The complete "how to" guide for selecting a disease management vendor.

PubMed

Linden, Ariel; Roberts, Nancy; Keck, Kevin

2003-01-01

Decision-makers in health plans, large medical groups, and self-insured employers face many challenges in selecting and implementing disease management programs. One strategy is the "buy" approach, utilizing one or more of the many vendors to provide disease management services for the purchasing organization. As a relatively new field, the disease management vendor landscape is continually changing, uncovering the many uncertainties about demonstrating outcomes, corporate stability, or successful business models. Given the large investment an organization may make in each disease management program (many cost 1 million dollars or more in annual fees for a moderately sized population), careful consideration must be given in selecting a disease management partner. This paper describes, in detail, the specific steps necessary and the issues to consider in achieving a successful contract with a vendor for full-service disease management.

Pregnancy through the Lens of Iranian Women with HIV: A Qualitative Study.

PubMed

Behboodi-Moghadam, Zahra; Khalajinia, Zohre; Nasrabadi, Ali-Reza Nikbakht; Mohraz, Minoo; Gharacheh, Maryam

2016-01-01

To explore the experience of pregnancy among Iranian women with HIV, 12 HIV-infected pregnant women who referred to counseling center for behavioral diseases in Imam Khomeini Hospital were recruited through purposive sampling. Data were collected by face-to-face, semi-structured interview and were analyzed using conventional content analysis method. Four main themes emerged from the data: fear and hope, stigma and discrimination, marital life stability, and trust in God. Despite concerns about mother-to-child transmission of HIV, and uncertain life span, HIV-infected women tended to continue their pregnancy, and having children was viewed as a window of hope for them. © The Author(s) 2015.

Leadership for AIDS Education. Keys to School Boardsmanship. A Program of Continuing Education for School Board Members.

ERIC Educational Resources Information Center

National School Boards Association, Alexandria, VA.

Human Immunodeficiency Virus (HIV) is a serious health problem in the United States and in the world. To date, there is no vaccine to protect people from HIV infection, nor is there a cure for those who are infected and are facing the consequences of this life-threatening disease. But infection with HIV can be prevented if people know and avoid…

New discoveries in the pathogenesis and classification of vitiligo.

PubMed

Rodrigues, Michelle; Ezzedine, Khaled; Hamzavi, Iltefat; Pandya, Amit G; Harris, John E

2017-07-01

Vitiligo is a common autoimmune disease that progressively destroys melanocytes in the skin, resulting in the appearance of patchy depigmentation. This disfiguring condition frequently affects the face and other visible areas of the body, which can be psychologically devastating. The onset of vitiligo often occurs in younger individuals and progresses for life, resulting in a heavy burden of disease and decreased quality of life. Presentation patterns of vitiligo vary, and recognition of these patterns provides both diagnostic and prognostic clues. Recent insights into disease pathogenesis offer a better understanding of the natural history of the disease, its associations, and potential for future treatments. The first article in this continuing medical education series outlines typical and atypical presentations of vitiligo, how they reflect disease activity, prognosis, and response to treatment. Finally, we discuss disease associations, risk factors, and our current understanding of disease pathogenesis. Copyright © 2016 American Academy of Dermatology, Inc. All rights reserved.

Biologics industry challenges for developing diagnostic tests for the National Veterinary Stockpile.

PubMed

Hardham, J M; Lamichhane, C M

2013-01-01

Veterinary diagnostic products generated ~$3 billion US dollars in global sales in 2010. This industry is poised to undergo tremendous changes in the next decade as technological advances move diagnostic products from the traditional laboratory-based and handheld immunologic assays towards highly technical, point of care devices with increased sensitivity, specificity, and complexity. Despite these opportunities for advancing diagnostic products, the industry continues to face numerous challenges in developing diagnostic products for emerging and foreign animal diseases. Because of the need to deliver a return on the investment, research and development dollars continue to be focused on infectious diseases that have a negative impact on current domestic herd health, production systems, or companion animal health. Overcoming the administrative, legal, fiscal, and technological barriers to provide veterinary diagnostic products for the National Veterinary Stockpile will reduce the threat of natural or intentional spread of foreign diseases and increase the security of the food supply in the US.

Update on clinical attire requirements in dental hygiene programs.

PubMed

Foley, E S

1994-01-01

Many changes have occurred in the clinical appearance of dental hygienists in the past few years because of increased emphasis on infection control and disease prevention. The purpose of this study was to assess dental hygiene program clinical attire requirements in 1993 and to compare them with requirements as described by a 1988 survey. Checklist questionnaires were mailed to the directors of all 211 dental hygiene programs in the United States and Puerto Rico in October 1993. Questions were asked regarding clinical attire requirements for students and faculty, including uniforms, gowns, lab coats, masks, protective eyewear, shoes, hair coverings, laundry management, and changes under consideration. Percentages were calculated by region and for all responding programs. Of 211 questionnaires mailed, 178 were returned, for a response rate of 84%. Results indicated that students and faculty are currently wearing more colorful uniforms and scrubs than in 1988. Long-sleeved lab coats, disposable gowns, and washable surgical gowns are increasing in use. Glasses and face masks were required for all students and faculty in both surveys, but chin-length face shields are increasing in use as optional face protection. In most instances, face shields are worn with face masks. Laundry services are being provided for faculty (employees); however, most students continue to be responsible for their own laundry after being instructed to follow stringent guidelines taught by the faculty. Increasing emphasis on personal and patient protection is moving clinical attire requirements toward a more surgical appearance. Dental hygiene educators continue to monitor and to stay current with federal infection control recommendations, regulations, and guidelines.

Increased dead space in face mask continuous positive airway pressure in neonates.

PubMed

Hishikawa, Kenji; Fujinaga, Hideshi; Ito, Yushi

2017-01-01

Continuous positive airway pressure (CPAP) by face mask is commonly performed in newborn resuscitation. We evaluated the effect of face mask CPAP on system dead space. Face mask CPAP increases dead space. A CPAP model study. We estimated the volume of the inner space of the mask. We devised a face mask CPAP model, in which the outlet of the mask was covered with plastic; and three modified face mask CPAP models, in which holes were drilled near to the cushion of the covered face mask to alter the air exit. We passed a continuous flow of 21% oxygen through each model and we controlled the inner pressure to 5 cmH 2 O by adjusting the flow-relief valve. To evaluate the ventilation in the inner space of each model, we measured the oxygen concentration rise time, that is, the time needed for the oxygen concentration of each model to reach 35% after the oxygen concentration of the continuous flow was raised from 21% to 40%. The volume of inner space of the face mask was 38.3 ml. Oxygen concentration rise time in the face mask CPAP model was significantly longer at various continuous flow rates and points of the inner space of the face mask compared with that of the modified face mask CPAP model. Our study indicates that face mask CPAP leads to an increase in dead space and a decrease in ventilation efficiency under certain circumstances. Pediatr Pulmonol. 2017;52:107-111. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Potential Impact and Study Considerations of Metabolomics in Cardiovascular Health and Disease: A Scientific Statement From the American Heart Association.

PubMed

Cheng, Susan; Shah, Svati H; Corwin, Elizabeth J; Fiehn, Oliver; Fitzgerald, Robert L; Gerszten, Robert E; Illig, Thomas; Rhee, Eugene P; Srinivas, Pothur R; Wang, Thomas J; Jain, Mohit

2017-04-01

Through the measure of thousands of small-molecule metabolites in diverse biological systems, metabolomics now offers the potential for new insights into the factors that contribute to complex human diseases such as cardiovascular disease. Targeted metabolomics methods have already identified new molecular markers and metabolomic signatures of cardiovascular disease risk (including branched-chain amino acids, select unsaturated lipid species, and trimethylamine- N -oxide), thus in effect linking diverse exposures such as those from dietary intake and the microbiota with cardiometabolic traits. As technologies for metabolomics continue to evolve, the depth and breadth of small-molecule metabolite profiling in complex systems continue to advance rapidly, along with prospects for ongoing discovery. Current challenges facing the field of metabolomics include scaling throughput and technical capacity for metabolomics approaches, bioinformatic and chemoinformatic tools for handling large-scale metabolomics data, methods for elucidating the biochemical structure and function of novel metabolites, and strategies for determining the true clinical relevance of metabolites observed in association with cardiovascular disease outcomes. Progress made in addressing these challenges will allow metabolomics the potential to substantially affect diagnostics and therapeutics in cardiovascular medicine. © 2017 American Heart Association, Inc.

Something Old, Something New: Using Family History and Genetic Testing to Diagnose and Manage Athletes with Inherited Cardiovascular Disease.

PubMed

Thomas, Matthew J; Battle, Robert W

2015-07-01

A primary objective of the preparticipation physical examination is to identify athletes at increased risk for sudden cardiac arrest (SCA). Review of an athlete's family history may identify those at risk for SCA. Genetic testing for inherited cardiovascular disease has emerged as a valuable addition to the repertoire of cardiologists facing the decision of clearing athletes with concerning clinical signs and/or family histories. Genetic testing may lead to various outcomes for an athlete including: reassurance, diagnosis in those with borderline clinical features, finding disease predisposition prior to the onset of clinical signs (ie, genotype-positive/phenotype-negative), or continued uncertainty. Copyright © 2015 Elsevier Inc. All rights reserved.

Advancing palliative and end-of-life science in cardiorespiratory populations: The contributions of nursing science.

PubMed

Grady, Patricia A

Nursing science has a critical role to inform practice, promote health, and improve the lives of individuals across the lifespan who face the challenges of advanced cardiorespiratory disease. Since 1997, the National Institute of Nursing Research (NINR) has focused attention on the importance of palliative and end-of-life care for advanced heart failure and advanced pulmonary disease through the publication of multiple funding opportunity announcements and by supporting a cadre of nurse scientists that will continue to address new priorities and future directions for advancing palliative and end-of-life science in cardiorespiratory populations. Published by Elsevier Inc.

Syphilis in the United States.

PubMed

Shockman, Solomon; Buescher, Lucinda S; Stone, Stephen P

2014-01-01

Syphilis gained notoriety in the 1500s, when it became widespread throughout Europe. While the origins of syphilis are not certain, recent data have shown that it may have originated in the Americas from a close relative that causes Yaws (Treponema pallidum pertenue).(1) For the past 500years, the disease has shown its various faces all over the world. The 19th century saw an entire medical subspecialty-syphilology (sometimes known as syphilography)-devoted to the study of the great disease, then known as "the great imitator." Syphilis has an entire textbook of presentations and can mimic many other infections and immune-mediated processes. At the beginning of the 20th century, the many faces of the disease led to Sir William Osler's well-known aphorism, "The physician who knows syphilis knows medicine."(2) When penicillin was discovered, and used to treat syphilis in 1943, some thought that syphilis would go by the wayside, but syphilis continued what it has been doing for so many years . . . inconspicuously infecting humans. The United States has seen the incidence of syphilis increase numerous times throughout the past 70years. Every decrease in the incidence of syphilis is followed shortly by an increase. A marked shift in the epidemiology occurred from 1990 to 2000. In the 1990s, syphilis primarily occurred in heterosexual minority groups. In the new millennium, a majority of cases of syphilis are now transmitted among men who have sex with men (MSM).(3) This contribution discusses the incidence of syphilis in the United States and the reasons these trends continue. © 2014 Elsevier Inc. All rights reserved.

Restless legs syndrome in dialysis patients: a comparison between hemodialysis and continuous ambulatory peritoneal dialysis.

PubMed

Merlino, Giovanni; Lorenzut, Simone; Romano, Giulio; Sommaro, Martina; Fontana, Augusto; Montanaro, Domenico; Valente, Mariarosaria; Gigli, Gian Luigi

2012-12-01

Restless legs syndrome (RLS) is common in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). A few studies so far have investigated RLS prevalence in ESRD patients undergoing continuous ambulatory peritoneal dialysis (CAPD). The aim of this study was to compare the prevalence, characteristics, consequences and predictors of RLS between HD and CAPD patients. We recruited 58 HD and 28 CAPD patients. A neurologist expert in sleep medicine performed RLS diagnosis during a face-to-face interview. The prevalence of RLS was slightly higher in HD than in CAPD patients (19 vs. 10.7%). RLS appeared after the onset of kidney complaint in HD patients; in contrast, in CAPD patients RLS preceded the occurrence of renal disease. Five HD patients reported that RLS symptoms occurred throughout the dialysis session. HD patients with RLS(+) had a higher mean number of HD sessions per week and a longer mean duration of HD session than the RLS(-) ones. Prevalence of females was significantly higher in CAPD patients with RLS(+) than in the RLS(-) ones. RLS frequently affects both HD and CAPD patients. RLS impaired sleep in both groups, but use of dopaminergic agents was uncommon in our sample. Dialysis schedule was associated with RLS in HD patients, while female sex was related to RLS in CAPD patients. Awareness concerning RLS identification and treatment in HD and CAPD patients is recommended.

