Science.gov

Sample records for assistance supply experiment

  1. Supply of physician assistants: 2013-2026.

    PubMed

    Hooker, Roderick S; Muchow, Ashley N

    2014-03-01

    As part of healthcare reform, physician assistants (PAs) are needed to help mitigate the physician shortage in the United States. This requires understanding the population of clinically active PAs for accurate prediction purposes. An inventory projection model of PAs drew on historical trends, the PA stock, graduation estimates, retirement trends, and PA intent to retire data. A new source of licensed health professionals, Provider 360 Database, was obtained to augment association information. Program growth and graduate projections indicated an annual 4.7% trend in new entrants to the workforce, offset by annual attrition estimates of 2.9%. As of 2013, there were 84,064 licensed PAs in the United States. The stock and flow equation conservatively predicts the supply of PAs to be 125,847 by 2026. Although the number of clinically active PAs is projected to increase at least by half by 2026, substantial gaps remain in understanding career trends and early attrition influences. Furthermore, education production could be constrained by inadequate clinical training sites and scarcity of faculty.

  2. Two Computer-Assisted Experiments

    ERIC Educational Resources Information Center

    Kraftmakher, Yaakov

    2013-01-01

    Two computer-assisted experiments are described: (i) determination of the speed of ultrasound waves in water and (ii) measurement of the thermal expansion of an aluminum-based alloy. A new data-acquisition system developed by PASCO scientific is used. In both experiments, the "Keep" mode of recording data is employed: the data are…

  3. Two Computer-Assisted Experiments

    ERIC Educational Resources Information Center

    Kraftmakher, Yaakov

    2013-01-01

    Two computer-assisted experiments are described: (i) determination of the speed of ultrasound waves in water and (ii) measurement of the thermal expansion of an aluminum-based alloy. A new data-acquisition system developed by PASCO scientific is used. In both experiments, the "Keep" mode of recording data is employed: the data are…

  4. [Heart assist (Vilnius University experience)].

    PubMed

    Miniauskas, Saulius; Rucinskas, Kestutis; Rasimavicius, Gintaras; Sirvydis, Vytautas

    2004-01-01

    used to 8 patients, to whom pharmaceutical treatment and intraaortic balloon pump were inefficient. Unfortunately, only one of the patients after 105 days was successfully disconnected from the extracorporeal membranous oxigenator, while maintaining his good haemodynamics. The third method of heart assist is the employment of artificial Berlin Heart ventricles. From 1999 up to 2003, 15 artificial Berlin Heart ventricles have been connected to thirteen patients, 7 of them as a bridge to heart transplant. One of the patients has already lived for over 2 years, while 6 patients had heart transplantation. There have been 8 post-cardiotomic patients with incorporated artificial Berlin Heart ventricles. The most experience has been accumulated in the use of intraaortic balloon pump. The fact that 53% of patients were discharged from hospital after such treatment indicates its efficiency. We have little experience in the employment of extracorporeal membranous oxigenator, therefore it is difficult to make conclusions. Whereas the application of Berlin Heart artificial ventricles is an effective method of assist circulation (heart assist), being a bridge to heart transplantation and effective in a long-term treatment.

  5. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Services and supplies incident to nurse... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under...

  6. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Services and supplies incident to nurse... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under...

  7. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Services and supplies incident to nurse... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under...

  8. Predictive Modeling the Physician Assistant Supply: 2010–2025

    PubMed Central

    Hooker, Roderick S.; Cawley, James F.; Everett, Christine M.

    2011-01-01

    Objective A component of health-care reform in 2010 identified physician assistants (PAs) as needed to help mitigate the expected doctor shortage. We modeled their number to predict rational estimates for workforce planners. Methods The number of PAs in active clinical practice in 2010 formed the baseline. We used graduation rates and program expansion to project annual growth; attrition estimates offset these amounts. A simulation model incorporated historical trends, current supply, and graduation amounts. Sensitivity analyses were conducted to systematically adjust parameters in the model to determine the effects of such changes. Results As of 2010, there were 74,476 PAs in the active workforce. The mean age was 42 years and 65% were female. There were 154 accredited educational programs; 99% had a graduating class and produced an average of 44 graduates annually (total n=6,776). With a 7% increase in graduate entry rate and a 5% annual attrition rate, the supply of clinically active PAs will grow to 93,099 in 2015, 111,004 in 2020, and 127,821 in 2025. This model holds clinically active PAs in primary care at 34%. Conclusions The number of clinically active PAs is projected to increase by almost 72% in 15 years. Attrition rates, especially retirement patterns, are not well understood for PAs, and variation could affect future supply. While the majority of PAs are in the medical specialties and subspecialties fields, new policy steps funding PA education and promoting primary care may add more PAs in primary care than the model predicts. PMID:21886331

  9. ASSISTments Dataset from Multiple Randomized Controlled Experiments

    ERIC Educational Resources Information Center

    Selent, Douglas; Patikorn, Thanaporn; Heffernan, Neil

    2016-01-01

    In this paper, we present a dataset consisting of data generated from 22 previously and currently running randomized controlled experiments inside the ASSISTments online learning platform. This dataset provides data mining opportunities for researchers to analyze ASSISTments data in a convenient format across multiple experiments at the same time.…

  10. ASSISTments Dataset from Multiple Randomized Controlled Experiments

    ERIC Educational Resources Information Center

    Selent, Douglas; Patikorn, Thanaporn; Heffernan, Neil

    2016-01-01

    In this paper, we present a dataset consisting of data generated from 22 previously and currently running randomized controlled experiments inside the ASSISTments online learning platform. This dataset provides data mining opportunities for researchers to analyze ASSISTments data in a convenient format across multiple experiments at the same time.…

  11. Hybrid power supplies: A capacitor-assisted battery

    NASA Astrophysics Data System (ADS)

    Catherino, Henry A.; Burgel, Joseph F.; Shi, Peter L.; Rusek, Andrew; Zou, Xiulin

    A hybrid electrochemical power supply is a concept that circumvents the need for designing any single power source to meet some extraordinary application requirement. A hybrid allows using components designed for near optimal operation without having to make unnecessary performance sacrifices. In many cases some additional synergistic effects appear. In this study, an electrochemical capacitor was employed as a power assist for a battery. An engine starting load was numerically modeled in the time domain and simulations were carried out. Actual measurements were then taken on the cranking of a diesel engine removed from a 5.0-tonne military truck and cranked in an environmental chamber. The cranking currents delivered by each power source were measured in the accessible current loops. This permitted the model parameters to be identified and, by doing that, studies using the analytical model demonstrated the merit of this hybrid application. The general system response of the battery/capacitor configuration was then modeled as a function of temperature. Doing this revealed electrical the interaction between the hybrid components. This study illustrates another case for advocating hybridized power systems.

  12. Mobile Assisted Language Learning Experiences

    ERIC Educational Resources Information Center

    Kim, Daesang; Ruecker, Daniel; Kim, Dong-Joong

    2017-01-01

    The purpose of this study was to investigate the benefits of learning with mobile technology for TESOL students and to explore their perceptions of learning with this type of technology. The study provided valuable insights on how students perceive and adapt to learning with mobile technology for effective learning experiences for both students…

  13. Mobile Assisted Language Learning Experiences

    ERIC Educational Resources Information Center

    Kim, Daesang; Ruecker, Daniel; Kim, Dong-Joong

    2017-01-01

    The purpose of this study was to investigate the benefits of learning with mobile technology for TESOL students and to explore their perceptions of learning with this type of technology. The study provided valuable insights on how students perceive and adapt to learning with mobile technology for effective learning experiences for both students…

  14. Experiences with Assisted Peritoneal Dialysis in China

    PubMed Central

    Xu, Rong; Zhuo, Min; Yang, Zhikai; Dong, Jie

    2012-01-01

    ♦ Objective: About half the patients on peritoneal dialysis (PD) in China need to be assisted by family members or home assistants. We explored whether these patients have a higher risk for peritonitis and death compared with self-care PD patients. ♦ Methods: We prospectively followed 313 incident PD patients until death or censoring. This cohort was divided into assisted and self-care PD groups according to the independence of bag exchange. Data on baseline demographics, Charlson comorbidity index, biochemistry, and residual renal function were recorded during the first 3 – 6 months. The outcome variables were first episode of peritonitis and all-cause mortality. ♦ Results: Of the 313 patients in this cohort study, 122 needed assistance in performing bag exchanges (86 from a family member, 36 from a home assistant); the remaining 191 patients did not need assistance. During a follow-up period averaging 44.5 months, 122 patients developed a first episode of peritonitis, and 135 patients died. Compared with patients having a family assistant, those with a home assistant had similar peritonitis-free and survival times, but a higher risk of mortality after adjustments for variables such as age, sex, Charlson comorbidity score, hemoglobin, serum albumin, and residual renal function. Furthermore, compared with self-care patients, assisted patients overall had a similar peritonitis-free time, but a higher risk of mortality, even after adjusting for covariates. ♦ Conclusions: Based on our single-center experience in China, we conclude that assisted PD is a good option for patients with poor self-care ability. This result provides evidence for recruiting patients who need assistance to PD programs in China. PMID:21632447

  15. 41 CFR 101-25.114 - Supply management surveys and assistance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Supply management surveys...-GENERAL 25.1-General Policies § 101-25.114 Supply management surveys and assistance. Under the provisions of 40 U.S.C. 487, the General Services Administration will perform surveys and/or reviews...

  16. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner, physician assistant, certified nurse...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Services and supplies incident to nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker... nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or...

  17. Cryogenic Supply for the Gerda Experiment

    NASA Astrophysics Data System (ADS)

    Haberstroh, Ch.

    2008-03-01

    In the GERDA experiment (GERmanium Detector Array for the search of neutrinoless double beta decay of 76Ge) germanium diodes are suspended in a superinsulated cryostat filled with 70 m3 of liquid argon. The cold medium is required since the diodes have to be operated at low temperatures, and furthermore for shielding against background radiation. For the same reason the whole experiment will be placed in the underground laboratories in the Gran Sasso mountains, Italy. In order to avoid any detrimental perturbation inside the dewar vessel, the liquid-argon (LAr) inventory in the main tank will be kept in a subcooled state at a working pressure of 0.12 MPa absolute at the surface. At the TU Dresden an appropriate cryogenic arrangement was designed to match these requirements. Liquid nitrogen (LN2) is used as a cooling fluid. Special care was taken to cope with the narrow temperature span between the LAr boiling temperature and triple point. In the proposed solution a subcooler located close to the cryostat neck provides a stable LAr convection inside the main tank. The working pressure is adjusted with a controlled, slightly elevated temperature level at the liquid-vapor interface.

  18. Nurses' moral experiences of assisted death.

    PubMed

    Elmore, James; Wright, David Kenneth; Paradis, Maude

    2016-01-01

    Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses' experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses' experiences of caring for people who request this option. To synthesize what has been learned about nurses' experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who undertake this type of care. Qualitative meta-synthesis. Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. The moral experience of the nurse is (1) defined by a profound sense of responsibility, (2) shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and (3) sustained by intra-team moral and emotional support. The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses' moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded.

  19. The personal assistance workforce: trends in supply and demand.

    PubMed

    Kaye, H Stephen; Chapman, Susan; Newcomer, Robert J; Harrington, Charlene

    2006-01-01

    The workforce providing noninstitutional personal assistance and home health services tripled between 1989 and 2004, according to U.S. survey data, growing at a much faster rate than the population needing such services. During the same period, Medicaid spending for such services increased dramatically, while both workforce size and spending for similar services in institutional settings remained relatively stable. Low wage levels for personal assistance workers, which have fallen behind those of comparable occupations; scarce health benefits; and high job turnover rates highlight the need for greater attention to ensuring a stable and well-trained workforce to meet growing demand.

  20. 43 CFR 404.12 - Can Reclamation provide assistance with the construction of a rural water supply project under...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the construction of a rural water supply project under this program? 404.12 Section 404.12 Public... RECLAMATION RURAL WATER SUPPLY PROGRAM Overview § 404.12 Can Reclamation provide assistance with the construction of a rural water supply project under this program? Reclamation may provide assistance with the...

  1. Tokamak Physics Experiment (TPX) power supply design and development

    SciTech Connect

    Neumeyer, C.; Bronner, G.; Lu, E.; Ramakrishnan, S.

    1995-04-01

    The Tokamak Physics Experiment (TPX) is an advanced tokamak project aimed at the production of quasi-steady state plasmas with advanced shape, heating, and particle control. TPX is to be built at the Princeton Plasma Physics Laboratory (PPPL) using many of the facilities from the Tokamak Fusion Test Reactor (TFTR). TPX will be the first tokamak to utilize superconducting (SC) magnets in both the toroidal field (TF) and poloidal field (PF) systems. This new feature requires a departure from the traditional tokamak power supply schemes. This paper describes the plan for the adaptation of the PPPL/FTR power system facilities to supply TPX. Five major areas are addressed, namely the AC power system, the TF, PF and Fast Plasma Position Control (FPPC) power supplies, and quench protection for the TF and PF systems. Special emphasis is placed on the development of new power supply and protection schemes.

  2. The supply of pharmaceuticals in humanitarian assistance missions: implications for military operations.

    PubMed

    Mahmood, Maysaa; Riley, Kevin; Bennett, David; Anderson, Warner

    2011-08-01

    In this article, we provide an overview of key international guidelines governing the supply of pharmaceuticals during disasters and complex emergencies. We review the World Health Organization's guidelines on pharmaceutical supply chain management and highlight their relevance for military humanitarian assistance missions. Given the important role of pharmaceuticals in addressing population health needs during humanitarian emergencies, a good understanding of how pharmaceuticals are supplied at the local level in different countries can help military health personnel identify the most appropriate supply options. Familiarity with international guidelines involved in cross-border movement of pharmaceuticals can improve the ability of military personnel to communicate more effectively with other actors involved in humanitarian and development spheres. Enhancing the knowledge base available to military personnel in terms of existing supply models and funding procedures can improve the effectiveness of humanitarian military operations and invite policy changes necessary to establish more flexible acquisition and funding regulations.

  3. The supply of pharmaceuticals in humanitarian assistance missions: implications for military operations.

    PubMed

    Mahmood, Maysaa; Riley, Kevin; Bennett, David; Anderson, Warner

    2011-01-01

    In this article, we provide an overview of key international guidelines governing the supply of pharmaceuticals during disasters and complex emergencies. We review the World Health Organization?s guidelines on pharmaceutical supply chain management and highlight their relevance for military humanitarian assistance missions. Given the important role of pharmaceuticals in addressing population health needs during humanitarian emergencies, a good understanding of how pharmaceuticals are supplied at the local level in different countries can help military health personnel identify the most appropriate supply options. Familiarity with international guidelines involved in cross-border movement of pharmaceuticals can improve the ability of military personnel to communicate more effectively with other actors involved in humanitarian and development spheres. Enhancing the knowledge base available to military personnel in terms of existing supply models and funding procedures can improve the effectiveness of humanitarian military operations and invite policy changes necessary to establish more flexible acquisition and funding regulations.

  4. Experiments with an EVA Assistant Robot

    NASA Technical Reports Server (NTRS)

    Burridge, Robert R.; Graham, Jeffrey; Shillcutt, Kim; Hirsh, Robert; Kortenkamp, David

    2003-01-01

    Human missions to the Moon or Mars will likely be accompanied by many useful robots that will assist in all aspects of the mission, from construction to maintenance to surface exploration. Such robots might scout terrain, carry tools, take pictures, curate samples, or provide status information during a traverse. At NASA/JSC, the EVA Robotic Assistant (ERA) project has developed a robot testbed for exploring the issues of astronaut-robot interaction. Together with JSC's Advanced Spacesuit Lab, the ERA team has been developing robot capabilities and testing them with space-suited test subjects at planetary surface analog sites. In this paper, we describe the current state of the ERA testbed and two weeks of remote field tests in Arizona in September 2002. A number of teams with a broad range of interests participated in these experiments to explore different aspects of what must be done to develop a program for robotic assistance to surface EVA. Technologies explored in the field experiments included a fuel cell, new mobility platform and manipulator, novel software and communications infrastructure for multi-agent modeling and planning, a mobile science lab, an "InfoPak" for monitoring the spacesuit, and delayed satellite communication to a remote operations team. In this paper, we will describe this latest round of field tests in detail.

  5. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Services and supplies incident to nurse practitioner and physician assistant services. 405.2415 Section 405.2415 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE...

  6. Assistive technologies along supply chains in health care and in the social services sector.

    PubMed

    Mayer, Peter; Hauer, Katharina; Schloffer, Evelyn; Leyrer, Barbara

    2015-01-01

    Health care systems in Austria and Slovenia are currently facing challenges due to scarce resources and demographic change which can be seen especially along the supply chains. The main objective of this paper is to present an option to improve the use of assistive technologies. An extensive literature research for the theoretic part as well as a qualitative survey for the empiric part focusing on short-term care were carried out. Results show that there is a lack of information and training on assistive technologies. As a consequence, their full potential cannot be exploited. Therefore a guideline for nursing consultations was developed. To conclude, both the literature research and the qualitative survey show that assistive technologies have high potentials to improve the supply chains in the health care and social services sector, but there is a lot of information and training on them needed.

  7. Power supplies and quench protection for the Tokamak Physics Experiment

    SciTech Connect

    Neumeyer, C.L.

    1994-07-01

    The Tokamak Physics Experiment (TPX) is an advanced tokamak project aimed at the production of quasi-steady state plasmas with advanced shape, heating, and particle control. TPX is to be built at the Princeton Plasma Physics Laboratory (PPPL) using many of the facilities from the Tokamak Fusion Test Reactor (TFTR). First plasma is scheduled for the year 2000. TPX will be the first tokamak to utilize superconducting (SC) magnets in both the toroidal field (TF) and poloidal field (PF) systems. This is a new feature which requires not only a departure from the traditional tokamak power supply schemes but also that ultra-reliable quench protection devices be used to rapidly discharge the stored energy from the magnets in the event of a quench. This paper describes the plan and basis for the adaptation and augmentation of the PPPL/TFTR power system facilities to supply TPX. Following a description of the basic operational requirements, four major areas are addressed, namely the AC power system, the TF power supply, the PF power supply, and quench protection for the TF and PF systems.

  8. Power supplies and quench protection for the Tokamak Physics Experiment

    SciTech Connect

    Neumeyer, C.L.

    1994-11-01

    The Tokamak Physics Experiment (TPX) is an advanced tokamak project aimed at the production of quasi-steady state plasmas with advanced shape, heating, and particle control. TPX is to be built at the Princeton Plasma Physics Laboratory (PPPL) using many of the facilities from the Tokamak Fusion Test Reactor (TFTR). First plasma is scheduled for the year 2000. TPX will be the first tokamak to utilize superconducting (SC) magnets in both the toroidal field (TF) and poloidal field (PF) systems. This is a new feature which requires not only a departure from the traditional tokamak power supply schemes but also that ultra-reliable quench protection devices be used to rapidly discharge the stored energy from the magnets in the event of a quench. This paper describes the plan and basis for the adaptation and augmentation of the PPPL/TFTR power system facilities to supply TPX. Following a description of the basic operational requirements, four major areas are addressed, namely the AC power system, the TF power supply, the PF power supply, and quench protection for the TF and PF systems.

  9. 43 CFR 404.56 - If a financial assistance agreement is entered into for a rural water supply project that...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... entered into for a rural water supply project that benefits more than one Indian tribe, is the approval of... Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Miscellaneous § 404.56 If a financial assistance agreement is entered into for a rural water supply project that...

  10. The supply voltage apparatus of the CUORE experiment

    NASA Astrophysics Data System (ADS)

    Arnaboldi, C.; Baú, A.; Carniti, P.; Cassina, L.; Giachero, A.; Gotti, C.; Maino, M.; Passerini, A.; Pessina, G.

    2016-07-01

    The Electronics system of experiments for the study of rare decays, such as the neutrino-less double beta decay, must be very stable over very long expected runs. We introduce our solution for the power supply of such an experiment, CUORE. In this case the power supply chain consists of a series of ACDCs, followed by DCDCs and then Linear Regulators. We emphasize here our approach to the DCDC regulation system that was designed with a complete rejection of the switching noise, across 100 MHz bandwidth. In the experimental layout the DCDC will be located far from the very front-end, with long connecting cables (10 m). We introduced our very simple and safe solution to prevent huge over-voltages, due to the energy stored in the inductance of the cables, generated after the release of accidental short circuits, so avoiding destructive effects. Some micro-controllers are present on every board and take care of the DCDC operation. These micro-controllers are managed from the control room, via CAN BUS protocol coupled via optical fibres. CUORE is an array of 1000 cryogenic detectors that will need 30 of our DCDCs.

  11. Wearable air supply for pneumatic artificial hearts and ventricular assist devices.

    PubMed

    Sipin, A J; Fabrey, W J; Smith, S H; Doussourd, J D; Olsen, D B

    1992-08-01

    An experimental wearable air supply for pneumatic artificial hearts and ventricular assist devices has been built and tested. The unit eliminates the need for tethering to a large, stationery driver. The miniaturized air supply is designed for ambulatory patients with implanted pulsatile pneumatic total artificial hearts (TAH) or pneumatic left-ventricular assist devices (LVAD), to permit mobility in clinical and home settings. The device has major short-term utility as a supply for pneumatic TAH or VAD bridges in patients awaiting heart transplants. The system design for the wearable driver includes a novel, fast rotary compressor, driven by a brushless direct current (DC) motor to supply air to the ventricle through an electromagnetically actuated directional valve, all controlled by a microcomputer. Stroke volume from 0 to 200 cc; pulse rate from 60 to 160 bpm, and duty cycle from 33% to 50% are selected on a keyboard, and the selected or measured parameters can be shown on a liquid crystal display. For control of delivery from a single ventricular assist device, stroke volume is controlled by variation of compressor speed. In the wearable air supply for a TAH, a single compressor drives both ventricles alternately through a double-acting directional valve. Air volume delivered to the left ventricle is adjusted by variation of compressor speed, and air volume to the right ventricle by variation of ejection time. The effect on blood flow rate of the lower impedance to the right ventricle is compensated by provision of a two-stage compressor, in which a single stage drives the right ventricle, and both stages connected in parallel drive the left ventricle. The overall dimensions of the prototype air supply for driving either a TAH or LVAD are 4.5 by 7.8 by 4.5 inches, including an emergency battery with a duration of 15 to 30 min depending on load. The weight is presently 5.5 lb, but this will be reduced in a production design and for a dedicated LVAD air supply

  12. Mountain Plains Learning Experience Guide: Plumbing. Course: Supply Piping Systems.

    ERIC Educational Resources Information Center

    Arneson, R.; And Others

    One of three individualized courses included in a plumbing curriculum, this course covers installing, servicing, and repairing supply lines and fixtures commonly found in residential/commercial structures. The course is comprised of four units: (1) Pipe and Fittings, (2) Cold Water Supply, (3) Hot Water Supply, and (4) Fixtures. Each unit begins…

  13. 43 CFR 404.12 - Can Reclamation provide assistance with the construction of a rural water supply project under...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Can Reclamation provide assistance with the construction of a rural water supply project under this program? 404.12 Section 404.12 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Overview §...

  14. 43 CFR 404.12 - Can Reclamation provide assistance with the construction of a rural water supply project under...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Can Reclamation provide assistance with the construction of a rural water supply project under this program? 404.12 Section 404.12 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Overview...

  15. 43 CFR 404.12 - Can Reclamation provide assistance with the construction of a rural water supply project under...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Can Reclamation provide assistance with the construction of a rural water supply project under this program? 404.12 Section 404.12 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Overview...

  16. Medical supply on contingency military operations: experience from Operation GRITROCK.

    PubMed

    Robinson, J P; Reeves, P

    2015-01-01

    Medical supply during military operations has the ability to affect the efficacy of the operation being undertaken, either negatively or positively. An appropriately-managed maritime platform with a robust medical supply chain during transit and on arrival in theatre is the main aim. A secure supply chain will reduce any implications that logistics may have with regard to capability, and negate the effects of deficiencies of short shelf life items occurring over time and during use in high tempo operations.

  17. Cryogenic supply for accelerators and experiments at FAIR

    NASA Astrophysics Data System (ADS)

    Kauschke, M.; Xiang, Y.; Schroeder, C. H.; Streicher, B.; Kollmus, H.

    2014-01-01

    In the coming years the new international accelerator facility FAIR (Facility for Antiproton and Ion Research), one of the largest research projects worldwide, will be built at GSI. In the final construction FAIR consists of synchrotrons and storage rings with up to 1,100 meters in circumference, two linear accelerators and about 3.5 kilometers beam transfer lines. The existing GSI accelerators serve as pre-accelerators. Partly the new machines will consist of superconducting magnets and therefore require a reliable supply with liquid helium. As the requirements for the magnets is depending on the machine and have a high variety, the cooling system is different for each machine; two phase cooling, forced flow cooling and bath cooling respectively. In addition the cold mass of the individual magnets varies between less than 1t up to 80t and some magnets will cause a dynamic heat load due to ramping that is higher than the static loads. The full cryogenic system will be operated above atmospheric pressure. The refrigeration and liquefaction power will be provided by two main cryogenic plants of 8 and 25 kW at 4K and two smaller plants next to the experiments.

  18. Cryogenic supply for accelerators and experiments at FAIR

    SciTech Connect

    Kauschke, M.; Xiang, Y.; Schroeder, C. H.; Streicher, B.; Kollmus, H.

    2014-01-29

    In the coming years the new international accelerator facility FAIR (Facility for Antiproton and Ion Research), one of the largest research projects worldwide, will be built at GSI. In the final construction FAIR consists of synchrotrons and storage rings with up to 1,100 meters in circumference, two linear accelerators and about 3.5 kilometers beam transfer lines. The existing GSI accelerators serve as pre-accelerators. Partly the new machines will consist of superconducting magnets and therefore require a reliable supply with liquid helium. As the requirements for the magnets is depending on the machine and have a high variety, the cooling system is different for each machine; two phase cooling, forced flow cooling and bath cooling respectively. In addition the cold mass of the individual magnets varies between less than 1t up to 80t and some magnets will cause a dynamic heat load due to ramping that is higher than the static loads. The full cryogenic system will be operated above atmospheric pressure. The refrigeration and liquefaction power will be provided by two main cryogenic plants of 8 and 25 kW at 4K and two smaller plants next to the experiments.

  19. Work Experience of Certified Laboratory Assistants.

    ERIC Educational Resources Information Center

    National Council on Medical Technology Education, Bethesda, MD.

    Questionnaires concerning the nature of work performed and the work setting, plans for continuing formal education, and opinions regarding the relevancy of training received were sent to all individuals (3,282) certified by the Board of Certified Laboratory Assistants (CLA's) since certification began in 1965. Some findings from the 970 returned…

  20. Assisted normality--a grounded theory of adolescent's experiences of living with personal assistance.

    PubMed

    Hultman, Lill; Forinder, Ulla; Pergert, Pernilla

    2016-01-01

    The purpose of the study was to explore how adolescents with disabilities experience everyday life with personal assistants. In this qualitative study, individual interviews were conducted at 35 occasions with 16 Swedish adolescents with disabilities, in the ages 16-21. Data were analyzed using grounded theory methodology. The adolescents' main concern was to achieve normality, which is about doing rather than being normal. They try to resolve this by assisted normality utilizing personal assistance. Assisted normality can be obtained by the existing relationship, the cooperation between the assistant and the adolescent and the situational placement of the assistant. Normality is obstructed by physical, social and psychological barriers. This study is from the adolescents' perspective and has implications for understanding the value of having access to personal assistance in order to achieve assisted normality and enable social interaction in everyday life. Access to personal assistance is important to enable social interaction in everyday life. A good and functional relationship is enabled through the existing relation, co-operation and situational placement of the assistant. If the assistant is not properly sensitized, young people risk turning into objects of care. Access to personal assistants cannot compensate for disabling barriers in the society as for example lack of acceptance.

  1. Preliminary Study of Heat Supply during Carbon Nanodots Synthesis by Microwave-assisted Method

    NASA Astrophysics Data System (ADS)

    Nakul, F.; Aimon, A. H.; Nuryadin, B. W.; Iskandar, F.

    2016-08-01

    Carbon nanodots (CNDs) are known to be good phosphor materials with wide range emission band, low cytotoxicity and excellent biocompatibility. In this work, CNDs were synthesized from a precursor consisting of citric acid [C6H8O7] as carbon source and urea [(NH2)2CO] as nitrogen source through a microwave-assisted method. The heat energy supplied during the microwave process was controlled. Further, we studied the effect of citric acid mass on the photoluminescence (PL) properties of the CNDs by varying its percentage in the precursors. The optimum luminescence intensity was obtained from the sample that was produced from 1.2 wt% citric acid mass. It had a single emission band with bright yellow luminescence.

  2. Wheelchair users' perceptions of and experiences with power assist wheels.

    PubMed

    Giacobbi, Peter R; Levy, Charles E; Dietrich, Frederick D; Winkler, Sandra Hubbard; Tillman, Mark D; Chow, John W

    2010-03-01

    To assess wheelchair users' perceptions of and experiences with power assist wheels using qualitative interview methods. Qualitative evaluations were conducted in a laboratory setting with a focus on users' experiences using power assist wheel in their naturalistic environments. Participants consisted of seven women and 13 men (M(age) = 42.75, SD = 14.68) that included one African American, one Hispanic, 17 whites, and one individual from Zambia. Qualitative interviews were conducted before, during, and after use of a power assist wheel. Main outcome measures included the wheelchair users' evaluations and experiences related to the use of power assist wheels. The primary evaluations included wheeling on challenging terrains, performance of novel activities, social/family aspects, fatigue, and pain. These descriptions indicated that most participants perceived positive experiences with the power assist wheels, including access to new and different activities. Secondary evaluations indicated that the unit was cumbersome and prohibitive for some participants because of difficulties with transport in and out of a vehicle and battery life. Most participants felt that power assist wheels provided more independence and social opportunities. The power assist wheel seems to offer physical and social benefits for most wheelers. Clinicians should consider users' home environment and overall life circumstances before prescribing.

  3. Lecture capturing assisted teaching and learning experience

    NASA Astrophysics Data System (ADS)

    Chen, Li

    2015-03-01

    When it comes to learning, a deep understanding of the material and a broadband of knowledge are equally important. However, provided limited amount of semester time, instructors often find themselves struggling to reach both aspects at the same time and are often forced to make a choice between the two. On one hand, we would like to spend much time to train our students, with demonstrations, step by step guidance and practice, to develop strong critical thinking skills and problem-solving skills. On the other hand, we also would like to cover a wide range of content topics to broaden our students' understanding. In this presentation, we propose a working scheme that may assist to achieve these two goals at the same time without sacrificing either one. With the help of recorded and pre-recorded lectures and other class materials, it allows instructors to spend more class time to focus on developing critical thinking skills and problem-solving skills, and to apply and connect principle knowledge with real life phenomena. It also allows our students to digest the material at a pace they are comfortable with by watching the recorded lectures over and over. Students now have something as a backup to refer to when they have random mistakes and/or missing spots on their notes, and hence take more ownership of their learning. Advanced technology have offered flexibility of how/when the content can be delivered, and have been assisting towards better teaching and learning strategies.

  4. Gaps in the supply of physicians, advance practice nurses, and physician assistants.

    PubMed

    Sargen, Michael; Hooker, Roderick S; Cooper, Richard A

    2011-06-01

    Based on the goals of health care reform, growth in the demand for health care will continue to increase the demand for physicians and, as physician shortages widen, advanced practice nurses (APNs) and physician assistants (PAs) will play larger roles. Together with physicians they constitute a workforce of "advanced clinicians." The objective of this study was to assess the capacity of this combined workforce to meet the future demand for clinical services. Projections were constructed to the year 2025 for the supply of physicians, APNs, and PAs, and these were compared with projections of the demand for advanced clinical services, based on federal estimates of future spending and historic relationships between spending and the health care labor force. If training programs for APNs and PAs grow as currently projected but physician residency programs are not further expanded, the aggregate per capita supply of advanced clinicians will remain close to its current level, which will be 20% less than the demand in 2025. Increasing the numbers of entry-level (PGY1) residents by 500 annually will narrow the gap, but it will remain >15%. The nation faces a substantial shortfall in its combined supply of physicians, APNs, and PAs, even under aggressive training scenarios, and deeper shortages if these scenarios are not achieved. Efforts must be made to expand the output of clinicians in all 3 disciplines, while also strengthening the infrastructure of clinical practice and facilitating the delegation of tasks to a broadened spectrum of caregivers in new models of care. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Assisted living and residential care in Oregon: two decades of state policy, supply, and Medicaid participation trends.

    PubMed

    Hernandez, Mauro

    2007-01-01

    The study describes Oregon state policy and supply developments for licensed long-term-care settings, particularly apartment-style assisted living facilities and more traditional residential care facilities. Data came from a variety of sources, including state agency administrative records, other secondary data sources, and key informant interviews. Descriptive statistics examined public financing, Medicaid reimbursement, and licensed bed supply trends from 1986 to 2004, as well as Medicaid resident use between 1990 and 2004. Residential care expansion, combined with nursing facility contraction, has transformed Oregon's supply of licensed long-term-care settings in favor of less institutional options. State financing, reimbursement, and licensing policies varied across provider type, with greater public resources supporting growth of assisted living facilities. By 2004, such settings were more likely to be Medicaid providers than residential care facilities and had a higher proportion of Medicaid residents relative to available bed supply. State financing and reimbursement policies may play a role in stimulating the supply of apartment-style assisted living available to low-income and/or rural service users. Less favorable policy conditions may have unintended consequences for the supply and use of other residential care settings.

  6. Clinical Engineering: Experiences of assisted professional practices

    NASA Astrophysics Data System (ADS)

    Langone, Luis; Vanetta, Marcos; Vazquez, Marcelo; Rotger, Viviana; Olivera, Juan Manuel

    2007-11-01

    In the curricula of the Biomedical Engineering career of the Facultad de Ciencias Exactas y Tecnología of the Universidad Nacional de Tucumán, Argenitna, there are the Assisted Professional Practices. Within this framework, the students have the possibility of performing practices in the clinic Sanatorio 9 de Julio. One of the objectives of these practices is to apply the concepts, methods and procedures studied along the career in the field work under real work conditions. From the point of view of the host institution, the objective is to improve the performance of the different services and areas applying the tools of Biomedical Engineering. The present work shows an example of such practices where an equipment preliminary analysis was made, its use and maintenance corresponding to the surgical unit of the clinic.

  7. Robotically assisted laparoscopic myomectomy: a Canadian experience.

    PubMed

    Mansour, Fady W; Kives, Sari; Urbach, David R; Lefebvre, Guylaine

    2012-04-01

    To compare operative and immediate postoperative outcomes of robotically assisted laparoscopic myomectomy (RALM) and open myomectomy. We conducted a retrospective review of 38 cases of RALM performed in women of reproductive age with symptomatic uterine fibroids between October 2008 and February 2011. Twenty-one cases of open myomectomy were used as historical controls. Operative and immediate postoperative outcomes were compared. Data analysis was performed using Student t test, chi-square test, and analysis of covariance where appropriate. The two groups were comparable in age, body mass index, parity, and symptoms. Up to 12 fibroids were resected robotically with a mean diameter of 9.1 ± 2.0 cm and a mean weight of 389 ± 170 g (range 73 to 900 g). RALM was associated with less blood loss (decrease in hemoglobin concentration 25.6 ± 12.0g/L) than open myomectomy (37.7 ± 20.1 g/L) (P = 0.018). Adjusting for baseline levels, postoperative hemoglobin levels were 99 g/L and 88 g/L in the robotic and open groups, respectively (P = 0.005). RALM was associated with shorter hospitalization (1.2 ± 0.5 vs. 2.5 ± 0.6 days, P < 0.001) and longer operating times (189.7 ± 71.5 vs. 92.5 ± 33.0 minutes, P < 0.001). Three patients in the open myomectomy group and one in the robotic group required blood transfusion. One patient in the robotic group developed lumbar plexopathy postoperatively. Robotically assisted laparoscopic myomectomy is associated with less blood loss and shorter hospital stay than myomectomy by laparotomy. Accumulating evidence of the risks and benefits of RALM will contribute to enhancing access to this technology on the part of women and their surgeons.

  8. 43 CFR 404.56 - If a financial assistance agreement is entered into for a rural water supply project that...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false If a financial assistance agreement is entered into for a rural water supply project that benefits more than one Indian tribe, is the approval of each Indian tribe required? 404.56 Section 404.56 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT...

  9. Assisted Living and Residential Care in Oregon: Two Decades of State Policy, Supply, and Medicaid Participation Trends

    ERIC Educational Resources Information Center

    Hernandez, Mauro

    2007-01-01

    Purpose: The study describes Oregon state policy and supply developments for licensed long-term-care settings, particularly apartment-style assisted living facilities and more traditional residential care facilities. Design and Methods: Data came from a variety of sources, including state agency administrative records, other secondary data…

  10. 43 CFR 404.56 - If a financial assistance agreement is entered into for a rural water supply project that...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false If a financial assistance agreement is entered into for a rural water supply project that benefits more than one Indian tribe, is the approval of each Indian tribe required? 404.56 Section 404.56 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT...

  11. Assisted Living and Residential Care in Oregon: Two Decades of State Policy, Supply, and Medicaid Participation Trends

    ERIC Educational Resources Information Center

    Hernandez, Mauro

    2007-01-01

    Purpose: The study describes Oregon state policy and supply developments for licensed long-term-care settings, particularly apartment-style assisted living facilities and more traditional residential care facilities. Design and Methods: Data came from a variety of sources, including state agency administrative records, other secondary data…

  12. Caregivers' experiences with the selection and use of assistive technology.

    PubMed

    Mortenson, W Ben; Pysklywec, Alex; Fuhrer, Marcus J; Jutai, Jeffrey W; Plante, Michelle; Demers, Louise

    2017-08-02

    Qualitative data from a mixed-methods clinical trial are used to examine caregivers' experiences with the selection and use of assistive technology to facilitate care recipients' independence. Through a thematic analysis of interviews from 27 caregivers, three broad themes were identified. "A partial peace of mind" described the generally positive psychological impacts from assistive technology, mainly reduced stress and a shift in caregiving labour from physical tasks to a monitoring role. "Working together" explored the caregivers' experiences of receiving assistive technology and the sense of collaboration felt by caregivers during the intervention process. Finally, "Overcoming barriers" addressed two impediments to accessing assistive technology: lack of funding and appointment wait times for service providers. The findings suggest that assistive technology provision by prescribers plays a beneficial role in the lives of caregivers, but access to such benefits can be hampered by contextual constraints. Implications for rehabilitation The study findings have a number of implications for rehabilitation practice: Family caregivers can be instrumental in determining what assistive technology is needed and then procured. Their involvement in the selection process is desirable because assistive technology may have both positive and negative impacts on them, and they themselves may use the devices chosen. Involving family caregivers as more active partners in the process of assistive technology provision may represent a greater time investment in the short term, but may contribute to better long-term outcomes for care recipients and caregivers as well. Limited access to funding and long appointment wait times are potential barriers to obtaining necessary assistive technologies.

  13. A high voltage power supply for the AE-C and D low energy electron experiment

    NASA Technical Reports Server (NTRS)

    Gillis, J. A.

    1974-01-01

    A description is given of the electrical and mechanical design and operation of high voltage power supplies for space flight use. The supply was used to generate the spiraltron high voltage for low energy electron experiment on AE-C and D. Two versions of the supply were designed and built; one design is referred to as the low power version (AE-C) and the other as the high power version (AE-D). Performance is discussed under all operating conditions.

  14. The DASCh Experience: How to Model a Supply Chain. Chapter 1

    DTIC Science & Technology

    1998-01-01

    Chapter 1 The DASCh Experience: How to Model a Supply Chain H. Van Dyke Parunak Center for Electronic Commerce, ERIM 3600 Green Court, Suite 550... supply chain modeling, we have found agent-based modeling to be more flexible than ODE models for basic exploration. One phenomenon we discovered...Section 2 of this paper describes the supply chain problem. Section 3 reports the three models that we constructed. Section 4 reviews the roles of each

  15. RF assisted Glow Discharge Condition experiment for SST-1 Tokamak

    NASA Astrophysics Data System (ADS)

    Raval, Dilip; Khan, Ziauddin; George, Siju; Dhanani, Kalpeshkumar R.; Paravastu, Yuvakiran; Semwal, Pratibha; Thankey, Prashant; Shoaib Khan, Mohammad; Kakati, Bharat; Pradhan, Subrata

    2017-04-01

    Impurity control reduces the radiation loss from plasma and hence enhances the plasma operation. Oxygen and water vapors are the most common impurities in tokamak devices. Water vapour can be reduced with extensive baking while in order to have a significant reduction in oxygen it is necessary to use glow discharge condition (GDC). RF assisted glow discharge cleaning system will be implemented to remove low z impurities at PFC installed SST-1 vacuum vessel. A RF assisted Glow discharge conditioning is studied at laboratory to find the optimum operating parameters in a view to implement at SST-1 tokamak. Helium is used as a fuel gas in the present experiment. It is observed that the ultimate impurity level is reduced significantly below to the accepted level for plasma operation after RF assisted GDC. The experimental findings of RF assisted Glow discharge conditioning is discussed in details in this paper.

  16. Moral Behavior of Resident Assistants: A Lived Experience

    ERIC Educational Resources Information Center

    Stark, Rachael H.; Anderson, Sharon K.

    2016-01-01

    This qualitative study explores the moral behavior in the lived experience of resident assistants who administer disciplinary policy at a large, public, urban institution located in the Mid-Atlantic region of the United States. The 12 participants volunteered to be interviewed by the first author utilizing the research question, "What is the…

  17. The Graduate Teaching Assistant (GTA): Lessons from North American Experience

    ERIC Educational Resources Information Center

    Park, Chris

    2004-01-01

    The employment of graduate students on a part-time basis to help with the teaching of undergraduates is growing in the UK and many higher education institutions are confronted with challenges about how best to do this. UK institutions have much to learn from North American experience of appointing graduate teaching assistants (GTAs), and this…

  18. The role of the assistant during robot-assisted partial nephrectomy: does experience matter?

    PubMed

    Potretzke, Aaron M; Knight, Brent A; Brockman, John A; Vetter, Joel; Figenshau, Robert S; Bhayani, Sam B; Benway, Brian M

    2016-06-01

    The objective of this study was to evaluate surgical outcomes with respect to the experience level of the bedside assistant during robot-assisted partial nephrectomy. A retrospective review was conducted of a prospectively maintained database of 414 consecutive robot-assisted laparoscopic partial nephrectomies performed by experienced robotic surgeons at our institution from April 2011 to September 2014. A senior-level assistant was defined as a resident in his or her post-graduate year (PGY) 4 or 5, or a fellow. Junior-level assistants were considered to be PGY-2, PGY-3, or a nurse first assistant. Multivariate analyses were performed using linear, Poisson, and logistic regression models. There were 115 junior-level cases and 299 senior-level cases. On univariate analysis, the experience level of the assistant had no impact on operative time (168 for junior level vs. 163 min for senior level, p = 0.656). Likewise, there were no differences between the junior- and senior-level groups with regard to warm ischemia time (21.3 vs. 20.9 min, p = 0.843), negative margin status (111/115 (96.5 %) vs. 280/299 (93.6 %), p = 0.340), or postoperative complications (17/115 (14.8 %) vs. 35/299 (11.7 %), p = 0.408). After multivariate analysis, operative time was associated with increased body mass index and tumor size (both p < 0.001), but not with resident experience level (p = 0.051). Estimated blood loss and postoperative complications were also not associated with the PGY of the assistant (p = 0.488 and p = 0.916, respectively). Despite common concern, the PGY status of a physician trainee serving as the bedside assistant does not appear to influence the outcomes of robot-assisted partial nephrectomy at a high-volume center.

  19. Failure analysis and lessons learned on LHC experiments crate and power supply equipment

    NASA Astrophysics Data System (ADS)

    Bobillier, V.; Mico, S.

    2015-02-01

    The LHC accelerator's first long shutdown period (LS1), in 2013-2014, has given the experiments the opportunity to perform planned upgrade and maintenance activities on systems and equipment. It has also been the right time to conduct a preventive maintenance campaign on crate and power supply equipment which is foreseen to operate smoothly for another 4 to 8 years. This paper presents the lessons learned during the LS1 power supply preventive maintenance activities as well as an in-depth analysis of the most common failure modes and weaknesses encountered on the power supplies in the LHC experiments over the past years of operation.

  20. Managing and Mentoring: Experiences of Assistant Professors in Working with Research Assistants

    PubMed Central

    Narendorf, Sarah Carter; Small, Eusebius; Cardoso, Jodi A. Berger; Wagner, Richard W.; Jennings, Sheara Williams

    2016-01-01

    Support from research assistants (RAs) is often framed as a resource to facilitate faculty research productivity, yet most assistant professors have received minimal training on how to effectively make use of this resource. This study collected data from a national sample of assistant professors to examine tasks RAs are asked to perform, satisfaction with RA work, challenges in working with RAs, and lessons learned to be successful. Authors used a sequential mixed-methods design, first conducting a Web-based survey with 109 assistant professors in social work schools with doctoral programs, then qualitative interviews with a subset of 13 respondents who volunteered to talk more about their experiences. Evidence indicated low levels of satisfaction regarding the preparation of students for RA work, particularly among those assistant professors working with first-year doctoral students. Primary challenges included lack of student skills and commitment and sufficient time to supervise and train students. Recommendations include careful assessment of student skills at the start of the relationship and setting clear expectations. Social work programs can improve faculty–RA relationships by training new assistant professors on how to support and manage RAs and training incoming students on basic research skills for their work as RAs. PMID:27257354

  1. Endoscopic-assisted epiphysiodesis: technique and 20-year experience.

    PubMed

    Ledesma, Justin B; Wang, Tianyi; Desmond, Elizabeth; Imrie, Meghan; Gamble, James G; Rinsky, Lawrence A

    2016-01-01

    The aim of the study was to describe the endoscopic-assisted epiphysiodesis technique and review our 20-year experience with it. A retrospective review of 44 patients who underwent proximal tibia and/or distal femur endoscopic-assisted epiphysiodesis was carried out. Only patients who had preoperative and postoperative scanograms with clinical follow-up of at least 6 months were included. The mean length of follow-up was 36.8 months. All patients had radiographic evidence of physeal fusion within 6-12 months from the index procedure. No patient required revision surgery. Endoscopic-assisted epiphysiodesis is safe, effective, and achieves predictable physeal fusion. Advantages over current techniques include reduced radiation exposure and lack of requirement for hardware placement.

  2. 76 FR 31356 - Notice of Proposed Information Collection for Public Comment; Technical Assistance Experience...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... Experience, Expertise, and Awards Received Matrices AGENCY: Office of the Community Planning and Development... Assistance Experience, Expertise, and Awards Received Matrices. Description of the need for the information proposed: The Technical Assistance Experience, Expertise, and Awards Received Matrices will allow...

  3. Maternal Experience of Interactions With Providers Among Mothers With Milk Supply Concern

    PubMed Central

    Flaherman, Valerie J.; Hicks, Katherine G.; Cabana, Michael D.; Lee, Kathryn A.

    2016-01-01

    Background Milk supply concern is the most common reason given by mothers for discontinuing breastfeeding. Objectives To describe maternal experiences of interactions with health care providers related to milk supply. Patients and methods Ten focus groups (N = 56 participants) were conducted among mothers who had had milk supply concern in the first month after birth. Group sessions were audio-recorded, transcribed, coded, and analyzed to identify themes. Results Interactions regarding milk supply concern evoked strong emotions, including gratitude, guilt, disappointment, and fear, and measurement of infant weight was frequently reported as a trigger for these emotions. Some mothers reported that experiencing “pressure” and “guilt” when providers emphasized exclusive breastfeeding led to suboptimal breastfeeding choices. Conclusions Interactions with providers about milk supply concern evoke strong emotions among mothers. Providers should be aware that how they communicate routine advice regarding infant weight and formula may have unintended consequences, including discontinuation of breastfeeding. PMID:22669980

  4. A new VME based high voltage power supply for large experiments

    SciTech Connect

    Ahn, S.C.; Angstadt, R.D.; Droege, T.F.; Johnson, M.E.; MacKinnon, B.A.; McNulty, S.E.; Shea, M.F.; Thompson, R.N.; Watson, M.M. ); Franzini, P. ); Jones, A.A. ); Lopez, M.L. ); Wimpenny, S.J.; Yang, M.J

    1991-11-01

    A new VME based high voltage power supply has been developed for the D{O} experiment at Fermilab. There are three types of supplies delivering up to {plus minus}5.6 kV at 1.0 mA or +2.0 kV at 3.0 mA with a set accuracy of 1.5 V and extremely low voltage ripples. Complete computer control has allowed many special features to be developed for the supply, including user-defined control land monitor groups, variable ramp rates, and advanced histogram and graphic functions. 3 refs.

  5. A new VME based high voltage power supply for large experiments

    SciTech Connect

    Ahn, S.C.; Angstadt, R.D.; Droege, T.F.; Johnson, M.E.; MacKinnon, B.A.; McNulty, S.E.; Shea, M.F.; Thompson, R.N.; Watson, M.M.; Franzini, P.; Jones, A.A.; Lopez, M.L.; Wimpenny, S.J.; Yang, M.J.

    1991-11-01

    A new VME based high voltage power supply has been developed for the D{O} experiment at Fermilab. There are three types of supplies delivering up to {plus_minus}5.6 kV at 1.0 mA or +2.0 kV at 3.0 mA with a set accuracy of 1.5 V and extremely low voltage ripples. Complete computer control has allowed many special features to be developed for the supply, including user-defined control land monitor groups, variable ramp rates, and advanced histogram and graphic functions. 3 refs.

  6. High-voltage power supply system for detecting equipment of DSS experiment at JINR Nuclotron

    NASA Astrophysics Data System (ADS)

    Piyadin, S. M.; Ladygin, V. P.; Pilyar, A. V.; Reznikov, S. G.; Janek, M.

    2017-01-01

    The eight-channel high-voltage power supply system based on using the Wenzel Elektronik N1130 module is described. The characteristics of 8DAC-12 and 8ADC-14 types control modules of CAMAC standard designed for high-voltage systems are presented. This system was successfully used to provide the power supply of scintillation detectors in the experiments on the study of the structure of light nuclei at JINR Nuclotron.

  7. Initial clinical experience using a novel laparoscopy assistant.

    PubMed

    Mishra, Raineesh; Martínez, Arturo Minor; Lorias Espinoza, Daniel

    2011-05-01

    This article presents the first clinical and experimental experiences of the PMASS (Postural Mechatronic Assistance Solo Surgery) from a prospective study carried on on thirteen laparoscopic procedures. Also, their advantages and disadvantages are identified. The PMASS is a system with three articulations; two articulations are passive and one is active; this handles the optic in real time, reducing the latency time by spatial relocation. The surgeons assisted themselves visually in 13 surgical procedures, having direct and intuitive control in real time of the laparoscopic vision field using the PMASS. The surgical and delay time was documented for each surgery. The surgical procedures were: Laparoscopic appendicectomy, ovarian cystectomy and laparoscopic sterilization. In all procedures, surgeons were able to auto-navigate in real time and there was no visual tremor while using the system. The global average times taken to perform the self-assisted surgery with the PMASS for the laparoscopic appendicectomies were 45 ± 4.5 minutes, ovarian cystectomies 49 ± 3.5 minutes and for the laparoscopic sterilization 22 ± 2 minutes. The approximate set-up time of PMASS was one minute, and removal almost a minute (the time required by the surgeon to remove the harness after completing the surgery). The laparoscope itself disengages from the PMASS in a couple of seconds approximately. There were no transoperative or postoperative complications during the procedures. Thirteen laparoscopic procedures were performed, the design of the mechatronic assistance allowed the surgeon to self-assist visually in real time and in an autonomous way in the solo-surgery mode, without compromising the surgical performance and the morbidity. Additionally, the latency times are also reduced by space relocation and coupling of the telescope.

  8. Experiences of women with osteoarthritis in assisted living facilities.

    PubMed

    Baird, Carol L; Yehle, Karen S; Schmeiser, Donna

    2007-01-01

    Osteoarthritis is one of the most common causes of disability in older adults. To help patients self-manage their arthritis, nurses need a better understanding of experiences of living with arthritis. Many older adults with symptomatic osteoarthritis may reside in supportive housing such as assisted living facilities. Recognizing challenges and symptoms may lead to improved health and quality of life, as well as greater independence, for older adults with osteoarthritis. A naturalistic inquiry design was used to gather data from 23 older women. Transcriptions were analyzed by deconstruction and reconstruction. Final themes are Restricting and Constricting, with intermediate categories of Not doing because of disability, Not doing by choice, Limiting ability to move without assistive devices, and Living within confining spaces. Findings suggest the need for further examination of symptoms, symptom management, and interventions to improve healthcare and quality of life of patients with osteoarthritis.

  9. [Initial experience in robot-assisted colorectal surgery in Mexico].

    PubMed

    Villanueva-Sáenz, Eduardo; Ramírez-Ramírez, Moisés Marino; Zubieta-O'Farrill, Gregorio; García-Hernández, Luis

    Colorectal surgery has advanced notably since the introduction of the mechanical suture and the minimally invasive approach. Robotic surgery began in order to satisfy the needs of the patient-doctor relationship, and migrated to the area of colorectal surgery. An initial report is presented on the experience of managing colorectal disease using robot-assisted surgery, as well as an analysis of the current role of this platform. A retrospective study was conducted in order to review five patients with colorectal disease operated using a robot-assisted technique over one year in the initial phase of the learning curve. Gender, age, diagnosis and surgical indication, surgery performed, surgical time, conversion, bleeding, post-operative complications, and hospital stay, were analysed and described. A literature review was performed on the role of robotic assisted surgery in colorectal disease and cancer. The study included 5 patients, 3 men and 2 women, with a mean age of 62.2 years. Two of them were low anterior resections with colorectal primary anastomoses, one of them extended with a loop protection ileostomy, a Frykman-Goldberg procedure, and two left hemicolectomies with primary anastomoses. The mean operating time was 6hours and robot-assisted 4hours 20minutes. There were no conversions and the mean hospital stay was 5 days. This technology is currently being used worldwide in different surgical centres because of its advantages that have been clinically demonstrated by various studies. We report the first colorectal surgical cases in Mexico, with promising results. There is enough evidence to support and recommend the use of this technology as a viable and safe option. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  10. Supply Positioning in Support of Humanitarian Assistance and Disaster Relief Operations

    DTIC Science & Technology

    2011-06-01

    Defense Support of Civil Authorities xiv EMF Expeditionary Medical Facilities EUCOM European Command FEMA Federal Emergency Management Agency...days Surgical Capacity General Thoracic Urology Gynecology Orthopedics Neurosurgery Ophthalmology Anesthesiology Oral surgery...aid logistics: Supply chain management in high gear. Journal of Operational Research Society, 57(5), 475–489. Vice Chairman Joint Chief of Staff

  11. Outcomes of the gross and developmental anatomy teaching assistant experience.

    PubMed

    Ocel, Joseph J; Palmer, Brian A; Wittich, Christopher M; Carmichael, Stephen W; Pawlina, Wojciech

    2003-11-01

    During the first-year Gross and Developmental Anatomy Course at Mayo Medical School, third-year medical students volunteer as teaching assistants (TAs). Their responsibilities include preparing for dissection, instructing students during dissection, writing examination questions, and giving a lecture. To evaluate the academic and professional impact of this experience on former TAs, a survey instrument was developed, and was sent to former TAs from the past 17 years. Seventy-two percent of the surveys were returned. Most respondents (84%) indicated that the TA experience was beneficial during their third-year surgical rotation. Over 60% identified benefits during Neurology, Obstetrics and Gynecology, and Internal Medicine rotations. The majority (62%) indicated they regularly use the knowledge gained from the TA experience. Communication was the most highly ranked area of skill development, with 86% of respondents indicating gains in lecture effectiveness and 97% in one-on-one teaching. Among respondents, 32% entered surgical or radiological fields, roughly paralleling the non-TA medical student population. All respondents indicated that they would repeat the experience and recommend it to other medical students. Although benefits for long-term career development have not yet been established, the Gross and Developmental Anatomy TA experience had perceived short-term benefits with respect to clinical rotations and teaching skill development. Copyright 2003 Wiley-Liss, Inc.

  12. Trans people's experiences with assisted reproduction services: a qualitative study.

    PubMed

    James-Abra, S; Tarasoff, L A; Green, D; Epstein, R; Anderson, S; Marvel, S; Steele, L S; Ross, L E

    2015-06-01

    What are the experiences of trans persons (i.e. those whose gender identity does not match the gender assigned to them at birth) who sought or accessed assisted reproduction (AR) services in Ontario, Canada, between 2007 and 2010? The majority of trans persons report negative experiences with AR service providers. Apart from research examining desire to have children among trans people, most of the literature on this topic has debated the ethics of assisting trans persons to become parents. To-date, all of the published research concerning trans persons' experiences with AR services is solely from the perspective of service providers; no studies have examined the experiences of trans people themselves. Secondary qualitative research study of data from nine trans-identified people and their partners (total n = 11) collected as part of a community-based study of access to AR services for sexual and gender minority people between 2010 and 2012. Trans-identified volunteers (and their partners, when applicable) who had used or attempted to access AR services since 2007 from across Ontario, Canada, participated in a 60-90 minute, semi-structured qualitative interview. Qualitative analysis was performed using a descriptive phenomenological approach. Emerging themes were continually checked against the data as part of an iterative process. The data highlight barriers to accessing AR services for trans people. Participant recommendations for improving AR service provision to better meet the needs of this population are presented. These recommendations address the following areas: (i) AR service provider education and training; (ii) service provider and clinic practices and (iii) clinic environment. The majority of study participants were trans people who identified as men and who resided in major urban areas; those living in smaller communities may have different experiences that were not adequately captured in this analysis. While existing literature debates the ethics of

  13. [Drug supply chain safety in hospitals: current data and experience of the Grenoble university hospital].

    PubMed

    Bedouch, P; Baudrant, M; Detavernier, M; Rey, C; Brudieu, E; Foroni, L; Allenet, B; Calop, J

    2009-01-01

    Drug supply chain safety has become a priority for public health which implies a collective process. This process associates all health professionals including the pharmacist who plays a major role. The objective of this present paper is to describe the several approaches proven effective in the reduction of drug-related problem in hospital, illustrated by the Grenoble University Hospital experience. The pharmacist gets involved first in the general strategy of hospital drug supply chain, second by his direct implication in clinical activities. The general strategy of drug supply chain combines risk management, coordination of the Pharmacy and Therapeutics Committee, selection and purchase of drugs and organisation of drug supply chain. Computer management of drug supply chain is a major evolution. Nominative drug delivering has to be a prior objective and its implementation modalities have to be defined: centralized or decentralized in wards, manual or automated. Also, new technologies allow the automation of overall drug distribution from central pharmacy and the implementation of automated drug dispensing systems into wards. The development of centralised drug preparation allows a safe compounding of high risk drugs, like cytotoxic drugs. The pharmacist should develop his clinical activities with patients and other health care professionals in order to optimise clinical decisions (medication review, drug order analysis) and patients follow-up (therapeutic monitoring, patient education, discharge consultation).

  14. Experience with laparoscopy-assisted retroperitoneal pyeloplasty in children.

    PubMed

    Abraham, Mohan K; Nasir, Abdul Rasheed A; Bindu, S; Ramakrishnan, P; Kedari, Prashant M; Unnithan, Gopidas R; Damisetti, Kalyan Ravi Prasad

    2009-07-01

    To describe a laparoscopy-assisted retroperitoneal pyeloplasty (LARP) and results of initial experience. Port placement used by Farhat in retroperitoneal-assisted laparoscopic pyeloplasty was modified for better cosmetic results. Surgery was done using 2-cm incision for 5-mm camera port and two 3-mm working ports. Dissection was done anterior to the kidney. The ureteropelvic junction was brought out through the 2-cm trocar site and the pyeloplasty was performed extracorporeally. Between January 2004 and February 2008, a total of 39 kidneys in 38 children with mean age of 4.1 months underwent LARP. The operative time, hospital stay, functional outcome and follow-up renogram studies were reviewed. The mean operative time was 147 min. 2-cm incision was extended in one patient with malrotated kidney. There was improvement in function in 37 (95%) with no failure. The mean split renal function, preoperative and at follow-up were 35.7 and 44.2%, respectively (P = 0.000). The mean glomerular filtration rate (ml/min), preoperative and at follow-up were 27.4 and 39.1%, respectively (P = 0.000). Mean follow-up period was 24 months. LARP is safe in treating UPJ obstruction in infants. It is recommended especially in small babies where laparoscopic pyeloplasty is difficult.

  15. Experience using individually supplied heater rods in critical power testing of advanced BWR fuel

    SciTech Connect

    Majed, M.; Morback, G.; Wiman, P.

    1995-09-01

    The ABB Atom FRIGG loop located in Vasteras Sweden has during the last six years given a large experience of critical power measurements for BWR fuel designs using indirectly heated rods with individual power supply. The loop was built in the sixties and designed for maximum 100 bar pressure. Testing up to the mid eighties was performed with directly heated rods using a 9 MW, 80 kA power supply. Providing test data to develop critical power correlations for BWR fuel assemblies requires testing with many radial power distributions over the full range of hydraulic conditions. Indirectly heated rods give large advantages for the testing procedure, particularly convenient for variation of individual rod power. A test method being used at Stern Laboratories (formerly Westinghouse Canada) since the early sixties, allows one fuel assembly to simulate all required radial power distributions. This technique requires reliable indirectly heated rods with independently controlled power supplies and uses insulated electric fuel rod simulators with built-in instrumentation. The FRIGG loop was adapted to this system in 1987. A 4MW power supply with 10 individual units was then installed, and has since been used for testing 24 and 25 rod bundles simulating one subbundle of SVEA-96/100 type fuel assemblies. The experience with the system is very good, as being presented, and it is selected also for a planned upgrading of the facility to 15 MW.

  16. Impact of pharmacists assisting with prescribing and undertaking medication review on oxycodone prescribing and supply for patients discharged from surgical wards.

    PubMed

    Tran, T; Taylor, S E; Hardidge, A; Findakly, D; Aminian, P; Elliott, R A

    2017-10-01

    Overprescribing of oxycodone is a contributor to the epidemic of prescription opioid misuse and deaths. Practice models to optimize oxycodone prescribing and supply need to be evaluated. We explored the impact of pharmacist-assisted discharge prescribing and medication review on oxycodone prescribing and supply for patients discharged from surgical wards. A retrospective audit was conducted on two surgical inpatient wards following a 16-week prospective pre- and post-intervention study. During the pre-intervention period, discharge prescriptions were prepared by hospital doctors and then reviewed by a ward pharmacist (WP) before being dispensed. Post-intervention, prescriptions were prepared by a project pharmacist in consultation with hospital doctors and then reviewed by a WP and dispensed. Proportion of patients who were prescribed, and proportion supplied, oxycodone on discharge; Median amount (milligrams) of oxycodone prescribed and supplied, for patients who were prescribed and supplied at least one oxycodone-containing preparation, respectively. A total of 320 and 341 patients were evaluated pre- and post-intervention, respectively. Pre-intervention, 75.6% of patients were prescribed oxycodone; after WP review, 60.3% were supplied oxycodone (P<.01); the median amount both prescribed and supplied was 100 milligrams/patient. Post-intervention, 68.6% of patients were prescribed oxycodone; after WP review, 57.8% were supplied oxycodone (P<.01); median amount prescribed and supplied was 50 milligrams/patient (difference in amount prescribed and supplied: 50 milligrams, P<.01). WP review of doctor-prepared prescriptions reduced the proportion of patients who were supplied oxycodone but not the amount supplied/patient. Having a pharmacist assist with prescribing reduced the amount of oxycodone supplied. © 2017 John Wiley & Sons Ltd.

