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Sample records for clinically applied hydroxylapatite

  1. Biocompatibility of clinically applied hydroxylapatite ceramic

    SciTech Connect

    van Blitterswijk, C.A.; Grote, J.J. )

    1990-02-01

    The biocompatibility of 11 porous canal wall prostheses and 4 dense incus prostheses, both types made of hydroxylapatite, was studied by light microscopy, scanning electron microscopy, transmission electron microscopy, and x-ray microanalysis. The duration of implantation varied between 4 and 40 months, and the 15 retrieved implants constitute 4% of the 375 clinically applied hydroxylapatite prostheses involved in this study. With respect to integration characteristics, coverage by epithelium and fibrous tissue, and biodegradation, the performance of clinically applied hydroxylapatite generally resembled that seen in animal experiments. However, the reactions during chronic infection in the human ear were more severe than those in experimentally induced acute infections in the rat middle ear. One of the canal wall prostheses showed trace element accumulation in the cytoplasm of phagocytes.

  2. The use of a porous hydroxylapatite implant in periodontal defects. I. Clinical results after six months.

    PubMed

    Kenney, E B; Lekovic, V; Han, T; Carranza, F A; Dimitrijevic, B

    1985-02-01

    Twenty-five patients with advanced periodontal destruction were used in the study. Following initial therapy, two angular interproximal defects were selected in each patient. During flap surgery a porous hydroxylapatite implant shaped to fit the periodontal defect was placed in one defect, the other defect was used as nonimplanted control. The material used for implantation was a hydroxylapatite replicate of coral from the genus Porites, with a pore size of 190 to 220 micron. Clinical parameters were measured prior to flap surgery for each of the defects. An occlusal acrylic stent was used to give a stable reference point for pocket depth, attachment level and gingival margin height measurements. Also gingival fluid, gingival inflammation, plaque index and tooth mobility were recorded. Periapical radiographs using a standardized positioning device were also taken. At the time of surgery, the depth of the osseous defect and the height of the alveolar crest were recorded. After 6 months the clinical measurements were repeated and a re-entry surgery was carried out in 15 selected sites. Results showed that the porous implant produced statistically significant reduction in pocket depth, in the depth of osseous lesion, and a statistically significant gain in attachment level, as compared to control areas.

  3. Presentation of Ligands on Hydroxylapatite

    NASA Technical Reports Server (NTRS)

    Chu, Barbara C. F.; Orgel, Leslie E.

    1997-01-01

    Conjugates of biotin with the decamer of glutamic acid (glu(sub 10)) and the trimer of D,L-2-amino-5-phosphonovaleric acid (I) have been synthesized, and it has been shown that they mediate the binding of avidin to hydroxylapatite. In a similar way a conjugate of methotrexate with glu(sub 10) mediates the binding of dihydrofolate reductase to the mineral. The presentation of ligands on the hydroxylapatite component of bone may find applications in clinical medicine.

  4. Calcium hydroxylapatite for facial rejuvenation.

    PubMed

    Berlin, Alexander; Cohen, Joel L; Goldberg, David J

    2006-09-01

    Porous calcium hydroxylapatite has been used in otolaryngology, dentistry and radiology for many years. Currently, calcium hydroxylapatite is gaining popularity for facial esthetics in the form of the product Radiesse (San Mateo, CA). Although Radiesse is not yet approved in the United States for cosmetic use, it is being used off-label by an increasing number of dermatologists and plastic surgeons for facial soft-tissue augmentation. Preliminary clinical and histologic studies have shown safety, efficacy and durability in various esthetic applications including the nasolabial folds and HIV lipoatrophy.

  5. Calcium hydroxylapatite: Radiesse.

    PubMed

    Ahn, Min S

    2007-02-01

    Among the array of choices for aesthetic soft tissue fillers, Radiesse occupies a unique niche as a safe, easily administered, "semi-permanent" material. Composed of calcium hydroxylapatite in a gel matrix, it has a proven safety profile and has been approved by the US Food and Drug Administration for use in the nasolabial folds and for HIV lipoatrophy. Radiesse have evolved quickly into a effective filler for moderately deep facial folds with high patient and physician approval.

  6. Hydroxylapatite Otologic Implants

    SciTech Connect

    McMillan, A.D.; Lauf, R.J.; Beale, B.; Johnson, R.

    2000-01-01

    A Cooperative Research and Development Agreement (CRADA) between Lockheed Martin Energy Research Corporation (LMER) and Smith and Nephew Richards Inc. of Bartlett, TN, was initiated in March 1997. The original completion date for the Agreement was March 25, 1998. The purpose of this work is to develop and commercialize net shape forming methods for directly creating dense hydroxylapatite (HA) ceramic otologic implants. The project includes three tasks: (1) modification of existing gelcasting formulations to accommodate HA slurries; (2) demonstration of gelcasting to fabricate green HA ceramic components of a size and shape appropriate to otologic implants: and (3) sintering and evaluation of the HA components.

  7. Injectable calcium hydroxylapatite microspheres (Radiesse).

    PubMed

    Ridenour, Brock; Kontis, Theda C

    2009-05-01

    Injectable calcium hydroxylapatite (Radiesse) received FDA approval in 2006 for the correction of facial lipoatrophy and moderate to severe facial wrinkles. This product consists of microspheres of a synthetic bone suspended in a methylcellulose gel matrix. Because the product is thicker than the hyaluronic acids, it is used for the correction of moderate to severe wrinkles, such as deep nasolabial folds. It is also used "off-label" to treat multiple areas of the face, nose, and hands. Radiesse is injected into the subdermal plane, and correction lasts approximately 1 year after injection.

  8. Stoichiometric transfer in pulsed laser deposition of hydroxylapatite

    NASA Astrophysics Data System (ADS)

    Arias, J. L.; Mayor, M. B.; Pou, J.; León, B.; Pérez-Amor, M.

    2000-02-01

    Hydroxylapatite (HA, Ca 10(PO 4) 6(OH) 2) is a calcium phosphate used as coating for dental and orthopaedical implants because its composition and structure is similar to the mineral part of bone. As an alternative to traditional plasma sprayed coating technique, pulsed laser deposition (PLD) has been applied due to its ability to reproduce complex stoichiometries. A hydroxylapatite target was ablated with an ArF laser in a water vapor atmosphere to investigate in which range of fluences the stoichiometric transfer to a titanium substrate is possible. The Ca/P ratio of the coatings was measured by energy dispersive spectroscopy (EDS), while their OH - and CO 32- content was evaluated by Fourier transform infrared spectroscopy (FT-IR) spectroscopy. The irradiated target surface was analyzed by scanning electron microscopy (SEM) and the ablation rate measured with a profilometer. While at higher fluences all the target material is congruently ablated and stoichiometry is transferred to the coatings, at lower fluences (<1.2 J cm -2) preferential ablation of Ca and strong out-difussion of CO 32- impurity as CO 2 takes place at the target. The incongruent melting of the hydroxylapatite target at low fluences provokes its enrichment in Ca. The higher Ca concentrations arriving to the substrate, together with the higher CO 2 partial pressure, yields enhanced substitution of PO 43- by CO 32- and increasing of the Ca/P ratio at the coating.

  9. Processing of hydroxylapatite coatings on titanium alloy bone prostheses

    DOEpatents

    Nastasi, M.A.; Levine, T.E.; Mayer, J.W.; Pizziconi, V.B.

    1998-10-06

    Processing of hydroxylapatite sol-gel films on titanium alloy bone prostheses. A method utilizing non-line-of-sight ion beam implantation and/or rapid thermal processing to provide improved bonding of layers of hydroxylapatite to titanium alloy substrates while encouraging bone ingrowth into the hydroxylapatite layers located away from the substrate, is described for the fabrication of prostheses. The first layer of hydroxylapatite is mixed into the substrate by the ions or rapidly thermally annealed, while subsequent layers are heat treated or densified using ion implantation to form layers of decreasing density and larger crystallization, with the outermost layers being suitable for bone ingrowth.

  10. Processing of hydroxylapatite coatings on titanium alloy bone prostheses

    DOEpatents

    Nastasi, Michael A.; Levine, Timothy E.; Mayer, James W.; Pizziconi, Vincent B.

    1998-01-01

    Processing of hydroxylapatite sol-gel films on titanium alloy bone prostheses. A method utilizing non-line-of-sight ion beam implantation and/or rapid thermal processing to provide improved bonding of layers of hydroxylapatite to titanium alloy substrates while encouraging bone ingrowth into the hydroxylapatite layers located away from the substrate, is described for the fabrication of prostheses. The first layer of hydroxylapatite is mixed into the substrate by the ions or rapidly thermally annealed, while subsequent layers are heat treated or densified using ion implantation to form layers of decreasing density and larger crystallization, with the outermost layers being suitable for bone ingrowth.

  11. Calcium Hydroxylapatite for Augmentation of Face and Hands: A Retrospective Analysis in Italian Subjects.

    PubMed

    Muti, Gabriele F; Astolfi, Giorgio; Renzi, Massimo; Rovatti, Pier P

    2015-09-01

    To assess the use and safety of calcium hydroxylapatite for volume restoration of the face and hands in clinical practice, subjects from four Italian aesthetic clinics who had received calcium hydroxylapatite augmentation treatment between January 2012 and December 2013 were recruited. Records were retrospectively reviewed for demographic characteristics, number of treatments, area treated, injection depth and volume, method of administration, and adverse events. A total of 1,783 treatments were administered to 800 subjects (female: 93.5%; mean age: 49.6 years). Overall, 620 (77.5%) subjects were treated over two sessions for a particular indication, and 243 (30.3%) treated over three sessions. The most frequently treated areas were the zygomatic area (men: 30.2%; women: 30.6% of all treatments), malar area (24.5% and 24.3%), and marionette lines (18.9% and 11.6%). A cannula was used for most treatments (86.7%). Injection volume ranged from 0.4 mL to 1.5 mL. Injection-site swelling and bruising occurred with 18.2% and 11.3% of treatments, respectively. Most cases resolved within one week and two weeks, respectively. No serious/unexpected adverse events occurred. In clinical practice, calcium hydroxylapatite is a versatile, well-tolerated treatment for filling folds and volume restoration of the face and hands.

  12. Template-directed oligonucleotide ligation on hydroxylapatite

    NASA Technical Reports Server (NTRS)

    Acevedo, O. L.; Orgel, L. E.

    1986-01-01

    It has been suggested that the prebiotic synthesis of the precursors of biopolymers could have occurred on a solid surface such as that provided by clay or some other mineral. One such scheme envisages that growing polymers were localized by adsorption to a mineral surface where an activating agent or activated monomers were supplied continuously or cyclically. Here, it is reported that a sequence of reactions in which initially formed oligo(G)s are reactivated by conversion to phosphorimidazolides in the presence of poly(C) and then allowed to ligate is ideal, in that repeated cycles can be carried out on the surface of hydroxylapatite, whereas in the liquid phase the cycle could be achieved only with considerable difficulty.

  13. Hand recontouring with calcium hydroxylapatite (Radiesse).

    PubMed

    Edelson, Kenneth L

    2009-03-01

    The aging hand is a common area of concern for many patients. Until recently, adequate treatment options have been hampered by pain of injecting into the dorsum and, post-injection, by the absence of longevity of treatment. In this article, we describe the off-label use of the soft tissue filler calcium hydroxylapatite (CaHA; Radiesse) for hand rejuvenation. The product is inherently biocompatible and, when placed in soft tissue, induces neocollagenesis. An alternative injection mixture of CaHA combined with lidocaine is described, as well as the novel "bolus" injection technique. The CaHA-lidocaine emulsion reduces the pain of injection to nearly none at all, improves the rheology of the procedure, and allows for deposition of the product into the correct plane of tissue. The volume of CaHA injected as well as the amount of lidocaine used for the mixture vary according to physician preference. In our practice, 1.3 mL of CaHA combined with 0.5 mL lidocaine per hand usually appears to be sufficient to improve the appearance of the atrophic dorsum of the hand. Side-effects of CaHA (Radiesse), particularly in this off-label application, are minimal and of short duration. The aesthetic result is immediate and generally persists for longer than 6 months. As a treatment option, hand rejuvenation with CaHA (Radiesse) is a very gratifying procedure both to the patient and to the physician.

  14. Eyelid mass secondary to injection of calcium hydroxylapatite facial filler.

    PubMed

    Lee, Min Joung; Sung, Mi Sun; Kim, Nam Ju; Choung, Ho-Kyung; Khwarg, Sang In

    2008-01-01

    A 37-year-old woman presented with a 2-month history of fullness and ptosis of the left upper eyelid. Examination revealed a 6-cm x 2-cm mass in the left brow and upper eyelid, and a diffuse mass in the lower eyelid. Marked ptosis of the left upper eyelid and elevation of the left lower eyelid were noted. CT showed masses with a bone-like density in the left eyelid and periorbital soft tissue. A through history revealed that the patient had received calcium hydroxylapatite filler injection for nose augmentation 3 days prior to the development of the eyelid masses. The eyelid masses were excised and pathologically confirmed as calcium hydroxylapatite microspherules surrounded by collagen and histiocytes. Two months after surgery, the eyelid masses and ptosis of the left upper eyelid were completely resolved. To our knowledge, this is the first reported case of eyelid mass after injection of calcium hydroxylapatite facial filler for nose augmentation.

  15. The role of calcium hydroxylapatite (Radiesse) in nonsurgical aesthetic rejuvenation.

    PubMed

    Lizzul, Paul F; Narurkar, Vic A

    2010-05-01

    Radiesse (Bioform Medical, San Mateo, CA) is a synthetic calcium hydroxylapatite microsphere filler suspended in an aqueous carrier gel. Radiesse currently has indications in the United States (U.S.) for the correction of signs of lipoatrophy in individuals with human immunodeficiency virus (HIV) as well as for the correction of moderate-to-deep nasolabial folds. There are also numerous off label reports in the literature of use in other facial aesthetic procedures. This review describes the composition of calcium hydroxylapatite, its mechanism of action, durability and safety, pre- and post-procedure care, injection techniques, appropriate use, concomitant anesthesia, as well as potential adverse events and complications.

  16. Calcium hydroxylapatite (Radiesse) for correction of the mid- and lower face: consensus recommendations.

    PubMed

    Graivier, Miles H; Bass, Lawrence S; Busso, Mariano; Jasin, Michael E; Narins, Rhoda S; Tzikas, Thomas L

    2007-11-01

    Restoring volume in the middle and lower portions of the face is becoming an indispensable component of modern facial rejuvenation. Radiesse (BioForm Medical, San Mateo, Calif.) is an injectable filler material composed of synthetic calcium hydroxylapatite microspheres (30 percent) suspended in an aqueous carrier gel (70 percent). At present, Radiesse is indicated in the United States for correction of moderate to deep nasolabial folds and for correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus. Its off-label use in other facial aesthetic indications is widely reported in the literature. The ability of Radiesse to provide immediate and durable effects has fueled interest in its use for expanded aesthetic applications, particularly in the middle and lower face. The authors' consensus panel, consisting of a cross-section of experts in plastic surgery, facial plastic surgery, and dermatology, was convened to review the scientific literature and compare clinical experiences regarding the use of calcium hydroxylapatite. This report describes the characteristic effects of aging in the middle and lower face and reviews the composition of calcium hydroxylapatite, its safety and durability, and its appropriate use in a variety of facial applications, including nasolabial folds, correction of human immunodeficiency virus-associated lipoatrophy, augmentation of the malar, submalar, and zygomatic regions, and correction of oral commissure defects, marionette lines, and prejowl sulcus. Recommendations for Radiesse use in each area, including anesthesia, and injection techniques are provided. Measures for enhancing patient comfort, anticipating and minimizing potential complications, and optimizing aesthetic results are also discussed.

  17. Hydroxylapatite nanoparticles obtained by fiber laser-induced fracture

    NASA Astrophysics Data System (ADS)

    Boutinguiza, M.; Lusquiños, F.; Riveiro, A.; Comesaña, R.; Pou, J.

    2009-03-01

    This work presents the results of laser-induced fragmentation of hydroxylapatite microparticles in water dissolution. Calcined fish bones in form of powder, which were previously milled to achieve microsized particles, were used as precursor material. Two different laser sources were employed to reduce the size of the suspended particles: a pulsed Nd:YAG laser and a Ytterbium doped fiber laser working in continuous wave mode. The morphology as well as the composition of the obtained particles was characterized by scanning electron microscopy (SEM), energy dispersive X-ray (EDX) spectroscopy and conventional and high resolution transmission electron microscopy (TEM, HRTEM). The results show that nanometric particles of hydroxylapatite and β-tricalcium phosphate as small as 10 nm diameter can be obtained.

  18. Equation of State of Carbonated Hydroxylapatite at Ambient Temperature up to 10 GPa: Significance of Carbonate

    SciTech Connect

    X Liu; S Shieh; M Fleet; L Zhang; Q He

    2011-12-31

    The incorporation of the carbonate ion into the crystal structure of hydroxylapatite results in the creation of vacancies, oxygen-loss, and disorder, with consequent changes in physical and chemical properties. High-pressure experimental investigation up to 10 GPa of two synthetic carbonated hydroxylapatite samples with up to 11 wt% CO3, using a diamond-anvil cell and synchrotron powder X-ray diffraction, provides the first rigorous assessment of the mechanical behavior of the carbonated hydroxylapatite. The pressure-volume data suggest that the isothermal bulk modulus of these carbonated hydroxylapatites has been significantly decreased by the presence of the carbonate (up to about 15%), which in turn will affect all the carbonated apatite-related reactions in the geosystem. Since hydroxylapatite is one of the major components of the bones and teeth, the incorporation of the carbonate in the hydroxylapatite weakens teeth and bones not only chemically, but also physically.

  19. Nurses' intention to apply clinical practice guidelines.

    PubMed

    Kogan, Ella; Tabak, Nili

    2012-12-01

    Using Ajzen and Madden's Theory of Planned Behavior, this study investigates factors which influence nurses' intention to apply clinical practice guidelines in their daily ward work. A convenience sample of 91 nurses in internal medicine wards in three Israeli hospitals answered four questionnaires. Data were processed by Pearson correlation coefficients and multivariate regression. The main findings were that burnout was negatively correlated with the intention to work according to guidelines and that professionalism (in the sense of a tendency to follow taught procedure rather than personal judgment) was positively correlated with it. Furthermore, nurses who perceive their behavioral control and subjective norms to be positive will be the most determined to work according to guidelines, provided they personally command the necessary resources to do so. PMID:23447906

  20. Production of nanoparticles from natural hydroxylapatite by laser ablation

    PubMed Central

    2011-01-01

    Laser ablation of solids in liquids technique has been used to obtain colloidal nanoparticles from biological hydroxylapatite using pulsed as well as a continuous wave (CW) laser. Transmission electron microscopy (TEM) measurements revealed the formation of spherical particles with size distribution ranging from few nanometers to hundred nanometers and irregular submicronic particles. High resolution TEM showed that particles obtained by the use of pulsed laser were crystalline, while those obtained by the use of CW laser were amorphous. The shape and size of particles are consistent with the explosive ejection as formation mechanism. PMID:21711800

  1. Clinical practice is not applied scientific method.

    PubMed

    Cox, K

    1995-08-01

    Practice is often described as applied science, but real life is far too complex and interactive to be handled by analytical scientific methods. The limitations of usefulness of scientific method in clinical practice result from many factors. The complexity of the large number of ill-defined variables at many levels of the problem. Scientific method focuses on one variable at a time across a hundred identical animals to extract a single, generalizable 'proof' or piece of 'truth'. Clinical practice deals with a hundred variables at one time within one animal from among a clientele of non-identical animals in order to optimize a mix of outcomes intended to satisfy that particular animal's current needs and desires. Interdependence among the variables. Most factors in the illness, the disease, the patient and the setting are interdependent, and cannot be sufficiently isolated to allow their separate study. Practice as a human transaction involving at least two people is too complex to be analysed one factor at a time when the interaction stimulates unpredictable responses. Ambiguous data. Words have many usages. People not only assign different interpretations to the same words, they assign different 'meanings', especially according to the threat or hope they may imply. The perceptual data gleaned from physical examination may be difficult to specify exactly or to confirm objectively. The accuracy and precision of investigational data and their reporting can be low, and are frequently unknown. Differing goals between science and practice. Science strives for exact points of propositional knowledge, verifiable by logical argument using objective data and repetition of the experiment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7661793

  2. Use of calcium hydroxylapatite (Radiesse) for facial augmentation.

    PubMed

    Jacovella, Patricio F

    2008-01-01

    Radiesse (Bioform Inc, USA) is a sterile, latex-free, non-pyrogenic, semi-solid, cohesive subdermal, injectable implant, whose principal component is synthetic calcium hydroxylapatite, a biocompatible material with over 20 years of use in medicine. The semi-solid nature of the product is created by suspending calcium hydroxylapatite microspheres of 25-45 microns diameter in a gel carrier of carboxymethylcellulose. The product has FDA approval for esthetic facial augmentation in the US. Such approval includes the long-lasting correction of moderate to severe facial wrinkles and folds and the treatment of facial fat loss due to immunodeficiency virus infection. Diverse facial regions can be injected in order to ameliorate or enhance some features: glabellar lines, subdermal support of the brows, malar and buccal fat pads, tear troughs, nasolabial folds, nose, lips, perioral region, marionette lines, oral commisures and chin among others, as well as saucerized acne scars. Other medical indications include nipple projection for nipple areolar reconstruction, urinary incontinence, vesicoureteral reflux, vocal cord augmentation, and use as a radiographic tissue marker. The average lasting result is from 12 to 18 months. Radiesse can be considered an effective soft-tissue filler for overall longevity, biocompatibility, and low rate of side effects.

  3. Applying proteomic technology to clinical virology.

    PubMed

    Mancone, C; Ciccosanti, F; Montaldo, C; Perdomo, A B; Piacentini, M; Alonzi, T; Fimia, G M; Tripodi, M

    2013-01-01

    Developing antiviral drugs, vaccines and diagnostic markers is still the most ambitious challenge in clinical virology. In the past few decades, data from high-throughput technologies have allowed for the rapid development of new antiviral therapeutic strategies, thus making a profound impact on translational research. Most of the current preclinical studies in virology are aimed at evaluating the dynamic composition and localization of the protein platforms involved in various host-virus interactions. Among the different possible approaches, mass spectrometry-based proteomics is increasingly being used to define the protein composition in subcellular compartments, quantify differential protein expression among samples, characterize protein complexes, and analyse protein post-translational modifications. Here, we review the current knowledge of the most useful proteomic approaches in the study of viral persistence and pathogenicity, with a particular focus on recent advances in hepatitis C research.

  4. Applying Research on Family Violence to Clinical Practice.

    ERIC Educational Resources Information Center

    Gelles, Richard J.

    1982-01-01

    Considers whether research on family violence can be applied to clinical practice. Suggests limitations of the knowledge base constrain the application of research on family violence to clinical work, and certain aspects of the research paradigm also limit the transfer of research knowledge to clinical practice. (Author)

  5. The effect of aging on the healing of hydroxylapatite implants.

    PubMed

    Shirota, T; Ohno, K; Suzuki, K; Michi, K; Tatsuo, S; Kohsuke, O; Kanako, S; Ken-Ichi, M

    1993-01-01

    The purpose of this study was to investigate the effect of aging on the healing process after insertion of a hydroxylapatite (HA) implant into bone. Three groups of eight male Wistar rats, aged 6 weeks (young group), 12 weeks (adult group), and approximately 2 years (old group) were used in this experiment. Two implants were placed into the tibia of each rat. The animals were killed 7, 14, 28, and 56 days after implantation, and 15-microns, hematoxylin-eosin-stained, undecalcified sections were prepared. The healing process was examined histologically, and histomorphometric measurements were made by a computer-based image analyzer to quantify the percentage of HA-bone contact and trabecular bone in the medullary cavity. In the young group, new trabecular bone formed actively around the HA implant and good HA-bone contact was achieved more rapidly than in the adult group. In the old group, both the quantity of newly formed trabecular bone around the implant and the extent of HA-bone contact were less than in the other groups. The results suggest that the rate and volume of new bone formation around implants decrease with increasing age.

  6. Energetics of the initial phase of adhesion of Streptococcus sanguis to hydroxylapatite.

    PubMed Central

    Cowan, M M; Taylor, K G; Doyle, R J

    1987-01-01

    The initial adhesion of Streptococcus sanguis 10556 to artificial salivary pellicle and to bare hydroxylapatite was studied at several temperatures between 18 and 37 degrees C. When the natural logarithms of rate constants for adsorption and desorption were plotted against reciprocal temperatures in Arrhenius plots, curved lines were obtained, indicating that the thermodynamic quantities of enthalpy and entropy of activation were temperature dependent. For the bare hydroxylapatite system, the heat capacity (delta Cp = dH/dT) was large and negative. delta Cp was also negative for adhesion to saliva-coated hydroxylapatite, although its value was lower. Negative heat capacities, when coupled with favorable entropy, are often indicative of either electrostatic or hydrophobic interactions. When electrolyte (100 mM ammonium sulfate) was added to the cell-hydroxylapatite bead mixture, the rate and extent of adhesion were decreased. Addition of nonpolar p-dioxane (10% [vol/vol], final concentration) to the mixture enhanced binding. This suggests that electrostatic linkages participate in the primary adhesion of streptococci to both substrata. The strongly positive entropy values and the lesser temperature dependence of the saliva-coated hydroxylapatite system suggest that another entropy-driven process is imposed on the electrostatic linkages. This supports a role for hydrophobicity, suggesting that a combination of electrostatic and hydrophobic forces mediate the initial adhesion of S. sanguis to the salivary pellicle. PMID:3036767

  7. Optimizing facial rejuvenation outcomes by combining poly-L-lactic acid, hyaluronic acid, calcium hydroxylapatite, and neurotoxins: two case studies.

    PubMed

    Lorenc, Z Paul; Daro-Kaftan, Elizabeth

    2014-02-01

    Reversal of the visible signs of facial aging with the use of injectable products as an alternative to surgery has become more popular, with nearly 5 million procedures performed in the United States in 2012. Volume augmentation products, such as hyaluronic acid (HA), calcium hydroxylapatite (CaHA), and poly-L-lactic acid (PLLA), are often used in combination with one another and with neurotoxins for facial rejuvenation because of the complementary modes of action. This article presents 2 case reports involving patientspecific combinations of 2 different HA products, injectable PLLA, and CaHA with incobotulinumtoxinA or abobotulinumtoxinA. The combination of HA, CaHA, PLLA, and neurotoxins has resulted in outstanding outcomes for many patients, with no clinical evidence of increased adverse events secondary to combination therapy. PMID:24509971

  8. Optimizing facial rejuvenation outcomes by combining poly-L-lactic acid, hyaluronic acid, calcium hydroxylapatite, and neurotoxins: two case studies.

    PubMed

    Lorenc, Z Paul; Daro-Kaftan, Elizabeth

    2014-02-01

    Reversal of the visible signs of facial aging with the use of injectable products as an alternative to surgery has become more popular, with nearly 5 million procedures performed in the United States in 2012. Volume augmentation products, such as hyaluronic acid (HA), calcium hydroxylapatite (CaHA), and poly-L-lactic acid (PLLA), are often used in combination with one another and with neurotoxins for facial rejuvenation because of the complementary modes of action. This article presents 2 case reports involving patientspecific combinations of 2 different HA products, injectable PLLA, and CaHA with incobotulinumtoxinA or abobotulinumtoxinA. The combination of HA, CaHA, PLLA, and neurotoxins has resulted in outstanding outcomes for many patients, with no clinical evidence of increased adverse events secondary to combination therapy.

  9. Skin necrosis after calcium hydroxylapatite injection into the glabellar and nasolabial folds.

    PubMed

    Georgescu, Dan; Jones, Yian; McCann, John D; Anderson, Richard L

    2009-01-01

    Calcium hydroxylapatite-induced skin necrosis occurred in 2 patients after injection in the glabella and the nasolabial fold, respectively. Supportive treatment with oral steroids, nitroglycerin paste, and warm compresses was initiated more than 48 hours after injection, and its role in recovery is uncertain. Both patients underwent microdermabrasion and used hydrocortisone ointment to flatten the scar, which resulted in gradual improvement with a reasonable cosmetic outcome 4 months after injection. This is the first report of calcium hydroxylapatite-induced skin necrosis. Injectors should be aware of this potential adverse event and counsel their patients appropriately.

  10. [PDCA Applied in Special Rectification of Medical Instrument Clinical Trial].

    PubMed

    Wang, Lei; Qu, Xintao; Yu, Xiuchun

    2015-07-01

    PDCA cycle was applied in special rectification activities for medical instrument clinical trial, with quality criteria of implementation made. Completed medical instrument clinical trial from January 2011 to December 2012 was believed as control group, from January 2013 to December 2014 as PDCA group, the scores of clinical trial and the score rate of items were compared and analyzed. Results show quality scores of clinical trial in PDCA group are higher than that in control group (51 vs. 81, P < 0.001), score rate of items increased except adverse events (P < 0.001). The special rectification activities with PDCA applied in our department are feasible and effective. It significantly improves implement quality of medical instrument clinical trial.

  11. [PDCA Applied in Special Rectification of Medical Instrument Clinical Trial].

    PubMed

    Wang, Lei; Qu, Xintao; Yu, Xiuchun

    2015-09-01

    PDCA cycle was applied in special rectification activities for medical instrument clinical trial, with quality criteria of implementation made. Completed medical instrument clinical trial from January 2011 to December 2012 was believed as control group, from January 2013 to December 2014 as PDCA group, the scores of clinical trial and the score rate of items were compared and analyzed. Results show quality scores of clinical trial in PDCA group are higher than that in control group (51 vs. 81, P < 0.001), score rate of items increased except adverse events (P < 0.001). The special rectification activities with PDCA applied in our department are feasible and effective. It significantly improves implement quality of medical instrument clinical trial.

  12. Calcium Hydroxylapatite With Integral Lidocaine Provides Improved Pain Control for the Correction of Nasolabial Folds.

    PubMed

    Schachter, Daniel; Bertucci, Vince; Solish, Nowell

    2016-08-01

    Calcium hydroxylapatite microspheres in a carrier gel (CaHA; Radiesse®: Merz North America, Inc., Raleigh, NC) is approved by the United States Food and Drug Administration for subdermal implantation for the correction of moderate-to-severe facial wrinkles and folds, such as nasolabial folds (NLFs). Lidocaine is often mixed with injectable dermal fillers to reduce injection pain. A new formulation of CaHA has been developed with the convenience of integral 0.3% lidocaine, CaHA (+).
    This multicenter, split-face, double-blind study randomized subjects to receive treatment with CaHA (+) in one NLF and CaHA without lidocaine in the contralateral NLF. The pain level for each NLF was evaluated immediately following the injection using a 10-cm visual analog scale (VAS), and every 15 minutes for 60 minutes plus follow-up visits. Additional endpoints included aesthetic outcomes and subject preference. All subjects (N=102) received treatment.
    CaHA (+) treatment resulted in a statistically and clinically significant reduction in pain ratings immediately after injection compared with CaHA. The mean difference in VAS scores for pain was -4.41 (P<0.0001). In 90% of subjects, the VAS scores were ≥2.0 cm lower for the CaHA (+)-treated NLF. A significant reduction in pain ratings throughout the first hour after injection was observed with CaHA (+) compared with CaHA (P<0.0001). Both treatment groups achieved significant aesthetic improvement; however, the pain differential resulted in a subject-reported preference for CaHA (+). CaHA (+) with integral lidocaine significantly reduces pain and is as effective as CaHA.

    J Drugs Dermatol. 2016;15(8):1005-1010.

  13. Calcium Hydroxylapatite With Integral Lidocaine Provides Improved Pain Control for the Correction of Nasolabial Folds.

    PubMed

    Schachter, Daniel; Bertucci, Vince; Solish, Nowell

    2016-08-01

    Calcium hydroxylapatite microspheres in a carrier gel (CaHA; Radiesse®: Merz North America, Inc., Raleigh, NC) is approved by the United States Food and Drug Administration for subdermal implantation for the correction of moderate-to-severe facial wrinkles and folds, such as nasolabial folds (NLFs). Lidocaine is often mixed with injectable dermal fillers to reduce injection pain. A new formulation of CaHA has been developed with the convenience of integral 0.3% lidocaine, CaHA (+).
    This multicenter, split-face, double-blind study randomized subjects to receive treatment with CaHA (+) in one NLF and CaHA without lidocaine in the contralateral NLF. The pain level for each NLF was evaluated immediately following the injection using a 10-cm visual analog scale (VAS), and every 15 minutes for 60 minutes plus follow-up visits. Additional endpoints included aesthetic outcomes and subject preference. All subjects (N=102) received treatment.
    CaHA (+) treatment resulted in a statistically and clinically significant reduction in pain ratings immediately after injection compared with CaHA. The mean difference in VAS scores for pain was -4.41 (P<0.0001). In 90% of subjects, the VAS scores were ≥2.0 cm lower for the CaHA (+)-treated NLF. A significant reduction in pain ratings throughout the first hour after injection was observed with CaHA (+) compared with CaHA (P<0.0001). Both treatment groups achieved significant aesthetic improvement; however, the pain differential resulted in a subject-reported preference for CaHA (+). CaHA (+) with integral lidocaine significantly reduces pain and is as effective as CaHA.

    J Drugs Dermatol. 2016;15(8):1005-1010. PMID:27538003

  14. Clinical and Applied Experience in Rehabilitation Counselor Education

    ERIC Educational Resources Information Center

    Tschopp, Molly K.; Chronister, Julie A.

    2008-01-01

    Applied training of pre-practicum, practicum, and internship are important gateway experiences for rehabilitation counselors-in-training. Counselor educators and supervisors must be aware of requirements and expectations of counselor-in-training supervision and common ethical issues specific to these clinical experiences of rehabilitation…

  15. Case report medical eponyms: an applied clinical informatics opportunity.

    PubMed

    Baskaran, L N Guptha Munugoor; Greco, P J; Kaelber, D C

    2012-01-01

    Medical eponyms are medical words derived from people's names. Eponyms, especially similar sounding eponyms, may be confusing to people trying to use them because the terms themselves do not contain physiologically descriptive words about the condition they refer to. Through the use of electronic health records (EHRs), embedded applied clinical informatics tools including synonyms and pick lists that include physiologically descriptive terms associated with any eponym appearing in the EHR can significantly enhance the correct use of medical eponyms. Here we describe a case example of two similar sounding medical eponyms--Wegener's disease and Wegner's disease-- which were confused in our EHR. We describe our solution to address this specific example and our suggestions and accomplishments developing more generalized approaches to dealing with medical eponyms in EHRs. Integrating brief physiologically descriptive terms with medical eponyms provides an applied clinical informatics opportunity to improve patient care.

  16. Applying developmental programming to clinical obstetrics: my ward round.

    PubMed

    Painter, R C

    2015-10-01

    The theory of developmental programming is supported by accumulating evidence, both observational and experimental. The direct application of the principles of developmental programming by clinicians to benefit pregnant women remains an area of limited attention. Examining a selection of inpatients at an obstetric referral center, I searched for situations in which clinical decision making could be driven by the principles of developmental programming. I also looked for situations in which the clinical research agenda could be dictated by these concepts. In the decision to undertake preventive measures to avoid preeclampsia, the offspring's perspective may support more liberal application of calcium and aspirin. Consideration of the long-term health perspective of the offspring could drive choices in the management of obesity and diabetes in pregnancy. The administration of corticosteroids in women delivering by elective cesarean at term may have modest short-term benefits, but additional trials are necessary to investigate long-term offspring health. The offspring of women suffering hyperemesis gravidarum may benefit from nutritional therapy. The long-term health of the offspring could affect couples' choice for IVF or expectant management. Applying the principles of developmental programming to the management of pregnant women could drive clinical decision making and is driving the clinical research agenda. Increasingly, developmental programming concepts are becoming an integral part of clinical practice, as well as determining the choice of outcomes in trials in obstetrics and fertility medicine. The presented cases underscore the need for more research to guide clinical practice.

  17. Micro-Raman spectroscopy shows how the coating process affects the characteristics of hydroxylapatite.

    PubMed

    Saber-Samandari, Saeed; Alamara, Kadhim; Saber-Samandari, Samaneh; Gross, Karlis A

    2013-12-01

    The diversity in the structural and chemical state of apatites allows implant manufacturers to fine-tune implant properties. This requires suitable manufacturing processes and characterization tools to adjust the amorphous phase and hydroxyl content from the source hydroxylapatite. Hydroxylapatite was processed by high-velocity oxy-fuel spraying, plasma spraying and flame spraying, and primarily analyzed by Raman spectroscopy. Investigation of rounded splats, the building blocks of thermal spray coatings, allowed correlation between the visual identity of the splat surface and the Raman spectra. Splats were heat-treated to crystallize any remaining amorphous phase. The ν1 PO4 stretching peak at 950-970 cm(-1) displayed the crystalline order, but the hydroxyl peak at 3572 cm(-1) followed the degree of dehydroxylation. Hydroxyl loss was greatest for flame-sprayed particles, which create the longest residence time for the melted particle. Higher-frequency hydroxyl peaks in flame- and plasma-sprayed splats indicated a lower structural order for the recrystallized hydroxylapatite within the splats. Crystallization at 700 °C has shown potential for revealing hydroxyl ions previously trapped in amorphous calcium phosphate. This work compares Fourier transform infrared and Raman spectroscopy to measure the hydroxyl content in rapidly solidified apatites and shows that Raman spectroscopy is more suitable. PMID:23973389

  18. Micro-Raman spectroscopy shows how the coating process affects the characteristics of hydroxylapatite.

    PubMed

    Saber-Samandari, Saeed; Alamara, Kadhim; Saber-Samandari, Samaneh; Gross, Karlis A

    2013-12-01

    The diversity in the structural and chemical state of apatites allows implant manufacturers to fine-tune implant properties. This requires suitable manufacturing processes and characterization tools to adjust the amorphous phase and hydroxyl content from the source hydroxylapatite. Hydroxylapatite was processed by high-velocity oxy-fuel spraying, plasma spraying and flame spraying, and primarily analyzed by Raman spectroscopy. Investigation of rounded splats, the building blocks of thermal spray coatings, allowed correlation between the visual identity of the splat surface and the Raman spectra. Splats were heat-treated to crystallize any remaining amorphous phase. The ν1 PO4 stretching peak at 950-970 cm(-1) displayed the crystalline order, but the hydroxyl peak at 3572 cm(-1) followed the degree of dehydroxylation. Hydroxyl loss was greatest for flame-sprayed particles, which create the longest residence time for the melted particle. Higher-frequency hydroxyl peaks in flame- and plasma-sprayed splats indicated a lower structural order for the recrystallized hydroxylapatite within the splats. Crystallization at 700 °C has shown potential for revealing hydroxyl ions previously trapped in amorphous calcium phosphate. This work compares Fourier transform infrared and Raman spectroscopy to measure the hydroxyl content in rapidly solidified apatites and shows that Raman spectroscopy is more suitable.

  19. Synthesis and characterization of phosphocitric acid, a potent inhibitor of hydroxylapatite crystal growth.

    PubMed

    Tew, W P; Mahle, C; Benavides, J; Howard, J E; Lehninger, A L

    1980-04-29

    Human urine and extracts of rat liver mitochondria contain apparently identical agents capable of inhibiting the precipitation or crystallization of calcium phosphate. Its general properties, as well as 1H NMR and mass spectra, have suggested that the agent is phosphocitric acid. This paper reports the synthesis of phosphocitric acid via the phosphorylation of triethyl citrate with o-phenylene phosphochloridate, hydrogenolysis of the product to yield triethyl phosphocitrate, hydrolytic removal of the blocking ethyl groups and also chromatographic purification. An enzymatic assay of phosphocitrate is described. Synthetic phosphocitrate was found to be an exceedingly potent inhibitor of the growth of hydroxylapatite seed crystals in a medium supersaturated with respect to Ca2+ and phosphate. Comparative assays showed phosphocitrate to be much more potent than the most active precipitation-crystallization inhibitors previously reported, which include pyrophosphate and ATP. 14C-Labeled phosphocitrate was bound very tightly to hydroxylapatite crystals. Such binding appeared to be essential for its inhibitory activity on crystal growth. Citrate added before but not after, phosphocitrate greatly enhanced the inhibitory potency of the latter. This enhancement effect was not given by other tricarboxylic acids. The monoethyl ester of phosphocitrate had no inhibitory effect on hydroxylapatite crystal growth.

  20. Applying Organ Clearance Concepts in a Clinical Setting

    PubMed Central

    2008-01-01

    Objective To teach doctor of pharmacy (PharmD) students how to apply organ clearance concepts in a clinical setting in order to optimize dose management, select the right drug product, and promote better patient-centered care practices. Design A student-focused 5-hour topic entitled "Organ Clearance Concepts: Modeling and Clinical Applications" was developed and delivered to second-year PharmD students. Active-learning techniques, such as reading assignments and thought-provoking questions, and collaborative learning techniques, such as small groups, were used. Student learning was assessed using application cards and a minute paper. Assessment Overall student responses to topic presentation were overwhelmingly positive. The teaching strategies here discussed allowed students to play an active role in their own learning process and provided the necessary connection to keep them motivated, as mentioned in the application cards and minute paper assessments. Students scored an average of 88% on the examination given at the end of the course. Conclusion By incorporating active-learning and collaborative-learning techniques in presenting material on organ clearance concept, students gained a more thorough knowledge of dose management and drug-drug interactions than if the concepts had been presented using a traditional lecture format. This knowledge will help students in solving critical patient situations in a real-world context. PMID:19214275

  1. Solubilization of the chromatin-bound estrogen receptor from chicken liver and fractionation on hydroxylapatite.

    PubMed

    Gschwendt, M

    1976-08-16

    1. High-affinity estrogen-binding sites can be solubilized from the liver chromatin of estrogenized chickens by treatment of the chromatin with 2 M KCL/5 M urea and fractionation on hydroxylapatite. Two estrogen-binding proteins are eluted from hydroxylapatite columns by 20mM phosphate (binding protein I) and 200mMphosphate (binding protein II), respectively. 2. The binding protein I is part of a non-histone protein fraction containing acid-soluble and insoluble proteins, whereas the binding protein II elutes together with high molecular weight nonhistone proteins containing acid insoluble proteins only. Both binding proteins exhibit the smae affinity for estradiol (Kd approximately 10(-9) M). 3. From chromatin of untreated chickens very small amounts of binding protein I (0.1 pmol/mg protein compared to 1.9 pmol/mg protein from estrogenized chickens) with the smae affinity for estradiol as that from estrogenized animals can be solubilized. Binding protein II is not detectable. 4. The "soluble nuclear estrogen receptor" extracted from crude liver nucleir of estrogenized chickens by 0.5 M KCL behaves on hydroxylapatite very similarly to salt/urea-dissociated chromatin with respect to the binding protein I. No binding protein II, however, can be demonstrated. 5. Chromatography of various preparations on Bio-Gel A-1.5 m indicates that the binding protein II is a residual chromatin fragment containing an unseparated binding protein-DNA complex, whereas the binding protein I represents the solubilized nucleic-acid-free chromosomal estrogen receptor. The "soluble nuclear receptor" and the binding protein I, however, are not identical with respect to their chromatographic behaviour on Bio-Gel A-1.5m, even though their estrogen binding entity remaining after trypsin treatment seems to be very similar.

  2. Investigation of xFe2O4 (x = Mn, Co) doped hydroxylapatite ferromagnetic biomaterials for the treatment of damaged bone and magnetically targeted drug delivery systems

    NASA Astrophysics Data System (ADS)

    Anand, Vikas; Singh, K. J.; Kaur, Kulwinder; Bhatia, Gaurav

    2016-05-01

    Magnetically attracted MnFe2O4 and CoFe2O4 doped hydroxylapatite samples have been prepared by using co-precipitation method in the laboratory. Bioactive nature of samples has been confirmed from XRD spectra. Ferromagnetic behavior of samples has been studied by using vibration sample magnetometer. Human osteoblast cell line MG63 has been used to explore the cell viability of samples. Drug carrier ability of samples has been checked with gentamycin as an antibiotic and results show that samples can be used as excellent drug carriers. Drug loaded samples can be easily targeted to specific area due to their attractive nature towards external magnetic field. Our results indicate that prepared samples possess good bioactive as well as ferromagnetic behavior with drug carrier ability and hence, our samples can be potential candidates for the clinical applications.

  3. Applying artificial intelligence to clinical guidelines: the GLARE approach.

    PubMed

    Terenziani, Paolo; Montani, Stefania; Bottrighi, Alessio; Molino, Gianpaolo; Torchio, Mauro

    2008-01-01

    We present GLARE, a domain-independent system for acquiring, representing and executing clinical guidelines (GL). GLARE is characterized by the adoption of Artificial Intelligence (AI) techniques in the definition and implementation of the system. First of all, a high-level and user-friendly knowledge representation language has been designed. Second, a user-friendly acquisition tool, which provides expert physicians with various forms of help, has been implemented. Third, a tool for executing GL on a specific patient has been made available. At all the levels above, advanced AI techniques have been exploited, in order to enhance flexibility and user-friendliness and to provide decision support. Specifically, this chapter focuses on the methods we have developed in order to cope with (i) automatic resource-based adaptation of GL, (ii) representation and reasoning about temporal constraints in GL, (iii) decision making support, and (iv) model-based verification. We stress that, although we have devised such techniques within the GLARE project, they are mostly system-independent, so that they might be applied to other guideline management systems.

  4. Effects of heat treatment of wood on hydroxylapatite type mineral precipitation and biomechanical properties in vitro.

    PubMed

    Rekola, J; Lassila, L V J; Hirvonen, J; Lahdenperä, M; Grenman, R; Aho, A J; Vallittu, P K

    2010-08-01

    Wood is a natural fiber reinforced composite. It structurally resembles bone tissue to some extent. Specially heat-treated birch wood has been used as a model material for further development of synthetic fiber reinforced composites (FRC) for medical and dental use. In previous studies it has been shown, that heat treatment has a positive effect on the osteoconductivity of an implanted wood. In this study the effects of two different heat treatment temperatures (140 and 200 degrees C) on wood were studied in vitro. Untreated wood was used as a control material. Heat treatment induced biomechanical changes were studied with flexural and compressive tests on dry birch wood as well as on wood after 63 days of simulated body fluid (SBF) immersion. Dimensional changes, SBF sorption and hydroxylapatite type mineral formation were also assessed. The results showed that SBF immersion decreases the biomechanical performance of wood and that the heat treatment diminishes the effect of SBF immersion on biomechanical properties. With scanning electron microscopy and energy dispersive X-ray analysis it was shown that hydroxylapatite type mineral precipitation formed on the 200 degrees C heat-treated wood. An increased weight gain of the same material during SBF immersion supported this finding. The results of this study give more detailed insight of the biologically relevant changes that heat treatment induces in wood material. Furthermore the findings in this study are in line with previous in vivo studies.

  5. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  6. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  7. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  8. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  9. 42 CFR 55a.102 - Who is eligible to apply for a Black Lung clinics grant?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Who is eligible to apply for a Black Lung clinics... SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.102 Who is eligible to apply for a Black Lung clinics grant? Any State or public or private entity may apply for a grant under...

  10. Methodologic approach to adverse events applied to bupropion clinical trials.

    PubMed

    Cato, A E; Cook, L; Starbuck, R; Heatherington, D

    1983-05-01

    A strategy for identifying and classifying adverse events and for assessing their relationship to therapy and frequency of occurrence is presented. Data from clinical trials of bupropion (Wellbutrin), a novel antidepressant, are presented as an example. Bupropion was studied in four double-blind, placebo-controlled trials (N = 360) at dosages of 300-750 mg/day. The incidence and frequency of adverse events associated with bupropion were minimal, and correlated well with the known pharmacologic and clinical properties of this new antidepressant. PMID:6406455

  11. [Genetics applied to clinical practice in neurodevelopmental disorders].

    PubMed

    Fernández-Jaén, Alberto; Cigudosa, Juan C; Martín Fernández-Mayoralas, Daniel; Suela, Javier; Fernández-Perrone, Ana L; Calleja-Pérez, Beatriz; López-Martín, Sara

    2014-02-24

    The medical literature contains a wide body of evidence supporting genetic involvement in neurodevelopmental disorders. Advances made in genetics and technology have increased the diagnostic cost-effectiveness of current studies from 3-5% to 30-40% in patients with intellectual disability or autism spectrum disorders. In this regard, chromosomal microarray studies display greater diagnostic power than conventional techniques (karyotype, subtelomeric analyses, etc.). The latest protocols in the biomedical field of the genetic study of these disorders cite chromosomal microarrays as the first-line analysis, while also recommending other specific studies depending on the patient's clinical features (fragile X syndrome, PTEN mutation, etc.). In the evaluation of other neurodevelopmental disorders (attention deficit hyperactivity disorder, learning disorders, etc.), the number of genetic tests carried out is limited and conditioned by the clinical characteristics or the patient's familial or personal history. Even in these situations, there are no genetic referral or evaluation protocols.

  12. When the FRAX® test is applied to controlled clinical trials

    PubMed Central

    Fiore, Carmelo Erio; Gaudio, Agostino

    2012-01-01

    Summary FRAX® is a computer-based algorithm developed by the World Health Organization Collaborating Centre for Metabolic Bone Diseases in Sheffield (UK). This algorithm calculates fracture probability from easily obtained clinical risk factors in men and women: age, sex, body mass index and dichotomized variables comprising prior fragility fracture, parental history of hip fracture, current tobacco smoking, use of long-term oral glucocorticoid, rheumatoid arthritis, other causes of secondary osteoporosis and high alcohol consumption (femoral neck bone mineral density can be optionally input to enhance fracture risk prediction). The output of FRAX® is the 10-year probability of a major osteoporotic fracture (hip, clinical spine, humerus or wrist fracture) and the 10-year probability of hip fracture. Recently various Authors have re-evaluated the effectiveness of drugs approved for postmenopausal osteoporosis to test whether they are more effective in women with higher FRAX® probabilities. PMID:23289024

  13. The Psychiatric Cultural Formulation: Applying Medical Anthropology in Clinical Practice

    PubMed Central

    Aggarwal, Neil Krishan

    2014-01-01

    This paper considers revisions to the DSM-IV Outline for Cultural Formulation from the perspective of clinical practice. First, the paper explores the theoretical development of the Cultural Formulation. Next, a case presentation demonstrates challenges in its actual implementation. Finally, the paper recommends a set of questions for the clinician on barriers to care and countertransference. The development of a standardized, user-friendly format can increase the Cultural Formulation’s utilization among all psychiatrists beyond those specializing in cultural psychiatry. PMID:22418398

  14. Synthesis and solubility of Pb-Ca and P-As hydroxylapatite solid solutions

    NASA Astrophysics Data System (ADS)

    Puzio, Bartosz; Młynarska, Maria; Motyka, Joanna; Oknińska, Joanna; Mandelt, Agnieszka; Chlebowska, Patrycja; Kwaśniak-Kominek, Monika; Manecki, Maciej

    2016-04-01

    The objective of the study are three solid solution series: - HPY hydroxylpyromorphite Pb5(PO4)3OH - HAP hydroxylapatite Ca5(PO4)3OH - HAP hydroxylapatite Ca5(PO4)3OH - JBM johnbaumite Ca5(AsO4)3OH - JBM johnbaumite Ca5(AsO4)3OH - HMI hydroxylmimetite Pb5(AsO4)3OH The phases were synthesized from aqueous solutions at high pH (over 8) at ambient temperature by dropwise mixing of chemical reagents: Pb(NO3)2, Ca(NO3)2.4H2O, (NH4)H2PO4, and Na2AsHO4.7H2O. The products of all syntheses are crystalline, monomineral fine powders (crystal size less than 1 μm). Their chemical composition is close to theoretical. Systematic shift of XRD peaks and FTIR or Raman bands is observed within the solid solution series. Dissolution experiments were run at 5oC, 25oC, 45oC, and 65oC. An aliquot of 0.5g of each phase was dissolved in 250 mL of 0.05M NH4NO3 (pH between 3 and 5) for about 3 months. In all cases dissolution resulted in increase of pH by about 1. The systems were considered in equilibrium when three consecutive samplings (ca. two weeks apart) resulted in similar concentrations (within 3 standard deviations). The dissolution of all phases in question is incongruent. The amount of precipitating secondary phases was too small for identification. The results of HPY - HAP dissolution experiments are inconclusive due to strongly incongruent dissolution. This is partially in contrary to recent report by Zhu et al. (2015). Systematic increase of solubility is observed in HAP - JBM series. Also, the solubility of these phases increases with the increase of temperature. This is more pronounced for HAP than for JBM. Systematic increase of solubility is also observed in HMI - JBM series. This work is partially funded by AGH research grant no 11.11.140.319 and partially by Polish NCN grant No 2014/01/M/ST10/00355. Zhu,Y., Zhu, Z., Zhao, X., Liang, Y., Huang, Y., 2015. Characterization, dissolution, and solubility of lead hydroxypyromorphite Pb5(PO4)3OH at 25-45oC. Journal of Chemistry

  15. Plasma-Sprayed Hydroxylapatite-Based Coatings: Chemical, Mechanical, Microstructural, and Biomedical Properties

    NASA Astrophysics Data System (ADS)

    Heimann, Robert B.

    2016-06-01

    This contribution discusses salient properties and functions of hydroxylapatite (HA)-based plasma-sprayed coatings, including the effect on biomedical efficacy of coating thickness, phase composition and distribution, amorphicity and crystallinity, porosity and surface roughness, cohesion and adhesion, micro- and nano-structured surface morphology, and residual coating stresses. In addition, it will provide details of the thermal alteration that HA particles undergo in the extremely hot plasma jet that leads to dehydroxylated phases such as oxyhydroxylapatite (OHA) and oxyapatite (OA) as well as thermal decomposition products such as tri-(TCP) and tetracalcium phosphates (TTCP), and quenched phases such as amorphous calcium phosphate (ACP). The contribution will further explain the role of ACP during the in vitro interaction of the as-deposited coatings with simulated body fluid resembling the composition of extracellular fluid (ECF) as well as the in vivo responses of coatings to the ECF and the host tissue, respectively. Finally, it will briefly describe performance profiles required to fulfill biological functions of osteoconductive bioceramic coatings designed to improve osseointegration of hip endoprostheses and dental root implants. In large parts, the content of this contribution is a targeted review of work done by the author and his students and coworkers over the last two decades. In addition, it is considered a stepping stone toward a standard operation procedure aimed at depositing plasma-sprayed bioceramic implant coatings with optimum properties.