Age-Related Differences in Brain Electrical Activity during Extended Continuous Face Recognition in Younger Children, Older Children and Adults

ERIC Educational Resources Information Center

Van Strien, Jan W.; Glimmerveen, Johanna C.; Franken, Ingmar H. A.; Martens, Vanessa E. G.; de Bruin, Eveline A.

2011-01-01

To examine the development of recognition memory in primary-school children, 36 healthy younger children (8-9 years old) and 36 healthy older children (11-12 years old) participated in an ERP study with an extended continuous face recognition task (Study 1). Each face of a series of 30 faces was shown randomly six times interspersed with…

Epidemiology of whooping cough & typing of Bordetella pertussis.

PubMed

Hegerle, Nicolas; Guiso, Nicole

2013-11-01

Bordetella pertussis is a Gram-negative human-restricted bacterium that evolved from the broad-range mammalian pathogen, Bordetella bronchiseptica. It causes whooping cough or pertussis in humans, which is the most prevalent vaccine-preventable disease worldwide. The introduction of the pertussis whole-cell vaccination for young children, followed by the introduction of the pertussis acellular vaccination (along with booster vaccination) for older age groups, has affected the bacterial population and epidemiology of the disease. B. pertussis is relatively monomorphic worldwide, but nevertheless, different countries are facing different epidemiological evolutions of the disease. Although it is tempting to link vaccine-driven phenotypic and genotypic evolution of the bacterium to epidemiology, many other factors should be considered and surveillance needs to continue, in addition to studies investigating the impact of current clinical isolates on vaccine efficacy.

Detection and control of Ganoderma boninense: strategies and perspectives.

PubMed

Hushiarian, Roozbeh; Yusof, Nor Azah; Dutse, Sabo Wada

2013-01-01

The oil palm, an economically important tree, has been one of the world's major sources of edible oil and a significant precursor of biodiesel fuel. Unfortunately, it now faces the threat of a devastating disease. Many researchers have identified Ganoderma boninense as the major pathogen that affects the oil palm tree and eventually kills it. But identification of the pathogen is just the first step. No single method has yet been able to halt the continuing spread of the disease. This paper discusses the modes of infection and transmission of Ganoderma boninense and suggests techniques for its early detection. Additionally, the paper proposes some possible ways of controlling the disease. Such measures, if implemented, could contribute significantly to the sustainability of the palm oil industry in South East Asia.

Climate Change and Global Food Systems: Potential Impacts on Food Security and Undernutrition.

PubMed

Myers, Samuel S; Smith, Matthew R; Guth, Sarah; Golden, Christopher D; Vaitla, Bapu; Mueller, Nathaniel D; Dangour, Alan D; Huybers, Peter

2017-03-20

Great progress has been made in addressing global undernutrition over the past several decades, in part because of large increases in food production from agricultural expansion and intensification. Food systems, however, face continued increases in demand and growing environmental pressures. Most prominently, human-caused climate change will influence the quality and quantity of food we produce and our ability to distribute it equitably. Our capacity to ensure food security and nutritional adequacy in the face of rapidly changing biophysical conditions will be a major determinant of the next century's global burden of disease. In this article, we review the main pathways by which climate change may affect our food production systems-agriculture, fisheries, and livestock-as well as the socioeconomic forces that may influence equitable distribution.

Face-space: A unifying concept in face recognition research.

PubMed

Valentine, Tim; Lewis, Michael B; Hills, Peter J

2016-10-01

The concept of a multidimensional psychological space, in which faces can be represented according to their perceived properties, is fundamental to the modern theorist in face processing. Yet the idea was not clearly expressed until 1991. The background that led to the development of face-space is explained, and its continuing influence on theories of face processing is discussed. Research that has explored the properties of the face-space and sought to understand caricature, including facial adaptation paradigms, is reviewed. Face-space as a theoretical framework for understanding the effect of ethnicity and the development of face recognition is evaluated. Finally, two applications of face-space in the forensic setting are discussed. From initially being presented as a model to explain distinctiveness, inversion, and the effect of ethnicity, face-space has become a central pillar in many aspects of face processing. It is currently being developed to help us understand adaptation effects with faces. While being in principle a simple concept, face-space has shaped, and continues to shape, our understanding of face perception.

T regulatory cells in childhood asthma.

PubMed

Strickland, Deborah H; Holt, Patrick G

2011-09-01

Asthma is a chronic disease of the airways, most commonly driven by immuno-inflammatory responses to ubiquitous airborne antigens. Epidemiological studies have shown that disease is initiated early in life when the immune and respiratory systems are functionally immature and less able to maintain homeostasis in the face of continuous antigen challenge. Here, we examine the cellular and molecular mechanisms that underlie initial aeroallergen sensitization and the ensuing regulation of secondary responses to inhaled allergens in the airway mucosa. In particular, we focus on how T-regulatory (Treg) cells influence early asthma initiation and the potential of Treg cells as therapeutic targets for drug development in asthma. Copyright © 2011 Elsevier Ltd. All rights reserved.

Examination of redirected continuous miner scrubber discharge configurations for exhaust face ventilation systems

PubMed Central

Organiscak, J.A.; Beck, T.W.

2015-01-01

The U.S. National Institute for Occupational Safety and Health (NIOSH) Office of Mine Safety and Health Research (OMSHR) has recently studied several redirected scrubber discharge configurations in its full-scale continuous miner gallery for both dust and gas control when using an exhaust face ventilation system. Dust and gas measurements around the continuous mining machine in the laboratory showed that the conventional scrubber discharge directed outby the face with a 12.2-m (40-ft) exhaust curtain setback appeared to be one of the better configurations for controlling dust and gas. Redirecting all the air toward the face equally up both sides of the machine increased the dust and gas concentrations around the machine. When all of the air was redirected toward the face on the off-curtain side of the machine, gas accumulations tended to be reduced at the face, at the expense of increased dust levels in the return and on the curtain side of the mining machine. A 6.1-m (20-ft) exhaust curtain setback without the scrubber operating resulted in the lowest dust levels around the continuous mining machine, but this configuration resulted in some of the highest levels of dust in the return and gas on the off-curtain side of the mining face. Two field studies showed some similarities to the laboratory findings, with elevated dust levels at the rear corners of the continuous miner when all of the scrubber exhaust was redirected toward the face either up the off-tubing side or equally up both sides of the mining machine. PMID:26251566

Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

PubMed

Kakyo, Tracy Alexis; Xiao, Lily Dongxia

2017-06-01

Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

Continuity, but at what cost? The impact of telemonitoring COPD on continuities of care: a qualitative study.

PubMed

Fairbrother, Peter; Pinnock, Hilary; Hanley, Janet; McCloughan, Lucy; Sheikh, Aziz; Pagliari, Claudia; McKinstry, Brian

2012-09-01

Continuity of care is widely regarded as an important marker of quality in the management of patients with long-term conditions. New services that integrate telemonitoring into care pathways have potential to change aspects of continuity in both positive and negative ways. A telemonitoring service for patients with chronic obstructive pulmonary disease (COPD) was introduced in Lothian, Scotland, in 2009. A qualitative study, nested within the TELESCOT COPD randomised control trial, was undertaken to explore the views of patients and professionals on telemonitoring. The perceived impact of telemonitoring on continuity of care was investigated as part of the research. Semi-structured interviews were undertaken with 38 patients (47% male, mean age 67.5 years). A maximum variation sample in relation to age, sex, socio-economic background, disease severity, and compliance with telemonitoring was recruited. Thirty-two stakeholders (healthcare professionals and managers) were interviewed. Transcribed coded data were analysed thematically using the framework approach. Interpretation was supported by multidisciplinary discussion. Patients and healthcare professionals considered that relationship-based continuity of care was important in the delivery of telemonitoring services. Managers placed emphasis on improved continuity of clinical management as a means of reducing healthcare costs. However, professionals described many operational challenges arising from the 'bolting-on' of telemonitoring provision to existing usual care provision which, they considered, resulted in the proliferation of additional managerial discontinuities. Managers and healthcare professionals face major challenges in meeting demands for both relationship continuity and continuity of clinical management in the development of telemonitoring services.

Finding resiliency in the face of financial barriers: Development of a conceptual framework for people with cardiovascular-related chronic disease.

PubMed

Campbell, David J T; Manns, Braden J; Leblanc, Pamela; Hemmelgarn, Brenda R; Sanmartin, Claudia; King-Shier, Kathryn

2016-12-01

Patients with chronic diseases often face financial barriers to optimize their health. These financial barriers may be related to direct healthcare costs such as medications or self-monitoring supplies, or indirect costs such as transportation to medical appointments. No known framework exists to understand how financial barriers impact patients' lives or their health outcomes.We undertook a grounded theory study to develop such a framework. We used semistructured interviews with a purposive sample of participants with cardiovascular-related chronic disease (hypertension, diabetes, heart disease, or stroke) from Alberta, Canada. Interview transcripts were analyzed in triplicate, and interviews continued until saturation was reached.We interviewed 34 participants. We found that the confluence of 2 events contributed to the perception of having a financial barrier-onset of chronic disease and lack of income or health benefits. The impact of having a perceived financial barrier varied considerably. Protective, predisposing, or modifying of factors determined how impactful a financial barrier would be. An individual's particular set of factors is then shaped by their worldview. This combination of factors and lens determines one's degree of resiliency, which ultimately impacts how well they cope with their disease.The role of financial barriers is complex. How well an individual copes with their financial barriers is intimately tied to resiliency, which is related to the composite of a personal circumstances and their worldview. Our framework for understanding the experience of financial barriers can be used by both researchers and clinicians to better understand patient behavior.

Gastroenterology in developing countries: Issues and advances

PubMed Central

Mandeville, Kate L; Krabshuis, Justus; Ladep, Nimzing Gwamzhi; Mulder, Chris JJ; Quigley, Eamonn MM; Khan, Shahid A

2009-01-01

Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments, lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas: diarrhoeal diseases, hepatitis B, and Helicobacter pylori. Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those setting up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of “cascades” are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries. PMID:19533805

Emotion and Destination Memory in Alzheimer's Disease.

PubMed

El Haj, Mohamad; Raffard, Stephane; Antoine, Pascal; Gely-Nargeot, Marie-Christine

2015-01-01

Research shows beneficial effect of emotion on self-related information in patients with Alzheimer's Disease (AD). Our paper investigates whether emotion improves destination memory (e.g., did I tell you about the manuscript?), which is thought to be self-related (e.g., did I tell you about the manuscript?). To this aim, twenty-seven AD patients and thirty healthy older adults told 24 neutral facts to eight neutral faces, eight positive faces, and eight negative faces. On a subsequent recognition task, participants had to decide whether they had previously told a given fact to a given face or not. Data revealed no emotional effect on destination memory in AD patients. However, in healthy older adults, better destination memory was observed for negative faces than for positive faces, and the latter memory was better than for neutral faces. The absence of emotional effect on destination memory in AD is interpreted in terms of substantial decline in this memory in the disease.

ERP Correlates of Target-Distracter Differentiation in Repeated Runs of a Continuous Recognition Task with Emotional and Neutral Faces

ERIC Educational Resources Information Center

Treese, Anne-Cecile; Johansson, Mikael; Lindgren, Magnus

2010-01-01

The emotional salience of faces has previously been shown to induce memory distortions in recognition memory tasks. This event-related potential (ERP) study used repeated runs of a continuous recognition task with emotional and neutral faces to investigate emotion-induced memory distortions. In the second and third runs, participants made more…

Online Continuing Education for Health Professionals: Does Sticky Design Promote Practice-Relevance?

ERIC Educational Resources Information Center

Zaghab, Roxanne Ward; Maldonado, Carlos; Whitehead, Dongsook; Bartlett, Felicia; de Bittner, Magaly Rodriguez

2015-01-01

Online continuing education (CE) holds promise as an effective method for rapid dissemination of emerging evidence-based practices in health care. Yet, the field of CE continues to develop and delivery is predominately face-to-face programs. Practice-oriented online educational methods and e-learning platforms are not fully utilized. Educational…

Integration of Chinese medicine with Western medicine could lead to future medicine: molecular module medicine.

PubMed

Zhang, Chi; Zhang, Ge; Chen, Ke-ji; Lu, Ai-ping

2016-04-01

The development of an effective classification method for human health conditions is essential for precise diagnosis and delivery of tailored therapy to individuals. Contemporary classification of disease systems has properties that limit its information content and usability. Chinese medicine pattern classification has been incorporated with disease classification, and this integrated classification method became more precise because of the increased understanding of the molecular mechanisms. However, we are still facing the complexity of diseases and patterns in the classification of health conditions. With continuing advances in omics methodologies and instrumentation, we are proposing a new classification approach: molecular module classification, which is applying molecular modules to classifying human health status. The initiative would be precisely defining the health status, providing accurate diagnoses, optimizing the therapeutics and improving new drug discovery strategy. Therefore, there would be no current disease diagnosis, no disease pattern classification, and in the future, a new medicine based on this classification, molecular module medicine, could redefine health statuses and reshape the clinical practice.

