Galileo's Trajectory with Mild Resistance

ERIC Educational Resources Information Center

Groetsch, C. W.

2012-01-01

An aspect of Galileo's classical trajectory that persists in a simple resistance model is noted. The resistive model provides a case study for the classroom analysis of limiting behaviour of an implicitly defined function. (Contains 1 note.)

Case Study: The Chemistry of Cocaine

ERIC Educational Resources Information Center

Dewprashad, Brahmadeo

2011-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

Case Study: Mini-Case Studies: Small Infusions of Active Learning for Large-Lecture Courses

ERIC Educational Resources Information Center

Carloye, Lisa

2017-01-01

In this article, the author introduces the usage of case studies to be an excellent method for engaging students through stories. The author notes she developed a series of mini-case studies that can be implemented, with a little advance preparation, within a 10- to 15-minute window during lecture. What makes them "mini" case studies?…

Case Study: What Makes a Good Case, Revisited: The Survey Monkey Tells All

ERIC Educational Resources Information Center

Herried, Clyde Freeman; Prud'homme-Genereux, Annie; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

2016-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. In this month's issue the authors provide a more definitive answer to the "What Makes a Good Case?" question based on a just-completed Survey Monkey survey given to NCCSTS teachers.

Case Study: Student-Produced Videos for the Flipped Classroom

ERIC Educational Resources Information Center

Prud'homme-Genereux, Annie

2016-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes a way of building a library of student-produced videos to use in the flipped classroom.

Bewitching Ideas Influence Learning: An Evaluation of an Interdisciplinary Teaching Experience

ERIC Educational Resources Information Center

Nava-Whitehead, Susan M.; Augusto, Kerri W.; Gow, Joan-Beth

2011-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. In this month's issue the authors describe an interdisciplinary approach to case study teaching that addresses the demand to balance the goals of process and content. The case study, Salem's Secrets…

Role of matching in case-control studies of antimicrobial resistance.

PubMed

Cerceo, Elizabeth; Lautenbach, Ebbing; Linkin, Darren R; Bilker, Warren B; Lee, Ingi

2009-05-01

Of 57 case-control studies of antimicrobial resistance, matching was used in 23 (40%). Matched variables differed substantially across studies. Of these 23 matched case-control studies, 12 (52%) justified the use of matching, and 9 (39%) noted the strengths or limitations of this approach. Analysis that accounted for matching was performed in only 52% of the case-control studies.

Teaching Business French through Case Studies: Presentation of a Marketing Case.

ERIC Educational Resources Information Center

Federico, Salvatore; Moore, Catherine

The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

Case Study: Let's Get Personal--Putting Personality into Your Cases

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2017-01-01

In this case study, the subject for discussion is the need to use teaching notes in order to add personality to case studies. Personality, it is said, is more important than policy, than demographics, than finances, or amorous peccadillos. Personality is essential. It is the interaction of people that capture our interest, yet, the question is…

Use of Case Studies for Stimulating Thinking and Learning.

ERIC Educational Resources Information Center

Zeakes, Samuel J.

Noting that a case-study approach can stimulate student thinking and learning, this paper describes how students in a writing-intensive course on parasitology wrote brief medical case studies of parasites already studied for other students to read, evaluate, and identify the parasite. The paper presents a brief description of the course, an…

The Effectiveness of a Case Study-Based First-Year Biology Class at a Black Women's College

ERIC Educational Resources Information Center

Pai, Aditi; Benning, Tracy; Woods, Natasha; McGinnis, Gene; Chu, Joanne; Netherton, Josh; Bauerle, Cynthia

2010-01-01

The authors used a case study-based approach in the introductory biology course at Spelman College. The course taught to entering freshmen was divided into three modules--ecology, evolution, and biodiversity, each designed around a case study. They noted that (1) case study teaching was dramatically more effective than the traditional lecture…

A study of the transferability of influenza case detection systems between two large healthcare systems

PubMed Central

Wagner, Michael M.; Cooper, Gregory F.; Ferraro, Jeffrey P.; Su, Howard; Gesteland, Per H.; Haug, Peter J.; Millett, Nicholas E.; Aronis, John M.; Nowalk, Andrew J.; Ruiz, Victor M.; López Pineda, Arturo; Shi, Lingyun; Van Bree, Rudy; Ginter, Thomas; Tsui, Fuchiang

2017-01-01

Objectives This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD) that use clinical notes from emergency department (ED) to detect influenza cases. Methods A BCD uses natural language processing (NLP) to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN) to infer patients’ diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC) and Intermountain Healthcare in Utah (BCDIH). At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source) institution, development parser, application (target) institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance. Results Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92). When tested for transferability using the other institution’s cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, p<0.01), and BCDIH discriminations declined more (from 0.93 to 0.87, p<0.0001). We attributed the BCDIH decline to the lower recall of the IH parser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task. Conclusion We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the accuracy of the NLP parser. PMID:28380048

A study of the transferability of influenza case detection systems between two large healthcare systems.

PubMed

Ye, Ye; Wagner, Michael M; Cooper, Gregory F; Ferraro, Jeffrey P; Su, Howard; Gesteland, Per H; Haug, Peter J; Millett, Nicholas E; Aronis, John M; Nowalk, Andrew J; Ruiz, Victor M; López Pineda, Arturo; Shi, Lingyun; Van Bree, Rudy; Ginter, Thomas; Tsui, Fuchiang

2017-01-01

This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD) that use clinical notes from emergency department (ED) to detect influenza cases. A BCD uses natural language processing (NLP) to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN) to infer patients' diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC) and Intermountain Healthcare in Utah (BCDIH). At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source) institution, development parser, application (target) institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance. Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92). When tested for transferability using the other institution's cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, p<0.01), and BCDIH discriminations declined more (from 0.93 to 0.87, p<0.0001). We attributed the BCDIH decline to the lower recall of the IH parser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task. We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the accuracy of the NLP parser.

Prospective Teachers' Representations for Teaching Note Values: An Analysis in the Context of Mathematics and Music

ERIC Educational Resources Information Center

Özgül, Ilhan; Incikabi, Lütfi

2017-01-01

In this study, the representations preferred by prospective teachers in the teaching of note values were determined and the accuracy of these representations was analyzed in the context of mathematics and music. The case study, one of the qualitative research designs, was used in the study. Study group of the research consisted of 113 pre-school…

Notes on Linguistics, 1990.

ERIC Educational Resources Information Center

Notes on Linguistics, 1990

1990-01-01

This document consists of the four issues of "Notes on Linguistics" published during 1990. Articles in the four issues include: "The Indians Do Say Ugh-Ugh" (Howard W. Law); "Constraints of Relevance, A Key to Particle Typology" (Regina Blass); "Whatever Happened to Me? (An Objective Case Study)" (Aretta…

Inter-rater reliability and generalizability of patient note scores using a scoring rubric based on the USMLE Step-2 CS format.

PubMed

Park, Yoon Soo; Hyderi, Abbas; Bordage, Georges; Xing, Kuan; Yudkowsky, Rachel

2016-10-01

Recent changes to the patient note (PN) format of the United States Medical Licensing Examination have challenged medical schools to improve the instruction and assessment of students taking the Step-2 clinical skills examination. The purpose of this study was to gather validity evidence regarding response process and internal structure, focusing on inter-rater reliability and generalizability, to determine whether a locally-developed PN scoring rubric and scoring guidelines could yield reproducible PN scores. A randomly selected subsample of historical data (post-encounter PN from 55 of 177 medical students) was rescored by six trained faculty raters in November-December 2014. Inter-rater reliability (% exact agreement and kappa) was calculated for five standardized patient cases administered in a local graduation competency examination. Generalizability studies were conducted to examine the overall reliability. Qualitative data were collected through surveys and a rater-debriefing meeting. The overall inter-rater reliability (weighted kappa) was .79 (Documentation = .63, Differential Diagnosis = .90, Justification = .48, and Workup = .54). The majority of score variance was due to case specificity (13 %) and case-task specificity (31 %), indicating differences in student performance by case and by case-task interactions. Variance associated with raters and its interactions were modest (<5 %). Raters felt that justification was the most difficult task to score and that having case and level-specific scoring guidelines during training was most helpful for calibration. The overall inter-rater reliability indicates high level of confidence in the consistency of note scores. Designs for scoring notes may optimize reliability by balancing the number of raters and cases.

Case Study: Crazy about Cryptids--An Ecological Hunt for Nessie and Other Legendary Creatures

ERIC Educational Resources Information Center

Rowe, Matthew P.

2015-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This hybrid case has three overarching and interrelated goals. First, it can be used to familiarize students with a range of ecological concepts and terms. Second, it is intended to engage students in…

Facilitating Collaboration in Lecture-Based Learning through Shared Notes Using Wireless Technologies

ERIC Educational Resources Information Center

Valtonen, T.; Havu-Nuutinen, S.; Dillon, P.; Vesisenaho, M.

2011-01-01

This paper reports a case study for developing lecture teaching in higher education by connecting simultaneously the benefits of face-to-face teaching and social software for capturing and sharing students' lecture notes. The study was conducted with 12 university students taking a degree course on pre-primary education. Data were collected on (1)…

Hot under the Collar: Weighing the Dangers of a Weight-Loss Drug

ERIC Educational Resources Information Center

DeSimone, Susan M.; Genereux, Annie Prud'homme

2011-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. In this month's issue the goal of the case study is for students to expand their understanding of membrane permeability and the proton motive force in mitochondria through the study of…

The Benign Hamburger.

ERIC Educational Resources Information Center

Peaslee, Graham; Lantz, Juliette M.; Walczak, Mary M.

1998-01-01

Uses a case study of food poisoning from hamburgers at the fictitious Jill-at-the-Grill to teach the nuclear science behind food irradiation. Includes case teaching notes on the benign hamburger. (ASK)

Demographic and clinical features of suspected dengue and dengue haemorrhagic fever in the Northern Province of Sri Lanka, a region afflicted by an internal conflict for more than 30 years-a retrospective analysis.

PubMed

Murugananthan, K; Kandasamy, M; Rajeshkannan, N; Noordeen, F

2014-10-01

The aim of this study was to determine the demographic, clinical, and notification data of suspected dengue fever (DF) and dengue hemorrhagic fever (DHF) cases admitted to Jaffna Teaching Hospital, Sri Lanka. The data were collected from bed head tickets of all patients presenting with clinically suspected DF/DHF from October 2009 to September 2010. A total of 1085 clinically suspected DF/DHF cases were identified, with high numbers occurring during December 2009 to March 2010. The majority of the reported patients were females (n = 550, 50.7%) and approximately three-quarters of the patients (n = 797, 73.5%) were adults. All had fever, but fever spikes were noted in only 129 cases (11.9%; 95% confidence interval (CI) 10.1-13.9%). Over 50% of cases had vomiting (95% CI 47.5-53.5%). Haemorrhages were noted in 266 (24.5%), with gum bleeding in 99 patients (37.2%). Low white blood cell and platelet counts were noted in 27.1% and 85.6% of cases, respectively. Of the 1085 cases, only 24 (2.2%) were screened for dengue IgM/IgG and only 458 cases (42.2%) were notified to the Epidemiology Unit, Ministry of Health, Sri Lanka. The absence of laboratory diagnosis and poor notification to the Epidemiology Unit were the major drawbacks noted. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Creating Your Own Case Studies: A Guide for Early Field Experience.

ERIC Educational Resources Information Center

Florio-Ruane, Susan

1990-01-01

A guide for creating case studies is provided for teacher educators to share with students. Suggestions are offered for becoming a participant observer in a classroom. The appendix contains sample appropriate and inappropriate field notes. (SM)

Improved patient notes from medical students during web-based teaching using faculty-calibrated peer review and self-assessment.

PubMed

McCarty, Teresita; Parkes, Marie V; Anderson, Teresa T; Mines, Jan; Skipper, Betty J; Grebosky, James

2005-10-01

This study examines the effectiveness of Calibrated Peer Review (CPR), a Web-based writing development program, to teach and assess medical students' patient note-writing skills in a standardized fashion. At the end of the clerkship year, 67 medical students were divided into three groups, introduced to CPR, and instructed in patient note-writing. Students then wrote notes for three clinical cases, presented in different order to each group. After training on faculty-calibrated standards, students evaluated their peers' notes and their own notes. Trained faculty, blinded to author, order, and group, also graded student notes. Faculty gave lower scores than students, but both groups found students' scores improved significantly from the first to the third note written. Student-written patient notes improved in quality while using CPR. The program uses approaches valued in medicine (accurate peer review and self-reflection) to enhance performance.

An Investigation of Strategic Decision Making in Service Marketing through Case Study Development and Analysis

ERIC Educational Resources Information Center

Rosetti, Joseph L.; Maceiko, Meghan

2009-01-01

Through the collaborative efforts of an undergraduate student and a professor of marketing, this paper focuses on a case study and corresponding teaching notes developed as a final component of an independent study in service marketing. The case utilizes the hospitality industry as the template for analysis of the appropriateness of marketing…

Electronic Nursing Notes: A Case Study on Interdisciplinary Collaboration

ERIC Educational Resources Information Center

Howard, Elizabeth V.; Teets, Janet

2006-01-01

In an interdisciplinary collaboration between the Computer & Information Technology (CIT) and Nursing (NSG) Departments at the Middletown and Hamilton regional campuses of Miami University (of Ohio), student team members created a Web-based application to create Electronic Nursing Notes. Students from the two departments worked together to…

Long-term study of patients with congenital pit of the optic nerve and persistent macular detachment.

PubMed

Theodossiadis, G P; Panopoulos, M; Kollia, A K; Georgopoulos, G

1992-08-01

During the period 1970-87 we evaluated the changes of the optic disc, peripapillary area, detached macula and visual acuity in 16 cases with congenital pit of the optic nerve and macular detachment. The study revealed in 9 of the 16 cases (56%) an increase of the dimension of the pit or changes in its color, findings which were directly related to the duration of the macular detachment. Chorioretinal scarring, pigment migration, or both, were also noted mainly at the temporal margin of optic disc. In 5/16 cases we found during the follow-up an extension of macular elevation. In altogether 10 out of 16 cases the retinal elevation covered the larger portion of the mid-periphery temporally. In 7/16 cases the final visual acuity remained unchanged, in 9/16 cases deteriorated. The difference, however, in the latter 9 cases between initial and final visual acuity was negligible. During the follow-up period deterioration of the visual fields was also noted.

Australian oral health case notes: assessment of forensic relevance and adherence to recording guidelines.

PubMed

Stow, L; James, H; Richards, L

2016-06-01

Dental case notes record clinical diagnoses and treatments, as well as providing continuity of patient care. They are also used for dento-legal litigation and forensic purposes. Maintaining accurate and comprehensive dental patient records is a dental worker's ethical and legal obligation. Australian registered specialist forensic odontologists were surveyed to determine the relevance of recorded case note items for dental identification. A dental case notes sample was assessed for adherence with odontologist nominated forensic value and compiled professional record keeping guidelines of forensic relevance. Frequency of item recording, confidence interval, examiner agreement and statistical significance were determined. Broad agreement existed between forensic odontologists as to which recorded dental items have most forensic relevance. Inclusion frequency of these items in sampled case notes varied widely (e.g. single area radiographic view present in 75%, CI = 65.65-82.50; completed odontogram in 56%, CI = 46.23-65.33). Recording of information specified by professional record keeping guidelines also varied, although overall inclusion was higher than for forensically desired items (e.g. patient's full name in 99%, CI = 94.01 - >99.99; named treating practitioner in 23%, CI = 15.78-32.31). Many sampled dental case notes lacked details identified as being valuable by forensic specialists and as specified by professional record keeping guidelines. © 2016 Australian Dental Association.

Surgical implications and variability in the use of the flat epithelial atypia diagnosis on breast biopsy specimens.

PubMed

Samples, Laura S; Rendi, Mara H; Frederick, Paul D; Allison, Kimberly H; Nelson, Heidi D; Morgan, Thomas R; Weaver, Donald L; Elmore, Joann G

2017-08-01

Flat epithelial atypia (FEA) is a relatively new diagnostic term with uncertain clinical significance for surgical management. Any implied risk of invasive breast cancer associated with FEA is contingent upon diagnostic reproducibility, yet little is known regarding its use. Pathologists in the Breast Pathology Study interpreted one of four 60-case test sets, one slide per case, constructed from 240 breast biopsy specimens. An electronic data form with standardized diagnostic categories was used; participants were instructed to indicate all diagnoses present. We assessed participants' use of FEA as a diagnostic term within: 1) each test set; 2) 72 cases classified by reference as benign without FEA; and 3) six cases classified by reference as FEA. 115 pathologists participated, providing 6900 total independent assessments. Notation of FEA ranged from 0% to 35% of the cases interpreted, with most pathologists noting FEA on 4 or more test cases. At least one participant noted FEA in 34 of the 72 benign non-FEA cases. For the 6 reference FEA cases, participant agreement with the case reference FEA diagnosis ranged from 17% to 52%; diagnoses noted by participating pathologists for these FEA cases included columnar cell hyperplasia, usual ductal hyperplasia, atypical lobular hyperplasia, and atypical ductal hyperplasia. We observed wide variation in the diagnosis of FEA among U.S. pathologists. This suggests that perceptions of diagnostic criteria and any implied risk associated with FEA may also vary. Surgical excision following a core biopsy diagnosis of FEA should be reconsidered and studied further. Copyright © 2017 Elsevier Ltd. All rights reserved.

Broadcast Condom Advertising: A Case Study.

ERIC Educational Resources Information Center

Kaplan, Herb; Houlberg, Rick

1990-01-01

Examines a San Francisco television station's decision to accept paid condom advertising. Notes that station leaders debated questions of public interest and public tastes in a city hard hit by AIDS. Finds that the station devised careful guidelines and began broadcasting the commercials on a trial basis. Notes that nearly all public and media…

The Composer's Program Note for Newly Written Classical Music: Content and Intentions.

PubMed

Blom, Diana M; Bennett, Dawn; Stevenson, Ian

2016-01-01

In concerts of western classical music the provision of a program note is a widespread practice dating back to the 18th century and still commonly in use. Program notes tend to inform listeners and performers about historical context, composer biographical details, and compositional thinking. However, the scant program note research conducted to date reveals that program notes may not foster understanding or enhance listener enjoyment as previously assumed. In the case of canonic works, performers and listeners may already be familiar with much of the program note information. This is not so in the case of newly composed works, which formed the basis of the exploratory study reported here. This article reports the views of 17 living contemporary composers on their writing of program notes for their own works. In particular, the study sought to understand the intended recipient, role and the content of composer-written program notes. Participating composers identified three main roles for their program notes: to shape a performer's interpretation of the work; to guide, engage or direct the listener and/or performer; and as collaborative mode of communication between the composer, performer, and listener. For some composers, this collaboration was intended to result in "performative listening" in which listeners were actively engaged in bringing each composition to life. This was also described as a form of empathy that results in the co-construction of the musical experience. Overall, composers avoided giving too much personal information and they provided performers with more structural information. However, composers did not agree on whether the same information should be provided to both performers and listeners. Composers' responses problematize the view of a program note as a simple statement from writer to recipient, indicating instead a more complex set of relations at play between composer, performer, listener, and the work itself. These relations are illustrated in a model. There are implications for program note writers and readers, and for educators. Future research might seek to enhance understanding of program notes, including whether the written program note is the most effective format for communications about music.

The Composer’s Program Note for Newly Written Classical Music: Content and Intentions

PubMed Central

Blom, Diana M.; Bennett, Dawn; Stevenson, Ian

2016-01-01

In concerts of western classical music the provision of a program note is a widespread practice dating back to the 18th century and still commonly in use. Program notes tend to inform listeners and performers about historical context, composer biographical details, and compositional thinking. However, the scant program note research conducted to date reveals that program notes may not foster understanding or enhance listener enjoyment as previously assumed. In the case of canonic works, performers and listeners may already be familiar with much of the program note information. This is not so in the case of newly composed works, which formed the basis of the exploratory study reported here. This article reports the views of 17 living contemporary composers on their writing of program notes for their own works. In particular, the study sought to understand the intended recipient, role and the content of composer-written program notes. Participating composers identified three main roles for their program notes: to shape a performer’s interpretation of the work; to guide, engage or direct the listener and/or performer; and as collaborative mode of communication between the composer, performer, and listener. For some composers, this collaboration was intended to result in “performative listening” in which listeners were actively engaged in bringing each composition to life. This was also described as a form of empathy that results in the co-construction of the musical experience. Overall, composers avoided giving too much personal information and they provided performers with more structural information. However, composers did not agree on whether the same information should be provided to both performers and listeners. Composers’ responses problematize the view of a program note as a simple statement from writer to recipient, indicating instead a more complex set of relations at play between composer, performer, listener, and the work itself. These relations are illustrated in a model. There are implications for program note writers and readers, and for educators. Future research might seek to enhance understanding of program notes, including whether the written program note is the most effective format for communications about music. PMID:27881967

Diagnostics of and Specific Hyposensitization to Pollen Rhinopathy (Hay Fever),

DTIC Science & Technology

Patients (120 in all) were studied for precise diagnosis of pollen rhinopathy. Among them aggravated allergic heredity was revealed in 63% of cases; a positive allergological anamnesis was noted in 55% of cases.

Transforming Public Education: Cases in Education Entrepreneurship. Instructor's Guide

ERIC Educational Resources Information Center

Childress, Stacey M., Ed.

2010-01-01

This instructor's guide is intended for use with "Transforming Public Education: Cases in Education Entrepreneurship." This volume includes a teaching note for each case in the student edition; the note provides basic guidance in how to initaite and organize the flow of the case discussion as well as how the case links to others before…

An Evaluation of Gender Differences in Computer-Based Case Simulations.

ERIC Educational Resources Information Center

Scheuneman, Janice Dowd; And Others

As part of the research leading to the implementation of computer-based case simulations (CCS) for the licensing examinations of the National Board of Medical Examiners, gender differences in performance were studied for one form consisting of 18 cases. A secondary purpose of the study was to note differences in style or approach that might…

Motor carrier case study evaluation report : appendix C, Vol. 2 : case study field notes, the Crescent Evaluation

DOT National Transportation Integrated Search

1994-02-01

The Crescent Project element of the HELP Program is a bi-national multi-jurisdictional : cooperative research and demonstration initiative involving the public and private sectors in an : application of advanced technologies for the creation of an in...

Teaming and Teaching in ECE: Neoliberal Reforms, Teacher Metaphors, and Identity in Head Start

ERIC Educational Resources Information Center

Bullough, Robert V., Jr.

2015-01-01

Noting that surprisingly little researcher attention has been directed toward teaming in early childhood education (ECE), the author conducted parallel case studies of two Head Start teacher teams in a single center. Drawing on interviews, extensive observational notes taken over the course of a school year, and teacher-generated metaphors, the…

Case Study of a Coffee War: Using the "Starbucks v. Charbucks" Dispute to Teach Trademark Dilution, Business Ethics, and the Strategic Value of Legal Acumen

ERIC Educational Resources Information Center

Melvin, Sean P.

2012-01-01

A Harvard Business School-style teaching case can be a powerful pedagogical tool to teach law and ethics to business students because instructors can combine a traditional business case study with Socratic-style dialogue and legal analysis from a managerial perspective. This teaching note includes suggestions for several methods of using the case,…

Remarks about the prognosis in case of antenatal diagnosis of gastroschisis.

PubMed

Poulain, P; Milon, J; Frémont, B; Proudhon, J F; Odent, S; Babut, J M; Le Marec, B; Grall, J Y; Giraud, J R

1994-05-18

We report our experience of 15 cases of gastroschisis which occurred between 1981 and 1993. All but one were diagnosed antenatally by ultrasound between 16 and 32 weeks of pregnancy. We made a termination of the pregnancy in 3 cases, for multiple malformations in 2 cases and one case of very early premature rupture of the membranes (PROM). When checked (11 cases), the karyotype was normal. We made a cesarean section in 11 cases: the indication was a complication for 6 (fetal distress, PROM, polyhydramnios, large dilatation of the gut). We noted growth retardation in 7 newborns and prematurity in 5/12 (mean gestational age of 36.8 weeks). The preoperative study of the gut noted 5 cases with intestinal damage and one case of complete necrosis of the gut. The global prognosis is not as good as usual, with a perinatal mortality of 41.6% (5/12). We discuss this latter point and examine the literature.

Project Career: A qualitative examination of five college students with traumatic brain injuries.

PubMed

Nardone, Amanda; Sampson, Elaine; Stauffer, Callista; Leopold, Anne; Jacobs, Karen; Hendricks, Deborah J; Elias, Eileen; Chen, Hui; Rumrill, Phillip

2015-01-01

Project Career is an interprofessional five-year development project designed to improve the employment success of undergraduate college and university students with traumatic brain injury (TBI). The case study information was collected and synthesized by the project's Technology and Employment Coordinators (TECs) at each of the project's three university sites. The project's evaluation is occurring independently through JBS International, Inc. Five case studies are presented to provide an understanding of student participants' experiences within Project Career. Each case study includes background on the student, engagement with technology, vocational supports, and interactions with his/her respective TEC. A qualitative analysis from the student's case notes is provided within each case study, along with a discussion of the overall qualitative analysis. Across all five students, the theme Positive Outcomes was mentioned most often in the case notes. Of all the different type of challenges, Cognitive Challenges were most often mentioned during meetings with the TECs, followed by Psychological Challenges, Physical Challenges, Other Challenges, and Academic Challenges, respectively. Project Career is providing academic enrichment and career enhancement that may substantially improve the unsatisfactory employment outcomes that presently await students with TBI following graduation.

A retrospective study of 100 cases of feline distal aortic thromboembolism: 1977-1993.

PubMed

Laste, N J; Harpster, N K

1995-01-01

The medical records of 100 cats with distal aortic thromboembolism were reviewed. The average age was 7.7 years, with the neutered male being the most common signalment (63%). Evidence of preexisting cardiac disease was noted in 11% of the cases. A murmur or arrhythmia was noted in 57% of the cases on presentation. Frequent laboratory abnormalities included elevations in blood glucose, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, and creatinine. Radiographic and electrocardiographic abnormalities were common (89% and 85%, respectively). The most frequent, underlying disease was hypertrophic feline cardiomyopathy (58%), with the left atrial size (as measured by M-mode) significantly increased in the majority of cases (mean left atrial-to-aortic ratio, 2.08). The average, long-term survival in the 37% of cases which survived the initial thromboembolic episode was 11.5 months. The remaining cases either died (28%) or were euthanized (35%).

Genital streptococcal infection in non-pregnant women: a case-note review.

PubMed

Sonnex, C

2013-06-01

The purpose of this case-note review was to examine the clinical features and management of women with either vulval or vaginal swabs culturing positive for streptococci. Group B haemolytic streptococcus was isolated in all cases. The majority of women with vulval streptococci presented with irritation or soreness. Candidal infection was found in 43% and a dermatosis in 27%. All women with positive vaginal culture had vaginal soreness and/or discharge. Candida was isolated in 27% and there were features of desquamative vaginitis in 20%. Women treated with erythromycin failed to improve symptomatically. The findings of this study suggest that streptococci mostly play a secondary role and colonize an already damaged genital epithelium.

The Zoom Lens: A Case Study in Geometrical Optics.

ERIC Educational Resources Information Center

Cheville, Alan; Scepanovic, Misa

2002-01-01

Introduces a case study on a motion picture company considering the purchase of a newly developed zoom lens in which students act as the engineers designing the zoom lens based on the criteria of company's specifications. Focuses on geometrical optics. Includes teaching notes and classroom management strategies. (YDS)

Successful AP Music Theory Instruction: A Case Study

ERIC Educational Resources Information Center

Buonviri, Nathan O.

2018-01-01

The purpose of this case study was to examine the instructional approach of a highly successful Advanced Placement Music Theory teacher. I visited the participant's class twice a week for 14 weeks, taking field notes, conducting interviews, and collecting instructional artifacts. Analysis of qualitative data revealed three main themes: classroom…

High and Low Visualization Skills and Pedagogical Decision of Preservice Secondary Mathematics Teachers

ERIC Educational Resources Information Center

Unal, Hasan

2011-01-01

The purpose of this study was to investigate the preservice secondary mathematics teachers' development of pedagogical understanding in the teaching of modular arithmetic problems. Data sources included, written assignments, interview transcripts and filed notes. Using case study and action research approaches cases of three preservice teachers…

Professional Identity of an Early Childhood Black Teacher in a Predominantly White School: A Case Study

ERIC Educational Resources Information Center

Al-Khatib, Amal J.; Lash, Martha J.

2017-01-01

This qualitative case study investigated the role of race, school context, and personal and professional experiences in the formation of an early childhood minority teacher's professional identity. Data sources included interviews, observations, conversations, field notes and school artefacts. Member checking, triangulation and extended…

Teaching Deanna to Read: A Case Study.

ERIC Educational Resources Information Center

Tiwald, Jeanette M.

1995-01-01

Describes a Reading Recovery case study involving a first-grade student who was at risk for learning how to read and write. Notes that this student learned to read strategically and was accelerated to the average band in her classroom after 81 Reading Recovery lessons, without first knowing the alphabet. (SR)

Unexpected deaths in cardiology outpatients - what can we learn from case review?

PubMed

Kitz, Thomas Michael; Burnand, Nikki; Ortner, Astrid; Rudd, Ian G; Sampson, Rod; Rushworth, Gordon F; Leslie, Stephen James

2016-12-01

A proportion of cardiac patients managed at a cardiology outpatient clinic will die between clinic visits. This study aimed to identify the cause of death, to determine if case review occurred and if a formal review of such cases might be useful. Single-centre retrospective cohort study. A remote regional centre in the North of Scotland. All patients who had been removed from the cardiology outpatient clinic due to death in the community. Cause of death, comorbidities and treatments were collected from hospital records and the national register of deaths. Chi-squared test and Student's t -test were used with significance taken at the 5% level. Of 10,606 patients who attended the cardiology outpatient clinic, 75 (0.7%) patients died in the community. The majority (57.0%) died from a non-cardiac cause. Eleven patients (14.9%) died due to an unexpected cardiac death. A detailed case note review was undertaken. In only two (18.2%) cases was any note made as to the cause of death in the hospital records and in only one was there details of post mortem discussion between primary and secondary care. A small proportion of patients attending a cardiology outpatient clinic died in the community. Documentation of the death in the hospital notes was very poor and evidence of post mortem communication between primary and secondary care was absent in all but one case. Better documentation and communication between primary and secondary care would seem desirable.

Passive Endwall Treatments for Enhancing Stability

NASA Technical Reports Server (NTRS)

Hathaway, Michael D.

2007-01-01

These lecture notes were presented at the von Karman Institutes lecture series on Advances in Axial Compressor Aerodynamics, May 2006. They provide a fairly extensive overview of what's been learned from numerous investigations of various passive casing endwall technologies that have been proposed for alleviating the stall limiting physics associated with the compressor endwall flow field. The lecture notes are organized to give an appreciation for the inventiveness and understanding of the earliest compressor technologists and to provide a coherent thread of understanding that has arisen out of the early investigations. As such the lecture notes begin with a historical overview of casing treatments from their infancy through the earliest proposed concepts involving blowing, suction and flow recirculation. A summary of lessons learned from these early investigations is provided at the end of this section. The lecture notes then provide a somewhat more in-depth overview of recent advancements in the development of passive casing treatments from the late 1990's through 2006, including advancements in understanding the flow mechanism of circumferential groove casing treatments, and the development of discrete tip injection and self-recirculating casing treatments. At the conclusion of the lecture notes a final summary of lessons learned throughout the history of the development of passive casing treatments is provided. Finally, a list of future needs is given. It is hoped that these lecture notes will be a useful reference for future research endeavors to improve our understanding of the fluid physics of passive casing treatments and how they act to enhance compressor stability, and that they will perhaps provide a springboard for future research activities in this area of interest

A comparative study of primary and secondary stereotypies.

PubMed

Ghosh, Debabrata; Rajan, Prashant V; Erenberg, Gerald

2013-12-01

This study compares primary stereotypies (repetitive, self-stimulating, and seemingly nonsensical movements that can occur within typically developing children) and secondary stereotypies (those occurring within autistic or mentally retarded children). Utilizing a retrospective chart review from 1995 to 2010, the current study compares primary and secondary stereotypies by the application of a classification system that organizes the movement by its type (motor only, phonic only, mixed) and complexity. In addition, it investigates other parameters associated with the movements such as duration, frequency, age, functional impairment, and progression. The sample group consisted of 28 primary and 28 secondary cases. Primary stereotypies were predominantly motor, simple, of shorter duration, and of less frequency, whereas secondary stereotypies had more vocalization, complexity, longer durations, and higher frequencies. Moreover, functional impairment due to stereotypies was noted in 3 primary and 7 secondary cases, and worsening of stereotypies was noted in 70% of primary versus 44% of secondary cases.

Fluorescence of fungi in superficial and deep fungal infections

PubMed Central

Elston, Dirk M

2001-01-01

Background Fluorescence of many fungi is noted when H&E stained sections are examined under a fluorescent microscope. In theory, this phenomenon could aid in the diagnosis of cutaneous and disseminated fungal infections without the delay associated with special stains. Seventy-six cases of superficial and deep fungal infections and 3 cases of protothecosis were studied to determine the clinical usefulness of this technique. Results In most cases, fluorescence was noted, but was not intense. Fluorescence of fungi did not correlate with the age of the specimen. In most cases, organisms in H&E stained sections were more easily identified with routine light microscopy than with fluorescent microscopy. Conclusion This report suggests that in H&E stained skin specimens, fluorescent microscopy is of little benefit in the identification of fungal organisms. PMID:11602016

Big Missiles and Big Decks: The Viability of Aircraft Carriers in an A2/AD World

DTIC Science & Technology

2016-06-01

RESEARCH DESIGN This thesis centers on a historical case study of two periods in which the United States and its carrier fleet faced some degree...19 3. Lessons Learned ...........................................................................21 C. APPLICABILITY OF CASE STUDIES ...employed the strategic concepts behind A2/AD since the Persian War of 480 BC. In his analysis of several historic case studies , Tangredi notes that a

Simple interventions can greatly improve clinical documentation: a quality improvement project of record keeping on the surgical wards at a district general hospital.

PubMed

Glen, Peter; Earl, Naomi; Gooding, Felix; Lucas, Emily; Sangha, Nicole; Ramcharitar, Steve

2015-01-01

Clinical documentation is an integral part of the healthcare professional's job. Good record keeping is essential for patient care, accurate recording of consultations and for effective communication within the multidisciplinary team. Within the surgical department at the Great Western Hospital, Swindon, the case notes were deemed to be bulky and cumbersome, inhibiting effective record keeping, potentially putting patients' at risk. The aim of this quality improvement project was therefore to improve the standard of documentation, the labelling of notes and the overall filing. A baseline audit was firstly undertaken assessing the notes within the busiest surgical ward. A number of variables were assessed, but notably, only 12% (4/33) of the case notes were found to be without loose pages. Furthermore, less than half of the pages with entries written within the last 72 hours contained adequate patient identifiers on them. When assessing these entries further, the designation of the writer was only recorded in one third (11/33) of the cases, whilst the printed name of the writer was only recorded in 65% (21/33) of the entries. This project ran over a 10 month period, using a plan, do study, act methodology. Initial focus was on simple education. Afterwards, single admission folders were introduced, to contain only information required for that admission, in an attempt to streamline the notes and ease the filing. This saw a global improvement across all data subsets, with a sustained improvement of over 80% compliance seen. An educational poster was also created and displayed in clinical areas, to remind users to label their notes with patient identifying stickers. This saw a 4-fold increase (16%-68%) in the labelling of notes. In conclusion, simple, cost effective measures in streamlining medical notes, improves the quality of documentation, facilitates the filing and ultimately improves patient care.

Something's Fishy in Paxton Lake: A Case on Speciation in Sticklebacks.

ERIC Educational Resources Information Center

Sharp, Joan

2002-01-01

Introduces a case study on speciation and evolutionary mechanisms. Teaches science process skills as well as natural selection, biological species concepts, basic genetic terminology, and classification. Includes teaching notes and classroom management strategies. (Contains 14 references.) (YDS)

Helping Crisis Managers Protect Reputational Assets: Initial Tests of the Situational Crisis Communication Theory.

ERIC Educational Resources Information Center

Coombs, W. Timothy; Holladay, Sherry J.

2002-01-01

Explains a comprehensive, prescriptive, situational approach for responding to crises and protecting organizational reputation: the situational crisis communication theory (SCCT). Notes undergraduate students read two crisis case studies from a set of 13 cases and responded to questions following the case. Validates a key assumption in SCCT and…

Monozygotic Twin Pregnancy Associated with In Vitro Fertilization: Report and Revision of Three Cases Presented in a Clinic at 10,925 Feet Above Sea Level.

PubMed

Tominaga, Luis Vargas; Cáceres, Ricardo Pella; Lechuga, Alberto Vargas; Durán, Livia Bartolo; Vargas, Mariela Serrano

2015-08-01

3 cases of monozygotic twin pregnancies associated with IVF presented at Centro de Fertilidad y Ginecología del Sur. In this study, we describe the cases and review the literature, noting possible related factors.

Models of Shelter Management Training and Delivery Systems.

DTIC Science & Technology

1980-05-31

case study can be pre- sented orally, in writing, through a dramatization, or on film. Advantages: the case can be designed to focus on a problem or...develop a good, complex case study ; it may not be possible to use a case with more than one group (Ax & Kohls, 1977; Bauman, 1977; U.S. Civil Service...Although public information on self-protection continued to be distributed, the shelter program remained incomplete (e.g., an AIR study in 1966 noted that

PLESA: Program for Persons of Limited English-Speaking Ability. Ten Case Studies.

ERIC Educational Resources Information Center

Reynolds, Jack; And Others

These ten case studies of the Program for Persons of Limited English-Speaking Ability (PLESA) report different approaches to providing training and employment assistance to unemployed persons of limited English-speaking ability. (A summary report of forty-seven projects is available separately. See Note.) The first four describe projects conducted…

Migration and Multilingualism in Western Europe: A Case Study of the Netherlands.

ERIC Educational Resources Information Center

Extra, Guus; Vallen, Ton

1997-01-01

Reviews demographic and linguistic consequences of recent processes of migration and minority group influx in Western Europe and describes the case of the Netherlands to illustrate these effects. Highlights first- and second-language studies of immigrant and ethnic minority groups and notes resulting major demographic trends in Dutch society and…

A Case Study of Middle Grades Leadership in a Conversion Charter School

ERIC Educational Resources Information Center

Bickmore, Dana L.; Dowell, Margaret-Mary Sulentic

2015-01-01

This 3-year case study examined middle grades principal leadership in a takeover charter school. The researcher analyzed principal and teacher interviews, field notes, and documents in relationship to a middle grades model of principal leadership. Results suggest the principals' limited experience, organizational factors unique to takeover charter…

Online Collaborative Learning in a Project-Based Learning Environment in Taiwan: A Case Study on Undergraduate Students' Perspectives

ERIC Educational Resources Information Center

Zhang, Ke; Peng, Shiang Wuu; Hung, Jui-long

2009-01-01

This case study investigated undergraduate students' first experience in online collaborative learning in a project-based learning (PBL) environment in Taiwan. Data were collected through interviews of 48 students, instructor's field notes, researchers' online observations, students' online discourse, and group artifacts. The findings revealed…

Cultivating Leadership for School and Community Change: A Case Study of Theory, Research and Practice

ERIC Educational Resources Information Center

Garcia, Samuel, Jr.

2017-01-01

Researchers have noted that effective school leadership is essential to ensuring positive student and school outcomes. To achieve these outcomes, university preparation programs must adequately train and develop aspiring school leaders with the knowledge, skills, and capacity needed to be effective leaders. This qualitative case study examines a…

PubMed

Ridha, Fatnassi; Houssem, Ragmoun; Latifa, Marzougui; Ines, Mkhinini; Sabra, Hammami

2017-01-01

The delivery of a macrosomic infant is a relatively common situation. It can put mother and fetus at high risk. The main maternal complications are the increase in cesarean rates, postpartum hemorrhage and cervicovaginal traumatic lacerations. The main fetal complication is shoulder dystocia increasing the risk of brachial plexus. The objective was to identify risk factors and maternal-fetal complications associated with fetal macrosomia. Comparative retrospective study conducted at Kairouan University Hospital maternity unit in 2010. We compared a group of 820 cases of macrosomic infants to a control group of 800 cases of infants born in the same period of time. During the study period we collected clinical data of 820 macrosomic cases on a total of 7.495 deliveries, corresponding to a total incidence of 10.94%. Several factors predisposing to fetal macrosomia were highlighted: Maternal age> 35 years was present in 28.5% of cases; Maternal obesity was found in 45% of cases; A personal history of macrosomia was noted in 28,8% of cases; Prolonged pregnancies > 41 weeks of amenorrhoea was noted in 35.6% of cases; Multiparity was found in 47% of cases. Maternal complications were essentially postpartum hemorrhage: 71 cases and genital traumas: 24 cases. Perinatal complications were dominated by shoulder dystocia: 27 cases (3.3%). Traumatic postpartum complications were found in 11.6%.

Case Report Form Reporter: A Key Component for the Integration of Electronic Medical Records and the Electronic Data Capture System.

PubMed

Matsumura, Yasushi; Hattori, Atsushi; Manabe, Shiro; Takahashi, Daiyo; Yamamoto, Yuichiro; Murata, Taizo; Nakagawa, Akito; Mihara, Naoki; Takeda, Toshihiro

2017-01-01

To improve the efficiency of clinical research, we developed a system to integrate electronic medical records (EMRs) and the electronic data capture system (EDC). EDC is divided into case report form (CRF) reporter and CDMS with CRF receiver with data communication using the operational data model (ODM). The CRF reporter is incorporated into the EMR to share data witth the EMR. In the data transcription type, doctors enter data using a progress note template, which are transmitted to the reporter template. It then generates the ODM. In the direct record type, reporter templates open from the progress note and generate narrative text to make record in the progress note. The configuration files for a study are delivered from the contents server to minimize the setup. This system has been used for 15 clinical studies including 3 clinical trials. This system can save labor and financial costs in clinical research.

Note Taking on Trial: A Legal Application of Note-Taking Research

ERIC Educational Resources Information Center

Kiewra, Kenneth A.

2016-01-01

This article is about note taking, but it is not an exhaustive review of note-taking literature. Instead, it portrays the application of note-taking research to an unusual and important area of practice--the law. I was hired to serve as an expert witness on note taking in a legal case that hinged, in part, on the completeness and accuracy of…

Unilateral Congenital Cataract: Clinical Profile and Presentation.

PubMed

Khokhar, Sudarshan; Jose, Cijin P; Sihota, Ramanjit; Midha, Neha

2018-03-01

To study the clinical profile and presentation of children with unilateral cataract. In this hospital-based, observational, cross-sectional study, patients 15 years of age or younger who presented with unilateral cataract were recruited. Cases of cataract secondary to causes such as trauma or uveitis were excluded. Age at detection and presentation, distance from the treatment center, presenting complaints, cataract morphology, and biometry were noted for each case. A total of 76 patients were recruited. Most patients presented with complaints of leukocoria. Persistent fetal vasculature accounted for 27.6% of cases and was the most common identifiable cause of cataract in this study. Subsequently, patients were divided into two groups: no persistent fetal vasculature (control) and persistent fetal vasculature. A male predominance was noted in both groups. The mean age at detection was 27.58 ± 37.02 and 6.17 ± 8.42 months and the mean age at presentation was 55.613 ± 45.21 and 14.83 ± 17.75 months in the control and persistent fetal vasculature groups, respectively. In the persistent fetal vasculature group, a significant difference was noted in the axial length, keratometry, and corneal diameter between the affected and normal eyes (P = .027, .00176, and .0114, respectively). In the control group, this difference was observed only in keratometry readings (P = .0464). The mean distance traveled by patients to reach the treatment center was 211 km. Persistent fetal vasculature is an important and less identified cause of unilateral cataract. A significant delay is noted in the detection and presentation of unilateral cataract. [J Pediatr Ophthalmol Strabismus. 2018;55(2):107-112.]. Copyright 2017, SLACK Incorporated.

Laparoscopic Appendectomy in Children: Preliminary Study in Pediatric Hospital Albert Royer, Dakar

PubMed Central

Fall, Mbaye; Wellé, Ibrahima Bocar; Lo, Faty Balla; Sagna, Aloise; Diop, Marie; Fall, Ibrahima

2015-01-01

Appendiceal pathology's management has benefited in recent years from the advent of laparoscopic surgery. This study is to make a preliminary assessment of laparoscopic management of acute and complicated appendicitis in children after a few months of practice at the University Hospital Albert Royer, Dakar. This is a retrospective study of 22 cases of patients, all operated on by the same surgeon. The parameters studied were age, sex, clinical data and laboratory features, radiological data, and results of surgical treatment. The mean age of patients was 9.5 years with a male predominance. The series includes 14 cases of acute appendicitis and 8 complicated cases. Appendectomy anterograde is practiced in 81% of cases. Appendectomy was associated with peritoneal wash in 17 patients including 9 cases of acute appendicitis. Drainage of Douglas pouch is performed in 2 patients with complicated appendicitis; the average production was 300 cc of turbid liquids and any complications were not founded. An abscess of Douglas pouch is noted in 2 patients with complicated appendicitis undrained. These Douglas abscesses were treated medically. No conversion of laparotomy was performed in the series. After an average of 8 months no other problems were noted. PMID:26448743

Electroacupuncture for children with autism spectrum disorder: pilot study of 2 cases.

PubMed

Chen, Wen-Xiong; Wu-Li, Liu; Wong, Virginia C N

2008-10-01

The objective of this study was to observe for efficacy, safety, and compliance of electroacupuncture for autism spectrum disorder (ASD). Two (2) children with ASD received electroacupuncture for 24 sessions over 8 weeks and were assessed pre- and postacupuncture. We defined a positive or negative change as an improvement or deterioration of 25%, respectively, in total score or any subscales of Aberrant Behavioral Checklist (ABC), Ritvo-Freeman Real Life Scale (RFRLS), WeeFIM, and as a rating of much improved or much worse on the Clinical Global Impression-Improvement (CGI-I) scale. For ABC, positive changes in "Irritability" and "Stereotypy" was noted in case 1 but no changes occurred for case 2. For RFRLS, positive changes were found for both cases in "Sensory motor," "Sensory response," and "Total score," although negative change was noted for case 2 in "Affectual response." For WeeFIM, there were no positive or negative changes in both cases. For CGI-I, positive change in case 1 with much improved in "Social relatedness, Communication, and Stereotypy behavior" was reported. A short intensive course of electroacupuncture might improve some core features of children with ASD.

Suicide notes.

PubMed

O'Donnell, I; Farmer, R; Catalan, J

1993-07-01

Detailed case reports of incidents of suicide and attempted suicide on the London Underground railway system between 1985 and 1989 were examined for the presence of suicide notes. The incidence of note-leaving was 15%. Notes provided little insight into the causes of suicide as subjectively perceived, or strategies for suicide prevention.

Language and Content: The Case of Law.

ERIC Educational Resources Information Center

Beasley, Colin J.

A discussion of the teaching and learning of English for special purposes focuses on the interrelationship of content and language, particularly in the case of education for the legal professions. It is noted that law students must both study a large corpus of case and statute law and legal principles and learn the language of the law, with its…

Ethnic Identity Construction in the Schooling Context: A Case Study of a Tibetan Neidi Boarding School in China

ERIC Educational Resources Information Center

Zhiyong, Zhu

2007-01-01

This article reviews the studies concerning ethnic identity construction in the schooling context. Next, it outlines a conceptual framework about theories of ethnic identity. Finally, it demonstrates a case study of ethnic identity construction of Neidi Tibet School with data collection and analysis. (Contains 1 note, 2 tables, and 2 figures.)

Unethical Leadership in Higher Education and the Precarious Journey to Recovery: A Case Study of the Alabama Community College System

ERIC Educational Resources Information Center

Kelly, Donald L.

2009-01-01

Recent events of the Alabama Community College System are examined as an historical organizational case study. Critical events are noted along with associated professional literature related to those events and actions. While the study attempts to explain the organizational culture that allowed the rise of unethical leadership, the primary focus…

Automated identification of wound information in clinical notes of patients with heart diseases: Developing and validating a natural language processing application.

PubMed

Topaz, Maxim; Lai, Kenneth; Dowding, Dawn; Lei, Victor J; Zisberg, Anna; Bowles, Kathryn H; Zhou, Li

2016-12-01

Electronic health records are being increasingly used by nurses with up to 80% of the health data recorded as free text. However, only a few studies have developed nursing-relevant tools that help busy clinicians to identify information they need at the point of care. This study developed and validated one of the first automated natural language processing applications to extract wound information (wound type, pressure ulcer stage, wound size, anatomic location, and wound treatment) from free text clinical notes. First, two human annotators manually reviewed a purposeful training sample (n=360) and random test sample (n=1100) of clinical notes (including 50% discharge summaries and 50% outpatient notes), identified wound cases, and created a gold standard dataset. We then trained and tested our natural language processing system (known as MTERMS) to process the wound information. Finally, we assessed our automated approach by comparing system-generated findings against the gold standard. We also compared the prevalence of wound cases identified from free-text data with coded diagnoses in the structured data. The testing dataset included 101 notes (9.2%) with wound information. The overall system performance was good (F-measure is a compiled measure of system's accuracy=92.7%), with best results for wound treatment (F-measure=95.7%) and poorest results for wound size (F-measure=81.9%). Only 46.5% of wound notes had a structured code for a wound diagnosis. The natural language processing system achieved good performance on a subset of randomly selected discharge summaries and outpatient notes. In more than half of the wound notes, there were no coded wound diagnoses, which highlight the significance of using natural language processing to enrich clinical decision making. Our future steps will include expansion of the application's information coverage to other relevant wound factors and validation of the model with external data. Copyright © 2016 Elsevier Ltd. All rights reserved.

Airport noise and teratogenesis.