  16. Electron microscope characteristics of dentin repair after hydroxylapatite direct pulp capping in rats.

    PubMed

    Jaber, L; Mascrès, C; Donohue, W B

    1991-11-01

    In order to study the osteogenic action of hydroxylapatite (HA) on the dental pulp, a pulp capping experiment was designed using the rat upper molar. Under general anesthesia, molar teeth in 14 male Sprague-Dawley rats were pulp capped with Osteogen (HA) or with Dycal as a control material. After pulp capping, the maxillary molars cavities were restored with amalgam and a pedodontic steel crown was adjusted and sealed over the molar teeth on either side of the maxilla. After 7 days, the areas of necrosis and acute inflammation were more evident in the pulps treated with Dycal than with Osteogen. Hard tissue formation began to appear around dentinal chips in the pulp and extended from the cavity walls into the pulp regardless of the material that was used. Furthermore, this calcified material was scattered throughout the pulp when Osteogen was used, but was not observed in the Dycal treated pulps. The hard tissue formation was thought to be due to the putative fibroblasts and odontoblasts found in the pulp. After 28 days dense dentinal tissue was observed bridging the exposure site when Dycal was used. The dentinal tissues formed with Osteogen was always of a globular type, and showed an irregular distribution. Since Osteogen tends to cause areas of dystrophic calcification in the pulp, its use is not be recommended for pulp capping purposes in humans, because these areas of calcification would make future endodontic treatment difficult. PMID:1661333

  17. Calcium hydroxylapatite filler for facial rejuvenation: a histologic and immunohistochemical analysis.

    PubMed

    Berlin, Alexander L; Hussain, Mussarratt; Goldberg, David J

    2008-06-01

    BACKGROUND Soft-tissue augmentation using calcium hydroxylapatite (CaHA) filler has been shown to be a safe and effective filler agent. A previous study utilizing electron microscopy demonstrated deposition of collagen around filler microspheres with minimal inflammatory response. OBJECTIVE The purpose of this study was to further characterize the expression of collagen in response to injected CaHA filler material using conventional, special, and immunohistochemical (IHC) staining. MATERIALS AND METHODS Five subjects with mild to moderate nasolabial rhytids underwent a single treatment with CaHA filler. Additionally, 0.1 to 0.2 mL of the filler material was injected subdermally into the postauricular area. Six months following the treatment, all subjects underwent biopsy of the treated postauricular area. Biopsies were analyzed using hematoxylin and eosin staining, special staining with picrosirius red (PSR), and IHC staining for collagen Types I and III. RESULTS All subjects completed the study with no complications. Biopsy specimens revealed increased deposition of collagen around the filler material, which was confirmed and further characterized using PSR and IHC staining. CONCLUSION Soft tissue augmentation with CaHA filler leads to long-term deposition of new collagen surrounding filler microspheres, which may contribute to the overall improvement in the appearance of treated rhytids.

  18. Low incidence of severe adverse effects after mandibular ridge reconstruction using hydroxylapatite.

    PubMed

    Mercier, P; Bellavance, F

    1999-08-01

    The short and long term adverse effects after ridge reconstruction using hydroxylapatite (HA) are presented in this study. The HA was inserted using a modified tunnelling technique, followed by a lowering of the floor of the mouth and a vestibuloplasty using split thickness skin graft, 4-6 weeks later. The study comprised 637 patients followed for a period of 1 to 10 years (mean 6.0+/-2.6 years). Major loss of HA was seen in 17 patients (2.7%). Donor site visibility (skin graft) appeared to improve greatly over the years from 29.2% to 8.8% at the latest follow-up. Neurosurgery deficits also improved from 11.6% (paraesthesia and dysaesthesia) to 4.6%. Long term follow-up revealed a high percentage of patient satisfaction (97%), indicating that the low incidence of severe adverse effects of the procedure does play a significant role in the appreciation of the procedure and prosthetic care. PMID:10416894

  19. Influence of cell surface characteristics on adhesion of Saccharomyces cerevisiae to the biomaterial hydroxylapatite.

    PubMed

    White, Jane S; Walker, Graeme M

    2011-02-01

    The influence of the physicochemical properties of biomaterials on microbial cell adhesion is well known, with the extent of adhesion depending on hydrophobicity, surface charge, specific functional groups and acid-base properties. Regarding yeasts, the effect of cell surfaces is often overlooked, despite the fact that generalisations may not be made between closely related strains. The current investigation compared adhesion of three industrially relevant strains of Saccharomyces cerevisiae (M-type, NCYC 1681 and ALY, strains used in production of Scotch whisky, ale and lager, respectively) to the biomaterial hydroxylapatite (HAP). Adhesion of the whisky yeast was greatest, followed by the ale strain, while adhesion of the lager strain was approximately 10-times less. According to microbial adhesion to solvents (MATS) analysis, the ale strain was hydrophobic while the whisky and lager strains were moderately hydrophilic. This contrasted with analyses of water contact angles where all strains were characterised as hydrophilic. All yeast strains were electron donating, with low electron accepting potential, as indicated by both surface energy and MATS analysis. Overall, there was a linear correlation between adhesion to HAP and the overall surface free energy of the yeasts. This is the first time that the relationship between yeast cell surface energy and adherence to a biomaterial has been described.

  20. Adsorption of arsenic with struvite and hydroxylapatite in phosphate-bearing solutions.

    PubMed

    Rouff, Ashaki A; Ma, Ning; Kustka, Adam B

    2016-03-01

    Arsenic sorption at above neutral pH is relevant when considering contaminant mobility in alkaline, phosphorus-bearing wastewaters, and may be viable in the presence phosphate minerals. Arsenic adsorption on struvite (MgNH4PO4 · 6H2O, MAP) and hydroxylapatite (Ca5(PO4)3OH, HAP) was evaluated at pH 8-11 from solutions with 2.7-0.125 mM phosphate and 0.05 mM As(III) or As(V). Over 7 d, As(III) removal from solution was minimal, but As(V) removal increased with pH, and was higher in the presence of MAP compared to HAP with a maximum of 74% removal in pH 11 MAP-bearing solutions. X-ray absorption fine structure spectroscopy (XAFS) analysis of solids recovered from pH 10-11 solutions revealed different mechanisms of As(V) sorption with MAP and HAP. Arsenic forms monodentate mononuclear surface complexes with MAP through the formation of a Mg-O-As bond, but is incorporated at the near-surface of HAP forming a johnbaumite-like (Ca5(AsO4)3OH) structure. Experiments using radioactive (33)P at pH 10-11 revealed faster exchange of P at the HAP surface, which could promote more facile As incorporation. Near-surface incorporated As in HAP may be less susceptible to remobilization compared to surface adsorbates formed with MAP. Overall, both MAP and HAP may sorb As at high pH in the presence of phosphate. This is relevant to the fate of As in alkaline contaminated waters in contact with phosphate mineral phases.

  1. The Effect of Applying Direct Observation of Procedural Skills (DOPS) on Nursing Students’ Clinical Skills: A Randomized Clinical Trial

    PubMed Central

    Hengameh, Habibi; Afsaneh, Raiesifar; Morteza, Khaghanizade; Hosein, Mahmudi; Marjan, Seyed Mazhari; Ebadi, Abbas

    2015-01-01

    Background: Remarkable advances in educational measurement have proved need to the implementation of modern and appropriate methods of clinical evaluation. This study was carried out to compare the effect of applying direct observation procedural skills and routine evaluation method on clinical skills of nursing students. Methods: This randomized clinical trial was conducted on students of Nursing Army College, Tehran, Iran. After obtaining approval from the Ethics Committee of the Baqiyatallah University of Medical Sciences Research Deputy, all nursing students and instructors who agreed to participate in this study sign the informed consent. The participants were randomly assigned into intervention and control groups. After the teachers were trained and an inter-raters reliability test was conducted, evaluation was performed through DOPS in the intervention group while the control groups were evaluated through the routine method. Assessment checklists for two procedures (Intra venous catheterization and change dressing) were valid and reliable. Finally data were analyzed through descriptive and analytical statistics (Chi-square, t-test, Repeated Measure ANOVA) using SPSS version 16. Results: No significant difference was observed between the two groups in terms of demographic variables (P>0.05), but a significant difference was observed between intervention and control scores (P=0.000). In other words, application of DOPS has improved clinical skills of the students significantly. Conclusion: Using this new method improved the students’ scores in clinical procedures implementation; therefore, we suggest that nursing colleges apply this evaluation method for clinical education. PMID:26153199

  2. Improving biological relevancy of transcriptional biomarkers experiments by applying the MIQE guidelines to pre-clinical and clinical trials.

    PubMed

    Dooms, M; Chango, A; Barbour, E; Pouillart, P; Abdel Nour, A M

    2013-01-01

    The "Minimum Information for the Publication of qPCR Experiments" (MIQE [3]) guidelines are very much targeted at basic research experiments and have to our knowledge not been applied to qPCR assays carried out in the context of clinical trials. This report details the use of the MIQE qPCR app for iPhone (App Store, Apple) to assess the MIQE compliance of one clinical and five pre-clinical trials. This resulted in the need to include 14 modifications that make the guidelines more relevant for the assessment of this special type of application. We also discuss the need for flexibility, since while some parameters increase experimental quality, they also require more reagents and more time, which is not always feasible in a clinical setting. PMID:22910527

  3. An evaluation of calcium hydroxylapatite (Radiesse) for cosmetic nasolabial fold correction: a meta-analysis and patient centric outcomes study.

    PubMed

    Fakhre, G Peter; Perdikis, Galen; Shaddix, Kyle K; Terkonda, Sarvam P; Waldorf, James C

    2009-11-01

    The use of calcium hydroxylapatite (Radiesse, BioForm Medical, San Mateo, California) for cosmetic soft tissue augmentation has increased significantly in recent years. Only a handful of authors have reported patient satisfaction data. A meta-analysis of published data was performed using a 5-point scale for patient satisfaction to allow data comparison across studies. A patient-centric outcomes study was also performed at our institution, using a blinded questionnaire. Five usable studies were identified for meta-analysis. Patient satisfaction was 4.16 of 5 in 324 patients at 3 to 6 months and 4.15 in 86 patients at 1 year. In our institutional patient-centric outcomes study, the early satisfaction rate was 3.7 of 5. At 1 year the rate was only 2.3 of 5. Calcium hydroxylapatite remains a viable option for augmentation of facial soft tissue structures. However, this report shows that further, accurate, large population outcomes assessments are absolutely required.

  4. Multimodal tissue perfusion imaging using multi-spectral and thermographic imaging systems applied on clinical data

    NASA Astrophysics Data System (ADS)

    Klaessens, John H. G. M.; Nelisse, Martin; Verdaasdonk, Rudolf M.; Noordmans, Herke Jan

    2013-03-01

    Clinical interventions can cause changes in tissue perfusion, oxygenation or temperature. Real-time imaging of these phenomena could be useful for surgical strategy or understanding of physiological regulation mechanisms. Two noncontact imaging techniques were applied for imaging of large tissue areas: LED based multispectral imaging (MSI, 17 different wavelengths 370 nm-880 nm) and thermal imaging (7.5 to 13.5 μm). Oxygenation concentration changes were calculated using different analyzing methods. The advantages of these methods are presented for stationary and dynamic applications. Concentration calculations of chromophores in tissue require right choices of wavelengths The effects of different wavelength choices for hemoglobin concentration calculations were studied in laboratory conditions and consequently applied in clinical studies. Corrections for interferences during the clinical registrations (ambient light fluctuations, tissue movements) were performed. The wavelength dependency of the algorithms were studied and wavelength sets with the best results will be presented. The multispectral and thermal imaging systems were applied during clinical intervention studies: reperfusion of tissue flap transplantation (ENT), effectiveness of local anesthetic block and during open brain surgery in patients with epileptic seizures. The LED multispectral imaging system successfully imaged the perfusion and oxygenation changes during clinical interventions. The thermal images show local heat distributions over tissue areas as a result of changes in tissue perfusion. Multispectral imaging and thermal imaging provide complementary information and are promising techniques for real-time diagnostics of physiological processes in medicine.

  5. Metabolic phenotyping applied to pre-clinical and clinical studies of acetaminophen metabolism and hepatotoxicity.

    PubMed

    Coen, Muireann

    2015-02-01

    Acetaminophen (APAP, paracetamol, N-acetyl-p-aminophenol) is a widely used analgesic that is safe at therapeutic doses but is a major cause of acute liver failure (ALF) following overdose. APAP-induced hepatotoxicity is related to the formation of an electrophilic reactive metabolite, N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified through conjugation with reduced glutathione (GSH). One method that has been applied to study APAP metabolism and hepatotoxicity is that of metabolic phenotyping, which involves the study of the small molecule complement of complex biological samples. This approach involves the use of high-resolution analytical platforms such as NMR spectroscopy and mass spectrometry to generate information-rich metabolic profiles that reflect both genetic and environmental influences and capture both endogenous and xenobiotic metabolites. Data modeling and mining and the subsequent identification of panels of candidate biomarkers are typically approached with multivariate statistical tools. We review the application of multi-platform metabolic profiling for the study of APAP metabolism in both in vivo models and humans. We also review the application of metabolic profiling for the study of endogenous metabolic pathway perturbations in response to APAP hepatotoxicity, with a particular focus on metabolites involved in the biosynthesis of GSH and those that reflect mitochondrial function such as long-chain acylcarnitines. Taken together, this body of work sheds much light on the mechanism of APAP-induced hepatotoxicity and provides candidate biomarkers that may prove of translational relevance for improved stratification of APAP-induced ALF.

  6. Case Study: Applying OpenEHR Archetypes to a Clinical Data Repository in a Chinese Hospital.

    PubMed

    Min, Lingtong; Wang, Li; Lu, Xudong; Duan, Huilong

    2015-01-01

    openEHR is a flexible and scalable modeling methodology for clinical information and has been widely adopted in Europe and Australia. Due to the reasons of differences in clinical process and management, there are few research projects involving openEHR in China. To investigate the feasibility of openEHR methodology for clinical information modelling in China, this paper carries out a case study to apply openEHR archetypes to Clinical Data Repository (CDR) in a Chinese hospital. The results show that a set of 26 archetypes are found to cover all the concepts used in the CDR. Of all these, 9 (34.6%) are reused without change, 10 are modified and/or extended, and 7 are newly defined. The reasons for modification, extension and newly definition have been discussed, including granularity of archetype, metadata-level versus data-level modelling, and the representation of relationships between archetypes. PMID:26262040

  7. Osseointegration of titanium fixtures in onlay grafting procedures with autogenous bone and hydroxylapatite. An experimental histometric study.

    PubMed

    Schliephake, H; van den Berghe, P; Neukam, F W

    1991-01-01

    The aim of the present study was to determine the degree of osseointegration of fixtures in different onlay grafting materials. Hydroxylapatite blocks of 2 different pore sizes and free monocortical bone grafts from the iliac crest were inserted in Göttingen minipigs and fixed with 2 titanium fixtures. The extent of the bone/implant interface area on the fixture surface was determined from histological specimens by morphometric measurements and related to the total thread surface of the fixtures. Fixtures inserted into bone grafts showed the most complete degree of osseointegration, whereas the smallest bone/implant interface area was found with fixtures inserted into those HA blocks with the smaller pore size. There was a significant decrease in the degree of osseointegration between the host bone site and the augmentation material only with the fixtures inserted into the HA blocks of smaller pore size.

  8. From the galleries to the clinic: applying art museum lessons to patient care.

    PubMed

    Miller, Alexa; Grohe, Michelle; Khoshbin, Shahram; Katz, Joel T

    2013-12-01

    Increasingly, medical educators integrate art-viewing into curricular interventions that teach clinical observation-often with local art museum educators. How can cross-disciplinary collaborators explicitly connect the skills learned in the art museum with those used at the bedside? One approach is for educators to align their pedagogical approach using similar teaching methods in the separate contexts of the galleries and the clinic. We describe two linked pedagogical exercises--Visual Thinking Strategies (VTS) in the museum galleries and observation at the bedside--from "Training the Eye: Improving the Art of Physical Diagnosis," an elective museum-based course at Harvard Medical School. It is our opinion that while strategic interactions with the visual arts can improve skills, it is essential for students to apply them in a clinical context with faculty support-requiring educators across disciplines to learn from one another.

  9. John or Jane? Exploring how clinical judgment is applied in managing access to opioid replacement therapy.

    PubMed

    Harlow, Warren; Happell, Brenda; Browne, Graeme

    2013-01-01

    In Australia, access to Opioid Replacement Therapy (ORT) poses a problem for clinicians when confronted with multiple requests for ORT treatment. This article forms part of a broader grounded theory study exploring how clinicians apply clinical judgement in managing access to ORT programs. The focus of this article is to report on the codes generated from the study's data analysis and to discuss how they influence clinician responses to the process. From March to August 2012, 35 clinicians from 10 publicly funded ORT clinics within the states of Queensland and New South Wales were recruited. To stimulate clinicians to use their clinical judgment, a scenario was presented requiring participants to choose between two consumers for preferential access to ORT and explain why. Responses as to who should receive treatment first varied between clinicians. Reasoning for their decisions was diverse, except "prioritising" was a consistently presenting element. Previous education, training, work experience, and their peers were all factors identified as influencing their decision making. Not all clinicians were confident with their choice. This study examined how clinical judgement is applied in managing access to ORT, showing variation in clinician responses and the factors influencing those decisions.

  10. Applying knowledge-anchored hypothesis discovery methods to advance clinical and translational research: the OAMiner project

    PubMed Central

    Jackson, Rebecca D; Best, Thomas M; Borlawsky, Tara B; Lai, Albert M; James, Stephen; Gurcan, Metin N

    2012-01-01

    The conduct of clinical and translational research regularly involves the use of a variety of heterogeneous and large-scale data resources. Scalable methods for the integrative analysis of such resources, particularly when attempting to leverage computable domain knowledge in order to generate actionable hypotheses in a high-throughput manner, remain an open area of research. In this report, we describe both a generalizable design pattern for such integrative knowledge-anchored hypothesis discovery operations and our experience in applying that design pattern in the experimental context of a set of driving research questions related to the publicly available Osteoarthritis Initiative data repository. We believe that this ‘test bed’ project and the lessons learned during its execution are both generalizable and representative of common clinical and translational research paradigms. PMID:22647689

  11. Method to integrate clinical guidelines into the electronic health record (EHR) by applying the archetypes approach.

    PubMed

    Garcia, Diego; Moro, Claudia Maria Cabral; Cicogna, Paulo Eduardo; Carvalho, Deborah Ribeiro

    2013-01-01

    Clinical guidelines are documents that assist healthcare professionals, facilitating and standardizing diagnosis, management, and treatment in specific areas. Computerized guidelines as decision support systems (DSS) attempt to increase the performance of tasks and facilitate the use of guidelines. Most DSS are not integrated into the electronic health record (EHR), ordering some degree of rework especially related to data collection. This study's objective was to present a method for integrating clinical guidelines into the EHR. The study developed first a way to identify data and rules contained in the guidelines, and then incorporate rules into an archetype-based EHR. The proposed method tested was anemia treatment in the Chronic Kidney Disease Guideline. The phases of the method are: data and rules identification; archetypes elaboration; rules definition and inclusion in inference engine; and DSS-EHR integration and validation. The main feature of the proposed method is that it is generic and can be applied toany type of guideline. PMID:23920682

  12. Clinically applied medical ethnography: relevance to cultural competence in patient care.

    PubMed

    Engebretson, Joan

    2011-06-01

    Medical anthropology provides an excellent resource for nursing research that is relevant to clinical nursing. By expanding the understanding of ethnographic research beyond ethnicity, nurses can conduct research that explores patient's constructions and explanatory models of health and healing and how they make meaning out of chronic conditions and negotiate daily life. These findings can have applicability to culturally competent care at both the organizational or systems level, as well as in the patient/provider encounter. Individual patient care can be improved by applying ethnographic research findings to build provider expertise and then using a cultural negotiation process for individualized patient care.

  13. Health technopole: innovation applied to clinical engineering & health technology management education.

    PubMed

    Vilcahuaman, L; Rivas, R

    2010-01-01

    In the Peruvian Health System, Clinical Engineering does not exist as a topic of intervention. 59% of biomedical equipment is officially classified as operational, however next to apply the correct classification methodology and include security issues, only 10% of the equipment are suitable for use in patients. The serious consequences for patients, is opposite to the increased public investment in the health sector. Reversing this context leads to structural changes at all levels of the organization and they will be achievable only through an appropriate educational program. A strategy focused on joint of capacities called Health Technopole has managed to implement an innovative Model of Education in Healthcare Technology Management HTM and Clinical Engineering CE aimed at solving this problem. The proposal focused on strategies to strengthen the educational goals such as creating HTM & CE Units in hospitals, the implementation of the methodology: Problem Based Learning and Project Management in HTM & CE in classroom and on line courses. The process includes an effective interaction with global organizations through teleconferences, Internships, Workshops and Seminars. A key component was the sustained multidisciplinary approach. Health Technopole CENGETS is an expert adviser for the Ministry of Health and is called for trainings, design training programs for regional governments and also supports global organizations such as PAHO / WHO and ORAS / CONHU. The proposal of innovation applied to HTM & CE Education is effective and is a benchmark for similar countries. PMID:21096296

  14. Constructivism applied to psychiatric-mental health nursing: an alternative to supplement traditional clinical education.

    PubMed

    DeCoux Hampton, Michelle

    2012-02-01

    With the popularity of accelerated pre-licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism-based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric-mental health nursing course. Students participated in a 10-week, multistage project that examined life histories, treatment resources, and evidence-based practice, as applied to a single individual with a mental illness. Students reported increased understanding of mental health and illness, developed personal relevance associated with the knowledge gained, and learned to problem solve with regard to nursing care of individuals diagnosed with mental illness. For many students, there also appeared to be a reduction in stigmatized attitudes towards mental illness. Constructivism-based learning is a promising alternative to supplement clinical hours, while effectively achieving learning outcomes. Future research is needed to further validate the use of this method for the learning of course content, as well as the reduction of stigma.

  15. Rorschach scores in applied clinical practice: a survey of perceived validity by experienced clinicians.

    PubMed

    Meyer, Gregory J; Hsiao, Wei-Cheng; Viglione, Donald J; Mihura, Joni L; Abraham, Leah M

    2013-01-01

    We surveyed practicing clinicians who regularly used the Rorschach about the perceived clinical validity of specific Rorschach scores from many coding systems. The survey included quantitative feedback on the validity of specific variables as well as qualitative input in several areas, including the validity of specific variables, the potentially unique information that can be obtained from them, coding challenges associated with Comprehensive System (CS) codes, and recommendations for CS developments. Participants were recruited by applying a snowball sampling strategy. Based on responses from 246 experienced clinicians from 26 countries, composite judgments on rated variables were quite reliable (e.g., M α = .95 across 88 CS variables), despite limited agreement among any 2 judges. The aggregated judgments clearly differentiated among scores that were considered more and less clinically valid and the overall results aligned with recently obtained meta-analytic conclusions from the traditional validity literature (Mihura, Meyer, Dumitrascu, & Bombel, 2012). The judges also provided guidance concerning revisions and enhancements that would facilitate Rorschach-based assessment in the future. We discuss the implication of the quantitative and qualitative findings and provide suggestions for future directions based on the results. PMID:23452352

  16. Applying Automated MR-Based Diagnostic Methods to the Memory Clinic: A Prospective Study.

    PubMed

    Klöppel, Stefan; Peter, Jessica; Ludl, Anna; Pilatus, Anne; Maier, Sabrina; Mader, Irina; Heimbach, Bernhard; Frings, Lars; Egger, Karl; Dukart, Juergen; Schroeter, Matthias L; Perneczky, Robert; Häussermann, Peter; Vach, Werner; Urbach, Horst; Teipel, Stefan; Hüll, Michael; Abdulkadir, Ahmed

    2015-01-01

    Several studies have demonstrated that fully automated pattern recognition methods applied to structural magnetic resonance imaging (MRI) aid in the diagnosis of dementia, but these conclusions are based on highly preselected samples that significantly differ from that seen in a dementia clinic. At a single dementia clinic, we evaluated the ability of a linear support vector machine trained with completely unrelated data to differentiate between Alzheimer's disease (AD), frontotemporal dementia (FTD), Lewy body dementia, and healthy aging based on 3D-T1 weighted MRI data sets. Furthermore, we predicted progression to AD in subjects with mild cognitive impairment (MCI) at baseline and automatically quantified white matter hyperintensities from FLAIR-images. Separating additionally recruited healthy elderly from those with dementia was accurate with an area under the curve (AUC) of 0.97 (according to Fig. 4). Multi-class separation of patients with either AD or FTD from other included groups was good on the training set (AUC >  0.9) but substantially less accurate (AUC = 0.76 for AD, AUC = 0.78 for FTD) on 134 cases from the local clinic. Longitudinal data from 28 cases with MCI at baseline and appropriate follow-up data were available. The computer tool discriminated progressive from stable MCI with AUC = 0.73, compared to AUC = 0.80 for the training set. A relatively low accuracy by clinicians (AUC = 0.81) illustrates the difficulties of predicting conversion in this heterogeneous cohort. This first application of a MRI-based pattern recognition method to a routine sample demonstrates feasibility, but also illustrates that automated multi-class differential diagnoses have to be the focus of future methodological developments and application studies.

  17. Applying Automated MR-Based Diagnostic Methods to the Memory Clinic: A Prospective Study.

    PubMed

    Klöppel, Stefan; Peter, Jessica; Ludl, Anna; Pilatus, Anne; Maier, Sabrina; Mader, Irina; Heimbach, Bernhard; Frings, Lars; Egger, Karl; Dukart, Juergen; Schroeter, Matthias L; Perneczky, Robert; Häussermann, Peter; Vach, Werner; Urbach, Horst; Teipel, Stefan; Hüll, Michael; Abdulkadir, Ahmed

    2015-01-01

    Several studies have demonstrated that fully automated pattern recognition methods applied to structural magnetic resonance imaging (MRI) aid in the diagnosis of dementia, but these conclusions are based on highly preselected samples that significantly differ from that seen in a dementia clinic. At a single dementia clinic, we evaluated the ability of a linear support vector machine trained with completely unrelated data to differentiate between Alzheimer's disease (AD), frontotemporal dementia (FTD), Lewy body dementia, and healthy aging based on 3D-T1 weighted MRI data sets. Furthermore, we predicted progression to AD in subjects with mild cognitive impairment (MCI) at baseline and automatically quantified white matter hyperintensities from FLAIR-images. Separating additionally recruited healthy elderly from those with dementia was accurate with an area under the curve (AUC) of 0.97 (according to Fig. 4). Multi-class separation of patients with either AD or FTD from other included groups was good on the training set (AUC >  0.9) but substantially less accurate (AUC = 0.76 for AD, AUC = 0.78 for FTD) on 134 cases from the local clinic. Longitudinal data from 28 cases with MCI at baseline and appropriate follow-up data were available. The computer tool discriminated progressive from stable MCI with AUC = 0.73, compared to AUC = 0.80 for the training set. A relatively low accuracy by clinicians (AUC = 0.81) illustrates the difficulties of predicting conversion in this heterogeneous cohort. This first application of a MRI-based pattern recognition method to a routine sample demonstrates feasibility, but also illustrates that automated multi-class differential diagnoses have to be the focus of future methodological developments and application studies. PMID:26401773

  18. Clinical usefulness of the clock drawing test applying rasch analysis in predicting of cognitive impairment.

    PubMed

    Yoo, Doo Han; Lee, Jae Shin

    2016-07-01

    [Purpose] This study examined the clinical usefulness of the clock drawing test applying Rasch analysis for predicting the level of cognitive impairment. [Subjects and Methods] A total of 187 stroke patients with cognitive impairment were enrolled in this study. The 187 patients were evaluated by the clock drawing test developed through Rasch analysis along with the mini-mental state examination of cognitive evaluation tool. An analysis of the variance was performed to examine the significance of the mini-mental state examination and the clock drawing test according to the general characteristics of the subjects. Receiver operating characteristic analysis was performed to determine the cutoff point for cognitive impairment and to calculate the sensitivity and specificity values. [Results] The results of comparison of the clock drawing test with the mini-mental state showed significant differences in according to gender, age, education, and affected side. A total CDT of 10.5, which was selected as the cutoff point to identify cognitive impairement, showed a sensitivity, specificity, Youden index, positive predictive, and negative predicive values of 86.4%, 91.5%, 0.8, 95%, and 88.2%. [Conclusion] The clock drawing test is believed to be useful in assessments and interventions based on its excellent ability to identify cognitive disorders.

  19. Clinical usefulness of the clock drawing test applying rasch analysis in predicting of cognitive impairment

    PubMed Central

    Yoo, Doo Han; Lee, Jae Shin

    2016-01-01

    [Purpose] This study examined the clinical usefulness of the clock drawing test applying Rasch analysis for predicting the level of cognitive impairment. [Subjects and Methods] A total of 187 stroke patients with cognitive impairment were enrolled in this study. The 187 patients were evaluated by the clock drawing test developed through Rasch analysis along with the mini-mental state examination of cognitive evaluation tool. An analysis of the variance was performed to examine the significance of the mini-mental state examination and the clock drawing test according to the general characteristics of the subjects. Receiver operating characteristic analysis was performed to determine the cutoff point for cognitive impairment and to calculate the sensitivity and specificity values. [Results] The results of comparison of the clock drawing test with the mini-mental state showed significant differences in according to gender, age, education, and affected side. A total CDT of 10.5, which was selected as the cutoff point to identify cognitive impairement, showed a sensitivity, specificity, Youden index, positive predictive, and negative predicive values of 86.4%, 91.5%, 0.8, 95%, and 88.2%. [Conclusion] The clock drawing test is believed to be useful in assessments and interventions based on its excellent ability to identify cognitive disorders. PMID:27512283

  20. Developing a technology for the use of operant extinction in clinical settings: an examination of basic and applied research.

    PubMed Central

    Lerman, D C; Iwata, B A

    1996-01-01

    Extinction of operant behavior, which involves terminating the reinforcement contingency that maintains a response, is important to the development, generalization, and reduction of behavior in clinical settings. We review basic and applied research findings on variables that influence the direct and indirect effects of extinction and discuss the potential value of a general technology for the use of extinction. We suggest that current research findings are not sufficient for the development of a comprehensive, applied technology of extinction and provide extensive guidelines for further studies on factors that may affect the course of extinction in clinical settings. PMID:8926226

  1. Applying the benefits of the AwM study in the clinic.

    PubMed

    Dodick, D W

    2008-09-01

    The Act when Mild (AwM) Study has illustrated the benefits to migraineurs of taking triptan medication when their migraine pain is still mild and within 1 h of the onset of symptoms. Yet many patients wait until the attack has fully developed before taking their medication, with potentially inferior outcomes. In order to reproduce the benefits of early intervention using the AwM paradigm in daily practice, a number of key barriers need to be addressed at both the physician and patient level. Notable physician-related barriers to be overcome, particularly at the primary care level, include accuracy of an early diagnosis of migraine in newly presenting patients, communication skills that generate a therapeutic engagement with migraine patients and enhance patient confidence, the application of knowledge about up-to-date strategies to optimize treatment outcomes, and the setting of achievable goals to avoid unrealistic expectations. Patient-related obstacles that need to be identified and overcome encompass patient attitude, expectations, and behaviour. Migraine patients may be reluctant to consult their physician, and, of those who do, many stop consulting because they perceive that physicians can do little to improve their situation. For this reason, migraine patients need to be counselled about the most appropriate medication for their level of symptoms. Moreover, patients need to be confident before they will adhere routinely to the advice they receive, and high in the priority of advice is the use of medication, particularly triptans, at the first sign of a migraine attack, rather than waiting until their attack has progressed to moderate or severe intensity. Patients who adhere to this advice are likely to experience a notable reduction in the pain, disability and time lost that they would otherwise suffer. The beneficial effects of early triptan intervention illustrated in the AwM Study can therefore be best reproduced in the clinic if the correct advice given

  2. Practicing Handoffs Early: Applying a Clinical Framework in the Anatomy Laboratory

    ERIC Educational Resources Information Center

    Lazarus, Michelle D.; Dos Santos, Jason A.; Haidet, Paul M.; Whitcomb, Tiffany L.

    2016-01-01

    The anatomy laboratory provides an ideal environment for the integration of clinical contexts as the willed-donor is often regarded as a student's "first patient." This study evaluated an innovative approach to peer teaching in the anatomy laboratory using a clinical handoff context. The authors introduced the "Situation,…

  3. Informatics systems to assess and apply clinical research on dental restorative materials.

    PubMed

    Anusavice, K J

    2003-12-01

    Dental biomaterials are used clinically for one or more of the following purposes: to restore function, to enhance esthetics, and to prevent or arrest demineralization of tooth structure. Studies of the clinical performance of restorations and prostheses made from these materials have generally focused on quality assessment and survival statistics. Data from these studies should provide probabilities of specific treatment outcomes that are useful for practicing dentists. However, the utility of these data is limited by the lack of national and international standards for assessing these clinical outcomes. Standardized approaches toward clinical informatics and treatment-decision analysis are urgently needed to minimize the variability of clinical outcomes reported in publications associated with direct and indirect restorative materials used for dental restorations and prostheses.

  4. Venlafaxine versus applied relaxation for generalized anxiety disorder: a randomized controlled study on clinical and electrophysiological outcomes.

    PubMed

    Zullino, Daniele; Chatton, Anne; Fresard, Emmanuelle; Stankovic, Miroslava; Bondolfi, Guido; Borgeat, François; Khazaal, Yasser

    2015-03-01

    Some components of generalized anxiety disorder, such as physical symptoms, are thought to reflect autonomic nervous system arousal. This study primarily assessed the relationships between psychophysiological and clinical measures using venlafaxine extended release or applied relaxation, and secondarily, the impact of combination treatment in patients not remitting after 8 weeks. Fifty-eight patients were randomly assigned to 8 weeks of treatment with either venlafaxine or applied relaxation (Phase I). Non-remitted patients received combination treatment for an additional 8 weeks (Phase II). Assessments included the Hamilton Anxiety Scale (HAM-A), Beck Depression Inventory, Penn State Worry Questionnaire and the Stroop Color-Word Task coupled with electrophysiological measures (skin conductance and frontalis electromyography (EMG)). In Phase 1, a time effect was found for the clinical and skin conductance measures. Thirteen patients from each group were in remission. In Phase 2, seven additional patients remitted. Baseline psychophysiological measures were not associated with baseline clinical variables or with clinical outcomes. Independently of treatment allocation, a reduction in frontal EMG values at week 4 was significantly associated with a decrease in HAM-A scores at week 8. At week 4, responders from the applied relaxation group had lower electrophysiological activity than the venlafaxine group. Baseline psychophysiological measures were not linked with clinical measures at study inclusion or with treatment response. Frontal EMG response at week 4 is a possible predictor of treatment response. Treatment combination enhances treatment response after initial failure. PMID:25464934

  5. A Study of the Effectiveness of Information Design Principles Applied to Clinical Research Questionnaires.

    ERIC Educational Resources Information Center

    Zimmerman, Beverly B.; Schultz, Jessica R.

    2000-01-01

    Investigates the effectiveness of information design principles and feedback-based usability testing in developing clinical questionnaires. Finds that a form developed using information design principles collected significantly more data than did a control form. (SR)

  6. Applying Active Learning to Assertion Classification of Concepts in Clinical Text

    PubMed Central

    Chen, Yukun; Mani, Subramani; Xu, Hua

    2012-01-01

    Supervised machine learning methods for clinical natural language processing (NLP) research require a large number of annotated samples, which are very expensive to build because of the involvement of physicians. Active learning, an approach that actively samples from a large pool, provides an alternative solution. Its major goal in classification is to reduce the annotation effort while maintaining the quality of the predictive model. However, few studies have investigated its uses in clinical NLP. This paper reports an application of active learning to a clinical text classification task: to determine the assertion status of clinical concepts. The annotated corpus for the assertion classification task in the 2010 i2b2/VA Clinical NLP Challenge was used in this study. We implemented several existing and newly developed active learning algorithms and assessed their uses. The outcome is reported in the global ALC score, based on the Area under the average Learning Curve of the AUC (Area Under the Curve) score. Results showed that when the same number of annotated samples was used, active learning strategies could generate better classification models (best ALC – 0.7715) than the passive learning method (random sampling) (ALC – 0.7411). Moreover, to achieve the same classification performance, active learning strategies required fewer samples than the random sampling method. For example, to achieve an AUC of 0.79, the random sampling method used 32 samples, while our best active learning algorithm required only 12 samples, a reduction of 62.5% in manual annotation effort. PMID:22127105

  7. Applying extracellular vesicles based therapeutics in clinical trials – an ISEV position paper

    PubMed Central

    Lener, Thomas; Gimona, Mario; Aigner, Ludwig; Börger, Verena; Buzas, Edit; Camussi, Giovanni; Chaput, Nathalie; Chatterjee, Devasis; Court, Felipe A.; del Portillo, Hernando A.; O'Driscoll, Lorraine; Fais, Stefano; Falcon-Perez, Juan M.; Felderhoff-Mueser, Ursula; Fraile, Lorenzo; Gho, Yong Song; Görgens, André; Gupta, Ramesh C.; Hendrix, An; Hermann, Dirk M.; Hill, Andrew F.; Hochberg, Fred; Horn, Peter A.; de Kleijn, Dominique; Kordelas, Lambros; Kramer, Boris W.; Krämer-Albers, Eva-Maria; Laner-Plamberger, Sandra; Laitinen, Saara; Leonardi, Tommaso; Lorenowicz, Magdalena J.; Lim, Sai Kiang; Lötvall, Jan; Maguire, Casey A.; Marcilla, Antonio; Nazarenko, Irina; Ochiya, Takahiro; Patel, Tushar; Pedersen, Shona; Pocsfalvi, Gabriella; Pluchino, Stefano; Quesenberry, Peter; Reischl, Ilona G.; Rivera, Francisco J.; Sanzenbacher, Ralf; Schallmoser, Katharina; Slaper-Cortenbach, Ineke; Strunk, Dirk; Tonn, Torsten; Vader, Pieter; van Balkom, Bas W. M.; Wauben, Marca; Andaloussi, Samir El; Théry, Clotilde; Rohde, Eva; Giebel, Bernd

    2015-01-01

    Extracellular vesicles (EVs), such as exosomes and microvesicles, are released by different cell types and participate in physiological and pathophysiological processes. EVs mediate intercellular communication as cell-derived extracellular signalling organelles that transmit specific information from their cell of origin to their target cells. As a result of these properties, EVs of defined cell types may serve as novel tools for various therapeutic approaches, including (a) anti-tumour therapy, (b) pathogen vaccination, (c) immune-modulatory and regenerative therapies and (d) drug delivery. The translation of EVs into clinical therapies requires the categorization of EV-based therapeutics in compliance with existing regulatory frameworks. As the classification defines subsequent requirements for manufacturing, quality control and clinical investigation, it is of major importance to define whether EVs are considered the active drug components or primarily serve as drug delivery vehicles. For an effective and particularly safe translation of EV-based therapies into clinical practice, a high level of cooperation between researchers, clinicians and competent authorities is essential. In this position statement, basic and clinical scientists, as members of the International Society for Extracellular Vesicles (ISEV) and of the European Cooperation in Science and Technology (COST) program of the European Union, namely European Network on Microvesicles and Exosomes in Health and Disease (ME-HaD), summarize recent developments and the current knowledge of EV-based therapies. Aspects of safety and regulatory requirements that must be considered for pharmaceutical manufacturing and clinical application are highlighted. Production and quality control processes are discussed. Strategies to promote the therapeutic application of EVs in future clinical studies are addressed. PMID:26725829

  8. Applying extracellular vesicles based therapeutics in clinical trials - an ISEV position paper.

    PubMed

    Lener, Thomas; Gimona, Mario; Aigner, Ludwig; Börger, Verena; Buzas, Edit; Camussi, Giovanni; Chaput, Nathalie; Chatterjee, Devasis; Court, Felipe A; Del Portillo, Hernando A; O'Driscoll, Lorraine; Fais, Stefano; Falcon-Perez, Juan M; Felderhoff-Mueser, Ursula; Fraile, Lorenzo; Gho, Yong Song; Görgens, André; Gupta, Ramesh C; Hendrix, An; Hermann, Dirk M; Hill, Andrew F; Hochberg, Fred; Horn, Peter A; de Kleijn, Dominique; Kordelas, Lambros; Kramer, Boris W; Krämer-Albers, Eva-Maria; Laner-Plamberger, Sandra; Laitinen, Saara; Leonardi, Tommaso; Lorenowicz, Magdalena J; Lim, Sai Kiang; Lötvall, Jan; Maguire, Casey A; Marcilla, Antonio; Nazarenko, Irina; Ochiya, Takahiro; Patel, Tushar; Pedersen, Shona; Pocsfalvi, Gabriella; Pluchino, Stefano; Quesenberry, Peter; Reischl, Ilona G; Rivera, Francisco J; Sanzenbacher, Ralf; Schallmoser, Katharina; Slaper-Cortenbach, Ineke; Strunk, Dirk; Tonn, Torsten; Vader, Pieter; van Balkom, Bas W M; Wauben, Marca; Andaloussi, Samir El; Théry, Clotilde; Rohde, Eva; Giebel, Bernd

    2015-01-01

    Extracellular vesicles (EVs), such as exosomes and microvesicles, are released by different cell types and participate in physiological and pathophysiological processes. EVs mediate intercellular communication as cell-derived extracellular signalling organelles that transmit specific information from their cell of origin to their target cells. As a result of these properties, EVs of defined cell types may serve as novel tools for various therapeutic approaches, including (a) anti-tumour therapy, (b) pathogen vaccination, (c) immune-modulatory and regenerative therapies and (d) drug delivery. The translation of EVs into clinical therapies requires the categorization of EV-based therapeutics in compliance with existing regulatory frameworks. As the classification defines subsequent requirements for manufacturing, quality control and clinical investigation, it is of major importance to define whether EVs are considered the active drug components or primarily serve as drug delivery vehicles. For an effective and particularly safe translation of EV-based therapies into clinical practice, a high level of cooperation between researchers, clinicians and competent authorities is essential. In this position statement, basic and clinical scientists, as members of the International Society for Extracellular Vesicles (ISEV) and of the European Cooperation in Science and Technology (COST) program of the European Union, namely European Network on Microvesicles and Exosomes in Health and Disease (ME-HaD), summarize recent developments and the current knowledge of EV-based therapies. Aspects of safety and regulatory requirements that must be considered for pharmaceutical manufacturing and clinical application are highlighted. Production and quality control processes are discussed. Strategies to promote the therapeutic application of EVs in future clinical studies are addressed.

  9. Applying Problem-Solving Methods to a Clinical Lab Sciences Curriculum.

    ERIC Educational Resources Information Center

    Bruce, Alease S.; Jochums, Brenda L.

    1990-01-01

    Describes how problem solving was incorporated into a clinical science curriculum by using a team teaching approach. The review of the content domain, the examination of objectives and test items, and the steps in the team development are included. The steps in development of the program are considered. (KR)

  10. Critical action research applied in clinical placement development in aged care facilities.

    PubMed

    Xiao, Lily D; Kelton, Moira; Paterson, Jan

    2012-12-01

    The aim of this study was to develop quality clinical placements in residential aged care facilities for undergraduate nursing students undertaking their nursing practicum topics. The proportion of people aged over 65 years is expected to increase steadily from 13% in 2006 to 26% of the total population in Australia in 2051. However, when demand is increasing for a nursing workforce competent in the care of older people, studies have shown that nursing students generally lack interest in working with older people. The lack of exposure of nursing students to quality clinical placements is one of the key factors contributing to this situation. Critical action research built on a partnership between an Australian university and five aged care organisations was utilised. A theoretical framework informed by Habermas' communicative action theory was utilised to guide the action research. Multiple research activities were used to support collaborative critical reflection and inform actions throughout the action research. Clinical placements in eight residential aged care facilities were developed to support 179 nursing students across three year-levels to complete their practicum topics. Findings were presented in three categories described as structures developed to govern clinical placement, learning and teaching in residential aged care facilities. PMID:23134277

  11. Wound staging: can nurses apply classroom education to the clinical setting?

    PubMed

    Arnold, N; Watterworth, B

    1995-06-01

    Traditionally, education on wound staging has been conducted in the classroom using drawings, photographs or slides to illustrate examples of wound stages. These methods portray wounds two-dimensionally, but clinically, wounds are three-dimensional. Seven home care nurses in central Florida were given a pre-test and post-test of 16 slides, four of each stage. Field visits with three of these nurses were then conducted by an ET nurse to evaluate the application of this education into clinical practice in the home setting. The questions studied were: Do nurses learn to accurately assess stages of wounds from classroom education? Does classroom ability to stage wounds equate to ability to stage correctly in the clinical setting? Test results showed Stage II and Stage III wounds to be most problematic in the classroom. The most improvement was seen in the staging of Stage II and Stage IV wounds two-dimensionally. In the field, one nurse consistently staged wounds correctly while two had problems with correct staging. Additional investigation is required to determine if these results can be generalized to other home health nurses and if changes in clinical ability will occur over time. PMID:7612139

  12. Automatic Domain Adaptation of Word Sense Disambiguation Based on Sublanguage Semantic Schemata Applied to Clinical Narrative

    ERIC Educational Resources Information Center

    Patterson, Olga

    2012-01-01

    Domain adaptation of natural language processing systems is challenging because it requires human expertise. While manual effort is effective in creating a high quality knowledge base, it is expensive and time consuming. Clinical text adds another layer of complexity to the task due to privacy and confidentiality restrictions that hinder the…

  13. Dialectical Behavior Therapy (DBT) Applied to College Students: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Pistorello, Jacqueline; Fruzzetti, Alan E.; MacLane, Chelsea; Gallop, Robert; Iverson, Katherine M.

    2012-01-01

    Objective: College counseling centers (CCCs) are increasingly being called upon to treat highly distressed students with complex clinical presentations. This study compared the effectiveness of Dialectical Behavior Therapy (DBT) for suicidal college students with an optimized control condition and analyzed baseline global functioning as a…

  14. Practicing handoffs early: Applying a clinical framework in the anatomy laboratory.

    PubMed

    Lazarus, Michelle D; Dos Santos, Jason A; Haidet, Paul M; Whitcomb, Tiffany L

    2016-10-01

    The anatomy laboratory provides an ideal environment for the integration of clinical contexts as the willed-donor is often regarded as a student's "first patient." This study evaluated an innovative approach to peer teaching in the anatomy laboratory using a clinical handoff context. The authors introduced the "Situation, Background, Assessment, Recommendation" (SBAR) handoff framework within the anatomy laboratory. Study participants included 147 second-year medical students completing the head and neck portion of an anatomy course. The authors used mixed methods to evaluate the impact of the anatomic SBAR on the student anatomy laboratory experience. Qualitative analysis of student evaluations revealed three themes which emerged from students' summaries of their anatomic handoff experiences: Learning-by-teaching; Acquiescing to doing more with less; and Distrust of the peer handoff process. All the themes demonstrated that the anatomic handoff encouraged students' focus on the knowledge preparation and reflection. Closed question analysis suggested that that students' perceptions of handoff usefulness were tied to deeper learning strategies. The handoff provided a mechanism for promoting students' focus on anatomical relationships and facilitated students' learning of transferable clinical skills. Together, these results suggest that the introduction of a handoff process in anatomy education provided both a mechanism for learning anatomy and a unique opportunity for early exposure to an essential clinical skill. This clinical and basic science integration may serve as a vertical integration thread which can be woven throughout undergraduate medical education. Future study will focus on exploring the long-term impacts and learning outcomes of this integration. Anat Sci Educ 9: 476-487. © 2016 American Association of Anatomists. PMID:26849177

  15. Applied cognitive psychology: Implications of cognitive psychology for clinical psychology and psychotherapy.

    PubMed

    Eysenck, Michael W

    2004-04-01

    Cognitive psychology has made numerous contributions to clinical psychology, and these contributions are considered especially with reference to the anxiety disorders. It is argued that there are four major contributions that can be identified. First, the cognitive approach has led to the development of complex models showing the main cognitive processes and structures of relevance to an understanding of anxiety disorders. Second, controlled laboratory studies permit a more detailed investigation of cognitive biases in anxious patients than generally is feasible in more naturalistic settings. Third, the cognitive approach provides relevant evidence with respect to the issue of whether cognitive biases play a role in the development and maintenance of anxiety disorders. Fourth, the enhanced understanding of the anxiety disorders that has arisen from the cognitive approach has had beneficial effects on therapeutic practice in a number of significant ways. In sum, it is claimed that clinical psychology has benefited considerably from cognitive theory and research.

  16. Biodegradable device applied in flatfoot surgery: comparative studies between clinical and technological aspects of removed screws.

    PubMed

    Ruozi, Barbara; Belletti, Daniela; Manfredini, Giuseppe; Tonelli, Massimo; Sena, Paola; Vandelli, Maria Angela; Forni, Flavio; Tosi, Giovanni

    2013-04-01

    Poly-L-lactide (PLLA) is one of the most used polymers for biomedical application; its use in sutures and other implants has been widely investigated. Although the knowledge of PLLA biodegradation and biocompatibility features is deep, PLLA screws used to correct the flat foot deformity have deserved attention since they are not degraded in most of cases after a long period of years (3-7) from the implantation. In this article, a clinical and radiological evaluation (NMR, histological and clinical outcomes) on patients was correlated with physico-chemical characterization (by SEM, DSC, GPC and XRD analysis at different temperatures) on both native and patient-recovered screws together with the theoretical degradation processes of PLLA-based implants. The data demonstrated the need for crossing the biodegradation and bioabsorption of the polymer with the characteristics of both the device (geometry, structure and fabrication process) and the implantation site.

  17. Interdisciplinary collaboration applied to clinical research: an example of remote monitoring in lung transplantation.

    PubMed

    VanWormer, Arin; Lindquist, Ruth; Robiner, William; Finkelstein, Stanley

    2012-01-01

    Collaboration across disciplines is vital in clinical practice. It is also needed to generate high-quality actionable research, yet few frameworks for interdisciplinary collaboration exit to promote effective communications among researchers with common goals, but varied backgrounds. A review of what has been learned about collaboration was undertaken to determine attributes of effective interdisciplinary collaboration and barriers to its realization in patients undergoing lung transplantation. PMID:22475710

  18. Considerations in Applying the Results of Randomized Controlled Clinical Trials to the Care of Older Adults With Kidney Disease in the Clinical Setting: The SHARP Trial.

    PubMed

    Butler, Catherine R; O'Hare, Ann M

    2016-01-01

    The Study of Heart and Renal Protection (SHARP) found that treatment with ezetemibe and low-dose simvastatin reduced the incidence of major atherosclerotic events in patients with kidney disease. Due to the paucity of evidence-based interventions that lower cardiovascular morbidity in this high-risk population, the SHARP trial will likely have a large impact on clinical practice. However, applying the results of clinical trials conducted in select populations to the care of individual patients in real-world settings can be fraught with difficulty. This is especially true when caring for older adults with complex comorbidity and limited life expectancy. These patients are often excluded from clinical trials, frequently have competing health priorities, and may be less likely to benefit and more likely to be harmed by medications. We discuss key considerations in applying the results of the SHARP trial to the care of older adults with CKD in real-world clinical settings using guiding principles set forth by the American Geriatrics Society's Expert Panel on the Care of Older Adults with Multimorbidity. Using this schema, we emphasize the importance of evaluating trial results in the unique context of each patient's goals, values, priorities, and circumstances.

  19. First-order logic theory for manipulating clinical practice guidelines applied to comorbid patients: a case study.

    PubMed

    Michalowski, Martin; Wilk, Szymon; Tan, Xing; Michalowski, Wojtek

    2014-01-01

    Clinical practice guidelines (CPGs) implement evidence-based medicine designed to help generate a therapy for a patient suffering from a single disease. When applied to a comorbid patient, the concurrent combination of treatment steps from multiple CPGs is susceptible to adverse interactions in the resulting combined therapy (i.e., a therapy established according to all considered CPGs). This inability to concurrently apply CPGs has been shown to be one of the key shortcomings of CPG uptake in a clinical setting1. Several research efforts are underway to address this issue such as the K4CARE2 and GuideLine INteraction Detection Assistant (GLINDA)3 projects and our previous research on applying constraint logic programming to developing a consistent combined therapy for a comorbid patient4. However, there is no generalized framework for mitigation that effectively captures general characteristics of the problem while handling nuances such as time and ordering requirements imposed by specific CPGs. In this paper we propose a first-order logic-based (FOL) approach for developing a generalized framework of mitigation. This approach uses a meta-algorithm and entailment properties to mitigate (i.e., identify and address) adverse interactions introduced by concurrently applied CPGs. We use an illustrative case study of a patient suffering from type 2 diabetes being treated for an onset of severe rheumatoid arthritis to show the expressiveness and robustness of our proposed FOL-based approach, and we discuss its appropriateness as the basis for the generalized theory.

