Successful IT Start-Ups' HRD Practices: Four Cases in South Korea

ERIC Educational Resources Information Center

Cho, Yonjoo; McLean, Gary N.

2009-01-01

Purpose: The purpose of this paper is to identify South Korea's successful IT start-ups' HRD practices to determine whether there are steps that must be taken to maintain their HRD expertise for continued growth. Design/methodology/approach: A case study approach employing four fast-growing IT start-up cases was undertaken based on semi-structured…

Educating Citizens for Participatory Democracy: A Case Study of Local Government Education Policy in Pelotas, Brazil

ERIC Educational Resources Information Center

McCowan, Tristan

2006-01-01

A case study was undertaken of Pelotas, a large town in southern Brazil, where a recent government of the Workers' Party (PT) implemented a range of social policy reforms. The study draws on interviews with key members of the Municipal Secretariat of Education and policy documents, analyzing them in relation to theoretical literature on…

A Multiple Case Study Analysis Exploring Autism Spectrum Disorder as a Culture

ERIC Educational Resources Information Center

Hutto, Lori Lynn

2017-01-01

This qualitative multiple case study analysis included the exploration of the phenomenon of Autism Spectrum Disorder (ASD) from a cultural standpoint, rather than the traditional view of deficits caused by disability. This effort was undertaken to determine if those within this population would be better served by the educational system and more…

A "Tale of Two Cities:" A Comparative Case Study of Community Engagement and Costs in Two Levy Campaigns

ERIC Educational Resources Information Center

Ingle, W. Kyle; Johnson, Paul A.; Petroff, Ruth Ann

2011-01-01

Using Anderson's (1998) framework for authentic community engagement and Levin and McEwan's (2001) "ingredients method," this comparative case study analyzed contrasting approaches to levy campaigns undertaken by two suburban school districts and the associated costs of the campaigns. We found that District A ran a campaign that…

A Case Study of the Texas Teacher Study: Technical Report. Project: Effects of Testing Reforms and Standards.

ERIC Educational Resources Information Center

Shepard, Lorrie A.; And Others

The Texas Examination of Current Administrators and Teachers is a basic literacy test that was administered to 202,000 practicing educators in March 1986. An in-depth case study was undertaken to examine the effects of the test as an instrument of educational reform and policy making. The two-year study involved 10 separate data-collection phases…

25 CFR 41.10 - Technical assistance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to, consulting services for the development of programs, plans, and feasibility studies and... section may be undertaken in the same manner as in the case of negative determinations of feasibility...

Schools, Social Capital and Space

ERIC Educational Resources Information Center

Allan, Julie; Catts, Ralph

2014-01-01

This paper reports on the significance of social capital in relation to education, exploring its relevance to teachers and other professionals as well as among young people. It draws on aspects of five case studies undertaken by the Schools and Social Capital Network, within the Applied Educational Research Scheme in Scotland. These case studies…

Applying the Joint Committee's 1994 Standards in International Contexts: A Case Study of Education Evaluations in Bangladesh

ERIC Educational Resources Information Center

Chatterji, Madhabi

2005-01-01

This case study examines the applicability of 1994 standards, offered by the Joint Committee on Standards for Educational Evaluation, to evaluations conducted in international contexts. The work is undertaken in response to an open invitation from the Joint Committee in its 1994 publication. The article addresses two purposes. First, it asks…

Effects of polymorphisms in vitamin E-, vitamin C-, and glutathione peroxidase-related genes on serum biomarkers and associations with glaucoma

USDA-ARS?s Scientific Manuscript database

To study the association of selected polymorphism in genes related to vitamin E, vitamin C, and glutathione peroxidase with these biomarkers and primary open-angle glaucoma (POAG) risk. A case-control study matched for age, sex, and bodyweight was undertaken. Two hundred fifty POAG cases and 250 con...

Skills Planning for Industry Growth: A Case Study of the Katherine Arts Industry. Occasional Paper

ERIC Educational Resources Information Center

Curry, Catherine

2009-01-01

The findings of a cultural industries skills audit undertaken in 2008 in Katherine, Northern Territory, are explored. The case study focusses in particular on the practical challenges and implications of auditing skills in a diverse industry sector and considers the usefulness of such an audit in preparing an industry for predicted change. This…

Implications of Student and Lecturer Qualitative Views on Reading Lists: A Case Study at Loughborough University, UK

ERIC Educational Resources Information Center

Brewerton, Gary

2014-01-01

This case study explores student and lecturer views of reading lists at Loughborough University. Taking the qualitative data from two surveys previously undertaken at the institution, it uses the grounded theory approach to identify key issues regarding the purpose, importance, visibility, content, currency, and length of reading lists, as well as…

Case Series: Mental Health Needs and Perspectives of Rural Children Reared by Parents Who Abuse Methamphetamine

ERIC Educational Resources Information Center

Ostler, Teresa; Haight, Wendy; Black, James; Choi, Ga-Young; Kingery, Linda; Sheridan, Kathryn

2007-01-01

Objective: This case-based, mixed-methods study was undertaken to understand the perspectives and mental health needs of rural children exposed to parental methamphetamine abuse. Method: Participants were 23 children involved with a state child protective agency because of parental methamphetamine abuse. A semistructured interview provided…

American Indians and Vocational Rehabilitation: A Case Review Study of Former Clients.

ERIC Educational Resources Information Center

Frank, Lyle W.

A review of 80 case files of American Indians in Northern Arizona was undertaken to identify factors associated with clients who were found to be ineligible for rehabilitation services and clients who were successfully and unsuccessfully rehabilitated. The 11 dependent variables considered were severity of disability, physical or mental…

The role of histology in forensic autopsies: is histological examination always necessary to determine a cause of death?

PubMed

Fronczek, Judith; Hollingbury, Frances; Biggs, Michael; Rutty, Guy

2014-03-01

In England and Wales there is a conflict between the law and advice from regulatory bodies in relation to the sampling of human tissue for histological examination following medico-legal post-mortem examinations. Considering the results of previous publications, we performed a specific study to investigate the role of histology in determining the cause of death in cases at a forensic unit. A retrospective study of 500 adult forensic cases was performed. Cases were categorized by the role the histological examination played in determining a cause of death and its contributory factors. Furthermore, cause of death, manner of death, organ systems involved, and discrepancies were assessed. Of the 500 cases, histology was undertaken in 287 cases (58 %). Microscopic examination provided the cause of death in 2 % of cases where histology had been undertaken, and it added to the cause of death in 8 %. In 61 % of cases microscopy confirmed the macroscopic findings, and in 30 % it did not influence the medical cause of death. Histological examination of all organs in all forensic cases for the purpose of providing a medical cause of death is not supported. Practice guidance should be adjusted to reflect that, while histological examination is essential in certain circumstances, the decision to retain material for histology should be made on a case by case basis at the pathologist's discretion.

An Investigation into the Challenges In-Service Student Teachers Encounter in Transformational Geometry, "Reflection and Rotation". The Case of Mufulira College of Education

ERIC Educational Resources Information Center

Kambilombilo, Dennis; Sakala, Whyson

2015-01-01

The study was conducted to investigate the challenges in-service mathematics student teachers face in transformational geometry; reflection and rotation. The Van Hiele Theory of levels of Thought was used as the theoretical framework for this study. A case study was undertaken using a written test. The research was carried on second and third…

The Education of Migrant Workers and their Families. Case Studies Undertaken for the National Commissions of Finland, France, Sweden, Yugoslavia. UNESCO Educational Studies and Documents No 27.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

The report consists of four case studies which show the extent and importance of the problem of education of migrant workers and their families as seen by Finland, France, Sweden, and Yugoslavia. Dealing mainly with the education of second generation Finnish workers in Sweden, the first study addresses the teaching of the mother tongue and the…

A PILOT STUDY COMPARING THE BLOCK SYSTEM AND THE INTERMITTENT SYSTEM OF SCHEDULING SPEECH CORRECTION CASES IN THE PUBLIC SCHOOLS.

ERIC Educational Resources Information Center

WEAVER, JOHN B.; WOLLERSHEIM, JANET P.

TO DETERMINE THE MOST EFFICIENT USES OF THE PUBLIC SCHOOL SPEECH CORRECTIONIST'S SKILLS AND TIME, A STUDY WAS UNDERTAKEN TO INVESTIGATE THE EFFECTIVENESS OF THE INTERMITTENT SYSTEM AND THE BLOCK SYSTEM OF SCHEDULING SPEECH CASES. WITH THE INTERMITTENT SYSTEM THE CORRECTIONIST IS ASSIGNED TO A NUMBER OF SCHOOLS AND GENERALLY SEES CHILDREN TWICE A…

Rural Community Action: A Series of Case Studies of Action Projects in Small New York State Communities. Miscellaneous Bulletin 116.

ERIC Educational Resources Information Center

Preston, James C.; Halton, Katherine B.

The report presents case studies of 7 community action projects which were undertaken by New York communities with populations under 10,000 and which show how local leaders can improve the quality of life in their communities. The report describes the background, initiation, expansion, implementation, consequences, and highlights of the projects,…

Leadership with a Purpose: Nine Case Studies of Schools in Tasmania and Victoria Where the Principal Had Undertaken the Principals as Literacy Leaders (PALL) Program

ERIC Educational Resources Information Center

Townsend, Tony; Bayetto, Anne; Dempster, Neil; Johnson, Greer; Stevens, Elizabeth

2018-01-01

This paper reports on Australian case study research in schools where principals completed the Principals as Literacy Leaders (PALL) program. The purpose was to gather data about the effects of PALL on principals' leadership and the impact of interventions in Reading on teaching, student learning, and achievement. Data gathering included…

"I DON'T CARE DO UR OWN PAGE!!" A Case Study of Using Wikis for Collaborative Work in a UK Secondary School

ERIC Educational Resources Information Center

Grant, Lyndsay

2009-01-01

Alongside other forms of social software, wikis have been heralded as supporting more collaborative and democratic teaching and learning practices. This paper explores, through a case study approach, the use of wikis to support a collaborative research project undertaken in a UK secondary school. Findings are analysed in the context of research on…

Case Study in the Power of Collaboration: Planning Process for the Kansas Educational Leadership Institute

ERIC Educational Resources Information Center

Devin, Mary

2013-01-01

This article reports on the collaborative efforts undertaken for systematic statewide support for the recruitment, development, and retention of quality leaders in schools and school districts in Kansas, USA. The author presents the case of a strong sense of "collaboration" that made the difference and stimulated movement from vision…

A Cross Case Analysis of Computer Use among ELL University Instructors in Taiwan

ERIC Educational Resources Information Center

Yang, Wan-Lin

2012-01-01

This study explored the use of computers by Taiwanese English language learning (ELL) teachers at Colleges of Technology in Taiwan. A cross case analysis of four teachers was undertaken to examine these teachers' actions, beliefs, and the contexts they teach in so as to illuminate issues related to the implementation of computers for instructional…

Cross-Cultural Discussions in a 3D Virtual Environment and Their Affordances for Learners' Motivation and Foreign Language Discussion Skills

ERIC Educational Resources Information Center

Jauregi, Kristi; Kuure, Leena; Bastian, Pim; Reinhardt, Dennis; Koivisto, Tuomo

2015-01-01

Within the European TILA project a case study was carried out where pupils from schools in Finland and the Netherlands engaged in debating sessions using the 3D virtual world of OpenSim once a week for a period of 5 weeks. The case study had two main objectives: (1) to study the impact that the discussion tasks undertaken in a virtual environment…

The Incidental Leader: The Role of Reading Recovery (RTM) Training in the Professional Lives of Teachers in a Rural Alabama School System. A Multiple Case Study

ERIC Educational Resources Information Center

Bounds, Sharon L.

2013-01-01

This qualitative multiple case study was undertaken to answer the following question: How did Reading® (RR) teachers and former Reading Recovery teachers in a mid-sized rural school system in the southeastern United States describe the influences of their Reading Recovery training as it related to their current professional lives? Additional…

Linkage between Researchers and Practitioners: A Qualitative Study.

ERIC Educational Resources Information Center

Huberman, Michael

1990-01-01

A multiple-case, "tracer" study was undertaken involving 11 research projects of the "Education et Vie Active" (Education and the Active Life)--a national vocational education program in Switzerland--to assess the importance of contacts between researchers and practitioners. Iterative data from interviews, observations, and…

Microcomputer Technology in Schools: Issues for Research.

ERIC Educational Resources Information Center

Kane, Janet H.; And Others

This exploratory, multi-disciplinary study, which was undertaken to identify a research agenda for the educational implementation and impact of microprocessing technology, used case study methodology to explore the relationship between the social contexts and the microcomputer innovation. Three geographically distinct school districts with a…

Possibilities and Challenges in Teachers' Collegial Learning

ERIC Educational Resources Information Center

Makopoulou, Kyriaki; Armour, Kathleen

2014-01-01

This paper reports a set of findings from a larger research study undertaken on Physical Education (PE) teachers' career-long professional learning in Greece. In total, nine case study PE teachers participated in the study. Data were collected using semi-structured interviews with the teachers. The data were analysed using a constructivist…

Doppler effect of subluminal and superluminal sources in eight dimensions

NASA Astrophysics Data System (ADS)

Chandola, H. C.; Rajput, B. S.

1984-06-01

The study of the relativistic Doppler effect of subliminal and superluminal sources has been undertaken in the eight-dimensional space. It has been shown that correct Doppler shifts are obtained in the external spaces of these sources and the conformal correspondence between Doppler effect curves holds in case of approaching and receeding sources but not in the transverse case.

Participation in Higher Education: Barriers and Opportunities for Non-Traditional Students in Higher Education in Germany and Spain

ERIC Educational Resources Information Center

Schömer, Frank; González-Monteagudo, José

2013-01-01

This paper explores participation in higher education in Germany and Spain through two case studies from the RANLHE project. There is one case in each national context (Germany and Spain) based on biographical interviews undertaken between 2008 and 2010. Social, economic and cultural dimensions are explored in order to better understand the German…

Unpacking the Nature and Practices of Inclusive Education: The Case of Two Schools in Hyderabad, India

ERIC Educational Resources Information Center

Sawhney, Sonia

2015-01-01

This paper reports insights into the nature and practices of inclusive schools in India using a case study methodology. Being a signatory of the Salamanca Statement, the Government of India has undertaken to implement an inclusive system of education in schools. An initial survey conducted to identify sample inclusive schools showed that inclusive…

Study of short term memory status in adult bipolar disorder patients in south Indian population.

PubMed

Aslam, Mohammed; Siddiq, Mohamed; Dhundasi, Salim A; Das, Kusal K; Kulkarni, B R

2011-01-01

The present study was undertaken to establish short term memory status in bipolar disorder cases as compared with normal age and sex matched control group in Bijapur (Karnataka). Results showed that a significant decrease in short term memory status in bipolar disorder cases as compared to their control group .Loss of attention, decreased processing speed and executive function patterns may be the probable causes of such observations.

Incidence of Low Body Mass Index in the Elderly in Forensic Cases-A Possible Marker for Frailty Syndrome?

PubMed

Byard, Roger W; Bellis, Maria

2016-05-01

Diagnosing frailty syndrome at autopsy may be difficult if no adequate clinical history is provided. As low body mass index (BMI) may be associated with frailty in the elderly, the following study was undertaken to determine the percentage of medicolegal cases with BMIs < 18.5 in decedents aged over 75 years. Review was undertaken over three time periods: January to December 1986, January to December 2006, and January to December 2012. In 1986, 16% (15 of 93) of individuals aged ≥75 years had BMIs < 18.5, in 2006, 15% (50 of 336), and in 2012, 13% (35 of 274). In no case was frailty syndrome mentioned. This study demonstrates that frailty syndrome appears to be an underappreciated diagnosis in forensic practice despite a significant percentage of elderly decedents (13-16% over a 27-year period) having low BMIs. Prospective assessment of this group is required to determine the incidence and contribution to mortality of frailty syndrome in a forensic context. © 2016 American Academy of Forensic Sciences.

A Market Case Study of Telecourse Promotion.

ERIC Educational Resources Information Center

Market Facts, Washington, DC.

A study was undertaken in 1981 to evaluate the telecourse campaign supported through the Corporation for Public Broadcasting (CPB) and the Public Broadcasting Service (PBS). This report contains a summary of promotional strategies used in six selected markets and an evaluation of the effectiveness of these strategies. The objectives of the study…

Implementing Competence Frameworks in Mexico

ERIC Educational Resources Information Center

de Anda, Maria Luisa

2011-01-01

This article is based on the Mexican case study undertaken as part of the comparative study of the implementation and impact of National Qualifications Frameworks (NQF). Even though Mexico does not have a comprehensive NQF, the country has considerable experience in the development of labour competence technical standards; these share some aims…

Building Inclusive Processes for School Improvement: A Case Study

ERIC Educational Resources Information Center

Arnaiz, Pilar; Escarbajal, Andrés; Guirao, José Manuel; Martínez, Rogelio

2016-01-01

This paper presents a study carried out in a nursery and primary school in order to ascertain the level of self-assessment undertaken by teachers with respect to their educational processes using the "ACADI" instrument, "School-based self-assessment of diversity awareness from an inclusive approach." The objective was to…

Administrative Leadership and Effective Small-Rural Schools: A Comparative Case Study.

ERIC Educational Resources Information Center

Jacobson, Stephen L.

A study of two neighboring rural school districts in New York State was undertaken to determine if differences in educational quality existed between the two communities--Applegate and Bakerville--and to identify factors affecting educational quality. Comparison of demographic and socioeconomic characteristics included racial and ethnic…

Study Service: A Tool of Innovation in Higher Education. Papers on Higher Education, No. 6.

ERIC Educational Resources Information Center

Monal, Isabel; And Others

Case studies of study service activities (activities that adapt higher education more closely to the community) are examined. The document describes 21 such studies, one from each of 21 countries, undertaken by college students in the community. Background information is included on the origin, conditions, and need for study service in higher…

Large outbreak of salmonella phage type 1 infection with high infection rate and severe illness associated with fast food premises.

PubMed

Giraudon, I; Cathcart, S; Blomqvist, S; Littleton, A; Surman-Lee, S; Mifsud, A; Anaraki, S; Fraser, G

2009-06-01

To describe the epidemiology of an outbreak of Salmonella enteritidis phage type 1 (PT1) infection associated with a fast food premises, and to identify the causative factors leading to an acute outbreak with high attack rate and severe illness including hospital admission. Integrated descriptive study of epidemiology, food and environmental microbiology, and professional environmental health assessment, supplemented by a case-case analytical study. Cases were identified through multiple sources and were interviewed to identify food items consumed. Descriptive epidemiology of all cases and a case-case analytical study of risk factors for severe illness were undertaken. Microbiological investigation included analysis and typing of pathogens from stools, blood and environmental surfaces. Professional environmental heath assessment of the premises was undertaken. S. enteritidis PT1 was recovered from two-thirds of faecal samples. Three cases had dual infection with enterotoxin-producing Clostridium perfringens. S. enteritidis PT1 was isolated from 14 of 40 food samples examined and C. perfringens was isolated from eight food samples. Environmental health inspection of the premises revealed multiple deficiencies, including deficits in food preparation and hygiene consistent with multiple cross-contamination, and time-temperature abuse of sauces widely used across menu items. Severe cases were associated with consumption of chips and salad. Outbreaks from fast food premises have been infrequently described. This outbreak demonstrates the potential for fast food premises, with multiple deficiencies in food preparation and hygiene, to produce large, intense community outbreaks with high attack rates and severe illness, highly confined in space and time.

Factors Influencing Students' Choice of Study Mode: An Australian Case Study

ERIC Educational Resources Information Center

Ifenthaler, Dirk; Gosper, Maree; Bailey, Matthew; Kretzschmar, Mandy

2014-01-01

Despite the expansion of online and blended learning, as well as open education, little research has been undertaken on what motivates students to enrol in particular study modes at university level. This project addresses this gap in higher education research by exploring the reasons why humanities students choose to study through specific modes.…

Trauma-related pathological dissociation in a case with cerebral palsy.

PubMed

Fung, Hong Wang

2016-01-01

This article provides a case report of a Chinese-Cantonese female with both cerebral palsy and dissociative identity disorder. To my knowledge, this is the first report of a case with dissociative identity disorder from Hong Kong, as well as the first report of a case with both dissociative identity disorder and cerebral palsy in the literature. Large-sample studies should be undertaken in the future to investigate the prevalence of dissociative disorders in a variety of populations in Hong Kong, including individuals with diagnosed brain diseases.

Case Studies in Science Education, Booklet X: Vortex as Harbinger.

ERIC Educational Resources Information Center

Hoke, Gordon

This booklet is the eleventh of a series of 16 booklets that together describe and present findings for a study which involved field observations and a survey of science teaching and learning in American public schools during the school year 1976-77. The study was undertaken to provide the National Science Foundation with a portrayal of current…

Assessment of Professional Training Programmes in International Agricultural Research Institutions: The Case of ICRAF

ERIC Educational Resources Information Center

Wanjiku, Julliet; Mairura, Franklin; Place, Frank

2010-01-01

The following survey was undertaken in 2005 to assess the effectiveness of professional training activities in international agricultural research organizations that were undertaken between 1999 and 2002 at ICRAF (International Centre for Research in Agroforestry), now World Agroforestry Centre, Nairobi. Trainees were randomly selected from…

Spatial Variability of Mercury Wet Deposition in Eastern Ohio: Summertime Meteorological Case Study Analysis of Local Source Influences

EPA Science Inventory

Extensive exploration of event precipitation data in the Ohio River Valley indicates that coal combustion emissions play an important role in mercury (Hg) wet deposition. During July-September 2006, an intensive study was undertaken to discern the degree of local source influence...

Knowledge to Action: Scholarship for Faculty and Staff

ERIC Educational Resources Information Center

Ratnapalan, Savithiri

2009-01-01

Introduction: This study was undertaken to evaluate the influence of a continuing education course in facilitating the development and implementation of educational projects of course participants. Methods: This is a case study evaluating a full-year course that consisted of 11 monthly seminars, each 4 hours in length, including practice in a…

Music as Post-Traumatic Discourse: Nikolay Myaskovsky's Sixth Symphony

ERIC Educational Resources Information Center

Zuk, Patrick

2018-01-01

This essay explores ways in which musicologists might extend work undertaken by humanities scholars in the interdisciplinary field of trauma studies that has highlighted the centrality of traumatic experience to modernist creativity. It is focussed around a case study of a musical composition that represents the emotional aftermath of a traumatic…

Improving Course Completions in Distance Education: An Institutional Case Study

ERIC Educational Resources Information Center

Thistoll, Tony; Yates, Anne

2016-01-01

This article reports two studies undertaken at The Open Polytechnic of New Zealand, a vocational distance education (DE) provider, where course completion rates have risen to match those of face-to-face technical institutions. A simple model of student engagement is presented, which reflects the triality between the student, institution, and…

Exploring Conditions for Transformative Learning in Work-Integrated Education

ERIC Educational Resources Information Center

McRae, Norah

2015-01-01

A qualitative study was undertaken that explored the conditions for transformative learning in cooperative education as a form of work-integrated learning (WIL), towards the development of a theoretical model. Four case studies were analyzed based on interviews with WIL students, supervisors and their co-op coordinator. The findings revealed that…

A Case Study of Employee Engagement: Distributed Leadership Constructs within Higher Education

ERIC Educational Resources Information Center

Garti, Richard

2017-01-01

Distributed leadership for learning and teaching is an approach in which collaborative working is undertaken between individuals who trust and respect each other's contribution. During the past 10 years, the idea of distributed leadership has emerged through the theory and practice within organizations. The specific problem this study addressed is…

Profile of a Museum Registrar: CASE Research Project 7-78.

ERIC Educational Resources Information Center

Hoachlander, Marjorie E.

This book represents the first independent research study directed toward the educational needs and interests of museum registrars to be undertaken by a university in collaboration with a nationally recognized museum. The study's primary objective was to provide data to be used for the development of materials and methods in the training and…

Half Century of Marriage: Continuity or Change?

ERIC Educational Resources Information Center

Weishaus, Sylvia; Field, Dorothy

Current research focusing on long-term marriages have assessed marriages at one time period only. To sort out age and stage differences from cohort effects, a longitudinal case study analysis was undertaken with the 17 surviving couples of the Berkeley Older Generation Study, a group that has been interviewed in young adulthood (1929-30), in…

Formal Service Practitioners' Views of Family Caregivers' Responsibilities and Difficulties

ERIC Educational Resources Information Center

Guberman, Nancy; Lavoie, Jean-Pierre; Pepin, Jacinthe; Lauzon, Sylvie; Montejo, Maria-Elisa

2006-01-01

This article identifies home care practitioners' perceptions of the responsibilities, difficulties, and needs for support of caregivers. It is based on a study undertaken in Quebec with 55 practitioners and 10 administrators from 10 CLSCs located in rural, urban, and metropolitan areas. The study had a qualitative, multiple-case design and used…

How clinical rationing works in practice: A case study of morbid obesity surgery.

PubMed

Owen-Smith, Amanda; Donovan, Jenny; Coast, Joanna

2015-12-01

Difficulties in setting healthcare priorities are encountered throughout the world. There is no agreement on the most appropriate principles or methods for healthcare rationing although there is some consensus that it should be undertaken as systematically and accountably as possible. Although some steps towards achieving accountability have been made at the macro and meso level, at the consultation level rationing remains implicit and poorly understood. Using morbid obesity surgery as a case study, we observed a series of UK National Health Service consultations where rationing was ongoing and conducted in-depth interviews with doctors and patients (2011-2014). A longitudinal approach was taken to research and in total 22 consultations were observed and 78 interviews were undertaken. Sampling was undertaken purposively and theoretically and analyses were undertaken thematically. Clinicians needed to prioritise 55 patients from 450 eligible referrals, but disagreed over the extent to which clinical and financial factors were the driving force behind decision-making. The most prominent rationing technique observed in consultations was rationing by selection, but examples of rationing by delay, by deterrence, and by deflection were also commonplace. Although all clinicians sought to avoid rationing by denial, only six of the 22 patients recruited to the research were known to have been treated at the end of the three-year period. Most clinicians sought to manage rationing implicitly, and only one explained the link between decision-making criteria and financial constraints on care availability. Although existing frameworks for categorising NHS rationing techniques were useful in identifying implicit strategies, in practice these techniques over-lapped substantially and we have proposed a simpler framework for analysing NHS rationing decisions at the consultation level, which includes just three categories - rationing by exclusion, rationing by deterrence, and rationing by delay. Copyright © 2015. Published by Elsevier Ltd.

Combining a Behavioral Approach with Reality Therapy

ERIC Educational Resources Information Center

Gronert, Richard R.

1970-01-01

Two comprehensive case studies present the careful use of a Time Out" approach to behavior modification with elementary school students. These sessions should be undertaken only under supervision of the school psychologist since a Time Out" can produce damaging psychological effects if used indiscriminately. (CJ)

An exploratory investigation of sexual health screening in the first 12 weeks of case management in populations with severe mental illness.

PubMed

Corbett, Rebecca; Elsom, Stephen; Sands, Natisha; Prematunga, Roshani

2017-04-01

The sexual health of people with mental illness is commonly overlooked, neglected or inadequately addressed in mental health care, despite evidence showing that people with severe mental illness are more vulnerable to sexually transmitted infections (including HIV), sexual side-effects, and sexual dysfunction than the general population. This article reports a study that investigated sexual health screening in five community mental health clinics within a large a regional health service in Victoria, Australia. The aim of the study was to examine the extent to which sexual health screening is currently undertaken on newly admitted case-managed consumers, and to identify the types of screening undertaken. An exploratory design using retrospective file audit was used in the study. A total of 186 medical records met the study inclusion criteria. The study found that less than 40% of consumers were provided with sexual health screening during their first 12 weeks of case management. The study also found that sexual side-effects, issues of fertility, sexual self-esteem, safe sexual practices, and sexual dysfunction were rarely screened for. Poor sexual health screening has implications for the safety and quality of mental health care and requires targeted research to improve understandings and approaches to care. © 2016 Australian College of Mental Health Nurses Inc.

The Instrumental Genesis Process in Future Primary Teachers Using Dynamic Geometry Software

ERIC Educational Resources Information Center

Ruiz-López, Natalia

2018-01-01

This paper, which describes a study undertaken with pairs of future primary teachers using GeoGebra software to solve geometry problems, includes a brief literature review, the theoretical framework and methodology used. An analysis of the instrumental genesis process for a pair participating in the case study is also provided. This analysis…

Needs Analysis in ESP Context: Saudi Engineering Students as a Case Study

ERIC Educational Resources Information Center

Alsamadani, Hashem Ahmed

2017-01-01

Needs analysis can be a vital asset for teachers of English for specific purposes (ESP) to identify their learners' key requirements or needs and determine the areas in which they are lacking skills. Against this background, this study was undertaken during the academic year 2015-16 to define the English language needs of engineering students…

Planning for the Elderly Without Architecture Is Like Architecture for the Elderly Without Planning

ERIC Educational Resources Information Center

Bednar, Michael; And Others

1977-01-01

A joint project between the separate divisions of planning and architecture at the UVA School of Architecture was conducted to allow graduate students to study the environmental needs of the elderly. The case-study approach was undertaken in Lynchburg, Virginia, and the year-long project was seen as a "real World" problem. (LBH)

Assessment of Groups Influence on Management Style as Related to University Governance

ERIC Educational Resources Information Center

Irtwange, S. V.; Orsaah, S.

2010-01-01

The study was undertaken with the objective of assessing groups influence on management style as related to University governance with University of Agriculture, Makurdi as a case study from academic staff perspective. The management style of the Vice Chancellor of the University of Agriculture, Makurdi between the period September 3, 1996 to…

Evaluation Services from Needs Assessment to Follow-up: A Case Study.

ERIC Educational Resources Information Center

Broadbooks, Wendy J.

This paper describes the nature and scope of evaluation services provided within the training division of Arthur Andersen & Company, and highlights some of the evaluation results. The cycle of assessment began with a needs assessment study at the curriculum level. Curriculum planning was undertaken for first-year trainees in the Tax Division.…

Predicting the Adoption of E-Learning Management System: A Case of Selected Private Universities in Nigeria

ERIC Educational Resources Information Center

Nicholas-Omoregbe, Olanike Sharon; Azeta, Ambrose Agbon; Chiazor, Idowu Aigbovo; Omoregbe, Nicholas

2017-01-01

Despite the availability of studies on e-learning management system (eLMS) using information system models, its theoretical foundations have not yet captured social constructs that are peculiar to developing countries including Nigeria. This study was undertaken with the aim of investigating factors that could influence eLMS adoption in higher…

Students' Perceived Learning and Anticipated Future Behaviors as a Result of Participation in the Student Judicial Process

ERIC Educational Resources Information Center

Howell, Martin T.

2005-01-01

This qualitative study was undertaken to explore the meaning that students make of their interactions with campus judicial systems. Using a multiple case study approach, 10 students from 3 institutions in the Southeastern United States were observed and interviewed. The findings presented here relate to students' perceived learning and anticipated…

Mixed Methods in Emerging Academic Subdisciplines: The Case of Sport Management

ERIC Educational Resources Information Center

van der Roest, Jan-Willem; Spaaij, Ramón; van Bottenburg, Maarten

2015-01-01

This article examines the prevalence and characteristics of mixed methods research in the relatively new subdiscipline of sport management. A mixed methods study is undertaken to evaluate the epistemological/philosophical, methodological, and technical levels of mixed methods design in sport management research. The results indicate that mixed…

Prevention of Pica, the Major Cause of Lead Poisoning in Children

ERIC Educational Resources Information Center

de la Burde, Brigitte; Reames, Betty

1973-01-01

Describes a study undertaken to establish a basis for various methods to combat the ingestion of plaster or paint containing lead by children from the lower socio-economic level. Stresses the need for the removal of substandard housing, case-finding, and early treatment of lead poisoning. (Author/SF)

TDEM AND NUMIS (PLUS) SOUNDINGS AT THE ASH MEADOWS NATIONAL WILDLIFE REFUGE: A CASE STUDY

EPA Science Inventory

During the summer of 2002, a cooperative project between the U.S. Geological Survey, the U.S. Environmental Protection Agency, and the Bureau de Recherches Geologiques et Minieres was undertaken to evaluate and gain knowledge of the Iris NUMIS instrument. The system was deployed ...

A Study of Alternative Computer Architectures for System Reliability and Software Simplification.

DTIC Science & Technology

1981-04-22

compression. Several known applications of neighborhood processing, such as noise removal, and boundary smoothing, are shown to be special cases of...Processing [21] A small effort was undertaken to implement image array processing at a very low cost. To this end, a standard Qwip Facsimile

Shared Service Centers and Professional Employability

ERIC Educational Resources Information Center

Rothwell, A. T.; Herbert, I. P.; Seal, W.

2011-01-01

This paper presents case study evidence of evolutionary changes in business support functions resulting in a fundamental hollowing out of the professional space over time and distance, creating the "hourglass" profession. In an IT-enabled, boundaryless world, many professional activities can now be undertaken, in the manner of the Martini slogan,…

Universities' Intermediary Role in the "Design for Sustainability" Field

ERIC Educational Resources Information Center

Küçüksayraç, Elif; Wever, Renee; Brezet, Han

2017-01-01

Purpose: This paper aims to investigate the intermediary role of universities in spreading design for sustainability into industry. Design/methodology/approach: Three case studies were undertaken on Delft University of Technology, Design for Sustainability Program from The Netherlands; a center on sustainable consumption and production; and Prof.…

VET Providers Planning to Deliver Degrees: Good Practice Guide

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2015

2015-01-01

This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…

Predicting agricultural impacts of large-scale drought: 2012 and the case for better modeling

USDA-ARS?s Scientific Manuscript database

We present an example of a simulation-based forecast for the 2012 U.S. maize growing season produced as part of a high-resolution, multi-scale, predictive mechanistic modeling study designed for decision support, risk management, and counterfactual analysis. The simulations undertaken for this analy...

Control of Aedes aegypti Breeding: A Novel Intervention for Prevention and Control of Dengue in an Endemic Zone of Delhi, India

PubMed Central

Nagpal, B. N.; Gupta, Sanjeev Kumar; Shamim, Arshad; Vikram, Kumar; Srivastava, Aruna; Tuli, N. R.; Saxena, Rekha; Singh, Himmat; Singh, V. P.; Bhagat, V. N.; Yadav, N. K.; Valecha, Neena

2016-01-01

Background and objective The study is based on hypothesis that whether continuous entomological surveillance of Ae. aegypti and simultaneous appropriate interventions in key containers during non-transmission (December–May) months would have any impact on breeding of Aedes and dengue cases during the following transmission months (June–November). The impact of the surveillance and intervention measures undertaken during non-transmission months were assessed by entomological indicators namely container index (CI), house index (HI), pupal index (PI) and breteau index (BI). Methods A total of 28 localities of West Zone of Delhi with persistent dengue endemicity were selected for the study. Out of these localities, 20 were included in study group while other 8 localities were in control group. IEC and various Aedes breeding control activities were carried out in study group in both non-transmission and transmission season whereas control group did not have any such interventions during non-transmission months as per guidelines of MCD. These activities were undertaken by a team of investigators from NIMR and SDMC, Delhi. In control group, investigators from NIMR carried out surveillance activity to monitor the breeding of Aedes mosquito in localities. Results Comparison of baseline data revealed that all indices in control and study group of localities were comparable and statistically non-significant (p>0.05). In both study and control groups, indices were calculated after pooling data on seasonal basis, i.e., transmission and non-transmission months for both years. The test of significance conducted on all the four indices, i.e., HI, PI, CI, and BI, revealed a significant difference (p<0.05) between the study group and control group during transmission and non-transmission months except in HI. Due to consistent intervention measures undertaken in non-transmission months in study group, reduction in CI, HI, BI and PI was observed 63%, 62%, 64% and 99% respectively during transmission months as compared to control group where increase of 59%, 102%, 73% and 71% respectively. As a result of reduction in larval indices, no dengue case (except one NS1) was observed in study group, whereas 38 dengue cases were observed in control group. Conclusion Through this pilot study, it is concluded that proper intervention in non-transmission season reduces vector density and subsequently dengue cases in transmission season. PMID:27918577

Control of Aedes aegypti Breeding: A Novel Intervention for Prevention and Control of Dengue in an Endemic Zone of Delhi, India.

PubMed

Nagpal, B N; Gupta, Sanjeev Kumar; Shamim, Arshad; Vikram, Kumar; Srivastava, Aruna; Tuli, N R; Saxena, Rekha; Singh, Himmat; Singh, V P; Bhagat, V N; Yadav, N K; Valecha, Neena

2016-01-01

The study is based on hypothesis that whether continuous entomological surveillance of Ae. aegypti and simultaneous appropriate interventions in key containers during non-transmission (December-May) months would have any impact on breeding of Aedes and dengue cases during the following transmission months (June-November). The impact of the surveillance and intervention measures undertaken during non-transmission months were assessed by entomological indicators namely container index (CI), house index (HI), pupal index (PI) and breteau index (BI). A total of 28 localities of West Zone of Delhi with persistent dengue endemicity were selected for the study. Out of these localities, 20 were included in study group while other 8 localities were in control group. IEC and various Aedes breeding control activities were carried out in study group in both non-transmission and transmission season whereas control group did not have any such interventions during non-transmission months as per guidelines of MCD. These activities were undertaken by a team of investigators from NIMR and SDMC, Delhi. In control group, investigators from NIMR carried out surveillance activity to monitor the breeding of Aedes mosquito in localities. Comparison of baseline data revealed that all indices in control and study group of localities were comparable and statistically non-significant (p>0.05). In both study and control groups, indices were calculated after pooling data on seasonal basis, i.e., transmission and non-transmission months for both years. The test of significance conducted on all the four indices, i.e., HI, PI, CI, and BI, revealed a significant difference (p<0.05) between the study group and control group during transmission and non-transmission months except in HI. Due to consistent intervention measures undertaken in non-transmission months in study group, reduction in CI, HI, BI and PI was observed 63%, 62%, 64% and 99% respectively during transmission months as compared to control group where increase of 59%, 102%, 73% and 71% respectively. As a result of reduction in larval indices, no dengue case (except one NS1) was observed in study group, whereas 38 dengue cases were observed in control group. Through this pilot study, it is concluded that proper intervention in non-transmission season reduces vector density and subsequently dengue cases in transmission season.

Protective effect of intradermal BCG against leprosy; a case-control study in central Brazil.

PubMed

Rodrigues, M L; Silva, S A; Neto, J C; de Andrade, A L; Martelli, C M; Zicker, F

1992-09-01

A case-control study was undertaken to evaluate the protective efficacy of intradermal BCG against leprosy in a high-endemic area of leprosy in central Brazil. Sixty-two cases and 186 controls were included in the study. Cases were all newly diagnosed leprosy patients under 16 years of age attending an outpatient health service, and all of them were schoolchildren. Three controls under 16 years old, frequency matched by sex and age group, were selected from schools geographically located in the area from which the cases came. The presence of BCG was negatively associated with leprosy, indicating a 5.3 risk of leprosy for those nonvaccinated and protective efficacy of 81%. Paucibacillary patients were more likely to have a BCG scar than multibacillary patients.

A systematic review and cost-effectiveness analysis of tonometer disinfection methods.

PubMed

Omar Akhtar, Ahmad; Singh, Hargurinder; Si, Francie; Hodge, William G

2014-08-01

The Goldmann applanation tonometer presents the problem of being one of the most widely used pieces of equipment in the ophthalmic clinic and a known risk factor for the transmission of epidemic keratoconjunctivitis (EKC). The purpose of this review is to assess the effectiveness of 3 methods of disinfection: alcohol swabs, immersion in peroxide, and the use of disposable prisms. An economic evaluation is undertaken to assess the cost-effectiveness of the 3 alternatives. In doing so, we contribute an evidence-based overview of the issue at an opportune time, because several jurisdictions are developing protocols regarding tonometer tip disinfection. Systematic review and cost-effectiveness analysis. A comprehensive literature review was undertaken with a librarian, comprising searches of 6 electronic databases and hand searches of the grey literature. A 3-level screening process was undertaken by 2 reviewers according to prespecified inclusion and exclusion criteria. Values from included papers were used to inform a cost-effectiveness analysis undertaken using a decision tree model implemented in TreeAge. The analysis was undertaken from the hospital perspective and included all equipment and labour costs. Synthesis of in vitro data indicates that all 3 methods are plausible methods of disinfection with a 64% reduction in log growth of EKC when peroxide is used compared with alcohol swabs. The incremental cost-effective ratios from the cost-effectiveness analysis were $12,000/case averted using peroxide and $61,000/case averted with Tonosafe as compared with alcohol. Assuming clinical infection rates match in vitro disinfection data, the cost of bleach is high and the cost of Tonosafe is unacceptably high to reduce 1 potential case of adenoviral keratoconjunctivitis. Copyright © 2014. Published by Elsevier Inc.

Energy-efficient building design in cold climates: Schools as a case study

NASA Astrophysics Data System (ADS)

Rangel Ruiz, Rocio

Buildings account for great amounts of greenhouse gas emissions. In terms of energy, buildings account for one third of the total amount of energy used in the country every year! Schools account for 14 percent of the energy used annually in commercial and institutional buildings. Further, schools are one of the most commonly constructed building types in Canada and spaces such as classrooms are often duplicated. This makes them preferred candidates for the research that was undertaken where energy-efficient solutions that can be transferred to different school designs were derived. Throughout the study, the Commercial Building Incentive Program (CBIP) was used as a benchmark. The objectives of the study were to demonstrate energy-efficient concepts, provide a case study to evaluate solutions, develop typological models and provide an understanding of the innovation process. The technological and societal aspects of the energy-efficient design were addressed. With respect to the technological aspects, the first step was the analysis of conventional design using a school in Calgary as a case study. The optimization of conventional design was undertaken using computer modeling to identify best practice solutions. Aspects that were included in the studies were lighting design, envelope characteristics, HVAC systems and building plant systems. The inclusion of passive design included the analysis of daylighting and natural ventilation. Computer modeling was used to assess daylighting in classrooms with unilateral and bilateral daylighting. Illuminance levels, glare and light distribution were evaluated. The study of natural ventilation was undertaken using literature review. Airflow and outdoor temperatures were the focus to identify solutions that could be incorporated into the design of classrooms. It was concluded that achieving excellence in energy efficiency in schools could be achieved using readily available technologies. Energy savings of up to 63 percent better than Canada's Model National Energy Code for Buildings (MNECB) reference case and utility cost savings of 30,000 (on a 50,000 annual cost) were achieved through conventional design optimization. Additional energy savings of three percent and utility cost savings of $7,000 were seen when passive strategies were included in the design. With respect to the societal aspects, an exploratory research study was undertaken to examine innovation. Architects and energy consultants were interviewed. All design professionals included in the study had participated in projects approved for a grant under CBIP. The purpose of the study was to identify drivers and barriers to energy efficiency. The study demonstrated that external and internal innovation pressures have a significant effect on whether or not the technology is adopted. Suggestions for reducing barriers and further promoting energy efficiency are discussed in this thesis. It is expected that the research will not only aid designers in assessing projects with regard to local priorities, but will also provide building guidelines that serve as tools for the development of the Canadian energy compliance for CO2 emissions.

Establishing the Role and Impact of Academic Librarians in Supporting Open Research: A Case Study at Leeds Beckett University, UK

ERIC Educational Resources Information Center

Bower, Kirsty; Sheppard, Nick; Bayjoo, Jennifer; Pease, Adele

2017-01-01

This practical article presents findings of a small scale study undertaken at a large U.K. University. The purpose of the study was to encourage academic engagement with Open Access (OA) and the Higher Education Funding Council for England (HEFCE) mandate with the measurable impact being increased engagement with the Repository and dissemination…

An Exploration of Comfort and Discomfort amongst Children and Young People with Intellectual Disabilities Who Depend on Postural Management Equipment

ERIC Educational Resources Information Center

Lyons, Elizabeth A.; Jones, Diana E.; Swallow, Veronica M.; Chandler, Colin

2017-01-01

Background: The natural response to the intrusive bodily sensation is positional change. This study explored how children and young people (CYP) with intellectual disabilities had their comfort needs met when using adaptive positioning equipment. Methods: Thirteen qualitative case studies were undertaken. A parent, a teacher/key worker and a…

"Education at Our School Is Not Free": The Hidden Costs of Fee-Free Schooling in Rwanda

ERIC Educational Resources Information Center

Williams, Timothy P.; Abbott, Pamela; Mupenzi, Alfred

2015-01-01

As primary school enrolment rates in Rwanda near ubiquity, completion rates remain low and repetition rates remain high. This study investigates the impact of the "hidden costs" of schooling in the context of Rwanda's fee-free education policy. Using a social-science case study, focus groups and interviews were undertaken with 200…

Physical Activity in Schools: A Qualitative Case Study of Eight Norwegian Schools' Experiences with the Implementation of a National Policy

ERIC Educational Resources Information Center

Larsen, Torill; Samdal, Oddrun; Tjomsland, Hege

2013-01-01

Purpose: Over the past decades numerous policies, programmes and interventions have been undertaken to increase students' participation in physical activity in school. Research shows that intervention effects are mostly related to the way in which the program or policy is implemented, nevertheless, few studies have focused on the implementation…

Gender Differences in Mathematics Achievement and Retention Scores: A Case of Problem-Based Learning Method

ERIC Educational Resources Information Center

Ajai, John T.; Imoko, Benjamin I.

2015-01-01

This study was undertaken to assess gender differences in mathematics achievement and retention by using Problem-Based Learning (PBL). The design of the study was pre-posttest quasi-experimental. Four hundred and twenty eight senior secondary one (SS I) students using multistage sampling from ten grant-aided and government schools were involved in…

49 CFR Appendix I to Subpart B of... - Appendix I to Subpart B of Part 1139

Code of Federal Regulations, 2014 CFR

2014-10-01

... Judge requested a discussion of the feasibility of NBTA undertaking the traffic and cost studies necessary to permit the separation of bus carrier expenses by types of service. As the record in this case indicates, no such studies have ever been undertaken and there is no present capability on the part of...

49 CFR Appendix I to Subpart B of... - Appendix I to Subpart B of Part 1139

Code of Federal Regulations, 2013 CFR

2013-10-01

... Judge requested a discussion of the feasibility of NBTA undertaking the traffic and cost studies necessary to permit the separation of bus carrier expenses by types of service. As the record in this case indicates, no such studies have ever been undertaken and there is no present capability on the part of...

49 CFR Appendix I to Subpart B of... - Appendix I to Subpart B of Part 1139

Code of Federal Regulations, 2011 CFR

2011-10-01

... Judge requested a discussion of the feasibility of NBTA undertaking the traffic and cost studies necessary to permit the separation of bus carrier expenses by types of service. As the record in this case indicates, no such studies have ever been undertaken and there is no present capability on the part of...

49 CFR Appendix I to Subpart B of... - Appendix I to Subpart B of Part 1139

Code of Federal Regulations, 2012 CFR

2012-10-01

... Judge requested a discussion of the feasibility of NBTA undertaking the traffic and cost studies necessary to permit the separation of bus carrier expenses by types of service. As the record in this case indicates, no such studies have ever been undertaken and there is no present capability on the part of...

49 CFR Appendix I to Subpart B of... - Appendix I to Subpart B of Part 1139

Code of Federal Regulations, 2010 CFR

2010-10-01

... Judge requested a discussion of the feasibility of NBTA undertaking the traffic and cost studies necessary to permit the separation of bus carrier expenses by types of service. As the record in this case indicates, no such studies have ever been undertaken and there is no present capability on the part of...

Languaging for Life: African Youth Talk Back to HIV/AIDS Research

ERIC Educational Resources Information Center

Norton, Bonny; Mutonyi, Harriet

2010-01-01

In this article, we present a case study, undertaken in Uganda, in which 12 young people debated and critiqued four research articles on HIV/AIDS relevant to Ugandan youth. The rationale for the study was to provide students with the opportunity to respond to health research that had a direct bearing on their lives. It also complements applied…

Noise Management in Twenty-First Century Libraries: Case Studies of Four U.S. Academic Institutions

ERIC Educational Resources Information Center

Franks, Janet E.; Asher, Darla C.

2014-01-01

University libraries have had to provide acceptable noise levels for many years and this pressure has not diminished in the twenty-first century. Library space has to be utilized to ensure noise levels are best managed. A study was undertaken across four university libraries in South Florida to determine how universities utilized their limited…

Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

PubMed

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

A case study: the initiative to improve RN scheduling at Hamilton Health Sciences.

PubMed

Wallace, Laurel-Anne; Pierson, Sharon

2008-01-01

In 2003, Hamilton Health Sciences embarked on an initiative to improve and standardize nursing schedules and scheduling practices. The scheduling project was one of several initiatives undertaken by a corporate-wide Nursing Resource Group established to enhance the work environment and patient care and to ensure appropriate utilization of nursing resources across the organization's five hospitals. This article focuses on major activities undertaken in the scheduling initiative. The step-by-step approach described, plus examples of the scheduling resources developed and samples of extended-tour schedules, will all provide insight, potential strategies and practical help for nursing administrators, human resources (HR) personnel and others interested in improving nurse scheduling.

Iraq: Recent Developments in Reconstruction Assistance

DTIC Science & Technology

2005-03-23

Developments in Reconstruction Assistance Summary Large-scale reconstruction assistance programs are being undertaken by the United States following the war...currently the case. The House approved the measure on March 16. On June 28, 2004, the entity implementing assistance programs , the Coalition Provisional...Large-scale reconstruction assistance programs are being undertaken by the United States in Iraq. This report describes recent developments in this

Incorporating the Aesthetic Dimension into Pedagogy

ERIC Educational Resources Information Center

Webster, R. Scott; Wolfe, Melissa

2013-01-01

This paper reports on a case study that was undertaken to discover not only the belief and intent behind the everyday opportunities that four exemplary teachers offered their high performing students but what activities they incorporated into their everyday lessons in an attempt to make sense of how aesthetic experiences may enhance learning. The…

Student Engagement in Distance-Based Vocational Education

ERIC Educational Resources Information Center

Yates, Anne; Brindley-Richards, Wendy; Thistoll, Tony

2014-01-01

Students enrolled in distance education courses tend to have lower course completion rates than those who attend face-to-face classes (Simpson, 2013). This article reports on a collective case study undertaken at a vocational, distance education provider in New Zealand, whose course completion rates have risen over recent years to match those of…

The Mammoth-June Ecosystem Management Project, Inyo National Forest

Treesearch

Connie Millar

1996-01-01

The Sierra Nevada Ecosystem Project (SNEP) case-study assessmentof the Mammoth-June Ecosystem Management Project(MJEMP) was undertaken to review and analyze the efficacy of alocal landscape analysis in achieving ecosystem-management objectivesin the Sierra Nevada. Of primary interest to SNEP was applicationof the new U.S. Forest Service (USFS) regional process...