  17. Parental Assistance in Providing Supervised Occupational Experience through Vocational Agriculture Programs.

    ERIC Educational Resources Information Center

    Rawls, Willie; Williams, David L.

    1979-01-01

    A study identified the ways parents assisted with supervised occupational experiences of students. The results revealed significant differences in the degree of assistance provided among parents of students holding different Future Farmers of America degrees. (LRA)

  18. Understanding the learning assistant experience with physics identity

    NASA Astrophysics Data System (ADS)

    Close, Eleanor W.; Close, Hunter G.; Donnelly, David

    2013-01-01

    Learning Assistants (LAs) have been shown to have better conceptual understanding and more favorable beliefs about science than non-LAs, and are more likely to choose a career in K-12 science teaching [1]. We propose that connections between elements of identity, persistence, and participation in an LA program can be explained using the concept of the community of practice and its intimate relationship to identity [2]. In separate work, Hazari et al. found that physics identity was highly correlated to expressed career plans in physics [3]. We hypothesize that a thriving LA program has many features of a well-functioning community of practice and contributes to all four elements of physics identity: personal interest, student performance, competence, and recognition by others. We explore how this analysis of the LA experience might shape decisions and influence outcomes of adoption and adaptations of the LA model.

  19. Experiences from an interprofessional student-assisted chronic disease clinic.

    PubMed

    Frakes, Kerrie-Anne; Brownie, Sharon; Davies, Lauren; Thomas, Janelle; Miller, Mary-Ellen; Tyack, Zephanie

    2014-11-01

    Faced with significant health and workforce challenges in the region, the Central Queensland Health Service District (CQHSD) commenced a student-assisted clinical service. The Capricornia Allied Health Partnership (CAHP) is an interprofessional clinical placement program in which pre-entry students from exercise physiology, nutrition and dietetics, occupational therapy, pharmacy, podiatry and social work are embedded in a collaborative chronic disease service delivery model. The model coordinates multiple student clinical placements to: address service delivery gaps for previously underserved people with chronic disease in need of early intervention and management; provide an attractive clinical placement opportunity for students that will potentially lead to future recruitment success, and demonstrate leadership in developing future health workforce trainees to attain appropriate levels of interprofessional capacity. The CAHP clinic commenced student placements and client services in February 2010. This report provides early evaluative information regarding student experiences included self-reported changes in practice.

  20. Hand-assisted laparoscopic donor nephrectomy: a single centre experience

    PubMed Central

    Macech, Michał; Alsharabi, Amro; Romanowski, Łukasz; Grochowiecki, Tadeusz; Lewandowska, Dorota; Kaliciński, Piotr; Durlik, Magdalena; Pączek, Leszek; Nazarewski, Sławomir

    2016-01-01

    Introduction The advantages of a minimally invasive nephrectomy are a faster recovery and better quality of life for the donors. Until recently, the majority of donor nephrectomies in Poland were done by open surgery. Aim To present a single centre experience in hand-assisted laparoscopic donor nephrectomy (HALDN). Material and methods The first videoscopic left donor nephrectomy in Poland was performed in our department in 2003 using a hand-assisted retroperitoneal approach. From 2011, we changed the method to a transperitoneal approach and started to harvest also right kidneys. Since then, it has become the method of choice for donor nephrectomy and has been performed in 59 cases. Preoperatively, kidneys were assessed by scintigraphy and by angio-computed tomography. We harvested 32 left and 27 right kidneys. There were double renal arteries in 2 cases and triple renal arteries in 1 case. The warm ischaemia time (WIT) was 80–420 s (average 176.13 s); operative time was 85–210 min (average 140 min). Results All procedures were uncomplicated, and all donors were discharged after 2–8 days with normal creatinine levels. The average follow-up period lasted 23 months (1–51 months). Out of all of the cases, 1 case had two minor complications, while all others were uneventful. None of the donors were lost to follow-up. All of the kidneys were transplanted. There were 2 cases of delayed graft function (DGF) and 2 cases of ureter necrosis. One of those kidneys was lost in the third postoperative week. Conclusions Our limited experience shows that HALDN is a safe method and should be used routinely instead of open surgery. PMID:28194249

  1. Status and Design Concepts for the Hydrogen On-Orbit Storage and Supply Experiment

    NASA Technical Reports Server (NTRS)

    Chato, David J.; VanDyke, Melissa; Batty, J. Clair; Schick, Scott

    1998-01-01

    This paper studies concepts for the Hydrogen On-Orbit Storage and Supply Experiment (HOSS). HOSS is a space flight experiment whose objectives are: Show stable gas supply for storage and direct gain solar-thermal thruster designs; and evaluate and compare low-g performance of active and passive pressure control via a thermodynamic vent system (TVS) suitable for solar-thermal upper stages. This paper shows that the necessary experimental equipment for HOSS can be accommodated in a small hydrogen dewar of 36 to 80 liter. Thermal designs for these dewars which meet the on-orbit storage requirements can be achieved. Furthermore ground hold insulation and shielding concepts are achieved which enable storing initially subcooled liquid hydrogen in these small dewars without venting in excess of 144 hours.

  2. Design Concepts Studied for the Hydrogen On-Orbit Storage and Supply Experiment

    NASA Technical Reports Server (NTRS)

    Chato, David J.

    1998-01-01

    The NASA Lewis Research Center, in conjunction with the Utah State University Space Dynamics Laboratory, studied concepts for the Hydrogen On-Orbit Storage and Supply Experiment (HOSS). HOSS is a space flight experiment whose objectives are (1) to show stable gas supply for solar-thermal thruster designs by using both storage and direct-gain approaches and (2) to evaluate and compare the low-gravity performance of active and passive pressure control via a thermodynamic vent system (TVS) suitable for solar-thermal upper stages. This study showed that the necessary experimental equipment for HOSS can be accommodated in a small hydrogen Dewar (36 to 80 liter). Thermal designs can be achieved that meet the on-orbit storage requirements for these Dewars. Furthermore, ground hold insulation concepts are easily achieved that can store liquid hydrogen in these small Dewars for more than 144 hr without venting.

  3. The Freshman Experience and the Role of Student Assistants.

    ERIC Educational Resources Information Center

    Santa Rita, Emilio

    The Student Assistants' Program (SAP) was implemented at Bronx Community College (BCC) (New York) to reduce attrition between admission and the first day of classes. The principal objective of the program is to train presently enrolled students to provide individual assistance to entering freshmen. These student assistants help new students with…

  4. Development of effective power supply using electric double layer capacitor for static magnetic field coils in fusion plasma experiments.

    PubMed

    Inomoto, M; Abe, K; Yamada, T; Kuwahata, A; Kamio, S; Cao, Q H; Sakumura, M; Suzuki, N; Watanabe, T; Ono, Y

    2011-02-01

    A cost-effective power supply for static magnetic field coils used in fusion plasma experiments has been developed by application of an electric double layer capacitor (EDLC). A prototype EDLC power supply system was constructed in the form of a series LCR circuit. Coil current of 100 A with flat-top longer than 1 s was successfully supplied to an equilibrium field coil of a fusion plasma experimental apparatus by a single EDLC module with capacitance of 30 F. The present EDLC power supply has revealed sufficient performance for plasma confinement experiments whose discharge duration times are an order of several seconds.

  5. Robot-assisted Kidney Transplantation: The European Experience.

    PubMed

    Breda, Alberto; Territo, Angelo; Gausa, Luis; Tuğcu, Volkan; Alcaraz, Antonio; Musquera, Mireia; Decaestecker, Karel; Desender, Liesbeth; Stockle, Michael; Janssen, Martin; Fornara, Paolo; Mohammed, Nasreldin; Siena, Giampaolo; Serni, Sergio; Guirado, Luis; Facundo, Carma; Doumerc, Nicolas

    2017-09-12

    Robot-assisted kidney transplantation (RAKT) has recently been introduced to reduce the morbidity of open kidney transplantation (KT). To evaluate perioperative and early postoperative RAKT outcomes. This was a multicenter prospective observational study of 120 patients who underwent RAKT, predominantly with a living donor kidney, in eight European institutions between July 2015 and May 2017, with minimum follow-up of 1 mo. The robot-assisted surgical steps were transperitoneal dissection of the external iliac vessels, venous/arterial anastomosis, graft retroperitonealization, and ureterovesical anastomosis. Descriptive analysis of surgical data and their correlations with functional outcomes. The median operative and vascular suture time was 250 and 38min, respectively. The median estimated blood loss was 150ml. No major intraoperative complications occurred, although two patients needed open conversion. The median postoperative estimated glomerular filtration rate was 21.2, 45.0, 52.6, and 58.0ml/min on postoperative day 1, 3, 7, and 30, respectively. Both early and late graft function were not related to overall operating time or rewarming time. Five cases of delayed graft function (4.2%) were reported. One case (0.8%) of wound infection, three cases (2.5%) of ileus, and four cases of bleeding (3.3%; three of which required blood transfusion), managed conservatively, were observed. One case (0.8%) of deep venous thrombosis, one case (0.8%) of lymphocele, and three cases (2.5%) of transplantectomy due to massive arterial thrombosis were recorded. In five cases (4.2%), surgical exploration was performed for intraperitoneal hematoma. Limitations of the study include selection bias, the lack of an open control group, and failure to report on patient cosmetic satisfaction. When performed by surgeons with robotic and KT experience, RAKT is safe and reproducible in selected cases and yields excellent graft function. We present the largest reported series on robot-assisted

  6. Ultrafast growth of single-crystal graphene assisted by a continuous oxygen supply.

    PubMed

    Xu, Xiaozhi; Zhang, Zhihong; Qiu, Lu; Zhuang, Jianing; Zhang, Liang; Wang, Huan; Liao, Chongnan; Song, Huading; Qiao, Ruixi; Gao, Peng; Hu, Zonghai; Liao, Lei; Liao, Zhimin; Yu, Dapeng; Wang, Enge; Ding, Feng; Peng, Hailin; Liu, Kaihui

    2016-11-01

    Graphene has a range of unique physical properties and could be of use in the development of a variety of electronic, photonic and photovoltaic devices. For most applications, large-area high-quality graphene films are required and chemical vapour deposition (CVD) synthesis of graphene on copper surfaces has been of particular interest due to its simplicity and cost effectiveness. However, the rates of growth for graphene by CVD on copper are less than 0.4 μm s(-1), and therefore the synthesis of large, single-crystal graphene domains takes at least a few hours. Here, we show that single-crystal graphene can be grown on copper foils with a growth rate of 60 μm s(-1). Our high growth rate is achieved by placing the copper foil above an oxide substrate with a gap of ∼15 μm between them. The oxide substrate provides a continuous supply of oxygen to the surface of the copper catalyst during the CVD growth, which significantly lowers the energy barrier to the decomposition of the carbon feedstock and increases the growth rate. With this approach, we are able to grow single-crystal graphene domains with a lateral size of 0.3 mm in just 5 s.

  7. Ultrafast growth of single-crystal graphene assisted by a continuous oxygen supply

    NASA Astrophysics Data System (ADS)

    Xu, Xiaozhi; Zhang, Zhihong; Qiu, Lu; Zhuang, Jianing; Zhang, Liang; Wang, Huan; Liao, Chongnan; Song, Huading; Qiao, Ruixi; Gao, Peng; Hu, Zonghai; Liao, Lei; Liao, Zhimin; Yu, Dapeng; Wang, Enge; Ding, Feng; Peng, Hailin; Liu, Kaihui

    2016-11-01

    Graphene has a range of unique physical properties and could be of use in the development of a variety of electronic, photonic and photovoltaic devices. For most applications, large-area high-quality graphene films are required and chemical vapour deposition (CVD) synthesis of graphene on copper surfaces has been of particular interest due to its simplicity and cost effectiveness. However, the rates of growth for graphene by CVD on copper are less than 0.4 μm s-1, and therefore the synthesis of large, single-crystal graphene domains takes at least a few hours. Here, we show that single-crystal graphene can be grown on copper foils with a growth rate of 60 μm s-1. Our high growth rate is achieved by placing the copper foil above an oxide substrate with a gap of ∼15 μm between them. The oxide substrate provides a continuous supply of oxygen to the surface of the copper catalyst during the CVD growth, which significantly lowers the energy barrier to the decomposition of the carbon feedstock and increases the growth rate. With this approach, we are able to grow single-crystal graphene domains with a lateral size of 0.3 mm in just 5 s.

  8. Students' Perceptions of Assistance Received from Parents and Teachers with Supervised Occupational Experience Programs.

    ERIC Educational Resources Information Center

    Williams, David L.

    1980-01-01

    A study of assistance received from parents and teachers with supervised occupational experience programs. Teachers provided the greatest assistance in areas of recordkeeping, encouragement, setting educational goals, and learning skills in agriculture. Parents' greatest assistance was in providing facilities, developing interest in agriculture,…

  9. [Anaesthetic management in left ventricular assist device implantation as destination therapy: Our first experience].

    PubMed

    del Barrio Gómez, E; Rodríguez, J M; Martínez, S; García, E; Vargas, M C; Sastre, J A

    2016-03-01

    Left ventricular assist devices have emerged as one of the main therapies of advanced cardiac failure due the increase of this disease and lack of organ supply for cardiac transplantation. The anaesthetic management is described on a patient without cardiac transplantation criteria. The device was successfully implanted as a destination therapy.

  10. Armor Development from Decapitated Flash Flood Bores in Supply-Limited Flume Experiments

    NASA Astrophysics Data System (ADS)

    Goodwin, K.; Rhodes, R.; Johnson, J. P.

    2013-12-01

    In rivers assumed to have quasi-normal flow, three main processes have been used to explain bed surface armoring: i) selective entrainment and transport of smaller grains, ii) limited supply of smaller grain sizes, and iii) equal mobility of grains of different sizes, which develops through natural feedbacks such that larger, less mobile grains are enriched on the surface relative to smaller grains. Flash flood-dominated river channels in arid environments often completely lack surface armoring, yet it is unclear whether increased sediment supply or transport of all grain sizes prevents armor development. In order to examine armor development in an end-member case of non-normal flow, we conducted a series of laboratory experiments using flash flood bores. The flume is 33.5 m long, 0.5 m wide, 0.8 m tall, and capable of creating reproducible flood bores by raising a high-speed computerized lift gate and releasing impounded water. For each experiment, the gate was quickly lowered as soon as the flood bore traveled the length of the flume, 'decapitating' the bore from subsequent flow, to better isolate the effects of the bore alone on entrainment and transport. Sediment was not fed into the upstream end of the flume and only sourced from the gravel bed (2 mm to 40 mm), resulting in supply-limited experimental conditions. In response to repeated flood bores, the surface grain size distribution rapidly coarsened. We interpret that kinetic sieving was the dominant cause of surface armoring in these experiments. LiDAR scans of the bed topography from before and after each bore show increased surface roughness due to grain size changes, but small surface elevation changes due to relatively limited erosion. Digital gravelometry from photographs taken after each bore show increased armoring, while sediment transported out the downstream end of the flume tended to be as coarse or coarser than the bed surface. Travel distances of three sizes of RFID-tagged tracer clasts show

  11. Continuous-Flow Left Ventricular Assist Device Support Improves Myocardial Supply:Demand in Chronic Heart Failure.

    PubMed

    Soucy, Kevin G; Bartoli, Carlo R; Phillips, Dustin; Giridharan, Guruprasad A; Sobieski, Michael A; Wead, William B; Dowling, Robert D; Wu, Zhongjun J; Prabhu, Sumanth D; Slaughter, Mark S; Koenig, Steven C

    2017-02-06

    Continuous-flow left ventricular assist devices (CF LVADs) are rotary blood pumps that improve mean blood flow, but with potential limitations of non-physiological ventricular volume unloading and diminished vascular pulsatility. In this study, we tested the hypothesis that left ventricular unloading with increasing CF LVAD flow increases myocardial flow normalized to left ventricular work. Healthy (n = 8) and chronic ischemic heart failure (IHF, n = 7) calves were implanted with CF LVADs. Acute hemodynamics and regional myocardial blood flow were measured during baseline (LVAD off, clamped), partial (2-4 L/min) and full (>4 L/min) LVAD support. IHF calves demonstrated greater reduction of cardiac energy demand with increasing LVAD support compared to healthy calves, as calculated by rate-pressure product. Coronary artery flows (p < 0.05) and myocardial blood flow (left ventricle (LV) epicardium and myocardium, p < 0.05) decreased with increasing LVAD support in normal calves. In the IHF model, blood flow to the septum, LV, LV epicardium, and LV myocardium increased significantly with increasing LVAD support when normalized to cardiac energy demand (p < 0.05). In conclusion, myocardial blood flow relative to cardiac demand significantly increased in IHF calves, thereby demonstrating that CF LVAD unloading effectively improves cardiac supply and demand ratio in the setting of ischemic heart failure.

  12. Family members' experiences of personal assistance given to a relative with disabilities.

    PubMed

    Ahlström, Gerd; Wadensten, Barbro

    2011-11-01

    Personal assistance is a type of home care common to many countries even though entitlement and legislative framework may vary from country to country. At present, there exists no knowledge about the family members' experiences of such assistance; therefore, the aim of this study was to investigate family members' experiences of personal assistance given to a relative of working age with a functional disability. Twenty-five family members who had a relative with a severe neurological disease in Sweden were interviewed about the significance of personal assistance, and the qualitative interviews were subjected to qualitative latent content analysis. The overall findings verify the close connection between the family members' experiences and their perception of the quality of the caring relationship between the personal assistant and the person with disability. The main finding was an appreciation of the personal assistance on the part of the family members. However, in situations where the encounter between the assistant and the relative with disability was perceived negatively, the family members experienced great anxiety. The shortcomings were the inability to maintain a private life with assistance and the limitation of choice because of the shortage of personal assistants. Beyond these general findings, this study found that personal assistance was experienced by the family members in terms of dignity and empowering care. This theme was generated from seven subthemes: Insight into private life, Security through the close relation, Social life through freedom of movement, Influence over the organisation of assistance, Self-determination and understanding, Friendship and mutual respect and Adaption to the dependency on assistance. The findings indicate that responsible officials, work leaders and assistants need constantly to improve the implementation of the law. In such efforts, the experiences of family members described in this study are a source of knowledge.

  13. Young women's perceptions and experiences with contraception supply in community pharmacies.

    PubMed

    Fakih, Souhiela; Batra, Peter; Gatny, Heather H; Kusunoki, Yasamin; Barber, Jennifer S; Farris, Karen B

    2015-01-01

    Unintended pregnancy is a major public health problem in the United States.Correct contraceptive use can reduce the rate of unintended pregnancy. Community pharmacies are well positioned to provide contraceptives and advice about contraception. To determine young women's perceptions and experiences with contraception supply in community pharmacies and to identify whether pharmacy characteristics predicted very positive experiences. This study comprised two cross-sectional surveys including an online women's pharmacy perceptions and experiences (PPE) survey and a faxed/observed survey of community pharmacies. One county in Michigan. Young women and community pharmacies. The two surveys were merged to explore pharmacy characteristics that may impact women's perceptions and experiences with community pharmacies. Multiple logistic regression analysis was used to explore relationships between pharmacy characteristics and positive outcomes. The response rate for the PPE survey was 54% (n = 343/637). Data from all community pharmacies in the county was retrieved via fax (n = 41/94, 43.6%) or observation (n = 53/94, 56.4%). Women were included in this analysis if they indicated a regular pharmacy (one they go to most often) in the county of interest (n = 210). More than 50% of women (n = 125/210) visited a pharmacy more than once per month. Sixty percent of women were currently using something to prevent pregnancy (n = 124/210, 60.8%). Thirty-five percent of women had a positive experience (n = 73/210, 34.8%). In the multiple logistic regression, women who visited a chain pharmacy had almost 65% lower odds of an overall positive experience with their regular pharmacy compared with women who visited a grocery or mass merchandise pharmacy (odds ratio 0.35 [95% CI 0.16], P = 0.75). Young women visit community pharmacies and use contraceptives frequently. Interventions need to be developed and implemented to improve young women's perceptions and experiences with

  14. New pulse forming network power supply for the Caltech Spheromak Formation Experiment

    NASA Astrophysics Data System (ADS)

    Moser, A. L.; Bellan, P. M.

    2009-11-01

    Past experiments on the Caltech Spheromak Formation Experiment produced plasmas with a 120 μF capacitor bank charged to 4--7 kV and supplying a 150 kA peak current with a FWHM of ˜10 μs. We recently completed construction of a pulse forming network (PFN) having two parallel sections of five 120 μF capacitors, designed to produce a 150 kA peak current pulse with FWHM of ˜50 μs. Preliminary experiments using only the PFN show the effect of the five--fold increase in current pulse length on the collimated jet precursor to spheromak formation: the jet extends to 55 cm, a length ˜1.5 times that previously seen, and can develop two visible twists upon onset of the kink instability. Future experiments will use the 120 μF capacitor bank for plasma breakdown and the PFN for sustainment. A recently constructed capacitively coupled probe and axial 60--channel magnetic probe array will be used to study critical ionization velocity limited collisions between the magnetized jet and a neutral target gas cloud.

  15. Instructional Experiences of Graduate Assistants Implementing Explicit and Reflective Introductory Biology Laboratories

    NASA Astrophysics Data System (ADS)

    Uludag Bautista, Nazan; Schussler, Elisabeth E.; Rybczynski, Stephen M.

    2014-05-01

    Science education reform documents identify nature of science (NOS) as a critical component of scientific literacy and call for universities, colleges, and K-12 schools to explicitly integrate NOS learning into science curricula. In response to these calls, this study investigated the classroom practices of nine graduate assistants (GAs) who taught expository and inquiry laboratories that implemented an explicit and reflective (ER) pedagogy to teach NOS. The purpose of this qualitative study was to better understand the experiences that enabled or inhibited GA implementation of an ER strategy in a college setting. The findings revealed that achieving quality implementation in this setting was very difficult. Factors such as GAs' ability to foster meaningful classroom discussions, laboratory logistics (e.g. lack of time and supplies), and the value undergraduates and GAs saw in learning about NOS were identified by GAs and observed by the researchers as barriers to the technique maximizing its potential. Thus, for meaningful infusion of NOS into science curricula, pedagogical support for GAs to manage meaningful classroom discussions in support of NOS or other complex topics is recommended for an ER approach to NOS learning to be successful in college settings.

  16. Moral Behavior of Resident Assistants: A Lived Experience

    ERIC Educational Resources Information Center

    Stark, Rachael H.

    2013-01-01

    Resident Assistants (RAs) are traditionally upper-class students who are responsible for enforcing residence-hall policies (Heala, 2006). These undergraduate paraprofessional students are consistently asked to hold their peers accountable for their behavior, yet this task can be a struggle for those RAs who are unable to display consistently moral…

  17. Moral Behavior of Resident Assistants: A Lived Experience

    ERIC Educational Resources Information Center

    Stark, Rachael H.

    2013-01-01

    Resident Assistants (RAs) are traditionally upper-class students who are responsible for enforcing residence-hall policies (Heala, 2006). These undergraduate paraprofessional students are consistently asked to hold their peers accountable for their behavior, yet this task can be a struggle for those RAs who are unable to display consistently moral…

  18. Experience with physician assistants in a Canadian arthroplasty program

    PubMed Central

    Bohm, Eric R.; Dunbar, Michael; Pitman, David; Rhule, Chris; Araneta, Jose

    2010-01-01

    Background Recent increases in orthopedic surgical services in Canada have added further demand to an already stretched orthopedic workforce. Various initiatives have been undertaken across Canada to meet this demand. One successful model has been the use of physician assistants (PAs) within the Winnipeg Regional Health Authority (WRHA). This study documents the effect of PAs working in an arthroplasty practice from the perspective of patients and health care providers. We also describe the costs, time savings for surgeons and the effects on surgical throughput and waiting times. Methods We calculated time savings by the use of a daily diary kept by the PAs. Surgeons’, residents’, nurses’ and patients’ opinions about PAs were recorded by use of a selfadministered questionnaire. We calculated costs using forgone general practitioner (GP) surgical assist fees and salary costs for PAs. We obtained information about surgical throughput and wait times from the WRHA waitlist database. Results In this study, PAs “saved” their supervising physician about 204 hours per year; this time can be used for other clinical, administrative or research duties. Physician assistants are regarded as important members of the health care team by surgeons, nurses, orthopedic residents and patients. When we compared the billing costs with those that would have been generated by the use of GP surgical assists, PAs were essentially cost neutral. Furthermore, they potentially freed GPs from the operating room to spend more time delivering primary care. We found that use of the double operating room model facilitated by PAs increased the surgical throughput of primary hip and knee replacements by 42%, and median wait times decreased from 44 weeks to 30 weeks compared with the preceding year. Conclusion Physician assistants integrate well into the care team and can increase surgical volumes to reduce wait times in a cost-effective manner. PMID:20334742

  19. Assistant Principals' Lived Experiences with Managerial Skills Needed for Promotion: A Phenomenological Study

    ERIC Educational Resources Information Center

    Flowers, Melnice

    2014-01-01

    The purpose of this qualitative, phenomenological study was to explore the lived experiences of assistant principals in what they deem to be the needed managerial skills for promotion to campus principal. The sample for the study included 20 assistant principals in an urban school district located in Texas. The process of phenomenological enquiry…

  20. Technohubs in Teacher Education: The Lived Experience of Assisting Peers with Instructional Technology Issues

    ERIC Educational Resources Information Center

    Rook, Michael Montalto

    2014-01-01

    This study examined prospective teachers' lived experiences of assisting peers with instructional technology issues. The study built upon one of ISTE's (2003) essential conditions for integrating technology in education: technical assistance for using technology. Through a review of relevant literature, an argument was made for the study based on…

  1. Assistant Principals' Lived Experiences with Managerial Skills Needed for Promotion: A Phenomenological Study

    ERIC Educational Resources Information Center

    Flowers, Melnice

    2014-01-01

    The purpose of this qualitative, phenomenological study was to explore the lived experiences of assistant principals in what they deem to be the needed managerial skills for promotion to campus principal. The sample for the study included 20 assistant principals in an urban school district located in Texas. The process of phenomenological enquiry…

  2. Technohubs in Teacher Education: The Lived Experience of Assisting Peers with Instructional Technology Issues

    ERIC Educational Resources Information Center

    Rook, Michael Montalto

    2014-01-01

    This study examined prospective teachers' lived experiences of assisting peers with instructional technology issues. The study built upon one of ISTE's (2003) essential conditions for integrating technology in education: technical assistance for using technology. Through a review of relevant literature, an argument was made for the study based on…

  3. Learning Experiences in Robotic-Assisted Laparoscopic Surgery.

    PubMed

    Nezhat, Ceana; Lakhi, Nisha

    2016-08-01

    With the use and adoption of computer-assisted laparoscopic technology gaining more prominence, important issues pertaining to the learning process are raised. Several modalities can be incorporated into a training program for robotic surgical development. The role and utility of various methods, including didactic instruction, virtual reality simulators, dry and wet laboratories, bedside assistance, mentoring, as well as proctorship, are still in the process of being assessed and validated. Integration of robotic training in residency and fellowship programs as well as the formation of a structured didactic robotic curriculum continues to be a challenge. Finally, methods to assess competency of training and the process for credentialing robotic surgeons still require further structuring and codification. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Citric acid-assisted phytoextraction of lead: a field experiment.

    PubMed

    Freitas, Eriberto Vagner; Nascimento, Clístenes Williams; Souza, Adailson; Silva, Fernando Bruno

    2013-06-01

    Soil contamination with heavy metals has become a serious environmental problem that requires affordable strategies of remediation. This study was carried out to assess the performance of maize and vetiver in the phytoextraction of Pb from a soil contaminated by battery recycling activities. The species were planted with different spacings between rows (0.80, 0.65 and 0.50m). Citric acid (40mmolkg(-1)) was applied on each experimental plot on the 61st d of cultivation in order to solubilize the Pb and assist the phytoextraction. The results showed that the chelating agent promoted a 14-fold increase in the Pb concentration in maize shoots as compared to the control, which accumulated only 111mgkg(-1) of the metal. The citric acid induced a Pb concentration in vetiver shoots that was 7.2-6.7-fold higher than the control at both the 0.65 and 0.50m plant spacing, respectively. The use of citric acid increased substantially the uptake and translocation of Pb to the shoots, regardless of plant spacing. Citric acid was efficient in solubilizing Pb from the soil and inducing its uptake by both species. Environmentally-friendly and cost effective, commercial citric acid is recommended for assisting Pb-phytoextraction in the studied area. Due to the low natural solubility of Pb and a time frame needed of longer than 150yr to accomplish the clean-up, phytoextraction with no chelate assistance is not recommended for the area.

  5. Building No. 1057, Experiment Station Assistant’s Residence, view of west ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Building No. 1057, Experiment Station Assistant’s Residence, view of west elevation - Wind River Administrative Site, Building No. 1057, Chapman Road, near Lookout Mountain Road, Carson, Skamania County, WA

  6. Building No. 1057, Experiment Station Assistant’s Residence, view of south ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Building No. 1057, Experiment Station Assistant’s Residence, view of south elevation - Wind River Administrative Site, Building No. 1057, Chapman Road, near Lookout Mountain Road, Carson, Skamania County, WA

  7. Building No. 1057, Experiment Station Assistant’s Residence, view of east ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Building No. 1057, Experiment Station Assistant’s Residence, view of east elevation - Wind River Administrative Site, Building No. 1057, Chapman Road, near Lookout Mountain Road, Carson, Skamania County, WA

  8. Building No. 1057, Experiment Station Assistant’s Residence, view of north ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Building No. 1057, Experiment Station Assistant’s Residence, view of north elevation - Wind River Administrative Site, Building No. 1057, Chapman Road, near Lookout Mountain Road, Carson, Skamania County, WA

  9. Effective Laboratory Experiences for Students with Disabilities: The Role of a Student Laboratory Assistant.

    ERIC Educational Resources Information Center

    Pence, Laura E.; Workman, Harry J.; Riecke, Pauline

    2003-01-01

    Dicusses the effects of using laboratory assistants for disabled students' learning in the chemistry laboratory. Presents two case studies and general strategies for approaching laboratory experiences for disabled students. (KHR)

  10. Low Income Students: Their Lived University Campus Experiences Pursuing Baccalaureate Degrees with Private Foundation Scholarship Assistance

    ERIC Educational Resources Information Center

    Arzy, Marsha Riley; Davies, Timothy Gray; Harbour, Clifford P.

    2006-01-01

    This qualitative study explored the Lived University Campus Experiences of Low Income Students Pursuing Baccalaureate Degrees with Private Foundation Scholarship Assistance. The findings emerged as the themes "Experiences of Affirmation, Cautious Engagement, Vulnerability, and Transformation." "Experiences of Affirmation" explained the positive…

  11. Young women’s perceptions and experiences with contraception supply in community pharmacies

    PubMed Central

    Fakih, Souhiela; Batra, Peter; Gatny, Heather H; Kusunoki, Yasamin; Barber, Jennifer S.; Farris, Karen B.

    2015-01-01

    Background Unintended pregnancy is a major public health problem in the United States.. Correct contraceptive use can reduce the rate of unintended pregnancy. Community pharmacies are well positioned to provide contraceptives and advise about contraception. Objectives (1) determine young women’s perceptions and experiences with contraception supply in community pharmacies and (2) identify whether very pharmacy characteristics predicted positive experiences. Design This study was comprised of two cross-sectional surveys including an online women’s pharmacy perceptions and experiences (PPE) survey and a faxed/observed survey of community pharmacies. Setting One County in Michigan, USA Participants Young women and community pharmacies Main outcome measure The two surveys were merged to explore pharmacy characteristics that may impact women’s perceptions and experiences with community pharmacies. Multiple logistic regression analysis was used to explore relationships between pharmacy characteristics and positive outcomes. Results The response rate for the PPE survey was 54% (n= 334/637). Data from all community pharmacies in the county was retrieved via fax (n= 41/94, 43.6%) or observation (n= 53/94, 56.4%). Women were included in this analysis if they indicated a regular (most commonly used) pharmacy in the county of interest (n=210). Over 50% of women (n= 125/210) visited a pharmacy more than once per month. Sixty percent of women were currently using something to prevent pregnancy (n=124/210, 60.8%). Thirty-five percent of women had a positive experience (n=73/210, 34.8%). In the multiple logistic regression, women who visited a chain pharmacy had almost 65% lower odds of an overall positive experience with their regular pharmacy, compared to women who visited a grocery or mass merchandise pharmacy (OR: 0.35, 95% CI: 0.16, 0.75). Conclusion Young women visit community pharmacies and use contraceptives frequently. Interventions need to be developed and

  12. [AESOP 3000--computer-assisted surgery, personal experience].

    PubMed

    Kasalický, M A; Sváb, J; Fried, M; Melechovský, D

    2002-07-01

    At present the most widely used system of CAS is a vocally controlled manipulator of the laparoscope AESOP 3000 (Automated Endoscopic System for Optimal Positioning) which makes it possible to implement some operations without the assistance of another surgeon ("Solo-surgery"). Because of financial costs the so far little used equipment ZEUS or DA VINCI are already "master-slave" systems with several robot arms where the surgeon operates by means of manipulators in the controlling unit without direct contact with the patient. At the First Surgical Clinic, General Faculty Hospital and First Medical Faculty Charles Universitx the authors use the robot system AESOP 3000 since March 2000, in particular in laparoscopic gastric banding on account of obesity, in laparoscopic cholecystectomies, laparoscopic gastroenteroanastomoses and operations in the area if the hiatus. This system made it possible to reduce the number of assisting physicians. E.g. in gastric banding one assistant is sufficient, in laparoscopic cholecystectomy it is possible to operate only with a suture nurse. The application of AESOP is particularly useful in laparoscopic appendectomies and inguinal hernioplasties where it makes possible so-called "solo-surgery" or "one man surgery". No doubt, it is however necessary to have the possibility to call immediately another doctor to the operation theatre in case of necessary conversion of laparoscopy of laparotomy. The authors did not record any case of unwanted movement of the robot arm or another serious technical problem. As compared with a manually guided laparoscope during the use of AESOP the number of unwanted or inadequate shifts of the optical equipment or its angular rotation decreased considerably.

  13. Computer-assisted cataloging: experiences at the UCLA Biomedical Library.

    PubMed Central

    Traister, R C

    1975-01-01

    The computer-assisted procedures developed in the UCLA Biomedical Library Cataloging Division have been in effect for approximately three years. The system utilizes a Delta Data System cathode ray tube terminal and cassette attachment for on or off-line input of data. Products of the system include catalog card sets arranged in filing order, a monthly Recent Acquisitions List, and computer-generated book catalogs. Planning, personnel, and equipment requirements are discussed, and preliminary cost figures for various parts of the system are given. Potential applications of the automated system on a regional level and in terms of the library's future automation plans are considered. PMID:1148443

  14. Laser-assisted uvulopalatoplasty: post operative complications (NILES, preliminary experience).

    PubMed

    Negm, H; Elkharbotly, A

    2001-09-15

    Laser (CO(2)) assisted uvulopalatoplasty (LAUP) is an out-patient technique under local anesthesia, proposed for the treatment of snoring. The National Institute of Laser Enhanced Sciences, Cairo University, began to offer (LAUP) to patients since summer 1996. A patient survey was developed to evaluate the postoperative complications. A total of 60 post-treatment surveys were completed using a written questionnaire or telephone calls at intervals ranging between day 1 and 6 months. Complications ranged from allergy to local anesthesia to severe pain. No serious complications were recorded. Further long run study is necessary for full understanding and assessment.

  15. Experience with ISO quality control in assisted reproductive technology.

    PubMed

    Alper, Michael M

    2013-12-01

    Assisted reproductive technology (ART) programs are complex organizations requiring the integration of multiple disciplines. ISO 9001:2008 is a quality management system that is readily adaptable to an ART program. The value that ISO brings to the entire organization includes control of documents, clear delineation of responsibilities of staff members, documentation of the numerous processes and procedures, improvement in tracking and reducing errors, and overall better control of systems. A quality ART program sets quality objectives and monitors their progress. ISO provides a sense of transparency within the organization and clearer understanding of how service is provided to patients. Most importantly, ISO provides the framework to allow for continual improvement.

  16. Clinical experience with 111 thoratec ventricular assist devices.

    PubMed

    McBride, L R; Naunheim, K S; Fiore, A C; Moroney, D A; Swartz, M T

    1999-05-01

    Ventricular assist devices (VADs) have gained wider acceptance due to refinements in patient selection and management and device availability. To evaluate early and late results, we reviewed our first 111 patients with the Thoratec VAD. Forty-four patients were supported for myocardial recovery. The mean age in the recovery group was 51.9 years. There were 18 left VADs (LVADs), 17 biventricular VADs (BVADs), and nine right VADs (RVADs). Complications included bleeding in 20 patients (45%) and device-related infection in 1 patient (2%). Nineteen were weaned from the VAD, with 12 survivors. Sixty-seven patients were supported as a bridge to cardiac transplantation. The mean age was 41.5 years. There were 39 LVADs and 28 BVADs. Complications included bleeding in 21 patients (31%) and device-related infection in 12 (18%). Three patients were weaned and 39 patients were transplanted from the assist device, for a total of 42 bridge survivors. Device-related thromboembolism occurred in 9 patients (8.1%), 7 of whom were bridge to transplantation. The duration of VAD support ranged from 0.1 to 27 days (mean 4.5 days) in the recovery group and 0.2 to 184 days (mean 40.7 days) in the bridge to transplantation group. The 10-year actuarial survival was 16% for the recovery group, 22%, for the bridge group, and 33% for transplanted patients. Despite advances, VAD support remains associated with significant morbidity and operative mortality.

  17. The Operation of Magnetically Assisted Fluidized Bed in Microgravity and Variable Gravity: Experiment and Theory

    NASA Astrophysics Data System (ADS)

    Sornchamni, T.; Jovanovic, G.; Atwater, J.; Akse, J.; Wheeler, R.

    Typically, the operation of a conventional fluidized bed relies on the balance of gravitational, buoyancy, and drag forces. In the absence of normal gravity, or under microgravity and variable gravity conditions, the gravitational force must be replaced with an alternative force to restore fluidization. Our work has shown that, given a suitable variable magnetic field design, the resulting magnetic field gradient can create sufficient magnetic force acting upon the ferromagnetic particles to replace or supplement the gravitational force. Therefore, the ferromagnetic granular media can be fluidized in either microgravity or hypogravity. In this paper, we present our experimental and theoretical work leading to a) development of theoretical model based on fundamental principles for the design of the Gradient Magnetically Assisted Fluidized Bed (G-MAFB), and b) practical implementation of the G-MAFB in the filtration and destruction of solid biowaste particles from liquid streams. The G-MAFB system consists of a fluidization column and series of Helmholtz electromagnetic coils, with DC power supply. Each Helmholtz ring is powered and controlled separately. Experiments are performed in both 0g (on board NASA KC- 135) and 1g (laboratory) environments. The experiments in 0g are conducted in a two-dimensional, square cross-section, tapered fluidization column. The tapered shape is introduced to provide additional stability to the fluidization particles. The experiments in 0g prove that the magnetic force has a significant role in keeping the particles from extruding out of the bed. Without the magnetic force, it is impossible to have fluidization in space. Solid waste destruction technologies are needed to support long duration human habitation in space. The current technologies, including supercritical water oxidation (SCWO), microwave powered combustion and fluidized bed incineration, have been applied to the destruction of solid wastes, but none are compatible with

  18. Assisting Your Preservice Teacher to Be Successful during Field Experiences

    ERIC Educational Resources Information Center

    Brett, Christine

    2006-01-01

    Field experience (junior practicum and student teaching) is considered by many to be the most influential part of a teacher preparation program (Cruickshank & Aramalin, 1986; Tannehill & Zakrajsek, 1988). During field experiences, preservice teachers (hereafter referred to as PSTs) are guided by a cooperating teacher (hereafter referred to as a…

  19. Assisting Your Preservice Teacher to Be Successful during Field Experiences

    ERIC Educational Resources Information Center

    Brett, Christine

    2006-01-01

    Field experience (junior practicum and student teaching) is considered by many to be the most influential part of a teacher preparation program (Cruickshank & Aramalin, 1986; Tannehill & Zakrajsek, 1988). During field experiences, preservice teachers (hereafter referred to as PSTs) are guided by a cooperating teacher (hereafter referred to as a…

  20. The registered nurse as a first assistant: the "downunder" experience.

    PubMed

    Brennan, B

    2001-04-01

    In 1996, Bernadette Brennan, RN, was awarded a fellowship from the Australian Confederation of Operating Room Nurses (now known as the Australian College of Operating Room Nurses Ltd.) to travel to the United States to study the role of the Advanced Nurse Practitioner, with an emphasis on the role of the registered nurse first assistant (RNFA). As part of this study, she undertook an RNFA course at Delaware County Community College. This article provides a description of her work to develop an educational program for RNFAs in Australia. Because of the size of the country and the many rural areas needing to be served, her challenge was to devise an accessible program that was also academically rigorous. Her trials as well as her triumphs are presented here.

  1. Commercialization of Plasma-Assisted Technologies: The Indian Experience

    NASA Astrophysics Data System (ADS)

    John, P. I.

    The paper describes an initiative by the Institute for Plasma Research (IPR), India in establishing links with the Indian industry for developing and commercialising advanced plasma-based industrial technologies. This has culminated in the creation of a self-financing technology development, incubation, demonstration and delivery facility. A business plan for converting the knowledge base to commercially viable technologies conceived technology as a product and the industry as the market and addressed issues like resistance to new technologies, the key role of entrepreneur, thrust areas and the necessity of technology incubation and delivery. Success of this strategy is discussed in a few case studies. We conclude by identifying the cost, environmental, strategic and techno-economic aspects, which would be the prime drivers for plasma-assisted manufacturing technology in India.

  2. Supply-side harm reduction strategies: Bolivia's experiment with social control.

    PubMed

    Farthing, Linda; Kohl, Benjamin

    2012-11-01

    Harm reduction approaches to drug control have almost exclusively focussed on consumers in northern countries. This article supports recent analysis that indicates that such policies also hold relevance for producer countries by drawing on recent policy innovations in Bolivia. When Evo Morales, the president of the national coca grower confederation, was elected the country's first indigenous president in 2005, he promised to fundamentally change 25 years of the U.S.-funded "drug war" that had generated repeated human rights violations. The new policy, which implicitly incorporates harm reduction principles combined with respect for human rights, recognizes coca leaf's traditional use and cultural importance and relies on vigorous local organizations to implement a community-based programme called social control. Results to date indicate that Bolivia's social control experience has reduced violence in coca growing communities, ensured small farmers a subsistence income from coca and increased sovereignty, while making a modest contribution to containing expansion of coca cultivation. The programme has registered 50,000 farmers who are allowed to cultivate limited quantities of coca to supply traditional users and helped them gain secure title to their land. This registration is combined with satellite surveillance to guarantee that farmers do not exceed limits established by law. To date, the programme's reach is incomplete and coca is still diverted to the drug trade. Nonetheless, the approach may offer lessons for other drug producer countries, particularly where strong socio-political organizations are found in combination with closeknit communities holding shared cultural values.

  3. Experiences in the provision, fitting and supply of external breast prostheses: findings from a national survey.

    PubMed

    Gallagher, P; Buckmaster, A; O'Carroll, S; Kiernan, G; Geraghty, J

    2009-11-01

    A good-quality external breast prosthesis and prosthesis-fitting service is integral to recovery post-mastectomy. However, this area of care has minimal information or research available. The aim of this study was to investigate women's experience of the provision, fitting, supply and use of breast prostheses in Ireland. Three national surveys were undertaken with women (n = 527), breast care nurses (BCNs) (n = 32) and retail prosthesis fitters (n = 12). The findings identified the importance of the prosthesis for shape, appearance to self, appearance to others, sense of well-being, self-confidence and femininity. Dissatisfaction with weight, comfort and movement of the prosthesis was identified. Cost and travel distance were found to influence the replacement of the prosthesis. Dissatisfaction emerged with the display and choice of products, and brochure availability at the prosthesis fitting. Women preferred to be fitted for the first silicone prosthesis by a BCN in a hospital setting whereas for the replacement prosthesis they preferred a trained fitter at a specialized prosthesis supplier. BCNs and retail fitters identified the need for service guidelines and increased availability of professional development opportunities in prosthesis-fitting. These findings contributed to the development of standards of care for breast prosthesis-fitting services to benefit women and to provide guidelines for those providing the service.

  4. Care assistant experiences of dementia care in long-term nursing and residential care environments.

    PubMed

    Talbot, Rebecca; Brewer, Gayle

    2016-11-01

    Care assistants have a unique insight into the lives of service users and those factors which may impede or enhance the delivery of high quality dementia oriented care. To address the paucity of research in this area, the present study examined care assistant experiences of dementia care in British long-term residential and nursing environments. Semi-structured interviews were conducted with eight care assistants and transcripts were analysed using interpretive phenomenological analysis. Super-ordinate themes emerging from the data were psychological wellbeing of the care assistant, barriers to effective dementia care, the dementia reality and organisational issues within the care environment. The study revealed important deficiencies in understanding and varying levels of dementia training. Whilst person centred strategies were being implemented, task orientated care remained dominant. Furthermore, care assistants reported taking the perspectives of those with dementia into account, and actively using these to develop relationship centred care.

  5. Opinions and Experiences of Dental Students and Faculty Concerning Computer-Assisted Learning.

    ERIC Educational Resources Information Center

    Plasschaert, Alphons J. M.; And Others

    1995-01-01

    A study investigated the experiences and attitudes of students and faculty in three dental schools in England, Netherlands, and the United States concerning computer-assisted learning (CAL), including their access to computers at home and at school, experience with interactive multimedia, and familiarity with the technique. Implications for use of…

  6. Excipient-assisted vinpocetine nanoparticles: experiments and molecular dynamic simulations.

    PubMed

    Li, Cai-Xia; Wang, Hao-Bo; Oppong, Daniel; Wang, Jie-Xin; Chen, Jian-Feng; Le, Yuan

    2014-11-03

    Hydrophilic excipients can be used to increase the solubility and bioavailability of poorly soluble drugs. In this work, the conventional water-soluble pharmaceutical excipients hydroxypropylmethylcellulose (HPMC), polyvinylpyrrolidone (PVP), and lactose (LAC) were used as solid supports to prevent drug nanoparticles from aggregation and enhance drug dissolution. Excipient-assisted vinpocetine (VIN) nanoparticles were prepared by reactive precipitation. The analysis results indicated that HPMC was a suitable excipient to prepare VIN nanoparticles. VIN/HPMC nanoparticles had a mean size of 130 nm within a narrow distribution. The dissolution rate of VIN nanoparticles was significantly faster than those of a physical mixture of VIN/HPMC and raw VIN. VIN/HPMC nanoparticles had a higher dissolution profile than VIN/PVP and VIN/LAC nanoparticles. Besides, molecular dynamics (MD) simulation was applied to investigate the molecular interactions between VIN and excipients. The calculated results revealed that VIN interacted with excipients by Coulomb and Lennard-Jones (LJ) interactions. Few hydrogen bonds were formed between VIN and excipients. The HPMC affording smaller particle size may be a result of the stronger interactions between VIN and HPMC (mainly LJ interaction) and the property of HPMC. These characteristics may greatly influence the adsorption behavior and may be the crucial parameter for the better performance of HPMC.

  7. Results in Assisted Peritoneal Dialysis: A Ten-Year Experience

    PubMed Central

    Querido, Sara; Branco, Patrícia Quadros; Costa, Elisabete; Pereira, Sara; Gaspar, Maria Augusta; Barata, José Diogo

    2015-01-01

    Background/Aims. Peritoneal dialysis is a successful renal replacement therapy (RRT) for old and dependent patients. We evaluated the clinical outcomes of an assisted peritoneal dialysis (aPD) program developed in a Portuguese center. Methods. Retrospective study based on 200 adult incident patients admitted during ten years to a PD program. We included all 17 patients who were under aPD and analysed various parameters, including complications with the technique, hospitalizations, and patient and technique survival. Results. The global peritonitis rate was lower in helped than in nonhelped patients: 0.4 versus 0.59 episodes/patient/year. The global hospitalization rate was higher in helped than in nonhelped patients: 0.67 versus 0.45 episodes/patient/year (p = NS). Technique survival in helped patients versus nonhelped patients was 92.3%, 92.3%, 83.1%, and 72.7% versus 91.9%, 81.7%, and 72.1%, and 68.3%, at 1, 2, 3, and 4 years, respectively (p = NS), and patient survival in helped patients versus nonhelped patients was 93.3%, 93.3%, 93.3%, and 74.7% versus 95.9% 93.7%, 89%, and 82% at 1, 2, 3, and 4 years, respectively (p = NS). Conclusions. aPD offers an opportune, reliable, and effective home care alternative for patients with no other RRT options. PMID:26600950

  8. Married Couples in Assisted Living: Adult Children's Experiences Providing Support

    ERIC Educational Resources Information Center

    Kemp, Candace L.

    2012-01-01

    Being married in later life often prevents relocation to long-term care settings, but couples do relocate to these environments. Typically, this transition does not mark the end of support provided by families, especially adult children. Little is known about children's experiences providing support in care settings when both parents are involved.…

  9. Married Couples in Assisted Living: Adult Children's Experiences Providing Support

    ERIC Educational Resources Information Center

    Kemp, Candace L.

    2012-01-01

    Being married in later life often prevents relocation to long-term care settings, but couples do relocate to these environments. Typically, this transition does not mark the end of support provided by families, especially adult children. Little is known about children's experiences providing support in care settings when both parents are involved.…

  10. Computer-Assisted Experiments with a Laser Diode

    ERIC Educational Resources Information Center

    Kraftmakher, Yaakov

    2011-01-01

    A laser diode from an inexpensive laser pen (laser pointer) is used in simple experiments. The radiant output power and efficiency of the laser are measured, and polarization of the light beam is shown. The "h/e" ratio is available from the threshold of spontaneous emission. The lasing threshold is found using several methods. With a…

  11. Computer-Assisted Experiments with a Laser Diode

    ERIC Educational Resources Information Center

    Kraftmakher, Yaakov

    2011-01-01

    A laser diode from an inexpensive laser pen (laser pointer) is used in simple experiments. The radiant output power and efficiency of the laser are measured, and polarization of the light beam is shown. The "h/e" ratio is available from the threshold of spontaneous emission. The lasing threshold is found using several methods. With a…

  12. Exploring the experience of clients with tetraplegia utilizing assistive technology for computer access.

    PubMed

    Folan, Alyce; Barclay, Linda; Cooper, Cathy; Robinson, Merren

    2015-01-01

    Assistive technology for computer access can be used to facilitate people with a spinal cord injury to utilize mainstream computer applications, thereby enabling participation in a variety of meaningful occupations. The aim of this study was to gain an understanding of the experiences of clients with tetraplegia trialing assistive technologies for computer access during different stages in a public rehabilitation service. In order to explore the experiences of clients with tetraplegia trialing assistive technologies for computer use, qualitative methodology was selected. Data were collected from seven participants using semi-structured interviews, which were audio-taped, transcribed and analyzed thematically. Three main themes were identified. These were: getting back into life, assisting in adjusting to injury and learning new skills. The findings from this study demonstrated that people with tetraplegia can be assisted to return to previous life roles or engage in new roles, through developing skills in the use of assistive technology for computer access. Being able to use computers for meaningful activities contributed to the participants gaining an enhanced sense of self-efficacy, and thereby quality of life. Implications for Rehabilitation Findings from this pilot study indicate that people with tetraplegia can be assisted to return to previous life roles, and develop new roles that have meaning to them through the use of assistive technologies for computer use. Being able to use the internet to socialize, and complete daily tasks, contributed to the participants gaining a sense of control over their lives. Early introduction to assistive technology is important to ensure sufficient time for newly injured people to feel comfortable enough with the assistive technology to use the computers productively by the time of discharge. Further research into this important and expanding area is indicated.

  13. Reoperations following Robot-Assisted Radical Cystectomy: A Decade of Experience.

    PubMed

    Hussein, Ahmed A; Hashmi, Zishan; Dibaj, Seyedeh; Altartir, Tareq; Fiorica, Thomas; Wing, Joseph; Durrani, Mohammad; Binkowski, John; Boateng, Lesley; Wilding, Gregory; Guru, Khurshid A

    2016-05-01

    There is a paucity of data regarding the operative management of complications after robot-assisted radical cystectomy. We reviewed operative management of robot-assisted radical cystectomy specific complications during our 10-year experience with this procedure and assessed the feasibility, safety and outcomes of robot-assisted reoperations. We retrospectively reviewed the records of all patients who underwent surgical interventions for robot-assisted radical cystectomy specific complications between 2005 and 2015. Univariable and multivariable logistic regression models were fit to evaluate predictors of surgical intervention after robot-assisted radical cystectomy. Kaplan-Meier curves were used to describe time to surgical interventions. A total of 92 patients (23%) underwent surgical intervention after robot-assisted radical cystectomy. Mean followup was 27 months. Average time to any surgical intervention after cystectomy was 14 months. The reoperation rate was 5%, 2% and 16% at 30, 31 to 90 and greater than 90 days, respectively. Using the Kaplan-Meier method surgical interventions occurred at a rate of 30% at 2 years and 46% at 5 years. Interventions for ureteroileal complications were the most common (48 cases) followed by interventions for bowel obstruction, fistulas and abdominal wall related complications (11 cases). Clavien 3 or greater complications and neoadjuvant chemotherapy were associated with surgical intervention. Even in experienced hands the long-term complications of robot-assisted radical cystectomy are notable. Of our patients 23% required surgical interventions after the procedure. Our initial experience with robot-assisted management of robot-assisted radical cystectomy complications appears safe and feasible, although the decision to proceed is determined primarily by surgeon experience. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Using assistive technology for schoolwork: the experience of children with physical disabilities.

    PubMed

    Murchland, Sonya; Parkyn, Helen

    2010-01-01

    This study explored the experience of children with physical disabilities using assistive technology for participation with schoolwork to gain a greater understanding of their perspectives and subjective experiences. A qualitative study involving thematic analysis of in-depth interviews of the child with a parent or significant adult. Purposeful sampling from a larger study recruited five children aged between 10 and 14 years, with differing physical disabilities who attended mainstream schools. All children used computer-based assistive technology. All of the children recognised that assistive technology enabled them to participate and reduced the impact of their physical disability, allowing independent participation, and facilitated higher learning outcomes. Issues related to ease of use, social implications and assistive technology systems are discussed.

  15. Hand-assisted laparoscopic live donor nephrectomy (right-sided approach): experience obtained from 31 cases.

    PubMed

    Maciel, R F

    2007-10-01

    The removal of a donor kidney by laparoscopic nephrectomy is a safe method that is widely used, mainly in left donor nephrectomy. However, for right donor nephrectomy where the right renal vein is short, open surgery has been more frequently described in the literature. Our objective was to describe our experience with 31 renal transplantations using 2 different techniques in right donor nephrectomy. In the period ranging from February 2002 to June 2005, we performed, 31 hand-assisted laparoscopic right donor nephrectomies. Twenty-five were performed by the method where the assistant used his hand to assist the surgery and 6 were by the laparoscopic method assisted by the first surgeon. The right donor nephrectomies assisted either by the hand of the assistant or the surgeon showed similar results. All recipients displayed diuresis in the immediate postoperative period. The serum creatinine level at 1 week after transplantation was 1.90 mg/dL (+/-1.55). Although the handling techniques are similar, we concluded that laparoscopic nephrectomy assisted by the surgeon is more adequate for right kidney extraction. It can be performed either by a resident doctor or a surgeon of the transplantation team, with or without experience in nephrectomy for transplantation.

  16. Paradox of Modern Pregnancy: A Phenomenological Study of Women's Lived Experiences from Assisted Pregnancy

    PubMed Central

    Ranjbar, Fahimeh; Akhondi, Mohammad-Mehdi; Borimnejad, Leili; Ghaffari, Saeed-Reza; Behboodi-Moghadam, Zahra

    2015-01-01

    The purpose of our study was describing the meaning of pregnancy through Assisted Reproductive Technologies (ARTs). A qualitative design with hermeneutic phenomenology approach was selected to carry out the research. Semistructured in-depth interviews were conducted with 12 women who experienced assisted pregnancy. Three themes emerged from women's experience including finding peace in life, paradoxical feelings, and struggling to realize a dream. We concluded that pregnancy is the beginning of a new and hard struggle for women with fertility problems. The findings of our study resulted in helpful implications for the health care professionals managing assisted pregnancies. PMID:26064687

  17. System redesign of the immunization supply chain: Experiences from Benin and Mozambique.

    PubMed

    Prosser, Wendy; Jaillard, Philippe; Assy, Emmanuelle; Brown, Shawn T; Matsinhe, Graça; Dekoun, Mawutondji; Lee, Bruce Y

    2017-04-19

    Evidence suggests that immunization supply chains are becoming outdated and unable to deliver needed vaccines due to growing populations and new vaccine introductions. Redesigning a supply chain could result in meeting current demands. The Ministries of Health in Benin in Mozambique recognized known barriers to the immunization supply chain and undertook a system redesign to address those barriers. Changes were made to introduce an informed push system while consolidating storage points, introducing transport loops, and increasing human resource capacity for distribution. Evaluations were completed in each country. Evaluation in each country indicated improved performance of the supply chain. The Effective Vaccine Management (EVM) assessment in Benin documented notable improvements in the distribution criteria of the tool, increasing from 40% to 100% at the district level. In Mozambique, results showed reduced stockouts at health facility level from 79% at baseline to less than 1% at endline. Coverage rates of DTP3 also increased from 68.9% to 92.8%. Benin and Mozambique are undertaking system redesign in order to respond to constraints identified in the vaccine supply chain. Results and learnings show improvements in supply chain performance and make a strong case for system redesign. These countries demonstrate the feasibility of system redesign for other countries considering how to address outdated supply chains. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  18. Left ventricular assist device exchange: the Toronto General Hospital experience.

    PubMed

    Tsubota, Hideki; Ribeiro, Roberto V P; Billia, Filio; Cusimano, Robert J; Yau, Terrence M; Badiwala, Mitesh V; Stansfield, William E; Rao, Vivek

    2017-08-01

    As support times for left ventricular assist devices (LVADs) become longer, several complications requiring device exchange may occur. To our knowledge, this is the first Canadian report regarding implantable LVAD exchange. We retrospectively reviewed the cases of consecutive, unique patients implanted with an LVAD between June 2006 and October 2015 at Toronto General Hospital. In total, 122 patients were impanted with an LVAD during the study period. Eight patients required LVAD exchange, and 1 patient had 2 replacements (9 of 122, 7.3%). There were 7 HeartMate II (HMII), 1 HVAD and 1 DuraHeart pumps exchanged. Two of these exchanges occurred early at the time of initial implant, whereas 7 occurred late (range 8-623 d). Six exchanges were made owing to pump thrombosis. Of the 3 exchanges made for other causes, 1 HMII exchange was owing to a driveline fracture, 1 DuraHeart patient had early inflow obstruction requiring exchange to HMII at the initial implant, and the third had a suspected inflow obstruction with no evidence of thrombosis at the time of the procedure. The mean support time before exchange was 225 days, and time from exchange to transplant, death or ongoing support was 245 days. Three patients were successfully bridged to transplant, and at the time of data collection 2 were supported awaiting transplant. Three patients died after a mean duration of 394.3 days (range 78-673 d) of support postreplacement. Four cases were successfully performed using a subcostal approach. Pump thrombosis is the most common cause for LVAD exchange, which can be performed with acceptable morbidity and mortality. The subcostal approach may be the preferred procedure for an HMII exchange when indicated.

  19. Video-assisted cardiac surgery: 6 years of experience.

    PubMed

    Fortunato Júnior, Jeronimo Antonio; Pereira, Marcelo Luiz; Martins, André Luiz M; Pereira, Daniele de Souza C; Paz, Maria Evangelista; Paludo, Luciana; Branco Filho, Alcides; Milosewich, Branka

    2012-01-01

    Minimally invasive and video-assisted cardiac surgery (VACS) has increased in popularity over the past 15 years. The small incisions have been associated with a good aesthetic effect and less surgical trauma, therefore less postoperative pain and rapid recovery. To present our series with VACS, after 6 years of use of the method. 136 patients underwent VACS, after written consent, between September 2005 and October 2011, 50% for men and age of 47.8 ± 15, 4 anos, divided into two groups: with cardiopulmonary (CEC) (GcCEC=105 patients): mitral valve disease (47/105), aortic disease (39/105), congenital heart disease (19/105) and without extracorporeal circulation (CEC) (GsCEC=31 patients): cardiac resynchronization (18/ 31), cardiac tumor (4/31) and minimally invasive coronary artery bypass grafting (6/31). GcCEC was held in right minithoracotomy (3 to 5 cm) and femoral access to perform cannulation. In GcCEC, mean length of ICU stay and hospital stay were respectively 2.4 ± 4.5 days and 5.0 ± 6.8 days. Twelve patients presented complications in post-operative and five (4.8%) death. Ninety-three (88.6%) patients evolved uneventful, were extubated in operating room, and remained a mean of 1.8 ± 0.9 days in ICU and 3.6 ± 1.3 days in the hospital. In GsCEC, were mean 1.3 ± 0.7 days in ICU and 2.9 ± 1.4 days in hospital and without complications or deaths. The results found in this series are comparable to those of world literature and confirm the method as an option the conventional technique.

  20. Computer-generated ovaries to assist follicle counting experiments.

    PubMed

    Skodras, Angelos; Marcelli, Gianluca

    2015-01-01

    Precise estimation of the number of follicles in ovaries is of key importance in the field of reproductive biology, both from a developmental point of view, where follicle numbers are determined at specific time points, as well as from a therapeutic perspective, determining the adverse effects of environmental toxins and cancer chemotherapeutics on the reproductive system. The two main factors affecting follicle number estimates are the sampling method and the variation in follicle numbers within animals of the same strain, due to biological variability. This study aims at assessing the effect of these two factors, when estimating ovarian follicle numbers of neonatal mice. We developed computer algorithms, which generate models of neonatal mouse ovaries (simulated ovaries), with characteristics derived from experimental measurements already available in the published literature. The simulated ovaries are used to reproduce in-silico counting experiments based on unbiased stereological techniques; the proposed approach provides the necessary number of ovaries and sampling frequency to be used in the experiments given a specific biological variability and a desirable degree of accuracy. The simulated ovary is a novel, versatile tool which can be used in the planning phase of experiments to estimate the expected number of animals and workload, ensuring appropriate statistical power of the resulting measurements. Moreover, the idea of the simulated ovary can be applied to other organs made up of large numbers of individual functional units.

  1. Power Supply System for the Atlas Experiment: Design Specifications, Implementation, Test and First Results

    NASA Astrophysics Data System (ADS)

    Lazzaroni, M.; Citterio, M.; Latorre, S.; Lanza, A.; Cova, P.; Delmonte, N.; Giuliani, F.

    2014-06-01

    The planned upgrade of instrumentation sensitivity in the ATLAS experiment of the Large Hadron Collider (LHC), at CERN, calls for a new type of power distribution architecture. Moreover, power supplies require DC-DC power converters able to work in very hostile environment and maintaining high level of Reliability, Availability, Maintainability and Safety (denoted as RAMS requirements) during the experimental activity. Two main issues need to be discussed: first, electronic devices and equipment must operate in very high background of both charged and neutral particles and high static magnetic field and, second, the increase of the radiation background and the requirements of new front-end electronics are indeed incompatible with the current capability of the actual distribution system. The APOLLO R&D collaboration, funded by the Italian Istituto Nazionale di Fisica Nucleare (INFN), aims to study dedicated topologies of both distribution system and DC-DC power converters and to design, build and test demonstrators, developing the needed technology for the industrialization phase. The collaboration has designed a 3kW, 280V-12V converter (MC) based on the Switch in Line architecture (SIL), a DC to DC phase-shifted converter characterized by a disposition in line of the MOSFETs with good soft switching performances, and in the last year many steps have been taken to enhance the power dissipation and the reliability and to improve the general features of the designed converter. In particular a new water heat sink was designed on the basis of TFD simulation accounting for the layout of the specific converter. Experimental activities in order to characterize both thermal and electrical features of the MC confirm the correctness of the adopted design criteria.