  20. Clinical use of vaginal or rectally applied microbicides in patients suffering from HIV/AIDS.

    PubMed

    Gupta, Satish Kumar; Nutan

    2013-01-01

    Microbicides, primarily used as topical pre-exposure prophylaxis, have been proposed to prevent sexual transmission of HIV. This review covers the trends and challenges in the development of safe and effective microbicides to prevent sexual transmission of HIV Initial phases of microbicide development used such surfactants as nonoxynol-9 (N-9), C13G, and sodium lauryl sulfate, aiming to inactivate the virus. Clinical trials of microbicides based on N-9 and C31G failed to inhibit sexual transmission of HIV. On the contrary, N-9 enhanced susceptibility to sexual transmission of HIV-1. Subsequently, microbicides based on polyanions and a variety of other compounds that inhibit the binding, fusion, or entry of virus to the host cells were evaluated for their efficacy in different clinical setups. Most of these trials failed to show either safety or efficacy for prevention of HIV transmission. The next phase of microbicide development involved antiretroviral drugs. Microbicide in the form of 1% tenofovir vaginal gel when tested in a Phase IIb trial (CAPRISA 004) in a coitally dependent manner revealed that tenofovir gel users were 39% less likely to become HIV-infected compared to placebo control. However, in another trial (VOICE MTN 003), tenofovir gel used once daily in a coitally independent mode failed to show any efficacy to prevent HIV infection. Tenofovir gel is currently in a Phase III safety and efficacy trial in South Africa (FACTS 001) employing a coitally dependent dosing regimen. Further, long-acting microbicide-delivery systems (vaginal ring) for slow release of such antiretroviral drugs as dapivirine are also undergoing clinical trials. Discovering new markers as correlates of protective efficacy, novel long-acting delivery systems with improved adherence in the use of microbicides, discovering new compounds effective against a broad spectrum of HIV strains, developing multipurpose technologies incorporating additional features of efficacy against other

  1. Towards Implementing a Global Competency-Based Nursing and Clinical Informatics Curriculum: Applying the TIGER Initiative.

    PubMed

    Hübner, Ursula; Ball, Marion; de Fátima Marin, Heimar; Chang, Polun; Wilson, Marisa; Anderson, Christel

    2016-01-01

    This workshop will review the history of the TIGER initiative in order to set the framework for an understanding of international informatics competencies. We will include a description of clinical nursing informatics programs in 37 countries as well as the results of a recent survey of nursing competencies in order to further discussions of internationally agreed-upon competency definitions. These two surveys will provide the basis for developing a consensus regarding the integration of core competencies into informatics curriculum developments. Expected outcomes include building consensus on core competencies and developing plans toward implementing intra- and inter-professional informatics competencies across disciplines globally. PMID:27332333

  2. Interactive tele-education applied to a distant clinical microbiology specialization university course.

    PubMed

    Andreazzi, Denise B; Rossi, Flávia; Wen, Chao L

    2011-09-01

    The microbiology laboratory provides a strategic support for infectious disease diagnosis and also alerts the medical community about bacterial resistance to antibiotics. The microbiologists' training is a challenge in Brazil, a country with an extensive territory, a diverse population, and disparity of resource allocation. The aim of this study was to implement an interactive tele-educational course in clinical microbiology to reach distant laboratory workers and to improve their professional skills. The course scientific content was defined according to competences associated, distributed in 560 h, with laboratory practices (knowledge matrix-contextual education). The 11-module course structure comprised 70% distance learning, 22% on campus (integrated modules), and 8% monographs. The group included 7 physicians and 21 microbiologists from 20 different Brazilian cities. The time flexibility and location were the two main reasons for student participation, thus decreasing absences to the workplace, different from the traditional teaching methodologies. The group performance was measured by monthly evaluations, and 1 year postcourse, the researcher visited their workplace. There was significant improvement in microbiological practices performed before compared with after group participation. Therefore, 76.9% of laboratory practices were modified because of the knowledge acquired in the course. Students showed behavioral changes in relation to performance in infection control as well as on the dissemination of their knowledge. This specialization course using distance education did not compromise the quality. This educational methodology represents an alternative to teach clinical microbiology to laboratory workers from remote hospitals, as a nationwide continuing educational strategy.

  3. A seminar series in applied biostatistics for clinical research fellows, faculty and staff.

    PubMed

    Deutsch, Reena

    2002-03-30

    Familiarity with experimental design and statistical analysis techniques is necessary for investigators to conduct state-of-the-art research in clinical medicine. A wide range of options for biostatistical training is available. These include formal academic courses for credit, one-on-one education offered under the guise of consultation, self-paced textbook or computer learning, intensive short courses, portions of extended courses spanning an assortment of other subjects, and a continuing series of seminars or lectures covering selected topics in statistics. The latter structure is described in this article. We offered an eight-week lecture series focusing on a new topic in biostatistics each week. The course targeted clinical faculty, postdoctoral fellows, residents, and other interested research staff at a large medical research institution. The series focused on interpretation of medical journal articles with regard to statistical issues. Another objective was to provide information to increase a participant's expertise in the design of research studies. Guidance was offered for effective communication with collaborating biostatisticians. The format and contents of the seminar series are described. Aspects of the course that proved to be successful are discussed.

  4. The Palliative Outcome Scale (POS) applied to clinical practice and research: an integrative review

    PubMed Central

    Rugno, Fernanda Capella; Carlo, Marysia Mara Rodrigues do Prado De

    2016-01-01

    ABSTRACT Objective: to identify and evaluate the evidence found in the international scientific literature on the application of the Palliative Outcome Scale (POS) in clinical practice and research in Palliative Care (PC). Method: integrative literature review, through the search of publications in journals indexed in PubMed / MEDLINE, LILACS, SciELO and CINAHL databases, between the years 1999 and 2014. Results: the final sample consisted of 11 articles. In the data analysis, the articles were classified into 2 units of analysis (studies using the POS as a resource in research and studies using the POS in clinical practice), in which the information was presented in the form of sub-themes related to publications of the selected studies, highlighting the synthesis of the results. Conclusion: POS emerged as an important tool for measuring outcomes to assess the quality of life of patients and families, of the quality of care provided and the PC service organization. The international scientific literature on the application of POS proved to be relevant to the advancement and consolidation of the field of knowledge related to PC. PMID:27533273

  5. Applied Proteogenomics OrganizationaL Learning and Outcomes (APOLLO) Network - Office of Cancer Clinical Proteomics Research

    Cancer.gov

    In the spirit of collaboration inspired by the Vice President’s Cancer Moonshot, the Department of Veterans Affairs (VA), the Department of Defense (DoD), and the National Cancer Institute (NCI) are proud to announce a new tri-agency coalition (APOLLO Network — Applied Proteogenomics OrganizationaL Learning and Outcomes) that will help cancer patients by enabling their oncologists to more rapidly and accurately identify effective drugs to treat cancer based on a patient’s unique proteogenomic profile.

  6. The main challenges that remain in applying high-throughput sequencing to clinical diagnostics.

    PubMed

    Loeffelholz, Michael; Fofanov, Yuriy

    2015-01-01

    Over the last 10 years, the quality, price and availability of high-throughput sequencing instruments have improved to the point that this technology may be close to becoming a routine tool in the diagnostic microbiology laboratory. Two groups of challenges, however, have to be resolved in order to move this powerful research technology into routine use in the clinical microbiology laboratory. The computational/bioinformatics challenges include data storage cost and privacy concerns, requiring analysis to be performed without access to cloud storage or expensive computational infrastructure. The logistical challenges include interpretation of complex results and acceptance and understanding of the advantages and limitations of this technology by the medical community. This article focuses on the approaches to address these challenges, such as file formats, algorithms, data collection, reporting and good laboratory practices. PMID:26394651

  7. Applying the molecular biology and epigenetics of head and neck cancer in everyday clinical practice.

    PubMed

    Glazer, Chad A; Chang, Steven S; Ha, Patrick K; Califano, Joseph A

    2009-01-01

    During the past decade, there has been a significant increase in knowledge regarding the molecular biology and epigenetics of head and neck squamous cell carcinoma (HNSCC). This has been aided by the steady development of new technology and novel techniques aimed at elucidating additional aberrant molecular alterations characteristic of HNSCC, including the advent of high throughput assays and the development of more sophisticated bioinformatics tools. In addition, advancements in the field of cancer epigenetics and microRNA have increased the complexity of understanding HNSCC tumorigenesis. These advances have lead to an increasing number of translational studies in the diagnosis, prognosis, and treatment of head and neck cancer. The end result is that molecular biomarkers, gene detection panels and targeted therapeutics are becoming a reality for the care of patients with HNSCC. In this article, we will focus on the many implications of this research as it pertains to clinical practice and the treatment of HNSCC patients.

  8. Parenting Coordination: Applying Clinical Thinking to the Management and Resolution of Post-Divorce Conflict.

    PubMed

    Demby, Steven L

    2016-05-01

    There is a small but significant number of parents who remain stuck in a high level of conflict with each other after the legal conclusion of their divorce. Exposure to chronically high levels of parental conflict is a strong risk factor negatively affecting both children's short- and long-term adjustment. Parenting coordination is a nonadversarial, child-focused dispute-resolution process designed to help divorced parents contain their conflict to protect children from its negative effect. Parenting coordination is a hybrid role combining different skills and conflict-resolution approaches. In high-conflict divorce, each parent's internalization of relationship patterns constructed from past experiences contributes to the intractable nature of the interparent conflict. A case presentation illustrates how this clinical perspective enhances the parenting coordinator's ability to work with parents to manage and contain their parenting conflicts with each other.

  9. Applying Process Improvement Methods to Clinical and Translational Research: Conceptual Framework and Case Examples.

    PubMed

    Daudelin, Denise H; Selker, Harry P; Leslie, Laurel K

    2015-12-01

    There is growing appreciation that process improvement holds promise for improving quality and efficiency across the translational research continuum but frameworks for such programs are not often described. The purpose of this paper is to present a framework and case examples of a Research Process Improvement Program implemented at Tufts CTSI. To promote research process improvement, we developed online training seminars, workshops, and in-person consultation models to describe core process improvement principles and methods, demonstrate the use of improvement tools, and illustrate the application of these methods in case examples. We implemented these methods, as well as relational coordination theory, with junior researchers, pilot funding awardees, our CTRC, and CTSI resource and service providers. The program focuses on capacity building to address common process problems and quality gaps that threaten the efficient, timely and successful completion of clinical and translational studies.

  10. Clinical efficiency of applying low-intensity laser therapy in treating dyscirculatory encephalopathy

    NASA Astrophysics Data System (ADS)

    Putilina, M. V.; Kozlov, V. I.; Vakhtin, V. I.

    2001-04-01

    An investigation was made of applying laser therapy combined with drug preparations in treating 300 patients affected by dyscirculatory encephalopathy. Neurological and neuropsychological examinations together with electroencephalography, rheoencephalography, computerized tomography, and magnetic resonance imaging were used to assess the patients' states prior to and after the treatment. It was found that the combined application of laser therapy and drug preparations produced a more pronounced therapeutic effect as compared with that produced by the separate application of laser therapy and drug preparations. The results obtained allowed us to conclude that the 0.89 micrometers laser infrared radiation increased patients' susceptibility to drugs. Moreover, the combined laser therapy improved the cerebral bloodflow and activated the metabolic and plastic functions of neurons. This decreased or eliminated late complications provoked by the cerebral blood circulation insufficiency.

  11. [Selective digestive decontamination. Why don't we apply the evidence in the clinical practice?].

    PubMed

    Taylor, N; van Saene, H K F; Abella, A; Silvestri, L; Vucic, M; Peric, M

    2007-04-01

    Selective digestive decontamination (SDD) is a prophylactic strategy whose objective is to reduce the incidence of infections, mainly mechanical ventilation associated pneumonia in patients who require intensive cares, preventing or eradicating the oropharyngeal and gastrointestinal carrier state of potentially pathogenic microorganisms. Fifty-four randomized clinical trials (RCTs) and 9 meta-analysis have evaluated SDD. Thirty eight RCTs show a significant reduction of the infections and 4 of mortality. All the meta-analyses show a significant reduction of the infections and 5 out of the 9 meta-analyses report a significant reduction in mortality. Thus, 5 patients from the ICU with SDD must be treated to prevent pneumonia and 12 patients from the ICU should be treated to prevent one death. The data that show benefit of the SDD on mortality have an evidence grade 1 or recommendation grade A (supported by at least two level 1 investigations). The aim of this review is to explain the pathogeny of infections in critical patients, describe selective digestive decontamination, analyze the evidence available on it efficacy and the potential adverse effects and discuss the reasons published by the experts who advise against the use of SDD, even though it is recognized as the best intervention evaluated in intensive cares to reduce morbidity and mortality of the infections.

  12. Dogs'olfactory diagnostics applied on human species: state of the art and clinical perspectives.

    PubMed

    Palmieri, B; Nardo, B; Lippi, G; Palmieri, L; Vadalà, M; Laurino, C

    2016-01-01

    Dogs'smell ability is about 10000-100000 more developed than humans' one. Dogs smell is usually exploited in forensic medicine, to find missing people and specific substances showing peculiar sensorial features. In clinic, there is the possibility to take advantage of dogs smell, which are conveniently trained, for the screening of cancers and other diseases. The common feature is the presence of molecules in organic samples that may be considered as biomarkers of a specific pathology. In cancer, scientific evidences exist about screening of melanoma, lung, breast, rectum, ovarian, prostate and bladder cancer. Instead, other pathologies manifest the presence of organic volatile compounds in biologic materials, such as spit, faeces and urine that may be studied by dogs smell in order to identify the presence of a specific disease. This review shows the state of the art of actual dogs' olfactory ability based on scientific principles and the advantages and the disadvantages of this method. The authors also reveal some potential pathologies joined by the presence of organic volatile compounds, which may be investigated by dogs smell. PMID:27598027

  13. Tissue spectrophotometry and thermographic imaging applied to routine clinical prediction of amputation level viability

    NASA Astrophysics Data System (ADS)

    Hanson, Jon M.; Harrison, David K.; Hawthorn, Ian E.

    2002-06-01

    About 5% of British males over 50 years develop peripheral arterial occlusive disease. Of these about 2% ultimately require lower limb amputation. In 1995 we proposed a new technique using lightguide spectrophotometry to measure the oxygen saturation level of haemoglobin (SO2) in the skin as a method for predicting tissue viability. This technique, in combination with thermographic imaging, was compared with skin blood flow measurements using the I125)4- Iodoantipyrine (IAP) clearance technique. The optical techniques gave a sensitivity and selectivity of 1.0 for the prediction of successful outcome of a below knee amputation compared with a specificity of 93% using the traditional IAP technique at a below knee to above knee amputation ratio (BKA:AKA) of 75%. The present study assesses the routine clinical application of these optical techniques. The study is ongoing, but the data to date comprises 22 patients. 4 patients were recommended for above knee amputation (AKA) and 18 patients for below knee amputation on the basis of thermographic and tissue SO2 measurements. All but one of the predicted BKA amputations healed. The study to date produces evidence of 94% healing rate (specificity) for a BKA:AKA ratio of 82%. This compares favorably with the previous figures given above.

  14. Dialectical Behavior Therapy (DBT) Applied to College Students: A Randomized Clinical Trial

    PubMed Central

    Pistorello, Jacqueline; Fruzzetti, Alan E.; MacLane, Chelsea; Gallop, Robert; Iverson, Katherine M.

    2012-01-01

    Objective College counseling centers (CCCs) are increasingly being called upon to treat highly distressed students with complex clinical presentations. This study compared the effectiveness of Dialectical Behavior Therapy (DBT) for suicidal college students to an optimized control condition, and analyzed baseline global functioning as a moderator. Method The intent-to-treat (ITT) sample included 63 college students between the ages of 18 and 25 who were suicidal at baseline, reported at least one lifetime non-suicidal self-injurious (NSSI) act or suicide attempt, and met three or more borderline personality disorder (BPD) diagnostic criteria. Participants were randomly assigned to DBT (n = 31) or an optimized Treatment as Usual (O-TAU) control condition (n = 32). Treatment was provided by trainees, supervised by experts in both treatments. Both treatments lasted 7–12 months and included both individual and group components. Assessments were conducted at pretreatment, 3-months, 6-months, 9-months, 12-months, and 18-months (follow-up). Results Mixed effects analyses (ITT sample) revealed that DBT, compared to the control condition, showed significantly greater decreases in suicidality, depression, number of NSSI events (if participant had self-injured), BPD criteria, and psychotropic medication use, and significantly greater improvements in social adjustment. Most of these treatment effects were observed at follow-up. No treatment differences were found for treatment dropout. Moderation analyses showed that DBT was particularly effective for suicidal students who were lower functioning at pretreatment. Conclusions DBT is an effective treatment for suicidal, multi-problem college students. Future research should examine the implementation of DBT in CCCs in a stepped care approach. PMID:22730955

  15. Health Technology Assessment of pathogen reduction technologies applied to plasma for clinical use.

    PubMed

    Cicchetti, Americo; Berrino, Alexandra; Casini, Marina; Codella, Paola; Facco, Giuseppina; Fiore, Alessandra; Marano, Giuseppe; Marchetti, Marco; Midolo, Emanuela; Minacori, Roberta; Refolo, Pietro; Romano, Federica; Ruggeri, Matteo; Sacchini, Dario; Spagnolo, Antonio G; Urbina, Irene; Vaglio, Stefania; Grazzini, Giuliano; Liumbruno, Giancarlo M

    2016-07-01

    Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration between the Italian National Blood Centre and the Post-Graduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. A large, multidisciplinary team was created and divided into six groups, each of which addressed one or more HTA domains.Plasma treated with amotosalen + UV light, riboflavin + UV light, methylene blue or a solvent/detergent process was compared to fresh-frozen plasma with regards to current use, technical features, effectiveness, safety, economic and organisational impact, and ethical, social and legal implications. The available evidence is not sufficient to state which of the techniques compared is superior in terms of efficacy, safety and cost-effectiveness. Evidence on efficacy is only available for the solvent/detergent method, which proved to be non-inferior to untreated fresh-frozen plasma in the treatment of a wide range of congenital and acquired bleeding disorders. With regards to safety, the solvent/detergent technique apparently has the most favourable risk-benefit profile. Further research is needed to provide a comprehensive overview of the cost-effectiveness profile of the different pathogen-reduction techniques. The wide heterogeneity of results and the lack of comparative evidence are reasons why more comparative studies need to be performed. PMID:27403740

  16. Health Technology Assessment of pathogen reduction technologies applied to plasma for clinical use

    PubMed Central

    Cicchetti, Americo; Berrino, Alexandra; Casini, Marina; Codella, Paola; Facco, Giuseppina; Fiore, Alessandra; Marano, Giuseppe; Marchetti, Marco; Midolo, Emanuela; Minacori, Roberta; Refolo, Pietro; Romano, Federica; Ruggeri, Matteo; Sacchini, Dario; Spagnolo, Antonio G.; Urbina, Irene; Vaglio, Stefania; Grazzini, Giuliano; Liumbruno, Giancarlo M.

    2016-01-01

    Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration between the Italian National Blood Centre and the Post-Graduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. A large, multidisciplinary team was created and divided into six groups, each of which addressed one or more HTA domains. Plasma treated with amotosalen + UV light, riboflavin + UV light, methylene blue or a solvent/detergent process was compared to fresh-frozen plasma with regards to current use, technical features, effectiveness, safety, economic and organisational impact, and ethical, social and legal implications. The available evidence is not sufficient to state which of the techniques compared is superior in terms of efficacy, safety and cost-effectiveness. Evidence on efficacy is only available for the solvent/detergent method, which proved to be non-inferior to untreated fresh-frozen plasma in the treatment of a wide range of congenital and acquired bleeding disorders. With regards to safety, the solvent/detergent technique apparently has the most favourable risk-benefit profile. Further research is needed to provide a comprehensive overview of the cost-effectiveness profile of the different pathogen-reduction techniques. The wide heterogeneity of results and the lack of comparative evidence are reasons why more comparative studies need to be performed. PMID:27403740

  17. Snake venoms in science and clinical medicine. 2. Applied immunology in snake venom research.

    PubMed

    Theakston, R D

    1989-01-01

    Enzyme-linked immunosorbent assay (ELISA) is a very important tool for studying both the epidemiology and clinical effects of snake bite in man. For epidemiology ELISA depends on the development and persistence of specific humoral venom antibody in previous snake bite victims. In the Nigerian savanna 63% of previous bite victims possessed specific venom antibodies against Echis carinatus venom; in Ecuador, where there is a 5% annual mortality due to snake bite in a population of Waorani Indians, venom antibodies against a wide range of different venoms were identified in previous bite victims using ELISA. In certain areas it is often not possible, using the symptoms of envenoming, to determine which species of snake has bitten the patient. Field studies using ELISA in Nigeria and Thailand have been successful in establishing the species responsible for envenoming. Current studies are in progress on the development of a rapid immunoassay which should be capable of detecting the biting species within 5-10 min of sampling from the admission patient. This will be useful for the clinician as it will enable the rapid detection of the species responsible for envenoming and, therefore, the use of the correct antivenom. Experimental work on the development of new methods of antivenom production includes immunization of experimental animals with venom/liposome preparations, the preparation of venom antigens using monoclonal antibodies on affinity columns, and recombinant deoxyribonucleic acid technology. Liposomal immunization requires only a single injection of venom to obtain a rapid, high level and protective immune response. Venom liposomes may also be given orally resulting in a serum immunoglobulin G immune response in experimental animals. Use of such a system may eventually result in immunization of man in areas of high snake bite incidence and mortality. PMID:2617643

  18. How to apply modern scientific and technological advances to the practice of clinical gastroenterology in Vietnam.

    PubMed

    Ha, M V

    1997-06-01

    There are some differences between the spectrum of gastroenterological diseases in Vietnam compared with those of more developed countries. These may be due to different living standards, quality of nutrition, and different infection rates of intestinal parasites and hepatotropic viruses. Gastric carcinoma and hepatocellular carcinoma (HCC) are leading malignancies, while colorectal cancer is less frequent. Bile duct stones often have Ascaris eggs in the centre, and they prevail in incidence over gall-bladder stones. The majority of digestive cancers are detected at a very late stage. The Vietnamese Association of Gastroenterology aims to contribute to the development of modern gastroenterology (GE) in Vietnam, to study and apply recent advances in imaging technology, such as fibre-optic diagnostic and therapeutical endoscopy, ultrasonography, laparoscopic surgery etc. and to do further work in molecular biology. For this purpose, besides our self-reliance, we need, and ask for, support and assistance from the Japanese Society of GE (JSGE), the Asian Pacific Association of GE (APAGE) and the Organisation Mondiale de GE (OMEGE). At the same time, we suggest a choice be made among the different technologies, bearing in mind their cost-effectiveness, and to give preference to measures for the primary prevention and early detection of the diseases. Japanese experience in the early detection of gastric cancer and HCC, and in the Percutaneous Ethanol Injection Therapy (PEIT) for treatment of HCC, are highly appreciated. We recommend also a judicious and scientific combination of traditional medicine and modern technology in the research and the struggle against digestive diseases.

  19. Environmental risk assessment of replication competent viral vectors applied in clinical trials: potential effects of inserted sequences.

    PubMed

    van den Akker, Eric; van der Vlugt, Cecile J B; Bleijs, Diederik A; Bergmans, Hans E

    2013-12-01

    Risk assessments of clinical applications involving genetically modified viral vectors are carried out according to general principles that are implemented in many national and regional legislations, e.g., in Directive 2001/18/EC of the European Union. Recent developments in vector design have a large impact on the concepts that underpin the risk assessments of viral vectors that are used in clinical trials. The use of (conditionally) replication competent viral vectors (RCVVs) may increase the likelihood of the exposure of the environment around the patient, compared to replication defective viral vectors. Based on this assumption we have developed a methodology for the environmental risk assessment of replication competent viral vectors, which is presented in this review. Furthermore, the increased likelihood of exposure leads to a reevaluation of what would constitute a hazardous gene product in viral vector therapies, and a keen interest in new developments in the inserts used. One of the trends is the use of inserts produced by synthetic biology. In this review the implications of these developments for the environmental risk assessment of RCVVs are highlighted, with examples from current clinical trials. The conclusion is drawn that RCVVs, notwithstanding their replication competency, can be applied in an environmentally safe way, in particular if adequate built-in safeties are incorporated, like conditional replication competency, as mitigating factors to reduce adverse environmental effects that could occur.

  20. Can Clinical Scenario Videos Improve Dental Students' Perceptions of the Basic Sciences and Ability to Apply Content Knowledge?

    PubMed

    Miller, Cynthia Jayne; Metz, Michael James

    2015-12-01

    Dental students often have difficulty understanding the importance of basic science classes, such as physiology, for their future careers. To help alleviate this problem, the aim of this study was to create and evaluate a series of video modules using simulated patients and custom-designed animations that showcase medical emergencies in the dental practice. First-year students in a dental physiology course formatively assessed their knowledge using embedded questions in each of the three videos; 108 to 114 of the total 120 first-year students answered the questions, for a 90-95% response rate. These responses indicated that while the students could initially recognize the cause of the medical emergency, they had difficulty in applying their knowledge of physiology to the scenario. In two of the three videos, students drastically improved their ability to answer high-level clinical questions at the conclusion of the video. Additionally, when compared to the previous year of the course, there was a significant improvement in unit exam scores on clinically related questions (6.2% increase). Surveys were administered to the first-year students who participated in the video modules and fourth-year students who had completed the course prior to implementation of any clinical material. The response rate for the first-year students was 96% (115/120) and for the fourth-year students was 57% (68/120). The first-year students indicated a more positive perception of the physiology course and its importance for success on board examinations and their dental career than the fourth-year students. The students perceived that the most positive aspects of the modules were the clear applications of physiology to real-life dental situations, the interactive nature of the videos, and the improved student comprehension of course concepts. These results suggest that online modules may be used successfully to improve students' perceptions of the basic sciences and enhance their ability to

  1. Clinical Effects of a Topically Applied Toll-like Receptor 9 Agonist in Active Moderate-to-Severe Ulcerative Colitis

    PubMed Central

    Atreya, Raja; Bloom, Stuart; Scaldaferri, Franco; Gerardi, Viviana; Admyre, Charlotte; Karlsson, Åsa; Knittel, Thomas; Kowalski, Jan; Lukas, Milan; Löfberg, Robert; Nancey, Stephane; Petryka, Robert; Rydzewska, Grazyna; Schnabel, Robert; Seidler, Ursula; Neurath, Markus F.

    2016-01-01

    Background and Aims: Toll-like receptors [TLRs] are potential drug targets for immunomodulation. We determined the safety and efficacy of the TLR-9 agonist DNA-based immunomodulatory sequence 0150 [DIMS0150] in ulcerative colitis [UC] patients refractory to standard therapy. Methods: In this randomized, double-blind, placebo-controlled trial, 131 patients with moderate-to-severe active UC were randomized to receive two single doses of the oligonucleotide DIMS0150 [30 mg] or placebo administered topically during lower GI endoscopy at baseline and Week 4. The primary endpoint was clinical remission, defined as Clinical Activity Index [CAI] ≤4, at Week 12. Secondary endpoints included mucosal healing and symptomatic remission of key patient-reported outcomes [absence of blood in stool and weekly stool frequency <35]. Results: There was no statistical significant difference between the groups in the induction of clinical remission at Week 12, with 44.4% in the DIMS0150 group vs. 46.5% in the placebo group. However, the proportion of patients who achieved symptomatic remission was 32.1% in the DIMS0150 group vs. 14.0% in the placebo group at Week 4 [p = 0.020], and 44.4% vs. 27.9% at Week 8 [p = 0.061]. More patients on DIMS0150 compared with those on placebo had mucosal healing [34.6% vs. 18.6%; p = 0.09] and histological improvement regarding the Geboes score [30.9% vs. 9.3%; p = 0.0073] at Week 4. Significantly more patients on DIMS0150 were in clinical remission with mucosal healing at Week 4: 21% vs. 4.7% in the placebo group [p = 0.02]. DIMS0150 was well tolerated, and no safety signals compared with placebo were evident. Conclusions: Therapy with the topically applied TLR-9 agonist DIMS0150 is a promising and well-tolerated novel therapeutic option for treatment-refractory, chronic active UC patients, warranting further clinical trials. PMID:27208386

  2. Potential workload in applying clinical practice guidelines for patients with chronic conditions and multimorbidity: a systematic analysis

    PubMed Central

    Buffel du Vaure, Céline; Ravaud, Philippe; Baron, Gabriel; Barnes, Caroline; Gilberg, Serge; Boutron, Isabelle

    2016-01-01

    Objectives To describe the potential workload for patients with multimorbidity when applying existing clinical practice guidelines. Design Systematic analysis of clinical practice guidelines for chronic conditions and simulation modelling approach. Data sources National Guideline Clearinghouse index of US clinical practice guidelines. Study selection We identified the most recent guidelines for adults with 1 of 6 prevalent chronic conditions in primary care (ie hypertension, diabetes, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), osteoarthritis and depression). Data extraction From the guidelines, we extracted all recommended health-related activities (HRAs) such as drug management, self-monitoring, visits to the doctor, laboratory tests and changes of lifestyle for a patient aged 45–64 years with moderate severity of conditions. Simulation modelling approach For each HRA identified, we performed a literature review to determine the potential workload in terms of time spent on this HRA. Then, we used a simulation modelling approach to estimate the potential workload needed to comply with these recommended HRAs for patients with several of these chronic conditions. Results Depending on the concomitant chronic condition, patients with 3 chronic conditions complying with all the guidelines would have to take a minimum of 6 to a maximum of 13 medications per day, visit a health caregiver a minimum of 1.2 to a maximum of 5.9 times per month and spend a mean (SD) of 49.6 (27.3) to 71.0 (34.5) h/month in HRAs. The potential workload increased greatly with increasing number of concomitant conditions, rising to 18 medications per day, 6.6 visits per month and 80.7 (35.8) h/month in HRAs for patients with 6 chronic conditions. PMID:27006342

  3. Making good theory practical: five lessons for an Applied Social Identity Approach to challenges of organizational, health, and clinical psychology.

    PubMed

    Haslam, S Alexander

    2014-03-01

    Social identity research was pioneered as a distinctive theoretical approach to the analysis of intergroup relations but over the last two decades it has increasingly been used to shed light on applied issues. One early application of insights from social identity and self-categorization theories was to the organizational domain (with a particular focus on leadership), but more recently there has been a surge of interest in applications to the realm of health and clinical topics. This article charts the development of this Applied Social Identity Approach, and abstracts five core lessons from the research that has taken this forward. (1) Groups and social identities matter because they have a critical role to play in organizational and health outcomes. (2) Self-categorizations matter because it is people's self-understandings in a given context that shape their psychology and behaviour. (3) The power of groups is unlocked by working with social identities not across or against them. (4) Social identities need to be made to matter in deed not just in word. (5) Psychological intervention is always political because it always involves some form of social identity management. Programmes that seek to incorporate these principles are reviewed and important challenges and opportunities for the future are identified.

  4. Analyzing Patients' Values by Applying Cluster Analysis and LRFM Model in a Pediatric Dental Clinic in Taiwan

    PubMed Central

    Lin, Shih-Yen; Liu, Chih-Wei

    2014-01-01

    This study combines cluster analysis and LRFM (length, recency, frequency, and monetary) model in a pediatric dental clinic in Taiwan to analyze patients' values. A two-stage approach by self-organizing maps and K-means method is applied to segment 1,462 patients into twelve clusters. The average values of L, R, and F excluding monetary covered by national health insurance program are computed for each cluster. In addition, customer value matrix is used to analyze customer values of twelve clusters in terms of frequency and monetary. Customer relationship matrix considering length and recency is also applied to classify different types of customers from these twelve clusters. The results show that three clusters can be classified into loyal patients with L, R, and F values greater than the respective average L, R, and F values, while three clusters can be viewed as lost patients without any variable above the average values of L, R, and F. When different types of patients are identified, marketing strategies can be designed to meet different patients' needs. PMID:25045741

  5. Analyzing patients' values by applying cluster analysis and LRFM model in a pediatric dental clinic in Taiwan.

    PubMed

    Wu, Hsin-Hung; Lin, Shih-Yen; Liu, Chih-Wei

    2014-01-01

    This study combines cluster analysis and LRFM (length, recency, frequency, and monetary) model in a pediatric dental clinic in Taiwan to analyze patients' values. A two-stage approach by self-organizing maps and K-means method is applied to segment 1,462 patients into twelve clusters. The average values of L, R, and F excluding monetary covered by national health insurance program are computed for each cluster. In addition, customer value matrix is used to analyze customer values of twelve clusters in terms of frequency and monetary. Customer relationship matrix considering length and recency is also applied to classify different types of customers from these twelve clusters. The results show that three clusters can be classified into loyal patients with L, R, and F values greater than the respective average L, R, and F values, while three clusters can be viewed as lost patients without any variable above the average values of L, R, and F. When different types of patients are identified, marketing strategies can be designed to meet different patients' needs. PMID:25045741

  6. Osseointegration of loaded dental implant with KrF laser hydroxylapatite films on Ti6Al4V alloy by minipigs

    NASA Astrophysics Data System (ADS)

    Dostalova, Tatjana; Himmlova, Lucia; Jelinek, Miroslav; Grivas, Christos

    2001-04-01

    This study was performed with the objective of evaluating osseointegration of titanium alloy Ti6Al4V dental implants coated with hydroxylapatite (HA) deposited by a KrF laser. For this a KrF excimer laser and stainless-steel deposition chamber were used. The thickness of the HA films was approximately 1 micrometers . IN this investigation experimental animals minipigs were used; the implants were placed vertically into the lower jaw. After 14 weeks of unloaded osseointegration, metal-ceramic crowns were inserted and, at the same time, fluorescent solution was injected into the experimental animals. Six months after insertion of crowns the animals were sacrificed. The vertical position of the implants was checked by a radiograph. Microscopic sections were cut and ground, and the sections were examined under polarized and fluorescent light using a microscope with a charge coupled device camera. The six month long osseointegration in the lower jaw has confirmed the presence of newly formed bone around all the implants. In the experimental group, which had a laser-deposited coating, the layer of fibrous connective tissue was seen only randomly. In the control group (titanium implant without a cover) the fibrous connective tissue between the implant and the newly formed bone was observed more frequently, but this difference was not significant.

  7. Multicultural Training Applied in Clinical Practice: Reflections from a Euro-American Female Counselor-in-Training Working with Mexican Immigrants

    ERIC Educational Resources Information Center

    Paynter, Clara K.; Estrada, Diane

    2009-01-01

    The clinical experience of a Euro-American female counselor-in-training providing bilingual family therapy services to Mexican immigrants is described. Cultural themes encountered when applying academic discourse to clinical work are raised in the context of case studies in which the student therapist works from a postmodern client-as-expert…

  8. A Randomized Clinical Trial Comparing an Acceptance Based Behavior Therapy to Applied Relaxation for Generalized Anxiety Disorder

    PubMed Central

    Hayes-Skelton, Sarah A.; Roemer, Lizabeth; Orsillo, Susan M.

    2013-01-01

    Objective To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in GAD over an empirically-supported treatment. Method This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an Acceptance Based Behavior Therapy (ABBT) or Applied Relaxation (AR). Assessments at pre-treatment, post-treatment, and 6-month follow-up included the following primary outcome measures: GAD Clinician Severity Rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses. Results Mixed Effect Regression Models showed significant large effects for Time for all primary outcome measures (d’s 1.36 to 1.61) but non-significant, small effects for Condition and Condition X Time (d’s 0.002 to 0.24), indicating clients in both treatments improved comparably over treatment. For secondary outcomes, Time was significant (d’s 0.74 to 1.38) but Condition and Condition X Time effects were not (d’s 0.11 to 0.31). No significant differences emerged over follow-up (d’s 0.02 to 0.16) indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at post-treatment and follow-up. Conclusions ABBT is a viable alternative for treating GAD. PMID:23647281

  9. Applied clinical pharmacology and public health in rural Asia – preventing deaths from organophosphorus pesticide and yellow oleander poisoning

    PubMed Central

    Eddleston, Michael

    2013-01-01

    Self-poisoning with pesticides or plants is a major clinical problem in rural Asia, killing several hundred thousand people every year. Over the last 17 years, our clinical toxicology and pharmacology group has carried out clinical studies in the North Central Province of Sri Lanka to improve treatment and reduce deaths. Studies have looked at the effectiveness of anti-digoxin Fab in cardiac glycoside plant poisoning, multiple dose activated charcoal in all poisoning, and pralidoxime in moderate toxicity organophosphorus insecticide poisoning. More recently, using a Haddon matrix as a guide, we have started conducting public health and animal studies to find strategies that may work outside of the hospital. Based on the 2009 GSK Research in Clinical Pharmacology prize lecture, this review shows the evolution of the group's research from a clinical pharmacology approach to one that studies possible interventions at multiple levels, including the patient, the community and government legislation. PMID:22943579

  10. Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients with Hypertension: Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study

    ERIC Educational Resources Information Center

    Karupaiah, Tilakavati; Wong, Kimberly; Chinna, Karuthan; Arasu, Kanimolli; Chee, Winnie Siew Swee

    2015-01-01

    The CORFIS ("Community-Based Cardiovascular Risk Factors Intervention Strategies") program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in…

  11. Developing a Technology for the Use of Operant Extinction in Clinical Settings: An Examination of Basic and Applied Research.

    ERIC Educational Resources Information Center

    Lerman, Dorothea C.; Iwata, Brian A.

    1996-01-01

    Basic and applied research on variables that influence the extinction of operant behaviors is reviewed and applied to the treatment of behavior disorders. The potential value of a general technology for the use of behavioral extinction is discussed. The paper concludes that current research findings are not sufficient for the development of a…

  12. Applying MetaMap to Medline for identifying novel associations in a large clinical dataset: a feasibility analysis

    PubMed Central

    Hanauer, David A; Saeed, Mohammed; Zheng, Kai; Mei, Qiaozhu; Shedden, Kerby; Aronson, Alan R; Ramakrishnan, Naren

    2014-01-01

    Objective We describe experiments designed to determine the feasibility of distinguishing known from novel associations based on a clinical dataset comprised of International Classification of Disease, V.9 (ICD-9) codes from 1.6 million patients by comparing them to associations of ICD-9 codes derived from 20.5 million Medline citations processed using MetaMap. Associations appearing only in the clinical dataset, but not in Medline citations, are potentially novel. Methods Pairwise associations of ICD-9 codes were independently identified in both the clinical and Medline datasets, which were then compared to quantify their degree of overlap. We also performed a manual review of a subset of the associations to validate how well MetaMap performed in identifying diagnoses mentioned in Medline citations that formed the basis of the Medline associations. Results The overlap of associations based on ICD-9 codes in the clinical and Medline datasets was low: only 6.6% of the 3.1 million associations found in the clinical dataset were also present in the Medline dataset. Further, a manual review of a subset of the associations that appeared in both datasets revealed that co-occurring diagnoses from Medline citations do not always represent clinically meaningful associations. Discussion Identifying novel associations derived from large clinical datasets remains challenging. Medline as a sole data source for existing knowledge may not be adequate to filter out widely known associations. Conclusions In this study, novel associations were not readily identified. Further improvements in accuracy and relevance for tools such as MetaMap are needed to realize their expected utility. PMID:24928177

  13. How to apply case reports in clinical practice using surrogate models via example of the trigeminocardiac reflex.

    PubMed

    Sandu, Nora; Chowdhury, Tumul; Schaller, Bernhard J

    2016-04-06

    Case reports are an increasing source of evidence in clinical medicine. Until a few years ago, such case reports were emerged into systematic reviews and nowadays they are often fitted to the development of clinical (thinking) models. We describe this modern progress of knowledge creation by the example of the trigeminocardiac reflex that was first described in 1999 by a case series and was developed over the cause-and-effect relationship, triangulation to systematic reviews and finally to thinking models. Therefore, this editorial not only underlines the increasing and outstanding importance of (unique) case reports in current science, but also in current clinical decision-making and therefore also that of specific journals like the Journal of Medical Case Reports.

  14. Now or Later?: An Empirical Investigation of When and Why Students Apply to Clinical Psychology PhD Programs

    ERIC Educational Resources Information Center

    Zimak, Eric H.; Edwards, Katie M.; Johnson, Shannon M.; Suhr, Julie

    2011-01-01

    This study used a national sample of PhD students in clinical psychology (N = 1,034) to explore when students decided to pursue their graduate degree, reasons for their decisions, and associated satisfaction. Results indicated that immediately after completing their undergraduate degree, 57% of current graduate students reported postponing…

  15. Transcranial near-infrared laser therapy applied to promote clinical recovery in acute and chronic neurodegenerative diseases

    PubMed Central

    Lapchak, Paul A

    2012-01-01

    One of the most promising methods to treat neurodegeneration is noninvasive transcranial near-infrared laser therapy (NILT), which appears to promote acute neuroprotection by stimulating mitochondrial function, thereby increasing cellular energy production. NILT may also promote chronic neuronal function restoration via trophic factor-mediated plasticity changes or possibly neurogenesis. Clearly, NILT is a treatment that confers neuroprotection or neurorestoration using pleiotropic mechanisms. The most advanced application of NILT is for acute ischemic stroke based upon extensive preclinical and clinical studies. In laboratory settings, NILT is also being developed to treat traumatic brain injury, Alzheimer’s disease and Parkinson’s disease. There is some intriguing data in the literature that suggests that NILT may be a method to promote clinical improvement in neurodegenerative diseases where there is a common mechanistic component, mitochondrial dysfunction and energy impairment. This article will analyze and review data supporting the continued development of NILT to treat neurodegenerative diseases. PMID:22145842

  16. Routing cancer immunology and immunotherapy from the lab to the clinic 4–5 th March 2014, Center for Applied Medical Research and University Clinic, Pamplona, Spain

    PubMed Central

    2014-01-01

    New approaches to generate effective anticancer responses by either inducing immune responses or inhibiting immunosuppression are under development to improve efficacy in patients. On March 4-5th, 2014, a symposium was held in Pamplona, Spain, to report the new strategies showing preclinical and clinical results regarding translational research efforts on the topic. Participants interacted through oral presentations of 15 speakers and further discussions on topics that included novel therapeutic agents for cancer immunotherapy, viral vectors and interferon-based approaches, experimental tumor imaging and immunostimulatory monoclonal antibodies. Promising agents to target cancer cells and therapeutic approaches that are under translation from bench to patients were presented. PMID:25060862

  17. Routing cancer immunology and immunotherapy from the lab to the clinic 4-5 th March 2014, Center for Applied Medical Research and University Clinic, Pamplona, Spain.

    PubMed

    Aznar, M Ángela; Melero, Ignacio; Quetglas, José I

    2014-01-01

    New approaches to generate effective anticancer responses by either inducing immune responses or inhibiting immunosuppression are under development to improve efficacy in patients. On March 4-5th, 2014, a symposium was held in Pamplona, Spain, to report the new strategies showing preclinical and clinical results regarding translational research efforts on the topic. Participants interacted through oral presentations of 15 speakers and further discussions on topics that included novel therapeutic agents for cancer immunotherapy, viral vectors and interferon-based approaches, experimental tumor imaging and immunostimulatory monoclonal antibodies. Promising agents to target cancer cells and therapeutic approaches that are under translation from bench to patients were presented.

  18. Applying the wisdom of stepping down inhaled corticosteroids in patients with COPD: a proposed algorithm for clinical practice.

    PubMed

    Kaplan, Alan G

    2015-01-01

    Current guidelines for the management of chronic obstructive pulmonary disease (COPD) recommend limiting the use of inhaled corticosteroids (ICS) to patients with more severe disease and/or increased exacerbation risk. However, there are discrepancies between guidelines and real-life practice, as ICS are being overprescribed. In light of the increasing concerns about the clinical benefit and long-term risks associated with ICS use, therapy needs to be carefully weighed on a case-by-case basis, including in patients already on ICS. Several studies sought out to determine the effects of withdrawing ICS in patients with COPD. Early studies have deterred clinicians from reducing ICS in patients with COPD as they reported that an abrupt withdrawal of ICS precipitates exacerbations, and results in a deterioration in lung function and symptoms. However, these studies were fraught with numerous methodological limitations. Recently, two randomized controlled trials and a real-life prospective study revealed that ICS can be safely withdrawn in certain patients. Of these, the WISDOM (Withdrawal of Inhaled Steroids During Optimized Bronchodilator Management) trial was the largest and first to examine stepwise withdrawal of ICS in patients with COPD receiving maintenance therapy of long-acting bronchodilators (ie, tiotropium and salmeterol). Even with therapy being in line with the current guidelines, the findings of the WISDOM trial indicate that not all patients benefit from including ICS in their treatment regimen. Indeed, only certain COPD phenotypes seem to benefit from ICS therapy, and validated markers that predict ICS response are urgently warranted in clinical practice. Furthermore, we are now better equipped with a larger armamentarium of novel and more effective long-acting β2-agonist/long-acting muscarinic antagonist combinations that can be considered by clinicians to optimize bronchodilation and allow for safer ICS withdrawal. In addition to providing a review of

  19. Applying the wisdom of stepping down inhaled corticosteroids in patients with COPD: a proposed algorithm for clinical practice

    PubMed Central

    Kaplan, Alan G

    2015-01-01

    Current guidelines for the management of chronic obstructive pulmonary disease (COPD) recommend limiting the use of inhaled corticosteroids (ICS) to patients with more severe disease and/or increased exacerbation risk. However, there are discrepancies between guidelines and real-life practice, as ICS are being overprescribed. In light of the increasing concerns about the clinical benefit and long-term risks associated with ICS use, therapy needs to be carefully weighed on a case-by-case basis, including in patients already on ICS. Several studies sought out to determine the effects of withdrawing ICS in patients with COPD. Early studies have deterred clinicians from reducing ICS in patients with COPD as they reported that an abrupt withdrawal of ICS precipitates exacerbations, and results in a deterioration in lung function and symptoms. However, these studies were fraught with numerous methodological limitations. Recently, two randomized controlled trials and a real-life prospective study revealed that ICS can be safely withdrawn in certain patients. Of these, the WISDOM (Withdrawal of Inhaled Steroids During Optimized Bronchodilator Management) trial was the largest and first to examine stepwise withdrawal of ICS in patients with COPD receiving maintenance therapy of long-acting bronchodilators (ie, tiotropium and salmeterol). Even with therapy being in line with the current guidelines, the findings of the WISDOM trial indicate that not all patients benefit from including ICS in their treatment regimen. Indeed, only certain COPD phenotypes seem to benefit from ICS therapy, and validated markers that predict ICS response are urgently warranted in clinical practice. Furthermore, we are now better equipped with a larger armamentarium of novel and more effective long-acting β2-agonist/long-acting muscarinic antagonist combinations that can be considered by clinicians to optimize bronchodilation and allow for safer ICS withdrawal. In addition to providing a review of

  20. [Subtypes of cocaine addicts with and without associated problematic alcohol use: towards a neuropsychology of personality applied to clinical practice].

    PubMed

    Pedrero Pérez, Eduardo J; Ruiz Sánchez de León, José M

    2012-01-01

    It is important to know which personality factors are associated with addiction so to distinguish addicts that require specialized treatment from those who do not, and to identify those addicts who achieve abstinence from those who continue their substance use despite the negative consequences. Cloninger's model includes biological and psychosocial variables that can be characterized in neuropsychological terms. Two samples were analyzed: individuals who had begun cocaine addiction treatment (n=183) and a non-clinical population sample (n = 183), matched for sex, age and educational level. Alcohol abuse/dependence was monitored as an independent variable. Significant differences and large effect size were found between addicts and non-clinical population in Novelty Seeking and Self-Directedness, and to a lesser extent, in Harm Avoidance. These differences increase when problematic use of alcohol is added. According to the profile of traits, clusters of addicts were established and differences were obtained in variables such as functional/dysfunctional impulsivity, dysexecutive symptoms and perceived stress. Six clusters were identified, some of minor severity, the most severely problematic clusters being characterized by higher levels of dysfunctional impulsivity, more dysexecutive symptoms and higher levels of perceived stress. Self-Directedness seems to reflect the deficit of prefrontal systems in the regulation of behavior, as well as in emotion and impulse control. It is proposed that evaluation of the personality is more useful than the mere assessment of symptoms for classifying addicts, determining their needs and designing a therapeutic itinerary. PMID:23241716

  1. [Subtypes of cocaine addicts with and without associated problematic alcohol use: towards a neuropsychology of personality applied to clinical practice].

    PubMed

    Pedrero Pérez, Eduardo J; Ruiz Sánchez de León, José M

    2012-01-01

    It is important to know which personality factors are associated with addiction so to distinguish addicts that require specialized treatment from those who do not, and to identify those addicts who achieve abstinence from those who continue their substance use despite the negative consequences. Cloninger's model includes biological and psychosocial variables that can be characterized in neuropsychological terms. Two samples were analyzed: individuals who had begun cocaine addiction treatment (n=183) and a non-clinical population sample (n = 183), matched for sex, age and educational level. Alcohol abuse/dependence was monitored as an independent variable. Significant differences and large effect size were found between addicts and non-clinical population in Novelty Seeking and Self-Directedness, and to a lesser extent, in Harm Avoidance. These differences increase when problematic use of alcohol is added. According to the profile of traits, clusters of addicts were established and differences were obtained in variables such as functional/dysfunctional impulsivity, dysexecutive symptoms and perceived stress. Six clusters were identified, some of minor severity, the most severely problematic clusters being characterized by higher levels of dysfunctional impulsivity, more dysexecutive symptoms and higher levels of perceived stress. Self-Directedness seems to reflect the deficit of prefrontal systems in the regulation of behavior, as well as in emotion and impulse control. It is proposed that evaluation of the personality is more useful than the mere assessment of symptoms for classifying addicts, determining their needs and designing a therapeutic itinerary.

  2. Radiosynovectomy of the elbow joint synovitis in rheumatoid arthritis treated with Lutetium - 177 labeled hydroxylapatite (Lu-177 HA) particulates; first case report and image of Lu -177 HA in the elbow joint

    PubMed Central

    Kamaleshwaran, Koramadai Karuppusamy; Rajamani, Venkataraman; Thirumalaisamy, Subbiah Gounder; Chakraborty, Sudipta; Kalarikal, Radhakrishnan; Mohanan, Vyshakh; Shinto, Ajit Sugunan

    2014-01-01

    Rheumatoid arthritis is a chronic disease that is mainly characterized by asymmetric erosive synovitis, particularly affecting the peripheral joints. Radiation synovectomy or radiosynovectomy, also known as radiosynoviorthesis was first described in 1950's as a adjuvant treatment for rheumatoid arthritis. Radiosynovectomy is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. Lu-177 has presence of gamma photons of imagable energy with low abundance which provides the additional benefit of carrying out simultaneous scintigraphy. We describe the first case report of use of Lu-177 hydroxylapatite particulates in a 35-year-old female patient who was presented with elbow joint synovitis due to rheumatoid arthritis. PMID:25400373

  3. A novel, multistep, combination facial rejuvenation procedure for treatment of the whole face with incobotulinumtoxinA, and two dermal fillers- calcium hydroxylapatite and a monophasic, polydensified hyaluronic acid filler.

    PubMed

    Pavicic, Tatjana; Few, Julius W; Huber-Vorländer, Jurgen

    2013-09-01

    Facial aging is a three-dimensional process, and facial rejuvenation procedures intended to reverse the effects of aging need to address this by combining products that relax hyperkinetic musculature, volumize/fill, and recontour/lift the whole face. In line with the desire of patients to achieve an overall youthful facial appearance, we report for the first time three cases where patients have been successfully treated across the whole face with a novel, three-step approach, layering incobotulinumtoxinA and two dermal fillers (calcium hydroxylapatite and a monophasic hyaluronic acid filler with CPM Technology) injected at three separate treatment visits. The results suggest that this layering approach based on an understanding of the underlying causes of facial aging, where different products are used in combination to treat the entire face, can enable patients to achieve the desired outcome of a return to the characteristics of a more youthful face.

  4. Radiosynovectomy of the elbow joint synovitis in rheumatoid arthritis treated with Lutetium - 177 labeled hydroxylapatite (Lu-177 HA) particulates; first case report and image of Lu -177 HA in the elbow joint.

    PubMed

    Kamaleshwaran, Koramadai Karuppusamy; Rajamani, Venkataraman; Thirumalaisamy, Subbiah Gounder; Chakraborty, Sudipta; Kalarikal, Radhakrishnan; Mohanan, Vyshakh; Shinto, Ajit Sugunan

    2014-10-01

    Rheumatoid arthritis is a chronic disease that is mainly characterized by asymmetric erosive synovitis, particularly affecting the peripheral joints. Radiation synovectomy or radiosynovectomy, also known as radiosynoviorthesis was first described in 1950's as a adjuvant treatment for rheumatoid arthritis. Radiosynovectomy is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. Lu-177 has presence of gamma photons of imagable energy with low abundance which provides the additional benefit of carrying out simultaneous scintigraphy. We describe the first case report of use of Lu-177 hydroxylapatite particulates in a 35-year-old female patient who was presented with elbow joint synovitis due to rheumatoid arthritis.

  5. Stereoscopic three-dimensional visualization applied to multimodal brain images: clinical applications and a functional connectivity atlas

    PubMed Central

    Rojas, Gonzalo M.; Gálvez, Marcelo; Vega Potler, Natan; Craddock, R. Cameron; Margulies, Daniel S.; Castellanos, F. Xavier; Milham, Michael P.

    2014-01-01

    Effective visualization is central to the exploration and comprehension of brain imaging data. While MRI data are acquired in three-dimensional space, the methods for visualizing such data have rarely taken advantage of three-dimensional stereoscopic technologies. We present here results of stereoscopic visualization of clinical data, as well as an atlas of whole-brain functional connectivity. In comparison with traditional 3D rendering techniques, we demonstrate the utility of stereoscopic visualizations to provide an intuitive description of the exact location and the relative sizes of various brain landmarks, structures and lesions. In the case of resting state fMRI, stereoscopic 3D visualization facilitated comprehension of the anatomical position of complex large-scale functional connectivity patterns. Overall, stereoscopic visualization improves the intuitive visual comprehension of image contents, and brings increased dimensionality to visualization of traditional MRI data, as well as patterns of functional connectivity. PMID:25414626

  6. Stereoscopic three-dimensional visualization applied to multimodal brain images: clinical applications and a functional connectivity atlas.

