA survey S3 (1994/95), which was performed 1997-1999, a total of 1,537 persons were interviewed and tested by skin prick and patch test. Furthermore data of the MONICA survey (RAST, cholesterol, food diaries) could be used. Within survey S4 (1999/2001) a total of 4,261 subjects were interviewed concerning their personal history of atopic diseases and the corresponding history of their partners. In survey S3 the prevalence of allergic sensitisation was 20.5 % for persons without formal graduation from school and 48.1 % for those with a university degree. 20.8 % reported a hypersensitivity to food and about one quarter exhibited a positive reaction in skin prick test. Atopic eczema and hay fever increased over quartiles of HDL cholesterol. Similar, allergic sensitisation (RAST) increased over quartiles of uptake of unsaturated fatty acids in men. 40 % of those who were patch tested exhibited a positive reaction, with perfume mix, nickel, thimerosal and balsam of Peru being the most prominent allergens. Inhabitants of the City of Augsburg were sensitised more often (34.0 % overall, 23.9 % pollen) than inhabitants of villages with (29.4 %, 17.0 %). Full time farmers were sensitised less frequently (22.0 %, 8.4 %). In survey S4 the lifetime prevalence of atopic diseases diagnosed by doctors was 5.1 % for atopic eczema, 6.1 % for asthma and 13.7 % for hay fever. Subjects who lived together with a partner who suffered from hay fever were affected in 19.6 % whereas 13.1 % had hay fever when the partner was not affected. Future studies will offer an unique opportunity to analyse the incidence and remission of manifestations of atopy in adults.

  9. Florida's Adult Education Programs. Challenges and Accomplishments.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee. Bureau of Adult/Community Education.

    Florida supported a wide range of educational activities for adults through an extensive network of public and private agencies during fiscal year 1989-90. In 1990, 419,429 adults participated in adult education programs. Adult educational programs assisted adults in completing requirements for U.S. citizenship and getting off welfare. A total of…

  10. Sibling Status Effects: Adult Expectations.

    ERIC Educational Resources Information Center

    Baskett, Linda Musun

    1985-01-01

    This study attempted to determine what expectations or beliefs adults might hold about a child based on his or her sibling status alone. Ratings on 50 adjective pairs for each of three sibling status types, only, oldest, and youngest child, were assessed in relation to adult expectations, birth order, and parental status of rater. (Author/DST)

  11. ESOL and the Adult Learner.

    ERIC Educational Resources Information Center

    Regan, Timothy F.

    Problems of adult basic education in the United States, symptomatic of the connection between poverty, poor education, and unemployment, have forged for the disadvantaged adult most of the links in the unbreakable chain of deprivation, frustration, and despair. The problem of ESOL (English for Speakers of Other Languages) instruction is…

  12. Adult Transition Program without Walls

    ERIC Educational Resources Information Center

    Moberg, Eric

    2010-01-01

    Best practices in adult transition special education for moderate to severe students suggest student-centered planning that maximizes independence in adult life. Based on the above sources, school districts and governing boards would best serve moderate to severe transition special education students with increasing integration into the community…

  13. Examining Controversies in Adult Education.

    ERIC Educational Resources Information Center

    Kreitlow, Burton W.; And Others

    Controversies over adult education purposes, methods, audiences, and procedures are examined. After outlining a procedure for reviewing competing positions on controversial topics, the book pairs the contrasting views of two authors on each of 10 key issues facing adult education. Chapters cover: philosophies at issue (David L. Boggs); identifying…

  14. Economic Essays on Adult Students

    ERIC Educational Resources Information Center

    Shetty, Sandeep

    2013-01-01

    Adult students are an important component of the current U.S education landscape. They account for over 40% of the degree-seeking fresh enrollees in the U.S. colleges and according to the U.S. Department of Education, their growth will soon outpace that of traditional students. Adult students have also received considerable attention in higher…

  15. Orienting Adult Learners to College.

    ERIC Educational Resources Information Center

    Singer, Tara S.

    1993-01-01

    Describes pilot program at University of Louisville (Kentucky) which was designed to assist in orienting adult learners to the collegiate environment. Addresses special concerns of adult learners, including child care, career planning, academic support, personal support, and financial aid. Explains program development and presentation, materials,…

  16. CURRICULUM GUIDE FOR ADULT EDUCATION.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia.

    THE STATE DEPARTMENT OF EDUCATION IN SOUTH CAROLINA PREPARED THIS CURRICULUM GUIDE FOR ADULT EDUCATION SUPPORTED BY PUBLIC FUNDS. OBJECTIVES AND CURRICULUM OUTLINES FOR ADULT BASIC EDUCATION ARE GIVEN TO COVER LEVELS I (GRADES 1 TO 3), II (GRADES 4 TO 6), AND III (GRADES 7 AND 8). THE OUTLINES COVER COURSES IN READING, BASIC LANGUAGE ARTS AND…

  17. Texas Adult Education Curriculum Guide.

    ERIC Educational Resources Information Center

    Texas Univ., Austin. Extension Instruction and Materials Center.

    This guide was created to provide Texas adult educators with a state-of-the-art resource for practical information about adult education materials and methods for their own growth and that of their students. The guide is organized in four parts. Part I provides preparatory information on the following topics: related resources; characteristics of…

  18. Travel and Adult Transformative Learning

    ERIC Educational Resources Information Center

    Lindstrom, Steven K.

    2011-01-01

    This phenomenological research study examines the lived experience of individual adult transformation in the context of travel. Adults throughout history have experienced profound personal and perception changes as a result of significant travel events. Transformative learning occurs through experience, crisis, and reflection, all of which are…

  19. Adult Education: Greece, November 1973.

    ERIC Educational Resources Information Center

    Coles, E. K. Townsend

    As part of a UNESCO program to assist the government of Greece in the preparation and implementation of a five-year plan for the development of adult education, an expert in the field and four Fellows were chosen to study adult education trends in Scotland, England, Denmark, France, Switzerland, and the Federal Republic of Germany. As a result of…

  20. The Politics of Adult Education

    ERIC Educational Resources Information Center

    Ellison, Art

    2016-01-01

    Art Ellison is longtime advocate for adult education, having managed numerous advocacy campaigns over the past forty years on the state and national levels. Prior to his employment in 1980 as the NH State Director of Adult Education he worked for many years as a high school teacher and as a community organizer. In this article, Ellison offers some…

  1. Reading and the Adult Learner.

    ERIC Educational Resources Information Center

    Johnson, Laura S., Ed.

    This monograph consists of selected International Reading Association convention and journal articles that describe reading programs for adult learners in the United States. The focus of the articles is on continuing adult education and developing advanced reading skills rather than on remedial or basic skills. Topics of selections include…

  2. Adult Learning Disorders: Contemporary Issues

    ERIC Educational Resources Information Center

    Wolf, Lorraine E., Ed.; Schreiber, Hope E., Ed.; Wasserstein, Jeanette, Ed.

    2008-01-01

    Recent advances in neuroimaging and genetics technologies have enhanced our understanding of neurodevelopmental disorders in adults. The authors in this volume not only discuss such advances as they apply to adults with learning disorders, but also address their translation into clinical practice. One cluster of chapters addresses developmental…

  3. Understanding Adult Education and Training.

    ERIC Educational Resources Information Center

    Foley, Griff, Ed.

    This book introduces readers to issues, debates and literatures related to a number of central areas of practice in adult education and training, especially in Australia. It is intended as a first attempt to define the field of adult education in Australia in an analytical and theoretical, as opposed to a theoretical and practical sense. Written…

  4. Predictive Modeling in Adult Education

    ERIC Educational Resources Information Center

    Lindner, Charles L.

    2011-01-01

    The current economic crisis, a growing workforce, the increasing lifespan of workers, and demanding, complex jobs have made organizations highly selective in employee recruitment and retention. It is therefore important, to the adult educator, to develop models of learning that better prepare adult learners for the workplace. The purpose of…

  5. Marketing Higher Education to Adults.

    ERIC Educational Resources Information Center

    Kelly, Diana K.

    With fewer recent high school graduates available to attend college, colleges need to increase their efforts to attract adults. If colleges want to attract more adult students, they must develop a comprehensive marketing plan. The marketing process entails a thorough marketing study that includes a detailed institutional analysis, an analysis of…

  6. Mass Media and Adult Education.

    ERIC Educational Resources Information Center

    Niemi, John A., Ed.

    Some important developments affecting the use of the mass media in adult education are described in this collection of papers. A paper by Dr. George Gordon accuses educators of lacking imagination in their whole approach to adult education, especially in their use of the media. Dr. Robert Carlson's paper delineates the history of educational…

  7. Adult Students and Career Planning.

    ERIC Educational Resources Information Center

    Augustin, James W.

    This study sought to determine the interests of adult students at the University of Wisconsin in using various types of career-related information and services, to assess the extent to which adult students use campus resources that provide career-related information and services and find them helpful, and to examine the process of selecting a…

  8. Native American Adult Reader I.

    ERIC Educational Resources Information Center

    King, Lovern Root, Ed.

    Aspects of Native American history and culture as well as issues and concerns of American Indians are presented in the twelve short articles in this reader for adults. Intended for use in an adult basic education/GED program, the reader features simply written stories (for grades 0-3), illustrations, vocabulary lists and student study questions.…

  9. Focus on Young Adult Programming.

    ERIC Educational Resources Information Center

    Union, Bunni; Williams, Sheila

    1996-01-01

    Presents three library youth service programs which focus on "Pizza and Politicians," a public library pizza party which gave high school students and college-aged young adults a chance to meet and question politicians; a young adult "Reading to Seniors" program; "Making Books," a public library journal-making project for middle school students.…

  10. Neuropsychological Assessment of Adult Offenders

    ERIC Educational Resources Information Center

    Marceau, Roger; Meghani, Rehana; Reddon, John R.

    2008-01-01

    This report is primarily concerned with reporting on the normative results obtained on a large sample of serious adult offenders. An expanded Halstead-Reitan Neuropsychological Test Battery was administered to 584 adult offenders (OF), 132 normal controls (NC), and 494 acute psychiatric patients (PP). Subjects were between 18 and 44 years of age.…

  11. Tough Times for Adult Learners

    ERIC Educational Resources Information Center

    Tuckett, Alan; Aldridge, Fiona

    2011-01-01

    The key message of NIACE's 2011 survey of adult participation in learning is that recession is bad for lifelong learning for anyone over the age of 25. The survey highlights the central importance of workplaces as sites of adult learning--and the challenges posed to a learning society when opportunities to learn reduce. It shows that the gap…

  12. Clinical Interviewing with Older Adults

    ERIC Educational Resources Information Center

    Mohlman, Jan; Sirota, Karen Gainer; Papp, Laszlo A.; Staples, Alison M.; King, Arlene; Gorenstein, Ethan E.

    2012-01-01

    Over the next few decades the older adult population will increase dramatically, and prevalence rates of psychiatric disorders are also expected to increase in the elderly cohort. These demographic projections highlight the need for diagnostic instruments and methods that are specifically tailored to older adults. The current paper discusses the…

  13. Adult Education in India & Abroad.

    ERIC Educational Resources Information Center

    Roy, Nikhil Ranjan

    A survey is made of various aspects of adult education in India since 1947, together with comparative accounts of the origin, development, and notable features of adult education in Denmark, Great Britain, the Soviet Union, and the United States. Needs and objectives in India, largely in the eradication of illiteracy, are set forth, and pertinent…

  14. Segmenting the Adult Education Market.

    ERIC Educational Resources Information Center

    Aurand, Tim

    1994-01-01

    Describes market segmentation and how the principles of segmentation can be applied to the adult education market. Indicates that applying segmentation techniques to adult education programs results in programs that are educationally and financially satisfying and serve an appropriate population. (JOW)

  15. Three Models of Adult Development.

    ERIC Educational Resources Information Center

    Levenson, Michael R.; Crumpler, Cheryl A.

    1996-01-01

    Compares ontogenetic models, which stress development through a series of stages; sociogenic models, which stress the influence of social context on adult behavior; and liberative models. Liberative models do not treat adult development as entirely dependent on biological or social determinism, and do stress individuals' conscious efforts at…

  16. Recruiting and Retaining Adult Students.

    ERIC Educational Resources Information Center

    Hadfield, Janice

    2003-01-01

    Adult learners, long the stepchildren of colleges and universities, have nearly become the norm, and they spend billions of dollars each year on education. This chapter takes a customer-oriented approach to recruiting and retaining adult students in higher education. (GCP)

  17. Books for Adult New Readers.

    ERIC Educational Resources Information Center

    O'Brien, Roberta Luther, Comp.

    This document is an annotated bibliography of recommended print materials for English-speaking adults reading at the seventh grade level or below. (Sixty percent of the titles are at fifth grade level or below). The titles were selected for their broad appeal to the average adult new reader. In the selection, special consideration was given to…

  18. Senior Adult Consumer Advisory Manual,

    ERIC Educational Resources Information Center

    Ater, E. Carolyn, Ed.

    This manual is intended for use by senior adult peer advisors (age 60 and over) engaged in helping relationships in providing consumer education to other senior adults. The advisory procedures are based on a problem solving approach which incorporates the development of a self-help concept. Chapter 1 provides information on consumer advising. It…

  19. Creating Adult Basic Education Programs.

    ERIC Educational Resources Information Center

    Harris, Dolores M.

    Adult basic education programs must teach the "social living skills" disadvantaged adults need, as well as basic literacy skills. In creating an ABE program, one must first assess the needs of the target population--through surveys, group meetings, an advisory council of members of the target population, demographic studies, and consideration of…

  20. Research Perspectives in Adult Education.

    ERIC Educational Resources Information Center

    Garrison, D. Randy, Ed.

    This book focuses on understanding the epistemological foundation of adult education, the research process, policy issues, and directions for the future. "An Epistemological Overview of the Field" (Garrison) provides an overview of adult education research: the historical development, issues, the scope of the knowledge base, and approaches to…

  1. Cultural Influences on Adult Learning.

    ERIC Educational Resources Information Center

    Conti, Gary J., Ed.; Fellenz, Robert A., Ed.

    Five projects are reported that examined factors related to adult learning in nontraditional environments. "Conrad, Montana: A Community of Memories" (Janice Counter, Lynn Paul, and Gary Conti) reports on a group of adults who for over 40 years have been active in building a better community for friends, relatives, and themselves. A 17-item…

  2. Adult Education in Israel IV.

    ERIC Educational Resources Information Center

    Kirmayer, Paul, Ed.; Michaelson, Serena T., Ed.

    This fourth journal edition, oriented towards the topic of adult education and the community in Israel, focuses on these two major themes: the different approaches to analyzing and understanding the community, its populations, and its connection to adult education; and educational institutions and cultural entities within the community. Seventeen…

  3. Adult Education at a Distance.

    ERIC Educational Resources Information Center

    Gaudet, Alphonse

    This document, which examines the use of educational technologies for distance education for adults in Canada, consists of five narrative sections and a bibliography. The first section introduces the topic and the document's objectives (to describe those technologies used in Canadian adult distance education, paying particular attention to those…

  4. Prevalence of Olfactory and Other Developmental Anomalies in Patients with Central Hypogonadotropic Hypogonadism

    PubMed Central

    Della Valle, Elisa; Vezzani, Silvia; Rochira, Vincenzo; Granata, Antonio Raffaele Michele; Madeo, Bruno; Genovese, Elisabetta; Pignatti, Elisa; Marino, Marco; Carani, Cesare; Simoni, Manuela

    2013-01-01

    Introduction: Hypogonadotropic hypogonadism (HH) is a heterogeneous disease caused by mutations in several genes. Based on the presence of hyposmia/anosmia it is distinguished into Kallmann syndrome (KS) and isolated HH. The prevalence of other developmental anomalies is not well established. Methods: We studied 36 patients with HH (31 males, 5 females, mean age 41.5), 9 with familial and 27 with sporadic HH (33 congenital, 3 adult-onset), by physical examination, smell test (BSIT Sensonics), audiometry, renal ultrasound, and magnetic resonance imaging of the olfactory structures. Results: Based on the smell test, patients were classified as normosmic (n = 21, 58.3%) and hypo/anosmic (n = 15, 41.6%). Hypoplasia/agenesis of olfactory bulbs was found in 40% of patients (10/25; 75% hypo/anosmic, 7.6% normosmic, p < 0.01, Fisher’s test). Remarkably, olfactory structures were normal in two anosmic patients, while one normosmic patient presented a unilateral hypoplastic bulb. Fourteen of 33 patients (42.4%) presented neurosensorial hearing loss of various degrees (28.5% hypo/anosmic, 52.6% normosmic, p = NS). Renal ultrasound revealed 27.7% of cases with renal anomalies (26.6% hypo/anosmic, 28.5% normosmic, p = NS). At least one midline defect was found in 50% of the patients (53.3% hypo/anosmic, 47.6% normosmic, p = NS), including abnormal palate, dental anomalies, pectus excavatum, bimanual synkinesis, iris coloboma, and absent nasal cartilage. Anamnestically 4/31 patients reported cryptorchidism (25% hypo/anosmic, 5.2% normosmic, p = NS). Conclusion: Hypo/anosmia is significantly related to anatomical anomalies of the olfactory bulbs/tracts but the prevalence of other developmental anomalies, especially midline defects and neurosensorial hearing loss, is high both in HH and KS and independent of the presence of anosmia/hyposmia. From the clinical standpoint KS and normosmic HH should be considered as the same complex, developmental

  5. Older adults challenged financially when adult children move home.

    PubMed

    Wallace, Steven P; Padilla-Frausto, D Imelda

    2014-02-01

    This policy brief looks at the financial burdens imposed on older Californians when adult children return home, often due to a crisis not of their own making, to live with their parents. The findings show that on average in California, the amount of money that older adults need in order to maintain a minimally decent standard of living while supporting one adult child in their home increases their expenses by a minimum of 50 percent. Low-income older adults are usually on fixed incomes, so helping an adult child can provide the child with a critical safety net but at the cost of the parents' own financial well-being. Policy approaches to assisting this vulnerable population of older adults include implementing reforms to increase Supplemental Security Income (SSI), improving the availability of affordable housing, assuring that all eligible nonelderly adults obtain health insurance through health care reform's expansion of Medi-Cal and subsidies, and increasing food assistance through SNAP and senior meal programs. PMID:24804354

  6. Older Adults Prefer Less Choice than Younger Adults

    PubMed Central

    Reed, Andrew E.; Mikels, Joseph A.; Simon, Kosali I.