Is bronchoscopy an obsolete tool in cystic fibrosis? The role of bronchoscopy in cystic fibrosis and its clinical use

PubMed Central

2017-01-01

Cystic fibrosis (CF) is a progressive life threatening multisystem genetic disease which affects the CF transmembrane conductance regulator channel. Respiratory causes remain the most common mortality in CF. With the onset of newborn screening, initiating treatments both for prophylaxis and disease management, optimizing nutritional support, and developing therapies targeting CF transmembrane conductance regulator protein, this has significantly changed the face of managing this devastating disease. Bronchoscopy and related procedures such as bronchoalveolar lavage (BAL), transbronchial biopsies, and protected brush sampling have been looked at in the management of CF as patients with CF continue to live longer with the help of newer therapies, the microbiome in the lung becomes less diverse along with increased occurrences for noninfectious causes of airway diseases. Though bronchoscopy has been used in conjunction with other modalities such as computed tomography and sputum induction providing a better understanding of the progression of the disease, it still remains valuable in the diagnosis and management of CF. PMID:29214071

42 CFR 410.48 - Kidney disease education services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Kidney disease education services. 410.48 Section... Kidney disease education services. (a) Definitions. As used in this section: Kidney disease patient education services means face-to-face educational services provided to patients with Stage IV chronic kidney...

A powerful team: the family physician advocating for patients with a rare disease.

PubMed

Dudding-Byth, Tracy

2015-09-01

Rare diseases are characteristically difficult to diagnose and for the majority, there are no effective treatments or evidence-based management guidelines. Although it is unrealistic to expect family physicians to recognise the wide clinical spectrum of rare diseases, their longitudinal and holistic approach to medicine place them in a unique position to consider the possibility of a rare disease. This article outlines the challenges faced by the rare disease community, and the role of the primary care physician to advocate for answers as their patients transition through the healthcare system. The road to the diagnosis of a rare disease can test the doctor-patient relationship. Patients often struggle for answers and family physicians are stymied by a lack of information. At the same time, the availability of cyber-based health information and online rare-disease patient groups has led to the emergence of the 'expert' patient, who seeks a collaborative and empowering relationship with their physician. Following diagnosis, the family physician plays a crucial part in providing continuity of care, advocating access to expert healthcare, coordinating complex management and becoming a source of psychological support.

Two faces of death: fatalities from disease and combat in America's principal wars, 1775 to present.

PubMed

Cirillo, Vincent J

2008-01-01

Throughout America's first 145 years of war, far more of the country's military personnel perished from infectious diseases than from enemy action. This enduring feature of war was finally reversed in World War II, chiefly as a result of major medical advances in prevention (vaccines) and treatment (antibiotics). Safeguarding the health of a command is indispensable for the success of any campaign. Wars are lost by disease, which causes an enormous drain on the military's resources and affects both strategy and tactics. Disease and combat mortality data from America's principal wars (1775-present) fall into two clearly defined time periods: the Disease Era (1775-1918), during which infectious diseases were the major killer of America's armed forces, and the Trauma Era (1941-present), in which combat-related fatalities predominated. The trend established in World War II continues to the present day. Although there are currently more than 3,400 U.S. military fatalities in Iraq, the disease-death toll is so low that it is exceeded by the number of suicides.

Continuous noninvasive ventilation delivered by a novel total face mask: a case series report.

PubMed

Belchior, Inês; Gonçalves, Miguel R; Winck, João Carlos

2012-03-01

Noninvasive ventilation (NIV) has been widely used to decrease the complications associated with tracheal intubation in mechanically ventilated patients. However, nasal ulcerations may occur when conventional masks are used for continuous ventilation. A total face mask, which has no contact with the more sensitive areas of the face, is a possible option. We describe 3 patients with acute respiratory failure due to amyotrophic lateral sclerosis, who developed nasal bridge skin necrosis during continuous NIV, and one patient with post-extubation respiratory failure due to a high spinal cord injury, who had facial trauma with contraindication for conventional mask use. The total face mask was very well tolerated by all the patients, and permitted safe and efficient continuous NIV for several days until the acute respiratory failure episode resolved. None of the patients required endotracheal intubation during the acute episode.

The Progress of Gene Therapy for Leber's Optic Hereditary Neuropathy.

PubMed

Zhang, Yong; Tian, Zhen; Yuan, Jiajia; Liu, Chang; Liu, Hong Li; Ma, Si Qi; Li, Bin

2017-01-01

Leber's Optic Hereditary Neuropathy (LHON) is a common cause of teenaged blindness in both eyes for which there is currently no effective treatment. In 1871, the German ophthalmologist Theodor Leber was the first to describe the clinical characteristics of his namesake disease, and through unremitting efforts over the past 100 years, researchers have continued to increase their understanding of LHON. In recent years, using gene therapy, several groups have obtained breakthroughs in the treatment of the disease. In this article, we will review the challenging journey that researchers faced towards our current understanding of LHON, and describe the transition of gene therapy research for LHON from the bench to bedside. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Tackling Africa's chronic disease burden: from the local to the global

PubMed Central

2010-01-01

Africa faces a double burden of infectious and chronic diseases. While infectious diseases still account for at least 69% of deaths on the continent, age specific mortality rates from chronic diseases as a whole are actually higher in sub Saharan Africa than in virtually all other regions of the world, in both men and women. Over the next ten years the continent is projected to experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. African health systems are weak and national investments in healthcare training and service delivery continue to prioritise infectious and parasitic diseases. There is a strong consensus that Africa faces significant challenges in chronic disease research, practice and policy. This editorial reviews eight original papers submitted to a Globalization and Health special issue themed: "Africa's chronic disease burden: local and global perspectives". The papers offer new empirical evidence and comprehensive reviews on diabetes in Tanzania, sickle cell disease in Nigeria, chronic mental illness in rural Ghana, HIV/AIDS care-giving among children in Kenya and chronic disease interventions in Ghana and Cameroon. Regional and international reviews are offered on cardiovascular risk in Africa, comorbidity between infectious and chronic diseases and cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe. We discuss insights from these papers within the contexts of medical, psychological, community and policy dimensions of chronic disease. There is an urgent need for primary and secondary interventions and for African health policymakers and governments to prioritise the development and implementation of chronic disease policies. Two gaps need critical attention. The first gap concerns the need for multidisciplinary models of research to properly inform the design of interventions. The second gap concerns understanding the processes and political economies of policy making in sub Saharan Africa. The economic impact of chronic diseases for families, health systems and governments and the relationships between national policy making and international economic and political pressures have a huge impact on the risk of chronic diseases and the ability of countries to respond to them. PMID:20403167

The Miracle Baby Grows Up: Hypoplastic Left Heart Syndrome in the Adult.

PubMed

Lewis, Matthew; Rosenbaum, Marlon

2017-08-01

Hypoplastic left heart syndrome (HLHS) is characterized by underdevelopment of the mitral valve, left ventricle, and aorta and is ultimately palliated with a single-ventricle repair. Universally fatal in infancy prior to the advent of modern surgical techniques, the majority of HLHS patients will now reach adulthood. However, despite improvements in early survival, the HLHS population continues to face significant morbidity and early mortality. This review delineates common sources of patient morbidity and highlights areas in need of additional research for this growing segment of the adult congenital heart disease population. It has become increasingly clear that palliated adult single ventricle patients, like those with HLHS, face significant life-long morbidity from elevated systemic venous pressures as a consequence of the Fontan procedure. Downstream organ dysfunction secondary to elevated Fontan pressures has the potential to significantly impact long-term management decisions, including strategies of organ allocation. Because of the presence of a morphologic systemic right ventricle, HLHS patients may be at even higher risk than other adult patients with a Fontan. Because the adult HLHS population continues to grow, recognition of common sources of patient morbidity and mortality is becoming increasingly important. A coordinated effort between patients and providers is necessary to address the many remaining areas of clinical uncertainty to help ensure continued improvement in patient prognosis and quality of life.

Obesity in America.

PubMed

Rosenthal, Raul J; Morton, John; Brethauer, Stacy; Mattar, Samer; De Maria, Eric; Benz, Jennifer K; Titus, Jennifer; Sterrett, David

2017-10-01

The prevalence of obesity in America continues to grow significantly. Awareness and understanding of the disease of obesity and treatment options for it appear to be lacking among the general US population. This study aimed to identify misperceptions in diagnosis and treatment of obesity, struggles Americans face in obtaining treatment, consequences of obesity, and perceived barriers to weight loss. University hospital, United States. A survey of 1509 adults was completed in September 2016 using AmeriSpeak, a probability-based panel designed to be representative of the US household population. The survey included oversamples of blacks and Hispanics. The study analyzed quantitative data from structured interviews and presents descriptive statistics related to public attitudes toward obesity. Of Americans, 81% consider obesity to be the most serious health problem facing the nation, tying cancer as the top issue and landing ahead of diabetes (72%), heart disease (72%), mental illness (65%), and HIV infection and AIDS (46%). Nearly all Americans (94%) agree that obesity itself, even when no other diseases are present, increases the risk for early death. Most Americans overestimate the effectiveness of some obesity treatments, such as diet and exercise alone. Many overweight and obese Americans do not consult a doctor at all about their issues of excess weight. There is increased awareness about the serious consequences of obesity, but there is still a lack of understanding about the reasons and best treatment modalities for the disease. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Acoustic transducer with damping means

DOEpatents

Smith, Richard W.; Adamson, Gerald E.

1976-11-02

An ultrasonic transducer specifically suited to high temperature sodium applications is described. A piezoelectric active element is joined to the transducer faceplate by coating the faceplate and juxtaposed active element face with wetting agents specifically compatible with the bonding procedure employed to achieve the joint. The opposite face of the active element is fitted with a backing member designed to assure continued electrical continuity during adverse operating conditions which can result in the fracturing of the active element. The fit is achieved employing a spring-loaded electrode operably arranged to electrically couple the internal transducer components, enclosed in a hermetically sealed housing, to accessory components normally employed in transducer applications. Two alternative backing members are taught for assuring electrical continuity. The first employs a resilient, discrete multipoint contact electrode in electrical communication with the active element face. The second employs a resilient, elastomeric, electrically conductive, damped member in electrical communication with the active element face in a manner to effect ring-down of the transducer. Each embodiment provides continued electrical continuity within the transducer in the event the active element fractures, while the second provides the added benefit of damping.

Feasibility of an online and a face-to-face version of a self-management program for young adults with a rheumatic disease: experiences of young adults and peer leaders

PubMed Central

2014-01-01

Background Based on the self-efficacy theory, an online and a face-to-face self-management programs ‘Challenge your Arthritis’ for young adults with a rheumatic disease have recently been developed. These two courses are led by young peer leaders. The objective of this study was to test the feasibility of the online and face-to-face self-management program. Methods Feasibility was evaluated on items of perceived usefulness, perceived ease of use, user-acceptance, and adherence to both programs in young adults and peer leaders. Additional analyses of interactions on the e-Health applications, discussion board and chat board, were conducted. Results Twenty-two young adults with a diagnosed rheumatic disease participated in the study: 12 young adults followed the online program and 10 followed the face-to-face program. Both programs appeared to be feasible, especially in dealing with problems in daily life, and the participants indicated the time investment as ‘worthwhile’. In using the online program, no technical problems occurred. Participants found the program easy to use, user friendly, and liked the ‘look and feel’ of the program. Conclusions Both the online and the face-to-face versions of a self-management program. ‘Challenge your arthritis’ were found to be feasible and well appreciated by young adults with a rheumatic disease. Because these programs are likely to be a practical aid to health practices, a randomized controlled study to investigate the effects on patient outcomes is planned. PMID:24666817

Feasibility of an online and a face-to-face version of a self-management program for young adults with a rheumatic disease: experiences of young adults and peer leaders.