    PubMed

    Rojas, Gonzalo M; Gálvez, Marcelo; Vega Potler, Natan; Craddock, R Cameron; Margulies, Daniel S; Castellanos, F Xavier; Milham, Michael P

    2014-01-01

    Effective visualization is central to the exploration and comprehension of brain imaging data. While MRI data are acquired in three-dimensional space, the methods for visualizing such data have rarely taken advantage of three-dimensional stereoscopic technologies. We present here results of stereoscopic visualization of clinical data, as well as an atlas of whole-brain functional connectivity. In comparison with traditional 3D rendering techniques, we demonstrate the utility of stereoscopic visualizations to provide an intuitive description of the exact location and the relative sizes of various brain landmarks, structures and lesions. In the case of resting state fMRI, stereoscopic 3D visualization facilitated comprehension of the anatomical position of complex large-scale functional connectivity patterns. Overall, stereoscopic visualization improves the intuitive visual comprehension of image contents, and brings increased dimensionality to visualization of traditional MRI data, as well as patterns of functional connectivity.

  7. Applying PET to Broaden the Diagnostic Utility of the Clinically Validated CA19.9 Serum Biomarker for Oncology

    PubMed Central

    Viola-Villegas, Nerissa Therese; Rice, Samuel L.; Carlin, Sean; Wu, Xiaohong; Evans, Michael J.; Sevak, Kuntal K.; Drobjnak, Marija; Ragupathi, Govind; Sawada, Ritsuko; Scholz, Wolfgang W.; Livingston, Philip O.; Lewis, Jason S.

    2014-01-01

    Despite their considerable advantages, many circulating biomarkers have well-documented limitations. One prominent shortcoming in oncology is a high frequency of false-positive indications for malignant disease in upfront diagnosis. Because one common cause of false positivism is biomarker production from benign disorders in unrelated host tissues, we hypothesized that probing the sites of biomarker secretion with an imaging tool could be a broadly useful strategy to deconvolute the meaning of foreboding but inconclusive circulating biomarker levels. Methods In preparation to address this hypothesis clinically, we developed 89Zr-5B1, a fully human, antibody-based radiotracer targeting tumor-associated CA19.9 in the preclinical setting. Results 89Zr-5B1 localized to multiple tumor models representing diseases with undetectable and supraphysiologic serum CA19.9 levels. Among these, 89Zr-5B1 detected orthotopic models of pancreatic ductal adenocarcinoma, an elusive cancer for which the serum assay is measured in humans but with limited specificity in part because of the frequency of CA19.9 secretion from benign hepatic pathologies. Conclusion In this report, a general strategy to supplement some of the shortcomings of otherwise highly useful circulating biomarkers with immunoPET is described. To expedite the clinical validation of this model, a human monoclonal antibody to CA19.9 (a highly visible but partially flawed serum biomarker for several cancers) was radiolabeled and evaluated, and the compelling preclinical evidence suggests that the radiotracer may enhance the fidelity of diagnosis and staging of pancreatic ductal adenocarcinoma, a notoriously occult cancer. PMID:24029655

  8. [Thinking and methods concerning applying data-mining technique in clinical efficacy evaluation of TCM treatment for child's pneumonia].

    PubMed

    Wang, Xue-feng; Dong, Dan; Liang, Mao-xin

    2007-10-01

    TCM syndrome differentiation system (TCM-SDS) possesses a complex nonlinear characteristic, which determines the falt that the evaluation of TCM efficacy should not be simplified to a causal or linear relationship. Previous selected indexes and methods for evaluating curative effect of Child's pneumonia have their limitations. This paper mainly introduces several thoughts and methods formed in the exploratory researches, employing data mining technology in this field. We believe that efficacy evaluation research of Child's pneumonia on the basis of standardized study of TCM-SDS is a scientific work. Applying data mining method in processing enormous and multilayer information of TCM differentiation has strong advantages in screening evaluating indexes of Child's pneumonia. Meanwhile, some major concerning technical categorizations and implementing strategies for the research are also introduced.

  9. The danger of applying uniform clinical policies across populations: the case of breast cancer in American Indians.

    PubMed Central

    Nutting, P A; Calonge, B N; Iverson, D C; Green, L A

    1994-01-01

    OBJECTIVES. This study examined the implications of annual screening mammography for cost and mortality in American Indian populations with differing baseline breast cancer rates. METHODS. A decision tree compared annual screening mammography and screening clinical breast examination with referral for diagnostic mammography when appropriate. The decision tree was constructed to examine the effect of different base-line cancer rates, stage at diagnosis, and stage-specific survival. Outcomes included 5-year relative survival, deaths prevented at 5 years, cost per death prevented, and total costs. RESULTS. The findings suggest that the total cost of breast cancer is 3.6 times higher with the screening mammography program but results in a 27.9% reduction in breast cancer deaths over the first 5 years of the program. Both costs and deaths prevented are sensitive to the incidence of breast cancer in the population and are less favorable in the range of incidence seen in American Indians. CONCLUSIONS. The cost and impact of a given strategy for cancer screening vary among communities with different disease incidence, stage at diagnosis, and stage-specific survival, as seen in American Indian populations. PMID:7943483

  10. The secret of the care of the patient is in knowing and applying the evidence about effective clinical communication.

    PubMed

    Frankel, R M; Sherman, H B

    2015-11-01

    American physicians and dentists conduct approximately 140 000-160 000 patient interviews in a practice lifetime, making the interview the most frequently performed medical procedure. Over the past 75 years, a steadily growing stream of scientific research has confirmed the fact that patient-clinician communication affects the course, direction, and both biomedical and functional outcomes of care. The field of clinical communication research has matured from anecdotes and aphorisms about 'bedside manner' to sophisticated randomized control trials and evidence-based outcomes that have been translated into reliable practice guidelines. Several key skills or habits of practice have been identified and studied in terms of their efficacy and effectiveness. These include the importance of agenda-setting, eliciting patients' perspectives about the nature of their ailments, communicating caring and concern, and testing for patient comprehension and agreement with proposed treatments. In addition to being effective, interpersonal communication can be deeply satisfying as well as offering a lower probability of law suits in the event of an adverse outcome. PMID:24725164

  11. Applying risk adjusted cost-effectiveness (RAC-E) analysis to hospitals: estimating the costs and consequences of variation in clinical practice.

    PubMed

    Karnon, Jonathan; Caffrey, Orla; Pham, Clarabelle; Grieve, Richard; Ben-Tovim, David; Hakendorf, Paul; Crotty, Maria

    2013-06-01

    Cost-effectiveness analysis is well established for pharmaceuticals and medical technologies but not for evaluating variations in clinical practice. This paper describes a novel methodology--risk adjusted cost-effectiveness (RAC-E)--that facilitates the comparative evaluation of applied clinical practice processes. In this application, risk adjustment is undertaken with a multivariate matching algorithm that balances the baseline characteristics of patients attending different settings (e.g., hospitals). Linked, routinely collected data are used to analyse patient-level costs and outcomes over a 2-year period, as well as to extrapolate costs and survival over patient lifetimes. The study reports the relative cost-effectiveness of alternative forms of clinical practice, including a full representation of the statistical uncertainty around the mean estimates. The methodology is illustrated by a case study that evaluates the relative cost-effectiveness of services for patients presenting with acute chest pain across the four main public hospitals in South Australia. The evaluation finds that services provided at two hospitals were dominated, and of the remaining services, the more effective hospital gained life years at a low mean additional cost and had an 80% probability of being the most cost-effective hospital at realistic cost-effectiveness thresholds. Potential determinants of the estimated variation in costs and effects were identified, although more detailed analyses to identify specific areas of variation in clinical practice are required to inform improvements at the less cost-effective institutions.

  12. Applying self-determination theory for improved understanding of physiotherapists' rationale for using research in clinical practice: a qualitative study in Sweden.

    PubMed

    Dannapfel, Petra; Peolsson, Anneli; Ståhl, Christian; Öberg, Birgitta; Nilsen, Per

    2014-01-01

    Physiotherapists are generally positive to evidence-based practice (EBP) and the use of research in clinical practice, yet many still base clinical decisions on knowledge obtained during their initial education and/or personal experience. Our aim was to explore motivations behind physiotherapists' use of research in clinical practice. Self-Determination Theory was applied to identify the different types of motivation for use of research. This theory posits that all behaviours lie along a continuum of relative autonomy, reflecting the extent to which a person endorses their actions. Eleven focus group interviews were conducted, involving 45 physiotherapists in various settings in Sweden. Data were analysed using qualitative content analysis and the findings compared with Self-Determination Theory using a deductive approach. Motivations underlying physiotherapists use of research in clinical practice were identified. Most physiotherapists expressed autonomous forms of motivation for research use, but some exhibited more controlled motivation. Several implications about how more evidence-based physiotherapy can be achieved are discussed, including the potential to tailor educational programs on EBP to better account for differences in motivation among participants, using autonomously motivated physiotherapists as change agents and creating favourable conditions to encourage autonomous motivation by way of feelings of competence, autonomy and a sense of relatedness.

  13. Virtual reality, augmented reality, and robotics applied to digestive operative procedures: from in vivo animal preclinical studies to clinical use

    NASA Astrophysics Data System (ADS)

    Soler, Luc; Marescaux, Jacques

    2006-04-01

    Technological innovations of the 20 th century provided medicine and surgery with new tools, among which virtual reality and robotics belong to the most revolutionary ones. Our work aims at setting up new techniques for detection, 3D delineation and 4D time follow-up of small abdominal lesions from standard mecial images (CT scsan, MRI). It also aims at developing innovative systems making tumor resection or treatment easier with the use of augmented reality and robotized systems, increasing gesture precision. It also permits a realtime great distance connection between practitioners so they can share a same 3D reconstructed patient and interact on a same patient, virtually before the intervention and for real during the surgical procedure thanks to a telesurgical robot. In preclinical studies, our first results obtained from a micro-CT scanner show that these technologies provide an efficient and precise 3D modeling of anatomical and pathological structures of rats and mice. In clinical studies, our first results show the possibility to improve the therapeutic choice thanks to a better detection and and representation of the patient before performing the surgical gesture. They also show the efficiency of augmented reality that provides virtual transparency of the patient in real time during the operative procedure. In the near future, through the exploitation of these systems, surgeons will program and check on the virtual patient clone an optimal procedure without errors, which will be replayed on the real patient by the robot under surgeon control. This medical dream is today about to become reality.

  14. A pragmatic study exploring the prevention of delirium among hospitalized older hip fracture patients: Applying evidence to routine clinical practice using clinical decision support.

    PubMed

    Holroyd-Leduc, Jayna M; Abelseth, Greg A; Khandwala, Farah; Silvius, James L; Hogan, David B; Schmaltz, Heidi N; Frank, Cyril B; Straus, Sharon E

    2010-10-22

    discharges to long-term care (6% post versus 13% pre; p = 0.20). Translation of evidence-based multi-component delirium prevention strategies into everyday clinical care, using the electronic medical record, was not found to be effective at decreasing delirium rates among hip facture patients.

  15. Applying clinically proven human techniques for contraception and fertility to endangered species and zoo animals: a review.

    PubMed

    Silber, Sherman J; Barbey, Natalie; Lenahan, Kathy; Silber, David Z

    2013-12-01

    Reversible contraception that does not alter natural behavior is a critical need for managing zoo populations. In addition to reversible contraception, other fertility techniques perfected in humans may be useful, such as in vitro fertilization (IVF) or oocyte and embryo banking for endangered species like amphibians and Mexican wolves (Canis lupus baileyi). Furthermore, the genetics of human fertility can give a better understanding of fertility in more exotic species. Collaborations were established to apply human fertility techniques to the captive population. Reversible vasectomy might be one solution for reversible contraception that does not alter behavior. Reversible approaches to vasectomy, avoiding secondary epididymal disruption, were attempted in South American bush dogs (Speothos venaticus), chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla), Przewalski's horse (Equus przewalski poliakov), and Sika deer (Cervus nippon) in a variety of zoos around the world. These techniques were first perfected in > 4,000 humans before attempting them in zoo animals. In vitro fertilization with gestational surrogacy was used to attempt to break the vicious cycle of hand rearing of purebred orangutans, and egg and ovary vitrification in humans have led to successful gamete banking for Mexican wolves and disappearing amphibians. The study of the human Y chromosome has even explained a mechanism of extinction related to global climate change. The best results with vasectomy reversal (normal sperm counts, pregnancy, and live offspring) were obtained when the original vasectomy was performed "open-ended," so as to avoid pressure-induced epididymal disruption. The attempt at gestational surrogacy for orangutans failed because of severe male infertility and the lack of success with human ovarian hyperstimulation protocols. Vitrification of oocytes is already being employed for the Amphibian Ark Project and for Mexican wolves. Vasectomy can be a reversible contraception

  16. Designing evidence-based medicine training to optimize the transfer of skills from the classroom to clinical practice: applying the four component instructional design model.

    PubMed

    Maggio, Lauren A; Cate, Olle Ten; Irby, David M; O'Brien, Bridget C

    2015-11-01

    Evidence-based medicine (EBM) skills, although taught in medical schools around the world, are not optimally practiced in clinical environments because of multiple barriers, including learners' difficulty transferring EBM skills learned in the classroom to clinical practice. This lack of skill transfer may be partially due to the design of EBM training. To facilitate the transfer of EBM skills from the classroom to clinical practice, the authors explore one instructional approach, called the Four Component Instructional Design (4C/ID) model, to guide the design of EBM training. On the basis of current cognitive psychology, including cognitive load theory, the premise of the 4C/ID model is that complex skills training, such as EBM training, should include four components: learning tasks, supportive information, procedural information, and part-task practice. The combination of these four components can inform the creation of complex skills training that is designed to avoid overloading learners' cognitive abilities; to facilitate the integration of the knowledge, skills, and attitudes needed to execute a complex task; and to increase the transfer of knowledge to new situations. The authors begin by introducing the 4C/ID model and describing the benefits of its four components to guide the design of EBM training. They include illustrative examples of educational practices that are consistent with each component and that can be applied to teaching EBM. They conclude by suggesting that medical educators consider adopting the 4C/ID model to design, modify, and/or implement EBM training in classroom and clinical settings.

  17. Long-term clinical evaluation of fracture and pulp injury following glass-ionomer cement or composite resin applied as a base filling in teeth restored with amalgam.

    PubMed

    De C Luz, M A; Ciaramicoli-Rodrigues, M T; Garone Netto, N; De Lima, A C

    2001-07-01

    The aim of this research was to analyse the long-term clinical behaviour of two dental materials applied as filling under silver amalgam restorations: glass-ionomer cement (GIC) and composite resin with adhesive system (CR). In this study, 117 posterior teeth (29 premolars and 88 molars) were selected with carious lesions which resulted in great loss of dentin and cusps with unsupported enamel. After caries removal, cavities were prepared and totally filled with GIC or with CR. In a following visit, new cavities were prepared, leaving the employed filling material as a base and support for the enamel, which were then restored with silver amalgam. Restorations were evaluated periodically after 6 months and up to 5 years. Both fracture and pulpal involvement rates were low. Although differences could be observed in the behaviour of the materials, statistical survival estimation showed that the performances of GIC and CR as filling material were similar. There was a significant association both between kind of tooth (molar or premolar) and long-term survival of the restorations; and between degree of unsupported enamel and the same long-term survival. Our results confirmed that the technique in which GIC or CR are used as filling under silver amalgam restorations is clinically acceptable. PMID:11422695

  18. Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients With Hypertension: Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study.

    PubMed

    Karupaiah, Tilakavati; Wong, Kimberly; Chinna, Karuthan; Arasu, Kanimolli; Chee, Winnie Siew Swee

    2015-06-01

    The CORFIS (Community-Based Cardiovascular Risk Factors Intervention Strategies) program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in CORFIS patients with hypertension. Based on submitted diet and exercise records (n = 209), adherence to sodium reduction, regular exercise, and increasing fruit and vegetable intake behaviors were quantified against weight, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) changes. Patients were categorized at 6 months into nonadherent/N-A (Precontemplation, Contemplation, and Preparation), newly adherent/NA (Action) and totally adherent/TA (Maintenance) groups. Self-reported adherence records did not meet recommended targets for healthful behaviors, but clinical benefits were achieved by adherent groups as indicated by effect size (Cohen's d) comparisons. SBP reduction was associated with adherence to sodium reduction in NA (d = 0.60, p < .001) and TA (d = 0.45, p < .001) compared to N-A (d = 0.13, p > .05). Marginally increasing fruit and vegetable consumption (Δ = 0.41 servings) resulted in sizeable reductions in weight for NA (d = 0.81, p < .001) > TA (d = 0.54, p < .001) > N-A (d = 0.21, p > .05) and in WC for NA (d = 0.68, p < .00) > TA (d = 0.53, p < .001) > N-A (d = 0.52, p > .05). Exercise behavior was least successful as pedometer counting was below 10,000 steps but sizeable weight and WC reductions were largest for NA (d = 0.71 and 0.79, respectively) > TA (d = 0.60 and 0.53, respectively) > N-A (d = 0.33 and 0.35, respectively). Patients reporting a shift to positive stages of change behaviors enjoyed clinically beneficial reductions in SBP, DBP, weight, and WC. PMID:25512075

  19. Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients With Hypertension: Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study.

    PubMed

    Karupaiah, Tilakavati; Wong, Kimberly; Chinna, Karuthan; Arasu, Kanimolli; Chee, Winnie Siew Swee

    2015-06-01

    The CORFIS (Community-Based Cardiovascular Risk Factors Intervention Strategies) program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in CORFIS patients with hypertension. Based on submitted diet and exercise records (n = 209), adherence to sodium reduction, regular exercise, and increasing fruit and vegetable intake behaviors were quantified against weight, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) changes. Patients were categorized at 6 months into nonadherent/N-A (Precontemplation, Contemplation, and Preparation), newly adherent/NA (Action) and totally adherent/TA (Maintenance) groups. Self-reported adherence records did not meet recommended targets for healthful behaviors, but clinical benefits were achieved by adherent groups as indicated by effect size (Cohen's d) comparisons. SBP reduction was associated with adherence to sodium reduction in NA (d = 0.60, p < .001) and TA (d = 0.45, p < .001) compared to N-A (d = 0.13, p > .05). Marginally increasing fruit and vegetable consumption (Δ = 0.41 servings) resulted in sizeable reductions in weight for NA (d = 0.81, p < .001) > TA (d = 0.54, p < .001) > N-A (d = 0.21, p > .05) and in WC for NA (d = 0.68, p < .00) > TA (d = 0.53, p < .001) > N-A (d = 0.52, p > .05). Exercise behavior was least successful as pedometer counting was below 10,000 steps but sizeable weight and WC reductions were largest for NA (d = 0.71 and 0.79, respectively) > TA (d = 0.60 and 0.53, respectively) > N-A (d = 0.33 and 0.35, respectively). Patients reporting a shift to positive stages of change behaviors enjoyed clinically beneficial reductions in SBP, DBP, weight, and WC.

  20. Medical students’ satisfaction with the Applied Basic Clinical Seminar with Scenarios for Students, a novel simulation-based learning method in Greece

    PubMed Central

    2016-01-01

    Purpose: The integration of simulation-based learning (SBL) methods holds promise for improving the medical education system in Greece. The Applied Basic Clinical Seminar with Scenarios for Students (ABCS3) is a novel two-day SBL course that was designed by the Scientific Society of Hellenic Medical Students. The ABCS3 targeted undergraduate medical students and consisted of three core components: the case-based lectures, the ABCDE hands-on station, and the simulation-based clinical scenarios. The purpose of this study was to evaluate the general educational environment of the course, as well as the skills and knowledge acquired by the participants. Methods: Two sets of questions were distributed to the participants: the Dundee Ready Educational Environment Measure (DREEM) questionnaire and an internally designed feedback questionnaire (InEv). A multiple-choice examination was also distributed prior to the course and following its completion. A total of 176 participants answered the DREEM questionnaire, 56 the InEv, and 60 the MCQs. Results: The overall DREEM score was 144.61 (±28.05) out of 200. Delegates who participated in both the case-based lectures and the interactive scenarios core components scored higher than those who only completed the case-based lecture session (P=0.038). The mean overall feedback score was 4.12 (±0.56) out of 5. Students scored significantly higher on the post-test than on the pre-test (P<0.001). Conclusion: The ABCS3 was found to be an effective SBL program, as medical students reported positive opinions about their experiences and exhibited improvements in their clinical knowledge and skills. PMID:27012313

  1. The Effect of Information About Gynecological Examination on the Anxiety Level of Women Applying to Gynecology Clinics: A Prospective, Randomized, Controlled Study

    PubMed Central

    Ulker, Kahraman; Kivrak, Yuksel

    2016-01-01

    Background: Crowded hospital outpatient clinics and endless waiting lines that make patients feel overlooked tend to exaggerate patients’ anxiety levels. In addition, fear of pain, shyness, religious and traditional thoughts, women’s sexual role in society, and previous information and experience also contribute to people’s anxiety levels with regard to gynecologic examination. Objectives: We aimed to analyze the effect of specific information about gynecologic examination on anxiety levels of women applying to gynecology clinics. Materials and Methods: In this randomized prospective study, the women applying for a gynecological examination were randomly allocated into control, intervention 1, and intervention 2 groups. Power analysis indicated that in order to achieve a one-point decrease from the previous anxiety score of 43.85 ± 5.41 at one side alpha 0.05 with a power of 80%, at least 79 women were needed in each group. Four medical school students interviewed 75 women (25 in control, 25 in intervention 1, and 25 in intervention 2). The data were collected using the demographic, social, and economic data form, and the Turkish version of the state-trait anxiety inventory (STAI). The women in the intervention 1 and 2 groups were instructed to read a paper that contained brief information about the gynecological examination procedure and the profits obtained from forests, respectively. All participants, including the women in the control group, filled the STAI by themselves. The three groups were compared appropriately. Results: The demographics pertaining to age, gravidity and parity, miscarriage, induced abortion, ectopic pregnancy, offspring number, place of residence, working status, education level and previous experience of gynecological examination did not differ among the groups (P > 0.05). According to the STAI scores, all groups had mild state (control: 40.20 ± 10.53, intervention 1: 42.00 ± 11.98, and intervention 2: 39.53 ± 10.32) and severe

  2. Isolation of the major herpes simplex virus type 1 (HSV-1)-specific glycoprotein by hydroxylapatite chromatography and its use in enzyme-linked immunosorbent assay for titration of human HSV-1-specific antibodies.

    PubMed

    Vestergaard, B F; Grauballe, P C

    1979-12-01

    A 131,000 molecular weight herpes simplex virus type 1 (HSV-1) glycoprotein designated antigen number 6 (Ag-6) was previously shown to possess almost exclusively HSV-1-specific antigenic sites. Fused rocket and crossed immunoelectrophoresis of fractions obtained from hydroxylapatite chromatography of crude HSV-1 antigen (Triton X-100-solubilized, infected tissue culture cells) showed that a subfraction of Ag-6 could be separated from the other HSV antigens. Enzyme-linked immunosorbent assay with the isolated Ag-6 showed that sera from rabbits infected with HSV-1 and HSV-1 human antisera contained antibodies to Ag-6, whereas sera from HSV-2-infected rabbits and sera from patients with primary HSV-2 infections did not react with Ag-6. Enzyme-linked immunosorbent assay of 852 human sera for antibodies to HSV type-common glycoproteins, Ag-6, and HSV 2-specific antigens showed that 139 sera which reacted negatively with HSV type-common glycoproteins also did not react with Ag-6 with HSV-2 specific antigens. The 713 sera reacting positively to HSV type-common antigens either reacted with Ag-6 (328 sera) or with HSV-2-specific antigens (31 sera) or both (354 sera). This means that Ag-6 might be useful in large-scale human serology for the detection of past infection with HSV-1, irrespective of whether or not past infection with HSV-2 has occurred.

  3. A clinical education program for speech-language pathologists applying reflective practice, evidence-based practice and case-based learning.

    PubMed

    Meilijson, Sara; Katzenberger, Irit

    2014-01-01

    This paper presents a comprehensive clinical education program for speech-language pathology students while considering the learning process and gradual acquisition of knowledge and skills for becoming a practicing speech-language pathologist. It describes the clinical speech and language education program for speech-language pathology students at Hadassah Academic College Jerusalem (HAC) based on three facets of learning: reflective practice, evidence-based practice and case-based learning. Also described are the choice of the model of learning and its implementation. The clinical education program presented reflects the professional development of the faculty at HAC as well as recent trends in clinical education methods.

  4. Is the Information about a Test Important? Applying the Methods of Evidence-Based Medicine to the Clinical Examination of Swallowing

    ERIC Educational Resources Information Center

    Rosenbek, John C.; McCullough, Gary H.; Wertz, Robert T.

    2004-01-01

    A hotly debated topic in oropharyngeal dysphagia is the Clinical Swallowing Examination's (CSE) importance in clinical practice. That debate can profit from the application of evidence-based medicine's (EBM) principles and procedures. These can guide both appropriate data collection and interpretation as will be demonstrated in the present report.…

  5. Quantitative recording of physician clinical estimates, beyond a global estimate and formal joint count, in usual care: applying the scientific method, using a simple one-page worksheet.

    PubMed

    Pincus, Theodore; Bergman, Martin J

    2009-11-01

    Little attention has been directed to quantitation of clinical impressions and estimates of physicians. This article describes a one-page worksheet for completion by the physician at each patient visit. It includes a physician global estimate and estimate of change in status and four quantitative estimates for the degree of inflammation, degree of organ damage, and degree of fibromyalgia or somatization. An estimate of prognosis is recorded, with no therapy and with available therapies. All changes in medications are recorded. A template is available for a formal 42 joint count. The worksheet requires fewer than 15 seconds and has proven of considerable value in clinical care.

  6. Clinical Evaluation of self and professionally applied desensitizing agents in relieving dentin hypersensitivity after a single topical application: A Randomized Controlled Trial

    PubMed Central

    Khatri, Sachin G.; Acharya, Shashidhar

    2014-01-01

    Objectives: The objective of this study is to evaluate the efficacy of self and professionally applied desensitizing agents in relieving dentinal hypersensitivity after single direct topical application. Study Design: This was a randomized controlled trial conducted among 57 patients. 8% Arginine paste was self-applied by the subject and Gluma desensitizer was applied by investigator. Numeric rating scale was used to measure hypersensitivity after tactile stimulus, Schiff scale was used for cold and air blast stimuli respectively. Scores were recorded at baseline, immediately, 15 and 30 days after the application. Friedman, Wilcoxon test as post hoc was used to analyze within group differences, between group differences analyzed using Mann Whitney U test (P<0.05 considered significant). Results: 8% Arginine paste elicited significantly higher reductions in sensitivity (P<0.05) than that of Gluma group at all follow ups. There was a significant decrease in hypersensitivity for both the groups from baseline till final follow-up (P<0.05) for all three stimuli. 8% Arginine paste was found to be more effective than Gluma desensitizer in providing immediate relief from dentine hypersensitivity and also sustained the effect significantly for a period of 30 days. Conclusions: Self applied 8% Arginine paste is effective than professionally applied Gluma desensitizer in relieving dentinal hypersensitivity immediately and over a period of one month. Key words:Dentine hypersensitivity, arginine, gluma, desensitizing agents. PMID:25593653

  7. Comparison of Clinical Success of Applying a Kind of Fissure Sealant on the Lower Permanent Molar Teeth in Dry and Wet Conditions

    PubMed Central

    Eskandarian, Tahereh; Baghi, Saeid; Alipoor, Abbas

    2015-01-01

    Statement of the Problem Fissure sealant therapy is among the most effective methods of preventing dental caries. However, it is lengthy and isolation of the teeth is difficult in this procedure especially in young children. Using new hydrophilic fissure sealant may reduce such problems. Purpose This study aimed to evaluate the clinical success of a hydrophilic fissure sealant on the lower permanent molar teeth in dry and wet conditions. Materials and Method This clinical trial assessed 31 patients (mean age 8.13±1.77 years) who needed fissure sealant therapy on their first or second mandibular permanent molar. Having performed dental prophylaxis, the teeth were etched and rinsed. Then one of the two was randomly selected and sealed with smartseal & loc in isolated and dry conditions; while, the other was wetted on the etched enamel by using a saliva-contaminated micro brush, and was then sealed with the same fissure as the first tooth. Six and 12 months later, two independent observers examined the clinical success of sealant through checking the marginal integrity, marginal discoloration, and anatomical form. Data were analyzed by using SPSS software, version 16. The bivariate Chi-square and Exact Fisher tests were used to compare the clinical success of the two treatment methods. Results There was a high interpersonal reliability between the two examiners (K= 0.713). After 12 months, 90.3% clinical success was observed in dry conditions and 83.9% in wet conditions for smartseal & loc; however, the difference was not statistically significant (p= 0.0707). Conclusion According to the results of this study, it seems that using new hydrophilic fissure sealant can reduce technical sensitivities and consequently decreases the apprehensions on saliva contamination of etched enamel during treatment procedures. PMID:26331144

  8. A Randomized Clinical Trial Comparison between Pivotal Response Treatment (PRT) and Structured Applied Behavior Analysis (ABA) Intervention for Children with Autism

    ERIC Educational Resources Information Center

    Mohammadzaheri, Fereshteh; Koegel, Lynn Kern; Rezaee, Mohammad; Rafiee, Seyed Majid

    2014-01-01

    Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, can positively influence the effectiveness of interventions for children with autism spectrum disorder (ASD). The purpose of this study was to compare two applied behavior analysis (ABA) intervention procedures, a…

  9. Applied breath analysis: an overview of the challenges and opportunities in developing and testing sensor technology for human health monitoring in aerospace and clinical applications

    PubMed Central

    Hunter, Gary W; Dweik, Raed A

    2010-01-01

    The aerospace industry requires the development of a range of chemical sensor technologies for such applications as leak detection, emission monitoring, fuel leak detection, environmental monitoring, and fire detection. A family of chemical sensors are being developed based on micromachining and microfabrication technology to fabricate microsensors with minimal size, weight, and power consumption, and the use of nanomaterials and structures to develop sensors with improved stability combined with higher sensitivity. However, individual sensors are limited in the amount of information that they can provide in environments that contain multiple chemical species. Thus, sensor arrays are being developed to address detection needs in such multi-species environments. These technologies and technical approaches have direct relevance to breath monitoring for clinical applications. This paper gives an overview of developing cutting-edge sensor technology and possible barriers to new technology implementation. This includes lessons learned from previous microsensor development, recent work in development of a breath monitoring system, and future directions in the implementation of cutting edge sensor technology. Clinical applications and the potential impact to the biomedical field of miniaturized smart gas sensor technology are discussed. PMID:20622933

  10. Applied Enzymology.

    ERIC Educational Resources Information Center

    Manoharan, Asha; Dreisbach, Joseph H.

    1988-01-01

    Describes some examples of chemical and industrial applications of enzymes. Includes a background, a discussion of structure and reactivity, enzymes as therapeutic agents, enzyme replacement, enzymes used in diagnosis, industrial applications of enzymes, and immobilizing enzymes. Concludes that applied enzymology is an important factor in…

  11. A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Structured Applied Behavior Analysis (ABA) Intervention for Children with Autism

    PubMed Central

    Mohammadzaheri, Fereshteh; Koegel, Lynn Kern; Rezaee, Mohammad; Rafiee, Seyed Majid

    2014-01-01

    Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, can positively influence the effectiveness of interventions for children with autism spectrum disorder (ASD). The purpose of this study was to compare two ABA intervention procedures, a naturalistic approach, Pivotal Response Treatment (PRT) with a structured ABA approach in a school setting. A Randomized Clinical Trial design using two groups of children, matched according to age, sex and mean length of utterance was used to compare the interventions. The data showed that the PRT approach was significantly more effective in improving targeted and untargeted areas after three months of intervention. The results are discussed in terms of variables that produce more rapid improvements in communication for children with ASD. PMID:24840596

  12. [The potential of the modern methods for clinical diagnostics applied in the forensic medical assessment of functional disturbances of the ankle joint in the case of its injury].

    PubMed

    Khabova, Z S; Fetisov, V A

    2012-01-01

    The present paper is focused on the problems of clinical diagnostics of the functional disturbances in the locomotor apparatus as exemplified by the injuries to the ankle joint. The results of analysis of the entire range of up-to-date diagnostic tools for the purpose suggest the necessity of revision of obsolete methodological principles still adopted in forensic medicine as regards the problem being condidered. It is proposed based on the recent progress achieved by the specialists in traumatology, orthopedics, medicosocial expertise, and the related areas that a forensic medical expert should not confine oneself to the consideration of the sole criterion, such as "the range of articular movements", for the estimation of the severity of harm to health in the patients presenting with a joint injury.

  13. A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Adult-Driven Applied Behavior Analysis (ABA) Intervention on Disruptive Behaviors in Public School Children with Autism

    PubMed Central

    Mohammadzaheri, Fereshteh; Koegel, Lynn Kern; Rezaei, Mohammad; Bakhshi, Enayatolah

    2015-01-01

    Children with autism often demonstrate disruptive behaviors during demanding teaching tasks. Language intervention can be particularly difficult as it involves social and communicative areas, which are challenging for this population. The purpose of this study was to compare two intervention conditions, a naturalistic approach, Pivotal Response Treatment (PRT) with a structured ABA approach on disruptive behavior during language intervention in the public schools. A Randomized Clinical Trial (RCT) design was used with two groups of children, matched according to age, sex and mean length of utterance. The data showed that the children demonstrated significantly lower levels of disruptive behavior during the PRT condition. The results are discussed with respect to antecedent manipulations that may be helpful in reducing disruptive behavior. PMID:25953148

  14. Applied geophysics

    SciTech Connect

    Dohr, G.

    1981-01-01

    This book discusses techniques which play a predominant role in petroleum and natural gas exploration. Particular emphasis has been placed on modern seismics which today claims over 90% of man-power and financial resources in exploration. The processing of geophysical data is the most important factor in applied physics and emphasis is placed on it in the discussion of exploration problems. Chapter titles include: refraction seismics; reflection seismics; seismic field techniques; digital seismics-electronic data processing; digital seismics-practical application; recent developments, special seismic procedures; gravitational methods; magnetic methods; geoelectric methods; well-logging; and miscellaneous methods in applied geophysics (thermal methods, radioactive dating, natural radioactivity surveys, and surface detection of gas. (DMC)

  15. Applied Nanotoxicology.

    PubMed

    Hobson, David W; Roberts, Stephen M; Shvedova, Anna A; Warheit, David B; Hinkley, Georgia K; Guy, Robin C

    2016-01-01

    Nanomaterials, including nanoparticles and nanoobjects, are being incorporated into everyday products at an increasing rate. These products include consumer products of interest to toxicologists such as pharmaceuticals, cosmetics, food, food packaging, household products, and so on. The manufacturing of products containing or utilizing nanomaterials in their composition may also present potential toxicologic concerns in the workplace. The molecular complexity and composition of these nanomaterials are ever increasing, and the means and methods being applied to characterize and perform useful toxicologic assessments are rapidly advancing. This article includes presentations by experienced toxicologists in the nanotoxicology community who are focused on the applied aspect of the discipline toward supporting state of the art toxicologic assessments for food products and packaging, pharmaceuticals and medical devices, inhaled nanoparticle and gastrointestinal exposures, and addressing occupational safety and health issues and concerns. This symposium overview article summarizes 5 talks that were presented at the 35th Annual meeting of the American College of Toxicology on the subject of "Applied Nanotechnology." PMID:26957538

  16. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice

    PubMed Central

    2011-01-01

    Background Psychological models predict behaviour in a wide range of settings. The aim of this study was to explore the usefulness of a range of psychological models to predict the health professional behaviour 'referral for lumbar spine x-ray in patients presenting with low back pain' by UK primary care physicians. Methods Psychological measures were collected by postal questionnaire survey from a random sample of primary care physicians in Scotland and north England. The outcome measures were clinical behaviour (referral rates for lumbar spine x-rays), behavioural simulation (lumbar spine x-ray referral decisions based upon scenarios), and behavioural intention (general intention to refer for lumbar spine x-rays in patients with low back pain). Explanatory variables were the constructs within the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Weinstein's Stage Model termed the Precaution Adoption Process (PAP), and knowledge. For each of the outcome measures, a generalised linear model was used to examine the predictive value of each theory individually. Linear regression was used for the intention and simulation outcomes, and negative binomial regression was used for the behaviour outcome. Following this 'theory level' analysis, a 'cross-theoretical construct' analysis was conducted to investigate the combined predictive value of all individual constructs across theories. Results Constructs from TPB, SCT, CS-SRM, and OLT predicted behaviour; however, the theoretical models did not fit the data well. When predicting behavioural simulation, the proportion of variance explained by individual theories was TPB 11.6%, SCT 12.1%, OLT 8.1%, and II 1.5% of the variance, and in the cross-theory analysis constructs from TPB, CS-SRM and II explained 16.5% of the variance in simulated behaviours. When predicting intention, the proportion of variance

  17. Acupoint-specific, frequency-dependent, and improved insulin sensitivity hypoglycemic effect of electroacupuncture applied to drug-combined therapy studied by a randomized control clinical trial.

    PubMed

    Lin, Rong-Tsung; Tzeng, Chung-Yuh; Lee, Yu-Chen; Chen, Ying-I; Hsu, Tai-Hao; Lin, Jaung-Geng; Chang, Shih-Liang

    2014-01-01

    The application of electroacupuncture (EA) to specific acupoints can induce a hypoglycemic effect in streptozotocin-induced rats, normal rats, and rats with steroid-induced insulin resistance. EA combined with the oral insulin sensitizer rosiglitazone improved insulin sensitivity in rats and humans with type II diabetes mellitus (DM). There are different hypoglycemic mechanisms between Zhongwan and Zusanli acupoints by EA stimulation. On low-frequency (2 Hz) stimulation at bilateral Zusanli acupoints, serotonin was involved in the hypoglycemic effect in normal rats. Moreover, after 15 Hz EA stimulation at the bilateral Zusanli acupoints, although enhanced insulin activity mainly acts on the insulin-sensitive target organs, the muscles must be considered. In addition, 15 Hz EA stimulation at the bilateral Zusanli acupoints has the combined effect of enhancing cholinergic nerve activity and increasing nitric oxide synthase (NOS) activity to enhance insulin activity. Despite the well-documented effect of pain control by EA in many systemic diseases, there are few high-quality long-term clinical trials on the hypoglycemic effect of EA in DM. Combination treatment with EA and other medications seems to be an alternative treatment to achieve better therapeutic goals that merit future investigation. PMID:25024728

  18. Applied Koopmanisma)

    NASA Astrophysics Data System (ADS)

    Budišić, Marko; Mohr, Ryan; Mezić, Igor

    2012-12-01

    A majority of methods from dynamical system analysis, especially those in applied settings, rely on Poincaré's geometric picture that focuses on "dynamics of states." While this picture has fueled our field for a century, it has shown difficulties in handling high-dimensional, ill-described, and uncertain systems, which are more and more common in engineered systems design and analysis of "big data" measurements. This overview article presents an alternative framework for dynamical systems, based on the "dynamics of observables" picture. The central object is the Koopman operator: an infinite-dimensional, linear operator that is nonetheless capable of capturing the full nonlinear dynamics. The first goal of this paper is to make it clear how methods that appeared in different papers and contexts all relate to each other through spectral properties of the Koopman operator. The second goal is to present these methods in a concise manner in an effort to make the framework accessible to researchers who would like to apply them, but also, expand and improve them. Finally, we aim to provide a road map through the literature where each of the topics was described in detail. We describe three main concepts: Koopman mode analysis, Koopman eigenquotients, and continuous indicators of ergodicity. For each concept, we provide a summary of theoretical concepts required to define and study them, numerical methods that have been developed for their analysis, and, when possible, applications that made use of them. The Koopman framework is showing potential for crossing over from academic and theoretical use to industrial practice. Therefore, the paper highlights its strengths in applied and numerical contexts. Additionally, we point out areas where an additional research push is needed before the approach is adopted as an off-the-shelf framework for analysis and design.

  19. Applying an Open-Source Segmentation Algorithm to Different OCT Devices in Multiple Sclerosis Patients and Healthy Controls: Implications for Clinical Trials.

    PubMed

    Bhargava, Pavan; Lang, Andrew; Al-Louzi, Omar; Carass, Aaron; Prince, Jerry; Calabresi, Peter A; Saidha, Shiv

    2015-01-01

    Background. The lack of segmentation algorithms operative across optical coherence tomography (OCT) platforms hinders utility of retinal layer measures in MS trials. Objective. To determine cross-sectional and longitudinal agreement of retinal layer thicknesses derived from an open-source, fully-automated, segmentation algorithm, applied to two spectral-domain OCT devices. Methods. Cirrus HD-OCT and Spectralis OCT macular scans from 68 MS patients and 22 healthy controls were segmented. A longitudinal cohort comprising 51 subjects (mean follow-up: 1.4 ± 0.9 years) was also examined. Bland-Altman analyses and interscanner agreement indices were utilized to assess agreement between scanners. Results. Low mean differences (-2.16 to 0.26 μm) and narrow limits of agreement (LOA) were noted for ganglion cell and inner and outer nuclear layer thicknesses cross-sectionally. Longitudinally we found low mean differences (-0.195 to 0.21 μm) for changes in all layers, with wider LOA. Comparisons of rate of change in layer thicknesses over time revealed consistent results between the platforms. Conclusions. Retinal thickness measures for the majority of the retinal layers agree well cross-sectionally and longitudinally between the two scanners at the cohort level, with greater variability at the individual level. This open-source segmentation algorithm enables combining data from different OCT platforms, broadening utilization of OCT as an outcome measure in MS trials. PMID:26090228

  20. A short-term clinical study design to investigate the chemical plaque inhibitory properties of mouthrinses when used as adjuncts to toothpastes: applied to chlorhexidine.

    PubMed

    Owens, J; Addy, M; Faulkner, J; Lockwood, C; Adair, R

    1997-10-01

    The removal of plaque by toothbrushing with toothpaste is the most common form of plaque control in the developed world. However, the use of chemical adjuncts such as mouthrinses is increasing. In practice mouthrinses and toothpaste are used together, however, in many clinical trials, employed to assess mouthrinse activity, toothpaste use is suspended. This fails to measure the effect of chemical interactions which are known to occur between toothpaste ingredients and mouthrinses. The objective of this trial was to develop a methodology which would assess the adjunctive chemical plaque inhibitory action of mouthrinses, when used with toothpaste but without the indeterminate variable of toothbrushing. The study was a single blind, randomised, 7-way crossover design, based on a variation of a 4 day plaque regrowth model. The 2 x daily rinsing regimens produced increasing plaque scores in the following order: (1) water/chlorhexidine, (2) chlorhexidine/water, (3) chlorhexidine/toothpaste slurry, (4) toothpaste slurry/chlorhexidine, (5) water/toothpaste slurry, (6) toothpaste slurry/water, (7) water/water. Chlorhexidine and water or chlorhexidine and toothpaste slurry combinations produced significantly lower plaque scores than water alone. Slurry and water combinations resulted in less plaque than water alone, but differences were not significant. Toothpaste slurry and chlorhexidine produced significantly increased plaque scores compared to chlorhexidine and water. The study suggests that, outside the Hawthorne effect, chlorhexidine rinses would be less effective in reducing plaque when used with toothpaste than when used alone. The methodology could be employed as a screening tool for the evaluation of mouthrinses expected to be used as adjuncts to normal oral hygiene methods. The same could be used to optimise oral hygiene regimens which include the use of mouthrinses.

  1. Clinical update: transendoscopic laser surgery for treatment of epiglottic entrapment: Nd:YAG and 808-nm diode laser applied individually and in combination

    NASA Astrophysics Data System (ADS)

    Tate, Lloyd P.; Tudor, R. A.

    1999-06-01

    Hospital records reviewed from 1986-1998 determined that 18 horses were presented for correction of epiglottic entrapment by the aryepiglottic fold. All horses had a history of an abnormal respiratory noise and/or exercise intolerance. In conjunction with epiglottic entrapment, 10 horses had dorsal displacement of the soft palate. Initial confirmation of the epiglottic entrapment was made by endoscopic examination. In addition, 3 horses had radiographs taken of the larynx and pharyngeal region to determine the length of the epiglottis.Laser surgical treatment was performed on the horses in a standing position under sedation. The treatment consisted of axially dividing the aryepiglottic fold from the base of the epiglottis to the tip or beyond by means of a laser fiber introduced through the biopsy channel of an endoscope. The Nd:YAG laser was applied transendoscopically to 11 horses using free fiber technique. Three horses received transendoscopic laser correction using the 808-nm diode laser with the fiber in contact configuration. A combination of both 808-nm diode laser and Nd:YAG lasers were used to facilitate correction in the last 4 horses. Partial re-entrapment occurred in 2 out of the 3 cases in which the 808-nm diode laser was used as a single modality for correction. This did not occur in the horses that received either the Nd:YAG laser treatment or Nd:YAG laser treatment in combination with the 808-nm diode laser. Horses that received either 808-nm diode laser irradiation alone or 808-nm diode laser irradiation in combination with Nd:YAG laser appeared to have less swelling than those that received only Nd:YAG irradiation.

  2. Applied geodesy

    SciTech Connect

    Turner, S.

    1987-01-01

    This volume is based on the proceedings of the CERN Accelerator School's course on Applied Geodesy for Particle Accelerators held in April 1986. The purpose was to record and disseminate the knowledge gained in recent years on the geodesy of accelerators and other large systems. The latest methods for positioning equipment to sub-millimetric accuracy in deep underground tunnels several tens of kilometers long are described, as well as such sophisticated techniques as the Navstar Global Positioning System and the Terrameter. Automation of better known instruments such as the gyroscope and Distinvar is also treated along with the highly evolved treatment of components in a modern accelerator. Use of the methods described can be of great benefit in many areas of research and industrial geodesy such as surveying, nautical and aeronautical engineering, astronomical radio-interferometry, metrology of large components, deformation studies, etc.

  3. MO-G-BRE-05: Clinical Process Improvement and Billing in Radiation Oncology: A Case Study of Applying FMEA for CPT Code 77336 (continuing Medical Physics Consultation)

    SciTech Connect

    Spirydovich, S; Huq, M

    2014-06-15

    Purpose: The improvement of quality in healthcare can be assessed by Failure Mode and Effects Analysis (FMEA). In radiation oncology, FMEA, as applied to the billing CPT code 77336, can improve both charge capture and, most importantly, quality of the performed services. Methods: We created an FMEA table for the process performed under CPT code 77336. For a given process step, each member of the assembled team (physicist, dosimetrist, and therapist) independently assigned numerical values for: probability of occurrence (O, 1–10), severity (S, 1–10), and probability of detection (D, 1–10) for every failure mode cause and effect combination. The risk priority number, RPN, was then calculated as a product of O, S and D from which an average RPN was calculated for each combination mentioned above. A fault tree diagram, with each process sorted into 6 categories, was created with linked RPN. For processes with high RPN recommended actions were assigned. 2 separate R and V systems (Lantis and EMR-based ARIA) were considered. Results: We identified 9 potential failure modes and corresponding 19 potential causes of these failure modes all resulting in unjustified 77336 charge and compromised quality of care. In Lantis, the range of RPN was 24.5–110.8, and of S values – 2–10. The highest ranking RPN of 110.8 came from the failure mode described as “end-of-treatment check not done before the completion of treatment”, and the highest S value of 10 (RPN=105) from “overrides not checked”. For the same failure modes, within ARIA electronic environment with its additional controls, RPN values were significantly lower (44.3 for end-of-treatment missing check and 20.0 for overrides not checked). Conclusion: Our work has shown that when charge capture was missed that also resulted in some services not being performed. Absence of such necessary services may result in sub-optimal quality of care rendered to patients.

  4. PSYCHOANALYSIS AS APPLIED AESTHETICS.

    PubMed

    Richmond, Stephen H

    2016-07-01

    The question of how to place psychoanalysis in relation to science has been debated since the beginning of psychoanalysis and continues to this day. The author argues that psychoanalysis is best viewed as a form of applied art (also termed applied aesthetics) in parallel to medicine as applied science. This postulate draws on a functional definition of modernity as involving the differentiation of the value spheres of science, art, and religion. The validity criteria for each of the value spheres are discussed. Freud is examined, drawing on Habermas, and seen to have erred by claiming that the psychoanalytic method is a form of science. Implications for clinical and metapsychological issues in psychoanalysis are discussed. PMID:27428582

  5. PSYCHOANALYSIS AS APPLIED AESTHETICS.

    PubMed

    Richmond, Stephen H

    2016-07-01

    The question of how to place psychoanalysis in relation to science has been debated since the beginning of psychoanalysis and continues to this day. The author argues that psychoanalysis is best viewed as a form of applied art (also termed applied aesthetics) in parallel to medicine as applied science. This postulate draws on a functional definition of modernity as involving the differentiation of the value spheres of science, art, and religion. The validity criteria for each of the value spheres are discussed. Freud is examined, drawing on Habermas, and seen to have erred by claiming that the psychoanalytic method is a form of science. Implications for clinical and metapsychological issues in psychoanalysis are discussed.

  6. Applying Clinical Neuropsychology in the Public Schools.

    ERIC Educational Resources Information Center

    Federhar, David B.

    Neuropsychology is an area in which the functioning or integrity of the brain is linked to measurable human behavior. This paper describes the use of the Reitan batteries (Reitan and Davison; 1974) in public school settings for documenting and prescribing appropriate academic programs. Three individual case studies are presented. Case 1 is a 16…

  7. Following the Rules Set by Accreditation Agencies and Governing Bodies to Maintain In-Compliance Status: Applying Critical Thinking Skills When Evaluating the Need for Change in the Clinical Laboratory.

    PubMed

    Byrne, Karen M; Levy, Kimberly Y; Reese, Erika M

    2016-05-01

    Maintaining an in-compliance clinical laboratory takes continuous awareness and review of standards, regulations, and best practices. A strong quality assurance program and well informed leaders who maintain professional networks can aid in this necessary task. This article will discuss a process that laboratories can follow to interpret, understand, and comply with the rules and standards set by laboratory accreditation bodies.

  8. A multi-center randomized proof-of-concept clinical trial applying [¹⁸F]FDG-PET for evaluation of metabolic therapy with rosiglitazone XR in mild to moderate Alzheimer's disease.

    PubMed

    Tzimopoulou, Sofia; Cunningham, Vincent J; Nichols, Thomas E; Searle, Graham; Bird, Nick P; Mistry, Prafull; Dixon, Ian J; Hallett, William A; Whitcher, Brandon; Brown, Andrew P; Zvartau-Hind, Marina; Lotay, Narinder; Lai, Robert Y K; Castiglia, Mary; Jeter, Barbara; Matthews, Julian C; Chen, Kewei; Bandy, Dan; Reiman, Eric M; Gold, Michael; Rabiner, Eugenii A; Matthews, Paul M

    2010-01-01

    Here we report the first multi-center clinical trial in Alzheimer's disease (AD) using fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) measures of brain glucose metabolism as the primary outcome. We contrasted effects of 12 months treatment with the PPARγ agonist Rosiglitazone XR versus placebo in 80 mild to moderate AD patients. Secondary objectives included testing for reduction in the progression of brain atrophy and improvement in cognition. Active treatment was associated with a sustained but not statistically significant trend from the first month for higher mean values in Kiindex and CMRgluindex, novel quantitative indices related to the combined forward rate constant for [18F]FDG uptake and to the rate of cerebral glucose utilization, respectively. However, neither these nor another analytical approach recently validated using data from the Alzheimer's Disease Neuroimaging Initiative indicated that active treatment decreased the progression of decline in brain glucose metabolism. Rates of brain atrophy were similar between active and placebo groups and measures of cognition also did not suggest clear group differences. Our study demonstrates the feasibility of using [18F]FDG-PET as part of a multi-center therapeutics trial. It suggests that Rosiglitazone is associated with an early increase in whole brain glucose metabolism, but not with any biological or clinical evidence for slowing progression over a 1 year follow up in the symptomatic stages of AD. PMID:20930300

  9. Applied Linguistics: Brazilian Perspectives

    ERIC Educational Resources Information Center

    Cavalcanti, Marilda C.

    2004-01-01

    The aim of this paper is to present perspectives in Applied Linguistics (AL) against the background of a historical overview of the field in Brazil. I take the stance of looking at AL as a field of knowledge and as a professional area of research. This point of view directs my reflections towards research-based Applied Linguistics carried out from…

  10. Calcium hydroxylapatite facial filler (Radiesse): indications, technique, and results.

    PubMed

    Jacovella, Patricio F

    2006-10-01

    This article discusses the use of Radiesse; a semisolid, cohesive subdermal injectable implant. Through direct and invaluable experience gained over time, plastic surgeons will decide which areas of the face may best be suited for Radiesse and which may be appropriate for other fillers.

  11. What are applied ethics?

    PubMed

    Allhoff, Fritz

    2011-03-01

    This paper explores the relationships that various applied ethics bear to each other, both in particular disciplines and more generally. The introductory section lays out the challenge of coming up with such an account and, drawing a parallel with the philosophy of science, offers that applied ethics may either be unified or disunified. The second section develops one simple account through which applied ethics are unified, vis-à-vis ethical theory. However, this is not taken to be a satisfying answer, for reasons explained. In the third section, specific applied ethics are explored: biomedical ethics; business ethics; environmental ethics; and neuroethics. These are chosen not to be comprehensive, but rather for their traditions or other illustrative purposes. The final section draws together the results of the preceding analysis and defends a disunity conception of applied ethics.

  12. Clinical neuroimaging

    SciTech Connect

    Gilman, S.; Mazziotta, J.C.

    1989-01-01

    Designed for practicing neurologists and neurosurgeons, this reference focuses on the newest techniques in computed assisted tomography. Text material covers basic principles of computed tomography, as well as the clinical advantages and disadvantages of each modality. The anatomical and/or physiological processes measured by XCT, PET, SPECT and MRI are first discussed in terms of the normal patient, and then applied to the diagnosis and treatment of patients with neurological disease (primarily of the brain). Emphasis is placed on areas of difficult diagnosis, such as differentiating recurrent tumor from radiation necrosis, early diagnosis of dementia, selection of patients for extracranial-intracranial bypass procedures, and localization of epileptic foci.