    2008-01-01

    Previous research has demonstrated that older adults prefer less autonomy and seek less information when making decisions on their own relative to younger adults (for a review, see Mather, 2006). Would older adults also prefer fewer options from which to choose? We tested this hypothesis in the context of different decision domains. Participants completed a choice preferences survey in which they indicated their desired number of choices across six domains of healthcare and everyday decisions. Our hypothesis was confirmed across all decision domains. We discuss implications from these results for theories of aging and healthcare policy. PMID:18808256

  7. Aspects of Adult Development. The Rossman Adult Learning Inventory: Creating Awareness of Adult Development.

    ERIC Educational Resources Information Center

    Romero, Frederick; And Others

    1990-01-01

    Romero's overview of adult developmental theory stresses the work of Erikson, Havighurst, Loevinger, Perry, Kohlberg, and Cross. Rossman and Rossman discuss the development of their Adult Learning Inventory with an extensive source summary for its 4 factors and a 62-item bibliography. (SK)

  8. Just How Adult Is This Young Adult Book: Young Adult Books for the Junior High Readers.

    ERIC Educational Resources Information Center

    Decker, Charlotte

    1999-01-01

    Discusses young adult novels and presents a bibliography to acquaint librarians with titles and authors that are suitable for emerging young adult readers in grades five through nine. Subject categories include realistic fiction, in the news, historical fiction, short stories, legendary characters, mysteries, science fiction/fantasy/horror, and…

  9. General Information about Adult Hodgkin Lymphoma

    MedlinePlus

    ... Adult Hodgkin Lymphoma Treatment (PDQ®)–Patient Version General Information About Adult Hodgkin Lymphoma Go to Health Professional ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  10. Treatment Options for Adult Acute Myeloid Leukemia

    MedlinePlus

    ... Treatment Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health Professional Version Key Points Adult ...

  11. Stages of Adult Acute Myeloid Leukemia

    MedlinePlus

    ... Treatment Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health Professional Version Key Points Adult ...

  12. Treatment Option Overview (Adult Acute Myeloid Leukemia)

    MedlinePlus

    ... Treatment Childhood AML Treatment Research Adult Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health Professional Version Key Points Adult ...

  13. Brain and Spinal Cord Tumors in Adults

    MedlinePlus

    ... saved articles window. My Saved Articles » My ACS » Brain and Spinal Cord Tumors in Adults Download Printable ... the topics below to get started. What Is Brain/CNS Tumors In Adults? What are adult brain ...

  14. Coaching as a Strategy for Helping Adults

    ERIC Educational Resources Information Center

    Wax, Dorothy M.; Wertheim, Judith

    2015-01-01

    This chapter focuses on the use of coaching for adult learners, the specific characteristics adults bring to the learning environment, and strategies for dealing with the obstacles adult learners may face.

  15. Cancer survivorship in adults.

    PubMed

    Kiserud, Cecilie E; Dahl, Alv A; Loge, Jon Håvard; Fosså, Sophie D

    2014-01-01

    With the favorable trend regarding survival of cancer in the Western world, there is an increasing focus among patients, clinicians, researchers, and politicians regarding cancer survivors' health and well-being. Their number is rapidly growing and more than 3 % of the adult populations in Western countries have survived cancer for 5 years or more. Cancer survivors are at increased risk for a variety of late effects after treatment, some life-threatening such as secondary cancer and cardiac diseases, others might negatively impact on their daily functioning and quality of life. The latter might include fatigue, anxiety disorders and difficulties returning to work while depression does not seem to be more common among survivors than in the general population. Still, the majority of survivors regain their health and social functioning. The field of cancer survivorship research has been rapidly growing. Models for follow-up care of cancer survivors have been proposed, but how to best integrate the knowledge of the field into clinical practice with adequate follow-up of cancer survivors at risk for developing late effects is still an unsolved question. PMID:24305772

  16. [Prehospitale analgesia in adults].

    PubMed

    Hossfeld, Björn; Holsträter, Susanne; Bernhard, Michael; Lampl, Lorenz; Helm, Matthias; Kulla, Martin

    2016-02-01

    After securing vital function, treatment of pain is an important aspect in emergency medical care. Irrespective of the underlying disease or injury, pain is an important warning symptom of the body and the most common reason for an emergency alert notification. A patient assesses quality of care and success of prehospital care using the criteria of the extent of pain relief he experiences. Since mild pain does not usually lead to an emergency alert, the criteria apply mainly to treatment of severe and very severe pain. Pain perception varies from individual to individual. Accordingly, assessment of pain intensity is the very first step in pain therapy. The Numeric Rating Scale (NRS) ranging from 0 (no pain) to 10 (worst pain imaginable) is suitable for pain assessment in adult emergency patients. Above a grade of 4, therapeutic intervention should be initiated with the goal of reducing pain to reach a value of <4, or at least to achieve a reduction by 3 points. The choice of analgesics that can be meaningfully used in pre-hospital emergency medicine is limited. The emergency physician should be aware of available drugs and administration routes. PMID:26949902

  17. A comprehensive newborn exam: part II. Skin, trunk, extremities, neurologic.

    PubMed

    Lewis, Mary L

    2014-09-01

    Skin findings are common during the newborn examination. Although these findings are often benign, it is important to visualize the entire skin surface to distinguish these findings and appropriately reassure parents. The chest should be observed for symmetric movement, pectus excavatum, pectus carinatum, prominent xiphoid, or breast tissue. The infant should be as relaxed as possible so that the physician can more easily detect any abdominal masses, which are often renal in origin. A single umbilical artery may be associated with another congenital abnormality, especially renal anomalies, and intrauterine growth restriction and prematurity. Signs of ambiguous genitalia include clitoromegaly and fused labia in girls, and bilateral undescended testes, a micropenis, or a bifid scrotum in boys. Sacral dimples do not warrant further evaluation if they are less than 0.5 cm in diameter, are located within 2.5 cm of the anal verge, and are not associated with cutaneous markers; dimples that do not fit these criteria require ultrasonography to evaluate for spinal dysraphism. Brachial plexus injuries are most common in newborns who are large for gestational age, and physical therapy may be required to achieve normal function. Patients with abnormal findings on Ortolani and Barlow maneuvers should be evaluated further for hip dysplasia. It is also important to assess newborns for tone and confirm the presence of normal primitive reflexes. PMID:25251089

  18. La lecture et les adultes (Reading and Adults).

    ERIC Educational Resources Information Center

    Caceres, Benigno

    1980-01-01

    Discusses methods used to help adults improve their reading skills and read with more enjoyment. Particular attention is paid to the Reading Club method. An illustration is given of a particular exercise used at a center in Paris. (AMH)

  19. Clueless: Adult Mysteries with Young Adult Appeal 2002.

    ERIC Educational Resources Information Center

    Charles, John; Morrison, Joanna

    2002-01-01

    This annotated bibliography includes adult mysteries that appeal to teen readers under the categories of Sherlock Holmes; reference sources; private investigators; amateur sleuths; historical sleuths; suspense and thrillers; police procedurals; mystery blends; and anthologies. (LRW)

  20. Computational models of adult neurogenesis

    NASA Astrophysics Data System (ADS)

    Cecchi, Guillermo A.; Magnasco, Marcelo O.

    2005-10-01

    Experimental results in recent years have shown that adult neurogenesis is a significant phenomenon in the mammalian brain. Little is known, however, about the functional role played by the generation and destruction of neurons in the context of an adult brain. Here, we propose two models where new projection neurons are incorporated. We show that in both models, using incorporation and removal of neurons as a computational tool, it is possible to achieve a higher computational efficiency that in purely static, synapse-learning-driven networks. We also discuss the implication for understanding the role of adult neurogenesis in specific brain areas like the olfactory bulb and the dentate gyrus.

  1. Thematic relations in adults' concepts.

    PubMed

    Lin, E L; Murphy, G L

    2001-03-01

    Concepts can be organized by their members' similarities, forming a kind (e.g., animal), or by their external relations within scenes or events (e.g., cake and candles). This latter type of relation, known as the thematic relation, is frequently found to be the basis of children's but not adults' classification. However, 10 experiments found that when thematic relations are meaningful and salient, they have significant influence on adults' category construction (sorting), inductive reasoning, and verification of category membership. The authors conclude that concepts function closely with knowledge of scenes and events and that this knowledge has a role in adults' conceptual representations. PMID:11293459

  2. Adult outcomes of preterm children.

    PubMed

    Hack, Maureen

    2009-10-01

    The survivors of the initial years of neonatal intensive care of preterm infants reached adulthood during the last decade. Reports of their adult outcomes examined have included neurodevelopmental, behavioral and health outcomes as well as social functioning and reproduction. Despite statistically significant differences between preterm young adults and controls in most outcomes studied, the majority of preterm survivors do well and live fairly normal lives. The two major predictors of adult outcomes are lower gestational age that reflect perinatal injury and family sociodemographic status which reflects both genetic and environmental effects.

  3. Adult-Onset Hypogonadism.

    PubMed

    Khera, Mohit; Broderick, Gregory A; Carson, Culley C; Dobs, Adrian S; Faraday, Martha M; Goldstein, Irwin; Hakim, Lawrence S; Hellstrom, Wayne J G; Kacker, Ravi; Köhler, Tobias S; Mills, Jesse N; Miner, Martin; Sadeghi-Nejad, Hossein; Seftel, Allen D; Sharlip, Ira D; Winters, Stephen J; Burnett, Arthur L

    2016-07-01

    In August 2015, an expert colloquium commissioned by the Sexual Medicine Society of North America (SMSNA) convened in Washington, DC, to discuss the common clinical scenario of men who present with low testosterone (T) and associated signs and symptoms accompanied by low or normal gonadotropin levels. This syndrome is not classical primary (testicular failure) or secondary (pituitary or hypothalamic failure) hypogonadism because it may have elements of both presentations. The panel designated this syndrome adult-onset hypogonadism (AOH) because it occurs commonly in middle-age and older men. The SMSNA is a not-for-profit society established in 1994 to promote, encourage, and support the highest standards of practice, research, education, and ethics in the study of human sexual function and dysfunction. The panel consisted of 17 experts in men's health, sexual medicine, urology, endocrinology, and methodology. Participants declared potential conflicts of interest and were SMSNA members and nonmembers. The panel deliberated regarding a diagnostic process to document signs and symptoms of AOH, the rationale for T therapy, and a monitoring protocol for T-treated patients. The evaluation and management of hypogonadal syndromes have been addressed in recent publications (ie, the Endocrine Society, the American Urological Association, and the International Society for Sexual Medicine). The primary purpose of this document was to support health care professionals in the development of a deeper understanding of AOH, particularly in how it differs from classical primary and secondary hypogonadism, and to provide a conceptual framework to guide its diagnosis, treatment, and follow-up. PMID:27343020

  4. Asthma in adults (acute)

    PubMed Central

    2011-01-01

    Introduction About 10% of adults have suffered an attack of asthma, and up to 5% of these have severe disease that responds poorly to treatment. Patients with severe disease have an increased risk of death, but patients with mild to moderate disease are also at risk of exacerbations. Most guidelines about the management of asthma follow stepwise protocols. This review does not endorse or follow any particular protocol, but presents the evidence about specific interventions. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute asthma? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 100 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: beta2 agonists (plus ipratropium bromide, pressured metered-dose inhalers, short-acting continuous nebulised, short-acting intermittent nebulised, short-acting iv, and inhaled formoterol); corticosteroids (inhaled); corticosteroids (single oral, combined inhaled, and short courses); education about acute asthma; generalist care; helium–oxygen mixture (heliox); magnesium sulphate (iv and adding isotonic nebulised magnesium to inhaled beta2 agonists); mechanical ventilation; oxygen supplementation (controlled 28% oxygen and controlled 100% oxygen); and specialist care. PMID:21463536

  5. Epilepsy in Adults with TSC

    MedlinePlus

    ... International TSC Research Conference Text Size Get Involved EPILEPSY IN ADULTS WITH TSC Download a PDF of ... age, including either new-onset seizures or ongoing epilepsy. Recent studies indicate that more than 80% of ...

  6. Split liver transplantation in adults.

    PubMed

    Hashimoto, Koji; Fujiki, Masato; Quintini, Cristiano; Aucejo, Federico N; Uso, Teresa Diago; Kelly, Dympna M; Eghtesad, Bijan; Fung, John J; Miller, Charles M

    2016-09-01

    Split liver transplantation (SLT), while widely accepted in pediatrics, remains underutilized in adults. Advancements in surgical techniques and donor-recipient matching, however, have allowed expansion of SLT from utilization of the right trisegment graft to now include use of the hemiliver graft as well. Despite less favorable outcomes in the early experience, better outcomes have been reported by experienced centers and have further validated the feasibility of SLT. Importantly, more than two decades of experience have identified key requirements for successful SLT in adults. When these requirements are met, SLT can achieve outcomes equivalent to those achieved with other types of liver transplantation for adults. However, substantial challenges, such as surgical techniques, logistics, and ethics, persist as ongoing barriers to further expansion of this highly complex procedure. This review outlines the current state of SLT in adults, focusing on donor and recipient selection based on physiology, surgical techniques, surgical outcomes, and ethical issues. PMID:27672272

  7. Adult Learners' Week in Australia.

    ERIC Educational Resources Information Center

    Cross, John

    2002-01-01

    Promotional materials and activities for Australia's Adult Learners Week, which are shaped by a variety of stakeholders , include media strategies and a website. Activities are evaluated using a market research company and website and telephone hotline statistics. (SK)

  8. National Adult Protective Services Association

    MedlinePlus

    ... Is Abuse? What Is Neglect? What is Financial Exploitation? Other Safety Concerns? History of Adult Protective Services ... Groups Banks and APS Get Involved Elder Financial Exploitation National Policy Elder Justice Act Implementation Program Standards ...

  9. Osteoporosis: Unique to Older Adults

    MedlinePlus

    ... fractures if needed annual flu shots. Protein-Calorie Malnutrition Many older adults living at home eat poorly. ... serious that a condition known as protein-calorie malnutrition (PCM) develops. Sometimes, PCM occurs after a long ...

  10. Youths Transitioning as Adult Learners

    ERIC Educational Resources Information Center

    Davis, C. Amelia

    2014-01-01

    This chapter considers how transitions to adulthood have been historically represented and presents alternative ways of thinking about transitions to adulthood through the context of adult basic education programs.

  11. Split liver transplantation in adults

    PubMed Central

    Hashimoto, Koji; Fujiki, Masato; Quintini, Cristiano; Aucejo, Federico N; Uso, Teresa Diago; Kelly, Dympna M; Eghtesad, Bijan; Fung, John J; Miller, Charles M

    2016-01-01

    Split liver transplantation (SLT), while widely accepted in pediatrics, remains underutilized in adults. Advancements in surgical techniques and donor-recipient matching, however, have allowed expansion of SLT from utilization of the right trisegment graft to now include use of the hemiliver graft as well. Despite less favorable outcomes in the early experience, better outcomes have been reported by experienced centers and have further validated the feasibility of SLT. Importantly, more than two decades of experience have identified key requirements for successful SLT in adults. When these requirements are met, SLT can achieve outcomes equivalent to those achieved with other types of liver transplantation for adults. However, substantial challenges, such as surgical techniques, logistics, and ethics, persist as ongoing barriers to further expansion of this highly complex procedure. This review outlines the current state of SLT in adults, focusing on donor and recipient selection based on physiology, surgical techniques, surgical outcomes, and ethical issues.

  12. Computer acceptance of older adults.

    PubMed

    Nägle, Sibylle; Schmidt, Ludger

    2012-01-01

    Even though computers play a massive role in everyday life of modern societies, older adults, and especially older women, are less likely to use a computer, and they perform fewer activities on it than younger adults. To get a better understanding of the factors affecting older adults' intention towards and usage of computers, the Unified Theory of Acceptance and Usage of Technology (UTAUT) was applied as part of a more extensive study with 52 users and non-users of computers, ranging in age from 50 to 90 years. The model covers various aspects of computer usage in old age via four key constructs, namely performance expectancy, effort expectancy, social influences, and facilitating conditions, as well as the variables gender, age, experience, and voluntariness it. Interestingly, next to performance expectancy, facilitating conditions showed the strongest correlation with use as well as with intention. Effort expectancy showed no significant correlation with the intention of older adults to use a computer.

  13. Older Adults and Mental Health

    MedlinePlus

    ... is a widely underrecognized and undertreated medical illness. Depression often co-occurs with other serious illnesses, such as heart disease, stroke, diabetes, cancer, and Parkinson's disease. Because many older adults face these illnesses as well as various social and ...

  14. Vaccinations for Adults with Diabetes

    MedlinePlus

    Vaccinations for Adults with Diabetes The table below shows which vaccinations you should have to protect your health if ... sure you and your healthcare provider keep your vaccinations up to date. Vaccine Do you need it? ...

  15. Recommended Immunizations for Adults 50+

    MedlinePlus

    ... page please turn Javascript on. Health Screenings and Immunizations Recommended Immunizations For Adults 50+ The content in this section ... out more, visit How Vaccines Prevent Disease . Vaccines, Vaccinations, and Immunizations Understanding the difference between vaccines, vaccinations, ...

  16. Split liver transplantation in adults

    PubMed Central

    Hashimoto, Koji; Fujiki, Masato; Quintini, Cristiano; Aucejo, Federico N; Uso, Teresa Diago; Kelly, Dympna M; Eghtesad, Bijan; Fung, John J; Miller, Charles M

    2016-01-01

    Split liver transplantation (SLT), while widely accepted in pediatrics, remains underutilized in adults. Advancements in surgical techniques and donor-recipient matching, however, have allowed expansion of SLT from utilization of the right trisegment graft to now include use of the hemiliver graft as well. Despite less favorable outcomes in the early experience, better outcomes have been reported by experienced centers and have further validated the feasibility of SLT. Importantly, more than two decades of experience have identified key requirements for successful SLT in adults. When these requirements are met, SLT can achieve outcomes equivalent to those achieved with other types of liver transplantation for adults. However, substantial challenges, such as surgical techniques, logistics, and ethics, persist as ongoing barriers to further expansion of this highly complex procedure. This review outlines the current state of SLT in adults, focusing on donor and recipient selection based on physiology, surgical techniques, surgical outcomes, and ethical issues. PMID:27672272

  17. Split liver transplantation in adults.

    PubMed

    Hashimoto, Koji; Fujiki, Masato; Quintini, Cristiano; Aucejo, Federico N; Uso, Teresa Diago; Kelly, Dympna M; Eghtesad, Bijan; Fung, John J; Miller, Charles M

    2016-09-01

    Split liver transplantation (SLT), while widely accepted in pediatrics, remains underutilized in adults. Advancements in surgical techniques and donor-recipient matching, however, have allowed expansion of SLT from utilization of the right trisegment graft to now include use of the hemiliver graft as well. Despite less favorable outcomes in the early experience, better outcomes have been reported by experienced centers and have further validated the feasibility of SLT. Importantly, more than two decades of experience have identified key requirements for successful SLT in adults. When these requirements are met, SLT can achieve outcomes equivalent to those achieved with other types of liver transplantation for adults. However, substantial challenges, such as surgical techniques, logistics, and ethics, persist as ongoing barriers to further expansion of this highly complex procedure. This review outlines the current state of SLT in adults, focusing on donor and recipient selection based on physiology, surgical techniques, surgical outcomes, and ethical issues.

  18. New Literacy Tools for Adults.

    ERIC Educational Resources Information Center

    Anderson, Jonathan

    1990-01-01

    Describes an Australian national study of technologies used for adult literacy: traditional technologies (print, radio, television, audio and videotape, teleconferencing, and computers) and new generation technologies (laser discs, CD-ROM, videodiscs, and hypermedia). (SK)

  19. Adult Education and Public Policy

    ERIC Educational Resources Information Center

    Fay, Francis A.