Provider Perspectives on Adopting and Using Collaborative Consultation in Natural Environments

ERIC Educational Resources Information Center

Salisbury, Christine L.; Woods, Juliann; Copeland, Christina

2010-01-01

An exploratory case study was undertaken to investigate the perspectives and experiences of six early intervention providers as they adopted and implemented a collaborative consultation approach to home visiting in urban neighborhoods. Survey, semistructured interview, and focus group methods were used over a 2-year period to obtain data about…

Maternal Thinking and Beyond: Towards a Care-Full Pedagogy for Early Childhood

ERIC Educational Resources Information Center

Luff, Paulette; Kanyal, Mallika

2015-01-01

This paper explores feminist philosopher Sara Ruddick's concept of "maternal thinking" and considers the applicability and use of her ideas for early childhood pedagogy. This is illustrated through a small-scale case study, undertaken in early years settings in England, in which three dimensions of maternal thinking are evidenced in the…

Does the Availability of Vocational Qualifications through Work Assist Social Inclusion?

ERIC Educational Resources Information Center

Smith, Erica; Smith, Andy

2011-01-01

Purpose: The purpose of this paper is to discuss whether the availability of qualifications through work-based traineeships in Australia assists social inclusion. Design/methodology/approach: Industry case studies, of the finance and cleaning industries, were undertaken as part of a national research project on quality in traineeships. The two…

The Cultural Understanding of Inclusion and Its Development within a Centralised System

ERIC Educational Resources Information Center

Strogilos, Vasilis

2012-01-01

This paper discusses inclusion in relation to centralised systems, in particular the constraints central control makes upon decisions at school level. The discussion is empowered by an evaluative case study research undertaken to understand the development of inclusion in contexts where flexible teaching and curriculum change are sometimes hard to…

Environmental Assessment: A Case Study of New York City.

ERIC Educational Resources Information Center

Lowenthal, David; Riel, Marquita

A project undertaken to advance the systematic analysis of public responses, attitudes, opinions, preferences, and values relating to the environment is discussed in this report, the first in a series of eight. The reports fall into two general categories: five describe and compare responses to representative milieus in New York, Boston, Cambridge…

Framing Literacy Policy: Power and Policy Drivers in Primary Schools

ERIC Educational Resources Information Center

Mills, Colin

2011-01-01

This article is linked to the theme of the special issue through its focus on micropolitical analysis of the changing role of "policy drivers", mediating national policy through interactions with primary school heads and teachers. The central arguments draw on case studies undertaken in two primary schools where changes related to…

GENETIC DIVERSITY AS AN INDICATOR OF ECOSYSTEM CONDITION AND SUSTAINABILITY: UTILITY FOR REGIONAL ASSESSMENTS OF STREAM CONDITION IN THE EASTERN UNITED STATES

EPA Science Inventory

This report documents research undertaken to determine if the theoretical promise of genetic diversity as an ecological indicator is realized in real-world applications. Results of two case studies confirm that genetic diversity is a useful indicator of environmental condition. ...

Exploring Levels of Job Satisfaction among Teachers in Public Secondary Schools in Tanzania

ERIC Educational Resources Information Center

Msuya, Ombeni William

2016-01-01

A case study on the role of extrinsic factors (hygiene factors) and socio-demographic factors in determining job satisfaction among teachers in public secondary schools in Tanzania was undertaken. Biographical variables pertaining to teachers' age, sex, marital status and work experience were investigated to determine whether they had any…

Laptop Classes in Some Australian Government Primary Schools

ERIC Educational Resources Information Center

Fluck, Andrew E.

2011-01-01

Australia was once a world leader for laptop adoption in schools. Now overtaken by extensive roll-outs of laptops in Maine and Uruguay, this paper seeks to explain why this lead was lost. Six case studies of government primary schools were undertaken to gather data about current initiatives. Comparative analysis shows how the potential of…

Enacting Caring Pedagogy in the Infant Classroom

ERIC Educational Resources Information Center

Shin, Minsun

2015-01-01

This single case study was undertaken to explore how an infant head teacher meets the needs of the infants, who express their desire to be cared for, in their caring encounters. Natural daily interactions between infants and the teacher were observed for approximately 10 weeks. Through the qualitative data analysis, the results of this study…

Exploration case studies

NASA Astrophysics Data System (ADS)

Underwood, Jimmy M.

1989-04-01

NASA's Office of Exploration has undertaken four case studies for prospective expansion of manned space activities beyond earth orbit. The subjects of these studies are (1) an expedition to the Martian moon Phobos; (2) a three-mission expedition to Mars; (3) the construction of a man-tended lunar observatory; and (4) the construction of a lunar outpost to serve as the basis for construction of a Martian outpost. The fourth alternative would follow the recommendation of the National Commission on Space for the creation of a 'bridge between worlds' in which explorers would develop ways in which to 'live off the land' in a space environment.

Novel ways to explore surgical interventions in randomised controlled trials: applying case study methodology in the operating theatre.

PubMed

Blencowe, Natalie S; Blazeby, Jane M; Donovan, Jenny L; Mills, Nicola

2015-12-28

Multi-centre randomised controlled trials (RCTs) in surgery are challenging. It is particularly difficult to establish standards of surgery and ensure that interventions are delivered as intended. This study developed and tested methods for identifying the key components of surgical interventions and standardising interventions within RCTs. Qualitative case studies of surgical interventions were undertaken within the internal pilot phase of a surgical RCT for obesity (the By-Band study). Each case study involved video data capture and non-participant observation of gastric bypass surgery in the operating theatre and interviews with surgeons. Methods were developed to transcribe and synchronise data from video recordings with observational data to identify key intervention components, which were then explored in the interviews with surgeons. Eight qualitative case studies were undertaken. A novel combination of video data capture, observation and interview data identified variations in intervention delivery between surgeons and centres. Although surgeons agreed that the most critical intervention component was the size and shape of the gastric pouch, there was no consensus regarding other aspects of the procedure. They conceded that evidence about the 'best way' to perform bypass was lacking and, combined with the pragmatic nature of the By-Band study, agreed that strict standardisation of bypass might not be required. This study has developed and tested methods for understanding how surgical interventions are designed and delivered delivered in RCTs. Applying these methods more widely may help identify key components of interventions to be delivered by surgeons in trials, enabling monitoring of key components and adherence to the protocol. These methods are now being tested in the context of other surgical RCTs. Current Controlled Trials ISRCTN00786323 , 05/09/2011.

Why do local authorities undertake controlled evaluations of health impact? A qualitative case study of interventions in housing.

PubMed

Milton, S; Petticrew, M; Green, J

2014-12-01

A significant amount of literature documents the challenges of undertaking evaluative research on the public health impacts of interventions in the non-health sector. However, few studies have investigated why such studies are undertaken despite the undoubted challenges. Taking housing as a case study, the authors aimed to identify the factors contributing to successful evaluative research in the non-health sector. Qualitative interview study. Semi-structured interviews with 16 investigators involved in seven successful experimental studies of housing interventions across the UK, analysed using thematic content analysis. Intervention studies were undertaken when existing collaborative links enabled 'windows of opportunity' to be exploited. Although different 'cultures of evidence' were reported across the collaborating teams, these did not necessarily map onto the public health research/non-academic divide, and did not undermine collaborative work when all parties could gain from taking part in the research. Focussing on success, rather than failure, suggests that to encourage the uptake of evaluative evidence in the non-health sector, efforts might be better directed at fostering opportunities for partnership building rather than simply on educating non-health partners in the principles of academic research. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

CLustre: semi-automated lineament clustering for palaeo-glacial reconstruction

NASA Astrophysics Data System (ADS)

Smith, Mike; Anders, Niels; Keesstra, Saskia

2016-04-01

Palaeo glacial reconstructions, or "inversions", using evidence from the palimpsest landscape are increasingly being undertaken with larger and larger databases. Predominant in landform evidence is the lineament (or drumlin) where the biggest datasets number in excess of 50,000 individual forms. One stage in the inversion process requires the identification of lineaments that are generically similar and then their subsequent interpretation in to a coherent chronology of events. Here we present CLustre, a semi-authomated algorithm that clusters lineaments using a locally adaptive, region growing, method. This is initially tested using 1,500 model runs on a synthetic dataset, before application to two case studies (where manual clustering has been undertaken by independent researchers): (1) Dubawnt Lake, Canada and (2) Victoria island, Canada. Results using the synthetic data show that classifications are robust in most scenarios, although specific cases of cross-cutting lineaments may lead to incorrect clusters. Application to the case studies showed a very good match to existing published work, with differences related to limited numbers of unclassified lineaments and parallel cross-cutting lineaments. The value in CLustre comes from the semi-automated, objective, application of a classification method that is repeatable. Once classified, summary statistics of lineament groups can be calculated and then used in the inversion.

Augmentation plating in management of failed femoral nailing.

PubMed

Verma, Rahul; Sharma, Pulak; Gaur, Sanjiv

2017-08-01

Non-union following interlocking nailing is a troubling complication in treatment of shaft femur fractures. There is no clear consensus on the treatment of this problem. This research was undertaken to study the role of augmentation plating combined with exchange nailing in such cases. A prospective clinical study was undertaken from January 2010 to December 2015. Patients with aseptic femoral shaft non-union, with or without implant failure following intramedullary nailing were included in the study. Augmentation plating combined with Exchange Nailing with a 4.5mm LCP was done. Fifteen patients (nine male and six female) with an average age of 43.7 years (range 18-67 years) were treated. Average timing from the first surgery was 7.3 months. Complete clinical and radiological union was achieved in all cases in a mean duration of 5.2 months. Average duration of follow up was 12.6 months. All the patients retained the preoperative hip and knee range of motion till the last follow up. Augmentation plating combined with exchange nailing in non-unions following intramedullary nailing of femur shaft fractures is a reasonably good and effective procedure with a very high success rate. © 2017 Elsevier Ltd. All rights reserved.

Assessment of Some Atomization Models Used in Spray Calculations

NASA Technical Reports Server (NTRS)

Raju, M. S.; Bulzin, Dan

2011-01-01

The paper presents the results from a validation study undertaken as a part of the NASA s fundamental aeronautics initiative on high altitude emissions in order to assess the accuracy of several atomization models used in both non-superheat and superheat spray calculations. As a part of this investigation we have undertaken the validation based on four different cases to investigate the spray characteristics of (1) a flashing jet generated by the sudden release of pressurized R134A from cylindrical nozzle, (2) a liquid jet atomizing in a subsonic cross flow, (3) a Parker-Hannifin pressure swirl atomizer, and (4) a single-element Lean Direct Injector (LDI) combustor experiment. These cases were chosen because of their importance in some aerospace applications. The validation is based on some 3D and axisymmetric calculations involving both reacting and non-reacting sprays. In general, the predicted results provide reasonable agreement for both mean droplet sizes (D32) and average droplet velocities but mostly underestimate the droplets sizes in the inner radial region of a cylindrical jet.

The Impact of Pecha Kucha Presentations in the Assessment of a Translation Studies Unit at the University of Western Australia

ERIC Educational Resources Information Center

Colombi, Anna Gadd

2017-01-01

Results of a case study on the implementation of Pecha Kucha presentations undertaken at The University of Western Australia in 2015 are presented and discussed here. Pecha Kucha, a fast-paced presentation format consisting of 20 slides set to proceed automatically every 20 seconds, was used in the assessment of the unit "Translation…

Responding to User's Expectation in the Library: Innovative Web 2.0 Applications at JUIT Library: A Case Study

ERIC Educational Resources Information Center

Ram, Shri; Anbu K., John Paul; Kataria, Sanjay

2011-01-01

Purpose: This paper seeks to provide an insight into the implementation of some of the innovative Web 2.0 applications at Jaypee University of Information Technology with the aim of exploring the expectations of the users and their awareness and usage of such applications. Design/methodology/approach: The study was undertaken at the Learning…

Drying firewood in a temporary solar kiln: a case study.

Treesearch

George R. Sampson; Anthony F. Gasbarro

1986-01-01

A pilot study was undertaken to determine drying rates for small diameter, unsplit paper birch firewood that was dried: (1) in a conventional top-covered pile; (2) in a simple, temporary solar kiln; and (3) in tree length. Drying rates were the same for firewood piles whether they were in the temporary solar kilns or only covered on top to keep rain or snow from...

Physiologic study of the terminal digestive tract in chronic painful constipation.

PubMed Central

Meunier, P

1986-01-01

A manometric study of the sigmoid colon and of the anorectum was undertaken in 65 chronically constipated patients complaining of abdominal pain, and in a control group of 23 healthy volunteers. Rectal compliance was tested in both groups. The sigmoid motility study allowed for the segregation of the constipated patients into three groups: hypokinesia (12 cases), normokinesia (34 cases), hyperkinesia (19 cases). Rectal manometry showed anal hypertony in 24 patients, impaired rectal conscious sensitivity in 12 subjects, and normal functions in the remaining cases. The rectal compliance study disclosed a decreased compliance in 15 cases and increased compliance in 13 other patients. In 12 cases disordered sigmoid motility was the only abnormality; in 10 cases only a rectoanal abnormality was found. Most of the patients (52%) exhibited miscellaneous disorders. In contrast, all parameters were normal in nine subjects. No consistent pattern of motility disorders was thus demonstrated in this clinically homogeneous group of patients with chronic, painful, constipation. PMID:3758814

Treatment of spinal fractures with paraplegia.

PubMed

Riska, E B; Myllynen, P

1981-01-01

Of 206 patients with vertebral fractures in the thoraco-lumbar spine with spinal cord injuries, an antero-lateral decompression with stabilization of the injured segment of the vertebral column was undertaken in 56 cases. In all these cases there was a compression of the spinal cord from the front. 8 patients made a complete recovery, 31 a good recovery, and 6 were improved. In 8 patients no improvement was noted. 2 patients developed pressure sores later and 1 patient died one year after the operation of uraemia. 22 patients out of 55 got a normal function of the bladder and 25 patients out of 54 a normal function of the anal sphincter. 16 patients out of 17 made a complete or good recovery after removal of a displaced rotated vertebral bony fragment from the spinal canal, and 7 patients out of 9 with wedge shaped fractures. In our clinic today, in cases of vertebral fractures with neural involvement, reduction and internal fixation with Harrington rods and fusion of the injured segment is undertaken as soon as possible, also during the night. If narrowing of the neural canal and compression of the spinal cord are verified, a decompression operation with interbody fusion is undertaken during the next days.

California: A Case Study in the Loss of Affirmative Action. A Policy Report

ERIC Educational Resources Information Center

Gandara, Patricia

2012-01-01

This paper briefly reviews the various efforts undertaken by the University of California to maintain diversity in the institution, and especially at its highly competitive flagship campuses, UCLA and Berkeley, in the face of the loss of affirmative action during the mid-1990s. It demonstrates the continuing decline in representation of…

Engaging Staff Communities in a Knowledge Transfer Strategy: A Case Study at the University of Melbourne

ERIC Educational Resources Information Center

Goodwill, Robyn J.

2012-01-01

Within the framework of the strategic journey undertaken between 2005 and 2010, this paper seeks to examine how the University of Melbourne sought to differentiate itself through the introduction and reconceptualisation of a "third stream" of academic work. Specifically, this paper seeks to investigate, through qualitative methods, how…

Evaluation of HIV/AIDS Secondary School Peer Education in Rural Nigeria

ERIC Educational Resources Information Center

van der Maas, Frank; Otte, Willem M.

2009-01-01

In this study, we assessed whether peer education is an effective method of HIV/AIDS awareness, in terms of knowledge, misconception and behavior, among adolescents in the rural area of Nigeria. A comparative case series (n = 250), cross-sectional structured survey (n = 135) and focus group discussions (n = 80) were undertaken among adolescents.…

Skill Upgrading within Informal Training: Lessons from the Indian Auto Mechanic

ERIC Educational Resources Information Center

Barber, Jamie

2004-01-01

Informal training is known to be the dominant skill acquisition strategy for the majority of workers in India and many other economically developing countries and there is much benefit in understanding the strengths and weaknesses of this form of training. A participant observation case study was undertaken in northern India to investigate these…

School Culture Meets Sport: A Case Study in New Zealand

ERIC Educational Resources Information Center

Burrows, Lisette; McCormack, Jaleh

2011-01-01

This article draws on ethnographic work undertaken with 21 students and several members of staff at an elite girls' school in New Zealand to investigate the relation between school culture, pedagogical practices and discourses of physical education and school sport. It explores what and who contours the participation of these young women in sport,…

Managing Heuristics as a Method of Inquiry in Autobiographical Graphic Design Theses

ERIC Educational Resources Information Center

Ings, Welby

2011-01-01

This article draws on case studies undertaken in postgraduate research at AUT University, Auckland. It seeks to address a number of issues related to heuristic inquiries employed by graphic design students who use autobiographical approaches when developing research-based theses. For this type of thesis, heuristics as a system of inquiry may…

Mapping WIL Activities in the Curriculum to Develop Graduate Capabilities: A Case Study in Accounting

ERIC Educational Resources Information Center

Natoli, Riccardo; Jackling, Beverley; Kaider, Friederika; Clark, Colin

2013-01-01

Big business continues to request universities to produce graduates who possess both technical and generic skills. Although work-integrated learning (WIL) programs can be used to develop these skills, WIL placements in Australia are undertaken by a minority of students. Perceiving a gap, one Australian university undertook a major WIL revamp to…

Learning Critical Thinking in Saudi Arabia: Student Perceptions of Secondary Pre-Service Teacher Education Programs

ERIC Educational Resources Information Center

Allamnakhrah, Alhasan

2013-01-01

Saudi scholars have been agitating for education reforms to incorporate critical thinking in education programs. This paper is a qualitative case study undertaken at King Abdul Aziz University and Arab Open University and examines students' perception of learning critical thinking in secondary pre-service teacher education programs in Saudi…

Promoting University Students' Engagement in Learning through Instructor-Initiated EFL Writing Groups

ERIC Educational Resources Information Center

Mutwarasibo, Faustin

2014-01-01

This article examines how to promote university students' engagement in learning by means of instructor-initiated English as a foreign language (EFL) writing groups. The research took place in Rwanda and was undertaken as a case study involving 34 second-year undergraduate students, divided into 12 small working groups, and one instructor. The…

Promoting University Students' Collaborative Learning through Instructor-Guided Writing Groups

ERIC Educational Resources Information Center

Mutwarasibo, Faustin

2013-01-01

This paper aims to examine how to promote university students' engagement in learning by means of instructor-initiated EFL writing groups. The research took place in Rwanda and was undertaken as a case study involving 34 second year undergraduate students, divided into 12 small working groups and one instructor. The data were collected by means of…

Motivation and Autonomy in Learning English as Foreign Language: A Case Study of Ecuadorian College Students

ERIC Educational Resources Information Center

Bravo, Jorge Cevallos; Intriago, Eder A.; Holguín, Jhonny Villafuerte; Garzon, Gustavo Molina; Arcia, Luis Ortega

2017-01-01

This quantitative research aims to examine how different levels of motivation relate to frequency of occurrence of autonomous language learning activities undertaken by undergraduate students. Eight hundred and sixty-two college students from 10 vocational training programs of a public university located in Ecuador, South America, participated in…

Literacy in the History Classroom: A Cross Case Analysis of Teacher Implemented Participatory Action Research

ERIC Educational Resources Information Center

D'warte, Jacqueline Ann

2010-01-01

This qualitative study researches a participatory action research project undertaken by 12 history teachers in two urban school districts. In this project middle and high school teachers were engaged in a yearlong action research project that involved them in implementing literacy strategies within their classrooms and reflecting on the use and…

Action Research as a School-Based Strategy in Intercultural Professional Development for Teachers

ERIC Educational Resources Information Center

Sales, Auxiliadora; Traver, Joan A.; Garcia, Rafaela

2011-01-01

Teacher professional development is a key factor for transforming professional and school culture. This article describes a case study undertaken in a Spanish school during the 2007-2008 academic year. Our aim is to explain how action research methodology was applied to encourage professional and school culture towards an intercultural and…

Progress of Infants/Toddlers with Severe Disabilities: Perceived and Measured Change

ERIC Educational Resources Information Center

Salisbury, Christine L.; Copeland, Christina G.

2013-01-01

An exploratory case study was undertaken to examine child and caregiver outcomes in a diverse sample of 21 infants/toddlers with severe disabilities who received services from an urban, Part C program where caregiver-focused intervention was emphasized. Purposive sampling and mixed methods were used to collect data on child developmental change,…

Dialogue--Missing in Action Competence: A Cultural Historical Activity Theory Approach in a Botswana School

ERIC Educational Resources Information Center

Silo, Nthalivi

2013-01-01

An in-depth case study on children's participation in environmental management activities in a primary school in Botswana was undertaken, drawing on cultural historical activity theory (CHAT) and the action competence model. This research revealed that due to a lack of dialogue between teachers and children, teachers tended to view children's…

English for Specific Purposes: A Case Study in an Industrial Setting.

ERIC Educational Resources Information Center

Alexander, Clare

A course outline and sample materials for a course in English for garment workshop employees in New York are presented, and theoretical considerations in establishing an English for specific purposes (ESP) course are explored. Attention is directed to the needs analysis process undertaken in the garment industry. Specifically, ESP is used to mean…

The Shaping of a Gendered School: A Case Study

ERIC Educational Resources Information Center

Shu-Ching, Lee

2014-01-01

Gender education has been emphasized in Taiwan in recent years. Related research undertaken such as textbook reviewing and teachers' gender consciousness has pointed out potential problems in regard to gender in education. The process of shaping gender in a school per se has not yet been explored. This article aims to elaborate on how school…

Undertaking an Institutional "Stock-Take" of SoTL: New Zealand University Case Studies

ERIC Educational Resources Information Center

Haigh, Neil; Gossman, Peter; Jiao, Xiaomin

2011-01-01

A working group was established at AUT University in 2005 with a brief to identify initiatives that might be taken to promote and support staff engagement in the Scholarship of Teaching and Learning (SoTL). The working group recognized that a "stock-taking" exercise would need to be undertaken before appropriate initiatives could be…

The Case for Problem Solving in Second Language Learning. CLCS Occasional Paper No. 33.

ERIC Educational Resources Information Center

Bourke, James Mannes

A study undertaken in Ireland investigated the effectiveness of a second language teaching strategy that focused on grammatical problem-solving. In this approach, the problems are located within the target language system, and the problem-solving involves induction of grammatical rules and use of those rules. Learners are confronted with instances…

Malleable Thought: The Role of Craft Thinking in Practice-Led Graphic Design

ERIC Educational Resources Information Center

Ings, Welby

2015-01-01

This article considers the potential of craft processes as creative engagements in graphic design research. It initially discusses the uneasy history of craft within the discipline, then draws upon case studies undertaken by three established designers who, in their postgraduate theses, engaged with craft as a process of thinking. In doing so, the…

Evolution in Action, a Case Study Based Advanced Biology Class at Spelman College

ERIC Educational Resources Information Center

Pai, Aditi

2009-01-01

The Biology department at Spelman, a historically black women's college has undertaken a major curriculum revision in the last few years. A primary goal of this revision is to increase the breadth of topics in biology classes. Historically, classes in the areas of ecology and evolution have been underrepresented whereas Spelman has always offered…

Subsidizing Infrastructure Investment with Tax-Preferred Bonds. A Joint CBO/JCT Study

ERIC Educational Resources Information Center

Musick, Nathan

2009-01-01

States and localities issue debt to finance projects undertaken by government and, in some cases, by the private sector (bonds issued by states and localities to finance either government operations or certain private-sector activities are known as municipal bonds). The federal government subsidizes the issuance of municipal bonds by offering tax…

The Role of VET in Alcohol and Other Drugs Workforce Development: Survey Technical Report

ERIC Educational Resources Information Center

Pidd, Ken; Carne, Amanda; Roche, Ann

2010-01-01

To examine the effectiveness of vocational education and training qualifications as a workforce development strategy in the community services and health industries, a case study was undertaken of the alcohol and other drug sector. The project comprised of two parts: (1) An online survey to gain an understanding of employer's perceptions of and…

Inclusive Work at a European Level: A Case Study

ERIC Educational Resources Information Center

Stephenson, Paul; Rumley, Glynis

2005-01-01

In this article, Paul Stephenson and Glynis Rumley describe the way in which educators in Kent have developed strong links with their colleagues and neighbours from Nord Pas de Calais in France. From a variety of projects undertaken, some of which were assisted by funding from European sources, children of all abilities and needs have been able to…

Digital Worlds as Sites of Belonging for Third Culture Kids: A New Literacies Perspective

ERIC Educational Resources Information Center

Hannaford, Jeanette

2016-01-01

Literacies developed in digital worlds are part of the out-of-school experiences that students bring into their classrooms every day. This article, which draws from a multiple case study undertaken in an international school, calls on a sociocultural--new literacies approach to explore identity, discourse and space within the online practices of…

Using Mobile Technology to Enhance Undergraduate Student Digital Information Literacy Skills: A Canadian Case Study

ERIC Educational Resources Information Center

Hanbidge, Alice Schmidt; Sanderson, Nicole; Tin, Tony

2015-01-01

Learning essential information literacy skills through the use of mobile phones is an innovative m-learning pilot project that was collaboratively undertaken in a Canadian university college over the course of two academic terms by faculty and the library staff. The research pilot project involved ninety one undergraduate students in five…

Translation Sociology and Social Capital in Rural Development Initiatives. A Case Study from the Italian Alps

ERIC Educational Resources Information Center

Magnani, Natalia; Struffi, Lauro

2009-01-01

This article analyses the results of a European "research and demonstration" project promoting multifunctional and sustainable agriculture in Alpine regions through a participatory approach. It focuses in particular on initiatives undertaken by a local farmers group in the Italian Alpine area of Val di Sole, the purpose being to draw…

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

45 CFR 1609.2 - Definition.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2 Definition. (a) Fee-generating case means any case or matter which, if undertaken on behalf of an eligible...

Emergency nurses' and department preparedness for an ebola outbreak: A (narrative) literature review.

PubMed

Pincha Baduge, Mihirika Sds; Morphet, Julia; Moss, Cheryle

2018-05-01

The 2014 Ebola Virus Disease outbreak in West Africa triggered a public health emergency of international concern. Emergency departments worldwide responded with Ebola containment and preparation measures. This paper reports a literature inquiry into how emergency departments and emergency nurses prepared to manage the Ebola risk. Narrative review was the method used. Guidelines (n = 5) for organisational and emergency department preparedness were retrieved from relevant websites. Searches for primary studies and case reports were undertaken in the MEDLINE and CINAHL databases. After screening and quality appraisal, 20 papers were included in the review. Research and case reports identified 17 different preparedness strategies, and practical interventions for containment undertaken in emergency departments. These included a requirement for surveillance and reporting, Ebola case management, inventory and logistic management, laboratory management, and communication and education. Emergency nurses' personal preparedness was influenced by the emotional readiness, their willingness to care for people at risk of Ebola, and the provision of psychological support. The preparation efforts reported internationally were generally consistent in strategy and intervention. The findings provide guidance for future preparedness strategies by emergency departments in response to threats like Ebola. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Cohort mortality study of North American industrial sand workers. II. Case-referent analysis of lung cancer and silicosis deaths.

PubMed

Hughes, J M; Weill, H; Rando, R J; Shi, R; McDonald, A D; McDonald, J C

2001-04-01

A cohort mortality study of 2670 men in nine North American industrial sand plants resulted in 83 deaths from lung cancer 20 or more years after hire (standardized mortality ratio 139) and 37 deaths from silicosis (including seven from silico-tuberculosis). The lung cancer excess was unrelated to duration of employment and not found in all plants. The primary aim was to determine whether lung cancer risk among these employees was related to quantitative estimates of crystalline silica exposure, after allowance for cigarette smoking. A secondary aim was to do the same for silicosis mortality, partly as a means of validating the estimated levels of exposure. A nested case-referent study was undertaken with cases matched with up to two controls on plant, age and date of first employment from men who survived the case. Exposures were estimated by linking work histories to a job-exposure matrix, undertaken separately. Cigarette smoking information was obtained from medical records and other sources, blind as to case-control status. Matched statistical analyses were conducted using conditional logistic regression. Odds ratios for silicosis mortality were significantly related to cumulative silica exposures and tended to a relationship with category of average crystalline silica concentration, but inconsistently with length of employment. After accounting for a strong effect of cigarette smoking, odds ratios for lung cancer were related to cumulative crystalline silica exposure and to average silica concentration, but not to length of employment. These findings support a causal relationship between lung cancer and quartz exposure after allowance for cigarette smoking, in the absence of cristobalite or other known occupational carcinogens.

Optimal management program for asbestos containing building materials to be available in the event of a disaster.

PubMed

Kim, Young-Chan; Hong, Won-Hwa

2017-06-01

The safe management and disposal of asbestos is a matter of considerable importance. A large number of studies have been undertaken to quantify the issue of waste management following a disaster. Nevertheless, there have been few (if any) studies concerning asbestos waste, covering the amount generated, the cost of disposal, and the degree of hazard incurred. Thus, the current study focuses on developing a program for the management of Asbestos Containing Building Materials (ACBMs), which form the source of asbestos waste in the event of a disaster. The study will also discuss a case study undertaken in a specific region in Korea in terms of: (1) the location of ACBM-containing buildings; (2) types and quantities of ACBMs; (3) the cost of ACBM disposal; (4) the amount of asbestos fiber present during normal times and during post-disaster periods; (5) the required order in which ACBM-containing buildings should be dismantled; and (6) additional greenhouse gases generated during ACBM removal. The case study will focus on a specific building, with an area of 35.34m 2 , and will analyze information concerning the abovementioned points. In addition, the case study will focus on a selected area (108 buildings) and the administrative district (21,063 buildings). The significance of the program can be established by the fact that it visibly transmits information concerning ACBM management. It is a highly promising program, with a widespread application for the safe management and optimal disposal of asbestos in terms of technology, policy, and methodology. Copyright © 2017 Elsevier Ltd. All rights reserved.

Role of intrapartum transcervical amnioinfusion in patients with meconium-stained amniotic fluid.

PubMed

Bhatia, Pushpa; Reena, Kumari; Nangia, Sangita

2013-03-01

The study was undertaken to evaluate maternal, perinatal outcomes following transcervical intrapartum amnioinfusion in women with meconium-stained amniotic fluid. A prospective comparative study was conducted on 100 women with meconium-stained amniotic fluid in labor. Group A: study group (50 cases) received amnioinfusion. Group B: control group (50 cases) did not receive amnioinfusion. FHR monitoring was done using cardiotocography. Significant relief from variable decelerations was seen in 68.18 % cases in the amnioinfusion group as compared to 7.1 % cases in the control group. 78 % cases who were given amnioinfusion had vaginal delivery as compared to 18 % cases in the control group. Fourteen percent cases in the study group had cesarean delivery as compared to 68 % cases in the control group. Meconium aspiration syndrome was seen in six percent neonates in the study group as compared to 20 % in the control group. Two neonates died in the control group due to meconium aspiration syndrome. There was no maternal mortality or major maternal complication. Intrapartum transcervical amnioinfusion is valuable in patients with meconium-stained amniotic fluid.

The treatment of an unstable slipped capital femoral epiphysis by either intracapsular cuneiform osteotomy or pinning in situ: a comparative study.

PubMed

Walton, R D M; Martin, E; Wright, D; Garg, N K; Perry, D; Bass, A; Bruce, C

2015-03-01

We undertook a retrospective comparative study of all patients with an unstable slipped capital femoral epiphysis presenting to a single centre between 1998 and 2011. There were 45 patients (46 hips; mean age 12.6 years; 9 to 14); 16 hips underwent intracapsular cuneiform osteotomy and 30 underwent pinning in situ, with varying degrees of serendipitous reduction. No patient in the osteotomy group was lost to follow-up, which was undertaken at a mean of 28 months (11 to 48); four patients in the pinning in situ group were lost to follow-up, which occurred at a mean of 30 months (10 to 50). Avascular necrosis (AVN) occurred in four hips (25%) following osteotomy and in 11 (42%) following pinning in situ. AVN was not seen in five hips for which osteotomy was undertaken > 13 days after presentation. AVN occurred in four of ten (40%) hips undergoing emergency pinning in situ, compared with four of 15 (47%) undergoing non-emergency pinning. The rate of AVN was 67% (four of six) in those undergoing pinning on the second or third day after presentation. Pinning in situ following complete reduction led to AVN in four out of five cases (80%). In comparison, pinning in situ following incomplete reduction led to AVN in 7 of 21 cases (33%). The rate of development of AVN was significantly higher following pinning in situ with complete reduction than following intracapsular osteotomy (p = 0.048). Complete reduction was more frequent in those treated by emergency pinning and was strongly associated with AVN (p = 0.005). Non-emergency intracapsular osteotomy may have a protective effect on the epiphyseal vasculature and should be undertaken with a delay of at least two weeks. The place of emergency pinning in situ in these patients needs to be re-evaluated, possibly in favour of an emergency open procedure or delayed intracapsular osteotomy. Non-emergency pinning in situ should be undertaken after a delay of at least five days, with the greatest risk at two and three days after presentation. Intracapsular osteotomy should be undertaken after a delay of at least 14 days. In our experience, closed epiphyseal reduction is harmful. Cite this article: Bone Joint J 2015;97-B:412-19. ©2015 The British Editorial Society of Bone & Joint Surgery.

A fatal case of Lassa fever in London, January 2009.

PubMed

Kitching, A; Addiman, S; Cathcart, S; Bischop, L; Krahé, D; Nicholas, M; Coakley, J; Lloyd, G; Brooks, T; Morgan, D; Turbitt, D

2009-02-12

In January 2009, the eleventh [corrected] case of Lassa fever imported to the United Kingdom was diagnosed in London. Risk assessment of 328 healthcare contacts with potential direct exposure to Lassa virus - through contact with the case or exposure to bodily fluids - was undertaken. No contacts were assessed to be at high risk of infection and no secondary clinical cases identified.

A Manual for the Illinois Student Longitudinal Case Study System (ISLCS). Procedures and Materials for Planning and Implementing the ISLCS.

ERIC Educational Resources Information Center

Carvell, Fred; Carvell, Joan B.

Designed for local school and district vocational educators, this manual contains instructions and materials necessary to plan and implement a student longitudinal followup system. Part 1 provides background information and definitions used in the system. In part 2 are described the 11 major activities that must be undertaken by local program…

Using National Surveys To Improve the Efficiency and Effectiveness of Broad-Based Program Evaluations.

ERIC Educational Resources Information Center

Clark, Sheldon B.; Boser, Judith A.

The suggestions offered in this paper are based on the experiences of two scientific researchers of how evaluations undertaken in a competitive arena, in which true experimental designs are not viable, can be designed in such a way that meaningful comparative data can be examined. Case studies of the Science and Engineering Research Semester and…

Moral and Spiritual Education as an Intrinsic Part of the Curriculum

ERIC Educational Resources Information Center

Clifford, Philomena

2013-01-01

This paper reports on a case study undertaken within a small, rural primary school in the UK to explore the extent to which it was possible to run a moral and spiritual programme as an intrinsic and inclusive part of the curriculum based on the children's acquisition of virtues. The pupils were encouraged to build on their own experience and…

Some Learning Outcomes from a Science Programme for Pre-service Primary Teachers Undertaken in the Context of a Developing Country.

ERIC Educational Resources Information Center

Taylor, Neil; Lucas, Keith B.

2001-01-01

Studied the learning outcomes of a science teaching program for preservice teachers in Fiji using quantitative and qualitative techniques. Results for 24 teachers show that students involved in the constructivist pedagogy generally developed a deeper conceptual understanding of the topic, and in some cases these learning outcomes could be linked…

Curriculum and Design Analysis of a Mathematics-Based Educational Television Program: A Case Study of Cyberchase Animated Television Series

ERIC Educational Resources Information Center

Yusop, Farrah Dina

2013-01-01

This paper presents a curriculum and design analyses of an Emmy-award winning children educational television series, Cyberchase. Using Posner's (2004) four process of curriculum analysis framework, this paper addresses each of the components and relates it to the design principles undertaken by the Cyberchase production team. Media and document…

The Critical Success Factors for School and Community (Joint Use) Libraries in New Zealand

ERIC Educational Resources Information Center

Matthews, Vivienne Kaye D.; Calvert, Philip J.

2007-01-01

Joint use libraries in New Zealand are generally found in the form of School and Community Libraries, primarily in rural areas, but there is little information available about their effectiveness or success. Research was undertaken by surveying all identified joint use libraries in New Zealand and then following this with detailed Case Studies of…

Girls in Science and Technology in Secondary and Post-Secondary Education: The Case of France

ERIC Educational Resources Information Center

Stevanovic, Biljana

2014-01-01

Based on surveys undertaken by the Institut national de la statistique et des études économiques (France's National Institute of Statistics and Economic Studies) and by the Direction de l'évaluation de la prospective et de la performance (Directorate of Evaluation, Forecasting and Performance), this article examines the evolution of female student…

Personal Reflections on the Governing of Private Schools: A Case Study

ERIC Educational Resources Information Center

Poultney, Val

2013-01-01

Much of what we understand about school governance is generally under-researched, and there has been almost no recent research undertaken into the governing of schools in the non-maintained, private or independent sectors that are financed by the payment of fees. These schools broadly follow a model of governance that is similar to that of the…

Enhancing the Capacity of Four-Year Postsecondary Educational Institutions to Promote Economic Development. A Report by the Task Force on Education and Economic Development.

ERIC Educational Resources Information Center

Southern Education Foundation, Atlanta, GA.

This report discusses efforts undertaken by the Southern Education Foundation's (SEF) Task Force on Education and Economic Development and summarizes case-study reports of activities at four-year, postsecondary educational institutions in the South to promote economic development. The activities of six institutions were reviewed: Jackson State…

Delivering Integrated Services. Models for Facilitating Change in Small and Mid-Sized Firms. Business Assistance Tools.

ERIC Educational Resources Information Center

Mitchell, Stephen M.

This guide draws on case studies to identify lessons for small and midsized firms who wish to improve the quality of their services and facilitate change. Following an introduction, section 2 describes the context in which the research was undertaken after a needs analysis was conducted of small and midsized businesses and service providers, and…

Investigating habitat value to inform contaminant remediation options: case study

Treesearch

Rebecca A. Efroymson; Mark J. Peterson; Neil R. Giffen; Michael G. Ryon; John G. Smith; William W. Hargrove; W. Kelly Roy; Christopher J. Welsh; Daniel L. Druckenbrod; Harry D. Quarles

2008-01-01

Habitat valuation methods were implemented to support remedial decisions for aquatic and terrestrial contaminated sites at the East Tennessee Technology Park (ETTP) on the US Department of Energy (DOE) Oak Ridge Reservation in Oak Ridge, TN, USA. The habitat valuation was undertaken for six contaminated sites: Contractor’s Spoil Area, K-901-N Disposal Area, K-770...

Including Pupils with Special Educational Needs and Disability in National Assessment: Comparison of Three Country Case Studies through an Inclusive Assessment Framework

ERIC Educational Resources Information Center

Douglas, Graeme; McLinden, Mike; Robertson, Christopher; Travers, Joseph; Smith, Emma

2016-01-01

The assessment of educational progress and outcomes of pupils is important to all concerned with education. This includes testing which is undertaken for accountability and award bearing purposes. This article examines how students with special educational needs and disability (SEND) are included in assessment. An "inclusive assessment"…

What Questions Are We Asking in the Contemporary Children's Literature Classroom?

ERIC Educational Resources Information Center

Abdul Aziz, Fazhuda

2012-01-01

This case study of four B.Ed TESL Overseas Link Degree trainee teachers was undertaken with the intention of discovering what goes on in the classroom in terms of the trainee teachers' classroom interactions in relation to their questioning techniques and responses. This is looked at how much of thinking is being encouraged and how much of the…

Workplace Education Programs in Small and Medium-Sized Michigan Firms. Staff Working Paper 92-13.

ERIC Educational Resources Information Center

Hollenbeck, Kevin; Anderson, William

A project collected data from small and medium-sized firms (employing fewer than 500) in Michigan concerning workplace education programs. It addressed why firms were or were not offering programs, program characteristics, and program impacts on firms and employees. Case studies of 28 businesses were undertaken from May 1991-July 1992 and a…

NEUROBILOGY OF ASPERGER'S SYNDROME : A CASE STUDY AND OVERVIEW

PubMed Central

Duggal, Harpreet S.; Dutta, Siddhartha; Sinha, Vinod K.; Basu, Soumya; Pandey, Smita; Nizamie, Haque S.; Nizamie, Alka

2001-01-01

Asperger's syndrome is an autistic spectrum disorder, which has engendered lesser attention in comparison to autism. Recent literature has focused on the involvement of cortical areas of the brain in this syndrome. We report a case of Asperger′s syndrome in which an extensive work-up, including neuropsychological, neurophysiological and neuroimaging procedures, were undertaken. The findings of the various investigative procedures are discussed and literature supporting the neurobiological basis of Asperger's syndrome is highlighted. Finally, we briefly touch upon the ‘Theory of Mind’ construct in autistic spectrum disorders. PMID:21407867

A retrospective study of owner-requested testing as surveillance for equine infectious anemia in Canada (2009-2012).

PubMed

Higgins, Sara N; Howden, Krista J; James, Carolyn R; Epp, Tasha; Lohmann, Katharina L

2017-12-01

This retrospective study was undertaken to estimate i) the surveillance coverage for equine infectious anemia (EIA) based on owner-requested testing, and ii) the incidence of case detection from this surveillance activity to inform a review of Canada's national disease control strategy. Based on sample submissions by accredited veterinarians to laboratories CFIA-approved for EIA testing between 2009 and 2012, the estimated national surveillance coverage was 14% for all years, and 72 cases of EIA were detected. The annual national incidence of EIA detection ranged from 0.03 to 0.08 cases/1000 horses. On average, a greater proportion of the horse population was tested in eastern Canada (32%) than in western Canada (6%, P < 0.0001). The cumulative incidence of EIA detection was higher in western Canada (0.25 cases/1000 horses) than in eastern Canada (0.02 cases/1000 horses, P < 0.0001). This study identified regional differences in owner-requested EIA testing and case detection resulting from this testing activity.

When the Child Gets in the News? A Case Study on the National Written Media in Turkey

ERIC Educational Resources Information Center

Kus, Zafer; Karatekin, Kadir; Öztürk, Durdane; Elvan, Özlem

2016-01-01

The main purpose of this study is to analyze news stories regarding children in the national print media in the last five years using top eight newspapers in terms of circulation and evaluate these news stories based on the Convention on the Rights of the Child, which was issued by the UN and signed by Turkey. The research was undertaken as a case…

Girls in the UK Have Similar Reasons to Boys for Intending to Study Mathematics Post-16 Thanks to the Support and Encouragement They Receive

ERIC Educational Resources Information Center

Mujtaba, Tamjid; Reiss, Michael

2016-01-01

This paper focuses on the aspirations of 13- and 15-year-olds to continue with mathematics after the age of 16 and the association with perceptions of their mathematics education during the academic year 2008/9. A quantitative analysis was undertaken on the views of 12,176 UK students, obtained through surveys, with qualitative case studies on two…

Increasing uptake rates of cervical cancer screening amongst Hong Kong Chinese women: the role of the practitioner.

PubMed

Twinn, S; Cheng, F

2000-08-01

Women's attendance for regular cervical screening has been identified as a significant factor in the prevention of cervical cancer. Evidence suggests, however, that both extrinsic and intrinsic factors influence women's attendance patterns for screening. Extrinsic factors, in particular the practitioner undertaking the screening procedure, have been shown to influence women's return rates for further screening. In Hong Kong, where uptake rates amongst Chinese women remain comparatively low, a study was undertaken to examine Chinese women's experiences and perceptions of cervical screening undertaken by either a female doctor or nurse. A multiple case study design using both qualitative and quantitative methods of data collection was employed. This paper reports the findings from the qualitative data obtained from 52 women participating in 12 focus group interviews held in the two case studies. Thematic analysis of the data demonstrated the importance of the caring nature, communication skills, experience and expertise of the practitioner to women's attendance pattern for screening. The experience and expertise of the practitioner, described by women as teaching, minimizing pain and discomfort and being considerate, were considered more influential to uptake rates than the professional discipline of the practitioner. Findings such as these indicate the importance of the influence of the practitioner in determining uptake rates for cervical screening amongst this population group.

New-onset asthma after exposure to the steam system additive 2-diethylaminoethanol. A descriptive study.

PubMed

Gadon, M E; Melius, J M; McDonald, G J; Orgel, D

1994-06-01

Through a leak in the steam heating system, the anticorrosive agent 2-diethylaminoethanol was released into the air of a large office building. Irritative symptoms were experienced by most of the 2500 employees, and 14 workers developed asthma within 3 months of exposure. This study was undertaken to review clinical characteristics of these asthmatics. Environmental exposure monitoring data and medical records were reviewed. Seven of 14 cases were defined as "confirmed" and 7 of 14 as "suspect," using the National Institute for Occupational Safety and Health surveillance case definition of occupational asthma. Spirometry was positive in 4 of 14 of the cases and peak flow testing in 10 of 14. Three cases were diagnosed on the basis of work-related symptoms and physical examination alone. The study suggests that acute exposure to the irritating steam additive 2-diethylaminoethanol was a contributing factor in the development of clinical asthma in this population.

The effect of body shape on weight-for-height and mid-upper arm circumference based case definitions of acute malnutrition in Ethiopian children.

PubMed

Myatt, Mark; Duffield, Arabella; Seal, Andrew; Pasteur, Frances

2009-01-01

Nutritional anthropometry surveys from Somalia and Ethiopia have reported that standard weight-for-height z-score (WHZ) and mid-upper arm circumference (MUAC) case definitions return different estimates of the prevalence of acute malnutrition in pastoralist livelihood zones but similar estimates of the prevalence of acute malnutrition in the agrarian livelihood zones. A study undertaken in Somalia to investigate this finding reported that children from pastoralist livelihood zones tended to have longer limbs and lower SSRs than children from agrarian livelihood zones. The present study investigated the relationship between weight-for-height and body shape and the relationship between MUAC and body shape in different populations of Ethiopian children. Six cross-sectional nutritional anthropometry surveys were undertaken. The combined survey datasets form the study sample. Data sources were grouped according to the livelihood zone from which data originated (either settled agrarian or semi-nomadic pastoralist). Case definitions of acute malnutrition using WHZ calculated using the NCHS and WHO reference populations and MUAC uncorrected for age or height were used. The SSR was used as an index of body shape. The association between body shape and the different case definitions of acute malnutrition were investigated using standard statistical techniques. Weight-for-height and MUAC case definitions yielded similar estimates of the prevalence of acute malnutrition in agrarian children but different estimates of the prevalence of acute malnutrition in pastoralist children. These populations also exhibit different SSRs. The SSR is an important predictor of weight-for-height. The SSR is a poor predictor of MUAC. WHZ and WHZ case status in children are associated with body shape and may overestimate the prevalence of acute malnutrition in some populations. Consideration should be given as to whether WHZ should be replaced by MUAC for the purposes of estimating the prevalence of acute malnutrition.

Moving from Case-by-Case Transfer to Formal Articulation: Assessing the Business Case. Research Results

ERIC Educational Resources Information Center

Finlay, Finola; Box, Dale

2008-01-01

Over the last couple of years, the British Columbia (BC) Council on Admissions and Transfer (BCCAT) has undertaken a review of the BC Transfer System. Preliminary findings indicate that the current structure of the BC Transfer Guide, which designates institutions as either sending institutions or receiving institutions based upon their historic…

Laparoscopic resection of an epidermoid cyst within an intrapancreatic accessory spleen: a case report and review article.

PubMed

Harris, Andrew Charles; Chaudry, Mohammed Asif; Menzies, Donald; Conn, Paul Chandler

2012-08-01

We report a case of an epidermoid cyst within an intrapancreatic accessory spleen that was treated by laparoscopic excision. A 39-year-old man with no abdominal symptoms was incidentally found to have a cystic pancreatic lesion on computed tomography scan undertaken for suspected deep vein thrombosis. Further computed tomography and magnetic resonance imaging confirmed similar findings and the laparoscopic resection of the distal pancreas and spleen was undertaken as malignancy could not be excluded. Microscopic analysis revealed a well-circumscribed epidermoid cyst within a thin splenic rim in the tail of the pancreas. Such histologic diagnoses are extremely rare, and this is the 26th case report to our knowledge in English language journals. These lesions should be treated surgically to exclude malignancy. This is the first case reported in the United Kingdom and the first to be excised by pure laparoscopic means, which we believe provides effective and successful surgical management.

Personality and Learning Styles Surrounded by W3 Software: The Macao Portuguese School Case

ERIC Educational Resources Information Center

Negreiros, João; Baptista, Zelia; Lee, Leanda

2014-01-01

One of the purposes of this study is to evaluate how the choice of teaching method can be assisted by knowledge of a student's personality type and learning style. The present research is undertaken in the context of Web 2.0 tools use within the Portuguese literature subject at Escola Portuguesa de Macao (EPM). The Felder-Soloman index of learning…

Teacher and Learner Perceptions on Mobile Learning Technology: A Case of Namibian High Schools from the Hardap Region

ERIC Educational Resources Information Center

Osakwe, Jude Odiakaosa; Nomusa, Dlodlo; Jere, Nobert

2017-01-01

Although the National ICT Policy for Education in Namibia was adopted in 2005, immediately followed by the National ICT Policy Implementation Plan in 2006, no known studies have been undertaken so far to evaluate its implementation. This has made it difficult to ascertain the ICT/mobile learning readiness of teachers and learners. This study…

Use of Data Quality Index in Student Feedback for Quality Assurance of Engineering Programmes at the Military Technological College, Muscat, Oman

ERIC Educational Resources Information Center

Khan, Wasi Uz Zaman; AlAjmi, Abdullah Ahmed Ali; Al Zubaidy, Sarim

2018-01-01

This case study was undertaken to assess the effectiveness of the modifications into the engineering programmes adopted by the Military Technological College (MTC) to satisfy the needs of Omani armed forces. It discusses the role of Quality Assurance (QA) in engineering education and accreditation process in the context of four engineering…

Enthusiasm, Relevance and Creativity: Could These Teaching Qualities Stop Us Alienating Pupils from Science?

ERIC Educational Resources Information Center

Turner, Sarah; Ireson, Gren; Twidle, John

2010-01-01

The poor attitude of pupils towards science continues to be a topic of concern within secondary schools. This article considers research and highlights what we can learn as teachers to persevere in tackling the problem. Alongside this review, a case study was undertaken with a sample of year 7 pupils (ages 11-12) in English schools who reported…

Measuring and managing the environmental cost of coffee production in Latin America

Treesearch

Victor Chavez Arce; Raul Raudales; Rich Trubey; David I. King; Richard B. Chandler; Carlin C. Chandler

2009-01-01

Coffee is a major international commodity, and because of this, coffee production has the potential for considerable global impacts on the environment. These impacts can include the consumption of energy, water, land and the loss of native forest. Here we quantify these costs using Costa Rica as a case study, and describe an initiative undertaken at the Montes de Oro...