  13. Geomorphology: Pure and applied

    SciTech Connect

    Hart, M.G.

    1986-01-01

    The book summarizes the history of intellectual debate in geomorphology and describes modern developments both ''pure'' and ''applied.'' The history begins well before W.M. Davis and follows through to such debates as those concerned with the Pleistocene. Modern developments in pure geomorphology are cast in terms of chapters on form, process, materials, and methods analysis. The applied chapters concentrate on environmental hazards and resources, and their management.

  14. Clinical professional governance for detailed clinical models.

    PubMed

    Goossen, William; Goossen-Baremans, Anneke

    2013-01-01

    This chapter describes the need for Detailed Clinical Models for contemporary Electronic Health Systems, data exchange and data reuse. It starts with an explanation of the components related to Detailed Clinical Models with a brief summary of knowledge representation, including terminologies representing clinic relevant "things" in the real world, and information models that abstract these in order to let computers process data about these things. Next, Detailed Clinical Models are defined and their purpose is described. It builds on existing developments around the world and accumulates in current work to create a technical specification at the level of the International Standards Organization. The core components of properly expressed Detailed Clinical Models are illustrated, including clinical knowledge and context, data element specification, code bindings to terminologies and meta-information about authors, versioning among others. Detailed Clinical Models to date are heavily based on user requirements and specify the conceptual and logical levels of modelling. It is not precise enough for specific implementations, which requires an additional step. However, this allows Detailed Clinical Models to serve as specifications for many different kinds of implementations. Examples of Detailed Clinical Models are presented both in text and in Unified Modelling Language. Detailed Clinical Models can be positioned in health information architectures, where they serve at the most detailed granular level. The chapter ends with examples of projects that create and deploy Detailed Clinical Models. All have in common that they can often reuse materials from earlier projects, and that strict governance of these models is essential to use them safely in health care information and communication technology. Clinical validation is one point of such governance, and model testing another. The Plan Do Check Act cycle can be applied for governance of Detailed Clinical Models

  15. Clinical bioethics.

    PubMed

    De Oliveira, Reinaldo Ayer; Oselka, Gabriel; Cohen, Cláudio; Costa, Sérgio ibiapina Ferreira

    2008-01-01

    Clinical bioethics was born out of the need to introduce different ethical values involved in the relationships among physician, patient and health institutions which are outside the technical-scientific framework of routine medical practice. Physicians tend to adopt the norms and rules provided for in the Medical Ethics Code to guide the exercising of their professional practice. However, it has recently become challenging to apply these norms to all conduct since some issues faced in the professional practice are simply not provided for by such norms. Ethical consideration in practice drawing solely on the medical ethics code in Brazil has proved insufficient, both in the context of universal issues such as organ transplants, start and end-of-life, as well as in addressing specific issues such as allocation of funds for health. Clinical bioethics employs clinical cases and situations as an instrument for discussion. These discussions entail analysis of not only the facts and circumstances surrounding each case, but also the values which lead to patients, health teams and institutions opting to recommend, accept or refuse a given conduct.

  16. On applying cognitive psychology.

    PubMed

    Baddeley, Alan

    2013-11-01

    Recent attempts to assess the practical impact of scientific research prompted my own reflections on over 40 years worth of combining basic and applied cognitive psychology. Examples are drawn principally from the study of memory disorders, but also include applications to the assessment of attention, reading, and intelligence. The most striking conclusion concerns the many years it typically takes to go from an initial study, to the final practical outcome. Although the complexity and sheer timescale involved make external evaluation problematic, the combination of practical satisfaction and theoretical stimulation make the attempt to combine basic and applied research very rewarding.

  17. Applied Astronomy: Asteroid Prospecting

    NASA Astrophysics Data System (ADS)

    Elvis, M.

    2013-09-01

    In the age of asteroid mining the ability to find promising ore-bearing bodies will be valuable. This will give rise to a new discipline- "Applied Astronomy". Just as most geologists work in industry, not in academia, the same will be true of astronomers. Just how rare or common ore-rich asteroids are likely to be, and the skills needed to assay their value, are discussed here, with an emphasis on remote - telescopic - methods. Also considered are the resources needed to conduct extensive surveys of asteroids for prospecting purposes, and the cost and timescale involved. The longer-term need for applied astronomers is also covered.

  18. Applied Music (Individual Study).

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    Background information and resources to help students in grades 9-12 in Texas pursue an individual study contract in applied music is presented. To fulfill a contract students must publicly perform from memory, with accompaniment as specified, three selections from a list of approved music for their chosen field (instrument or voice). Material…

  19. Applying to College

    ERIC Educational Resources Information Center

    Tierney, William G.

    2009-01-01

    This article suggests that unlike their well-off counterparts who apply to college in the fall and know they will go somewhere when the applications have been sent, low-income students face unique challenges that extend the process in a manner entirely different from the wealthy. The notion that college-going is a cultural interpretation is…

  20. Essays on Applied Microeconomics

    ERIC Educational Resources Information Center

    Mejia Mantilla, Carolina

    2013-01-01

    Each chapter of this dissertation studies a different question within the field of Applied Microeconomics. The first chapter examines the mid- and long-term effects of the 1998 Asian Crisis on the educational attainment of Indonesian children ages 6 to 18, at the time of the crisis. The effects are identified as deviations from a linear trend for…

  1. Applied Linguistics in Europe

    ERIC Educational Resources Information Center

    de Bot, Kees

    2004-01-01

    In this contribution developments in Applied Linguistics in Europe are linked to major social changes that have taken place over the last decades. These include: The decline of the USSR and the end of the cold war; The development of the EEC and the EU and fading of borders; The economic growth of Western Europe; Labor migration from the south to…

  2. Applied Statistics with SPSS

    ERIC Educational Resources Information Center

    Huizingh, Eelko K. R. E.

    2007-01-01

    Accessibly written and easy to use, "Applied Statistics Using SPSS" is an all-in-one self-study guide to SPSS and do-it-yourself guide to statistics. What is unique about Eelko Huizingh's approach is that this book is based around the needs of undergraduate students embarking on their own research project, and its self-help style is designed to…

  3. Applied Behavior Analysis

    ERIC Educational Resources Information Center

    Szapacs, Cindy

    2006-01-01

    Teaching strategies that work for typically developing children often do not work for those diagnosed with an autism spectrum disorder. However, teaching strategies that work for children with autism do work for typically developing children. In this article, the author explains how the principles and concepts of Applied Behavior Analysis can be…

  4. Africa and Applied Linguistics.

    ERIC Educational Resources Information Center

    Makoni, Sinfree, Ed.; Meinhof, Ulrike H., Ed.

    2003-01-01

    This collection of articles includes: "Introducing Applied Linguistics in Africa" (Sinfree Makoni and Ulrike H. Meinhof); "Language Ideology and Politics: A Critical Appraisal of French as Second Official Language in Nigeria" (Tope Omoniyi); "The Democratisation of Indigenous Languages: The Case of Malawi" (Themba Moyo); "Classroom Code-Switching…

  5. Signals: Applying Academic Analytics

    ERIC Educational Resources Information Center

    Arnold, Kimberly E.

    2010-01-01

    Academic analytics helps address the public's desire for institutional accountability with regard to student success, given the widespread concern over the cost of higher education and the difficult economic and budgetary conditions prevailing worldwide. Purdue University's Signals project applies the principles of analytics widely used in…

  6. Applying Mathematical Processes (AMP)

    ERIC Educational Resources Information Center

    Kathotia, Vinay

    2011-01-01

    This article provides insights into the "Applying Mathematical Processes" resources, developed by the Nuffield Foundation. It features Nuffield AMP activities--and related ones from Bowland Maths--that were designed to support the teaching and assessment of key processes in mathematics--representing a situation mathematically, analysing,…

  7. Quality in applied science

    NASA Astrophysics Data System (ADS)

    Sten, T.

    1993-12-01

    Science is in many senses a special kind of craft and only skilled craftsmen are able to distinguish good work from bad. Due to the variation in approaches, methods and even philosophical basis, it is nearly impossible to derive a general set of quality criteria for scientific work outside specific research traditions. Applied science introduces a new set of quality criteria having to do with the application of results in practical situations and policy making. A scientist doing basic research relates mainly to the scientific community of which he is a member, while in applied contract research the scientist has to consider the impact of his results both for the immediate users and upon interest groups possibly being affected. Application thus raises a whole new set of requirements having to do with business ethics, policy consequences and societal ethics in general.

  8. Applied Meteorology Unit (AMU)

    NASA Technical Reports Server (NTRS)

    Bauman, William; Lambert, Winifred; Wheeler, Mark; Barrett, Joe; Watson, Leela

    2007-01-01

    This report summarizes the Applied Meteorology Unit (AMU) activities for the second quarter of Fiscal Year 2007 (January - March 2007). Tasks reported on are: Obiective Lightning Probability Tool, Peak Wind Tool for General Forecasting, Situational Lightning Climatologies for Central Florida, Anvil Threat Corridor Forecast Tool in AWIPS, Volume Averaqed Heiqht lnteq rated Radar Reflectivity (VAHIRR), Tower Data Skew-t Tool, and Weather Research and Forecastini (WRF) Model Sensitivity Study

  9. [Implantation of collagen coated hydroxyapatite particles. A clinical-histological study in humans].

    PubMed

    Sanz, M; Bascones, A; Kessler, A; García Nuñez, J; Newman, M G; Robertson, M A; Carranza, F A

    1989-05-01

    In this study, histologic behaviour of collagen coated hydroxylapatite particles implanted in human periodontal osseous defects has been analyzed. This material was surgically implanted in four patients, and reentry and block biopsies were carried out 4 and 6 months later. The histologic results demonstrate that this material is well tolerated by surrounding tissues, not eliciting an inflammatory reaction. At four months, the hydroxylapatite particles appear encapsulated by a very cellular connective tissue and at 6 months are found in direct contact with osteoid and mature bone. This material acts as a filler material, being fully biocompatible and stimulating an osseoconductive reaction of the adjacent alveolar bone. PMID:2637052

  10. [Implantation of collagen coated hydroxyapatite particles. A clinical-histological study in humans].

    PubMed

    Sanz, M; Bascones, A; Kessler, A; García Nuñez, J; Newman, M G; Robertson, M A; Carranza, F A

    1989-05-01

    In this study, histologic behaviour of collagen coated hydroxylapatite particles implanted in human periodontal osseous defects has been analyzed. This material was surgically implanted in four patients, and reentry and block biopsies were carried out 4 and 6 months later. The histologic results demonstrate that this material is well tolerated by surrounding tissues, not eliciting an inflammatory reaction. At four months, the hydroxylapatite particles appear encapsulated by a very cellular connective tissue and at 6 months are found in direct contact with osteoid and mature bone. This material acts as a filler material, being fully biocompatible and stimulating an osseoconductive reaction of the adjacent alveolar bone.

  11. Applied science. Introduction.

    PubMed

    Bud, Robert

    2012-09-01

    Such categories as applied science and pure science can be thought of as "ideological." They have been contested in the public sphere, exposing long-term intellectual commitments, assumptions, balances of power, and material interests. This group of essays explores the contest over applied science in Britain and the United States during the nineteenth century. The essays look at the concept in the context of a variety of neighbors, including pure science, technology, and art. They are closely related and connected to contemporary historiographic debate. Jennifer Alexander links the issues raised to a recent paper by Paul Forman. Paul Lucier and Graeme Gooday deal with the debates in the last quarter of the century in the United States and Britain, respectively. Robert Bud deals with the earlier part of the nineteenth century, with an eye specifically on the variety of concepts hybridized under the heading of "applied science." Eric Schatzberg looks at the erosion of the earlier concept of art. As a whole, the essays illuminate both long-term changes and nuanced debate and are themselves intended to provoke further reflection on science in the public sphere.

  12. Applied ALARA techniques

    SciTech Connect

    Waggoner, L.O.

    1998-02-05

    The presentation focuses on some of the time-proven and new technologies being used to accomplish radiological work. These techniques can be applied at nuclear facilities to reduce radiation doses and protect the environment. The last reactor plants and processing facilities were shutdown and Hanford was given a new mission to put the facilities in a safe condition, decontaminate, and prepare them for decommissioning. The skills that were necessary to operate these facilities were different than the skills needed today to clean up Hanford. Workers were not familiar with many of the tools, equipment, and materials needed to accomplish:the new mission, which includes clean up of contaminated areas in and around all the facilities, recovery of reactor fuel from spent fuel pools, and the removal of millions of gallons of highly radioactive waste from 177 underground tanks. In addition, this work has to be done with a reduced number of workers and a smaller budget. At Hanford, facilities contain a myriad of radioactive isotopes that are 2048 located inside plant systems, underground tanks, and the soil. As cleanup work at Hanford began, it became obvious early that in order to get workers to apply ALARA and use hew tools and equipment to accomplish the radiological work it was necessary to plan the work in advance and get radiological control and/or ALARA committee personnel involved early in the planning process. Emphasis was placed on applying,ALARA techniques to reduce dose, limit contamination spread and minimize the amount of radioactive waste generated. Progress on the cleanup has,b6en steady and Hanford workers have learned to use different types of engineered controls and ALARA techniques to perform radiological work. The purpose of this presentation is to share the lessons learned on how Hanford is accomplishing radiological work.

  13. NASA Applied Sciences Program

    NASA Technical Reports Server (NTRS)

    Frederick, Martin

    2006-01-01

    This presentation highlights the NASA Applied Sciences Program. The goal of the program is to extend the results of scientific research and knowledge beyond the science community to contribute to NASA's partners' applications of national priority, such as agricultural efficiency, energy management and Homeland Security. Another purpose of the program's scientific research is to increase knowledge of the Earth-Sun system to enable improved predictions of climate, weather, and natural hazards. The program primarily optimizes benefits for citizens by contributing to partnering on applications that are used by state, local and tribal governments.

  14. Applied Meteorology Unit (AMU)

    NASA Technical Reports Server (NTRS)

    Bauman, William H., Jr.; Crawford, Winifred; Short, David; Barrett, Joe; Watson, Leela

    2008-01-01

    This report summarizes the Applied Meteorology Unit (AMU) activities for the second quarter of Fiscal Year 2008 (January - March 2008). Projects described are: (1) Peak Wind Tool for User Launch Commit Criteria (LCC), (2) Peak Wind Tool for General Forecasting, (3) Situational Lightning Climatologies for Central Florida. Phase III, (4) Volume Averaged Height Integrated Radar Reflectivity (VAHIRR), (5) Impact of Local Sensors, (6) Radar Scan Strategies for the PAFB WSR-74C Replacement and (7) WRF Wind Sensitivity Study at Edwards Air Force Base.

  15. Applied Meteorology Unit (AMU)

    NASA Technical Reports Server (NTRS)

    Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Wheeler, Mark

    2010-01-01

    This report summarizes the Applied Meteorology Unit (AMU) activities for the first quarter of Fiscal Year 2010 (October - December 2009). A detailed project schedule is included in the Appendix. Included tasks are: (1) Peak Wind Tool for User Launch Commit Criteria (LCC), (2) Objective Lightning Probability Tool, Phase III, (3) Peak Wind Tool for General Forecasting, Phase II, (4) Upgrade Summer Severe Weather Tool in Meteorological Interactive Data Display System (MIDDS), (5) Advanced Regional Prediction System (ARPS) Data Analysis System (ADAS) Update and Maintainability, (5) Verify 12-km resolution North American Model (MesoNAM) Performance, and (5) Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) Graphical User Interface.

  16. Clinical Laboratory Science: Applied Biology with Great Potential.

    ERIC Educational Resources Information Center

    Stanley, Melissa

    1990-01-01

    Described are a variety of careers under the umbrella of medical technology. The status of medical technology and medical technology education are discussed. Different curricula for medical technology are compared. (CW)

  17. Clinical Instruction for Professional Practice

    ERIC Educational Resources Information Center

    Gardner, Greg; Sexton, Patrick; Guyer, M. Susan; Willeford, K. Sean; Levy, Linda S.; Barnum, Mary G.; Fincher, A. Louise

    2009-01-01

    Objective: To present the principles of adult learning and mentoring to help clinical instructors better educate athletic training students (ATSs) during their clinical experiences, with the end result being a better prepared, competent entry-level practitioner. Background: The principles of adult learning must be applied to ATS clinical education…

  18. Applied physiology of diving.

    PubMed

    Lin, Y C

    1988-01-01

    Recreational diving is a popular sport, although human ability to stay in and under water is severely limited physiologically. An understanding of these limitations enhances safety and enjoyment of sports diving. Breath-hold diving involves head-out water immersion, apnoea and submersion, exercise, cold stress, and pressure exposure. Each of these components, by itself, elicits prominent and specific physiological effects. Combination of these factors produces a unique and interesting physiological response generally known as diving reflex. Humans display weak diving responses, but exhibit no oxygen conservation function. Nevertheless, application of diving-induced physiological changes is now finding its way into clinical practice. Apnoea, face immersion, and head-out water immersion all show promise of clinical application. There are several spin-offs from diving research worth noting. Diuresis, enhancement of cardiac performance, and redistribution of blood flow, all produced by head-out water immersion, have been shown to be clinically useful, besides providing physiological data useful to space travel. Results from investigations on apnoea have been shown to be relevant to the following: treating some forms of cardiac arrhythmias; understanding drowning, sudden infant death syndrome and sleep apnoea; and confirming hyperventilation as the major cause of drowning. In comparison to marine mammals, humans are poor divers because of severe physiological constraints which limit their breath-hold time, diving depth, and ability to conserve body heat. Although under special circumstances humans can achieve unusually long breath-hold time and reach exceptional depth with a single breath, the sustainable working time and depth are only about 1 minute and 5 metres, respectively. Hypothermia inevitably results in divers working in the ocean. Without thermal protection, the intolerable limit of 35 degrees C is reached within 30 minutes in winter (10 degrees C) water and

  19. [Echinocandins: Applied pharmacology].

    PubMed

    Azanza Perea, José Ramón

    2016-01-01

    The echinocandins share pharmacodynamic properties, although there are some interesting differences in their pharmacokinetic behaviour in the clinical practice. They are not absorbed by the oral route. They have a somewhat special distribution in the organism, as some of them can reach high intracellular concentrations while, with some others, the concentration is reduced. They are highly bound to plasma proteins, thus it is recommended to administer a loading dose for anidulafungin and caspofungin, although this procedure is not yet clear with micafungin. Echinocandins are excreted via a non-microsomal metabolism, so the urinary concentration is very low. Some carrier proteins that take part in the biliary clearance process are probably involved in the interactions described with caspofungin and micafungin. These two drugs must be used with caution in patients with severely impaired hepatic function, while all of them can be used without special precautions when there is renal impairment or the patient requires renal replacement therapy.

  20. Applying robotics to HAZMAT

    NASA Technical Reports Server (NTRS)

    Welch, Richard V.; Edmonds, Gary O.

    1994-01-01

    The use of robotics in situations involving hazardous materials can significantly reduce the risk of human injuries. The Emergency Response Robotics Project, which began in October 1990 at the Jet Propulsion Laboratory, is developing a teleoperated mobile robot allowing HAZMAT (hazardous materials) teams to remotely respond to incidents involving hazardous materials. The current robot, called HAZBOT III, can assist in locating characterizing, identifying, and mitigating hazardous material incidents without risking entry team personnel. The active involvement of the JPL Fire Department HAZMAT team has been vital in developing a robotic system which enables them to perform remote reconnaissance of a HAZMAT incident site. This paper provides a brief review of the history of the project, discusses the current system in detail, and presents other areas in which robotics can be applied removing people from hazardous environments/operations.

  1. Applying robotics to HAZMAT

    NASA Astrophysics Data System (ADS)

    Welch, Richard V.; Edmonds, Gary O.

    1994-02-01

    The use of robotics in situations involving hazardous materials can significantly reduce the risk of human injuries. The Emergency Response Robotics Project, which began in October 1990 at the Jet Propulsion Laboratory, is developing a teleoperated mobile robot allowing HAZMAT (hazardous materials) teams to remotely respond to incidents involving hazardous materials. The current robot, called HAZBOT III, can assist in locating characterizing, identifying, and mitigating hazardous material incidents without risking entry team personnel. The active involvement of the JPL Fire Department HAZMAT team has been vital in developing a robotic system which enables them to perform remote reconnaissance of a HAZMAT incident site. This paper provides a brief review of the history of the project, discusses the current system in detail, and presents other areas in which robotics can be applied removing people from hazardous environments/operations.

  2. Applied Healthspan Engineering

    PubMed Central

    Mendelsohn, Andrew

    2010-01-01

    Abstract According to the Homeric Hymn to Aphrodite, when Eos asked Zeus for Tithonus to be granted immortality, she forgot to ask for eternal youth. Applied Healthspan Engineering (AHE) seeks to address this problem. All organisms have a minimal level of functional reserve required to sustain life that eventually declines to a point incompatible with survival at death. AHE seeks to maintain or restore optimal functional reserve of critical tissues and organs. Tissue reserve correlates with well being. Diet, physical exercise, and currently available small-molecule-based therapeutics may attenuate the rate of decline of specific organs or organ systems, but are unlikely to restore lost reserve. Inherent evolutionary-derived limitations in tissue homeostasis and cell maintenance necessitate the development of therapies to enhance regenerative processes and possibly replace whole organs or tissues. AHE supports the study of cell, tissue, and organ homeostatic mechanisms to derive new regenerative and tissue replacement therapies to extend the period of human health. PMID:20462384

  3. Applied computational aerodynamics

    SciTech Connect

    Henne, P.A.

    1990-01-01

    The present volume discusses the original development of the panel method, the mapping solutions and singularity distributions of linear potential schemes, the capabilities of full-potential, Euler, and Navier-Stokes schemes, the use of the grid-generation methodology in applied aerodynamics, subsonic airfoil design, inverse airfoil design for transonic applications, the divergent trailing-edge airfoil innovation in CFD, Euler and potential computational results for selected aerodynamic configurations, and the application of CFD to wing high-lift systems. Also discussed are high-lift wing modifications for an advanced-capability EA-6B aircraft, Navier-Stokes methods for internal and integrated propulsion system flow predictions, the use of zonal techniques for analysis of rotor-stator interaction, CFD applications to complex configurations, CFD applications in component aerodynamic design of the V-22, Navier-Stokes computations of a complete F-16, CFD at supersonic/hypersonic speeds, and future CFD developments.

  4. Applied antineutrino physics workshop.

    SciTech Connect

    Lund, James C.

    2008-01-01

    This workshop is the fourth one of a series that includes the Neutrino Geophysics Conference at Honolulu, Hawaii, which I attended in 2005. This workshop was organized by the Astro-Particle and Cosmology laboratory in the recently opened Condoret building of the University of Paris. More information, including copies of the presentations, on the workshop is available on the website: www.apc.univ-paris7.fr/AAP2007/. The workshop aims at opening neutrino physics to various fields such that it can be applied in geosciences, nuclear industry (reactor and spent fuel monitoring) and non-proliferation. The workshop was attended by over 60 people from Europe, USA, Asia and Brazil. The meeting was also attended by representatives of the Comprehensive nuclear-Test Ban Treaty (CTBT) and the International Atomic Energy Agency (IAEA). The workshop also included a workshop dinner on board of a river boat sailing the Seine river.

  5. Methods of applied dynamics

    NASA Technical Reports Server (NTRS)

    Rheinfurth, M. H.; Wilson, H. B.

    1991-01-01

    The monograph was prepared to give the practicing engineer a clear understanding of dynamics with special consideration given to the dynamic analysis of aerospace systems. It is conceived to be both a desk-top reference and a refresher for aerospace engineers in government and industry. It could also be used as a supplement to standard texts for in-house training courses on the subject. Beginning with the basic concepts of kinematics and dynamics, the discussion proceeds to treat the dynamics of a system of particles. Both classical and modern formulations of the Lagrange equations, including constraints, are discussed and applied to the dynamic modeling of aerospace structures using the modal synthesis technique.

  6. NASA Applied Sciences Program

    NASA Technical Reports Server (NTRS)

    Estes, Sue M.; Haynes, J. A.

    2009-01-01

    NASA's strategic Goals: a) Develop a balanced overall program of science, exploration, and aeronautics consistent with the redirection of human spaceflight program to focus on exploration. b) Study Earth from space to advance scientific understanding and meet societal needs. NASA's partnership efforts in global modeling and data assimilation over the next decade will shorten the distance from observations to answers for important, leading-edge science questions. NASA's Applied Sciences program will continue the Agency's efforts in benchmarking the assimilation of NASA research results into policy and management decision-support tools that are vital for the Nation's environment, economy, safety, and security. NASA also is working with NOAH and inter-agency forums to transition mature research capabilities to operational systems, primarily the polar and geostationary operational environmental satellites, and to utilize fully those assets for research purposes.

  7. Lessons learned and applied

    PubMed Central

    Hebert, Corey Joseph; Hall, Corey M.; Odoms, La’ Nyia J.

    2012-01-01

    Most vaccines available in the United States (US) have been incorporated into vaccination schedules for infants and young children, age groups particularly at risk of contracting infectious diseases. High universal vaccination coverage is responsible for substantially reducing or nearly eliminating many of the diseases that once killed thousands of children each year in the US. Despite the success of infant vaccinations, periods of low vaccination coverage and the limited immunogenicity and duration of protection of certain vaccines have resulted in sporadic outbreaks, allowing some diseases to spread in communities. These challenges suggest that expanded vaccination coverage to younger infants and adolescents, and more immunogenic vaccines, may be needed in some instances. This review focuses on the importance of infant immunization and explores the successes and challenges of current early childhood vaccination programs and how these lessons may be applied to other invasive diseases, such as meningococcal disease. PMID:22617834

  8. Selecting and applying flowmeters

    SciTech Connect

    Belevich, P.

    1996-05-01

    An important aspect of any process control system that requires fluid flow measurement is properly selecting and applying the flow sensor or flowmeter. A bewildering array of terms, factors and concepts that must be considered to ensure optimum design can make this a complex and sometimes confusing process. To select a proper meter for a specific application, a complete understanding of the process operating conditions and equipment performance requirements is necessary. Once these parameters are specified, actual flowmeter selection is greatly simplified. Selection parameters include accuracy, rangeability, and additional characteristics. Commonly used flowmeters include differential pressure devices, variable area meters, vortex shedding flowmeters, displacement meters, magnetic flowmeters, coriolis mass meters, thermal flowmeters, and ultrasonic flowmeters.

  9. Gaitography applied to prosthetic walking.

    PubMed

    Roerdink, Melvyn; Cutti, Andrea G; Summa, Aurora; Monari, Davide; Veronesi, Davide; van Ooijen, Mariëlle W; Beek, Peter J

    2014-11-01

    During walking on an instrumented treadmill with an embedded force platform or grid of pressure sensors, center-of-pressure (COP) trajectories exhibit a characteristic butterfly-like shape, reflecting the medio-lateral and anterior-posterior weight shifts associated with alternating steps. We define "gaitography" as the analysis of such COP trajectories during walking (the "gaitograms"). It is currently unknown, however, if gaitography can be employed to characterize pathological gait, such as lateralized gait impairments. We therefore registered gaitograms for a heterogeneous sample of persons with a trans-femoral and trans-tibial amputation during treadmill walking at a self-selected comfortable speed. We found that gaitograms directly visualize between-person differences in prosthetic gait in terms of step width and the relative duration of prosthetic and non-prosthetic single-support stance phases. We further demonstrated that one should not only focus on the gaitogram's shape but also on the time evolution along that shape, given that the COP evolves much slower in the single-support phase than in the double-support phase. Finally, commonly used temporal and spatial prosthetic gait characteristics were derived, revealing both individual and systematic differences in prosthetic and non-prosthetic step lengths, step times, swing times, and double-support durations. Because gaitograms can be rapidly collected in an unobtrusive and markerless manner over multiple gait cycles without constraining foot placement, clinical application of gaitography seems both expedient and appealing. Studies examining the repeatability of gaitograms and evaluating gaitography-based gait characteristics against a gold standard with known validity and reliability are required before gaitography can be clinically applied.

  10. Instructions for Applying | Division of Cancer Prevention

    Cancer.gov

    This is NOT a grant application - if successful, funds will not be transferred to your institution to support your project. Rather, this is an application to access the scientific capabilities and resources of the NCI with the goal of moving promising cancer chemopreventive agents into clinical testing. If successful, you will partner with the NCI in developing a drug development pipeline. | Apply to access the scientific capabilities and resources of the NCI with the goal of moving promising cancer chemopreventive agents into clinical testing.

  11. Applied Linguistics and the "Annual Review of Applied Linguistics."

    ERIC Educational Resources Information Center

    Kaplan, Robert B.; Grabe, William

    2000-01-01

    Examines the complexities and differences involved in granting disciplinary status to the role of applied linguistics, discusses the role of the "Annual Review of Applied Linguistics" as a contributor to the development of applied linguistics, and highlights a set of publications for the future of applied linguistics. (Author/VWL)

  12. Clinical Research and Clinical Trials

    MedlinePlus

    ... you can get involved. Doing your own clinical research project? Then select the Guidance for Clinical Researchers link to learn more about the NICHD's clinical research processes and policies. Last Reviewed: 03/06/2012 ...

  13. Applying evolutionary anthropology.

    PubMed

    Gibson, Mhairi A; Lawson, David W

    2015-01-01

    Evolutionary anthropology provides a powerful theoretical framework for understanding how both current environments and legacies of past selection shape human behavioral diversity. This integrative and pluralistic field, combining ethnographic, demographic, and sociological methods, has provided new insights into the ultimate forces and proximate pathways that guide human adaptation and variation. Here, we present the argument that evolutionary anthropological studies of human behavior also hold great, largely untapped, potential to guide the design, implementation, and evaluation of social and public health policy. Focusing on the key anthropological themes of reproduction, production, and distribution we highlight classic and recent research demonstrating the value of an evolutionary perspective to improving human well-being. The challenge now comes in transforming relevance into action and, for that, evolutionary behavioral anthropologists will need to forge deeper connections with other applied social scientists and policy-makers. We are hopeful that these developments are underway and that, with the current tide of enthusiasm for evidence-based approaches to policy, evolutionary anthropology is well positioned to make a strong contribution.

  14. Applying Evolutionary Anthropology

    PubMed Central

    Gibson, Mhairi A; Lawson, David W

    2015-01-01

    Evolutionary anthropology provides a powerful theoretical framework for understanding how both current environments and legacies of past selection shape human behavioral diversity. This integrative and pluralistic field, combining ethnographic, demographic, and sociological methods, has provided new insights into the ultimate forces and proximate pathways that guide human adaptation and variation. Here, we present the argument that evolutionary anthropological studies of human behavior also hold great, largely untapped, potential to guide the design, implementation, and evaluation of social and public health policy. Focusing on the key anthropological themes of reproduction, production, and distribution we highlight classic and recent research demonstrating the value of an evolutionary perspective to improving human well-being. The challenge now comes in transforming relevance into action and, for that, evolutionary behavioral anthropologists will need to forge deeper connections with other applied social scientists and policy-makers. We are hopeful that these developments are underway and that, with the current tide of enthusiasm for evidence-based approaches to policy, evolutionary anthropology is well positioned to make a strong contribution. PMID:25684561

  15. Applied equine genetics

    PubMed Central

    FINNO, C. J.; BANNASCH, D. L.

    2015-01-01

    Summary Genome sequencing of the domestic horse and subsequent advancements in the field of equine genomics have led to an explosion in the development of tools for mapping traits and diseases and evaluating gene expression. The objective of this review is to discuss the current progress in the field of equine genomics, with specific emphasis on assembly and analysis of the reference sequence and subsequent sequencing of a Quarter Horse mare; the genomic tools currently available to researchers and their implications in genomic investigations in the horse; the genomics of Mendelian and non-Mendelian traits; the genomics of performance traits and considerations regarding genetic testing in the horse. The whole-genome sequencing of a Quarter Horse mare has provided additional variants within the equine genome that extend past single nucleotide polymorphisms to include insertions/deletions and copy number variants. Equine single nucleotide polymorphism arrays have allowed for the investigation of both simple and complex genetic traits while DNA microarrays have provided a tool for examining gene expression across various tissues and with certain disease conditions. Recently, next-generation sequencing has become more affordable and both whole-genome DNA sequencing and transcriptome-wide RNA sequencing are methodologies that are being applied to equine genomic research. Research in the field of equine genomics continues to expand rapidly as the cost of genotyping and sequencing decreases, resulting in a need for quality bioinformatics software and expertise to appropriately handle both the size and complexity of these data. PMID:24802051

  16. Basic and applied research on choice responding.

    PubMed Central

    Fisher, W W; Mazur, J E

    1997-01-01

    Choice responding refers to the manner in which individuals allocate their time or responding among available response options. In this article, we first review basic investigations that have identified and examined variables that influence choice responding, such as response effort and reinforcement rate, immediacy, and quality. We then describe recent bridge and applied studies that illustrate how the results of basic research on choice responding can help to account for human behavior in natural environments and improve clinical assessments and interventions. PMID:9316255

  17. Applied Historical Astronomy

    NASA Astrophysics Data System (ADS)

    Stephenson, F. Richard

    2014-01-01

    F. Richard Stephenson has spent most of his research career -- spanning more than 45 years -- studying various aspects of Applied Historical Astronomy. The aim of this interdisciplinary subject is the application of historical astronomical records to the investigation of problems in modern astronomy and geophysics. Stephenson has almost exclusively concentrated on pre-telescopic records, especially those preserved from ancient and medieval times -- the earliest reliable observations dating from around 700 BC. The records which have mainly interested him are of eclipses (both solar and lunar), supernovae, sunspots and aurorae, and Halley's Comet. The main sources of early astronomical data are fourfold: records from ancient and medieval East Asia (China, together with Korea and Japan); ancient Babylon; ancient and medieval Europe; and the medieval Arab world. A feature of Stephenson's research is the direct consultation of early astronomical texts in their original language -- either working unaided or with the help of colleagues. He has also developed a variety of techniques to help interpret the various observations. Most pre-telescopic observations are very crude by present-day standards. In addition, early motives for skywatching were more often astrological rather than scientific. Despite these drawbacks, ancient and medieval astronomical records have two remarkable advantages over modern data. Firstly, they can enable the investigation of long-term trends (e.g. in the terrestrial rate of rotation), which in the relatively short period covered by telescopic observations are obscured by short-term fluctuations. Secondly, over the lengthy time-scale which they cover, significant numbers of very rare events (such as Galactic supernovae) were reported, which have few -- if any-- counterparts in the telescopic record. In his various researches, Stephenson has mainly focused his attention on two specific topics. These are: (i) long-term changes in the Earth's rate of

  18. Essays in applied microeconomics

    NASA Astrophysics Data System (ADS)

    Wang, Xiaoting

    In this dissertation I use Microeconomic theory to study firms' behavior. Chapter One introduces the motivations and main findings of this dissertation. Chapter Two studies the issue of information provision through advertisement when markets are segmented and consumers' price information is incomplete. Firms compete in prices and advertising strategies for consumers with transportation costs. High advertising costs contribute to market segmentation. Low advertising costs promote price competition among firms and improves consumer welfare. Chapter Three also investigates market power as a result of consumers' switching costs. A potential entrant can offer a new product bundled with an existing product to compensate consumers for their switching cost. If the primary market is competitive, bundling simply plays the role of price discrimination, and it does not dominate unbundled sales in the process of entry. If the entrant has market power in the primary market, then bundling also plays the role of leveraging market power and it dominates unbundled sales. The market for electric power generation has been opened to competition in recent years. Chapter Four looks at issues involved in the deregulated electricity market. By comparing the performance of the competitive market with the social optimum, we identify the conditions under which market equilibrium generates socially efficient levels of electric power. Chapter Two to Four investigate the strategic behavior among firms. Chapter Five studies the interaction between firms and unemployed workers in a frictional labor market. We set up an asymmetric job auction model, where two types of workers apply for two types of job openings by bidding in auctions and firms hire the applicant offering them the most profits. The job auction model internalizes the determination of the share of surplus from a match, therefore endogenously generates incentives for an efficient division of the matching surplus. Microeconomic

  19. Essays in Applied Microeconomics

    NASA Astrophysics Data System (ADS)

    Ge, Qi

    This dissertation consists of three self-contained applied microeconomics essays on topics related to behavioral economics and industrial organization. Chapter 1 studies how sentiment as a result of sports event outcomes affects consumers' tipping behavior in the presence of social norms. I formulate a model of tipping behavior that captures consumer sentiment following a reference-dependent preference framework and empirically test its relevance using the game outcomes of the NBA and the trip and tipping data on New York City taxicabs. While I find that consumers' tipping behavior responds to unexpected wins and losses of their home team, particularly in close game outcomes, I do not find evidence for loss aversion. Coupled with the findings on default tipping, my empirical results on the asymmetric tipping responses suggest that while social norms may dominate loss aversion, affect and surprises can result in freedom on the upside of tipping. Chapter 2 utilizes a novel data source of airline entry and exit announcements and examines how the incumbent airlines adjust quality provisions as a response to their competitors' announcements and the role of timing in such responses. I find no evidence that the incumbents engage in preemptive actions when facing probable entry and exit threats as signaled by the competitors' announcements in either short term or long term. There is, however, evidence supporting their responses to the competitors' realized entry or exit. My empirical findings underscore the role of timing in determining preemptive actions and suggest that previous studies may have overestimated how the incumbent airlines respond to entry threats. Chapter 3, which is collaborated with Benjamin Ho, investigates the habit formation of consumers' thermostat setting behavior, an often implicitly made decision and yet a key determinant of home energy consumption and expenditures. We utilize a high frequency dataset on household thermostat usage and find that

  20. Applied physiology of swimming.

    PubMed

    Lavoie, J M; Montpetit, R R

    1986-01-01

    Scientific research in swimming over the past 10 to 15 years has been oriented toward multiple aspects that relate to applied and basic physiology, metabolism, biochemistry, and endocrinology. This review considers recent findings on: 1) specific physical characteristics of swimmers; 2) the energetics of swimming; 3) the evaluation of aerobic fitness in swimming; and 4) some metabolic and hormonal aspects related to swimmers. Firstly, the age of finalists in Olympic swimming is not much different from that of the participants from other sports. They are taller and heavier than a reference population of the same age. The height bias in swimming may be the reason for lack of success from some Asian and African countries. Experimental data point toward greater leanness, particularly in female swimmers, than was seen 10 years ago. Overall, female swimmers present a range of 14 to 19% body fat whereas males are much lower (5 to 10%). Secondly, the relationship between O2 uptake and crawl swimming velocity (at training and competitive speeds) is thought to be linear. The energy cost varies between strokes with a dichotomy between the 2 symmetrical and the 2 asymmetrical strokes. Energy expenditure in swimming is represented by the sum of the cost of translational motion (drag) and maintenance of horizontal motion (gravity). The cost of the latter decreases as speed increases. Examination of the question of size-associated effects on the cost of swimming using Huxley's allometric equation (Y = axb) shows an almost direct relationship with passive drag. Expressing energy cost in litres of O2/m/kg is proposed as a better index of technical swimming ability than the traditional expression of VO2/distance in L/km. Thirdly, maximal direct conventional techniques used to evaluate maximal oxygen consumption (VO2 max) in swimming include free swimming, tethered swimming, and flume swimming. Despite the individual peculiarities of each method, with similar experimental conditions

  1. Essays in applied economics

    NASA Astrophysics Data System (ADS)

    Arano, Kathleen

    Three independent studies in applied economics are presented. The first essay looks at the US natural gas industrial sector and estimates welfare effects associated with the changes in natural gas regulatory policy over the past three decades. Using a disequilibrium model suited to the natural gas industry, welfare transfers and deadweight losses are calculated. Results indicate that deregulation policies, beginning with the NGPA of 1978, have caused the industry to become more responsive to market conditions. Over time, regulated prices converge toward the estimated equilibrium prices. As a result of this convergence, deadweight losses associated with regulation are also diminished. The second essay examines the discounted utility model (DU), the standard model used for intertemporal decision-making. Prior empirical studies challenge the descriptive validity of the model. This essay addresses the four main inconsistencies that have been raised: domain dependence, magnitude effects, time effects, and gain/loss asymmetries. These inconsistencies, however, may be the result of the implicit assumption of linear utility and not a failure of the DU model itself. In order to test this hypothesis, data was collected from in-class surveys of economics classes at Mississippi State University. A random effects model for panel data estimation which accounts for individual specific effects was then used to impute discount rates measured in terms of dollars and utility. All four inconsistencies were found to be present when the dollar measures were used. Using utility measures of the discount rate resolved the inconsistencies in some cases. The third essay brings together two perspectives in the study of religion and economics: modeling religious behavior using economic tools and variables, and modeling economic behavior using religious variables. A system of ordered probit equations is developed to simultaneously model religious activities and economic outcomes. Using data

  2. Applied physiology of swimming.

    PubMed

    Lavoie, J M; Montpetit, R R

    1986-01-01

    Scientific research in swimming over the past 10 to 15 years has been oriented toward multiple aspects that relate to applied and basic physiology, metabolism, biochemistry, and endocrinology. This review considers recent findings on: 1) specific physical characteristics of swimmers; 2) the energetics of swimming; 3) the evaluation of aerobic fitness in swimming; and 4) some metabolic and hormonal aspects related to swimmers. Firstly, the age of finalists in Olympic swimming is not much different from that of the participants from other sports. They are taller and heavier than a reference population of the same age. The height bias in swimming may be the reason for lack of success from some Asian and African countries. Experimental data point toward greater leanness, particularly in female swimmers, than was seen 10 years ago. Overall, female swimmers present a range of 14 to 19% body fat whereas males are much lower (5 to 10%). Secondly, the relationship between O2 uptake and crawl swimming velocity (at training and competitive speeds) is thought to be linear. The energy cost varies between strokes with a dichotomy between the 2 symmetrical and the 2 asymmetrical strokes. Energy expenditure in swimming is represented by the sum of the cost of translational motion (drag) and maintenance of horizontal motion (gravity). The cost of the latter decreases as speed increases. Examination of the question of size-associated effects on the cost of swimming using Huxley's allometric equation (Y = axb) shows an almost direct relationship with passive drag. Expressing energy cost in litres of O2/m/kg is proposed as a better index of technical swimming ability than the traditional expression of VO2/distance in L/km. Thirdly, maximal direct conventional techniques used to evaluate maximal oxygen consumption (VO2 max) in swimming include free swimming, tethered swimming, and flume swimming. Despite the individual peculiarities of each method, with similar experimental conditions

  3. Leadership Theory Lets Clinical Instructors Guide Students toward Autonomy.

    ERIC Educational Resources Information Center

    Keenan, Mary J.; And Others

    1988-01-01

    Discusses situational leadership theories and suggests that clinical instructors should apply them within clinical learning settings to help students participate more responsibly in their learning experiences. (JOW)

  4. Development of clinical sites.

    PubMed

    O'Brien, Mary

    2015-02-01

    Clinical experiences are vital to all types of healthcare educational programs. Supervised clinical experiences provide the opportunity for the learner to apply didactic knowledge and theory to real world situations and hone skills necessary for entry into practice. Nurse anesthesia programs utilize a wide variety of clinical sites to expose student registered nurse anesthetists to experiences that will prepare them clinically, academically and professionally to enter practice as a Certified Registered Nurse Anesthetist. This article describes the process of developing a clinical site. A thorough evaluation will determine the types of experiences meant to be offered at the site, the resources available to house and educate the students, and how to evaluate the effectiveness of the clinical site. Open communication between the clinical coordinator and the program director or designee is essential to ensure success of the clinical site. The Council on Accreditation of Nurse Anesthesia Educational Programs has resources available to guide those interested in becoming a clinical site, as well as for program administrators who seek to add new experiences to their programs. PMID:25842629

  5. Situational Supervision for Athletic Training Clinical Education

    ERIC Educational Resources Information Center

    Levy, Linda S.; Gardner, Greg; Barnum, Mary G.; Willeford, K. Sean; Sexton, Patrick; Guyer, M. Susan; Fincher, A. Louise

    2009-01-01

    Introduction: The medical education model provides the basis for athletic training students to learn theoretical and practical skills. Clinical rotations are completed where they apply what they have learned under the direct supervision of a clinical instructor (CI) or approved clinical instructor (ACI). Approved clinical instructors are taught…

  6. Clinical Trials

    MedlinePlus

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  7. The Routledge Applied Linguistics Reader

    ERIC Educational Resources Information Center

    Wei, Li, Ed.

    2011-01-01

    "The Routledge Applied Linguistics Reader" is an essential collection of readings for students of Applied Linguistics. Divided into five sections: Language Teaching and Learning, Second Language Acquisition, Applied Linguistics, Identity and Power and Language Use in Professional Contexts, the "Reader" takes a broad interpretation of the subject…

  8. HEAVY-ION IMAGING APPLIED TO MEDICINE

    SciTech Connect

    Fabrikant, J.I.; Tobias, C.A.; Capp, M.P.; Benton, E.V.; Holley, W.R.

    1980-02-01

    Heavy particle radiography is a newly developed noninvasive low dose imaging procedure with increased resolution of minute density differences in soft tissues of the body. The method utilizes accelerated high energy ions, primarily carbon and neon, at the BEVALAC accelerator at the Lawrence Berkeley Laboratory. The research program applied to medicine utilizes heavy-ion radiography for low dose mammography, for treatment planning for cancer patients, and for imaging and accurate densitometry of skeletal structures and brain and spinal neoplasms. The presentation will be illustrated with clinical cases under study. Discussion will include the potential of heavy-ion imaging, and particularly reconstruction tomography, as an adjunct to existing diagnostic imaging procedures in medicine, both for the applications to the diagnosis, management and treatment of clinical cancer in man, but also for the early detection of small soft tissue tumors at low radiation dose.

  9. Clinical challenge.

    PubMed

    2016-09-01

    Questions for this month's clinical challenge are based on articles in this issue. The clinical challenge is endorsed by the RACGP Quality Improvement and Continuing Professional Development (QI&CPD) program and has been allocated four Category 2 points (Activity ID:59922). Answers to this clinical challenge are available immediately following successful completion online at http://gplearning.racgp.org.au. Clinical challenge quizzes may be completed at any time throughout the 2014-16 triennium; therefore, the previous months' answers are not published. Each of the questions or incomplete statements below is followed by four suggested answers or completions. Select the most appropriate statement as your answer. PMID:27606376

  10. A Survey of Applied Linguistics.

    ERIC Educational Resources Information Center

    Wardhaugh, Ronald, Ed.; Brown, H. Douglas, Ed.

    This book provides a comprehensive review of the major areas of applied linguistics with original contributions by fourteen scholars. The following chapters are included: (1) "What is Applied Linguistics?" by H. Douglas Brown; (2) "Language Development," by Lois Bloom; (3) "First Language Teaching," by Jean Malmstrom (discusses the teaching of…

  11. Conversation Analysis and Applied Linguistics.

    ERIC Educational Resources Information Center

    Schegloff, Emanuel A.; Koshik, Irene; Jacoby, Sally; Olsher, David

    2002-01-01

    Offers biographical guidance on several major areas of conversation-analytic work--turn-taking, repair, and word selection--and indicates past or potential points of contact with applied linguistics. Also discusses areas of applied linguistic work. (Author/VWL)

  12. Writing, Literacy, and Applied Linguistics.

    ERIC Educational Resources Information Center

    Leki, Ilona

    2000-01-01

    Discusses writing and literacy in the domain of applied linguistics. Focus is on needs analysis for literacy acquisition; second language learner identity; longitudinal studies as extensions of identity work; and applied linguistics contributions to second language literacy research. (Author/VWL)

  13. Applied Communication. Florida Teaching Supplement.

    ERIC Educational Resources Information Center

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

    The information in this supplementary notebook is intended to provide teachers with additional materials, ideas, suggestions, and activities to help in implementing the Applied Communication modules that combine language arts skills with vocational applications. The Applied Communication instructional materials were funded and developed by a…

  14. Applied Linguistics in Society. Papers from the Annual Meeting of the British Association for Applied Linguistics (20th, Nottingham, England, United Kingdom, September 1987). British Studies in Applied Linguistics, 3.

    ERIC Educational Resources Information Center

    Grunwell, Pamela, Ed.

    A selection of papers from the 1987 meeting of the applied linguistics association includes the following: "Applied Linguistics in Society" (John Trim); "European Developments in Applied Linguistics" (Theo van Els); "Translation and Interpretation: Retrospect and Prospect" (Peter Newmark); "Clinical Linguistics: Retrospect and Prospect" (Pamela…

  15. [Electronic glottography (clinical aspects)].

    PubMed

    Chernobel'skiĭ, S I

    1991-01-01

    In order to study the application of electronic glottography in clinical laryngology, 200 patients with different diseases were examined, using a glottographic unit, computer, oscilloscope, and a recorder. It was found that glottography is an objective method which can be applied to evaluate and detect disorders of vocal folds in different states. This method fails to determine the vibration capacity of an individual fold or diagnose laryngeal lesions without an additional examination.

  16. Graduation Credit for Applied Academics.

    ERIC Educational Resources Information Center

    Rose, Dennis M.

    1988-01-01

    Describes a pilot project in applied academics that involved hiring certified mathemathics and science instructors so that students could obtain academic rather than vocational credit for material that vocational instructors had previously taught. (JOW)

  17. An Excursion in Applied Mathematics.

    ERIC Educational Resources Information Center

    von Kaenel, Pierre A.

    1981-01-01

    An excursion in applied mathematics is detailed in a lesson deemed well-suited for the high school student or undergraduate. The problem focuses on an experimental missile guidance system simulated in the laboratory. (MP)

  18. Towards open applied Earth sciences

    EPA Science Inventory

    Concepts of open science -- in the context of cyber/digital technology and culture -- could greatly benefit applied and secondary Earth science efforts. However, international organizations (e.g., environmental agencies, conservation groups and sustainable development organizatio...

  19. Applied photonic therapy in veterinary medicine

    NASA Astrophysics Data System (ADS)

    Wood, Terry R.; McLaren, Brian C.

    2005-04-01

    There can be no question that specific systemic physiological results occur, when red light (660nm) is applied to the skin, it is now more a question of detailed mechanisms. Before gathering statistically signifcant clinical trial data, it is important to first enumerate the type of results observed in practice. Case histories are presented highlighting the use of photonic therapy in veterinary medicine. Over 900 surgical procedures have been performed and documented, utilizing the principles of photonic therapy, and while hemostasis, pain relief, and nausea relief, were the primary goals, the peri-operative death rate, the post-operative seroma, and post-operative infection were reduced to almost zero, and there was a noticeable increase in the healing rate. Scientifically applied photonic therapy, rather than supplanting conventional veterinary medicine, compliments and increases the veterinarian's set of skills. This paper proposes a hypothesis of how 660 nm light applied to specific points on the skin, produces various physiological changes in animals. By using animals, there can be no placebo, hypnotic or psychosomatic confounding effects.

  20. Clinical photography.

    PubMed

    Jakowenko, Janelle

    2009-01-01

    Digital cameras, when used correctly, can provide the basis for telemedicine services. The increasing sophistication of digital cameras, combined with the improved speed and availability of the Internet, make them an instrument that every health-care professional should be familiar with. Taking satisfactory images of patients requires clinical photography skills. Photographing charts, monitors, X-ray films and specimens also requires expertise. Image capture using digital cameras is often done with insufficient attention, which can lead to inaccurate study results. The procedures in clinical photography should not vary from camera to camera, or from country to country. Taking a photograph should be a standardised process. There are seven main scenarios in clinical photography and health professionals who use cameras should be familiar with all of them. Obtaining informed consent prior to photography should be a normal part of the clinical photography routine.

  1. Clinical Trials

    MedlinePlus

    ... of visits, and any adjustments to treatment. (back) Requirements for Participation Admission into a clinical trial is based on a rigid set of requirements. You must be diagnosed with the illness that ...

  2. Clinical neuroimaging

    SciTech Connect

    Theodore, W.H.

    1988-01-01

    This book contains chapters on neuroimaging. Included are the following chapters: diagnostic neuroimaging in stroke, position emission tomography in cerebrovascular disease: clinical applications, and neuroradiologic work-up of brain tumors.

  3. Implementing Peer Evaluation of Clinical Teaching

    ERIC Educational Resources Information Center

    Laske, Rita Ann

    2013-01-01

    Clinical education provides the nursing student opportunities to learn the practice of nursing. In the clinical setting, the nursing student applies classroom knowledge to the real patient care situation. The clinical instructor facilitates this important process by assisting students to integrate knowledge into their practice, improve their…

  4. Clinical supervision.

    PubMed

    Goorapah, D

    1997-05-01

    The introduction of clinical supervision to a wider sphere of nursing is being considered from a professional and organizational point of view. Positive views are being expressed about adopting this concept, although there are indications to suggest that there are also strong reservations. This paper examines the potential for its success amidst the scepticism that exists. One important question raised is whether clinical supervision will replace or run alongside other support systems.

  5. Breast cancer treatment with imiquimod: applying an old lotion to a new disease.

    PubMed

    Kohrt, Holbrook

    2012-12-15

    Over the prior two decades, imiquimod, a toll-like receptor 7 agonist, has been applied to nearly 50 clinical settings. Because of its immunomodulatory role, the topical cream today, for the first time, is being applied to cutaneous breast cancer in preclinical models and in a phase II clinical trial.

  6. From art to applied science.

    PubMed

    Schatzberg, Eric

    2012-09-01

    Before "applied science" and "technology" became keywords, the concept of art was central to discourse about material culture and its connections to natural knowledge. By the late nineteenth century, a new discourse of applied science had replaced the older discourse of art. This older discourse of art, especially as presented in Enlightenment encyclopedias, addressed the relationship between art and science in depth. But during the nineteenth century the concept of fine art gradually displaced the broader meanings of "art," thus undermining the utility of the term for discourse on the relationship between knowledge and practice. This narrowed meaning of "art" obscured key aspects of the industrial world. In effect, middle-class agents of industrialism, including "men of science," used the rhetoric of "applied science" and, later, "technology" to cement the exclusion of artisanal knowledge from the discourse of industrial modernity.