    1972-01-01

    Author discussed American public's shifts in values and priorities" and suggests that adult educators become involved in 'real politique'" in order to help form public policy in the future. (Author/SP)

  20. Root Caries in Older Adults.

    PubMed

    Gregory, Dick; Hyde, Susan

    2015-08-01

    Older adults are retaining an increasing number of natural teeth, and nearly half of all individuals aged 75 and older have experienced root caries. Root caries is a major cause of tooth loss in older adults, and tooth loss is the most significant negative impact on oral health-related quality of life for the elderly. The need for improved preventive efforts and treatment strategies for this population is acute.

  1. Root Caries in Older Adults.

    PubMed

    Gregory, Dick; Hyde, Susan

    2015-08-01

    Older adults are retaining an increasing number of natural teeth, and nearly half of all individuals aged 75 and older have experienced root caries. Root caries is a major cause of tooth loss in older adults, and tooth loss is the most significant negative impact on oral health-related quality of life for the elderly. The need for improved preventive efforts and treatment strategies for this population is acute. PMID:26357814

  2. What Does It Take to Be an Adult in Austria? Views of Adulthood in Austrian Adolescents, Emerging Adults, and Adults

    ERIC Educational Resources Information Center

    Sirsch, Ulrike; Dreher, Eva; Mayr, Eva; Willinger, Ulrike

    2009-01-01

    The present study examined the defining features of emerging adulthood, subjects' conceptions of the transition to adulthood, and the perceived adult status in Austria. The sample consisted of 775 subjects (226 adolescents, 317 emerging adults, 232 adults). Results showed that most Austrian emerging adults feel themselves to be between adolescence…

  3. Adult Stem and Progenitor Cells

    NASA Astrophysics Data System (ADS)

    Geraerts, Martine; Verfaillie, Catherine M.

    The discovery of adult stem cells in most adult tissues is the basis of a number of clinical studies that are carried out, with therapeutic use of hematopoietic stem cells as a prime example. Intense scientific debate is still ongoing as to whether adult stem cells may have a greater plasticity than previously thought. Although cells with some features of embryonic stem cells that, among others, express Oct4, Nanog and SSEA1 are isolated from fresh tissue, it is not clear if the greater differentiation potential is acquired during cell culture. Moreover, adult more pluripotent cells do not have all pluripotent characteristics typical for embryonic stem cells. Recently, some elegant studies were published in which adult cells could be completely reprogrammed to embryonic stem cell-like cells by overexpression of some key transcription factors for pluripotency (Oct4, Sox2, Klf4 and c-Myc). It will be interesting for the future to investigate the exact mechanisms underlying this reprogramming and whether similar transcription factor pathways are present and/or can be activated in adult more pluripotent stem cells.

  4. Adult hippocampal neurogenesis and aging.

    PubMed

    Klempin, Friederike; Kempermann, Gerd

    2007-08-01

    The demographic changes in the foreseeable future stress the need for research on successful cognitive aging. Advancing age constitutes a primary risk factor for disease of the central nervous system most notably neurodegenerative disorders. The hippocampus is one of the brain regions that is prominently affected by neurodegeneration and functional decline even in what is still considered "normal aging". Plasticity is the basis for how the brain adapts to changes over time. The discovery of adult hippocampal neurogenesis has added a whole new dimension to research on structural plasticity in the adult and aging hippocampus. In this article, we briefly summarize and discuss recent findings on the regulation of adult neurogenesis with relevance to aging. Aging is an important co-variable for many regulatory mechanisms affecting adult neurogenesis but so far, only few studies have specifically addressed this interaction. We hypothesize that adult neurogenesis contributes to a neural reserve, i.e. the maintained potential for structural plasticity that allows compensation in situations of functional losses with aging. As such we propose that adult neurogenesis might contribute to the structural correlates of successful aging. PMID:17401726

  5. Adult Education and Development, No. 47.

    ERIC Educational Resources Information Center

    Adult Education and Development, 1996

    1996-01-01

    This serial issue contains a total of 26 articles grouped under five headings: "Adult Learning: A Key for the Twenty-First Century (Fifth International Conference on Adult Education (Confintea V))"; "Trends in Adult Education Policy" (Belanger); "Adult Education in Modern Times" (Geissler); "From Criticism to Constructiveness" (Torres); "An…

  6. Literacy Education in Adult Basic Education

    ERIC Educational Resources Information Center

    Kruidenier, John

    2002-01-01

    Adult basic education programs, sometimes called adult basic and secondary education programs, typically serve adults over the age of sixteen who do not have a high school diploma and are no longer eligible for traditional secondary education programs. Although adult basic education (ABE) is situated apart from the elementary, secondary, and…

  7. 38 CFR 18.438 - Adult education.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on...

  8. 38 CFR 18.438 - Adult education.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on...

  9. 38 CFR 18.438 - Adult education.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on...

  10. 38 CFR 18.438 - Adult education.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on...

  11. Dealing with Disruptive Behavior of Adult Learners

    ERIC Educational Resources Information Center

    Dobmeier, Robert; Moran, Joseph

    2008-01-01

    The adult education literature on disruptive behavior of adult learners was reviewed and a survey on disruptive behavior of adult learners was conducted with adult educators. The findings are synthesized in a conceptual framework for understanding the types and causes of disruptive behavior, which fall into the categories of inattention,…

  12. Adult Learners: Pathways to Progression. FEDA Paper.

    ERIC Educational Resources Information Center

    Reisenberger, Anna; Sanders, John

    1997-01-01

    A study focused on facilitating progression for adults from nonvocational adult education to qualification-bearing courses in further education (FE) and studied their patterns of progression and which factors helped or hindered such progress. Information was collected from adult learners in 10 adult and FE organizations in Britain through a…

  13. Adult Education in Israel, II-III.

    ERIC Educational Resources Information Center

    Kirmayer, Paul, Ed.; Pinnes, Noy, Ed.

    This is the second booklet in English that deals with adult education in Israel. The following papers are included: "Editors' Notes" (Paul Kirmayer, Noy Pinnes); "Introduction" (Meir Peretz); "Defining 'Adult Education'" (Yehezkel Cohen); "Planning Study Programs for Adults" (Rachel Tokatli); "The Role of Adult Education: Changing the Individual…

  14. Study Circle Guide: Adult Student Persistence

    ERIC Educational Resources Information Center

    National Center for the Study of Adult Learning and Literacy (NCSALL), 2006

    2006-01-01

    This study circle was created by the National Center for the Study of Adult Learning and Literacy (NCSALL). The study circle is part of NCSALL's efforts to help connect research and practice in the field of adult basic education and adult literacy. The Adult Student Persistence Study Circle is one of a series of study circles that NCSALL has…

  15. Directory of Resources for Adults with Disabilities.

    ERIC Educational Resources Information Center

    Office of Vocational and Adult Education, Washington, DC. Div. of Adult Education.

    This directory of resources for disabled adults was compiled to assist state directors of the federally funded, state-administered Adult Education Program as well as administrators and practitioners in providing services for adults with disabilities. The first two sections include 15 federal and nonfederal organizations serving adults with various…

  16. 38 CFR 18.438 - Adult education.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Adult education. 18.438 Section 18.438 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Adult Education § 18.438 Adult education. A recipient that provides adult education may not, on...

  17. Defining Cigarette Smoking Status in Young Adults: A Comparison of Adolescent vs Adult Measures

    ERIC Educational Resources Information Center

    Delnevo, Cristine D.; Lewis, M. Jane; Kaufman, Ira; Abatemarco, Diane J.

    2004-01-01

    Objective: To determine the agreement between 2 measures (adult vs adolescent) of current cigarette smoking among young adults. Methods: We examined data from 1007 young adults from the New Jersey Adult Tobacco Survey. The adult measure incorporates lifetime and present use, whereas the adolescent measure assesses past 30-day use. The kappa…

  18. Weight Management in Older Adults.

    PubMed

    Gill, Lydia E; Bartels, Stephen J; Batsis, John A

    2015-09-01

    As the number of older adults increases rapidly, the national epidemic of obesity is also affecting our aging population. This is particularly concerning given the numerous health risks and increased costs associated with this condition. Weight management is extremely important for older adults given the risks associated with abdominal adiposity, which is a typical fat redistribution during aging, and the prevalence of comorbid conditions in this age group. However, approaches to weight loss must be considered critically given the dangers of sarcopenia (a condition that occurs when muscle mass and quality are lost), the increased risk of hip fracture with weight loss, and the association between reduced mortality and increased BMI in older adults. This overview highlights the challenges and implications of measuring adiposity in older adults and the dangers and benefits of weight loss in this population and provides an overview of the new Medicare Obesity Benefit. In addition, we provide a summary of outcomes from successful weight loss interventions for older adults and discuss implications for advancing clinical practice. PMID:26627496

  19. Adult-onset mitochondrial myopathy.

    PubMed Central

    Fernandez-Sola, J.; Casademont, J.; Grau, J. M.; Graus, F.; Cardellach, F.; Pedrol, E.; Urbano-Marquez, A.

    1992-01-01

    Mitochondrial diseases are polymorphic entities which may affect many organs and systems. Skeletal muscle involvement is frequent in the context of systemic mitochondrial disease, but adult-onset pure mitochondrial myopathy appears to be rare. We report 3 patients with progressive skeletal mitochondrial myopathy starting in adult age. In all cases, the proximal myopathy was the only clinical feature. Mitochondrial pathology was confirmed by evidence of ragged-red fibres in muscle histochemistry, an abnormal mitochondrial morphology in electron microscopy and by exclusion of other underlying diseases. No deletions of mitochondrial DNA were found. We emphasize the need to look for a mitochondrial disorder in some non-specific myopathies starting in adult life. Images Figure 1 Figure 2 PMID:1589382

  20. [Adult hepatoblastoma. A case report].

    PubMed

    Goikoetxea Urdiain, A; Sánchez Acedo, P; Mateo Retuerta, J; Tarifa Castilla, A; Zazpe Ripa, C; Herrera Cabezón, J

    Adult hepatoblastoma is a rare pathology. Its pathogeny is not well understood and prognosis is very bad. We pre-sent a case of adult hepatoblastoma treated in our centre. A 65 year-old male, without previous hepatopathy, who consulted due to right hypochondrial pain with a subacute evolution. The pathological diagnosis was adult epithelial hepatoblastoma, with free surgical margins. The patient recei-ved a second surgical intervention 5 months later due to early recurrence and died 10 months after the diagnosis due to a new massive recurrence. His definitive diagnosis is histological. Radical surgery is the only treatment that increases survival, but recurrence is frequent. There are no well-defined patterns of adjuvant chemotherapy nor is there any trans-plant experience. PMID:27599957

  1. All adults once were children.

    PubMed

    Block, Robert W

    2016-01-01

    All adults once were children, and children exposed to unrelenting adversities or toxic stress are at risk for developing a multitude of health conditions that threaten their development and eventual adult health status. Pediatricians and their pediatric surgeon colleagues can help families and their children develop resiliency by properly addressing the needs of families and their children and by participating in advocacy opportunities related to federal, state, and local policies affecting children. Evolving neuroscience that expands our knowledge of brain health and the relatively new field of epigenetics continue to contribute scientific information that underscores the need for attention to the health and wellbeing of the developing child in order to prevent many diseases and conditions among adults that continue to escalate healthcare costs. Resiliency is needed to combat the effects of toxic stress, and physicians are urged to work with their communities to assist families who need help learning about parenting resources to promote children's capacities for success.

  2. Vaccinations for the Older Adult.

    PubMed

    Gnanasekaran, Gowrishankar; Biedenbender, Rex; Davidson, Harley Edward; Gravenstein, Stefan

    2016-08-01

    Vaccine response declines with age, but currently recommended vaccines are safe and effective in reducing, if not preventing, disease altogether. Over the last decade, advancements in vaccine immunogenicity, either by increasing dose or conjugating vaccines to protein, have resulted in more immunogenic vaccines that also seem more effective in reducing clinical disease both for influenza and pneumococcus. Meanwhile, there is a resurgence in incident pertussis, exceeding prevalence from five decades ago, adding older adults to a recommended target vaccination group. This article discusses currently available vaccines, in the context of current epidemiology and recommendations, for older adults. PMID:27394026

  3. Pain management in older adults.

    PubMed

    Schilling, Margo L

    2003-05-01

    Pain is a common complaint of older adults. Persistent pain has a significant negative impact on elderly individuals' sense of well being, physical function, and quality of life. Increasing age and cognitive impairment are risk factors for undertreatment of persistent pain. Safe and effective therapy is available for pain syndromes that commonly affect older adults. Recognition of failure of health providers to appropriately assess and manage persistent pain has led to the recent development and adoption of regulatory guidelines for the implementation of effective pain management programs.

  4. Water intoxication in adult cattle.

    PubMed

    Kawahara, Naoya; Ofuji, Sosuke; Abe, Sakae; Tanaka, Ai; Uematsu, Masami; Ogata, Yoshimi

    2016-05-01

    Water intoxication is a common disorder in calves and is usually characterized by transient hemoglobinuria. In contrast, the condition is very rare in adult cattle, with few reports on naturally occurring cases. In the present report, four female Japanese Black cattle, aged 16-25 months, showed neurological signs when they drank water following a water outage. Hemoglobinuria was not grossly observed, while severe hyponatremia was revealed by laboratory tests. Autopsy indicated cerebral edema with accumulation of serous fluid in expanded Virchow-Robin spaces. These results indicate the possibility of water intoxication associated with cerebral edema due to severe dilutional hyponatremia in adult cattle.

  5. Water intoxication in adult cattle.

    PubMed

    Kawahara, Naoya; Ofuji, Sosuke; Abe, Sakae; Tanaka, Ai; Uematsu, Masami; Ogata, Yoshimi

    2016-05-01

    Water intoxication is a common disorder in calves and is usually characterized by transient hemoglobinuria. In contrast, the condition is very rare in adult cattle, with few reports on naturally occurring cases. In the present report, four female Japanese Black cattle, aged 16-25 months, showed neurological signs when they drank water following a water outage. Hemoglobinuria was not grossly observed, while severe hyponatremia was revealed by laboratory tests. Autopsy indicated cerebral edema with accumulation of serous fluid in expanded Virchow-Robin spaces. These results indicate the possibility of water intoxication associated with cerebral edema due to severe dilutional hyponatremia in adult cattle. PMID:27506091

  6. Teaching the adult ostomy patient.

    PubMed

    O'Shea, H S

    2001-01-01

    Ostomy education is based on principles of adult learning, including assessment of the learners' readiness, ability, and need to learn. Such teaching incorporates specific strategies designed to promote cognitive, affective, and psychomotor learning and strategies to overcome potential cultural barriers. In addition, modifications may be included to meet the needs of aged or disabled patients who have cognitive deficits or low literacy skills. Finally, ostomy education must include an evaluation of its effectiveness. This article reviews general guidelines for planning, implementing, and evaluating patient education for adult patients with ostomies.

  7. Septic arthritis in adult horses.

    PubMed

    Carstanjen, B; Boehart, S; Cislakova, M

    2010-01-01

    Septic arthritis in horses is a serious disease which can become life-threatening. In case the infection can be eliminated before irreversible joint damage occurs, complete recovery is possible. This article gives an overview of the literature concerning etiology, diagnosis and strategies of therapy in cases of septic arthritis in adult horses, with special reference to novel options of treatment.

  8. Arts & Humanities in Adult Education.

    ERIC Educational Resources Information Center

    Word's Worth: A Quarterly Newsletter of the Lifelong Learning Network, 1998

    1998-01-01

    This issue of a quarterly newsletter on lifelong learning focuses on the theme of the arts and humanities in adult literacy education. The following articles are included: (1) "In Defense of a Practical Education" (Earl Shorris); (2) "From the Program Director" (Elizabeth Bryant McCrary); (3) "Vermont Council on the Humanities: Book Discussion…

  9. Adult Children and Aging Parents.

    ERIC Educational Resources Information Center

    Myers, Jane E.

    This book was developed to assist counselors and other caregivers in working with adult children and their aging parents. The first chapter addresses normative developmental issues in later life. This includes the demography of aging, theories of aging, and attitudes toward older persons, along with suggestions for identifying at-risk populations,…

  10. COPD: Unique to Older Adults

    MedlinePlus

    ... Multiple Health Problems Prevention Join our e-newsletter! Aging & Health A to Z COPD Unique to Older Adults This section provides information ... not a weakness or a normal part of aging. Most people feel better with ... help you can, so that your COPD does not prevent you from living your life ...

  11. Radical Ideas in Adult Education.

    ERIC Educational Resources Information Center

    Ohliger, John

    The outline for an adult education colloquim states 17 discussion questions. Under each question, the outline refers to appropriate items on an eight page, 81-item, annotated bibliography. The first of three topical areas, ideas about people, considers: all people's desire to learn and their rough equality in intelligence; common people's ability…

  12. New Directions in Adult Education

    ERIC Educational Resources Information Center

    McRainey, D. Lynn

    2008-01-01

    How are educators moving museums' interpretive goals beyond exhibition galleries? How are programs creating new relationships between a museum and its adult audiences? As plans for physical transformation at the Chicago History Museum took form, the education department launched a parallel process of planning to redefine the "look and feel" for…

  13. Hearing loss in older adults.

    PubMed

    Walling, Anne D; Dickson, Gretchen M

    2012-06-15

    Hearing loss affects approximately one-third of adults 61 to 70 years of age and more than 80 percent of those older than 85 years. Men usually experience greater hearing loss and have earlier onset compared with women. The most common type is age-related hearing loss; however, many conditions can interfere with the conduction of sound vibrations to the inner ear and their conversion to electrical impulses for conduction to the brain. Screening for hearing loss is recommended in adults older than 50 to 60 years. Office screening tests include the whispered voice test and audioscopy. Older patients who admit to having difficulty hearing may be referred directly for audiometry. The history can identify risk factors for hearing loss, especially noise exposure and use of ototoxic medications. Examination of the auditory canal and tympanic membrane can identify causes of conductive hearing loss. Audiometric testing is required to confirm hearing loss. Adults presenting with idiopathic sudden sensorineural hearing loss should be referred for urgent assessment. Management of hearing loss is based on addressing underlying causes, especially obstructions (including cerumen) and ototoxic medications. Residual hearing should be optimized by use of hearing aids, assistive listening devices, and rehabilitation programs. Surgical implants are indicated for selected patients. Major barriers to improved hearing in older adults include lack of recognition of hearing loss; perception that hearing loss is a normal part of aging or is not amenable to treatment; and patient nonadherence with hearing aids because of stigma, cost, inconvenience, disappointing initial results, or other factors.

  14. Communication Technology for Adult Education.

    ERIC Educational Resources Information Center

    Rehman, S.