Retention and Attrition of Students in Higher Education: Challenges in Modern Times to What Works

ERIC Educational Resources Information Center

Maher, Marguerite; Macallister, Helen

2013-01-01

Retention and attrition rates in higher education have long been a focus of research. This paper presents findings of a single case study, undertaken in a School of Education, which identify important strategies that have led to attrition of five to eight per cent, compared with 18 per cent cross the education sector in Australia (Department of…

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…

Attitudes towards Basque, Spanish and English: An Analysis of the Most Influential Variables

ERIC Educational Resources Information Center

Lasagabaster, David

2005-01-01

The enlargement of the European Union (EU) has strengthened the position of English, a situation which has led some voices to warn against the hegemony of this language. Yet, very few studies have been undertaken in contexts where English is added to the presence of both a minority and a majority language. This is the case of the Basque Autonomous…

Applied PhD Research in a Work-Based Environment: An Activity Theory-Based Analysis

ERIC Educational Resources Information Center

Granata, S. N.; Dochy, F.

2016-01-01

Activity theory is used to compare PhD undertaken at university, that is, academic PhD, with PhD performed in collaboration with industry, that is, semi-industrial PhD. The research is divided into a literature review and a case study. Semi-industrial and academic PhD are modelled as activity systems, and differences are highlighted in terms of…

Aspiration cytology of extramammary tumours metastatic to the breast.

PubMed

Handa, Uma; Chhabra, Seema; Mohan, Harsh

2007-10-01

This study was undertaken to highlight the use of fine needle aspiration cytology (FNAC) to distinguish tumours metastatic to the breast from primary breast malignancies. A total of 1866 fine needle aspirates of the breast were performed during a period of 7 years. Three hundred and fourteen cases of breast malignancies were diagnosed and 5 (1.5%) out of these cases were metastatic in origin. The metastatic tumors included, 2 cases of malignant melanoma (chest wall and left arm), 1 case each of haematolymphoid malignancy, adenocarcinoma of the ovary, and squamous cell carcinoma (left leg). FNA diagnosis of metastasis to the breast is essential in order to avoid unnecessary mastectomy and to ensure appropriate chemotherapy and/or irradiation treatment.

Energy drinks give you wings but also an abnormal exercise test.

PubMed

Choudhury, Tawfiqur R; Abdool, Muhammad A; Galasko, Gavin

2017-07-27

This is the case of a 53-year-old man with known coronary artery disease who underwent two exercise treadmill tests (ETT). The first test, which yielded an abnormal result, was undertaken shortly after he had drunk two cans of Red Bull, a popular energy drink (ED). A second ETT was undertaken 1 week later by the same team without EDs on board and the test result was normal. This case suggests that drinking EDs prior to an ETT could lead to a false positive result and should be discouraged prior to exercise testing. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Childhood pneumonia and meningitis in the Eastern Highlands Province, Papua New Guinea in the era of conjugate vaccines: study methods and challenges.

PubMed

Blyth, Christopher C; Ford, Rebecca; Sapura, Joycelyn; Kumani, Tonny; Masiria, Geraldine; Kave, John; Yuasi, Lapule; Greenhill, Andrew; Hwaihwanje, Ilomo; Lang, Amanda; Lehmann, Deborah; Pomat, William

2017-01-01

Pneumonia and meningitis are common causes of severe childhood illness in Papua New Guinea (PNG). The etiology of both clinical conditions in PNG has not been recently assessed. Changes in lifestyle, provision and access to healthcare, antimicrobial utilization and resistance, and the national childhood vaccination schedule necessitate reassessment. A prospective case-control study was undertaken, enrolling children <5 years of age to determine the contemporary etiology of clinically defined moderate or severe pneumonia or suspected meningitis. Cases were identified following presentation for inpatient or outpatient care in Goroka town, the major population centre in the Eastern Highlands Province. Following enrolment, routine diagnostic specimens including blood, nasopharyngeal swabs, urine and (if required) cerebrospinal fluid, were obtained. Cases residing within one hour's drive of Goroka were followed up, and recruitment of healthy contemporaneous controls was undertaken in the cases' communities. 998 cases and 978 controls were enrolled over 3 years. This included 784 cases (78.6%) with moderate pneumonia, 187 (18.7%) with severe pneumonia and 75 (7.5%) with suspected meningitis, of whom 48 (4.8%) had concurrent pneumonia. The median age of cases was 7.8 months (Interquartile range [IQR] 3.9-14.3), significantly lower than community controls, which was 20.8 months (IQR 8.2-36.4). Half the cases were admitted to hospital (500/998; 50.1%). Recruitment of cases and controls and successful collection of diagnostic specimens improved throughout the study, with blood volume increasing and rates of blood culture contamination decreasing. The overall case fatality rate was 18/998 (1.8%). Of cases eligible for follow-up, outcome data was available from 76.7%. Low but increasing coverage of Haemophilus influenzae type B conjugate vaccines on the national schedule was observed during the study period: three dose DTPw-HepB-Hib coverage in children >3 months increased from 14.9 to 43.0% and 29.0 to 47.7% in cases and controls (both p  < 0.001). Despite inclusion in the national immunization program in 2014, 2015 PCV13 three-dose coverage in cases and controls >3 months was only 4.0 and 6.5%. Recruitment of large numbers of pediatric pneumonia and meningitis cases and community controls in a third-world setting presents unique challenges. Successful enrolment of 998 cases and 978 controls with comprehensive clinical data, biological specimens and follow up was achieved. Increased vaccine coverage remains an ongoing health priority.

Identification, Characterisation and Clinical Development of the New Generation of Breast Cancer Susceptibility Alleles

DTIC Science & Technology

2009-03-01

undertaken to date by some considerable margin . We have genotyped 4000 familial breast cancer cases on the Illumina 670 SNP chip and will be comparing this...apoptosis, and steroid hor- mone metabolism, have rarely been evaluated to this level. Association Studies In an association study, the frequency of...to bias, and utilized too lenient levels of significance, resulting in incon- sistency and lack of replication of findings. The majority of putative

Layers of Oppression and Exclusion in the Context of HIV and AIDS: The Case of Adult and Child Learners in the Richmond District, Province of Kwazulu-Natal

ERIC Educational Resources Information Center

Muthukrishna, Nithi; Ramsuran, Anitha

2007-01-01

This paper emerges out of a larger qualitative study that aimed at mapping barriers to basic education experienced by children and adults in the context of the HIV and AIDS pandemic. The study was undertaken in Richmond district and involved a range of centres of learning (formal and informal) including three high schools, five primary schools,…

An Australian case study of patient attitudes towards the use of computerised medical records and unique identifiers.

PubMed

Bomba, D; de Silva, A

2001-01-01

Research into patient attitudes towards the use of technology in health care needs to be given much greater attention within health informatics. Past research has often focused more on the needs of health care providers rather than the end users. This article attempts to redress this knowledge bias by reporting on a case study of the responses gained from patients in a selected Australian medical practice towards the use of computerised medical records and unique identifiers. The responses (n=138) were gained from a survey of patients over a 13 day period of practice operation. This case study serves as an example of the type of future consumer health informatics research which can be undertaken not just in Australia but also in other countries, both at local regional levels and at a national level.

Domestic Violence and Private Family Court Proceedings: Promoting Child Welfare or Promoting Contact?

PubMed

Macdonald, Gillian S

2016-06-01

Despite improved understanding regarding domestic violence, child welfare and child contact, and related policy developments, problems persist regarding how the family courts deal with fathers' violence in contested contact/residence cases. In the study reported here, analysis was undertaken of welfare reports prepared for the courts in such cases to investigate how and to what extent issues of domestic violence and children's perspectives on these issues were taken into account when making recommendations to the courts. Analysis found that despite evidence of domestic violence and child welfare concerns, contact with fathers was viewed as desirable and inevitable in the vast majority of cases. © The Author(s) 2015.

Rapid amelioration of severe manic episodes with right unilateral ultrabrief pulse ECT: a case series of four patients.

PubMed

Sidorov, Alexey; Mayur, Prashanth

2017-02-01

The aim of this small case series is to describe four cases of severe mania, where ultrabrief pulse electroconvulsive therapy (ECT) was used as a primary mode of treatment. A retrospective file review was undertaken of four patients identified as having received ultrabrief pulse ECT for severe mania. The outcome measures for treatment efficacy were the Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI). All the patients showed significant clinical improvement. A comparison of pre- and post-treatment YMRS and CGI scores showed a dramatic decrease in all four cases. However, one patient was shifted to brief pulse ECT due to inadequate response. Ultrabrief pulse ECT may be an effective treatment in cases of severe mania. Due to the very small number of cases in the current case series, no specific conclusions regarding efficacy may be drawn; however, larger, controlled studies would be indicated.

Epidemiological and laboratory characterization of a yellow fever outbreak in northern Uganda, October 2010-January 2011.

PubMed

Wamala, Joseph F; Malimbo, Mugagga; Okot, Charles L; Atai-Omoruto, Ann D; Tenywa, Emmanuel; Miller, Jeffrey R; Balinandi, Stephen; Shoemaker, Trevor; Oyoo, Charles; Omony, Emmanuel O; Kagirita, Atek; Musenero, Monica M; Makumbi, Issa; Nanyunja, Miriam; Lutwama, Julius J; Downing, Robert; Mbonye, Anthony K

2012-07-01

In November 2010, following reports of an outbreak of a fatal, febrile, hemorrhagic illness in northern Uganda, the Uganda Ministry of Health established multisector teams to respond to the outbreak. This was a case-series investigation in which the response teams conducted epidemiological and laboratory investigations on suspect cases. The cases identified were line-listed and a data analysis was undertaken regularly to guide the outbreak response. Overall, 181 cases met the yellow fever (YF) suspected case definition; there were 45 deaths (case fatality rate 24.9%). Only 13 (7.5%) of the suspected YF cases were laboratory confirmed, and molecular sequencing revealed 92% homology to the YF virus strain Couma (Ethiopia), East African genotype. Suspected YF cases had fever (100%) and unexplained bleeding (97.8%), but jaundice was rare (11.6%). The overall attack rate was 13 cases/100000 population, and the attack rate was higher for males than females and increased with age. The index clusters were linked to economic activities undertaken by males around forests. This was the largest YF outbreak ever reported in Uganda. The wide geographical case dispersion as well as the male and older age preponderance suggests transmission during the outbreak was largely sylvatic and related to occupational activities around forests. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Improving operating theatre efficiency: an intervention to significantly reduce changeover time.

PubMed

Soliman, Bishoy A B; Stanton, Raymond; Sowter, Steven; Rozen, Warren Matthew; Shahbaz, Shekib

2013-07-01

Operating theatre inefficiency and changeover delays are not only a significant source of wasted resources, but also a familiar source of frustration to patients and health-care providers. This study aimed to prove that the surgical registrar through active involvement in patient changeover can significantly improve operating room efficiency and minimize delays. A two-phase prospective cohort study was undertaken, conducted over the course of 4 weeks at a single institution. The only inclusion criteria comprised patients to undertake endoscopic urological day surgery cases and require general anaesthesia. There were no exclusions. In the first phase (observational, with no intervention), changeover times between cases were documented. The second phase followed a structured intervention, involving the surgical registrar being actively involved in the patient's operative journey. Outcome measures were qualitative measures of operative efficiency. Statistical analysis was undertaken. There were 42 patients included in this study, with 21 patients in each of its arms. A 48% (P-value < 0.01) reduction in overall case changeover times was demonstrated with the utilization of a structured intervention from 27.7 min (95% confidence interval (CI) 22.8-32.7%) to 15.7 min (95% CI 13.2-18.2%). The intervention results were statistically significant (P-value < 0.05) for all markers of efficiency except for the waiting time in the anaesthetic holding bay (P-value 0.13). The surgical registrar can improve operating room efficiency by using a structured intervention, ultimately reducing patient changeover times. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Reorienting health services with capacity building: a case study of the Core Skills in Health Promotion Project.

PubMed

Yeatman, H R; Nove, T

2002-12-01

This paper presents a case study of the application of a framework for capacity building [Hawe, P., King, L., Noort, M., Jordens, C. and Lloyd, B. (2000) Indicators to Help with Capacity Building in Health Promotion. NSW Health, Sydney] to describe actions aimed at building organizational support for health promotion within an area health service in New South Wales, Australia. The Core Skills in Health Promotion Project (CSHPP) arose from an investigation which reported that participants of a health promotion training course had increased health promotion skills but that they lacked the support to apply their skills in the workplace. The project was action-research based. It investigated and facilitated the implementation of a range of initiatives to support community health staff to apply a more preventive approach in their practice and it contributed to the establishment of new organizational structures for health promotion. An evaluation was undertaken 4 years after the CSHPP was established, and 2 years after it had submitted its final report. Interviews with senior managers, document analysis of written reports, and focus groups with middle managers and service delivery staff were undertaken. Change was achieved in the three dimensions of health infrastructure, program maintenance and problem solving capacity of the organization. It was identified that the critically important elements in achieving the aims of the project-partnership, leadership and commitment-were also key elements of the capacity building framework. This case study provides a practical example of the usefulness of the capacity building framework in orienting health services to be supportive of health promotion.

Effect of Active Learning Techniques on Students' Choice of Approach to Learning in Dentistry: A South African Case Study

ERIC Educational Resources Information Center

Khan, S.

2011-01-01

The purpose of this article is to report on empirical work, related to a techniques module, undertaken with the dental students of the University of the Western Cape, South Africa. I will relate how a range of different active learning techniques (tutorials; question papers and mock tests) assisted students to adopt a deep approach to learning in…

Vitalizing Creative Learning in Science and Technology through an Extracurricular Club: A Perspective Based on Activity Theory

ERIC Educational Resources Information Center

Hong, Jon-Chao; Chen, Mei-Yung; Hwang, Ming-Yueh

2013-01-01

A case study was undertaken in a junior high school that had won the highest award of the National PowerTech Contest in Taiwan. In the contest, students were required to create their own wooden robot (mechatronics project) in the morning and compete in the afternoon, in order to better avoid the intervention of parents and teachers in the process.…

Co-Constructing an Academic Community Ethos--Challenging Culture and Managing Change in Higher Education: A Case Study Undertaken over Two Years

ERIC Educational Resources Information Center

Robertson, Chris; Robins, Alison; Cox, Robyn

2009-01-01

Early work on change in higher education by Guba and Clarke (1966) suggested that in achieving systematic change in institutions of higher education "there is a difference between what is needed and what is done". The authors, which are the leaders of particular project at the Institute of Education (IoE), University of Worcester, knew…

Factors affecting presentation and delay in patients with testicular cancer: results of a qualitative study.

PubMed

Gascoigne, P; Mason, M D; Roberts, E

1999-01-01

A qualitative study was undertaken with men treated for testicular tumours, to ascertain how they interpreted their symptoms and the factors which influenced a decision to consult a physician. The research was undertaken with six men who had been diagnosed as having testicular tumours. Interviews were also conducted with four wives and one mother. The findings showed that giving men information on testicular cancer may not guarantee early presentation. Symptoms were not generally attributed to cancer and the one patient who practised self-examination had delayed seeking help for 6 months. The extent to which symptoms affected the patient's lifestyle was also a factor in the decision-making process, as was the checking of symptoms with other family members. Wives were often pivotal in persuading men to seek help. The discovery of testicular symptoms produced emotional responses which included embarrassment and fear of both cancer and castration. There was evidence of strong feelings of masculine identity bound up with the appearance of 'normal' genitals. Provider-delay was identified in four cases and was associated with misattribution of symptoms by physicians and the failure to initiate specialist referral. Delay was under-recorded in the hospital notes in all cases where presentation was not immediate.

Subependymomas: a clinicopathological study of 6 symptomatic cases.

PubMed

Limaïem, F; Bellil, S B H; Bellil, K; Chelly, I; Jemel, H; Haouet, S; Khaldi, M; Zitouna, M; Kchir, N

2008-10-01

Subependymomas are rare, slow-growing, ependymal neoplasms that commonly occur in the fourth or lateral ventricles. A retrospective study of 6 histologically proven subependymomas was undertaken to analyse their clinicopathological characteristics. There were five male and one female patients ranging in age from 11 to 50 years (mean 35.8 years). All patients were symptomatic at diagnosis. The most common clinical presentations included headache (n=6) and vomiting (n=3). Tumours were located in the lateral ventricle in five cases and in the fourth ventricle in one case. Magnetic resonance imaging detected obstructive hydrocephalus in all cases. Five patients underwent gross total resection and one patient had subtotal excision of the tumour. Histologically, all tumours were characterised by clustering of isomorphic cells arranged against a fibrillary background. Focal cystic degeneration was seen in 5 tumours. During the follow-up period, which ranged between 2 months and 10 years, all patients were symptom-free with no evidence of recurrence.

Paediatric retinal detachment: aetiology, characteristics and outcomes.

PubMed

McElnea, Elizabeth; Stephenson, Kirk; Gilmore, Sarah; O'Keefe, Michael; Keegan, David

2018-01-01

To provide contemporary data on the aetiology, clinical features and outcomes of paediatric retinal detachment. A retrospective review of all those under 16y who underwent surgical repair for retinal detachment at a single centre between the years 2008 and 2015 inclusive was performed. In each case the cause of retinal detachment, the type of detachment, the presence or absence of macular involvement, the number and form of reparative surgeries undertaken, and the surgical outcome achieved was recorded. Twenty-eight eyes of 24 patients, 15 (62.5%) of whom were male and 9 (37.5%) of whom were female, their mean age being 11.6y and range 2-16y developed retinal detachment over the eight year period studied. Trauma featured in the development of retinal detachment in 14 (50.0%) cases. Retinal detachment was associated with other ocular and/or systemic conditions in 11 (39.3%) cases. A mean of 3.0 procedures with a range of 1-9 procedures per patient were undertaken in the management of retinal detachment. Complex vitrectomy combined with scleral buckling or complex vitrectomy alone were those most frequently performed. Mean postoperative visual acuity was 1.2 logMAR with range 0.0-3.0 logMAR. In 22 of 26 (84.6%) cases which underwent surgical repair the retina was attached at last follow-up. Aggressive management of paediatric retinal detachment including re-operation increases the likelihood of anatomical success. In cases where the retinal detachment can be repaired by an external approach alone there is a more favourable visual outcome.

Epidemiology of Parkinson disease in the city of Kolkata, India

PubMed Central

Das, S.K.; Misra, A.K.; Ray, B.K.; Hazra, A.; Ghosal, M.K.; Chaudhuri, A.; Roy, T.; Banerjee, T.K.; Raut, D.K.

2010-01-01

Objective: No well-designed longitudinal study on Parkinson disease (PD) has been conducted in India. Therefore, we planned to determine the prevalence, incidence, and mortality rates of PD in the city of Kolkata, India, on a stratified random sample through a door-to-door survey. Method: This study was undertaken between 2003 to 2007 with a validated questionnaire by a team consisting of 4 trained field workers in 3 stages. Field workers screened the cases, later confirmed by a specialist doctor. In the third stage, a movement disorders specialist undertook home visits and reviewed all surviving cases after 1 year from last screening. Information on death was collected through verbal autopsy. A nested case-control study (1:3) was also undertaken to determine putative risk factors. The rates were age adjusted to the World Standard Population. Result: A total population of 100,802 was screened. The age-adjusted prevalence rate (PR) and average annual incidence rate were 52.85/100,000 and 5.71/100,000 per year, respectively. The slum population showed significantly decreased PR with age compared with the nonslum population. The adjusted average annual mortality rate was 2.89/100,000 per year. The relative risk of death was 8.98. The case-control study showed that tobacco chewing protected and hypertension increased PD occurrence. Conclusion: This study documented lower prevalence and incidence of PD as compared with Caucasian and a few Oriental populations. The mortality rates were comparable. The decreased age-specific PR among slum populations and higher relative risk of death need further probing. GLOSSARY AAIR = average annual incidence rate; AAMR = average annual mortality rate; CI = confidence interval; FSQ = family screening questionnaire; ICC = intraclass correlation coefficient; IR = incidence rate; MD = movement disorder; NSSO = National Sample Survey Organization; OR = odds ratio; PD = Parkinson disease; PPS = parkinsonism plus syndrome; PR = prevalence rate; PRM = Poisson regression modeling; RR = relative risk; SP = secondary parkinsonism; VA = verbal autopsy. PMID:20938028

Physical activity and common mental disorders.

PubMed

Harvey, Samuel B; Hotopf, Matthew; Overland, Simon; Mykletun, Arnstein

2010-11-01

Previous studies have suggested that physical activity may have antidepressant and/or anti-anxiety effects. To examine the bidirectional relationship between physical activity and common mental disorders and establish the importance of context, type and intensity of activity undertaken. A clinical examination of 40 401 residents of Norway was undertaken. Participants answered questions relating to the frequency and intensity of both leisure-time and workplace activity. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Biological and social data were also collected. There was an inverse relationship between the amount of leisure-time physical activity and case-level symptoms of depression. This cross-sectional association was only present with leisure-time (as opposed to workplace) activity and was not dependent on the intensity of activities undertaken. Higher levels of social support and social engagement were important in explaining the relationship between leisure activity and depression. Biological changes such as alterations to parasympathetic vagal tone (resting pulse) and changes to metabolic markers had a less important role. Individuals who engage in regular leisure-time activity of any intensity are less likely to have symptoms of depression. The context and social benefits of exercise are important in explaining this relationship.

A fuelwood plantation site selection procedure using geographic information system technology: A case study in support of the NASA Global Habitability Program

NASA Technical Reports Server (NTRS)

Roller, N. E. G.; Colwell, J. E.; Sellman, A. N.

1985-01-01

A study undertaken in support of NASA's Global Habitability Program is described. A demonstration of geographic information system (GIS) technology for site evaluation and selection is given. The objective was to locate potential fuelwood plantations within a 50 km radius of Nairobi, Kenya. A model was developed to evaluate site potential based on capability and suitability criteria and implemented using the Environmental Research Institute of Michigan's geographic information system.

Enhancing public involvement in assistive technology design research.

PubMed

Williamson, Tracey; Kenney, Laurence; Barker, Anthony T; Cooper, Glen; Good, Tim; Healey, Jamie; Heller, Ben; Howard, David; Matthews, Martin; Prenton, Sarah; Ryan, Julia; Smith, Christine

2015-05-01

To appraise the application of accepted good practice guidance on public involvement in assistive technology research and to identify its impact on the research team, the public, device and trial design. Critical reflection and within-project evaluation were undertaken in a case study of the development of a functional electrical stimulation device. Individual and group interviews were undertaken with lay members of a 10 strong study user advisory group and also research team members. Public involvement was seen positively by research team members, who reported a positive impact on device and study designs. The public identified positive impact on confidence, skills, self-esteem, enjoyment, contribution to improving the care of others and opportunities for further involvement in research. A negative impact concerned the challenge of engaging the public in dissemination after the study end. The public were able to impact significantly on the design of an assistive technology device which was made more fit for purpose. Research team attitudes to public involvement were more positive after having witnessed its potential first hand. Within-project evaluation underpins this case study which presents a much needed detailed account of public involvement in assistive technology design research to add to the existing weak evidence base. The evidence base for impact of public involvement in rehabilitation technology design is in need of development. Public involvement in co-design of rehabilitation devices can lead to technologies that are fit for purpose. Rehabilitation researchers need to consider the merits of active public involvement in research.

Hypermedia without Programming: Automatic Generation of Presentation Documents for Case-based Instruction.

ERIC Educational Resources Information Center

Grissom, Scott; Koschmann, Tim

The objective of this project was to develop a way of producing instructional materials such that once an acceptable design had been achieved, hypermedia documents could be easily generated with no additional programming or design effort. The project was undertaken to support a case-based instructional curriculum in medical education. Southern…

Evaluating Faculty Pedagogic Practices to Inform Strategic Academic Professional Development: A Case of Cases

ERIC Educational Resources Information Center

Drew, Steve; Klopper, Christopher

2014-01-01

An investigation was undertaken into how a process involving peer review and observation of teaching can be used to enhance academics' teaching practices and inform professional development activities at an organization level. We describe an innovative and highly structured approach to gathering evidence of pedagogic practice from academic…

Fetal Growth and Childhood Acute Lymphoblastic Leukemia: Findings from the Childhood Leukemia International Consortium (CLIC)

PubMed Central

Milne, Elizabeth; Greenop, Kathryn R.; Metayer, Catherine; Schüz, Joachim; Petridou, Eleni; Pombo-de-Oliveira, Maria S.; Infante-Rivard, Claire; Roman, Eve; Dockerty, John D.; Spector, Logan G.; Koifman, Sérgio; Orsi, Laurent; Rudant, Jérémie; Dessypris, Nick; Simpson, Jill; Lightfoot, Tracy; Kaatsch, Peter; Baka, Margarita; Faro, Alessandra; Armstrong, Bruce K.; Clavel, Jacqueline; Buffler, Patricia A.

2013-01-01

Positive associations have been reported between measures of accelerated fetal growth and risk of childhood acute lymphoblastic leukemia (ALL). We investigated this association by pooling individual-level data from 12 case-control studies participating in the Childhood Leukemia International Consortium. Two measures of fetal growth – weight-for-gestational-age and proportion of optimal birth weight (POBW) – were analysed. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression, and combined in fixed effects meta-analyses. Pooled analyses of all data were also undertaken using multivariable logistic regression. Subgroup analyses were undertaken when possible. Data on weight for gestational age were available for 7,348 cases and 12,489 controls from all 12 studies and POBW data were available for 1,680 cases and 3,139 controls from three studies. The summary ORs from the meta-analyses were 1.24 (95% CI 1.13, 1.36) for children who were large for gestational age relative to appropriate for gestational age, and 1.16 (95% CI: 1.09, 1.24) for a one standard deviation increase in POBW. The pooled analyses produced similar results. The summary and pooled ORs for small-for-gestational-age children were 0.83 (95% CI: 0.75, 0.92) and 0.86 (95% CI 0.77, 0.95) respectively. Results were consistent across subgroups defined by sex, ethnicity and immunophenotype, and when the analysis was restricted to children who did not have high birth weight. The evidence that accelerated fetal growth is associated with a modest increased risk of childhood ALL is strong and consistent with known biological mechanisms involving insulin like growth factors. PMID:23754574

Tocotrienols, health and ageing: A systematic review.

PubMed

Georgousopoulou, Ekavi N; Panagiotakos, Demosthenes B; Mellor, Duane D; Naumovski, Nenad

2017-01-01

A systematic review of studies was undertaken to evaluate the potential effect of intake of tocotrienols or circulating levels of tocotrienols on parameters associated with successful ageing, specifically in relation to cognitive function, osteoporosis and DNA damage. Following PRISMA guidelines a systematic review of epidemiological observational studies and clinical trials was undertaken. Inclusion criteria included all English language publications in the databases PubMed and Scopus, through to the end of July 2016. Evidence from prospective and case-control studies suggested that increased blood levels of tocotrienols were associated with favorable cognitive function outcomes. A clinical trial of tocotrienol supplementation for 6 months suggested a beneficial effect of intake on DNA damage rates, but only in elderly people. Regarding osteoporosis, only in vitro studies with cultures of human bone cells were identified, and these demonstrated significant inhibition of osteoclast activity and promotion of osteoblast activity. Research in middle-aged and elderly humans suggests that tocotrienols have a potential beneficial anti-ageing action with respect to cognitive impairment and DNA damage. Clinical trials are required to elucidate these effects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessing the benefits of OHER (Office of Health and Environmental Research) research: Three case studies

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

Nesse, R.J.; Callaway, J.M.; Englin, J.E.

1987-09-01

This research was undertaken to estimate the societal benefits and costs of selected past research performed for the Office of Health and Environmental Research (OHER) of the US Department of Energy (DOE). Three case studies of representative OHER and DOE research were performed. One of these, the acid rain case study, includes research conducted elsewhere in DOE. The other two cases were the OHER marine research program and the development of high-purity germanium that is used in radiation detectors. The acid rain case study looked at the research benefits and costs of furnace sorbent injection and duct injection, technologies thatmore » might reduce acid deposition precursors. Both appear to show benefits in excess of costs. We examined in detail one of the OHER marine research program's accomplishments - the increase in environmental information used by the Outer Continental Shelf leasing program to manage bidding for off-shore oil drilling. The results of an econometric model show that environmental information of the type supported by OHER is unequivocally linked to government and industry leasing decisions. The germanium case study indicated that the benefits of germanium radiation detectors were significant.« less

Liver Resections Combined with Closure of Loop Ileostomies: A Retrospective Analysis

PubMed Central

Lordan, Jeffrey T.; Riga, Angela T.; Karanjia, Nariman D.

2008-01-01

Background. The management of patients with colorectal liver metastases and loop ileostomies remains controversial. This study was performed to assess the outcome of combined liver resection and loop ileostomy closure. Methods. Analysis of prospectively collected perioperative data, including morbidity and mortality, of 283 consecutive hepatectomies for colorectal liver metastases was undertaken. Consecutive liver resections were performed from 1996 to 2006 in one centre by a single surgeon (NDK). Fourteen of these patients had combined liver resection and ileostomy closure. Case-matched analysis was undertaken. Results. Six (2.2%) patients died in the hepatectomy only group and none died in the combined group. There was no difference in operative blood loss between the two groups (0.09). Perioperative morbidity was 36% in the combined group and 23% in the hepatectomy alone group (P = 0.33). Mean hospital stay was 14 days in the combined group and 11 days in the hepatectomy only group (P = 0.046). Case-matched analysis showed a significant increase in hospital stay (P = 0.03) and complications (P = 0.049) in the combined group. Conclusion. In patients with CRLM, combined liver resection and closure of ileostomy may be associated with a higher operative morbidity and a prolonged hospital stay. PMID:19096524

Evidence-based clinical policy: case report of a reproducible process to encourage understanding and evaluation of evidence.

PubMed

Rikard-Bell, G; Waters, E; Ward, J

2006-07-01

We report within a case study a reproducible process to facilitate the explicit incorporation of evidence by a multidisciplinary group into clinical policy development. To support the decision-making of a multidisciplinary Intersectoral Advisory Group (IAG) convened by the Royal Australasian College of Physicians Health Policy Unit, a systematic review of randomized controlled trials about environmental tobacco smoke and smoking cessation interventions in paediatric settings was first undertaken. As reported in detail here, IAG members were then formally engaged in a transparent and replicable process to understand and interpret the synthesized evidence and to proffer their independent reactions regarding policy, practice and research. Our intention was to ensure that all IAG members were democratically engaged and made aware of the available evidence. As clinical policy must engage stakeholder representatives from diverse backgrounds, a process to equalize understanding of the evidence and 'democratize' judgment about its implications is needed. Future research must then examine the benefits of such explicit steps when guidelines, in turn, are implemented. We hypothesize that changes to future practice will be more likely if processes undertaken to develop guidelines are transparent to clinicians and other target groups.

An interesting case report of vertebral artery dissection following polytrauma.

PubMed

Acharya, Vikas; Chandrasekaran, Suresh; Nair, Sujit

2016-01-01

The authors present an interesting case of a 19-year-old male who presented as a polytrauma patient following a fall from a height. He was initially managed on the intensive care unit with intracranial pressure bolt monitoring after being intubated and sedated and having his other traumatic injuries stabilized. Upon attempting to wean sedation and extubation a repeat CT scan of the head was undertaken and showed a new area suggested of cerebral infarction, this was a new finding. Further imaging found that he had a cervical vertebral artery dissection following this polytrauma mode of injury. The incidence of vertebral artery dissection following generalized or local trauma is rising but routine imaging/screening in these patients is not undertaken. Our report displays select images related to this case report and emphasizes the consideration of routine imaging in head and neck traumatic injuries to diagnose internal carotid and/or vertebral artery dissections much earlier. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Microsurgical transfer of the second toe for congenital deficiency of the thumb.

PubMed

Lister, G

1988-10-01

Twelve second-toe transfers have been performed to substitute for thumbs congenitally deficient through constriction ring syndrome, symbrachydactyly, and true transverse arrest. The children were on average 3 years of age, and the youngest was undertaken at 10 months. Anatomic variations were the rule in the six cases of transverse absence and the three cases of symbrachydactyly, requiring nerves, tendons, and vessels in the toe be connected to whatever appropriate structure could be located. All transfers survived, and only one required exploration. Sensation appeared good in the 11 seen in later review, but interphalangeal motion was achieved in only 3. However, good use was made of the digit by all except one patient, an early patient in whom there was not an adequate skeleton on which to base the transfer. This small series suggests that in appropriate cases toe transfer can be undertaken early for congenital deficiency with little fear of encountering microsurgical problems unique to the infant.

Effects of Dynamic Impact Loading on Microstructure of FCC (TWIP) Steel

DTIC Science & Technology

2014-08-01

experimental development and fundamental studies into weld metal solidification cracking in steels and stainless steels . He has also undertaken...bands (ABS) may appear when the steel is subjected to high strain rate deformation. They concluded the following: 1. For TWIP steel deformed under...mm) was selected as a trial material in this case. The Explosive Bulge Test (EBT) was performed on the TWIP steel using charge weight (PE4 high

Integrated Source Case Investigation for Tuberculosis (TB) and HIV in the Caregivers and Household Contacts of Hospitalised Young Children Diagnosed with TB in South Africa: An Observational Study

PubMed Central

Lala, Sanjay G.; Little, Kristen M.; Tshabangu, Nkeko; Moore, David P.; Msandiwa, Reginah; van der Watt, Martin; Chaisson, Richard E.; Martinson, Neil A.

2015-01-01

Background Contact tracing, to identify source cases with untreated tuberculosis (TB), is rarely performed in high disease burden settings when the index case is a young child with TB. As TB is strongly associated with HIV infection in these settings, we used source case investigation to determine the prevalence of undiagnosed TB and HIV in the caregivers and household contacts of hospitalised young children diagnosed with TB in South Africa. Methods Caregivers and household contacts of 576 young children (age ≤7 years) with TB diagnosed between May 2010 and August 2012 were screened for TB and HIV. The primary outcome was the detection of laboratory-confirmed, newly-diagnosed TB disease and/or HIV-infection in close contacts. Results Of 576 caregivers, 301 (52·3%) self-reported HIV-positivity. Newly-diagnosed HIV infection was detected in 63 (22·9%) of the remaining 275 caregivers who self-reported an unknown or negative HIV status. Screening identified 133 (23·1%) caregivers eligible for immediate anti-retroviral therapy (ART). Newly-diagnosed TB disease was detected in 23 (4·0%) caregivers. In non-caregiver household contacts (n = 1341), the prevalence of newly-diagnosed HIV infection and TB disease was 10·0% and 3·2% respectively. On average, screening contacts of every nine children with TB resulted in the identification of one case of newly-diagnosed TB disease, three cases of newly diagnosed HIV-infection, and three HIV-infected persons eligible for ART. Conclusion In high burden countries, source case investigation yields high rates of previously undiagnosed HIV and TB infection in the close contacts of hospitalised young children diagnosed with TB. Furthermore, integrated screening identifies many individuals who are eligible for immediate ART. Similar studies, with costing analyses, should be undertaken in other high burden settings–integrated source case investigation for TB and HIV should be routinely undertaken if our findings are confirmed. PMID:26378909

Multicolor Scanning Laser Imaging in Diabetic Retinopathy.

PubMed

Ahmad, Mohammad S Z; Carrim, Zia Iqbal

2017-11-01

Diabetic retinopathy is a common cause of blindness in individuals younger than 60 years. Screening for retinopathy is undertaken using conventional color fundus photography and relies on the identification of hemorrhages, vascular abnormalities, exudates, and cotton-wool spots. These can sometimes be difficult to identify. Multicolor scanning laser imaging, a new imaging modality, may have a role in improving screening outcomes, as well as facilitating treatment decisions. Observational case series comprising two patients with known diabetes who were referred for further examination after color fundus photography revealed abnormal findings. Multicolor scanning laser imaging was undertaken. Features of retinal disease from each modality were compared. Multicolor scanning laser imaging provides superior visualization of retinal anatomy and pathology, thereby facilitating risk stratification and treatment decisions. Multicolor scanning laser imaging is a novel imaging technique offering the potential for improving the reliability of screening for diabetic retinopathy. Validation studies are warranted.

Contributory factors and potentially avoidable neonatal encephalopathy associated with perinatal asphyxia.

PubMed

Sadler, Lynn C; Farquhar, Cynthia M; Masson, Vicki L; Battin, Malcolm R

2016-06-01

The recently published monograph, Neonatal encephalopathy and neurologic outcome, from the American College of Obstetricians and Gynecologists calls for a root cause analysis to identify components of care that contributed to cases of neonatal encephalopathy to design better practices, surveillance mechanisms, and systems. All cases of infants born in New Zealand with moderate and severe neonatal encephalopathy were reported to the New Zealand Perinatal and Maternal Mortality Review Committee from 2010. A national clinical review of these individual cases has not previously been undertaken. The objective of the study was to undertake a multidisciplinary structured review of all cases of neonatal encephalopathy that arose following the onset of labor in the absence of acute peripartum events in 2010-2011 to determine the frequency of contributory factors, the proportion of potentially avoidable morbidity and mortality and to identify themes for quality improvement. National identification of, and collection of clinical records on, cases of moderate or severe neonatal encephalopathy occurring after the onset of labor in the absence of an acute peripartum event, excluding those with normal gases and Apgar scores at 1 minute, among all cases of moderate and severe neonatal encephalopathy at term in New Zealand in 2010-2011 was undertaken. Cases were included if they had abnormal gases as defined by any of pH of ≤ 7.2, base excess of ≤ -10, or lactate of ≥ 6 or if there were no cord gases, an Apgar score at 1 minute of ≤ 7. A clinical case review was undertaken by a multidisciplinary team using a structured tool to record contributory factors (organization and/or management, personnel, and barriers to access and/or engagement with care), potentially avoidable morbidity and mortality and to identify themes to guide quality improvement. Eighty-three babies fulfilled the inclusion criteria for the review, 56 moderate (67%) and 27 severe (33%), 21 (25%) of whom were deceased prior to hospital discharge. Eighty-four percent of 64 babies with cord gas results had one of pH of ≤ 7.0, base excess of ≤ -12, or lactate of ≥ 6; and 42% (8 of 19) without cord gases had 5 minute Apgar scores < 5. Excluding 5 babies who died within a day of birth, all but 1 baby were admitted to a neonatal unit within 1 day of birth. Contributory factors were identified in 84% of 83 cases, most commonly personnel factors (76%). Fifty-five percent of cases with morbidity or mortality were considered to be potentially avoidable, and 52% of cases were considered potentially avoidable because of personnel factors. The most frequently identified theme related to the use and interpretation of cardiotocography in labor. A multidisciplinary case review of neonatal encephalopathy following apparently uncomplicated labor identified a high rate of potentially avoidable morbidity and mortality and issues amenable to quality improvement such as multidisciplinary training of staff in fetal surveillance in labor. Copyright © 2015 Elsevier Inc. All rights reserved.

[National screening for phenylketonuria, congenital hypothyroidism and congenital adrenal hyperplasia].

PubMed

Osório, R V; Vilarinho, L; Soares, J P

1992-03-01

In Portugal the screening for phenylketonuria (PKU) and congenital hypothyroidism (CH) was begun towards the end of 1979, and by 1990 59 cases of PKU and 227 cases of CH had been detected. The early initiation of treatment and the observed mental and motor development, point towards a normal development in these children. A trial screen for congenital adrenal hyperplasia was carried out in 100.000 newborns, from which it was concluded that, under the present conditions, screening at a national level is not justified. A similar study is currently being undertaken for biotinidase deficiency and cystic fibrosis. The results ares discussed, as are the cost/benefits evaluations.

Progress and Challenges in Short to Medium Range Coupled Prediction

NASA Technical Reports Server (NTRS)

Brassington, G. B.; Martin, M. J.; Tolman, H. L.; Akella, Santha; Balmeseda, M.; Chambers, C. R. S.; Cummings, J. A.; Drillet, Y.; Jansen, P. A. E. M.; Laloyaux, P.;

Troubling STEM: Making a Case for an Ethics/STEM Partnership

ERIC Educational Resources Information Center

Steele, Astrid

2016-01-01

Set against the backdrop of a STEM-based (science, technology, engineering and mathematics) activity in a teacher education science methods class, the author examines the need for ethics education to be partnered with STEM education. To make the case, the origin of the STEM initiative, undertaken and strongly supported by both US government and…

Ciguatera fish poisoning in industrial ship crewmembers: a retrospective study in a seaport general practice in Trinidad and Tobago.

PubMed

Poon-King, C M; Chen, A; Poon-King, T

2004-09-01

The objective of this study was to outline the epidemiology of Ciguatera fish poisoning as seen in a general practice serving two industrial seaports in Trinidad and Tobago, in order to highlight the potential public health implications. A retrospective study was undertaken of all the cases of Ciguatera fish poisoning identified between November 1, 1992 and October 31, 1998 in a seaport general practice to identify signs, symptoms and treatment. An investigation of one outbreak was undertaken. Four outbreaks affecting 42 male ship crewmembers were identified. The suspect fish were caught in northern Caribbean waters en route to Trinidad and Tobago. The most common early symptoms were diarrhoea, vomiting, abdominal cramps, pruritus and tiredness. In the third outbreak, dysaesthesia was common. Progression to muscular weakness, ataxic gait, unsteadiness and other neurotoxic signs were seen in moderate to severe disease. Hypotension was an important prognostic sign in the initial case. Treatment was symptomatic and supportive and included vitamins B12 and BCO, folic acid, prostigmine, steroids and antihistamines as indicated. In the investigation of the second outbreak, the relative risk of 'eating fish meat' was 5 (95% CI 1.45, 17.27, p < 0.0001). Abdominal symptoms, pruritus, and muscle weakness with a history of consuming a fish-meal were diagnostic indicators of 'ciguatera fish poisoning.' All cases were industrial ship crewmembers. It is suggested that increased clinician awareness with early and appropriate treatment, and focussed public health intervention may help limit the potential public health impact of ciguatera poisoning in industrial ship crewmembers and other fish-consuming communities in the future.

Ber-H2 (CD30) immunohistochemical staining in malignant melanoma.

PubMed

Polski, J M; Janney, C G

1999-09-01

Malignant melanoma can be included in the differential diagnosis of Hodgkin's disease, anaplastic large cell lymphoma, or embryonal carcinoma These malignancies express CD30, a marker of diagnostic value. A retrospective immunohistochemical study was undertaken to determine the frequency of immunoreactivity of Ber-H2 (anti-CD30 monoclonal antibody) in malignant melanoma Archival paraffin-embedded tissue from 24 primary and metastatic lesions was used. No Ber-H2 labeling was observed in the majority of the studied cases. Variable weak cytoplasmic staining was present in only one case. The findings are compared with the previous reports claiming frequent CD30 expression in malignant melanoma. We discuss issues pertaining to the interpretation of the Ber-H2 IHC staining in formalin-fixed, paraffin-embedded tissue.

Serum homocysteine levels in cerebrovascular accidents.

PubMed

Zongte, Zolianthanga; Shaini, L; Debbarma, Asis; Singh, Th Bhimo; Devi, S Bilasini; Singh, W Gyaneshwar

2008-04-01

Hyperhomocysteinemia has been considered an independent risk factor in the development of stroke. The present study was undertaken to evaluate serum homocysteine levels in patients with cerebrovascular accidents among the Manipuri population and to compare with the normal cases. Ninety-three cerebrovascular accident cases admitted in the hospital were enrolled for the study and twenty-seven age and sex matched individuals free from cerebrovascular diseases were taken as control group. Serum homocysteine levels were estimated by ELISA method using Axis homocysteine EIA kit manufactured by Ranbaxy Diagnostic Ltd. India. The finding suggests that hyperhomocysteinemia is associated with cerebrovascular accident with male preponderance, which increases with advancing age. However, whether hyperhomocysteinemia is the cause or the result of cerebrovascular accidents needs further investigations.

Weight of the Evidence or Wait for the Evidence? Protecting Underground Miners From Diesel Particulate Matter

PubMed Central

Monforton, Celeste

2006-01-01

A coalition of mine operators has used a variety of tactics to obstruct scientific inquiry and impede public health action designed to protect underground miners from diesel particulate matter. These workers are exposed to the highest level of diesel particulate matter compared with any other occupational group. This case study profiles a decade-long saga of the Methane Awareness Resource Group Diesel Coalition to impede epidemiological studies on diesel exhaust undertaken by the National Institute for Occupational Safety and Health and the National Cancer Institute, and to derail a health standard promulgated by the Mine Safety and Health Administration. The case study highlights the coalition’s mastery of legislative, judicial, and executive branch operations and the reaction of policymakers. PMID:16380560

The use of salutogenesis theory in empirical studies of maternity care for healthy mothers and babies.

PubMed

Perez-Botella, Mercedes; Downe, Soo; Magistretti, Claudia Meier; Lindstrom, Bengt; Berg, Marie

2015-03-01

Health care outcomes used in service evaluation and research tend to measure morbidity and mortality. This is the case even in maternity care, where most women and babies are healthy. Salutogenesis theory recognises that health is a continuum, with explicit inclusion of well-being as well as illness and pathology. This offers the potential to reframe the outcomes and therefore, the focus of, maternity care research and provision. The aim of this study was to identify how salutogenesis has been defined and used in maternity care research undertaken with healthy women. A scoping review was undertaken, using a formal pre-defined search strategy. Inclusion criteria encompassed research papers relating to the maternity episode up to 1 year after birth, using salutogenesis or any of its associated concepts, focused on healthy women, and written in a language which any of the members of the group could understand. The search was undertaken in two phases (database inception--April 2011 and May 2011-February 2013). Included studies were subject to narrative analysis. Eight papers met the inclusion criteria. They covered seven topics, spanning the antenatal, intrapartum and postnatal periods. Only two papers employed both positive health orientation and explicit use of Antonovsky's theory. The remaining studies used discrete aspects of the theory. Salutogenic framing is rarely used in maternity care research with healthy participants. An increase in research that measures salutogenically orientated outcomes could, eventually, provide a balance to the current over-emphasis on pathology in maternity care design and provision worldwide. Copyright © 2014 Elsevier B.V. All rights reserved.

NATO NEC C2 Maturity Model

DTIC Science & Technology

2010-02-01

Academy of the United Kingdom Petra Eggenhofer Germany Universität der Bundeswehr München, Germany Fred van Ettinger Ne herlands C2 Centre of Excellence...C2 Centre of Excellence Jose Martins Portugal Military Academy, Portugal Jimmie McEver USA Evidence Based Research, Inc. Allen Murashige USA HQ USAF...integrating the results from the disparate case studies undertaken to validate the N2C2M2. Ms. Petra Eggenhofer from the Universität der Bundeswehr München

Is Routine Pathologic Evaluation of Sebaceous Cysts Necessary?: A 15-Year Retrospective Review of a Single Institution.

PubMed

Gargya, Vipul; Lucas, Heather D; Wendel Spiczka, Amy J; Mahabir, Raman Chaos

2017-02-01

A question arose in our practice of whether all cysts considered sebaceous should be sent for pathologic evaluation. To address this controversial topic, we performed a retrospective study of our single institution's histopathology database. A natural language search of the CoPath database across the institution was undertaken using the diagnosis of sebaceous cyst, epidermal cyst, epidermoid cyst, epithelial cyst, infundibular cyst, pilar cyst, trichilemmal cyst, and steatocystoma. A surgical pathologic review of all specimens with one of these preexcision diagnoses was included in the 15-year retrospective study of 1998 to 2013. All slides were confirmed to have undergone histopathologic review, and the preexcision diagnoses were compared with the postexcision diagnoses. Chart review was undertaken in instances of a diagnosis of malignancy. A total of 13,746 samples were identified. Forty-eight specimens had histopathologic diagnosis of malignancy, for an incidence of 0.3% and with the most common malignancy being squamous cell carcinoma. Chart review showed that for all cases, the surgeons reported uncertainty with regard to the diagnosis because of history or physical characteristics, or both. In addition, a comprehensive literature review showed results consistent with our data and illustrated 19 cases during the past 10 years in which most of the findings were squamous cell carcinoma. We propose the recommendation that routine pathologic evaluation of sebaceous cysts is necessary only when clinical suspicion exists.

Burden of asymptomatic malaria among a tribal population in a forested village of central India: a hidden challenge for malaria control in India.

PubMed

Chourasia, M K; Raghavendra, K; Bhatt, R M; Swain, D K; Valecha, N; Kleinschmidt, I

2017-06-01

Chhattisgarh in India is a malaria-endemic state with seven southern districts that contributes approximately 50-60% of the reported malaria cases in the state every year. The problem is further complicated due to asymptomatic malaria cases which are largely responsible for persistent transmission. This study was undertaken in one of the forested villages of the Keshkal subdistrict in Kondagaon district to ascertain the proportion of the population harbouring subclinical malarial infections. Community-based cross-sectional study. Mass blood surveys were undertaken of the entire population of the village in the post-monsoon seasons of 2013 and 2014. Fingerprick blood smears were prepared from individuals of all ages to detect malaria infections in their blood. Individuals with fever at the time of the survey were tested with rapid diagnostic tests, and parasitaemia in thick blood smears was confirmed by microscopy. Malaria-positive cases were treated with anti-malarials in accordance with the national drug policy. Peripheral blood smears of 134 and 159 individuals, including children, were screened for malaria infection in 2013 and 2014, respectively. Overall, the malaria slide positivity rates were 27.6% and 27.7% in 2013 and 2014, respectively, and the prevalence rates of asymptomatic malaria were 20% and 22.8%. This study showed that, for two consecutive years, the prevalence of asymptomatic malaria infection was significantly higher among children aged ≤14 years (34.4% and 34.1% for 2013 and 2014, respectively) compared with adults (15.2% and 18.2% for 2013 and 2014, respectively; P = 0.023 and 0.04, respectively). The number of asymptomatic malaria cases, especially Plasmodium falciparum, is significant, reinforcing the underlying challenge facing the malaria elimination programme in India. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

An outbreak of vancomycin-resistant Enterococcus faecium in an acute care pediatric hospital: Lessons from environmental screening and a case-control study

PubMed Central

Drews, Steven J; Richardson, Susan E; Wray, Rick; Freeman, Renee; Goldman, Carol; Streitenberger, Laurie; Stevens, Derek; Goia, Cristina; Kovach, Danuta; Brophy, Jason; Matlow, Anne G

2008-01-01

BACKGROUND The present study describes a vancomycin-resistant enterococci (VRE) outbreak investigation and a case-control study to identify risk factors for VRE acquisition in a tertiary care pediatric hospital. OBJECTIVE To report an outbreak investigation and a case-control study to identify risk factors for VRE colonization or infection in hospitalized children. METHODS Screening for VRE cases was performed by culture or polymerase chain reaction. A case-control study of VRE-colonized patients was undertaken. Environmental screening was performed using standard culture and susceptibility methods, with pulsed-field gel electrophoresis to determine relationships between VRE isolates. Statistical analysis was performed using SAS version 9.0 (SAS Institute Inc, USA). RESULTS Thirty-four VRE-positive cases were identified on 10 wards between February 28, 2005, and May 27, 2005. Pulsed-field gel electrophoresis analysis confirmed a single outbreak strain that was also isolated from a video game found on one affected ward. Multivariate analysis identified cephalosporin use as the major risk factor for VRE colonization. CONCLUSIONS In the present study outbreak, VRE colonization was significantly associated with cephalosporin use. Because shared recreational items and environmental surfaces may be colonized by VRE, they warrant particular attention in housekeeping protocols, particularly in pediatric institutions. PMID:19412380

Ultrathin metallized PBI paper

NASA Technical Reports Server (NTRS)

Chenevey, E. C.

