Lattice Boltzmann computation of creeping fluid flow in roll-coating applications

NASA Astrophysics Data System (ADS)

Rajan, Isac; Kesana, Balashanker; Perumal, D. Arumuga

2018-04-01

Lattice Boltzmann Method (LBM) has advanced as a class of Computational Fluid Dynamics (CFD) methods used to solve complex fluid systems and heat transfer problems. It has ever-increasingly attracted the interest of researchers in computational physics to solve challenging problems of industrial and academic importance. In this current study, LBM is applied to simulate the creeping fluid flow phenomena commonly encountered in manufacturing technologies. In particular, we apply this novel method to simulate the fluid flow phenomena associated with the "meniscus roll coating" application. This prevalent industrial problem encountered in polymer processing and thin film coating applications is modelled as standard lid-driven cavity problem to which creeping flow analysis is applied. This incompressible viscous flow problem is studied in various speed ratios, the ratio of upper to lower lid speed in two different configurations of lid movement - parallel and anti-parallel wall motion. The flow exhibits interesting patterns which will help in design of roll coaters.

The Retrieval of Information in an Elementary School Library Media Center: An Alternative Method of Classification in the Common School Library, Amherst, Massachusetts.

ERIC Educational Resources Information Center

Cooper, Linda

1997-01-01

Discusses the problems encountered by elementary school children in retrieving information from a library catalog, either the traditional card catalog or an OPAC (online public access catalog). An alternative system of classification using colors and symbols is described that was developed in the Common School (Amherst, Massachusetts). (Author/LRW)

Guidelines for determining the capacity of d-regions with premature concrete deterioration of ASR/DEF.

DOT National Transportation Integrated Search

2012-11-01

When a bridge engineer encounters a design or analysis problem concerning a bridge substructure, that structure will commonly have a mixture of member types, some slender, and some squat. Slender members are generally governed by flexure, and normal ...

Guidelines for analyzing the capacity of d-regions with premature concrete deterioration of ASR/DEF.

DOT National Transportation Integrated Search

2015-03-01

When a bridge engineer encounters a design or analysis problem concerning a bridge substructure, : that structure will commonly have a mixture of member types, some slender, and some squat. : Slender members are generally governed by flexure, and nor...

Barriers to Employment for Transition-age Youth with Developmental and Psychiatric Disabilities.

PubMed

Noel, Valerie A; Oulvey, Eugene; Drake, Robert E; Bond, Gary R

2017-05-01

Youth with developmental and psychiatric disabilities encounter significant vocational challenges, even when they receive supported employment services. We examined the barriers to employment for 280 transition-age youth with disabilities enrolled in supported employment in eight community rehabilitation centers. Employment team members identified each youth's top three barriers to employment using a 21-item checklist. Lack of work experience, transportation problems, and program engagement issues represented common barriers for both youth with developmental disabilities (53, 36, and 25%) and youth with psychiatric disabilities (20, 33, and 26%). Additional common barriers among youth with developmental disabilities included cognitive problems (32%) and lack of social skills (23%) and among youth with psychiatric disabilities included poor control of psychiatric symptoms (23%). Despite receiving evidence-based employment services, youth with disabilities encounter many barriers to employment. Awareness of typical barriers for transition-age youth, including those specific to different disability groups, may help employment programs anticipate challenges and develop strategies that avoid these barriers and their effects on employment opportunities.

Common skin problems in the community and primary care.

PubMed

Armstrong, Kirsty

2014-10-01

Skin problems can be hard to diagnose, leaving clinicians frustrated and patients incorrectly treated, but rashes and lesions can be markers of systemic disease and infections. However, by using simple history-taking and mnemonics, safety and correct diagnoses can be achieved. This article will consider some common problems encountered in primary and community care, issues that need to be excluded, resources that will help with diagnosis and some management guidelines. This is not an exhaustive guide, and advice should be sought from learned colleagues in specific cases. Pressure area care and the use of compression bandaging will not be discussed unless it is of relevance to the subject of rashes and lesions.

Interdisciplinarity in Adapted Physical Activity

ERIC Educational Resources Information Center

Bouffard, Marcel; Spencer-Cavaliere, Nancy

2016-01-01

It is commonly accepted that inquiry in adapted physical activity involves the use of different disciplines to address questions. It is often advanced today that complex problems of the kind frequently encountered in adapted physical activity require a combination of disciplines for their solution. At the present time, individual research…

Using a Semi-Realistic Database to Support a Database Course

ERIC Educational Resources Information Center

Yue, Kwok-Bun

2013-01-01

A common problem for university relational database courses is to construct effective databases for instructions and assignments. Highly simplified "toy" databases are easily available for teaching, learning, and practicing. However, they do not reflect the complexity and practical considerations that students encounter in real-world…

Let's Tell a Story Together

ERIC Educational Resources Information Center

Kelsey, Karishma; Zaliwski, Andrew

2017-01-01

Aim/Purpose: The teaching solution presented in this paper was implemented to overcome the common problems encountered by authors during years of practice of applied business studies teaching. Background: In our school, we have deep multicultural environments where both teachers and students are coming from different countries and cultures. The…

Glaucoma in juvenile xanthogranuloma.

PubMed

Vendal, Zarmeena; Walton, David; Chen, Teresa

2006-01-01

Juvenile xanthogranuloma (JXG) is a benign histiocytic skin disorder mainly encountered during infancy. Approximately 10% of cases exhibit ocular manifestations leading to serious complications. Specifically, secondary glaucoma can result in severe and blinding eye disease. We present a case of a two-month-old female with JXG related glaucoma in order to demonstrate the classic presentation and the problems commonly encountered in treating this disease. The natural history, pathogenesis, and treatment of the condition are then discussed and the pertinent literature reviewed. JXG should be considered in any case of unilateral glaucoma that presents in infancy.

Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study.

PubMed

Russel, M G V M; Ryan, B M; Dagnelie, P C; de Rooij, M; Sijbrandij, J; Feleus, A; Hesselink, M; Muris, J W; Stockbrugger, R

2003-03-01

The majority of patients with inflammatory bowel disease (IBD) have a normal life expectancy and therefore should not be weighted when applying for life assurance. There is scant literature on this topic. In this study our aim was to document and compare the incidence of difficulties in application for life and medical insurance in a population based cohort of IBD patients and matched population controls. A population based case control study of 1126 IBD patients and 1723 controls. Based on a detailed questionnaire, the frequency and type of difficulties encountered when applying for life and medical insurance in matched IBD and control populations were appraised. In comparison with controls, IBD patients had an 87-fold increased risk of encountering difficulties when applying for life assurance (odds ratio (OR) 87 (95% confidence interval (CI) 31-246)), with a heavily weighted premium being the most common problem. Patients of high educational status, with continuous disease activity, and who smoked had the highest odds of encountering such problems. Medical insurance difficulties were fivefold more common in IBD patients compared with controls (OR 5.4 (95% CI 2.3-13)) although no specific disease or patient characteristics were identified as associated with such difficulties. This is the first detailed case control study that has investigated insurance difficulties among IBD patients. Acquiring life and medical insurance constituted a major problem for IBD patients in this study. These results are likely to be more widely representative given that most insurance companies use international guidelines for risk assessment. In view of the recent advances in therapy and promising survival data on IBD patients, evidence based guidelines for risk assessment of IBD patients by insurance companies should be drawn up to prevent possible discriminatory practices.

Insurance problems among inflammatory bowel disease patients: results of a Dutch population based study

PubMed Central

Russel, M G V M; Ryan, B M; Dagnelie, P C; de Rooij, M; Sijbrandij, J; Feleus, A; Hesselink, M; Muris, J W; Stockbrugger, R

2003-01-01

Background and aims: The majority of patients with inflammatory bowel disease (IBD) have a normal life expectancy and therefore should not be weighted when applying for life assurance. There is scant literature on this topic. In this study our aim was to document and compare the incidence of difficulties in application for life and medical insurance in a population based cohort of IBD patients and matched population controls. Methods: A population based case control study of 1126 IBD patients and 1723 controls. Based on a detailed questionnaire, the frequency and type of difficulties encountered when applying for life and medical insurance in matched IBD and control populations were appraised. Results: In comparison with controls, IBD patients had an 87-fold increased risk of encountering difficulties when applying for life assurance (odds ratio (OR) 87 (95% confidence interval (CI) 31–246)), with a heavily weighted premium being the most common problem. Patients of high educational status, with continuous disease activity, and who smoked had the highest odds of encountering such problems. Medical insurance difficulties were fivefold more common in IBD patients compared with controls (OR 5.4 (95% CI 2.3–13)) although no specific disease or patient characteristics were identified as associated with such difficulties. Conclusions: This is the first detailed case control study that has investigated insurance difficulties among IBD patients. Acquiring life and medical insurance constituted a major problem for IBD patients in this study. These results are likely to be more widely representative given that most insurance companies use international guidelines for risk assessment. In view of the recent advances in therapy and promising survival data on IBD patients, evidence based guidelines for risk assessment of IBD patients by insurance companies should be drawn up to prevent possible discriminatory practices. PMID:12584216

Investigation of fatigue by Australian general practice registrars: a cross-sectional study.

PubMed

Morgan, Simon; Henderson, Kim M; Tapley, Amanda; Thomson, Allison; Wilson, Jessica; Scott, John; Spike, Neil A; McArthur, Lawrie; van Driel, Mieke L; Magin, Parker J

2015-06-01

Fatigue is the most common undifferentiated problem presenting in general practice. Previous studies have shown that this presentation leads to multiple investigations. There is no published literature describing the management of patients with fatigue by general practice (GP) registrars. To document the investigation-ordering behaviour of GP registrars in managing patients with a new diagnosis of unexplained fatigue. This was a cross-sectional analysis of data from Registrar Clinical Encounters in Training (ReCEnT), an ongoing cohort study of GP registrars' consultations. We established the prevalence of new diagnoses of unexplained fatigue and associations with that diagnosis, the rate of test ordering and the number and types of investigations ordered. 644 registrars contributed data from 68 986 encounters. In 0.78% of patient encounters, a new diagnosis of unexplained fatigue was made. Pathology was ordered in 78.4% of these problems (versus 18.1% in non-fatigue problems), at a rate of 488 tests per 100 new fatigue problems. Our study suggests that unexplained fatigue elicits a non-rational approach to test ordering by registrars. These findings contribute to the understanding of GP registrar management of fatigue, and undifferentiated presentations more broadly, and suggest educational approaches to improve practice, including dealing with uncertainty.

Dermatology for the Allergist

PubMed Central

Lockey, Richard

2010-01-01

Abstract: Allergists/immunologists see patients with a variety of skin disorders. Some, such as atopic and allergic contact dermatitis, are caused by abnormal immunologic reactions, whereas others, such as seborrheic dermatitis or rosacea, lack an immunologic basis. This review summarizes a select group of dermatologic problems commonly encountered by an allergist/immunologist. PMID:23268431

International Cooperation for a Single World Production Standard of High Definition Television.

ERIC Educational Resources Information Center

Hongcharu, Boonchai

Broadcasters, television engineers and the production industry have encountered many problems with diverse television standards since the introduction of color television. With the advent of high definition television (HDTV), the chance to have a common production standard for international exchange of programs and technical information has…

Sample Strategies Used To Serve Rural Students in the Least Restrictive Environment.

ERIC Educational Resources Information Center

Helge, Doris

This booklet provides sample strategies to ameliorate service delivery problems commonly encountered by rural special educators. Strategies to increase acceptance of disabled students by nondisabled peers include buddy systems and class activities that promote personal interaction, simulation activities, and social and personal skills development.…

Teacher Education With an Inquiry Emphasis.

ERIC Educational Resources Information Center

Wright, David P.

A program for prospective elementary and secondary teachers emphasizing inquiry and problem solving techniques for use in the classroom is described. In the conceptual framework of this program, a situation is defined as a set of circumstances that teachers commonly encounter, and an issue is a theoretical, ethical, or methodological question. A…

The Early Years: Integrating Design

ERIC Educational Resources Information Center

Ashbrook, Peggy; Nellor, Sue

2015-01-01

Engineering is such a common part of children's work in early childhood programs that teachers can simply look around the room to identify examples where students have engaged in engineering practices. This article presents a classroom activity that integrates engineering design by building on the everyday problems that young children encounter in…

New Ways to Learn a Foreign Language.

ERIC Educational Resources Information Center

Hall, Robert A., Jr.

This text focuses on the nature of language learning in the light of modern linguistic analysis. Common linguistic problems encountered by students of eight major languages are examined--Latin, Greek, French, Spanish, Portuguese, Italian, German, and Russian. The text discusses the nature of language, building new language habits, overcoming…

RURAL EDUCATION ON THE WORLD SCENE.

ERIC Educational Resources Information Center

SWANSON, GORDON I.

AN HISTORICAL REVIEW OF THE DEVELOPMENT OF RURAL EDUCATION IN THE UNITED STATES IS PRESENTED ALONG WITH SYMPTOMS AND DEFINITIONS OF UNDER-DEVELOPED OR DEVELOPING ECONOMIC SYSTEMS. COMMON EDUCATIONAL CHARACTERISTICS ARE DISCUSSED, AND A COMPARISON IS DRAWN BETWEEN THE PROBLEMS THAT MAY BE ENCOUNTERED IN THE DEVELOPMENT OF EDUCATION IN THE UNITED…

Measuring Protein Interactions by Optical Biosensors

PubMed Central

Zhao, Huaying; Boyd, Lisa F.; Schuck, Peter

2017-01-01

This unit gives an introduction to the basic techniques of optical biosensing for measuring equilibrium and kinetics of reversible protein interactions. Emphasis is given to the description of robust approaches that will provide reliable results with few assumptions. How to avoid the most commonly encountered problems and artifacts is also discussed. PMID:28369667

Cost Analysis for Educational Program Evaluation.

ERIC Educational Resources Information Center

Haller, Emil J.

Concerned with the problem of determining program costs as part of the evaluation process, this article helps the practitioner arrive at useful conceptions of the term "cost" and procedures for assessing the costs of an educational program. Its purpose is to help design costing procedures for evaluation situations that are commonly encountered. An…

On Translating French Occurring in English into Spanish.

ERIC Educational Resources Information Center

Sebastian, Robert N.

1989-01-01

Explores problems encountered during attempts to translate French expressions occurring in English (such as concierge) into Spanish, particularly when the English interpretation of the expression is different from the standard French usage. Spanish translations are provided for about 200 French terms and expressions commonly used in English. (61…

Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems.

PubMed

D'Alessandro, Donna; Kingsley, Peggy

2002-01-01

The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.

Understanding ethical dilemmas in the emergency department: views from medical students' essays.

PubMed

House, Joseph B; Theyyunni, Nikhil; Barnosky, Andrew R; Fuhrel-Forbis, Andrea; Seeyave, Desiree M; Ambs, Dawn; Fischer, Jonathan P; Santen, Sally A

2015-04-01

For medical students, the emergency department (ED) often presents ethical problems not encountered in other settings. In many medical schools there is little ethics training during the clinical years. The benefits of reflective essay writing in ethics and professionalism education are well established. The purpose of this study was to determine and categorize the types of ethical dilemmas and scenarios encountered by medical students in the ED through reflective essays. During a 4(th)-year emergency medicine rotation, all medical students wrote brief essays on an ethical situation encountered in the ED, and participated in an hour debriefing session about these essays. Qualitative analysis was performed to determine common themes from the essays. The frequency of themes was calculated. The research team coded 173 essays. The most common ethical themes were autonomy (41%), social justice (32.4%), nonmaleficence (31.8%), beneficence (26.6%), fidelity (12%), and respect (8.7%). Many of the essays contained multiple ethical principles that were often in conflict with each other. In one essay, a student grappled with the decision to intubate a patient despite a preexisting do-not-resuscitate order. This patient encounter was coded with autonomy, beneficence, and nonmaleficence. Common scenarios included ethical concerns when caring for critical patients, treatment of pain, homeless or alcoholic patients, access to care, resource utilization, and appropriateness of care. Medical students encounter patients with numerous ethically based issues. Frequently, they note conflicts between ethical principles. Such essays constitute an important resource for faculty, resident, and student ethics training. Copyright © 2015 Elsevier Inc. All rights reserved.

Mydriasis during Orbital Floor Fracture Reconstruction: A Novel Diagnostic and Treatment Algorithm

PubMed Central

Yeo, Matthew S.; Al-Mousa, Radwan; Sundar, Gangadhara; Lim, Thiam Chye

2010-01-01

Orbital floor fractures are the most commonly encountered traumatic fractures in the facial skeleton. Mydriasis that is detected during orbital floor fracture reconstruction may cause significant distress to surgeons, as it may be associated with sinister events such as visual loss. It is not an uncommon problem; previous studies have shown the incidence of mydriasis to be 2.1%. The combination of careful preoperative evaluation and planning, as well as specific intraoperative investigations when mydriasis is encountered, can be immensely valuable in allaying surgeons' anxiety during orbital floor fracture reconstruction. In this review article, the authors discuss the common causes of mydriasis and present a novel systematic approach to its diagnostic evaluation devised by our unit that has been successfully implemented since 2008. PMID:22132259

Multiple cranial neuropathy: a common diagnostic problem.

PubMed

Garg, R K; Karak, B

1999-10-01

Syndrome of multiple cranial palsies is a common clinical problem routinely encountered in neurological practice. Anatomical patterns of cranial nerves involvement help in localizing the lesion. Various infections, malignant neoplasms and autoimmune vasculitis are common disorders leading to various syndromes of multiple cranial nerve palsies. A large number of diffuse neurological disorders (e.g. Gullian-Barre syndrome, myopathies) may also present with syndrome of multiple cranial nerve palsies. Despite extensive biochemical and radiological work-up the accurate diagnosis may not be established. Few such patients represent "idiopathic" variety of multiple cranial nerve involvement and show good response to corticosteroids. Widespread and sequential involvements of cranial nerves frequently suggest possibility of malignant infiltration of meninges, however, confirmation of diagnosis may not be possible before autopsy.

Adapting an Effective Counseling Model from Patient-centered Care to Improve Motivation in Clinical Training Programs.

PubMed

Hamada, Hisayuki; Martin, Dawn; Batty, Helen P

2006-12-01

The value of establishing a patient-centered relationship within the context of the clinical encounter is well documented. The learner-centered method of medical education parallels the patient-centered clinical method; therefore, it should be explored as a method for teaching in the context of the learning encounter. In Japan and other Asian countries, rotations through services not related to the learner's chosen medical specialty are mandatory parts of the medical internship. Participation and effort in these rotations are often met with resistance from learners and are a common problem for medical educators. We adapted the counseling method for patients based on patient-centered methods such as motivational interviewing and solution-focused therapy to address this common problem. We show one case of a medical resident who lost his motivation to learn during his training. A resident has many kinds of mental and physical stress. One such problem arises from the gap between what they want to do and what they have to do. Strategies from motivational interviewing and solution-focused therapy were adapted to successfully resolve a common teaching problem in Japan. A physician teacher (preceptor) helped this resident solve the issue for himself instead of arguing in favor of change. The positive aspects of the counseling method were based on patient-centered medicine and proved useful and effective in counseling for medical residents. We may take the lessons learned from using patient-centered counseling methods to further develop a clear and systematic process of counseling methods for residents to conduct learner-centered medical education.

Anesthetic management of achondroplastic dwarf undergoing cesarean section--a case report.

PubMed

Cevik, Banu; Colakoğlu, Serhan

2010-10-01

There are more than 100 different types of dwarfism. Achondroplasia is the most common of these conditions. The aim of this report is to describe the anesthetic management of these patient, discussing the anesthetic considerations and emphasizing the difficulties encountered. A 32-year-old achondroplastic parturient underwent cesarean section under general anesthesia. We did not encounter problems related with airway management. The operation went without any complication. There are risks for both regional and general anesthesia in achondroplastic patients. The most important point is the careful preoperative assessment. Anesthesia plan should be specified to individual basis.

A Comparison of Heat versus Methanol Fixation for Gram Staining Bacteria

ERIC Educational Resources Information Center

Minnerath, Jeanne M.; Roland, Jenna M.; Rossi, Lucas C.; Weishalla, Steven R.; Wolf, Melissa M.

2009-01-01

Gram staining bacteria is a fundamental technique introduced in general biology and microbiology laboratory courses. Two common problems students encounter when Gram staining bacteria are (1) having a difficult time locating bacterial cells on the microscope slide and (2) over-decolorizing bacterial cells during the staining procedure such that…

Computer-Based Information System Cultivated To Support a College of Education.

ERIC Educational Resources Information Center

Smith, Gary R.

This brief paper discusses four of the computer applications explored at Wayne State University over the past decade to provide alternative solutions to problems commonly encountered in teacher education and in providing support for the classroom teacher. These studies examined only databases that are available in the public domain; obtained…

Teaching Case: Adapting the Access Northwind Database to Support a Database Course

ERIC Educational Resources Information Center

Dyer, John N.; Rogers, Camille

2015-01-01

A common problem encountered when teaching database courses is that few large illustrative databases exist to support teaching and learning. Most database textbooks have small "toy" databases that are chapter objective specific, and thus do not support application over the complete domain of design, implementation and management concepts…

A Comparison of Behavioral and Constructivist Interventions for Increasing Math-Fact Fluency in a Second-Grade Classroom

ERIC Educational Resources Information Center

Poncy, Brian C.; McCallum, Elizabeth; Schmitt, Ara J.

2010-01-01

Although basic math skill deficits are commonly encountered across elementary and secondary school students, few empirically validated, group-administered interventions are available for educators attempting to prevent or remedy such problems. This study compared the effectiveness of two theoretically distinct interventions for improving the…

Acute and overuse injuries of the abdomen and groin in athletes.

PubMed

Atkins, Justin M; Taylor, Jonathan C; Kane, Shawn F

2010-01-01

Abdominal and groin injuries are common problems encountered by athletes across a wide variety of sports. They range from benign but annoying, such as exercise-related transient abdominal pain (ETAP), to the activity-limiting and possibly career-ending condition of athletic hernia. This article covers ETAP, rectus abdominus injuries, osteitis pubis, athletic hernia, and abdominal/groin hernias to provide an update on the current pathophysiology and treatment of common abdominal and pelvic conditions in the athlete.

Perceptions and practices on menstruation amongst Nigerian secondary school girls.

PubMed

Adinma, Echendu Dolly; Adinma, J I B

2008-04-01

This cross-sectional descriptive study was conducted amongst 550 secondary school girls in southeastern Nigeria to determine their perceptions, problems, and practices on menstruation. Majority of the students, (75.6%), were aged 15-17 years. Only 39.3% perceived menstruation to be physiological. Abdominal pain/discomfort, (66.2%), was the commonest medical problem encountered by the respondents, although 45.8% had multiple problems. Medical problems were most commonly discussed with the mother, (47.1%), and least commonly discussed with the teachers, 0.4%. Analgesics, (75.6%), were most commonly used to relieve menstrual pain. Only 10% of respondents used non-pharmacologic remedies. Unsanitary menstrual absorbents were used by 55.7% of the respondents. Menstruation perceptions are poor, and practices often incorrect. A multi-dimensional approach focusing on capacity building of mothers, and teachers on sexuality education skills; using religious organizations as avenues for sexuality education; and effectively using the Mass Media as reproductive health education channels are recommended towards improving adolescents' perceptions and practices on menstruation.

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

PubMed

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

2008-08-01

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

Patients with cardiac disease: considerations for the dental practitioner.

PubMed

Jowett, N I; Cabot, L B

2000-09-23

The provision of dental treatment under both local anaesthesia and sedation has an excellent safety record, although medical problems may occur. The high prevalence of cardiac disease in the population, particularly ischaemic heart disease, makes it the most common medical problem encountered in dental practice. Additionally, the increasing survival of children with congenital heart disease makes them a significant proportion of those attending for dental treatment. While most dental practitioners feel confident in performing cardio-pulmonary resuscitation, treating patients with co-existent cardio-vascular disease often causes concern over potential problems during treatment. This article aims to allay many of these fears by describing the commoner cardiac conditions and how they may affect dental treatment. It outlines prophylactic and remediable measures that may be taken to enable safe delivery of dental care.

Reasons for encounter and disease patterns in Danish primary care: changes over 16 years.

PubMed

Moth, Grete; Olesen, Frede; Vedsted, Peter

2012-06-01

Approximately 98% of Danish citizens are listed with a general practice which they consult for medical advice. Although 85% of the population contact their general practitioner (GP) every year, little is known about these contacts. The aim of the present paper is to gain updated knowledge about patients' reasons for encounter and the GP activities and to make comparisons with a similar study from 1993. All GPs in the Central Denmark Region were invited to register all contacts during one randomly chosen day within a year. The registration included questions about patients' reasons for encounter, the types and contents of the contacts, referrals, and distribution between new episodes and follow-up contacts. Aggregated data were compared with the results from 1993. A total of 404 (46%) GPs participated. The number of contacts per 1000 inhabitants had risen by 19.7%. The reasons for encounter and final diagnoses resembled those in 1993. Musculoskeletal, psychological, and respiratory problems were the most common reasons for encounter, psychological problems being the only type to increase over the period. Interestingly, the proportion of diagnoses within the ICPC 'A' chapter rose from 13.5 to 19.7%. The referral rate rose by 2% (relative: 18.7%) from 10.7% to 12.7% and the share of follow-up contacts rose from 45.9% to 50.4% (relative: 8.7%). Quite small changes were seen in the patterns of reasons for encounter and diagnoses from 1993 to 2009. However, an increase was found in contacts with general practice and referrals and in the proportion of follow-ups.

Psychiatric research: what ethical concerns do LRECs encounter? A postal survey. Local research ethics committees.

PubMed

Osborn, D P J; Fulford, K W M

2003-02-01

Psychiatric research can occasionally present particular ethical dilemmas, but it is not clear what kind of problems local research ethics committees (LRECs) actually experience in this field. We aimed to assess the type of problems that committees encounter with psychiatric research, using a postal survey of 211 LRECs. One hundred and seven (51%) of those written to replied within the time limit. Twenty eight (26%) experienced few problems with psychiatric applications. Twenty six (24%) emphasised the value of a psychiatric expert on the committee. The most common issues raised were informed consent (n=64, 60%) and confidentiality (n=17, 16%). The use of placebos (and washout periods) (n=18, 17%), the validity of psychiatric questionnaires (n=16, 15%) and overuse of psychiatric "jargon" (n=14, 13%) in psychiatric applications also raised concern. Our results suggest that LRECs have specific concerns regarding methodology, consent, and confidentiality in psychiatric research, and that they find psychiatric input invaluable.

Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016.

PubMed

Farrer, Louise M; Walker, Jennie; Harrison, Christopher; Banfield, Michelle

2018-01-01

General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.

The Library Manager's Deskbook: 102 Expert Solutions to 101 Common Dilemmas.

ERIC Educational Resources Information Center

Carson, Paula Phillips; And Others

This is a handbook of advice for handling the everyday problems encountered in all types and sizes of libraries. It is designed to assist managers before, during, and after crises develop. Organized in an question-and-answer format, it tackles many dilemmas that can occur in the library, then offers solutions drawn from actual experience. The…

Centralized waste treatment of industrial wastewater

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

Saltzberg, E.R.; Cushnie, G.C. Jr.

1985-01-01

Centralized waste treatment (CWT) for industrial wastewater is described in this book. With the CWT approach, industrial firms send their wastes to a common processing plant. The book addresses the engineering and business-related problems that are encountered by private CWT firms, local governments, and industry in creating sufficient CWT capacity to meet the growing demand for CWT services.

Problems Encountered by Religious Vocational Secondary School and Other Secondary School Students in Physical Education and Sports Activities

ERIC Educational Resources Information Center

Bar, Mustafa; Yaman, Menzure Sibel; Hergüner, Gülten

2016-01-01

The study aimed to determine problems encountered by Religious Vocational Secondary School and other Secondary School students in physical education and sports activities and to compare these problems according to school type and gender. A questionnaire named "Problems encountered in attending to physical education and sports activities"…

The Educational Problems of the Turkish Citizens Living in Switzerland in the Process of Adjustment to Europe

ERIC Educational Resources Information Center

Ari, Asim

2007-01-01

Every society experiences migration and influxes of immigrants. The most common reasons for migration include political and economic obligations as well as wishing access to better educational opportunities. Although the concept of migration is as old as human history, Turkish society encountered the concept after World War II. Two million Turkish…

Using Role-Playing Games to Teach Astronomy: An Evaluation

ERIC Educational Resources Information Center

Francis, Paul

2005-01-01

Since 1998, I've been experimenting with the use of role-playing games to teach astronomy. Students play the role of competing teams of researchers, racing to solve some astrophysical mystery. In this article, I review what has been learned from using these games around the world over the last eight years. The most common problem encountered is a…

Experiences with physical conditioning programs in middle-aged men

NASA Technical Reports Server (NTRS)

Schuster, B.; Stanley, E.

1969-01-01

Long term effects of physical exercise and conditioning in the prevention and treatment of coronary heart disease are studied. Some aspects of the problem are outlined and difficulties encountered in a group of middle aged business executives using a carefully prescribed, but non-regimented and loosely supervised conditioning program employing commonly used forms of exercise (bicycling and jogging), are described.

Eviscerated urinary bladder via ruptured umbilical hernia: a rare occurrence.

PubMed

Pandey, A; Kumar, V; Gangopadhyay, A N; Upadhyaya, V D

2008-06-01

Umbilical hernia is a common problem encountered in children. Rupture and evisceration are very rare phenomena, and the usual content that is eviscerated is the bowel. We present an infant who had a ruptured umbilical hernia with eviscerated urinary bladder dome. As this is the first case of its kind, it is being reported with a brief review of literature.

Facial trauma: general principles of management.

PubMed

Hollier, Larry H; Sharabi, Safa E; Koshy, John C; Stal, Samuel

2010-07-01

Facial fractures are common problems encountered by the plastic surgeon. Although ubiquitous in nature, their optimal treatment requires precise knowledge of the most recent evidence-based and technologically advanced recommendations. This article discusses a variety of contemporary issues regarding facial fractures, including physical and radiologic diagnosis, treatment pearls and caveats, and the role of various synthetic materials and plating technologies for optimal facial fracture fixation.

Towards the development of day one competences in veterinary behaviour medicine: survey of veterinary professionals experience in companion animal practice in Ireland.

PubMed

Golden, Olwen; Hanlon, Alison J

2018-01-01

Veterinary behaviour medicine should be a foundation subject of the veterinary curriculum because of its wide scope of applications to veterinary practice. Private practitioners are likely to be the primary source of information on animal behaviour for most pet owners, however studies indicate that behavioural issues are not frequently discussed during companion animal consultations and many practitioners lack confidence in dealing with behavioural problems, likely due to poor coverage of this subject in veterinary education.There is a need to identify learning outcomes to support day one competences in veterinary behaviour medicine and these should be informed by practice-based evidence. This study aimed to investigate the nature and frequency of behavioural queries experienced by veterinary professionals in Ireland, the provision of behavioural services at companion animal practices, behaviour referral practices and challenges associated with providing a behaviour service. Two online surveys were developed, one for private veterinary practitioners (PVP) and one for veterinary nurses (VN). Invitations to participate were distributed using contact details from the Premises Accreditation Scheme database on the Veterinary Council of Ireland website. Thirty-eight PVPs and 69 VNs completed the survey. Results indicated that less than half of companion animal practices offer behavioural consults and under a third of practices provide training and socialization events. Over half of the practices surveyed have referred cases to a behavioural specialist.The majority of respondents encountered behavioural queries weekly. Ninety-eight percent reported receiving queries regarding dog behaviour. Toilet training and unruly behaviour were two issues encountered frequently. Behavioural issues in cats were also common. House soiling and destructive behaviour were the problems most frequently encountered by respondents.The two most commonly cited barriers to providing behavioural consultations were lack of in-house or personal expertise, and that clients were not willing to pay for these services.Furthermore over half of all veterinary professionals surveyed indicated that they had received inadequate undergraduate training in veterinary behaviour medicine. Behavioural problems in companion animals can affect the quality of life of pets and their owners. Our survey findings indicate that many veterinary professionals frequently encounter behavioural problems and identify an opportunity for improved provision in behaviour medicine in veterinary education.

Reference coordinate systems: An update. Supplement 11

NASA Technical Reports Server (NTRS)

Mueller, Ivan I.

1988-01-01

A common requirement for all geodetic investigations is a well-defined coordinate system attached to the earth in some prescribed way, as well as a well-defined inertial coordinate system in which the motions of the terrestrial frame can be monitored. The paper deals with the problems encountered when establishing such coordinate systems and the transformations between them. In addition, problems related to the modeling of the deformable earth are discussed. This paper is an updated version of the earlier work, Reference Coordinate Systems for Earth Dynamics: A Preview, by the author.

Content-addressable read/write memories for image analysis

NASA Technical Reports Server (NTRS)

Snyder, W. E.; Savage, C. D.

1982-01-01

The commonly encountered image analysis problems of region labeling and clustering are found to be cases of search-and-rename problem which can be solved in parallel by a system architecture that is inherently suitable for VLSI implementation. This architecture is a novel form of content-addressable memory (CAM) which provides parallel search and update functions, allowing speed reductions down to constant time per operation. It has been proposed in related investigations by Hall (1981) that, with VLSI, CAM-based structures with enhanced instruction sets for general purpose processing will be feasible.

Avoiding (or fixing) problems with lawyers and courts.

PubMed

Reid, William H

2013-03-01

Clinicians who do work for attorneys and courts sometimes encounter problems in defining their roles, with access to records or litigants, with unexpected changes or additions to their tasks, or with being compensated for their work. Understanding the context of the forensic consultation and the processes commonly employed by lawyers and the judiciary can prevent many problems. Be cautious about "informal" requests from attorneys, particularly if they involve your own patients. Maintain solid business practices and make sure your role, relationship, and financial agreement with the person or entity retaining you are clear, ethical, and well documented before you begin work on a case.

Meckel’s diverticulum: new solutions for an old problem?

PubMed Central

Chauhan, Abhishek; Suggett, Nigel; Guest, Peter; Goh, Jason

2016-01-01

Meckel's diverticulum (MD) is the most commonly encountered true diverticulum in the small bowel. Although overall a rare cause of gastrointestinal bleeding, it remains an important differential in a child/young adult presenting with lower gastrointestinal bleeding. We present two MD cases, one associated with brisk bleeding resulting in haemodynamic instability and the other in insidious blood loss causing symptoms of chronic iron deficiency. These cases illustrate the heterogeneous nature of the clinical picture associated with Meckel's diverticulae, a condition most gastroenterological and surgical units will encounter. We subsequently discuss the diagnostic and management dilemma Meckel's diverticulae pose and appraise the latest evidence and management strategies in this regard. PMID:28839845

Operational procedures for ground station operation: ATS-3 Hawaii-Ames satellite link experiment

NASA Technical Reports Server (NTRS)

Nishioka, K.; Gross, E. H.

1979-01-01

Hardware description and operational procedures for the ATS-3 Hawaii-Ames satellite computer link are presented in basic step-by-step instructions. Transmit and receive channels and frequencies are given. Details such as switch settings for activating the station to the sequence of turning switches on are provided. Methods and procedures for troubleshooting common problems encountered with communication stations are also provided.

Effects of light regime and IBA concentration on adventitious rooting of an eastern cottonwood (Populus deltoides) clone

Treesearch

Alexander P. Hoffman; Joshua P. Adams; Andrew Nelson

2016-01-01

Eastern cottonwood (Populus deltoides) has received a substantial amount of interest from invitro studies within the past decade. The ability to efficiently multiply the stock of established clones such as clone 110412 is a valuable asset for forest endeavors. However, a common problem encountered is initiating adventitious rooting in new micropropagation protocols....

Medical support for law enforcement-extended operations incidents.

PubMed

Levy, Matthew J; Tang, Nelson

2014-01-01

As the complexity and frequency of law enforcement-extended operations incidents continue to increase, so do the opportunities for adverse health and well-being impacts on the responding officers. These types of clinical encounters have not been well characterized nor have the medical response strategies which have been developed to effectively manage these encounters been well described. The purpose of this article is to provide a descriptive epidemiology of the clinical encounters reported during extended law enforcement operations, as well as to describe a best practices approach for their effective management. This study retrospectively examined the clinical encounters of the Maryland State Police (MSP) Tactical Medical Unit (TMU) during law enforcement extended operations incidents lasting 8 or more hours. In addition, a qualitative analysis was performed on clinical data collected by federal law enforcement agencies during their extended operations. Forty-four percent of missions (455/1,047) supported by the MSP TMU lasted 8 or more hours. Twenty-six percent of these missions (117/455) resulted in at least one patient encounter. Nineteen percent of patient chief complaints (45/238) were related to heat illness/ dehydration. Fifteen percent of encounters (36/238) were for musculoskeletal injury/pain. Eight percent of patients (19/238) had nonspecific sick call (minor illness) complaints. The next most common occurring complaints were cold-related injuries, headache, sinus congestion, and wound/laceration, each of which accounted for 7 percent of patients (16/238), respectively. Analysis of federal law enforcement agencies' response to such events yielded similar clinical encounters. A wide range of health problems are reported by extended law enforcement operations personnel. Timely and effective treatment of these problems can help ensure that the broader operations mission is not compromised. An appropriate operational strategy for managing health complaints reported during extended operations involves the deployment of a well-trained medical support team using the core concepts of tactical emergency medical support.

Solving the Capacitive Effect in the High-Frequency sweep for Langmuir Probe in SYMPLE

NASA Astrophysics Data System (ADS)

Pramila; Patel, J. J.; Rajpal, R.; Hansalia, C. J.; Anitha, V. P.; Sathyanarayana, K.

2017-04-01

Langmuir Probe based measurements need to be routinely carried out to measure various plasma parameters such as the electron density (ne), the electron temperature (Te), the floating potential (Vf), and the plasma potential (Vp). For this, the diagnostic electronics along with the biasing power supplies is installed in standard industrial racks with a 2KV isolation transformer. The Signal Conditioning Electronics (SCE) system is populated inside the 4U-chassis based system with the front-end electronics, designed using high common mode differential amplifiers which can measure small differential signal in presence of high common mode dc- bias or ac ramp voltage used for biasing the probes. DC-biasing of the probe is most common method for getting its I-V characteristic but method of biasing the probe with a sweep at high frequency encounters the problem of corruption of signal due to capacitive effect specially when the sweep period and the discharge time is very fast and die down in the order of μs or lesser. This paper presents and summarises the method of removing such effects encountered while measuring the probe current.

Self-reported occupational health problems among Libyan dentists.

PubMed

Arheiam, Arheiam; Ingafou, Mohamed

2015-01-01

To investigate the prevalence of the most common occupation-related health problems as well as factors associated with their incidence among dental practitioners. A cross-sectional, questionnaire-based survey of Libyan dental practitioners. Participants provided information regarding their experience of occupationally related problems they encountered over the past 12 months which included inquiries about musculoskeletal pain, percutaneous injuries, allergy, eye and sight problems, and hearing problems. Musculoskeletal problems were the most frequently reported (48.2%), followed by percutaneous injuries (35%), eye problems (22%), allergy (11%) and hearing problems (7.6%). Musculoskeletal problems were significantly higher among dentists who work in private sector, full timer as well as those who prefer to work in a sitting position (p=0.021, 0.027 and 0.008, respectively). Practitioners with less than 5 years in service reported significantly higher percentage of percutaneous injuries (p=0.027) than their senior counterparts, whereas practitioners who spent more than 10 years in service were more likely to suffer from visual disturbances (p=0.033). The findings of this study indicate that musculoskeletal problems and percutaneous injuries are the most commonly reported occupational health problems among dentists, whereas allergic reactions and hearing problems are the least reported ones. Dentists should use alternate working positions to minimise musculoskeletal problems and adopt more effective strategies to prevent percutaneous injuries particularly among novices.

Effects of native and non-native grassland plant communities on breeding passerine birds: implications for restoration of northwest bunchgrass prairie

Treesearch

Patricia L. Kennedy; Sandra J. DeBano; Anne M. Bartuszevige; Andrea S. Lueders

2009-01-01

One common problem encountered when restoring grasslands is the prominence of non-native plant species. It is unclear what effect non-native plants have on habitat quality of grassland passerines, which are among the most imperiled groups of birds. In 2004 and 2005, we compared patterns of avian reproduction and the mechanisms that might influence those patterns across...

Diabetes in pregnancy.

PubMed

Spearing, G J

1977-10-01

Diabetes, while at one time a rarity in pregnancy, is now one of the more common medical problems encountered by the obstetrician. Immaculate control is essential and can only be accomplished by close co-operation between the patient and all her medical attendants. The patient can then anticipate an almost trouble free pregnancy and should deliver a baby of normal weight with none of the usual stigmata associated with babies of diabetic mothers.

Nonrheumatoid Arthritis of the Hand.

PubMed

Lans, Jonathan; Machol, Jacques A; Deml, Christian; Chen, Neal C; Jupiter, Jesse B

2018-01-01

Arthropathy of the hand is commonly encountered. Contributing factors such as aging, trauma, and systemic illness all may have a role in the evolution of this pathology. Besides rheumatoid arthritis, other diseases affect the small joints of the hand. A review of nonrheumatoid hand arthropathies is beneficial for clinicians to recognize these problems. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Inflight Medical Events in the Shuttle Program

NASA Technical Reports Server (NTRS)

Baisden, Denise L.; Effenhauser, R. K.; Wear, Mary L.

1999-01-01

Since the first launch of the Space Shuttle in 1981, the astronauts and their flight surgeons have dealt with a variety of inflight medical issues. A review will be provided of these issues as well as medications used in the treatment of these medical problems. Detailed medical debriefs are conducted by the flight ,surgeon with the individual crewmembers three days after landing. These debriefs were review for Shuttle flights from 1988 through 1999 to determine the frequency of inflight medical events. Medical events were grouped by ICD category and the frequency of medical events within those categories were reviewed. The ICD category of Symptoms, Signs and Ill-defined Conditions had the most medical events. Facial fullness and headache were the most common complaints within this category. The ICD category of Respiratory System had the next most common medical events with sinus congestion being the most common complaint. This was followed by Digestive System complaints and Nervous System/Sense Organ complaints. A variety of inflight medical events have occurred throughout the Shuttle program. Fortunately, the majority of these problems have been minor and have been well within the capability of the medical equipment flown and the skills of the Crew Medical Officers. Medical ,problems/procedures that are routine on the ground often present unique problems in the space flight environment. It is important that the flight surgeon understand the common medical problems encountered.

Practical problems which women encounter with available contraception in Australia.

PubMed

Weisberg, E

1994-06-01

Australian women face major difficulties with contraception because of the limited range of choices, the need for meticulous attention to compliance with most available methods and because of cost limitations for a significant minority of the population. The most commonly used methods are oral contraceptive pills and barrier methods, and each has substantial compliance problems which can be minimized with care and counselling. There is an urgent need for a wider range of options in Australia and for good information and publicity about them. Present progress in this direction gives some hope for the near future.

Sleep-related problems in common medical conditions.

PubMed

Parish, James M

2009-02-01

Common medical problems are often associated with abnormalities of sleep. Patients with chronic medical disorders often have fewer hours of sleep and less restorative sleep compared to healthy individuals, and this poor sleep may worsen the subjective symptoms of the disorder. Individuals with lung disease often have disturbed sleep related to oxygen desaturations, coughing, or dyspnea. Both obstructive lung disease and restrictive lung diseases are associated with poor quality sleep. Awakenings from sleep are common in untreated or undertreated asthma, and cause sleep disruption. Gastroesophageal reflux is a major cause of disrupted sleep due to awakenings from heartburn, dyspepsia, acid brash, coughing, or choking. Patients with chronic renal disease commonly have sleep complaints often due to insomnia, insufficient sleep, sleep apnea, or restless legs syndrome. Complaints related to sleep are very common in patients with fibromyalgia and other causes of chronic pain. Sleep disruption increases the sensation of pain and decreases quality of life. Patients with infectious diseases, including acute viral illnesses, HIV-related disease, and Lyme disease, may have significant problems with insomnia and hypersomnolence. Women with menopause have from insomnia, sleep-disordered breathing, restless legs syndrome, or fibromyalgia. Patients with cancer or receiving cancer therapy are often bothered by insomnia or other sleep disturbances that affect quality of life and daytime energy. The objective of this article is to review frequently encountered medical conditions and examine their impact on sleep, and to review frequent sleep-related problems associated with these common medical conditions.

Postinflammatory ossicular fixation: CT analysis with surgical correlation

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

Swartz, J.D.; Wolfson, R.J.; Marlowe, F.I.

1985-03-01

Postinflammatory ossicular fixation is a common problem encountered by the otologic surgeon upon exploration because of conductive hearing loss in patients with chronic otitis media. These nonotosclerotic noncongenital lesions take three pathologic forms: fibrous tissue fixation (chronic adhesive otitis media), hyalinization of collagen (tympanosclerosis), and new bone formation (fibro-osseous sclerosis). More than 300 patients with the clinical diagnosis of chronic otitis media have been examined. This study encompasses 23 proved cases.

Outcome Measures for Heavy Menstrual Bleeding

PubMed Central

Quinn, Stephen D; Higham, Jenny

2016-01-01

Heavy menstrual bleeding is one of the most commonly encountered gynecological problems. While accurate objective quantification of menstrual blood loss is of value in the research setting, it is the subjective assessment of blood loss that is of greater importance when assessing the severity of heavy menstrual bleeding and any subsequent response to treatment. In this review the various approaches to objective, subjective and semi-subjective assessment of menstrual blood loss will be discussed. PMID:26693585

Urological considerations in space medicine.

NASA Technical Reports Server (NTRS)

Cockett, A. T. K.; Adey, W. R.; Roberts, A. P.

1972-01-01

Urological problems encountered during the preparation phases of Biosatellite III, flight of Bonny the Space Monkey, are detailed. The solution to each problem is detailed. The catheter system employed, antibiotic coverage used, and bacteria encountered in the urine of the five animals are detailed. Urinary calcium levels in three ground based animals are illustrated. Testicular alterations encountered in all animals are mentioned. It is concluded that space flights of duration beyond nine days may present serious problems of a urological nature.

Dual stage potential field method for robotic path planning

NASA Astrophysics Data System (ADS)

Singh, Pradyumna Kumar; Parida, Pramod Kumar

2018-04-01

Path planning for autonomous mobile robots are the root for all autonomous mobile systems. Various methods are used for optimization of path to be followed by the autonomous mobile robots. Artificial potential field based path planning method is one of the most used methods for the researchers. Various algorithms have been proposed using the potential field approach. But in most of the common problems are encounters while heading towards the goal or target. i.e. local minima problem, zero potential regions problem, complex shaped obstacles problem, target near obstacle problem. In this paper we provide a new algorithm in which two types of potential functions are used one after another. The former one is to use to get the probable points and later one for getting the optimum path. In this algorithm we consider only the static obstacle and goal.

Identification and Management of Information Problems by Emergency Department Staff

PubMed Central

Murphy, Alison R.; Reddy, Madhu C.

