A qualitative study of primary care professionals’ views of case finding for depression in patients with diabetes or coronary heart disease in the UK

PubMed Central

2013-01-01

Background Routinely conducting case finding (also commonly referred to as screening) in patients with chronic illness for depression in primary care appears to have little impact. We explored the views and experiences of primary care nurses, doctors and managers to understand how the implementation of case finding/screening might impact on its effectiveness. Methods Two complementary qualitative focus group studies of primary care professionals including nurses, doctors and managers, in five primary care practices and five Community Health Partnerships, were conducted in Scotland. Results We identified several features of the way case finding/screening was implemented that may lead to systematic under-detection of depression. These included obstacles to incorporating case finding/screening into a clinical review consultation; a perception of replacing individualised care with mechanistic assessment, and a disconnection for nurses between management of physical and mental health. Far from being a standardised process that encouraged detection of depression, participants described case finding/screening as being conducted in a way which biased it towards negative responses, and for nurses, it was an uncomfortable task for which they lacked the necessary skills to provide immediate support to patients at the time of diagnosis. Conclusion The introduction of case finding/screening for depression into routine chronic illness management is not straightforward. Routinized case finding/screening for depression can be implemented in ways that may be counterproductive to engagement (particularly by nurses), with the mental health needs of patients living with long term conditions. If case finding/screening or engagement with mental health problems is to be promoted, primary care nurses require more training to increase their confidence in raising and dealing with mental health issues and GPs and nurses need to work collectively to develop the relational work required to promote cognitive participation in case finding/screening. PMID:23557512

A qualitative study of primary care professionals' views of case finding for depression in patients with diabetes or coronary heart disease in the UK.

PubMed

Maxwell, Margaret; Harris, Fiona; Hibberd, Carina; Donaghy, Eddie; Pratt, Rebekah; Williams, Chris; Morrison, Jill; Gibb, Jennifer; Watson, Philip; Burton, Chris

2013-04-04

Routinely conducting case finding (also commonly referred to as screening) in patients with chronic illness for depression in primary care appears to have little impact. We explored the views and experiences of primary care nurses, doctors and managers to understand how the implementation of case finding/screening might impact on its effectiveness. Two complementary qualitative focus group studies of primary care professionals including nurses, doctors and managers, in five primary care practices and five Community Health Partnerships, were conducted in Scotland. We identified several features of the way case finding/screening was implemented that may lead to systematic under-detection of depression. These included obstacles to incorporating case finding/screening into a clinical review consultation; a perception of replacing individualised care with mechanistic assessment, and a disconnection for nurses between management of physical and mental health. Far from being a standardised process that encouraged detection of depression, participants described case finding/screening as being conducted in a way which biased it towards negative responses, and for nurses, it was an uncomfortable task for which they lacked the necessary skills to provide immediate support to patients at the time of diagnosis. The introduction of case finding/screening for depression into routine chronic illness management is not straightforward. Routinized case finding/screening for depression can be implemented in ways that may be counterproductive to engagement (particularly by nurses), with the mental health needs of patients living with long term conditions. If case finding/screening or engagement with mental health problems is to be promoted, primary care nurses require more training to increase their confidence in raising and dealing with mental health issues and GPs and nurses need to work collectively to develop the relational work required to promote cognitive participation in case finding/screening.

An effective framework for finding similar cases of dengue from audio and text data using domain thesaurus and case base reasoning

NASA Astrophysics Data System (ADS)

Sandhu, Rajinder; Kaur, Jaspreet; Thapar, Vivek

2018-02-01

Dengue, also known as break-bone fever, is a tropical disease transmitted by mosquitoes. If the similarity between dengue infected users can be identified, it can help government's health agencies to manage the outbreak more effectively. To find similarity between cases affected by Dengue, user's personal and health information are the two fundamental requirements. Identification of similar symptoms, causes, effects, predictions and treatment procedures, is important. In this paper, an effective framework is proposed which finds similar patients suffering from dengue using keyword aware domain thesaurus and case base reasoning method. This paper focuses on the use of ontology dependent domain thesaurus technique to extract relevant keywords and then build cases with the help of case base reasoning method. Similar cases can be shared with users, nearby hospitals and health organizations to manage the problem more adequately. Two million case bases were generated to test the proposed similarity method. Experimental evaluations of proposed framework resulted in high accuracy and low error rate for finding similar cases of dengue as compared to UPCC and IPCC algorithms. The framework developed in this paper is for dengue but can easily be extended to other domains also.

Quantifying the Reuse of Learning Objects

ERIC Educational Resources Information Center

Elliott, Kristine; Sweeney, Kevin

2008-01-01

This paper reports the findings of one case study from a larger project, which aims to quantify the claimed efficiencies of reusing learning objects to develop e-learning resources. The case study describes how an online inquiry project "Diabetes: A waste of energy" was developed by searching for, evaluating, modifying and then…

Making Sense of Education "Responsibly": Findings from a Study of Student Teachers' Understanding(s) of Education, Sustainable Development and Education for Sustainable Development

ERIC Educational Resources Information Center

Nikel, Jutta

2007-01-01

This article discusses findings from a tri-country study of student teachers' understandings of the purposes of education, their conceptions of sustainable development and the task of Education for Sustainable Development (ESD). At its heart are case studies of 30 student teachers from Initial Teacher Education Programmes in England, Denmark and…

76 FR 9722 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition To List Solanum...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... settlement agreement resolving that case, signed April 27, 2005, we agreed to submit our 12-month finding for... for Biological Diversity v. Hamilton, Case No. 1:08-CV-02830-CAP). In a settlement agreement approved... urban and tourism development at Nanny Point, most of the natural population has been transferred to the...

75 FR 57720 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition to List Agave...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-22

... agreement resolving that case, signed April 27, 2005, we agreed to submit our 12-month finding for A... (Center for Biological Diversity v. Hamilton, Case No. 1:08-cv-02830 -CAP). In a settlement agreement... already developed and managed as tourism and residential projects. Based on information reported by the...

First sternocostal degenerative arthritis with intrarticular fluid collection. A case report.

PubMed

Chalazonitis, Athanasios N; Condilis, Nicolas; Tilentzoglou, Anastasia C; Pontikis, John; Tzovara, Joannie

2006-01-01

A rare case with clinical condition of first sternocostal degenerative arthritis with intra-articular fluid collection that developed after long-lasting intense exercise (weight-lifting) for twenty years is reported. Imaging findings and differential diagnoses of the case are presented.

Characteristic features of tacrolimus-induced lung disease in rheumatoid arthritis patients.

PubMed

Sasaki, Takanori; Nakamura, Wataru; Inokuma, Shigeko; Matsubara, Erika

2016-02-01

This paper aims to study the background and clinical characteristics of tacrolimus (TAC)-induced lung disease. A case of a rheumatoid arthritis (RA) patient who developed TAC-induced interstitial lung disease (TAC-ILD) is reported. The Japanese Pharmaceuticals and Medical Devices Agency (PMDA) website was searched for cases of TAC-ILD and its prevalence among all cases of TAC-related adverse events. As for cases of TAC-ILD, its underlying disease, preexisting lung diseases, and fatal outcome were also searched. Literature review of TAC-ILD cases was added. A 65-year-old female RA patient with preexisting bronchiectasis developed near-fatal TAC-ILD. Amelioration of RA, ground-glass opacities in the upper, anterior, and central lung fields, and decrease in peripheral blood lymphocyte count were the major findings in this patient. A search of the PMDA website revealed the following: the prevalence of TAC-ILD was 3 % of all cases of TAC-related adverse events, 56 out of 85 RA cases (66 %), and one out of 15 other cases had a preexisting lung disease; the prevalences of fatal outcome in RA and other cases were 24 and 38 %, respectively. A few cases in the literature had preexisting ILD and developed diffuse alveolar damage. In our case, preexisting bronchiectasis, arthritis remission, newly developed ground-glass opacities (GGOs) in the upper, anterior, and central lung fields, and decrease in peripheral blood lymphocyte count were the major findings. From the search of the PMDA website, about one fourth of the cases with TAC-related lung injury had a fatal outcome, and among RA patients, two thirds had preexisting lung diseases.

Social Capital and Economic Development in Regional Australia: A Case Study

ERIC Educational Resources Information Center

Woodhouse, Andrew

2006-01-01

This article reports the findings of a case study of social capital and economic development conducted in two towns in regional Australia between 2001 and 2002. The hypothesis driving the research states that a town displaying a high level of social capital will also display a high level of economic development, while a town with a low level of…

Cases, Simulacra, and Semantic Web Technologies

ERIC Educational Resources Information Center

Carmichael, P.; Tscholl, M.

2013-01-01

"Ensemble" is an interdisciplinary research and development project exploring the potential role of emerging Semantic Web technologies in case-based learning across learning environments in higher education. Empirical findings have challenged the claim that cases "bring reality into the classroom" and that this, in turn, might…

Loxoprofen-induced interstitial pneumonia: a case report.

PubMed

Kato, Motoyasu; Sasaki, Shinichi; Sekimoto, Yasuhito; Arano, Naoko; Jo, Hitomi; Suina, Kentaro; Kuriyama, Sachiko; Muraki, Keiko; Nagashima, Osamu; Yoshioka, Yasuko; Tominaga, Shigeru; Takahashi, Kazuhisa

2016-05-25

Loxoprofen is a nonsteroidal anti-inflammatory drug used in the treatment of many diseases. However, there are no case reports about loxoprofen-induced pneumonia. We have encountered a rare case of loxoprofen-induced pneumonia. We report the case of a 71-year-old Japanese woman who was initially treated with loxoprofen for fever. She was admitted to our hospital because of worsening of her symptoms, including fever and dyspnea. Her symptoms improved after treatment with ceftriaxone. Seven days after admission, she again developed high fever. She was again treated with loxoprofen and levofloxacin. However, acute respiratory failure developed after initiation of loxoprofen treatment. Chest computed tomography showed peribronchovascular consolidation. She was diagnosed with loxoprofen-induced pneumonia for which she was administered steroids. After treatment, her dyspnea and radiological findings improved. The findings in this case report reveal an association between treatment with a nonsteroidal anti-inflammatory drug and pneumonia. This rare case was diagnosed after accidental retreatment with loxoprofen. This is the first report of loxoprofen-induced pneumonia.

Development of Standardized Clinical Training Cases for Diagnosis of Sexual Abuse using a Secure Telehealth Application

ERIC Educational Resources Information Center

Frasier, Lori D.; Thraen, Ioana; Kaplan, Rich; Goede, Patricia

2012-01-01

Objectives: The training of physicians, nurse examiners, social workers and other health professional on the evidentiary findings of sexual abuse in children is challenging. Our objective was to develop peer reviewed training cases for medical examiners of child sexual abuse, using a secure web based telehealth application (TeleCAM). Methods:…

Thinking Globally: The National College of School Leadership--A Case Study in Distributed Leadership Development

ERIC Educational Resources Information Center

Dean, Diane R.

2007-01-01

This article presents findings from a case study on the National College of School Leadership (NCSL) in Nottingham, England, an exemplary program that bridges the theory-to-practice gap using distributed leadership philosophies to develop leadership among school administrators and has manifested a positive impact on school leadership in England.…

Development of a consensus approach for return of pathology incidental findings in the Genotype-Tissue Expression (GTEx) project.

PubMed

Lockhart, Nicole C; Weil, Carol J; Carithers, Latarsha J; Koester, Susan E; Little, A Roger; Volpi, Simona; Moore, Helen M; Berkman, Benjamin E

2018-06-14

The active debate about the return of incidental or secondary findings in research has primarily focused on return to research participants, or in some cases, family members. Particular attention has been paid to return of genomic findings. Yet, research may generate other types of findings that warrant consideration for return, including findings related to the pathology of donated biospecimens. In the case of deceased biospecimen donors who are also organ and/or tissue transplant donors, pathology incidental findings may be relevant not to family members, but to potential organ or tissue transplant recipients. This paper will describe the ethical implications of pathology incidental findings in the Genotype-Tissue Expression (GTEx) project, the process for developing a consensus approach as to if/when such findings should be returned, possible implications for other research projects collecting postmortem tissues and how the scenario encountered in GTEx fits into the larger return of results/incidental findings debate. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Case for Teacher Leadership: Towards Definition and Development.

ERIC Educational Resources Information Center

Fay, Carolyn

The first part of this paper presents the findings of a study of the leadership needs of five practicing teacher leaders. Findings identified an expressed need for specific teacher development and training, which led to the creation of a Leadership Institute for the Future of Teaching (LIFT). The second part of the paper describes the LIFT…

Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation

PubMed Central

Jit, Mark; Stagg, Helen R; Aldridge, Robert W; White, Peter J

2011-01-01

Objective To assess the cost effectiveness of the Find and Treat service for diagnosing and managing hard to reach individuals with active tuberculosis. Design Economic evaluation using a discrete, multiple age cohort, compartmental model of treated and untreated cases of active tuberculosis. Setting London, United Kingdom. Population Hard to reach individuals with active pulmonary tuberculosis screened or managed by the Find and Treat service (48 mobile screening unit cases, 188 cases referred for case management support, and 180 cases referred for loss to follow-up), and 252 passively presenting controls from London’s enhanced tuberculosis surveillance system. Main outcome measures Incremental costs, quality adjusted life years (QALYs), and cost effectiveness ratios for the Find and Treat service. Results The model estimated that, on average, the Find and Treat service identifies 16 and manages 123 active cases of tuberculosis each year in hard to reach groups in London. The service has a net cost of £1.4 million/year and, under conservative assumptions, gains 220 QALYs. The incremental cost effectiveness ratio was £6400-£10 000/QALY gained (about €7300-€11 000 or $10 000-$16 000 in September 2011). The two Find and Treat components were also cost effective, even in unfavourable scenarios (mobile screening unit (for undiagnosed cases), £18 000-£26 000/QALY gained; case management support team, £4100-£6800/QALY gained). Conclusions Both the screening and case management components of the Find and Treat service are likely to be cost effective in London. The cost effectiveness of the mobile screening unit in particular could be even greater than estimated, in view of the secondary effects of infection transmission and development of antibiotic resistance. PMID:22067473

Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation.

PubMed

Jit, Mark; Stagg, Helen R; Aldridge, Robert W; White, Peter J; Abubakar, Ibrahim

2011-09-14

To assess the cost effectiveness of the Find and Treat service for diagnosing and managing hard to reach individuals with active tuberculosis. Economic evaluation using a discrete, multiple age cohort, compartmental model of treated and untreated cases of active tuberculosis. London, United Kingdom. Population Hard to reach individuals with active pulmonary tuberculosis screened or managed by the Find and Treat service (48 mobile screening unit cases, 188 cases referred for case management support, and 180 cases referred for loss to follow-up), and 252 passively presenting controls from London's enhanced tuberculosis surveillance system. Incremental costs, quality adjusted life years (QALYs), and cost effectiveness ratios for the Find and Treat service. The model estimated that, on average, the Find and Treat service identifies 16 and manages 123 active cases of tuberculosis each year in hard to reach groups in London. The service has a net cost of £1.4 million/year and, under conservative assumptions, gains 220 QALYs. The incremental cost effectiveness ratio was £6400-£10,000/QALY gained (about €7300-€11,000 or $10,000-$16 000 in September 2011). The two Find and Treat components were also cost effective, even in unfavourable scenarios (mobile screening unit (for undiagnosed cases), £18,000-£26,000/QALY gained; case management support team, £4100-£6800/QALY gained). Both the screening and case management components of the Find and Treat service are likely to be cost effective in London. The cost effectiveness of the mobile screening unit in particular could be even greater than estimated, in view of the secondary effects of infection transmission and development of antibiotic resistance.

Introducing Case-Based Peer-Assisted Learning in a Professional Course

ERIC Educational Resources Information Center

Hodgson, Yvonne; Brack, Charlotte; Benson, Robyn

2014-01-01

This paper describes students' experience of participating in a case-based peer-assisted learning (PAL) program in order to examine whether the approach is pedagogically effective and likely to contribute to students' professional development. It presents the findings of a study which examined the integration of PAL and case-based learning (CBL)…

Peace Pilgrim, Exemplar of Level V

ERIC Educational Resources Information Center

Piechowski, Michael

2009-01-01

Cases of secondary integration (Level V), the most advanced level of development through positive disintegration, are easily found within the religious sphere. To find a secular case of secondary integration presents a greater challenge. The life of Peace Pilgrim (1908-1981), known personally to a great many people, appears to be such a case. The…

Public hospital resource allocations in El Salvador: accounting for the case mix of patients.

PubMed

Fiedler, J L; Schmidt, R M; Wight, J B

1998-09-01

National hospitals in developing countries command a disproportionate share of medical care budgets, justified on the grounds that they have a more difficult patient case mix and higher occupancy rates than decentralized district hospitals or clinics. This paper empirically tests the hypothesis by developing direct measures of the severity of patient illness, hospital case-mix and a resource intensity index for each of El Salvador's public hospitals. Based on an analysis of inpatient care staffing requirements, national hospitals are found to receive funding far in excess of what case-mix and case-load considerations would warrant. The findings suggest that significant system-wide efficiency gains can be realized by allocating hospital budgets on the bases of performance-related criteria which incorporate the case-mix approach developed here.

[Non-alcoholic fatty liver: 10 years' experience at the Insituto Nacional de la Nutrición Salvador Zubirán].

PubMed

de la Mora, G; Olivera, M; de la Cerda, R; Arista, J; Kershenobich, D; Uribe, M

1994-01-01

To describe the characteristics of non-alcoholic steatohepatitis (NASH) at the Instituto Nacional de la Nutricion Salvador Zubiran. We reviewed all liver biopsy reports from January 1982 to December 1991. From patient records we obtained the following data: clinical, biochemical, imaging studies and we reviewed the histological material. We correlated clinical, biochemical and histological data. From 2963 biopsies reviewed we obtained 16 cases of NASH. We found a 7:1 female/male ratio. Median age was 30 years and six patients were obese. Eleven patients had concomitant disease (diabetes in seven) and nine were using drugs. All had been studied for biochemical abnormalities and were asymptomatic. Ten patients had hepatomegaly and six splenomegaly. Ultrasound suggested the diagnosis in 50% of the cases. All had steatosis, inflammatory infiltrate, necrosis, fibrosis and Mallory bodies at different stages. One case had cirrhosis on initial biopsy and two developed cirrhosis on follow-up (one and eight years later). We did not find any correlation between clinical, biochemical or imaging characteristics and histological findings. When we compared these findings between obese and non obese patients and primary and secondary NASH we did not find any differences between groups. NASH is infrequent in our institution. The underlying pathogenesis seems to be multifactorial. There is no biochemical-histological correlation. Cirrhosis can develop in some cases.

The use of scenarios for long-range planning by investor-owned electric utilities in the Pacific Northwest

NASA Astrophysics Data System (ADS)

Lyons, John V.

Scenario planning is a method of organizing and understanding large amounts of quantitative and qualitative data for leaders to make better strategic decisions. There is a lack of academic research about scenario planning with a subsequent shortage of definitions and theories. This study utilized a case study methodology to analyze scenario planning by investor-owned electric utilities in the Pacific Northwest in their integrated resource planning (IRP) process. The cases include Avista Corporation, Idaho Power, PacifiCorp, Portland General Electric, and Puget Sound Energy. This study sought to determine how scenario planning was used, what scenario approach was used, the scenario outcomes, and the similarities and differences in the scenario planning processes. The literature review of this study covered the development of scenario planning, common definitions and theories, approaches to scenario development, and scenario outcomes. A research methodology was developed to classify the scenario development approach into intuitive, hybrid, or quantitative approaches; and scenario outcomes of changed thinking, stories of plausible futures, improved decision making, and enhanced organizational learning. The study found all three forms of scenario planning in the IRPs. All of the cases used a similar approach to IRP development. All of the cases had at least improved decision making as an outcome of scenario planning. Only one case demonstrated all four scenario outcomes. A critical finding was a correlation between the use of the intuitive approach and the use of all scenario outcomes. Another major finding was the unique use of predetermined elements, which are normally consistent across scenarios, but became critical uncertainties in some of the scenarios in the cases for this study. This finding will need to be confirmed by future research as unique to the industry or an aberration. An unusually high number of scenarios were found for cases using the hybrid approach, which was unexpected based on the literature. This work expanded the methods for studying scenario planning, enhanced the body of scholarly works on scenario planning, and provided a starting point for additional research concerning the use of scenario planning by electric utilities.

Dangerous space emphysema after dental treatment

PubMed Central

Hagr, Abdulrahman

2010-01-01

We report the case of an elderly female patient who presented with dangerous space emphysema occurring after a dental procedure. This case presented a diagnostic and management dilemma because of the development of an unusual complication of dental disease. In our review of the medical literature, we were unable to find any cases with similar manifestations and clinical courses. PMID:20835314

Trends and Lessons Learned in Interdisciplinary and Non-Business Case Method Application.

ERIC Educational Resources Information Center

Anyansi-Archibong, Chi; Czuchry, Andrew J.; House, Claudia S.; Cicirello, Tony

2000-01-01

Presents results of a survey designed to test the level of development and application of cases in non-business courses such as sciences, mathematics, engineering, health, and technology. Findings support the growing popularity of the case method of teaching and learning outside the business domain. Suggests a framework for establishing win-win…

A Case Study of Autonomy and Motivation in a Student-Led Game Development Project

ERIC Educational Resources Information Center

Prigmore, M.; Taylor, R.; De Luca, D.

2016-01-01

This paper presents the findings of an exploratory case study into the relationship between student autonomy and motivation in project based learning, using Self-Determination Theory (SDT) to frame the investigation. The case study explores how different forms of motivation affect the students' response to challenges and their intention to…

Teaching Undergraduate Accounting Majors How to Interpret the Accounting Standards Codification: An Alternative to Research Cases

ERIC Educational Resources Information Center

Toerner, Michael C.; Swindle, C. Bruce; Burckel, Daryl V.

2014-01-01

Professional accountants regularly search the FASB'S Accounting Standards Codification to find answers to financial accounting questions. Accounting educators know this and frequently use research cases in an attempt to help students begin developing this ability. But many students struggle with these cases because they have not been taught how to…

Wearing More than One Hat: Improving Student-Authored Case Longevity while Encouraging Additional Student Roles

ERIC Educational Resources Information Center

Corrigan, Hope; Craciun, Georgiana

2012-01-01

The marketing education literature emphasizes and documents the effectiveness of using the student-authored case (SAC) method as a means to develop managerial and critical thinking skills. However, most SACs are short lived, lack suggested case solutions, do not benefit from peer feedback, and present challenges in finding relevant company data.…

A case of classical maple syrup urine disease that was successfully managed by living donor liver transplantation.

PubMed

Takano, Chika; Ishige, Mika; Ogawa, Erika; Usui, Hiromi; Kagawa, Reiko; Tajima, Go; Fujiki, Ryoji; Fukao, Toshiyuki; Mizuta, Koichi; Fuchigami, Tatsuo; Takahashi, Shori

2017-08-01

Classical MSUD is often fatal without appropriate medical interventions because of metabolic crisis. There are numerous reports suggesting the therapeutic potential of deceased donor liver transplantation for MSUD. However, the usefulness of LDLT for MSUD is unknown. We report a case of classical MSUD, which was successfully managed by LDLT from the patient's father at 1 year of age. Abnormal brain findings, which were cured with effective treatment, gradually disappeared after LDLT. The patient then developed normally. Findings from this case suggest the importance of LDLT for maintaining low leucine levels and subsequent normal neurological development. Although LDLT involves a modest surgical insult, LDLT with a related donor achieves acceptable leucine levels for life. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Juvenile xanthogranuloma of the corneal limbus: report of two cases and review of the literature.

PubMed

Mocan, Mehmet C; Bozkurt, Banu; Orhan, Diclehan; Kuzey, Gamze; Irkec, Murat

2008-07-01

To report the clinical and histopathologic findings of limbal juvenile xanthogranuloma lesions in 2 pediatric cases. Case report and literature review. Two cases (a 7-month-old girl and a 7-year-old boy), both of whom developed a yellowish corneoscleral limbal mass not associated with other ocular or systemic findings, were evaluated. Both cases underwent simple excision of the lesion followed by local steroid treatment. Histopathologic examination in both cases revealed foamy histiocytes within an inflammatory infiltrate. One of the lesions also harbored multinucleate giant cells. Immunohistochemical staining was positive for CD68 and negative for S-100 and CD1a in both cases. Juvenile xanthogranuloma may rarely present with an isolated lesion occurring only at the corneoscleral limbus. The diagnosis in the early stages of this disorder may be established with immunophenotyping and characteristic histopathologic features even without the presence of the multinucleate giant cells.

University of Wisconsin System Leaders' Perceptions of Economic Development

ERIC Educational Resources Information Center

Eckmann, David A.

2017-01-01

This case study of one comprehensive university's economic-development engagement in its region was designed to better understand perceptions and actions by higher education leaders and economic development professionals. Findings indicated that one regional comprehensive university was an effective economic development partner because its leaders…

Doing Case Study Research: A Practical Guide for Beginning Researchers. Third Edition

ERIC Educational Resources Information Center

Hancock, Dawson R.; Algozzine, Bob

2016-01-01

Reflecting recent knowledge and developments in the field, this very practical, easy-to-use guide emphasizes learning how to do case study research--from the first step of deciding whether a case study is the way to go to the last step of verifying and confirming findings before disseminating them. The authors show students how to determine an…

A new worm infiltrating the human cornea: A report of three cases.

PubMed

McBurney-Lin, Shan; Khorram, David; Gee, Stephen; Hoberg, Eric P; Klassen-Fischer, Mary K; Neafie, Ronald C

2018-03-01

To characterize a new species of parasitic nematode that triggers uveitis. Three previously healthy, relatively young people each contracted a corneal stromal nematode that, upon surgical removal and examination, did not match any known nematodes. Clinical ocular findings included corneal opacification, visible corneal worms, conjunctival injection, and uveitis. The three cases presented here represent a previously undescribed parasitic infection of the cornea by an unidentified nematode. These findings may represent a previously unrecognized zoonotic infection from wildlife sources and potentially a newly documented nematode requiring description. Future clinical findings regarding this newly described nematode are needed to further develop our understanding of the disease.

Prader-Willi syndrome: a case report with atypical developmental features.

PubMed

Sewaybricker, Letícia E; Guaragna-Filho, Guilherme; Paula, Georgette B; Andrade, Juliana G R; Tincani, Bruna J; D'Souza-Li, Lília; Lemos-Marini, Sofia H V; Maciel-Guerra, Andréa T; Guerra-Júnior, Gil

2014-09-01

To describe the case of a male Prader-Willi syndrome (PWS) patient with atypical development features. We report the case of a male adolescent with confirmed diagnosis of PWS which presents atypical phenotype. The patient progressed with spontaneous and complete pubertal development, stature in the normal range, and weight control without any pharmacological treatment, except metformin. PWS is an imprinting paternally inherited disorder of 15q11-13 characterized by hypotonia in infant age, hyperphagia, varied degrees of mental retardation, behavior problems, hypogonadism, short stature, and other less common findings.

Creation of virtual patients from CT images of cadavers to enhance integration of clinical and basic science student learning in anatomy.

PubMed

Jacobson, Stanley; Epstein, Scott K; Albright, Susan; Ochieng, Joseph; Griffiths, Jeffrey; Coppersmith, Veronica; Polak, Joseph F

2009-08-01

The goal of this study was to determine whether computerized tomographic (CT) images of cadavers could be used in addition to images from patients to develop virtual patients (VPs) to enhance integrated learning of basic and clinical science. We imaged 13 cadavers on a Siemens CT system. The DICOM images from the CT were noted to be of high quality by a radiologist who systematically identified all abnormal and pathological findings. The pathological findings from the CT images and the cause of death were used to develop plausible clinical cases and study questions. Each case was designed to highlight and explain the abnormal anatomic findings encountered during the cadaveric dissection. A 3D reconstruction was produced using OsiriX and then formatted into a QuickTime movie which was then stored on the Tufts University Sciences Knowledgebase (TUSK) as a VP. We conclude that CT scanning of cadavers produces high-quality images that can be used to develop VPs. Although the use of the VPs was optional and fewer than half of the students had an imaged cadaver for dissection, 59 of the 172 (34%) students accessed and reviewed the cases and images positively and were very encouraging for us to continue.

Class Model Development Using Business Rules

NASA Astrophysics Data System (ADS)

Skersys, Tomas; Gudas, Saulius

New developments in the area of computer-aided system engineering (CASE) greatly improve processes of the information systems development life cycle (ISDLC). Much effort is put into the quality improvement issues, but IS development projects still suffer from the poor quality of models during the system analysis and design cycles. At some degree, quality of models that are developed using CASE tools can be assured using various. automated. model comparison, syntax. checking procedures. It. is also reasonable to check these models against the business domain knowledge, but the domain knowledge stored in the repository of CASE tool (enterprise model) is insufficient (Gudas et al. 2004). Involvement of business domain experts into these processes is complicated because non- IT people often find it difficult to understand models that were developed by IT professionals using some specific modeling language.

[The role of lactate acidosis in the development and treatment of various neurologic syndromes in children and adolescents].

PubMed

Arveladze, G A; Geladze, N M; Sanikidze, T B; Khachapuridze, N S; Bakhtadze, S Z

2015-02-01

The aim of the study was to detect the role of lactate acidosis, also to find the share of mitochondrial insufficiency in development of various neurologic syndromes in children and adolescents. The detection of cellular energetic metabolism and acid based imbalance is also important for finding the specific method of management. We have studied 200 patients with various degree of neurodevelopment delay with epilepsy and epileptic syndromes, headache, vertigo, early strokes, floppy infant syndrome, atrophy of ophthalmic nerve, cataracta, neurosensory deafness, systemic myopathy, cerebral palsy. In 27% of cases with various ages we have detected lactate acidosis and increase level of pyruvate. Mitochondrial insufficiency was seen in 8% of cases which gives us opportunity to find the specific method of treatment in this group of patients. Each patient with neurological symptoms requires correction of parameters of energetic and oxidative metabolism.

Non-Hodgkin lymphoma in the developing world: review of 4539 cases from the International Non-Hodgkin Lymphoma Classification Project.

PubMed

Perry, Anamarija M; Diebold, Jacques; Nathwani, Bharat N; MacLennan, Kenneth A; Müller-Hermelink, Hans K; Bast, Martin; Boilesen, Eugene; Armitage, James O; Weisenburger, Dennis D

2016-10-01

The distribution of non-Hodgkin lymphoma subtypes varies around the world, but a large systematic comparative study has never been done. In this study, we evaluated the clinical features and relative frequencies of non-Hodgkin lymphoma subtypes in five developing regions of the world and compared the findings to the developed world. Five expert hematopathologists classified 4848 consecutive cases of lymphoma from 26 centers in 24 countries using the World Health Organization classification, and 4539 (93.6%) were confirmed to be non-Hodgkin lymphoma, with a significantly greater number of males than females in the developing regions compared to the developed world (P<0.05). The median age at diagnosis was significantly lower for both low- and high-grade B-cell lymphoma in the developing regions. The developing regions had a significantly lower frequency of B-cell lymphoma (86.6%) and a higher frequency of T- and natural killer-cell lymphoma (13.4%) compared to the developed world (90.7% and 9.3%, respectively). Also, the developing regions had significantly more cases of high-grade B-cell lymphoma (59.6%) and fewer cases of low-grade B-cell lymphoma (22.7%) compared to the developed world (39.2% and 32.7%, respectively). Among the B-cell lymphomas, diffuse large B-cell lymphoma was the most common subtype (42.5%) in the developing regions. Burkitt lymphoma (2.2%), precursor B- and T-lymphoblastic leukemia/lymphoma (1.1% and 2.9%, respectively) and extranodal natural killer/T-cell lymphoma (2.2%) were also significantly increased in the developing regions. These findings suggest that differences in etiologic and host risk factors are likely responsible, and more detailed epidemiological studies are needed to better understand these differences. Copyright© Ferrata Storti Foundation.

Tangled paths: Three experienced teachers' growth in understanding during an extended science community of practice professional development effort

NASA Astrophysics Data System (ADS)

Brown, Nancy Melamed

This qualitative investigation extends the study of teacher learning within a reform-based community of practice model of professional development. This long-term, multiple case study examined three experienced teachers' transformations in thinking about science instruction. Data were collected during the three years of the Guided Inquiry supporting Multiple Literacies research project, designed to develop instructional practices informed by a socio-cultural, inquiry-based orientation. Data sources included: transcripts of semi-structured interviews collected at strategic points, the teacher's journals, initial application information, and teachers' written case studies. Using an interpretive case study approach, tenets of the teachers' orientations were identified through a recursive process. Results are organized to reflect two principles that were integral to the design of the professional development community. The first principle describes changes in teachers' orientations about the goals and characteristics of science instruction in the elementary grades. The second describes changes about teachers' knowledge about themselves as learners and the influence of this knowledge on their thinking about science instruction and student learning. Illustrative findings indicate that: (a) it is possible for teachers' language regarding conceptions of their practice to change with only superficial change in their orientations, (b) teachers can hold dualistic ways of thinking about their practice, (c) in some cases, teachers use a significant amount of autobiography about their own learning to explain their practice; over time, this was replaced with warrants using the language that developed within the professional development community, and (d) long-term case studies revealed differences in orientations that emerged and were refined over time. These findings provide strong support for communities of practice as a model of professional development and hold implications for advancing teacher learning.

Automated detection of extradural and subdural hematoma for contrast-enhanced CT images in emergency medical care

NASA Astrophysics Data System (ADS)

Hara, Takeshi; Matoba, Naoto; Zhou, Xiangrong; Yokoi, Shinya; Aizawa, Hiroaki; Fujita, Hiroshi; Sakashita, Keiji; Matsuoka, Tetsuya

2007-03-01

We have been developing the CAD scheme for head and abdominal injuries for emergency medical care. In this work, we have developed an automated method to detect typical head injuries, rupture or strokes of brain. Extradural and subdural hematoma region were detected by comparing technique after the brain areas were registered using warping. We employ 5 normal and 15 stroke cases to estimate the performance after creating the brain model with 50 normal cases. Some of the hematoma regions were detected correctly in all of the stroke cases with no false positive findings on normal cases.

Determinants in the development of advanced nursing practice: a case study of primary-care settings in Hong Kong.

PubMed

Twinn, Sheila; Thompson, David R; Lopez, Violeta; Lee, Diana T F; Shiu, Ann T Y

2005-01-01

Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. Sampling methods reflected the population groups and stage of the case study. Sampling included a total population of 41 nurses from whom a secondary volunteer sample was drawn for face-to-face interviews. In each case study, a convenience sample of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic sample of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice; (2) the use of skills mix; (3) the perceived contribution of ANP to patient care; and (4) patients' expectations of care. The level of autonomy of individual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.

Etiological aspects of double monsters.

PubMed

Jaschevatzky, O E; Goldman, B; Kampf, D; Wexler, H; Grünstein, S

1980-06-01

Four cases of double monsters are reported, including a rare case of craniofacial duplication (diprosopus). Based on the findings observed, etiological factors of these malformations are discussed. We suggest that exogenous (environmental) factors such as habits, way of life or religious practices of certain populations can influence the development of double monsters.

Identity Statuses in Upper-Division Physics Students

ERIC Educational Resources Information Center

Irving, Paul W.; Sayre, Eleanor C.

2016-01-01

We use the theories of identity statuses and communities of practice to describe three different case studies of students finding their paths through undergraduate physics and developing a physics subject-specific identity. Each case study demonstrates a unique path that reinforces the link between the theories of communities of practice and…

Ophthalmic pathology of Nance-Horan syndrome: case report and review of the literature.

PubMed

Ding, Xiaoyan; Patel, Mrinali; Herzlich, Alexandra A; Sieving, Pamela C; Chan, Chi-Chao

2009-09-01

Nance-Horan syndrome (NHS) is a rare X-linked disorder typified by dense congenital central cataracts, microcornea, anteverted and simplex pinnae, brachymetacarpalia, and numerous dental anomalies due in most cases to a mutation in the NHS gene. We present a case of clinical manifestation and ocular pathology in a patient with NHS. This article also reviews and discusses the relevant literature. Classic and novel ocular pathological findings of a young male with NHS are described, including congenital cataracts, infantile glaucoma, scleral staphyloma, and severe retinal cystoid degeneration. We report a new pathological finding of severe retinal cystoid degeneration in this NHS patient and confirm abnormal development of the anterior chamber angle structure. These findings, coupled with our analysis of the available NHS literature, provide new understanding of the histopathological basis of ocular abnormalities and vision loss in NHS.

Childhood hematologic cancer and residential proximity to oil and gas development

PubMed Central

McKenzie, Lisa M.; Allshouse, William B.; Byers, Tim E.; Bedrick, Edward J.; Serdar, Berrin; Adgate, John L.

2017-01-01

Background Oil and gas development emits known hematological carcinogens, such as benzene, and increasingly occurs in residential areas. We explored whether residential proximity to oil and gas development was associated with risk for hematologic cancers using a registry-based case-control study design. Methods Participants were 0–24 years old, living in rural Colorado, and diagnosed with cancer between 2001–2013. For each child in our study, we calculated inverse distance weighted (IDW) oil and gas well counts within a 16.1-kilometer radius of residence at cancer diagnosis for each year in a 10 year latency period to estimate density of oil and gas development. Logistic regression, adjusted for age, race, gender, income, and elevation was used to estimate associations across IDW well count tertiles for 87 acute lymphocytic leukemia (ALL) cases and 50 non-Hodgkin lymphoma (NHL) cases, compared to 528 controls with non-hematologic cancers. Findings Overall, ALL cases 0–24 years old were more likely to live in the highest IDW well count tertiles compared to controls, but findings differed substantially by age. For ages 5–24, ALL cases were 4.3 times as likely to live in the highest tertile, compared to controls (95% CI: 1.1 to 16), with a monotonic increase in risk across tertiles (trend p-value = 0.035). Further adjustment for year of diagnosis increased the association. No association was found between ALL for children aged 0–4 years or NHL and IDW well counts. While our study benefited from the ability to select cases and controls from the same population, use of cancer-controls, the limited number of ALL and NHL cases, and aggregation of ages into five year ranges, may have biased our associations toward the null. In addition, absence of information on O&G well activities, meteorology, and topography likely reduced temporal and spatial specificity in IDW well counts. Conclusion Because oil and gas development has potential to expose a large population to known hematologic carcinogens, further study is clearly needed to substantiate both our positive and negative findings. Future studies should incorporate information on oil and gas development activities and production levels, as well as levels of specific pollutants of interest (e.g. benzene) near homes, schools, and day care centers; provide age-specific residential histories; compare cases to controls without cancer; and address other potential confounders, and environmental stressors. PMID:28199334

The Female Voice: Applications to Bowen's Family Systems Theory.

ERIC Educational Resources Information Center

Knudson-Martin, Carmen

1994-01-01

Responds to calls from feminist scholars to address potential biases against women in theories of family therapy. Summarizes findings from studies of female development and integrates findings into expanded model of Bowen's family systems theory. Includes case example comparing expanded model with traditional application of Bowen's theory.…

A Novel Method of Case Representation and Retrieval in CBR for E-Learning

ERIC Educational Resources Information Center

Khamparia, Aditya; Pandey, Babita

2017-01-01

In this paper we have discussed a novel method which has been developed for representation and retrieval of cases in case based reasoning (CBR) as a part of e-learning system which is based on various student features. In this approach we have integrated Artificial Neural Network (ANN) with Data mining (DM) and CBR. ANN is used to find the…

Spiritual Development in Adolescence: Toward Enriching Theories, Research, and Professional Practice

ERIC Educational Resources Information Center

Petersen, Anne C.

2008-01-01

The author notes that she finds the case for making spiritual development a priority surprisingly compelling--"surprisingly" because although she is an expert on adolescent development, she has not done research or previously written about spiritual development. She suggests that a systems analysis occur first, before engaging frontline youth…

Developing Competencies for Using the Interactive Whiteboard to Implement Communicative Language Teaching in the English as a Foreign Language Classroom

ERIC Educational Resources Information Center

Cutrin Schmid, Euline

2010-01-01

This paper discusses the findings of a case study conducted with an English as a Foreign Language (EFL) teacher at a German secondary school. This case study is part of a research project that investigates the new competencies that EFL teachers need to acquire in order to be able to use the interactive whiteboard (IWB) to develop their practice,…

Malformations of cortical development and epilepsy: evaluation of 101 cases (part II).

PubMed

Güngör, Serdal; Yalnizoğlu, Dilek; Turanli, Güzide; Saatçi, Işil; Erdoğan-Bakar, Emel; Topçu, Meral

2007-01-01

Malformations of cortical development (MCD) form a spectrum of lesions produced by insult to the developing neocortex. Clinical presentation and electrophysiologic findings of MCD are variable and depend on the affected cortical area. We evaluated epilepsy, EEG, and response to antiepileptic treatment in patients with MCD with respect to the neuroimaging findings. We studied 101 patients, ranging between 1 month and 19 years of age. Fifty-four patients were diagnosed with polymicrogyria (PMG), 23 patients with lissencephaly, 12 patients with schizencephaly, and 12 patients with heterotopia. With regards to epilepsy and seizure type, 72/101 (71.3%) patients had epilepsy, and 62/101 (61.4%) patients presented with seizures. Overall, 32.7% of patients had generalized seizures, and 25.7% had complex partial seizures. Mean age at the onset of seizures was 2.7 +/- 3.4 years. The onset of epilepsy tended to be younger in patients with lissencephaly and older in patients with heterotopias. Of the cases, 79.2% had abnormal EEG (56.3% with epileptiform abnormality, 22.9% with non-epileptiform abnormality). EEG was abnormal in 44.9% (13/29) of the cases without epilepsy. EEG showed bilateral synchronous and diffuse epileptiform discharges in 90% of patients with lissencephaly. Patients with schizencephaly had mostly focal epileptiform discharges. Heterotopia cases had a high rate of EEG abnormalities (72.7%). Patients with PMG had epileptiform abnormality in 59.5% of the cases. Patients with heterotopias and PMG achieved better seizure control in comparison with the other groups. In conclusion, epilepsy is the most common problem in MCD. Epilepsy and EEG findings of patients with MCD are variable and seem to be correlated with the extent of cortical involvement.

Executive Development: Meeting the Needs of Top Teams and Boards.

ERIC Educational Resources Information Center

Jackson, Sheila; Farndale, Elaine; Kakabadse, Andrew

2003-01-01

A literature review and six case studies examined the roles and responsibilities of the chief executive officers and board chairs, the capabilities required for success, and related executive development activity. Findings include the importance of focusing executive development on capability enhancement to ensure that it supports organizational…

Usefulness and limitations of postmortem computed tomography in forensic analysis of gunshot injuries: Three case reports.

PubMed

Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Kozakai, Masataka; Saito, Haruo; Funayama, Masato

2016-01-01

Gunshot injury has always been an important field of investigation in postmortem forensic radiology. The localization and retrieval of the bullet and of potentially important fragments are vital to these cases. Using postmortem multidetector-row computed tomography (MDCT) prior to forensic autopsy, we sought to illustrate the importance of this modality in the noninvasive characterization of gunshot wounds. We obtained and analyzed MDCT images in three cases of gunshot wounds (accidental close-range shotgun shooting, suicidal contact gunshot to the head and accidental long-range buckshot shooting). We discuss the value of postmortem MDCT findings in gunshot wound cases by comparing with forensic autopsy findings in Japan, a developing country with miserably low autopsy rate. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

MRI-induced soft tissue pain: incidental finding of a 15-year-old foreign body

PubMed Central

El Sayed Omar, Theofilos; El-Khani, Ussamah; Nehme, Jean

2013-01-01

We present the case of an 82-year-old woman who developed intense right middle finger pain during MRI scan This alerted the clinical team to the incidental finding of a 15-year-old metallic foreign body in the distal phalanx of the right middle finger. This case report is a reminder that the responsible clinician should be vigilant when screening for metallic foreign body on completion of the MRI checklist, and should adopt a low threshold for plain imaging prior to MRI. PMID:23417938

Killing-Yano tensors in spaces admitting a hypersurface orthogonal Killing vector

NASA Astrophysics Data System (ADS)

Garfinkle, David; Glass, E. N.

2013-03-01

Methods are presented for finding Killing-Yano tensors, conformal Killing-Yano tensors, and conformal Killing vectors in spacetimes with a hypersurface orthogonal Killing vector. These methods are similar to a method developed by the authors for finding Killing tensors. In all cases one decomposes both the tensor and the equation it satisfies into pieces along the Killing vector and pieces orthogonal to the Killing vector. Solving the separate equations that result from this decomposition requires less computing than integrating the original equation. In each case, examples are given to illustrate the method.

Atypical findings in three patients with Pai syndrome and literature review.

PubMed

Lederer, Damien; Wilson, Brian; Lefesvre, Pierre; Poorten, Vincent Vander; Kirkham, Nigel; Mitra, Dipayan; Verellen-Dumoulin, Christine; Devriendt, Koenraad

2012-11-01

Pai syndrome is a rare disorder characterized by congenital nasal or facial polyp, midline cleft lip, pericallosal lipoma, ocular anomalies, and normal neuropsychological development. Here, we report on three patients with Pai syndrome and atypical findings: temporal triangular alopecia, posterior lenticonus, bilateral palatal pits, bifid uvula, hypospadias, sacral dimple, true tracheal bronchus, and epilepsy. Thirty-three cases of Pai syndrome have been described so far. We present a review of the previously reported cases and suggest modified diagnostic criteria for Pai syndrome. Copyright © 2012 Wiley Periodicals, Inc.

Pre-radiographic MRI findings are associated with onset of knee symptoms: the most study

PubMed Central

Javaid, M. K.; Lynch, J. A.; Tolstykh, I.; Guermazi, A.; Roemer, F.; Aliabadi, P.; McCulloch, C.; Curtis, J.; Felson, D.; Lane, N. E.; Torner, J.; Nevitt, M.

2010-01-01

Summary Objective Magnetic resonance imaging (MRI) has greater sensitivity to detect osteoarthritis (OA) damage than radiographs but it is uncertain which MRI findings in early OA are clinically important. We examined MRI abnormalities detected in knees without radiographic OA and their association with incident knee symptoms. Method Participants from the Multicenter Osteoarthritis Study (MOST) without frequent knee symptoms (FKS) at baseline were eligible if they also lacked radiographic features of OA at baseline. At 15 months, knees that developed FKS were defined as cases while control knees were drawn from those that remained without FKS. Baseline MRIs were scored at each subregion for cartilage lesions (CARTs); osteophytes (OST); bone marrow lesions (BML) and cysts. We compared cases and controls using marginal logistic regression models, adjusting for age, gender, race, body mass index (BMI), previous injury and clinic site. Results 36 case knees and 128 control knees were analyzed. MRI damage was common in both cases and controls. The presence of a severe CART (P = 0.03), BML (P = 0.02) or OST (P = 0.02) in the whole knee joint was more common in cases while subchondral cysts did not differ significantly between cases and controls (P > 0.1). Case status at 15 months was predicted by baseline damage at only two locations; a BML in the lateral patella (P = 0.047) and at the tibial subspinous subregions (P = 0.01). Conclusion In knees without significant symptoms or radiographic features of OA, MRI lesions of OA in only a few specific locations preceded onset of clinical symptoms and suggest that changes in bone play a role in the early development of knee pain. Confirmation of these findings in other prospective studies of knee OA is warranted. PMID:19919856

An interesting case of peripheral vascular disease, vascular reperfusion, and subsequent development of pain due to Paget's disease of bone.

PubMed

Kwun, Sunna; Tucci, Joseph R

2013-01-01

To present a case of Paget's disease of bone that was unmasked after vascular reperfusion. In this case study, we review the presentation, evaluation, diagnosis, and management of a patient with Paget's disease and peripheral vascular disease. A 79-year-old-woman with a history of coronary artery heart disease and recent finding of a T5 compression fracture was hospitalized for evaluation of right lower extremity claudication. Angiography demonstrated a focal complete occlusion of the distal right femoral and popliteal arteries. A self-expanding stent was placed in the distal femoral and popliteal arteries. Approximately 48 hours after the procedure, the patient developed severe, right lower leg pain. On endocrine evaluation, the patient was found to have clinical signs suggesting Paget's disease of bone, which was subsequently confirmed by imaging. This patient's development of severe pain following reperfusion of distal femoral and popliteal arteries is in keeping with the known and aforementioned hypervascularity of pagetic bone. The finding of increased warmth over an area of skeletal deformation should always raise the possibility of Paget's disease of bone.

Plasma bicarbonate and odds of incident hypertension.

PubMed

Mandel, Ernest I; Forman, John P; Curhan, Gary C; Taylor, Eric N

2013-12-01

Several biomarkers of metabolic acidosis, including lower plasma bicarbonate, have been associated with prevalent hypertension in cross-sectional studies. We sought to examine prospectively whether lower plasma bicarbonate is associated with incident hypertension. We conducted a prospective case-control study nested within the Nurses' Health Study II. Plasma bicarbonate was measured in 695 nonobese women without hypertension at time of blood draw who subsequently developed hypertension during 6 years of follow-up. Control subjects were matched to case subjects according to age, race, time and day of blood draw, and day of menstrual cycle. We used unconditional logistic regression to generate odds ratios (ORs) for development of hypertension by quintile of baseline plasma bicarbonate. After adjusting for matching factors, body mass index, family history of hypertension, plasma creatinine, and dietary and lifestyle factors, higher plasma bicarbonate was associated with lower odds of developing hypertension across quintiles (P for linear trend = 0.04). Those in the highest compared with the lowest quintile of plasma bicarbonate had 31% lower odds of developing hypertension (OR = 0.69; 95% confidence interval = 0.48-0.99). Further adjustment for diet-estimated net endogenous acid production, plasma insulin, 25-hydroxyvitamin D, and uric acid did not alter these findings. Our case-control study is consistent with a modest association between higher plasma bicarbonate and reduced odds of developing hypertension among nonobese women, although our findings are of borderline statistical significance. Further research is required to confirm this finding as part of a larger prospective cohort study and to elucidate the mechanism for this relation.

Contested Values in Further Education: Findings from a Case Study of the Management of Change.

ERIC Educational Resources Information Center

Elliott, Geoffrey; Crossley, Michael

1997-01-01

The recent trend toward development of a radical, market-oriented educational policy with seemingly contradictory pressures for centralization and decentralization has been well-documented. Based on a case study of a large urban (British) college, this paper considers implications, suggesting that contemporary policy thrusts have spawned…

Library Experience and Information Literacy Learning of First Year International Students: An Australian Case Study

ERIC Educational Resources Information Center

Hughes, Hilary; Hall, Nerilee; Pozzi, Megan

2017-01-01

This qualitative case study provides fresh understandings about first year undergraduate international students' library and information use at an Australian university, and their associated information literacy learning needs. The findings provide evidence to inform the development of library spaces and information literacy responses that enhance…

Removed from the List: A Comparative Longitudinal Case Study of a Reconstitution-Eligible School.

ERIC Educational Resources Information Center

Mac Iver, Douglas J.; Ruby, Allen; Balfanz, Robert; Byrnes, Vaughan

2002-01-01

Longitudinal case study of reform efforts centering on the Talent Development Middle School model at low-performing, high-poverty middle school in Philadelphia. Finds that student gains in mathematics, science, and reading achievement at subject school exceeded that of students in comparable school. (Contains 19 references.) (PKP)

Ophthalmic Pathology of Nance-Horan Syndrome: Case Report and Review of the Literature

PubMed Central

Ding, Xiaoyan; Patel, Mrinali; Herzlich, Alexandra A.; Sieving, Pamela C.; Chan, Chi-Chao

2009-01-01

Background Nance-Horan syndrome (NHS) is a rare X-linked disorder typified by dense congenital central cataracts, microcornea, anteverted and simplex pinnae, brachymetacarpalia, and numerous dental anomalies due in most cases to a mutation in the NHS gene. Material and Methods We present a case of clinical manifestation and ocular pathology in a patient with NHS. This article also reviews and discusses the relevant literature. Results Classic and novel ocular pathological findings of a young male with NHS are described, including congenital cataracts, infantile glaucoma, scleral staphyloma, and severe retinal cystoid degeneration. Conclusions We report a new pathological finding of severe retinal cystoid degeneration in this NHS patient and confirm abnormal development of the anterior chamber angle structure. These findings, coupled with our analysis of the available NHS literature, provide new understanding of the histopathological basis of ocular abnormalities and vision loss in NHS. PMID:19941417

Pulmonary vascular anomalies: a review of clinical and radiological findings of cases presenting with different complaints in childhood.

PubMed

Nacaroğlu, Hikmet Tekin; Ünsal-Karkıner, Canan Şule; Bahçeci-Erdem, Semiha; Özdemir, Rahmi; Karkıner, Aytaç; Alper, Hüdaver; Can, Demet

2016-01-01

Congenital pulmonary vascular abnormalities arise from several etiologies. These anomalies are difficult to categorize and sorted into distinct classifications. Major pulmonary vascular abnormalities can be ranked as interruption of the main pulmonary artery or its absence, emergence of the left pulmonary artery in the right pulmonary artery, pulmonary venous drainage abnormalities, and pulmonary arteriovenous malformations (PAVMs). Some of the cases are asymptomatic and diagnosed by coincidence, whereas a few of them are diagnosed by typical findings in the newborn and infancy period, symptoms, and radiological appearances. Early diagnosis is important, since death may occur as a result of pulmonary and cardiac pathologies developed in patients with pulmonary vascular anomalies. In this case presentation, the clinical and radiological findings of patients that presented with different complaints and were diagnosed with pulmonary vascular anomalies were introduced.

Neighborhoods Matter: The Role of Universities in the School Reform Neighborhood Development Movement

ERIC Educational Resources Information Center

Taylor, Henry Louis; McGlynn, Linda; Luter, D. Gavin

2013-01-01

Where you find distressed neighborhoods, you will also find poorly performing public schools. Yet many contemporary school reform efforts ignore neighborhood-level factors that undeniably impact school performance. The purpose of this study is to use a case study approach with social institutional and urban school reform regime frameworks to…

CR softcopy display presets based on optimum visualization of specific findings

NASA Astrophysics Data System (ADS)

Andriole, Katherine P.; Gould, Robert G.; Webb, W. R.

1999-07-01

The purpose of this research is to assess the utility of providing presets for computed radiography (CR) softcopy display, based not on the window/level settings, but on image processing applied to the image based on optimization for visualization of specific findings, pathologies, etc. Clinical chest images are acquired using an Agfa ADC 70 CR scanner, and transferred over the PACS network to an image processing station which has the capability to perform multiscale contrast equalization. The optimal image processing settings per finding are developed in conjunction with a thoracic radiologist by manipulating the multiscale image contrast amplification algorithm parameters. Softcopy display of images processed with finding-specific settings are compared with the standard default image presentation for fifty cases of each category. Comparison is scored using a five point scale with positive one and two denoting the standard presentation is preferred over the finding-specific presets, negative one and two denoting the finding-specific preset is preferred over the standard presentation, and zero denoting no difference. Presets have been developed for pneumothorax and clinical cases are currently being collected in preparation for formal clinical trials. Subjective assessments indicate a preference for the optimized-preset presentation of images over the standard default, particularly by inexperienced radiology residents and referring clinicians.

Mechanisms of perianeurysmal edema following endovascular embolization of aneurysms.