PubMed

Edmonds, L D; Layde, P M; Erickson, J D

1979-01-01

It has been suggested that exposures to high-noise levels near major airports may cause increased incidence of birth defects in the offspring of parents residing near these airports. Using data gathered in Metropolitan Atlanta during 1970 to 1972, we compared the rates of seventeen categories of defects in high- and low-noise census tracts. No significant differences were observed. However, when we subdivided the category of central nervous system defects into several subcategories of specific defects, we noted a significantly increased incidence of spina bifida without hydrocephalus in the high-noise areas. Because the small number of cases associated with this finding we did a matched case-control study using all cases of central nervous system defects born during the years 1968 to 1976. No significantly increased risk for residents in the high-noise areas was noted in this study. It is our opinion that noise or other factors associated with residence near airports are unlikely to be important environmental teratogens.

The ANKLe Score: An Audit of Otolaryngology Emergency Clinic Record Keeping

PubMed Central

Dexter, Sara C; Hayashi, Daichi; Tysome, James R

2008-01-01

INTRODUCTION Accurate and legible medical records are essential to good quality patient care. Guidelines from The Royal College of Surgeons of England (RCSE) state the content required to form a complete medical record, but do not address legibility. An audit of otolaryngology emergency clinic record keeping was performed using a new scoring system. PATIENTS AND METHODS The Adjusted Note Keeping and Legibility (ANKLe) score was developed as an objective and quantitative method to assess both the content and legibility of case notes, incorporating the RCSE guidelines. Twenty consecutive otolaryngology emergency clinic case notes from each of 7 senior house officers were audited against standards for legibility and content using the ANKLe score. A proforma was introduced to improve documentation and handwriting advice was given. A further set of 140 notes (20 notes for each of the 7 doctors) was audited in the same way to provide feedback. RESULTS The introduction of a proforma and advice on handwriting significantly increased the quality of case note entries in terms of content, legibility and overall ANKLe score. CONCLUSIONS Accurate note keeping can be improved by the use of a proforma. The legibility of handwriting can be improved using simple advice. The ANKLe score is an objective assessment tool of the overall quality of medical note documentation which can be adapted for use in other specialties. PMID:18430339

Employee Attitudes Regarding Electronic Mail Policies: A Case Study.

ERIC Educational Resources Information Center

Hacker, Kenneth L.; Goss, Blaine; Townley, Charles; Horton, Valerie J.

1998-01-01

Investigates attitudes toward e-mail and e-mail policies through a case study of e-mail users at a university library. Indicates those who use e-mail frequently have more favorable attitudes to it than less frequent users and are more opposed to policies regulating e-mail communication. Notes that employees prefer guidelines to restrictive…

Manifestations, Treatment Implications and Speech-Language Consideration in Gorlin Syndrome: A Case Study.

ERIC Educational Resources Information Center

Andrews, Alice E.; Stonestreet, Ruth H.

This paper presents a case study of Gorlin Syndrome, also known as Basal Cell Nevus Syndrome, a rare genetic disorder characterized by widespread developmental defects. Criteria for diagnosis are listed, noting the presence of frequent basal cell carcinomas at a relatively young age and multiple cysts of the jaw. Speech and/or language impairments…

Songs of Despair: A Case Study of Adolescent Suicide.

ERIC Educational Resources Information Center

Sapp, Allen D.

This report outlines the extent of the problem of adolescent suicide in the United States, noting that suicide is the third leading cause of death among adolescents in this country and that the rate of suicide by adolescents is expected to continue to increase in the future. It examines one adolescent suicide, using the case study method, to…

Minority Voices: A Case Study of Children and Parents in a Manchester Primary School

ERIC Educational Resources Information Center

Winterbottom, Christian; Leedy, Allyson K.

2014-01-01

Presently, there are a growing number of ethnic minority students in the primary schools in northwest England. Through sociocultural theory, this paper examines student and parent perspectives of their experiences in the schools. Using a qualitative methodology, including observation, in-depth interviews, and field notes this case study focused on…

Addressing the Teaching of English Language Learners in the United States: A Case Study of Teacher Educators' Response

ERIC Educational Resources Information Center

Hallman, Heidi L.; Meineke, Hannah R.

2016-01-01

This article discusses teacher educators' response to how teacher education programs should prepare prospective teachers to be teachers of English language learners. In the case study presented, the authors note that discussions have ensued about whether teaching English language learners (ELLs) should be addressed through separate coursework or…

Design Fixation and Cooperative Learning in Elementary Engineering Design Project: A Case Study

ERIC Educational Resources Information Center

Luo, Yi

2015-01-01

This paper presents a case study examining 3rd, 4th and 5th graders' design fixation and cooperative learning in an engineering design project. A mixed methods instrument, the Cooperative Learning Observation Protocol (CLOP), was adapted to record frequency and class observation on cooperative learning engagement through detailed field notes.…

Translanguaging Practices at a Bilingual University: A Case Study of a Science Classroom

ERIC Educational Resources Information Center

Mazak, Catherine M.; Herbas-Donoso, Claudia

2015-01-01

The objective of this ethnographic case study is to describe in detail one professor's translanguaging practices in an undergraduate science course at an officially bilingual university. The data-set is comprised of ethnographic field notes of 11 observed classes, audio recordings of those classes, an interview with the professor, and artifacts…

Analysis of Mission Effectiveness: Modern System Architecture Tools for Project Developers

DTIC Science & Technology

2017-12-01

operator input and scripted instructions to describe low-level flow. Note that the case study in Chapter IV describes one pass through evaluation...capability of the sensors. A constraint on the case study is that each sensor type must cover the entire operations area. Cost is a function of 53...completed. 5. Assessment This case study focuses on the first recursive refinement phase completed in a multi-phase effort to demonstrate the effects

Absent end diastolic flow of umbilical artery Doppler: pregnancy outcome in 62 cases.

PubMed

Poulain, P; Palaric, J C; Milon, J; Betremieux, P; Proudhon, J F; Signorelli, D; Grall, J Y; Giraud, J R

1994-02-01

We retrospectively studied the outcome of pregnancy in 62 cases of absent end diastolic flow (AEDF) of umbilical artery Doppler flow velocity waveform. The history of pregnancies revealed that nearly all were of high risk. Many cases presented cerebral (65%) or uterine (55.5%) Doppler flow abnormalities, or both (38%). We noted 10 fetal deaths and decided 7 pregnancy terminations. Malformation and chromosomal defect rate was 16%. We noted 44 (71%) live-births, a very high rate of cesarean section (86%), prematurity (75%), small for gestational age (39%). Forty-five percent of the neonates had a 1-min Apgar score under 7, which dropped to 27% at 5 min. Neonate mortality rate was 6.9% and the total mortality rate was 34% (21/62). Morbidity was significant (7 cases with severe morbidity, 2 cases with chromosomal abnormality of poor prognosis). We compared different sub-groups with a view to looking for some prenatal factors which predict poor neonatal outcome in case of AEDF.

Systematic review of discharge coding accuracy

PubMed Central

Burns, E.M.; Rigby, E.; Mamidanna, R.; Bottle, A.; Aylin, P.; Ziprin, P.; Faiz, O.D.

2012-01-01

Introduction Routinely collected data sets are increasingly used for research, financial reimbursement and health service planning. High quality data are necessary for reliable analysis. This study aims to assess the published accuracy of routinely collected data sets in Great Britain. Methods Systematic searches of the EMBASE, PUBMED, OVID and Cochrane databases were performed from 1989 to present using defined search terms. Included studies were those that compared routinely collected data sets with case or operative note review and those that compared routinely collected data with clinical registries. Results Thirty-two studies were included. Twenty-five studies compared routinely collected data with case or operation notes. Seven studies compared routinely collected data with clinical registries. The overall median accuracy (routinely collected data sets versus case notes) was 83.2% (IQR: 67.3–92.1%). The median diagnostic accuracy was 80.3% (IQR: 63.3–94.1%) with a median procedure accuracy of 84.2% (IQR: 68.7–88.7%). There was considerable variation in accuracy rates between studies (50.5–97.8%). Since the 2002 introduction of Payment by Results, accuracy has improved in some respects, for example primary diagnoses accuracy has improved from 73.8% (IQR: 59.3–92.1%) to 96.0% (IQR: 89.3–96.3), P= 0.020. Conclusion Accuracy rates are improving. Current levels of reported accuracy suggest that routinely collected data are sufficiently robust to support their use for research and managerial decision-making. PMID:21795302

Integration of Peer Philosophy into a Standardized Self-Management Mobile Health Intervention.

PubMed

Fortuna, Karen L; Storm, Marianne; Aschbrenner, Kelly A; Bartels, Stephen J

2018-04-19

Description of certified peer specialists integration of peer philosophy into the delivery of a self-management intervention enhanced with mobile health. Qualitative examination of peer case notes that were routinely entered on a peer care management electronic dashboard. This study included consumers with serious mental illness (N = 8) with a mean age of 68.8 years (SD = 4.9). Certified peer specialists (N = 3) were all female and aged 55 years or older. Peers entered 146 case notes on the peer care management notes dashboard. Five themes emerged including encouragement of self-determination, bio-psychosocial-spiritual framework guides practice, sharing lived experience to teach self-management skills, personalized text messages to reinforce self-management skill development, and identifying unmet needs and advocating for human rights. Peers unique perspectives and expertise was complemented with the standardized delivery of evidence-based intervention enhanced with mobile health.

Travel history key to picking up on signs of bubonic plague.

PubMed

2015-11-01

Health officials note an uptick in cases of bubonic plague in the United States this year, with at least 12 reported human cases reported since April 1. The CDC notes that healthcare providers should consider plague in patients who have traveled to plague-endemic areas and exhibit fever, headache, chills, weakness, and one or more swollen or tender and painful lymph nodes, referred to as buboes. Officials note that the disease rarely passes from person to person, but that this is a concern with patients who have developed the pneumonic form of the disease. Health officials note that in recent years there has been an average of seven cases of human plague each year in the United States, and that most of these cases are the bubonic form of the illness. Four patients confirmed to have plague this year have died, including the most recent case, a Utah man in his 70s. Most cases of plague in the United States occur in two regions. The first includes northern New Mexico, northern Arizona, and southern Colorado, and the second includes California, southern Oregon, and far western Nevada. When plague is suspected, treatment with antibiotics should begin immediately.

Is daily shaving of axillary and pubic hair a feature of suicide in the Muslim community?

PubMed

Demirci, Serafettin; Dogan, Kamil Hakan; Erkol, Zerrin; Deniz, Idris

2008-12-01

In the Islamic context, "fitrah" refers to humanity's innate disposition toward virtue and the ability to differentiate between right and wrong. A common quote regarding fitrah, from the Prophet is "The fitrah consists of 5 things: circumcision, trimming the moustache, cutting the nails, plucking the armpit hairs, and shaving the pubic hairs."In this study, our aim was to determine the status of axillary and pubic shaving in medicolegal death cases that took place in the Konya Province of Turkey and to evaluate the relationship with the origin of suicide. Of 2850 medicolegal death cases, 206 (7.2%) were of suicidal origin. It was observed that the average age in the cases of suicidal origin was 36.76 +/- 17.72 years, and 146 of 206 cases (70.9%) were men. As a method of suicide, hanging was the chosen method in 100 cases (48.5%), whereas firearm injuries occurred in 54 cases (26.2%), and intoxication was involved in 37 cases (18.0%). Daily axillary and pubic shaving was observed in 26 of 2644 (1.0%) death cases that occurred with nonsuicidal reasons, but in 65 of 206 were (31.6%) suicidal cases. Because suicidal notes were present in 25 (12.1%) of all of the suicidal cases, the ratio of daily axillary and pubic shaving was significantly higher than that of the suicidal notes.In investigating the cases of suicidal origin for medicolegal purposes, evidence showing that this action was committed by the victim, the presence of a suicide note at the death scene and, a history of a previous suicidal attempt, it was thought that the presence of daily axillary and pubic shaving on external examination of the victim's body, when of Muslim faith, could also be considered a feature of suicide.

Impact of a Paper vs Virtual Simulated Patient Case on Student-Perceived Confidence and Engagement

PubMed Central

Gallimore, Casey E.; Pitterle, Michael; Morrill, Josh

2016-01-01

Objective. To evaluate online case simulation vs a paper case on student confidence and engagement. Design. Students enrolled in a pharmacotherapy laboratory course completed a patient case scenario as a component of an osteoarthritis laboratory module. Two laboratory sections used a paper case (n=53); three sections used an online virtual case simulation (n=81). Student module performance was assessed through a submitted subjective objective assessment plan (SOAP) note. Students completed pre/post surveys to measure self-perceived confidence in providing medication management. The simulation group completed postmodule questions related to realism and engagement of the online virtual case simulation. Group assessments were performed using chi-square and Mann Whitney tests. Assessment. A significant increase in all 13 confidence items was seen in both student groups following completion of the laboratory module. The simulation group had an increased change of confidence compared to the paper group in assessing medication efficacy and documenting a thorough assessment. Comparing the online virtual simulation to a paper case, students agreed the learning experience increased interest, enjoyment, relevance, and realism. The simulation group performed better on the subjective SOAP note domain though no differences in total SOAP note scores was found between the two groups. Conclusion. Virtual case simulations result in increased student engagement and may lead to improved documentation performance in the subjective domain of SOAP notes. However, virtual patient cases may offer limited benefit over paper cases in improving overall student self-confidence to provide medication management. PMID:26941442

Impact of a Paper vs Virtual Simulated Patient Case on Student-Perceived Confidence and Engagement.

PubMed

Barnett, Susanne G; Gallimore, Casey E; Pitterle, Michael; Morrill, Josh

2016-02-25

To evaluate online case simulation vs a paper case on student confidence and engagement. Students enrolled in a pharmacotherapy laboratory course completed a patient case scenario as a component of an osteoarthritis laboratory module. Two laboratory sections used a paper case (n=53); three sections used an online virtual case simulation (n=81). Student module performance was assessed through a submitted subjective objective assessment plan (SOAP) note. Students completed pre/post surveys to measure self-perceived confidence in providing medication management. The simulation group completed postmodule questions related to realism and engagement of the online virtual case simulation. Group assessments were performed using chi-square and Mann Whitney tests. A significant increase in all 13 confidence items was seen in both student groups following completion of the laboratory module. The simulation group had an increased change of confidence compared to the paper group in assessing medication efficacy and documenting a thorough assessment. Comparing the online virtual simulation to a paper case, students agreed the learning experience increased interest, enjoyment, relevance, and realism. The simulation group performed better on the subjective SOAP note domain though no differences in total SOAP note scores was found between the two groups. Virtual case simulations result in increased student engagement and may lead to improved documentation performance in the subjective domain of SOAP notes. However, virtual patient cases may offer limited benefit over paper cases in improving overall student self-confidence to provide medication management.

Evaluation of a novel very high sun-protection-factor moisturizer in adults with rosacea-prone sensitive skin.

PubMed

Grivet-Seyve, Mathieu; Santoro, Francine; Lachmann, Nadège

2017-01-01

Rosacea-prone sensitive skin requires high sun-protection factor (SPF) moisturizers. This study evaluated Daylong Extreme SPF 50+ lotion, a novel cream containing five ultraviolet filters, two emollients, and three skin conditioners. This was an open-label, single-center study. On day 1, before treatment, subjects answered a questionnaire on their skin conditions and sunscreen habits, and both subjects and dermatologist evaluated skin status. Subjects applied the product once daily in the morning to the face for 21 days, and after approximately 3-5 minutes they assessed tolerability and short-term cosmetic acceptability in a questionnaire and daily diary. On day 22, the dermatologist and subjects evaluated skin status for long-term tolerance and cosmetic acceptability. The study enrolled 44 individuals (mean age 58.8 years, 91% female). At baseline, most subjects (39 of 44) showed erythema, and ~30% showed dryness and scaling. Dermatologists noted four cases of pustules and one case of papules. After 21 days' treatment with the product, the dermatologist reported significantly less erythema, dryness and scaling, three cases of pustules and two cases of papules. At baseline, ~75% of subjects noted a feeling of dryness, >50% reported tension, and nearly 25% reported tickling. After using the product for 21 days, subjects reported significantly less tension, dryness, and tickling. Some subjects noted itching and burning before and after using the product. One subject noted papules during treatment. Most subjects said that the product was pleasant, did not irritate the skin or cause stinging/burning, was easy to apply, quickly absorbed, and nongreasy, improved skin moisturization, helped prevent sun-provoked facial redness, did not worsen rosacea, and was easily incorporated into their skincare regimen. Half would switch to the product, and 80% of subjects would buy and recommend the product. The product was well tolerated in rosacea-prone subjects, producing objective and subjective improvements in skin status and symptoms.

Evaluation of a novel very high sun-protection-factor moisturizer in adults with rosacea-prone sensitive skin

PubMed Central

Grivet-Seyve, Mathieu; Santoro, Francine; Lachmann, Nadège

2017-01-01

Background/objective Rosacea-prone sensitive skin requires high sun-protection factor (SPF) moisturizers. This study evaluated Daylong Extreme SPF 50+ lotion, a novel cream containing five ultraviolet filters, two emollients, and three skin conditioners. Subjects and methods This was an open-label, single-center study. On day 1, before treatment, subjects answered a questionnaire on their skin conditions and sunscreen habits, and both subjects and dermatologist evaluated skin status. Subjects applied the product once daily in the morning to the face for 21 days, and after approximately 3–5 minutes they assessed tolerability and short-term cosmetic acceptability in a questionnaire and daily diary. On day 22, the dermatologist and subjects evaluated skin status for long-term tolerance and cosmetic acceptability. Results The study enrolled 44 individuals (mean age 58.8 years, 91% female). At baseline, most subjects (39 of 44) showed erythema, and ~30% showed dryness and scaling. Dermatologists noted four cases of pustules and one case of papules. After 21 days’ treatment with the product, the dermatologist reported significantly less erythema, dryness and scaling, three cases of pustules and two cases of papules. At baseline, ~75% of subjects noted a feeling of dryness, >50% reported tension, and nearly 25% reported tickling. After using the product for 21 days, subjects reported significantly less tension, dryness, and tickling. Some subjects noted itching and burning before and after using the product. One subject noted papules during treatment. Most subjects said that the product was pleasant, did not irritate the skin or cause stinging/burning, was easy to apply, quickly absorbed, and nongreasy, improved skin moisturization, helped prevent sun-provoked facial redness, did not worsen rosacea, and was easily incorporated into their skincare regimen. Half would switch to the product, and 80% of subjects would buy and recommend the product. Conclusion The product was well tolerated in rosacea-prone subjects, producing objective and subjective improvements in skin status and symptoms. PMID:28652793

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history.

PubMed

Rockett, Ian R H; Caine, Eric D; Connery, Hilary S; D'Onofrio, Gail; Gunnell, David J; Miller, Ted R; Nolte, Kurt B; Kaplan, Mark S; Kapusta, Nestor D; Lilly, Christa L; Nelson, Lewis S; Putnam, Sandra L; Stack, Steven; Värnik, Peeter; Webster, Lynn R; Jia, Haomiao

2018-01-01

A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation-the other two major, but overtly violent methods. This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011-2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43-49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11-44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11-2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10-1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06-66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19-3.18) and depression (OR, 1.48; 95% CI, 1.17-1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths.

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history

PubMed Central

Caine, Eric D.; Connery, Hilary S.; D’Onofrio, Gail; Gunnell, David J.; Miller, Ted R.; Nolte, Kurt B.; Kaplan, Mark S.; Kapusta, Nestor D.; Lilly, Christa L.; Nelson, Lewis S.; Putnam, Sandra L.; Stack, Steven; Värnik, Peeter; Webster, Lynn R.; Jia, Haomiao

2018-01-01

Objective A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods. Methods This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011–2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. Results A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43–49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11–44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11–2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10–1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06–66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19–3.18) and depression (OR, 1.48; 95% CI, 1.17–1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. Conclusions Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths. PMID:29320540

76 FR 18145 - Privacy Act of 1974; New System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... to include final determinations; billing information to include payment delinquencies; case notes... delinquencies; and case notes. Information collected includes the individual's name, address, telephone number... outside USDA, and so have some impact on privacy of individuals, they are either necessary for carrying...

Psychiatric comorbidity may not predict suicide during and after hospitalization. A nested case-control study with blinded raters.

PubMed

Walby, Fredrik A; Odegaard, Erik; Mehlum, Lars

2006-06-01

To investigate the differential impact of DSM-IV axis-I and axis-II disorders on completed suicide and to study if psychiatric comorbidity increases the risk of suicide in currently and previously hospitalized psychiatric patients. A nested case-control design based on case notes from 136 suicides and 166 matched controls. All cases and controls were rediagnosed using the SCID-CV for axis-I and the DSM-IV criteria for axis-II disorders and the inter-rater reliability was satisfactory. Raters were blind to the case and control status and the original hospital diagnoses. Depressive disorders and bipolar disorders were associated with an increased risk of suicide. No such effect was found for comorbidity between axis-I disorders and for comorbidity between axis-I and axis-II disorders. Psychiatric diagnoses, although made using a structured and criteria-based approach, was based on information recorded in case notes. Axis-II comorbidity could only be investigated at an aggregated level. Psychiatric comorbidity did not predict suicide in this sample. Mood disorders did, however, increase the risk significantly independent of history of previous suicide attempts. Both findings can inform identification and treatment of patients at high risk for completed suicide.

Inactivation of Smad4 in gastric carcinomas.

PubMed

Powell, S M; Harper, J C; Hamilton, S R; Robinson, C R; Cummings, O W

1997-10-01

Allelic loss of chromosome 18q has been noted in intestinal type gastric adenocarcinomas. Smad4 is a gene located at 18q that was recently cloned in humans and found to be significantly altered in pancreatic cancers. We sought to determine whether Smad4 genetic alterations played a significant role in gastric tumorigenesis by studying 35 gastric adenocarcinomas of all histopathological types and pathological stages. Microdissected specimens were used for mutational analysis of Smad4 at the nucleotide level, including the entire coding region and intron/exon boundaries. Allelic imbalance was also analyzed at the Smad4 locus using two nearby microsatellite markers. One case of apparent biallelic inactivation of Smad4 was found in our study of 35 gastric carcinomas. A nonsense point mutation at codon 334 was demonstrated, which, similar to other Smad4 mutations, is predicted to truncate the conserved COOH-terminal domain of this protein. This Smad4 C to T transition mutation was proven to be somatically acquired. Allelic loss was also noted on chromosome 18q at a marker near Smad4 in this mutated gastric cancer, apparently producing complete inactivation of Smad4 in this tumor. Significant 18q allelic loss (56% of 34 informative cases) was noted in our gastric carcinomas using microsatellite markers near the Smad4 locus, regardless of histological subtype or pathological stage. Additionally, three cases of microsatellite instability were observed. Thus, Smad4 inactivation was noted in our gastric carcinomas; however, this event was rare. The frequent loss of chromosomal arm 18q observed in gastric cancers suggests the presence of other tumor suppressor genes in this region that are involved in gastric tumorigenesis. Further studies are needed to identify these other targets of inactivation during gastric cancer development.

Autism in a Child with Congenital Cytomegalovirus Infection.

ERIC Educational Resources Information Center

Markowitz, Phillip I.

1983-01-01

A case study is described in which early infantile autism was diagnosed in a child with congenital cytomegalovirus (CMU) infection. It is suggested that congenital infection should be considered as an etiological agent in autism. The case's synergistic effect of CMU-induced brain damage, deafness, and maternal deprivation in noted. (CL)

Enhancing Leadership in Colleges and Universities: A Case Approach

ERIC Educational Resources Information Center

Sandeen, Arthur

2011-01-01

In view of the serious challenges facing college and university administrators, it is encouraging to note the increased interest in improving leadership knowledge and skills. This book presents an additional option to college and university administrators in their efforts to enhance their leadership skills. The case study approach to improving…

Hong Kong's Cross-System University Partnerships

ERIC Educational Resources Information Center

Postiglione, Gerard A.; Yunyun, Qin; Te, Alice Y. C.

2016-01-01

The authors examine the special case of Hong Kong higher education's institutional partnerships in the Chinese mainland. After noting the rise of cross-system university partnership in Asia, it provides a neoinstitutional perspective on the differences between the two China higher education systems. Finally, a case study of the experience of the…

Prevalence of Asperger syndrome among patients of an Early Intervention in Psychosis team.

PubMed

Davidson, Conor; Greenwood, Nick; Stansfield, Alison; Wright, Stephen

2014-05-01

There is a lack of systematic studies into comorbidity of Asperger syndrome and psychosis. To determine the prevalence of Asperger syndrome among patients of an early intervention in psychosis service. This study was a cross-sectional survey consisting of three phases: screening, case note review and diagnostic interviews. All patients on caseload (n = 197) were screened using the Autism Spectrum Disorder in Adults Screening Questionnaire. The case notes of patients screened positive were then reviewed for information relevant to Asperger syndrome. Those suspected of having Asperger syndrome were invited for a diagnostic interview. Thirty patients were screened positive. Three of them already had a diagnosis of Asperger syndrome made by child and adolescent mental health services. After case note review, 13 patients were invited to interview. Four did not take part, so nine were interviewed. At interview, four were diagnosed with Asperger syndrome. In total, seven patients had Asperger syndrome. Thus, the prevalence rate in this population is at least 3.6%. The results suggest that the prevalence of Asperger syndrome in first-episode psychosis is considerably higher than that in the general population. Clinicians working in early intervention teams need to be alert to the possibility of Asperger syndrome when assessing patients. © 2013 Wiley Publishing Asia Pty Ltd.

The Rural Health Care Delivery System in the Dingxian Experiment: A Case Study of Educational Transfer in Republican China.

ERIC Educational Resources Information Center

Lee, Wai-man; Lo, L. Nai-kwai

1988-01-01

Discusses dependency theory in comparative education studies. Examines U.S. educational transfer to China during the Republican period as it functioned through the public health delivery model of the Dingxian Experiment. Notes that resistance to dependency in this case could serve as a model for avoiding the technological misfitting of programs.…

Chair Report Consultancy Meeting on Nuclear Security Assessment Methodologies (NUSAM) Transport Case Study Working Group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shull, Doug

The purpose of the consultancy assignment was to (i) apply the NUSAM assessment methods to hypothetical transport security table top exercise (TTX) analyses and (ii) document its results to working materials of NUSAM case study on transport. A number of working group observations, using the results of TTX methodologies, are noted in the report.

MANAGEMENT OF ENDOMETRIOSIS IN TWO CAPTIVE MANDRILLS (MANDRILLUS SPHINX).

PubMed

Okeson, Danelle M; Higbie, Christine T; Mylniczenko, Natalie D; Haynes, April; Bennett, Suzanne; Klocke, Emily; Carpenter, James W

2016-06-01

Endometriosis has been reported in humans, great apes, and Old World monkeys. Although cases are noted anecdotally in Mandrillus spp., and a previously reported case was noted on postmortem examination, to the authors' knowledge, no previous reports of case management have been published in the peer-reviewed literature. This paper describes the medical and surgical management of endometriosis in two mandrills (Mandrillus sphinx).

Identification of forged Bank of England £20 banknotes using IR spectroscopy

NASA Astrophysics Data System (ADS)

Sonnex, Emily; Almond, Matthew J.; Baum, John V.; Bond, John W.

2014-01-01

Bank of England notes of £20 denomination have been studied using infrared spectroscopy in order to generate a method to identify forged notes. An aim of this work was to develop a non-destructive method so that a small, compact Fourier transform infrared spectrometer (FT-IR) instrument could be used by bank workers, police departments or others such as shop assistants to identify forged notes in a non-lab setting. The ease of use of the instrument is the key to this method, as well as the relatively low cost. The presence of a peak at 1400 cm-1 arising from νasym (CO32-) from the blank paper section of a forged note proved to be a successful indicator of the note's illegality for the notes that we studied. Moreover, differences between the spectra of forged and genuine £20 notes were observed in the ν(OH) (ca. 3500 cm-1), ν(Csbnd H) (ca. 2900 cm-1) and ν(Cdbnd O) (ca. 1750 cm-1) regions of the IR spectrum recorded for the polymer film covering the holographic strip. In cases where these simple tests fail, we have shown how an infrared microscope can be used to further differentiate genuine and forged banknotes by producing infrared maps of selected areas of the note contrasting inks with background paper.

Identification of forged Bank of England £20 banknotes using IR spectroscopy.

PubMed

Sonnex, Emily; Almond, Matthew J; Baum, John V; Bond, John W

2014-01-24

Bank of England notes of £20 denomination have been studied using infrared spectroscopy in order to generate a method to identify forged notes. An aim of this work was to develop a non-destructive method so that a small, compact Fourier transform infrared spectrometer (FT-IR) instrument could be used by bank workers, police departments or others such as shop assistants to identify forged notes in a non-lab setting. The ease of use of the instrument is the key to this method, as well as the relatively low cost. The presence of a peak at 1400 cm(-1) arising from νasym (CO3(2-)) from the blank paper section of a forged note proved to be a successful indicator of the note's illegality for the notes that we studied. Moreover, differences between the spectra of forged and genuine £20 notes were observed in the ν(OH) (ca. 3500 cm(-1)), ν(C-H) (ca. 2900 cm(-1)) and ν(C=O) (ca. 1750 cm(-1)) regions of the IR spectrum recorded for the polymer film covering the holographic strip. In cases where these simple tests fail, we have shown how an infrared microscope can be used to further differentiate genuine and forged banknotes by producing infrared maps of selected areas of the note contrasting inks with background paper. Copyright © 2013 Elsevier B.V. All rights reserved.

A Comparison of Suicide Note Writers with Suicides Who Did Not Leave Notes

ERIC Educational Resources Information Center

Callanan, Valerie J.; Davis, Mark S.

2009-01-01

There is disagreement in the suicide literature on the value of suicide notes as a data source, particularly regarding the extent to which suicide decedents who write notes differ from those who do not. Using 10 years of suicide cases from Summit County, Ohio, these two groups were compared on 40 variables including sociodemographic…

Comparison of case note review methods for evaluating quality and safety in health care.

PubMed

Hutchinson, A; Coster, J E; Cooper, K L; McIntosh, A; Walters, S J; Bath, P A; Pearson, M; Young, T A; Rantell, K; Campbell, M J; Ratcliffe, J

2010-02-01

To determine which of two methods of case note review--holistic (implicit) and criterion-based (explicit)--provides the most useful and reliable information for quality and safety of care, and the level of agreement within and between groups of health-care professionals when they use the two methods to review the same record. To explore the process-outcome relationship between holistic and criterion-based quality-of-care measures and hospital-level outcome indicators. Case notes of patients at randomly selected hospitals in England. In the first part of the study, retrospective multiple reviews of 684 case notes were undertaken at nine acute hospitals using both holistic and criterion-based review methods. Quality-of-care measures included evidence-based review criteria and a quality-of-care rating scale. Textual commentary on the quality of care was provided as a component of holistic review. Review teams comprised combinations of: doctors (n = 16), specialist nurses (n = 10) and clinically trained audit staff (n = 3) and non-clinical audit staff (n = 9). In the second part of the study, process (quality and safety) of care data were collected from the case notes of 1565 people with either chronic obstructive pulmonary disease (COPD) or heart failure in 20 hospitals. Doctors collected criterion-based data from case notes and used implicit review methods to derive textual comments on the quality of care provided and score the care overall. Data were analysed for intrarater consistency, inter-rater reliability between pairs of staff using intraclass correlation coefficients (ICCs) and completeness of criterion data capture, and comparisons were made within and between staff groups and between review methods. To explore the process-outcome relationship, a range of publicly available health-care indicator data were used as proxy outcomes in a multilevel analysis. Overall, 1473 holistic and 1389 criterion-based reviews were undertaken in the first part of the study. When same staff-type reviewer pairs/groups reviewed the same record, holistic scale score inter-rater reliability was moderate within each of the three staff groups [intraclass correlation coefficient (ICC) 0.46-0.52], and inter-rater reliability for criterion-based scores was moderate to good (ICC 0.61-0.88). When different staff-type pairs/groups reviewed the same record, agreement between the reviewer pairs/groups was weak to moderate for overall care (ICC 0.24-0.43). Comparison of holistic review score and criterion-based score of case notes reviewed by doctors and by non-clinical audit staff showed a reasonable level of agreement (p-values for difference 0.406 and 0.223, respectively), although results from all three staff types showed no overall level of agreement (p-value for difference 0.057). Detailed qualitative analysis of the textual data indicated that the three staff types tended to provide different forms of commentary on quality of care, although there was some overlap between some groups. In the process-outcome study there generally were high criterion-based scores for all hospitals, whereas there was more interhospital variation between the holistic review overall scale scores. Textual commentary on the quality of care verified the holistic scale scores. Differences among hospitals with regard to the relationship between mortality and quality of care were not statistically significant. Using the holistic approach, the three groups of staff appeared to interpret the recorded care differently when they each reviewed the same record. When the same clinical record was reviewed by doctors and non-clinical audit staff, there was no significant difference between the assessments of quality of care generated by the two groups. All three staff groups performed reasonably well when using criterion-based review, although the quality and type of information provided by doctors was of greater value. Therefore, when measuring quality of care from case notes, consideration needs to be given to the method of review, the type of staff undertaking the review, and the methods of analysis available to the review team. Review can be enhanced using a combination of both criterion-based and structured holistic methods with textual commentary, and variation in quality of care can best be identified from a combination of holistic scale scores and textual data review.

A guide to writing case reports for the Journal of Medical Case Reports and BioMed Central Research Notes

PubMed Central

2013-01-01

Case reports are a time-honored, important, integral, and accepted part of the medical literature. Both the Journal of Medical Case Reports and the Case Report section of BioMed Central Research Notes are committed to case report publication, and each have different criteria. Journal of Medical Case Reports was the world’s first international, PubMed-listed medical journal devoted to publishing case reports from all clinical disciplines and was launched in 2007. The Case Report section of BioMed Central Research Notes was created and began publishing case reports in 2012. Between the two of them, thousands of peer-reviewed case reports have now been published with a worldwide audience. Authors now also have Cases Database, a continually updated, freely accessible database of thousands of medical case reports from multiple publishers. This informal editorial outlines the process and mechanics of how and when to write a case report, and provides a brief look into the editorial process behind each of these complementary journals along with the author’s anecdotes in the hope of inspiring all authors (both novice and experienced) to write and continue writing case reports of all specialties. Useful hyperlinks are embedded throughout for easy and quick reference to style guidelines for both journals. PMID:24283456

What Works Clearinghouse Standards and Generalization of Single-Case Design Evidence

ERIC Educational Resources Information Center

Hitchcock, John H.; Kratochwill, Thomas R.; Chezan, Laura C.

2015-01-01

A recent review of existing rubrics designed to help researchers evaluate the internal and external validity of single-case design (SCD) studies found that the various options yield consistent results when examining causal arguments. The authors of the review, however, noted considerable differences across the rubrics when addressing the…

The cytologic features of NUT midline carcinoma.

PubMed

Bellizzi, Andrew M; Bruzzi, Cynthia; French, Christopher A; Stelow, Edward B

2009-12-25

Nuclear protein in testis (NUT) midline carcinoma (NMC) represents an aggressive, high-grade carcinoma typically involving the upper aerodigestive tract or mediastinum. Although the tumor was originally noted in young persons, we have subsequently identified 5 adult cases. To our knowledge, the cytology of NMC has not been systematically described. We recently published a series of NMCs identified by fluorescent in situ hybridization for characteristic NUT rearrangement. Three of these patients had undergone fine-needle aspiration. Patient age, sex, primary tumor location, and aspiration site were noted. Cases were assessed for the following: cellularity, architecture, cytoplasm, cell size, nuclear contours, nucleoli, chromatin, anisonucleosis/cytosis, mitotic activity, background, and nuclear crush. The 3 cases occurred in 2 women and 1 man, ages 31-79 years. Primaries involved the sinonasal tract (2) and larynx. Aspirates were of right neck masses (2) and supraclavicular lymph node. Smears were highly cellular and generally noncohesive. Cytoplasm was scant/delicate, although occasional cells with denser cytoplasm were noted in 1 case. Cells were 2-3 times the diameter of a small lymphocyte with irregular nuclear contours, discrete nucleoli, and fine/granular to vesicular chromatin. Anisonucleosis/cytosis was slight to moderate. Mitotic figures were noted in each case. The background contained naked nuclei and karyorrhectic debris; nuclear crush was noted. NMCs exhibit cytologic features of a poorly differentiated or undifferentiated carcinoma. Although reports mention squamous differentiation as a histologic feature, it is typically focal, and overt squamous differentiation was not identified in our cases. Given morphologic overlap with other high-grade carcinomas, diagnosis requires a high index of suspicion. (c) 2009 American Cancer Society.

I Can Hardly Wait Till Monday: Women Teachers Talk about What Works for Them and for Boys.

ERIC Educational Resources Information Center

Hartman, Deborah

Noting that the majority of teachers of boys are women, this book provides a series of case studies in which experienced women teachers talk about enjoying and using boys' energy in the classroom, tuning in to the ways that boys communicate, and varying lessons to suit all learning styles. Case studies from various schools in Australia illustrate…

Mike's Educational Program: Long Island, New York. Case Study. Social Relationships of Children and Adolescents with Deaf-Blindness Research Project.

ERIC Educational Resources Information Center

Mar, Harvey H.; Sall, Nancy

This case study describes the educational history and current program of Mike, a mainstreamed sixth-grader with deaf-blindness. It addresses the boy's successes and the ongoing challenges faced by his family, his educational team, and his peers. Background information notes his diagnosis of total blindness and moderate to severe hearing loss, his…

Following a natural experiment of guideline adaptation and early implementation: a mixed-methods study of facilitation

PubMed Central

2012-01-01

Background Facilitation is emerging as an important strategy in the uptake of evidence. However, it is not entirely clear from a practical perspective how facilitation occurs to help move research evidence into nursing practice. The Canadian Partnership Against Cancer, also known as the 'Partnership,' is a Pan-Canadian initiative supporting knowledge translation activity for improved care through guideline use. In this case-series study, five self-identified groups volunteered to use a systematic methodology to adapt existing clinical practice guidelines for Canadian use. With 'Partnership' support, local and external facilitators provided assistance for groups to begin the process by adapting the guidelines and planning for implementation. Methods To gain a more comprehensive understanding of the nature of facilitation, we conducted a mixed-methods study. Specifically, we examined the role and skills of individuals actively engaged in facilitation as well as the actual facilitation activities occurring within the 'Partnership.' The study was driven by and builds upon a focused literature review published in 2010 that examined facilitation as a role and process in achieving evidence-based practice in nursing. An audit tool outlining 46 discrete facilitation activities based on results of this review was used to examine the facilitation noted in the documents (emails, meeting minutes, field notes) of three nursing-related cases participating in the 'Partnership' case-series study. To further examine the concept, six facilitators were interviewed about their practical experiences. The case-audit data were analyzed through a simple content analysis and triangulated with participant responses from the focus group interview to understand what occurred as these cases undertook guideline adaptation. Results The analysis of the three cases revealed that almost all of the 46 discrete, practical facilitation activities from the literature were evidenced. Additionally, case documents exposed five other facilitation-related activities, and a combination of external and local facilitation was apparent. Individuals who were involved in the case or group adapting the guideline(s) also performed facilitation activities, both formally and informally, in conjunction with or in addition to appointed external and local facilitators. Conclusions Facilitation of evidence-based practice is a multifaceted process and a team effort. Communication and relationship-building are key components. The practical aspects of facilitation explicated in this study validate what has been previously noted in the literature and expand what is known about facilitation process and activity. PMID:22309743

TVT ABBREVO: cadaveric study of tape position in foramen obturatum and adductor region.

PubMed

Hubka, Petr; Nanka, Ondrej; Masata, Jaromir; Martan, Alois; Svabik, Kamil

2016-07-01

The aim of the study was to describe fixation of the TVT ABBREVO and establish whether the tape penetrates through obturator muscles and membrane (obturator complex) into the adductor region and, if so, how far it penetrates. Eight formalin-embalmed female cadavers were used to simulate TVT ABBREVO surgery (totalling 16 insertions). Following tape insertion, dissection was performed and ends of the tape were identified. In cases of penetration, the length of tape penetrating into the adductor region was measured. Of the 16 cases, the tape ended in the obturator membrane in eight, in the internal obturator muscle in one, and penetrated through the obturator membrane into the external obturator muscle in five, where it remained. In two cases, it penetrated through the obturator internus muscle, obturator membrane and obturator externus muscle into the group of thigh adductors; one penetration was by 3 mm and the second by 10 mm. No contact with the obturator nerve or its branches was noted in any case. No TVT contact with the obturator nerve was noted; tape penetrated into the adductor region in two of the 16 cases.

Four cases of vertebrobasilar insufficiency.

PubMed

Inui, H; Yoneyama, K; Kitaoku, Y; Nakane, M; Ohue, S; Yamanaka, T; Ueda, T; Fujita, N; Miyahara, H; Matsunaga, T

1998-01-01

Four cases of vertebrobasilar insufficiency are reported. Case 1 was a 38-year-old man who felt a sudden onset of dizziness when he turned his head to the back. An abnormal positional nystagmus was observed when he rotated his head to the left. A magnetic resonance angiogram (MRA) demonstrated total occlusion of the left vertebral artery (VA). Case 2 was a 31-year-old woman who had a total occlusion of her left VA as observed in the MRA. Case 3 was a 68-year-old man who noted dizziness. The systolic blood pressure change on his Schellong test was 28 mmHg. On his MRA, severe displacement of the basilar and the vertebral arteries was visible. Case 4 was a 76-year-old woman who noted a blackout-like sensation. Optokinetic nystagmus was noted with a hyponystagmus pattern, and an eye tracking test showed a saccadic pattern. On her MRA, the vertebrobasilar system was narrowed. The arterial architecture and any stenosis of the blood vessels could be detected non-invasively by MRA.

Inflammatory Tinea capitis: a 12-year study and a review of the literature.

PubMed

Zaraa, Inès; Hawilo, Abdelmohti; Aounallah, Amina; Trojjet, Sondes; El Euch, Dalenda; Mokni, Mourad; Ben Osman, Amel

2013-03-01

Inflammatory Tinea capitis (TC) is a rare form of TC. The aim of this study was to review epidemiological, clinical and mycological profile of inflammatory TC. We present a retrospective study (1999-2010), enrolled all the cases of inflammatory TC observed at a referral hospital in the northern Tunisia. One hundred and twenty-one patients with inflammatory TC, 83 male patients (68.6%) and 38 female patients (31.4%) were enrolled. The mean age was about 8 years. A majority of TC (71.9%) were in patients lesser than 10 years of age. Positive family history and contact with animals were noted in seven and 35 cases respectively. Direct examination was positive in 110 cases (59 ectothrix, 51 endothrix) and positive cultures were obtained in 105 patients (49 Trichophyton violaceum, 31 Microsporum canis, 13 Trichophyton interdigitale complex, 12 Trichophyton verrucosum). Systemic treatment was carried out in 115 patients with griseofulvin, in one with terbinafine. A complete recovery was noted in 88 cases; and persistent alopecia in 28 cases. The inflammatory TC is rare, but more common in rural families. The disease mostly affected male genders (68.6%) and T. violaceum remains the common pathogen of inflammatory TC in northern Tunisia. © 2012 Blackwell Verlag GmbH.

Characteristic Features of Hanging: A Study in Rural District of Central India.

PubMed

Ambade, Vipul Namdeorao; Kolpe, Dayanand; Tumram, Nilesh; Meshram, Satin; Pawar, Mohan; Kukde, Hemant

2015-09-01

The ligature mark is the most relevant feature of hanging. This study was undertaken with a view to determine the characteristic features of hanging and its association with ligature material or mode of suspension. Of a total medicolegal deaths reported at an Apex Medical Centre, hanging was noted in 4.1% cases, all suicidal with mortality rate of 1.5 per 100,000 population per year. The hanging was complete in 67.7% with nylon rope as the commonest type of ligature material used for ligation. The hanging mark was usually single, situated above thyroid cartilage, incomplete, prominent, and directed toward nape of neck. The mark of dribbling of saliva was seen in 11.8% cases. Facial congestion, petechial hemorrhage, and cyanosis were significantly seen in partial hanging. Though occasionally reported, the argent line was noted in 78.7% hanging deaths with neck muscle hemorrhage in 23.6% cases. Fracture of neck structure was predominant in complete hanging. © 2015 American Academy of Forensic Sciences.

Determining legal responsibility in otolaryngology: a review of 44 trials since 2008.

PubMed

Svider, Peter F; Husain, Qasim; Kovalerchik, Olga; Mauro, Andrew C; Setzen, Michael; Baredes, Soly; Eloy, Jean Anderson

2013-01-01

Medicolegal factors contribute to increasing healthcare costs through the direct costs of malpractice litigation, malpractice insurance premiums, and defensive medicine. Malpractice litigation trends are constantly changing as a result of technological innovations and changes in laws. In this study, we examine the most recent legal decisions related to Otolaryngology and characterize the factors responsible for determining legal responsibility. The Westlaw legal database (Thomson Reuters, New York, NY) was used to search for jury verdicts since 2008 in Otolaryngology malpractice cases. The 44 cases included in this analysis were studied to determine the procedures most commonly litigated and progressing to trial, as well as the year, location, alleged cause of malpractice, specialty of co-defendants, and case outcomes. Out of the 44 cases included in this analysis, physicians were not found liable in 36 (81.8%) cases. Rhinologic procedures comprised 38.6% of cases litigated, and rulings were in physicians' favor in 66.7% of endoscopic sinus surgery (ESS) cases and all non-ESS rhinologic cases. A perceived lack of informed consent was noted in 34.1% of cases. The 8 jury awards averaged $940,000 (range, $148,000-$3,600,000). Otolaryngologists were not found liable in the majority of cases reviewed. Rhinologic surgeries were the most common procedures resulting in litigation. Adenotonsillectomies, thyroidectomies, and airway management are also well-represented. Perceived deficits in informed consent and misdiagnosis were noted in a considerable proportion of otolaryngologic malpractice cases resulting in jury decisions. Copyright © 2013 Elsevier Inc. All rights reserved.

Natural orifice translumenal endoscopic surgery (NOTES): emerging trends and specifications for a virtual simulator.

PubMed

Schwaitzberg, Steven D; Dorozhkin, Denis; Sankaranarayanan, Ganesh; Matthes, Kai; Jones, Daniel B; De, Suvranu

2016-01-01

A virtual translumenal endoscopic surgical trainer (VTEST) is being developed to accelerate the development of natural orifice translumenal endoscopic surgery (NOTES) procedures and devices in a safe and risk-free environment. For a rapidly developing field such as NOTES, a needs analysis must be conducted regularly to discover emerging research trends and areas of potential high impact for a virtual simulator. This paper presents a survey-based study which follows a similar study conducted by this group in 2011 (Sankaranarayanan et al. in Surg Endosc 27:1607-1616, 2013). A 32-point questionnaire was distributed at the 2012 Natural Orifice Surgery Consortium for Assessment and Research annual meeting. These data were subsequently augmented by an identical online survey, targeted at the members of the American Society for Gastrointestinal Endoscopy and the Society of American Gastrointestinal and Endoscopic Surgeons, and analyzed. Twenty-eight NOTES experts participated in the 2012 study. Cholecystectomy (CE) procedure remained the most commonly performed NOTES technique, with 18 positive responses (64%). In contrast to 2011, the popularity of the NOTES appendectomy (AE) was significantly lower, with only 2 (7%) instances (CE vs. AE, p < 0.001), while the number of peroral endoscopic myotomy (POEM, PE) cases had increased significantly, with 11 (39%) positive responses, respectively (PE vs. AE, p = 0.013). Strong preference toward hybrid rather than pure NOTES techniques (82 vs. 11%, p < 0.001) was also expressed. Other responses were similar to those in the 2011 study, with the VTEST™ utility in developing and testing new techniques and instruments ranked particularly high. Based on the results of this study, a decision was made to focus exclusively on the transvaginal hybrid NOTES cholecystectomy procedure, including both rigid and flexible scope techniques. The importance of developing a virtual NOTES simulator was reaffirmed, with POEM identified as a promising candidate for future simulator development.

BASINS User Information and Guidance

EPA Pesticide Factsheets

This page provides links to guidance on how to use BASINS, including the User’s Manual, tutorials and training, technical notes, case studies, and publications that highlight the use of BASINS in various watershed analyses.

Necrotic and inflammatory changes in metal-on-metal resurfacing hip arthroplasties

PubMed Central

2009-01-01

Background Necrosis and inflammation in peri-implant soft tissues have been described in failed second-generation metal-on-metal (MoM) resurfacing hip arthroplasties and in the pseudotumors associated with these implants. The precise frequency and significance of these tissue changes is unknown. Method We analyzed morphological and immunophenotypic changes in the periprosthetic soft tissues and femoral heads of 52 revised MoM arthroplasties (fracture in 21, pseudotumor in 13, component loosening in 9, and other causes in 9 cases). Results Substantial necrosis was observed in the periprosthetic connective tissue in 28 of the cases, including all pseudotumors, and 5 cases of component loosening. A heavy, diffuse inflammatory cell infiltrate composed mainly of HLA-DR+/CD14+/CD68+ macrophages and CD3+ T cells was seen in 45 of the cases. Perivascular lymphoid aggregates composed of CD3+ cells and CD20+ B cells were noted in 27 of the cases, but they were not seen in all cases of component loosening or pseudotumors. Plasma cells were noted in 30 cases. Macrophage granulomas were noted in 6 cases of component loosening. In the bone marrow of the femoral head, a macrophage and T cell response was seen in 31 of the cases; lymphoid aggregates were noted in 19 of the cases and discrete granulomas in 1 case. Interpretation Our findings indicate that there is a spectrum of necrotic and inflammatory changes in response to the deposition of cobalt-chrome (Co-Cr) wear particles in periprosthetic tissues. Areas of extensive coagulative necrosis and a macrophage and T lymphocyte response occur in implant failure and pseudotumors, in which there is also granuloma formation. The pathogenesis of these changes is uncertain but it may involve both a cytotoxic response and a delayed hypersensitivity (type IV) response to Co-Cr particles. PMID:19995315

Adjunctive antipsychotic in the treatment of body dysmorphic disorder - A retrospective naturalistic case note study.