  2. Startup experience with the MFTF-B ECRH 100 kV dc power supply

    SciTech Connect

    Bishop, S.R.; Goodman, R.A.; Wilson, J.H.

    1983-11-30

    One of the 24 Accel dc Power Supplies (ADCPS) originally intended for the Mirror Fusion Test Facility (MFTF-B) Neutral Beam Power Supply (NBPS) System has been converted to provide negative polarity output at 90 kV with a load current of 64 A dc. The load duty cycle is a pulse of 30-seconds duration with a pulse repetition period of five minutes. A new control system has been built which will serve as a prototype for the MFTF-B ADCPS controls, and a test setup was built which will be used to test the ADCPS. The Electron Cyclotron Resonance Heating (ECRH) dc Power Supply (DCPS) has been tested under both no-load and dummy-load conditions, under remote control, without notable problems. Test results indicate that the power supply should be reliable and safe to operate, and will meet the load duty requirements.

  3. Interprofessional educational experience to assist in student readiness toward neurorehabilitation.

    PubMed

    Bondoc, Salvador; Wall, Tracy

    2015-04-01

    Occupational and physical therapy professionals are natural partners in neurorehabilitation especially in the acute stages of recovery. To enhance student-learning experiences from both disciplines, we have developed an interprofessional (IP) learning unit that was embedded in neurorehabilitation tracks of each respective program. The primary goal of this project was to examine interprofessional attitudes and perception toward interprofessional learning and practice. A total of 117 occupational therapy (53) and physical therapy (64) students completed an IP case-based learning module with the goal of developing an IP care plan typically seen in neurorehabilitation. Using a sequential explanatory mixed methods design, we collected data pre- and postintervention using the Readiness for Interprofessional Learning Survey (RIPLS). We also utilized a postintervention questionnaire and focus groups intended to solicit information regarding IP competencies. At pretest, students had high ratings on the RIPLS that led to minimal changes at posttest (p = .157). However, common threads from the questionnaire and focus groups showed positive effects on student learning and attitudes toward interprofessionalism. Students reported positive experiences with the IP module. An IP case-based educational module has the potential to facilitate professional development and readiness for future IP practice. Students from different disciplines appreciate the value of IP education (IPE) in reinforcing their professional identity and understanding the professional contributions of others. Our findings are consistent with literature on best practices for IPE.

  4. System-level considerations for the front-end readout ASIC in the CBM experiment from the power supply perspective

    NASA Astrophysics Data System (ADS)

    Kasinski, K.; Koczon, P.; Ayet, S.; Löchner, S.; Schmidt, C. J.

    2017-03-01

    New fixed target experiments using high intensity beams with energy up to 10 AGeV from the SIS100 synchrotron presently being constructed at FAIR/GSI are under preparation. Most of the readout electronics and power supplies are expected to be exposed to a very high flux of nuclear reaction products and have to be radiation tolerant up to 3 MRad (TID) and sustain up to 1014/cm2 of 1 MeV neutron equivalent in their life time. Moreover, the mostly minimum ionising particles under investigation leave very little signal in the sensors. Therefore very low noise level amplitude measurements are required by the front-end electronics for effective tracking. Sensor and interconnecting micro-cable capacitance and series resistance in conjunction with intrinsic noise of the charge sensitive amplifier are dominant noise sources in the system. However, the single-ended architecture of the amplifiers employed for the charge processing channels implies a potential problem with noise contributions from power supply sources. Strict system-level constraints leave very little freedom in selecting a power supply structure optimal with respect to: power efficiency, cooling capabilities and power density on modules, but also noise injection to the front-end via the power supply lines. Design of the power supply and distribution system of the Silicon Tracking System in the CBM experiment together with details on the front-end ASICs (STS -XYTER2) and measurement results of power supply and conditioning electronics (selected DC/DC converter and LDO regulators) are presented.

  5. Design and experiment on a multi-functioned and programmable piezoelectric ceramic power supply with high precision for speckle interferometry

    NASA Astrophysics Data System (ADS)

    Wang, Biao; Ye, Yan; Wang, Yong-hong; Yang, En-zhen

    2016-01-01

    Speckle interferometry is a method of measuring structure's tiny deformations which requires accurate phase information of interference fringes. The phase information is acquired by micro-displacement produced by piezoelectric ceramic (PZT). In order to drive the PZT micro-displacement actuator, a multi-functioned and programmable PZT power supply with high precision is designed. Calibration experiment has been done to the PZT micro-actuator in speckle interferometry. Some experiments were also done to test its relevant characteristics. The experiment results show that it has high linearity, repeatability, stability, low ripple and can meet the requirement of the reliability and displacement accuracy in speckle interferometry.

  6. Laparoscopic robotic-assisted gastrointestinal surgery: the Geneva experience.

    PubMed

    Soravia, Claudio; Schwieger, Ian; Witzig, Jacques-Alain; Wassmer, Frank-Alain; Vedrenne, Thierry; Sutter, Pierre; Dufour, Jean-Philippe; Racloz, Yves

    2008-01-01

    The continuing development of robotic surgery supports its use in laparoscopic gastrointestinal surgery. Our study retrospectively reviewed the surgical outcome and patient's satisfaction of gastrointestinal laparoscopic robotic procedures. From January 2003 to September 2007, 94 patients (27 women, 67 men) with a mean age of 53 years (range 19-84 years) underwent laparoscopic surgery with a da Vinci robotic system. There were 40 colorectal cases (43%), 31 anti-reflux surgery cases (33%) and 14 obesity surgery cases (15%); the remaining cases consisted of gastric and gallbladder surgery, intra-abdominal tumour excisions, and hepatic cyst resections. The majority of the cases (88, 94%) were performed for benign disease. The mean operative time was 153 min (range 60-330 min). One patient needed a blood transfusion. The mean body mass index was 25 (range 16-47). No death occurred. Five cases (5.3%) were converted to conventional laparoscopic surgery (n = 3) or to laparotomy (n = 2). Morbidity consisted of one Nissen redo surgery to loosen a tight anti-reflux valve 6 days after robotic surgery, a robotic left ureter repair and pelvic haemorrhage following proctectomy requiring re-operation to control haemostasis and to remove pelvic haematoma. Mean follow-up time was 11 months (range 15 days to 34 months). One case of incisional trocar hernia needed re-operation. Overall patient's satisfaction was high: few scars were cheloïd, while functional surgical outcome was rated high by most of the patients. Our preliminary experience was encouraging, with minimal morbidity and very high acceptance by patients.

  7. Machine-learning-assisted materials discovery using failed experiments

    NASA Astrophysics Data System (ADS)

    Raccuglia, Paul; Elbert, Katherine C.; Adler, Philip D. F.; Falk, Casey; Wenny, Malia B.; Mollo, Aurelio; Zeller, Matthias; Friedler, Sorelle A.; Schrier, Joshua; Norquist, Alexander J.

    2016-05-01

    Inorganic-organic hybrid materials such as organically templated metal oxides, metal-organic frameworks (MOFs) and organohalide perovskites have been studied for decades, and hydrothermal and (non-aqueous) solvothermal syntheses have produced thousands of new materials that collectively contain nearly all the metals in the periodic table. Nevertheless, the formation of these compounds is not fully understood, and development of new compounds relies primarily on exploratory syntheses. Simulation- and data-driven approaches (promoted by efforts such as the Materials Genome Initiative) provide an alternative to experimental trial-and-error. Three major strategies are: simulation-based predictions of physical properties (for example, charge mobility, photovoltaic properties, gas adsorption capacity or lithium-ion intercalation) to identify promising target candidates for synthetic efforts; determination of the structure-property relationship from large bodies of experimental data, enabled by integration with high-throughput synthesis and measurement tools; and clustering on the basis of similar crystallographic structure (for example, zeolite structure classification or gas adsorption properties). Here we demonstrate an alternative approach that uses machine-learning algorithms trained on reaction data to predict reaction outcomes for the crystallization of templated vanadium selenites. We used information on ‘dark’ reactions—failed or unsuccessful hydrothermal syntheses—collected from archived laboratory notebooks from our laboratory, and added physicochemical property descriptions to the raw notebook information using cheminformatics techniques. We used the resulting data to train a machine-learning model to predict reaction success. When carrying out hydrothermal synthesis experiments using previously untested, commercially available organic building blocks, our machine-learning model outperformed traditional human strategies, and successfully predicted

  8. Machine-learning-assisted materials discovery using failed experiments.

    PubMed

    Raccuglia, Paul; Elbert, Katherine C; Adler, Philip D F; Falk, Casey; Wenny, Malia B; Mollo, Aurelio; Zeller, Matthias; Friedler, Sorelle A; Schrier, Joshua; Norquist, Alexander J

    2016-05-05

    Inorganic-organic hybrid materials such as organically templated metal oxides, metal-organic frameworks (MOFs) and organohalide perovskites have been studied for decades, and hydrothermal and (non-aqueous) solvothermal syntheses have produced thousands of new materials that collectively contain nearly all the metals in the periodic table. Nevertheless, the formation of these compounds is not fully understood, and development of new compounds relies primarily on exploratory syntheses. Simulation- and data-driven approaches (promoted by efforts such as the Materials Genome Initiative) provide an alternative to experimental trial-and-error. Three major strategies are: simulation-based predictions of physical properties (for example, charge mobility, photovoltaic properties, gas adsorption capacity or lithium-ion intercalation) to identify promising target candidates for synthetic efforts; determination of the structure-property relationship from large bodies of experimental data, enabled by integration with high-throughput synthesis and measurement tools; and clustering on the basis of similar crystallographic structure (for example, zeolite structure classification or gas adsorption properties). Here we demonstrate an alternative approach that uses machine-learning algorithms trained on reaction data to predict reaction outcomes for the crystallization of templated vanadium selenites. We used information on 'dark' reactions--failed or unsuccessful hydrothermal syntheses--collected from archived laboratory notebooks from our laboratory, and added physicochemical property descriptions to the raw notebook information using cheminformatics techniques. We used the resulting data to train a machine-learning model to predict reaction success. When carrying out hydrothermal synthesis experiments using previously untested, commercially available organic building blocks, our machine-learning model outperformed traditional human strategies, and successfully predicted conditions

  9. The Undergraduate Teaching Assistant Experience Offers Opportunities Similar to the Undergraduate Research Experience†

    PubMed Central

    Schalk, Kelly A.; McGinnis, J. Randy; Harring, Jeffrey R.; Hendrickson, Amy; Smith, Ann C.

    2009-01-01

    There has been a growing concern in higher education about our failure to produce scientifically trained workers and scientifically literate citizens. Active-learning and research-oriented activities are posited as ways to give students a deeper understanding of science. We report on an undergraduate teaching assistant (UTA) experience and suggest that students who participate as a UTA obtain benefits analogous to those who participate as an undergraduate research assistant (URA). We examined the experiences of 24 undergraduates acting as UTAs in a general microbiology course. Self-reported gains by the UTAs were supported by observational data from undergraduates in the course who were mentored by the UTAs and by the graduate teaching assistants (GTAs) with whom the UTAs worked. Specifically, data from the UTAs’ journals and self-reported Likert scales and rubrics indicated that our teaching assistants developed professional characteristics such as self-confidence and communication and leadership skills, while they acquired knowledge of microbiology content and laboratory skills. Data from the undergraduate Likert scale as well as the pre- and post-GTA rubrics further confirmed our UTA’s data interpretations. These findings are significant because they offer empirical data to support the suggestion that the UTA experience is an effective option for developing skills and knowledge in undergraduates that are essential for careers in science. The UTA experience provides a valuable alternative to the URA experience. PMID:23653688

  10. Dental assisting experience as a predictor of dental hygiene academic performance.

    PubMed

    DeAngelis, S; Goral, V

    1995-01-01

    Selecting dental hygiene students who ultimately will be successful in their formal education and board examinations is critical to dental hygiene education and the profession. This study examined prior dental assisting experience as a predictor of performance during dental hygiene education as well as on licensure examinations. The study included all 132 female students who graduated from the University of Arkansas for Medical Sciences, Department of Dental Hygiene, from 1989 through 1993. The prior assisting group (n = 43) consisted of students with at least six months of dental assisting experience as reported by the student and/or previous dentist employers. The nonassisting group (n = 89) had no dental assisting experience prior to admission. Student records were used to compile evaluative data for each subject including: prerequisite college science grade-point average (GPA); dental hygiene GPA at the end of the first year of the program; dental hygiene GPA at the end of the second year; combined GPA for the three semesters of clinical dental hygiene coursework; quality points for specific dental hygiene courses including preclinical dental hygiene instrumentation, dental hygiene clinic I, dental anatomy, and dental materials; and National Board Dental Hygiene Examination Scores and performance on the Southern Regional Board Examination. Student's t-test analysis was used to compare the prerequisite college science GPA for the assisting and nonassisting groups. Multivariate analysis was used for all other measures of comparison. Student's t-test analysis revealed no significant differences in terms of the prerequisite college science GPA as a control for this extraneous variable. The results of multivariate analysis demonstrated that the prior dental assisting group had significantly higher cumulative clinic GPAs as well as clinic I quality points. No significant differences were noted in first-year GPA, cumulative program GPA, dental materials, preclinical

  11. Teaching Assistants' Preparation for, Attitudes towards, and Experiences with Academic Dishonesty: Lessons Learned

    ERIC Educational Resources Information Center

    Seals, Michael; Hammons, James O.; Mamiseishvili, Ketevan

    2014-01-01

    This study examined teaching assistants' (TAs) preparation for, attitudes towards, and experiences with academic dishonesty at a public research university. Of 470 TAs, 184 (39%) completed the survey instrument. The major findings of the study were: (a) TAs were more satisfied with their informal than their formal preparation for dealing with…

  12. Creating Meaningful Art Experiences with Assistive Technology for Students with Physical, Visual, Severe, and Multiple Disabilities

    ERIC Educational Resources Information Center

    Coleman, Mari Beth; Cramer, Elizabeth Stephanie

    2015-01-01

    Various levels of assistive technology can be used in the art classroom to provide a fulfilling artmaking experience for all levels of learners. The purpose of this article is to add to the body of knowledge by providing ideas generated from collaboration between the fields of special education and art education that the authors feel will benefit…

  13. International Teaching Assistants' Experiences in the U.S. Classrooms: Implications for Practice

    ERIC Educational Resources Information Center

    Ashavskaya, Ekaterina

    2015-01-01

    Recently, a number of studies have examined the lived experiences of the international teaching assistants (ITAs) in the U.S. classrooms. The findings show that the ITAs face many challenges such as classroom management, instructional, linguistic, cultural and social challenges. Following this line of research, this interview-based study examined…

  14. An Experiment on Mathematics Pedagogy: Traditional Method versus Computer-Assisted Instruction

    ERIC Educational Resources Information Center

    Zhang, Yixin

    2005-01-01

    The purpose of this study was to determine the effectiveness of computer-assisted instruction (CAI) versus traditional lecture-type instruction on triangles. Two quasi experiments were conducted in six 6th grade classes with a total of 108 students respectively. The students in the control groups were taught the concepts of triangles in their…

  15. Becoming Physics People: Development of Integrated Physics Identity through the Learning Assistant Experience

    ERIC Educational Resources Information Center

    Close, Eleanor W.; Conn, Jessica; Close, Hunter G.

    2016-01-01

    In this study, we analyze the experience of students in the Physics Learning Assistant (LA) program at Texas State University in terms of the existing theoretical frameworks of "community of practice" and "physics identity," and explore the implications suggested by these theories for LA program adoption and adaptation.…

  16. Assistant Principal Experiences that Contribute to Their Transformational Leadership Practices as New Principals

    ERIC Educational Resources Information Center

    DeVillier, Doug

    2009-01-01

    This qualitative research study used narrative inquiry to explore the assistant principal experiences that contribute to transformational leadership practices in new principals. Eight administrators, who were in their first or second year as a principal, participated in the study. The findings suggested that principals play an important role in…

  17. Robotically Assisted Gynecologic Surgery: 2-Year Experience in the French Foch Hospital

    PubMed Central

    Goetgheluck, Julie; Carbonnel, Marie; Ayoubi, Jean Marc

    2014-01-01

    Robotically assisted laparoscopic surgery has seen rapid expansion over the past few years and it constantly evolves with a progressive enlargement of its range of indications. In the present paper we would like to share our 2-year experience regarding the use of robotics in various laparoscopic procedures, including hysterectomy, myomectomy, adnexal surgery, and sacrocolpopexy. PMID:25593933

  18. The Impact of ICT on Work-Life Experiences among University Teaching Assistants

    ERIC Educational Resources Information Center

    Osterlund, Katherine; Robson, Karen

    2009-01-01

    Email is now commonplace in the university environment, but little research has addressed the impact of this technology on the work-life experiences of Teaching Assistants (TAs). These workers are of interest as they are typically responsible for most day-to-day, routine interaction with undergraduates, for ensuring students understand lectures…

  19. The Experiences of Teacher-Assistant Principals in Catholic Elementary Schools: Boundary Spanners and Player Managers

    ERIC Educational Resources Information Center

    Beltramo, J. Luciano

    2014-01-01

    This article presents a phenomenological study of teacher-assistant principals (teacher-APs) in Catholic elementary schools. Drawing from player manager and role theories, this article describes the lived experiences of these individuals, particularly how they perceive the benefits and constraints of their unique role in both faculty and…

  20. Collaboration Factors and Quality of Learning Experience on Interactive Mobile Assisted Social E-Learning

    ERIC Educational Resources Information Center

    Wang, Shengmei

    2014-01-01

    This study (n = 52) examined mobile assisted in-class course using collaborative learning theories over an 18-week semester in a college level course. A self-evaluation survey containing 50 closed-ended items with two open-ended questions about participants' collaboration experience through the mobile techs was conducted during the last week of…

  1. Becoming Physics People: Development of Integrated Physics Identity through the Learning Assistant Experience

    ERIC Educational Resources Information Center

    Close, Eleanor W.; Conn, Jessica; Close, Hunter G.

    2016-01-01

    In this study, we analyze the experience of students in the Physics Learning Assistant (LA) program at Texas State University in terms of the existing theoretical frameworks of "community of practice" and "physics identity," and explore the implications suggested by these theories for LA program adoption and adaptation.…

  2. The Impact of ICT on Work-Life Experiences among University Teaching Assistants

    ERIC Educational Resources Information Center

    Osterlund, Katherine; Robson, Karen

    2009-01-01

    Email is now commonplace in the university environment, but little research has addressed the impact of this technology on the work-life experiences of Teaching Assistants (TAs). These workers are of interest as they are typically responsible for most day-to-day, routine interaction with undergraduates, for ensuring students understand lectures…

  3. The Frustrated GTA: A Qualitative Investigation Identifying the Needs within the Graduate Teaching Assistant Experience.

    ERIC Educational Resources Information Center

    Worthen, Thomas K.

    This paper presents the results of a study to identify the specific needs graduate teaching assistants (GTAs) in speech communication have while teaching. Six GTAs completed a description of their experience as GTAs, maintained a day-by-day teaching log and participated in a group discussion. The paper uses a qualitative-phenomenological approach…

  4. Computer-Related Assistive Technology: Satisfaction and Experiences among Users with Disabilities

    ERIC Educational Resources Information Center

    Burton, Mary; Nieuwenhuijsen, Els R.; Epstein, Marcy J.

    2008-01-01

    Many people with disabilities use assistive technology devices (ATDs) for computer access. The specific focus of this exploratory study was (a) to assess the experiences, opinions, and satisfaction levels of 24 individuals with disabilities using computer-related ATDs; (b) to investigate their awareness of health risk factors related to computer…

  5. Supply and Demand for Improved Sanitation: Results from Randomized Pricing Experiments in Rural Tanzania.

    PubMed

    Peletz, Rachel; Cock-Esteb, Alicea; Ysenburg, Dorothea; Haji, Salim; Khush, Ranjiv; Dupas, Pascaline

    2017-06-20

    Improving access to sanitation is a global public health priority. Sufficient consumer demand is required for sanitation coverage to expand through private provision. To measure consumer demand for hygienic latrine platform products in rural Tanzania, we conducted a randomized, voucher-based real-money sales trial with 1638 households with unimproved latrines. We also evaluated multiple supply chain options to determine the costs of supplying latrine platform products to rural households. For concrete latrine SanPlats, 60% of households were willing to pay US$0.48 and 10% of households were willing to pay US$4.05, yet the average cost of supplying the SanPlat to households was US$7.51. Similarly, for plastic sanitary platforms, willingness-to-pay (WTP) dropped from almost 60% at a price of US$1.43 to 5% at a price of US$12.29, compared to an average supply cost of US$23.28. WTP was not significantly different between villages that had participated in the National Sanitation Campaign and those that had not. Randomized informational interventions, including hygiene data-sharing and peer-based exposure to latrine platform products, had minimal effects on WTP. In conclusion, current household demand for latrine platform products is too low to achieve national goals for improved sanitation coverage through fully commercial distribution.

  6. Drought and Water Supply. Implications of the Massachusetts Experience for Municipal Planning.

    ERIC Educational Resources Information Center

    Russell, Clifford S.; And Others

    This book uses the 1962-66 Massachusetts drought data as a base of information to build a planning model of water resources that is of interest to students and professionals involved with water management. Using a demand-supply ratio to measure the relative inadequacy of a given water system, the authors then project demand into the drought period…

  7. FERMI magnet power supplies: design strategies and five years of operational experience

    NASA Astrophysics Data System (ADS)

    Visintini, Roberto

    2015-05-01

    FERMI is the FEL-based light source in operation for external users since 2011 at the Elettra Research Center in Trieste, Italy. FERMI@Elettra is the name of the project for the construction and commissioning of this source. The design strategies adopted in the project had to consider the extremely close presence and the routine operation for users of the synchrotron-based source Elettra. There are more than 350 magnets and coils distributed along the linear accelerator, the two chains of undulators and the electron beam dump. Almost each magnetic element requires a dedicated DC power supply. Magnets, power supplies, and the connecting cables constitute a system, strongly interconnected with the remote control system, the machine and personnel safety system, and the infrastructure. All this has to fulfill the requirements from the particle physics specialists. We adopted a "systemic" approach in the design of new magnets and the re-use of the old ones, as well as the choice and the design of the associated power supplies. The commissioning of the systems started early 2010 and almost all magnet power supplies are in operation since then. During these 5 years, we introduced few minor upgrades and patches while the adopted solutions proved their soundness in terms of performance and reliability, causing very little downtime to the FERMI operations.

  8. Drought and Water Supply. Implications of the Massachusetts Experience for Municipal Planning.

    ERIC Educational Resources Information Center

    Russell, Clifford S.; And Others

    This book uses the 1962-66 Massachusetts drought data as a base of information to build a planning model of water resources that is of interest to students and professionals involved with water management. Using a demand-supply ratio to measure the relative inadequacy of a given water system, the authors then project demand into the drought period…

  9. Euthanasia and physician-assisted suicide: knowledge, attitudes and experiences of nurses in Andalusia (Spain).

    PubMed

    Tamayo-Velázquez, María-Isabel; Simón-Lorda, Pablo; Cruz-Piqueras, Maite

    2012-09-01

    The aim of this study is to assess the knowledge, attitudes and experiences of Spanish nurses in relation to euthanasia and physician-assisted suicide. In an online questionnaire completed by 390 nurses from Andalusia, 59.1% adequately identified a euthanasia situation and 64.1% a situation involving physician-assisted suicide. Around 69% were aware that both practices were illegal in Spain, while 21.4% had received requests for euthanasia and a further 7.8% for assisted suicide. A total of 22.6% believed that cases of euthanasia had occurred in Spain and 11.4% believed the same for assisted suicide. There was greater support (70%) for legalisation of euthanasia than for assisted suicide (65%), combined with a greater predisposition towards carrying out euthanasia (54%), if it were to be legalised, than participating in assisted suicide (47.3%). Nurses in Andalusia should be offered more education about issues pertaining to the end of life, and extensive research into this area should be undertaken.

  10. Personal care assistants' experiences of caring for people on home mechanical ventilation.

    PubMed

    Israelsson-Skogsberg, Åsa; Lindahl, Berit

    2017-03-01

    The aim of this study was to describe personal care assistants' (PCA) experiences of working with a ventilator-assisted person at home. Data were collected from fifteen audiotaped semistructured interviews with PCAs supporting a child or adult using home mechanical ventilation (HMV). Thirteen women and two men participated; their working experience with HMV users ranged from one to 17 years (median 6 years). Data were subjected to qualitative content analysis in an inductive and interpretive manner. Five categories emerged from the data: Being part of a complex work situation; Taking on a multidimensional responsibility; Caring carried out in someone's home; Creating boundaries in an environment with indistinct limits; and Being close to another's body and soul. The participants felt very close to the person they worked with, both physically and emotionally. They had a great responsibility and therefore a commensurate need for support, guidance and a well-functioning organisation around the HMV user. There is international consensus that advanced home care will continue to expand and personal care assistance is key in this development. We suggest that one way to move forward for PCAs working with HMV users is to create multiprofessional teams led by a key-person who coordinates the individual needs. More research is needed within this area from a broad perspective including the HMV-assisted persons, relatives, personal care assistants and management organisations. © 2016 Nordic College of Caring Science.

  11. Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study.

    PubMed

    Vedana, Kelly Graziani Giacchero; Magrini, Daniel Fernando; Miasso, Adriana Inocenti; Zanetti, Ana Carolina Guidorizzi; de Souza, Jacqueline; Borges, Tatiana Longo

    2017-08-01

    To understand emergency nursing experiences in assisting people with suicidal behavior. Grounded theory study with symbolic interactionism conducted in 2015 to 2016 in Brazil with 19 nurses. Assistance for people with suicidal behavior is critical, challenging, evokes different feelings and requires knowledge, skills and emotional control. Nurses did not feel prepared or supported, and identified recurrent gaps and problems. Nurses occupied a limited role, restricted to attending to physical needs. They predominantly manifested opposition, judgments and incomprehension about patients. This study presents key elements to be addressed in interventions and investigations regarding nursing support, training and supervision. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The First Korean Experience of Telemanipulative Robot-Assisted Laparoscopic Cholecystectomy Using the da Vinci System

    PubMed Central

    Kang, Chang Moo; Chi, Hoon Sang; Hyeung, Woo Jin; Kim, Kyung Sik; Choi, Jin Sub; Kim, Byong Ro

    2007-01-01

    With the advancement of laparoscopic instruments and computer sciences, complex surgical procedures are expected to be safely performed by robot assisted telemanipulative laparoscopic surgery. The da Vinci system (Intuitive Surgical, Mountain View, CA, USA) became available at the many surgical fields. The wrist like movements of the instrument's tip, as well as 3-dimensional vision, could be expected to facilitate more complex laparoscopic procedure. Here, we present the first Korean experience of da Vinci robotic assisted laparoscopic cholecystectomy and discuss the introduction and perspectives of this robotic system. PMID:17594166

  13. Experiences of Infertile Women Seeking Assisted Pregnancy in Iran: A Qualitative Study

    PubMed Central

    Ranjbar, Fahimeh; Behboodi-Moghadam, Zahra; Borimnejad, Leili; Ghaffari, Saeed Reza; Akhondi, Mohammad Mehdi

    2015-01-01

    Background: Assisted reproductive technologies (ARTs) are complicated and stressful techniques and the social and cultural norms are major obstacles against their use. Many qualitative studies have been done in the field of women’s experiences of infertility, but less is known about the experiences of infertile women seeking assisted pregnancy. The aim of this study was to understand and describe the experience of women who have used assisted reproductive technologies for their current pregnancy. Methods: This qualitative study was conducted based on a content analysis approach. With purposive sampling, 12 pregnant women who were using ART were recruited from Avicenna Fertility Center in Tehran. Women were selected purposefully and with maximum variation. Interviews were performed after a positive test of pregnancy and women were introduced to researchers in their first visit of pregnancy in the prenatal clinic. Interviews were recorded, transcribed verbatim and analyzed concurrently. Semi-structured interviews were coded, categorized and the themes were also identified. Results: Four main themes were uncovered which included struggle to achieve pregnancy, fear and uncertainty, escape from stigma and the pursuit to achieve husband satisfaction. Conclusion: It is essential for these women to be counseled and prepared by their health care providers after the use of ARTs. Distress can be reduced for infertile women seeking assisted pregnancy when they are prepared for possible failures, empowered to deal with stigma, and have their partners’ involvement in counseling sessions. PMID:27110521

  14. Staff experiences of providing maternity services in rural southern Tanzania – a focus on equipment, drug and supply issues

    PubMed Central

    2013-01-01

    Background The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Methods Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. Results The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result. Conclusions Inadequately stocked and equipped facilities compromise the health system’s ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions. PMID:23410228

  15. Staff experiences of providing maternity services in rural southern Tanzania - a focus on equipment, drug and supply issues.

    PubMed

    Penfold, Suzanne; Shamba, Donat; Hanson, Claudia; Jaribu, Jennie; Manzi, Fatuma; Marchant, Tanya; Tanner, Marcel; Ramsey, Kate; Schellenberg, David; Schellenberg, Joanna Armstrong

    2013-02-14

    The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result. Inadequately stocked and equipped facilities compromise the health system's ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions.

  16. PDA-assisted simulated clinical experiences in undergraduate nursing education: a pilot study.

    PubMed

    Schlairet, Maura C

    2012-01-01

    Descriptive literature on use of personal digital assistants (PDAs) in nursing education exists; but, quantitative outcome-driven studies of efficacy are lacking. Few studies have explored the integration of technologies like simulated clinical experiences (SCEs) with informatics competencies. The purpose of this pilot study was to determine if nursing students' knowledge and attitude scores following a PDA-assisted SCE would be equivalent to textbook-assisted scores. Using a convenience sample of first-semester baccalaureate students and an equivalence design, multiple lessons were learned about the use of PDAs in the context of SCE. Learning was supported through use of PDAs in place of traditional text references; students viewed PDAs as beneficial resources in the provision of care; PDA use prompted reflection and triggered important need-learning connections; orientation to the use of PDAs promoted positive student attitudes; and use of PDAs helped meet nursing informatics curricular requirements.

  17. The Relationship of Prior Training and Previous Teaching Experience to Self-Efficacy among Graduate Teaching Assistants.

    ERIC Educational Resources Information Center

    Prieto, Loreto R.; Altmaier, Elizabeth M.

    1994-01-01

    A study of 78 graduate teaching assistants (GTAs) found that those with exposure to prior training and higher amounts of teaching experience demonstrated higher self-efficacy than those with less training and experience. It is suggested that these factors may increase teaching assistant effectiveness and that both formal and on-the-job training of…

  18. Identification, assessment, and control of hazards in water supply: experiences from Water Safety Plan implementations in Germany.

    PubMed

    Mälzer, H-J; Staben, N; Hein, A; Merkel, W

    2010-01-01

    According to the recommendations of the World Health Organization (WHO) for Water Safety Plans (WSP), a Technical Risk Management was developed, which considers standard demands in drinking water treatment in Germany. It was already implemented at several drinking water treatment plants of different size and treatment processes in Germany. Hazards affecting water quality, continuity, and the reliability of supply from catchment to treatment and distribution could be identified by a systematic approach, and suitable control measures were defined. Experiences are presented by detailed examples covering methods, practical consequences, and further outcomes. The method and the benefits for the water suppliers are discussed and an outlook on the future role of WSPs in German water supply is given.

  19. Analysis of Power Supply Heating Effect during High Temperature Experiments Based on the Electromagnetic Steel Teeming Technology

    NASA Astrophysics Data System (ADS)

    He, Ming; Wang, Qiang; Liu, Xin'an; Shi, Chunyang; Liu, Tie; He, Jicheng

    2017-04-01

    For further lowering inclusions and improving the quality of steel, a new electromagnetic steel-teeming technology based on electromagnetic induction heating was proposed. To assess the proposed technology, an experimental platform that imitates the actual production condition of steelmakers was established. High temperature experiments were performed to investigate the melting length of Fe-C alloy under different power and frequency conditions. The heating effect was analyzed, and the method of magnetic shielding to reduce the power loss of power supply was put forward. The results show that when the power is 40 kW and frequency is 25 kHz, the melting length of the Fe-C alloy is 89.2 mm in 120 s, which meets the requirements of steel teeming. In addition, when magnetic shielding material is installed under the induction coil, the power loss is reduced by about 64 %, effectively improving the heating effect of power supply.

  20. Nursing home practices following resident death: the experience of Certified Nursing Assistants.

    PubMed

    Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R

    2015-01-01

    This study examined certified nursing assistants' (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities' practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. [Clinical experience of supplying sodium chloride for the treatment of patients with severe heart failure].

    PubMed

    He, Li-xia; Sun, Lu-lu; Yang, Yue-jin; Zhang, Jian; Zhang, Yu-hui; Song, Wei-hua; Huang, Yan; Lü, Rong; Ji, Shi-ming

    2012-09-01

    To observe the effect and safety of supplying sodium chloride in the treatment of patients with severe heart failure. Consecutive 51 hospitalized patients with severe heart failure and cardiac edema were included in this study. Normal diet (6 g NaCl/d) was supplied to all patients. On the basis of controlling fluid intake and treating related etiological factors as well as standard medications including furosemide for severe heart failure, patients with mild hyponatremia (serum sodium level 130 - 134 mmol/L) ate additional salted vegetables, patients with moderate hyponatremia (serum sodium level 125 - 129 mmol/L) and severe hyponatremia (serum sodium level < 125 mmol/L) ate additional salted vegetables and were received additionally intravenous 3%NaCl hypertonic saline infusion (10 ml/h) until reaching normal serum sodium level. On admission, 37.25% (19/51) patients had hyponatremia. During the first two weeks hospitalization period, 88.24% (45/51) patients were treated with intravenous diuretics and total incidence of hyponatremia was 64.71% (33/51), mild hyponatremia was 50.98% (26/51), middle and severe hyponatremia was 13.73% (7/51); among them, hyponatremia lasted less than 3 d in 57.58% (19/33) patients and ≥ 3 d in 42.42% (14/33) patients. Heart failure exacerbation and hypernatremia were not observed in patients receiving additional sodium chloride therapy. Hospitalization time was similar among patients with different blood natrium levels [average (16 ± 12) d]. Fifty out of 51 (98%) patients discharged from the hospital with improved heart failure symptoms and signs. Supplying additional sodium chloride could rapid correct hyponatremia in heart failure patients with or without intravenous diuretics therapy which might contribute to a favorable prognosis in hospitalized heart failure patients.

  2. The experience of pregnancy resulting from Assisted Reproductive Technology (ART) treatment: A qualitative Brazilian study.

    PubMed

    Dornelles, L M N; MacCallum, F; Lopes, R C S; Piccinini, C A; Passos, E P

    2016-04-01

    Pregnancies achieved through medical treatments following a period of infertility may demand extra emotional and practical investment from women. This paper aims at understanding the experience of pregnancy after Assisted Reproductive Technology, and exploring whether this experience is affected by previous failed infertility treatments. This paper uses a qualitative approach. Participants were nineteen expectant first-time mothers from Brazil who conceived through Assisted Reproductive Technology treatment. During the third trimester of gestation, a semi-structured interview was administered to assess perceptions of and feelings about treatment and pregnancy. Interview transcripts were analysed using thematic analysis, and the sample was divided into two groups according to whether it was the participant's first treatment or not. Themes identified include: tolerance of the demands of treatment and pregnancy, consideration of the mechanics of treatment and pregnancy, and emotionally painful aspects of treatment and pregnancy. Pregnancy itself was regarded as a reward or compensation for the difficulties undergone. Perspectives differed according to whether pregnancy followed the first Assisted Reproductive Technology treatment; those who had undergone previously unsuccessful treatments focused less on the mechanical aspects of the process but were more concerned about possible physical problems. The similarities and differences found according to number of treatments attempted should be taken into consideration when providing psychological support for expectant Assisted Reproductive Technology mothers. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. Robot-Assisted Cardiac Surgery Using the Da Vinci Surgical System: A Single Center Experience

    PubMed Central

    Kim, Eung Re; Lim, Cheong; Kim, Dong Jin; Kim, Jun Sung; Park, Kay Hyun

    2015-01-01

    Background We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Methods Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Results Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were 194.8±48.6 minutes and 126.1±22.6 minutes in mitral valve repair operations and 132.0±32.0 minutes and 76.1±23.1 minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was 128.3±43.1 minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Conclusion Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team. PMID:25883892

  4. Robot-assisted cardiac surgery using the da vinci surgical system: a single center experience.

    PubMed

    Kim, Eung Re; Lim, Cheong; Kim, Dong Jin; Kim, Jun Sung; Park, Kay Hyun

    2015-04-01

    We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were 194.8±48.6 minutes and 126.1±22.6 minutes in mitral valve repair operations and 132.0±32.0 minutes and 76.1±23.1 minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was 128.3±43.1 minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.

  5. Sustaining the benefits of rural water supply investments: Experience from Cochabamba and Chuquisaca, Bolivia

    NASA Astrophysics Data System (ADS)

    Davis, Jennifer; Lukacs, Heather; Jeuland, Marc; Alvestegui, Alfonso; Soto, Betty; LizáRraga, Gloria; Bakalian, Alex; Wakeman, Wendy

    2008-12-01

    Many rural water supply interventions in developing countries have been marked by a poor record of sustainability. Considerable progress has been made over the past several decades on the development of lower-cost technologies that are easier for communities in developing countries to maintain and also on improving project design and implementation to enhance sustainability of outcomes. Less attention has been given to the necessary and sufficient supports for water system maintenance in the postconstruction period. This study explores the contribution of various types of postconstruction support (PCS) to the sustainability of rural water supply systems in Bolivia. Using regression and matched pair statistical analyses, the effects of PCS on water system performance and user satisfaction with service are modeled. Communities that received management-oriented PCS visits from external agencies, and those whose system operators attended training workshops, had better performing systems than communities that received no such support. Engineering-oriented PCS visits to communities had no measurable impact on system functioning or user satisfaction.

  6. Effectiveness of an Expert System for Astronaut Assistance on a Sleep Experiment

    NASA Technical Reports Server (NTRS)

    Heher, Dennis; Callini, Gianluca; Essig, Susanne M.; Young, Laurence R.; Koga, Dennis (Technical Monitor)

    1998-01-01

    Principal Investigator-in-a-Box ([PI]) is an expert system designed to train and assist astronauts with the performance of an experiment outside their field of expertise, particularly when contact with the Principal Investigators on the ground is limited or impossible. In the current case, [PI] was designed to assist with the calibration and troubleshooting procedures of the Neurolab Sleep and Respiration Experiment during the pre-sleep period of no ground contact. It displays physiological signals in real time during the pre-sleep instrumentation period, and alerts the astronauts when a poor signal quality is detected. Results of the first study indicated a beneficial effect of [PI] and training in reducing anomaly detection time and the number of undetected anomalies. For the in-flight performance, excluding the saturated signals, the expert system had an 84.2% detection accuracy, and the questionnaires filled out by the astronauts showed positive crew reactions to the expert system.

  7. The own body as a nurse's living experience on assisting others in their dying process.

    PubMed

    de Santana, Maria Teresa B Mariotti; Jorge, Maria Salete Bessa

    2007-01-01

    It refers to the study of the researcher's perception when analyzing her own existence, aiming to learn the sense and meaning of her own body as a living experience while assisting the other in the process of dying. The Merleau-Ponty phenomenology and the new hermeneutic approaches were chosen. A point of contact was established between the living experience of the approximation of the object, unveiled by the own body inserted in the world, the object and the subject of the study. The themes that emerged were about the magical-religious knowledge influences of the perceived world, the real knowledge and the teaching-learning process. The phenomenon elaborated, result of the study, allowed the learning of the thesis of the existence of a sense and meaning for the own body of health professionals when assisting others in the dying process.

  8. The overvoltage protection module for the power supply system for the pixel detector at Belle II experiment at KEK

    SciTech Connect

    Kapusta, P.; Kisielewski, B.

    2015-07-01

    In this paper the overvoltage protection modules (OVP) for the power supply (PS) system of the Belle II pixel detector (PXD) are described. The aim of the OVP is to protect the detector and associated electronics against overvoltage conditions. Most critical in the system are voltages supplying the front-end ASICs. The PXD detector consists of the DEPFET sensor modules with integrated chips like the Drain Current Digitizer, the Switcher and the Data Handling Processor. These chips, implemented in modern sub-micron technologies, are quite vulnerable to variations in the supply voltages. The PXD will be placed in the Belle II experiment as close as possible to the interaction point, where access during experiment is very limited or even impossible, thus the PS and OVP systems exploit the remote-sensing method. Overvoltage conditions are due to failures of the PS itself, wrong setting of the output voltages or transient voltages coming out of hard noisy environment of the experiment. The OVP modules are parts of the PS modules. For powering the PXD 40 PS modules are placed 15 m outside the Belle II spectrometer. Each one is equipped with the OVP board. All voltages (22) are grouped in 4 domains: Analog, Digital, Steering and Gate which have independent grounds. The OVP boards are designed from integrated circuits from Linear Technology. All configurations were simulated with the Spice program. The control electronics is designed in a Xilinx CPLD. Two types of integrated circuits were used. LT4356 surge stopper protects loads from high voltage transients. The output voltages are limited to a safe value and also protect loads against over current faults. For less critical voltages, the LTC2912 voltage monitors are used that detect under-voltage and overvoltage events. It has to be noted that the OVP system is working independently of any other protection of the PS system, which increases its overall reliability. (authors)

  9. Photosynthetic and anatomical responses of Eucalyptus grandis leaves to potassium and sodium supply in a field experiment.

    PubMed

    Battie-Laclau, Patricia; Laclau, Jean-Paul; Beri, Constance; Mietton, Lauriane; Muniz, Marta R Almeida; Arenque, Bruna Cersózimo; DE Cassia Piccolo, Marisa; Jordan-Meille, Lionel; Bouillet, Jean-Pierre; Nouvellon, Yann

    2014-01-01

    Although vast areas in tropical regions have weathered soils with low potassium (K) levels, little is known about the effects of K supply on the photosynthetic physiology of trees. This study assessed the effects of K and sodium (Na) supply on the diffusional and biochemical limitations to photosynthesis in Eucalyptus grandis leaves. A field experiment comparing treatments receiving K (+K) or Na (+Na) with a control treatment (C) was set up in a K-deficient soil. The net CO2 assimilation rates were twice as high in +K and 1.6 times higher in +Na than in the C as a result of lower stomatal and mesophyll resistance to CO2 diffusion and higher photosynthetic capacity. The starch content was higher and soluble sugar was lower in +K than in C and +Na, suggesting that K starvation disturbed carbon storage and transport. The specific leaf area, leaf thickness, parenchyma thickness, stomatal size and intercellular air spaces increased in +K and +Na compared to C. Nitrogen and chlorophyll concentrations were also higher in +K and +Na than in C. These results suggest a strong relationship between the K and Na supply to E. grandis trees and the functional and structural limitations to CO2 assimilation rates.

  10. Effective Laboratory Experiences for Students with Disabilities: The Role of a Student Laboratory Assistant

    NASA Astrophysics Data System (ADS)

    Pence, Laura E.; Workman, Harry J.; Riecke, Pauline

    2003-03-01

    Two separate experiences with students whose disabilities significantly limited the number of laboratory activities they could accomplish independently has given us a general experience base for determining successful strategies for accommodating students facing these situatiuons. For a student who had substantially limited physical mobility and for a student who had no visual ability, employing a student laboratory assistant allowed the students with disabilities to have a productive and positive laboratory experience. One of the priorities in these situations should be to avoid depersonalizing the student with a disability. Interactions with the instructor and with other students should focus on the disabled student rather than the student laboratory assistant who may be carrying out specific tasks. One of the most crucial aspects of a successful project is the selection of a laboratory assistant who has excellent interpersonal skills and who will add his or her creativity to that of the student with a disability to meet unforeseen challenges. Other considerations are discussed, such as the importance of advance notification that a disabled student has enrolled in a course as well as factors that should contribute to choosing an optimum laboratory station for each situation.

  11. Computer-related assistive technology: satisfaction and experiences among users with disabilities.

    PubMed

    Burton, Mary; Nieuwenhuijsen, Els R; Epstein, Marcy J

    2008-01-01

    Many people with disabilities use assistive technology devices (ATDs) for computer access. The specific focus of this exploratory study was (a) to assess the experiences, opinions, and satisfaction levels of 24 individuals with disabilities using computer-related ATDs; (b) to investigate their awareness of health risk factors related to computer usage; and (c) to examine the psychosocial impact of computer-related ATDs on users. Data were collected via telephone interviews with 24 individuals with physical disabilities who had experience using one or more ATDs. The Quebec User Evaluation with Assistive Technology instrument was used to evaluate users' satisfaction with ATDs in a number of dimensions, including their physical attributes. The Psychosocial Impact of Assistive Devices Scale measured the psychosocial impact (i.e., independence, competence, and adequacy) of an ATD on users. Additional questions were posed to gather information about user's opinions and experiences. Training appeared to be an important component for ATD users, many of whom preferred a setting to try out devices rather than group or individual training. Respondents with visual impairments revealed a higher level of adaptability versus those without visual impairments (p = .001). Additional research is needed to develop specific survey items focused on users of computer-related ATDs and the evaluation of the psychosocial impact of ATDs on computer users.

  12. EC assisted start-up experiments reproduction in FTU and AUG for simulations of the ITER case

    SciTech Connect

    Granucci, G.; Ricci, D.; Farina, D.; Figini, L.; Cavinato, M.; Stober, J.; Tudisco, O.

    2014-02-12

    The breakdown and plasma start-up in ITER are well known issues studied in the last few years in many tokamaks with the aid of calculation based on simplified modeling. The thickness of ITER metallic wall and the voltage limits of the Central Solenoid Power Supply strongly limit the maximum toroidal electric field achievable (0.3 V/m), well below the level used in the present generation of tokamaks. In order to have a safe and robust breakdown, the use of Electron Cyclotron Power to assist plasma formation and current rump up has been foreseen. This has raised attention on plasma formation phase in presence of EC wave, especially in order to predict the required power for a robust breakdown in ITER. Few detailed theory studies have been performed up to nowadays, due to the complexity of the problems. A simplified approach, extended from that proposed in ref[1] has been developed including a impurity multispecies distribution and an EC wave propagation and absorption based on GRAY code. This integrated model (BK0D) has been benchmarked on ohmic and EC assisted experiments on FTU and AUG, finding the key aspects for a good reproduction of data. On the basis of this, the simulation has been devoted to understand the best configuration for ITER case. The dependency of impurity distribution content and neutral gas pressure limits has been considered. As results of the analysis a reasonable amount of power (1 - 2 MW) seems to be enough to extend in a significant way the breakdown and current start up capability of ITER. The work reports the FTU data reproduction and the ITER case simulations.

  13. Practical care work and existential issues in palliative care: experiences of nursing assistants.

    PubMed

    Ahsberg, Elizabeth; Carlsson, Maria

    2014-12-01

    Despite increasing international interest in palliative care, little focus has been given to the role of nursing assistants, nor to research on existential issues. To investigate nursing assistants' experiences of existential issues in palliative care. An explorative study using focus group discussions as data. Seven nursing assistants working in a palliative care unit and a nursing home participated on three occasions. Data were analysed using a content analysis approach. Two overlapping domains were extracted: practical care, interpreted in themes as meeting others, the patient's body and organisational boundaries; and existential issues, interpreted as the difficult part, the valuable part and death and dying. Communication seemed to be a theme central to both domains. The results indicate that nursing assistants may give existential support in addition to practical aspects of care. The intimate interactions inherent in practical aspects of personal care create opportunities for meaningful conversations. Such conversations may constitute existential support for patients and a meaningful task for staff. © 2013 John Wiley & Sons Ltd.

  14. Attitudes towards assisted dying are influenced by question wording and order: a survey experiment.

    PubMed

    Magelssen, Morten; Supphellen, Magne; Nortvedt, Per; Materstvedt, Lars Johan

    2016-04-27

    Surveys on attitudes towards assisted dying play an important role in informing public debate, policy and legislation. Unfortunately, surveys are often designed with insufficient attention to framing effects; that is, effects on the respondents' stated attitudes caused by question wording and context. The purpose of this study was to demonstrate and measure such framing effects. Survey experiment in which an eight-question survey on attitudes towards assisted dying was distributed to Norwegian citizens through a web-based panel. Two variations of question wording as well as two variations of question order were employed. Respondents were randomized to receive one of four questionnaire versions. Three thousand and fifty responses were received. There were moderate to large question wording and question order effects. A majority of Norwegian citizens favour the legalization of assisted dying for patients with terminal or chronic disease. Stakeholders in the assisted dying debate need to acknowledge potential framing effects, and accordingly should interpret survey results with caution. The same holds for researchers who conduct attitude surveys in the field of bioethics.

  15. Code Sharing and Collaboration: Experiences from the Scientist's Expert Assistant Project and their Relevance to the Virtual Observatory

    NASA Technical Reports Server (NTRS)

    Jones, Jeremy; Grosvenor, Sandy; Wolf, Karl; Li, Connie; Koratkar, Anuradha; Powers, Edward I. (Technical Monitor)

    2001-01-01

    In the Virtual Observatory (VO), software tools will perform the functions that have traditionally been performed by physical observatories and their instruments. These tools will not be adjuncts to VO functionality but will make up the very core of the VO. Consequently, the tradition of observatory and system independent tools serving a small user base is not valid for the VO. For the VO to succeed, we must improve software collaboration and code sharing between projects and groups. A significant goal of the Scientist's Expert Assistant (SEA) project has been promoting effective collaboration and code sharing between groups. During the past three years, the SEA project has been developing prototypes for new observation planning software tools and strategies. Initially funded by the Next Generation Space Telescope, parts of the SEA code have since been adopted by the Space Telescope Science Institute. SEA has also supplied code for SOFIA, the SIRTF planning tools, and the JSky Open Source Java library. The potential benefits of sharing code are clear. The recipient gains functionality for considerably less cost. The provider gains additional developers working with their code. If enough users groups adopt a set of common code and tools, defacto standards can emerge (as demonstrated by the success of the FITS standard). Code sharing also raises a number of challenges related to the management of the code. In this talk, we will review our experiences with SEA - both successes and failures - and offer some lessons learned that may promote further successes in collaboration and re-use.

  16. Code Sharing and Collaboration: Experiences from the Scientist's Expert Assistant Project and their Relevance to the Virtual Observatory

    NASA Technical Reports Server (NTRS)

    Jones, Jeremy; Grosvenor, Sandy; Wolf, Karl; Li, Connie; Koratkar, Anuradha; Powers, Edward I. (Technical Monitor)

    2001-01-01

    In the Virtual Observatory (VO), software tools will perform the functions that have traditionally been performed by physical observatories and their instruments. These tools will not be adjuncts to VO functionality but will make up the very core of the VO. Consequently, the tradition of observatory and system independent tools serving a small user base is not valid for the VO. For the VO to succeed, we must improve software collaboration and code sharing between projects and groups. A significant goal of the Scientist's Expert Assistant (SEA) project has been promoting effective collaboration and code sharing between groups. During the past three years, the SEA project has been developing prototypes for new observation planning software tools and strategies. Initially funded by the Next Generation Space Telescope, parts of the SEA code have since been adopted by the Space Telescope Science Institute. SEA has also supplied code for SOFIA, the SIRTF planning tools, and the JSky Open Source Java library. The potential benefits of sharing code are clear. The recipient gains functionality for considerably less cost. The provider gains additional developers working with their code. If enough users groups adopt a set of common code and tools, defacto standards can emerge (as demonstrated by the success of the FITS standard). Code sharing also raises a number of challenges related to the management of the code. In this talk, we will review our experiences with SEA - both successes and failures - and offer some lessons learned that may promote further successes in collaboration and re-use.

  17. Challenges in setting up a potable water supply system in a United Nations peacekeeping mission: the South Sudan experience.

    PubMed

    Hazra, Aniruddha

    2013-01-01

    A United Nations peacekeeping contingent was deployed in the conflict affected areas of South Sudan with inadequate environmental sanitation, lack of clean drinking water and a heightened risk of water-borne diseases. In the immediate post-deployment phase, the contingent-owned water purification system was pressed into service. However, laboratory analyses of processed water revealed its unsuitability for human consumption. A systematic, sanitary survey was conducted to identify the shortcomings in the water supply system's ability to provide potable water. Under field conditions, the 'H2S method' was used to detect faecal contamination of drinking water. The raw water from the only available source, the White Nile River, was highly turbid and contaminated by intestinal and other pathogens due to an unprotected watershed. Water sterilizing powder was not readily available in the local area to replenish the existing stocks that had deteriorated during the long transit period from the troop contributing country. The water pipelines that had been laid along the ground, under water-logged conditions, were prone to microbial recontamination due to leakages in the network. The critical evaluation of the water supply system and necessary modifications in the purification process, based upon locally available options, yielded safe drinking water. Provision of safe drinking water in the mission area requires an in-depth analysis of prevailing conditions and appropriate planning in the pre-deployment phase. The chemicals for water purification should be procured through UN sources via a 'letter of assist' request from the troop contributor. Copyright © 2012 Elsevier GmbH. All rights reserved.

  18. Initial experience with the new da Vinci single-port robot-assisted platform.

    PubMed

    Ballestero Diego, R; Zubillaga Guerrero, S; Truan Cacho, D; Carrion Ballardo, C; Velilla Diez, G; Calleja Hermosa, P; Gutiérrez Baños, J L

    2017-06-01

    To describe our experience in the first cases of urological surgeries performed with the da Vinci single-port robot-assisted platform. We performed 5 single-port robot-assisted surgeries (R-LESS) between May and October 2014. We performed 3 ureteral reimplant surgeries, one ureteropyeloplasty in an inverted kidney and 1 partial nephrectomy. The perioperative and postoperative results were collected, as well as a report of the complications according to the Clavien classification system. Of the 5 procedures, 4 were performed completely by LESS, while 1 procedure was reconverted to multiport robot-assisted surgery. There were no intraoperative complications. We observed perioperative complications in 4 patients, all of which were grade 1 or 2. The mean surgical time was 262minutes (range, 230-300). In our initial experience with the da Vinci device, R-LESS surgery was feasible and safe. There are still a number of limitations in its use, which require new and improved R-LESS platforms. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Retroauricular Endoscope-Assisted Approach to the Neck: Early Experience in Latin America.

    PubMed

    Lira, Renan Bezerra; Chulam, Thiago Celestino; Koh, Yoon Woo Woo; Choi, Eun Chang Chang; Kowalski, Luiz Paulo

    2016-04-01

    Introduction There has been a significant increase in concern towards improving aesthetic and functional outcomes without compromising the oncologic effectiveness in head and neck surgery. In this subset, endoscope-assisted and robotic procedures allowed the development of new approaches to the neck, including the retroauricular access, which is now routinely used, especially in Korea. Objectives This study aims to provide a descriptive analysis of our initial experience with retroauricular endoscope-assisted approach assessing feasibility, safety, and aesthetic results. Methods Prospective analysis of the first 11 eligible patients submitted to retroauricular endoscope-assisted approach for neck procedures in the Head and Neck Surgery Department at AC Camargo Cancer Center. Results A total of 18 patients were included in this study, comprising 7 supraomohyoid neck dissections, 8 submandibular gland excisions, 3 thyroid lobectomies, and one paraganglioma excision. There was no significant local complications, surgical accident, or need for conversion into conventional open procedure in this series. Conclusion Our initial experience has shown us that this approach is feasible, safe, oncologically efficient, and applicable to selected cases, with a clear cosmetic benefit.

  20. Retroauricular Endoscope-Assisted Approach to the Neck: Early Experience in Latin America

    PubMed Central

    Lira, Renan Bezerra; Chulam, Thiago Celestino; Koh, Yoon Woo Woo; Choi, Eun Chang Chang; Kowalski, Luiz Paulo

    2016-01-01

    Introduction There has been a significant increase in concern towards improving aesthetic and functional outcomes without compromising the oncologic effectiveness in head and neck surgery. In this subset, endoscope-assisted and robotic procedures allowed the development of new approaches to the neck, including the retroauricular access, which is now routinely used, especially in Korea. Objectives This study aims to provide a descriptive analysis of our initial experience with retroauricular endoscope-assisted approach assessing feasibility, safety, and aesthetic results. Methods Prospective analysis of the first 11 eligible patients submitted to retroauricular endoscope-assisted approach for neck procedures in the Head and Neck Surgery Department at AC Camargo Cancer Center. Results A total of 18 patients were included in this study, comprising 7 supraomohyoid neck dissections, 8 submandibular gland excisions, 3 thyroid lobectomies, and one paraganglioma excision. There was no significant local complications, surgical accident, or need for conversion into conventional open procedure in this series. Conclusion Our initial experience has shown us that this approach is feasible, safe, oncologically efficient, and applicable to selected cases, with a clear cosmetic benefit. PMID:27096018

  1. Energy supply and environmental issues: The Los Alamos National Laboratory experience in regional and international programs

    SciTech Connect

    Goff, S.J.

    1995-12-31

    The Los Alamos National Laboratory, operated by the University of California, encompasses more than forty-three square miles of mesas and canyons in northern New Mexico. A Department of Energy national laboratory, Los Alamos is one of the largest multidisciplinary, multiprogram laboratories in the world. Our mission, to apply science and engineering capabilities to problems of national security, has expanded to include a broad array of programs. We conduct extensive research in energy, nuclear safeguards and security, biomedical science, computational science, environmental protection and cleanup, materials science, and other basic sciences. The Energy Technology Programs Office is responsible for overseeing and developing programs in three strategic areas: energy systems and the environment, transportation and infrastructure, and integrated chemicals and materials processing. Our programs focus on developing reliable, economic and environmentally sound technologies that can help ensure an adequate supply of energy for the nation. To meet these needs, we are involved in programs that range from new and enhanced oil recovery technologies and tapping renewable energy sources, through efforts in industrial processes, electric power systems, clean coal technologies, civilian radioactive waste, high temperature superconductivity, to studying the environmental effects of energy use.

  2. Pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter: a single institution experience.

    PubMed

    Fu, Weijun; Zhang, Xu; Zhang, Xiaoyi; Zhang, Peng; Gao, Jiangping; Dong, Jun; Chen, Guangfu; Xu, Axiang; Ma, Xin; Li, Hongzhao; Shi, Lixin

    2014-01-01

    To report our experience of pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter, seven patients (one bilateral) with symptomatic congenital megaureter underwent pure laparoscopic or robot-assisted laparoscopic surgery. The megaureter was exposed at the level of the blood vessel and was isolated to the bladder narrow area. Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations and anti-reflux ureter bladder anastomosis were performed intraperitoneally by pure laparoscopic or robot-assisted laparoscopic surgery. The clinical data of seven patients after operation were analyzed, including the operation time, intraoperative complications, intraoperative bleeding volumes, postoperative complications, postoperative hospitalization time and pathological results. All of the patients were followed. The operation was successfully performed in seven patients. The mean operation times for pure laparoscopic surgery and robotic-assistant laparoscopic surgery were 175 (range: 150-220) and 187 (range: 170-205) min, respectively, and the mean operative blood loss volumes were 20 (range: 10-30) and 28.75 (range: 15-20) ml, respectively. There were no intraoperative complications. The postoperative drainage time was 5 (range: 4-6) and 5.75 (range: 5-6) d, respectively, and the indwelling catheter time was 6.33 (range: 4-8) d and 7 (range: 7-7) d, respectively. The postoperative hospitalization time was 7.67 (range: 7-8) d and 8 (range: 7-10) d, respectively. There was no obvious pain, no secondary bleeding and no urine leakage after the operation. Postoperative pathology reports revealed chronic urothelial mucosa inflammation. The follow-up results confirmed that all patients were relieved of their symptoms. Both pure laparoscopic and robot-assisted laparoscopic surgery using different anti-reflux ureter bladder anastomoses are safe and effective approaches in the minimally invasive treatment of congenital

  3. Virtual environment, a behavioral and countermeasure tool for assisted gesture in weightlessness: Experiments during parabolic flights

    NASA Astrophysics Data System (ADS)

    Fass, Didier

    2005-08-01

    We present results of experiments performed by three subjects on earth and in hypergravity and weightlessness during parabolic flights (Flight campaign n°8 CNES- SPACEHAB), using a virtual and augmented reality system for assisted action. Using analysis of three- dimensional hand movements (drawing of ellipses), we compare the dynamical sensory-motor integration and motor performance (orientation, shape, figural and kinematics features) with or without the assistance of virtual environments. Using this gesture-based method we evaluate physiological effects and integration of both change of gravity and artefactual environment on performance. We demonstrate how artificial visual information dynamically generated by a wearable virtual environment may help gesture in the three-dimensional space parabolic flight, according to the theoretical integrative neuroscience principles.

  4. Perceptions of Support Networks During the Graduate-Assistant Athletic Trainer Experience.

    PubMed

    Mazerolle, Stephanie M; Clines, Stephanie; Eason, Christianne M; Pitney, William A

    2015-12-01

    The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously. To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships. Semistructured phone interviews. Graduate-assistant ATs in various clinical settings. Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non-athletic training-based curriculum = 6). Median age was 24 years. Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability. Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support. Our results confirm the literature regarding the GAAT's pursuit of continued formal mentoring. The GAATs perceived less support from full-time AT staff members due to limited availability. Therefore, GAATs leaned on their peers for

  5. Taking personal responsibility: Nurses' and assistant nurses' experiences of good nursing practice in psychiatric inpatient care.

    PubMed

    Gabrielsson, Sebastian; Sävenstedt, Stefan; Olsson, Malin

    2016-10-01

    Therapeutic nurse-patient relationships are considered essential for good nursing practice in psychiatric inpatient care. Previous research suggests that inpatient care fails to fulfil patients' expectations in this regard, and that nurses might experience the reality of inpatient care as an obstruction. The aim of the present study was to explore nurses' and assistant nurses' experiences of good nursing practice in the specific context of psychiatric inpatient care. Qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and assistant nurses in order to explore their experiences with nursing practice related to psychiatric inpatient care. Interviews were transcribed and analysed using an interpretive descriptive approach. Findings describe good nursing practice as a matter of nurses and assistant nurses taking personal responsibility for their actions and for the individual patient as a person. Difficulties in providing dignified nursing care and taking personal responsibility cause them to experience feelings of distress and frustration. Shared values and nursing leadership supports being moral and treating patients with respect, having enough time supports being present and connecting with patients, and working as a part of a competent team with critical daily discussions and diversity supports being confident and building trust. The findings suggest that taking personal responsibility is integral to good nursing practice. If unable to improve poor circumstances, nurses might be forced to promote their own survival by refuting or redefining their responsibility. Nurses need to prioritize being with patients and gain support in shaping their own nursing practice. Nursing leadership should provide moral direction and defend humanistic values. © 2016 Australian College of Mental Health Nurses Inc.

  6. Perceptions of Support Networks During the Graduate-Assistant Athletic Trainer Experience

    PubMed Central

    Mazerolle, Stephanie M.; Clines, Stephanie; Eason, Christianne M.; Pitney, William A.

    2015-01-01

    Context  The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously. Objective  To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships. Design  Semistructured phone interviews. Setting  Graduate-assistant ATs in various clinical settings. Patients or Other Participants  Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non–athletic training-based curriculum = 6). Median age was 24 years. Data Collection and Analysis  Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability. Results  Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support. Conclusions  Our results confirm the literature regarding the GAAT's pursuit of continued formal

  7. The First Year Experience of a Peer Assisted Learning Program in Two Institutes of Technology in Ireland

    ERIC Educational Resources Information Center

    Ginty, Carina; Harding, Nuala

    2014-01-01

    This paper describes a collaborative action research study in which peer assisted learning was deployed simultaneously across a range of disciplines in two institutes of technology in Ireland. The aim of the research was to determine if peer assisted learning enhances the learning experience of first year participants. An action research approach…

  8. Undergraduate Teaching Assistants: A Learner-Centered Model for Enhancing Student Engagement in the First-Year Experience

    ERIC Educational Resources Information Center

    Gordon, Jessica; Henry, Peter; Dempster, Michaux

    2013-01-01

    In this paper, we provide an in-depth view of the Undergraduate Teaching Assistant (UTA) program at Virginia Commonwealth University as a potential model for other large research universities who might wish to implement similar learner-centered initiatives in their first-year experience courses. Unlike graduate teaching assistants, whose primary…

  9. Computer network that assists in the planning, execution and evaluation of in-reactor experiments

    SciTech Connect

    Bauer, T.H.; Froehle, P.H.; August, C.; Baldwin, R.D.; Johanson, E.W.; Kraimer, M.R.; Simms, R.; Klickman, A.E.