2014-01-01

Patient-care teams frequently encounter information problems during their daily activities. These information problems include wrong, outdated, conflicting, incomplete, or missing information. Information problems can negatively impact the patient-care workflow, lead to misunderstandings about patient information, and potentially lead to medical errors. Existing research focuses on understanding the cause of these information problems and the impact that they can have on the hospital’s workflow. However, there is limited research on how patient-care teams currently identify and manage information problems that they encounter during their work. Through qualitative observations and interviews in an emergency department (ED), we identified the types of information problems encountered by ED staff, and examined how they identified and managed the information problems. We also discuss the impact that these information problems can have on the patient-care teams, including the cascading effects of information problems on workflow and the ambiguous accountability for fixing information problems within collaborative teams. PMID:25954457

Problems Encountered during the Scientific Research Process in Graduate Education: The Institute of Educational Sciences

ERIC Educational Resources Information Center

Akyürek, Erkan; Afacan, Özlem

2018-01-01

This study was conducted to determine the problems faced by graduate students when conducting scientific research and to make suggestions for solving these problems. The research model was a case study. Semi-structured interviews were conducted with participants in the study with questions about the problems encountered during scientific research…

Response problems in a vacation panel study

Treesearch

Christine A. Vogt; Susan I. Stewart

2001-01-01

This paper investigates response problems encountered in a panel study of travel behavior. Though the overall response rate to the three-wave panel study was acceptable (over 60%), three types of response problems were encountered: refusal, non-response, and attrition. In a follow-up phone survey, a sample of individuals from each problem response group was questioned...

Swallowing Disorders in Schizophrenia.

PubMed

Kulkarni, Deepika P; Kamath, Vandan D; Stewart, Jonathan T

2017-08-01

Disorders of swallowing are poorly characterized but quite common in schizophrenia. They are a source of considerable morbidity and mortality in this population, generally as a result of either acute asphyxia from airway obstruction or more insidious aspiration and pneumonia. The death rate from acute asphyxia may be as high as one hundred times that of the general population. Most swallowing disorders in schizophrenia seem to fall into one of two categories, changes in eating and swallowing due to the illness itself and changes related to psychotropic medications. Behavioral changes related to the illness are poorly understood and often involve eating too quickly or taking inappropriately large boluses of food. Iatrogenic problems are mostly related to drug-induced extrapyramidal side effects, including drug-induced parkinsonism, dystonia, and tardive dyskinesia, but may also include xerostomia, sialorrhea, and changes related to sedation. This paper will provide an overview of common swallowing problems encountered in patients with schizophrenia, their pathophysiology, and management. While there is a scarcity of quality evidence in the literature, a thorough history and examination will generally elucidate the predominant problem or problems, often leading to effective management strategies.

Nonlinear model predictive control of a wave energy converter based on differential flatness parameterisation

NASA Astrophysics Data System (ADS)

Li, Guang

2017-01-01

This paper presents a fast constrained optimization approach, which is tailored for nonlinear model predictive control of wave energy converters (WEC). The advantage of this approach relies on its exploitation of the differential flatness of the WEC model. This can reduce the dimension of the resulting nonlinear programming problem (NLP) derived from the continuous constrained optimal control of WEC using pseudospectral method. The alleviation of computational burden using this approach helps to promote an economic implementation of nonlinear model predictive control strategy for WEC control problems. The method is applicable to nonlinear WEC models, nonconvex objective functions and nonlinear constraints, which are commonly encountered in WEC control problems. Numerical simulations demonstrate the efficacy of this approach.

NMESys: An expert system for network fault detection

NASA Technical Reports Server (NTRS)

Nelson, Peter C.; Warpinski, Janet

1991-01-01

The problem of network management is becoming an increasingly difficult and challenging task. It is very common today to find heterogeneous networks consisting of many different types of computers, operating systems, and protocols. The complexity of implementing a network with this many components is difficult enough, while the maintenance of such a network is an even larger problem. A prototype network management expert system, NMESys, implemented in the C Language Integrated Production System (CLIPS). NMESys concentrates on solving some of the critical problems encountered in managing a large network. The major goal of NMESys is to provide a network operator with an expert system tool to quickly and accurately detect hard failures, potential failures, and to minimize or eliminate user down time in a large network.

Management of vertebral compression fracture in general practice: BEACH program.

PubMed

Megale, Rodrigo Z; Pollack, Allan; Britt, Helena; Latimer, Jane; Naganathan, Vasi; McLachlan, Andrew J; Ferreira, Manuela L

2017-01-01

The pain associated with vertebral compression fractures can cause significant loss of function and quality of life for older adults. Despite this, there is little consensus on how best to manage this condition. To describe usual care provided by general practitioners (GPs) in Australia for the management of vertebral compression fractures. Data from the Bettering the Evaluation And Care of Health (BEACH) program collected between April 2005 and March 2015 was used for this study. Each year, a random sample of approximately 1,000 GPs each recorded information on 100 consecutive encounters. We selected those encounters at which vertebral compression fracture was managed. Analyses of management options were limited to encounters with patients aged 50 years or over. i) patient demographics; ii) diagnoses/problems managed; iii) the management provided for vertebral compression fracture during the encounter. Robust 95% confidence intervals, adjusted for the cluster survey design, were used to assess significant differences between group means. Vertebral compression fractures were managed in 211 (0.022%; 95% CI: 0.018-0.025) of the 977,300 BEACH encounters recorded April 2005- March 2015. That provides a national annual estimate of 26,000 (95% CI: 22,000-29,000) encounters at which vertebral fractures were managed. At encounters with patients aged 50 years or over (those at higher risk of primary osteoporosis), prescription of analgesics was the most common management action, particularly opioids analgesics (47.1 per 100 vertebral fractures; 95% CI: 38.4-55.7). Prescriptions of paracetamol (8.2; 95% CI: 4-12.4) or non-steroidal anti-inflammatory drugs (4.1; 95% CI: 1.1-7.1) were less frequent. Non-pharmacological treatment was provided at a rate of 22.4 per 100 vertebral fractures (95% CI: 14.6-30.1). At least one referral (to hospital, specialist, allied health care or other) was given for 12.3 per 100 vertebral fractures (95% CI: 7.8-16.8). The prescription of oral opioid analgesics remains the common general practice approach for vertebral compression fractures management, despite the lack of evidence to support this. Clinical trials addressing management of these fractures are urgently needed to improve the quality of care patients receive.

Common Speech Problems Encountered in General Practice

PubMed Central

Godfrey, Charles M.; Ward, Jean F.

1962-01-01

The authors consider speech and communication in the light of whole patient care and point out that defects may be signs and symptoms of underlying organic disease. They describe the four classifications of speech disorders—articulation, rhythm, voice and language, with an indication of the speech therapy required and duration of treatment. Special emphasis has been given to those speech problems which are seen by the family physician; these are usually of the articulation group. A short discussion of stuttering and aphasia is given. Emphasis is put on the direction of treatment by the physician and the use of well-qualified personnel as members of the rehabilitation team. PMID:13963265

Recurrent vulvovaginitis.

PubMed

Powell, Anna M; Nyirjesy, Paul

2014-10-01

Vulvovaginitis (VV) is one of the most commonly encountered problems by a gynecologist. Many women frequently self-treat with over-the-counter medications, and may present to their health-care provider after a treatment failure. Vulvovaginal candidiasis, bacterial vaginosis, and trichomoniasis may occur as discreet or recurrent episodes, and have been associated with significant treatment cost and morbidity. We present an update on diagnostic capabilities and treatment modalities that address recurrent and refractory episodes of VV. Copyright © 2014 Elsevier Ltd. All rights reserved.

Dysphagia and dentistry.

PubMed

Curl, Charlotte; Boyle, Carole

2014-06-01

Dysphagia is defined as a 'difficulty in swallowing' and is commonly found in the general population, particularly in the elderly. This article gives an overview of the more frequently encountered swallowing disorders and provides advice on how to manage the dysphagic patient in the dental surgery. Clinical Relevance: By identifying patients with dysphagia and being aware of the potential problems that the clinician may experience when treating them, the risk of aspiration, choking and healthcare-acquired upper respiratory tract infections may be reduced.

The influence of solvent processing on polyester bioabsorbable polymers.

PubMed

Manson, Joanne; Dixon, Dorian

2012-01-01

Solvent-based methods are commonly employed for the production of polyester-based samples and coatings in both medical device production and research. The influence of solvent casting and subsequent drying time was studied using thermal analysis, spectroscopy and weight measurement for four grades of 50 : 50 poly(lactic-co-glycolic acid) (PLGA) produced by using chloroform, dichloromethane, and acetone. The results demonstrate that solvent choice and PLGA molecular weight are critical factors in terms of solvent removal rate and maintaining sample integrity, respectively. The protocols widely employed result in high levels of residual solvent and a new protocol is presented together with solutions to commonly encountered problems.

Treatment of Fungal Urinary Tract Infection.

PubMed

Thomas, Lewis; Tracy, Chad R

2015-11-01

Funguria, and particularly candiduria, is an increasingly common problem encountered by the practicing urologist and is associated with high-acuity care, indwelling catheters, diabetes mellitus, antibiotic and steroid use, and urinary tract disease. In most cases, candiduria is asymptomatic and follows a benign clinical course with antifungal therapy only required in symptomatic or high-risk cases, because spontaneous resolution is common in patients with asymptomatic colonization. Rarely, invasive infections can occur (such as fungus balls or renal abscesses) and may require percutaneous and endoscopic interventions. This article highlights the workup and treatment of funguria and its related urologic manifestations. Copyright © 2015 Elsevier Inc. All rights reserved.

International Classification of Primary Care-2 coding of primary care data at the general out-patients' clinic of General Hospital, Lagos, Nigeria.

PubMed

Olagundoye, Olawunmi Abimbola; van Boven, Kees; van Weel, Chris

2016-01-01

Primary care serves as an integral part of the health systems of nations especially the African continent. It is the portal of entry for nearly all patients into the health care system. Paucity of accurate data for health statistics remains a challenge in the most parts of Africa because of inadequate technical manpower and infrastructure. Inadequate quality of data systems contributes to inaccurate data. A simple-to-use classification system such as the International Classification of Primary Care (ICPC) may be a solution to this problem at the primary care level. To apply ICPC-2 for secondary coding of reasons for encounter (RfE), problems managed and processes of care in a Nigerian primary care setting. Furthermore, to analyze the value of selected presented symptoms as predictors of the most common diagnoses encountered in the study setting. Content analysis of randomly selected patients' paper records for data collection at the end of clinic sessions conducted by family physicians at the general out-patients' clinics. Contents of clinical consultations were secondarily coded with the ICPC-2 and recorded into excel spreadsheets with fields for sociodemographic data such as age, sex, occupation, religion, and ICPC elements of an encounter: RfE/complaints, diagnoses/problems, and interventions/processes of care. Four hundred and one encounters considered in this study yielded 915 RfEs, 546 diagnoses, and 1221 processes. This implies an average of 2.3 RfE, 1.4 diagnoses, and 3.0 processes per encounter. The top 10 RfE, diagnoses/common illnesses, and processes were determined. Through the determination of the probability of the occurrence of certain diseases beginning with a RfE/complaint, the top five diagnoses that resulted from each of the top five RfE were also obtained. The top five RfE were: headache, fever, pain general/multiple sites, visual disturbance other and abdominal pain/cramps general. The top five diagnoses were: Malaria, hypertension uncomplicated, visual disturbance other, peptic ulcer, and upper respiratory infection. From the determination of the posterior probability given the top five RfE, malaria, hypertension, upper respiratory infection, refractive error, and conjuctivitis were the five most frequent diagnoses that resulted from a complaint of a headache. The study demonstrated that ICPC-2 can be applied to primary care data in the Nigerian context to generate information about morbidity and services provided. It also provided an empirical basis to support diagnosis and prognostication in a primary care setting. In developing countries where the transition to electronic health records is still evolving and fraught with limitations, more reliable data collection can be achieved from paper records through the application of the ICPC-2.

Everyday Ethics: Ethical Issues and Stress in Nursing Practice

PubMed Central

Ulrich, Connie M.; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-01-01

Aim This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Background Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. Methods A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analyzed using descriptive statistics, cross-tabulations and Pearson correlations. Results A total of 422 questionnaires were used in the analysis. The five most frequently-occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Conclusion Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. PMID:20735502

Everyday ethics: ethical issues and stress in nursing practice.

PubMed

Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-11-01

This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.

What inhibits working women with mental disorders from returning to their workplace?-A study of systematic re-employment support in a medical institution.

PubMed

Hayashi, Karin; Taira, Yoichi; Maeda, Takamitsu; Matsuda, Yumie; Kato, Yuki; Hashi, Kozue; Kuroki, Nobuo; Katsuragawa, Shuichi

2016-01-01

It has been customary for working women in Japan to retire when they marry and to devote themselves to household work as well as having children. However, according to a report published by the Ministry of Internal Affairs and Communications in 2013, the number of working women has increased consistently. As more women are advancing into society, they have more options with respect to lifestyle but may encounter new psychological burdens. Therefore, we reviewed trends among participants in a re-work day care program (hereinafter referred to as "re-work program") to clarify various problems encountered by working women and the prevalence of mental disorders. A total of 454 participants (352 males, mean age 46.5 ± 9.4 years; 102 females, mean age 39.8 ± 9.4 years) who participated in our re-work program were included in this study. We reviewed their basic characteristics: life background, clinical diagnoses, outcomes after use of the re-work program, and reasons for failing to return to the workplace or start working where applicable. The number of female participants was small and accounted for less than one fourth of all participants. As many as 67.3 % of the males succeeded in returning to the workplace, but only 48.0 % of the females were successful. The most common reason for failing to return to the workplace in both sexes was the exacerbation of symptoms; among females, other reasons, such as pregnancy, marriage, and family circumstances, were observed occasionally, but these reasons were not reported by the males. We found that female-specific problems were not the only issue, but rather work-life balance, relationships in the workplace, and gender differences in work roles could also trigger psychiatric disorders. A deeper understanding of the problems encountered by women in the workforce is important for the treatment of their psychiatric disorders. Therefore, it is considered essential for family members, co-workers, medical staff, and others to understand the various problems encountered by working women. Coping with these problems appropriately will aid in treating mental disorders and creating an environment suitable to prevent their development among women.

Elasticity solutions for a class of composite laminate problems with stress singularities

NASA Technical Reports Server (NTRS)

Wang, S. S.

1983-01-01

A study on the fundamental mechanics of fiber-reinforced composite laminates with stress singularities is presented. Based on the theory of anisotropic elasticity and Lekhnitskii's complex-variable stress potentials, a system of coupled governing partial differential equations are established. An eigenfunction expansion method is introduced to determine the orders of stress singularities in composite laminates with various geometric configurations and material systems. Complete elasticity solutions are obtained for this class of singular composite laminate mechanics problems. Homogeneous solutions in eigenfunction series and particular solutions in polynomials are presented for several cases of interest. Three examples are given to illustrate the method of approach and the basic nature of the singular laminate elasticity solutions. The first problem is the well-known laminate free-edge stress problem, which has a rather weak stress singularity. The second problem is the important composite delamination problem, which has a strong crack-tip stress singularity. The third problem is the commonly encountered bonded composite joints, which has a complex solution structure with moderate orders of stress singularities.

Peritoneal dialysis glossary 2009.

PubMed

Liakopoulos, Vassilios; Stefanidis, Ioannis; Dombros, Nicholas V

2010-06-01

A number of attempts to create a commonly accepted terminology regarding definitions and terms used for clinical entities, methods, problems, and materials encountered by health professionals involved in peritoneal dialysis (PD) were undertaken in the past, the last one in 1990. Later on, some relevant sporadic attempts in a number of textbooks have been made, but they did not include the whole spectrum of PD. This glossary is an attempt to address the need for a universally accepted PD terminology including the latest advances in PD connection systems and fluids.

The Experimental Design Assistant.

PubMed

Percie du Sert, Nathalie; Bamsey, Ian; Bate, Simon T; Berdoy, Manuel; Clark, Robin A; Cuthill, Innes; Fry, Derek; Karp, Natasha A; Macleod, Malcolm; Moon, Lawrence; Stanford, S Clare; Lings, Brian

2017-09-01

Addressing the common problems that researchers encounter when designing and analysing animal experiments will improve the reliability of in vivo research. In this article, the Experimental Design Assistant (EDA) is introduced. The EDA is a web-based tool that guides the in vivo researcher through the experimental design and analysis process, providing automated feedback on the proposed design and generating a graphical summary that aids communication with colleagues, funders, regulatory authorities, and the wider scientific community. It will have an important role in addressing causes of irreproducibility.

[Primary carcinoma of the thyroid growing in thyroglossal duct cyst: presentation of two cases].

PubMed

Godlewska, Paulina; Bruszewska, Elzbieta; Kozłowicz-Gudzińska, Izabella; Prokurat, Andrzej I; Chrupek, Małgorzata; Zegadło-Mylik, Maria A; Kluge, Przemysław

2007-01-01

Thyroglossal duct remnants (TGDR), most often cysts, are the most common type of developmental abnormalities of the thyroid gland. In about 1 to 2% of TGDR neoplastic transformation occurs. Papillary carcinoma of the thyroid may be encountered in over 90% of such cases. Two cases of primary papillary carcinoma of the thyroid in TGDR in young girls are presented. The diagnostic and therapeutic problems are shared, and up-to-date management guidelines in similar cases are discussed.

The Experimental Design Assistant

PubMed Central

Bamsey, Ian; Bate, Simon T.; Berdoy, Manuel; Clark, Robin A.; Cuthill, Innes; Fry, Derek; Karp, Natasha A.; Macleod, Malcolm; Moon, Lawrence; Stanford, S. Clare; Lings, Brian

2017-01-01

Addressing the common problems that researchers encounter when designing and analysing animal experiments will improve the reliability of in vivo research. In this article, the Experimental Design Assistant (EDA) is introduced. The EDA is a web-based tool that guides the in vivo researcher through the experimental design and analysis process, providing automated feedback on the proposed design and generating a graphical summary that aids communication with colleagues, funders, regulatory authorities, and the wider scientific community. It will have an important role in addressing causes of irreproducibility. PMID:28957312

Challenges in conducting qualitative research in health: A conceptual paper.

PubMed

Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

2015-01-01

Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others.

Shuttle Orbiter Active Thermal Control Subsystem design and flight experience

NASA Technical Reports Server (NTRS)

Bond, Timothy A.; Metcalf, Jordan L.; Asuncion, Carmelo

1991-01-01

The paper examines the design of the Space Shuttle Orbiter Active Thermal Control Subsystem (ATCS) constructed for providing the vehicle and payload cooling during all phases of a mission and during ground turnaround operations. The operation of the Shuttle ATCS and some of the problems encountered during the first 39 flights of the Shuttle program are described, with special attention given to the major problems encountered with the degradation of the Freon flow rate on the Orbiter Columbia, the Flash Evaporator Subsystem mission anomalies which occurred on STS-26 and STS-34, and problems encountered with the Ammonia Boiler Subsystem. The causes and the resolutions of these problems are discussed.

A Study on the Application of Creative Problem Solving Teaching to Statistics Teaching

ERIC Educational Resources Information Center

Hu, Ridong; Xiaohui, Su; Shieh, Chich-Jen

2017-01-01

Everyone would encounter the life issue of solving complicated problems generated by economic behaviors among all activities for making a living. Various life problems encountered therefore could be generalized by economic statistics. In other words, a lot of important events in daily life are related to economic statistics. For this reason,…

The present status of geography education in boys' intermediate schools of Riyadh, Saudi Arabia

NASA Astrophysics Data System (ADS)

Al-Gahtany, Abdulrahman Mohammed

The purpose of this study was to describe the present status of geography education in boys' intermediate schools in Riyadh, Saudi Arabia as perceived by geography teachers and supervisors; that is, to investigate the objectives, content, methods of teaching, tools and resources that are available and used in classrooms, evaluation techniques, and problems encountered in the teaching of geography. To collect data from this representative sample population, a questionnaire was developed by the researcher specifically for this study. Questionnaire data was collected from 19 social studies supervisors and 213 geography teachers. Percentages, frequencies, means, and standard deviations were computed for each questionnaire item. Chi Square tests were applied to determine if any significant differences could be identified between the observed and expected responses of supervisors and teachers. Major findings of the study indicated that both supervisors and teachers tend to strongly support the identified geography objectives. Most teachers and supervisors also indicated that the current geography curriculum contains enough information about Saudi Arabia, the Arabic world, and the Islamic world. In addition, the also indicated that geography content promotes a sense of patriotism and cultural pride. Responses indicated that educators see deficiencies in the content: it does not focus sufficiently on current events nor on developing student skills such as research and technical skills like drawing maps. Lecture and discussion are the most commonly used strategies in the teaching of geography. Field trips, role-playing, scientific competitions, scientific games, solving problems, and individual learning are less commonly used. Teaching tools most commonly used are wall maps and earth globes, whereas the use of geographical transparencies, models, and instruments is not common. Most of the teachers do lot use computers in their teaching. Evaluation techniques depend completely on traditional examinations to evaluate the performance of the students. Chi-square test shows that there are significant differences in observed and expected frequencies between teachers and supervisors with respect to geography learning objectives, geography content, methods of teaching, tools and resources, and the problems that geography teachers encounter in their teaching.

Medical treatment of acquired nystagmus.

PubMed

Ehrhardt, David; Eggenberger, Eric

2012-11-01

This article synthesises recent findings and addresses relevant anatomy, pathophysiologic considerations, and current treatment options for common forms of acquired nystagmus including vestibular and gaze holding dysfunction. Some forms of nystagmus have relatively specific treatments, such as baclofen for periodic alternating nystagmus, and repositioning for benign paroxysmal positional vertigo. Recent studies have brought changes to many of the treatments of nystagmus variants. Additionally, other recent advances in nystagmus treatment, like the usage of 4-aminopyridine, have added potent medications to the physician's armamentarium. Nystagmus is a commonly encountered entity in clinical practice. However, evidence supported treatments are scarce. Medical treatment of nystagmus is difficult, with often limited and variable response to pharmacologic therapies. This mandates a continued re-evaluation of patients and creation of an individualized approach to this common clinical problem.

Use of Emergency Department Data to Monitor and Respond to an Increase in Opioid Overdoses in New Hampshire, 2011-2015.

PubMed

Daly, Elizabeth R; Dufault, Kenneth; Swenson, David J; Lakevicius, Paul; Metcalf, Erin; Chan, Benjamin P

Opioid-related overdoses and deaths in New Hampshire have increased substantially in recent years, similar to increases observed across the United States. We queried emergency department (ED) data in New Hampshire to monitor opioid-related ED encounters as part of the public health response to this health problem. We obtained data on opioid-related ED encounters for the period January 1, 2011, through December 31, 2015, from New Hampshire's syndromic surveillance ED data system by querying for (1) chief complaint text related to the words "fentanyl," "heroin," "opiate," and "opioid" and (2) opioid-related International Classification of Diseases ( ICD) codes. We then analyzed the data to calculate frequencies of opioid-related ED encounters by age, sex, residence, chief complaint text values, and ICD codes. Opioid-related ED encounters increased by 70% during the study period, from 3300 in 2011 to 5603 in 2015; the largest increases occurred in adults aged 18-29 and in males. Of 20 994 total opioid-related ED visits, we identified 18 554 (88%) using ICD code alone, 690 (3%) using chief complaint text alone, and 1750 (8%) using both chief complaint text and ICD code. For those encounters identified by ICD code only, the corresponding chief complaint text included varied and nonspecific words, with the most common being "pain" (n = 3335, 18%), "overdose" (n = 1555, 8%), "suicidal" (n = 816, 4%), "drug" (n = 803, 4%), and "detox" (n = 750, 4%). Heroin-specific encounters increased by 827%, from 4% of opioid-related encounters in 2011 to 24% of encounters in 2015. Opioid-related ED encounters in New Hampshire increased substantially from 2011 to 2015. Data from New Hampshire's ED syndromic surveillance system provided timely situational awareness to public health partners to support the overall response to the opioid epidemic.

Auricular reconstruction for microtia: Part II. Surgical techniques.

PubMed

Walton, Robert L; Beahm, Elisabeth K

2002-07-01

Reconstruction of the microtic ear represents one of the most demanding challenges in reconstructive surgery. In this review the two most commonly used techniques for ear reconstruction, the Brent and Nagata techniques, are addressed in detail. Unique to this endeavor, the originator of each technique has been allowed to submit representative case material and to address the pros and cons of the other's technique. What follows is a detailed, insightful overview of microtia reconstruction, as a state of the art. The review then details commonly encountered problems in ear reconstruction and pertinent technical points. Finally, a glimpse into the future is offered with an accounting of the advances made in tissue engineering as this technology applies to auricular reconstruction.

Definition of boundary and initial conditions in the analysis of saturated ground-water flow systems - An introduction

USGS Publications Warehouse

Franke, O. Lehn; Reilly, Thomas E.; Bennett, Gordon D.

1987-01-01

Accurate definition of boundary and initial conditions is an essential part of conceptualizing and modeling ground-water flow systems. This report describes the properties of the seven most common boundary conditions encountered in ground-water systems and discusses major aspects of their application. It also discusses the significance and specification of initial conditions and evaluates some common errors in applying this concept to ground-water-system models. An appendix is included that discusses what the solution of a differential equation represents and how the solution relates to the boundary conditions defining the specific problem. This report considers only boundary conditions that apply to saturated ground-water systems.

Neutropenia and Neutropenic Complications in ABVD Chemotherapy for Hodgkin Lymphoma

PubMed Central

Vakkalanka, Bhanu; Link, Brian K.

2011-01-01

A combination of Adriamycin (a.k.a. Doxorubicin), Bleomycin, Vinblastine, and Dacarbazine (ABVD) is the most commonly used chemotherapy regime for Hodgkin lymphoma. This highly effective treatment is associated with a significant risk of neutropenia. Various strategies are adopted to counter this commonly encountered problem, including dose modification, use of colony stimulating factors, and prophylactic or therapeutic use of antibiotics. Data to support these approaches is somewhat controversial, and in keeping with the paucity of definitive evidence, there is a wide disparity in the management of neutropenia in patients receiving ABVD chemotherapy. This paper summarizes the evidence for managing ABVD-related neutropenia during the treatment of Hodgkin lymphoma. PMID:21687649

Broken bones: common pediatric fractures--part I.

PubMed

Hart, Erin S; Albright, Maurice B; Rebello, Gleeson N; Grottkau, Brian E

2006-01-01

Musculoskeletal injuries are one of the most frequently encountered problems in pediatric practice, with fractures accounting for a surprisingly large percentage of these injuries. A fracture occurs when bone is subjected to more energy than it can absorb. Pediatric healthcare providers must have a good understanding of normal bone growth and development and must recognize common mechanisms of injury and fracture patterns seen in children. Nearly 20% of children who present with an injury have a fracture, and it is estimated that 42% of boys and 27% of girls will sustain a fracture during childhood (Wilkins, 1996). The immature skeleton has several unique properties that directly affect the management of fractures in children.

Commons problems, common ground: Earth-surface dynamics and the social-physical interdisciplinary frontier

NASA Astrophysics Data System (ADS)

Lazarus, E.

2015-12-01

In the archetypal "tragedy of the commons" narrative, local farmers pasture their cows on the town common. Soon the common becomes crowded with cows, who graze it bare, and the arrangement of open access to a shared resource ultimately fails. The "tragedy" involves social and physical processes, but the denouement depends on who is telling the story. An economist might argue that the system collapses because each farmer always has a rational incentive to graze one more cow. An ecologist might remark that the rate of grass growth is an inherent control on the common's carrying capacity. And a geomorphologist might point out that processes of soil degradation almost always outstrip processes of soil production. Interdisciplinary research into human-environmental systems still tends to favor disciplinary vantages. In the context of Anthropocene grand challenges - including fundamental insight into dynamics of landscape resilience, and what the dominance of human activities means for processes of change and evolution on the Earth's surface - two disciplines in particular have more to talk about than they might think. Here, I use three examples - (1) beach nourishment, (2) upstream/downstream fluvial asymmetry, and (3) current and historical "land grabbing" - to illustrate a range of interconnections between physical Earth-surface science and common-pool resource economics. In many systems, decision-making and social complexity exert stronger controls on landscape expression than do physical geomorphological processes. Conversely, human-environmental research keeps encountering multi-scale, emergent problems of resource use made 'common-pool' by water, nutrient and sediment transport dynamics. Just as Earth-surface research can benefit from decades of work on common-pool resource systems, quantitative Earth-surface science can make essential contributions to efforts addressing complex problems in environmental sustainability.

Syllable-constituent perception by hearing-aid users: Common factors in quiet and noise

PubMed Central

Miller, James D.; Watson, Charles S.; Leek, Marjorie R.; Dubno, Judy R.; Wark, David J.; Souza, Pamela E.; Gordon-Salant, Sandra; Ahlstrom, Jayne B.

2017-01-01

The abilities of 59 adult hearing-aid users to hear phonetic details were assessed by measuring their abilities to identify syllable constituents in quiet and in differing levels of noise (12-talker babble) while wearing their aids. The set of sounds consisted of 109 frequently occurring syllable constituents (45 onsets, 28 nuclei, and 36 codas) spoken in varied phonetic contexts by eight talkers. In nominal quiet, a speech-to-noise ratio (SNR) of 40 dB, scores of individual listeners ranged from about 23% to 85% correct. Averaged over the range of SNRs commonly encountered in noisy situations, scores of individual listeners ranged from about 10% to 71% correct. The scores in quiet and in noise were very strongly correlated, R = 0.96. This high correlation implies that common factors play primary roles in the perception of phonetic details in quiet and in noise. Otherwise said, hearing-aid users' problems perceiving phonetic details in noise appear to be tied to their problems perceiving phonetic details in quiet and vice versa. PMID:28464618

The Use of Proteomic Tools to Address Challenges Faced in Clonal Propagation of Tropical Crops through Somatic Embryogenesis.

PubMed

Chin, Chiew Foan; Tan, Hooi Sin

2018-05-04

In many tropical countries with agriculture as the mainstay of the economy, tropical crops are commonly cultivated at the plantation scale. The successful establishment of crop plantations depends on the availability of a large quantity of elite seedling plants. Many plantation companies establish plant tissue culture laboratories to supply planting materials for their plantations and one of the most common applications of plant tissue culture is the mass propagation of true-to-type elite seedlings. However, problems encountered in tissue culture technology prevent its applications being widely adopted. Proteomics can be a powerful tool for use in the analysis of cultures, and to understand the biological processes that takes place at the cellular and molecular levels in order to address these problems. This mini review presents the tissue culture technologies commonly used in the propagation of tropical crops. It provides an outline of some the genes and proteins isolated that are associated with somatic embryogenesis and the use of proteomic technology in analysing tissue culture samples and processes in tropical crops.

Anal Health Care Basics

PubMed Central

Chang, Jason; McLemore, Elisabeth; Tejirian, Talar

2016-01-01

Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate. Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area. Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases. In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists. PMID:27723447

[Features of cranio-cerebral trauma in victims of road accidents].

PubMed

Ogleznev, K Ia; Stankevich, P V

2001-01-01

The paper deals with the specific features of brain injury (BI) in victims of road traffic accidents (RTA). RTA victims are most commonly pedestrians (62.6%) and less commonly drivers (17.5%). In over half the cases (62.6%), BI due to RTA is associated with extracranial lesions, leading to diagnostic problems. The pattern and site of lesions are related to the type of a transport vehicle and to the role of a victim as a traffic participant. Multiple extracranial lesions are mostly frequently encountered in victim pedestrians (30.3%), BI concurrent with chest damage is common in drivers (12.8%), BI concurrent with "whip" injury of the cervical spine is found in drivers and passengers though such combinations may also seen in pedestrians (1.5%--5 cases). The most severe form of brain compression is multifactorial compression (27.6%) and its most common form is compression with subdural hematoma (35.3%).

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

Araujo, R. A. N.; Sfair, R.; Winter, O. C., E-mail: ran.araujo@gmail.com, E-mail: rsfair@feg.unesp.br, E-mail: ocwinter@gmail.com

The Centaur population is composed of minor bodies wandering between the giant planets that frequently perform close gravitational encounters with these planets, leading to a chaotic orbital evolution. Recently, the discovery of two well-defined narrow rings was announced around the Centaur 10199 Chariklo. The rings are assumed to be in the equatorial plane of Chariklo and to have circular orbits. The existence of a well-defined system of rings around a body in such a perturbed orbital region poses an interesting new problem. Are the rings of Chariklo stable when perturbed by close gravitational encounters with the giant planets? Our approachmore » to address this question consisted of forward and backward numerical simulations of 729 clones of Chariklo, with similar initial orbits, for a period of 100 Myr. We found, on average, that each clone experiences during its lifetime more than 150 close encounters with the giant planets within one Hill radius of the planet in question. We identified some extreme close encounters that were able to significantly disrupt or disturb the rings of Chariklo. About 3% of the clones lose their rings and about 4% of the clones have their rings significantly disturbed. Therefore, our results show that in most cases (more than 90%), the close encounters with the giant planets do not affect the stability of the rings in Chariklo-like systems. Thus, if there is an efficient mechanism that creates the rings, then these structures may be common among these kinds of Centaurs.« less

Identification of commonly encountered Pratylenchus in Oregon

USDA-ARS?s Scientific Manuscript database

Pratylenchus species are commonly encountered in soil samples collected from a diversity of economically important crops in Oregon, including potato and small fruits. Proper identification is critical to the selection of an appropriate management strategy since, in many cases, populations are an as...

Lessons Learned From the Development, Operation, and Review of Mechanical Systems on the Space Shuttle, International Space Station, and Payloads

NASA Technical Reports Server (NTRS)

Dinsel, Alison; Jermstad, Wayne; Robertson, Brandan

2006-01-01

The Mechanical Design and Analysis Branch at the Johnson Space Center (JSC) is responsible for the technical oversight of over 30 mechanical systems flying on the Space Shuttle Orbiter and the International Space Station (ISS). The branch also has the responsibility for reviewing all mechanical systems on all Space Shuttle and International Space Station payloads, as part of the payload safety review process, through the Mechanical Systems Working Group (MSWG). These responsibilities give the branch unique insight into a large number of mechanical systems, and problems encountered during their design, testing, and operation. This paper contains narrative descriptions of lessons learned from some of the major problems worked on by the branch during the last two years. The problems are grouped into common categories and lessons learned are stated.

Survey of editors and reviewers of high-impact psychology journals: statistical and research design problems in submitted manuscripts.

PubMed

Harris, Alex; Reeder, Rachelle; Hyun, Jenny

2011-01-01

The authors surveyed 21 editors and reviewers from major psychology journals to identify and describe the statistical and design errors they encounter most often and to get their advice regarding prevention of these problems. Content analysis of the text responses revealed themes in 3 major areas: (a) problems with research design and reporting (e.g., lack of an a priori power analysis, lack of congruence between research questions and study design/analysis, failure to adequately describe statistical procedures); (b) inappropriate data analysis (e.g., improper use of analysis of variance, too many statistical tests without adjustments, inadequate strategy for addressing missing data); and (c) misinterpretation of results. If researchers attended to these common methodological and analytic issues, the scientific quality of manuscripts submitted to high-impact psychology journals might be significantly improved.

Use of 3D vision for fine robot motion

NASA Technical Reports Server (NTRS)

Lokshin, Anatole; Litwin, Todd

1989-01-01

An integration of 3-D vision systems with robot manipulators will allow robots to operate in a poorly structured environment by visually locating targets and obstacles. However, by using computer vision for objects acquisition makes the problem of overall system calibration even more difficult. Indeed, in a CAD based manipulation a control architecture has to find an accurate mapping between the 3-D Euclidean work space and a robot configuration space (joint angles). If a stereo vision is involved, then one needs to map a pair of 2-D video images directly into the robot configuration space. Neural Network approach aside, a common solution to this problem is to calibrate vision and manipulator independently, and then tie them via common mapping into the task space. In other words, both vision and robot refer to some common Absolute Euclidean Coordinate Frame via their individual mappings. This approach has two major difficulties. First a vision system has to be calibrated over the total work space. And second, the absolute frame, which is usually quite arbitrary, has to be the same with a high degree of precision for both robot and vision subsystem calibrations. The use of computer vision to allow robust fine motion manipulation in a poorly structured world which is currently in progress is described along with the preliminary results and encountered problems.

Addressing Problems Encountered in Case-Based Teaching

ERIC Educational Resources Information Center

Turgeon, A. J.

2007-01-01

TURF 436 (Case Studies in Turfgrass Management) is the capstone course for turfgrass science majors at the Pennsylvania State University. Students are introduced to problems and complex problematic situations encountered in the management of golf and sports turf and in professional lawn-care operations. Following completion of the orientation case…

Travel Medicine Encounters of Australian General Practice Trainees-A Cross-Sectional Study.

PubMed

Morgan, Simon; Henderson, Kim M; Tapley, Amanda; Scott, John; van Driel, Mieke L; Spike, Neil A; McArthur, Lawrie A; Davey, Andrew R; Catzikiris, Nigel F; Magin, Parker J

2015-01-01

Travel medicine is a common and challenging area of clinical practice and practitioners need up-to-date knowledge and experience in a range of areas. Australian general practitioners (GPs) play a significant role in the delivery of travel medicine advice. We aimed to describe the rate and nature of travel medicine consultations, including both the clinical and educational aspects of the consultations. A cross-sectional analysis from an ongoing cohort study of GP trainees' clinical consultations was performed. Trainees contemporaneously recorded demographic, clinical, and educational details of consecutive patient consultations. Proportions of all problems/diagnoses managed in these consultations that were coded "travel-related" and "travel advice" were both calculated with 95% confidence intervals (CIs). Associations of a problem/diagnosis being "travel-related" or "travel advice" were tested using simple logistic regression within the generalized estimating equations (GEE) framework. A total of 856 trainees contributed data on 169,307 problems from 108,759 consultations (2010-2014). Travel-related and travel advice problems were managed at a rate of 1.1 and 0.5 problems per 100 encounters, respectively. Significant positive associations of travel-related problems were younger trainee and patient age; new patient to the trainee and practice; privately billing, larger, urban, and higher socioeconomic status practices; and involvement of the practice nurse. Trainees sought in-consultation information and generated learning goals in 34.7 and 20.8% of travel advice problems, respectively, significantly more than in non-travel advice problems. Significant positive associations of travel advice problems were seeking in-consultation information, generation of learning goals, longer consultation duration, and more problems managed. Our findings reinforce the importance of focused training in travel medicine for GP trainees and adequate exposure to patients in the practice setting. In addition, our findings have implications more broadly for the delivery of travel medicine in general practice. © 2015 International Society of Travel Medicine.

A Study of the Causes of Physical and Emotional Problems Encountered by Older Women Returning to Secretarial Employment After A Prolonged Absence. Final Report.

ERIC Educational Resources Information Center

Lloyd, Glenna G.

The problem of this study was to identify the cause of the physical and emotional problems encountered by older women who have returned to work after a prolonged absence. Such information, it was believed, would be valuable to business and educational institutions in retraining or updating prospective secretarial employees. Data for the study were…

The Malone antegrade continence enema for neurogenic and structural fecal incontinence and constipation.

PubMed

Koyle, M A; Kaji, D M; Duque, M; Wild, J; Galansky, S H

1995-08-01

Problems of fecal elimination are commonly encountered by the pediatric urologist and surgeon. The Malone antegrade continence enema has been described as a means to administer a large volume enema via a continent catheterizable appendicocecostomy, resulting in reliable fecal elimination. Of 22 patients undergoing this procedure 16 reported total continence 4 months or longer after surgery. Complications are relatively minor and tap water appears to be a safe solution for the antegrade continence enema. A nonrefluxing, imbricated appendicocecostomy is preferable to prevent cutaneous fecal or gas leaks.

Quality planning in Construction Project

NASA Astrophysics Data System (ADS)

Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

2017-12-01

The purpose of this paper is to investigate deeper on the factors that contribute to the effectiveness of quality planning, identifying the common problems encountered in quality planning, practices and ways for improvements in quality planning for construction projects. This paper involves data collected from construction company representatives across Malaysia that are obtained through semi-structured interviews as well as questionnaire distributions. Results shows that design of experiments (average index: 4.61), inspection (average index: 4.45) and quality audit as well as other methods (average index: 4.26) rank first, second and third most important factors respectively.

Approximation Methods in Multidimensional Filter Design and Related Problems Encountered in Multidimensional System Design.

DTIC Science & Technology

1983-03-21

zero , it is necessary that B M(0) be nonzero. In the case considered here, B M(0) is taken to be nonsingula and withot loss of generality it may be set...452. (c.51 D. Levin, " General order Padd type rational approximants defined from a double power series," J. Inst. Maths. Applics., 18, 1976, pp. 1-8...common zeros in the closed unit bidisc, U- 2 . The 2-D setting provides a nice theoretical framework for generalization of these stabilization results to

The Integration of Two Healthcare Systems: A Common Healthcare Problem.

PubMed

Cassatly, Hannah; Cassatly, Michael

2015-01-01

The change in reimbursement mandated by the Affordable Care Act is causing a rapid consolidation of the marketplace as well as the delivery of clinical care in a team-based model. This case report examines the successful joining of two clinical teams concurrent with the merger of two healthcare organizations and discusses some of the difficulties encountered. A subsequent discussion focuses on the resolution: the need for physicians to embrace the team concept of healthcare delivery and for healthcare systems to facilitate this transition with team and leadership coaching.

Obstructed Umbilical Hernia: A Normal Presentation with Abnormal Contents.

PubMed

P Agrawal, Vijay; S Shetty, Nikhil; Narasimhaprasad, Ashwin

2015-01-01

Umbilical hernia is a common problem encountered in children. The rarity of finding cecum and appendix is probably due to the fact that the appendix is seldom found in the proximity of the umbilicus. It would, therefore, appear worthwhile to report the occurrence of cecum and an inflamed appendix with Ladd's bands in an umbilical hernia of a child. The last case with similar presentation was presented in 1950s. Agrawal VP, Shetty NS, Narasimhaprasad A. Obstructed Umbilical Hernia: A Normal Presentation with Abnormal Contents. Euroasian J Hepato-Gastroenterol 2015;5(2):110-111.

Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding Study.

PubMed

Sullivan, P B; Lambert, B; Rose, M; Ford-Adams, M; Johnson, A; Griffiths, P

2000-10-01

The aim of this study was to estimate the prevalence and severity of feeding and nutritional problems in children with neurological impairment within a defined geographical area. In a cross-sectional study, a validated questionnaire was sent to 377 parents of children (aged 4 to 13 years) on the Oxford Register of Early Childhood Impairments with oromotor dysfunction. The return rate was 72%. Of these, 93% had cerebral palsy; 47% were unable to walk; 78% had speech difficulty; and 28% continuous drooling of saliva. Gastrointestinal problems were commonly encountered: 59% were constipated; 22% had significant problems with vomiting, and 31% had suffered at least one chest infection in the previous 6 months. Feeding problems were prevalent: 89% needed help with feeding and 56% choked with food; 20% of parents described feeding as stressful and unenjoyable. Prolonged feeding times (3h/day) were reported by 28%. Only 8% of participants received caloric supplements and 8% were fed via gastrostomy tube. Even though 38% of respondents considered their child to be underweight, 64% of children had never had their feeding and nutrition assessed. The results highlight that feeding problems in children with neurological impairment are common and severe, causing parental concern. Many of these children would benefit from nutritional assessment and management as part of their overall care.

Hypothesis testing of scientific Monte Carlo calculations.

PubMed

Wallerberger, Markus; Gull, Emanuel

2017-11-01

The steadily increasing size of scientific Monte Carlo simulations and the desire for robust, correct, and reproducible results necessitates rigorous testing procedures for scientific simulations in order to detect numerical problems and programming bugs. However, the testing paradigms developed for deterministic algorithms have proven to be ill suited for stochastic algorithms. In this paper we demonstrate explicitly how the technique of statistical hypothesis testing, which is in wide use in other fields of science, can be used to devise automatic and reliable tests for Monte Carlo methods, and we show that these tests are able to detect some of the common problems encountered in stochastic scientific simulations. We argue that hypothesis testing should become part of the standard testing toolkit for scientific simulations.

Crystallization of Membrane Proteins by Vapor Diffusion

PubMed Central

Delmar, Jared A.; Bolla, Jani Reddy; Su, Chih-Chia; Yu, Edward W.

2016-01-01

X-ray crystallography remains the most robust method to determine protein structure at the atomic level. However, the bottlenecks of protein expression and purification often discourage further study. In this chapter, we address the most common problems encountered at these stages. Based on our experiences in expressing and purifying antimicrobial efflux proteins, we explain how a pure and homogenous protein sample can be successfully crystallized by the vapor diffusion method. We present our current protocols and methodologies for this technique. Case studies show step-by-step how we have overcome problems related to expression and diffraction, eventually producing high quality membrane protein crystals for structural determinations. It is our hope that a rational approach can be made of the often anecdotal process of membrane protein crystallization. PMID:25950974

Hypothesis testing of scientific Monte Carlo calculations

NASA Astrophysics Data System (ADS)

Wallerberger, Markus; Gull, Emanuel

2017-11-01

The steadily increasing size of scientific Monte Carlo simulations and the desire for robust, correct, and reproducible results necessitates rigorous testing procedures for scientific simulations in order to detect numerical problems and programming bugs. However, the testing paradigms developed for deterministic algorithms have proven to be ill suited for stochastic algorithms. In this paper we demonstrate explicitly how the technique of statistical hypothesis testing, which is in wide use in other fields of science, can be used to devise automatic and reliable tests for Monte Carlo methods, and we show that these tests are able to detect some of the common problems encountered in stochastic scientific simulations. We argue that hypothesis testing should become part of the standard testing toolkit for scientific simulations.

Patterns of illness and injury encountered in amateur ocean yacht racing: an analysis of the British Telecom Round the World Yacht Race 1996-1997.

PubMed

Price, C J S; Spalding, T J W; McKenzie, C

2002-12-01

To quantify the incidence and type of medical problem arising during an amateur circumnavigation yacht race, the BT Global Challenge. All cases from 14 participating yachts in a confidential medical log completed by an appointed medic were reported. A total of 685 cases were reported, of which 299 (43.6%) were injuries and 386 (56.4%) illnesses. The subtype of injury, illness, and three evacuations at sea are described. Injury and other forms of medical problem are relatively common in an amateur long distance ocean yacht race. Most can be adequately managed at sea, provided that optimal communication, training, and equipment are provided and maintained.

Challenges in conducting qualitative research in health: A conceptual paper

PubMed Central

Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

2015-01-01

Background: Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. Materials and Methods: This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. Results: One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. Conclusions: The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others. PMID:26793245

Gastrointestinal gas.

PubMed Central

Fardy, J; Sullivan, S

1988-01-01

Complaints related to gastrointestinal gas are commonly encountered in clinical practice. Various therapies have been proposed, yet none has appeared to be extremely effective. A review of the literature revealed little hard evidence to support the use of simethicone, pancreatic enzymes, anticholinergic agents or antibiotics. Evidence supporting the use of prokinetic agents has been the strongest, and there may be a pathophysiologic basis for the use of these agents if the complaints are related to abnormal intestinal motility. The use of activated charcoal for adsorbing intestinal gas has been effective in healthy subjects but has not been properly investigated in patients with gas complaints. Dietary modification may be beneficial in certain cases. Additional controlled trials are necessary to clarify the issues in the treatment of this common problem. PMID:3058280

Self-regulation of common age-related challenges: benefits for older adults' psychological and physical health.

PubMed

Wrosch, Carsten; Dunne, Erin; Scheier, Michael F; Schulz, Richard

2006-06-01

This article addresses the role played by adaptive self-regulation in protecting older adults' psychological and physical health. A theoretical model is outlined illustrating how common age-related challenges (i.e., physical challenges and life regrets) can influence older adults' health. In addition, the proposed model suggests that older adults can avoid the adverse health effects of encountering these problems if they engage in adaptive self-regulation. Finally, this article reviews recent studies that examined the adaptive value of self-regulation processes for managing physical challenges and life regrets in the elderly. The findings from cross-sectional, longitudinal, and experimental studies document the importance of adaptive self-regulation for maintaining older adults' health.