PubMed

Tomokiyo, M; Kazekawa, K; Onizuka, M; Aikawa, H; Tsutsumi, M; Ikoh, M; Kodama, T; Nii, K; Matsubara, S; Tanaka, A

2007-03-15

After coil embolization for an aneurysm, edema surrounding the aneurysm revealed by magnetic resonance imaging (MRI) is rarely seen and is usually associated with neurological symptoms. Perianeurysmal edema was found by postoperative MRI in three out of 182 patients with cerebral aneurysm, which was treated with Guglielmi Detachable Coil (GDC), and neurological symptoms developed simultaneously. In cases where neurological symptoms improved with conservative medical treatment, a temporary increase in the volume of an aneurysm, due to coil and thrombus formation, may result in edema. In cases where symptoms were not alleviated with conservative medical treatment, persistent water-hammer effect against the residual lumen of the aneurysm as well as an increase in the volume of aneurysm by hemorrhage in the aneurysmal wall may contribute to the development of perianeurysmal edema. Consideration of the mechanism of edema development by neurological symptoms, MRI findings, and angiographic findings is needed in order to select appropriate treatment.

Mechanisms of Perianeurysmal Edema Following Endovascular Embolization of Aneurysms

PubMed Central

Tomokiyo, M.; K., Kazekawa; Onizuka, M.; Aikawa, H.; Tsutsumi, M.; Ikoh, M.; Kodama, T.; Nii, K.; Matsubara, S.; Tanaka, A.

2007-01-01

Summary After coil embolization for an aneurysm, edema surrounding the aneurysm revealed by magnetic resonance imaging (MRI) is rarely seen and is usually associated with neurological symptoms. Perianeurysmal edema was found by postoperative MRI in three out of 182 patients with cerebral aneurysm, which was treated with Guglielmi Detachable Coil (GDC), and neurological symptoms developed simultaneously. In cases where neurological symptoms improved with conservative medical treatment, a temporary increase in the volume of an aneurysm, due to coil and thrombus formation, may result in edema. In cases where symptoms were not alleviated with conservative medical treatment, persistent water-hammer effect against the residual lumen of the aneurysm as well as an increase in the volume of aneurysm by hemorrhage in the aneurysmal wall may contribute to the development of perianeurysmal edema. Consideration of the mechanism of edema development by neurological symptoms, MRI findings, and angiographic findings is needed in order to select appropriate treatment. PMID:20566093

Managing In-House Development of a Campus-Wide Information System

ERIC Educational Resources Information Center

Shurville, Simon; Williams, John

2005-01-01

Purpose: To show how a combination of hard and soft project and change management methodologies guided successful in-house development of a campus-wide information system. Design/methodology/approach: A case study of the methodologies and management structures that guided the development is presented. Findings: Applying a combination of the…

Culturally Based Intervention Development: The Case of Latino Families Dealing with Schizophrenia

ERIC Educational Resources Information Center

Barrio, Concepcion; Yamada, Ann-Marie

2010-01-01

Objectives: This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. Method: Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this…

Student-Teachers' Supervision as a Professional Development Activity: Building Work-Related Skills

ERIC Educational Resources Information Center

Minott, Mark A.; Willett, Ionie Liburd

2011-01-01

The purpose of this research was to identify and outline the work-related skills that cooperating teachers in the Cayman Islands and Saint Kitts-Nevis developed or reinforced as they supervised student-teachers. A qualitative case-study methodology was used. The findings indicate that cooperating teachers developed and reinforced essential…

Ectopic Molar Pregnancy: Diagnostic Efficacy of Magnetic Resonance Imaging and Review of the Literature.

PubMed

Yamada, Yasushi; Ohira, Satoshi; Yamazaki, Teruyuki; Shiozawa, Tanri

2016-01-01

Ectopic molar pregnancy is extremely rare, and preoperative diagnosis is difficult. Our literature search found only one report of molar pregnancy diagnosed preoperatively. Moreover, there is no English literature depicting magnetic resonance image (MRI) findings of ectopic molar pregnancy. We report a case of ectopic molar pregnancy preoperatively diagnosed using MRI. A literature review of 31 cases of ectopic molar pregnancy demonstrated that lesions have been found in the fallopian tube (19 cases, 61%), ovary (5 cases, 16%), cornu (3 cases, 10%), peritoneum (2 cases, 6%), uterine cervix (1 case, 3%), and cesarean scar (1 case, 3%). Abdominal pain and abnormal vaginal bleeding were reported in 70% and 61% of the patients, respectively. Twenty-one cases (67%) presented with rupture and hemoperitoneum. All patients underwent surgical resection or dilatation and curettage. Methotrexate therapy was performed in one case because residual trophoblastic tissue was suspected. A second operation was performed in one case of ovarian molar pregnancy because serum hCG levels increased again after primary focal ovarian resection. No patients developed metastatic disease or relapsed. These findings suggest the prognosis of ectopic molar pregnancy to be favorable.

Hanging an Airplane: A Case Study in Static Equilibrium

NASA Astrophysics Data System (ADS)

Katz, Debora M.

2009-11-01

Our classrooms are filled with engineering majors who take a semester-long course in static equilibrium. Many students find this class too challenging and drop their engineering major. In our introductory physics class, we often breeze through static equilibrium; to physicists equilibrium is just a special case of Newton's second law. While it is difficult to find more time in the syllabus for any one topic, a hands-on case study may help students to develop their physical intuition about static equilibrium and may help them to succeed in their subsequent classes. This article describes a hands-on case study that you may wish to use in your classroom. (You may also wish to check a case study involving a boat published in this journal in the 1990s. ) The hands-on case study presented here can be easily modified to work at the high school or introductory college level. There are three major components: I) planning, II) doing, and III) calculating.

"Herbal seizures"--atypical symptoms after ibogaine intoxication: a case report.

PubMed

Breuer, Lorenz; Kasper, Burkhard S; Schwarze, Bernd; Gschossmann, Juergen M; Kornhuber, Johannes; Müller, Helge H

2015-10-31

Misuse of various new psychotropic substances such as ibogaine is increasing rapidly. Knowledge of their negative side effects is sparse. We present a case of intoxication with the herbal substance ibogaine in a 22-year-old white man. After taking a cumulative dose of 38 g (taken in two doses), he developed visual memories, nausea and vomiting. He developed a generalized tonic-clonic seizure with additional grand mal seizures. He was treated with midazolam and levetiracetam. Extended drug screenings and computed tomography and magnetic resonance imaging findings were all negative. Knowledge of the side effects of ibogaine has mainly come from reports of cardiovascular complications; seizures are rarely mentioned and experimental findings are inconsistent. It seems that ibogaine acts like a proconvulsive drug at high doses.

F-18 FDG PET/CT findings of a case of sacral nerve root neurolymphomatosis that occurred during chemotherapy.

PubMed

Suga, Kazuyoshi; Yasuhiko, Kawakami; Matsunaga, Naofumi; Yujiri, Toshiaki; Nakazora, Tatsuki; Ariyoshi, Kouichi

2011-01-01

Neurolymphomatosis (NL) is a rare, unique subtype of lymphomatous infiltration of peripheral nerves. Clinical/radiologic diagnosis of NL is challenging. We report F-18 FDG PET/CT findings of a case of breast diffuse large B-cell lymphoma, in which NL developed regardless of regression of systemic lesions during induction chemotherapy. FDG PET/CT showed characteristic findings of well-demarcated, linear abnormal FDG uptake along a sacral vertebral foramen, leading to diagnosis of NL, with the finding of thickened nerve roots on magnetic resonance imaging. Altered chemotherapeutic regimen resulted in disappearance of these abnormal FDG uptake, with recovery of neurologic symptoms. Peripheral nerve NL may occur during chemotherapy, and FDG PET/CT can be a useful imaging modality in diagnosis and monitoring of therapeutic response of this disease.

Why Irregulars Win: Asymmetry of Motivations and the Outcomes of Irregular Warfare

DTIC Science & Technology

2016-12-01

have on dependent variables.” 58 Alexander L. George and Andrew Bennett, Case Studies and Theory Development in the Social Sciences, BCSIA Studies in...of case studies is used to evaluate irregular wars and the motivations of the combatants. The findings suggest that asymmetries of motivation only...irregular wars. A mixed methodology, including heuristics, process tracing, and comparison of case studies is used to evaluate irregular wars and the

Cavitary pulmonary nodules in atypical collagen disease and lupoid drug reaction. Report of two cases.

PubMed

Muren, C; Strandberg, O

1989-01-01

The case histories of two patients with cavitary pulmonary nodules and the findings at chest radiography are reviewed. The first patient had a connective tissue disease with features common to systematic lupus erythematosus and Wegener's granulomatosis. In the second patient the lung changes developed as part of a drug reaction to carbamezapine and/or phenytoin. The common denominator of the cavitating nodules is probably the presence of granulomas, developing as a sequela of pulmonary vasculitis.

A case of pulmonary hemorrhage due to drug-induced pneumonitis secondary to ticagrelor therapy.

PubMed

Whitmore, Timothy J; O'Shea, John P; Starac, Diana; Edwards, Mark G; Waterer, Grant W

2014-03-01

We report a case of significant pulmonary hemorrhage developing shortly after commencing ticagrelor and aspirin therapy and requiring coronary artery bypass grafting to safely cease the antiplatelet therapy. Lung biopsy findings were consistent with drug-induced lung injury. Clinicians should be aware of this significant adverse event with this drug class.

[Cystic Rheumatoid Arthritis--case report].

PubMed

Mourão, Ana Filipa; Santos, Fernando Pimentel; Falcão, Sandra; Pinto, Teresa Laura; Barros, Rita; de Matos, António Alves; Branco, Jaime Cunha

2007-01-01

Among the many radiological findings seen in Rheumatoid Arthritis RA small subchondral geodes and erosions are typical. Large geodes are far less common abnormalities and their presence may indicate diagnostic and therapeutic difficulties. We present a case report of a 55-year old woman with seronegative RA that developed a large geode in the knee with extensive joint destruction.

The CAST Initiative in Guam: A Model of Effective Teachers Teaching Teachers

ERIC Educational Resources Information Center

Zuercher, Deborah K.; Kessler, Cristy; Yoshioka, Jon

2011-01-01

The CAST (content area specialized training) model of professional development enables sustainable teacher leadership and is responsive to the need for culturally relevant educational practices. The purpose of this paper is to share the background, methods, findings and recommendations of a case study on the CAST initiative in Guam. The case study…

CASE Fundraising in International Schools Report 2016. Findings from Data Collected for the Academic Year 2014-15

ERIC Educational Resources Information Center

Council for Advancement and Support of Education, 2016

2016-01-01

The CASE Fundraising in International Schools Survey (FRIS) provides a set of measurement standards for advancement programmes at international schools around the world. The survey was first conducted in 2009 among practitioners to trace the expansion and innovation of development and external relations initiatives in international schools. Given…

Developing a Customized Program Assessment Methodology for Assurance of Learning: A Case Study

ERIC Educational Resources Information Center

Baker, Hope; Brawley, Dorothy; Campbell, Jane; Capozzoli, Ernest; Malgeri, Linda; Roberts, Gary

2007-01-01

For most academic institutions, selecting and/or designing a Program Assessment methodology for Assurance of Learning is a challenging task. This paper describes the steps taken to establish goals, values and criteria driving this process for a College of Business. In this case analysis, we document the options we explored in finding the right…

Hepatobiliary fascioliasis: a case with unusual radiological features.

PubMed

Yeşildağ, Ahmet; Senol, Altuğ; Köroğlu, Mert; Koçkar, Cem; Oyar, Orhan; Işler, Mehmet

2010-12-01

We report a case of hepatobiliary fascioliasis presenting with unusual radiological findings that have not been reported previously. Imaging studies revealed hepatic cystic pouches communicating with intrahepatic bile ducts. Snail-like, oval shaped and conglomerated echogenic particles with no acoustic shadowing, suggesting F. hepatica, were detected in these cystic pouches. In addition, secondary sclerosing cholangitis developed after fascioliasis.

The impact of science teachers' epistemological beliefs on authentic inquiry: A multiple-case study

NASA Astrophysics Data System (ADS)

Jackson, Dionne Bennett

The purpose of this study was to examine how science teachers' epistemological beliefs impacted their use of authentic inquiry in science instruction. Participants in this multiple-case study included a total of four teachers who represented the middle, secondary and post-secondary levels. Based on the results of the pilot study conducted with a secondary science teacher, adjustments were made to the interview questions and observation protocol. Data collection for the study included semi-structured interviews, direct observations of instructional techniques, and the collection of artifacts. The cross case analysis revealed that the cases epistemological beliefs were mostly Transitional and the method of instruction used most was Discussion. Two of the cases exhibited consistent beliefs and instructional practices, whereas the other two exhibited beliefs beyond their instruction. The findings of this study support the literature on the influence of contextual factors and professional development on teacher beliefs and practice. The findings support and contradict literature relevant to the consistency of teacher beliefs with instruction. This study's findings revealed that the use of reform-based instruction, or Authentic Inquiry, does not occur when science teachers do not have the beliefs and experiences necessary to implement this form of instruction.

Parameterized Algorithmics for Finding Exact Solutions of NP-Hard Biological Problems.

PubMed

Hüffner, Falk; Komusiewicz, Christian; Niedermeier, Rolf; Wernicke, Sebastian

2017-01-01

Fixed-parameter algorithms are designed to efficiently find optimal solutions to some computationally hard (NP-hard) problems by identifying and exploiting "small" problem-specific parameters. We survey practical techniques to develop such algorithms. Each technique is introduced and supported by case studies of applications to biological problems, with additional pointers to experimental results.

Making transit-oriented development work in low-income Latino neighborhoods : a comparative case study of Boyle Heights, Los Angeles and Logan Heights, San Diego.

DOT National Transportation Integrated Search

2016-12-01

This research project is a continuation of a previous NITC-funded study. The first study compared the MacArthur Park TOD in Los Angeles to the : Fruitvale Village TOD in Oakland. The findings from this new study further validate the key findings from...

Atypical Intracranial Epidermoid Cysts: Rare Anomalies with Unique Radiological Features

PubMed Central

Law, Eric K. C.; Lee, Ryan K. L.; Ng, Alex W. H.; Siu, Deyond Y. W.; Ng, Ho-Keung

2015-01-01

Epidermoid cysts are benign slow growing extra-axial tumours that insinuate between brain structures, while their occurrences in intra-axial or intradiploic locations are exceptionally rare. We present the clinical, imaging, and pathological findings in two patients with atypical epidermoid cysts. CT and MRI findings for the first case revealed an intraparenchymal epidermoid cyst that demonstrated no restricted diffusion. The second case demonstrated an aggressive epidermoid cyst that invaded into the intradiploic spaces, transverse sinus, and the calvarium. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts. PMID:25667778

Fetal Magnetic Resonance Imaging Findings in Prenatal Zika Virus Infection.

PubMed

Sanín-Blair, José Enrique; Gutiérrez-Márquez, Carolina; Herrera, Diego A; Vossough, Arastoo

2017-01-01

Brain lesions and malformations have been described on ultrasonography of prenatal Zika infection; however, there are scarce reports about fetal magnetic resonance (MR) findings. We report 3 cases of fetuses with confirmed intrauterine Zika virus infection evaluated by ultrasound and fetal MR. Various morphometric measurements were assessed and brain maturation was calculated with the fetal total maturation score. Fetuses with prenatal Zika virus infection showed retardation in brain maturation indexes evaluated by fetal MR. Brain calcifications were demonstrated by neurosonography in all cases, while fetal MR characterized the specific type of cortical development malformation. © 2017 S. Karger AG, Basel.

Are Simulation Stethoscopes a Useful Adjunct for Emergency Residents' Training on High-fidelity Mannequins?

PubMed

Warrington, Steven J; Beeson, Michael S; Fire, Frank L

2013-05-01

Emergency medicine residents use simulation training for many reasons, such as gaining experience with critically ill patients and becoming familiar with disease processes. Residents frequently criticize simulation training using current high-fidelity mannequins due to the poor quality of physical exam findings present, such as auscultatory findings, as it may lead them down an alternate diagnostic or therapeutic pathway. Recently wireless remote programmed stethoscopes (simulation stethoscopes) have been developed that allow wireless transmission of any sound to a stethoscope receiver, which improves the fidelity of a physical examination and the simulation case. Following institutional review committee approval, 14 PGY1-3 emergency medicine residents were assessed during 2 simulation-based cases using pre-defined scoring anchors on multiple actions, such as communication skills and treatment decisions (Appendix 1). Each case involved a patient presenting with dyspnea requiring management based off physical examination findings. One case was a patient with exacerbation of heart failure, while the other was a patient with a tension pneumothorax. Each resident was randomized into a case associated with the simulation stethoscope. Following the cases residents were asked to fill out an evaluation questionnaire. Residents perceived the most realistic physical exam findings on those associated with the case using the simulation stethoscope (13/14, 93%). Residents also preferred the simulation stethoscope as an adjunct to the case (13/14, 93%), and they rated the simulation stethoscope case to have significantly more realistic auscultatory findings (4.4/5 vs. 3.0/5 difference of means 1.4, p=0.0007). Average scores of residents were significantly better in the simulation stethoscope-associated case (2.5/3 vs. 2.3/3 difference of means 0.2, p=0.04). There was no considerable difference in the total time taken per case. A simulation stethoscope may be a useful adjunct to current emergency medicine simulation-based training. Residents both preferred the use of the simulation stethoscope and perceived physical exam findings to be more realistic, leading to improved fidelity. Potential sources of bias include the small population, narrow scoring range, and the lack of blinding. Further research, focusing on use for resident assessment and clinical significance with a larger population and blinding of graders, is needed.

Are Simulation Stethoscopes a Useful Adjunct for Emergency Residents' Training on High-fidelity Mannequins?

PubMed Central

Beeson, Michael S.; Fire, Frank L.

2013-01-01

Introduction: Emergency medicine residents use simulation training for many reasons, such as gaining experience with critically ill patients and becoming familiar with disease processes. Residents frequently criticize simulation training using current high-fidelity mannequins due to the poor quality of physical exam findings present, such as auscultatory findings, as it may lead them down an alternate diagnostic or therapeutic pathway. Recently wireless remote programmed stethoscopes (simulation stethoscopes) have been developed that allow wireless transmission of any sound to a stethoscope receiver, which improves the fidelity of a physical examination and the simulation case. Methods: Following institutional review committee approval, 14 PGY1-3 emergency medicine residents were assessed during 2 simulation-based cases using pre-defined scoring anchors on multiple actions, such as communication skills and treatment decisions (Appendix 1). Each case involved a patient presenting with dyspnea requiring management based off physical examination findings. One case was a patient with exacerbation of heart failure, while the other was a patient with a tension pneumothorax. Each resident was randomized into a case associated with the simulation stethoscope. Following the cases residents were asked to fill out an evaluation questionnaire. Results: Residents perceived the most realistic physical exam findings on those associated with the case using the simulation stethoscope (13/14, 93%). Residents also preferred the simulation stethoscope as an adjunct to the case (13/14, 93%), and they rated the simulation stethoscope case to have significantly more realistic auscultatory findings (4.4/5 vs. 3.0/5 difference of means 1.4, p=0.0007). Average scores of residents were significantly better in the simulation stethoscope-associated case (2.5/3 vs. 2.3/3 difference of means 0.2, p=0.04). There was no considerable difference in the total time taken per case. Conclusion: A simulation stethoscope may be a useful adjunct to current emergency medicine simulation-based training. Residents both preferred the use of the simulation stethoscope and perceived physical exam findings to be more realistic, leading to improved fidelity. Potential sources of bias include the small population, narrow scoring range, and the lack of blinding. Further research, focusing on use for resident assessment and clinical significance with a larger population and blinding of graders, is needed. PMID:23687548

Architecture and Development: Two Case Studies

ERIC Educational Resources Information Center

Bechhoefer, William B.

1975-01-01

An American Fulbright lecturer finds lessons learned about the growth of architectural education in Tunisia and Afghanistan relevant for other developing nations. He emphasizes the responsibility that accompanies the imposition of a foreign system: recognition of local variations from the model and evaluation of programs and curriculum responsive…

Massive localized lymphedema of the male external genitalia: a clinicopathologic study of 6 cases.

PubMed

Lee, Stephen; Han, Jeong S; Ross, Hillary M; Epstein, Jonathan I

2013-02-01

Massive localized lymphedema is a reactive pseudotumor strongly associated with obesity. The tumor most commonly presents as pendulous masses in the lower limbs with only 3 reported cases involving external male genitalia. In this study, we report an additional 6 cases localized to the external male genitalia. The cases were retrospectively identified from the surgical pathology database of the Johns Hopkins Hospital. All 6 patients were obese (5 presented with diffuse scrotal edema and 1 with a penile mass). In all cases, the clinical impression was of a benign chronic process developing over 3 months to 1 year. All 3 cases from outside institutions were referred with benign pathologic diagnoses. The lesions ranged in size from 4 to 55 cm. Microscopically, all cases exhibited stromal fibrosis and edema, multinucleated stromal cells, perivascular chronic inflammation, and lymphangiectasia. Entrapped fat was a minor feature and seen in only 3 cases. Variable hyperplasia and hypertrophy of dartos muscle were noted in 6 lesions. Three cases showed prominent microvascular proliferation around the edge of individual dartos muscle bundles. In summary, diagnosis of massive localized lymphedema requires appropriate correlation between clinical and microscopic findings. Lesions in the male external genitalia share many microscopic findings with massive localized lymphedema at other sites, although entrapped adipose tissue is not prominent. Additional, although not specific, findings include variably hyperplastic and hypertrophic dartos muscle and capillary neoangiogenesis at the interface between smooth muscle bundles and stroma. Copyright © 2013 Elsevier Inc. All rights reserved.

A hypothesis-driven physical examination learning and assessment procedure for medical students: initial validity evidence.

PubMed

Yudkowsky, Rachel; Otaki, Junji; Lowenstein, Tali; Riddle, Janet; Nishigori, Hiroshi; Bordage, Georges

2009-08-01

Diagnostic accuracy is maximised by having clinical signs and diagnostic hypotheses in mind during the physical examination (PE). This diagnostic reasoning approach contrasts with the rote, hypothesis-free screening PE learned by many medical students. A hypothesis-driven PE (HDPE) learning and assessment procedure was developed to provide targeted practice and assessment in anticipating, eliciting and interpreting critical aspects of the PE in the context of diagnostic challenges. This study was designed to obtain initial content validity evidence, performance and reliability estimates, and impact data for the HDPE procedure. Nineteen clinical scenarios were developed, covering 160 PE manoeuvres. A total of 66 Year 3 medical students prepared for and encountered three clinical scenarios during required formative assessments. For each case, students listed anticipated positive PE findings for two plausible diagnoses before examining the patient; examined a standardised patient (SP) simulating one of the diagnoses; received immediate feedback from the SP, and documented their findings and working diagnosis. The same students later encountered some of the scenarios during their Year 4 clinical skills examination. On average, Year 3 students anticipated 65% of the positive findings, correctly performed 88% of the PE manoeuvres and documented 61% of the findings. Year 4 students anticipated and elicited fewer findings overall, but achieved proportionally more discriminating findings, thereby more efficiently achieving a diagnostic accuracy equivalent to that of students in Year 3. Year 4 students performed better on cases on which they had received feedback as Year 3 students. Twelve cases would provide a reliability of 0.80, based on discriminating checklist items only. The HDPE provided medical students with a thoughtful, deliberate approach to learning and assessing PE skills in a valid and reliable manner.

Characteristics and Implications of Diagnostic Justification Scores Based on the New Patient Note Format of the USMLE Step 2 CS Exam.

PubMed

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

2015-11-01

To determine the psychometric characteristics of diagnostic justification scores based on the patient note format of the United States Medical Licensing Examination Step 2 Clinical Skills exam, which requires students to document history and physical findings, differential diagnoses, diagnostic justification, and plan for immediate workup. End-of-third-year medical students at one institution wrote notes for five standardized patient cases in May 2013 (n = 180) and 2014 (n = 177). Each case was scored using a four-point rubric to rate each of the four note components. Descriptive statistics and item analyses were computed and a generalizability study done. Across cases, 10% to 48% provided no diagnostic justification or had several missing or incorrect links between history and physical findings and diagnoses. The average intercase correlation for justification scores ranged from 0.06 to 0.16; internal consistency reliability of justification scores (coefficient alpha across cases) was 0.38. Overall, justification scores had the highest mean item discrimination across cases. The generalizability study showed that person-case interaction (12%) and task-case interaction (13%) had the largest variance components, indicating substantial case specificity. The diagnostic justification task provides unique information about student achievement and curricular gaps. Students struggled to correctly justify their diagnoses; performance was highly case specific. Diagnostic justification was the most discriminating element of the patient note and had the greatest variability in student performance across cases. The curriculum should provide a wide range of clinical cases and emphasize recognition and interpretation of clinically discriminating findings to promote the development of clinical reasoning skills.

Quality Service in the International Hotel Sector: A Catalyst for Strategic Human Resource Development?

ERIC Educational Resources Information Center

Maxwell, Gill; Watson, Sandra; Quail, Samantha

2004-01-01

This paper analyses the nature of, and relationship between, a quality service initiative and the concept of strategic human resource development. Hilton International is the case study used for this analysis. The principal finding is that the quality initiative is acting as a catalyst for a strategic approach to human resource development to…

Teachers' Perceptions of the Impact of Professional Development on Learning and Teaching in a Developing Nation

ERIC Educational Resources Information Center

Mohan, Parmeshwar Prasad; Lingam, Govinda Ishwar; Chand, Deepa Dewali

2017-01-01

This research examined teachers' perceptions of the impact of Professional Development (PD) programmes on learning and teaching in two Fijian secondary schools. Through a qualitative research design, data were gathered using document analysis and semi-structured interviews with 30 teachers from the two case study schools. The major findings to…

Developing School Leaders: Practitioner Growth during an Advanced Leadership Development Program for Principals and Administrator-Trained Teachers

ERIC Educational Resources Information Center

Browne-Ferrigno, Tricia

2007-01-01

This article shares findings from an exploratory case study about an advanced school leadership development program designed specifically for practicing principals and administrator-trained teachers. The program was designed to help a high-need rural district transform its principalship from school management into learner-center leadership while…

Developing a Deeper Understanding of Community-Based Pedagogies with Teachers: Learning with and from Teachers in Colombia

ERIC Educational Resources Information Center

Sharkey, Judy; Clavijo Olarte, Amparo; Ramírez, Luz Maribel

2016-01-01

Here we share findings from a 9-month qualitative case study involving a school-university professional development inquiry into how teachers develop, implement, and interpret community-based pedagogies (CBPs), an asset-based approach to curriculum that acknowledges mandated standards but begins with recognizing and valuing local knowledge. After…

Application of the critical pathway and integrated case teaching method to nursing orientation.

PubMed

Goodman, D

1997-01-01

Nursing staff development programs must be responsive to current changes in healthcare. New nursing staff must be prepared to manage continuous change and to function competently in clinical practice. The orientation pathway, based on a case management model, is used as a structure for the orientation phase of staff development. The integrated case is incorporated as a teaching strategy in orientation. The integrated case method is based on discussion and analysis of patient situations with emphasis on role modeling and integration of theory and skill. The orientation pathway and integrated case teaching method provide a useful framework for orientation of new staff. Educators, preceptors and orientees find the structure provided by the orientation pathway very useful. Orientation that is developed, implemented and evaluated based on a case management model with the use of an orientation pathway and incorporation of an integrated case teaching method provides a standardized structure for orientation of new staff. This approach is designed for the adult learner, promotes conceptual reasoning, and encourages the social and contextual basis for continued learning.

25-hydroxyvitamin D and breast cancer, colorectal cancer, and colorectal adenomas: case-control versus nested case-control studies.

PubMed

Grant, William B

2015-02-01

Existing literature includes concerns regarding reliability of case-control studies of breast cancer incidence with respect to 25-hydroxyvitamin D (25(OH)D) concentrations. For breast cancer, only case-control studies consistently find inverse correlations between 25(OH)D and breast cancer. However, for colorectal cancer, nested case-control studies find significant inverse correlations with respect to 25(OH)D concentrations at baseline for mean follow-up times of 7 years. This is a review of results currently existing in literature. I provide evidence that 25(OH)D concentration values are only useful for short follow-up times for breast cancer since it develops rapidly. To support the robust nature of breast cancer case-control studies, I show that results from 11 studies from seven countries align in a robust power-law fit to the odds ratio versus mean 25(OH)D concentrations. Case-control studies of breast cancer incidence rates provide reliable results. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Extragastrointestinal stromal tumor of the mesoappendix: CT findings and a review of the literature

PubMed Central

2012-01-01

Background Gastrointestinal stromal tumors (GISTs) are nonepithelial, mesenchymal neoplasms that rarely occur in children. Case presentation We present a unique case of a GIST that developed outside the gastrointestinal tract within the mesoappendix of a 6-year old boy. Computed tomography (CT) revealed a slightly lobulated, homogeneous soft-tissue mass, with marked contrast enhancement. Conclusion This case study provides new insight into the CT appearance of extragastrointestinal stromal tumors. PMID:23039908

R&D in Vaccines Targeting Neglected Diseases: An Exploratory Case Study Considering Funding for Preventive Tuberculosis Vaccine Development from 2007 to 2014

PubMed Central

Costa Barbosa Bessa, Theolis; Santos de Aragão, Erika; Medeiros Guimarães, Jane Mary

2017-01-01

Based on an exploratory case study regarding the types of institutions funding the research and development to obtain new tuberculosis vaccines, this article intends to provoke discussion regarding the provision of new vaccines targeting neglected disease. Although our findings and discussion are mainly relevant to the case presented here, some aspects are more generally applicable, especially regarding the dynamics of development in vaccines to prevent neglected diseases. Taking into account the dynamics of innovation currently seen at work in the vaccine sector, a highly concentrated market dominated by few multinational pharmaceutical companies, we feel that global PDP models can play an important role throughout the vaccine development cycle. In addition, the authors call attention to issues surrounding the coordination of actors and resources in the research, development, manufacturing, and distribution processes of vaccine products arising from PDP involvement. PMID:28133608

Nanotechnology in Mexico: Key Findings Based on OECD Criteria

ERIC Educational Resources Information Center

Foladori, Guillermo; Arteaga Figueroa, Edgar; Záyago Lau, Edgar; Appelbaum, Richard; Robles-Belmont, Eduardo; Villa, Liliana; Parker, Rachel; Leos, Vanessa

2015-01-01

This analysis of Mexico's nanotechnology policies utilizes indicators developed by the Organization for Economic Co-operation and Development, which in 2008 conducted a pilot survey comparing the nanotechnology policies of 24 countries. In this paper, we apply the same questionnaire to the Mexican case, adding business information derived from the…

Developing Instructional Leaders through Assistant Principals' Academy: A Partnership for Success

ERIC Educational Resources Information Center

Gurley, D. Keith; Anast-May, Linda; Lee, H. T.

2015-01-01

This article describes findings from a single-case qualitative study of a unique 2-year professional development academy for practicing assistant principals designed and implemented in partnership between school district personnel and university educational leadership faculty members. The study was conducted based on the theoretical framework of…

Distributing Leadership to Establish Developing and Learning School Organisations in the Swedish Context

ERIC Educational Resources Information Center

Liljenberg, Mette

2015-01-01

Leadership is considered to be significant for creating a developing and learning school organisation. In Sweden, distributed leadership and teacher teams are an "institutionalised practice"; despite this, sustainable school improvement is difficult to achieve. This article presents findings from a case study of three schools that…

Personal, Professional Coaching: Transforming Professional Development for Teacher and Administrative Leaders

ERIC Educational Resources Information Center

Patti, Janet; Holzer, Allison A.; Stern, Robin; Brackett, Marc A.

2012-01-01

This article makes the case for a different approach to the professional development of teachers and school leaders called personal, professional coaching (PPC). Personal, professional coaching is grounded in reflective practices that cultivate self-awareness, emotion management, social awareness, and relationship management. Findings from two…

Developing Internationalisation Strategies, University of Winchester, UK

ERIC Educational Resources Information Center

Neale, Richard Hugh; Spark, Alasdair; Carter, Joy

2018-01-01

Purpose: Internationalisation has been a theme in UK higher education for a decade or more. The review of this paper, a practice-based case study, is to find how Winchester formulated two successive internationalisation strategies. Design/methodology/approach: The strategies were developed using a research-oriented method: grounded in the…

"Coursera" Online Course: A Platform for English Teachers' Meaningful and Vibrant Professional Development

ERIC Educational Resources Information Center

Silvia, Arnis

2015-01-01

This article reports on English teachers' attitudes towards a professional development program run by "Coursera" ("coursera.org"). These teachers were participants of "Foundation of Teaching for Learning 1: Introduction" online course. Using a survey case study, the findings reveal that most of the participants…

Equine disorders of sexual development in 17 mares including XX, SRY-negative, XY, SRY-negative and XY, SRY-positive genotypes.

PubMed

Villagómez, D A F; Lear, T L; Chenier, T; Lee, S; McGee, R B; Cahill, J; Foster, R A; Reyes, E; St John, E; King, W A

2011-01-01

We described the clinical, cytogenetic and molecular findings of 17 clinical equine cases presented for abnormal sexual development and infertility. Six horses with an enlarged clitoris had an XX, SRY-negative genotype, which displayed male-like behavior (adult individuals). Bilateral ovotestes were noted in 2 of those cases, while another case showed increased levels of circulating testosterone. Six horses with a female phenotype, including normal external genitalia, had an XY, SRY-negative genotype. These individuals had small gonads and an underdeveloped internal reproductive tract. Four horses with normal appearing external genitalia had an XY, SRY-positive genotype, 3 of them had hypoplastic testes and male-like behavior. In addition, one young filly with enlarged clitoris and hypoplastic testes had the same genotype but did not show male-like behavior due to her age. Three of these horses were related with 2 being siblings. These findings demonstrate the diversity of disorders of sexual development seen in the horse. Furthermore, they emphasize the need for further research to identify genes involved in abnormal sex determination and differentiation in the horse. Copyright © 2010 S. Karger AG, Basel.

CaseLog: semantic network interface to a student computer-based patient record system.

PubMed Central

Cimino, C.; Goldman, E. K.; Curtis, J. A.; Reichgott, M. J.

1993-01-01

We have developed a computer program called CaseLog, which serves as an exemplary, computer-based patient record (CPR) system. The program allows for the introduction of the students to issues unique to patient record systems. These include record security, unique patient identifiers, and the use of controlled vocabularies. A particularly challenging aspect of the development of this program was allowing for student entry of controlled vocabulary terms. There were four goals we wished to achieve: students should be able to find the terms they are looking for; once a term has been found, it should be easy to find contextually related terms; it should be easy to determine that a sought-for term is not in the vocabulary; and the structure of the vocabulary should be dynamically altered by contextual information to allow its use for a variety of purposes. We chose a semantic network for our vocabulary structure. Within the processing power of the equipment we were working with, we achieved our goals. This paper will describe the development of the vocabulary, the design of the CaseLog program, and the feedback from student users of the program. PMID:8130581

Mucinous cystadenocarcinoma of the breast: a case report and review of the literature.

PubMed

Honma, Naoko; Sakamoto, Goi; Ikenaga, Motoko; Kuroiwa, Kojiro; Younes, Mamoun; Takubo, Kaiyo

2003-08-01

We report a case of mucinous cystadenocarcinoma (MCA) of the breast in a 96-year-old woman. This is an extremely rare variant of primary breast carcinoma that bears a striking resemblance to MCAs of the ovary and pancreas. The macroscopic appearance and secretion pattern (cytologic findings) resembled cystic hypersecretory carcinoma. However, microscopically, the epithelial cells were quite different from those of cystic hypersecretory carcinoma. In the present study as well as in the literature, MCAs tend to occur more frequently in elderly women. Immunohistochemical findings suggest that they may develop independently of estrogenic stimulation. Although MCAs show high proliferative activity, the prognosis was favorable in the present case as well as in the reported cases. Because MCAs appear to have a distinct pathogenesis and biologic behavior, they should be distinguished from ordinary mucinous carcinomas, cystic hypersecretory carcinomas, and carcinomas of other histologic subtypes.

Progressive supranuclear palsy: neuropathologically based diagnostic clinical criteria.

PubMed Central

Collins, S J; Ahlskog, J E; Parisi, J E; Maraganore, D M

1995-01-01

All cases examined postmortem at the Mayo Clinic that met the classic neuropathological criteria for progressive supranuclear palsy (PSP) were identified for retrospective clinical analyses. The necropsy material was re-examined by a second neuropathologist to confirm the pathological diagnosis of PSP, yielding 12 cases. A range of clinical signs were documented in these patients, with numerous findings beyond those noted in the original descriptions of this disorder. Atypical clinical findings included absence of supranuclear gaze palsy (two cases), prominent asymmetry (two), arm dystonia (two), upper limb apraxia (two), myoclonus (two), chorea (one), eyelid opening apraxia (one), and respiratory disturbance (one). A definite clinical diagnosis of PSP had been made during life in only eight of the 12 patients. From the retrospective analysis of these 12 cases, a set of clinical criteria were developed for the premortem diagnosis of PSP emphasising differences from other akinetic-rigid disorders. PMID:7876846

Development and validation of case-finding algorithms for the identification of patients with anti-neutrophil cytoplasmic antibody-associated vasculitis in large healthcare administrative databases.

PubMed

Sreih, Antoine G; Annapureddy, Narender; Springer, Jason; Casey, George; Byram, Kevin; Cruz, Andy; Estephan, Maya; Frangiosa, Vince; George, Michael D; Liu, Mei; Parker, Adam; Sangani, Sapna; Sharim, Rebecca; Merkel, Peter A

2016-12-01

The aim of this study was to develop and validate case-finding algorithms for granulomatosis with polyangiitis (Wegener's, GPA), microscopic polyangiitis (MPA), and eosinophilic GPA (Churg-Strauss, EGPA). Two hundred fifty patients per disease were randomly selected from two large healthcare systems using the International Classification of Diseases version 9 (ICD9) codes for GPA/EGPA (446.4) and MPA (446.0). Sixteen case-finding algorithms were constructed using a combination of ICD9 code, encounter type (inpatient or outpatient), physician specialty, use of immunosuppressive medications, and the anti-neutrophil cytoplasmic antibody type. Algorithms with the highest average positive predictive value (PPV) were validated in a third healthcare system. An algorithm excluding patients with eosinophilia or asthma and including the encounter type and physician specialty had the highest PPV for GPA (92.4%). An algorithm including patients with eosinophilia and asthma and the physician specialty had the highest PPV for EGPA (100%). An algorithm including patients with one of the diagnoses (alveolar hemorrhage, interstitial lung disease, glomerulonephritis, and acute or chronic kidney disease), encounter type, physician specialty, and immunosuppressive medications had the highest PPV for MPA (76.2%). When validated in a third healthcare system, these algorithms had high PPV (85.9% for GPA, 85.7% for EGPA, and 61.5% for MPA). Adding the anti-neutrophil cytoplasmic antibody type increased the PPV to 94.4%, 100%, and 81.2% for GPA, EGPA, and MPA, respectively. Case-finding algorithms accurately identify patients with GPA, EGPA, and MPA in administrative databases. These algorithms can be used to assemble population-based cohorts and facilitate future research in epidemiology, drug safety, and comparative effectiveness. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Development and Validation of Case-Finding Algorithms for the Identification of Patients with ANCA-Associated Vasculitis in Large Healthcare Administrative Databases

PubMed Central

Sreih, Antoine G.; Annapureddy, Narender; Springer, Jason; Casey, George; Byram, Kevin; Cruz, Andy; Estephan, Maya; Frangiosa, Vince; George, Michael D.; Liu, Mei; Parker, Adam; Sangani, Sapna; Sharim, Rebecca; Merkel, Peter A.

2016-01-01

Purpose To develop and validate case-finding algorithms for granulomatosis with polyangiitis (Wegener’s, GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA). Methods 250 patients per disease were randomly selected from 2 large healthcare systems using the International Classification of Diseases version 9 (ICD9) codes for GPA/EGPA (446.4) and MPA (446.0). 16 case-finding algorithms were constructed using a combination of ICD9 code, encounter type (inpatient or outpatient), physician specialty, use of immunosuppressive medications, and the anti-neutrophil cytoplasmic antibody (ANCA) type. Algorithms with the highest average positive predictive value (PPV) were validated in a third healthcare system. Results An algorithm excluding patients with eosinophilia or asthma and including the encounter type and physician specialty had the highest PPV for GPA (92.4%). An algorithm including patients with eosinophilia and asthma and the physician specialty had the highest PPV for EGPA (100%). An algorithm including patients with one of the following diagnoses: alveolar hemorrhage, interstitial lung disease, glomerulonephritis, acute or chronic kidney disease, the encounter type, physician specialty, and immunosuppressive medications had the highest PPV for MPA (76.2%). When validated in a third healthcare system, these algorithms had high PPV (85.9% for GPA, 85.7% for EGPA, and 61.5% for MPA). Adding the ANCA type increased the PPV to 94.4%, 100%, and 81.2% for GPA, EGPA, and MPA respectively. Conclusion Case-finding algorithms accurately identify patients with GPA, EGPA, and MPA in administrative databases. These algorithms can be used to assemble population-based cohorts and facilitate future research in epidemiology, drug safety, and comparative effectiveness. PMID:27804171

The Impact of Mass and Universal Higher Education on Curriculum and Instruction: Case Studies of China and Japan

ERIC Educational Resources Information Center

Huang, Futao

2017-01-01

Based on case studies of China and Japan, this study undertakes comparative research on major aspects of university curriculum and instruction-teaching activities of academics, their role in curriculum development, and their perceptions of these activities--between a mass and a universal higher education system. Major findings from the APA…

76 FR 31282 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition To List Puerto...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-31

... natural features and historic value has the potential to be developed to promote tourisms. Further, the... certain cases of lack of enforcement that have led to threats to the species and its habitat. For these... cases. Species that are dependent on specialized habitat types, that are limited in distribution or that...

Teaching Science for Empowerment in an Urban Classroom: A Case Study of a Hmong Teacher

ERIC Educational Resources Information Center

Upadhyay, Bhaskar

2009-01-01

This is a case study of Lee, a Hmong teacher, who reflects on her own schooling experiences in order to develop a culturally sensitive pedagogy based on empowerment and funds of knowledge. The findings indicate that Lee teaches science effectively using culturally sensitive pedagogy--utilizing Hmong students' and parents' funds of knowledge in…

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures

PubMed Central

Weidauer, Lee A.; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-01-01

Background: Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. Purpose: To determine factors associated with the development of stress fractures in female athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. Results: No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). Conclusion: A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures. PMID:26535343

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures.

PubMed

Weidauer, Lee A; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-07-01

Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. To determine factors associated with the development of stress fractures in female athletes. Case-control study; Level of evidence, 3. A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures.

Late onset GM2 gangliosidosis presenting with motor neuron disease: an autopsy case.

PubMed

Yokoyama, Teruo; Nakamura, Seigo; Horiuchi, Emiko; Ishiyama, Miyako; Kawashima, Rei; Nakamura, Kazuo; Hasegawa, Kazuko; Yagishita, Saburo

2014-06-01

Adult-onset GM2 gangliosidosis is very rare and only three autopsy cases have been reported up to now. We report herein an autopsy case of adult-onset GM2 gangliosidosis. The patient developed slowly progressive motor neuron disease-like symptoms after longstanding mood disorder and cognitive dysfunction. He developed gait disturbance and weakness of lower limbs at age 52 years. Because of progressive muscle weakness and atrophy, he became bed-ridden at age 65. At age of 68, he died. His neurological findings presented slight cognitive disturbance, slight manic state, severe muscle weakness, atrophy of four limbs and no extrapyramidal signs and symptoms, and cerebellar ataxia. Neuropathologically, mild neuronal loss and abundant lipid deposits were noted in the neuronal cytoplasm throughout the nervous system, including peripheral autonomic neurons. The most outstanding findings were marked neuronal loss and distended neurons in the anterior horn of the spinal cord, which supports his clinical symptomatology of lower motor neuron disease in this case. The presence of lipofuscin, zebra bodies and membranous cytoplasmic bodies (MCB) and the increase of GM2 ganglioside by biochemistry led to diagnosis of GM2 gangliosidosis. © 2013 Japanese Society of Neuropathology.

In response to 'Can sugars be produced from fatty acids? A test case for pathway analysis tools'.

PubMed

Faust, Karoline; Croes, Didier; van Helden, Jacques

2009-12-01

In their article entitled 'Can sugars be produced from fatty acids? A test case for pathway analysis tools' de Figueiredo and co-authors assess the performance of three pathway prediction tools (METATOOL, PathFinding and Pathway Hunter Tool) using the synthesis of glucose-6-phosphate (G6P) from acetyl-CoA in humans as a test case. We think that this article is biased for three reasons: (i) the metabolic networks used as input for the respective tools were of very different sizes; (ii) the 'assessment' is restricted to two study cases; (iii) developers are inherently more skilled to use their own tools than those developed by other people. We extended the analyses led by de Figueiredo and clearly show that the apparent superior performance of their tool (METATOOL) is partly due to the differences in input network sizes. We also see a conceptual problem in the comparison of tools that serve different purposes. In our opinion, metabolic path finding and elementary mode analysis are answering different biological questions, and should be considered as complementary rather than competitive approaches. Supplementary data are available at Bioinformatics online.

Rheumatoid arthritis (RA)-specific autoantibodies in patients with interstitial lung disease and absence of clinically apparent articular RA.

PubMed

Gizinski, Alison M; Mascolo, Margherita; Loucks, Jennifer L; Kervitsky, Alma; Meehan, Richard T; Brown, Kevin K; Holers, V Michael; Deane, Kevin D

2009-05-01

The purpose of this study was to identify rheumatoid arthritis (RA)-related autoantibodies in subjects with interstitial lung disease (ILD) and no articular findings of RA, supporting the hypothesis that RA-related autoimmunity may be generated in non-articular sites, such as the lung. This was a retrospective chart review utilizing clinic databases of patients with ILD to identify cases with lung disease, RA-related autoantibody positivity, and no clinical evidence of articular RA. Four patients with ILD, RF, and anti-CCP positivity and no articular findings of RA were identified. All four patients were male with a mean age at time of diagnosis of ILD of 70 years old. All had a history of smoking. Three patients died within 2 years of diagnosis of ILD and never developed articular symptoms consistent with RA; the final case met full criteria for articular RA several months after stopping immunosuppressive treatment for ILD. RF and anti-CCP can be present in smokers with ILD without clinical evidence of articular RA and in one case symptomatic ILD and autoantibody positivity preceded the development of articular RA. These findings suggest that RA-specific autoimmunity may be generated due to immunologic interactions in the lung and may be related to environmental factors such as smoking.

Two rare cases of adult-onset phalangeal microgeodic syndrome with magnetic resonance imaging-proven bone edema transiently occurring in winter.

PubMed

Nishino, Ayako; Kawashiri, Shin-ya; Nakashima, Yoshikazu; Kawakami, Atsushi

2013-10-01

We report two rare cases of adult-onset phalangeal microgeodic syndrome (PMS), which commonly develops in children. Both cases were Japanese women, with case 1: 60 years old and case 2: 58 years old. They developed swelling and stiffness in their fingers in winter, and their symptoms disappeared without any treatment in summer. Magnetic resonance imaging (MRI) of bilateral hands showed diffuse bone edema of the middle and proximal phalanges in winter, but the abnormal findings also disappeared in summer. The specific abnormalities observed on MRI were very useful for the diagnosis of PMS. Interestingly, they appeared in winter and disappeared in summer in parallel with the symptoms. Copyright © 2013 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Hemiconvulsion-hemiplegia-epilepsy syndrome: characteristic early magnetic resonance imaging findings.

PubMed

Freeman, Jeremy L; Coleman, Lee T; Smith, Lindsay J; Shield, Lloyd K

2002-01-01

We report three patients with hemiconvulsion-hemiplegia-epilepsy syndrome who presented acutely and were shown to have striking neuroimaging findings suggestive of diffuse cytotoxic edema confined to one hemisphere, including extensive diffusion-weighted imaging abnormalities in two cases. Two patients subsequently developed progressive and extensive atrophy of the involved hemisphere. These findings are consistent with earlier descriptions of the classic neuroradiologic features of this syndrome and are helpful in the differential diagnosis of acute infantile hemiplegia. Further, the findings support the previously proposed pathogenetic mechanism of neuronal injury caused by status epilepticus.

Publishing a Simulation Game.

ERIC Educational Resources Information Center

Gohring, Ralph J.

1979-01-01

A case study describing the process involved in publishing a personally developed simulation game including finding a publisher, obtaining a copyright, negotiating the contract, controlling front-end costs, marketing the product, and receiving feedback from users. (CMV)

Nondestructive Testing System for Retreads

DOT National Transportation Integrated Search

1975-11-01

An important problem in retreading tires is the assurance of a satisfactory casing. Since 1972 the National Highway Traffic Safety Administration has had under development an air-coupled through-transmission ultrasonic inspection system for finding a...

A Simulation Study Comparing Procedures for Assessing Individual Educational Growth. Report No. 182.

ERIC Educational Resources Information Center

Richards, James M., Jr.

A computer simulation procedure was developed to reproduce the overall pattern of results obtained in the Educational Testing Service Growth Study. Then simulated data for seven sets of 10,000 to 15,000 cases were analyzed, and findings compared on the basis of correlations between estimated and true growth scores. Findings showed that growth was…

Educating Young Adults to Be Work-Ready in Ireland and the United Kingdom: A Review of Programmes and Outcomes

ERIC Educational Resources Information Center

Symonds, Jennifer E.; O'Sullivan, Carmel

2017-01-01

Across Europe, young adult unemployment remains an important issue. Those who have grown up in contexts of social and educational disadvantage can find it particularly difficult to find work. In response, governments, charitable foundations and in the rare case, researchers, have developed programmes of training and work-based learning to help…

Pathologic Outcomes following Urethral Diverticulectomy in Women

PubMed Central

Laudano, Melissa A.; Jamzadeh, Asha E.; Lee, Richard K.; Robinson, Brian D.; Tyagi, Renuka; Kaplan, Steven A.; Te, Alexis E.

2014-01-01

Purpose. Although most urethral diverticula in women are benign, there is a subset of patients who develop malignant changes. Limited studies report the pathologic findings associated with this relatively rare entity. We describe the clinicopathologic findings of women who underwent urethral diverticulectomy. Methods. A consecutive series of 29 women who underwent surgical resection of a urethral diverticulum were identified between 1992 and 2013. Clinical and radiographic data was collected by retrospective review of patient medical records. All pathological slides were rereviewed by a single urologic pathologist. Results. Of the 14 women with clinical data, 9 (64%) presented with urgency, 7 (50%) with urinary frequency, 3 (21%) with urinary incontinence, and 3 (21%) with dysuria. Mean diverticular size was 2.3 (±1.4) cm. Although one patient (3%) had invasive adenocarcinoma on final pathology, the remaining 28 cases (97%) demonstrated benign features. The most common findings were inflammation (55%) and nephrogenic adenoma (21%). Conclusions. Although most urethral diverticula in women are benign, there is a subset of patients who develop malignancy in association with the diverticulum. In this series, 97% of cases had a benign histology. These findings are important when counseling patients regarding treatment options. PMID:24860605

Pathologic Outcomes following Urethral Diverticulectomy in Women.

PubMed

Laudano, Melissa A; Jamzadeh, Asha E; Dunphy, Claire; Lee, Richard K; Robinson, Brian D; Tyagi, Renuka; Kaplan, Steven A; Te, Alexis E; Chughtai, Bilal

2014-01-01

Purpose. Although most urethral diverticula in women are benign, there is a subset of patients who develop malignant changes. Limited studies report the pathologic findings associated with this relatively rare entity. We describe the clinicopathologic findings of women who underwent urethral diverticulectomy. Methods. A consecutive series of 29 women who underwent surgical resection of a urethral diverticulum were identified between 1992 and 2013. Clinical and radiographic data was collected by retrospective review of patient medical records. All pathological slides were rereviewed by a single urologic pathologist. Results. Of the 14 women with clinical data, 9 (64%) presented with urgency, 7 (50%) with urinary frequency, 3 (21%) with urinary incontinence, and 3 (21%) with dysuria. Mean diverticular size was 2.3 (±1.4) cm. Although one patient (3%) had invasive adenocarcinoma on final pathology, the remaining 28 cases (97%) demonstrated benign features. The most common findings were inflammation (55%) and nephrogenic adenoma (21%). Conclusions. Although most urethral diverticula in women are benign, there is a subset of patients who develop malignancy in association with the diverticulum. In this series, 97% of cases had a benign histology. These findings are important when counseling patients regarding treatment options.

Three cases of thyroid cancer following the diagnosis of testicular cancer: treatment-related complication or genetics?

PubMed

Spiliopoulou, Pavlina; Bowers, Sarah Pauline; Gibson, Sarah; White, Jeff; Reed, Nick

2016-05-01

Large-scale epidemiological studies have shown that the incidence of second primary thyroid cancer in subjects diagnosed and treated for testicular cancer is raised. This finding is strongly associated to treatment with radiotherapy and/or chemotherapy and it is explained by their mutagenic effect. On the other hand, inherited cancer susceptibility syndromes inducing both testicular and thyroid cancers denote that these tumours might share common genomic aberrations. We herein present our experience with three cases of metachronous development of thyroid cancer after diagnosis and treatment of testicular cancer in our tertiary cancer centre. Our case report contributes to the limited available literature on such findings and aims to raise awareness of the cancer physicians treating these particular tumour types. © The Author(s) 2016.

The Role of Research in Online Curriculum Development: The Case of "EarthLabs" Climate Change and Earth System Modules

ERIC Educational Resources Information Center

McNeal, Karen S.; Libarkin, Julie C.; Ledley, Tamara Shapiro; Bardar, Erin; Haddad, Nick; Elins, Kathy; Dutta, Saranee

2014-01-01

This study reports on an effort to illustrate the coupling of educational research with ongoing curriculum development to promote effective and evidence-based online learning. The research findings have been used to inform the "EarthLabs" curriculum development team as they revise existing modules and create new modules, in order to…

Do Online Web Resources Help Professionals to Work More Effectively? A Case Study Based on Three Sites

ERIC Educational Resources Information Center

Chambers, Gary N.; Threlfall, John; Roper, Tom

2012-01-01

This article contains important messages for all those with an interest in enhancing the effectiveness of professional development supported by websites. It is informed by the findings of a Training and Development Agency for Schools (TDA) funded evaluation of the use and effectiveness of three websites whose development the TDA had supported.…

Technology Integration in Science Education: A Study of How Teachers Use Modern Learning Technologies in Biology Classrooms

NASA Astrophysics Data System (ADS)

Gnanakkan, Dionysius Joseph

This multiple case-study investigated how high school biology teachers used modern learning technologies (probes, interactive simulations and animations, animated videos) in their classrooms and why they used the learning technologies. Another objective of the study was to assess whether the use of learning technologies alleviated misconceptions in Biology documented by American Association for the Advancement of Science. The sample consisted of eight teachers: four rural public school teachers, two public selective enrollment school teachers, and two private school teachers. Each teacher was followed for two Units of instruction. Data collected included classroom observations, field notes, student assignments and tests, teacher interviews, and pre-and post-misconception assessments. Paired t-tests were done to analyze the pre-post test data at a significance level of 0.05 and the qualitative data was analyzed using the constant comparative method. Each case study was characterized and then a cross-case analyses was done to find common themes across the different cases. Teachers were found to use the learning technologies as a tool to supplement instruction to visualize abstract processes, collect data, and explore abstract concepts and processes. Teachers were found to situate learning, use scaffolding and questioning and make students work in collaborative groups. The genetics, photosynthesis, and evolution misconceptions were better alleviated than cellular respiration. Student work that was collected demonstrated a superficial understanding of the concepts under discussion even when they had misconceptions. The teachers used the learning technologies in their classrooms for a variety of reasons: visual illustrations, time-saving measure to collect data, best way to collect data, engaging and fun for students and the interactive nature of the visualization tools and models. The study's findings had many implications for research, professional development, teacher education, teaching practice, administrators, and learning technology developers. More detailed research within similar school settings (public, charter, and private) is needed to verify the common findings across the different cases in this study. An implication is that learning technology integration could be modeled with instructional scaffolds and questioning and incorporating higher order thinking tasks. Learning technology developers should consider the collaborative learning groups while developing these technologies.