PubMed

Rashid, Haroon; Khan, Akif A; Fineberg, Naomi A

2015-06-01

A retrospective naturalistic case note study to determine the frequency, co-morbidity and treatment-response of body dysmorphic disorder (BDD). Records from 280 patients attending a highly specialised obsessive-compulsive disorder (OCD)/BDD service were analysed. The clinical outcome was measured either through scoring of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) for OCD/BDD, or textual analysis of case notes for evidence of symptomatic improvement, treatment tolerability, and premature disengagement. A total of 32 patients (11.43%) were diagnosed with BDD. Of these, 28 (87.5%) had at least one co-morbidity. All patients were offered cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitor (SSRI). Adjunctive low-dose antipsychotic was prescribed for 21 (66%) patients. Overall, 18/32 (56%) responded, and 7/32 (22%) disengaged prematurely. Patients offered antipsychotic, SSRI and CBT (n = 21) were compared with those offered SSRI and CBT only (n = 11). The treatment was well-tolerated. Whereas there was no significant inter-group difference in the clinical response rate, premature disengagement occurred less frequently in the antipsychotic-treated patients (9.5% versus 45%; Fisher's Exact Test P = 0.0318). BDD frequently presents with co-morbidity, treatment-resistance and premature disengagement. Adjunctive antipsychotic was associated with significantly better treatment adherence, but responder rates did not differ significantly, possibly related to the small sample-size. A well-powered randomised controlled study is warranted, to determine clinical outcomes with adjunctive antipsychotic in BDD.

Natural language processing of clinical notes for identification of critical limb ischemia.

PubMed

Afzal, Naveed; Mallipeddi, Vishnu Priya; Sohn, Sunghwan; Liu, Hongfang; Chaudhry, Rajeev; Scott, Christopher G; Kullo, Iftikhar J; Arruda-Olson, Adelaide M

2018-03-01

Critical limb ischemia (CLI) is a complication of advanced peripheral artery disease (PAD) with diagnosis based on the presence of clinical signs and symptoms. However, automated identification of cases from electronic health records (EHRs) is challenging due to absence of a single definitive International Classification of Diseases (ICD-9 or ICD-10) code for CLI. In this study, we extend a previously validated natural language processing (NLP) algorithm for PAD identification to develop and validate a subphenotyping NLP algorithm (CLI-NLP) for identification of CLI cases from clinical notes. We compared performance of the CLI-NLP algorithm with CLI-related ICD-9 billing codes. The gold standard for validation was human abstraction of clinical notes from EHRs. Compared to billing codes the CLI-NLP algorithm had higher positive predictive value (PPV) (CLI-NLP 96%, billing codes 67%, p < 0.001), specificity (CLI-NLP 98%, billing codes 74%, p < 0.001) and F1-score (CLI-NLP 90%, billing codes 76%, p < 0.001). The sensitivity of these two methods was similar (CLI-NLP 84%; billing codes 88%; p < 0.12). The CLI-NLP algorithm for identification of CLI from narrative clinical notes in an EHR had excellent PPV and has potential for translation to patient care as it will enable automated identification of CLI cases for quality projects, clinical decision support tools and support a learning healthcare system. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Identification of Forged Bank of England 20 Gbp Banknotes Using IR Spectroscopy

NASA Astrophysics Data System (ADS)

Sonnex, Emily

2014-06-01

Bank of England notes of 20 GBP denomination have been studied using infrared spectroscopy in order to generate a method to identify forged notes. A principal aim of this work was to develop a method so that a small, compact ATR FTIR instrument could be used by bank workers, police departments or others such as shop assistants to identify forged notes in a non-lab setting. The ease of use of the instrument is the key to this method, as well as the relatively low cost. The presence of a peak at 1400 wn from the blank paper section of a forged note proved to be a successful indicator of the note's illegality for the notes that we studied. Moreover, differences between the spectra of forged and genuine 20 GBP notes were observed in the ν(OH) (ca. 3500 wn), ν(C-H) (ca. 2900 wn) and ν(C=O) (ca. 1750 wn) regions of the IR spectrum recorded for the polymer film covering the holographic strip. In cases where these simple tests fail, we have shown how an infrared microscope can be used to further differentiate genuine and forged banknotes by producing infrared maps of selected areas of the note contrasting inks with background paper. Further to this, with an announcement by the Bank of England to produce polymer banknotes in the future, the work has been extended using Australian polymer banknotes to show that the method would be transferable.

Global Education and the Cooperation of NGOs and Schools: A German Case Study

ERIC Educational Resources Information Center

Bergmüller, Claudia

2016-01-01

In recent years, there has been growing pressure but also an increase of possibilities for non-governmental organizations (NGOs) to cooperate with schools in the field of global education. However, especially in cases of more continuous forms of cooperation, difficulties in process management are noted and the intended cooperation impacts often…

United Nations Operations: Who Should be in Charge?

DTIC Science & Technology

1994-04-01

interpretation would also appear to resolve Kelsen’s dilemma (see KELSEN , supra note 35, at 935) with respect to the Korean conflict. Kelsen argues the Security...and Scheffer, supra note 35, at 131. 45. See D. J. HARRIS, CASES AND MATERIAL ON INTERNATIONAL LAW 681 (4th ed. 1991); KELSEN , supra note 35, at 756...167 (July 20). 58. KELSEN , supra note 35, at 768. 59. SEYERSTED, supra note 46, at 156. 60. In opening the Security Council session of 31 December 1992

[Shoulder dystocia: Quality of retranscription in medical files].

PubMed

Martin, E; Bouet, P-E; Sentilhes, L; Legendre, G

2016-03-01

Shoulder dystocia is a rare obstetrical event and potentially serious. Apart from possible psychological implications, it may be responsible for maternal (haemorrhage and perineal tear) and neonatal complications (brachial plexus) leading to complaints and even lawsuits. The transcription of this event in medical files is essential as it is a reflection of the work in an emergency. It allows the obstetrician to defend him in case of trial. Our objective was to assess the quality of the transcription of shoulder dystocia situations in medical files. Retrospective chart study conducted in a university hospital with maternity type III. The primary objective was the rate of comprehensive records (name maneuvers and order of maneuvers of the anterior shoulder hand, time between the expulsion of the head and body, Apgar score). Between 2007 and 2015, 54 cases of shoulder dystocia requiring a second line maneuver after vaginal delivery (Wood and/or Jacquemier) were included. In all, 98.2% of the files were incomplete. The maneuvers and their order were noted in 100% of cases. However, the operation was not correctly described in 16.7% of cases. The anterior shoulder was noted in 16.7% of cases. The time between the expulsion of the head and the body was noted in one single files. Neither broken collarbone nor brachial plexus were observed. To improve the management of dystocia shoulder and transcription of data in files, simulation sessions and the creation of a standardized form would be needed. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The impact of three discharge coding methods on the accuracy of diagnostic coding and hospital reimbursement for inpatient medical care.

PubMed

Tsopra, Rosy; Peckham, Daniel; Beirne, Paul; Rodger, Kirsty; Callister, Matthew; White, Helen; Jais, Jean-Philippe; Ghosh, Dipansu; Whitaker, Paul; Clifton, Ian J; Wyatt, Jeremy C

2018-07-01

Coding of diagnoses is important for patient care, hospital management and research. However coding accuracy is often poor and may reflect methods of coding. This study investigates the impact of three alternative coding methods on the inaccuracy of diagnosis codes and hospital reimbursement. Comparisons of coding inaccuracy were made between a list of coded diagnoses obtained by a coder using (i)the discharge summary alone, (ii)case notes and discharge summary, and (iii)discharge summary with the addition of medical input. For each method, inaccuracy was determined for the primary, secondary diagnoses, Healthcare Resource Group (HRG) and estimated hospital reimbursement. These data were then compared with a gold standard derived by a consultant and coder. 107 consecutive patient discharges were analysed. Inaccuracy of diagnosis codes was highest when a coder used the discharge summary alone, and decreased significantly when the coder used the case notes (70% vs 58% respectively, p < 0.0001) or coded from the discharge summary with medical support (70% vs 60% respectively, p < 0.0001). When compared with the gold standard, the percentage of incorrect HRGs was 42% for discharge summary alone, 31% for coding with case notes, and 35% for coding with medical support. The three coding methods resulted in an annual estimated loss of hospital remuneration of between £1.8 M and £16.5 M. The accuracy of diagnosis codes and percentage of correct HRGs improved when coders used either case notes or medical support in addition to the discharge summary. Further emphasis needs to be placed on improving the standard of information recorded in discharge summaries. Copyright © 2018 Elsevier B.V. All rights reserved.

Meeting Common Core English Language Arts and English Language Development Standards with Character Education Lesson Plans in Alternative Education Grades 9 through 12

ERIC Educational Resources Information Center

Hoedel, Joseph M.; Lee, Robert E.

2016-01-01

This is a case study in which the Character Development and Leadership Program replaced an alternative high school's traditional English language offerings. A triangulated case study used student records, field notes, and interviews of stakeholders to compare the academic year prior to this substitution and the 2 academic years following it. All 3…

Intraocular osseous metaplasia. A clinico-pathological study.

PubMed

Vemuganti, Geeta K; Honavar, Santosh G; Jalali, Subhadra

2002-09-01

To evaluate the clinico-pathologic features of intraocular osseous metaplasia. Pathology specimens of enucleated eyes submitted to the ophthalmic pathology service at a tertiary eye-care referral center between January 1995 and June 1999 were studied for intraocular osseous metaplasia. Specific histopathologic features noted in specimens with osseous metaplasia were the presence of retinal detachment, gliosis, retinal pigment epithelial hyperplasia, drusen, epiretinal membrane, fibrovascular proliferation and inflammation. Immunohistochemistry using monoclonal antibody against glial fibrillary acidic protein was performed to assess the glial component within the membranes and the proliferative vitreoretinal mass. Clinical records were reviewed and correlated with histopathologic findings. Osseous metaplasiaS was noted in 8 of 151 (5.2%) eyes examined. Clinical diagnosis in these was phthisis bulbi, staphyloma, absolute glaucoma and microphthalmos. Enucleation was performed for relief of symptoms (in painful blind eyes) or for cosmesis, and in an eye inciting sympathetic ophthalmia. Retinal detachment, gliosis and retinal pigment epithelial hyperplasia were noted in all the cases. Drusen with calcification or ossification (5 of 8), fibrovascular proliferation in the vitreous (5 of 8) and active inflammation (4 of 8) were the other associated histologic features. Location of ossification was subretinal in 3 cases, preretinal (ora serrata) in 1 case and in both locations in 4 cases. The eyes with subretinal osseous metaplasia had associated calcified drusen, while preretinal ossification was seen within the fibrovascular membranes. Chronic retinal detachment, hyperplasia and transdifferentiation of retinal pigment epithelium appear to be a few of the prerequisites for intraocular osseous metaplasia. Ossification can occur at isolated subretinal and preretinal locations or can involve both. Though a larger study is required to postulate the chronology of events, in this small series, isolated subretinal ossification appears to be initiated by calcification and ossification of drusen, while in the pre-retinal region it is associated with vitreoretinal proliferation.

7 CFR 1786.205 - Application procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... subpart should apply by letter to the appropriate RUS Regional Director or, in the case of power supply borrowers, to the Director of the Power Supply Division. The borrower will be required to submit... amount, outstanding balance, and date(s) of any substitute FFB note(s) amending the original FFB Note; (4...

Sonographic findings of ruptured epidermal inclusion cysts in superficial soft tissue: emphasis on shapes, pericystic changes, and pericystic vascularity.

PubMed

Jin, Wook; Ryu, Kyung Nam; Kim, Gou Young; Kim, Hyun Cheol; Lee, Jae Hoon; Park, Ji Seon

2008-02-01

The purpose of this study was to retrospectively evaluate the sonographic findings of ruptured epidermal inclusion cysts in superficial soft tissue, with an emphasis on shapes, pericystic changes, and pericystic vascularity. The cases of 61 patients with surgically confirmed epidermal inclusion cysts were reviewed, and 13 patients were found to have ruptured cysts. The Ethics Committees of our institutions did not require patient approval or informed patient consent for this retrospective study. We evaluated the shapes, sizes, locations, pericystic changes, and pericystic vascularity for the 13 cases. The shapes of the ruptured epidermal inclusion cysts were classified into 3 types: with lobulations (type I, 2 cases), with protrusions (type II, 8 cases), and with abscess pocket formations (type III, 3 cases). The mean long diameter of the cysts was 3 cm. Common sites of ruptured epidermal inclusion cysts were the plantar surface of the metatarsophalangeal joint (4 cases) and buttocks (3 cases). Pericystic changes were noted in all of the type II and III cysts. Increased vascularity on color Doppler sonography was prominent in 3 type II cysts and 3 type III cysts. Deep abscess formation was noted in the epidermal inclusion cysts, especially for the type III cysts. A ruptured epidermal inclusion cyst visualized by sonography had variable shapes; the sonographic findings can be useful for obtaining a correct diagnosis of a ruptured epidermal inclusion cyst.

Pediatric pancreatic trauma: trending toward nonoperative management?

PubMed

Cuenca, Alex G; Islam, Saleem

2012-11-01

Pancreatic trauma is rare in children and optimal care has not been defined. We undertook this study to review the cumulative experience from three centers. After obtaining Institutional Review Board approval at each site, the trauma registries of three institutions were searched for pancreatic injuries. The charts were reviewed and data pertaining to demographics, hospital course, and outcome were obtained and analyzed. During the study period, a total of 79 pancreatic injuries were noted. The most common mechanism of injury was motor vehicle crash (44%) followed by child abuse (11%) and bicycle crashes (11%). Computed tomographic (CT) scans were obtained in 95 per cent with peripancreatic fluid the most common finding. Median Injury Severity Score (ISS) was 9, whereas median organ injury score was 2, and a higher grade correlated with need for operation (P = 0.001). Pancreatic operations were performed in 32 patients, whereas nonoperative management was noted in 47 cases. We noted no differences in length of stay, age, ISS, or initial blood pressure in operative versus nonoperatively managed cases. Pancreatic injuries were rare in children with trauma. CT scans were the most common method of diagnosis. Nonoperative management appeared to be safe and was more common, especially for the lower grade injuries.

A case study of experimental passing zones on Route 8 in Patrick County.

DOT National Transportation Integrated Search

1982-01-01

This study examined the operational characteristics of the four-mile section of Route 8 between Routes 57 and 58. It was noted that these characteristics were significantly improved after provision of the experimental passing zones. Average and 85th ...

31 CFR 203.20 - Investment account requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... obligations will be in the form of open-ended interest-bearing notes, or in the case of term investments, interest-bearing notes maintained for a predetermined period of time, and additions and reductions will be... in the form of interest-bearing notes payable upon a predetermined period of time not to exceed 90...

31 CFR 203.20 - Investment account requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... obligations will be in the form of open-ended interest-bearing notes, or in the case of term investments, interest-bearing notes maintained for a predetermined period of time, and additions and reductions will be... in the form of interest-bearing notes payable upon a predetermined period of time not to exceed 90...

7 CFR 1463.105 - Base quota levels for eligible quota holders.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the BQL adjustment factor 1.071295. (Note: The factor adjusts the 2004 basic quota to the 2002 basic... farm. (Note: In the case of undivided tract ownership, BQL must be distributed among the tract quota... basic quota, multiplied by the BQL adjustment factor 1.23457. (Note: The factor adjusts the 2004 basic...

7 CFR 1463.105 - Base quota levels for eligible quota holders.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the BQL adjustment factor 1.071295. (Note: The factor adjusts the 2004 basic quota to the 2002 basic... farm. (Note: In the case of undivided tract ownership, BQL must be distributed among the tract quota... basic quota, multiplied by the BQL adjustment factor 1.23457. (Note: The factor adjusts the 2004 basic...

Validity Evidence and Scoring Guidelines for Standardized Patient Encounters and Patient Notes From a Multisite Study of Clinical Performance Examinations in Seven Medical Schools.

PubMed

Park, Yoon Soo; Hyderi, Abbas; Heine, Nancy; May, Win; Nevins, Andrew; Lee, Ming; Bordage, Georges; Yudkowsky, Rachel

2017-11-01

To examine validity evidence of local graduation competency examination scores from seven medical schools using shared cases and to provide rater training protocols and guidelines for scoring patient notes (PNs). Between May and August 2016, clinical cases were developed, shared, and administered across seven medical schools (990 students participated). Raters were calibrated using training protocols, and guidelines were developed collaboratively across sites to standardize scoring. Data included scores from standardized patient encounters for history taking, physical examination, and PNs. Descriptive statistics were used to examine scores from the different assessment components. Generalizability studies (G-studies) using variance components were conducted to estimate reliability for composite scores. Validity evidence was collected for response process (rater perception), internal structure (variance components, reliability), relations to other variables (interassessment correlations), and consequences (composite score). Student performance varied by case and task. In the PNs, justification of differential diagnosis was the most discriminating task. G-studies showed that schools accounted for less than 1% of total variance; however, for the PNs, there were differences in scores for varying cases and tasks across schools, indicating a school effect. Composite score reliability was maximized when the PN was weighted between 30% and 40%. Raters preferred using case-specific scoring guidelines with clear point-scoring systems. This multisite study presents validity evidence for PN scores based on scoring rubric and case-specific scoring guidelines that offer rigor and feedback for learners. Variability in PN scores across participating sites may signal different approaches to teaching clinical reasoning among medical schools.

The impact of domain knowledge on structured data collection and templated note design.

PubMed

Windle, T; McClay, J C; Windle, J R

2013-01-01

The objective of this case report is to evaluate the importance of specialized domain knowledge when designing and using structured templated notes in a clinical environment. To analyze the impact of specialization on structured note generation we compared notes generated for three scenarios: 1) We compared the templated history of present illness (HPI) for patients presenting with a dermatology concern to the dermatologist versus the emergency department. 2) We compared the evaluation of chest pain by ED physicians versus cardiologists. 3) Finally, we compared the data elements asked for in the evaluation of the gastrointestinal system between cardiologists and the liver transplant service (LTS). We used the SNOMED CT representation via BioPortal to evaluate specificity and grouping between data elements and specialized physician groups. We found few similarities in structured data elements designed by and for the specific physician groups. The distinctness represented both differences in granularity as well as fundamental differences in data elements requested. When compared to ED physicians, dermatologists had different and more granular elements while cardiologists requested much more granular data. Comparing cardiologists and LTS, there were differences in the data elements requested. This case study supports the importance of domain knowledge in EHR design and implementation. That different specialities should want and use different information is well supported by cognitive science literature. Despite this, it is rare for domain knowledge to be considered in EHR implementation. Physicians with correct domain knowledge should be involved in the design process of templated notes.

The relationship between childhood trauma and adult psychosis in a UK Early Intervention Service: results of a retrospective case note study.

PubMed

Reeder, Francesca D; Husain, Nusrat; Rhouma, Abdul; Haddad, Peter M; Munshi, Tariq; Naeem, Farooq; Khachatryan, Davit; Chaudhry, Imran B

2017-01-01

There is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review. This is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis. The mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample). Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%), parental mental illness (19%), bullying (18%), absence of a parent (13%), and 'other' trauma (24%) - the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma. A high prevalence of childhood trauma (particularly trauma related to the home environment or family unit) was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with psychosis are asked about childhood trauma; but in 19% of our sample there was no documentation that this had been done indicating the need for improvement in assessment.

Poison control center experience with tianeptine: an unregulated pharmaceutical product with potential for abuse.

PubMed

Marraffa, Jeanna M; Stork, Christine M; Hoffman, Robert S; Su, Mark K

2018-05-25

Interest in tianeptine as a potential drug of abuse is increasing in the United States. We performed a retrospective study of calls to the New York State Poison Control Centers (PCCs) designed to characterize one state's experience with tianeptine. Data were gathered from existing records utilizing the poison center data collection system, Toxicall® entered between 1 January 2000 through 1 April 2017. Information regarding patient demographics, reported dose and formulation of tianeptine, reported coingestants, brief narrative description of the case, disposition, and case outcome was collected. There were nine reported cases of tianeptine exposure. Seven were male with a mean age of 27. Three reported therapeutic use of tianeptine and five reported intentional abuse. One case was an unintentional pediatric exposure. Doses were reported in three cases; 12.5 mg in a pediatric unintentional exposure, and 5 and 10 g daily in the two reports of intentional abuse. Of note, five patients complained of symptoms consistent with opioid withdrawal. In one of two cases in which naloxone was administered, an improvement in mental status and the respiratory drive was noted. Outcomes reported in Toxicall® were minor in two cases, moderate in five cases, major in one case, and not reported in one case. These cases, reported to the New York State PCCs should alert readers to the potential for tianeptine abuse, dependence, and withdrawal.

Abnormal neurodevelopmental outcomes are very likely in cases of bilateral neonatal arterial ischaemic stroke.

PubMed

Jin, Ju Hyun; Shin, Jeong Eun; Lee, Soon Min; Eun, Ho Seon; Park, Min Soo; Park, Kook In; Namgung, Ran

2017-02-01

Neonatal arterial ischaemic stroke (AIS) is an important cause of severe neurological disability. This study aimed to analyse the clinical manifestations and outcomes of AIS patients. We enrolled neonates with AIS admitted to Severance Children's Hospital and Gangnam Severance Hospital between 2008 and 2015. AIS was confirmed using magnetic resonance imaging (MRI). We retrospectively reviewed the clinical manifestations, MRI findings, electroencephalography (EEG) findings and neurodevelopmental outcomes. The study comprised 29 neonates (18 boys). The mean follow-up period was 15.4 months (range 6-44 months), and the mean age at diagnosis was 8.1 days. Seizure was the most common symptom (66%). Bilateral involvement was more common than unilateral involvement (52%). The middle cerebral artery was the most commonly identified territory (79%). Abnormal EEG findings were noted in 93% of the cases. Neurodevelopment was normal in 11 (38%) patients, while cerebral palsy and delayed development were noted in eight (28%) and six (21%) patients, respectively. Patients with bilateral involvement were very likely to have abnormal neurodevelopmental outcomes. Our study showed that abnormal neurodevelopmental outcomes were very likely after cases of neonatal AIS with bilateral involvement, and clinicians should consider early and more effective interventions in such cases. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Use of a combined oxygen/nitrous oxide/morphine chlorydrate protocol for analgesia in burned children requiring painful local care.

PubMed

Ozil, Camille; Vialle, Raphaël; Thevenin-Lemoine, Camille; Conti, Elvira; Annequin, Daniel

2010-03-01

We present the results of the use of a protocol of inhalational oxygen/nitrous oxide mixtures associated with oral opioids on a prospective cohort of 33 children undergoing local care for acute but limited burned skin lesions. All the children were orally administered 0.4 mg/kg morphine chlorydrate, and nitrous oxide was administered as an equimolar mixture (50% N2O, 50% O2) via a face mask during the procedure. Pain and comfort of the patient were evaluated by the use of a validated behavioural score. After the end of the procedure, child and parent satisfactions were noted. Mean age was 3 years 6 months (10 months-11 years). A successful detersion procedure was performed in all the cases. Behavioural score was 6 in 15 cases out of 33, comprising between 7 and 9 in 15 patients and 10 in three patients. Subjective satisfaction of pain management was noted in 16 out of 20 patients after the procedure. Subjective satisfaction of the parents was noted in all the cases. Our study demonstrates that the use of a simple protocol of inhalational oxygen/nitrous oxide mixtures associated with oral opioids could be safe and effective. This association was well tolerated without any adverse effect.

Student Self Governance: A Case Study

ERIC Educational Resources Information Center

Deegan, William L.

1974-01-01

Reports on a study which reviewed student successes and failures in an on-going student controlled program, where accountability, persistence and continuing commitment were required. Several conclusions are presented and weaknesses noted in these programs, many of which can be seen in faculty and administrative programs, too. (Author/PC)

26 CFR 1.453-9 - Gain or loss on disposition of installment obligations.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) the amount realized, in the case of satisfaction at other than face value or in the case of a sale or... the face value of the obligation over an amount equal to the income which would be returnable were the.... Face value of notes 15,000 Amount of income returnable were the notes satisfied in full, 50 percent of...

26 CFR 1.453-9 - Gain or loss on disposition of installment obligations.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) the amount realized, in the case of satisfaction at other than face value or in the case of a sale or... the face value of the obligation over an amount equal to the income which would be returnable were the.... Face value of notes 15,000 Amount of income returnable were the notes satisfied in full, 50 percent of...

26 CFR 1.453-9 - Gain or loss on disposition of installment obligations.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) the amount realized, in the case of satisfaction at other than face value or in the case of a sale or... the face value of the obligation over an amount equal to the income which would be returnable were the.... Face value of notes 15,000 Amount of income returnable were the notes satisfied in full, 50 percent of...

26 CFR 1.453-9 - Gain or loss on disposition of installment obligations.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) the amount realized, in the case of satisfaction at other than face value or in the case of a sale or... the face value of the obligation over an amount equal to the income which would be returnable were the.... Face value of notes 15,000 Amount of income returnable were the notes satisfied in full, 50 percent of...

26 CFR 1.453-9 - Gain or loss on disposition of installment obligations.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) the amount realized, in the case of satisfaction at other than face value or in the case of a sale or... the face value of the obligation over an amount equal to the income which would be returnable were the.... Face value of notes 15,000 Amount of income returnable were the notes satisfied in full, 50 percent of...

Cytokeratin 5/6 and cytokeratin 8/18 expression in triple negative breast cancers: clinicopathologic significance in South-Asian population.

PubMed

Hashmi, Atif Ali; Naz, Samreen; Hashmi, Shumaila Kanwal; Hussain, Zubaida Fida; Irfan, Muhammad; Bakar, Syed Muhammad Abu; Faridi, Naveen; Khan, Amir; Edhi, Muhammad Muzzammil

2018-06-08

Cytokeratin 5/6 and Cytokeratin 8/18 are basal and luminal markers of breast cancer and they have pathological and prognostic significance in breast cancer. We performed Cytokeratin 5/6 and CK8/18 immunohistochemistry on 150 cases of triple negative breast cancers and association with various clinicopathological features was evaluated. Positive CK5/6 expression was noted in 8% (12 cases) of TNBC while 2.4% (4 cases) showed focal positive (< 10%) and 89.3% (134) were negative with CK5/6. Complete loss of CK8/18 expression was seen in 4.7% (7 cases) while 32.7% (49 cases) revealed focal loss of CK8/18 and 62.7% (94 cases) showed intact normal expression of CK8/18. No significant association of CK5/6 and CK8/18 with various clinicopathological parameters was observed. We found a low expression of basal cytokeratin (CK5/6) in TNBC our studied population, while loss/altered expression of CK8/18 in approximately 38% of TNBC. Although no prognostic relevance of these finding was noted in our study, however these findings are different from those reported in literature in other parts of the world. Therefore we suggest a more through immunohistochemical and genomic profiling of TNBC in our population for better understanding of this disease in this part of the world.

How the Ethnography of Communication Provides Resources for Design

ERIC Educational Resources Information Center

Leighter, James L.; Rudnick, Lisa; Edmonds, Theresa J.

2013-01-01

Designing solutions to social problems requires some degree of interpretive accountability to the sociocultural systems in which design solutions must live. Our case studies show how ethnography of communication research generates distinctive resources for design. (Contains 5 notes.)

77 FR 30512 - Notice of Proposed Information Collection Requests; Office of Planning, Evaluation and Policy...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-23

..., including through the use of information technology. Please note that written comments received in response.... This study aims to fill a gap by conducting qualitative case studies of up to 15 sites. This study will systematically analyze qualitative data across multiple respondents to generate portraits of programs and...

Veterans Education: Coming Home to the Community College Classroom

ERIC Educational Resources Information Center

Persky, Karen Rae

2010-01-01

The purpose of this study was to identify the needs of veterans who are community college students and to examine community college programs and services essential to meeting their needs. A qualitative case study design using interviews, observations, field notes, document reviews, a focus group, and a preinterview demographic questionnaire…

"Pathos" Reconsidered from the Perspective of Classical Chinese Rhetorical Theories.

ERIC Educational Resources Information Center

Garrett, Mary M.

1993-01-01

Proposes that cross-cultural rhetorical studies may provide insights into the sources of difficulties with "pathos." Presents an extensive case study that appeals to the emotions in classical Chinese rhetorics. Notes that the presuppositions of these rhetorics highlight the contingent nature of certain fundamental assumptions of many…

Method overtness, forensic autopsy, and the evidentiary suicide note: A multilevel National Violent Death Reporting System analysis.

PubMed

Rockett, Ian R H; Caine, Eric D; Stack, Steven; Connery, Hilary S; Nolte, Kurt B; Lilly, Christa L; Miller, Ted R; Nelson, Lewis S; Putnam, Sandra L; Nestadt, Paul S; Jia, Haomiao

2018-01-01

Higher prevalence of suicide notes could signify more conservatism in accounting and greater proneness to undercounting of suicide by method. We tested two hypotheses: (1) an evidentiary suicide note is more likely to accompany suicides by drug-intoxication and by other poisoning, as less violent and less forensically overt methods, than suicides by firearm and hanging/suffocation; and (2) performance of a forensic autopsy attenuates any observed association between overtness of method and the reported presence of a note. This multilevel (individual/county), multivariable analysis employed a generalized linear mixed model (GLMM). Representing the 17 states participating in the United States National Violent Death Reporting System throughout 2011-2013, the study population comprised registered suicides, aged 15 years and older. Decedents totaled 32,151. The outcome measure was relative odds of an authenticated suicide note. An authenticated suicide note was documented in 31% of the suicide cases. Inspection of the full multivariable model showed a suicide note was more likely to manifest among drug intoxication (adjusted odds ratio [OR], 1.70; 95% CI, 1.56, 1.85) and other poisoning suicides (OR, 2.12; 1.85, 2.42) than firearm suicides, the referent. Respective excesses were larger when there was no autopsy or autopsy status was unknown (OR, 1.86; 95% CI, 1.61, 2.14) and (OR, 2.25; 95% CI, 1.86, 2.72) relative to the comparisons with a forensic autopsy (OR, 1.62, 95% CI, 1.45, 1.82 and OR, 2.01; 95% CI, 1.66, 2.43). Hanging/suffocation suicides did not differ from the firearm referent given an autopsy. Suicide requires substantial affirmative evidence to establish manner of death, and affirmation of drug intoxication suicides appears to demand an especially high burden of proof. Findings and their implications argue for more stringent investigative standards, better training, and more resources to support comprehensive and accurate case ascertainment, as the foundation for developing evidence-based suicide prevention initiatives.

Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.

PubMed

Wills, John; Schwend, Richard M; Paterson, Andrew; Albin, Maurice S

2005-10-15

Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. To report 2 cases where visible bubbling at the operative site was the first clinical indication of VAE-induced cardiovascular collapse and to raise the level of consciousness that VAE in the prone position can occur, often with serious consequences. Twenty-two cases of VAE during surgery for scoliosis in the prone position have been reported. Ten were fatal and ten were in children. Visible bubbling at the operative site was noted in two published cases. Retrospective study of 2 cases of VAE at one institution. Clinical, anesthetic, and radiographic features are presented. Details of previously published cases are reviewed and discussed. Both patients were girls with adolescent scoliosis who underwent prone positioned posterior spinal fusion with instrumentation. Visible bubbling of air at the thoracic aspect of the surgical site was noted near the completion of instrumentation and was the first indication of VAE. In both cases, this was clinically recognized and promptly treated. One patient survived normally and the other died. Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.

[The managment of serious pregnant disease in the intensive care unit].

PubMed

Ali, Elhusseini; Bechir, Khemiri; Badis, Chennoufi Mohamed; Nabil, Mathlouthi; Hanene, Ellouze; Mourad, Bouchnak; Salah, Hendaoui Mohamed; Hayen, Maghrebi; Ezzeddine, Sfar; Hela, Chelli

2005-02-01

We report a retrospective study over a period of 4 years and half and bearing on 59 patients that require an intensive care. The number of childbirth during this period was 22237 with 8.97% of Caesareans. The main obstetrical diseases was: gravidic toxaemia 75.5%, uterine inertia 7%, cardiopathy 5% of the cases. The reasons for the transfer were: eclamptic state in 27% of the cases, hémostasis disorder 22% of the cases, and acute pulmonary oedema 18.6% of the cases. Average duration of hospitalization was 3.18 days. Five cases of death were noted.

[Control-lateral sciatrica after surgery for herniated disk].

PubMed

Sicard, A; Banai, M

1976-12-01

A study of 1,427 case records permitted the authors to discover 10 cases of reoperation for sciatica which appeared on the opposite side after removal of a dischernia. A new hernia was noted in 6 cases, whereas radiculitis of unknown origin, appeared to be responsible in 4 cases. The 10 patients who became cured, either after removal of the hernia, or after decompression through the foramin. These few cases, in fact rare, may be considered as relapses and thus poor surgical results. The provide a contribution to the understanding of intervertebral disc disease and raise an interesting medico-legal problem.

50. THIRD FLOOR, HALL, LOOKING SOUTH. Note ceiling extends down ...

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

50. THIRD FLOOR, HALL, LOOKING SOUTH. Note ceiling extends down over window case and exterior frieze extends halfway down top light of sash - Robinson-Aiken House, 48 Elizabeth Street, Charleston, Charleston County, SC

INTERNAL LIMITING MEMBRANE PEELING-DEPENDENT RETINAL STRUCTURAL CHANGES AFTER VITRECTOMY IN RHEGMATOGENOUS RETINAL DETACHMENT.

PubMed

Hisatomi, Toshio; Tachibana, Takashi; Notomi, Shoji; Koyanagi, Yoshito; Murakami, Yusuke; Takeda, Atsunobu; Ikeda, Yasuhiro; Yoshida, Shigeo; Enaida, Hiroshi; Murata, Toshinori; Sakamoto, Taiji; Sonoda, Koh-Hei; Ishibashi, Tatsuro

2018-03-01

To examine retinal changes after vitrectomy with internal limiting membrane (ILM) peeling, we used 3-dimensional optical coherence tomography (3D-OCT) in rhegmatogenous retinal detachment cases. The 68 eyes from 67 patients with rhegmatogenous retinal detachment were studied, including 35 detached macula cases (51%) and 33 attached macula cases. Internal limiting membrane peeling was performed with fine forceps after brilliant blue G staining. The 3D-OCT images were obtained with volume-rendering technologies from cross-sectional OCT images. The 3D-OCT detected 45 eyes (66%) with ILM peeling-dependent retinal changes, including dissociated optic nerve fiber layer appearance, dimple sign, temporal macular thinning, ILM peeling area thinning, or forceps-related retinal thinning. The ILM peeled area was detectable in only 9 eyes with 3D-OCT, whereas it was undetectable in other 59 eyes. The dissociated optic nerve fiber layer appearance was detected in 8 of the total cases (12%), and dimple signs were observed in 14 cases (21%). Forceps-related thinning was also noted in eight cases (24%) of attached macula cases and in four cases (11%) of detached macula cases. No postoperative macular pucker was noted in the observational period. The 3D-OCT clearly revealed spatial and time-dependent retinal changes after ILM peeling. The changes occurred in 2 months and remained thereafter.

15 CFR 50.5 - Fee structure for age search and citizenship information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE SPECIAL SERVICES AND STUDIES BY THE BUREAU OF... to the $65.00 transcript fee. Note: An additional charge of $20.00 per case is charged for expedited...

Use of Electronic Health Record Simulation to Understand the Accuracy of Intern Progress Notes

PubMed Central

March, Christopher A.; Scholl, Gretchen; Dversdal, Renee K.; Richards, Matthew; Wilson, Leah M.; Mohan, Vishnu; Gold, Jeffrey A.

2016-01-01

Background With the widespread adoption of electronic health records (EHRs), there is a growing awareness of problems in EHR training for new users and subsequent problems with the quality of information present in EHR-generated progress notes. By standardizing the case, simulation allows for the discovery of EHR patterns of use as well as a modality to aid in EHR training. Objective To develop a high-fidelity EHR training exercise for internal medicine interns to understand patterns of EHR utilization in the generation of daily progress notes. Methods Three months after beginning their internship, 32 interns participated in an EHR simulation designed to assess patterns in note writing and generation. Each intern was given a simulated chart and instructed to create a daily progress note. Notes were graded for use of copy-paste, macros, and accuracy of presented data. Results A total of 31 out of 32 interns (97%) completed the exercise. There was wide variance in use of macros to populate data, with multiple macro types used for the same data category. Three-quarters of notes contained either copy-paste elements or the elimination of active medical problems from the prior days' notes. This was associated with a significant number of quality issues, including failure to recognize a lack of deep vein thrombosis prophylaxis, medications stopped on admission, and issues in prior discharge summary. Conclusions Interns displayed wide variation in the process of creating progress notes. Additional studies are being conducted to determine the impact EHR-based simulation has on standardization of note content. PMID:27168894

Use of Electronic Health Record Simulation to Understand the Accuracy of Intern Progress Notes.

PubMed

March, Christopher A; Scholl, Gretchen; Dversdal, Renee K; Richards, Matthew; Wilson, Leah M; Mohan, Vishnu; Gold, Jeffrey A

2016-05-01

Background With the widespread adoption of electronic health records (EHRs), there is a growing awareness of problems in EHR training for new users and subsequent problems with the quality of information present in EHR-generated progress notes. By standardizing the case, simulation allows for the discovery of EHR patterns of use as well as a modality to aid in EHR training. Objective To develop a high-fidelity EHR training exercise for internal medicine interns to understand patterns of EHR utilization in the generation of daily progress notes. Methods Three months after beginning their internship, 32 interns participated in an EHR simulation designed to assess patterns in note writing and generation. Each intern was given a simulated chart and instructed to create a daily progress note. Notes were graded for use of copy-paste, macros, and accuracy of presented data. Results A total of 31 out of 32 interns (97%) completed the exercise. There was wide variance in use of macros to populate data, with multiple macro types used for the same data category. Three-quarters of notes contained either copy-paste elements or the elimination of active medical problems from the prior days' notes. This was associated with a significant number of quality issues, including failure to recognize a lack of deep vein thrombosis prophylaxis, medications stopped on admission, and issues in prior discharge summary. Conclusions Interns displayed wide variation in the process of creating progress notes. Additional studies are being conducted to determine the impact EHR-based simulation has on standardization of note content.

[Cholesterosis of the gallbladder].

PubMed

Baĭbekov, I M; Vorozheĭkin, V M; Altiev, B K; Khoroshaev, V A

1985-01-01

Altogether 238 gall bladders from the necropsy cases and 260 those removed surgically were examined morphologically. Various forms of cholesterosis were found in 5 cases from the first group and in 12 cases from the second. The gall bladder mucous membrane was studied by scanning electron microscopy. Low incidence of this disease is noted in the Central Asia. The mucous membrane surface in health and cholesterosis is described. The conclusion is drawn about the link of the cholesterosis incidence with the traditional nutrition in this area.

Alcohol Involvement in Suicide and Self-Harm.

PubMed

Larkin, Celine; Griffin, Eve; Corcoran, Paul; McAuliffe, Carmel; Perry, Ivan J; Arensman, Ella

2017-11-01

Alcohol misuse and alcohol consumption are significant risk factors for suicidal behavior. This study sought to identify factors associated with alcohol consumption in cases of suicide and nonfatal self-harm presentations. Suicide cases in Cork, Ireland, from September 2008 to June 2012 were identified through the Suicide Support and Information System. Emergency department presentations of self-harm in the years 2007-2013 were obtained from the National Self-Harm Registry Ireland. Alcohol consumption was detected in the toxicology of 44% out of 307 suicide cases. Only younger age was significantly associated with having consumed alcohol among suicides. Alcohol consumption was noted in the case notes in 21% out of 8,145 self-harm presentations. Logistic regression analyses indicated that variables associated with having consumed alcohol in a self-harm presentation included male gender, older age, overdose as a method, not being admitted to a psychiatric ward, and presenting out-of-hours. Data was limited to routinely collected variables by the two different monitoring systems. Alcohol consumption commonly precedes suicidal behavior, and several factors differentiated alcohol-related suicidal acts. Self-harm cases, in particular, differ in profile when alcohol is consumed and may require a tailored clinical approach to minimize risk of further nonfatal or fatal self-harm.

Shared written case formulations and weight change in outpatient therapy for anorexia nervosa: a naturalistic single case series.

PubMed

Gladwin, Alice M; Evangeli, Michael

2013-01-01

The therapeutic effects of written shared case formulations are underexplored and have not been examined in anorexia nervosa. This study explored the relationship between (a) the delivery (b) the quality of a shared written case formulation and weight in outpatient psychological therapy for anorexia nervosa. A naturalistic single case series approach was used to examine the case notes of women who had attended a specialist eating disorders service over a 2-year period. The case notes of 15 adult women who had undergone outpatient psychological therapy for anorexia nervosa with a shared written case formulation component were reviewed. The impact of the quality of the case formulation on weekly weight was examined for 14 of the clients where the case formulation was available. The nature of the relationship between the delivery of the written shared case formulation and weight was examined for all 15 clients. There was some evidence to support an association between delivery of the shared written case formulation and weight changes (both weight gain [five out of 15 clients] and weight loss [three out of 15 clients]) in individual cases. Higher case formulation quality was related to cases where weight change did not occur. The delivery of case formulations can be associated with important therapeutic change (both beneficial and potentially harmful) in anorexia nervosa. Future research into the causal mechanisms associated with sharing formulations will face the challenge of adopting strategies that allow for an in-depth exploration of complex therapy variables whilst overcoming methodological challenges. Copyright © 2012 John Wiley & Sons, Ltd.

Case studies in medical futility.

PubMed

Mains, Douglas A; Coustasse, Alberto; Lurie, Sue G

2007-01-01

Technology has provided means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient. This study presents two case histories, compiled from historical patient charts, staff notes and observations, that illustrate the variety of ethical issues involved and the role culture plays in the decision making process related to possible futile medical treatment. Ethical and cultural issues related to the cases are discussed and processes are presented that can help hospitals to avoid, or decrease the level of, medically futile care, and improve the cultural appropriateness of medical care and relationships with patients.

Mining Peripheral Arterial Disease Cases from Narrative Clinical Notes Using Natural Language Processing

PubMed Central

Afzal, Naveed; Sohn, Sunghwan; Abram, Sara; Scott, Christopher G.; Chaudhry, Rajeev; Liu, Hongfang; Kullo, Iftikhar J.; Arruda-Olson, Adelaide M.

2016-01-01

Objective Lower extremity peripheral arterial disease (PAD) is highly prevalent and affects millions of individuals worldwide. We developed a natural language processing (NLP) system for automated ascertainment of PAD cases from clinical narrative notes and compared the performance of the NLP algorithm to billing code algorithms, using ankle-brachial index (ABI) test results as the gold standard. Methods We compared the performance of the NLP algorithm to 1) results of gold standard ABI; 2) previously validated algorithms based on relevant ICD-9 diagnostic codes (simple model) and 3) a combination of ICD-9 codes with procedural codes (full model). A dataset of 1,569 PAD patients and controls was randomly divided into training (n= 935) and testing (n= 634) subsets. Results We iteratively refined the NLP algorithm in the training set including narrative note sections, note types and service types, to maximize its accuracy. In the testing dataset, when compared with both simple and full models, the NLP algorithm had better accuracy (NLP: 91.8%, full model: 81.8%, simple model: 83%, P<.001), PPV (NLP: 92.9%, full model: 74.3%, simple model: 79.9%, P<.001), and specificity (NLP: 92.5%, full model: 64.2%, simple model: 75.9%, P<.001). Conclusions A knowledge-driven NLP algorithm for automatic ascertainment of PAD cases from clinical notes had greater accuracy than billing code algorithms. Our findings highlight the potential of NLP tools for rapid and efficient ascertainment of PAD cases from electronic health records to facilitate clinical investigation and eventually improve care by clinical decision support. PMID:28189359

An Application of an IDEFO Model to Improve the Process of Base Closure: A Case Study

DTIC Science & Technology

1993-12-01

Leave blank) 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED December 1993 Master’s Thesis 4. TITLE AND SUBTITLE AN APLICATION OF AN IDEFO MODEL 5...Closure: A Case Study by Varanda K. Phillips December, 1993 Thesis Advisor: Kenneth J. Euske Approved for public release; distribution is unlimited. AY...10. SPONSOR ING/MONITORING AGENCY REPORT NUMBER 11. SUPPLEMENTARY NOTES The views expressed in this thesis are those of the author and do not reflect

Color Vision Deficits and Literacy Acquisition.

ERIC Educational Resources Information Center

Hurley, Sandra Rollins

1994-01-01

Shows that color blindness, whether partial or total, inhibits literacy acquisition. Offers a case study of a third grader with impaired color vision. Presents a review of literature on the topic. Notes that people with color vision deficits are often unaware of the handicap. (RS)

From Rhetoric to Reality: Case Studies of Two Fifth Grade Science Teachers to Inform Reform

ERIC Educational Resources Information Center

Maynard, Kathie Jo

2013-01-01

The purpose of this qualitative study was to explore two elementary teachers' implementation of engineering design over two academic years and to describe how their teaching practice changed over the two instructional cycles. This study used field notes and audio transcripts of the teachers during their engineering design teaching, written…

An Examination of Amotivated Students within the Sport Education Model

ERIC Educational Resources Information Center

Perlman, Dana

2012-01-01

The purpose of this study was to examine the perceptions and experiences of 33 amotivated students (i.e. students with low levels of motivation) during four consecutive seasons of the Sport Education Model. A qualitative case-study approach was utilized within this study and data was collected using interviews, field notes and reflective journals.…

Finding Ways to Teach to Students with FASD: A Research Study

ERIC Educational Resources Information Center

Edmonds, Kelly; Crichton, Susan

2008-01-01

This study examines a unique educational program designed for youth with Fetal Alcohol Spectrum Disorder [FASD] in Alberta, Canada. Care was taken to include the participants' voice in this case study resulting in key insights and strategies for working with youth and/or students struggling with FASD. Using observation notes, survey and interview…

The Tale of Three Campuses: A Case Study in Outdoor Campus Assessment

ERIC Educational Resources Information Center

Eckert, Erica L.

2013-01-01

In a study for APPA's Center for Facilities Research (CFaR), Cain and Reynolds (2006a; 2006b) linked the quality of campus facilities and the attractiveness of campus to college choice among their study's participants but also noted that facilities may not always be the primary motivation. Further, the physical campus environment can impact…

Sexual Abuse Experiences of Women in Peru: An Exploratory Study

ERIC Educational Resources Information Center

Deboer, Rebekah E.; Tse, Luke M.

2010-01-01

This ethnographic study relied primarily on case notes and interviews with the president of Centro Prenatal Vida Nueva, a pregnancy center in Lima, Peru, to study the sexual abuse experiences of 33 Peruvian women. Given the language limitations of the researchers, the analyses were completed in collaboration with the president of the center, a…

Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases.

PubMed

Pugliese, Raffaele; Forgione, Antonello; Sansonna, Fabio; Ferrari, Giovanni Carlo; Di Lernia, Stefano; Magistro, Carmelo

2010-03-01

Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique that aims at reducing or abolishing skin incisions and potentially also postoperative pain. The purpose of this study was to analyse operative and long-term results of a series of hybrid transvaginal cholecystectomy. Between July 2007 and May 2009, transvaginal NOTES cholecystectomy for symptomatic cholelithiasis was performed by a hybrid technique in 18 women (mean age 54 years), including four women with a body mass index >30 kg/m(2). Dissection was conducted in the first four cases by a round-tip unipolar electrode (UE) introduced through the operative channel of the endoscope coming from the vagina and in the last 14 cases by a ultrasonic scalpel (US) introduced through a 5-mm abdominal port. The short-term outcomes and the long-term results of the two methods were compared. The transvaginal approach entailed no intraoperative complication and no conversion. The overall mean duration of procedures was 75 min (range 40-190). In the first four cases (UE), the operating time was 148 min (range 140-190), whilst in the last 14 (US), it was considerably shorter, 53 min (range 40-60, p < 0.01). We experienced one biliary leak in the UE group, whilst morbidity with US was nil (p < 0.005). The biliary leak healed in 7 days with nasobiliary drainage. No other complications were encountered in either group. The mean follow-up was 12 months (range 1-22), and none of the patients has complained of dyspareunia or other colpotomy-related complications so far. Until specifically designed endoscopic tools are available for NOTES, the hybrid technique with US dissection conducted through a 5-mm port should be preferred in transvaginal cholecystectomy in order to shorten the duration of surgery and make this approach effective, safe and reproducible. After a mean follow-up of 1 year, none of our patients has complained of any problem related to transvaginal approach.

Lionfish string experiences of an inland poison center: a retrospective study of 23 cases.

PubMed

Trestrail, J H; al-Mahasneh, Q M

1989-04-01

From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world.

Assessor Decision Making While Marking a Note-Taking Listening Test: The Case of the OET

ERIC Educational Resources Information Center

Harding, Luke; Pill, John; Ryan, Kerry

2011-01-01

This article investigates assessor decision making when using and applying a marking guide for a note-taking task in a specific purpose English language listening test. In contexts where note-taking items are used, a marking guide is intended to stipulate what kind of response should be accepted as evidence of the ability under test. However,…

Problem Solving Strategies of Selected Pre-Service Secondary School Mathematics Teachers in Malaysia

ERIC Educational Resources Information Center

Yew, Wun Theam; Zamri, Sharifah Norul Akmar Syed

2016-01-01

Problem solving strategies of eight pre-service secondary school mathematics teachers (PSSMTs) were examined in this study. A case study research design was employed and clinical interview technique was used to collect the data. Materials collected for analysis consisted of audiotapes and videotapes of clinical interviews, subjects' notes and…

'Well, I Have to Write That": A Cross-Case Qualitative Analysis of Young Writers' Motivations to Write

ERIC Educational Resources Information Center

Magnifico, Alecia Marie

2013-01-01

Hickey (2003), taking a "stridently sociocultural" position on motivation, notes that conceptualizations of motivation must shift to successfully study "motivation-in-context" (p. 401 ). This study represents an attempt to navigate such a shift. Rather than taking established understandings of achievement goals and motivation…

Ethnic Differences in Self Poisoning: A Comparative Study between an Asian and White Adolescent Group.