1978-01-01

A study to determine the feasibility of preparing ultrathin papers with a target weight of 3.5 g/m squared from polybenzimidazole (PBI) fibrids was undertaken. Small hand sheets of target weight were fabricated. They were light brown, low density materials with sufficient strength to be readily handleable. Characterization of these sheets included strength, fold endurance, thermal gravimetric analysis in air and nitrogen and photomicrographs. Two different batches of PBI fibrids were studied and differences in fabrication performance were noted. In neither case could target weight papers be prepared using conventional paper making techniques.

The Epidemiology of Longevity and Exceptional Survival

PubMed Central

Newman, Anne B.; Murabito, Joanne M.

2013-01-01

The field of the “epidemiology of longevity” has been expanding rapidly in recent years. Several long-term cohort studies have followed older adults long enough to identify the most long-lived and to define many factors that lead to a long life span. Very long-lived people such as centenarians have been examined using case-control study designs. Both cohort and case-control studies have been the subject of genome-wide association studies that have identified genetic variants associated with longevity. With growing recognition of the importance of rare variations, family studies of longevity will be useful. Most recently, exome and whole-genome sequencing, gene expression, and epigenetic studies have been undertaken to better define functional variation and regulation of the genome. In this review, we consider how these studies are leading to a deeper understanding of the underlying biologic pathways to longevity. PMID:23372024

When to Suspect and How to Diagnose Mitochondrial Disorders?

PubMed

Korenev, Sergei; Morris, Andrew A M

2016-10-01

Disorders of the mitochondrial respiratory chain are an exceedingly diverse group. The clinical features can affect any tissue or organ and occur at any age, with any mode of inheritance. The diagnosis of mitochondrial disorders requires knowledge of the clinical phenotypes and access to a wide range of laboratory techniques. A few syndromes are associated with a specific genetic defect and in these cases it is appropriate to proceed directly to an appropriate test of blood or urine. In most cases, however, the best strategy starts with biochemical and histochemical studies on a muscle biopsy. Appropriate molecular genetic studies can then be chosen, based on these results and the clinical picture. Unfortunately, there is currently limited availability of respiratory chain studies in India. Exome sequencing is undertaken increasingly often; without preceding mitochondrial studies, this can lead to misleading results.

Two-, three-, and four-poster jets in cross flow

NASA Technical Reports Server (NTRS)

Vukits, Thomas J.; Sullivan, John P.; Murthy, S. N. B.

1993-01-01

In connection with the problems of the ingestion of hot exhaust gases in engines of V/STOL and STOVL aircraft in ground effect, a series of studies have been undertaken. Ground impinging, two- and three-poster jets operating in the presence of cross flow were studied. The current paper is divided into two parts. The first part is a comparison of the low speed, two-, three-, and four-poster jet cases, with respect to the flowfield in the region of interaction between the forward and the jet flows. These include cases with mass balanced inlet suction. An analysis of the inlet entry plane of the low speed two- and three-poster jet cases is also given. In the second part, high speed results for a two jet configuration without inlet suction are given. The results are based on quantitative, marker concentration distributions obtained by digitizing video images.

Climate change vulnerability assessments as catalysts for social learning: four case studies in south-eastern Australia

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

Preston, Benjamin L

2012-01-01

Technical assessments of vulnerability and/or risk are increasingly being undertaken to assess the impacts of climate change. Underlying this is the belief that they will bring clarity to questions regarding the scale of institutional investments required, plausible adaptation policies and measures, and the timing of their implementation. Despite the perceived importance of technical assessments in 'evidence-based' decision environments, assessments cannot be undertaken independent of values and politics, nor are they capable of eliminating the uncertainty that clouds decision-making on climate adaptation As such, assessments can trigger as many questions as they answer, leaving practitioners and stakeholders to question their value.more » This paper explores the value of vulnerability/risk assessments in climate change adaptation planning processes as a catalyst for learning in four case studies in Southeastern Australia. Data were collected using qualitative interviews with stakeholders involved in the assessments and analysed using a social learning framework. This analysis revealed that detailed and tangible strategies or actions often do not emerge directly from technical assessments. However, it also revealed that the assessments became important platforms for social learning. In providing these platforms, assessments present opportunities to question initial assumptions, explore multiple framings of an issue, generate new information, and galvanise support for collective actions. This study highlights the need for more explicit recognition and understanding of the important role social learning plays in climate change vulnerability assessments and adaptation planning more broadly.« less

The effectiveness of simulated robots for supporting the learning of introductory programming: a multi-case case study

NASA Astrophysics Data System (ADS)

Major, Louis; Kyriacou, Theocharis; Brereton, Pearl

2014-07-01

This work investigates the effectiveness of simulated robots as tools to support the learning of programming. After the completion of a systematic review and exploratory research, a multi-case case study was undertaken. A simulator, named Kebot, was developed and used to run four 10-hour programming workshops. Twenty-three student participants (aged 16-18) in addition to 23 pre-service, and 3 in-service, teachers took part. The effectiveness of this intervention was determined by considering opinions, attitudes, and motivation as well as by analysing students' programming performance. Pre- and post-questionnaires, in- and post-workshop exercises, and interviews were used. Participants enjoyed learning using the simulator and believed the approach to be valuable and engaging. The performance of students indicates that the simulator aids learning as most completed tasks to a satisfactory standard. Evidence suggests robot simulators can offer an effective means of introducing programming. Recommendations to support the development of other simulators are provided.

Ecstasy-Associated Pneumomediastinum

PubMed Central

Marasco, Silvana F; Lim, H Kiat

2007-01-01

INTRODUCTION Ecstasy, also known as MDMA (3,4, methylenedioxymethamphetamine), is a popular illicit party drug amongst young adults. The drug induces a state of euphoria secondary to its stimulant activity in the central nervous system. PATIENTS AND METHODS A database review at two major inner city hospitals was undertaken to identify patients presenting with pneumomediastinum and their charts reviewed. A Medline review of all reported cases of pneumomediastinum associated with ecstasy abuse was undertaken. RESULTS A total of 56 patients presenting with pneumomediastinum were identified over a 5-year period. Review of the charts revealed a history of ecstasy use in the hours prior to presentation in six of these patients, representing the largest series reported to date. CONCLUSIONS Review of previously reported cases reveals the likely mechanism is due to Valsalva manoeuvre during periods of extreme physical exertion, and not a direct pharmacological effect of the drug. PMID:17535617

A methodological review of qualitative case study methodology in midwifery research.

PubMed

Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

2016-10-01

To explore the use and application of case study research in midwifery. Case study research provides rich data for the analysis of complex issues and interventions in the healthcare disciplines; however, a gap in the midwifery research literature was identified. A methodological review of midwifery case study research using recognized templates, frameworks and reporting guidelines facilitated comprehensive analysis. An electronic database search using the date range January 2005-December 2014: Maternal and Infant Care, CINAHL Plus, Academic Search Complete, Web of Knowledge, SCOPUS, Medline, Health Collection (Informit), Cochrane Library Health Source: Nursing/Academic Edition, Wiley online and ProQuest Central. Narrative evaluation was undertaken. Clearly worded questions reflected the problem and purpose. The application, strengths and limitations of case study methods were identified through a quality appraisal process. The review identified both case study research's applicability to midwifery and its low uptake, especially in clinical studies. Many papers included the necessary criteria to achieve rigour. The included measures of authenticity and methodology were varied. A high standard of authenticity was observed, suggesting authors considered these elements to be routine inclusions. Technical aspects were lacking in many papers, namely a lack of reflexivity and incomplete transparency of processes. This review raises the profile of case study research in midwifery. Midwives will be encouraged to explore if case study research is suitable for their investigation. The raised profile will demonstrate further applicability; encourage support and wider adoption in the midwifery setting. © 2016 John Wiley & Sons Ltd.

Factors influencing passive surveillance for T. b. rhodesiense human african trypanosomiasis in Uganda.

PubMed

Acup, Christine; Bardosh, Kevin Louis; Picozzi, Kim; Waiswa, Charles; Welburn, Susan Christina

2017-01-01

Sleeping sickness or Human African Trypanosomiasis (HAT) is a neglected tropical disease of public health importance across much of Sub-Saharan Africa. In Uganda, chronic T. b. gambiense HAT (gHAT) and acute T. b. rhodesiense HAT (rHAT) occur in two large but discrete geographical foci. Both forms are difficult to diagnose, expensive to treat and ultimately fatal in the absence of treatment. The area affected by zoonotic rHAT has been steadily expanding, placing a high burden on local health systems. HAT is a disease of neglected populations and is notorious for being under-reported. Here we examine the factors that influence passive rHAT surveillance within the district health system in four Ugandan districts into which the disease had recently been introduced, focusing on staff knowledge, infrastructure and data management. A mixed methods study was undertaken between 2011 and 2013 in Dokolo, Kaberamaido, Soroti and Serere districts to explore health facility capacity and clinical service provision, diagnostic capacity, HAT knowledge and case reporting. Structured interviews were undertaken with 86 medical personnel, including clinicians, nurses, midwives and technicians across 65 HC-II and HC-III medical facilities, where the health infrastructure was also directly observed. Eleven semi-structured interviews were undertaken with medical staff in each of the three designated HAT treatment facilities (Dokolo, Lwala and Serere HC-IV) in the area. HAT treatment centre case records, collected between 2009 and 2012, were analyzed. Most medical staff in HC-II and HC-III facilities had been made aware of HAT from radio broadcasts, newspapers and by word of mouth, suggestive of a lack of formal training. Key knowledge as regards the causative agent, clinical signs and that HAT drugs are provided free of charge was lower amongst HC-II than HC-III staff. Many respondents did not know whether HAT was endemic in their district. In rHAT specialist treatment centres, staff were knowledgeable of HAT and were confident in their ability to diagnose and manage cases. Between 2009-2012, 342 people were diagnosed in the area, 54% in the late stage of the disease. Over the period of this study the proportion of rHAT cases identified in early stage fell and by 2012 the majority of cases identified were diagnosed in the late stage. This study illustrates the critical role of the district health system in HAT management. The increasing proportion of cases identified at a late stage in this study indicates a major gap in lower tier levels in patient referral, diagnosis and reporting that urgently needs to be addressed. Integrating HAT diagnosis into national primary healthcare programs and providing training to medical workers at all levels is central to the new 2030 WHO HAT elimination goal. Given the zoonotic nature of rHAT, joined up active surveillance in human and animal populations in Uganda is also needed. The role of the Coordinating Office for Control of Trypanosomiasis in Uganda in implementing a One Health approach will be key to sustainable management of zoonotic HAT. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Reversal to normal anatomy after failed gastric bypass: systematic review of indications, techniques, and outcomes.

PubMed

Pucher, Philip H; Lord, Amy C; Sodergren, Mikael H; Ahmed, Ahmed R; Darzi, Ara; Purkayastha, Sanjay

2016-08-01

Roux-en-Y gastric bypass (RYGB) is one of the most common and most effective procedures performed to combat obesity and obesity-related metabolic disease. In a small proportion of patients, however, complications may necessitate the attempted reversal of RYGB to normal anatomy. The indications for this procedure, as well as technique, complication rate, and success in resolving symptoms are not clearly defined. To assess current literature describing outcomes after reversal of RYGB. A systematic search of online databases was conducted. Two independent researchers identified and extracted data for studies describing outcomes after RYGB reversal surgery. Indications, techniques, and outcomes were compared, with results pooled where possible. Eight articles were included in the final data synthesis, incorporating data for 46 patients. Reversal was undertaken due to metabolic, physical, nutritional, or other complications. All successfully underwent RYGB reversal with no reported mortality. Surgical technique varied greatly across the included studies. Postoperative morbidity was high, with 42% suffering complications (56% of which were major). Symptom relief or improvement was achieved in 82% of cases. Reversal of RYGB may be undertaken for a variety of indications after RYGB. Though this may successfully eliminate or improve symptoms in a large proportion of patients, the risk of morbidity is high. Surgery should be undertaken after careful patient selection and in appropriately skilled centers only. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Psychiatric Morbidity Pattern in a Child Guidance Clinic.

PubMed

Chaudhury, S; Prasad, P L; Zacharias, R; Madhusudan, T; Saini, R

2007-04-01

There is a paucity of Indian studies on psychiatric morbidity in children. Present work was undertaken in a child guidance clinic in armed forces. Retrospective analysis of 213 patients who attended a child guidance clinic was done. Majority (n=138) were boys. 55.9% were referred from paediatric outpatient department while medical officers in periphery referred 38.5%. The diagnoses was mental retardation in 30.97%, behavioral and emotional disorders in 23.06% and neurotic, stress related and somatoform disorders in 15.98% cases.

Geologic Reconnaissance and Lithologic Identification by Remote Sensing

DTIC Science & Technology

remote sensing in geologic reconnaissance for purposes of tunnel site selection was studied further and a test case was undertaken to evaluate this geological application. Airborne multispectral scanning (MSS) data were obtained in May, 1972, over a region between Spearfish and Rapid City, South Dakota. With major effort directed toward the analysis of these data, the following geologic features were discriminated: (1) exposed rock areas, (2) five separate rock groups, (3) large-scale structures. This discrimination was accomplished by ratioing multispectral channels.

El Niño Southern Oscillation as an early warning tool for malaria outbreaks in India.

PubMed

Dhiman, Ramesh C; Sarkar, Soma

2017-03-20

Risks of malaria epidemics in relation to El Niño and Southern Oscillation (ENSO) events have been mapped and studied at global level. In India, where malaria is a major public health problem, no such effort has been undertaken that inter-relates El Niño, Indian Summer Monsoon Rainfall (ISMR) and malaria. The present study has been undertaken to find out the relationship between ENSO events, ISMR and intra-annual variability in malaria cases in India, which in turn could help mitigate the malaria outbreaks. Correlation coefficients among 'rainfall index' (ISMR), '+ winter ONI' (NDJF) and 'malaria case index' were calculated using annual state-level data for the last 22 years. The 'malaria case index' representing 'relative change from mean' was correlated to the 4 month (November-February) average positive Oceanic Niño Index (ONI). The resultant correlations between '+ winter ONI' and 'malaria case index' were further analysed on geographical information system platform to generate spatial correlation map. The correlation between '+ winter ONI' and 'rainfall index' shows that there is great disparity in effect of ENSO over ISMR distribution across the country. Correlation between 'rainfall index' and 'malaria case index' shows that malaria transmission in all geographical regions of India are not equally affected by the ISMR deficit or excess. Correlation between '+ winter ONI' and 'malaria case index' was found ranging from -0.5 to + 0.7 (p < 0.05). A positive correlation indicates that increase in El Niño intensity (+ winter ONI) will lead to rise in total malaria cases in the concurrent year in the states of Orissa, Chhattisgarh, Jharkhand, Bihar, Goa, eastern parts of Madhya Pradesh, part of Andhra Pradesh, Uttarakhand and Meghalaya. Whereas, negative correlations were found in the states of Rajasthan, Haryana, Gujarat, part of Tamil Nadu, Manipur, Mizoram and Sikkim indicating the likelihood of outbreaks in La Nina condition. The generated map, representing spatial correlation between ' + winter ONI' and 'malaria case index', indicates positive correlations in eastern part, while negative correlations in western part of India. This study provides plausible guidelines to national programme for planning intervention measures in view of ENSO events. For better resolution, district level study with inclusion of IOD and 'epochal variation of monsoon rainfall' factors at micro-level is desired for better forecast of malaria outbreaks in the regions with 'no correlation'.

Ranking 93 health interventions for low- and middle-income countries by cost-effectiveness

PubMed Central

Gelband, Hellen; Jamison, Dean; Levin, Carol; Nugent, Rachel; Watkins, David

2017-01-01

Background Cost-effectiveness rankings of health interventions are useful inputs for national healthcare planning and budgeting. Previous comprehensive rankings for low- and middle- income countries were undertaken in 2005 and 2006, accompanying the development of strategies for the Millennium Development Goals. We update the rankings using studies published since 2000, as strategies are being considered for the Sustainable Development Goals. Methods Expert systematic searches of the literature were undertaken for a broad range of health interventions. Cost-effectiveness results using Disability Adjusted Life-Years (DALYs) as the health outcome were standardized to 2012 US dollars. Results 149 individual studies of 93 interventions qualified for inclusion. Interventions for Reproductive, Maternal, Newborn and Child Health accounted for 37% of interventions, and major infectious diseases (AIDS, TB, malaria and neglected tropical diseases) for 24%, consistent with the priorities of the Millennium Development Goals. More than half of the interventions considered cost less than $200 per DALY and hence can be considered for inclusion in Universal Health Care packages even in low-income countries. Discussion Important changes have occurred in rankings since 2006. Priorities have changed as a result of new technologies, new methods for changing behavior, and significant price changes for some vaccines and drugs. Achieving the Sustainable Development Goals will require LMICs to study a broader range of health interventions, particularly in adult health. Some interventions are no longer studied, in some cases because they have become usual care, in other cases because they are no longer relevant. Updating cost-effectiveness rankings on a regular basis is potentially a valuable exercise. PMID:28797115

Epidemiology of pituitary pars intermedia dysfunction: A systematic literature review of clinical presentation, disease prevalence and risk factors.

PubMed

Ireland, J L; McGowan, C M

2018-05-01

Pituitary pars intermedia dysfunction (PPID) is caused by an age-related degenerative disease of dopaminergic neurones. Despite its importance in equine practice, available information regarding its epidemiology is limited. This systematic review aimed to assess published literature to evaluate available evidence regarding the clinical presentation, prevalence and risk factors for PPID in horses and ponies. Electronic database searches were undertaken using a range of terms, and English language publications published prior to August 2016 were included. Both authors independently reviewed screened papers for inclusion, extracted data, and assessed the quality of reporting using predefined criteria. Data were extracted using modified critically appraised topic data collection forms. Meta-analysis was not undertaken due to marked between-study variations. Following removal of duplicate records, of 358 published papers yielded by the search, 97 abstracts were screened for eligibility and 29 publications meeting inclusion criteria were included in the review. Most studies reviewed were case series or cross-sectional studies, with considerable variation in study populations and PPID case definition. Hypertrichosis and/or other hair coat abnormalities, laminitis and epaxial muscle wastage or muscle atrophy are the most frequently reported clinical signs, with prevalence of these signs increasing with increasing horse age. The most robust prevalence estimates for PPID were 21.2% in horses and ponies aged ≥15 years and 2.9% amongst the general equine population. Findings regarding breed and sex predispositions were equivocal and only increasing age has been identified as a significant risk factor for PPID. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

The control effect in a detached laminar boundary layer of an array of normal synthetic jets

NASA Astrophysics Data System (ADS)

Valenzuela Calva, Fernando; Avila Rodriguez, Ruben

2016-11-01

In this work, 3D numerical simulations of an array of three normal circular synthetic jets embedded in an attached laminar boundary layer that separates under the influence of an inclined flap are performed for flow separation control. At the beginning of the present study, three cases are used to validate the numerical simulation with data obtained from experiments. The experimental data is chosen based on the cases which presented higher repeatability and reliability. Simulations showed reasonable agreement when compared with experiments. The simulations are undertaken at three synthetic jet operating conditions, i.e. Case A: L = 2, VR = 0.32; Case B: L = 4, VR = 0.64 and Case C: L = 6, VR = 0.96. The vortical structures produced for each synthetic jet operating condition are hairpin vortices for Case A and tilted vortices for Case B and C, respectively. By examining the spatial wall shear stress variations, the effect on the boundary layer prior to separation of the middle synthetic jet is evaluated. For effective flow control, produced at a relatively low the finding from this study suggests that hairpin vortical structures are more desirable structures. Universidad Nacional Autonoma de Mexico.

Crashes of instructional flights : analysis of cases and remedial approaches.

DOT National Transportation Integrated Search

1996-02-01

Abstract: Instructional flights experience more than 300 crashes annually and are involved in more than one-third of all midair collisions. Research was undertaken to identify the circumstances of instructional crashes and describe factors related to...

Spindle Epithelial Tumor with Thymus-Like Differentiation (SETTLE): A Next-Generation Sequencing Study.

PubMed

Stevens, Todd M; Morlote, Diana; Swensen, Jeff; Ellis, Michelle; Harada, Shuko; Spencer, Sharon; Prieto-Granada, Carlos N; Folpe, Andrew L; Gatalica, Zoran

2018-05-07

Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a malignant biphasic neoplasm of the thyroid or neck with propensity for late metastasis. Unlike synovial sarcoma, its main morphologic mimic, SETTLE lacks synovial sarcoma-associated translocations. A single case of SETTLE has shown a KRAS mutation but to date no comprehensive next generation sequencing studies of this rare neoplasm have been undertaken. Herein, we subjected 5 well defined cases of SETTLE to direct sequence analysis of 592 genes and fusion gene analysis of 52 genes frequently rearranged in human cancers. We identified one case with two pathogenic variants in the KMT2D gene, one being in an intron splice site (c.674-1A>G) and the other being a frameshift variant (p.M2829fs). This same case also had a pathogenic nonsense variant in the KMT2C gene (p.R1237*). A second case of SETTLE carried a pathogenic NRAS missense variant, Q61R. No other molecular alterations, microsatellite instability, gene fusions or amplifications were identified.

Suicidal Decapitation by Hanging-A Population-based Study.

PubMed

Byard, Roger W; Gilbert, John D

2018-05-01

A prospective study was undertaken at Forensic Science SA over a 15-year period from July 2002 to June 2017 for all cases of adult (>18 years) suicidal hangings with decapitation. A total of 1446 cases of suicidal hangings were identified from a general population of approximately 1.5 million (1206 males-age range 18-97 years, average 42.6; and 240 females-age range 18-96 years, average 40.1). Only three cases of decapitation were found, all from long-drop hangings; these consisted of three males (ages 32-55 years; average 45 years). Spinal transections had occurred between the first and second, second and third, and third and fourth cervical vertebrae, respectively. In this study, the number of suicidal hangings with decapitation represented only 0.2% of the total number of hangings. These events are therefore extremely rare, most likely due to most suicidal hangings occurring from relatively low levels in a domestic environment. © 2017 American Academy of Forensic Sciences.

Two-tier Haddon matrix approach to fault analysis of accidents and cybernetic search for relationship to effect operational control: a case study at a large construction site.

PubMed

Mazumdar, Atmadeep; Sen, Krishna Nirmalya; Lahiri, Balendra Nath

2007-01-01

The Haddon matrix is a potential tool for recognizing hazards in any operating engineering system. This paper presents a case study of operational hazards at a large construction site. The fish bone structure helps to visualize and relate the chain of events, which led to the failure of the system. The two-tier Haddon matrix approach helps to analyze the problem and subsequently prescribes preventive steps. The cybernetic approach has been undertaken to establish the relationship among event variables and to identify the ones with most potential. Those event variables in this case study, based on the cybernetic concepts like control responsiveness and controllability salience, are (a) uncontrolled swing of sheet contributing to energy, (b) slippage of sheet from anchor, (c) restricted longitudinal and transverse swing or rotation about the suspension, (d) guilt or uncertainty of the crane driver, (e) safe working practices and environment.

Data Management and Data Quality in PERCH, a Large International Case-Control Study of Severe Childhood Pneumonia.

PubMed

Watson, Nora L; Prosperi, Christine; Driscoll, Amanda J; Higdon, Melissa M; Park, Daniel E; Sanza, Megan; DeLuca, Andrea N; Awori, Juliet O; Goswami, Doli; Hammond, Emily; Hossain, Lokman; Johnson, Catherine; Kamau, Alice; Kuwanda, Locadiah; Moore, David P; Neyzari, Omid; Onwuchekwa, Uma; Parker, David; Sapchookul, Patranuch; Seidenberg, Phil; Shamsul, Arifin; Siazeele, Kazungu; Srisaengchai, Prasong; Sylla, Mamadou; Levine, Orin S; Murdoch, David R; O'Brien, Katherine L; Wolff, Mark; Deloria Knoll, Maria

2017-06-15

The Pneumonia Etiology Research for Child Health (PERCH) study is the largest multicountry etiology study of pediatric pneumonia undertaken in the past 3 decades. The study enrolled 4232 hospitalized cases and 5325 controls over 2 years across 9 research sites in 7 countries in Africa and Asia. The volume and complexity of data collection in PERCH presented considerable logistical and technical challenges. The project chose an internet-based data entry system to allow real-time access to the data, enabling the project to monitor and clean incoming data and perform preliminary analyses throughout the study. To ensure high-quality data, the project developed comprehensive quality indicator, data query, and monitoring reports. Among the approximately 9000 cases and controls, analyzable laboratory results were available for ≥96% of core specimens collected. Selected approaches to data management in PERCH may be extended to the planning and organization of international studies of similar scope and complexity. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Healthcare managers' decision making: findings of a small scale exploratory study.

PubMed

Macdonald, Jackie; Bath, Peter A; Booth, Andrew

2008-12-01

Managers who work in publicly funded healthcare organizations are an understudied group. Some of the influences on their decisions may be unique to healthcare. This study considers how to integrate research knowledge effectively into healthcare managers' decision making, and how to manage and integrate information that will include community data. This first phase in a two-phase mixed methods research study used a qualitative, multiple case studies design. Nineteen semi-structured interviews were undertaken using the critical incident technique. Interview transcripts were analysed using the NatCen Framework. One theme represented ;information and decisions'. Cases were determined to involve complex multi-level, multi-situational decisions with participants in practical rather than ceremonial work roles. Most considered organizational knowledge in the first two decision phases and external knowledge, including research, in the third phase. All participants engaged in satisficing to some degree.

5 CFR 550.805 - Back pay computations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 550.805 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... employment (including a business enterprise) undertaken to replace the employment from which the employee was..., in the case of erroneous payments received from a Federal employee retirement system, must be...

5 CFR 550.805 - Back pay computations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 550.805 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... employment (including a business enterprise) undertaken to replace the employment from which the employee was..., in the case of erroneous payments received from a Federal employee retirement system, must be...

5 CFR 550.805 - Back pay computations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 550.805 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... employment (including a business enterprise) undertaken to replace the employment from which the employee was..., in the case of erroneous payments received from a Federal employee retirement system, must be...

5 CFR 550.805 - Back pay computations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 550.805 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... employment (including a business enterprise) undertaken to replace the employment from which the employee was..., in the case of erroneous payments received from a Federal employee retirement system, must be...

45 CFR 1620.7 - Reporting.

Code of Federal Regulations, 2010 CFR

2010-10-01

... priorities; mechanisms which will be utilized to ensure effective client participation in priority-setting... Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PRIORITIES IN USE OF RESOURCES... information on all emergency cases or matters undertaken that were not within the recipient's priorities, and...

[Confirmed Dengue, Chikungunya and Zika Cases during the Period 2014 to 2016 in Barcelona, Spain].

PubMed

González, Roser; Camprubí, Esteve; Fernández, Lidia; Millet, Joan Pau; Peracho, Víctor; Gorrindo, Pilar; Avellanés, Ingrid; Romero, Arancha; Caylà, Joan A

2017-03-07

Arbovirus infections are a group of diseases whose incidence is increasing and that entail an important problem for public health. The aim of this study was to describe detected cases of arbovirosis in Barcelona, and surveillance and control actions performed in order to reduce the risk of transmission. Descriptive cross-sectional study of confirmed dengue, chikungunya and Zika cases in Barcelona during 2014-2016 (1st trimester). Suspected cases detected in the city were notified to the Epidemiology Department of the Barcelona Public Health Agency, where an epidemiological survey is undertaken and, if appropriate, Urban Pests Surveillance and Control Department is contacted. They perform an entomological inspection and implement control and monitoring actions. We collected sociodemographical, epidemiological, clinical and entomological variables. In 2014, 50 chikungunya and 20 dengue cases were detected; 25 entomological inspections were carried out in residences and 38 in the street. In 2015, 47 chikungunya, 51 dengue and 2 Zika cases were detected; 27 inspections were carried out in residences and 80 in the street. In 2016, 17 chikungunya, 52 dengue and 48 Zika cases were detected; 50 inspections were carried out in residences and 103 in the street. No autochtonous case was detected. We observed an increasing incidence of arbovirosis cases during the 3-year study period. There was a progressive intensification of vector surveillance and control actions (inspections, sample collection…).

Case-based reimbursement for psychiatric hospital care.

PubMed

Sederer, L I; Eisen, S V; Dill, D; Grob, M C; Gougeon, M L; Mirin, S M

1992-11-01

A fixed-prepayment system (case-based reimbursement) for patients initially requiring hospital-level care was evaluated for one year through an arrangement between a private nonprofit psychiatric hospital and a self-insured company desiring to provide psychiatric services to its employees. This clinical and financial experiment offered a means of containing costs while monitoring quality of care. A two-group, case-control study was undertaken of treatment outcomes at discharge, patient satisfaction with hospital care, and service use and costs during the program's first year. Compared with costs for patients in the control group, costs for those in the program were lower per patient and per admission; cumulative costs for patients requiring rehospitalization were also lower. However, costs for outpatient services for patients in the program were not calculated. Treatment outcomes and patients' satisfaction with hospital care were comparable for the two groups.

An Outbreak of Cryptosporidium parvum across England & Scotland Associated with Consumption of Fresh Pre-Cut Salad Leaves, May 2012

PubMed Central

McKerr, Caoimhe; Adak, Goutam K.; Nichols, Gordon; Gorton, Russell; Chalmers, Rachel M.; Kafatos, George; Cosford, Paul; Charlett, Andre; Reacher, Mark; Pollock, Kevin G.; Alexander, Claire L.; Morton, Stephen

2015-01-01

Background We report a widespread foodborne outbreak of Cryptosporidium parvum in England and Scotland in May 2012. Cases were more common in female adults, and had no history of foreign travel. Over 300 excess cases were identified during the period of the outbreak. Speciation and microbiological typing revealed the outbreak strain to be C. parvum gp60 subtype IIaA15G2R1. Methods Hypothesis generation questionnaires were administered and an unmatched case control study was undertaken to test the hypotheses raised. Cases and controls were interviewed by telephone. Controls were selected using sequential digit dialling. Information was gathered on demographics, foods consumed and retailers where foods were purchased. Results Seventy-four laboratory confirmed cases and 74 controls were included in analyses. Infection was found to be strongly associated with the consumption of pre-cut mixed salad leaves sold by a single retailer. This is the largest documented outbreak of cryptosporidiosis attributed to a food vehicle. PMID:26017538

An Outbreak of Cryptosporidium parvum across England & Scotland Associated with Consumption of Fresh Pre-Cut Salad Leaves, May 2012.

PubMed

McKerr, Caoimhe; Adak, Goutam K; Nichols, Gordon; Gorton, Russell; Chalmers, Rachel M; Kafatos, George; Cosford, Paul; Charlett, Andre; Reacher, Mark; Pollock, Kevin G; Alexander, Claire L; Morton, Stephen

2015-01-01

We report a widespread foodborne outbreak of Cryptosporidium parvum in England and Scotland in May 2012. Cases were more common in female adults, and had no history of foreign travel. Over 300 excess cases were identified during the period of the outbreak. Speciation and microbiological typing revealed the outbreak strain to be C. parvum gp60 subtype IIaA15G2R1. Hypothesis generation questionnaires were administered and an unmatched case control study was undertaken to test the hypotheses raised. Cases and controls were interviewed by telephone. Controls were selected using sequential digit dialling. Information was gathered on demographics, foods consumed and retailers where foods were purchased. Seventy-four laboratory confirmed cases and 74 controls were included in analyses. Infection was found to be strongly associated with the consumption of pre-cut mixed salad leaves sold by a single retailer. This is the largest documented outbreak of cryptosporidiosis attributed to a food vehicle.

Conflicts in developing countries: a case study from Rio de Janeiro

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

Bredariol, Celso Simoes; Magrini, Alessandra

In developing countries, environmental conflicts are resolved mainly in the political arena. In the developed nations, approaches favoring structured negotiation support techniques are more common, with methodologies and studies designed especially for this purpose, deriving from Group Communications and Decision Theory. This paper analyzes an environmental dispute in the City of Rio de Janeiro, applying conflict analysis methods and simulating its settlement. It concludes that the use of these methodologies in the developing countries may be undertaken with adaptations, designed to train community groups in negotiating while fostering the democratization of the settlement of these disputes.

Prescribing wellness: a case study exploring the use of health information brochures.

PubMed

Jamison, Jennifer R

2004-05-01

A case study was undertaken to ascertain the potential usefulness of brochures as a strategy for encouraging short-term and longer-term acquisition of healthy behaviors at the consumer-health care system interface. Purposive sampling of chiropractic clinics and convenience sampling of patients attending these primary contact practitioners were undertaken. Patients were asked to complete a questionnaire. Interested patients were given a health information brochure on topics of their choice. Patients who had requested health information brochures were phoned at 3 weeks, 3 months, and 1 year after completing the initial questionnaire and asked if they had implemented any of the suggestions for health promotion or risk prevention. A minimum of 4 attempts were made to contact each participant by telephone. Data were analyzed using descriptive statistics. Twenty-one chiropractic clinics and 781 patients participated. Although every third patient requested one or more health information brochures, fewer than 1 in 4 of those receiving brochures implemented some health-promoting behavior. Although some patients persisted with their newly initiated health-promoting behaviors, compliance diminished over time. Exercise and dietary change were the behaviors most likely to be modified. Implementation of even one healthy behavior can have a ubiquitous health benefit. Despite dwindling compliance, it is therefore suggested that suitably formulated health information brochures that inform and encourage adoption of healthy behaviors by motivated patients deserve consideration by all health professionals working at the consumer-health care system interface.

Durability of aneurysm treatments in patients with active Behcet's disease.

PubMed

Elsharawy, Mohamed A; Elsaid, Aymen; Al-Dhafery, Bander; Alghnimi, Ibrahim; Almabyouq, Fatimah

2016-10-01

Aneurysms in Behcet's disease are rare, serious, and recurrent. To achieve durable treatment, patients should receive immunosuppressive therapy before intervention to induce remission. We present early and long-term results of emergency cases of active Behcet's disease, which did not permit waiting for suppressive treatment. The study was undertaken on all cases admitted to the vascular unit, King Fahd Hospital of University for aneurysm treatment in patients with active Behcet's disease over about 10 years. All patients had exclusion of the aneurysm either by open surgery or endovascular intervention. Morbidities and mortality were recorded within the hospital admission and on the follow-up. During the study period, three cases were included. All interventions were successful and lifesaving. However, two cases, treated with surgical interposition grafts, were blocked in the intermediate term follow-up (2-12 months) and one case, treated with endovascular treatment, complicated with pseudoaneurysm at femoral puncture site after six months. Although early results were good, intermediate ones were not satisfactory because of progressive graft thrombosis and formation of new aneurysms. Awareness of these rare cases help for early identification and proper immunosuppressive before emergency vascular intervention is warranted. © The Author(s) 2015.

[Tonsillectomy for PANDAS?].

PubMed

Windfuhr, J P

2016-04-01

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disease attributed to children with obsessive compulsive or tic disorders associated with streptococcal infections. Because otolaryngologists evaluate a large number of pediatric patients with recurrent streptococcal infections, tonsillectomy (TE) is a common option of therapy. This study was undertaken to evaluate the efficacy of tonsillectomy in patients presenting with a verified PANDAS. A PubMed research was performed using search terms "tonsillectomy" and "PANDAS", "OCD", "compulsive", "pediatric autoimmune", "Chorea" and "Tic" limited by publication date January 1, 1995 to July 31, 2015. Reviews without patients were not included in the review. Nine papers matched our search terms, including 6 case reports with 8 patients and 3 case series. Most case reports were in favor for TE, but this was by far not supported by the findings in the case series. The follow-up ranged form 2-36 months (case reports) and 24-36 months (case series). establishing the diagnosis of PANDAS is complicated by underlying co-morbidities in the field of neurology-psychiatry and the lack of a reliable biomarker. The positive outcome after TE as reported in case studies may be influenced by the postoperative medication and is not supported by the results of large-scale studies. In the light of the considerable postoperative morbidity and unavoidable mortality rate it appears wise to indicate TE only in clinical studies with standardized inclusion criteria. © Georg Thieme Verlag KG Stuttgart · New York.

[RS3PE syndrome: An update on its treatment using the presentation of a case].

PubMed

Amodeo, M C; Poyato, M; Rodríguez, M

2015-01-01

The present study was undertaken in order to try to clarify certain aspects of RS3PE syndrome, for which there is no unanimity of opinion in the current literature. An attempt will be made to clarify the best and most suitable drug for treatment, and the dosage duration. In order to do this, a literature search was performed, and a review is presented of the 108 cases collected. In 95% cases glucocorticoids were the most used, with prednisone in being used in 68.5% of cases. Although there is no unanimity criteria regarding the dosage and duration, 73.8% cases were treated with a prednisone dose from 15 to 20 mg/day (median 18.2 mg/day, SD 8.9). Two-thirds (66.1%) of cases were treated for 3 to 6 months (median 5.3 months, SD 3.8). A case is presented that serves as a common thread of these observations. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Implementing nurse prescribing: a case study in diabetes.

PubMed

Stenner, Karen; Carey, Nicola; Courtenay, Molly

2010-03-01

This paper is a report of a study exploring the views of nurses and team members on the implementation of nurse prescribing in diabetes services. Nurse prescribing is adopted as a means of improving service efficiency, particularly where demand outstretches resources. Although factors that support nurse prescribing have been identified, it is not known how these function within specific contexts. This is important as its uptake and use varies according to mode of prescribing and area of practice. A case study was undertaken in nine practice settings across England where nurses prescribed medicines for patients with diabetes. Thematic analysis was conducted on qualitative data from 31 semi-structured interviews undertaken between 2007 and 2008. Participants were qualified nurse prescribers, administrative staff, physicians and non-nurse prescribers. Nurses prescribed more often following the expansion of nurse independent prescribing rights in 2006. Initial implementation problems had been resolved and few current problems were reported. As nurses' roles were well-established, no major alterations to service provision were required to implement nurse prescribing. Access to formal and informal resources for support and training were available. Participants were accepting and supportive of this initiative to improve the efficiency of diabetes services. The main factors that promoted implementation of nurse prescribing in this setting were the ability to prescribe independently, acceptance of the prescribing role, good working relationships between doctors and nurses, and sound organizational and interpersonal support. The history of established nursing roles in diabetes care, and increasing service demand, meant that these diabetes services were primed to assimilate nurse prescribing.

[Post-operative peritoneal washing cytology in cases of stage IIIa endometrial carcinoma with positive peritoneal cytology].

PubMed

Kato, T; Hirai, Y; Hasumi, K

1995-07-01

According to the new FIGO staging of corpus cancer, the cases with positive peritoneal cytology alone belong in stage IIIa. The authors previously reported, however, good prognosis of IIIa cases with only positive peritoneal cytology. In order to assess the potential of malignant cells in the peritoneal cavity to metastasize, post-operative peritoneal washing cytology was undertaken. This study was conducted on a total of 115 consecutive patients with endometrial carcinoma who underwent primary surgical therapy at the Cancer Institute Hospital during the 25-month period from December, 1991 to December, 1993. Fifteen cases were included in stage IIIa with positive intraoperative peritoneal cytology alone. In 12 cases with endometrioid adenocarcinoma, a Silascon tube was indwelt in the abdominal cavity before closure of the abdomen. The peritoneal cavity was washed with 500 ml of physiological saline through the indwelt tube 14 days after the operation. The cytology of recovered washings was negative in all cases. Only two cases received postoperative chemotherapy owing to other prognostic factors. These 12 cases are alive with no evidence of disease after 12 to 36 months. The present study demonstrated that malignant cells in the peritoneal cavity appear to have a very low potential for implantation into the peritoneum.

Liberalisation, gender, and the land question in sub-Saharan Africa.

PubMed

Izumi, K

1999-11-01

This article focuses on land reform initiatives undertaken in sub-Saharan African countries since the late 1980s. Section 1 sheds light on the changes in land tenure during the economic liberalization of the region. Section 2 briefly examines the gender-blind "mainstream" theoretical debates on land, and gender-sensitive studies on land issues. Section 3 offers insights on land issues in Africa from a gender perspective. Sections 4 and 5 reviewed the cases of Tanzania and Zimbabwe who have undergone a radical transition in terms of institutional land reforms since the 1980s, and the impact of economic and political liberalization on women's access and rights to land. Drawing on the two case studies, this paper is a call for policy makers, researchers, and activists to refocus their attention to these neglected issues.

Twinkle artefact in the ultrasound diagnosis of superficial epidermoid cysts

PubMed Central

Clarke, Richard; Suresh, Priya; Thomas, Rose

2016-01-01

Aim The aim of the study was to evaluate whether the twinkle artefact is a valuable feature in the sonographic diagnosis of superficial epidermoid cysts. Materials and methods A retrospective search was undertaken of our institution’s Radiology Information System and pathology database to identify cases of superficial masses showing the twinkle artefact that proceeded to surgical excision. Results Eighteen superficial masses demonstrating the twinkle artefact were identified that were submitted for pathological analysis. Of these, 17 were confirmed to represent epidermoid cysts and only 1 case had an alternative diagnosis (proliferating trichilemmal cyst). Conclusion The presence of the twinkle artefact appears to be a specific and valuable ancillary sonographic feature for the diagnosis of superficial epidermoid cysts. PMID:27867407

The Utility of Template Analysis in Qualitative Psychology Research.

PubMed

Brooks, Joanna; McCluskey, Serena; Turley, Emma; King, Nigel

2015-04-03

Thematic analysis is widely used in qualitative psychology research, and in this article, we present a particular style of thematic analysis known as Template Analysis. We outline the technique and consider its epistemological position, then describe three case studies of research projects which employed Template Analysis to illustrate the diverse ways it can be used. Our first case study illustrates how the technique was employed in data analysis undertaken by a team of researchers in a large-scale qualitative research project. Our second example demonstrates how a qualitative study that set out to build on mainstream theory made use of the a priori themes (themes determined in advance of coding) permitted in Template Analysis. Our final case study shows how Template Analysis can be used from an interpretative phenomenological stance. We highlight the distinctive features of this style of thematic analysis, discuss the kind of research where it may be particularly appropriate, and consider possible limitations of the technique. We conclude that Template Analysis is a flexible form of thematic analysis with real utility in qualitative psychology research.

Audit of Clinical Coding of Major Head and Neck Operations

PubMed Central

Mitra, Indu; Malik, Tass; Homer, Jarrod J; Loughran, Sean

2009-01-01

INTRODUCTION Within the NHS, operations are coded using the Office of Population Censuses and Surveys (OPCS) classification system. These codes, together with diagnostic codes, are used to generate Healthcare Resource Group (HRG) codes, which correlate to a payment bracket. The aim of this study was to determine whether allocated procedure codes for major head and neck operations were correct and reflective of the work undertaken. HRG codes generated were assessed to determine accuracy of remuneration. PATIENTS AND METHODS The coding of consecutive major head and neck operations undertaken in a tertiary referral centre over a retrospective 3-month period were assessed. Procedure codes were initially ascribed by professional hospital coders. Operations were then recoded by the surgical trainee in liaison with the head of clinical coding. The initial and revised procedure codes were compared and used to generate HRG codes, to determine whether the payment banding had altered. RESULTS A total of 34 cases were reviewed. The number of procedure codes generated initially by the clinical coders was 99, whereas the revised codes generated 146. Of the original codes, 47 of 99 (47.4%) were incorrect. In 19 of the 34 cases reviewed (55.9%), the HRG code remained unchanged, thus resulting in the correct payment. Six cases were never coded, equating to £15,300 loss of payment. CONCLUSIONS These results highlight the inadequacy of this system to reward hospitals for the work carried out within the NHS in a fair and consistent manner. The current coding system was found to be complicated, ambiguous and inaccurate, resulting in loss of remuneration. PMID:19220944

Cause of Death in “John Doe & Jane Doe”: A 5 year review

PubMed Central

Dasari, Harish; Singh, Amandeep

2014-01-01

Sometimes the opinion regarding the cause of death in “John Doe or Jane Doe” i.e. on unknown dead bodies is a test of ability of the forensic expert and on many occasions it yields little or no results. Here the identification of the body as such poses problems; rest aside the opinion regarding the cause/ manner of death. The present 5yr study was undertaken in the Department of Forensic Medicine & Toxicology, Government Medical College & Hospital, Chandigarh to find the patterns of cause of death in unknown dead bodies, as very little literature is available with regard to John Doe or Jane Doe cases as a group, in India. Unidentified bodies comprised 4 % of the total 3165 cases brought for post-mortem examination to the department. Maximum cases belonged to the age group 41 - 50 years, 30 %. Majority of the opinions regarding the cause of death were given as “no definite opinion” (31%), followed by “cranio-cerebral damage” (30 %) and coronary insufficiency/ Cardiac disease/ aortic aneurysm rupture, (8.9%). Following measures should be undertaken to increase the chances of getting these unknown bodies identified and thereby increasing the chances of arriving at a definite cause of death: drafting of additional legislation for the management of unidentified dead bodies along with streamlining of work on the part of police, use of active investigation and modern investigative techniques, fixing the accountability of the police. Internet based sites of the police like ZIPNET (Zonal Integrated Police Networking) in Northern India, should also be used. PMID:25302219

Alcohol and drug consumption, depressive features, and family violence as associated with complaints to the Prosecutor's Office in Central Mexico.

PubMed

Rey, Guillermina Natera; García, Francisco Juárez; Icaza, María Elena Medina-Mora; Sainz, Marcela Tiburcio

2007-01-01

The article is aimed at reporting the characteristics of the population detected at State Prosecutors' Offices including the two such offices that existed in the city selected for the study, one located in a general hospital for the inspection of violence-related cases (n = 156); and the second in the facility where all detainees are taken when arrested (n = 129), and where victims can file a complaint (n = 186). A household survey undertaken among the population 18 to 65 years of age (n = 887) was used as a group of reference. Both studies were undertaken in Pachuca City, the capital of Hidalgo, located 100 km from Mexico City during the second half of 1996. Face-to-face questionnaires were used to obtain sociodemographic data, drug use and drinking patterns, depressive symptomatology, and family violence. Discriminant and logistic regression analysis were undertaken. The age group from 18 to 24 displayed the highest number of legal complaints and arrests (OR = 1.773). The likelihood for appearing at a State Prosecutor's Office was higher for those living in an atmosphere of threats and injuries within the family (OR = 19) and for those that reported alcohol consumption on the day of the event (OR = 14). Extremely high rates of family violence were obtained in this sample, increasing the likelihood of arriving at the Prosecutor's Office either because arrested or for being a victim. Results confirm the relationship between alcohol use, depression, and violence, reinforcing the need to prevent alcohol abuse, especially among youth.

Histological Changes in the Thyroid Gland in Cases of Infant and Early Childhood Asphyxia-A Preliminary Study.

PubMed

Byard, Roger W; Bellis, Maria

2016-05-01

A retrospective blinded study of thyroid gland histology was undertaken in 50 infants and young children aged from 1 to 24 months. Deaths were due to (i) suffocation (N = 7), hanging (4), wedging (3), and chest and/or neck compression (4), and (ii) SIDS (20), noncervical trauma (7), organic disease, (4) and drug toxicity (1). In the asphyxia group (N = 18), thyroid gland congestion ranged from 0 to 3+ with 39% of cases (7/18) having moderate/marked congestion. In three cases, focal aggregates of red blood cells (blood islands) were observed within the intrafollicular colloid. These deaths involved chest compression, chest and/or neck compression, and crush asphyxia in a vehicle accident, and all had facial petechiae. Only 22% of the 32 control cases (7/32) had moderate/marked congestion with no blood islands being identified (p < 0.05). Blood islands within the thyroid gland may be caused by congestion associated with crushing or compression and may provide supportive evidence for this diagnosis. © 2016 American Academy of Forensic Sciences.

Surgical Management of Dural Arteriovenous Fistula After Craniotomy: Case Report and Review of Literature.

PubMed

Pabaney, Aqueel H; Robin, Adam M; Basheer, Azam; Malik, Ghaus

2016-05-01

Development of dural arteriovenous fistula (dAVF) with cortical venous drainage at the site of previous craniotomy is a rare manifestation of nontraumatic subarachnoid hemorrhage (SAH). The authors present a case of postcraniotomy dAVF formation and discuss plausible underlying mechanisms of fistula formation and treatment options as well as review the literature. A 62-year-old man, who had undergone craniotomy 2 decades previously, presented with SAH. Workup revealed a low-flow dAVF with leptomeningeal venous drainage at the posterior margin of the craniotomy. Surgical resection of fistula was undertaken that resulted in cure. Spontaneous SAH in patients with a previous history of an intracranial procedure (e.g., craniotomy, ventriculostomy) should prompt detailed imaging evaluation. In the absence of vascular disease, meticulous review of the angiogram must be undertaken to rule out dAVF at the procedure site and it should be treated definitively. Copyright © 2016 Elsevier Inc. All rights reserved.

The doctor in claims for work injuries and ill health--legal pitfalls.

PubMed

Lee, See-Muah; Sng, Judy; Koh, David

2009-08-01

Occupational health work is currently undertaken by the specialist and the non-specialist physician alike. The work scope can vary from medical assessments of individual workers to health risk assessment at the workplace. The scope of the latter will include evaluation of exposures, hazards, risks and its management to control these risks. Much of the case law governing legal disputes over industrial safety and health have involved the employers. Over the years, the actions brought forth by workers have resulted in a formidable volume of case law based on statutes and on the common law of negligence in tort. Disputes over the assessment of workers' health or workplace health risks to the extent that it is a failure to discharge a reasonable standard of care, may result in the doctor being a defendant. Measures to prevent these legal pitfalls include communication with employers about the causative link of the illness suffered to workplace factors and the clarity of contractual obligations undertaken with regard to workplace health risk assessment.