Childhood hematologic cancer and residential proximity to oil and gas development.

PubMed

McKenzie, Lisa M; Allshouse, William B; Byers, Tim E; Bedrick, Edward J; Serdar, Berrin; Adgate, John L

2017-01-01

Oil and gas development emits known hematological carcinogens, such as benzene, and increasingly occurs in residential areas. We explored whether residential proximity to oil and gas development was associated with risk for hematologic cancers using a registry-based case-control study design. Participants were 0-24 years old, living in rural Colorado, and diagnosed with cancer between 2001-2013. For each child in our study, we calculated inverse distance weighted (IDW) oil and gas well counts within a 16.1-kilometer radius of residence at cancer diagnosis for each year in a 10 year latency period to estimate density of oil and gas development. Logistic regression, adjusted for age, race, gender, income, and elevation was used to estimate associations across IDW well count tertiles for 87 acute lymphocytic leukemia (ALL) cases and 50 non-Hodgkin lymphoma (NHL) cases, compared to 528 controls with non-hematologic cancers. Overall, ALL cases 0-24 years old were more likely to live in the highest IDW well count tertiles compared to controls, but findings differed substantially by age. For ages 5-24, ALL cases were 4.3 times as likely to live in the highest tertile, compared to controls (95% CI: 1.1 to 16), with a monotonic increase in risk across tertiles (trend p-value = 0.035). Further adjustment for year of diagnosis increased the association. No association was found between ALL for children aged 0-4 years or NHL and IDW well counts. While our study benefited from the ability to select cases and controls from the same population, use of cancer-controls, the limited number of ALL and NHL cases, and aggregation of ages into five year ranges, may have biased our associations toward the null. In addition, absence of information on O&G well activities, meteorology, and topography likely reduced temporal and spatial specificity in IDW well counts. Because oil and gas development has potential to expose a large population to known hematologic carcinogens, further study is clearly needed to substantiate both our positive and negative findings. Future studies should incorporate information on oil and gas development activities and production levels, as well as levels of specific pollutants of interest (e.g. benzene) near homes, schools, and day care centers; provide age-specific residential histories; compare cases to controls without cancer; and address other potential confounders, and environmental stressors.

Defining datasets and creating data dictionaries for quality improvement and research in chronic disease using routinely collected data: an ontology-driven approach.

PubMed

de Lusignan, Simon; Liaw, Siaw-Teng; Michalakidis, Georgios; Jones, Simon

2011-01-01

The burden of chronic disease is increasing, and research and quality improvement will be less effective if case finding strategies are suboptimal. To describe an ontology-driven approach to case finding in chronic disease and how this approach can be used to create a data dictionary and make the codes used in case finding transparent. A five-step process: (1) identifying a reference coding system or terminology; (2) using an ontology-driven approach to identify cases; (3) developing metadata that can be used to identify the extracted data; (4) mapping the extracted data to the reference terminology; and (5) creating the data dictionary. Hypertension is presented as an exemplar. A patient with hypertension can be represented by a range of codes including diagnostic, history and administrative. Metadata can link the coding system and data extraction queries to the correct data mapping and translation tool, which then maps it to the equivalent code in the reference terminology. The code extracted, the term, its domain and subdomain, and the name of the data extraction query can then be automatically grouped and published online as a readily searchable data dictionary. An exemplar online is: www.clininf.eu/qickd-data-dictionary.html Adopting an ontology-driven approach to case finding could improve the quality of disease registers and of research based on routine data. It would offer considerable advantages over using limited datasets to define cases. This approach should be considered by those involved in research and quality improvement projects which utilise routine data.

Explaining resource consumption among non-normal neonates

PubMed Central

Schwartz, Rachel M.; Michelman, Thomas; Pezzullo, John; Phibbs, Ciaran S.

1991-01-01

The adoption by Medicare in 1983 of prospective payment using diagnosis-related groups (DRGs) has stimulated research to develop case-mix grouping schemes that more accurately predict resource consumption by patients. In this article, the authors explore a new method designed to improve case-mix classification for newborns through the use of birth weight in combination with DRGs to adjust the unexplained case-mix severity. Although the findings are developmental in nature, they reveal that the model significantly improves our ability to explain resource use. PMID:10122360

Orthochina.org: case-based orthopaedic Wiki project in China.

PubMed

Ma, Zhen-Sheng; Zhang, Hong-Ju; Yu, Tao; Ren, Gang; Du, Guo-Sheng; Wang, Yong-Hua

2008-10-01

Traditional continuing medical education (CME) depended primarily on periodic courses and conferences. The cost-effectiveness of these courses has not been established, and often the content is not tailored to best meet the needs of the students. Internet training has the potential to accomplish these goals. Over the last 10 years, we have developed a Web site entitled "Orthochina.org," based upon the wiki concept, which uses an interactive, case-based format. We describe the development of online case discussions, and various technical and administrative requirements. As of December 31, 2007, there were 33,984 registered users, 9,759 of which passed the confirmation procedures. In 2007, an average of 211 registrants visited daily. The average number of first page clicks was 4,248 per day, and the average number of posts was 70 per day. All cases submitted for discussion include the patient's complaint, physical examination findings, and relevant images based on specific criteria for case discussion. The case discussions develop well professionally. No spam posting or unauthorized personal advertisement is permitted. In conclusion, online academic discussions proceed well when the orthopaedic surgeons who participate have established their identities.

Neurological features and management of Wilson disease in children: an evaluation of 12 cases.

PubMed

Bayram, Ayşe Kaçar; Gümüş, Hakan; Arslan, Duran; Özçora, Güldemet Kaya; Kumandaş, Sefer; Karacabey, Neslihan; Canpolat, Mehmet; Per, Hüseyin

2016-03-01

Wilson's disease is an autosomal recessive disorder of copper metabolism which leads to copper overload in different tissues of the body. The aim of this study was to present the neurologic features of Wilson's disease and to assess the clinical course of neurological findings in children receiving anti-copper treatment. Twelve children with a diagnosis of Wilson's disease and findings of central nervous system involvement who were followed up in the Department of Pediatric Neurology and Pediatric Gastroenterology of the School of Medicine at Erciyes University were enrolled in the study. The study cases consisted of five boys (42%) and seven girls (58%). The mean age at the time of diagnosis was 9.9±3.4 years (5-15 years). The mean duration of follow-up was 49.0±36.4 months (15-128 months). Neurological findings at presentation included headache in seven cases (58%), tremor in seven cases (58%), dystonia in three cases (25%), ataxia in two cases (17%), dizziness in two cases (17%), numbness in the hands and acute weakness in one case (8%) and syncope in one case (8%). Headache, dizziness, syncope, numbness in hands and acute weakness symptoms resolved completely within six months after receiving treatment. Movement disorders either decreased or remained stable in seven of the eight cases. However, one patient developed progressively worsening dystonia despite to all treatments. Wilson's disease can be manifested with signs and symptoms of central nervous system in the childhood. Wilson's disease should be considered in all children presenting with movement disorders. A complete neurological assessment should be carried out in all cases with Wilson's disease.

Neurological features and management of Wilson disease in children: an evaluation of 12 cases

PubMed Central

Bayram, Ayşe Kaçar; Gümüş, Hakan; Arslan, Duran; Özçora, Güldemet Kaya; Kumandaş, Sefer; Karacabey, Neslihan; Canpolat, Mehmet; Per, Hüseyin

2016-01-01

Aim: Wilson’s disease is an autosomal recessive disorder of copper metabolism which leads to copper overload in different tissues of the body. The aim of this study was to present the neurologic features of Wilson’s disease and to assess the clinical course of neurological findings in children receiving anti-copper treatment. Material and Methods: Twelve children with a diagnosis of Wilson’s disease and findings of central nervous system involvement who were followed up in the Department of Pediatric Neurology and Pediatric Gastroenterology of the School of Medicine at Erciyes University were enrolled in the study. Results: The study cases consisted of five boys (42%) and seven girls (58%). The mean age at the time of diagnosis was 9.9±3.4 years (5–15 years). The mean duration of follow-up was 49.0±36.4 months (15–128 months). Neurological findings at presentation included headache in seven cases (58%), tremor in seven cases (58%), dystonia in three cases (25%), ataxia in two cases (17%), dizziness in two cases (17%), numbness in the hands and acute weakness in one case (8%) and syncope in one case (8%). Headache, dizziness, syncope, numbness in hands and acute weakness symptoms resolved completely within six months after receiving treatment. Movement disorders either decreased or remained stable in seven of the eight cases. However, one patient developed progressively worsening dystonia despite to all treatments. Conclusions: Wilson’s disease can be manifested with signs and symptoms of central nervous system in the childhood. Wilson’s disease should be considered in all children presenting with movement disorders. A complete neurological assessment should be carried out in all cases with Wilson’s disease. PMID:27103860

Müllerian agenesis with hypohidrotic ectodermal dysplasia syndrome.

PubMed

Whaley, Katie; Winter, Jordan; Eyster, Kathleen M; Hansen, Keith A

2012-04-01

To describe the association of müllerian agenesis with hypohidrotic ectodermal dysplasia. Case report. University medical center. A 17-year-old woman with hypohidrotic ectodermal dysplasia referred for evaluation of primary amenorrhea. History, physical examination, and ultrasound. Physical findings of these two syndromes. Physical examination and ultrasound demonstrated müllerian agenesis with findings of hypohidrotic ectodermal dysplasia. This is the first description of the association of müllerian agenesis with ectodermal dysplasia. This rare case might provide further insight into the development of the uterus and the ectoderm as well as its derivatives. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

A Case Study of 4 & 5 Cost Effectiveness

NASA Technical Reports Server (NTRS)

Neal, Ralph D.; McCaugherty, Dan; Joshi, Tulasi; Callahan, John

1997-01-01

This paper looks at the Independent Verification and Validation (IV&V) of NASA's Space Shuttle Day of Launch I-Load Update (DoLILU) project. IV&V is defined. The system's development life cycle is explained. Data collection and analysis are described. DoLILU Issue Tracking Reports (DITRs) authored by IV&V personnel are analyzed to determine the effectiveness of IV&V in finding errors before the code, testing, and integration phase of the software development life cycle. The study's findings are reported along with the limitations of the study and planned future research.

Pectus carinatum--first ultrastructural findings of a potential metabolic lesion.

PubMed

Brochhausen, Christoph; Müller, Felix Karl P; Turial, Salmai; James Kirkpatrick, C

2012-03-01

The histological and ultrastructural findings of rib specimens after two re-interventions in the case of recurrence of pectus carinatum (PC) are presented in this report. A 15-year-old boy developed recurrences of mild PC after re-chondroplasties using the Ravitch technique. Histological study of the resected cartilage showed markedly degenerative changes of the sternocostal cartilage. For the first time, intracellular crystalline inclusions in some of the chondrocytes were found. These findings indicate metabolic changes as a possible pathogenetic parameter in PC.

Developing and Implementing an Online Doctoral Programme

ERIC Educational Resources Information Center

Combe, Colin

2005-01-01

Purpose: This article is a critical reflection of the development and implementation of one of the first online doctoral programs in the UK set up at the University of Northumbria, Newcastle in 2000. Design/methodology/approach: The method adopted for analysis takes the form of a case study. Findings: Effective market research has to be undertaken…

Policy and Curriculum Development in Greece. the Case of Secondary School Curriculum

ERIC Educational Resources Information Center

Ifanti, Amalia A.

2007-01-01

This paper examines the politics and values of the secondary school curriculum in Greece and attempts to find out the influences of cultural tradition and centralized control on curriculum development. In particular, it studies the decision-making process and the politics of educational control, employing some theoretical elements from centralist…

Between Continuity and Change: Identities and Narratives within Teacher Professional Development

ERIC Educational Resources Information Center

Curwood, Jen Scott

2014-01-01

This year-long ethnographic case study examined high school teachers' participation in technology-focused professional development. By pairing a dialogical perspective on teacher identity with a micro-level analysis of narratives, findings indicate that teachers use language and other semiotic resources to express their own identity as well as to…

Inception, Growth, and Development of a Community College Foundation: Lessons To Be Learned.

ERIC Educational Resources Information Center

Jenkins, Larry W.; Glass, Jr., J. Conrad

1999-01-01

Many community colleges are struggling to find alternative sources of funding. This article presents a case study of a community college that established a foundation. It examines why the foundation was begun, what factors influenced its development, and how it has evolved over time. Contains 41 references. (TGO)

Tuberculosis in a South African prison – a transmission modelling analysis

PubMed Central

Johnstone-Robertson, Simon; Lawn, Stephen D; Welte, Alex; Bekker, Linda-Gail; Wood, Robin

2015-01-01

Background Prisons are recognised internationally as institutions with very high tuberculosis (TB) burdens where transmission is predominantly determined by contact between infectious and susceptible prisoners. A recent South African court case described the conditions under which prisoners awaiting trial were kept. With the use of these data, a mathematical model was developed to explore the interactions between incarceration conditions and TB control measures. Methods Cell dimensions, cell occupancy, lock-up time, TB incidence and treatment delays were derived from court evidence and judicial reports. Using the Wells-Riley equation and probability analyses of contact between prisoners, we estimated the current TB transmission probability within prison cells, and estimated transmission probabilities of improved levels of case finding in combination with implementation of national and international minimum standards for incarceration. Results Levels of overcrowding (230%) in communal cells and poor TB case finding result in annual TB transmission risks of 90% per annum. Implementing current national or international cell occupancy recommendations would reduce TB transmission probabilities by 30% and 50%, respectively. Improved passive case finding, modest ventilation increase or decreased lock-up time would minimally impact on transmission if introduced individually. However, active case finding together with implementation of minimum national and international standards of incarceration could reduce transmission by 50% and 94%, respectively. Conclusions Current conditions of detention for awaiting-trial prisoners are highly conducive for spread of drug-sensitive and drug-resistant TB. Combinations of simple well-established scientific control measures should be implemented urgently. PMID:22272961

Finding the Little 'c' in Physics: A Multiple Case Study Examining the Development of Creative Activities in the Physics Classroom

NASA Astrophysics Data System (ADS)

Wheeler, Christopher

This study focused on how physics teachers develop and implement activities that promote creative thinking strategies in the standards based physics classroom. A particular focus was placed on every day or little "c", creativity, which can be taught in the high school classroom. The study utilized a multiple case study design, which allows for in-depth study in a variety of settings. Four participants from various high schools were identified utilizing administrator recommendations. Data were then collected via interviews, observations, and documents. The data were coded and analyzed for emerging themes. The themes were then merged to determine findings to the stated research questions. The research demonstrated the importance of modifying activities for student interest and understanding through effective use of scientific inquiry. The past experiences and professional development of the participants served as a vital piece to the development of their educational pedagogy especially concerning inquiry and questioning strategies. It was also established that an unstructured, positive classroom environment is a vital aspect of teaching while supporting creative thinking skills.

Dissent by Design: Fostering Student Activism in Higher Education through a Case Study of Student Affairs in a Public University in the Philippines

ERIC Educational Resources Information Center

Bernardo, Maria Aurora Correa; Baranovich, Diana-Lea

2016-01-01

Student activism is a ubiquitous component in most democratic societies. Despite its disconcerting implications to the university's operations, it remains an important agenda to student development in higher education. This study presents the case of a university in the Philippines where student activism is a predominant ethos. The findings expose…

Preparing School Leaders for a Changing World: Case Studies of Exemplary Programs. School Leadership Study. Case Study Summaries

ERIC Educational Resources Information Center

LaPointe, Michelle, Ed.; Darling-Hammond, Linda, Ed.; Meyerson, Debra, Ed.

2007-01-01

In 2003, with funding from The Wallace Foundation, a national team of researchers organized by Stanford University and The Finance Project set out to find and examine a set of exemplary pre- and in-service professional development programs for principals, along with the policy contexts in which they operate. The purpose of the study was to…

Leveraging tuberculosis case relative locations to enhance case detection and linkage to care in Swaziland.

PubMed

Brunetti, Marie; Rajasekharan, Sathyanath; Ustero, Piluca; Ngo, Katherine; Sikhondze, Welile; Mzileni, Buli; Mandalakas, Anna; Kay, Alexander W

2018-01-01

In Swaziland, as in many high HIV/TB burden settings, there is not information available regarding the household location of TB cases for identifying areas of increased TB incidence, limiting the development of targeted interventions. Data from "Butimba", a TB REACH active case finding project, was re-analyzed to provide insight into the location of TB cases surrounding Mbabane, Swaziland. The project aimed to identify geographical areas with high TB burdens to inform active case finding efforts. Butimba implemented household contact tracing; obtaining landmark based, informal directions, to index case homes, defined here as relative locations. The relative locations were matched to census enumeration areas (known location reference areas) using the Microsoft Excel Fuzzy Lookup function. Of 403 relative locations, an enumeration area reference was detected in 388 (96%). TB cases in each census enumeration area and the active case finders in each Tinkhundla, a local governmental region, were mapped using the geographic information system, QGIS 2.16. Urban Tinkhundla predictably accounted for most cases; however, after adjusting for population, the highest density of cases was found in rural Tinkhundla. There was no correlation between the number of active case finders currently assigned to the 7 Tinkhundla surrounding Mbabane and the total number of TB cases (Spearman rho = -0.57, p  = 0.17) or the population adjusted TB cases (Spearman rho = 0.14, p  = 0.75) per Tinkhundla. Reducing TB incidence in high-burden settings demands novel analytic approaches to study TB case locations. We demonstrated the feasibility of linking relative locations to more precise geographical areas, enabling data-driven guidance for National Tuberculosis Programs' resource allocation. In collaboration with the Swazi National Tuberculosis Control Program, this analysis highlighted opportunities to better align the active case finding national strategy with the TB disease burden.

Developmental outcomes after early prefrontal cortex damage.

PubMed

Eslinger, Paul J; Flaherty-Craig, Claire V; Benton, Arthur L

2004-06-01

The neuropsychological bases of cognitive, social, and moral development are minimally understood, with a seemingly wide chasm between developmental theories and brain maturation models. As one approach to bridging ideas in these areas, we review 10 cases of early prefrontal cortex damage from the clinical literature, highlighting overall clinical profiles and real life developmental outcomes. Based on these cases, there is preliminary evidence to support distinctive developmental differences after: (1) dorsolateral, (2) mesial, and (3) orbital-polar prefrontal lesions, for more profound impairments after bilateral damage, and possibly for recovery differences after very early vs. later childhood lesion onset. Further case and group studies are needed to confirm reliable effects of specific lesion locations, the influence of age of lesion onset, and related experiential and treatment variables in determining adult outcomes. Rather than a single underlying deficit associated with early prefrontal cortex damage, we interpret the findings to suggest that it is the altered integration and interplay of cognitive, emotional, self-regulatory, and executive/metacognitive deficits that contribute to diverse developmental frontal lobe syndromes. The findings support the fundamental importance of prefrontal cortex maturation in protracted cognitive, social-emotional, and moral development.

Interface dermatitis in skin lesions of Kikuchi-Fujimoto's disease: a histopathological marker of evolution into systemic lupus erythematosus?

PubMed

Paradela, S; Lorenzo, J; Martínez-Gómez, W; Yebra-Pimentel, T; Valbuena, L; Fonseca, E

2008-12-01

Kikuchi's disease (KD) is a self-limiting histiocytic necrotizing lymphadenitis (HNL). Cutaneous manifestations are frequent and usually show histopathological findings similar to those observed in the involved lymph nodes. HNL with superposed histological features to KD has been described in patients with lupus erythematosus (LE), and a group of healthy patients previously reported as having HNL may evolve into LE after several months. Up to date, features to predict which HNL patients will have a self-limiting disease and which could develop LE have been not identified. In order to clarify the characteristics of skin lesions associated with KD, we report a case of HNL with evolution into systemic lupus erythematosus (SLE) and a review of previous reports of KD with cutaneous manifestations. A 17-year-old woman presented with a 4-month history of fever and generalised lymphadenopathy. A diagnosis of HNL was established based on a lymph node biopsy. One month later, she developed an erythematoedematous rash on her upper body, with histopathological findings of interface dermatitis. After 8 months, anti-nuclear antibodies (ANA) at titre of 1/320, anti-DNA-ds antibodies and marked decrease of complement levels were detected. During the following 2 years, she developed diagnostic criteria for SLE, with arthralgias, pleuritis, aseptic meningitis, haemolytic anaemia and lupus nephritis. To our knowledge, 27 cases of nodal and cutaneous KD have been reported, 9 of which later developed LE. In all these patients, the skin biopsy revealed interface dermatitis. Skin biopsy revealed a pattern of interface dermatitis in all reviewed KD cases, which evolved into LE. Even this histopathological finding was not previously considered significant; it might be a marker of evolution into LE.

Bronchial ulceration as a prognostic indicator for varicella pneumonia: case report and systematic literature review.

PubMed

Inokuchi, Ryota; Nakamura, Kensuke; Sato, Hajime; Shinohara, Kazuaki; Aoki, Yuta; Doi, Kent; Gunshin, Masataka; Ishii, Takeshi; Matsubara, Takehiro; Hiruma, Takahiro; Nakajima, Susumu; Yahagi, Naoki

2013-04-01

Adult varicella pneumonia is a common and serious complication of varicella zoster virus (VZV) infection in pregnant woman and immunocompromised individuals, with mortality rates of 30-50%. The poor prognosis is attributable to very aggressive disease progression and delayed onset of treatment. Here, we present a case of varicella pneumonia in a 69-year-old woman following long-term immunosuppressive treatment for kidney transplant. Respiratory failure developed within 3 d after admission for skin rash, and the patient died 28 d later despite acyclovir and foscarnet treatment. The autopsy showed extensive mucosal airway ulcerations from the pharynx to the main bronchi and numerous VZV-infected cells. We searched PubMed, Web of Science, and EMBASE (1980 through February 2012), as well as several medical report databases created by Japanese healthcare professionals, for all reported cases of varicella pneumonia for which bronchoscopy findings were documented. Twenty-four cases were included and we found that patients with limited or shallow ulcers had favorable outcomes, whereas patients with vast and deep ulcerations had fatal outcomes. These findings indicate that bronchoscopy findings, particularly those showing bronchial involvement, may be useful for evaluating varicella pneumonia. Copyright © 2012 Elsevier B.V. All rights reserved.

Bridging the gap between research and practice: The development of a digital library of research syntheses.

PubMed

Barroso, Julie; Edlin, April; Sandelowski, Margarete; Lambe, Camille

2006-01-01

This article describes the development of a digital library as a resource for clinicians and researchers working with women with HIV infection. We wanted to find a new way of communicating the findings from the 114 studies that we used as the method case. The development of the SandBar Digital Library (http://sonweb.unc.edu/sandbar), a product of a 5-year project to develop the analytic techniques for qualitative metasynthesis, is described from its inception, including analyses of the potential users and how they might use such a resource. The Digital Library evolved over a 3-year period, with continuous feedback from a group of researchers and clinicians who are also experts in the care of HIV-positive people. It provides a concise and comprehensive compilation of findings in two major areas of concern for the seropositive women who were the participants in the studies: motherhood and stigma.

The Family Investigation of Nephropathy and Diabetes (FIND): design and methods.

PubMed

Knowler, William C; Coresh, Josef; Elston, Robert C; Freedman, Barry I; Iyengar, Sudha K; Kimmel, Paul L; Olson, Jane M; Plaetke, Rosemarie; Sedor, John R; Seldin, Michael F

2005-01-01

The Family Investigation of Nephropathy and Diabetes (FIND) is a multicenter study designed to identify genetic determinants of diabetic nephropathy. It is conducted in eight U.S. clinical centers and a coordinating center, and with four ethnic groups (European Americans, African Americans, Mexican Americans, and American Indians). Two strategies are used to localize susceptibility genes: a family-based linkage study and a case-control study using mapping by admixture linkage disequilibrium (MALD). In the family-based study, probands with diabetic nephropathy are recruited with their parents and selected siblings. Linkage analyses will be conducted to identify chromosomal regions containing genes that influence the development of diabetic nephropathy or related quantitative traits such as serum creatinine concentration, urinary albumin excretion, and plasma glucose concentrations. Regions showing evidence of linkage will be examined further with both genetic linkage and association studies to identify genes that influence diabetic nephropathy or related traits. Two types of MALD studies are being done. One is a case-control study of unrelated individuals of Mexican American heritage in which both cases and controls have diabetes, but only the case has nephropathy. The other is a case-control study of African American patients with nephropathy (cases) and their spouses (controls) unaffected by diabetes and nephropathy; offspring are genotyped when available to provide haplotype data. Identification of genes that influence susceptibility to diabetic nephropathy will lead to a better understanding of how nephropathy develops. This should eventually lead to improved treatment and prevention.

Financing and Policy Contexts for Principal Preparation and In-Service Training Programs: Mid-Course Findings from a Study of Innovative Programs. School Leadership Study: Developing Successful Principals

ERIC Educational Resources Information Center

Cohen, Carol; Fickel, Lucinda

2005-01-01

All principal preparation and professional development programs operate within a local, state, and national policy and financing context that influences their structure, shapes their priorities, and, in some cases, dictates their existence. Financing and policy directly affect how much professional development for principals takes place, what…

Using a knowledge utilization framework to explore how findings from one study can be applied to other nursing contexts.

PubMed

Olsen, P R; Bradbury-Jones, C

2013-09-01

To discuss the complexities of moving research into practice and through a case example, explore how empirical findings from one specific study could be applied to nursing in other contexts. The processes of moving research findings into practice are complex and multidimensional. In this paper, an innovative approach to social support, network-focused nursing (NFN), is used as a case example to illustrate these complexities. Social support is associated with better recovery and survival after illness and based on this, a NFN programme was developed in a Danish oncology youth unit. Subsequently, a research study was undertaken to investigate the programme and based on the findings, the concept NFN was developed. A knowledge utilization framework is used to explore how empirical findings from the NFN study could be applied to nursing more generally. Aligned with this, the specific considerations for implementing NFN are explicated. Strong leadership, education, management support and effective communication are critical factors for research utilization. Moving research into practice requires openness to new ideas. Nursing and healthcare policies therefore need to support environments in which creativity and innovation can flourish. NFN was developed in teenager and young adult cancer care, but its principles may be transferable to other clinical environments. It is important that nurse managers and policy makers ensure that support and education are available to nurses to facilitate moving research into practice. Moreover, resources need to be considered, particularly in countries where financial and organizational infrastructures may be weak. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.

[The value of transbronchial lung biopsy findings in the diagnosis of a case of TS-1-induced pulmonary toxicity].

PubMed

Ito, Shunsuke; Yamaguchi, Tomoyoshi; Morisue, Ryo; Ogaw, Yukari; Munakata, Kazuo; Fukuda, Yuh

2011-12-01

We report the case of a 67-year-old man with a diagnosis of stage IV stomach cancer in May 2010 who was treated with outpatient chemotherapy using TS-1, paclitaxel and lentinan. Dyspnea and coughing developed after drug administration in November and the patient was hospitalized on day 5 after the appearance of symptoms due to hypoxemia and the presence of ground-glass opacities in the right middle and lower lung fields. On the same day, bronchoscopy was performed for differentiation from infection and lymphangitic carcinomatosis. A transbronchial lung biopsy suggested drug-induced pulmonary toxicity, and a drug lymphocyte stimulation test was highly positive for TS-1. Discontinuation of TS-1 alone improved his respiratory status and imaging findings. TS-1 is available only in Japan, and because it is administered orally and its toxicity is minimal, its use has been expanded to treat a variety of malignancies. Drug-induced pulmonary toxicity due to TS-1 occurs in only 0.03% of all cases, and there are few reports regarding the histopathological findings of TS-1-related pulmonary toxicity. Although it can be difficult to diagnose drug-induced pulmonary toxicity because it demonstrates a variety of imaging findings, the present case suggests that it is important to proactively perform transbronchial lung biopsy at the early stage of diagnosis and promptly determine a course of treatment.

Short stature/short limb skeletal dysplasia with severe combined immunodeficiency and bowing of the femora: report of two patients and review.

PubMed Central

MacDermot, K D; Winter, R M; Wigglesworth, J S; Strobel, S

1991-01-01

We report two patients with severe combined immunodeficiency and short stature/short limb skeletal dysplasia. Case 1 presented at birth with rhizomelic shortening of the extremities and bowing of the femora. She developed clinical signs of severe combined immunodeficiency at 13 months and died at 21 months. Case 2 had severe prenatal shortening and bowing of the extremities and a small, malformed chest. Symptoms of severe combined immunodeficiency and severe failure to thrive developed soon after birth and she died at 5 months. The diagnosis of severe combined immunodeficiency in our patients was based on their clinical course and necropsy findings, supported in case 1 by the results of immune function tests. The results of investigation of immune function (immunoglobulins, lymphocyte subpopulations, lymphocyte function) are very variable in this syndrome as in other variants of severe combined immunodeficiency. Bone histopathology in both patients showed grossly irregular costochondral junctions, but normal transition of proliferating to hypertrophic chondrocytes. These cases belong to early lethal type 1 short limb skeletal dysplasia with severe combined immunodeficiency. Review of previously published cases with severe combined immunodeficiency and well documented skeletal findings show eight patients with prenatal onset of bowing and shortening of the extremities and metaphyseal abnormalities. These include two sib pairs concordant for the skeletal changes. In these cases, adenosine deaminase levels were not reported. An additional four published cases with associated adenosine deaminase deficiency had only mild metaphyseal abnormalities, but subsequently showed no linear growth.(ABSTRACT TRUNCATED AT 250 WORDS) Images PMID:1999827

Clinical Findings and Pain Symptoms as Potential Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case-Control Study

PubMed Central

Ohrbach, Richard; Fillingim, Roger B.; Mulkey, Flora; Gonzalez, Yoly; Gordon, Sharon; Gremillion, Henry; Lim, Pei-Feng; Ribeiro-Dasilva, Margarete; Greenspan, Joel D.; Knott, Charles; Maixner, William; Slade, Gary

2011-01-01

Clinical characteristics might be associated with temporomandibular disorders (TMD) because they are antecedent risk factors that increase the likelihood of a healthy person developing the condition or because they represent signs or symptoms of either subclinical or overt TMD. In this baseline case-control study of the multisite Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) project, 1,633 controls and 185 cases with chronic, painful TMD completed questionnaires and received clinical examinations. Odds ratios measuring association between each clinical factor and TMD were computed, with adjustment for study-site as well as age, sex, and race/ethnicity. Compared to controls, TMD cases reported more trauma, greater parafunction, more headaches and other pain disorders, more functional limitation in using the jaw, more nonpain symptoms in the facial area, more temporomandibular joint noises and jaw locking, more neural or sensory medical conditions, and worse overall medical status. They also exhibited on examination reduced jaw mobility, more joint noises, and a greater number of painful masticatory, cervical, and body muscles upon palpation. The results indicated that TMD cases differ substantially from controls across almost all variables assessed. Future analyses of follow-up data will determine whether these clinical characteristics predict increased risk for developing first-onset pain-related TMD Perspective Clinical findings from OPPERA’s baseline case-control study indicate significant differences between chronic TMD cases and controls with respect to trauma history, parafunction, other pain disorders, health status, and clinical examination data. Future analyses will examine their contribution to TMD onset. PMID:22074750

Chronic traumatic encephalopathy and athletes

PubMed Central

Mannix, Rebekah; Zafonte, Ross; Pascual-Leone, Alvaro

2015-01-01

Recent case reports have described athletes previously exposed to repetitive head trauma while participating in contact sports who later in life developed mood disorders, headaches, cognitive difficulties, suicidal ideation, difficulties with speech, and aggressive behavior. Postmortem discoveries show that some of these athletes have pathologic findings that are collectively termed chronic traumatic encephalopathy (CTE). Current hypotheses suggest that concussions or perhaps blows to the head that do not cause the signs and symptoms necessary for making the diagnosis of concussion, so-called subconcussive blows, cause both the clinical and pathologic findings. There are, however, some athletes who participate in contact sports who do not develop the findings ascribed to CTE. Furthermore, there are people who have headaches, mood disorders, cognitive difficulties, suicidal ideation, and other clinical problems who have neither been exposed to repeated head trauma nor possessed the pathologic postmortem findings of those currently diagnosed with CTE. The current lack of prospective data and properly designed case-control studies limits the current understanding of CTE, leading to debate about the causes of the neuropathologic findings and the clinical observations. Given the potential for referral and recall bias in available studies, it remains unclear whether or not the pathologic findings made postmortem cause the presumed neurobehavioral sequela and whether the presumed risk factors, such as sports activity, cerebral concussions, and subconcussive blows, are solely causative of the clinical signs and symptoms. This article discusses the current evidence and the associated limitations. PMID:26253448

Development of feedforward receptive field structure of a simple cell and its contribution to the orientation selectivity: a modeling study.

PubMed

Garg, Akhil R; Obermayer, Klaus; Bhaumik, Basabi

2005-01-01

Recent experimental studies of hetero-synaptic interactions in various systems have shown the role of signaling in the plasticity, challenging the conventional understanding of Hebb's rule. It has also been found that activity plays a major role in plasticity, with neurotrophins acting as molecular signals translating activity into structural changes. Furthermore, role of synaptic efficacy in biasing the outcome of competition has also been revealed recently. Motivated by these experimental findings we present a model for the development of simple cell receptive field structure based on the competitive hetero-synaptic interactions for neurotrophins combined with cooperative hetero-synaptic interactions in the spatial domain. We find that with proper balance in competition and cooperation, the inputs from two populations (ON/OFF) of LGN cells segregate starting from the homogeneous state. We obtain segregated ON and OFF regions in simple cell receptive field. Our modeling study supports the experimental findings, suggesting the role of synaptic efficacy and the role of spatial signaling. We find that using this model we obtain simple cell RF, even for positively correlated activity of ON/OFF cells. We also compare different mechanism of finding the response of cortical cell and study their possible role in the sharpening of orientation selectivity. We find that degree of selectivity improvement in individual cells varies from case to case depending upon the structure of RF field and type of sharpening mechanism.

Chronic traumatic encephalopathy and athletes.

PubMed

Meehan, William; Mannix, Rebekah; Zafonte, Ross; Pascual-Leone, Alvaro

2015-10-27

Recent case reports have described athletes previously exposed to repetitive head trauma while participating in contact sports who later in life developed mood disorders, headaches, cognitive difficulties, suicidal ideation, difficulties with speech, and aggressive behavior. Postmortem discoveries show that some of these athletes have pathologic findings that are collectively termed chronic traumatic encephalopathy (CTE). Current hypotheses suggest that concussions or perhaps blows to the head that do not cause the signs and symptoms necessary for making the diagnosis of concussion, so-called subconcussive blows, cause both the clinical and pathologic findings. There are, however, some athletes who participate in contact sports who do not develop the findings ascribed to CTE. Furthermore, there are people who have headaches, mood disorders, cognitive difficulties, suicidal ideation, and other clinical problems who have neither been exposed to repeated head trauma nor possessed the pathologic postmortem findings of those currently diagnosed with CTE. The current lack of prospective data and properly designed case-control studies limits the current understanding of CTE, leading to debate about the causes of the neuropathologic findings and the clinical observations. Given the potential for referral and recall bias in available studies, it remains unclear whether or not the pathologic findings made postmortem cause the presumed neurobehavioral sequela and whether the presumed risk factors, such as sports activity, cerebral concussions, and subconcussive blows, are solely causative of the clinical signs and symptoms. This article discusses the current evidence and the associated limitations. © 2015 American Academy of Neurology.

The Effects of Divorce on Children and Implications for Court Custody Cases.

ERIC Educational Resources Information Center

Khoe, Lynn

In the last decade, the rising number of divorces has resulted in large numbers of children lviing in one-parent homes. A review of the literature on the impact of divorce on children's psychosocial adjustment, cognitive development, school peformance, and sex role development revealed several interesting findings. Age of children at time of…

The Role of Language in Religious Identity Making: A Case of a Caribbean-Chinese Youth

ERIC Educational Resources Information Center

Skerrett, Allison

2017-01-01

This article explores the processes of religious identity development in a Caribbean-Chinese adolescent who is from a multifaith, multilingual home. Findings include (1) the youth developed a Christian religious identity through his multiple situatedness within home and school worlds that privileged that faith and the dominant language of English…

Future Game Developers within a Virtual World: Learner Archetypes and Team Leader Attributes

ERIC Educational Resources Information Center

Franetovic, Marija

2016-01-01

This case study research sought to understand a subset of the next generation in reference to virtual world learning within a game development course. The students completed an ill-structured team project which was facilitated using authentic learning strategies within a virtual world over a period of seven weeks. Research findings emerged from…

Supporting Beginner Teacher Identity Development: External Mentors and the Third Space

ERIC Educational Resources Information Center

McIntyre, Joanna; Hobson, Andrew J.

2016-01-01

This paper reports findings from a study of support provided by non-school-based mentors of secondary science teachers in England. It focuses on the identity development of beginning teachers of physics, some of the recipients of the mentoring. Drawing on the analysis of interview and case study data, and utilising third space theory, the authors…

Participation and Power: Reflections on the Role of Government in Land Use Planning and Rural Development

ERIC Educational Resources Information Center

Aarts, Noelle; Leeuwis, Cees

2010-01-01

Purpose: To examine the role of power in interactive policymaking settings. Design/Methodology/Approach: A literature study is combined with four case studies relating to citizen participation in natural resource management and rural development in the Netherlands. Findings: Many of the identified problems and dilemmas of interactive policymaking…

Beyond the Gender Binary: A Case Study of Two Transgender Students at a Midwestern Research University

ERIC Educational Resources Information Center

Bilodeau, Brent

2005-01-01

Few non-pathologizing models of transgender identity development currently exist. This study uses an adaptation of the D'Augelli (1994) lifespan model of sexual orientation identity development to consider the lives of transgender college students. Interviews with two transgender-identified students find that they have developmental experiences in…

We Modify Each Other's Lessons: The Role of Literacy Work Circles in Developing Professional Community

ERIC Educational Resources Information Center

Wardrip, Peter Samuelson; Gomez, Louis M.; Gomez, Kimberley

2015-01-01

To address teacher isolation in schools, more reform leaders are finding hope in establishing professional communities as a way to promote continuous school improvement. This case study presents one approach for developing teacher professional community: a teacher work circle. Using the characteristics of professional community created by Kruse,…

Context Matters: A Model of the Factors Associated with the Effectiveness of Youth Entrepreneurship Training

ERIC Educational Resources Information Center

Wiger, Nancy Pellowski; Chapman, David W.; Baxter, Aryn; DeJaeghere, Joan

2015-01-01

Government and development organizations are increasingly turning to entrepreneurship training programmes as a means of assisting those caught in poverty to develop the skills needed to find or create employment. Drawing on case studies from East Africa, this article argues that while such programmes offer a potentially useful strategy for…

Effective Learning Systems through Blended Teaching Modules in Adult Secondary Education Systems in Developing Nations: Need for Partnership

ERIC Educational Resources Information Center

Ike, Eucharia; Okechukwu, Ibeh Bartholomew

2015-01-01

We investigated methodological lessons in randomly selected adult secondary schools to construct a case for international partnership while examining education development in Nigeria. Standard database and web-based searches were conducted for publications between 1985 and 2012 on learning systems. This paper presents its absence and finds a heavy…

Sexuality Education: Findings and Recommendations from an Analysis of 10 United States Programmes

ERIC Educational Resources Information Center

Cushman, Nicole; Kantor, Leslie M.; Schroeder, Elizabeth; Eicher, Lesley; Gambone, Gina

2014-01-01

In this study, we identified 10 sexuality education programmes from different locations in the USA that aim to give young people knowledge and skills to develop healthy relationships, as well as avoid pregnancy and disease. We conducted in-depth interviews with programme administrators to develop a series of case studies and provide concrete…

ICT Policy and Implementation in Education: Cases in Canada, Northern Ireland and Ireland

ERIC Educational Resources Information Center

Austin, Roger; Hunter, Bill

2013-01-01

Countries with similar levels of economic development often implement different education ICT policies. Much of the existing research attributes such differences to economic and political factors. In this paper, we examine the development of ICT policy and implementation in the two parts of Ireland and in two Canadian provinces and find that…

Innovation Configuration Mapping as a Professional Development Tool: The Case of One-to-One Laptop Computing

ERIC Educational Resources Information Center

Towndrow, Phillip A.; Fareed, Wan

2015-01-01

This article illustrates how findings from a study of teachers' and students' uses of laptop computers in a secondary school in Singapore informed the development of an Innovation Configuration (IC) Map--a tool for identifying and describing alternative ways of implementing innovations based on teachers' unique feelings, preoccupations, thoughts…

[Toxic ulcerative contact dermatitis due to prefabricated concrete (cement burns)].

PubMed

Bandmann, H J; Agathos, M

1977-01-01

In the present report the case of a toxic ulcerous contact dermatitis (cement burns) by pre-fabricated concrete is described. This can be clearly distinguished by anamnesis, findings and development from the allergic and cumulative-toxic contact dermatitis caused by cement and related substances. It is pointed out, that in the few cases of "cement burns" made known up to now, pre-fabricated concrete was always the triggering agent.

Don't aim too high: Avoiding shoulder injury related to vaccine administration.

PubMed

Cross, Gail B; Moghaddas, Jason; Buttery, Jim; Ayoub, Sally; Korman, Tony M

2016-05-01

Shoulder injury related to vaccine administration (SIRVA) is a previously described phenomenon that is the result of improper vaccine delivery. Appropriate injection technique for administration of intramuscular vaccinations can reduce the risk of shoulder injury. In this article, we describe the cases of two patients who developed SIRVA. A literature review was conducted to find and describe other cases of shoulder injury that developed post-vaccination. SIRVA has previously been described in the world literature. Seventeen cases in women and five cases in men were found. Pain and reduction in the range of movement within a few hours of vaccination were cardinal signs of a shoulder injury. This included injuries to the soft tissues of the shoulder as well as injuries to bone and joint. SIRVA can be avoided with correct vaccination technique as described.

Cytomegalovirus Retinitis in Three Pediatric Cases with Acute Lymphoblastic Leukemia: Case Series and Review of the Literature.

PubMed

Demir, Sevliya Öcal; Çeliker, Hande; Karaaslan, Ayşe; Kadayifci, Eda Kepenekli; Akkoç, Gülşen; Atıcı, Serkan; Yakut, Nurhayat; Şenay, Emel; Kazokoğlu, Haluk; Koç, Ahmet; Bakır, Mustafa; Soysal, Ahmet

2016-11-22

Cytomegalovirus (CMV) retinitis is typically diagnosed in patient with AIDS and those who underwent allogeneic hematopoietic cell transplant. However, it may develop in patients with acute lymphoblastic leukemia (ALL) who have not undergone hematopoietic cell transplantation. To increase awareness of CMV retinitis in this group, we describe 3 patients ages 3, 9, and 12, with ALL who developed CMV retinitis. The diagnosis of CMV retinitis was made on the basis of ophthalmological findings suggesting typical retinal lesions. In 2 cases, CMV DNAemia was present, while in 1 patient CMV DNA was detected only in vitreous fluid using the PCR technique. All cases were treated with intravenous ganciclovir for 2 or 3 weeks as induction therapy, followed by oral valganciclovir prophylaxis. Initially, active retinitis lesions resolved in all cases; however, in 1 patient CMV retinitis relapsed 3 times during follow-up. In this case, by using foscarnet therapy, satisfactory responses were achieved and the progression of CMV retinitis lesions stopped and eventually regressed.

Case managers for older persons with multi-morbidity and their everyday work – a focused ethnography

PubMed Central

2013-01-01

Background Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences. Methods The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed verbatim and subjected to thematic analysis. Results An overarching theme emerged from the data: Challenging current professional identity, with three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy. Conclusions Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs. PMID:24279695

Kikuchi's lymphadenitis. A morphologic analysis of 75 cases with special reference to unusual features.

PubMed

Tsang, W Y; Chan, J K; Ng, C S

1994-03-01

Seventy-five cases of Kikuchi's lymphadenitis, a self-limiting pseudomalignant condition, were reviewed to determine the spectrum of histologic findings. There were 55 females and 20 males; ages ranged from 9 to 57 years (mean, 25.5). Most patients presented with cervical lymphadenopathy (68 cases). Associated clinical findings were fever (20/52) and leukopenia (15/33). Serum antinuclear antibodies were negative in 15 patients among 16 tested. Among 32 patients with follow-up information, 31 remained well, including one who developed recurrence after 2 years. One patient died of fatal myocardial disease during the active disease. Histologically, the lymph nodes showed paracortical hyperplasia, often associated with a starry-sky appearance resulting from interspersed histiocytes and immunoblasts. The consistent finding was the presence of variable-sized discrete or confluent nodules in the paracortex composed of the following: (a) karyorrhectic and eosinophilic granular debris; (b) histiocytes, many of which were phagocytic and possessed distinctive peripherally placed crescentic nuclei and voluminous cytoplasm containing eosinophilic or karyorrhectic debris (for which we propose the designation crescentic histiocytes), mixed with nonphagocytic histiocytes having twisted or reniform nuclei which were often centrally placed; (c) plasmacytoid monocytes, which were medium-sized cells with eccentrically placed round nuclei and amphophilic cytoplasm; and (d) variable numbers of immunoblasts, which sometimes showed atypia such as irregular nuclear foldings and coarse chromatin. Neutrophils were absent or very sparse. In some nodules, coagulative necrosis was present in the center (45 cases). Foamy histiocytes were found in 23 cases, and they predominated in 11. Small clusters of plasmacytoid monocytes were noted in the paracortex in 40 cases. Perinodal inflammation was a common finding, and perinodal involvement by the karyorrhectic process occurred in 15 cases. In addition, we found a number of previously unreported features. Signet-ring histiocytes with clear or homogeneous lightly amphophilic cytoplasm and nuclei compressed into thin crescents, found in seven cases, could mimic signet-ring cell adenocarcinoma. In three cases, some germinal centers were involved by the karyorrhectic process. Foci of lymphocyte-depleted fibrovascular organization were present in eight cases, probably representing the resolving phase of the karyorrhectic process. Despite the broad morphologic spectrum, the intermingling of the distinctive crescentic histiocytes, karyorrhectic debris, and plasmacytoid monocytes in the form of nodules, together with the paucity of neutrophils, are the consistent findings that should permit a confident histologic diagnosis of Kikuchi's lymphadenitis.

School Law.

ERIC Educational Resources Information Center

Splitt, David A.

1986-01-01

Outlines important implications for consideration in developing employment policies prohibiting sexual harassment. The recent Supreme Court decision on a sexual harassment case shows that employers are not "insulated" from liability if courts find harassment in the workplace. Also discusses two other Supreme Court decisions. (MD)

Directly observed treatment short-course (DOTS) for treatment of new tuberculosis cases in Somali Regional State, Eastern Ethiopia: ten years retrospective study.

PubMed

Woldeyohannes, Desalegn; Sisay, Solomon; Mengistu, Belete; Kassa, Hiwot

2015-08-19

A third of the world population is infected with tuberculosis (TB) bacilli. TB accounts for 25% of all avoidable deaths in developing countries. The objective of the study was to assess impact of directly observed treatment short-course (DOTS) strategy on new tuberculosis case finding and treatment outcomes in Somali Regional State, Ethiopia from 2003 up to 2012 and from 2004 up to 2013, respectively. A health facility based retrospective study was employed. Quarterly reports were collected using World Health Organization (WHO) reporting format for TB case finding and treatment outcome from all zones in the region to the Federal Ministry of Health. A total of 31, 198 all types of new TB cases were registered and reported during the period from 2003 up to 2012, in the region. Out of these, smear positive pulmonary TB cases were 12,466 (40%), and 10,537 (33.8%) and 8195 (26.2%) for smear negative pulmonary TB and extra-pulmonary TB cases, respectively. An average case detection rate (CDR) of 19.1% (SD 3.6) and treatment success rate (TSR) of 85.5% (SD 5.0) for smear positive pulmonary TB were reported for the specified years period. For the overall study period, trend chi-squire analysis for CDR was X(2) = 2.1; P > 0.05 and X(2) = 5.64; P < 0.05 for TSR. The recommended TSR set by WHO was achieved (85.5%) and the CDR reported was far below (19.1%) from the recommended target. Extensive efforts should be established to maintain the achieved TSR and to increase the low CDR for the smear positive pulmonary TB cases through implementing alternative case finding strategies.

First-trimester emergencies: a radiologist's perspective.

PubMed

Phillips, Catherine H; Wortman, Jeremy R; Ginsburg, Elizabeth S; Sodickson, Aaron D; Doubilet, Peter M; Khurana, Bharti

2018-02-01

The purpose of this article is to help the practitioner ensure early diagnosis and response to emergencies in the first trimester by reviewing anatomy of the developing embryo, highlighting the sonographic appearance of common first-trimester emergencies, and discussing key management pathways for treating emergent cases. First-trimester fetal development is a stepwise process that can be challenging to evaluate in the emergency department (ED) setting. This is due, in part, to the complex anatomy of early pregnancy, subtlety of the sonographic findings, and the fact that fewer than half of patients with ectopic pregnancy present with the classic clinical findings of a positive pregnancy test, vaginal bleeding, pelvic pain, and tender adnexa. Ultrasound (US) has been the primary approach to diagnostic imaging of first-trimester emergencies, with magnetic resonance imaging (MRI) and computed tomography (CT) playing a supportive role in a small minority of cases. Familiarity with the sonographic findings diagnostic of and suspicious for early pregnancy failure, ectopic pregnancy, retained products of conception, gestational trophoblastic disease, failed intrauterine devices, and complications associated with assisted reproductive technology (ART) is critical for any emergency radiologist. Evaluation of first-trimester emergencies is challenging, and knowledge of key imaging findings and familiarity with management pathways are needed to ensure early diagnosis and response.

Intensity of factor VIII treatment and the development of inhibitors in non-severe hemophilia A patients: results of the INSIGHT case-control study.

PubMed

van Velzen, A S; Eckhardt, C L; Peters, M; Leebeek, F W G; Escuriola-Ettingshausen, C; Hermans, C; Keenan, R; Astermark, J; Male, C; Peerlinck, K; le Cessie, S; van der Bom, J G; Fijnvandraat, K

2017-07-01

Essentials Research suggests that intensive treatment episodes may increase the risk to develop inhibitors. We performed an international nested case-control study with 298 non-severe hemophilia A patients. Surgery and a high dose of factor VIII concentrate were associated with increased inhibitor risk. Physicians need to review arguments for factor VIII dose and elective surgery extra critically. Background Inhibitor development is a major complication of treatment with factor VIII concentrates in hemophilia. Findings from studies among severe hemophilia A patients suggest that intensive treatment episodes increase the risk of developing inhibitors. Objectives We set out to assess whether intensive treatment is also associated with an increased risk of inhibitor development among non-severe hemophilia A patients. Patients/Methods We performed a nested case-control study. A total of 75 inhibitor patients (cases) and 223 control patients were selected from 2709 non-severe hemophilia A patients (FVIII:C, 2-40%) of the INSIGHT cohort study. Cases and controls were matched for date of birth and cumulative number of exposure days (EDs) to FVIII concentrates. Conditional logistic regression was used to calculate both unadjusted and adjusted odds ratios (aOR); the latter were adjusted for a priori specified confounders. Results Peak treatment of 5 or 10 consecutive EDs did not increase inhibitor risk (aOR, 1.0; 95% confidence interval (CI), 0.4-2.5; and aOR, 1.8; CI, 0.6-5.5, respectively). Both surgical intervention (aOR, 4.2; CI, 1.7-10.3) and a high mean dose (> 45 IU kg -1 /ED) of FVIII concentrate (aOR, 7.5; CI, 1.6-35.6) were associated with an increased inhibitor risk. Conclusions Our findings suggest that high-dose FVIII treatment and surgery increase the risk of inhibitor development in non-severe hemophilia A. Together with the notion that non-severe hemophilia A patients are at a lifelong risk of inhibitor development, we suggest that in the future physicians will review the arguments for the FVIII dose and elective surgery extra critically. © 2017 International Society on Thrombosis and Haemostasis.

Utilizing a 'systems' approach to improve the management of waste from healthcare facilities: best practice case studies from England and Wales.

PubMed

Tudor, Terry L; Woolridge, Anne C; Bates, Margaret P; Phillips, Paul S; Butler, Sharon; Jones, Keith

2008-06-01

Changes in environmental legislation and standards governing healthcare waste, such as the Hazardous Waste Regulations are expected to have a significant impact on healthcare waste quantities and costs in England and Wales. This paper presents findings from two award winning case study organizations, the Cardiff and Vale NHS Trust and the Cornwall NHS Trust on 'systems' they have employed for minimizing waste. The results suggest the need for the development and implementation of a holistic range of systems in order to develop best practice, including waste minimization strategies, key performance indicators, and staff training and awareness. The implications for the sharing of best practice from the two case studies are also discussed.

Case report: Guillain-Barre syndrome with pneumococcus - A new association in pediatrics.

PubMed

Khatib, Hassan El; Naous, Amal; Ghanem, Soha; Dbaibo, Ghassan; Rajab, Mariam

2018-01-01

Guillain-Barre Syndrome, an acute flaccid paralysis known to be caused by recent Gastro-intestinal infections mainly campylobacter, and Respiratory infections mainly mycoplasma pneumoniae and influenza. One reported case of severe invasive pneumococcal disease in a 68 year old female, that presented with Austrian's triad of meningitis, pneumonia and endocarditis, and progressed to develop Guillain Barre syndrome, an association never been documented before. We present a case of 13 year old male, presented with hypoactivity and inability to bare his own weight, developed septic shock due to pneumococcus with Acute Respiratory Distress Syndrome, and was found to have neurological findings of Guillain-Barre Syndrome. A new association in pediatric age group, never been reported before.

Vaginal para-urethral myxoid leiomyoma: case report and review of the literature.

PubMed

Costantini, Elisabetta; Cochetti, Giovanni; Porena, Massimo

2008-08-01

Vaginal leiomyoma is a rare solid tumour of unknown aetiology, which usually develops in women between the ages of 35 and 50. As it presents with a wide range of symptoms, diagnosis is based on histological findings. Here we present the case of a 27-year-old white woman with a painless vaginal mass associated with dyspareunia, dysmenorrhea and foul-smelling vaginal discharge. She underwent surgery by vaginal route, and the histological findings confirmed a myxoid leiomyoma. After 17 months, the patient was disease-free, and symptoms disappeared. Vaginal leiomyomas are rare, local recurrence and transformation into sarcoma are rare, and complete surgical excision as soon as possible is recommended.