ERIC Educational Resources Information Center

Biswas, Sheela

1990-01-01

Conducted retrospective case note study comparing various characteristics of self-poisoning between White (N=34) and Asian adolescents (N=38). Results showed "Culture Conflict" was implicated in slightly more Asian female self-poisonings as compared to males, Asian females used "non ingestants" significantly more than White…

A Cultural Epistemology of Success: Perspectives from within Three Cambodian Families.

ERIC Educational Resources Information Center

Canniff, Julie G.

Noting that success defines the American identity, this ethnographic case study examined the dynamics of culture, spirituality, and success in the lives of three generations of three Cambodian families. The study pursued three research objectives: (1) to challenge the dominance of quantitative measures to judge refugee students' academic success;…

Egypt: Beyond Pharaohs, Feluccas and Fellahin.

ERIC Educational Resources Information Center

Holt, Evelyn R.

In a random study of five middle school social studies textbooks available for adoption in the state of Indiana in 1984, great variation in the treatment of Egypt was noted. Coverage of contemporary history was incomplete in all cases. All texts dealt with Egypt's ancient history, but what was reported was questionable. Only one text addressed in…

Embedded Librarians: Just-in-Time or Just-in-Case? A Research Study

ERIC Educational Resources Information Center

Heathcock, Kristin

2015-01-01

Embedded librarians in online courses provide a wealth of service and information to students. Though students indicate that these services are valuable, the librarians providing embedded services frequently note that these projects are very time consuming. This study examines the provision of a less time-intensive model of embedded librarianship…

Microbiology, infection control and infection related outcome in pediatric patients in an oncology center in Eastern India: Experience from Tata Medical Center, Kolkata.

PubMed

Bhattacharyya, Arpita; Krishnan, Shekhar; Saha, Vaskar; Goel, Gaurav; Bhattacharya, Sanjay; Hmar, Lalawmpuia

2014-01-01

Infection is a major determinant in the outcome of patients with cancer. The aim was to know the epidemiology and outcome of patients with cancer in a cancer care center in Eastern India. Retrospective study of pediatric patients in Tata Medical Center, Kolkata, India. Patients (n = 262) between the age group of 0 and 18 years were reviewed for infections and infection-related outcome (January to December 2013). Modified Wald method was used to determine confidence interval of proportions. Gram-negative bacteria were found to be the most common cause of bloodstream infections (BSIs) (56.4%), followed by Gram-positive cocci (34.5%), and Candida species (9.1%). Carbapenem-resistance was noted among 24% of Gram-negative bacilli (GNB), and extended-spectrum beta-lactamase among 64% of GNBs. A single case of Vibrio cholerae septicemia was also noted. No case of vancomycin-resistant Enterococcus was observed, whereas only two cases of methicillin-resistant Staphylococcus aureus bacteremia (1/3 of all Staphylococcus aureus bacteremia) were detected. Escherichia coli, followed by Klebsiella, Pseudomonas, and Acinetobacter were the predominant organisms detected in BSIs. Among Candida spp. BSIs no resistance to caspofungin, amphotericin B, Voriconazole was noted. Candida tropicalis was the most common isolate, and 1 isolate of Candida glabrata showed dose-dependent sensitivity to fluconazole. Three out of 25 patients died of multi-drug resistant Gram-negative bacteria (12%) in 2013. Seventeen patients had radiological evidence of invasive fungal infections (no mortality was noted). Periodic review of infection-related data, as well as infection control practices, is essential to optimize clinical outcome in patients with pediatric malignancies.

Assessment of DNA damage and repair efficiency in drug naïve schizophrenia using comet assay.

PubMed

Muraleedharan, Aparna; Menon, Vikas; Rajkumar, Ravi Philip; Chand, Parkash

2015-09-01

The etiology of schizophrenia continues to be confounding and elusive. Some knowledge gaps exist in the neurodegenerative theory of schizophrenia. Oxidative DNA damage and repair deficits are relevant to the mechanisms of neurodegeneration but have not been studied in drug naïve schizophrenia. The present study used the comet assay technique to study the extent of DNA damage in circulating peripheral lymphocytes of patients with drug naïve schizophrenia (n = 40) along with an age and gender matched control group (n = 40). We also assessed the DNA repair efficiency in cases following incubation in a nutrient medium. All the assayed comet parameters demonstrated significantly greater baseline DNA damage in cases in comparison to the controls except for head diameter (p < 0.001 for all significant results, p = 0.32 for head diameter). Gender, age and duration of illness (p = 0.21, 0.69 and 0.12 respectively for tail length) did not influence any of the parameters significantly. Significant decrease was noted in the comet tail length and percentage of DNA in comet tail (p < 0.001 for both) in cases following incubation suggesting that the DNA repair machinery was preserved. No difference in DNA repair efficiency was noted between the genders (p = 0.23 for tail length). Our findings confirm the presence of significant baseline DNA damage in schizophrenia even prior to the initiation of anti-psychotic treatment. Additionally, intact genomic repair efficiency was noted in this group as a whole. These results provide some evidence for oxidative DNA damage as molecular link underpinning neurodegeneration in drug naïve schizophrenia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Documentation of Dual Sensory Impairment in Electronic Medical Records.

PubMed

Dullard, Brittney; Saunders, Gabrielle H

2016-04-01

To examine the documentation of sensory impairment in the electronic medical records (EMRs) of Veterans with both hearing and vision losses (dual sensory impairment [DSI]). A retrospective chart review of the EMRs of 20 patients with DSI was conducted. Providers' documentation of the presence of sensory impairment, the use of assistive technology during clinical appointments, and the content of notes mentioning communication issues were extracted from each chart note in the EMR for the prior 6 years. Primary care providers documented DSI in 50% of EMRs, vision loss alone in 40%, and hearing loss alone in 10% of EMRs. Audiologists documented vision loss in 50% of cases, whereas ophthalmologists/optometrists documented hearing loss in 15% of cases. Examination of two selected cases illustrates that care can be compromised when providers do not take note of sensory impairments during planning and provision of clinical care. Sensory impairment is poorly documented by most providers in EMRs. This is alarming because vision and hearing affect patient-physician communication and the use of medical interventions. The results of this study raise awareness about the need to document the presence of sensory impairments and use the information when planning treatment for individuals with DSI. © The Author 2014. 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.

An audit of the quality of operation notes in an otolaryngology unit.

PubMed

Bateman, N D; Carney, A S; Gibbin, K P

1999-04-01

Hand-written operation notes are often produced as evidence in medico-legal cases. Incomplete and illegible notes, along with the use of confusing abbreviations, are a common source of weakness in a surgeon's defence. An audit of 100 sets of operation notes was carried out in a single otolaryngology department. Notes were scrutinised for the accuracy of data, ward, department and name of surgeon, as well as for the inclusion of unacceptable abbreviations. Using an aide-memoire attached to the front of the operation sheet, the audit was repeated with identical criteria. The aide-memoire improved the standard of operation note with respect to all measured criteria. Clear identification of operating surgeon improved from 74% to 93%, and the avoidance of unacceptable abbreviations rose from 53% to 84%. We conclude that a simple aide-memoire attached to operation note sheets can significantly improve the quality of note-keeping and potentially avoid medico-legal problems.

NOTES: a review of the technical problems encountered and their solutions.

PubMed

Mintz, Yoav; Horgan, Santiago; Cullen, John; Stuart, David; Falor, Eric; Talamini, Mark A

2008-08-01

Natural orifice translumenal endoscopic surgery (NOTES) is currently investigated and developed worldwide. In the past few years, multiple groups have confronted this challenge. Many technical problems are encountered in this technique due to the currently available tools for this approach. Some of the unique technical problems in NOTES include: blindly performed primary incisions; uncontrolled pneumoperitoneal pressure; no support for the endoscope in the abdominal cavity; inadequate vision; insufficient illumination; limited retraction and exposure; and the complexity of suturing and performing a safe anastomosis. In this paper, we review the problems encountered in NOTES and provide possible temporary solutions. Acute and survival studies were performed on 15 farm pigs. The hybrid technique approach (i.e., endoscopic surgery with the aid of laparoscopic vision) was performed in all cases. Procedures performed included liver biopsies, bilateral tubal ligation, oophprectomy, cholecystectomy, splenectomy and small bowel resection, and anastomosis. All attempted procedures were successfully performed. New methods and techniques were developed to overcome the technical problems. Closure of the gastrotomy was achieved by T-bar sutures and by stapler closure of the stomach incision. Small bowel anastomosis was achieved by the dual-lumen NOTES technique. The hybrid technique serves as a temporary approach to aid in developing the NOTES technique. A rectal or vaginal port of entry enables and facilitates gastrointestinal NOTES by using available laparoscopic instruments. The common operations performed today in the laparoscopic fashion could be probably performed in the NOTES approach. The safety of these procedures, however, is yet to be determined.

[Cutaneous manifestations of male breast cancer].

PubMed

Hali, Fouzia; Khadir, Khadija; Idhammou, Wassima; Bensardi, Fatima-Zahra; Lefriyekh, Mohamed-Rachid; Benider, Abdelatif; Zamiati, Soumia; Benchikhi, Hakima

2011-11-01

The appearance of skin symptoms in male breast is the main reason for consultation in our context. The aim of this study is to describe the various cutaneous manifestations of male breast cancer through a series of cases collected in a dermatology department. A retrospective study was conducted in the dermatology department at the CHU Ibn Rochd January 1988 to December 2009. All cases of male breast cancer initially diagnosed in dermatology were included. The various epidemiological, clinical, histological and therapeutic data were collected from medical records. Twenty cases were collected. The mean age was 61.25 years. Skin invasion by tumor was found in all patients, and it was the reason for consultation. It was a cutaneous involvement at the nipple and areola (17 cases) and at the periareolar skin (three cases). The clinical appearance of skin involvement was vegetative type in 12 cases, infiltrating with nipple retraction in five cases and nodule with skin change in three cases. The average period of consultation was 25 months. The axillary lymph nodes were noted in 11 patients and distant metastases in eight patients. The cutaneous metastases outside breast were noted in six patients. The histological types were: infiltrating ductal carcinoma in 15 cases (75%), papillary carcinoma in two cases (10%) and non-specific carcinoma in three cases (15%). The treatment was surgery in 14 patients and consisted of radical mastectomy with complete axillary nodal dissection according to Patey. Complementary therapies, chemotherapy or radiotherapy, were indicated in 14 patients. Our single-center study with dermatological recruitment illustrates the frequency and variety of skin disease in male breast cancer and demonstrates that they are still the main reason for consultation in our context. Better information for public and practitioners would allow earlier diagnosis and a more favourable prognosis. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Analytical characterization of the aroma of five premium red wines. Insights into the role of odor families and the concept of fruitiness of wines.

PubMed

Escudero, Ana; Campo, Eva; Fariña, Laura; Cacho, Juan; Ferreira, Vicente

2007-05-30

The aroma profile of five premium red wines has been studied by sensory descriptive analysis, quantitative gas chromatography-olfactometry (GC-O), and chemical quantitative analysis. The most relevant findings have been confirmed by sensory analysis. Forty-five odorants, including the most intense, were identified. At least 37 odorants can be found at concentrations above their odor threshold. A satisfactory agreement between GC-O and quantitative data was obtained in most cases. Isobutyl-2-methoxypyrazine, (E)-whiskey lactone, and guaiacol were responsible for the veggie, woody, and toasted characters of the wines, respectively. The sweet-caramel notes are related to the presence of at least five compounds with flowery and sweet notes. The phenolic character can be similarly related to the presence of 12 volatile phenols. The berry fruit note of these wines is related to the additive effect of nine fruity esters. Ethanol exerts a strong suppression effect on fruitiness, whereas norisoprenoids and dimethyl sulfide enhance fruity notes.

From source material to news story in New Zealand print media: a prospective study of the stigmatizing processes in depicting mental illness.

PubMed

Nairn, R; Coverdale, J; Claasen, D

2001-10-01

The aim of this study was to analyse how newspaper articles that depict mental illnesses are generated from source materials. From a prospectively collected national sample of print materials involving mental illness, 50 published items that related to the Privacy Commissioner's opinion about disclosure of a psychiatric patient's health information were identified. A copy of the Privacy Commissioner's original Case Note and three news stories about the Case Note distributed by the New Zealand Press Association constituted the database. These materials were subjected to discourse analysis. We identified themes and their transformation from the Case Note through the news stories and examined the impact of these transformations on the stigmatization of mental illness. Four themes were identified: human rights, vulnerability, risk of dangerousness and threat, and mental illness/psychiatric patient. The only potentially positive theme, human rights, was limited both by being fragmented in the source material, and by being utilized, in the published news stories to undermine the legitimacy of the patient's right to privacy. Use of the other themes was consistent with stereotypes about mental illness. Although there were no inaccuracies in the content of the news stories they were substantially more negative than the source material in their depiction of the identified patient. A potentially positive discourse (human rights) was not by itself sufficient to ensure a positive portrayal of mental illness. An understanding of the transformations is important for efforts to effectively combat the stigmatization of those with mental illness.

The impact of genital warts: loss of quality of life and cost of treatment in eight sexual health clinics in the UK.

PubMed

Woodhall, S C; Jit, M; Soldan, K; Kinghorn, G; Gilson, R; Nathan, M; Ross, J D; Lacey, C J N

2011-10-01

To estimate the loss of quality of life and cost of treatment associated with genital warts seen in sexual health clinics. A cross-sectional questionnaire study and case note review of individuals with genital warts, carried out in eight sexual health clinics in England and Northern Ireland. Individuals with genital warts attending the participating clinics were invited to take part in the questionnaire study. 895 participants were recruited. A separate sample of 370 participants who had attended a participating clinic with a first visit for a first or recurrent episode of genital warts between April and June 2007 was included in the case note review. Quality of life was measured using the EQ-5D questionnaire and the cost of an episode of care was derived from the case note review. The weighted mean EQ-5D index score was 0.87 (95% CI 0.85 to 0.89). The weighted mean disutility was 0.056 (95% CI 0.038 to 0.074). The estimated mean loss of quality-adjusted life-years associated with an episode of genital warts was 0.018 (95% CI 0.0079 to 0.031), equivalent to 6.6 days of healthy life lost per episode. The weighted mean cost per episode of care was £94 (95% CI £84 to £104), not including the cost of a sexually transmitted infection screen. Genital warts have a substantial impact on the health service and the individual. This information can be utilised for economic evaluation of human papillomavirus vaccination.

SOLVENT-BASED TO WATERBASED ADHESIVE-COATED SUBSTRATE RETROFIT - VOLUME I: COMPARATIVE ANALYSIS

EPA Science Inventory

This volume represents the analysis of case study facilities' experience with waterbased adhesive use and retrofit requirements. (NOTE: The coated and laminated substrate manufacturing industry was selected as part of NRMRL'S support of the 33/50 Program because of its significan...

Little Mito: The Story of the Origins of a Cell.

ERIC Educational Resources Information Center

Vail, Stephanie; Herreid, Clyde Freeman

2002-01-01

Uses the case study method approach to teach about cell structure, organelle functions, the origin of eukaryotic cells, and evolution. Presents a story in which each structure of the cell is characterized with a personality. Includes teaching notes and classroom management strategies. (YDS)

Science Education Notes.

ERIC Educational Resources Information Center

School Science Review, 1979

1979-01-01

Included is information regarding: the adaptation of microcomputer materials in physics curricula; a school-industry liaison case study involving basic electronics for teachers; the use of language in science lessons; problems in teaching image-synthesis skills; and tabulated results of a questionnaire concerning a ten-year span of organic…

Drama: The Play's the Thing.

ERIC Educational Resources Information Center

Irwin, Eleanor C.

1987-01-01

Discusses the history and theory of drama therapy and illustrates it through case studies. Makes suggestions for counselors who wish to use drama to promote psychological development. Notes that using dramatic activities allows counselors to view the inner world of their clients through symbolization, characterization, and interaction. (ABB)

Incidence, Management, and Outcome of Molar Pregnancies at a Tertiary Care Hospital in Quetta, Pakistan

PubMed Central

Fatima, Mahrukh; Kasi, Pashtoon Murtaza; Baloch, Shahnaz Naseer; Kassi, Masoom; Marri, Shah Muhammad; Kassi, Mahwash

2011-01-01

Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases. The incidence appears to be higher in women from South Asia. The purpose of our prospective study was to determine the incidence, presentation, and outcomes of all molar pregnancies at our institution. During the study period, there were a total of 16,625 patients admitted to our department; out of whom 85 patients were diagnosed with a molar pregnancy. Vaginal bleeding was the commonest symptom (94.2%); theca lutein cysts were noted in 39% of the cases. Suction, dilatation, and curettage were noted to be the preferred method in almost all cases; hysterectomy was done in 12 (14.1%) patients. Single-agent chemotherapy was employed in high-risk patients and was well tolerated. Mean followup for these patients was 5.7 months (range 1–24 months). None of these patients developed persistent trophoblastic disease, invasive mole, or choriocarcinoma during the follow-up period. PMID:22028979

Improved external valvuloplasty, intravenous laser photocoagulation and local sclerotheraphy treatment of primary deep venous valvular insufficiency: long term result

NASA Astrophysics Data System (ADS)

Wang, Chun-xi; Han, Li-na; Gu, Ying; Liang, Fa-qi; Zhang, Li; Liu, Hong-yi; Zhao, Wen-guang; Wang, Qi; Wang, Xiao-ling

2007-11-01

The purpose of this article is to report long-term follow-up of improved external vulvuloplasty, intravenous laser photocoagulation and local sclerotherapy treatment of primary deep venous valvular insufficiency in eight hundred and seventy-two patients from Nov. 2000 to May 2006. Patients were evaluated clinically and with duplex ultrasound at 1, 3, and 12 months, and yearly thereafter until the fifth year to assess treatment efficacy and adverse reactions. Successful occlusion of the great saphenous vein and absence of deep vein reflux on color Doppler imaging, were noted in 956 limbs of 852 cases( 1 month follow-up), 946 limbs of 842 cases (6 month to 1 year follow-up), 717 of 626 (1~2 year follow-up), 501 of 417 (2~3 year follow-up), 352 of 296 (3~5year follow-up), 142 of 106 (5 year follow-up) after initial treatment. The cumulative total number of recurrence of reflux was fifteen cases. The respective competence rate was 95.18%, 96.23%, 94.23%, 95.25%, 94.23% and 94.12%. Of note, all recurrence occurred before 9 months, with the majority noted before 3 months. Bruising was noted in 0.7% of patients, tightness along the course of treated vein in 1.0% of limbs. There have been no paresthesia of cases, skin burns and deep vein thrombosis.

Preoperative Pulmonary Nodule Localization: A Comparison of Methylene Blue and Hookwire Techniques.

PubMed

Kleedehn, Mark; Kim, David H; Lee, Fred T; Lubner, Meghan G; Robbins, Jessica B; Ziemlewicz, Timothy J; Hinshaw, J Louis

2016-12-01

Small pulmonary nodules are often difficult to identify during thoracoscopic resection, and preoperative CT-guided localization performed using either hookwire placement or methylene blue injection can be helpful. The purpose of this study is to compare the localization success and complication rates of these two techniques. One hundred two consecutive patients who underwent a total of 109 localization procedures performed with CT fluoroscopic guidance were analyzed. The procedures included 52 hookwire insertions and 57 methylene blue injections. The localization success and complication rates associated with the two groups were compared. All nodules in both groups were identified intraoperatively, except for those in two patients in the hookwire group who did not proceed to undergo same-day surgery, including one with a massive systemic air embolus that resulted in death. Hookwires were dislodged in seven of 52 cases (13%), but the surgeons were still able to locate the nodules through visualization of the parenchymal puncture sites. The total number of complications was higher in the hookwire insertion group than in the methylene blue injection group, but this trend was not statistically significant, with all types of complications occurring in 28 cases (54%) versus 26 cases (46%) (p = 0.45), major complications noted in four cases (8%) versus one case (2%) (p = 0.19), pneumothorax observed in 20 cases (38%) versus 14 cases (25%) (p = 0.15), and perilesional hemorrhage occurring in six cases (12%) versus two cases (4%) (p = 0.15), respectively. The present study suggests that methylene blue injection and hookwire insertion are statistically equivalent for preoperative pulmonary nodule localization; however, seven of 52 hookwires dislodged, and trends toward more frequent and severe complications were noted in the hookwire insertion group.

Animal Assisted Therapy and Trauma Survivors.

PubMed

Mims, Debra; Waddell, Rhondda

2016-01-01

Animal therapy is making strides in the treatment of posttraumatic stress disorder (PTSD). For years, animals have been used with great benefit in the treatment of the aged and the terminally ill. Now animal assisted therapy is benefitting sufferers of PTSD. The results of animal assisted therapy in the treatment of PTSD patients have seen significant results. In one study of the effect of dogs with patients, psychologists noted an 82% reduction in symptoms. One particular case noted that interacting with the dog for as little as one week, enabled a patient to decrease the amount of anxiety and sleep medications by half.

Directly observed daily mouth care provided to care home residents in one area of Kent, UK.

PubMed

Zander, A; Boniface, D

2017-03-01

To gather accurate data on the daily mouth care provided in care homes including tooth brushing, oral health assessment, and recording of care provided. Direct observation and notes review. Both nursing and 'regular' care homes. 365 Residents living in 16 care homes and their carers underwent observation, notes review or data collection in some form. Provision of mouth morning care. Of 161 residents observed, most (93, 58%) did not have their teeth/dentures brushed. If performed, brushing was often carried out by the resident themselves (36 cases, 53%), rather than by a carer (32 cases, 44%). Carers used a toothbrush to clean inside a resident's mouth in just 7 cases (4.3% of all personal care routines observed). Smaller care homes were no more likely to brush residents teeth than larger care homes, and nursing homes were no more likely to brush teeth than other care homes. Of the 309 sets of notes available for review, 41 (13%) contained a dedicated oral health needs assessment, and 109 (35%) contained a daily oral care chart in some form. Mouth care was often recorded inaccurately (15% of cases). This is the first observational study in the UK to assess oral care actually provided to residents by carers in care homes. The findings reveal a substantially different picture of daily mouth care than was previously understood and suggest that many of the nation's care home residents may not be receiving adequate, or any, oral health care. Copyright© 2017 Dennis Barber Ltd

The life cycles of intense cyclonic and anticyclonic circulation systems observed over oceans

NASA Technical Reports Server (NTRS)

Smith, Phillip J.

1994-01-01

The work over the past six months has focused on the October/November 1985 blocking case study noted in the last progress report. A summary of the results of this effort is contained in the attached preprint papers for the Symposium on the Life Cycles of Extratropical Cyclones. Using this case study as a model, Ph.D. student Anthony Lupo is now initiating the multiple-case diagnosis by first examining two more fall 1985 blocking episodes. In addition, two secondary efforts have been completed, as summarized in the attached M.S. thesis abstracts. Both studies, which were primarily funded by a fellowship and a teaching assistantship, complement the objectives of this study by providing diagnoses of additional cyclone cases to serve as a comparative base for the pre-blocking cyclones to be studied in the multiple-case blocking diagnosis.

[THREE CASES OF ACCIDENTAL AUTO-INJECTION OF ADRENALINE].

PubMed

Yanagida, Noriyuki; Iikura, Katsuhito; Ogura, Kiyotake; Wang, Ling-jen; Asaumi, Tomoyuki; Sato, Sakura; Ebisawa, Motohiro

2015-12-01

Reports on accidental auto-injection of adrenaline are few. We encountered three cases of accidental injection of adrenaline. In this study, we have examined and reported the clinical courses and symptoms of our cases. CASE 1 involved a female physician in her 50s who had attended an explanatory meeting on auto-injection of adrenaline. She mistook EpiPen® to be the EpiPen trainer and accidentally injected herself with 0.3 mg EpiPen®. Her systolic/diastolic pressure peaked at 7 min to reach 144/78 mmHg and decreased to 120/77 mmHg at 14 min. Except for palpitation after 7 min, the only subjective symptom was local pain at the injection site. CASE 2 was noted in a 6-year-old boy. He accidentally pierced his right forefinger with 0.15 mg EpiPen®, and after 20 min, his right forefinger was swollen. The swelling improved 80 min after the accidental injection. CASE 3 was noted in a 4-year-old girl. She accidentally injected herself with 0.15 mg EpiPen®. Her systolic/diastolic pressure peaked at 23 min to reach 123/70 mmHg and decreased to 96/86 mmHg at 28 min. Severe adverse effects of accidental auto-injection of adrenaline were not observed in these three cases. Our findings suggest that while handling adrenaline auto-injectors, we should keep in mind the possibility of accidental injection.

Mining peripheral arterial disease cases from narrative clinical notes using natural language processing.

PubMed

Afzal, Naveed; Sohn, Sunghwan; Abram, Sara; Scott, Christopher G; Chaudhry, Rajeev; Liu, Hongfang; Kullo, Iftikhar J; Arruda-Olson, Adelaide M

2017-06-01

Lower extremity peripheral arterial disease (PAD) is highly prevalent and affects millions of individuals worldwide. We developed a natural language processing (NLP) system for automated ascertainment of PAD cases from clinical narrative notes and compared the performance of the NLP algorithm with billing code algorithms, using ankle-brachial index test results as the gold standard. We compared the performance of the NLP algorithm to (1) results of gold standard ankle-brachial index; (2) previously validated algorithms based on relevant International Classification of Diseases, Ninth Revision diagnostic codes (simple model); and (3) a combination of International Classification of Diseases, Ninth Revision codes with procedural codes (full model). A dataset of 1569 patients with PAD and controls was randomly divided into training (n = 935) and testing (n = 634) subsets. We iteratively refined the NLP algorithm in the training set including narrative note sections, note types, and service types, to maximize its accuracy. In the testing dataset, when compared with both simple and full models, the NLP algorithm had better accuracy (NLP, 91.8%; full model, 81.8%; simple model, 83%; P < .001), positive predictive value (NLP, 92.9%; full model, 74.3%; simple model, 79.9%; P < .001), and specificity (NLP, 92.5%; full model, 64.2%; simple model, 75.9%; P < .001). A knowledge-driven NLP algorithm for automatic ascertainment of PAD cases from clinical notes had greater accuracy than billing code algorithms. Our findings highlight the potential of NLP tools for rapid and efficient ascertainment of PAD cases from electronic health records to facilitate clinical investigation and eventually improve care by clinical decision support. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Fetal protection and potential liability: judicial application of the Pregnancy Discrimination Act and the disparate impact theory.

PubMed

Moelis, L S

1985-01-01

"Fetal vulnerability programs," which are employer attempts to protect employees' unborn fetuses from harm caused by the mothers' exposure to hazardous material in the workplace, have been challenged as a form of employment discrimination. This Note analyzes the recent judicial application of the Pregnancy Discrimination Act (PDA) and the disparate impact theory to fetal vulnerability cases. The Note also examines the business necessity defense's accommodation of legitimate employer interests. The Note concludes that a more potent business necessity defense, a stricter standard for evaluating alternative protective measures, and a judicial interpretation of the PDA which is more consistent with congressional intent are necessary for fair and reasonable resolution of these cases.

The Case of the Missing Childhoods: Methodological Notes for Composing Children in Writing Studies

ERIC Educational Resources Information Center

Dyson, Anne Haas

2013-01-01

Writing studies has been an intellectual playground dominated by the "big kids." If we are to understand how writing becomes "relevant" to children as children, then we must study them, not for who they are becoming, but for who they are in life spaces shared with other children. This essay on the methodology entailed in…

First-Hand Experience with Engineering Design and Career Interest in Engineering: An Informal STEM Education Case Study

ERIC Educational Resources Information Center

Ayar, Mehmet C.

2015-01-01

The purpose of this study is to present students' experiences, interest in engineering, and personal narratives while participating in a robotics summer camp in a metropolitan city in Turkey. In this study, I used qualitative data collection methods such as interviews, field notes, and observations. I used the four principles of Engle and Conant…

The Eclipse of Progressive, Democratic Education in the United States: A Case Study of Springfield, Missouri Schools, 1924-1952.

ERIC Educational Resources Information Center

Nelson, Lynn R.; Drake, Frederick D.

This paper focuses on Springfield (Missouri) public schools and the superintendency of Harry P. Study, a progressive educator who advocated "education for a democratic community" during the 1920s in a city and state that held conservative values and beliefs. Noting that Study was a cosmopolitan and experienced educator, the paper…

Gifts on a High Note: A Case Study of Major Donors to Music Programs in Higher Education

ERIC Educational Resources Information Center

Barascout, Roger

2012-01-01

This study is an examination of the giving decision-making process, as well as the factors, characteristics, and motivators of major donors to music programs in higher education. The college and the conservatory of music selected for this study are part of large, public, doctoral, research universities in metropolitan areas with at least three…

Interorganizational Special Education Programming in Rural Areas: Technical Report on the Multisite Naturalistic Field Study. Volumes I through IV.

ERIC Educational Resources Information Center

Skrtic, Thomas M.; And Others

The report discusses a field study of the implementation of major requirements of P.L. 94-142, the Education For All Handicapped Children Act, by rural districts, and presents detailed case studies of five districts' responses. The first volume introduces the naturalistic model of inquiry, noting its philosophical underpinnings and basic…

Retrospective Analysis of Nonepileptic Patients With Isolated Epileptiform Discharges Treated With Anticonvulsants.

PubMed

Swatzyna, Ronald J; Tarnow, Jay D; Proler, Meyer L; Roark, Alexandra J; MacInerney, Erin K; Kozlowski, Gerald P

2017-09-01

Many antiepileptic drugs (AEDs) have been tested on nonepileptic patients with a variety of diagnoses. The Food and Drug Administration has only approved certain AEDs for a small number of psychiatric conditions. There are few studies of nonepileptic patients that recommend an empirical trial of AEDs when isolated epileptiform discharges (IEDs) are identified in the electroencephalogram (EEG). However, no trials have been published. The purpose of this study is to evaluate the outcome of treating nonepileptic patients with AEDs when IEDs are present. Refractory cases were reviewed from a multidisciplinary practice whose EEG readings contained IEDs and were subsequently medicated with anticonvulsants by the clinic's psychiatrist. The psychiatrist's progress notes were assessed to determine the impact of adding anticonvulsants based on parent reports, teacher reports, and clinical observation. The final sample was composed of 76 refractory cases. Of the 76 patients treated with anticonvulsants, the majority were found to be improved in follow-up progress notes: 65 improved (85.53%), 6 unchanged (7.89%), and 5 more severe (6.58%). These observational findings suggest that further studies will be needed to show that IEDs may predict positive treatment outcome to anticonvulsant medication and act as a step toward an evidence-based treatment. Also, EEG screening may prove to be useful for refractory cases regardless of age, gender, or diagnosis.

Programmable Logic Application Notes

NASA Technical Reports Server (NTRS)

Katz, Richard

2000-01-01

This column will be provided each quarter as a source for reliability, radiation results, NASA capabilities, and other information on programmable logic devices and related applications. This quarter will start a series of notes concentrating on analysis techniques with this issues section discussing worst-case analysis requirements.

A survey of major east coast snowstorms, 1960-1983. Part 2: Case studies of eighteen storms

NASA Technical Reports Server (NTRS)

Kocin, P. J.; Uccellini, L. W.

1985-01-01

Snowfall, surface and upper air charts, and available satellite images are presented for eighteen major East Coast snowstorms that occurred between 1960 and 1983. The charts and descriptions of key fields are provided so that students, weather forecasters, and researchers alike can visualize how a large sample of major winter cyclones form and intensify. Although there are noted similarities in certain aspects of the surface and upper tropospheric development of the storms, significant case-to-case variability precludes the ability to effectively composite these weather systems.

Inservice Teacher Education in Nigeria: A Case Study.

ERIC Educational Resources Information Center

Esu, Akon E. O.

1991-01-01

Examines the current status of in-service teacher education in Nigeria, indicating three approaches: the central office approach; the long vacation program; and the Associateship Certificate in Education distance learning approach. Recommendations for planning and implementing in-service teacher education programs in Nigeria are noted. (SM)

Student Leadership Development: A Functional Framework

ERIC Educational Resources Information Center

Hine, Gregory Stephen Colin

2014-01-01

This article presents a longitudinal, qualitative case study of a student leadership program in a Catholic secondary school in Perth, Western Australia. Data were collected over a period of three years through multiple methods, including one-on-one interviewing, focus group interviewing, document searches, field notes, and researcher reflective…

Globalization and Women in Southeast Asian Higher Education Management.

ERIC Educational Resources Information Center

Luke, Carmen

2002-01-01

This case study of Southeast Asian women in higher education management investigates culture-specific dimensions of "glass ceiling" impediments to career advancement in higher education. Respondents note that despite considerable training and expertise, Asian values and ideologies demand enactment of a construct of Asian femininity that…

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

PubMed

Baltazar, J C; Tiglao, T V; Tempongko, S B

1993-01-01

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed.

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

PubMed Central

Baltazar, J. C.; Tiglao, T. V.; Tempongko, S. B.

1993-01-01

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed. PMID:8324851

The Use Value of "Fight Club" in Teaching Theories of Religion

ERIC Educational Resources Information Center

Smith, William E.

2008-01-01

Teaching theories and methods for the academic study of religion poses certain challenges, especially when first-year students are the primary targeted audience. In the following note from the classroom, the author describes a model for successfully employing the film "Fight Club" as a case study for exploring some of the theoretical concepts of…

What Can You Learn about Writing in School?: A Case Study in an Elementary Classroom.

ERIC Educational Resources Information Center

Florio, Susan; And Others

A two-year study investigated writing in the elementary school. Data collected included field notes from observation of a second/third grade classroom, videotapes of selected classroom activities, weekly journals kept by the teacher reflecting her thoughts on teaching in general and on writing in particular, interviews with the teacher about the…

College and Career Readiness and the Every Student Succeeds Act

ERIC Educational Resources Information Center

Malin, Joel R.; Bragg, Debra D.; Hackmann, Donald G.

2017-01-01

Purpose: This study addressed the current policy push to improve students' college and career readiness (CCR) as manifested within the Every Student Succeeds Act (ESSA) and examined CCR policy in the state of Illinois as a case study, noting ways in which provisions for CCR programs prepare all students, including those historically underserved by…

Using the Harp as a Communication Channel with Children with Autism

ERIC Educational Resources Information Center

Kissinger, Lori; Worley, David W.

2008-01-01

This study focused on the feasibility of using the concert harp as a communication channel for children with autism. Two qualitative case studies using constant comparison analysis were conducted over a six-day observation period resulting in field notes both from the primary researcher and the teacher who regularly worked with the two children in…

Ubiquitous Writing, Technologies, and the Social Practice of Literacies of Coordination

ERIC Educational Resources Information Center

Pigg, Stacey; Grabill, Jeffrey T.; Brunk-Chavez, Beth; Moore, Jessie L.; Rosinski, Paula; Curran, Paul G.

2014-01-01

This article shares results from a multi-institutional study of the role of writing in college students' lives. Using case studies built from a larger population survey along with interviews, diaries, and a daily SMS texting protocol, we found that students report SMS texting, lecture notes, and emails to be the most frequent writing…

Case study of Bell's palsy applying complementary treatment within an occupational therapy model.

PubMed

Haltiwanger, Emily; Huber, Theresa; Chang, Joe C; Gonzalez-Stuart, Armando; Gonzales-Stuart, Armando

2009-01-01

For 7% of people with Bell's palsy, facial impairment is permanent. The case study patient was a 48-year-old female who had no recovery from paralysis 12 weeks after onset. Goals were to restore facial sensory-motor functions, functional abilities and reduce depression. Facial paralysis was assessed by clinical observations, the Facial Disability Index and Beck Depression Index. Complementary interventions of aromatherapy, reflexology and electro-acupuncture were used with common physical agent modalities in an intensive home activity and exercise programme. The patient had 100% return of function and resolution of depression after 10 days of intervention. The limitation of this study is that it was a retrospective case study and the investigators reconstructed the case from clinical notes. Further research using a prospective approach is recommended to replicate this study. 2009 John Wiley & Sons, Ltd

The conversion to electronic hospital notes at Mayo Clinic. Overcoming barriers and challenges.

PubMed

Andreen, Debra L; Dobie, Linda J; Jasperson, Jan C; Lucas, Thomas A; Wubbenhorst, Cathryn L

2010-01-01

This article describes the conversion to electronic hospital notes at a large, multi-specialty group practice: Mayo Clinic in Rochester, Minnesota. Because of the size of the institution and the barriers to the adoption of electronic notes, the process was a gradual one that took several years. Making a convincing case for change to institutional leaders and maintaining their support was crucial to success. Equally vital was the careful investigation of user requirements and the development of software features that allowed providers to complete their notes quickly in the fast-paced hospital environment. Care providers discovered the value of having immediate access to legible hospital notes throughout the campus and from remote locations.

A polyphonic acoustic vortex and its complementary chords

NASA Astrophysics Data System (ADS)

Wilson, C.; Padgett, M. J.

2010-02-01

Using an annular phased array of eight loudspeakers, we generate sound beams that simultaneously contain phase singularities at a number of different frequencies. These frequencies correspond to different musical notes and the singularities can be set to overlap along the beam axis, creating a polyphonic acoustic vortex. Perturbing the drive amplitudes of the speakers means that the singularities no longer overlap, each note being nulled at a slightly different lateral position, where the volume of the other notes is now nonzero. The remaining notes form a tri-note chord. We contrast this acoustic phenomenon to the optical case where the perturbation of a white light vortex leads to a spectral spatial distribution.

Prognostic significance of epidermal growth factor receptor (EGFR) over expression in urothelial carcinoma of urinary bladder.

PubMed

Hashmi, Atif Ali; Hussain, Zubaida Fida; Irfan, Muhammad; Khan, Erum Yousuf; Faridi, Naveen; Naqvi, Hanna; Khan, Amir; Edhi, Muhammad Muzzammil

2018-06-07

Epidermal growth factor receptor (EGFR) has been shown to have abnormal expression in many human cancers and is considered as a marker of poor prognosis. Frequency of over expression in bladder cancer has not been studied in our population; therefore we aimed to evaluate the frequency and prognostic significance of EGFR immunohistochemical expression in locoregional population. We performed EGFR immunohistochemistry on 126 cases of bladder cancer and association of EGFR expression with tumor grade, lamina propria invasion, deep muscle invasion and recurrence of disease was evaluated. High EGFR expression was noted in 26.2% (33 cases), 15.1% (19 cases) and 58.7% (74 cases) revealed low and no EGFR expression respectively. Significant association of EGFR expression was noted with tumor grade, lamina propria invasion, deep muscle invasion and recurrence status while no significant association was seen with age, gender and overall survival. Kaplan- Meier curves revealed significant association of EGFR expression with recurrence while no significant association was seen with overall survival. Significant association of EGFR overexpression with tumor grade, muscularis propria invasion and recurrence signifies its prognostic value; therefore EGFR can be used as a prognostic biomarker in Urothelial bladder carcinoma.

A Comparison of Vertical and Transverse Sections in the Histological Diagnosis of Alopecia Areata Scalp Biopsy Specimens

PubMed Central

Singh, Kanika; Sharma, Sonal; Singh, Usha Rani; Bhattacharya, Sambit Nath

2016-01-01

Context: Both vertical and transverse sections are used for the diagnosis of alopecia areata. However when a single biopsy is submitted the pathologist has to decide which type is better. Aims: To compare the diagnostic histological features in vertical and transverse sections in alopecia areata scalp biopsy specimens. Settings and Design: Tertiary Care Hospital. Comparative Study. Materials and Methods: A total of 30 patients were enrolled in the study. Two four mm punch biopsy were taken. One was used to take vertical sections and the other for transverse section and histological features of alopecia areata noted in both. Statistical Analysis Used: Chi-square test, percentage. Results: Diagnosis of alopecia areata could be made in 30 (100%) cases in transverse sections and 28 cases (93.3%) in vertical sections. The number of hair follicles available for evaluation was more in the transverse section. Nanogen follicles and miniaturization of follicles were better visualized in the transverse sections. However the catagen and telogen follicles were noted in both vertical and transverse sections but the number and the ratio of anagen and telogen hair follicles could be better assessed in the transverse sections. Presence of peribulbar lymphocytic infiltrate, eosinophils and pigment casts were noted in both transverse and vertical sections. Conclusions: Transverse sections provide a better assessment of the histological features of alopecia areata than vertical sections and thus should be preferred. PMID:27625562

A Comparison of Vertical and Transverse Sections in the Histological Diagnosis of Alopecia Areata Scalp Biopsy Specimens.

PubMed

Singh, Kanika; Sharma, Sonal; Singh, Usha Rani; Bhattacharya, Sambit Nath

2016-01-01

Both vertical and transverse sections are used for the diagnosis of alopecia areata. However when a single biopsy is submitted the pathologist has to decide which type is better. To compare the diagnostic histological features in vertical and transverse sections in alopecia areata scalp biopsy specimens. Tertiary Care Hospital. Comparative Study. A total of 30 patients were enrolled in the study. Two four mm punch biopsy were taken. One was used to take vertical sections and the other for transverse section and histological features of alopecia areata noted in both. Chi-square test, percentage. Diagnosis of alopecia areata could be made in 30 (100%) cases in transverse sections and 28 cases (93.3%) in vertical sections. The number of hair follicles available for evaluation was more in the transverse section. Nanogen follicles and miniaturization of follicles were better visualized in the transverse sections. However the catagen and telogen follicles were noted in both vertical and transverse sections but the number and the ratio of anagen and telogen hair follicles could be better assessed in the transverse sections. Presence of peribulbar lymphocytic infiltrate, eosinophils and pigment casts were noted in both transverse and vertical sections. Transverse sections provide a better assessment of the histological features of alopecia areata than vertical sections and thus should be preferred.

Using Natural Language Processing to Improve Efficiency of Manual Chart Abstraction in Research: The Case of Breast Cancer Recurrence

PubMed Central

Carrell, David S.; Halgrim, Scott; Tran, Diem-Thy; Buist, Diana S. M.; Chubak, Jessica; Chapman, Wendy W.; Savova, Guergana

2014-01-01

The increasing availability of electronic health records (EHRs) creates opportunities for automated extraction of information from clinical text. We hypothesized that natural language processing (NLP) could substantially reduce the burden of manual abstraction in studies examining outcomes, like cancer recurrence, that are documented in unstructured clinical text, such as progress notes, radiology reports, and pathology reports. We developed an NLP-based system using open-source software to process electronic clinical notes from 1995 to 2012 for women with early-stage incident breast cancers to identify whether and when recurrences were diagnosed. We developed and evaluated the system using clinical notes from 1,472 patients receiving EHR-documented care in an integrated health care system in the Pacific Northwest. A separate study provided the patient-level reference standard for recurrence status and date. The NLP-based system correctly identified 92% of recurrences and estimated diagnosis dates within 30 days for 88% of these. Specificity was 96%. The NLP-based system overlooked 5 of 65 recurrences, 4 because electronic documents were unavailable. The NLP-based system identified 5 other recurrences incorrectly classified as nonrecurrent in the reference standard. If used in similar cohorts, NLP could reduce by 90% the number of EHR charts abstracted to identify confirmed breast cancer recurrence cases at a rate comparable to traditional abstraction. PMID:24488511

[Clinical features and course of Kawasaki disease in central Tunisia: a study about 14 cases collected over a period of three years (2000-2002)].

PubMed

Chemli, Jalel; Kchaou, Habib; Amri, Fethi; Belkadhi, Adel; Essoussi, Ahmed Sahloul; Gueddiche, Neji; Harbi, Abdelaziz

2005-08-01

To analyze the clinical features and course of Kawasaki disease in central Tunisia. We studied retrospectively 14 cases of children with Kawasaki disease collected in tunisian center during three years (2000-2002). The study is about 11 boys and 3 girls (sex - ratio: 3.6/1) aged from 6 months to 8 years (mean age : 4 years). Twelve patients had at least 5 diagnostic criteria of the illness, the two others had an incomplete form. We noted cardiac complications in seven patients treated belatedly, beyond 10 days of progression, because of atypical clinical presentations. All patients had all a middle caliber coronary aneurysm that was complicated by a thrombus in three cases, associated with pericarditis and minimal mitral insufficiency in a case and with a cardiac rhythm disturbance (block of branch) in another case. Besides the cardiac complications, several other visceral manifestation could be noted: joint symptoms in five cases, GI tract symptomes in three cases, neuro-meningeal in two cases and urinary trad symptomes in two other cases. Specific treatment (aspirin with antiinflammatory dose and intravenous immune globulin (IVIG)) has been instituted in all patients. The course was favorable for 12 patients with fast regression of clinical manifestation and progressive normalisation of biologic values. Two patients did not respond to the initial IVIG treatment, and had to recense received an additional course of IGIV but without clinical nor biological improvement. These two patients were treated with corticosteroids. Cardiac lesions disappeared completely in all patients even for those with thrombosis and in patients with IVIG-resistant Kawasaki disease. Only one patient had kept neurologic sequellae: aphasia, bevavioral problemes and partial epilepsy. Kawasaki disease is not rare in our region. Incomplete or atypical presentations are frequent and are a source of diagnostic delay. Coronary aneurysm due to the delay of treatment often regresses even in patients with IVIG-resistant Kawasaki disease.

Using natural language processing for identification of herpes zoster ophthalmicus cases to support population-based study.

PubMed

Zheng, Chengyi; Luo, Yi; Mercado, Cheryl; Sy, Lina; Jacobsen, Steven J; Ackerson, Brad; Lewin, Bruno; Tseng, Hung Fu

2018-06-19

Diagnosis codes are inadequate for accurately identifying herpes zoster ophthalmicus (HZO). There is significant lack of population-based studies on HZO due to the high expense of manual review of medical records. To assess whether HZO can be identified from the clinical notes using natural language processing (NLP). To investigate the epidemiology of HZO among HZ population based on the developed approach. A retrospective cohort analysis. A total of 49,914 southern California residents aged over 18 years, who had a new diagnosis of HZ. An NLP-based algorithm was developed and validated with the manually curated validation dataset (n=461). The algorithm was applied on over 1 million clinical notes associated with the study population. HZO versus non-HZO cases were compared by age, sex, race, and comorbidities. We measured the accuracy of NLP algorithm. NLP algorithm achieved 95.6% sensitivity and 99.3% specificity. Compared to the diagnosis codes, NLP identified significant more HZO cases among HZ population (13.9% versus 1.7%). Compared to the non-HZO group, the HZO group was older, had more males, had more Whites, and had more outpatient visits. We developed and validated an automatic method to identify HZO cases with high accuracy. As one of the largest studies on HZO, our finding emphasizes the importance of preventing HZ in the elderly population. This method can be a valuable tool to support population-based studies and clinical care of HZO in the era of big data. This article is protected by copyright. All rights reserved.

Early Childhood Numeracy in a Multiage Setting

ERIC Educational Resources Information Center

Wood, Karen; Frid, Sandra

2005-01-01

This research is a case study examining numeracy teaching and learning practices in an early childhood multiage setting with Pre-Primary to Year 2 children. Data were collected via running records, researcher reflection notes, and video and audio recordings. Video and audio transcripts were analysed using a mathematical discourse and social…

Phoenix: Quantum Quality at Maricopa: TQM on Campus, Case Study Number Two.

ERIC Educational Resources Information Center

Assar, Kathleen E.

1993-01-01

Implementation of the Total Quality Management approach in the Maricopa County Community College District (Arizona), a large 10-campus system, is described. The program's current early stages are reported noting the serious administrative commitment and thorough training, seen as key factors in potential success. (MSE)

Colleges Under Pressure: Budgeting, Presidential Competence, and Faculty Uncertainty.

ERIC Educational Resources Information Center

Neumann, Anna

A comparative case study examining selected aspects of internal college leadership during financially troubled times is discussed. Continuous negotiation between university presidents and faculty members is explained. Presentation of the budget to the college community is examined, noting how the president may use the event to define hard times…

Are We Preparing or Training Teachers? Developing Professional Judgment in and beyond Teacher Preparation Programs

ERIC Educational Resources Information Center

Scales, Roya Q.; Wolsey, Thomas DeVere; Lenski, Susan; Smetana, Linda; Yoder, Karen K.; Dobler, Elizabeth; Grisham, Dana L.; Young, Janet R.

2018-01-01

This three phase longitudinal multiple-case study, framed by positioning theory, investigated how four novice teachers learned to use professional judgment in their literacy instruction. Data sources from coursework, student teaching, and novice teaching were included. Interviews, observations, researchers' observational notes, and school and…

Online Project Based Learning in Innovation Management.

ERIC Educational Resources Information Center

O'Sullivan, David

2003-01-01

An innovation management course has three strands with face-to-face and online components: (1) seminars with online course notes and slides; (2) assignments (group online case studies, tutorials, in-class presentations); and (3) assessment (online, oral, in-class, written). Students are able to benchmark their work online and teachers use the…

Implicit Sublexical Phonological Processing in an Acquired Dyslexic Patient.

ERIC Educational Resources Information Center

Hildebrandt, Nancy; Sokol, Scott M.

1993-01-01

Reports a case study of an acquired dyslexic subject who showed no evidence of having any access to sublexical phonological information. Notes, however, that the subject showed normal effects of spelling regularity for low-frequency words, suggesting sublexical phonological processing. Suggests that the types of explicit tasks previously used are…

Unequal Opportunities: The Recruitment, Selection and Promotion Prospects for Black Teachers.