Pulmonary fibrosis in asbestos insulation workers with lung cancer: a radiological and histopathological evaluation.

PubMed Central

Kipen, H M; Lilis, R; Suzuki, Y; Valciukas, J A; Selikoff, I J

1987-01-01

This study was undertaken to determine the relation between radiographic and histological manifestations of pulmonary asbestosis (interstitial fibrosis) in insulation workers who had died of lung cancer. Of 450 confirmed deaths from lung cancer a chest radiograph suitable for determining evidence of pneumoconiosis was obtained in 219. Of these cases, 138 also had a tissue specimen submitted that was suitable for histological study to determine the extent of histological fibrosis. There was a significant albeit limited correlation between the radiographic and histological findings (r = 0.27, p less than 0.0013). All 138 cases had histological evidence of parenchymal fibrosis; in 25 (18%), however, there was no radiographic evidence of parenchymal fibrosis. In 10 cases (7%) both parenchymal and pleural disease were undetectable on the radiograph. Thus a negative chest radiograph does not exclude the presence of interstitial fibrosis (asbestosis) in a substantial proportion of insulation workers previously exposed to asbestos who develop lung cancer. PMID:3814551

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.

Hypothyroidism presenting as reversible renal impairment: an interesting case report.

PubMed

Vikrant, Sanjay; Chander, Subhash; Kumar, Satish; Gupta, Dalip

2013-10-01

We describe an interesting case of reversible renal impairment secondary to hypothyroidism. A 57-years-old man was referred from peripheral institution for evaluation of elevated serum creatinine. He had vague complaints of weakness, lethargy and muscle ache but no urinary symptoms. He was found to have hypothyroidism, and thyroid hormone replacement therapy (THRT) was started which resulted in reversal of the renal dysfunction. There was marked improvement in estimated glomerular filtration rate. 99mTc DTPA renal scans done before and after THRT suggested hypothyroidism responsible for this reversible renal impairment. Several studies have described the pathophysiology of diminished renal function in hypothyroidism. Few studies or case reports have shown total amelioration of renal impairment as seen in our patient. The etiology is presumed to be multifactorial, in which hemodynamic effects and a direct effect of thyroid hormone on the kidney play an important role. We suggest that patients with renal impairment of unknown cause have thyroid function tests undertaken as part of routine investigation.

Case Study Analysis of U.S. Policy Solutions to Enable China New Energy Cities

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

Simon, J.; Tian, T.; Liu, C.

2015-05-28

This report summarizes various policies for encouraging investment and installation of renewable energy across the country. In particular, we attempt to explain the benefits of, and considerations behind, each policy type and provide examples of implementation across the United States While recognized as important, this report does not address policies or examples of successful energy efficiency or alternative-fuel vehicle strategies. In addition, we summarize the renewable energy policy strategies undertaken by three areas of the United States: New Jersey, Hawaii, and San Francisco.

Quantitation of cholesterol incorporation into extruded lipid bilayers.

PubMed

Ibarguren, Maitane; Alonso, Alicia; Tenchov, Boris G; Goñi, Felix M

2010-09-01

Cholesterol incorporation into lipid bilayers, in the form of multilamellar vesicles or extruded large unilamellar vesicles, has been quantitated. To this aim, the cholesterol contents of bilayers prepared from phospholipid:cholesterol mixtures 33-75 mol% cholesterol have been measured and compared with the original mixture before lipid hydration. There is a great diversity of cases, but under most conditions the actual cholesterol proportion present in the extruded bilayers is much lower than predicted. A quantitative analysis of the vesicles is thus required before any experimental study is undertaken. 2010 Elsevier B.V. All rights reserved.

Genetic and environmental risk factors for rheumatoid arthritis in a UK African ancestry population: the GENRA case-control study.

PubMed

Traylor, Matthew; Curtis, Charles; Patel, Hamel; Breen, Gerome; Hyuck Lee, Sang; Xu, Xiaohui; Newhouse, Stephen; Dobson, Richard; Steer, Sophia; Cope, Andrew P; Markus, Hugh S; Lewis, Cathryn M; Scott, Ian C

2017-08-01

To evaluate whether genetic and environmental factors associated with RA in European and Asian ancestry populations are also associated with RA in African ancestry individuals. A case-control study was undertaken in 197 RA cases and 868 controls of African ancestry (Black African, Black Caribbean or Black British ethnicity) from South London. Smoking and alcohol consumption data at RA diagnosis was captured. Genotyping was undertaken (Multi-Ethnic Genotyping Array) and human leukocyte antigen (HLA) alleles imputed. The following European/Asian RA susceptibility factors were tested: 99 genome-wide loci combined into a genetic risk score; HLA region [20 haplotypes; shared epitope (SE)]; smoking; and alcohol consumption. The SE was tested for its association with radiological erosions. Logistic regression models were used, including ancestry-informative principal components, to control for admixture. European/Asian susceptibility loci were associated with RA in African ancestry individuals. The genetic risk score provided an odds ratio (OR) for RA of 1.53 (95% CI: 1.31, 1.79; P = 1.3 × 10 - 7 ). HLA haplotype ORs in European and African ancestry individuals were highly correlated ( r = 0.83, 95% CI: 0.56, 0.94; P = 1.1 × 10 - 4 ). Ever-smoking increased (OR = 2.36, 95% CI: 1.46, 3.82; P = 4.6 × 10 - 4 ) and drinking alcohol reduced (OR = 0.34, 95% CI: 0.20, 0.56; P = 2.7 × 10 - 5 ) RA risk in African ancestry individuals. The SE was associated with erosions (OR = 2.61, 95% CI: 1.36, 5.01; P = 3.9 × 10 - 3 ). Gene-environment RA risk factors identified in European/Asian ancestry populations are relevant in African ancestry individuals. As modern statistical methods facilitate analysing ancestrally diverse populations, future genetic studies should incorporate African ancestry individuals to ensure their implications for precision medicine are universally applicable. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Some in-field experiences of non-synchronous vibrations in large rotating machinery

NASA Technical Reports Server (NTRS)

Colnago, Giuseppe; Frigeri, Claudio; Vallini, Andrea; Zanetta, Gian Antonio

1989-01-01

Some problems associated with non-synchronous vibrations are analyzed by describing three cases experienced with fairly large rotating machines in operating conditions. In each case, a brief description is first given of the machine and of the instrumentation used. The experimental results are then presented, with reference to time or frequency domain recordings. The lines followed in diagnosis are then discussed and, lastly, the corrective action undertaken is presented.

Surgical, Orthodontic and Prosthodontic Rehabilitation of a Patient with Follicular Ameloblastoma: A Case Report

PubMed Central

Sailer, Herman F.; Tarawneh, Fadi; Fourkas, Panagiotis; Antoniades, Dimitrios Z.; Athanasiou, Athanasios E.

2010-01-01

This case report describes the combined surgical, orthodontic and prosthodontic rehabilitation of an adult female patient with a previous history of follicular ameloblastoma, which was treated through partial mandibulectomy and an immediate replacement of missing bone with an autologous calvarial bone graft. Orthodontic treatment was undertaken in order to restore occlusal disturbances and obtain sufficient space for two dental implants and an optimum prosthodontic rehabilitation. PMID:20396452

Anesthetic management of an obstetric patient with MELAS syndrome: case report and literature review.

PubMed

Maurtua, M; Torres, A; Ibarra, V; DeBoer, G; Dolak, J

2008-10-01

Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS syndrome) is a mitochondrial disorder associated with neurologic, cardiac, neuromuscular, hepatic, metabolic and gastrointestinal dysfunction and potential anesthetic and obstetric complications. The case of a parturient with MELAS syndrome requiring labor analgesia is presented. A Medline literature search limited to the English language was undertaken to review cases of MELAS syndrome. Based on our experience and literature review, parturients with MELAS syndrome appear to benefit from neuraxial analgesia and anesthesia, which blunt excessive oxygen consumption and acidosis.

Mesothelioma associated with the shipbuilding industry in coastal Virginia.

PubMed

Tagnon, I; Blot, W J; Stroube, R B; Day, N E; Morris, L E; Peace, B B; Fraumeni, J F

1980-11-01

A case-control study was undertaken to clarify reasons for a four-fold increased incidence of mesothelioma discovered among white males in coastal Tidewater, Va., from 1972 to 1978. Sixty-one cases were identified. Interviews with next of kin revealed that the excess was linked to employment in area shipyards. Three-fourths of the cases had been employed in the shipbuilding industry, nearly all beginning employment prior to 1950. Most were career employees, but an increased risk was also found among those who worked only temporarily, mainly during World War II, and were reportedly exposed to asbestos. More of the cases than controls were pipecoverers or pipefitters, but cases were reported to work in a variety of shipyard trades. Few of the mesothelioma cases were heavy smokers, a trend that may be related in part to the competing risks for fatal diseases caused by the interactions of smoking and asbestos exposure. Information obtained by interview for five of the six white females diagnosed with mesothelioma revealed that the husband of four had been employed in the shipbuilding industry.

Novel application of the matched case-control design to compare food supply chains during an Escherichia coli O157 outbreak, United Kingdom, 2016.

PubMed

Inns, Thomas; Cleary, Paul; Bundle, Nick; Foulkes, Sarah; Sharp, Ashley; Utsi, Lara; McBrien, Chris; Teagle, Rehman; Waldram, Alison; Williams, Chris; McCann, Cathy; Smith, Rob; Saleh, Sepeedeh; McCarthy, Noel; Vivancos, Roberto; Hawker, Jeremy; Decraene, Valerie

2018-05-01

There is a need for innovative methods to investigate outbreaks of food-borne infection linked to produce with a complex distribution network. The investigation of a large outbreak of Escherichia coli O157 PT34 infection in the United Kingdom in 2016 indicated that catering venues associated with multiple cases had used salad leaves sourced from one supplier. Our aim was to investigate whether catering venues linked to cases were more likely to have used salad leaves from this supplier. We conducted a matched case-control study, with catering venues as the units of analysis. We compared venues linked to cases to those without known linked cases. We included 43 study pairs and obtained information on salad leaf products received by each venue. The odds of a case venue being supplied with salad leaves by Supplier A were 7.67 times (95% confidence interval: 2.30-25.53) those of control venues. This association provided statistical evidence to support the findings of the other epidemiological investigations undertaken for this outbreak. This is a novel approach which is labour-intensive but which addresses the challenge of investigating exposures to food across a complex distribution network.

Genome-wide association study of preeclampsia detects novel maternal single nucleotide polymorphisms and copy-number variants in subsets of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study cohort

PubMed Central

Zhao, Linlu; Bracken, Michael B.; DeWan, Andrew T.

2013-01-01

Summary A genome-wide association study was undertaken to identify maternal single nucleotide polymorphisms (SNPs) and copy-number variants (CNVs) associated with preeclampsia. Case-control analysis was performed on 1070 Afro-Caribbean (n=21 cases and 1049 controls) and 723 Hispanic (n=62 cases and 661 controls) mothers and 1257 mothers of European ancestry (n=50 cases and 1207 controls) from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. European ancestry subjects were genotyped on Illumina Human610-Quad and Afro-Caribbean and Hispanic subjects were genotyped on Illumina Human1M-Duo BeadChip microarrays. Genome-wide SNP data were analyzed using PLINK. CNVs were called using three detection algorithms (GNOSIS, PennCNV, and QuantiSNP), merged using CNVision, and then screened using stringent criteria. SNP and CNV findings were compared to those of the Study of Pregnancy Hypertension in Iowa (SOPHIA), an independent preeclampsia case-control dataset of Caucasian mothers (n=177 cases and 116 controls). A list of top SNPs were identified for each of the HAPO ethnic groups, but none reached Bonferroni-corrected significance. Novel candidate CNVs showing enrichment among preeclampsia cases were also identified in each of the three ethnic groups. Several variants were suggestively replicated in SOPHIA. The discovered SNPs and copy-number variable regions present interesting candidate genetic variants for preeclampsia that warrant further replication and investigation. PMID:23551011

Potential Psychosocial Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case-Control Study

PubMed Central

Fillingim, Roger B.; Ohrbach, Richard; Greenspan, Joel D.; Knott, Charles; Dubner, Ronald; Bair, Eric; Baraian, Cristina; Slade, Gary D.; Maixner, William

2011-01-01

Case-control studies have consistently associated psychosocial factors with chronic pain in general, and with temporomandibular disorders (TMD) specifically. Moreover, a handful of prospective studies suggest that pre-existing psychosocial characteristics represent risk factors for new onset TMD. The current study presents psychosocial findings from the baseline case-control study of the Orofacial Pain Prospective Evaluation and Risk Assessment (OPPERA) cooperative agreement. For this study, 1,633 TMD-free controls and 185 TMD cases completed a battery of psychosocial instruments assessing general psychosocial adjustment and personality, affective distress, psychosocial stress, somatic awareness, and pain coping and catastrophizing. In bivariate and demographically-adjusted analyses, odds of TMD were associated with higher levels of psychosocial symptoms, affective distress, somatic awareness, and pain catastrophizing. Among controls, significant gender and ethnic group differences in psychosocial measures were observed, consistent with previous findings. Principal component analysis was undertaken to identify latent constructs revealing four components: stress and negative affectivity, global psychosocial symptoms, passive pain coping, and active pain coping. These findings provide further evidence of associations between psychosocial factors and TMD. Future prospective analyses in the OPPERA cohort will determine if the premorbid presence of these psychosocial factors predicts increased risk for developing new-onset TMD. PMID:22074752

A Systematic Review Comparing the Acceptability, Validity and Concordance of Discrete Choice Experiments and Best-Worst Scaling for Eliciting Preferences in Healthcare.

PubMed

Whitty, Jennifer A; Oliveira Gonçalves, Ana Sofia

2018-06-01

The aim of this study was to compare the acceptability, validity and concordance of discrete choice experiment (DCE) and best-worst scaling (BWS) stated preference approaches in health. A systematic search of EMBASE, Medline, AMED, PubMed, CINAHL, Cochrane Library and EconLit databases was undertaken in October to December 2016 without date restriction. Studies were included if they were published in English, presented empirical data related to the administration or findings of traditional format DCE and object-, profile- or multiprofile-case BWS, and were related to health. Study quality was assessed using the PREFS checklist. Fourteen articles describing 12 studies were included, comparing DCE with profile-case BWS (9 studies), DCE and multiprofile-case BWS (1 study), and profile- and multiprofile-case BWS (2 studies). Although limited and inconsistent, the balance of evidence suggests that preferences derived from DCE and profile-case BWS may not be concordant, regardless of the decision context. Preferences estimated from DCE and multiprofile-case BWS may be concordant (single study). Profile- and multiprofile-case BWS appear more statistically efficient than DCE, but no evidence is available to suggest they have a greater response efficiency. Little evidence suggests superior validity for one format over another. Participant acceptability may favour DCE, which had a lower self-reported task difficulty and was preferred over profile-case BWS in a priority setting but not necessarily in other decision contexts. DCE and profile-case BWS may be of equal validity but give different preference estimates regardless of the health context; thus, they may be measuring different constructs. Therefore, choice between methods is likely to be based on normative considerations related to coherence with theoretical frameworks and on pragmatic considerations related to ease of data collection.

Lung transplantation in Hong Kong: 12 years of experience.

PubMed

Wong, Chi Fong; Fung, Siu Leung; Yan, See Wan; Lee, Joseph; Cheng, Lik Cheung; Chiu, Clement S W

2008-11-01

A lung transplant programme was launched in August 1994 at Grantham Hospital in Hong Kong with the first single-lung transplant performed in July 1995. A retrospective study was undertaken of all patients who had undergone lung transplantation and their outcomes analysed. Data were collected from hospital and outpatient records. There were 12 transplants (two single-lung and 10 double-lung) performed in the 12 years to December 2006. No postoperative or early mortality was observed. In addition to the usual complications there were two cases of early pulmonary tuberculosis and one rare case of delayed fungal sternotomy infection. The 1-year, 3-year and 5-year survival rates were 100%, 100% and 76.2%, respectively. All fatalities were related to the consequences of chronic rejection or its treatment. Despite the limited experience and the small case volume, the survival of patients was good and comparable with international experience.

[Renal dysplasia: clinico-pathologic review].

PubMed

Cunha, A S; de Sousa, J F; Garcia, C

1992-05-01

Histology records from 63 nephrectomies were reviewed; 22 patients had unilateral totally dysplastic kidneys and 5 had polar or segmental dysplasia. A clinicopathological study of these cases was undertaken. In the first group, there was a slight male preponderance and 75% of the patients presented were under two years of age. Urinary tract infection was the most common complaint. 4 patients were diagnosed in utero by ultrasound and 5 infants presented an abdominal mass. Hypertension was documented in a newborn baby. Ipsilateral lower urinary tract anomalies were found in 12 patients and those of the contralateral kidney in 2 children. There were 3 cases of extrarenal anomalies. Histological examination revealed 13 cases of multicystic dysplasia and 9 of solid dysplasia. Metaplastic cartilage was found in 1 case. In the group of segmental dysplasia, age ranging from 27 weeks' gestation to 8 years, at the time of the diagnosis. They all had duplex kidneys and 4 had ureterocele. Histological study in these cases was similar to the one found in the previous series, although superimposed inflammatory changes were more pronounced. Some of the theories regarding the pathogenesis of this disorder are reviewed and the importance of its diagnosis is emphasised.

Giant cell tumour of tendon sheath: A 10-year study from a tertiary care centre.

PubMed

Kumar, R; Bharani, V; Gupta, N; Gupta, K; Dey, P; Srinivasan, R; Rajwanshi, A

2018-06-01

Cytology of giant cell tumour of tendon sheath (GCTTS) is often sufficient to diagnose this lesion and has been previously described in small series. The present study was undertaken to evaluate detailed cytomorphological features and differential diagnostic entities and pitfalls in the diagnosis. All the cases of GCTTS reported on FNAC were retrieved from July 2007 to June 2017. The cases were reviewed for various cytomorphological features, which were correlated with follow-up histopathology wherever available. A total of 72 cases of GCTTS were retrieved, follow-up histopathology was available in 20 cases. The common sites of involvement were fingers and palm followed by wrists, elbow, knee, ankle and shoulder. The characteristic cytomorphology consisted of mononuclear cells, multinucleated giant cells and pigment laden macrophages in variable numbers. There were four discordant cases that were confirmed on histopathology as sarcoidosis, melanoma, fibrous histiocytoma and eumycetoma. GCTTS can be confused cytologically with giant cell rich lesions of bone and soft tissue and pigment containing lesions including melanoma. Ladybird cell is a characteristic feature seen in this lesion. Proper clinicoradiological correlation is essential before offering a diagnosis of GCTTS on cytology. © 2018 John Wiley & Sons Ltd.

Giant scrotal elephantiasis.

PubMed

Kuepper, Daniel

2005-02-01

How much can a man carry? Penoscrotal elephantiasis is a debilitating syndrome. This is a case report of a patient with giant genital elephantiasis secondary to long-standing lymphogranuloma venereum infection in Ethiopia. Complete surgical resection of the pathologic tissue and penile reconstruction was undertaken with good cosmetic and functional results.

Prevalence and predictors of refractive error and spectacle coverage in Nakuru, Kenya: a cross-sectional, population-based study.

PubMed

Bastawrous, Andrew; Mathenge, Wanjiku; Foster, Allen; Kuper, Hannah

2013-10-01

A cross-sectional study was undertaken in Nakuru, Kenya to assess the prevalence of refractive error and the spectacle coverage in a population aged ≥50 years. Of the 5,010 subjects who were eligible, 4,414 underwent examination (response rate 88.1 %). LogMAR visual acuity was assessed in all participants and refractive error was measured in both eyes using a Topcon auto refractor RM8800. Detailed interviews were undertaken and ownership of spectacles was assessed. Refractive error was responsible for 51.7 % of overall visual impairment (VI), 85.3 % (n = 191) of subjects with mild VI, 42.7 % (n = 152) of subjects with moderate VI, 16.7 % (n = 3) of subjects with severe VI and no cases of blindness. Myopia was more common than hyperopia affecting 59.5 % of those with refractive error compared to 27.4 % for hyperopia. High myopia (<-5.0 DS) was also more common than extreme hyperopia (>+5.0 DS). Of those who needed distance spectacles (spectacle coverage), 25.5 % owned spectacles. In conclusion, the oldest, most poor and least educated are most likely to have no spectacles and they should be specifically targeted when refractive services are put in place.

Armanni-Ebstein phenomenon and hypothermia.

PubMed

Zhou, Chong; Byard, Roger W

2011-03-20

Retrospective review was undertaken of 46 cases of lethal hypothermia for the presence of subnuclear vacuolization of renal tubular epithelial cells. Fifteen of the 46 cases (33%) had renal tubular vacuolization typical of the Armanni-Ebstein phenomenon. The age range was 30-87 years (average 59 years) with a male to female ratio of 6:9. Nine of the 15 cases with Armanni-Ebstein changes (60%) had a history of diabetes mellitus, and in seven of these vitreous humour biochemical analyses were performed, all of which revealed diabetic ketoacidosis (vitreous glucose levels = 32.9-85.3 mmol/L; β-hydroxybutyrate = 7.4-20 mmol/L). This study has confirmed the association between hypothermia and renal tubular epithelial vacuolization, but in addition raises the prospect that this may be contributed to in some cases by underlying diabetic ketoacidosis. Hypothermic deaths should, therefore, raise the possibility of diabetes mellitus and initiate postmortem biochemical measurement of vitreous humor glucose and β-hydroxybutyrate levels. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The learning curve of robot-assisted laparoscopic fundoplication in children: a prospective evaluation and CUSUM analysis.

PubMed

Cundy, Thomas P; Rowland, Simon P; Gattas, Nicholas E; White, Alan D; Najmaldin, Azad S

2015-06-01

Fundoplication is a leading application of robotic surgery in children, yet the learning curve for this procedure (RF) remains ill-defined. This study aims to identify various learning curve transition points, using cumulative summation (CUSUM) analysis. A prospective database was examined to identify RF cases undertaken during 2006-2014. Time-based surgical process outcomes were evaluated, as well as clinical outcomes. A total of 57 RF cases were included. Statistically significant transitions beyond the learning phase were observed at cases 42, 34 and 37 for docking, console and total operating room times, respectively. A steep early learning phase for docking time was overcome after 12 cases. There were three Clavien-Dindo grade ≥ 3 complications, with two patients requiring redo fundoplication. We identified numerous well-defined learning curve trends to affirm that experience confers significant temporal improvements. Our findings highlight the value of the CUSUM method for learning curve evaluation. Copyright © 2014 John Wiley & Sons, Ltd.

Lack of association between alpha2-macroglobulin polymorphisms and Alzheimer's disease.

PubMed

Wang, X; Luedecking, E K; Minster, R L; Ganguli, M; DeKosky, S T; Kamboh, M I

2001-02-01

This study was undertaken to investigate the role of two alpha2-macroglobulin (A2M) polymorphisms, an intronic 5-bp deletion and Ile1000Val, in the development of Alzheimer's disease (AD) and to evaluate the interaction between the apolipoprotein E (APOE) and A2M polymorphisms. The A2M polymorphisms were screened by using polymerase-chain-reaction-based assays in 555 white late-onset AD cases and 446 controls. The gentoype distributions of the 5-bp deletion and Ile1000Val polymorphisms were comparable between cases and controls (P = 0.158 and P = 0.148, respectively). Likewise, there was no significant difference in allele frequencies of each polymorphism among cases and controls (P = 0.361 and P = 0.062, respectively). The stratification of data by APOE*4 status also did not yield any significant association. In conclusion, we observed no association between either the intronic deletion polymorphism or the Ile1000Val polymorphism of A2M and AD in our case-control cohort.

[Steinert myotonic dystrophy and blepharoptosis surgery: 9 case reports].

PubMed

Karim, A; Schapiro, D; Morax, S

2003-01-01

Steinert myopathic dystrophy is a generalized, hereditary disease with bone, muscular, heart and ocular involvement. This is a retrospective study of nine patients with significant blepharoptosis due to Steinert disease, who were treated at the Adolphe de Rothschild Ophthalmology Foundation over a period of 5 years. Ptosis was symmetric and major in all cases with poor levator excursion. Severity criteria were an absence of the Bell phenomenon and diminished orbicularis tone. A frontalis suspension was performed in eight cases with intentional undercorrection. The outcome was favorable in all cases, 2 with a slight overcorrection underwent a second operation conclusion: Surgical treatment of ptosis in Steinert disease is difficult because of a risk of lagophthalmic, keratopathy due to the severity of the disease, an absence of the Bell phenomenon and ophthalmoplegia. This surgery must be undertaken with caution, most often using a frontalis suspension. Undercorrection must be systematic, with the single goal of freeing the pupil in the primary position.

Primary breast lymphomas--a retrospective analysis of twelve cases.

PubMed

Barişta, I; Baltali, E; Tekuzman, G; Kars, A; Ruacan, S; Ozişik, Y; Güler, N; Güllü, I H; Atahan, I L; Firat, D

2000-01-01

This study was undertaken to define the natural history and treatment results of patients with primary breast non-Hodgkin's lymphoma (NHL). Twelve female patients who had been followed at Hacettepe University Hospital between 1973 and 1997 were retrospectively evaluated. All patients presented with breast masses (6 in the right breast and 6 in the left) that had recently enlarged. The most common histologic subtype was diffuse, small cleaved-cell lymphoma. Chemotherapy regimens were employed in 9 patients. Radiotherapy was delivered to the breast and its lymphatics in 8 patients. Lumpectomy, simple or modified radical mastectomy was performed in 5 cases. An objective response was attained with surgery, chemotherapy, or radiotherapy alone in 2, 1, and 1 cases, respectively. Combined modality treatment including either two or three modalities was successful in 7 cases. The median progression-free and overall survival times were 49 and 56 months, respectively. Although primary NHL of the breast is a rare disease compared to carcinoma, it should be considered in the differential diagnosis of breast masses.

Osmotic demyelination syndrome associated with hypophosphataemia: 2 cases and a review of literature.

PubMed

Turnbull, Jessica; Lumsden, Daniel; Siddiqui, Ata; Lin, Jean-Pierre; Lim, Ming

2013-04-01

Central and extrapontine myelinolysis are collectively known as osmotic demyelination syndrome. This encephalopathic illness has been well documented in the adult literature, occurring most commonly in the context of chronic alcoholism, correction of hyponatraemia and liver transplantation. Aetiology and outcome in the paediatric population are less well understood. Two cases of osmotic demyelination syndrome occurring in children with transient severe hypophosphataemia during the course of their illness are presented. Both had very different neurological outcomes, but the changes of central and extrapontine myelinolysis were apparent on neuroimaging. Sixty-one cases in the paediatric literature were then reviewed. We summarize aetiology and outcome in paediatric cases of osmotic demyelination syndrome and postulate a role for hypophosphataemia as a contributing factor in the development of these sometimes devastating conditions. Hypophosphataemia may contribute to the risk of developing osmotic demyelination syndrome in at-risk paediatric patients and further study of this association should be undertaken. ©2012 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.

The contributions of human factors and ergonomics to a sustainable minerals industry.

PubMed

Horberry, Tim; Burgess-Limerick, Robin; Fuller, Ruth

2013-01-01

This article describes examples of the application of human factors research and development work to a sustainable minerals industry. It begins by outlining human-related aspects of the minerals industry and the key human factors work previously undertaken in this domain. The focus then switches to sustainability in the minerals industry. Sustainability principles are introduced and illustrations provided of how human factors research and development work fits within such a framework. Three case studies of human factors in the minerals industry research are presented and the sustainability implications in each case study are highlighted. Finally, future trends related to human factors work in a sustainable minerals industry are addressed, in particular the opportunities and possible adverse consequences that increasing deployment of mining automation might bring. Minerals industries are a major global activity with significant sustainability implications. Aspects of sustainability in mining are examined using three case studies. These illustrate the contribution of human factors/ergonomics in reducing risks; developing emergency response management systems; and the value of participatory ergonomics in improving the design of mining equipment.

Are transnational tobacco companies' market access strategies linked to economic development models? A case study of South Korea.

PubMed

Lee, Sungkyu; Holden, Chris; Lee, Kelley

2013-01-01

Transnational tobacco companies (TTCs) have used varied strategies to access previously closed markets. Using TTCs' efforts to enter the South Korean market from the late 1980s as a case study, this article asks whether there are common patterns in these strategies that relate to the broader economic development models adopted by targeted countries. An analytical review of the existing literature on TTCs' efforts to access emerging markets was conducted to develop hypotheses relating TTCs' strategies to countries' economic development models. A case study of Korea was then undertaken based on analysis of internal tobacco industry documents. Findings were consistent with the hypothesis that TTCs' strategies in Korea were linked to Korea's export-oriented economic development model and its hostile attitude towards foreign investment. A fuller understanding of TTCs' strategies for expansion globally can be derived by locating them within the economic development models of specific countries or regions. Of foremost importance is the need for governments to carefully balance economic and public health policies when considering liberalisation.

Are transnational tobacco companies’ market access strategies linked to economic development models? A case study of South Korea

PubMed Central

Lee, Sungkyu; Holden, Chris; Lee, Kelley

2013-01-01

Transnational tobacco companies (TTCs) have used varied strategies to access previously closed markets. Using TTCs’ efforts to enter the South Korean market from the late 1980s as a case study, this article asks whether there are common patterns in these strategies that relate to the broader economic development models adopted by targeted countries. An analytical review of the existing literature on TTCs’ efforts to access emerging markets was conducted to develop hypotheses relating TTCs’ strategies to countries’ economic development models. A case study of Korea was then undertaken based on analysis of internal tobacco industry documents. Findings were consistent with the hypothesis that TTCs’ strategies in Korea were linked to Korea’s export-oriented economic development model and its hostile attitude toward foreign investment. A fuller understanding of TTCs’ strategies for expansion globally can be derived by locating them within the economic development models of specific countries or regions. Of foremost importance is the need for governments to carefully balance economic and public health policies when considering liberalisation. PMID:23327486

Prevalence and Risk Factors of Esophageal Candidiasis in Healthy Individuals: A Single Center Experience in Korea

PubMed Central

Choi, Jae Hyeuk; Lee, Chang Geun; Kang, Hyoun Woo; Lim, Chi Yeon; Choi, Jong-Sun

2013-01-01

Purpose Esophageal candidiasis (EC) is the most frequent opportunistic fungal infection in immunocompromised host. However, we have found EC in healthy individuals through esophagogastroduodenoscopy (EGD). The aim of this study was to determine the prevalence and risk factors for EC in healthy individuals. Materials and Methods We retrospectively reviewed the medical records of 281 patients who had been incidentally diagnosed with EC. We also conducted age and sex matched case control study to identify the risk factor for EC. Results The prevalence of EC was 0.32% (281/88125). The most common coexisting EGD finding was reflux esophagitis (49/281, 17.4%). An antifungal agent was prescribed in about half of EC, 139 cases (49.5%). Follow-up EGD was undertaken in 83 cases (29.5%) and 20 cases of candidiasis was persistently found. Case control study revealed EC were more often found in user of antibiotics (p=0.015), corticosteroids (p=0.002) and herb medication (p=0.006) as well as heavy drinking (p<0.001). Conclusion The prevalence of EC was 0.32% (281/88125) in Korea. Use of antibiotics, corticosteroids and herb as well as heavy drinking were significant risk factors for EC in healthy individuals. PMID:23225813

Effect of coffee (caffeine) against human cataract blindness

PubMed Central

Varma, Shambhu D

2016-01-01

Previous biochemical and morphological studies with animal experiments have demonstrated that caffeine given topically or orally to certain experimental animal models has significant inhibitory effect on cataract formation. The present studies were undertaken to examine if there is a correlation between coffee drinking and incidence of cataract blindness in human beings. That has been found to be the case. Incidence of cataract blindness was found to be significantly lower in groups consuming higher amounts of coffee in comparison to the groups with lower coffee intake. Mechanistically, the caffeine effect could be multifactorial, involving its antioxidant as well as its bioenergetic effects on the lens. PMID:26869755

Acute cocaine intoxication in a smuggler. One case report and a review of the literature.

PubMed

Farah, E; Ghayad, E

1999-01-01

The smuggling of cocaine into many countries by ingestion of wrapped cocaine packets and gastro-intestinal concealment is a common and well-recognized practice. This is a report of the case of a smuggler carrying 14 ingested packets of cocaine and who presented an acute intoxication with a rare complication, rhabdomyolysis, which were managed medically and the packets removed surgically. A discussion and a review of the literature are undertaken.

A Survey of Research Projects in Schools and Colleges of Optometry.

ERIC Educational Resources Information Center

Whitener, John C.

1981-01-01

A survey undertaken by the American Optometric Association reveals research projects, investigators, and in some cases, funding sources for research in the areas of low vision, ophthalmic lenses, pharmacology, anatomy and pathology, and sensory and motor functions. A total of 205 projects are charted. (MSE)

Ijime: The Bullying of Japanese Youth.

ERIC Educational Resources Information Center

Schoolland, Ken

1986-01-01

"Ijime," which means the intimidation of the weakest people in a social group, has become prevalent in the Japanese educational system. Between April and October of 1985, 155,066 cases of bullying were reported in Japan's schools. The education council cites the rigorous discipline measures undertaken by teachers as the cause of rising…

Disaster Preparedness, Adaptive Politics and Lifelong Learning: A Case of Japan

ERIC Educational Resources Information Center

Kitagawa, Kaori

2016-01-01

Preparedness for disaster scenarios is progressively becoming an educational agenda for governments because of diversifying risks and threats worldwide. In disaster-prone Japan, disaster preparedness has been a prioritised national agenda, and preparedness education has been undertaken in both formal schooling and lifelong learning settings. This…

Female genital mutilation in Iraqi Kurdistan: description and associated factors.

PubMed

Saleem, Rozhgar A; Othman, Nasih; Fattah, Fattah H; Hazim, Luma; Adnan, Berivan

2013-01-01

The high prevalence of female genital mutilation has been a concern in Iraqi Kurdistan. This study was undertaken to estimate its prevalence and describe factors associated with its occurrence. A cross-sectional survey was undertaken from March to April 2011 of females aged up to 20 years using interviews and clinical examination. The survey included 1,508 participants with mean age of 13.5 years (SD 5.6). Overall female genital mutilation prevalence was 23%, and the mean age at which it had been performed was 4.6 years (SD 2.4). Type I (partial or total removal of the clitoris) comprised 76% of those who had had female genital mutilation; in 79% of cases the decision to perform it was made by the mother; and in 54% of cases it was performed by traditional birth attendants/midwives. Women aged 16 years and over were more likely to have had female genital mutilation compared to children aged below 6 years (OR 11.9, p < .001). Children of uneducated mothers were eight times as likely to have had genital mutilation compared to children of mothers with over nine years of education (OR 8.0, p < .001). Among women aged 17 years and younger, 34% of those who were married had been circumcised versus 17% of those who were not married (p < .001). Participants residing in the northeast of Kurdistan region were more likely to have been circumcised. The study results show that female genital mutilation is a frequent practice in Iraqi Kurdistan. Attention and intervention is needed to address this aspect of the well-being of girls and women.

Predicting microbiologically defined infection in febrile neutropenic episodes in children: global individual participant data multivariable meta-analysis

PubMed Central

Phillips, Robert S; Sung, Lillian; Amman, Roland A; Riley, Richard D; Castagnola, Elio; Haeusler, Gabrielle M; Klaassen, Robert; Tissing, Wim J E; Lehrnbecher, Thomas; Chisholm, Julia; Hakim, Hana; Ranasinghe, Neil; Paesmans, Marianne; Hann, Ian M; Stewart, Lesley A

2016-01-01

Background: Risk-stratified management of fever with neutropenia (FN), allows intensive management of high-risk cases and early discharge of low-risk cases. No single, internationally validated, prediction model of the risk of adverse outcomes exists for children and young people. An individual patient data (IPD) meta-analysis was undertaken to devise one. Methods: The ‘Predicting Infectious Complications in Children with Cancer' (PICNICC) collaboration was formed by parent representatives, international clinical and methodological experts. Univariable and multivariable analyses, using random effects logistic regression, were undertaken to derive and internally validate a risk-prediction model for outcomes of episodes of FN based on clinical and laboratory data at presentation. Results: Data came from 22 different study groups from 15 countries, of 5127 episodes of FN in 3504 patients. There were 1070 episodes in 616 patients from seven studies available for multivariable analysis. Univariable analyses showed associations with microbiologically defined infection (MDI) in many items, including higher temperature, lower white cell counts and acute myeloid leukaemia, but not age. Patients with osteosarcoma/Ewings sarcoma and those with more severe mucositis were associated with a decreased risk of MDI. The predictive model included: malignancy type, temperature, clinically ‘severely unwell', haemoglobin, white cell count and absolute monocyte count. It showed moderate discrimination (AUROC 0.723, 95% confidence interval 0.711–0.759) and good calibration (calibration slope 0.95). The model was robust to bootstrap and cross-validation sensitivity analyses. Conclusions: This new prediction model for risk of MDI appears accurate. It requires prospective studies assessing implementation to assist clinicians and parents/patients in individualised decision making. PMID:26954719

Novel Linkage of Individual and Geographic Data to Study Firearm Violence

PubMed Central

Branas, Charles C.; Culhane, Dennis; Richmond, Therese S.; Wiebe, Douglas J.

2010-01-01

Firearm violence is the end result of a causative web of individual-level and geographic risk factors. Few, if any, studies of firearm violence have been able to simultaneously determine the population-based relative risks that individuals experience as a result of what they were doing at a specific point in time and where they were, geographically, at a specific point in time. This paper describes the linkage of individual and geographic data that was undertaken as part of a population-based case-control study of firearm violence in Philadelphia. New methods and applications of these linked data relevant to researchers and policymakers interested in firearm violence are also discussed. PMID:20617158

Risk factors in lateral epicondylitis (tennis elbow): a case-control study.

PubMed

Titchener, A G; Fakis, A; Tambe, A A; Smith, C; Hubbard, R B; Clark, D I

2013-02-01

Lateral epicondylitis is a common condition, but relatively little is known about its aetiology and associated risk factors. We have undertaken a large case-control study using The Health Improvement Network database to assess and quantify the relative contributions of some constitutional and environmental risk factors for lateral epicondylitis in the community. Our dataset included 4998 patients with lateral epicondylitis who were individually matched with a single control by age, sex, and general practice. The median age at diagnosis was 49 (interquartile range 42-56) years . Multivariate analysis showed that the risk factors associated with lateral epicondylitis were rotator cuff pathology (OR 4.95), De Quervain's disease (OR 2.48), carpal tunnel syndrome (OR 1.50), oral corticosteroid therapy (OR 1.68), and previous smoking history (OR 1.20). Diabetes mellitus, current smoking, trigger finger, rheumatoid arthritis, alcohol intake, and obesity were not found to be associated with lateral epicondylitis.

Examining key design decisions involved in developing a serious game for child sexual abuse prevention.

PubMed

Stieler-Hunt, Colleen; Jones, Christian M; Rolfe, Ben; Pozzebon, Kay

2014-01-01

This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitizing game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has implications for the design of Serious Games more generally, including that research should underpin game design decisions, game designers should consider ways of bridging the game to real life, the learning that arises from the game should go beyond rote-learning, designers should consider how the player can make the game-world their own and comprehensive evaluations of Serious Games should be undertaken.

The business case for connectivity

NASA Technical Reports Server (NTRS)

Adams, Dennis; Hirschheim, Rudy

1991-01-01

Information systems that provide competitive advantages to organizations can be broadly classified into those that improve the effectiveness of a business function and those that improve the reach of information in the organization. The latter, organizational connectivity systems, can be categorized as intraorganizational and interorganizational systems. Intraorganization systems provide connectivity to function areas within the business, while interorganizational systems support the exchange of business data between independent business units. These system are not confined to a single entity but span organizational boundaries which can be national or international in scope. A series of case studies was undertaken in an effort to better understand the issues and problems associated with providing an increased flow of information within and outside of an organization. Ten issues emerged from this study. In summary, it is necessary for firms to first consider how effective their internal communications systems are before launching projects that tie the organization to external systems.

Impacts on U.S. Energy Markets and the Economy of Reducing Oil Imports

EIA Publications

1996-01-01

This study was undertaken at the request of the General Accounting Office (GAO). Its purpose is to evaluate the impacts on U.S. energy markets and the economy of reducing oil imports. The approach and assumptions underlying this report were specified by GAO and are attached as an Appendix. The study focuses on two approaches: (1) a set of cases with alternative world crude oil price trajectories and (2) two cases which investigate the use of an oil import tariff to achieve a target reduction in the oil imports. The analysis presented uses the National Energy Modeling System, which is maintained by the Office of Integrated Analysis and Forecasting within the Energy Information Administration (EIA), and the DRI/McGraw Hill Macroeconomic Model of the U.S. Economy, a proprietary model maintained by DRI and subscribed to by EIA.

Advances in EPG for treatment and research: an illustrative case study.

PubMed

Scobbie, James M; Wood, Sara E; Wrench, Alan A

2004-01-01

Electropalatography (EPG), a technique which reveals tongue-palate contact patterns over time, is a highly effective tool for speech research. We report here on recent developments by Articulate Instruments Ltd. These include hardware for Windows-based computers, backwardly compatible (with Reading EPG3) software systems for clinical intervention and laboratory-based analysis for EPG and acoustic data, and an enhanced clinical interface with client and file management tools. We focus here on a single case study of a child aged 10+/-years who had been diagnosed with an intractable speech disorder possibly resulting ultimately from a complete cleft of hard and soft palate. We illustrate how assessment, diagnosis and treatment of the intractable speech disorder are undertaken using this new generation of instrumental phonetic support. We also look forward to future developments in articulatory phonetics that will link EPG with ultrasound for research and clinical communities.

Examining key design decisions involved in developing a serious game for child sexual abuse prevention

PubMed Central

Stieler-Hunt, Colleen; Jones, Christian M.; Rolfe, Ben; Pozzebon, Kay

2014-01-01

This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitizing game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has implications for the design of Serious Games more generally, including that research should underpin game design decisions, game designers should consider ways of bridging the game to real life, the learning that arises from the game should go beyond rote-learning, designers should consider how the player can make the game-world their own and comprehensive evaluations of Serious Games should be undertaken. PMID:24550880

Social media and professionalism: a retrospective content analysis of Fitness to Practise cases heard by the GDC concerning social media complaints.

PubMed

Neville, P

2017-09-08

Introduction Since 2013, all General Dental Council (GDC) registrants' online activities have been regulated by the GDC's social media guidelines. Failure to comply with these guidelines results in a Fitness to Practise (FtP) complaint being investigated.Aims This study explores the prevalence of social media related FtP cases investigated by the GDC from 1 September 2013 to 21 June 2016.Method Documentary analysis of social media related FtP cases published on the GDC's website was undertaken. All cases that met the study's inclusion criteria were analysed using a quantitative content analysis framework.Findings It was found that 2.4% of FtP cases published on the GDC website during that period were related to breaches of the social media guidelines. All of the cases investigated were proven and upheld. Most of those named in the complaints were dental nurses and the most common type of complaint was inappropriate Facebook comments.Conclusions The low incidence rate should be interpreted with caution, being illustrative of the types of issues that might arise rather than the volume. The GDC will need to remain vigilant in this area and ensure that social media awareness training is an active part of CPD for all the dental team.

Arthroscopy in the early diagnosis of injuries to the knee joint.

PubMed

Lysholm, J; Gillquist, J; Liljedahl, S O

1981-02-01

In a series of 192 patients with acute knee injuries the diagnosis at arthroscopy was compared with the clinical diagnosis with or without confirmation at arthrotomy. Arthroscopy was used in 117 cases, clinical examination in 72 cases, and arthrography in 3 cases. All patients presented for diagnosis and treatment within 4 weeks of injury, and most within 1 week. The anterior cruciate ligament (ACL) was torn in 100 cases, and in 92 this was the main injury. The incidence of complete, isolated ACL tear was 1.5 per cent. ACL tear occurred in a higher proportion of cases in the arthroscopy group compared with diagnosis by other methods. An ACL tear was usually combined with injury to the medial ligament complex. Twenty-five patients showed tear of the posterior cruciate ligament (PCL), and in one-third of these there was also injury to the ACL. The medial ligaments were injured in 77 per cent of the whole series and this was the predominant lesion in 57 cases. Tear of the postero-medial capsular ligament (PMCL) was found in more than half of our patients. The ratio lateral/medial meniscus tear was 1:1.6 in the arthroscopy group and 1:27 in the group where arthroscopy was not undertaken. Arthroscopy resulted in an increase in the number of components of injury identified owing to improved diagnosis of tears of the ACL, the PMCL, the lateral meniscus, and possibly also of the PCL. There were no complication or side-effects of arthroscopy. In 93 per cent of cases primary suture was done. Reconstruction was rarely necessary if operation was undertaken within 2 weeks of injury.

Essential activities and knowledge domains of case management: new insights from the CCMC role and functions study.

PubMed

Tahan, Hussein

2006-01-01

The Commission for Case Manager Certification (CCMC) defines case management (CM) as "a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs. [Case management] uses communication and available resources to promote quality, cost-effective outcomes." The practice of CM spans the entire health-care spectrum, including pre-acute, acute, and post-acute settings, and the involvement of varied care providers, such as nurses, social workers, rehabilitation counselors, physicians, and other allied health professionals. So what does it mean to practice as a case manager? What roles and job functions are performed and what knowledge is required of a professional in the field for effective practice? These highly relevant questions reflect the thinking of the CCMC commissioners when the latest Case Manager Role and Functions study was undertaken. The primary purpose of this research, which is conducted every 5 years by the CCMC, is to capture the current state of CM practice. This type of in-depth research is required to support an evidence-based certification examination such as the one offered by CCMC-the certified case manager (CCM) credential. Moreover, as the first and largest nationally accredited organization to certify US case managers, the CCMC recognizes its responsibility to undertake and promote scientifically conducted research in the field of CM.

Chagas disease in European countries: the challenge of a surveillance system.

PubMed

Basile, L; Jansa, J M; Carlier, Y; Salamanca, D D; Angheben, A; Bartoloni, A; Seixas, J; Van Gool, T; Canavate, C; Flores-Chavez, M; Jackson, Y; Chiodini, P L; Albajar-Vinas, P

2011-09-15

A study of aggregate data collected from the literature and official sources was undertaken to estimate expected and observed prevalence of Trypanosoma cruzi infection, annual incidence of congenital transmission and rate of underdiagnosis of Chagas disease among Latin American migrants in the nine European countries with the highest prevalence of Chagas disease. Formal and informal data sources were used to estimate the population from endemic countries resident in Europe in 2009, diagnosed cases of Chagas disease and births from mothers originating from endemic countries. By 2009, 4,290 cases had been diagnosed in Europe, compared with an estimated 68,000 to 122,000 expected cases. The expected prevalence was very high in undocumented migrants (on average 45% of total expected cases) while the observed prevalence rate was 1.3 cases per 1,000 resident migrants from endemic countries. An estimated 20 to 183 babies with congenital Chagas disease are born annually in the study countries. The annual incidence rate of congenital transmission per 1,000 pregnancies in women from endemic countries was between none and three cases. The index of under diagnosis of T. cruzi infection was between 94% and 96%. Chagas disease is a public health challenge in the studied European countries. Urgent measures need to be taken to detect new cases of congenital transmission and take care of the existing cases with a focus on migrants without legal residency permit and potential difficulty accessing care.

Ultrasonic cavity preparation using CVD coated diamond bur: A case report

PubMed Central

de Vasconcellos, Beatriz Tholt; Thompson, Jeffrey Y.; de Paula Macedo, Manoel Roberto; de Oliveira Maia, Janaína Monalisa; Oda, Margareth; Garone-Netto, Narciso

2013-01-01

Before any restorative procedure can be undertaken a proper cavity preparation is required. This clinical step is the mechanical alteration of the tooth to receive a restorative material with which a satisfactory form, function and the esthetics of the tooth will be established. In recent years improvements in materials and techniques have been devised and new technologies are now available for this purpose. The aim of the present study is to report two clinical cases in which a CVD coated diamond bur coupled to an ultrasonic handpiece is used in dental preparation. This technique provides an accurate and conservative tooth preparation with ideal access and visibility and because of enhanced efficiency can also play a role in eliminating some of the patient discomfort of the dental treatment. PMID:23408140

An Epidemiological Study on Pattern and Incidence of Mandibular Fractures

PubMed Central

Natu, Subodh S.; Pradhan, Harsha; Gupta, Hemant; Alam, Sarwar; Gupta, Sumit; Pradhan, R.; Mohammad, Shadab; Kohli, Munish; Sinha, Vijai P.; Shankar, Ravi; Agarwal, Anshita

2012-01-01

Mandible is the second most common facial fracture. There has been a significant increase in the number of cases in recent years with the advent of fast moving automobiles. Mandibular fractures constitute a substantial proportion of maxillofacial trauma cases in Lucknow. This study was undertaken to study mandibular fractures clinicoradiologically with an aim to calculate incidence and study pattern and the commonest site of fractures in population in and around Lucknow. Patient presenting with history of trauma at various centers of maxillofacial surgery in and around Lucknow were included in this study. Detailed case history was recorded followed by thorough clinical examination, and radiological interpretation was done for establishing the diagnosis and the data obtained was analyzed statistically. Out of 66 patients with mandibular fractures, highest percentage was found in 21–30 years of age with male predominance. Road traffic accidents were the most common cause of fracture with parasymphysis being commonest site. Commonest combination was parasymphysis with subcondyle. There was no gender bias in etiology with number of fracture sites. The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment. PMID:23227327

Incidence of Negative Appendectomy: Experience From a Company Hospital in Nigeria

PubMed Central

Osime, OC; Ajayi, PA

2005-01-01

Objective: The aim of this study was to determine the rate of negative appendectomy in a company hospital in Nigeria. Background: Appendicitis is one of the most common abdominal conditions requiring surgical intervention. Appendectomy, like most surgical procedures, has its complications and therefore should only be undertaken when indicated. Case series have reported the incidence of negative appendectomy in Western nations. The purpose of this retrospective study is to evaluate the incidence of negative appendectomy in a Nigerian hospital, where all the operations were carried out by consultant surgeons. Methods: All case files of patients who received an appendectomy at Chevron Hospital in Warri, Nigeria between January, 1999 and December, 2003 were reviewed. Demographic data, symptoms and signs on presentation, intra-operative findings and histological reports on the excised vermiform appendixes were extracted from the case files and analyzed. Results: The incidence of negative appendectomy in this study was 16.1%; all nine patients that had negative appendectomy were female. Conclusion: The incidence of negative appendectomy observed at Chevron Hospital in Warri, Nigeria is lower than that reported by most studies; one factor may be that all the patients in the present study were evaluated and operated on by consultant surgeons. PMID:20847869

A case-control study: occupational cooking and the risk of uveal melanoma

PubMed Central

2010-01-01

Background A European-wide population based case-control study (European rare cancer study) undertaken in nine European countries examined risk factors for uveal melanoma. They found a positive association between cooks and the risk of uveal melanoma. In our study we examine whether cooks or people who worked in cook related jobs have an increased uveal melanoma risk. Methods We conducted a case-control study during 2002 and 2005. Overall, 1653 eligible subjects (age range: 20-74 years, living in Germany) participated. Interviews were conducted with 459 incident uveal melanoma cases, 827 population controls, 180 ophthalmologist controls and 187 sibling controls. Data on occupational exposure were obtained from a self-administered postal questionnaire and a computer-assisted telephone interview. We used conditional logistic regression to estimate odds ratios adjusting for the matching factors. Results Overall, we did not observe an increased risk of uveal melanoma among people who worked as cooks or who worked in cook related jobs. When we restricted the source population of our study to the population of the Federal State of Northrhine-Westphalia, we observed an increased risk among subjects who were categorized as cooks in the cases-control analysis. Conclusion Our results are in conflict with former results of the European rare cancer study. Considering the rarity of the disease laboratory in vitro studies of human uveal melanoma cell lines should be done to analyze potential exposure risk factors like radiation from microwaves, strong light from incandescent ovens, or infrared radiation. PMID:20969762

Estimation of GHG emissions in Egypt up to the year 2020

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

ElMahgary, Y.; Abdel-Fattah, A.I.; Shama, M.A.