Ultrastructural findings in Hashimoto's thyroiditis and focal lymphocytic thyroiditis with reference to giant cell formation.

PubMed

Knecht, H; Hedinger, C E

1982-09-01

Ultrastructural findings in two cases of Hashimoto's disease and two cases of focal lymphocytic thyroiditis are reported. Stimulated thyrocytes, oncocytes and degenerating thyrocytes were observed in all cases. Multinucleated thyrocytes and epithelial pseudogiant cells were identified in Hashimoto's disease only. Infiltrating lymphocytes, plasma cells, monocytes and macrophages were present in all cases. The ultrastructure of germinal centres was similar to that seen in lymphatic organs. Giant cells of both intra- and extrafollicular localization were seen in Hashimoto's disease. Most of the giant cells were macrophage-derived. Two different ways of giant cell formation were identified: besides the familiar dissolution of plasma membranes of adjacent macrophages, another mechanism of fusion was observed. At sites of contact, peculiar membrane structures were developed and disintegration of plasma membranes occurred in parts adjacent to these structures. These are not identical to desmosomes and are different from Langerhans' granules. They probably represent special organelles for the initiation of cellular fusion.

Linking case management and community development.

PubMed

Austin, Carol D; McClelland, Robert W; Gursansky, Di

2006-01-01

Case management, in various forms, is now institutionalized as a core part of policy and programs designed to deliver home- and community-based services to older adults. The case management role, in theory, requires attention to both client and system goals, although in practice the system goals that have received most attention have been gatekeeping and resource allocation. While case managers have been admonished to find and develop resources in the community, this has primarily taken the form of including informal services in individual client care plans. What has been missing is focused attention to the potential of the community as a nurturing environment with the capacity to support older adults and their caregivers. Sustainable care for older adults cannot be achieved by formal service and family support alone. This article proposes the creation of linkages between case managers, who build the service arrangements for older people, and community developers, who are responsible for building community capacity and social capital. It is argued that this linkage is essential for establishing the foundations of a caring community with the capacity to support older people.

A systematic review of publications studies on medical tourism.

PubMed

Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi

2013-01-01

Medical tourism for any study area is complex. Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists' motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism.

A systematic review of publications studies on medical tourism

PubMed Central

Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi

2013-01-01

Introduction: Medical tourism for any study area is complex. Materials and Methods: Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Results: Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists’ motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. Conclusion: The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism. PMID:24251287

Interaction between Cytomegalovirus and Herpes Simplex Virus Type 1 Associated with the Risk of Alzheimer's Disease Development.

PubMed

Lövheim, Hugo; Olsson, Jan; Weidung, Bodil; Johansson, Anders; Eriksson, Sture; Hallmans, Göran; Elgh, Fredrik

2018-01-01

Several environmental factors, including infectious agents, have been suggested to cause Alzheimer's disease (AD). Cytomegalovirus (CMV) has been associated with AD in several recent studies. To investigate whether carriage of CMV, alone or in combination with Herpes simplex virus (HSV), increased the risk of developing AD. Plasma samples from 360 AD cases (75.3% women, mean age 61.2 years), taken an average of 9.6 years before AD diagnosis, and 360 age-, sex-, cohort-, and sampling date matched dementia-free controls were analyzed to detect anti-CMV (immunoglobulin [Ig] G and IgM), group-specific anti-HSV (IgG and IgM), and specific anti-HSV1 and HSV2 IgG antibodies by enzyme-linked immunosorbent assays. AD cases and dementia-free controls were compared using conditional logistic regression analyses. The presence of anti-CMV IgG antibodies did not increase the risk of AD (odds ratio [OR], 0.857; p = 0.497). Among AD cases, an association between CMV and HSV1 carriage was detected (OR 7.145, p < 0.001); in a conditional logistic regression model, the interaction between CMV and HSV1 was associated with AD development (OR 5.662; p = 0.007). The present findings do not support a direct relationship between CMV infection and the development of AD; however, an interaction between CMV and HSV1 was found to be associated significantly with AD development. These findings suggest that CMV infection facilitates the development of HSV1-associated AD, possibly via its effects on the immune system.

Spontaneous dislocation of a crystalline lens to the anterior chamber with pupillary block glaucoma in Noonan Syndrome: a case report.

PubMed

Mukhopadhyaya, Udayaditya; Chakraborti, Chandana; Mondal, Anindita; Pattyanayak, Ujjal; Agarwal, Rajesh Kumar; Tripathi, Partha

2014-01-01

We report a 13-year-old child with Noonan Syndrome who developed spontaneous dislocation of the crystalline lens in anterior chamber leading to pupillary block glaucoma in the left eye and subluxation of lens in right eye. Intracapsular extraction of the dislocated lens was done in the left eye. Prompt diagnosis and management is needed in such cases to avoid glaucoma and corneal endothelial cell damage. We could not find any such case after thorough Medline search.

Cephalic Tetanus in an Immunized Teenager: An Unusual Case Report.

PubMed

Felter, Robert A; Zinns, Lauren E

2015-07-01

Tetanus is a rare disease in developed countries but is prevalent worldwide. It has significant morbidity and mortality. The causative agent Clostridium tetani is ubiquitous in nature. In the United States, approximately 50 to 100 cases are reported per year but rarely in immunocompetent, fully immunized patients. Of the four types of tetanus (generalized, neonatal, cephalic, and localized), cephalic is the least common. We present a case of cephalic tetanus in a 14-year-old boy who completed his primary immunizations with a video of his physical examination findings.

Cargo Logistics Airlift Systems Study (CLASS). Volume 5: Summary

NASA Technical Reports Server (NTRS)

Burby, R. J.; Kuhlman, W. H.

1980-01-01

Findings and conclusions derived during the study of freighter aircraft requirements to the year 2008 are summarized. These results represent the stepping off point for the much needed coordinated planning efforts by government agencies, the airlines, the users, and the aircraft manufacturers. The methodology utilized in the investigations is shown. The analysis of the current system encompassed evaluations of the past and current cargo markets and on sight surveys of airport and cargo terminals. The findings that resulted provided the basis for formulating the case study procedures, developing the future scenario, and developing the future cargo market demand.

Impact of PGL-I Seropositivity on the Protective Effect of BCG Vaccination among Leprosy Contacts: A Cohort Study

PubMed Central

Düppre, Nádia C.; Camacho, Luiz Antonio B.; Sales, Anna M.; Illarramendi, Ximena; Nery, José Augusto C.; Sampaio, Elizabeth P.; Sarno, Euzenir N.; Bührer-Sékula, Samira

2012-01-01

Background Contacts of leprosy patients are at increased risk of developing leprosy and need to be targeted for early diagnosis. Seropositivity to the phenolic glycolipid I (PGL-I) antigen of Mycobacterium leprae has been used to identify contacts who have an increased risk of developing leprosy. In the present study, we studied the effect of seropositivity in patient contacts, on the risk of developing leprosy, stratified by Bacille Calmette Guerin (BCG) vaccination after index case diagnosis. Methodology/Principal Findings Leprosy contacts were examined as part of the surveillance programme of the Oswaldo Cruz Institute Leprosy Outpatient Clinic in Rio de Janeiro. Demographic, social, epidemiological and clinical data were collected. The presence of IgM antibodies to PGL-I in sera and BCG vaccination status at the time of index case diagnosis were evaluated in 2,135 contacts. During follow-up, 60 (2.8%; 60/2,135) leprosy cases were diagnosed: 41 among the 1,793 PGL-I-negative contacts and 19 among the 342 PGL-I-positive contacts. Among PGL-I-positive contacts, BCG vaccination after index case diagnosis increased the adjusted rate of developing clinical manifestations of leprosy (Adjusted Rate Ratio (aRR) = 4.1; 95% CI: 1.8–8.2) compared with the PGL-I-positive unvaccinated contacts (aRR = 3.2; 95% CI: 1.2–8.1). The incidence density was highest during the first year of follow-up for the PGL-I-positive vaccinated contacts. However, all of those contacts developed PB leprosy, whereas most MB cases (4/6) occurred in PGL-I-positive unvaccinated contacts. Conclusion Contact examination combined with PGL-I testing and BCG vaccination remain important strategies for leprosy control. The finding that rates of leprosy cases were highest among seropositive contacts justifies targeting this specific group for close monitoring. Furthermore, it is recommended that PGL-I-positive contacts and contacts with a high familial bacteriological index, regardless of serological response, should be monitored. This group could be considered as a target for chemoprophylaxis. PMID:22724040

The effects of natural language processing on cross-institutional portability of influenza case detection for disease surveillance.

PubMed

Ferraro, Jeffrey P; Ye, Ye; Gesteland, Per H; Haug, Peter J; Tsui, Fuchiang Rich; Cooper, Gregory F; Van Bree, Rudy; Ginter, Thomas; Nowalk, Andrew J; Wagner, Michael

2017-05-31

This study evaluates the accuracy and portability of a natural language processing (NLP) tool for extracting clinical findings of influenza from clinical notes across two large healthcare systems. Effectiveness is evaluated on how well NLP supports downstream influenza case-detection for disease surveillance. We independently developed two NLP parsers, one at Intermountain Healthcare (IH) in Utah and the other at University of Pittsburgh Medical Center (UPMC) using local clinical notes from emergency department (ED) encounters of influenza. We measured NLP parser performance for the presence and absence of 70 clinical findings indicative of influenza. We then developed Bayesian network models from NLP processed reports and tested their ability to discriminate among cases of (1) influenza, (2) non-influenza influenza-like illness (NI-ILI), and (3) 'other' diagnosis. On Intermountain Healthcare reports, recall and precision of the IH NLP parser were 0.71 and 0.75, respectively, and UPMC NLP parser, 0.67 and 0.79. On University of Pittsburgh Medical Center reports, recall and precision of the UPMC NLP parser were 0.73 and 0.80, respectively, and IH NLP parser, 0.53 and 0.80. Bayesian case-detection performance measured by AUROC for influenza versus non-influenza on Intermountain Healthcare cases was 0.93 (using IH NLP parser) and 0.93 (using UPMC NLP parser). Case-detection on University of Pittsburgh Medical Center cases was 0.95 (using UPMC NLP parser) and 0.83 (using IH NLP parser). For influenza versus NI-ILI on Intermountain Healthcare cases performance was 0.70 (using IH NLP parser) and 0.76 (using UPMC NLP parser). On University of Pisstburgh Medical Center cases, 0.76 (using UPMC NLP parser) and 0.65 (using IH NLP parser). In all but one instance (influenza versus NI-ILI using IH cases), local parsers were more effective at supporting case-detection although performances of non-local parsers were reasonable.

Neurological impairment in a surviving twin following intrauterine fetal demise of the co-twin: a case study.

PubMed

Forrester, K R; Keegan, K M; Schmidt, J W

2013-01-01

It has been established that twin pregnancies are at an increased risk for complications, including the risk of morbidity or mortality for one or both of the infants. Cerebral palsy and other associated neurological deficits also occur at higher rates in twin pregnancies. This report examines two cases of intrauterine demise of one twin with subsequent survival of the co-twin. In both cases, the surviving infant suffered significant neurological sequelae. Impairments observed in these two cases include multicystic encephalomalacia and periventricular leukomalacia as well as the subsequent development of cerebral palsy. This case study explores the predisposing factors, incidence, pathophysiology, consequences, and future research implications of these findings.

Regional Pericarditis Status Post Cardiac Ablation: A Case Report

PubMed Central

Orme, Joseph; Eddin, Moneer; Loli, Akil

2014-01-01

Context: Regional pericarditis is elusive and difficult to diagnosis. Healthcare providers should be familiar with post-cardiac ablation complications as this procedure is now widespread and frequently performed. The management of regional pericarditis differs greatly from that of acute myocardial infarction. Case report: A 52 year-old male underwent atrial fibrillation ablation and developed severe mid-sternal chest pain the following day with electrocardiographic findings suggestive of acute myocardial infarction, and underwent coronary angiography, a left ventriculogram, and 2D transthoracic echocardiogram, all of which were unremarkable without evidence of obstructive coronary disease, wall motion abnormalities, or pericardial effusions. Ultimately, the patient was diagnosed with regional pericarditis. After diagnosis, the patient's presenting symptoms resolved with treatment including nonsteroidal anti-inflammatory agents and colchicine. Conclusion: This is the first reported case study of regional pericarditis status post cardiac ablation. Electrocardiographic findings were classic for an acute myocardial infarction; however, coronary angiography and left ventriculogram demonstrated no acute coronary occlusion or ventricular wall motion abnormalities. Healthcare professionals must remember that the electrocardiographic findings in pericarditis are not always classic and that pericarditis can occur status post cardiac ablation. PMID:25317395

Delayed rotation of the cerebellar vermis: a pitfall in early second-trimester fetal magnetic resonance imaging.

PubMed

Pinto, J; Paladini, D; Severino, M; Morana, G; Pais, R; Martinetti, C; Rossi, A

2016-07-01

We describe two cases in which delayed rotation of the cerebellar vermis simulated a Dandy-Walker malformation (DWM) on early second-trimester magnetic resonance imaging (MRI). Two pregnant women with suspected fetal posterior fossa anomaly on ultrasound examination underwent fetal MRI at 21 (Case 1) and 19 (Case 2) weeks' gestation. In both cases, upward rotation of the cerebellar vermis was noted; on midsagittal imaging, the brainstem-vermis angle was 28° and 43°, respectively, while cerebellar morphometry showed a reduced vermian anteroposterior diameter compared to reference data. The posterior fossa appeared to be mildly enlarged, while all other findings were normal. Follow-up MRI at 28 + 3 weeks' gestation (Case 1) and at 1 postnatal year (Case 2) showed completely normal findings. Both children had normal psychomotor development and neurological examinations at 1 year of age. Incomplete rotation of the cerebellar vermis can be a physiological finding on early second-trimester fetal MRI examination and can simulate DWM or other forms of cerebellar hypoplasia. Embryologically, delayed permeabilization of Blake's pouch could account for the delayed vermian rotation. Follow-up imaging at a later gestational age is crucial to ensure that this condition is not over-reported and to avoid the potential risk of unnecessary pregnancy interruption. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Helicobacter heilmannii-associated Gastritis: Clinicopathologic Findings and Comparison with Helicobacter pylori-associated Gastritis

PubMed Central

Kwak, Ji Eun; Chang, Sun Hee; Kim, Hanseong; Chi, Je G.; Kim, Kyung-Ah; Yang, Jeon Ho; Lee, June Sung; Moon, Young-Soo; Kim, Kyoung-Mee

2007-01-01

The aims of this study were to evaluate the clinicopathologic features of Helicobacter heilmannii-associated gastritis and to compare H. heilmannii-associated gastritis with H. pylori-associated gastritis. We reviewed 5,985 consecutive gastric biopsy specimens. All cases of chronic gastritis with Helicobacter infection were evaluated with the Updated Sydney System, and the grades of all gastritis variables were compared between H. heilmannii-associated gastritis and H. pylori-associated gastritis groups. There were 10 cases of H. heilmannii-associated gastritis (0.17%) and 3,285 cases of H. pylori-associated gastritis (54.9%). The organisms were superficially located within the mucous layer without adhesion to epithelial cells. Interestingly, in one case many intracytoplasmic H. heilmannii organisms were observed in parietal cells with cell damage. A case of low-grade mucosa-associated lymphoid tissue (MALT) lymphoma concomitant with H. heilmannii infection was detected. Compared to H. pylori-associated gastritis, H. heilmannii-associated gastritis showed less severe neutrophilic activity (p<0.0001), mononuclear cell infiltration (p=0.0029), and endoscopic findings of chronic gastritis devoid of erosion or ulcer (p=0.0309). In conclusion, we present the detailed clinicopathologic findings of H. heilmannii-associated gastritis compared to H. pylori-associated gastritis. H. heilmannii-associated gastritis is uncommon and milder than H. pylori-associated gastritis, however it may be noteworthy with respect to the development of MALT lymphoma. PMID:17297253

Disease management: findings from leading state programs.

PubMed

Wheatley, Ben

2002-12-01

Disease management programs are designed to contain costs by improving health among the chronically ill. More than 20 states are now engaged in developing and implementing Medicaid disease management programs for their primary care case management and fee-for-service populations.

The Cancer Digital Slide Archive - TCGA

Cancer.gov

Dr. David Gutman and Dr. Lee Cooper developed The Cancer Digital Slide Archive (CDSA), a web platform for accessing pathology slide images of TCGA samples. Find out how they did it and how to use the CDSA website in this Case Study.

Implementing partnership-driven clinical federated electronic health record data sharing networks.

PubMed

Stephens, Kari A; Anderson, Nicholas; Lin, Ching-Ping; Estiri, Hossein

2016-09-01

Building federated data sharing architectures requires supporting a range of data owners, effective and validated semantic alignment between data resources, and consistent focus on end-users. Establishing these resources requires development methodologies that support internal validation of data extraction and translation processes, sustaining meaningful partnerships, and delivering clear and measurable system utility. We describe findings from two federated data sharing case examples that detail critical factors, shared outcomes, and production environment results. Two federated data sharing pilot architectures developed to support network-based research associated with the University of Washington's Institute of Translational Health Sciences provided the basis for the findings. A spiral model for implementation and evaluation was used to structure iterations of development and support knowledge share between the two network development teams, which cross collaborated to support and manage common stages. We found that using a spiral model of software development and multiple cycles of iteration was effective in achieving early network design goals. Both networks required time and resource intensive efforts to establish a trusted environment to create the data sharing architectures. Both networks were challenged by the need for adaptive use cases to define and test utility. An iterative cyclical model of development provided a process for developing trust with data partners and refining the design, and supported measureable success in the development of new federated data sharing architectures. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Pyometra in captive large felids: a review of eleven cases.

PubMed

McCain, Stephanie; Ramsay, Ed; Allender, Matthew C; Souza, Carlos; Schumacher, Juergen

2009-03-01

Eleven cases of pyometra were diagnosed in a captive exotic felid collection over 3 yr in seven African lions (Panthera leo), two tigers (P. tigris), one liger (lion-tiger crossbreed), and one leopard (P. pardus). Clinical signs included anorexia, lethargy, vulvar discharge, and vomiting. Diagnosis was based on clinical signs, complete blood cell counts, plasma biochemistry and electrolyte values, radiographs, and abdominal ultrasonography. The most common findings on complete blood count and biochemistry profiles were leukocytosis (>15,000/microL) and hyperproteinemia (>8.2 g/dL) due to increased globulins. Abdominal radiographic findings were largely nonspecific, but ultrasonography routinely showed a distended, fluid-filled uterus. Each case was treated with ovariohysterectomy and systemic antibiotic therapy. Lions were shown to be at an increased risk for developing pyometra compared with other species. Pyometra should be considered as a differential diagnosis in anorexic or lethargic intact female large felids, and ovariohysterectomy may be warranted in nonbreeding female lions.

Impact of Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) and Positron Emission Tomography/Computed Tomography (PET/CT) in the Diagnosis of Traumatic Brain Injury (TBI): Case Report.

PubMed

Molina-Vicenty, Irma L; Santiago-Sánchez, Michelaldemar; Vélez-Miró, Iván; Motta-Valencia, Keryl

2016-09-01

Traumatic brain injury (TBI) is defined as damage to the brain resulting from an external force. TBI, a global leading cause of death and disability, is associated with serious social, economic, and health problems. In cases of mild-to-moderate brain damage, conventional anatomical imaging modalities may or may not detect the cascade of metabolic changes that have occurred or are occurring at the intracellular level. Functional nuclear medicine imaging and neurophysiological parameters can be used to characterize brain damage, as the former provides direct visualization of brain function, even in the absence of overt behavioral manifestations or anatomical findings. We report the case of a 30-year-old Hispanic male veteran who, after 2 traumatic brain injury events, developed cognitive and neuropsychological problems with no clear etiology in the presence of negative computed tomography (CT) findings.

Sulfur mustard-induced poikiloderma: a case report.

PubMed

Emadi, Seyed Naser; Kaffashi, Mohammad; Poursaleh, Zohreh; Akhavan-Moghaddam, Jamal; Soroush, Mohammad Reza; Emadi, Seyed Emad; Taghavi, Nez'hat-o-Sadat

2011-06-01

Sulfur mustard (SM) is a potent chemical warfare agent that was widely used during the First World War and the Iran-Iraq conflict. This vesicant agent causes several acute and chronic effects on the skin, eye, and respiratory system. We report the case of a 41-year-old man who was injured with SM in Iraq chemical attack in 1988. After exposure, he developed severe skin blisters on his upper trunk, dorsum of hands, and genitalia. Based on several clinical observations, such as atrophy, pigmentation, and vascular changes on genitalia with relevant findings in histopathological studies, persistent pigmentation, and damaged skin appendix in hand lesions, a diagnosis of "SM-induced poikiloderma" was postulated. The absence of any complication on the palmar aspect of hands is another remarkable finding in presented case, which suggests a plausible role of the palms as a vector for transporting SM to other sites of the skin.

An Articulated Pan-Canadian Core Curriculum: Are We Dreaming in Colour? The Tourism Learning System. An Association of Canadian Community Colleges Sponsored Sectoral Case Study.

ERIC Educational Resources Information Center

Bird, Geoffrey; Hood, Terry; White, Brian

This paper offers findings from a case study of western Canada's Tourism Learning System (TLS) initiative. TLS aims to facilitate possible adoption of a national tourism learning system, as well as adaptation of development principles to other industries. The tourism industry now accounts for more than 25% of the world's trade and nearly 10% of…

Cerebello-cortical heterotopia in dentate nucleus, and other microdysgeneses in trisomy D1 (Patau) syndrome.

PubMed

Hori, A; Peiffer, J; Pfeiffer, R A; Iizuka, R

1980-01-01

Several new histological findings in six cases of the trisomy D1 syndrome are described: hyperplasia of fetal structures (indusium griseum, median raphe of the medulla oblongata) and completely developed cerebellar cortical heterotopia in the dentate nucleus. In one case, a heterotopic pontine nucleus was found within the cerebellar white matter. The coexistence of overdeveloped and remaining fetal structures is emphasized. Several hypotheses regarding cerebellar dysgenesis are discussed.

Assessment of the Potential for Color Overlays to Enhance the Reading Skills of Enlisted Navy Recruits

DTIC Science & Technology

2006-07-30

as an intervention . Readers with MIS symptoms read significantly faster with their chosen overlay than without it. These findings justify further...recent years, the techniques for routine diagnosis and effective intervention methods for MIS have been improved and developed. Although Irlen is...The British Royal Navy, for example, screens for MIS on a case-by-case basis and provides overlays and filters as intervention . Furthermore

An efficient graph theory based method to identify every minimal reaction set in a metabolic network

PubMed Central

2014-01-01

Background Development of cells with minimal metabolic functionality is gaining importance due to their efficiency in producing chemicals and fuels. Existing computational methods to identify minimal reaction sets in metabolic networks are computationally expensive. Further, they identify only one of the several possible minimal reaction sets. Results In this paper, we propose an efficient graph theory based recursive optimization approach to identify all minimal reaction sets. Graph theoretical insights offer systematic methods to not only reduce the number of variables in math programming and increase its computational efficiency, but also provide efficient ways to find multiple optimal solutions. The efficacy of the proposed approach is demonstrated using case studies from Escherichia coli and Saccharomyces cerevisiae. In case study 1, the proposed method identified three minimal reaction sets each containing 38 reactions in Escherichia coli central metabolic network with 77 reactions. Analysis of these three minimal reaction sets revealed that one of them is more suitable for developing minimal metabolism cell compared to other two due to practically achievable internal flux distribution. In case study 2, the proposed method identified 256 minimal reaction sets from the Saccharomyces cerevisiae genome scale metabolic network with 620 reactions. The proposed method required only 4.5 hours to identify all the 256 minimal reaction sets and has shown a significant reduction (approximately 80%) in the solution time when compared to the existing methods for finding minimal reaction set. Conclusions Identification of all minimal reactions sets in metabolic networks is essential since different minimal reaction sets have different properties that effect the bioprocess development. The proposed method correctly identified all minimal reaction sets in a both the case studies. The proposed method is computationally efficient compared to other methods for finding minimal reaction sets and useful to employ with genome-scale metabolic networks. PMID:24594118

Development and Application of the CAT-RPM Report for Strengths-Based Case Management of At-Risk Youth in Schools

ERIC Educational Resources Information Center

Bower, J. M.; Carroll, A.; Ashman, A.

2015-01-01

The Contextualised Assessment Tool for Risk and Protection Management (CAT-RPM) has been established as a valid and reliable tool for differentiating groups across age, sex and behaviour and assisting young people to find their strengths [Bower, J., A. Carroll, and A. Ashman. 2014. "The Development and Validation of the Contextualised…

A Community Development Approach to Service-Learning: Building Social Capital between Rural Youth and Adults

ERIC Educational Resources Information Center

Henness, Steven A.; Ball, Anna L.; Moncheski, MaryJo

2013-01-01

Using 4-H and FFA case study findings, this article explores how community service-learning supports the building of social capital between rural youth and adults and the positive effects on community viability. Key elements of practice form a community development approach to service-learning, which opens up doorways for youth to partner with…

An Investigation of How a Physics Professional Development Course Influenced the Teaching Practices of Five Elementary School Teachers

ERIC Educational Resources Information Center

Harlow, Danielle B.

2014-01-01

This paper reports the results of an investigation of how a professional development content course based on the Physics and Everyday Thinking (PET) curriculum affected the teaching practices of five case study elementary school teachers. The findings of this study highlight different ways that teachers use what they learn in content courses to…

The Educational Implications of Introducing a NQF for Developing Countries

ERIC Educational Resources Information Center

Young, Michael

2011-01-01

The one-year research project on the implementation of NQFs in developing countries was launched by the ILO 2009 in collaboration with the ETF. This article reviews some of the educational issues that arose from the project. The findings of the case studies raise issues that are important for how future research and policy on NQFs is taken…

The CARE guidelines: consensus-based clinical case reporting guideline development

PubMed Central

Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David

2013-01-01

A case report is a narrative that describes, for medical, scientific or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) premeeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines and (3) postmeeting feedback, review and pilot testing, followed by finalisation of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist—a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. PMID:24155002

Evaluation of a Pilot Project on Information and Communication Technology for Rural Education Development: A Cofimvaba Case Study on the Educational Use of Tablets

ERIC Educational Resources Information Center

Phiri, Acheson Charles; foko, Thato; Mahwai, Nare

2014-01-01

In an endeavour to find solutions to the country's improving but ailing education system the South African government through some of its departments is attempting to find out if the introduction of technology in the class room has the potential to improve teaching and learning. The paper is based on a pilot study currently underway in Cofimvaba…

Intelligence in Bali--A Case Study on Estimating Mean IQ for a Population Using Various Corrections Based on Theory and Empirical Findings

ERIC Educational Resources Information Center

Rindermann, Heiner; te Nijenhuis, Jan

2012-01-01

A high-quality estimate of the mean IQ of a country requires giving a well-validated test to a nationally representative sample, which usually is not feasible in developing countries. So, we used a convenience sample and four corrections based on theory and empirical findings to arrive at a good-quality estimate of the mean IQ in Bali. Our study…

Treatment default amongst patients with tuberculosis in urban Morocco: predicting and explaining default and post-default sputum smear and drug susceptibility results.

PubMed

Cherkaoui, Imad; Sabouni, Radia; Ghali, Iraqi; Kizub, Darya; Billioux, Alexander C; Bennani, Kenza; Bourkadi, Jamal Eddine; Benmamoun, Abderrahmane; Lahlou, Ouafae; Aouad, Rajae El; Dooley, Kelly E

2014-01-01

Public tuberculosis (TB) clinics in urban Morocco. Explore risk factors for TB treatment default and develop a prediction tool. Assess consequences of default, specifically risk for transmission or development of drug resistance. Case-control study comparing patients who defaulted from TB treatment and patients who completed it using quantitative methods and open-ended questions. Results were interpreted in light of health professionals' perspectives from a parallel study. A predictive model and simple tool to identify patients at high risk of default were developed. Sputum from cases with pulmonary TB was collected for smear and drug susceptibility testing. 91 cases and 186 controls enrolled. Independent risk factors for default included current smoking, retreatment, work interference with adherence, daily directly observed therapy, side effects, quick symptom resolution, and not knowing one's treatment duration. Age >50 years, never smoking, and having friends who knew one's diagnosis were protective. A simple scoring tool incorporating these factors was 82.4% sensitive and 87.6% specific for predicting default in this population. Clinicians and patients described additional contributors to default and suggested locally-relevant intervention targets. Among 89 cases with pulmonary TB, 71% had sputum that was smear positive for TB. Drug resistance was rare. The causes of default from TB treatment were explored through synthesis of qualitative and quantitative data from patients and health professionals. A scoring tool with high sensitivity and specificity to predict default was developed. Prospective evaluation of this tool coupled with targeted interventions based on our findings is warranted. Of note, the risk of TB transmission from patients who default treatment to others is likely to be high. The commonly-feared risk of drug resistance, though, may be low; a larger study is required to confirm these findings.

Feasibility, Yield, and Cost of Active Tuberculosis Case Finding Linked to a Mobile HIV Service in Cape Town, South Africa: A Cross-sectional Study

PubMed Central

Kranzer, Katharina; Lawn, Stephen D.; Meyer-Rath, Gesine; Vassall, Anna; Raditlhalo, Eudoxia; Govindasamy, Darshini; van Schaik, Nienke; Wood, Robin; Bekker, Linda-Gail

2012-01-01

Background The World Health Organization is currently developing guidelines on screening for tuberculosis disease to inform national screening strategies. This process is complicated by significant gaps in knowledge regarding mass screening. This study aimed to assess feasibility, uptake, yield, treatment outcomes, and costs of adding an active tuberculosis case-finding program to an existing mobile HIV testing service. Methods and Findings The study was conducted at a mobile HIV testing service operating in deprived communities in Cape Town, South Africa. All HIV-negative individuals with symptoms suggestive of tuberculosis, and all HIV-positive individuals regardless of symptoms were eligible for participation and referred for sputum induction. Samples were examined by microscopy and culture. Active tuberculosis case finding was conducted on 181 days at 58 different sites. Of the 6,309 adults who accessed the mobile clinic, 1,385 were eligible and 1,130 (81.6%) were enrolled. The prevalence of smear-positive tuberculosis was 2.2% (95% CI 1.1–4.0), 3.3% (95% CI 1.4–6.4), and 0.4% (95% CI 1.4 015–6.4) in HIV-negative individuals, individuals newly diagnosed with HIV, and known HIV, respectively. The corresponding prevalence of culture-positive tuberculosis was 5.3% (95% CI 3.5–7.7), 7.4% (95% CI 4.5–11.5), 4.3% (95% CI 2.3–7.4), respectively. Of the 56 new tuberculosis cases detected, 42 started tuberculosis treatment and 34 (81.0%) completed treatment. The cost of the intervention was US$1,117 per tuberculosis case detected and US$2,458 per tuberculosis case cured. The generalisability of the study is limited to similar settings with comparable levels of deprivation and TB and HIV prevalence. Conclusions Mobile active tuberculosis case finding in deprived populations with a high burden of HIV and tuberculosis is feasible, has a high uptake, yield, and treatment success. Further work is now required to examine cost-effectiveness and affordability and whether and how the same results may be achieved at scale. PMID:22879816

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

PubMed

Lee, Sungkyu; Holden, Chris; Lee, Kelley

2013-01-01

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

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

PubMed Central

Lee, Sungkyu; Holden, Chris; Lee, Kelley

2013-01-01

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

Endodontic 'solutions' part 1: a literature review on the use of endodontic lubricants, irrigants and medicaments.

PubMed

Good, Melissa; El, Karim Ikhlas A; Hussey, David L

2012-05-01

Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of'solutions' could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic'solution' usage within dental schools. The literature review was undertaken under the following headings: pre-op oral rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases.The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2.

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2017-02-01

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

Chronic Fatigue Syndrome versus Systemic Exertion Intolerance Disease

PubMed Central

Jason, Leonard A.; Sunnquist, Madison; Brown, Abigail; Newton, Julia L.; Strand, Elin Bolle; Vernon, Suzanne D.

2015-01-01

Background The Institute of Medicine has recommended a change in the name and criteria for Chronic Fatigue Syndrome (CFS), renaming the illness Systemic Exertion Intolerance Disease (SEID). The new SEID case definition requires substantial reductions or impairments in the ability to engage in pre-illness activities, unrefreshing sleep, post-exertional malaise, and either cognitive impairment or orthostatic intolerance. Purpose In the current study, samples were generated through several different methods and were used to compare this new case definition to previous case definitions for CFS, Myalgic Encephalomyelitis (ME-ICC), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), as well as a case definition developed through empirical methods. Methods We used a cross-sectional design with samples from tertiary care settings, a biobank sample, and other forums. 796 patients from the US, Great Britain, and Norway completed the DePaul Symptom Questionnaire. Results Findings indicated that the SEID criteria identified 88% of participants in the samples analyzed, which is comparable to the 92% that met the Fukuda criteria. The SEID case definition was compared to a four item empiric criteria, and findings indicated that the four item empiric criteria identified a smaller, more functionally limited and symptomatic group of patients. Conclusion The recently developed SEID criteria appears to identify a group comparable in size to the Fukuda et al. criteria, but a larger group of patients than the Canadian ME/CFS and ME criteria, and selects more patients who have less impairment and fewer symptoms than a four item empiric criteria. PMID:26345409

Natural history and clinical detection of undiagnosed coeliac disease in a North American community.

PubMed

Hujoel, I A; Van Dyke, C T; Brantner, T; Larson, J; King, K S; Sharma, A; Murray, J A; Rubio-Tapia, A

2018-05-01

Coeliac disease is a substantially underdiagnosed disorder, with clinical testing currently guided by case finding. To determine the presence of indications for diagnostic testing and frequency of clinical testing in undiagnosed coeliac disease. This was a case-control study of adults without prior diagnosis of coeliac disease. Undiagnosed cases were identified through sequential serology, and unaffected age- and gender-matched controls were selected. Medical records were systematically reviewed for indications for and evidence of clinical testing. Of 47 557 adults, 408 cases of undiagnosed coeliac disease were identified. 408 serology negative matched controls were selected. Eight-matched pairs were excluded, leading to 800 included individuals (61% female; median age 44.2 years). The odds of any indication for clinical testing were similar among undiagnosed coeliac disease and controls (odds ratio (OR) 1.18; 95% CI: 0.85-1.63, P = 0.32). Most individual indications were not associated with serologic status. Exceptions to this include hypothyroidism, which was more likely in cases of undiagnosed coeliac disease, and dyspepsia and chronic diarrhoea, which were less likely. Cases of undiagnosed coeliac disease were more likely to develop osteoporosis (P = 0.005), dermatitis herpetiformis (P = 0.006), chronic fatigue (P = 0.033), thyroiditis (P = 0.003), autoimmune diseases (P = 0.008), and have a family member diagnosed with coeliac disease (P = 0.001). This study strongly suggests that current case finding is not effective in detecting undiagnosed coeliac disease. Individuals with undiagnosed coeliac disease were more likely than controls to develop indications for testing overtime. A more effective method for detection of coeliac disease is needed. © 2018 John Wiley & Sons Ltd and Mayo Foundation.

A method of sealing perforated sinus membrane and histologic finding of bone substitutes: a case report.

PubMed

Shin, Hong-In; Sohn, Dong-Seok

2005-12-01

To augment the atrophic posterior maxilla, a sinus bone graft has been widely used for sinus floor augmentation. Various bone substitutes have been developed and grafted in the maxillary sinus with and without membranes perforation, although autogenous bone is recommended as a gold standard of grafting materials. Membrane perforation is the most common complication associated with sinus bone graft. To repair a perforation, various methods have been developed. This case report is focused on histologic findings of 1 bovine hydroxyapatite (Bio-Oss; Geistlich Pharma AG, Wolhusen, Switzerland) and 2 kinds of human mineral allograft- Tutoplast cancellous microchips (TutoGen Medical GmbH, Neunkirchen am. Brand Germany), and irradiated allogeniccancellous bone and marrow (ICB; Rocky Mountain Tissue Bank, Aurora, CO) used for sinus graft in the same patient with membrane perforation after various healing periods. Mineral allograft showed favorable new bone regeneration with the repair of membrane perforation. This case report also describes a technique regarding how to repair completely perforated sinus membrane after the removal of a mucocele using human collagen membrane (Tutoplast pericardium; TutoGen Medical GmbH) and fibrin adhesive (Greenplast; Green Cross Co., Youngin, Korea) to stabilize collagen membrane.

77 FR 57563 - Notice of Submission for OMB Review; Office of Planning, Evaluation and Policy Development...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-18

... review of recent research on the identification of ELs with special needs, and (2) case studies of six school districts and three schools in each district. Findings will be descriptive in nature. The study is...

Information as a Tool for Development.

ERIC Educational Resources Information Center

Figueiredo, Nice

1992-01-01

Discusses the concept of information value and presents major findings of user studies and collection evaluations. A case study describing the implementation of networks for information in the areas of biomedicine and agronomy in Brazil in the late 1960s is presented. (35 references) (MES)

Advantages and Challenges of Distributing Leadership in Middle-Level Schools

ERIC Educational Resources Information Center

Grenda, J. Patrick; Hackmann, Donald G.

2014-01-01

This multiple-site case study examined distributed leadership practices of three middle school principals, using observations, interviews, and document analysis. Findings disclosed that the principals built on the interdisciplinary teaming structure to develop empowering organizational structures that promoted democratic governance. Employing…

Applying the food technology neophobia scale in a developing country context. A case-study on processed matooke (cooking banana) flour in Central Uganda.

PubMed

De Steur, Hans; Odongo, Walter; Gellynck, Xavier

2016-01-01

The success of new food technologies largely depends on consumers' behavioral responses to the innovation. In Eastern Africa, and Uganda in particular, a technology to process matooke into flour has been introduced with limited success. We measure and apply the Food technology Neophobia Scale (FTNS) to this specific case. This technique has been increasingly used in consumer research to determine consumers' fear for foods produced by novel technologies. Although it has been successful in developed countries, the low number and limited scope of past studies underlines the need for testing its applicability in a developing country context. Data was collected from 209 matooke consumers from Central Uganda. In general, respondents are relatively neophobic towards the new technology, with an average FTNS score of 58.7%, which hampers the success of processed matooke flour. Besides socio-demographic indicators, 'risk perception', 'healthiness' and the 'necessity of technologies' were key factors that influenced consumer's preference of processed matooke flour. Benchmarking the findings against previous FTNS surveys allows to evaluate factor solutions, compare standardized FTNS scores and further lends support for the multidimensionality of the FTNS. Being the first application in a developing country context, this study provides a case for examining food technology neophobia for processed staple crops in various regions and cultures. Nevertheless, research is needed to replicate this method and evaluate the external validity of our findings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Potential for early warning of maalria in India using NOAA-AVHRR based vegetation health indices

NASA Astrophysics Data System (ADS)

Dhiman, R. C.; Kogan, Felix; Singh, Neeru; Singh, R. P.; Dash, A. P.

Malaria is still a major public health problem in India with about 1 82 million cases annually and 1000 deaths As per World Health Organization WHO estimates about 1 3 million Disability Adjusted Life Years DALYs are lost annually due to malaria in India Central peninsular region of India is prone to malaria outbreaks Meteorological parameters changes in ecological conditions development of resistance in mosquito vectors development of resistance in Plasmodium falciparum parasite and lack of surveillance are the likely reasons of outbreaks Based on satellite data and climatic factors efforts have been made to develop Early Warning System EWS in Africa but there is no headway in this regard in India In order to find out the potential of NOAA satellite AVHRR derived Vegetation Condition Index VCI Temperature Condition Index TCI and a cumulative indicator Vegetation Health Index VHI were attempted to find out their potential for development of EWS Studies were initiated by analysing epidemiological data of malaria vis-a-vis VCI TCI and VHI from Bikaner and Jaisalmer districts of Rajasthan and Tumkur and Raichur districts of Karnataka Correlation coefficients between VCI and monthly malaria cases for epidemic years were computed Positive correlation 0 67 has been found with one-month lag between VCI and malaria incidence in respect of Tumkur while a negative correlation with TCI -0 45 is observed In Bikaner VCI is found to be negatively related -0 71 with malaria cases in epidemic year of 1994 Weekly

A case study of autonomy and motivation in a student-led game development project

NASA Astrophysics Data System (ADS)

Prigmore, M.; Taylor, R.; De Luca, D.

2016-07-01

This paper presents the findings of an exploratory case study into the relationship between student autonomy and motivation in project based learning, using Self-Determination Theory (SDT) to frame the investigation. The case study explores how different forms of motivation affect the students' response to challenges and their intention to complete the project. Earlier studies have made little explicit use of theoretical perspectives on student autonomy and motivation, a weakness this study attempts to address. As an exploratory case study seeking to evaluate the suitability of a particular theoretical framework, we chose a small case: three students on a one-term computer games development project. Given the small scale, the approach is necessarily qualitative, drawing on project documentation and one-to-one interviews with the students. Our conclusion is that the concepts of SDT provide a useful framework for analysing students' motivations to undertake project work, and its predictions can offer useful guidance on how to initiate and supervise such projects.

An 'inflammatory' variant of solar purpura: a simulant of leukocytoclastic vasculitis and neutrophilic dermatoses.

PubMed

Wood, Benjamin A; LeBoit, Philip E

2013-08-01

To study the clinical and pathological features of cases of apparent solar purpura, with attention to the recently described phenomenon of inflammatory changes within otherwise typical lesions. We studied 95 cases diagnosed as solar purpura and identified 10 cases (10.5%) in which significant neutrophilic inflammation was present, potentially simulating a leukocytoclastic vasculitis or neutrophilic dermatosis. An additional three cases were identified in subsequent routine practice. The clinical features, including follow-up for subsequent development of vasculitis and histological features were studied. In all cases the histological features were typical of solar purpura, with the exception of inflammatory changes, typically associated with clefting of elastotic stroma. Clinical follow-up information was available for all patients and none developed subsequent evidence of a cutaneous or systemic vasculitis or neutrophilic dermatosis. Inflammatory changes appear to be more frequent in solar purpura than is generally recognised. Awareness of this histological variation and correlation with the clinical findings and evolution is important in avoiding misdiagnosis.

A realist evaluation of the management of a well- performing regional hospital in Ghana

PubMed Central

2010-01-01

Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. Conclusion This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers. PMID:20100330

A realist evaluation of the management of a well-performing regional hospital in Ghana.

PubMed

Marchal, Bruno; Dedzo, McDamien; Kegels, Guy

2010-01-25

Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers.

Acute renal failure in acute poisoning: prospective study from a tertiary care centre of South India.

PubMed

Sweni, Shah; Meenakshisundaram, Ramachandran; Sakthirajan, R; Rajendiran, Chinnasamy; Thirumalaikolundusubramanian, Ponniah

2012-03-01

Cases of people presenting with poisoning are likely to develop acute renal failure (ARF), which may be due to multiple mechanisms/aetiologies. These cases need careful observation and appropriate treatment. To find the risk of ARF among acute poisoning cases, identify the underlying causes and to analyse the outcome. In this prospective study with nested case control, 1,250 cases admitted to the Poison Control, Training and Research Centre of Government General Hospital, Madras Medical College were monitored and evaluated for development of ARF. Patients with history of diabetes/hypertension, known chronic kidney disease, chronic NSAID therapy, those on drugs that increase serum creatinine by inhibiting creatinine secretion and other co-morbid illnesses were excluded. Data were interpreted after subjecting them to bivariate logistic regression and then step wise multivariate analysis. Thirty-two cases developed ARF. Twenty-four were due to snake bite, the rest due to chemical poisons. Chances of developing ARF were greater (6.15%) among the poisoning due to bites and stings than chemical poisoning (0.9%). Five in the former and seven in the latter expired. Among cases bitten by snakes, only 22 (7%) cases bitten by Russell Viper Daboia russelii developed renal failure. Copper sulphate and rat killer poisonings were the commonest causes of chemical induced ARF, dichromate, indigenous medicines and vasmol 33 (paraphenelyne diamine) were the least causes for ARF. None of the patients with organophosphate developed ARF nor did any of the 150 admitted for overdose of medicines developed ARF. The risk of ARF among the cases of poisoning was 2.5%. The outcome of ARF among bites and stings was better than chemical poisoning, and the difference was highly significant (p= 0.005, OR = 0.04-1.0, 95% CI = 0.004-0.38). Early recognition and appropriate measures reduce the occurrence of ARF. © 2011 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Risk stratification for malignant progression in Barrett's esophagus: Gender, age, duration and year of surveillance.

PubMed

Gatenby, Piers; Bhattacharjee, Santanu; Wall, Christine; Caygill, Christine; Watson, Anthony

2016-12-28

To clarify risk based upon segment length, diagnostic histological findings, patient age and year of surveillance, duration of surveillance and gender. Patients registered with the United Kingdom Barrett's Oesophagus Registry from 9 United Kingdom centers were included. The outcome measures were (1) development of all grades of dysplasia; (2) development of high-grade of dysplasia or adenocarcinoma; and (3) development of adenocarcinoma. Prevalent cases and subjects with < 1 year of follow-up were excluded. The covariates examined were segment length, previous biopsy findings, age at surveillance, duration of surveillance, year of surveillance and gender. One thousand and one hundred thirty six patients were included (total 6474 patient-years). Fifty-four patients developed adenocarcinoma (0.83% per annum), 70 developed high-grade dysplasia/adenocarcinoma (1.1% per annum) and 190 developed any grade of dysplasia (3.5% per annum). High grade dysplasia and adenocarcinoma increased with age and duration of surveillance. The risk of low-grade dysplasia development was not dependent on age at surveillance. Segment length and previous biopsy findings were also significant factors for development of dysplasia and adenocarcinoma. The risk of development of low-grade dysplasia is independent of age at surveillance, but high-grade dysplasia and adenocarcinoma were more commonly found at older age. Segment length and previous biopsy findings are also markers of risk. This study did not demonstrate stabilisation of the metaplastic segment with prolonged surveillance.

Active case finding of tuberculosis: historical perspective and future prospects

PubMed Central

Golub, J. E.; Mohan, C. I.; Comstock, G. W.; Chaisson, R. E.

2015-01-01

SUMMARY Despite a history of remarkable scientific achievements in microbiology and therapeutics, tuberculosis (TB) continues to pose an extraordinary threat to human health. Case finding and treatment of TB disease are the principal means of controlling transmission and reducing incidence. This review presents a historical perspective of active case finding (ACF) of TB, detailing case detection strategies that have been used over the last century. This review is divided into the following sections: mass radiography, house-to-house surveys, out-patient case detection, enhanced case finding, high-risk populations and cost-effectiveness. The report concludes with a discussion and recommendations for future case finding strategies. Understanding the strengths and weaknesses of these methods will help inform and shape ACF as a TB control policy in the twenty-first century. PMID:16333924

RadPath: A Web-based System for Integrating and Correlating Radiology and Pathology Findings During Cancer Diagnosis.

PubMed

Arnold, Corey W; Wallace, W Dean; Chen, Shawn; Oh, Andrea; Abtin, Fereidoun; Genshaft, Scott; Binder, Scott; Aberle, Denise; Enzmann, Dieter

2016-01-01

The current paradigm of cancer diagnosis involves uncoordinated communication of findings from radiology and pathology to downstream physicians. Discordance between these findings can require additional time from downstream users to resolve, or given incorrect resolution, may adversely impact treatment decisions. To mitigate this problem, we developed a web-based system, called RadPath, for correlating and integrating radiology and pathology reporting. RadPath includes interfaces to our institution's clinical information systems, which are used to retrieve reports, images, and test results that are structured into an interactive compendium for a diagnostic patient case. The system includes an editing interface for physicians, allowing for the inclusion of additional clinical data, as well as the ability to retrospectively correlate and contextualize imaging findings following pathology diagnosis. During pilot deployment and testing over the course of 1 year, physicians at our institution have completed 60 RadPath cases, requiring an average of 128 seconds from a radiologist and an average of 93 seconds from a pathologist per case. Several technical and workflow challenges were encountered during development, including interfacing with diverse clinical information systems, automatically structuring report contents, and determining the appropriate physicians to create RadPath summaries. Reaction to RadPath has been positive, with users valuing the system's ability to consolidate diagnostic information. With the increasing complexity of medicine and the movement toward team-based disease management, there is a need for improved clinical communication and information exchange. RadPath provides a platform for generating coherent and correlated diagnostic summaries in cancer diagnosis with minimal additional effort from physicians. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Subcutaneous phaeohyphomycosis caused by Cladophialophora bantiana.

PubMed

Hussey, Sean M; Gander, Rita; Southern, Paul; Hoang, Mai P

2005-06-01

Primary subcutaneous phaeohyphomycosis can rarely be caused by Cladophialophora bantiana, and we present the histologic and culture findings of such a case. A 32-year-old African American woman with systemic lupus erythematosus presented with a 2-year history of multiple, recurrent, tender, and ulcerated skin nodules with purulent drainage on her upper back. Histologic sections of the excision demonstrated features of phaeohyphomycosis. Culture findings were characteristic of C bantiana. Of interest, at age 10 she had sustained traumatic implantation of wood splinters into this area during a tornado, yet clinical symptoms of a subcutaneous infection did not manifest until she developed lupus erythematosus at age 27. Our case highlights the role of trauma and immunosuppression in the pathogenesis of subcutaneous phaeohyphomycosis.

The role of women in food provision and food choice decision-making in Singapore: a case study.

PubMed

Wang, May C; Naidoo, Nasheen; Ferzacca, Steve; Reddy, Geetha; Van Dam, Rob M

2014-01-01

As countries develop economically and increasing numbers of women enter the workforce, children are partly being cared for by someone other than their mother. Little is known about the impact of this shift in child-care provider on children's nutrition. This study presents findings from a case study of Singapore, a small country that has experienced phenomenal economic growth. Focus groups were conducted with 130 women of varying educational levels and ethnicities to learn about food decisions in their families. The findings showed that Singaporean working women cook infrequently, families eat out frequently, and children exert considerable influence on food choices. Implications for work-family policies and child health are discussed.

Topological Band Theory for Non-Hermitian Hamiltonians

NASA Astrophysics Data System (ADS)

Shen, Huitao; Zhen, Bo; Fu, Liang

2018-04-01

We develop the topological band theory for systems described by non-Hermitian Hamiltonians, whose energy spectra are generally complex. After generalizing the notion of gapped band structures to the non-Hermitian case, we classify "gapped" bands in one and two dimensions by explicitly finding their topological invariants. We find nontrivial generalizations of the Chern number in two dimensions, and a new classification in one dimension, whose topology is determined by the energy dispersion rather than the energy eigenstates. We then study the bulk-edge correspondence and the topological phase transition in two dimensions. Different from the Hermitian case, the transition generically involves an extended intermediate phase with complex-energy band degeneracies at isolated "exceptional points" in momentum space. We also systematically classify all types of band degeneracies.

The Role of Women in Food Provision and Food Choice Decision-Making in Singapore: A Case Study

PubMed Central

WANG, MAY C.; NAIDOO, NASHEEN; FERZACCA, STEVE; REDDY, GEETHA; VAN DAM, ROB M.

2015-01-01

As countries develop economically and increasing numbers of women enter the workforce, children are partly being cared for by someone other than their mother. Little is known about the impact of this shift in child-care provider on children’s nutrition. This study presents findings from a case study of Singapore, a small country that has experienced phenomenal economic growth. Focus groups were conducted with 130 women of varying educational levels and ethnicities to learn about food decisions in their families. The findings showed that Singaporean working women cook infrequently, families eat out frequently, and children exert considerable influence on food choices. Implications for work–family policies and child health are discussed. PMID:25357270

Atypical presentation of Leigh syndrome associated with a Leber hereditary optic neuropathy primary mitochondrial DNA mutation.

PubMed

Fruhman, Gary; Landsverk, Megan L; Lotze, Timothy E; Hunter, Jill V; Wangler, Michael F; Adesina, Adekunle M; Wong, Lee-Jun C; Scaglia, Fernando

2011-06-01

Leber hereditary optic neuropathy (LHON) is caused by point mutations in mitochondrial DNA (mtDNA), and is characterized by bilateral, painless sub-acute visual loss that develops during the second decade of life. Here we report the case of a five year old girl who presented with clinical and neuroradiological findings reminiscent of Leigh syndrome but carried a mtDNA mutation m.11778G>A (p.R340H) in the MTND4 gene usually observed in patients with LHON. This case is unusual for age of onset, gender, associated neurological findings and evolution, further expanding the clinical spectrum associated with primary LHON mtDNA mutations. Copyright © 2011 Elsevier Inc. All rights reserved.

Poikilodermatous changes on the forearms of a woman practicing aroma-therapy: extracervical poikiloderma of Civatte?*

PubMed Central

Katoulis, Alexandros; Makris, Michalis; Gregoriou, Stamatis; Rallis, Eustathios; Kanelleas, Antonis; Stavrianeas, Nicolaos; Rigopoulos, Dimitris

2014-01-01

We report the case of a 48-year-old, Caucasian female who presented with slowly progressing asymptomatic poikilodermatous changes of the extensor aspects of the forearms. She also had typical Poikiloderma of Civatte on the V of the neck and erythemato-telangiectatic rosacea of the central face. The patient had been practicing aroma-therapy for many years. Histologic examination revealed findings consistent with PC. Patch-testing revealed positive reactions to Fragrance mix and Nickel sulphate. Based on clinical and histological findings, a diagnosis of extracervical PC was suggested. PC with extra-cervical or extra-facial involvement is rare. In addition, this case supports the theory that contact sensitization to fragrances may contribute to the development of PC. PMID:25054757

[Mathematic analysis of risk factors influence on occupational respiratory diseases development].

PubMed

Budkar', L N; Bugaeva, I V; Obukhova, T Iu; Tereshina, L G; Karpova, E A; Shmonina, O G

2010-01-01

Analysis covered 1348 case histories of workers exposed to industrial dust in Urals region. The analysis applied mathematical processing of survival theory and correlation analysis. The authors studied influence of various factors: dust concentration, connective tissue dysplasia, smoking habits--on duration for diseases caused by dust to appear. Findings are that occupational diseases develop reliably faster with higher ambient dust concentrations and with connective tissue dysplasia syndrome. Smoking habits do not alter duration of pneumoconiosis development, but reliably increases development of occupational dust bronchitis.

Potential autofertility in true hermaphrodites.

PubMed

Bayraktar, Zeki

2018-02-01

This article examines the studies on the pregnancies of true hermaphrodites and self-fertilization in hermaphrodite mammals that have been published in the last 40 years. The number of hermaphrodite pregnants reported in the literature since 1975 was 14, the number of pregnancies was 26 and the number of healthy born babies was 20. All of the babies that were born were male. The pregnancy developed following gonadectomy in seven cases (nine pregnancies). In some cases, either gonadectomy was not performed at all or it was performed after pregnancy (eight cases, 17 pregnancies). The karyotype was 46,XX in four of these eight cases that became pregnant despite in situ ovotestis while it was 46,XX/46,XY in the other four cases (chimera). In the literature, pregnancy cases that developed through self-fertilization were not reported in humans. However, self-fertilization was detected in mammals. Pregnancy through self-fertilization developed in 7 of over 250 hermaphrodite rabbits with ovotestis that were observed by being isolated and all of them gave birth to healthy rabbits. Furthermore, the ovarian tissues of true hermaphrodites were mainly functional and ovulatory. The testicular tissues were mainly immature. However, spermatogenesis was determined in some cases. In fact, both ovulation and spermatogenesis were detected in some cases. All of these findings show that true hermaphrodites with ovarian and testicular tissues are potentially autofertile.