    1979-01-01

    The author draws attention to the quantitative and qualitative targets set for achievement by the National Adult Education Programme in India. She recommends a thorough and extensive use of educational media, not merely for motivational purposes, but for raising awareness and training the large numbers of instructors required to run the program.…

  15. Cardiac Rehabilitation in Older Adults.

    PubMed

    Schopfer, David W; Forman, Daniel E

    2016-09-01

    The biology of aging and the pathophysiology of cardiovascular disease (CVD) overlap, with the effect that CVD is endemic in the growing population of older adults. Moreover, CVD in older adults is usually complicated by age-related complexities, including multimorbidity, polypharmacy, frailty, and other intricacies that add to the risks of ambiguous symptoms, deconditioning, iatrogenesis, falls, disability, and other challenges. Cardiac rehabilitation (CR) is a comprehensive lifestyle program that can have particular benefit for older patients with cardiovascular conditions. Although CR was originally designed primarily as an exercise training program for younger adults after a myocardial infarction or coronary artery bypass surgery, it has evolved as a comprehensive lifestyle program (promoting physical activity as well as education, diet, risk reduction, and adherence) for a broader range of CVD (coronary heart disease, heart failure, and valvular heart disease). It provides a valuable opportunity to address and moderate many of the challenges pertinent for the large and growing population of older adults with CVD. Cardiac rehabilitation promotes physical function (cardiorespiratory fitness as well as strength and balance) that helps overcome disease and deconditioning as well as related vulnerabilities such as disability, frailty, and falls. Similarly, CR facilitates education, monitoring, and guidance to reduce iatrogenesis and promote adherence. Furthermore, CR fosters cognition, socialization, and independence in older patients. Yet despite all its conceptual benefits, CR is significantly underused in older populations. This review discusses benefits and the paradoxical underuse of CR, as well as evolving models of care that may achieve greater application and efficacy. PMID:27297002

  16. Adult Reading Habits and Patterns.

    ERIC Educational Resources Information Center

    Scales, Alice M.; Rhee, Ock

    2001-01-01

    Examines the reading habits and patterns of White and Asian American adults. Hypothesizes that when grouped by demographic variables, participants' responses about their reading habits and patterns would not differ. Concludes that gender, race, and education were predictors for participants' reading habits; education and race were predictors for…

  17. Technical and Adult Education Review.

    ERIC Educational Resources Information Center

    West Virginia State Dept. of Education, Charleston.

    This annual review is a synthesis of the West Virginia Division of Technical and Adult Education Services programs and plans at the conclusion of fiscal year 1991. It begins with letters from the State Superintendent of Schools and Assistant State Superintendent. West Virginia Board of Education mission and goals and the division's programmatic…

  18. Adult Basic Education; Operations Manual.

    ERIC Educational Resources Information Center

    Missouri State Dept. of Education, Jefferson City.

    This publication is an administrative guide for Missouri school administrators and local adult basic education supervisors. First, general information is given as to legislative authority, standards for approval, procedures for implementation, expenditures and reimbursement, teacher qualifications, program administration, student eligibility and…

  19. Adult Vaccination--A Commentary

    ERIC Educational Resources Information Center

    Logan, Jennifer

    2008-01-01

    Traditionally, vaccines have been associated with childhood. Historically, many of the most-feared communicable diseases attacked infants and toddlers, and those who survived were generally protected from those diseases as adults. During the past century tremendous advances in vaccination spared millions the morbidity and mortality associated with…

  20. Assessing Adult Literacy by Telephone.

    ERIC Educational Resources Information Center

    Sticht, Thomas G.; Hofstetter, C. Richard; Hofstetter, Carolyn H.

    1996-01-01

    Examines the construct and action validity of the use of simple checklists to assess the declarative knowledge component of adult's literacy by telephone. Finds significant relationships among knowledge when assessed either by listening (telephone) or by reading (mailed questionnaire) modality. Concludes that the telephone method may provide a…

  1. Adult Literacy Issues in Canada.

    ERIC Educational Resources Information Center

    Burnaby, Barbara

    1991-01-01

    Literacy issues are discussed that affect Canadians age 15 and older who are barely literate in any language. Topics include the following: definitions of literacy; policy overviews and surveys; the impact of literacy on Canadian institutions; access for literacy learners; adult learning and classroom practice; and the plain language movement. (76…

  2. Computer Technology in Adult Education.

    ERIC Educational Resources Information Center

    Slider, Patty; Hodges, Kathy; Carter, Cea; White, Barbara

    This publication provides materials to help adult educators use computer technology in their teaching. Section 1, Computer Basics, contains activities and materials on these topics: increasing computer literacy, computer glossary, parts of a computer, keyboard, disk care, highlighting text, scrolling and wrap-around text, setting up text,…

  3. Adult Learning in the Workplace.

    ERIC Educational Resources Information Center

    1999

    This document contains four symposium papers on adult learning in the workplace. "The Relationship between Workplace Learning and Employee Satisfaction in Small Businesses" (Robert W. Rowden, Shamsuddin Ahmad) reports the results of a study of the nature and extent of HRD, level of job satisfaction among workers, and correlation between HRD…

  4. Quitting Smoking for Older Adults

    MedlinePlus

    ... Related Topics Alcohol Use and Older Adults COPD Lung Cancer The information in this topic was provided by the National Cancer Institute Topic last reviewed: June 2014 For an enhanced version of this page please turn Javascript on. Quitting Smoking for Older ...

  5. Death of an Adult Child

    MedlinePlus

    ... iGive.com Purchase Through AmazonSmile Contact Us Donate Death of an Adult Child The death of any child, regardless of cause or age, ... the situations that may have caused their child’s death. Judgmental statements from others indicating that the child ...

  6. Adult Education and the Environment

    ERIC Educational Resources Information Center

    Field, John

    2008-01-01

    Due to the effects of global warming, writes Field, everyone now lives in times of plague, floods, and famine. While the UK government's track record on green issues is not all bad, still it is vulnerable to criticism. In this article, the author discusses what adult education has to offer to the environmental movement, despite existing…

  7. The Child and the Adult.

    ERIC Educational Resources Information Center

    Cavalletti, Sofia

    1994-01-01

    Discusses young children's relationship with God and the place of religion in their lives, focusing on the role of adults in proclaiming the essential elements of Christianity to children. Argues that even very young children can understand the essence of religion. (MDM)

  8. Successful International Adult Education Programs.

    ERIC Educational Resources Information Center

    Langford, Frances P.

    An examination of international adult education programs that have proved to be successful indicates that the key elements of success are nonmaterial in nature. Unity in spirit and action, equality of the sexes, elimination of prejudice, practice of the art of consultation, trustworthiness, and the preservation of human dignity and honor appear to…

  9. Morphological Processing in Adult Dyslexia

    ERIC Educational Resources Information Center

    Leikin, Mark; Hagit, Even Zur

    2006-01-01

    This study employed the masked-priming paradigm [Forster and Davis (J Exp Psychol bearn Mem Cogn 10: 680-698, 1984).], along with traditional methods of evaluation of morphological awareness and phonological processing, to obtain a finer-grained picture of the relationship between morphological abilities and reading in adult dyslexic readers.…

  10. Understanding Persistence in Adult Learning

    ERIC Educational Resources Information Center

    McGivney, Veronica

    2004-01-01

    The paper summarizes recent data on the retention and non-completion patterns of adult students, especially those over the age of 25 who have had a gap since completing full-time education. While data on further and higher education suggest that older learners are less likely than younger ones to complete longer, qualification-bearing programmes,…

  11. Films/Videos for Adults.

    ERIC Educational Resources Information Center

    Stanford, Beverly Hardcastle

    1993-01-01

    Reviews six films designed for adults released between 1988 and 1992, most of which focus on the challenges that children face, including (1) See What I'm Saying; (2) Something Magical; (3) We Have Something to Say: Children, Computers, and Special Education; (4) Shortchanging Girls, Shortchanging America; (5) Take Me to Your Leaders; and (6) The…

  12. Adult Education and Development, 1993.

    ERIC Educational Resources Information Center

    Hinzen, Heribert, Ed.

    1993-01-01

    These two issues of a half-yearly journal for adult education cover Africa, Asia, and Latin America. Number 40 consists of 35 articles on 4 themes: Multicultural dimensions; environmental learning; cooperation and partnership with Eastern Europe; and women and training. Articles include: "It Is Time to Understand that the World Belongs to All of…

  13. Socioeconomic Outcomes from Adult Education.

    ERIC Educational Resources Information Center

    Gooderham, Paul N.

    1991-01-01

    The degree to which age and gender influence completion of higher secondary education (HSE) and employment status was measured with a sample of 350 Norwegian adults. Application of a Status Attainment model revealed that post-HSE educational attainment is an important determinant of socioeconomic status for both men and women. (SK)

  14. Essential English for Micronesian Adults.

    ERIC Educational Resources Information Center

    Conrad, Jo Ann; Reinecke, Hank

    This student workbook is designed to help Micronesian adults learn everyday English. Its ten chapters move from simple one-word picture labeling to more abstract ideas in a spiraled fashion, reiterating the essential elements of the English language in different, more complicated ways. Subjects covered include names for everyday objects and…

  15. The Florida Adult Literacy Plan.

    ERIC Educational Resources Information Center

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

    This document presents the Adult Literacy Plan for the state of Florida. Section 1 provides a rationale for the plan. Section 2 sets forth goals and objectives. The statutory intent is described in Section 3, which focuses on the Florida Model Literacy Program Act of 1987 (FMLPA). Section 4 presents a statement of the problem. It provides…

  16. Adult Basic Education Annotated Bibliography.

    ERIC Educational Resources Information Center

    Carter, Nancy B.

    This annotated bibliography contains sections divided according to area of study, and within each category materials are listed alphabetically by publisher. Publishers and mailing addresses are listed at the end of the bibliography. Throughout the annotations, whenever specific grade level divisions are not named, the regular Adult Basic Education…

  17. National Adult Physical Fitness Survey.

    ERIC Educational Resources Information Center

    President's Council on Physical Fitness and Sports Newsletter, 1973

    1973-01-01

    This report of a personal interview research survey conducted for the President's Council on Physical Fitness and Sports in 1972 presents the following findings: (a) 45 percent of all adult Americans do not engage in any form of exercise; (b) walking is the most popular form of exercise, followed by bicycle riding, swimming, calisthenics, bowling,…

  18. Adult Education in Saudi Arabia.

    ERIC Educational Resources Information Center

    Griffin, Tim D.; Algren, Mark S.

    Religion pervades all aspects of Saudi Arabia, the conservative home of Islam, where the constitution is the Quran and law is interpreted by religious scholars. A formal adult basic education program was initiated in 1960. As part of the country's modernization since the early 1970s, the Saudi government has begun an enormous nation-building plan…

  19. PSYCHOLOGICAL FOUNDATIONS OF ADULT EDUCATION.

    ERIC Educational Resources Information Center

    LANYON, RICHARD I.; SCHWARTZ, MILTON M.

    TWO PAPERS ARE INCLUDED IN THIS BULLETIN. THE MILTON SCHWARTZ PAPER, "THEORIES OF MOTIVATION AND THEIR APPLICATION TO ADULT EDUCATION," SURVEYS THE THINKING, RESEARCH, AND CONCLUSIONS OF SOME OF THE LEADING FIGURES CONCERNED WITH SOCIAL MOTIVATION. THE AUTHOR ATTEMPTS TO CLASSIFY THESE THEORIES BY GENERATING A TWO-DIMENSIONAL SCHEMA OF SOCIAL…

  20. Counseling Adults for Life Transitions.

    ERIC Educational Resources Information Center

    Walz, Garry R.; Benjamin, Libby

    Adult counseling is assuming increasing importance in counselor education and training. Most important is the developmental aspect of growth all through life, since adulthood is not a static period but can be as fraught with conflict and choice as childhood or adolescence. Outlines describe some important differences between young people and…

  1. Women in Adult Basic Education

    ERIC Educational Resources Information Center

    Park, Rosemarie J.

    1977-01-01

    A survey of adult basic education (ABE) program directors in five states revealed that most ABE teachers are women and work part-time without benefits while most ABE administrators are men who are employed full-time. Concludes that women employed in ABE are victims of discrimination. (EM)

  2. Multitasking in adults with ADHD.

    PubMed

    Gawrilow, Caterina; Merkt, Julia; Goossens-Merkt, Heinrich; Bodenburg, Sebastian; Wendt, Mike

    2011-09-01

    Adults with ADHD have problems in everyday multitasking situations presumably because of deficits in executive functions. The present study aims to find out (a) whether adults with ADHD show deficient multitasking performance in a standardized task, (b) how they perceive the multitasking situation, and (c) which task structure might be beneficial for them as compared with adults without ADHD. Therefore, we experimentally compared task performance, mood, and motivation in a group of 45 men with ADHD (M-age = 34.47, SD = 9.95) with a comparison group of 42 men without ADHD (M-age = 31.12, SD = 10.59) in three conditions: (a) a multitasking paradigm, (b) an interleaving condition in which tasks had to be performed without planning or monitoring, and (c) a non-interleaving condition. Our results showed no impaired multitasking performance in adults with ADHD. However, they showed better mood and more motivation in the non-interleaving condition.

  3. Adult Learning in Traditional Music

    ERIC Educational Resources Information Center

    Cope, Peter

    2005-01-01

    This study is based on interviews carried out with 13 adult learners of traditional fiddle playing. The average age of the learners was 56 and they had been learning to play for between 2 and 20 years. All of the interviewees had taken music at school but none of them had been stimulated to participate further in any significant sense. The…

  4. NGO Perspectives on Adult Literacy

    ERIC Educational Resources Information Center

    Archer, David

    2004-01-01

    Since 2000, the only serious attempt to mobilise new resources for education has been the World Bank's co-ordinated "Fast Track Initiative (FTI)." However, the FTI only raises funds for achieving universal completion of primary school and it does not address early childhood education or adult literacy. To date the Global Campaign for Education has…

  5. The Economics of Adult Education

    ERIC Educational Resources Information Center

    Desjardins, Richard

    2013-01-01

    As the "Hamburg Declaration" makes clear, adult education (AE) is a key component of development strategies that seek to ensure the long-term well-being of nations. Yet, with few exceptions most countries systematically underinvest in AE. Of course, it is no easy task to achieve adequate investment levels that reflect an appropriate balance…

  6. Visuomotor Binding in Older Adults

    ERIC Educational Resources Information Center

    Bloesch, Emily K.; Abrams, Richard A.

    2010-01-01

    Action integration is the process through which actions performed on a stimulus and perceptual aspects of the stimulus become bound as a unitary object. This process appears to be controlled by the dopaminergic system in the prefrontal cortex, an area that is known to decrease in volume and dopamine functioning in older adults. Although the…

  7. Social Environment and Adult Learning.

    ERIC Educational Resources Information Center

    Fellenz, Robert A., Ed.; Conti, Gary J., Ed.

    This monograph contains papers from an institute on the theme of adult learning in the social environment. "Bill Moyers' Journal: An Interview with Myles Horton" provides excerpts from a televised interview that discusses Myles Horton's life, work, and association with the Highlander Folk School. "Myles Horton's Views on Learning in the Social…

  8. Where Now for Adult Learning?

    ERIC Educational Resources Information Center

    Keep, Ewart; Rogers, David; Hunt, Sally; Walden, Christopher; Fryer, Bob; Gorard, Stephen; Williams, Ceri; Jones, Wendy; Hartley, Ralph

    2010-01-01

    With 6 billion British pounds of public spending reductions already on the table, and far deeper cuts inevitable, what are the prospects for adult learning in the new Parliament? Some of the regular contributors of this journal were asked what they expected and what they would like to see. Ewart Keep warns that the coalition parties' commitments…

  9. Conscious Choking: Adult and Child

    MedlinePlus

    ... and AED LIFEGUARDING Refresher Conscious Choking—Adult and Child (2:25) QUICK LINKS Home RedCross.org Purchase Course Materials Shop Our Store Contact Us Privacy Policy Terms and Conditions All rights reserved. 2011 American National Red Cross.

  10. Young adults as users of adult healthcare: experiences of young adults with complex or life-limiting conditions.

    PubMed

    Beresford, B; Stuttard, L

    2014-08-01

    Awareness is growing that young adults may have distinctive experiences of adult healthcare and that their needs may differ from those of other adult users. In addition, the role of adult health teams in supporting positive transitions from paediatrics is increasingly under discussion. This paper contributes to these debates. It reports a qualitative study of the experiences of young adults - all with complex chronic health conditions - as users of adult health services. Key findings from the study are reported, including an exploration of factors that help to explain interviewees' experiences. Study findings are discussed in the context of existing evidence from young adults in adult healthcare settings and theories of 'young adulthood'. Implications for training and practice are considered, and priorities for future research are identified.

  11. Cochlear Implantation in Older Adults

    PubMed Central

    Lin, Frank R.; Chien, Wade W.; Li, Lingsheng; Niparko, John K.; Francis, Howard W.

    2012-01-01

    Cochlear implants allow individuals with severe-to-profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation is approximately 150,000 and will continue to increase with the aging of the population. Should cochlear implantation (CI) be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12 year experience with cochlear implantation in adults ≥60 years (n = 445) at Johns Hopkins to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that cochlear implantation in adults ≥60 years consistently improved speech understanding scores with a mean increase of 60. 0% (S. D. 24. 1) on HINT sentences in quiet . The magnitude of the gain in speech scores was negatively associated with age at implantation such that for every increasing year of age at CI the gain in speech scores was 1. 3 percentage points less (95% CI: 0. 6 – 1. 9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40–60%) had significantly greater post-CI speech scores by a mean of 10. 0 percentage points (95% CI: 0. 4 – 19. 6) than those with lower pre-CI speech scores (HINT <40%) after adjusting for age at CI and age at hearing loss onset. These results suggest that older adult CI candidates who are younger at implantation and with higher preoperative speech scores obtain the highest speech understanding scores after cochlear implantation with possible implications for current Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take into

  12. Idiopathic Adult Growth Hormone Deficiency

    PubMed Central

    2013-01-01

    GH secretion is controlled by hypothalamic as well as intrapituitary and peripheral signals, all of which converge upon the somatotroph, resulting in integrated GH synthesis and secretion. Enabling an accurate diagnosis of idiopathic adult GH deficiency (IAGHD) is challenged by the pulsatility of GH secretion, provocative test result variability, and suboptimal GH assay standardization. The spectrum between attenuated GH secretion associated with the normal aging process and with obesity and truly well-defined IAGHD is not distinct and may mislead the diagnosis. Adult-onset GHD is mainly caused by an acquired pituitary deficiency, commonly including prior head/neck irradiation, or an expanding pituitary mass causing functional somatotroph compression. To what extent rare cryptic causes account for those patients seemingly classified as IAGHD is unclear. About 15% of patients with adult GHD and receiving GH replacement in open-label surveillance studies are reported as being due to an idiopathic cause. These patients may also reflect a pool of subjects with an as yet to be determined occult defect, or those with unclear or incomplete medical histories (including forgotten past sports head injury or motor vehicle accident). Therefore, submaximal diagnostic evaluation likely leads to an inadvertent diagnosis of IAGHD. In these latter cases, adherence to rigorous biochemical diagnostic criteria and etiology exclusion may result in reclassification of a subset of these patients to a distinct known acquired etiology, or as GH-replete. Accordingly, rigorously verified IAGHD likely comprises less than 10% of adult GHD patients, an already rare disorder. Regardless of etiology, patients with adult GHD, including those with IAGHD, exhibit a well-defined clinical phenotype including increased fat mass, loss of lean muscle mass, decreased bone mass, and enhanced cardiac morbidity. Definition of unique efficacy and dosing parameters for GH replacement and resultant therapeutic

  13. Young Adults' Implicit and Explicit Attitudes towards the Sexuality of Older Adults.

    PubMed

    Thompson, Ashley E; O'Sullivan, Lucia F; Byers, E Sandra; Shaughnessy, Krystelle

    2014-09-01

    Sexual interest and capacity can extend far into later life and result in many positive health outcomes. Yet there is little support for sexual expression in later life, particularly among young adults. This study assessed and compared young adults' explicit and implicit attitudes towards older adult sexuality. A sample of 120 participants (18-24 years; 58% female) completed a self-report (explicit) measure and a series of Implicit Association Tests capturing attitudes towards sexuality among older adults. Despite reporting positive explicit attitudes, young people revealed an implicit bias against the sexual lives of older adults. In particular, young adults demonstrated implicit biases favouring general, as compared to sexual, activities and young adults as compared to older adults. Moreover, the bias favouring general activities was amplified with regard to older adults as compared to younger adults. Our findings challenge the validity of research relying on self-reports of attitudes about older adult sexuality.