1994-09-01

Within the frame of UNEP's project on the Methodologies of Determining the Costs of Abatement of GHG Emissions, a case study on Egypt was undertaken by VTT (Technical Research Centre of Finland) in cooperation with the Egyptian Environment Authority Agency (EEAA). Both the bottom-up or engineering models and the top-down or the macroeconomic models were used. In the bottom-up approach, the economic sectors were divided into seven groups: petroleum industry, power generation, heavy industry, light industry, residential and commercial sector, transport and agriculture and domestic wastes. First, a comprehensive inventory for the year 1990 was prepared for all the GHGmore » emissions mainly, but not exclusively, from energy sources. This included CO[sub 2], CH[sub 4] and N[sub 2]O. A base scenario of economic and energy growth of Egypt for business-as-usual alternative was fixed using the results of several optimization processes undertaken earlier by the National Committee of Egypt. GHG emissions of the different sources in this base scenario were then determined using LEAP model and spread sheets.« less

Emergence of West Nile virus infections in humans in Turkey, 2010 to 2011.

PubMed

Kalaycioglu, H; Korukluoglu, G; Ozkul, A; Oncul, O; Tosun, S; Karabay, O; Gozalan, A; Uyar, Y; Caglayık, D Y; Atasoylu, G; Altas, A B; Yolbakan, S; Ozden, T N; Bayrakdar, F; Sezak, N; Pelıtlı, T S; Kurtcebe, Z O; Aydın, E; Ertek, M

2012-05-24

In 2010, 47 human cases of West Nile virus (WNV)infection, including 12 laboratory-confirmed and 35 probable cases, were identified in Turkey. These were the first cases detected during routine surveillance.The patients were from 15 provinces, mainly located in the western part of the country. Incidence was 0.19/100,000 with a maximum of 1.39 in Sakarya province.Forty of the total 47 cases showed neuroinvasive manifestation. Median age was 58 years with a range of four to 86. Ten of the patients died. Enhanced surveillance in humans and animals and mosquito control measures were implemented. The WNV infections were included in the national notifiable diseases list as of April 2011. In 2011, three probable and two confirmed cases of WNV infection were diagnosed in provinces where infections had been detected in the previous year, supporting a lower activity than 2010. However,detection of WNV infections in humans in 2010 and 2011 consecutively, may indicate that WNV has become endemic in the western part of Turkey. Field epidemiological studies were undertaken to understand more about the nature of infection in Turkey.

Deliberate self-harm as seen in Kampala, Uganda - a case-control study.

PubMed

Kinyanda, Eugene; Hjelmeland, Heidi; Musisi, Seggane

2004-04-01

A study to investigate deliberate self-harm (DSH) in an African context was undertaken in Uganda. A case-control study in which 100 cases of DSH and 300 controls matched on age and sex were recruited from three general hospitals in Kampala and subjected to a structured interview using a modified version of the European Parasuicide Study Interview Schedule I. Among the cases, 63% were males, with a male to female ratio of 1.7:1 and a peak age range of 20-24 years. Higher educational attainment, higher socio-economic class and poor housing were significantly associated with DSH. District of current residence, district of birth, religion, ethnicity, marital status, number of children, current living arrangement, area of usual residence, employment status of respondent and partner were not significantly associated with DSH. Pesticides and medications, mainly antimalarials and diazepam, were the main methods of DSH used. The most commonly reported psychiatric disorders were adjustment disorder, acute stress reactions and depression. DSH in Uganda appears to predominantly afflict the young. Disturbed interpersonal relationships, poverty and loneliness were important factors in the immediate precipitation of this behaviour. The fact that pesticide poisoning is still the predominantly used method in DSH in this area calls for a review of the legislation that controls the sale and availability of these agricultural chemicals.

The heterogeneous management of pediatric ankle traumas: A retrospective descriptive study.

PubMed

Voizard, Philippe; Moore, James; Leduc, Stéphane; Nault, Marie-Lyne

2018-06-01

Frequent misdiagnosis of pediatric ankle traumas leads to inappropriate management, which may result in residual pain, instability, slower return to physical activity, and long-term degenerative changes. The purpose of this study was to evaluate the consistency of diagnosis, management, and the treatment of acute lateral pediatric ankle trauma in a tertiary care pediatric hospital. The hypothesis was that the initial diagnosis is often incorrect, and the treatment varies considerably amongst orthopedic surgeons.We conducted a retrospective study of all cases of ankle sprains and Salter-Harris one (SH1) fractures referred to our orthopedic surgery service between May and August 2014. Exclusion criteria included ankle fractures other than SH1 types, and cases where treatment was initially undertaken elsewhere before referral to our service. Primary outcome was the difference between initial and final diagnosis.Among 3047 cases reviewed, 31 matched our inclusion criteria. Initial diagnosis was 20 SH1 fractures, 8 acute ankle sprains, and 3 uncertain, with a change in diagnosis for 48.5% at follow-up.Accurate diagnosis can be difficult in pediatric ankle trauma, with case management and specific treatments varying considerably. This study reinforces the need to evaluate the safety of a general treatment algorithm for all lateral ankle trauma with normal radiographs.Level of evidence III.

Laryngeal Involvement of Rhabdomyosarcoma in an Adult

PubMed Central

Abali, Hüseyin; Aksoy, Sercan; Sungur, Arzu; Yalçin, Suayib

2003-01-01

Background Although initial presentation of sarcomas in the head and neck region is relatively common, involvements of the larynx by rhabdomyosarcoma either primary or metastatic have been reported rarely. Case report A case of rhabdomyosarcoma in the right thigh, which involved laryngeal structures three years after the diagnosis, is presented. Conclusions The laryngeal involvement by primary and metastatic rhabdosarcomas is very rare, however when it occurs it can result in life treating upper airway obstruction. After emergency intervention, radiotherapy and / or chemotherapy must be undertaken for long-term benefit and surgery may be helpful only in selected cases. PMID:14556654

Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome

PubMed Central

Sáez‐Francàs, Naia; Santillo, Dafna; Alegre, Jose

2017-01-01

This review explores the current evidence on benefits and harms of therapeutic interventions in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and makes recommendations. CFS/ME is a complex, multi‐system, chronic medical condition whose pathophysiology remains unknown. No established diagnostic tests exist nor are any FDA‐approved drugs available for treatment. Because of the range of symptoms of CFS/ME, treatment approaches vary widely. Studies undertaken have heterogeneous designs and are limited by sample size, length of follow‐up, applicability and methodological quality. The use of rintatolimod and rituximab as well as counselling, behavioural and rehabilitation therapy programs may be of benefit for CFS/ME, but the evidence of their effectiveness is still limited. Similarly, adaptive pacing appears to offer some benefits, but the results are debatable: so is the use of nutritional supplements, which may be of value to CFS/ME patients with biochemically proven deficiencies. To summarize, the recommended treatment strategies should include proper administration of nutritional supplements in CFS/ME patients with demonstrated deficiencies and personalized pacing programs to relieve symptoms and improve performance of daily activities, but a larger randomized controlled trial (RCT) evaluation is required to confirm these preliminary observations. At present, no firm conclusions can be drawn because the few RCTs undertaken to date have been small‐scale, with a high risk of bias, and have used different case definitions. Further, RCTs are now urgently needed with rigorous experimental designs and appropriate data analysis, focusing particularly on the comparison of outcomes measures according to clinical presentation, patient characteristics, case criteria and degree of disability (i.e. severely ill ME cases or bedridden). PMID:28052319

Serous Tubal Carcinogenesis: The Recent Concept of Origin of Ovarian, Primary Peritoneal and Fallopian Tube High-Grade Serous Carcinoma.

PubMed

Kar, Tushar; Kar, Asaranti; Dhal, Ipsita; Panda, Sasmita; Biswal, Priyadarshini; Nayak, Bhagyalaxmi; Rout, Niranjan; Samantray, Sagarika

2017-12-01

Pelvic (non-uterine) high-grade serous carcinomas (PHGSC) including ovarian, tubal and primary peritoneal serous carcinomas have increased death: incidence ratio due to presentation at advanced stage, rapid progression, poor prognosis and high morbidity. Ambiguity regarding their pathogenesis and lack of a proper screening method is the cause of their late detection and high fatality rate. This study was undertaken to assess the fallopian tube for the presence of precursor lesions in pelvic serous carcinoma. This was a prospective case-control study carried out in a tertiary care center. Consecutive specimens of 55 cases of pelvic high-grade serous carcinoma and 41 controls inclusive of 21 low-grade serous carcinoma, 10 benign adnexal masses and 10 normal adnexa were included in the study. Both side fallopian tubes in each case were subjected to histopathological examination and p53, Ki67 immunohistochemistry. There were 55 cases of PHGSC comprising of 50 cases of ovarian HGSC, two cases of primary peritoneal carcinoma (PPC) and three cases of tubal carcinoma. Serous tubal intraepithelial carcinoma (STIC) was detected in 14 cases (28%), p53 signature in 13 cases (26%) and tubal intraepithelial lesion in transition in 10 cases (20%) of ovarian HGSC. One case (50%) of PPC and one (33%) case of tubal carcinoma revealed the presence of STIC. None of the controls exhibited any precursor lesion except ovarian low-grade serous carcinoma where p53 was detected in 20% of cases. This revelation concludes that fallopian tubes are the sites of precursors of PHGSC to a large extent. In the absence of a proper screening method of HGSC, prophylactic bilateral salpingectomy at hysterectomy for benign diseases can achieve ultimate goal of reduction in incidence of PHGSC.

Countdown to 2015 country case studies: what have we learned about processes and progress towards MDGs 4 and 5?

PubMed

Moucheraud, Corrina; Owen, Helen; Singh, Neha S; Ng, Courtney Kuonin; Requejo, Jennifer; Lawn, Joy E; Berman, Peter

2016-09-12

Countdown to 2015 was a multi-institution consortium tracking progress towards Millennium Development Goals (MDGs) 4 and 5. Case studies to explore factors contributing to progress (or lack of progress) in reproductive, maternal, newborn and child health (RMNCH) were undertaken in: Afghanistan, Bangladesh, China, Ethiopia, Kenya, Malawi, Niger, Pakistan, Peru, and Tanzania. This paper aims to identify cross-cutting themes on how and why these countries achieved or did not achieve MDG progress. Applying a standard evaluation framework, analyses of impact, coverage and equity were undertaken, including a mixed methods analysis of how these were influenced by national context and coverage determinants (including health systems, policies and financing). The majority (7/10) of case study countries met MDG-4 with over two-thirds reduction in child mortality, but none met MDG-5a for 75 % reduction in maternal mortality, although six countries achieved >75 % of this target. None achieved MDG-5b regarding reproductive health. Rates of reduction in neonatal mortality were half or less that for post-neonatal child mortality. Coverage increased most for interventions administered at lower levels of the health system (e.g., immunisation, insecticide treated nets), and these experienced substantial political and financial support. These interventions were associated with ~30-40 % of child lives saved in 2012 compared to 2000, in Ethiopia, Malawi, Peru and Tanzania. Intrapartum care for mothers and newborns -- which require higher-level health workers, more infrastructure, and increased community engagement -- showed variable increases in coverage, and persistent equity gaps. Countries have explored different approaches to address these problems, including shifting interventions to the community setting and tasks to lower-level health workers. These Countdown case studies underline the importance of consistent national investment and global attention for achieving improvements in RMNCH. Interventions with major global investments achieved higher levels of coverage, reduced equity gaps and improvements in associated health outcomes. Given many competing priorities for the Sustainable Development Goals era, it is essential to maintain attention to the unfinished RMNCH agenda, particularly health systems improvements for maternal and neonatal outcomes where progress has been slower, and to invest in data collection for monitoring progress and for rigorous analyses of how progress is achieved in different contexts.

Global Value Chain and Manufacturing Analysis on Geothermal Power Plant Turbines

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

Akar, Sertac; Augustine, Chad; Kurup, Parthiv

In this study, we have undertaken a robust analysis of the global supply chain and manufacturing costs for components of Organic Rankine Cycle (ORC) Turboexpander and steam turbines used in geothermal power plants. We collected a range of market data influencing manufacturing from various data sources and determined the main international manufacturers in the industry. The data includes the manufacturing cost model to identify requirements for equipment, facilities, raw materials, and labor. We analyzed three different cases; 1) 1 MW geothermal ORC Turboexpander 2) 5 MW ORC Turboexpander 3) 20 MW geothermal Steam Turbine

Comparison of Three Optical Methods for Measuring Model Deformation

NASA Technical Reports Server (NTRS)

Burner, A. W.; Fleming, G. A.; Hoppe, J. C.

2000-01-01

The objective of this paper is to compare the current state-of-the-art of the following three optical techniques under study by NASA for measuring model deformation in wind tunnels: (1) video photogrammetry, (2) projection moire interferometry, and (3) the commercially available Optotrak system. An objective comparison of these three techniques should enable the selection of the best technique for a particular test undertaken at various NASA facilities. As might be expected, no one technique is best for all applications. The techniques are also not necessarily mutually exclusive and in some cases can be complementary to one another.

Evaluation of the nasolabial angle in the Indian population

PubMed Central

Dua, Vinay; Gupta, Shilpa; Singh, Chanjyot

2010-01-01

Nasolabial angle has become the angle depicting the esthetics so has attained the prime importance in the treatment planning. Dr Jay P. Fitzgerland and Dr. Ram S. Nanda. In 1992 gave norms for Caucasian population. A radiographic cephalometric study was undertaken with 45 subjects of Indian origin to evaluate and compare with their result. The method of evaluation was according to the criteria given by Dr. Jay P Fitzergerald in AJODO 1992; 102:328-34. Significant decrease in nasolabial angle values was found in case of Indian population as compared to white adults. PMID:22114388

Meckel's Diverticulum—Revisited

PubMed Central

Malik, Ajaz A.; Shams-ul-Bari; Wani, Khurshid A.; Khaja, Abdul R.

2010-01-01

Meckel's diverticulum is a true intestinal diverticulum that results from the failure of the vitelline duct to obliterate during the fifth week of fetal development. In about 50% cases, it contains ectopic or heterotopic tissue which can be the cause of complications. A systematic review of literature was undertaken to study the history, incidence, embryoanatomy, clinical presentation, complication and management of Meckel's diverticulum. Although Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, it is often difficult to diagnose. It may remain asymptomatic or it may mimic disorders such as Crohn's disease, appendicitis and peptic ulcer disease. PMID:20065566

Prevalence of Atherosclerotic Coronary Stenosis in Asymptomatic North Indian Population: A Post-mortem Coronary Angiography Study.

PubMed

Bansal, Yogender Singh; Mandal, Shatrugan Prasad; Kumar, Senthil; Setia, Puneet

2015-09-01

A preliminary study of coronaries using post-mortem angiography was undertaken to see the prevalence of atherosclerotic coronary stenosis in non-cardiac unnatural deaths. This study was conducted in a tertiary care centre located in Chandigarh. A total of 128 medico-legal cases were studied comprising 88 males and 40 females. Post-mortem examinations of these MLC cases were conducted in the Department of Forensic Medicine, PGIMER, Chandigarh. All hearts were visually screened by post-mortem coronary angiography first and then grossly examined using serial transverse incision technique in positive screening cases to find the degree of narrowing. Of the study group, 34% males and 20% females showed evidence of narrowing on angiography. Of the males showing coronary stenosis, 83% had single vessel disease and 13% had double vessel disease, while only one individual had triple vessel disease. In cases of female, all the cases of coronary stenosis were single vessel disease. Left anterior descending coronary artery (LAD) was the most common vessel involved, followed by right coronary artery (RCA) & Left circumflex artery (LCX) and in cases of double vessel disease, LAD in combination with LCX was responsible for 75% of the cases. Remarkably 23.6% of study population in the age group of less than 40 years showed appreciable narrowing in at least one of the coronaries. In general, the prevalence of CAD is on the rise, particularly in younger population owing to the changes in their lifestyle and food habits. This preliminary study revealed evidence of narrowing of at least one coronary in 34% male and 20% female population and 23.6% subjects were less than 40 years old. Further detailed studies are needed especially in younger age group and to support the need for preventive cardiology in the early years of life.

Mentored retroperitoneal laparoscopic renal surgery in children: a safe approach to learning.

PubMed

Farhat, W; Khoury, A; Bagli, D; McLorie, G; El-Ghoneimi, A

2003-10-01

To review the feasibility of introducing advanced retroperitoneal renal laparoscopic surgery (RRLS) to a paediatric urology division, using the mentorship-training model. Although the scope of practice in paediatric urology is currently adapting endoscopic surgery into daily practice, most paediatric urologists in North America have had no formal training in laparoscopic surgery. The study included four paediatric urologists with 3-25 years of practice; none had had any formal laparoscopic training or ever undertaken advanced RRLS. An experienced laparoscopic surgeon (the mentor) assisted the learning surgeons over a year. The initial phases of learning incorporated detailed lectures, visualization through videotapes and 'hands-on' demonstration by the expert in the technique of the standardized steps for each type of surgery. Over 10 months, ablative and reconstructive RRLS was undertaken jointly by the surgeons and the mentor. After this training the surgeons operated independently. To prevent lengthy operations, conversion to open surgery was planned if there was no significant progression after 2 h of laparoscopic surgery. Over the 10 months of mentorship, 36 RRLS procedures were undertaken in 31 patients (28 ablative and eight reconstructive). In all cases the mentored surgeons accomplished both retroperitoneal access and the creation of a working space within the cavity. The group was able to initiate ablative RRLS but the mentor undertook all the reconstructive procedures. After the mentorship period, over 10 months, 12 ablative procedures were undertaken independently, and five other attempts at RRLS failed. Although the mentored approach can successfully and safely initiate advanced RRLS in a paediatric urology division, assessing the laparoscopic practice pattern after mentorship in the same group of trainees is warranted. Ablative RRLS is easier to learn for the experienced surgeon, but reconstructive procedures, e.g. pyeloplasty, require a high degree of skill in laparoscopic technique, which may only be acquired through formal training focusing primarily on suturing techniques.

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013

PubMed Central

Durski, Kara N; Tituli, Carol; Ogaoga, Divi; Joshua, Cynthia; Dofai, Alfred; Leydon, Jennie; Nilles, Eric

2016-01-01

Introduction During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. Methods Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. Results A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. Discussion Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases. PMID:27757248

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013.

PubMed

Durski, Kara N; Tituli, Carol; Ogaoga, Divi; Musto, Jennie; Joshua, Cynthia; Dofai, Alfred; Leydon, Jennie; Nilles, Eric

2016-01-01

During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases.

Contextual E-Learning Evaluation: A Preliminary Framework

ERIC Educational Resources Information Center

Voigt, Christian; Swatman, Paula M. C.

2004-01-01

The evaluation of solutions is a major unresolved issue for all those involved in e-learning. In this paper we illustrate the importance of context by means of a qualitative comparison of two e-learning prototype implementations--an action research case undertaken in conjunction with a major German insurance company; and a more experimental…

Rearticulating the Case for Micro Language Planning in a Language Ecology Context

ERIC Educational Resources Information Center

Baldauf, Richard B., Jr.

2006-01-01

Language planning is normally thought of in terms of large-scale, usually national planning, often undertaken by governments and meant to influence, if not change, ways of speaking or literacy practices within a society. It normally encompasses four aspects: status planning (about society), corpus planning (about language), language-in-education…

Regulatory Intermediation and Quality Assurance in Higher Education: The Case of the Auditors

ERIC Educational Resources Information Center

King, Roger; Griffiths, Paul; Williams, Ruth

2007-01-01

The paper takes the external quality assurance of English universities and colleges as an example of regulation in higher education as undertaken by the Quality Assurance Agency (QAA). Regulatory scholarship generally has been largely disinterested in higher education and the paper applies a "regulatory lens" to higher education quality…

Small Wars 2.0: A Working Paper on Land Force Planning After Iraq and Afghanistan

DTIC Science & Technology

2011-02-01

official examination of future ground combat demands that look genetically distinct from those undertaken in the name of the WoT. The concept of...under the worst-case rubric but for very different reasons. The latter are small wars. However, that by no means aptly describes their size

Evaluation of the Current Status and Knowledge Contributions of Professional Doctorates

ERIC Educational Resources Information Center

Costley, Carol

2013-01-01

The article examines the status and knowledge contributions of professional doctorates (PDs) undertaken by practising professionals who in most cases are not intending to join the academic community. The purpose of these doctorates is usually to research and develop an original contribution to practice through practitioner-research. Giving greater…

Forging School-Scientist Partnerships: A Case of Easier Said than Done?

ERIC Educational Resources Information Center

Falloon, Garry

2013-01-01

Since the early 1980s, a number of initiatives have been undertaken worldwide which have involved scientists and teachers working together in projects designed to support the science learning of students. Many of these have attempted to establish school-scientist partnerships. In these, scientists, teachers, and students formed teams engaged in…

77 FR 38185 - Approval and Promulgation of Implementation Plans; State of North Carolina; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... Transport Rule than BART; and EPA's proposed ``Better than BART'' determination relies on a 2014 base case... cannot be evaluated in isolation from one another. The Commenter supports its position by repeating... isolation from the reasonable progress requirements. We have on several occasions undertaken evaluations of...

Public Service Advertising and Social Problems: the Case of Drug Abuse Prevention.

ERIC Educational Resources Information Center

McEwen, William J.; Hanneman, Gerhard J.

This paper explores certain findings of a DAIR (Drug Abuse Information Research) project undertaken at the University of Connecticut which is investigating the dissemination and impact of drug abuse information. Specifically, findings regarding audience response to persuasive antidrug abuse messages on television are discussed. On the basis of the…

Indications for Vitamin B12 Therapy

PubMed Central

Delva, M. Dianne; Anderson, J.E.

1992-01-01

A retrospective chart audit was undertaken to determine the clinical reasons for vitamin B12 therapy in family practice. Abnormal laboratory tests and symptoms were the most common reasons for initiating therapy. The high proportion of cases with little supporting evidence of B12 deficiency suggests that other factors influence treatment decisions. PMID:20469527

Pay Equity for the Library Profession: An Employer's Perspective

ERIC Educational Resources Information Center

Schmidmaier, Dagmar

2008-01-01

Pay equity, as a concept and outcome, is significant for libraries and librarians because it demonstrates the value of the library and information profession, and the significance of the work undertaken by librarians and allied professionals. The State Library's involvement in the NSW Pay Equity Case and precursor investigations into the worth of…

The Problem of Self-Censorship

ERIC Educational Resources Information Center

Hill, Rebecca

2010-01-01

Self-censorship, not to be confused with actual censorship, is the most complicated, but least understood form of censorship. In most cases of actual censorship, objections to a book are based on offensive language, sexual content, or unsuitability by age, and a complaint is filed to suppress the book. Often an internal review is undertaken, and a…

Legionnaire's disease: a nosocomial outbreak in Turkey.

PubMed

Ozerol, I H; Bayraktar, M; Cizmeci, Z; Durmaz, R; Akbas, E; Yildirim, Z; Yologlu, S

2006-01-01

Six nosocomial cases of Legionella pneumophila occurred over a two-week period, with one further case being diagnosed retrospectively after 30 days. Strains isolated from the hospital water system were clonally related to a single sputum isolate. A sero-epidemiological investigation into legionella exposure amongst staff and inpatients was undertaken at the eight-year-old Inonu University Medical Centre in Turkey, which has 600 beds and central air conditioning. There is no disinfection programme for the hospital water system. A total of 500 serum samples (400 hospital staff and 100 inpatients) were screened for antibody to L. pneumophila by enzyme-linked immunosorbent assay (ELISA). Seroreactive cases were confirmed by a four-fold antibody rise in ELISA, a high indirect immunofluorescent assay (IFA) antibody titre or a positive urinary antigen test. ELISA showed that 24 (6%) of the 400 hospital staff and seven (7%) of the 100 inpatients had antibody titres higher than the cut-off value. ELISA-seroreactive cases were followed for two to four weeks. Of these subjects, seven (three patients and four staff) showed a four-fold rise in antibody titre by ELISA, six (three patients and three staff) had a high IFA titre, three patients with pneumonia had a positive urinary antigen test, and one of these patients also had a positive sputum culture. In addition, 22 water distribution systems were screened for the presence of L. pneumophila by culture. L. pneumophila was isolated from 15 sites. Pulsed-field gel electrophoresis typing indicated that all strains isolated from water systems were identical and clonally related to the strain isolated from sputum. Superheating and flushing of water systems were undertaken with legionella being re-isolated from four sites. Repeated superheating and flushing eliminated legionella completely. This study demonstrated that rapid detection of L. pneumophila and adequate superheating and flushing of water systems are effective for elimination and reduction of spread of this organism.

What Drives Farmers to Make Top-Down or Bottom-Up Adaptation to Climate Change and Fluctuations? A Comparative Study on 3 Cases of Apple Farming in Japan and South Africa

PubMed Central

Fujisawa, Mariko; Kobayashi, Kazuhiko; Johnston, Peter; New, Mark

2015-01-01

Agriculture is one of the most vulnerable sectors to climate change. Farmers have been exposed to multiple stressors including climate change, and they have managed to adapt to those risks. The adaptation actions undertaken by farmers and their decision making are, however, only poorly understood. By studying adaptation practices undertaken by apple farmers in three regions: Nagano and Kazuno in Japan and Elgin in South Africa, we categorize the adaptation actions into two types: farmer initiated bottom-up adaptation and institution led top-down adaptation. We found that the driver which differentiates the type of adaptation likely adopted was strongly related to the farmers’ characteristics, particularly their dependence on the institutions, e.g. the farmers’ cooperative, in selling their products. The farmers who rely on the farmers’ cooperative for their sales are likely to adopt the institution-led adaptation, whereas the farmers who have established their own sales channels tend to start innovative actions by bottom-up. We further argue that even though the two types have contrasting features, the combinations of the both types of adaptations could lead to more successful adaptation particularly in agriculture. This study also emphasizes that more farm-level studies for various crops and regions are warranted to provide substantial feedbacks to adaptation policy. PMID:25822534

A case-control study of the relationship between a passive second stage of labor and obstetric anal sphincter injuries.

PubMed

Gossett, Dana R; Deibel, Philip; Lewicky-Gaupp, Christina

2016-02-01

To estimate the relationship between a passive second stage of labor and obstetric anal sphincter injuries (OASIS). A retrospective, case-control study was undertaken of women who delivered at a tertiary-care center in Chicago, IL, USA, between November 2005 and December 2012. Cases had sustained OASIS and were matched on the basis of parity with controls who had no OASIS. Data were obtained from an electronic repository and chart review. Participants with a passive second stage of labor lasting 60 minutes or more were deemed to have "labored down." A logistic regression model to predict OASIS was created. Overall, 1629 cases were compared with 1312 controls. OASIS were recorded among 1452 (57.8%) of 2510 women who did not labor down compared with 169 (40.0%) of 423 women who labored down (P<0.001). However, in binary logistic regression, the addition of laboring down to the model only increased the predictive accuracy from 80.1% to 80.7%. When known risk factors for OASIS are accounted for, the effect of laboring down on perineal outcome is negligible. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Gliomas and exposure to wood preservatives.

PubMed Central

Cordier, S; Poisson, M; Gerin, M; Varin, J; Conso, F; Hemon, D

1988-01-01

A case-referent study was undertaken to look for occupational risk factors among patients with glioma treated in a neurological hospital in Paris between 1975 and 1984. In the study group were 125 men with gliomas (aged less than or equal to 65) and 238 patients (also less than or equal to 65) admitted for non-neoplastic, non-malformative vascular diseases in the same department during the same period constituting the reference group. All diagnoses were confirmed by tomodensitometry. Information on occupational history was obtained from a postal questionnaire and from medical records. Comparison of cases and referents showed a significant excess risk among teachers (OR = 4.1) and a raised risk among wood workers (OR = 1.6). Four of nine cases of glioma who had been employed as wood workers reported that a colleague had suffered from glioma (those reports were confirmed by hospital records). None were reported among 11 referent wood workers. Using a complementary questionnaire on wood work, exposure assessment to wood preservatives and solvents showed that frequent exposure to organochlorine wood preservatives and to organic solvents occurred more often among cases than referent wood workers (p less than 0.10). PMID:3196664

Social Networking: A Collaborative Open Educational Resource

ERIC Educational Resources Information Center

Toetenel, Lisette

2014-01-01

Studies undertaken since the introduction of Web 2.0 have focussed mainly on open educational resources (OERs) such as email, blogging and virtual learning environments. No consistent efforts have been undertaken to study the use of social networking sites as a tool for learning in the second language classroom. This study examined the use of…

[Some special indications for wearing contact lenses (author's transl)].

PubMed

Müller, K

1978-12-01

The typical distinguishing features of special cases which require contact lenses for satisfactory vision are described. Hence in the first case with anisometria associated with irregular astigmatism of one eye, to which a toric soft contact lens was adapted. In the second case a visual acuity of only 0,6 monocular was attained with the best spectacle lens, however with contact lense the visual acuity was 1.25. Here a verdict from a social court is mentioned, which obliged the sickness insurance to take over the costs for such a case. In the third case the adaptation of contact lenses was undertaken after radical bilateral keratoplasty because of parenchymatous keratitis, and an improvement in visual acuity of at least 400% resulted.

Action learning across the decades.

PubMed

Eason, Ken

2017-05-02

Purpose The purpose of this paper is to explore how action learning concepts were used in two healthcare projects undertaken many decades apart. The specific purpose in both cases was to examine how action learning can contribute to shared learning across key stakeholders in a complex socio-technical system. In each case study, action learning supported joint design programmes and the sharing of perspectives about the complex system under investigation. Design/methodology/approach Two action learning projects are described: first, the Hospital Internal Communications (HIC) project led by Reg Revans in the 1960s. Senior staff in ten London hospitals formed action learning teams to address communication issues. Second, in the Better Outcomes for People with Learning Disabilities: Transforming Care (BOLDTC) project, videoconferencing equipment enabled people with learning disabilities to increase their opportunities to communicate. A mutual learning process was established to enable stakeholders to explore the potential of the technical system to improve individual care. Findings The HIC project demonstrated the importance of evidence being shared between team members and that action had to engage the larger healthcare system outside the hospital. The BOLDTC project confirmed the continuing relevance of action learning to healthcare today. Mutual learning was achieved between health and social care specialists and technologists. Originality/value This work draws together the socio-technical systems tradition (considering both social and technical issues in organisations) and action learning to demonstrate that complex systems development needs to be undertaken as a learning process in which action provides the fuel for learning and design.

Post-disaster resettlement, development and change: a case study of the 1990 Manjil earthquake in Iran.

PubMed

Badri, S Ali; Asgary, Ali; Eftekhari, A R; Levy, Jason

2006-12-01

Planned and involuntary resettlement after natural disasters has been a major policy in post-disaster reconstruction in developing countries over the past few decades. Studies show that resettlement can result in significant adverse impacts on the resettled population. Conversely, a well-planned and managed resettlement process can produce positive long-term development outcomes. This article presents the results of a case study undertaken 11 years after the 1990 Manjil earthquake in Iran. During the reconstruction period, a policy of involuntary planned resettlement was pursued extensively. The socioeconomic changes that occurred as a consequence of this policy of involuntary resettlement are analysed. Data were collected via a questionnaire survey that involved a sample of 194 relocated households (grouped into a settlement that later became a town). The paper shows that relocated families face difficult socioeconomic challenges after relocation and regrouping. This is especially true with respect to employment, income, the empowerment of women and lifestyle issues.

Effect of intense pulsed light on immature burn scars: A clinical study

PubMed Central

Sarkar, Arindam; Dewangan, Yatindra Kumar; Bain, Jayanta; Rakshit, Pritha; Dhruw, Krishnanand; Basu, Sandip Kanti; Saha, Jayanta Kumar; Majumdar, Bijay Kumar

2014-01-01

Introduction: As intense pulsed light (IPL) is widely used to treat cutaneous vascular malformations and also used as non-ablative skin rejunuvation to remodel the skin collagen. A study has been undertaken to gauze the effect of IPL on immature burn scars with regard to vascularity, pliability and height. Materials and Methods: This study was conducted between June 2013 and May 2014, among patients with immature burn scars that healed conservatively within 2 months. Photographic evidence of appearance of scars and grading and rating was done with Vancouver Scar Scale parameters. Ratings were done for both case and control scar after the completion of four IPL treatment sessions and were compared. Results: Out of the 19 cases, vascularity, pliability and height improved significantly (P < 0.05) in 13, 14 and 11 scars respectively following IPL treatment. Conclusions: Intense pulsed light was well-tolerated by patients, caused good improvement in terms of vascularity, pliability, and height of immature burn scar. PMID:25593424

Interprofessional collaboration in family health teams

PubMed Central

Goldman, Joanne; Meuser, Jamie; Rogers, Jess; Lawrie, Lynne; Reeves, Scott

2010-01-01

ABSTRACT OBJECTIVE To examine family health team (FHT) members’ perspectives and experiences of interprofessional collaboration and perceived benefits. DESIGN Qualitative case study using semistructured interviews. SETTING Fourteen FHTs in urban and rural Ontario. PARTICIPANTS Purposeful sample of the members of 14 FHTs, including family physicians, nurse practitioners, nurses, dietitians, social workers, pharmacists, and managers. METHODS A multiple case-study approach involving 14 FHTs was employed. Thirty-two semistructured interviews were conducted and data were analyzed by employing an inductive thematic approach. A member-checking technique was also undertaken to enhance the validity of the findings. MAIN FINDINGS Five main themes are reported: rethinking traditional roles and scopes of practice, management and leadership, time and space, interprofessional initiatives, and early perceptions of collaborative care. CONCLUSION This study shows the importance of issues such as roles and scopes of practice, leadership, and space to effective team-based primary care, and provides a framework for understanding different types of interprofessional interventions used to support interprofessional collaboration. PMID:20944025

Preliminary report on anaerobic culture at Mymensingh Medical College Hospital in Bangladesh.

PubMed

Ahmed, S; Hossain, M A; Musa, A K; Shamsuzzaman, A K; Mahmud, M C; Nahar, K; Paul, S K; Sumona, A A; Begum, Z; Zahan, N A; Huda, S N; Ahmed, M U; Khan, A H; Kalam, A; Haque, N; Nasrin, S A

2010-01-01

Puerperal sepsis is an important cause of maternal morbidity and mortality in developing countries. This study was undertaken to isolate and identify the anaerobic bacterial agents of puerperal sepsis among the patients admitted in Mymensingh Medical College Hospital (MMCH) during the period from July 2006 to June 2007. Endocervical swabs/secretions were collected from 50 cases of puerperal sepsis and were cultured anaerobically. Anaerobiasis was done by using gas pack (BD GAS PAK TM EZ) in anaerobic jar. Out of 50 samples, 42(84%) yielded growth in cultures. Among 42 culture positive cases, 20(40%) were Aerobic organisms and 22(44%) were mixed, i.e., Aerobic and Anaerobic bacteria. The isolated Anaerobic organisms were Peptostreptococcus 14(63.63%), Bacteroides fragilis 3(13.64%), Prevotella melaninogenica 3(13.64%) and Clostridium perfringens 2(9.09%). As a preliminary study, it was observed that anaerobic culture could be carried out with available logistic arrangement. So, it was recommended to design further study on anaerobic bacterial isolation with particular emphasis on their antimicrobial susceptibility.

Achondroplasia with 47, xxy karyotype: a case report of the neonatal diagnosis of an extremely unusual association

PubMed Central

2012-01-01

Background The association of achondroplasia and Klinefelter syndrome is extremely rare. To date, five cases have been previously reported, all of them diagnosed beyond the postnatal period, and only one was molecularly characterized. We describe the first case of this unusual association diagnosed in the neonatal period, the clinical findings and the molecular studies undertaken. Case presentation The boy was born at term with clinical and radiological features indicating the diagnosis of achondroplasia or hypochondroplasia combined with the prenatal karyotype of Klinefelter syndrome (47,XXY). Neonatal FGFR3 mutation screening showed that the newborn was heterozygous for the classic achondroplasia G340R mutation. Microsatellite marker analysis showed that the sex chromosome aneuploidy had arisen from a non-disjunction error in paternal meiosis I, with a recombination event in the pseudoautosomal region 1 (PAR1). Conclusion Specific mutation analysis is appropriate to confirm the clinical diagnosis of achondroplasia for appropriate diagnosis, prognosis, and genetic counseling, especially when the karyotype does not explain the abnormal prenatal sonographic findings. In the present case, a recombination event was observed in the PAR1 region, although recombinational events in paternally derived Klinefelter syndrome cases are much rarer than expected. PMID:22747519

Targeted Treatment of Yaws With Household Contact Tracing: How Much Do We Miss?

PubMed Central

Dyson, Louise; Marks, Michael; Crook, Oliver M; Sokana, Oliver; Solomon, Anthony W; Bishop, Alex; Mabey, David C W; Hollingsworth, T Déirdre

2018-01-01

Abstract Yaws is a disabling bacterial infection found primarily in warm and humid tropical areas. The World Health Organization strategy mandates an initial round of total community treatment (TCT) with single-dose azithromycin followed either by further TCT or active case-finding and treatment of cases and their contacts (the Morges strategy). We sought to investigate the effectiveness of the Morges strategy. We employed a stochastic household model to study the transmission of infection using data collected from a pre-TCT survey conducted in the Solomon Islands. We used this model to assess the proportion of asymptomatic infections that occurred in households without active cases. This analysis indicated that targeted treatment of cases and their household contacts would miss a large fraction of asymptomatic infections (65%–100%). This fraction was actually higher at lower prevalences. Even assuming that all active cases and their households were successfully treated, our analysis demonstrated that at all prevalences present in the data set, up to 90% of (active and asymptomatic) infections would not be treated under household-based contact tracing. Mapping was undertaken as part of the study “Epidemiology of Yaws in the Solomon Islands and the Impact of a Trachoma Control Programme,” in September–October 2013. PMID:29140407

Should sputum-negative presumptive TB patients be actively followed to identify missing cases in India?

PubMed

Waikar, S; Pathak, A; Ghule, V; Kapoor, A; Sagili, K; Babu, E R; Chadha, S

2017-12-21

Setting: Sputum smear microscopy, the primary diagnostic tool used for diagnosis of tuberculosis (TB) in India's Revised National TB Control Programme (RNTCP), has low sensitivity, resulting in a significant number of TB cases reported as sputum-negative. As the revised guidelines pose challenges in implementation, sputum-negative presumptive TB (SNPT) patients are subjected to 2 weeks of antibiotics, followed by chest X-ray (CXR), resulting in significant loss to care among these cases. Objective: To determine whether reducing delays in CXR would yield additional TB cases and reduce initial loss to follow-up for diagnosis among SNPT cases. Methods: In an ongoing intervention in five districts of Maharashtra, SNPT patients were offered upfront CXR. Results: Of 119 male and 116 female SNPT patients with a mean age of 45 years who were tested by CXR, 32 (14%) were reported with CXR suggestive of TB. Administering upfront CXR in SNPT patients yielded twice as many additional cases, doubling the proportion of cases detected among all those tested as against administering CXR 2 weeks after smear examination. Conclusion: Our interventional study showed that the yield of TB cases was significantly greater when upfront CXR examination was undertaken without waiting for a 2-week antibiotic trial.

Is work organisation associated with work status 3 months after injury? Results from a case-control study of New Zealand workers.

PubMed

Lilley, Rebbecca; Derrett, Sarah; Davie, Gabrielle

2015-01-01

Little empirical examination of the relationship between work organisational factors and return to work following injury has been undertaken despite the growing recognition of examining broader multi-dimensional contexts for recovery following injury. To explore relationships between pre-injury work organisational factors and work status (working/work absent) 3-month after injury among people employed prior to injury. Cases (work absent) and controls (working), selected from a larger study of injury outcomes according to reported work status 3-month after injury, completed a postal questionnaire. Work organisational factors were compared between cases and controls using univariate and multivariable analyses. One hundred and twelve participants completed the questionnaire (44 cases; 68 controls). Of 11 work organisation factors examined, organisational size was the only explanatory variable significantly associated with work status in the multivariable model. Higher odds of work absence were found in small (< 50 employees) (OR 5.6) and large (> 500 employees) (OR 7.2) workplaces, compared with medium-sized (50-500 employees) organisations. Variations in post-injury work patterns among those working pre-injury may be partly explained by organisation size. Future research examining work status following injury should examine the influence of work organisational factors in larger studies.

Laboratory Information Management System (LIMS): A case study

NASA Technical Reports Server (NTRS)

Crandall, Karen S.; Auping, Judith V.; Megargle, Robert G.

1987-01-01

In the late 70's, a refurbishment of the analytical laboratories serving the Materials Division at NASA Lewis Research Center was undertaken. As part of the modernization efforts, a Laboratory Information Management System (LIMS) was to be included. Preliminary studies indicated a custom-designed system as the best choice in order to satisfy all of the requirements. A scaled down version of the original design has been in operation since 1984. The LIMS, a combination of computer hardware, provides the chemical characterization laboratory with an information data base, a report generator, a user interface, and networking capabilities. This paper is an account of the processes involved in designing and implementing that LIMS.

Borderline personality disorder: study in adolescence.

PubMed

James, A; Berelowitz, M; Vereker, M

1996-04-01

The study of the presentation, symptomatology and family characteristics of an exclusively adolescent sample of patients with borderline personality disorder (BPD) was undertaken. Twenty-four cases of borderline personality disorder, 20 females, 4 males, identified using chart review and meeting the criteria of the Diagnostic Interview for Borderlines (DIB) and DSM III-R, were matched with psychiatric controls. Adolescents with borderline personality disorder were found to have high rates of affective symptomatology with Axis I diagnosis of major depressive disorder MDD (DSM-III-R), and high rates of interpersonal psychopathology, i.e., manipulation, devaluation, and a pervasive sense of boredom. The latter seem to be characteristic as for adults with borderline personality disorder. The families were particularly angry and volatile.

Market assessment overview

NASA Technical Reports Server (NTRS)

Habib-Agahi, H.

1981-01-01

Market assessment, refined with analysis disaggregated from a national level to the regional level and to specific market applications, resulted in more accurate and detailed market estimates. The development of an integrated set of computer simulations, coupled with refined market data, allowed progress in the ability to evaluate the worth of solar thermal parabolic dish systems. In-depth analyses of both electric and thermal market applications of these systems are described. The following market assessment studies were undertaken: (1) regional analysis of the near term market for parabolic dish systems; (2) potential early market estimate for electric applications; (3) potential early market estimate for industrial process heat/cogeneration applications; and (4) selection of thermal and electric application case studies for fiscal year 1981.

Reducing aluminum: an occupation possibly associated with bladder cancer.

PubMed Central

Thériault, G; De Guire, L; Cordier, S

1981-01-01

A case-control study, undertaken to identify reasons for the exceptionally high incidence of bladder cancer among men in the Chicoutimi census division of the province of Quebec, revealed an increased risk associated with employment in the electrolysis department of an aluminum reduction plant. The estimated relative risk was 2.83 (95% confidence interval; 1.06 to 7.54). An interaction was found between such employment and cigarette smoking, resulting in a combined relative risk of 5.70 (95% confidence interval: 2.00 to 12.30). These findings suggest that employment in an aluminum reduction plant accounts for part of the excess of bladder cancer in the region studied. PMID:7214271

Optimising calcium monitoring post thyroid and parathyroid surgery

PubMed Central

Rayner, Eleanor; Williams, Nerida; Dunn, Julie

2014-01-01

There is a risk of hypocalcaemia following total thyroidectomy and parathyroidectomy surgery, with the nadir being two to five days post operatively.[1] This project examined and improved the post-operative monitoring of serum calcium in patients undergoing these procedures at the Royal Devon and Exeter (RD&E) Hospital over a ten month period in 2013. A retrospective audit was undertaken, identifying whether serum calcium was monitored according to guideline; ie measured within the first 24 hours of surgery and daily thereafter until the patient was normocalcaemic.[2–3] The audit showed an overall compliance in 79% (n = 34) of cases. Of the non-compliant cases (n=9), seven also suffered hypocalcaemia. The current process was mapped by a flow chart and used as a basis for discussing experiences and identifying areas for improvement. Interventions implemented included a patient leaflet, a process flow chart displayed in the team office and in the weekend handover book, standard text for use in discharge summaries describing the process to GPs, the issuing of prescriptions or actual supplements for patients felt to be at high risk of hypocalcaemia, and finally education to the wider surgical junior doctor team. Percentage compliance with guidelines was compared before and after intervention with a re-audit undertaken in April 2014. Significant improvement was shown, with 100% of re-audit cases compliant (n=41), and all seven cases of hypocalcaemia were managed in full compliance with guideline. PMID:26732097

Gastric adenocarcinoma in common variable immunodeficiency: features of cancer and associated gastritis may be characteristic of the condition.

PubMed

De Petris, Giovanni; Dhungel, Bal M; Chen, Longwen; Chang, Yu-Hui H

2014-10-01

Common variable immunodeficiency (CVID) is associated with an increased risk of gastric cancer. The aim of the study was to determine the morphological features of CVID-associated gastric adenocarcinoma (CAGA) and of the background gastritis. The population of gastric cancer patients with CVID of Mayo Clinic in the period 2000-2010 was studied; 6 cases of CVID (2 males, 4 females, average age 47 years, age range 26-71 years) were found in 5793 patients with gastric cancer in the study period. Each patient underwent gastric resection for which histology slides were reviewed. Chronic gastritis variables, CVID-related findings, and features of the adenocarcinoma were recorded. CAGA was of intestinal type, with high number of intratumoral lymphocytes (ITLs). Cancer was diagnosed in younger patients than in the overall population of gastric cancer. Severe atrophic metaplastic pangastritis with extensive dysplasia was present in the background in 4 cases, with features of lymphocytic gastritis in 2 cases. Features of CVID (plasma cells paucity in 4 of 6 cases, lymphoid nodules prominent in four cases) could be detected. In summary, gastric adenocarcinoma at young age with ITLs, accompanied by atrophic metaplastic pangastritis, should alert the pathologist of the possibility of CAGA. It follows that, in presence of those characteristics, the search of CVID-associated abnormalities should be undertaken in the nonneoplastic tissues. © The Author(s) 2014.

A Typology of International Student Community Engagement

ERIC Educational Resources Information Center

Fleischman, David; Raciti, Maria; Lawley, Meredith

2014-01-01

This paper presents an empirical study undertaken to develop a typology of international student community engagement activities that incorporates the perceptions of three key stakeholder groups--the international students, the community and the university. Framed by the notion of value co-creation, our exploratory study was undertaken at a…

[Art therapy and the promotion of child development in a hospitalization context].

PubMed

Valladares, Ana Cláudia Afonso; da Silva, Mariana Teixeira

2011-09-01

This study aimed to evaluate and compare the development of hospitalized children before and after art therapy interventions. Qualitative case studies were undertaken in this descriptive-exploratory research, based on the developmental evaluation of the children. The study participants were five children between seven and ten years old, in the Hospital of Tropical Illnesses (HDT) in the city of Goiânia, state of Goiás, Brazil, in 2006. Results showed that art therapy interventions efficiently promoted children's development. Art therapy is a resource for positively channeling the variables of hospitalized children's development and for neutralizing affective factors that naturally appear, as well as for exposing the child's healthier potentials, which sometimes receive little stimulus in the context of hospitalization.

Retraction techniques in laparoscopic colorectal surgery: a literature-based review.

PubMed

Ladwa, N; Sajid, M S; Pankhania, N K; Sains, P; Baig, M K

2013-08-01

To systematically review the published literature and describe the various techniques of bowel and mesentery retraction available for use in laparoscopic colorectal resection. A comprehensive search of the literature was undertaken using MESH terms 'retraction', 'laparoscopic' and 'colorectal'. All articles describing methods of retraction in laparoscopic colorectal surgery were included. Twelve methods of retraction in laparoscopic colorectal surgery were described. Five case-based series and three case studies were reported on 108 patients. Techniques were classified into those offering retraction of the small or large bowel or according to the mode of retraction. Many retraction methods are available to the surgeon varying in cost, invasiveness and complexity. Adequate retraction remains a challenge for optimal exposure and dissection during laparoscopic colorectal surgery. © 2013 The Authors Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

Hot wire anemometer measurements in the unheated air flow tests of the SRB nozzle-to-case joint

NASA Technical Reports Server (NTRS)

Ramachandran, N.

1988-01-01

Hot-Wire Anemometer measurements made in the Solid Rocket Booster (SRB) nozzle-to-case joint are discussed. The study was undertaken to glean additional information on the circumferential flow induced in the SRB nozzle joint and the effect of this flow on the insulation bonding flaws. The tests were conducted on a full-scale, 2-D representation of a 65-in long segment of the SRB nozzle joint, with unheated air as the working fluid. Both the flight Mach number and Reynolds number were matched simultaneously and different pressure gradients imposed along the joint face were investigated. Hot-wire anemometers were used to obtain velocity data for different joint gaps and debond configurations. The procedure adopted for hot-wire calibration and use is outlined and the results from the tests summarized.

Investigation of Low-Reynolds-Number Rocket Nozzle Design Using PNS-Based Optimization Procedure

NASA Technical Reports Server (NTRS)

Hussaini, M. Moin; Korte, John J.