Novel genes identified in a high-density genome wide association study for nicotine dependence.

PubMed

Bierut, Laura Jean; Madden, Pamela A F; Breslau, Naomi; Johnson, Eric O; Hatsukami, Dorothy; Pomerleau, Ovide F; Swan, Gary E; Rutter, Joni; Bertelsen, Sarah; Fox, Louis; Fugman, Douglas; Goate, Alison M; Hinrichs, Anthony L; Konvicka, Karel; Martin, Nicholas G; Montgomery, Grant W; Saccone, Nancy L; Saccone, Scott F; Wang, Jen C; Chase, Gary A; Rice, John P; Ballinger, Dennis G

2007-01-01

Tobacco use is a leading contributor to disability and death worldwide, and genetic factors contribute in part to the development of nicotine dependence. To identify novel genes for which natural variation contributes to the development of nicotine dependence, we performed a comprehensive genome wide association study using nicotine dependent smokers as cases and non-dependent smokers as controls. To allow the efficient, rapid, and cost effective screen of the genome, the study was carried out using a two-stage design. In the first stage, genotyping of over 2.4 million single nucleotide polymorphisms (SNPs) was completed in case and control pools. In the second stage, we selected SNPs for individual genotyping based on the most significant allele frequency differences between cases and controls from the pooled results. Individual genotyping was performed in 1050 cases and 879 controls using 31 960 selected SNPs. The primary analysis, a logistic regression model with covariates of age, gender, genotype and gender by genotype interaction, identified 35 SNPs with P-values less than 10(-4) (minimum P-value 1.53 x 10(-6)). Although none of the individual findings is statistically significant after correcting for multiple tests, additional statistical analyses support the existence of true findings in this group. Our study nominates several novel genes, such as Neurexin 1 (NRXN1), in the development of nicotine dependence while also identifying a known candidate gene, the beta3 nicotinic cholinergic receptor. This work anticipates the future directions of large-scale genome wide association studies with state-of-the-art methodological approaches and sharing of data with the scientific community.

FATAL HONEY POISONING IN SOUTHWEST CHINA: A CASE SERIES OF 31 CASES.

PubMed

Zhang, Qiang; Chen, Xinguang; Chen, Shunan; Ye, Yinlong; Luo, Jiancheng; Li, Juanjuan; Yu, Siyang; Liu, Hui; Liu, Zhitao

2017-01-01

Honey poisoning cases occur in southwestern China. In this case series, we attempted to determine the symptoms and causes of honey poisoning from 2007 to 2012 in southwestern China. We also conducted a quantitative melissopalynological analysis of honey samples. During the study period, 31 honey poisoning cases occurred in the study location, all during July to August. All the cases occurred after consuming at least 100 grams of honey. The most frequent symptoms were nausea and vomiting (100%), abdominal pain (90.3%), diarrhea (74.2%), palpitations (61.3%), dizziness (54.8%), chest congestion (48.4%) and dyspnea (48.4%). Severe cases developed oliguria/anuria, twitch, hematuria, ecchymosis or hematochezia. The median time from ingestion to onset of symptoms was 29 hours. Eight patients died (mortality rate: 25.8%). The pollen of Tripterygium hypoglaucum (a plant with poisonous nectar and pollen) was detected in 22 of 29 honey samples examined (75.9%). The results of pollen analysis were consistent with the clinical findings of previous cases. T. hypoglaucum appears to be the cause of honey poisoning in southwestern China. Honey poisoning should be included in the differential diagnosis of patients who consume honey in this region and develop symptoms of food poisoning.

Can pharmaco-electroencephalography help improve survival of central nervous system drugs in early clinical development?

PubMed

Wilson, Frederick J; Leiser, Steven C; Ivarsson, Magnus; Christensen, Søren R; Bastlund, Jesper F

2014-03-01

Pharmaco-electroencephalography has significant yet unrealised promise as a translatable intermediate biomarker of central pharmacodynamic activity that could help reduce Phase 2 attrition in the development of central nervous system drugs. In an effort to understand its true potential, a framework for decision-making was proposed and the utility of pharmaco-electroencephalography was assessed through several case studies. A key finding was that lack of standardisation reduces the value of data pooling and meta-analyses and renders assessment of translatability difficult, limiting utility in all but simple cases. Pre-competitive collaboration is essential both to improving understanding of translation and developing modern signal processing techniques. Copyright © 2013 Elsevier Ltd. All rights reserved.

Rebuilding Government Legitimacy in Post-Conflict Societies: Case Studies of Nepal and Afghanistan

DTIC Science & Technology

2015-01-01

Post-conflict Societies: Case Studies of Nepal and Afghanistan 5a. CONTRACT NUMBER FA2386-12-1-4052 5b. GRANT NUMBER Grant 12RSZ057 AOARD...on the government of different groups in the Nepal , a list of 13 local and regional groups was compiled (see Appendix E). These comprised the eight... Nepal , and email and mobile phone use is inconsistent (especially in rural areas), alternative strategies needed to be developed for finding

Localized severe aggressive periodontitis. Disease progression and tooth preservation: a short case report over 14 years.

PubMed

Pelka, Matthias; Petschelt, Anselm

2009-04-01

A case of a 31-year-old female with aggressive periodontitis over 14 years is presented. From 1993 to 2000, no periodontal therapy occurred; disease development and progression could be reconstructed upon radiographic findings. In 2000, full-mouth disinfection therapy and antibiotic therapy was performed, as well as regenerative surgical treatments. Seven years after surgical treatment, stable periodontal conditions and clear bone regeneration in the surgical areas was evident.

The Beneficial Role of Random Strategies in Social and Financial Systems

NASA Astrophysics Data System (ADS)

Biondo, Alessio Emanuele; Pluchino, Alessandro; Rapisarda, Andrea

2013-05-01

In this paper we focus on the beneficial role of random strategies in social sciences by means of simple mathematical and computational models. We briefly review recent results obtained by two of us in previous contributions for the case of the Peter principle and the efficiency of a Parliament. Then, we develop a new application of random strategies to the case of financial trading and discuss in detail our findings about forecasts of markets dynamics.

Gas gangrene and osteomyelitis of the foot in a diabetic patient treated with tea tree oil

PubMed Central

2011-01-01

Diabetic foot wounds represent a class of chronic non-healing wounds that can lead to the development of soft tissue infections and osteomyelitis. We reviewed the case of a 44-year-old female with a diabetic foot wound who developed gas gangrene while treating her wound with tea tree oil, a naturally derived antibiotic agent. This case report includes images that represent clinical examination and x-ray findings of a patient who required broad-spectrum antibiotics and emergent surgical consultation. Emergency Department (ED) detection of these complications may prevent loss of life or limb in these patients. PMID:21559069

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) induced by oral metronidazole.

PubMed

Şikar Aktürk, Aysun; Bayramgürler, Dilek; Salman, Selma; Yıldız, Kürşat Demir; Odyakmaz Demirsoy, Evren

2014-12-01

Baboon syndrome is a special form of systemic contact dermatitis to systemic or local administration of contact allergens. Baboon syndrome without known previous cutaneous sensitisation was also described as drug-related baboon syndrome or symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). The major drugs causing SDRIFE was beta-lactam antibiotic such as amoxicillin and ampicillin. We report a case of 16-year-old woman who developed pruritic eruptions after oral metronidazole treatment for diarrhea. She was diagnosed SDRIFE according to her clinical and histopathological findings. To our knowledge, our patient is the first case who developed SDRIFE due to metronidazole in the literature.

The economic impact of shale gas development on state and local economies: benefits, costs, and uncertainties.

PubMed

Barth, Jannette M

2013-01-01

It is often assumed that natural gas exploration and development in the Marcellus Shale will bring great economic prosperity to state and local economies. Policymakers need accurate economic information on which to base decisions regarding permitting and regulation of shale gas extraction. This paper provides a summary review of research findings on the economic impacts of extractive industries, with an emphasis on peer-reviewed studies. The conclusions from the studies are varied and imply that further research, on a case-by-case basis, is necessary before definitive conclusions can be made regarding both short- and long-term implications for state and local economies.

A catalyst for system change: a case study of child health network formation, evolution and sustainability in Canada.

PubMed

McPherson, Charmaine; Ploeg, Jenny; Edwards, Nancy; Ciliska, Donna; Sword, Wendy

2017-02-01

The purpose of this study was to examine key processes and supportive and inhibiting factors involved in the development, evolution, and sustainability of a child health network in rural Canada. This study contributes to a relatively new research agenda aimed at understanding inter-organizational and cross-sectoral health networks. These networks encourage collaboration focusing on complex issues impacting health - issues that individual agencies cannot effectively address alone. This paper presents an overview of the study findings. An explanatory qualitative case study approach examined the Network's 13-year lifespan. Data sources were documents and Network members, including regional and 71 provincial senior managers from 11 child and youth service sectors. Data were collected through 34 individual interviews and a review of 127 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. Three themes related to network development, evolution and sustainability were identified: (a) Network relationships as system triggers, (b) Network-mediated system responsiveness, and (c) Network practice as political. Study findings have important implications for network organizational development, collaborative practice, interprofessional education, public policy, and public system responsiveness research. Findings suggest it is important to explicitly focus on relationships and multi-level socio-political contexts, such as supportive policy environments, in understanding health networks. The dynamic interplay among the Network members; central supportive and inhibiting factors; and micro-, meso-, and macro-organizational contexts was identified.

Ocular involvement in paediatric haemolytic uraemic syndrome.

PubMed

Sturm, Veit; Menke, Marcel N; Landau, Klara; Laube, Guido F; Neuhaus, Thomas J

2010-11-01

The aim of this study was to estimate the frequency and severity of ocular involvement in paediatric patients with haemolytic uraemic syndrome (HUS). The study was designed as an institutional, retrospective, observational case series. Charts for all 87 paediatric patients with HUS treated at the University Children's Hospital Zurich between 1995 and 2007 were reviewed. Patients with ocular involvement were identified and clinical findings presented. Three of 69 examined patients with HUS showed ocular involvement. Ophthalmic findings in two children were consistent with bilateral Purtscher retinopathy, showing multiple haemorrhages, exudations and superficial retinal whitening. The third child presented with bilateral isolated central intraretinal haemorrhages as a milder form of ocular involvement. In one of the children with Purtscher retinopathy, laser photocoagulation was required for bilateral rubeosis irides and development of disc neovascularization. Longterm outcomes in the two severely affected children showed decreased visual acuity caused by partial atrophy of the optic nerves. In the milder case visual acuity was not impaired at any time. A minority of paediatric patients with HUS developed ocular involvement. Acute ocular findings varied in severity from isolated intraretinal haemorrhages to Purtscher-like retinopathy with retinal ischaemia. Longterm complications included the development of neovascularizations and consecutive optic nerve atrophy. Although ocular involvement in HUS seems to be rare, physicians should be aware of this complication because of its possible vision-endangering consequences. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

Black hairy tongue associated with olanzapine treatment: a case report.

PubMed

Tamam, Lut; Annagur, Bilge Burcak

2006-10-01

Olanzapine is an atypical antipsychotic drug approved for acute and long-term treatment of bipolar disorder. Although relatively safe as compared to other classical antipsychotic medications, there are a number of uncommon adverse effects of olanzapine such as oral cavity lesions. In addition to the relatively common side effect of dry mouth, several articles have reported an association between olanzapine treatment and the development of oral lesions such as apthous stomatitis, pharyngitis, glossitis and oral ulceration. Although there are several cases in which the tongue was affected in conjunction with stomatitis or pharyngitis, we could not find a case report indicating a direct relationship between olanzapine use and a tongue lesion. We present here the case of a patient with bipolar disorder, who developed recurrent black hairy tongue on two different occasions following the addition of olanzapine to lithium treatment. In the present case, xerostomia (dry mouth), which is an adverse reaction of both olanzapine and lithium, may have played a role in the development of black hairy tongue. All agents with a possible side effect of xerostomia may predispose patients to black hairy tongue, especially when they are administered in combination. To preclude the development of this complication with such drugs, extra time and effort should be given to improving oral hygiene.

Letting the story unfold: a case study of client-centered therapy for childhood traumatic grief.

PubMed

Goodman, Robin F; Morgan, Alison V; Juriga, Sandra; Brown, Elissa J

2004-01-01

There has been increasing interest in the newly identified condition of childhood traumatic grief (CTG) since the 2001 attack on the World Trade Center. The case presented here is one of an adolescent girl who was diagnosed with CTG following the death of her father, a firefighter killed in the line of duty on September 11, 2001. Literature on CTG, its treatment, and adolescent development will be discussed. The application of client-centered treatment to CTG will be highlighted by the case description and diagnostic findings prior to, during, and following treatment.

Chopart's amputation for resection of clear cell sarcoma of the foot: a case report and review of the literature.

PubMed

Berenji, Manijeh; Kwok-Oleksy, Christina; Dang, Binh Nguyen; Trepal, Michael J; Wallack, Marc K

2009-01-01

Clear cell sarcoma (CCS) is a subset of soft tissue sarcoma that occurs mainly in young Caucasians. Although on initial presentation these growths might not appear to be malignant, CCS has a tendency to disseminate to regional lymph nodes and ultimately develop distant metastasis. We report a case of CCS from our institution, discussing the radiological and pathological findings, surgical treatments, and survival prognoses. To our knowledge, this is the first reported case of using a Chopart's amputation technique in the resection of CCS of the foot. 4.

Intense Loyalty in Organizations: A Case Study of College Athletics.

ERIC Educational Resources Information Center

Adler, Peter; Adler, Patricia A.

1988-01-01

Using data gathered during a five-year participant-observation study of a major college basketball program, this paper examines the intense form of organizational loyalty associated with college athletics. Finds five essential ingredients for developing intense organizational loyalty: documentation, identification, commitment, integration, and…

Intestinal lymphangiectasia: an undescribed cause of malabsorption and incomplete immunological recovery in HIV-infected patients.

PubMed

Marco-Lattur, Maria D; Payeras, Antoni; Campins, Antoni A; Pons, Jaume; Cifuentes, Carmen; Riera, Melcior

2011-02-01

Although paradoxical virological and immunological response after HAART has been well studied, intestinal lymphangiectasia (IL) in HIV-1 infected patients has not previously described. To describe HIV patients who developed IL. Clinical Case series. 4 patients with HIV and IL diagnosis based on clinical, endoscopic and pathological findings. All four cases had prior mycobacterial infections with abdominal lymph node involvement and a very low CD4 cell count nadir. They developed intestinal lymphangiectasia despite appropriate virological suppression with HAART and repeatedly negative mycobacterial cultures. Two patients were clinically symptomatic with oedemas, ascites, diarrhoea, asthenia, weight loss; but the other two were diagnosed with malabsorption as a result of laboratory findings, with hypoproteinemia and hypoalbuminemia. Three of them were diagnosed by video capsule endoscopy. IL should be considered in HIV-1 infected patients who present with clinical or biochemical malabsorption parameters when there is no immunological recovery while on HAART. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Key principles of community-based natural resource management: a synthesis and interpretation of identified effective approaches for managing the commons.

PubMed

Gruber, James S

2010-01-01

This article examines recent research on approaches to community-based environmental and natural resource management and reviews the commonalities and differences between these interdisciplinary and multistakeholder initiatives. To identify the most effective characteristics of Community-based natural resource management (CBNRM), I collected a multiplicity of perspectives from research teams and then grouped findings into a matrix of organizational principles and key characteristics. The matrix was initially vetted (or "field tested") by applying numerous case studies that were previously submitted to the World Bank International Workshop on CBNRM. These practitioner case studies were then compared and contrasted with the findings of the research teams. It is hoped that the developed matrix may be useful to researchers in further focusing research, understanding core characteristics of effective and sustainable CBNRM, providing practitioners with a framework for developing new CBNRM initiatives for managing the commons, and providing a potential resource for academic institutions during their evaluation of their practitioner-focused environmental management and leadership curriculum.

[An autopsy case of progressive generalized muscle atrophy over 14 years due to post-polio syndrome].

PubMed

Oki, Ryosuke; Uchino, Akiko; Izumi, Yuishin; Ogawa, Hirohisa; Murayama, Shigeo; Kaji, Ryuji

2016-01-01

We report the case of a 72-year-old man who had contracted acute paralytic poliomyelitis in his childhood. Thereafter, he had suffered from paresis involving the left lower limb, with no relapse or progression of the disease. He began noticing slowly progressive muscle weakness and atrophy in the upper and lower extremities in his 60s. At the age of 72, muscle weakness developed rapidly, and he demonstrated dyspnea on exertion and dysphagia. He died after about 14 years from the onset of muscle weakness symptoms. Autopsy findings demonstrated motoneuron loss and glial scars not only in the plaque-like lesions in the anterior horns, which were sequelae of old poliomyelitis, but also throughout the spine. No Bunina bodies, TDP-43, and ubiquitin inclusions were found. Post-polio syndrome is rarely fatal due to rapid progressive dyspnea and dysphagia. Thus, the pathological findings in the patient are considered to be related to the development of muscle weakness.

Low Fertility, Socioeconomic Development, and Gender Equity1

PubMed Central

Anderson, Thomas; Kohler, Hans-Peter

2015-01-01

While new empirical findings and theoretical frameworks provide insight into the interrelations between socioeconomic development, gender equity, and low fertility, puzzling exceptions and outliers in these findings call for a more all-encompassing framework to understand the interplay between these processes. We argue that the pace and onset of development are two important factors to be considered when analyzing gender equity and fertility. Within the developed world, “first-wave developers”—or countries that began socioeconomic development in the 19th/early 20th century – currently have much higher fertility levels than “late developers”. We lay out a novel theoretical approach to explain why this is the case and provide empirical evidence to support our argument. Our approach not only explains historical periods of low fertility but also sheds light on why there exists such large variance in fertility rates among today’s developed countries. PMID:26526031

Consortium on the Genetics of Schizophrenia (COGS) assessment of endophenotypes for schizophrenia: an introduction to this Special Issue of Schizophrenia Research.

PubMed

Swerdlow, Neal R; Gur, Raquel E; Braff, David L

2015-04-01

The COGS is a multi-site NIMH-sponsored investigation of the genetic basis of 12 primary and multiple secondary quantitative endophenotypes in schizophrenia. Since 2003, COGS has completed studies using a family-based ascertainment strategy (COGS-1), and a case-control ascertainment strategy (COGS-2) (cumulative "n">4000). COGS-1 family study confirmed robust deficits in, and heritability of, these endophenotypes in schizophrenia, and provided evidence for a coherent genetic architecture underlying the risk for neurocognitive and neurophysiological deficits in this disorder. COGS-2 case-control findings, many reported herein, establish a foundation for fine genomic mapping and other analyses of these endophenotypes and risk genes for SZ. Several reports in this Special Issue compare findings of endophenotype deficits generated by fundamentally different COGS-1 vs. COGS-2 ascertainment strategies. Despite the expectation that family-based and case-control designs would establish demographically and potentially biologically distinct patient cohorts, findings generally revealed comparable patterns of endophenotype deficits across studies. The COGS-2 case-control design facilitated the accrual of a larger "n", permitting detailed analyses of factors moderating endophenotype performance. Some COGS-2 endophenotypes not assessed in COGS-1 are also reported, as is a new factor analytic strategy for identifying shared vs. unique factors among the COGS endophenotypes which can be used to develop composite variables with distinct genetic signatures. The path to date of COGS-1 endophenotype and genetic findings, followed by replication and extension in COGS-2, establishes benchmarks for endophenotype deficits in SZ and their moderation by specific factors, and clear expectations for informative findings from upcoming COGS-2 genetic analyses. Published by Elsevier B.V.

Invasive Pulmonary Aspergillosis-mimicking Tuberculosis.

PubMed

Kim, Sung-Han; Kim, Mi Young; Hong, Sun In; Jung, Jiwon; Lee, Hyun Joo; Yun, Sung-Cheol; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee

2015-07-01

Pulmonary tuberculosis is occasionally confused with invasive pulmonary aspergillosis (IPA) in transplant recipients, since clinical suspicion and early diagnosis of pulmonary tuberculosis and IPA rely heavily on imaging modes such as computed tomography (CT). We therefore investigated IPA-mimicking tuberculosis in transplant recipients. All adult transplant recipients who developed tuberculosis or IPA at a tertiary hospital in an intermediate tuberculosis-burden country during a 6-year period were enrolled. First, we tested whether experienced radiologists could differentiate pulmonary tuberculosis from IPA. Second, we determined which radiologic findings could help us differentiate them. During the study period, 28 transplant recipients developed pulmonary tuberculosis after transplantation, and 80 patients developed IPA after transplantation. Two experienced radiologists scored blindly 28 tuberculosis and 50 randomly selected IPA cases. The sensitivities of radiologists A and B for IPA were 78% and 68%, respectively (poor agreement, kappa value = 0.25). The sensitivities of radiologists A and B for tuberculosis were 64% and 61%, respectively (excellent agreement, kappa value = 0.77). We then compared the CT findings of the 28 patients with tuberculosis and 80 patients with IPA. Infarct-shaped consolidations and smooth bronchial wall thickening were more frequent in IPA, and mass-shaped consolidations and centrilobular nodules (<10 mm, clustered) were more frequent in tuberculosis. Certain CT findings appear to be helpful in differentiating between IPA and tuberculosis. Nevertheless, the CT findings of about one-third of pulmonary tuberculosis cases in transplant recipients are very close to those of IPA. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Posterior reversible encephalopathy syndrome and association with systemic lupus erythematosus.

PubMed

Ferreira, T S; Reis, F; Appenzeller, S

2016-10-01

Posterior reversible encephalopathy syndrome (PRES) is a neurological complex disorder with many clinical associations and causative factors. It is important to recognize this condition because early diagnosis and treatment usually result in its complete resolution, radiological imaging becoming the key for the correct diagnosis. We retrospectively reviewed charts and magnetic resonance imaging findings in the University of Campinas from January 2005 to July 2015, selecting three cases of patients with systemic lupus erythematosus syndrome who developed PRES, for whom risk factors, characteristics, magnetic resonance imaging findings and neurological resolution were analyzed. We also conducted a review of the English-language literature. The three cases had neurological symptoms like acute onset of headache, altered mental status, cortical blindness and seizures. Brain magnetic resonance imaging demonstrated posterior cortical and white matter alterations involving posterior brain territories, which were more conspicuous on T2-weighted and fluid-attenuated inversion recovery. Spectroscopy, diffusion-weighted imaging and susceptibility-weighted imaging were also important for neuroradiological evaluation. Immunosuppressive drugs were taken in all cases. Partial clinical and radiological recovery was observed in two cases, and complete resolution was observed in the third patient. We found 52 cases of PRES in systemic lupus erythematosus patients. Almost all patients were women 94%, ranging from 8 to 62 years old. Posterior brain territory involvements were found in 98% of patients. Hemorrhagic complications involved 26% of patients, becoming a risk factor for clinical sequels. The total percentage of patients with no complete resolution of radiological findings on follow-up images was 27.5%. In patients with autoimmune disorders, endothelial dysfunction may occur secondary to autoimmunity and the use of cytotoxic drugs, supposedly facilitating the occurrence of more severe PRES. The hypothesis that patients with autoimmune diseases have a propensity to develop non-reversible lesions has been raised. © The Author(s) 2016.

Adalimumab and Non-Arteritic Anterior Ischaemic Optic Neuropathy: A Case Report.

PubMed

Kinard, Krista; Walsh, Jessica A; Penmetsa, Gopi K; Warner, Judith E A

2014-01-01

Sequential anterior ischaemic optic neuropathy was observed in a patient treated with a tumour necrosis factor α (TNF) inhibitor, adalimumab, for ankylosing spondylitis. He developed decreased visual acuity in the right eye after 17 months of treatment. Findings showed right optic disc oedema with haemorrhages and visual field defect. Adalimumab was discontinued and vision stabilised. After restarting adalimumab, he developed optic neuropathy in the left eye. Findings showed optic disc oedema, with haemorrhages and visual field changes in the left eye. Adalimumab may be associated with optic neuropathy; providers prescribing TNF inhibitors should be aware of optic neuropathy as a potential complication.

A VLSI architecture for performing finite field arithmetic with reduced table look-up

NASA Technical Reports Server (NTRS)

Hsu, I. S.; Truong, T. K.; Reed, I. S.

1986-01-01

A new table look-up method for finding the log and antilog of finite field elements has been developed by N. Glover. In his method, the log and antilog of a field element is found by the use of several smaller tables. The method is based on a use of the Chinese Remainder Theorem. The technique often results in a significant reduction in the memory requirements of the problem. A VLSI architecture is developed for a special case of this new algorithm to perform finite field arithmetic including multiplication, division, and the finding of an inverse element in the finite field.

Summer Entrepreneur an Activity for Stimulating Entrepreneurship among Youths: A Case Study in a Swedish County

ERIC Educational Resources Information Center

Karlsson, Hakan

2011-01-01

This paper aims to outline findings from a research project that has investigated an initiative to stimulate youths to become more entrepreneurial. The concept of summer entrepreneur has been developed in the last decade in a Swedish county. It was developed out of the idea that youths should have a possibility to run their own companies as…

Divergence and Necessary Conditions for Extremums

NASA Technical Reports Server (NTRS)

Quirein, J. A.

1973-01-01

The problem is considered of finding a dimension reducing transformation matrix B that maximizes the divergence in the reduced dimension for multi-class cases. A comparitively simple expression for the gradient of the average divergence with respect to B is developed. The developed expression for the gradient contains no eigenvectors or eigenvalues; also, all matrix inversions necessary to evaluate the gradient are available from computing the average divergence.

Raising Citizens or Raising Test Scores? Teach for America, "No Excuses" Charters, and the Development of the Neoliberal Citizen

ERIC Educational Resources Information Center

Sondel, Beth

2015-01-01

This article addresses how teachers conceptualize and attempt to develop citizens within the context of market-based reforms. Findings are based on a qualitative case study of Teach For America teachers at a Knowledge is Power Program charter school in New Orleans. Using Westheimer and Kahne's taxonomy of citizenship, I provide evidence that…

Job Analysis Results for Malicious-Code Reverse Engineers: A Case Study

DTIC Science & Technology

2014-05-01

Testing in Personnel Selection: Contemporary Issues in Cognitive Ability and Personality Testing .” Journal of Business Inquiry: Research , Edu- cation, and...federally funded research and development center. Any opinions, findings and conclusions or recommendations expressed in this material are those of...predict the develop- ment of expertise is important. Currently, job analysis research on teams of malicious-code re- verse engineers is lacking. Therefore

Computing Models for FPGA-Based Accelerators

PubMed Central

Herbordt, Martin C.; Gu, Yongfeng; VanCourt, Tom; Model, Josh; Sukhwani, Bharat; Chiu, Matt

2011-01-01

Field-programmable gate arrays are widely considered as accelerators for compute-intensive applications. A critical phase of FPGA application development is finding and mapping to the appropriate computing model. FPGA computing enables models with highly flexible fine-grained parallelism and associative operations such as broadcast and collective response. Several case studies demonstrate the effectiveness of using these computing models in developing FPGA applications for molecular modeling. PMID:21603152

Improving Low Income Job Seekers' Employment Prospects: The Role of Labor Market Intermediaries. A Background Paper [and Three Case Studies].

ERIC Educational Resources Information Center

Kazis, Richard

Recent labor market and economic trends have spotlighted the need for work force development systems and policies to simultaneously serve employers seeking qualified workers and individuals who want to find work and advance toward self-sufficiency. This need has in turn led to the development of labor market intermediaries that can perform a wide…

Facebook as a Learning Tool? A Case Study on the Appropriation of Social Network Sites from Mobile Phones in Developing Countries

ERIC Educational Resources Information Center

Pimmer, Christoph; Linxen, Sebastian; Grohbiel, Urs

2012-01-01

This exploratory research investigates how students and professionals use social network sites (SNSs) in the setting of developing and emerging countries. Data collection included focus groups consisting of medical students and faculty as well as the analysis of a Facebook site centred on medical and clinical topics. The findings show how users,…

Helping Children through Crisis: A Special Report from the Editors of the Brown University Child Behavior and Development Letter.

ERIC Educational Resources Information Center

Lipsitt, Lewis P., Ed.

Noting that today's children face many dangers such as depression (in some cases leading to suicide), child abuse, eating disorders, accidents, alcohol and other drug abuse, and AIDS, this report, drawn from past issues of The Brown University Child Behavior and Development Letter, presents some of the most interesting and useful findings on these…

A Study of the Impact of Transformative Professional Development on Hispanic Student Performance on State Mandated Assessments of Science in Elementary School

ERIC Educational Resources Information Center

Johnson, Carla C.; Fargo, Jamison D.

2014-01-01

This paper reports the findings of a study of the impact of the transformative professional development (TPD) model on student achievement on state-mandated assessments of science in elementary school. Two schools (one intervention and one control) participated in the case study where teachers from one school received the TPD intervention across a…

Development of Integrative STEM Curriculum: A Multiple Case Study of Multi-Disciplinary Teams in Two Pennsylvania High Schools

NASA Astrophysics Data System (ADS)

Rider-Bertrand, Joey H.

At the start of the 21st century, STEM education was a new priority in many schools as the focus shifted from separate disciplines to integrative STEM education. Unfortunately, there was limited research to offer guidance to practitioners (Brown, 2012; Honey, Pearson & Schweingruber, 2014). This qualitative, multiple case study explored the experiences of two multi-disciplinary teams of secondary teachers from Pennsylvania who developed and implemented integrative STEM curriculum. Four teachers from a rural high school and four teachers from a suburban high school participated in the study. A document review of integrative STEM curriculum and semi-structured interviews were conducted to learn about the curriculum development process and teachers' perceptions regarding conditions that support or hinder success. Individual and cross-case analyses were performed to establish findings and themes. Although the individual case themes varied slightly, the cross-case themes and assertions that emerged provided highly sought after guidance to practitioners and added to the limited body of research on integrative STEM education. This study found that current curriculum models do not fit integrative STEM curriculum, the development process is fluid, and substantial administrative support and resources are necessary to develop, implement, and sustain integrative STEM education programs. The results offered implications for all educators, as well as two examples of how teachers navigated the terrain of integrative STEM curriculum.

H pylori recurrence after successful eradication.

PubMed

Niv, Yaron

2008-03-14

Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfection (colonization with a new strain, more than 12 mo after eradication) is considered to be responsible for most of the cases. This observation was confirmed only in developed countries, while in developing countries a recent meta-analysis demonstrated a high rate of reinfection. The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries, respectively. Nested meta-analysis (only cases with a longer follow-up and a negative (13)CUBT a year after eradication) revealed annual recurrence rate of 1.45% [relative risk (RR), 0.54] and 12.00% (RR, 0.92) in developed and developing countries, respectively. These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication, with a 46% drop in the recurrence rate after the first year post eradication, while in developing countries reinfection is more pronounced, and continue at the same rate since eradication. A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries, since reinfection is highly prevalent.

H pylori recurrence after successful eradication

PubMed Central

Niv, Yaron

2008-01-01

Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries. Recrudescence (recolonization of the same strain within 12 mo after eradication) rather than reinfection (colonization with a new strain, more than 12 mo after eradication) is considered to be responsible for most of the cases. This observation was confirmed only in developed countries, while in developing countries a recent meta-analysis demonstrated a high rate of reinfection. The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries, respectively. Nested meta-analysis (only cases with a longer follow-up and a negative 13CUBT a year after eradication) revealed annual recurrence rate of 1.45% [relative risk (RR), 0.54] and 12.00% (RR, 0.92) in developed and developing countries, respectively. These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication, with a 46% drop in the recurrence rate after the first year post eradication, while in developing countries reinfection is more pronounced, and continue at the same rate since eradication. A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries, since reinfection is highly prevalent. PMID:18330934

Nursing students' experiences with the use of authentic assessment rubric and case approach in the clinical laboratories.

PubMed

Wu, Xi Vivien; Heng, Mary Anne; Wang, Wenru

2015-04-01

One current challenge for nurse educators is to examine effective nursing assessment tools which integrate nursing knowledge into practice. Authentic assessment allows nursing students to apply knowledge to real-life experiences. Contextualized cases have engaged students for preparation of diverse clinical situations and develop critical thinking skills. This study aimed to explore nursing students' experiences and learning outcomes with the use of an authentic assessment rubric and a case approach. An exploratory qualitative approach using focus-group discussions and an open-ended survey was adopted. Sixteen nursing students participated in three focus-group discussions and 39 nursing students completed an open-ended survey. Nursing students noted that an authentic assessment rubric with a case approach provided clarity for their learning goals; built confidence; developed knowledge, skill competencies and critical thinking skills; increased awareness of caring attributes and communication skills; and enriched and extended learning through self-, peer- and teacher-assessments. These findings provide rich insights for nurse educators and curriculum developers in the use of an authentic assessment rubric and a case approach in nursing education. Copyright © 2014 Elsevier Ltd. All rights reserved.

A retrospective health policy analysis of the development and implementation of the voluntary health insurance system in Lebanon: learning from failure.

PubMed

El-Jardali, Fadi; Bou-Karroum, Lama; Ataya, Nour; El-Ghali, Hana Addam; Hammoud, Rawan

2014-12-01

Public policymaking is complex and suffers from limited uptake of research evidence, particularly in the Eastern Mediterranean Region (EMR). In-depth case studies examining health policymaking in the EMR are lacking. This retrospective policy analysis aims at generating insights about how policies are being made, identifying factors influencing policymaking and assessing to what extent evidence is used in this process by using the Lebanese Voluntary Health Insurance policy as a case study. The study examined the policymaking process through a policy tracing technique that covered a period of 12 years. The study employed a qualitative research design using a case study approach and was conducted in two phases over the course of two years. Data was collected using multiple sources including: 1) a comprehensive and chronological media review; 2) twenty-two key informant interviews with policymakers, stakeholders, and journalists; and 3) a document review of legislations, minutes of meetings, actuarial studies, and official documents. Data was analyzed and validated using thematic analysis. Findings showed that the voluntary health insurance policy was a political decision taken by the government to tackle an urgent political problem. Evidence was not used to guide policy development and implementation and policy implementers and other stakeholders were not involved in policy development. Factors influencing policymaking were political interests, sectarianism, urgency, and values of policymakers. Barriers to the use of evidence were lack of policy-relevant research evidence, political context, personal interests, and resource constraints. Findings suggest that policymakers should be made more aware of the important role of evidence in informing public policymaking and the need for building capacity to develop, implement and evaluate policies. Study findings are likely to matter in light of the changes that are unfolding in some Arab countries and the looming opportunities for policy reforms. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Addressing uncertainty in adaptation planning for agriculture.

PubMed

Vermeulen, Sonja J; Challinor, Andrew J; Thornton, Philip K; Campbell, Bruce M; Eriyagama, Nishadi; Vervoort, Joost M; Kinyangi, James; Jarvis, Andy; Läderach, Peter; Ramirez-Villegas, Julian; Nicklin, Kathryn J; Hawkins, Ed; Smith, Daniel R

2013-05-21

We present a framework for prioritizing adaptation approaches at a range of timeframes. The framework is illustrated by four case studies from developing countries, each with associated characterization of uncertainty. Two cases on near-term adaptation planning in Sri Lanka and on stakeholder scenario exercises in East Africa show how the relative utility of capacity vs. impact approaches to adaptation planning differ with level of uncertainty and associated lead time. An additional two cases demonstrate that it is possible to identify uncertainties that are relevant to decision making in specific timeframes and circumstances. The case on coffee in Latin America identifies altitudinal thresholds at which incremental vs. transformative adaptation pathways are robust options. The final case uses three crop-climate simulation studies to demonstrate how uncertainty can be characterized at different time horizons to discriminate where robust adaptation options are possible. We find that impact approaches, which use predictive models, are increasingly useful over longer lead times and at higher levels of greenhouse gas emissions. We also find that extreme events are important in determining predictability across a broad range of timescales. The results demonstrate the potential for robust knowledge and actions in the face of uncertainty.

Factors that influence case managers' resource allocation decisions in pediatric home care: an ethnographic study.

PubMed

Fraser, Kimberly D; Estabrooks, Carole; Allen, Marion; Strang, Vicki

2009-03-01

Case managers make decisions that directly affect the amount and type of services home care clients receive and subsequently affect the overall available health care resources of home care programs. A recent systematic review of the literature identified significant knowledge gaps with respect to resource allocation decision-making in home care. Using Spradley's methodology, we designed an ethnographic study of a children's home care program in Western Canada. The sample included 11 case managers and program leaders. Data sources included interviews, card sorts, and participant observation over a 5-month period. Data analyses included open coding, domain, taxonomic, and componential analysis. One of the key findings was a taxonomy of factors that influence case manager resource allocation decisions. The factors were grouped into one of four main categories: system-related, home care program-related, family related, or client-related. Family related factors have not been previously reported as influencing case manager resource allocation decision-making and nor has the team's role been reported as an influencing factor. The findings of this study are examined in light of Daniels and Sabin's Accountability for Reasonableness framework, which may be useful for future knowledge development about micro-level resource allocation theory.

Addressing uncertainty in adaptation planning for agriculture

PubMed Central

Vermeulen, Sonja J.; Challinor, Andrew J.; Thornton, Philip K.; Campbell, Bruce M.; Eriyagama, Nishadi; Vervoort, Joost M.; Kinyangi, James; Jarvis, Andy; Läderach, Peter; Ramirez-Villegas, Julian; Nicklin, Kathryn J.; Hawkins, Ed; Smith, Daniel R.

2013-01-01

We present a framework for prioritizing adaptation approaches at a range of timeframes. The framework is illustrated by four case studies from developing countries, each with associated characterization of uncertainty. Two cases on near-term adaptation planning in Sri Lanka and on stakeholder scenario exercises in East Africa show how the relative utility of capacity vs. impact approaches to adaptation planning differ with level of uncertainty and associated lead time. An additional two cases demonstrate that it is possible to identify uncertainties that are relevant to decision making in specific timeframes and circumstances. The case on coffee in Latin America identifies altitudinal thresholds at which incremental vs. transformative adaptation pathways are robust options. The final case uses three crop–climate simulation studies to demonstrate how uncertainty can be characterized at different time horizons to discriminate where robust adaptation options are possible. We find that impact approaches, which use predictive models, are increasingly useful over longer lead times and at higher levels of greenhouse gas emissions. We also find that extreme events are important in determining predictability across a broad range of timescales. The results demonstrate the potential for robust knowledge and actions in the face of uncertainty. PMID:23674681

Concomitant CNS pathology in a patient with amyotropic lateral sclerosis following poliomyelitis in childhood.

PubMed

Casula, M; Steentjes, K; Aronica, E; van Geel, B M; Troost, D

2011-01-01

Post-polio syndrome (PPS) develops in approximately 30% of polio survivors several decades after the acute attack of paralytic poliomyelitis. Some of these patients develop post-poliomyelitis muscular atrophy (PPMA) which is characterized by a slowly progressive muscle weakness. Due to its clinicopathological features, investigators have often studied PPS and PPMA in association with amyotrophic lateral sclerosis (ALS), the underlying hypothesis being an increased risk of developing ALS from a prior acute paralytic poliomyelitis. Various studies, however, have indicated that de novo ALS cases in patients with prior acute paralytic poliomyelitis are rare. Herein, we describe a rare case of a 75-year-old woman who at post-mortem examination presented a combination of a PPS with proven histopathological sporadic ALS features. Furthermore, neuropathology of this case also revealed several other histopathological findings reminiscent of a tauopathy, synucleinopathy and amyloid angiopathy and a large pituitary cyst. To our knowledge, this is the first reported case of PPS with clear pathological hallmarks of sporadic ALS, including ubiquitin-, TDP-43, phosphorylated TDP-43- and p62-positive inclusions, with accompanying features compatible with Alzheimer's and Parkinson's disease.

A Cross-Course Investigation of Integrative Cases for Evolution Education.

PubMed

White, Peter John Thomas; Heidemann, Merle K; Smith, James J

2015-12-01

Evolution is a cornerstone theory in biology, yet many undergraduate students have difficulty understanding it. One reason for this is that evolution is often taught in a macro-scale context without explicit links to micro-scale processes. To address this, we developed a series of integrative evolution cases that present the evolution of various traits from their origin in genetic mutation, to the synthesis of modified proteins, to how these proteins produce novel phenotypes, to the related macro-scale impacts that the novel phenotypes have on populations in ecological communities. We postulated that students would develop a fuller understanding of evolution when learning biology in a context where these integrative evolution cases are used. We used a previously developed assessment tool, the ATEEK (Assessment Tool for Evaluating Evolution Knowledge), within a pre-course/post-course assessment framework. Students who learned biology in courses using the integrative cases performed significantly better on the evolution assessment than did students in courses that did not use the cases. We also found that student understanding of evolution increased with increased exposure to the integrative evolution cases. These findings support the general hypothesis that students acquire a more complete understanding of evolution when they learn about its genetic and molecular mechanisms along with macro-scale explanations.

A Cross-Course Investigation of Integrative Cases for Evolution Education †

PubMed Central

White, Peter John Thomas; Heidemann, Merle K.; Smith, James J.

2015-01-01

Evolution is a cornerstone theory in biology, yet many undergraduate students have difficulty understanding it. One reason for this is that evolution is often taught in a macro-scale context without explicit links to micro-scale processes. To address this, we developed a series of integrative evolution cases that present the evolution of various traits from their origin in genetic mutation, to the synthesis of modified proteins, to how these proteins produce novel phenotypes, to the related macro-scale impacts that the novel phenotypes have on populations in ecological communities. We postulated that students would develop a fuller understanding of evolution when learning biology in a context where these integrative evolution cases are used. We used a previously developed assessment tool, the ATEEK (Assessment Tool for Evaluating Evolution Knowledge), within a pre-course/post-course assessment framework. Students who learned biology in courses using the integrative cases performed significantly better on the evolution assessment than did students in courses that did not use the cases. We also found that student understanding of evolution increased with increased exposure to the integrative evolution cases. These findings support the general hypothesis that students acquire a more complete understanding of evolution when they learn about its genetic and molecular mechanisms along with macro-scale explanations. PMID:26753023

Intrathyroidal epithelial thymoma/carcinoma showing thymus-like differentiation; comparison with thymic lymphoepithelioma-like carcinoma and a possibility of development from a multipotential stem cell.

PubMed

Hirokawa, Mitsuyoshi; Miyauchi, Akira; Minato, Hiroshi; Yokoyama, Shigeo; Kuma, Seiji; Kojima, Masaru

2013-06-01

The purpose of our article is to describe the immunohistochemical findings of intrathyroidal epithelial thymoma/carcinoma showing thymus-like differentiation (ITET/CASTLE) of the thyroid in detail, to clarify the difference between ITET/CASTLE and thymic lymphoepithelioma-like carcinoma (LELC), and to discuss the pathogenesis of ITET/CASTLE. We immunohistochemically examined five ITET/CASTLE and eight LELC cases. All of ITET/CASTLE cases were strongly positive for CD5, P63, high-molecular-weight cytokeratin and B-cell CLL/lymphoma-2. Carcinoembryonic antigen-positive carcinoma cells were found in four ITET/CASTLE cases. Neuroendocrine marker-positive carcinoma cells were scattered in all cases. Immunohistochemical findings in thymic LELC were essentially similar to those in ITET/CASTLE, but the sensitivity was different. There is a possibility that ITET/CASTLE and thymic LELC are not the quite same disease entity. We think that ITET/CASTLE is derived from ectopic thymus, but not related to solid cell nests. © 2012 APMIS Published by John Wiley & Sons Ltd.

A Study of the Impact of Thirteen Celebrity Suicides on Subsequent Suicide Rates in South Korea from 2005 to 2009

PubMed Central

Fu, King-wa; Chan, C. H.

2013-01-01

A number of ecological studies have found a pattern of increasing suicide rates after suicides of several Asian entertainment celebrities. However, the finding may be subject to positive outcome bias where cases with no perceived impact may be routinely excluded. In this study, we deploy interrupted time-series analysis using ARIMA transfer function models to investigate systematically the impact of thirteen celebrity suicides on subsequent suicide rates in South Korea. We find that three out of eleven cases were found to be followed by a significant increase in suicide rate, while controlling for seasonality, secular trends, and unemployment rates. Such significant increases could last for nine weeks. Non-significance cases may be attributable to the small amount of media coverage, the “displacement” effect of preceding case, and the negative connotation of celebrity deaths. We therefore conclude that whether or not the impacts were detected may be largely conditioned by various contextual factors. Current evidence based on ecological studies is insufficient to draw a firm conclusion. Further studies using multiple approaches should be developed. PMID:23342026

Magnetic resonance imaging findings in patients presenting with (sub)acute cerebellar ataxia.

PubMed

Schneider, Tanja; Thomalla, Götz; Goebell, Einar; Piotrowski, Anna; Yousem, David Mark

2015-06-01

Acute or subacute cerebellar inflammation is mainly caused by postinfectious, toxic, neoplastic, vascular, or idiopathic processes and can result in cerebellar ataxia. Previous magnetic resonance (MR) studies in single patients who developed acute or subacute ataxia showed varying imaging features. Eighteen patients presenting with acute and subacute onset of ataxia were included in this study. Cases of chronic-progressive/hereditary and noncerebellar causes (ischemia, multiple sclerosis lesions, metastasis, bleedings) were excluded. MR imaging findings were then matched with the clinical history of the patient. An underlying etiology for ataxic symptoms were found in 14/18 patients (postinfectious/infectious, paraneoplastic, autoimmune, drug-induced). In two of five patients without MR imaging findings and three of eight patients with minimal imaging features (cerebellar atrophy, slight signal alterations, and small areas of restricted diffusion), adverse clinical outcomes were documented. Of the five patients with prominent MR findings (cerebellar swelling, contrast enhancement, or broad signal abnormalities), two were lost to follow-up and two showed long-term sequelae. No correlation was found between the presence of initial MRI findings in subacute or acute ataxia patients and their long-term clinical outcome. MR imaging was more flagrantly positive in cases due to encephalitis.

A Hopping Good Time: Wood Frogs in the Classroom.

ERIC Educational Resources Information Center

Shimkanin, John; Ulm, Glenn; King, Trina

1998-01-01

Presents a case for using wood frogs to study biology with students. Offers tips on where to find the eggs, how to care for them, what to expect as they hatch, and how to engage students in a study of their stages of development. (DDR)

Innovating Conservation Agriculture: The Case of No-Till Cropping

ERIC Educational Resources Information Center

Coughenour, C. Milton

2003-01-01

The extensive sociological studies of conservation agriculture have provided considerable understanding of farmers' use of conservation practices, but attempts to develop predictive models have failed. Reviews of research findings question the utility of the conceptual and methodological perspectives of prior research. The argument advanced here…

[Asperger syndrome with highly exceptional calendar memory: a case report].

PubMed

Sevik, Ali Emre; Cengel Kültür, Ebru; Demirel, Hilal; Karlı Oğuz, Kader; Akça, Onur; Lay Ergün, Eser; Demir, Başaran

2010-01-01

Some patients with pervasive developmental disorders develop unusual talents, which are characterized as savant syndrome. Herein we present neuropsychological examination and brain imaging (fMRI and brain SPECT) findings of an 18-year-old male with Asperger syndrome and highly unusual calendar memory. Neuropsychological evaluation of the case indicated mild attention, memory, and problem solving deficits, and severe executive function deficits that included conceptualization, category formation, and abstraction. Functional MRI findings showed activation above the baseline level (P<0.05) in the bilateral inferior parietal lobule, precuneus, superior and middle frontal gyri, and medial frontal cortex. Brain SPECT findings, in comparison to rest-SPECT findings, showed that there was hypoperfusion in some brain regions, including the right frontal cortex and right parietal cortex. Baseline blood perfusion in the left frontal cortex was also observed, as well as hypoperfusion in the right parietal-occipital cortex and in the right basal ganglion (compared to the left side). The results of the present study and further research will contribute to our understanding of calendar memory and savant syndrome.

Equine Multinodular Pulmonary Fibrosis in association with asinine herpesvirus type 5 and equine herpesvirus type 5: a case report

PubMed Central

2012-01-01

A standardbred gelding with a history of 10 days pyrexia and lethargy was referred to the Equine Hospital at the Swedish University of Agricultural Sciences in Uppsala, Sweden. The horse had tachypnea with increased respiratory effort and was in thin body condition. Laboratory findings included leukocytosis, hyperfibrinogenemia and hypoxemia. Thoracic radiographs showed signs of pneumonia with a multifocal nodular pattern, which in combination with lung biopsy findings indicated Equine Multinodular Pulmonary Fibrosis (EMPF). EMPF is a recently described disease in adult horses with clinical signs of fever, weight loss and respiratory problems. The pathological findings include loss of functional pulmonary parenchyma due to extensive nodular interstitial fibrosis which has been related to infection with the equine herpesvirus type 5 (EHV-5). In this case, lung biopsy and tracheal wash samples tested positive for both asinine herpesvirus type 5 (AHV-5) and EHV-5 using PCR assays. The horse failed to respond to treatment and was euthanized for humane reasons. Postmortem examination confirmed the diagnosis of EMPF. This case suggests that not only EHV-5 alone should be considered in association with the development of this disease. PMID:23009194

Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ.

PubMed

Albright, Len; Derickson, Elizabeth S; Massey, Douglas S

2013-06-01

This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ - the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities.

Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ

PubMed Central

Albright, Len; Derickson, Elizabeth S.; Massey, Douglas S.

2016-01-01

This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ – the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities. PMID:27390552

Poststaphylococcal coagulase negative reactive arthritis: a case report.

PubMed

Krasniqi, Xhevdet; Rexhepi, Sylejman; Gashi, Masar; Berisha, Blerim; Abazi, Flora; Koçinaj, Dardan

2009-12-18

We report a case of a 49-year-old patient who developed poststaphylococcal coagulase negative reactive arthritis. The woman presented with constitutional symptoms, arthritis, urinary infection and conjunctivitis. The blood culture was positive for the staphylococcal coagulase negative infection. Erythrocyte sedimentation rate and C-reactive protein were elevated, whereas the rheumatoid factor was negative. Radiographic findings confirmed diagnosis of pleuropneumonia, and one year later of chronic asymmetric sacroileitis. Physicians should be aware of possible reactive arthritis after staphylococcal coagulase negative bacteremia.

Poststaphylococcal coagulase negative reactive arthritis: a case report

PubMed Central

2009-01-01

We report a case of a 49-year-old patient who developed poststaphylococcal coagulase negative reactive arthritis. The woman presented with constitutional symptoms, arthritis, urinary infection and conjunctivitis. The blood culture was positive for the staphylococcal coagulase negative infection. Erythrocyte sedimentation rate and C-reactive protein were elevated, whereas the rheumatoid factor was negative. Radiographic findings confirmed diagnosis of pleuropneumonia, and one year later of chronic asymmetric sacroileitis. Physicians should be aware of possible reactive arthritis after staphylococcal coagulase negative bacteremia. PMID:20062603

Retinitis and optic neuritis in a child with chickenpox: case report and review of literature.

PubMed

Tappeiner, Christoph; Aebi, Christoph; Garweg, Justus G

2010-12-01

In immunocompetent individuals, necrotizing retinopathy is a rare complication of chickenpox. Herein, we report on a 3-year-old immunocompetent boy who developed retinitis and optic neuritis 3 days after the onset of chickenpox and compare the findings to published cases. Since macula and optic nerve were affected, visual acuity remained poor. An early diagnosis and treatment of ocular manifestations in chickenpox is imperative for the preservation of a residual visual function and prevention of blinding secondary complications.

The Many Faces of Meningococcal Disease: A Case Series and Review of Presentations and Treatment Options

DTIC Science & Technology

2004-01-01

United States. Classic findings include headache, fevers , and a petechial rash that begins on the lower extremities with a predilection for areas of...cough and sore throat, but no headache or fevers . He reported to the medical clinic at 9:00 a.m., 6 hours after the rash began. He was in acute...meningitidis septicemia (meningococcemia). Case 2 A 22-year-old active-duty female developed fevers , headaches, confusion, and a rash on her

Hepatotoxicity associated with weight loss or sports dietary supplements, including OxyELITE Pro™ - United States, 2013.

PubMed

Chatham-Stephens, Kevin; Taylor, Ethel; Chang, Arthur; Peterson, Amy; Daniel, Johnni; Martin, Colleen; Deuster, Patricia; Noe, Rebecca; Kieszak, Stephanie; Schier, Josh; Klontz, Karl; Lewis, Lauren

2017-01-01

In September 2013, the Hawaii Department of Health (HDOH) was notified of seven adults who developed acute hepatitis after taking OxyELITE Pro™, a weight loss and sports dietary supplement. CDC assisted HDOH with their investigation, then conducted case-finding outside of Hawaii with FDA and the Department of Defense (DoD). We defined cases as acute hepatitis of unknown etiology that occurred from April 1, 2013, through December 5, 2013, following exposure to a weight loss or muscle-building dietary supplement, such as OxyELITE Pro™. We conducted case-finding through multiple sources, including data from poison centers (National Poison Data System [NPDS]) and FDA MedWatch. We identified 40 case-patients in 23 states and two military bases with acute hepatitis of unknown etiology and exposure to a weight loss or muscle building dietary supplement. Of 35 case-patients who reported their race, 15 (42.9%) reported white and 9 (25.7%) reported Asian. Commonly reported symptoms included jaundice, fatigue, and dark urine. Twenty-five (62.5%) case-patients reported taking OxyELITE Pro™. Of these 25 patients, 17 of 22 (77.3%) with available data were hospitalized and 1 received a liver transplant. NPDS and FDA MedWatch each captured seven (17.5%) case-patients. Improving the ability to search surveillance systems like NPDS and FDA MedWatch for individual and grouped dietary supplements, as well as coordinating case-finding with DoD, may benefit ongoing surveillance efforts and future outbreak responses involving adverse health effects from dietary supplements. This investigation highlights opportunities and challenges in using multiple sources to identify cases of suspected supplement associated adverse events. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Ten years' experience of Directly Observed Treatment Short-course (DOTS) in Gambella Regional State, Ethiopia: An evaluation of tuberculosis control program.