PubMed

Ammerlaan, Judy; van Os-Medendorp, Harmieke; Scholtus, Lieske; de Vos, André; Zwier, Matthijs; Bijlsma, Hans; Kruize, Aike A

2014-03-25

Based on the self-efficacy theory, an online and a face-to-face self-management programs 'Challenge your Arthritis' for young adults with a rheumatic disease have recently been developed. These two courses are led by young peer leaders. The objective of this study was to test the feasibility of the online and face-to-face self-management program. Feasibility was evaluated on items of perceived usefulness, perceived ease of use, user-acceptance, and adherence to both programs in young adults and peer leaders. Additional analyses of interactions on the e-Health applications, discussion board and chat board, were conducted. Twenty-two young adults with a diagnosed rheumatic disease participated in the study: 12 young adults followed the online program and 10 followed the face-to-face program. Both programs appeared to be feasible, especially in dealing with problems in daily life, and the participants indicated the time investment as 'worthwhile'. In using the online program, no technical problems occurred. Participants found the program easy to use, user friendly, and liked the 'look and feel' of the program. Both the online and the face-to-face versions of a self-management program. 'Challenge your arthritis' were found to be feasible and well appreciated by young adults with a rheumatic disease. Because these programs are likely to be a practical aid to health practices, a randomized controlled study to investigate the effects on patient outcomes is planned.

Marital status of people with epilepsy in Korea.

PubMed

Kim, Myeong-Kyu; Kwon, Oh-Young; Cho, Yong-Won; Kim, Yosik; Kim, Sung-Eun; Kim, Hoo-Won; Lee, Sang Kun; Jung, Ki-Young; Lee, Il Keun

2010-11-01

A multicentre face-to-face interview was conducted to identify factors contributing to the marital status of people with epilepsy (PWE) in Korea. The marriage rate of PWEs was only 80% and the divorce rate was more than double that in the general population. Among the single subjects, 34% replied that they were unmarried because of epilepsy, and 76% of divorced PWEs replied that epilepsy was the cause of the divorce. The factors affecting the single and divorced status in PWEs included gender, an earlier onset of seizure and seizure onset before marriage. Not informing the spouse of the disease before marriage for fear of discrimination was not related to disadvantage in marriage negotiation or to divorce. Social stigmatization of epilepsy continues and impacts on the marital status of PWEs in Korea. However, there is no correlation between the perceived and the enacted stigmas of epilepsy. Copyright © 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

Emerging and Reemerging Diseases in the World Health Organization (WHO) Eastern Mediterranean Region-Progress, Challenges, and WHO Initiatives.

PubMed

Buliva, Evans; Elhakim, Mohamed; Tran Minh, Nhu Nguyen; Elkholy, Amgad; Mala, Peter; Abubakar, Abdinasir; Malik, Sk Md Mamunur Rahman

2017-01-01

The Eastern Mediterranean Region (EMR) of the World Health Organization (WHO) continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human-animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1) infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous support of WHO, to build and maintain a resilient public health system for detection and response to all acute public health events.

Emerging and Reemerging Diseases in the World Health Organization (WHO) Eastern Mediterranean Region—Progress, Challenges, and WHO Initiatives

PubMed Central

Buliva, Evans; Elhakim, Mohamed; Tran Minh, Nhu Nguyen; Elkholy, Amgad; Mala, Peter; Abubakar, Abdinasir; Malik, Sk Md Mamunur Rahman

2017-01-01

The Eastern Mediterranean Region (EMR) of the World Health Organization (WHO) continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human–animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1) infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous support of WHO, to build and maintain a resilient public health system for detection and response to all acute public health events. PMID:29098145

Face familiarity promotes stable identity recognition: exploring face perception using serial dependence

PubMed Central

Kok, Rebecca; Van der Burg, Erik; Rhodes, Gillian; Alais, David

2017-01-01

Studies suggest that familiar faces are processed in a manner distinct from unfamiliar faces and that familiarity with a face confers an advantage in identity recognition. Our visual system seems to capitalize on experience to build stable face representations that are impervious to variation in retinal input that may occur due to changes in lighting, viewpoint, viewing distance, eye movements, etc. Emerging evidence also suggests that our visual system maintains a continuous perception of a face's identity from one moment to the next despite the retinal input variations through serial dependence. This study investigates whether interactions occur between face familiarity and serial dependence. In two experiments, participants used a continuous scale to rate attractiveness of unfamiliar and familiar faces (either experimentally learned or famous) presented in rapid sequences. Both experiments revealed robust inter-trial effects in which attractiveness ratings for a given face depended on the preceding face's attractiveness. This inter-trial attractiveness effect was most pronounced for unfamiliar faces. Indeed, when participants were familiar with a given face, attractiveness ratings showed significantly less serial dependence. These results represent the first evidence that familiar faces can resist the temporal integration seen in sequential dependencies and highlight the importance of familiarity to visual cognition. PMID:28405355

A Qualitative Impairment in Face Perception in Alzheimer's Disease: Evidence from a Reduced Face Inversion Effect.

PubMed

Lavallée, Marie Maxime; Gandini, Delphine; Rouleau, Isabelle; Vallet, Guillaume T; Joannette, Maude; Kergoat, Marie-Jeanne; Busigny, Thomas; Rossion, Bruno; Joubert, Sven

2016-01-01

Prevalent face recognition difficulties in Alzheimer's disease (AD) have typically been attributed to the underlying episodic and semantic memory impairment. The aim of the current study was to determine if AD patients are also impaired at the perceptual level for faces, more specifically at extracting a visual representation of an individual face. To address this question, we investigated the matching of simultaneously presented individual faces and of other nonface familiar shapes (cars), at both upright and inverted orientation, in a group of mild AD patients and in a group of healthy older controls matched for age and education. AD patients showed a reduced inversion effect (i.e., larger performance for upright than inverted stimuli) for faces, but not for cars, both in terms of error rates and response times. While healthy participants showed a much larger decrease in performance for faces than for cars with inversion, the inversion effect did not differ significantly for faces and cars in AD. This abnormal inversion effect for faces was observed in a large subset of individual patients with AD. These results suggest that AD patients have deficits in higher-level visual processes, more specifically at perceiving individual faces, a function that relies on holistic representations specific to upright face stimuli. These deficits, combined with their memory impairment, may contribute to the difficulties in recognizing familiar people that are often reported in patients suffering from the disease and by their caregivers.

49 CFR 236.774 - Movement, facing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Movement, facing. 236.774 Section 236.774 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Movement, facing. The movement of a train over the points of a switch which face in a direction opposite to...

49 CFR 236.818 - Switch, facing point.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Switch, facing point. 236.818 Section 236.818 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Switch, facing point. A switch, the points of which face traffic approaching in the direction for which...

49 CFR 236.818 - Switch, facing point.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Switch, facing point. 236.818 Section 236.818 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Switch, facing point. A switch, the points of which face traffic approaching in the direction for which...

49 CFR 236.818 - Switch, facing point.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Switch, facing point. 236.818 Section 236.818 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Switch, facing point. A switch, the points of which face traffic approaching in the direction for which...

49 CFR 236.818 - Switch, facing point.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Switch, facing point. 236.818 Section 236.818 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Switch, facing point. A switch, the points of which face traffic approaching in the direction for which...

49 CFR 236.818 - Switch, facing point.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Switch, facing point. 236.818 Section 236.818 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Switch, facing point. A switch, the points of which face traffic approaching in the direction for which...

Predicting the role of veterinary medicine in future health and food safety challenges

NASA Astrophysics Data System (ADS)

Fejzić, N.; Šerić-Haračić, S.

2017-09-01

Animals have always been a source of food, materials, protection and wellbeing for humans; however, animal diseases, including zoonoses, have both direct and indirect negative effects on human health, economy and the society. Since its establishment, the veterinary profession has provided crucial input in eradicating disease, increasing animal production and reducing losses due to diseases. Currently, foodborne diseases and zoonoses have raised awareness in developed countries, which have excellent systems for disease surveillance and reporting both in humans and animal populations. Due to lack of modern, integrated surveillance and reporting, the burden of zoonoses and foodborne diseases in developing European countries is much harder to assess. Differences in countries’ animal health status (demonstrated through disease surveillance) have been a main pivot point for international trade of animals and animal products. However, rapid and dramatic evolvement of the health trends in the world changed the principles of animal disease surveillance. Approaches requiring lower cost (i.e. risk-based surveillance) are now proposed, not only due to less available public funding, but also because the costs are harder to justify to policy makers if a disease is exotic and/or rare. Therefore, the veterinary profession has faced insufficient interest of governments and funds for further research into many persistent endemic animal diseases and zoonoses. On the other hand, eradication of selected diseases in some areas while elsewhere they still persist, and the continuous emergence of new diseases, cannot guarantee permanent epidemiological stability. As food safety and security become more important, global trends and events have highlighted the biological, health and economic inseparability of the relationships between humans, animals as pets and/or food sources and wildlife within the social and ecological framework of living space that these species share. Veterinarians are called on and expected to offer strategic and operational solutions for better integration of public health systems (i.e. One Health), animal health, food safety and environmental protection. At the same time, the profession faces challenges in the organisation and implementation of surveillance and disease mitigation measures.

Securitising health: Australian newspaper coverage of pandemic influenza.

PubMed

Stephenson, Niamh; Jamieson, Michelle

2009-05-01

This paper analyses contemporary Australian newspaper coverage of the threat of pandemic influenza in humans, specifically in the light of recent transformations in biomedical and public health understandings of infectious disease as continuously emerging. Our analysis suggests that the spectre of pandemic influenza is characterised, in newspaper accounts, as invoking a specific form of nation building. The Australian nation is depicted as successfully securing itself in the face of a threat from Asia (and in the absence of an effective international health body). What is described in newspaper accounts reflects a shift in the public health response to infectious disease. This response does not entail a direct focus on protecting either the population or national territory. Instead, it involves the continuous rehearsal of readiness to react to disasters through the networking of government and private agencies responsible for maintaining critical infrastructure. In this way, coverage of pandemic influenza positions health as central to national security, with little reporting of the reasons for or the potential implications of this alliance. Thus, the imperative to 'be prepared' is presented as self-evident.

Innovation in the North: are health service providers ready for the uptake of an internet-based chronic disease management platform?

PubMed

Tillotson, Sherri; Lear, Scott; Araki, Yuriko; Horvat, Dan; Prkachin, Ken; Bates, Joanna; Balka, Ellen

2009-01-01

Remote and rural regions in Canada are faced with unique challenges in the delivery of primary health services. The purpose of this study was to understand how patients and healthcare professionals in northern British Columbia might make use of the Internet to manage cardiovascular diseases. The study used a qualitative methodology. Eighteen health professionals and 6 patients were recruited for a semi-structured interview that explored their experience in managing patients with cardiovascular disease and their opinions and preferences about the use of the Internet in chronic disease management. Key findings from the data suggest that a) use of the Internet helps to maintain continuity of care while a patient moves through various stages of care, b) the Internet may possibly be used as an educational tool in chronic disease self-management, c) there is a need for policy development to support Internet-based consultation processes, and d) while health providers endorse the notion of electronic advancement in their practice, the need for secure and stable electronic systems is essential.

Prospects of Pluripotent and Adult Stem Cells for Rare Diseases.

PubMed

García-Castro, Javier; Singeç, Ilyas

2017-01-01

Rare diseases are highly diverse and complex regarding molecular underpinning and clinical manifestation and afflict millions of patients worldwide. The lack of appropriate model systems with face and construct validity and the limited availability of live tissues and cells from patients has largely hampered the understanding of underlying disease mechanisms. As a consequence, there are no adequate treatment options available for the vast majority of rare diseases. Over the last decade, remarkable progress in pluripotent and adult stem cell biology and the advent of powerful genomic technologies opened up exciting new avenues for the investigation, diagnosis, and personalized therapy of intractable human diseases. Utilizing the entire range of available stem cell types will continue to cross-fertilize different research areas and leverage the investigation of rare diseases based on evidence-based medicine. Standardized cell engineering and manufacturing from inexhaustible stem cell sources should lay the foundation for next-generation drug discovery and cell therapies that are broadly applicable in regenerative medicine. In this chapter we discuss how patient- and disease-specific iPS cells as well as adult stem cells are changing the pace of biomedical research and the translational landscape.

Prevention of perinatal group B streptococcal infections: a review with an Indian perspective.

PubMed

Narava, S; Rajaram, G; Ramadevi, A; Prakash, G V; Mackenzie, S

2014-01-01

Group B Streptococcus (GBS) is an important cause of maternal and neonatal morbidity and mortality in many parts of the world. Asymptomatic colonisation of the vagina and rectum with Group B streptococci is common in pregnancy. Maternal colonisation of GBS can vary depending on ethnicity and geographical distribution. Vertical transmission of this organism from mother to foetus may lead to neonatal GBS disease. Intra-partum use of antibiotics in these women has led to a decrease in the rate of early onset but not late onset GBS disease. Identification of women with GBS is the key factor in the prevention of perinatal GBS disease. There are different screening strategies available to identify women at risk of perinatal GBS disease. Clinicians continue to face the challenge of choosing between preventive strategies to reduce the impact of perinatal GBS disease. Controversy exists regarding the ideal preventive strategy. In India, the mortality and morbidity associated with the GBS disease remains largely a under-recognised problem. This comprehensive review summarises the salient features of GBS disease and discusses the epidemiology, risk factors, screening strategies, intra-partum antibiotic prophylaxis with an Indian perspective and how it compares with the Western nations.