  7. Applied Remote Sensing Program (ARSP)

    NASA Technical Reports Server (NTRS)

    Johnson, J. D.; Foster, K. E.; Mouat, D. A.; Miller, D. A.; Conn, J. S.

    1976-01-01

    The activities and accomplishments of the Applied Remote Sensing Program during FY 1975-1976 are reported. The principal objective of the Applied Remote Sensing Program continues to be designed projects having specific decision-making impacts as a principal goal. These projects are carried out in cooperation and collaboration with local, state and federal agencies whose responsibilities lie with planning, zoning and environmental monitoring and/or assessment in the application of remote sensing techniques. The end result of the projects is the use by the involved agencies of remote sensing techniques in problem solving.

  8. CRC handbook of applied thermodynamics

    SciTech Connect

    Palmer, D.A. . Research and Development Dept.)

    1987-01-01

    The emphasis of this book is on applied thermodynamics, featuring the stage of development of a process rather than the logical development of thermodynamic principles. It is organized according to the types of problems encountered in industry, such as probing research, process assessment, and process development. The applied principles presented can be used in most areas of industry including oil and gas production and processing, chemical processing, power generation, polymer production, food processing, synthetic fuels production, specialty chemicals and pharmaceuticals production, bioengineered processes, etc.

  9. CURRENT TRENDS IN APPLIED LINGUISTICS.

    ERIC Educational Resources Information Center

    KACHRU, BRAJ B.

    WITH PROGRESS IN THEORETICAL AND APPLIED LINGUISTICS, THE APPLICATION OF LINGUISTICS TO LANGUAGE TEACHING HAS COME UNDER INCREASING SCRUTINY. WHILE THE STRUCTURALISTS HAVE FOUND COMPETITION IN THE MORE RECENT CONCEPTS OF THE COMPETENCE-ORIENTED AND THE PERFORMANCE-ORIENTED APPROACHES, AND MENTALISTIC THEORIES SEEM TO PROVIDE MORE EXPLANATIONS THAN…

  10. Toward an Applied Administrative Science.

    ERIC Educational Resources Information Center

    Dunbar, Roger L. M.

    1983-01-01

    A study of 65 articles from the 1981 volumes of "Administrative Science Quarterly" and "Harvard Business Review," using smallest space analysis, found that the few studies adopting subjective (instead of objective) approaches to analyzing organizational change were most likely to provide a basis for an applied administrative science. (Author/RW)

  11. Applied aerodynamics: Challenges and expectations

    NASA Technical Reports Server (NTRS)

    Peterson, Victor L.; Smith, Charles A.

    1993-01-01

    Aerospace is the leading positive contributor to this country's balance of trade, derived largely from the sale of U.S. commercial aircraft around the world. This powerfully favorable economic situation is being threatened in two ways: (1) the U.S. portion of the commercial transport market is decreasing, even though the worldwide market is projected to increase substantially; and (2) expenditures are decreasing for military aircraft, which often serve as proving grounds for advanced aircraft technology. To retain a major share of the world market for commercial aircraft and continue to provide military aircraft with unsurpassed performance, the U.S. aerospace industry faces many technological challenges. The field of applied aerodynamics is necessarily a major contributor to efforts aimed at meeting these technological challenges. A number of emerging research results that will provide new opportunities for applied aerodynamicists are discussed. Some of these have great potential for maintaining the high value of contributions from applied aerodynamics in the relatively near future. Over time, however, the value of these contributions will diminish greatly unless substantial investments continue to be made in basic and applied research efforts. The focus: to increase understanding of fluid dynamic phenomena, identify new aerodynamic concepts, and provide validated advanced technology for future aircraft.

  12. Applying Creativity Research to Cooking

    ERIC Educational Resources Information Center

    Beghetto, Ronald A.; Kaufman, James C.; Hatcher, Ryan

    2016-01-01

    What, if any, benefit might there be to applying creativity research to cooking? The purpose of this paper was to address this question. Specifically, we draw on concepts and theories from creativity research to help clarify what is meant by creative cooking. This includes exploring creative cooking through the lens of the 4-C and Propulsion…

  13. Applied Linguistics in the Philippines.

    ERIC Educational Resources Information Center

    Tucker, G. Richard

    This paper traces the three major developmental strands that converged to contribute to the definition of the applied linguistics field in the Philippines: the institution and capacity-building work supported by the Ford and Rockefeller Foundations; the forging of a vibrant consortium among three Filipino institutions of higher education to offer…

  14. Applied Linguistics Research on Asianness

    ERIC Educational Resources Information Center

    Kobayashi, Yoko

    2011-01-01

    As China is increasingly occupying the world's attention, its explosively expanding economical and political clout has also been felt in the applied linguistics domain, with the discussion on China's/Chinese language issues growing by leaps and bounds (e.g. China's English education policies, Chinese language classes in the West). Amid the world's…

  15. Applied Remote Sensing Program (ARSP)

    NASA Technical Reports Server (NTRS)

    Mouat, D. A.; Johnson, J. D.; Foster, K. E.

    1977-01-01

    Descriptions of projects engaged by the Applied Remote Sensors Program in the state of Arizona are contained in an annual report for the fiscal year 1976-1977. Remote sensing techniques included thermal infrared imagery in analog and digital form and conversion of data into thermograms. Delineation of geologic areas, surveys of vegetation and inventory of resources were also presented.

  16. Case Studies in Applied Mathematics.

    ERIC Educational Resources Information Center

    Mathematical Association of America, Washington, DC.

    This collection of nine case studies in applied mathematics was written primarily for the use of the instructor by a Conference sponsored by the Committee on the Undergraduate Program in Mathematics (CUPM). Each chapter contains exercises of varying degrees of difficulty and several include student projects. The materials were used on a trial…

  17. Applied Learning for Middle Schoolers.

    ERIC Educational Resources Information Center

    Miller, Paula; And Others

    1995-01-01

    From leading garden tours to planning a visit for Japanese teachers and participating in community theater, middle schoolers at Fort Worth's Applied Learning Academy learn academic content by working on community projects. Students' writing skills soared as they developed, edited, and field-tested brochures and trail-guide maps for their botanical…

  18. Applied Mathematics. Florida Teaching Supplement.

    ERIC Educational Resources Information Center

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

    The information in this supplementary notebook is intended to provide teachers with additional materials, ideas and suggestions, and activities to help in implementing the first 21 units of the Applied Mathematics modules that help develop and refine job-related mathematics skills. An introduction lists the 36 units of the complete Applied…

  19. [Clinical gait analysis: user guide].

    PubMed

    Armand, Stéphane; Bonnefoy-Mazure, Alice; Hoffmeyer, Pierre; De Coulon, Geraldo

    2015-10-14

    Clinical gait analysis has become an indispensable medical examination for the management of patients with complex gait disorders. As its name suggests, the purpose of this examination is to assess patients whilst they are walking in a laboratory setting. Measurements include: 3 dimensional joint motion, forces applied to joints, and electromyographic muscle activity. This quantitative data allows identification of walking deviations and to deduce the likely causes of these deviations thanks to the clinical data available for each patient.

  20. 42 CFR 68a.3 - Who is eligible to apply?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible to apply? 68a.3 Section 68a.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM FOR INDIVIDUALS...

  1. 42 CFR 68a.3 - Who is eligible to apply?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Who is eligible to apply? 68a.3 Section 68a.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM FOR INDIVIDUALS...

  2. The Representation of Applied Psychology Areas in Introductory Psychology Textbooks

    ERIC Educational Resources Information Center

    Haselhuhn, Charlotte W.; Clopton, Kerri L.

    2008-01-01

    Many psychology majors indicate helping others as a reason for majoring in psychology, yet many enter positions not closely related to the field. This discrepancy may be due to a lack of student knowledge of the applied areas of psychology. The purpose of this study was to investigate the coverage of clinical, counseling,…

  3. Topical and Applied Interests of Introductory Psychology Students

    ERIC Educational Resources Information Center

    Stalder, Daniel R.; Stec, Deborah A.

    2007-01-01

    Using forced-choice and continuous measures, introductory psychology students reported highest interest for the topical areas of clinical and social psychology (over biological, cognitive, and developmental) and for the applied areas of education and health (over business, environment, and law) at both the beginning and end of semesters. Among…

  4. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  5. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  6. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  7. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  8. Defining and Applying a Functionality Approach to Intellectual Disability

    ERIC Educational Resources Information Center

    Luckasson, R.; Schalock, R. L.

    2013-01-01

    Background: The current functional models of disability do not adequately incorporate significant changes of the last three decades in our understanding of human functioning, and how the human functioning construct can be applied to clinical functions, professional practices and outcomes evaluation. Methods: The authors synthesise current…

  9. 42 CFR 55a.107 - What other regulations apply?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D—Public Health Service grant appeals procedure; 42 CFR part 50, subpart E—Maximum allowable cost for drugs; 45 CFR part 16—Procedures of the Departmental Grant Appeals Board; 45 CFR part...

  10. Clinical trials

    PubMed Central

    Garnham, J. C.

    1974-01-01

    The choice of standard drugs to be used in clinical trials must be based on consideration of human absorption data, in vitro characteristics, possible interactions, comparative efficacy and safety, previous data regarding the standard in relation to the syndrome to be studied, and correlation of blood levels, effectiveness and safety. PMID:4465771

  11. Clinical cytomics

    NASA Astrophysics Data System (ADS)

    Tárnok, Attila; Mittag, Anja; Lenz, Dominik

    2006-02-01

    The goal of predictive medicine is the detection of changes in patient's state prior to the clinical manifestation of the deterioration of the patients current status. Therefore, both the diagnostic of diseases like cancer, coronary atherosclerosis or congenital heart failure and the prognosis of the effect specific therapeutics on patients outcome are the main fields of predictive medicine. Clinical Cytomcs is based on the analysis of specimens from the patient by Cytomic technologies that are mainly imaging based techniques and their combinations with other assays. Predictive medicine aims at the recognition of the "fate" of each individual patients in order to yield unequivocal indications for decision making (i.e. how does the patient respond to therapy, react to medication etc.). This individualized prediction is based on the Predictive Medicine by Clinical Cytomics concept. These considerations have recently stimulated the idea of the Human Cytome Project. A major focus of the Human Cytome Project is multiplexed cy-tomic analysis of individual cells of the patient, extraction of predictive information and individual prediction that merges into individualized therapy. Although still at the beginning, Clinical Cytomics is a promising new field that may change therapy in the near future for the benefit of the patients.

  12. [Clinical pathology].

    PubMed

    Dimitrijević, Jovan

    2006-05-01

    This work describes the basic elements of pathology used in clinical practice. Pathology plays an important role in clinical and scientific work, but only a few areas of pathology will be covered. Although the contribution of oncological and surgical pathology to therapy is the most well known, the cases chosen here will involve infectious pathology, diseases of the kidney and the liver, autoimmune diseases, as well as organ transplantation. Especially important is the description of methods that enable more accurate morphological diagnoses, such as histochemistry, immunohistochemistry, immunofluorescence, and electronic microscopy. Previous experience and joint work with clinical doctors have enabled the definition of significant morphological elements as well as of essential methods of pathohistological diagnosis. Besides, as is often the case, although disease symptoms are difficult to discern and biochemical results do not show significant changes compared to normal values, the results of biopsy come as a surprise to clinical doctors. For example, in virus hepatitis B involving so-called asymptomatic HBsAg carriers, we discovered every morphological form of hepatitis, from minimal lesions to chronic, persistent, and active hepatitis. With hepatitis C, certain morphological lesions point to the etiopathogenesis of this disease and thus help to confirm the diagnosis and to instigate therapy on time. Another significant experience involves kidney biopsies in cases when clinical findings are asymptomatic. Often, in such cases, morphological findings point to glomerulonephritis and glomerulopathy at different stages. Timely and subtle morphological diagnostics offer a more precise explanation for the pathological injury of tissues than other diagnostic methods. In this way, by adopting new methods, the work of pathologists is included more and more in everyday clinical practice. The inclusion of pathologists in a transplantation team makes sure a proper selection of

  13. Isoperformance curves in applied psychology.

    PubMed

    Jones, M B; Kennedy, R S

    1996-03-01

    Isoperformance is a technique for reading information out of a data-analytic model, comparable to expected mean square or omega squared analyses. It results in a trade-off function (an isoperformance curve) among the determinants of performance. The technique was developed primarily to generate trade-off functions between personnel aptitude and time in training or on the job. However, the technique is general and can be applied in any trade-off situation. In part, the purpose of this paper is to recall the antecedents of isoperformance in psychophysics and to recount the origins and development of the isoperformance readout. Its main purpose, however, is to present several examples of isoperformance curves in applied psychology and to make the case for their usefulness.

  14. An Applied Physicist Does Econometrics

    NASA Astrophysics Data System (ADS)

    Taff, L. G.

    2010-02-01

    The biggest problem those attempting to understand econometric data, via modeling, have is that economics has no F = ma. Without a theoretical underpinning, econometricians have no way to build a good model to fit observations to. Physicists do, and when F = ma failed, we knew it. Still desiring to comprehend econometric data, applied economists turn to mis-applying probability theory---especially with regard to the assumptions concerning random errors---and choosing extremely simplistic analytical formulations of inter-relationships. This introduces model bias to an unknown degree. An applied physicist, used to having to match observations to a numerical or analytical model with a firm theoretical basis, modify the model, re-perform the analysis, and then know why, and when, to delete ``outliers'', is at a considerable advantage when quantitatively analyzing econometric data. I treat two cases. One is to determine the household density distribution of total assets, annual income, age, level of education, race, and marital status. Each of these ``independent'' variables is highly correlated with every other but only current annual income and level of education follow a linear relationship. The other is to discover the functional dependence of total assets on the distribution of assets: total assets has an amazingly tight power law dependence on a quadratic function of portfolio composition. Who knew? )

  15. Towards "open applied" Earth sciences

    NASA Astrophysics Data System (ADS)

    Ziegler, C. R.; Schildhauer, M.

    2014-12-01

    Concepts of open science -- in the context of cyber/digital technology and culture -- could greatly benefit applied and secondary Earth science efforts. However, international organizations (e.g., environmental agencies, conservation groups and sustainable development organizations) that are focused on applied science have been slow to incorporate open practices across the spectrum of scientific activities, from data to decisions. Myriad benefits include transparency, reproducibility, efficiency (timeliness and cost savings), stakeholder engagement, direct linkages between research and environmental outcomes, reduction in bias and corruption, improved simulation of Earth systems and improved availability of science in general. We map out where and how open science can play a role, providing next steps, with specific emphasis on applied science efforts and processes such as environmental assessment, synthesis and systematic reviews, meta-analyses, decision support and emerging cyber technologies. Disclaimer: The views expressed in this paper are those of the authors and do not necessarily reflect the views or policies of the organizations for which they work and/or represent.

  16. Teaching in daily clinical practice: how to teach in a clinical setting.

    PubMed

    Ruesseler, M; Obertacke, U

    2011-06-01

    Teaching in the clinical setting is challenging; however, it is the location where students apply their learned facts and learn skills and attitudes most effectively. In order to improve clinical teaching, it is important to know and implement the principles of adult learning. The clinical teacher should know or assess the learners' prior knowledge and skills, as well as their stage of learning, before starting a new teaching session. The learners should be actively involved in the clinical processes. Questions to probe students' deeper understanding and capability to analyze, synthesize, and apply medical knowledge should be an important part of clinical teaching. Regular structured feedback is an important part of any learning experience.

  17. Clinical biochemistry

    NASA Technical Reports Server (NTRS)

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.

    1975-01-01

    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  18. Nose: Applied Aspects in Dermatology.

    PubMed

    Lakshmi, Dammaningala Venkataramaiah; Shilpa, Kanathur; Nataraja, Holavanahally Veerabhadrappa; Divya, Kallapa Gorur

    2016-01-01

    Nose is the most prominent part of the mid-face and has important physiological, aesthetic and psychological functions. Skin diseases on the nose are commonly seen by dermatologists, otorhinolaryngologists, and plastic surgeons. Because of its exposed, highly visible localization, lesions on the skin of the nose are often noticed by patients themselves, typically very early in the course of the disease. Similarly, the dermatological lexicon is well known with descriptive terminologies, synonyms, acronyms, eponyms, toponyms, misnomers. We have tried to compile the anatomical applications of nose in cosmetology and dermatosurgery subspecialities with nasal eponyms and signs encountered in clinical dermatology that would be helpful for residents. PMID:27057038

  19. Applying critical thinking to nursing.

    PubMed

    Price, Bob

    2015-08-19

    Critical thinking and writing are skills that are not easy to acquire. The term 'critical' is used differently in social and clinical contexts. Nursing students need time to master the inquisitive and ruminative aspects of critical thinking that are required in academic environments. This article outlines what is meant by critical thinking in academic settings, in relation to both theory and reflective practice. It explains how the focus of a question affects the sort of critical thinking required and offers two taxonomies of learning, to which students can refer when analysing essay requirements. The article concludes with examples of analytical writing in reference to theory and reflective practice.

  20. Nose: Applied Aspects in Dermatology

    PubMed Central

    Lakshmi, Dammaningala Venkataramaiah; Shilpa, Kanathur; Nataraja, Holavanahally Veerabhadrappa; Divya, Kallapa Gorur

    2016-01-01

    Nose is the most prominent part of the mid-face and has important physiological, aesthetic and psychological functions. Skin diseases on the nose are commonly seen by dermatologists, otorhinolaryngologists, and plastic surgeons. Because of its exposed, highly visible localization, lesions on the skin of the nose are often noticed by patients themselves, typically very early in the course of the disease. Similarly, the dermatological lexicon is well known with descriptive terminologies, synonyms, acronyms, eponyms, toponyms, misnomers. We have tried to compile the anatomical applications of nose in cosmetology and dermatosurgery subspecialities with nasal eponyms and signs encountered in clinical dermatology that would be helpful for residents. PMID:27057038

  1. Aerospace reliability applied to biomedicine.

    NASA Technical Reports Server (NTRS)

    Lalli, V. R.; Vargo, D. J.

    1972-01-01

    An analysis is presented that indicates that the reliability and quality assurance methodology selected by NASA to minimize failures in aerospace equipment can be applied directly to biomedical devices to improve hospital equipment reliability. The Space Electric Rocket Test project is used as an example of NASA application of reliability and quality assurance (R&QA) methods. By analogy a comparison is made to show how these same methods can be used in the development of transducers, instrumentation, and complex systems for use in medicine.

  2. Applying quantum principles to psychology

    NASA Astrophysics Data System (ADS)

    Busemeyer, Jerome R.; Wang, Zheng; Khrennikov, Andrei; Basieva, Irina

    2014-12-01

    This article starts out with a detailed example illustrating the utility of applying quantum probability to psychology. Then it describes several alternative mathematical methods for mapping fundamental quantum concepts (such as state preparation, measurement, state evolution) to fundamental psychological concepts (such as stimulus, response, information processing). For state preparation, we consider both pure states and densities with mixtures. For measurement, we consider projective measurements and positive operator valued measurements. The advantages and disadvantages of each method with respect to applications in psychology are discussed.

  3. Fire retardancy using applied materials

    NASA Technical Reports Server (NTRS)

    Feldman, R.

    1971-01-01

    An example of advanced technology transfer from the Little Joe, Surveyor, Comsat, re-entry and Apollo age to everyday fire protection needs is presented. Utilizing the principle of sublimation cooling for thermostatic temperature control, the material meets a wide range of fire retardancy and heat transmission control requirements. Properties vary from flexible tape for conduits and electrical cables to rigid coatings for column protection, with a broad spectrum of sublimation temperatures available. The material can be applied in the field or in the factory, utilizing mass production techniques, yielding a product that is reliable, effective, widely available and low in cost.

  4. Applying STAMP in Accident Analysis

    NASA Technical Reports Server (NTRS)

    Leveson, Nancy; Daouk, Mirna; Dulac, Nicolas; Marais, Karen

    2003-01-01

    Accident models play a critical role in accident investigation and analysis. Most traditional models are based on an underlying chain of events. These models, however, have serious limitations when used for complex, socio-technical systems. Previously, Leveson proposed a new accident model (STAMP) based on system theory. In STAMP, the basic concept is not an event but a constraint. This paper shows how STAMP can be applied to accident analysis using three different views or models of the accident process and proposes a notation for describing this process.

  5. Participating in Clinical Trials

    MedlinePlus

    ... this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical ... to treat or cure a disease. Phases of Clinical Trials Clinical trials of drugs are usually described based ...

  6. Integrated clinical information system.

    PubMed

    Brousseau, G

    1995-01-01

    contains personalized profiles: questionnaires based on the predetermined choices of the information most relevant to the specific user. The SIDOCI clinical dictionary also includes the hospital's suggested or mandatory interventions, clinical guidelines, and protocols. These clinical guidelines are customized at the hospital, service, and professional levels. Common interventions have been regrouped so that health professionals may apply the appropriate diagnostic, therapeutic, educational, or other intervention plans. The clinical dictionary also serves as a teaching and continuing education tool. The patient profile is a permanent record containing information on allergies, blood type, primary and secondary diagnoses, ongoing treatments, and prior hospitalizations. The problem list dealing with the current hospitalization includes symptoms, signs, and diagnoses. This standard clinical record facilitates communication between the services and provides a quick overview of the patient's history should emergency treatment be required. This health information system integrates Requests and Results, Progress Notes, and Analysis of the results. In addition, functions inherent to a patient's clinical cycle such as Administrative Management of episodes, Adaptation to physical and professional structures of the hospital, Messages between health professionals, and Electronic signature constitute the basis of SIDOCI. The most exciting aspect of this research project is its social impact: a more efficient health care system will improve the lives of all citizens. Moreover this applied research project involves the information industry and directly calls for the input of users such as doctors, nurses and hospital support staff.

  7. Integrated clinical information system.

    PubMed

    Brousseau, G

    1995-01-01

    contains personalized profiles: questionnaires based on the predetermined choices of the information most relevant to the specific user. The SIDOCI clinical dictionary also includes the hospital's suggested or mandatory interventions, clinical guidelines, and protocols. These clinical guidelines are customized at the hospital, service, and professional levels. Common interventions have been regrouped so that health professionals may apply the appropriate diagnostic, therapeutic, educational, or other intervention plans. The clinical dictionary also serves as a teaching and continuing education tool. The patient profile is a permanent record containing information on allergies, blood type, primary and secondary diagnoses, ongoing treatments, and prior hospitalizations. The problem list dealing with the current hospitalization includes symptoms, signs, and diagnoses. This standard clinical record facilitates communication between the services and provides a quick overview of the patient's history should emergency treatment be required. This health information system integrates Requests and Results, Progress Notes, and Analysis of the results. In addition, functions inherent to a patient's clinical cycle such as Administrative Management of episodes, Adaptation to physical and professional structures of the hospital, Messages between health professionals, and Electronic signature constitute the basis of SIDOCI. The most exciting aspect of this research project is its social impact: a more efficient health care system will improve the lives of all citizens. Moreover this applied research project involves the information industry and directly calls for the input of users such as doctors, nurses and hospital support staff. PMID:8591228

  8. Clinical arthrography

    SciTech Connect

    Arndt, R.; Horns, J.W.; Gold, R.H.; Blaschke, D.D.

    1985-01-01

    This book deals with the method and interpretation of arthrography of the shoulder, knee, ankle, elbow, hip, wrist, and metacarpophalangeal, interphalangeal, and temporomandibular joints. The emphasis is on orthopaedic disorders, usually of traumatic origin, which is in keeping with the application of arthrography in clinical practice. Other conditions, such as inflammatory and degenerative diseases, congenital disorders and, in the case of the hip, arthrography of reconstructive joint surgery, are included. Each chapter is devoted to one joint and provides a comprehensive discussion on the method of arthrography, including single and double contrast techniques where applicable, normal radiographic anatomy, and finally, the interpretation of the normal and the abnormal arthrogram.

  9. Data Understanding Applied to Optimization

    NASA Technical Reports Server (NTRS)

    Buntine, Wray; Shilman, Michael

    1998-01-01

    The goal of this research is to explore and develop software for supporting visualization and data analysis of search and optimization. Optimization is an ever-present problem in science. The theory of NP-completeness implies that the problems can only be resolved by increasingly smarter problem specific knowledge, possibly for use in some general purpose algorithms. Visualization and data analysis offers an opportunity to accelerate our understanding of key computational bottlenecks in optimization and to automatically tune aspects of the computation for specific problems. We will prototype systems to demonstrate how data understanding can be successfully applied to problems characteristic of NASA's key science optimization tasks, such as central tasks for parallel processing, spacecraft scheduling, and data transmission from a remote satellite.

  10. Thermoeconomics applied to HVAC systems

    SciTech Connect

    Tozer, R.; Valero, A.; Lozano, M.A.

    1999-07-01

    Thermoeconomics uses thermodynamics in conjunction with economic analysis to achieve improved cost benefit and quality in design. The thermodynamic analysis uses the second law and availability or exergy, which is a measure of the usefulness of energy. This paper uses exergy rather than energy in the thermoeconomic analysis and system optimization. The objective of thermoeconomics is to minimize a cost function, which is usually capital or life-cycle costs, which are expressed in terms of thermodynamic variables of the system. This will establish the most cost-effective design parameters for the specific design configuration analyzed. This paper presents the methods for applying a thermoeconomic analysis to several HVAC systems. The design conditions are analyzed, providing detailed exergy costing related to the plant investment and operating costs of the base design. By reviewing these, the most appropriate system variables are selected and the system cost is optimized, therefore achieving important life-cycle cost and capital investment savings.

  11. Implementing an Applied Science Program

    NASA Technical Reports Server (NTRS)

    Rickman, Doug; Presson, Joan

    2007-01-01

    The work implied in the NASA Applied Science Program requires a delicate balancing act for the those doing it. At the implementation level there are multiple tensions intrinsic to the program. For example each application of an existing product to a decision support process requires deep knowledge about the data and deep knowledge about the decision making process. It is highly probable no one person has this range of knowledge. Otherwise the decision making process would already be using the data. Therefore, a team is required. But building a team usually requires time, especially across agencies. Yet the program mandates efforts of relatively short duration. Further, those who know the data are scientists, which makes them essential to the program. But scientists are evaluated on their publication record. Anything which diverts a scientist from the research for his next publication is an anathema to him and potential death to their career. Trying to get another agency to use NASA data does not strike most scientists as material inherently suitable for publication. Also, NASA wishes to rapidly implement often substantial changes to another agency's process. For many reasons, such as budget and program constraints, speed is important. But the owner of a decision making process is tightly constrained, usually by law, regulation, organization and custom. Changes when made are slow, cautious, even hesitant, and always done according a process specific to the situation. To manage this work MSFC must balance these and other tensions. Some things we have relatively little control over, such as budget. These we try to handle by structural techniques. For example by insisting all of our people work on multiple projects simultaneously we inherently have diversification of funding for all of our people. In many cases we explicitly use some elements of tension to be productive. For example the need for the scientists to constantly publish is motivation to keep tasks short and

  12. An Introduction to Applied Biogeography

    NASA Astrophysics Data System (ADS)

    Spellerberg, Ian F.; Sawyer, John W. D.

    1999-03-01

    Biogeography is about the geographical distribution, both past and present, of plants, animals and other organisms. In this undergraduate textbook, Spellerberg and Sawyer bring a modern approach to a developing subject, writing in a lively and sometimes provocative manner. Throughout the text, the authors emphasize the applications of biogeography to conservation management, economic production, environmental assessment, sustainable use of resources, landscape planning, and public health. They discuss applications of island biogeography in conservation, the concept of wildlife corridors, the analysis of biogeographical data, and the role of humans and their cultures in biogeography. The applied approach of this textbook, along with its numerous illustrative examples and figures, make it a unique introduction to the field for many geography, biology and environmental science students.

  13. [Basic science and applied science].

    PubMed

    Pérez-Tamayo, R

    2001-01-01

    A lecture was presented by the author at the Democratic Opinion Forum on Health Teaching and Research, organized by Mexico's National Health Institutes Coordinating Office, at National Cardiology Institute "Ignacio Chavez", where he presented a critical review of the conventional classification of basic and applied science, as well as his personal view on health science teaching and research. According to the author, "well-conducted science" is that "generating reality-checked knowledge" and "mis-conducted science" is that "unproductive or producing 'just lies' and 'non-fundable'. To support his views, the author reviews utilitarian and pejorative definitions of science, as well as those of committed and pure science, useful and useless science, and practical and esoterical science, as synonyms of applied and basic science. He also asserts that, in Mexico, "this classification has been used in the past to justify federal funding cutbacks to basic science, allegedly because it is not targeted at solving 'national problems' or because it was not relevant to priorities set in a given six-year political administration period". Regarding health education and research, the author asserts that the current academic programs are inefficient and ineffective; his proposal to tackle these problems is to carry out a solid scientific study, conducted by a multidisciplinary team of experts, "to design the scientific researcher curricula from recruitment of intelligent young people to retirement or death". Performance assessment of researchers would not be restricted to publication of papers, since "the quality of scientific work and contribution to the development of science is not reflected by the number of published papers". The English version of this paper is available at: http://www.insp.mx/salud/index.html

  14. Applying adult learning practices in medical education.

    PubMed

    Reed, Suzanne; Shell, Richard; Kassis, Karyn; Tartaglia, Kimberly; Wallihan, Rebecca; Smith, Keely; Hurtubise, Larry; Martin, Bryan; Ledford, Cynthia; Bradbury, Scott; Bernstein, Henry Hank; Mahan, John D

    2014-07-01

    The application of the best practices of teaching adults to the education of adults in medical education settings is important in the process of transforming learners to become and remain effective physicians. Medical education at all levels should be designed to equip physicians with the knowledge, clinical skills, and professionalism that are required to deliver quality patient care. The ultimate outcome is the health of the patient and the health status of the society. In the translational science of medical education, improved patient outcomes linked directly to educational events are the ultimate goal and are best defined by rigorous medical education research efforts. To best develop faculty, the same principles of adult education and teaching adults apply. In a systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education, the use of experiential learning, feedback, effective relationships with peers, and diverse educational methods were found to be most important in the success of these programs. In this article, we present 5 examples of applying the best practices in teaching adults and utilizing the emerging understanding of the neurobiology of learning in teaching students, trainees, and practitioners. These include (1) use of standardized patients to develop communication skills, (2) use of online quizzes to assess knowledge and aid self-directed learning, (3) use of practice sessions and video clips to enhance significant learning of teaching skills, (4) use of case-based discussions to develop professionalism concepts and skills, and (5) use of the American Academy of Pediatrics PediaLink as a model for individualized learner-directed online learning. These examples highlight how experiential leaning, providing valuable feedback, opportunities for practice, and stimulation of self-directed learning can be utilized as medical education continues its dynamic transformation in the years ahead. PMID

  15. Clinical research in allied health.

    PubMed

    Selker, L G

    1994-01-01

    Allied health professionals in nutrition and medical dietetics, occupational therapy, physical therapy, and speech-language pathology and audiology play both unique and key cross-cutting roles in the furtherance of clinical research. Clinical research in nutrition and medical dietetics uniquely focuses on food nutrient intake and the metabolic utilization of nutrients. Clinical research in occupational therapy has a special focus on the relationship of impairment to disability, the adaptation to disability and the maximization of function. Physical therapy clinical research uniquely targets movement dysfunction and its evaluation and treatment within the context of quality and effective care. Clinical research in speech-language pathology and audiology is singular in its focus on deafness and hearing disorders, voice, speech, language and related disorders, and intersections among these and other neurological and physical conditions. Thus, all of these disciplines are making unique contributions to clinical research. Clinical research in these allied health professions is much more than the above specific foci. Inasmuch as these disciplines are rooted in practice, their contributions to research are inherently clinical. Many, if not most, of these contributions represent further validations of clinical practice or its underlying knowledge base. This means that, at a macro level, clinical research in allied health is very much "applied" research. Within allied health clinical research, this emphasis is redoubled at the "person," or individual level, where considerable attention is given to concepts of function and effectiveness. Clinical research in allied health has played a key cross-cutting role through its emphasis on collaboration. Possibly due to their professional maturation within multidisciplinary academic units, allied health professionals have demonstrated a level of comfort with multidisciplinary and interdisciplinary collaborations unique within many

  16. Five practices of efficient factories applied to dental education.

    PubMed

    Nalliah, Romesh P

    2015-05-01

    Efficient factories, such as dental school clinics (DSC), are trying to improve the quality of their product by reducing inefficiencies, error rates, and wastage. Dental education is an expensive business for the student and the institution. Dental materials and equipment are costly, and students are novice providers who work slowly and inefficiently compared to an experienced dentist; this is not a good business model. The objective of this article was to present and apply five practices of efficient factories that could be applied to the DSC setting. I propose that this will lead to improved educational outcomes and improved patient outcomes in DSC. PMID:25891379

  17. Automating clinical dietetics documentation.

    PubMed

    Grace-Farfaglia, P; Rosow, P

    1995-06-01

    A review of commonly used charting formats discussed in the dietetics literature revealed that the subjective, objective assessment and planning (SOAP) approach is most frequently used by dietitians. Formats reported in the nursing literature were charting by exception (CBE); problem, intervention, evaluation (PIE); and focus/data, action, response (Focus/DAR). The strengths and weaknesses of the charting styles as they apply to the needs of clinical dietetic specialists were reviewed. We then decided to test in house the Focus/DAR format by assessing chart entries for adherence to style, brevity, and physician response. Dietitians pilot tested all the methods, but found them time consuming to use. The consensus was that SOAP could be adapted to the documentation needs of the individual situation and required little additional staff training. Often because of time limitations, a narrative summary was most appropriate. Chart entry length was reduced as much as 200% when staff were given brief clinical communication as a goal, and a further reduction when line limits were imposed. The physician response was positive, with recommendations followed in 50% of charts, compared with 34% in a previous audit. A nutrition documentation system was developed by the researchers by reviewing medical chart structure, documentation standards, methods of risk identification, and terminology for clinical documentation style. The resulting system affected the decision making of physicians, who could now scan notes more quickly and implement nutrition recommendations in a more timely fashion.

  18. Towards clinical bioethics (or a return to clinical ethics?).

    PubMed

    Petrini, C

    2013-01-01

    Medical ethics has traditionally been oriented towards the clinical setting. Since the middle of the last century, however, various circumstances (associated mainly, though not exclusively, with rapid advances in technology and knowledge) have considerably broadened both the field of enquiry and the scope of this discipline. This is due partly to the overlap between medical ethics and bioethics, which in recent decades has acquired its own identity and concerns a multitude of ethical aspects in the biomedical field. Clinical ethics taps into the vast wealth of deontology, so that it has no need for additional criteria or principles, or for the definition of new values: rather, it recognizes the need to apply existing criteria, principles and values to contingent circumstances and contexts. A special role is reserved for ethics committees and, above all, for clinical ethics consultants, although in some countries the former are concerned mainly with authorisations for clinical trials. Clinical ethics consultants, however, may have a more incisive influence in clinical decisions: the special requisites and skills they need have been defined and discussed in various documents which are mentioned briefly in the present article. The presence of these consultants does not exonerate clinical physicians from their responsibilities or from liability for their decisions, in the formation of which they must refer constantly to codes of professional ethics. PMID:24424236

  19. Applied physiology of ice hockey.

    PubMed

    Cox, M H; Miles, D S; Verde, T J; Rhodes, E C

    1995-03-01

    Today's elite hockey players are physically bigger and have improved levels of physiological fitness when compared with their predecessors. Correspondingly, previous ice hockey studies that have become widely referenced may have little relevance to current players and the way the game is presently played. A great need exists to apply exercise science to the game of ice hockey. Although much has been written about the physiology of ice hockey, there is little information based on well controlled studies. Particularly, there is a paucity of knowledge concerning optimal training schedules, training specificity, recovery profiles and seasonal detraining. Moreover, the reports that do exist have attempted to make comparisons across all levels of skill and talent. Thus, fundamental questions remain as to actual physiological exercise response and specialised training programmes for ice hockey players, particularly at the elite level. There is a demand for new properly designed experiments to find answers pertaining to the appropriate training methods for today's ice hockey players. Future research directions should consider the relationships between performance and such variables as neuromuscular skills, strength, power, peripheral adaptations, travel, hydration, detraining and sport-specific training programmes. Incidence and severity of injury among ice hockey players in relation to fatigue and fitness must also be investigated. Much of the information currently used in ice hockey will remain speculative and anecdotal until these studies are conducted. PMID:7784758

  20. Applied extreme-value statistics

    SciTech Connect

    Kinnison, R.R.

    1983-05-01

    The statistical theory of extreme values is a well established part of theoretical statistics. Unfortunately, it is seldom part of applied statistics and is infrequently a part of statistical curricula except in advanced studies programs. This has resulted in the impression that it is difficult to understand and not of practical value. In recent environmental and pollution literature, several short articles have appeared with the purpose of documenting all that is necessary for the practical application of extreme value theory to field problems (for example, Roberts, 1979). These articles are so concise that only a statistician can recognise all the subtleties and assumptions necessary for the correct use of the material presented. The intent of this text is to expand upon several recent articles, and to provide the necessary statistical background so that the non-statistician scientist can recognize and extreme value problem when it occurs in his work, be confident in handling simple extreme value problems himself, and know when the problem is statistically beyond his capabilities and requires consultation.

  1. Intelligence Applied to Air Vehicles

    NASA Technical Reports Server (NTRS)

    Rosen, Robert; Gross, Anthony R.; Fletcher, L. Skip; Zornetzer, Steven (Technical Monitor)

    2000-01-01

    The exponential growth in information technology has provided the potential for air vehicle capabilities that were previously unavailable to mission and vehicle designers. The increasing capabilities of computer hardware and software, including new developments such as neural networks, provide a new balance of work between humans and machines. This paper will describe several NASA projects, and review results and conclusions from ground and flight investigations where vehicle intelligence was developed and applied to aeronautical and space systems. In the first example, flight results from a neural network flight control demonstration will be reviewed. Using, a highly-modified F-15 aircraft, a NASA/Dryden experimental flight test program has demonstrated how the neural network software can correctly identify and respond to changes in aircraft stability and control characteristics. Using its on-line learning capability, the neural net software would identify that something in the vehicle has changed, then reconfigure the flight control computer system to adapt to those changes. The results of the Remote Agent software project will be presented. This capability will reduce the cost of future spacecraft operations as computers become "thinking" partners along with humans. In addition, the paper will describe the objectives and plans for the autonomous airplane program and the autonomous rotorcraft project. Technologies will also be developed.

  2. REGENERATIVE MEDICINE AS APPLIED TO GENERAL SURGERY

    PubMed Central

    Orlando, Giuseppe; Wood, Kathryn J; De Coppi, Paolo; Baptista, Pedro M; Binder, Kyle W; Bitar, Khalil N; Breuer, Christopher; Burnett, Luke; Christ, George; Farney, Alan; Figliuzzi, Marina; Holmes, James H; Koch, Kenneth; Macchiarini, Paolo; Sani, Sayed-Hadi Mirmalek; Opara, Emmanuel; Remuzzi, Andrea; Rogers, Jeffrey; Saul, Justin M; Seliktar, Dror; Shapira-Schweitzer, Keren; Smith, Tom; Solomon, Daniel; Van Dyke, Mark; Yoo, James J; Zhang, Yuanyuan; Atala, Anthony; Stratta, Robert J; Soker, Shay

    2012-01-01

    The present review illustrates the state of the art of regenerative medicine (RM) as applied to surgical diseases and demonstrates that this field has the potential to address some of the unmet needs in surgery. RM is a multidisciplinary field whose purpose is to regenerate in vivo or ex vivo human cells, tissues or organs in order to restore or establish normal function through exploitation of the potential to regenerate, which is intrinsic to human cells, tissues and organs. RM uses cells and/or specially designed biomaterials to reach its goals and RM-based therapies are already in use in several clinical trials in most fields of surgery. The main challenges for investigators are threefold: Creation of an appropriate microenvironment ex vivo that is able to sustain cell physiology and function in order to generate the desired cells or body parts; identification and appropriate manipulation of cells that have the potential to generate parenchymal, stromal and vascular components on demand, both in vivo and ex vivo; and production of smart materials that are able to drive cell fate. PMID:22330032

  3. Anaphylaxis to topically applied sodium fusidate.

    PubMed

    Park, Mi-Ran; Kim, Do-Soo; Kim, Jihyun; Ahn, Kangmo

    2013-03-01

    Fusidic acid is a bacteriostatic antibiotic that is effective primarily on gram-positive bacteria, such as Staphylococcus and Corynebacterium species. It is often topically applied to the skin, but is also given systemically as a tablet or injection. Allergic contact dermatitis, or urticaria, has been reported as a side effect of fusidic acid treatment, whereas anaphylaxis to topically administered fusidic acid has not been reported previously. A 16-year-old boy visited an outpatient clinic for further evaluation of anaphylaxis. He suffered abrasions on his arms during exercise, which were treated with a topical ointment containing sodium fusidate. Within 30 minutes, he developed urticaria and eyelid swelling, followed by a cough and respiratory difficulty. His symptoms were relieved by emergency treatment in a nearby hospital. To investigate the etiology, oral provocation with fusidate was performed. After 125 mg (1/2 tablet) of sodium fusidate was administered, he developed a cough and itching of the throat within 30 minutes, which was followed by chest discomfort and urticaria. Forced expiratory volume in 1 second (FEV1) dropped from 4.09 L at baseline to 3.50 L after challenge, although wheezing was not heard in his chest. After management with an inhaled bronchodilator using a nebulizer, chest discomfort was relieved and FEV1 rose to 3.86 L. The patient was directed not to use fusidate, especially on abrasions. Here we report the first case of anaphylaxis resulting from topical fusidic acid application to abrasions. PMID:23450038

  4. Regenerative medicine as applied to general surgery.

    PubMed

    Orlando, Giuseppe; Wood, Kathryn J; De Coppi, Paolo; Baptista, Pedro M; Binder, Kyle W; Bitar, Khalil N; Breuer, Christopher; Burnett, Luke; Christ, George; Farney, Alan; Figliuzzi, Marina; Holmes, James H; Koch, Kenneth; Macchiarini, Paolo; Mirmalek Sani, Sayed-Hadi; Opara, Emmanuel; Remuzzi, Andrea; Rogers, Jeffrey; Saul, Justin M; Seliktar, Dror; Shapira-Schweitzer, Keren; Smith, Tom; Solomon, Daniel; Van Dyke, Mark; Yoo, James J; Zhang, Yuanyuan; Atala, Anthony; Stratta, Robert J; Soker, Shay

    2012-05-01

    The present review illustrates the state of the art of regenerative medicine (RM) as applied to surgical diseases and demonstrates that this field has the potential to address some of the unmet needs in surgery. RM is a multidisciplinary field whose purpose is to regenerate in vivo or ex vivo human cells, tissues, or organs to restore or establish normal function through exploitation of the potential to regenerate, which is intrinsic to human cells, tissues, and organs. RM uses cells and/or specially designed biomaterials to reach its goals and RM-based therapies are already in use in several clinical trials in most fields of surgery. The main challenges for investigators are threefold: Creation of an appropriate microenvironment ex vivo that is able to sustain cell physiology and function in order to generate the desired cells or body parts; identification and appropriate manipulation of cells that have the potential to generate parenchymal, stromal and vascular components on demand, both in vivo and ex vivo; and production of smart materials that are able to drive cell fate.

  5. Talk in Interaction in the Speech-Language Pathology Clinic: Bringing Theory to Practice through Discourse

    ERIC Educational Resources Information Center

    Leaby, Margaret M.; Walsh, Irene P.

    2008-01-01

    The importance of learning about and applying clinical discourse analysis to enhance the talk in interaction in the speech-language pathology clinic is discussed. The benefits of analyzing clinical discourse to explicate therapy dynamics are described.

  6. Morphometrics applied to medical entomology.

    PubMed

    Dujardin, Jean-Pierre

    2008-12-01

    Morphometrics underwent a revolution more than one decade ago. In the modern morphometrics, the estimate of size is now contained in a single variable reflecting variation in many directions, as many as there are landmarks under study, and shape is defined as their relative positions after correcting for size, position and orientation. With these informative data, and the corresponding software freely available to conduct complex analyses, significant biological and epidemiological features can be quantified more accurately. We discuss the evolutionary significance of the environmental impact on metric variability, mentioning the importance of concepts like genetic assimilation, genetic accommodation, and epigenetics. We provide examples of measuring the effect of selection on metric variation by comparing (unpublished) Qst values with corresponding (published) Fst. The primary needs of medical entomologists are to distinguish species, especially cryptic species, and to detect them where they are not expected. We explain how geometric morphometrics could apply to these questions, and where there are deficiencies preventing the approach from being utilized at its maximum potential. Medical entomologists in connection with control programs aim to identify isolated populations where the risk of reinfestation after treatment would be low ("biogeographical islands"). Identifying them can be obtained from estimating the number of migrants per generation. Direct assessment of movement remains the most valid approach, but it scores active movement only. Genetic methods estimating gene flow levels among interbreeding populations are commonly used, but gene flow does not necessarily mean the current flow of migrants. Methods using the morphometric variation are neither suited to evaluate gene flow, nor are they adapted to estimate the flow of migrants. They may provide, however, the information needed to create a preliminary map pointing to relevant areas where one could

  7. Peptide radioimmunoassays in clinical medicine

    SciTech Connect

    Geokas, M.C.; Yalow, R.S.; Straus, E.W.; Gold, E.M.

    1982-09-01

    The radioimmunoassay technique, first developed for the determination of hormones, has been applied to many substances of biologic interest by clinical and research laboratories around the world. It has had an enormous effect in medicine and biology as a diagnostic tool, a guide to therapy, and a probe for the fine structure of biologic systems. For instance, the assays of insulin, gastrin, secretin, prolactin, and certain tissue-specific enzymes have been invaluable in patient care. Further refinements of current methods, as well as the emergence of new immunoassay techniques, are expected to enhance precision, specificity, reliability, and convenience of the radioimmunoassay in both clinical and research laboratories.

  8. Electrochemical Sensors for Clinic Analysis

    PubMed Central

    Wang, You; Xu, Hui; Zhang, Jianming; Li, Guang

    2008-01-01

    Demanded by modern medical diagnosis, advances in microfabrication technology have led to the development of fast, sensitive and selective electrochemical sensors for clinic analysis. This review addresses the principles behind electrochemical sensor design and fabrication, and introduces recent progress in the application of electrochemical sensors to analysis of clinical chemicals such as blood gases, electrolytes, metabolites, DNA and antibodies, including basic and applied research. Miniaturized commercial electrochemical biosensors will form the basis of inexpensive and easy to use devices for acquiring chemical information to bring sophisticated analytical capabilities to the non-specialist and general public alike in the future.

  9. Comparison of applying particulate demineralized bone matrix (DBM), putty DBM and open flap debridement in periodontal horizontal bone defects. A 12-month longitudinal, multi-centre, triple-blind, split-mouth, randomized, controlled clinical study. Part 2 - evaluation of the interdental soft tissue.

    PubMed

    Kaya, Y; Yalim, M; Bahçecitapar, M; Baloş, K

    2009-07-01

    To date, there have been many studies clinically evaluating periodontal regenerative procedures by the help of routinely used hard and soft tissue parameters; however, these parameters are not capable of assessing interdental soft tissue located above the regenerative periodontal surgery area. The purpose of this study was to assess interproximal soft tissue changes following application of (i) particulate form demineralized bone matrix (DBM), (ii) putty form DBM and (ii) open flap debridement (OFD, control), using modified curtain technique in the treatment of interproximal suprabony (horizontal) defects located in anterior maxillary region, as previously reported. Twenty-five chronic periodontitis patients with 125 interproximal surgery sites (radiologically >or=4 mm horizontal bone defect) were also participate in this second stage of the triple-blind, split mouth, randomized, controlled clinical trial. Surgery sites were assessed by (i) plaque index (PI), (ii) gingival index (GI), (iii) the presence of interdental soft tissue clefts or craters and (iv) the loss of interdental papilla height by using papilla presence index (PPI), during the healing period. At the baseline and 3, 6, 9 and 12 months after the operations, these measurements were repeated. In all groups, there is a significant increase in the prevalence of soft tissue cleft and crater formation (P < 0.01), with increase in PI and GI scores at interdental soft tissue defect areas (P < 0.001), 3 months after the operations. There was also an increase in PPI scores after the operations in all treatment groups (P < 0.01). Three procedures affected the interproximal soft tissues similarly. There was no significant difference among groups in terms of all parameters (P > 0.05). Particulate DBM, putty DBM and OFD demostrated similar interproximal soft tissue changes especially increasing interproximal PI and GI scores in 3 months follow-up. PMID:19453849

  10. Developing Cross Cultural Competence: Applying Development and Prevention Ideals to Counseling Young Children

    ERIC Educational Resources Information Center

    Wolfgang, Jeff; Frazier, Kimberly; West-Olatunji, Cirecie; Barrett, Joe

    2011-01-01

    As counselors turn their attention to child-based counseling, there is a need to apply the core tenets of the discipline of counseling to young children and incorporate cross-cultural issues into clinical competence. Using Multicultural Counseling Theory (MCT), the authors discuss conventional approaches to providing clinical interventions for…

  11. Cardioprotection in the clinical setting.

    PubMed

    Ivanes, Fabrice; Mewton, Nathan; Rioufol, Gilles; Piot, Christophe; Elbaz, Meyer; Revel, Didier; Croisille, Pierre; Ovize, Michel

    2010-06-01

    Reperfusion therapy is the primary treatment of acute myocardial infarction and must be applied as soon as possible to limit the ischemic insult. Unfortunately, reperfusion is responsible for additional myocardial damage likely involving opening of the mitochondrial permeability transition pore. Ischemic postconditioning is a powerful intervention that dramatically reduces lethal reperfusion injury. Several clinical studies using angioplasty postconditioning now support its protective effects in patients with an acute myocardial infarction. Alternatively, pharmacological postconditioning could afford comparable protection and be applied to a much larger number of patients. Indeed, the mitochondrial permeability transition pore inhibitor cyclosporine A has been shown to generate a similar protection in acute myocardial infarction patients. Future large-scale trials are needed to determine whether angioplasty or pharmacological postconditioning may improve clinical outcome in STEMI patients. PMID:20589423

  12. Applying Research Evidence to Optimize Telehomecare

    PubMed Central

    Bowles, Kathryn H.; Baugh, Amy C.

    2010-01-01

    Telemedicine is the use of technology to provide healthcare over a distance. Telehomecare, a form of telemedicine based in the patient's home, is a communication and clinical information system that enables the interaction of voice, video, and health-related data using ordinary telephone lines. Most home care agencies are adopting telehomecare to assist with the care of the growing population of chronically ill adults. This article presents a summary and critique of the published empirical evidence about the effects of telehomecare on older adult patients with chronic illness. The knowledge gained will be applied in a discussion regarding telehomecare optimization and areas for future research. The referenced literature in PubMed, MEDLINE, CDSR, ACP Journal Club, DARE, CCTR, and CINAHL databases was searched for the years 1995–2005 using the keywords “telehomecare” and “telemedicine,” and limited to primary research and studies in English. Approximately 40 articles were reviewed. Articles were selected if telehealth technology with peripheral medical devices was used to deliver home care for adult patients with chronic illness. Studies where the intervention consisted of only telephone calls or did not involve video or in-person nurse contact in the home were excluded. Nineteen studies described the effects of telehomecare on adult patients, chronic illness outcomes, providers, and costs of care. Patients and providers were accepting of the technology and it appears to have positive effects on chronic illness outcomes such as self-management, rehospitalizations, and length of stay. Overall, due to savings from healthcare utilization and travel, telehomecare appears to reduce healthcare costs. Generally, studies have small sample sizes with diverse types and doses of telehomecare intervention for a select few chronic illnesses; most commonly heart failure. Very few published studies have explored the cost or quality implications since the change in home

  13. Award for Distinguished Professional Contributions to Applied Research: Luciano L'Abate

    ERIC Educational Resources Information Center

    American Psychologist, 2009

    2009-01-01

    Luciano L'Abate, recipient of the Award for Distinguished Professional Contributions to Applied Research, contributed to applied research through the introduction of the laboratory method in clinical psychology assessment and intervention, leading to the development of the first automated playroom, linking play therapy with research in child…

  14. Ubiquitous Multicriteria Clinic Recommendation System.

    PubMed

    Chen, Toly

    2016-05-01

    Advancements in information, communication, and sensor technologies have led to new opportunities in medical care and education. Patients in general prefer visiting the nearest clinic, attempt to avoid waiting for treatment, and have unequal preferences for different clinics and doctors. Therefore, to enable patients to compare multiple clinics, this study proposes a ubiquitous multicriteria clinic recommendation system. In this system, patients can send requests through their cell phones to the system server to obtain a clinic recommendation. Once the patient sends this information to the system, the system server first estimates the patient's speed according to the detection results of a global positioning system. It then applies a fuzzy integer nonlinear programming-ordered weighted average approach to assess four criteria and finally recommends a clinic with maximal utility to the patient. The proposed methodology was tested in a field experiment, and the experimental results showed that it is advantageous over two existing methods in elevating the utilities of recommendations. In addition, such an advantage was shown to be statistically significant. PMID:26984357

  15. Detailed Clinical Models: A Review

    PubMed Central

    Goossen-Baremans, Anneke; van der Zel, Michael

    2010-01-01

    Objectives Due to the increasing use of electronic patient records and other health care information technology, we see an increase in requests to utilize these data. A highly level of standardization is required during the gathering of these data in the clinical context in order to use it for analyses. Detailed Clinical Models (DCM) have been created toward this purpose and several initiatives have been implemented in various parts of the world to create standardized models. This paper presents a review of DCM. Methods Two types of analyses are presented; one comparing DCM against health care information architectures and a second bottom up approach from concept analysis to representation. In addition core parts of the draft ISO standard 13972 on DCM are used such as clinician involvement, data element specification, modeling, meta information, and repository and governance. Results Six initiatives were selected: Intermountain Healthcare, 13606/OpenEHR Archetypes, Clinical Templates, Clinical Contents Models, Health Level 7 templates, and Dutch Detailed Clinical Models. Each model selected was reviewed for their overall development, involvement of clinicians, use of data types, code bindings, expressing semantics, modeling, meta information, use of repository and governance. Conclusions Using both a top down and bottom up approach to comparison reveals many commonalties and differences between initiatives. Important differences include the use of or lack of a reference model and expressiveness of models. Applying clinical data element standards facilitates the use of conceptual DCM models in different technical representations. PMID:21818440

  16. Epidemiology for the clinical neurologist.

    PubMed

    Jacob, M E; Ganguli, M

    2016-01-01

    Epidemiology is a foundation of all clinical and public health research and practice. Epidemiology serves seven important uses for the advancement of medicine and public health. It enables community diagnosis by quantifying risk factors and diseases in the community; completes the clinical picture of disease by revealing the entire distribution of disease and presenting meaningful population averages from representative samples; identifies risk factors for disease by detecting and quantifying associations between exposures and disease and evaluating causal hypotheses; computes individual risk to identify high-risk groups to whom preventive interventions can be targeted; evaluates historic trends that monitor disease over time and provide clues to etiology; delineates new syndromes and disease subtypes not previously apparent in clinical settings, helping to streamline effective disease management; and investigates the effects of health services on population health to identify effective public health interventions. The clinician with a grasp of epidemiologic principles is in a position to critically evaluate the research literature, to apply it to clinical practice, and to undertake valid clinical epidemiology research with patients in clinical settings. PMID:27637949

  17. Ubiquitous Multicriteria Clinic Recommendation System.

    PubMed

    Chen, Toly

    2016-05-01

    Advancements in information, communication, and sensor technologies have led to new opportunities in medical care and education. Patients in general prefer visiting the nearest clinic, attempt to avoid waiting for treatment, and have unequal preferences for different clinics and doctors. Therefore, to enable patients to compare multiple clinics, this study proposes a ubiquitous multicriteria clinic recommendation system. In this system, patients can send requests through their cell phones to the system server to obtain a clinic recommendation. Once the patient sends this information to the system, the system server first estimates the patient's speed according to the detection results of a global positioning system. It then applies a fuzzy integer nonlinear programming-ordered weighted average approach to assess four criteria and finally recommends a clinic with maximal utility to the patient. The proposed methodology was tested in a field experiment, and the experimental results showed that it is advantageous over two existing methods in elevating the utilities of recommendations. In addition, such an advantage was shown to be statistically significant.