    1985-01-01

    For over 20 years complex, in-reactor experiments have been performed at Argonne National Laboratory (ANL) to investigate the performance of nuclear reactor fuel and to support the development of large computer codes that address questions of reactor safety in full-scale plants. Not only are computer codes an important end-product of the research, but computer analysis is also involved intimately at most stages of experiment planning, data reduction, and evaluation. For instance, many experiments are of sufficiently long duration or, if they are of brief duration, occur in such a purposeful sequence that need for speedy availability of on-line data is paramount. This is made possible most efficiently by computer assisted displays and evaluation. A purposeful linking of main-frame, mini, and micro computers has been effected over the past eight years which greatly enhances the speed with which experimental data are reduced to useful forms and applied to the relevant technological issues. This greater efficiency in data management led also to improvements in the planning and execution of subsequent experiments. Raw data from experiments performed at INEL is stored directly on disk and tape with the aid of minicomputers. Either during or shortly after an experiment, data may be transferred, via a direct link, to the Illinois offices of ANL where the data base is stored on a minicomputer system. This Idaho-to-Illinois link has both enhanced experiment performance and allowed rapid dissemination of results.

  10. Chemistry Graduate Teaching Assistants' Experiences in Academic Laboratories and Development of a Teaching Self-image

    NASA Astrophysics Data System (ADS)

    Gatlin, Todd Adam

    Graduate teaching assistants (GTAs) play a prominent role in chemistry laboratory instruction at research based universities. They teach almost all undergraduate chemistry laboratory courses. However, their role in laboratory instruction has often been overlooked in educational research. Interest in chemistry GTAs has been placed on training and their perceived expectations, but less attention has been paid to their experiences or their potential benefits from teaching. This work was designed to investigate GTAs' experiences in and benefits from laboratory instructional environments. This dissertation includes three related studies on GTAs' experiences teaching in general chemistry laboratories. Qualitative methods were used for each study. First, phenomenological analysis was used to explore GTAs' experiences in an expository laboratory program. Post-teaching interviews were the primary data source. GTAs experiences were described in three dimensions: doing, knowing, and transferring. Gains available to GTAs revolved around general teaching skills. However, no gains specifically related to scientific development were found in this laboratory format. Case-study methods were used to explore and illustrate ways GTAs develop a GTA self-image---the way they see themselves as instructors. Two general chemistry laboratory programs that represent two very different instructional frameworks were chosen for the context of this study. The first program used a cooperative project-based approach. The second program used weekly, verification-type activities. End of the semester interviews were collected and served as the primary data source. A follow-up case study of a new cohort of GTAs in the cooperative problem-based laboratory was undertaken to investigate changes in GTAs' self-images over the course of one semester. Pre-semester and post-semester interviews served as the primary data source. Findings suggest that GTAs' construction of their self-image is shaped through the

  11. Experiments on Ball and Roller Bearings Under Conditions of High Speed and Small Oil Supply

    NASA Technical Reports Server (NTRS)

    Getzlaff, Gunter

    1940-01-01

    This report describes a testing machine on which 35 millimeter bearings (bore) can be run at speeds of the order of 21,000 rpm, while the following factors are recorded: 1) oil circulation through bearing and oil temperature. 2) maximum temperature of outer bearing ring, 3) radial and axial load on bearing, 4) radial, axial, and angular clearance of bearing, 5) power consumption of bearing. The experiments show that the lubrication was most reliable and oil consumption lowest when the oil was introduced through a hole in the outer or inner ring of the bearing.

  12. Initial experience with the EndoAssist camera-holding robot in laparoscopic urological surgery.

    PubMed

    Kommu, Sashi S; Rimington, Peter; Anderson, Christopher; Rané, Abhay

    2007-01-01

    Although the advantages of laparoscopic surgery are well documented, one disadvantage is that, for optimum performance, an experienced camera driver is required who can provide the necessary views for the operating surgeon. In this paper we describe our experience with urological laparoscopic techniques using the novel EndoAssist robotic camera holder and review the current status of alternative devices. A total of 51 urological procedures (25 using the EndoAssist device and 26 using a conventional human camera driver) conducted by three experienced surgeons were studied prospectively, including nephrectomy (simple and radical), pyeloplasty, radical prostatectomy, and radical cystoprostatectomy. The surgeon noted the extent of body comfort and muscle fatigue in each case. Other aspects documented were ease of scope movement, i.e. usability, need to clean the telescope, time of set-up, surgical performance, and whether it was necessary to change the position of the arm during the surgery. All three surgeons involved in the evaluation felt comfortable throughout all procedures, with no loss of autonomy. It was, however, obvious that the large arc generated whilst doing a nephrectomy led to more episodes of lens cleaning, and the arm had to be relocated on some occasions. Clearer benefits were seen while performing pelvic surgery or pyeloplasty, perhaps because the arc of movement was smaller. The EndoAssist is an effective, easy to use device for robotic camera driving which reduces the constraint of having to have an experienced camera driver for optimum visualisation during laparoscopic urological procedures.

  13. In vivo experiment leading to clinical application of an electrohydraulic ventricular assist device with magnetic coupling.

    PubMed

    Kim, W G; Choi, J S; Won, Y S; Jo, Y H; Park, S K; Chung, C I; Kim, J; Min, B G; Ahn, H; Rho, J R

    1999-01-01

    We developed an electrohydraulic ventricular assist device with magnetic coupling. The integrated system consists of a blood pump, a water conduit for pressure transmission, a bellows type pumping sac, an actuator for transforming the circular motion of a motor to the linear motion of a pusher plate attached to the pumping sac with magnetic coupling, and a controller. The purpose of the coupling was to prevent excessive sucking against the atrial wall. Number 21 Medtronic Hall (Irvine, CA) mechanical valves were used in the inflow and outflow ports of the blood pump. Maximum dynamic stroke volume was 48 ml, and against a mean afterload of 100 mm Hg, maximum pump output was 7 L/min. Chronic in vivo experiments were performed in three sheep, and during these evaluations the system showed no noticeable problems related to mechanical or electronic devices. When left atrial pressure decreased below 0 mm Hg, the magnetic coupling system decoupled the pumping sac and pusher plate with satisfactory reliability. The device was clinically applied in a postoperative patient with chronic dilating cardiomyopathy, and no significant device related problems ensued. These results prove that the electrohydraulic ventricular assist system with magnetic coupling is a suitable ventricular assist device.

  14. VIDEO-ASSISTED ANAL FISTULA TREATMENT: TECHNICAL CONSIDERATIONS AND PRELIMINARY RESULTS OF THE FIRST BRAZILIAN EXPERIENCE

    PubMed Central

    MENDES, Carlos Ramon Silveira; FERREIRA, Luciano Santana de Miranda; SAPUCAIA, Ricardo Aguiar; LIMA, Meyline Andrade; ARAUJO, Sergio Eduardo Alonso

    2014-01-01

    Backgroung Anorectal fistula represents an epithelized communication path of infectious origin between the rectum or anal canal and the perianal region. The association of endoscopic surgery with the minimally invasive approach led to the development of the video-assisted anal fistula treatment. Aim To describe the technique and initial experience with the technique video-assisted for anal fistula treatment. Technique A Karl Storz video equipment was used. Main steps included the visualization of the fistula tract using the fistuloscope, the correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening which can be accomplished through firing a stapler, cutaneous-mucosal flap, or direct closure using suture. Results The mean distance between the anal verge and the external anal orifice was 5.5 cm. Mean operative time was 31.75 min. In all cases, the internal fistula opening could be identified after complete fistuloscopy. In all cases, internal fistula opening was closed using full-thickness suture. There were no intraoperative or postoperative complications. After a 5-month follow-up, recurrence was observed in one (12.5%) patient. Conclusion Video-assisted anal fistula treatment is feasible, reproducible, and safe. It enables direct visualization of the fistula tract, internal opening and secondary paths. PMID:24676305

  15. Video-assisted anal fistula treatment: technical considerations and preliminary results of the first Brazilian experience.

    PubMed

    Mendes, Carlos Ramon Silveira; Ferreira, Luciano Santana de Miranda; Sapucaia, Ricardo Aguiar; Lima, Meyline Andrade; Araujo, Sergio Eduardo Alonso

    2014-01-01

    Anorectal fistula represents an epithelized communication path of infectious origin between the rectum or anal canal and the perianal region. The association of endoscopic surgery with the minimally invasive approach led to the development of the video-assisted anal fistula treatment. To describe the technique and initial experience with the technique video-assisted for anal fistula treatment. A Karl Storz video equipment was used. Main steps included the visualization of the fistula tract using the fistuloscope, the correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening which can be accomplished through firing a stapler, cutaneous-mucosal flap, or direct closure using suture. The mean distance between the anal verge and the external anal orifice was 5.5 cm. Mean operative time was 31.75 min. In all cases, the internal fistula opening could be identified after complete fistuloscopy. In all cases, internal fistula opening was closed using full-thickness suture. There were no intraoperative or postoperative complications. After a 5-month follow-up, recurrence was observed in one (12.5%) patient. Video-assisted anal fistula treatment is feasible, reproducible, and safe. It enables direct visualization of the fistula tract, internal opening and secondary paths.

  16. Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults.

    PubMed

    Chhabra, Jaspreet S; Balaji Sudharsan, S; Singh, Abhishek; Mishra, Shashikant; Ganpule, Arvind; Sabnis, Ravindra; Desai, Mahesh R

    2016-03-01

    To present our technique and experience of robot-assisted ureterocalycostomy (RAUC) in managing secondary pelvi-ureteric junction obstruction (PUJO) in adults. We retrospectively reviewed all patients from our centre who underwent RAUC, between 2011 and 2015, for secondary PUJO resulting from previous surgical intervention. Six procedures in five patients, including a bilateral RAUC were performed. The median (range) patient age was 33.7 (18-41) years. The outcome variables included operative time, duration of hospital stay, and objective evidence of unimpeded drainage on urography. The mean (range) operating time was 172 (144-260) min and estimated blood loss was 100 (50-250) mL. There were no conversions to open or laparoscopic surgery, and no intraoperative complications. Two patients had Clavien-Dindo Grade I complications that were managed conservatively and one patient had a Grade IIIb complication, which required balloon dilatation and re-stenting. After a median (range) follow-up of 11 (7-48) months, five of the six renal units had successful outcomes. The robot-assisted approach appears to be ideally suited for redo cases demanding fine dissection with meticulous suturing. In our present series of adult patients, we could safely and successfully perform RAUC with minimal morbidity. However, a larger multi-institutional outcome analysis is required to substantiate the role of the robot-assisted approach in performing UC.

  17. Robot-assisted ureterocalycostomy: A single centre contemporary experience in adults

    PubMed Central

    Chhabra, Jaspreet S.; Balaji Sudharsan, S.; Singh, Abhishek; Mishra, Shashikant; Ganpule, Arvind; Sabnis, Ravindra; Desai, Mahesh R.

    2016-01-01

    Objective To present our technique and experience of robot-assisted ureterocalycostomy (RAUC) in managing secondary pelvi-ureteric junction obstruction (PUJO) in adults. Patients and methods We retrospectively reviewed all patients from our centre who underwent RAUC, between 2011 and 2015, for secondary PUJO resulting from previous surgical intervention. Six procedures in five patients, including a bilateral RAUC were performed. The median (range) patient age was 33.7 (18–41) years. The outcome variables included operative time, duration of hospital stay, and objective evidence of unimpeded drainage on urography. Results The mean (range) operating time was 172 (144–260) min and estimated blood loss was 100 (50–250) mL. There were no conversions to open or laparoscopic surgery, and no intraoperative complications. Two patients had Clavien–Dindo Grade I complications that were managed conservatively and one patient had a Grade IIIb complication, which required balloon dilatation and re-stenting. After a median (range) follow-up of 11 (7–48) months, five of the six renal units had successful outcomes. Conclusion The robot-assisted approach appears to be ideally suited for redo cases demanding fine dissection with meticulous suturing. In our present series of adult patients, we could safely and successfully perform RAUC with minimal morbidity. However, a larger multi-institutional outcome analysis is required to substantiate the role of the robot-assisted approach in performing UC. PMID:26966590

  18. Effects of varied nitrate and phosphate supply on polysaccharidic and proteinaceous gel particle production during tropical phytoplankton bloom experiments

    NASA Astrophysics Data System (ADS)

    Engel, A.; Borchard, C.; Loginova, A.; Meyer, J.; Hauss, H.; Kiko, R.

    2015-10-01

    Gel particles such as the polysaccharidic transparent exopolymer particles (TEP) and the proteinaceous Coomassie stainable particles (CSP) play an important role in marine biogeochemical and ecological processes like particle aggregation and export, or microbial nutrition and growth. So far, effects of nutrient availability or of changes in nutrient ratios on gel particle production and fate are not well understood. The tropical ocean includes large oxygen minimum zones, where nitrogen losses due to anaerobic microbial activity result in a lower supply of nitrate relative to phosphate to the euphotic zone. Here, we report of two series of mesocosm experiments that were conducted with natural plankton communities collected from the eastern tropical North Atlantic (ETNA) close to Cape Verde in October 2012. The experiments were performed to investigate how different phosphate (experiment 1, Varied P: 0.15-1.58 μmol L-1) or nitrate (experiment 2, Varied N: 1.9-21.9 μmol L-1) concentrations affect the abundance and size distribution of TEP and CSP. In the days until the bloom peak was reached, a positive correlation between gel particle abundance and Chl a concentration was determined, linking the release of dissolved gel precursors and the subsequent formation of gel particles to autotrophic production. After the bloom peak, gel particle abundance remained stable or even increased, implying a continued partitioning of dissolved into particulate organic matter after biomass production itself ceased. During both experiments, differences between TEP and CSP dynamics were observed; TEP were generally more abundant than CSP. Changes in size distribution indicated aggregation of TEP after the bloom, while newly formed CSP decomposed. Abundance of gel particles clearly increased with nitrate concentration during the second experiment, suggesting that changes in [DIN] : [DIP] ratios can affect gel particle formation with potential consequences for carbon and nitrogen

  19. Dietetic students' experiences providing meal assistance in long-term care facilities.

    PubMed

    Osinga, Nicole; Keller, Heather

    2013-01-01

    This qualitative study involved describing the experiences of dietetic students who provided meal help to older adults. Of interest were benefits and challenges, and how training could be enhanced. Individual, face-to-face, semi-structured interviews were conducted with nine undergraduate dietetic students. In the preceding year, these students had volunteered as meal helpers in a long-term care home. Interviews were digitally recorded and transcribed verbatim. Qualitative thematic analysis was used to analyze the transcripts. All participating students were female and from one undergraduate program. Three main themes emerged: growing into the role, learning outside the classroom, and providing quality assistance. This study provides an understanding of how meal helping can be a valuable experience for emerging dietitians. It also gives insights into training and the development of the meal helper role.

  20. Time travel: the lived experience of providing feeding assistance to a family member with dementia.

    PubMed

    Lopez, Ruth Palan; Amella, Elaine J

    2011-04-01

    A major concern facing family members of people with advanced dementia is deciding how to provide food and water. Nurses play a significant role in supporting mealtimes, yet little is known about the meaning of mealtime for family caregivers of people with dementia. The purpose of this phenomenological study was to explore the experience of providing feeding assistance to a family member with dementia from the perspective of community and nursing home family caregivers. Data were collected through in-depth interviews with 16 family caregivers of individuals with advanced dementia. Analysis revealed that the experience was likened to living in a time warp whereby family caregivers were propelled from pleasant memories of the past, to the stark reality of the present, to a foreboding and uncertain future. Findings can guide nurses to dialogue with family members and to ensure that the full spectrum of mealtime is preserved. Copyright 2011, SLACK Incorporated.

  1. An expert system for fault management assistance on a space sleep experiment.

    PubMed

    Atamer, A; Delaney, M; Young, L R

    2002-10-01

    The expert system, Principal Investigator-in-a-box, or [PI], was designed to assist astronauts or other operators in performing experiments outside their expertise. Currently, the software helps astronauts calibrate instruments for a Sleep and Respiration Experiment without contact with the investigator on the ground. It flew on the Space Shuttle missions STS-90 and STS-95. [PI] displays electrophysiological signals in real time, alerts astronauts via the indicator lights when a poor signal quality is detected, and advises astronauts how to restore good signal quality. Thirty subjects received training on the sleep instrumentation and the [PI] interface. A beneficial effects of [PI] and training reduced troubleshooting time. [PI] benefited subjects on the most difficult scenarios, even though its lights were not 100% accurate. Further, questionnaires showed that most subjects preferred monitoring waveforms with [PI] assistance rather than monitoring waveforms alone. This study addresses problems of complex troubleshooting and the extended time between training and execution that is common to many human operator situations on earth such as in power plant operation, and marine exploration.

  2. An expert system for fault management assistance on a space sleep experiment

    NASA Technical Reports Server (NTRS)

    Atamer, A.; Delaney, M.; Young, L. R.

    2002-01-01

    The expert system, Principal Investigator-in-a-box, or [PI], was designed to assist astronauts or other operators in performing experiments outside their expertise. Currently, the software helps astronauts calibrate instruments for a Sleep and Respiration Experiment without contact with the investigator on the ground. It flew on the Space Shuttle missions STS-90 and STS-95. [PI] displays electrophysiological signals in real time, alerts astronauts via the indicator lights when a poor signal quality is detected, and advises astronauts how to restore good signal quality. Thirty subjects received training on the sleep instrumentation and the [PI] interface. A beneficial effects of [PI] and training reduced troubleshooting time. [PI] benefited subjects on the most difficult scenarios, even though its lights were not 100% accurate. Further, questionnaires showed that most subjects preferred monitoring waveforms with [PI] assistance rather than monitoring waveforms alone. This study addresses problems of complex troubleshooting and the extended time between training and execution that is common to many human operator situations on earth such as in power plant operation, and marine exploration.

  3. Bile Duct Anastomosis Supplied With Biodegradable Stent in Liver Transplantation: The Initial Experience.

    PubMed

    Janousek, L; Maly, S; Oliverius, M; Kocik, M; Kucera, M; Fronek, J

    2016-12-01

    The most common biliary complications after orthotopic liver transplantation are bile leaks, anastomotic and intrahepatic strictures, stones, and ampullary dysfunction. These complications can occur in up to 10% to 30% of liver transplant recipients. Leaks occur early in the posttransplant period; the stricture formation typically graduates over time. Ten patients underwent transplantation in our preliminary study: 5 were randomized to the group with stent placement and 5 to the control group. We investigated the role of an absorbable biliary stent with the goal of proving patency of duct-to-duct biliary anastomosis. The stents are made of machine-knitted polydioxanone monofilaments. Our initial results show that duct-to-duct biliary reconstruction using an absorbable internal stent had good patency in all 5 patients. There were no signs of biliary leakage accompanying the anastomoses in any of the cases, and there was no stone formation observed after liver transplantation. The biliary stent was completely absorbed, with no adverse effects. Based on our initial experience and data, we concluded that biodegradable stents can be successfully and safely used in clinical practice. Further large prospective randomized studies are needed to estimate the efficacy of the bioabsorbable stents. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. [Our experiences in the blood supply by means of a blood bank].

    PubMed

    Rajcić, E

    1975-01-01

    "GIVE US BLOOD TODAY, YOU'LL GET IT WHEN YOU NEED IT". Under this slogan the blood transfusion service gathers the blood donors offering, in return for the given blood the security that, any moment and in required quantities, the blood will be provided for every donor i.e. every member of any collective that acts on the request and "deposits" blood in so called blood banks", at least twice a year. Agitation among the prospective blood donors is completely confided to prominent people, social and medical workers, who do it permanently, and not from time to time, and who, if possible, are also blood donors, and owing to their own example, more convincing. The obligations between the blood transfusion service and "the investors" are regulated by oral agreement. It is noticed that the mutual moral obligation has more positive influence on the fulfillment of obligation than the administrative measure--a contract. According to this experience, individual work, a personal contact with prospective blood donors, and the feeling of personal security that is offered to them give the best results in motivating the people to become blood donors.

  5. Designing assisted living technologies 'in the wild': preliminary experiences with cultural probe methodology.

    PubMed

    Wherton, Joseph; Sugarhood, Paul; Procter, Rob; Rouncefield, Mark; Dewsbury, Guy; Hinder, Sue; Greenhalgh, Trisha

    2012-12-20

    , and acute illness. Discussions between researchers and participants about the materials collected (and sometimes about what had prevented them completing the tasks) helped elicit further information relevant to assisted living technology design. The probe materials were particularly helpful when having conversations with non-English speaking participants through an interpreter. Cultural probe methods can help build a rich picture of the lives and experiences of older people to facilitate the co-production of assisted living technologies. But their application may be constrained by the participant's physical, mental and emotional capacity. They are most effective when used as a tool to facilitate communication and development of a deeper understanding of older people's needs.

  6. Designing assisted living technologies ‘in the wild’: preliminary experiences with cultural probe methodology

    PubMed Central

    2012-01-01

    psychological resources, life events, and acute illness. Discussions between researchers and participants about the materials collected (and sometimes about what had prevented them completing the tasks) helped elicit further information relevant to assisted living technology design. The probe materials were particularly helpful when having conversations with non-English speaking participants through an interpreter. Conclusions Cultural probe methods can help build a rich picture of the lives and experiences of older people to facilitate the co-production of assisted living technologies. But their application may be constrained by the participant’s physical, mental and emotional capacity. They are most effective when used as a tool to facilitate communication and development of a deeper understanding of older people’s needs. PMID:23256612

  7. A Laboratory Experiment on the Evolution of a Sand Gravel Reach Under a Lack of Sediment Supply

    NASA Astrophysics Data System (ADS)

    Orru, C.; Chavarrias, V.; Ferrara, V.; Blom, A.

    2014-12-01

    A flume experiment was conducted to examine the evolution of a sand-gravel reach under a lack of sediment supply. The experimental data are used to validate a numerical sand-gravel model. A bed composed of a bi-modal sediment mixture is installed with a uniform slope and an imposed gradual fining pattern. Initially, the sand fraction gradually increases in streamwise direction until the bed is fully composed of sand. The water discharge and downstream water level were constant, and the sediment feed rate was equal to zero. The experiment was dominated by bed load, partial transport, and a subcritical flow regime was imposed. The flow rate was such that only sand was mobile (partial transport), which led to a coarsening over the upstream reach and a gradual reduction of the sediment transport rate during the experiment. New equipment was used to measure the evolution of the grain size distribution of the bed surface during the experiment over the entire flume using image analysis. In the upstream reach we observed a gradual coarsening over time and the formation of an armour layer, which resulted in a more abrupt transition in grain size of the bed surface. Bed degradation increased in streamwise direction. This is due to the initial streamwise increase in the availability of sand in the bed. The different volume fraction content of sand in the bed allowed for the gravel to sink more in the downstream part of the upstream reach. The sand reach suffered from a larger degradation. Finally, we see one reach dominated by sand, small bedforms, and a small bed slope, and a gravel reach dominated by a larger bed slope.

  8. Simulation and experiment research on the proportional pressure control of water-assisted injection molding

    NASA Astrophysics Data System (ADS)

    Zhou, Hua; Chen, Yinglong; Zhang, Zengmeng; Yang, Huayong

    2012-05-01

    Water-assisted injection molding (WAIM), a newly developed fluid-assisted injection molding technology has drawn more and more attentions for the energy saving, short cooling circle time and high quality of products. Existing research for the process of WAIM has shown that the pressure control of the injecting water is mostly important for the WAIM. However, the proportional pressure control for the WAIM system is quite complex due to the existence of nonlinearities in the water hydraulic system. In order to achieve better pressure control performance of the injecting water to meet the requirements of the WAIM, the proportional pressure control of the WAIM system is investigated both numerically and experimentally. A newly designed water hydraulic system for WAIM is first modeled in AMEsim environment, the load characteristics and the nonlinearities of water hydraulic system are both considered, then the main factors affecting the injecting pressure and load flow rate are extensively studied. Meanwhile, an open-loop model-based compensation control strategy is employed to regulate the water injection pressure and a feedback proportional integrator controller is further adopted to achieve better control performance. In order to verify the AMEsim simulation results WAIM experiment for particular Acrylonitrile Butadiene Styrene (ABS) parts is implemented and the measured experimental data including injecting pressure and flow rate results are compared with the simulation. The good coincidence between experiment and simulation shows that the AMEsim model is accurate, and the tracking performance of the load pressure indicates that the proposed control strategy is effective for the proportional pressure control of the nonlinear WAIM system. The proposed proportional pressure control strategy and the conclusions drawn from simulation and experiment contribute to the application of water hydraulic proportional control and WAIM technology.

  9. Code Sharing and Collaboration: Experiences From the Scientist's Expert Assistant Project and Their Relevance to the Virtual Observatory

    NASA Technical Reports Server (NTRS)

    Korathkar, Anuradha; Grosvenor, Sandy; Jones, Jeremy; Li, Connie; Mackey, Jennifer; Neher, Ken; Obenschain, Arthur F. (Technical Monitor)

    2001-01-01

    In the Virtual Observatory (VO), software tools will perform the functions that have traditionally been performed by physical observatories and their instruments. These tools will not be adjuncts to VO functionality but will make up the very core of the VO. Consequently, the tradition of observatory and system independent tools serving a small user base is not valid for the VO. For the VO to succeed, we must improve software collaboration and code sharing between projects and groups. A significant goal of the Scientist's Expert Assistant (SEA) project has been promoting effective collaboration and code sharing among groups. During the past three years, the SEA project has been developing prototypes for new observation planning software tools and strategies. Initially funded by the Next Generation Space Telescope, parts of the SEA code have since been adopted by the Space Telescope Science Institute. SEA has also supplied code for the SIRTF (Space Infrared Telescope Facility) planning tools, and the JSky Open Source Java library. The potential benefits of sharing code are clear. The recipient gains functionality for considerably less cost. The provider gains additional developers working with their code. If enough users groups adopt a set of common code and tools, de facto standards can emerge (as demonstrated by the success of the FITS standard). Code sharing also raises a number of challenges related to the management of the code. In this talk, we will review our experiences with SEA--both successes and failures, and offer some lessons learned that might promote further successes in collaboration and re-use.

  10. Implications of on-the-job Experience for the Curriculum for Library Technical Assistants at Pasadena City College.

    ERIC Educational Resources Information Center

    Green, Sylvia N.

    Reported are the results of a study undertaken to determine the extent to which library technical assistant students at Pasadena City College (California) brought previously learned skills from job experiences into the classroom and to ascertain whether the curriculum could be modified to minimize repetition of earlier experiences. Identification…

  11. Computer-assisted communication and team decision-making performance: the moderating effect of openness to experience.

    PubMed

    Colquitt, Jason A; Hollenbeck, John R; Ilgen, Daniel R; LePine, Jeffrey A; Sheppard, Lori

    2002-04-01

    This study examined the effects of computer-assisted communication on team decision-making performance as a function of the team's openness to experience. Seventy-nine teams performing a multiple-cue probability learning task were randomly assigned to 1 of 2 experimental conditions: (a) verbal communication or (b) computer-assisted communication (which combined verbal and computerized communication). The results indicated that access to computer-assisted communication improved the decision-making performance of teams, but only when the teams were high in openness to experience. This effect was observed using both global openness and more specific openness facets, as well as a variety of team-level aggregation strategies. Moreover, the beneficial effects of openness in computer-assisted conditions were mediated by the efficiency with which teams integrated verbal and computerized forms of communication.

  12. Effects of nitrogen supply on Pseudo-nitzschia calliantha and Pseudo-nitzschia cf. seriata: field and laboratory experiments.

    PubMed

    Melliti Ben Garali, Sondes; Sahraoui, Inès; de la Iglesia, Pablo; Chalghaf, Mohamed; Diogène, Jorge; Ksouri, Jamel; Sakka Hlaili, Asma

    2016-08-01

    The effects of inorganic and organic nitrogen supply on the growth and domoic acid (DA) production of Pseudo-nitzschia cf. seriata and Pseudo-nitzschia calliantha from Bizerte Lagoon (SW Mediterranean Sea) were studied during field and laboratory experiments. Nitrogen enrichments (40 µM NO3 (-); 10 µM NH4 (+); 20 µM CH4N2O) and a control, with no added N, were carried out in separate carboys with seawater collected from Bizerte Lagoon. In the field experiments, all N-enrichments resulted in significant increases in chlorophyll a concentration, and maintained exponential growth until the end of the experiment. The initial diatom community was dominated by a bloom of P. cf. seriata (9.3 × 10(5) cells l(-1)). After 6 days of incubation, the abundance of P. cf. seriata was greatest in the urea addition (1.52 × 10(6) cells l(-1)), compared to the ammonium treatment (0.47 × 10(6) cells l(-1)), nitrate treatment (0.70 × 10(6) cells l(-1)) and control (0.36 × 10(6) cells l(-1)). The specific growth rates, calculated from increases in chlorophyll a and cell abundance, were statistically different across all treatments, with the highest in the urea and nitrate additions. Similar results were obtained from the laboratory experiments. These were carried out with P. calliantha isolated from Bizerte Lagoon and grown in f/2 medium enriched with 40 µM nitrate, 10 µM ammonium and 20 µM urea. The exponential growth rate was significantly faster for the cells cultured with urea (1.50 d(-1)) compared to the nitrate (0.90 d(-1)) and ammonium (0.80 d(-1)) treatments and the control (0.40 d(-1)). Analysis of DA, performed at the beginning and the end of the both experiments in all treatments, revealed very low concentrations (below the limit of quantification, 0.02- 1.310(-7) pg cell(-1), respectively).The field and laboratory experiments demonstrate that P.cf. seriata and P. calliantha are able to grow efficiently on the three forms of N, but with a

  13. Experiments on robot-assisted navigated drilling and milling of bones for pedicle screw placement.

    PubMed

    Ortmaier, T; Weiss, H; Döbele, S; Schreiber, U

    2006-12-01

    This article presents experimental results for robot-assisted navigated drilling and milling for pedicle screw placement. The preliminary study was carried out in order to gain first insights into positioning accuracies and machining forces during hands-on robotic spine surgery. Additionally, the results formed the basis for the development of a new robot for surgery. A simplified anatomical model is used to derive the accuracy requirements. The experimental set-up consists of a navigation system and an impedance-controlled light-weight robot holding the surgical instrument. The navigation system is used to position the surgical instrument and to compensate for pose errors during machining. Holes are drilled in artificial bone and bovine spine. A quantitative comparison of the drill-hole diameters was achieved using a computer. The interaction forces and pose errors are discussed with respect to the chosen machining technology and control parameters. Within the technological boundaries of the experimental set-up, it is shown that the accuracy requirements can be met and that milling is superior to drilling. It is expected that robot assisted navigated surgery helps to improve the reliability of surgical procedures. Further experiments are necessary to take the whole workflow into account. Copyright 2006 John Wiley & Sons, Ltd.

  14. Magnetic resonance imaging (MRI)-assisted laparoscopic anorectoplasty for imperforate anus: a single center experience.

    PubMed

    Thomas, Tina T; Teitelbaum, Daniel H; Smith, Ethan A; Dillman, Jonathan R; Vellody, Ranjith; Jarboe, Marcus D

    2017-01-01

    Surgical procedures for high imperforate anus have ranged from the posterior sagittal anorectoplasty (PSARP) to laparoscopic-assisted anorectoplasty (LAARP). PSARP bisects the sphincter muscle complex, introducing muscle injury and scarring. LAARP uses a straight trocar to traverse an often non-linear sphincter muscle complex. MRI-assisted LAARP (MRI-LAARP) guides the neorectum precisely through the middle of the entire sphincter complex along its trajectory. We present our experience utilizing MRI intraoperatively during LAARP. Ten children underwent MRI-LAARP procedures. Intraoperative MRI was performed to delineate the sphincter complex, and to guide the advancement of an MRI-compatible needle through the center of the complex from skin to the peritoneal cavity. The remainder of the procedure was completed using the standard LAARP technique. All had successful MRI needle placement through the sphincter complex. Nine patients had successful laparoscopic pull-through procedures; one was converted to open due to severe intraperitoneal adhesions. Postoperative stay averaged 5.4 ± 4.4 days. Out of the ten patients, one child had mild dehiscence of the anal anastomosis requiring revision 11 days postoperatively. The theoretical advantage of the MRI-LAARP is placing the neorectum through the entire sphincter complex without transecting the muscle. Follow-up of these patients shows good short-term results; however, long-term follow-up will be needed to best assess sphincter and bowel function.

  15. Effects of varied nitrate and phosphate supply on polysaccharidic and proteinaceous gel particles production during tropical phytoplankton bloom experiments

    NASA Astrophysics Data System (ADS)

    Engel, A.; Borchard, C.; Loginova, A.; Meyer, J.; Hauss, H.; Kiko, R.

    2015-04-01

    It has been suggested that oxygen minimum zones (OMZ) will expand in the tropical oceans as a result of global change with potential consequences for marine element cycling, such as an increase in anaerobic nitrogen loss, resulting in a lower supply of nitrate relative to phosphate to the euphotic zone. So far, the effects of changes in nutrient ratios on organic matter recycling and export fluxes are not well understood. Here, were investigated how different phosphate (Varied P: 0.15-1.58 μmol L-1) or nitrate (Varied N: 1.9-21.9 μmol L-1) concentrations affect the abundance and size distribution of polysaccharidic transparent exopolymer particles (TEP), which are suggested to enhance particle aggregation and export fluxes, and on proteinaceous coomassie stainable particles (CSP), a supposedly good substrate for heterotrophic bacteria. Two series of mesocosm bloom experiments were conducted with natural plankton communities collected from the Eastern Tropical North Atlantic (ETNA) close to Cape Verde in October 2012. Until bloom peak, a positive correlation between gel particle abundance and Chl a concentration was determined, linking the release of dissolved gel precursors and the subsequent formation of gel particles to autotrophic production. After bloom peak, gel particle abundance remained stable or even increased, implying a continued partitioning of dissolved into particulate organic matter after biomass production itself ceased. During both experiments, differences between TEP and CSP dynamics were observed; TEP were generally more abundant than CSP. Changes in size distribution indicated aggregation of TEP during the bloom, while newly formed CSP decomposed. Abundance of gel particles clearly increased with nitrate concentration during the second experiment, suggesting that changes in [DIN]:[DIP] ratios can affect gel particle formation with potential consequences for carbon and nitrogen cycling as well as food web dynamics in tropical ecosystems.

  16. Robot-assisted low anterior resection in fifty-three consecutive patients: an Indian experience.

    PubMed

    Kenawadekar, R D; Dhange, R Z; Pandit, A; Bandawar, M S; Joshi, S; Agarwal, G; Jagtap, A P; Puntambekar, S

    2013-12-01

    From December 2005 to December 2009, we performed 150 laparoscopic colorectal procedures. Based on this experience, we started offering robot-assisted colorectal surgery from December 2009. This study is a prospective evaluation of consecutive patients in order to study the technical feasibility and oncological outcome of robot-assisted low anterior resection. This investigation was conducted at a single minimal access surgery institute. Between December 2009 and December 2011, 53 consecutive patients with rectal adenocarcinoma underwent a robot-assisted low anterior resection (LAR) or ultralow anterior resection (ULAR) with total mesorectal excision (TME), using the standard da Vinci 'S' model. Patient demographics, mean operative time, mean postoperative hospital stay, blood loss, days to first flatus, resumption of oral feeds, urinary incontinence, and sexual dysfunction were studied. Surgical and pathological outcomes such as quality of TME, free circumferential margins, and number of lymph nodes dissected were also evaluated. Robot docking and undocking times were noted. Of the 53 patients, 41 were men and 12 were women. Their mean age was 66.7 years (range 37-90 years). The ASA grades were distributed as follows: ASA I 15 (28.3 %), ASA II 25 (47.16 %), ASA III 12 (22.64 %), ASA IV 1 (1.88 %). The mean operative time was 180 min (150-230 min) and the mean blood loss was 101.6 ml (50-300 ml). The robot docking time was 10 min (15-25 min) and the undocking time was 5 min (3-10 min). The mean hospital stay was 8 days (7-15 days). None of the patients was converted to either laparoscopic or open procedure. The longitudinal and circumferential margins were negative in all patients. Histopathological reports of 45 patients showed complete TME while 8 patients showed nearly complete TME. No repositioning of the robot was needed for splenic flexure mobilization, thus decreasing the operative time. Along with TME, even the splenic flexure mobilization

  17. Some Experiences in 3D Laser Scanning for Assisting Restoration and Evaluating Damage in Cultural Heritage

    NASA Astrophysics Data System (ADS)

    Fuentes, L. M.; Finat, Javier; Fernández-Martin, J. J.; Martínez, J.; SanJose, J. I.

    The recent incorporation of laser devices provides advanced tools for assisting the conservation and restoration of Cultural Heritage. It is necessary to have as complete as possible understanding of the object state before evaluating or defining the reach of the restoration process. Thus, a special effort is devoted to surveying, measuring and generating a high-resolution 3D model prior to restoration planning. This work presents results of several experiments performed on damaged pieces for evaluation purposes in Cultural Heritage. Some software tools are applied for carving-work analysis, conservation-state monitoring, and simulation of weathering processes for evaluating temporal changes. In all cases considered, a high resolution information capture has been performed with a laser scanner, the Minolta 910. Our approach is flexible enough to be adapted to other kinds of pieces or Cultural Heritage artefacts, in order to provide an assessment for intervention planning in conservation and restoration tasks.

  18. Arginine-assisted solubilization system for drug substances: solubility experiment and simulation.

    PubMed

    Hirano, Atsushi; Kameda, Tomoshi; Arakawa, Tsutomu; Shiraki, Kentaro

    2010-10-28

    The poor aqueous solubility of drug substances hampers their broader applications. This paper describes a de novo strategy to increase the aqueous solubility of drug substances using an arginine-assisted solubilization system (AASS) with alkyl gallates as model drug substances. Solubility experiments of alkyl gallates showed that arginine greatly increases the aqueous solubility of different alkyl gallates, whose aqueous solubilities differ widely. In contrast, lysine showed marginal effects on alkyl gallates solubility. Molecular dynamic simulation indicated a greater interaction of arginine with alkyl gallates than that of lysine, which reflects favorable interaction between the guanidinium group of arginine and the aromatic ring of alkyl gallates. Such interaction apparently disrupts association of alkyl gallate molecules, leading to solubilization. These results indicate AASS as a promising approach to solubilize poorly soluble drug substances containing aromatic ring structures.

  19. Does the experience of interpersonal predictors of suicidal desire predict positive attitudes toward Physician Assisted Suicide?

    PubMed

    Tucker, Raymond P; Buchanan, Carmen A; O'Keefe, Victoria M; Wingate, Laricka R

    2014-01-01

    The current study examined the relationship between Physician Assisted Suicide (PAS) attitudes and interpersonal risk factors of suicidal desire as outlined by the interpersonal-psychological theory of suicidal behavior (Joiner, 2005). It was hypothesized that both thwarted belongingness and perceived burdensomeness would be positively related to PAS acceptance. Results indicated that thwarted belongingness and perceived burdensomeness predicted significance of favorable attitudes toward PAS in a college sample. Results suggest that attitudes toward PAS may be influenced by the experience of thwarted belongingness and perceived burdensomeness and provide a clear rationale for the study of these variables in populations more apt to consider hastened death. Future work regarding the application of the interpersonal-psychological theory of suicidal behavior in hastened death research is discussed.

  20. Optimization of ion-assisted ITO films by design of experiment

    NASA Astrophysics Data System (ADS)

    Schwyn Thöny, Silvia; Buchholz, Jürgen; Waldner, Stephan

    2011-09-01

    In this work we want to demonstrate how the methodology of Design of Experiment (DOE) can be used for the development of ion-assisted ITO films deposited at low temperatures. The optimization method allows us to identify the process parameters, which yield films with high transmittance and low resistivity. The article will show the results obtained for transmittance and resistivity. Furthermore, the dispersion of the refractive index and the extinction coefficient will be determined as well as the surface roughness. In ITO there is a trade-off between transmittance / absorbance and sheet resistance. Virtually absorption free films could be obtained with a resistivity of 3.2 μΩm, whereas the lowest resistivity (2.7 μΩm) yielded a transmittance, which was reduced by a few percent.

  1. Monte Carlo simulations of multiple scattering effects in laser assisted free-free scattering experiments

    NASA Astrophysics Data System (ADS)

    Deharak, B. A.; Savich, J. L.; Roberts, H. M.; Brown, E. G.; McGill, M. R.; Kim, B. N.; Weaver, C. M.; Martin, N. L. S.

    2016-05-01

    We have conducted a series of Monte Carlo simulations of laser assisted free-free scattering experiments. The simulations make use of Kroll-Watson approximation to account for the effects of the laser field on the scattering process. The parameters for these simulations are believed to mimic the experimental conditions of the work reported by Wallbank and Holmes, particularly the target number density. The simulations account for the effects multiple scattering (i.e., the scattering of a single incident electron from multiple target atoms). We present a comparison of the results of these simulations to the experimental results of Wallbank and Holmes. This work was supported by the National Science Foundation under Grants Nos. PHY-0855040 (NLSM) and PHY-1402899 (BAd).

  2. Developing an assisted automated peritoneal dialysis (aAPD) service—a single-centre experience

    PubMed Central

    Brown, Nina

    2011-01-01

    There is an ongoing increase in the number of elderly or frail patients requiring renal replacement therapy. Assisted automated peritoneal dialysis (aAPD) is one treatment option for this patient group and is becoming increasingly recognized as a distinct dialysis modality. In this article, we review the current status of aAPD and its evolution across Europe, describing the differences in service provision. We also report our experience locally of outcomes on our aAPD population over the last 4 years. We found that aAPD is a viable dialysis modality in the frail and elderly with limited lifespan, and complications of peritoneal dialysis are perhaps lower than would be expected in this population. This form of therapy also avoids the disruption to life which results from hospital-based dialysis. PMID:25949510

  3. Reality of nerve sparing and surgical margins in surgeons' early experience with robot-assisted radical prostatectomy in Japan.

    PubMed

    Tatsugami, Katsunori; Yoshioka, Kunihiko; Shiroki, Ryoichi; Eto, Masatoshi; Yoshino, Yasushi; Tozawa, Keiichi; Fukasawa, Satoshi; Fujisawa, Masato; Takenaka, Atsushi; Nasu, Yasutomo; Kashiwagi, Akira; Gotoh, Momokazu; Terachi, Toshiro

    2017-03-01

    To analyze nerve sparing performance at an early stage of robot-assisted radical prostatectomy, and the correlation between the surgeons' experience and the risk of a positive surgical margin in patients treated with robot-assisted radical prostatectomy. Patients' records from January 2009 to March 2013 were retrospectively reviewed, and 3469 patients with localized prostate cancer were identified at 45 institutions. Individual surgeon's experience with nerve sparing was recorded as the number of nerve sparing cases among total robot-assisted radical prostatectomies beginning with the first case during which nerve sparing was carried out. Patients were selected by propensity score matching for nerve sparing, and predictive factors of positive surgical margins were analyzed in patients with and without positive surgical margins. A total of 152 surgeons were studied, and the median number of robot-assisted radical prostatectomy cases for all surgeons was 21 (range 1-511). In all, 54 surgeons (35.5%) undertook nerve sparing during their first robot-assisted radical prostatectomy case. For 2388 patients selected with (1194) and without (1194) nerve sparing, predictive factors for positive surgical margin were high initial prostate-specific antigen level (P < 0.0001), high biopsy Gleason score (P = 0.0379), presence of neoadjuvant hormone therapy (P = 0.0002) and surgeon's experience with >100 cases (P = 0.0058). Thus, nerve sparing was not associated with positive surgical margins. The surgeon's experience influences the occurrence of positive surgical margins, although a considerable number of surgeons carried out nerve sparing during their early robot-assisted radical prostatectomy cases. Surgeons should consider their own experience and prostate cancer characteristics before carrying out a nerve sparing robot-assisted radical prostatectomy. © 2017 The Japanese Urological Association.

  4. Three hundred robotic-assisted mitral valve repairs: the Cedars-Sinai experience.

    PubMed

    Ramzy, Danny; Trento, Alfredo; Cheng, Wen; De Robertis, Michele A; Mirocha, James; Ruzza, Andrea; Kass, Robert M

    2014-01-01

    The study objective was to review our first 300 consecutive robotic-assisted mitral repairs performed from June 2005 to October 2012 and to compare the surgical outcomes of our previously reported initial 120 cases with the subsequent 180 procedures. Our initial 120 robotic-assisted mitral repairs were previously reported, and we now compare our early experience with the recent 180 consecutive procedures for a total of 300 robotic-assisted mitral repairs. There was no patient selection. Every patient in need of isolated mitral valve repair underwent this procedure. All patients received an annuloplasty band and 1 or more of the following: leaflet resection, secondary chordal transposition, or polytetrafluoroethylene neochordal replacement and edge-to-edge repair. All 300 patients had preoperative echocardiographic findings of severe mitral regurgitation. There were no differences (P = not significant) between the initial and the recent cohorts for preoperative characteristics, including age (58.4 ± 10.5 years vs 59.9 years), female gender (35.8% vs 36.1%), ejection fraction (61.9% vs 60.6%), congestive heart failure (35.0% vs 36.7%), creatinine (0.94 mg/dL vs 0.98 mg/dL), and New York Heart Association class. The incidence of anterior and posterior leaflet prolapse was similar in both groups, whereas Barlow syndrome was higher in group 2 (5.8% vs 27.8%). There was 1 (0.33%) hospital mortality and no deaths in the last 180 cases. Overall, 8 patients (2.7%) required subsequent mitral valve replacement via a median sternotomy, 6 (5.0%) in the first group and 2 (1.1%) in the second group (P = .06). One patient in each group had mitral valve re-repair through a right mini-thoracotomy, and 1 patient in the first group required a mitral valve replacement via a mini-thoracotomy during the original procedure. Two of the 180 patients had documented cerebrovascular accident, but both fully recovered clinically. There was no cerebrovascular accident in the last 120

  5. Roles of National and Local Governments and the Dietetic Association in Nutrition Assistance Response to Natural Disasters: Systems and Experiences in Japan and the USA.

    PubMed

    Sudo, Noriko

    2015-01-01

    In the first half of this symposium, the disaster response system in Japan will be introduced. The ultimate aim of nutrition assistance is to keep people in disaster areas healthy. This is a task for the Ministry of Health, Labour and Welfare and the health departments of prefectural governments. Our first speaker, Dr. Yasuhiro Kanatani, National Institute of Public Health, will briefly overview the disaster response system in Japan and its related laws. He will also mention how the Ministry responded to the Great East Japan Earthquake. In the second presentation, I will play one chapter of DVD that we released in last September. In that chapter, Ms. Makiko Sawaguchi, a registered dietitian working for a public health center in the area affected by the Great East Japan Earthquake, talks about her experience in supporting disaster victims. As an employee of Iwate Prefectural Government, she helped affected municipal governments and coordinated outside support. One type of outside support was registered dietitians dispatched by the Japan Dietetic Association (JDA). Dr. Nobuyo Tsuboyama-Kasaoka will report what those dietitians did in the affected areas. She will also explain the aim and training of the JDA-Disaster Assistance Team. Provision of food is essential in nutrition assistance. This is a task for the Ministry of Agriculture, Forestry and Fisheries. Our fourth speaker, Mr. Kunihiro Doi, analyzed the government procurement data and will discuss the limitations of government emergency food supplies and lessons learned from the Great East Japan Earthquake. As for the systems and experiences in the US, we invited Ms. Toni Abernathy from the Office of Emergency Management, Food and Nutrition Service (FNS), United States Department of Agriculture.

  6. Comparison and modeling of effects of normal and reduced precipitation supply in field experiment with spring barley

    NASA Astrophysics Data System (ADS)

    Pohanková, Eva; Orság, Matěj; Fischer, Milan; Hlavinka, Petr

    2015-04-01

    This paper evaluates two-year (2013 and 2014) results of field experiments with spring barley (cultivar Bojos) under reduced precipitation supply. The field experiments were carried out at the experimental station in Domanínek (Czech Republic; 49°31,470'N, 16°14,400'E, altitude 530 m a.s.l.) and conducted by Institute of Agrosystems and bioclimatology at Mendel Univerzity in Brno in cooperation with Global Change Research Centre AS CR. The field experiments consisted of small plots in two variants and three repetitions. The first variant was uncovered the second was partially covered to exclude rain through out the whole vegetation season. For the partial covering of the plot, a material which transmits solar radiation and diverts rainwater away from the percentage coverage of the plots was used. In 2013, the covered area of the experimental plot was 30%, and in 2014, it was 70%. The main aim was to determine whether there are any differences in the spring barley's development, growth and yield in the uncovered and the partially covered plots, and a comparison of the results. Firstly, differences of key parameters (seasonal dynamics of the leaf area index and above ground biomass, soil water content, yield components and yields) compared; secondly, the results of the field experiments served as input data for the crop growth model DAISY. Subsequently, the crop growth model' ability to simulate crop growth and crop development which were affected by the drought stress was explored. The results were assessed using the following statistical indexes: root mean square error (RMSE) and mean bias error (MBE). This study was funded by project "Building up a multidisciplinary scientific team focused on drought" No. CZ.1.07/2.3.00/20.0248, NAZV-JPI - project supported by Czech National Agency of Agricultural Research No. QJ1310123 "Crop modelling as a tool for increasing the production potential and food security of the Czech Republic under Climate Change" and project LD

  7. Becoming physics people: Development of integrated physics identity through the Learning Assistant experience

    NASA Astrophysics Data System (ADS)

    Close, Eleanor W.; Conn, Jessica; Close, Hunter G.

    2016-06-01

    [This paper is part of the Focused Collection on Preparing and Supporting University Physics Educators.] In this study, we analyze the experience of students in the Physics Learning Assistant (LA) program at Texas State University in terms of the existing theoretical frameworks of community of practice and physics identity, and explore the implications suggested by these theories for LA program adoption and adaptation. Regression models from physics identity studies show that the physics identity construct strongly predicts intended choice of a career in physics. The goal of our current project is to understand the details of the impacts of participation in the LA experience on participants' practice and self-concept, in order to identify critical elements of LA program structure that positively influence physics identity and physics career intentions for students. Our analysis suggests that participation in the LA program impacts LAs in ways that support both stronger "physics student" identity and stronger "physics instructor" identity, and that these identities are reconciled into a coherent integrated physics identity. Increased comfort in interactions with peers, near peers, and faculty seems to be an important component of this identity development and reconciliation, suggesting that a focus on supporting community membership is useful for effective program design.

  8. DuraHeart™ magnetically levitated left ventricular assist device: Osaka University experience.

    PubMed

    Sakaguchi, Taichi; Matsumiya, Goro; Yoshioka, Daisuke; Miyagawa, Shigeru; Nishi, Hiroyuki; Yoshikawa, Yasushi; Fukushima, Satsuki; Saito, Shunsuke; Ueno, Takayoshi; Sawa, Yoshiki

    2013-01-01

    The DuraHeart left ventricular assist device (LVAD) is the world's first approved magnetically levitated implantable centrifugal pump. We report our initial experience with the DuraHeart as a bridge to heart transplantation. Between 2008 and 2011, 23 patients (17 males; mean age 35 years, range 16-53 years) with endstage heart failure underwent implantation with the DuraHeart LVAD at Osaka University Hospital. Of those, 7 underwent conversion surgery from a Nipro paracorporeal LVAD to the DuraHeart. There were no deaths during the mean support period of 559±241 days (176-999 days). In total, 17 patients (74%) remain with the LVAD and 5 (22%) underwent heart transplantation after 580±302 days (176-982 days) of support. Major adverse events included 8 (34%) driveline/pocket infections, 4 (17%) cerebrovascular accidents, 4 (17%) right heart failures requiring mechanical support, and 3 (13%) mechanical device failures (magnetic levitation failure caused by driveline fracture). Of the 5 patients who developed pump pocket infection, 3 underwent previous conversion surgery from the Nipro LVAD. Our initial experience with the DuraHeart LVAD in Japan demonstrated excellent long-term survival with acceptable rates of adverse events. With refinement of the system, including mechanical durability, this pump will further enhance the quality of life for patients who require long-term mechanical circulatory support.

  9. Robot-assisted radical cystectomy with intracorporeal neobladder diversion: The Karolinska experience

    PubMed Central

    Collins, Justin W.; Sooriakumaran, P.; Sanchez-Salas, R.; Ahonen, R.; Nyberg, T.; Wiklund, N. P.; Hosseini, A.

    2014-01-01

    Introduction: The aim of this report is to describe our surgical technique of totally intracorporeal robotic assisted radical cystectomy (RARC) with neobladder formation. Materials and Methods: Between December 2003 and March 2013, a total of 147 patients (118 male, 29 female) underwent totally intracorporeal RARC for urinary bladder cancer. We also performed a systematic search of Medline, Embase and PubMed databases using the terms RARC, robotic cystectomy, robot-assisted, totally intracorporeal RARC, intracorporeal neobladder, intracorporeal urinary diversion, oncological outcomes, functional outcomes, and complication rates. Results: The mean age of our patients was 64 years (range 37-87). On surgical pathology 47% had pT1 or less disease, 27% had pT2, 16% had pT3 and 10% had pT4. The mean number of lymph nodes removed was 21 (range 0-60). 24% of patients had lymph node positive dAQ1isease. Positive surgical margins occurred in 6 cases (4%). Mean follow-up was 31 months (range 4-115 months). Two patients (1.4%) died within 90 days of their operation. Using Kaplan-Meier analysis, overall survival and cancer specific survival at 60 months was 68% and 69.6%, respectively. 80 patients (54%) received a continent diversion with totally intracorporeal neobladder formation. In the neobladder subgroup median total operating time was 420 minutes (range 265-760). Daytime continence and satisfactory sexual function or potency at 12 months ranged between 70-90% in both men and women. Conclusions: Our experience with totally intracorporeal RARC demonstrates acceptable oncological and functional outcomes that suggest this is a viable alternative to open radical cystectomy. PMID:25097318

  10. Early Experience of Robot-Assisted Esophagectomy With Circular End-to-End Stapled Anastomosis.

    PubMed

    Wee, Jon O; Bravo-Iñiguez, Carlos E; Jaklitsch, Michael T

    2016-07-01

    Surgical resection is a critical element in the treatment of esophageal cancer. Esophagectomy is technically challenging and is associated with high morbidity and mortality rates. Efforts to reduce these rates have spurred the adoption of minimally invasive techniques. This study describes a single-institution experience of robot-assisted esophagectomy with circular end-to-end stapled anastomosis. Between December 2013 and April 2015, a series of consecutive patients underwent robot-assisted Ivor Lewis esophagectomy with circular end-to-end anastomosis (RAILE-EEA) at a tertiary care center with curative intent. We retrospectively reviewed their electronic medical records using real-time prospectively collected data. The operative and postoperative outcomes were recorded. Twenty patients underwent RAILE-EEA during the study period. The abdominal mobilization was performed laparoscopically, and the thoracic portion was robotic. The median total operative time was 455 minutes (range, 318-765 minutes), the 90-day operative mortality was 0%, and morbidity was present in 11 of 20 patients (55%). Atrial fibrillation was the most common event and was observed in 3 patients (15%). There were no anastomotic leaks. The median estimated blood loss was 275 mL, and the conversion rate was 0%. Complete (R0) resection was achieved in all cases. The mean number of lymph nodes was 23.2 (± 2.26). The median follow-up time was 330 days (range, 108-600 days), and the overall 1-year survival was 84%. RAILE-EEA in our institution suggests a safe, effective, and reproducible alternative with satisfactory postoperative outcomes for the treatment of esophageal cancer. It provided good local control, adequate lymphadenectomy, low morbidity, and low 90-day operative mortality. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Discussing physician-assisted dying: physicians' experiences in the United States and the Netherlands.

    PubMed

    Voorhees, Jennifer R; Rietjens, Judith A C; van der Heide, Agnes; Drickamer, Margaret A

    2014-10-01

    This study aims to further our understanding of the experiences of physicians when discussing physician-assisted dying (PAD) within the context of doctor-patient relationships in various sociolegal settings. Although patients bring up PAD in diverse settings, little is known about how physicians experience these discussions, and such experiences have not been directly compared across countries. A total of 36 physicians in the Netherlands and the United States (including Oregon) were interviewed using individual semistructured interview guides. Interviews were conducted by a single interviewer, audiotaped, and independently transcribed. Inductive qualitative analysis, aided by NVivo7 software, directed purposive sampling of physicians until saturation was met. Multiple coders in a multidisciplinary team analyzed emerging themes and developed theory. PAD discussions, which ranged from theoretical discussions to actual requests, could be gateways to discussions of other end-of-life issues important to patients and could strengthen doctor-patient relationships. Physicians found discussions to be emotionally intense, but often rewarding. Where PAD was legal, physicians utilized existing criteria to guide communication, and discussions were open and honest with patients and colleagues. Where PAD was illegal, conversations were less explicit, and physicians dealt with requests in relative isolation. In addition, physicians' views of their professional role, patients' rights, and religion influenced both their willingness to have and the content of PAD discussions. Discussion of PAD is an energy-consuming, yet potentially enriching part of the doctor-patient relationship. Legal guidelines may help to provide structure and support for physicians when patients broach the topic of PAD. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Toward Transformative Learning: An Inquiry into the Work and Subsequent Learning Experiences of Individuals Who Assisted Hurricane Katrina Evacuees

    ERIC Educational Resources Information Center

    Ficks, David B., II.

    2010-01-01

    The purpose of this multi-case study was to examine in depth the personal and learning experiences of helping professionals and volunteer helpers when challenged to assist adult Hurricane Katrina evacuees and victims in the aftermath of the disaster. The study contributes theoretically, practically and substantively to the adult education field.…

  13. Lifelong Learning: Teaching Assistants' Experiences of Economic, Social and Cultural Change Following Completion of a Foundation Degree

    ERIC Educational Resources Information Center

    Woolhouse, Clare; Dunne, Linda; Goddard, Gill

    2009-01-01

    This paper stems from a longitudinal research project that explored the perceptions and experiences of teaching assistants (predominantly women) who have undertaken a foundation degree. It draws upon Bourdieu's notion of habitus and investigates shifts in economic, cultural and social capital for this particular group of educational professionals.…

  14. Toward Transformative Learning: An Inquiry into the Work and Subsequent Learning Experiences of Individuals Who Assisted Hurricane Katrina Evacuees

    ERIC Educational Resources Information Center

    Ficks, David B., II.

    2010-01-01

    The purpose of this multi-case study was to examine in depth the personal and learning experiences of helping professionals and volunteer helpers when challenged to assist adult Hurricane Katrina evacuees and victims in the aftermath of the disaster. The study contributes theoretically, practically and substantively to the adult education field.…

  15. Regenerative water supply for an interplanetary space station: The experience gained on the space stations “Salut”, “Mir”, ISS and development prospects

    NASA Astrophysics Data System (ADS)

    Bobe, Leonid; Samsonov, Nikoly; Gavrilov, Lev; Novikov, Vladimir; Tomashpolskiy, Mihail; Andreychuk, Peter; Protasov, Nikoly; Synjak, Yury; Skuratov, Vladimir

    2007-06-01

    Based on the experience in operation of Russian space stations Salut, Mir and International space station ISS the station's water balance data, parameters and characteristics of the systems for water recovery have been obtained. Using the data design analysis an integrated water supply system for an interplanetary space station has been performed. A packaged physical/chemical system for water supply is composed of an integrated system for water recovery from humidity condensate, green house condensate, water from carbon dioxide reduction system and condensate from urine system; a system for water reclamation from urine; hygiene water processing system and a water storage system. The take off mass of the packaged water supply system (including expendables, redundancy hardware, equivalent mass of power consumption and of thermal control) is appropriate for Mars missions. The international space station is indispensable for verifying innovative processes and new water recovery systems intended for missions to Mars.

  16. Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania

    PubMed Central

    2014-01-01

    Background Provision of quality emergency obstetric care relies upon the presence of skilled health attendants working in an environment where drugs and medical supplies are available when needed and in adequate quantity and of assured quality. This study aimed to describe the experience of rural health facility managers in ensuring the timely availability of drugs and medical supplies for emergency obstetric care (EmOC). Methods In-depth interviews were conducted with a total of 17 health facility managers: 14 from dispensaries and three from health centers. Two members of the Council Health Management Team and one member of the Council Health Service Board were also interviewed. A survey of health facilities was conducted to supplement the data. All the materials were analysed using a qualitative thematic analysis approach. Results Participants reported on the unreliability of obtaining drugs and medical supplies for EmOC; this was supported by the absence of essential items observed during the facility survey. The unreliability of obtaining drugs and medical supplies was reported to result in the provision of untimely and suboptimal EmOC services. An insufficient budget for drugs from central government, lack of accountability within the supply system and a bureaucratic process of accessing the locally mobilized drug fund were reported to contribute to the current situation. Conclusion The unreliability of obtaining drugs and medical supplies compromises the timely provision of quality EmOC. Multiple approaches should be used to address challenges within the health system that prevent access to essential drugs and supplies for maternal health. There should be a special focus on improving the governance of the drug delivery system so that it promotes the accountability of key players, transparency in the handling of information and drug funds, and the participation of key stakeholders in decision making over the allocation of locally collected drug funds. PMID

  17. Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania.

    PubMed

    Mkoka, Dickson Ally; Goicolea, Isabel; Kiwara, Angwara; Mwangu, Mughwira; Hurtig, Anna-Karin

    2014-03-19

    Provision of quality emergency obstetric care relies upon the presence of skilled health attendants working in an environment where drugs and medical supplies are available when needed and in adequate quantity and of assured quality. This study aimed to describe the experience of rural health facility managers in ensuring the timely availability of drugs and medical supplies for emergency obstetric care (EmOC). In-depth interviews were conducted with a total of 17 health facility managers: 14 from dispensaries and three from health centers. Two members of the Council Health Management Team and one member of the Council Health Service Board were also interviewed. A survey of health facilities was conducted to supplement the data. All the materials were analysed using a qualitative thematic analysis approach. Participants reported on the unreliability of obtaining drugs and medical supplies for EmOC; this was supported by the absence of essential items observed during the facility survey. The unreliability of obtaining drugs and medical supplies was reported to result in the provision of untimely and suboptimal EmOC services. An insufficient budget for drugs from central government, lack of accountability within the supply system and a bureaucratic process of accessing the locally mobilized drug fund were reported to contribute to the current situation. The unreliability of obtaining drugs and medical supplies compromises the timely provision of quality EmOC. Multiple approaches should be used to address challenges within the health system that prevent access to essential drugs and supplies for maternal health. There should be a special focus on improving the governance of the drug delivery system so that it promotes the accountability of key players, transparency in the handling of information and drug funds, and the participation of key stakeholders in decision making over the allocation of locally collected drug funds.

  18. Initial experience with personal digital assistant-based reflectance photoplethysmograph for free tissue transfer monitoring.