PubMed

Sisay, Solomon; Mengistu, Belete; Erku, Woldargay; Woldeyohannes, Desalegne

2016-12-01

World Health Organization (WHO) declared tuberculosis (TB) as a global public health emergency and recommended DOTS as a standard strategy for controlling the disease. TB is one of the major causes of infectious diseases in the world, and 25% of all avoidable deaths in developing countries. About a third of the world's population is estimated to be infected with tubercle bacilli, and hence at risk of developing active disease. The objective of the study was, therefore, to evaluate the impact of DOTS strategy on smear-positive pulmonary tuberculosis case finding and their treatment outcomes in Gambella Regional State, Ethiopia. A retrospective health facility-based descriptive study was employed. Quarterly data were collected by using WHO structured reporting format for TB case finding and treatment outcome from all DOTS implementing health facilities in the region. A total of 10,024 TB cases (all forms) were registered and reported between the periods from 2003 up to 2012. Out of these, 4100 (40.9%) were smear-positive pulmonary TB, 3164 (31.6%) were smear-negative pulmonary TB and 2760 (27.5%) had extra-pulmonary TB. An average case detection rate (CDR) 1 of 40.9% (SD=0.1) and treatment success rate (TSR) 2 of 55.7% (SD=0.28) for smear-positive pulmonary TB including other forms of TB were reported for the specified years period. Additionally, the average mean values of treatment defaulter and treatment failure rates were 4.2% and 0.3%, respectively. The recommended TSR set by WHO was achieved as it was already been fulfilled more than 85% from 2009 up to 2011 in the region and the reported CDR was far below (40.9%) for smear-positive pulmonary TB including other forms of TB from the target. Therefore, extensive efforts should be established to maintain the achieved TSR and to increase the low level of CDR for all forms of TB cases through implementing alternative case finding strategies. Copyright © 2016.

Primary meningeal rhabdomyosarcoma.

PubMed

Palta, Manisha; Riedel, Richard F; Vredenburgh, James J; Cummings, Thomas J; Green, Scott; Chang, Zheng; Kirkpatrick, John P

2011-01-01

Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI) demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13). Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC) systemic therapy.

Street ketamine-associated bladder dysfunction: an emerging health problem.

PubMed

Lee, Py; Ong, Ta; Chua, Cb; Lei, Ccm; Teh, Gc

2009-01-01

Ketamine is frequently abused nowadays as a recreational drug. Case reports are emerging since 2007 to describe a new clinical entity of severe bladder dysfunction associated with chronic abuse of street ketamine. Severe lower urinary tract symptoms of urinary frequency and urgency which are refractory to conventional treatment. Quality of life is adversely affected as a consequence. Chronic kidney disease will develop in advanced cases. Investigation findings: The urine is sterile on culture. Ultrasound will show reduced bladder capacity with thickened bladder wall. In advanced stage, hydronephrosis and renal impairment will develop. Patients should be advised to stop street ketamine use immediately. Anticholinergic medication could be tried to alleviate the symptoms. Refractory cases with dilatation of the upper urinary tract might need urinary diversion. Awareness of this new condition is essential in diagnosis. Early intervention offers better treatment outcome.

K-11 students’ creative thinking ability on static fluid: a case study

NASA Astrophysics Data System (ADS)

Hanni, I. U.; Muslim; Hasanah, L.; Samsudin, A.

2018-05-01

Creative thinking is one of the fundamental components of 21st-century education that needs to be possessed and developed in students. Thus, the students have the ability to find many alternative solutions to solve problems in physics learning. The study aimed at providing the students’ creative thinking ability on Static Fluid. A case study has been implemented through a single case, namely embedded design. Participants in this study are 27 K-11 students. The instrument utilized is Test for Creative Thinking-Static Fluid (TCT-SF) which has been validated by the experts. The result shows that 10.74 (approximately 35.8%) of the maximum scores. In conclusion, students’ creative thinking ability on Static Fluid is still stumpy, hence, it is needed to develop creative thinking ability in K-11 students’ context.

Case finding of lifestyle and mental health disorders in primary care: validation of the ‘CHAT’ tool

PubMed Central

Goodyear-Smith, Felicity; Coupe, Nicole M; Arroll, Bruce; Elley, C Raina; Sullivan, Sean; McGill, Anne-Thea

2008-01-01

Background Primary care is accessible and ideally placed for case finding of patients with lifestyle and mental health risk factors and subsequent intervention. The short self-administered Case-finding and Help Assessment Tool (CHAT) was developed for lifestyle and mental health assessment of adult patients in primary health care. This tool checks for tobacco use, alcohol and other drug misuse, problem gambling, depression, anxiety and stress, abuse, anger problems, inactivity, and eating disorders. It is well accepted by patients, GPs and nurses. Aim To assess criterion-based validity of CHAT against a composite gold standard. Design of study Conducted according to the Standards for Reporting of Diagnostic Accuracy statement for diagnostic tests. Setting Primary care practices in Auckland, New Zealand. Method One thousand consecutive adult patients completed CHAT and a composite gold standard. Sensitivities, specificities, positive and negative predictive values, and likelihood ratios were calculated. Results Response rates for each item ranged from 79.6 to 99.8%. CHAT was sensitive and specific for almost all issues screened, except exercise and eating disorders. Sensitivity ranged from 96% (95% confidence interval [CI] = 87 to 99%) for major depression to 26% (95% CI = 22 to 30%) for exercise. Specificity ranged from 97% (95% CI = 96 to 98%) for problem gambling and problem drug use to 40% (95% CI = 36 to 45%) for exercise. All had high likelihood ratios (3–30), except exercise and eating disorders. Conclusion CHAT is a valid and acceptable case-finding tool for most common lifestyle and mental health conditions. PMID:18186993

[Lymphoscintigraphy study of oedema after femoropopliteal segment surgery].

PubMed

Martorell, Alberto; Vallejos, Virginia; Esteban, Carlos; Milá, Marta; Callejas, José M; Fraile, Manuel

2010-07-01

Post-surgical oedema of the femoropopliteal segment is a frequent complication, unrelated to the severity of the previous symptoms or changes in subsequent distal arterial pressure. The aim of the study is to assess whether the oedema present in femoropopliteal bypass patients is of lymphatic origin, and the possible influence of the prosthesis and the type of intervention used. An analytical, observational and case-control study of 30 patients who had a femoropopliteal bypass. Isotopic lymphoscintigraphy of the superficial and deep lymphatic system was performed on both limbs in all patients selected for the study. The saphenous vein was used in 19 patients and PTFE in 11. The patients were divided into controls, 15 without oedema, and cases, 15 with oedema. Surgery technique: 9 reconstructions of the popliteal portion (1st p.p.), 18 third popliteal portion (3rd p.p.), and 3 distal branches. Scintigraphy findings: Asymmetric lymphatic drainage between the 2 limbs was observed in the all 30 examinations, except 1 case (which did not have oedema). There was no lymphatic drainage in 5 cases (one developed oedema). Cases with controls and patients with an autologous or synthetic graft, as well as shunts above and below the knee, were compared. The only statistical difference obtained was that the latter developed oedema more often than those performed close to the knee. Therefore, the scintigraphy findings did not point to lymphatic damage as a cause of post-femoropopliteal surgery oedema. The material used did not appear to influence this. The below-knee shunts suffered more oedema than those above the knee. Copyright 2009 AEC. Published by Elsevier Espana. All rights reserved.

Dynamical features in fetal and postnatal zinc-copper metabolic cycles predict the emergence of autism spectrum disorder

PubMed Central

Curtin, Paul; Curtin, Austen; Gennings, Chris; Arora, Manish; Siper, Paige; Meyering, Kristin; Kolevzon, Alexander; Mollon, Josephine; Zammit, Stanley; Wright, Robert O.; Reichenberg, Abraham

2018-01-01

Metals are critical to neurodevelopment, and dysregulation in early life has been documented in autism spectrum disorder (ASD). However, underlying mechanisms and biochemical assays to distinguish ASD cases from controls remain elusive. In a nationwide study of twins in Sweden, we tested whether zinc-copper cycles, which regulate metal metabolism, are disrupted in ASD. Using novel tooth-matrix biomarkers that provide direct measures of fetal elemental uptake, we developed a predictive model to distinguish participants who would be diagnosed with ASD in childhood from those who did not develop the disorder. We replicated our findings in three independent studies in the United States and the UK. We show that three quantifiable characteristics of fetal and postnatal zinc-copper rhythmicity are altered in ASD: the average duration of zinc-copper cycles, regularity with which the cycles recur, and the number of complex features within a cycle. In all independent study sets and in the pooled analysis, zinc-copper rhythmicity was disrupted in ASD cases. In contrast to controls, in ASD cases, the cycle duration was shorter (F = 52.25, P < 0.001), regularity was reduced (F = 47.99, P < 0.001), and complexity diminished (F = 57.30, P < 0.001). With two distinct classification models that used metal rhythmicity data, we achieved 90% accuracy in classifying cases and controls, with sensitivity to ASD diagnosis ranging from 85 to 100% and specificity ranging from 90 to 100%. These findings suggest that altered zinc-copper rhythmicity precedes the emergence of ASD, and quantitative biochemical measures of metal rhythmicity distinguish ASD cases from controls. PMID:29854952

Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm.

PubMed

Baumbach, Sebastian F; Lobo, Christopher M; Badyine, Ilias; Mutschler, Wolf; Kanz, Karl-Georg

2014-03-01

Olecranon bursitis and prepatellar bursitis are common entities, with a minimum annual incidence of 10/100,000, predominantly affecting male patients (80 %) aged 40-60 years. Approximately 1/3 of cases are septic (SB) and 2/3 of cases are non-septic (NSB), with substantial variations in treatment regimens internationally. The aim of the study was the development of a literature review-based treatment algorithm for prepatellar and olecranon bursitis. Following a systematic review of Pubmed, the Cochrane Library, textbooks of emergency medicine and surgery, and a manual reference search, 52 relevant papers were identified. The initial differentiation between SB and NSB was based on clinical presentation, bursal aspirate, and blood sampling analysis. Physical findings suggesting SB were fever >37.8 °C, prebursal temperature difference greater 2.2 °C, and skin lesions. Relevant findings for bursal aspirate were purulent aspirate, fluid-to-serum glucose ratio <50 %, white cell count >3,000 cells/μl, polymorphonuclear cells >50 %, positive Gram staining, and positive culture. General treatment measures for SB and NSB consist of bursal aspiration, NSAIDs, and PRICE. For patients with confirmed NSB and high athletic or occupational demands, intrabursal steroid injection may be performed. In the case of SB, antibiotic therapy should be initiated. Surgical treatment, i.e., incision, drainage, or bursectomy, should be restricted to severe, refractory, or chronic/recurrent cases. The available evidence did not support the central European concept of immediate bursectomy in cases of SB. A conservative treatment regimen should be pursued, following bursal aspirate-based differentiation between SB and NSB.

Shifts in Geographic Distribution and Antimicrobial Resistance during a Prolonged Typhoid Fever Outbreak — Bundibugyo and Kasese Districts, Uganda, 2009–2011

PubMed Central

Walters, Maroya Spalding; Routh, Janell; Mikoleit, Matthew; Kadivane, Samuel; Ouma, Caroline; Mubiru, Denis; Mbusa, Ben; Murangi, Amos; Ejoku, Emmanuel; Rwantangle, Absalom; Kule, Uziah; Lule, John; Garrett, Nancy; Halpin, Jessica; Maxwell, Nikki; Kagirita, Atek; Mulabya, Fred; Makumbi, Issa; Freeman, Molly; Joyce, Kevin; Hill, Vince; Downing, Robert; Mintz, Eric

2014-01-01

Background Salmonella enterica serovar Typhi is transmitted by fecally contaminated food and water and causes approximately 22 million typhoid fever infections worldwide each year. Most cases occur in developing countries, where approximately 4% of patients develop intestinal perforation (IP). In Kasese District, Uganda, a typhoid fever outbreak notable for a high IP rate began in 2008. We report that this outbreak continued through 2011, when it spread to the neighboring district of Bundibugyo. Methodology/Principal Findings A suspected typhoid fever case was defined as IP or symptoms of fever, abdominal pain, and ≥1 of the following: gastrointestinal disruptions, body weakness, joint pain, headache, clinically suspected IP, or non-responsiveness to antimalarial medications. Cases were identified retrospectively via medical record reviews and prospectively through laboratory-enhanced case finding. Among Kasese residents, 709 cases were identified from August 1, 2009–December 31, 2011; of these, 149 were identified during the prospective period beginning November 1, 2011. Among Bundibugyo residents, 333 cases were identified from January 1–December 31, 2011, including 128 cases identified during the prospective period beginning October 28, 2011. IP was reported for 507 (82%) and 59 (20%) of Kasese and Bundibugyo cases, respectively. Blood and stool cultures performed for 154 patients during the prospective period yielded isolates from 24 (16%) patients. Three pulsed-field gel electrophoresis pattern combinations, including one observed in a Kasese isolate in 2009, were shared among Kasese and Bundibugyo isolates. Antimicrobial susceptibility was assessed for 18 isolates; among these 15 (83%) were multidrug-resistant (MDR), compared to 5% of 2009 isolates. Conclusions/Significance Molecular and epidemiological evidence suggest that during a prolonged outbreak, typhoid spread from Kasese to Bundibugyo. MDR strains became prevalent. Lasting interventions, such as typhoid vaccination and improvements in drinking water infrastructure, should be considered to minimize the risk of prolonged outbreaks in the future. PMID:24603860

Clinicopathological study of severe chronic active Epstein-Barr virus infection that developed in association with lymphoproliferative disorder and/or hemophagocytic syndrome.

PubMed

Ohshima, K; Suzumiya, J; Sugihara, M; Nagafuchi, S; Ohga, S; Kikuchi, M

1998-12-01

Chronic active Epstein-Barr virus (CAEBV) infection has been previously reported to be sometimes associated with an aggressive clinical course. However, the role of EBV in the CAEBV is not well clarified. A retrospective study was performed on nine adult and five child patients (eight males and six females). Histologically, at first admission, the presence of neoplastic lesions could not be confirmed. The lymph nodes in half of all cases revealed paracortical hyperplasia with transformed lymphocytes (hyperplastic type). Half of the cases showed non-suppurative necrosis and an increased number of histiocytes with phagocytosis (histiocytic type). Activated histiocytes with lymphokine positivity were frequently detected in the histiocytic type. In the phenotypical study, 10 of the examined 11 cases showed increased numbers of natural killer (NK) cells and/or CD8-positive T lymphocytes. In situ hybridization (ISH) showed EBV-infected lymphoid cells, but the number of EBV-infected cells varied. Double-labeling immunochemistry/ISH demonstrated EBV-infected T cells, including NK cells, but not B cells. In addition, three cases showed a monoclonal dissemination of EBV terminal repetitive sequence (TR), and two cases showed oligoclonal dissemination. From those findings, monoclonal, oligoclonal and polyclonal populations of EBV-infected T or NK cells were considered to be present in CAEBV states. During the clinical course, 12 of the 14 cases died within 5 years. Six cases died from EBV-associated hematopoietic tumors (histiocytic tumor, T cell lymphoma, B cell lymphoma, plasmacytoma, and NK cell leukemia); one from non-EBV-associated acute myelogenous leukemia, and five due to hemophagocytic syndrome. The examined EBV-associated hematopoietic tumors showed monoclonal EBV terminal repetitive sequences. There is a possibility that the monoclonal dissemination of EBV-infected cells develops from oligoclonal or polyclonal EBV-infected cells. And active histiocytes with lymphokine positivity were frequently detected in the cases with histologically histiocytic type. These findings seem to be related with the causes of death due to hemophagocytic syndrome.

The effectiveness of therapeutic assessment with an adult client: a single-case study using a time-series design.

PubMed

Aschieri, Filippo; Smith, Justin D

2012-01-01

This article presents the therapeutic assessment (TA; Finn, 2007) of a traumatized young woman named Claire. Claire reported feeling debilitated by academic demands and the expectations of her parents, and was finding it nearly impossible to progress in her studies. She was also finding it difficult to develop and sustain intimate relationships. The emotional aspects of close relationships were extremely difficult for her and she routinely blamed herself for her struggles in this arena. The assessor utilized the TA model for adults, with the exception of not including an optional intervention session. The steps of TA, particularly the extended inquiry and the discussion of test findings along the way, cultivated a supportive and empathic atmosphere with Claire. By employing the single-case time-series experimental design used in previous TA studies (e.g., Smith, Handler, & Nash, 2010; Smith, Wolf, Handler, & Nash, 2009), the authors demonstrated that Claire experienced statistically significant improvement correlated with the onset of TA. Results indicated that participation in TA coincided with a positive shift in the trajectory of her reported symptoms and with recognizing the affection she held for others in her life. This case illustrates the successful application of case-based time-series methodology in the evaluation of an adult TA. The potential implications for future study are discussed.

Neuropathology of Autosomal Dominant Alzheimer Disease in the National Alzheimer Coordinating Center Database.

PubMed

Ringman, John M; Monsell, Sarah; Ng, Denise W; Zhou, Yan; Nguyen, Andy; Coppola, Giovanni; Van Berlo, Victoria; Mendez, Mario F; Tung, Spencer; Weintraub, Sandra; Mesulam, Marek-Marsel; Bigio, Eileen H; Gitelman, Darren R; Fisher-Hubbard, Amanda O; Albin, Roger L; Vinters, Harry V

2016-03-01

Alzheimer disease (AD) represents a genetically heterogeneous entity. To elucidate neuropathologic features of autosomal dominant AD ([ADAD] due to PSEN1, APP, or PSEN2 mutations), we compared hallmark AD pathologic findings in 60 cases of ADAD and 120 cases of sporadic AD matched for sex, race, ethnicity, and disease duration. Greater degrees of neuritic plaque and neurofibrillary tangle formation and cerebral amyloid angiopathy (CAA) were found in ADAD (p values < 0.01). Moderate to severe CAA was more prevalent in ADAD (63.3% vs. 39.2%, p = 0.003), and persons with PSEN1 mutations beyond codon 200 had higher average Braak scores and severity and prevalence of CAA than those with mutations before codon 200. Lewy body pathology was less extensive in ADAD but was present in 27.1% of cases. We also describe a novel pathogenic PSEN1 mutation (P267A). The finding of more severe neurofibrillary pathology and CAA in ADAD, particularly in carriers of PSEN1 mutations beyond codon 200, warrants consideration when designing trials to treat or prevent ADAD. The finding of Lewy body pathology in a substantial minority of ADAD cases supports the assertion that development of Lewy bodies may be in part driven by abnormal β-amyloid protein precursor processing. © 2016 American Association of Neuropathologists, Inc. All rights reserved.

Integrated Content, Language, and Literacy Instruction in a Canadian French Immersion Context: A Professional Development Journey

ERIC Educational Resources Information Center

Cammarata, Laurent; Haley, Corey

2018-01-01

Although immersion programs are very popular in Canada, they are complex to implement and not as successful as we would hope them to be when it comes to the development of students' language skills. This article reports on the findings of a case study conducted within the context of an ongoing five-year grant funded project in Western Canada whose…

The impact of dietary habits on the pathogenesis of rheumatoid arthritis: a case-control study.

PubMed

Rambod, Masoume; Nazarinia, Mohammadali; Raieskarimian, Farahnaz

2018-05-22

It has not been clear what kinds and how much nutrients could be harmful, preventive, or healthful for development of rheumatoid arthritis. This study aimed to determine the impact of dietary habits on the pathogenesis of rheumatoid arthritis. This case-control study was conducted on a total of 500 rheumatoid arthritis patients and 500 healthy controls refereed to three clinics of Shiraz University of Medical Sciences in 2015-2016. Convenience sampling was used for data collection in both case and control groups. An approved valid and reliable questionnaire including information about the intake of different kinds of beverages, and nutritious and non-nutritious diet was used. Data were analyzed by SPSS, version 20, using t test, chi-square and Multiple Logistic Regression model. The associations between rheumatoid arthritis development and variables including drinking 1-7 cups of coffee (OR = .44, CI .25-.76), ≥ 8 cups of coffee (OR = .50, CI .28-.90), full-fat milk (OR = 1.01, CI 1.003-1.03) per month, and intake of green tea (OR = .65, CI .45-.93) and solid oils (OR = 2.29, CI:1.57-3.34) were significant. Based on the findings, coffee consumption more than one cup per month and green tea might have preventive effects on developing rheumatoid arthritis. On the other hand, patients who consumed more full-fat milk per month and solid oil might be at risk of development of rheumatoid arthritis. Therefore, modification of diet based on these findings is suggested. Performing a cohort study to determine the causality effect of dietary habits and development and prevention of rheumatoid arthritis is recommended.

Understanding girls' enrollment at Louise's Farm School: A qualitative case study

NASA Astrophysics Data System (ADS)

Nowak, Ashley E. P.

This thesis presents a qualitative case study of enrollment and retention considerations at Louise's Farm School (LFS) in Palmer, Alaska, with a focus on how gender is performed in this domain. Interviews with 25 students, 12 parents, and 14 instructors revealed the enrollment decision-making process, identifying constraints to and enablers of girls' participation. Findings included three primary factors as greatly influencing girls' enrollment: (1) mothers' backgrounds; (2) mothers' knowledge of and the misperceptions regarding outcomes of LFS programing; and (3) girls' interest in LFS curriculum. Findings also exposed differences in mothers' and instructors' expectations for the educative development of girls and boys, suggesting that there is greater pressure on girls to perform academically while boys are expected to need greater space for physical expression.

[Anaphylactic shock due to patent blue: four case report and review of literature].

PubMed

Lucas, N; Interne, S Benay; Laine, P; Nicolie, B; Fondrinier, E

2010-04-01

Description of four cases of anaphylactic shock with blue dye injection (bleu patenté V Guerbet 2.5%) during sentinel node biopsy for breast cancer. Women with breast carcinoma and combined approach with radioactive tracer and blue patent injection. Four cases were observed, which means an incidence of 0.57%. We report one case of grade II anaphylactic reaction and three cases of grade III requiring active reanimation and adrenaline perfusion. One patient developed a pulmonary embolism during the postoperative period, but no death was observed. We find an incidence of 1.06% of allergy but only 0.25% of anaphylactic shock (grade III). These rare but serious cases must weigh up the benefits and risks of using blue dye. We suggest using blue dye injection only in case of radioisotope detection failure. Of course, this approach must be evaluated. (c) 2009 Elsevier Masson SAS. All rights reserved.

Diffuse Lewy body disease: clinical features in 15 cases.

PubMed Central

Byrne, E J; Lennox, G; Lowe, J; Godwin-Austen, R B

1989-01-01

Fifteen cases of diffuse Lewy body disease were diagnosed on pathological grounds during a single year in one health district. The range and frequency of clinical features contrast strikingly with previous reports. The majority of cases presented with classical levodopa-responsive Parkinson's disease either alone (6 cases) or with mild cognitive impairment (3 cases); the remaining 6 cases presented with cognitive impairment alone. In time almost all patients developed both dementia and Parkinsonism. The dementia was cortical in type, but unusual in that most (12 cases) showed day-to-day fluctuation in severity at some point in their illness. These findings suggest that diffuse Lewy body disease is not rare, and that it presents in a range of ways from dementia with subsequent Parkinsonism to Parkinson's disease with subsequent dementia. The latter mode of presentation suggests that it should be considered as a significant pathological substrate of dementia in Parkinson's disease. Images PMID:2545827

Computational modeling in the optimization of corrosion control to reduce lead in drinking water

EPA Science Inventory

An international “proof-of-concept” research project (UK, US, CA) will present its findings during this presentation. An established computational modeling system developed in the UK is being calibrated and validated in U.S. and Canadian case studies. It predicts LCR survey resul...

Hands-On Mathematics: Two Cases from Ancient Chinese Mathematics

ERIC Educational Resources Information Center

Wang, Youjun

2009-01-01

In modern mathematical teaching, it has become increasingly emphasized that mathematical knowledge should be taught by problem-solving, hands-on activities, and interactive learning experiences. Comparing the ideas of modern mathematical education with the development of ancient Chinese mathematics, we find that the history of mathematics in…

Using a Realist Research Methodology in Policy Analysis

ERIC Educational Resources Information Center

Lourie, Megan; Rata, Elizabeth

2017-01-01

The article describes the usefulness of a realist methodology in linking sociological theory to empirically obtained data through the development of a methodological device. Three layers of analysis were integrated: 1. the findings from a case study about Maori language education in New Zealand; 2. the identification and analysis of contradictions…

Dynamic Leadership Succession: Strengthening Urban Principal Succession Planning

ERIC Educational Resources Information Center

Peters-Hawkins, April L.; Reed, Latish C.; Kingsberry, Francemise

2018-01-01

The Dynamic Leadership Succession model is used to analyze a leadership succession case in an urban school district. The qualitative findings show that the district did not forecast school leadership needs well; however, the principal sought to develop and mentor teacher leaders as her assistant principals. Second, sustaining efforts within the…

Delaying the Academy: A Gap Year Education

ERIC Educational Resources Information Center

O'Shea, Joseph

2011-01-01

This investigation serves as one of the first empirical analyses to examine the international volunteering gap year from an educational perspective, concluding an in-depth case study of a prominent gap year organisation in the UK. Contrary to widespread industry promotion of international development, the findings suggest that the experience can…

A Bridge to Graduation for At-Risk Latino Males: A Case Study

ERIC Educational Resources Information Center

Behr, Michelle; Marston, Christine; Nelson, Kyle Anne

2014-01-01

Changing demographics, low Latino graduation rates, and changes to education funding--nationally and locally--challenge society to develop innovative strategies to navigate transformations affecting public education. This article presents findings from a collaborative community-engaged evaluation of a dropout prevention program for at-risk male…

Genetics Reasoning with Multiple External Representations.

ERIC Educational Resources Information Center

Tsui, Chi-Yan; Treagust, David F.

2003-01-01

Explores a case study of a class of 10th grade students whose learning of genetics involved activities using BioLogica, a computer program that features multiple external representations (MERs). Findings indicate that the MERs in BioLogica contributed to students' development of genetics reasoning by engendering their motivation and interest but…

Creating a Shared Formulary in 7 Critical Access Hospitals

ERIC Educational Resources Information Center

Wakefield, Douglas S.; Ward, Marcia M.; Loes, Jean L.; O'Brien, John; Abbas, Nancy

2010-01-01

Purpose: This paper reports a case study of 7 Critical Access Hospitals' (CAH) and 1 rural referral hospital's successful collaboration to develop a shared formulary. Methods: Study methods included document reviews, interviews with key informants, and use of descriptive statistics. Findings: Through a systematic review and decision process, CAH…

Using Instant Messaging for Collaborative Learning: A Case Study

ERIC Educational Resources Information Center

Sotillo, Susana M.

2006-01-01

As recent second language acquisition (SLA) studies have shown, the negotiation of linguistic items such as vocabulary, verb tenses, and grammar rules with different types of interlocutors--native speakers (NSs) and advanced non-native speakers (NNSs) of English--seems to facilitate second language development among students. Findings from…

Learners' Perceptions of Instructional Design Practice in a Situated Learning Activity

ERIC Educational Resources Information Center

Woolf, Nicholas; Quinn, James

2009-01-01

This case study investigated learners' perceptions of value from participating in a learning activity designed to model professional instructional design practice. Learners developed instructional design products for a corporate client in the context of a classroom-based course. The findings indicate that learners perceived different kinds of…

A Multiperspective Analysis on Developing and Maintaining Trust in Senior Student Affairs Leadership

ERIC Educational Resources Information Center

Ruthkosky, Philip J.

2013-01-01

This study examines senior student affairs leadership through the diverse lenses of subordinates, administrative peers, presidents, and senior student affairs officers (SSAOs). Guided by an interpretive paradigm, a qualitative methodology was employed consisting of a six-case comparative analysis and grounded theory approach. The findings provide…

Learning from a Wiki Way of Learning

ERIC Educational Resources Information Center

Page, Kelly L.; Reynolds, Nina

2015-01-01

There is a growing need to design learning experiences in higher education that develop collaborative and mediated social writing practices. A wiki way of learning addresses these needs. This paper reports findings from a case study involving 58 postgraduate students who in small groups participated over eight weeks in a mediated collaborative…

Working with Difference in Online Collaborative Groups

ERIC Educational Resources Information Center

Smith, Regina O.

2005-01-01

This qualitative cross-case study explored the experiences that learners describe within online collaborative groups. The study context was a fully online graduate course on adult learning. The findings suggest that the small online groups demonstrated dynamics and process that are characteristic of individual growth and development and group…

Shared Decision-Making and the Limits of Democratization: A Case Study of Site-Based Reform.

ERIC Educational Resources Information Center

Radnofsky, Mary L.; Spielmann, Guy

This paper presents findings of an ethnographic study of a school district's Staff Development, Supervision, and Evaluation Program (SDSEP). Data were gathered through interviews, observations, participant observation, analysis of kinesics and proxemics, semiotic analysis of discourse, unobtrusive measures, and analysis of official documents. The…

Integrating Multimedia into the Curriculum: A Case Study Evaluation.

ERIC Educational Resources Information Center

Felix, Uschi

1997-01-01

Evaluates software developed for advanced learners of a second language. The software uses the target language (German) exclusively, brings together language and literature teaching, and includes a large variety of written exercises with scored feedback. Findings reveal that students are enthusiastic about using this multimedia program and…

E-Learning in the Corporate University

ERIC Educational Resources Information Center

Homan, Gill; Macpherson, Allan

2005-01-01

Purpose: To explore the development of e-learning within the context of corporate universities with the aim of informing the debate on e-learning and establishing key areas of concern for emerging corporate universities. Design/methodology/approach: Three case reviews of large leading edge organizations in different sectors. Findings: Whilst…

A Custody Evaluation Model for Pre-School Children.

ERIC Educational Resources Information Center

Roseby, Vivienne

This document addresses the needs of mental health consultants involved in decision-making in custody disputes. A psycho-ecological model for assessing contexts of development in cases involving preschool children is presented, and the theoretical basis and rationale for the model are discussed. Issues, instruments, and findings of recent…

New Strategies for Improving Rural Family Life.

ERIC Educational Resources Information Center

Coombs, Philip H.

Presented in capsule form for the convenience of busy policy makers, planners, and program managers, this booklet summarizes major findings of a three-year study on practical aspects of rural development, with particular emphasis on ways of alleviating extreme poverty among disadvantaged rural families. Using case studies from Bangladesh, India,…

Genetic and Environmental Influences on Adolescent Attachment

ERIC Educational Resources Information Center

Fearon, Pasco; Shmueli-Goetz, Yael; Viding, Essi; Fonagy, Peter; Plomin, Robert

2014-01-01

Background: Twin studies consistently point to limited genetic influence on attachment security in the infancy period, but no study has examined whether this remains the case in later development. This study presents the findings from a twin study examining the relative importance of genetic and environmental influences on attachment in…

Organizational Commitment, Knowledge Management Interventions, and Learning Organization Capacity

ERIC Educational Resources Information Center

Massingham, Peter; Diment, Kieren

2009-01-01

Purpose: The purpose of this paper is to examine the relationship between organizational commitment and knowledge management initiatives in developing learning organization capacity (LOC). Design/methodology/approach: This is an empirical study based on a single case study, using partial least squares (PLS) analysis. Findings: The strategic…

A Case Study in Applying Lean Sustainability Concepts to Universities

ERIC Educational Resources Information Center

Comm, Clare L.; Mathaisel, Dennis F. X.

2005-01-01

Purpose: To apply the concepts of lean and sustainability to higher education. Design/methodology/approach: A questionnaire was developed, administered to 18 public and private universities and analyzed. Findings: The focus in higher education is now on cost reduction or budget containment initiatives. Although these initiatives were not…

Counseling Practice: In Defense of Passive Modes of Professional Engagement

ERIC Educational Resources Information Center

Hansen, James T.

2010-01-01

Historically, passive ideologies of counseling have regularly morphed into active approaches. The author contends that professional power and status are the underlying motives for this ideological transition. Based on empirical findings and recent philosophical developments, a case is made for the counseling profession to revalue passive…

Development of a Gestational Age-Specific Case Definition for Neonatal Necrotizing Enterocolitis.

PubMed

Battersby, Cheryl; Longford, Nick; Costeloe, Kate; Modi, Neena

2017-03-01

Necrotizing enterocolitis (NEC) is a major cause of neonatal morbidity and mortality. Preventive and therapeutic research, surveillance, and quality improvement initiatives are hindered by variations in case definitions. To develop a gestational age (GA)-specific case definition for NEC. We conducted a prospective 34-month population study using clinician-recorded findings from the UK National Neonatal Research Database between December 2011 and September 2014 across all 163 neonatal units in England. We split study data into model development and validation data sets and categorized GA into groups (group 1, less than 26 weeks' GA; group 2, 26 to less than 30 weeks' GA; group 3, 30 to less than 37 weeks' GA; group 4, 37 or more weeks' GA). We entered GA, birth weight z score, and clinical and abdominal radiography findings as candidate variables in a logistic regression model, performed model fitting 1000 times, averaged the predictions, and used estimates from the fitted model to develop an ordinal NEC score and cut points to develop a dichotomous case definition based on the highest area under the receiver operating characteristic curves [AUCs] and positive predictive values [PPVs]. Abdominal radiography performed to investigate clinical concerns. Ordinal NEC likelihood score, dichotomous case definition, and GA-specific probability plots. Of the 3866 infants, the mean (SD) birth weight was 2049.1 (1941.7) g and mean (SD) GA was 32 (5) weeks; 2032 of 3663 (55.5%) were male. The total included 2978 infants (77.0%) without NEC and 888 (23.0%) with NEC. Infants with NEC in group 1 were less likely to present with pneumatosis (31.1% vs 47.2%; P = .01), blood in stool (11.8% vs 29.6%; P < .001), or mucus in stool (2.1% vs 5.6%; P = .048) but more likely to present with gasless abdominal radiography findings (6.3% vs 0.9%; P = .009) compared with infants with NEC in group 3. In the ordinal NEC score analysis, we allocated 3 points to pneumatosis, 2 points to blood in stool, and 1 point each to abdominal tenderness and abdominal discoloration; 1 point was assigned if 1 or more of pneumoperitoneum, fixed loop, and portal venous gas were present, and 1 point was assigned if both increased and/or bilious aspirates and abdominal distension were present. The cutoff scores for the dichotomous GA-specific case definition were 2 or greater for infants in groups 1 and 2, 3 or greater for infants in group 3, and 4 or greater for infants in group 4. The ordinal NEC score and dichotomous case definition discriminated well between infants with (AUC, 87%) and without (AUC, 80%) NEC. The case definition has a sensitivity of 66.2% (95% CI, 63.0-69.4), a specificity of 94.4% (95% CI, 93.2-95.4), an AUC of 80.0% (95% CI, 79-82), and a PPV of 85.5% (95% CI, 82.6-88.1). Applying the cut points to the 431 infants who underwent a laparotomy yielded a sensitivity of 76.5% (95% CI, 70.0-82.1), a specificity of 74.4% (95% CI, 68.3-80.0), an AUC of 75.0% (95% CI, 71.0- 80.0), and a PPV of 72.9% (95% CI, 66.4-78.7). The risk of NEC and clinical presentation are associated with GA. Adoption of a consistent GA-specific case definition would strengthen global efforts to reduce the population burden of this devastating neonatal disease.

Risk stratification for malignant progression in Barrett’s esophagus: Gender, age, duration and year of surveillance

PubMed Central

Gatenby, Piers; Bhattacharjee, Santanu; Wall, Christine; Caygill, Christine; Watson, Anthony

2016-01-01

AIM To clarify risk based upon segment length, diagnostic histological findings, patient age and year of surveillance, duration of surveillance and gender. METHODS Patients registered with the United Kingdom Barrett’s Oesophagus Registry from 9 United Kingdom centers were included. The outcome measures were (1) development of all grades of dysplasia; (2) development of high-grade of dysplasia or adenocarcinoma; and (3) development of adenocarcinoma. Prevalent cases and subjects with < 1 year of follow-up were excluded. The covariates examined were segment length, previous biopsy findings, age at surveillance, duration of surveillance, year of surveillance and gender. RESULTS One thousand and one hundred thirty six patients were included (total 6474 patient-years). Fifty-four patients developed adenocarcinoma (0.83% per annum), 70 developed high-grade dysplasia/adenocarcinoma (1.1% per annum) and 190 developed any grade of dysplasia (3.5% per annum). High grade dysplasia and adenocarcinoma increased with age and duration of surveillance. The risk of low-grade dysplasia development was not dependent on age at surveillance. Segment length and previous biopsy findings were also significant factors for development of dysplasia and adenocarcinoma. CONCLUSION The risk of development of low-grade dysplasia is independent of age at surveillance, but high-grade dysplasia and adenocarcinoma were more commonly found at older age. Segment length and previous biopsy findings are also markers of risk. This study did not demonstrate stabilisation of the metaplastic segment with prolonged surveillance. PMID:28082811

Urban Archaeology: how to Communicate a Story of a Site, 3d Virtual Reconstruction but not Only

NASA Astrophysics Data System (ADS)

Capone, M.

2011-09-01

Over the past few years experimental systems have been developed to introduce new ways of enjoying cultural heritage using digital media. Technology had a lead role in this testing ground increasing the need to develop new way of communication according to contemporary iconography culture. Most applications are aimed at creating online databases that allow free access to information, that helps to spread the culture and simplify the study about cultural heritage. To this type of application are added others, which are aimed at defining new and different ways of cultural heritage enjoyment. Very interesting applications are those regarding to reconstruction of archaeological landscape. The target of these applications is to develop a new level of knowledge that increases the value of the archaeological find and the level of understanding. In fact, digital media can bridge the gap of communication associated to archaeological find: the virtual simulation offers the possibility to put it in the context and it defines a new way to enjoy the cultural heritage. In most of these cases the spectacular and recreational factor generally prevails. We believe that experimentation is needed in this area, particularly for the development of Urban Archaeology. In this case, another trouble to enjoy is added to the lack of communication, typical of archaeological finds, because it is "hidden" in an irreversible way: it is under water or under city. So, our research is mainly oriented to define a methodological path to elaborate a communication strategy to increase interest about Urban Archaeology.

Pancreas and gallbladder agenesis in a newborn with semilobar holoprosencephaly, a case report.

PubMed

Hilbrands, Robert; Keymolen, Kathelijn; Michotte, Alex; Marichal, Miriam; Cools, Filip; Goossens, Anieta; Veld, Peter In't; De Schepper, Jean; Hattersley, Andrew; Heimberg, Harry

2017-05-19

Pancreatic agenesis is an extremely rare cause of neonatal diabetes mellitus and has enabled the discovery of several key transcription factors essential for normal pancreas and beta cell development. We report a case of a Caucasian female with complete pancreatic agenesis occurring together with semilobar holoprosencephaly (HPE), a more common brain developmental disorder. Clinical findings were later confirmed by autopsy, which also identified agenesis of the gallbladder. Although the sequences of a selected set of genes related to pancreas agenesis or HPE were wild-type, the patient's phenotype suggests a genetic defect that emerges early in embryonic development of brain, gallbladder and pancreas. Developmental defects of the pancreas and brain can occur together. Identifying the genetic defect may identify a novel key regulator in beta cell development.

Working Group 3: Operations Analysis for Systems of System within a Networked C2 Context: Introduction, Purpose, and Approach

DTIC Science & Technology

2012-01-01

1200 Session 3 – C2 Framework, OR Methods MOOs, MOEs, MOPs Development Case Study – 1300-1630 Session 4 – Findings...Objective 1: Understand the impact of the application of traditional operational research techniques to networked C2 systems. • Objective 2: Develop ...for the network. 3. Cost measures including cost and time to implement the solution (for example, a basic rule-of-thumb I use for development

Role of routine abdominal ultrasonography in intensified tuberculosis case finding algorithms at HIV clinics in high TB burden settings.

PubMed

Spalgais, Sonam; Agarwal, Upasna; Sarin, Rohit; Chauhan, Devesh; Yadav, Anita; Jaiswal, Anand

2017-05-18

High proportion of TB in people living with HIV (PLHIV) is undiagnosed. Due to this active TB case finding is recommended for HIV clinics in high TB burden countries. Presently sputum examination and chest radiography are frontline tests recommended for HIV infected TB presumptives. Abdominal TB which occurs frequently in PLHIV may be missed even by existing programmatic intensified case finding protocols. This study evaluated the routine use of ultrasonography (USG) for active case finding of abdominal TB in HIV clinics. Retrospective analysis of eight years' data from an HIV Clinic in a TB hospital in India. Patients underwent chest x-ray, sputum examination, USG abdomen and routine blood tests at entry to HIV care. Case forms were scrutinized for diagnosis of TB, USG findings and CD4 cell counts. Abdominal TB was classified as probable or possible TB. Probable TB was based on presence of two major USG (abdomen) findings suggestive of active TB, or one major USG finding with at least two minor USG findings or at least two symptoms, or any USG finding with microbiologically confirmed active TB at another site. Possible TB was based on the presence of one major USG finding, or the presence of two minor USG findings with at least two symptoms. Bacteriological confirmation was not obtained. Eight hundred and eighty-nine people PLHIV underwent a baseline USG abdomen. One hundred and thirteen of 340 cases already diagnosed with TB and 87 of the 91 newly diagnosed with TB at time of HIV clinic registration had abdominal TB. Non-abdominal symptoms like weight loss, fever and cough were seen in 53% and 22% cases had no symptoms at all. Enlarged abdominal lymph nodes with central caseation, ascitis, splenic microabsesses, bowel thickening and hepatosplenomegaly were the USG findings in these cases. Abdominal TB is a frequent TB site in PLHIV presenting with non-abdominal symptoms. It can be easily detected on basis of features seen on a simple abdominal ultrasound. Abdominal USG should be essential part of intensified TB case finding algorithms for HIV infected people living in high TB burden settings.

Spatial Risk Assessments Based on Vector-Borne Disease Epidemiologic Data: Importance of Scale for West Nile Virus Disease in Colorado

PubMed Central

Winters, Anna M.; Eisen, Rebecca J.; Delorey, Mark J.; Fischer, Marc; Nasci, Roger S.; Zielinski-Gutierrez, Emily; Moore, Chester G.; Pape, W. John; Eisen, Lars

2010-01-01

We used epidemiologic data for human West Nile virus (WNV) disease in Colorado from 2003 and 2007 to determine 1) the degree to which estimates of vector-borne disease occurrence is influenced by spatial scale of data aggregation (county versus census tract), and 2) the extent of concordance between spatial risk patterns based on case counts versus incidence. Statistical analyses showed that county, compared with census tract, accounted for approximately 50% of the overall variance in WNV disease incidence, and approximately 33% for the subset of cases classified as West Nile neuroinvasive disease. These findings indicate that sub-county scale presentation provides valuable risk information for stakeholders. There was high concordance between spatial patterns of WNV disease incidence and case counts for census tract (83%) but not for county (50%) or zip code (31%). We discuss how these findings impact on practices to develop spatial epidemiologic data for vector-borne diseases and present data to stakeholders. PMID:20439980

Two Cases of Melasma with Unusual Histopathologic Findings

PubMed Central

Kang, Won-Hyoung

2006-01-01

We reported two cases of clinically typical melasma presenting with unusual histopathologic findings. In one case, the epidermal melanocytes were markedly increased in number and protruded into the dermis, and in the other case, increased epidermal pigmentation as well as dermal melanocytosis were found. We suggested that the various treatment modalities of melasma should be applied depend on its histopathologic finding. PMID:16614533

Testing the EKC hypothesis by considering trade openness, urbanization, and financial development: the case of Turkey.

PubMed

Ozatac, Nesrin; Gokmenoglu, Korhan K; Taspinar, Nigar

2017-07-01

This study investigates the environmental Kuznets curve (EKC) hypothesis for the case of Turkey from 1960 to 2013 by considering energy consumption, trade, urbanization, and financial development variables. Although previous literature examines various aspects of the EKC hypothesis for the case of Turkey, our model augments the basic model with several covariates to develop a better understanding of the relationship among the variables and to refrain from omitted variable bias. The results of the bounds test and the error correction model under autoregressive distributed lag mechanism suggest long-run relationships among the variables as well as proof of the EKC and the scale effect in Turkey. A conditional Granger causality test reveals that there are causal relationships among the variables. Our findings can have policy implications including the imposition of a "polluter pays" mechanism, such as the implementation of a carbon tax for pollution trading, to raise the urban population's awareness about the importance of adopting renewable energy and to support clean, environmentally friendly technology.

Concept Test of a Smoking Cessation Smart Case.

PubMed

Comello, Maria Leonora G; Porter, Jeannette H

2018-04-05

Wearable/portable devices that unobtrusively detect smoking and contextual data offer the potential to provide Just-In-Time Adaptive Intervention (JITAI) support for mobile cessation programs. Little has been reported on the development of these technologies. To address this gap, we offer a case report of users' experiences with a prototype "smart" cigarette case that automatically tracks time and location of smoking. Small-scale user-experience studies are typical of iterative product design and are especially helpful when proposing novel ideas. The purpose of the study was to assess concept acceptability and potential for further development. We tested the prototype case with a small sample of potential users (n = 7). Participants used the hardware/software for 2 weeks and reconvened for a 90-min focus group to discuss experiences and provide feedback. Participants liked the smart case in principle but found the prototype too bulky for easy portability. The potential for the case to convey positive messages about self also emerged as a finding. Participants indicated willingness to pay for improved technology (USD $15-$60 on a one-time basis). The smart case is a viable concept, but design detail is critical to user acceptance. Future research should examine designs that maximize convenience and that explore the device's ability to cue intentions and other cognitions that would support cessation. This study is the first to our knowledge to report formative research on the smart case concept. This initial exploration provides insights that may be helpful to other developers of JITAI-support technology.

Use of Lumbar Punctures in the Management of Ocular Syphilis.

PubMed

Reekie, Ian; Reddy, Yaviche

2018-01-01

Ocular syphilis has become rare in the developed world, but is a common presentation to ophthalmology departments in South Africa. We investigated the proportion of patients diagnosed with ocular syphilis who went on to receive lumbar punctures, and determined the fraction of these who had cerebrospinal fluid findings suggestive of neurosyphilis. We aimed to determine whether the use of lumbar punctures in ocular syphilis patients was beneficial in picking up cases of neurosyphilis. Retrospective study of case notes of patients admitted to two district hospitals in Durban, South Africa, with ocular syphilis over a 20-month period. A total of 31 of 68 ocular syphilis patients underwent lumbar puncture, and of these, eight (25.8%) had findings suggestive of neurosyphilis. Lumbar puncture in ocular syphilis patients should continue to be a routine part of the investigation of these patients; a large proportion of ocular syphilis patients show cerebrospinal fluid findings suggestive of neurosyphilis, are at risk of the complications of neurosyphilis, and should be managed accordingly.

Early detection of myocardial dysfunction using two-dimensional speckle tracking echocardiography in a young cat with hypertrophic cardiomyopathy

PubMed Central

Mochizuki, Yohei; Yoshimatsu, Hiroki; Niina, Ayaka; Teshima, Takahiro; Matsumoto, Hirotaka; Koyama, Hidekazu

2018-01-01

Case summary A 5-month-old intact female Scottish Fold cat was presented for cardiac evaluation. Careful auscultation detected a slight systolic murmur (Levine I/VI). The findings of electrocardiography, thoracic radiography, non-invasive blood pressure measurements and conventional echocardiographic studies were unremarkable. However, two-dimensional speckle tracking echocardiography revealed abnormalities in myocardial deformations, including decreased early-to-late diastolic strain rate ratios in longitudinal, radial and circumferential directions, and deteriorated segmental systolic longitudinal strain. At the follow-up examinations, the cat exhibited echocardiographic left ventricular hypertrophy and was diagnosed with hypertrophic cardiomyopathy using conventional echocardiography. Relevance and novel information This is the first report on the use of two-dimensional speckle tracking echocardiography for the early detection of myocardial dysfunction in a cat with hypertrophic cardiomyopathy; the myocardial dysfunction was detected before the development of hypertrophy. The findings from this case suggest that two-dimensional speckle tracking echocardiography can be useful for myocardial assessment when conventional echocardiographic and Doppler findings are ambiguous. PMID:29449957

Association of periodontal disease, oral procedures, and other clinical findings with bacterial endocarditis in dogs.

PubMed

Peddle, Gordon D; Drobatz, Kenneth J; Harvey, Colin E; Adams, Allison; Sleeper, Meg M

2009-01-01

To identify risk factors potentially associated with the development of bacterial endocarditis in dogs and determine whether periodontal disease and surgical procedures (oral and nonoral) were associated with bacterial endocarditis. Retrospective case-control study. 76 dogs with (cases) and 80 dogs without (controls) bacterial endocarditis. Medical records were reviewed for information on signalment, physical examination findings, recent medical history, and results of echocardiography, clinicopathologic testing, and necropsy. None of the dogs with endocarditis had a history of undergoing any dental or oral procedure in the 3 months prior to the diagnosis of endocarditis, and no significant difference was found between groups with regard to the prevalence of oral infection. Dogs with endocarditis were significantly more likely to have undergone a nonoral surgical procedure that required general anesthesia in the preceding 3 months or to have developed a new heart murmur or a change in intensity of an existing heart murmur. Preexisting cardiac dis-ease (congenital or acquired) was not found to be a risk factor. Results did not provide any evidence of an association between bacterial endocarditis in dogs and either dental or oral surgical procedures or oral infection. Findings suggested that the routine use of prophylactic antimicrobial administration in dogs undergoing oral procedures needs to be reevaluated.

The organisational and human resource challenges facing primary care trusts: protocol of a multiple case study

PubMed Central

2001-01-01

Background The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. Methods The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development. PMID:11737883

Dual malignancy in adolescence: A rare case report of metachronous papillary carcinoma of thyroid following dysgerminoma of ovary

PubMed Central

Chakrabarti, Suvadip; Desai, Sanjay M.; Mehta, Dharmendra Y.; Somanath, Shreyas

2016-01-01

Dual malignancy is rare in adolescents. Dual malignancy with the second malignancy of thyroid is rare. No association has been reported between dysgerminoma of ovary and carcinoma thyroid in medical literature. Despite a thorough PubMed search (key words — Papillary carcinoma of thyroid, metachronous, dysgerminoma ovary), we were unable to find a previous reported case of metachronous papillary carcinoma of thyroid (PTC) following dysgerminoma of the ovary. After surgery, the patient is being regularly followed up for recurrence/development of new primary. We report this unusual and rare case in a 17-year-old female patient. PMID:27904567

Fat embolism syndrome.

PubMed

Dhar, Dinesh

2012-12-01

Nearly all patients following fractures of bones develop sub-clinical form of fat embolism but the classical form of fat embolism syndrome (FES) presents with triad of respiratory, neurologic and dermal manifestations. Non-traumatic conditions can also have fat embolism, but the incidence is very low. The diagnosis is mainly clinical supported by laboratory and radiological finding. Treatment is mainly supportive with early stabilization of fractured bones. In most cases, prognosis is good if the condition is detected and treated early. High index of suspicion in polytrauma patient is the key to early diagnosis of this condition. This report describes two cases of FES, the second case being fulminant fat embolism with added mortality.

The dependency of adhesion and friction on electrostatic attraction

NASA Astrophysics Data System (ADS)

Persson, B. N. J.

2018-04-01

I develop a general mean-field theory for the influence of electrostatic attraction between two solids on the contact mechanics. I assume elastic solids with random surface roughness. I consider two cases, namely, with and without an electrically insulating layer between the conducting solids. The former case is important for, e.g., the finger-touch screen interaction. I study how the electrostatic attraction influences the adhesion and friction. For the case of an insulating layer, I find that when the applied nominal contact pressure is relatively small, as the applied voltage increases, there is a sharp increase in the contact area, and hence in the friction, at a critical voltage.

Finding the forest in the trees. The challenge of combining diverse environmental data

NASA Technical Reports Server (NTRS)

1995-01-01

Development of analytical and functional guidelines to help researchers and technicians engaged in interdisciplinary research to better plan and implement their supporting data management activities is addressed. An emphasis is on the projects that involve both geophysical and ecological issues. Six case studies were used to identify and to understand problems associated with collecting, integrating, and analyzing environmental data from local to global spatial scales and over a range of temporal scales. These case studies were also used to elaborate the common barriers to interfacing data of disparate sources and types. A number of lessons derived from the case studies are summarized and analyzed.

Event Locations in Extra-Familial Child Sexual Molestation Cases: The Istanbul Example.

PubMed

Gönültaş, Burak M; Sahin, Bahadir

2018-04-01

A great deal of attention has been devoted to sexual molestation cases, both in theory and in practice. Child molesters are versatile and are not easily identified. Various theories and tactics, the most contemporary of which is environmental criminology, have been developed to find those criminals. Locations of victims, crime scenes, and distances among them as well as other situational variables are used to predict possible future offences in environmental criminology. This study applies the theory to sexual molestation crimes in Istanbul. Dependent distance variables are found to be correlated with several situational variables in a selected sample of 127 extra-familial child sexual molestation cases.

Malignant arrhythmia as the first manifestation of Wolff-Parkinson-White syndrome: a case with minimal preexcitation on electrocardiography.

PubMed

Gungor, B; Alper, A T

2013-09-01

Wolff-Parkinson-White (WPW) syndrome is defined as the presence of an accessory atrioventricular pathway which is manifested as delta waves and short PR interval on electrocardiography (ECG). However, some WPW cases do not have typical findings on ECG and may remain undiagnosed unless palpitations occur. Sudden cardiac death may be the first manifestation of WPW and develops mostly secondary to degeneration of atrial fibrillation into ventricular fibrillation. In this report, we present a case of undiagnosed WPW with minimal preexcitation on ECG and who suffered an episode of malignant arrhythmia as the first manifestation of the disease.

Medical leadership arrangements in English healthcare organisations: findings from a national survey and case studies of NHS trusts.

PubMed

Dickinson, Helen; Ham, Chris; Snelling, Iain; Spurgeon, Peter

2013-11-01

This project sought to describe the involvement of doctors in leadership roles in the NHS and the organisational structures and management processes in use in NHS trusts. A mixed methods approach was adopted combining a questionnaire survey of English NHS trusts and in-depth case studies of nine organisations who responded to the survey. Respondents identified a number of challenges in the development of medical leadership, and there was often perceived to be an engagement gap between medical leaders and doctors in clinical roles. While some progress has been made in the development of medical leadership in the NHS in England, much remains to be done to complete the journey that started with the Griffiths Report in 1983. We conclude that a greater degree of professionalism needs to be brought to bear in the development of medical leadership. This includes developing career structures to make it easier for doctors to take on leadership roles; providing training, development and support in management and leadership at different stages of doctors' careers; and ensuring that pay and other rewards are commensurate with the responsibilities of medical leaders. The time commitment of medical leaders and the proportion of doctors in leadership roles both need to increase. The paper concludes considering the implications of these findings for other health systems. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Stakeholder Perceptions of Cyberbullying Cases: Application of the Uniform Definition of Bullying.

PubMed

Moreno, Megan A; Suthamjariya, Nina; Selkie, Ellen

2018-04-01

The Uniform Definition of Bullying was developed to address bullying and cyberbullying, and to promote consistency in measurement and policy. The purpose of this study was to understand community stakeholder perceptions of typical cyberbullying cases, and to evaluate how these case descriptions align with the Uniform Definition. In this qualitative case analysis we recruited stakeholders commonly involved in cyberbullying. We used purposeful sampling to identify and recruit adolescents and young adults, parents, and professionals representing education and health care. Participants were asked to write a typical case of cyberbullying and descriptors in the context of a group discussion. We applied content analysis to case excerpts using inductive and deductive approaches, and chi-squared tests for mixed methods analyses. A total of 68 participants contributed; participants included 73% adults and 27% adolescents and young adults. A total of 650 excerpts were coded from participants' example cases and 362 (55.6%) were consistent with components of the Uniform Definition. The most frequently mentioned component of the Uniform Definition was Aggressive Behavior (n = 218 excerpts), whereas Repeated was mentioned infrequently (n = 19). Most participants included two to three components of the Uniform Definition within an example case; none of the example cases included all components of the Uniform Definition. We found that most participants described cyberbullying cases using few components of the Uniform Definition. Findings can be applied toward considering refinement of the Uniform Definition to ensure stakeholders find it applicable to cyberbullying. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Newly discovered ebola virus associated with hemorrhagic fever outbreak in Uganda.