ERIC Educational Resources Information Center

Brar, Harbhajan Singh

1991-01-01

The 1988 Education Reform Act greatly impacted equal opportunities in recruitment and selection of black teachers in the United Kingdom. A case study examines recruitment and selection in London, noting that ad hoc practices (encouraged by the 1988 Act) perpetuates the poor position of black teachers. (SM)

Analogical Reasoning and Conceptual Change: A Case Study of Johannes Kepler

DTIC Science & Technology

1997-01-01

1993), Hansom (1958), Holton (1973), Kaestter (1963) . Koyre (1973), Kuhn (1957), Layer (1984), Mason (1962), Stephenson (t994a, 19946), Toulmin and...and the planets- As Toulmin and Goodfield (1961) noted : One cannot find before Kepler I{EPLER’S CONCEPTUAL CHANCE 31 any clear recognition that the

Alchemy in Iowa: Arts Education at Harding Junior High School.

ERIC Educational Resources Information Center

Vallance, Elizabeth

1991-01-01

Case study of an Iowa junior high school describes how the school and community identified their resources and used them to create successful arts education programs from ordinary resources. The article examines four types of commitment that shaped school practice, noting effective teaching practices and administrative policy. (SM)

Call It Trash, Garbage or Refuse: Four Case Studies Illustrate Community Waste Management Options.

ERIC Educational Resources Information Center

Kazzi, John W.

1990-01-01

Describes four successful community programs dealing with waste management issues, developed with assistance from Keep America Beautiful System: litter prevention (Beatrice, Nebraska); composting yard waste (Centralia, Illinois); recycling (Lake Jackson, Texas); and waste-to-energy incineration (Gastonia, North Carolina). Notes related education…

Towards Democratic Leadership: Co-principal Initiatives.

ERIC Educational Resources Information Center

Court, Marian

2003-01-01

A case study of a New Zealand primary school coprincipalship describes the impact of some intergroup misunderstandings and struggles over power. Concludes that building a democratic school community requires a set of considerations and practices different from those promoted within a market-managerial approach. (Contains 7 notes and 51…

Effects of a Facility Dog on Student Learning and Learning Environment

ERIC Educational Resources Information Center

Bradley, Jordana; Maldonado, Nancy

2013-01-01

Educators must consider alternative teaching strategies. Facility dogs as an instructional enhancement are an innovative teaching approach. This case study, guided by human-animal bond theory, investigated how the presence of a trained facility dog, Smooch, affected the school environment. Interviews, field notes and observations were used to…

Success Structure for Accelerated Acquisition of English by Young ESL Learners

ERIC Educational Resources Information Center

Mohamed, Abdul Rashid; Tumin, Mahani; Omar, Hamzah

2008-01-01

This is an investigation into the accelerated acquisition of English among young ESL learners in an International School. It employed an ethnographic case study approach where data were gathered through non-participant observations, unstructured interviews, relevant documents, students' portfolios, field notes and biographical details. The sample…

Sanctions for Reporters Who Refuse to Disclose Sources in Libel Cases.

ERIC Educational Resources Information Center

Mehra, Achal

1983-01-01

Notes that the courts have specific sanctions under the "Federal Rules of Civil Procedure" to ensure discovery in libel and invasion of privacy cases. Examines media-related cases in which courts have used these sanctions and relates them to nonmedia cases. (FL)

Gallium scanning in cerebral and cranial infections. [/sup 67/Ga, /sup 99m/Tc tracer techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waxman, A.D.; Siemsen, J.K.

1976-08-01

Eighteen patients with cranial or intracranial infections were studied with technetium and gallium brain scans. Seven of 18 lesions were noted with gallium and not with pertechnetate, while the reverse pattern was not seen. Brain abscesses were visualized with gallium but not with pertechnetate in two of five cases. Osteomyelitis of the skull and mastoiditis showed intense gallium uptake in all cases, while meningitis or cerebritis gave inconsistent results.

[Cytogenetic study of a recent case of trisomy 12p].

PubMed

André, M J

1976-09-01

A case of trisomy for the short arm and a part of the long arm of chromosome 12 is reported. Before the pregnancy sterility was noted during several years. Birth weight was normal; the newborn with multiple congenital defects died before the 4th day. Her mother, grandmother, and two brothers of the latter showed a balanced translocation t (5 ; 12) (p15 ; q132). The affected child inherited the derived 12 as a 47th chromosome.

Physical examination performed by psychiatrists.

PubMed

Hodgson, Richard; Adeyemo, Olubukola

2004-01-01

Too little, too late? Physical examinations performed by trainee psychiatrists on newly admitted psychiatric patients. To assess the comprehensiveness of the physical examination carried out by psychiatric trainees on acute in-patient units. To quantify delays in undertaking physical examination on psychiatric inpatients. A prospective case note study of 60 consecutive admissions to acute psychiatric wards in North Staffordshire. Information regarding demography, details of physical examination and routine blood investigations was collected. The case notes of 60 inpatients were studied. Mean age was 38.7 years and the sex ratio equal. A delay in performing a physical occurred in 17 (28.8%) patients. No explanation for a delay was given in six (10.0%) cases. The mean time to physical examination from admission was 61.8 h (range 0-612 h). The standard of physical examination was variable. The central nervous system (CNS) was reported as 'grossly intact' in six (10.2%) cases with only 34 (57.6%) of patients having a comprehensive CNS examination. Psychiatric patients are not receiving a comprehensive physical examination. Whilst the patient's ability to co-operate may account for a delay in the examination, it is unlikely to be the reason for the CNS being examined in just half the patients. Opportunities to reduce the physical morbidity associated with mental illness may be being lost. (MJ Psych Clin Pract 2004; 8: 57-60).

Chloral hydrate sedation for magnetic resonance imaging in newborn infants.

PubMed

Finnemore, Anna; Toulmin, Hilary; Merchant, Naz; Arichi, Tom; Tusor, Nora; Cox, David; Ederies, Ash; Nongena, Phumza; Ko, Christopher; Dias, Ryan; Edwards, Anthony D; Groves, Alan M

2014-02-01

The aim of this study was to look for clinically significant adverse effects of chloral hydrate used in a large cohort of infants sedated for magnetic resonance imaging. Case notes of infants who underwent magnetic resonance imaging (MRI) scanning from 2008 to 2010 were reviewed, with patient demographics, sedation dose, comorbidities, time to discharge, and side effects of sedation noted. Four hundred and eleven infants (median [range] postmenstrual age per weight at scan 42 [31(+4) -60] weeks per 3500 g [1060-9900 g]) were sedated with chloral hydrate (median [range] dose 50 [20-80] mg·kg(-1)). In three cases (0.7%), desaturations occurred which prompted termination of the scan. One infant (0.2%) was admitted for additional observation following sedation but had no prolonged effects. In 17 (3.1%) cases, infants had desaturations which were self-limiting or responded to additional inspired oxygen such that scanning was allowed to continue. When adhering to strict protocols, MRI scanning in newborn infants in this cohort was performed using chloral hydrate sedation with a relatively low risk of significant adverse effects. © 2013 John Wiley & Sons Ltd.

A review of prophylactic antibiotics use in plastic surgery in China and a systematic review.

PubMed

Li, Ge-hong; Hou, Dian-ju; Fu, Hua-dong; Guo, Jing-ying; Guo, Xiao-bo; Gong, Hui

2014-12-01

The purpose of this study was to investigate the use of antibiotic prophylaxis for plastic surgical procedures at our hospital, and to perform a systematic literature review of randomized controlled trials evaluating the use of prophylactic antibiotics in plastic surgery. The records of patients who received plastic surgical procedures with Class I surgical incisions between 2009 and 2010 were retrospectively reviewed. A systematic literature review was conducted for studies examining the use of prophylactic antibiotics for Class I surgical wounds. A total of 13,997 cases with Class I surgical incisions were included. Prophylactic antibiotics were given in 13,865 cases (99.1%). The antibiotics used were primarily cefuroxime, clindamycin, metronidazole, cefoxitin sodium, and gentamicin. The average duration of administration was 4.84 ± 3.07 (range, 1-51) days. Antibiotics were administered postoperatively in >99% of cases while preoperative antibiotic administration was only given in 32 cases (0.23%). Wound infections occurred in 21 cases for an overall infection rate of 0.15%. Fourteen studies met the inclusion criteria of the systematic review. There was marked variation in the timing of antibiotic administration with antibiotics given pre-, peri-, and postoperatively. Of studies that compared the use of prophylactic antibiotics with placebo, a reduction in wound infections was noted in 4 trials and no difference was noted in 6 trials. No significant difference in infection rates was shown between the prophylactic and postoperative arms. In conclusion, prophylactic antibiotics are overused in plastic surgical procedures. Evidence-based guidelines for the use of prophylactic antibiotics in plastic surgical procedures are needed. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Comorbid Vulvar Lichen Planus and Lichen Sclerosus.

PubMed

Day, Tania; Moore, Sarah; Bohl, Tanja Gizela; Scurry, James

2017-07-01

The aims of the study are to assess the histopathologic characteristics of vulvar biopsies consistent with lichen planus (LP) in women with a previous or concurrent histopathologic diagnosis of vulvar lichen sclerosus (LS) and to describe the clinical features of comorbid LP and LS. Patients were included if a diagnosis of LP was confirmed after review of the hematoxylin and eosin slides and the histopathology reporting LS noted a band of abnormal collagen. Data were collected on anatomic site, clinical appearance, histopathology, microbiology, treatment, and follow-up. There were 31 cases with a mean age of 69.5 years. Thirty specimens showed erosive LP, of which 22 were from inner labium minus and 8 from vestibule. There were no significant differences between biopsy site in epithelial thickness, erosion, lymphocytic infiltrate, or basal layer pattern. One third of cases showed a regenerative pattern of LP. Of the 26 patients with clinical records available, erythema at the biopsy site was noted in all cases; in 23 the notes specified central erythema and peripheral pallor. Forty-six percent were prescribed topical corticosteroids before biopsy. All 26 were treated with topical corticosteroids, 23% were prescribed antimycotics, and 38% required other supplemental therapies. Comorbid vulvar LP and LS are not rare; clinicians suspecting one should evaluate for the other and consider separate biopsies of morphologically distinct areas. Clinicopathological correlation is an invaluable tool in assessing biopsies when both diagnoses are suspected, because the regenerative pattern of LP may otherwise be overlooked or misdiagnosed.

A New Insight Into Sudden Cardiac Death in Young People: A Systematic Review of Cases of Takotsubo Cardiomyopathy.

PubMed

Wang, Yueyue; Xia, Lei; Shen, Xiaodong; Han, Guoxin; Feng, Dan; Xiao, Hongju; Zhai, Yongzhi; Chen, Xin; Miao, Yuanyuan; Zhao, Chunhong; Wang, Yingchan; Guo, Mingguang; Li, Tanshi; Zhu, Hai Yan

2015-08-01

Takotsubo cardiomyopathy (TTC) causes sudden cardiac death and has garnered increased attention worldwide in recent years. However, few studies have clearly classified the risk factors for this disease, including gender, race and morbidity, as well as the physical and mental stressors that can exacerbate the disease, particularly in young patients. To better analyze the characteristics of young TTC patients, we performed a systematic review of reported cases involving young patients.A computer-assisted search was performed using prominent electronic medical information sources to identify literature published between January 1965 and December 2013. Relevant studies containing clinical data of young TTC patients were included.Ninety-six records that included information about 104 cases were ultimately selected for our review. Several of the following results were noted: First, physical stress was more likely to exacerbate TTC than was mental stress in young patients. Second, more female than male TTC patients were noted among both young patients and the general population. Third, ethnicity appears to play no role in the disease, as no significant differences were noted among individuals of different races with respect to clinical characteristics, morbidity or stressors. Fourth, the clinical manifestations of TTC were similar to those of other cardiac diseases, including coronary heart disease. However, TTC may be detected using the combination of echocardiography and ventriculography.Clinicians should consider TTC if young patients present with symptoms similar to those of coronary heart disease so that harmful treatments such as coronary artery stent placement may be avoided. Moreover, the answers to questions regarding the clinical diagnostic criteria, etiology, pathophysiology, and the management of this syndrome in youth remain unclear; therefore, further research is needed.

The impact of genital warts: loss of quality of life and cost of treatment in eight sexual health clinics in the UK

PubMed Central

Jit, M; Soldan, K; Kinghorn, G; Gilson, R; Nathan, M; Ross, J D; Lacey, C J N

2011-01-01

Objectives To estimate the loss of quality of life and cost of treatment associated with genital warts seen in sexual health clinics. Methods A cross-sectional questionnaire study and case note review of individuals with genital warts, carried out in eight sexual health clinics in England and Northern Ireland. Individuals with genital warts attending the participating clinics were invited to take part in the questionnaire study. 895 participants were recruited. A separate sample of 370 participants who had attended a participating clinic with a first visit for a first or recurrent episode of genital warts between April and June 2007 was included in the case note review. Quality of life was measured using the EQ-5D questionnaire and the cost of an episode of care was derived from the case note review. Results The weighted mean EQ-5D index score was 0.87 (95% CI 0.85 to 0.89). The weighted mean disutility was 0.056 (95% CI 0.038 to 0.074). The estimated mean loss of quality-adjusted life-years associated with an episode of genital warts was 0.018 (95% CI 0.0079 to 0.031), equivalent to 6.6 days of healthy life lost per episode. The weighted mean cost per episode of care was £94 (95% CI £84 to £104), not including the cost of a sexually transmitted infection screen. Conclusions Genital warts have a substantial impact on the health service and the individual. This information can be utilised for economic evaluation of human papillomavirus vaccination. PMID:21636616

Position coding effects in a 2D scenario: the case of musical notation.

PubMed

Perea, Manuel; García-Chamorro, Cristina; Centelles, Arnau; Jiménez, María

2013-07-01

How does the cognitive system encode the location of objects in a visual scene? In the past decade, this question has attracted much attention in the field of visual-word recognition (e.g., "jugde" is perceptually very close to "judge"). Letter transposition effects have been explained in terms of perceptual uncertainty or shared "open bigrams". In the present study, we focus on note position coding in music reading (i.e., a 2D scenario). The usual way to display music is the staff (i.e., a set of 5 horizontal lines and their resultant 4 spaces). When reading musical notation, it is critical to identify not only each note (temporal duration), but also its pitch (y-axis) and its temporal sequence (x-axis). To examine note position coding, we employed a same-different task in which two briefly and consecutively presented staves contained four notes. The experiment was conducted with experts (musicians) and non-experts (non-musicians). For the "different" trials, the critical conditions involved staves in which two internal notes that were switched vertically, horizontally, or fully transposed--as well as the appropriate control conditions. Results revealed that note position coding was only approximate at the early stages of processing and that this encoding process was modulated by expertise. We examine the implications of these findings for models of object position encoding. Copyright © 2013 Elsevier B.V. All rights reserved.

Doulas' Perceptions on Single Mothers' Risk and Protective Factors, and Aspirations Relative to Child-Birth

ERIC Educational Resources Information Center

Arat, Gizem

2013-01-01

This study the author aims to explore the perceptions of doulas on single mothers' risk and protective factors, and aspirations relative to child-birth in the postpartum care. The current study was conducted by semi-structured questions, case file reviews, field notes, and twelve home visits via utilizing Grounded Theory. These mothers receive…

Patterns of Sophistication and Naivety: Some Features of Anthropological Approaches to the Study of Education. Occasional Paper No. 22.

ERIC Educational Resources Information Center

Erickson, Frederick

The limits and boundaries of anthropology are briefly discussed, along with a general description of lay attitudes towards the field. A research case is given to illustrate the way in which anthropological study methods can contribute to educational research. Noted among these contributions is an informed distrust that anthropologists exhibit…

Liberal Adult Education Adapts to the Technological Society: Case Study of West Germany's Adult Education Centers (Volkshochschulen).

ERIC Educational Resources Information Center

Carlson, Robert A.

The report, based on a six-month study as a participant-observer, discusses developments now under way in West Germany's Adult Education Centers movement. The article offers a comparative approach that takes account of trends in Europe and North America. It puts these developments into a philosophical framework, noting that Germany may provide a…

"Ganchulinas" and "Rainbowli" Colors: Young Multilingual Children Play with Language in Head Start Classroom

ERIC Educational Resources Information Center

Axelrod, Ysaaca

2017-01-01

The purpose of this ethnographic case study was to study the language development of 4-year-old emergent bilinguals in a bilingual (Spanish/English) Head Start classroom with flexible language practices. Data were collected throughout the 10-month school year by visiting the classroom 2-3 times per week. Data include: field notes (observations and…

Exploring the Relevance of the Personal and Social Responsibility Model in Adapted Physical Activity: A Collective Case Study

ERIC Educational Resources Information Center

Wright, Paul M.; White, Katherine; Gaebler-Spira, Deborah

2004-01-01

The purpose of this study was to examine the application of the Personal and Social Responsibility Model (PSRM) in an adapted physical activity program. Although the PSRM was developed for use with underserved youth, scholars in the field of adapted physical activity have noted its potential relevance for children with disabilities. Using a…

Coordinated Translanguaging Pedagogy as Distributed Cognition: A Case Study of Two Dual Language Bilingual Education Preschool Coteachers' Languaging Practices during Shared Book Readings

ERIC Educational Resources Information Center

Pontier, Ryan; Gort, Mileidis

2016-01-01

This study examined how a pair of Spanish/English dual language bilingual education (DLBE) preschool teachers enacted their bilingualism while working cohesively and simultaneously toward common instructional goals. We drew on classroom video data, field notes, and other relevant artifacts collected weekly during shared readings of English- and…

A Note on the Heterogeneous Choice Model

ERIC Educational Resources Information Center

Rohwer, Goetz

2015-01-01

The heterogeneous choice model (HCM) has been proposed as an extension of the standard logit and probit models, which allows taking into account different error variances of explanatory variables. In this note, I show that in an important special case, this model is just another way to specify an interaction effect.

Traumatic inferior shoulder dislocation: a review of management and outcome.

PubMed

Nambiar, Mithun; Owen, David; Moore, Peter; Carr, Ashley; Thomas, Malcolm

2018-02-01

Traumatic inferior shoulder dislocation (ISD) is rare, estimated to occur in 0.5% of all shoulder dislocations. We describe the demographics, natural history and outcome of this injury. The aim of the study is to provide a summary of the demographics, clinical presentation, management and outcome of patients who suffer ISD METHODS: We conducted a systematic review of the English language literature on ISD using PubMed, Medline, CINHAL, Cochrane Database and Evidence-Based Medicine Reviews. Articles were examined independently by two of the authors and data were extracted using a standard form. Descriptive statistics were performed. 199 patients were identified, from 101 articles. Mean age was 44 years (range 13-94 years). All cases were caused by trauma, with falls accounting for 44% of all cases. There were three reported cases (2%) of open dislocations and 29 cases (15%) of bilateral ISD. Proximal humerus and scapular fractures were reported in 39 and 8% of patients, respectively. Neurological injury after dislocation was noted in 58 patients (29%). Vascular injury was noted in 20 patients (10%), which included axillary arterial injury in 19 patients and an upper limb deep vein thrombosis in one patient. Follow-up data were available for 107 patients (54%), with an average duration of 2.7 years (1 week-32 years). Avascular necrosis (AVN) was noted between 8 weeks and 2 years after initial injury in three patients (1.5%). Clinical and radiographic assessment of ISD is key to diagnosis and successful reduction. Patients can be treated with shoulder immobilisation for 2-3 weeks. In the setting of ongoing pain or instability, further imaging should be performed. The outcome of ISD is generally favourable.

Hybrid endovascular repair for aortic arch pathology: intermediate outcomes and complications: a retrospective analysis.

PubMed

Kang, Woong Chol; Shin, Eak Kyun; Park, Chul-Hyun; Kang, Jin Mo; Ko, Young-Guk; Choi, Donghoon; Youn, Young Nam; Shim, Won-Heum

2013-08-01

To evaluate the outcomes of hybrid endovascular repair for aortic arch pathology. This study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies. Twenty-one patients (16 men; mean age, 64.7 ± 16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for treatment included increased aneurysm size in 16 cases (71.4%), rupture or impending aneurysmal rupture in 5 cases (23.8%), and rapid growth of aortic dissection (≥ 10 mm/y) in 1 case (4.8%). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7%); and the Valiant stent grafts in 7 patients (33.3%). Perioperative complications affected 5 patients (23.8%), as follows: bleeding (n = 4, 19.0%); stroke (n = 3, 14.3%); renal failure (n = 2, 9.5%); vascular injury (n = 1, 4.8%), and respiratory failure (n = 1, 4.8%). Two patients died within 30 days (9.5%). Technical success was achieved in 15 patients (71.5%). Early endoleaks were noted in 4 patients (19.0%). One patient died during follow-up (mean, 21.3 ± 11.6 months) due to a de novo intramural hematoma. Persistent early endoleaks were noted in 4 patients (19.0%); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted. The death-free survival and reintervention-free survival rates during follow-up were 85.7% and 90.5%, respectively. Hybrid treatment with supra-aortic vessel transposition and endovascular repair may be an option in frail patients in who open procedures is too risky. © 2013 Wiley Periodicals, Inc.

Hidden care: Revelations of a case-note audit of physical health care in a community mental health service.

PubMed

Lawn, Sharon; Zabeen, Sara; Rowlands, Nikki; Picot, Sharon

2018-05-24

People with severe mental illness (SMI) are widely reported to be at an increased risk of morbidity and premature death due to physical health conditions. Mental health nurses are ideally placed to address physical and mental health comorbidity as part of their day-to-day practice. This study involved an audit of hardcopy and electronic clinical case-notes of a random sample of 100 people with SMI case managed by community mental health service in metropolitan South Australia, to determine how well physical health conditions and risk factors, screening, and follow-up are recorded within their service records. Every contact between 1 July 2015 and 30 June 2016 was read. One-way ANOVA, Scheffe's test, and Fisher's exact test determined any significant associations across audit variables, which included gender, age, income, living arrangement, diagnosis, lifestyle factors, recording of physical health measures, and carer status. A focus on physical health care was evident from everyday case-note records; however, because this information was 'buried' within the plethora of entries and not brought to the fore with other key information about the person's psychiatric needs, it remained difficult to gain a full picture of potential gaps in physical health care for this population. Under-reporting, gaps and inconsistencies in the systematic recording of physical health information for this population are likely to undermine the quality of care they receive from mental health services, the ability of mental health service providers to respond in a timely way to their physical healthcare needs, and their communication with other healthcare providers. © 2018 Australian College of Mental Health Nurses Inc.

Case Series in Cognitive Neuropsychology: Promise, Perils and Proper Perspective

PubMed Central

Rapp, Brenda

2012-01-01

Schwartz & Dell (2010) advocated for a major role for case series investigations in cognitive neuropsychology. They defined the key features of this approach and presented a number of arguments and examples illustrating the benefits of case series studies and their contribution to computational cognitive neuropsychology. In the Special Issue on “Case Series in Cognitive Neuropsychology” there are six commentaries on Schwartz and Dell (2010) as well as a response to the six commentaries by Dell and Schwartz. In this paper, I provide a brief summary of the key points made in Schwartz and Dell (2010) and I review the promise and perils of case series design as revealed by the six commentaries. I conclude by placing the set of papers within a broader perspective, providing some clarification of the historical record on case series and single case approaches, raising some cautionary notes for case series studies and situating both case series and single case approaches within the larger context of theory development in the cognitive sciences. PMID:22746685

A case of reccuring giant condyloma of vulva in infant without sexual abuse successfully treated with electrocoagulation in Benin

PubMed Central

Akpadjan, Fabrice; Adégbidi, Hugues; Attinsounon, Cossi Angelo; Koudoukpo, Christiane; Dégboé, Bérénice; Agbessi, Nadège; Atadokpèdé, Félix

2017-01-01

We report here a case of giant vulval condyloma in a two-year-old infant infected by her “baby sitter” without sexual abuse. Treated by surgical excision coupled with electrocoagulation, it was noted a rapid recurrence two weeks after treatment requiring a second electrocoagulation session. More than a year later, no lesion was noted, thus demonstrating therapeutic success. The unavailability of imiquimod in our context requires a systematic use of invasive treatment regardless of the age of the patient. PMID:28904687

A case of reccuring giant condyloma of vulva in infant without sexual abuse successfully treated with electrocoagulation in Benin.

PubMed

Akpadjan, Fabrice; Adégbidi, Hugues; Attinsounon, Cossi Angelo; Koudoukpo, Christiane; Dégboé, Bérénice; Agbessi, Nadège; Atadokpèdé, Félix

2017-01-01

We report here a case of giant vulval condyloma in a two-year-old infant infected by her "baby sitter" without sexual abuse. Treated by surgical excision coupled with electrocoagulation, it was noted a rapid recurrence two weeks after treatment requiring a second electrocoagulation session. More than a year later, no lesion was noted, thus demonstrating therapeutic success. The unavailability of imiquimod in our context requires a systematic use of invasive treatment regardless of the age of the patient.

Risk disparities in the globalisation of assisted reproductive technology: the case of Asia.

PubMed

Ha, Jung-Ok

2013-01-01

This paper analyses the disparities in risks associated with biomedical technology focusing on the results of assisted reproductive technology (ART). ART among biomedical technologies transferred to Asia is a representative case that reveals in its clinical use and related scientific research the global politics of technology. This study notes the global politics at work in the recognition of and reaction to such risks. While many Asian countries aggressively pursue technological development, weak legislative and administrative regulations have created various problems and controversial cases. This study asserts that risks associated with technology are characterised as social facts not natural ones or mere 'side effects', since technological development and risk are closely intertwined.

Sebaceous hyperplasia of the vulva: a series of cases reporting no association with the Muir-Torre syndrome.

PubMed

Roma, Andres A; Barry, Jessica; Pai, Rish K; Billings, Steven D

2014-07-01

Sebaceous gland hyperplasia is a common skin condition, very rarely reported in the female genital region. We present 13 cases from 12 patients, the first case series of sebaceous gland hyperplasia of the vulva. Differences in age at presentation and clinical presentation compared with classic sebaceous gland hyperplasia from the head and neck region were noted. Also, it was rarely included in the clinical differential diagnosis. Immunohistochemical studies to determine any possible association with the Muir-Torre syndrome were performed and mismatch repair protein loss was not identified.

Retrospective evaluation of prehospital triage, presentation, interventions and outcome in paediatric drowning managed by a physician staffed helicopter emergency medical service.

PubMed

Garner, Alan A; Barker, Claire L; Weatherall, Andrew D

2015-11-06

Drowning patients may benefit from the advanced airway management capabilities that can be provided by physician staffed helicopter emergency medical services. The aim of this study is to describe paediatric drowning patients treated by such a service examining tasking systems, initial physiology at the incident scene, survival and neurological outcome. Retrospective analysis of paediatric drowning victims over a 5- year period. Case identification system, patient age, site of drowning, presence or absence of cardiac output, first Glasgow Coma Scale (GCS) score and interventions were collected from prehospital notes, and survival and neurological outcomes from hospital and rehabilitation notes. The P-HEMS direct case identification system operating in parallel with a central control system identified all severe drowning cases but 3 of 7 cases (43%) were missed when the central control system operated in isolation. All severe drowning cases (22) identified for P-HEMS response were intubated and transported directly to a paediatric specialist centre. Intubation required adjuvant anaesthesia in 10 (45%) cases. All children with GCS greater than eight on arrival of the P-HEMS survived neurologically intact. Seven of eight children with a GCS between four and seven survived without neurological impairment and all children with a GCS greater than three survived. Four of twelve asystolic children survived including one child who at 18 months post drowning is neurologically normal. All children who survived had return of spontaneous circulation prior to arrival in the emergency department. P-HEMS played a significant role in the management of severe paediatric drowning in this case series. Requirement for P-HEMS only interventions were high and all identified cases were transferred directly to a paediatric specialist centre. Discontinuation of the P-HEMS direct case identication system that operated during the majority of the study period resulted in deterioration in system performance with some paediatric drowning cases subsequently not identified for P-HEMS response being transported to adult hospitals.

[Retinal whitening following vitrectomy for epiretinal macular membrane].

PubMed

Uemura, A

1993-09-01

To investigate the clinical pictures of retinal whitening following epiretinal membrane dissection. I studied retrospectively the records of 18 eyes which had undergone vitrectomy. Two types of retinal whitening were observed: cotton wool-like spots within the superficial retinal layers and a linear or dendritic pattern within the deep retinal layers. The spots were mainly noted in idiopathic cases and resolved completely in a few weeks, and the pattern was observed in macular pucker cases after retinal detachment surgery and persisted for a long time after vitrectomy.

An investigation into the relationship between vigabatrin, movement disorders, and brain magnetic resonance imaging abnormalities in children with infantile spasms.

PubMed

Fong, Choong Yi; Osborne, John P; Edwards, Stuart W; Hemingway, Cheryl; Hancock, Eleanor; Johnson, Anthony L; Kennedy, Colin R; Kneen, Rachel; Likeman, Marcus; Lux, Andrew L; Mordekar, Santosh R; Murugan, Velayutham; Newton, Richard W; Pike, Michael; Quinn, Michael; Spinty, Stefan; Vassallo, Grace; Verity, Christopher M; Whitney, Andrea; O'Callaghan, Finbar J K

2013-09-01

We aimed to investigate the relationship between movement disorders, changes on brain magnetic resonance imaging (MRI), and vigabatrin therapy in children with infantile spasms. Retrospective review and brain MRI analysis of children enrolled in the International Collaborative Infantile Spasms Study (ICISS) who developed a movement disorder on vigabatrin therapy. Comparisons were made with controls within ICISS who had no movement disorder. Ten of 124 infants had a movement disorder and in eight it had developed on vigabatrin therapy. Two had a movement disorder that resolved on dose-reduction of vigabatrin, one had improvement on withdrawing vigabatrin, two had resolution without any dose change, and in three it persisted despite vigabatrin withdrawal. The typical brain MRI changes associated with vigabatrin therapy were noted in two infants. Ten control infants were identified. Typical MRI changes noted with vigabatrin were noted in three controls. It is possible that in two out of eight cases, vigabatrin was associated with the development of a movement disorder. In six out of eight cases a causal relationship was less plausible. The majority of infants treated with vigabatrin did not develop a movement disorder. MRI changes associated with vigabatrin do not appear to be specifically related to the movement disorder. © 2013 Mac Keith Press.

Diagnostic imaging learning resources evaluated by students and recent graduates.

PubMed

Alexander, Kate; Bélisle, Marilou; Dallaire, Sébastien; Fernandez, Nicolas; Doucet, Michèle

2013-01-01

Many learning resources can help students develop the problem-solving abilities and clinical skills required for diagnostic imaging. This study explored veterinary students' perceptions of the usefulness of a variety of learning resources. Perceived resource usefulness was measured for different levels of students and for academic versus clinical preparation. Third-year (n=139) and final (fifth) year (n=105) students and recent graduates (n=56) completed questionnaires on perceived usefulness of each resource. Resources were grouped for comparison: abstract/low complexity (e.g., notes, multimedia presentations), abstract/high complexity (e.g., Web-based and film case repositories), concrete/low complexity (e.g., large-group "clicker" workshops), and concrete/high complexity (e.g., small-group interpretation workshops). Lower-level students considered abstract/low-complexity resources more useful for academic preparation and concrete resources more useful for clinical preparation. Higher-level students/recent graduates also considered abstract/low-complexity resources more useful for academic preparation. For all levels, lecture notes were considered highly useful. Multimedia slideshows were an interactive complement to notes. The usefulness of a Web-based case repository was limited by accessibility problems and difficulty. Traditional abstract/low-complexity resources were considered useful for more levels and contexts than expected. Concrete/high-complexity resources need to better represent clinical practice to be considered more useful for clinical preparation.

A Disorder Unique to Adolescence? The Kleine-Levin Syndrome.

ERIC Educational Resources Information Center

Cawthorn, Paul

1990-01-01

Describes Kleine-Levin syndrome, rare disorder characterized by excessive sleep and abnormal hunger. Notes that, in its pure form, disorder can only be diagnosed in adolescent males. Presents case study of 15-year-old male with disease. Presents evidence which suggests link between Kleine-Levin syndrome and cyclic affective disorders. (Author/ABL)

A Model for Effective Teaching and Learning in Research Methods.

ERIC Educational Resources Information Center

Poindexter, Paula M.

1998-01-01

Proposes a teaching model for making research relevant. Presents a case study of the model as used in advertising and public relations research classes. Notes that the model consists of a knowledge base, team process, a realistic goal-oriented experience, self-management, expert consultation, and evaluation and synthesis. Discusses resulting…

Integration: Dirty Word or Golden Key?

ERIC Educational Resources Information Center

Kerry, Trevor

2007-01-01

This article examines the notion of integrated studies as a way of organising curriculum in schools. Drawing on the insights of educational philosophy, curriculum theory and learning theory it establishes the soundness of a theoretical case for integration. It examines what this view means for the art and science of teaching, and notes examples of…

From Tyrannosaurus to Pokemon: Autonomy in the Teaching of Writing.

ERIC Educational Resources Information Center

Graham, L.

2001-01-01

Discusses action research case studies of representative children and changes to classroom teaching. Notes that children were given the opportunity to: write about things that mattered to them; write as experts; hear their writing read aloud; and experience genuine response to this writing. Finds boys made most progress when given the opportunity…

Feet and Syllables in "Elephants" and "Missiles": A Reappraisal

ERIC Educational Resources Information Center

Zonneveld, Wim; van der Pas, Brigit; de Bree, Elise

2007-01-01

Using data from a case study presented in Chiat (1989), Marshall and Chiat (2003) compare two different approaches to account for the realization of intervocalic consonants in child phonology: "coda capture theory" and the "foot domain account". They argue in favour of the latter account. In this note, we present a reappraisal…

Agent Regeneration and Hazardous Waste Minimization and Teaching Note. IBM Case Study. Doc #93-1.

ERIC Educational Resources Information Center

Oliker, L. Richard; And Others

The manufacturing process used to produce printbands for International Business Machines, Inc. involves a photolithographic process in which the stainless steel panels are chemically machined using strong ferric chloride etching solution containing hydrochloric acid. The waste material that results from this chemical reaction is a solution…

The San Diego Panasonic Partnership: A Case Study in Restructuring.

ERIC Educational Resources Information Center

Holzman, Michael; Tewel, Kenneth J.

1992-01-01

The Panasonic Foundation provides resources for restructuring school districts. The article examines its partnership with the San Diego City School District, highlighting four schools that demonstrate promising practices and guiding principles. It describes recent partnership work on systemic issues, noting the next steps to be taken in San Diego.…

Jurors' Responses to "Longevity and the Secondary Theatre Arts Teacher: A Case Study."

ERIC Educational Resources Information Center

Klein, Jeanne

1999-01-01

Responds to an article in the same issue of this journal which examines factors influencing longevity in the career of a particular high school theatre arts teacher. Notes responses of some jurors regarding methodological concerns and theoretical grounding, but appreciates the writer's personal affinity with her subject and welcomes the…

A Note on Educational Management and the Third Revolution Lithium Regimen: A Reassessment and Commentary.

ERIC Educational Resources Information Center

Snell, Joel C.; Green, Donald W.

1989-01-01

Describes downside of the Third Revolution biological psychiatry. Presents case study in which misapplication of one medication, lithium, jeopardized the professionalism of a college faculty member. Discusses administrative strategies used to resolve the problem and suggests an alternative strategy. Concludes that psychiatric treatment can be…

Forging Appealing Identities in Complex Environments: A Case Study of American Law Schools

ERIC Educational Resources Information Center

Pizarro Milian, Roger

2017-01-01

Competition has intensified substantially within the American law school sector in recent decades. Scholars note that this has augmented pressures to engage in institutional self-promotion, as law schools attempt to distinguish themselves within a severely over-crowded marketplace. To date, however, few have ventured to empirically examine the…

Using Film to Illustrate Theory: A Case Study of "High Fidelity"

ERIC Educational Resources Information Center

Thompson-Hayes, Marceline; Moore, Nerma

2012-01-01

As noted by Proctor (1999), "a quick perusal of communication textbooks, instructors manuals, and conference papers suggests that film use is common in contemporary communication courses." One reason the use of film is popular is that it can engage students in higher learning processes such as applying, analyzing, synthesizing, and evaluating…

Factors Affecting Student Retention at One Independent School in the Southwest

ERIC Educational Resources Information Center

Ahlstrom, Dan Roger

2013-01-01

This mixed-methods case study determined the factors and examined the issues associated with student retention at a faith-based independent day school in southwestern United States of America. The data included online surveys, personal interviews, collection of archival information, and the researcher's extensive field notes. Surveys (530) were…

Striking the Right Note: The Cultural Preparedness Approach to Developing Resonant Career Guidance Programmes

ERIC Educational Resources Information Center

Arulmani, G.

2011-01-01

Cultural preparedness is presented as a conceptual framework that could guide the development of culture-resonant interventions. The "Jiva" careers programme is presented as a case study to illustrate a method of career and livelihood planning based upon Indian epistemology and cultural practices. Social cognitive environments and career beliefs…

Discipline and Rules in Four Hong Kong Kindergarten Classrooms: A Qualitative Case Study

ERIC Educational Resources Information Center

Ho, Joyce; Grieshaber, Susan Jane; Walsh, Kerryann

2017-01-01

Classroom discipline is a topic of international interest and teachers are bombarded with advice regarding how to and why they should manage children's behaviour in their classrooms. This paper draws on data related to classroom discipline gathered from a detailed classroom observation schedule, teacher interviews, and field notes with four…

Acquired Severe Disabilities and Complex Health Care Needs: Access to Inclusive Education

ERIC Educational Resources Information Center

Ballard, Sarah L.; Dymond, Stacy K.

2016-01-01

This case study examined one high school student's access to inclusive education and experiences in an inclusive English class after he acquired severe disabilities and complex health care needs from a nontraumatic brain injury. Multiple sources of data (i.e., interviews, field notes, and documents) were collected and analyzed to formulate…

Selection of Technical Communication Concepts for Integration into an Accounting Information Systems Course: A WAC Case Study.

ERIC Educational Resources Information Center

Gelinas, Ulric J., Jr.; Rama, D. V.; Skelton, Terrance M.

1997-01-01

Profiles a writing-across-the-curriculum project in an accountancy program. Notes that the team's collaborative process produced three critical planning decisions: (1) establishing "fitness-for-use" for evaluating student communications; (2) selecting only those forms of communication used in accountancy; and (3) teaching only those…

Stepfamily Realities: How To Overcome Difficulties and Have a Happy Family.

ERIC Educational Resources Information Center

Newman, Margaret

Noting that the failure rate of second (and subsequent) marriages is higher than that for first-time marriages, this book addresses the major issues confronting members of stepfamilies. Drawing on case studies and experiences with a broad range of stepfamily situations, the book provides valuable insights and practical advice to help stepfamilies…

How To Select the Right Candidate for an Internship Program for Japanese Host Companies.

ERIC Educational Resources Information Center

Kumayama, Akihisa

The method used by the American Graduate School of International Management (AZ) to select participants for internships with Japanese companies is described and some case studies are offered as illustrations. The composition of the selection committee is noted, the interview process is discussed briefly (focusing on elicitation of student…

Increasing Urban Students' Engagement with School: Toward the Expeditionary Learning Model

ERIC Educational Resources Information Center

Ikpeze, Chinwe

2013-01-01

This paper documents the findings of a case study of one K-10 urban expeditionary learning (EL) school. Drawing on theoretical perspectives consistent with the sociocultural theory, data were collected from a variety of sources that included a survey, interviews, field notes from classroom observations and other school activities. Thematic…

Turbulence in Compressible Flows

NASA Technical Reports Server (NTRS)

1997-01-01

Lecture notes for the AGARD Fluid Dynamics Panel (FDP) Special Course on 'Turbulence in Compressible Flows' have been assembled in this report. The following topics were covered: Compressible Turbulent Boundary Layers, Compressible Turbulent Free Shear Layers, Turbulent Combustion, DNS/LES and RANS Simulations of Compressible Turbulent Flows, and Case Studies of Applications of Turbulence Models in Aerospace.

Ecological Disaster and Rhetorical Response: Exxon's Communications in the Wake of the Valdez Spill.

ERIC Educational Resources Information Center

Tyler, Lisa

1992-01-01

Examines Exxon's communication efforts in the wake of the Exxon Valdez oil spill disaster. Identifies communication practices that damaged the corporation's credibility, antagonized the public, and contributed to the public perception of its corporate arrogance. Notes that the Valdez spill makes a good case for classroom study. (PRA)

How clarinettists articulate: The effect of blowing pressure and tonguing on initial and final transients.

PubMed

Li, Weicong; Almeida, André; Smith, John; Wolfe, Joe

2016-02-01

Articulation, including initial and final note transients, is important to tasteful music performance. Clarinettists' tongue-reed contact, the time variation of the blowing pressure P¯mouth, the mouthpiece pressure, the pressure in the instrument bore, and the radiated sound were measured for normal articulation, accents, sforzando, staccato, and for minimal attack, i.e., notes started very softly. All attacks include a phase when the amplitude of the fundamental increases exponentially, with rates r ∼1000 dB s(-1) controlled by varying both the rate of increase in P¯mouth and the timing of tongue release during this increase. Accented and sforzando notes have shorter attacks (r∼1300 dB s(-1)) than normal notes. P¯mouth reaches a higher peak value for accented and sforzando notes, followed by a steady decrease for accented notes or a rapid fall to a lower, nearly steady value for sforzando notes. Staccato notes are usually terminated by tongue contact, producing an exponential decrease in sound pressure with rates similar to those calculated from the bandwidths of the bore resonances: ∼400 dB s(-1). In all other cases, notes are stopped by decreasing P¯mouth. Notes played with different dynamics are qualitatively similar, but louder notes have larger P¯mouth and larger r.

The Far-Infrared Surveyor Mission Study: Paper I, the Genesis

NASA Technical Reports Server (NTRS)

Meixner, M.; Cooray, A.; Carter, R.; DiPirro, M.; Flores, A.; Leisawitz, D.; Armus, L.; Battersby, C.; Bergin, E.; Bradford, C. M.;

'He left me a message on Facebook': comparing the risk profiles of self-harming patients who leave paper suicide notes with those who leave messages on new media.

PubMed

Barrett, Jessica R; Shetty, Hitesh; Broadbent, Matthew; Cross, Sean; Hotopf, Matthew; Stewart, Robert; Lee, William

2016-05-01

In cases of non-fatal self-harm, suicide notes are a major risk factor for repeated self-harm and suicide. Suicide notes can now be left on new media services, emails or text messages, as well as on paper. In a group of people who had harmed themselves, we aimed to compare new media note-leavers with paper note-leavers and characterise these groups demographically and by risk factors. Clinical notes of patients who presented with non-fatal self-harm to two London emergency departments were anonymously searched for mentions of new media use. These were categorised and risk factors were compared for those who had left a new media note, a paper note, or no note to establish differences in risk of note-leaving. New media note-leaving was associated with younger age and substance use; both risk factors for repeated self-harm. However, suicidal intent remained highest in paper note-leavers. Paper note-leavers remain at greatest risk, however new media note leaving is still correlated with risk factors related to repeated self-harm and suicide. Clinicians should enquire about new media use during emergency department assessments of self-harm. None. © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Histopathology in diagnosis of broiler chicken and layer diseases--review of cases 1999-2010.

PubMed

Dolka, I; Sapierzyński, R; Bielecki, W; Malicka, E; Zbikowski, A; Szeleszczuk, P

2012-01-01

The aim of this study was to estimate the prevalence of histopathological lesions in the different organs in relation to the commercial-type and the age of birds (i.e. broiler chickens and layers). During the period 1999-2010 a total of 189 cases was submitted to the Division of Animal Pathomorphology, Department of Pathology and Veterinary Diagnostics at WULS. Most cases were found in broiler chickens (66.7%). The majority of the histopathological lesions were detected in the liver and lymphoid organs. In of 29% cases of hepatic injury pathognomonic lesions associated with inclusion body hepatitis (IBH) were found. The mean age of birds was 23 days. Among IBH cases proventriculitis (58%) was more often found than gizzard lesions (25.8%). Interestingly, we noted some intranuclear inclusions in the epithelial cells within the proventriculus. A low percentage of histopathological evidence of infectious bursal disease (IBD) was reported in chickens. The gastrointestinal tract was the second most frequent predilection site for histopathological lesions. Histopathological findings within the heart and lungs were less common and were more often seen in the upper respiratory tract. Cases of infectious laryngotracheitis (ILT) were registered in broiler chickens (3.2%, mean age 37 days) and in layers (4.8%; mean age 196 days). Lesions associated with Marek's disease, avian leukosis and fowl pox were recognized only in layers, respectively in 3.2% (mean age 176 days), 1.6% (mean age 205 days) and 1.1% (mean age 196 days) of all cases. Avian encephalomyelitis (AE) was noted only in 0.5% of all cases.

Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents.

PubMed

Purushothaman, Suja; Salmani, Deepalaxmi; Prarthana, Kaleramma Gopalakrishna; Bandelkar, Srinidhi Muddanna Gundappa; Varghese, Sarah

2014-07-01

Its being long recognized about the highly debilitating and destructive nature of cerebrovascular accidents (CVAs). Around the world CVAs has posed as a major factor in medical morbidity and mortality. It has thrown up challenges with regards to their medical management and also towards posttreatment rehabilitation. It is well-known that neurologic disorder contributes variously towards varied electrocardiogram (ECG) changes and stroke is no exception. To study the ECG changes and its relation to mortality in cases of CVA. A total of 100 patients with acute stroke were enrolled in the study. All the 100 patients underwent ECG recording within first 24 h of admission. The patients were divided into ischemic and hemorrhagic group depending on the nature of lesion. Out of 100 cases, 58 were ischemic and 42 were hemorrhagic. The ECG changes were noted in 78 patients. Among the ischemic group, the changes noted in the ECG were: T wave inversion (34.48%), ST segment depression (32.75%), QTc prolongation (29.31%), and presence of U waves (27.58%). In cases of hemorrhagic stroke, it was: T wave inversion (33.33%), arrhythmias (33.33%), U waves (30.95%), and ST segment depression (23.80%). Mortality was higher in patients with ST-T changes in ischemic group (66.66%) and in patients with positive U waves (60%) in hemorrhagic group. In acute stroke patients, changes in ECG were commonly seen. The changes varied from T-wave inversion to ST segment depression in ischemic stroke. In hemorrhagic stroke it consisted of T wave inversion and arrhythmias. Overall mortality was high in cases of hemorrhagic compared to ischemic group.

Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents

PubMed Central

Purushothaman, Suja; Salmani, Deepalaxmi; Prarthana, Kaleramma Gopalakrishna; Bandelkar, Srinidhi Muddanna Gundappa; Varghese, Sarah

2014-01-01

Background: Its being long recognized about the highly debilitating and destructive nature of cerebrovascular accidents (CVAs). Around the world CVAs has posed as a major factor in medical morbidity and mortality. It has thrown up challenges with regards to their medical management and also towards posttreatment rehabilitation. It is well-known that neurologic disorder contributes variously towards varied electrocardiogram (ECG) changes and stroke is no exception. Objective: To study the ECG changes and its relation to mortality in cases of CVA. Materials and Methods: A total of 100 patients with acute stroke were enrolled in the study. All the 100 patients underwent ECG recording within first 24 h of admission. The patients were divided into ischemic and hemorrhagic group depending on the nature of lesion. Results: Out of 100 cases, 58 were ischemic and 42 were hemorrhagic. The ECG changes were noted in 78 patients. Among the ischemic group, the changes noted in the ECG were: T wave inversion (34.48%), ST segment depression (32.75%), QTc prolongation (29.31%), and presence of U waves (27.58%). In cases of hemorrhagic stroke, it was: T wave inversion (33.33%), arrhythmias (33.33%), U waves (30.95%), and ST segment depression (23.80%). Mortality was higher in patients with ST-T changes in ischemic group (66.66%) and in patients with positive U waves (60%) in hemorrhagic group. Conclusion: In acute stroke patients, changes in ECG were commonly seen. The changes varied from T-wave inversion to ST segment depression in ischemic stroke. In hemorrhagic stroke it consisted of T wave inversion and arrhythmias. Overall mortality was high in cases of hemorrhagic compared to ischemic group. PMID:25097430

Organizational Factors that Influence E-Learning Development and Implementation in the Corporate Context

ERIC Educational Resources Information Center

Wang, Feng-Kwei; Schwen, Thomas

2003-01-01

In the context of Autoparts, a multinational manufacturer for automotive electronics, Lotus Notes was employed to create an e-learning system. This system was titled "Using Notes for Case-based Learning Environments" (UNCLE). The UNCLE project attempted to encapsulate knowledge and understanding of those organizational factors that might influence…

Note Passing and Gendered Discipline in Vietnamese Schools

ERIC Educational Resources Information Center

Horton, Paul

2015-01-01

While researchers agree that note passing is predominantly an activity engaged in by girls, there has been relatively little consideration of why this is the case. In this article, I argue that gendered expectations about the appropriate characters of boys and girls in Vietnam are incorporated into the disciplinary framework of schools, and that…

Model-free methods to study membrane environmental probes: a comparison of the spectral phasor and generalized polarization approaches

PubMed Central

Malacrida, Leonel; Gratton, Enrico; Jameson, David M

2016-01-01

In this note, we present a discussion of the advantages and scope of model-free analysis methods applied to the popular solvatochromic probe LAURDAN, which is widely used as an environmental probe to study dynamics and structure in membranes. In particular, we compare and contrast the generalized polarization approach with the spectral phasor approach. To illustrate our points we utilize several model membrane systems containing pure lipid phases and, in some cases, cholesterol or surfactants. We demonstrate that the spectral phasor method offers definitive advantages in the case of complex systems. PMID:27182438

Spatial Case Information Management System (SCIMS)

Science.gov Websites

SCIMS facilitates the update of the Land Administration System (LAS) Case File location. Please select Cleanup Notes Utilities LAS Request Import Utility Privacy Copyright System Status Support User Guide

Transesophageal NOTES--a critical analysis of relevant problems.