Leptospirosis in a British soldier after travel to Borneo.

PubMed

Burns, Daniel S; Clay, K A; Bailey, M S

2016-12-01

Undifferentiated febrile illness in a returning soldier is a common problem encountered by serving medical officers. A 32-year-old soldier presented to Birmingham Heartlands Hospital with fever and acute kidney injury after return from Borneo. Leptospirosis was suspected and empirical antibiotics were started before subsequent confirmation by serology and PCR. Leptospirosis is common in South-East Asia, and troops exercising in jungle areas, and in the UK, are at risk. Advice, including inpatient management when appropriate, is available from the UK Role 4 Military Infectious Diseases and Tropical Medicine Service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Affirmative Action and Women in Higher Education.

ERIC Educational Resources Information Center

Hazzard, Terry

The purposes of this paper are to: (1) discuss the historical development of women in higher education; (2) describe the implementation of federal policies for women; (3) focus on selected problems encountered by women in the work-place; and (4) offer recommendations and suggestions for eliminating some of the problems that women encounter. The…

Dilemmas in the (un)veiling of the diagnosis of Alzheimer's disease: walking an ethical and professional tight rope.

PubMed

Karnieli-Miller, Orit; Werner, Perla; Aharon-Peretz, Judith; Eidelman, Shmuel

2007-08-01

To enhance the understanding and effect of physician's difficulties, attitudes and communication styles on the disclosure of the diagnosis of AD in practice. Qualitative, phenomenological study, combining pre-encounter interviews with physicians, observations of actual encounters of diagnosis disclosure of AD, and post-encounter interviews. There were various ways or tactics to (un)veil the bad news that may be perceived as different ways of dulling the impact and avoiding full and therefore problematic statements. In the actual encounters this was accomplished by keeping encounters short, avoiding elaboration, confirmation of comprehension and explicit terminology and using fractured sentences. The present study's findings highlight the difficulties encountered in breaking the news about AD, in the way it is actually done, and the problems that may arise from this way of un/veiling the news. The main problem is that the reluctance to make a candid disclosure of the diagnosis as was demonstrated in this study may violate basic moral and legal rights and may also deprive patients and caregivers of some of the benefits of early disclosure of diagnosis. There is a need for assisting physicians to cope with their personal difficulties, problems and pitfalls in breaking the news.

Monitoring Reasons for Encounter via an Electronic Patient Record System: the Case of a Rural Practice Initiative

PubMed Central

Klinis, Spyridon; Markaki, Adelais; Kounalakis, Dimitrios; Symvoulakis, Emmanouil K.

2012-01-01

The objective of this brief communication was to tabulate common reasons for encounter in a Greek rural general practice, as result of a recently adopted electronic patient record (EPR) application. Twenty encounter reasons accounted for 3,797 visits (61% of all patient encounters), whereas 565 other reasons accounted for the remaining 2,429 visits (39%). Number one reason for encounter was health maintenance or disease prevention seeking services, including screening examinations for malignancies, immunization and provision of medical opinion reports. Hypertension, lipid disorder and ischemic heart disease without angina were among the most common reasons for seeking care. A strengths/weaknesses/opportunities/threats (SWOT) analysis on the key role of an EPR system in collecting data from rural and remote primary health care settings is also presented. PMID:23091407

The Problem-Based Learning Process: Reflections of Pre-Service Elementary School Teachers

ERIC Educational Resources Information Center

Baysal, Zeliha Nurdan

2017-01-01

This study aims to identify the benefits acquired by third-year pre-service elementary school teachers participating in a problem-based learning process in social studies education, the issues they encountered in that process and those they are likely to encounter, and their feelings about the process. Semi-structured interviews were used as one…

Child Neurology Education for Pediatric Residents.

PubMed

Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

2017-03-01

The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

An Evaluation of Database Solutions to Spatial Object Association

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

Kumar, V S; Kurc, T; Saltz, J

2008-06-24

Object association is a common problem encountered in many applications. Spatial object association, also referred to as crossmatch of spatial datasets, is the problem of identifying and comparing objects in two datasets based on their positions in a common spatial coordinate system--one of the datasets may correspond to a catalog of objects observed over time in a multi-dimensional domain; the other dataset may consist of objects observed in a snapshot of the domain at a time point. The use of database management systems to the solve the object association problem provides portability across different platforms and also greater flexibility. Increasingmore » dataset sizes in today's applications, however, have made object association a data/compute-intensive problem that requires targeted optimizations for efficient execution. In this work, we investigate how database-based crossmatch algorithms can be deployed on different database system architectures and evaluate the deployments to understand the impact of architectural choices on crossmatch performance and associated trade-offs. We investigate the execution of two crossmatch algorithms on (1) a parallel database system with active disk style processing capabilities, (2) a high-throughput network database (MySQL Cluster), and (3) shared-nothing databases with replication. We have conducted our study in the context of a large-scale astronomy application with real use-case scenarios.« less

A Bayesian approach to truncated data sets: An application to Malmquist bias in Supernova Cosmology

NASA Astrophysics Data System (ADS)

March, Marisa Cristina

2018-01-01

A problem commonly encountered in statistical analysis of data is that of truncated data sets. A truncated data set is one in which a number of data points are completely missing from a sample, this is in contrast to a censored sample in which partial information is missing from some data points. In astrophysics this problem is commonly seen in a magnitude limited survey such that the survey is incomplete at fainter magnitudes, that is, certain faint objects are simply not observed. The effect of this `missing data' is manifested as Malmquist bias and can result in biases in parameter inference if it is not accounted for. In Frequentist methodologies the Malmquist bias is often corrected for by analysing many simulations and computing the appropriate correction factors. One problem with this methodology is that the corrections are model dependent. In this poster we derive a Bayesian methodology for accounting for truncated data sets in problems of parameter inference and model selection. We first show the methodology for a simple Gaussian linear model and then go on to show the method for accounting for a truncated data set in the case for cosmological parameter inference with a magnitude limited supernova Ia survey.

Psychiatric services in primary care settings: a survey of general practitioners in Thailand

PubMed Central

Lotrakul, Manote; Saipanish, Ratana

2006-01-01

Background General Practitioners (GPs) in Thailand play an important role in treating psychiatric disorders since there is a shortage of psychiatrists in the country. Our aim was to examine GP's perception of psychiatric problems, drug treatment and service problems encountered in primary care settings. Methods We distributed 1,193 postal questionnaires inquiring about psychiatric practices and service problems to doctors in primary care settings throughout Thailand. Results Four hundred and thirty-four questionnaires (36.4%) were returned. Sixty-seven of the respondents (15.4%) who had taken further special training in various fields were excluded from the analysis, giving a total of 367 GPs in this study. Fifty-six per cent of respondents were males and they had worked for 4.6 years on average (median = 3 years). 65.6% (SD = 19.3) of the total patients examined had physical problems, 10.7% (SD = 7.9) had psychiatric problems and 23.9% (SD = 16.0) had both problems. The most common psychiatric diagnoses were anxiety disorders (37.5%), alcohol and drugs abuse (28.1%), and depressive disorders (29.2%). Commonly prescribed psychotropic drugs were anxiolytics and antidepressants. The psychotropic drugs most frequently prescribed were diazepam among anti-anxiety drugs, amitriptyline among antidepressant drugs, and haloperidol among antipsychotic drugs. Conclusion Most drugs available through primary care were the same as what existed 3 decades ago. There should be adequate supply of new and appropriate psychotropic drugs in primary care. Case-finding instruments for common mental disorders might be helpful for GPs whose quality of practice was limited by large numbers of patients. However, the service delivery system should be modified in order to maintain successful care for a large number of psychiatric patients. PMID:16867187

Common problems in the elicitation and analysis of expert opinion affecting probabilistic safety assessments

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

Meyer, M.A.; Booker, J.M.

1990-01-01

Expert opinion is frequently used in probabilistic safety assessment (PSA), particularly in estimating low probability events. In this paper, we discuss some of the common problems encountered in eliciting and analyzing expert opinion data and offer solutions or recommendations. The problems are: that experts are not naturally Bayesian. People fail to update their existing information to account for new information as it becomes available, as would be predicted by the Bayesian philosophy; that experts cannot be fully calibrated. To calibrate experts, the feedback from the known quantities must be immediate, frequent, and specific to the task; that experts are limitedmore » in the number of things that they can mentally juggle at a time to 7 {plus minus} 2; that data gatherers and analysts can introduce bias by unintentionally causing an altering of the expert's thinking or answers; that the level of detail the data, or granularity, can affect the analyses; and the conditioning effect poses difficulties in gathering and analyzing of the expert data. The data that the expert gives can be conditioned on a variety of factors that can affect the analysis and the interpretation of the results. 31 refs.« less

Preliminary Evaluation of BIM-based Approaches for Schedule Delay Analysis

NASA Astrophysics Data System (ADS)

Chou, Hui-Yu; Yang, Jyh-Bin

2017-10-01

The problem of schedule delay commonly occurs in construction projects. The quality of delay analysis depends on the availability of schedule-related information and delay evidence. More information used in delay analysis usually produces more accurate and fair analytical results. How to use innovative techniques to improve the quality of schedule delay analysis results have received much attention recently. As Building Information Modeling (BIM) technique has been quickly developed, using BIM and 4D simulation techniques have been proposed and implemented. Obvious benefits have been achieved especially in identifying and solving construction consequence problems in advance of construction. This study preforms an intensive literature review to discuss the problems encountered in schedule delay analysis and the possibility of using BIM as a tool in developing a BIM-based approach for schedule delay analysis. This study believes that most of the identified problems can be dealt with by BIM technique. Research results could be a fundamental of developing new approaches for resolving schedule delay disputes.

Ability of Social Work Students to Determine the Appropriateness of Solutions to Problems Encountered in Social Work Practice.

ERIC Educational Resources Information Center

Sturges, Jack; Yarbrough, Roy D.

The purpose of this study was to determine whether there was an association between the amount of formal social work education completed and ability of students to judge the degree of appropriateness of proposed solutions to problems frequently encountered in social work practice, and secondarily to determine whether students' judgments of problem…

Mothers' Perceptions of Citizenship, Practices for Developing Citizenship Conscience of Their Children and Problems They Encountered

ERIC Educational Resources Information Center

Ersoy, A. Figen

2012-01-01

Family plays an important role in the development of citizenship awareness of children. The purpose of the present study is to figure out the citizenship perceptions of mothers, their practices for developing citizenship conscience of their children and to explore the problems they have encountered. In this study, critical case sampling method has…

Tactics Employed and Problems Encountered by University English Majors in Hong Kong in Using a Dictionary

ERIC Educational Resources Information Center

Chan, Alice Yin Wa

2005-01-01

Building on the results of a small-scale survey which investigated the general use of dictionaries by university English majors in Hong Kong using a questionnaire survey and their specific use of dictionaries using an error correction task, this article discusses the tactics these students employed and the problems they encountered when using a…

Curriculum renewal in child psychiatry.

PubMed

Hanson, M; Tiberius, R; Charach, A; Ulzen, T; Sackin, D; Jain, U; Reiter, S; Shomair, G

1999-11-01

To ensure uniform design and evaluation of a clerkship curriculum for child and adolescent psychiatry teaching common disorders and problems in an efficient manner across 5 teaching sites and to include structures for continuous improvement. The curriculum committee selected for course inclusion disorders and problems of child psychiatry that were commonly encountered by primary care physicians. Instruction methods that encouraged active student learning were selected. Course coordination across sites was encouraged by several methods: involving faculty, adopting a centralized examination format, and aligning teaching methods with examination format. Quantitative and qualitative methods were used to measure students' perceptions of the course's value. These evaluative results were reviewed, and course modifications were implemented and reevaluated. The average adjusted student return rate for course evaluation questionnaires for the 3-year study period was 63%. Clerks' ratings of course learning value demonstrated that the course improved significantly and continually across all sites, according to a Scheffé post-hoc analysis. Analysis of student statements from focus-group transcripts contributed to course modifications, such as the Brief Focused Interview (BFI). Our curriculum in child psychiatry, which focused on common problems and used active learning methods, was viewed as a valuable learning experience by clinical clerks. Curriculum coordination across multiple teaching sites was accomplished by including faculty in the process and by using specific teaching and examination strategies. Structures for continuous course improvement were effective.

Chemical water shutoff profile research status and development trends

NASA Astrophysics Data System (ADS)

Xu, L. T.

2017-08-01

Excess water production is now a common problem encountered in almost every water flooding mature oilfield. The exploitation of oil field is faced with great challenge because of the decrease of oil field production. For the development of high water cut rare the status quo chemical water shutoff profile control technology is an important solution to solve this problem. Oilfield chemical water shutoff has important application prospects. This paper analyzes the water shutoff profile control and water shutoff profile control agent currently oilfield applications, moreover the use and development of blocking agent profile technology is to improve reservoir recovery and propose solutions. With the constant increase in water cut, profile technology should be simple, efficient, practical and profile control agent of development should be economic, environmental, and long period

A Grignard-like Organic Reaction in Water

NASA Astrophysics Data System (ADS)

Breton, Gary W.; Hughey, Christine A.

1998-01-01

The addition of a Grignard reagent to a carbonyl-containing compound to form an alcohol is an important reaction to demonstrate in organic chemistry laboratory courses. However, the reaction presents several practical problems for the lab instructor including the need for anhydrous solvents (e.g., ether), dry glassware, and the occasional problem of slow reaction initiation. We have scaled, and tested, a known Grignard-like reaction between allyl bromide and benzaldehyde mediated by zinc metal in aqueous media. The procedure retains the desirable features of the traditional Grignard reaction, while eliminating some of the commonly encountered difficulties. Thus, addition of allyl bromide (1.2 eq) to benzaldehyde and zinc in a two-phase mixture of THF and saturated aqueous NH4Cl afforded addition product 1-phenyl-3-buten-1-ol in 70-85% yields.

Patterns of illness and injury encountered in amateur ocean yacht racing: an analysis of the British Telecom Round the World Yacht Race 1996–1997

PubMed Central

Price, C; Spalding, T; McKenzie, C; Farquharson-Rober..., M

2002-01-01

Objectives: To quantify the incidence and type of medical problem arising during an amateur circumnavigation yacht race, the BT Global Challenge. Methods: All cases from 14 participating yachts in a confidential medical log completed by an appointed medic were reported. Results: A total of 685 cases were reported, of which 299 (43.6%) were injuries and 386 (56.4%) illnesses. The subtype of injury, illness, and three evacuations at sea are described. Conclusion: Injury and other forms of medical problem are relatively common in an amateur long distance ocean yacht race. Most can be adequately managed at sea, provided that optimal communication, training, and equipment are provided and maintained. PMID:12453842

Hexa Helix: Modified Quad Helix Appliance to Correct Anterior and Posterior Crossbites in Mixed Dentition

PubMed Central

Yaseen, Syed Mohammed; Acharya, Ravindranath

2012-01-01

Among the commonly encountered dental irregularities which constitute developing malocclusion is the crossbite. During primary and mixed dentition phase, the crossbite is seen very often and if left untreated during these phases then a simple problem may be transformed into a more complex problem. Different techniques have been used to correct anterior and posterior crossbites in mixed dentition. This case report describes the use of hexa helix, a modified version of quad helix for the management of anterior crossbite and bilateral posterior crossbite in early mixed dentition. Correction was achieved within 15 weeks with no damage to the tooth or the marginal periodontal tissue. The procedure is a simple and effective method for treating anterior and bilateral posterior crossbites simultaneously. PMID:23119188

Presentation and management of chronic pain.

PubMed

Rajapakse, Dilini; Liossi, Christina; Howard, Richard F

2014-05-01

Chronic pain is an important clinical problem affecting significant numbers of children and their families. The severity and impact of chronic pain on everyday function is shaped by the complex interaction of biological, psychological and social factors that determine the experience of pain for each individual, rather than a straightforward reflection of the severity of disease or extent of tissue damage. In this article we present the research findings that strongly support a biopsychosocial concept of chronic pain, describe the current best evidence for management strategies and suggest a common general pathway for all types of chronic pain. The principles of management of some of the most important or frequently encountered chronic pain problems in paediatric practice; neuropathic pain, complex regional pain syndrome (CRPS), musculoskeletal pain, abdominal pain and headache are also described.

Migrating pharyngeal foreign bodies: a series of four cases of saw-toothed fish bones.

PubMed

Chung, Sung Min; Kim, Han Su; Park, Eun Hee

2008-09-01

Pharyngeal foreign bodies are common problems seen at emergency rooms or ENT outpatient clinics, and fish bones are the most common foreign bodies encountered in East Asia and in Korea. One of the rare complications of a swallowed sharp fish bone is its migration from the site of entry into the subcutaneous tissues of the neck. We present four unusual cases of ingested fish bones that migrated out of the upper digestive tract to the neck. In the first case, this caused a recurrent deep neck infection for 2 years; in the second case, there was penetration of the facial artery; in the third case, there was a hematoma of the floor of the mouth; in the fourth case, there was a retropharyngeal abscess.

Improving Collaborative Learning by Supporting Casual Encounters in Distance Learning.

ERIC Educational Resources Information Center

Contreras, Juan; Llamas, Rafael; Vizcaino, Aurora; Vavela, Jesus

Casual encounters in a learning environment are very useful in reinforcing previous knowledge and acquiring new knowledge. Such encounters are very common in traditional learning environments and can be used successfully in social environments in which students can discover and construct knowledge through a process of dialogue, negotiation, or…

A novel cause of community-acquired pneumonia in a young immunocompetent host.

PubMed

James, Nicholas; Gilman, Matthew; Duncan, Robert; Gray, Anthony

2016-09-01

Diffuse pulmonary infiltrates represent a common problem encountered by pulmonologists. The differential diagnosis is extensive and includes infectious, inflammatory, environmental and malignant conditions. Appropriate evaluation, aside from a thorough history and physical examination, includes serologic, radiographic and procedural elements. We describe a case of a healthy male with diffuse pulmonary infiltrates. Work up revealed a novel infectious etiology. Although this particular microorganism has been described to cause native valve endocarditis, recurrent breast abscesses, osteomyelitis and bacteremia, it has to date not been described as a cause for community acquired pneumonia in immunocompetent hosts. © 2014 John Wiley & Sons Ltd.

Introduction to veterinary clinical oncology

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

Weller, R.E.

1991-10-01

Veterinary clinical oncology involves a multidisciplinary approach to the recognition and management of spontaneously occurring neoplasms of domestic animals. This requires some knowledge of the causes, incidence, and natural course of malignant disease as it occurs in domestic species. The purpose of this course is to acquaint you with the more common neoplastic problems you will encounter in practice, so that you can offer your clients an informed opinion regarding prognosis and possible therapeutic modalities. A major thrust will be directed toward discussing and encouraging treatment/management of malignant disease. Multimodality therapy will be stressed. 10 refs., 3 tabs.

Anthropometric accommodation in USAF cockpits

NASA Technical Reports Server (NTRS)

Zehner, Gregory F.

1994-01-01

Over the past three years, a new set of methodologies has been developed to specify and evaluate anthropometric accommodation in USAF crewstation designs. These techniques are used to improve the ability of the pilot to reach controls, to safely escape the aircraft, to achieve adequate mobility and comfort, and to assure full access to the visual field both inside and outside the aircraft. This paper summarized commonly encountered aircraft accommodation problems, explains the failure of the traditional 'percentile man' design concept to resolve these difficulties, and suggests an alternative approach for improving cockpit design to better accommodate today's more heterogeneous flying population.

A General Algorithm for Reusing Krylov Subspace Information. I. Unsteady Navier-Stokes

NASA Technical Reports Server (NTRS)

Carpenter, Mark H.; Vuik, C.; Lucas, Peter; vanGijzen, Martin; Bijl, Hester

2010-01-01

A general algorithm is developed that reuses available information to accelerate the iterative convergence of linear systems with multiple right-hand sides A x = b (sup i), which are commonly encountered in steady or unsteady simulations of nonlinear equations. The algorithm is based on the classical GMRES algorithm with eigenvector enrichment but also includes a Galerkin projection preprocessing step and several novel Krylov subspace reuse strategies. The new approach is applied to a set of test problems, including an unsteady turbulent airfoil, and is shown in some cases to provide significant improvement in computational efficiency relative to baseline approaches.

Gasoline immersion injury

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

Simpson, L.A.; Cruse, C.W.

1981-01-01

Chemical burns and pulmonary complications are the most common problems encountered in the patient immersed in gasoline. Our patient demonstrated a 46-percent total-body-surface area, partial-thickness chemical burn. Although he did not develop bronchitis or pneumonitis, he did display persistent atelectasis, laryngeal edema, and subsequent upper airway obstruction. This had not previously been reported in gasoline inhalation injuries. Hydrocarbon hepatitis secondary to the vascular endothelial damage is apparently a reversible lesion with no reported long-term sequelae. Gasoline immersion injuries may be a series multisystem injury and require the burn surgeon to take a multisystem approach to its diagnosis and treatment.

The Therapeutic Roller Coaster

PubMed Central

CHU, JAMES A.

1992-01-01

Survivors of severe childhood abuse often encounter profound difficulties. In addition to posttraumatic and dissociative symptomatology, abuse survivors frequently have characterologic problems, particularly regarding self-care and maintaining relationships. Backgrounds of abuse, abandonment, and betrayal are often recapitulated and reenacted in therapy, making the therapeutic experience arduous and confusing for therapists and patients. Efforts must be directed at building an adequate psychotherapeutic foundation before undertaking exploration and abreaction of past traumatic experiences. This discussion sets out a model for treatment of childhood abuse survivors, describing stages of treatment and suggesting interventions. Common treatment dilemmas or "traps" are discussed, with recommendations for their resolution. PMID:22700116

Neural learning of constrained nonlinear transformations

NASA Technical Reports Server (NTRS)

Barhen, Jacob; Gulati, Sandeep; Zak, Michail

1989-01-01

Two issues that are fundamental to developing autonomous intelligent robots, namely, rudimentary learning capability and dexterous manipulation, are examined. A powerful neural learning formalism is introduced for addressing a large class of nonlinear mapping problems, including redundant manipulator inverse kinematics, commonly encountered during the design of real-time adaptive control mechanisms. Artificial neural networks with terminal attractor dynamics are used. The rapid network convergence resulting from the infinite local stability of these attractors allows the development of fast neural learning algorithms. Approaches to manipulator inverse kinematics are reviewed, the neurodynamics model is discussed, and the neural learning algorithm is presented.

Thermal and mechanical treatments for nickel and some nickel-base alloys: Effects on mechanical properties

NASA Technical Reports Server (NTRS)

Hall, A. M.; Beuhring, V. F.

1972-01-01

This report deals with heat treating and working nickel and nickel-base alloys, and with the effects of these operations on the mechanical properties of the materials. The subjects covered are annealing, solution treating, stress relieving, stress equalizing, age hardening, hot working, cold working, combinations of working and heat treating (often referred to as thermomechanical treating), and properties of the materials at various temperatures. The equipment and procedures used in working the materials are discussed, along with the common problems that may be encountered and the precautions and corrective measures that are available.

Obstructed Umbilical Hernia: A Normal Presentation with Abnormal Contents

PubMed Central

P Agrawal, Vijay; Narasimhaprasad, Ashwin

2015-01-01

Umbilical hernia is a common problem encountered in children. The rarity of finding cecum and appendix is probably due to the fact that the appendix is seldom found in the proximity of the umbilicus. It would, therefore, appear worthwhile to report the occurrence of cecum and an inflamed appendix with Ladd’s bands in an umbilical hernia of a child. The last case with similar presentation was presented in 1950s. How to cite this article Agrawal VP, Shetty NS, Narasimhaprasad A. Obstructed Umbilical Hernia: A Normal Presentation with Abnormal Contents. Euroasian J Hepato-Gastroenterol 2015;5(2):110-111. PMID:29201704

Quantitative simultaneous multi-element microprobe analysis using combined wavelength and energy dispersive systems

NASA Technical Reports Server (NTRS)

Walter, L. S.; Doan, A. S., Jr.; Wood, F. M., Jr.; Bredekamp, J. H.

1972-01-01

A combined WDS-EDS system obviates the severe X-ray peak overlap problems encountered with Na, Mg, Al and Si common to pure EDS systems. By application of easily measured empirical correction factors for pulse pile-up and peak overlaps which are normally observed in the analysis of silicate minerals, the accuracy of analysis is comparable with that expected for WDS electron microprobe analyses. The continuum backgrounds are subtracted for the spectra by a spline fitting technique based on integrated intensities between the peaks. The preprocessed data are then reduced to chemical analyses by existing data reduction programs.

Importance of Nonenteric Protozoan Infections in Immunocompromised People

PubMed Central

Barratt, J. L. N.; Harkness, J.; Marriott, D.; Ellis, J. T.; Stark, D.

2010-01-01

Summary: There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed. PMID:20930074

A survey of sports medicine physicians regarding psychological issues in patient-athletes.

PubMed

Mann, Barton J; Grana, William A; Indelicato, Peter A; O'Neill, Daniel F; George, Steven Z

2007-12-01

To determine the extent to which sports medicine physicians encounter and discuss psychological issues among athletes they treat and to evaluate physicians' perceptions of the availability and efficacy of sport psychologists and other mental health resources. Cross-sectional study. A survey was sent via e-mail to all physician members of 4 prominent sports medicine professional associations: the American Orthopaedic Society for Sports Medicine, American College of Sports Medicine, American Medical Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. The extent to which respondents discuss psychological issues with athletes varied by subspecialty and by specific issues assessed. Fears about reinjury, fears related to surgery, and lack of patience with recovery/rehabilitation were the 3 most common injury-related topics discussed with patient-athletes. The 3 most common non-injury-related topics discussed were stress/pressure, anxiety, and burnout. Family practitioners were more likely to discuss injury-related psychological issues than were orthopaedic surgeons. Orthopaedic surgeons reported the lowest frequencies of discussing non-injury-related psychological issues. Only 19% of all respondents indicated there were adequate numbers of sport psychologists and other mental health professionals in their geographical area to treat the needs of athletes. Three quarters of respondents reported they rarely or never referred athletes to sport psychologists for injury-related issues, and two thirds indicated they rarely or never referred athletes to sport psychologists for non-injury-related problems. Respondents rated sport psychologists and athletic trainers/physical therapists to be moderately effective in working with athletes regarding psychological problems. Sports medicine physicians frequently encounter psychological issues with patient-athletes. There is a need for tools to facilitate assessment of these problems as well as greater communication between the mental health community and sports medicine physicians. In addition, knowledge of and access to professionals who are specifically trained to deal with the sometimes unique psychological needs of athletes should be improved.

Analysis of the Problems Encountered in Education of Teachers and Solution Recommendations in Accordance with the Opinions of Faculty of Education Students

ERIC Educational Resources Information Center

Sahan, Gülsün

2016-01-01

The purpose of this study is to put forth the problems encountered in education of teachers and solution recommendations in accordance with the opinions of faculty of education students. Within this framework, the opinions of 182 first grade students from the departments of classroom, social sciences, science and mathematics teaching at Bartin…

Using the CER Hub to ensure data quality in a multi-institution smoking cessation study.

PubMed

Walker, Kari L; Kirillova, Olga; Gillespie, Suzanne E; Hsiao, David; Pishchalenko, Valentyna; Pai, Akshatha Kalsanka; Puro, Jon E; Plumley, Robert; Kudyakov, Rustam; Hu, Weiming; Allisany, Art; McBurnie, MaryAnn; Kurtz, Stephen E; Hazlehurst, Brian L

2014-01-01

Comparative effectiveness research (CER) studies involving multiple institutions with diverse electronic health records (EHRs) depend on high quality data. To ensure uniformity of data derived from different EHR systems and implementations, the CER Hub informatics platform developed a quality assurance (QA) process using tools and data formats available through the CER Hub. The QA process, implemented here in a study of smoking cessation services in primary care, used the 'emrAdapter' tool programmed with a set of quality checks to query large samples of primary care encounter records extracted in accord with the CER Hub common data framework. The tool, deployed to each study site, generated error reports indicating data problems to be fixed locally and aggregate data sharable with the central site for quality review. Across the CER Hub network of six health systems, data completeness and correctness issues were prevalent in the first iteration and were considerably improved after three iterations of the QA process. A common issue encountered was incomplete mapping of local EHR data values to those defined by the common data framework. A highly automated and distributed QA process helped to ensure the correctness and completeness of patient care data extracted from EHRs for a multi-institution CER study in smoking cessation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Quadratic constrained mixed discrete optimization with an adiabatic quantum optimizer

NASA Astrophysics Data System (ADS)

Chandra, Rishabh; Jacobson, N. Tobias; Moussa, Jonathan E.; Frankel, Steven H.; Kais, Sabre

2014-07-01

We extend the family of problems that may be implemented on an adiabatic quantum optimizer (AQO). When a quadratic optimization problem has at least one set of discrete controls and the constraints are linear, we call this a quadratic constrained mixed discrete optimization (QCMDO) problem. QCMDO problems are NP-hard, and no efficient classical algorithm for their solution is known. Included in the class of QCMDO problems are combinatorial optimization problems constrained by a linear partial differential equation (PDE) or system of linear PDEs. An essential complication commonly encountered in solving this type of problem is that the linear constraint may introduce many intermediate continuous variables into the optimization while the computational cost grows exponentially with problem size. We resolve this difficulty by developing a constructive mapping from QCMDO to quadratic unconstrained binary optimization (QUBO) such that the size of the QUBO problem depends only on the number of discrete control variables. With a suitable embedding, taking into account the physical constraints of the realizable coupling graph, the resulting QUBO problem can be implemented on an existing AQO. The mapping itself is efficient, scaling cubically with the number of continuous variables in the general case and linearly in the PDE case if an efficient preconditioner is available.

Determining problems experienced by student nurses in their work with clinical educators in Turkey.

PubMed

Elcigil, Ayfer; Yildirim Sari, Hatice

2007-07-01

Clinical education is considered an indispensable and vital part of nursing education. Educators have an important role in the successful completion of a student's clinical education. The clinical educator's approach, experience and knowledge have an influence on the students. Students encounter certain problems during their clinical practice under the supervision of educators. This study was conducted to determine the nature of the problems student nurses encounter during clinical training in Turkey. The focus-group interviews were used for this study. Three groups of 8, a total group of 24, composed of students completing their third year were included in the interviews. The students in this study had completed their practical training in the departments of internal medicine, surgery, pediatrics, psychiatry and public health. Among the problems mostly encountered by students, as established by the study, were inadequate assessment by the clinical educator, judgment, negative feedback, communication problems, inadequate guidance and overload. At the end of the research, recommendations were that educators should offer information in the direction of student expectations, increase their positive feedback and lighten the academic workload of these students.

Estimating errors in least-squares fitting

NASA Technical Reports Server (NTRS)

Richter, P. H.

1995-01-01

While least-squares fitting procedures are commonly used in data analysis and are extensively discussed in the literature devoted to this subject, the proper assessment of errors resulting from such fits has received relatively little attention. The present work considers statistical errors in the fitted parameters, as well as in the values of the fitted function itself, resulting from random errors in the data. Expressions are derived for the standard error of the fit, as a function of the independent variable, for the general nonlinear and linear fitting problems. Additionally, closed-form expressions are derived for some examples commonly encountered in the scientific and engineering fields, namely ordinary polynomial and Gaussian fitting functions. These results have direct application to the assessment of the antenna gain and system temperature characteristics, in addition to a broad range of problems in data analysis. The effects of the nature of the data and the choice of fitting function on the ability to accurately model the system under study are discussed, and some general rules are deduced to assist workers intent on maximizing the amount of information obtained form a given set of measurements.

The Library and Human Memory. Final Report on Mechanized Information Services in the University Library, Phase I - Planning. Part 13.

ERIC Educational Resources Information Center

Norman, Donald A.

This paper discusses the differences between the storage problems encountered in a large library and those encountered in the human memory. Some of the properties of the human memory system and some of the major issues which affect the interaction between human users and the existing library systems are outlined. The problem of browsing is used as…

Laboratory errors and patient safety.

PubMed

Miligy, Dawlat A

2015-01-01

Laboratory data are extensively used in medical practice; consequently, laboratory errors have a tremendous impact on patient safety. Therefore, programs designed to identify and reduce laboratory errors, as well as, setting specific strategies are required to minimize these errors and improve patient safety. The purpose of this paper is to identify part of the commonly encountered laboratory errors throughout our practice in laboratory work, their hazards on patient health care and some measures and recommendations to minimize or to eliminate these errors. Recording the encountered laboratory errors during May 2008 and their statistical evaluation (using simple percent distribution) have been done in the department of laboratory of one of the private hospitals in Egypt. Errors have been classified according to the laboratory phases and according to their implication on patient health. Data obtained out of 1,600 testing procedure revealed that the total number of encountered errors is 14 tests (0.87 percent of total testing procedures). Most of the encountered errors lay in the pre- and post-analytic phases of testing cycle (representing 35.7 and 50 percent, respectively, of total errors). While the number of test errors encountered in the analytic phase represented only 14.3 percent of total errors. About 85.7 percent of total errors were of non-significant implication on patients health being detected before test reports have been submitted to the patients. On the other hand, the number of test errors that have been already submitted to patients and reach the physician represented 14.3 percent of total errors. Only 7.1 percent of the errors could have an impact on patient diagnosis. The findings of this study were concomitant with those published from the USA and other countries. This proves that laboratory problems are universal and need general standardization and bench marking measures. Original being the first data published from Arabic countries that evaluated the encountered laboratory errors and launch the great need for universal standardization and bench marking measures to control the laboratory work.

Outcomes of planetary close encounters - A systematic comparison of methodologies

NASA Technical Reports Server (NTRS)

Greenberg, Richard; Carusi, Andrea; Valsecchi, G. B.

1988-01-01

Several methods for estimating the outcomes of close planetary encounters are compared on the basis of the numerical integration of a range of encounter types. An attempt is made to lay the foundation for the development of predictive rules concerning the encounter outcomes applicable to the refinement of the statistical mechanics that apply to planet-formation and similar problems concerning planetary swarms. Attention is given to Oepik's (1976) formulation of the two-body approximation, whose predicted motion differs from the correct three-body behavior.

Medical care at the Sweetwaters Music Festival.

PubMed

Yates, K M; Hazell, W C; Schweder, L

2001-04-13

To describe medical cover and medical presentations at the four-day 1999 Sweetwaters Music Festival, and make comparisons with other festivals. All medical contacts were counted, and patients presenting to the medical tent were included in the study. Case records were studied to determine demographic data, nature of complaint, treatment and disposition. A Medline literature search was performed to obtain information on other festivals. There were 2,231 medical contacts overall (8.9% of estimated attendees) and 217 presentations to the medical tent (0.9% of estimated attendees). 53% of patients presenting to the medical tent were men and the mean patient age was 25 years. Lacerations (16%), intoxication (13%), local infections (12%) and soft tissue injuries (9%) were the most common problems. There were no deaths or cardiac arrests. Problems encountered were similar to other music festivals, with minor injuries predominant.

Adapting Experiential Learning to Develop Problem-Solving Skills in Deaf and Hard-of-Hearing Engineering Students.

PubMed

Marshall, Matthew M; Carrano, Andres L; Dannels, Wendy A

2016-10-01

Individuals who are deaf and hard-of-hearing (DHH) are underrepresented in science, technology, engineering, and mathematics (STEM) professions, and this may be due in part to their level of preparation in the development and retention of mathematical and problem-solving skills. An approach was developed that incorporates experiential learning and best practices of STEM instruction to give first-year DHH students enrolled in a postsecondary STEM program the opportunity to develop problem-solving skills in real-world scenarios. Using an industrial engineering laboratory that provides manufacturing and warehousing environments, students were immersed in real-world scenarios in which they worked on teams to address prescribed problems encountered during the activities. The highly structured, Plan-Do-Check-Act approach commonly used in industry was adapted for the DHH student participants to document and communicate the problem-solving steps. Students who experienced the intervention realized a 14.6% improvement in problem-solving proficiency compared with a control group, and this gain was retained at 6 and 12 months, post-intervention. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Novel Nipple Reconstruction Technique for Maintaining Nipple Projection: The Boomerang Flap

PubMed Central

Kim, Young-Eun; Hong, Ki Yong; Minn, Kyung Won

2016-01-01

Nipple-areolar complex (NAC) reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up. Several factors might contribute to nipple projection loss, and we tried to overcome these factors by performing nipple reconstructions using a boomerang flap technique, which is a modified C–V flap that utilizes the previous mastectomy scar to maintain long-term nipple projection. PMID:27689057

A Novel Nipple Reconstruction Technique for Maintaining Nipple Projection: The Boomerang Flap.

PubMed

Kim, Young-Eun; Hong, Ki Yong; Minn, Kyung Won; Jin, Ung Sik

2016-09-01

Nipple-areolar complex (NAC) reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up. Several factors might contribute to nipple projection loss, and we tried to overcome these factors by performing nipple reconstructions using a boomerang flap technique, which is a modified C-V flap that utilizes the previous mastectomy scar to maintain long-term nipple projection.

The role of ethical principles in health care and the implications for ethical codes.

PubMed Central

Limentani, A E

1999-01-01

A common ethical code for everybody involved in health care is desirable, but there are important limitations to the role such a code could play. In order to understand these limitations the approach to ethics using principles and their application to medicine is discussed, and in particular the implications of their being prima facie. The expectation of what an ethical code can do changes depending on how ethical properties in general are understood. The difficulties encountered when ethical values are applied reactively to an objective world can be avoided by seeing them as a more integral part of our understanding of the world. It is concluded that an ethical code can establish important values and describe a common ethical context for health care but is of limited use in solving new and complex ethical problems. PMID:10536764

Optical navigation during the Voyager Neptune encounter

NASA Technical Reports Server (NTRS)

Riedel, J. E.; Owen, W. M., Jr.; Stuve, J. A.; Synnott, S. P.; Vaughan, R. M.

1990-01-01

Optical navigation techniques were required to successfully complete the planetary exploration phase of the NASA deep-space Voyager mission. The last of Voyager's planetary encounters, with Neptune, posed unique problems from an optical navigation standpoint. In this paper we briefly review general aspects of the optical navigation process as practiced during the Voyager mission, and discuss in detail particular features of the Neptune encounter which affected optical navigation. New approaches to the centerfinding problem were developed for both stars and extended bodies, and these are described. Results of the optical navigation data analysis are presented, as well as a description of the optical orbit determination system and results of its use during encounter. Partially as a result of the optical navigation processing, results of scientific significance were obtained. These results include the discovery and orbit determination of several new satellites of Neptune and the determination of the size of Triton, Neptune's largest moon.

Enhancing the Capacity of School Nurses to Reduce Excessive Anxiety in Children: Development of the CALM Intervention.

PubMed

Drake, Kelly L; Stewart, Catherine E; Muggeo, Michela A; Ginsburg, Golda S

2015-08-01

Excessive anxiety is among the most common psychiatric problems facing youth. Because anxious youth tend to have somatic complaints, many seek help from the school nurse. Thus, school nurses are in an ideal position to provide early intervention. This study addresses this problem and describes the plans to develop and test a new intervention (Child Anxiety Learning Modules; CALM), delivered by school nurses, to reduce child anxiety and improve academic functioning. An iterative development process including consultation with an expert panel, two open trials, and a pilot randomized controlled study comparing CALM to usual care is proposed. Feedback will be solicited from all participants during each phase and data on outcome measures will be provided by children, parents, teachers, and independent evaluators. Data will be collected on intervention satisfaction and feasibility. Primary outcomes that include child anxiety symptoms, classroom behavior, and school performance (e.g., attendance, grades, standardized test scores) will be collected at pre- and post-interventions and at a 3-month follow-up evaluation. Pediatric anxiety is a common problem that school nurses frequently encounter. Consequently, they are well positioned to play a key role in enhancing access to behavioral health interventions to reduce anxiety and may therefore make a significant positive public health impact. © 2015 Wiley Periodicals, Inc.

Experimental issues related to frequency response function measurements for frequency-based substructuring

NASA Astrophysics Data System (ADS)

Nicgorski, Dana; Avitabile, Peter

2010-07-01

Frequency-based substructuring is a very popular approach for the generation of system models from component measured data. Analytically the approach has been shown to produce accurate results. However, implementation with actual test data can cause difficulties and cause problems with the system response prediction. In order to produce good results, extreme care is needed in the measurement of the drive point and transfer impedances of the structure as well as observe all the conditions for a linear time invariant system. Several studies have been conducted to show the sensitivity of the technique to small variations that often occur during typical testing of structures. These variations have been observed in actual tested configurations and have been substantiated with analytical models to replicate the problems typically encountered. The use of analytically simulated issues helps to clearly see the effects of typical measurement difficulties often observed in test data. This paper presents some of these common problems observed and provides guidance and recommendations for data to be used for this modeling approach.

An approach to complex acid-base problems

PubMed Central

Herd, Anthony M.

2005-01-01

OBJECTIVE To review rules and formulas for solving even the most complex acid-base problems. SOURCES OF INFORMATION MEDLINE was searched from January 1966 to December 2003. The search was limited to English-language review articles involving human subjects. Nine relevant review papers were found and provide the background. As this information is well established and widely accepted, it is not judged for strength of evidence, as is standard practice. MAIN MESSAGE An understanding of the body’s responses to acidemia or alkalemia can be gained through a set of four rules and two formulas that can be used to interpret almost any acid-base problems. Physicians should, however, remember the “golden rule” of acid-base interpretation: always look at a patient’s clinical condition. CONCLUSION Physicians practising in acute care settings commonly encounter acid-base disturbances. While some of these are relatively simple and easy to interpret, some are more complex. Even complex cases can be resolved using the four rules and two formulas. PMID:15751566

In Connecticut: improving patient medication management in primary care.

PubMed

Smith, Marie; Giuliano, Margherita R; Starkowski, Michael P

2011-04-01

Medications are a cornerstone of the management of most chronic conditions. However, medication discrepancies and medication-related problems-some of which can cause serious harm-are common. Pharmacists have the expertise to identify, resolve, monitor, and prevent these problems. We present findings from a Centers for Medicare and Medicaid Services demonstration project in Connecticut, in which nine pharmacists worked closely with eighty-eight Medicaid patients from July 2009 through May 2010. The pharmacists identified 917 drug therapy problems and resolved nearly 80 [corrected] percent of them after four encounters. The result was an estimated annual saving of $1,123 per patient on medication claims and $472 per patient on medical, hospital, and emergency department expenses-more than enough to pay for the contracted pharmacist services. We recommend that the Center for Medicare and Medicaid Innovation support the evaluation of pharmacist-provided medication management services in primary care medical homes, accountable care organizations, and community health and care transition teams, as well as research to explore how to enhance team-based care.

Alignment of the Stanford Linear Collider Arcs: Concepts and results

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

Pitthan, R.; Bell, B.; Friedsam, H.

1987-02-01

The alignment of the Arcs for the Stanford Linear Collider at SLAC has posed problems in accelerator survey and alignment not encountered before. These problems come less from the tight tolerances of 0.1 mm, although reaching such a tight statistically defined accuracy in a controlled manner is difficult enough, but from the absence of a common reference plane for the Arcs. Traditional circular accelerators, including HERA and LEP, have been designed in one plane referenced to local gravity. For the SLC Arcs no such single plane exists. Methods and concepts developed to solve these and other problems, connected with themore » unique design of SLC, range from the first use of satellites for accelerator alignment, use of electronic laser theodolites for placement of components, computer control of the manual adjustment process, complete automation of the data flow incorporating the most advanced concepts of geodesy, strict separation of survey and alignment, to linear principal component analysis for the final statistical smoothing of the mechanical components.« less

Quantifying the Effects of Gas-Rich Flyby Encounters on Galaxy Evolution

NASA Astrophysics Data System (ADS)

Dumas, Julie; Holley-Bockelmann, Kelly; Lang, Meagan

2017-01-01

Recent work has shown that flyby encounters may be a common event in a galaxy's lifetime. Galaxy flybys are a one-time encounter when two halos interpenetrate, but unlike a galaxy merger, the two halos later detach. Relatively little work has been done to assess how flybys affect galaxy evolution. We present preliminary results of a suite of high-resolution hydrodynamical + N-body simulations of gas-rich flyby encounters, concentrating on Milky Way-like primaries. We track the bulk changes in structure, star formation history, kinematics, and morphology over a broad span of flyby encounters.

Obstructive sleep apnea (OSA): a complication of acute infectious mononucleosis infection in a child.

PubMed

Cheng, Jeffrey

2014-03-01

Independently, obstructive sleep apnea (OSA) and infectious mononucleosis are not uncommon in the pediatric population, but acute onset of OSA, as a respiratory complication in the setting of acute EBV infection is extremely uncommon. Previous reports of this clinical entity are sparse and from nearly two decades ago. Urgent adenotonsillectomy was commonly advocated. This complication may be managed medically with systemic corticosteroids and non-invasive continuous positive airway pressure (CPAP), and a case is presented to highlight an updated management approach to this rarely encountered clinical problem in children. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

OARSI Clinical Trials Recommendations for Hip Imaging in Osteoarthritis

PubMed Central

Gold, Garry E.; Cicuttini, Flavia; Crema, Michel D.; Eckstein, Felix; Guermazi, Ali; Kijowski, Richard; Link, Thomas M.; Maheu, Emmanuel; Martel-Pelletier, Johanne; Miller, Colin G.; Pelletier, Jean-Pierre; Peterfy, Charles G.; Potter, Hollis G.; Roemer, Frank W.; Hunter, David. J

2015-01-01

Imaging of hip in osteoarthritis (OA) has seen considerable progress in the past decade, with the introduction of new techniques that may be more sensitive to structural disease changes. The purpose of this expert opinion, consensus driven recommendation is to provide detail on how to apply hip imaging in disease modifying clinical trials. It includes information on acquisition methods/ techniques (including guidance on positioning for radiography, sequence/protocol recommendations/ hardware for MRI); commonly encountered problems (including positioning, hardware and coil failures, artifacts associated with various MRI sequences); quality assurance/ control procedures; measurement methods; measurement performance (reliability, responsiveness, and validity); recommendations for trials; and research recommendations. PMID:25952344

Field surgery on a future conventional battlefield: strategy and wound management.

PubMed Central

Ryan, J. M.; Cooper, G. J.; Haywood, I. R.; Milner, S. M.

1991-01-01

Most papers appearing in the surgical literature dealing with wound ballistics concern themselves with wound management in the civilian setting. The pathophysiology of modern war wounds is contrasted with ballistic wounds commonly encountered in peacetime, but it should be noted that even in peacetime the modern terrorist may have access to sophisticated military weaponry, and that patients injured by them may fall within the catchment area of any civilian hospital. Management problems associated with both wound types are highlighted; areas of controversy are discussed. The orthodox military surgical approach to ballistic wounds is expounded and defended. Images Figure 2 Figure Figure 4 PMID:1996857

Heat and mass transfer analogy for condensation of humid air in a vertical channel

NASA Astrophysics Data System (ADS)

Desrayaud, G.; Lauriat, G.