Influence of continuous mining arrangements on respirable dust exposures

PubMed Central

Beck, T. W.; Organiscak, J. A.; Pollock, D. E.; Potts, J. D.; Reed, W. R.

2017-01-01

In underground continuous mining operations, ventilation, water sprays and machine-mounted flooded-bed scrubbers are the primary means of controlling respirable dust exposures at the working face. Changes in mining arrangements — such as face ventilation configuration, orientation of crosscuts mined in relation to the section ventilation and equipment operator positioning — can have impacts on the ability of dust controls to reduce occupational respirable dust exposures. This study reports and analyzes dust concentrations measured by the Pittsburgh Mining Research Division for remote-controlled continuous mining machine operators as well as haulage operators at 10 U.S. underground mines. The results of these respirable dust surveys show that continuous miner exposures varied little with depth of cut but are significantly higher with exhaust ventilation. Haulage operators experienced elevated concentrations with blowing face ventilation. Elevated dust concentrations were observed for both continuous miner operators and haulage operators when working in crosscuts driven into or counter to the section airflow. Individual cuts are highlighted to demonstrate instances of minimal and excessive dust exposures attributable to particular mining configurations. These findings form the basis for recommendations for lowering face worker respirable dust exposures. PMID:28529441

49 CFR 236.337 - Locking faces of mechanical locking; fit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Locking faces of mechanical locking; fit. 236.337 Section 236.337 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... Rules and Instructions § 236.337 Locking faces of mechanical locking; fit. Locking faces shall fit...

Access to Awareness for Faces during Continuous Flash Suppression Is Not Modulated by Affective Knowledge

PubMed Central

Rabovsky, Milena; Stein, Timo; Abdel Rahman, Rasha

2016-01-01

It is a controversially debated topic whether stimuli can be analyzed up to the semantic level when they are suppressed from visual awareness during continuous flash suppression (CFS). Here, we investigated whether affective knowledge, i.e., affective biographical information about faces, influences the time it takes for initially invisible faces with neutral expressions to overcome suppression and break into consciousness. To test this, we used negative, positive, and neutral famous faces as well as initially unfamiliar faces, which were associated with negative, positive or neutral biographical information. Affective knowledge influenced ratings of facial expressions, corroborating recent evidence and indicating the success of our affective learning paradigm. Furthermore, we replicated shorter suppression durations for upright than for inverted faces, demonstrating the suitability of our CFS paradigm. However, affective biographical information did not modulate suppression durations for newly learned faces, and even though suppression durations for famous faces were influenced by affective knowledge, these effects did not differ between upright and inverted faces, indicating that they might have been due to low-level visual differences. Thus, we did not obtain unequivocal evidence for genuine influences of affective biographical information on access to visual awareness for faces during CFS. PMID:27119743

The mere exposure effect in patients with Alzheimer's disease.

PubMed

Winograd, E; Goldstein, F C; Monarch, E S; Peluso, J P; Goldman, W P

1999-01-01

The mere exposure effect was examined in patients with mild to moderate Alzheimer's disease (AD). Twenty patients and 20 elderly controls judged the physical characteristics of faces. Implicit memory was tested later by presenting pairs of faces (old and new) and asking participants which faces they liked better. Patients and controls exhibited above chance preference for previously exposed faces. Experiment 2 evaluated whether the preserved implicit memory of patients was mediated by explicit memory. Patients and controls again judged faces but then later chose which faces they had seen before. Patients exhibited impaired recognition memory compared to controls. These findings suggest that a mere exposure effect for unfamiliar faces is present in mild to moderate AD. The results are discussed in terms of perceptual and conceptual priming and relatively spared occipital lobe functioning in early AD.

Dialysis services for tourists to the Veneto Region: a qualitative study.

PubMed

Footman, Katharine; Mitrio, Silva; Zanon, Dario; Glonti, Ketevan; Risso-Gill, Isabelle; McKee, Martin; Knai, Cécile

2015-03-01

The European Union has an established mechanism which enables patients with end-stage kidney disease (ESKD) to receive dialysis abroad, allowing them to benefit from the legal right to freedom of movement. The number of patients seeking dialysis abroad has increased in recent years and the Veneto Region of Italy, a major tourist destination, has made significant investment in providing tourist haemodialysis services. To understand the issues involved in providing dialysis services for tourists moving within the European Union, such as the experience of patients using the service, the challenges faced by professionals and patients and continuity of care. Semi-structured interviews. Interviews were conducted with patients, health professionals and key stakeholders in two dialysis centres set up for tourists in the Veneto Region's Local Health Authority 10. The study uncovered high levels of patient satisfaction and a positive impact on patients' quality of life. However, the service faces a number of challenges relating to accessibility, language barriers and continuity of care for the patient when leaving Veneto. The study also demonstrates the importance of coordinating care prior to the tourists' stay. Tourist dialysis centres are necessary to make the right to freedom of movement for patients with ESKD a reality. The findings suggest that communicating and coordinating high-quality care across borders in the EU may be facilitated by increased standardisation of norms and documents for continuity of care, such as care plans and discharge summaries. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

An innovative survey design to understand sustainable travel behaviors : potential of a rolling sample survey to replace traditional household travel surveys.

DOT National Transportation Integrated Search

2014-10-01

We propose an innovative survey with rolling samples to address a major fiscal challenge faced by many MPOs. Faced with a small, but : continuous budget, MPOs are increasingly unable to continue the current survey practice: conducting a large survey ...

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY 2018 POSITION STATEMENT ON INTEGRATION OF INSULIN PUMPS AND CONTINUOUS GLUCOSE MONITORING IN PATIENTS WITH DIABETES MELLITUS.

PubMed

Grunberger, George; Handelsman, Yehuda; Bloomgarden, Zachary T; Fonseca, Vivian A; Garber, Alan J; Haas, Richard A; Roberts, Victor L; Umpierrez, Guillermo E

2018-03-01

This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. AACE/ACE Task Force on Integration of Insulin Pumps and Continuous Glucose Monitoring in the Management of Patients With Diabetes Mellitus Chair George Grunberger, MD, FACP, FACE Task Force Members Yehuda Handelsman, MD, FACP, FNLA, MACE Zachary T. Bloomgarden, MD, MACE Vivian A. Fonseca, MD, FACE Alan J. Garber, MD, PhD, FACE Richard A. Haas, MD, FACE Victor L. Roberts, MD, MBA, FACP, FACE Guillermo E. Umpierrez, MD, CDE, FACP, FACE Abbreviations: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology A1C = glycated hemoglobin BGM = blood glucose monitoring CGM = continuous glucose monitoring CSII = continuous subcutaneous insulin infusion DM = diabetes mellitus FDA = Food & Drug Administration MDI = multiple daily injections T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR 3 = Sensor-Augmented Pump Therapy for A1C Reduction phase 3 trial.

Meaning of living with severe chronic obstructive lung disease: a qualitative study

PubMed Central

Marx, Gabriella; Nasse, Maximilian; Stanze, Henrikje; Boakye, Sonja Owusu; Nauck, Friedemann; Schneider, Nils

2016-01-01

Objectives To explore what it means for patients to live with chronic obstructive pulmonary disease (COPD) as an incurable and constantly progressing disease. Design Qualitative longitudinal study using narrative and semistructured interviews. This paper presents findings of the initial interviews. Analysis using grounded theory. Setting Lung care clinics and community care in Lower Saxony, Germany. Participants 17 patients with advanced-stage COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) III/IV). Findings Analysis shows that these patients have difficulties accepting their life situation and feel at the mercy of the disease, which could be identified as a core-experienced phenomenon. Over a long period of time, patients have only a vague feeling of being ill, caused by uncertain knowledge, slow progress and doubtful attribution of clinical symptoms of the disease (causal conditions). As an action strategy, patients try to maintain daily routines for as long as possible after diagnosis. Both effective standard and rescue medication, which helps to reduce breathlessness and other symptoms, and the feeling of being faced with one's own responsibility (intervening conditions) support this strategy, whereby patients' own responsibility is too painful to acknowledge. As a consequence, patients try to deny the threat to life for a long period of time. Frequently, they need to experience facing their own limits, often in the form of an acute crisis, to realise their health situation. The experience of the illness is contextualised by a continuous increase in limited mobility and social isolation. Conclusion In order to help patients to improve disease awareness, to accept their life situation and to improve their reduced quality of life, patients may benefit from the early integration of palliative care (PC), considering its multiprofessional patient-centred and team-centred approach. Psychological support and volunteer work, which are relevant aspects of PC, should be appropriate to address psychosocial needs. More research is needed to evaluate how patients could benefit from early PC. PMID:27932338

Flying the nest: a challenge for young adults with cystic fibrosis and their parents

PubMed Central

Bregnballe, Vibeke; Boisen, Kirsten A; Schiøtz, Peter Oluf; Pressler, Tacjana; Lomborg, Kirsten

2017-01-01

Objectives As young patients with cystic fibrosis (CF) grow up, they are expected to take increasing responsibility for the treatment and care of their disease. The aim of this study was to explore the disease-related challenges faced by young adults with CF and their parents, when they leave home. Materials and methods A questionnaire survey of Danish patients with CF aged 18–25 years and their parents was conducted. The questionnaires were based on focus-group interviews with young adults with CF and their parents, and addressed challenges faced in the transition phase between childhood and adulthood, including different areas of disease management in everyday life. Results Among all of the patients invited, 62% (n=58/94) of young adults and 53% (n=99/188) of their parents participated in the study. In total, 40% of the 18- to 25-year-olds were living with their parents, and the parents continued to play an active role in the daily care of their offspring’s disease. Among the young adults who had left home, both the patients and their parents reported many difficulties regarding disease management; the young adults reported difficulties in contacting social services and in affording and preparing sufficient CF-focused meals, and their parents reported difficulties in answering questions concerning social rights and CF in general, and in knowing how to give their offspring the best help, how much to interfere, and how to relinquish control of managing their offspring’s disease. Conclusion Young adults with CF who have left home have difficulties in handling the disease and their parents have difficulties in knowing how to give them the best help. There is an urgent need for holistic CF transitional care, including ensuring that young adults master the essential skills for self-management as they leave their parents. PMID:28243066

A psychiatrist's role in “coming out” process: Context and controversies post-377

PubMed Central

Kalra, Gurvinder

2012-01-01

After the Delhi High Court judgment on reading down Section 377 Indian penal code, many individuals of alternate sexuality are wanting to come out to themselves and significant others in their lives. In this process, they often turn to psychiatrists seeking help. However the past of this specialty wherein homosexuality and other sexualities were considered a disease still haunts it with anecdotal reports of reorienting treatments continuing in certain parts of the country. While it is important to not continue with this unethical practice, at the same time, it is also important to be supportive to the issues that this and various other marginalized sexualities in our country face. This viewpoint is an attempt to reiterate certain steps that are to be followed by psychiatrists who find themselves in such clinical consultations. PMID:22556443

29 CFR 1918.101 - Eye and face protection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Eye and face protection. 1918.101 Section 1918.101 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.101 Eye and... uses appropriate eye and/or face protection when the employee is exposed to an eye or face hazard, and...

29 CFR 1917.91 - Eye and face protection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Eye and face protection. 1917.91 Section 1917.91 Labor... (CONTINUED) MARINE TERMINALS Personal Protection § 1917.91 Eye and face protection. (a)(1)(i) The employer shall ensure that each affected employee uses protective eye and face protection devices that comply...

29 CFR 1917.91 - Eye and face protection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Eye and face protection. 1917.91 Section 1917.91 Labor... (CONTINUED) MARINE TERMINALS Personal Protection § 1917.91 Eye and face protection. (a)(1)(i) The employer shall ensure that each affected employee uses protective eye and face protection devices that comply...

29 CFR 1918.101 - Eye and face protection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Eye and face protection. 1918.101 Section 1918.101 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.101 Eye and... uses appropriate eye and/or face protection when the employee is exposed to an eye or face hazard, and...

Why Some Students Continue to Value Individual, Face-to- Face Research Consultations in a Technology-Rich World

ERIC Educational Resources Information Center

Magi, Trina J.; Mardeusz, Patricia E.

2013-01-01

For decades, academic librarians have provided individual research consultations for students. There is little information, however, about why students schedule consultations, the kinds of assistance students feel are provided by librarians during consultations, and what students find valuable about face-to-face consultations, even with the…

Interactive Distance Learning Effectively Provides Winning Sports Nutrition Workshops.