1996-01-01

An optimization approach to rocket nozzle design, based on computational fluid dynamics (CFD) methodology, is investigated for low-Reynolds-number cases. This study is undertaken to determine the benefits of this approach over those of classical design processes such as Rao's method. A CFD-based optimization procedure, using the parabolized Navier-Stokes (PNS) equations, is used to design conical and contoured axisymmetric nozzles. The advantage of this procedure is that it accounts for viscosity during the design process; other processes make an approximated boundary-layer correction after an inviscid design is created. Results showed significant improvement in the nozzle thrust coefficient over that of the baseline case; however, the unusual nozzle design necessitates further investigation of the accuracy of the PNS equations for modeling expanding flows with thick laminar boundary layers.

Toward Best Practice in Evaluation: A Study of Australian Health Promotion Agencies.

PubMed

Francis, Louise J; Smith, Ben J

2015-09-01

Evaluation makes a critical contribution to the evidence base for health promotion programs and policy. Because there has been limited research about the characteristics and determinants of evaluation practice in this field, this study audited evaluations completed by health promotion agencies in Victoria, Australia, and explored the factors that enabled or hindered evaluation performance. Twenty-four agencies participated. A systematic assessment of 29 recent evaluation reports was undertaken, and in-depth interviews were carried out with 18 experienced practitioners. There was wide variability in the scope of evaluations and the level of reporting undertaken. Formative evaluation was uncommon, but almost all included process evaluation, especially of strategy reach and delivery. Impact evaluation was attempted in the majority of cases, but the designs and measures used were often not specified. Practitioners strongly endorsed the importance of evaluation, but the reporting requirements and inconsistent administrative procedures of the funding body were cited as significant barriers. Budget constraints, employment of untrained coworkers, and lack of access to measurement tools were other major barriers to evaluation. Capacity building to strengthen evaluation needs to encompass system, organizational, and practitioner-level action. This includes strengthening funding and reporting arrangements, fostering partnerships, and tailoring workforce development opportunities for practitioners. © 2015 Society for Public Health Education.

Hospital volume of throughput and periprocedural and medium‐term adverse events after percutaneous coronary intervention: retrospective cohort study of all 17 417 procedures undertaken in Scotland, 1997–2003

PubMed Central

Burton, K R; Slack, R; Oldroyd, K G; Pell, A C H; Flapan, A D; Starkey, I R; Eteiba, H; Jennings, K P; Northcote, R J; Hillis, W Stewart; Pell, J P

2006-01-01

Objective To determine whether percutaneous coronary intervention (PCI) hospital volume of throughput is associated with periprocedural and medium‐term events, and whether any associations are independent of differences in case mix. Design Retrospective cohort study of all PCIs undertaken in Scottish National Health Service hospitals over a six‐year period. Methods All PCIs in Scotland during 1997–2003 were examined. Linkage to administrative databases identified events over two years' follow up. The risk of events by hospital volume at 30 days and two years was compared by using logistic regression and Cox proportional hazards models. Results Of the 17 417 PCIs, 4900 (28%) were in low‐volume hospitals and 3242 (19%) in high‐volume hospitals. After adjustment for case mix, there were no significant differences in risk of death or myocardial infarction. Patients treated in high‐volume hospitals were less likely to require emergency surgery (adjusted odds ratio 0.18, 95% confidence interval (CI) 0.07 to 0.54, p  =  0.002). Over two years, patients in high‐volume hospitals were less likely to undergo surgery (adjusted hazard ratio 0.52, 95% CI 0.35 to 0.75, p  =  0.001), but this was offset by an increased likelihood of further PCI. There was no net difference in coronary revascularisation or in overall events. Conclusion Death and myocardial infarction were infrequent complications of PCI and did not differ significantly by volume. Emergency surgery was less common in high‐volume hospitals. Over two years, patients treated in high‐volume centres were as likely to undergo some form of revascularisation but less likely to undergo surgery. PMID:16709693

Hospital volume of throughput and periprocedural and medium-term adverse events after percutaneous coronary intervention: retrospective cohort study of all 17,417 procedures undertaken in Scotland, 1997-2003.

PubMed

Burton, K R; Slack, R; Oldroyd, K G; Pell, A C H; Flapan, A D; Starkey, I R; Eteiba, H; Jennings, K P; Northcote, R J; Hillis, W Stewart; Pell, J P

2006-11-01

To determine whether percutaneous coronary intervention (PCI) hospital volume of throughput is associated with periprocedural and medium-term events, and whether any associations are independent of differences in case mix. Retrospective cohort study of all PCIs undertaken in Scottish National Health Service hospitals over a six-year period. All PCIs in Scotland during 1997-2003 were examined. Linkage to administrative databases identified events over two years' follow up. The risk of events by hospital volume at 30 days and two years was compared by using logistic regression and Cox proportional hazards models. Of the 17,417 PCIs, 4900 (28%) were in low-volume hospitals and 3242 (19%) in high-volume hospitals. After adjustment for case mix, there were no significant differences in risk of death or myocardial infarction. Patients treated in high-volume hospitals were less likely to require emergency surgery (adjusted odds ratio 0.18, 95% confidence interval (CI) 0.07 to 0.54, p = 0.002). Over two years, patients in high-volume hospitals were less likely to undergo surgery (adjusted hazard ratio 0.52, 95% CI 0.35 to 0.75, p = 0.001), but this was offset by an increased likelihood of further PCI. There was no net difference in coronary revascularisation or in overall events. Death and myocardial infarction were infrequent complications of PCI and did not differ significantly by volume. Emergency surgery was less common in high-volume hospitals. Over two years, patients treated in high-volume centres were as likely to undergo some form of revascularisation but less likely to undergo surgery.

The role of a food policy coalition in influencing a local food environment: an Australian case study.

PubMed

McCartan, Julia; Palermo, Claire

2017-04-01

To explore how an Australian rural food policy coalition acts to influence a local food environment, focusing specifically on its composition, functions and processes as well as its food-related strategies and policy outputs. A qualitative case study approach was undertaken. Three sources were used to triangulate data: eleven semi-structured in-depth interviews with coalition members, analysis of thirty-seven documents relating to the coalition and observation at one coalition meeting. Data were analysed using a thematic and constant comparison approach. Community Coalition Action Theory provided a theoretical framework from which to interpret findings. Two rural local government areas on the south-eastern coast of Victoria, Australia. Eleven members of the food policy coalition. Five themes emerged from the data analysis. The themes described the coalition's leadership processes, membership structure, function to pool resources for food system advocacy, focus on collaborative cross-jurisdictional strategies and ability to influence policy change. This Australian case study demonstrates that with strong leadership, a small-sized core membership and focus on collaborative strategies, food policy coalitions may be a mechanism to positively influence local food environments.

A case study of data integration for aquatic resources using semantic web technologies

USGS Publications Warehouse

Gordon, Janice M.; Chkhenkeli, Nina; Govoni, David L.; Lightsom, Frances L.; Ostroff, Andrea C.; Schweitzer, Peter N.; Thongsavanh, Phethala; Varanka, Dalia E.; Zednik, Stephan

2015-01-01

Use cases, information modeling, and linked data techniques are Semantic Web technologies used to develop a prototype system that integrates scientific observations from four independent USGS and cooperator data systems. The techniques were tested with a use case goal of creating a data set for use in exploring potential relationships among freshwater fish populations and environmental factors. The resulting prototype extracts data from the BioData Retrieval System, the Multistate Aquatic Resource Information System, the National Geochemical Survey, and the National Hydrography Dataset. A prototype user interface allows a scientist to select observations from these data systems and combine them into a single data set in RDF format that includes explicitly defined relationships and data definitions. The project was funded by the USGS Community for Data Integration and undertaken by the Community for Data Integration Semantic Web Working Group in order to demonstrate use of Semantic Web technologies by scientists. This allows scientists to simultaneously explore data that are available in multiple, disparate systems beyond those they traditionally have used.

Suprarenal solitary fibrous tumor associated with a NF1 gene mutation mimicking a kidney neoplasm: implications for surgical management

PubMed Central

2014-01-01

Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm, usually occurring in the pleura. Pararenal SFT, mimicking an adrenal gland or renal tumor, as here described, is extremely rare. We report a case of a right suprarenal SFT, incidentally discovered by abdominal ultrasound in a 54-year-old woman carrying a point neurofibromatosis 1 (NF1) gene mutation. Preoperative diagnostic work-up was ineffective in evaluating its origin, and an open radical right nephrectomy was therefore undertaken. Immunohistochemical assay showed a positivity for CD34, CD99 and Bcl-2, so suggesting a diagnosis of SFT. According to our knowledge, the association between this type of tumor and NF1 gene mutation has never been described. In cases of pararenal tumors, a more detailed preoperative diagnosis could be useful to better plan the extension of resection, allowing, in selected cases, nephron-sparing surgery. More studies are needed to better analyze the relationship between NF1 gene mutation and SFT. PMID:24708790

Sexual history and Epstein-Barr virus infection.

PubMed

Crawford, Dorothy H; Swerdlow, Anthony J; Higgins, Craig; McAulay, Karen; Harrison, Nadine; Williams, Hilary; Britton, Kathryn; Macsween, Karen F

2002-09-15

To determine the role of sexual contact in transmission of Epstein-Barr virus (EBV) and occurrence of infectious mononucleosis (IM), a cross-sectional study was undertaken of EBV serologic testing and histories of IM and sexual behavior among 1006 new students at Edinburgh University. Prevalence of EBV seropositivity was significantly greater among women (79.2%) than among men (67.4%; P<.001) and among those who had ever been sexually active (82.7%) than among those who had not (63.7%; P<.001). Having a greater number of sex partners was a highly significant risk factor for EBV seropositivity. Two thirds of IM cases, but only a tenth of asymptomatic primary EBV infections, were statistically attributable to sexual intercourse. The findings suggest that EBV transmission occurs during sexual intercourse or closely associated behaviors. Transmission in this way appears to account for most cases of IM but for only a minority of cases of asymptomatic EBV infection, which mainly occur at younger ages.

Aligning Event Logs to Task-Time Matrix Clinical Pathways in BPMN for Variance Analysis.

PubMed

Yan, Hui; Van Gorp, Pieter; Kaymak, Uzay; Lu, Xudong; Ji, Lei; Chiau, Choo Chiap; Korsten, Hendrikus H M; Duan, Huilong

2018-03-01

Clinical pathways (CPs) are popular healthcare management tools to standardize care and ensure quality. Analyzing CP compliance levels and variances is known to be useful for training and CP redesign purposes. Flexible semantics of the business process model and notation (BPMN) language has been shown to be useful for the modeling and analysis of complex protocols. However, in practical cases one may want to exploit that CPs often have the form of task-time matrices. This paper presents a new method parsing complex BPMN models and aligning traces to the models heuristically. A case study on variance analysis is undertaken, where a CP from the practice and two large sets of patients data from an electronic medical record (EMR) database are used. The results demonstrate that automated variance analysis between BPMN task-time models and real-life EMR data are feasible, whereas that was not the case for the existing analysis techniques. We also provide meaningful insights for further improvement.

Do variations in the theatre team have an impact on the incidence of complications?

PubMed Central

Baylis, Oliver J; Adams, Wendy E; Allen, David; Fraser, Scott G

2006-01-01

Background To examine whether variations in non-medical personnel influence the incidence of complications in a cataract theatre. Methods A retrospective Case-Control study was undertaken in a single-site, designated cataract theatre. Staffing variations within theatre were examined and the incidence of cataract complications was assessed. Results 100 complicated lists and 200 uncomplicated control lists were chosen. At least 7 nurses were present for every list. Mean experience of the nurses was 6.4 years for case lists and 6.5 years for control lists. Average scrub nurse experience in years was 7.6 years for complicated lists and 8.0 years for controls. 26% of complicated case lists were affected by unplanned leave and 17% in control lists. Odds ratio 1.7 (1.0 to 3.1) 95% CI. Conclusion Unplanned leave can have a detrimental effect on the operating list. The impact of this may be modifiable with careful planning. PMID:16542439

Scoliosis in Dandy-Walker syndrome: a case report and review of literature.

PubMed

Menon, Venugopal K; Sorur, Tamer M M; Al Ghafri, Khalifa A; Shahin, Marwan M H E

2017-12-01

This submission presents a case of scoliosis in a patient with established Dandy-Walker anomaly of the brain. A retrospective review of the patient's case notes was undertaken and the limited literature on this subject reviewed. The 13-year-old girl presented with a stiff right thoracic scoliosis typical of adolescent idiopathic scoliosis. The scoliotic segment also presented with significant lordosis. She had facial and truncal dysmorphism characteristic of Dandy-Walker complex and her brain images confirmed the diagnosis. She underwent scoliosis surgery by the posterior approach uneventfully. In conclusion scoliosis is hitherto unreported in the Dandy-Walker complex. The results of intervention appear satisfactory.

Tumor necrosis factor antagonist therapy and lymphoma development: twenty-six cases reported to the Food and Drug Administration.

PubMed

Brown, S Lori; Greene, Mark H; Gershon, Sharon K; Edwards, Evelyne T; Braun, M Miles

2002-12-01

Etanercept and infliximab are tumor necrosis factor (TNF) antagonists that have been recently approved for the treatment of rheumatoid arthritis (RA) and Crohn's disease (CD). This study was undertaken to investigate the occurrence of lymphoproliferative disorders in patients treated with these agents. Relevant data in the MedWatch postmarket adverse event surveillance system run by the US Food and Drug Administration were reviewed. We identified 26 cases of lymphoproliferative disorders following treatment with etanercept (18 cases) or infliximab (8 cases). The majority of cases (81%) were non-Hodgkin's lymphomas. The interval between initiation of therapy with etanercept or infliximab and the development of lymphoma was very short (median 8 weeks). In 2 instances (1 infliximab, 1 etanercept), lymphoma regression was observed following discontinuation of anti-TNF treatment, in the absence of specific cytotoxic therapy directed toward the lymphoma. Although data from a case series such as this cannot establish a clear causal relationship between exposure to these medications and the risk of lymphoproliferative disease, the known predisposition of patients with RA and CD to lymphoma, the known excess of lymphoma in other immunosuppressed populations, and the known immunosuppressive effects of the anti-TNF drugs provide a biologic basis for concern and justification for the initiation of additional epidemiologic studies to formally evaluate this possible association.

An evaluation of the effectiveness of a case-specific approach to challenging behaviour associated with dementia.

PubMed

Bird, Michael; Llewellyn-Jones, Robert H; Korten, Ailsa

2009-01-01

Treatment of challenging behaviour in dementia using standardized psychopharmacological or psychosocial approaches remains problematical. A case-specific approach was trialled in this study, based on extensive evidence that each case is different in aetiology, the effects of the behaviour on others and what interventions are possible given the available resources. Forty-four consecutive referrals for challenging behaviour (two-thirds in residential care) were assessed across multiple causal domains. Both assessment and development of interventions were undertaken in collaboration with family carers and care staff. Measures of behaviour and associated carer distress, as well as medication and service use, were taken pre-intervention and at 2- and 5-month follow-ups. Psychotropic medication was used with a minority of participants but, overall, antipsychotic use was reduced. Psychosocial methods predominated, with 77% of cases judged as mainly or entirely psychosocial by an expert panel. There were significant mean improvements in behaviour and carer distress. Using conservative criteria there was a 65.9% clinical success rate. Results confirm those of other studies which have used multifaceted interventions tailored to the unique needs of each case. They compare favourably with results from trials of standardized psycho-pharmacological or psychosocial approaches. More trials are needed, necessarily involving further development of robust methodologies which reflect the case-specific nature of challenging behaviour associated with dementia.

Shortcuts to Excellence: Techniques To Increase Personal Productivity, Job Satisfaction and Organizational Effectiveness.

ERIC Educational Resources Information Center

Brown, Michael H.

This document presents a case history of an 80-hour consulting contract undertaken in 1984 whereby a human resources consultant provided training in team building, communication skills, and creative problem solving to the management team of the Water Revenue Department (WRD) of the government of the District of Columbia. The troubled history of…

Adult Learning--Providing Equal Opportunities or Widening Differences? The Polish Case

ERIC Educational Resources Information Center

Kocór, Marcin; Worek, Barbara

2017-01-01

Educational activity among adults is not only a key factor of social development but also one of the most important priorities of public policies. Although large sums have been earmarked and numerous actions undertaken to encourage adult learning, many people remain educationally passive, a particularly acute problem in Poland. We point to the…

Monitoring Cetaceans in the North Pacific

DTIC Science & Technology

2009-04-01

Pacific by Kathleen M. Stafford April 2009 THIS PAGE INTENTIONALLY LEFT...September 2007-30 August 2008 4. TITLE AND SUBTITLE: Title (Mix case letters) Monitoring cetaceans in the North Pacific . 6. AUTHOR(S) Kathleen...words) Two projects were undertaken in order to monitor cetaceans in the North Pacific . The first was designed to obtain passive acoustic data from

Incentive and Disincentive to Participation in the Work Incentive Program. Final Report.

ERIC Educational Resources Information Center

Garvin, Charles D., Ed.

Initially this report presents a summary of three Work Incentive Programs (WIN) undertaken by a consortium of schools of social work at the University of Chicago, University of Michigan, and Case Western Reserve University, discussing in detail the design, major findings, and recommendations made. The next two chapters are devoted to discussions…

The Role of Professional Background, Case Characteristics, and Protective Agency Response in Mandated Child Abuse Reporting.

ERIC Educational Resources Information Center

Zellman, Gail L.; Bell, Robert M.

This document presents a report on research undertaken to assess the incidence of child abuse reporting and of failure to report among mandated reporters; the contributions of workplace, personal, and institutional factors to reporting behavior; and the interaction of mandated reporters with the child protective agencies to which they report. The…

Lifelong Learning in Public Libraries in 12 European Union Countries: Issues in Monitoring and Evaluation

ERIC Educational Resources Information Center

Stanziola, Javier

2011-01-01

Public libraries in Europe have supported lifelong learning for the past 500 years. Since the Lisbon Strategy emphasized the role of lifelong learning in economic policy, public libraries have been repositioning their services to respond to this new context. In some cases, these roles are undertaken with limited legislative or strategic changes…

Harmonising Training and Development across an Industry: The Case of Australian Rail

ERIC Educational Resources Information Center

Short, Tom; Harris, Roger McL.

2017-01-01

Purpose: This paper aims to explore why harmonisation, given its potential, is so difficult to achieve. It analyses the issues and challenges in achieving harmonisation of training and development across an industry. Design/methodology/approach: The approach was a meta-analysis of six research projects undertaken in the Australian rail industry.…

e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China.

PubMed

Li, Junhua; Seale, Holly; Ray, Pradeep; Wang, Quanyi; Yang, Peng; Li, Shuang; Zhang, Yi; Macintyre, C Raina

2013-03-13

To assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response. This research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital. In phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study. In phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer). PRIMARY AND SECONDARY MEASURES: For the case study, five areas were examined to assess the hospital's preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers' exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response. This article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospital's preparedness. These issues include a poor sharing of patient health records, prescription errors, unavailability of software tools to assist physicians in answering patient questions, physicians' concerns about the reliability of ICT and the high monetary cost of e-health implementation and uncertainty over return on investment, and their dissatisfaction with the software in use. Prior to the implementation of e-Health, planning must be undertaken to ensure the smooth introduction of the system. The assessment of organisational preparedness is an important step in this planning process. On the basis of a case study, deficient areas of organisational preparedness were identified for the prospective implementation of electronic health records. Accordingly, we suggested possible solutions for the areas in need of improvement to facilitate e-Health implementation's success.

e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China

PubMed Central

Li, Junhua; Seale, Holly; Ray, Pradeep; Wang, Quanyi; Yang, Peng; Li, Shuang; Zhang, Yi; MacIntyre, C Raina

2013-01-01

Objective To assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response. Design This research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital. Setting In phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study. Participants In phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer). Primary and secondary measures For the case study, five areas were examined to assess the hospital's preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers’ exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response. Results This article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospital's preparedness. These issues include a poor sharing of patient health records, prescription errors, unavailability of software tools to assist physicians in answering patient questions, physicians’ concerns about the reliability of ICT and the high monetary cost of e-health implementation and uncertainty over return on investment, and their dissatisfaction with the software in use. Conclusions Prior to the implementation of e-Health, planning must be undertaken to ensure the smooth introduction of the system. The assessment of organisational preparedness is an important step in this planning process. On the basis of a case study, deficient areas of organisational preparedness were identified for the prospective implementation of electronic health records. Accordingly, we suggested possible solutions for the areas in need of improvement to facilitate e-Health implementation's success. PMID:23485719

Where chloroquine still works: the genetic make-up and susceptibility of Plasmodium vivax to chloroquine plus primaquine in Bhutan.

PubMed

Wangchuk, Sonam; Drukpa, Tobgyel; Penjor, Kinley; Peldon, Tashi; Dorjey, Yeshey; Dorji, Kunzang; Chhetri, Vishal; Trimarsanto, Hidayat; To, Sheren; Murphy, Amanda; von Seidlein, Lorenz; Price, Ric N; Thriemer, Kamala; Auburn, Sarah

2016-05-12

Bhutan has made substantial progress in reducing malaria incidence. The national guidelines recommend chloroquine (CQ) and primaquine (PQ) for radical cure of uncomplicated Plasmodium vivax, but the local efficacy has not been assessed. The impact of cases imported from India on the genetic make-up of the local vivax populations is currently unknown. Patients over 4 years of age with uncomplicated P. vivax mono-infection were enrolled into a clinical efficacy study and molecular survey. Study participants received a standard dose of CQ (25 mg/kg over 3 days) followed by weekly review until day 28. On day 28 a 14-day regimen of PQ (0.25 mg/kg/day) was commenced under direct observation. After day 42, patients were followed up monthly for a year. The primary and secondary endpoints were risk of treatment failure at day 28 and at 1 year. Parasite genotyping was undertaken at nine tandem repeat markers, and standard population genetic metrics were applied to examine population diversity and structure in infections thought to be acquired inside or outside of Bhutan. A total of 24 patients were enrolled in the clinical study between April 2013 and October 2015. Eight patients (33.3 %) were lost to follow-up in the first 6 months and another eight patients lost between 6 and 12 months. No (0/24) treatment failures occurred by day 28 and no (0/8) parasitaemia was detected following PQ treatment. Some 95.8 % (23/24) of patients were aparasitaemic by day 2. There were no haemolytic or serious events. Genotyping was undertaken on parasites from 12 autochthonous cases and 16 suspected imported cases. Diversity was high (H E 0.87 and 0.90) in both populations. There was no notable differentiation between the autochthonous and imported populations. CQ and PQ remains effective for radical cure of P. vivax in Bhutan. The genetic analyses indicate that imported infections are sustaining the local vivax population, with concomitant risk of introducing drug-resistant strains.

Indian Manpower Resources in the Southwest: A Pilot Study.

ERIC Educational Resources Information Center

Taylor, Benjamin J.; O'Connor, Dennis J.

The Indian Manpower Resource Study (IMRS) was undertaken to provide basic information essential to the planning and development of effective programs to make use of the manpower resource of reservation Indians in Arizona and New Mexico. In the past, decision making has largely been undertaken with a minimum of valid information. The reservations…

Domestic Violence as a Risk Factor for Attempted Suicide in Married Women.

PubMed

Indu, Pankajakshan Vijayanthi; Remadevi, Sivaraman; Vidhukumar, Karunakaran; Shah Navas, Peer Mohammed; Anilkumar, Thekkethayyil Viswanathan; Subha, Nanoo

2017-08-01

High rates of suicide attempts and domestic violence (DV) in women of reproductive age group have been reported from South India, but the association between them was not studied. Hence, this study was undertaken to assess whether DV is a risk factor for attempted suicide in married women of reproductive age group. A hospital-based case-control study with 77 incident cases of attempted suicide in married women of the age group of 18 to 45 years and 153 controls belonging to the same age group, without history of suicide attempt, was undertaken over a period of 6 months. Univariate and multivariate analyses were done. The crude odds ratio (cOR) for DV was found to be 6.15 (95% confidence interval [95% CI] = [2.95, 12.82], p value = .0001). Other statistically significant risk factors included younger age group (below 30 years); gross family income > Rs. 5,000; higher occupational status of spouse; having poor social support; having a family history of psychiatric disorders, substance use disorders, and suicide/suicide attempt; higher impulsiveness scores; having higher scores of stressful life events over the past 12 months, and alcohol use disorder in husband. Islamic faith was found to be a significant protective factor. On logistic regression, DV was found to be an independent risk factor for attempted suicide in this study population (adjusted OR = 3.79, 95% CI = [1.35, 10.62], p value = .011). Age groups, stressful life events, impulsiveness, and alcohol use disorder in husband were the confounders adjusted for in logistic regression along with other significant risk and protective factors. Significant dose-response relationship was also observed between DV and attempted suicide. In accordance with the stress-diathesis model for suicidal behavior, DV is found to be a stressor which precipitates suicide attempt in those with diathesis like family history of psychiatric disorders. Clinical, research, and policy implications of the findings are discussed.

Improved survival after stroke: is admission to hospital the major explanation? Trend analyses of the Auckland Regional Community Stroke Studies.

PubMed

Carter, Kristie N; Anderson, Craig S; Hackett, Maree L; Barber, P Alan; Bonita, Ruth

2007-01-01

There is uncertainty regarding the impact of changes in stroke care and natural history of stroke in the community. We examined factors responsible for trends in survival after stroke in a series of population-based studies. We used statistical models to assess temporal trends in 28-day and 1-year case fatality after first-ever stroke cases registered in 3 stroke incidence studies undertaken in Auckland, New Zealand, over uniform 12-month calendar periods in 1981-1982 (n = 1,030), 1991-1992 (1,305) and 2001-2002 (1,423). Cox proportional hazards regression was used to evaluate the significance of pre-defined 'patient', 'disease' and 'service/care' factors on these trends. Overall, there was a 40% decline in 28-day case fatality after stroke over the study periods, from 32% (95% confidence interval, 29-35%) in 1981-1982 to 23% (21-25%) in 1991-1992 and then 19% (17-21%) in 2002-2003. Similar relative declines were seen in 1-year case fatality. In regression models, the trends were still significant after adjusting for patient and disease factors. However, further adjustment for care factors (higher hospital admission and neuroimaging) explained most of the improvement in survival. These data show significant downwards trends in case fatality after stroke in Auckland over 20 years, which can largely be attributed to improved stroke care associated with increases in hospital admission and brain imaging during the acute phase of the illness.

Vocal Fold Bowing in Elderly Male Monozygotic Twins: A Case Study

PubMed Central

Tanner, Kristine; Sauder, Cara; Thibeault, Susan L.; Dromey, Christopher; Smith, Marshall E.

2009-01-01

Objectives This study examined case histories, diagnostic features, and treatment response in two 79-year-old male monozygotic (identical) twins with vocal fold bowing, exploring both genetic and environmental factors. Study Design Case study. Methods DNA concordance was examined via cheek swab. Case histories, videostroboscopy, auditory- and visual-perceptual assessment, electromyography, acoustic measures, and Voice Handicap ratings were undertaken. Both twins underwent surgical intervention and subsequent voice therapy. Results Monozygosity was confirmed for DNA polymorphisms, with 10 of 10 concordance for STR DNA markers. For both twins, auditory and visual-perceptual assessments indicated severe bowing, hoarseness and breathiness, although Twin 1 was judged to be extremely severe. Differences in RMS amplitudes were observed for TA and LCA muscles, with smaller relative amplitudes observed for the Twin 1 versus Twin 2. No consistent voice improvement was observed following surgical intervention(s), despite improved mid-membranous vocal fold closure. Marked reductions in Voice Handicap Index total scores were observed following behavioral voice therapy, coinciding with increased mid-membranous and posterior laryngeal (interarytenoid) glottal closure. No substantive differences in acoustic measures were observed. Conclusions Vocal fold bowing was more severe for Twin 1 versus Twin 2 despite identical heritability factors. Overall voice improvement with treatment was greater for Twin 2 than Twin 1. Environmental factors might partially account for the differences observed between the twins, including variability in their responsiveness to behavioral voice therapy. Voice therapy was useful in improving mid-membranous and posterior laryngeal closure, although dysphonia remained severe in both cases. PMID:19664899

Case study approach to modeling historical disinfection by-product exposure in Iowa drinking waters.

PubMed

Krasner, Stuart W; Cantor, Kenneth P; Weyer, Peter J; Hildesheim, Mariana; Amy, Gary

2017-08-01

In the 1980s, a case-control epidemiologic study was conducted in Iowa (USA) to analyze the association between exposure to disinfection by-products (DBPs) and bladder cancer risk. Trihalomethanes (THMs), the most commonly measured and dominant class of DBPs in drinking water, served as a primary metric and surrogate for the full DBP mixture. Average THM exposure was calculated, based on rough estimates of past levels in Iowa. To reduce misclassification, a follow-up study was undertaken to improve estimates of past THM levels and to re-evaluate their association with cancer risk. In addition, the risk associated with haloacetic acids, another class of DBPs, was examined. In the original analysis, surface water treatment plants were assigned one of two possible THM levels depending on the point of chlorination. The re-assessment considered each utility treating surface or groundwater on a case-by-case basis. Multiple treatment/disinfection scenarios and water quality parameters were considered with actual DBP measurements to develop estimates of past levels. The highest annual average THM level in the re-analysis was 156μg/L compared to 74μg/L for the original analysis. This allowed the analysis of subjects exposed at higher levels (>96μg/L). The re-analysis established a new approach, based on case studies and an understanding of the water quality and operational parameters that impact DBP formation, for determining historical exposure. Copyright © 2017. Published by Elsevier B.V.

Recent Developments at DG Competition: 2016/2017.

PubMed

Buehler, Benno; Coublucq, Daniel; Hariton, Cyril; Langus, Gregor; Valletti, Tommaso

2017-01-01

The Directorate General for Competition at the European Commission enforces competition law in the areas of antitrust, merger control, and state aids. This year's article provides first a general presentation of the role of the Chief Competition Economist's team and surveys the main achievements of the Directorate General for Competition over 2016/2017. The article then reviews the economic work undertaken in one merger case between Dow/DuPont, which raised specific issues related to innovation, as well as in an antitrust case on parity clauses related to Amazon e-books.

Day-case anaesthesia for termination of pregnancy. Evaluation of a total intravenous anaesthetic technique.

PubMed

Ogg, T W; Jennings, R A; Morrison, C G

1983-11-01

An investigation was undertaken to assess the use of a total intravenous anaesthetic technique of fentanyl and methohexitone for outpatient vaginal termination of pregnancy. When compared with a technique of fentanyl, methohexitone, nitrous oxide and trichloroethylene the total intravenous method caused swifter recovery, minimal side-effects and no cardiovascular depression. However, both anaesthetic techniques produced significant postoperative reduction of memory for new facts when compared with a control group receiving no general anaesthesia. There is a need to continue the search for anaesthetic methods appropriate for day cases.

Orthodontic Treatment of Binder Syndrome: A Case Report With 5 Years of Follow-up.

PubMed

Cossellu, Gianguido; Biagi, Roberto; Faggioni, Giulia; Farronato, Giampietro

2015-07-01

We report here the case of orthodontic nonsurgical treatment in a patient with Binder syndrome. This rare syndrome (<1/10,000) is a deforming alteration of the middle third of the face, also known as maxillonasal dysplasia/dysostosis. The therapeutic approach often undertaken is an orthodontic-surgical protocol, which includes several invasive interventions such as LeFort I or II. In this patient and early diagnosis made it possible to intervene on an orthodontic level only, thus avoiding highly invasive surgical procedures (as of a 5-year follow-up).

Case report 868. Congenital bilateral spondylolysis and spondylolisthesis of the fourth cervical vertebra.

PubMed

Jeyapalan, K; Chavda, S V

1994-10-01

A case of congenital bilateral spondylolysis of fourth cervical vertebra was reported and the characteristic radiological features shown. Although the diagnosis is often suggested by the plain films, demonstration of the typical CT findings is often necessary to reach a final diagnosis. Awareness of this entity and its specific radiological features will help to differentiate this relatively benign cervical anomaly from other, more ominous, unstable causes of cervical spondylolisthesis such as those related to acute cervical injury. It may also prevent any inappropriate treatment from being undertaken.

Improving rational thermal comfort prediction by using subpopulation characteristics: A case study at Hermitage Amsterdam

PubMed Central

Kramer, Rick; Schellen, Lisje; Schellen, Henk; Kingma, Boris

2017-01-01

ABSTRACT This study aims to improve the prediction accuracy of the rational standard thermal comfort model, known as the Predicted Mean Vote (PMV) model, by (1) calibrating one of its input variables “metabolic rate,” and (2) extending it by explicitly incorporating the variable running mean outdoor temperature (RMOT) that relates to adaptive thermal comfort. The analysis was performed with survey data (n = 1121) and climate measurements of the indoor and outdoor environment from a one year-long case study undertaken at Hermitage Amsterdam museum in the Netherlands. The PMVs were calculated for 35 survey days using (1) an a priori assumed metabolic rate, (2) a calibrated metabolic rate found by fitting the PMVs to the thermal sensation votes (TSVs) of each respondent using an optimization routine, and (3) extending the PMV model by including the RMOT. The results show that the calibrated metabolic rate is estimated to be 1.5 Met for this case study that was predominantly visited by elderly females. However, significant differences in metabolic rates have been revealed between adults and elderly showing the importance of differentiating between subpopulations. Hence, the standard tabular values, which only differentiate between various activities, may be oversimplified for many cases. Moreover, extending the PMV model with the RMOT substantially improves the thermal sensation prediction, but thermal sensation toward extreme cool and warm sensations remains partly underestimated. PMID:28680934

Improving rational thermal comfort prediction by using subpopulation characteristics: A case study at Hermitage Amsterdam.

PubMed

Kramer, Rick; Schellen, Lisje; Schellen, Henk; Kingma, Boris

2017-01-01

This study aims to improve the prediction accuracy of the rational standard thermal comfort model, known as the Predicted Mean Vote (PMV) model, by (1) calibrating one of its input variables "metabolic rate," and (2) extending it by explicitly incorporating the variable running mean outdoor temperature (RMOT) that relates to adaptive thermal comfort. The analysis was performed with survey data ( n = 1121) and climate measurements of the indoor and outdoor environment from a one year-long case study undertaken at Hermitage Amsterdam museum in the Netherlands. The PMVs were calculated for 35 survey days using (1) an a priori assumed metabolic rate, (2) a calibrated metabolic rate found by fitting the PMVs to the thermal sensation votes (TSVs) of each respondent using an optimization routine, and (3) extending the PMV model by including the RMOT. The results show that the calibrated metabolic rate is estimated to be 1.5 Met for this case study that was predominantly visited by elderly females. However, significant differences in metabolic rates have been revealed between adults and elderly showing the importance of differentiating between subpopulations. Hence, the standard tabular values, which only differentiate between various activities, may be oversimplified for many cases. Moreover, extending the PMV model with the RMOT substantially improves the thermal sensation prediction, but thermal sensation toward extreme cool and warm sensations remains partly underestimated.

Early prognostic markers for fatal fulminant hepatic failure cases with viral hepatitis: proton nuclear magnetic resonance spectroscopic studies of serum.

PubMed

Bala, Lakshmi; Mehrotra, Mayank; Mohindra, Samir; Saxena, Rajan; Khetrapal, Chunni Lal

2013-02-01

Fulminant hepatic failure is associated with liver metabolic derangements which could have fatal consequences. The aim of the present study is to identify serum markers for early prediction of the outcome. Proton nuclear magnetic resonance spectroscopic studies of serum of fulminant hepatic failure patients due to viral hepatitis with grade II/III of encephalopathy (twenty-four: ten prospective and fourteen retrospective) and twenty-five controls were undertaken. Of the twenty-four patients, fifteen survived with medical management alone while nine had fatal outcome. The results demonstrated significantly elevated indices of amino acids (alanine, lysine, glutamine, histidine, tyrosine, phenylalanine and 1,2-propanediol) in fatal cases compared to survivors and controls. Principal component analysis showed clear separation of fatal and surviving cases. Liver function parameters were significantly deranged in patients but they failed to provide early significant differences between surviving and fatal cases. Compared to model for end-stage liver disease scores, principal component analysis appear to be better as an early prognostic indicator. Biochemical mapping of pathways suggested interruptions in amino acid metabolism and urea cycle. Proton nuclear magnetic resonance studies of serum have the potential of rapidly identifying patients with irreversible fulminant hepatic failure requiring liver transplantation as life saving option. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Histopathologic Findings in Autopsies with Emphasis on Interesting and Incidental Findings-A Pathologist's Perspective.

PubMed

Patel, Sapna; Rajalakshmi, B R; Manjunath, G V

2016-11-01

Autopsy aids to the knowledge of pathology by unveiling the rare lesions which are a source of learning from a pathologist's perspective Some of them are only diagnosed at autopsy as they do not cause any functional derangement. This study emphasizes the various incidental lesions which otherwise would have been unnoticed during a person's life. The aim of this study was to determine the spectrum of histopathological findings including neoplastic lesions related or unrelated to the cause of death. It was also aimed to highlight various incidental and interesting lesions in autopsies. A retrospective study of medicolegal autopsies for six years was undertaken in a tertiary care centre to determine the spectrum of histopathological findings including neoplastic lesions related or unrelated to the cause of death and to highlight various incidental and interesting lesions in autopsies. Statistical Analysis: Individual lesions were described in numbers and incidence in percentage. The study consisted of a series of 269 autopsy cases and histopathological findings were studied only in 202 cases. The commonest cause of death was pulmonary oedema. The most common incidental histopathological finding noted was atherosclerosis in 55 (27.2%) cases followed by fatty liver in 40 (19.8%) cases. Neoplastic lesions accounted for 2.47% of cases. This study has contributed a handful of findings to the pool of rare lesions in pathology. Some of these lesions encountered which served as feast to a pathologist are tumour to tumour metastasis, a case with coexistent triple lesions, Dubin Johnson syndrome, von Meyenburg complex, Multilocular Cystic Renal Cell Carcinoma (MCRCC), Autosomal Dominant Polycystic Kidney Disease (ADPKD), liver carcinod and an undiagnosed vaso-occlusive sickle cell crisis. Autopsy studies help in the detection of unexpected findings significant enough to have changed patient management had they been recognized before death.

Achondroplasia with 47, XXY karyotype: a case report of the neonatal diagnosis of an extremely unusual association.

PubMed

Ros-Pérez, Purificación; Regidor, Francisco J; Colino, Esmeralda; Martínez-Payo, Cristina; Barroso, Eva; Heath, Karen E

2012-06-29

The association of achondroplasia and Klinefelter syndrome is extremely rare. To date, five cases have been previously reported, all of them diagnosed beyond the postnatal period, and only one was molecularly characterized. We describe the first case of this unusual association diagnosed in the neonatal period, the clinical findings and the molecular studies undertaken. The boy was born at term with clinical and radiological features indicating the diagnosis of achondroplasia or hypochondroplasia combined with the prenatal karyotype of Klinefelter syndrome (47,XXY). Neonatal FGFR3 mutation screening showed that the newborn was heterozygous for the classic achondroplasia G340R mutation. Microsatellite marker analysis showed that the sex chromosome aneuploidy had arisen from a non-disjunction error in paternal meiosis I, with a recombination event in the pseudoautosomal region 1 (PAR1). Specific mutation analysis is appropriate to confirm the clinical diagnosis of achondroplasia for appropriate diagnosis, prognosis, and genetic counseling, especially when the karyotype does not explain the abnormal prenatal sonographic findings. In the present case, a recombination event was observed in the PAR1 region, although recombinational events in paternally derived Klinefelter syndrome cases are much rarer than expected.

Factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation: a retrospective case study in Southeast China

PubMed Central

Guo, Wan-liang; Zhan, Yang; Fang, Fang; Deng, Yan-bing; Zhao, Jun-gang

2018-01-01

Objective The aim of this study was to evaluate factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation (CCM). Design A 3-year retrospective study was undertaken between January 2013 and December 2015 in four centres in China. Setting This involved a retrospective chart review of paediatric patients with CCM in four large hospitals in Southeast China. Participants Sixty-five paediatric patients with CCM were included in this study. We derived all available information on patient demographics, clinical characteristics, preoperative complications and surgical methods from the charts of all these patients. Interventions Univariate and multivariate logistic regression analyses were used to evaluate factors significantly affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM. Results Twenty-three of the 65 case surgeries were performed using laparoscopic technique, and 42 surgeries were performed by conventional open surgery. The median operating time was 215 min (range 120–430 min). The morphological subtype of CCM and the presence of cholecystitis or cholangitis were the only factors found to affect the operating time (p<0.05). Logistic regression analysis confirmed cholangitis as an independent risk factor. Conclusions The morphological subtype of CMM and the presence of cholecystitis or cholangitis are factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM, whereas cholangitis is an independent risk factor. PMID:29804066

Sociodemographic risk factors associated with low birthweight in United Arab Emirates.

PubMed

Bener, A; Abdulrazzaq, Y M; Dawodu, A

1996-07-01

This case-control study was undertaken to determine sociodemographic risk factors for low birth weight in Al-Ain (United Arab Emirates) over a 12-month period in 1992-93. A total of 3485 live births occurred of which 293 (8.4%) were low birth weight. The risk factors considered were mother's occupation, house conditions, place of residence (urban or rural), maternal smoking habits, antenatal care, availability of help in the home, maternal BMI and educational status. Multiple logistic regression analysis showed that mother's occupation, maternal smoking, antenatal care, and lack of help in the home were associated with increased risk of low birth weight.

Wind conditions in urban layout - Numerical and experimental research

NASA Astrophysics Data System (ADS)

Poćwierz, Marta; Zielonko-Jung, Katarzyna

2018-01-01

This paper presents research which compares the numerical and the experimental results for different cases of airflow around a few urban layouts. The study is concerned mostly with the analysis of parameters, such as pressure and velocity fields, which are essential in the building industry. Numerical simulations have been performed by the commercial software Fluent, with the use of a few different turbulence models, including popular k-ɛ, k-ɛ realizable or k-ω. A particular attention has been paid to accurate description of the conditions on the inlet and the selection of suitable computing grid. The pressure measurement near buildings and oil visualization were undertaken and described accordingly.

The SERENITY Runtime Monitoring Framework

NASA Astrophysics Data System (ADS)

Spanoudakis, George; Kloukinas, Christos; Mahbub, Khaled

This chapter describes SERENITY’s approach to runtime monitoring and the framework that has been developed to support it. Runtime monitoring is required in SERENITY in order to check for violations of security and dependability properties which are necessary for the correct operation of the security and dependability solutions that are available from the SERENITY framework. This chapter discusses how such properties are specified and monitored. The chapter focuses on the activation and execution of monitoring activities using S&D Patterns and the actions that may be undertaken following the detection of property violations. The approach is demonstrated in reference to one of the industrial case studies of the SERENITY project.

Impact assessment of on-site sanitation system on groundwater quality in alluvial settings: A case study from Lucknow city in North India.

PubMed

Jangam, Chandrakant; Ramya Sanam, S; Chaturvedi, M K; Padmakar, C; Pujari, Paras R; Labhasetwar, Pawan K

2015-10-01

The present case study has been undertaken to investigate the impact of on-site sanitation on groundwater quality in alluvial settings in Lucknow City in India. The groundwater samples have been collected in the areas of Lucknow City where the on-site sanitation systems have been implemented. The groundwater samples have been analyzed for the major physicochemical parameters and fecal coliform. The results of analysis reveal that none of the groundwater samples exceeded the Bureau of Indian Standards (BIS) limits for all the parameters. Fecal coliform was not found in majority of the samples including those samples which were very close to the septic tank. The study area has a thick alluvium cover as a top layer which acts as a natural barrier for groundwater contamination from the on-site sanitation system. The t test has been performed to assess the seasonal effect on groundwater quality. The statistical t test implies that there is a significant effect of season on groundwater quality in the study area.

Veterans treatment courts: A case study of their efficacy for Veterans' needs.

PubMed

Erickson, John W

Veterans Treatment Courts (VTCs) were created to: (1) address issues unique to U.S. Military Veterans; and, (2) where possible, avoid punishing veterans for crimes that may have been committed as a direct result of their mental conditions (e.g., Posttraumatic Stress Disorder (PTSD) and/or Traumatic Brain Injury (TBI)). Little research has been undertaken to ascertain whether VTCs are accomplishing their intended goals. To that end, the present case study examined three operating VTCs in order to determine if they are meeting their objectives. The research provides further information about VTC operations and recidivism rates. The research further reveals that, while the three VTCs examined are arguably benefitting veterans, they are not reaching a greater part of the population due largely to the gatekeeping role of VTC prosecutors, and the rigid eligibility requirements established by the three VTCs for veteran participation. Consequently, it's possible that the low recidivism rates reported by the three VTCs examined are inflated or constitute false positives. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluating the use of Social Impact Assessment in the context of agricultural development projects in Iran

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

Ahmadvand, Mostafa, E-mail: ahmadvand_2000@yahoo.co; Karami, Ezatollah, E-mail: ekarami@shirazu.ac.i; Zamani, Gholam Hossein, E-mail: zamani@shirazu.ac.i

2009-11-15

The utilisation of Social Impact Assessment (SIA) in Iran is analysed in terms of its policy context and its application in practice. Five case studies where SIA was employed in conjunction with Environmental Impact Assessments (EIA) for agricultural development projects are evaluated. In addition, the performance of the policy context is assessed. This research revealed that there are legal and institutional constraints to the effective functioning of SIA in Iran, and that there are deficiencies in the operating guidelines. There were serious problems associated with the way SIA was undertaken in all five case studies. Recommendations to improve the policymore » framework for the conduct of SIA are made. The recommendations advocate for a higher profile of SIA within legislation, for social issues to have greater emphasis in official guidelines for the conduct of EIA and SIA, and for a range of measures to increase the professionalism of SIA practice.« less

Frequency of traumatic lesions alleged by victims of assault during police custody.

PubMed

Lorin de la Grandmaison, G; Houssaye, C; Bourokba, N; Durigon, M

2007-08-01

A retrospective study was undertaken to determine the frequency of traumatic lesions found in individuals alleging police brutality during official custody in the département of Hauts-de-Seine, located in the west suburbs of Paris. All medical certificates relating to the examination of 11,653 individuals detained during the year 2004 were analysed. From this population, there were 119 cases where victimized individuals alleged police assault and 245 revealed aggressive police manhandling, as indicated by traces of tight handcuffs. Among the individuals alleging police violence, most of them showed recent traumatic lesions (n=91). The majority of lesions were superficial contusions frequently located in the cervico-cephalic area. All traumatic lesions were compatible with the allegations of police assault. Neurological complications secondary to the application of handcuffs were encountered in less than 2% of the cases. Although no death was recorded in police custody during the period of the study, approximately 5% of the population that had encountered some form of police violence was found to require emergency hospitalization.

Case Report: GcMAF Treatment in a Patient with Multiple Sclerosis.

PubMed

Inui, Toshio; Katsuura, Goro; Kubo, Kentaro; Kuchiike, Daisuke; Chenery, Leslye; Uto, Yoshihiro; Nishikata, Takahito; Mette, Martin

2016-07-01

Gc protein-derived macrophage-activating factor (GcMAF) has various functions as an immune modulator, such as macrophage activation, anti-angiogenic activity and anti-tumor activity. Clinical trials of second-generation GcMAF demonstrated remarkable clinical effects in several types of cancers. Thus, GcMAF-based immunotherapy has a wide application for use in the treatment of many diseases via macrophage activation that can be used as a supportive therapy. Multiple sclerosis (MS) is considered to be an autoimmune disorder that affects the myelinated axons in the central nervous system (CNS). This study was undertaken to examine the effects of second-generation GcMAF in a patient with MS. This case study demonstrated that treatments of GcMAF in a patient with MS have potent therapeutic actions with early beneficial responses, especially improvement of motor dysfunction. GcMAF shows therapeutic potency in the treatment of MS. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Experimental and Numerical Study of Nozzle Plume Impingement on Spacecraft Surfaces

NASA Astrophysics Data System (ADS)

Ketsdever, A. D.; Lilly, T. C.; Gimelshein, S. F.; Alexeenko, A. A.

2005-05-01

An experimental and numerical effort was undertaken to assess the effects of a cold gas (To=300K) nozzle plume impinging on a simulated spacecraft surface. The nozzle flow impingement is investigated experimentally using a nano-Newton resolution force balance and numerically using the Direct Simulation Monte Carlo (DSMC) numerical technique. The Reynolds number range investigated in this study is from 0.5 to approximately 900 using helium and nitrogen propellants. The thrust produced by the nozzle was first assessed on a force balance to provide a baseline case. Subsequently, an aluminum plate was attached to the same force balance at various angles from 0° (parallel to the plume flow) to 10°. For low Reynolds number helium flow, a 16.5% decrease in thrust was measured for the plate at 0° relative to the free plume expansion case. For low Reynolds number nitrogen flow, the difference was found to be 12%. The thrust degradation was found to decrease at higher Reynolds numbers and larger plate angles.

Basic medium oxidation of aromatic α-hydroxy-ketones: A free radical mechanism

NASA Astrophysics Data System (ADS)

Gómez-Vidales, Virginia; Vargas, Marina; Meléndez, Iván; Salmón, Manuel; Sansón-O, Carmen; Zaragoza, I. P.; Zolotukhin, Mikhail; Salcedo, Roberto

2010-01-01

A systematic study was undertaken of the EPR of sodium hydroxide solutions of Benzoin, Anisoin and Thenoin in both ethanol and DMSO as well as their corresponding ionised species of varying colours. In all cases, the EPR consist of symmetric spectra, resulting from the generation of a free radical-anion. Furthermore, theoretical DFT methods were applied in order to study the radical anions, revealing the reason for the colour change in the solutions and in the case of benzoin, found to be related to the interaction between the cis and trans-isomers with the molecules in the two solvents. We have defined the structure of the cis-isomer and for the first time we have described how the adduct between the cis-isomer and the solvent molecule, results in a stable conformer. This corresponds with the EPR results which indicated a significant difference between the cis and trans-isomers. Both the theoretical and experimental results inspired similar descriptions of the significant differences between the cis and trans-isomers in solution.

Research Ethics Committees and Participatory Action Research With Young People: The Politics of Voice.

PubMed

Yanar, Zeynep M; Fazli, Mehria; Rahman, Jahanara; Farthing, Rys

2016-04-01

Participatory action research (PAR) is a methodological approach that seeks to maximize the participation of people whose lives it researches. It is underpinned by an ethical concern to research "with" people, rather than "on" people. However, this ethical approach to research is often, paradoxically, problematized by universities' research ethics committees (RECs). This article explores one site of tension between PAR and RECs-the requirement for anonymity for below 18-year-olds. It explores this tension by exploring a case study of a peer-to-peer research project undertaken by young women in East London, and using our own experiences and perspectives, it argues that anonymity can be unjust, disempowering, and unnecessary, and can reduce "pride." Without wanting to develop specific recommendations, given the limited scope of our case study, this article uses firsthand experiences to add weight to the broader discussions calling for a critical rethink of REC guidelines. © The Author(s) 2016.