This study examines energy transport associated with liquid film condensation in natural convection flows driven by differences in density due to temperature and concentration gradients. The condensation problem is based on the thin-film assumptions. The most common compositional gradient, which is encountered in humid air at ambient temperature is considered. A steady laminar Boussinesq flow of an ideal gas-vapor mixture is studied for the case of a vertical parallel plate channel. New correlations for the latent and sensible Nusselt numbers are established, and the heat and mass transfer analogy between the sensible Nusselt number and Sherwood number is demonstrated.

A clinical guide to needle desensitization for the paediatric patient.

PubMed

Taylor, Greig D; Campbell, Caroline

2015-05-01

Needle phobia is a common problem encountered by dental practitioners and it can pose a challenge, especially in the paediatric patient. Needle desensitization can be used for patients who have needle fear or phobia and help them overcome this by repeated, non-threatening and controlled contacts. This paper will describe an accepted technique of needle desensitization and work through the steps required to achieve a successful outcome of local anaesthesia being delivered in a calm, safe and controlled manner. Clinical Relevance: Needle desensitization is an effective technique which can be used to enable a needle phobic patient to receive a dental injection.

Diagnosis of gastrointestinal bleeding: A practical guide for clinicians

PubMed Central

Kim, Bong Sik Matthew; Li, Bob T; Engel, Alexander; Samra, Jaswinder S; Clarke, Stephen; Norton, Ian D; Li, Angela E

2014-01-01

Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is not apparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians. PMID:25400991

Intensive Care and its Discontents: Psychiatric Illness in the Critically Ill.

PubMed

Hashmi, Ali M; Han, Jin Y; Demla, Vishal

2017-09-01

Critically ill patients can develop a host of cognitive and psychiatric complaints during their intensive care unit (ICU) stay, many of which persist for weeks or months following discharge from the ICU and can seriously affect their quality of life, including their ability to return to work. This article describes some common psychiatric problems encountered by clinicians in the ICU, including their assessment and management. A comprehensive approach is needed to decrease patient suffering, improve morbidity and mortality, and ensure that critically ill patients can return to the highest quality of life after an ICU stay. Copyright © 2017 Elsevier Inc. All rights reserved.

Financial abuse of older people by a family member: a difficult terrain for service providers in Australia.

PubMed

Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana

2014-01-01

Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.

Martial arts sports medicine: current issues and competition event coverage.

PubMed

Nishime, Robert S

2007-06-01

More sports medicine professionals are becoming actively involved in the care of the martial arts athlete. Although there are many different forms of martial arts practiced worldwide, certain styles have shown a potential for increased participation in competitive-type events. Further research is needed to better understand the prevalence and profiles of injuries sustained in martial arts full-contact competitive events. Breaking down the martial art techniques into basic concepts of striking, grappling, and submission maneuvers, including choking and joint locking, may facilitate better understanding and management of injuries. This article outlines this approach and reviews the commonly encountered injuries and problems during martial arts full-contact competitions.

The laser interferometer skin-friction meter - A numerical and experimental study

NASA Technical Reports Server (NTRS)

Murphy, J. D.; Westphal, R. V.

1986-01-01

Limits to the applicability of thin-film lubrication theory are established. The following two problems are considered: (1) the response of the oil film to a time-varying skin friction such as is encountered in turbulent boundary layers, and (2) a 'surface-wave instability' encountered at high skin-friction levels. Results corresponding to the first problem reveal that the laser interferometer skin-friction meter may, in principle, be applied to the measurement of instantaneous skin friction. In addressing the second problem, it is shown that the observed surface waves are not the result of a hydrodynamic instability.

Feline reproduction: problems and clinical challenges.

PubMed

Little, Susan

2011-07-01

Many veterinarians are closely involved with pedigree cat breeding and have become familiar with the unique characteristics of feline reproduction and breeding management. However, even veterinarians who do not have involvement with the pedigree cat fancy require a basic knowledge of the reproductive problems that are most likely to be encountered in working with non-breeding pet cats as well as stray and feral cats. This article reviews reproductive problems and challenges in both sexes - namely, ovarian remnant syndrome, mammary fibroadenomatous hyperplasia, congenital anomalies of the reproductive tract and pregnancy diagnosis in the queen, and cryptorchidism and low libido in the tom. Feline reproduction has not received the amount of investigation and attention that has been directed at canine reproduction. The result is that less data is available both for description of normal reproduction and for management of common problems. This article reviews most of the available evidence for the conditions discussed. Efforts should focus on making information more readily available to the practitioner and expanding the knowledge base in this important area of feline medicine. Copyright © 2011 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

Physical activity problem-solving inventory for adolescents: Development and initial validation

USDA-ARS?s Scientific Manuscript database

Youth encounter physical activity barriers, often called problems. The purpose of problem-solving is to generate solutions to overcome the barriers. Enhancing problem-solving ability may enable youth to be more physically active. Therefore, a method for reliably assessing physical activity problem-s...

Development of a replacement AMLCD used on multiple platforms

NASA Astrophysics Data System (ADS)

Walsh, Kevin L.; Gobron, Robert

2002-08-01

A goal of military display users and manufacturers is commonality: to utilize a given display on as many platforms as possible. The often-addressed concern of obsolescence of commercial AMLCDs used on military programs becomes a key issue, though, with regard to commonality. Obsolescence occurs as the tools used in the manufacture of an AMLCD age and as new and improved materials and processes are developed. The LCD manufacturer, at some point, decides to cease the manufacture of a particular AMLCD. The users of that AMLCD then have two choices: make a lifetime buy of LCDs, or find a replacement. For a display which has achieved some degree of commonality, this choice must be faced by a number of different users on a number of platforms. This paper addresses some of the problems encountered when such a choice is made, as an SVGA display made by one manufacturer is replaced by an XGA display made by a different manufacturer.

Hardware problems encountered in solar heating and cooling systems

NASA Technical Reports Server (NTRS)

Cash, M.

1978-01-01

Numerous problems in the design, production, installation, and operation of solar energy systems are discussed. Described are hardware problems, which range from simple to obscure and complex, and their resolution.

Nurses' perceptions and problems in the usability of a medication safety app.

PubMed

Ankem, Kalyani; Cho, Sookyung; Simpson, Diana

2017-10-16

The majority of medication apps support medication adherence. Equally, if not more important, is medication safety. Few apps report on medication safety, and fewer studies have been conducted with these apps. The usability of a medication safety app was tested with nurses to reveal their perceptions of the graphical user interface and to discover problems they encountered in using the app. Usability testing of the app was conducted with RN-BSN students and informatics students (n = 18). Perceptions of the graphical components were gathered in pretest and posttest questionnaires, and video recordings of the usability testing were transcribed. The significance of the difference in mean performance time for 8 tasks was tested, and qualitative analysis was deployed to identify problems encountered and to rate the severity of each problem. While all participants perceived the graphical user interface as easy to understand, nurses took significantly more time to complete certain tasks. More nurses found the medication app to be lacking in intuitiveness of user interface design, in capability to match real-world data, and in providing optimal information architecture. To successfully integrate mobile devices in healthcare, developers must address the problems that nurses encountered in use of the app.

Challenging Nurses’ Cultural Competence of Disability to Improve Interpersonal Interactions

PubMed Central

Roscigno, Cecelia I.

2013-01-01

Worldwide, at least 6.9 billion people have an impairment producing health condition (IPHC). Insensitive encounters with health care providers (HCPs) can result in negative appraisals, fear, and avoidance, but little is known about what things are commonly perceived as insensitive. A review of published narratives describing negative encounters with HCPs was conducted. Narrative analysis was used to compare, contrast, and synthesize six themes describing the common negative encounters: (a) ignoring or minimizing their knowledge; (b) detached interpersonal interactions; (c) placing a negative skew on their life quality; (d) a lack of HCP knowledge related to their complete needs; (e) assuming they should be asexual and childless; and, (f) an inherent power differential. The medical model of disability is perceived by individuals with IPHCs to inform negative encounters perceived as insensitive. This preliminary knowledge is important so we can address education needs, plan future research questions, and establish clinical practice improvements. PMID:23291869

Emergency management of blunt chest trauma in children: an evidence-based approach.

PubMed

Pauzé, Denis R; Pauzé, Daniel K

2013-11-01

Pediatric trauma is commonly encountered in the emergency department, and trauma to the head, chest, and abdomen may be a source of significant morbidity and mortality. As children have unique thoracic anatomical and physiological properties, they may present with diagnostic challenges that the emergency clinician must be aware of. This review examines the effects of blunt trauma to the pediatric chest, as well as its relevant etiologies and associated mortality. Diagnostic and treatment options for commonly encountered injuries such as pulmonary contusions, rib fractures, and pneumothoraces are examined. Additionally, this review discusses rarely encountered--yet highly lethal--chest wall injuries such as blunt cardiac injuries, commotio cordis, nonaccidental trauma, and aortic injuries.

Common cold outbreaks: A network theory approach

NASA Astrophysics Data System (ADS)

Vishkaie, Faranak Rajabi; Bakouie, Fatemeh; Gharibzadeh, Shahriar

2014-11-01

In this study, at first we evaluated the network structure in social encounters by which respiratory diseases can spread. We considered common-cold and recorded a sample of human population and actual encounters between them. Our results show that the database structure presents a great value of clustering. In the second step, we evaluated dynamics of disease spread with SIR model by assigning a function to each node of the structural network. The rate of disease spread in networks was observed to be inversely correlated with characteristic path length. Therefore, the shortcuts have a significant role in increasing spread rate. We conclude that the dynamics of social encounters' network stands between the random and the lattice in network spectrum. Although in this study we considered the period of common-cold disease for network dynamics, it seems that similar approaches may be useful for other airborne diseases such as SARS.

NASA flight cell and battery issues

NASA Technical Reports Server (NTRS)

Schulze, N. R.

1989-01-01

The author presents the important battery and cell problems, encompassing both test failures and accidents, which were encountered during the past year. Practical issues facing programs, which have to be considered in the development of a battery program strategy, are addressed. The problems of one program, the GRO (Gamma Ray Observatory), during the past year are focused on to illustrate the fundamental types of battery problems that occur. Problems encountered by other programs are briefly mentioned to complete the accounting. Two major categories of issues are defined, namely, whose which are quality and design related, i.e., problems having inherent manufacturing-process-related aspects with an impact on cell reliability, and these which are accident triggered or man induced, i.e., those operational issues having an impact on battery and cell reliability.

Analysis of Statistical Methods and Errors in the Articles Published in the Korean Journal of Pain

PubMed Central

Yim, Kyoung Hoon; Han, Kyoung Ah; Park, Soo Young

2010-01-01

Background Statistical analysis is essential in regard to obtaining objective reliability for medical research. However, medical researchers do not have enough statistical knowledge to properly analyze their study data. To help understand and potentially alleviate this problem, we have analyzed the statistical methods and errors of articles published in the Korean Journal of Pain (KJP), with the intention to improve the statistical quality of the journal. Methods All the articles, except case reports and editorials, published from 2004 to 2008 in the KJP were reviewed. The types of applied statistical methods and errors in the articles were evaluated. Results One hundred and thirty-nine original articles were reviewed. Inferential statistics and descriptive statistics were used in 119 papers and 20 papers, respectively. Only 20.9% of the papers were free from statistical errors. The most commonly adopted statistical method was the t-test (21.0%) followed by the chi-square test (15.9%). Errors of omission were encountered 101 times in 70 papers. Among the errors of omission, "no statistics used even though statistical methods were required" was the most common (40.6%). The errors of commission were encountered 165 times in 86 papers, among which "parametric inference for nonparametric data" was the most common (33.9%). Conclusions We found various types of statistical errors in the articles published in the KJP. This suggests that meticulous attention should be given not only in the applying statistical procedures but also in the reviewing process to improve the value of the article. PMID:20552071

Viewing lava safely: an epidemiology of hiker injury and illness in Hawaii Volcanoes National Park.

PubMed

Heggie, Travis W; Heggie, Tracey M

2004-01-01

To report the injuries and illnesses encountered by wilderness hikers in Hawaii Volcanoes National Park attempting to hike to active lava flows and to investigate the roles that demographics, prior hiking experience, hiking behavior, and preparedness play in hiker vulnerability to injury and illness. During an 8-week period, daily on-site exit interviews of lava hikers were conducted by a uniformed park ranger and park volunteer. Information about the hiker's home residence, wilderness hiking experience, preparedness, health status, and health problems encountered during the hike was collected from a total of 804 hikers. A high rate of injury and illness was found among the study population. Scrapes and abrasions (59%), blisters (51%), and muscle strains and sprains (47%) were the most common injuries. Dehydration (77%) and respiratory irritation (46%) were the most common illnesses. Lower extremities were the most common site of injuries, and beginning hikers were the most vulnerable to injury and illness. Many hikers were inexperienced tourists willing to disregard warning signs and enter high-risk areas. Hawaii Volcanoes National Park is one of 22 US national park units with volcanic resources. The injuries and illnesses reported by the study group identify the impact that this type of environment can have on the safety of wilderness users in areas with similar resources. Recreating in remote and severe areas has inherent risks, but the high rate of injuries and illnesses sustained by the hikers of this study can potentially be reduced through the development of more direct risk management methods.

Application of the NASA airborne oceanographic lidar to the mapping of chlorophyll and other organic pigments

NASA Technical Reports Server (NTRS)

Hoge, F. E.; Swift, R. N.

1981-01-01

Laser fluorosensing techniques used for the airborne measurement of chlorophyll a and other naturally occurring waterborne pigments are reviewed. Previous experiments demonstrating the utility of the airborne oceanographic lidar (AOL) for assessment of various marine parameters are briefly discussed. The configuration of the AOL during the NOAA/NASA Superflux experiments is described. The participation of the AOL in these experiments is presented and the preliminary results are discussed. The importance of multispectral receiving capability in a laser fluorosensing system for providing reproducible measurements over wide areas having spatial variations in water column transmittance properties is addressed. This capability minimizes the number of truthing points required and is usable even in shallow estuarine areas where resuspension of bottom sediment is common. Finally, problems encountered on the Superflux missions and the resulting limitations on the AOL data sets are addressed and feasible solutions to these problems are provided.

An investigation of chatter and tool wear when machining titanium

NASA Technical Reports Server (NTRS)

Sutherland, I. A.

1974-01-01

The low thermal conductivity of titanium, together with the low contact area between chip and tool and the unusually high chip velocities, gives rise to high tool tip temperatures and accelerated tool wear. Machining speeds have to be considerably reduced to avoid these high temperatures with a consequential loss of productivity. Restoring this lost productivity involves increasing other machining variables, such as feed and depth-of-cut, and can lead to another machining problem commonly known as chatter. This work is to acquaint users with these problems, to examine the variables that may be encountered when machining a material like titanium, and to advise the machine tool user on how to maximize the output from the machines and tooling available to him. Recommendations are made on ways of improving tolerances, reducing machine tool instability or chatter, and improving productivity. New tool materials, tool coatings, and coolants are reviewed and their relevance examined when machining titanium.

Inter-Fork Strand Annealing causes genomic deletions during the termination of DNA replication.

PubMed

Morrow, Carl A; Nguyen, Michael O; Fower, Andrew; Wong, Io Nam; Osman, Fekret; Bryer, Claire; Whitby, Matthew C

2017-06-06

Problems that arise during DNA replication can drive genomic alterations that are instrumental in the development of cancers and many human genetic disorders. Replication fork barriers are a commonly encountered problem, which can cause fork collapse and act as hotspots for replication termination. Collapsed forks can be rescued by homologous recombination, which restarts replication. However, replication restart is relatively slow and, therefore, replication termination may frequently occur by an active fork converging on a collapsed fork. We find that this type of non-canonical fork convergence in fission yeast is prone to trigger deletions between repetitive DNA sequences via a mechanism we call Inter-Fork Strand Annealing (IFSA) that depends on the recombination proteins Rad52, Exo1 and Mus81, and is countered by the FANCM-related DNA helicase Fml1. Based on our findings, we propose that IFSA is a potential threat to genomic stability in eukaryotes.

A new member of the genus Isotomurus from the Kuril Islands (Collembola: Isotomidae): returning to the problem of "colour pattern species".

PubMed

Potapov, Mikhail; Porco, David; Deharveng, Louis

2018-03-14

Colour pattern is the most common character to identify species in several large genera of Collembola. Its use often raises problems due to various and poorly investigated extent of chromatic variability among species. Isotomurus festus sp. nov. is here described from Kunashir Isl. (the Kuriles, the Far East of Russia). The species, a member of the 'antennalis' group, is characterized by the lack of trichobothria and slender claws, but is greatly variable in coloration. DNA barcoding (COI) results supports that all the colour forms encountered belong to the same species. While colour pattern has been shown to be the most reliable character for species identification in several Entomobryidae genera, it might not be the case in Isotomurus Börner, 1903, the sole large Isotomidae genus where colour pattern is routinely used for taxonomy.

Integrating counselling into general practice.

PubMed

Stone, L; Blashki, G

2000-03-01

General practice counselling has many significant differences to counselling in other settings. General practitioners have long term relationships with their patients involving physical as well as mental health care. General practitioners are often the first point of contact for distressed patients who may not perceive their problem to have a psychological basis. There are barriers to counselling including time management and cultural expectations of the consultation. To outline a practical biopsychosocial model for counselling in the general practice setting using the knowledge and skills unique to each GP. Theoretical and practical barriers to counselling commonly encountered in general practice are discussed. Assessing the problem in a biopsychosocial format highlights strengths and skills the patient already possesses and involves consideration of physical sensations, emotions, behaviours, key relationships, family, social roles and resources. Counselling in general practice requires flexibility and an ability to adapt available resources to address patient needs in an individually appropriate way.

Improved Method for Prediction of Attainable Wing Leading-Edge Thrust

NASA Technical Reports Server (NTRS)

Carlson, Harry W.; McElroy, Marcus O.; Lessard, Wendy B.; McCullers, L. Arnold

1996-01-01

Prediction of the loss of wing leading-edge thrust and the accompanying increase in drag due to lift, when flow is not completely attached, presents a difficult but commonly encountered problem. A method (called the previous method) for the prediction of attainable leading-edge thrust and the resultant effect on airplane aerodynamic performance has been in use for more than a decade. Recently, the method has been revised to enhance its applicability to current airplane design and evaluation problems. The improved method (called the present method) provides for a greater range of airfoil shapes from very sharp to very blunt leading edges. It is also based on a wider range of Reynolds numbers than was available for the previous method. The present method, when employed in computer codes for aerodynamic analysis, generally results in improved correlation with experimental wing-body axial-force data and provides reasonable estimates of the measured drag.

Sex of the GP--20 years on.

PubMed

Harrison, Christopher M; Britt, Helena C; Charles, Janice

2011-08-15

Previous research with the Australian Morbidity and Treatment Survey (1990-1991) showed significant differences in general practitioner characteristics and patient mix of male and female GPs. Even after adjusting for these, it was seen that male and female GPs managed different types of medical conditions. The proportion of female GPs increased from 19.6% in 1990-1991 to 37.1% in 2009-2010. This study investigates whether differences remain two decades later. Analysis of 2009-2010 Bettering the Evaluation and Care of Health (BEACH) data examining GP characteristics, patient encounter characteristics, patient reasons for encounter (RFE), problem types managed and management methods used, by GP sex. Whether GP sex was an independent predictor of problem types being managed, or management methods used, was tested using multiple logistic regressions and Poisson regression. 988 GPs recorded 98 800 GP-patient encounters. Adjusted differences in clinical activity of male and female GPs. After adjustment, compared with male GPs, females recorded more RFEs about general and unspecified issues and endocrine, female genital, pregnancy and family planning problems; and fewer concerning the musculoskeletal, respiratory, skin and male genital systems. Female GPs managed more general and unspecified, digestive, circulatory, psychological, endocrine, female genital and social problems; recorded nearly 20% more clinical treatments and referrals; recorded nearly 10% more imaging and pathology tests; and 4.3% fewer medications. After two decades, even with increased numbers of female GPs, the differences in problems managed by male and female GPs remain, and will probably continue. Female GPs use more resources per encounter, but may not use more resources in terms of annual patient care.

Management of Pleural Effusion, Empyema, and Lung Abscess

PubMed Central

Yu, Hyeon

2011-01-01

Pleural effusion is an accumulation of fluid in the pleural space that is classified as transudate or exudate according to its composition and underlying pathophysiology. Empyema is defined by purulent fluid collection in the pleural space, which is most commonly caused by pneumonia. A lung abscess, on the other hand, is a parenchymal necrosis with confined cavitation that results from a pulmonary infection. Pleural effusion, empyema, and lung abscess are commonly encountered clinical problems that increase mortality. These conditions have traditionally been managed by antibiotics or surgical placement of a large drainage tube. However, as the efficacy of minimally invasive interventional procedures has been well established, image-guided small percutaneous drainage tubes have been considered as the mainstay of treatment for patients with pleural fluid collections or a lung abscess. In this article, the technical aspects of image-guided interventions, indications, expected benefits, and complications are discussed and the published literature is reviewed. PMID:22379278

Failed medial patellofemoral ligament reconstruction: Causes and surgical strategies

PubMed Central

Sanchis-Alfonso, Vicente; Montesinos-Berry, Erik; Ramirez-Fuentes, Cristina; Leal-Blanquet, Joan; Gelber, Pablo E; Monllau, Joan Carles

2017-01-01

Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical indication or inappropriate surgical technique/patient selection; (2) a technical error; and (3) an incorrect assessment of the concomitant risk factors for instability. An understanding of the anatomy and biomechanics of the MPFL and cautiousness with the imaging techniques while favoring clinical over radiological findings and the use of common sense to determine the adequate surgical technique for each particular case, are critical to minimizing MPFL surgery failure. Additionally, our approach to dealing with failure after primary MPFL reconstruction is also presented. PMID:28251062

Shallow Reflection Method for Water-Filled Void Detection and Characterization

NASA Astrophysics Data System (ADS)

Zahari, M. N. H.; Madun, A.; Dahlan, S. H.; Joret, A.; Hazreek, Z. A. M.; Mohammad, A. H.; Izzaty, R. A.

2018-04-01

Shallow investigation is crucial in enhancing the characteristics of subsurface void commonly encountered in civil engineering, and one such technique commonly used is seismic-reflection technique. An assessment of the effectiveness of such an approach is critical to determine whether the quality of the works meets the prescribed requirements. Conventional quality testing suffers limitations including: limited coverage (both area and depth) and problems with resolution quality. Traditionally quality assurance measurements use laboratory and in-situ invasive and destructive tests. However geophysical approaches, which are typically non-invasive and non-destructive, offer a method by which improvement of detection can be measured in a cost-effective way. Of this seismic reflection have proved useful to assess void characteristic, this paper evaluates the application of shallow seismic-reflection method in characterizing the water-filled void properties at 0.34 m depth, specifically for detection and characterization of void measurement using 2-dimensional tomography.

Some didactical suggestions for a deeper embedding of DC circuits into electromagnetism

NASA Astrophysics Data System (ADS)

Cavinato, M.; Giliberti, M.; Barbieri, S. R.

2017-09-01

Undergraduate students often encounter great difficulties in understanding Ohm’s law and electrical circuits. Considering the widespread students’ beliefs and their common mistakes, as they come out from the literature and our teaching experience, we think that a relevant source of these problems comes from the fact that electrical circuits are generally treated separately from the other topics of electromagnetism, with poor reference to the circulation of the electric field. We present here a way to deal with electrical circuits that could help students to overcome their difficulties. In our approach, the electric field is the protagonist and the mathematical tool the students are asked to use is its circulation. In the light of the circulation of the electric field, the experimental Ohm’s law is revisited, the concept of electromotive force is discussed and some suggestions to eliminate common misconceptions about the role of a battery in a circuit are presented.

The diagnosis and management of common sleep disorders in adolescents.

PubMed

Reiter, Joel; Rosen, Dennis

2014-08-01

Sleep problems in adolescents are very common and negatively impact the quality of their health and lives, yet often go undiagnosed. This review is meant to familiarize pediatricians with some of the more commonly encountered sleep disorders in this age group, and to review their diagnosis and management. Recent findings reinforce the ubiquity of insufficient and poor-quality sleep in teens and their consequences on physical and mental health, cognition, and behavior. Increasing use of technology by teens, especially at night, plays a growing role in this. Parentally set bedtimes can be effective in increasing the sleep duration, thereby diminishing the consequences of insufficient sleep. Parasomnias, common in early childhood, usually diminish with the transition into adolescence. An almost 10-fold increase in the incidence of narcolepsy has been reported following the use of one type of vaccination against influenza H1N1 in Europe. Recent guidelines for the diagnosis and management of obstructive sleep apnea are reviewed, as are recent guidelines pertaining to the management of sleep disorders of children on the autism spectrum. Sleep disorders in adolescents are both very common and underdiagnosed, adversely affecting their overall well being.

The Mariner Mars 1971 radio frequency subsystem

NASA Technical Reports Server (NTRS)

Hughes, R. S.

1972-01-01

The radio frequency subsystem (RFS) for the Mariner Mars 1971 (MM'71) spacecraft is described. The MM'69 RFS was used as the baseline design for the MM'71 RFS, and the report describes the design changes made to the 1969 RFS for use on MM'71. It also cites various problems encountered during the fabrication and testing of the RFS, as well as the types of tests to which the RFS was subjected. In areas where significant problems were encountered, a detailed description of the problem and its solution is presented. In addition, some recommendations are given for modifications to the RFS and test techniques for future programs.

Thinning of Large Biological Cells for Cryo-TEM Characterization by Cryo-FIB Milling

PubMed Central

Strunk, Korrinn M.; Ke, Danxia; Gray, Jennifer L.; Zhang, Peijun

2013-01-01

SUMMARY Focused ion beam milling at cryogenic temperatures (cryo-FIB) is a valuable tool that can be used to thin vitreous biological specimens for subsequent imaging and analysis in a cryo-transmission electron microscope (cryo-TEM) in their frozen-hydrated state. This technique offers the potential benefit of eliminating the mechanical artifacts that are typically found with cryo-ultramicrotomy. However, due to the additional complexity in transferring samples in and out of the FIB, contamination and devitrification of the amorphous ice is commonly encountered. In order to address these problems, we have designed a new sample cryo-shuttle that specifically accepts Polara TEM cartridges directly in order to simplify the transfer process between the FIB and TEM. We used the quality of the ice in the sample as an indicator to test various parameters used the process, and demonstrated with successful milling of large mammalian cells. By comparing the results from larger HeLa cells to those from E. coli cells, we discuss some of the artifacts and challenges we have encountered using this technique. PMID:22906009

[Prevention of road accidents in the road haulage field].

PubMed

Rosso, G L; Zanelli, R; Corino, P; Bruno, S

2007-01-01

Every year many traffic accidents with fatal outcomes occur in our Country. According to the recent indications of the European Agency for Safety and Health at Work, the Piedmont region has financed the plan: Prevention of road accidents in the road haulage field. The aims of the plan are to stimulate transport companies to the target of road safety and to improve and enforce sanitary surveillance, in order to improve the safety on road haulage and to prevent traffic injuries. the plan foresees, over a period of two years, a few encounters with all the interested parties (companies, police forces, labour unions etc). During those encounters we have to give a questionnaire for evaluating the companies' knowledge about the problem and we have to choose a common plan with the aim of improving road safety. The Piedmont regional plan recalls the need to increase the attention to numerous and diversified hazards for safety on road haulage. It also imposes the choice of measures that include: risk assessment, health education, technical and environmental prevention, sanitary surveillance and clinical interventions (diagnosis and rehabilitation of occupational accidents).

How good is Google? The quality of otolaryngology information on the internet.

PubMed

Pusz, Max D; Brietzke, Scott E

2012-09-01

To assess the quality of the information a patient (parent) may encounter using a Google search for typical otolaryngology ailments. Cross-sectional study. Tertiary care center. A Google keyword search was performed for 10 common otolaryngology problems including ear infection, hearing loss, tonsillitis, and so on. The top 10 search results for each were critically examined using the 16-item (1-5 scale) standardized DISCERN instrument. The DISCERN instrument was developed to assess the quality and comprehensiveness of patient treatment choice literature. A total of 100 Web sites were assessed. Of these, 19 (19%) were primarily advertisements for products and were excluded from DISCERN scoring. Searches for more typically chronic otolaryngic problems (eg, tinnitus, sleep apnea, etc) resulted in more biased, advertisement-type results than those for typically acute problems (eg, ear infection, sinus infection, P = .03). The search for "sleep apnea treatment" produced the highest scoring results (mean overall DISCERN score = 3.49, range = 1.81-4.56), and the search for "hoarseness treatment" produced the lowest scores (mean = 2.49, range = 1.56-3.56). Results from major comprehensive Web sites (WebMD, EMedicinehealth.com, Wikipedia, etc.) scored higher than other Web sites (mean DISCERN score = 3.46 vs 2.48, P < .001). There is marked variability in the quality of Web site information for the treatment of common otolaryngologic problems. Searches on more chronic problems resulted in a higher proportion of biased advertisement Web sites. Larger, comprehensive Web sites generally provided better information but were less than perfect in presenting complete information on treatment options.

A preliminary study on travel health issues of medical students undertaking electives.

PubMed

Goldsmid, John M; Bettiol, Silvana S; Sharples, Nadine

2003-01-01

With the inclusion of elective programs, often overseas, in many medical courses, it was decided that a preliminary retrospective analysis of health problems associated with these programs in medical students from the University of Tasmania would be desirable. A questionnaire covering general travel health issues was distributed to all medical students in the University of Tasmania, on return from their elective. They were asked to complete the questionnaire and return it on an anonymous and voluntary basis. In addition, student elective submissions were consulted for information relating to their chosen destination. Results of the study indicate that general practitioners were the most common source of pretravel advice for Tasmanian medical students. Overall, 64% of students experienced some sort of health problem of which travelers' diarrhea was the most common. Most problems were mild and self-limiting, but a number of serious infections were recorded, including acute leptospirosis, paratyphoid, and Staphylococcus aureus cellulitis. Of particular concern were the reports of assault and sexual harassment recorded by several students. Elective programs are an important part of many medical courses. With the widespread destinations chosen by students, it is important that they be given adequate pretravel health advice. Most of the health problems encountered by students from the University of Tasmania were mild, but exposure to serious infections was recorded. It is thus imperative that students take out travel health insurance and that they are counseled on how to avoid dangerous situations while abroad.

Further Studies of the Response of Single Rotor Helicopters to Vortex Encounters

DOT National Transportation Integrated Search

1985-09-01

This report is a continuation of the studies described in Reference where a simplified approach to the problem of predicting the uncontrolled response of a single rotor helicopter to an encounter with the wing tip vortex of a large transport aircraft...

Energy Problems and Environmental Concern

ERIC Educational Resources Information Center

Train, Russell E.

1973-01-01

Discusses problems encountered in energy extraction and consumption, involving nuclear power plant construction, environmental consequences of energy systems, and energy conservation ethics. Indicates that the increasing concern over environmental quality is not the true cause of present energy problems. (CC)

HFL-10 lifting body flight control system characteristics and operational experience

NASA Technical Reports Server (NTRS)

Painter, W. D.; Sitterle, G. J.

1974-01-01

A flight evaluation was made of the mechanical hydraulic flight control system and the electrohydraulic stability augmentation system installed in the HL-10 lifting body research vehicle. Flight tests performed in the speed range from landing to a Mach number of 1.86 and the altitude range from 697 meters (2300 feet) to 27,550 meters (90,300 feet) were supplemented by ground tests to identify and correct structural resonance and limit-cycle problems. Severe limit-cycle and control sensitivity problems were encountered during the first flight. Stability augmentation system structural resonance electronic filters were modified to correct the limit-cycle problem. Several changes were made to control stick gearing to solve the control sensitivity problem. Satisfactory controllability was achieved by using a nonlinear system. A limit-cycle problem due to hydraulic fluid contamination was encountered during the first powered flight, but the problem did not recur after preflight operations were improved.

Ambulatory EHR functionality: a comparison of functionality lists.

PubMed

Drury, Barbara M

2006-01-01

There is a proliferation of lists intended to define and clarify the functionality of an ambulatory electronic health record system. These lists come from both private and public entities and vary in terminology, granularity, usability, and comprehensiveness. For example, functionality regarding a problem list includes the following possible definitions: * "Create and maintain patient-specific problem lists," from the HL7 Electronic Health Record Draft Standard for Trial Use. * "Provide a flexible mechanism for retrieval of encounter information that can be organized by diagnosis, problem, problem type," from the Bureau of Primary Health Care. * "The system shall associate encounters, orders, medications and notes with one or more problems," from the Certification Commission on Health Information Technology. * "Displays dates of problems on problem list," from COPIC Insurance Co. * "Shall automatically close acute problems using an automated algorithm," from the Physicians Foundations HIT Subcommittee. This article will compare the attributes of these five electronic health record functionality lists and their usefulness to different audiences-clinicians, application developers and payers.

Ergonomic problems encountered by the surgical team during video endoscopic surgery.

PubMed

Kaya, Oskay I; Moran, Munevver; Ozkardes, Alper B; Taskin, Emre Y; Seker, Gaye E; Ozmen, Mahir M

2008-02-01

The aim of this study is to analyze the problems related to the ergonomic conditions faced by video endoscopic surgical teams during video endoscopic surgery by means of a questionnaire. A questionnaire was distributed to 100 medical personnel, from 8 different disciplines, who performed video endoscopic surgeries. Participants were asked to answer 13 questions related to physical, perceptive, and cognitive problems. Eighty-two questionnaires were returned. Although there were differences among the disciplines, participants assessment of various problems ranged from 32% to 72% owing to poor ergonomic conditions. As the problems encountered by the staff during video endoscopic surgery and the poor ergonomic conditions of the operating room affect the productivity of the surgical team and the safety and efficiency of the surgery, redesigning of the instruments and the operating room is required.

[Some psychological problems in family planning work].

PubMed

Chen, J

1983-11-29

Psychology has significance in family planning work, because it may promote the scientific nature of family planning work and thus increase its effectiveness. Since people have some common aspects in their psychological process, family planning workers should master some common rules of the people's psychological process in order to understand psychological trends and possible behavior. Through this method, family planning workers may find how to adjust to problems they may encounter in their daily work, such as the worries about a single child being too lonely, spoiled, and hard to handle for the parents, the traditional belief that more children represent good fortune, and more male children may provide security for one's old age. Traditionally, the Chinese people believed that only male children can carry on the family line and that more children will provide a larger labor force, which is beneficial to a family's financial situation. In family planning work, all such incorrect ways of thinking should be corrected and revised. Studies of children's psychology should also be developed so that children may develop a healthy mentality. All these are crucial to the success of family planning work and the promotion of population quality.

Orthopaedic Problems of the Mentally Retarded

ERIC Educational Resources Information Center

McSweeney, Anthony

1972-01-01

Problems encountered by orthopedic surgeons treating the mentally retarded are identified, and cooperation among pediatricians, psychiatrists, psychologists, social workers, physiotherapists, occupational therapists, and orthopedic surgeons is recommended. (GW)

Methodological Problems Encountered in the Review of Research in Science Teaching

ERIC Educational Resources Information Center

Lawlor, E. P.; Lawlor, F. X.

1972-01-01

Describes the difficulties encountered in selecting material to be included in the reviews of science education research in the Curtis Series'' published by the Columbia Teachers' College Press. Presents evidence outlining the weaknesses of using a jury'' to determine so-called superior research. (AL)

Developing Multiplicative Thinking from Additive Reasoning

ERIC Educational Resources Information Center

Tobias, Jennifer M.; Andreasen, Janet B.

2013-01-01

As students progress through elementary school, they encounter mathematics concepts that shift from additive to multiplicative situations (NCTM 2000). When they encounter fraction problems that require multiplicative thinking, they tend to incorrectly extend additive properties from whole numbers (Post et al. 1985). As a result, topics such as …

Clue Insensitivity in Remote Associates Test Problem Solving

ERIC Educational Resources Information Center

Smith, Steven M.; Sifonis, Cynthia M.; Angello, Genna

2012-01-01

Does spreading activation from incidentally encountered hints cause incubation effects? We used Remote Associates Test (RAT) problems to examine effects of incidental clues on impasse resolution. When solution words were seen incidentally 3-sec before initially unsolved problems were retested, more problems were resolved (Experiment 1). When…

CPR Drilling.

ERIC Educational Resources Information Center

Kittleson, Mark

1980-01-01

Problems encountered by cardiopulmonary resuscitation (CPR) instructors are discussed and some possible solutions to these problems are suggested. Management techniques for effective use of class size, time, and instructional materials are described. (JN)

Taking evolution seriously in political science.

PubMed

Lewis, Orion; Steinmo, Sven

2010-09-01

In this essay, we explore the epistemological and ontological assumptions that have been made to make political science "scientific." We show how political science has generally adopted an ontologically reductionist philosophy of science derived from Newtonian physics and mechanics. This mechanical framework has encountered problems and constraints on its explanatory power, because an emphasis on equilibrium analysis is ill-suited for the study of political change. We outline the primary differences between an evolutionary ontology of social science and the physics-based philosophy commonly employed. Finally, we show how evolutionary thinking adds insight into the study of political phenomena and research questions that are of central importance to the field, such as preference formation.

Proposed military handbook for dynamic data acquisition and analysis - An invitation to review

NASA Technical Reports Server (NTRS)

Himelblau, Harry; Wise, James H.; Piersol, Allan G.; Grundvig, Max R.

1990-01-01

A draft Military Handbook prepared under the sponsorship of the USAF Space Division is presently being distributed throughout the U.S. for review by the aerospace community. This comprehensive document provides recommended guidelines for the acquisition and analysis of structural dynamics and aeroacoustic data, and is intended to reduce the errors and variability commonly found in flight, ground and laboratory dynamic test measurements. In addition to the usual variety of measurement problems encountered in the definition of dynamic loads, the development of design and test criteria, and the analysis of failures, special emphasis is given to certain state-of-the-art topics, such as pyroshock data acquisition and nonstationary random data analysis.

Aggressive behaviour - prevention and management in the general practice environment.

PubMed

Sim, Moira G; Wain, Toni; Khong, Eric

2011-11-01

Aggressive behaviour is commonly encountered in the general practice setting and can often be de-escalated using good communication skills. This article provides strategies to reduce and manage early aggression in the general practice environment. Aggressive behaviour usually occurs when a person feels unfairly treated. Having a systematic approach to the problem can improve safety for both staff and patients. This includes patient centred practice, identifying and managing the early signs of aggression to prevent escalation, having a plan to seek assistance if required, setting limits using a calm respectful manner and reinforcing limits using behaviour contracts when required. The physical layout of the practice and restraint of aggressive people are beyond the scope of this article.

Asian Rhinoplasty: Preoperative Simulation and Planning Using Adobe Photoshop.

PubMed

Kiranantawat, Kidakorn; Nguyen, Anh H

2015-11-01

A rhinoplasty in Asians differs from a rhinoplasty performed in patients of other ethnicities. Surgeons should understand the concept of Asian beauty, the nasal anatomy of Asians, and common problems encountered while operating on the Asian nose. With this understanding, surgeons can set appropriate goals, choose proper operative procedures, and provide an outcome that satisfies patients. In this article the authors define the concept of an Asian rhinoplasty-a paradigm shift from the traditional on-top augmentation rhinoplasty to a structurally integrated augmentation rhinoplasty-and provide a step-by-step procedure for the use of Adobe Photoshop as a preoperative program to simulate the expected surgical outcome for patients and to develop a preoperative plan for surgeons.

Diagnosis and management of plantar fasciitis.

PubMed

Thompson, John V; Saini, Sundeep S; Reb, Christopher W; Daniel, Joseph N

2014-12-01

Plantar fasciitis, a chronic degenerative process that causes medial plantar heel pain, is responsible for approximately 1 million physician visits each year. Individuals with plantar fasciitis experience pain that is most intense during their first few steps of the day or after prolonged standing. The authors provide an overview of the diagnosis and management of a common problem encountered in the primary care setting. Routine imaging is not initially recommended for the evaluation of plantar fasciitis but may be required to rule out other pathologic conditions. Overall, plantar fasciitis carries a good prognosis when patients use a combination of several conservative treatment modalities. Occasionally, referral to a specialist may be necessary. © 2014 The American Osteopathic Association.

Caring for homeless persons with serious mental illness in general hospitals.

PubMed

Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

2013-01-01

The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Practical use and pitfalls of hepatocyte-specific contrast agents (HSCAs) for pediatric hepatic and biliary magnetic resonance imaging.

PubMed

Ayyala, Rama S; Anupindi, Sudha A; Callahan, Michael J

2017-02-01

Magnetic resonance imaging is commonly used to evaluate for hepatic and biliary pathology in the pediatric population. Recently, there has been increased use of hepatocyte-specific contrast agents (HSCAs), such as Gadoxetate disodium in children. Traditionally, HSCAs have been used to characterize focal liver lesions. However, these agents can also be used to problem solve specific hepatic or biliary diagnostic dilemmas. The purpose of this manuscript is to review the practical uses of HSCA in children with both hepatic and biliary indications, and review the corresponding imaging findings. We will highlight the diagnostic uses of HSCA in children, as well as pitfalls encountered.

Orthodontics

PubMed Central

Hemrend, Bernard; Altuna, Gurkan; Tompson, Bryan

1989-01-01

The authors of this article offer an introduction to the field of orthodontics. They present the latest advances in orthodontic appliances and some of the possible consequences of orthodontic treatment. They discuss a number of cases and offer examples of some of the more common problems that the orthodontist is asked to treat. Such cases include severe Class II, division 1 malocclusion, surgical orthodontics, “long-face” syndrome, adult orthodontics-TMJ-periodontics, late adult growth, and post-retention changes. Practical information useful to the physician who encounters patient with these disorders is balanced with good research data to support the various claims. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9 PMID:21249042

Time Trends in the Family Physician Management of Insomnia: The Australian Experience (2000-2015).

PubMed

Miller, Christopher B; Valenti, Lisa; Harrison, Christopher M; Bartlett, Delwyn J; Glozier, Nick; Cross, Nathan E; Grunstein, Ronald R; Britt, Helena C; Marshall, Nathaniel S

2017-06-15

To evaluate changes in rates of family physician (FP) management of insomnia in Australia from 2000-2015. The Bettering the Evaluation And Care of Health (BEACH) program is a nationally representative cross-sectional survey of 1,000 newly randomly sampled family physicians' activity in Australia per year, who each record details of 100 consecutive patient encounters. This provided records of approximately 100,000 encounters each year. We identified all encounters with patients older than 15 years where insomnia or difficulty sleeping was managed and assessed trends in these encounters from 2000-2015. There was no change in the management rate of insomnia from 2000-2007 (1.54 per 100 encounters [95% confidence interval [CI]: 1.49-1.58]). This rate was lower from 2008-2015 (1.31 per 100 encounters [95% CI: 1.27-1.35]). There was no change in FP management: pharmacotherapy was used in approximately 90% of encounters; nonpharmacological advice was given at approximately 20%; and onward referral at approximately 1% of encounters. Prescription of temazepam changed from 54.6 [95% CI: 51.4-57.9] per 100 insomnia problems in 2000-2001 to 43.6 [95% CI: 40.1-47.0] in 2014-2015, whereas zolpidem increased steadily from introduction in 2000 to 14.6 [95% CI: 12.2-17.1] per 100 insomnia problems in 2006-2007, and then decreased to 7.3 [95% CI: 5.4-9.2] by 2014-2015. Insomnia management frequency decreased after 2007 in conjunction with ecologically associated Australian media reporting of adverse effects linked to zolpidem use. Australian FPs remain reliant on pharmacotherapy for the management of insomnia. © 2017 American Academy of Sleep Medicine

Challenges Encountered by 17 Autistic Young Adults in Hong Kong

ERIC Educational Resources Information Center

Wong, Shui-wai

2017-01-01

The self-portrayals of 17 young persons with autism spectrum disorder reveal the challenges encountered by them, including study problems, inter-personal relationships, being bullied by classmates at school, discrimination by the public in general and teachers, social workers, and peers in particular, obstacles to post-secondary education,…

Value of Family and Group Counseling Models where Grandparents Function as Parents to Their Grandchildren

ERIC Educational Resources Information Center

Edwards, Oliver W.; Ray, Shannon L.

2010-01-01

Those involved in circumstances in which children are raised by their grandparents often encounter serious problems that require assistance from counselors. Research suggests that grandparents and parents in these families typically experience heightened stress and psychosocial distress. Additionally, the children often encounter behavioral,…

Israeli Adolescents and Military Service: Encounters.

ERIC Educational Resources Information Center

Levy, Amihay; And Others

1987-01-01

Asserts that inadequate attention has been paid to the problems of the young soldier entering army life in Israel. Delineates some areas of friction and vulnerability between the worlds of the youth and the military. Describes the systematization of these encounters into groups, creating the "Binary Model," which helps in locating and…

U.S. healthcare providers’ experience with Lyme and other tick-borne diseases

PubMed Central

Brett, Meghan E.; Hinckley, Alison F.; Zielinski-Gutierrez, Emily C.; Mead, Paul S.

2015-01-01

Surveillance indicates that tick-borne diseases are a common problem in the United States. Nevertheless, little is known regarding the experience or management practices of healthcare providers who treat these conditions. The purpose of the present study was to characterize the frequency of tick-borne diseases in clinical practice and the knowledge of healthcare providers regarding their management. Four questions about tick-borne diseases were added to the 2009 Docstyles survey, a nationally representative survey of >2000 U.S. healthcare providers. Topics included diseases encountered, management of patients with early Lyme disease (LD), provision of tick-bite prophylaxis, and sources of information on tick-borne diseases. Overall, 51.3% of practitioners had treated at least one patient for a tick-borne illness in the previous year. Among these, 75.1% had treated one type of disease, 19.0% two types of disease, and 5.9% three or more diseases. LD was encountered by 936 (46.8%) providers; Rocky Mountain spotted fever was encountered by 184 (9.2%) providers. Given a scenario involving early LD, 89% of providers would prescribe antibiotics at the first visit, with or without ordering a blood test. Tick-bite prophylaxis was prescribed by 31.0% of all practitioners, including 41.1% in high-LD-incidence states and 26.0% in low-incidence states. Tick-borne diseases are encountered frequently in clinical practice. Most providers would treat early LD promptly, suggesting they are knowledgeable regarding the limitations of laboratory testing in this setting. Conversely, providers in low-LD-incidence states frequently prescribe tick-bite prophylaxis, suggesting a need for education to reduce potential misdiagnosis and overtreatment. PMID:24713280

"What constitutes a 'problem'?" Producing 'alcohol problems' through online counselling encounters.

PubMed

Savic, Michael; Ferguson, Nyssa; Manning, Victoria; Bathish, Ramez; Lubman, Dan I

2017-08-01

Typically, health policy, practice and research views alcohol and other drug (AOD) 'problems' as objective things waiting to be detected, diagnosed and treated. However, this approach to policy development and treatment downplays the role of clinical practices, tools, discourses, and systems in shaping how AOD use is constituted as a 'problem'. For instance, people might present to AOD treatment with multiple psycho-social concerns, but usually only a singular AOD-associated 'problem' is considered serviceable. As the assumed nature of 'the serviceable problem' influences what treatment responses people receive, and how they may come to be enacted as 'addicted' or 'normal' subjects, it is important to subject clinical practices of problem formulation to critical analysis. Given that the reach of AOD treatment has expanded via the online medium, in this article we examine how 'problems' are produced in online alcohol counselling encounters involving people aged 55 and over. Drawing on poststructural approaches to problematisation, we not only trace how and what 'problems' are produced, but also what effects these give rise to. We discuss three approaches to problem formulation: (1) Addiction discourses at work; (2) Moving between concerns and alcohol 'problems'; (3) Making 'problems' complex and multiple. On the basis of this analysis, we argue that online AOD counselling does not just respond to pre-existing 'AOD problems'. Rather, through the social and clinical practices of formulation at work in clinical encounters, online counselling also produces them. Thus, given a different set of circumstances, practices and relations, 'problems' might be defined or emerge differently-perhaps not as 'problems' at all or perhaps as different kinds of concerns. We conclude by highlighting the need for a critical reflexivity in AOD treatment and policy in order to open up possibilities for different ways of engaging with, and responding to, people's needs in their complexity. Copyright © 2017 Elsevier B.V. All rights reserved.