PubMed

Grund, Karl E; Lehmann, Thorsten G

2010-10-01

The transesophageal access route has not become a principal topic in the discussion about NOTES up to now. Analyzing the problems in this new field of surgery, however, the transesophageal route shows high relevance. Here, all possibilities, limitations, and problems of NOTES become obvious. This paper contains a critical analysis of the literature published to date (nine full papers, five abstracts). Nearly all publications represent experimental studies in living pigs. In most cases a submucosal tunnel technique is performed as access route to mediastinum, pleural cavity, and heart. Interventions and operations include simple mediastinoscopies as well as epicardial operations after exposition of the heart. For access and manipulation, conventional flexible endoscopes and instruments are used. Clips, T-bars, or a combination of both achieve the closure. Some studies rely on spontaneous closure of the incision without any suturing or approximation. In such experimental settings, the following results are presented: Access is achieved in 90% of cases, the aim of the operation is met in 92%, technical success in closure is achieved in 90%, healing of incision assessed as good in two of five studies, satisfactory in three of five studies. Mortality, ranging from 6 to 25%, and complication rates were (surprisingly) high. It has to be stressed that analyzing these papers published to date, no adequate attention is paid to basic facts and problems of general and thoracic surgery (e.g. different forms, prevention, diagnosis and therapy of pneumothorax or differentiated forms of ventilation). Relevant differences in the anatomy and physiology of the esophagus and mediastinum between humans and pigs should additionally be taken into account to choose optimal experimental parameters when transferring results to human settings. Moreover, requirements regarding sterility and hygiene in a structure like the mediastinum, which is at high risk from the point of view of infection biology, have not yet been respected. These factors should be taken into account in further studies--as well as clinically relevant disease patterns in humans--to be able to realize possible advantages of this NOTES access in a clinical setting.

Advance care planning: challenges and approaches for pediatricians.

PubMed

Heckford, Emma; Beringer, Antonia Jane

2014-09-01

There is increasing recognition of the value of advance care planning for children with life-limiting conditions. It is important that we acknowledge and reflect on the challenges that this work presents in order to optimize practice. Our aim was to review advance care planning for children with life-threatening or life-limiting conditions (LTLLCs) in our local area. We conducted a retrospective case note review. Study subjects were from two National Health Service (NHS) Trusts in Bristol in the United Kingdom. Cases were identified from Child Death Overview Panel data. Forty-two sets of case notes were reviewed in relation to 20 children. Measurements included quantitative and qualitative review of advance care planning in relation to standards set by The Association for Children's Palliative Care (ACT). In 25% of cases there was no documented discussion with families about the approach to end of life (EOL). In 25% of cases there was no evidence of an advance care plan, and the content and accessibility of those that did exist was variable. Forty-five percent of families were not offered a choice with regard to location of care (LOC) in the last months of life and 50% were not offered a choice about location of death (LOD). We hope that acknowledgement of some of the challenges, alongside recognition of the clear benefits, of planning will help pediatricians to deliver this important area of care.

Using the Lens of Pedagogical Content Knowledge for Teaching the Nature of Science to Portray Novice Chemistry Teachers' Transforming NOS in Early Years of Teaching Profession

ERIC Educational Resources Information Center

Supprakob, Surayot; Faikhamta, Chatree; Suwanruji, Potjanart

2016-01-01

Pedagogical content knowledge for teaching the nature of science (PCK for NOS) has attracted interest in recent decades. This study investigated the PCK for NOS of six novice chemistry teachers with various educational backgrounds. An interpretive case study was performed. Multiple data sources including classroom observations, field notes,…

I Have Something to Tell You: A Child with a Cochlear Implant's Struggles and Determination to Engage with Peers in an Inclusive Preschool Classroom

ERIC Educational Resources Information Center

Lindeman, Karen Wise

2012-01-01

This study investigated how a child with early cochlear implantation interacted with peers in his inclusive preschool setting. A qualitative case-study framed in a socio-linguistic framework guided the data collection and analysis. Data collection included detailed field notes, classroom free play observations, informal student interviews, teacher…

The Role of the Principal in the Implementation of Positive Behavioral Interventions and Supports in Exemplar Elementary Schools in North Carolina

ERIC Educational Resources Information Center

Headen, Monica Dolores

2013-01-01

This qualitative multiple case study examines how principals contribute to the success of exemplar elementary PBIS schools in North Carolina and how their thoughts about PBIS informed their actions. Guided by the literature on principals and change efforts and sensemaking, this study used individual interviews, focus group interviews, field notes,…

Using iPad-Based Mobile Learning to Teach Creative Engineering within a Problem-Based Learning Pedagogy

ERIC Educational Resources Information Center

Li, Yulong; Wang, Lixun

2018-01-01

This case study, noting the increasing interest in iPad-based mobile learning research and aware of the current dearth of engineering talent in the UK, aims to contribute to a still sparse area of research that links iPad use to engineering education. To achieve this, the study investigates the integration of iPad-based mobile learning…

Trochanteric bursitis: the last great misnomer.

PubMed

Board, Tim N; Hughes, Simon J; Freemont, Anthony J

2014-12-05

Trochanteric bursitis has been used as a general term to describe pain around the greater trochanteric region of the hip. We hypothesised that trochanteric bursitis may not however have an inflammatory component and that accordingly, bursal inflammation has no role in lateral hip pain. This study was designed to test this hypothesis. Patients undergoing primary total hip replacement were enrolled in this prospective, case-controlled, blinded study. Twenty-five patients who met the criteria for diagnosis of trochanteric bursitis (group A) were matched with a control group of 25 patients (group B). Trochanteric bursal samples were harvested from all patients intraoperatively and sent for histological analysis for the presence of inflammation. The intraoperative appearance of the abductor tendon insertion was also noted. None of the samples showed any evidence of acute or chronic inflammatory changes. Intraoperatively, five patients (20%) in group A were noted to have thinning of the gluteus medius tendon but no macroscopic tendon tears were detected in any bursal samples. This study suggests that there is no inflammatory component to so-called trochanteric bursitis, which accordingly casts doubt on both the terminology and the existence of this condition as a separate clinical entity. Clinicians should search for an alternative cause of symptoms in such cases.

Pharmaco-EEG: A Study of Individualized Medicine in Clinical Practice.

PubMed

Swatzyna, Ronald J; Kozlowski, Gerald P; Tarnow, Jay D

2015-07-01

Pharmaco-electroencephalography (Pharmaco-EEG) studies using clinical EEG and quantitative EEG (qEEG) technologies have existed for more than 4 decades. This is a promising area that could improve psychotropic intervention using neurological data. One of the objectives in our clinical practice has been to collect EEG and quantitative EEG (qEEG) data. In the past 5 years, we have identified a subset of refractory cases (n = 386) found to contain commonalities of a small number of electrophysiological features in the following diagnostic categories: mood, anxiety, autistic spectrum, and attention deficit disorders, Four abnormalities were noted in the majority of medication failure cases and these abnormalities did not appear to significantly align with their diagnoses. Those were the following: encephalopathy, focal slowing, beta spindles, and transient discharges. To analyze the relationship noted, they were tested for association with the assigned diagnoses. Fisher's exact test and binary logistics regression found very little (6%) association between particular EEG/qEEG abnormalities and diagnoses. Findings from studies of this type suggest that EEG/qEEG provides individualized understanding of pharmacotherapy failures and has the potential to improve medication selection. © EEG and Clinical Neuroscience Society (ECNS) 2014.

Transitioning from child and adolescent mental health services with attention-deficit hyperactivity disorder in Ireland: Case note review.

PubMed

Tatlow-Golden, Mimi; Gavin, Blanaid; McNamara, Niamh; Singh, Swaran; Ford, Tamsin; Paul, Moli; Cullen, Walter; McNicholas, Fiona

2018-06-01

In a context of international concern about early adult mental health service provision, this study identifies characteristics and service outcomes of young people with attention-deficit hyperactivity disorder (ADHD) reaching the child and adolescent mental health service (CAMHS) transition boundary (TB) in Ireland. The iTRACK study invited all 60 CAMHS teams in Ireland to participate; 8 teams retrospectively identified clinical case files for 62 eligible young people reaching the CAMHS TB in all 4 Health Service Executive Regions. A secondary case note analysis identified characteristics, co-morbidities, referral and service outcomes for iTRACK cases with ADHD (n = 20). Two-thirds of young people with ADHD were on psychotropic medication and half had mental health co-morbidities, yet none was directly transferred to public adult mental health services (AMHS) at the TB. Nearly half were retained in CAMHS, for an average of over a year; most either disengaged from services (40%) and/or actively refused transfer to AMHS (35%) at or after the TB. There was a perception by CAMHS clinicians that adult services did not accept ADHD cases or lacked relevant service/expertise. Despite high rates of medication use and co-morbid mental health difficulties, there appears to be a complete absence of referral to publicly available AMHS for ADHD youth transitioning from CAMHS in Ireland. More understanding of obstacles and optimum service configuration is essential to ensure that care is both available and accessible to young people with ADHD. © 2017 John Wiley & Sons Australia, Ltd.

A brief history of punctoplasty: the 3-snip revisited.

PubMed

Caesar, R H; McNab, A A

2005-01-01

To determine when and how to perform punctoplasty, review the history, and determine the efficacy of posterior ampullectomy. Retrospective analysis of 53 cases of punctal stenosis, operated by a single surgeon by means of posterior ampullectomy via 3-snips. A review of the history of the procedure from papers found with a Medline search for 1-snip, 2-snip, 3-snip, and punctoplasty. In all, 102 sets of notes were reviewed. The age range was from 9 to 89 years with a mean age of 56 years. A total of 74% of patients were female. We excluded 22 patients who had additional surgery and 16 patients who elected not to have surgery. There was no comment as to success or failure in four sets of notes and seven notes could not be found; these cases were also excluded. Of the remaining 53 patients, success was documented in 49 cases, or 92%. The historical review helps explain the debate about the procedure. The retrospective review confirms that posterior ampullectomy via 3-snips is an effective procedure.

Air Quality Dispersion Modeling - Alternative Models

EPA Pesticide Factsheets

Models, not listed in Appendix W, that can be used in regulatory applications with case-by-case justification to the Reviewing Authority as noted in Section 3.2, Use of Alternative Models, in Appendix W.

Fatal Cerebral Edema With Status Epilepticus in Children With Dravet Syndrome: Report of 5 Cases.

PubMed

Myers, Kenneth A; McMahon, Jacinta M; Mandelstam, Simone A; Mackay, Mark T; Kalnins, Renate M; Leventer, Richard J; Scheffer, Ingrid E

2017-04-01

Dravet syndrome (DS) is a well-recognized developmental and epileptic encephalopathy associated with SCN1A mutations and 15% mortality by 20 years. Although over half of cases succumb to sudden unexpected death in epilepsy, the cause of death in the remainder is poorly defined. We describe the clinical, radiologic, and pathologic characteristics of a cohort of children with DS and SCN1A mutations who developed fatal cerebral edema causing mass effect after fever-associated status epilepticus. Cases were identified from a review of children with DS enrolled in the Epilepsy Genetics Research Program at The University of Melbourne, Austin Health, who died after fever-associated status epilepticus. Five children were identified, all of whom presented with fever-associated convulsive status epilepticus, developed severe brain swelling, and died. All had de novo SCN1A mutations. Fever of 40°C or greater was measured in all cases. Signs of brainstem dysfunction, indicating cerebral herniation, were first noted 3 to 5 days after initial presentation in 4 patients, though were apparent as early as 24 hours in 1 case. When MRI was performed early in a patient's course, focal regions of cortical diffusion restriction were noted. Later MRI studies demonstrated diffuse cytotoxic edema, with severe cerebral herniation. Postmortem studies revealed diffuse brain edema and widespread neuronal damage. Laminar necrosis was seen in 1 case. Cerebral edema leading to fatal brain herniation is an important, previously unreported sequela of status epilepticus in children with DS. This potentially remediable complication may be a significant contributor to the early mortality of DS. Copyright © 2017 by the American Academy of Pediatrics.

Case Management and the Integration of Services: How Service Delivery Systems Shape Case Management.

ERIC Educational Resources Information Center

Moore, Stephen

1992-01-01

Notes that primary role that case management plays in coordination of services is determined by level of service integration and by level of resources in service delivery system. Describes conditions under which case management serves as mechanism for rationing services, marketing function, brokering function, or development role. Discusses…

The Use of Case Studies in Teaching Undergraduate Neuroscience

PubMed Central

Meil, William M.

2007-01-01

Case studies have been the cornerstone of many discoveries in neurology and continue to be an indispensable source of knowledge. Attaching a name, face, and story to the study of neurological disorders makes them more “real” and memorable. This article describes the value of the case study methodology and its advantages as a pedagogical approach. It also illustrates how the seminal case of H.M. can be used to highlight the advantages and disadvantages of the case study methodology. Three exercises are described for incorporating case studies into neuroscience courses. The first exercise requires students to conduct a literature review regarding their assigned case and then design an experiment to address a lingering question regarding that neurological disorder. Survey results of 90 students provide quantitative and qualitative support for this approach. The vast majority of students indicated this exercise was a valuable learning experience; sparked interest in the topic and in biopsychology; increased their knowledge and stimulated critical thinking. The second exercise discusses how students might conduct their own case studies. The third exercise emphasizes the use of case studies as a platform to examine competing hypotheses regarding neurological conditions and their treatment. A table listing case studies appropriate for undergraduate neuroscience courses is included. Cases are categorized by the type of neurological disorder and notes regarding the nature of and content of each case are provided. PMID:23493154

Clinicians' perception of the preventability of inpatient mortality.

PubMed

Nash, Robert; Srinivasan, Ramya; Kenway, Bruno; Quinn, James

2018-03-12

Purpose The purpose of this paper is to assess whether clinicians have an accurate perception of the preventability of their patients' mortality. Case note review estimates that approximately 5 percent of inpatient deaths are preventable. Design/methodology/approach The design involved in the study is a prospective audit of inpatient mortality in a single NHS hospital trust. The case study includes 979 inpatient mortalities. A number of outcome measures were recorded, including a Likert scale of the preventability of death- and NCEPOD-based grading of care quality. Findings Clinicians assessed only 1.4 percent of deaths as likely to be preventable. This is significantly lower than previously published values ( p<0.0001). Clinicians were also more likely to rate the quality of care as "good," and less likely to identify areas of substandard clinical or organizational management. Research limitations/implications The implications of objective assessment of the preventability of mortality are essential to drive quality improvement in this area. Practical implications There is a wide disparity between independent case note review and clinicians assessing the care of their own patients. This may be due to a "knowledge gap" between reviewers and treating clinicians, or an "objectivity gap" meaning clinicians may not recognize preventability of death of patients under their care. Social implications This study gives some insight into deficiencies in clinical governance processes. Originality/value No similar study has been performed. This has significant implications for the idea of the preventability of mortality.

Analysis of human papilloma virus in oral squamous cell carcinoma using p16: An immunohistochemical study

PubMed Central

Patil, S.; Rao, R. S.; Amrutha, N.; Sanketh, D. S.

2014-01-01

Aims: The aim of this study is to evaluate the expression of human papilloma virus (HPV) in oral squamous cell carcinoma (OSCC) and to correlate the association of HPV in histological grades of OSCC using p16 (p16INK4a) immunohistochemistry (IHC). Subjects and Methods: This study consists of 30 histological diagnosed cases of OSCC (10-well-differentiated oral squamous cell carcinoma [WDOSCC], 10-moderately differentiated oral squamous cell carcinoma [MDOSCC] and 10-poorly differentiated oral squamous cell carcinoma [PDOSCC]). The sections were subjected to IHC procedure using p16. Two parameters in immunohistochemical p16 expression were evaluated by 3 observers based on the criteria by Galgano M. Tetal (2010) (a) percentage of p16 positive cases (b) pattern of p16 staining in various grades of OSCC. Statistical Analysis Used: Kappa test. Results: Totally, 30 samples of 0SCC, p16 positivity was noted in 26/30 (86.66%). Of 26 positive cases, p16 staining was positive in 7/10 (70%) of WDOSCC, 9/10 (90%) in MDOSCC and, 10/10 (100%) PDOSCC. Incidentally, we also found single dispersed cell staining in WDOSCC, patchy staining in MDOSCC and more diffuse staining pattern predominant in PDOSCC. Conclusions: Our study revealed an association between HPV and OSCC. Diffuse staining pattern was noted in PDOSCC, which in turn depicts the increase viral overload, which might have an influence on its aggressive behavior. PMID:24818098

Endovascular Treatment of Cerebral Aneurysms in Relation to Their Parent Artery Wall: A Single Center Study

PubMed Central

Mitsos, A.P.; Giannakopoulou, M.D.; Kaklamanos, I.G.; Kapritsou, M.; Konstantinou, M.I.; Fotis, T.; Mamoura, K.V.; Mariolis-Sapsakos, T.; Ntountas, I.T.; Konstantinou, E.A.

2013-01-01

We report our two-year experience in the endovascular treatment of brain aneurysms in relation to their parent artery wall. We prospectively recorded patients with intracranial aneurysms (107 ruptured - 38 unruptured) treated with coiling during a two-year period: 145 patients, 94 females and 51 males - mean age 56 years. The aneurysms were divided into side-wall (A) and bifurcation (B) groups. A total occlusion rate was noted in post-embolization angiograms in 101 aneurysms (70%) with a morbidity of 4%. No angiographic recurrence arose in the six-month follow-up. The two groups had a similar total occlusion rate (68.31% and 71.8% respectively), while the complication rate was 3% in group A and 4.7% in group B. Significant differences between the two groups were noted in the number of assisted coiling cases: 28 out of 60 cases (46.7%) in group A - 14 out of 85 cases (16.5%) in group B. Further statistical analysis showed strong dependencies for the type of endovascular procedure between the ruptured and unruptured aneurysms in both groups (p 0.000<0.05), but no dependencies between the aneurysm occlusion rate and the ruptured or non-ruptured aneurysms, or between the occlusion rate and the type of endovascular procedure (p 0.552 >0.05 and 0.071 >0.05 respectively). In conclusion, the anatomic relation of the aneurysm sac with the wall of the parent artery is important, as significant differences in endovascular practice, devices and techniques were noted between side-wall and bifurcation aneurysms. PMID:23859171

A note on the accuracy of spectral method applied to nonlinear conservation laws

NASA Technical Reports Server (NTRS)

Shu, Chi-Wang; Wong, Peter S.

1994-01-01

Fourier spectral method can achieve exponential accuracy both on the approximation level and for solving partial differential equations if the solutions are analytic. For a linear partial differential equation with a discontinuous solution, Fourier spectral method produces poor point-wise accuracy without post-processing, but still maintains exponential accuracy for all moments against analytic functions. In this note we assess the accuracy of Fourier spectral method applied to nonlinear conservation laws through a numerical case study. We find that the moments with respect to analytic functions are no longer very accurate. However the numerical solution does contain accurate information which can be extracted by a post-processing based on Gegenbauer polynomials.

Is there still an unknown Freud? A note on the publications of Freud's texts and on unpublished documents.

PubMed

Falzeder, Ernst

2007-01-01

This article presents an overview of the existing editions of what Freud wrote (works, letters, manuscripts and drafts, diaries and calendar notes, dedications and margin notes in books, case notes, and patient calendars) and what he is recorded as having said (minutes of meetings, interviews, memoirs of and interviews with patients, family members, and followers, and other quotes). There follows a short overview of biographies of Freud and other documentation on his life. It is concluded that a wealth of material is now available to Freud scholars, although more often than not this information is used in a biased and partisan way.

Transvaginal laparoscopically assisted endoscopic cholecystectomy: preliminary clinical results for a series of 43 cases in China.

PubMed

Niu, Jun; Song, Wei; Yan, Ming; Fan, Wei; Niu, Weibo; Liu, Enyu; Peng, Cheng; Lin, Pengfei; Li, Peng; Khan, Abdul Qadir

2011-04-01

Transvaginal cholecystectomy has been performed successfully at several research institutions worldwide using natural orifice transluminal endoscopic surgery (NOTES) techniques. However, it is a growing new surgical concept in China. Several technical challenges hinder the safe clinical application of NOTES. This study investigated transvaginal endoscopic cholecystectomy performed with the assistance of a single umbilical trocar and achieved helpful initial clinical experience. From May 2009 to April 2010, a total of 43 transvaginal human cholecystectomies were performed. A single umbilical trocar was used for safe access and laparoscopic assistance during the operation. After the gallbladder had been removed through the vagina, the colpotomy was closed with absorbable stitches under direct vision. In addition, Student's t-test was performed for two samples to estimate the superiority of NOTES over a conventional laparoscopic cholecystectomy (LC) operation. The procedure was successfully completed for all the patients. No intra- or post-operative complications occurred. The patients recovered promptly after surgery, and all were satisfied with ideal cosmetic outcomes. The postoperative pain, hospital stay, and cost of hospitalization with NOTES were much less than with conventional LC operations. Although endoscopic instruments specifically designed for NOTES are not available, the addition of an umbilical trocar is an optimal way to allow safe performance of NOTES procedures in an easily reproducible manner. The authors' initial experience demonstrates that this hybrid technique is potentially feasible and effective for reducing postoperative pain and recovery times while improving the cosmetic results of transvaginal cholecystectomy.

Improving paediatric tuberculosis and HIV clinical record keeping: the use of audit and a structured pro forma in a South African regional level hospital.

PubMed

Goenka, Anu; Annamalai, Medeshni; Dhada, Barnesh; Stephen, Cindy R; McKerrow, Neil H; Patrick, Mark E

2014-04-01

We report on the impact of revisions made to an existing pro forma facilitating routine assessment and the management of paediatric HIV and tuberculosis (TB) in KwaZulu-Natal, South Africa. An initial documentation audit in 2010 assessed 25 sets of case notes for the documentation of 16 select indicators based on national HIV and TB guidelines. Using the findings of this initial audit, the existing case note pro forma was revised. The introduction of the revised pro forma was accompanied by training and a similar repeat audit was undertaken in 2012. This demonstrated an overall improvement in documentation. The three indicators that improved most were documentation of maternal HIV status, child's HIV status and child's TB risk assessment (all P < 0.001). This study suggests that tailor-made documentation pro formas may have an important role to play in improving record keeping in low-resource settings.

Medical Record Documentation Among Interns: A Prospective Quality Improvement Study.

PubMed

Owen, Jm; Conway, R; Silke, B; O'Riordan, D

2015-06-01

Comprehensive record keeping is a key aspect of medical practice. The National Hospitals Office (NHO) and Irish Medical Council (IMC) have published guidelines in this area. A prospective audit of 100 patients assessed by interns was performed to quantify adherence with these guidelines followed by an educational session and email reminders. Adherence was reassessed in an incidental manner. Compliance was recorded in a number of areas including the reason for review and documentation of a plan both 98 (98%). However less than half of interns recorded the patient's name, background history or their impression of the case. Only 31(31%) noted the patient's MRN and only 1(1%) the information they gave to the patient. Significant improvements following the intervention were found, however significant deficits remained in a number of areas including the noting of an impression of the case 62(62%) and information given to patients 18(18%). Suboptimal documentation can be improved through education and clinical auditing.

Electronic health record systems in ophthalmology: impact on clinical documentation.

PubMed

Sanders, David S; Lattin, Daniel J; Read-Brown, Sarah; Tu, Daniel C; Wilson, David J; Hwang, Thomas S; Morrison, John C; Yackel, Thomas R; Chiang, Michael F

2013-09-01

To evaluate quantitative and qualitative differences in documentation of the ophthalmic examination between paper and electronic health record (EHR) systems. Comparative case series. One hundred fifty consecutive pairs of matched paper and EHR notes, documented by 3 attending ophthalmologist providers. An academic ophthalmology department implemented an EHR system in 2006. Database queries were performed to identify cases in which the same problems were documented by the same provider on different dates, using paper versus EHR methods. This was done for 50 consecutive pairs of examinations in 3 different diseases: age-related macular degeneration (AMD), glaucoma, and pigmented choroidal lesions (PCLs). Quantitative measures were used to compare completeness of documenting the complete ophthalmologic examination, as well as disease-specific critical findings using paper versus an EHR system. Qualitative differences in paper versus EHR documentation were illustrated by selecting representative paired examples. (1) Documentation score, defined as the number of examination elements recorded for the slit-lamp examination, fundus examination, and complete ophthalmologic examination and for critical clinical findings for each disease. (2) Paired comparison of qualitative differences in paper versus EHR documentation. For all 3 diseases (AMD, glaucoma, PCL), the number of complete examination findings recorded was significantly lower with paper than the EHR system (P ≤ 0.004). Among the 3 individual examination sections (general, slit lamp, fundus) for the 3 diseases, 5 of the 9 possible combinations had significantly lower mean documentation scores with paper than EHR notes. For 2 of the 3 diseases, the number of critical clinical findings recorded was significantly lower using paper versus EHR notes (P ≤ 0.022). All (150/150) paper notes relied on graphical representations using annotated hand-drawn sketches, whereas no (0/150) EHR notes contained drawings. Instead, the EHR systems documented clinical findings using textual descriptions and interpretations. There were quantitative and qualitative differences in the nature of paper versus EHR documentation of ophthalmic findings in this study. The EHR notes included more complete documentation of examination elements using structured textual descriptions and interpretations, whereas paper notes used graphical representations of findings. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Laminar resorption in modified osteo-odonto-keratoprosthesis procedure: a cause for concern.

PubMed

Iyer, Geetha; Srinivasan, Bhaskar; Agarwal, Shweta; Rachapalle, Sudhir Reddi

2014-08-01

To analyze the cases of lamina resorption following the modified osteo-odonto-keratoprosthesis (MOOKP) procedure. Retrospective case series. Case records of 18 eyes (20 laminae) of 17 patients who showed evidence of lamina resorption out of the 85 eyes (87 laminae) of 82 patients that underwent MOOKP procedure between March 2003 and March 2013 were analyzed. Of the 17 patients (20 laminae), 1 underwent MOOKP procedure following multiple graft failures, 6 (7 laminae) belonged to the chemical injury group, and 10 (12 laminae) to the Stevens-Johnson syndrome (SJS) group. Resorption was noted in 20 out of 87 laminae (22.98%). The need for removal of lamina/extrusion was noted in 3 out of the 7 laminae in the chemical injury group and 8 out of the 12 laminae in the SJS group. The mean duration to the first sign suggestive of resorption among patients of SJS was 36.7 months and among patients of chemical injury was 43 months. Vitritis was the presenting feature (7 of 20 laminae, 35%) indicative of early resorption, and the occurrence of the same in eyes with lamina resorption was noted to be statistically significant in comparison to controls (P<.001). Sixteen out of 20 laminae showed evidence of resorption superiorly. Vitritis was the most common presenting feature of lamina resorption and could be an indicator of lamina resorption. Resorption of the laminae was noted to occur along the aspect with thinner bone support in all eyes. Incidence of severe resorption with extrusion of cylinder/requiring lamina removal was noted to be higher among patients with SJS. Copyright © 2014 Elsevier Inc. All rights reserved.

Using Dialogue to Create Inclusive Classrooms: A Case Study from a Faculty Institute

ERIC Educational Resources Information Center

Maxwell, Kelly; Gurin, Patricia

2017-01-01

Classrooms should be liberatory spaces where people are nurtured and content comes to life. But students and faculty frequently note the charged nature of the classroom, especially when course content focuses on aspects of identity such as race and ethnicity or dynamics related to power and inequality. This article describes a Faculty Dialogues…

A Rationale for the Outcomes of Insurgencies: A Comparison Case Study Between Insurgencies in Peru and Nepal

DTIC Science & Technology

2014-12-01

December 1987 and February 1992.100 Sigmund Freud notes such violent attitudes, and documents that human instincts are of two types—those that...Routledge Contemporary South Asia Series, 2010), 144. 101 Sigmund Freud , “Why War,” in Conflict after the Cold War: Arguments on Causes of War and

A Note on Improving Process Efficiency in Panel Surveys with Paradata

ERIC Educational Resources Information Center

Kreuter, Frauke; Müller, Gerrit

2015-01-01

Call scheduling is a challenge for surveys around the world. Unlike cross-sectional surveys, panel surveys can use information from prior waves to enhance call-scheduling algorithms. Past observational studies showed the benefit of calling panel cases at times that had been successful in the past. This article is the first to experimentally assign…

Turning Points of the Spherical Pendulum and the Golden Ratio

ERIC Educational Resources Information Center

Essen, Hanno; Apazidis, Nicholas

2009-01-01

We study the turning point problem of a spherical pendulum. The special cases of the simple pendulum and the conical pendulum are noted. For simple initial conditions the solution to this problem involves the golden ratio, also called the golden section, or the golden number. This number often appears in mathematics where you least expect it. To…

Unethical Scholarship Today: A Preliminary Typology.

ERIC Educational Resources Information Center

Cooper, Douglas W.

Today many signs point to an uneasy concern among scholars regarding the ethics of their peers. All too frequently the press reports cases of ethical breaches in many fields of scholarship. Over the years a few people have continued to note and study patterns of deviant and unethical behavior in scholarship. But in spite of the need to…

The Art Teacher and Environmental Education--A Scottish Viewpoint

ERIC Educational Resources Information Center

Thomson, Russell

1978-01-01

Discusses the role of the art teacher with relation to environmental education and the nature of the art specialist's training including the part played by past artists in influencing the art curriculum as well as that of William Morris and Walter Gropius, two noted architects. Concludes with a case study of the town in which the author was…

A Comparison of General and Content-Specific Literacy Strategies for Learning Science Content

ERIC Educational Resources Information Center

Reed, Deborah K.; Whalon, Kelly; Lynn, Devon; Miller, Nicole; Smith, Keely

2017-01-01

This study employed an adapted alternating treatments single-case design to explore students' learning of biology content when using a general note-taking (GNT) strategy and a content-specific graphic organizer (CGO) to support reading high school biology texts. The 4 focal participants were 15-18-year-olds committed to a moderate risk juvenile…

Providers' Reported and Actual Use of Coaching Strategies in Natural Environments

ERIC Educational Resources Information Center

Salisbury, Christine; Cambray-Engstrom, Elizabeth; Woods, Juliann

2012-01-01

This case study examined the agreement between reported and actual use of coaching strategies based on home visit data collected on a diverse sample of providers and families. Paired videotape and contact note data of and from providers during home visits were collected over a six month period and analyzed using structured protocols. Results of…

Discursive Power and the New Labor Force: The Metamorphosis of a Speech Community

ERIC Educational Resources Information Center

Miles, Christopher

2010-01-01

This article describes the results of a six-month ethnographic case study of a French immigrant of Senegalese descent and how he recreates the culture of an American company's speech community. Data were collected through interviews, field notes, and shadowing the participant at his place of employment. The transcribed interviews and field notes…

Evidence from Biochemical Pathways in Favor of Unfinished Evolution Rather than Intelligent Design

ERIC Educational Resources Information Center

Behrman, Edward J.; Marzluf, George A.

2004-01-01

An argument is made in favor of imperfect or unfinished evolution based on some metabolic pathways in which it seems that intelligent design would have done better. The case studies noted indicate the absence of highly intelligent design and are not intended as comprehensive collection but as a limited sample of inefficient situations in…

David's Story: How Technology Helped a Severely Disabled Learner Read and Write.

ERIC Educational Resources Information Center

Hill, Margaret H.; Stephens, Liz C.

This case study describes how one autistic learner, an 11-year-old boy, became a co-researcher with university literacy instructors to investigate how hypermedia can help him develop language and literacy skills. Data was collected for one year from video taping, journal notes, interviews with teachers and parents, test scores, and student…

78 FR 26777 - Technological Advisory Council Recommendation for Improving Receiver Performance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-08

... paper makes note that an interference limits policy approach may not be appropriate in all cases. Are.... SUMMARY: The FCC's Technological Advisory Council (TAC) has been tasked to study the role of receivers in.../ecfs2/ . [ssquf] Paper Filers: Parties who choose to file by paper must file an original and one copy of...

We Need to "Catch Them before They Fall": Response to Intervention and Elementary Emergent Bilinguals

ERIC Educational Resources Information Center

López, Minda Morren; Mendoza, Marie Arnold

2013-01-01

The authors of this case study examine response to intervention (RTI) implementation with Emergent Bilinguals in a large urban district. As participants noted, it is not appropriate to assess, instruct, and intervene with students through a one-size-fits-all approach. Instead, multiple factors such as language background, program participation,…

77 FR 47617 - Notice of Submission for OMB Review; Office of Planning, Evaluation and Policy Development...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... information technology. Please note that written comments received in response to this notice will be... conducting qualitative case studies of up to 15 sites with a focus on preventing students from dropping out... qualitative data across multiple respondents to generate portraits of programs and strategies that the sites...

Talking to Texts and Sketches: The Function of Written and Graphic Mediation in Engineering Design.

ERIC Educational Resources Information Center

Lewis, Barbara

2000-01-01

Describes the author's research that explores the role of language, particularly texts, in the engineering design process. Notes that results of this case study support a new "mediated" model of engineering design as an inventional activity in which designers use talk, written language, and other symbolic representations as tools to think about…

Listening for Competence through Documentation: Assessing Children with Language Delays Using Digital Video

ERIC Educational Resources Information Center

Suarez, Stephanie Cox; Daniels, Karen J.

2009-01-01

This case study uses documentation as a tool for formative assessment to interpret the learning of twin boys with significantly delayed language skills. Reggio-inspired documentation (the act of collecting, interpreting, and reflecting on traces of learning from video, images, and observation notes) focused on the unfolding of the boys' nonverbal…

The Process of Including Elementary Students with Autism and Intellectual Impairments in Their Typical Classrooms.

ERIC Educational Resources Information Center

Downing, June E.; And Others

A qualitative case study methodology was used to examine the process of including three students with autism, intellectual impairments, and behavioral challenges in age-appropriate typical classrooms and home schools. Data were obtained over a 9-month period from field notes of a participant researcher and three paraeducators, structured…

Authorship, Gender, and Institutional Affiliation in Library History: The Case of "Libraries & Culture."

ERIC Educational Resources Information Center

Herubel, Jean-Pierre V. M.

1991-01-01

Describes a study that examined two characteristics of authorship--the gender of the authors and their institutional affiliation--to see who is producing published research in the field of library history. The results of an analysis of articles, technical notes, and reviews from 23 years of "Library and Culture" are discussed. (two…

Student Voice Use and Vocal Health during an All-State Chorus Event

ERIC Educational Resources Information Center

Daugherty, James F.; Manternach, Jeremy N.; Price, Kathy K.

2011-01-01

This field-based case study documented students' (N = 256) voice use and voice health perceptions during a 3-day all-state high school chorus event through daily surveys, phonation duration data, analysis of rehearsal voice use behaviors, and field notes. Among the primary results are the following: (a) First and final day survey comparisons…

Laws Affecting School Libraries. Bulletin, 1940, No. 7

ERIC Educational Resources Information Center

Lathrop, Edith A.; Keesecker, Ward W.

1941-01-01

This study is limited strictly to a consideration of express legislation; and administrative regulations or practice have been excluded from its scope, except in a few cases where their inclusion as a note has been necessary for clarification of a point. Moreover, no attempt has been made to evaluate the laws affecting libraries, but to present…

Israel's "Planning and Grants Committee": A Case Study of Autonomy and Control in Higher Education.

ERIC Educational Resources Information Center

Iram, Yaacov

The higher education system in Israel is discussed, noting that tertiary education in that country makes a clear distinction between higher (university and academic) education and postsecondary education that is largely vocational. The Planning and Grants Committee (PGC) of the Council for Higher Education is responsible for the budgets of…

Technical Note: Field-observed angles of repose for stored grain in the United States

USDA-ARS?s Scientific Manuscript database

Bulk grain angle of repose (AoR) is a key parameter for inventorying grain, predicting flow characteristics, and designing bins and grain handling systems. The AoR is defined for two cases, piling (dynamic) or emptying (static), and usually varies with grain type. The objective of this study was to ...

Rapid Population Growth and Rural Community Change: A Focus on Land Use Issues.

ERIC Educational Resources Information Center

Garkovich, Lorraine

Land use controls are often a major point of conflict between recent migrants and long-term residents of rapidly growing communities. Such conflict was noted in a case study of a rural community undergoing rapid population growth. The revision of a comprehensive land use plan for the community provided the opportunity to evaluate citizen…

Don't Blame ME, Daddy. False Accusations of Child Sexual Abuse: A Hidden National Tragedy.

ERIC Educational Resources Information Center

Tong, Dean

Noting the increase in false accusations of child sexual abuse where divorce and custody litigation is in progress, this book examines the consequences of such accusations for everyone involved and provides defensive strategies for those falsely accused. The book draws on four case studies, including a personal one, to illustrate the chronology…

7 CFR 1962.49 - Civil and criminal cases.

Code of Federal Regulations, 2010 CFR

2010-01-01

... sources, has agreed in the note or other instrument to do so, but refuses to comply with that agreement... office). Ordinarily, it will not be necessary to inform the third-party purchaser of OGC's decision when... now be sent to the borrower and any other obligor(s) on the note. Any appeal must be concluded before...

Compartment A126 port side. Note ash hoist for boiler room ...

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

Compartment A-126 port side. Note ash hoist for boiler room compartment B-1 and compartment B-2. Scuttlebutt (drinking water fountain) is at right center of photograph. Manikin wearing WWII wave uniform is in display case at left center. (045) - USS Olympia, Penn's Landing, 211 South Columbus Boulevard, Philadelphia, Philadelphia County, PA

Sherlock Holmes and the Strange Case of the Missing Attribution: A Historical Note on "The Grandfather Passage"

ERIC Educational Resources Information Center

Reilly, Jamie; Fisher, Jamie L.

2012-01-01

Purpose: In 1963, Charles Van Riper published "My Grandfather," a short reading passage that has evolved into a ubiquitous metric of reading ability and speech intelligibility. In this historical note, we describe several heretofore unacknowledged similarities between "The Grandfather Passage" (Darley, Aronson, & Brown, 1975) and a portion of "The…

Historical note: Drumine--a new Australian local anaesthetic.

PubMed

Bailey, R J

1977-02-01

An article in the Australiasian Medical Gazette of October, 1886 indicates the method of extraction, experimentation and therapeutic application of an active principle, prepared from Euphorbia Drummondii. Further correspondence is noted, refining the method of extraction, reporting cases, answering criticisms, and announcing eventually, drumine's commercial preparation. Despite enthusiastic support, the drug soon disappears from the therapeutic scene.

Electrical injuries due to railway high tension cables.

PubMed

Reichl, M; Kay, S

1985-08-01

We have noted a large number of young boys being admitted to our Unit with burns due to railway high tension cables. On review of these cases we have noted: most of the burns were due to arcing, there is a high level of ignorance among the population at risk. We propose some ways of preventing these injuries.

7 CFR 1738.30 - Rural broadband access loans and loan guarantees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... interest at a rate set by the lender consistent with the current applicable market rate for a loan of... Derivative or any Guaranteed-Amount Debt Derivative; or (B) Any holder of the Guaranteed Loan Note or any Guaranteed Loan Portion Note or any Derivative, as the case may be, having a claim to payments on the...

Application Note: Power Grid Modeling With Xyce.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sholander, Peter E.

This application note describes how to model steady-state power flows and transient events in electric power grids with the SPICE-compatible Xyce TM Parallel Electronic Simulator developed at Sandia National Labs. This application notes provides a brief tutorial on the basic devices (branches, bus shunts, transformers and generators) found in power grids. The focus is on the features supported and assumptions made by the Xyce models for power grid elements. It then provides a detailed explanation, including working Xyce netlists, for simulating some simple power grid examples such as the IEEE 14-bus test case.

Child sexual abuse: report of 311 cases with review of literature.

PubMed

Essabar, Laila; Khalqallah, Abdenbi; Dakhama, Badr Sououd Benjelloun

2015-01-01

Child sexual abuse (CSA) is a global problem that has significant consequences for public health; it has been a prominent topic of public concern for more than a decade, but many basic facts about the problem remain unclear or in dispute. We conducted a study of 311 cases of CSA in order to highlight the epidemiological features and negative impact on victims' well-being and to emphasize the need for a multidisciplinary approach to the primary prevention and management of CSA. We noted an increase in cases number with male predominance. Most of our patients came from lower socioeconomic classes. The perpetrators were male in 100% of cases; acquaintances in 70% of cases and family members in 22 cases. Physical examination were normal in 61% of cases, however, a range of psychological and physical effects were identified with dramatic health consequences: three cases of attempted suicide, five pregnancies and one case of HIV virus infection.

[Dandy-Walker complex: a clinicopathologic study of 9 cases].

PubMed

Zhang, Xiao-bo; Gu, Yi-qun; Sun, Xiao-fei; Wang, Ying-nan; Wang, Ai-chun

2013-12-01

To investigate the etiology, pathogenesis, clinicopathologic characteristics, clinical prognosis and treatment of Dandy-Walker syndrome. Nine cases of Dandy-Walker syndrome were included in the study. The autopsy findings and clinical history were evaluated along with review of the literature. The causes, pathogenetic mechanism, pathologic features and prognosis of Dandy-Walker syndrome were analyzed. Among 9 Dandy-Walker syndrome cases, six patients presented with variants of Dandy-Walker complex and 3 cases had classic Dandy-Walker malformation. In addition, 4 patients presented with combined lateral ventricle expansion and multiple malformations were seen in 7 cases. Combined umbilical cord abnormality was noted in 4 patients with variant of Dandy-Walker complex and combined placental abnormality was seen in one classic Dandy-Walker syndrome. Dandy-Walker syndrome is a rare disease. In addition to complex pathogenesis with possible genetic and environmental antigenic etiologies, placental and umbilical cord abnormality may be also related to its development.

Phase locked neural activity in the human brainstem predicts preference for musical consonance.

PubMed

Bones, Oliver; Hopkins, Kathryn; Krishnan, Ananthanarayan; Plack, Christopher J

2014-05-01

When musical notes are combined to make a chord, the closeness of fit of the combined spectrum to a single harmonic series (the 'harmonicity' of the chord) predicts the perceived consonance (how pleasant and stable the chord sounds; McDermott, Lehr, & Oxenham, 2010). The distinction between consonance and dissonance is central to Western musical form. Harmonicity is represented in the temporal firing patterns of populations of brainstem neurons. The current study investigates the role of brainstem temporal coding of harmonicity in the perception of consonance. Individual preference for consonant over dissonant chords was measured using a rating scale for pairs of simultaneous notes. In order to investigate the effects of cochlear interactions, notes were presented in two ways: both notes to both ears or each note to different ears. The electrophysiological frequency following response (FFR), reflecting sustained neural activity in the brainstem synchronised to the stimulus, was also measured. When both notes were presented to both ears the perceptual distinction between consonant and dissonant chords was stronger than when the notes were presented to different ears. In the condition in which both notes were presented to the both ears additional low-frequency components, corresponding to difference tones resulting from nonlinear cochlear processing, were observable in the FFR effectively enhancing the neural harmonicity of consonant chords but not dissonant chords. Suppressing the cochlear envelope component of the FFR also suppressed the additional frequency components. This suggests that, in the case of consonant chords, difference tones generated by interactions between notes in the cochlea enhance the perception of consonance. Furthermore, individuals with a greater distinction between consonant and dissonant chords in the FFR to individual harmonics had a stronger preference for consonant over dissonant chords. Overall, the results provide compelling evidence for the role of neural temporal coding in the perception of consonance, and suggest that the representation of harmonicity in phase locked neural firing drives the perception of consonance. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration With a 19-G Needle Device.

PubMed

Tremblay, Alain; McFadden, Seamus; Bonifazi, Martina; Luzzi, Valentina; Kemp, Samuel V; Gasparini, Stefano; Chee, Alex; MacEachern, Paul; Dumoulin, Elaine; A Hergott, Christopher; Shah, Pallav L

2018-05-16

Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration is a well-established first-line minimally invasive modality for mediastinal lymph node sampling. Although results are excellent overall, the technique underperforms in certain situations. We aimed to describe our results using a new 19-G EBUS-guided transbronchial needle aspiration device to determine safety and feasibility of this approach. We completed a retrospective chart review of all cases performed to the time of data analysis at each of 3 study sites. A total of 165 procedures were performed with a total of 297 individual lymph nodes or lesions sampled with the 19-G device by 10 bronchoscopists. Relatively large targets were selected for sampling with the device (mean lymph node size: 20.4 mm; lung lesions: 33.5 mm). A specific diagnosis was obtained in 77.3% of cases with an additional 13.6% of cases with benign lymphocytes, for a procedural adequacy rate of 90.9%. Procedure sample adequacy was 88.6% in suspected malignant cases, 91.0% in suspected sarcoidosis/lymphadenopathy cases, and 85.7% of cases with suspected lymphoma. On a per-node basis, a specific diagnosis was noted in 191/280 (68.2%) of samples, with an additional 61 showing benign lymphocytes for a per-node sample adequacy rate of 90%. One case (0.6%) of intraprocedure bleeding was noted. A new flexible 19-G EBUS needle was successfully and safely applied in a large patient cohort for sampling of lung and enlarged mediastinal lesions with high diagnostic rates across clinical indications.

The Case For Space: A Legislative Framework For An Independent United States Space Force

DTIC Science & Technology

2018-04-01

However, this proposal has merit, and is the subject of extensive studies . AU/ACSC/Neil, M/Grant, D/AY18 10 One primary purpose of such...issues with DOD space acquisition, yet even within this one confined area of study noted problems that appear to be systemic. The GAO report...recommendations drawn from these studies seem to have fallen on deaf ears, and whatever changes these various studies prompted failed to adequately address

Heterogeneity of the IgE response to allergenic determinants of cefaclor in serum samples from patients with cefaclor-induced anaphylaxis.

PubMed

Kim, Sang-Hoon; Choi, Jeong-Hee; Park, Hae-Sim

2005-06-01

Beta-lactam antibiotics, such as cefaclor, may cause IgE-mediated anaphylactic reactions. However, the clinically available serologic test has not been widely accepted, and the antigenic determinants of these drugs are unclear. To describe 4 cases of anaphylaxis caused by cefaclor in which a specific IgE response to cefaclor was demonstrated. Four patients with anaphylaxis to cefaclor and 35 nonatopic controls never exposed to cefaclor were studied. Skin tests and oral challenges with this drug were performed. The specific IgE response to the antigenic determinant of cefaclor-human serum albumin (HSA) conjugate was compared in each patient. The serum specific IgE to cefaclor-HSA conjugate was detected using enzyme-linked immunosorbent assay (ELISA). Also, ELISA inhibition studies using various concentrations of cefaclor-HSA, HSA alone, and free cefaclor were performed, as were hapten inhibition studies using cefaclor, cephalexin, cefadroxil, ampicillin, ceftriaxone, and cefotaxime. Three patients showed high levels of serum specific IgE to cefaclor-HSA and marked inhibition patterns to free cefaclor and cefaclor-HSA conjugate on ELISA inhibition testing. Hapten inhibition testing in 3 individual serum samples showed 2 different patterns. In patient 3, significant dose-dependent inhibitions (up to 92%) were noted with additions of free cefaclor and cefaclor-HSA conjugate, and lesser inhibitions (up to 74%) were noted with cephalexin, which shares the aminobenzyl side chain. In patients 1 and 2, marked dose-dependent inhibitions were noted only with additions of cefaclor-HSA conjugate and free cefaclor, whereas minimal inhibitions were noted with the other 5 compounds. The specific IgE response to cefaclor-HSA conjugate in patients with cefaclor anaphylaxis occurs against the hapten, in which heterogeneity of the antigenic determinant was noted to depend on the individual.

The role of copy and paste function in orthopedic trauma progress notes.

PubMed

Winn, Wesley; Shakir, Irshad A; Israel, Heidi; Cannada, Lisa K

2017-01-01

The electronic medical record (EMR) is standard in institutions. While there is not concern for legibility of notes and access to charts, there is an ease of copy and paste for daily notes. This may not lead to accurate portrayal of patient's status. Our purpose was to evaluate the use of copy and paste functions in daily notes of patients with injuries at high risk for complications. IRB approval was obtained for a retrospective review. Inclusion criteria included patients aged 18 and older treated at our Level 1 Trauma Center after implementation of Epic Systems Corporation, Verona, WI, USA. Those who were surgically treated for bicondylar tibial plateau fracture, or open tibial shaft fracture type I or II were included. Manual comparison of daily progress to the previous day's note was carried out. Comparisons were made by evaluating the subjective, objective, and plan portions of the notes, coded nominally using 1 for a change 0 for remaining the same. 38 patients' charts were reviewed during a 10-month (July 2012-April 2013) period, and the average length of stay was 12 days (range: 2-35). A total of 418 notes were compared. The overall average of copied data was 85% daily. In the subjective portion, 85-97% of the data was copied on a daily basis and 71-92% of the data was copied within the objective portion of the notes. There were 15 medical complications necessitating intervention. Of these medical complications, the note the day after the complication reflected the event in 10 out of 15, or 70%, of the complications. Thus 5, or 30%, of the patients did not have notes reflecting the complication ( p  < 0.05). There were 7 complications related to the injuries: 4 cases of compartment syndrome, 1 case of foot drop, representing a change in neurologic status, an amputation, and a wound infection treated with antibiotics. Four of the 7 complications (57%) were not reflected in the notes the following day after the complication ( p  < 0.05). There were 54 planned returns to the operating room for procedures, yet 30 of the 54 (56%) notes regarding planned surgical procedures notes did not accurately report the plan for surgery ( p  < 0.05). There were 4 patients with unplanned trips to the operating room and 3 of the notes (75%) did not reflect this ( p  < 0.05). Twelve patients (32%) did not have notes accurately reflecting discharge plans and/or destination ( p  < 0.05). Our results demonstrated widespread use of copy and paste function. We encourage evaluation of the charts by comparing notes to check and a plan to minimize this practice. There needs to be consistent note writing guidelines and appropriate templates used. This will decrease the inaccuracies in the chart and provide a clear picture of the patient, their injuries, and current status.

Cryptogenic Organizing Pneumonia With Lung Nodules Secondary to Pulmonary Manifestation of Crohn Disease.