  14. Clofarabine in Adult Patients With Advanced Solid Tumors

    ClinicalTrials.gov

    2014-02-04

    Solid Tumors; Leukemia, Lymphocytic, Acute, Pediatric; Leukemia, Lymphocytic, Acute, Adult; Leukemia, Myelocytic, Acute, Pediatric; Leukemia, Myelocytic, Acute, Adult; Myelodysplastic Syndromes, Adult

  15. CPR - adult and child 9 years and older

    MedlinePlus

    Cardiopulmonary resuscitation - adult; Rescue breathing and chest compressions - adult; Resuscitation - cardiopulmonary - adult; Cardiopulmonary resuscitation - child 9 years and older; Rescue breathing ...

  16. General Information about Adult Acute Lymphoblastic Leukemia

    MedlinePlus

    ... Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Lymphoblastic Leukemia Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  17. General Information about Adult Acute Myeloid Leukemia

    MedlinePlus

    ... Acute Myeloid Leukemia Treatment (PDQ®)–Patient Version General Information About Adult Acute Myeloid Leukemia Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  18. General Information about Adult Soft Tissue Sarcoma

    MedlinePlus

    ... Soft Tissue Sarcoma Treatment (PDQ®)–Patient Version General Information About Adult Soft Tissue Sarcoma Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  19. General Information about Adult Primary Liver Cancer

    MedlinePlus

    ... Primary Liver Cancer Treatment (PDQ®)–Patient Version General Information About Adult Primary Liver Cancer Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  20. Senior Health: Older Adults and Newer Technology

    MedlinePlus

    ... Medical Director Senior Health: Older Adults and Newer Technology Volume 15 · Issue 6 · November/December 2005 Text ... adults who struggle to stand and walk. New technology includes knee units, shock-absorbing pylons, and other ...

  1. Rising Blood Sugar Hitting More Obese Adults

    MedlinePlus

    ... medlineplus.gov/news/fullstory_159853.html Rising Blood Sugar Hitting More Obese Adults To curb diabetes, researchers ... News) -- Among obese American adults, control of blood sugar is worsening, leading to more diabetes and heart ...

  2. Personality Profiles of Physically Impaired Young Adults.

    ERIC Educational Resources Information Center

    Richman, Lynn C.; Harper, Dennis C.

    1980-01-01

    Different forms of chronic observable disability may have differing impacts on adult personality adjustment. Young adults with cleft lip/palate display fewer personality adjustment problems than those with orthopedic impairment. (Author)

  3. The Dynamic Mandala of Adult Education.

    ERIC Educational Resources Information Center

    Draper, James A.

    1992-01-01

    Outlines basic assumptions and principles underlying adult education and describes today's challenges: maintaining democracy, technological changes, explosion of information, global competition/cooperation, environment, and universal human rights. Advocates a holistic world view of adult education. (SK)

  4. Screening for Hepatitis C Infections in Adults

    MedlinePlus

    ... Task Force learned about the potential benefits and harms of screening: (1) Adults at high risk for ... C Virus Infection in Adults Potential Benefits and Harms of Screening and Treatment The Task Force reviewed ...

  5. Weakened Immune System and Adult Vaccination

    MedlinePlus

    ... for Healthcare Professionals Weakened Immune System and Adult Vaccination Recommend on Facebook Tweet Share Compartir Vaccines are ... up to age 26 years Learn about adult vaccination and other health conditions Asplenia Diabetes Type 1 ...

  6. Lung Disease Including Asthma and Adult Vaccination

    MedlinePlus

    ... Healthcare Professionals Lung Disease including Asthma and Adult Vaccination Language: English Español (Spanish) Recommend on Facebook Tweet ... more about health insurance options. Learn about adult vaccination and other health conditions Asplenia Diabetes Heart Disease, ...

  7. Concussion - what to ask your doctor - adult

    MedlinePlus

    ... to ask your doctor about concussion - adult; Brain injury - mild - what to ask your doctor - adult ... I start contact sports, such as football or soccer? When can I begin skiing or snowboarding When ...

  8. Adult Education: Profiles in Diversity and Strength.

    ERIC Educational Resources Information Center

    Weinstein-Shr, Gail

    Even Start is a family literacy and support program for families with young children. This paper identifies several characteristics of adult learners in order to suggest effective approaches for working with adults to improve literacy skills. The first section presents five case studies illustrating adults with different histories, circumstances,…

  9. Adult Multiple Intelligences. NCSALL Study Circle Guide

    ERIC Educational Resources Information Center

    Parrella, A.; Hofer, J.; Bubp, S.; Finn-Miller, S.; Graves, N.; Meador, P.

    2004-01-01

    This Study Circle guide was created by the National Center for the Study of Adult Learning and Literacy (NCSALL) as part of the Practitioner Dissemination and Research Network (PDRN). The guide is part of NCSALL's effort to help connect research and practice in the field of adult basic education and adult literacy. The purpose of the study circle…

  10. The Adult Learner: Some Things We Know

    ERIC Educational Resources Information Center

    Fogarty, Robin J.; Pete, Brian M.

    2007-01-01

    This book addresses the "warrior" who rises to the challenge of teaching the adult learner. The discussion is designed as a catalyst for dialogue about the adult learner and to uncover the complexities of teaching this rare and riveting species. This book is organized around three interlocking themes: some things we know about the adult learner;…

  11. Canadian Adult Education: Still a Movement

    ERIC Educational Resources Information Center

    Nesbit, Tom

    2011-01-01

    Writing recently in this journal, two of Canada's veteran adult educators contemplated the "death" of the Canadian adult education movement. I disagree and argue that adult education in Canada is as vital an activity as ever and one that still fully justifies being called a movement. Specifically, Selman and Selman (2009) list five trends that…

  12. Raising "Hot Topics" through Young Adult Literature

    ERIC Educational Resources Information Center

    Groenke, Susan; Maples, Joellen; Henderson, Jill

    2010-01-01

    While young adult literature increases adolescents' motivation to read, and adolescents choose to read young adult novels over more canonical works when given opportunities to choose, the authors present yet another reason for teaching young adult literature in the middle school classroom: it provides a medium through which adolescents and their…

  13. Changing Medical Students' Attitudes toward Older Adults

    ERIC Educational Resources Information Center

    Gonzales, Ernest; Morrow-Howell, Nancy; Gilbert, Pat

    2010-01-01

    Given the growth in the number of older adults and the ageist attitudes many in the health care profession hold, interventions aimed at improving health professionals' attitudes toward older adults are imperative. Vital Visionaries is an intergenerational art program designed to improve medical students' attitudes toward older adults. Participants…

  14. Physical Criteria for Adult Learning Environments.

    ERIC Educational Resources Information Center

    White, Sally

    The development of learning environments especially for adults has been neglected and research in planning such environments is fragmented and minimal. There is general agreement that facilities for adults should have an aura of adulthood to contribute to an adult's feeling of ease, confidence, and capability; that they should be flexible in room…

  15. Nutrition Goals for Older Adults: A Review.

    ERIC Educational Resources Information Center

    Horwath, Caroline C.

    1991-01-01

    Discusses specific goals of nutrition education for older adults and high-risk groups within the elderly population through review of three crucial areas: current knowledge of eating patterns, nutrient intake, and supplement use of older adults; existing information on multiple influences on eating habits of older adults; and potential benefits…

  16. Enhancing Learning in Training and Adult Education.

    ERIC Educational Resources Information Center

    Morgan, Ronald R.; Ponticell, Judith A.; Gordon, Edward E.

    This book, which is designed to prepare individuals to become workplace consultants, examines the theory and practice of enhancing learning in training and adult education. The following are among the topics discussed: putting cognition theory into practice in instruction; cognitive science perspective on adult learning (adults as learners, three…

  17. Adult Education School to Work. Final Report.

    ERIC Educational Resources Information Center

    Bean, Molly

    A project identified and established components related to adult basic education's role in school-to-work (STW) transition. It focused on developing a cognitive framework for competency-based adult employability classes, integrating adult basic and literacy education (ABLE)-funded programs into the Erie Area STW partnership, and establishing a…

  18. HIV Education for Adult Literacy Programs.

    ERIC Educational Resources Information Center

    Smith, Barbara E.

    This staff development package is designed to inform adult literacy practitioners about Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus (AIDS/HIV) and to facilitate implementation of HIV education in adult literacy programs. It is intended to teach them to plan and implement HIV education for their adult literacy students and to…

  19. Audiovocal Integration in Adults Who Stutter

    ERIC Educational Resources Information Center

    Loucks, Torrey; Chon, HeeCheong; Han, Woojae

    2012-01-01

    Background: Altered auditory feedback can facilitate speech fluency in adults who stutter. However, other findings suggest that adults who stutter show anomalies in "audiovocal integration", such as longer phonation reaction times to auditory stimuli and less effective pitch tracking. Aims: To study audiovocal integration in adults who stutter…

  20. Learning Havens for Stressed Adult Learners

    ERIC Educational Resources Information Center

    Seay, Sandra E.

    2005-01-01

    Having stressful workdays is not the sole prerogative of adult students enrolled in educational leadership programs. According to a report released by the American Institute of Stress in 2002, 80% of adult workers felt stress in the workplace. From this it can be assumed that a certain amount of stress accompanies every adult who enters an evening…

  1. Teaching Adult Students Mathematical Investigations-6.

    ERIC Educational Resources Information Center

    Angiama, R. O.

    Teaching Adult Students Mathematical Investigation is based on the continuing research work carried out for the last ten years of teaching on the Foundation Course in Mathematics at Goldsmiths, University of London. Teaching Mathematical Investigation to adult students is a very challenging and often rewarding experience for adult educators as…

  2. Museums: Adult Education as Cultural Politics

    ERIC Educational Resources Information Center

    Borg, Carmel; Mayo, Peter

    2010-01-01

    The sites of adult education practice are multiple, and museums feature regularly among these sites (Chadwick and Stannett, 1995, 2000). This chapter explores the potential of museums as sites for critical "public pedagogy." It foregrounds the role of adult educators as co-interrogators with adult learners of what is generally perceived as…

  3. Adult Learners, Learning and Public Libraries.

    ERIC Educational Resources Information Center

    Burge, Elizabeth J.; And Others

    1983-01-01

    Ten articles focusing on adult learning services in public libraries highlight global trends, support for intentional change, counseling and information needs of adult learners, adult learner services at Pratt Library and North York (Ontario) library, process of learning, administrative considerations, political factors, and implications for…

  4. Current World Trends in Adult Education.

    ERIC Educational Resources Information Center

    Bown, Lalage

    Adult education is now seen as an integral part of lifelong education. Adult education has become an instrument of policy that helps forward the goals of social and economic development. In many countries, adult education is being used to promote a greater sense of community and understanding across cultural and ethnic divisions. The tasks of…

  5. Strengths and Satisfaction across the Adult Lifespan

    ERIC Educational Resources Information Center

    Isaacowitz, Derek M.; Vaillant, George E.; Seligman, Martin E. P.

    2003-01-01

    Positive psychology has recently developed a classification of human strengths (Peterson & Seligman, in press). We aimed to evaluate these strengths by investigating the strengths and life satisfaction in three adult samples recruited from the community (young adult, middle-aged, and older adult), as well as in the surviving men of the Grant study…

  6. Adult Skills Training Center: Feasibility Study.

    ERIC Educational Resources Information Center

    Skalski, John M.; Baratta, Anthony N.

    A 4-phase project, this study was conducted to determine the feasibility of a bilingual vocational skill training program for out-of-school youth and adults of the Perth Amboy Hispanic community. Sampled were 494 out-of-school youth and adults in the area. Findings include: (1) There is a significant need for an adult vocational skills training…

  7. Do Inequalities in Adult Learning Matter?

    ERIC Educational Resources Information Center

    Aldridge, Fiona; Iain Murray; Berry, Caroline

    2012-01-01

    The National Institute of Adult Continuing Education (NIACE) Adult Participation in Learning Survey 10 years ago showed that two-fifths of the adult population said that they had taken part in learning in the last three years. A decade later, the 2012 survey shows that little has changed--active participation in learning remains a minority…

  8. A European Vision for Adult Education

    ERIC Educational Resources Information Center

    Waddington, Sue; Tuckett, Alan; Boucher, Fiona

    2012-01-01

    The National Institute of Adult Continuing Education (NIACE) is the UK national coordinator for the European Agenda for Adult Learning, with the challenge of creating a coherent message across the four countries to inform European cooperation on adult learning. To start the debate, the journal staff asked Sue Waddington, Alan Tuckett, and Fiona…

  9. Participation in Adult Education: Attitudes and Barriers

    ERIC Educational Resources Information Center

    Boeren, Ellen

    2011-01-01

    In this paper, we control the intention theory of Fishbein and Ajzen (1980) for the participation in an adult education course. Based on the Flemish Eurostat Adult Education Survey, we reveal that participants in adult education have a more positive attitude towards learning and that within the group of non-participants, those who formulate an…

  10. The Craft of Teaching Adults. Third Edition.

    ERIC Educational Resources Information Center

    Barer-Stein, Thelma, Ed.; Kompf, Michael, Ed.

    This book, which is intended as a text for future and experienced adult educators, examines current theories and best practices in adult education. The book consists of 20 chapters written by prominent practitioners in the field of adult education. The chapter titles and authors are as follows: "Teachers Sharing Experiences" (James A. Draper);…

  11. Philosophical Foundations of Adult Education. Second Edition.

    ERIC Educational Resources Information Center

    Elias, John L.; Merriam, Sharan B.

    This book examines the philosophical foundations of adult education (AE). The following topics are discussed: philosophy of AE (philosophy and action in theory and practice and philosophy for adult educators); liberal AE (historical development, liberal education and the educated person, broad scope, process, liberal education of adults, Great…

  12. Barriers to Adult Learning: Bridging the Gap

    ERIC Educational Resources Information Center

    Falasca, Marina

    2011-01-01

    A fundamental aspect of adult education is engaging adults in becoming lifelong learners. More often than not, this requires removing barriers to learning, especially those relating to the actual organisational or institutional learning process. This article explores some of the main barriers to adult learning discussed in the literature and…

  13. Transitioning Adult Education Students into Community College

    ERIC Educational Resources Information Center

    Humpherys, Bryce Ralph

    2012-01-01

    At both a national and state level there is a growing need for skilled workers in the labor force. Educating low skilled adults is one way to address this need. Adult education programs teach low skilled adults basic academic skills to prepare them for work and life in U.S. society. Until recently little attention was paid to transitioning…

  14. The Effectiveness of Storytelling on Adult Learning

    ERIC Educational Resources Information Center

    Caminotti, Enzo; Gray, Jeremy

    2012-01-01

    Purpose: As two doctoral students and adult learners, the authors strongly believe that story telling can be a great tool for educators working with adult learners. The purpose of this paper is to increase awareness of how effective storytelling can be for adult learners. Design/methodology/approach: The approach of this paper is one of gathering…

  15. Adult Jewish Learners: Entering the Conversation

    ERIC Educational Resources Information Center

    Schuster, Diane Tickton

    2005-01-01

    During the past decade, the author has conducted research about the learning journeys of contemporary Jewish adults enriched by insights of adult education scholars and practitioners. While the author has benefited from the perspectives of colleagues, it is the burgeoning population of adult students that has most profoundly influenced her…

  16. Recognition and Adult Education: An Incongruent Opportunity

    ERIC Educational Resources Information Center

    Sandberg, Fredrik

    2016-01-01

    Building on narratives of students in adult education in Sweden, where the majority of the students are young adults, this paper argues that adult education has both negative and positive aspects in helping individuals to be recognised as valuable. Students, often part of the precariat class, have not always been able to survive in the job market…

  17. Adult Literacy. Cuyahoga County Data Brief

    ERIC Educational Resources Information Center

    Center on Urban Poverty and Community Development (NJ1), 2010

    2010-01-01

    There are no direct measures of adult literacy in Cuyahoga County. Instead, this report uses estimates based on a statistical model derived from the National Survey of Adult Literacy. Adult literacy levels range from Level 1 (the most basic) to Level 5 (the most complex). People with Level 1 literacy are at a severe disadvantage in the sense that…

  18. Informal Adult Learning and Everyday Literacy Practices

    ERIC Educational Resources Information Center

    Taylor, Maurice C.

    2006-01-01

    This study investigated the types of informal learning activities that adults with low literacy skills engage in outside of formal literacy programs and how these activities relate to their literacy practices. Key informants for the study included 10 adults identified at International Adult Literacy Survey levels 1 and 2. Using ethnographic…

  19. Almost Lost Bearings in Adult Education.

    ERIC Educational Resources Information Center

    Gorman, Max

    1999-01-01

    A sign of a loss of vision in adult education is disuse of the term liberal education and increasing use of the term continuous education. Mandated accreditation of adult-education courses runs counter to the tradition of liberal adult education, which is a matter of intrinsic value, not external evaluation. (SK)

  20. Globalisation, Transnational Policies and Adult Education

    ERIC Educational Resources Information Center

    Milana, Marcella

    2012-01-01

    Globalisation, transnational policies and adult education--This paper examines policy documents produced by the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the European Union (EU) in the field of adult education and learning. Both these entities address adult education as an explicit object of policy. This paper…

  1. Older Adults and Gambling: A Review

    ERIC Educational Resources Information Center

    Ariyabuddhiphongs, Vanchai

    2012-01-01

    This paper uses the social cognitive theory model to review the literature on older adult gambling, and related personal and environment characteristics. Results show that lottery is the kind of gambling most frequently played by older adults, followed by casino games. Older adults take trips to casinos to socialize, find excitement, and win…

  2. Teaching Adult Learners: An Assessment, A Resource.

    ERIC Educational Resources Information Center

    Gunn, Susan C.; And Others

    A resource for adult educators, this guide was developed as a teacher aid to be used with "Learning Activities for Adults," a curriculum supplement developed by adult education teachers in Florida that is based on Florida's Minimum Student Performance Standards. This assessment and resource is divided into five general knowledge areas: adult…

  3. Alternatives for Staff Development of Adult Educators.

    ERIC Educational Resources Information Center

    Burrichter, Arthur W.; Gardner, Daniel L.