ERIC Educational Resources Information Center

Ricketts, Jennifer; Hoelscher-Day, Sharon; Begeman, Gale; Houtkooper, Linda

2001-01-01

Interactive distance-education (n=226) and face-to-face (n=129) continuing education workshops for health care and education professionals on sports nutrition were evaluated immediately and after 6 months. The well-designed distance-education format was as effective and acceptable as face to face and increased sports nutrition knowledge. (SK)

Young onset Parkinson's disease. Practical management of medical issues.

PubMed

Calne, Susan M; Kumar, Ajit

2008-01-01

Young Onset Parkinson's disease (YOPD) is defined as Parkinson's disease diagnosed between the ages of 21 and 40 years. Problems faced by this group are different from those faced by older subjects because they face decades with the illness. This article reviews current literature and offers suggestions for intervention when appropriate and practical suggestions in the areas of drug treatment, rehabilitation, nutrition, sexuality, pregnancy, menstruation and menopause. The suggestions are not exclusively restricted to the management of YOPD, but emphasis is placed on items where people with YOPD have either had particular difficulties or where they can proactively self-manage their illness.

The experiences of patients with Duchenne muscular dystrophy in facing and learning about their clinical conditions.

PubMed

Fujino, Haruo; Iwata, Yuko; Saito, Toshio; Matsumura, Tsuyoshi; Fujimura, Harutoshi; Imura, Osamu

2016-01-01

Patients experience extreme difficulty when facing an intractable genetic disease. Herein, we examine the experiences of patients with Duchenne muscular dystrophy in facing and learning about their disease. A total of seven patients with Duchenne muscular dystrophy (age range: 20-48) participated. We conducted in-depth interviews with them about how they learned of their disease and how their feelings regarding the disease changed over time. Transcribed data were analysed using thematic analysis. The following themes emerged from this analysis: "experiences before receiving the diagnosis," "experiences when they learned of their condition and progression of the disease," "supports," and "desired explanations." Anxiety and worry were most pronounced when they had to transition to using wheelchairs or respirators due to disease progression; indeed, such transitions affect the patients psychological adjustment. In such times, support from significant others in their lives helped patients adjust.

Online and unsupervised face recognition for continuous video stream

NASA Astrophysics Data System (ADS)

Huo, Hongwen; Feng, Jufu

2009-10-01

We present a novel online face recognition approach for video stream in this paper. Our method includes two stages: pre-training and online training. In the pre-training phase, our method observes interactions, collects batches of input data, and attempts to estimate their distributions (Box-Cox transformation is adopted here to normalize rough estimates). In the online training phase, our method incrementally improves classifiers' knowledge of the face space and updates it continuously with incremental eigenspace analysis. The performance achieved by our method shows its great potential in video stream processing.

Key papers in prostate cancer.

PubMed

Rodney, Simon; Shah, Taimur Tariq; Patel, Hitendra R H; Arya, Manit

2014-11-01

Prostate cancer is the most common cancer and second leading cause of death in men. The evidence base for the diagnosis and treatment of prostate cancer is continually changing. We aim to review and discuss past and contemporary papers on these topics to provoke debate and highlight key dilemmas faced by the urological community. We review key papers on prostate-specific antigen screening, radical prostatectomy versus surveillance strategies, targeted therapies, timing of radiotherapy and alternative anti-androgen therapeutics. Previously, the majority of patients, irrespective of risk, underwent radical open surgical procedures associated with considerable morbidity and mortality. Evidence is emerging that not all prostate cancers are alike and that low-grade disease can be safely managed by surveillance strategies and localized treatment to the prostate. The question remains as to how to accurately stage the disease and ultimately choose which treatment pathway to follow.

Predicting Workplace Transfer of Learning: A Study of Adult Learners Enrolled in a Continuing Professional Education Training Program

ERIC Educational Resources Information Center

Nafukho, Fredrick Muyia; Alfred, Mary; Chakraborty, Misha; Johnson, Michelle; Cherrstrom, Catherine A.

2017-01-01

Purpose: The primary purpose of this study was to predict transfer of learning to workplace among adult learners enrolled in a continuing professional education (CPE) training program, specifically training courses offered through face-to-face, blended and online instruction formats. The study examined the predictive capacity of trainee…

The role of the food industry in health: lessons from tobacco?

PubMed

Capewell, Simon; Lloyd-Williams, Ffion

2018-03-01

In this review, we highlight poor diet as the biggest risk factor for non-communicable diseases. We examine the denial tactics used by the food industry, how they reflect the tactics previously used by the tobacco industry, and how campaigners can use this knowledge to achieve future public health successes. Data sources are wide ranging, notably publications relating to public health, obesity and processed food, the effectiveness hierarchy and food industry denialism tactics. Global burden of disease analyses consistently demonstrate that poor diet produces a bigger burden of non-communicable disease than tobacco, alcohol and inactivity put together. The lessons learnt from the tobacco control experience of successfully fighting the tobacco industry can be applied to other industries including processed food and sugary drinks. Tackling obesity and poor diet is a more complex issue than tobacco. Food industries continue to promote weak or ineffective policies such as voluntary reformulation, and resist regulation and taxation. However, the UK food industry now faces increasing pressure from professionals, public and politicians to accept reformulation and taxes, or face more stringent measures. The rise in childhood and adult obesity needs to be arrested and then reversed. Unhealthy processed food and sugary drinks are a major contributing factor. There is increasing interest in the tactics being used by the food industry to resist change. Advocacy and activism will be essential to counter these denialism tactics and ensure that scientific evidence is translated into effective regulation and taxation.

Exploring Sources of Emotional Distress among People Living with Scleroderma: A Focus Group Study

PubMed Central

Gumuchian, Stephanie T.; Peláez, Sandra; Delisle, Vanessa C.; Carrier, Marie-Eve; Jewett, Lisa R.; El-Baalbaki, Ghassan; Fortune, Catherine; Hudson, Marie; Impens, Ann; Körner, Annett; Persmann, Jennifer; Kwakkenbos, Linda; Bartlett, Susan J.; Thombs, Brett D.

2016-01-01

Background Systemic sclerosis, or scleroderma, is a chronic and rare connective tissue disease with negative physical and psychological implications. Sources of emotional distress and the impact they have on the lives of people with scleroderma are not well understood. Objectives To gain an in-depth understanding of the emotional experiences and sources of emotional distress for women and men living with scleroderma through focus group discussions. Methods Three semi-structured focus group discussions were conducted (two in English, one in French) with a total of 22 people with scleroderma recruited through the Scleroderma Society of Ontario in Hamilton, Ontario and a scleroderma clinic in Montreal, Canada. Interviews were recorded, transcribed, and then coded for emerging themes using thematic inductive analysis. Results Core themes representing sources of emotional distress were identified, including: (a) facing a new reality; (b) the daily struggle of living with scleroderma; (c) handling work, employment and general financial burden; (d) changing family roles; (e) social interactions; and (f) navigating the health care system. Collectively, these themes refer to the stressful journey of living with scleroderma including the obstacles faced and the emotional experiences beginning prior to receiving a diagnosis and continuing throughout the participants’ lives. Conclusion Scleroderma was portrayed as being an unpredictable and overwhelming disease, resulting in many individuals experiencing multiple sources of emotional distress. Interventions and supportive resources need to be developed to help individuals with scleroderma and people close to them manage and cope with the emotional aspects of the disease. PMID:27008209

How 'blended' is blended learning?: students' perceptions of issues around the integration of online and face-to-face learning in a Continuing Professional Development (CPD) health care context.

PubMed

Glogowska, Margaret; Young, Pat; Lockyer, Lesley; Moule, Pam

2011-11-01

This paper explores students' perceptions of blended learning modules delivered in a Continuing Professional Development (CPD) health care context in the UK. 'Blended learning' is the term used to describe a hybrid model of learning where traditional face-to-face teaching approaches and newer electronic learning activities and resources are utilised together. A new model of CPD for health care practitioners based on a blended learning approach was developed at a university in the south west of England. As part of the evaluation of the new modules, a qualitative study was conducted, in which 17 students who had experienced the modules were interviewed by telephone. Three main themes emerged from the interviews relating to the 'blended' nature of the blended learning modules. These were i) issues around the opportunities for discussion of online materials face-to-face; ii) issues of what material should be online versus face-to-face and iii) balancing online and face-to-face components. Teaching staff engaged in the development of blended learning courses need to pay particular attention to the ways in which they develop and integrate online and face-to-face materials. More attention needs to be paid to allowing opportunity for students to come together to create a 'community of inquiry'. Copyright © 2011 Elsevier Ltd. All rights reserved.

Workplace injury management: using new technology to deliver and evaluate physician continuing medical education.

PubMed

Karlinsky, Harry; Dunn, Celina; Clifford, Bill; Atkins, Jim; Pachev, George; Cunningham, Ken; Fenrich, Peter; Bayani, Yassaman

2006-12-01

Physicians typically receive little continuing medical education (CME) about their role in workplace injury management as well as on workplace injuries and disease. Although new technologies may help educate physicians in these areas, careful evaluation is required, given the understudied nature of these interventions. The objective of this study is to evaluate two promising new technologies to deliver CME (online learning and videoconferencing) and to compare the effectiveness of these delivery methods to traditional CME interventions (large urban traditional conference lectures and small group local face-to-face outreach) in their impact on physician knowledge related to workplace injury management. This study utilized a prospective, controlled evaluation of two educational programs for BC physicians: 1) The Diagnosis and Management of Lateral Epicondylitis; and 2) Is Return-to-Work Good Medicine? Each educational module was delivered in each of four ways (Outreach Visit, Videoconference Session, Conference Lecture, Online) and physicians self-selected their participation--both in terms of topic and delivery method. Questionnaires related to knowledge as well as learner attitude and satisfaction were administered prior (pre-test) and following (post-test) all educational sessions. 581 physician encounters occurred as a result of the educational interventions and a significant percentage of the physicians participated in the research per se (i.e. there were 358 completed sets of pre-test and post-test 'Knowledge' questionnaires). Overall the results showed that the developed training programs increased physicians' knowledge of both Lateral Epicondylitis and the physician's role in Return-To-Work planning as reflected in improved post-test performance when compared to pre-test scores. Furthermore, videoconferencing and online training were at least as effective as conference lectures and instructor-led small group outreach sessions in their impact on physician knowledge. Use of effective videoconferencing and online learning activities will increase physician access to quality CME related to workplace injury management and will overcome access barriers intrinsic to types of CME interventions based on instructor-student face-to-face interactions.

Online vs. Face-to-Face Course Evaluations: Considerations for Administrators and Faculty

ERIC Educational Resources Information Center

Marzano, Michael P.; Allen, Robert

2016-01-01

The purpose of this study was to determine whether students evaluate courses differently, and perhaps more critically, when delivered online vs. face-to-face (F2F). Course evaluations are associated with the instructor that taught the course. Course evaluation continues to be a significant assessment vehicle of faculty performance used by many…

Comparison of Student Academic Achievement in an Information Technology Course across Modalities

ERIC Educational Resources Information Center

Susee, Dawn

2017-01-01

Online education continues to grow at a faster pace than traditional education. Even though students may prefer face-to-face education, they find the anywhere, anytime aspect of online education hard to resist. Universities are offering more courses in both a face-to-face and online option. For both accreditation and quality assurance purposes, it…

Student Success in Face-to-Face and Distance Teleclass Environments: A Matter of Contact?

ERIC Educational Resources Information Center

Deka, Teddi S.; McMurry, Patrick

2006-01-01

Learning from a distance continues to gain popularity. An influx of traditional, and even on-campus students attest to its flexibility, but are they equipped to succeed in a low-contact distance environment versus a face-to-face, on-campus environment? This research explored whether several variables including background, preparedness and…

Financial Conflicts Facing Late-Life Remarried Alzheimer's Disease Caregivers

ERIC Educational Resources Information Center

Sherman, Carey Wexler; Bauer, Jean W.

2008-01-01

This qualitative study explores financial conflicts faced by late-life remarried wives providing care for their husbands with Alzheimer's disease. Interviews with 9 women identified intergenerational secrets and tensions regarding financial and inheritance decisions. Participants' remarried spouse status, underlying family boundary ambiguities,…

49 CFR 236.745 - Face, locking.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Face, locking. 236.745 Section 236.745 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Face, locking. The locking surface of a locking dog, tappet or cross locking of an interlocking machine. ...

49 CFR 236.745 - Face, locking.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Face, locking. 236.745 Section 236.745 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Face, locking. The locking surface of a locking dog, tappet or cross locking of an interlocking machine. ...

49 CFR 236.745 - Face, locking.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Face, locking. 236.745 Section 236.745 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Face, locking. The locking surface of a locking dog, tappet or cross locking of an interlocking machine. ...

49 CFR 236.745 - Face, locking.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Face, locking. 236.745 Section 236.745 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Face, locking. The locking surface of a locking dog, tappet or cross locking of an interlocking machine. ...