Strategy Keys as Tools for Problem Solving

ERIC Educational Resources Information Center

Herold-Blasius, Raja

2017-01-01

Problem solving is one of the main competences we seek to teach students at school for use in their future lives. However, when dealing with mathematical problems, teachers encounter a wide variety of difficulties. To foster students' problem-solving skills, the authors developed "strategy keys." Strategy keys can serve as material to…

Skin Diseases Affecting High-Level Competition Sailors: Descriptive Study Carried Out During the 2012 AG2R Transatlantic Boat Race.

PubMed

Loddé, Brice; Mahé, Catherine; Jacolot, Laure; Pougnet, Richard; Lucas, David; Jegaden, Dominique; Dewitte, Jean-Dominique; Misery, Laurent; Lucas, Ray

2016-03-01

The primary objective of this study was to identify skin disorders encountered in a population of sport sailors. Unlike merchant mariners and fishermen, there is sparse literature on this maritime population. Secondary objectives were to uncover on-board conditions that may contribute to dermatological problems in this population. We conducted a prospective study during the 2012 AG2R transatlantic race. Sixteen two-man crews participated in this race, all using the same model of sailboat (Bénéteau Figaro 2). Clinical examinations were conducted, photographs taken, and questionnaires containing 34 questions were handed out before departure and on arrival, 22 to 24 days later. Twenty-eight of 32 skippers (88%) participated in departure data collection, and 18 (56%) completed data collection on arrival. The average age of sailors was 34 years (SD = 8). Compared with skin diseases documented on departure, there was an increased amount of folliculitis on the buttocks, fungal infections, and hyperkeratosis of the hands on arrival. Furthermore, several new skin problems were found postrace: skin scaling, skin erosions on the buttocks, dyshidrosis, thermal burns, and sunburns. The use of protective gear and sunscreen was common, but on-board hygiene was poor with infrequent bathing and clothing changes. Skin conditions are nearly universal in this maritime population. Further assessments are needed to know if long-term use of protective gear; improved hygiene; use of barrier creams; and proper on-board care of fungal infections, wounds, and burns could reduce the number and severity of skin problems encountered in sport sailors. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Beyond Ockham's razor: redefining problem-solving in clinical sleep medicine using a "five-finger" approach.

PubMed

McCarty, David E

2010-06-15

The rule of diagnostic parsimony--otherwise known as "Ockham's Razor"--teaches students of medicine to find a single unifying diagnosis to explain a given patient's symptoms. While this approach has merits in some settings, a more comprehensive approach is often needed for patients with chronic, nonspecific presentations for which there is a broad differential diagnosis. The cardinal manifestations of sleep disorders--daytime neurocognitive impairment and subjective sleep disturbances-are examples of such presentations. Successful sleep medicine clinicians therefore approach every patient with the knowledge that multiple diagnoses-rather than simply one-are likely to be found. Teaching an integrated and comprehensive approach to other clinicians in an organized and reproducible fashion is challenging, and the evaluation of effectiveness of such teaching is even more so. As a practical aid for teaching the approach to--and evaluation of--a comprehensive sleep medicine encounter, five functional domains of sleep medicine clinical problem-solving are presented as potential sources for sleep/wake disruption: (1) circadian misalignment, (2) pharmacologic factors, (3) medical factors, (4) psychiatric/psychosocial factors, and (5) primary sleep medicine diagnoses. These domains are presented and explained in an easy-to-remember "five finger" format. The five finger format can be used in real time to evaluate the completeness of a clinical encounter, or can be used in the design of standardized patients to identify areas of strength and potential weakness. A score sheet based upon this approach is offered as an alternative to commonly used Likert scales as a potentially more objective and practical measure of clinical problem-solving competence, making it useful for training programs striving to achieve or maintain fellowship accreditation.

Problem-based learning: Using students' questions to drive knowledge construction

NASA Astrophysics Data System (ADS)

Chin, Christine; Chia, Li-Gek

2004-09-01

This study employed problem-based learning for project work in a year 9 biology class. The purpose of the study was to investigate (a) students' inspirations for their self-generated problems and questions, (b) the kinds of questions that students asked individually and collaboratively, and (c) how students' questions guided them in knowledge construction. Data sources included observation and field notes, students' written documents, audiotapes and videotapes of students working in groups, and student interviews. Sources of inspiration for students' problems and questions included cultural beliefs and folklore; wonderment about information propagated by advertisements and the media; curiosity arising from personal encounters, family members' concerns, or observations of others; and issues arising from previous lessons in the school curriculum. Questions asked individually pertained to validation of common beliefs and misconceptions, basic information, explanations, and imagined scenarios. The findings regarding questions asked collaboratively are presented as two assertions. Assertion 1 maintained that students' course of learning were driven by their questions. Assertion 2 was that the ability to ask the right'' questions and the extent to which these could be answered, were important in sustaining students' interest in the project. Implications of the findings for instructional practice are discussed.

Ciguatera poisoning: a global issue with common management problems.

PubMed

Ting, J Y; Brown, A F

2001-12-01

Ciguatera poisoning, a toxinological syndrome comprising an enigmatic mixture of gastrointestinal, neurocutaneous and constitutional symptoms, is a common food-borne illness related to contaminated fish consumption. As many as 50000 cases worldwide are reported annually, and the condition is endemic in tropical and subtropical regions of the Pacific Basin, Indian Ocean and Caribbean. Isolated outbreaks occur sporadically but with increasing frequency in temperate areas such as Europe and North America. Increase in travel between temperate countries and endemic areas and importation of susceptible fish has led to its encroachment into regions of the world where ciguatera has previously been rarely encountered. In the developed world, ciguatera poses a public health threat due to delayed or missed diagnosis. Ciguatera is frequently encountered in Australia. Sporadic cases are often misdiagnosed or not medically attended to, leading to persistent or recurrent debilitating symptoms lasting months to years. Without treatment, distinctive neurologic symptoms persist, occasionally being mistaken for multiple sclerosis. Constitutional symptoms may be misdiagnosed as chronic fatigue syndrome. A common source outbreak is easier to recognize and therefore notify to public health organizations. We present a case series of four adult tourists who developed ciguatera poisoning after consuming contaminated fish in Vanuatu. All responded well to intravenous mannitol. This is in contrast to a fifth patient who developed symptoms suggestive of ciguatoxicity in the same week as the index cases but actually had staphylococcal endocarditis with bacteraemia. In addition to a lack of response to mannitol, clinical and laboratory indices of sepsis were present in this patient. Apart from ciguatera, acute gastroenteritis followed by neurological symptoms may be due to paralytic or neurotoxic shellfish poisoning, scombroid and pufferfish toxicity, botulism, enterovirus 71, toxidromes and bacteraemia. Clinical aspects of ciguatera toxicity, its pathophysiology, diagnostic difficulties and epidemiology are discussed.

Separation in Logistic Regression: Causes, Consequences, and Control.

PubMed

Mansournia, Mohammad Ali; Geroldinger, Angelika; Greenland, Sander; Heinze, Georg

2018-04-01

Separation is encountered in regression models with a discrete outcome (such as logistic regression) where the covariates perfectly predict the outcome. It is most frequent under the same conditions that lead to small-sample and sparse-data bias, such as presence of a rare outcome, rare exposures, highly correlated covariates, or covariates with strong effects. In theory, separation will produce infinite estimates for some coefficients. In practice, however, separation may be unnoticed or mishandled because of software limits in recognizing and handling the problem and in notifying the user. We discuss causes of separation in logistic regression and describe how common software packages deal with it. We then describe methods that remove separation, focusing on the same penalized-likelihood techniques used to address more general sparse-data problems. These methods improve accuracy, avoid software problems, and allow interpretation as Bayesian analyses with weakly informative priors. We discuss likelihood penalties, including some that can be implemented easily with any software package, and their relative advantages and disadvantages. We provide an illustration of ideas and methods using data from a case-control study of contraceptive practices and urinary tract infection.

Immersed boundary methods for simulating fluid-structure interaction

NASA Astrophysics Data System (ADS)

Sotiropoulos, Fotis; Yang, Xiaolei

2014-02-01

Fluid-structure interaction (FSI) problems commonly encountered in engineering and biological applications involve geometrically complex flexible or rigid bodies undergoing large deformations. Immersed boundary (IB) methods have emerged as a powerful simulation tool for tackling such flows due to their inherent ability to handle arbitrarily complex bodies without the need for expensive and cumbersome dynamic re-meshing strategies. Depending on the approach such methods adopt to satisfy boundary conditions on solid surfaces they can be broadly classified as diffused and sharp interface methods. In this review, we present an overview of the fundamentals of both classes of methods with emphasis on solution algorithms for simulating FSI problems. We summarize and juxtapose different IB approaches for imposing boundary conditions, efficient iterative algorithms for solving the incompressible Navier-Stokes equations in the presence of dynamic immersed boundaries, and strong and loose coupling FSI strategies. We also present recent results from the application of such methods to study a wide range of problems, including vortex-induced vibrations, aquatic swimming, insect flying, human walking and renewable energy. Limitations of such methods and the need for future research to mitigate them are also discussed.

[Ethics in clinical practice and in health care].

PubMed

Pintor, S; Mennuni, G; Fontana, M; Nocchi, S; Giarrusso, P; Serio, A; Fraioli, A

2015-01-01

The clinical ethics is the identification, analysis and solution of moral problems that can arise during the care of a patient. Given that when dealing with ethical issues in health care some risks will be encountered (talking about ethics in general, or as a problem overlapped with others in this area, or by delegation to legislative determinations) in the text certain important aspects of the topic are examined. First of all ethics as human quality of the relationship between people for the common good, especially in health services where there are serious problems like the life and the health. It is also necessary a "humanizing relationship" between those who work in these services in order to achieve quality and efficiency in this business. It is important a proper training of health professionals, especially doctors, so that they can identify the real needs and means of intervention. It is also important that scientific research must respect fundamental ethical assumptions. In conclusion, ethics in health care is not a simple matter of "cookbook" rules, but involves the responsibility and consciousness of individual operators.

Democracy in NGOs: Making the Cooperative Option Work.

ERIC Educational Resources Information Center

Wardle, Chris

1988-01-01

Discusses several problems encountered by nongovernmental organizations (NGOs) that structure themselves as cooperatives, with all members being equal. Presents four problem areas--(1) decision making, (2) meetings, (3) job rotation, and (4) growth--as well as strategies to solve potential problems. (CH)

The Effect of New Vocabulary on Problem Solving in Novice Physics Students.

ERIC Educational Resources Information Center

Sobolewski, Stanley J.

One of the difficulties encountered by novice problem solvers in introductory physics is in the area of problem solving. It has been shown in other studies that poor problem solvers are affected by the surface aspects of the problem in contrast with more efficient problem solvers who are capable of constructing a mental model of the physical…

Problems Implementing Problem-Based Learning by a Private Malaysian University

ERIC Educational Resources Information Center

Tik, Chan Chang

2014-01-01

In this case study the focus is on lecturers' readiness in the design of PBL problems and to facilitate students' learning. This paper also looks into students' readiness in terms of acquiring metacognitive skills and collaborating in group to solve PBL problems. Problems encountered by both lecturers and students are discussed in the context of…

Determining the Performances of Pre-Service Primary School Teachers in Problem Posing Situations

ERIC Educational Resources Information Center

Kilic, Cigdem

2013-01-01

This study examined the problem posing strategies of pre-service primary school teachers in different problem posing situations (PPSs) and analysed the issues they encounter while posing problems. A problem posing task consisting of six PPSs (two free, two structured, and two semi-structured situations) was delivered to 40 participants.…

Back pain and the resolution of diagnostic uncertainty in illness narratives.

PubMed

Lillrank, Annika

2003-09-01

In this paper I consider 30 Finnish women's written narratives about the process of getting back pain diagnosed. From the beginning of the early discomfort of back pain, the women were sure of its bodily and subjective reality. They struggled repeatedly to be taken seriously, and only after years of medical disparagement did they encounter medical professionals who were able solve the riddle and give it a name, a diagnosis. Since back pain is a baffling problem and challenges the central biomedical epistemology-objective knowledge and measurable findings separate from subjective experience-it allowed the doctors to show a disrespectful attitude toward back pain sufferers. The moral essence of the women's common story was the stigmatizing experience when doctors did not take subjective pain seriously. Instead, doctors' neglectful attitudes became part of the prolonged problem. During the long-lasting uncertainty, women tried multiple coping strategies to ease their lives and developed mental attitudes to endure the pain. Since the protagonists did not give up the lived certainty of back pain they were gradually able to challenge medical uncertainty and to demand a thorough medical examination, and/or through random circumstance they encountered doctors who were willing to take their symptoms seriously. This triggered turning points that immediately or very soon resulted in solving the riddle of the puzzling pain. To be finally diagnosed was a great relief. However, to be taken seriously as a person was considered to be the greatest relief.

Patients' experiences of healthcare encounters in severe irritable bowel syndrome: an analysis based on narrative and feminist theory.

PubMed

Björkman, Ida; Simrén, Magnus; Ringström, Gisela; Jakobsson Ung, Eva

2016-10-01

This study aimed to explore patients' experiences of healthcare encounters in severe irritable bowel syndrome. Irritable bowel syndrome is a common functional disorder with symptoms such as abdominal pain and disturbed bowel habits, the cause of which is not completely known. Treatments options are limited, and healthcare encounters in irritable bowel syndrome have been described as unsatisfying and frustrating for both patients and professional healthcare providers. Furthermore, the influence of power on healthcare encounters has long been recognised, especially regarding the disadvantaged position of those suffering from functional illness which cannot be identified by commonly used tests or investigations. We interviewed 10 patients during 2014, all attending an outpatient clinic and suffering from severe irritable bowel syndrome. Relying on narrative and feminist theory, we explored how they actively negotiate professional discourse communicated to them in the clinical encounter. The patients' experiences of healthcare encounters in irritable bowel syndrome were mostly described as negative, and often induced feelings of confusion and self-doubt. Positive encounters were described as being listened to, believed and taken seriously. Narrators found it especially problematic when healthcare professionals described irritable bowel syndrome as a minor disorder with primarily stress or psychological aetiology and put the responsibility for recovery onto the patient. Patients' actively negotiated such professional discourse by presenting a counternarrative describing their own suffering and strengths, experienced healthcare shortcomings and possible organic aetiology of irritable bowel syndrome. Patients suffering from severe irritable bowel syndrome described how they often felt a need to protect their positive identities in the face of trivialisation and disbelief by healthcare professionals. A deepened understanding of patients' experiences of healthcare encounters in irritable bowel syndrome could enable more helpful and supporting interventions by healthcare professionals. © 2016 John Wiley & Sons Ltd.

Medical and psychological problems faced by young Australian gap year travellers.

PubMed

Furuya-Kanamori, Luis; Mills, Deborah; Sheridan, Sarah; Lau, Colleen

2017-09-01

Gap year travellers can potentially be exposed to many infectious diseases and other travel-related health problems including injuries and psychological problems. Currently, there is little information on health and wellbeing of this particular group of travellers. Participants were recruited from an organization that specialized in organising international gap year placements. Gap year travellers were asked to complete a pre-departure survey on demographics, placement destination and duration, previous travel experience, hobbies, risk taking behaviour, anticipated problems during the placement, and pre-travel preparations. After the placement, participants were asked to complete a post-trip survey on their experiences, problems, health issues, and medical treatment required. The 88 and 34 gap year travellers aged 17-23 years completed pre- and post-placement surveys respectively. The duration of placements ranged from 3 to 12 months. Psychological stressors were frequently reported [ n = 26 (76.5%) felt home sick; n = 18 (52.9%) experienced culture shock; n = 17 (50.0%) had difficulty communicating with the locals]. The majority of participants (91.2%) tried to work out a solution for the stressor on their own. Twenty-eight (82.4%) participants reported medical problems during their placement; the most common problems were sunburn ( n = 19; 55.9%), respiratory infections ( n = 15; 44.1%), weight change ( n = 14; 41.2%), and diarrhoea/food poisoning ( n = 13; 38.2%). Three participants (3.4%) were admitted to hospital; for a muscle injury, head injury and skin infection after getting a tribal tattoo. Psychological stressors were common, but most did not seek help. Some medical problems encountered during their placement may have been preventable with improved pre-departure preparation. Gap year, pre-departure, preparation. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Common respiratory conditions of the newborn

PubMed Central

Gallacher, David J.; Hart, Kylie

2016-01-01

Key points Respiratory distress is a common presenting feature among newborn infants. Prompt investigation to ascertain the underlying diagnosis and appropriate subsequent management is important to improve outcomes. Many of the underlying causes of respiratory distress in a newborn are unique to this age group. A chest radiograph is crucial to assist in diagnosis of an underlying cause. Educational aims To inform readers of the common respiratory problems encountered in neonatology and the evidence-based management of these conditions. To enable readers to develop a framework for diagnosis of an infant with respiratory distress. The first hours and days of life are of crucial importance for the newborn infant as the infant adapts to the extra-uterine environment. The newborn infant is vulnerable to a range of respiratory diseases, many unique to this period of early life as the developing fluid-filled fetal lungs adapt to the extrauterine environment. The clinical signs of respiratory distress are important to recognise and further investigate, to identify the underlying cause. The epidemiology, diagnostic features and management of common neonatal respiratory conditions are covered in this review article aimed at all healthcare professionals who come into contact with newborn infants. PMID:27064402

Robotic assisted Roux-en-Y hepaticojejunostomy in a post-cholecystectomy type E2 bile duct injury

PubMed Central

Prasad, Arun; De, Sudipto; Mishra, Purak; Tiwari, Abhishek

2015-01-01

Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice for common hepatic duct injury type E2. It has been performed laparoscopically with the advancement of laparoscopic skill. Recently, a telemanipulative robotic surgical system was introduced, providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of the operative field. We present a case of 36-year-old female patient who had undergone elective cholecystectomy 2 mo ago for gall stones and had a common bile duct injury during surgery. As the stricture was old and complete it could not be tackled endoscopically. We did a laparoscopic assisted adhesiolysis followed by robotic Roux-en-Y hepaticojejunostomy. No intraoperative complications or technical problems were encountered. Postoperative period was uneventful and she was discharged on the 4th postoperative day. At follow-up, she is doing well without evidence of jaundice or cholangitis. This is the first reported case of robotic hepaticojejunostomy following common bile duct injury. The hybrid technique gives the patient benefit of laparoscopic adhesiolysis and robotic suturing. PMID:25684934

Methods of reconstruction for bone defect after tumor excision: a review of alternatives.

PubMed

Nishida, Jun; Shimamura, Tadashi

2008-08-01

Bone defect is a common problem encountered in the treatment of musculoskeletal tumor surgery. Allograft is a commonly used technique to reconstruct a large osseous defect following tumor excision in the United States and some European countries, and relatively good results have been reported because of its biologic nature. However, with the use of an allograft, there are concerns of transmission of infectious diseases, immunological reactions, and social or religious refusal in some regions in the world. Under these circumstances, vascularized autogenous fibular or iliac bone grafts are commonly used techniques and bone lengthening techniques using external fixation have been reported recently. These procedures utilize viable bone. In addition to these procedures, some biological reconstructive techniques utilizing nonviable bone have been performed as surgical alternatives for allografts using treated recycling bone including irradiated or pasteurized resected bone graft and reconstruction using an autograft containing tumor treated by liquid nitrogen. Although each technique has its proper advantages and disadvantages, the clinical results are similar to the allograft, and numerous techniques are now available as reasonable alternatives for allografts.

Beyond Ockham's Razor: Redefining Problem-Solving in Clinical Sleep Medicine using a “Five-Finger” Approach

PubMed Central

McCarty, David E.

2010-01-01

The rule of diagnostic parsimony—otherwise known as “Ockham's Razor”—teaches students of medicine to find a single unifying diagnosis to explain a given patient's symptoms. While this approach has merits in some settings, a more comprehensive approach is often needed for patients with chronic, nonspecific presentations for which there is a broad differential diagnosis. The cardinal manifestations of sleep disorders—daytime neurocognitive impairment and subjective sleep disturbances—are examples of such presentations. Successful sleep medicine clinicians therefore approach every patient with the knowledge that multiple diagnoses—rather than simply one—are likely to be found. Teaching an integrated and comprehensive approach to other clinicians in an organized and reproducible fashion is challenging, and the evaluation of effectiveness of such teaching is even more so. As a practical aid for teaching the approach to—and evaluation of—a comprehensive sleep medicine encounter, five functional domains of sleep medicine clinical problem-solving are presented as potential sources for sleep/wake disruption: (1) circadian misalignment, (2) pharmacologic factors, (3) medical factors, (4) psychiatric/psychosocial factors, and (5) primary sleep medicine diagnoses. These domains are presented and explained in an easy-to-remember “five finger” format. The five finger format can be used in real time to evaluate the completeness of a clinical encounter, or can be used in the design of standardized patients to identify areas of strength and potential weakness. A score sheet based upon this approach is offered as an alternative to commonly used Likert scales as a potentially more objective and practical measure of clinical problem-solving competence, making it useful for training programs striving to achieve or maintain fellowship accreditation. Citation: McCarty DE. Beyond Ockham's Razor: redefining problem-solving in clinical sleep medicine using a “five-finger” approach. J Clin Sleep Med 2010;6(3):292-269. PMID:20572425

Helping Students Navigate Faith Challenges in the Biblical Studies Classroom

ERIC Educational Resources Information Center

Sharp, Carolyn J.; Clark-Soles, Jaime

2012-01-01

What happens when students encounter the academic study of the Bible in the seminary or undergraduate classroom? Does a teacher have a responsibility to help students navigate challenges to Christian faith that might arise? What pedagogical problems and opportunities does this encounter present? How does this issue manifest differently in…

Tips for Novice Researchers: Operational Difficulties Encountered in Underdeveloped Countries.

ERIC Educational Resources Information Center

Belcher El-Nahhas, Susan M.

This paper provides a general overview of the type of problems encountered in the field of research so that individuals who are contemplating conducting research in an underdeveloped country for the first time are better prepared, and hence, better able to complete their research. The paper recounts a female researcher's personal experiences in…

Doctor-patient communication on the telephone.

PubMed

Curtis, P; Evens, S

1989-01-01

Since its invention, the telephone has been an important tool in medical practice, particularly for primary care physicians. Approximately half the calls made to a physician's office during regular consulting hours are for clinical problems and most are handled effectively over the phone without an immediate office visit. Telephone encounters are generally very brief, and managing such calls requires a pragmatic approach that is often quite different from the approach taken in the office visit. The telephone encounter should be recognized and recorded as a specific medical interaction in the medical chart for both clinical and legal reasons. Effective telephone encounters depend on good communication skills; decision making regarding disposition is a major goal. The physician's perception of a medical problem may be different from the patient's; patients are frequently seeking advice and reassurance rather than diagnosis and treatment, and may call because of anxiety and psychological stress. For physicians and their families who are not prepared for after-hours telephone encounters, calls that interrupt more "legitimate" activities may result in anger or frustration for the physician and dissatisfaction for the patient.

Problem-Solving Examples as Interactive Learning Objects for Educational Digital Libraries

ERIC Educational Resources Information Center

Brusilovsky, Peter; Yudelson, Michael; Hsiao, I-Han

2009-01-01

The paper analyzes three major problems encountered by our team as we endeavored to turn problem solving examples in the domain of programming into highly reusable educational activities, which could be included as first class objects in various educational digital libraries. It also suggests three specific approaches to resolving these problems,…

Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics.

PubMed

Tseng, Mei-Chih Meg; Chen, Kuan-Yu; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

2016-04-30

Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

ADOPTING THE PROBLEM BASED LEARNING APPROACH IN A GIS PROJECT MANAGEMENT CLASS

EPA Science Inventory

Problem Based Learning (PBL) is a process that emphasizes the need for developing problem solving skills through hands-on project formulation and management. A class adopting the PBL method provides students with an environment to acquire necessary knowledge to encounter, unders...

Problems in Evaluating Adult Literacy Programmes.

ERIC Educational Resources Information Center

Rajyalakshmi, C.

1980-01-01

The study of the Functional Literacy Program in India encountered problems of opposition to evaluation, inappropriate respondents, and difficulties in contacting participants, which point to changes that should be made in the evaluation methods. (SK)

76 FR 6054 - Use of Less-Than-Lethal Force: Delegation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-03

... report any medical problems encountered by subjects being subdued and arrested, and no medical problems.... Therefore, for accuracy in terminology, we replace the term ``non-lethal'' with the more accurate term...

Health profiles of foreigners attending primary care clinics in Malaysia.

PubMed

Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming

2016-06-14

The world population has become more globalised with increasing number of people residing in another country for work or other reasons. Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia. Data were derived from the 2012 National Medical Care Survey (NMCS), a cross sectional survey of primary care encounters from public and private primary care clinics sampled from five regions in Malaysia. Patients with foreign nationality were identified and analysed for demographic profiles, reasons for encounter (RFEs), diagnosis, and provision of care. Foreigners accounted for 7.7 % (10,830) of all patient encounters from NMCS. Most encounters were from private clinics (90.2 %). Median age was 28 years (IQR: 24.0, 34.8) and 69.9 % were male. Most visits to the primary care clinics were for symptom-based complaints (69.5 %), followed by procedures (23.0 %) and follow-up visit (7.4 %). The commonest diagnosis in public clinics was antenatal care (21.8 %), followed by high risk pregnancies (7.5 %) and upper respiratory tract infection (URTI) (6.8 %). Private clinics had more cases for general medical examination (13.5 %), URTI (13.1 %) and fever (3.9 %). Medications were prescribed to 76.5 % of these encounters. More foreigners were seeking primary medical care from private clinics and the encounters were for general medical examinations and acute minor ailments. Those who sought care from public clinics were for obstetric problems and chronic diseases. Medications were prescribed to two-thirds of the encounters while other interventions: laboratory investigations, medical procedures and follow-up appointment had lower rates in private clinics. Foreigners are generally of young working group and are expected to have mandatory medical checks. The preponderance of obstetrics seen in public clinics suggests a need for improved access to maternal care and pregnancy related care. This has implication on policy and health care provision and access for foreigners and future studies are needed to look into strategies to solve these problems.

Applications of remote sensing to water resources

NASA Technical Reports Server (NTRS)

1977-01-01

Analyses were made of selected long-term (1985 and beyond) objectives, with the intent of determining if significant data-related problems would be encountered and to develop alternative solutions to any potential problems. One long-term objective selected for analysis was Water Availability Forecasting. A brief overview was scheduled in FY-77 of the objective -- primarily a fact-finding study to allow Data Management personnel to gain adequate background information to perform subsequent data system analyses. This report, includes discussions on some of the larger problems currently encountered in water measurement, the potential users of water availability forecasts, projected demands of users, current sensing accuracies, required parameter monitoring, status of forecasting modeling, and some measurement accuracies likely to be achievable by 1980 and 1990.

Learning Impasses in Problem Solving

NASA Technical Reports Server (NTRS)

Hodgson, J. P. E.

1992-01-01

Problem Solving systems customarily use backtracking to deal with obstacles that they encounter in the course of trying to solve a problem. This paper outlines an approach in which the possible obstacles are investigated prior to the search for a solution. This provides a solution strategy that avoids backtracking.

Using CAS to Solve Classical Mathematics Problems

ERIC Educational Resources Information Center

Burke, Maurice J.; Burroughs, Elizabeth A.

2009-01-01

Historically, calculus has displaced many algebraic methods for solving classical problems. This article illustrates an algebraic method for finding the zeros of polynomial functions that is closely related to Newton's method (devised in 1669, published in 1711), which is encountered in calculus. By exploring this problem, precalculus students…

Beyond Utility Targeting: Toward Axiological Air Operations

DTIC Science & Technology

2000-01-01

encounter the leader- sociopath , bereft of values, quite willing to live underground in hiding and in- sensitive to the absence of human comforts...that is a mere one thousand value-analysis problems to begin solving. A more difficult problem to solve is the problem of the leader- sociopath

Fix and forget or fix and report: a qualitative study of tensions at the front line of incident reporting.

PubMed

Hewitt, Tanya Anne; Chreim, Samia

2015-05-01

Practitioners frequently encounter safety problems that they themselves can resolve on the spot. We ask: when faced with such a problem, do practitioners fix it in the moment and forget about it, or do they fix it in the moment and report it? We consider factors underlying these two approaches. We used a qualitative case study design employing in-depth interviews with 40 healthcare practitioners in a tertiary care hospital in Ontario, Canada. We conducted a thematic analysis, and compared the findings with the literature. 'Fixing and forgetting' was the main choice that most practitioners made in situations where they faced problems that they themselves could resolve. These situations included (A) handling near misses, which were seen as unworthy of reporting since they did not result in actual harm to the patient, (B) prioritising solving individual patients' safety problems, which were viewed as unique or one-time events and (C) encountering re-occurring safety problems, which were framed as inevitable, routine events. In only a few instances was 'fixing and reporting' mentioned as a way that the providers dealt with problems that they could resolve. We found that generally healthcare providers do not prioritise reporting if a safety problem is fixed. We argue that fixing and forgetting patient safety problems encountered may not serve patient safety as well as fixing and reporting. The latter approach aligns with recent calls for patient safety to be more preventive. We consider implications for practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The BAPE 2 balloon-borne CO2

NASA Technical Reports Server (NTRS)

Degnan, J. J.; Walker, H. E.; Peruso, C. J.; Johnson, E. H.; Klein, B. J.; Mcelroy, J. H.

1972-01-01

The systems and techniques which were utilized in the experiment to establish an air-to-ground CO2 laser heterodyne link are described along with the successes and problems encountered when the heterodyne receiver and laser transmitter package were removed from the controlled environment of the laboratory. Major topics discussed include: existing systems and the underlying principles involved in their operation; experimental techniques and optical alignment methods which were found to be useful; theoretical calculations of signal strengths expected under a variety of test conditions and in actual flight; and the experimental results including problems encountered and their possible solutions.

Interim report : a non-overlay cathodic protection system.

DOT National Transportation Integrated Search

1983-01-01

This interim report describes Virginia's experience in installing its first cathodic protection system for a bridge deck. The installation was completed with practically no problems. Very minor problems have been encountered with the rectifier/contro...

Cloud encounter statistics in the 28.5-43.5 KFT altitude region from four years of GASP observations

NASA Technical Reports Server (NTRS)

Jasperson, W. H.; Nastrom, G. D.; Davis, R. E.; Holdeman, J. D.

1983-01-01

The results of an analysis of cloud encounter measurements taken at aircraft flight altitudes as part of the Global Atmospheric Sampling Program are summarized. The results can be used in estimating the probability of cloud encounter and in assessing the economic feasibility of laminar flow control aircraft along particular routes. The data presented clearly show the tropical circulation and its seasonal migration; characteristics of the mid-latitude regime, such as the large-scale traveling cyclones in the winter and increased convective activity in the summer, can be isolated in the data. The cloud encounter statistics are shown to be consistent with the mid-latitude cyclone model. A model for TIC (time-in-clouds), a cloud encounter statistic, is presented for several common airline routes.

Safety in bear country: protective measures and bullet performance at short range.

Treesearch

W.R. Meehan; J.F. Thilenius

1983-01-01

Bears are frequently encountered by people working in or enjoying the outdoors. Some government agencies have regulations concerning the firearms their personnel carry for protection against bears.Guidelines to prevent hazardous encounters with bears are presented, and the performance of commonly used weapons and ammunition is discussed. The ballistic...

Russian-English Glossary of International Maritime Law Terms (and Selected Terms in Related Disciplines.)

ERIC Educational Resources Information Center

Naval Intelligence Support Center, Washington, DC.

This glossary contains over 750 terms encountered in international maritime law texts. It includes terms of the art, fairly common abbreviations, geographic names, and prepositional phrases routinely encountered in international treaties, conventions, and agreements. The prepositional phrases are recorded exactly as they appear in formal texts.…

A general purpose subroutine for fast fourier transform on a distributed memory parallel machine

NASA Technical Reports Server (NTRS)

Dubey, A.; Zubair, M.; Grosch, C. E.

1992-01-01

One issue which is central in developing a general purpose Fast Fourier Transform (FFT) subroutine on a distributed memory parallel machine is the data distribution. It is possible that different users would like to use the FFT routine with different data distributions. Thus, there is a need to design FFT schemes on distributed memory parallel machines which can support a variety of data distributions. An FFT implementation on a distributed memory parallel machine which works for a number of data distributions commonly encountered in scientific applications is presented. The problem of rearranging the data after computing the FFT is also addressed. The performance of the implementation on a distributed memory parallel machine Intel iPSC/860 is evaluated.

In pursuit of the perfect penis: Hypospadias repair outcomes.

PubMed

Winship, Brenton B; Rushton, H Gil; Pohl, Hans G

2017-06-01

Hypospadias is commonly assessed and repaired by pediatric urologists. Mild, distal hypospadias is generally more a cosmetic problem than a functional one and is more frequently encountered than severe, proximal hypospadias. Outcomes following repair, especially of mild phenotypes, are important to understand, but range widely in timing and measurability. Surgical complications, postoperative satisfaction of parents, patients, surgeons and even lay observers, urinary function, sexual function, and quality of life all may be considered as relevant outcomes of hypospadias repair. Existing studies examining these outcomes are diverse in their conclusions, but are important to understand when counseling parents and patients prior to any surgical intervention. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Using Role-Playing Games to Teach Astronomy: An Evaluation

NASA Astrophysics Data System (ADS)

Francis, Paul

Since 1998, I've been experimenting with the use of role-playing games to teach astronomy. Students play the role of competing teams of researchers, racing to solve some astrophysical mystery. In this article, I review what has been learned from using these games around the world over the last eight years. The most common problem encountered is a tendency for students to become overly political. An unexpected benefit of these games is the boost that they give to student self- confidence. Overall, they seem to work well with a wide range of students, ranging from ninth grade to graduate school, and students exposed to this game comment repeatedly on how the games changed their attitudes toward the scientific process.

Asian Rhinoplasty: Preoperative Simulation and Planning Using Adobe Photoshop

PubMed Central

Kiranantawat, Kidakorn; Nguyen, Anh H.

2015-01-01

A rhinoplasty in Asians differs from a rhinoplasty performed in patients of other ethnicities. Surgeons should understand the concept of Asian beauty, the nasal anatomy of Asians, and common problems encountered while operating on the Asian nose. With this understanding, surgeons can set appropriate goals, choose proper operative procedures, and provide an outcome that satisfies patients. In this article the authors define the concept of an Asian rhinoplasty—a paradigm shift from the traditional on-top augmentation rhinoplasty to a structurally integrated augmentation rhinoplasty—and provide a step-by-step procedure for the use of Adobe Photoshop as a preoperative program to simulate the expected surgical outcome for patients and to develop a preoperative plan for surgeons. PMID:26648803

Advances in the Treatment of Fragile X Syndrome

PubMed Central

Hagerman, Randi J.; Berry-Kravis, Elizabeth; Kaufmann, Walter E.; Ono, Michele Y.; Tartaglia, Nicole; Lachiewicz, Ave; Kronk, Rebecca; Delahunty, Carol; Hessl, David; Visootsak, Jeannie; Picker, Jonathan; Gane, Louise; Tranfaglia, Michael

2010-01-01

The FMR1 mutations can cause a variety of disabilities, including cognitive deficits, attention-deficit/hyperactivity disorder, autism, and other socioemotional problems, in individuals with the full mutation form (fragile X syndrome) and distinct difficulties, including primary ovarian insufficiency, neuropathy and the fragile X-associated tremor/ataxia syndrome, in some older premutation carriers. Therefore, multigenerational family involvement is commonly encountered when a proband is identified with a FMR1 mutation. Studies of metabotropic glutamate receptor 5 pathway antagonists in animal models of fragile X syndrome have demonstrated benefits in reducing seizures, improving behavior, and enhancing cognition. Trials of metabotropic glutamate receptor 5 antagonists are beginning with individuals with fragile X syndrome. Targeted treatments, medical and behavioral interventions, genetic counseling, and family supports are reviewed here. PMID:19117905

OARSI Clinical Trials Recommendations: Hand imaging in clinical trials in osteoarthritis.

PubMed

Hunter, D J; Arden, N; Cicuttini, F; Crema, M D; Dardzinski, B; Duryea, J; Guermazi, A; Haugen, I K; Kloppenburg, M; Maheu, E; Miller, C G; Martel-Pelletier, J; Ochoa-Albíztegui, R E; Pelletier, J-P; Peterfy, C; Roemer, F; Gold, G E

2015-05-01

Tremendous advances have occurred in our understanding of the pathogenesis of hand osteoarthritis (OA) and these are beginning to be applied to trials targeted at modification of the disease course. The purpose of this expert opinion, consensus driven exercise is to provide detail on how one might use and apply hand imaging assessments in disease modifying clinical trials. It includes information on acquisition methods/techniques (including guidance on positioning for radiography, sequence/protocol recommendations/hardware for MRI); commonly encountered problems (including positioning, hardware and coil failures, sequences artifacts); quality assurance/control procedures; measurement methods; measurement performance (reliability, responsiveness, validity); recommendations for trials; and research recommendations. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

False biochemical diagnosis of hyperthyroidism in streptavidin-biotin-based immunoassays: the problem of biotin intake and related interferences.

PubMed

Piketty, Marie-Liesse; Polak, Michel; Flechtner, Isabelle; Gonzales-Briceño, Laura; Souberbielle, Jean-Claude

2017-05-01

Immunoassays are now commonly used for hormone measurement, in high throughput analytical platforms. Immunoassays are generally robust to interference. However, endogenous analytical error may occur in some patients; this may be encountered in biotin supplementation or in the presence of anti-streptavidin antibody, in immunoassays involving streptavidin-biotin interaction. In these cases, the interference may induce both false positive and false negative results, and simulate a seemingly coherent hormonal profile. It is to be feared that this type of errors will be more frequently observed. This review underlines the importance of keeping close interactions between biologists and clinicians to be able to correlate the hormonal assay results with the clinical picture.

Role of Enhancing Visual Effects Education Delivery to Encounter Career Challenges in Malaysia

ERIC Educational Resources Information Center

Ng, Lynn-Sze

2017-01-01

Problem-based Learning (PBL) is one of the most effective methods of instruction that helps Visual Effects (VFX) students to be more adaptable at encountering career challenges in Malaysia. These challenges are; lack of several important requirements such as, the basic and fundamental knowledge of VFX concepts, the ability to understand real-world…

Dental Fear among Medical and Dental Undergraduates

PubMed Central

Hakim, H.; Razak, I. A.

2014-01-01

Objective. To assess the prevalence and level of dental fear among health related undergraduates and to identify factors causing such fear using Kleinknecht's Dental Fear Survey (DFS) questionnaire. Methods. Kleinknecht's DFS questionnaire was used to assess dental fear and anxiety among the entire enrollment of the medical and dental undergraduates' of the University of Malaya. Results. Overall response rate was 82.2%. Dental students reported higher prevalence of dental fear (96.0% versus 90.4%). However, most of the fear encountered among dental students was in the low fear category as compared to their medical counterpart (69.2 versus 51.2%). Significantly more medical students cancelled dental appointment due to fear compared to dental students (P = 0.004). “Heart beats faster” and “muscle being tensed” were the top two physiological responses experienced by the respondents. “Drill” and “anesthetic needle” were the most fear provoking objects among respondents of both faculties. Conclusion. Dental fear and anxiety are a common problem encountered among medical and dental undergraduates who represent future health care professionals. Also, high level of dental fear and anxiety leads to the avoidance of the dental services. PMID:25386615

Occupational neurology.

PubMed Central

Feldman, R. G.

1987-01-01

The nervous system is vulnerable to the effects of certain chemicals and physical conditions found in the work environment. The activities of an occupational neurologist focus on the evaluation of patients with neurological disorders caused by occupational or environmental conditions. When one is making a differential diagnosis in patients with neurological disorders, the possibility of toxic exposure or encounters with physical factors in the workplace must not be overlooked. Central to an accurate clinical diagnosis is the patient's history. A diagnosis of an occupational or environmental neurological problem requires a careful assessment of the clinical abnormalities and confirmation of these disabilities by objective tests such as nerve conduction velocity, evoked potentials, electroencephalogram, neuropsychological batteries, or nerve biopsy. On the basis of information about hazards in the workplace, safety standards and environmental and biological monitoring can be implemented in the workplace to reduce the risks of undue injury. Clinical manifestations of headache, memory disturbance, and peripheral neuropathy are commonly encountered presentations of the effects of occupational hazards. Physicians in everyday clinical practice must be aware of the signs and symptoms associated with exposure to possible neurotoxins and work methods. Occupational and environmental circumstances must be explored when evaluating patients with neurologic disorders. PMID:3577214

Problem Solving Skills for Children.

ERIC Educational Resources Information Center

Youngs, Bettie B.

This guide was written for children, to help them handle problems they might encounter, learn about other children and how they have handled similar problems, and learn what to do when things go wrong or when they feel misunderstood. In the introduction, children are assured that, even when they have problems, they can be happy again. The body of…

Problem Solving Instruction for Overcoming Students' Difficulties in Stoichiometric Problems

ERIC Educational Resources Information Center

Shadreck, Mandina; Enunuwe, Ochonogor Chukunoye

2017-01-01

The study sought to find out difficulties encountered by high school chemistry students when solving stoichiometric problems and how these could be overcome by using a problem-solving approach. The study adopted a quasi-experimental design. 485 participants drawn from 8 highs schools in a local education district in Zimbabwe participated in the…

Alcohol and Other Drugs on Campus: The Scope of the Problem. Infofacts/Resources

ERIC Educational Resources Information Center

Kapner, Daniel Ari

2008-01-01

The most widespread health problem on college and university campuses in the United States is high-risk alcohol and other drug (AOD) use. Recent reports confirm that the nation's campuses continue to encounter significant consequences as a result of this problem. This "Infofacts/Resources" offers an overview of the problem and highlights effective…

Mariner 10 Venus encounter. [scientific objectives and instruments for flyby observations

NASA Technical Reports Server (NTRS)

Dunne, J. A.

1974-01-01

Review of the scientific objectives of the Mariner 10 mission with regard to observations of Venus during a flyby, and description of the equipment installed on the spacecraft to fulfill these objectives. A detailed description is given of the hardware modifications made to the payload specifically for the Venus sequence. In discussing the encounter operations, two spacecraft problems which significantly affected the Venus encounter sequence are cited - namely, a failure of the television optic heaters to come on shortly after launch, and the occurrence of a roll gyro oscillation.

Automation--planning to implementation; the problems en route.

PubMed Central

Pizer, I H

1976-01-01

Once the major decision to automate library processes is made, there are a variety of problems which may be encountered before the planned system becomes operational. These include problems of personnel, budget, procurement of adjunct services, institutional priorities, and manufacturing uncertainties. Actual and potential difficulties are discussed. PMID:1247703

Conceptualizing Perseverance in Problem Solving as Collective Enterprise

ERIC Educational Resources Information Center

Sengupta-Irving, Tesha; Agarwal, Priyanka

2017-01-01

Students are expected to learn mathematics such that when they encounter challenging problems they will persist. Creating opportunities for students to persist in problem solving is therefore argued as essential to effective teaching and to children developing positive dispositions in mathematical learning. This analysis takes a novel approach to…

Financial Stress, Parental Depressive Symptoms, Parenting Practices, and Children's Externalizing Problem Behaviors: Underlying Processes

ERIC Educational Resources Information Center

Lee, Chih-Yuan Steven; Lee, Jaerim; August, Gerald J.

2011-01-01

This study examined the relationships among financial stress encountered by families, parents' social support, parental depressive symptoms, parenting practices, and children's externalizing problem behaviors to advance our understanding of the processes by which family financial stress is associated with children's problem behaviors. We also…

Problem Solving.

ERIC Educational Resources Information Center

Pollak, Ave

This guide is intended for use in presenting a three-session course designed to develop the problem-solving skills required of persons employed in the manufacturing and service industries. The course is structured so that, upon its completion, students will be able to accomplish the following: describe and analyze problems encountered at work;…

Twenty Recent Novels (and More) about Adolescents for Bibliotherapy.

ERIC Educational Resources Information Center

Hipple, Ted; Comer, Melissa; Boren, Dodie

1997-01-01

Lists 20 problems adolescents may encounter, with a description of one young adult novel in which that problem is a central feature. Some of the problems addressed include abuse, AIDS, alcohol, alienation, crime, death, disabilities, divorce, drugs, ethics, homosexuality, peer pressure, pregnancy, prejudice, rape, religious pressure, school, sex,…

Support Services for Remote Users of Online Public Access Catalogs.

ERIC Educational Resources Information Center

Kalin, Sally W.

1991-01-01

Discusses the needs of remote users of online public access catalogs (OPACs). User expectations are discussed; problems encountered by remote-access users are examined, including technical problems and searching problems; support services are described, including instruction, print guides, and online help; and differences from the needs of…

Exploring Principals' Nonroutine Problems in Bilingual Immersion Schools: Lessons Learned for Multicultural Leadership

ERIC Educational Resources Information Center

Schwabsky, Nitza

2013-01-01

The present study examines the nonroutine problems that eight Anglo-American principals encountered in managing three elementary bilingual immersion schools in the Northwest United States. Using qualitative inquiry to collect data, I employed the multisited ethnographic research model. The principals reported nonroutine problems in the following…

Another Look at the Language Difficulties of International Students

ERIC Educational Resources Information Center

Zhang, Yanyin; Mi, Yinan

2010-01-01

International students encounter language-related problems in their academic studies. Specific problem areas have been identified and possible underlying causes have been explored. The present study investigates the impact of two variables--length of study and academic disciplines--in relation to the problems. The findings from a survey and…

Probabilistic evaluation of n traces with no putative source: A likelihood ratio based approach in an investigative framework.

PubMed

De March, I; Sironi, E; Taroni, F

2016-09-01

Analysis of marks recovered from different crime scenes can be useful to detect a linkage between criminal cases, even though a putative source for the recovered traces is not available. This particular circumstance is often encountered in the early stage of investigations and thus, the evaluation of evidence association may provide useful information for the investigators. This association is evaluated here from a probabilistic point of view: a likelihood ratio based approach is suggested in order to quantify the strength of the evidence of trace association in the light of two mutually exclusive propositions, namely that the n traces come from a common source or from an unspecified number of sources. To deal with this kind of problem, probabilistic graphical models are used, in form of Bayesian networks and object-oriented Bayesian networks, allowing users to intuitively handle with uncertainty related to the inferential problem. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Numerical difficulties and computational procedures for thermo-hydro-mechanical coupled problems of saturated porous media

NASA Astrophysics Data System (ADS)

Simoni, L.; Secchi, S.; Schrefler, B. A.