PubMed

Zaman, Taufiq; Watson, Joseph; Zaman, Mohammad

2017-01-01

Crohn disease is an immune-mediated inflammatory condition with gastrointestinal and extraintestinal manifestations in patients. Pulmonary involvement of Crohn disease is one manifestation. There have been case reports which have shown Crohn disease and lung nodules which were noted to be histopathological as cryptogenic organizing pneumonia (COP). In our case, a 22-year-old woman with Crohn disease was seen with complaints of chest pain and cough. Computed tomographic scan of chest showed multiple bilateral lung nodules, for which biopsy was done, which showed COP. The case study is followed by a deeper discussion of COP and the extraintestinal manifestation seen in inflammatory bowel disease.

[Is BNP assay useful for the diagnosis of acute dyspnea in emergencies departments?].

PubMed

Lakhdhar, Rim; Hamouda, Chokri; Ben Ammar, Lotfi; Majed, Kamel; Moncef, Fekih; Kaabachi, Naziha; Drissa, Habiba; Borsali Falfoul, Nebiha

2013-01-01

It would be interesting to the emergency doctor to have at his disposal a helpful diagnostic tool like brain natriuretic peptide (BNP). Such assay is simple, available and reliable. To report our experience on the role of BNP in the etiological diagnosis of acute dyspnea (AD) in emergency room (ER) and to assess the cost-effectiveness ratio of such diagnosis strategy. A prospective study conducted in the ER of Rabta university teaching hospital of Tunis, from March 1st to June 20th 2010, involving 30 consecutive patients presenting to the emergency for AD. All patients underwent echocardiography in their acute phase and benefited from the dosage of BNP during the first 4 hours. The echocardiography parameters were collected by a single operator who was unaware of the results of the BNP dosage. The mean age of patients was 72.8years with a sex ratio of 1.5. AD was of orthopnea type in 9 cases and stage III NYHA dyspnea in the other patients. Clinical and radiological signs of left heart failure were noted in 30% of cases. Ultrasound data have objectified systolic dysfunction in 4 cases, diastolic in 3 cases and systolic plus diastolic in 10 cases. The BNP levels were below 100 pg/ml in 10 cases with pulmonary origin of the AD. A BNP level between 100 and 400 pg/ml was noted in 3 cases. In our study, the clinical probability of AHF prior to performing the test was estimated at 53% and estimated at 100% after the BNP assay. The BNP assay has reduced the length of stay in the emergency department 4 to 5 days and saved nearly 50% of the cost of care per patient. The BNP assay, has allowed us to confirm the AHF all cases. Given the prognostic value and economic benefit of this test we recommend its use in ER of our country.

Clinical and electrodiagnostic characteristics of nitrous oxide-induced neuropathy in Taiwan.

PubMed

Li, Han-Tao; Chu, Chun-Che; Chang, Kuo-Hsuan; Liao, Ming-Feng; Chang, Hong-Shiu; Kuo, Hung-Chou; Lyu, Rong-Kuo

2016-10-01

Nitrous oxide-induced neuropathy is toxic neuropathy occasionally encountered in Taiwanese neurological clinics. Only several case reports described their electrodiagnostic features. We used a case-control design to investigate the detailed electrodiagnostic characteristics and possible factors relating to severe nerve injury. We retrospectively reviewed 33 patients with nitrous oxide-induced neuropathy over a 10-year period and reported their demographic data, spinal cord MRI, laboratory examinations and nerve conduction studies. 56 healthy controls' nerve conduction studies were collected for comparison analysis. We noted significant motor and sensory amplitudes reduction, conduction velocities slowing, and latencies prolongation in most tested nerves compared to the controls. Similar nerve conduction study characteristics with prominent lower limbs' motor and sensory amplitudes reduction was observed in patient groups with or without abnormal vitamin B12 and/or homocysteine levels. Among those with lower limbs' motor or sensory amplitudes reduction <20% of the lower limit of normal, higher homocysteine levels were detected. Severe impairments of the lower limbs' sensory and motor amplitudes were frequently noted in patients with nitrous oxide exposure. Nitrous oxide exposure itself is an important factor for the development of neuropathy. Our study contributes to the understanding of electrodiagnostic features underlying the nitrous oxide-induced neuropathy. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Autistic Disorder in Nineteenth-Century London. Three Case Reports

ERIC Educational Resources Information Center

Waltz, Mitzi; Shattock, Paul

2004-01-01

This article examines the existence, description, perception, treatment, and outcome of symptoms consistent with autistic disorder in nineteenth-century London, England, based on case histories from the notes of Dr William Howship Dickinson at Great Ormond Street Hospital for Children. Three cases meeting the DSM-IV criteria for autistic disorder…

Educator Sexual Abuse: Two Case Reports

ERIC Educational Resources Information Center

Burgess, Ann Wolbert; Welner, Michael; Willis, Danny G.

2010-01-01

Sexual abuse by educators has become an increasingly noted type of sexual abuse, especially among adolescents, for two reasons. First, there is a potential for these cases to be silent and prolonged and second, when disclosed, the forensic implications usually include both criminal and/or civil sanctions. For forensic case evaluations,…

Software quality assurance | News

Science.gov Websites

Measure was removed: "Sufficient level of detail in the requirements to develop test cases." ; This control measure was removed since the sufficient level of detail needed to develop test cases is recorded for all test cases. (Note: This is mandatory for applications graded with a High Quality Assurance

Blaetter der Erinnerung - Leaves of Memory - an autobiography

NASA Astrophysics Data System (ADS)

Kobold, H. A.

2004-12-01

The following notes of the blind author, entitled "leaves of memory" were written in 1940, two years before his death. The notes, which were written by hand with the aid of a special deskpad, were later transcribed. The present condition contains the complete text; only incorrectly written or transcribed names of persons or geographical places were corrected. The autobiography covers Hermann Kobold's youth and education in Hannover (1858-1877), his scientific studies at Goettingen University (1877-1880), the time as an assistant at Nicolaus von Konkoly's private observatory (1880-1883), his participation in the Venus transit expedition to Aiken, South Carolina (1882), his work for the German Venus Transit Commission in Berlin (1883-1886), and his years as an observer and professor at the University Observatory in Strasbourg (1886-1902). The notes come to a close with Kobold's departure from Strasbourg to accept a position at Kiel University Observatory. The autobiography give a subjective view of scientific and university life in the last decades of the 19th century, a view which is, however, free from any "self-censured" texts like annual reports or obituaries. The notes offer rare insights, e.g. in the behaviour of Kobold's contemporaries and the influence exercised in the case of appointments.

Neither Saints nor Sinners: Initial Reporting of the "Progressive" Case.

ERIC Educational Resources Information Center

Swain, Bruce M.

1980-01-01

Examines the circumstances of the 1979 "Progressive" case, in which the federal government quashed an article about hydrogen bomb production. Notes reportorial lapses that prevented a full and balanced account of the situation. (RL)

[Lobular idiopathic granulomatos mastitis. About 10 cases].

PubMed

Hmissa, Sihem; Sahraoui, Wassila; Missaoui, Nabiha; Stita, Wided; Mokni, Moncef; Yacoubi, Mohamed T; Khairi, Hedi; Korbi, Sadok

2006-06-01

Our retrospective study was performed on 10 cases of granulomatous mastitis registered in Obstetric Gynaecology Department and Pathology Department of CHU F. Hached, Sousse, during 8 years period. The mean age was 36.4 years (range 32-59). Among these 10 cases. 8 were observed in reproductive-age women and 2 were noted in menopausal women. Clinical findings showed unilateral breast nodule associated with inflammatory signs in 4 cases, mammelonary retraction in 2 cases and serous or sero-purulent mamelonnary flow in 4 cases. Mamnmographic examination suggested a malignant tumor in 5 patients. In all cases, the diagnosis is made by histopathology. Surgical treatment consisted in wide excision with drainage or radical mastectomy, eventually with combination with antibiotic therapy and non steroid anti-inflammatory drugs. Prognostic features showed a good cicatrization in 4 cases, local recurrence and cutaneous fistulization in one patient. Granulomatous mastitis aetiology is still unclear, auto-immune aetio-pathogenesis appears more interesting and should be clarified.

The Educational and Moral Significance of the American Chemical Society's The Chemist's Code of Conduct

NASA Astrophysics Data System (ADS)

Bruton, Samuel V.

2003-05-01

While the usefulness of the case study method in teaching research ethics is frequently emphasized, less often noted is the educational value of professional codes of ethics. Much can be gained by having students examine codes and reflect on their significance. This paper argues that codes such as the American Chemical Society‘s The Chemist‘s Code of Conduct are an important supplement to the use of cases and describes one way in which they can be integrated profitably into a class discussion of research ethics.

[Gayet-Wernicke's encephalopathy. A study of 13 cases observed in a refugee population hospitalized at the Conakry Teaching Hospital].

PubMed

Cissé, A F; Camara, N; Diallo, L L; Morel, Y; Koné, S; Camara, M I; Koumbassa, M L; Tafsir, D; Soumah, D; Djigué, B S; Camara, O B; Barry, M; Bangoura, S A; Kourouma, S; Da Silva, L; Cissé, A

2008-12-01

The authors report 13 cases of Gayet-Wernicke's encephalopathy observed in 13 patients of a refugee population. 11 presented the classical triad: oculomotor signs, cerebral ataxia and state of confusion and in 2 patients, only 2 symptoms were noted. The etiological factors: chronic alcoholism, malnutrition, uncontrollable vomiting, HIV and tuberculosis were identified. The outcome was evaluated on the basis of the disappearance of symptoms after treatment with 500 mg of thiamine in 7 patients, 1 death and 5 patients progressed toward Korsakoff amnesic syndrome.

Harsh humour: a therapeutic discourse.

PubMed

McCreaddie, May

2010-11-01

Humour research in healthcare has tended to focus on rehearsed as opposed to spontaneous humour. This paper reports an empirical example of spontaneous humour in healthcare interactions: a negative case analysis from a constructivist grounded theory study. Twenty Clinical Nurse Specialist (CNS)-patient interactions and CNS pre- and postinteraction audio diaries provided the baseline data corpus. Follow-up interviews, field notes, focus groups and observations serviced theory generation with a constant comparison approach to data collection and analyses. Interpretative and illustrative frameworks incorporating humour theories, non-laughter humour support, discursive features and prosodical features of speech were applied to all data. This paper is based upon the negative case comprising a 90-minute follow-up interview and 10 hours of field note observations. The negative case - a CNS working with female drug users' sexual and reproductive health needs - contradicted emerging findings from the baseline data corpus. First, the negative case had greater awareness of humour, deliberately initiated humour and recognised parameters and exclusion zones. Second, a good patient personal was evident in the baseline data corpus but the negative case worked with 'bad' patients. Accordingly, a specific type of humour - harsh humour - was evident in the negative case. Harsh humour used areas of potential discord (e.g. drug use) as a focus of humour creation and maintenance. The deliberate initiation of harsh humour enabled the negative case and her colleagues to achieve their aims by engaging effectively with unpredictable, reluctant and recalcitrant patients. The negative case demonstrates how humour can be used to therapeutically enhance healthcare interactions with disenfranchised individuals. Humour is not superficial but integral to the accomplishment of key aspects of interactions. Health and social care workers should consider the potential for therapeutic humour to engage and maintain all patients - disenfranchised or otherwise - in healthcare interactions. © 2010 Blackwell Publishing Ltd.

As bitter as a trombone: synesthetic correspondences in nonsynesthetes between tastes/flavors and musical notes.

PubMed

Crisinel, Anne-Sylvie; Spence, Charles

2010-10-01

In parallel to studies of various cases of synesthesia, many cross-modal correspondences have also been documented in nonsynesthetes. Among these correspondences, implicit associations between taste and pitch have been reported recently (Crisinel & Spence, 2009, 2010). Here, we replicate and extend these findings through explicit matching of sounds of varying pitch to a range of tastes/flavors. In addition, participants in the experiment reported here also chose the type of musical instrument most appropriate for each taste/flavor. The association of sweet and sour tastes to high-pitched notes was confirmed. By contrast, umami and bitter tastes were preferentially matched to low-pitched notes. Flavors did not display such strong pitch associations. The choice of musical instrument seems to have been driven primarily by a matching of the hedonic value and familiarity of the two types of stimuli. Our results raise important questions about our representation of tastes and flavors and could also lead to applications in the marketing of food products.

Biomechanical effects of two different collar implant structures on stress distribution under cantilever fixed partial dentures.

PubMed

Merıç, Gökçe; Erkmen, Erkan; Kurt, Ahmet; Eser, Atilim; özden, Ahmet Utku

2011-11-01

The purpose of the study was to compare the effects of two distinct collar geometries of implants on stress distribution in the bone around the implants supporting cantilever fixed partial dentures (CFPDs) as well as in the implant-abutment complex and superstructures. The three-dimensional finite element method was selected to evaluate the stress distribution. CFPDs which was supported by microthread collar structured (MCS) and non-microthread collar structured (NMCS) implants was modeled; 300 N vertical, 150 N oblique and 60 N horizontal forces were applied to the models separately. The stress values in the bone, implant-abutment complex and superstructures were calculated. In the MCS model, higher stresses were located in the cortical bone and implant-abutment complex in the case of vertical load while decreased stresses in cortical bone and implant-abutment complex were noted within horizontal and oblique loading. In the case of vertical load, decreased stresses have been noted in cancellous bone and framework. Upon horizontal and oblique loading, a MCS model had higher stress in cancellous bone and framework than the NMCS model. Higher von Mises stresses have been noted in veneering material for NMCS models. It has been concluded that stress distribution in implant-supported CFPDs correlated with the macro design of the implant collar and the direction of applied force.

Analysis of patient diaries in Danish ICUs: a narrative approach.

PubMed

Egerod, Ingrid; Christensen, Doris

2009-10-01

The objective was to describe the structure and content of patient diaries written for critically ill patients in Danish intensive care units (ICUs). Critical illness is associated with physical and psychological aftermath including cognitive impairment and post-traumatic stress. Patient diaries written in the intensive care unit are used to help ICU-survivors come to terms with their illness. The study had a qualitative, descriptive and explorative design, using a narrative approach of analysis. Data were analysed on several levels: extra-case level, case level, diary-entry level, and sub-entry level. The sample consisted of 25 patient diaries written by critical care nurses in 2007 for patients at a general ICU in Denmark. The base narrative describes three stages: crisis, turning point, and normalisation. Each case includes parallel plots of nurse, patient and family, which converge during normalisation. Each diary is structured by: summary, daily entries and end note. Each diary entry is structured by: greeting, narrator status, patient status, family status/contextual cues and sign-off note. Patient diaries acknowledge the patient experience and provide new insights into nursing performance. This study offers a framework for understanding ICU patient diaries, which may facilitate cross-unit comparisons and support future guideline development. The dual perspectives of patient diaries and the ambiguous ownership of the narratives may pave the way for insights to improve critical care nursing and ICU rehabilitation.

Severe Legionnaire's disease requiring intensive care treatment.

PubMed

van Riemsdijk-van Overbeeke, I C; van den Berg, B

1996-11-01

Legionnaire's disease is well known as severe pneumonia requiring intensive care treatment in many cases. In this study the clinical course is described of patients admitted to the medical ICU of the University Hospital of Rotterdam for respiratory distress due to Legionnaire's disease. From the register of admissions to the medical ICU all patients suffering from Legionnaire's disease were identified. All data on clinical signs and symptoms present on admission were collected. The circumstances in which the infections were contracted were sought, as well as the tests establishing the diagnosis. The occurrence of various organ failures and complications were noted, as were the causes of death on the ICU. From 1978 till 1995 the diagnosis of Legionella pneumonia was made in 17 patients admitted to the ICU: in 13 patients a community-acquired infection was established. As in 12 patients Legionnaire's disease was diagnosed on serological tests, it took several weeks before the diagnosis could be established in these patients. In all patients the circumstances predisposing to Legionnaire's disease were noted. Respiratory distress was present in all patients, ventilatory support was required in 14. Apart from this, both profound shock and renal failure were commonly encountered. As complications jaundice, rhabdomyolysis and polyneuropathy were frequently noted. Three patients died: 2 due to irreversible shock and 1 due to hospital-acquired sepsis. Legionnaire's disease can develop into life-threatening pneumonia requiring intensive care treatment in previously healthy subjects. As the clinical features are aspecific, careful search for predisposing circumstances such as recent travel or use of a contaminated water-supply is mandatory. As the diagnosis required positive serological tests in most patients, a considerable delay in diagnosis was noted. Despite the frequent occurrence of multiple organ failure, a favourable outcome can be anticipated in most cases.

Use of Modified SOAP Notes and Peer-Led Small-Group Discussion in a Medical Physiology Course: Addressing the Hidden Curriculum

ERIC Educational Resources Information Center

Kibble, Jonathan; Hansen, Penelope A.; Nelson, Loren

2006-01-01

Peer leading of small-group discussion of cases; use of modified subjective, objective, assessment of physiology (SOAP) notes; and opportunities for self-assessment were introduced into a Medical Physiology course to increase students' awareness and practice of professional behaviors. These changes arose from faculty members' understanding of the…

31 CFR 315.35 - Payment (redemption).

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Savings Notes. A Series E bond will be paid at any time after two months from issue date at the... time after six (6) months from issue date. In any case where Series H bonds are surrendered to a..., SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES General Provisions for Payment § 315.35...

Granulomatous lobular mastitis: report of a case with previously undescribed histopathological abnormalities.

PubMed

Axelsen, R A; Reasbeck, P

1988-10-01

A 41-yr-old multiparous woman presented with a discrete breast lump which proved histologically to be an example of granulomatous lobular mastitis. The clinical and histological features were similar to those noted in previous reports. Additional histological features in the present case were an intense mononuclear cell infiltration of lobular and ductal epithelium, associated with nuclear fragments morphologically suggestive of apoptosis. These appearances, which have not previously been described, are illustrated, together with the more classical features of the condition well demonstrated by the present case. The novel histological features noted here suggest that the development of granulomatous lobular mastitis may be at least in part immunologically mediated, and that the cellular infiltrates seen may be a manifestation of cell-mediated destruction of mammary epithelium.

Transdural Indocyanine Green Videography for Superficial Temporal Artery-to-Middle Cerebral Artery Bypass-Technical Note.

PubMed

Yokota, Hiroshi; Yonezawa, Taiji; Yamada, Tomonori; Miyamae, Seisuke; Kim, Taekyun; Takamura, Yoshiaki; Masui, Katsuya; Aketa, Shuta

2017-10-01

Neurosurgical application of indocyanine green (ICG) videography before performing a dural opening, known as transdural ICG videography, has been used during surgery of meningiomas associated with venous sinuses as well as cranial and spinal arteriovenous malformations. However, its use for a superficial temporal artery (STA)-to-middle cerebral artery (MCA) bypass has not been reported. We performed a retrospective analysis of medical records of patients who underwent transdural ICG videography during STA-MCA bypass performed between January 2012 and March 2015. The primary outcome was visualization of recipient cortical arteries; secondary outcomes were surgical modifications and complications as well as any adverse events associated with transdural ICG videography. We analyzed 29 STA-MCA bypass procedures performed in 30 hemispheres with atherosclerotic steno-occlusive disease and found that the proper recipient was identified in 28 hemispheres. Subsequently modified procedures for those were a tailored dural incision and craniotomy correction. No complications associated with ICG administration were encountered; during the postoperative course, transient aphasia was noted in 1 case, chronic subdural hematoma was noted in 1 case, and subdural effusion was noted in 2 cases. Transdural ICG videography for atherosclerotic steno-occlusive disease facilitates modifications during STA-MCA bypass procedures. Recognition of the proper recipient cortical arteries before a dural incision allows the neurosurgeon to perform a tailored dural incision and extension of the bone window, although the contribution to surgical outcome has yet to be determined. Copyright © 2017 Elsevier Inc. All rights reserved.

Reanalysis of the anthrax epidemic in Rhodesia, 1978-1984.

PubMed

Wilson, James M; Brediger, Walter; Albright, Thomas P; Smith-Gagen, Julie

2016-01-01

In the mid-1980s, the largest epidemic of anthrax of the last 200 years was documented in a little known series of studies by Davies in The Central African Journal of Medicine . This epidemic involved thousands of cattle and 10,738 human cases with 200 fatalities in Rhodesia during the Counterinsurgency. Grossly unusual epidemiological features were noted that, to this day, have not been definitively explained. This study performed a historical reanalysis of the data to reveal an estimated geographic involvement of 245,750 km 2 , with 171,990 cattle and 17,199 human cases. Here we present the first documented geotemporal visualization of the human anthrax epidemic.

Characteristics of Abductive Inquiry in Earth and Space Science: An Undergraduate Teacher Prospective Case Study

NASA Astrophysics Data System (ADS)

Ramalis, T. R.; Liliasari; Herdiwidjaya, D.

2016-08-01

The purpose this case study was to describe characteristic features learning activities in the domain of earth and space science. Context of this study is earth and space learning activities on three groups of student teachers prospective, respectively on the subject of the shape and size of Earth, land and sea breeze, and moon's orbit. The analysis is conducted qualitatively from activity data and analyze students doing project work, student worksheets, group project report documents, note and audio recordings of discussion. Research findings identified the type of abduction: theoretical models abduction, factual abduction, and law abduction during the learning process. Implications for science inquiry learning as well as relevant research were suggested.

Risk factors associated with neonatal deaths: a matched case-control study in Indonesia.

PubMed

Abdullah, Asnawi; Hort, Krishna; Butu, Yuli; Simpson, Louise

2016-01-01

Similar to global trends, neonatal mortality has fallen only slightly in Indonesia over the period 1990-2010, with a high proportion of deaths in the first week of life. This study aimed to identify risk factors associated with neonatal deaths of low and normal birthweight infants that were amenable to health service intervention at a community level in a relatively poor province of Indonesia. A matched case-control study of neonatal deaths reported from selected community health centres (puskesmas) was conducted over 10 months in 2013. Cases were singleton births, born by vaginal delivery, at home or in a health facility, matched with two controls satisfying the same criteria. Potential variables related to maternal and neonatal risk factors were collected from puskesmas medical records and through home visit interviews. A conditional logistic regression was performed to calculate odds ratios using the clogit procedure in Stata 11. Combining all significant variables related to maternal, neonatal, and delivery factors into a single multivariate model, six factors were found to be significantly associated with a higher risk of neonatal death. The factors identified were as follows: neonatal complications during birth; mother noting a health problem during the first 28 days; maternal lack of knowledge of danger signs for neonates; low Apgar score; delivery at home; and history of complications during pregnancy. Three risk factors (neonatal complication at delivery; neonatal health problem noted by mother; and low Apgar score) were significantly associated with early neonatal death at age 0-7 days. For normal birthweight neonates, three factors (complications during delivery; lack of early initiation of breastfeeding; and lack of maternal knowledge of neonatal danger signs) were found to be associated with a higher risk of neonatal death. The study identified a number of factors amenable to health service intervention associated with neonatal deaths in normal and low birthweight infants. These factors include maternal knowledge of danger signs, response to health problems noted by parents in the first month, early initiation of breastfeeding, and delivery at home. Addressing these factors could reduce neonatal deaths in low resource settings.

A Randomized Effectiveness Trial of a Systems-Level Approach to Stepped Care for War-Related PTSD

DTIC Science & Technology

2016-05-01

period rather than storing the hard copies at their respective posts was approved. Also, an amendment changing the study Initiating PI from COL...care is the de facto mental health system; in Collaborative Medicine Case Studies : Evidence in Prac- tice. Edited by Kessler R, Stafford D. New York...Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT During the 6.5 year study period, investigators developed the STEPS UP

Growth Optimization Studies to Develop InAs/GaInSb Superlattice Materials for Very Long Wavelength Infrared Detection (Postprint)

DTIC Science & Technology

2014-10-01

AFRL-RX-WP-JA-2015-0188 GROWTH OPTIMIZATION STUDIES TO DEVELOP INAS/GAINSB SUPERLATTICE MATERIALS FOR VERY LONG WAVELENGTH INFRARED...Interim 3. DATES COVERED (From – To) 17 January 2013 – 28 September 2014 4. TITLE AND SUBTITLE GROWTH OPTIMIZATION STUDIES TO DEVELOP INAS/GAINSB...AVAILABILITY STATEMENT Approved for public release; distribution unlimited. This report contains color. 13. SUPPLEMENTARY NOTES PA Case Number: 88ABW

Malaria is associated with poor school performance in an endemic area of the Brazilian Amazon

PubMed Central

Vitor-Silva, Sheila; Reyes-Lecca, Roberto C; Pinheiro, Tamam RA; Lacerda, Marcus VG

2009-01-01

Background Approximately 40% of the world's population is at risk for malaria. In highly endemic tropical areas, malaria is a major cause of morbidity and mortality during infancy. There is a complex interrelationship between malaria, malnutrition and intestinal helminths, and this may impair cognitive development in children. The aim of this study was to determine the relationship between malaria and school performance in children living in an endemic area where Plasmodium vivax is the species responsible for most of the cases. Methods The study was conducted in the Municipality of Careiro, Amazonas, Brazil, with five to14 year-old children, studying the first eight grades of public school, during the year 2008. After an initial active case detection, during nine months of follow-up, passive malaria cases detection was instituted, through a thick blood smear performed in every child with fever. School performance was evaluated by the final notes in Mathematics and Portuguese Language. Performance was considered poor when either of the final notes in these disciplines was below the 50th percentile for the respective class and grade. Results The total number of students followed-up in the cohort was 198. Malarial attacks were reported in 70 (35.4%) of these students, with no cases of severe disease. Plasmodium vivax was detected in 69.2% of the attacks, Plasmodium falciparum in 25.5% and both species in 5.3%. In the multivariate analysis, adjusting for age, mother's education, time living in the study area and school absenteeism, presenting with at least one episode of malaria independently predicted a poor performance at school [OR = 1.91 (1.04-3.54); p = 0.039]. Conclusion Non-severe malaria compromises the school performance of children even during a nine-month follow-up, potentially contributing to the maintenance of underdevelopment in countries endemic for malaria. This is the first evidence of such impact in Latin America, where P. vivax is responsible for the majority of the cases. PMID:19835584

Echinococcosis in Serbia: an issue for the 21st century?

PubMed

Bobić, Branko; Nikolić, Aleksandra; Radivojević, Sofija Katić; Klun, Ivana; Djurković-Djaković, Olgica

2012-11-01

Echinococcosis (hydatidosis) is traditionally endemic in Southeast Europe, Serbia included. In Serbia, echinococcosis is mandatory reportable, and this review analyzes the officially reported data as well as the research data published between 1998 and 2010. Official data on human and animal infections were obtained from the Institute of Public Health of Serbia (IPHS, 2010), and from the Ministry of Agriculture, Trade, Forestry and Water Management (MATFWM) and the Statistical Office, respectively. Published data were obtained by searching the Medline, Scopus, and Google databases using "echinococcosis," "hydatidosis," and "Serbia" as key words. In addition, the search included national journals and doctoral theses, as well as conference proceedings. Only Echinococcus granulosus has been reported in Serbia, with a total of 409 cases of human infection officially reported during the observed period as opposed to 820 cases described in clinical studies. No trend in the incidence of infection was shown among adults, but the number of cases in children continuously decreased over the period. Patients were more frequently female and from rural areas. Differences in the geographic distribution of cases were noted, with a lower incidence in the central part of country. Liver disease was by far the most common presentation, but cases of unusual cyst locations have been described. Among domestic animals, sheep were the most highly infected species. A decreasing incidence of echinococcosis in animals has been noted as of the 1970s. Echinococcosis continues to be endemic in Serbia in the 21st century, but despite predictions, neither official data nor those from clinical studies indicate its re-emergence. However, there is gross underreporting. Public health authorities should actively work to increase reporting, as only valid reported data provide an accurate basis for future control plans.

The Trade-Offs of Developing a Case Management Model for Chronically Mentally Ill People.

ERIC Educational Resources Information Center

Belcher, John R.

1993-01-01

Addresses role of case management in care of chronically mentally ill persons. Notes that case management can be effective if designed so that services match client needs and service costs are measured accurately. Contends that profit-maximizing nature of U.S. health care system makes some form of capitation likely in design of case management…

From School Libraries to School Media Centres: Experiences, the Present Situation and Possible Improvement.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Paris (France). Div. of Educational Sciences, Contents & Methods of Educ.

This report presents case studies of the role of school libraries and their transformation into school media centers in elementary and secondary schools in Serbia, Croatia, and Hungary. It is noted that the school media center is not conceived of as a simple mechanism for storing books and audiovisual aids, but as an active center for…

A Quantitative Analysis of Virginia Public School Special Education Due Process Cases and Their Resolutions from 2004-2016

ERIC Educational Resources Information Center

Beaudoin-Saunders, Valerie Ann

2017-01-01

Special education-related lawsuits are a concern to school systems. They are time-consuming, expensive, and contentious. School and parental relationships become strained when litigation is involved. This study analyzed data from the Virginia Department of Education's due process database over a 12-year period of time to note common disabilities…

Failures and Reform in Mathematics Education: The Case of Engineering. National Institute Briefing Note No. 5.

ERIC Educational Resources Information Center

Wolf, Alison

The structure of education for 16- to 18-year-olds in Great Britain discourages them from making mathematics, science, and engineering serious options for future study. The emerging structure of the labor market, in which a large proportion of high-status jobs do not require higher mathematics, increases the numbers who decide not to commit…

Student Aid and Tuition in Washington State. A Case Study of Federal-State Interaction.

ERIC Educational Resources Information Center

Brunner, Seth P.; Gladieux, Lawrence E.

Postsecondary student financing policies in the State of Washington are examined in this report that focuses on the interaction between federal and state student aid programs. The increasing importance of this type of investigation is noted in view of the recent growth in federal student aid. Financial aid available to students in Washington State…

Use of Mass-Flux Measurement and Vapor-Phase Tomography to Quantify Vadose-Zone Source Strength and Distribution

DTIC Science & Technology

2016-01-01

noted i) K = Permeability (Pa-Pb)i = Pressure differential between the sampling location and the extraction well µ= Viscosity Values for permeability...A case study of soil-gas 29 sampling in silt and clay -rich (low-permeability) soils. Ground Water Monitor. Remed. 29: 144-152. Ni, C.F. and T-CJ

Principals and Technology: A Case Study of the Use and Perceived Effectiveness of Technology to Communicate with Constituents

ERIC Educational Resources Information Center

Allman, Bonnie Ann

2012-01-01

Among the many qualities or attributes that serve as the framework for school leadership development programs, communication is repeatedly noted as being an important facet of the administrative leader's repertoire (Finch, Gregson & Faulkner, 1992;Gougeon, 1991). It is not enough for a leader to be concerned only about communicating with…

Aboriginal Title and Sustainable Development: A Case Study

ERIC Educational Resources Information Center

Allen, Derek

2016-01-01

In June 2014, the Supreme Court of Canada held that Aboriginal title should be granted to the Tsilhqo'tin Nation over a portion of its traditional territory in British Columbia.1 This was the first time that a Canadian court had granted Aboriginal title to a specific land area. The court noted that Aboriginal title is collective title held for…

Granulomatous lobular mastitis.

PubMed

Miliauskas, J R; Pieterse, A S; Williams, R S

1995-02-01

Two cases of benign lobular granulomatous mastitis, both clinically felt to be carcinoma, are reported. One patient was cured by local excision of the mass while the other was cured by oral prednisolone, demonstrating the variable ways to treat this entity. The clinical and histological features were similar to those noted in previous reports. Immunological studies revealed predominantly stromal T lymphocytes and only duct intra-epithelial T lymphocytes.

"You See the Whole Tree, Not Just the Stump:" Religious Fundamentalism, Capital and Public Schooling

ERIC Educational Resources Information Center

Minikel-Lacocque, Julie

2015-01-01

This article draws on data from a larger collective case study which focused on the transition to college for Latino/a students at a prestigious, public, predominantly White institution. Here, I focus on one student and analyze interview and field note data to examine this transition for Jasmine, a fundamentalist Christian who identifies as a…

Residential Interior Design as Complex Composition: A Case Study of a High School Senior's Composing Process

ERIC Educational Resources Information Center

Smagorinsky, Peter; Zoss, Michelle; Reed, Patty M.

2006-01-01

This research analyzed the composing processes of one high school student as she designed the interiors of homes for a course in interior design. Data included field notes, an interview with the teacher, artifacts from the class, and the focal student's concurrent and retrospective protocols in relation to her design of home interiors. The…

Studying the Supra-National in Education: GATS, Education and Teacher Union Policies

ERIC Educational Resources Information Center

Fredriksson, Ulf

2004-01-01

This article starts by putting the General Agreement on Trade in Services (GATS) into a general context of privatisation. It is noted that the privatisation process is in many cases complex and not only about full-scale privatisation of schools. The growing trade in education must be seen in this context. GATS is not an agreement which deals with…

Citizenship Education Curricula: Comparing the Multiple Meanings of Supra-National Citizenship in Europe and Beyond

ERIC Educational Resources Information Center

Philippou, Stavroula; Keating, Avril; Ortloff, Debora Hinderliter

2009-01-01

This special issue of "JCS" has examined the changes and challenges facing citizenship education policy and curricula by way of case studies from Europe and beyond. It is indicated that European and/or global integration have had an impact on all of the citizenship curricula examined. However, it is also noted that each case…

Long-Term Outcome from a Medium Secure Service for People with Intellectual Disability

ERIC Educational Resources Information Center

Alexander, R. T.; Crouch, K.; Halstead, S.; Piachaud, J.

2006-01-01

Background: The purpose of this paper is to describe long-term outcomes for patients discharged over a 12-year period from a medium secure service for people with intellectual disabilities (ID). Methods: A cohort study using case-notes analysis and a structured interview of current key informants. Results: Eleven per cent of the sample was…

Khan Academy Videos in Chinese: A Case Study in OER Revision

ERIC Educational Resources Information Center

Rao, Allen; Hilton, John, III; Harper, Sarah

2017-01-01

Over the past decade, great progress has been made in improving the quality and availability of Open Educational Resources (OER). OER proponents often discuss the ability for users to revise and remix OER to make them more suitable for local contexts; however, much OER goes unmodified. This note from the field examines the efforts of NetEase…

The International Baccalaureate Career Programme: A Case Study of College and Career Readiness Policy Goals

ERIC Educational Resources Information Center

Lakes, Richard D.; Donovan, Martha K.

2018-01-01

The International Baccalaureate (IB) is noted in school reform policy circles as the gold standard of academic excellence. While the presence of IB as a sought-after education vendor has grown in the past decade, the organization has attempted to shake off its image as an elite agency serving only private international schools with its…

Examining the Effect of Our World Exhibit on Student Visitors: A Science Center Case

ERIC Educational Resources Information Center

Ayar, Mehmet C.

2016-01-01

This study is about the effect of the Our World exhibit at a science center on student visitors. It elicits students' views about the exhibits, zones, and activities, along with their level of interest and experiences. Data from students (n = 346) through a survey, field notes, observations and interviews (n = 18) were collected. The findings…

Motivating Grade 1 Children to Read: Exploring the Role of Choice, Curiosity, and Challenge in Mobile Ebooks

ERIC Educational Resources Information Center

Ciampa, Katia

2016-01-01

A pre-experimental case study design was used to explore the value of intrinsic motivation in mobile eBook reading among 30 Grade 1 child participants. Data collection comprised pre- and post-test motivation questionnaires and researcher field notes. Child participants' enjoyment of mobile eBooks corresponded to 3 motivational aspects of intrinsic…

From Mario to FIFA: What Qualitative Case Study Research Suggests about Games-Based Learning in a US Classroom

ERIC Educational Resources Information Center

Gerber, Hannah R.; Abrams, Sandra Schamroth; Onwuegbuzie, Anthony J.; Benge, Cindy L.

2014-01-01

This article explores the impact of using commercial-off-the-shelf (COTS) videogames in a high school curriculum when developed through a connected learning frame by examining the influence that COTS videogames have on transforming students' literacy learning in-school. However, it must be noted that transforming literacy in school is about more…

The Usefulness of the DBC-ASA as a Screening Instrument for Autism in Children with Intellectual Disabilities: A Pilot Study

ERIC Educational Resources Information Center

Deb, Shoumitro; Dhaliwal, Akal-Joat; Roy, Meera

2009-01-01

Aims: To explore the validity of Developmental Behaviour Checklist-Autism Screening Algorithm (DBC-ASA) as a screening instrument for autism among children with intellectual disabilities. Method: Data were collected from the case notes of 109 children with intellectual disabilities attending a specialist clinic in the UK. Results: The mean score…

Modeling and Diagnostic Software for Liquefying-Fuel Rockets

NASA Technical Reports Server (NTRS)

Poll, Scott; Iverson, David; Ou, Jeremy; Sanderfer, Dwight; Patterson-Hine, Ann

2005-01-01

A report presents a study of five modeling and diagnostic computer programs considered for use in an integrated vehicle health management (IVHM) system during testing of liquefying-fuel hybrid rocket engines in the Hybrid Combustion Facility (HCF) at NASA Ames Research Center. Three of the programs -- TEAMS, L2, and RODON -- are model-based reasoning (or diagnostic) programs. The other two programs -- ICS and IMS -- do not attempt to isolate the causes of failures but can be used for detecting faults. In the study, qualitative models (in TEAMS and L2) and quantitative models (in RODON) having varying scope and completeness were created. Each of the models captured the structure and behavior of the HCF as a physical system. It was noted that in the cases of the qualitative models, the temporal aspects of the behavior of the HCF and the abstraction of sensor data are handled outside of the models, and it is necessary to develop additional code for this purpose. A need for additional code was also noted in the case of the quantitative model, though the amount of development effort needed was found to be less than that for the qualitative models.

Vision-based Detection of Acoustic Timed Events: a Case Study on Clarinet Note Onsets

NASA Astrophysics Data System (ADS)

Bazzica, A.; van Gemert, J. C.; Liem, C. C. S.; Hanjalic, A.

2017-05-01

Acoustic events often have a visual counterpart. Knowledge of visual information can aid the understanding of complex auditory scenes, even when only a stereo mixdown is available in the audio domain, \\eg identifying which musicians are playing in large musical ensembles. In this paper, we consider a vision-based approach to note onset detection. As a case study we focus on challenging, real-world clarinetist videos and carry out preliminary experiments on a 3D convolutional neural network based on multiple streams and purposely avoiding temporal pooling. We release an audiovisual dataset with 4.5 hours of clarinetist videos together with cleaned annotations which include about 36,000 onsets and the coordinates for a number of salient points and regions of interest. By performing several training trials on our dataset, we learned that the problem is challenging. We found that the CNN model is highly sensitive to the optimization algorithm and hyper-parameters, and that treating the problem as binary classification may prevent the joint optimization of precision and recall. To encourage further research, we publicly share our dataset, annotations and all models and detail which issues we came across during our preliminary experiments.

Glaucoma incidence in an unselected cohort of diabetic patients: is diabetes mellitus a risk factor for glaucoma? DARTS/MEMO collaboration. Diabetes Audit and Research in Tayside Study. Medicines Monitoring Unit.

PubMed

Ellis, J D; Evans, J M; Ruta, D A; Baines, P S; Leese, G; MacDonald, T M; Morris, A D

2000-11-01

To evaluate whether diabetes mellitus is a risk factor for the development of primary open angle glaucoma or ocular hypertension (OHT). A historical cohort study of an unselected population comprising all residents of the Tayside region of Scotland was performed using record linkage techniques followed by case note review. Ascertainment of prevalent diabetes was achieved using the Diabetes Audit and Research in Tayside Study (DARTS) validated regional diabetes register. Glaucoma and treated OHT were defined by encashment of community prescriptions and the statutory surgical procedure coding database. The study population comprised 6631 diabetic subjects and 166 144 non-diabetic subjects aged >40 years without glaucoma or OHT at study entry. 65 patients with diabetes and 958 without diabetes were identified as new cases of glaucoma or treated OHT during the 24 month study period, yielding a standardised morbidity ratio of 127 (95% CI, 96-158). Case note review demonstrated non-differential misclassification of prevalent glaucoma and OHT as incident disease (diabetic cohort 20%, non-diabetic cohort 24%; p=0.56) primarily as a result of non-compliance in medically treated disease. Removing misclassified cases and adjusting for age yielded an incidence of primary open angle glaucoma in diabetes of 1.1/1000 patient years (95% CI, 0.89-1. 31) compared to 0.7/1000 patient years (95% CI, 0.54-0.86) in the non-diabetic cohort; RR 1.57 (95% CI, 0.99-2.48). This study failed to confirm an association between diabetes mellitus and primary open angle glaucoma and ocular hypertension. A non-significant increase in diagnosed and treated disease in the diabetic population was observed, but evidence was also found that detection bias contributes to this association.

The ventrolateral medulla and medullary raphe in sudden unexpected death in epilepsy.

PubMed

Patodia, Smriti; Somani, Alyma; O'Hare, Megan; Venkateswaran, Ranjana; Liu, Joan; Michalak, Zuzanna; Ellis, Matthew; Scheffer, Ingrid E; Diehl, Beate; Sisodiya, Sanjay M; Thom, Maria

2018-06-01

Sudden unexpected death in epilepsy (SUDEP) is a leading cause of premature death in patients with epilepsy. One hypothesis proposes that sudden death is mediated by post-ictal central respiratory depression, which could relate to underlying pathology in key respiratory nuclei and/or their neuromodulators. Our aim was to investigate neuronal populations in the ventrolateral medulla (which includes the putative human pre-Bötzinger complex) and the medullary raphe. Forty brainstems were studied comprising four groups: 14 SUDEP, six epilepsy controls, seven Dravet syndrome cases and 13 non-epilepsy controls. Serial sections through the medulla (from obex 1 to 10 mm) were stained for Nissl, somatostatin, neurokinin 1 receptor (for pre-Bötzinger complex neurons) and galanin, tryptophan hydroxylase and serotonin transporter (neuromodulatory systems). Using stereology total neuronal number and densities, with respect to obex level, were measured. Whole slide scanning image analysis was used to quantify immunolabelling indices as well as co-localization between markers. Significant findings included reduction in somatostatin neurons and neurokinin 1 receptor labelling in the ventrolateral medulla in sudden death in epilepsy compared to controls (P < 0.05). Galanin and tryptophan hydroxylase labelling was also reduced in sudden death cases and more significantly in the ventrolateral medulla region than the raphe (P < 0.005 and P < 0.05). With serotonin transporter, reduction in labelling in cases of sudden death in epilepsy was noted only in the raphe (P ≤ 0.01); however, co-localization with tryptophan hydroxylase was significantly reduced in the ventrolateral medulla. Epilepsy controls and cases with Dravet syndrome showed less significant alterations with differences from non-epilepsy controls noted only for somatostatin in the ventrolateral medulla (P < 0.05). Variations in labelling with respect to obex level were noted of potential relevance to the rostro-caudal organization of respiratory nuclear groups, including tryptophan hydroxylase, where the greatest statistical difference noted between all epilepsy cases and controls was at obex 9-10 mm (P = 0.034), the putative level of the pre-Bötzinger complex. Furthermore, there was evidence for variation with duration of epilepsy for somatostatin and neurokinin 1 receptor. Our findings suggest alteration to neuronal populations in the medulla in SUDEP with evidence for greater reduction in neuromodulatory neuropeptidergic and mono-aminergic systems, including for galanin, and serotonin. Other nuclei need to be investigated to evaluate if this is part of more widespread brainstem pathology. Our findings could be a result of previous seizures and may represent a pathological risk factor for SUDEP through impaired respiratory homeostasis during a seizure.

Teaching Business Cases Online through Discussion Boards: Strategies and Best Practices

ERIC Educational Resources Information Center

Rollag, Keith

2010-01-01

What are the most effective and efficient ways to teach business cases online, specifically in asynchronous electronic discussion boards? This article describes several design strategies and approaches used by instructors at Babson College to structure and facilitate online case discussions in our blended Fast Track MBA program. (Contains 3 notes,…

Case: The Ethics and Economics of Expanding Interstate 69 in Indiana.

ERIC Educational Resources Information Center

Clapp-Itnyre, Alisa

2000-01-01

Presents and discusses a case used in a business communication class that centers on an interstate highway extension in southern Indiana. Describes the rationale for teaching the case, and student responses. Notes that, in confronting these issues, students learn to see that facts yield to different interpretations based on differing perspectives…

Contribution of MRI to clinically equivocal penile fracture cases.

PubMed

Türkay, Rüştü; Yenice, Mustafa Gürkan; Aksoy, Sema; Şeker, Gökhan; Şahin, Selçuk; İnci, Ercan; Tuğcu, Volkan; Taşcı, Ali İhsan

2016-11-01

Penile fracture is a surgical emergency defined as rupture of the tunica albuginea. Although most cases can be diagnosed with clinical evaluation, it has been stated in the literature that diagnosis in as many as 15% of cases can be challenging. In uncertain cases, imaging can help determine diagnosis. Present study included 20 cases where diagnosis could not be made with certainty and magnetic resonance imaging (MRI) was performed. MR images were examined for tunical rupture and accompanying pathologies. When rupture was observed, localization and length of rupture were noted. All patients underwent degloving surgery. All imaging findings were compared to surgical findings. MRI revealed 19 tunical ruptures. In 1 case, hematoma was seen with no sign of penile fracture. No urethral injuries were found. All MRI findings were confirmed during surgery. Performing MRI in clinically equivocal cases can provide crucial data to make precise diagnosis and improve patient management.

RADIATION-INDUCED ACUTE SEBORRHEIC MANIFESTATIONS AFTER RADIOTHERAPY FOR BASOCELLULAR EPITHELIOMA. CURE WITH ANTIBIOTICS (in French)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Degos, R.; Duverne, J.; Picot, Ch.

1961-04-01

An unusual case of radiodermatitis in a 58-yr-old woman operated on for basocellular epithelioma of the inner aspect of the right eyelid is described. Postoperative radiation treatment was given as follows: 2000-r doses of unfiltered 50-kv x rays, three times, one week apart, for a total of 6000 r. After 15 days, slight ulceration of the irradiated portion and marked dermatitis of the surrounding skin area were noted. Local application of solution and ointments provided analgesia but did not cure the condition, which spread from the cheek to nose and chin, and was accompanied by seborrhea, over a period ofmore » 16 months. Bacterial examination revealed staphylococci, which promptly responded to antibiotic (erythromycin) treatment. A similarity was noted between this patient's condition and the more common reactions of children to scalp radiation treatment for ringworm. Other cases are cited to show occasional unusual side- effects of radiation treatment, and the possibility that the present case represents a unique type of skin response to radiation is discussed. Allergy alone, it is contended, probably does not explain the reaction observed, but a bacterial infection was involved in the reaction. It is concluded that this case and the two others mentioned indicate that other factors are of importance, the nature of which needs to be determined by further study. (BBB)« less

The relationship between waiting times and 'adherence' to the Scottish Intercollegiate Guidelines Network 98 guideline in autism spectrum disorder diagnostic services in Scotland.

PubMed

McKenzie, Karen; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Rutherford, Marion; Murray, Aja; Irvine, Linda

2016-05-01

The aim of this study was to explore the extent to which the Scottish Intercollegiate Guidelines Network 98 guidelines on the assessment and diagnosis of autism spectrum disorder were adhered to in child autism spectrum disorder diagnostic services in Scotland and whether there was a significant relationship between routine practice which more closely reflected these recommendations (increased adherence) and increased waiting times. Retrospective, cross-sectional case note analysis was applied to data from 80 case notes. Adherence ranged from a possible 0 (no adherence) to 19 (full adherence). Overall, 17/22 of the recommendations were adhered to in over 50 of the 80 cases and in 70 or more cases for 11/22 of the recommendations, with a mean adherence score of 16 (standard deviation = 1.9). No significant correlation was found between adherence and total wait time for untransformed (r = 0.15, p = 0.32) or transformed data (r = 0.12, p = 0.20). The results indicated that the assessment and diagnostic practices were consistent with the relevant Scottish Intercollegiate Guidelines Network 98 guideline recommendations. Increased adherence to the 19 included recommendations was not significantly related to increased total waiting times, indicating that the Scottish Intercollegiate Guidelines Network 98 recommendations have generally been integrated into practice, without a resultant increase in patient waits. © The Author(s) 2015.

Rate of Subtalar Joint Arthrodesis After Retrograde Tibiotalocalcaneal Arthrodesis With Intramedullary Nail Fixation: Evaluation of the RAIN Database.

PubMed

Dujela, Michael; Hyer, Christopher F; Berlet, Gregory C

2017-11-01

Hindfoot arthritis or significant deformity involving the ankle and subtalar joint (STJ) is a disabling condition with few salvage options. Many surgeons note a decreased STJ fusion rate compared with ankle union when a retrograde nail construct is used. The purpose of this study was to report the STJ fusion rate of tibiotalocalcaneal (TTC) arthrodesis with retrograde nail. A chart and radiographic review was performed. TTC fusions performed in patients with osteoarthritis, posttraumatic arthritis, or deformity correction with retrograde nail fixation were included. Exclusion criteria included neuropathy, Charcot arthropathy, and failed total ankle replacement. Ultimately, 66 retrograde TTC fusions (in 63 patients) met inclusion criteria. The average age was 57.0 years. There were 29 female and 34 male patients. Radiographic fusion of the ankle and STJ was demonstrated in 68.2% of the patients. There were 11 cases (16.7%) of ankle arthrodesis with STJ nonunion, 6 cases (9.1%) of STJ fusion but ankle nonunion, and 4 cases (6.1%) of stable radiographic nonunion of both joints. The mean time to subtalar fusion was 112.1 days. One patient required revision surgery and conversion to below-knee amputation. One patient required a CROW walker for assistance with gait. A 22.8% radiographic nonunion rate of the STJ was noted in retrograde TTC fusion. Despite this, patients were stable and pain free. Level IV: Retrospective Case series.

A note on tilted Bianchi type VIh models: the type III bifurcation

NASA Astrophysics Data System (ADS)

Coley, A. A.; Hervik, S.

2008-10-01

In this note we complete the analysis of Hervik, van den Hoogen, Lim and Coley (2007 Class. Quantum Grav. 24 3859) of the late-time behaviour of tilted perfect fluid Bianchi type III models. We consider models with dust, and perfect fluids stiffer than dust, and eludicate the late-time behaviour by studying the centre manifold which dominates the behaviour of the model at late times. In the dust case, this centre manifold is three-dimensional and can be considered a double bifurcation as the two parameters (h and γ) of the type VIh model are varied. We therefore complete the analysis of the late-time behaviour of tilted ever-expanding Bianchi models of types I VIII.