49 CFR 236.745 - Face, locking.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Face, locking. 236.745 Section 236.745 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Face, locking. The locking surface of a locking dog, tappet or cross locking of an interlocking machine. ...

Michelangelo's eye disease.

PubMed

Gallenga, P E; Neri, Giampiero; D'Anastasio, Ruggero; Pettorrossi, Vito Enrico; Alfieri, Emilio; Capasso, Luigi

2012-06-01

Charged by the Pope Julius II for painting the Cappella Sistina in Rome (between 1508 and 1512), Michelangelo worked in an elevated scaffolding, in an anomalous position with dyes (including poisoning lead salts) and solvents (such as toxic turpentine) dripping on his face and continuously inhaling, in a dim environment illuminated only with oil lamps and candles, as he described himself and sketched in a sonet addressed to Giovanni da Pistoia. In 1510 he began suffering from eye disease: the main symptom was the necessity to elevate the document he was reading up to the level of his eyes. This defect disappeared few months after he finished painting his masterpiece. We hypothesize that the Michelangelo's eyes disease was a form of acquired and transitory nystagmus induced by the many hours he spent in up gaze, with a skew deviation, a form of ocular tilt reaction resulting from the impairment of spatial sensitivity (inversion illusion) due to the persistence of the artist's head in a horizontal position, looking upward. Copyright © 2012 Elsevier Ltd. All rights reserved.

Remission of rheumatoid arthritis: should we care about definitions?

PubMed

Aletaha, D; Smolen, J S

2006-01-01

A state of remission can be achieved in more and more rheumatoid arthritis (RA) patients. The combination of several RA disease activity measures seems to be important to provide an overall view of disease activity. Remission can be defined by two different approaches: one using a categorical model, requiring criteria for multiple variables to be fulfilled, each with its own threshold value (remission "criteria"); the other using a dimensional model, providing single measures of activity, which allow definition of remission by a single cut point (remission cut points for composite indices). The face validity of remission as defined by composite indices surpasses the one for the "criteria". Likewise, the ones that are not weighted seem to surpass the weighted ones, as can be seen by the significant proportion of patients that continues to have considerable swollen joint counts despite being in Disease Activity Score (DAS)-28 remission. All composite indices seem to perform similarly well as tests for remission using expert judgments as the gold standard.

Can We Talk through a Robot As if Face-to-Face? Long-Term Fieldwork Using Teleoperated Robot for Seniors with Alzheimer's Disease.

PubMed

Kuwamura, Kaiko; Nishio, Shuichi; Sato, Shinichi

2016-01-01

This work presents a case study on fieldwork in a group home for the elderly with dementia using a teleoperated robot called Telenoid. We compared Telenoid-mediated and face-to-face conditions with three residents with Alzheimer's disease (AD). The result indicates that two of the three residents with moderate AD showed a positive reaction to Telenoid. Both became less nervous while communicating with Telenoid from the time they were first introduced to it. Moreover, they started to use more body gestures in the face-to-face condition and more physical interactions in the Telenoid-mediated condition. In this work, we present all the results and discuss the possibilities of using Telenoid as a tool to provide opportunities for seniors to communicate over the long term.

Health care for undocumented immigrants in Texas: past, present, and future.

PubMed

Kuruvilla, Rohit; Raghavan, Rajeev

2014-07-01

Providing health care to the 1.6 million undocumented immigrants in Texas is an existing challenge. Despite continued growth of this vulnerable population, legislation between 1986 and 2013 has made it more difficult for states to provide adequate and cost-effective care. As this population ages and develops chronic illnesses, Texas physicians, health care administrators, and legislators will be facing a major challenge. New legislation, such as the Affordable Care Act and immigration reform, does not address or attempt to solve the issue of providing health care to this population. One example of inadequate care and poor resource allocation is the experience of undocumented immigrants with end-stage renal disease (ESRD). In Texas, these immigrants depend on safety net hospital systems for dialysis treatments. Often, treatments are provided only when their conditions become an emergency, typically at a higher cost, with worse outcomes. This article reviews the legislation regarding health care for undocumented immigrants, particularly those with chronic illnesses such as ESRD, and details specific challenges facing Texas physicians in the future.

Anaesthetic Management in a Child with Goldenhar Syndrome.

PubMed

Khan, Waqas Ahmed; Salim, Bushra; Khan, Ausaf Ahmed; Chughtai, Shakaib

2017-03-01

Goldenhar syndrome is a congenital disorder involving deformities of the face. It usually affects one side of the face only and poses significant challenges in the airway management. We herein, report an 8-year boy, known case of Goldenhar syndrome, who presented to our radiology suite for a magnetic resonance imaging (MRI) brain, followed by a computed tomography (CT) scan brain. The boy had various features of Goldenhar syndrome, e.g. cleft palate, absent right eye and ear, right mandibular hypoplasia, micrognathia, and preauricular tags. His developmental milestones were delayed. Airway evaluation showed Mallampati class II with limited movements of head and neck, which suggested possibility of difficult laryngoscopy and intubation. He had no vertebral anomalies or cardiac disease. A difficult airway continues to be a major cause of anaesthesia-related morbidity and mortality; and maintaining spontaneous breathing remains a vital technique in its management. Lack of anaesthesia-related complications with supraglottic devices encouraged us to present the advantage of utilising a laryngeal mask airway (LMA) under anaesthesia for successful management of predicted difficult airway.

Hepatitis Vaccines

PubMed Central

Ogholikhan, Sina; Schwarz, Kathleen B.

2016-01-01

Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B globally. Given the lack of a hepatitis C vaccine, the many challenges facing the production of a hepatitis C vaccine will be shown, along with current and former vaccination trials. As there is no current FDA-approved hepatitis E vaccine, we will present vaccination data that is available in the rest of the world. Finally, we will discuss the existing challenges and questions facing future endeavors for each of the hepatitis viruses, with efforts continuing to focus on dramatically reducing the morbidity and mortality associated with these serious infections of the liver. PMID:26978406

Wechsler Memory Scale-III Faces test performance in patients with mild cognitive impairment and mild Alzheimer's disease.

PubMed

Seelye, Adriana M; Howieson, Diane B; Wild, Katherine V; Moore, Mindy Milar; Kaye, Jeffrey A

2009-08-01

Little is known about the sensitivity of the Wechsler Memory Scale-Third Edition (WMS-III) Faces subtest to memory impairment associated with mild cognitive impairment (MCI). In this study, Faces performance was examined in 24 MCI patients, 46 mild Alzheimer's disease (AD) patients, and 98 elderly controls. We hypothesized that participants with diagnoses of MCI or AD would be impaired relative to controls on Faces. Analyses showed that AD participants performed significantly worse than MCI and intact participants, although there were no significant differences between MCI and intact participants. Data suggest that brain areas specialized for face recognition memory may be less affected by MCI and mild AD than regions specialized for verbal memory.

Animal models of non-alcoholic fatty liver disease: current perspectives and recent advances.

PubMed

Lau, Jennie Ka Ching; Zhang, Xiang; Yu, Jun

2017-01-01

Non-alcoholic fatty liver disease (NAFLD) is a continuous spectrum of diseases characterized by excessive lipid accumulation in hepatocytes. NAFLD progresses from simple liver steatosis to non-alcoholic steatohepatitis and, in more severe cases, to liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Because of its growing worldwide prevalence, various animal models that mirror both the histopathology and the pathophysiology of each stage of human NAFLD have been developed. The selection of appropriate animal models continues to be one of the key questions faced in this field. This review presents a critical analysis of the histopathology and pathogenesis of NAFLD, the most frequently used and recently developed animal models for each stage of NAFLD and NAFLD-induced HCC, the main mechanisms involved in the experimental pathogenesis of NAFLD in different animal models, and a brief summary of recent therapeutic targets found by the use of animal models. Integrating the data from human disease with those from animal studies indicates that, although current animal models provide critical guidance in understanding specific stages of NAFLD pathogenesis and progression, further research is necessary to develop more accurate models that better mimic the disease spectrum, in order to provide both increased mechanistic understanding and identification/testing of novel therapeutic approaches. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

Heading for Hardship: Retirement Income for American Women in the Next Century. Mother's Day Report 1990.

ERIC Educational Resources Information Center

Older Women's League, Washington, DC.

Millions of women face bleak retirement futures. In 40 years, when today's 25-year-olds retire, fewer women will be retiring married, and therefore fewer will have access to a husband's retirement income. Young women continue to face a future of significantly lower wages. Caregiving responsibilities continue to fall predominantly on women's…

The rate and cost of nurse turnover in Australia.

PubMed

Roche, Michael A; Duffield, Christine M; Homer, Caroline; Buchan, James; Dimitrelis, Sofia

2015-01-01

Nurse turnover is a critical issue facing workforce planners across the globe, particularly in light of protracted and continuing workforce shortages. An ageing population coupled with the rise in complex and chronic diseases, have contributed to increased demands placed on the health system and importantly, nurses who themselves are ageing. Costs associated with nurse turnover are attracting more attention; however, existing measurements of turnover show inconsistent findings, which can be attributed to differences in study design, metrics used to calculate turnover and variations in definitions for turnover. This paper will report the rates and costs of nurse turnover across three States in Australia.

Not on the Face Alone: Perception of Contextualized Face Expressions in Huntington's Disease

ERIC Educational Resources Information Center

Aviezer, Hillel; Bentin, Shlomo; Hassin, Ran R.; Meschino, Wendy S.; Kennedy, Jeanne; Grewal, Sonya; Esmail, Sherali; Cohen, Sharon; Moscovitch, Morris

2009-01-01

Numerous studies have demonstrated that Huntington's disease mutation-carriers have deficient explicit recognition of isolated facial expressions. There are no studies, however, which have investigated the recognition of facial expressions embedded within an emotional body and scene context. Real life facial expressions are typically embedded in…

What health professionals should know about the health effects of air pollution and climate change on children and pregnant mothers.

PubMed

Poursafa, Parinaz; Kelishadi, Roya

2011-01-01

Health professionals face the adverse health effects of climate change and air pollution in their practices. This review underscores the effects of these environmental factors on maternal and children's health, as the most vulnerable groups to climate change and air pollution. We reviewed electronic databases for a search of the literature to find relevant studies published in English from 1990 to 2011. Environmental factors, notably climate change and air pollution influence children's health before conception and continue during pregnancy, childhood, and adolescence. Experts have suggested that such health hazards may represent the greatest public health challenge that humanity has faced. The accumulation of greenhouse gases such as carbon dioxide, primarily from burning fossil fuels, results in warming which has an impact on air pollution particularly on levels of ozone and particulates. Heat-related health effects include increased rates of pregnancy complications, pre-eclampsia, eclampsia, low birth weight, renal effects, vector-borne diseases as malaria and dengue, increased diarrheal and respiratory disease, food insecurity, decreased quality of foods (notably grains), malnutrition, water scarcity, exposures to toxic chemicals, worsened poverty, natural disasters and population displacement. Air pollution has many adverse health effects for mothers and children. In addition to short-term effects like premature labour, intrauterine growth retardation, neonatal and infant mortality rate, malignancies (notably leukaemia and Hodgkin lymphoma), respiratory diseases, allergic disorders and anaemia, exposure to criteria air pollutants from early life might be associated with increase in stress oxidative, inflammation and endothelial dysfunction which in turn might have long-term effects on chronic non-communicable diseases. Health professionals have an exclusive capability to help prevent and reduce the harmful effects of environmental factors for high-risk groups, and should consider this capacity in their usual practice.

[Behaviors on drug-abuse and prevalence of sexually transmitted diseases among drug users in Tianjin, China, from 2011 to 2015].

PubMed

Guo, Y; Zhou, N; Li, J; Ning, T L; Guo, W

2016-02-01

To understand the change of behavioral characteristics among drug users (DUS) in Tianjin and the prevalence rates of major sexually transmitted disease infections. A series of cross-sectional surveys were used. Between April and June, 2011 to 2015, a cross-sectional survey with face to face interview, was undertaken. Interview was conducted among DUS who entered the drug rehabilitation center and blood samples were drawn to test for HIV/syphilis/HCV infections. Multivariate logistic regression analysis was used to analyze the relationship between the infection of major sexually transmitted diseases and drug abuse or sexual behavior. 2 000 DUS were included during the 5-year study, with the average age of the DUS as 34.5 ± 8.7. Female accounted for 17.9% and club drug (new drugs) users accounted 45.4% of the participants, with its proportion increasing over the years. Comparing to traditional drug users, club drug users showed more sexual activities with partners, but lower proportion of condom use. Prevalence rates of HIV/Syphilis and HCV were 1.3%, 11.0%, 52.0%, respectively. The prevalence of syphilis among club drug users was significantly higher than those on traditional-drug use (χ(2)=67.778,P<0.001). Data from Binary logistic regression analysis showed that club drug use (adjusted OR=1.607, 95% CI:1.191-2.170) and females (adjusted OR=5.287, 95%CI: 3.824-7.311) were associated with syphilis infection among DUS. Drug abuse behavior changed among the drug abuse in Tianjin. Proportion of club drug use continued to increase so as the risk of infected sexually transmitted diseases.