    PubMed

    Stack, Brendan C; Futran, Neal D; Zang, Billy; Scharf, John E

    2003-08-01

    Improved microsurgical technique has resulted in a high percentage of successful free tissue transfers. When a tissue transfer fails in the head and neck, however, the results are orocutaneous fistulas, carotid artery exposure, and deformity that adds morbidity, expense, and may delay adjuvant therapy. Postoperative monitoring of tissue perfusion can detect early problems in free tissue transfer that may allow for early intervention and salvage. The authors have demonstrated that reflectance photoplethysmography can detect perfusion changes in free tissue transfer within 5 minutes of a pedicle "insult" intraoperatively. Normative data for viable flaps from various donor sites have been established. The authors now report their initial experience with a newly developed reflectance photoplethysmograph based on a hand-held computer for routine clinical use. Their results are compared with a conventional surveillance protocol that included observation, bleeding to pin prick, and bedside duplex scanning of the vascular pedicle. In a series of 30 free tissue transfers (29 patients), there was one ischemic event (skin paddle loss only), which was detected by the monitor. The monitor was able to predict correctly (one flap) survival of a free tissue transfer even when duplex ultrasonic data were indicative of an absence of perfusion. Personal digital assistant-based photoplethysmography appears to be a promising device for bedside diagnosis of free tissue transfer viability or ischemia.

  19. HeartMate II Left Ventricular Assist Device Pump Exchange: A Single-Institution Experience.

    PubMed

    Shaikh, Asad F; Joseph, Susan M; Lima, Brian; Hall, Shelley A; Malyala, Rajasekhar; Rafael, Aldo E; Gonzalez-Stawinski, Gonzalo V; Chamogeorgakis, Themistokles

    2016-11-30

    Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution. The indications, demographics, and outcome were extracted and analyzed. Results Of 250 total patients with implanted HMII LVADs, 16 (6%) required pump exchange during the study period. The initial indications for LVAD placement in these patients were bridge to transplantation (n = 6 [37.5%]) or destination therapy (n = 10 [62.5%]). Fifteen patients (93.8%) required pump exchange due to pump thrombosis and 1 (6.2%) due to refractory driveline infection. Nine patients (56.2%) underwent repeat median sternotomy while a left subcostal approach was used in the remaining seven patients. Fifteen patients (93.7%) survived until hospital discharge. During the follow-up period (median, 155 days), 11 patients remained alive and 4 of these underwent successful cardiac transplantation. Conclusion HMII LVAD pump exchange can be safely performed for driveline infection or pump thrombosis when heart transplantation is not an option.

  20. Understanding the Learning Assistant experience with Physics Identity and Community of Practice

    NASA Astrophysics Data System (ADS)

    Close, Eleanor; Close, Hunter; Donnelly, David

    2012-10-01

    Learning Assistants (LAs) have been shown to have better conceptual understanding and more favorable beliefs about science than non-LAs, and are more likely to choose a career in K-12 science teaching [1]. We propose that connections between elements of identity, persistence, and participation in an LA program can be explained using the concept of the community of practice and its intimate relationship to identity [2]. In separate work, Hazari et al. found that physics identity was highly correlated to expressed career plans in physics [3]. We hypothesize that a thriving LA program has many features of a well-functioning community of practice and contributes to all four elements of physics identity: personal interest, student performance, competence, and recognition by others. We explore how this analysis of the LA experience might shape decisions and influence outcomes of adoption and adaptations of the LA model.[4pt] [1] Otero, Pollock, & Finkelstein, Am. J. Phys. 78 (11), 1218-1224 (2010).[0pt] [2] Wenger, Communities of Practice: Learning, Meaning, and Identity. (Cambridge Univ. Press, 1998).[0pt] [3] J. Res. Sci. Teach. 47 (8), 978-1003 (2010).

  1. Coblation assisted transnasal endoscopic resection of nasopharyngeal cyst: 10 years experience and outcomes

    PubMed Central

    Wang, Qinying; Chen, Haihong; Wang, Shenqing

    2015-01-01

    Objectives: To determine the outcomes of coblation assisted transnasal endoscopic resection of nasopharyngeal cyst. Method: Retrospective chart review outcomes in 12 patients who underwent endoscopic resect cysts of the nasopharynx at our department between 2001 and 2010. Twelve patient, aged 28 to 71 years, with cysts of the nasopharynx. The outcome variables of complications and the rate of recurrence were analyzed, respectively. Results: In 12 cases, retention cysts in 2 cases, branchial cyst in 1 case, adenoid middle fossa cyst infection in 6 cases, Tornwaldt’s cyst in 3 cases. The use of the coblation device was associated with a significant decrease in blood loss. There were no postoperative complications, and the overall follow-up period was 2-7 years and shows no signs of recurrence. Conclusions: We describe transnasal endoscopic procedures to resect cysts of the nasopharynx. We found that radiofrequency coblation is a useful and safe tool associated with minimal blood loss in the resection of these cysts. In our experience, it has been a highly successful, safe, and effective procedure. PMID:26131108

  2. Hands-On Experiences in Deploying Cost-Effective Ambient-Assisted Living Systems.

    PubMed

    Dasios, Athanasios; Gavalas, Damianos; Pantziou, Grammati; Konstantopoulos, Charalampos

    2015-06-18

    Older adults' preferences to remain independent in their own homes along with the high costs of nursing home care have motivated the development of Ambient Assisted Living (AAL) technologies which aim at improving the safety, health conditions and wellness of the elderly. This paper reports hands-on experiences in designing, implementing and operating UbiCare, an AAL based prototype system for elderly home care monitoring. The monitoring is based on the recording of environmental parameters like temperature and light intensity as well as micro-level incidents which allows one to infer daily activities like moving, sitting, sleeping, usage of electrical appliances and plumbing components. The prototype is built upon inexpensive, off-the-shelf hardware (e.g., various sensors, Arduino microcontrollers, ZigBee-compatible wireless communication modules) and license-free software, thereby ensuring low system deployment costs. The network comprises nodes placed in a house's main rooms or mounted on furniture, one wearable node, one actuator node and a centralized processing element (coordinator). Upon detecting significant deviations from the ordinary activity patterns of individuals and/or sudden falls, the system issues automated alarms which may be forwarded to authorized caregivers via a variety of communication channels. Furthermore, measured environmental parameters and activity incidents may be monitored through standard web interfaces.

  3. Stereotactic breast biopsy with an 8-gauge, directional, vacuum-assisted probe: initial experience.

    PubMed

    Lifrange, Eric; Dondelinger, Robert F; Quatresooz, Pascale; Vandevorst, Geraldine; Colin, Claude

    2002-09-01

    This study was prospectively conducted to assess the feasibility, safety and accuracy of an 8-G directional vacuum-assisted biopsy (DVAB) probe in the diagnostic management of nonpalpable breast lesions (NPBL). Of 170 planned procedures which were indicated for investigation of BI-RADS category-3 to category-5 lesions, 153 were performed in 138 consecutive patients. The probe was targeted by the stereotactic unit of a prone table (United States Surgical Corporation, Norwalk, Conn.; and Lorad, Danbury, Conn.). Four to 18 (mean 8) core specimens were obtained for each lesion. In case of complete removal of the lesion, a localizing clip was deployed at the biopsy site. Adequate material for histopathologic examination was obtained in all cases (100%). Four of 138 (3%) patients experienced mild hematomas. We observed 15 of 39 failures (38%) to place the localizing clips. Thirteen of 153 (8%) procedures were inconclusive and required reintervention. Following DVAB, 42 of 138 (30%) patients underwent surgery. Subject to incomplete follow-up of the entire cohort, we observed no false-positive and one false-negative diagnosis. These preliminary results suggest that DVAB using an 8-G probe are feasible, safe and accurate. In our experience, clip placement was problematic. It is probable that increasing the dimensions of DVAB will only be relevant in a limited number of clinical situations, primarily the desire to obtain complete radiologic resections of the target abnormality.

  4. Experience of a patient with an extracorporeal ventricular assist system who participated in a sleepover program.

    PubMed

    Gon, Shigeyoshi; Suematsu, Yoshihito; Morizumi, Sei; Shimizu, Tsuyoshi

    2011-09-01

    A 19-year-old woman suffered fulminant myocarditis owing to a mycoplasma infection and was inserted with an intra-aortic balloon pump and a percutaneous cardiopulmonary support. Antibiotics and gamma globulin were administered, however, the patient's cardiac function did not recover, and the TOYOBO ventricular assist device (VAD) was implanted. She had rehabilitation training such as maintaining a standing position at the bedside and walking in the hospital, and a hospital outing program to a family restaurant was conducted two times with the VAD. The patient wished to attend the coming-of-age ceremony in Tachikawa city, which is 3 h away from our hospital by car. Therefore, we planned the program including a night stay at her home. The patient and her family fully understood the risks and wished to participate in the sleepover program. In preparing for the sleepover, the patient and her family learned to operate the VAD, and she was able to move to the lavatory and through the house with the help of only her family. A physician and a clinical engineer stayed at her house for infusion of antibiotics and management of sudden changes. There was no adverse event. In Japan, the community support of patients with VAD is not yet established, and we hope that our experience becomes a help to support return to society for patients with VAD.

  5. Hands-On Experiences in Deploying Cost-Effective Ambient-Assisted Living Systems

    PubMed Central

    Dasios, Athanasios; Gavalas, Damianos; Pantziou, Grammati; Konstantopoulos, Charalampos

    2015-01-01

    Older adults’ preferences to remain independent in their own homes along with the high costs of nursing home care have motivated the development of Ambient Assisted Living (AAL) technologies which aim at improving the safety, health conditions and wellness of the elderly. This paper reports hands-on experiences in designing, implementing and operating UbiCare, an AAL based prototype system for elderly home care monitoring. The monitoring is based on the recording of environmental parameters like temperature and light intensity as well as micro-level incidents which allows one to infer daily activities like moving, sitting, sleeping, usage of electrical appliances and plumbing components. The prototype is built upon inexpensive, off-the-shelf hardware (e.g., various sensors, Arduino microcontrollers, ZigBee-compatible wireless communication modules) and license-free software, thereby ensuring low system deployment costs. The network comprises nodes placed in a house’s main rooms or mounted on furniture, one wearable node, one actuator node and a centralized processing element (coordinator). Upon detecting significant deviations from the ordinary activity patterns of individuals and/or sudden falls, the system issues automated alarms which may be forwarded to authorized caregivers via a variety of communication channels. Furthermore, measured environmental parameters and activity incidents may be monitored through standard web interfaces. PMID:26094631

  6. The Berlin Heart EXCOR Pediatric ventricular assist device: history, North American experience, and future directions.

    PubMed

    Fraser, Charles D; Jaquiss, Robert D B

    2013-07-01

    Options for long-term mechanical circulatory support to sustain pediatric heart failure patients requiring cardiac transplantation while they wait for donor hearts have been unsatisfactory. The conventional approach has been to use extracorporeal membrane oxygenation (ECMO), but its lack of feasibility for long-term use and the major complications associated with the technology have limited its use, especially in light of lengthy waiting lists for donor hearts. With the advent of the Berlin Heart EXCOR® Pediatric ventricular assist device (VAD), pediatric heart failure specialists have gained an important tool for helping this patient population survive until a donor heart can be identified. The EXCOR Pediatric VAD is designed to support pediatric patients of all age groups, from newborns to teenagers, and can be used successfully for many months. This paper describes the early experience with the EXCOR Pediatric VAD and the challenging journey undertaken to gain U.S. FDA approval, including successful completion of the first worldwide prospective clinical study of VADs in a pediatric population.

  7. Evaluation of Robotic-Assisted Laparoscopic and Open Pyeloplasty in Children: Single-Surgeon Experience

    PubMed Central

    Murthy, P; Cohn, JA

    2015-01-01

    Introduction Robotic-assisted laparoscopic pyeloplasty (RALP), the most commonly undertaken paediatric robotic urologic surgery, has not been compared against open pyeloplasty (OPN) by a single surgeon. Here, we describe our experience and outcomes. Methods Children undergoing RALP or OPN from 2007 to 2013 were reviewed. Clinical success was defined as resolution of presenting symptoms and improved/stable hydronephrosis on ultrasound. Results RALP and OPN cohorts comprised 52 and 40 patients, respectively. RALP patients were significantly older (6.8 vs 1.2 years, p<0.01) and heavier (28.4 vs 8.4 kg, p<0.01). Operative times for RALP were longer (203.3 vs 135.0 min, p<0.01), but decreased significantly with increasing experience (r2=0.42, p<0.01). Seven type-IIIb Clavien–Dindo complications occurred in RALP patients compared with two in OPN cases. There were no differences in postoperative narcotic administration (p=0.92) or duration of stay in hospital (DOSH) (p=0.93). A total of 11/40 (28%) OPN patients required epidural analgesia but none were placed in the RALP cohort. A total of 49/52 (94%) RALP patients and 40/40 OPN cases had successful outcomes. Three RALP patients required revision RALP. Conclusions These data show that outcomes for RALP and OPN were comparable. An initial learning curve with RALP is to be expected, but operative times for RALP approached those for OPN. Previously reported benefits of RALP (reduced analgesic requirements, DOSH) were not observed. This difference may have been due to comparison of a heterogeneous cohort. Close evaluation of complications allowed for improved placement of stents in RALP. PMID:25723686

  8. Assessment of Initial Test Conditions for Experiments to Assess Irradiation Assisted Stress Corrosion Cracking Mechanisms

    SciTech Connect

    Busby, Jeremy T; Gussev, Maxim N

    2011-04-01

    Irradiation-assisted stress corrosion cracking is a key materials degradation issue in today s nuclear power reactor fleet and affects critical structural components within the reactor core. The effects of increased exposure to irradiation, stress, and/or coolant can substantially increase susceptibility to stress-corrosion cracking of austenitic steels in high-temperature water environments. . Despite 30 years of experience, the underlying mechanisms of IASCC are unknown. Extended service conditions will increase the exposure to irradiation, stress, and corrosive environment for all core internal components. The objective of this effort within the Light Water Reactor Sustainability program is to evaluate the response and mechanisms of IASCC in austenitic stainless steels with single variable experiments. A series of high-value irradiated specimens has been acquired from the past international research programs, providing a valuable opportunity to examine the mechanisms of IASCC. This batch of irradiated specimens has been received and inventoried. In addition, visual examination and sample cleaning has been completed. Microhardness testing has been performed on these specimens. All samples show evidence of hardening, as expected, although the degree of hardening has saturated and no trend with dose is observed. Further, the change in hardening can be converted to changes in mechanical properties. The calculated yield stress is consistent with previous data from light water reactor conditions. In addition, some evidence of changes in deformation mode was identified via examination of the microhardness indents. This analysis may provide further insights into the deformation mode under larger scale tests. Finally, swelling analysis was performed using immersion density methods. Most alloys showed some evidence of swelling, consistent with the expected trends for this class of alloy. The Hf-doped alloy showed densification rather than swelling. This observation may be

  9. Complications of hand-assisted laparoscopic renal surgery: single-center ten-year experience.

    PubMed

    Moore, Nathan W; Nakada, Stephen Y; Hedican, Sean P; Moon, Timothy D

    2011-06-01

    To review our perioperative complications during the first decade of using hand-assisted laparoscopic nephrectomy using a sleeve (HALN). HALN is a minimally invasive procedure first reported by our group in 1997. After institutional review board approval, the charts of the patients who had undergone HALN, hand-assisted laparoscopic partial nephrectomy, or hand-assisted laparoscopic nephroureterectomy from 1997 to 2007, at our institution, were retrospectively reviewed. Standard laparoscopic procedures were not included. The relevant patient characteristics, operative details, American Society of Anesthesiologists score, body mass index, comorbidities, medications, and complications were recorded. A total of 227 consecutive patients had undergone Hand-assisted laparoscopic renal surgery, and all their charts were reviewed. Of these 227, 134 were radical HALN, 37 were nonradical HALN, 42 were hand-assisted laparoscopic partial nephrectomy, and 15 were hand-assisted laparoscopic nephroureterectomy. Complications developed in 59 patients (26%): 8% major and 18% minor. The procedure-specific complication rate was 29% for radical HALN, 27% for nonradical HALN, 33% for hand-assisted laparoscopic nephroureterectomy, and 17% for hand-assisted laparoscopic partial nephrectomy. Complications included blood transfusion in 6%, urinary retention in 4%, ileus in 4%, and wound infection in 4%. From 2003 through 2007 (n = 163), our overall complication rate was 22% (8% major and 13% minor). From 1997 to 2002 (n = 65), the overall complication rate was 38% (P = .02). The American Society of Anesthesiologists score and the use of systemic steroids were associated with the occurrence of perioperative complications. Our results have shown that hand assistance provides a safe, minimally invasive laparoscopic procedure. Our complications rates were comparable to those with other standard and hand-assist series, although the spectrum of complications varied. Hand-assisted laparoscopic

  10. One year experience with computer-assisted propofol sedation for colonoscopy.

    PubMed

    Lin, Otto S; La Selva, Danielle; Kozarek, Richard A; Tombs, Deborah; Weigel, Wade; Beecher, Ryan; Koch, Johannes; McCormick, Susan; Chiorean, Michael; Drennan, Fred; Gluck, Michael; Venu, Nanda; Larsen, Michael; Ross, Andrew

    2017-04-28

    To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse. Procedural success rates, polyp detection rates, procedure times and recovery times were recorded and compared against corresponding historical measures from 2286 colonoscopies done with midazolam and fentanyl from September 2013 to August 2014. Adverse events in the CAPS group were recorded. The mean age of the CAPS cohort was 59.9 years (48.7% male); 31.3% were ASA I, 67.3% ASA II and 1.4% ASA III. 45.1% of the colonoscopies were for screening, 31.5% for surveillance, and 23.4% for symptoms. The mean propofol dose administered was 250.7 mg (range 16-1470 mg), with a mean fentanyl dose of 34.1 mcg (0-100 mcg). The colonoscopy completion and polyp detection rates were similar to that of historical measures. Recovery times were markedly shorter (31 min vs 45.6 min, P < 0.001). In CAPS patients, there were 20 (0.7%) cases of mild desaturation (< 90%) treated with a chin lift and reduction or temporary discontinuation of the propofol infusion, 21 (0.8%) cases of asymptomatic hypotension (< 90 systolic blood pressure) treated with a reduction in the propofol rate, 4 (0.1%) cases of marked agitation or discomfort due to undersedation, and 2 cases of pronounced transient desaturation requiring brief (< 1 min) mask ventilation. There were no sedation-related serious adverse events such as emergent intubation, unanticipated hospitalization or permanent injury. CAPS appears to be a safe, effective and efficient means of providing moderate sedation for colonoscopy in relatively healthy patients. Recovery times were

  11. One year experience with computer-assisted propofol sedation for colonoscopy

    PubMed Central

    Lin, Otto S; La Selva, Danielle; Kozarek, Richard A; Tombs, Deborah; Weigel, Wade; Beecher, Ryan; Koch, Johannes; McCormick, Susan; Chiorean, Michael; Drennan, Fred; Gluck, Michael; Venu, Nanda; Larsen, Michael; Ross, Andrew

    2017-01-01

    AIM To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse. Procedural success rates, polyp detection rates, procedure times and recovery times were recorded and compared against corresponding historical measures from 2286 colonoscopies done with midazolam and fentanyl from September 2013 to August 2014. Adverse events in the CAPS group were recorded. RESULTS The mean age of the CAPS cohort was 59.9 years (48.7% male); 31.3% were ASA I, 67.3% ASA II and 1.4% ASA III. 45.1% of the colonoscopies were for screening, 31.5% for surveillance, and 23.4% for symptoms. The mean propofol dose administered was 250.7 mg (range 16-1470 mg), with a mean fentanyl dose of 34.1 mcg (0-100 mcg). The colonoscopy completion and polyp detection rates were similar to that of historical measures. Recovery times were markedly shorter (31 min vs 45.6 min, P < 0.001). In CAPS patients, there were 20 (0.7%) cases of mild desaturation (< 90%) treated with a chin lift and reduction or temporary discontinuation of the propofol infusion, 21 (0.8%) cases of asymptomatic hypotension (< 90 systolic blood pressure) treated with a reduction in the propofol rate, 4 (0.1%) cases of marked agitation or discomfort due to undersedation, and 2 cases of pronounced transient desaturation requiring brief (< 1 min) mask ventilation. There were no sedation-related serious adverse events such as emergent intubation, unanticipated hospitalization or permanent injury. CONCLUSION CAPS appears to be a safe, effective and efficient means of providing moderate sedation for colonoscopy in relatively healthy

  12. Peer-Assisted Tutoring in a Chemical Engineering Curriculum: Tutee and Tutor Experiences

    ERIC Educational Resources Information Center

    Kieran, Patricia; O'Neill, Geraldine

    2009-01-01

    Peer-Assisted Tutorials (PATs), a form of Peer-Assisted Learning (PAL), were introduced to a conventional 4-year honours degree programme in Chemical Engineering. PATs were designed to support students in becoming more self-directed in their learning, to develop student confidence in tackling Chemical Engineering problems and to promote effective…

  13. A Peer-Assisted Learning Experience in Computer Programming Language Learning and Developing Computer Programming Skills

    ERIC Educational Resources Information Center

    Altintas, Tugba; Gunes, Ali; Sayan, Hamiyet

    2016-01-01

    Peer learning or, as commonly expressed, peer-assisted learning (PAL) involves school students who actively assist others to learn and in turn benefit from an effective learning environment. This research was designed to support students in becoming more autonomous in their learning, help them enhance their confidence level in tackling computer…

  14. A Peer-Assisted Learning Experience in Computer Programming Language Learning and Developing Computer Programming Skills

    ERIC Educational Resources Information Center

    Altintas, Tugba; Gunes, Ali; Sayan, Hamiyet

    2016-01-01

    Peer learning or, as commonly expressed, peer-assisted learning (PAL) involves school students who actively assist others to learn and in turn benefit from an effective learning environment. This research was designed to support students in becoming more autonomous in their learning, help them enhance their confidence level in tackling computer…

  15. Course Evaluation Matters: Improving Students' Learning Experiences with a Peer-Assisted Teaching Programme

    ERIC Educational Resources Information Center

    Carbone, Angela; Ross, Bella; Phelan, Liam; Lindsay, Katherine; Drew, Steve; Stoney, Sue; Cottman, Caroline

    2015-01-01

    In the rapidly changing global higher education sector, greater attention is being paid to the quality of university teaching. However, academics have traditionally not received formal teacher training. The peer-assisted teaching programme reported on in this paper provides a structured yet flexible approach for peers to assist each other in…

  16. Padova Hospitale Onlus: report of a 15-year experience in surgical and medical assistance in developing countries.

    PubMed

    Semplicini, Andrea; Vindigni, Vincenzo; Giatsidis, Giorgio; Chiarelli, Angelo

    2013-07-01

    Nowadays, an urgent need for global medical cooperation and assistance still bears on health care providers. Because plastic, reconstructive, and aesthetic surgery is a surgical specialty with social purposes, the humanitarian importance of the discipline is, nowadays, stronger than ever. Padova Hospitale Onlus is a nonprofit charity association with the aim to ensure sustainable medical programs, in particular in the field of plastic and reconstructive surgery. The activity of the association in fund-raising strategies, volunteer enrollment, and operative strategies has been reviewed and reported to stimulate further collaboration, emulation, and contributions. Since 1996, the association has assisted over 20,000 people during 50 missions over the 5 continents, performing more than 2000 surgical operations and almost 8000 medical examination, involving more than 320 volunteers, supplying health care material or health care facilities. Furthermore, a high rate of surgical records and of medical assistance has been performed in the last 2 years, depicting a positive rising trend of activity. However, scarce financial means, absence of a structured coordination, and/or cooperation between associations may often affect the long-term sustainability of these interventions. Thus, only an experienced and structured association may grant the required resources to sustain adequate and fruitful short-term or long-term projects for the promotion of a humanitarian cooperation as much "demand driven" as possible.

  17. Families' experiences with patients who died after assisted suicide: a retrospective interview study in southern Switzerland.

    PubMed

    Gamondi, C; Pott, M; Payne, S

    2013-06-01

    In Switzerland, if certain conditions are met, assisted suicide is not prosecuted. International debate suggests that requests for hasten death are often altered by the provision of palliative care. Aims of the study were to explore patients' reasons for choice of assisted suicide and family perceptions of the interactions with health care professionals. This is a qualitative study upon 11 relatives of 8 patients cared for by a palliative care team, deceased of assisted suicide. Pain and symptom burden were not regarded by patients as key reasons to seek assisted suicide: existential distress and fear of loss of control were the determinants. Most patients had made pre-illness decisions to use assisted suicide. A general need for perceived control and fear of dependency were reported as a common characteristic of these patients. Patients held misunderstandings about the nature and purpose of palliative care, and the interviewed indicated that patients did not regard provision of palliative care services as influential in preventing their decision. Assisted suicide was preferred despite provision of palliative care. Better understanding of the importance placed on perceived control and anticipated dependency is needed. Further research is needed to develop appropriate support for patients contemplating assisted suicide.

  18. 43 CFR 12.720 - Excepted articles, materials, and supplies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... AND AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Buy American Requirements for Assistance Programs Buy American Act-Supplies § 12.720 Excepted articles, materials, and supplies. (a) As...

  19. 43 CFR 12.720 - Excepted articles, materials, and supplies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... AND AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Buy American Requirements for Assistance Programs Buy American Act-Supplies § 12.720 Excepted articles, materials, and supplies. (a) As...

  20. 43 CFR 12.720 - Excepted articles, materials, and supplies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... AND AUDIT REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Buy American Requirements for Assistance Programs Buy American Act-Supplies § 12.720 Excepted articles, materials, and supplies. (a) As...

  1. Influence of the experience of operator and assistant on the survival rate of proximal ART restorations: two-year results.

    PubMed

    Kemoli, A M; van Amerongen, W E; Opinya, G

    2009-12-01

    The objective of the study was to determine the influence of the experience of the operator and the assistant on the survival rate of proximal ART- restorations after 2 years when placed using two methods of tooth-isolation and three glass ionomer cement-brands. A clinical intervention study. Each of 804 children aged 6-8 years received one proximal restoration in their primary molars. The restorations were placed by 'experienced/inexperienced' operators randomly paired with 'experienced/ inexperienced' assistants. The atraumatic restorative treatment (ART) approach was used with 3 brands of glass ionomer cements (GIC) and 2 tooth-isolation methods (rubber dam vs cotton rolls). Trained and calibrated evaluators evaluated the restorations, soon after placement and after 2 years. The data collected were analyzed using SPSS 14.0, to determine and relate the survival rate of the restorations to the operator and assistant with respect to the other factors such as the restorative material used and the isolation method applied. After 2 years, the survival rate of the restorations was 30.8%. In general, there were no statistical significant differences in the survival rate of the restorations made by the 'experienced' vs 'inexperienced' operators, but individually, the operator with more experience was associated with a significantly higher survival rate of the restorations. The experienced assistants were associated with significantly higher survival rates of the restorations. The most 'experienced' operator paired with any 'experienced' assistant and using rubber dam tooth-isolation method, was associated with a significantly higher survival rate of the restorations. The combination of the 'experienced' operator and assistant using rubber dam tooth-isolation method had the best chance of survival for proximal ART restorations, irrespective of the material-brand used.

  2. Hydro-jet assisted laparoscopic partial nephrectomy: initial experience in a porcine model.

    PubMed

    Shekarriz, H; Shekarriz, B; Upadhyay, J; Bürk, C; Wood, D P; Bruch, H P

    2000-03-01

    Hemostasis represents a challenge when performing laparoscopic partial nephrectomy. Hydro-Jet cutting is an advanced technology that has been used to create an ultra-coherent water force that functions like a sharp knife. In the surgical field, it has mainly been used for liver surgery and initial clinical experience with laparoscopic cholecystectomies has been favorable. This technique allowed selective parenchymal cutting with preservation of vessels and bile ducts. We describe a novel Hydro-Jet assisted dissection technique for laparoscopic partial nephrectomy in a porcine model. Ten partial nephrectomies were performed in 5 pigs using a Muritz 1000 (Euromed Medizintechnik, A. Pein, Schwerin, Germany) Hydro-Jet generator. A thin stream of ultra coherent fluid is forced at a high velocity through a small nozzle. A modified probe allows both blunt dissection concomitantly with high-pressure water application. Coagulation can be applied via a bipolar thermoapplicator as needed. Laparoscopic partial nephrectomy was successful in all animals. Water-jet cutting through the parenchyma was virtually bloodless and preserved the vasculature and the collecting system. The vessels were then ligated or coagulated under direct vision. The continuous water flow established a bloodless operating field and a clear view for the surgeon. The mean dissection time and warm ischemia time were 45+/-9 and 17+/-3 minutes, respectively. This preliminary study supports the suitability of this technique for laparoscopic partial nephrectomy to improve hemostasis. The improved anatomical dissection and hemostasis may further decrease morbidity and operative time. Further studies are underway to compare this technique with laser coagulation for laparoscopic partial nephrectomy.

  3. Oregon emergency physicians' experiences with, attitudes toward, and concerns about physician-assisted suicide.

    PubMed

    Schmidt, T A; Zechnich, A D; Tilden, V P; Lee, M A; Ganzini, L; Nelson, H D; Tolle, S W

    1996-10-01

    To determine emergency physicians' (EPs') attitudes toward physician-assisted suicide (PAS), factors associated with those attitudes, current experiences with attempted suicides in terminally ill persons, and concerns about the impact of legalizing PAS on emergency medicine practice. A cross-sectional, anonymous mailed survey was taken of EPs in the state of Oregon. Of 356 eligible physicians, 248 (70%) returned the survey. Of the respondents, 69% indicated that PAS should be legal, 65% considered PAS consistent with the physician's role, and 19% believed that it is immoral. The respondents were concerned that patients might feel pressure if they perceived themselves to be either a care burden on others (82%) or a financial stress to others (69%). Only 37% indicated that the Oregon initiative has enough safeguards to protect vulnerable persons. Support for legalization was not associated with gender, age, or practice location. Respondents with no religious affiliation were most supportive of PAS (p < 0.001), and Catholic respondents were least suppportive (p = 0.03). A majority (58%) had treated at least 1 terminally ill patient after an apparent overdose. Most respondents (97%) indicated at least 1 circumstance for which they would sometimes be willing to let a terminally ill patient die without resuscitation after PAS if the Oregon initiative becomes law: if verified with an advance directive from the patient (81%), with documentation in writing from the physician (73%), after speaking to the primary physician (64%), if a competent patient verbally confirmed intent (60%), or if the family verbally confirmed intent (52%). Although the majority of Oregon EPs favor the concept of legalization of PAS, most have concerns that safeguards in the Oregon initiative are inadequate to protect vulnerable patients. These physicians would consider not resuscitating terminally ill patients who have attempted suicide under the law's provisions, only in the setting of

  4. Robotic-assisted partial nephrectomy without using ureteral stent: a single center experience

    PubMed Central

    Özkan, Burak; Coşkuner, Enis Rauf; Yalçın, Veli

    2016-01-01

    Objective To share our results of robotic assisted partial nephrectomy (RAPN) we performed without using ureteral stent in a single center from Turkey. Material and methods Medical records of consecutive 45 patients (34 men and 11 women) who underwent RAPN for kidney lesions between March 2011 and December 2014 were retrieved, and evaluated. All the procedures were performed by a transperitoneal approach without using ureteral stent prior to surgery. Renal artery clamping was used in all cases and intraoperative ultrasonography was used in 2 cases. Results Patients undergoing RAPN had a mean tumor size of 4.42 cm (2–8) and a mean renal nephrometry score of 5.82 (4–11). The mean estimated blood loss was 250 mL (150–450 ml) and the mean operative time was 195 minutes (150–300). There was no statistical difference between the preoperative and postoperative serum creatinine levels at the first follow-up visit (0.9 vs. 0.95, p=0.087). Surgical margin positivity was not detected in any patient, and the mean surgical margin distance was calculated as 0.4 mm (0.2–10). In only 1 patient disease recurrence was detected at the 21st month of the the follow-up period, and no distant metastases was reported in our patients at a mean follow-up of 10 months (3–36 mos). Our complication rate was 11.1% and according to the Clavien system complications were as; grade 2 (3 patients), grade 3a (1 patient) and grade 3b (1 patient). Conclusion With appropriately selected patients and adequate surgical experience, RAPN performed without using ureteral stent is a safe and feasible method for localized renal tumors. PMID:27011873

  5. Clinical results with Jarvik 2000 axial flow left ventricular assist device: Osaka University Experience.

    PubMed

    Yoshioka, Daisuke; Matsumiya, Goro; Toda, Koichi; Sakaguchi, Taichi; Yoshikawa, Yasushi; Saito, Shunsuke; Matsuda, Hikaru; Sawa, Yoshiki

    2014-12-01

    The aim of this study was to evaluate our clinical experience with the Jarvik 2000 axial flow pump (Jarvik Heart, Inc, New York, NY, USA), a miniature axial flow left ventricular assist device (LVAD). The clinical results of eight patients, who underwent LVAD implantation with the Jarvik 2000 (median age 55.0 years; six men) between 2005 and 2010, including two who participated in a multicenter clinical trial in Japan, were reviewed. Two patients underwent LVAD implantation as destination therapy. Four patients underwent Jarvik 2000 implantation via median sternotomy, while the other four underwent implantation via left thoracotomy. There were no major complications during surgery. Four patients were supported for more than 2 years. The longest support duration was 1,618 days. Six patients successfully bridged to heart transplantation after a median 725 days of support. One patient on destination therapy died of a cerebral infarction. The other patient on destination therapy had had the LVAD for 1,618 days. The overall survival rates at 1, 2, and 3 years were 100, 86, and 86%, respectively. The median postoperative serum lactate dehydrogenase level was 860.5 U/L at 1 month, 735 U/L at 6 months, and 692 U/L at 1 year. There were no fatal device-related infections. We found that the Jarvik 2000 with pin bearing could support patients with end-stage heart failure with acceptable mortality and morbidity rates. Further evaluations of the prevalence of thromboembolic and hemolytic events in patients with the new conical-bearing Jarvik 2000 are required.

  6. Experiences in the Application of Project-Based Learning in a Switching-Mode Power Supplies Course

    ERIC Educational Resources Information Center

    Lamar, D. G.; Miaja, P. F.; Arias, M.; Rodriguez, A.; Rodriguez, M.; Vazquez, A.; Hernando, M. M.; Sebastian, J.

    2012-01-01

    This paper presents the introduction of problem-based learning (PBL) in a power electronics course at the University of Oviedo, Gijon, Spain, by means of two practical projects: the design and construction of a switching-mode power supply (SMPS) prototype and the static study of a dc-dc converter topology. The goal of this innovation was for…

  7. Low-Income Urban Mothers' Experiences with the Supplemental Nutrition Assistance Program.

    PubMed

    Robbins, Sarah; Ettinger, Anna K; Keefe, Carolyn; Riley, Anne; Surkan, Pamela J

    2017-03-01

    Food insecurity remains a public health concern in the United States, particularly among low-income urban ethnically diverse families, even with the Supplemental Nutrition Assistance Program (SNAP). Limited phenomenologic data exist to capture how programmatic changes to SNAP address the needs of users and why a gap in SNAP use may exist. The primary aim of this study was to examine the experiences of low-income, Baltimore, MD, mothers in applying for and maintaining access to SNAP. Secondary aims included understanding participants' perspectives on the influence of changes in SNAP over a 3-year period and how SNAP fits into the overall system of social services for families. In this qualitative, phenomenologic study, in-depth interviews were conducted with 13 mothers and three focus groups with 20 mothers, for a total sample of 33 mothers receiving SNAP benefits. Ten mothers participated in the first round of data collection (January to May 2010), and 23 in the second round (February to May 2013). Participants were 33 mothers receiving SNAP benefits in Baltimore City, MD. Baltimore SNAP users' experiences with applying for and maintaining access to SNAP, as well as with program changes to the SNAP program. Data were analyzed using an iterative emergent design and phenomenologic approach. A constructivist perspective was implemented throughout the coding process. SNAP functioned as a valuable support system within the broader social safety net for mothers living in poverty, yet participants expressed frustration about the processes of applying for and maintaining benefits due to communication problems and poor integration of services. In applying for and accessing SNAP, positive interactions with caseworkers and previous knowledge of the SNAP program were important for maintaining benefits. Interviews and focus group discussions revealed the need for additional outreach and education about the implemented program changes to build trust and improve access to SNAP

  8. 40 CFR 35.6305 - Obtaining supplies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... STATE AND LOCAL ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Personal Property Requirements Under A Cooperative Agreement § 35.6305 Obtaining supplies....

  9. Exploring the experiences of bereaved families involved in assisted suicide in Southern Switzerland: a qualitative study.

    PubMed

    Gamondi, Claudia; Pott, Murielle; Forbes, Karen; Payne, Sheila

    2015-06-01

    In Switzerland, helping with assisted suicide under certain conditions is not prosecuted. With approximately 300 cases annually, this leaves behind a large group of bereaved people where its consequences are mostly unknown. The study aimed to explore family involvement in decision making prior to assisted suicide, and to examine their ways of coping during the bereavement period. A qualitative interview study used the principles of Grounded Theory analysis. Eleven relatives of eight patients, who died in Southern Switzerland after assisted suicide, participated in semistructured interviews. The large majority of family members faced moral dilemmas during the decision-making phase. Their respect for patient's autonomy was a key justification to resolve dilemmas. Two types of involvement were identified: categorised as 'passive' when the decision making was located with the patient, and 'active' when assisted suicide was proposed by the family member and/or the relative was involved in some way. The relatives reported feelings of isolation during and after assisted suicide. Family members reported fear of social stigma and did not openly disclose assisted suicide as the cause of death. None of those interviewed received formal psychological support. Bereaved families express moral dilemmas, feelings of isolation and secrecy in the management of assisted suicide in Southern Switzerland. These features seem underestimated and not sufficiently recognised by the healthcare professionals. Management of assisted suicide requests should include consideration of family members' needs, in addition to those of the patient. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Holmium:YAG laser-assisted otolaryngologic surgery: Lahey Clinic experience

    NASA Astrophysics Data System (ADS)

    Shapshay, Stanley M.; Rebeiz, Elie E.; Pankratov, Michail M.

    1993-07-01

    The Holmium:YAG laser was used to assist in 36 rhinologic procedures including surgery for chronic sinus disease, chronic dacryocystitis, recurrent choanal stenosis, and a sphenoid sinus mucocele. There were no laser related complications. The laser permitted controlled ablation of bone and soft tissue in all cases with satisfactory results. The Ho:YAG laser can be used in otolaryngology to assist in cases where surgical access is difficult or when controlled, precise bone and soft tissue ablation is necessary.

  11. Gaze-based assistive technology used in daily life by children with severe physical impairments - parents' experiences.

    PubMed

    Borgestig, Maria; Rytterström, Patrik; Hemmingsson, Helena

    2017-07-01

    To describe and explore parents' experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based assistive technology (AT)) for use in daily life. Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents' experiences, hermeneutical interpretations were used during data analysis. The findings demonstrate that for parents, children's gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show personality and competencies, and gave children possibilities to develop. Overall, children's gaze-based AT provides hope for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. Gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children's future.

  12. Outcome of MRI-guided vacuum-assisted breast biopsy – initial experience at Institute of Oncology Ljubljana, Slovenia

    PubMed Central

    Zebic-Sinkovec, Marta; Hertl, Kristijana; Kadivec, Maksimiljan; Cavlek, Mihael; Podobnik, Gasper; Snoj, Marko

    2012-01-01

    Background Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to surgical excision and to investigate the outcome of MRI-guided breast biopsy as a function of the MRI features of the lesions. Patients and methods. In 14 women (median age 51 years) with 14 MRI-detected lesions, MRI-guided vacuum-assisted breast biopsy was performed. We evaluated the MRI findings that led to biopsy and we investigated the core and postoperative histology results and follow-up data. Results The biopsy was technically successful in 14 (93%) of 15 women. Of 14 biopsies in 14 women, core histology revealed 6 malignant (6/14, 43%), 6 benign (6/14, 43%) and 2 high-risk (2/14, 14%) lesions. Among the 6 cancer 3 were invasive and 3 were ductal carcinoma in situ (DCIS). The probability of malignancy in our experience was higher for non-mass lesion type and for washout and plateau kinetics. Conclusions Our initial experience confirms that MRI-guided vacuum-assisted biopsy is fast, safe and accurate alternative to surgical biopsy for breast lesions detected at MRI only. PMID:23077445

  13. Modified robotic-assisted thyroidectomy: an initial experience with the retroauricular approach.

    PubMed

    Kandil, Emad; Saeed, Ahmad; Mohamed, Salah E; Alsaleh, Nuha; Aslam, Rizwan; Moulthrop, Thomas

    2015-03-01

    New approaches for robotic-assisted thyroidectomy, including the retroauricular approach, were recently described. We have modified the established surgical approach for retroauricular robotic thyroidectomy. Herein, we report our initial experience to identify challenges and limitations of this new surgical approach. Prospective case series. This study was performed under institutional review board approval for patients who underwent retroauricular robotic hemithyroidectomy at an academic North American institution. The retroauricular approach was modified by using the space between the two heads of the sternocleidomastoid muscle as our working space. Additionally, selected patients underwent concomitant neck lift surgery with robotic thyroid surgery. Clinical characteristics, total operative time, blood loss, surgical outcomes, and length of hospital stay were evaluated. Twelve female patients were included in this study. Mean age was 45 ± 4.43 years, and mean body mass index was 28.6 ± 2.15. Mean thyroid nodule size was 1.15 ± 0.26 cm(3). All cases were completed successfully via single retroauricular incision. There was no conversion to an open approach. Four out of 12 patients (33%) underwent additional concomitant neck lift surgery, with a mean total operative time of 156 ± 15.88 minutes. The mean operative time for the remaining eight patients who underwent the robotic approach without additional neck lift surgery was 145.4 ± 10.08 minutes. There were no cases of permanent vocal cord paralysis or permanent hypoparathyroidism. Mean blood loss was 22.4 ± 4.32 mL. Four patients (33%) were discharged home on the same day of surgery, and the remaining eight patients were discharged after an overnight stay. Single-incision retroauricular robotic hemithyroidectomy can be a safe and feasible alternative to other remote access techniques. Neck lift surgery can be performed safely in a select group of patients. However, future studies are

  14. From Resistance to Existence-Experiences of Medication-Assisted Treatment as Disclosed by People with Opioid Dependence.

    PubMed

    Lindgren, Britt-Marie; Eklund, Margita; Melin, Ylva; Graneheim, Ulla Hällgren

    2015-01-01

    This study aimed to describe the lived experiences of participating in a medication-assisted treatment as disclosed by individuals with opioid dependence. Eleven narrative interviews were conducted and subjected to qualitative content analysis. The experiences of participating in the programme were described as a process from resistance to existence. The participants seized the chance to claim a life lived with dignity, struggled with hidden challenges, and eventually were freed from their pasts and were grateful for an existence with dignity. The recovery process was a long-term commitment and participants asked for a more individual and flexible process based on personal needs and values.

  15. [New techniques in childbirth assistance. Experience and results of theoretical and practical training].

    PubMed

    Surico, N; Grimaldi, G

    2001-02-01

    In 1995, the Course on Integrated Obstetrical and Gynaecological Techniques was added to the training program of the Obstetrics and Gynaecology Clinic and to the Midwife Diploma School, at the Faculty of Medicine of the A. Avogadro University of East Piemonte. This addition was due to the demand to create a service to train young medical doctors and student midwives on the basis of the requirements of the World Health Organisation, concerning a more natural way of giving birth. In this paper the results obtained after a four years practical application of these clinical techniques are presented. The factors considered were the type of assistance offered in correlation with different outcomes for both mother and child. The study demonstrates a general improvement in the quality of assistance and a decrease of costs for the National Health Service. The data have been compared with those of the neighbour Hospital Division, where deliveries are assisted with traditional techniques.

  16. Robot-assisted Surgery for Benign Ureteral Strictures: Experience and Outcomes from Four Tertiary Care Institutions.

    PubMed

    Buffi, Nicolò Maria; Lughezzani, Giovanni; Hurle, Rodolfo; Lazzeri, Massimo; Taverna, Gianluigi; Bozzini, Giorgio; Bertolo, Riccardo; Checcucci, Enrico; Porpiglia, Francesco; Fossati, Nicola; Gandaglia, Giorgio; Larcher, Alessandro; Suardi, Nazareno; Montorsi, Francesco; Lista, Giuliana; Guazzoni, Giorgio; Mottrie, Alexandre

    2017-06-01

    Minimally invasive treatment of benign ureteral strictures is still challenging because of its technical complexity. In this context, robot-assisted surgery may overcome the limits of the laparoscopic approach. To evaluate outcomes for robotic ureteral repair in a multi-institutional cohort of patients treated for ureteropelvic junction obstruction and ureteral stricture (US) at four tertiary referral centres. This retrospective study reports data for 183 patients treated with standard robot-assisted pyeloplasty (PYP) and robotic uretero-ureterostomy (UUY) at four high-volume centres from January 2006 to September 2014. Robotic PYP and robot-assisted UUY were performed according to previously reported surgical techniques. Preoperative, intraoperative, and postoperative variables and outcomes were assessed. A descriptive statistical analysis was performed. No robot-assisted UUY cases required surgical conversion, while 2.8% of PYP cases were not completed robotically. The median operative time was 120 and 150min for robot-assisted PYP and robot-assisted UUY, respectively. No intraoperative complications were reported. The overall complication rate for all procedures was 11% (n=20) and complications were mostly of low grade. The high-grade complication rate was 2.2% (n=4). At median follow-up of 24 mo, the overall success rate was >90% for both procedures. The study limitations include its retrospective nature and the heterogeneity of the study population. Robotic surgery for benign US is safe and effective, with limited risk of high-grade complications and good intermediate-term results. In this study we review the use of robotic surgery at four different tertiary care centres in the treatment of patients affected by benign ureteral strictures. Our results demonstrate that robotic surgery is a safe alternative to the standard open approach in the treatment of ureteral strictures. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All

  17. Combined Conventional and Endoscopic Microdebrider-Assisted Adenoidectomy: A Tertiary Centre Experience

    PubMed Central

    Prakash, S.B.; Priyadarshini, V.

    2017-01-01

    Introduction Adenoidectomy is one of the most commonly performed surgical procedures in children. Conventional adenoidectomy is associated with incomplete adenoid tissue removal with persistence of symptoms. The advent of rigid nasal endoscopes, cold light source, fiber optics and powered instruments used in functional endoscopic sinus surgery helped in the development of endoscopic microdebrider-assisted adenoidectomy. Aim To establish the safety and efficacy of combined conventional and endoscopic microdebrider-assisted adenoidectomy procedure. Materials and Methods This is a prospective study of 60 child patients who underwent combined conventional and endoscopic microdebrider-assisted adenoidectomy. The study was conducted from September 2013 to September 2015. Only child patients with grade 3 and grade 4 Adenoid Hypertrophy (AH) was included in the study. At the end of conventional adenoidectomy and after combined procedure, the AH was graded again. Post-operative complications like neck pain, hypernasality and swallowing problems were noted. Their symptom score was reviewed before surgery and after one month and one year of surgery. The duration of surgery and amount of blood loss was recorded. Results By this technique, complete clearance of adenoid tissue was obtained in all 60 (100%) cases. The mean pre-operative symptom score for AH was 3.7, which improved to 0 after one month of combined conventional and endoscopic microdebrider-assisted adenoidectomy. All child patients were symptom-free at the end of one month and one year. The duration of conventional adenoidectomy was 5 minutes 12 seconds while total duration of the combined conventional and endoscopic microdebrider-assisted adenoidectomy was 14 minutes 45 seconds. There was no significant blood loss (15±3 ml approximately). There were no major complications in this study. Conclusion The combined approach of conventional curette along with endoscopic microdebrider-assisted adenoidectomy is a safe

  18. Occupational therapists as dog handlers: the collective experience with animal-assisted therapy in Iraq.

    PubMed

    Fike, Lorie; Najera, Cecilia; Dougherty, David

    2012-01-01

    The first pair of US Army animal-assisted therapy (AAT) dogs deployed to Iraq in December 2007 with the 85th Medical Detachment Combat and Operational Stress Control unit. As of this writing, 6 dogs have deployed to Iraq and Afghanistan, offering Soldiers a small reminder of home. Army occupational therapists led the way in this endeavor as primary handlers; the path has been rocky but ultimately rewarding. This article depicts how occupational therapists used AAT and animal-assisted activities to help Soldiers cope with the stressors of living in a deployed environment. Challenges and lessons-learned, including anecdotal examples, are discussed.

  19. Computer-assisted drug development (CADD): an emerging technology for designing first-time-in-man and proof-of-concept studies from preclinical experiments.

    PubMed

    Gomeni, R; Bani, M; D'Angeli, C; Corsi, M; Bye, A

    2001-06-01

    Computer-assisted drug development (CADD) is an emerging technology for accelerating drug development based on the integration of mathematical modelling and simulation. This methodology provides a knowledge-based decisional tool on alternative development strategies based on the evaluation of potential risks on drug safety, and the definition of experimental design of new trials with expected power and probability of success. An example of CADD implementation is presented to design the first-time-in-man (FTIM) and the proof-of-concept (PoC) study of a new CNS compound. The final objective of the example presented is not necessarily to supply a success story of a correct prediction of human data from animal studies but to define a credible strategy suitable to design FTIM and PoC studies using preclinical data without the support of any human in vivo information. Rhesus monkey and human PK were initially estimated using allometric scaling on data collected in dogs, cynomolgus monkeys and rats. A PK/PD model was derived from a study conducted in rodent and validated by comparing the model predicted response to the one observed in a PET experiment conducted in rhesus monkey. The final PK/PD model, incorporating potential variability and uncertainty on scaled human prediction together with a receptor affinity adjustment derived from in vitro binding studies, was used to design the first-time-in-man and the proof-of-concept study.

  20. Assistive Technology as an Evolving Resource for a Successful Employment Experience

    ERIC Educational Resources Information Center

    Murphy, Patricia M.

    2005-01-01

    Strategic pooling of assistive technology, human resources and funding options has made meaningful employment possible for the 25-year-old man with cerebral palsy who is the subject of this paper. Since graduating from high school four years ago, he has held a part-time job at the warehouse of a bookseller. To perform his job, which involves…

  1. Assisted Suicide, Euthanasia, and Suicide Prevention: The Implications of the Dutch Experience.

    ERIC Educational Resources Information Center

    Hendin, Herbert

    1995-01-01

    A study illustrates how legal sanction promotes a culture that transforms suicide into assisted suicide and encourages choosing death when faced with serious illness. The question of extending legal euthanasia to those not physically ill complicates the issue. Also, doctors may feel they can end a terminally-ill patient's life without consent.…

  2. Project Breakthrough: A Responsive Environment Field Experiment with Pre-School Children from Public Assistance Families.

    ERIC Educational Resources Information Center

    Cook County Dept. of Public Aid, Chicago, IL.

    This is a report on the research evaluation of an educational program for very young children initiated under the conviction that adult illiteracy might be prevented through intervention into the "cycle of poverty." The method of intervention was to provide a group of preschool children from public assistance families with a training…

  3. Students' Experiences and Perceptions of Peer Assisted Study Sessions: Towards Ongoing Improvement

    ERIC Educational Resources Information Center

    van der Meer, Jacques; Scott, Carole

    2009-01-01

    Much research has been done on the effectiveness of Supplemental Instruction programs, (Peer Assisted Study Sessions, PASS, in Australasia). Less research has emerged on on students' reasons for participating in PASS and their perceptions of the effectiveness of the program. In this article, we will report on a small improvement-focused research…

  4. Teaching to Learn: Analyzing the Experiences of First-Time Physics Learning Assistants

    ERIC Educational Resources Information Center

    Gray, Kara Elizabeth

    2013-01-01

    The Colorado Learning Assistant (LA) Model has demonstrated that it is successful in helping to meet multiple goals including enhancing student learning in LA-supported courses, increasing conceptual understanding of physics among LAs, and improving the teaching practices of former LAs in K-12 schools. The research reported here investigated the…

  5. ROUTINE SALINE INFUSION SONOHYSTEROGRAPHY PRIOR TO ASSISTED CONCEPTION: A REVIEW OF OUR INITIAL EXPERIENCE

    PubMed Central

    Obajimi, G.; Ogunkinle, B.

    2016-01-01

    Saline infusion sonohysterography has been employed to evaluate the uterine cavity prior to commencement of assisted conception.Intra-uterine lesions play an important role in the outcome of assisted conception procedures. A descriptive retrospective study of 760 patients who had saline infusion sonohysterography prior to assisted conception, between January 2008 and December, 2010. Forty-six percent of the patients had intra-uterine pathologies. Submucous fibroids accounted for almost half (48.57%) of the pathologies, followed by adhesions (28.57%) and endometrial polyps (22.86%). Complications arising from the procedure were minor and occurred in 26 patients (3.42%). Abdominal cramps, vaginal bleeding and vaginal discharge occurred in 14 (53.85%), 8 (30.77%) and 4 (15.38%) respectively. The average duration of the procedure was 6 minutes with a range of 4-9 minutes. Saline infusion sonohysterography is a reliable, cost effective and safe diagnostic tool in the evaluation of the uterine cavity prior to assisted conception. PMID:28337095

  6. Assisted Suicide, Euthanasia, and Suicide Prevention: The Implications of the Dutch Experience.

    ERIC Educational Resources Information Center

    Hendin, Herbert

    1995-01-01

    A study illustrates how legal sanction promotes a culture that transforms suicide into assisted suicide and encourages choosing death when faced with serious illness. The question of extending legal euthanasia to those not physically ill complicates the issue. Also, doctors may feel they can end a terminally-ill patient's life without consent.…

  7. Experiences of Resident Assistants with Potentially Suicidal Students: Identification, Referral, and Expectations

    ERIC Educational Resources Information Center

    Bender, Katherine M.

    2013-01-01

    Resident Assistants (RAs), living on campus and tasked with advising students while keeping them safe, are in a position to identify and refer students who may be at risk for suicide or other mental health issues. This study examined RA ability to identify students at risk for suicide, RA comfort in working with students at risk for suicide, RA…

  8. Instructional Experiences of Graduate Assistants Implementing Explicit and Reflective Introductory Biology Laboratories

    ERIC Educational Resources Information Center

    Bautista, Nazan Uludag; Schussler, Elisabeth E.; Rybczynski, Stephen M.

    2014-01-01

    Science education reform documents identify nature of science (NOS) as a critical component of scientific literacy and call for universities, colleges, and K-12 schools to explicitly integrate NOS learning into science curricula. In response to these calls, this study investigated the classroom practices of nine graduate assistants (GAs) who…

  9. Experiences of Resident Assistants with Potentially Suicidal Students: Identification, Referral, and Expectations

    ERIC Educational Resources Information Center

    Bender, Katherine M.

    2013-01-01

    Resident Assistants (RAs), living on campus and tasked with advising students while keeping them safe, are in a position to identify and refer students who may be at risk for suicide or other mental health issues. This study examined RA ability to identify students at risk for suicide, RA comfort in working with students at risk for suicide, RA…

  10. Enhancing the Experience of Student Teams in Large Classes: Training Teaching Assistants to Be Coaches

    ERIC Educational Resources Information Center

    Sargent, Leisa D.; Allen, Belinda C.; Frahm, Jennifer A.; Morris, Gayle

    2009-01-01

    To address the increasing demand for mass undergraduate management education and, at the same time, a greater emphasis on student teamwork, this study outlines the development, delivery, and evaluation of a training intervention designed to build team-coaching skills in teaching assistants. Specifically, "practice-centered" and…

  11. Chronotopic Thresholds, Reflection, and Transformation of Supervision Experiences for Preschool Assistants in Norwegian Preschools

    ERIC Educational Resources Information Center

    Gradovski, Mikhail; Løkken, Ingrid M.

    2015-01-01

    To maintain team learning for assistants in preschools, dialogue and group discussions are important. These dialogues and discussions can happen both as a part of spontaneous supervision and as a part of an organized process of supervision. Bakhtinian theory of understanding and its notion of dialogue could be used to organize supervision of…

  12. English Learning Support Assistants' Experiences of Including Children with Special Educational Needs in Physical Education

    ERIC Educational Resources Information Center

    Vickerman, Philip; Blundell, Milly

    2012-01-01

    According to Blatchford, learning support assistants (LSA) in schools within England comprise of a quarter of their workforce. In recent years, the inclusion of children with special educational needs (SEN) in mainstream school settings has seen significant rises. Furthermore, the English government has raised expectations on the amount of…

  13. Teaching to Learn: Analyzing the Experiences of First-Time Physics Learning Assistants

    ERIC Educational Resources Information Center

    Gray, Kara Elizabeth

    2013-01-01

    The Colorado Learning Assistant (LA) Model has demonstrated that it is successful in helping to meet multiple goals including enhancing student learning in LA-supported courses, increasing conceptual understanding of physics among LAs, and improving the teaching practices of former LAs in K-12 schools. The research reported here investigated the…

  14. Collaborative Teaching in an Intensive Spanish Course: A Professional Development Experience for Teaching Assistants

    ERIC Educational Resources Information Center

    Stepp-Greany, Jonita

    2004-01-01

    This pilot project was designed to provide professional development to teaching assistants (TAs) and improve undergraduate instruction in an intensive Spanish course through the use of collaboration and experiential instruction. TAs improved their teaching strategies, learned techniques to solve classroom problems, and reported satisfaction from…

  15. Chronotopic Thresholds, Reflection, and Transformation of Supervision Experiences for Preschool Assistants in Norwegian Preschools

    ERIC Educational Resources Information Center

    Gradovski, Mikhail; Løkken, Ingrid M.

    2015-01-01

    To maintain team learning for assistants in preschools, dialogue and group discussions are important. These dialogues and discussions can happen both as a part of spontaneous supervision and as a part of an organized process of supervision. Bakhtinian theory of understanding and its notion of dialogue could be used to organize supervision of…

  16. Pond Life That "Know Their Place": Exploring Teaching and Learning Support Assistants' Experiences through Positioning Theory

    ERIC Educational Resources Information Center

    Watson, Debbie; Bayliss, Phil; Pratchett, Glynis

    2013-01-01

    Teaching and learning support assistants (TLSAs) are notoriously underpaid and undervalued as members of school workforces in England and elsewhere in the world, where the discourse of "support" has worked to legitimize their poor status. This article reports and explores empirical findings through the lens of positioning theory. This…

  17. Quantitative Ultrasound-Assisted Extraction for Trace-Metal Determination: An Experiment for Analytical Chemistry

    ERIC Educational Resources Information Center

    Lavilla, Isela; Costas, Marta; Pena-Pereira, Francisco; Gil, Sandra; Bendicho, Carlos

    2011-01-01

    Ultrasound-assisted extraction (UAE) is introduced to upper-level analytical chemistry students as a simple strategy focused on sample preparation for trace-metal determination in biological tissues. Nickel extraction in seafood samples and quantification by electrothermal atomic absorption spectrometry (ETAAS) are carried out by a team of four…

  18. Quantitative Ultrasound-Assisted Extraction for Trace-Metal Determination: An Experiment for Analytical Chemistry

    ERIC Educational Resources Information Center

    Lavilla, Isela; Costas, Marta; Pena-Pereira, Francisco; Gil, Sandra; Bendicho, Carlos

    2011-01-01

    Ultrasound-assisted extraction (UAE) is introduced to upper-level analytical chemistry students as a simple strategy focused on sample preparation for trace-metal determination in biological tissues. Nickel extraction in seafood samples and quantification by electrothermal atomic absorption spectrometry (ETAAS) are carried out by a team of four…

  19. Instructional Experiences of Graduate Assistants Implementing Explicit and Reflective Introductory Biology Laboratories

    ERIC Educational Resources Information Center

    Bautista, Nazan Uludag; Schussler, Elisabeth E.; Rybczynski, Stephen M.

    2014-01-01

    Science education reform documents identify nature of science (NOS) as a critical component of scientific literacy and call for universities, colleges, and K-12 schools to explicitly integrate NOS learning into science curricula. In response to these calls, this study investigated the classroom practices of nine graduate assistants (GAs) who…

  20. Assisting Beginning Teachers and School Communities to Grow through Extended and Collaborative Mentoring Experiences

    ERIC Educational Resources Information Center

    Long, Janette

    2009-01-01

    Mentoring as a strategy to assist and retain beginning teachers in the profession has been perceived as the panacea for reducing attrition rates. Whilst this may be true in many cases, mentoring alone has been unable to stem the flow of resignations. In this essay on scholarship and teaching, the author explores surrounding mentoring programs. New…

  1. Assisting a child with tuberous sclerosis complex (TSC): a qualitative deep analysis of parents’ experience and caring needs

    PubMed Central

    Graffigna, Guendalina; Bosio, Caterina; Cecchini, Isabella

    2013-01-01

    Objective This study was aimed to explore parents’ experience of assisting children affected by tuberous sclerosis complex (TSC) with subependymal giant-cell astrocytoma (SEGA) manifestation, in order to understand their caring needs and expectation of support. Setting and procedure The study was designed according to the qualitative method of interpretative description and implied two sequential phases of data collection. The first phase was based on in-depth interviews with 18 Italian caregivers of children living with TSC. The second phase of the research was based on an online forum with 30 caregivers of children living with TSC. Participants 48 Italian caregivers, assisting patients with TSC with SEGA manifestation have been involved in the study. Results When a TSC diagnosis is made, the whole family is affected psychologically. TSC has a great impact on families’ quality of life and on their ability to cope with the disease and support the child's ability to recover and reach an acceptable level of well-being. Caregivers report the experience of losing control and the feeling of loneliness and abandon from the healthcare system. Conclusion and practice implications Families of children affected by TSC need targeted psychosocial assistance in order to support patients and caregivers and facilitate their social integration. PMID:24319280

  2. How health professionals perceive and experience treating people on social assistance: a qualitative study among dentists in Montreal, Canada

    PubMed Central

    2013-01-01

    Background In Canada, the prevalence of oral diseases is very high among people on social assistance. Despite great need for dental treatment, many are reluctant to consult dental professionals, arguing that dentists do not welcome or value poor patients. The objective of this research was thus to better understand how dentists perceived and experienced treating people on social assistance. Methods This descriptive qualitative research was based on in-depth semi-structured interviews with 33 dentists practicing in Montreal, Canada. Generally organized in dentists’ offices, the interviews lasted 60 to 120 minutes; they were digitally recorded and later transcribed verbatim. The interview transcripts were coded with NVivo software, and data was displayed in analytic matrices. Three members of the research team interpreted the data displayed and wrote the results of this study. Results Dentists express high levels of frustration with people on social assistance as a consequence of negative experiences that fall into 3 categories: 1) Organizational issues (people on social assistance ostensibly make the organization of appointments and scheduling difficult); 2) Biomedical issues (dentists feel unable to provide them with adequate treatment and fail to improve their oral health); 3) Financial issues (they are not lucrative patients). To explain their stance, dentists blame people on social assistance for neglecting themselves, and the health care system for not providing adequate coverage and fees. Despite dentists’ willingness to treat all members of society, an accumulation of frustration leads to feelings of powerlessness and discouragement. Conclusions The current situation is unacceptable; we urge public health planners and governmental health agencies to ally themselves with the dental profession in order to implement concrete solutions. PMID:24192504

  3. Outcomes of HeartWare Ventricular Assist System support in 141 patients: a single-centre experience.

    PubMed

    Wu, Long; Weng, Yu-Guo; Dong, Nian-Guo; Krabatsch, Thomas; Stepanenko, Alexander; Hennig, Ewald; Hetzer, Roland

    2013-07-01

    A third-generation ventricular assist device, the HeartWare Ventricular Assist System, has demonstrated its reliability and durability in animal models and clinical experience. However, studies of a large series of applications are still lacking. We evaluate the safety and efficacy of the HeartWare pump in 141 patients with end-stage heart failure at a single centre. A total of 141 patients (116 men and 25 women with a mean age of 52 years) in New York Heart Association (NYHA) Class IV received implantation of the HeartWare Ventricular Assist System between August 2009 and April 2011 at the Deutsches Herzzentrum Berlin. The outcomes were measured in terms of laboratory data, adverse events, NYHA functional class and survival during device support. The HeartWare system provided an adequate haemodynamic support for patients both inside and outside the hospital. NYHA class improved to I-II. Organ function and pulmonary vascular resistance improved significantly. In this cohort of patients, 14 patients underwent heart transplantation, one had had the device explanted following myocardial recovery, one had changed to another assist device, 81 were on ongoing support and 44 died. The overall actuarial survival rates at 6 and 12 months were 70 and 67%, respectively, and the 3-, 6- and 12-month survival rates on a left ventricular assist device (LVAD) support for bridge to transplantation patients were 82, 81 and 79%, respectively. Infection and bleeding were the main adverse events. Four patients underwent an LVAD exchange for pump thrombosis. The HeartWare system provides a safe and effective circulatory support in a population with a wide range of body surface areas, with a satisfactory actuarial survival time and an improved quality of life. It can be used for univentricular or biventricular support, being implanted into the pericardial space with simplified surgical techniques.