2008-12-01

This paper analyses the numerical difficulties commonly encountered in solving fully coupled numerical models and proposes a numerical strategy apt to overcome them. The proposed procedure is based on space refinement and time adaptivity. The latter, which in mainly studied here, is based on the use of a finite element approach in the space domain and a Discontinuous Galerkin approximation within each time span. Error measures are defined for the jump of the solution at each time station. These constitute the parameters allowing for the time adaptivity. Some care is however, needed for a useful definition of the jump measures. Numerical tests are presented firstly to demonstrate the advantages and shortcomings of the method over the more traditional use of finite differences in time, then to assess the efficiency of the proposed procedure for adapting the time step. The proposed method reveals its efficiency and simplicity to adapt the time step in the solution of coupled field problems.

The Value of Information for Populations in Varying Environments

NASA Astrophysics Data System (ADS)

Rivoire, Olivier; Leibler, Stanislas

2011-04-01

The notion of information pervades informal descriptions of biological systems, but formal treatments face the problem of defining a quantitative measure of information rooted in a concept of fitness, which is itself an elusive notion. Here, we present a model of population dynamics where this problem is amenable to a mathematical analysis. In the limit where any information about future environmental variations is common to the members of the population, our model is equivalent to known models of financial investment. In this case, the population can be interpreted as a portfolio of financial assets and previous analyses have shown that a key quantity of Shannon's communication theory, the mutual information, sets a fundamental limit on the value of information. We show that this bound can be violated when accounting for features that are irrelevant in finance but inherent to biological systems, such as the stochasticity present at the individual level. This leads us to generalize the measures of uncertainty and information usually encountered in information theory.

A distance learning model in a physical therapy curriculum.

PubMed

English, T; Harrison, A L; Hart, A L

1998-01-01

In response to the rural health initiative established in 1991, the University of Kentucky has developed an innovative distance learning program of physical therapy instruction that combines classroom lecture and discussion via compressed video technology with laboratory experiences. The authors describe the process of planning, implementing, and evaluating a specific distance learning course in pathomechanics for the professional-level master's-degree physical therapy students at the University of Kentucky. This presentation may serve as a model for teaching distance learning. Descriptions of optimal approaches to preclass preparation, scheduling, course delivery, use of audiovisual aids, use of handout material, and video production are given. Special activities that may enhance or deter the achievement of the learning objectives are outlined, and a problem-solving approach to common problems encountered is presented. An approach to evaluating and comparing course outcomes for the distance learnere is presented. For this particular course, there was no statistically significant difference in the outcome measures utilized to compare the distance learners with the on-site learners.

Transit security : a description of problems and countermeasures

DOT National Transportation Integrated Search

1984-10-01

This report provides a broad perspective on transit security. It examines a wide range of transit security problems encountered by transit systems, namely: crime against passengers and employees; crimes involving revenues, including fare evasion by p...

Adaptation of Social Problem Solving for Children Questionnaire in 6 Age Groups and its Relationships with Preschool Behavior Problems

ERIC Educational Resources Information Center

Dereli-Iman, Esra

2013-01-01

Social Problem Solving for Child Scale is frequently used to determine behavioral problems of children with their own word and to identify ways of conflict encountered in daily life, and interpersonal relationships in abroad. The primary purpose of this study was to adapt the Wally Child Social Problem-Solving Detective Game Test. In order to…

A practical model for pressure probe system response estimation (with review of existing models)

NASA Astrophysics Data System (ADS)

Hall, B. F.; Povey, T.

2018-04-01

The accurate estimation of the unsteady response (bandwidth) of pneumatic pressure probe systems (probe, line and transducer volume) is a common practical problem encountered in the design of aerodynamic experiments. Understanding the bandwidth of the probe system is necessary to capture unsteady flow features accurately. Where traversing probes are used, the desired traverse speed and spatial gradients in the flow dictate the minimum probe system bandwidth required to resolve the flow. Existing approaches for bandwidth estimation are either complex or inaccurate in implementation, so probes are often designed based on experience. Where probe system bandwidth is characterized, it is often done experimentally, requiring careful experimental set-up and analysis. There is a need for a relatively simple but accurate model for estimation of probe system bandwidth. A new model is presented for the accurate estimation of pressure probe bandwidth for simple probes commonly used in wind tunnel environments; experimental validation is provided. An additional, simple graphical method for air is included for convenience.

Dermatitis and aircrew.

PubMed

Leggat, Peter A; Smith, Derek R

2006-01-01

Dermatitis is a common problem both in the workplace and in the general community. Airline personnel represent a novel occupational group as they are also exposed to a wide range of potential chemical irritants and other aggravating factors, such as low relative humidity and airborne pollutants. Common skin irritants include dielectric fluids from electrodischarge machining, 'prepreg' materials and sealants in aircraft manufacture, kerosene and various jet-fuel components. Commercial jet fuel is a complex mixture of aliphatic and aromatic compounds, and there is potential for dermal exposure among refueling and maintenance crew. Low relative humidity appears to exacerbate dermatitis amongst aircrew, especially on longer flight durations. Pilots may also be exposed to additional skin irritants outside of the cabin environment, such as ethylene glycol, hydraulic fluid or jet fuel, all of which may be encountered during routine inspections of aircraft before and after flight. Given these factors, preventive measures must carefully consider the undoubted potential for contact with irritants and allergens, which may lead to dermatitis in airline personnel.

Ethical problems and moral sensitivity in physiotherapy: a descriptive study.

PubMed

Kulju, Kati; Suhonen, Riitta; Leino-Kilpi, Helena

2013-08-01

This study identified and described ethical problems encountered by physiotherapists in their practice and physiotherapists' moral sensitivity in ethical situations. A questionnaire-based survey was constructed to identify ethical problems, and the Moral Sensitivity Questionnaire Revised version was used to measure moral sensitivity. Physiotherapists (n = 116) working in public health services responded to the questionnaire. Based on the results, most of the physiotherapists encounter ethical problems weekly. They concern mainly financial considerations, equality and justice, professionalism, unethical conduct of physiotherapists or other professions and patients' self-determination. The dimension of moral strength was emphasised in physiotherapists' self-evaluations of their moral sensitivity. As a conclusion, ethical problems do occur not only at individual level but also at organisational and society level. Physiotherapists seem to have moral strength for speaking on behalf of the patient. Scarce resources make them feel insufficient but much could still be done to provide quality care in co-operation with other health-care professionals.

Improving inferences from fisheries capture-recapture studies through remote detection of PIT tags

USGS Publications Warehouse

Hewitt, David A.; Janney, Eric C.; Hayes, Brian S.; Shively, Rip S.

2010-01-01

Models for capture-recapture data are commonly used in analyses of the dynamics of fish and wildlife populations, especially for estimating vital parameters such as survival. Capture-recapture methods provide more reliable inferences than other methods commonly used in fisheries studies. However, for rare or elusive fish species, parameter estimation is often hampered by small probabilities of re-encountering tagged fish when encounters are obtained through traditional sampling methods. We present a case study that demonstrates how remote antennas for passive integrated transponder (PIT) tags can increase encounter probabilities and the precision of survival estimates from capture-recapture models. Between 1999 and 2007, trammel nets were used to capture and tag over 8,400 endangered adult Lost River suckers (Deltistes luxatus) during the spawning season in Upper Klamath Lake, Oregon. Despite intensive sampling at relatively discrete spawning areas, encounter probabilities from Cormack-Jolly-Seber models were consistently low (< 0.2) and the precision of apparent annual survival estimates was poor. Beginning in 2005, remote PIT tag antennas were deployed at known spawning locations to increase the probability of re-encountering tagged fish. We compare results based only on physical recaptures with results based on both physical recaptures and remote detections to demonstrate the substantial improvement in estimates of encounter probabilities (approaching 100%) and apparent annual survival provided by the remote detections. The richer encounter histories provided robust inferences about the dynamics of annual survival and have made it possible to explore more realistic models and hypotheses about factors affecting the conservation and recovery of this endangered species. Recent advances in technology related to PIT tags have paved the way for creative implementation of large-scale tagging studies in systems where they were previously considered impracticable.

Correlation Filtering of Modal Dynamics using the Laplace Wavelet

NASA Technical Reports Server (NTRS)

Freudinger, Lawrence C.; Lind, Rick; Brenner, Martin J.

1997-01-01

Wavelet analysis allows processing of transient response data commonly encountered in vibration health monitoring tasks such as aircraft flutter testing. The Laplace wavelet is formulated as an impulse response of a single mode system to be similar to data features commonly encountered in these health monitoring tasks. A correlation filtering approach is introduced using the Laplace wavelet to decompose a signal into impulse responses of single mode subsystems. Applications using responses from flutter testing of aeroelastic systems demonstrate modal parameters and stability estimates can be estimated by correlation filtering free decay data with a set of Laplace wavelets.

An analysis of the cultural problems encountered during caregiving by the nurses working in two different regions of Turkey.

PubMed

Kilic, Serap Parlar; Besen, Dilek Buyukkaya; Tokem, Yasemin; Fadiloglu, Cicek; Karadag, Gulendam

2014-06-01

The aim of this study was to identify the cultural problems encountered during caregiving by the nurses working in two university hospitals located in western and eastern Turkey. This descriptive, comparative study was conducted between July 2008 and October 2009 with 338 nurses who volunteered to take part in the study. The study data were collected using an individual description questionnaire consisting of 10 questions and another questionnaire consisting of 14 questions to identify the cultural problems encountered by nurses when giving care. The study showed with respect to training received on transcultural nursing that only 59 nurses had this training, but the percentage was higher in the nurses working at the hospital in the west (54.2%) (P > 0.05). It was found that a large number of nurses in the sample group (n = 286) gave care to at least one individual from another culture, but the percentage was significantly higher in the nurses working in the west (56.7%) than in the nurses working in the east (43.3%) (P < 0.05). When the problems experienced by the nurses during caregiving because of cultural characteristics of patients were explored, it was found that they experienced problems mostly in 'communication', and the percentage of those having problems was higher in the nurses working in the west (60.8%) (P > 0.05). The problem experienced in this area was mostly because of the fact that patients 'did not speak Turkish' (63.8%). In conclusion, the nurses gave care to patients from different cultures, and most of them had trouble when giving care to patients from different cultures. © 2013 Wiley Publishing Asia Pty Ltd.

Radio science ground data system for the Voyager-Neptune encounter, part 1

NASA Technical Reports Server (NTRS)

Kursinski, E. R.; Asmar, S. W.

1991-01-01

The Voyager radio science experiments at Neptune required the creation of a ground data system array that includes a Deep Space Network complex, the Parkes Radio Observatory, and the Usuda deep space tracking station. The performance requirements were based on experience with the previous Voyager encounters, as well as the scientific goals at Neptune. The requirements were stricter than those of the Uranus encounter because of the need to avoid the phase-stability problems experienced during that encounter and because the spacecraft flyby was faster and closer to the planet than previous encounters. The primary requirement on the instrument was to recover the phase and amplitude of the S- and X-band (2.3 and 8.4 GHz) signals under the dynamic conditions encountered during the occultations. The primary receiver type for the measurements was open loop with high phase-noise and frequency stability performance. The receiver filter bandwidth was predetermined based on the spacecraft's trajectory and frequency uncertainties.

Some problems of the design of highly directional spacecraft antennas

NASA Technical Reports Server (NTRS)

Prigoda, B. A.

1974-01-01

Problems of optimization and selection of the most expedient forms of design of directional antenna systems encountered in spacecraft design are discussed. Selection of a given type of antenna depends on its characteristic size, weight, and potential.

Community Work and Local Authority Decision Making: Potential and Problems

ERIC Educational Resources Information Center

Corina, Lewis

1976-01-01

British local authority and decision making procedures are described for community developers. Included are potential ways of influencing the authority system, and problems and areas of weakness that may be encountered in dealing with the system. (ABM)

The Influence of Problems Faced during Internships on Interns' Views of Their Profession and Their Intention to Work in the Tourism Industry

ERIC Educational Resources Information Center

Kasli, Mehmet; Ilban, Mehmet Oguzhan

2013-01-01

Problem Statement: The problem of this research is identifying the difficulties that undergraduate students experience during their internships and assessing their future intention to work in the tourism industry. Purpose of Study: This research aims to identify the problems undergraduate students encounter as interns in tourism programs and to…

Acts of Attention: An Exploration of Teacher Candidates' Attention to Educational Encounters, and How It Relates to Task Formulation

ERIC Educational Resources Information Center

Harvey, Victoria A.

2015-01-01

This study begins with the belief that the ways in which teachers see and attend to educational encounters matter for their actions in classrooms. Using microethnography as a framework, this dissertation explores the relationship between teacher candidate attention, problem formulation, and action. Through analysis of the M.Ed. inquiry reports of…

Unethical Behaviours Preservice Teachers Encounter on Social Networks

ERIC Educational Resources Information Center

Deveci Topal, Arzu; Kolburan Gecer, Aynur

2015-01-01

The development of web 2.0 technology has resulted in an increase in internet sharing. The scope of this study is social networking, which is one of the web 2.0 tools most heavily used by internet users. In this paper, the unethical behaviours that preservice teachers encounter on social networks and the ways to deal with these problems are…

Applications of Genetic Methods to NASA Design and Operations Problems

NASA Technical Reports Server (NTRS)

Laird, Philip D.

1996-01-01

We review four recent NASA-funded applications in which evolutionary/genetic methods are important. In the process we survey: the kinds of problems being solved today with these methods; techniques and tools used; problems encountered; and areas where research is needed. The presentation slides are annotated briefly at the top of each page.

Having the Memory of an Elephant: Long-Term Retrieval and the Use of Analogues in Problem Solving

ERIC Educational Resources Information Center

Chen, Zhe; Mo, Lei; Honomichl, Ryan

2004-01-01

The authors report 4 experiments exploring long-term analogical transfer from problem solutions in folk tales participants heard during childhood, many years before encountering the target problems. Substantial culture-specific analogical transfer was found when American and Chinese participants' performance was compared on isomorphs of problems…

Applying an Information Problem-Solving Model to Academic Reference Work: Findings and Implications.

ERIC Educational Resources Information Center

Cottrell, Janet R.; Eisenberg, Michael B.

2001-01-01

Examines the usefulness of the Eisenberg-Berkowitz Information Problem-Solving model as a categorization for academic reference encounters. Major trends in the data include a high proportion of questions about location and access of sources, lack of synthesis or production activities, and consistent presence of system problems that impede the…

Data System Implementation: A Leader Navigates People Problems around Technology and Data Use

ERIC Educational Resources Information Center

Cho, Vincent; Jimerson, Jo Beth; Wayman, Jeffrey C.

2015-01-01

Computer data systems have become a lynchpin to supporting school data use. However, successfully implementing such systems is no easy task. In this case, readers explore the ways in which "technology problems" and "people problems" can be intertwined. The case follows Dr. Molly Winters as she encounters social and…

Why Do Disadvantaged Filipino Children Find Word Problems in English Difficult?

ERIC Educational Resources Information Center

Bautista, Debbie; Mulligan, Joanne

2010-01-01

Young Filipino students are expected to solve mathematical word problems in English, a language that many encounter only in schools. Using individual interviews of 17 Filipino children, we investigated why word problems in English are difficult and the extent to which the language interferes with performance. Results indicate that children could…

School Nurses' Perceived Prevalence and Competence to Address Student Mental Health Problems

ERIC Educational Resources Information Center

Stephan, Sharon H.; Connors, Elizabeth H.

2013-01-01

Due to under-identification of student mental health problems and limited specialty mental health providers in schools, school nurses are often faced with identifying and addressing student mental health needs. This exploratory study assessed prevalence and types of student mental health problems encountered by school nurses, as well as their…

Molten salt corrosion of SiC and Si3N4

NASA Technical Reports Server (NTRS)

Jacobson, N. S.; Smialek, J. L.; Fox, D. S.

1986-01-01

The most severe type of corrosion encountered in heat engines is corrosion by molten sodium sulfate, formed by the reaction of ingested sodium chloride and sulfur impurities in the fuel. This problem was studied extensively for superalloys, but only recently examined for ceramics. This problem is addressed with laboratory studies to understand the fundamental reaction mechanisms and with burner studies to provide a more realistic simulation of the conditions encountered in a heat engine. In addition the effect of corrosion on the strengths of these materials was assessed. Each of these aspects will be reviewed and some ideas toward possible solutions will be discussed.

Comparison of Low-Energy Lunar Transfer Trajectories to Invariant Manifolds

NASA Technical Reports Server (NTRS)

Anderson, Rodney L.; Parker, Jeffrey S.

2011-01-01

In this study, transfer trajectories from the Earth to the Moon that encounter the Moon at various flight path angles are examined, and lunar approach trajectories are compared to the invariant manifolds of selected unstable orbits in the circular restricted three-body problem. Previous work focused on lunar impact and landing trajectories encountering the Moon normal to the surface, and this research extends the problem with different flight path angles in three dimensions. The lunar landing geometry for a range of Jacobi constants are computed, and approaches to the Moon via invariant manifolds from unstable orbits are analyzed for different energy levels.

The Voyager spacecraft /James Watt International Gold Medal Lecture/

NASA Technical Reports Server (NTRS)

Heacock, R. L.

1980-01-01

The Voyager Project background is reviewed with emphasis on selected features of the Voyager spacecraft. Investigations by the Thermo-electric Outer Planets Spacecraft Project are discussed, including trajectories, design requirements, and the development of a Self Test and Repair computer, and a Computer Accessed Telemetry System. The design and configuration of the spacecraft are described, including long range communications, attitude control, solar independent power, sequencing and control data handling, and spacecraft propulsion. The development program, maintained by JPL, experienced a variety of problems such as design deficiencies, and process control and manufacturing problems. Finally, the spacecraft encounter with Jupiter is discussed, and expectations for the Saturn encounter are expressed.

A subcutaneous channeling probe for implanting long leads

NASA Technical Reports Server (NTRS)

Lund, G. F.; Simmonds, R. C.; Williams, B. A.

1977-01-01

The channeling probe described in the present paper was designed to overcome surgical problems of the type that were encountered when a multichannel radio transmitter had to be implanted in a cow. The probe was made of a flexible but sufficiently stiff 9.5-mm-diam nylon rod, consisting of 46-cm sections for convenience in sterilization and surgical handling. Stainless steel sleaves reinforced the threaded connecting joints. At one end, arrowhead-shaped channeling heads could be attached to produce wide channels for large sensors. The other end was tapered for narrow channels. Postoperative problems were not encountered in the use of this probe in cows, sheep, and dogs.

Understanding Social and Legal Justice Issues for Aboriginal Women within the Context of an Indigenous Australian Studies Classroom: A Problem-Based Learning Approach

ERIC Educational Resources Information Center

Mackinlay, Elizabeth; Thatcher, Kristy; Seldon, Camille

2004-01-01

Problem-based learning (PBL) is a pedagogical approach in which students encounter a problem and systematically set about finding ways to understand the problem through dialogue and research. PBL is an active process where students take responsibility for their learning by asking their own questions about the problem and in this paper we explore…

Administrative encounters in general practice: low value or hidden value care?

PubMed

Trevena, Lyndal J; Harrison, Christopher; Britt, Helena C

2018-02-19

To determine the frequency of general practice administrative encounters, and to determine whether they represent low value care. Secondary analysis of data from the Bettering Evaluation and Care of Health (BEACH) dataset. 1 568 100 GP-patient encounters in Australia, 2000-01 to 2015-16. An annual nationally representative random sample of about 1000 GPs, who each recorded the details of 100 consecutive encounters with patients. Proportions of general practice encounters that were potentially low value care encounters (among the patient's reasons for the encounter was at least one administrative, medication, or referral request) and potentially low value care only encounters (such reasons were the sole reason for the encounter). For 2015-16, we also examined other health care provided by GPs at these encounters. During 2015-16, 18.5% (95% CI, 17.7-19.3%) of 97 398 GP-patient encounters were potentially low value care request encounters; 7.4% (95% CI, 7.0-7.9%) were potentially low value care only encounters. Administrative work was requested at 3.8% (95% CI, 3.5-4.0%) of GP visits, 35.4% of which were for care planning and coordination, 33.5% for certification, and 31.2% for other reasons. Medication requests were made at 13.1% (95% CI, 12.4-13.7%) of encounters; other health care was provided at 57.9% of medication request encounters, counselling, advice or education at 23.4%, and pathology testing was ordered at 16.7%. Referrals were requested at 2.8% (95% CI, 1.7-3.0%) of visits, at 69.4% of which additional health care was provided. The problems managed most frequently at potentially low value care only encounters were chronic diseases. Most patients requested certificates, medications and referrals in the context of seeking help for other health needs. Additional health care, particularly for chronic diseases, was provided at most GP administrative encounters. The MBS Review should consider the hidden value of these encounters.

Medical events during the 2009 Los Angeles County Station Fire: lessons for wildfire EMS planning.

PubMed

Squire, Benjamin; Chidester, Cathy; Raby, Stephanie

2011-01-01

Little is known about the types of injuries and medical problems encountered by fire department personnel during suppression of large campaign-type wildland fires. Such information could help to plan for response to medical incidents during future wildfires. To describe the injuries and medical problems experienced by firefighters during the 2009 Los Angeles County Station Fire. This was a retrospective analysis of case records of patients treated during the Los Angeles County Station Fire. Data were abstracted from two sources: the incident command medical tracking sheet and prehospital patient care reports (PCRs). The sample included 183 patient contacts, of which PCRs were available for 65. For the remaining 118 patients, data were abstracted from the incident command medical tracking sheet. The most common chief complaint was extremity injury, accounting for 44 patient contacts (24% of all patients), with smoke inhalation second, at 32 patient contacts (17%). Of the 65 patients with PCRs, 31 (52%) were treated with oxygen, 26 (40%) had intravenous (IV) lines started, and 15 (23%) received an IV fluid bolus. Half of the patients were transported to an emergency department (ED); the remainder were treated on scene or self-transported to a non-acute care facility. Most firefighter injuries and illnesses encountered during the Los Angeles Station Fire were minor. The prevalence of injuries observed should be taken into consideration in creation of protocols and mandatory equipment lists for fireline paramedics. Furthermore, advanced training for paramedics in the diagnosis and treatment of minor medical conditions may be useful.

Using National Health Care Databases and Problem-Based Practice Analysis to Inform Integrated Curriculum Development.

PubMed

Baker, Amy J; Raymond, Mark R; Haist, Steven A; Boulet, John R

2017-04-01

One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments (EDs), clinics, and hospitals.Selected data from the National Hospital Ambulatory Medical Care Survey: Emergency Department illustrate how instructional materials can be derived from the results of such public-use health care data. Using fever as the reason for visit to the ED, the patient management path is depicted in the form of a case drill-down by exploring the most common diagnoses, blood tests, diagnostic studies, procedures, and medications associated with fever.Although these types of data are quite useful, they should not serve as the sole basis for determining which instructional cases to include. Additional sources of information should be considered to ensure the inclusion of cases that represent infrequent but high-impact problems and those that illustrate fundamental principles that generalize to other cases.

Untreated Peristomal Skin Complications among Long-Term Colorectal Cancer Survivors with Ostomies: Lessons from a Study of Family Caregiving

PubMed Central

McMullen, Carmit K.; Wasserman, Joseph; Altschuler, Andrea; Grant, Marcia; Hornbrook, Mark C.; Liljestrand, Petra; Briggs, Catherine; Krouse, Robert S.

2013-01-01

This ethnography of family caregiving explored why peristomal skin complications are both common and undertreated among colorectal cancer (CRC) survivors with intestinal ostomies. We sought to identify factors that hinder or facilitate prompt detection and treatment of ostomy and skin problems. We collected data through in-depth interviews with 31 cancer survivors and their family caregivers, fieldwork, structured assessments, and medical records review. We analyzed data using qualitative theme and matrix analyses. We found that survivors who received help changing the skin barrier around their stoma had fewer obstacles to detection and treatment of peristomal skin complications. Half of the survivors received unpaid help with ostomy care. All such help came from spouses. Married couples who collaborated in ostomy care reported that having assistance in placing the ostomy appliance helped with preventing leaks, detecting skin changes, and modifying ostomy care routines. Survivors who struggled to manage ostomy care independently reported more obstacles to alleviating and seeking treatment for skin problems. Nurses who encounter CRC survivors with ostomies can improve treatment of peristomal skin problems by asking patients and caregivers about ostomy care and skin problems, examining the peristomal area, and facilitating routine checkups with a wound, ostomy and continence nurse. PMID:22119975

First UMTA and AoA National Conference on Transportation for the Elderly and Handicapped

DOT National Transportation Integrated Search

1985-05-01

The Conference was highly successful in detailing problems now encountered in : providing transportation services to the elderly and handicapped and in : recommending specific solutions to those problems. There was a strong focus on : realistic, prac...

Motor carrier concerns about transportation problems in Oregon : final report.

DOT National Transportation Integrated Search

2004-03-01

This report summarizes an analysis of data from a statewide survey of freight motor carrier firms, conducted by the Oregon Department of Transportation (ODOT) in the summer of 2001, to identify freight industry concerns about problems they encounter ...

Minding Your Business: How to Avoid the Seven Deadly Financial Pitfalls.

ERIC Educational Resources Information Center

Stephens, Keith

1990-01-01

Describes financial management problems typically encountered by child care center directors and owners. Offers suggestions for planning and management techniques to overcome problems of cash flow, budgeting, rising costs, underpricing, declining revenues, fee collection, and liquidity. (NH)

How humans transmit language: horizontal transmission matches word frequencies among peers on Twitter.

PubMed

Bryden, John; Wright, Shaun P; Jansen, Vincent A A

2018-02-01

Language transmission, the passing on of language features such as words between people, is the process of inheritance that underlies linguistic evolution. To understand how language transmission works, we need a mechanistic understanding based on empirical evidence of lasting change of language usage. Here, we analysed 200 million online conversations to investigate transmission between individuals. We find that the frequency of word usage is inherited over conversations, rather than only the binary presence or absence of a word in a person's lexicon. We propose a mechanism for transmission whereby for each word someone encounters there is a chance they will use it more often. Using this mechanism, we measure that, for one word in around every hundred a person encounters, they will use that word more frequently. As more commonly used words are encountered more often, this means that it is the frequencies of words which are copied. Beyond this, our measurements indicate that this per-encounter mechanism is neutral and applies without any further distinction as to whether a word encountered in a conversation is commonly used or not. An important consequence of this is that frequencies of many words can be used in concert to observe and measure language transmission, and our results confirm this. These results indicate that our mechanism for transmission can be used to study language patterns and evolution within populations. © 2018 The Author(s).

Parkes radio science system design and testing for Voyager Neptune encounter

NASA Technical Reports Server (NTRS)

Rebold, T. A.; Weese, J. F.

1989-01-01

The Radio Science System installed at Parkes, Australia for the Voyager Neptune encounter was specified to meet the same stringent requirements that were imposed upon the Deep Space Network Radio Science System. The system design and test methodology employed to meet these requirements at Parkes are described, and data showing the measured performance of the system are presented. The results indicate that the system operates with a comfortable margin on the requirements. There was a minor problem with frequency-dependent spurious signals which could not be fixed before the encounter. Test results characterizing these spurious signals are included.

Bariatric CT Imaging: Challenges and Solutions.

PubMed

Fursevich, Dzmitry M; LiMarzi, Gary M; O'Dell, Matthew C; Hernandez, Manuel A; Sensakovic, William F

2016-01-01

The obesity epidemic in the adult and pediatric populations affects all aspects of health care, including diagnostic imaging. With the increasing prevalence of obese and morbidly obese patients, bariatric computed tomographic (CT) imaging is becoming common in day-to-day radiology practice, and a basic understanding of the unique problems that bariatric patients pose to the imaging community is crucial in any setting. Because larger patients may not fit into conventional scanners, having a CT scanner with an adequate table load limit, a large gantry aperture, a large scan field of view, and a high-power generator is a prerequisite for bariatric imaging. Iterative reconstruction methods, high tube current, and high tube voltage can reduce the image noise that is frequently seen in bariatric CT images. Truncation artifacts, cropping artifacts, and ring artifacts frequently complicate the interpretation of CT images of larger patients. If recognized, these artifacts can be easily reduced by using the proper CT equipment, scan acquisition parameters, and postprocessing options. Lastly, because of complex contrast material dynamics, contrast material-enhanced studies of bariatric patients require special attention. Understanding how the rate of injection, the scan timing, and the total mass of iodine affect vascular and parenchymal enhancement will help to optimize contrast-enhanced studies in the bariatric population. This article familiarizes the reader with the challenges that are frequently encountered at CT imaging of bariatric patients, beginning with equipment selection and ending with a review of the most commonly encountered obesity-related artifacts and the technical considerations in the acquisition of contrast-enhanced images. (©)RSNA, 2016.

The evaluation of shear deformation for contact analysis with large displacement

NASA Astrophysics Data System (ADS)

Nizam, Z. M.; Obiya, H.; Ijima, K.; Azhar, A. T. S.; Hazreek, Z. A. M.; Shaylinda, M. Z. N.

2018-04-01

A common problem encountered in the study of contact problem is the failure to obtain stable and accurate convergence result when the contact node is close to the element edge, which is referred as “critical area”. In previous studies, the modification of the element force equation to apply it to a node-element contact problem using the Euler-Bernoulli beam theory [1]. A simple single-element consists two edges and a contact point was used to simulate contact phenomenon of a plane frame. The modification was proven to be effective by the converge-ability of the unbalanced force at the tip of element edge, which enabled the contact node to “pass-through”, resulting in precise results. However, in another recent study, we discover that, if shear deformation based on Timoshenko beam theory is taken into consideration, a basic simply supported beam coordinate afforded a much simpler and more efficient technique for avoiding the divergence of the unbalanced force in the “critical area”. Using our unique and robust Tangent Stiffness Method, the improved equation can be used to overcome any geometrically nonlinear analyses, including those involving extremely large displacements.

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

Fox, T.; Tietjen, G.L.; McInroy, J.F.

The Autopsy Tissue Program was begun in 1960. To date, tissues on 900 or more persons in 7 geographic regions have been collected and analyzed for plutonium content. The tissues generally consist of lung, liver, kidney, lymph, bone, and gonadal tissues for each individual. The original objective of the program was to determine the level of plutonium in human tissues due solely to fallout from weapons testing. The baseline thus established was to be used to evaluate future changes. From the first, this program was beset with chemical and statistical difficulties. Many factors whose effects were not recognized and notmore » planned for were found later to be important. Privacy and ethical considerations hindered the gathering of adequate data. Since the chemists were looking for amounts of plutonium very close to background, possible contamination was a very real problem. Widely used chemical techniques introduced a host of statistical problems. The difficulties encountered touch on areas common to large data sets, unusual outlier detection methods minimum detection limits, problems with aliquot sizes, and time-trends in the data. The conclusions point out areas to which the biologists will have to devote much more careful attention than was believed.« less

The logistics management and coordination in procurement phase of organ transplantation.

PubMed

Genç, Ruhet

2008-12-01

The number of organ transplantation surgeries has increased particularly in the last decade due to technological and scientific advances in medicine. Despite this increase, many patients, however, remain in waiting lists for transplantation surgery. Main reasons for these waiting lists are that there are limited number of organ donations and specifically problems in the management of organ transplantation activities. An efficient management of the allocation and transportation of organs (in other words, logistics management of organ transplantation) are thus extremely important. The aim of the paper is to review current practices of logistics management in the procurement phase of organ transplantation. It initially reviews the organizational structures of the international and national coordination centres, which are founded to coordinate organ transplantation activities and to enhance collaboration among physicians and medical staff. The paper, then, focuses on the possible managerial problems encountered during the procurement phase of organ transplantation. With this respect, common transportation difficulties from global and local perspective are also analyzed. This paper tries to take attention to a systematic regard of the organ transplantation from logistics point of view, thus providing applicable solutions to managerial problems in terms of allocation and transportation of organs.

Struggling for confirmation--patients' experiences of dissatisfaction with hospital care.

PubMed

Eriksson, Ulrika; Svedlund, Marianne

2007-03-01

The aim of the study was to illuminate patients' experiences of dissatisfaction with hospital care. During the last decade, interest in measuring patient satisfaction has become an important indicator of the quality of care. Researchers have, however, criticized the concept theoretically and methodologically. Subsequently, researchers have increasingly argued that the focus of attention should shift to explore patient dissatisfaction. A qualitative approach. Narrative interviews were conducted with six people who had experienced dissatisfaction during a hospital care episode. The interview text was analysed using qualitative content analysis. The results show the patients' struggle for confirmation, the feeling of distrust in health care and what they have been forced to sacrifice because of lack of treatment. A feeling of being a troublesome patient is also apparent. At the same time a positive encounter is described, as well as situations of confirmation from caregivers. The results also show hope and a will to get on with life. Dissatisfaction relating to aspects of encounter is a common problem in health care and conceivable causes and possible solutions are discussed from different perspectives. RELEVANCE TO CLINICAL: Caregivers as well as patients are in need of confirmation. If management were to take notice of and confirm caregivers this could consequently help them to gain the strength and energy necessary to provide care permeated with confirmation. A veritable, trustworthy care can be established through personal presence. To take notice of, confirm and listen to patients, creates opportunities for providing them with a positive experience of human encounter, which in the long run is rewarding from all perspectives.

Use of computer modeling to investigate a dynamic interaction problem in the Skylab TACS quad-valve package

NASA Technical Reports Server (NTRS)

Hesser, R. J.; Gershman, R.

1975-01-01

A valve opening-response problem encountered during development of a control valve for the Skylab thruster attitude control system (TACS) is described. The problem involved effects of dynamic interaction among valves in the quad-redundant valve package. Also described is a detailed computer simulation of the quad-valve package which was helpful in resolving the problem.

Medical considerations in triathlon competition: recommendations for triathlon organisers, competitors and coaches.

PubMed

Dallam, George M; Jonas, Steven; Miller, Thomas K

2005-01-01

Competitors in triathlons experience a range of environmental conditions and physiological demands in excess of that found in individual sport events of comparable duration. Consequently, there is a broad range of possible medical problems and complications that must be taken into account when preparing for such races. For most competitors, an Olympic-distance triathlon typically takes between 2-4 hours to complete. This race begins with a swimming segment of 1500 m. Given the wide variety of race venues found around the world, these swims occur in an assortment of water temperatures (from warm to cold) and conditions (from ocean surf to lake calm). Swimmers often exit the water in a state of moderate dehydration and hypothermia and then immediately start the 40 km cycling leg. Many do so in their swimming attire. A wide variety of road surfaces, technically challenging topography, variable environmental conditions and dramatically changing velocities can be encountered on the cycle course. The race concludes with a 10 km running leg. Since it is the final leg, it is often completed in higher ambient temperatures than those encountered at the start, with the athlete possibly running in a significant state of dehydration and fatigue. Other medical problems commonly encountered in triathlon include: muscle cramping, heat illness, postural hypotension, excessive exposure to ultraviolet radiation, musculoskeletal injuries and trauma, gastrointestinal problems as well as post-race bacterial infection, immunosuppression, sympathetic nervous system and psychological exhaustion, and haemolysis. The rate of occurrence of such events and the severity of their potentially negative outcomes is a function of the methods used by both the race organisers and the competitors to prevent or respond to the conditions imposed by the race. Triathletes also commonly compete in both shorter 'sprint distance' events (in the range of a 0.75 km swim, 20 km cycle and 5 km run) and longer events including both one-half and full Ironman distances (2.5 and 3.8 km swim, 80 and 180 km cycle, 20 and 42 km run, respectively), as well as ultra-distance events that exceed the Ironman distance. In the longer events, the previously mentioned medical considerations are further magnified and additional considerations such as hyponatraemia can also occur. Reducing risk associated with these concerns is accomplished by: taking into account weather and water temperature/conditions data prior to event scheduling; effective swim, cycle and run course organisation and management; environmental monitoring prior to and during the event; the implementation of a water safety plan; provision of appropriate fluid replacement throughout the course; implementation of helmet use and non-drafting regulations in the cycling leg; and competitor knowledge regarding fluid replacement, biomechanical technique, physical preparation, safe equipment and course familiarity. Despite these concerns, triathlon participation appears to relatively safe for persons of all ages, assuming that high-risk adults undertake health screening.

Diagnosis and Management of Nasopharyngeal Stenosis.

PubMed

Berent, Allyson C

2016-07-01

Choanal atresia is rare in small animal veterinary medicine, and most cases are misdiagnosed and are actually a nasopharyngeal stenosis (NPS), which is frustrating to treat because of the high recurrence rates encountered after surgical intervention. Minimally invasive treatment options like balloon dilation (BD), metallic stent placement (MS), or covered metallic stent (CMS) placement have been met with success but are associated with various complications that must be considered. The most common complication with BD alone is stenosis recurrence. The most common complications encountered with MS placement is tissue in-growth, chronic infections and the development of an oronasal fistula. The most common complications with a CMS is chronic infections and the development of an oronasal fistula, but stricture recurrence is avoided. Copyright © 2016 Elsevier Inc. All rights reserved.

Decision-problem state analysis methodology

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

A methodology for analyzing a decision-problem state is presented. The methodology is based on the analysis of an incident in terms of the set of decision-problem conditions encountered. By decomposing the events that preceded an unwanted outcome, such as an accident, into the set of decision-problem conditions that were resolved, a more comprehensive understanding is possible. All human-error accidents are not caused by faulty decision-problem resolutions, but it appears to be one of the major areas of accidents cited in the literature. A three-phase methodology is presented which accommodates a wide spectrum of events. It allows for a systems content analysis of the available data to establish: (1) the resolutions made, (2) alternatives not considered, (3) resolutions missed, and (4) possible conditions not considered. The product is a map of the decision-problem conditions that were encountered as well as a projected, assumed set of conditions that should have been considered. The application of this methodology introduces a systematic approach to decomposing the events that transpired prior to the accident. The initial emphasis is on decision and problem resolution. The technique allows for a standardized method of accident into a scenario which may used for review or the development of a training simulation.

A systematic review of the quality of statistical methods employed for analysing quality of life data in cancer randomised controlled trials.

PubMed

Hamel, Jean-Francois; Saulnier, Patrick; Pe, Madeline; Zikos, Efstathios; Musoro, Jammbe; Coens, Corneel; Bottomley, Andrew

2017-09-01

Over the last decades, Health-related Quality of Life (HRQoL) end-points have become an important outcome of the randomised controlled trials (RCTs). HRQoL methodology in RCTs has improved following international consensus recommendations. However, no international recommendations exist concerning the statistical analysis of such data. The aim of our study was to identify and characterise the quality of the statistical methods commonly used for analysing HRQoL data in cancer RCTs. Building on our recently published systematic review, we analysed a total of 33 published RCTs studying the HRQoL methods reported in RCTs since 1991. We focussed on the ability of the methods to deal with the three major problems commonly encountered when analysing HRQoL data: their multidimensional and longitudinal structure and the commonly high rate of missing data. All studies reported HRQoL being assessed repeatedly over time for a period ranging from 2 to 36 months. Missing data were common, with compliance rates ranging from 45% to 90%. From the 33 studies considered, 12 different statistical methods were identified. Twenty-nine studies analysed each of the questionnaire sub-dimensions without type I error adjustment. Thirteen studies repeated the HRQoL analysis at each assessment time again without type I error adjustment. Only 8 studies used methods suitable for repeated measurements. Our findings show a lack of consistency in statistical methods for analysing HRQoL data. Problems related to multiple comparisons were rarely considered leading to a high risk of false positive results. It is therefore critical that international recommendations for improving such statistical practices are developed. Copyright © 2017. Published by Elsevier Ltd.

In Print or Out of Print? The Continuing Problem.

ERIC Educational Resources Information Center

Kayden, Mimi

1982-01-01

Briefly describes the problems encountered by libraries in attempting to purchase out-of-stock books and discusses some of the reasons for changes in the way publishers handle backlist materials, including sales volume and its relation to increased printing costs. (JL)

The Impaired Social Worker.

ERIC Educational Resources Information Center

Reamer, Frederic G.

1992-01-01

Discusses concept of the impaired professional; reviews research on various types of impairment (personality disorders, depression and other emotional problems, marital problems, and physical illness), prevalence and causes of impairment, and responses to it; and outlines model assessment and action plan for social workers who encounter an…

The Brown University Child and Adolescent Behavior Letter, 1999.

ERIC Educational Resources Information Center

Lipsitt, Lewis P., Ed.

1999-01-01

These 12 monthly issues from 1999 explore problems encountered by children and adolescents. Regular features include "Keep Your Eye On...," brief accounts of research into childhood and adolescent problems; "What's New in Research," summarizing research from recent publications and professional conferences;…

Segregation of asphalt mixes caused by surge silos : final report.

DOT National Transportation Integrated Search

1982-01-01

Segregation of asphalt mixes continues to be a problem in Virginia, particularly with base mixes and coarse surface mixes. Although the problem is encountered primarily on jobs using surge silos, it has been related to other factors such as mix desig...

The Brown University Child and Adolescent Behavior Letter, 1998.

ERIC Educational Resources Information Center

Lipsitt, Lewis P., Ed.

1998-01-01

These 12 monthly issues from 1998 explore problems encountered by children and adolescents. Regular features include "Keep Your Eye On...," brief accounts of research into childhood and adolescent problems, "What's New in Research," summarizing research from recent publications and professional conferences;…

Understanding non ulcer dyspepsia.

PubMed

Loh, K Y; Siang, T K

2008-06-01

Non ulcer dyspepsia is one of the most common problems encountered in primary care practice. The underlying pathophysiology of non ulcer dyspepsia is not fully understood, but it is known that this condition is associated with H. pylori infection and motility disorder. The presenting abdominal symptoms are non specific: they include bloating, belching, flatulence, excessive fullness after eating and nausea. Psychological condition such as anxiety, depression and stress do play a role in the recurrence of symptoms. Upper GI endoscopy is necessary in patients who presents with alarm symptoms suggestive of possible underlying organic condition before one makes the diagnosis of non ulcer dyspepsia. Pharmacological therapy using H2 receptor antagonist and proton pump inhibitors are effective for symptom relief. Patient's education and supportive care should be part of the management strategy in recurrent chronic dyspepsia.

Orthotics in Sports Shoes

PubMed Central

Schamberger, Wolf

1983-01-01

We are all born with a varying assortment of biomechanical discrepancies. Ordinarily these may be of no consequence, but to those who try to achieve excellence in a certain sport these discrepancies can spell the difference between success and failure. Some athletes may have to accept the fact that biomechanically the odds are against them ever becoming excellent and that intensive training may in fact be detrimental to their wellbeing. However, the majority can be helped with advice on proper shoe wear and orthotic correction. This article highlights the role of foot orthotics as indicated for various biomechanically-related problems commonly encountered in athletes. ImagesFig. 5Fig. 6Fig. 8Fig. 9Fig. 10Fig. 11Fig. 12Fig. 13Fig. 15Fig. 16Fig. 18Fig. 19Fig. 20Fig. 21Fig. 22Fig. 23 PMID:21283401

Asymptotic Poincare lemma and its applications

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

Ziolkowski, R.W.; Deschamps, G.A.

1984-05-01

An asymptotic version of Poincare's lemma is defined and solutions are obtained with the calculus of exterior differential forms. They are used to construct the asymptotic approximations of multidimensional oscillatory integrals whose forms are commonly encountered, for example, in electromagnetic problems. In particular, the boundary and stationary point evaluations of these integrals are considered. The former is applied to the Kirchhoff representation of a scalar field diffracted through an aperture and simply recovers the Maggi-Rubinowicz-Miyamoto-Wolf results. Asymptotic approximations in the presence of other (standard) critical points are also discussed. Techniques developed for the asymptotic Poincare lemma are used to generatemore » a general representation of the Leray form. All of the (differential form) expressions presented are generalizations of known (vector calculus) results. 14 references, 4 figures.« less

A blind source separation approach for humpback whale song separation.

PubMed

Zhang, Zhenbin; White, Paul R

2017-04-01

Many marine mammal species are highly social and are frequently encountered in groups or aggregations. When conducting passive acoustic monitoring in such circumstances, recordings commonly contain vocalizations of multiple individuals which overlap in time and frequency. This paper considers the use of blind source separation as a method for processing these recordings to separate the calls of individuals. The example problem considered here is that of the songs of humpback whales. The high levels of noise and long impulse responses can make source separation in underwater contexts a challenging proposition. The approach present here is based on time-frequency masking, allied to a noise reduction process. The technique is assessed using simulated and measured data sets, and the results demonstrate the effectiveness of the method for separating humpback whale songs.

Abnormal uterine bleeding unrelated to structural uterine abnormalities: management in the perimenopausal period.

PubMed

Sabbioni, Lorenzo; Zanetti, Isabella; Orlandini, Cinzia; Petraglia, Felice; Luisi, Stefano

2017-02-01

Abnormal uterine bleeding (AUB) is one of the commonest health problems encountered by women and a frequent phenomenon during menopausal transition. The clinical management of AUB must follow a standardized classification system to obtain the better diagnostic pathway and the optimal therapy. The PALM-COEIN classification system has been approved by the International Federation of Gynecology and Obstetrics (FIGO); it recognizes structural causes of AUB, which can be measured visually with imaging techniques or histopathology, and non-structural entities such as coagulopathies, ovulatory dysfunctions, endometrial and iatrogenic causes and disorders not yet classified. In this review we aim to evaluate the management of nonstructural causes of AUB during the menopausal transition, when commonly women experience changes in menstrual bleeding patterns and unexpected bleedings which affect their quality of life.

User-Centered Design for Psychosocial Intervention Development and Implementation

PubMed Central

Lyon, Aaron R.; Koerner, Kelly

2018-01-01

The current paper articulates how common difficulties encountered when attempting to implement or scale-up evidence-based treatments are exacerbated by fundamental design problems, which may be addressed by a set of principles and methods drawn from the contemporary field of user-centered design. User-centered design is an approach to product development that grounds the process in information collected about the individuals and settings where products will ultimately be used. To demonstrate the utility of this perspective, we present four design concepts and methods: (a) clear identification of end users and their needs, (b) prototyping/rapid iteration, (c) simplifying existing intervention parameters/procedures, and (d) exploiting natural constraints. We conclude with a brief design-focused research agenda for the developers and implementers of evidence-based treatments. PMID:29456295

Obstacles Related to Structuring for Mathematization Encountered by Students When Solving Physics Problems

ERIC Educational Resources Information Center

Niss, Martin

2017-01-01

This paper studies the cognitive obstacles related to one aspect of mathematization in physics problem-solving, namely, what might be called "structuring for mathematization," where the problem situation is structured in such a way that a translation to a mathematical universe can be done. We report the results of an analysis of four…

Tree planting - strip-mined area in Maryland

Treesearch

Fred L. Bagley

1980-01-01

This report is written to elucidate some of the problems encountered in the planting of trees on strip-mined areas in Maryland. When problems are recognized, normally a solution (or at least, an improvement) can be instituted to alleviate the problem. The methods cited herein are those of experienced foresters engaged in strip-mine planting during the past seventeen...