The Unilateralist’s Curse and the Case for a Principle of Conformity

PubMed Central

Bostrom, Nick; Douglas, Thomas; Sandberg, Anders

2016-01-01

In some situations a number of agents each have the ability to undertake an initiative that would have significant effects on the others. Suppose that each of these agents is purely motivated by an altruistic concern for the common good. We show that if each agent acts on her own personal judgment as to whether the initiative should be undertaken, then the initiative will be undertaken more often than is optimal. We suggest that this phenomenon, which we call the unilateralist’s curse, arises in many contexts, including some that are important for public policy. To lift the curse, we propose a principle of conformity, which would discourage unilateralist action. We consider three different models for how this principle could be implemented, and respond to an objection that could be raised against it. PMID:27499570

Palmoplantar keratoderma with progressive gingivitis and recurrent pyodermas.

PubMed

Moss, Tyler A; Spillane, Anne P; Almquist, Sam F; McCleskey, Patrick E; Wisco, Oliver J

2014-04-01

Papillon-Lefèvre syndrome (PLS) is a rare inherited palmoplantar keratoderma (PPK) that is associated with progressive gingivitis and recurrent pyodermas. We present a case exhibiting classic features of this autosomal-recessive condition and review the current understanding of its pathophysiology, diagnosis, and treatment. Additionally, a review of pertinent transgredient PPKs is undertaken, with key and distinguishing features of each syndrome highlighted.

Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Perceptual Outcomes of Velopharyngeal Function

ERIC Educational Resources Information Center

Pereira, Valerie J.; Sell, Debbie; Tuomainen, Jyrki

2013-01-01

Background: Abnormal facial growth is a well-known sequelae of cleft lip and palate (CLP) resulting in maxillary retrusion and a class III malocclusion. In 10-50% of cases, surgical correction involving advancement of the maxilla typically by osteotomy methods is required and normally undertaken in adolescence when facial growth is complete.…

"Too Many Actors and Too Few Jobs": A Case for Curriculum Extension in UK Vocational Actor Training

ERIC Educational Resources Information Center

Wilkie, Ian

2015-01-01

This article questions the current situation for vocational acting training (VAT) in the UK. It aims to provide an update on the report into burgeoning provision of acting training (and the attempt to address subsequent high rates of actor unemployment) that was originally undertaken by the Calouste Gulbenkian Foundation (CGF, 1975) in their…

Public Administration Education in a Continental European Legalistic Setting: The Hungarian Case

ERIC Educational Resources Information Center

Gellén, Márton

2014-01-01

The Trans-European Dialogue in 2013 was dedicated to the revisiting of the research undertaken by György Hajnal in 2003 (Hajnal, 2003) on public administration education in Europe. As part of the preparations to the conference, Hajnal also revisited his research after 10 years. The findings presented on the conference offer a theoretical framework…

Integrating management techniques to restore sites invaded by mile-a-minute weed, Persicaria perfoliata

Treesearch

Ellen C. Lake; Judith Hough-Goldstein; Vincent D' Amico

2014-01-01

Efforts to suppress an invasive weed are often undertaken with the goal of facilitating the recovery of a diverse native plant community. In some cases, however, reduction in the abundance of the target weed results in an increase in other exotic weeds. Mile-a-minute weed (Persicaria perfoliata (L.) H. Gross (Polygonaceae)) is an annual vine from...

Factors Affecting the Decision to Merge: The Case of Strategic Mergers in Norwegian Higher Education

ERIC Educational Resources Information Center

Kyvik, Svein; Stensaker, Bjørn

2013-01-01

Much research has been undertaken to investigate the cultural, structural and, to some extent, the economic effects of mergers in higher education. However, surprisingly little research has been done on why higher education institutions decide to merge. This article identifies and discusses a number of structural factors that may play a role when…

The Ring of Gyges: Anonymity and Technological Advance’s Effect on the Deterrence of Nonstate Actors in 2035

DTIC Science & Technology

2012-10-01

Technical Information Center, 1972), 723–24. A case in point is the Manhattan Project undertaken by the United States to produce the first atomic weapon. A...capital and operations costs from 1942 through 1945. Costs adjusted using a base year of 1944 (the year of highest Manhattan Project expenditures). 39

Risk Assessment and Geography Teachers: A Survey

ERIC Educational Resources Information Center

Parry, Gareth; Clarke, Linda

2004-01-01

Recently the issue of health and safety procedures on field trips and school visits has come to the fore, as a result of a series of tragedies involving the deaths of pupils. A review of some of the recent court cases and inquests involving the victims of field trips was undertaken. This indicated that schools and teachers are failing to implement…

Engineering a Business School in a Former Soviet-Era Closed City: The Case of Omsk, Siberia

ERIC Educational Resources Information Center

Chukhlomin, Valeri; Chukhlomina, Irina

2013-01-01

This article describes a modernization project undertaken by a nationally accredited Russian university located in Omsk, Siberia, and aimed at developing a new international business school. A unique feature of the project is that it was successfully implemented in a former Soviet-era closed city. Until 1991, the university hadn't had any…

Investment in Human Capital through Institutions of Higher Education for the Revival of Kenya's Economy

ERIC Educational Resources Information Center

Wawire, Nelson W.; Nafukho, Fredrick M.

2006-01-01

Despite economic theory postulating that increases in investment in human capital and physical capital leads to increase in economic growth, in the Kenyan case, this has not been true. This paper empirically examines the contribution of human capital and physical capital to economic growth in Kenya. Measures to be undertaken by higher education…

E-learning and nursing assessment skills and knowledge - An integrative review.

PubMed

McDonald, Ewan W; Boulton, Jessica L; Davis, Jacqueline L

2018-07-01

This review examines the current evidence on the effectiveness of digital technologies or e-based learning for enhancing the skills and knowledge of nursing students in nursing assessment. This integrative review identifies themes emerging from e-learning and 'nursing assessment' literature. Literature reviews have been undertaken in relation to digital learning and nursing education, including clinical skills, clinical case studies and the nurse-educator role. Whilst perceptions of digital learning are well covered, a gap in knowledge persists for understanding the effectiveness of e-learning on nursing assessment skills and knowledge. This is important as comprehensive assessment skills and knowledge are a key competency for newly qualified nurses. The MEDLINE, CINAHL, Cochrane Library and ProQuest Nursing and Allied Health Source electronic databases were searched for the period 2006 to 2016. Hand searching in bibliographies was also undertaken. Selection criteria for this review included: FINDINGS: Twenty articles met the selection criteria for this review, and five major themes for e-based learning were identified (a) students become self-evaluators; (b) blend and scaffold learning; (c) measurement of clinical reasoning; (d) mobile technology and Facebook are effective; and (e) training and preparation is vital. Although e-based learning programs provide a flexible teaching method, evidence suggests e-based learning alone does not exceed face-to-face patient simulation. This is particularly the case where nursing assessment learning is not scaffolded. This review demonstrates that e-based learning and traditional teaching methods used in conjunction with each other create a superior learning style. Copyright © 2018 Elsevier Ltd. All rights reserved.

Dental cementum in age estimation: a polarized light and stereomicroscopic study.

PubMed

Kasetty, Sowmya; Rammanohar, M; Raju Ragavendra, T

2010-05-01

Dental hard tissues are good candidates for age estimation as they are less destructive and procedures to determine age can be easily performed. Although cementum annulations and cementum thickness are important parameters in this regard, they are seldom used. This study was undertaken to review the methods, difficulties in execution of techniques, and accuracy of cementum thickness and annulations in estimating the age. Unstained and stained ground sections of tooth were used to measure cemental thickness and count cemental annulations based on which age was estimated and was compared with known age. Although there was positive relation between cemental thickness and annulations with age, only in 1-1.5% of cases, age could be predicted with accuracy.

Vertical integration of teaching in Australian general practice--a survey of regional training providers.

PubMed

Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah

2011-06-06

To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.

Cancer care decision making in multidisciplinary meetings.

PubMed

Dew, Kevin; Stubbe, Maria; Signal, Louise; Stairmand, Jeannine; Dennett, Elizabeth; Koea, Jonathan; Simpson, Andrew; Sarfati, Diana; Cunningham, Chris; Batten, Lesley; Ellison-Loschmann, Lis; Barton, Josh; Holdaway, Maureen

2015-03-01

Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority-the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes. © The Author(s) 2014.

Pancreatic and duodenal injuries: keep it simple.

PubMed

Rickard, Matthew J F X; Brohi, Karim; Bautz, Peter C

2005-07-01

The management of pancreatic and duodenal trauma has moved away from complex reconstructive procedures to simpler methods in keeping with the trend towards organ-specific, damage control surgery. A retrospective case note review was undertaken over a 30-month period to evaluate a simplified protocol for the management of these injuries. Of 100 consecutive patients there were 51 with pancreatic injury, 30 with a duodenal injury and 19 with combined pancreaticoduodenal trauma. Overall mortality was 18.0%, with a late mortality (after 24 h) of 9.9%. This is comparable to previous studies. Morbidity from abscesses, fistulas and anastomotic breakdown was acceptably low. The concept of staged laparotomy can be successfully applied to wounds of the pancreas and duodenum. Debridement of devitalized tissue and drainage can be employed for most cases of pancreatic trauma. Most duodenal injuries can be managed with debridement and primary repair. Temporary exclusion and reoperation should be employed for unstable patients.

Electrophysiological evidence for the modulation of retrieval orientation by depth of study processing.

PubMed

Rugg, M D; Allan, K; Birch, C S

2000-07-01

Event-related potentials (ERPs) were employed to investigate whether brain activity elicited by retrieval cues in a memory test varies according to the encoding task undertaken at study. Two recognition memory test blocks were administered, preceded, in one case, by a "shallow" study task (alphabetic judgement) and, in the other case, by a "deep" task (sentence generation). ERPs elicited by the new words in each test block differed, the ERPs elicited in the block following the shallow study task exhibiting the more positive-going waveforms. This finding was taken as evidence that subjects adopt different "retrieval sets" when attempting to retrieve items that had been encoded in terms of alphabetic versus semantic attributes. Differences between the ERPs elicited by correctly classified old and new words (old/new effects) also varied with encoding task. The effects for deeply studied words resembled those found in previous ERP studies of recognition memory, whereas old/new effects for shallowly studied words were confined to a late-onsetting, right frontal positivity. Together, the findings indicate that the depth of study processing influences two kinds of memory-related neural activity, associated with memory search operations, and the processing of retrieved information, respectively.

The frequency and characteristics of chronic widespread pain in general practice: a case-control study.

PubMed

Rohrbeck, Jens; Jordan, Kelvin; Croft, Peter

2007-02-01

Chronic widespread pain is common in the community but is not often diagnosed in primary care. One explanation may be that widespread pain is presented and treated in primary care as multiple episodes of regional pain. To determine whether patients who consult with multiple regional pain syndromes have characteristics consistent with chronic widespread pain. Case-control study. One general practice in North Staffordshire, UK. Participants were 148 cases who consulted regularly with different musculoskeletal pains over 5 years, and 524 controls who had not consulted for musculoskeletal pain during the same period. A postal questionnaire survey and medical record review were undertaken. Cases with musculoskeletal pain reported more health problems and higher levels of fatigue than controls, and significantly worse general health and greater sleep disturbance (odds ratios 3.3. and 3.1, respectively). They generally reported more severe symptoms and consulted more frequently for a range of problems, but this was not explained by a general propensity to consult. Patients who consult in primary care with multiple regional pain syndromes have similar characteristics to those associated with chronic widespread pain and fibromyalgia. Recognising the need for general approaches to pain management, rather than treating each syndrome as a regional problem of pain, may improve the outcome in such patients.

Merkel cell polyomavirus detection in Merkel cell cancer tumors in Northern Germany using PCR and protein expression.

PubMed

Leitz, Miriam; Stieler, Kristin; Grundhoff, Adam; Moll, Ingrid; Brandner, Johanna M; Fischer, Nicole

2014-10-01

Merkel cell carcinoma is a highly malignant skin cancer which predominantly occurs in elderly and immunocompromised persons. The identification of the Merkel cell polyomavirus (MCPyV) has inaugurated a new understanding of Merkel cell carcinoma pathogenesis. The frequent detection of the virus in Merkel cell carcinoma tissue (70-90%), its monoclonal integration in the tumor cells and the expression of viral oncogenes highly suggest that MCPyV is causally linked to the pathogenesis of the majority of Merkel cell cancer (MCC) cases. Using qualitative and quantitative PCR together with immunohistochemical staining this study aimed at characterizing the presence of MCPyV sequences and viral early gene expression in a cohort of MCC cases (n = 32) selected in Northern Germany. 40-57% of the cases were identified as MCPyV positive with 40.6% of the cases positive by immunohistochemical staining and 51.6-57.6% positive by PCR. Interestingly, in the majority (64%) of LT-Antigen positive tumors only 25-50% of tumor cells express LT-Antigen. These data are in accord with published studies describing heterogeneity in MCPyV viral loads and suggest that detection of MCPyV in Merkel cell carcinoma by PCR should be undertaken using multiple primer pairs. © 2013 Wiley Periodicals, Inc.

Mutational analysis of multiple lung cancers: Discrimination between primary and metastatic lung cancers by genomic profile.

PubMed

Goto, Taichiro; Hirotsu, Yosuke; Mochizuki, Hitoshi; Nakagomi, Takahiro; Shikata, Daichi; Yokoyama, Yujiro; Oyama, Toshio; Amemiya, Kenji; Okimoto, Kenichiro; Omata, Masao

2017-05-09

In cases of multiple lung cancers, individual tumors may represent either a primary lung cancer or both primary and metastatic lung cancers. Treatment selection varies depending on such features, and this discrimination is critically important in predicting prognosis. The present study was undertaken to determine the efficacy and validity of mutation analysis as a means of determining whether multiple lung cancers are primary or metastatic in nature. The study involved 12 patients who underwent surgery in our department for multiple lung cancers between July 2014 and March 2016. Tumor cells were collected from formalin-fixed paraffin-embedded tissues of the primary lesions by using laser capture microdissection, and targeted sequencing of 53 lung cancer-related genes was performed. In surgically treated patients with multiple lung cancers, the driver mutation profile differed among the individual tumors. Meanwhile, in a case of a solitary lung tumor that appeared after surgery for double primary lung cancers, gene mutation analysis using a bronchoscopic biopsy sample revealed a gene mutation profile consistent with the surgically resected specimen, thus demonstrating that the tumor in this case was metastatic. In cases of multiple lung cancers, the comparison of driver mutation profiles clarifies the clonal origin of the tumors and enables discrimination between primary and metastatic tumors.

A French network of bipolar expert centres: a model to close the gap between evidence-based medicine and routine practice.

PubMed

Henry, Chantal; Etain, Bruno; Mathieu, Flavie; Raust, Aurélie; Vibert, Jean-Francois; Scott, Jan; Leboyer, Marion

2011-06-01

Bipolar disorders are a major public health concern. Efforts to provide optimal care by general practitioners and psychiatrists are undermined by the complexity of the disorder and difficulties in applying clinical practice guidelines and new research findings to the spectrum of cases seen in day to day practice. A national network of bipolar expert centres was established. Each centre has established strong links to local health services and provides support to clinicians in delivering personalized care plans derived from systematic case assessments undertaken at the centre. A common set of diagnostic and clinical assessment tools has been adopted at eight centres. Evaluations are undertaken by trained assessors and cross-centre reliability is monitored. A web application, e-bipolar© is used to record data in a common computerized medical file. Anonymized data is entered into a shared national database for use in multi-centre audit and research. Instead of offering treatment advice based on clinical practice guidelines recommendations for selected sub-populations of patients (a 'top-down' approach), the French bipolar network offers systematic, comprehensive, longitudinal, and multi-dimensional assessments of cases representative of general bipolar populations. This 'bottom-up' strategy may offer a more efficient and effective way to transfer knowledge and share expertise as the referrer can appreciate the rationale underpinning suggested treatment protocols and more readily apply such principles and approaches to other cases. The network also builds an infrastructure for clinical cohort and comparative-effectiveness research on more representative patient populations. Copyright © 2010 Elsevier B.V. All rights reserved.

Socio-technical issues and challenges in implementing safe patient handovers: insights from ethnographic case studies.

PubMed

Balka, Ellen; Tolar, Marianne; Coates, Shannon; Whitehouse, Sandra

2013-12-01

Ineffective handovers in patient care, including those where information loss occurs between care providers, have been identified as a risk to patient safety. Computerization of health information is often offered as a solution to improve the quality of care handovers and decrease adverse events related to patient safety. The purpose of this paper is to broaden our understanding of clinical handover as a patient safety issue, and to identify socio-technical issues which may come to bear on the success of computer based handover tools. Three in depth ethnographic case studies were undertaken. Field notes were transcribed and analyzed with the aid of qualitative data analysis software. Within case analysis was performed on each case, and subsequently, cross case analyses were performed. We identified five types of socio-technical issues which must be addressed if electronic handover tools are to succeed. The inter-dependencies of these issues are addressed in relation to arenas in which health care work takes place. We suggest that the contextual nature of information, ethical and medico-legal issues arising in relation to information handover, and issues related to data standards and system interoperability must be addressed if computerized health information systems are to achieve improvements in patient safety related to handovers in care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Scoliosis in Dandy-Walker syndrome: a case report and review of literature

PubMed Central

Sorur, Tamer M. M.; Al Ghafri, Khalifa A.; Shahin, Marwan M. H. E.

2017-01-01

This submission presents a case of scoliosis in a patient with established Dandy-Walker anomaly of the brain. A retrospective review of the patient’s case notes was undertaken and the limited literature on this subject reviewed. The 13-year-old girl presented with a stiff right thoracic scoliosis typical of adolescent idiopathic scoliosis. The scoliotic segment also presented with significant lordosis. She had facial and truncal dysmorphism characteristic of Dandy-Walker complex and her brain images confirmed the diagnosis. She underwent scoliosis surgery by the posterior approach uneventfully. In conclusion scoliosis is hitherto unreported in the Dandy-Walker complex. The results of intervention appear satisfactory. PMID:29354751

OMC Compressor Case

NASA Technical Reports Server (NTRS)

Humphrey, W. Donald

1997-01-01

This report summarizes efforts expended in the development of an all-composite compressor case. Two pre-production units have been built, one utilizing V-CAP and one utilizing AFR-700B resin systems. Both units have been rig tested at elevated temperatures well above design limit loads. This report discusses the manufacturing processes, test results, and Finite Element Analysis performed. The V-CAP unit was funded by NASA-Lewis Research Center in 1994 under contract number NAS3- 27442 for Development of an All-Composite OMC Compressor Case. This contract was followed by an Air Force study in 1996 to build and identical unit using the AFR-700B resin system in place of the V-CAP system. The second compressor case was funded under U.S. Air Force contract F33615-93-D-5326, Advanced Materials for Aerospace Structures Special Studies (AMAS3), Delivery Order 0021 entitled "Advanced Polymeric Composite Materials and Structures Technology for Advanced High Temperature Gas Turbine Engines.' Initial studies using the V-CAP resin system were undertaken in 1993 under a NASA Lewis contract (NAS3-26829). A first prototype unit was developed in a joint program between Textron-Lycoming (now Allied Signal) and Brunswick (now Lincoln Composites). This unit included composite end closures using low density, high temperature molded end closures. The units was similar in size and shape to a titanium case currently used on the PT-21 0 engine and was funded as part of the integrated High Performance Turbine Engine Technology (EHPTET) initiative of DOD and NASA.

Lupus vulgaris and tuberculosis verrucosa cutis (TBVC)--a clinical, pathological and epidemiological study of 71 cases.

PubMed

Padmavathy, L; Lakshmana Rao, L; Pari, T; Ethirajan, N; Krishnaswamy, B

2008-10-01

The epidemiological aspects and diagnostic problems encountered in a rural set up are largely unknown. The present study on cutaneous tuberculosis encompassing clinical, pathological and epidemiological aspects was undertaken at Rajah Muthiah Medical college and Hospital (RMMC&H), a teaching hospital mainly catering to the health needs of a predominantly rural population from villages and hamlets around Chidambaram, a taluq headquarters, located in Cuddalore district ofTamil Nadu. During the period of study, 5744 cases (82%) of pulmonary tuberculosis and 1261 (18%) of extra-pulmonary tuberculosis were encountered. Cutaneous tuberculosis accounted for 117 (1.67%) of tuberculosis cases. Of the seventy-one patients with cutaneous tuberculosis, 39 had lupus vulgaris and 32 with TBVC. Lupus vulgaris was more prevalent with male pre-ponderance. The maximum incidence was seen in the second decade of life. Both LV and TBVC showed a male pre-ponderance, M:F ratio being 3:2 and 2:1 in LV and TBVC respectively. A majority of patients with LV (27 cases; 69.2%) and TBVC (31 cases; 96.8%) manifested with a single site of involvement. Lower extremities were more commonly involved among patients hailing from poor economic strata who were not habituated to the use of footwear while working out doors. Over crowding was also a contributing factor. The relationships between BCG vaccination and Mantoux test with cutaneous tuberculosis, association with pulmonary tuberculosis in addition to the underlying predisposing socio-economic factors are discussed.

Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

PubMed

King, Robert

2009-05-01

In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy.

Perforated peptic ulcer in Tikur Anbessa Hospital: a review of 74 cases.

PubMed

Ersumo, Tessema; W/Meskel, Yidnekachew; Kotisso, Berhanu

2005-01-01

Little is known on the pattern of perforated peptic ulcer in Ethiopia. To evaluate the early, outcome of management, a five-year retrospective analysis of 74 operated cases of perforated peptic ulcer was undertaken. Perforated peptic ulcer accounted for 3.4% of the adult emergency surgical procedures. The mean age was 32.6 years, with a male to female ratio of 7.2 to 1.0. Fifty-six percent of the cases were unmarried. In nearly 22.0% of the patients, no previous history of peptic ulcer disease was documented. Delay in diagnosis was noted in 95% of the cases. Most patients had duodenal ulcer perforation, and about 78% had purulent peritonitis at laparotomy. Fourteen died in hospital. Early presentation of patients to surgical care facilities may reduce morbidity and mortality in cases of peptic ulcer perforation.

Pattern of organophosphorous poisoning: a retrospective community based study.

PubMed

Chataut, J; Adhikari, R K; Sinha, N P; Marahatta, S B

2011-01-01

Pesticide poisoning is very common in Nepal. Hospital based studies from various parts of Nepal have shown that poisoning with organophosphorus compounds is the most common type of poisoning. Current study is undertaken to see the pattern of organophosphorus poisoning and to identify the common risk factors among the cases. If the risk factors are modifiable, attempts in addressing the risk factors and decreasing the likelihood of poisoning will certainly be fruitful in reducing the morbidity and mortality associated with organophosphorus poisoning. To assess the risk factors of organophosphorus poisoning which is major public health problem in Nepal. A community based retrospective study of 75 cases of organophosphate poisoning who were brought to the emergency department of Dhulikhel hospital over the period of 3 years. Basic information was collected from hospital records and home visits were made to study the risk factors. Data were collected through interviews of the study population and their family members using a pre-designed questionnaire. In this study 75 cases and their families were interviewed of which there were 59% males and 42% females (M/F ratio of 1:1.4). The majority (40%) of the poisoning cases were in the age group 25-34 years. Lower literacy level showed positive association with the incidence of poisoning. Occupation wise vast majority (80%) of the cases were engaged in agricultural work. Suicidal attempts by ingesting organophosphate compounds were high in farmers and females. In this study, majority of the poisoning were attempts of intentional self harm. Agriculture workers and females are high risk groups and may be associated with the fact that they have easy access to the poison. Interventions directed towards health education, counseling, and enforcement of laws restricting the availability and use of harmful pesticides may help in reducing such events in future.

Research on Internationalisation in Higher Education--Exploratory Analysis

ERIC Educational Resources Information Center

Yemini, Miri; Sagie, Netta

2016-01-01

Research on internationalisation in higher education has dramatically expanded over the last several decades. This study aims to provide an overview of the research developments undertaken between 1980 and 2014, on internationalisation in higher education. Explorative, systematic literature screening and analysis were undertaken, encompassing over…

Tuberculosis in Sulaimaniyah, Iraqi Kurdistan: A Detailed Analysis of Cases Registered in Treatment Centers.

PubMed

Karadakhy, Kamaran; Othman, Nasih; Ibrahimm, Faredun; Saeed, Akam Ali; Amin, Ari Abdul-Adheem Hama

2016-01-01

Tuberculosis (TB) remains a major public health problem especially in low and middle-income countries. The current study was undertaken to estimate the incidence of the disease and describe its epidemiological characteristics in Iraqi Kurdistan. A retrospective study was carried out on cases registered in the directly observed treatment-short course (DOTS) centers in Sulaimaniyah province. Information was collected from the summary reports of all cases registered in 2010 and detailed information was obtained from 307 cases in the main center. During 2010, a total of 530 new and relapsed cases were registered in the DOTS centers amounting to an annual incidence of 31 per 100,000. Over 73% of cases were pulmonary TB and 45% of all cases had positive smear. Most common symptoms were cough (58%), sweating (49%) and fever (48). Almost 43% of patients were diagnosed by direct swab examination, 30% by biopsy and 23% through clinical and radiologic examination. In relation to outcome, 89% of patients were treated successfully, 7% died and 3% defaulted. Mortality rate was 8% in pulmonary infection and 4% in extrapulmonary infection. Old age (65 years and over) was significantly associated with higher odds of death compared to people aged 34 years and younger (OR 6.7, 95% CI 1.3-36.1, P=0.03). The incidence of TB is still high in the Iraqi Kurdistan. The DOTS has been successful in treating the majority of cases but there are areas needing improvement especially record-keeping and patient follow-up during and after treatment.

Tuberculosis in Sulaimaniyah, Iraqi Kurdistan: A Detailed Analysis of Cases Registered in Treatment Centers

PubMed Central

Karadakhy, Kamaran; Ibrahimm, Faredun; Saeed, Akam Ali; Amin, Ari Abdul-Adheem Hama

2016-01-01

Background: Tuberculosis (TB) remains a major public health problem especially in low and middle-income countries. The current study was undertaken to estimate the incidence of the disease and describe its epidemiological characteristics in Iraqi Kurdistan. Materials and Methods: A retrospective study was carried out on cases registered in the directly observed treatment-short course (DOTS) centers in Sulaimaniyah province. Information was collected from the summary reports of all cases registered in 2010 and detailed information was obtained from 307 cases in the main center. Results: During 2010, a total of 530 new and relapsed cases were registered in the DOTS centers amounting to an annual incidence of 31 per 100,000. Over 73% of cases were pulmonary TB and 45% of all cases had positive smear. Most common symptoms were cough (58%), sweating (49%) and fever (48). Almost 43% of patients were diagnosed by direct swab examination, 30% by biopsy and 23% through clinical and radiologic examination. In relation to outcome, 89% of patients were treated successfully, 7% died and 3% defaulted. Mortality rate was 8% in pulmonary infection and 4% in extrapulmonary infection. Old age (65 years and over) was significantly associated with higher odds of death compared to people aged 34 years and younger (OR 6.7, 95% CI 1.3–36.1, P=0.03). Conclusion: The incidence of TB is still high in the Iraqi Kurdistan. The DOTS has been successful in treating the majority of cases but there are areas needing improvement especially record-keeping and patient follow-up during and after treatment. PMID:28469675

Verrucous carcinoma of the skin: long-term follow-up results following surgical therapy.

PubMed

Koch, Horst; Kowatsch, Eberhard; Hödl, Stefan; Smola, Michael G; Radl, Roman; Hofmann, Thiemo; Scharnagl, Erwin

2004-08-01

Owing to the benign appearance and slow growth of verrucous carcinoma of the skin, its diagnosis and therapeutic management still pose problems. This study was undertaken to point out clinical and histopathologic features of verrucous carcinoma of the skin and to provide diagnostic and therapeutic guidelines on the basis of the long-term results from 20 patients. A retrospective study of the long-term results of 20 patients treated surgically for verrucous carcinoma of the skin is presented. In 16 cases, a wide resection with histopathologic examination of the margins was possible. Two tumors were shaved; 1 case required below-knee amputation and 1 patient refused primary amputation. In April 1999, 9 of the 10 surviving patients underwent physical examination, ultrasonography of the regional lymph nodes and the abdomen, and chest X-ray. The protocols of autopsies or postmortem examinations of the deceased patients were consulted. The deceased patients achieved an average tumor-free survival period of 86.1 months; eight of the surviving patients had an average tumor-free follow-up of 127.4 months. Two patients suffered recurrences. Curative treatment can be achieved by timely and complete resection of verrucous carcinoma of the skin, even in advanced cases.

A new surveillance system for undiagnosed serious infectious illness for the London 2012 Olympic and Paralympic Games.

PubMed

Heinsbroek, E; Said, B; Kirkbride, H

2012-08-02

A new surveillance system was developed to detect possible new or emerging infections presenting as undiagnosed serious infectious illness (USII) for use during the London 2012 Olympic and Paralympic Games. Designated clinicians in sentinel adult and paediatric intensive care units (ICU/ PICUs) reported USII using an online reporting tool or provided a weekly nil notification. Reported cases were investigated for epidemiological links. A pilot study was undertaken for six months between January and July 2011 to evaluate the feasibility and acceptability of the system. In this six-month period, 5 adults and 13 children were reported by six participating units (3 ICUs, 3 PICUs). Of these 18 patients, 12 were reported within four days after admission to an ICU/PICU. Nine patients were subsequently diagnosed and were thus excluded from the surveillance. Therefore, only nine cases of USII were reported. No clustering was identified.On the basis of the pilot study, we conclude that the system is able to detect cases of USII and is feasible and acceptable to users. USII surveillance has been extended to a total of 19 sentinel units in London and the south-east of England during the London 2012 Olympic and Paralympic Games.

Expert scientific judgment and cancer risk assessment: a pilot study of pharmacokinetic data.

PubMed

Hawkins, N C; Graham, J D

1988-12-01

When high-dose tumor data are extrapolated to low doses, it is typically assumed that the dose of a carcinogen delivered to target cells is proportional to the dose administered to test animals, even at exposure levels below the experimental range. Since pharmacokinetic data are becoming available that in some cases question the validity of this assumption, risk assessors must decide whether to maintain the standard assumption. A pilot study of formaldehyde is reported that was undertaken to demonstrate how expert scientific judgment can help guide a controversial risk assessment where pharmacokinetic data are considered inconclusive. Eight experts on pharmacokinetic data were selected by a formal procedure, and each was interviewed personally using a structured interview protocol. The results suggest that expert scientific opinion is polarized in this case, a situation that risk assessors can respond to with a range of risk characterizations considered biologically plausible by the experts. Convergence of expert opinion is likely in this case of several specific research strategies ar executed in a competent fashion. Elicitation of expert scientific judgment is a promising vehicle for evaluating the quality of pharmacokinetic data, expressing uncertainty in risk assessment, and fashioning a research agenda that offers possible forging of scientific consensus.

Acute nonlymphocytic leukemia and residential exposure to power frequency magnetic fields

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

Severson, R.K.

1986-01-01

A population-based case-control study of adult acute nonlymphocytic leukemia (ANLL) and residential exposure to power frequency magnetic fields was conducted in King, Pierce and Snohomish Counties in Washington state. Of 164 cases who were diagnosed from January 1, 1981 through December 31, 1984, 114 were interviewed. Controls were selected from the study area on the basis of random digit dialing and frequency matched to the cases by age and sex. Analyses were undertaken to evaluate whether exposure to high levels of power frequency magnetic fields in the residence were associated with an increased risk of ANLL. Neither the directly measuredmore » magnetic fields nor the surrogate values based on the wiring configurations were associated with ANLL. Additional analyses suggested that persons with prior allergies were at decreased risk of acute myelocytic leukemia (AML). Also, persons with prior autoimmune diseases were at increased risk of AML. The increase in AML risk in rheumatoid arthritics was of borderline statistical significance. Finally, cigarette smoking was associated with an increased risk of AML. The risk of AML increased significantly with the number of years of cigarette smoking.« less

A case study of view-factor rectification procedures for diffuse-gray radiation enclosure computations

NASA Technical Reports Server (NTRS)

Taylor, Robert P.; Luck, Rogelio

1995-01-01

The view factors which are used in diffuse-gray radiation enclosure calculations are often computed by approximate numerical integrations. These approximately calculated view factors will usually not satisfy the important physical constraints of reciprocity and closure. In this paper several view-factor rectification algorithms are reviewed and a rectification algorithm based on a least-squares numerical filtering scheme is proposed with both weighted and unweighted classes. A Monte-Carlo investigation is undertaken to study the propagation of view-factor and surface-area uncertainties into the heat transfer results of the diffuse-gray enclosure calculations. It is found that the weighted least-squares algorithm is vastly superior to the other rectification schemes for the reduction of the heat-flux sensitivities to view-factor uncertainties. In a sample problem, which has proven to be very sensitive to uncertainties in view factor, the heat transfer calculations with weighted least-squares rectified view factors are very good with an original view-factor matrix computed to only one-digit accuracy. All of the algorithms had roughly equivalent effects on the reduction in sensitivity to area uncertainty in this case study.

Breastfeeding, infant formula supplementation, and Autistic Disorder: the results of a parent survey

PubMed Central

Schultz, Stephen T; Klonoff-Cohen, Hillary S; Wingard, Deborah L; Akshoomoff, Natacha A; Macera, Caroline A; Ji, Ming; Bacher, Christopher

2006-01-01

Background Although Autistic Disorder is associated with several congenital conditions, the cause for most cases is unknown. The present study was undertaken to determine whether breastfeeding or the use of infant formula supplemented with docosahexaenoic acid and arachidonic acid is associated with Autistic Disorder. The hypothesis is that breastfeeding and use of infant formula supplemented with docosahexaenoic acid/arachidonic acid are protective for Autistic Disorder. Methods This is a case-control study using data from the Autism Internet Research Survey, an online parental survey conducted from February to April 2005 with results for 861 children with Autistic Disorder and 123 control children. The analyses were performed using logistic regression. Results Absence of breastfeeding when compared to breastfeeding for more than six months was significantly associated with an increase in the odds of having autistic disorder when all cases were considered (OR 2.48, 95% CI 1.42, 4.35) and after limiting cases to children with regression in development (OR 1.95, 95% CI 1.01, 3.78). Use of infant formula without docosahexaenoic acid and arachidonic acid supplementation versus exclusive breastfeeding was associated with a significant increase in the odds of autistic disorder when all cases were considered (OR 4.41, 95% CI 1.24, 15.7) and after limiting cases to children with regression in development (OR 12.96, 95% CI 1.27, 132). Conclusion The results of this preliminary study indicate that children who were not breastfed or were fed infant formula without docosahexaenoic acid/arachidonic acid supplementation were significantly more likely to have autistic disorder. PMID:16978397

Challenges in the Management of a Patient with Myxoedema Coma in Ghana: A Case Report.

PubMed

Akpalu, Josephine; Atiase, Yacoba; Yorke, Ernest; Fiscian, Henrietta; Kootin-Sanwu, Cecilia; Akpalu, Albert

2017-03-01

Myxoedema coma is a rare life-threatening disease, and it is essential that it is managed appropriately to reduce the associated high mortality. However, in the setting where efficient healthcare delivery is hampered by inadequacies, the management of such cases may pose a significant challenge. We present the case of a middle-aged woman diagnosed with myxoedema coma and severe hyponatremia. The case report highlights some of the challenges that may be encountered during the management of myxoedema coma in similar settings and outlines the management strategies undertaken to overcome them in the absence of national guidelines. It also brings to the fore the need for clinicians to look out for clinical features suggestive of hypothyroidism particularly among high risk individuals for early diagnosis and treatment. None declared.

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

PubMed

Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

Shoulder dystocia--malpractice or acceptable risk?

PubMed

Skolbekken, J A

2000-09-01

In 1988 a new patient insurance system was introduced in Norway. It was initially described as an 'objectified' system, similar to one based on the no-fault principle. Early doubts were raised about the system's status, as it contains rules stating that compensation will not be given if the medical intervention is adequate and the involved risk is acceptable. This study was undertaken to examine the practice of these rules. An archival study was performed on the 41 shoulder dystocia cases that had been closed in the decade from 1988-1997. These cases were selected as shoulder dystocia was found to be the obstetrical event most often leading to a decision on acceptable risk. The most common injury in these cases was Erb's palsy, but fatalities and brain injuries were also observed. Compensation was given in nine cases, whereas it was denied due to an acceptable medical risk in the remaining cases. Indications of inconsistency among the reached decisions were found, and judged to be a result of differences of opinion between expert witnesses on the adequacy of the obstetrical practice. Doubts are raised as to whether similar decisions are reached in similar cases. Shoulder dystocia may be an acceptable risk in the sense that it is hard to predict and prevent. Whether the consequences of such a risk should be compensated, remains a political and economical issue. Present thinking leads to decisions that create a divide between the lucky unlucky and the plainly unlucky.

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.

Safety in out-of-hours operating in trauma and orthopaedics at a district general hospital.

PubMed

Gulamhussein, M A; Chaudhry, S; Noor, S; Chaudhry, T; Guha, A; Knebel, R

2017-05-01

INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure. Furthermore, the clinical urgency and safety of cases was assessed based on whether there was any record of life or limb threatening indications at the time of admission. RESULTS Overall, 131 procedures were performed after 9pm, with 102 performed between 9pm and midnight, and 29 after midnight. Consultants performed 16 cases and the remaining 115 cases were operated on by middle grades or specialty trainees. A fifth (20%) of the cases were genuinely life or limb threatening. A total of 123 procedures were classed as having good outcomes. The complication rate was 8%. CONCLUSIONS In our study, 80% of the procedures performed after 9pm could not be categorised as life or limb threatening. Appropriate NCEPOD classification would ensure that only life or limb threatening cases were listed for theatre after 9pm. Alternative methods of operating within working hours should be considered.

Safety in out-of-hours operating in trauma and orthopaedics at a district general hospital

PubMed Central

Chaudhry, S; Noor, S; Chaudhry, T; Guha, A; Knebel, R

2017-01-01

INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure. Furthermore, the clinical urgency and safety of cases was assessed based on whether there was any record of life or limb threatening indications at the time of admission. RESULTS Overall, 131 procedures were performed after 9pm, with 102 performed between 9pm and midnight, and 29 after midnight. Consultants performed 16 cases and the remaining 115 cases were operated on by middle grades or specialty trainees. A fifth (20%) of the cases were genuinely life or limb threatening. A total of 123 procedures were classed as having good outcomes. The complication rate was 8%. CONCLUSIONS In our study, 80% of the procedures performed after 9pm could not be categorised as life or limb threatening. Appropriate CEPOD classification would ensure that only life or limb threatening cases were listed for theatre after 9pm. Alternative methods of operating within working hours should be considered. PMID:27917666

Molecular epidemiology of hepatitis A virus infection in Northeast India.

PubMed

Bose, Moumita; Bose, Sujoy; Saikia, Anjan; Medhi, Subhash; Deka, Manab

2015-07-01

The present study was undertaken to screen the molecular epidemiology of Hepatitis A virus (HAV) in Northeast India (NEI) who are ethnically distinct, tribal dominated and of lower socio-economic status with almost no information available from NEI on these aspects. Briefly, 3 ml blood was collected from 324 random liver disease cases with jaundice, receiving care at Central Hospital, N.F. Railway, Guwahati, Assam with informed consent. The patients detected with HAV-IgM positive status were included and were stratified as acute viral hepatitis (AVH) and fulminant hepatitis (FHF) based on clinical profile. Viral RNA was isolated and HAV-RNA was detected by Real-time PCR using primers for the VP3-VP1 region. HAV genotyping was studied by PCR-direct sequencing-phylogenetic analysis approach using the VP1/2A region of HAV isolates. Statistical analysis was performed using SPSS13.0 software. A total of 69 cases were HAV infected with two HBV co-infected cases (n = 69 + 2 = 71), 62 cases and two co-infected cases were AVH and others were FHF cases. HAV infection was predominant in especially in the young and adult age group. HAV-RNA was detected in 28 cases, out of which 19 cases could be genotyped (12 AVH, 7 FHF); which showed the prevalence of genotype IIIA or IA only. Although HAV genotype IIIA was the major genotype in both the AVH (10/12, 83.33%) and FHF (5/7, 71.43%) group, but the difference in distribution of genotypes in AVH and FHF cases was statistically non-significant (P = 0.550). HAV genotype IIIA is associated with the majority of HAV infected cases and severity in NEI. © 2015 Wiley Periodicals, Inc.

mTOR-inhibiting pharmacotherapy for the treatment of non-infectious uveitis: a systematic review protocol.

PubMed

Blair, Joshua; Barry, Robert; Murray, Philip I; Moore, David J; Denniston, Alastair K

2018-06-09

Non-infectious uveitis represents a sub-type of intraocular inflammation often associated with disorders of immune dysregulation. If untreated, the intraocular inflammation may progress to severe visual impairment and blindness. Current treatment is heavily reliant on systemic corticosteroid, often at doses associated with severe side effects. There is a need for efficacious corticosteroid-sparing immunomodulatory therapy for these patients. Current immunomodulators include various immunosuppressants and biologics but mammalian target of rapamycin (mTOR) inhibitors (such as sirolimus and everolimus) may also be contenders for this role. The systematic review proposed here will evaluate the evidence for the use of sirolimus and everolimus in the context of non-infectious uveitis. Standard systematic review methodology will be used to identify, select and extract data from any comparative or non-comparative study of mTOR inhibitors in patients with non-infectious uveitis excluding case reports. Searches of bibliographic databases (MEDLINE, EMBASE, The Cochrane Library and CINAHL) and clinical trials registers will be performed, with no restriction on language or date of publication. Translation of non-English language articles will be undertaken where necessary. The primary outcome of interest will be uveitis activity as measured by vitreous haze. Secondary outcomes will include other pre-specified measures of uveitis activity (such as anterior chamber cells or central macular thickness) best corrected visual acuity, heath-related quality of life, requirement for concurrent treatment and adverse events. Risk of bias assessment will be performed appropriate to each study design. Study selection, data extraction and risk of bias assessment will be undertaken by two reviewers independently. Data will be grouped, tabulated and narratively synthesised. Meta-analysis will be undertaken where appropriate clinical and methodological homogeneity exists. The review will be published according to PRISMA guidance. Studies of various designs have investigated the clinical use of mTOR inhibitors for non-infectious uveitis, and a large international randomised controlled trail of sirolimus for non-infectious uveitis is due to report. The findings of this systematic review will help inform ophthalmologists and aid the improvement of treatment protocols for non-infectious uveitis with regard to the use of mTOR inhibitors. PROSPERO CRD42017056390.

The use of exploratory analyses within the National Institute for Health and Care Excellence single technology appraisal process: an evaluation and qualitative analysis.

PubMed

Kaltenthaler, Eva; Carroll, Christopher; Hill-McManus, Daniel; Scope, Alison; Holmes, Michael; Rice, Stephen; Rose, Micah; Tappenden, Paul; Woolacott, Nerys

2016-04-01

As part of the National Institute for Health and Care Excellence (NICE) single technology appraisal (STA) process, independent Evidence Review Groups (ERGs) critically appraise the company submission. During the critical appraisal process the ERG may undertake analyses to explore uncertainties around the company's model and their implications for decision-making. The ERG reports are a central component of the evidence considered by the NICE Technology Appraisal Committees (ACs) in their deliberations. The aim of this research was to develop an understanding of the number and type of exploratory analyses undertaken by the ERGs within the STA process and to understand how these analyses are used by the NICE ACs in their decision-making. The 100 most recently completed STAs with published guidance were selected for inclusion in the analysis. The documents considered were ERG reports, clarification letters, the first appraisal consultation document and the final appraisal determination. Over 400 documents were assessed in this study. The categories of types of exploratory analyses included fixing errors, fixing violations, addressing matters of judgement and the ERG-preferred base case. A content analysis of documents (documentary analysis) was undertaken to identify and extract relevant data, and narrative synthesis was then used to rationalise and present these data. The level and type of detail in ERG reports and clarification letters varied considerably. The vast majority (93%) of ERG reports reported one or more exploratory analyses. The most frequently reported type of analysis in these 93 ERG reports related to the category 'matters of judgement', which was reported in 83 (89%) reports. The category 'ERG base-case/preferred analysis' was reported in 45 (48%) reports, the category 'fixing errors' was reported in 33 (35%) reports and the category 'fixing violations' was reported in 17 (18%) reports. The exploratory analyses performed were the result of issues raised by an ERG in its critique of the submitted economic evidence. These analyses had more influence on recommendations earlier in the STA process than later on in the process. The descriptions of analyses undertaken were often highly specific to a particular STA and could be inconsistent across ERG reports and thus difficult to interpret. Evidence Review Groups frequently conduct exploratory analyses to test or improve the economic evaluations submitted by companies as part of the STA process. ERG exploratory analyses often have an influence on the recommendations produced by the ACs. More in-depth analysis is needed to understand how ERGs make decisions regarding which exploratory analyses should be undertaken. More research is also needed to fully understand which types of exploratory analyses are most useful to ACs in their decision-making. The National Institute for Health Research Health Technology Assessment programme.

Commissioning and equity in primary care in Australia: Views from Primary Health Networks.

PubMed

Henderson, Julie; Javanparast, Sara; MacKean, Tamara; Freeman, Toby; Baum, Fran; Ziersch, Anna

2018-01-01

This paper reports findings from 55 stakeholder interviews undertaken in six Primary Health Networks (PHNs) in Australia as part of a study of the impact of population health planning in regional primary health organisations on service access and equity. Primary healthcare planning is currently undertaken by PHNs which were established in 2015 as commissioning organisations. This was a departure from the role of Medicare Locals, the previous regional primary health organisations which frequently provided services. This paper addresses perceptions of 23 senior staff, 11 board members and 21 members of clinical and community advisory councils or health priority groups from six case study PHNs on the impact of commissioning on equity. Participants view the collection of population health data as facilitating service access through redistributing services on the basis of need and through bringing objectivity to decision-making about services. Conversely, participants question the impact of the political and geographical context and population profile on capacity to improve service access and equity through service commissioning. Service delivery was seen as fragmented, the model is at odds with the manner in which Aboriginal Community Controlled Health Organisations (ACCHOs) operate and rural regions lack services to commission. As a consequence, reliance upon commissioning of services may not be appropriate for the Australian primary healthcare context. © 2017 John Wiley & Sons Ltd.

Application of groundwater residence time tracers and broad screening for micro-organic contaminants in the Indo-Gangetic aquifer system

NASA Astrophysics Data System (ADS)

Lapworth, Dan; Das, Prerona; Mukherjee, Abhijit; Petersen, Jade; Gooddy, Daren; Krishan, Gopal

2017-04-01

Groundwater abstracted from aquifers underlying urban centres across India provide a vital source of domestic water. Abstraction from municipal and private supplies is considerable and growing rapidly with ever increasing demand for water from expanding urban populations. This trend is set to continue. The vulnerability of deeper aquifers (typically >100 m below ground) used for domestic water to contamination migration from often heavily contaminated shallow aquifer systems has not been studies in detail in India. This paper focusses on the occurrence of micro-organic contaminants within sedimentary aquifers beneath urban centres which are intensively pumped for drinking water and domestic use. New preliminary results from a detailed case study undertaken across Varanasi, a city with an estimated population of ca. 1.5 million in Uttar Pradesh. Micro -organic groundwater quality status and evolution with depth is investigated through selection of paired shallow and deep sites across the city. These results are considered within the context of paired groundwater residence time tracers within the top 150m within the sedimentary aquifer system. Groundwater emerging contaminant results are compared with surface water quality from the Ganges which is also used for drinking water supply. Broad screening for >800 micro-organic compounds was undertaken. Age dating tools were employed to constrain and inform a conceptual model of groundwater recharge and contaminant evolution within the sedimentary aquifer system.

Governing the surgical count through communication interactions: implications for patient safety.

PubMed

Riley, R; Manias, E; Polglase, A

2006-10-01

Intermittently, the incidence of retained surgical items after surgery is reported in the healthcare literature, usually in the form of case studies. It is commonly recognised that poor communication practices influence surgical outcomes. To explore the power relationships in the communication between nurses and surgeons that affect the conduct of the surgical count. A qualitative, ethnographic study was undertaken. Data were collected in three operating room departments in metropolitan Melbourne, Australia. 11 operating room nurses who worked as anaesthetic, instrument and circulating nurses were individually observed during their interactions with surgeons, anaesthetists, other nurses and patients. Data were generated through 230 h of participant observation, 11 individual and 4 group interviews, and the keeping of a diary by the first author. A deconstructive analysis was undertaken. Results are discussed in terms of the discursive practices in which clinicians engaged to govern and control the surgical count. The three major issues presented in this paper are judging, coping with normalisation and establishing priorities. The findings highlight the power relationships between members of the surgical team and the complexity of striking a balance between organisational policy and professional judgement. Increasing professional accountability may help to deal with the issues of normalisation, whereas greater attention needs to be paid to issues of time management. More sophisticated technological solutions need to be considered to support manual counting techniques.

Disability in post-earthquake Haiti: prevalence and inequality in access to services.

PubMed

Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah

2015-01-01

To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with transport (40%). People with disabilities did not participate equally in education or employment and had poorer access to health care.

Osteomalacia: a forgotten cause of fractures in the elderly

PubMed Central

Rokan, Z; Kealey, W D

2015-01-01

We present a case of a man who suffered bilateral neck of femur fractures secondary to osteomalacia, attributable to a combination of his reclusive lifestyle, poor diet and long-term anticonvulsant therapy. These fractures may have been prevented if certain risk factors had been identified early. This case aims to highlight the importance of identifying vulnerable older adults in the community who are at risk of fragility fractures secondary to osteomalacia. It should be recognised that not only osteoporosis but other factors can precipitate these fractures as well and that preventative measures should be undertaken in those individuals at risk. PMID:25666245

[Labor monitoring in high-risk situations].

PubMed

Houfflin-Debarge, V; Closset, E; Deruelle, P

2008-02-01

Intrapartum asphyxia is increased in several situations such as intrauterine growth retardation, preterm labor, postdate pregnancy or maternal diabetes. In all these cases, fetal heart rate monitoring should be preferred to intermittent auscultation. Fetal scalp blood pH or lactates can be used to identify fetuses at risk of intrapartum asphyxia. However, fetal scalp blood sampling should not delay delivery in case of severe abnormal fetal heart rate as fetal asphyxia could occur rapidly in theses high-risk pregnancies. Data is insufficient to recommend fetal pulse oximetry or ECG analysis. Research should be undertaken to evaluate their performance in these situations.