  4. Ultrasound-assisted lipoplasty treatment for axillary bromidrosis: clinical experience of 375 cases.

    PubMed

    Hong, Joon Pio; Shin, Hyun Woo; Yoo, Sung-Chul; Chang, Hak; Park, Sang Hoon; Koh, Kyung Suck; Hur, Jae Young; Lee, Taik Jong

    2004-04-01

    Bromidrosis is a condition of abnormal offensive body odor caused mostly by apocrine gland secretion from the axilla. Although no morbid sequelae are known, the odor can be disturbing enough to cause social impairment and psychological distress. Medical care is available but is temporary and yields limited clinical benefit. Surgical treatment may provide a more definite remedy through reduction of the apocrine gland. However, there are risks for complication following surgical treatment such as subdermal excision, subcutaneous shaving, en bloc excision, and liposuction. The search for a less invasive but still effective procedure has led the authors to use ultrasound-assisted liposuction, which has reduced the risk of complication and recurrence. The purpose of this article was to evaluate the long-term outcome of ultrasound-assisted liposuction for the treatment of bromidrosis. From August 1998 to September 2002, 375 consecutive patients underwent ultrasound-assisted liposuction for bromidrosis of the axilla. The average age of the patients was 25.7 years (range, 15 to 55 years) and the average follow-up period was 18.8 months (range, 7 to 56 months). Subjective complaints of recurrences were noted in 22 patients (5.9 percent) and secondary ultrasound-assisted liposuction was performed, resulting in no further complaints. Complications other than recurrences were mild skin sloughing (3.2 percent), hematoma (1.3 percent), subcutaneous band (0.3 percent), and hypesthesia of the hand (0.3 percent), all of which healed spontaneously. Through a questionnaire that was answered by 264 patients, a subjective satisfaction rate was measured. Among the completed questionnaires, 91.7 percent reported satisfactory reduction of odor. Ultrasound-assisted liposuction to treat bromidrosis of the axilla provides advantages such as rapid recovery, less restriction of movement, unnoticeable scars, and a low rate of recurrence. The long-term outcome supports the benefits of this

  5. 44 CFR 13.33 - Supplies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Supplies. 13.33 Section 13.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... GOVERNMENTS Post-Award Requirements Changes, Property, and Subawards § 13.33 Supplies. (a) Title. Title...

  6. 44 CFR 13.33 - Supplies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Supplies. 13.33 Section 13.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... GOVERNMENTS Post-Award Requirements Changes, Property, and Subawards § 13.33 Supplies. (a) Title. Title...

  7. 44 CFR 13.33 - Supplies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Supplies. 13.33 Section 13.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... GOVERNMENTS Post-Award Requirements Changes, Property, and Subawards § 13.33 Supplies. (a) Title. Title to...

  8. 44 CFR 13.33 - Supplies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Supplies. 13.33 Section 13.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... GOVERNMENTS Post-Award Requirements Changes, Property, and Subawards § 13.33 Supplies. (a) Title. Title to...

  9. 44 CFR 13.33 - Supplies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Supplies. 13.33 Section 13.33 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... GOVERNMENTS Post-Award Requirements Changes, Property, and Subawards § 13.33 Supplies. (a) Title. Title to...

  10. 13 CFR 143.33 - Supplies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Supplies. 143.33 Section 143.33 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS... residual inventory of unused supplies exceeding $5,000 in total aggregate fair market value upon...

  11. Ghost peaks observed after atmospheric pressure matrix-assisted laser desorption/ionization experiments may disclose new ionization mechanism of matrix-assisted hypersonic velocity impact ionization.

    PubMed

    Moskovets, Eugene

    2015-08-30

    Understanding the mechanisms of matrix-assisted laser desorption/ionization (MALDI) promises improvements in the sensitivity and specificity of many established applications in the field of mass spectrometry. This paper reports a serendipitous observation of a significant ion yield in a post-ionization experiment conducted after the sample had been removed from a standard atmospheric pressure (AP)-MALDI source. This post-ionization is interpreted in terms of collisions of microparticles moving with a hypersonic velocity into a solid surface. Calculations show that the thermal energy released during such collisions is close to that absorbed by the top matrix layer in traditional MALDI. The microparticles, containing both the matrix and analytes, could be detached from a film produced inside the inlet capillary during the sample ablation and accelerated by the flow rushing through the capillary. These observations contribute some new perspective to ion formation in both laser and laser-less matrix-assisted ionization. An AP-MALDI ion source hyphenated with a three-stage high-pressure ion funnel system was utilized for peptide mass analysis. After the laser had been turned off and the MALDI sample removed, ions were detected during a gradual reduction of the background pressure in the first funnel. The constant-rate pressure reduction led to the reproducible appearance of different singly and doubly charged peptide peaks in mass spectra taken a few seconds after the end of the MALDI analysis of a dried-droplet spot. The ion yield as well as the mass range of ions observed with a significant delay after a completion of the primary MALDI analysis depended primarily on the background pressure inside the first funnel. The production of ions in this post-ionization step was exclusively observed during the pressure drop. A lower matrix background and significant increase in relative yield of double-protonated ions are reported. The observations were partially consistent

  12. [Assisted Reproductive Technology in Female Transplant Recipients: Experience of a Reproductive Medicine Unit and Literature Review].

    PubMed

    Vale-Fernandes, Emídio; Póvoa, Ana Margarida; Soares, Sandra; Calejo, Lucinda; Xavier, Pedro; Sousa, Sónia; Beires, Jorge; Montenegro, Nuno

    2016-01-01

    Diseases in end stage typically occur with hypothalamic-pituitary-ovarian axis disorders, with consequent anovulation and infertility. The solid organ transplantation increased survival of patients with end-stage organs disease and the vast majority of women improve their reproductive capacity after transplantation. Although adoption can always be a possibility, the transplanted infertile woman has the right to self-reproductive determination using assisted reproductive techniques. While it is known that pregnancies in transplantedwomen are at high risk, there is no evidence of differences in pregnancy outcome in pregnant transplanted subject to technical, compared with spontaneous pregnancies. The use of assisted reproductive techniques in transplanted women is a medical, ethical and psychosocial challenge, whose approach must be multidisciplinary, to ensure reproductive success without compromising the function of the transplanted organ or maternal health, allowing the birth of a healthy child. The literature remains scarce. Three clinical cases are presented.

  13. How people on social assistance perceive, experience, and improve oral health.

    PubMed

    Bedos, C; Levine, A; Brodeur, J-M

    2009-07-01

    Oral diseases are highly prevalent among people on social assistance. Despite benefiting from public dental coverage in North America, these people rarely consult the dentist. One possible reason is rooted in their perception of oral health and the means to improve it. To respond to this question, largely unexplored, we conducted qualitative research through 8 focus groups and 15 individual interviews in Montreal (Canada). Thematic analysis revealed that people on social assistance: (a) define oral health in a social manner, placing tremendous value on dental appearance; (b) complain about the decline of their dental appearance and its devastating impact on self-esteem, social interaction, and employability; and (c) feel powerless to improve their oral health and therefore contemplate extractions and complete dentures. Our research demonstrates that perception of oral health strongly influences treatment preference and explains low and selective use of dental services in this disadvantaged population.

  14. 10 CFR 603.1330 - Supplies.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Supplies. 603.1330 Section 603.1330 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in this Part § 603.1330 Supplies. Tangible property other than real property and equipment. Supplies have...

  15. Valuing biodiversity attributes and water supply using choice experiments: a case study of La Campana Peñuelas Biosphere Reserve, Chile.

    PubMed

    Cerda, Claudia

    2013-01-01

    The main objective of this study is to assess public economic preferences for biodiversity conservation and water supply and to analyse the factors influencing those preferences. A survey based on the choice experiment method was carried out at Peñuelas National Reserve, Chile, an area that is threatened by both occasional forest fires and the growing housing market. The input of local administrators was used to define environmental attributes of the area related to biodiversity conservation and water supply. Attributes were selected for analysis by the choice experiment. The selected attributes were the following: existence of endemic orchid species, chances of observing animals with scenic attraction, additional protection for an endemic amphibian, and availability of drinkable water in the future. A monetary variable consisting of an increase in the rate for entry to the area was also incorporated to estimate willingness to pay (WTP) for additional protection for the selected attributes. Three hundred four Chilean visitors to the reserve were randomly selected for interviews. Econometric analysis based on the Theory of Utility Maximization shows that visitors are willing to pay to protect the selected attributes. WTP values for the attributes range from CHP $2,600 ($5.4) to $6,600 ($14) per person per visit. The results of this research provide reserve managers information about tradeoffs that could be used to enhance public support and maximise the social benefits of nature conservation management programmes.

  16. Robot-assisted surgery in elderly and very elderly population: our experience in oncologic and general surgery with literature review.

    PubMed

    Ceccarelli, Graziano; Andolfi, Enrico; Biancafarina, Alessia; Rocca, Aldo; Amato, Maurizio; Milone, Marco; Scricciolo, Marta; Frezza, Barbara; Miranda, Egidio; De Prizio, Marco; Fontani, Andrea

    2017-02-01

    .2%, and others 10.4%. Robot-assisted surgery is a safe and effective technique in aging patient population too. There was no increased risk of death or morbidity compared to younger patients in the three groups examined. A higher conversion rate was observed in our experience for patients aged 65-79. Prolonged operative time and in any cases steep positions (Trendelenburg) have not represented a problem for the majority of patients. In any case, considering the high direct costs, minimally invasive robot-assisted surgery should be performed on a case-by-case basis, tailored to each patient with their specific histories and comorbidities.

  17. Anatomic pulmonary resection by video-assisted thoracoscopy: the Brazilian experience (VATS Brazil study)

    PubMed Central

    Terra, Ricardo Mingarini; Kazantzis, Thamara; Pinto-Filho, Darcy Ribeiro; Camargo, Spencer Marcantonio; Martins-Neto, Francisco; Guimarães, Anderson Nassar; Araújo, Carlos Alberto; Losso, Luis Carlos; Ghefter, Mario Claudio; de Lima, Nuno Ferreira; Gomes-Neto, Antero; Brito-Filho, Flávio; Haddad, Rui; Saueressig, Maurício Guidi; Lima, Alexandre Marcelo Rodrigues; de Siqueira, Rafael Pontes; Pinho, Astunaldo Júnior de Macedo e; Vannucci, Fernando

    2016-01-01

    ABSTRACT Objective: The objective of this study was to describe the results of anatomic pulmonary resections performed by video-assisted thoracoscopy in Brazil. Methods: Thoracic surgeons (members of the Brazilian Society of Thoracic Surgery) were invited, via e-mail, to participate in the study. Eighteen surgeons participated in the project by providing us with retrospective databases containing information related to anatomic pulmonary resections performed by video-assisted thoracoscopy. Demographic, surgical, and postoperative data were collected with a standardized instrument, after which they were compiled and analyzed. Results: The surgeons provided data related to a collective total of 786 patients (mean number of resections per surgeon, 43.6). However, 137 patients were excluded because some data were missing. Therefore, the study sample comprised 649 patients. The mean age of the patients was 61.7 years. Of the 649 patients, 295 (45.5%) were male. The majority-521 (89.8%)-had undergone surgery for neoplasia, which was most often classified as stage IA. The median duration of pleural drainage was 3 days, and the median hospital stay was 4 days. Of the 649 procedures evaluated, 598 (91.2%) were lobectomies. Conversion to thoracotomy was necessary in 30 cases (4.6%). Postoperative complications occurred in 124 patients (19.1%), the most common complications being pneumonia, prolonged air leaks, and atelectasis. The 30-day mortality rate was 2.0%, advanced age and diabetes being found to be predictors of mortality. Conclusions: Our analysis of this representative sample of patients undergoing pulmonary resection by video-assisted thoracoscopy in Brazil showed that the procedure is practicable and safe, as well as being comparable to those performed in other countries. PMID:27383936

  18. Balloon-assisted guide catheter positioning to overcome extreme cervical carotid tortuosity: technique and case experience

    PubMed Central

    Peeling, Lissa; Fiorella, David

    2014-01-01

    Background and significance We describe a method by which to efficiently and atraumatically achieve distal positioning of a flexible guiding catheter beyond extreme cervical tortuosity using a hypercompliant temporary occlusion balloon. Methods A retrospective review of a prospective neuroendovascular database was used to identify cases in which a hypercompliant balloon catheter (Hyperform or Hyperglide, ev3/Covidien, Irvine, California, USA; Scepter or Scepter XC, Alisa Viejo, California, USA) was used to achieve distal positioning of a flexible guiding catheter (Navion, ev3/Covidien, Irvine, California, USA; Neuron, Penumbra Inc, Alameda, California, USA). After achieving a stable guiding sheath position within the proximal cervical carotid artery, a hypercompliant balloon catheter was manipulated beyond the tortuous cervical internal carotid segment into the distal carotid artery. The balloon was then inflated to anchor it distally within an intracranial (cavernous or petrous) segment of the internal carotid artery. The guiding catheter was then advanced beyond the tortuous cervical segment, over the balloon catheter, as gentle counter traction was applied to the balloon. Results Balloon-assisted guiding catheter placement was used to perform endovascular treatments of 12 anterior circulation aneurysms. One patient underwent coiling alone. Five patients underwent balloon-assisted coiling. One patient underwent balloon and stent assisted coil embolization. Four patients with five carotid aneurysms (one with bilateral carotid aneurysms) underwent vascular reconstruction with the pipeline embolization device. All patients had severe tortuosity of the extracranial carotid system. Three patients had findings consistent with cervical carotid fibromuscular dysplasia. The technique was successful each time it was attempted. No parent artery dissections or catheter induced vasospam were noted in any case. Discussion Hypercompliant balloon catheters can be reliably used

  19. Laparoscopy-assisted gastrectomy in the elderly: experience from a UK centre.

    PubMed

    Tandon, A; Rajendran, I; Aziz, M; Kolamunnage-Dona, R; Nunes, Q M; Shrotri, M

    2017-04-01

    BACKGROUND Gastric cancer has a high incidence in the elderly in the UK, with a significant number of patients aged 75 years or more. While surgery forms the mainstay of treatment, evidence pertaining to the management of gastric cancer in the Western population in this age group is scarce. METHODS We retrospectively reviewed the outcomes of laparoscopy-assisted total and distal gastrectomies at our centre from 2005 to 2015. Patients aged 70 years or above were included in the elderly group. RESULTS A total of 60 patients underwent laparoscopy-assisted gastrectomy over a 10-year period, with a predominance of male patients. There was no significant difference in the rate of overall surgical and non-surgical complications, in-hospital mortality, operation time and length of hospital stay, between the elderly and non-elderly groups. Univariate analysis, performed for risk factors relating to anastomotic leak and surgical complications, showed that age over 70 years and higher American Association of Anesthesiologists grades are associated with a higher, though not statistically significant, number of anastomotic leaks (P = 1.000 and P = 0.442, respectively) and surgical complications (P = 0.469 and P = 0.162, respectively). The recurrence rate within the first 3 years of surgery was significantly higher in the non-elderly group compared with the elderly group (Log Rank test, P = 0.002). There was no significant difference in survival between the two groups (Log Rank test, P = 0.619). CONCLUSIONS Laparoscopy-assisted gastrectomy is safe and feasible in an elderly population. There is a need for well-designed, prospective, randomised studies with quality of life data to inform our practice in future.

  20. NURSING HOME PRACTICES FOLLOWING RESIDENT DEATH: THE EXPERIENCE OF CERTIFIED NURSING ASSISTANTS

    PubMed Central

    Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R.

    2015-01-01

    This study examined certified nursing assistants’ (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities’ practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience. PMID:25554351

  1. From theory to bench experiment by computer-assisted drug design.

    PubMed

    Schneider, Gisbert

    2012-01-01

    Tight integration of computer-assisted molecular design with practical realization by medicinal chemistry will be essential for finding next-generation drugs that are optimized for multiple pharmaceutically relevant properties. ETH Zürich has established an interdisciplinary research group devoted to exploring the potential of this scientific approach by combining expertise from pharmaceutical chemistry and computer sciences. In this article, some of the group's activities and projects are presented. A current focus is on machine-learning applications aiming at hit and lead structure identification by virtual screening and de novo design. The central concept of 'adaptive fitness landscapes' is highlighted along with practical examples from drug discovery projects.

  2. Electrical field-assisted thermal decomposition of boron nitride nanotube: Experiments and first principle calculations

    NASA Astrophysics Data System (ADS)

    Xu, Zhi; Golberg, Dmitri; Bando, Yoshio

    2009-09-01

    We directly observed the Joule-heating-induced decomposition of multiwalled BN nanotubes using a transmission electron microscope equipped with a scanning tunneling microscope unit. The decomposition temperature is found to be dependent on an applied electrical field. We propose a model that due to the partially ionic nature of the B-N bond, the decomposition energy is both temperature- and electrical field-related: it is named as electrical field-assisted thermal decomposition. The model fits the experimental data very well and is considered to be general for all nanostructures with polar bonds.

  3. Impact of continuous and intermittent supply of electric assistance on high-strength 2,4-dichlorophenol (2,4-DCP) degradation in electro-microbial system.

    PubMed

    Cao, Zhanping; Zhang, Minghui; Zhang, Jingli; Zhang, Hongwei

    2016-07-01

    The high-strength 2,4-DCP, which exists in two states: dissolved and colloidal, was studied by a continuously electro-microbial system (CEMS) and an intermittently electro-microbial system (IEMS). The hydrolysis rate of colloidal 2,4-DCP in the IEMS without electric assistance was much higher than that in the CEMS. However, the degradation rate of the dissolved 2,4-DCP and the dissolved intermediates (2-chlorophenol and 4-chlorophenol) in the IEMS without electric assistance were much lower than that in the CEMS. By adjusting the intermittent operation mode, the degradation time of 2,4-DCP was shortened greatly. Microbial characteristics in the CEMS and the IEMS were different. The correlation analysis for the main factors affecting the hydrolysis was performed by SPSS, and it was found that the correlation coefficient (rp) was -0.912 for extracellular polymeric substances (EPS) content, 0.823 for zeta potential and 0.632 for relative hydrophobicity, respectively.

  4. Initial experience with magnet-assisted single trocar appendectomy in children.

    PubMed

    Padilla, Benjamin E; Dominguez, Guillermo; Millan, Carolina; Bignon, Horacio; Buela, Enrique; Bellia, Gaston; Elias, Maria Eugenia; Albertal, Mariano; Martinez-Ferro, Marcelo

    2013-05-01

    Single-incision laparoscopic surgery (SILS) is increasingly being used to treat acute appendicitis. Existing SILS techniques suffer from inefficient triangulation and poor ergonomics. In an effort to improve on existing SILS techniques, we developed the magnet-assisted single trocar (MAST) appendectomy. We retrospectively analyzed all MAST appendectomies performed between March 2010 and February 2011. Outcomes included demographics, diagnosis, operative time, hospital stay, and complications. Twenty-three MAST appendectomies were performed in 10 boys and 13 girls. The mean age at operation was 12.22 years (range, 5-19 years), and the mean weight was 46.5 kg (range, 25-82 kg). At presentation the mean white blood cell count was 15,000 with 74% polymorphonuclear neutrophils. The mean operative time was 61 minutes (range, 20-105 minutes), and length of stay was 3.6 days (range, 1-7 days). In total, 4 operations (17%) required one additional 5-mm trocar to complete the operation, and none was converted to an open operation. There were no intraoperative complications, nor were there any wound infections. MAST appendectomy is safe and effective in children. Magnetic instruments provide excellent triangulation and improve ergonomics. This technique uses a single 12-mm trocar and can be performed without the aid of a surgical assistant.

  5. Human experience and product usability: principles to assist the design of user-product interactions.

    PubMed

    Chamorro-Koc, Marianella; Popovic, Vesna; Emmison, Michael

    2009-07-01

    This paper introduces research that investigates how human experience influences people's understandings of product usability. It describes an experiment that employs visual representation of concepts to elicit participants' ideas of a product's use. Results from the experiment lead to the identification of relationships between human experience, knowledge, and context-of-use--relationships that influence designers' and users' concepts of product usability. These relationships are translated into design principles that inform the design activity with respect to the aspects of experience that trigger people's understanding of a product's use. A design tool (ECEDT) is devised to aid designers in the application of these principles. This tool is then trialled in the context of a design task in order to verify applicability of the findings.

  6. Affordable Care Act Qualified Health Plan Enrollment for AIDS Drug Assistance Program Clients: Virginia's Experience and Best Practices

    PubMed Central

    Rodney, Robert C.; Rhodes, Anne; Bailey, Steven; Dillingham, Rebecca

    2016-01-01

    Abstract With the implementation of the Affordable Care Act (ACA) in 2014, many safety net resources, including state AIDS Drug Assistance Programs (ADAPs), incorporated ACA Qualified Health Plans (QHPs) into their healthcare delivery model. This article highlights the benefits of the ACA for persons living with HIV. It also describes the range of strategies employed by state ADAPs to enroll patients in QHPs. The Virginia ADAP ACA implementation experience is described to illustrate one ADAP's shift to purchasing QHPs in addition to providing direct medications. Virginia ADAP is in a Medicaid nonexpansion state and funds the full costs of the QHP premiums, deductibles, and medication copayments. Virginia's experience is applicable to other Medicaid nonexpansion states and to state ADAPs in Medicaid expansion states, who are looking for options for their Medicaid ineligible clients. This article provides practical details of Virginia ADAP's ACA implementation as well as insights and best practices at both the state and clinic level. PMID:27346694

  7. Affordable Care Act Qualified Health Plan Enrollment for AIDS Drug Assistance Program Clients: Virginia's Experience and Best Practices.

    PubMed

    McManus, Kathleen A; Rodney, Robert C; Rhodes, Anne; Bailey, Steven; Dillingham, Rebecca

    2016-09-01

    With the implementation of the Affordable Care Act (ACA) in 2014, many safety net resources, including state AIDS Drug Assistance Programs (ADAPs), incorporated ACA Qualified Health Plans (QHPs) into their healthcare delivery model. This article highlights the benefits of the ACA for persons living with HIV. It also describes the range of strategies employed by state ADAPs to enroll patients in QHPs. The Virginia ADAP ACA implementation experience is described to illustrate one ADAP's shift to purchasing QHPs in addition to providing direct medications. Virginia ADAP is in a Medicaid nonexpansion state and funds the full costs of the QHP premiums, deductibles, and medication copayments. Virginia's experience is applicable to other Medicaid nonexpansion states and to state ADAPs in Medicaid expansion states, who are looking for options for their Medicaid ineligible clients. This article provides practical details of Virginia ADAP's ACA implementation as well as insights and best practices at both the state and clinic level.

  8. How do individuals' health behaviours respond to an increase in the supply of health care? Evidence from a natural experiment.

    PubMed

    Fichera, Eleonora; Gray, Ewan; Sutton, Matt

    2016-06-01

    The efficacy of the management of long-term conditions depends in part on whether healthcare and health behaviours are complements or substitutes in the health production function. On the one hand, individuals might believe that improved health care can raise the marginal productivity of their own health behaviour and decide to complement health care with additional effort in healthier behaviours. On the other hand, health care can lower the cost of unhealthy behaviours by compensating for their negative effects. Individuals may therefore reduce their effort in healthier lifestyles. Identifying which of these effects prevails is complicated by the endogenous nature of treatment decisions and individuals' behavioural responses. We explore whether the introduction in 2004 of the Quality and Outcomes Framework (QOF), a financial incentive for family doctors to improve the quality of healthcare, affected the population's weight, smoking and drinking behaviours by applying a sharp regression discontinuity design to a sample of 32,102 individuals in the Health Survey for England (1997-2009). We find that individuals with the targeted health conditions improved their lifestyle behaviours. This complementarity was only statistically significant for smoking, which reduced by 0.7 cigarettes per person per day, equal to 18% of the mean. We investigate whether this change was attributable to the QOF by testing for other discontinuity points, including the introduction of a smoking ban in 2007 and changes to the QOF in 2006. We also examine whether medication and smoking cessation advice are potential mechanisms and find no statistically significant discontinuities for these aspects of health care supply. Our results suggest that a general improvement in healthcare generated by provider incentives can have positive unplanned effects on patients' behaviours.

  9. Stratified Community Responses to Methane and Sulfate Supplies in Mud Volcano Deposits: Insights from an In Vitro Experiment

    PubMed Central

    Zhang, Yu; Maignien, Lois; Stadnitskaia, Alina; Boeckx, Pascal; Xiao, Xiang; Boon, Nico

    2014-01-01

    Numerous studies on marine prokaryotic communities have postulated that a process of anaerobic oxidation of methane (AOM) coupled with sulfate reduction (SR) is the main methane sink in the world's oceans. AOM has also been reported in the deep biosphere. But the responses of the primary microbial players in eliciting changes in geochemical environments, specifically in methane and sulfate supplies, have yet to be fully elucidated. Marine mud volcanoes (MVs) expel a complex fluid mixture of which methane is the primary component, forming an environment in which AOM is a common phenomenon. In this context, we attempted to identify how the prokaryotic community would respond to changes in methane and sulfate intensities, which often occur in MV environments in the form of eruptions, diffusions or seepage. We applied an integrated approach, including (i) biochemical surveys of pore water originated from MV, (ii) in vitro incubation of mud breccia, and (iii) prokaryotic community structure analysis. Two distinct AOM regions were clearly detected. One is related to the sulfate methane transition zone (SMTZ) at depth of 30–55 cm below the sea floor (bsf); the second is at 165–205 cm bsf with ten times higher rates of AOM and SR. This finding contrasts with the sulfide concentrations in pore waters and supports the suggestion that potential AOM activity below the SMTZ might be an important methane sink that is largely ignored or underestimated in oceanic methane budget calculations. Moreover, the incubation conditions below the SMTZ favor the growth of methanotrophic archaeal group ANME-2 compared to ANME-1, and promote the rapid growth and high diversity of bacterial communities. These incubation conditions also promote the increase of richness in bacterial communities. Our results provide direct evidence of the mechanisms by which deep AOM processes can affect carbon cycling in the deep biosphere and global methane biochemistry. PMID:25393146

  10. Periodic supply of indium as surfactant for N-polar InN growth by plasma-assisted molecular-beam epitaxy

    NASA Astrophysics Data System (ADS)

    Yao, Yong-Zhao; Sekiguchi, Takashi; Ohgaki, Takeshi; Adachi, Yutaka; Ohashi, Naoki; Okuno, Hanako; Takeguchi, Masaki

    2009-07-01

    We have investigated the self-surfactant effect of In for N-polar InN growth by plasma-assisted molecular-beam epitaxy. We found that InN quality was significantly improved if a thin In coverage (about 1.8 ML) was introduced before InN growth. However, this In coverage was slowly consumed during subsequent InN growth under N-rich condition. Periodically restoring In coverage for thick InN growth was proposed to solve this consumption problem. We suggest that the effect of In surfactant is to terminate the surface N dangling bonds and form an In adlayer, under which an efficient diffusion channel for lateral N adatom transport is created.

  11. Nursing Supplies

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Nursing Supplies Page Content Article Body Throughout most of ... budget. (Nursing equipment also makes wonderful baby gifts.) Nursing Bras A well-made nursing bra that comfortably ...

  12. [Provision of assistive devices in amyotrophic lateral sclerosis. Analysis of 3 years case management in an internet-based supply network].

    PubMed

    Funke, A; Grehl, T; Großkreutz, J; Münch, C; Walter, B; Kettemann, D; Karnapp, C; Gajewski, N; Meyer, R; Maier, A; Gruhn, K M; Prell, T; Kollewe, K; Abdulla, S; Kobeleva, X; Körner, S; Petri, S; Meyer, T

    2015-08-01

    The provision of assistive devices (PAD) is a key element of care in amyotrophic lateral sclerosis (ALS). Since 2011, assistive devices (AD) have been coordinated in an internet-supported care network at university-based ALS centers in Berlin, Bochum, Hannover and Jena. The digitization of PAD processes has facilitated the evaluation of real-life ALS care. Orthotics (OT), augmentative and alternative communication (AAC), supported treadmill (ST) and powered wheelchair (PW) were the PAD groups analyzed for delivery rates (proportion of delivered AD vs. medically indicated AD), rejection by patients and payers and latency of provision of care. Between June 2011 and October 2014 a total of 1479 patients and 12,478 AD were coordinated, among which 3313 PAD were related to OT, AAC, ST or EM. The median delivery rate was 64.3 %. The mean rejection rate by patients was 9.8 % (OT 5.4 %, AAC 9.8 %, ST 10.2 % and PW 15.6 %). Marked differences were noted in the rejection rate by payers and in care provision latency: OT (16.2 %, 68 days, n = 734), AAC (30.4 %, 96 days, n = 392), ST (34.8 %, 113 days, n = 164) and PW (35.6 %, 129 days, n = 259). Analysis of rejection rates showed significant differences among insurers. Only two thirds of the medically indicated AD reached the patients. Rejection rates by patients and payers and latency of provision of care were high. The PAD can substantially vary among health insurance companies. The establishment of consented criteria for PAD and their integration into treatment regimens and guidelines are crucial tasks for the future.

  13. Power Supply

    NASA Astrophysics Data System (ADS)

    1991-01-01

    Maxwell Laboratories capacitor charging power supply is the first commercial spinoff from the NASA CCDS program - a consortia of industries and government establishments to accelerate development of ground and space based commercial applications of NASA technology. The power supply transforms and conditions large voltages to charge capacitors used in x-ray sources, medical accelerators, etc. It is lighter, more reliable, more compact and efficient. Originally developed for space lasers, its commercial potential was soon recognized.

  14. Simulation and experiment of cutting force in ultrasonic torsional vibration assisted micro-milling

    NASA Astrophysics Data System (ADS)

    Hu, Haijun; Sun, Yazhou; Lu, Zesheng

    2010-10-01

    A coupled thermo-mechanical model of Ultrasonic Torsional Vibration Assisted Micro-milling (UTVAM) was established with ABAQUS, the primary cause which leads to a decrease in cutting force after adding Ultrasonic Torsional Vibration (UTV) to micro-milling was analyzed. Micro-milling with and without UTV were both carried out on the self-designed UTVAM experimental system, using forged aluminum alloy. Single-factor method was used to analyze the influence rules of cutting parameters such as spindle speed, feed per tooth and depth of cut on cutting force. It was found that feed per tooth plays a more important role than other parameters, a smaller feed per tooth can have a better effects on reducing of cutting force in UTVAM.

  15. Trap-assisted tunneling hole injection in SiO{sub 2}: Experiment and theory

    SciTech Connect

    Nasyrov, K. A.; Shaimeev, S. S.; Gritsenko, V. A.

    2009-11-15

    The injection of holes from silicon through silicon oxide (SiO{sub 2}) in a tantalum nitride-aluminum oxide-silicon nitride-silicon oxide-silicon (TANOS) structure has been studied experimentally. Using the high-permittivity Al{sub 2}O{sub 3} insulator as a blocking one suppresses the parasitic injection of electrons from the conducting TaN contact. This allows the injection of holes from the substrate into nitride to be studied up to comparatively high electric fields. The experimental data are not described by the standard Fowler-Nordheim law with reasonable physical parameters. At the same time, these data are in good agreement with the model of trap-assisted tunneling hole injection in SiO{sub 2}. The developed theory shows that the traps in a narrow energy band make a major contribution to this process, i.e., this injection is resonant in nature.

  16. Operation of magnetically assisted fluidized beds in microgravity and variable gravity: experiment and theory

    NASA Technical Reports Server (NTRS)

    Sornchamni, T.; Jovanovic, G. N.; Reed, B. P.; Atwater, J. E.; Akse, J. R.; Wheeler, R. R.

    2004-01-01

    The conversion of solid waste into useful resources in support of long duration manned missions in space presents serious technological challenges. Several technologies, including supercritical water oxidation, microwave powered combustion and fluidized bed incineration, have been tested for the conversion of solid waste. However, none of these technologies are compatible with microgravity or hypogravity operating conditions. In this paper, we present the gradient magnetically assisted fluidized bed (G-MAFB) as a promising operating platform for fluidized bed operations in the space environment. Our experimental and theoretical work has resulted in both the development of a theoretical model based on fundamental principles for the design of the G-MAFB, and also the practical implementation of the G-MAFB in the filtration and destruction of solid biomass waste particles from liquid streams. c2004 COSPAR. Published by Elsevier Ltd. All rights reserved.

  17. Operation of magnetically assisted fluidized beds in microgravity and variable gravity: experiment and theory

    NASA Technical Reports Server (NTRS)

    Sornchamni, T.; Jovanovic, G. N.; Reed, B. P.; Atwater, J. E.; Akse, J. R.; Wheeler, R. R.

    2004-01-01

    The conversion of solid waste into useful resources in support of long duration manned missions in space presents serious technological challenges. Several technologies, including supercritical water oxidation, microwave powered combustion and fluidized bed incineration, have been tested for the conversion of solid waste. However, none of these technologies are compatible with microgravity or hypogravity operating conditions. In this paper, we present the gradient magnetically assisted fluidized bed (G-MAFB) as a promising operating platform for fluidized bed operations in the space environment. Our experimental and theoretical work has resulted in both the development of a theoretical model based on fundamental principles for the design of the G-MAFB, and also the practical implementation of the G-MAFB in the filtration and destruction of solid biomass waste particles from liquid streams. c2004 COSPAR. Published by Elsevier Ltd. All rights reserved.

  18. Imageless computer-assisted versus conventional total hip arthroplasty: one surgeon's initial experience.

    PubMed

    Brown, Matthew L; Reed, Jeffrey D; Drinkwater, Christopher J

    2014-05-01

    Computer-assisted surgery (CAS) systems are advocated to improve component positioning in THA, though potential operative risks and costs of CAS have fueled debate. The present study examines the radiographic outcomes, operative efficiency, cost, and midterm functional outcomes for patients who underwent THA, either with CAS or conventional instrumentation. Patient baseline characteristics were recorded for 126 lower-extremities in the CAS series, and 215 in the conventional series. There was no difference in Harris Hip Score or leg length discrepancy between series. Inclination angle, blood loss, and operating room times were increased for CAS. These results suggest that CAS confers no advantage over conventional methods regarding accuracy of THA component placement, drives unreimbursed increases in procedure costs, may expose patients to additional operative risk, and produces no functional benefit at midterm follow-up. © 2014.

  19. Intra-operative image update: first experiences with new software in computer-assisted sinus surgery.

    PubMed

    Wurm, Jochen; Bohr, Christopher; Iro, Heinrich; Bumm, Klaus

    2008-09-01

    So far, conventional navigation systems do not provide the opportunity for any modification of acquired image datasets. In particular, the surgical progress in the operating field cannot be visualized unless new imaging scans are performed. In a feasibility study, new software creating intra-operative image updates by virtual means was tested in conjunction with conventional navigation. With this new software, surgically removed tissue volumes can be traced and viewed directly within the diagnostic image data. The new software represents an interesting and helpful amendment to conventional computer-assisted surgery in selected cases. During surgical procedures around bony structures, the surgeon gets an accurate virtual image update of the surgical progress in the operating field and the amount of tissue removed. However, in cases where mobile structures are present or soft tissue shifts are expected, this feature seems to be suitable only to a limited extent.

  20. Initial experiences with the HeartMate vented electric left ventricular assist system in Japan.

    PubMed

    Saito, Shunsuke; Nakatani, Takeshi; Niwaya, Kazuo; Kobayashi, Junjiro; Hanatani, Akihisa; Tagusari, Osamu; Nakajima, Hiroyuki; Miyatake, Kunio; Yagihara, Toshikatsu; Kitamura, Soichiro

    2007-01-01

    We report three consecutive cases of long-term circulatory support using the HeartMate vented electric (VE) left ventricular assist system (LVAS). The HeartMate VE LVAS dramatically improved the functional status and quality of life of these three patients with end-stage heart failure, and all were successfully bridged to transplantation after 659, 995, and 1055 days of support on the device. Only an antiplatelet agent was used for anticoagulation therapy, and no cerebrovascular event occurred. Although the pump stopped in two of these three patients 665 days and 491 days after implantation, both were supported by the backup pneumatic driver thereafter. The drive-line exit site became infected in one patient and thinning of the left ventricular wall due to an unknown cause occurred in one patient.

  1. Operation of magnetically assisted fluidized beds in microgravity and variable gravity: experiment and theory.

    PubMed

    Sornchamni, T; Jovanovic, G N; Reed, B P; Atwater, J E; Akse, J R; Wheeler, R R

    2004-01-01

    The conversion of solid waste into useful resources in support of long duration manned missions in space presents serious technological challenges. Several technologies, including supercritical water oxidation, microwave powered combustion and fluidized bed incineration, have been tested for the conversion of solid waste. However, none of these technologies are compatible with microgravity or hypogravity operating conditions. In this paper, we present the gradient magnetically assisted fluidized bed (G-MAFB) as a promising operating platform for fluidized bed operations in the space environment. Our experimental and theoretical work has resulted in both the development of a theoretical model based on fundamental principles for the design of the G-MAFB, and also the practical implementation of the G-MAFB in the filtration and destruction of solid biomass waste particles from liquid streams. c2004 COSPAR. Published by Elsevier Ltd. All rights reserved.

  2. Power of Peer-Assisted Learning: An Interdisciplinary Mobility Laboratory Experience.

    PubMed

    Lorio, Anne K; Florman, Terri M; Gore, Jane B; Housley, Stephen N; Nelson, Michelle A

    2016-02-01

    The benefits of early patient mobility in the hospital environment has been well established. This article highlights an interactive peer-assisted learning (PAL) mobility laboratory. Physical therapy (PT) students taught patient mobility skills to nursing students, with the goal of enhancing mobility knowledge and improved understanding of the two disciplines' roles and responsibilities. The students were divided into 10 groups, with six nursing and three PT students in each group; each group rotated through the 10 mobility stations every 20 minutes. After completing all stations, the nursing students reviewed a case scenario requiring application of the recently learned knowledge and skills. Analysis revealed that the nursing students demonstrated significant improvement in overall knowledge of safe patient mobility, as well as improved confidence in the instruction of safe patient mobility. Both groups reported that the PAL strategy was successful in achieving the intended goals of improved interprofessional understanding. Copyright 2016, SLACK Incorporated.

  3. Necessity and benefits of physician assistants' participation in international clinical experiences.

    PubMed

    Kibe, Lucy Wachera

    2012-01-01

    Several consultation stations have been set up in an unfinished stone building. My team is made up of a Kenyan physician assistant (called clinical officer), a Kenyan medical student, and me, a US physician assistant student. We are huddled around a small worn-out square table. A middle-aged woman and her two children, ages 2 and 6, approach the table. They have traveled 2 miles to the medical camp. The children, covered in dust, are emaciated with protruding abdomens, dry skin, and congested noses. The clinical officer (CO) conducts a brief interview in Swahili, the Kenyan national language. The mother explains that they have been coughing up thick yellow sputum for a week and have no appetite. They've also had diarrhea for a couple of weeks. I examine the children, who are obviously scared. Hot, moist skin. They are both running a fever. I listen to the lungs: reduced lung sounds. The protruding abdomens are rock hard. I report the findings to the team. The CO turns to the Kenyan medical student and me and quizzes us on differential diagnoses with rationale for each. We come up with malaria, pneumonia, TB, and worm infestation. Due to limited resources, medical diagnosis in Kenya relies heavily on history and physical exam. The CO explains that comorbid conditions are probable. Luckily, we have malaria-testing kits at the camp. They test negative for malaria. We decide to treat them for pneumonia. We also offer them a free hot meal, toothbrushes, T-shirts, coloring paper, and crayons. The children manage to smile. The mother is so grateful, she cries.

  4. Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital

    PubMed Central

    Romero, Carlos M.; Cornejo, Rodrigo; Tobar, Eduardo; Gálvez, Ricardo; Luengo, Cecilia; Estuardo, Nivia; Neira, Rodolfo; Navarro, José Luis; Abarca, Osvaldo; Ruiz, Mauricio; Berasaín, María Angélica; Neira, Wilson; Arellano, Daniel; Llanos, Osvaldo

    2015-01-01

    Objective To evaluate the efficacy and safety of percutaneous tracheostomy by means of single-step dilation with fiber optic bronchoscopy assistance in critical care patients under mechanical ventilation. Methods Between the years 2004 and 2014, 512 patients with indication of tracheostomy according to clinical criteria, were prospectively and consecutively included in our study. One-third of them were high-risk patients. Demographic variables, APACHE II score, and days on mechanical ventilation prior to percutaneous tracheostomy were recorded. The efficacy of the procedure was evaluated according to an execution success rate and based on the necessity of switching to an open surgical technique. Safety was evaluated according to post-operative and operative complication rates. Results The mean age of the group was 64 ± 18 years (203 women and 309 males). The mean APACHE II score was 21 ± 3. Patients remained an average of 11 ± 3 days on mechanical ventilation before percutaneous tracheostomy was performed. All procedures were successfully completed without the need to switch to an open surgical technique. Eighteen patients (3.5%) presented procedure complications. Five patients experienced transient desaturation, 4 presented low blood pressure related to sedation, and 9 presented minor bleeding, but none required a transfusion. No serious complications or deaths associated with the procedure were recorded. Eleven patients (2.1%) presented post-operative complications. Seven presented minor and transitory bleeding of the percutaneous tracheostomy stoma, 2 suffered displacement of the tracheostomy cannula, and 2 developed a superficial infection of the stoma. Conclusion Percutaneous tracheostomy using the single-step dilation technique with fiber optic bronchoscopy assistance seems to be effective and safe in critically ill patients under mechanical ventilation when performed by experienced intensive care specialists using a standardized procedure. PMID:26340151

  5. Long-term management of ventilated-assisted individuals: the Boston University experience.

    PubMed

    Make, B J

    1986-04-01

    In the 4 1/2 years beginning in January 1981, the University Hospital at the Boston University Medical Center admitted 46 ventilator-assisted individuals to its Respiratory Care Center and discharged 38 of them to their homes with ventilators. Of the 46 admitted, 23 had COPD and 23 had neuromuscular or skeletal disorders. All the latter were successfully sent home, and 15 of the 23 with COPD went home. At follow-up in 1985, of the 38 patients managed at home for periods of 1 to 51 months, 30 were surviving and 4 with COPD and 4 with neuromuscular disorders had died. One died immediately after discharge, one who had amyotrophic lateral sclerosis lived 9 months at home before dying, and the other 6 lived at home a year or more before dying. These results were made possible by an inpatient facility that had the goal of improving the quality of life of ventilator-assisted persons. This was done by the use of portable ventilators on motorized wheelchairs, by the use of traditional rehabilitation techniques, and by encouraging and training patients to become independent and responsible for their own personal and respiratory care. The hospital-based Respiratory Care Center is staffed by a team from physical therapy, occupational therapy, respiratory therapy, rehabilitation nursing, social service, psychiatry, rehabilitation medicine, and otolaryngology. A pulmonary physician directs the program and a respiratory nurse specialist is co-director and oversees its daily operation. The rehabilitation process has six stages: Stage 1 is stabilization, Stage II is evaluation, Stage III is rehabilitation planning, Stage IV is rehabilitation training, Stage V is discharge planning.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Robotic-Assisted Paraesophageal Hernia Repair: Initial Experience at a Single Institution.

    PubMed

    Galvani, Carlos A; Loebl, Hannah; Osuchukwu, Obiyo; Samamé, Julia; Apel, Matthew E; Ghaderi, Iman

    2016-04-01

    Laparoscopic surgery is considered the standard approach for the treatment of paraesophageal hernias (PEHs). Despite its advantages, this approach is technically demanding with a significant learning curve. Data about the safety and utility of the robotically assisted paraesophageal hernia repair (RA-PEHR) are scarce. The aim of this study is to assess the feasibility and safety of robotic assistance for the treatment of PEH. Between June 2010 and December 2015, patients who underwent elective RA-PEHR were included in a prospectively collected database. Demographic data, American Society of Anesthesiologists (ASA) classification, preoperative testing, operative time (OT), length of hospital stay (LOS), conversion rate, morbidity, and mortality were recorded and reviewed retrospectively. Sixty-one patients underwent RA-PEHR with mesh, 72% were female (mean age of 63 and mean body mass index [BMI] of 30). ASA classification was 2.6 (57% of patients had an ASA III). With respect to the type of the hernia, the preoperative diagnosis was: Type II 26%, III 64%, and IV 13%. OT averaged 186 minutes (88-360), including robot setup time. After the 16th case, OT significantly decreased by 4.09 minutes (P = .01). There were no conversions. The average blood loss was 51 mL. Perioperative complications, including intraoperative and 30-day complications, were 6% and 23%, respectively. The mean length of hospitalization was 2.6 (1-18) days. There were no deaths. Forty patients (66%) were available for follow-up, and length of follow-up was 17 ± 15 months. Anatomic recurrence was observed in 42% of patients and only 23% of patients were symptomatic. This report represents the largest series to date of RA-PEHR. RA-PEHR has proved to be feasible and safe with a learning curve comparable to the standard laparoscopic approach.

  7. Some Experiments in Man-Machine Interaction Relevant to Computer Assisted Instruction.

    ERIC Educational Resources Information Center

    Barker, P. G.

    1982-01-01

    Briefly describes some experiments in human-machine interaction in the context of its relevance to multimedia audiovisual instruction, with emphasis on the use of microcomputer systems augmented with slides or audiocassettes. Fifteen references are listed. (Author/LLS)

  8. Effectiveness of different methods to control legionella in the water supply: ten-year experience in an Italian university hospital.

    PubMed

    Marchesi, I; Marchegiano, P; Bargellini, A; Cencetti, S; Frezza, G; Miselli, M; Borella, P

    2011-01-01

    We report our ten-year experience of hyperchlorination, thermal shock, chlorine dioxide, monochloramine, boilers and point-of-use filters for controlling legionella contamination in a hospital hot water distribution system. Shock disinfections were associated with a return to pre-treatment contamination levels within one or two months. We found that chlorine dioxide successfully maintained levels at <100 cfu/L, whilst preliminary experiments gave satisfactory results with monochloramine. No contamination was observed applying point-of-use filters and electric boilers at temperatures of >58°C and no cases of nosocomial legionellosis were detected in the ten-year observation period. Our performance ranking in reducing legionella contamination was filter, boiler, chlorine dioxide, hyperchlorination and thermal shock. Chlorine dioxide was the least expensive procedure followed by thermal shock, hyperchlorination, boiler and filter. We suggest adopting chlorine dioxide and electric boilers in parallel.

  9. PI-in-a-box: Intelligent onboard assistance for spaceborne experiments in vestibular physiology

    NASA Technical Reports Server (NTRS)

    Colombano, Silvano; Young, Laurence; Wogrin, Nancy; Rosenthal, Don

    1988-01-01

    In construction is a knowledge-based system that will aid astronauts in the performance of vestibular experiments in two ways: it will provide real-time monitoring and control of signals and it will optimize the quality of the data obtained, by helping the mission specialists and payload specialists make decisions that are normally the province of a principal investigator, hence the name PI-in-a-box. An important and desirable side-effect of this tool will be to make the astronauts more productive and better integrated members of the scientific team. The vestibular experiments are planned by Prof. Larry Young of MIT, whose team has already performed similar experiments in Spacelab missions SL-1 and D-1, and has experiments planned for SLS-1 and SLS-2. The knowledge-based system development work, performed in collaboration with MIT, Stanford University, and the NASA-Ames Research Center, addresses six major related functions: (1) signal quality monitoring; (2) fault diagnosis; (3) signal analysis; (4) interesting-case detection; (5) experiment replanning; and (6) integration of all of these functions within a real-time data acquisition environment. Initial prototyping work has been done in functions (1) through (4).

  10. Cross-border-assisted reproduction: a qualitative account of UK travellers' experiences.

    PubMed

    Hudson, Nicky; Culley, Lorraine; Blyth, Eric; Norton, Wendy; Pacey, Allan; Rapport, Frances

    2016-06-01

    Surveys on patients' experiences of cross-border fertility treatment have reported a range of positive and challenging features. However, the number of such studies is limited, and there is no detailed qualitative account of the experiences of UK patients who travel overseas for fertility treatment. The present study used a cross-sectional, qualitative design and in-depth interviews. Fifty-one participants (41 women and 10 men, representing 41 treatment 'cases') participated in semi-structured interviews. The experiences reported were broadly positive with a large proportion of participants (39 cases, 95%) citing a favourable overall experience with only two cases (5%) reporting a more negative experience. Thematic analysis revealed 6 major categories and 20 sub-categories, which described the positive and challenging aspects of cross-border fertility travel. The positive aspects were represented by the categories: 'access', 'control' and 'care and respect'. The more challenging aspects were categorized as 'logistics and coordination of care', 'uncertainty' and 'cultural dissonance'. The study confirms findings from others that despite some challenges, there is a relatively high level of patient satisfaction with cross-border treatment with participants able to extend the boundaries of their fertility-seeking trajectories and in some cases, regain a sense of control over their treatment.

  11. Anatomic pulmonary resection by video-assisted thoracoscopy: the Brazilian experience (VATS Brazil study).

    PubMed

    Terra, Ricardo Mingarini; Kazantzis, Thamara; Pinto-Filho, Darcy Ribeiro; Camargo, Spencer Marcantonio; Martins-Neto, Francisco; Guimarães, Anderson Nassar; Araújo, Carlos Alberto; Losso, Luis Carlos; Ghefter, Mario Claudio; Lima, Nuno Ferreira de; Gomes-Neto, Antero; Brito-Filho, Flávio; Haddad, Rui; Saueressig, Maurício Guidi; Lima, Alexandre Marcelo Rodrigues; Siqueira, Rafael Pontes de; Pinho, Astunaldo Júnior de Macedo E; Vannucci, Fernando

    2016-01-01

    The objective of this study was to describe the results of anatomic pulmonary resections performed by video-assisted thoracoscopy in Brazil. Thoracic surgeons (members of the Brazilian Society of Thoracic Surgery) were invited, via e-mail, to participate in the study. Eighteen surgeons participated in the project by providing us with retrospective databases containing information related to anatomic pulmonary resections performed by video-assisted thoracoscopy. Demographic, surgical, and postoperative data were collected with a standardized instrument, after which they were compiled and analyzed. The surgeons provided data related to a collective total of 786 patients (mean number of resections per surgeon, 43.6). However, 137 patients were excluded because some data were missing. Therefore, the study sample comprised 649 patients. The mean age of the patients was 61.7 years. Of the 649 patients, 295 (45.5%) were male. The majority-521 (89.8%)-had undergone surgery for neoplasia, which was most often classified as stage IA. The median duration of pleural drainage was 3 days, and the median hospital stay was 4 days. Of the 649 procedures evaluated, 598 (91.2%) were lobectomies. Conversion to thoracotomy was necessary in 30 cases (4.6%). Postoperative complications occurred in 124 patients (19.1%), the most common complications being pneumonia, prolonged air leaks, and atelectasis. The 30-day mortality rate was 2.0%, advanced age and diabetes being found to be predictors of mortality. Our analysis of this representative sample of patients undergoing pulmonary resection by video-assisted thoracoscopy in Brazil showed that the procedure is practicable and safe, as well as being comparable to those performed in other countries. O objetivo deste estudo foi descrever os resultados de ressecções pulmonares anatômicas por videotoracoscopia no Brasil. Cirurgiões torácicos (membros da Sociedade Brasileira de Cirurgia Torácica) foram convidados, por correio eletr

  12. 43 CFR 12.730 - Buy American Act-Supplies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Buy American Act-Supplies. 12.730 Section... REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Buy American Requirements for Assistance Programs Buy American Act-Supplies § 12.730 Buy American Act—Supplies. As prescribed in § 12.725, insert the following...

  13. 43 CFR 12.730 - Buy American Act-Supplies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Buy American Act-Supplies. 12.730 Section... REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Buy American Requirements for Assistance Programs Buy American Act-Supplies § 12.730 Buy American Act—Supplies. As prescribed in § 12.725, insert the following...

  14. 43 CFR 12.730 - Buy American Act-Supplies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Buy American Act-Supplies. 12.730 Section... REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Buy American Requirements for Assistance Programs Buy American Act-Supplies § 12.730 Buy American Act—Supplies. As prescribed in § 12.725, insert the following...

  15. 43 CFR 12.730 - Buy American Act-Supplies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Buy American Act-Supplies. 12.730 Section... REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Buy American Requirements for Assistance Programs Buy American Act-Supplies § 12.730 Buy American Act—Supplies. As prescribed in § 12.725, insert the following...

  16. 43 CFR 12.730 - Buy American Act-Supplies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Buy American Act-Supplies. 12.730 Section... REQUIREMENTS AND COST PRINCIPLES FOR ASSISTANCE PROGRAMS Buy American Requirements for Assistance Programs Buy American Act-Supplies § 12.730 Buy American Act—Supplies. As prescribed in § 12.725, insert the...

  17. Supply chain planning classification

    NASA Astrophysics Data System (ADS)

    Hvolby, Hans-Henrik; Trienekens, Jacques; Bonde, Hans

    2001-10-01

    Industry experience a need to shift in focus from internal production planning towards planning in the supply network. In this respect customer oriented thinking becomes almost a common good amongst companies in the supply network. An increase in the use of information technology is needed to enable companies to better tune their production planning with customers and suppliers. Information technology opportunities and supply chain planning systems facilitate companies to monitor and control their supplier network. In spite if these developments, most links in today's supply chains make individual plans, because the real demand information is not available throughout the chain. The current systems and processes of the supply chains are not designed to meet the requirements now placed upon them. For long term relationships with suppliers and customers, an integrated decision-making process is needed in order to obtain a satisfactory result for all parties. Especially when customized production and short lead-time is in focus. An effective value chain makes inventory available and visible among the value chain members, minimizes response time and optimizes total inventory value held throughout the chain. In this paper a supply chain planning classification grid is presented based current manufacturing classifications and supply chain planning initiatives.

  18. The experience of gasless endoscopic-assisted thyroidectomy via the anterior chest approach for Graves' disease.

    PubMed

    Hong, Yun; Yu, Shi-Tong; Cai, Qian; Liang, Fa-Ya; Han, Ping; Huang, Xiao-Ming

    2016-10-01

    The aim of this study was to evaluate the safety, feasibility, effectiveness, and cosmesis of a gasless endoscopic-assisted thyroidectomy via the anterior chest in patients with Graves' disease. We retrospectively reviewed 38 patients with Graves' disease treated with thyroidectomy from November 2007 to June 2015. We analyzed clinical characteristics of patients, type of operation, operative indications, operative duration, length of postoperative hospital stay, and postoperative complications. The thyroidectomies were classified as total thyroidectomy (n = 12) or near-total thyroidectomy with a remnant of <1 g (n = 26). Surgical indications were recurrence after antithyroid drugs (ATDs) and unwillingness to undergo radioiodine therapy (n = 27), local compressive symptoms (n = 2), adverse drug reactions to ATDs (n = 5), and patient's preference (n = 4). Mean resection weight was 71.7 ± 16.2 g (range 44-109 g), mean operative duration 87.7 ± 17.3 min (range 66-136 min), intraoperative blood loss 70.6 ± 11.3 mL (range 43-92 mL), and drainage was 42.0 ± 8.5 mL (range 20-62 mL). Temporary postoperative recurrent laryngeal nerve palsy and temporary hypoparathyroidism occurred in 3 cases (7.89 %) each. Mean hospital stay was 2.5 ± 0.3 days (range 2-4 days). There was no recurrence of hyperthyroidism over the follow-up period of for 68.1 ± 5.6 months (range 6-89 months). All patients were satisfied with their cosmetic results. Gasless endoscopic-assisted thyroidectomy via the anterior chest approach for Graves' disease is a safe, feasible, and effective and provides an excellent cosmetic outcome procedure. It is a valid option in appropriately selected patients.

  19. Supply of and demand for assisted reproductive technologies in the United States: clinic- and population-based data, 1995-2010.

    PubMed

    Stephen, Elizabeth Hervey; Chandra, Anjani; King, Rosalind Berkowitz

    2016-02-01

    To study national-level trends in assisted reproduction technology (ART) treatments and outcomes as well as the characteristics of women who have sought this form of infertility treatment. Population-based study. Not applicable. For CDC: All reporting clinics from 1996-2010. For NSFG: for the logistic analysis, sample comprising 2,325 women aged 22-44 years who have ever used medical help to get pregnant, excluding women who used only miscarriage prevention services. None. CDC data (number of cycles, live birth deliveries, live births, patient diagnoses); and NSFG data (individual use of ART procedures). Between 1995 and 2010, use of ART increased. Parity and age are strong predictors of using ART procedures. The other correlates are higher education, having had tubal surgery, and having a current fertility problem. The two complementary data sets highlight the trends of ART use. An increase in the use of ART services over this time period is seen in both data sources. Nulliparous women aged 35-39 years are the most likely to have ever used ART services. Copyright © 2016 American Society for Reproductive Medicine. All rights reserved.

  20. An Examination of the Outcomes of the Undergraduate Leadership Teaching Assistant (ULTA) Experience as a High-Impact Practice in Leadership Education

    ERIC Educational Resources Information Center

    Odom, Summer F.; Ho, Sarah P.; Moore, Lori L.

    2015-01-01

    The Undergraduate Leadership Teaching Assistant (ULTA) experience offers students a high-impact opportunity to develop, practice, and evaluate their leadership knowledge, skills, and abilities. The purpose of this qualitative study was to examine outcomes of the ULTA experience as a high-impact practice for students studying leadership. Weekly…

  1. Speech-language pathology telehealth in rural and remote schools: the experience of school executive and therapy assistants.

    PubMed

    Fairweather, Glenn C; Lincoln, Michelle A; Ramsden, Robyn

    2017-01-01

    Difficulties in accessing allied health services, especially in rural and remote areas, appear to be driving the use of telehealth services to children in schools. The objectives of this study were to investigate the experiences and views of school executive staff and therapy assistants regarding the feasibility and acceptability of a speech-language pathology telehealth program for children attending schools in rural and remote New South Wales, Australia. The program, called Come N See, provided therapy interventions remotely via low-bandwidth videoconferencing, with email follow-up. Over a 12-week period, children were offered therapy blocks of six fortnightly sessions, each lasting a maximum of 30 minutes. School executives (n=5) and therapy assistants (n=6) described factors that promoted or threatened the program's feasibility and acceptability, during semistructured interviews. Thematic content analysis with constant comparison was applied to the transcribed interviews to identify relationships in the data. Emergent themes related to (a) unmet speech pathology needs, (b) building relationships, (c) telehealth's advantages, (d) telehealth's disadvantages, (e) anxiety replaced by joy and confidence in growing skills, and (f) supports. School executive staff and therapy assistants verified that the delivery of the school-based telehealth service was feasible and acceptable. However, the participants saw significant opportunities to enhance this acceptability through building into the program stronger working relationships and supports for stakeholders. These findings are important for the future development of allied health telehealth programs that are sustainable as well as effective and fit the needs of all crucial stakeholders. The results have significant implications for speech pathology clinical practice relating to technology, program planning and teamwork within telehealth programs.

  2. Robotic-assisted laparoscopic approach for posterior bladder neck dissection and placement of pediatric bladder neck sling: initial experience.

    PubMed

    Storm, Douglas W; Fulmer, Brant R; Sumfest, Joel M

    2008-11-01

    Bladder neck sling cystourethropexy is a common procedure used to correct intrinsic sphincter deficiency in children with spinal dyspharism. Various modifications of the procedure have been made but all involve circumferential dissection of the bladder neck and proximal urethra. The posterior dissection can be challenging and can result in injury to the rectum, urethra, or vagina. The posterior approach to the bladder neck as reported by Lottmann and later by de Badiola addresses these potential complications. Using these principles of the posterior approach, we performed a robotic-assisted laparoscopic placement of an acellular human dermal allograft bladder neck sling in 2 patients. We present our initial experience regarding this surgical technique. The diagnosis of intrinsic sphincter deficiency was established in 2 female patients, aged 9 and 10 years. Both patients had a neurogenic bladder secondary to spina bifida. Video urodynamics confirmed adequate bladder compliance and intrinsic sphincter deficiency. Robotic-assisted laparoscopic placement of a bladder neck sling was performed in both patients. Both procedures were completed intracorporeally. The mean blood loss was 20 mL. The mean operative time was 189 minutes. No intraoperative or postoperative complications occurred. The mean hospital stay was 3 days (range 2-4). The follow-up ranged from 13 to 22 months. Postoperative studies revealed continued low-pressure, compliant bladders and stable upper tracts. At last follow-up, the 2 patients were using catheterization without difficulty and were continent. The robotic-assisted laparoscopic approach to performing bladder neck dissection and placement of a bladder neck sling in children is technically feasible.

  3. [Attitudes and experiences regarding physician assisted suicide : A survey among members of the German Association for Palliative Medicine].

    PubMed

    Jansky, Maximiliane; Jaspers, Birgit; Radbruch, Lukas; Nauck, Friedemann

    2017-01-01

    The need to regulate physician-assisted suicide (PAS) and organizations offering assisted suicide has been controversially debated in Germany. Before the German parliament voted on various drafts in November 2015, the German Association for Palliative Medicine surveyed its members on their attitudes and experiences regarding PAS. Items for the survey were derived from the literature and consented in a focus group. 2005-2015 - PubMed: PAS [Title/Abstract] UND survey (all countries), grey literature. We invited 5152 members of the DGP to participate in the online/paper survey. Descriptive quantitative and content analytic qualitative analysis of data using SPSS and MaxQDA. We obtained 1811 valid data sets (response rate 36.9%). 33.7% of the participants were male, 43.6% were female, and 0.4% identifed as other. Physicians accounted for 48.5% of the respondents, 17.8% nurses, other professions 14.3%, and about 20% of the data was missing socio-demographic information. More than 90% agreed that "wishes for PAS may be ambivalent" and "are rather a wish to end an unbearable situation". Of the 833 participating physicians, 56% refused participating in PAS and 74.2% had been asked to perform PAS. PAS was actually performed by 3%. Of all participating members, 56% approved of a legal ban of organizations offering assisted suicide. More than 60% of all professions agreed that PAS is not a part of palliative care. The respondents show a broad spectrum of attitudes, only partly supporting statements of relevant bodies, such as DGP. Because many are confronted with the issue, PAS is relevant to professionals in palliative care.

  4. Robot-assisted microwave thermoablation of liver tumors: a single-center experience.

    PubMed

    Beyer, L P; Pregler, B; Niessen, C; Dollinger, M; Graf, B M; Müller, M; Schlitt, H J; Stroszczynski, C; Wiggermann, P

    2016-02-01

    To evaluate and compare the needle placement accuracy, patient dose, procedural time, complication rate and ablation success of microwave thermoablation using a novel robotic guidance approach and a manual approach. We performed a retrospective single-center evaluation of 64 microwave thermoablations of liver tumors in 46 patients (10 female, 36 male, mean age 66 years) between June 2014 and February 2015. Thirty ablations were carried out with manual guidance, while 34 ablations were performed using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and MRI) was performed on all patients. The total procedure time and dose-length product were significantly reduced under robotic guidance (18.3 vs. 21.7 min, [Formula: see text]; 2216 vs. 2881 mGy[Formula: see text]cm, [Formula: see text]). The position of the percutaneous needle was more accurate using robotic guidance (needle deviation 1.6 vs. 3.3 mm, [Formula: see text]). There was no significant difference between both groups regarding the complication rate and the ablation success. Robotic assistance for liver tumor ablation reduces patient dose and allows for fast positioning of the microwave applicator with high accuracy. The complication rate and ablation success of percutaneous microwave thermoablation of malignant liver tumors using either CT fluoroscopy or robotic guidance for needle positioning showed no significant differences in the 6-week follow-up.