  18. Paediatric clinical pharmacology in the UK

    PubMed Central

    Choonara, Imti; Sammons, Helen

    2014-01-01

    Paediatric clinical pharmacology is the scientific study of medicines in children and is a relatively new subspecialty in paediatrics in the UK. Training encompasses both the study of the effectiveness of drugs in children (clinical trials) and aspects of drug toxicity (pharmacovigilance). Ethical issues in relation to clinical trials and also studies of the pharmacokinetics and drug metabolism in children are crucial. Paediatric patients require formulations that young children in particular are able to take. The scientific evidence generated from clinical trials, pharmacokinetic studies and studies of drug toxicity all need to be applied in order to ensure that medicines are used rationally in children. PMID:25202131

  19. Portfolio 2000: managing clinical systems.

    PubMed

    Hunter, L L

    1998-01-01

    Powerful forces are changing the provision of health care. Management is transitioning into new responsibility for a leaner, more flexible, customer-focused operation to support the goals of integrated systems of the 21st century--to minimize disease and to promote health. In response to this evolution, the clinical systems management concept describes multidimensional competencies, which are transportable throughout the continuum of care (1). These new knowledge competencies and core competencies applied in a different context are characterized in this paper.

  20. Applied technology section. Monthly report, December 1993

    SciTech Connect

    Buckner, M.R.

    1994-01-28

    This monthly report contains abstracts of the progress made in various projects from the applied technology section at the Savannah River Plant. Research areas include engineering modeling and simulation, applied physics, experimental thermal hydraulics, and packaging and transportation.

  1. Applied Psycholinguistics--Amphibian or Phantom?

    ERIC Educational Resources Information Center

    Titone, Renzo

    1975-01-01

    A tentative classification of internal departments of psycholinguistics is suggested and a list of applied fields is presented. Applied psycholinguistics is not seen here to have a right to scientific independence. (SCC)

  2. A Prospective, Comparative, Evaluator-blind Clinical Study Investigating Efficacy and Safety of Two Injection Techniques with Radiesse® for the Correction of Skin Changes in Aging Hands

    PubMed Central

    Gubanova, Elena I; Starovatova, Polina A

    2015-01-01

    Background: Dermal fillers are used to correct age-related changes in hands. Aims: Assess efficacy and safety of two injection techniques to treat age-related changes in the hands using calcium hydroxylapatite filler, Radiesse®. Settings and Design: This was a prospective, comparative, evaluator-blind, single-center study. Materials and Methods: Radiesse® (0.8 mL/0.2 mL 2% lidocaine) was injected subdermally on Day (D)01, using a needle multipoint technique in one hand (N) and a fan-like cannula technique in the other (C). Assessments were made pre-injection, on D14, Month (M)02, M03 and M05 using the Merz Aesthetics Hand Grading Scale (MAS) and Global Aesthetic Improvement Scale (GAIS). Participants completed questionnaires on satisfaction, pain and adverse events (AEs). Statistical Analysis Used: Data distribution was tested with the Shapiro-Wilk and Levene's tests. The Wilcoxon signed-rank and Chi-square tests were employed to evaluate quantitative and qualitative data, respectively. Results: All 10 participants completed the study, four opted for a M03 touch-up (0.8 mL Radiesse®). Evaluator-assessed mean GAIS scores were between 2 (significant improvement but not complete correction) and 3 (optimal cosmetic result) at each time point. The MAS score improved from D01 to M05 (N: 2.60 to 1.40; C: 2.20 to 1.30). Following treatment, participants reported skin was softer, more elastic, more youthful and less wrinkled. Other than less noticeable veins and tendons on the C hand, no differences in participant satisfaction were noted. All AEs were mild, with no serious AEs reported. Conclusions: Both injection techniques (needle and cannula) demonstrated equivalent clinical efficacy with a comparable safety profile for the correction of age-related changes in hands with Radiesse®. PMID:26644738

  3. Clinical Physiology: A Successful Academic and Clinical Discipline is Threatened in Sweden

    ERIC Educational Resources Information Center

    Arheden, Hakan

    2009-01-01

    Clinical physiologists in Sweden are physicians (the majority with a PhD degree) with thorough training in system physiology and pathophysiology. They investigate patients in a functional approach and are engaged in basic and applied physiology teaching and research. In 1954, clinical physiology was founded as an independent academic and clinical…

  4. Western Perspectives in Applied Linguistics in Africa

    ERIC Educational Resources Information Center

    Makoni, Sinfree; Meinhof, Ulrike H.

    2004-01-01

    The aim of this article is to analyze the nature of the historical and contemporary social contexts within which applied linguistics in Africa emerged, and is currently practiced. The article examines the challenges "local" applied Linguistics in Africa is confronted with as it tries to amplify applied linguistic programs emanating from…

  5. Critical and Alternative Directions in Applied Linguistics

    ERIC Educational Resources Information Center

    Pennycook, Alastair

    2010-01-01

    Critical directions in applied linguistics can be understood in various ways. The term "critical" as it has been used in "critical applied linguistics," "critical discourse analysis," "critical literacy" and so forth, is now embedded as part of applied linguistic work, adding an overt focus on questions of power and inequality to discourse…

  6. Oklahoma administrators' perceptions of applied science

    NASA Astrophysics Data System (ADS)

    Horn, Stanley James

    1998-12-01

    Scope and method of study. The purpose of this study was to assess the perceptions of Oklahoma Public School Superintendents when applied science courses such as Applied Biology/Chemistry and Applied Physics (Principles of Technology) are compared to traditional science courses such as Biology, Chemistry, and Physics. The study was conducted with a population of 69 Oklahoma comprehensive school superintendents who were under contract during the 1997/98 school year. Each participant was employed by a school district that offered either Applied Biology/Chemistry, Applied Physics (also known as Principles of Technology) or both. All participants completed an 18-question telephone survey. Combined means and percentages of participants responses to the survey were recorded to draw conclusions about the study. Findings and conclusions. Superintendents perceive teachers and students as having good acceptance of applied science courses. Superintendents believe students think of applied science courses as excellent hands-on science, and teachers think of them as acceptable alternative science. Superintendents are somewhat satisfied with applied science courses. They believe it makes no difference if a student is college bound, non-college bound, more motivated or less motivated as to whom benefits from applied science courses. Superintendents feel there is no difference in applied science courses and traditional science courses when teaching science concepts of "PASS Skills," or preparing students for college or work. They perceive the cost of applied science courses to be somewhat greater than traditional science courses. They also think additional training for applied science teachers should be in the form of a seminar. Superintendents feel full credit toward high school graduation and college entrance requirements should be given to the students of applied science courses. Superintendents believe there is no difference as to which course, applied science or traditional

  7. Evaluating Language. Papers from the Annual Meeting of the British Association for Applied Linguistics (Essex, England, United Kingdom, September 1992).

    ERIC Educational Resources Information Center

    Graddol, David, Ed.; Swann, Joan, Ed.

    Papers from a British conference on applied linguistics address various aspects of evaluation and language. Articles include: "Grammar and Language Impairment: Clinical Linguistics as Applied Linguistics" (Paul Fletcher); "Putting Our Practice Into Theory" (Deborah Cameron); "Applied Linguistics as Evaluation of Theory and Practice:…

  8. Salivary biomarkers for clinical applications.

    PubMed

    Zhang, Lei; Xiao, Hua; Wong, David T

    2009-01-01

    For clinical applications such as monitoring health status, disease onset and progression, and treatment outcome, there are three necessary prerequisites: (i) a simple method for collecting biologic samples, ideally noninvasively; (ii) specific biomarkers associated with health or disease; and (iii) a technology platform to rapidly utilize the biomarkers. Saliva, often regarded as the 'mirror of the body', is a perfect surrogate medium to be applied for clinical diagnostics. Saliva is readily accessible via a totally noninvasive method. Salivary biomarkers, whether produced by healthy individuals or by individuals affected by specific diseases, are sentinel molecules that could be used to scrutinize health and disease surveillance. The visionary investment by the US National Institute of Dental and Craniofacial Research, the discovery of salivary biomarkers, and the ongoing development of salivary diagnostic technologies have addressed its diagnostic value for clinical applications. The availability of more sophisticated analytic techniques gives optimism that saliva can eventually be placed as a biomedium for clinical diagnostics. This review presents current salivary biomarker research and technology developmental efforts for clinical applications.

  9. Finite Element Analysis Applied to Dentoalveolar Trauma: Methodology Description

    PubMed Central

    da Silva, B. R.; Moreira Neto, J. J. S.; da Silva, F. I.; de Aguiar, A. S. W.

    2011-01-01

    Dentoalveolar traumatic injuries are among the clinical conditions most frequently treated in dental practice. However, few studies so far have addressed the biomechanical aspects of these events, probably as a result of difficulties in carrying out satisfactory experimental and clinical studies as well as the unavailability of truly scientific methodologies. The aim of this paper was to describe the use of finite element analysis applied to the biomechanical evaluation of dentoalveolar trauma. For didactic purposes, the methodological process was divided into steps that go from the creation of a geometric model to the evaluation of final results, always with a focus on methodological characteristics, advantages, and disadvantages, so as to allow the reader to customize the methodology according to specific needs. Our description shows that the finite element method can faithfully reproduce dentoalveolar trauma, provided the methodology is closely followed and thoroughly evaluated. PMID:21991463

  10. International Conference on Applied Sciences (ICAS2013)

    NASA Astrophysics Data System (ADS)

    Lemle, Ludovic Dan; Jiang, Yiwen

    2014-03-01

    The International Conference on Applied Sciences (ICAS2013) took place in Wuhan, P R China from 26-27 October 2013 at the Military Economics Academy. The conference is regularly organized, alternately in Romania and in P R China, by ''Politehnica'' University of Timişoara, Romania, and Military Economics Academy of Wuhan, P R China, with the aim to serve as a platform for the exchange of information between various areas of applied sciences, and to promote the communication between the scientists of different nations, countries and continents. The conference has been organized for the first time in 15-16 June 2012 at the Engineering Faculty of Hunedoara, Romania. The topics of the conference covered a comprehensive spectrum of issues: Economical sciences Engineering sciences Fundamental sciences Medical sciences The conference gathered qualified researchers whose expertise can be used to develop new engineering knowledge that has applicability potential in economics, defense, medicine, etc. The number of registered participants was nearly 90 from 5 countries. During the two days of the conference 4 invited and 36 oral talks were delivered. A few of the speakers deserve a special mention: Mircea Octavian Popoviciu, Academy of Romanian Scientist — Timişoara Branch, Correlations between mechanical properties and cavitation erosion resistance for stainless steels with 12% chromium and variable contents of nickel; Carmen Eleonora Hărău, ''Politehnica'' University of Timişoara, SWOT analysis of Romania's integration in EU; Ding Hui, Military Economics Academy of Wuhan, Design and engineering analysis of material procurement mobile operation platform; Serban Rosu, University of Medicine and Pharmacy ''Victor Babeş'' Timişoara, Cervical and facial infections — a real life threat, among others. Based on the work presented at the conference, 14 selected papers are included in this volume of IOP Conference Series: Materials Science and Engineering. These papers

  11. Unsupervised mining of frequent tags for clinical eligibility text indexing.

    PubMed

    Miotto, Riccardo; Weng, Chunhua

    2013-12-01

    Clinical text, such as clinical trial eligibility criteria, is largely underused in state-of-the-art medical search engines due to difficulties of accurate parsing. This paper proposes a novel methodology to derive a semantic index for clinical eligibility documents based on a controlled vocabulary of frequent tags, which are automatically mined from the text. We applied this method to eligibility criteria on ClinicalTrials.gov and report that frequent tags (1) define an effective and efficient index of clinical trials and (2) are unlikely to grow radically when the repository increases. We proposed to apply the semantic index to filter clinical trial search results and we concluded that frequent tags reduce the result space more efficiently than an uncontrolled set of UMLS concepts. Overall, unsupervised mining of frequent tags from clinical text leads to an effective semantic index for the clinical eligibility documents and promotes their computational reuse.

  12. Ultrasound artifacts: classification, applied physics with illustrations, and imaging appearances.

    PubMed

    Prabhu, Somnath J; Kanal, Kalpana; Bhargava, Puneet; Vaidya, Sandeep; Dighe, Manjiri K

    2014-06-01

    Ultrasound has become a widely used diagnostic imaging modality in medicine because of its safety and portability. Because of rapid advances in technology, in recent years, sonographic imaging quality has significantly increased. Despite these advances, the potential to encounter artifacts while imaging remains.This article classifies both common and uncommon gray-scale and Doppler ultrasound artifacts into those resulting from physiology and those caused by hardware. A brief applied-physics explanation for each artifact is listed along with an illustrated diagram. The imaging appearance of artifacts is presented in case examples, along with strategies to minimize the artifacts in real time or use them for clinical advantage where applicable.

  13. Applying XDS for sharing CDA-based medical records

    NASA Astrophysics Data System (ADS)

    Kim, Joong Il; Jang, Bong Mun; Han, Dong Hoon; Yang, Keon Ho; Kang, Won-Suk; Jung, Haijo; Kim, Hee-Joung

    2006-03-01

    Many countries have set long-term objectives for establishing an Electronic Healthcare Records system(EHRs). Various IT Strategies note that integration of EHR systems has a high priority. Because the EHR systems are based on different information models and different technology platforms, one of the key integration problems in the realization of the EHRs for the continuity of patient care, is the inability to share patient records between various institutions. Integrating the Healthcare Enterprise (IHE) committee has defined the detailed implementations of existing standards such as DICOM, HL7, in a publicly available document called the IHE technical framework (IHE-TF). Cross-enterprise document sharing (XDS), one of IHE technical frameworks, is describing how to apply the standards into the information systems for the sharing of medical documents among hospitals. This study aims to design Clinical Document Architecture (CDA) schema based on HL7, and to apply implementation strategies of XDS using this CDA schema.

  14. Boston Society's 11th Annual Applied Pharmaceutical Analysis conference.

    PubMed

    Lee, Violet; Liu, Ang; Groeber, Elizabeth; Moghaddam, Mehran; Schiller, James; Tweed, Joseph A; Walker, Gregory S

    2016-02-01

    Boston Society's 11th Annual Applied Pharmaceutical Analysis conference, Hyatt Regency Hotel, Cambridge, MA, USA, 14-16 September 2015 The Boston Society's 11th Annual Applied Pharmaceutical Analysis (APA) conference took place at the Hyatt Regency hotel in Cambridge, MA, on 14-16 September 2015. The 3-day conference affords pharmaceutical professionals, academic researchers and industry regulators the opportunity to collectively participate in meaningful and relevant discussions impacting the areas of pharmaceutical drug development. The APA conference was organized in three workshops encompassing the disciplines of regulated bioanalysis, discovery bioanalysis (encompassing new and emerging technologies) and biotransformation. The conference included a short course titled 'Bioanalytical considerations for the clinical development of antibody-drug conjugates (ADCs)', an engaging poster session, several panel and round table discussions and over 50 diverse talks from leading industry and academic scientists. PMID:26853375

  15. Efficiency Improvement of Dentistry Clinics: Introducing an Intervening Package for Dentistry Clinics, Isfahan, Iran

    PubMed Central

    Alaghemandan, Hamed; Yarmohammadian, Mohammad H.; Khorasani, Elahe; Rezaee, Sobhan

    2014-01-01

    Background: In Isfahan, the second metropolitan in Iran, there are 1448 dentistry treatment centers that most of them are inefficient. Today, efficiency is the most important issue in health care centers as well as dentistry clinics. The goal of this research is to investigate the affordability and efficiency of dentistry clinics in Isfahan province, Iran. Methods: The current work is a quantitative research, designed in three methodological steps, including two surveys and experimental studies, for understanding current deficiencies of Iranian dentistry clinics. First, we ran a survey. Then, we analyzed the results of the questionnaires which guided us to find a particular intervening package to improve the efficiency of the clinics. At the second step, we chose an inefficient clinic named Mohtasham (Iran, Isfahan) to evaluate our intervening package. Results: Based on what the interviewees answered, we mention the most important issues to be considered for improving the efficiency of dental clinics in Isfahan. By considering mentioned problematic issues, an intervening package was designed. This intervening package was applied in Mohtasham clinic, since June 2010. It improved the clinic's income from 16328 US$ with 4125 clients in 2010, to 420,000 US$ with 14784 patients in 2012. Conclusions: The proposed intervening package changed this clinic to an efficient and economic one. Its income increased 5.08 times and its patient's numbers grew 4.01 times simultaneously. In other words, Mohtasham's experience demonstrates the reliability of the package and its potentiality to be applied in macro level to improve other dentistry clinics. PMID:24627744

  16. How to apply vacuum-assisted closure therapy.

    PubMed

    Ellis, Georgina

    2016-03-01

    RATIONALE AND KEY POINTS: This article aims to provide an overview of the technique for applying vacuum-assisted closure therapy (V.A.C. therapy), using the example of one of the most basic dressing types: V.A.C. GranuFoam, a black polyurethane foam. Practitioners should refer to the manufacturer's instructions for application of other dressing types. ▶ V.A.C. therapy is used to apply negative pressure to the wound bed to promote wound healing. ▶ V.A.C therapy promotes perfusion, reduces oedema, draws the wound edges together and stimulates the formation of granulation tissue. ▶ The correct technique for applying V.A.C. therapy is essential to ensure patient safety and optimum wound healing outcomes. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How you think this article will change your practice. 2. How the use of V.A.C. therapy might affect the patient's experience. PMID:26932648

  17. [Application of nutrigenomics in clinical nutrition].

    PubMed

    He, Gui-zhen; Cui, Xiao-yu; Dong, Liang-guang

    2006-12-01

    In the past decade, the focus of nutritional study shifted from epidemiology and physiology to molecular biology. Advanced research strategies and technologies including genomics, transcriptomics, proteomics, metabolomics, and system biology have been gradually applied in clinical nutrition. This article reviews the effects of nutrients on gene expressions, application of modern molecular biology in clinical nutrition, as well as the advances and challenges in recent years..

  18. Evidence and Clinical Trials.

    NASA Astrophysics Data System (ADS)

    Goodman, Steven N.

    1989-11-01

    This dissertation explores the use of a mathematical measure of statistical evidence, the log likelihood ratio, in clinical trials. The methods and thinking behind the use of an evidential measure are contrasted with traditional methods of analyzing data, which depend primarily on a p-value as an estimate of the statistical strength of an observed data pattern. It is contended that neither the behavioral dictates of Neyman-Pearson hypothesis testing methods, nor the coherency dictates of Bayesian methods are realistic models on which to base inference. The use of the likelihood alone is applied to four aspects of trial design or conduct: the calculation of sample size, the monitoring of data, testing for the equivalence of two treatments, and meta-analysis--the combining of results from different trials. Finally, a more general model of statistical inference, using belief functions, is used to see if it is possible to separate the assessment of evidence from our background knowledge. It is shown that traditional and Bayesian methods can be modeled as two ends of a continuum of structured background knowledge, methods which summarize evidence at the point of maximum likelihood assuming no structure, and Bayesian methods assuming complete knowledge. Both schools are seen to be missing a concept of ignorance- -uncommitted belief. This concept provides the key to understanding the problem of sampling to a foregone conclusion and the role of frequency properties in statistical inference. The conclusion is that statistical evidence cannot be defined independently of background knowledge, and that frequency properties of an estimator are an indirect measure of uncommitted belief. Several likelihood summaries need to be used in clinical trials, with the quantitative disparity between summaries being an indirect measure of our ignorance. This conclusion is linked with parallel ideas in the philosophy of science and cognitive psychology.

  19. Applied Technology Proficiency of High School Students in Applied and Traditional Courses

    ERIC Educational Resources Information Center

    Field, Dennis W.

    2003-01-01

    This investigation compares applied technology skill levels of high school students enrolled in various applied and comparable traditional courses, particularly Principles of Technology and physics courses respectively. Outcomes from ACT's Applied Technology Work Keys[R] assessment test were used as a measure of applied technology skill levels.…

  20. On the relation between applied behavior analysis and positive behavioral support

    PubMed Central

    Carr, James E.; Sidener, Tina M.

    2002-01-01

    Anderson and Freeman (2000) recently defined positive behavioral support (PBS) as a systematic approach to the delivery of clinical and educational services that is rooted in behavior analysis. However, the recent literature contains varied definitions of PBS as well as discrepant notions regarding the relation between applied behavior analysis and PBS. After summarizing common definitional characteristics of PBS from the literature, we conclude that PBS is comprised almost exclusively of techniques and values originating in applied behavior analysis. We then discuss the relations between applied behavior analysis and PBS that have been proposed in the literature. Finally, we discuss possible implications of considering PBS a field separate from applied behavior analysis. PMID:22478389

  1. Being a Clinical Educator

    ERIC Educational Resources Information Center

    Higgs, Joy; Mcallister, Lindy

    2007-01-01

    What is it like to be a clinical educator? How do clinical educators experience and describe their continuing journey of becoming a clinical educator? Within the model developed in this research, dimensions of being a clinical educator were identified. These dimensions include (a) having a sense of self (and the impact of bringing self into the…

  2. 32 CFR 37.1220 - Applied research.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Applied research. 37.1220 Section 37.1220... REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1220 Applied research... technology such as new materials, devices, methods and processes. It typically is funded in...

  3. 32 CFR 37.1220 - Applied research.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false Applied research. 37.1220 Section 37.1220... REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1220 Applied research... technology such as new materials, devices, methods and processes. It typically is funded in...

  4. Applying Psychological Theories to Educational Practice

    ERIC Educational Resources Information Center

    Sternberg, Robert

    2008-01-01

    Two approaches to the application of psychological theories to education might be referred to as domain-general and domain-specific. The domain-general approach seeks a general theory of cognitive and other skills that apply across subject-matter areas. The domain-specific approach seeks to apply specific theories within given domains, such as…

  5. Applied Linguistics: The Challenge of Theory

    ERIC Educational Resources Information Center

    McNamara, Tim

    2015-01-01

    Language has featured prominently in contemporary social theory, but the relevance of this fact to the concerns of Applied Linguistics, with its necessary orientation to practical issues of language in context, represents an ongoing challenge. This article supports the need for a greater engagement with theory in Applied Linguistics. It considers…

  6. Applied Implications of Reinforcement History Effects

    ERIC Educational Resources Information Center

    Pipkin, Claire St. Peter; Vollmer, Timothy R.

    2009-01-01

    Although the influence of reinforcement history is a theoretical focus of behavior analysis, the specific behavioral effects of reinforcement history have received relatively little attention in applied research and practice. We examined the potential effects of reinforcement history by reviewing nonhuman, human operant, and applied research and…

  7. Child Participant Roles in Applied Linguistics Research

    ERIC Educational Resources Information Center

    Pinter, Annamaria

    2014-01-01

    Children's status as research participants in applied linguistics has been largely overlooked even though unique methodological and ethical concerns arise in projects where children, rather than adults, are involved. This article examines the role of children as research participants in applied linguistics and discusses the limitations of…

  8. Applied Linguistics in Its Disciplinary Context

    ERIC Educational Resources Information Center

    Liddicoat, Anthony J.

    2010-01-01

    Australia's current attempt to develop a process to evaluate the quality of research (Excellence in Research for Australia--ERA) places a central emphasis on the disciplinary organisation of academic work. This disciplinary focus poses particular problems for Applied Linguistics in Australia. This paper will examine Applied Linguistics in relation…

  9. Autobiographic Narratives as Data in Applied Linguistics

    ERIC Educational Resources Information Center

    Pavlenko, Aneta

    2007-01-01

    In the past decade, language memoirs, linguistic autobiographies, and learners' journals and diaries have become a popular means of data collection in applied linguistics. It is not always clear however how one should go about analyzing these data. The aim of this paper is to offer a critical review of analytical frameworks applied to second…

  10. The Contextual Interference Effect in Applied Settings

    ERIC Educational Resources Information Center

    Barreiros, Joao; Figueiredo, Teresa; Godinho, Mario

    2007-01-01

    This paper analyses the research literature that approaches the contextual interference effect in applied settings. In contrast to the laboratory settings, in which high interference conditions depress acquisition and promote learning evaluated in retention and transfer tests, in applied settings most of the studies (60%) fail to observe positive…

  11. ISAE- The International Society for Applied Ethology

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The International Society for Applied Ethology (ISAE) was created in 1966 as the Society for Veterinary Ethology, with a primary membership of U.K.-based veterinarians. It quickly expanded to encompass researchers and clinicians working in all areas of applied animal behavior and all over the world....

  12. Nuclear Facilities and Applied Technologies at Sandia

    SciTech Connect

    Wheeler, Dave; Kaiser, Krista; Martin, Lonnie; Hanson, Don; Harms, Gary; Quirk, Tom

    2014-11-28

    The Nuclear Facilities and Applied Technologies organization at Sandia National Laboratories’ Technical Area Five (TA-V) is the leader in advancing nuclear technologies through applied radiation science and unique nuclear environments. This video describes the organization’s capabilities, facilities, and culture.

  13. Applied Behavior Analysis and Statistical Process Control?

    ERIC Educational Resources Information Center

    Hopkins, B. L.

    1995-01-01

    Incorporating statistical process control (SPC) methods into applied behavior analysis is discussed. It is claimed that SPC methods would likely reduce applied behavior analysts' intimate contacts with problems and would likely yield poor treatment and research decisions. Cases and data presented by Pfadt and Wheeler (1995) are cited as examples.…

  14. Bioinformatics meets clinical informatics.

    PubMed

    Smith, Jeremy; Protti, Denis

    2005-01-01

    The field of bioinformatics has exploded over the past decade. Hopes have run high for the impact on preventive, diagnostic, and therapeutic capabilities of genomics and proteomics. As time has progressed, so has our understanding of this field. Although the mapping of the human genome will certainly have an impact on health care, it is a complex web to unweave. Addressing simpler "Single Nucleotide Polymorphisms" (SNPs) is not new, however, the complexity and importance of polygenic disorders and the greater role of the far more complex field of proteomics has become more clear. Proteomics operates much closer to the actual cellular level of human structure and proteins are very sensitive markers of health. Because the proteome, however, is so much more complex than the genome, and changes with time and environmental factors, mapping it and using the data in direct care delivery is even harder than for the genome. For these reasons of complexity, the expected utopia of a single gene chip or protein chip capable of analyzing an individual's genetic make-up and producing a cornucopia of useful diagnostic information appears still a distant hope. When, and if, this happens, perhaps a genetic profile of each individual will be stored with their medical record; however, in the mean time, this type of information is unlikely to prove highly useful on a broad scale. To address the more complex "polygenic" diseases and those related to protein variations, other tools will be developed in the shorter term. "Top-down" analysis of populations and diseases is likely to produce earlier wins in this area. Detailed computer-generated models will map a wide array of human and environmental factors that indicate the presence of a disease or the relative impact of a particular treatment. These models may point to an underlying genomic or proteomic cause, for which genomic or proteomic testing or therapies could then be applied for confirmation and/or treatment. These types of

  15. Being a clinical educator.

    PubMed

    Higgs, Joy; McAllister, Lindy

    2007-05-01

    What is it like to be a clinical educator? How do clinical educators experience and describe their continuing journey of becoming a clinical educator? Within the model developed in this research, dimensions of being a clinical educator were identified. These dimensions include (a) having a sense of self (and the impact of bringing self into the clinical educator's role), (b) having a sense of relationship with others (and the place of this "interactive self" as a central feature of clinical education), (c) having a sense of being a clinical educator (and how this understanding relates to the previous two dimensions), (d) having a sense of agency (which is vital to the performance of many clinical education roles), (e) seeking dynamic self-congruence, and (e) growth as a clinical educator. This paper presents an overview of the model, discusses its strengths and limitations as a representation of speech pathology clinical educators' experiences, and briefly considers its value for professional development. PMID:17072770

  16. Clinical excellence in cardiology.

    PubMed

    Ziegelstein, Roy C

    2011-08-15

    A recent study identified 7 domains of clinical excellence on the basis of interviews with "clinically excellent" physicians at academic institutions in the United States: (1) communication and interpersonal skills, (2) professionalism and humanism, (3) diagnostic acumen, (4) skillful negotiation of the health care system, (5) knowledge, (6) taking a scholarly approach to clinical practice, and (7) having passion for clinical medicine. What constitutes clinical excellence in cardiology has not previously been defined. The author discusses clinical excellence in cardiology using the framework of these 7 domains and also considers the additional domain of clinical experience. Specific aspects of the domains of clinical excellence that are of greatest relevance to cardiology are highlighted. In conclusion, this discussion characterizes what constitutes clinical excellence in cardiology and should stimulate additional discussion of the topic and an examination of how the domains of clinical excellence in cardiology are related to specific patient outcomes.

  17. Ultrasound imaging in research and clinical medicine.

    PubMed

    Schellpfeffer, Michael A

    2013-06-01

    The use of ultrasound imaging in clinical obstetrics continues to grow at an almost exponential rate. Ultrasound imaging in developmental biology has only begun to be used to enhance the traditional methodologies to study the developing embryo/fetus. The various modalities of ultrasound imaging are reviewed as they apply to current uses in clinical obstetrics and developmental biologic research. New modalities are also discussed in both clinical obstetrics and developmental biologic research as well as the current limitations of ultrasound imaging faced in both of these fields. PMID:23897593

  18. Gatekeepers for Pragmatic Clinical Trials

    PubMed Central

    Whicher, Danielle M.; Miller, Jennifer E.; Dunham, Kelly M.; Joffe, Steven

    2015-01-01

    To successfully implement a pragmatic clinical trial, investigators need access to numerous resources, including financial support, institutional infrastructure (e.g., clinics, facilities, staff), eligible patients, and patient data. Gatekeepers are people or entities who have the ability to allow or deny access to the resources required to support the conduct of clinical research. Based on this definition, gatekeepers relevant to the United States clinical research enterprise include research sponsors, regulatory agencies, payers, health system and other organizational leadership, research team leadership, human research protections programs, advocacy and community groups, and clinicians. This manuscript provides a framework to help guide gatekeepers’ decision-making related to the use of resources for pragmatic clinical trials. These include (1) concern for the interests of individuals, groups, and communities affected by the gatekeepers’ decisions, including protection from harm and maximization of benefits, (2) advancement of organizational mission and values, and (3) stewardship of financial, human, and other organizational resources. Separate from these ethical considerations, gatekeepers’ actions will be guided by relevant federal, state, and local regulations. This framework also suggests that to further enhance the legitimacy of their decision-making, gatekeepers should adopt transparent processes that engage relevant stakeholders when feasible and appropriate. We apply this framework to the set of gatekeepers responsible for making decisions about resources necessary for pragmatic clinical trials in the United States, describing the relevance of the criteria in different situations and pointing out where conflicts among the criteria and relevant regulations may affect decision-making. Recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding the use of limited

  19. [Clinical trials with advanced therapy medicinal products].

    PubMed

    Schüssler-Lenz, M; Schneider, C K

    2010-01-01

    For advanced therapies, the same basic principles for assessment apply as for any other biotechnological medicinal product. Nevertheless, the extent of data for quality, safety, and efficacy can be highly specific. Until recently, advanced therapies were not uniformly regulated across Europe, e.g., tissue engineered products were regulated either as medicinal products or medical devices. Thus, for some products no data from clinical studies are available, e.g., for autologous chondrocyte products. The draft guideline on Good Clinical Practice for clinical trials with advanced therapies describes specific additional requirements, e.g., ensuring traceability. Most clinical studies with advanced therapies in Germany are still in early phase I or II trials with highly divergent types of products and clinical indications. The Committee for Advanced Therapies (CAT) at the European Medicines Agency (EMEA) has been established to meet the scientific and regulatory challenges with advanced therapies.

  20. Applications of Aptasensors in Clinical Diagnostics

    PubMed Central

    Hong, Ping; Li, Wenli; Li, Jinming

    2012-01-01

    Aptamers are artificial oligonucleotides (DNA or RNA) selected in vitro that bind a broad range of targets with high affinity and specificity; a sensitive yet simple method to utilize aptamers as recognition elements for the development of biosensors (aptasensors) is to transduce the signal electrochemically. So far, aptasensors have been applied to clinical diagnostics and several technologies are in development. Aptasensors will extend the limits of current clinical diagnostics. Although the potential diagnostic applications are unlimited, the most current applications are foreseen in the areas of biomarker detection, cancer clinical testing, detection of infectious microorganisms and viruses. This review attempts to list examples of the research progresses of aptamers in biosensor platforms that have been published in recent years; in particular, we display cases of aptasensors that are already incorporated in clinical diagnostics or have potential applications in clinical diagnostics. PMID:22438706

  1. Concept analysis of culture applied to nursing.

    PubMed

    Marzilli, Colleen

    2014-01-01

    Culture is an important concept, especially when applied to nursing. A concept analysis of culture is essential to understanding the meaning of the word. This article applies Rodgers' (2000) concept analysis template and provides a definition of the word culture as it applies to nursing practice. This article supplies examples of the concept of culture to aid the reader in understanding its application to nursing and includes a case study demonstrating components of culture that must be respected and included when providing health care.

  2. A value analysis model applied to the management of amblyopia.

    PubMed Central

    Beauchamp, G R; Bane, M C; Stager, D R; Berry, P M; Wright, W W

    1999-01-01

    PURPOSE: To assess the value of amblyopia-related services by utilizing a health value model (HVM). Cost and quality criteria are evaluated in accordance with the interests of patients, physicians, and purchasers. METHODS: We applied an HVM to a hypothetical statistical ("median") child with amblyopia whose visual acuity is 20/80 and to a group of children with amblyopia who are managed by our practice. We applied the model to calculate the value of these services by evaluating the responses of patients and physicians and relating these responses to clinical outcomes. RESULTS: The consensus value of care for the hypothetical median child was calculated to be 0.406 (of 1.000). For those children managed in our practice, the calculated value is 0.682. Clinically, 79% achieved 20/40 or better visual acuity, and the mean final visual acuity was 0.2 logMAR (20/32). Value appraisals revealed significant concerns about the financial aspects of amblyopia-related services, particularly among physicians. Patients rated services more positively than did physicians. CONCLUSIONS: Amblyopia care is difficult, sustained, and important work that requires substantial sensitivity to and support of children and families. Compliance and early detection are essential to success. The value of amblyopia services is rated significantly higher by patients than by physicians. Relative to the measured value, amblyopia care is undercompensated. The HVM is useful to appraise clinical service delivery and its variation. The costs of failure and the benefits of success are high; high-value amblyopia care yields substantial dividends and should be commensurately compensated in the marketplace. PMID:10703133

  3. Applied andrology in chickens and turkeys

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The theories and practices of applied andrology in commercial poultry species (turkey, layer chicken and broiler chicken) are reviewed. Poultry male reproductive biology, including reproductive anatomy and spermatogenesis, is compared with mammalian livestock species. A detailed description of pou...

  4. Applied physics: The virtues of tiling

    NASA Astrophysics Data System (ADS)

    Fratzl, Peter

    2014-12-01

    A cracked metal film on an elastic substrate has been shown to provide ultrahigh sensitivity in detecting mechanical vibrations. The result draws inspiration from principles of tiling that apply to many biological systems. See Letter p.222

  5. Applied Physics at Heriot-Watt.

    ERIC Educational Resources Information Center

    Colles, M. J.

    1979-01-01

    Describes a course in applied physics with solid state electronics, aimed at providing a continuing broad background in general physics while allowing for the gradual development of an emphasis on applications, engineering expertise, and relevant industrial experience. (Author/GA)

  6. Applied-field MPD thruster geometry effects

    NASA Technical Reports Server (NTRS)

    Myers, Roger M.

    1991-01-01

    Eight MPD thruster configurations were used to study the effects of applied field strength, propellant, and facility pressure on thruster performance. Vacuum facility background pressures higher than approx. 0.12 Pa were found to greatly influence thruster performance and electrode power deposition. Thrust efficiency and specific impulse increased monotonically with increasing applied field strength. Both cathode and anode radii fundamentally influenced the efficiency specific impulse relationship, while their lengths influence only the magnitude of the applied magnetic field required to reach a given performance level. At a given specific impulse, large electrode radii result in lower efficiencies for the operating conditions studied. For all test conditions, anode power deposition was the largest efficiency loss, and represented between 50 and 80 pct. of the input power. The fraction of the input power deposited into the anode decreased with increasing applied field and anode radii. The highest performance measured, 20 pct. efficiency at 3700 seconds specific impulse, was obtained using hydrogen propellant.

  7. Introductory Applied Quantum and Statistical Mechanics

    NASA Astrophysics Data System (ADS)

    Hagelstein, Peter L.; Senturia, Stephen D.; Orlando, Terry P.

    2004-03-01

    * An applied focus for electrical engineers and materials scientists. * Theoretical results supported with real-world systems and applications. * Includes worked examples and self-study questions. * Solutions manual available.

  8. Applying Change of Variable to Calculus Problems

    ERIC Educational Resources Information Center

    Kachapova, Farida; Kachapov, Ilias

    2011-01-01

    This article describes the technique of introducing a new variable in some calculus problems to help students master the skills of integration and evaluation of limits. This technique is algorithmic and easy to apply.

  9. Applied Pharmacokinetics: Course Description and Retrospective Evaluation.

    ERIC Educational Resources Information Center

    Beck, Diane E.

    1984-01-01

    An applied course designed to allow students to formulate pharmacokinetic recommendations individually for actual patient data and compare their recommendations to those of a pharmacokinetic consulting service is described and evaluated, and an objective student evaluation method is outlined. (MSE)

  10. Applied Aeroscience and CFD Branch Overview

    NASA Technical Reports Server (NTRS)

    LeBeau, Gerald J.; Kirk, Benjamin S.

    2014-01-01

    The principal mission of NASA Johnson Space Center is Human Spaceflight. In support of the mission the Applied Aeroscience and CFD Branch has several technical competencies that include aerodynamic characterization, aerothermodynamic heating, rarefied gas dynamics, and decelerator (parachute) systems.

  11. [What did bachelard mean by "applied rationalism" ?].

    PubMed

    Tiles, Mary

    2013-01-01

    Bachelard was concerned with the processes whereby scientific knowledge is acquired, including the activity of knowing subjects. He did not equate reasoning with logic but rather argued that reasoning resulted from the use of mathematics in organizing both thought and experimental practices, which is why he conceived science as applied mathematics. This had material and technical implications, for Bachelard was concerned with the element of reason inherent in technical materialism as well as the concrete reality inherent in applied rationalism.

  12. The impact of applied behavior analysis on diverse areas of research.

    PubMed

    Kazdin, A E

    1975-01-01

    The impact of applied behavior analysis on various disciplines and areas of research was assessed through two major analyses. First, the relationship of applied behavior analysis to the general area of "behavior modification" was evaluated by examining the citation characteristics of journal articles in JABA and three other behavior-modification journals. Second, the penetration of applied behavior analysis into diverse areas and disciplines, including behavior modification, psychiatry, clinical psychology, education, special education, retardation, speech and hearing, counselling, and law enforcement and correction was assessed. Twenty-five journals representing diverse research areas were evaluated from 1968 to 1974 to assess the extent to which operant techniques were applied for therapeutic, rehabilitative, and educative purposes and the degree to which methodological desiderata of applied behavior analysis were met. The analyses revealed diverse publication outlets for applied behavior analysis in various disciplines.

  13. Preceptor Handbook: Rural Clinical Nurse Placement Center.

    ERIC Educational Resources Information Center

    Stuart-Siddall, Sandra; Haberlin, Jean

    This handbook provides Rural Clinical Nurse Placement Program (RCNP) preceptors with a program overview and practical suggestions to apply during student placement. An introductory section describes how the program addresses the maldistribution of nurses by raising awareness about the rural experience, adding a needed perspective to the urban bias…

  14. Exploring Continuous Clinical Placement for Undergraduate Students

    ERIC Educational Resources Information Center

    McKenna, Lisa G.; Wray, Natalie; McCall, Louise

    2009-01-01

    Clinical placements are integral to health professional preparatory courses. These placements allow for the application of classroom-based learning into real patient care situations. In doing so, they provide opportunities for applying theoretical knowledge into practice contexts, skills development and socialisation into the chosen profession.…

  15. Effects of CO2, thulium, and erbium lasers on middle ear synthetic implants

    NASA Astrophysics Data System (ADS)

    Bottrill, Ian; Valtonen, Hannu J.; Poe, Dennis S.

    1995-05-01

    10.6 micrometers CO2, 2.01 micrometers Thulium:YAG (Tm:YAG) and 2.94 micrometers Erbium:YAG (Er:YAG) are currently being used or investigated for potential applications in otologic surgery. In addition to biologic tissue there are numerous synthetic materials (Gelfoam, Silastic, C-Flex, Silicone and Teflon), mineral components (Hydroxylapatite) and metals (stainless steel) that may be encountered during surgery. Their behavior in response to laser irradiation is, for the most part, unknown. We investigated the effects of these lasers, operated at clinically relevant parameters on these materials. We looked for signs of melting, perforation, charring, smoke formation and ignition. The results show that wet Gelfoam proved to be a partially effective barrier to all lasers. Silastic transmitted the energy of the Tm and Er:YAG with minimal damage, but charred, ignited or exploded with the CO2 depending on the energy applied. All lasers melted C-Flex at higher energies. On Silicon, CO2 produced flames, char and melting; the other lasers produced a tiny spark and less melting. Teflon charred and perforated when exposed to any laser, but only Tm:YAG produced a spark. All lasers at moderate and high energies shattered hydroxylapatite. Stainless steel was not affected by CO2, but was perforated by Tm:YAG and Er:YAG. The results suggest that none of the tested lasers are safe for all currently used prosthetic materials and therefore they should be used with caution.

  16. Applying Cultural Competency in Clinical Practice: Findings from Multicultural Experts' Experience

    ERIC Educational Resources Information Center

    Kwong, Miu Ha

    2009-01-01

    This study employed a qualitative (grounded theory) method to achieve a better understanding, conceptualization, and operationalization of how cultural competency translated into practice could be observed and evaluated in social work students and practitioners. The research findings presented in this study were organized into three overarching…

  17. Applying the Concept of Trustworthiness to the Evaluation of a Clinical Program.

    ERIC Educational Resources Information Center

    Barzansky, Barbara; And Others

    An attending tutor program designed to increase faculty-student contact within an Obstetrics and Gynecology clerkship was evaluated. Sessions were observed, written documents were reviewed, and faculty and students were interviewed in order to determine if the program was meeting its goals. Based on the evaluation data, the program was…

  18. A Clinical Application of Applied Humanism for Young Adults with Severe and Profound Retardation.

    ERIC Educational Resources Information Center

    Mazzelli, AnnaMaria; Polirstok, Susan Rovet; Dana, Lawrence; Buono, Serafina; Mongelli, Vita; Trubia, Grazia; Ayala, Giovanni

    2000-01-01

    Describes an intensive habilitation program in Sicily for young adults with severe and profound retardation. Participants in the program showed significant improvement in functional skills and an accompanying reduction in maladaptive and stereotypic behaviors, without complex behavior plans; punishing contingencies; or high dose neuroleptic,…

  19. Topically applied antibiotics in acne vulgaris: clinical response and suppression of Corynebacterium acnes in open comedones.

    PubMed

    Resh, W; Stoughton, R B

    1976-02-01

    Topical antibiotics were used on patients with acne vulgaris. Corynebacterium acnes organisms from open comedones were quantitated during treatment, and the progress of the disease was evaluated. Clindamycin lotion completely suppressed the growth of C acnes organisms, whereas erythromycin and tetracycline did not depress the C acnes counts. Taken as a group, these antibiotics gave a substantial improvement of the disease on the treated side as compared with paired untreated sides of the face and back.

  20. Clinical Evaluation of Direct Aperture Optimization When Applied to Head-And-Neck IMRT

    SciTech Connect

    Jones, Stephen Williams, Matthew

    2008-04-01

    Direct Machine Parameter Optimization (DMPO) is a leaf segmentation program released as an optional item of the Pinnacle planning system (Philips Radiation Oncology Systems, Milpitas, CA); it is based on the principles of direct aperture optimization where the size, shape, and weight of individual segments are optimized to produce an intensity modulated radiation treatment (IMRT) plan. In this study, we compare DMPO to the traditional method of IMRT planning, in which intensity maps are optimized prior to conversion into deliverable multileaf collimator (MLC) apertures, and we determine if there was any dosimetric improvement, treatment efficiency gain, or planning advantage provided by the use of DMPO. Eleven head-and-neck patients treated with IMRT had treatment plans generated using each optimization method. For each patient, the same planning parameters were used for each optimization method. All calculations were performed using Pinnacle version 7.6c software and treatments were delivered using a step-and-shoot IMRT method on a Varian 2100EX linear accelerator equipped with a 120-leaf Millennium MLC (Varian Medical Systems, Palo Alto, CA). Each plan was assessed based on the calculation time, a conformity index, the composite objective value used in the optimization, the number of segments, monitor units (MUs), and treatment time. The results showed DMPO to be superior to the traditional optimization method in all areas. Considerable advantages were observed in the dosimetric quality of DMPO plans, which also required 32% less time to calculate, 42% fewer MUs, and 35% fewer segments than the conventional optimization method. These reductions translated directly into a 29% decrease in treatment times. While considerable gains were observed in planning and treatment efficiency, they were specific to our institution, and the impact of direct aperture optimization on plan quality and workflow will be dependent on the planning parameters, planning system, and linear accelerators used by a particular institution.

  1. Applying behavior analysis to clinical problems: review and analysis of habit reversal.

    PubMed Central

    Miltenberger, R G; Fuqua, R W; Woods, D W

    1998-01-01

    This article provides a review and analysis of habit reversal, a multicomponent procedure developed by Azrin and Nunn (1973, 1974) for the treatment of nervous habits, tics, and stuttering. The article starts with a discussion of the behaviors treated with habit reversal, behavioral covariation among habits, and functional analysis and assessment of habits. Research on habit reversal and simplified versions of the procedure is then described. Next the article discusses the limitations of habit reversal and the evidence for its generality. The article concludes with an analysis of the behavioral processes involved in habit reversal and suggestions for future research. PMID:9757583

  2. Helping patients make better decisions: how to apply behavioral economics in clinical practice

    PubMed Central

    Courtney, Maureen Reni; Spivey, Christy; Daniel, Kathy M

    2014-01-01

    Clinicians are committed to effectively educating patients and helping them to make sound decisions concerning their own health care. However, how do clinicians determine what is effective education? How do they present information clearly and in a manner that patients understand and can use to make informed decisions? Behavioral economics (BE) is a subfield of economics that can assist clinicians to better understand how individuals actually make decisions. BE research can help guide interactions with patients so that information is presented and discussed in a more deliberate and impactful way. We can be more effective providers of care when we understand the factors that influence how our patients make decisions, factors of which we may have been largely unaware. BE research that focuses on health care and medical decision making is becoming more widely known, and what has been reported suggests that BE interventions can be effective in the medical realm. The purpose of this article is to provide clinicians with an overview of BE decision science and derived practice strategies to promote more effective behavior change in patients. PMID:25378915

  3. Managing clinical grant costs.

    PubMed

    Glass, Harold E; Hollander, Karen

    2009-05-01

    The rapidly increasing cost of pharmaceutical R&D presents a major challenge for the industry. This paper examines one aspect of that spending, clinical grants, and presents ways that pharmaceutical companies can best manage those expenditures. The first part of the paper examines the role of clinical grant payments as a motivation for clinical trial participation. The second part outlines a number of current management practices for controlling clinical grant costs. Financial compensation is an important matter for many physicians conducting clinical trials, especially those in office-based practices and those conducting phase 4 clinical trials. Since financial considerations are important to most types of investigators, and there is no compelling evidence that paying at high rates insures timely performance or quality data, companies engaging clinical investigators must manage their clinical grant funds as effectively as possible. Sound financial management requires that clinical development professionals appreciate the complex relationship between the pharmaceutical company and the physicians who serve as clinical investigators on that company's clinical trials. Sensible financial management of clinical grants also demands that sponsor companies get the most value for their clinical grant spending. Ultimately, good clinical grant management requires an attitude that combines good business sense with an understanding that pharmaceutical R&D strives to bring to market new drugs that can help patient populations around the world. Investigators are medical contractors in clinical trials, and while they are engaged in their vital research, they are a part of the research process that must be carefully budgeted and managed. Society, pharmaceutical companies, clinical investigators, and patients will reap the benefits of adequately budgeted, and well managed clinical grants.

  4. Applied Mathematical Sciences research at Argonne, October 1, 1978-March 31, 1980

    SciTech Connect

    Pieper, G. W.

    1980-01-01

    This report reviews the research activities of the Applied Mathematical Sciences Section for the period October 1, 1978, through March 31, 1980. The body of the report discusses various projects carried out in four major areas of research: applied analysis, computational mathematics, software engineering, and software clinics. Information on section staff, visitors, workshops, and seminars is found in the appendices. Descriptions of individual research topics are very brief.

  5. Mentoring in the Clinical Setting to Improve Student Decision-Making Competence

    ERIC Educational Resources Information Center

    Stick-Mueller, Misty; Boesch, Ron; Silverman, Steven; Carpenter, Scott; Illingworth, Robert; Countryman, James

    2010-01-01

    Introduction: The physician-intern relationship can be difficult to develop. A new chiropractic intern in a teaching clinic undergoes a major transition from classroom to clinical practice and must learn to turn classroom knowledge into clinical application. The ability to start formulating clinical techniques and apply them on a patient is…

  6. Applied Physics. Course Materials: Physics 111, 112, 113. Seattle Tech Prep Applied Academics Project.

    ERIC Educational Resources Information Center

    South Seattle Community Coll., Washington.

    This publication contains materials for three courses in Applied Physics in the Applied Academics program at South Seattle Community College. It begins with the article, "Community College Applied Academics: The State of the Art?" (George B. Neff), which describes the characteristics, model, courses, and coordination activity that make up this…

  7. Applied Math. Course Materials: Math 111, 112, 113. Seattle Tech Prep Applied Academics Project.

    ERIC Educational Resources Information Center

    South Seattle Community Coll., Washington.

    This publication contains materials for three courses in Applied Math in the Applied Academics program at South Seattle Community College. It begins with the article, "Community College Applied Academics: The State of the Art?" (George B. Neff), which describes the characteristics, model, courses, and coordination activity that make up this…

  8. Papers in Applied Linguistics. The Edinburgh Course in Applied Linguistics, Vol. 2.

    ERIC Educational Resources Information Center

    Allen, J.P.B., Ed.; Corder, S. Pit, Ed.

    This volume is a collection of articles on various aspects of applied linguistics as it relates to language teaching. Chapter 1, by S. Pit Corder, entitled "Applied Linguistics and Language Teaching," gives a short, general survey of applied linguistics in language teaching. Chapters 2-5 give an account of the main concepts in what is now called…

  9. 76 FR 3912 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-21

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice and... how to optimally utilize mechanistic biomarkers and apply clinical pharmacology tools, such...

  10. Research Areas - Clinical Trials

    Cancer.gov

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  11. Evidence of clinical competence.

    PubMed

    Lejonqvist, Gun-Britt; Eriksson, Katie; Meretoja, Riitta

    2012-06-01

    This cross-sectional research used a qualitative questionnaire to explore clinical competence in nursing. The aim was to look for evidence of how clinical competence showed itself in practice. In the research, the views from both education and working life are combined to broadly explore and describe clinical competence from the perspective of students, clinical preceptors and teachers. The questions were formulated on how clinical competence is characterised and experienced, what contributes to it and how it is maintained, and on the relation between clinical competence and evidence-based care. The answers were analysed by inductive content analysis. The results showed that clinical competence in practice is encountering, knowing, performing, maturing and improving. Clinical competence is an ongoing process, rather than a state and manifests itself in an ontological and a contextual dimension.