Reflective Teaching via a Problem Exploration--Teaching Adaptations--Resolution Cycle: A Mixed Methods Study of Preservice Teachers' Reflective Notes

ERIC Educational Resources Information Center

Hayden, H. Emily; Chiu, Ming Ming

2015-01-01

We explore development of elementary preservice teachers' reflective practices as they solved problems encountered while teaching in a reading clinic. Written reflections (N = 175) were collected across 8 weeks from 23 preservice teachers and analyzed to investigate relationships among problem exploration, teaching adaptations, and problem…

Problem Solving in Technology Rich Contexts: Mathematics Sense Making in Out-of-School Environments

ERIC Educational Resources Information Center

Lowrie, Tom

2005-01-01

This investigation describes the way in which a case study participant (aged 7) represented, posed and solved problems in a technology game-based environment. The out-of-school problem-solving context placed numeracy demands on the participant that were more complex and sophisticated than the type of mathematics experiences he encountered in…

Modelling Difficulties and Their Overcoming Strategies in the Solution of a Modelling Problem

ERIC Educational Resources Information Center

Dede, Ayse Tekin

2016-01-01

The purpose of the study is to reveal the elementary mathematics student teachers' difficulties encountered in the solution of a modelling problem, the strategies to overcome those difficulties and whether the strategies worked or not. Nineteen student teachers solved the modelling problem in their four or five-person groups, and the video records…

Complex Problem Solving in Radiologic Technology: Understanding the Roles of Experience, Reflective Judgment, and Workplace Culture

ERIC Educational Resources Information Center

Yates, Jennifer L.

2011-01-01

The purpose of this research study was to explore the process of learning and development of problem solving skills in radiologic technologists. The researcher sought to understand the nature of difficult problems encountered in clinical practice, to identify specific learning practices leading to the development of professional expertise, and to…

Functional Behavioral Assessment for a Boy with Duchenne Muscular Dystrophy and Problem Behavior: A Case Study from Greece

ERIC Educational Resources Information Center

Theodoridou, Zoe; Koutsoklenis, Athanasios

2013-01-01

This article focuses on the application of functional behavioral assessment (FBA) to design a positive behavior intervention (PBI) for a boy with Duchenne muscular dystrophy (DMD) who encounters serious difficulties at the mainstream school because of behavioral problems and physical limitations. After the definition of problem behavior and its…

Science Curriculum from the Perspectives of Turkish Teachers: Problems Encountered and Suggestions for Solutions

ERIC Educational Resources Information Center

Bekmezci, Sinan Muhammet; Ates, Özlem

2017-01-01

The purpose of this research is to identify the problems that teachers have experienced during the implementation of the science curriculum and their suggestions for solution to these problems. In the research, survey model has been used among the descriptive research methods in which quantitative and qualitative data have been used together. The…

An Analysis of Problems in College Students' Participation in the Western China Program

ERIC Educational Resources Information Center

Yumei, Yi

2008-01-01

Since its initiation in 2003, the College Student Western China Program has had several satisfying achievements. At the same time, however, problems exist in the project. This article gives a brief analysis of problems encountered in the project from the aspects of publicity and campaign work, plans and schedules, student participation, voluntary…

Young Filipino Students Making Sense of Arithmetic Word Problems in English

ERIC Educational Resources Information Center

Bautista, Debbie; Mulligan, Joanne; Mitchelmore, Michael

2009-01-01

Young Filipino children are expected to solve mathematical word problems in English, a task which they typically encounter only in schools. In this exploratory study, task-based interviews were conducted with seven Filipino children from a public school. The children were asked to read and solve addition and subtraction word problems in English or…

Shared decision making for stroke prevention in atrial fibrillation: study protocol for a randomized controlled trial.

PubMed

Kunneman, Marleen; Branda, Megan E; Noseworthy, Peter A; Linzer, Mark; Burnett, Bruce; Dick, Sara; Spencer-Bonilla, Gabriela; Fernandez, Cara A; Gorr, Haeshik; Wambua, Mike; Keune, Shelly; Zeballos-Palacios, Claudia; Hargraves, Ian; Shah, Nilay D; Montori, Victor M

2017-09-29

Nonvalvular atrial fibrillation (AF) is a common ongoing health problem that places patients at risk of stroke. Whether and how a patient addresses this risk depends on each patient's goals, context, and values. Consequently, leading cardiovascular societies recommend using shared decision making (SDM) to individualize antithrombotic treatment in patients with AF. The aim of this study is to assess the extent to which the ANTICOAGULATION CHOICE conversation tool promotes high-quality SDM and influences anticoagulation uptake and adherence in patients with AF at risk of strokes. This study protocol describes a multicenter, encounter-level, randomized trial to assess the effect of using the ANTICOAGULATION CHOICE conversation tool in the clinical encounter, compared to usual care. The participating centers include an academic hospital system, a suburban community group practice, and an urban safety net hospital, all in Minnesota, USA. Patients with ongoing nonvalvular AF at risk of strokes (CHA 2 DS 2 -VASc score ≥ 1 in men, or ≥ 2 in women) will be eligible for participation. We aim to include 999 patients and their clinicians. The primary outcome is the quality of SDM as perceived by participants, and as assessed by a post-encounter survey that ascertains (a) knowledge transfer, (b) concordance of the decision made, (c) quality of communication, and (d) satisfaction with the decision-making process. Recordings of encounters will be reviewed to assess the extent of patient involvement and how participants use the tool (fidelity). Anticoagulant use, choice of agent, and adherence will be drawn from patients' medical and pharmacy records. Strokes and bleeding events will be drawn from patient records. This study will provide a valid and precise measure of the effect of the ANTICOAGULATION CHOICE conversation tool on SDM quality and processes, and on the treatment choices and adherence to therapy among AF patients at risk of stroke. ClinicalTrials.gov, NCT02905032 . Registered on 9 September 2016.

Diastolic dysfunction and heart failure with a preserved ejection fraction: Relevance in critical illness and anaesthesia

PubMed Central

Maharaj, R.

2012-01-01

Epidemiological and clinical studies suggest that HF with a preserved ejection fraction will become the more common form of HF which clinicians will encounter. The spectrum of diastolic disease extends from the asymptomatic phase to fulminant cardiac failure. These patients are commonly encountered in operating rooms and critical care units. A clearer understanding of the underlying pathophysiology and clinical implications of HF with a preserved ejection fraction is fundamental to directing further research and to evaluate interventions. This review highlights the impact of diastolic dysfunction and HF with a preserved ejection fraction during the perioperative period and during critical illness. PMID:23960679

Clinico-epidemiological study of tinea incognito with microbiological correlation.

PubMed

Dutta, Bornali; Rasul, Elmy Samsul; Boro, Bobita

2017-01-01

Tinea incognito is a dermatophytic infection with a clinical presentation that is modified due to previous treatment with topical or systemic steroids, as well as topical immunomodulators. It tends to mimic other dermatological conditions. To evaluate the various clinical manifestations, sites, predisposing factors and causative agents of tinea incognito. A prospective observational study was done on one hundred clinically suspected cases of tinea incognito, with a history of topical or systemic steroid use for a period of at least six weeks. They were subject to direct microscopy and fungal culture, and re-evaluated at the end of the third and sixth week. Eczema-like conditions were the most common clinical manifestation, followed by inflammatory, autoimmune and infective conditions. The face was the most commonly affected site. Direct microscopy was positive in 85% of cases, and fungal culture was positive in 63% of cases. Trichophyton rubrum was the most common species isolated. Pharmacists were responsible for 78% of tinea incognito cases, and betamethasone dipropionate was the most common drug used. As this was a hospital outpatient-based study, cases with severe systemic problems could have attended other departments. Cases involving the hair and nails were negligible. Tinea incognito is a commonly encountered, yet poorly reported entity in the study population. An increased level of awareness and vigilance on the sale of steroid containing compounds will help control this dermatological condition.

Reminder Cards Improve Physician Documentation of Obesity But Not Obesity Counseling.

PubMed

Shungu, Nicholas; Miller, Marshal N; Mills, Geoffrey; Patel, Neesha; de la Paz, Amanda; Rose, Victoria; Kropa, Jill; Edi, Rina; Levy, Emily; Crenshaw, Margaret; Hwang, Chris

2015-01-01

Physicians frequently fail to document obesity and obesity-related counseling. We sought to determine whether attaching a physical reminder card to patient encounter forms would increase electronic medical record (EMR) assessment of and documentation of obesity and dietary counseling. Reminder cards for obesity documentation were attached to encounter forms for patient encounters over a 2-week intervention period. For visits in the intervention period, the EMR was retrospectively reviewed for BMI, assessment of "obesity" or "morbid obesity" as an active problem, free-text dietary counseling within physician notes, and assessment of "dietary counseling" as an active problem. These data were compared to those collected through a retrospective chart review during a 2-week pre-intervention period. We also compared physician self-report of documentation via reminder cards with EMR documentation. We found significant improvement in the primary endpoint of assessment of "obesity" or "morbid obesity" as an active problem (42.5% versus 28%) compared to the pre-intervention period. There was no significant difference in the primary endpoints of free-text dietary counseling or assessment of "dietary counseling" as an active problem between the groups. Physician self-reporting of assessment of "obesity" or "morbid obesity" as an active problem (77.7% versus 42.5%), free-text dietary counseling on obesity (69.1% versus 35.4%) and assessment of "dietary counseling" as an active problem (54.3% versus 25.2%) were all significantly higher than those reflected in EMR documentation. This study demonstrates that physical reminder cards are a successful means of increasing obesity documentation rates among providers but do not necessarily increase rates of obesity-related counseling or documentation of counseling. Our study suggests that even with such interventions, physicians are likely under-documenting obesity and counseling compared to self-reported rates.

Confronting Common Folklore: Catching a Cold

ERIC Educational Resources Information Center

Keeley, Page

2012-01-01

Almost every child has experienced the sniffly, stuffy, and achy congestion of the common cold. In addition, many have encountered the "old wives tales" that forge a link between personal actions and coming down with this common respiratory infection. Much of this health folklore has been passed down from generation to generation (e.g., getting a…

Association Between Internet Use and Sleep Problems in Adolescents.

PubMed

Ekinci, Özalp; Çelik, Tanju; Savaş, Nazan; Toros, Fevziye

2014-06-01

Sleep problems are commonly encountered in adolescents. It has been shown that electronic media have a negative influence on the sleep quality and daytime functioning in adolescents. This study aims to investigate the association between internet use and sleep problems in adolescents. A total of 1212 adolescents were recruited to the study. Self-report study questionnaire included two main parts: Young's Internet Addiction Scale (IAS) and a semi-structured inquiry on sleep habits/problems. Of the study sample, 16% (n=198) reported their sleep quality as bad or very bad. One-fourth of the sample reported using internet everyday and 27% of them reported spending more than one hour when online. The mean IAS total score was 35.56±13.87. Adolescents with a higher IAS score reported getting to bed later in the night, needing more time to fall asleep and having an increased number of awakenings in the night than the adolescents with lower IAS score (p=.001). They were also found to have higher frequencies of several sleep problems including difficulty in initiating and sustaining sleep, difficulty in waking up and feelings of sleepiness in day. In addition, sleep quality of them was worse when compared to the adolescents with a lower IAS score (p=.001). Problematic sleep habits and sleep problems were found to be more frequent in adolescents with a higher IAS total score. Health care providers must be aware of the possible negative impact of excessive and uncontrolled internet use on adolescents' sleep habits.

Using video to introduce clinical materials.

PubMed

Kommalage, Mahinda; Senadheera, Chandanie

2012-08-01

The early introduction of clinical material is a recognised strategy in medical education. The University of Ruhana Medical School, where a traditional curriculum is followed, offers students pre-clinical subjects without clinical exposure during their first and second years. Clinical materials in the form of videos were introduced to first-year students. In the videos, patients and their relatives described the diseases and related problems. Students were instructed to identify the problems encountered by patients and relatives. Each video was followed by a discussion of the problems identified by the students. The medical, social and economic problems encountered by patients and relatives were emphasised during post-video discussions. A lecture was conducted linking the contents of the videos to subsequent lectures. The aim of this study is to investigate whether combining teaching preclinical material with a video presentation of relevant clinical cases facilitates the interest and understanding of students. Quantitative data were collected using a questionnaire, whereas qualitative data were collected using focus group discussions. Quantitative data showed that students appreciated the video, had 'better' knowledge acquisition and a 'better' understanding of problems encountered by patients. Qualitative analysis highlighted the following themes: increased interest; enhanced understanding; relevance of basic knowledge to clinical practice; orientation to profession; and personalising theories. The introduction of patients in the form of videos helped students to understand the relevance of subject material for clinical practice, increased their interest and facilitated a better understanding of the subject material. Therefore, it seems video is a feasible medium to introduce clinical materials to first-year students who follow a traditional curriculum in a resource-limited environment. © Blackwell Publishing Ltd 2012.

Some Problems in Studying the English Elements in the Main European Languages

ERIC Educational Resources Information Center

Filipovic, Rudolf

1972-01-01

A study is being done, to be reported on subsequently, on the infiltrations of English into the languages of Europe. Objectives of the project, some problems encountered, and planned results and products are discussed. See FL 508 197 for availability. (RM)

Academic Value of Internships in Agronomy: A Survey.

ERIC Educational Resources Information Center

Herring, Matthew D.; And Others

1990-01-01

A survey of the academic requirements of internships, benefits in taking part in an internship, and problems encountered in internship programs are described. Results indicated that one of the problems with internship programs occurred when faculty did not have direct control over the experience. (CW)

The Powers That Be: AAVE as the Composition Curriculum.

ERIC Educational Resources Information Center

Richardson, Elaine

This Powerpoint presentation argues that the problems encountered in implementing African-centered curriculum into the university composition classroom attest to the need for African centered education in kindergarten through university level educational institutions. The solution of the problem of African American students' disproportionate…

Amino Acids, Aromatic Compounds, and Carboxylic Acids: How Did They Get Their Common Names?

ERIC Educational Resources Information Center

Leung, Sam H.

2000-01-01

Surveys the roots of the common names of organic compounds most likely to be encountered by undergraduate organic chemistry students. Includes information for 19 amino acids, 17 aromatic compounds, and 21 carboxylic acids. (WRM)

Evolution of general surgical problems in patients with left ventricular assist devices.

PubMed

McKellar, Stephen H; Morris, David S; Mauermann, William J; Park, Soon J; Zietlow, Scott P

2012-11-01

Left ventricular assist devices (LVADs) are increasingly used to treat patients with end-stage heart failure. These patients may develop acute noncardiac surgical problems around the time of LVAD implantation or, as survival continues to improve, chronic surgical problems as ambulatory patients remote from the LVAD implant. Previous reports of noncardiac surgical problems in LVAD patients included patients with older, first-generation devices and do not address newer, second-generation devices. We describe the frequency and management of noncardiac surgical problems encountered during LVAD support with these newer-generation devices to assist noncardiac surgeons involved in the care of patients with LVADs. We retrospectively reviewed the medical records of consecutive patients receiving LVADs at our institution. We collected data for any consultation by noncardiac surgeons within the scope of general surgery during LVAD support and subsequent treatment. Ninety-nine patients received implantable LVADs between 2003 and 2009 (first-generation, n = 19; second-generation, n = 80). Excluding intestinal hemorrhage, general surgical opinions were rendered for 34 patients with 49 problems, mostly in the acute recovery phase after LVAD implantation. Of those, 27 patients underwent 28 operations. Respiratory failure and intra-abdominal pathologies were the most common problems addressed, and LVAD rarely precluded operation. Patients with second-generation LVADs were more likely to survive hospitalization (P = .04) and develop chronic, rather than emergent, surgical problems. Patients with LVADs frequently require consultation from noncardiac surgeons within the scope of general surgeons and often require operation. Patients with second-generation LVADs are more likely to become outpatients and develop more elective surgical problems. Noncardiac surgeons will be increasingly involved in caring for patients with LVADs and should anticipate the problems unique to this patient population. Copyright © 2012 Mosby, Inc. All rights reserved.

Serious Illness, Injury, and Death in Child Protection and Preparation for End-of-Life Situations among Child Welfare Services Workers

ERIC Educational Resources Information Center

Csikai, Ellen L.; Herrin, Charlotte; Tang, Maggie; Church, Wesley T., II

2008-01-01

A mailed survey of child welfare workers in one southern state assessed various aspects of encounters with end-of-life situations in practice. Findings revealed that child deaths, children with life-threatening or life-limiting illnesses, and parental deaths were most commonly encountered and that coworkers were relied on for support. Many had no…

What Makes a Social Encounter Meaningful: The Impact of Social Encounters of Homeschooled Children on Emotional and Behavioral Problems

ERIC Educational Resources Information Center

Guterman, Oz; Neuman, Ari

2017-01-01

In modern society, a large part of the socialization process occurs in schools. Therefore, one of the most significant questions raised with regard to homeschooling concerns the impact of this type of education on the emotional world of the child. However, there is almost no mention in the research of how the nature of the social activity of…

Lifetime of binary asteroids versus gravitational encounters and collisions

NASA Technical Reports Server (NTRS)

Chauvineau, Bertrand; Farinella, Paolo; Mignard, F.

1992-01-01

We investigate the effect on the dynamics of a binary asteroid in the case of a near encounter with a third body. The dynamics of the binary is modeled as a two-body problem perturbed by an approaching body in the following ways: near encounters and collisions with a component of the system. In each case, the typical value of the two-body energy variation is estimated, and a random walk for the cumulative effect is assumed. Results are applied to some binary asteroid candidates. The main conclusion is that the collisional disruption is the dominant effect, giving lifetimes comparable to or larger than the age of the solar system.

Connection between encounter volume and diffusivity in geophysical flows

NASA Astrophysics Data System (ADS)

Rypina, Irina I.; Smith, Stefan G. Llewellyn; Pratt, Larry J.

2018-04-01

Trajectory encounter volume - the volume of fluid that passes close to a reference fluid parcel over some time interval - has been recently introduced as a measure of mixing potential of a flow. Diffusivity is the most commonly used characteristic of turbulent diffusion. We derive the analytical relationship between the encounter volume and diffusivity under the assumption of an isotropic random walk, i.e., diffusive motion, in one and two dimensions. We apply the derived formulas to produce maps of encounter volume and the corresponding diffusivity in the Gulf Stream region of the North Atlantic based on satellite altimetry, and discuss the mixing properties of Gulf Stream rings. Advantages offered by the derived formula for estimating diffusivity from oceanographic data are discussed, as well as applications to other disciplines.

Preclinical students’ experiences in early clerkships after skills training partly offered in primary health care centers: a qualitative study from Indonesia

PubMed Central

2012-01-01

Background Students may encounter difficulties when they have to apply clinical skills trained in their pre-clinical studies in clerkships. Early clinical exposure in the pre-clinical phase has been recommended to reduce these transition problems. The aim of this study is to explore differences in students' experiences during the first clerkships between students exclusively trained in a skills laboratory and peers for whom part of their skills training was substituted by early clinical experiences (ECE). Methods Thirty pre-clinical students trained clinical skills exclusively in a skills laboratory; 30 peers received part of their skills training in PHC centers. Within half a year after commencing their clerkships all 60 students shared their experiences in focus group discussions (FGDs). Verbatim transcripts of FGDs were analyzed using Atlas-Ti software. Results Clerkship students who had participated in ECE in PHC centers felt better prepared to perform their clinical skills during the first clerkships than peers who had only practiced in a skills laboratory. ECE in PHC centers impacted positively in particular on students’ confidence, clinical reasoning, and interpersonal communication. Conclusion In the Indonesian setting ECE in PHC centers reduce difficulties commonly encountered by medical students in the first clerkships. PMID:22640419

From wholes to fragments to wholes-what gets lost in translation?

PubMed

Kirkengen, Anna Luise

2018-05-31

The highly demanding and, in a certain sense, unique, working conditions of general practitioners (GPs) are characterized by two phenomena: First, they involve an increasing familiarity with individual patients over time, which promotes a deepening of insight. Second, they enable the GP to encounter all kinds of health problems, which in turn facilitates pattern recognition, at both individual and group levels, particularly the kind of patterns currently termed "multimorbidity." Whereas the term "comorbidity" is used to denote states of bad health in which 1 disease is considered to predate and evoke other ailments or diseases, the term multimorbidity is applied when finding several presumably separate diseases in a person who suffers from them either sequentially or simultaneously. Encounters with patients whose suffering fits the biomedical concept and terminology of multimorbidity are among the most common which GPs face, presenting them with some of their most demanding tasks. The term multimorbidity needs to be examined, however. As it alludes to a multiplicity of diseases, it rests on an assumption of separateness of states of bad health that might not be well founded. An adequate determination of what to deem a "separate" state of bad health would require that the biomedical concept of causation be scrutinized. © 2018 John Wiley & Sons, Ltd.

Illness and exposure to negative life experiences in adolescence: two sides of the same coin? A study of 15-year-olds in Oslo, Norway.

PubMed

Haavet, O R; Straand, J; Saugstad, O D; Grünfeld, B

2004-03-01

To investigate associations between negative life experiences and common illnesses among adolescents. Cross-sectional questionnaire study carried out at all lower secondary schools (10 grade) in Oslo. Norway, during 2000 and 2001 (n = 8316 pupils). Different negative life experiences and illnesses were addressed. The participation rate was 88%. Among reported negative life experiences last year were a pressure felt to succeed (62%), death of a close person (26%), exposure to physical violence (22%), bullying at school (15%) and sexual violation (4%). A large number of the pupils had some chronic illness: hay fever (38%), eczema (29%) and asthma (13%). Reported illnesses the previous 12 month were: headache (56%), painful neck or shoulders (35%), sore throat at least three times (15%), lower respiratory tract infection (9%) and mental problems for which help was sought (7%). During the week prior to the survey, 26% of all girls had symptoms of a depressive disorder, while this applied to 10% of all boys. Fifty-three percent of the boys (29% of the girls) who had depressive symptoms had been exposed to physical violence. Sexually violated boys had a high probability for seeking help for mental problems (OR = 4.9) and for frequent episodes of sore throat (OR = 2.5). Corresponding odds ratios for girls were 1.7 and 2.5, respectively. Common illnesses in adolescence are significantly associated with negative life experiences. In clinical encounters with adolescents not only should the presenting complaints be addressed, but also other common illnesses and relevant background factors such as negative life events.

Social Problems in Turkish Social Studies Coursebooks and Workbooks

ERIC Educational Resources Information Center

Yesiltas, Erkan; Eryilmaz, Önder; Pehlivan, Aysegül

2016-01-01

In Turkey, the social studies course, which is taught in elementary 5th to 7th grades, prepares students to solve problems they may encounter in their future life. Therefore, the teaching of social problems to help students get to know them is one of the most important issues for the social studies course. The primary aim of this study is to…

"Students Get Bogged Down": How Religious Israeli Elementary Teachers View Problems and Solutions in Bible Teaching

ERIC Educational Resources Information Center

Walfish, Ruth A.; Brody, David L.

2018-01-01

Bible teachers in contemporary society confront serious problems related to the nature of the biblical text and the socio-cultural context of their teaching. This study, based on semi-structured interviews, examines the problems that five expert religious Israeli elementary school teachers encounter in their teaching and the solutions they employ.…

Investigating tiredness in Australian general practice. Do pathology tests help in diagnosis?

PubMed

Gialamas, Angela; Beilby, Justin J; Pratt, Nicole L; Henning, Rhys; Marley, John E; Roddick, John F

2003-08-01

Tiredness is a common presentation in general practice for which pathology tests are commonly ordered. Our aim was to study their utilisation for tiredness. We examined an integrated database which contains the medical records for 58,139 patients and their 696,518 associated general practitioner encounters. Three hundred and forty-two patients and their 1652 associated encounters were randomly selected out of 12,291 patients and their 26,748 associated encounters that had mentioned tiredness (or a synonym). One hundred and eighty-one patients (53%) had at least one pathology test ordered at any time in their episode of care. Patients over 60 years of age, patients who consulted their GP more than once and patients without comorbidity were more likely to have a pathology test ordered. Only 12 patients (3%) had a significant clinical diagnosis based on an abnormal pathology test. Pathology testing for patients presenting with tiredness is high. Most tests do not yield a significant clinical diagnosis.

The Real World of the Beginning Teacher.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. National Commission on Teacher Education and Professional Standards.

Problems and goals of beginning teachers are the subject of these speeches presented by both experienced and beginning teachers at the 1965 national conference of the National Commission on Teacher Education and Professional Standards. The problems include the differences between teacher expectations and encounters, unrealistic teaching and…

Virtual Bridge Design

ERIC Educational Resources Information Center

Bisogno, Janet; JeanPierre, Bobby

2008-01-01

The West Point Bridge Design (WPBD) building project engages students in project-based learning by giving them a real-life problem to solve. By using technology, students are able to become involved in solving problems that they normally would not encounter. Involvement with interactive websites, such as WPBD, assists students in using…

Objective Sleep in Pediatric Anxiety Disorders and Major Depressive Disorder

ERIC Educational Resources Information Center

Forbes, Erika E.; Bertocci, Michele A.; Gregory, Alice M.; Ryan, Neal D.; Axelson, David A.; Birmaher, Boris; Dahl, Ronald E.

2008-01-01

A study to examine sleep problems encountered in anxiety and depressive disorders among children and adolescents is conducted. Results indicated subjective and objective sleep problems in children and adolescents with anxiety disorders and need to be kept in mind when treating young anxious people.

Bereavement Support for Children

ERIC Educational Resources Information Center

Auman, Mary Jo

2007-01-01

The death of a parent is one of the most significant and stressful events children can encounter. Surviving children may experience psychiatric problems and social dysfunction during their childhood and possibly throughout their adult lives. Children surviving a sibling's death may develop behavioral problems, because no one can fill the emptiness…

The Brown University Child and Adolescent Behavior Letter, 1997.

ERIC Educational Resources Information Center

Lipsitt, Lewis P., Ed.

1997-01-01

These 12 monthly issues, one special report, and index from 1997 explore problems encountered by children and adolescents. Regular features include "Keep Your Eye On...," brief accounts of research into childhood and adolescent problems; "What's New in Research," summarizing research from recent publications and professional…

Problemes linguistiques des enfants de travailleurs migrants (Linguistic Problems of the Children of Migrant Workers).

ERIC Educational Resources Information Center

de Greve, Marcel, Ed.; Rosseel, Eddy, Ed.

Papers on language difficulties encountered by migrant workers' children include: "Anomie in Bicultural Education" (Hugo Baetens Beardsmore); "An Investigation into Bilingual Education for Children from Favoured Socio-Economic Backgrounds" (Hugo Baetens Beardsmore); "Orientations of Foreign Children Relating to Placement…

Bronchobiliary fistula: principles of management.

PubMed

Chua, H K; Allen, M S; Deschamps, C; Miller, D L; Pairolero, P C

2000-10-01

Bronchobiliary fistula is an uncommon entity. Recently, we encountered 2 patients with this problem. Both were treated successfully with resection of the involved pulmonary tissue and interposition of viable tissue between the lung and the fistulous tract. This approach, although invasive, provided a rapid resolution of the patients' problem.

Foreign bodies in the aerodigestive tract in pediatric patients.

PubMed

Higo, Ryuzaburo; Matsumoto, Yu; Ichimura, Keiichi; Kaga, Kimitaka

2003-12-01

To investigate pediatric foreign body cases in the aerodigestive tract, and to elucidate the characteristic problems in Japan. A total of 310 pediatric patients (age 15 or below), gathered from two medical university hospitals (University of Tokyo and Jichi Medical School), were included in this study. Data were collected by retrospective chart review and were statistically analyzed. Two-year-olds were the most common patients, and the range from age 1 to age 4 included 67.7% of all the patients. The most involved sites were the nose (39.4%) and the pharynx (38.4%), followed by the esophagus (12.9%) and the trachea-bronchi (6.5%). Fish bones and toys were the representative foreign bodies (30.7 and 13.6%, respectively). Other foreign bodies often encountered included coins, food, candy, peanuts and nuts, and batteries. The type of foreign body was closely related to the site in which foreign bodies were lodged: 77.3% of foreign bodies in the pharynx were fish bones, and toys were the most common impacted foreign body in the nose. In the esophagus, representative impacted foreign bodies were coins (35.7%), but disk-type battery ingestion has been increasing in recent years. Although most foreign bodies in the esophagus were safely removed, one case of a disk-type battery had a serious sequela. In the trachea-bronchi, peanuts, food, cotton, and coins were impacted. A rigid bronchoscope was basically used to remove foreign bodies, but in some cases, a fine flexible endoscope, with a channel for fiber forceps, was useful, because it could be inserted into narrow bronchi. Advance of a flexible endoscope will make it an excellent tool for diagnosis and management of the trachea-bronchial foreign body. Fish bones in the pharynx, which were closely related to Japanese eating habits, and toys in the nose, were the typical foreign bodies encountered in this study. In the esophagus, an increased incidence of disk-type battery ingestion has become a serious problem in recent years. Since prevention is the most essential way to manage foreign body cases, feedback from studies to public education should be encouraged.

A comparison of multiple imputation methods for handling missing values in longitudinal data in the presence of a time-varying covariate with a non-linear association with time: a simulation study.

PubMed

De Silva, Anurika Priyanjali; Moreno-Betancur, Margarita; De Livera, Alysha Madhu; Lee, Katherine Jane; Simpson, Julie Anne

2017-07-25

Missing data is a common problem in epidemiological studies, and is particularly prominent in longitudinal data, which involve multiple waves of data collection. Traditional multiple imputation (MI) methods (fully conditional specification (FCS) and multivariate normal imputation (MVNI)) treat repeated measurements of the same time-dependent variable as just another 'distinct' variable for imputation and therefore do not make the most of the longitudinal structure of the data. Only a few studies have explored extensions to the standard approaches to account for the temporal structure of longitudinal data. One suggestion is the two-fold fully conditional specification (two-fold FCS) algorithm, which restricts the imputation of a time-dependent variable to time blocks where the imputation model includes measurements taken at the specified and adjacent times. To date, no study has investigated the performance of two-fold FCS and standard MI methods for handling missing data in a time-varying covariate with a non-linear trajectory over time - a commonly encountered scenario in epidemiological studies. We simulated 1000 datasets of 5000 individuals based on the Longitudinal Study of Australian Children (LSAC). Three missing data mechanisms: missing completely at random (MCAR), and a weak and a strong missing at random (MAR) scenarios were used to impose missingness on body mass index (BMI) for age z-scores; a continuous time-varying exposure variable with a non-linear trajectory over time. We evaluated the performance of FCS, MVNI, and two-fold FCS for handling up to 50% of missing data when assessing the association between childhood obesity and sleep problems. The standard two-fold FCS produced slightly more biased and less precise estimates than FCS and MVNI. We observed slight improvements in bias and precision when using a time window width of two for the two-fold FCS algorithm compared to the standard width of one. We recommend the use of FCS or MVNI in a similar longitudinal setting, and when encountering convergence issues due to a large number of time points or variables with missing values, the two-fold FCS with exploration of a suitable time window.

Triaging: common complaints in the workplace.

PubMed

Zimmermann, Polly Gerber; Wachs, Joy E

2003-06-01

Occupational health nurses regularly encounter clients with benign, common complaints. However, the mundane nature should not detract from the need for careful evaluation and guidance. Obtaining a comprehensive history and making key assessments help guide the occupational health nurse to properly manage the client's complaint.

The pattern of acute poisoning in a teaching hospital, north-west Ethiopia.

PubMed

Abula, Teferra; Wondmikun, Yared

2006-04-01

Poisoning by means of hazardous chemicals through ignorance, mishap or intentionally is becoming a serious health problem worldwide. Epidemiological data on this important health issue are, however, scarce in Ethiopia. The purpose of this study is to assess the pattern of acute poisonings and determine the approaches employed for the management of poisoning. The medical records of patients with acute poisonings presented to the Gondar University hospital between July 2001 and June 2004 were reviewed retrospectively. One hundred and two patients presenting to the emergency department of the hospital were due to acute poisoning; accounting for about 0.45% of emergency room admissions. Organophosphates, rat poison and alcohol were the commonly encountered poisoning agents (in about 70% of cases) mainly in adults possibly with suicidal or para-suicidal intention. The approaches employed in the management of poisoning mainly involved gastrointestinal decontamination procedures. Specific antidotes were used in a substantial number of patients. The fatality rate was 2.4%. Poisoning with suicidal intention is becoming a serious health problem particularly in adults. Pesticides are commonly used toxicants. The approaches in the management of poisoning are justifiable in some cases. However, much is to be done to improve the recording of patient-related information and record-keeping processes. Further large scale studies are required to investigate national trends of poisoning and factors associated with poisoning.

Vibration characteristics of the HPOTP (High-Pressure Oxygen Turbopump) of the SSME (Space Shuttle Main Engine)

NASA Technical Reports Server (NTRS)

Childs, D. W.; Moyer, D. S.

1984-01-01

Attention is given to rotor dynamic problems that have been encountered and eliminated in the course of Space Shuttle Main Engine (SSME) development, as well as continuing, subsynchronous problems which are being encountered in the development of a 109-percent power level engine. The basic model for the SSME's High Pressure Oxygen Turbopump (HPOTP) encompasses a structural dynamic model for the rotor and housing, and component models for the liquid and gas seals, turbine clearance excitation forces, and impeller diffuser forces. Linear model results are used to examine the synchronous response and stability characteristics of the HPOTP, with attention to bearing load and stability problems associated with the second critical speed. Differences between linear and nonlinear model results are discussed and explained in terms of simple models. Simulation results indicate that while synchronous bearing loads can be reduced, subsynchronous motion is not eliminated by seal modifications.

Trapped particle absorption by the Ring of Jupiter

NASA Technical Reports Server (NTRS)

Fillius, W.

1983-01-01

The interaction of trapped radiation with the ring of Jupiter is investigated. Because it is an identical problem, the rings of Saturn and Uranus are also examined. Data from the Pioneer II encounter, deductions for some of the properties of the rings of Jupiter and Saturn. Over a dozen Jupiter magnetic field models are available in a program that integrates the adiabatic invariants to compute B and L. This program is to label our UCSD Pioneer II encounter data with the most satisfactory of these models. The expected effects of absorbing material on the trapped radiation are studied to obtain the loss rate as a function of ring properties. Analysis of the particle diffusion problem rounds out the theoretical end of the ring absorption problem. Other projects include identification of decay products for energetic particle albedo off the rings and moons of Saturn and a search for flux transfer events at the Jovian magnetopause.

Analysis of severe atmospheric disturbances from airline flight records

NASA Technical Reports Server (NTRS)

Wingrove, R. C.; Bach, R. E., Jr.; Schultz, T. A.

1989-01-01

Advanced methods were developed to determine time varying winds and turbulence from digital flight data recorders carried aboard modern airliners. Analysis of several cases involving severe clear air turbulence encounters at cruise altitudes has shown that the aircraft encountered vortex arrays generated by destabilized wind shear layers above mountains or thunderstorms. A model was developed to identify the strength, size, and spacing of vortex arrays. This model is used to study the effects of severe wind hazards on operational safety for different types of aircraft. The study demonstrates that small remotely piloted vehicles and executive aircraft exhibit more violent behavior than do large airliners during encounters with high-altitude vortices. Analysis of digital flight data from the accident at Dallas/Ft. Worth in 1985 indicates that the aircraft encountered a microburst with rapidly changing winds embedded in a strong outflow near the ground. A multiple-vortex-ring model was developed to represent the microburst wind pattern. This model can be used in flight simulators to better understand the control problems in severe microburst encounters.

Common difficulties encountered in collecting native seed

Treesearch

Richard Dunne

1999-01-01

The increased demand for native seed has surpassed our ability to provide high quality range-collected seed. This paper discusses some of the hazards and common mistakes associated with the collection of wildland native seed. Among the common difficulties in collecting native seed are: (1) native species do not produce seed often in the arid West; (2) there is a...

Between normality and deviance: the breakdown of batterers' identity following police intervention.

PubMed

Buchbinder, Eli; Eisikovits, Zvi

2004-04-01

With the transformation of intimate violence from private trouble to social problem, police intervention in domestic violence cases became more prevalent. Research has focused mainly on battered women's perception of police intervention, their evaluations, and their level of satisfaction with the intervention. However, there is little research examining the perpetrators' subjective perceptions of such interventions. The purpose of this study is to describe and analyze battering men's perceptions of police intervention. The study is based on semistructured, in-depth interviews with 20 batterers who had repeated encounters with police. Findings show a continuum of self-management, ranging from attempts to preserve a normative identity in the first encounter to struggling against criminalization in the second encounter and adopting a victim identity in the third encounter. The findings are discussed in the context of gender identity and power relations.

An issue encountered in solving problems in electricity and magnetism: curvilinear coordinates

NASA Astrophysics Data System (ADS)

Gülçiçek, Çağlar; Damlı, Volkan

2016-11-01

In physics lectures on electromagnetic theory and mathematical methods, physics teacher candidates have some difficulties with curvilinear coordinate systems. According to our experience, based on both in-class interactions and teacher candidates’ answers in test papers, they do not seem to have understood the variables in curvilinear coordinate systems very well. For this reason, the problems that physics teacher candidates have with variables in curvilinear coordinate systems have been selected as a study subject. The aim of this study is to find the physics teacher candidates’ problems with determining the variables of drawn shapes, and problems with drawing shapes based on given variables in curvilinear coordinate systems. Two different assessment tests were used in the study to achieve this aim. The curvilinear coordinates drawing test (CCDrT) was used to discover their problems related to drawing shapes, and the curvilinear coordinates detection test (CCDeT) was used to find out about problems related to determining variables. According to the findings obtained from both tests, most physics teacher candidates have problems with the ϕ variable, while they have limited problems with the r variable. Questions that are mostly answered wrongly have some common properties, such as value. According to inferential statistics, there is no significant difference between the means of the CCDeT and CCDrT scores. The mean of the CCDeT scores is only 4.63 and the mean of the CCDrT is only 4.66. Briefly, we can say that most physics teacher candidates have problems with drawing a shape using the variables of curvilinear coordinate systems or in determining the variables of drawn shapes. Part of this study was presented at the XI. National Science and Mathematics Education Congress (UFBMEK) in 2014.

Training, age and technological change: difficulties associated with age, the design of tools, and the organization of work.

PubMed

Cau-Bareille, Dominique; Gaudart, Corinne; Delgoulet, Catherine

2012-01-01

This article presents two ergonomic studies carried out when two French administrative bodies modernized their work tools. Our objective was to identify and define the vocational learning of experienced technicians who were required to adopt new working methods to cope with these technological changes. We observed the work activity of technicians of different ages and length of service both before and during training, and also after their return to their work unit during the appropriation phase. These two studies revealed some difficulties that were common to all the technicians and others that were more specific to the older employees. In terms of the design of the training course, we were able to point out some mistaken assumptions about the technicians' original command of the work activity and the computers, which made it difficult for them to adopt new work procedures. The difficulties encountered by the older employees were ultimately found to be more an indication of organizational problems to do with the management of change rather than training problems due to age.

A HUPO test sample study reveals common problems in mass spectrometry-based proteomics

PubMed Central

Bell, Alexander W.; Deutsch, Eric W.; Au, Catherine E.; Kearney, Robert E.; Beavis, Ron; Sechi, Salvatore; Nilsson, Tommy; Bergeron, John J.M.

2009-01-01

We carried out a test sample study to try to identify errors leading to irreproducibility, including incompleteness of peptide sampling, in LC-MS-based proteomics. We distributed a test sample consisting of an equimolar mix of 20 highly purified recombinant human proteins, to 27 laboratories for identification. Each protein contained one or more unique tryptic peptides of 1250 Da to also test for ion selection and sampling in the mass spectrometer. Of the 27 labs, initially only 7 labs reported all 20 proteins correctly, and only 1 lab reported all the tryptic peptides of 1250 Da. Nevertheless, a subsequent centralized analysis of the raw data revealed that all 20 proteins and most of the 1250 Da peptides had in fact been detected by all 27 labs. The centralized analysis allowed us to determine sources of problems encountered in the study, which include missed identifications (false negatives), environmental contamination, database matching, and curation of protein identifications. Improved search engines and databases are likely to increase the fidelity of mass spectrometry-based proteomics. PMID:19448641

The challenge of diagnosing focal hand dystonia in musicians

PubMed Central

Rosset-Llobet, J.; Candia, V.; Molas, S. Fàbregas i; Dolors Rosinés i Cubells, D.; Pascual-Leone, A.

2012-01-01

Background and purpose To most clinicians, medical problems in musicians, particularly those concerning focal hand dystonia, constitute an unfamiliar domain difficult to manage. The latter can importantly influence diagnostics and the course of treatment. The purpose of this study was to enlighten the issue and to identify possible problems in diagnosing musicians’ cramp within the Spanish medical community. Methods We used a brief questions’ catalog and clinical histories of 665 musicians seen at our clinic for performing artists. We analyzed patients’ diagnosis records in 87 cases of focal hand dystonia (13.1%). In so doing, we surveyed previous diagnoses and diverse treatments prescriptions prior to referral to our clinic. Results Referrals came primarily from orthopaedists and neurologists. The 52.9% arrived at our clinic without a diagnosis or a suspicion of suffering from focal dystonia. The most frequently attempted diagnoses other than musicians’ dystonia included nerve compression, tendonitis and trigger fingers. Commonly prescribed treatments included rest, various surgical procedures, physiotherapy and oral anti-inflammatory medication. Conclusions This data depicts the diagnostic challenges of medical professionals may encounter when confronted with musician’s focal dystonia. PMID:19473363

Automated simultaneous multiple feature classification of MTI data

NASA Astrophysics Data System (ADS)

Harvey, Neal R.; Theiler, James P.; Balick, Lee K.; Pope, Paul A.; Szymanski, John J.; Perkins, Simon J.; Porter, Reid B.; Brumby, Steven P.; Bloch, Jeffrey J.; David, Nancy A.; Galassi, Mark C.

2002-08-01

Los Alamos National Laboratory has developed and demonstrated a highly capable system, GENIE, for the two-class problem of detecting a single feature against a background of non-feature. In addition to the two-class case, however, a commonly encountered remote sensing task is the segmentation of multispectral image data into a larger number of distinct feature classes or land cover types. To this end we have extended our existing system to allow the simultaneous classification of multiple features/classes from multispectral data. The technique builds on previous work and its core continues to utilize a hybrid evolutionary-algorithm-based system capable of searching for image processing pipelines optimized for specific image feature extraction tasks. We describe the improvements made to the GENIE software to allow multiple-feature classification and describe the application of this system to the automatic simultaneous classification of multiple features from MTI image data. We show the application of the multiple-feature classification technique to the problem of classifying lava flows on Mauna Loa volcano, Hawaii, using MTI image data and compare the classification results with standard supervised multiple-feature classification techniques.

An exploratory study of recycled sputtering and CsF2- current enhancement for AMS

NASA Astrophysics Data System (ADS)

Zhao, X.-L.; Charles, C. R. J.; Cornett, R. J.; Kieser, W. E.; MacDonald, C.; Kazi, Z.; St-Jean, N.

2016-01-01

The analysis of 135Cs/Cs ratios at levels below 10-12 by accelerator mass spectrometry (AMS) would preferably use commonly available negative ion injection systems. The sputter ion sources in these injectors should ideally produce currents of Cs- or Cs-containing molecular anions approaching μA levels from targets containing mg quantities of Cs. However, since Cs is the most electro-positive stable element in nature with a low electron affinity, the generation of large negative atomic, or molecular beams containing Cs, has been very challenging. In addition, the reduction of the interferences from the 135Ba isobar and the primary 133Cs+ beam used for sputtering are also necessary. The measurement of a wide range of the isotope ratios also requires the ion source memory of previous samples be minimized. This paper describes some progresses towards a potential solution of all these problems by recycled sputtering using fluorinating targets of PbF2 with mg CsF mixed in. The problems encountered indicate that considerable further studies and some redesign of the present ion sources will be desirable.

Hierarchical video summarization

NASA Astrophysics Data System (ADS)

Ratakonda, Krishna; Sezan, M. Ibrahim; Crinon, Regis J.

1998-12-01

We address the problem of key-frame summarization of vide in the absence of any a priori information about its content. This is a common problem that is encountered in home videos. We propose a hierarchical key-frame summarization algorithm where a coarse-to-fine key-frame summary is generated. A hierarchical key-frame summary facilitates multi-level browsing where the user can quickly discover the content of the video by accessing its coarsest but most compact summary and then view a desired segment of the video with increasingly more detail. At the finest level, the summary is generated on the basis of color features of video frames, using an extension of a recently proposed key-frame extraction algorithm. The finest level key-frames are recursively clustered using a novel pairwise K-means clustering approach with temporal consecutiveness constraint. We also address summarization of MPEG-2 compressed video without fully decoding the bitstream. We also propose efficient mechanisms that facilitate decoding the video when the hierarchical summary is utilized in browsing and playback of video segments starting at selected key-frames.

The challenge of diagnosing focal hand dystonia in musicians.

PubMed

Rosset-Llobet, J; Candia, V; Fàbregas i Molas, S; Dolors Rosinés i Cubells, D; Pascual-Leone, A

2009-07-01

To most clinicians, medical problems in musicians, particularly those concerning focal hand dystonia, constitute an unfamiliar domain difficult to manage. The latter can importantly influence diagnostics and the course of treatment. The purpose of this study was to enlighten the issue and to identify possible problems in diagnosing musicians' cramp within the Spanish medical community. We used a brief questions' catalog and clinical histories of 665 musicians seen at our clinic for performing artists. We analyzed patients' diagnosis records in 87 cases of focal hand dystonia (13.1%). In so doing, we surveyed previous diagnoses and diverse treatments prescriptions prior to referral to our clinic. Referrals came primarily from orthopaedists and neurologists. The 52.9% arrived at our clinic without a diagnosis or a suspicion of suffering from focal dystonia. The most frequently attempted diagnoses other than musicians' dystonia included nerve compression, tendonitis and trigger fingers. Commonly prescribed treatments included rest, various surgical procedures, physiotherapy and oral anti-inflammatory medication. This data depicts the diagnostic challenges of medical professionals may encounter when confronted with musician's focal dystonia.

An analysis dictionary learning algorithm under a noisy data model with orthogonality constraint.

PubMed

Zhang, Ye; Yu, Tenglong; Wang, Wenwu

2014-01-01

Two common problems are often encountered in analysis dictionary learning (ADL) algorithms. The first one is that the original clean signals for learning the dictionary are assumed to be known, which otherwise need to be estimated from noisy measurements. This, however, renders a computationally slow optimization process and potentially unreliable estimation (if the noise level is high), as represented by the Analysis K-SVD (AK-SVD) algorithm. The other problem is the trivial solution to the dictionary, for example, the null dictionary matrix that may be given by a dictionary learning algorithm, as discussed in the learning overcomplete sparsifying transform (LOST) algorithm. Here we propose a novel optimization model and an iterative algorithm to learn the analysis dictionary, where we directly employ the observed data to compute the approximate analysis sparse representation of the original signals (leading to a fast optimization procedure) and enforce an orthogonality constraint on the optimization criterion to avoid the trivial solutions. Experiments demonstrate the competitive performance of the proposed algorithm as compared with three baselines, namely, the AK-SVD, LOST, and NAAOLA algorithms.

Exploring Education. Students from Overseas.

ERIC Educational Resources Information Center

Yates, Alfred, Ed.

Students entering college for the first time are often confronted with adjustment problems that seem to them unsurmountable and impossible. There is the transition from living dependently with parents to semi-independent living on the college campus, in addition to the many problems encountered in academic areas. If a student, accustomed to the…

New Territory: Problems of Adjusting to the First Year of a Social Science PhD.

ERIC Educational Resources Information Center

Hockey, John

1994-01-01

Problems encountered by first-year social science doctoral students in adjusting to their new status as novice researchers are examined, including intellectual solitariness, professional and social isolation, new work organization requirements, anxiety concerning time and productivity, intellectual life, and supervision. Factors contributing to…

Theory Oriented Research: Problems and Challenges.

ERIC Educational Resources Information Center

Greer, John T.