  5. Video-assisted thoracoscopic surgery for spontaneous pneumothorax in children-our experience.

    PubMed

    Zganjer, M; Kljenak, A

    2007-01-01

    The aim of this case report was to analyse the efficiency of video-assisted thoracic surgery (VATS) in the treatment of spontaneous pneumothorax. Spontaneous pneumothorax occurs subsequently to a disruption of visceral pleura and escape of air into pleural space. A retrospective study was performed in 5 patients from December 2001 until May 2006. Four procedures for recurrent spontaneous pneumothorax and one procedure for primary spontaneous pneumothorax were performed. The main symptoms in our patients included chest pain (100%), shortness of breath (60%) and cough (10%) In all patients we made routine X-rays and CT scans. With CT scans in four patients we detected apical bullae. In one patient we had not appropriate diagnosis and we made VATS as diagnostic and later therapeutic procedure. In all patients bullae were in apical zone and resected with endostapler device. There was no postoperative mortality or any complications after VATS. The median duration of the operation was 75 minutes (65-120 minutes), and postoperative hospital stay was 6 days (range 5 to 8 days). On the basis of our results and results from literature we conclude that VATS allows effective, safe performance of standard surgical procedures, avoiding a formal thoracotomy incision (Ref. 15). Full Text (Free, PDF) www.bmj.sk.

  6. Experience with ultrasonographically guided vacuum-assisted resection of benign breast tumors.

    PubMed

    Tagaya, N; Nakagawa, A; Ishikawa, Y; Oyama, T; Kubota, K

    2008-04-01

    To evaluate the feasibility and safety of vacuum-assisted resection of benign breast tumours using an 8 G handheld device. Over a 2-year period, 22 patients with 26 breast tumours diagnosed as benign using aspiration biopsy cytology were enrolled. The mean patient age was 38 years, and the mean maximal diameter of the tumour was 13 mm. A handheld Aloka SSD 6500 ultrasonography device with a linear-type 7.5 MHz transducer was inserted into the posterior aspect of the tumour with the patient under local anaesthesia, and the tumour was resected under ultrasonographic guidance. This method was employed successfully in all patients, and the mean operation time was 33 min. Post-procedure complications included subcutaneous bleeding in 12 cases and haematoma in one. The pathological diagnoses were fibroadenoma in 16 cases, mastopathy in six, and tubular adenoma and pseudoangiomatous stromal hyperplasia in two cases each, respectively. Follow-up ultrasonography revealed residual tumours in four cases (15.4%). Although this method is feasible and safe without severe complications, it is necessary to select appropriate patients, and to obtain informed consent regarding the possibility of recurrence or residual tumour.

  7. Blastocyst transfer for patients with multiple assisted reproduction treatment failures: preliminary experience.

    PubMed

    Sakkas, D; Percival, G; D'Arcy, Y; Lenton, W; Sharif, K; Afnan, M

    2001-01-01

    This preliminary study reports the results obtained from a patient group in which blastocyst culture and transfer were performed, and discusses the advantages and disadvantages of introducing blastocyst transfer in a clinic. Twenty-six patients who had failed to achieve a pregnancy in previous in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments were offered the choice of a fresh cycle with culture to the blastocyst stage. Of the 26 patients who elected to attempt blastocyst culture, 11 opted to have transfer on day 2 or day 3 due to low numbers of embryos. Of the 15 patients who proceeded to blastocyst culture, 46.2% of the embryos cultured reached the blastocyst stage or later and eight of the patients achieved a clinical pregnancy. More oocytes were collected in this patient group, hence the chances of obtaining blastocysts were higher. Offering blastocyst culture to patients with a reasonable chance of success who have had previous multiple assisted reproduction failures is an acceptable way of introducing blastocyst culture into practice.

  8. Experience of a Korean Disaster Medical Assistance Team in Sri Lanka after the South Asia Tsunami

    PubMed Central

    Kwak, Young Ho; Shin, Sang Do; Kim, Kyu Seok; Kwon, Woon Yong

    2006-01-01

    On 26 December 2004, a huge tsunami struck the coasts of South Asian countries and it resulted in 29,729 deaths and 16,665 injuries in Sri Lanka. This study characterizes the epidemiology, clinical data and time course of the medical problems seen by a Korean disaster medical assistance team (DMAT) during its deployment in Sri Lanka, from 2 to 8 January 2005. The team consisting of 20 surgical and medical personnel began to provide care 7 days after tsunami in the southern part of Sri Lanka, the Matara and Hambantota districts. During this period, a total of 2,807 patients visited our field clinics with 3,186 chief complaints. Using the triage and refer system, we performed 3,231 clinical examinations and made 3,259 diagnoses. The majority of victims had medical problems (82.4%) rather than injuries (17.6%), and most conditions (92.1%) were mild enough to be discharged after simple management. There were also substantial needs of surgical managements even in the second week following the tsunami. Our study also suggests that effective triage system, self-sufficient preparedness, and close collaboration with local authorities may be the critical points for the foreign DMAT activity. PMID:16479081

  9. A Brazilian Experience in Assisted Automated Peritoneal Dialysis: A Reliable and Effective Home Care Approach

    PubMed Central

    Franco, Marcia Regina Gianotti; Fernandes, Natália; Ribeiro, Claúdia Azevedo; Qureshi, Abdul Rashid; Divino-Filho, Jose Carolino; da Glória Lima, Maria

    2013-01-01

    ♦ Introduction: Automated assisted peritoneal dialysis (AAPD) has been shown to be successful as renal replacement therapy for elderly and physically incapable end-stage renal disease (ESRD) patients. In early 2003, a pioneer AAPD program was initiated at GAMEN Renal Clinic in Rio de Janeiro, Brazil. ♦ Objective: We evaluated the results of an AAPD program offered as an option to elderly ESRD patients with physical or cognitive debilities or as last resort to patients with vascular access failure or hemodynamic instability during hemodialysis. ♦ Methods: A cohort of 30 consecutive patients started AAPD from January 2003 to March 2008 and was followed to July 2009. Demographics, clinical and laboratory parameters, causes of death, and patient and technique survival were analyzed. ♦ Results: Median age of the patients was 72 years (range: 47 - 93 years), with 60% being older than 65. The Davies score was greater than 2 in 73% of patients, and the Karnofsky index was less than 70 in 40%. The overall peritonitis rate was 1 episode in 37 patient-months. The total duration of AAPD ranged from 3 to 72 months. Patient survival was 80% at 12 months, 60% at 24 months, and 23.3% at 48 months. The most common cause of death was cardiovascular problems (70%). ♦ Conclusions: In this clinical observational study, AAPD fulfilled its expected role, offering an opportune, reliable, and effective homecare alternative for ESRD patients with no other renal replacement therapy options. PMID:23660606

  10. Early Experience in Da Vinci Robot-Assisted Partial Nephrectomy: An Australian Single Centre Series

    PubMed Central

    Ting, Francis; Savdie, Richard; Chopra, Sam; Yuen, Carlo; Brenner, Phillip

    2015-01-01

    Introduction and Objectives. To demonstrate the safety and efficacy of the robot-assisted partial nephrectomy (RAPN) technique in an Australian setting. Methods. Between November 2010 and July 2014, a total of 76 patients underwent 77 RAPN procedures using the Da Vinci Surgical System© at our institution. 58 of these procedures were performed primarily by the senior author (PB) and are described in this case series. Results. Median operative time was 4 hours (range 1.5–6) and median warm ischaemic time (WIT) was 8 minutes (range 0–30) including 11 cases with zero ischaemic time. All surgical margins were clear with the exception of one patient who had egress of intravascular microscopic tumour outside the capsule to the point of the resection margin. Complications were identified in 9 patients (15.8%). Major complications included conversion to open surgery due to significant venous bleeding (n = 1), reperfusion injury (n = 1), gluteal compartment syndrome (n = 1), DVT/PE (n = 1), and readmission for haematuria (n = 1). Conclusion. This series demonstrates the safety and efficacy of the RAPN technique in an Australian setting when performed by experienced laparoscopic surgeons in a dedicated high volume robotic centre. PMID:26167299

  11. Video assisted thoracoscopic excision of mediastinal ectopic parathyroid adenomas: a UK regional experience

    PubMed Central

    Khan, Ali Zamir; Rew, David; Lagattolla, Nicholas; Singh, Neeta

    2015-01-01

    Background To report the first series of video-assisted thoracoscopic surgery (VATS) resection of mediastinal ectopic parathyroid adenomas (MEPAs) in the UK. Methods A case series of seven cases undergoing VATS between 2004 and 2009 to treat single gland hyperparathyroidism. Methylene blue (MB) was used in 5/7 cases immediately before exploration to identify the adenomas. Carbon dioxide (CO2) up to pressures of 10 mmHg was used safely to deflate the lung in two cases. Results There were five women and two men with a mean age of 53 years (range, 27-72 years). Histopathology confirmed successful resection of the parathyroid adenoma in 6/7 cases. There was one conversion to open thoracotomy due to bleeding from the azygos vein resulting from excessive traction. Despite marked MB uptake, this patient proved to have tuberculoid adenopathy and no parathyroid tissue was identified. Postoperative plasma calcium returned to normal in 6/7 patients and parathyroid hormone (PTH) level in 6/7 patients. The median hospital stay was 2 days and there was no mortality in this series. Conclusions MEPAs can be safely resected using VATS with minimal surgical morbidity, short drainage time and short hospital stay. CO2 insufflation and the intraoperative use of MB are safe and help to accurately localise the ectopic adenoma. VATS should be considered as the first-line approach for resection of MEPAs. PMID:26693148

  12. Survival on the Streets: Experiences of the Homeless Population and Constructive Suggestions for Assistance

    ERIC Educational Resources Information Center

    McBride, Rebecca G.

    2012-01-01

    This phenomenological study explored the experiences and needs of 11 individuals of the homeless population. Results revealed 5 themes: need for employment, perceptions of needs, perceptions of programs and shelters, coping mechanisms, and perceptions of treatment. Counseling implications for practice are discussed.

  13. First Year Experience: How We Can Better Assist First-Year International Students in Higher Education

    ERIC Educational Resources Information Center

    Yan, Zi; Sendall, Patricia

    2016-01-01

    While many American colleges and universities are providing a First Year Experience (FYE) course or program for their first year students, those programs are not often customized to take into account international students' (IS) unique challenges. Using quantitative and qualitative methods, this study evaluated a FYE course that was customized for…

  14. Parents' Experiences When Seeking Assistance for Their Children with Challenging Behaviors

    ERIC Educational Resources Information Center

    Doubet, Sharon L.; Ostrosky, Michaelene M.

    2016-01-01

    The experiences of seven parents, whose preschoolers engaged in persistent challenging behaviors, were investigated. Individual interviews with each parent, member checking, and follow-up discussions to seek clarity on participants' comments were conducted. Four major categories of responses emerged from the data as parents shared their journeys…

  15. Race and Racism in the Experiences of Black Male Resident Assistants at Predominantly White Universities

    ERIC Educational Resources Information Center

    Harper, Shaun R.; Davis, Ryan J.; Jones, David E.; McGowan, Brian L.; Ingram, Ted N.; Platt, C. Spencer

    2011-01-01

    Recent research has shown a nexus between active out-of-class engagement and the accrual of unique race/gender-specific educational outcomes among Black male undergraduates. Yet, rarely explored are the racialized experiences of those who become actively engaged and assume leadership positions on campuses where racial diversity is low, hence the…

  16. The Graduate Teaching Assistant: Effects on Students in Large Undergraduate Courses. Purdue Experiment in Mass Instruction.

    ERIC Educational Resources Information Center

    McGee, Reece; Knuckman, Charlene S.

    An Introductory Sociology class enrolling up to 1,000 students per semester was the group used in this experiment to discover empirically validated means of teaching the mass class with both emotional satisfaction to students and pedagogical efficiency. The course was conducted in lecture-discussion style with two lectures and one discussion…

  17. Microwave-Assisted Esterification: A Discovery-Based Microscale Laboratory Experiment

    ERIC Educational Resources Information Center

    Reilly, Maureen K.; King, Ryan P.; Wagner, Alexander J.; King, Susan M.

    2014-01-01

    An undergraduate organic chemistry laboratory experiment has been developed that features a discovery-based microscale Fischer esterification utilizing a microwave reactor. Students individually synthesize a unique ester from known sets of alcohols and carboxylic acids. Each student identifies the best reaction conditions given their particular…

  18. Microwave-Assisted Esterification: A Discovery-Based Microscale Laboratory Experiment

    ERIC Educational Resources Information Center

    Reilly, Maureen K.; King, Ryan P.; Wagner, Alexander J.; King, Susan M.

    2014-01-01

    An undergraduate organic chemistry laboratory experiment has been developed that features a discovery-based microscale Fischer esterification utilizing a microwave reactor. Students individually synthesize a unique ester from known sets of alcohols and carboxylic acids. Each student identifies the best reaction conditions given their particular…

  19. Parents' Experiences When Seeking Assistance for Their Children with Challenging Behaviors

    ERIC Educational Resources Information Center

    Doubet, Sharon L.; Ostrosky, Michaelene M.

    2016-01-01

    The experiences of seven parents, whose preschoolers engaged in persistent challenging behaviors, were investigated. Individual interviews with each parent, member checking, and follow-up discussions to seek clarity on participants' comments were conducted. Four major categories of responses emerged from the data as parents shared their journeys…

  20. Survival on the Streets: Experiences of the Homeless Population and Constructive Suggestions for Assistance

    ERIC Educational Resources Information Center

    McBride, Rebecca G.

    2012-01-01

    This phenomenological study explored the experiences and needs of 11 individuals of the homeless population. Results revealed 5 themes: need for employment, perceptions of needs, perceptions of programs and shelters, coping mechanisms, and perceptions of treatment. Counseling implications for practice are discussed.

  1. Children's experiences of food insecurity can assist in understanding its effect on their well-being

    USDA-ARS?s Scientific Manuscript database

    An understanding of the experience of food insecurity by children is essential for better measurement and assessment of its effect on children's nutritional, physical, and mental health. Our qualitative study explored children's perceptions of household food insecurity to identify these perceptions ...

  2. Implant-assisted magnetic drug targeting in permeable microvessels: Comparison of two-fluid statistical transport model with experiment

    NASA Astrophysics Data System (ADS)

    ChiBin, Zhang; XiaoHui, Lin; ZhaoMin, Wang; ChangBao, Wang

    2017-03-01

    In experiments and theoretical analyses, this study examines the capture efficiency (CE) of magnetic drug carrier particles (MDCPs) for implant-assisted magnetic drug targeting (IA-MDT) in microvessels. It also proposes a three-dimensional statistical transport model of MDCPs for IA-MDT in permeable microvessels, which describes blood flow by the two-fluid (Casson and Newtonian) model. The model accounts for the permeable effect of the microvessel wall and the coupling effect between the blood flow and tissue fluid flow. The MDCPs move randomly through the microvessel, and their transport state is described by the Boltzmann equation. The regulated changes and factors affecting the CE of the MDCPs in the assisted magnetic targeting were obtained by solving the theoretical model and by experimental testing. The CE was negatively correlated with the blood flow velocity, and positively correlated with the external magnetic field intensity and microvessel permeability. The predicted CEs of the MDCPs were consistent with the experimental results. Additionally, under the same external magnetic field, the predicted CE was 5-8% higher in the IA-MDT model than in the model ignoring the permeability effect of the microvessel wall.

  3. Creating an assistive technology clinic: the experience of the Johns Hopkins AT clinic for patients with ALS.

    PubMed

    Casey, Kelly Showalter

    2011-01-01

    For persons with Amyotrophic Lateral Sclerosis (ALS), comprehensive multidisciplinary care can effectively improve overall quality of life from diagnosis to end of life [16]. Considering the rapidly progressive loss in overall function experienced by persons with ALS, it is essential to provide comprehensive multidisciplinary care, including Assistive Technology (AT) services, in an effective and efficient manner. AT is an important adjunctive therapy for people with neurological disability. For people with complex conditions, access to a comprehensive AT clinic can be the best way to access these tools. Unfortunately, few medical centers have invested in AT clinics, and managers may not understand how to go about developing AT resources at their facility. This article chronicles the step-by-step development of The Johns Hopkins Assistive Technology Clinic for persons with ALS. It offers background evidence, the process of program development, and insight into the experience of professional accountability of one occupational therapist turned AT Director. It also details descriptions of the stakeholders and their roles in the development process, funding and ethical considerations, and barriers to implementation. It is hoped that this may provide guidance for teams who may wish to build AT facilities in their own practice settings.

  4. Hydro-Jet Assisted Laparoscopic Cholecystectomy: Initial Experience in a Porcine Model

    PubMed Central

    Shekarriz, Hodjat; Upadhyay, Jyoti; Comman, Andreas; Markert, Uwe; Bürk, Conny G.; Kujath, Peter; Bruch, Hans-Peter

    2002-01-01

    Background and Objectives: Hydro-Jet technology has long been used for cutting various materials like metal and wood in the industrial field. In the medical field, this technology has been applied successfully for selective cutting of the parenchyma of the liver. However, to our knowledge, no data exist on the use of the Hydro-Jet technique for laparoscopic cholecystectomy. The purpose of this study was to evaluate a new dissection technique using a high-pressure water stream (Hydro-Jet) and a new dissection probe for laparoscopic cholecystectomy. Methods: Thirty pigs underwent laparoscopic cholecystectomy. Pigs were randomized to receive either the conventional or Hydro-Jet assisted dissection technique. The feasibility of this technique and the features of surgical dissection were evaluated and compared between the 2 groups. Results: Laparoscopic cholecystectomy was successful in all animals with no need for conversion to open surgery. The mean operative time was 28 and 36 minutes for Hydro-Jet versus conventional dissection, respectively. Complications using the Hydro-Jet and conventional techniques included 6% and 20% gallbladder perforation and 6.5% and 13% liver laceration, respectively. The use of the Hydro-Jet for cholecystectomy had clear technical advantages over conventional dissection. The Hydro-Jet resulted in a selective dissection of fibrous and connective tissue preserving blood vessels for later ligation. Therefore, the dissection was performed in a relatively bloodless field. The ease of dissection using the new bent tipped dissector represents another advantage. Finally, the continuous water flow allowed a clear view for the operator. Conclusions: This study shows that Hydro-jet dissection represents an excellent alternative to the conventional technique for laparoscopic cholecystectomy. The improved anatomical dissection combined with an almost bloodless operating field secondary to continuous water flow may decrease dissection

  5. Extraperitoneal robot-assisted laparoscopic radical prostatectomy: a single-center experience beyond the learning curve.

    PubMed

    Ploussard, Guillaume; Salomon, Laurent; Parier, Bastien; Abbou, Claude Clément; de la Taille, Alexandre

    2013-06-01

    To report our surgical technique and outcomes after extraperitoneal robot-assisted laparoscopic radical prostatectomy (RALRP). At Henri Mondor's Hospital, we performed the first RALRP in 2001 and started to perform routinely RALRP since 2006. Preoperative characteristics, perioperative parameters, functional and oncological outcomes were collected in a prospective database and studied. All parameters were tested in patients undergoing RALRP beyond the learning curve of each surgeon. The overall cohort included 792 patients. RALRP offers interesting results in terms of hospital stay, operative time, and blood loss. The overall rate of complications was low, especially concerning the rates of anastomosis' complications. An extraprostatic extension was seen in 42.8 % of specimens. The overall rate of positive margins was 30.7 % of specimens. In our cohort, after a mean follow-up of 19 months, 8.7 % of PSA failure has been reported. The rate of continence was 77.4 % at 6 months and 96.8 % at 2 years. The rate of potency was 17 % at 3 months and 60.9 % at 2 years. The 2-year rate was 86.7 % in case of intrafascial dissection. A trifecta outcome was achieved in 44 and 53 % of men at 12 and 24 months, respectively. The extraperitoneal approach confers interesting results in terms of perioperative parameters as previously described in series using a transperitoneal approach. Functional outcomes in terms of continence and potency recovery after extraperitoneal seem equivalent to those reported after transperitoneal RALRP. Longer follow-up is warranted to confirm our favorable mid-term oncologic outcomes.

  6. Initial Experience with a Wireless Ultrasound-Guided Vacuum-Assisted Breast Biopsy Device.

    PubMed

    Choi, E-Ryung; Han, Boo-Kyung; Ko, Eun Sook; Ko, Eun Young; Choi, Ji Soo; Cho, Eun Yoon; Nam, Seok Jin

    2015-01-01

    To determine the imaging characteristic of frequent target lesions of wireless ultrasound (US)-guided, vacuum-assisted breast biopsy (Wi-UVAB) and to evaluate diagnostic yield, accuracy and complication of the device in indeterminate breast lesions. From March 2013 to October 2014, 114 women (age range, 29-76 years; mean age, 50.0 years) underwent Wi-UVAB using a 13-gauge needle (Mammotome Elite®; Devicor Medical Products, Cincinnati, OH, USA). In 103 lesions of 96 women with surgical (n = 81) or follow-up (n = 22) data, complications, biopsy procedure, imaging findings of biopsy targets and histologic results were reviewed. Mean number of biopsy cores was 10 (range 4-25). Nine patients developed moderate bleeding. All lesions were suspicious on US, and included non-mass lesions (67.0%) and mass lesions (33.0%). Visible calcifications on US were evident in 57.3% of the target lesions. Most of the lesions (93.2%) were nonpalpable. Sixty-six (64.1%) were malignant [ductal carcinoma in situ (DCIS) rate, 61%] and 12 were high-risk lesions (11.7%). Histologic underestimation was identified in 11 of 40 (27.5%). DCIS cases and in 3 of 9 (33.3%) high-risk lesions necessitating surgery. There was no false-negative case. Wi-UVAB is very handy and advantageous for US-unapparent non-mass lesions to diagnose DCIS, especially for calcification cases. Histologic underestimation is unavoidable; still, Wi-UVAB is safe and accurate to diagnose a malignancy.

  7. Single-Surgeon Experience With Robot-Assisted Ureteroneocystostomy for Distal Ureteral Pathologies in Adults

    PubMed Central

    Lee, Ziho; Sehgal, Shailen; Llukani, Elton; Reilly, Christopher; Doumanian, Leo; Mydlo, Jack; Lee, David Inkoo

    2013-01-01

    Purpose To demonstrate our technical approach for robot-assisted ureteroneocystostomy (R-UNC) for benign and malignant distal ureteral pathologies. Materials and Methods Between January 2009 and January 2013, a total of 10 patients underwent R-UNC in the distal ureter by a single surgeon. Indications for R-UNC were as follows: idiopathic (3), fistula (2), iatrogenic (2), malignancy (2), and chronic vesicoureteral reflux (1). Results Tension-free anastomosis was attained in all 10 R-UNC procedures. A psoas hitch was performed in 6/10 cases (60%). Intravesical and extravesical reimplantations were completed in 5/10 (50%) and 5/10 cases (50%), respectively. A nonrefluxing ureter was constructed in 2/10 cases (20%). The patients' mean age was 52.9±16.6 years, their mean body mass index was 30.8±6.3 kg/m2, the mean operative time was 211.7±69.3 minutes, mean estimated blood loss was 102.5±110.8 mL, and mean length of stay was 2.8±2.3 days. There were no intraoperative complications. There was one Clavien-Dindo grade I and one Clavien-Dindo grade II postoperative complication. The mean postoperative follow-up duration was 28.5±15.5 months. Two patients had recurrence of ureteral strictures at 3 months postoperatively and were managed successfully with balloon dilation. Conclusions Our technique for R-UNC demonstrates good perioperative outcomes. However, underlying periureteral inflammation and pelvic adhesions may predispose patients for stricture recurrence after R-UNC. PMID:23956826

  8. Balloon-assisted maturation for arteriovenous fistula maturation failure: an early period experience

    PubMed Central

    Park, Sun Cheol; Ko, Seung Yeon; Kim, Ji Il; Moon, In Sung

    2016-01-01

    Purpose Balloon-assisted maturation (BAM) is emerging as a salvage management for arteriovenous fistula maturation failure (AVF MF). However, BAM is a relatively new, yet controversial technique for AVF maturation. Therefore, we evaluated the effectiveness of BAM for AVF MF. Methods Between January 2012 and December 2014, 249 AVFs were created. The total MF rate was 24.8%. But, only 110 AVFs were enrolled, including 74 brachiocephalic (BC) AVFs and 36 radiocephalic (RC) AVFs. The follow-up period was 12 months. Among those, there were 42 MFs (22 BC AVFs and 20 RC AVFs) and 68 maturation successes (MS) (52 BC AVFs and 16 RC AVFs). BAM was involved in MF group. We compared the clinical characteristics, AVF flows, and AVF flow ratios of MF and MS groups. Also, we evaluated the etiology, management, and result of MF. Results There was no difference in clinical characteristics between MF and MS groups. In MF group, 39 balloon angioplasties (BAs) for 42 AVF MFs were performed. Number of BA was 1.45 ± 0.57 and duration of BA was 21.30 ± 21.24 weeks. BAM rate was 46.2%. For 1 year after AVF creation, AVF flows of MS group were significantly larger than those of MF group (P < 0.05) but there was no difference in AVF flow ratio between MF and MS groups (P > 0.05). Conclusion BA for AVF MF is a relatively applicable and effective modality. Although a large volume study is necessary, we suggest BAM is an effective salvage management for AVF MF. PMID:27186572

  9. COIS, Favier works with experiment assisted by Helms during LMS-1 mission

    NASA Image and Video Library

    1996-07-09

    STS078-398-032 (20 June - 7 July 1996) --- Astronaut Susan J. Helms, payload commander, measures the distance between Jean-Jacques Favier’s head and the luminous torque, used for the Canal and Otolith Interaction Study (COIS) on the Life and Microgravity Spacelab (LMS-1) mission. Favier, representing the French Space Agency (CNES), is one of two international payload specialists on the almost-17-day flight. This view shows the Voluntary Head Movement (VHM) segment of the experiment. The VHM is meant to characterize how the coordination of head and eye movement changes as a result of spaceflight. Since most vestibular functions are influenced by gravity, the COIS experiment is meant to measure response differences in microgravity.

  10. Computer-assisted comparison of analysis and test results in transportation experiments

    SciTech Connect

    Knight, R.D.; Ammerman, D.J.; Koski, J.A.

    1998-05-10

    As a part of its ongoing research efforts, Sandia National Laboratories` Transportation Surety Center investigates the integrity of various containment methods for hazardous materials transport, subject to anomalous structural and thermal events such as free-fall impacts, collisions, and fires in both open and confined areas. Since it is not possible to conduct field experiments for every set of possible conditions under which an actual transportation accident might occur, accurate modeling methods must be developed which will yield reliable simulations of the effects of accident events under various scenarios. This requires computer software which is capable of assimilating and processing data from experiments performed as benchmarks, as well as data obtained from numerical models that simulate the experiment. Software tools which can present all of these results in a meaningful and useful way to the analyst are a critical aspect of this process. The purpose of this work is to provide software resources on a long term basis, and to ensure that the data visualization capabilities of the Center keep pace with advancing technology. This will provide leverage for its modeling and analysis abilities in a rapidly evolving hardware/software environment.

  11. Stent-Assisted Coiling of 501 Wide-Necked Intracranial Aneurysms: A Single-Center 8-Year Experience.

    PubMed

    Zheng, Yongtao; Song, Yanbing; Liu, Yingjun; Xu, Qiang; Tian, Yanlong; Leng, Bing

    2016-10-01

    Stent-assisted coiling has expanded the treatment of complex wide-necked intracranial aneurysms. We present our experience with stent-assisted coiling, with an emphasis on procedure-related neurologic complications and the incidence of angiographic recurrence. A total of 480 patients with 501 aneurysms who were treated with stent-assisted coiling between January 2007 and December 2014 were reviewed retrospectively. Baseline characteristics, procedure-related complications, angiographic follow-up results, and clinical outcomes were statistically analyzed. Among the 480 patients, 423 (88%) were treated electively and 57 (11%) were treated in the context of subarachnoid hemorrhage. There were 22 (4.58%) overall procedure-related complications, which caused death in 4 patients (0.83%) and morbidity in 4 patients (0.83%). In a logistic regression analysis, the complications differed significantly among the patients with hypertension (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.09-7.48; P = 0.03), patients with aneurysms treated with coiling before stenting (OR, 3.07; 95% CI, 1.07-8.81; P = 0.04), and patients treated with multiple stents (OR, 4.96; 95% CI, 1.02-24.07; P = 0.04). Angiographic follow-up was available for 396 patients (83.4%) for a mean of 13 months. The rates of recanalization and retreatment were 13.9% and 3.5%, respectively. In a logistic analysis, larger aneurysm size and initial incomplete aneurysm occlusion were predictors of recanalization. Clinical follow-up was available for 406 patients (85.6%) for a mean of 44.8 months, and 399 patients (98.3%) achieved a Glasgow Outcome Scale score of 5. Stent-assisted coiling appears to be a safe and effective option for treating complex wide-necked aneurysms. Higher complication rates are associated with coiling before stenting, use of multiple stents, and hypertension. Stent delivery before coil deployment reduces the risk of procedural complications. Larger aneurysm size and initial

  12. Application of IMF screws to assist internal rigid fixation of jaw fractures: our experiences of 168 cases

    PubMed Central

    Bai, Zhenxi; Gao, Zhibiao; Xiao, Xia; Zhang, Wenjuan; Fan, Xing; Wang, Zhaoling

    2015-01-01

    Intermaxillary fixation (IMF) screws were first introduced to achieve IMF as a kind of bone borne appliance for jaw fractures in 1989. Because this method can overcome many disadvantages associated with tooth borne appliance, IMF screws have been popularly used for jaw fractures since then. From March 2011 to February 2014, we treated 168 cases with single or multiple jaw fractures by open reduction and a total of 705 IMF screws were intraoperatively applied in all the cases to achieve IMF and maintain dental occlusion as an adjuvant to open reduction. The numbers, implantation sites and complications of IMF screws were retrospectively analyzed. In our experience, we found that IMF screws were important to assist open reduction of jaw fractures but their roles should be objectively assessed and the reliability of open reduction and internal rigid fixation must be emphasized. Much attention should be paid when implanting. PMID:26617892

  13. Application of IMF screws to assist internal rigid fixation of jaw fractures: our experiences of 168 cases.

    PubMed

    Bai, Zhenxi; Gao, Zhibiao; Xiao, Xia; Zhang, Wenjuan; Fan, Xing; Wang, Zhaoling

    2015-01-01

    Intermaxillary fixation (IMF) screws were first introduced to achieve IMF as a kind of bone borne appliance for jaw fractures in 1989. Because this method can overcome many disadvantages associated with tooth borne appliance, IMF screws have been popularly used for jaw fractures since then. From March 2011 to February 2014, we treated 168 cases with single or multiple jaw fractures by open reduction and a total of 705 IMF screws were intraoperatively applied in all the cases to achieve IMF and maintain dental occlusion as an adjuvant to open reduction. The numbers, implantation sites and complications of IMF screws were retrospectively analyzed. In our experience, we found that IMF screws were important to assist open reduction of jaw fractures but their roles should be objectively assessed and the reliability of open reduction and internal rigid fixation must be emphasized. Much attention should be paid when implanting.

  14. Certified nursing assistants' perspectives of nursing home residents' pain experience: communication patterns, cultural context, and the role of empathy.

    PubMed

    Dobbs, Debra; Baker, Tamara; Carrion, Iraida V; Vongxaiburana, Elizabeth; Hyer, Kathryn

    2014-03-01

    This study explored the following issues related to pain management among nursing home (NH) residents: 1) communication patterns between NH residents and certified nursing assistants (CNAs) about pain; 2) how race and ethnicity influence NH residents' pain experiences; and 3) CNAs' personal experiences with pain that may affect their empathy toward the resident's pain experience. The study consisted of a convenience sample of four focus groups (n = 28) from a NH in central Florida. A content analysis approach was used. Data were analyzed with the use of Atlas.ti version 6.2. The content analysis identified four main themes: 1) attitudes as barriers to communication about resident pain care; 2) cultural, religious, and gender influences of resident pain care by CNAs; 3) the role of empathy in CNAs care of residents with pain; and 4) worker strategies to detect pain. Attitudes among CNAs about resident cognitive status and perceived resident burden need to be recognized as barriers to the detection and reporting of pain by CNAs and should be addressed. In addition, NHs should consider a person-centered approach to pain that is culturally competent given the cultural influences of both residents and staff. Finally, educational programs for CNAs that include empathy-inducing scenarios could potentially improve the care provided by CNAs when dealing with residents' pain.

  15. Large-Scale Biaxial Friction Experiments with an Assistance of the NIED Shaking Table

    NASA Astrophysics Data System (ADS)

    Fukuyama, E.; Mizoguchi, K.; Yamashita, F.; Togo, T.; Kawakata, H.; Yoshimitsu, N.; Shimamoto, T.; Mikoshiba, T.; Sato, M.; Minowa, C.

    2012-12-01

    We constructed a large-scale biaxial friction apparatus using a large shaking table working at NIED (table dimension is 15m x 15m). The actuator of the shaking table becomes the engine of the constant speed loading. We used a 1.5m long rock sample overlaid on a 2m one. Their height and width are both 0.5m. Therefore, the slip area is 1.5m x 0.5m. The 2m long sample moves with the shaking table and the 1.5m sample is fixed to the basement of the shaking table. Thus, the shaking table displacement controls the dislocation between two rock samples. The shaking table can generate 0.4m displacement with a velocity ranging between 0.0125mm/s and 1m/s. We used Indian gabbro for the rock sample of the present experiments. Original flatness of the sliding surface was formed less than 0.024mm undulation using a large-scale plane grinder. Surface roughness evolved as subsequent experiments were done. Wear material was generated during each experiment, whose grain size becomes bigger as the experiments proceed. This might suggest a damage evolution on the sliding surface. In some experiments we did not remove the gouge material before sliding to examine the effect of gouge layer. Normal stress can be applied up to 1.3MPa. The stiffness of this apparatus was measured experimentally and was of the order of 0.1GN/m. We first measured the coefficient of friction at low sliding velocity (0.1~1mm/s) where the steady state was achieved after the slip of ~5mm. The coefficient of friction was about 0.75 under the normal stress between 0.13 and 1.3MPa. This is consistent with those estimated by previous works using smaller rock samples. We observed that the coefficient of friction decreased gradually with increasing slip velocity, but simultaneously the friction curves at the higher velocities are characterized by stick-slip vibration. Our main aim of the experiments is to understand the rupture propagation from slow nucleation to fast unstable rupture during the loading of two contact

  16. Power supply

    DOEpatents

    Yakymyshyn, Christopher Paul; Hamilton, Pamela Jane; Brubaker, Michael Allen

    2007-12-04

    A modular, low weight impedance dropping power supply with battery backup is disclosed that can be connected to a high voltage AC source and provide electrical power at a lower voltage. The design can be scaled over a wide range of input voltages and over a wide range of output voltages and delivered power.

  17. The Importance of Visual Experience, Gender, and Emotion in the Assessment of an Assistive Tactile Mouse.

    PubMed

    Brayda, Luca; Campus, Claudio; Memeo, Mariacarla; Lucagrossi, Laura

    2015-01-01

    Tactile maps are efficient tools to improve spatial understanding and mobility skills of visually impaired people. Their limited adaptability can be compensated with haptic devices which display graphical information, but their assessment is frequently limited to performance-based metrics only which can hide potential spatial abilities in O&M protocols. We assess a low-tech tactile mouse able to deliver three-dimensional content considering how performance, mental workload, behavior, and anxiety status vary with task difficulty and gender in congenitally blind, late blind, and sighted subjects. Results show that task difficulty coherently modulates the efficiency and difficulty to build mental maps, regardless of visual experience. Although exhibiting attitudes that were similar and gender-independent, the females had lower performance and higher cognitive load, especially when congenitally blind. All groups showed a significant decrease in anxiety after using the device. Tactile graphics with our device seems therefore to be applicable with different visual experiences, with no negative emotional consequences of mentally demanding spatial tasks. Going beyond performance-based assessment, our methodology can help with better targeting technological solutions in orientation and mobility protocols.

  18. The lived experience of moral distress: nurses who assisted with elective abortions.

    PubMed

    Hanna, Debra R

    2005-01-01

    The concept of moral distress has been studied mainly as an occupational issue and has not been developed for use in clinical practice. This study was designed to bridge prior studies of occupational moral distress with future clinical investigations of moral distress. Study aims were to discover the essence, properties, and full content domain of the concept of moral distress in order to develop a universal definition of the concept. A modified phenomenological study of nurses' experience of a particular moral issue was conducted. A maximum variation sampling strategy was used to recruit a final sample of registered nurses (N = 10). Interior aversion is the essential act of moral distress. Five properties of the lived experience of moral distress were identified: perception, pain, valuing, altered participation, and perspective. Three types of moral distress identified in this study were: shocked, muted, and suppressed (persistent). Type of moral distress was related to situational conditions, recognition of moral ends, quality of coping processes, and temporal breadth. Negative outcomes of moral distress, which probably exist, were undetectable with this study design. The definition has been composed in universal terms, but remains tentative, since the full content domain of moral distress was largely but not definitively identified.

  19. Video assisted resternotomy in high-risk redo operations - the St Mary's experience.

    PubMed

    Athanasiou, Thanos; DeL Stanbridge, Rex; Kumar, Pankaj; Cherian, Ashok

    2002-05-01

    The incidence of re-operative median sternotomy is rising. During resternotomy, catastrophic haemorrhage remains a dreaded complication. We describe our approach and experience with the combined use of Mayfield resternotomy retractor and anterior sternal retraction which allows division of adhesions between the sternum and mediastinal structures under direct vision with endoscopic or conventional instruments prior to resternotomy with a standard Hall reciprocating saw. The mean time to divide the retro-sternal adhesions was 26.4+/-16.7 min. No morbidity related to sternal division was observed. For redo surgery, repeat sternotomy under direct vision may reduce the sternotomy related morbidity (especially the need for cardiopulmonany bypass due to significant haemorrhage) and mortality.

  20. Coupled pot and lysimeter experiments assessing plant performance in microbially assisted phytoremediation.

    PubMed

    Nicoară, Andrei; Neagoe, Aurora; Stancu, Paula; de Giudici, Giovanni; Langella, Francesca; Sprocati, Anna Rosa; Iordache, Virgil; Kothe, Erika

    2014-01-01

    We performed an experiment at pot scale to assess the effect of plant growth-promoting bacteria (PGPB) on the development of five plant species grown on a tailing dam substrate. None of the species even germinated on inoculated unamended tailing material, prompting use of compost amendment. The effect of inoculation on the amended material was to increase soil respiration, and promote elements immobilisation at plant root surface. This was associated with a decrease in the concentrations of elements in the leaching water and an increase of plant biomass, statistically significant in the case of two species: Agrostis capillaris and Festuca rubra. The experiment was repeated at lysimeter scale with the species showing the best development at pot scale, A. capillaris, and the significant total biomass increase as a result of inoculation was confirmed. The patterns of element distribution in plants also changed (the concentrations of metals in the roots of A. capillaris and F. rubra significantly decreased in inoculated treatments, while phosphorus concentration significantly increased in roots of A. capillaris in inoculated treatment at lysimeter scale). Measured variables for plant oxidative stress did not change after inoculations. There were differences of A. capillaris plant-soil system response between experimental scales as a result of different substrate column structure and plant age at the sampling moment. Soil respiration was significantly larger at lysimeter scale than at pot scale. Leachate concentrations of As, Mn and Ni had significantly larger concentrations at lysimeter scale than at pot scale, while Zn concentrations were significantly smaller. Concentrations of several metals were significantly smaller in A. capillaris at lysimeter scale than at pot scale. From an applied perspective, a system A. capillaris-compost-PGPB selected from the rhizosphere of the tailing dam native plants can be an option for the phytostabilisation of tailing dams. Results

  1. Microneedle assisted micro-particle delivery from gene guns: experiments using skin-mimicking agarose gel.

    PubMed

    Zhang, Dongwei; Das, Diganta B; Rielly, Chris D

    2014-02-01

    A set of laboratory experiments has been carried out to determine if micro-needles (MNs) can enhance penetration depths of high-speed micro-particles delivered by a type of gene gun. The micro-particles were fired into a model target material, agarose gel, which was prepared to mimic the viscoelastic properties of porcine skin. The agarose gel was chosen as a model target as it can be prepared as a homogeneous and transparent medium with controllable and reproducible properties allowing accurate determination of penetration depths. Insertions of various MNs into gels have been analysed to show that the length of the holes increases with an increase in the agarose concentration. The penetration depths of micro-particle were analysed in relation to a number of variables, namely the operating pressure, the particle size, the size of a mesh used for particle separation and the MN dimensions. The results suggest that the penetration depths increase with an increase of the mesh pore size, because of the passage of large agglomerates. As these particles seem to damage the target surface, then smaller mesh sizes are recommended; here, a mesh with a pore size of 178 μm was used for the majority of the experiments. The operating pressure provides a positive effect on the penetration depth, that is it increases as pressure is increased. Further, as expected, an application of MNs maximises the micro-particle penetration depth. The maximum penetration depth is found to increase as the lengths of the MNs increase, for example it is found to be 1272 ± 42, 1009 ± 49 and 656 ± 85 μm at 4.5 bar pressure for spherical micro-particles of 18 ± 7 μm diameter when we used MNs of 1500, 1200 and 750 μm length, respectively.

  2. 43 CFR 12.720 - Excepted articles, materials, and supplies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Excepted articles, materials, and supplies... Assistance Programs Buy American Act-Supplies § 12.720 Excepted articles, materials, and supplies. (a) As... articles, materials, and supplies on the list referred to in paragraph (b) of this section are not...

  3. 43 CFR 12.720 - Excepted articles, materials, and supplies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Excepted articles, materials, and supplies... Assistance Programs Buy American Act-Supplies § 12.720 Excepted articles, materials, and supplies. (a) As... articles, materials, and supplies on the list referred to in paragraph (b) of this section are not...

  4. The role of technical assistance in expanding access to Xpert(®) MTB/RIF: experience in sub-Saharan Africa.

    PubMed

    Umubyeyi, A N; Bonsu, F; Chimzizi, R; Jemal, S; Melese, M; Ruttoh, E; Mundy, C

    2016-03-21

    To improve tuberculosis (TB) diagnosis, many national TB programmes have committed to deploying Xpert(®) MTB/RIF. Implementation of this relatively new technology has suffered from a lack of comprehensive technical assistance, however, including the formulation of policies and plans to address operational issues. While providing technical assistance, we observed numerous operational challenges in the implementation and scale-up of Xpert in five sub-Saharan African countries: low coverage, poor laboratory infrastructure, limited access, poor linkages to treatment, inadequate data on outcomes, problems with specimen transport, diagnostic algorithms that are not aligned with updated World Health Organization recommendations on target patient groups and financing challenges. We recommend better country preparedness and training, laboratory information and quality systems, supply management and referral mechanisms.

  5. How do older adults experience and perceive socially assistive robots in aged care: a systematic review of qualitative evidence.

    PubMed

    Vandemeulebroucke, Tijs; de Casterlé, Bernadette Dierckx; Gastmans, Chris

    2017-02-09

    The aim of this review was to gain a better understanding of how older adults experience, perceive, think, and feel about the use of socially assistive robots (SARs) in aged care settings. We conducted a literature search for studies that used a qualitative or a mixed-method approach having a significant qualitative element. Pubmed, Cinahl, Embase, Scopus, and Web of Science electronic databases were queried. Candidate articles published in journals and conference proceedings were considered for review. Two independent reviewers assessed the included studies for methodological quality using the Critical Appraisal Skills Program, after which data on subjects' self-reported opinions and perceptions were extracted and synthesized using thematic analyses. Seventeen studies producing 23 publications were included. Based on the opinions of older adults, four themes emerged in relation to the use of SARS: (1) roles of a SAR; (2) interaction between the older adult and the SAR, which could be further subdivided into (a) the technical aspect of the interaction and (b) the human aspect of the interaction; (3) appearance of the SAR; and (4) normative/ethical issues regarding the use of SARs in aged care. Older adults have clear positive and negative opinions about different aspects of SARs in aged care. Nonetheless, some opinions can be ambiguous and need more attention if SARs are to be considered for use in aged care. Understanding older adults' lived experiences with SARs creates the possibility of using an approach that embeds technological innovation into the care practice itself.

  6. Considerations for clinics and practitioners treating foreign patients with assisted reproductive technology: lessons from experiences at Ghent University Hospital, Belgium.

    PubMed

    De Sutter, Petra

    2011-11-01

    Cross-border reproductive care (CBRC) is not a new concept, having been around since the beginning of assisted reproductive technology. Countries having taken the lead in developing new technologies have seen an influx of patients from other countries, because of legal limitations or the unavailability of good-quality care in their home country. This paper describes the experience of the Ghent University Hospital fertility centre with Dutch and French patients and tries to set out standards of care for CBRC patients. Dutch patients usually have longer histories, more complex pathology and are better informed, more outspoken and more financially secure. Thus, the care for these patients is challenging. The standards of care should be the same for local patients and CBRC patients; however, the nature of the complexity of the problems they come with will necessitate more time investment. Experience shows that many patients who have no access to treatment in their own country obtain reasonably good results. Some of them, however, are beyond possible help and these patients need a high standard of psychological care. All should be done to avoid that cross-border patients compromise the local care system. Special arrangements should be taken to manage possible complications following treatment. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  7. A retrospective study: clinical experience using vacuum-assisted closure in the treatment of wounds.

    PubMed Central

    Antony, Suresh; Terrazas, Sandra

    2004-01-01

    We report the results of our wound care experience using the wound vac as an adjunct therapy in the treatment of sternal, spinal, and lower-extremity wounds. This is a retrospective study in which 42 patients were evaluated between 1999 and 2002 for nonhealing sternal, spinal, and lower-extremity wounds. There were 12 patients with sternal wounds with a variety of pathogens who were treated with antimicrobials along with the wound VAC. The VAC was applied for an average of 12 days, and all 12 patients went onto complete closure by the end of four weeks. There were 14 patients in the lower-extremity wound group, again, with a variety of pathogens. The VAC was placed for an average of 29.3 days to achieve closure along with the wound VAC. There were 16 spinal wound patients with a variety of pathogens. All the patients received antimicrobial therapy, with the average duration of the VAC beings 27.6 days and closure taking about eight weeks. The wound VAC, along with appropriate antimicrobial therapy and surgery, appears to help reduce the number of days to healing, along with a reduction in the number hospital days and possibly costs to the health system. Images Figure 1a Figure 1b Figure 2a Figure 2b Figure 3a Figure 3b Figure 4 Figure 5 PMID:15303413

  8. Basic research and 12 years of clinical experience in computer-assisted navigation technology: a review.

    PubMed

    Ewers, R; Schicho, K; Undt, G; Wanschitz, F; Truppe, M; Seemann, R; Wagner, A

    2005-01-01

    Computer-aided surgical navigation technology is commonly used in craniomaxillofacial surgery. It offers substantial improvement regarding esthetic and functional aspects in a range of surgical procedures. Based on augmented reality principles, where the real operative site is merged with computer generated graphic information, computer-aided navigation systems were employed, among other procedures, in dental implantology, arthroscopy of the temporomandibular joint, osteotomies, distraction osteogenesis, image guided biopsies and removals of foreign bodies. The decision to perform a procedure with or without computer-aided intraoperative navigation depends on the expected benefit to the procedure as well as on the technical expenditure necessary to achieve that goal. This paper comprises the experience gained in 12 years of research, development and routine clinical application. One hundred and fifty-eight operations with successful application of surgical navigation technology--divided into five groups--are evaluated regarding the criteria "medical benefit" and "technical expenditure" necessary to perform these procedures. Our results indicate that the medical benefit is likely to outweight the expenditure of technology with few exceptions (calvaria transplant, resection of the temporal bone, reconstruction of the orbital floor). Especially in dental implantology, specialized software reduces time and additional costs necessary to plan and perform procedures with computer-aided surgical navigation.

  9. Sensomics-Assisted Elucidation of the Tastant Code of Cooked Crustaceans and Taste Reconstruction Experiments.

    PubMed

    Meyer, Stefanie; Dunkel, Andreas; Hofmann, Thomas

    2016-02-10

    Sensory-guided fractionation by means of ultrafiltration and cation-exchange chromatography, followed by MS/MS quantitation, and taste re-engineering experiments revealed the key taste molecules coining the characteristic taste profile of the cooked meat of king prawns. Furthermore, quantitative analysis demonstrated that the taste differences between crustaceans are due to quantitative differences in the combinatorial code of tastants, rather than to qualitative differences in the tastant composition. Besides the amino acids glycine, L-proline, and L-alanine, the characteristic seafood-like sweet profile was found to be due to the sweet modulatory action of quaternary ammonium compounds, among which betaine, homarine, stachydrin, and trimethylamine-N-oxide were found as the key contributors on the basis of dose-activity considerations. Knowledge of this combinatorial tastant code provides the foundation for the development of more sophisticated crustacean flavors that are lacking any heavy metal ions and allergenic proteins present when using crustacean extracts for food flavoring.

  10. Strategic Supply

    DTIC Science & Technology

    2006-01-01

    leaders as Sears, Limited Brands, DHL, Circuit City, Cingular, Nestle and IKEA (Manugistics, 2006). The Strategic Supply Chain Industry Study Group...inventory turns have increased. Other global customers have also reaped the benefits of the Manugistics software. IKEA , Sweden’s retail icon...turned to Manugistics after a mid-1990s ERP implementation failed to fix their forecasting problems, which gave way to fluctuating inventory levels. IKEA

  11. Power supply

    DOEpatents

    Hart, Edward J.; Leeman, James E.; MacDougall, Hugh R.; Marron, John J.; Smith, Calvin C.

    1976-01-01

    An electric power supply employs a striking means to initiate ferroelectric elements which provide electrical energy output which subsequently initiates an explosive charge which initiates a second ferroelectric current generator to deliver current to the coil of a magnetic field current generator, creating a magnetic field around the coil. Continued detonation effects compression of the magnetic field and subsequent generation and delivery of a large output current to appropriate output loads.

  12. Strategic Supply

    DTIC Science & Technology

    2005-01-01

    turn helped fuel its highly efficient and effective distribution network. Wal-Mart has characteristically been at the forefront 2 of IT advances...identification technologies that is wireless and applied to tags and labels that capture a host of characteristics of objects. Within the supply chain...behavior, leading to faster processing and improved productivity. RFID technology can authenticate objects and monitor environmental characteristics

  13. Diagnostic Performance of MR-guided Vacuum-Assisted Breast Biopsy: 8 Years of Experience.

    PubMed

    Ferré, Romuald; Ianculescu, Victor; Ciolovan, Laura; Mathieu, Marie-Christine; Uzan, Catherine; Canale, Sandra; Delaloge, Suzette; Dromain, Clarisse; Balleyguier, Corinne

    2016-01-01

    Breast magnetic resonance imaging (MRI) has demonstrated increased sensitivity over conventional imaging in identifying and characterizing in situ and invasive, multifocal, and multicentric disease. A histologic diagnosis is required for any enhancing lesion displaying suspicious features, especially in the presence of lower and often variable reported specificity values. Breast MRI findings occult on mammography and ultrasound should undergo an MR-guided biopsy. We retrospectively evaluate our 8 years' experience with this procedure. Our study included 259 lesions in 255 consecutive patients referred for MR-guided breast biopsy. MRI screening of women at a high risk for developing breast cancer accounted for 84 lesions, 54 lesions were detected on MRI staging for multifocal and multicentric disease, and 115 were incidental findings or lesions that presented diagnosis related issues on conventional imaging. Six procedures were cancelled due to lack of visualization. MR-guided breast biopsy was performed for 100 mass and 153 nonmass enhancements. Pathology results were classified into benign (113 lesions), high risk (47 lesions), and malignant (40 ductal carcinoma in situ, 38 invasive ductal carcinoma, 15 invasive lobular carcinoma). Subsequent surgery for high risk and malignant findings revealed an underestimation rate of 34% (16/47) for high risk lesions and of 7.5% for ductal carcinoma in situ (3/40). The overall positive predictive value (PPV) was calculated at 43.1% (33.3% for high-risk women, 70.3% for cancer staging, and 37.4% for incidental/undetermined lesions). The PPV was higher for mass (57%) versus nonmass enhancements (34%). MR-guided breast biopsy proved to be a reliable procedure for the diagnosis and management of occult breast MRI findings, or lesions that preclude biopsy under conventional guidance. The PPV displayed significant variation between patient subgroups, correlating higher values with a higher associated breast cancer prevalence.

  14. Robotic-assisted modified retroauricular cervical approach: initial experience in Latin America.

    PubMed

    Chulam, Thiago Celestino; Lira, Renan Bezerra; Kowalski, Luiz Paulo

    2016-01-01

    to evaluate the thickness of the gastric wall at the time of intra gastric balloon (IGB) placement, at the time of its withdrawal and one month after withdrawal. fifteen morbidly obese patients underwent the introduction of IGB under general anesthesia. In all patients, there was infusion of 500ml of distilled water in the balloon for the test. Measurements of the thickness of the gastric wall were made in the antrum, body and proximal body, using a radial echoendoscope with a frequency of 12MHz and maximum zoom, and its own balloon inflated with 5ml of distilled water. the presence of IGB led to increased wall thickness of the gastric body by expanding the muscle layer. These changes were apparently transient, since 30 days after the balloon withdrawal there was a tendency to return of the wall thickness values ​​observed before the balloon insertion. the use of intragastric balloon for the treatment of obesity determines transient increase in the wall thickness of the gastric body caused by expanded muscle layer. A preocupação com a melhoria dos resultados estéticos e funcionais sem comprometimento dos resultados oncológicos na cirurgia de cabeça e pescoço tem aumentado significativamente. Os procedimentos minimamente invasivos e principalmente aqueles que utilizam a tecnologia robótica permitiram o desenvolvimento de novas abordagens, incluindo o acesso retroauricular, que agora é usado rotineiramente, especialmente na Coréia do Sul. A presente nota irá ilustrar a técnica e a experiência inicial na América Latina, demonstrando que esta abordagem é viável, segura e eficaz oncologicamente, podendo ser utilizada em casos selecionados com um benefício estético evidente.

  15. Perioperative supply chain management.

    PubMed

    Feistritzer, N R; Keck, B R

    2000-09-01

    Faced with declining revenues and increasing operating expenses, hospitals are evaluating numerous mechanisms designed to reduce costs while simultaneously maintaining quality care. Many facilities have targeted initial cost reduction efforts in the reduction of labor expenses. Once labor expenses have been "right sized," facilities have continued to focus on service delivery improvements by the optimization of the "supply chain" process. This report presents a case study of the efforts of Vanderbilt University Medical Center in the redesign of its supply chain management process in the department of Perioperative Services. Utilizing a multidisciplinary project management structure, 3 work teams were established to complete the redesign process. To date, the project has reduced costs by $2.3 million and enhanced quality patient care by enhancing the delivery of appropriate clinical supplies during the perioperative experience.

  16. Students with Disabilities Experience in Higher Education Online Courses: An Exploratory Study of Self-Efficacy, Use of Assistive Technologies and Mobile Media

    ERIC Educational Resources Information Center

    Francis, Chandinie Devi Parasram

    2012-01-01

    The overarching aim of this mixed methods study was to explore the online experiences of students with disabilities, with particular focus on students' use of assistive technologies, mobile media and self-efficacy. Using a multifaceted an integrative approach, this study considered a framework of universal design, Scherer's Matching Person and…

  17. Development of Power Assisting Suit

    NASA Astrophysics Data System (ADS)

    Yamamoto, Keijiro; Ishii, Mineo; Hyodo, Kazuhito; Yoshimitsu, Toshihiro; Matsuo, Takashi

    In order to realize a wearable power assisting suit for assisting a nurse to carry a patient in her arms, the power supply and control systems of the suit have to be miniaturized, and it has to be wireless and pipeline-less. The new wearable suit consists of shoulders, arms, back, waist and legs units to be fitted on the nurse's body. The arms, waist and legs have new pneumatic rotary actuators driven directly by micro air pumps supplied by portable Ni-Cd batteries. The muscle forces are sensed by a new muscle hardness sensor utilizing a sensing tip mounted on a force sensing film device. An embedded microcomputer is used for the calculations of control signals. The new wearable suit was applied practically to a human body and a series of movement experiments that weights in the arms were held and taken up and down was performed. Each unit of the suit could transmit assisting torque directly to each joint verifying its practicability.

  18. KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, technicians on the floor watch as a tray is extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

    NASA Image and Video Library

    2003-09-24

    KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, technicians on the floor watch as a tray is extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

  19. KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (left) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

    NASA Image and Video Library

    2003-09-24

    KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (left) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

  20. KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (right) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

    NASA Image and Video Library

    2003-09-24

    KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (right) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

  1. KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Japanese astronaut Koichi Wakata looks over the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

    NASA Image and Video Library

    2003-09-24

    KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Japanese astronaut Koichi Wakata looks over the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

  2. Meanings and experiences of assistive technologies in everyday lives of older citizens: a meta-interpretive review.

    PubMed

    Dahler, Anne Marie; Rasmussen, Dorte Malig; Andersen, Pernille Tanggaard

    2016-11-01

    The purpose of this study was to synthesize the available qualitative studies on the meaning of assistive technologies (AT) in elderly people's everyday lives in order to identify central concepts, themes, and findings from existing research. A systematic search of the literature was conducted, using predetermined search strategies. Exclusion criteria were, in accordance with the meta-interpretive approach, developed iteratively during the reading of abstracts and articles. Interpretations from the studies were used as data for thematic analysis and synthesis of findings. Review of these studies show that older people not only have positive attitude towards AT, but also that acceptance of technologies is a potentially stressful process where trust towards technologies and other people are of importance. Older people have ambivalent experiences with technology, as it gives rise to possibilities as well as constraints, and safety as well as worries. AT enact sometimes conflicting values related to self and society. Although AT seem to support societal discourses on active aging, the empirical studies in this field show that the technologies enter older people's lives in complex ways, enacting social values and ambivalences and interact with caretakers, relatives and other actors, within specific institutional settings. Implications for rehabilitation In implementing AT, attention should be paid to ambivalences and conflicting values enacted by AT in older people's lives In implementing AT, attention should be paid not only to independency but also to the eventually dependencies, created by the use of AT.

  3. Laparoscopic-Assisted Anorectal Pull-Through for High Imperforate Anus: 14 Years Experience in a Single Center.

    PubMed

    Ruggeri, Giovanni; Destro, Francesca; Randi, Beatrice; Lima, Mario

    2016-05-01

    To report our 14 years experience with the laparoscopic-assisted anorectal pull-through (LAARP) for the treatment of male neonates with high imperforate anus. We reviewed all medical charts of patients who underwent LAARP from January 2001 to January 2015 collecting information regarding demographic data, associated anomalies, type of fistula, pelvic floor muscles tropism, surgery (operative time, conversion to open technique, and complications), and follow-up. Follow-up data were obtained through the use of validated questionnaires that aim to assess the intestinal function in terms of constipation and continence. At the Department of Pediatric Surgery of the University of Bologna, 13 male patients were operated in the study period (our protocol consisted of colostomy at birth followed by delayed LAARP). Mean age at operation was 4.75 months (range 1-14). There was one conversion to open technique due to a strong tension from the colostomy (this patient was excluded). Functional results were acceptable at a minimum 2-year-long follow-up. LAARP is a good choice for the correction of the high imperforate anus. Short-term outcomes are similar to those after posterior sagittal anorectoplasty (PSARP). Long-term outcomes should be better assessed.

  4. Bereaved Caregiver Perspectives on the End-of-Life Experience of Patients With a Left Ventricular Assist Device.

    PubMed

    McIlvennan, Colleen K; Jones, Jacqueline; Allen, Larry A; Swetz, Keith M; Nowels, Carolyn; Matlock, Daniel D

    2016-04-01

    For patients and their loved ones, decisions regarding the end of life in the setting of chronic progressive illness are among the most complex in health care. Complicating these decisions are increasingly available, invasive, and potentially life-prolonging technologies such as the left ventricular assist device (LVAD). To understand the experience of bereaved caregivers and patients at the end of life who have an LVAD. Semistructured, in-depth interviews were conducted between September 10 and November 21, 2014, with 8 bereaved caregivers of patients with an LVAD who were recruited from a single institution. Data were analyzed from December 13, 2014, to February 18, 2015, using a mixed inductive and deductive approach. Themes from semistructured interviews. The 8 caregivers (6 females) described 3 main themes that coalesced around feelings of confusion in the final weeks with their loved ones: (1) the process of death with an LVAD, (2) the legal and ethically permissible care of patients with an LVAD approaching death, and (3) fragmented integration of palliative and hospice care. Despite increasing use of LVADs in patients with advanced heart failure, bereaved caregivers of patients with an LVAD describe a high level of confusion at the end of life. There remains a need for the health care community to develop clear guidance on the management of patients with an LVAD at the end of life. Future work will focus on the educational process and the ideal timing and reiteration of such information to patients and families.

  5. Efficient ECH-assisted plasma start-up using trapped particle configuration in the versatile experiment spherical torus

    NASA Astrophysics Data System (ADS)

    An, YoungHwa; Lee, Jeongwon; Jo, JongGab; Jung, Bong-Ki; Lee, HyunYeong; Chung, Kyoung-Jae; Na, Yong-Su; Hahm, T. S.; Hwang, Y. S.

    2017-01-01

    An efficient and robust ECH (electron cyclotron heating)-assisted plasma start-up scheme with a low loop voltage and low volt-second consumption utilizing the trapped particle configuration (TPC) has been developed in the versatile experiment spherical torus (VEST). The TPC is a mirror-like magnetic field configuration providing a vertical magnetic field in the same direction as the equilibrium field. It significantly enhances ECH pre-ionization with enhanced particle confinement due to its mirror effect, and intrinsically provides an equilibrium field with a stable decay index enabling prompt plasma current initiation. Consequently, the formation of TPC before the onset of the loop voltage allows the plasma to start up with a lower loop voltage and lower volt-second consumption as well as a wider operation range in terms of ECH pre-ionization power and H2 filling pressure. The TPC can improve the widely-used field null configuration significantly for more efficient start-up when ECH pre-ionization is used. This can then be utilized in superconducting tokamaks requiring a low loop voltage start-up, such as ITER, or in spherical tori with limited volt-seconds. The TPC can be particularly useful in superconducting tokamaks with a limited current slew-rate of superconducting PF coils, as it can save volt-second consumption before plasma current initiation by providing prompt initiation with an intrinsic stable equilibrium field.

  6. Robot-assisted nerve-sparing radical prostatectomy using near-infrared fluorescence technology and indocyanine green: initial experience.

    PubMed

    Mangano, Mario S; De Gobbi, Alberto; Beniamin, Francesco; Lamon, Claudio; Ciaccia, Matteo; Maccatrozzo, Luigino

    2017-05-23

    Indocyanine green (ICG) is a fluorescent molecule that provokes detectable photon emission. The use of ICG with near-infrared (NIR) imaging system (Akorn, Lake Forest, IL) has been described during robotic partial nephrectomy (RAPN) as an adjunctive means of identifying renal artery and parenchymal perfusion.We propose the use of the ICG with NIR fluorescence during laparoscopic robot-assisted radical prostatectomy (RARP), to identify the benchmark artery improving the preservation of neurovascular bundle and to improve the visualization of the vascularization and then the hemostasis. From April 2015 to February 2016, 62 patients underwent to RARP in our Urology Unit. In 26 consecutive patients, in the attempt to have a better visualization of neurovascular bundles, we used to inject ICG during the procedure. We evaluated the percentage of identification of neurovascular bundles using NIR fluorescence. Then, we evaluated complications related to injection of ICG and operative time differences between RARP with and without ICG injection performed by the same surgeons. We identified prostatic arteries and neurovascular bundles using NIR fluorescence technology in all patients (100%). There was not any increase in the operative time compared with RARP without ICG injection performed by the same surgeons. Complications related to injection of ICG did not occurred. In our experience, even if on a limited number of patients, the application of ICG with NIR fluorescence during RARP is helpful to identify the benchmark artery of neurovascular bundle.