PubMed

Towner, Jonathan S; Sealy, Tara K; Khristova, Marina L; Albariño, César G; Conlan, Sean; Reeder, Serena A; Quan, Phenix-Lan; Lipkin, W Ian; Downing, Robert; Tappero, Jordan W; Okware, Samuel; Lutwama, Julius; Bakamutumaho, Barnabas; Kayiwa, John; Comer, James A; Rollin, Pierre E; Ksiazek, Thomas G; Nichol, Stuart T

2008-11-01

Over the past 30 years, Zaire and Sudan ebolaviruses have been responsible for large hemorrhagic fever (HF) outbreaks with case fatalities ranging from 53% to 90%, while a third species, Côte d'Ivoire ebolavirus, caused a single non-fatal HF case. In November 2007, HF cases were reported in Bundibugyo District, Western Uganda. Laboratory investigation of the initial 29 suspect-case blood specimens by classic methods (antigen capture, IgM and IgG ELISA) and a recently developed random-primed pyrosequencing approach quickly identified this to be an Ebola HF outbreak associated with a newly discovered ebolavirus species (Bundibugyo ebolavirus) distantly related to the Côte d'Ivoire ebolavirus found in western Africa. Due to the sequence divergence of this new virus relative to all previously recognized ebolaviruses, these findings have important implications for design of future diagnostic assays to monitor Ebola HF disease in humans and animals, and ongoing efforts to develop effective antivirals and vaccines.

Newly Discovered Ebola Virus Associated with Hemorrhagic Fever Outbreak in Uganda

PubMed Central

Towner, Jonathan S.; Sealy, Tara K.; Khristova, Marina L.; Albariño, César G.; Conlan, Sean; Reeder, Serena A.; Quan, Phenix-Lan; Lipkin, W. Ian; Downing, Robert; Tappero, Jordan W.; Okware, Samuel; Lutwama, Julius; Bakamutumaho, Barnabas; Kayiwa, John; Comer, James A.; Rollin, Pierre E.; Ksiazek, Thomas G.; Nichol, Stuart T.

2008-01-01

Over the past 30 years, Zaire and Sudan ebolaviruses have been responsible for large hemorrhagic fever (HF) outbreaks with case fatalities ranging from 53% to 90%, while a third species, Côte d'Ivoire ebolavirus, caused a single non-fatal HF case. In November 2007, HF cases were reported in Bundibugyo District, Western Uganda. Laboratory investigation of the initial 29 suspect-case blood specimens by classic methods (antigen capture, IgM and IgG ELISA) and a recently developed random-primed pyrosequencing approach quickly identified this to be an Ebola HF outbreak associated with a newly discovered ebolavirus species (Bundibugyo ebolavirus) distantly related to the Côte d'Ivoire ebolavirus found in western Africa. Due to the sequence divergence of this new virus relative to all previously recognized ebolaviruses, these findings have important implications for design of future diagnostic assays to monitor Ebola HF disease in humans and animals, and ongoing efforts to develop effective antivirals and vaccines. PMID:19023410

Implementing inquiry-based kits within a professional development school model

NASA Astrophysics Data System (ADS)

Jones, Mark Thomas

2005-07-01

Implementation of guided inquiry teaching for the first time carries inherent problems for science teachers. Reform efforts on inquiry-based science teaching are often unsustainable and are not sensitive to teachers' needs and abilities as professionals. Professional development schools are meant to provide a research-based partnership between a public school and a university. These collaborations can provide support for the professional development of teachers. This dissertation reports a study focused on the implementation of inquiry-based science kits within the support of one of these collaborations. The researcher describes the difficulties and successful adaptations experienced by science teachers and how a coteaching model provided support. These types of data are needed in order to develop a bottom-up, sustainable process that will allow teachers to implement inquiry-based science. A qualitative methodology with "researcher as participant" was used in this study of two science teachers during 2002--2003. These two teachers were supported by a coteaching model, which included preservice teachers for each teacher as well as a supervising professor. Data were collected from the researcher's direct observations of coteachers' practice. Data were also collected from interviews and reflective pieces from the coteachers. Triangulation of the data on each teacher's case supported the validity of the findings. Case reports were prepared from these data for each classroom teacher. These case reports were used and cross-case analysis was conducted to search for major themes and findings in the study. Major findings described the hurdles teachers encounter, examples of adaptations observed in the teachers' cases and the supportive interactions with their coteachers while implementing the inquiry-based kits. In addition, the data were used to make recommendations for future training and use of the kits and the coteaching model. Results from this study showed that the kit's guided structure of inquiry and the collaboration both affected the inservice teachers in the following ways: The coteaching model supported behavioral and material management issues caused by the implementation of the kits; collaboration with preservice teachers created a "smaller-class-size" effect, which allowed teachers to attend to a smaller number of students for cooperative learning and assessment, and the elementary inservice teachers learned pedagogical strategies and science content from collaborating with secondary preservice teachers in kit use and from the kits' curriculum. Results were used as a self-study for future training and support for implementation of inquiry-based kits.

Risk Factors Profile of Shoulder Dystocia in Oman: A Case Control Study

PubMed Central

Al-Khaduri, Maha M.; Abudraz, Rania Mohammed; Al-Farsi, Yahya M.

2014-01-01

Objective This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. Methods A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factors, delivery, and obstetric complications were collected. Results Dystocia was significantly associated with older maternal age, higher parity, larger BMI, diabetes, and previous record of dystocia. In addition, dystocia was associated more with vacuum and forceps deliveries. Routine traction (51%) was the most used manoeuvre. Among dystocia cases, 13% were associated with fetal complications of which Erb’s Palsy was the most prevalent (79%). Conclusion Our finding of significant associations with risk factors lays out the ground to develop a predictability index for shoulder dystocia, which would help in making it preventable. Further p rospective studies are required to confirm the obtained results. PMID:25337307

Diagnosis and management of biliary complications in pediatric living donor liver transplant recipients.

PubMed

Feier, Flávia H; Chapchap, Paulo; Pugliese, Renata; da Fonseca, Eduardo A; Carnevale, Francisco C; Moreira, Airton M; Zurstrassen, Charles; Santos, Aline C; Miura, Irene K; Baggio, Vera; Porta, Adriana; Guimarães, Teresa; Cândido, Helry; Benavides, Marcel; Godoy, Andre; Leite, Katia M R; Porta, Gilda; Kondo, Mario; Seda-Neto, João

2014-08-01

The incidence of biliary complications (BCs) after living donor liver transplantation (LDLT) can reach 40%. Published data on the pediatric population are limited, and treatment protocols vary. Our aim was to describe the clinical scenario for BCs and treatment approaches after LDLT. Between October 1995 and December 2012, 489 pediatric LDLT procedures were performed. BCs developed in 71 patients (14.5%). Biliary strictures (BSs) developed in 45 (9.2%) patients, and bile leaks (BLs) developed in 33 patients (6.7%). The BL diagnosis was clinical in all cases, and 69.7% of the patients underwent surgery. Nearly half of the BS cases had clinical features or suggestive ultrasound findings. Liver biopsy findings suggested BSs in 51.7%. Percutaneous transhepatic cholangiography was performed in 95.6% of the BS patients. The success rate was 77% [mean number of percutaneous biliary interventions (PBIs) = 3.9 ± 1.98, median drainage time = 8 months]. In conclusion, BL patients can be managed with conservative therapy, even though most of these patients will ultimately be treated with surgery. Diagnosing a BS requires a high degree of clinical suspicion because the available resources for its identification can fail in up to 50% of cases. A higher number of PBIs and the use of a drainage catheter for a longer time may be required to achieve better results with this technique. © 2014 American Association for the Study of Liver Diseases.

Hodgkin/Reed-Sternberg cells and Hodgkin's disease in patients with B-cell chronic lymphocytic leukaemia: an immunohistological, molecular and clinical study of four cases suggesting a heterogeneous pathogenetic background.

PubMed

Pescarmona, E; Pignoloni, P; Mauro, F R; Cerretti, R; Anselmo, A P; Mandelli, F; Baroni, C D

2000-08-01

We report the immunohistological, molecular and clinical findings in four patients affected by B-cell chronic lymphocytic leukaemia (CLL) who developed "Richter's syndrome with Hodgkin's disease (HD) features" or "CLL with Hodgkin's transformation", all characterised by the presence of typical Hodgkin/Reed-Sternberg (H/RS) cells in lymph node biopsies. In three cases the nodal involvement by CLL was demonstrated both by the presence of a predominant background of CD5/CD19/CD23+ small lymphocytes and an IgH monoclonal rearrangement revealed by PCR analysis. Conversely, in the remaining case there was neither immunohistological nor molecular evidence of lymph node involvement by CLL. In all four cases H/RS cells were Epstein-Barr virus (EBV) latent membrane protein (LMP-1) positive. These findings suggest that the presence of H/RS cells in the first three patients, who had CLL/HD nodal involvement, might be related to transformation or clonal evolution of CLL cells in H/RS cells, which is in keeping with use of the term "CLL with Hodgkin's transformation". In the fourth case a de novo HD may be postulated, representing a second malignancy presumably not clonally related to CLL. In all cases a key pathogenetic role of EBV is suggested by the expression of LMP-1 in H/RS cells. Our findings indicate that the presence of typical H/RS cells in lymph node biopsies in CLL patients may reflect a heterogeneous pathogenetic background. The different clinico-pathologic settings should be taken into consideration because of their possible implications for patients' treatment and prognosis.

Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease.

PubMed

Underhill, R A

2015-12-01

The etiology of myalgic encephalomyelitis also known as chronic fatigue syndrome or ME/CFS has not been established. Controversies exist over whether it is an organic disease or a psychological disorder and even the existence of ME/CFS as a disease entity is sometimes denied. Suggested causal hypotheses have included psychosomatic disorders, infectious agents, immune dysfunctions, autoimmunity, metabolic disturbances, toxins and inherited genetic factors. Clinical, immunological and epidemiological evidence supports the hypothesis that: ME/CFS is an infectious disease; the causal pathogen persists in patients; the pathogen can be transmitted by casual contact; host factors determine susceptibility to the illness; and there is a population of healthy carriers, who may be able to shed the pathogen. ME/CFS is endemic globally as sporadic cases and occasional cluster outbreaks (epidemics). Cluster outbreaks imply an infectious agent. An abrupt flu-like onset resembling an infectious illness occurs in outbreak patients and many sporadic patients. Immune responses in sporadic patients resemble immune responses in other infectious diseases. Contagion is shown by finding secondary cases in outbreaks, and suggested by a higher prevalence of ME/CFS in sporadic patients' genetically unrelated close contacts (spouses/partners) than the community. Abortive cases, sub-clinical cases, and carrier state individuals were found in outbreaks. The chronic phase of ME/CFS does not appear to be particularly infective. Some healthy patient-contacts show immune responses similar to patients' immune responses, suggesting exposure to the same antigen (a pathogen). The chronicity of symptoms and of immune system changes and the occurrence of secondary cases suggest persistence of a causal pathogen. Risk factors which predispose to developing ME/CFS are: a close family member with ME/CFS; inherited genetic factors; female gender; age; rest/activity; previous exposure to stress or toxins; various infectious diseases preceding the onset of ME/CFS; and occupational exposure of health care professionals. The hypothesis implies that ME/CFS patients should not donate blood or tissue and usual precautions should be taken when handling patients' blood and tissue. No known pathogen has been shown to cause ME/CFS. Confirmation of the hypothesis requires identification of a causal pathogen. Research should focus on a search for unknown and known pathogens. Finding a causal pathogen could assist with diagnosis; help find a biomarker; enable the development of anti-microbial treatments; suggest preventive measures; explain pathophysiological findings; and reassure patients about the validity of their symptoms.

A Case of Lymphomatoid Keratosis

PubMed Central

Choi, Min Jee; Kim, Hei Sung; Kim, Hyung Ok; Song, Kye Yong

2010-01-01

Lymphomatoid keratosis (LK) is considered to be a rare variant of cutaneous lymphoid hyperplasia, with epidermotropism. We herein report a case of LK which developed on the abdomen of an elderly Korean woman. A 60-year-old woman presented with a 10-year history of a pruritic, solitary, brown to black plaque on the abdomen. Histopathologically, the specimen showed hyperkeratosis, parakeratosis, acanthosis and Pautrier's micro-abscess in the epidermis, and a lichenoid infiltration of lymphocytes in the dermis, which expressed both B cell and T cell lineage on the immune-histochemical staining. Based on these clinical and histopathological findings, our case was diagnosed as LK. To our knowledge, this is the first case report of LK in the Korean dermatologic literature. PMID:20548920

Dynamic Sonographic Visualization of an Occult Posterior Lateral Meniscocapsular Separation: A Case Report.

PubMed

Schroeder, Allison; Musahl, Volker; Urbanek, Christopher; Onishi, Kentaro

2018-04-05

Meniscocapsular separation describes detachment of the meniscus from the knee joint capsule. Diagnosis is challenging with conventional examination and imaging methods. We report a case of an 18-year-old female softball catcher with unrevealing magnetic resonance imaging despite continued left knee locking and discomfort with deep squatting. Meniscocapsular separation was revealed only on dynamic sonographic exam, where knee flexion revealed a 3.1-mm gap that developed between the capsule and peripheral meniscus. Arthroscopy confirmed the sonographic findings, and repair resulted in complete resolution of symptoms. This case highlights the utility of dynamic diagnostic sonography in a rare case of posterior lateral meniscocapsular separation. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Rare copy number variants in patients with congenital conotruncal heart defects.

PubMed

Xie, Hongbo M; Werner, Petra; Stambolian, Dwight; Bailey-Wilson, Joan E; Hakonarson, Hakon; White, Peter S; Taylor, Deanne M; Goldmuntz, Elizabeth

2017-03-01

Previous studies using different cardiac phenotypes, technologies and designs suggest a burden of large, rare or de novo copy number variants (CNVs) in subjects with congenital heart defects. We sought to identify disease-related CNVs, candidate genes, and functional pathways in a large number of cases with conotruncal and related defects that carried no known genetic syndrome. Cases and control samples were divided into two cohorts and genotyped to assess each subject's CNV content. Analyses were performed to ascertain differences in overall CNV prevalence and to identify enrichment of specific genes and functional pathways in conotruncal cases relative to healthy controls. Only findings present in both cohorts are presented. From 973 total conotruncal cases, a burden of rare CNVs was detected in both cohorts. Candidate genes from rare CNVs found in both cohorts were identified based on their association with cardiac development or disease, and/or their reported disruption in published studies. Functional and pathway analyses revealed significant enrichment of terms involved in either heart or early embryonic development. Our study tested one of the largest cohorts specifically with cardiac conotruncal and related defects. These results confirm and extend previous findings that CNVs contribute to disease risk for congenital heart defects in general and conotruncal defects in particular. As disease heterogeneity renders identification of single recurrent genes or loci difficult, functional pathway and gene regulation network analyses appear to be more informative. Birth Defects Research 109:271-295, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Understanding the medical markers of elder abuse and neglect: physical examination findings.

PubMed

Gibbs, Lisa M

2014-11-01

A specific foundation of knowledge is important for evaluating potential abuse from physical findings in the older adult. The standard physical examination is a foundation for detecting many types of abuse. An understanding of traumatic injuries, including patterns of injury, is important for health care providers, and inclusion of elder abuse in the differential diagnosis of patient care is essential. One must possess the skills needed to piece the history, including functional capabilities, and physical findings together. Armed with this skill set, health care providers will develop the confidence needed to identify and intervene in cases of elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

[Benign proliferative breast disease with and without atypia].

PubMed

Coutant, C; Canlorbe, G; Bendifallah, S; Beltjens, F

2015-12-01

In the last few years, diagnostics of high-risk breast lesions (atypical ductal hyperplasia [ADH], flat epithelial atypia [FEA], lobular neoplasia: atypical lobular hyperplasia [ALH], lobular carcinoma in situ [LCIS], radial scar [RS], usual ductal hyperplasia [UDH], adenosis, sclerosing adenosis [SA], papillary breast lesions, mucocele-like lesion [MLL]) have increased with the growing number of breast percutaneous biopsies. The management of these lesions is highly conditioned by the enlarged risk of breast cancer combined with either an increased probability of finding cancer after surgery, either a possible malignant transformation (in situ or invasive cancer), or an increased probability of developing cancer on the long range. An overview of the literature reports grade C recommendations concerning the management and follow-up of these lesions: in case of ADH, FEA, ALH, LCIS, RS, MLL with atypia, diagnosed on percutaneous biopsies: surgical excision is recommended; in case of a diagnostic based on vacuum-assisted core biopsy with complete disappearance of radiological signal for FEA or RS without atypia: surgical abstention is a valid alternative approved by multidisciplinary meeting. In case of ALH (incidental finding) associated with benign lesion responsible of radiological signal: abstention may be proposed; in case of UDH, adenosis, MLL without atypia, diagnosed on percutaneous biopsies: the concordance of radiology and histopathology findings must be ensured. No data is available to recommend surgery; in case of non-in sano resection for ADH, FEA, ALH, LCIS (except pleomorphic type), RS, MLL: surgery does not seem to be necessary; in case of previous ADH, ALH, LCIS: a specific follow-up is recommended in accordance with HAS's recommendations. In case of FEA and RS or MLL combined with atypia, little data are yet available to differ the management from others lesions with atypia; in case of UDH, usual sclerosing adenosis, RS without atypia, fibro cystic disease: no specific follow-up is recommended in agreement with HAS's recommendations. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Usefulness of symptoms to screen for celiac disease.

PubMed

Rosén, Anna; Sandström, Olof; Carlsson, Annelie; Högberg, Lotta; Olén, Ola; Stenlund, Hans; Ivarsson, Anneli

2014-02-01

To describe the frequency of symptoms and associated conditions among screening-detected celiac disease (CD) cases and non-CD children and to evaluate questionnaire-based case-finding targeting the general population. In a population-based CD screening of 12-year-olds, children and their parents completed questionnaires on CD-associated symptoms and conditions before knowledge of CD status. Questionnaire data for those who had their CD detected in the screening (n = 153) were compared with those of children with normal levels of CD markers (n = 7016). Hypothetical case-finding strategies were also evaluated. Questionnaires were returned by 7054 (98%) of the children and by 6294 (88%) of their parents. Symptoms were as common among screening-detected CD cases as among non-CD children. The frequency of children with screening-detected CD was similar when comparing the groups with and without any CD-related symptoms (2.1% vs 2.1%; P = .930) or CD-associated conditions (3.6% vs 2.1%; P = .07). Case-finding by asking for CD-associated symptoms and/or conditions would have identified 52 cases (38% of all cases) at a cost of analyzing blood samples for 2282 children (37%) in the study population. The current recommended guidelines for finding undiagnosed CD cases, so-called active case-finding, fail to identify the majority of previously undiagnosed cases if applied in the general population of Swedish 12-year-olds. Our results warrant further studies on the effectiveness of CD case-finding in the pediatric population, both at the clinical and population-based levels.

iHelp: an intelligent online helpdesk system.

PubMed

Wang, Dingding; Li, Tao; Zhu, Shenghuo; Gong, Yihong

2011-02-01

Due to the importance of high-quality customer service, many companies use intelligent helpdesk systems (e.g., case-based systems) to improve customer service quality. However, these systems face two challenges: 1) Case retrieval measures: most case-based systems use traditional keyword-matching-based ranking schemes for case retrieval and have difficulty to capture the semantic meanings of cases and 2) result representation: most case-based systems return a list of past cases ranked by their relevance to a new request, and customers have to go through the list and examine the cases one by one to identify their desired cases. To address these challenges, we develop iHelp, an intelligent online helpdesk system, to automatically find problem-solution patterns from the past customer-representative interactions. When a new customer request arrives, iHelp searches and ranks the past cases based on their semantic relevance to the request, groups the relevant cases into different clusters using a mixture language model and symmetric matrix factorization, and summarizes each case cluster to generate recommended solutions. Case and user studies have been conducted to show the full functionality and the effectiveness of iHelp.

Case Finding Using Syndromic Surveillance Data During an Outbreak of Shiga Toxin-Producing Escherichia coli O26 Infections, Oregon, 2015.

PubMed

Hines, Jonas Z; Bancroft, June; Powell, Melissa; Hedberg, Katrina

Shiga toxin-producing Escherichia coli (STEC) causes an estimated 265 000 infections in the United States annually. Of emerging non-O157:H7 STEC serotypes, O26 is the most commonly recognized. During an outbreak of STEC O26 in Oregon in 2015, we used syndromic surveillance data to supplement case finding by laboratory reporting. From 157 records retrieved by querying syndromic surveillance data, we detected 4 confirmed and 5 suspected cases. However, none of the suspected cases were confirmed by stool culture, and by the time that the data were being analyzed, the confirmed cases were already known to investigators. Syndromic surveillance data can potentially supplement case finding during outbreaks of foodborne disease. To be an effective case-finding strategy, timely completion of all steps, including collecting specimens from suspected cases, should be performed in real time.

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures.

PubMed

Harvey, N C W; McCloskey, E V; Mitchell, P J; Dawson-Hughes, B; Pierroz, D D; Reginster, J-Y; Rizzoli, R; Cooper, C; Kanis, J A

2017-05-01

This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into four distinct themes: (1) case finding and management of individuals at high risk of fracture, (2) public awareness of osteoporosis and fragility fractures, (3) reimbursement and health system policy and (4) epidemiology of fracture in the developing world. Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits, are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all. Systematic approaches to case-finding individuals who are at high risk of sustaining fragility fractures are described. These include strategies and models of care intended to improve case finding for individuals who have sustained fragility fractures, those undergoing treatment with medicines which have an adverse effect on bone health and people who have diseases, whereby bone loss and, consequently, fragility fractures are a common comorbidity. Approaches to deliver primary fracture prevention in a clinically effective and cost-effective manner are also explored. Public awareness of osteoporosis is low worldwide. If older people are to be more pro-active in the management of their bone health, that needs to change. Effective disease awareness campaigns have been implemented in some countries but need to be undertaken in many more. A major need exists to improve awareness of the risk that osteoporosis poses to individuals who have initiated treatment, with the intention of improving adherence in the long term. A multisector effort is also required to support patients and their clinicians to have meaningful discussions concerning the risk-benefit ratio of osteoporosis treatment. With regard to prioritisation of fragility fracture prevention in national policy, there is much to be done. In the developing world, robust epidemiological estimates of fracture incidence are required to inform policy development. As the aging of the baby boomer generation is upon us, this review provides a comprehensive analysis of how bone health can be improved worldwide for all.

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

PubMed Central

Harvey, Nicholas C.W.; McCloskey, Eugene V.; Mitchell, Paul J.; Dawson-Hughes, Bess; Pierroz, Dominique D.; Reginster, Jean-Yves; Rizzoli, René; Cooper, Cyrus; Kanis, John A.

2017-01-01

Introduction This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into 4 distinct themes: Case-finding and management of individuals at high risk of fracturePublic awareness of osteoporosis and fragility fracturesReimbursement and health system policyEpidemiology of fracture in the developing world Methods Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all. Results Systematic approaches to case-finding individuals who are at high risk of sustaining fragility fractures are described. These include strategies and models of care intended to improve case-finding for individuals who have sustained fragility fractures, those undergoing treatment with medicines which have an adverse effect on bone health, and people who have diseases whereby bone loss and, consequently, fragility fractures are a common comorbidity. Approaches to deliver primary fracture prevention in a clinically effective and cost-effective manner are also explored. Public awareness of osteoporosis is low worldwide. If older people are to be more pro-active in the management of their bone health, that needs to change. Effective disease awareness campaigns have been implemented in some countries, but need to be undertaken in many more. A major need exists to improve awareness of the risk that osteoporosis poses to individuals who have initiated treatment, with the intention of improving adherence in the long-term. A multisector effort is also required to support patients and their clinicians to have meaningful discussions concerning the risk-benefit ratio of osteoporosis treatment. With regard to prioritisation of fragility fracture prevention in national policy, there is much to be done. In the developing world, robust epidemiological estimates of fracture incidence are required to inform policy development. Conclusion As the aging of the Baby Boomer generation is upon us, this review provides a comprehensive analysis of how bone health can be improved worldwide for all. PMID:28175979

Novel associations in disorders of sex development: findings from the I-DSD Registry.

PubMed

Cox, Kathryn; Bryce, Jillian; Jiang, Jipu; Rodie, Martina; Sinnott, Richard; Alkhawari, Mona; Arlt, Wiebke; Audi, Laura; Balsamo, Antonio; Bertelloni, Silvano; Cools, Martine; Darendeliler, Feyza; Drop, Stenvert; Ellaithi, Mona; Guran, Tulay; Hiort, Olaf; Holterhus, Paul-Martin; Hughes, Ieuan; Krone, Nils; Lisa, Lidka; Morel, Yves; Soder, Olle; Wieacker, Peter; Ahmed, S Faisal

2014-02-01

The focus of care in disorders of sex development (DSD) is often directed to issues related to sex and gender development. In addition, the molecular etiology remains unclear in the majority of cases. To report the range of associated conditions identified in the international DSD (I-DSD) Registry. Anonymized data were extracted from the I-DSD Registry for diagnosis, karyotype, sex of rearing, genetic investigations, and associated anomalies. If necessary, clarification was sought from the reporting clinician. Of 649 accessible cases, associated conditions occurred in 168 (26%); 103 (61%) cases had one condition, 31 (18%) had two conditions, 20 (12%) had three conditions, and 14 (8%) had four or more conditions. Karyotypes with most frequently reported associations included 45,X with 6 of 8 affected cases (75%), 45,X/46,XY with 19 of 42 cases (45%), 46,XY with 112 of 460 cases (24%), and 46,XX with 27 of 121 cases (22%). In the 112 cases of 46,XY DSD, the commonest conditions included small for gestational age in 26 (23%), cardiac anomalies in 22 (20%), and central nervous system disorders in 22 (20%), whereas in the 27 cases of 46,XX DSD, skeletal and renal anomalies were commonest at 12 (44%) and 8 (30%), respectively. Of 170 cases of suspected androgen insensitivity syndrome, 19 (11%) had reported anomalies and 9 of these had confirmed androgen receptor mutations. Over a quarter of the cases in the I-DSD Registry have an additional condition. These associations can direct investigators toward novel genetic etiology and also highlight the need for more holistic care of the affected person.

Evaluating the Usability of Authoring Environments for Serious Games.

PubMed

Slootmaker, Aad; Hummel, Hans; Koper, Rob

2017-08-01

Background . The EMERGO method and online platform enable the development and delivery of scenario-based serious games that foster students to acquire professional competence. One of the main goals of the platform is to provide a user-friendly authoring environment for creating virtual environments where students can perform authentic tasks. Aim . We present the findings of an in-depth qualitative case study of the platform's authoring environment and compare our findings on usability with those found for comparable environments in literature. Method . We carried out semi-structured interviews, with two experienced game developers who have authored a game for higher education, and a literature review of comparable environments. Findings . The analysis shows that the usability of the authoring environment is problematic, especially regarding understandability and learnability , which is in line with findings of comparable environments. Other findings are that authoring is well integrated with the EMERGO method and that functionality and reliability of the authoring environment are valued. Practical implications . The lessons learned are presented in the form of general guidelines to improve the understandability and learnability of authoring environments for serious games .

Evaluating the Usability of Authoring Environments for Serious Games

PubMed Central

Slootmaker, Aad; Hummel, Hans; Koper, Rob

2017-01-01

Background. The EMERGO method and online platform enable the development and delivery of scenario-based serious games that foster students to acquire professional competence. One of the main goals of the platform is to provide a user-friendly authoring environment for creating virtual environments where students can perform authentic tasks. Aim. We present the findings of an in-depth qualitative case study of the platform’s authoring environment and compare our findings on usability with those found for comparable environments in literature. Method. We carried out semi-structured interviews, with two experienced game developers who have authored a game for higher education, and a literature review of comparable environments. Findings. The analysis shows that the usability of the authoring environment is problematic, especially regarding understandability and learnability, which is in line with findings of comparable environments. Other findings are that authoring is well integrated with the EMERGO method and that functionality and reliability of the authoring environment are valued. Practical implications. The lessons learned are presented in the form of general guidelines to improve the understandability and learnability of authoring environments for serious games. PMID:29081638

The Development and Status of Earth Science Education: A Comparison of Three Case Studies: Israel, England and Wales and the United States of America. Part I.

ERIC Educational Resources Information Center

Orion, Nir; King, Chris; Krockover, Gerald H.; Adams, Paul E.

1999-01-01

Explores the development and status of Earth Science Education in Israel and England and Wales. Finds that, despite separate traditions for education in the Earth Sciences, there are a surprisingly large number of commonalities between current trends in each of the countries in the study, and each has had difficulty determining what constitutes an…

Developing a Conceptual Framework for Evaluation of E-Content of Virtual Courses: E-Learning Center of an Iranian University Case Study

ERIC Educational Resources Information Center

Akhavan, Peyman; Arefi, Majid Feyz

2014-01-01

The purpose of this study is to obtain suitable quality criteria for evaluation of electronic content for virtual courses. We attempt to find the aspects which are important in developing e-content for virtual courses and to determine the criteria we need to judge for the quality and efficiency of learning objects and e-content. So we can classify…

Iodine-131 induced hepatotoxicity in previously healthy patients with Grave's disease.

PubMed

Jhummon, Navina Priya; Tohooloo, Bhavna; Qu, Shen

2013-01-01

To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave's disease (GD) patients after the treatment with radioactive iodine (131)I (RAI). We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine (131)I.

Allergic contact dermatitis from color film developers: clinical and histologic features.

PubMed

Brancaccio, R R; Cockerell, C J; Belsito, D; Ostreicher, R

1993-05-01

We evaluated two patients with allergic contact dermatitis that resulted from exposure to color film developers. A lichenoid eruption developed in one patient, whereas an eruption more characteristic of an acute spongiotic dermatitis developed in the second patient. Histologic findings in the first case were those of a "lichenoid dermatitis" but with features distinct from classic lichen planus. The biopsy specimens from the second patient showed a subacute spongiotic process with a bandlike infiltrate suggestive of an evolving lichenoid process. Contact allergy to color developers may result in eruptions similar to lichen planus. This process appears to evolve from an acute spongiotic dermatitis in its early phase to a lichenoid dermatitis in fully developed and more chronic forms. Although the histologic features are those of a "lichenoid" dermatitis, some features, such as the presence of spongiosis, eosinophils, and a less intense inflammatory infiltrate, may enable distinction between lichenoid allergic contact dermatitis and true lichen planus. In addition, clinicopathologic correlation with patch test results should permit accurate diagnosis in most cases.

Iodine-131 induced hepatotoxicity in previously healthy patients with Grave’s disease

PubMed Central

2013-01-01

Objective To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave’s disease (GD) patients after the treatment with radioactive iodine 131I (RAI). Case presentation We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. Conclusion To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine 131I. PMID:23497434

Finding-specific display presets for computed radiography soft-copy reading.

PubMed

Andriole, K P; Gould, R G; Webb, W R

1999-05-01

Much work has been done to optimize the display of cross-sectional modality imaging examinations for soft-copy reading (i.e., window/level tissue presets, and format presentations such as tile and stack modes, four-on-one, nine-on-one, etc). Less attention has been paid to the display of digital forms of the conventional projection x-ray. The purpose of this study is to assess the utility of providing presets for computed radiography (CR) soft-copy display, based not on the window/level settings, but on processing applied to the image optimized for visualization of specific findings, pathologies, etc (i.e., pneumothorax, tumor, tube location). It is felt that digital display of CR images based on finding-specific processing presets has the potential to: speed reading of digital projection x-ray examinations on soft copy; improve diagnostic efficacy; standardize display across examination type, clinical scenario, important key findings, and significant negatives; facilitate image comparison; and improve confidence in and acceptance of soft-copy reading. Clinical chest images are acquired using an Agfa-Gevaert (Mortsel, Belgium) ADC 70 CR scanner and Fuji (Stamford, CT) 9000 and AC2 CR scanners. Those demonstrating pertinent findings are transferred over the clinical picture archiving and communications system (PACS) network to a research image processing station (Agfa PS5000), where the optimal image-processing settings per finding, pathologic category, etc, are developed in conjunction with a thoracic radiologist, by manipulating the multiscale image contrast amplification (Agfa MUSICA) algorithm parameters. Soft-copy display of images processed with finding-specific settings are compared with the standard default image presentation for 50 cases of each category. Comparison is scored using a 5-point scale with the positive scale denoting the standard presentation is preferred over the finding-specific processing, the negative scale denoting the finding-specific processing is preferred over the standard presentation, and zero denoting no difference. Processing settings have been developed for several findings including pneumothorax and lung nodules, and clinical cases are currently being collected in preparation for formal clinical trials. Preliminary results indicate a preference for the optimized-processing presentation of images over the standard default, particularly by inexperienced radiology residents and referring clinicians.

[Ulcerating Herpes simplex infections in intensive care patients].

PubMed

Fischer, M; Wohlrab, J; Radke, J; Marsch, W C; Soukup, J

2002-11-01

Herpes simplex infections are potentially a life-threatening situation for immunocompromised as well as critically ill patients. The correct diagnosis is made more difficult in comatose patients by the fact that the characteristic symptom of extreme pain cannot be registered. The clinical dermatological findings (polycyclic configuration, easily bleeding ulcers) are thus especially important in patients under intensive care conditions. As examples, the cases of 3 critically ill patients (subarachnoid bleeding or head injury) developing therapy-resistant, flat sacral or perioral skin ulcers with peripheral blisters are presented. Herpes simplex virus was confirmed immunohistologically and in the smear test. All patients subsequently died. These cases emphasize that patients in the intensive care unit are in danger of developing a chronic persistent Herpes simplex infection due to latent immunosuppression. Chronic persistent Herpes infections may be underrated in intensive therapy, and must always be ruled out in case of therapy-resistant erosions or ulcerations.

A case study of effective practice in mathematics teaching and learning informed by Valsiner's zone theory

NASA Astrophysics Data System (ADS)

Geiger, Vince; Anderson, Judy; Hurrell, Derek

2017-02-01

The characteristics that typify an effective teacher of mathematics and the environments that support effective teaching practices have been a long-term focus of educational research. In this article we report on an aspect of a larger study that investigated `best practice' in mathematics teaching and learning across all Australian states and territories. A case study from one Australian state was developed from data collected via classroom observations and semi-structured interviews with school leaders and teachers and analysed using Valsiner's zone theory. A finding of the study is that `successful' practice is strongly tied to school context and the cultural practices that have been developed by school leaders and teachers to optimise student learning opportunities. We illustrate such an alignment of school culture and practice through a vignette based on a case of one `successful' school.

Treatment Default amongst Patients with Tuberculosis in Urban Morocco: Predicting and Explaining Default and Post-Default Sputum Smear and Drug Susceptibility Results

PubMed Central

Ghali, Iraqi; Kizub, Darya; Billioux, Alexander C.; Bennani, Kenza; Bourkadi, Jamal Eddine; Benmamoun, Abderrahmane; Lahlou, Ouafae; Aouad, Rajae El; Dooley, Kelly E.

2014-01-01

Setting Public tuberculosis (TB) clinics in urban Morocco. Objective Explore risk factors for TB treatment default and develop a prediction tool. Assess consequences of default, specifically risk for transmission or development of drug resistance. Design Case-control study comparing patients who defaulted from TB treatment and patients who completed it using quantitative methods and open-ended questions. Results were interpreted in light of health professionals’ perspectives from a parallel study. A predictive model and simple tool to identify patients at high risk of default were developed. Sputum from cases with pulmonary TB was collected for smear and drug susceptibility testing. Results 91 cases and 186 controls enrolled. Independent risk factors for default included current smoking, retreatment, work interference with adherence, daily directly observed therapy, side effects, quick symptom resolution, and not knowing one’s treatment duration. Age >50 years, never smoking, and having friends who knew one’s diagnosis were protective. A simple scoring tool incorporating these factors was 82.4% sensitive and 87.6% specific for predicting default in this population. Clinicians and patients described additional contributors to default and suggested locally-relevant intervention targets. Among 89 cases with pulmonary TB, 71% had sputum that was smear positive for TB. Drug resistance was rare. Conclusion The causes of default from TB treatment were explored through synthesis of qualitative and quantitative data from patients and health professionals. A scoring tool with high sensitivity and specificity to predict default was developed. Prospective evaluation of this tool coupled with targeted interventions based on our findings is warranted. Of note, the risk of TB transmission from patients who default treatment to others is likely to be high. The commonly-feared risk of drug resistance, though, may be low; a larger study is required to confirm these findings. PMID:24699682

Diagnostic Challenges in Chronic Constrictive Pericarditis.

PubMed

Braga, Ana; Oliveira, Afonso; Domingues, Kevin; Andrade, Maria João; Abecacis, Miguel; Neves, José Pedro

2017-01-01

Chronic constrictive pericarditis (CCP) is a disease that has multiple possible causes and is associated with variable clinical findings, depending on its severity. It develops insidiously, and in many cases, particularly in developed countries, no antecedent diagnosis can be found. These cases are termed idiopathic. Tuberculosis is the leading cause of constrictive pericarditis in developing nations but represents only a small minority in developed countries. Here the authors describe two different case reports where tuberculosis was the probable cause of CCP. A 21-year-old man born in Cape Verde living in Europe for 4 years and a 24-year-old man born in Guiné Bissau were both admitted due to intense precordial pain and syncope after exertion. Interestingly both had fatigability, dyspnea, chest discomfort and palpitations on exertion, as well as progressive involuntary weight loss and decubitus cough. On physical examination they had tachycardia, jaundice, cachexia, elevated jugular venous pressure, hepatomegaly and ascites. Both electrocardiograms showed prominent P waves and chest X-ray showed bilateral pulmonary interstitial infiltrates and enlargement of the right cavities. Analytically, elevated bilirubin, leukopenia and thrombocytopenia was also found in both. Echocardiography revealed findings, in both cases, compatible with CCP including less common signs as annulus reversus and annulus paradoxus. Thoraco-abdomino-pelvic CT from both patients revealed chronic liver disease with congestion, pleural effusion, pericardial calcifications, ascites and massive mediastinal and abdominal adenopathies. Blood cultures and IGRA test were negative. However, given the presumptive diagnosis of tuberculosis (TB), anti-TB therapy was started. Despite the diagnosis of "end-stage" CCP with very high operative risk multidisciplinary team decided after informed consent, to perform total anterior pericardiectomy, that occurred without complications. Pericardial and mediastinal biopsies, pericardial/pleural fluid cultures/ immune-phenotyping were inconclusive. Anti- tuberculosis therapy was maintained. After surgery, the patients had a remarkable clinical improvement (NYHA I) that persisted in 6- month follow-up. These two case reports illustrate that despite the markedly elevated operative risk of pericardiectomy in "end-stage" forms of disease after patients informed consent must be a considered option. The other point to consider is that, despite rare, tuberculosis still is a possible diagnosis to consider in CCP in Portugal.

Gendered Learning Environments in Managerial Work

ERIC Educational Resources Information Center

Gustavsson, Maria; Eriksson, Anna Fogelberg

2010-01-01

The aim is to investigate female and male managers' learning environments with particular focus on their opportunities for and barriers to learning and career development in the managerial work of a male-dominated industrial company. In the case study 42 managers, 15 women and 27 men in the company were interviewed. The findings demonstrate that…

The River Street Autism Program: A Case Study of a Regional Service Center Behavioral Intervention Program

ERIC Educational Resources Information Center

Dyer, Kathleen; Martino, Gayle M.; Parvenski, Tom

2006-01-01

An urgent demand from Connecticut parents for behavioral intervention resulted in the development of the River Street Autism Program (RSAP). This research-to-practice program implements intervention service based on empirical research findings conducted with children diagnosed with autism and pervasive developmental disorders. RSAP is provided…

Self-Authoring a Civic Identity: A Qualitative Analysis of Change-Oriented Service Learning

ERIC Educational Resources Information Center

Iverson, Susan V.; James, Jennifer H.

2013-01-01

This qualitative case study explored how undergraduate students' involvement with change-oriented service-learning contributed to their civic-political development. Using Baxter Magolda's notion of self-authorship as an analytic lens, findings suggested that students' involvement with change-oriented service-learning led to (a)…

Keeping Connected: A Review of the Research Relationship

ERIC Educational Resources Information Center

Moss, Julianne; Hay, Trevor

2014-01-01

In this paper, some key findings of the Keeping Connected project are discussed in light of the methodological challenges of developing an analytical approach in a large-scale study, particularly in starting with open-ended, participant-selected, digital still visual images as part of 31 longitudinal case studies. The paper works to clarify the…

Schools as Entrepreneurs: Helping Small Towns Survive.

ERIC Educational Resources Information Center

Wall, Milan; Luther, Vicki

Because schools are often the biggest employers in rural areas, it may make sense for rural schools to initiate economic development partnerships with the community, rather than wait for business to take the initiative, as is more commonly the case with urban school-business partnerships. This booklet reports findings of a national research…

75 FR 52952 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

... maintain a paper Work Activities Journal for a one-week period. Each registrar will record the number of hours and minutes dedicated to case finding, records abstraction, follow-up, and quality assurance, and... development, travel, and death clearances on a monthly or annual basis. At the end of the one-week data...

Management, Leadership, and User Control in Self-Advocacy: An English Case Study

ERIC Educational Resources Information Center

Tilley, Elizabeth

2013-01-01

This paper presents findings from a qualitative research project on an English self-advocacy organization. In light of recent political and economic developments that have threatened the sustainability of a number of self-advocacy groups for people with intellectual disability, I seek to explore how one particular organization managed to survive…

Chicana Bloggers: Creating Diversity Online via Participation

ERIC Educational Resources Information Center

Santoy, Janie Jaramillo

2013-01-01

This column addresses the importance of acknowledging the knowledge-making practice of Chicana bloggers. The author argues the online practices of Chicanas can be used to determine ways to develop 21st-century literacies of students, especially students of color. The author presents findings from a case study of three Chicana bloggers that reveal…

Sellar and supra-sellar glioblastoma masquerading as a pituitary macroadenoma.

PubMed

Mahta, Ali; Buhl, Ralf; Huang, Hongguang; Jansen, Olav; Kesari, Santosh; Ulmer, Stephan

2013-04-01

A few number of suprasellar gliomas have been reported thus far of which, some of them developed several years after radiation therapy for pituitary adenomas or craniopharyngiomas. Herein, we report a case of sellar glioblastoma with suprasellar extension with no prior radiation history who mimicked clinical and radiologic findings of a pituitary macroadenoma.

Re-Culturing Educator Preparation Programs: A Collaborative Case Study of Continuous Improvement

ERIC Educational Resources Information Center

Snow, Jennifer; Dismuke, Sherry; Zenkert, A. J.; Loffer, Carolyn

2017-01-01

Teacher educators at one institution of higher education collaborated to reculture systems for a focus on continuous improvement even within mounting accountability pressures. A framework of social network theory allowed for themes to develop around layered interactions of faculty, processes, and professional capital. Findings focused on people,…

Community Building as an Instructional Goal in Japanese Adult Basic Education

ERIC Educational Resources Information Center

Jacobson, Erik

2009-01-01

This paper presents the results of a multisite case study of adult basic education in Japan. A key finding of the study is that as part of community building within classrooms, students, teachers, and administrators prioritize human relations and expressions of empathy rather than academic skill development. In contrast to Japanese educational…

Preparing Globally Competent Teacher Candidates through Cross-Cultural Experiential Learning

ERIC Educational Resources Information Center

Kopish, Michael A.

2016-01-01

This manuscript presents findings and implications from a case study of one global educator's attempt to develop globally competent teacher candidates in an elective teacher preparation course. Global Citizenship Education served as the framing paradigm for the course and human experiences of immigrants and refugees served as the milieu for…

Organizational Development in Transition: The Schooling Perspective.

ERIC Educational Resources Information Center

Snyder, Karolyn J.; And Others

This paper presents the initial findings of a comprehensive 28-school multi-site case study, which sought to identify patterns in schools that are changing bureaucratic work patterns to those found in quality-management systems. The schools are located in Florida, Virginia, Minnesota, and Louisiana; all are led by principals who are trainers in…

Brief Report: Childhood Disintegrative Disorder as a Likely Manifestation of Vitamin B12 Deficiency

ERIC Educational Resources Information Center

Malhotra, Savita; Subodh, B. N.; Parakh, Preeti; Lahariya, Sanjay

2013-01-01

Childhood disintegrative disorder is a rare disorder, characterized by regression of acquired skills after a period of normal development. The case of childhood disintegrative disorder presented here was found to have vitamin B12 deficiency and hyperhomocysteinemia on extensive evaluation to find a probable cause for regression. This case…

Opportunities and Challenges for Teacher Professional Development: A Case of Collaborative Learning Community in South Korea

ERIC Educational Resources Information Center

Park, Minjeong; So, Kyunghee

2014-01-01

This study investigates how characteristics of a collaborative professional learning activity support and hinder teacher learning and growth by examining the experiences of three Korean secondary teachers who participated in a school-initiated collaborative teacher learning project. The findings demonstrated that this learning opportunity…

A Model for Outsourcing HRD

ERIC Educational Resources Information Center

Simmonds, David; Gibson, Rebecca

2008-01-01

Purpose: The purpose of this paper is to provide an overview of approaches to outsourcing HRD in the UK. Design/methodology/approach: This paper employs semi-structured interviews and case studies. The research model was developed from a literature review. Findings: There are many problems associated with outsourcing any or all aspects of the HRD…

Exploring Conditions for Transformative Learning in Work-Integrated Education

ERIC Educational Resources Information Center

McRae, Norah

2015-01-01

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

Labor's Untold Story: A Textbook Case of Neglect and Distortion

ERIC Educational Resources Information Center

American Educator, 2012

2012-01-01

In the high school history textbooks children read, too often they find that labor's role in American history--and labor's important accomplishments, which changed American life--are misrepresented, downplayed, or ignored. That is a tragedy because labor played (and continues to play) a key role in the development of American democracy and the…

Math Talk and Student Strategy Trajectories: The Case of Two First Grade Classrooms

ERIC Educational Resources Information Center

Murata, Aki; Siker, Jody; Kang, Bona; Baldinger, Evra M.; Kim, Hee-Jeong; Scott, Mallika; Lanouette, Kathryn

2017-01-01

This study investigated different math-talk facilitations, and conceptualized the teachers' talk moves for productive student mathematics discussions. Our findings suggest that students' strategy development is supported by talk moves coordinating a wide range of student strategies, representations and discussions that are at a process-level and…

75 FR 46946 - Proposed Collection; Comment Request; Assessing the Long-Term Impacts of the John E. Fogarty...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... countries. The primary objective of the study is to develop detailed case studies of the long- term impacts... income countries. The findings will provide valuable information concerning return on the Center's... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment...

75 FR 29763 - Proposed Collection; Comment Request; Assessing the Long-Term Impacts of the John E. Fogarty...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-27

... in low and middle income countries. The primary objective of the study is to develop detailed case... located in low and middle income countries. The findings will provide valuable information concerning... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment...

Optimal stocking of species by diameter class for even-aged mid-to-late rotation Appalachian hardwoods

Treesearch

Joseph B. Roise; Joosang Chung; Chris B. LeDoux

1988-01-01

Nonlinear programming (NP) is applied to the problem of finding optimal thinning and harvest regimes simultaneously with species mix and diameter class distribution. Optimal results for given cases are reported. Results of the NP optimization are compared with prescriptions developed by Appalachian hardwood silviculturists.

Full Costing of Business Programs: Benefits and Caveats

ERIC Educational Resources Information Center

Simmons, Cynthia; Wright, Michael; Jones, Vernon

2006-01-01

Purpose: To suggest an approach to program costing that includes the approaches and concepts developed in activity based costing. Design/methodology/approach: The paper utilizes a hypothetical case study of an Executive MBA program as a means of illustrating the suggested approach to costing. Findings: The paper illustrates both the benefits of…

Member Perceptions of Informal Science Institution Graduate Certificate Program: Case Study of a Community of Practice

ERIC Educational Resources Information Center

Ball, Lois A.

2012-01-01

This research attempted to understand the experiences of a cohort of informal and formal science educators and informal science institution (ISI) community representatives during and after completion of a pilot graduate certificate program. Informal science educators (ISEs) find limited opportunities for professional development and support which…

The Matching Process in E-Mentoring: A Case Study in Luxury Hotels

ERIC Educational Resources Information Center

Simmonds, David; Lupi, Anne Marie Zammit

2010-01-01

Purpose: This paper seeks to examine the effectiveness of an innovative e-mentoring programme introduced in an international group of luxury hotels. Design/methodology/approach: The paper employs the survey method, with quantitative and qualitative data analysis. The research model was developed from a literature review. Findings: While mentoring…

Designing Reading Instruction for Cultural Minorities: The Case of the Kamehameha Early Education Program.

ERIC Educational Resources Information Center

Calfee, Robert C.; And Others

This is a report on the Kamehameha Early Education Program (KEEP), a research and development project designed to find ways of improving the school performance of educationally disadvantaged Hawaiian children. The project, implemented in a laboratory school setting and continuously monitored, is described as a reading instruction program for…

Research and Action: The Role of an Educational Center.

ERIC Educational Resources Information Center

Flugman, Bert

1986-01-01

Discusses the Center for Advanced Study in Education (CASE) in Manhattan as a representative research and development center in a collaborative role with the New York City Schools. Presents its role as educational problem solver for immediate solutions rather than for interesting findings. Provides examples of three on-going problem solving…

The Role and Impact of Continuing Education on Rural Revitalization: A Case Study

ERIC Educational Resources Information Center

Miller, Marilyn

2008-01-01

This article presents the findings of a study that explored the role and impact of continuing education on rural revitalization. A community development approach, academic expertise, and a university's resources were used to assist the citizens of Montmartre, Saskatchewan, to establish Centre 48, an arts and continuing education centre. Courses…

Developing Graduate Students' Self-Efficacy with Learner-Centred Lecturing

ERIC Educational Resources Information Center

Troop, Meagan; Wallar, Lauren; Aspenlieder, Erin

2015-01-01

This paper presents the findings of a mixed-method case study conducted at the University of Guelph on the relationship between practice lecturing and graduate student self-efficacy. Building on the work of Boman (2013), and using surveys and individual interviews, we measured and characterized the perceived changes in graduate students'…

Exploring the Malaysian Rural School Teachers' Professional Local Knowledge in Enhancing Students' Thinking Skills

ERIC Educational Resources Information Center

Jamil, Hazri; Arbaa, Rohani; Ahmad, Mohamad Zohir

2017-01-01

This paper discussed a qualitative research findings on the case of Malaysian teachers employed their professional local knowledge for enhancing students' thinking skills in classroom practices. In this paper, a teacher's professional local knowledge is viewed as a teacher's professional knowledge and skills developed through the combination of…

Playful Talk: Negotiating Opportunities to Learn in Collaborative Groups

ERIC Educational Resources Information Center

Sullivan, Florence R.; Wilson, Nicholas C.

2015-01-01

This case study examines the role of playful talk in negotiating the "how" of collaborative group work in a 6th-grade science classroom. Here we develop and test a Vygotsky-derived hypothesis that postulates playful talk as a mechanism for identity exploration and group status negotiation. Our findings indicate that students utilized the…

Stakeholders' Perceptions of Participation in Science Expos: A South African Case Study

ERIC Educational Resources Information Center

Ngcoza, Kenneth M.; Sewry, Joyce; Chikunda, Charles; Kahenge, Wendy

2016-01-01

Science Expos are intended to develop and empower learners to identify local problems and hence find solutions thereof using scientific processes. Science Expos are perceived as spaces for sharing experiences of science which engender love for science so that learners may ultimately pursue science-related careers. Despite these ideals, there is…

Validation of the Hwalek-Sengstock Elder Abuse Screening Test.

ERIC Educational Resources Information Center

Neale, Anne Victoria; And Others

Elder abuse is recognized as an under-detected and under-reported social problem. Difficulties in detecting elder abuse are compounded by the lack of a standardized, psychometrically valid instrument for case finding. The development of the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) followed a larger effort to identify indicators and…

Understanding Effective High Schools: Evidence for Personalization for Academic and Social Emotional Learning

ERIC Educational Resources Information Center

Rutledge, Stacey A.; Cohen-Vogel, Lora; Osborne-Lampkin, La'Tara; Roberts, Ronnie L.

2015-01-01

This article presents findings from a year-long multilevel comparative case study exploring the characteristics of effective urban high schools. We developed a comprehensive framework from the school effectiveness research that guided our data collection and analysis at the four high schools. Using value-added methodology, we identified two higher…

Case Study of a Research Intervention: The University of Utah's Collaborative Approach.

ERIC Educational Resources Information Center

Driscoll, Amy

A report is presented on the progress of the Applying Research to Teacher Education (ARTE) Research Utilization in Elementary Teacher Education (RUETE) study. The purpose of the study is to develop preservice instruction incorporating current research findings on effective instruction and effective schools and to assess the impact of the…

Hypertrophic Cardiomyopathy Associated with Mid-cavity Obstruction and High Left Intraventricular Pressure

PubMed Central

A. Bejiqi, Ramush; J. Retkoceri, Ragip; Sh. Bejiqi, Hana

2011-01-01

We report a case of a child, with a rare form of the idiopathic hypertrophic cardiomyopathy, associated with mid-cavity obstruction and high intraventricular peak pressure. Cardiomyopathy, diagnosed antenataly, was followed postnataly and, despite of a lot echocardiographic findings - the growing, development and clinical signs are minimal. PMID:23407799

[A case of systemic lupus erythematosus complicated with psoriasis vulgaris].

PubMed

Shidara, Kumi; Soejima, Makoto; Shiseki, Mariko; Ohta, Syuji; Nishinarita, Makoto

2003-12-01

A 49-years-old female admitted to our hospital because of skin eruptions on the extremities in 1985. She had suffered from polyarthralgia, skin eruptions since 1983. Physical examinations revealed discoid lesion, central nervous system involvement, and polyarthritis. Laboratory tests revealed leukopenia, thrombocytopenia, and hypocomplementemia. Antinuclear antibody, ant-DNA antibody, LE test were positive. From these findings, she was diagnosed as systemic lupus erythematosus (SLE). She developed lupus peritonitis in 1990 and 1994, which was successfully treated by steroid pulse therapy. Since then, the activity of SLE was in good control under administration of prednisolone 10 mg/day. Chilblain lupus was seen from 1993, Raynaud's phenomenon from 1996, and she further developed subcutaneous induration on her chest, back and upper extremities in 1999. Skin biopsy findings were compatible with lupus panniculitis. In 2002, erythematous patches with scales were observed on her right hand and left knee, and these skin lesions were histologically diagnosed as psoriasis vulgaris. An autoimmune response similar to SLE is speculated in psoriasis. We describe a rare case of SLE with various skin lesions including psoriasis vulgaris.

Parotitis associated with Crimean Congo hemorrhagic fever virus.