    The product of a three-year adult education teacher training project conducted for Florida's adult educators, this guide is designed to assist planners, facilitators, evaluators, and administrators of staff development programs for adult education teachers to design and conduct effective personal and professional learning experiences. It provides…

  4. Conversations with Long-Time Adult Educators.

    ERIC Educational Resources Information Center

    Maher, Patricia A.; Passmore, Denise

    A study conducted life history interviews with long-time adult educators regarding their career paths and choices, philosophical perspectives, influences in professional careers, changes witnessed in the field, and predictions about future trends in adult education. A literature review focused on the history of adult education in the United States…

  5. Adult Reading Development. An Information Awareness Service.

    ERIC Educational Resources Information Center

    DeCrow, Roger, Ed.

    A digest of findings from a national survey by Louis Harris and Associates of adult reading skills comprises this edition of Adult Reading Development, a publication of the National Reading Center. The study measured the ability of adults to respond to practical real-life situations such as reading direct-dial instructions in a telephone directory…

  6. Adult Language Learners: Context and Innovation

    ERIC Educational Resources Information Center

    Smith, Ann F. V., Ed.; Strong, Gregory, Ed.

    2009-01-01

    "Adult Language Learners: Context and Innovation" presents instructional practices that are particularly successful with adults. Adult language learners are goal oriented and direct their learning to fulfill particular needs or demands: to advance their studies, to progress up the career ladder, to follow business opportunities, to pass a driving…

  7. Adult neurology training during child neurology residency.

    PubMed

    Schor, Nina F

    2012-08-21

    As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

  8. Vocational and Adult Education in Europe.

    ERIC Educational Resources Information Center

    van Wieringen, Fons, Ed.; Attwell, Graham, Ed.

    This book contains 25 papers on vocational and adult education in Europe and the United States. The following papers are included: "Vocational and Adult Education in Europe: Introduction to the Volume" (Fons van Wieringen, Graham Attwell); "Introduction to Section 1: Markets and Institutions in Vocational and Adult Education" (Fons van Wieringen);…

  9. Competency-Based Adult Education: Florida Model.

    ERIC Educational Resources Information Center

    Singer, Elizabeth

    This compilation of program materials serves as an introduction to Florida's Brevard Community College's (BCC's) Competency-Based Adult High School Completion Project, a multi-year project designed to teach adult administrators, counselors, and teachers how to organize and implement a competency-based adult education (CBAE) program; to critique…

  10. Children Grow Up: Autism in Adolescents & Adults.

    ERIC Educational Resources Information Center

    Meyers, Kathleen; Griesman, Brenda

    The booklet examines issues associated with autism in adolescents and adults. Teenagers with autism exhibit behaviors not unlike their nondisabled peers, and standard definitions of the syndrome may not be relevant at that age. Brief articles explore the range of emotions families may encounter with a young adult or adult who has autism, typical…

  11. Adult Age Differences in Vocabulary Acquisition.

    ERIC Educational Resources Information Center

    Long, Lisa Laumann; Shaw, Raymond J.

    2000-01-01

    Younger (n=41, ages 18-27) and older (n=39, ages 55-85) adults were given rare words to define. Older adults gave more complete definitions and had higher vocabulary test scores, but lower working memory scores. For older adults existing vocabulary knowledge contributed more than working memory to the ability to derive meaning from context. (SK)

  12. Educational Opportunities for Adults in California

    ERIC Educational Resources Information Center

    de Cos, Patricia L.

    2004-01-01

    Assembly member Carol Liu, Chair of the Assembly Select Committee on Adult Education, requested that the California Research Bureau prepare a report on adult education. The legislative request specified that the following topics be covered: (1) a definition of adult education; (2) recent information on student enrollment, funding sources and…

  13. The Adult Illiterate in the Community.

    ERIC Educational Resources Information Center

    Kedney, R. J., Ed.

    This collection of papers is intended to provide adult educators and administrators information that will assist in making decisions about, initiating, financing, and evaluating adult literacy programs in England. Papers in the first part of the book focus on definitions of adult literacy, examining the dimensions of the problem, the potential…

  14. Adult Education Collection at Syracuse University.

    ERIC Educational Resources Information Center

    Charters, Alexander N., Comp.

    Intended to give adult educators and adult education researchers greater and easier access to the Syracuse University adult education collection, the guide inventories, describes the resources, and names a contact person for each of 18 parts of the diverse collection. The following are the holdings attended to, which also reflect the guide's…

  15. Museums and the Education of Adults.

    ERIC Educational Resources Information Center

    Chadwick, Alan, Ed.; Stannett, Annette, Ed.

    This book, which is intended for individuals involved in the education of adults and museum education, explores the potential role of museums in creation of a learning society, possibilities for collaboration between museums and adult education providers, access to museum resources by adult learners, and training and staff development. The…

  16. Empowering the Older Adult through Folklore

    ERIC Educational Resources Information Center

    Warner, Dorothy Anne

    2006-01-01

    An opportunity exists for those working with older adults in nursing homes to significantly encourage independence in the older adult using a creative approach. The use of folklore is suggested as a means for assisting the older adult toward a reconnection with the individuation process.

  17. Embracing the Obvious: Adult Education Goes International.

    ERIC Educational Resources Information Center

    Cassara, Beverly Benner

    International adult education can be defined as training and development of insights and values for the purpose of professional action. The frame of reference for international adult education is international understanding. Adult educators can help their students understand why they need to become literate as they examine literacy efforts in…

  18. Adult Children of Dysfunctional Families: Childhood Roles.

    ERIC Educational Resources Information Center

    Jenkins, Stephen J.; And Others

    1993-01-01

    Used retrospective accounts to compare adult children of alcoholics (ACOAs), adults who experienced stressful events in childhood not involving parental alcoholism (A-D+), and adults with no reported dysfunction in family of origin (A-D-) with regard to dysfunctional roles adopted as children. Dysfunctional role adoption was more frequent in ACOA…

  19. Adult Education: Unesco Guidelines for Future Development

    ERIC Educational Resources Information Center

    Literacy Work, 1977

    1977-01-01

    Presents draft recommendations/guidelines for the future development of adult education approved in 1976 by a UNESCO-appointed special committee. Recommendations cover the definition of adult education; objectives and strategy; structure and content; methods, means, research, and evaluation; the relations between adult education, youth education,…

  20. Critical Discourse Analysis, Adult Education and "Fitba"

    ERIC Educational Resources Information Center

    Player, John

    2013-01-01

    In this article I will use an example of current adult education practice, the Glory and Dismay Football Literacies Programme (GDFLP) to appraise the value of critical discourse analysis (CDA) for adult learners, both individually and collectively, and for adult education practitioners with an interest in developing critical literacy skills. The…

  1. Mentoring during Adolescence and Adult Resilience

    ERIC Educational Resources Information Center

    Jakacki, Pola Christina

    2011-01-01

    The purpose of this study was to determine if there was a significant relationship between mentoring and adult resilience, specifically adults that were mentored as adolescents. The study sample comprised of 657 adults from various locations across the country. For this quantitative study, they completed a two-part questionnaire made up of the…

  2. Adult Education in the Urban Context

    ERIC Educational Resources Information Center

    Martin, Larry G.

    2004-01-01

    Context is vitally important for urban adult education because it tends to create physical, psychological, and sociocultural distance between and among learners and various providers of adult and continuing education programs, thereby creating barriers and the differential provision of adult learning opportunities for some urban populations.

  3. Making a Difference: Innovations in Adult Education.

    ERIC Educational Resources Information Center

    Mauch, Werner, Ed.; Papen, Uta, Ed.

    This book highlights examples of innovative educational practices in the field of organized adult learning. Fifteen chapters present outcomes of collective research in the Innovations in Nonformal and Adult Education (INNAE) project. "Common Learning--Collective Research: Innovating Adult Education" (Werner Mauch, Uta Papen) describes the…

  4. Kentucky Competency-Based Adult Education Curriculum.

    ERIC Educational Resources Information Center

    Kentucky Univ., Lexington. Coll. of Education.

    This curriculum was developed to assist adult education teachers (especially in Kentucky) to prepare adults to function in today's society and that of the next century. Materials in the guide go beyond preparing adults to pass the General Educational Development (GED) test to preparing them with life skills. The curriculum includes traditional…

  5. Adults as Learners: Proceedings of a Conference.

    ERIC Educational Resources Information Center

    Bortner, Rayman W., Ed.; And Others

    The proceedings consist of 11 papers grouped in two major categories: the context of adult learning (social significance and fact and fiction about adult learning) and the utilization of learning models for adult instruction. Contributors are Floyd B. Fischer, George L. Maddox, Rolf H. Monge, Eric F. Gardner, Arthur W. Combs, William J. Hoyer,…

  6. Credit Traps Can Hurt Your Adult Learners.

    ERIC Educational Resources Information Center

    Valentine, Tom, Ed.; Sandlin, Jenny, Ed.

    1996-01-01

    This document, which was written for adult educators in Georgia, offers instructional plans and practical strategies for helping students in adult literacy, adult basic education (ABE), General Educational Development, and English-as-a-second-language (ESL) programs understand the credit traps that can hurt them. The document begins with a…

  7. Current Issues in Reference and Adult Services.

    ERIC Educational Resources Information Center

    Hansen, Andrew M., Ed.; And Others

    1985-01-01

    This five-article section on current issues in reference and adult services highlights origins of American Library Association's Reference and Adult Services Division, history and development of RQ's column "The Exchange," 25 years of adult services articles, documents reference service and changing attitudes of librarians, and library literacy.…

  8. Freirean Philosophy and Pedagogy in the Adult Education Context: The Case of Older Adults' Learning

    ERIC Educational Resources Information Center

    Findsen, Brian

    2007-01-01

    Central tenets of Freirean philosophy and pedagogy are explored and applied to the emerging field of older adults' learning (educational gerontology), a sub-field of adult education. I argue that many of Freire's concepts and principles have direct applicability to the tasks of adult educators working alongside marginalized older adults. In…

  9. Adult Education at the Crossroads: Learning Our Way Out. Global Perspectives on Adult Education and Training.

    ERIC Educational Resources Information Center

    Finger, Matthias; Asun, Jose Manuel

    This book assesses the current state of adult education, including the traditions out of which adult education comes, its current problems, and its possible futures. It begins with an overview of Ivan Illich's theory and explains its significance for adult education. Part 1 examines the main historical traditions in adult education, including the…

  10. Emerging Adult versus Adult Status among College Students: Examination of Explanatory Variables

    ERIC Educational Resources Information Center

    Blinn-Pike, Lynn; Worthy, Sheri Lokken; Jonkman, Jeffrey N.; Smith, G. Rush

    2008-01-01

    The first purpose of this study was to report how many college students, 18 to 25 years of age, are classified as "emerging adults," "undecideds" or "adults." The second purpose was to determine the relationships between emerging adults versus adults and (a) background characteristics, (b) risk-taking behaviors; (c) sensation-seeking scores, and…

  11. Effective Literacy Instruction for Adults with Specific Learning Disabilities: Implications for Adult Educators

    ERIC Educational Resources Information Center

    Hock, Michael F.

    2012-01-01

    Adults with learning disabilities (LD) attending adult basic education, GED programs, or community colleges are among the lowest performers on measures of literacy. For example, on multiple measures of reading comprehension, adults with LD had a mean reading score at the third grade level, whereas adults without LD read at the fifth grade level.…

  12. Chickenpox in adults - clinical management.

    PubMed

    Tunbridge, A J; Breuer, J; Jeffery, K J M

    2008-08-01

    Acute varicella zoster virus (VZV) infection, or chickenpox, is still perceived by many as a mild infection of childhood. However, chickenpox is increasingly common in adults and adolescents who together with immunosuppressed individuals are at a higher risk of severe infection. Antiviral therapy is available which both ameliorates symptoms and decreases the severity of chickenpox if administered early in the course of the infection. Passive immunisation with varicella zoster immunoglobulin (VZIG) may prevent or attenuate infection following exposure to varicella of an immunocompromised or pregnant individual or a neonate. Active immunisation is available and is universal in many developed countries. This review reflects current best practice in management of chickenpox in adults by specialist physicians in the UK. The accompanying flowchart has been formulated to guide emergency physicians and general practitioners through the decision-making process regarding treatment and admission for specialist care.

  13. [Langerhans cell histiocytosis in adults].

    PubMed

    Néel, A; Artifoni, M; Donadieu, J; Lorillon, G; Hamidou, M; Tazi, A

    2015-10-01

    Langerhans cell histiocytosis (LCH) is a rare disease characterized by the infiltration of one or more organs by Langerhans cell-like dendritic cells, most often organized in granulomas. The disease has been initially described in children. The clinical picture of LCH is highly variable. Bone, skin, pituitary gland, lung, central nervous system, lymphoid organs are the main organs involved whereas liver and intestinal tract localizations are less frequently encountered. LCH course ranges from a fulminant multisystem disease to spontaneous resolution. Several randomized controlled trials have enable pediatricians to refine the management of children with LCH. Adult LCH has some specific features and poses distinct therapeutic challenges, knowing that data on these patients are limited. Herein, we will provide an overview of current knowledge regarding adult LCH and its management. We will also discuss recent advances in the understanding of the disease, (i.e. the role of BRAF oncogene) that opens the way toward targeted therapies.

  14. [Langerhans cell histiocytosis in adults].

    PubMed

    Néel, A; Artifoni, M; Donadieu, J; Lorillon, G; Hamidou, M; Tazi, A

    2015-10-01

    Langerhans cell histiocytosis (LCH) is a rare disease characterized by the infiltration of one or more organs by Langerhans cell-like dendritic cells, most often organized in granulomas. The disease has been initially described in children. The clinical picture of LCH is highly variable. Bone, skin, pituitary gland, lung, central nervous system, lymphoid organs are the main organs involved whereas liver and intestinal tract localizations are less frequently encountered. LCH course ranges from a fulminant multisystem disease to spontaneous resolution. Several randomized controlled trials have enable pediatricians to refine the management of children with LCH. Adult LCH has some specific features and poses distinct therapeutic challenges, knowing that data on these patients are limited. Herein, we will provide an overview of current knowledge regarding adult LCH and its management. We will also discuss recent advances in the understanding of the disease, (i.e. the role of BRAF oncogene) that opens the way toward targeted therapies. PMID:26150351

  15. Children's perceptions of babyfaced adults.

    PubMed

    Montepare, J M; Zebrowitz-McArthur, L

    1989-10-01

    Drawing on McArthur and Baron's (1983) ecological theory of social perception, the present research examined younger and older children's ability to differentiate male and female adults who varied in the babyishness of their facial appearance. Children's perceptions of the targets' dominance and warmth were also assessed. Systematic effects were found on all measures and were qualified by targets' sex and children's age group. PMID:2812994

  16. Adult neurogenesis in Parkinson's disease.

    PubMed

    Marxreiter, Franz; Regensburger, Martin; Winkler, Jürgen

    2013-02-01

    Parkinson's disease (PD), the second most common neurodegenerative disorder, affects 1-2 % of humans aged 60 years and older. The diagnosis of PD is based on motor symptoms such as bradykinesia, rigidity, tremor, and postural instability associated with the striatal dopaminergic deficit that is linked to neurodegenerative processes in the substantia nigra (SN). In the past, cellular replacement strategies have been evaluated for their potential to alleviate these symptoms. Adult neurogenesis, the generation of new neurons within two proliferative niches in the adult brain, is being intensively studied as one potential mode for cell-based therapies. The subventricular zone provides new neurons for the olfactory bulb functionally contributing to olfaction. The subgranular zone of the hippocampus produces new granule neurons for the dentate gyrus, required for memory formation and proper processing of anxiety provoking stimuli. Recent years have revealed that PD is associated with non-motor symptoms such as hyposmia, anhedonia, lack of novelty seeking behavior, depression, and anxiety that are not directly associated with neurodegenerative processes in the SN. This broad spectrum of non-motor symptoms may partly rely on proper olfactorial processing and hippocampal function. Therefore, it is conceivable that some non-motor deficits in PD are related to defective adult neurogenesis. Accordingly, in animal models and postmortem studies of PD, adult neurogenesis is severely affected, although the exact mechanisms and effects of these changes are not yet fully understood or are under debate due to conflicting results. Here, we review the current concepts related to the dynamic interplay between endogenous cellular plasticity and PD-associated pathology.

  17. Hearing loss in older adults.

    PubMed

    Walling, Anne D; Dickson, Gretchen M

    2012-06-15

    Hearing loss affects approximately one-third of adults 61 to 70 years of age and more than 80 percent of those older than 85 years. Men usually experience greater hearing loss and have earlier onset compared with women. The most common type is age-related hearing loss; however, many conditions can interfere with the conduction of sound vibrations to the inner ear and their conversion to electrical impulses for conduction to the brain. Screening for hearing loss is recommended in adults older than 50 to 60 years. Office screening tests include the whispered voice test and audioscopy. Older patients who admit to having difficulty hearing may be referred directly for audiometry. The history can identify risk factors for hearing loss, especially noise exposure and use of ototoxic medications. Examination of the auditory canal and tympanic membrane can identify causes of conductive hearing loss. Audiometric testing is required to confirm hearing loss. Adults presenting with idiopathic sudden sensorineural hearing loss should be referred for urgent assessment. Management of hearing loss is based on addressing underlying causes, especially obstructions (including cerumen) and ototoxic medications. Residual hearing should be optimized by use of hearing aids, assistive listening devices, and rehabilitation programs. Surgical implants are indicated for selected patients. Major barriers to improved hearing in older adults include lack of recognition of hearing loss; perception that hearing loss is a normal part of aging or is not amenable to treatment; and patient nonadherence with hearing aids because of stigma, cost, inconvenience, disappointing initial results, or other factors. PMID:22962895

  18. Children's perceptions of babyfaced adults.

    PubMed

    Montepare, J M; Zebrowitz-McArthur, L

    1989-10-01

    Drawing on McArthur and Baron's (1983) ecological theory of social perception, the present research examined younger and older children's ability to differentiate male and female adults who varied in the babyishness of their facial appearance. Children's perceptions of the targets' dominance and warmth were also assessed. Systematic effects were found on all measures and were qualified by targets' sex and children's age group.

  19. Older Adults and Food Safety

    MedlinePlus

    ... Administrative Forms Standard Forms Skip Navigation Z7_0Q0619C0JGR010IFST1G5B10H1 Web Content Viewer (JSR 286) Actions ${title} Loading... / Topics / ... Safety / Older Adults and Food Safety Z7_0Q0619C0JGR010IFST1G5B10H3 Web Content Viewer (JSR 286) Actions ${title} Loading... Z7_ ...

  20. Natural antibodies in healthy adults.

    PubMed

    Veres, J

    1975-01-01

    The serum of 100 adults living in Budapest was examined for isohaemagglutinin titre with haemaglutination, for staphylococcal-antitoxin titre with haemolysis inhibition and for bacterial antibody titre against 17 different groups of bacteria with passive haemagglutination. Antibody levels in males, except for certain bacterial antibodies, were somewhat lower than in females. The antibody titres, especially in men, decreased gradually from 20 to 50 years of age and were usually lower in Rh negative than in Rh positive persons.