Prospective randomized clinical trial comparing laparoscopic cholecystectomy and hybrid natural orifice transluminal endoscopic surgery (NOTES) (NCT00835250).

PubMed

Noguera, José F; Cuadrado, Angel; Dolz, Carlos; Olea, José M; García, Juan C

2012-12-01

Natural orifice transluminal endoscopic surgery (NOTES) is a technique still in experimental development whose safety and effectiveness call for assessment through clinical trials. In this paper we present a three-arm, noninferiority, prospective randomized clinical trial of 1 year duration comparing the vaginal and transumbilical approaches for transluminal endoscopic surgery with the conventional laparoscopic approach for elective cholecystectomy. Sixty female patients between the ages of 18 and 65 years who were eligible for elective cholecystectomy were randomized in a ratio of 1:1:1 to receive hybrid transvaginal NOTES (TV group), hybrid transumbilical NOTES (TU group) or conventional laparoscopy (CL group). The main study variable was parietal complications (wound infection, bleeding, and eventration). The analysis was by intention to treat, and losses were not replaced. Cholecystectomy was successfully performed on 94% of the patients. One patient in the TU group was reconverted to CL owing to difficulty in maneuvering the endoscope. After a minimum follow-up period of 1 year, no differences were noted in the rate of parietal complications. Postoperative pain, length of hospital stay, and time off from work were similar in the three groups. No patient developed dyspareunia. Surgical time was longer among cases in which a flexible endoscope was used (CL, 47.04 min; TV, 64.85 min; TU, 59.80 min). NOTES approaches using the flexible endoscope are not inferior in safety or effectiveness to conventional laparoscopy. The transumbilical approach with flexible endoscope is as effective and safe as the transvaginal approach and is a promising, single-incision approach.

Comparative Study of Gender Difference Performance in Geography: A Case Study of Some Selected Schools in Zaria Inspectorate Division of Kaduna State, Nigeria

ERIC Educational Resources Information Center

Obadaki, Yusuf Yakubu; Omowumi, Yakubu Kabirat

2013-01-01

Although, male superiority over females in tasks measuring spatial ability is an accepted truism which has been dominated by many authors, in recent days females claim to be equal to the males in all fields of life. It will be interesting to note that this gender difference in performance on spatial tasks does not appear in all cultures. In order…

"We're Keeping on Top of the Students": Making Sense of Test Data with More Informal Data in a Grade-Level Instructional Team

ERIC Educational Resources Information Center

Wardrip, Peter S.; Herman, Phillip

2018-01-01

Internationally, there has been a policy push for using student data for instruction. Yet, research has noted few examples of actually understanding how this data-use practice takes place. This study presents a case of an instructional data team making sense of student data. The study shares data to show how teachers' process for using data to…

Implications for US Special Operations Forces and the Interagency in Phase Zero: Case Studies in the Pacific Theater, 2000 to 2014

DTIC Science & Technology

2016-06-10

What Would Sun Tzu Say?” Military Review (May-June 2004): 20. A note of Special Forces Groups: There are five active duty Special Forces Groups that...2004): 2-4. Maxwell, David. “Operation Enduring Philippines: What Would Sun Tzu Say?” Military Review (May-June 2004): 20-23. Nye Jr., Joseph S...Recommendations for Further Study ............................................................................ 84 BIBLIOGRAPHY

NLP based congestive heart failure case finding: A prospective analysis on statewide electronic medical records.

PubMed

Wang, Yue; Luo, Jin; Hao, Shiying; Xu, Haihua; Shin, Andrew Young; Jin, Bo; Liu, Rui; Deng, Xiaohong; Wang, Lijuan; Zheng, Le; Zhao, Yifan; Zhu, Chunqing; Hu, Zhongkai; Fu, Changlin; Hao, Yanpeng; Zhao, Yingzhen; Jiang, Yunliang; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Todd, Rogow; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

2015-12-01

In order to proactively manage congestive heart failure (CHF) patients, an effective CHF case finding algorithm is required to process both structured and unstructured electronic medical records (EMR) to allow complementary and cost-efficient identification of CHF patients. We set to identify CHF cases from both EMR codified and natural language processing (NLP) found cases. Using narrative clinical notes from all Maine Health Information Exchange (HIE) patients, the NLP case finding algorithm was retrospectively (July 1, 2012-June 30, 2013) developed with a random subset of HIE associated facilities, and blind-tested with the remaining facilities. The NLP based method was integrated into a live HIE population exploration system and validated prospectively (July 1, 2013-June 30, 2014). Total of 18,295 codified CHF patients were included in Maine HIE. Among the 253,803 subjects without CHF codings, our case finding algorithm prospectively identified 2411 uncodified CHF cases. The positive predictive value (PPV) is 0.914, and 70.1% of these 2411 cases were found to be with CHF histories in the clinical notes. A CHF case finding algorithm was developed, tested and prospectively validated. The successful integration of the CHF case findings algorithm into the Maine HIE live system is expected to improve the Maine CHF care. Copyright © 2015. Published by Elsevier Ireland Ltd.

[Clinical, biological and therapeutic profile of anemia by vitamin B12 deficiency in the department of hematology of Marrakech (Morocco)].

PubMed

Nafil, H; Tazi, I; Sifessalam, M; Bouchtia, M; Mahmal, L

2013-05-01

The aim of this study is to examine retrospectively the clinical, biological and treatment features of anemia by vitamin B12 deficiency in the Hematology department of CHU Mohamed VI Marrakech. We report the results of a retrospective study conducted during six years (2005-2010). It included all patients with anemia (with or without thrombocytopenia or leukopenia) associated with vitamin B12 levels <200 pg / ml. One hundred twenty one cases were analyzed. The average age of patients was 62 years (38-89 years) with a female predominance (sex ratio F/M: 1.3). The clinical symptomatology is dominated by pallor (97.5%), cardiovascular signs (46%) and digestive symptoms (34.7%). Neurological signs were noted in 17.3% of cases. The blood count showed anemia (hemoglobin: mean= 6.9 g/dl), macrocythemia (MCV: mean= 109 fl). Leukopenia was noted in 35 patients (29%), thrombocytopenia in 34 patients (28%) and pancytopenia in 21 patients (17,3%). The average vitamin B12 was 72 pg/ml. The causes of B12 deficiency are pernicious anemia (43%), food-cobalamin malabsorption (43%), and in 14% of cases no etiology was found. Gastritis was found in 82.7% of our patients and Helicobacter pylori (HP) infection in 72.7% of cases. Reticulocyte crisis was observed after parenteral administration of hydroxocobalamine within an average of 8 days and normalization of blood counts, in all patients, within an average of 51 days. In patients with HP infection, eradication therapy of HP was performed. The cure rate of the HP is 90%.

The effects of natural language processing on cross-institutional portability of influenza case detection for disease surveillance.

PubMed

Ferraro, Jeffrey P; Ye, Ye; Gesteland, Per H; Haug, Peter J; Tsui, Fuchiang Rich; Cooper, Gregory F; Van Bree, Rudy; Ginter, Thomas; Nowalk, Andrew J; Wagner, Michael

2017-05-31

This study evaluates the accuracy and portability of a natural language processing (NLP) tool for extracting clinical findings of influenza from clinical notes across two large healthcare systems. Effectiveness is evaluated on how well NLP supports downstream influenza case-detection for disease surveillance. We independently developed two NLP parsers, one at Intermountain Healthcare (IH) in Utah and the other at University of Pittsburgh Medical Center (UPMC) using local clinical notes from emergency department (ED) encounters of influenza. We measured NLP parser performance for the presence and absence of 70 clinical findings indicative of influenza. We then developed Bayesian network models from NLP processed reports and tested their ability to discriminate among cases of (1) influenza, (2) non-influenza influenza-like illness (NI-ILI), and (3) 'other' diagnosis. On Intermountain Healthcare reports, recall and precision of the IH NLP parser were 0.71 and 0.75, respectively, and UPMC NLP parser, 0.67 and 0.79. On University of Pittsburgh Medical Center reports, recall and precision of the UPMC NLP parser were 0.73 and 0.80, respectively, and IH NLP parser, 0.53 and 0.80. Bayesian case-detection performance measured by AUROC for influenza versus non-influenza on Intermountain Healthcare cases was 0.93 (using IH NLP parser) and 0.93 (using UPMC NLP parser). Case-detection on University of Pittsburgh Medical Center cases was 0.95 (using UPMC NLP parser) and 0.83 (using IH NLP parser). For influenza versus NI-ILI on Intermountain Healthcare cases performance was 0.70 (using IH NLP parser) and 0.76 (using UPMC NLP parser). On University of Pisstburgh Medical Center cases, 0.76 (using UPMC NLP parser) and 0.65 (using IH NLP parser). In all but one instance (influenza versus NI-ILI using IH cases), local parsers were more effective at supporting case-detection although performances of non-local parsers were reasonable.

Chest CT in children: anesthesia and atelectasis.

PubMed

Newman, Beverley; Krane, Elliot J; Gawande, Rakhee; Holmes, Tyson H; Robinson, Terry E

2014-02-01

There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain reliable and reproducible high-quality, motion-free chest CT images in children.

Barriers to dispatcher-assisted cardiopulmonary resuscitation in Singapore.

PubMed

Ho, Andrew Fu Wah; Sim, Zariel Jiaying; Shahidah, Nur; Hao, Ying; Ng, Yih Yng; Leong, Benjamin S H; Zarinah, Siti; Teo, Winston K L; Goh, Geraldine Shu Yi; Jaafar, Hamizah; Ong, Marcus E H

2016-08-01

Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. We analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones was noted. Barriers to chest compressions were identified. A total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was "could not move patient" (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs. 99.0%, p<0.001), CPR instructions given (79.3% vs. 98.3%, p<0.001) and CPR started (67.9% vs. 98.3%, p<0.001), while the time taken to reach each of these stages were significantly longer (p<0.001). Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

On the image of AGS 3He 2+ $$\\vec{n}$$ 0 in the blue

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meot, F.; Huang, H.; Tsoupas, N.

This note addresses the transport of Helion spinmore » $$\\vec{n}$$ 0 vector, from its periodic orientation in the AGS to RHIC Blue ring injection kicker, via the AGS extraction system and the AtR line. The goal is to investigate optimal injection energy into RHIC, in the matter of Helion spin matching, in the hypothesis of equal warm and cold snake strengths in the AGS. The study uses recently computed OPERA 3-D field maps of the AGS cold snake, including possibility of independent solenoid and helix settings (as discussed in Tech. Note C-A/AP/485), together with the machinery of the AGS and AtR models developed in the stepwise ray-tracing code Zgoubi. Computing tools and methods employed are discussed as well, in order to facilitate possible further checks or investigations. They are however similar to those used in an earlier study regarding the image in RHIC Blue and Yellow of AGS $$\\vec{n}$$ 0 via the AtR in the case of proton beam (Tech. Note C-A/AP/502), which can be referred to for additional details.« less

Vorarephilia: a case study in masochism and erotic consumption.

PubMed

Lykins, Amy D; Cantor, James M

2014-01-01

Vorarephilia ("vore") is an infrequently presenting paraphilia, characterized by the erotic desire to consume or be consumed by another person or creature. Few data exist on vore though several cases have been reported which appear to be consistent with basic vorarephilic interests. Because this sexual interest cannot be enacted in real life due to physical and/or legal restraints, vorarephilic fantasies are often composed in text or illustrations and shared with other members of this subculture via the Internet. Similarities with aspects of bondage/dominance sadomasochism interests, more specifically dominance and submission, are noted. The current case report describes a man with masochistic sexual interests which intersected with submissive vorarephilic fantasy.

Kleptomania: a case series

PubMed Central

Saluja, Bharat; Chan, Lai Gwen; Dhaval, Dani

2014-01-01

Kleptomania is an enigmatic condition and is among the very few psychiatric disorders in which crime is medicalised and used as a legal defence. The scientific literature on kleptomania is scarce. Early literature and recent studies have shown a female preponderance, with an early age of onset of stealing in people with comorbid personality disorder(s). In a retrospective review of the case notes of theft offenders who had forensic psychiatric evaluations performed in a one-year period in 2010 at the Institute of Mental Health, Singapore, we found three patients who were diagnosed with kleptomania. In this report, we describe the pertinent clinical and sociodemographic characteristics, as well as the diagnostic issues of kleptomania in relation to the three cases. PMID:25630329

33. INTERIOR VIEW LOOKING WEST IN MAIN BUILDING FROM CANT ...

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

33. INTERIOR VIEW LOOKING WEST IN MAIN BUILDING FROM CANT ROLL CASE IMMEDIATELY WEST OF BEAM SAW. NOTE RE-SAW AT LEFT OF ROLL CASE, TRIM SAW OPERATOR'S STATION JUST TO RIGHT OF ROLL CASE, AND TRIM SAWS AT RIGHT MIDDLE GROUND. HEAD RIG IS IN BACKGROUND DOWN ROLL CASE IN CENTER OF PHOTOGRAPH. - Hull-Oakes Lumber Company, 23837 Dawson Road, Monroe, Benton County, OR

West Africa [in "State of the Climate in 2014"

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hagos, Samson M.; Ijampy, James A.; Sima, Fatou

This chapter provides summaries of the 2014 temperature and precipitation conditions across seven broad regions: North America, Central America and the Caribbean, South America, Africa, Europe, Asia, and Oceania. In most cases, summaries of notable weather events are also included. Local scientists provided the annual summary for their respective regions and, unless otherwise noted, the source of the data used is typically the agency affiliated with the authors. Please note that different nations, even within the same section, may use unique periods to define their normals. Section introductions will typically define the prevailing practices for that section, and exceptions willmore » be noted within the text. In a similar way, many contributing authors use languages other than English as their primary professional language. To minimize additional loss of fidelity through re-interpretation after translation, editors have been conservative and careful to preserve the voice of the author. In some cases, this may result in abrupt transitions in style from section to section.« less

SFA Ombudsman Serving Students. Interim Report, September 1999 to March 2000.

ERIC Educational Resources Information Center

Department of Education, Washington, DC. Student Financial Assistance.

This 6-page pamphlet shares what the Student Financial Assistance (SFA) Office of the Ombudsman has learned from cases it has handled. An initial section offers information on the case management process, noting that the ombudsman process depends on the case's complexity and that many are revolved quickly. Next, it examines customer-reported case…

Freedom and Control of Student Publications in the American High School.

ERIC Educational Resources Information Center

King, Thomas J.

While noting the restrictions on the generalizability of case law, the author conducts a case-by-case review of litigation concerning student publications in the senior high school. He answers four questions: (1) May the teachers and/or administrators of a school exercise "prior censorship" or control over the content of independent-underground…

Prospective experimental study of transrectal viscerotomy closure using transanal endoscopic suture vs. circular stapler: a step toward NOTES.

PubMed

Diana, M; Leroy, J; Wall, J; De Ruijter, V; Lindner, V; Dhumane, P; Mutter, D; Marescaux, J

2012-06-01

Endoluminal full-thickness closure of the rectal wall is critical in emerging procedures including endoscopic submucosal dissection and transrectal natural orifice transluminal endoscopic surgery (NOTES). This study aimed to compare manual suture using the transanal endoscopic operation platform (TEO; Karl Storz, Tüttlingen, Germany) with the end-to-end anastomosis hemorrhoid circular stapler (EEA; Covidien, Dublin, Ireland) for closure of the rectal viscerotomy during transrectal NOTES segmental colectomy. A total of 12 swine underwent transrectal hybrid NOTES partial colectomies. Animals were divided into two groups according to the viscerotomy closure technique: 1) TEO manual suture; 2) EEA circular stapler closure. Mean (± SD) viscerotomy closure time was 67.5 ± 59.5 minutes and 31.5 ± 19.6 minutes for TEO and EEA, respectively. There was one conversion to laparoscopy in the TEO group and a misfiring in the EEA group that required a TEO salvage suture. There was one positive air-leak test in each group. Peritoneal fluid collected at the end of the procedure tested positive for bacterial contamination in all cases. A mild stenosis was present in 4 /6 viscerotomies (67 %) in the TEO group and in 1/6 (17 %) in the EEA group on endoscopic control. Inflammatory changes were mild in 3/5 (60 %) and 4/5 (80 %) viscerotomies in the TEO and EEA groups, respectively, whereas severe inflammation was found in 2/5 (TEO) and 1 /5 (EEA). Transrectal viscerotomy closure using the EEA circular stapler technique is feasible, easy to perform, and histologically comparable to suture closure through a TEO platform. It may offer an attractive alternative for NOTES segmental colectomies and endoscopic resections. © Georg Thieme Verlag KG Stuttgart · New York.

[Post traumatic injuries of the duodenum and/or pancreas. Perioperative management].

PubMed

Beye, M D; Kane, O; Diouf, E; Ndoye, M D; Ndiaye, P I; Fall, B; Sall, B K

2002-01-01

The duodenal and/or pancreatic lesions rarely occur during abdominal contusions, this, because of the deep and retroperitoneal position of the duodeno-pancreatic entity. These lesions occur mostly in the young adults and occur mostly on violent trauma, hence the high frequency of associated lesions. Their management is well codified and the prognosis depends on the degree of pancreatic damage. The authors reporting of 3 cases of duodenaland or post-traumatic lesion, in a retrospective study. The after therapeutic management necessitated a pre-operative reanimation, simple duodenal suturing in the 3 cases with relearning gastrotomy, alimentation jejenostomy and closing of thepyloric sphincter,with association of cholostomy in one of the cases. The pancreatic lesions of type contusion observed in 2 cases necessitated simple drainage of the pancreatic sector without resection. The evolution was favourable in 2 cases. One case of death was noted in a patient who developed acute pancreatis.

How safe is 1% alum irrigation in controlling intractable vesical hemorrhage?

PubMed

Goswami, A K; Mahajan, R K; Nath, R; Sharma, S K

1993-02-01

A prospective study was done to evaluate the efficacy and safety of intravesical instillation of 1% alum solution in 12 cases of hematuria of vesical origin, uncontrolled by saline irrigation for 24 hours via a 3-way Foley catheter. There were 10 cases of transitional cell carcinoma and 2 of radiation cystitis. Complete response was noted in 6 patients and a partial response in 4. Local side effects included suprapubic pain and vesical tenesmus, which were controlled by antispasmodic and/or analgesic drugs. Transient low grade pyrexia (maximum up to 38.2C) was noted in 4 patients. Among the other various clinical and biochemical parameters, serum aluminum level and prothrombin time showed statistically highly significant changes. Serum aluminum increased from an average baseline value of 1.68 to 3.36 mumol./l. without clinical evidence of aluminum toxicity and with levels well below the recommended safe limit. Prothrombin time increased parallel with the increase in serum aluminum level to a maximum of 1 1/2 times the control. Prothrombin values, therefore, can be used clinically, since they are readily obtainable whereas serum aluminum levels are not. Vesical irrigation with 1% alum solution is a safe method to control hematuria of vesical origin in properly selected cases.

Clostridium difficile in the Military Population

DTIC Science & Technology

2016-08-05

association between race and infection . This is similar to the Buchner and associates case- control study; which noted an increase in occurrence of C...sustained within a hospital , additional persons infected with C. difficile are needed10. Acute appendicitis ranking first among diagnoses for hospitalized ...Buchner AM, Sonnenberg A. Epidemiology of Clostridium difficile infection in a large population of hospitalized US military veterans. Dig Dis Sci

Early Childhood Education and Care Policy in the United States of America. OECD Country Note.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France).

This paper is the result of an intensive case study by an Organisation for Economic Cooperation and Development (OECD) review team, whose purpose was to investigate early childhood education and care (ECEC) in the United States, 1 of 12 countries participating in the OECD review between 1998 and 2000. The paper draws on information provided by a…

The Relative Quality and Cost-Effectiveness of Private and Public Schools for Low-Income Families: A Case Study in a Developing Country

ERIC Educational Resources Information Center

Tooley, James; Dixon, Pauline; Shamsan, Yarim; Schagen, Ian

2010-01-01

The "mushrooming" of private schools for low-income families has been widely noted in the literature; however, very little is known about the quality of these schools. This research explored the relative quality of private unaided (recognised and unrecognised) and government schools in low-income areas of Hyderabad, India. A preliminary…

Requirements Analysis for Effective Management Information Systems Design: A Framework and Case Study.

DTIC Science & Technology

1981-12-01

68 1. Product Policy ---------------------------- 68 2. Price Policy ------------------------------ 69 3. Policy toward Rivals...compete with its rivals; the aim of these policies is to achieve product differentiation; b) Pricing Policies - price structures that are generally...actions which a firm takes to minimize both its actual and potential competition. It should be noted that product and pricing policies are greatly

The 1984 Literacy Campaign in the People's Democratic Republic of Yemen. A Case Study. Notes, Comments...No. 183.

ERIC Educational Resources Information Center

Fara, Mohammed Saeed; Fisher, Nigel

In 1984, the People's Democratic Republic of Yemen undertook a nationwide literacy campaign, which mobilized the entire nation in an effort to reach an estimated 194,000 illiterate people, 77 percent of them women. The campaign plan demanded the full and active participation of formal school teachers and students at secondary level and above as…

Gender Ratio in a Clinical Population Sample, Age of Diagnosis and Duration of Assessment in Children and Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Rutherford, Marion; McKenzie, Karen; Johnson, Tess; Catchpole, Ciara; O'Hare, Anne; McClure, Iain; Forsyth, Kirsty; McCartney, Deborah; Murray, Aja

2016-01-01

This article reports on gender ratio, age of diagnosis and the duration of assessment procedures in autism spectrum disorder diagnosis in a national study which included all types of clinical services for children and adults. Findings are reported from a retrospective case note analysis undertaken with a representative sample of 150 Scottish…

Informal Lifelong Learning for Development in Papua New Guinea: A Case Study from the Margins into the Mainstream

ERIC Educational Resources Information Center

Kidu, Carol

2018-01-01

This article traces the impact of the Ginigoada Foundation on the educational development of thousands of children and adults in Papua New Guinea (PNG). Port Moresby, capital city of Papua New Guinea (PNG), had been noted for the lack of educational opportunities for the majority of the population who lived in urban villages and squatter…

Inequity of Education Financial Resources: A Case Study of First Nations School Funding Compared to Provincial School Funding in Saskatchewan

ERIC Educational Resources Information Center

Carr-Stewart, Sheila; Marshall, Jim; Steeves, Larry

2011-01-01

In a review of First Nations band-managed school policies, the Department of Indian and Northern Affairs Canada (2002) noted what had been devolved was "the specific operation of the school. What was not devolved was an [education] system which would support the school" (p. 5) delivery of quality educational programming for First…

No Green-On-Blue Against the Reds?: Organizational Strategies Behind Insider Attacks in Afghanistan

DTIC Science & Technology

2013-06-01

Oaks, Calif: Sage Publications, 2003 ), 1. 46 Alexander L. George, Case Studies and Theory Development in the Social Sciences, BCSIA Studies in...the actions we take.2 For example, Kiras notes that the US missed opportunities to address the root causes of violence in Iraq during 2003 -2004...Warfare,” 230. 4 Merriam-Webster, Inc, Merriam-Webster’s Collegiate Dictionary, 11th ed (Springfield, Mass: Merriam-Webster, Inc, 2003 ), 649. 5

Measurements and time-domain simulations of multiphonics in the trombone.

PubMed

Velut, Lionel; Vergez, Christophe; Gilbert, Joël

2016-10-01

Multiphonic sounds of brass instruments are studied in this article. They are produced by playing a note on a brass instrument while simultaneously singing another note in the mouthpiece. This results in a peculiar sound, heard as a chord or a cluster of more than two notes in most cases. This effect is used in different artistic contexts. Measurements of the mouth pressure, the pressure inside the mouthpiece, and the radiated sound are recorded while a trombone player performs a multiphonic, first by playing an F 3 and singing a C 4 , then playing an F 3 and singing a note with a decreasing pitch. Results highlight the quasi-periodic nature of the multiphonic sound and the appearance of combination tones due to intermodulation between the played and the sung sounds. To assess the ability of a given brass instrument physical model to reproduce the measured phenomenon, time-domain simulations of multiphonics are carried out. A trombone model consisting in an exciter and a resonator nonlinearly coupled is forced while self-oscillating to reproduce simultaneous singing and playing. Comparison between simulated and measured signals is discussed. Spectral content of the simulated pressure match very well with the measured one, at the cost of a high forcing pressure.

Adult-onset minimal change disease among Taiwanese: clinical features, therapeutic response, and prognosis.

PubMed

Huang, J J; Hsu, S C; Chen, F F; Sung, J M; Tseng, C C; Wang, M C

2001-01-01

There are some racial differences in the prevalence and prognosis of idiopathic nephrotic syndrome; however, reports about minimal change disease (MCD) in Chinese were rare. We retrospectively analyzed 123 Chinese adults with idiopathic nephrotic syndrome, who received percutaneous renal biopsy in our institution within the last 10 years. In total, 46 patients (37.4%) were compatible with the pathological diagnosis of MCD. The male to female ratio was 1.2:1. The mean age of onset was 30.9 years, and 80% of the patients with MCD were less than 40 years. The mean daily proteinuria was 10.2 g, and serum albumin was 1.8 mg/dl. Azotemia occurred in 16 (35%) of 46 cases; hypertension, 13%; and microscopic hematuria, 13%. High selectivity index for proteinuria (SI <0.1) was noted in 12 (39%) of 31 cases; and high IgE level was found in 83.7% of the study subjects, although only one case had allergic history. Complete remission in 36 MCD patients treated with corticosteroid was achieved by 42% (15/36), 80% (29/36), and 94% (34/36) within 4, 8, and 12 weeks, respectively. The time interval to remission was similar between the younger group (<40 years old, 1.7 months) and older group (>40 years old, 1.6 months). Nineteen (56%) of 34 cases with steroid response did not relapse, and the other cases (44%) had a mean relapse rate of 1.5 times per patient within a period of 45 months. The age of onset in MCD cases was not significantly correlated with steroid-responsive rate, and the time interval to remission. However, a tendency existed between the onset in the young age and the sequentially relapsing rate (p = 0.06). Two cases with primary steroid resistance and 5 cases with frequent relapse or steroid dependence responded well to intravenous pulse therapy of cyclophosphamide, except one refractory case. No thrombotic episode was ever noted in our group. Regarding infectious complications, primary peritonitis occurred in one, pneumonia in one, and cellulitis in 6 cases during active nephrotic stage. Two mortality cases, one with E. coli-related necrotizing fasciitis and one from pneumonia, were noted. In brief, compared with children, adult patients with MCD had lesser high selectivity index for proteinuria, the same steroid-responsive rate (94%), but slower response, and significantly lesser relapsing rate. The intravenous pulse therapy of cyclophosphamide may be an alternative regimen for adult patients with steroid resistance or dependency. In addition, the Asian adult-onset MCD had younger age, male predominance, and lesser relapsing rate in comparison to those of the Western population.

High-energy Nd:glass laser for oncology

NASA Astrophysics Data System (ADS)

Boutchenkov, Vyatcheslav A.; Utenkov, Boris I.; Zaitsev, V. K.; Bayanov, Valentin I.; Serebryakov, Victor A.

1991-07-01

The use of high energy solid state lasers for the treatment of human skin neoplasia was based on the experiments and clinic studies by Helsper and Goldman (1964), McGuff (1966). The heat of precise local volume is emitted due to the pulse laser radiation. The thermal effect results in the superficial necrosis of tissues with their integrity destruction, vascular repture accompanied by bloodstoke in some cases and by capillary embolism in others. Obvious tumour destruction is note only in case of high density irradiation. General tumour destruction depends on biological neoplasia features as well as the laser type.

Occupation, hobbies, and acute leukemia in adults.

PubMed

Terry, Paul D; Shore, David L; Rauscher, Garth H; Sandler, Dale P

2005-10-01

Occupational and industrial exposures have been implicated in the etiology of leukemia, yet uncertainty remains regarding potential high risk occupations. We examined the associations between self-reported occupations and hobbies and acute leukemia risk using data from 811 cases and 637 controls participating in a case-control study in the U.S. and Canada. We found that several occupations may increase the risk of acute leukemia, particularly occupations related to petroleum products, rubber, nuclear energy, munitions, plastics, and electronics manufacturing. Differences were noted according to histological type. Other occupations and hobbies were not clearly associated with risk.

Binasal hemianopia.

PubMed

Salinas-Garcia, R F; Smith, J L

1978-09-01

The visual fields of 100 patients referred for neuro-ophthalmologic examination were reviewed; eight cases had binasal visual field defects. Most clinicians have suspected an intracranial cause for such field defects since the classic report of Cushing and Walker in 1912. However, in this study, the cause for the binasal hemianopia was found to be ischemic optic neuropathy in two patients, and one case each of optic nerve drusen, glaucoma, congenital optic nerve pits, and retinitis pigmentosa sine pigmento. Thus 75% of the cases had an intraocular cause for the binasal hemianopia. Two patients had congenital hydrocephalus, and an intracranial basis was thus noted in 25% of these cases. The neurosurgeon should realize that the patient with binasal field defects is much more likely to have an ocular cause than an intracranial one for his problem.

Spontaneous diabetes mellitus in captive Mandrillus sphinx monkeys: a case report.

PubMed

Pirarat, N; Kesdangsakolwut, S; Chotiapisitkul, S; Assarasakorn, S

2008-06-01

Case history The two obese mandrills (Mandrillus sphinx) showed clinical signs of depression, anorexia, hyperglycemia, hypertriglyceridemia, glucosuria, proteinuria and ketonuria. Septic bed sore wounds were noted on both fore and hind limbs. Results Histopathological study revealed severe islet amyloidosis in both mandrills. Immunohistochemical study using polyclonal anti-cat amylin antibody confirmed derivation of the islet amyloid from islet amyloid polypeptide (IAPP). Cardiomyopathy and myocardial fibrosis were also evident. Conclusions The present study documents diabetes mellitus in two obese mandrills. Diabetes in these animals had features very similar type 2 diabetes mellitus of humans, including the development of severe, IAPP-derived islet amyloidosis. The mandrill may, therefore, serve as an animal model of human type 2 diabetes mellitus.

[Technical notes on mastectomy performed as part of transsexualism F to M].

PubMed

Roffé, J-L

2012-08-01

Mastectomy in case of large breast should use a particular technique. The principle of mastectomy by periareolar flap or higher in MAP must be abandoned in favor of mastectomy by lower horizontal with the office of the WFP transformed by a tummy. Main technical note contains the plasty in MAP because the conventional mastectomy is well known. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Whooping cough--a study of severity in hospital cases.

PubMed Central

Robinson, D A; Mandal, B K; Ironside, A G; Dunbar, E M

1981-01-01

In an attempt to determine the clinical severity and prognosis of children admitted to hospital with whooping cough, 127 patients were studied prospectively during a 12-month period. Clinical and laboratory criteria were used and the impression gained was that most cases were mild, although 3 children were dangerously ill and at least 30% had symptoms lasting 2 months or longer. There were no deaths, and no permanent sequelae were noted. The mean age of patients was higher than in other series, which might have accounted for the fairly low severity. Although there was some evidence of a decline in severity and mortality, whooping cough is still an unpleasant and protracted illness. PMID:7294871

Reanalysis of the anthrax epidemic in Rhodesia, 1978–1984

PubMed Central

Brediger, Walter; Albright, Thomas P.; Smith-Gagen, Julie

2016-01-01

In the mid-1980s, the largest epidemic of anthrax of the last 200 years was documented in a little known series of studies by Davies in The Central African Journal of Medicine. This epidemic involved thousands of cattle and 10,738 human cases with 200 fatalities in Rhodesia during the Counterinsurgency. Grossly unusual epidemiological features were noted that, to this day, have not been definitively explained. This study performed a historical reanalysis of the data to reveal an estimated geographic involvement of 245,750 km2, with 171,990 cattle and 17,199 human cases. Here we present the first documented geotemporal visualization of the human anthrax epidemic. PMID:27867766

Higher Education.

ERIC Educational Resources Information Center

Hendrickson, Robert M.

This chapter reports 1982 cases involving aspects of higher education. Interesting cases noted dealt with the federal government's authority to regulate state employees' retirement and raised the questions of whether Title IX covers employment, whether financial aid makes a college a program under Title IX, and whether sex segregated mortality…

Tumour necrosis factor-alpha and nitric oxide response in different categories of tuberculosis patients.

PubMed

Chakraborty, U; Goswami, A; Saha, S; Mukherjee, T; Dey, S K; Majumdar, S; Pal, N K

2013-04-01

To compare the magnitude of tumour necrosis factor alpha (TNF-α) and nitric oxide (NO) response in different categories of active tuberculosis (TB) patients by ex vivo experiment. New, relapsed (recurrent), miliary and pleural effusion TB cases were recruited with matched healthy controls. TNF-α and NO were measured from the culture supernatant of peripheral blood monocytes derived from cases and controls with and without challenge with live Mycobacterium tuberculosis H37Rv. TNF-α and NO production varied significantly among the different categories of TB patients. The magnitude was highest among patients with pleural effusion and lowest in miliary TB cases. In between, progressive decreases in response were noted in new and relapse cases. Overall, positive correlations between TNF-α and NO were noted among the diseased and healthy groups. Distinct TNF-α and NO levels appear to be associated with different clinical forms of TB and might help to assess prognosis and contribute to a better understanding of underlying immunopathological mechanisms.

Sudden or unnatural deaths involving anabolic-androgenic steroids.

PubMed

Darke, Shane; Torok, Michelle; Duflou, Johan

2014-07-01

Anabolic-androgenic steroids (AASs) are frequently misused. To determine causes of death, characteristics, toxicology, and pathology of AAS positive cases, all cases (n = 24) presenting to the New South Wales Department of Forensic Medicine (1995-2012) were retrieved. All were male, and the mean age was 31.7 years. Deaths were mainly due to accidental drug toxicity (62.5%), then suicide (16.7%) and homicide (12.5%). Abnormal testosterone/epitestosterone ratios were reported in 62.5%, followed by metabolites of nandrolone (58.3%), stanozolol (33.3%), and methandienone (20.8%). In 23 of 24 cases, substances other than steroids were detected, most commonly psychostimulants (66.7%). In nearly half, testicular atrophy was noted, as was testicular fibrosis and arrested spermatogenesis. Left ventricular hypertrophy was noted in 30.4%, and moderate to severe narrowing of the coronary arteries in 26.1%. To summarize, the typical case was a male polydrug user aged in their thirties, with death due to drug toxicity. Extensive cardiovascular disease was particularly notable. © 2014 American Academy of Forensic Sciences.

Human fatalities from wild elephant attacks--a study of fourteen cases.

PubMed

Das, Sobhan Kr; Chattopadhyay, Saurabh

2011-05-01

Human-wild elephant conflicts are frequently reported from various parts of the country. Encroaching of animal habitat by human civilization is a primary reason for this. The present study comprises of fourteen autopsy cases conducted at the department of Forensic Medicine, B.S Medical College, Bankura, West Bengal, India over a period of three years. The study attempts to find out the nature of injuries caused by wild elephant attack and the common factors contributing to human-wild elephant conflict so that vulnerable population can be cautioned to avoid conflicts. A distinct seasonal as well as diurnal variation of attack incidences was noted. Attacks were sudden and unprovoked. Killer elephants were wild tuskers in all the cases. Victims were from the low socioeconomic group and the cause of death was due to trampling on the vital organs like chest and head. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Employment discrimination implications of genetic screening in the workplace under Title VII and the Rehabilitation Act.

PubMed

Canter, E F

1984-01-01

The emergence of genetic screening techniques will permit employers to exclude hypersusceptible individuals from potentially hazardous workplace environments. The denial of employment opportunities to these individuals, however, may constitute discrimination. This Note analyzes genetic screening cases with respect to currently available remedies contained in Title VII of the Civil Rights Act of 1964 and the Rehabilitation Act of 1973. The Note concludes that Title VII claims may succeed but only in limited circumstances and that Rehabilitation Act claims will encounter numerous obstacles to relief. Additionally, the Note discusses some of the implications of the use of genetic screening in the workplace.

A Note About HARP's State Trimming Method

NASA Technical Reports Server (NTRS)

Butler, Ricky W.; Hayhurst, Kelly J.; Johnson, Sally C.

1998-01-01

This short note provides some additional insight into how the HARP program works. In some cases, it is possible for HARP to tdm away too many states and obtain an optimistic result. The HARP Version 7.0 manual warns the user that 'Unlike the ALL model, the SAME model can automatically drop failure modes for certain system models. The user is cautioned to insure that no important failure modes are dropped; otherwise, a non-conservative result can be given.' This note provides an example of where this occurs and a pointer to further documentation that gives a means of bounding the error associated with trimming these states.

Paleopathological findings in radiographs of ancient and modern Greek skulls.

PubMed

Papagrigorakis, Manolis J; Karamesinis, Kostas G; Daliouris, Kostas P; Kousoulis, Antonis A; Synodinos, Philippos N; Hatziantoniou, Michail D

2012-12-01

The skull, when portrayed radiologically, can be a useful tool in detecting signs of systemic diseases and results of pathological growth mechanisms. The aim of this study was therefore to examine, compare, and classify findings in cranial configuration of pathological origin, in modern and ancient skulls. The material consists of 240 modern and 141 ancient dry skulls. Three radiographs for each skull (lateral, anteroposterior, basilar) provide enough evidence for differential diagnoses. Cases of osteoporosis are among the interesting pathological findings. A prevalence of female modern skulls in those determined as osteoporotic skulls is noted. Special interest is placed on the area of the sella turcica and many variations, regarding the shape and texture, are recognized both in ancient and modern skulls. Malignancies and important causes of cranial destruction are identified in both skull collections. Diploid thickening and osteolytic areas appear commonly among ancient remains. Moreover, from the ancient skull collection, one case possibly recognizable as fibrous dysplasia is noted while another case with an unusual exostosis gives rise to many questions. Interpreted with caution, the results of the present study, which can serve as an approach of paleopathology and paleoradiology, indicate similarity trends in cranial configuration of pathologic origin in modern and ancient people. Radiography and cephalometry were the main diagnostic tools used to gather evidence and are evaluated as a quite appropriate method to examine anthropological material and assess the internal structure of skeletal remains since they are non-destructive techniques.

Anti-nucleosome antibodies as a disease marker in systemic lupus erythematosus and its correlation with disease activity and other autoantibodies.

PubMed

Pradhan, Vandana D; Patwardhan, Manisha M; Ghosh, Kanjaksha

2010-01-01

Detection of anti-nucleosome antibodies (anti-nuc) in patients with systemic lupus erythematosus (SLE) has been well established and it is claimed that their presence is associated with disease activity. The aim of this study is to evaluate the incidence of anti-nuc antibodies and to correlate them with disease activity and its association with other autoantibodies like anti-nuclear antibodies (ANA), anti-double stranded DNA (anti-dsDNA), anti-histone antibodies (AHA), as well as autoantibodies to histone subfractions like H1, (H2A-H4) complex, H2B, and H3. This cross-sectional study included 100 SLE patients referred from the Rheumatology, Dermatology, and Nephrology Departments. SLE disease activity was evaluated by using SLE-Disease Activity Index (SLEDAI) score. A patient was defined as having active SLE when the SLEDAI score was more than 5.0. Fifty normal controls were also tested as a healthy control group. Anti-nuc antibodies, anti-dsDNA, and AHA were tested by Enzyme-Linked Immunosorbent Assay (ELISA) and ANA was detected by an indirect immunofluorescence test. All patients studied were in an active stage of disease and were untreated, of which 44 patients had renal biopsy-proven kidney involvement, which was categorized as lupus nephritis (LN) and 56 patients did not show any renal manifestations (SLE without LN). Anti-nuc antibodies were positive in 88%, anti-dsDNA in 80%, and AHA in 38% of the cases. ANA was positive in all SLE patients studied. None of the normal controls was found to be positive for these antibodies. Although a slightly higher incidence of autoantibodies were noted in LN, there was no statistical difference noted between LN and SLE without LN groups for anti-nuc and anti-dsDNA antibodies (p > 0.05). A higher incidence of autoantibodies to ANA specificities were noted in anti-nuc positive cases, but there was no statistical difference between anti-nuc positive and anti-nuc negative cases for ANA specificities among LN and SLE without nephritis groups (p > 0.05). Anti-nuc antibody detection could be a better tool for the diagnosis of SLE. Although there was no significant difference in LN and SLE without LN groups, this study suggests that anti-nuc detection can be useful as an additional disease activity marker to other laboratory tests.

Common allergies do not influence the prevalence of cutaneous hypersensitivity reactions to antiepileptic drugs.

PubMed

Bosak, Magdalena; Porębski, Grzegorz; Słowik, Agnieszka; Turaj, Wojciech

2017-09-01

The aim of the study was to establish whether the presence of common allergies increases the risk of drug-related hypersensitivity reactions among patients with epilepsy treated with antiepileptic drugs (AEDs). We studied 753 patients with epilepsy seen in tertiary outpatient epilepsy clinic. We obtained data related to epilepsy type, past and ongoing treatment with AEDs, occurrence of maculopapular exanthema or more serious cutaneous adverse reactions (Stevens-Johnson syndrome - SJS) and their characteristics. We noted an occurrence of allergic reactions unrelated to treatment with AED, including rash unrelated to AED, bronchial asthma, persistent or seasonal allergic rhinitis, atopic dermatitis, rash after specific food and other allergic reactions. There were 61 cases of AED-related cutaneous hypersensitivity reaction (including 3 cases of SJS) noted in association with 2319 exposures to AEDs (2.63%) among 55 out of 753 patients (7.3%). Cutaneous hypersensitivity reaction to AED was most commonly noted after lamotrigine (12.1%), carbamazepine (5.4%) and oxcarbazepine (4.1%). Prevalence of allergic reactions unrelated to AED was similar between patients with and without AED-related cutaneous hypersensitivity reaction (rash unrelated to AED: 16.4% vs. 10.2%; bronchial asthma: 1.8% vs. 0.1%; persistent allergic rhinitis: 7.3% vs. 10.2%; seasonal allergic rhinitis: 7.3% vs. 11.7%; atopic dermatitis: 0 vs. 0.7%; rash after specific food: 5.4% vs. 6.4%; other allergic reactions: 5.4% vs. 5.2%, respectively; P>0.1 for each difference). Presence of common allergies is not a significant risk factor for AED-related cutaneous hypersensitivity reaction among patients with epilepsy. Copyright © 2017 Elsevier B.V. All rights reserved.

A New Insight Into Sudden Cardiac Death in Young People

PubMed Central

Wang, Yueyue; Xia, Lei; Shen, Xiaodong; Han, Guoxin; Feng, Dan; Xiao, Hongju; Zhai, Yongzhi; Chen, Xin; Miao, Yuanyuan; Zhao, Chunhong; Wang, Yingchan; Guo, Mingguang; Li, Tanshi; Zhu, Hai Yan

2015-01-01

Abstract Takotsubo cardiomyopathy (TTC) causes sudden cardiac death and has garnered increased attention worldwide in recent years. However, few studies have clearly classified the risk factors for this disease, including gender, race and morbidity, as well as the physical and mental stressors that can exacerbate the disease, particularly in young patients. To better analyze the characteristics of young TTC patients, we performed a systematic review of reported cases involving young patients. A computer-assisted search was performed using prominent electronic medical information sources to identify literature published between January 1965 and December 2013. Relevant studies containing clinical data of young TTC patients were included. Ninety-six records that included information about 104 cases were ultimately selected for our review. Several of the following results were noted: First, physical stress was more likely to exacerbate TTC than was mental stress in young patients. Second, more female than male TTC patients were noted among both young patients and the general population. Third, ethnicity appears to play no role in the disease, as no significant differences were noted among individuals of different races with respect to clinical characteristics, morbidity or stressors. Fourth, the clinical manifestations of TTC were similar to those of other cardiac diseases, including coronary heart disease. However, TTC may be detected using the combination of echocardiography and ventriculography. Clinicians should consider TTC if young patients present with symptoms similar to those of coronary heart disease so that harmful treatments such as coronary artery stent placement may be avoided. Moreover, the answers to questions regarding the clinical diagnostic criteria, etiology, pathophysiology, and the management of this syndrome in youth remain unclear; therefore, further research is needed. PMID:26266349

Diet and lung cancer in California Seventh-day Adventists.

PubMed

Fraser, G E; Beeson, W L; Phillips, R L

1991-04-01

The Adventist Health Study, a cohort study of 34,198 California Seventh-day Adventists, identified 61 cases of new primary lung cancer over 6 years of follow-up (1977-1982). The population studied was unique in that only 4% admitted to current cigarette smoking and about half were lacto-ovovegetarians. A total of 36% of the lung tumors were adenocarcinomas, and 19% were squamous cell carcinomas. The expected associations with cigarette smoking were noted for Kreyberg group I tumors (squamous cell, large cell, and small cell carcinoma; relative risk (RR) = 53.2 for current smokers and 7.07 for past smokers), but much lesser associations were noted for Kreyberg group II tumors (adenocarcinoma and bronchoalveolar carcinoma; RR = 1.99 for current smokers and 1.59 for past smokers). In this study, fruit consumption was the dietary constituent that showed a strong, statistically significant protective association with lung cancer that was independent of smoking (fruit consumption less than 3 times/week, RR = 1.0; 3-7 times/week, RR = 0.30; greater than or equal to 2 times/day, RR = 0.26). This association was somewhat stronger for Kreyberg group II tumors, but similar trends were also noted for Kreyberg group I tumors. Confounding with smoking seems unlikely in a population with very few current smokers and where both stratification and Cox modeling methods of analysis led to similar conclusions.

Endodontic cellulitis 'flare-up'. Case report.

PubMed

Matusow, R J

1995-02-01

Endodontic cellulitis involves facial swelling which can vary from mild to severe and can occur as a primary case or a flare-up following initial treatment of asymptomatic teeth with periapical lesions. The microbial spectrum in primary cases involves a significant mixture of anaerobic and facultative aerobic microbes, chiefly streptococci. In a previous study, cultures from flare-up cases, utilizing the same anaerobic techniques as in primary cases, revealed an absence of obligate anaerobes and an 80 per cent incidence of facultative aerobic streptococci. These cases also revealed a significant time lapse from onset of symptoms to the cellulitis phase. No sex or age factors were noted in the primary or flare-up cases. The purpose of this case report is to restate a traditional theory, namely, the alteration of the oxidation/reduction potential (Eh), as a major factor for endodontic cellulitis flare-ups; to confirm the pathogenic potential of oral facultative streptococci; and that asymptomatic endodontic lesions tend to exist with mixed aerobic/anaerobic microbial flora.

Familial Aggregation of Chiari Malformation: Presentation, Pedigree, and Review of the Literature.

PubMed

Nagy, Laszlo; Mobley, James; Ray, Coby

2016-01-01

This article reports the largest familial aggregation of Chiari malformation in a single family to date as reported in the literature. This study is a retrospective case series of a family of whom five individuals have a confirmed case of Chiari malformation and three additional individuals have Chiari signs and symptoms. This contribution further supports the implication of genetics in the transmission of Chiari malformation. The family reported in this study also has a significant incidence of Ehlers-Danlos. Three sisters, including a set of twins, presented with confirmed cases of Chiari malformation and four of the five children of the twin sisters presented with confirmed or suspected Chiari malformation. Of note, the non-twin sister has three children who are unaffected. This report provides further evidence for a shared loci between the Chiari malformation and Ehlers-Danlos.

Models of the First-Term Reenlistment Decision.

DTIC Science & Technology

1980-09-01

cases in each cell . bIncludes 41 cases indicated as E2 in survey. elncludes 18 cases indicated as E6 in survey. creases. For example, among E-4...1876) (4078) oThe numbers in parentheses show the number of cases in each cell . Clearly, the extent to which these correlations reflect causal...101) NOTE: Numbers in parentheses show the number of cases in each cell . aAmount computed from October 1975 pay tables based on the individual’s

[Catheter-related bladder discomfort after urological surgery: importance of the type of surgery and efficiency of treatment by clonazepam].

PubMed

Maro, S; Zarattin, D; Baron, T; Bourez, S; de la Taille, A; Salomon, L

2014-09-01

Bladder catheter can induce a Catheter-Related Bladder Discomfort (CRBD). Antagonist of muscarinic receptor is the gold standard treatment. Clonazepam is an antimuscarinic, muscle relaxing oral drug. The aim of this study is to look for a correlation between the type of surgical procedure and the existence of CRBD and to evaluate the efficiency of clonazepam. One hundred patients needing bladder catheter were evaluated. Sexe, age, BMI, presence of diabetes, surgical procedure and existence of CRBD were noted. Pain was evaluated with analogic visual scale. Timing of pain, need for specific treatment by clonazepam and its efficiency were noted. Correlation between preoperative data, type of surgical procedure, existence of CRBD and efficiency of treatment were evaluated. There were 79 men and 21 women (age: 65.9 years, BMI: 25.4). Twelve patients presented diabetes. Surgical procedure concerned prostate in 39 cases, bladder in 19 cases (tumor resections), endo-urology in 20 cases, upper urinary tract in 12 cases (nephrectomy…) and lower urinary tract in 10 cases (sphincter, sub-uretral tape). Forty patients presented CRBD, (pain 4.5 using VAS). This pain occurred 0.6 days after surgery. No correlation was found between preoperative data and CRBD. Bladder resection and endo-urological procedures were surgical procedures which procured CRBD. Clonazepam was efficient in 30 (75 %) out of 40 patients with CRBD. However, it was less efficient in case of bladder tumor resection. CRBD is frequent and occurred immediately after surgery. Bladder resection and endo-urology were the main surgical procedures which induced CRBD. Clonazepam is efficient in 75 %. Bladder resection is the surgical procedure which is the most refractory to treatment. 5. Copyright © 2014 Elsevier Masson SAS. All rights reserved.