PubMed

Kaya, Selçuk; Yilmaz, Gurdal; Ertunç, Barış; Koksal, Iftihar

2012-02-01

Crimean Congo Hemorrhagic Fever (CCHF) is a potentially fatal tick-borne viral disease, the course of which may accompanied by various clinical findings. We describe a picture of non-suppurative parotitis developing in association with CCHF virus. A 48-year-old patient presenting to our hospital with lethargy, hemorrhage and pain and swelling below the left ear was diagnosed with CCHF through IgM antibody and polymerase chain reaction positivity in serum investigated for CCHF virus. A picture of non-suppurative parotitis developed on the 3rd day of admission. Other causes of parotitis were excluded with the help of serological tests, and the case was regarded as one of CCHF-associated parotitis. The patient was put on adjuvant therapy, an improvement in clinical findings was observed and he was discharged in a healthy condition on the 8th day. Ours is the first case in the literature of parotitis seen during CCHF. CCHF should be considered in differential diagnosis in addition to other frequently encountered viral agents in patients from endemic regions presenting with a picture of non-suppurative parotitis. Copyright © 2011 Elsevier B.V. All rights reserved.

Velopharyngeal Incoordination Caused by Phenytoin-Induced Toxicity.

PubMed

Hwang, Chang Ho

2017-02-01

Phenytoin induces lymphoid proliferation, resulting in complications that can range from tissue hyperplasia to lymphoma. Some of the complications resolve spontaneously after drug discontinuation. This report describes for the first time a case of dysphagia with lack of velopharyngeal coordination and nasopharyngeal reflux combined with massive palatine tonsillar hypertrophy. The condition did not develop before phenytoin administration, was induced by phenytoin, and spontaneously resolved upon drug discontinuation. The patient was referred for a video-fluoroscopic swallowing study owing to a recurring nasal reflux of foods that had developed since phenytoin administration. The video-fluoroscopic swallowing study revealed incidentally that the large bilateral elongated masses extended downward into the larynx and disturbed velar elevation. This finding was confirmed by computed tomography of the neck, which showed that palatine tonsillar hypertrophy disturbed the laryngopharynx on both sides. The symptoms (sleep apnea and nasal reflux) and the abnormal imaging findings disappeared without surgery approximately 1 month after drug discontinuation. This case suggests that dysphagia related to phenytoin-induced lymphoid hypertrophy may be treated by phenytoin discontinuation followed by a sufficient amount of time to allow symptom resolution rather than by prompt surgery.

Description and pilot results from a novel method for evaluating return of incidental findings from next-generation sequencing technologies.

PubMed

Goddard, Katrina A B; Whitlock, Evelyn P; Berg, Jonathan S; Williams, Marc S; Webber, Elizabeth M; Webster, Jennifer A; Lin, Jennifer S; Schrader, Kasmintan A; Campos-Outcalt, Doug; Offit, Kenneth; Feigelson, Heather Spencer; Hollombe, Celine

2013-09-01

The aim of this study was to develop, operationalize, and pilot test a transparent, reproducible, and evidence-informed method to determine when to report incidental findings from next-generation sequencing technologies. Using evidence-based principles, we proposed a three-stage process. Stage I "rules out" incidental findings below a minimal threshold of evidence and is evaluated using inter-rater agreement and comparison with an expert-based approach. Stage II documents criteria for clinical actionability using a standardized approach to allow experts to consistently consider and recommend whether results should be routinely reported (stage III). We used expert opinion to determine the face validity of stages II and III using three case studies. We evaluated the time and effort for stages I and II. For stage I, we assessed 99 conditions and found high inter-rater agreement (89%), and strong agreement with a separate expert-based method. Case studies for familial adenomatous polyposis, hereditary hemochromatosis, and α1-antitrypsin deficiency were all recommended for routine reporting as incidental findings. The method requires <3 days per topic. We establish an operational definition of clinically actionable incidental findings and provide documentation and pilot testing of a feasible method that is scalable to the whole genome.

Effective and less invasive diagnostic strategy for gastrointestinal GVHD

PubMed Central

Endo, Katsuya; Fujishima, Fumiyoshi; Kuroha, Masatake; Moroi, Rintaro; Onodera, Motoyuki; Naito, Takeo; Kanazawa, Yoshitake; Kimura, Tomoya; Shiga, Hisashi; Kakuta, Yoichi; Kinouchi, Yoshitaka; Shimosegawa, Tooru

2018-01-01

Background and study aims  Rectosigmoidoscopy with biopsy has been regarded to be a useful procedure to diagnose gastrointestinal graft-versus-host disease (GVHD). However, little is known about the specific colonoscopic features of gastrointestinal GVHD. In this study, we focused on the 4 unique colonoscopic findings – orange peel appearance, spotty redness, small mucosal sloughing, and diffuse mucosal defect – which are possible specific findings of gastrointestinal GVHD. We aimed to estimate the usefulness of these four unique colonoscopic findings in the rectosigmoid portion to diagnose gastrointestinal GVHD. Patients and methods  Seventy patients who were histologically diagnosed with gastrointestinal GVHD at our institute were retrospectively enrolled. Colonoscopic findings were reviewed, focusing on the four characteristic findings. The percentage of the positive cases for the characteristic findings was calculated. The final scoping portion and the number of cases showing any of the four characteristic findings in the rectosigmoid portion were also evaluated. The relationships between biopsy sites and the histological findings were also evaluated. Results  Orange peel appearance was observed in 66 cases (94.3 %). Spotty redness was observed in 45 cases (64.3 %). Small mucosal sloughing was observed in 49 cases (70.0 %). Diffuse mucosal defect was observed in six cases (8.6 %). The number of cases that were concurrently positive for one, two, and three findings were 16 (20.8 %), 20 (26.0 %), and 34 (48.6 %), respectively. Fifty-eight cases (82.9 %) were investigated up to the rectosigmoid portion, and 12 (17.1 %) were investigated beyond the sigmoid colon. All of the cases showed at least 1 of the 4 characteristics in the rectosigmoid portion. The percentage of crypt apoptosis in the biopsy specimen from orange peel appearance, spotty redness, small mucosal sloughing, and diffuse mucosal defect were 87.5 %, 83.3 %, 87.2 %, and 88.9 %, respectively. Conclusion  Orange peel appearance, spotty redness, small mucosal sloughing, and diffuse mucosal defect are the characteristic colonoscopic findings useful for diagnosis of gastrointestinal GVHD. These findings are frequently observed in the rectosigmoid portion. The histological detection rates for crypt cell apoptosis from these findings are high. Identifying the four characteristic findings on rectosigmoidoscopy and taking biopsies from these areas could be essential for the diagnostic strategy for gastrointestinal GVHD. PMID:29507868

New roads toward North-South cooperation.

PubMed

Terpstra, E G

1989-12-01

A Netherlands Parliament member gives a European Perspective on population and development, problems in urban development, and methods of cooperation between industrialized and developing countries. On population and development, the relationship between population explosion and poverty, underdevelopment, environment, social infrastructure, and food shortages is pointed out. Most population growth in the years ahead will be in developing countries. Rampant population growth and burgeoning poverty strain the world's carrying capacity and environment, both in industrial and developing countries. Development policy and cooperation will fail in the absence of efforts to stem population growth. On this front, religious and political leaders have groundbreaking cooperative steps in supporting international family planning efforts through the global forum of Spiritual and Parliamentary Leaders on Human Survival. Economic development, environment, and population issues are inexorably tied together. The numerous problems faced by uncontrolled Third World urbanization are discussed with potential solutions for change. Incorporating women in the development process is strongly encouraged. The interdependent North-South relationship is discussed. All nations, the private sector, nongovernmental organizations, and women must cooperate to find solutions and effect positive change on a case-by-case basis.

Improving Transportation Services for the University of the Thai Chamber of Commerce: A Case Study on Solving the Mixed-Fleet Vehicle Routing Problem with Split Deliveries

NASA Astrophysics Data System (ADS)

Suthikarnnarunai, N.; Olinick, E.

2009-01-01

We present a case study on the application of techniques for solving the Vehicle Routing Problem (VRP) to improve the transportation service provided by the University of The Thai Chamber of Commerce to its staff. The problem is modeled as VRP with time windows, split deliveries, and a mixed fleet. An exact algorithm and a heuristic solution procedure are developed to solve the problem and implemented in the AMPL modeling language and CPLEX Integer Programming solver. Empirical results indicate that the heuristic can find relatively good solutions in a small fraction of the time required by the exact method. We also perform sensitivity analysis and find that a savings in outsourcing cost can be achieved with a small increase in vehicle capacity.

Combined Churg-Strauss syndrome and allergic bronchopulmonary aspergillosis - case report and review of the literature.

PubMed

Ren, Shaohua

2013-01-01

A rare case of combined Churg-Strauss syndrome (CSS) and allergic bronchopulmonary aspergillosis (ABPA) was presented. A 41-year-old woman was diagnosed with CSS based upon asthma, eosinophilia (23%), chest radiographic findings, paranasal sinusitis, peripheral neuropathy and positive p- anti-neutrophil cytoplasmic antibodies (pANCA). The diagnosis of ABPA was established on the pathological findings of allegic mucin impaction and fungal hyphae on lung biopsy. It was further proved by positive serum IgE and IgG antibodies specific to afumigatus. The clinical investigation features were reviewed in the patients with combined CSS and ABPA. All patients had the time sequence of the development of CSS after ABPA uniformly, suggesting immunopathogenesis involving the emergence of CSS. The role of lung biopsy in the diagnosis of the condition was emphasized. © 2012 Blackwell Publishing Ltd.

Vernix caseosa peritonitis as a rare complication of cesarean section. A case report.

PubMed

Tawfik, O; Prather, J; Bhatia, P; Woodroof, J; Gunter, J; Webb, P

1998-06-01

Vernix caseosa peritonitis is a rare complication of cesarean section with distinctive histopathologic findings. Vernix caseosa peritonitis occurred in a 28-year-old, pregnant woman following emergency cesarean section. Exploratory laparotomy revealed right subphrenic and perihepatic fluid collections with multiple small abdominal abscesses. Cytopathologic examination of the peritoneal lavage specimen showed a purulent inflammatory exudate admixed with occasional squamous debris, portions of hair shafts, meconium pigment, and foamy and multinucleated giant cells. During hospitalization the patient had developed Clostridium perfringens acute endometritis, presumably due to aggressive treatment with broad-spectrum antibiotics. Pathologists are in a unique position to make the correct diagnosis in an otherwise-ambiguous clinical presentation because of the distinctive histopathologic and cytopathologic findings of this entity. Computed tomography-guided fine needle aspiration cytologic evaluation can be diagnostic in such cases.

The CARE guidelines: consensus-based clinical case report guideline development.

PubMed

Gagnier, Joel J; Kienle, Gunver; Altman, Douglas G; Moher, David; Sox, Harold; Riley, David

2014-01-01

A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design. Develop, disseminate, and implement systematic reporting guidelines for case reports. We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines. This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent. We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery. Copyright © 2014 Reproduced with permission of Global Advances in Health and Medicine. Published by Elsevier Inc. All rights reserved.

Dissemination and implementation: INQRI's potential impact.

PubMed

Titler, Marita G; Wilson, Deleise S; Resnick, Barbara; Shever, Leah L

2013-04-01

Application of research evidence in care delivery improves patient outcomes. Large gaps still exist, however, between recommended care and that used in practice. To increase the understanding of implementation studies, and dissemination of research findings, we present the perspective of investigators from seven Interdisciplinary Nursing Quality Research Initiative (INQRI)-funded studies. To describe implementation strategies, challenges, and lessons learned from conducting 5 INQRI-funded implementation studies, and present 2 case examples of other INQRI studies to illustrate dissemination strategies. Potential impact of study findings are set forth. Qualitative descriptive methods were used for the implementation studies. Case examples were set forth by investigators using reflection questions. Four of the 5 implementation studies focused on clinical topics and 1 on professional development of nurse managers, 4 were multisite studies. Common implementation strategies used across studies addressed education, ongoing interaction with sites, use of implementation tools, and visibility of the projects on the study units. Major challenges were the Institutional Review Board approval process and the short length of time allocated for implementation. Successes and lessons learned included creating excitement about research, packaging of study tools and resources for use by other organizations, and understanding the importance of context when conducting this type of research. Case examples revealed that study findings have been disseminated to study sites and to the health care community through publications and presentations. The potential impact of all 7 studies is far reaching. This study captures several nuanced perspectives from 5 Principal Investigators, who were completing INQRI-funded implementation studies. These nuanced perspectives are important lessons for other scientists embarking on implementation studies. The INQRI case examples illustrate important dissemination strategies and impact of findings on quality of care.

Patterns and correlates of co-occurrence among multiple types of child maltreatment

PubMed Central

Kim, Kihyun; Mennen, Ferol E.; Trickett, Penelope K.

2017-01-01

This study examined the patterns and correlates of the types of maltreatment experienced by adolescents aged 9–12, participating in an ongoing longitudinal study on the impact of neglect on children’s development. Using case record abstraction, the study compared the child protection classification and findings from the case record abstraction with regard to the rates of four types of maltreatment (i.e. physical, sexual, emotional abuse and neglect) as well as co-occurrence across multiple types of maltreatment. Next, the study examined the frequently observed patterns of child maltreatment. Finally, the study investigated whether aspects of caretaker functioning and the detailed incident characteristics in the cases of neglect differed by the number of different types of maltreatment the children experienced. Results showed significant discrepancies between the Child Protective Service classification and case record abstraction. Child Protective Service classification considerably underestimated the rate of co-occurrence across multiple types of maltreatment. Neglect accompanied by physical and emotional abuse was the most common form. Some of the caretaker functioning variables distinguished the number of types of maltreatment. Based on the findings, future-research directions and practice implication were discussed. PMID:29225485

Validation of a computer case definition for sudden cardiac death in opioid users

PubMed Central

2012-01-01

Background To facilitate the use of automated databases for studies of sudden cardiac death, we previously developed a computerized case definition that had a positive predictive value between 86% and 88%. However, the definition has not been specifically validated for prescription opioid users, for whom out-of-hospital overdose deaths may be difficult to distinguish from sudden cardiac death. Findings We assembled a cohort of persons 30-74 years of age prescribed propoxyphene or hydrocodone who had no life-threatening non-cardiovascular illness, diagnosed drug abuse, residence in a nursing home in the past year, or hospital stay within the past 30 days. Medical records were sought for a sample of 140 cohort deaths within 30 days of a prescription fill meeting the computer case definition. Of the 140 sampled deaths, 81 were adjudicated; 73 (90%) were sudden cardiac deaths. Two deaths had possible opioid overdose; after removing these two the positive predictive value was 88%. Conclusions These findings are consistent with our previous validation studies and suggest the computer case definition of sudden cardiac death is a useful tool for pharmacoepidemiologic studies of opioid analgesics. PMID:22938531

Find and treat or find and lose? Tuberculosis treatment outcomes among screened newly arrived asylum seekers in Germany 2002 to 2014.

PubMed

Kuehne, Anna; Hauer, Barbara; Brodhun, Bonita; Haas, Walter; Fiebig, Lena

2018-03-01

BackgroundGermany has a low tuberculosis (TB) incidence. A relevant and increasing proportion of TB cases is diagnosed among asylum seekers upon screening. Aim: We aimed to assess whether cases identified by screening asylum seekers had equally successful and completely reported treatment outcomes as cases diagnosed by passive case finding and contact tracing in the general population. Methods: We analysed characteristics and treatment outcomes of pulmonary TB cases notified in Germany between 2002 and 2014, stratified by mode of case finding. We performed three multivariable analyses with different dependent variables: Model A: successful vs all other outcomes, Model B: successful vs documented non-successful clinical outcome and Model C: known outcome vs lost to follow-up. Results: TB treatment success was highest among cases identified by contact tracing (87%; 3,139/3,591), followed by passive case finding (74%; 28,804/39,019) and by screening asylum seekers (60%; 884/1,474). Cases identified by screening asylum seekers had 2.4 times higher odds of not having a successful treatment outcome as opposed to all other outcomes (A), 1.4 times higher odds of not having a successful treatment outcome as opposed to known non-successful outcomes (B) and 2.3 times higher odds of loss to follow-up (C) than cases identified by passive case finding. Conclusion: Screened asylum seekers had poorer treatment outcomes and were more often lost to follow-up. Linking patients to treatment facilities and investigating potential barriers to treatment completion are needed to secure screening benefits for asylum seekers and communities.

Carboxyatractyloside poisoning in humans.

PubMed

Turgut, Mehmet; Alhan, Cafer Cumhur; Gürgöze, Metin; Kurt, Abdullah; Doğan, Yaşar; Tekatli, Muhittin; Akpolat, Nusret; Aygün, A Denizmen

2005-06-01

Cocklebur (Xanthium strumarium) is an herbaceous annual plant with worldwide distribution. The seeds contain the glycoside carboxyatractyloside, which is highly toxic to animals. We describe nine cases of carboxyatractyloside poisoning in humans which, to our knowledge, has not previously been reported. The clinical, laboratory and histopathological findings and our therapeutic approach are also discussed. The patients presented with acute onset abdominal pain, nausea and vomiting, drowsiness, palpitations, sweating and dyspnoea. Three of them developed convulsions followed by loss of consciousness and death. Laboratory findings showed raised liver enzymes, indicating severe hepatocellular damage. BUN and creatinine levels were raised, especially in the fatal cases who also displayed findings of consumption coagulopathy. CPK-MB values indicative of myocardial injury were also raised, especially in the fatal cases. Three of the patients died within 48 hours of ingesting carboxyatractyloside. Post-mortem histopathology of the liver confirmed centrilobular hepatic necrosis and renal proximal tubular necrosis, secondary changes owing to increased permeability and microvascular haemorrhage in the cerebrum and cerebellum, and leucocytic infiltrates in the muscles and various organs including pancreas, lungs and myocardium. Carboxyatractyloside poisoning causes multiple organ dysfunction and can be fatal. Coagulation abnormalities, hyponatraemia, marked hypoglycaemia, icterus and hepatic and renal failure are signs of a poor prognosis. No antidote is available and supportive therapy is the mainstay of treatment.

Posterior reversible encephalopathy syndrome in chronic alcoholism with acute psychiatric symptoms.

PubMed

Kimura, Ryo; Yanagida, Makoto; Kugo, Aki; Taguchi, Satoki; Matsunaga, Hidenori

2010-01-01

To highlight the association between posterior reversible encephalopathy syndrome (PRES) and chronic alcoholism. We present a case report, a review of the literature and a discussion. We report on the case of a 51-year-old man with chronic alcoholism, who suddenly developed visual disturbance and confusion. Magnetic resonance imaging (MRI) on admission demonstrated abnormal findings. However, clinical symptoms and imaging promptly improved, indicating the diagnosis of PRES. PRES should be considered when making a diagnosis for disturbed consciousness in alcoholic patients. Copyright 2010 Elsevier Inc. All rights reserved.

The neurophysiology of language processing shapes the evolution of grammar: evidence from case marking.

PubMed

Bickel, Balthasar; Witzlack-Makarevich, Alena; Choudhary, Kamal K; Schlesewsky, Matthias; Bornkessel-Schlesewsky, Ina

2015-01-01

Do principles of language processing in the brain affect the way grammar evolves over time or is language change just a matter of socio-historical contingency? While the balance of evidence has been ambiguous and controversial, we identify here a neurophysiological constraint on the processing of language that has a systematic effect on the evolution of how noun phrases are marked by case (i.e. by such contrasts as between the English base form she and the object form her). In neurophysiological experiments across diverse languages we found that during processing, participants initially interpret the first base-form noun phrase they hear (e.g. she…) as an agent (which would fit a continuation like … greeted him), even when the sentence later requires the interpretation of a patient role (as in … was greeted). We show that this processing principle is also operative in Hindi, a language where initial base-form noun phrases most commonly denote patients because many agents receive a special case marker ("ergative") and are often left out in discourse. This finding suggests that the principle is species-wide and independent of the structural affordances of specific languages. As such, the principle favors the development and maintenance of case-marking systems that equate base-form cases with agents rather than with patients. We confirm this evolutionary bias by statistical analyses of phylogenetic signals in over 600 languages worldwide, controlling for confounding effects from language contact. Our findings suggest that at least one core property of grammar systematically adapts in its evolution to the neurophysiological conditions of the brain, independently of socio-historical factors. This opens up new avenues for understanding how specific properties of grammar have developed in tight interaction with the biological evolution of our species.

ALS and the Military: A Population-Based Study in the Danish Registries

PubMed Central

Seals, Ryan M.; Kioumourtzoglou, Marianthi-Anna; Gredal, Ole; Hansen, Johnni; Weisskopf, Marc G.

2016-01-01

Background Prior studies have suggested that military service may be associated with the development of amyotrophic lateral sclerosis. We conducted a population-based case-control study in Denmark to assess whether occupation in the Danish military is associated with an increased risk of developing amyotrophic lateral sclerosis. Methods There were 3,650 incident cases of amyotrophic lateral sclerosis recorded in the Danish National Patient Registry between 1982 and 2009. Each case was matched to 100 age- and sex-matched population controls alive and free of amyotrophic lateral sclerosis on the date of the case diagnosis. Comprehensive occupational history was obtained from the Danish Pension Fund database, which began in 1964. Results 2.4% (n=8,922) of controls had a history of employment in the military prior to the index date. Military employees overall had an elevated rate of ALS (OR=1.3; 95% CI: 1.1-1.6). A ten-year increase in years employed by the military was associated with an odds ratio of 1.2 (95% CI: 1.0-1.4), and all quartiles of time employed were elevated. There was little suggestion of a pattern across calendar year of first employment, but there was some evidence that increasing age at first employment was associated with increased ALS rates. Rates were highest in the decade immediately following the end of employment (OR=1.6; 95% CI: 1.2-2.2). Conclusions In this large population-based case-control study, employment by the military is associated with increased rates of ALS. These findings are consistent with earlier findings that military service or employment may entail exposure to risk factors for ALS. PMID:26583610

Blood manganese concentrations in Jamaican children with and without autism spectrum disorders

PubMed Central

2014-01-01

Background Manganese is an essential element for human health and development. Previous studies have shown neurotoxic effects in children exposed to higher levels of manganese. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that impairs social interaction and communication. Several studies have hypothesized that ASD is caused through environmental exposures during crucial stages in brain development. We investigated the possible association between blood manganese concentrations (BMC) and ASD. We also identified factors associated with BMC in typically developing (TD) Jamaican children. Methods We used data from 109 ASD cases with their 1:1 age- and sex-matched TD controls to compare mean BMC in Jamaican children (2–8 years of age) with and without ASD. We administered a pre-tested questionnaire to assess demographic and socioeconomic information, medical history, and potential exposure to manganese. Finally, we collected 2 mL of whole blood from each child for analysis of manganese levels. Using General Linear Models (GLM), we assessed the association between BMC and ASD status. Furthermore, we used two independent sample t-tests to identify factors associated with BMC in TD children. Results In univariable GLM analysis, we found no significant association between BMC and ASD, (10.9 μg/L for cases vs. 10.5 μg/L for controls; P = 0.29). In a multivariable GLM adjusting for paternal age, parental education, place of child’s birth (Kingston parish), consumption of root vegetables, cabbage, saltwater fish, and cakes/buns, there was still no significant association between BMC and ASD status, (11.5 μg/L for cases vs. 11.9 μg/L for controls; P = 0.48). Our findings also indicated TD children who ate fresh water fish had a higher BMC than children who did not (11.0 μg/L vs. 9.9 μg/L; P = 0.03) as younger TD children (i.e., 2 ≤ age ≤4), (12.0 μg/L vs. 10.2 μg/L; P = 0.01). Conclusions While these results cannot be used to assess early exposure at potentially more susceptible time period, our findings suggest that there is no significant association between manganese exposures and ASD case status in Jamaica. Our findings also indicate that BMC in Jamaican children resemble those of children in the developed world and are much lower than those in the developing countries. PMID:25149876

Preventing the preventable through effective surveillance: the case of diphtheria in a rural district of Maharashtra, India

PubMed Central

2013-01-01

Background Epidemic diphtheria is still poorly understood and continues to challenge both developing and developed countries. In the backdrop of poor immunization coverage, non-existent adult boosters, weak case based surveillance and persistence of multiple foci, there is a heightened risk of re-emergence of the disease in epidemic forms in India. Investigating each outbreak to understand the epidemiology of the disease and its current status in the country is therefore necessary. Dhule a predominantly tribal and rural district in Northern Maharashtra has consistently recorded low vaccination coverages alongside sporaidic cases of diphtheria over the last years. Methods This study reports the findings of an onsite survey conducted to assess a recent outbreak of diphtheria in Dhule district and the response mounted to it. Secondary data regarding outbreak detection and response were obtained from the district surveillance office. Clinical data were extracted from hospital records of eleven lab confirmed cases including one death case. Frequency distributions were calculated for each identified clinical and non- clinical variable using Microsoft™ Excel® 2010. Results Our findings suggest a shift in the median age of disease to adolescents (10-15 years) without gender differences. Two cases (18%) reported disease despite immunization. Clinical symptoms included cough (82%), fever (73%), and throat congestion (64%). About 64% and 36% of the 11 confirmed cases presented with a well defined pseudomembrane and a tonsillar patch respectively. Drug resistance was observed in all three culture positive cases. One death occurred despite the administration of Anti-Diphtheric Serum in a partially immunized case (CFR 9%). Genotyping and toxigenicity of strain was not possible due to specimen contamination during transport as testing facilities were unavailable in the district. Conclusions The outbreak raises several concerns regarding the epidemiology of diphtheria in Dhule. The reason for shift in the median age despite consistently poor immunization coverage (below 50%) remains unclear. Concomitant efforts should now focus on improving and monitoring primary immunization and booster coverages across all age groups. Gradually introducing adult immunization at ten year intervals may become necessary to prevent future vulnerabilities. Laboratory networks for genotyping and toxigenicity testing are urgently mandated at district level given the endemicity of the disease in the surrounding region and its recent introduction in remote Dhule. Contingency funds with pre- agreements to obtain ADS and DT/Td vaccines at short notice and developing standard case management protocols at district level are necessary. Monitoring the disease, emerging strains and mutations, alongside drug resistance through robust and effective surveillance is a pragmatic way forward. PMID:23566309

Case Study Teaching Method Improves Student Performance and Perceptions of Learning Gains†

PubMed Central

Bonney, Kevin M.

2015-01-01

Following years of widespread use in business and medical education, the case study teaching method is becoming an increasingly common teaching strategy in science education. However, the current body of research provides limited evidence that the use of published case studies effectively promotes the fulfillment of specific learning objectives integral to many biology courses. This study tested the hypothesis that case studies are more effective than classroom discussions and textbook reading at promoting learning of key biological concepts, development of written and oral communication skills, and comprehension of the relevance of biological concepts to everyday life. This study also tested the hypothesis that case studies produced by the instructor of a course are more effective at promoting learning than those produced by unaffiliated instructors. Additionally, performance on quantitative learning assessments and student perceptions of learning gains were analyzed to determine whether reported perceptions of learning gains accurately reflect academic performance. The results reported here suggest that case studies, regardless of the source, are significantly more effective than other methods of content delivery at increasing performance on examination questions related to chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication. This finding was positively correlated to increased student perceptions of learning gains associated with oral and written communication skills and the ability to recognize connections between biological concepts and other aspects of life. Based on these findings, case studies should be considered as a preferred method for teaching about a variety of concepts in science courses. PMID:25949753

Nursing home case mix in Wisconsin. Findings and policy implications.

PubMed

Arling, G; Zimmerman, D; Updike, L

1989-02-01

Along with many other states, Wisconsin is considering a case mix approach to Medicaid nursing home reimbursement. To support this effort, a nursing home case mix model was developed from a representative sample of 410 Medicaid nursing home residents from 56 facilities in Wisconsin. The model classified residents into mutually exclusive groups that were homogeneous in their use of direct care resources, i.e., minutes of direct care time (weighted for nurse skill level) over a 7-day period. Groups were defined initially by intense, Special, or Routine nursing requirements. Within these nursing requirement categories, subgroups were formed by the presence/absence of behavioral problems and dependency in activities of daily living (ADL). Wisconsin's current Skilled/Intermediate Care (SNF/ICF) classification system was analyzed in light of the case mix model and found to be less effective in distinguishing residents by resource use. The case mix model accounted for 48% of the variance in resource use, whereas the SNF/ICF classification system explained 22%. Comparisons were drawn with nursing home case mix models in New York State (RUG-II) and Minnesota. Despite progress in the study of nursing home case mix and its application to reimbursement reform, methodologic and policy issues remain. These include the differing operational definitions for nursing requirements and ADL dependency, the inconsistency in findings concerning psychobehavioral problems, and the problem of promoting positive health and functional outcomes based on models that may be insensitive to change in resident conditions over time.

Case study teaching method improves student performance and perceptions of learning gains.

PubMed

Bonney, Kevin M

2015-05-01

Following years of widespread use in business and medical education, the case study teaching method is becoming an increasingly common teaching strategy in science education. However, the current body of research provides limited evidence that the use of published case studies effectively promotes the fulfillment of specific learning objectives integral to many biology courses. This study tested the hypothesis that case studies are more effective than classroom discussions and textbook reading at promoting learning of key biological concepts, development of written and oral communication skills, and comprehension of the relevance of biological concepts to everyday life. This study also tested the hypothesis that case studies produced by the instructor of a course are more effective at promoting learning than those produced by unaffiliated instructors. Additionally, performance on quantitative learning assessments and student perceptions of learning gains were analyzed to determine whether reported perceptions of learning gains accurately reflect academic performance. The results reported here suggest that case studies, regardless of the source, are significantly more effective than other methods of content delivery at increasing performance on examination questions related to chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication. This finding was positively correlated to increased student perceptions of learning gains associated with oral and written communication skills and the ability to recognize connections between biological concepts and other aspects of life. Based on these findings, case studies should be considered as a preferred method for teaching about a variety of concepts in science courses.

The FIDELIS initiative: innovative strategies for increased case finding.

PubMed

Hinderaker, S G; Rusen, I D; Chiang, C-Y; Yan, L; Heldal, E; Enarson, D A

2011-01-01

Low-income, high tuberculosis (TB) burden countries. To compare case finding of new smear-positive pulmonary TB patients in projects funded to apply innovative approaches. Prospective application of innovative approaches to case finding within routine services to determine the numbers of additional cases detected and the cost per additional case detected, according to the type of approach applied. Between 2003 and 2007, 51 FIDELIS projects were implemented in 18 countries; 273,239 cases were reported, of which 85,267 were additional to the number reported in the previous year. The median cost per additional case was US$103. The interventions employed were: 1) social mobilisation and information, education and communication; 2) engagement of the private sector; 3) innovative approaches for microscopy services; 4) enhanced or semi-active case finding; 5) health systems strengthening; and 6) use of incentives. None of these was significantly more likely to detect additional cases or to have a lower cost per additional case than any of the others. While there was a substantial increase in cases detected, at a moderate cost per additional case, we were unable to show that any single intervention had an advantage over the others.

Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

PubMed Central

Jewkes, Rachel; Christofides, Nicola; Vetten, Lisa; Jina, Ruxana; Sigsworth, Romi; Loots, Lizle

2009-01-01

Background Health services for victims of rape are recognised as a particularly neglected area of the health sector internationally. Efforts to strengthen these services need to be guided by clinical research. Expert medical evidence is widely used in rape cases, but its contribution to the progress of legal cases is unclear. Only three studies have found an association between documented bodily injuries and convictions in rape cases. This article aims to describe the processing of rape cases by South African police and courts, and the association between documented injuries and DNA and case progression through the criminal justice system. Methods and Findings We analysed a provincially representative sample of 2,068 attempted and completed rape cases reported to 70 randomly selected Gauteng province police stations in 2003. Data sheets were completed from the police dockets and available medical examination forms were copied. 1,547 cases of rape had medical examinations and available forms and were analysed, which was at least 85% of the proportion of the sample having a medical examination. We present logistic regression models of the association between whether a trial started and whether the accused was found guilty and the medico-legal findings for adult and child rapes. Half the suspects were arrested (n = 771), 14% (209) of cases went to trial, and in 3% (31) of adults and 7% (44) of children there was a conviction. A report on DNA was available in 1.4% (22) of cases, but the presence or absence of injuries were documented in all cases. Documented injuries were not associated with arrest, but they were associated with children's cases (but not adult's) going to trial (adjusted odds ratio [AOR] for having genital and nongenital injuries 5.83, 95% confidence interval [CI] 1.87–18.13, p = 0.003). In adult cases a conviction was more likely if there were documented injuries, whether nongenital injuries alone AOR 6.25 (95% CI 1.14–34.3, p = 0.036), ano-genital injuries alone (AOR 7.00, 95% CI 1.44–33.9, p = 0.017), or both nongenital and ano-genital injuries (AOR 12.34, 95% CI 2.87–53.0, p = 0.001). DNA was not associated with case outcome. Conclusions This is the first study, to our knowledge, to show an association between documentation of ano-genital injuries, trials commencing, and convictions in rape cases in a developing country. Its findings are of particular importance because they show the value of good basic medical practices in documentation of injuries, rather than more expensive DNA evidence, in assisting courts in rape cases. Health care providers need training to provide high quality health care responses after rape, but we have shown that the core elements of the medico-legal response require very little technology. As such they should be replicable in low- and middle-income country settings. Our findings raise important questions about the value of evidence that requires the use of forensic laboratories at a population level in countries like South Africa that have substantial inefficiencies in their police services. Please see later in the article for the Editors' Summary PMID:19823567

Migraine and risk of narcolepsy in children: A nationwide longitudinal study.

PubMed

Yang, Chun-Pai; Hsieh, Meng-Lun; Chiang, Jen-Huai; Chang, Hsing-Yi; Hsieh, Vivian Chia-Rong

2017-01-01

The association between migraine and narcolepsy remains controversial. We aim to investigate whether migraine is associated with an increased risk of developing narcolepsy in children. In this longitudinal study, nationwide medical-claims data of pediatric patients (0-17y) with migraine are identified using the National Health Insurance Research Database (NHIRD) between 1997 and 2010 in Taiwan. Two cohorts are selected: migraine cases (n = 8,923) and propensity score-matched non-migraine controls (n = 35,692). Children with previous history of narcolepsy or headache before the index date are excluded. Cohorts are followed until the end of 2012, their withdrawal from the NHI program, or incidence of narcolepsy (ICD-9-CM: 347). Cox proportional hazards regression models are used to estimate hazard ratios (HRs) and 95% confidence intervals of developing narcolepsy in children with migraine compared to their non-migraine controls. A total of 13 incident cases with narcolepsy are observed during follow-up, with incidence rates of 0.1915 and 0.0278 per 1,000 person-years in migraine and non-migraine children, respectively. After a mean follow-up period of 4.68 and 5.04 years in the case and control cohort, respectively, the former exhibited a greater risk of developing narcolepsy compared to the latter (adjusted hazard ratio (aHR) = 5.30, 95% confidence interval (CI): 1.61, 17.4; p = 0.006). This finding persisted after controlling for potential confounders like baseline comorbidities and concurrent medication uptake, and in our analyses with migraine subtypes. Migraine is an independent risk factor for narcolepsy development in children. Further studies are needed to validate our findings and to explore the exact pathophysiological mechanisms linking migraine and narcolepsy.

Preferences for Explanation Generality Develop Early in Biology But Not Physics.

PubMed

Johnston, Angie M; Sheskin, Mark; Johnson, Samuel G B; Keil, Frank C

2017-04-11

One of the core functions of explanation is to support prediction and generalization. However, some explanations license a broader range of predictions than others. For instance, an explanation about biology could be presented as applying to a specific case (e.g., "this bear") or more generally across "all animals." The current study investigated how 5- to 7-year-olds (N = 36), 11- to 13-year-olds (N = 34), and adults (N = 79) evaluate explanations at varying levels of generality in biology and physics. Findings revealed that even the youngest children preferred general explanations in biology. However, only older children and adults preferred explanation generality in physics. Findings are discussed in light of differences in our intuitions about biological and physical principles. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

A pHorseshoe

NASA Astrophysics Data System (ADS)

Plumsky, Roger

1999-07-01

Students often find pH calculations boring and irrelevant, and many memorize calculation schemes without understanding. It has been suggested that such topics should be dropped from the first-year chemistry course. I have found an approach that involves memorization but enables students of average ability to achieve understanding through its use and subsequent development of the topic. Providing students with a memorization scheme at the outset eliminates initial frustration and discouragement and leads to better understanding by the time the unit has been developed. Understanding is developed after the students have successfully calculated conversions between pH and hydrogen ion concentration. In this article the pHorseshoe is described not only for the purpose of sharing with other teachers who might find it useful but also to explain why, in this case at least, memorization is the servant of understanding and not a substitute for it.

Ten Years toward Equity: Preliminary Results from a Follow-Up Case Study of Academic Computing Culture

PubMed Central

Crenshaw, Tanya L.; Chambers, Erin W.; Heeren, Cinda; Metcalf, Heather E.

2017-01-01

Just over 10 years ago, we conducted a culture study of the Computer Science Department at the flagship University of Illinois at Urbana-Champaign, one of the top five computing departments in the country. The study found that while the department placed an emphasis on research, it did so in a way that, in conjunction with a lack of communication and transparency, devalued teaching and mentoring, and negatively impacted the professional development, education, and sense of belonging of the students. As one part of a multi-phase case study spanning over a decade, this manuscript presents preliminary findings from our latest work at the university. We detail early comparisons between data gathered at the Department of Computer Science at the University of Illinois at Urbana-Champaign in 2005 and our most recent pilot case study, a follow-up research project completed in 2016. Though we have not yet completed the full data collection, we find it worthwhile to reflect on the pilot case study data we have collected thus far. Our data reveals improvements in the perceptions of undergraduate teaching quality and undergraduate peer mentoring networks. However, we also found evidence of continuing feelings of isolation, incidents of bias, policy opacity, and uneven policy implementation that are areas of concern, particularly with respect to historically underrepresented groups. We discuss these preliminary follow-up findings, offer research and methodological reflections, and share next steps for applied research that aims to create positive cultural change in computing. PMID:28579969

New application of 18F-fluoride PET for the detection of bone remodeling in early-stage osteoarthritis of the hip.

PubMed

Kobayashi, Naomi; Inaba, Yutaka; Tateishi, Ukihide; Yukizawa, Yohei; Ike, Hiroyuki; Inoue, Tomio; Saito, Tomoyuki

2013-10-01

Recent studies have reported the acceleration of subchondral bone remodeling during the development of osteoarthritis (OA). However, it is not possible to evaluate such molecular abnormalities using conventional radiographic techniques. We have applied 18F-fluoride PET to the analysis of painful or dysplastic hips at various stages of OA and then compared this with radiographic findings and clinical findings. A consecutive series of 65 joints from 48 patients (average age, 40 years; range, 19-72 years) with a hip joint complaint or radiographic dysplastic hip were enrolled in this study. Twenty-five contralateral joints without any evidence of OA or clinical symptoms were assigned as a normal control group. Radiographic evaluations were performed on the basis of Kellgren and Lawrence grade and the minimum joint space. Clinical evaluations were performed using the grading scale for pain severity and the SUVmax was measured for each joint. The association between SUVmax and the radiographic or clinical findings was evaluated. 18F-fluoride PET shows a significantly higher uptake value for progressive-stage OA cases than for early-stage cases and also shows a significantly higher uptake value in cases with severe pain. Even in early-OA-stage patients who do not show joint space narrowing on a plain x-ray, cases with severe pain show a significantly higher uptake value. 18F-fluoride PET has great potential as an imaging method for diagnosing early-stage OA without any marked radiographic changes.

Exploring the beliefs and practices of five preservice secondary science teachers from recruitment through induction in a university preparation program: A longitudinal study

NASA Astrophysics Data System (ADS)

Fletcher, Steven Samuel

This three-year longitudinal study explores the evolving beliefs and practices of five prospective secondary science teachers in a university preparation program from recruitment through their first year in the classroom. As an interpretive qualitative study, the format for data collection and analysis utilizes a case-study methodology with cross-case analysis. Data was collected through semi-structured interviews, collected artifacts, and classroom observations. There are a number of important conclusions from this study. First, the teachers' beliefs about teaching initially shift to a contemporary focus during the program, but ultimately return to a didactic orientation by their first year in the classroom. At the same time, the teachers' beliefs about learning remain consistently more contemporary in nature. Second, the participants believe that they practice teaching science as inquiry at a higher level than are indicated by researcher observations. Third, while participants value advanced content and educational theory coursework, they do not always see the link between these experiences and their development as science teachers. Fourth, the findings from this study reveal that internal and external contextual factors impacted, to varying degrees, the development of the science teachers. The findings from this study contribute to a deeper understanding of the development of science teachers from preservice education to the induction years, which indicates a pattern that is not linear. The findings from this study also reinforce the importance of internal and external contextual factors on the development of science teachers. Ultimately, this study is important to the field of secondary science teacher education as it depicts the complex interactions between the individual, the preparation program, and the school placements that impact the beliefs and practices of preservice and beginning teachers.

The impact of a Role Emerging Placement while a student occupational therapist, on subsequent qualified employability, practice and career path.

PubMed

Thew, Miranda; Thomas, Yvonne; Briggs, Michelle

2018-06-01

Although Role Emerging Placements (REP) are now a common feature in pre-registration occupational therapy curricula, there is a need to expand the understanding of the impact of this experience on employability, practice and career path of qualified occupational therapists. A case finding online survey was used to create a purposive sample for Thematic Analysis of semi-structured interviews with practising occupational therapists from one UK Masters' level pre-registration occupational therapy program. The case finding survey (n = 19) led to recruitment of six participants to be interviewed. The qualitative findings reflected the impact of a REP experience on occupational therapists' employability, practice and career path. The complementary features of the more traditional placement and the role emergent type of placement were considered as being useful and beneficial to qualified practice regardless of setting. However, the REP additionally, had an internal and outward impact. Internally, the therapist gains a passion for occupation-focussed practice and builds confidence to promote both self and the profession. Outwardly, the therapist can offer extra skills in qualified practice, particularly in innovative service development and delivery, thereby offering added value for employability. A REP experience as an occupational therapy student, can develop additional skills for qualified professional practice than traditional practice placements alone. The impact of such a placement matches with the 'Generation Y' traits of young adults who are now starting to emerge into training and the work place, translates well into a variety of working environments and lasts into career development. The placement model of occupation-focussed project development and the less apprentice style learning of a REP may be influential, and could be a suitable model within traditional placements. © 2018 Occupational Therapy Australia.

Testing expert systems

NASA Technical Reports Server (NTRS)

Chang, C. L.; Stachowitz, R. A.

1988-01-01

Software quality is of primary concern in all large-scale expert system development efforts. Building appropriate validation and test tools for ensuring software reliability of expert systems is therefore required. The Expert Systems Validation Associate (EVA) is a validation system under development at the Lockheed Artificial Intelligence Center. EVA provides a wide range of validation and test tools to check correctness, consistency, and completeness of an expert system. Testing a major function of EVA. It means executing an expert system with test cases with the intent of finding errors. In this paper, we describe many different types of testing such as function-based testing, structure-based testing, and data-based testing. We describe how appropriate test cases may be selected in order to perform good and thorough testing of an expert system.

Dynamics and control of Ebola virus transmission in Montserrado, Liberia: a mathematical modeling analysis

PubMed Central

Lewnard, Joseph A.; Ndeffo Mbah, Martial L.; Alfaro-Murillo, Jorge A.; Altice, Frederick L.; Bawo, Luke; Nyenswah, Tolbert G.; Galvani, Alison P.

2014-01-01

Background A substantial scale-up in public health response is needed to control the unprecedented Ebola virus disease (EVD) epidemic in West Africa. Current international commitments seek to expand intervention capacity in three areas: new EVD Treatment Centers (ETCs); case ascertainment through contact tracing; and household protective kit allocation. Methods We developed a transmission model of Ebola virus that we fitted to reported EVD cases and deaths in Montserrado County, Liberia. We used this model to evaluate effectiveness of expanding ETCs, improving case ascertainment, and allocating protective kits for controlling the outbreak in Montserrado. Findings We estimated the basic reproductive number for EVD in Montserrado to be 2·49 [2·38–2·60]. We expect that allocating 4,800 additional ETC beds and increasing case ascertainment fivefold in November can avert 77312 [68400–85870] cases relative to the status quo by 15 December. Complementing these measures with protective kit allocation increases the expectation as high as 97940 [90096–105606] cases. If deployed by 15 October, equivalent interventions would have been expected to avert 137432 [129736–145874] cases. If delayed to 15 November, we expect the interventions will at best avert 53957 [49963–60490] cases. Interpretation The number of ETC beds needed to effectively control EVD in Montserrado substantially exceeds the total pledged by the United States to West Africa. Accelerated case ascertainment is required to maximize effectiveness of expanding ETC capacity. Distributing protective kits can further augment EVD prevention. Our findings highlight the rapidly closing window of opportunity for controlling the outbreak and averting a catastrophic toll of EVD cases and deaths. Funding NIH: U01-GM087719, U01-GM105627, K24-DA017072 PMID:25455986

Translating Current Science into Materials for High School via a Scientist-Teacher Partnership

NASA Astrophysics Data System (ADS)

Brown, Julie C.; Bokor, Julie R.; Crippen, Kent J.; Koroly, Mary Jo

2014-04-01

Scientist-teacher partnerships are a unique form of professional development that can assist teachers in translating current science into classroom instruction by involving them in meaningful collaborations with university researchers. However, few reported models aim to directly alter science teachers' practices by supporting them in the development of curriculum materials. This article reports on a multiple case study of seven high school science teachers who attended an ongoing scientist-teacher partnership professional development program at a major Southeastern research university. Our interest was to understand the capacity of this professional development program for supporting teachers in the transfer of personal learning experiences with advanced science content and skills into curriculum materials for high school students. Findings indicate that, regardless of their ultimate success constructing curriculum materials, all cases considered the research grounded professional development supports beneficial to their professional growth with the exception of collective participation. Additionally, the cases also described how supports such as professional recognition and transferability served as affordances to the process of constructing these materials. However, teachers identified multiple constraints, including personal learning barriers, their classroom context, and the cost associated with implementing some of their curriculum ideas. Results have direct implications for future research and the purposeful design of professional development experiences through scientist-teacher partnerships.

Management of unerupted maxillary deciduous central incisor: a case report.

PubMed

Shakra, Karam Abu

2014-01-01

Failure of eruption of primary teeth can be considered rare, especially in maxillary anterior teeth. The problem can be either mechanical obstruction of eruption or a failure of the eruption mechanism. This case report presents failure of eruption of the maxillary right deciduous central incisor in a 4-year-old girl. The unerupted primary tooth was removed surgically. The histological finding revealed fibroma with reactive giant cells. Periodic follow-up visits were advised to monitor the developing dentition and to ensure enough space for the permanent incisor. How to cite this article: Shakra KA. Management of Unerupted Maxillary Deciduous Central Incisor: A Case Report. Int J Clin Pediatr Dent 2014;7(1):58-60.

Bilateral cerebrovascular accidents in incontinentia pigmenti.

PubMed

Fiorillo, Loretta; Sinclair, D Barry; O'Byrne, Mary L; Krol, Alfons L

2003-07-01

Incontinentia Pigmenti is an X-linked dominant neurocutaneous disorder with central nervous system manifestations in 30% of cases, including seizures and mental retardation. Ischemic or hemorrhagic cerebrovascular accidents have been reported rarely in incontinentia pigmenti. Chart review and literature search was performed following identification of the index case. We describe a patient with incontinentia pigmenti who developed bilateral cerebrovascular accidents in the neonatal period, with resultant severe neurologic sequelae. This is the second reported case of bilateral cerebrovascular accidents in a patient with incontinentia pigmenti. This finding may be secondary to cerebrovascular anomalies, similar to those observed in the retina. Recognition of cerebrovascular accidents as a complication of incontinentia pigmenti will hopefully lead to earlier recognition and treatment.

Building organizational supports for knowledge sharing in county human service organizations: a cross-case analysis of works-in-progress.

PubMed

Lee, Chris; Austin, Michael J

2012-01-01

Building on the literature related to evidence-based practice, knowledge management, and learning organizations, this cross-case analysis presents twelve works-in-progress in ten local public human service organizations seeking to develop their own knowledge sharing systems. The data for this cross-case analysis can be found in the various contributions to this Special Issue. The findings feature the developmental aspects of building a learning organization that include knowledge sharing systems featuring transparency, self-assessment, and dissemination and utilization. Implications for practice focus on the structure and processes involved in building knowledge sharing teams inside public human service organizations. Copyright © Taylor & Francis Group, LLC

Multiple magnet ingestion: is there a role for early surgical intervention?

PubMed

Salimi, Amrollah; Kooraki, Soheil; Esfahani, Shadi Abdar; Mehdizadeh, Mehrzad

2012-01-01

Children often swallow foreign bodies. Multiple magnet ingestion is rare, but can result in serious complications. This study presents three unique cases of multiple magnet ingestion: one case an 8-year-old boy with multiple magnet ingestion resulting in gastric obstruction and the other two cases with intestinal perforations due to multiple magnet intake. History and physical examination are unreliable in children who swallow multiple magnets. Sometimes radiological findings are not conclusive, whether one magnet is swallowed or more. If magnets are not moved in sequential radiology images, we recommend early surgical intervention before gastrointestinal complications develop. Toy companies, parents, physicians, and radiologists should be warned about the potential complications of such toys.

Translating childhood tuberculosis case management research into operational policies.

PubMed

Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O

2011-08-01

The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.

Pneumoconiosis in different sectors and their differences in Turkey.

PubMed

Alıcı, Nur Şafak; Çımrın, Arif; Coşkun Beyan, Ayşe

2016-12-01

Pneumoconiosis which is one of the ancient diseases, still affects many workers throughout the world despite "existing" control programs. We add data from a single center reviewing risk factors for pneumoconiosis; evaluate functional and radiological findings in different sectors. We reviewed medical records of patients diagnosed with pneumoconiosis who were admitted to our center between the years 2013 and 2015. Several personal and occupational features, together with functional and radiologic data, were collected. 60 were young males. Twenty-four of the cases (39.3%) worked at dental technician, 24 cases (39.3%) were ceramic workers, 5 cases (8.2%) were sandblasters, 2 cases (3.3%) were welders, 3 cases (4.9%) were miners, and 3 cases (4.9%) were marble cutters. The sectors in which the exposure started at the earliest ages were dental technicians and sandblasters, while the shortest working time was in sandblasting. The dental technicians were younger than the ceramic workers at the age of diagnosis (Kruskall-Wallis p= 0.003). The exposure time of the sandblasters was significantly shorter, especially than the ceramic workers (Kruskall-Wallis p= 0.002). The cases have been referred to us with pneumoconiosis suspicion based on the radiographic findings in the PA chest roentgenogram performed during the periodic examinations at their work place; but unlike other studies, in our study, following the HRCT assessment, cases which did not present any visible pathology in the re-evaluation of their PA chest roentgenogram, but had HRCT findings have been diagnosed as pneumoconiosis. Among the 44 cases in which micro-nodules had been detected at their HRCT, 15 of them had been previously classified as profusion of small opacities 0/1 according to their PA chest roentgenogram findings. It has been seen that the HRCT findings differ among sectors. Ceramics workers and sandblasters had significantly more micro-nodules, while dental technicians had significantly more mediastinal lymphadenopathies (Chi square, p= 0.004 and p= 0.007 respectively). When the relationship between the existence of big opacities and complaints was studied, statistically significant weight loss was detected in cases which had C opacities (chi square p= 0.01). Statistically significant FEV1 decrease was observed in cases which had weight loss (independent samples t-test p= 0.046). It has been observed that when the profusion of small opacities increased, while there was no statistically significant functional status change in non-smokers, a significant functional impairment was observed in smokers. Pneumoconiosis still exists in Turkey. Even a short exposure time as 2 years can cause pneumoconiosis. Workers in different sectors had different functional, radiological properties and smoking can affect the diseases' course. There are serious limitations related to the surveillance of both the workplace environment and the employees' health in Turkey. Without institutional preventive measures, personal protection and surveillance examinations, occupational hazards will continue to cause premature deaths. Pneumoconiosis in different sectors is a prototype of uncontrolled industry in the developing world.

"I Don't Like Hearing Angel and Not Seeing Her! Why Did We Do That?" An Exploration of Students' Media Literacy Development through Production

ERIC Educational Resources Information Center

Luchs, Michele; Emery, Winston

2004-01-01

In this exploratory case study we look at student media production to find out what students know and have learned about the media through production work. We used a media education conceptual framework developed by Dick as a means of describing the day to day media learning of a group of ten students, four girls and six boys, producing a video…

A Business Case Framework for Planning Clinical Nurse Specialist-Led Interventions.

PubMed

Bartlett Ellis, Rebecca J; Embree, Jennifer L; Ellis, Kurt G

2015-01-01

The purpose of this article is to describe a business case framework that can guide clinical nurse specialists (CNS) in clinical intervention development. Increased emphasis on cost-effective interventions in healthcare requires skills in analyzing the need to make the business case, especially for resource-intensive interventions. This framework assists the CNS to anticipate resource use and then consider if the intervention makes good business sense. We describe a business case framework that can assist the CNS to fully explore the problem and determine if developing an intervention is a good investment. We describe several analyses that facilitate making the business case to include the following: problem identification and alignment with strategic priorities, needs assessment, stakeholder analysis, market analysis, intervention implementation planning, financial analysis, and outcome evaluation. The findings from these analyses can be used to develop a formal proposal to present to hospital leaders in a position to make decisions. By aligning intervention planning with organizational priorities and engaging patients in the process, interventions will be more likely to be implemented in practice and produce robust outcomes. The business case framework can be used to justify to organization decision makers the need to invest resources in new interventions that will make a difference for quality outcomes as well as the financial bottom line. This framework can be used to plan interventions that align with organizational strategic priorities, plan for associated costs and benefits, and outcome evaluation. Clinical nurse specialists are well positioned to lead clinical intervention projects that will improve the quality of patient care and be cost-effective. To do so requires skill development in making the business case.

[Development of nursing pratice in family medecine groups].

PubMed

D'Amour, Danielle; Goudreau, Johanne; Hudon, Eveline; Beaulieu, Marie-Dominique; Lamothe, Lise; Jobin, Guy; Gilbert, Frédéric

2008-01-01

The purpose of the study was to analyze the development of nursing practice in family medicine groups (FMGs). The two-year case study consisted of 73 semi-directed interviews ofnurses, physicians and managers in five FMGs. The findings led to three main observations: nursing practice varies considerably from one FMG to another, the development of nurses' practice seems to be associated with the development of a collaborative relationship, and the satisfaction of the professionals in the FMG, nurses in particular, depends on the type of practice. It is important to implement measures to encourage the optimal use ofnurses' skills in a FMG.

A corporate approach to social monitoring and assessment for development in a fragile environment.

PubMed

May, Peter H; Dabbs, Alan W; Fernández-Dávila, Patricia; Da Vinha, Valéria; Zaidenweber, Nathan

2002-05-01

The prevailing corporate trend regarding development of energy resources in the tropics emphasizes financial gain over long-term societal benefits. Some corporations are beginning to find a competitive advantage linked to proactive relations with host communities and adequate protection of fragile ecosystems. Herein, we describe a case study where an international energy production company worked with stakeholders to achieve social capital and sustainable development. The strategies aimed to strengthen local capacity to improve social welfare and to ensure conservation and wise use of biodiversity. We provide examples, discuss lessons learned and make recommendations for future development projects.