  7. Making Each Other's Daily Life: Nurse Assistants' Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes.

    PubMed

    James, Inger; Fredriksson, Carin; Wahlström, Catrin; Kihlgren, Annica; Blomberg, Karin

    2014-01-01

    In a larger action research project, guidelines were generated for how a meaningful daily life could be developed for older persons. In this study, we focused on the nurse assistants' (NAs) perspectives, as their knowledge is essential for a well-functioning team and quality of care. The aim was to learn from NAs' experiences and knowledge about how to develop a meaningful daily life for older persons in nursing homes and the meaning NAs ascribe to their work. The project is based on Participatory and Appreciative Action and Reflection. Data were generated through interviews, participating observations and informal conversations with 27 NAs working in nursing homes in Sweden, and a thematic analysis was used. NAs developed a meaningful daily life by sensing and finding the "right" way of being (Theme 1). They sense and read the older person in order to judge how the person was feeling (Theme 2). They adapt to the older person (Theme 3) and share their daily life (Theme 4). NAs use emotional involvement to develop a meaningful daily life for the older person and meaning in their own work (Theme 5), ultimately making each other's daily lives meaningful. IT WAS OBVIOUS THAT NAS BASED THE DEVELOPMENT OF A MEANINGFUL DAILY LIFE ON DIFFERENT FORMS OF KNOWLEDGE: the oreticaland practical knowledge, and practical wisdom, all of which are intertwined. These results could be used within the team to constitute a meaningful daily life for older persons in nursing homes.

  8. Some preliminary matrix-assisted laser desorption/ionization imaging experiments on maternal and fetal sides of human placenta.

    PubMed

    Roverso, Marco; Lapolla, Annunziata; Cosma, Chiara; Seraglia, Roberta; Galvan, Elisa; Visentin, Silvia; Cosmi, Eric; Desoye, Gernot; Traldi, Pietro

    2014-01-01

    An investigation on placenta proteins has been carried out by matrix-assisted laser desorption/ionization (MALDI) ion imaging (II) experiments. This was performed by laser irradiation of the maternal and fetal sides of placenta tissue. To investigate the possible changes in protein profile due to the development of gestational diabetes mellitus (GDM), five placenta samples from GDM patients and five placenta samples from healthy pregnant women were analyzed. An extensive optimization of the tissue slice treatment and of the matrix deposition method was performed. As already observed in MALDI spectra of placenta homogenates, and also in the MALDI-II condition, the most abundant peaks are due to hemoglobin α chain, hemoglobin β chain and hemoglobin γ chain. However, higher molecular weight protein species were detected in the m/z range 20,000-47,000. The species at m/z 30335, m/z 31235 and m/z 32000 show some differences in their abundance in the maternal and fetal sides of the tissue in both classes of subjects under investigation. Comparison with the literature data suggest that they can result from the presence of mitochondrial proteins at tissue level.

  9. Toyota drivers' experiences with Dynamic Radar Cruise Control, Pre-Collision System, and Lane-Keeping Assist.

    PubMed

    Eichelberger, Angela H; McCartt, Anne T

    2016-02-01

    Advanced crash avoidance and driver assistance technologies potentially can prevent or mitigate many crashes. Previous surveys with drivers have found favorable opinions for many advanced technologies; however, these surveys are not necessarily representative of all drivers or all systems. As the technologies spread throughout the vehicle fleet, it is important to continue studying driver acceptance and use of them. This study focused on 2010-2013 Toyota Sienna and Prius models that were equipped with adaptive cruise control, forward collision avoidance, and lane departure warning and prevention (Prius models only). Telephone interviews were conducted in summer 2013 with 183 owners of vehicles with these technologies. About 9 in 10 respondents wanted adaptive cruise control and forward collision avoidance on their next vehicle, and 71% wanted lane departure warning/prevention again. Males and females reported some differences in their experiences with the systems; for example, males were more likely to have turned on lane departure warning/prevention than females, and when using this system, males reported more frequent warnings than did females. Relative to older drivers, drivers age 40 and younger were more likely to have seen or heard a forward collision warning. Consistent with the results in previous surveys of owners of luxury vehicles, the present survey found that driver acceptance of the technologies was high, although less so for lane departure warning/prevention. Experiences with the Toyota systems differed by driver age and gender to a greater degree than in previous surveys, suggesting that the responses of drivers may begin to differ as crash avoidance technology becomes available on a wider variety of vehicles. Crash avoidance technologies potentially can prevent or mitigate many crashes, but their success depends in part on driver acceptance. These systems will be effective only to the extent that drivers use them. Copyright © 2015 Elsevier Ltd and

  10. Drinking Water Supply Assistance Act of 2013

    THOMAS, 113th Congress

    Sen. Enzi, Michael B. [R-WY

    2013-12-13

    12/15/2013 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 261. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  11. Drinking Water Supply Assistance Act of 2013

    THOMAS, 113th Congress

    Sen. Enzi, Michael B. [R-WY

    2013-12-13

    12/15/2013 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 261. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  12. Ghost peaks observed after AP-MALDI experiment may disclose new ionization mechanism of matrix assisted hypersonic velocity impact ionization

    PubMed Central

    Moskovets, Eugene

    2015-01-01

    RATIONALE Understanding the mechanisms of MALDI promises improvements in the sensitivity and specificity of many established applications in the field of mass spectrometry. This paper reports a serendipitous observation of a significant ion yield in a post-ionization experiment conducted after the sample has been removed from a standard atmospheric pressure (AP)-MALDI source. This post-ionization is interpreted in terms of collisions of microparticles moving with a hypersonic velocity into a solid surface. Calculations show that the thermal energy released during such collisions is close to that absorbed by the top matrix layer in traditional MALDI. The microparticles, containing both the matrix and analytes, could be detached from a film produced inside the inlet capillary during the sample ablation and accelerated by the flow rushing through the capillary. These observations contribute some new perspective to ion formation in both laser and laserless matrix-assisted ionization. METHODS An AP-MALDI ion source hyphenated with a three-stage high-pressure ion funnel system was utilized for peptide mass analysis. After the laser was turned off and MALDI sample was removed, ions were detected during a gradual reduction of the background pressure in the first funnel. The constant-rate pressure reduction led to the reproducible appearance of different singly- and doubly-charged peptide peaks in mass spectra taken a few seconds after the end of the MALDI analysis of a dried-droplet spot. RESULTS The ion yield as well as the mass range of ions observed with a significant delay after a completion of the primary MALDI analysis depended primarily on the background pressure inside the first funnel. The production of ions in this post-ionization step was exclusively observed during the pressure drop. A lower matrix background and significant increase in relative yield of double-protonated ions are reported. CONCLUSIONS The observations were partially consistent with a model of

  13. Robot-assisted pyeloplasty: follow-up of first Canadian experience with comparison of outcomes between experienced and trainee surgeons.

    PubMed

    Erdeljan, Petar; Caumartin, Yves; Warren, Jeff; Nguan, Christopher; Nott, Linda; Luke, Patrick P W; Pautler, Stephen E

    2010-09-01

    Robot-assisted pyeloplasty (RAP) has been established recently as an option in the management of ureteropelvic junction obstruction (UPJO). We present the first Canadian experience with RAP with respect to operative results and outcomes. We compare the surgical outcomes between experienced and trainee surgeons, with respect to operating room times and success rates. Eighty-eight patients underwent transperitoneal RAP for UPJO using the da Vinci robotic platform. Two surgeons performed Anderson-Hynes dismembered pyeloplasty in 85 cases and YV-plasty in 5 cases. Five patients had RAP for secondary UPJO after failure of other treatments. Diuretic renography was performed at 6 weeks, and 6, 12, 18, 24, and 36 months postpyeloplasty. The mean follow-up was 14.1 ± 8.5 months. The mean operative time was 167.7 ± 43.2 minutes, and the mean anastomotic time was 41.9 ± 14.1 minutes. The mean operative duration significantly decreased with time (P < 0.05). Ten patients needed simultaneous nephroscopic stone management via the pyelotomy incision. The mean blood loss was 56.6 ± 55.4 mL, and the mean hospital stay was 2.5 ± 0.5 days. There were five major postoperative (stent migration, urinoma) and three minor complications that were associated with the RAP procedures. Postoperative renal scintigraphy demonstrated only four cases with persistent obstruction. Eighty-three (94.3%) patients experienced improvement of symptoms whereas 5 continued to be symptomatic. Two patients needed secondary procedures to relieve persisting obstruction. There were no statistical differences in outcomes between the experienced surgeons and trainees (P = 0.28). In the first large case series of RAP from Canada, we demonstrate that RAP can be performed with relatively short operative times and is safe and effective, achieving similar long-term results with standard open repair. We show that robot-assisted surgery can be safely transitioned to surgical trainees. With its cost and availability

  14. Is the learning curve for video-assisted thoracoscopic lobectomy affected by prior experience in open lobectomy?

    PubMed

    Okyere, Sharon; Attia, Rizwan; Toufektzian, Levon; Routledge, Tom

    2015-07-01

    A best evidence topic was written according to a structured protocol. The question addressed is the learning curve for video-assisted thoracoscopic (VATS) lobectomy affected by prior experience in open lobectomy? Two hundred and two studies were identified of which seven presented the best evidence on the topic. The authors, date, journal, country of publication, study type, participating surgeon and relevant outcomes are tabulated. The studies presented discuss the learning experiences of surgeons with a range of proficiency in open lobectomy in performing VATS lobectomy. Four of the studies made direct comparisons between the outcomes achieved by trainees and fully qualified surgeons. Trainees performed a total of 154 VATS lobectomies and the consultants performed 714. The reported number of open lobectomies performed by trainees ranged 14-50. In one study, a qualified surgeon who had performed 100 open lobectomies achieved a statistically significant progression in his learning curve and was able to safely perform VATS lobectomies after 6 months. A trainee who had performed only 14 open lobectomies achieved a similar blood loss to his experienced supervisors (P = 0.79). Two trainee surgeons who had each performed at least 20 open lobectomies achieved similar mean intraoperative blood loss (P = 0.2) and complication rate (P = 0.4) to their experienced consultant when performing VATS lobectomy. Average duration of chest drainage was similar between consultant and trainee groups (P = 0.34) and was improved in favour of trainees in one group (P < 0.001); this might be due to the fact that they operated on more technically straightforward cases. Four trainee surgeons who had performed at least 50 open pulmonary resections each managed to achieve a similar mean operative time to their consultant in their first 46 cases, and a lower morbidity (26 vs 34.7%). There was no increase in mortality in the trainee groups. Surgeons with limited experience in open lobectomy can

  15. An experience with video-assisted anal fistula treatment (VAAFT) with new insights into the treatment of anal fistulae.

    PubMed

    Seow-En, I; Seow-Choen, F; Koh, P K

    2016-06-01

    The aim of this retrospective study was to assess our experience of 41 patients with anal fistulae treated with video-assisted anal fistula treatment (VAAFT). Forty-one consecutive patients with cryptoglandular anal fistulae were included. Patients with low intersphincteric anal fistulae or those with gross perineal abscess were excluded. Eleven (27 %) patients had undergone prior fistula surgery with 5 (12 %) having had three or more previous operations. All patients underwent the diagnostic phase as well as diathermy and curettage of the fistula tracts during VAAFT. Primary healing rate was 70.7 % at a median follow-up of 34 months. Twelve patients recurred or did not heal and underwent a repeat VAAFT procedure utilising various methods of dealing with the internal opening. There was a secondary healing rate of 83 % with two recurrences. Overall, stapling of the internal opening had a 22 % recurrence rate, while anorectal advancement flap had a 75 % failure rate. There was no recurrence seen in six cases after using the over-the-scope-clip (OTSC(®)) system to secure the internal opening. VAAFT is useful in the identification of fistula tracts and enables closure of the internal opening. Adequate closure is essential with the method used to close large or fibrotic internal openings being the determining factor for success or failure. The OTSC system delivered the most consistent result without leaving a substantial perianal wound. Ensuring thorough curettage and drainage of the tract during VAAFT is also important to facilitate healing. We believe that this understanding will bring about a decrease in the high recurrence rates currently seen in many series of anal fistulae.

  16. Initial Experience with Magnetic Resonance-Guided Vacuum-Assisted Biopsy in Korean Women with Breast Cancer

    PubMed Central

    Jung, Hye Na; Ko, Eun Young; Shin, Jung Hee

    2014-01-01

    Purpose The aim of this study is to describe our initial experience with magnetic resonance (MR)-guided biopsy and to determine the malignancy rate of additional lesions identified by MR only in Korean women with breast cancer. Methods A retrospective review identified 22 consecutive patients with breast cancer who had undergone MR-guided vacuum-assisted biopsies (VAB) of MR-only identified lesions from May 2009 to October 2011.We evaluated the rate of compliance, the technical success for MR-guided VAB and the MR imaging findings of the target lesions. VAB histology was compared with surgical histology and follow-up imaging findings. Results The biopsy recommendations for MR-only identified lesions were accepted in 46.8% (22/47) of patients. One of 22 procedures failed due to the target's posterior location. Among 21 MR-guided VAB procedures, the target lesions were considered as a mass in 12 cases and a nonmass enhancement in nine cases. VAB histology revealed malignancies in 14% (3/21) of cases, high-risk lesions in 24% (5/21) and benign lesions in 62% (13/21). Eleven cases (52%, 11/21) had a positive surgical correlation, and one of them was upgraded from atypical ductal hyperplasia to invasive ductal carcinoma. In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions. The final malignancy rate was 19% (4/21). Conclusion MR-guided VAB for MR-only identified lesions yielded a 19% malignancy rate in Korean women with breast cancer. MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy. PMID:25320626

  17. Becoming physics people: Development of physics identity in self-concept and practice through the Learning Assistant experience

    NASA Astrophysics Data System (ADS)

    Close, Eleanor

    2016-03-01

    The physics department at Texas State University has implemented a Learning Assistant (LA) program with reform-based instructional changes in our introductory course sequences. We are interested in how participation in the LA program influences LAs' identity both as physics students and as physics teachers; in particular, how being part of the LA community changes participants' self-concepts and their day-to-day practice. We analyze video of weekly LA preparation sessions and interviews with LAs as well as written artifacts from program applications, pedagogy course reflections, and evaluations. Our analysis of self-concepts is informed by the identity framework developed by Hazari et al., and our analysis of practice is informed by Lave and Wenger's theory of Communities of Practice. Regression models from quantitative studies show that the physics identity construct strongly predicts intended choice of a career in physics; the goal of our current project is to understand the details of the impacts of participation in the LA experience on participants' practice and self-concept, in order to identify critical elements of LA program structure that positively influence physics identity and physics career intentions for students. Our analysis suggests that participation in the LA program impacts LAs in ways that support both stronger ``physics student'' identity and stronger ``physics instructor'' identity, and that these identities are reconciled into a coherent integrated physics identity. In addition to becoming more confident and competent in physics, LAs perceive themselves to have increased competence in communication and a stronger sense of belonging to a supportive and collaborative community; participation in the LA program also changes their ways of learning and of being students, both within and beyond physics. This research and the TXST LA program are supported by NSF DUE-1240036, NSF DUE-1431578, and the Halliburton Foundation.

  18. Life in transition: a qualitative study of the illness experience and vocational adjustment of patients with left ventricular assist device.

    PubMed

    Overgaard, Dorthe; Grufstedt Kjeldgaard, Heidi; Egerod, Ingrid

    2012-01-01

    A left ventricular assist device (LVAD) is used as a bridge to transplantation in patients with acute heart failure. The device is a major bodily invasion that challenges everyday life. Only few studies have explored the psychosocial adjustments of patients living with an LVAD. The aim of this study was to explore the lived experience of patients with LVADs. The present study had a qualitative explorative design using in-depth interviews of 10 adult patients that had experienced life with an LVAD from 2008 to 2010 in Denmark. We constructed an interview guide with themes relating to the chronology of the illness trajectory. Data were managed by the qualitative computer package NVivo 8. As a theoretical framework, we chose a life-stage model for the main theme: Life With LVAD. The model describes the developmental tasks in each age group, and we looked at the physical, psychological, social, and vocational adjustments of patients with LVADs. Despite the suddenness of onset and gravity of illness, the patients in our study coped well with their situation. While bridging to transplantation, the patients experienced the ambivalence of gratitude and frustration toward the LVAD, and during preparation for cardiac transplantation, they experienced the ambivalence of hope and fear. Some resolved their emotional ambiguity by procrastination in relation to vocational adjustments that were necessary due to their illness. Older patients with occupational security were quicker to resume work and everyday life. Patients with LVADs succeeded somewhat in reestablishing their lives, but the younger individuals still need to consider vocational options. Some patients need help to get out of the sick role that kept them on disability benefits. The patients all relied on support from close family: parents, spouses, and children.

  19. Effects of post-capture ventilation assistance and elevated water temperature on sockeye salmon in a simulated capture-and-release experiment

    PubMed Central

    Robinson, Kendra A.; Hinch, Scott G.; Gale, Marika K.; Clark, Timothy D.; Wilson, Samantha M.; Donaldson, Michael R.; Farrell, Anthony P.; Cooke, Steven J.; Patterson, David A.

    2013-01-01

    The live release of wild adult Pacific salmon (Oncorhynchus spp.) following capture is a management tactic often used in commercial, aboriginal, and recreational fisheries. Fisheries capture and handling can be both exhausting and stressful to fish, which can limit their ability to swim and survive after release. As a result, researchers have assessed methods intended to improve post-release survival by assisting the flow of water over the gills of fish prior to release. Such approaches use recovery bags or boxes that direct water over the gills of restrained fish. This study evaluated a method of assisting ventilation that mimics one often employed by recreational anglers (i.e. holding fish facing into a current). Under laboratory conditions, wild Fraser River sockeye salmon (Oncorhynchus nerka) either received manual ventilation assistance for 1 min using a jet of water focused at the mouth or were left to recover unassisted following a capture-and-release simulation. A control group consisted of fish that were not exposed to the simulation or ventilation assistance. The experiment was conducted at 16 and 21°C, average and peak summer water temperatures for the Fraser River, and fish survival was monitored for 33 days. At 21°C, all fish perished within 3 days after treatment in all experimental groups, highlighting the consequences of handling adult sockeye salmon during elevated migration temperatures. Survival was higher at 16°C, with fish surviving on average 15–20 days after treatment. At 16°C, the capture-and-release simulation and ventilation assistance did not affect the survival of males; however, female survival was poor after the ventilation assistance compared with the unassisted and control groups. Our results suggest that the method of ventilation assistance tested in this study may not enhance the post-release survival of adult Fraser River sockeye salmon migrating in fresh water. PMID:27293599

  20. Maintenance and supply options

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The object of the Maintenance and Supply Option was to develop a high level operational philosophy related to maintenance and supply operations and incorporate these concepts into the Lunar Base Study. Specific products to be generated during this task were three trade studies and a conceptual design of the Logistic Supply Module. The crew size study was performed to evaluate crew sizes from the baseline size of four to a crew size of eight and determine the preferred crew size. The second trade study was to determine the impact of extending surface stay times and recommend a preferred duration of stay time as a function of crew, consumables, and equipment support capabilities. The third trade study was an evaluation of packaging and storage methods to determine the preferred logistics approach to support the lunar base. A modified scenario was developed and served as the basis of the individual trade studies. Assumptions and guidelines were also developed from experience with Apollo programs, Space Shuttle operations, and Space Station studies. With this information, the trade studies were performed and a conceptual design for the Logistic Supply Module was developed.

  1. Impact of the North American Free Trade Agreement on high-fructose corn syrup supply in Canada: a natural experiment using synthetic control methods

    PubMed Central

    Barlow, Pepita; McKee, Martin; Basu, Sanjay; Stuckler, David

    2017-01-01

    BACKGROUND: Critics of free trade agreements have argued that they threaten public health, as they eliminate barriers to trade in potentially harmful products, such as sugar. Here we analyze the North American Free Trade Agreement (NAFTA), testing the hypothesis that lowering tariffs on food and beverage syrups that contain high-fructose corn syrup (HFCS) increased its use in foods consumed in Canada. METHODS: We used supply data from the Food and Agriculture Organization of the United Nations to assess changes in supply of caloric sweeteners including HFCS after NAFTA. We estimate the impact of NAFTA on supply of HFCS in Canada using an innovative, quasi-experimental methodology — synthetic control methods — that creates a control group with which to compare Canada’s outcomes. Additional robustness tests were performed for sample, control groups and model specification. RESULTS: Tariff reductions in NAFTA coincided with a 41.6 (95% confidence interval 25.1 to 58.2) kilocalorie per capita daily increase in the supply of caloric sweeteners including HFCS. This change was not observed in the control groups, including Australia and the United Kingdom, as well as a composite control of 16 countries. Results were robust to placebo tests and additional sensitivity analyses. INTERPRETATION: NAFTA was strongly associated with a marked rise in HFCS supply and likely consumption in Canada. Our study provides evidence that even a seemingly modest change to product tariffs in free trade agreements can substantially alter population-wide dietary behaviour and exposure to risk factors. PMID:28676578

  2. Impact of the North American Free Trade Agreement on high-fructose corn syrup supply in Canada: a natural experiment using synthetic control methods.

    PubMed

    Barlow, Pepita; McKee, Martin; Basu, Sanjay; Stuckler, David

    2017-07-04

    Critics of free trade agreements have argued that they threaten public health, as they eliminate barriers to trade in potentially harmful products, such as sugar. Here we analyze the North American Free Trade Agreement (NAFTA), testing the hypothesis that lowering tariffs on food and beverage syrups that contain high-fructose corn syrup (HFCS) increased its use in foods consumed in Canada. We used supply data from the Food and Agriculture Organization of the United Nations to assess changes in supply of caloric sweeteners including HFCS after NAFTA. We estimate the impact of NAFTA on supply of HFCS in Canada using an innovative, quasi-experimental methodology - synthetic control methods - that creates a control group with which to compare Canada's outcomes. Additional robustness tests were performed for sample, control groups and model specification. Tariff reductions in NAFTA coincided with a 41.6 (95% confidence interval 25.1 to 58.2) kilocalorie per capita daily increase in the supply of caloric sweeteners including HFCS. This change was not observed in the control groups, including Australia and the United Kingdom, as well as a composite control of 16 countries. Results were robust to placebo tests and additional sensitivity analyses. NAFTA was strongly associated with a marked rise in HFCS supply and likely consumption in Canada. Our study provides evidence that even a seemingly modest change to product tariffs in free trade agreements can substantially alter population-wide dietary behaviour and exposure to risk factors. © 2017 Canadian Medical Association or its licensors.

  3. Experiments and models of the plasma assisted chemical vapor deposition of copper from copper hexafluoroacetylacetonate and hydrogen

    NASA Astrophysics Data System (ADS)

    Lakshmanan, Satish Kumar

    Low resistivity, high electromigration and stress migration resistance of copper interconnects will improve device reliability and lower RC delays, as device dimensions decrease into the deep sub-micron region. Plasma assisted chemical vapor deposition (PACVD) using a Hsb2 plasma and copper(II) hexafluoro acetylacetonate (Cu(Hfa)sb2), is an attractive process because of its ability to form pure copper films conformally, in narrow vias and trenches, at low substrate temperatures (150-220sp°C). Copper films have been deposited by hydrogen plasma assisted chemical vapor deposition at pressures of 0.5-3.0 torr, substrate temperatures of 150-250sp°C, plasma powers of 3.0-85.0 W and precursor mole fractions of 0.1-0.8%, in a cold wall PACVD research reactor and a commercial Watkins Johnson Select 7000 reactor. Film purity and morphology have been analyzed by X-Ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM) and X-Ray diffraction (XRD). Under the conditions investigated, the film growth rates were measured to be in the range of 40-200 A/min. An activation energy of 5 kcal/mol is suggested for the deposition, by the experiments. Further, the deposition rate, precursor conversion, film purity and morphology can be tailored by adjusting the operating conditions appropriately. A new distributed parameter model of a capacitively coupled rf Hsb2 discharge including a copper precursor has been developed, from the first three moments of the Boltzmann equation. The model predicts the concentrations and fluxes of (1) the positive ions Hsp+, Hsbsp{2}{+} and Hsbsp{3}{+} (2) the electrons and (3) atomic hydrogen, under the conditions that produce low resistivity copper films. A lumped parameter model has also been developed, which shows that Cu(Hfa)sb2 decomposes only when electron concentrations are high, resulting in the incorporation of carbon and fluorine in the growing film. However, at low pressures and powers, Cu(Hfa)sb2 reacts predominantly with H on

  4. Scale-up considerations for surface collecting agent assisted in-situ burn crude oil spill response experiments in the Arctic: Laboratory to field-scale investigations.

    PubMed

    Bullock, Robin J; Aggarwal, Srijan; Perkins, Robert A; Schnabel, William

    2017-04-01

    In the event of a marine oil spill in the Arctic, government agencies, industry, and the public have a stake in the successful implementation of oil spill response. Because large spills are rare events, oil spill response techniques are often evaluated with laboratory and meso-scale experiments. The experiments must yield scalable information sufficient to understand the operability and effectiveness of a response technique under actual field conditions. Since in-situ burning augmented with surface collecting agents ("herders") is one of the few viable response options in ice infested waters, a series of oil spill response experiments were conducted in Fairbanks, Alaska, in 2014 and 2015 to evaluate the use of herders to assist in-situ burning and the role of experimental scale. This study compares burn efficiency and herder application for three experimental designs for in-situ burning of Alaska North Slope crude oil in cold, fresh waters with ∼10% ice cover. The experiments were conducted in three project-specific constructed venues with varying scales (surface areas of approximately 0.09 square meters, 9 square meters and 8100 square meters). The results from the herder assisted in-situ burn experiments performed at these three different scales showed good experimental scale correlation and no negative impact due to the presence of ice cover on burn efficiency. Experimental conclusions are predominantly associated with application of the herder material and usability for a given experiment scale to make response decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Human-Supplied versus Computer-Supplied Feedback: An Empirical and Pragmatic Study.

    ERIC Educational Resources Information Center

    Croy, Marvin J.; And Others

    1994-01-01

    Reports on a study of 29 students of deductive logic that compared instructor-supplied and computer-supplied diagnostic feedback used with computer-assisted instruction programs. Dependent measures included exam performance, class attendance and responsiveness, and attitudes toward the instructor, computers, other students, and the course.…

  6. Comparison of hand-assisted laparoscopic and open donor nephrectomy: a single-center experience from South Korea.

    PubMed

    Seo, Seong Il; Kim, Joon Chul; Hwangbo, Kyung; Park, Yong Hyun; Hwang, Tae Kon

    2005-01-01

    We report our experience with hand-assisted laparoscopic donor nephrectomy (HALDN) and compare to our results with conventional open donor nephrectomy (ODN). From February 2000 to January 2003, 100 patients (M:F 54:46) underwent HALDN at the Kangnam St. Mary's hospital. These patients were divided into early (1st 50 cases) and late (2nd 50 cases) groups. These cohorts were compared with 40 patients (M:F 26:14) who underwent ODN via a flank incision from January 1999 to January 2003 at the same institution. Patient data were obtained from medical record review and personal and telephone interviews. The HALDN was completed successfully in 99 donors. The mean operative times (minutes) were 225 (140-425), 178 (135-250), and 188 (140-260) in the early HALDN, late HALDN, and ODN groups, respectively (P<0.05). The mean warm ischemia times (seconds) of the ODN (135+/-52.4) and late HALDN (150+/-76.7) groups were shorter than that of the early HALDN group (207+/-88.5) (P<0.05). On average, a regular diet was resumed after 2.1, 1.89, and 2.05 days, respectively. (P<0.05), and patients were discharged home 4.12, 4.04, and 6.8 days (P<0.05) after surgery in the early HALDN, late HALDN, and ODN groups. Analgesic use was significantly reduced in the HALDN group in comparison with ODN (P<0.05). Complications consisted of two cases of chyloperitoneum and one case each of open conversion, transfusion, prolonged ileus, liver enzyme elevation, and recipient ureteral necrosis in the early HALDN group; one case of subcutaneous emphysema in the late HALDN group; and one case each of transfusion and liver enzyme elevation in the ODN group. The mean donor (1 and 30 days) and recipient (6 months) serum creatinine concentrations did not differ among the groups (P>0.05). The HALDN appears to be a safe, technically feasible, and effective alternative to conventional ODN. The procedure may offer several advantages over conventional ODN in terms of less postoperative pain, shorter convalescence

  7. Gravity-Assist Mechanical Simulator for Outreach

    NASA Technical Reports Server (NTRS)

    Doody, David F.; White, Victor E.; Schaff, Mitch D.

    2012-01-01

    There is no convenient way to demonstrate mechanically, as an outreach (or inreach) topic, the angular momentum trade-offs and the conservation of angular momentum associated with gravityassist interplanetary trajectories. The mechanical concepts that underlie gravity assist are often misunderstood or confused, possibly because there is no mechanical analog to it in everyday experience. The Gravity Assist Mech - anical Simulator is a hands-on solution to this longstanding technical communications challenge. Users intuitively grasp the concepts, meeting specific educational objectives. A manually spun wheel with high angular mass and low-friction bearings supplies momentum to an attached spherical neodymium magnet that represents a planet orbiting the Sun. A steel bearing ball following a trajectory across a glass plate above the wheel and magnet undergoes an elastic collision with the revolving magnet, illustrating the gravitational elastic collision between spacecraft and planet on a gravity-assist interplanetary trajectory. Manually supplying the angular momentum for the elastic collision, rather than observing an animation, intuitively conveys the concepts, meeting nine specific educational objectives. Many NASA and JPL interplanetary missions are enabled by the gravity-assist technique.

  8. Robot-assisted laparoscopic approach for artificial urinary sphincter implantation in 11 women with urinary stress incontinence: surgical technique and initial experience.

    PubMed

    Biardeau, Xavier; Rizk, Jérôme; Marcelli, François; Flamand, Vincent

    2015-05-01

    Artificial urinary sphincter (AUS) implantation is recommended for women suffering urinary stress incontinence. Robot-assisted laparoscopy allows improved dexterity and visibility compared to traditional laparoscopy, potentially providing significant advantages for deep pelvic surgery. To report our surgical technique and initial experience in transperitoneal robot-assisted laparoscopic AUS implantation in women with urinary stress incontinence. Eleven eligible patients with AUS implantation or revision using robot-assisted laparoscopy for urinary stress incontinence were included between January 2012 and February 2014 at Department of Urology, Lille University Hospital. Procedures were performed with the assistance of a four-arm da Vinci robot. The urethrovaginal space was dissected after transperitoneal access to the Retzius space. An 11-mm port placed in the right iliac fossa allowed introduction of the AUS device. The cuff and balloon tubes were externalised via a 5-mm suprapubic incision. The peritoneum was finally sutured. Clinical data were prospectively collected before, during, and after the procedure. Results were classified as complete continence (no leakage and no pad usage), social continence (leakage and/or pad usage with no impact on social life), or failure (leakage and/or pad usage impacting social life). After mean follow-up of 17.6 mo (interquartile range 10.8-26 mo), eight patients (72.7%) had a successful AUS implantation, of whom seven (87.5%) reported complete continence and one had social continence. Two vaginal injuries and two bladder injuries occurred intraoperatively. Two patients experienced early minor postoperative complications and two had a major postoperative complication. Robot-assisted laparoscopic AUS implantation is a feasible procedure. Further studies will better assess the place of robot-assisted laparoscopy in AUS implantation. We investigated the treatment of 11 patients with stress urinary incontinence using robot-assisted

  9. Teaching Experiences of Native and Nonnative English-Speaking Graduate Teaching Assistants and Their Perceptions of Preservice Teachers

    ERIC Educational Resources Information Center

    Ates, B.; Eslami, Z. R.

    2012-01-01

    The authors report on a qualitative multiple case study exploring the perceptions of nonnative English-speaking (NNES) and native English-speaking (NES) graduate teaching assistants (GTAs) toward undergraduate preservice teachers at a university located in the Southwestern United States. Three NNES GTAs and one NES GTA participated in the study.…

  10. Teaching Assistants, Neuro-Linguistic Programming (NLP) and Special Educational Needs: "Reframing" the Learning Experience for Students with Mild SEN

    ERIC Educational Resources Information Center

    Kudliskis, Voldis

    2014-01-01

    This study examines how an understanding of two NLP concepts, the meta-model of language and the implementation of reframing, could be used to help teaching assistants enhance class-based interactions with students with mild SEN. Participants (students) completed a pre-intervention and a post-intervention "Beliefs About my Learning…

  11. Application of Theory to a Technical Assistance Experiment: Development Communication Theory and the Basic Village Education Project in Guatemala.

    ERIC Educational Resources Information Center

    Kelly, James D.

    This paper attempts to assess the influence of development communication theory on the planning and implementation of technical assistance projects in the Third World that utilize mass communication as an agent of change. Like political development theory, communication theory has often been applied in an ethnocentric manner in less developed…

  12. Practices of Assistive Technology Implementation and Facilitation: Experiences of Teachers of Students with Visual Impairments in Singapore

    ERIC Educational Resources Information Center

    Wong, Meng Ee; Law, Janet S. P.

    2016-01-01

    Assistive technology is defined by the Individuals With Disabilities Education Improvement Act (IDEIA) of 2004 as "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability"…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  14. Teaching Assistants, Neuro-Linguistic Programming (NLP) and Special Educational Needs: "Reframing" the Learning Experience for Students with Mild SEN

    ERIC Educational Resources Information Center

    Kudliskis, Voldis

    2014-01-01

    This study examines how an understanding of two NLP concepts, the meta-model of language and the implementation of reframing, could be used to help teaching assistants enhance class-based interactions with students with mild SEN. Participants (students) completed a pre-intervention and a post-intervention "Beliefs About my Learning…

  15. Teaching Experiences of Native and Nonnative English-Speaking Graduate Teaching Assistants and Their Perceptions of Preservice Teachers

    ERIC Educational Resources Information Center

    Ates, B.; Eslami, Z. R.

    2012-01-01

    The authors report on a qualitative multiple case study exploring the perceptions of nonnative English-speaking (NNES) and native English-speaking (NES) graduate teaching assistants (GTAs) toward undergraduate preservice teachers at a university located in the Southwestern United States. Three NNES GTAs and one NES GTA participated in the study.…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  17. The Use of Secondary Science Classroom Teaching Assistant Experiences To Recruit Academically Talented Science Majors into Teaching.

    ERIC Educational Resources Information Center

    Tomanek, Debra; Cummings, Katharine E.

    2000-01-01

    Presents case studies of three science majors who decided to enter teacher education after participating in a classroom teaching assistant project. Finds that some academically talented science majors can be positively influenced to teach by direct work with students, opportunities to earn teacher certification with the science major, and frequent…

  18. The use of computer-assisted orthopaedic surgery in complex cases of hip and knee arthroplasty: experience from a developing country.

    PubMed

    Hafez, Mahmoud A

    2012-08-01

    The technology of computer-assisted orthopaedic surgery (CAOS) has been used in many developed countries for the last two decades. Initially, it was thought that CAOS would be the standard in surgical practice, but so far its clinical application has been limited due to the involved cost and complexity. The cost-effectiveness of CAOS techniques has also been questioned. Therefore, it is expected that the application of CAOS in developing countries would be more limited for the same reasons. Herein, the author presents a surgical experience of using different CAOS techniques in Egypt. Computer-assisted templating software was used in complex and neglected cases of hip arthritis and in cases of leg length discrepancy. Navigation techniques were employed in knee arthroplasty in patients with extraarticular deformities. Computer-assisted patient-specific instruments were used for bilateral simultaneous knee arthroplasty in medically unfit patients and in patients with severe articular deformities. Contrary to expectations, the experience proved that CAOS is more useful and possibly cost-effective when used in hip and knee arthroplasty for complex and neglected cases in developing countries.

  19. The Initial Learning Curve for Robot-Assisted Sleeve Gastrectomy: A Surgeon's Experience While Introducing the Robotic Technology in a Bariatric Surgery Department

    PubMed Central

    Vilallonga, Ramon; Fort, José Manuel; Gonzalez, Oscar; Caubet, Enric; Boleko, Angeles; Neff, Karl John; Armengol, Manel

    2012-01-01

    Objective. Robot-assisted sleeve gastrectomy has the potential to treat patients with obesity and its comorbidities. To evaluate the learning curve for this procedure before undergoing Roux en-Y gastric bypass is the objective of this paper. Materials and Methods. Robot-assisted sleeve gastrectomy was attempted in 32 consecutive patients. A survey was performed in order to identify performance variables during completion of the learning curve. Total operative time (OT), docking time (DT), complications, and length of hospital stay were compared among patients divided into two cohorts according to the surgical experience. Scattergrams and continuous curves were plotted to develop a robotic sleeve gastrectomy learning curve. Results. Overall OT time decreased from 89.8 minutes in cohort 1 to 70.1 minutes in cohort 2, with less than 5% change in OT after case 19. Time from incision to docking decreased from 9.5 minutes in cohort 1 to 7.6 minutes in cohort 2. The time required to dock the robotic system also decreased. The complication rate was the same in the two cohorts. Conclusion. Our survey indicates that technique and outcomes for robot-assisted sleeve gastrectomy gradually improve with experience. We found that the learning curve for performing a sleeve gastrectomy using the da Vinci system is completed after about 20 cases. PMID:23029610

  20. The effects of phosphate supply on growth of plants from the Brasilian Cerrado: experiments with seedlings of the annual weed, Bidens gardneri Baker (Compositeae) and the tree, Qualea grandiflora (Mart.) (Vochysiaceae).

    PubMed

    Felippe, G M; Dale, J E

    1990-01-01

    Plants of the cerrado tree species Qualea grandiflora and the annual herb Bidens gardneri were grown from seed in controlled environment rooms at 30/20° C and 12 hour photoperiod. Seedlings were grown in pots or small tubes containing sand and provided with various amounts of mineral solutions based on the formulation of Hoagland and Arnon but with the phosphate content modified in some cases. In a long-term experiment lasting 213 days, plants supplied with full strength Hoagland's solution all died but plants of Qualea given 1/10 strength solution survived, although they grew very slowly. Low relative growth rates (0.008-0.036 d(-1)) were also a feature of other experiments with Qualea and calculated rates of net assimilation rate gave values of 3-7 mg CO2 dm(-2) h(-1). Expansion of the photosynthetic surface proceeded slowly and the cotyledons were the main site of photosynthesis for more than 40 days. The low rates of growth occurred despite significant uptake of phosphorus by young plants and in shortterm experiments growth was independent of the amount of phosphate supplied and accumulated. In contrast, the values of R found for plants of Bidens reached 0.24 d(-1). Growth of young plants was dependent on the external supply of phosphorus, being reduced when this was low and also when it was very high. Growth of the photosynthetic surface was also much more rapid than for Qualea and also varied with supply of phosphorus. The results are discussed in the context of the occurrence of these species in the Cerrado.

  1. Food and water supply

    NASA Technical Reports Server (NTRS)

    Popov, I. G.

    1975-01-01

    Supplying astronauts with adequate food and water on short and long-term space flights is discussed based on experiences gained in space flight. Food consumption, energy requirements, and suitability of the foodstuffs for space flight are among the factors considered. Physicochemical and biological methods of food production and regeneration of water from astronaut metabolic wastes, as well as wastes produced in a closed ecological system, or as a result of technical processes taking place in various spacecraft systems are suggested for long-term space flights.

  2. Food and water supply

    NASA Technical Reports Server (NTRS)

    Popov, I. G.

    1975-01-01

    Supplying astronauts with adequate food and water on short and long-term space flights is discussed based on experiences gained in space flight. Food consumption, energy requirements, and suitability of the foodstuffs for space flight are among the factors considered. Physicochemical and biological methods of food production and regeneration of water from astronaut metabolic wastes, as well as wastes produced in a closed ecological system, or as a result of technical processes taking place in various spacecraft systems are suggested for long-term space flights.

  3. DoD Supply Chain Management Implementation Guide

    DTIC Science & Technology

    2000-12-01

    The DoD Supply Chain Management Implementation Guide is a tool to assist logistics personnel who are responsible for implementing supply chain management . This...progress toward fully incorporating supply chain management into the DoD logistics process. This document is Intended to serve as a roadmap for...individuals and organizations seeking day-to-day direction for implementing supply chain management in a DoD environment.

  4. The impact of improvement of water supply and sanitation facilities on diarrhea and intestinal parasites: a Brazilian experience with children in two low-income urban communities.

    PubMed

    Gross, R; Schell, B; Molina, M C; Leão, M A; Strack, U

    1989-06-01

    During the second half of 1986 the impact of the improvement of water supply and excreta disposal facilities on diarrheal diseases and intestinal parasitosis was studied in 254 children up to six years of age from two favelas (shanty towns) of Belo Horizonte, Brazil. The estimated incidence of diarrhea was 6.2 episodes/child year and the estimated period prevalence reached 31.0 episode days/child/year. The point prevalence of parasitosis was 70.7% (Ascaris lumbricoides: 55.4%, Trichuris trichiura: 19.6%, Giardia lamblia: 17.9%). The estimated prevalence of diarrhea decreased with improvement of water supply and sanitation facilities to 45% and 44% respectively, but no statistically significant impact was observed in the case of parasitosis. School education and weaning practice were found to be other important determinants of diarrhea.

  5. A novel morphological response of maize (Zea mays) adult roots to heterogeneous nitrate supply revealed by a split-root experiment.

    PubMed

    Yu, Peng; Li, Xuexian; Yuan, Lixing; Li, Chunjian

    2014-01-01

    Approximately 35-55% of total nitrogen (N) in maize plants is taken up by the root at the reproductive stage. Little is known about how the root of an adult plant responds to heterogeneous nutrient supply. In this study, root morphological and physiological adaptations to nitrate-rich and nitrate-poor patches and corresponding gene expression of ZmNrt2.1 and ZmNrt2.2 of maize seedlings and adult plants were characterized. Local high nitrate (LoHN) supply increased both lateral root length (LRL) and density of the treated nodal roots of adult maize plants, but only increased LRL of the treated primary roots of seedlings. LoHN also increased plant total N acquisition but not N influx rate of the treated roots, when expressed as per unit of root length. Furthermore, LoHN markedly increased specific root length (m g(-1)) of the treated roots but significantly inhibited the growth of the lateral roots outside of the nitrate-rich patches, suggesting a systemic carbon saving strategy within a whole root system. Surprisingly, local low nitrate (LoLN) supply stimulated nodal root growth of adult plants although LoLN inhibited growth of primary roots of seedlings. LoLN inhibited the N influx rate of the treated roots and did not change plant total N content. The gene expression of ZmNrt2.1 and ZmNrt2.2 of the treated roots of seedlings and adult plants was inhibited by LoHN but enhanced by LoLN. In conclusion, maize adult roots responded to nitrate-rich and nitrate-poor patches by adaptive morphological alterations and displayed carbon saving strategies in response to heterogeneous nitrate supply.

  6. Robot-Assisted Ventral Mesh Rectopexy for Rectal Prolapse: A 5-Year Experience at a Tertiary Referral Center.

    PubMed

    van Iersel, Jan J; Formijne Jonkers, Hendrik A; Paulides, Tim J C; Verheijen, Paul M; Draaisma, Werner A; Consten, Esther C J; Broeders, Ivo A M J

    2017-11-01

    Laparoscopic ventral mesh rectopexy is being increasingly performed internationally to treat rectal prolapse syndromes. Robotic assistance appears advantageous for this procedure, but literature regarding robot-assisted ventral mesh rectopexy is limited. The primary objective of this study was to assess the safety and effectiveness of robot-assisted ventral mesh rectopexy in the largest consecutive series of patients to date. This study is a retrospective cross-sectional analysis of prospectively collected data. The study was conducted in a tertiary referral center. All of the patients undergoing robot-assisted ventral mesh rectopexy for rectal prolapse syndromes between 2010 and 2015 were evaluated. Preoperative and postoperative (mesh and nonmesh) morbidity and functional outcome were analyzed. The actuarial recurrence rates were calculated using the Kaplan-Meier method. A total of 258 patients underwent robot-assisted ventral mesh rectopexy (mean ± SD follow-up = 23.5 ± 21.8 mo; range, 0.2 - 65.1 mo). There were no conversions and only 5 intraoperative complications (1.9%). Mortality (0.4%) and major (1.9%) and minor (<30 d) early morbidity (7.0%) were acceptably low. Only 1 (1.3%) mesh-related complication (asymptomatic vaginal mesh erosion) was observed. A significant improvement in obstructed defecation (78.6%) and fecal incontinence (63.7%) were achieved for patients (both p < 0.0005). At final follow-up, a new onset of fecal incontinence and obstructed defecation was induced or worsened in 3.9% and 0.4%. The actuarial 5-year external rectal prolapse and internal rectal prolapse recurrence rates were 12.9% and 10.4%. This was a retrospective study including patients with minimal follow-up. No validated scores were used to assess function. The study was monocentric, and there was no control group. Robot-assisted ventral mesh rectopexy is a safe and effective technique to treat rectal prolapse syndromes, providing an acceptable recurrence rate and good

  7. Initial experience with robot-assisted modified radical neck dissection for the management of thyroid carcinoma with lateral neck node metastasis.

    PubMed

    Kang, Sang-Wook; Lee, So Hee; Ryu, Haeng Rang; Lee, Kang Young; Jeong, Jong Ju; Nam, Kee-Hyun; Chung, Woong Youn; Park, Cheong Soo

    2010-12-01

    Since the introduction of endoscopic techniques in thyroid surgery, several trials of endoscopic lateral neck dissection have been conducted with the aim of avoiding a long cervical scar, but these endoscopic procedures require more effort than open surgery, mainly because of the relatively nonsophisticated instruments used. However, the recent introduction of surgical robotic systems has simplified the operations and increased the precision of endoscopic techniques. We have described our initial experience with robot-assisted modified radical neck dissection (MRND) in thyroid cancer using the da Vinci S system. From October 2007 to October 2009, 33 patients with thyroid cancer with lateral neck lymph node (LN) metastases underwent robot-assisted thyroidectomy and additional robotic MRND using a gasless, transaxillary approach. Clinicopathologic data were analyzed retrospectively. Mean patient age was 37 ± 9 years and the gender ratio (male to female) was 7:26. The mean operating time was 281 ± 41 minutes and mean postoperative hospital stay was 5.4 ± 1.6 days. The mean tumor size was 1.1 ± 0.5 cm and 20 cases (61%) had papillary thyroid microcarcinoma. The mean number of retrieved LNs was 6.1 ± 4.4 in the central neck compartment and 27.7 ± 11.0 in the lateral compartment. No serious postoperative complications, such as Horner's syndrome or major nerve injury, occurred. Robot-assisted MRND is technically feasible, safe, and produces excellent cosmetic results. Based on our initial experience, robot-assisted MRND should be viewed as an acceptable alternative method in patients with low-risk, well-differentiated thyroid cancer with lateral neck node metastasis. Copyright © 2010 Mosby, Inc. All rights reserved.

  8. Assisting the Assistant Principal

    ERIC Educational Resources Information Center

    Davis, James

    2008-01-01

    Retaining quality staff members is a hot topic in the public school arena. Although teachers are often the focus of concern, hiring and retaining quality assistant principals must be addressed as well. Interviewing and hiring the right assistant principal--and then ensuring that he or she remains on in a campus for several years--can do a great…

  9. Interventional therapy procedures assisted by medical imaging and simulation. The experience of U 703 Inserm (Lille France).

    PubMed

    Vermandel, M; Betrouni, N; Rousseau, J; Dubois, P

    2007-04-27

    Since the early 1990s, minimally invasive techniques have been increasingly used in ever more and diversified fields of application. These techniques have some shared characteristics (predominant role of medical imaging, intensive use of new communication technologies, a multidisciplinary medical and scientific framework, etc.) but also shared specific problems (high-tech tools unfamiliar to the medical users, a major and long period of time for technological development, unavailability of training systems, difficulties in obtaining regulatory approval). For a long time, our Laboratory of Medical Physics (U 703 Inserm) has developed an innovative research activity in biomedical engineering in the field of assisted therapy, medical imaging and medical simulation. This paper presents the general context of interventional therapy procedures assisted by image and simulation and describes our scientific activities based on realistic objectives close to medical practice.

  10. Ventilation catheter-assisted airway stenting under local anaesthesia for patients with airway stenosis: initial clinical experience.

    PubMed

    Wei, Ning; Fu, Yu-Fei; Zhang, Ke; Wan, Hao-Guang; Xu, Hao

    2015-04-01

    This report details our preliminary results of ventilation catheter-assisted airway stenting under local anaesthesia for airway stenosis. Fifteen consecutive patients with airway stenosis underwent ventilation catheter-assisted airway stenting under local anaesthesia. A 4F angiographic catheter was used as the ventilation catheter. During the treatment, the distal tip of the ventilation catheter was placed across the stenosis into one of the main bronchi and the proximal tip of the catheter was linked to the oxygen tube for oxygen supplementation. Airway stenting was performed under ventilation support. Patients maintained autonomous respiration throughout the procedures. Data on technical success, clinical outcome and follow-up were collected and analysed. Ventilation catheter-assisted airway stenting under local anaesthesia was technically successful and well tolerated in all patients. Respiratory difficulty was improved in all patients after treatment. The average Hugh-Jones classification grade, arterial oxygen saturation value, and respiratory rate improved from 4.20 ± 0.68, 80.60 ± 3.83%, and 30.33 ± 2.02 times/min, respectively, before stenting to 1.47 ± 0.52 (P < 0.001), 94.93 ± 1.33% (P < 0.001), and 18.07 ± 1.33 times/min (P < 0.001), respectively, after stenting. After 2-11 months (average 5.73 ± 2.40 months) of follow-up, one patient experienced re-stenosis of the stent. The mean survival time of the 15 patients was 162.00 ± 71.60 days (range 55-320 days). Ventilation catheter-assisted airway stenting under local anaesthesia can be an effective, simple and safe method for airway stenosis.

  11. The tax-free year in Iceland: A natural experiment to explore the impact of a short-term increase in labor supply on the risk of heart attacks.

    PubMed

    Ólafsdóttir, Thorhildur; Hrafnkelsson, Birgir; Thorgeirsson, Gudmundur; Ásgeirsdóttir, Tinna Laufey

    2016-09-01

    Evidence is mixed on whether society-wide economic conditions affect cardiovascular health and the reasons for the suggested relationship are largely untested. We explore whether a short-term increase in labor supply affects the probability of acute myocardial infarctions, using a natural experiment in Iceland. In 1987 personal income taxes were temporarily reduced to zero, resulting in an overall increase in labor supply. We merge and analyze individual-level, registry-based data on earnings and AMIs including all Icelandic men and women aged 45-74 during the period 1982-1992. The results support the prominent hypothesis of increased work as a mechanism explaining worsening heart health in upswings, for men aged 45-64 who were self-employed. We furthermore find a larger increase in probability of AMIs during the tax-free year in men aged 45-54 than men aged 55-64. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. A multicenter experience of through-the-scope balloon-assisted enteroscopy in surgically altered gastrointestinal anatomy.

    PubMed

    Cai, Jennifer X; Diehl, David L; Kiesslich, Ralf; Storm, Andrew C; El Zein, Mohamad H; Tieu, Alan H; Hoffman, Arthur; Singh, Vikesh K; Khashab, Mouen A; Okolo, Patrick I; Kumbhari, Vivek

    2017-07-01

    Surgically altered gastrointestinal anatomy poses challenges for deep enteroscopy. Current overtube-assisted methods have long procedure times and utilize endoscopes with smaller working channels that preclude use of standard accessories. A through-the-scope balloon-assisted enteroscopy (TTS-BAE) device uses standard endoscopes with a large working channel to allow metallic and plastic stent insertion. We aim to determine the efficacy and safety of TTS-BAE in patients with altered surgical anatomy. A retrospective, multicenter study of TTS-BAE in altered anatomy patients at two USA and one German institution was performed between January 2013 and December 2014. Type of anatomy, procedure indication and duration, adverse events, and target, technical, and clinical success were recorded. A total of 32 patients (mean age 54 years, Caucasian 81.6%, female 42.1%, mean BMI 25.4 kg/m(2)) underwent 38 TTS-BAE procedures. Thirty-two percent of cases had a prior attempt at conventional enteroscopy which failed to reach the target site. The target was successfully reached in 23 (60.5%) cases. Of the 23 cases that reached the intended target, 22 (95.7%) achieved technical success and 21 (91.3%) achieved clinical success. The median procedure time was 43 min. Target, technical, and clinical success rates for TTS-BAE-assisted ERCP (n = 31) were 58.1, 54.8 and 54.8%. Seven self-expandable metallic stents (five biliary, two jejunal) were attempted, and all successfully deployed. Adverse events occurred in 4 (10.4%) cases, including one luminal perforation. TTS-BAE is an alternative to overtube-assisted enteroscopy that is comparable in safety in patients with surgically altered anatomies. Technical success in the instances where the target had been reached was excellent. TTS-BAE confers an advantage over overtube-assisted enteroscopy as it can facilitate the deployment of self-expandable metallic stents in the biliary tree and deep small bowel.

  13. Public Perceptions of Doctors of Chiropractic: Results of a National Survey and Examination of Variation According to Respondents' Likelihood to Use Chiropractic, Experience With Chiropractic, and Chiropractic Supply in Local Health Care Markets.

    PubMed

    Weeks, William B; Goertz, Christine M; Meeker, William C; Marchiori, Dennis M

    2015-10-01

    The purpose of this study was to determine whether general perceptions of doctors of chiropractic (DCs) varied according to likeliness to use chiropractic care, whether particular demographic characteristics were associated with chiropractic care use, and whether perception of DCs varied according to the per-capita supply of DCs in local health care markets. We performed a secondary analysis of results from a 26-item nationally representative survey of 5422 members of The Gallup Panel that was conducted in the spring of 2015 (response rate, 29%) that sought to elicit the perceptions and use of DCs by US adults. We compared survey responses across: (1) respondents who had different likelihoods to use DCs for treatment of neck or back pain and (2) respondents who had different experiences using DCs. We linked respondents' zip codes to hospital referral regions for which we had the per-capita supply of DCs. Using the χ(2) test, we examined relationships between likeliness to use a DC, experience using a DC, respondent demographic variables, perceptions of DCs, and the per-capita supply of DCs in the local health care market. Most (61.4%) respondents believed that chiropractic care was effective at treating neck and back pain, 52.6% thought DCs were trustworthy, and 24.2% thought chiropractic care was dangerous; however, as respondents' likelihood to use a DC increased, perceptions of effectiveness and trustworthiness increased, and perceptions of danger decreased. Of all 5422 survey respondents, 744 or 13.7% indicated that they had seen a DC within the last 12 months. As one moved from distant to more recent experience using a DC, respondents were more likely to be female, married, white, and employed; those who had a distant history of using a DC were older and more likely to be retired than the other groups. A higher per-capita supply of DCs was associated with higher utilization rates and showed a more favorable regard for DCs. US adults often use chiropractic

  14. Endovascular balloon-assisted embolization of intracranial and cervical arteriovenous malformations using dual-lumen coaxial balloon microcatheters and Onyx: initial experience.

    PubMed

    Jagadeesan, Bharathi D; Grigoryan, Mikayel; Hassan, Ameer E; Grande, Andrew W; Tummala, Ramachandra P

    2013-12-01

    Ethylene vinyl alcohol copolymer (Onyx) is widely used for the embolization of arteriovenous malformations (AVMs) of the brain, head, and neck. Balloon-assisted Onyx embolization may provide additional unique advantages in the treatment of AVMs in comparison with traditional catheter-based techniques. To report our initial experience in performing balloon-assisted AVM embolization for brain and neck AVMs with the use of the new Scepter-C and Scepter-XC coaxial dual-lumen balloon microcatheters. Balloon-assisted transarterial embolization was performed in a series of 7 patients with AVMs (4 with brain AVMs, 1 with a dural arteriovenous fistula, and 2 with neck AVMs) by using Onyx delivered through the lumen of Scepter-C or Scepter XC coaxial balloon microcatheters. Following the initial balloon-catheter navigation into a feeding artery and the subsequent inflation of the balloon, the embolization was performed by using Onyx 18, Onyx 34, or both. A total of 12 embolization sessions were performed via 17 arterial feeders in these 7 patients. In 1 patient, there was an arterial perforation from the inflation of the balloon; in all others, the embolization goals were successfully achieved with no adverse events. The balloon microcatheters showed excellent navigability, and there were no problems with retrieval or with the repeated inflation and deflation of the balloons. A proximal Onyx plug, which is crucial in many AVM embolizations, was not necessary with this technique. Additionally, fluoroscopy and procedural times seemed lower with this technique compared with conventional embolization methods.

  15. Evaluation of combined matrix-assisted laser desorption/ionization time-of-flight and matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometry experiments for peptide mass fingerprinting analysis.

    PubMed

    da Silva, David; Wasselin, Thierry; Carré, Vincent; Chaimbault, Patrick; Bezdetnaya, Lina; Maunit, Benoît; Muller, Jean-François

    2011-07-15

    Peptide Mass Fingerprinting (PMF) is still of significant interest in proteomics because it allows a large number of complex samples to be rapidly screened and characterized. The main part of post-translational modifications is generally preserved. In some specific cases, PMF suffers from ambiguous or unsuccessful identification. In order to improve its reliability, a combined approach using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) and matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometry (MALDI-FTICRMS) was evaluated. The study was carried out on bovine serum albumin (BSA) digest. The influence of several important parameters (the matrix, the sample preparation method, the amount of the analyte) on the MOWSE score and the protein sequence coverage were evaluated to allow the identification of specific effects. A careful investigation of the sequence coverage obtained by each kind of experiment ensured the detection of specific peptides for each experimental condition. Results highlighted that DHB-FTICRMS and DHB- or CHCA-TOFMS are the most suited combinations of experimental conditions to achieve PMF analysis. The association (convolution) of the data obtained by each of these techniques ensured a significant increase in the MOWSE score and the protein sequence coverage.

  16. Health supply chain management.

    PubMed

    Zimmerman, Rolf; Gallagher, Pat

    2010-01-01

    This chapter gives an educational overview of: * The actual application of supply chain practice and disciplines required for service delivery improvement within the current health environment. * A rationale for the application of Supply Chain Management (SCM) approaches to the Health sector. * The tools and methods available for supply chain analysis and benchmarking. * Key supply chain success factors.

  17. Endoscopic submucosal dissection of early gastric neoplasia with a water jet-assisted knife: a Western, single-center experience.

    PubMed

    Schumacher, Brigitte; Charton, Jean-Pierre; Nordmann, Thomas; Vieth, Michael; Enderle, Markus; Neuhaus, Horst

    2012-06-01

    Endoscopic submucosal dissection (ESD) of early gastric neoplasia has not yet been established in Western countries because of a lack of data and the difficult, time-consuming, and hazardous nature of the method. Some of the technical limitations may be overcome by use of a water jet-assisted knife, which allows a combination of a high-pressure water jet and electrosurgical interventions. To evaluate the efficacy and safety of water jet-assisted ESD (WESD) with a water jet-assisted knife in selected patients with early gastric neoplasia. Single-center, prospective study. This study involved 29 consecutive patients (13 female; median age 61 years; age range 35-93 years) with early gastric neoplasia that met the expanded criteria of the Japanese Gastric Cancer Association. Histology of biopsies had shown gastric adenocarcinoma in 21 cases, adenoma in 8 case, and suspicion of a GI stromal tumor in 1 case. The median maximal diameter of the lesions was 20 mm (range 10-40 mm). All procedures were done with patients under sedation with propofol. The water jet-assisted knife was used for setting coagulation markers around the neoplastic lesions, then for circumferential incision and dissection in combination with repeated submucosal injection of saline solution with a water jet system. Bleeding was treated with diathermia by use of the water jet-assisted knife or hemostatic forceps in case of failure or larger vessels. Clips were used for closure of perforations. Complete resection of neoplasia, procedure time, complication and recurrence rates. According to endoscopic criteria, complete resection of the targeted area could be achieved in all cases, with an en bloc resection rate of 90%. The median procedure duration was 74 minutes (range 15-402 minutes). Exchange of the device was needed in only 10 cases because of severe bleeding from larger vessels, which could be managed by use of hemostatic forceps. The 30-day morbidity rate was 4 of 30 (13.8%) because of

  18. Single-port video-assisted thoracoscopic surgery lung resection: experiences in Fujian Medical University Union Hospital

    PubMed Central

    Zhu, Yong; Xu, Guobing; Zheng, Bin; Liang, Mingqiang; Wu, Weidong; Zheng, Wei

    2015-01-01

    Video-assisted thoracoscopic surgery (VATS) is currently a better choice than thoracotomy for lung resection, and then single-port VATS has been increasingly applied in clinical settings with the improvements in both endoscopic instruments and surgical skills. Our center began to perform single-port VATS lobectomy in May 2014 and had performed all sort of lung resection in 168 patients till December 2014, including wedge resection, routine lobectomy, sleeve lobectomy, segmentectomy and pneumonectomy. All these procedures were successfully performed without any severe complication. We believe the single-port VATS lung resection is a safe and feasible procedure after surgery practice. PMID:26380741

  19. Inertia compensation control of a one-degree-of-freedom exoskeleton for lower-limb assistance: initial experiments.

    PubMed

    Aguirre-Ollinger, Gabriel; Colgate, J Edward; Peshkin, Michael A; Goswami, Ambarish

    2012-01-01

    A new method of lower-limb exoskeleton control aimed at improving the agility of leg-swing motion is presented. In the absence of control, an exoskeleton's mechanism usually hinders agility by adding mechanical impedance to the legs. The uncompensated inertia of the exoskeleton will reduce the natural frequency of leg swing, probably leading to lower step frequency during walking as well as increased metabolic energy consumption. The proposed controller emulates inertia compensation by adding a feedback loop consisting of low-pass filtered angular acceleration multiplied by a negative gain. This gain simulates negative inertia in the low-frequency range. The resulting controller combines two assistive effects: increasing the natural frequency of the lower limbs and performing net work per swing cycle. The controller was tested on a statically mounted exoskeleton that assists knee flexion and extension. Subjects performed movement sequences, first unassisted and then using the exoskeleton, in the context of a computer-based task resembling a race. In the exoskeleton's baseline state, the frequency of leg swing and the mean angular velocity were consistently reduced. The addition of inertia compensation enabled subjects to recover their normal frequency and increase their selected angular velocity. The work performed by the exoskeleton was evidenced by catch trials in the protocol.

  20. Specific learning curve for port placement and docking of da Vinci(®) Surgical System: one surgeon's experience in robotic-assisted radical prostatectomy.

    PubMed

    Dal Moro, F; Secco, S; Valotto, C; Artibani, W; Zattoni, F

    2012-12-01

    Port placement and docking of the da Vinci(®) Surgical System is fundamental in robotic-assisted laparoscopic radical prostatectomy (RALP). The aim of our study was to investigate learning curves for port placement and docking of robots (PPDR) in RALP. This manuscript is a retrospective review of prospectively collected data looking at PPDR in 526 patients who underwent RALP in our institute from April 2005 to May 2010. Data included patient-factor features such as body mass index (BMI), and pre-, intra- and post-operative data. Intra-operative information included operation time, subdivided into anesthesia, PPDR and console times. 526 patients underwent RALP, but only those in whom PPDR was performed by the same surgeon without laparoscopic and robotic experience (F.D.M.) were studied, totalling 257 cases. The PPDR phase revealed an evident learning curve, comparable with other robotic phases. Efficiency improved until approximately the 60th case (P < 0.001), due more to effective port placement than to docking of robotic arms. In our experience, conversion to open surgery is so rare that statistical evaluation is not significant. Conversion due to robotic device failure is also very rare. This study on da Vinci procedures in RALP revealed a learning curve during PPDR and throughout the robotic-assisted procedure, reaching a plateau after 60 cases.