  12. Spina Bifida Clinic Directory

    MedlinePlus

    ... Minneapolis Spina Bifida Clinic 2001 Blaisdell Ave. Minneapolis, MN 55404 (952) 993-9100 www.parknicollett.com Shriners ... Clinic (pediatric only) 2025 E. River Parkway Minneapolis, MN 55414 (612) 596-6105 www.twincitiesshrinershospital.org Mayo ...

  13. Clinical ethics revisited

    PubMed Central

    Singer, Peter A; Pellegrino, Edmund D; Siegler, Mark

    2001-01-01

    A decade ago, we reviewed the field of clinical ethics; assessed its progress in research, education, and ethics committees and consultation; and made predictions about the future of the field. In this article, we revisit clinical ethics to examine our earlier observations, highlight key developments, and discuss remaining challenges for clinical ethics, including the need to develop a global perspective on clinical ethics problems. PMID:11346456

  14. Clinical career ladders: Thomas Jefferson University Hospital.

    PubMed

    Smith, J E; Sheaffer, S L; Frey, B M

    1989-11-01

    The clinical career ladder program developed for pharmacists at Thomas Jefferson University Hospital, a 700-bed teaching hospital, is described. A task force was assembled to develop a clinical career ladder that would parallel the managerial advancement track in terms of rewards and recognition. The task force created separate lists of competencies for staff and clinical pharmacists and ranked the competencies according to their complexity and the number of years most pharmacists would need to achieve them. Separate pathways were established for staff and clinical pharmacists: staff pharmacist I, II, and III and clinical pharmacist I, II, and III. A salary scale designed to provide meaningful salary increases between levels was established. Nearly all pharmacists who are hired begin at level I and are allowed to apply for promotion to level II within six months. Opportunities for promotion occur twice annually. Pharmacists who have received an overall rating of effective or outstanding at the most recent performance appraisal may submit documented evidence that they have gained the knowledge and skills required at the higher level. A promotions review board evaluates each application and informs the director of pharmacy as to whether the applicant meets the criteria for promotion. Response to the program has been favorable, as indicated by the number of pharmacists who have applied for promotion and the quality of their applications. A carefully planned clinical career ladder program was well received by pharmacists, who responded by acquiring the knowledge and skills necessary for promotion.

  15. Quantitative Imaging in Cancer Clinical Trials.

    PubMed

    Yankeelov, Thomas E; Mankoff, David A; Schwartz, Lawrence H; Lieberman, Frank S; Buatti, John M; Mountz, James M; Erickson, Bradley J; Fennessy, Fiona M M; Huang, Wei; Kalpathy-Cramer, Jayashree; Wahl, Richard L; Linden, Hannah M; Kinahan, Paul E; Zhao, Binsheng; Hylton, Nola M; Gillies, Robert J; Clarke, Laurence; Nordstrom, Robert; Rubin, Daniel L

    2016-01-15

    As anticancer therapies designed to target specific molecular pathways have been developed, it has become critical to develop methods to assess the response induced by such agents. Although traditional, anatomic CT, and MRI examinations are useful in many settings, increasing evidence suggests that these methods cannot answer the fundamental biologic and physiologic questions essential for assessment and, eventually, prediction of treatment response in the clinical trial setting, especially in the critical period soon after treatment is initiated. To optimally apply advances in quantitative imaging methods to trials of targeted cancer therapy, new infrastructure improvements are needed that incorporate these emerging techniques into the settings where they are most likely to have impact. In this review, we first elucidate the needs for therapeutic response assessment in the era of molecularly targeted therapy and describe how quantitative imaging can most effectively provide scientifically and clinically relevant data. We then describe the tools and methods required to apply quantitative imaging and provide concrete examples of work making these advances practically available for routine application in clinical trials. We conclude by proposing strategies to surmount barriers to wider incorporation of these quantitative imaging methods into clinical trials and, eventually, clinical practice. Our goal is to encourage and guide the oncology community to deploy standardized quantitative imaging techniques in clinical trials to further personalize care for cancer patients and to provide a more efficient path for the development of improved targeted therapies.

  16. How to Establish Clinical Prediction Models

    PubMed Central

    Bang, Heejung

    2016-01-01

    A clinical prediction model can be applied to several challenging clinical scenarios: screening high-risk individuals for asymptomatic disease, predicting future events such as disease or death, and assisting medical decision-making and health education. Despite the impact of clinical prediction models on practice, prediction modeling is a complex process requiring careful statistical analyses and sound clinical judgement. Although there is no definite consensus on the best methodology for model development and validation, a few recommendations and checklists have been proposed. In this review, we summarize five steps for developing and validating a clinical prediction model: preparation for establishing clinical prediction models; dataset selection; handling variables; model generation; and model evaluation and validation. We also review several studies that detail methods for developing clinical prediction models with comparable examples from real practice. After model development and vigorous validation in relevant settings, possibly with evaluation of utility/usability and fine-tuning, good models can be ready for the use in practice. We anticipate that this framework will revitalize the use of predictive or prognostic research in endocrinology, leading to active applications in real clinical practice. PMID:26996421

  17. Teaching and Assessing Clinical Reasoning Skills.

    PubMed

    Modi, Jyoti Nath; Anshu; Gupta, Piyush; Singh, Tejinder

    2015-09-01

    Clinical reasoning is a core competency expected to be acquired by all clinicians. It is the ability to integrate and apply different types of knowledge, weigh evidence critically and reflect upon the process used to arrive at a diagnosis. Problems with clinical reasoning often occur because of inadequate knowledge, flaws in data gathering and improper approach to information processing. Some of the educational strategies which can be used to encourage acquisition of clinical reasoning skills are: exposure to a wide variety of clinical cases, activation of previous knowledge, development of illness scripts, sharing expert strategies to arrive at a diagnosis, forcing students to prioritize differential diagnoses; and encouraging reflection, metacognition, deliberate practice and availability of formative feedback. Assessment of clinical reasoning abilities should be done throughout the training course in diverse settings. Use of scenario based multiple choice questions, key feature test and script concordance test are some ways of theoretically assessing clinical reasoning ability. In the clinical setting, these skills can be tested in most forms of workplace based assessment. We recommend that clinical reasoning must be taught at all levels of medical training as it improves clinician performance and reduces cognitive errors. PMID:26519715

  18. Good Clinical Practice Guidance and Pragmatic Clinical Trials: Balancing the Best of Both Worlds.

    PubMed

    Mentz, Robert J; Hernandez, Adrian F; Berdan, Lisa G; Rorick, Tyrus; O'Brien, Emily C; Ibarra, Jenny C; Curtis, Lesley H; Peterson, Eric D

    2016-03-01

    Randomized, clinical trials are commonly regarded as the highest level of evidence to support clinical decisions. Good Clinical Practice guidelines have been constructed to provide an ethical and scientific quality standard for trials that involve human subjects in a manner aligned with the Declaration of Helsinki. Originally designed to provide a unified standard of trial data to support submission to regulatory authorities, the principles may also be applied to other studies of human subjects. Although the application of Good Clinical Practice principles generally led to improvements in the quality and consistency of trial operations, these principles have also contributed to increasing trial complexity and costs. Alternatively, the growing availability of electronic health record data has facilitated the possibility for streamlined pragmatic clinical trials. The central tenets of Good Clinical Practice and pragmatic clinical trials represent potential tensions in trial design (stringent quality and highly efficient operations). In the present article, we highlight potential areas of discordance between Good Clinical Practice guidelines and the principles of pragmatic clinical trials and suggest strategies to streamline study conduct in an ethical manner to optimally perform clinical trials in the electronic age.

  19. Modern psychometrics applied in rheumatology–A systematic review

    PubMed Central

    2012-01-01

    Background Although item response theory (IRT) appears to be increasingly used within health care research in general, a comprehensive overview of the frequency and characteristics of IRT analyses within the rheumatic field is lacking. An overview of the use and application of IRT in rheumatology to date may give insight into future research directions and highlight new possibilities for the improvement of outcome assessment in rheumatic conditions. Therefore, this study systematically reviewed the application of IRT to patient-reported and clinical outcome measures in rheumatology. Methods Literature searches in PubMed, Scopus and Web of Science resulted in 99 original English-language articles which used some form of IRT-based analysis of patient-reported or clinical outcome data in patients with a rheumatic condition. Both general study information and IRT-specific information were assessed. Results Most studies used Rasch modeling for developing or evaluating new or existing patient-reported outcomes in rheumatoid arthritis or osteoarthritis patients. Outcomes of principle interest were physical functioning and quality of life. Since the last decade, IRT has also been applied to clinical measures more frequently. IRT was mostly used for evaluating model fit, unidimensionality and differential item functioning, the distribution of items and persons along the underlying scale, and reliability. Less frequently used IRT applications were the evaluation of local independence, the threshold ordering of items, and the measurement precision along the scale. Conclusion IRT applications have markedly increased within rheumatology over the past decades. To date, IRT has primarily been applied to patient-reported outcomes, however, applications to clinical measures are gaining interest. Useful IRT applications not yet widely used within rheumatology include the cross-calibration of instrument scores and the development of computerized adaptive tests which may reduce the

  20. University cardiology clinic.

    PubMed

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  1. University cardiology clinic.

    PubMed

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  2. Cultural awareness: Enhancing clinical experiences in rural Appalachia.

    PubMed

    Presley, Chaundel

    2013-01-01

    Students often work with clients from a cultural group different than their own. This is especially true for students completing clinical practica in Appalachia, where there is a culture unique to that geographic area. To prepare for this unique setting, common cultural scenarios experienced in the clinical setting must be addressed to help provide culturally appropriate patient care while developing required clinical competencies. Although applicable to most nursing students, the author discusses culturally specific approaches to clinical care of clients from Appalachia, specifically applied to nurse practitioner students, preceptors, and clinical faculty.

  3. APPLIED AUDIOLOGY FOR CHILDREN. SECOND EDITION.

    ERIC Educational Resources Information Center

    DALE, D.M.C.

    THE PURPOSE OF THE BOOK IS TO HELP TEACHERS, PARENTS, DOCTORS, AND WORKERS IN AUDIOLOGY CLINICS MAKE THE MOST OF SOUND IN THE EDUCATIONAL AND SOCIAL TREATMENT OF DEAFNESS. ASPECTS OF SOUND AMPLIFICATION CONSIDERED ARE THE NATURE OF SOUND, ELECTRICAL AMPLIFICATION, AND VARIOUS TYPES OF HEARING AIDS (INDIVIDUAL, GROUP, INDUCTION LOOP, SPEECH…

  4. Applying games technology to veterinary teaching.

    PubMed

    Balogh, Márton

    2014-01-18

    Veterinarian Márton Balogh has been interested in computers, gaming and programming since he was eight years old. Here, he explains how he is using software that is more often associated with the creation of 3D computer games to develop an immersive, virtual consultation room, complete with patient, to help train veterinary students in clinical examination techniques.

  5. [A critical review of applied criminology].

    PubMed

    Vollbach, Alexander

    2016-01-01

    By reporting on a recent decision of the Regional Court (LG) of Marburg (Germany) calling attention to applied criminology, a concept still insufficiently considered in the administration of criminal justice, the paper argues that professional action in the execution of the sentence represents nothing else but applied criminology. Based on this assumption, the paper discusses practical diagnosis and correctional planning. Beyond that, the paper deals with the future of criminology. In the opinion of the author an important aspect for the future of criminology will be if it will be able to remain in touch with the world in which we live, as an independent empirical science. Applied criminology and its methodology constitute the link between science and practice. PMID:27120896

  6. Methemoglobinemia from topically applied anesthetic spray.

    PubMed

    Dinneen, S F; Mohr, D N; Fairbanks, V F

    1994-09-01

    Topically applied anesthetic spray is commonly used as part of premedication for general anesthesia and for endoscopic procedures; it is rarely associated with side effects. In this report, we describe two cases of toxic methemoglobinemia that resulted from topically applied anesthetic spray used before endoscopy. In both cases, standard doses were used; however, methemoglobin levels of 45% and 38% developed within 1 hour of the procedure. Both patients had normal levels of erythrocyte methemoglobin reductase, an indication that this rare but potentially fatal side effect can occur in persons who have no predisposing factors. Because toxic methemoglobinemia is easily treated, our report emphasizes the need to recognize this problem when topically applied anesthetic sprays are used.

  7. [A critical review of applied criminology].

    PubMed

    Vollbach, Alexander

    2016-01-01

    By reporting on a recent decision of the Regional Court (LG) of Marburg (Germany) calling attention to applied criminology, a concept still insufficiently considered in the administration of criminal justice, the paper argues that professional action in the execution of the sentence represents nothing else but applied criminology. Based on this assumption, the paper discusses practical diagnosis and correctional planning. Beyond that, the paper deals with the future of criminology. In the opinion of the author an important aspect for the future of criminology will be if it will be able to remain in touch with the world in which we live, as an independent empirical science. Applied criminology and its methodology constitute the link between science and practice.

  8. Applied behavior analysis and statistical process control?

    PubMed Central

    Hopkins, B L

    1995-01-01

    This paper examines Pfadt and Wheeler's (1995) suggestions that the methods of statistical process control (SPC) be incorporated into applied behavior analysis. The research strategies of SPC are examined and compared to those of applied behavior analysis. I argue that the statistical methods that are a part of SPC would likely reduce applied behavior analysts' intimate contacts with the problems with which they deal and would, therefore, likely yield poor treatment and research decisions. Examples of these kinds of results and decisions are drawn from the cases and data Pfadt and Wheeler present. This paper also describes and clarifies many common misconceptions about SPC, including W. Edwards Deming's involvement in its development, its relationship to total quality management, and its confusion with various other methods designed to detect sources of unwanted variability. PMID:7592156

  9. Assessing clinical pragmatism.

    PubMed

    Jansen, Lynn A

    1998-03-01

    "Clinical pragmatism" is an important new method of moral problem-solving in clinical practice. This method draws on the pragmatic philosophy of John Dewey and recommends an experimental approach to solving moral problems in clinical practice. Although the method may shed some light on how clinicians and their patients ought to interact when moral problems are at hand, it nonetheless is deficient in a number of respects. Clinical pragmatism fails to explain adequately how moral poblems can be solved experimentally, it underestimates the relevance and importance of judgment in clinical ethics, and it presents a questionable account of the role that moral principles should play in moral problem solving.

  10. Symbolic Interaction and Applied Social Research

    PubMed Central

    Kotarba, Joseph A.

    2014-01-01

    In symbolic interaction, a traditional yet unfortunate and unnecessary distinction has been made between basic and applied research. The argument has been made that basic research is intended to generate new knowledge, whereas applied research is intended to apply knowledge to the solution of practical (social and organizational) problems. I will argue that the distinction between basic and applied research in symbolic interaction is outdated and dysfunctional. The masters of symbolic interactionist thought have left us a proud legacy of shaping their scholarly thinking and inquiry in response to and in light of practical issues of the day (e.g., Znaniecki, and Blumer). Current interactionist work continues this tradition in topical areas such as social justice studies. Applied research, especially in term of evaluation and needs assessment studies, can be designed to serve both basic and applied goals. Symbolic interaction provides three great resources to do this. The first is its orientation to dynamic sensitizing concepts that direct research and ask questions instead of supplying a priori and often impractical answers. The second is its orientation to qualitative methods, and appreciation for the logic of grounded theory. The third is interactionism’s overall holistic approach to interfacing with the everyday life world. The primary illustrative case here is the qualitative component of the evaluation of an NIH-funded, translational medical research program. The qualitative component has provided interactionist-inspired insights into translational research, such as examining cultural change in medical research in terms of changes in the form and content of formal and informal discourse among scientists; delineating the impact of significant symbols such as "my lab" on the social organization of science; and appreciating the essence of the self-concept "scientist" on the increasingly bureaucratic and administrative identities of medical researchers. This

  11. Defining applied behavior analysis: An historical analogy

    PubMed Central

    Deitz, Samuel M.

    1982-01-01

    This article examines two criteria for a definition of applied behavior analysis. The criteria are derived from a 19th century attempt to establish medicine as a scientific field. The first criterion, experimental determinism, specifies the methodological boundaries of an experimental science. The second criterion, philosophic doubt, clarifies the tentative nature of facts and theories derived from those facts. Practices which will advance the science of behavior are commented upon within each criteria. To conclude, the problems of a 19th century form of empiricism in medicine are related to current practices in applied behavior analysis. PMID:22478557

  12. Applying a Genetic Algorithm to Reconfigurable Hardware

    NASA Technical Reports Server (NTRS)

    Wells, B. Earl; Weir, John; Trevino, Luis; Patrick, Clint; Steincamp, Jim

    2004-01-01

    This paper investigates the feasibility of applying genetic algorithms to solve optimization problems that are implemented entirely in reconfgurable hardware. The paper highlights the pe$ormance/design space trade-offs that must be understood to effectively implement a standard genetic algorithm within a modem Field Programmable Gate Array, FPGA, reconfgurable hardware environment and presents a case-study where this stochastic search technique is applied to standard test-case problems taken from the technical literature. In this research, the targeted FPGA-based platform and high-level design environment was the Starbridge Hypercomputing platform, which incorporates multiple Xilinx Virtex II FPGAs, and the Viva TM graphical hardware description language.

  13. Dynamic programming in applied optimization problems

    NASA Astrophysics Data System (ADS)

    Zavalishchin, Dmitry

    2015-11-01

    Features of the use dynamic programming in applied problems are investigated. In practice such problems as finding the critical paths in network planning and control, finding the optimal supply plan in transportation problem, objects territorial distribution are traditionally solved by special methods of operations research. It should be noted that the dynamic programming is not provided computational advantages, but facilitates changes and modifications of tasks. This follows from the Bellman's optimality principle. The features of the multistage decision processes construction in applied problems are provided.

  14. Applied orienting response research: some examples.

    PubMed

    Tremayne, P; Barry, R J

    1990-01-01

    The development of orienting response (OR) theory has not been accompanied by many applications of the concept--most research still appears to be lab-based and "pure," rather than "applied." We present some examples from our own work in which the OR perspective has been applied in a wider context. These cover the exploration of processing deficits in autistic children, aspects of the "repression" of anxiety in elite athletes, and the locus of alcohol effects. Such applications of the OR concept in real-life situations seem a logical and, indeed, necessary step in the evolution of this area of psychophysiology.

  15. Defining Clinical Excellence in Adult Infectious Disease Practice.

    PubMed

    Chida, Natasha M; Ghanem, Khalil G; Auwaerter, Paul G; Wright, Scott M; Melia, Michael T

    2016-09-01

    Clinical excellence should be recognized, particularly in the current climate that appropriately prioritizes relationship-centered care. In order to develop a recognition model, a definition of clinical excellence must be created and agreed upon. A paradigm recently suggested by C. Christmas describes clinical excellence through the following domains: diagnostic acumen, professionalism and humanism, communication and interpersonal skills, skillful negotiation of the healthcare system, knowledge, taking a scholarly approach to clinical practice, and having passion for clinical medicine. This work references examples of infectious disease (ID) clinical excellence across Christmas' domains and, in doing so, both examines how the definition of clinical excellence applies to ID practice and highlights the importance of ID physicians. Emphasizing such aspirational standards may not only inspire trainees and practicing physicians to pursue their own fulfilling clinical ID careers, it may also encourage health systems to fully value outstanding ID physicians who labor tirelessly to provide patients with exceptional care. PMID:27419186

  16. Defining Clinical Excellence in Adult Infectious Disease Practice

    PubMed Central

    Chida, Natasha M.; Ghanem, Khalil G.; Auwaerter, Paul G.; Wright, Scott M.; Melia, Michael T.

    2016-01-01

    Clinical excellence should be recognized, particularly in the current climate that appropriately prioritizes relationship-centered care. In order to develop a recognition model, a definition of clinical excellence must be created and agreed upon. A paradigm recently suggested by C. Christmas describes clinical excellence through the following domains: diagnostic acumen, professionalism and humanism, communication and interpersonal skills, skillful negotiation of the healthcare system, knowledge, taking a scholarly approach to clinical practice, and having passion for clinical medicine. This work references examples of infectious disease (ID) clinical excellence across Christmas' domains and, in doing so, both examines how the definition of clinical excellence applies to ID practice and highlights the importance of ID physicians. Emphasizing such aspirational standards may not only inspire trainees and practicing physicians to pursue their own fulfilling clinical ID careers, it may also encourage health systems to fully value outstanding ID physicians who labor tirelessly to provide patients with exceptional care. PMID:27419186

  17. Defining Clinical Excellence in Adult Infectious Disease Practice.

    PubMed

    Chida, Natasha M; Ghanem, Khalil G; Auwaerter, Paul G; Wright, Scott M; Melia, Michael T

    2016-09-01

    Clinical excellence should be recognized, particularly in the current climate that appropriately prioritizes relationship-centered care. In order to develop a recognition model, a definition of clinical excellence must be created and agreed upon. A paradigm recently suggested by C. Christmas describes clinical excellence through the following domains: diagnostic acumen, professionalism and humanism, communication and interpersonal skills, skillful negotiation of the healthcare system, knowledge, taking a scholarly approach to clinical practice, and having passion for clinical medicine. This work references examples of infectious disease (ID) clinical excellence across Christmas' domains and, in doing so, both examines how the definition of clinical excellence applies to ID practice and highlights the importance of ID physicians. Emphasizing such aspirational standards may not only inspire trainees and practicing physicians to pursue their own fulfilling clinical ID careers, it may also encourage health systems to fully value outstanding ID physicians who labor tirelessly to provide patients with exceptional care.

  18. Can research influence clinical practice?

    PubMed

    Jiménez, Juan Pablo

    2007-06-01

    After briefly reviewing the unfavourable reception accorded empirical research by parts of the psychoanalytic community, as well as some of the benefits to clinical practice of analysts being involved in research activities, the author examines whether the findings of process and outcome research in psychotherapy and psychoanalysis can help identify the most appropriate forms of intervention for producing therapeutic change, given the specific condition of the patient and the relationship that the individual establishes with the analyst. He argues that research findings can influence clinical practice on various levels and in different areas, and goes on to examine a number of related issues: the specificity of therapeutic interventions versus the relevance of common curative factors; the dyadic conception of technique and ways of understanding the therapeutic action of the treatment alliance; and the strategic or heuristic conception in psychoanalytic therapy. Finally, the author presents clinical material with the aim of illustrating how the knowledge acquired through research can be applied to psychoanalytic treatment. PMID:17537698

  19. Clinical applications of Gallium-68.

    PubMed

    Banerjee, Sangeeta Ray; Pomper, Martin G

    2013-06-01

    Gallium-68 is a positron-emitting radioisotope that is produced from a (68)Ge/(68)Ga generator. As such it is conveniently used, decoupling radiopharmacies from the need for a cyclotron on site. Gallium-68-labeled peptides have been recognized as a new class of radiopharmaceuticals showing fast target localization and blood clearance. (68)Ga-DOTATOC, (8)Ga-DOTATATE, (68)Ga-DOTANOC, are the most prominent radiopharmaceuticals currently in use for imaging and differentiating lesions of various somatostatin receptor subtypes, overexpressed in many neuroendocrine tumors. There has been a tremendous increase in the number of clinical studies with (68)Ga over the past few years around the world, including within the United States. An estimated ∼10,000 scans are being performed yearly in Europe at about 100 centers utilizing (68)Ga-labeled somatostatin analogs within clinical trials. Two academic sites within the US have also begun to undertake human studies. This review will focus on the clinical experience of selected, well-established and recently applied (68)Ga-labeled imaging agents used in nuclear medicine.

  20. Standardisation of neonatal clinical practice.

    PubMed

    Bhutta, Z A; Giuliani, F; Haroon, A; Knight, H E; Albernaz, E; Batra, M; Bhat, B; Bertino, E; McCormick, K; Ochieng, R; Rajan, V; Ruyan, P; Cheikh Ismail, L; Paul, V

    2013-09-01

    The International Fetal and Newborn Growth Consortium for the 21(st) Century (INTERGROWTH-21(st) ) is a large-scale, population-based, multicentre project involving health institutions from eight geographically diverse countries, which aims to assess fetal, newborn and preterm growth under optimal conditions. Given the multicentre nature of the project and the expected number of preterm births, it is vital that all centres follow the same standardised clinical care protocols to assess and manage preterm infants, so as to ensure maximum validity of the resulting standards as indicators of growth and nutrition with minimal confounding. Moreover, it is well known that evidence-based clinical practice guidelines can reduce the delivery of inappropriate care and support the introduction of new knowledge into clinical practice. The INTERGROWTH-21(st) Neonatal Group produced an operations manual, which reflects the consensus reached by members of the group regarding standardised definitions of neonatal morbidities and the minimum standards of care to be provided by all centres taking part in the project. The operational definitions and summary management protocols were developed by consensus through a Delphi process based on systematic reviews of relevant guidelines and management protocols by authoritative bodies. This paper describes the process of developing the Basic Neonatal Care Manual, as well as the morbidity definitions and standardised neonatal care protocols applied across all the INTERGROWTH-21(st) participating centres. Finally, thoughts about implementation strategies are presented.

  1. Perceptions of Anatomy: Critical Components in the Clinical Setting

    ERIC Educational Resources Information Center

    Lazarus, Michelle D.; Chinchilli, Vernon M.; Leong, Shou Ling; Kauffman, Gordon L., Jr.

    2012-01-01

    The evolution in undergraduate medical school curricula has significantly impacted anatomy education. This study investigated the perceived role of clinical anatomy and evaluated perceptions of medical students' ability to apply anatomical knowledge in the clinic. The aim of this study was to develop a framework to enhance anatomical educational…

  2. An innovative clinical practicum to teach evidence-based practice.

    PubMed

    Brancato, Vera C

    2006-01-01

    A clinical practicum was successfully implemented for RN to BSN students to apply evidence-based practice to actual clinical problems affecting nursing practice. The author describes how this practicum was implemented and the requisite resources and support systems. This senior-level capstone course enabled students to understand and value a lifelong learning approach to evidence-based practice.

  3. Modeling of liver metastatic disease with applied drug therapy.

    PubMed

    Filipovic, Nenad; Djukic, Tijana; Saveljic, Igor; Milenkovic, Petar; Jovicic, Gordana; Djuric, Marija

    2014-07-01

    Colorectal carcinoma is acknowledged as the second leading cause of total cancer-related death in the European Region. The majority of deaths related to colorectal carcinoma are connected with liver metastatic disease. Approximately, in 25% of all patients, liver metastatic disease is diagnosed at the same time as the primary diagnosis, while up to a quarter of others would develop liver metastases in the course of the illness. In this study, we developed reaction-diffusion model and analyzed the effect of drug therapy on liver metastatic disease for a specific patient. Tumor volumes in specific time points were obtained using CT scan images. The nonlinear function for cell proliferation rate as well as data about clinically applied drug therapy was included in the model. Fitting procedure was used for parameter estimation. Good agreement of numerical and experimental results shows the feasibility and efficacy of the proposed system. PMID:24831076

  4. CULTURAL COMPETENCE AND PSYCHOTHERAPY: APPLYING ANTHROPOLOGICALLY INFORMED CONCEPTIONS OF CULTURE

    PubMed Central

    Lakes, Kimberley; López, Steven R.; Garro, Linda C.

    2013-01-01

    The authors apply two contemporary notions of culture to advance the conceptual basis of cultural competence in psychotherapy: Kleinman’s (1995) definition of culture as what is at stake in local, social worlds, and Mattingly and Lawlor’s (2001) concept of shared narratives between practitioners and patients. The authors examine these cultural constructs within a clinical case of an immigrant family caring for a young boy with an autism-spectrum disorder. Their analysis suggests that the socially based model of culture and the concept of shared narratives have the potential to broaden and enrich the definition of cultural competence beyond its current emphasis on the presumed cultural differences of specific racial and ethnic minority groups. PMID:22122131

  5. The Ising Model Applied on Chronification of Pain

    PubMed Central

    2016-01-01

    This is a hypothesis-article suggesting an entirely new framework for understanding and treating longstanding pain. Most medical and psychological models are described with boxes and arrows. Such models are of little clinical and explanatory use when describing the phenomenon of chronification of pain due to unknown causes. To date no models that have been provided - and tested in a scientific satisfactory way - lays out a plan for specific assessment due to a specific causal explanation, and in the end serves the clinicians, patients and researcher with tools on how to address the specific pain condition to every individual pain patient's condition. By applying the Ising model (from physics) on the phenomenon of chronification of pain, one is able to detangle all these factors, and thus have a model that both suggests an explanation of the condition and outlines how one might target the treatment of chronic pain patients with the use of network science. PMID:26398917

  6. Smart Technology in Lung Disease Clinical Trials.

    PubMed

    Geller, Nancy L; Kim, Dong-Yun; Tian, Xin

    2016-01-01

    This article describes the use of smart technology by investigators and patients to facilitate lung disease clinical trials and make them less costly and more efficient. By "smart technology" we include various electronic media, such as computer databases, the Internet, and mobile devices. We first describe the use of electronic health records for identifying potential subjects and then discuss electronic informed consent. We give several examples of using the Internet and mobile technology in clinical trials. Interventions have been delivered via the World Wide Web or via mobile devices, and both have been used to collect outcome data. We discuss examples of new electronic devices that recently have been introduced to collect health data. While use of smart technology in clinical trials is an exciting development, comparison with similar interventions applied in a conventional manner is still in its infancy. We discuss advantages and disadvantages of using this omnipresent, powerful tool in clinical trials, as well as directions for future research. PMID:26135330

  7. The tacit dimension of clinical judgment.

    PubMed Central

    Goldman, G. M.

    1990-01-01

    Two distinct views of the nature of clinical judgment are identified and contrasted. The dominant view that clinical judgment is a fully explicit process is compared to the relatively neglected view that tacit knowledge plays a substantial role in the clinician's mental operations. The tacit dimension of medical thinking is explored at length. The discussion suggests severe limits when applying decision analysis, expert systems, and computer-aided cost-benefit review to medicine. The goals and practices of postgraduate medical education are also examined from this perspective, as are various other implications for the clinician. The paper concludes that it is valuable to explore the nature of medical thinking in order to improve clinical practice and education. Such explorations should, however, take cognizance of the often overlooked tacit dimension of clinical judgment. Possible constraints on the medical applicability of both formal expert systems and heavily didactic instructional programs are considered. PMID:2356625

  8. Statistics in clinical research: Important considerations

    PubMed Central

    Barkan, Howard

    2015-01-01

    Statistical analysis is one of the foundations of evidence-based clinical practice, a key in conducting new clinical research and in evaluating and applying prior research. In this paper, we review the choice of statistical procedures, analyses of the associations among variables and techniques used when the clinical processes being examined are still in process. We discuss methods for building predictive models in clinical situations, and ways to assess the stability of these models and other quantitative conclusions. Techniques for comparing independent events are distinguished from those used with events in a causal chain or otherwise linked. Attention then turns to study design, to the determination of the sample size needed to make a given comparison, and to statistically negative studies. PMID:25566715

  9. Smart Technology in Lung Disease Clinical Trials.

    PubMed

    Geller, Nancy L; Kim, Dong-Yun; Tian, Xin

    2016-01-01

    This article describes the use of smart technology by investigators and patients to facilitate lung disease clinical trials and make them less costly and more efficient. By "smart technology" we include various electronic media, such as computer databases, the Internet, and mobile devices. We first describe the use of electronic health records for identifying potential subjects and then discuss electronic informed consent. We give several examples of using the Internet and mobile technology in clinical trials. Interventions have been delivered via the World Wide Web or via mobile devices, and both have been used to collect outcome data. We discuss examples of new electronic devices that recently have been introduced to collect health data. While use of smart technology in clinical trials is an exciting development, comparison with similar interventions applied in a conventional manner is still in its infancy. We discuss advantages and disadvantages of using this omnipresent, powerful tool in clinical trials, as well as directions for future research.

  10. Clinical practice guidelines in hypertension: a review.

    PubMed

    Álvarez-Vargas, Mayita Lizbeth; Galvez-Olortegui, José Kelvin; Galvez-Olortegui, Tomas Vladimir; Sosa-Rosado, José Manuel; Camacho-Saavedra, Luis Arturo

    2015-10-23

    The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in hypertension. This is the first in a series of review articles, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Of all clinical practice guidelines, three were selected and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used to assess each guide. The guidelines obtained the lowest score in the domain of applicability (mean 43.8%); while the highest score was for clarity of presentation (mean 81.5%). The lowest percentage was found in the applicability domain (European guideline) and the highest of all scores was found in two domains: scope and purpose, and clarity of presentation (Canadian guideline). Assessing the quality of the clinical practice guidelines analyzed, the Canadian is one with the best scores obtained by applying the AGREE II instrument, and it is advised to be used without modifications.

  11. Conciliating cognition and consciousness: the perceptual foundations of clinical reasoning.

    PubMed

    Braude, Hillel D

    2012-10-01

    Clinical reasoning has been defined as a form of cognition applied to evaluating and managing a patient's medical problem. As a kind of cognition, a product of the human psyche, it is logical to expect that clinical reasoning should be best understood through methods derived from psychology, neuropsychology and the cognitive sciences. However, the application of scientific methods to evaluating clinical reasoning is unable to analyse clinical reasoning in terms of first-person experience and consciousness. By reducing clinical reasoning to its cognitive components the cognitivist approach tends to ignore the larger context in which clinical reasoning occurs. By reducing its conception of clinical reasoning to its cognitive components, the neuropsychological approach fails to acknowledge clinical reasoning as a form of intentionality, a gestalt, grounded in human perception. A full epistemology of clinical reasoning requires a phenomenological analysis that can make sense of the relation between pre-reflective consciousness and explicit forms of knowing. In this paper I conciliate cognition and consciousness in medicine through analysing the phenomenology of perception in clinical reasoning. I compare the application of phenomenology to clinical reasoning with the attempt to model clinical reasoning on Aristotelian practical wisdom or phronesis. Finally, I analyse empathy as a type of perception critical for effective clinical interaction and exemplary for reflecting on perception as the intersubjective foundation of clinical reasoning.

  12. Populations, Natural Selection, and Applied Organizational Science.

    ERIC Educational Resources Information Center

    McKelvey, Bill; Aldrich, Howard

    1983-01-01

    Deficiencies in existing models in organizational science may be remedied by applying the population approach, with its concepts of taxonomy, classification, evolution, and population ecology; and natural selection theory, with its principles of variation, natural selection, heredity, and struggle for existence, to the idea of organizational forms…

  13. Applying Servant Leadership in Today's Schools

    ERIC Educational Resources Information Center

    Culver, Mary K.

    2009-01-01

    This book illustrates how the ideal of servant leadership can be applied in your school today. With real-life scenarios, discussions, and self assessments, this book gives practical suggestions to help you develop into a caring and effective servant leader. There are 52 scenarios in this book, focusing on situations as varied as: (1) Dealing with…

  14. Applied fluvial geomorphology. Report No. 31

    SciTech Connect

    MacBroom, J.G.

    1981-03-01

    The first portion of this report discusse the geologic properties and characteristics of natural rivers and floodplains. The second part outlines the influence of man on fluvial geomorphology, ecological considerations, and the natural characteristics of rivers that should be applied in the design of river and bridge projects.

  15. Applied fluvial geomorphology. Report No. 31

    SciTech Connect

    MacBroom, J.G.

    1981-03-01

    The first portion of this report discusses the geologic properties and characteristics of natural rivers and floodplains. The second part outlines the influence of man on fluvial geomorphology, ecological considerations, and the natural characteristics of rivers that should be applied in the design of river and bridge projects.

  16. Applied Art in Trade and Industrial Education.

    ERIC Educational Resources Information Center

    King, Annie; Zirkle, Chris

    Ohio Hi-Point Joint Vocational School (JVS) has developed a comprehensive art program within the vocational setting. Selected trade and industrial programs at the school, as well as programs in agriculture and home economics, incorporate art instruction. The goals of the applied art program are as follows: to give students the opportunity to…

  17. Applied Science for the Over 16s

    ERIC Educational Resources Information Center

    Browning, D. R.

    1975-01-01

    Urges that more applied science and technology be included in college science curricula. Reviews courses which are working toward this end, such as an engineering course which requires the student to spend a week in an industrial environment and to produce a report on his visit. (MLH)

  18. Introduction: Conversation Analysis in Applied Linguistics

    ERIC Educational Resources Information Center

    Sert, Olcay; Seedhouse, Paul

    2011-01-01

    This short, introductory paper presents an up-to-date account of works within the field of Applied Linguistics which have been influenced by a Conversation Analytic paradigm. The article reviews recent studies in classroom interaction, materials development, proficiency assessment and language teacher education. We believe that the publication of…

  19. Promoting Rigorous Validation Practice: An Applied Perspective

    ERIC Educational Resources Information Center

    Mattern, Krista D.; Kobrin, Jennifer L.; Camara, Wayne J.

    2012-01-01

    As researchers at a testing organization concerned with the appropriate uses and validity evidence for our assessments, we provide an applied perspective related to the issues raised in the focus article. Newton's proposal for elaborating the consensus definition of validity is offered with the intention to reduce the risks of inadequate…

  20. Center for Applied Linguistics, Washington DC, USA

    ERIC Educational Resources Information Center

    Sugarman, Julie; Fee, Molly; Donovan, Anne

    2015-01-01

    The Center for Applied Linguistics (CAL) is a private, nonprofit organization with over 50 years' experience in the application of research on language and culture to educational and societal concerns. CAL carries out its mission to improve communication through better understanding of language and culture by engaging in a variety of projects in…

  1. Applied Biomechanics in an Instructional Setting

    ERIC Educational Resources Information Center

    Hudson, Jackie L.

    2006-01-01

    Biomechanics is the science of how people move better, meaning more skillfully and more safely. This article places more emphasis on skill rather than safety, though there are many parallels between them. It shares a few features of the author's paradigm of applied biomechanics and discusses an integrated approach toward a middle school football…

  2. Engineering and Applied Science, Recent Research Reports.

    ERIC Educational Resources Information Center

    National Science Foundation, Washington, DC. Directorate of Engineering and Applied Science.

    This collection contains abstracts of technical reports and journal articles resulting from research funded by the National Science Foundation. Included in the collection are abstracts arranged in several categories: (1) electrical, computer, and systems engineering; (2) civil and mechanical engineering; (3) applied research; (4) problem-focused…

  3. Applied Information Systems Research Program Workshop

    NASA Technical Reports Server (NTRS)

    Bredekamp, Joe

    1991-01-01

    Viewgraphs on Applied Information Systems Research Program Workshop are presented. Topics covered include: the Earth Observing System Data and Information System; the planetary data system; Astrophysics Data System project review; OAET Computer Science and Data Systems Programs; the Center of Excellence in Space Data and Information Sciences; and CASIS background.

  4. Exploring the Applied Arts. Publication No. 0041.

    ERIC Educational Resources Information Center

    Sokolowski, Kathleen

    The program covered in this curriculum guide deals with applied arts, concentrating on the areas of advertising, fashion illustration, graphic design, cartooning, and textile design and decoration. These areas have been developed to give a hands-on experience to the students by simulating the working world and the student's place in it. Each area…

  5. Applied optics to engineering photonics: a retrospective

    NASA Astrophysics Data System (ADS)

    Tatam, Ralph P.

    2011-12-01

    This paper provides a short overview of the time I spent as a member of the Applied Optics Group at the University of Kent (1985-1989) followed by a review of my research during my time at Cranfield University (1989 to date).

  6. Thermodynamic Laws Applied to Economic Systems

    ERIC Educational Resources Information Center

    González, José Villacís

    2009-01-01

    Economic activity in its different manifestations--production, exchange, consumption and, particularly, information on quantities and prices--generates and transfers energy. As a result, we can apply to it the basic laws of thermodynamics. These laws are applicable within a system, i.e., in a country or between systems and countries. To these…

  7. Educating and Training Undergraduate Applied Statisticians.

    ERIC Educational Resources Information Center

    Peres, Clovis A.; And Others

    1985-01-01

    A course on Applied Statistics, offered since 1978 at the Instituto de Matematica e Estatistica, Universidade de Sao Paulo, Brasil, is designed to educate statisticians at the bachelor's level for jobs in government statistical offices, industry, and business. (Author/LMO)

  8. Newspaper Twitter: Applied Drama and Microblogging

    ERIC Educational Resources Information Center

    Wotzko, Rebecca

    2012-01-01

    This paper discusses the use of applied drama within the microblogging platform "Twitter" as a method to increase students' social media and news literacy. Online news sites are increasingly using "Twitter" as a source for eyewitness accounts of events or public opinion. "Twitter" offers users a simple way to publicly broadcast or "tweet" about…

  9. Applied Research as Academic Public Relations.

    ERIC Educational Resources Information Center

    Leichty, Greg

    Applied communication research should be used by communication professors, communication departments, and colleges as an important tool for strengthening their relationships with their communities, students, and communication practitioners. Professors spend a great deal of time doing research and teaching people about research. Public…

  10. The Moral Self: Applying Identity Theory

    ERIC Educational Resources Information Center

    Stets, Jan E.; Carter, Michael J.

    2011-01-01

    This research applies identity theory to understand the moral self. In identity theory, individuals act on the basis of their identity meanings, and they regulate the meanings of their behavior so that those meanings are consistent with their identity meanings. An inconsistency produces negative emotions and motivates individuals to behave…

  11. Applying Computerized Adaptive Testing in Schools.

    ERIC Educational Resources Information Center

    Olsen, James B.

    1990-01-01

    Presents two studies applying computerized adaptive testing (CAT) in schools. Compared paper-administered, computer-administered, and CAT modes for administering school achievement and assessment tests. Then compared computerized adaptive aptitude test results with individually administered Weschler Intelligence Scale for Children-Revised. Found…

  12. A Primer on Disseminating Applied Quantitative Research

    ERIC Educational Resources Information Center

    Bell, Bethany A.; DiStefano, Christine; Morgan, Grant B.

    2010-01-01

    Transparency and replication are essential features of scientific inquiry, yet scientific communications of applied quantitative research are often lacking in much-needed procedural information. In an effort to promote researchers dissemination of their quantitative studies in a cohesive, detailed, and informative manner, the authors delineate…

  13. Teaching Applied Ethics to the Righteous Mind

    ERIC Educational Resources Information Center

    Murphy, Peter

    2014-01-01

    What does current empirically informed moral psychology imply about the goals that can be realistically achieved in college-level applied ethics courses? This paper takes up this question from the vantage point of Jonathan Haidt's Social Intuitionist Model of human moral judgment. I summarize Haidt's model, and then consider a variety of…

  14. Applying Social Psychological Concepts Outside the Classroom

    ERIC Educational Resources Information Center

    Lakin, Jessica L.; Wichman, Aaron L.

    2005-01-01

    This article evaluates a writing assignment in which social psychology students gathered examples from outside the classroom (e.g., cartoons, movies) and analyzed them with course material. Compared to a control group, students who completed the assignment learned that it was easier to apply social psychology to the real world. A follow-up survey…

  15. Instrumentation for Applied Physics and Industrial Applications

    NASA Astrophysics Data System (ADS)

    Hillemanns, H.; Le Goff, J.-M.

    This document is part of Part 2 'Principles and Methods' of Subvolume B 'Detectors for Particles and Radiation' of Volume 21 'Elementary Particles' of Landolt-Börnstein - Group I 'Elementary Particles, Nuclei and Atoms'. It contains the Section '7.3 Instrumentation for Applied Physics and Industrial Applications' of Chapter '7 Applications of Detectors in Technology; Medicine and Other Fields' with the content:

  16. AN INTERACTION MODEL APPLIED TO SUPERVISION.

    ERIC Educational Resources Information Center

    BOYD, ROBERT D.

    THIS STUDY OUTLINES A SMALL GROUP INTERACTION MODEL WHICH CAN BE APPLIED TO SUPERVISION. IT CONSISTS OF THREE CHANNELS -- (1) THE MOTIVATIONAL CHANNEL IN WHICH THE MOTIVATIONAL ASPECT OF AN UTTERANCE (I.E. QUESTIONS, EXCLAMATIONS, ASSERTIONS) IS IDENTIFIED ACCORDING TO THE PARTICULAR EGO CRISIS (TRUST VS. MISTRUST, AUTONOMY VS. SHAME DOUBT,…

  17. Applied programs at Brookhaven National Laboratory

    SciTech Connect

    Not Available

    1991-09-01

    This document overviews the areas of current research at Brookhaven National Laboratory. Technology transfer and the user facilities are discussed. Current topics are presented in the areas of applied physics, chemical science, material science, energy efficiency and conservation, environmental health and mathematics, biosystems and process science, oceanography, and nuclear energy. (GHH)

  18. Uniform insulation applied-B ion diode

    DOEpatents

    Seidel, David B.; Slutz, Stephen A.

    1988-01-01

    An applied-B field extraction ion diode has uniform insulation over an anode surface for increased efficiency. When the uniform insulation is accomplished with anode coils, and a charge-exchange foil is properly placed, the ions may be focused at a point on the z axis.

  19. Ideology in Applied Linguistics for Language Teaching

    ERIC Educational Resources Information Center

    Waters, Alan

    2009-01-01

    It is contended that much of present-day applied linguistics for language teaching (ALLT) fails to mediate effectively, primarily because an ideological construction, emanating from a critical theory perspective, is too often imposed on everyday pedagogical practices. This has resulted in an exaggerated level of concern about the power imbalances…

  20. Plenary Speeches: Applied Linguists without Borders

    ERIC Educational Resources Information Center

    Tarone, Elaine

    2013-01-01

    Until 1989, the American Association for Applied Linguistics (AAAL) could have been viewed as an interest group of the Linguistics Society of America (LSA); AAAL met in two designated meeting rooms as a subsection of the LSA conference. In 1991, I was asked to organize the first independent meeting of AAAL in New York City, with the help of…

  1. Problems Portraying Migrants in Applied Linguistics Research

    ERIC Educational Resources Information Center

    Block, David

    2010-01-01

    This paper is a very personal attempt to explore the problematics of portraying migrants in Applied Linguistics research. I begin with a discussion of identity, in particular what we might mean when we use the term, and from there I go on to explore its fundamental imprecision through an analysis of a census question about ethnicity. I then…

  2. Edinburgh Working Papers in Applied Linguistics, 1997.

    ERIC Educational Resources Information Center

    Mitchell, Keith, Ed.; Parkinson, Brian, Ed.

    1997-01-01

    Papers on applied linguistics and language pedagogy include: "A Genre Analysis Study of 80 Medical Abstracts" (Kenneth Anderson, Joan Maclean); "Oral Classroom Testing in an Adult French Community Class" (Sheena Davies, Aileen Irvine, Jacqueline Larrieu); "Whose Relevance? Interpretation of Hybrid Texts by a Multiple Audience" (Katalin Egri…

  3. Applied Linguistics and Primary School Teaching

    ERIC Educational Resources Information Center

    Ellis, Sue, Ed.; McCartney, Elspeth, Ed.

    2011-01-01

    Modern primary teachers must adapt literacy programmes and ensure efficient learning for all. They must also support children with language and literacy difficulties, children learning English as an additional language and possibly teach a modern foreign language. To do this effectively, they need to understand the applied linguistics research…

  4. Applying Brain-Friendly Instructional Practices

    ERIC Educational Resources Information Center

    Erlauer-Myrah, Laura

    2006-01-01

    In this article, the author offers advice for principals on working with teachers to change the instructional climate and on how to apply brain-friendly instructions to improve the effectiveness of one's teaching. To lead an entire district toward the use of brain-compatible instruction, the author suggests to start with a group of motivated…

  5. Applying Technology to Your Core Mission.

    ERIC Educational Resources Information Center

    Fickes, Michael

    2000-01-01

    Discusses how colleges and universities can best apply new information technology (IT) tools to the core mission and offers some examples to illustrate how IT managers and staff are accomplishing it. IT manager's approaches in defining a school's competitive positioning and technology's role in classroom learning are discussed as is solving…

  6. Applied-field MPD thruster geometry effects

    NASA Technical Reports Server (NTRS)

    Myers, Roger M.

    1991-01-01

    Eight MPD thruster configurations were used to study the effects of applied-field strength, propellant, and facility pressure on thruster performance. Vacuum facility background pressures higher than about 0.12 Pa were found to significantly influence thruster performance and electrode power deposition. Thrust efficiency and specific impulse increased monotonically with increasing applied field strength. Both cathode and anode radii fundamentally influenced the efficiency-specific impulse relationship, while their lengths influenced only the magnitude of the applied magnetic field required to reach a given performance level. At a given specific impulse, large electrode radii result in lower efficiencies for the operating conditions studied. For all test conditions, anode power deposition was the largest efficiency loss, and represented between 50 percent and 80 percent of the input power. The fraction of the input power deposited into the anode decreased with increasing applied field and anode radius. The highest performance measured, 20 percent efficiency at 3700 seconds specific impulse, was obtained using hydrogen propellant.

  7. Edinburgh Working Papers in Applied Linguistics, 1998.

    ERIC Educational Resources Information Center

    Parkinson, Brian, Ed.

    1998-01-01

    Papers on applied linguistics and language pedagogy include: "Non-Exact Quantification in Slide Presentations of Medical Research" (Ron Howard); "Modality and Point of View: A Contrastive Analysis of Japanese Wartime and Peacetime Newspaper Discourse" (Noriko Iwamoto); "Classroom Transcripts and 'Noticing' in Teacher Education" (Tony Lynch);…

  8. Applying Technology in the Work Environment.

    ERIC Educational Resources Information Center

    Greenwood, Reed, Ed.

    A series of papers is presented from two symposia sponsored by the Work Environment and Technology Committee and offered at annual conferences of the President's Committee on Employment of People with Disabilities. The 1988 symposium was called "Applying Technology in the Work Environment" and the 1989 symposium was called "Reasonable…

  9. Positive Behavior Support and Applied Behavior Analysis

    ERIC Educational Resources Information Center

    Johnston, J. M.; Foxx, R. M.; Jacobson, J. W.; Green, G.; Mulick, J. A.

    2006-01-01

    This article reviews the origins and characteristics of the positive behavior support (PBS) movement and examines those features in the context of the field of applied behavior analysis (ABA). We raise a number of concerns about PBS as an approach to delivery of behavioral services and its impact on how ABA is viewed by those in human services. We…

  10. Applied Literature and Composition Curriculum Guide.

    ERIC Educational Resources Information Center

    Georgia State Dept. of Education, Atlanta.

    Redesigned to reflect a more standards-driven as opposed to course-driven approach, the Applied Literature and Composition courses (I and II) described in this paper not only prepare the two-year college/technical school students for entering the real world of work, but also for post-secondary and college level work. It notes that the course is…

  11. Applied Welding Technology. Technical Committee Report.

    ERIC Educational Resources Information Center

    Idaho State Dept. of Education, Boise. Div. of Vocational Education.

    This Technical Committee Report prepared by industry representatives in Idaho lists the skills currently necessary for an employee in that state to obtain a job in applied welding technology, retain a job once hired, and advance in that occupational field. (Task lists are grouped according to duty areas generally used in industry settings, and are…

  12. Applying Dynamic Evaluation Approach in Education

    ERIC Educational Resources Information Center

    Grammatikopoulos, V.; Koustelios, A.; Tsigilis, N.; Theodorakis, Y.

    2004-01-01

    The purpose of the current study was to implement a newly proposed evaluation method (Dimitropoulos, 1999), that is, the dynamic evaluation approach in the field of education. The dynamic approach was applied in order to evaluate the Olympic Education Program in Greece. The results of the present field study were encouraging. Dynamic evaluation…

  13. Psycholinguistics in Applied Linguistics: Trends and Perspectives.

    ERIC Educational Resources Information Center

    de Bot, Kees

    2000-01-01

    Discusses the relationship between the terms psycholinguistics and applied linguistics, and in the process explores key issues in multilingual processing, such as the structure of the bilingual lexicon, language choice in production and perception, and the language mode. (Author/VWL)

  14. Second Language Acquisition and Applied Linguistics.

    ERIC Educational Resources Information Center

    Larsen-Freeman, Diane

    2000-01-01

    Discusses the second language acquisition (SLA) process and the differential success of second language learners. Examines the fundamental challenges that this characterization faces, and highlights the contributions SLA is capable of in the coming decade. Offers topics for a training and development of curriculum for future applied linguists from…

  15. Applied Mathematics in the Undergraduate Curriculum.

    ERIC Educational Resources Information Center

    Committee on the Undergraduate Program in Mathematics, Berkeley, CA.

    After considering the growth in the use of mathematics in the past 25 years, this report makes four major recommendations regarding the undergraduate curriculum: (1) The mathematics department should offer a course or two in applied mathematics which treat some realistic situations completely, including the steps of problem formulation, model…

  16. Applied Creativity: The Creative Marketing Breakthrough Model

    ERIC Educational Resources Information Center

    Titus, Philip A.

    2007-01-01

    Despite the increasing importance of personal creativity in today's business environment, few conceptual creativity frameworks have been presented in the marketing education literature. The purpose of this article is to advance the integration of creativity instruction into marketing classrooms by presenting an applied creative marketing…

  17. Personalizing Drug Selection Using Advanced Clinical Decision Support

    PubMed Central

    Pestian, John; Spencer, Malik; Matykiewicz, Pawel; Zhang, Kejian; Vinks, Alexander A.; Glauser, Tracy

    2009-01-01

    This article describes the process of developing an advanced pharmacogenetics clinical decision support at one of the United States’ leading pediatric academic medical centers. This system, called CHRISTINE, combines clinical and genetic data to identify the optimal drug therapy when treating patients with epilepsy or Attention Deficit Hyperactivity Disorder. In the discussion a description of clinical decision support systems is provided, along with an overview of neurocognitive computing and how it is applied in this setting. PMID:19898682

  18. 42 CFR 68a.16 - What other regulations and statutes apply?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false What other regulations and statutes apply? 68a.16 Section 68a.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM...

  19. 42 CFR 68a.16 - What other regulations and statutes apply?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What other regulations and statutes apply? 68a.16 Section 68a.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM...

  20. 42 CFR 68a.16 - What other regulations and statutes apply?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false What other regulations and statutes apply? 68a.16 Section 68a.16 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL INSTITUTES OF HEALTH (NIH) CLINICAL RESEARCH LOAN REPAYMENT PROGRAM...