  1. Preserving mobility in older adults.

    PubMed Central

    Buchner, D M

    1997-01-01

    Age-related loss of strength contributes to impaired mobility and increases the risk of falls. Recent research has focused on 2 approaches to preventing age-related loss of strength--promoting physical activity and exercise (especially strength training) and using trophic factors to enhance muscle performance. Epidemiologic evidence strongly supports a role of regular physical activity in successful aging by preserving muscle performance, promoting mobility, and reducing fall risk. Randomized controlled trials provide convincing evidence that strength and endurance training improve muscle performance in older adults. Evidence is rapidly accumulating from randomized trials that endurance, strength, and balance training promote mobility and reduce fall risk, though exercise effects differ according to the type of exercise, details of the exercise program, and the target group of older adults. Because lifetime regular physical activity is recommended for all older adults, a reasonable strategy (especially for weak adults) is an activity program that includes strength training. In contrast, insufficient evidence exists to recommend the long-term use of trophic factors to preserve muscular performance. An intervention that merits additional study is avoiding the use of psychoactive drugs because drugs like benzodiazepines appear to be risk factors for inactivity and may have unrecognized direct effects on muscular performance. Because chronic illness is a risk factor for inactivity and disuse muscle atrophy, randomized trials comparing strength training with other interventions would be useful in understanding whether strength training has advantages in preserving muscle performance and improving health-related quality of life in a variety of chronic illnesses such as depressive illness. PMID:9348757

  2. Adult phenylketonuria outcome and management.

    PubMed

    Trefz, F; Maillot, F; Motzfeldt, K; Schwarz, M

    2011-01-01

    The problem to evaluate treatment outcome in adult PKU (phenylketonuric) patients lies in the heterogeneity of the adult PKU population. This heterogeneity is not only based on the different treatment history of every individual patient but also on the different severity of the underlying defect of the enzyme phenylalanine hydroxylase. Recent, partly double blind studies in adult PKU patients further support recommendation for lifelong treatment. However, it has become evident that dietary treatment is suboptimal and continuation to adulthood often not accepted. Late detected PKU patients (up to 4-6 years of age) benefit from strict dietary treatment and are able to catch up in intellectual performance. Untreated, severely retarded patients with behavioral changes may benefit from introduction of dietary treatment. However, individual decision is necessary and based on the personal situation of the patient. In early and well treated patients a number of studies have demonstrated that cognitive and neurosychologic tests are different from controls. In addition there is evidence that patients with higher blood phenylalanine (phe) levels demonstrate more often psychiatric symptoms like depression and anxiety. Medical problems are more often observed: there are certain risks as impaired growth, decreased bone mineral density and nutrional deficits probably caused by dietary treatment with an artificial protein substitute and/or missing compliance with an unpleasant diet. The long term risk of a strict dietary treatment must be balanced with the risk of higher blood phe (mean blood phenylalanine >600-900 μmol/L) on cognitive and neuropsychological functions and psychiatric symptoms. Further studies should consider the role of blood phe exposure for brain development in childhood and for brain function in all ages. Besides mean blood phe, fluctuation of blood phe over time is important. Fluctuation of blood phe is decreased by sapropterin treatment in responsive

  3. [Latent autoimmune diabetes in adults].

    PubMed

    Maioli, M; Puddu, L; Pes, G M

    2006-01-01

    Latent autoimmune diabetes in adults (LADA) is a disorder with onset after age 30, insulin independence for at least 6 months after diagnosis, and the presence of circulating pancreatic islet autoantibodies. The prevalence of LADA varies substantially across ethnic groups and ranges approximately from 1% to 10% among patients with type 2 diabetes. In this review we discuss the nomenclature, diagnostic criteria, immunologic and genetic markers, metabolic alterations and therapy of this form of diabetes.

  4. Adult Neurogenesis and Psychiatric Disorders.

    PubMed

    Kang, Eunchai; Wen, Zhexing; Song, Hongjun; Christian, Kimberly M; Ming, Guo-Li

    2016-01-01

    Psychiatric disorders continue to be among the most challenging disorders to diagnose and treat because there is no single genetic or anatomical locus that is causative for the disease. Current treatments are often blunt tools used to ameliorate the most severe symptoms, at the risk of disrupting functional neural systems. There is a critical need to develop new therapeutic strategies that can target circumscribed functional or anatomical domains of pathology. Adult hippocampal neurogenesis may be one such domain. Here, we review the evidence suggesting that adult hippocampal neurogenesis plays a role in emotional regulation and forms of learning and memory that include temporal and spatial memory encoding and context discrimination, and that its dysregulation is associated with psychiatric disorders, such as affective disorders, schizophrenia, and drug addiction. Further, adult neurogenesis has proven to be an effective model to investigate basic processes of neuronal development and converging evidence suggests that aberrant neural development may be an etiological factor, even in late-onset diseases. Constitutive neurogenesis in the hippocampus of the mature brain reflects large-scale plasticity unique to this region and could be a potential hub for modulation of a subset of cognitive and affective behaviors that are affected by multiple psychiatric disorders. PMID:26801682

  5. [Adult-onset rare diseases].

    PubMed

    Pfliegler, György; Kovács, Erzsébet; Kovács, György; Urbán, Krisztián; Nagy, Valéria; Brúgós, Boglárka

    2014-03-01

    The present paper is focusing on rare diseases manifesting in late childhood or adulthood. A part of these syndromes are not of genetic origin, such as relatively or absolutely rare infections, autoimmune diseases, tumours, or diseases due to rare environmental toxic agents. In addition, even a large proportion of genetic disorders may develop in adulthood or may have adult forms as well, affecting are almost each medical specialization. Examples are storage disorders (e.g. adult form of Tay-Sachs disease, Gaucher-disease), enzyme deficiencies (e.g. ornithin-transcarbamylase deficiency of the urea cycle disorders), rare thrombophilias (e.g. homozygous factor V. Leiden mutation, antithrombin deficiency), or some rare monogenic disorders such as Huntington-chorea and many others. It is now generally accepted that at least half of the 6-8000 "rare diseases" belong either to the scope of adult-care (e.g. internal medicine, neurology), or to "age-neutral" specialities such as ophtalmology, dermatology etc.). PMID:24566697

  6. Management of adult choledochal cysts.

    PubMed Central

    Powell, C S; Sawyers, J L; Reynolds, V H

    1981-01-01

    A review of the English literature reveals a total of 1,337 patients with choledochal cysts. Improved diagnostic techniques to visualize the biliary system are demonstrating an increasing number of unsuspected choledochal cysts in adult patients. Either choledochal cysts remain clinically silent until adulthood or may develop in later life. Experience is reported with adult patients having type I, II, III, and IV choledochal cysts. Type I cysts are preferably managed by excision but cyst anatomy may necessitate choledochoenteric drainage. Type II cysts are treated by excision except for those located within the pancreatic portion of the common bile duct. These are best managed by transduodenal cystoduodenostomy. The type III cyst (choledochocele) should be excised carefully, identifying and preserving the common bile and pancreatic ducts. Type IV cysts include a combination of any one of the first three types of cyst plus the presence of intrahepatic cyst or cysts. Treatment of these cysts is dictated by the type and location of the extrahepatic cyst. Since choledochal cysts are being recognized with increased frequency in adults, surgeons need to be aware of the diagnostic and treatment modalities available for each type of biliary cyst. Images Fig. 3. Fig. 4. Fig. 6. Fig. 7. Fig. 9. Fig. 10. PMID:7235770

  7. Colds and the flu - what to ask your doctor - adult

    MedlinePlus

    ... to ask your doctor about colds and the flu - adult; Influenza - what to ask your doctor - adult; Upper respiratory ... what to ask your doctor - adult; H1N1 ("Swine") flu - what to ask your doctor - adult

  8. Sexual dysfunction within an adult developmental perspective.

    PubMed

    Fagan, P J; Meyer, J K; Schmidt, C W

    1986-01-01

    The focus of this paper is on the adult who has adequately mastered the oedipal stage of psychosexual development and who presents with a sexual dysfunction. Drawing on the developmental sequence of Erik Erikson, the authors suggest that failure to address adequately an adult psychosocial crisis may result in sexual dysfunction. There may be both adult developmental deficits and regression to adolescent and adult stages previously negotiated. Both may be symptomatically represented by sexual dysfunction. The authors urge that the sexual and marital problems be evaluated within an adult developmental framework and that the therapy address the psychosocial issues which are appropriate to the developmental stage of the patient.

  9. Sexual dysfunction within an adult developmental perspective.

    PubMed

    Fagan, P J; Meyer, J K; Schmidt, C W

    1986-01-01

    The focus of this paper is on the adult who has adequately mastered the oedipal stage of psychosexual development and who presents with a sexual dysfunction. Drawing on the developmental sequence of Erik Erikson, the authors suggest that failure to address adequately an adult psychosocial crisis may result in sexual dysfunction. There may be both adult developmental deficits and regression to adolescent and adult stages previously negotiated. Both may be symptomatically represented by sexual dysfunction. The authors urge that the sexual and marital problems be evaluated within an adult developmental framework and that the therapy address the psychosocial issues which are appropriate to the developmental stage of the patient. PMID:3820320

  10. Diagnosis of adult GH deficiency.

    PubMed

    Ghigo, E; Aimaretti, G; Corneli, G

    2008-02-01

    The current guidelines for the diagnosis of adult GHD are mainly based on the statements from the GH Research Society Consensus from Port Stevens in 1997. It is stated that diagnosis of adult GHD must be shown biochemically by provocative tests within the appropriate clinical context. The insulin tolerance test (ITT) was indicated as that of choice and severe GHD defined by a GH peak lower than 3 microg/L. The need to rely on provocative tests is based on evidence that that the measurement of IGF-I as well as of IGFBP-3 levels does not distinguish between normal and GHD subjects. Hypoglycemia may be contraindicated; thus, alternative provocative tests were considered, provided they are used with appropriate cut-off limits. Among classical provocative tests, arginine and glucagon alone were indicated as alternative tests, although less discriminatory than ITT. Testing with the combined administration of GHRH plus arginine was recommended as an alternative to ITT, mostly taking into account its marked specificity. Based on data in the literature in the last decade, the GRS Consensus Statements should be appropriately amended. Regarding the appropriate clinical context for the suspicion of adult GHD, one should evaluate patients with hypothalamic or pituitary disease or a history of cranial irradiation, as well as those with childhood-onset GHD are at obvious risk as adults for severe GHD. Brain injuries (trauma, subarachnoid hemorrage, tumours of the central nervous system) very often cause acquired hypopituitarism, including severe GHD. Given the epidemiology of brain injuries, the important role of the endocrinologist in providing major clinical benefit to brain injured patients who are still undiagnosed should be underscored. From the biochemical point of view, although normal IGF-I levels do not rule out severe GHD, very low IGF-I levels in patients highly suspected for GHD (i.e. patients with childhood-onset, severe GHD or with multiple hypopituitarism acquired

  11. [Adult].

    PubMed

    Milke-García, María Del Pilar

    2016-09-01

    Adulthood starts after youth and is characterized by the completion of growth and the achievement of organic and psychological maturity. Obesity and other preventable diseases related to lifestyle are common at this age. A complete, balanced and sufficient diet, together with exercise are important in order to prevent and treat these diseases. Several studies have brought about the mechanisms by which the incorporation of milk and dairy products to diet is beneficial in order to prevent and treat these diseases. Milk also contributes to the improvement of dental, bone and intestinal health, theoretically helps in body weight control, has a definite role on the muscular and bone mass maintenance and is an option for hydration during exercise, this being as important as diet for overweight, obesity, diabetes, dislipidemias and hypertension control.

  12. [Adult].

    PubMed

    Milke-García, María Del Pilar

    2016-09-01

    Adulthood starts after youth and is characterized by the completion of growth and the achievement of organic and psychological maturity. Obesity and other preventable diseases related to lifestyle are common at this age. A complete, balanced and sufficient diet, together with exercise are important in order to prevent and treat these diseases. Several studies have brought about the mechanisms by which the incorporation of milk and dairy products to diet is beneficial in order to prevent and treat these diseases. Milk also contributes to the improvement of dental, bone and intestinal health, theoretically helps in body weight control, has a definite role on the muscular and bone mass maintenance and is an option for hydration during exercise, this being as important as diet for overweight, obesity, diabetes, dislipidemias and hypertension control. PMID:27603885

  13. The Future of Adult Education in the Military

    ERIC Educational Resources Information Center

    Zacharakis, Jeffrey; Van Der Werff, Jay A.

    2012-01-01

    The future of adult education in the military is in many ways tied to the future of adult education. If adult educators limit their vision of what adult education is to adult learning principles, to facilitated learning, to adult basic education, and to training and education, they limit the potential of what they can do and how they do it. Adult…

  14. Effective literacy instruction for adults with specific learning disabilities: implications for adult educators.

    PubMed

    Hock, Michael F

    2012-01-01

    Adults with learning disabilities (LD) attending adult basic education, GED programs, or community colleges are among the lowest performers on measures of literacy. For example, on multiple measures of reading comprehension, adults with LD had a mean reading score at the third grade level, whereas adults without LD read at the fifth grade level. In addition, large numbers of adults perform at the lowest skill levels on quantitative tasks. Clearly, significant instructional challenges exist for adults who struggle with literacy issues, and those challenges can be greater for adults with LD. In this article, the literature on adults with LD is reviewed, and evidenced-based instructional practices that significantly narrow the literacy achievement gap for this population are identified. Primary attention is given to instructional factors that have been shown to affect literacy outcomes for adults with LD. These factors include the use of explicit instruction, instructional technology, and intensive tutoring in skills and strategies embedded in authentic contexts.

  15. Lead toxicity in older adults.

    PubMed

    Vig, E K; Hu, H

    2000-11-01

    Recent studies have shown that lead, even at relatively low levels of exposure, has the potential to harm not only the young and the occupationally-exposed, but also older people. Because they have been alive for a longer period of time, older adults have had more potential exposures to lead. They may have been exposed to lead while working in unregulated occupations, or they may have encountered more lead in the environment on a daily basis. Several large epidemiological studies have found that older people have higher blood and bone lead levels than younger adults. Additionally, sporadic clusters of acute lead exposure among older adults as a result of activities such as ceramic glaze hobby work and consumption of moonshine whiskey continue to be reported. After lead enters the body, it circulates in the blood reaching the soft tissues and bone. Researchers have learned that lead can hibernate within bone for decades. Although lead within bone is of uncertain toxicity to bone tissue, conditions of bone resorption, such as osteoporosis, can cause bone lead to reenter the bloodstream where it can then re-expose the soft tissue, and, potentially, exert delayed deleterious effects. Evidence is emerging that blood and bone lead levels, reflecting relatively modest exposures, are associated with hypertension, renal insufficiency, and cognitive impairment. Medical treatments that now exist to slow the rate of bone resorption may maintain lead within bones. On-going studies evaluating the relationship between body lead stores and both cognitive and renal impairment, as well as the potential modifying effect of bone resorption, will help determine whether bone resorption should be retarded specifically to preserve organ function. Physicians should be aware of potential past and present lead exposures among their older patients. Ongoing lead exposure should be prevented. In the future, treatment of osteoporosis may be undertaken not only to improve bone health but also to

  16. Perimenstrual Flare of Adult Acne

    PubMed Central

    Geller, Lauren; Rosen, Jamie; Frankel, Amylynne; Goldenberg, Gary

    2014-01-01

    Background: Acne is typically regarded as an adolescent disease. A significant body of literature suggests a post-adolescent or adult form of acne. Female patients are known to experience perimenstrual acne flares, the exact prevalence of which is unknown. Objective: To establish a pattern of perimenstrual acne flare in adult women in order to better characterize the disorder. Methods: Subjects aged 18 and over were recruited during previously scheduled visits with their dermatologist at Mount Sinai Hospital in New York. An anonymous survey was distributed to women who reported their first menses at least six months earlier and had a complaint of acne within the last 30 days. Women <18 years of age and postmenopausal women were excluded from the study population. Results: Participants included women 18- to 29-years old (67%) and women 30- to 49-years old (33%). The ethnicity of respondents was Caucasian (50%), African American (20%), Latino (19%), Asian (5%), and Other (6%). The majority of participants with perimenstrual acne reported the onset of acne between the ages of 12 and 18 years. Sixty-five percent of participants reported that their acne symptoms were worse with their menses. Of those who reported perimenstrual acne symptoms, 56 percent reported worsening symptoms in the week preceding their menses, 17 percent reported worsening symptoms during their menses, three percent reported worsening symptoms after their menses, and 24 percent reported worsening symptoms throughout their cycle. Thirty-five percent of patients with perimenstrual acne reported oral contraceptive pill use. Conclusion: A significant number of adult women have perimenstrual acne symptoms. This study has proven to be useful in characterizing perimenstrual acne flare and is one of the first qualitative documentations of the presence and degree of this disorder. PMID:25161758

  17. Vision Loss in Older Adults.

    PubMed

    Pelletier, Allen L; Rojas-Roldan, Ledy; Coffin, Janis

    2016-08-01

    Vision loss affects 37 million Americans older than 50 years and one in four who are older than 80 years. The U.S. Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in adults older than 65 years. However, family physicians play a critical role in identifying persons who are at risk of vision loss, counseling patients, and referring patients for disease-specific treatment. The conditions that cause most cases of vision loss in older patients are age-related macular degeneration, glaucoma, ocular complications of diabetes mellitus, and age-related cataracts. Vitamin supplements can delay the progression of age-related macular degeneration. Intravitreal injection of a vascular endothelial growth factor inhibitor can preserve vision in the neovascular form of macular degeneration. Medicated eye drops reduce intraocular pressure and can delay the progression of vision loss in patients with glaucoma, but adherence to treatment is poor. Laser trabeculoplasty also lowers intraocular pressure and preserves vision in patients with primary open-angle glaucoma, but long-term studies are needed to identify who is most likely to benefit from surgery. Tight glycemic control in adults with diabetes slows the progression of diabetic retinopathy, but must be balanced against the risks of hypoglycemia and death in older adults. Fenofibrate also slows progression of diabetic retinopathy. Panretinal photocoagulation is the mainstay of treatment for diabetic retinopathy, whereas vascular endothelial growth factor inhibitors slow vision loss resulting from diabetic macular edema. Preoperative testing before cataract surgery does not improve outcomes and is not recommended. PMID:27479624

  18. Vision Loss in Older Adults.

    PubMed

    Pelletier, Allen L; Rojas-Roldan, Ledy; Coffin, Janis

    2016-08-01

    Vision loss affects 37 million Americans older than 50 years and one in four who are older than 80 years. The U.S. Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in adults older than 65 years. However, family physicians play a critical role in identifying persons who are at risk of vision loss, counseling patients, and referring patients for disease-specific treatment. The conditions that cause most cases of vision loss in older patients are age-related macular degeneration, glaucoma, ocular complications of diabetes mellitus, and age-related cataracts. Vitamin supplements can delay the progression of age-related macular degeneration. Intravitreal injection of a vascular endothelial growth factor inhibitor can preserve vision in the neovascular form of macular degeneration. Medicated eye drops reduce intraocular pressure and can delay the progression of vision loss in patients with glaucoma, but adherence to treatment is poor. Laser trabeculoplasty also lowers intraocular pressure and preserves vision in patients with primary open-angle glaucoma, but long-term studies are needed to identify who is most likely to benefit from surgery. Tight glycemic control in adults with diabetes slows the progression of diabetic retinopathy, but must be balanced against the risks of hypoglycemia and death in older adults. Fenofibrate also slows progression of diabetic retinopathy. Panretinal photocoagulation is the mainstay of treatment for diabetic retinopathy, whereas vascular endothelial growth factor inhibitors slow vision loss resulting from diabetic macular edema. Preoperative testing before cataract surgery does not improve outcomes and is not recommended.