This paper discusses problems the author encountered in attempting to conduct a study of teacher motivation as influenced by a combination of participative decision-making and financial rewards. Over a 3-year period, teacher motivation was to be viewed as influenced by two independent variables--participative decision-making and financial rewards;…

Examples of Cross-Cultural Problems Encountered by Americans Working Overseas; An Instructor's Handbook.

ERIC Educational Resources Information Center

Foster, Robert J.

Intended mainly as a source book for instructors in area training programs, this handbook contains summary accounts of events illustrating problems frequently met by Americans working overseas, especially those providing technical assistance in developing nations. Examples are drawn from case studies, interviews, anthropology texts, and other…

Identifying Fallacies of Reference in Argumentation

ERIC Educational Resources Information Center

Gough, Jim

2009-01-01

The experience of teaching informal logic (sometimes called practical logic) at the introductory level over the last fifteen years has allowed the author the opportunity to identify some interesting problems. These problems have been encountered by students attempting to understand some of the ideas presented in the informal logic course and by…

Efficacy of a Latino Mother-Child Communication Intervention in Elementary Schools

ERIC Educational Resources Information Center

McNaughton, Diane B.; Cowell, Julia Muennich; Fogg, Louis

2015-01-01

Children of Latino immigrants in the United States encounter ecological stressors that heighten their risk for depressive symptoms, externalizing behavior, and problems in school. Studies have shown that affirming parent-child communication is protective of child depressive symptoms and accompanying problems. The purpose of this study was to…

Understanding Critical Thinking to Create Better Doctors

ERIC Educational Resources Information Center

Zayapragassarazan, Zayabalaradjane; Menon, Vikas; Kar, Sitanshu Sekhar; Batmanabane, Gitanjali

2016-01-01

Medical students master an enormous body of knowledge, but lack systematic problem solving ability and effective clinical decision making. High profile reports have called for reforms in medical education to create a better generation of doctors who can cope with the system based problems they would encounter in an interdisciplinary and…

Anatomy of a bearing torque problem

NASA Technical Reports Server (NTRS)

Phinney, Damon D.

1987-01-01

In the early 1970s, an antenna despin drive was developed for MBB solar science satellite HELIOS. A problem with high bearing drag torque that was encountered on the two flight models of this drive, after successful tests were completed on twelve bearings, an engineering model, and the qualification unit is discussed.

SOME PROBLEMS IN THE CONSTRUCTION OF AN ELECTRON LINEAR ACCELERATOR (in Dutch)

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

Verhaeghe, J.; Vanhuyse, V.; Van Leuven, P.

1959-01-01

Special problems encountered in the construction of the electron linear accelerator of the Natuurkundig Laboratorium der Rijksuniversiteit of Ghent are discussed. The subjects considered are magnetic focusing, magnetic screening of the electron gun cathode, abnormal attenuation-multipactor effects, and electron energy control. (J.S.R.)

Difficulties for University Students with Mental Health Problems: A Critical Interpretive Synthesis

ERIC Educational Resources Information Center

Markoulakis, Roula; Kirsh, Bonnie

2013-01-01

Postsecondary institutions are witnessing an increase in the number and severity of student mental health problems, necessitating an understanding of the difficulties these students encounter in striving for higher education. The authors conducted a critical interpretive synthesis of 10 articles pertaining to difficulties experienced by students…

English Preservice Teaching: Problems and Suggested Solutions

ERIC Educational Resources Information Center

Naeem, Marwa Ahmed Refat

2014-01-01

The present study investigated the problems faced by Egyptian EFL prospective teachers during their first encounter with preservice teaching. The sample for the study included 135 prospective EFL teachers trained in five preparatory (middle) schools in Kafr El-Sheikh city, Egypt. At the end of their first year training course, the prospective…

Education's Role in National Development Plans: Ten Country Cases.

ERIC Educational Resources Information Center

Thomas, R. Murray, Ed.

The place education has been assigned in the national development programs of 10 nations is discussed, the problems that these countries have encountered in managing education are examined, and the measures adopted to solve educational problems are assessed. Included are the following papers: (1) "The Nature of National Development…

Human Gene Discovery Laboratory: A Problem-Based Learning Experience

ERIC Educational Resources Information Center

Bonds, Wesley D., Sr.; Paolella, Mary Jane

2006-01-01

A single-semester elective combines Mendelian and molecular genetics in a problem-solving format. Students encounter a genetic disease scenario, construct a family pedigree, and try to confirm their medical diagnoses through laboratory experiences. Encouraged to generate ideas as they test their hypotheses, students realize the importance of data…

Turkish EFL Pre-Service Teachers' Pronunciation Problems

ERIC Educational Resources Information Center

Bardakçi, Mehmet

2015-01-01

This classroom research deals with pronunciation problems that Turkish EFL teacher candidates would encounter. The participants were 22 EFL pre-service teachers with B2 level of proficiency in English. The presentations which were carried out by these participants were analyzed both by the participants themselves and the researcher. The results…

Knowledge Inertia and Organizational Learning as the Explanation of Organizational Performance

ERIC Educational Resources Information Center

Aküzüm, Cemal

2014-01-01

Knowledge is an important concept for individuals and organizations both as a power and source. Thus, knowledge management has become important subject for researchers. However, when people encounter problems, they usually try to produce solutions by utilizing their previous knowledge and experience. Such problem solving strategies are called…

Establishing a Child Care Substitute Caregiver System.

ERIC Educational Resources Information Center

Love, Lynne

Substitute caregivers are needed by day care centers in every state. Indeed, some areas are experiencing severe shortages of applicants for child care positions and short-term substitute work. This article describes problems encountered in current substitute caregiver systems and suggests ways of dealing with such problems. Specifically discussed…

Introspection in Problem Solving

ERIC Educational Resources Information Center

Jäkel, Frank; Schreiber, Cornell

2013-01-01

Problem solving research has encountered an impasse. Since the seminal work of Newell und Simon (1972) researchers do not seem to have made much theoretical progress (Batchelder and Alexander, 2012; Ohlsson, 2012). In this paper we argue that one factor that is holding back the field is the widespread rejection of introspection among cognitive…

Maintaining "Professional Distance": A Dilemma for the ABE Teacher.

ERIC Educational Resources Information Center

Willing, Delight C.; Haney, Hutch

1994-01-01

Too often, many adult educators are unaware of the problems resulting from failing to maintain an appropriate "professional distance" from their adult basic education (ABE) or English-as-a-Second-Language (ESL) students when those students encounter personal problems or crises that appear to be interfering with their learning. ABE…

Student Problems. Adult Literacy Independent Learning Packet.

ERIC Educational Resources Information Center

Koefer, Ann M.

This independent learning packet, which is designed for administrators, teachers, counselors, and tutors in Pennsylvania's Region 7 Tri-Valley Literacy Staff Development area as well as for their adult students, examines the following seven problems encountered by students: the job market, child care, single parenting/parenting skills, divorce,…

Impact Assessment of Problem-Based Learning in an Engineering Science Course

ERIC Educational Resources Information Center

Nasr, Karim J.; Ramadan, Bassem H.

2008-01-01

This paper presents the development and implementation of Problem-Based Learning (PBL) in an engineering thermodynamics course at Kettering University. In this project, the thermodynamics course was restructured as modules presenting practical applications first, whereas principles were introduced just-in-time and as encountered. Theoretical…

Alleviating Comprehension Problems in Movies. Working Paper.

ERIC Educational Resources Information Center

Tatsuki, Donna

This paper describes the various barriers to comprehension that learners may encounter when viewing feature films in a second language. Two clusters of interfacing factors that may contribute to comprehension hot spots emerged from a quantitative analysis of problems noted in student logbooks. One cluster had a strong acoustic basis, whereas the…

The Brown University Child and Adolescent Behavior Letter, 1996.

ERIC Educational Resources Information Center

Lipsitt, Lewis P., Ed.

1996-01-01

These 12 monthly newsletters from 1996 explore the many problems encountered by children and adolescents as they grow up. Regular departments in the newsletter issues include "Keep Your Eye On...," which briefly presents results of research into childhood and adolescent problems; "What's New in Research," summarizing research…

The Brown University Child and Adolescent Behavior Letter, 1995.

ERIC Educational Resources Information Center

Lipsitt, Lewis P., Ed.

1995-01-01

These 12 monthly newsletters from 1995 explore the myriad problems encountered by children and adolescents as they grow up. Regular departments in the newsletter issues include "Keep Your Eye On...," which briefly presents results of research into childhood and adolescent problems; "New Research," summarizing research from recent publications and…

Variability in opioid prescribing for children undergoing ambulatory surgery in the United States.

PubMed

Van Cleve, William C; Grigg, Eliot B

2017-09-01

We attempted to describe the opioid prescribing patterns for ambulatory pediatric surgery in the United States from 2007 to 2014. Retrospective database review. Operating room ambulatory encounters as determined by the Truven Health Marketscan Commercial Claims and Encounters database. A total of 929,874 ambulatory surgical encounters were identified in patients <18years of age and, of these, 439,286 encounters generated an analgesic prescription. N/A MEASUREMENTS: The analgesic prescription was described in terms of the type of opioid along with the inclusion of acetaminophen and/or NSAIDs. The probability of receiving a post-operative analgesic prescription increased with age, ranging from 18.2% of infants to 71.7% of teens. Acetaminophen with codeine (APAP/C) was the most common drug for infants (63.8%), while acetaminophen with hydrocodone (APAP/H) was the most common analgesic prescription for teens (53.6%). APAP/C and APAP/H were the predominant drugs used for all procedure types. Substantial variability in analgesic prescribing at the level of the procedure performed, both in terms of the probability of receiving a prescription and in which drugs were prescribed. We observed significant age and procedure-based variability in opioid prescribing following pediatric ambulatory surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Atmospheric Propagation and Combining of High-Power Lasers

DTIC Science & Technology

2015-09-08

Brightness-scaling potential of actively phase- locked solid state laser arrays,” IEEE J. Sel. Topics Quantum Electron., vol. 13, no. 3, pp. 460–472, May...attempting to phase- lock high-power lasers, which is not encountered when phase- locking low-power lasers, for example mW power levels. Regardless, we...technology does not currently exist. This presents a challenging problem when attempting to phase- lock high-power lasers, which is not encountered when

Unmanned Aerial Vehicle Operational Test and Evaluation Lessons Learned

DTIC Science & Technology

2003-12-01

prevented during the test design phase. Test designers should ensure that the appropriate data can be collected in sample sizes large enough to support...encountered during previous tests in an attempt to prevent them from occurring in future tests. The focus of this paper is on UAVs acquired to perform...CHAPTER III TEST DESIGN III. TEST DESIGN Many of the problems encountered during UAV OT could have been prevented during the test

Human Trafficking in the Emergency Department

PubMed Central

Patel, Ronak B.; Ahn, Roy; Burke, Thomas F.

2010-01-01

Human trafficking continues to persist, affecting up to 200 million people worldwide. As clinicians in emergency departments commonly encounter victims of intimate partner violence, some of these encounters will be with trafficking victims. These encounters provide a rare opportunity for healthcare providers to intervene and help. This case report of a human trafficking patient from a teaching hospital illustrates the complexity in identifying these victims. Clinicians can better identify potential trafficking cases by increasing their awareness of this phenomenon, using qualified interpreters, isolating potential victims by providing privacy and using simple clear reassuring statements ensuring security. A multidisciplinary approach can then be mobilized to help these patients. PMID:21293753

[Poisonous animals at bathing beaches].

PubMed

Junghanss, T; Bodio, M

2000-05-18

Tourists and native inhabitants of tropical and subtropical regions differ significantly with regard to the risk and nature of incidents involving venomous and poisonous animals. While the indigenous population encounters such risks daily during work and other activities, tourists are usually endangered while swimming or diving, or by ingesting toxin-containing fish and/or other seafood. Whether abroad or at home, allergic reactions to the stings of bees, wasps and hornets are probably the most common manifestations of an encounter with a "poisonous animal". Travellers should be well acquainted with the dangers entailed in encountering or ingesting a venomous or poisonous animal--prevention is the most important measure.

Sexual harassment in medical training.

PubMed

Komaromy, M; Bindman, A B; Haber, R J; Sande, M A

1993-02-04

Sexual harassment has become a national concern and one that is increasingly recognized in the field of medicine. Although there are reports of the sexual harassment of medical trainees, there is little information on the prevalence of this problem and whether it is adequately addressed by training institutions. Surveys with descriptions and examples of sexual harassment were mailed to 133 internal medicine residents in a university training program. The residents were asked to report anonymously whether they had encountered sexual harassment during medical school or residency, the frequency and type of harassment, its effect on them, whether they chose to report it to a person in authority, and the factors that influenced this decision. Surveys were returned by 82 residents (response rate, 62 percent), 33 women and 49 men. Twenty-four women (73 percent) and 11 men (22 percent) reported that they had been sexually harassed at least once during their training. The women were more likely than the men to have been physically harassed, and the women's harassers were of higher professional status. Among those harassed, 19 of the women (79 percent) and 5 of the men (45 percent) thought that the experience created a hostile environment or interfered with their performance at work, but only 2 women and no men reported their experiences to an authority. The women cited a lack of confidence that they would be helped as the main reason for not reporting the experience, whereas men most commonly said that they had dealt with the problem without the need for outside assistance. Many medical trainees encounter what they believe to be sexual harassment during medical school or residency, and this often creates a hostile learning and work environment. Training institutions need to address the adverse effects this may have on medical education and patient care.

Integrating Visualizations into Modeling NEST Simulations

PubMed Central

Nowke, Christian; Zielasko, Daniel; Weyers, Benjamin; Peyser, Alexander; Hentschel, Bernd; Kuhlen, Torsten W.

2015-01-01

Modeling large-scale spiking neural networks showing realistic biological behavior in their dynamics is a complex and tedious task. Since these networks consist of millions of interconnected neurons, their simulation produces an immense amount of data. In recent years it has become possible to simulate even larger networks. However, solutions to assist researchers in understanding the simulation's complex emergent behavior by means of visualization are still lacking. While developing tools to partially fill this gap, we encountered the challenge to integrate these tools easily into the neuroscientists' daily workflow. To understand what makes this so challenging, we looked into the workflows of our collaborators and analyzed how they use the visualizations to solve their daily problems. We identified two major issues: first, the analysis process can rapidly change focus which requires to switch the visualization tool that assists in the current problem domain. Second, because of the heterogeneous data that results from simulations, researchers want to relate data to investigate these effectively. Since a monolithic application model, processing and visualizing all data modalities and reflecting all combinations of possible workflows in a holistic way, is most likely impossible to develop and to maintain, a software architecture that offers specialized visualization tools that run simultaneously and can be linked together to reflect the current workflow, is a more feasible approach. To this end, we have developed a software architecture that allows neuroscientists to integrate visualization tools more closely into the modeling tasks. In addition, it forms the basis for semantic linking of different visualizations to reflect the current workflow. In this paper, we present this architecture and substantiate the usefulness of our approach by common use cases we encountered in our collaborative work. PMID:26733860

Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

PubMed

Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

2018-01-05

Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

A KPI-based process monitoring and fault detection framework for large-scale processes.

PubMed

Zhang, Kai; Shardt, Yuri A W; Chen, Zhiwen; Yang, Xu; Ding, Steven X; Peng, Kaixiang

2017-05-01

Large-scale processes, consisting of multiple interconnected subprocesses, are commonly encountered in industrial systems, whose performance needs to be determined. A common approach to this problem is to use a key performance indicator (KPI)-based approach. However, the different KPI-based approaches are not developed with a coherent and consistent framework. Thus, this paper proposes a framework for KPI-based process monitoring and fault detection (PM-FD) for large-scale industrial processes, which considers the static and dynamic relationships between process and KPI variables. For the static case, a least squares-based approach is developed that provides an explicit link with least-squares regression, which gives better performance than partial least squares. For the dynamic case, using the kernel representation of each subprocess, an instrument variable is used to reduce the dynamic case to the static case. This framework is applied to the TE benchmark process and the hot strip mill rolling process. The results show that the proposed method can detect faults better than previous methods. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

New classification of epilepsy-related neoplasms: The clinical perspective.

PubMed

Kasper, Burkhard S; Kasper, Ekkehard M

2017-02-01

Neoplastic CNS lesions are a common cause of focal epilepsy refractory to anticonvulsant treatment, i.e. long-term epilepsy-associated tumors (LEATs). Epileptogenic tumors encompass a variety of intriguing lesions, e.g. dysembryoplastic neuroepithelial tumors or gangliogliomas, which differ from more common CNS neoplasms in their clinical context as well as on histopathology. Long-term epilepsy-associated tumor classification is a rapidly evolving issue in surgical neuropathology, with new entities still being elucidated. One major issue to be resolved is the inconsistent tissue criteria applied to LEAT accounting for high diagnostic variability between individual centers and studies, a problem recently leading to a proposal for a new histopathological classification by Blümcke et al. in Acta Neuropathol. 2014; 128: 39-54. While a new approach to tissue diagnosis is appreciated and needed, histomorphological criteria alone will not suffice and we here approach the situation of encountering a neoplastic lesion in an epilepsy patient from a clinical perspective. Clinical scenarios to be supported by an advanced LEAT classification will be illustrated and discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Parallel software support for computational structural mechanics

NASA Technical Reports Server (NTRS)

Jordan, Harry F.

1987-01-01

The application of the parallel programming methodology known as the Force was conducted. Two application issues were addressed. The first involves the efficiency of the implementation and its completeness in terms of satisfying the needs of other researchers implementing parallel algorithms. Support for, and interaction with, other Computational Structural Mechanics (CSM) researchers using the Force was the main issue, but some independent investigation of the Barrier construct, which is extremely important to overall performance, was also undertaken. Another efficiency issue which was addressed was that of relaxing the strong synchronization condition imposed on the self-scheduled parallel DO loop. The Force was extended by the addition of logical conditions to the cases of a parallel case construct and by the inclusion of a self-scheduled version of this construct. The second issue involved applying the Force to the parallelization of finite element codes such as those found in the NICE/SPAR testbed system. One of the more difficult problems encountered is the determination of what information in COMMON blocks is actually used outside of a subroutine and when a subroutine uses a COMMON block merely as scratch storage for internal temporary results.

Mind Your Step: the Effects of Mobile Phone Use on Gaze Behavior in Stair Climbing.

PubMed

Ioannidou, Flora; Hermens, Frouke; Hodgson, Timothy L

2017-01-01

Stair walking is a hazardous activity and a common cause of fatal and non-fatal falls. Previous studies have assessed the role of eye movements in stair walking by asking people to repeatedly go up and down stairs in quiet and controlled conditions, while the role of peripheral vision was examined by giving participants specific fixation instructions or working memory tasks. We here extend this research to stair walking in a natural environment with other people present on the stairs and a now common secondary task: using one's mobile phone. Results show that using the mobile phone strongly draws one's attention away from the stairs, but that the distribution of gaze locations away from the phone is little influenced by using one's phone. Phone use also increased the time needed to walk the stairs, but handrail use remained low. These results indicate that limited foveal vision suffices for adequate stair walking in normal environments, but that mobile phone use has a strong influence on attention, which may pose problems when unexpected obstacles are encountered.

'Full dose' reirradiation of human cervical spinal cord.

PubMed

Ryu, S; Gorty, S; Kazee, A M; Bogart, J; Hahn, S S; Dalal, P S; Chung, C T; Sagerman, R H

2000-02-01

With the progress of modern multimodality cancer treatment, retreatment of late recurrences or second tumors became more commonly encountered in management of patients with cancer. Spinal cord retreatment with radiation is a common problem in this regard. Because radiation myelopathy may result in functional deficits, many oncologists are concerned about radiation-induced myelopathy when retreating tumors located within or immediately adjacent to the previous radiation portal. The treatment decision is complicated because it requires a pertinent assessment of prognostic factors with and without reirradiation, radiobiologic estimation of recovery of occult spinal cord damage from the previous treatment, as well as interactions because of multimodality treatment. Recent studies regarding reirradiation of spinal cord in animals using limb paralysis as an endpoint have shown substantial and almost complete recovery of spinal cord injury after a sufficient time after the initial radiotherapy. We report a case of "full" dose reirradiation of the entire cervical spinal cord in a patient who has not developed clinically detectable radiation-induced myelopathy on long-term follow-up of 17 years after the first radiotherapy and 5 years after the second radiotherapy.

Clinical Manifestations and Distribution of Cutaneous Leishmaniasis in Pakistan

PubMed Central

Afghan, Abaseen Khan; Kassi, Masoom; Kasi, Pashtoon Murtaza; Ayub, Adil; Kakar, Niamatullah; Marri, Shah Muhammad

2011-01-01

Cutaneous leishmaniasis (CL) is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical manifestations of the disease seen along with the geographic areas affected, where the hosts are particularly susceptible. This would also be helpful in presenting the broad spectrum of the disease for training of health care workers and help in surveillance of CL in the region. The increased clinical diversity and the spectrum of phenotypic manifestations noted underscore the fact that the diagnosis of CL should be not only considered when dealing with common skin lesions, but also highly suspected by dermatologists and even primary care physicians even when encountering uncommon pathologies. Hence, we would strongly advocate that since most of these patients present to local health care centers and hospitals, primary care practitioners and even lady health workers (LHWs) should be trained in identification of at least the common presentations of CL. PMID:22174721

A framework for a process-driven common foundation programme for graduates.

PubMed

Jasper, M; Rolfe, G

1993-10-01

This paper discusses some of the problems encountered in writing a shortened Common Foundation Programme in nursing for graduates, and outlines a course which takes as its starting point the particular educational needs and requirements of the student group. Thus, the first question to be addressed by the curriculum writers when designing the course was "How can we teach these students?", rather than "What can we teach them?". The resulting process-driven course is heavily influenced by the student-centred philosophy of Carl Rogers, and utilizes a variety of large- and small-group methods to facilitate the students in gradually taking responsibility for, and making decisions about, their learning needs. The paper continues with some strategies for ensuring a smooth transition from a tutor-led, syllabus-driven start to the course, to a student-led, process-driven finish for both the theoretical and clinical components, and for the assessment schedule. Finally, a student-centred approach to evaluation is briefly outlined, and the paper concludes by suggesting that the principles employed in designing and implementing this course could be successfully transferred to a wide variety of other educational settings.

Prediction versus aetiology: common pitfalls and how to avoid them.

PubMed

van Diepen, Merel; Ramspek, Chava L; Jager, Kitty J; Zoccali, Carmine; Dekker, Friedo W

2017-04-01

Prediction research is a distinct field of epidemiologic research, which should be clearly separated from aetiological research. Both prediction and aetiology make use of multivariable modelling, but the underlying research aim and interpretation of results are very different. Aetiology aims at uncovering the causal effect of a specific risk factor on an outcome, adjusting for confounding factors that are selected based on pre-existing knowledge of causal relations. In contrast, prediction aims at accurately predicting the risk of an outcome using multiple predictors collectively, where the final prediction model is usually based on statistically significant, but not necessarily causal, associations in the data at hand.In both scientific and clinical practice, however, the two are often confused, resulting in poor-quality publications with limited interpretability and applicability. A major problem is the frequently encountered aetiological interpretation of prediction results, where individual variables in a prediction model are attributed causal meaning. This article stresses the differences in use and interpretation of aetiological and prediction studies, and gives examples of common pitfalls. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Exploring medication use by blind patients in Saudi Arabia

PubMed Central

Kentab, Basma Y.; Al-Rowiali, Kholuod Z.; Al-Harbi, Rehab A.; Al-Shammari, Nouf H.; Balhareth, Wiam M.; Al-Yazeed, Huda F.

2014-01-01

Objective To explore the characteristics of medication use and challenges experienced by the blind patients. Methods This cross-sectional descriptive study included blind persons living in Saudi Arabia who were at least 18 years of age. Participants were recruited through a number of nongovernmental blind associations (in the central, western, eastern regions), universities, social networks, and specialized websites for the blind. A questionnaire was designed and administered via face-to-face meetings with participants and made available online through Google Docs. Results There were a total of 121 respondents of which 26 were excluded based on their ability to visually identify their medications or being <18 years old. The majority of the respondents were 18–29 years old (68%), 49% were male and 51% were female. Around 57% had a college degree while 27% had a high school degree. Diagnosis with a chronic disease was reported by 71 participants (79%, 5 missing). The most common diseases were diabetes and asthma (22%) followed by hypertension (17%). Most blind patients (75%) believed that physicians were the most reliable source of medication information. The medication information and services provided by pharmacists were viewed as inadequate by 46%. The most common challenges encountered by blind patients were linked to drug identification (75%), dose recognition (82%), and identification of expiration date (92%). A large number of patients had to rely on persons with normal vision for dispensing and administering the medications. Conclusions Pharmacists can no longer ignore the medication use problems encountered by the blind people. This study may serve as an initial step for planning improvements in pharmaceutical services provided to blind patients. The government, pharmaceutical companies and pharmacists must work in collaboration to address the special needs of the blind. PMID:25685049

Musculoskeletal training: are GP trainees exposed to the right case mix for independent practice?

PubMed

Goff, Iain; Wise, Elspeth Mary; Coady, David; Walker, David

2016-02-01

Musculoskeletal conditions are common in general practice, but clinicians express poor self confidence in dealing with them. Training in general practice relies on clinical exposure to a range of presentations in order to gain competence. It has been suggested that trainees are exposed to a different case mix from qualified general practices (GPs), due to seeing more minor illness and less chronic disease and that this may be responsible in part for their subsequent lack of confidence. The aims of this study were to analyse the case mix of musculoskeletal conditions encountered by general practice trainees and to compare this to the overall population consulting behaviour. This is a prospective observational study. Thirteen general practices in North East England were recruited. Musculoskeletal disorders encountered by 13 GP trainees (7 junior and 6 senior) were prospectively recorded using a handheld diary. Disorders were classified according to working diagnosis or body region if diagnosis was unclear. Musculoskeletal (MSK) disorders comprised 17 % of consultations, and the distribution of diagnoses of these was in proportion to epidemiological studies of MSK disorders in the UK as they present in primary care. Back pain was the most frequent label with 141 (29 %) consultations with a further 43 (9 %) for neck pain. Inflammatory arthritis accounted for the same number 43 (9 %). Individual joint problems were 115 (24 %) with knee being most common. A specific diagnosis was more likely to be applied when symptoms were more distal and less likely when axial. Trainees are exposed to the same spectrum of MSK disorders as are present in the population as a whole. Case mix does not appear to be a significant factor in low confidence levels in dealing with MSK disorders.

Group structure and group process for effective space station astronaut teams

NASA Technical Reports Server (NTRS)

Nicholas, J. M.; Kagan, R. S.

1985-01-01

Space Station crews will encounter new problems, many derived from the social interaction of groups working in space for extended durations. Solutions to these problems must focus on the structure of groups and the interaction of individuals. A model of intervention is proposed to address problems of interpersonal relationships and emotional stress, and improve the morale, cohesiveness, and productivity of astronaut teams.

A review of the Los Alamos effort in the development of nuclear rocket propulsion

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

Durham, F.P.; Kirk, W.L.; Bohl, R.J.

1991-01-01

This paper reviews the achievements of the Los Alamos nuclear rocket propulsion program and describes some specific reactor design and testing problems encountered during the development program along with the progress made in solving these problems. The relevance of these problems to a renewed nuclear thermal rocket development program for the Space Exploration Initiative (SEI) is discussed. 11 figs.

[Oganization of sanitary care organization in the 1st Infantry Battalion of the 7th Puma Brigade during offensive attacks at the Dinara Mountain in the Winter 94 operation].

PubMed

Pigac, Biserka; Kretić, Marijan; Vuković, Jurica

2006-09-01

The aim of this paper is to show sanitary care organization in the 1st infantry battalion of 7th Puma Brigade during attacks at the Dinara mountain in the Winter 94 operation, and to compare it with the general pattern described. The problems encountered and mistakes made in the medical care organization that were caused either by the lack of coordination between the command and military personnel or the lack of equipment, inadequate equipment, geographical characteristics of the area, communication problems, weather conditions or any other reason influencing sanitary care are presented. Based on the analysis of two cases, it is concluded that sanitary care was organizaed according to the echelon principles. During the war, medical care was satisfactory in spite of all the problems and shortcomings, mainly owing to the young, brave and enthusiastic command and medical personnel. Medical care in the Croatian Army during the war was an integral part of the military-civilian health care system. Despite rather common problems and deficiencies, the achievements in taking care of the wounded and sick persons were satisfactory, all the wounded men were properly managed, functionally and cosmetically recovered, and capable of normal living and work. These results were especially gratifying since they were, in general, recorded in young men.

Shuttle payload S-band communications system

NASA Technical Reports Server (NTRS)

Batson, B. H.; Teasdale, W. E.; Pawlowski, J. F.; Schmidt, O. L.

1985-01-01

The Shuttle payload S-band communications system design, operational capabilities, and performance are described in detail. System design requirements, overall system and configuration and operation, and laboratory/flight test results are presented. Payload communications requirements development is discussed in terms of evolvement of requirements as well as the resulting technical challenges encountered in meeting the initial requirements. Initial design approaches are described along with cost-saving initiatives that subsequently had to be made. The resulting system implementation that was finally adopted is presented along with a functional description of the system operation. A description of system test results, problems encountered, how the problems were solved, and the system flight experience to date is presented. Finally, a summary of the advancements made and the lessons learned is discussed.

Mental hospital depopulation in Canada: patient perspectives.

PubMed

Herman, N J; Smith, C M

1989-06-01

This paper reviews briefly the history of mental health depopulation in Canada over the past 30 years. The term "deinstitutionalization" is often used but is unsatisfactory. Using an exploratory, qualitative, methodological approach, data were collected on the problems encountered by a disproportionate, stratified random sample of 139 formerly institutionalized patients living in various geographical locales in Eastern Canada. Adopting a symbolic interactionist theoretical approach, this study, in an effort to fill a neglect in the literature, attempted to discover what the everyday world(s) of Canadian ex-mental patients was really like. Problems encountered related to stigma, poor housing, lack of back living skills, poverty, unemployment and aftercare. Quotations from patients are provided to illustrate such themes. The findings are discussed.

[Problems encountered during the installation of an automated anesthesia documentation system (AIMS)].

PubMed

Müller, H; Naujoks, F; Dietz, S

2002-08-01

Problems encountered during the installation and introduction of an automated anaesthesia documentation system are discussed. Difficulties have to be expected in the area of staff training because of heterogeneous experience in computer usage and in the field of online documentation of vital signs. Moreover the areas of net administration and hardware configuration as well as general administrative issues also represent possible sources of drawbacks. System administration and reliable support provided by personnel of the department of anaesthesiology assuring staff motivation and reducing time of system failures require adequately staffed departments. Based on our own experiences, we recommend that anaesthesiology departments considering the future installation and use of an automated anaesthesia documentation system should verify sufficient personnel capacities prior to their decision.

Do general practice patients with and without appointment differ? Cross-sectional study.

PubMed

Riedl, Bernhard; Kehrer, Simon; Werner, Christoph U; Schneider, Antonius; Linde, Klaus

2018-06-23

Even in practices with a comprehensive appointment system a minority of patients walks in without prior notice, sometimes causing problems for practice service quality. We aimed to explore differences between patients consulting primary care practices with and without appointment. Consecutive patients visiting five primary care practices without an appointment and following patients with an appointment were asked to fill in a four-page questionnaire addressing socio-demographic characteristics, the reason for encounter, urgency of seeing a physician, depressive, somatic and anxiety symptoms, personality traits, and satisfaction with the practice. Physicians also documented the reason for encounter and assessed the urgency. Data were analyzed using univariate and multivariate methods. Two hundred fifty-one patients without and 250 patients with appointment participated. Patients without appointment were significantly younger (mean age 44 vs. 50 years) and reported less often chronic diseases (29% vs. 45%). Also, reasons for encounter differed (e.g., 27% vs. 16% with a respiratory problem). Patients' ratings of urgency did not differ between groups (p = 0.46), but physicians rated urgency higher among patients without appointment (p < 0.001). In logistic regression analyses younger age, male gender, absence of chronic disease, positive screening for at least one mental disorder, low values on the personality trait openness for experience, a high urgency rating by the physician, and a respiratory or musculoskeletal problem as reason for encounter were significantly associated with a higher likelihood of being a patient without appointment. In this study, younger age and a high urgency rating by physicians were the variables most consistently associated with the likelihood of being a patient without appointment. Overall, differences between patients seeking general practices with a comprehensive appointment system without prior notice and patients with appointments were relatively minor.

[Evaluation of the standard application of Delphi in the diagnosis of chronic obstructive pulmonary disease caused by occupational irritant chemicals].

PubMed

Zhao, L; Yan, Y J

2017-11-20

Objective: To investigate the problems encountered in the application of the standard (hereinafter referred to as standard) for the diagnosis of chronic obstructive pulmonary disease caused by occu-pational irritant chemicals, to provide reference for the revision of the new standard, to reduce the number of missed patients in occupational COPD, and to get rid of the working environment of those who suffer from chronic respiratory diseases due to long-term exposure to poisons., slowing the progression of the disease. Methods: Using Delphi (Delphi) Expert research method, after the senior experts to demonstrate, to under-stand the GBZ 237-2011 "occupational irritant chemicals to the diagnosis of chronic obstructive pulmonary dis-ease" standard evaluation of the system encountered problems, to seek expert advice, The problems encoun-tered during the clinical implementation of the standards promulgated in 2011 are presented. Results: Through the Delphi Expert investigation method, it is found that experts agree on the content evaluation and implemen-tation evaluation in the standard, but the operational evaluation of the standard is disputed. According to the clinical experience, the experts believe that the range of occupational irritant gases should be expanded, and the operation of the problem of smoking, seniority determination and occupational contact history should be challenged during the diagnosis. Conclusions: Since the promulgation in 2011 of the criteria for the diagnosis of chronic obstructive pulmonary disease caused by occupational stimulant chemicals, there have been some problems in the implementation process, which have caused many occupationally exposed to irritating gases to suffer from "occupational chronic respiratory Diseases" without a definitive diagnosis.

Duodenal Injury: Analysis of Common Misconceptions in Diagnosis and Treatment

PubMed Central

Flint, Lewis M.; McCoy, Martha; Richardson, J. David; Polk, Hiram C.

1980-01-01

Seventy-five consecutive patients who sustained injuries to the duodenum were admitted to our hospital over a nine-year period. Nineteen blunt injuries and 56 penetrating injuries were encountered. Blunt injuries were usually the result of motor vehicle accidents and steering wheel impact was frequently implicated. Penetrating injuries most commonly followed gunshot wounds, particularly those where the bullet tract travelled transversely across the peritoneal cavity. Seventy-nine per cent of the patients had two or more associated intra-abdominal organ injuries with other intestinal injuries, biliary tract injuries, and pancreatic injuries predominating. Forty-seven per cent of the patients were admitted in shock. Following blunt injury, diagnostic delay was encountered in two patients. Adjuncts to diagnosis such as abdominal roentgenograms, serum amylase levels, and contrast gastroduodenography, were not helpful. Peritoneal lavage, however, was valuable in patients with equivocal physical findings. Intraoperative diagnosis was also challenging. Complete mobilization of the structures surrounding the duodenum to provide exposure of the entire duodenum was necessary. Six injuries that initially appeared trivial would have been missed had this procedure not been followed. Suture closure was the most common reparative technique used. Tube decompression of the duodenum was a valuable addition. No suture line dehiscences were encountered in ten patients so treated. Overall mortality in patients surviving more than 24 hours was 12%. PMID:7387230

Targeting efflux pumps to overcome antifungal drug resistance

PubMed Central

Holmes, Ann R; Cardno, Tony S; Strouse, J Jacob; Ivnitski-Steele, Irena; Keniya, Mikhail V; Lackovic, Kurt; Monk, Brian C; Sklar, Larry A; Cannon, Richard D

2016-01-01

Resistance to antifungal drugs is an increasingly significant clinical problem. The most common antifungal resistance encountered is efflux pump-mediated resistance of Candida species to azole drugs. One approach to overcome this resistance is to inhibit the pumps and chemosensitize resistant strains to azole drugs. Drug discovery targeting fungal efflux pumps could thus result in the development of azole-enhancing combination therapy. Heterologous expression of fungal efflux pumps in Saccharomyces cerevisiae provides a versatile system for screening for pump inhibitors. Fungal efflux pumps transport a range of xenobiotics including fluorescent compounds. This enables the use of fluorescence-based detection, as well as growth inhibition assays, in screens to discover compounds targeting efflux-mediated antifungal drug resistance. A variety of medium- and high-throughput screens have been used to identify a number of chemical entities that inhibit fungal efflux pumps. PMID:27463566

Method for conducting electroless metal-plating processes

DOEpatents

Petit, George S.; Wright, Ralph R.

1978-01-01

This invention is an improved method for conducting electroless metal-plating processes in a metal tank which is exposed to the plating bath. The invention solves a problem commonly encountered in such processes: how to determine when it is advisable to shutdown the process in order to clean and/or re-passivate the tank. The new method comprises contacting the bath with a current-conducting, non-catalytic probe and, during plating operations, monitoring the gradually changing difference in electropotential between the probe and tank. It has been found that the value of this voltage is indicative of the extent to which nickel-bearing decomposition products accumulate on the tank. By utilizing the voltage to determine when shutdown for cleaning is advisable, the operator can avoid premature shutdown and at the same time avoid prolonging operations to the point that spontaneous decomposition occurs.

Endocrown with Leucite-Reinforced Ceramic: Case of Restoration of Endodontically Treated Teeth

PubMed Central

da Cunha, Leonardo Fernandes; Mondelli, José; Auersvald, Caroline Moreira; Gonzaga, Carla Castiglia; Mondelli, Rafael Francisco Lia; Correr, Gisele Maria; Furuse, Adilson Yoshio

2015-01-01

A common problem encountered by dentists is the restorative treatment of nonvital teeth. When the pulp chamber presents appropriate conditions for retention, the endocrown is indicated. This monolithic, ceramic adhesive restoration is singularly used yet warrants wider recognition and use. The endocrown allows preservation of the tooth structure and is minimally invasive. Currently, this treatment option, of a core buildup and full coverage restoration, reduces tooth structure excessively. This treatment presents not only functional limitations but also aesthetic concerns. Recently, the VITA-PM9 system, a leucite-reinforced glass ceramic, has been increasingly used in a variety of clinical situations due to its satisfactory physical-mechanical and aesthetic properties. Therefore, the present study describes a case of surgical restoration of a nonvital tooth using the endocrown technique and the VITA-PM9. PMID:26557391

Role of Square Flap in Post Burn Axillary Contractures.

PubMed

Karki, Durga; Narayan, Ravi Prakash

2017-09-01

Post-burn contractures are a commonly encountered problem and many techniques have been described in their treatment. Z-plasties are the commonest local flap procedure done for linear bands with adjacent healthy tissue. Our aim was to assess the use of square flap technique in axillary contractures. Ten patients with type I and II axillary contractures underwent release by the square flap technique. All cases were followed up for at least one year and analysed for range of motion and aesthetic outcome. All cases achieved full range of movement postoperatively with no recurrence during follow up period and a good cosmetic outcome. Square flap was shown to be a reliable technique for mild to moderate axillary contractures of the anterior or posterior axillary folds even when there is significant adjacent scarring of chest wall or back of types I and II.

Managing Small Spacecraft Projects: Less is Not Easier

NASA Technical Reports Server (NTRS)

Barley, Bryan; Newhouse, Marilyn

2012-01-01

Managing small, low cost missions (class C or D) is not necessarily easier than managing a full flagship mission. Yet, small missions are typically considered easier to manage and used as a training ground for developing the next generation of project managers. While limited resources can be a problem for small missions, in reality most of the issues inherent in managing small projects are not the direct result of limited resources. Instead, problems encountered by managers of small spacecraft missions often derive from 1) the perception that managing small projects is easier if something is easier it needs less rigor and formality in execution, 2) the perception that limited resources necessitate or validate omitting standard management practices, 3) less stringent or unclear guidelines or policies for small projects, and 4) stakeholder expectations that are not consistent with the size and nature of the project. For example, the size of a project is sometimes used to justify not building a full, detailed integrated master schedule. However, while a small schedule slip may not be a problem for a large mission, it can indicate a serious problem for a small mission with a short development phase, highlighting the importance of the schedule for early identification of potential issues. Likewise, stakeholders may accept a higher risk posture early in the definition of a low-cost mission, but as launch approaches this acceptance may change. This presentation discusses these common misconceptions about managing small, low cost missions, the problems that can result, and possible solutions.

School Grounds Guide: A Pictured Guide for Identifying Common Organisms Found In and Around the School Ground.

ERIC Educational Resources Information Center

Bain, Rodney

Designed for quick, easy identification of some of the most commonly encountered organisms found in and around the school ground, this illustrated guide identifies by a picture and a short biological description the common animals and plants found in and around school lawns, house lawns, parks, fence rows, flower gardens, vacant lots, and…

Specific Learning Difficulties--What Teachers Need to Know

ERIC Educational Resources Information Center

Hudson, Diana

2015-01-01

This book clearly explains what Specific Learning Difficulties (SpLD) are, and describes the symptoms of conditions most commonly encountered in the mainstream classroom: dyslexia, dyspraxia, dyscalculia, dysgraphia, Autism Spectrum Disorder, ADHD, and OCD. The author provides an overview of the strengths and weaknesses commonly associated with…

Co-infection with cytomegalovirus and Epstein-Barr virus in mononucleosis: case report and review of literature.

PubMed

Olson, Douglas; Huntington, Mark K

2009-09-01

A 25-year-old woman presented with infectious mononucleosis. Serological studies demonstrated elevated IgM titres to both cytomegalovirus (CMV) and Epstein-Barr virus (EBV). The role of each of these agents in infectious mononucleosis is reviewed, as are literature reports of co-infection by these two viruses. Both near-simultaneous infections and temporally remote sequential infections with acute CMV triggering an immunoreactivation of EBV are reported in the literature. We believe the current case is most consistent with the latter. Infectious mononucleosis is a common infection of childhood and young adulthood. Although a variety of agents may be associated with infectious mononucleosis, EBV is the most common etiology. We encountered a patient with serological findings that were suggestive of the simultaneous presence of two etiological agents of infectious mononucleosis: EBV and CMV. This prompted an inquiry into how commonly dual infections are encountered and their significance.

A critical theory of medical discourse: how patients and health professionals deal with social problems.

PubMed

Waitzkin, H; Britt, T

1989-01-01

Criticism of social context does not generally appear in medical encounters. When contextual issues arise in medical discourse, messages of ideology and social control may become apparent, usually without the conscious awareness of the participants. By easing the physical or psychological impact of contextual difficulties, or by encouraging patients' conformity to mainstream expectations of desirable behavior, encounters with doctors can help win patients' consent to troubling social conditions. Seen in this light, doctor-patient encounters become micropolitical situations that do not typically encourage explicit statements or actions by health professionals to change contextual sources of their patients' difficulties. A critical theory influenced by structuralism suggests that the surface meanings of signs in medical discourse prove less important than their structural relationships. In addition, a theoretical approach adopting elements of post-structuralism and Marxist literary criticism emphasizes the marginal, absent, or excluded elements of medical discourse. Contextual features that shape a text include social class, sex, age, and race. Through the underlying structure of medical discourse, contextual problems are expressed, marginalized, and managed.

Patient perspectives of telemedicine quality

PubMed Central

LeRouge, Cynthia M; Garfield, Monica J; Hevner, Alan R

2015-01-01

Background The purpose of this study was to explore the quality attributes required for effective telemedicine encounters from the perspective of the patient. Methods We used a multi-method (direct observation, focus groups, survey) field study to collect data from patients who had experienced telemedicine encounters. Multi-perspectives (researcher and provider) were used to interpret a rich set of data from both a research and practice perspective. Results The result of this field study is a taxonomy of quality attributes for telemedicine service encounters that prioritizes the attributes from the patient perspective. We identify opportunities to control the level of quality for each attribute (ie, who is responsible for control of each attribute and when control can be exerted in relation to the encounter process). This analysis reveals that many quality attributes are in the hands of various stakeholders, and all attributes can be addressed proactively to some degree before the encounter begins. Conclusion Identification of the quality attributes important to a telemedicine encounter from a patient perspective enables one to better design telemedicine encounters. This preliminary work not only identifies such attributes, but also ascertains who is best able to address quality issues prior to an encounter. For practitioners, explicit representation of the quality attributes of technology-based systems and processes and insight on controlling key attributes are essential to implementation, utilization, management, and common understanding. PMID:25565781

Drug-related police encounters across the globe: How do they compare?

PubMed

Hughes, Caitlin E; Barratt, Monica J; Ferris, Jason A; Maier, Larissa J; Winstock, Adam R

2018-06-01

Drug law enforcement subsumes the majority of drug policy expenditure across the globe. Fuelled by knowledge that much of this investment is ineffective or counter-productive there have been increasing calls for cross-national comparisons to identify where policing approaches differ and what types of approaches may be more effective. Yet, to date cross-national comparison of drug law enforcement has proven a methodologically hazardous affair. Using a new drug policing module added to the 2017 Global Drug Survey, this study seeks to provide the first cross-national comparison of the incidence, nature and intensity of illicit drug-related police encounters amongst people who use drugs. The Global Drug Survey was administered in late 2016. Across 26 countries including Australia, Germany, Italy, Mexico, Switzerland, the UK and the USA a total of 45,942 people who had recently used drugs completed the drug policing module. Key variables assessed included the incidence and frequency of drug-related police encounters in the last 12 months that involved: a) being stopped and searched; b) encountering a drug detection dog; c) being given a caution or warning; d) being charged and arrested; and e) paying a bribe. Multi-level models were used to control for pre-existing national differences in drug use prevalence and non-drug specific policing (including the total number of police personnel in each country). Drug-related police encounters were most commonly reported in Italy and Scotland. Conversely, police encounters were most likely to lead to arrest in Norway, Finland and Sweden. The type and locations of encounters further differed across countries, with for example stop and search most reported in Greece and Colombia, and encounters with drug detection dogs most reported in Scotland, Italy, UK and Australia. Multi-level models showed that the incidence of reported policing encounters continued to differ significantly across countries after controlling for pre-existing national differences in drug use prevalence and policing, and that drug policing encounters were 4 to 14 times more common in some nations than others. The findings unearth significant cross-national differences in the incidence and nature of drug-related policing of people who use drugs. This suggests that there may be opportunities for countries to learn from each other about how and why they differ, and the potential benefits of switching to lower intensity modes of drug policing. Copyright © 2018 Elsevier B.V. All rights reserved.

Households encountering with catastrophic health expenditures in Ferdows, Iran.

PubMed

Ghoddoosinejad, Javad; Jannati, Ali; Gholipour, Kamal; Baghban Baghestan, Elham

2014-08-01

Out-of-pocket payments are the main sources of healthcare financing in most developing countries. Healthcare services can impose a massive cost burden on households, especially in developing countries. The purpose of this study was to calculate households encountered with catastrophic healthcare expenditures in Ferdows, Iran. The sample included 100 households representing 20% of all households in Ferdows, Iran. The data were collected using self-administered questionnaire. The ability to pay of households was calculated, and then if costs of household health were at least 40% of their ability to pay, it was considered as catastrophic expenditures. Rate of households encountered to catastrophic health expenditures was estimated to be 24%, of which dentistry services had the highest part in catastrophic health expenditures. Low ability to pay of households should be supported against these expenditures. More equitable health system would solve the problem, although more financial aid should be provided for households encountered to catastrophic costs.