  19. Lead toxicity in older adults.

    PubMed

    Vig, E K; Hu, H

    2000-11-01

    Recent studies have shown that lead, even at relatively low levels of exposure, has the potential to harm not only the young and the occupationally-exposed, but also older people. Because they have been alive for a longer period of time, older adults have had more potential exposures to lead. They may have been exposed to lead while working in unregulated occupations, or they may have encountered more lead in the environment on a daily basis. Several large epidemiological studies have found that older people have higher blood and bone lead levels than younger adults. Additionally, sporadic clusters of acute lead exposure among older adults as a result of activities such as ceramic glaze hobby work and consumption of moonshine whiskey continue to be reported. After lead enters the body, it circulates in the blood reaching the soft tissues and bone. Researchers have learned that lead can hibernate within bone for decades. Although lead within bone is of uncertain toxicity to bone tissue, conditions of bone resorption, such as osteoporosis, can cause bone lead to reenter the bloodstream where it can then re-expose the soft tissue, and, potentially, exert delayed deleterious effects. Evidence is emerging that blood and bone lead levels, reflecting relatively modest exposures, are associated with hypertension, renal insufficiency, and cognitive impairment. Medical treatments that now exist to slow the rate of bone resorption may maintain lead within bones. On-going studies evaluating the relationship between body lead stores and both cognitive and renal impairment, as well as the potential modifying effect of bone resorption, will help determine whether bone resorption should be retarded specifically to preserve organ function. Physicians should be aware of potential past and present lead exposures among their older patients. Ongoing lead exposure should be prevented. In the future, treatment of osteoporosis may be undertaken not only to improve bone health but also to

  20. A Comparison of Correctional Adult Educators and Formal Adult Educators in Terms of Their Expressed Beliefs in the Collaborative Teaching Mode. Theory and Methods of Adult Education.

    ERIC Educational Resources Information Center

    Sua, Dangbe Wuo

    A study compared correctional adult educators and formal adult educators in terms of their expressed beliefs in the collaborative teaching mode as measured by the Principles of Adult Learning Scale. The sample consisted of 8 correctional adult educators from the Lake Correctional Institution and 10 adult education teachers from the Manatee Area…

  1. Underactive Bladder in Older Adults.

    PubMed

    Chuang, Yao-Chi; Plata, Mauricio; Lamb, Laura E; Chancellor, Michael B

    2015-11-01

    Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies. PMID:26476113

  2. Developmental origins of adult diseases

    PubMed Central

    Mathew, Vivek; Ayyar, S. Vageesh

    2012-01-01

    There is considerable evidence for the fact that early life environment in human beings are associated with future development of various metabolic diseases. Fetal programming and perinatal events appear to exert effects on later life that are independent of environmental risk factors in adults. Our understanding of the underlying mechanisms are limited and remains unclear. However several animal models and epidemiological studies have shown this association, and it is assumed secondary to the penalties of developmental plasticity. In this review, we amalgamate facts from several disciplines to support this hypothesis. PMID:22837912

  3. Underactive Bladder in Older Adults.

    PubMed

    Chuang, Yao-Chi; Plata, Mauricio; Lamb, Laura E; Chancellor, Michael B

    2015-11-01

    Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies.

  4. The older adult experiencing sepsis.

    PubMed

    Englert, Nadine C; Ross, Carl

    2015-01-01

    Sepsis is a potentially fatal response to infection affecting patients across the life span. Sepsis can progress from systemic inflammatory response to severe sepsis and septic shock if not recognized promptly and managed effectively. Risk factors for sepsis include age, gender, the presence of invasive devices (eg, urinary catheters), and chronic medical conditions (eg, chronic obstructive pulmonary disease). Sepsis awareness is essential and includes identification of population-focused risk factors, recognition of clinical signs and symptoms, and timely implementation of interventions. The purpose of this article was to examine sepsis in older adults, including prevalence, atypical presentation of the condition, and considerations for sepsis management in the elderly population.

  5. Anthropometry of Malaysian young adults.

    PubMed

    Karmegam; Karuppiah; Salit, Mohd Sapuan; Ismail, Mohd Yusof; Ismail, Napsiah; Tamrin, Shamsul Bahri Mohd; Gobalakrishnan, Krishnan; Palanimuthu, Seetha; Palaniandy, Thiyagu

    2011-12-01

    This paper presents the results of an anthropometric data collected from polytechnic students in Malaysia. A total of 1032 (595 males and 437 females) students participated in the study. Their ages ranged from 18 to 24 years. A total of 34 anthropometric dimensions were measured. Descriptive statistics such as mean, standard deviation, standard error of mean, coefficient of variation, minimum, maximum and percentile for each parameter were estimated. In addition, the comparison between Malaysia anthropometric data and Thailand (South) anthropometric data were also presented. The results show that there is a total of 12 and 11 (of dimensions parameters) significant differences (p < 0.05) between the male and female adults respectively.

  6. Service patterns of adult survivors of childhood versus adult sexual assault/abuse.

    PubMed

    Grossman, Susan F; Lundy, Marta; Bertrand, Cathy; Ortiz, Cynthia; Tomas-Tolentino, Grace; Ritzema, Kim; Matson, Julia

    2009-11-01

    This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the demographic characteristics, referral sources, and service patterns of the two groups. Results indicate that paths into service differ for the two groups. Furthermore, adult survivors of childhood sexual assault/abuse obtain significantly more hours of service and service contacts on average than adult survivors of adult sexual assault/abuse. Implications for policy and practice are discussed. PMID:20183424

  7. Nocturnal eating syndrome in adults.

    PubMed

    Spaggiari, M C; Granella, F; Parrino, L; Marchesi, C; Melli, I; Terzano, M G

    1994-06-01

    Ten adult subjects were referred to our sleep disorders center complaining of difficulty in maintaining sleep due to frequent and recurrent awakenings to eat or drink. All patients manifested more than one episode per night, characterized by compulsive food seeking and a return to sleep only after adequate food intake. Food-seeking drive was described as an urgent abnormal need to swallow food and was associated with an absence of real hunger. Six subjects showed an elective nighttime intake of carbohydrates, and in all cases only edible substances were injected. The patients were always fully awake during the episodes and could clearly recall them in the morning. Polysomnographic investigation showed low levels of sleep efficiency, a high number of awakenings and a strict relation between nocturnal eating episodes and nonrapid eye movement (NREM) sleep. The average length of each episode was 3.5 minutes. The "eating latency", that is the interval between awakening and chewing start, was shorter than 30 seconds in 50% of the episodes. No medical, hormonal or neurological disorders were found during clinical and laboratory investigations. Body mass index was abnormally high in six patients. Anorexia nervosa and bulimia were carefully excluded. Various psychiatric disturbances were found in nine subjects, who were nevertheless well-functioning adults. Concurrent dyssomniac disorders, such as narcolepsy or periodic leg movements occasionally associated with restless legs syndrome, were diagnosed in five patients.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Urinary tract infections in adults

    PubMed Central

    Wei Tan, Chee; Chlebicki, Maciej Piotr

    2016-01-01

    A urinary tract infection (UTI) is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. The incidence of UTIs in adult males aged under 50 years is low, with adult women being 30 times more likely than men to develop a UTI. Appropriate classification of UTI into simple or complicated forms guides its management and the ORENUC classification can be used. Diagnosis of a UTI is based on a focused history, with appropriate investigations depending on individual risk factors. Simple uncomplicated cystitis responds very well to oral antibiotics, but complicated UTIs may require early imaging, and referral to the emergency department or hospitalisation to prevent urosepsis may be warranted. Escherichia coli remains the predominant uropathogen in acute community-acquired uncomplicated UTIs and amoxicillin-clavulanate is useful as a first-line antibiotic. Family physicians are capable of managing most UTIs if guided by appropriate history, investigations and appropriate antibiotics to achieve good outcomes and minimise antibiotic resistance. PMID:27662890

  9. Environment and asthma in adults.

    PubMed

    Le Moual, Nicole; Jacquemin, Bénédicte; Varraso, Raphaëlle; Dumas, Orianne; Kauffmann, Francine; Nadif, Rachel

    2013-09-01

    The present review addresses recent advances and especially challenging aspects regarding the role of environmental risk factors in adult-onset asthma, for which the causes are poorly established. In the first part of the review, we discuss aspects regarding some environmental risk factors for adult-onset asthma: air pollution, occupational exposures with a focus on an emerging risk represented by exposure to cleaning agents (both at home and in the workplace), and lifestyle and nutrition. The second part is focused on perspectives and challenges, regarding relevant topics on which research is needed to improve the understanding of the role of environmental factors in asthma. Aspects of exposure assessment, the complexity of multiple exposures, the interrelationships of the environment with behavioral characteristics and the importance of studying biological markers and gene-environment interactions to identify the role of the environment in asthma are discussed. We conclude that environmental and lifestyle exposures play an important role in asthma or related phenotypes. The changes in lifestyle and the environment in recent decades have modified the specific risk factors in asthma even for well-recognized risks such as occupational exposures. To better understand the role of the environment in asthma, the use of objective (quantitative measurement of exposures) or modern tools (bar code, GPS) and the development of multidisciplinary collaboration would be very promising. A better understanding of the complex interrelationships between socio-economic, nutritional, lifestyle and environmental conditions might help to study their joint and independent roles in asthma.

  10. Urinary tract infections in adults.

    PubMed

    Tan, Chee Wei; Chlebicki, Maciej Piotr

    2016-09-01

    A urinary tract infection (UTI) is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. The incidence of UTIs in adult males aged under 50 years is low, with adult women being 30 times more likely than men to develop a UTI. Appropriate classification of UTI into simple or complicated forms guides its management and the ORENUC classification can be used. Diagnosis of a UTI is based on a focused history, with appropriate investigations depending on individual risk factors. Simple uncomplicated cystitis responds very well to oral antibiotics, but complicated UTIs may require early imaging, and referral to the emergency department or hospitalisation to prevent urosepsis may be warranted. Escherichia coli remains the predominant uropathogen in acute community-acquired uncomplicated UTIs and amoxicillin-clavulanate is useful as a first-line antibiotic. Family physicians are capable of managing most UTIs if guided by appropriate history, investigations and appropriate antibiotics to achieve good outcomes and minimise antibiotic resistance. PMID:27662890

  11. Osteoporosis in unstable adult scoliosis

    SciTech Connect

    Velis, K.P.; Healey, J.H.; Schneider, R.

    1988-12-01

    New noninvasive techniques as well as conventional methods were used to evaluate skeletal mass in the following three populations of adult white women as follows: (1) 79 subjects with preexisting idiopathic scoliosis designated as unstable (US) because of the associated presence in the lumbar spine of lateral spondylolisthesis with segmental instability; (2) 67 subjects with preexisting idiopathic scoliosis without lateral spondylolisthesis designated as stable (SS); and (3) 248 age-matched nonscoliotic controls. Ages in all three groups were categorized into premenopausal (25-44 years), perimenopausal (45-54 years), and postmenopausal (55-84 years). The results showed higher scoliosis morbidity in the US compared to the SS populations. The prevalence and severity of osteoporosis were markedly increased in US versus SS populations. Femoral neck density determined by dual-photon absorptiometry techniques averaged 26% to 48% lower in all age categories of US patients compared to controls. These changes were found in the youngest age groups, indicating reductions in bone mineral content earlier in the adult life of white women with a specific type of high-morbidity US characterized by the marker of lateral spondylolisthesis.

  12. Energy requirements of adult cats.

    PubMed

    Bermingham, Emma N; Thomas, David G; Morris, Penelope J; Hawthorne, Amanda J

    2010-04-01

    A meta-analysis was carried out in order to establish the energy requirements of adult cats. Publications that identified cat body weight (BW) were used to generate allometric relationships between energy requirements and BW of healthy adult cats, using log-log linear regression. Energy requirements were expressed in kcal/kg BW to be consistent with those reported by the National Research Council. Mean maintenance energy requirements were 55.1 (se 1.2) kcal/kg BW (115 treatment groups). Three allometric equations were identified to predict the energy requirements for maintenance of BW in the cat based on BW: light (53.7 kcal/kg BW- 1.061), normal (46.8 kcal/kg BW- 1.115) and heavy (131.8 kcal/kg BW- 0 .366). When reported on lean mass, the allometric equation revealed maintenance requirements were 58.4 kcal/kg lean mass- 1.140 (adjusted R2 0.694; thirty-six treatment groups). The present review suggests that values for maintenance energy requirements based on BW alone may not be an accurate prediction and more detailed information on the age, sex and neuter status, BW and composition would enhance the ability to interpret the maintenance energy requirements of cats.

  13. Everyday Cognition in older adults

    PubMed Central

    Farias, Sarah Tomaszewski; Park, Lovingly Quitania; Harvey, Danielle J.; Simon, Christa; Reed, Bruce R.; Carmichael, Owen; Mungas, Dan

    2013-01-01

    The recently developed Everyday Cognition scales (ECog) measure multiple cognitively-relevant functional domains (e.g. Everyday Memory, Everyday Language, Everyday Visuospatial abilities and three everyday executive domains). The present study further evaluated the validity of the ECog by examining its relationship with objective measures of neuropsychological function, and neurobiological markers of disease as reflected by structural neuroimaging. Participants included 474 older adults (244 normals, 142 with MCI, 88 with dementia). The neuropsychological domains measured were episodic memory, semantic memory, spatial ability, and executive functioning. Brain MRI volumes included total brain (BV), hippocampus (HC) and dorsolateral prefrontal cortex (DLPFC). Neuropsychological measures of episodic memory and executive function were most consistently related to the ECog domains; spatial abilities had a specific relationship to the Everyday Visuospatial ECog domain. HC and BV volumes were related to most ECog domains, while DLPFC volume was independently related to two everyday executive domains (Everyday Planning and Everyday Organization). The pattern of associations varied somewhat as a function of diagnosis. Episodic memory and HC had more consistent associations with the ECog domains in older adults with MCI/dementia than in cognitively normal elderly. PMID:23369894

  14. Fetal origins of adult disease.

    PubMed

    Calkins, Kara; Devaskar, Sherin U

    2011-07-01

    Dr. David Barker first popularized the concept of fetal origins of adult disease (FOAD). Since its inception, FOAD has received considerable attention. The FOAD hypothesis holds that events during early development have a profound impact on one's risk for development of future adult disease. Low birth weight, a surrogate marker of poor fetal growth and nutrition, is linked to coronary artery disease, hypertension, obesity, and insulin resistance. Clues originally arose from large 20th century, European birth registries. Today, large, diverse human cohorts and various animal models have extensively replicated these original observations. This review focuses on the pathogenesis related to FOAD and examines Dr. David Barker's landmark studies, along with additional human and animal model data. Implications of the FOAD extend beyond the low birth weight population and include babies exposed to stress, both nutritional and nonnutritional, during different critical periods of development, which ultimately result in a disease state. By understanding FOAD, health care professionals and policy makers will make this issue a high health care priority and implement preventive measures and treatment for those at higher risk for chronic diseases.

  15. Infected urachal cyst in a young adult.

    PubMed

    Muśko, Natalia; Dobruch, Jakub; Piotrowicz, Sebastian; Szostek, Przemysław; Borówka, Andrzej

    2014-01-01

    The urachus is the remnant of the cloaca, which in adults attaches the bladder dome to the umbilicus. After birth it obliterates and presents as the midline umbilical ligament. Patent urachal anomalies are usually detected in childhood. In adults they occur very rarely and the presentation and diagnosis may be occasionally challenging. We present and discuss the case of an infected urachal cyst found in a 30-year-old adult. PMID:25140240

  16. Franklian psychotherapy with adults molested as children.

    PubMed

    Lantz, J; Lantz, J

    1992-12-01

    A Franklian approach to treatment with adults who were molested as children recognizes that the trauma client's experiences of trauma and terror as a child can be transformed to discover real meaning potentials in the adult's daily life. In this paper the authors present a five-stage treatment approach based upon the Logotherapy concepts of Viktor Frankl which they have found to be helpful with adult survivors of childhood sexual abuse. Case material is presented to illustrate the described intervention approach.

  17. Update on food allergy in adults.

    PubMed

    Chaudhry, Rabia Quddus; Oppenheimer, John J

    2012-08-01

    Though much has been studied and written about food allergy, the majority of the available literature focuses on food allergies in the pediatric population. Unfortunately, it is likely that in regard to food allergies, adults are not just big children, and extrapolating findings from pediatric to adult patient populations might lead to erroneous assumptions. Thus, it is important to validate the correlation between pediatric and adult data, gather data regarding adult food allergy and understand the specific nuances of subsets of adults to better treat their food allergy. This review was conducted by identifying potentially relevant studies regarding food allergies in adults through electronic databases, including PubMed, Medline, and Google Scholar. The search terms included "allergy", "food" and "adults". Parameters of 19+ years of age were added to search terms and all journals were written in or translated to English. From these search results, focus was placed on studies from 2010 to 2012. This systematic update on food allergy in adults found that the evidence regarding prevalence, diagnosis and management of food allergies is very limited, with the majority of data derived from children and young adults.

  18. Imaginary companions in childhood and adult creativity.

    PubMed

    Myers, W A

    1979-01-01

    Case material is presented to illustrate the thesis that the ability to create an imaginary companion during childhood is an early expression of the special ego aptitudes found in creative individuals in adult life. Such "companions" allow these children to attempt to master creatively a variety of narcissistic mortifications suffered in reality and to displace unacceptable affects. In creative adults who had imaginary companions in childhood, the early fantasies serve as an organizing schema in memory for the childhood traumata. Stimuli in adult life which evoke the earlier traumata may revive the original imaginary companion fantasies. These then serve as nodal bases for the creation of specific adult works of art.

  19. Young and Older Adults' Reading of Distracters.

    PubMed

    Kemper, Susan; McDowd, Joan; Metcalf, Kim; Liu, Chiung-Ju

    2008-06-01

    We used eye-tracking technology to examine young and older adults' performance in the reading with distraction paradigm. One-, 2- and 4-word distracters that formed meaningful phrases were used. There were marked age differences in fixation patterns. Young adults' fixations to the distracters and targets increased with distracter length, suggesting that they were attempting to integrate the distracters with the sentence and had more and more difficulty doing so as the distracters increased in length. Young adults did have better comprehension of the sentences than older adults and also better recognition memory for target words and distracters.

  20. Adult Educator Handbook of Rights and Responsibilities: What Adult Educators Need To Know about Working with Adults with Disabilities.

    ERIC Educational Resources Information Center

    Horton, Betty; Hall, Jean

    Intended for adult education administrators and instructors, the purpose of this handbook is to provide practical information on the legal rights and responsibilities of adult education programs and of students with disabilites related to providing and obtaining accommodations. The Handbook contains specific information about disabilities,…