Potential Strategies to Address the Major Clinical Barriers Facing Stem Cell Regenerative Therapy for Cardiovascular Disease: A Review.

PubMed

Nguyen, Patricia K; Neofytou, Evgenios; Rhee, June-Wha; Wu, Joseph C

2016-11-01

Although progress continues to be made in the field of stem cell regenerative medicine for the treatment of cardiovascular disease, significant barriers to clinical implementation still exist. To summarize the current barriers to the clinical implementation of stem cell therapy in patients with cardiovascular disease and to discuss potential strategies to overcome them. Information for this review was obtained through a search of PubMed and the Cochrane database for English-language studies published between January 1, 2000, and July 25, 2016. Ten randomized clinical trials and 8 systematic reviews were included. One of the major clinical barriers facing the routine implementation of stem cell therapy in patients with cardiovascular disease is the limited and inconsistent benefit observed thus far. Reasons for this finding are unclear but may be owing to poor cell retention and survival, as suggested by numerous preclinical studies and a small number of human studies incorporating imaging to determine cell fate. Additional studies in humans using imaging to determine cell fate are needed to understand how these factors contribute to the limited efficacy of stem cell therapy. Treatment strategies to address poor cell retention and survival are under investigation and include the following: coadministration of immunosuppressive and prosurvival agents, delivery of cardioprotective factors packaged in exosomes rather than the cells themselves, and use of tissue-engineering strategies to provide structural support for cells. If larger grafts are achieved using these strategies, it will be imperative to carefully monitor for the potential risks of tumorigenicity, immunogenicity, and arrhythmogenicity. Despite important achievements to date, stem cell therapy is not yet ready for routine clinical implementation. Significant research is still needed to address the clinical barriers outlined herein before the next wave of large clinical trials is under way.

Teledermatology consultation using a smartphone multimedia messaging service for common skin diseases in the Korean army: a clinical evaluation of its diagnostic accuracy.

PubMed

Shin, Hyoseung; Kim, Dong Hyun; Ryu, Hyeong Ho; Yoon, So Young; Jo, Seong Jin

2014-03-01

We evaluated the diagnostic accuracy of teleconsultations for skin diseases common in the army using a smartphone multimedia messaging service (MMS). Images of skin lesions were obtained from 100 army patients using digital cameras built into smartphones. Three remotely located dermatologists received the dermatology images and associated clinical information via the MMS. The teledermatologists' diagnoses were compared with those obtained from face-to-face examinations. The three most common diagnoses made at the dermatology clinics were eczema, viral warts and fungal infections. The mean diagnostic agreement between face-to-face and teledermatology consultations was 71% (SD 2). The mean kappa coefficient was 0.73 (SD 0.06) for the three most common diagnostic categories. The mean values for sensitivity were 78% (SD 0), 88% (SD 21) and 61% (SD 11) for eczema, viral warts and fungal infections, respectively, and the specificity values were above 90% for these skin diseases. Teledermatology consultation using smartphones is simple. Although diagnoses using telemedicine do not perfectly match diagnoses from face-to-face consultations the diagnostic accuracy using smartphones is superior to that of clinicians who are not specialized in dermatology.

Face Adaptation and Attractiveness Aftereffects in 8-Year-Olds and Adults

ERIC Educational Resources Information Center

Anzures, Gizelle; Mondloch, Catherine J.; Lackner, Christine

2009-01-01

A novel method was used to investigate developmental changes in face processing: attractiveness aftereffects. Consistent with the norm-based coding model, viewing consistently distorted faces shifts adults' attractiveness preferences toward the adapting stimuli. Thus, adults' attractiveness judgments are influenced by a continuously updated face…

Monitoring Outpatient Care

NASA Technical Reports Server (NTRS)

2003-01-01

Each year, health care costs for managing chronically ill patients increase as the life expectancy of Americans continues to grow. To handle this situation, many hospitals, doctors practices, and home care providers are turning to disease management, a system of coordinated health care interventions and communications, to improve outpatient care. By participating in daily monitoring programs, patients with congestive heart failure, chronic obstructive pulmonary disease, diabetes, and other chronic conditions requiring significant self-care are facing fewer emergency situations and hospitalizations. Cybernet Medical, a division of Ann Arbor, Michigan-based Cybernet Systems Corporation, is using the latest communications technology to augment the ways health care professionals monitor and assess patients with chronic diseases, while at the same time simplifying the patients interaction with technology. Cybernet s newest commercial product for this purpose evolved from research funded by NASA, the National Institute of Mental Health, and the Advanced Research Projects Agency. The research focused on the physiological assessment of astronauts and soldiers, human performance evaluation, and human-computer interaction. Cybernet Medical's MedStar Disease Management Data Collection System is an affordable, widely deployable solution for improving in-home-patient chronic disease management. The system's battery-powered and portable interface device collects physiological data from off-the-shelf instruments.

Meningococcal Disease

MedlinePlus

... and Control of Meningococcal Disease Resources Beyond the Science: Putting a Face on Meningococcal Disease National Meningitis Association Facts about Meningococcal Disease for Adults adultvaccination.org Meningococcal ...

The Future of General Internal Medicine

PubMed Central

Larson, Eric B; Fihn, Stephan D; Kirk, Lynne M; Levin, Wendy; Loge, Ronald V; Reynolds, Eileen; Sandy, Lewis; Schroeder, Steven; Wenger, Neil; Williams, Mark

2004-01-01

The Society of General Internal Medicine asked a task force to redefine the domain of general internal medicine. The task force believes that the chaos and dysfunction that characterize today's medical care, and the challenges facing general internal medicine, should spur innovation. These are our recommendations: while remaining true to its core values and competencies, general internal medicine should stay both broad and deep—ranging from uncomplicated primary care to continuous care of patients with multiple, complex, chronic diseases. Postgraduate and continuing education should develop mastery. Wherever they practice, general internists should be able to lead teams and be responsible for the care their teams give, embrace changes in information systems, and aim to provide most of the care their patients require. Current financing of physician services, especially fee-for-service, must be changed to recognize the value of services performed outside the traditional face-to-face visit and give practitioners incentives to improve quality and efficiency, and provide comprehensive, ongoing care. General internal medicine residency training should be reformed to provide both broad and deep medical knowledge, as well as mastery of informatics, management, and team leadership. General internal medicine residents should have options to tailor their final 1 to 2 years to fit their practice goals, often earning a certificate of added qualification (CAQ) in special generalist fields. Research will expand to include practice and operations management, developing more effective shared decision making and transparent medical records, and promoting the close personal connection that both doctors and patients want. We believe these changes constitute a paradigm shift that can benefit patients and the public and reenergize general internal medicine. PMID:14748863

Smart wearable systems: current status and future challenges.

PubMed

Chan, Marie; Estève, Daniel; Fourniols, Jean-Yves; Escriba, Christophe; Campo, Eric

2012-11-01

Extensive efforts have been made in both academia and industry in the research and development of smart wearable systems (SWS) for health monitoring (HM). Primarily influenced by skyrocketing healthcare costs and supported by recent technological advances in micro- and nanotechnologies, miniaturisation of sensors, and smart fabrics, the continuous advances in SWS will progressively change the landscape of healthcare by allowing individual management and continuous monitoring of a patient's health status. Consisting of various components and devices, ranging from sensors and actuators to multimedia devices, these systems support complex healthcare applications and enable low-cost wearable, non-invasive alternatives for continuous 24-h monitoring of health, activity, mobility, and mental status, both indoors and outdoors. Our objective has been to examine the current research in wearable to serve as references for researchers and provide perspectives for future research. Herein, we review the current research and development of and the challenges facing SWS for HM, focusing on multi-parameter physiological sensor systems and activity and mobility measurement system designs that reliably measure mobility or vital signs and integrate real-time decision support processing for disease prevention, symptom detection, and diagnosis. For this literature review, we have chosen specific selection criteria to include papers in which wearable systems or devices are covered. We describe the state of the art in SWS and provide a survey of recent implementations of wearable health-care systems. We describe current issues, challenges, and prospects of SWS. We conclude by identifying the future challenges facing SWS for HM. Copyright © 2012 Elsevier B.V. All rights reserved.

Memory for faces with emotional expressions in Alzheimer's disease and healthy older participants: positivity effect is not only due to familiarity.

PubMed

Sava, Alina-Alexandra; Krolak-Salmon, Pierre; Delphin-Combe, Floriane; Cloarec, Morgane; Chainay, Hanna

2017-01-01

Young individuals better memorize initially seen faces with emotional rather than neutral expressions. Healthy older participants and Alzheimer's disease (AD) patients show better memory for faces with positive expressions. The socioemotional selectivity theory postulates that this positivity effect in memory reflects a general age-related preference for positive stimuli, subserving emotion regulation. Another explanation might be that older participants use compensatory strategies, often considering happy faces as previously seen. The question about the existence of this effect in tasks not permitting such compensatory strategies is still open. Thus, we compared the performance of healthy participants and AD patients for positive, neutral, and negative faces in such tasks. Healthy older participants and AD patients showed a positivity effect in memory, but there was no difference between emotional and neutral faces in young participants. Our results suggest that the positivity effect in memory is not entirely due to the sense of familiarity for smiling faces.

Barriers to Online Postsecondary Education Crumble: Enrollment in Traditional Face-to-Face Courses Declines as Enrollment in Online Courses Increases

ERIC Educational Resources Information Center

Gray, Dahli

2013-01-01

Contrary to expectations, total postsecondary enrollment in the United States (US) declined in Fall 2011. In fact, it continues to decline while online enrollment continues to increase. Students can more easily cross geographic boundaries as online access causes barriers to postsecondary education to crumble, and more than 50% of the demand for…

The Impact of Online Teaching and Learning about Emotional Intelligence, Myers Briggs Personality Dimensions and Mindfulness on Personal and Social Awareness

ERIC Educational Resources Information Center

Cotler, Jami L.

2016-01-01

As computer-meditated communication continues to evolve and become more sophisticated and accessible, the applications for this technology continue to grow. One area that has garnered a considerable amount of attention is online teaching and learning. Research has shown increasing evidence that learning outcomes of face-to-face, in comparison to…

Student Equity: Discouraging Cheating in Online Courses

ERIC Educational Resources Information Center

Michael, Timothy B.; Williams, Melissa A.

2013-01-01

As online programs at conventional universities continue to expand, administrators and faculty face new challenges. Academic dishonesty is nothing new, but an online testing environment requires different strategies and tactics from what we have had to consider in the past. Our university has recently adapted successful face-to-face programs in…

MBTI Personality Type and Other Factors that Relate to Preference for Online versus Face-to-Face Instruction

ERIC Educational Resources Information Center

Harrington, Rick; Loffredo, Donald A.

2010-01-01

Online college classes are being offered at a rate that far exceeds the growth of overall higher education classes. However, much can still be learned about how to create a better online classroom environment by determining why a large percentage of students continue to prefer face-to-face classes. One factor among many that may have an influence…

Continuing the Conversation about Face-to-Face, Online, and Blended Learning a Meta-Analysis of Empirical Literature 2006-2017

ERIC Educational Resources Information Center

Wandera, Silas

2017-01-01

This paper serves two purposes. First, it statistically compares learning outcomes of face-to-face, online and blended learning instruction. Then it looks at the instructional practices that are associated with effective blended and online learning. A meta-analysis of 30 studies, with 3,687 participants, resulted in 36 effect sizes. The contrasts…

Super size me: is a big Australia good for our health?

PubMed

Pelser, Deborah

2010-05-03

Australia faces a federally instigated migration drive aimed at increasing its population to 35 million by 2049. Immigration is welcomed by politicians, economists and business people, who credit it with helping Australia fare better than other developed countries during the recent global financial crisis. Australia's capital cities will have to expand considerably to house the new migrants. Increased urbanisation, when not accompanied by appropriate town planning, is associated with higher rates of chronic disease. Despite the migration drive, Australia's population will continue to age, and by 2056 one in four Australians will be over the age of 65 years. Australian health services are already heavily burdened. Health professionals must engage with governments to ensure that appropriate plans are put in place to accommodate the increased burden of disease that will accompany a more populous Australia. Failure to do so will compromise the health of our nation.

Successful treatment of recalcitrant necrotizing eosinophilic folliculitis using indomethacin and cephalexin.

PubMed

Fallah, Haady; Dunlop, Kate; Kossard, Steven

2006-11-01

A 56-year-old man presented with a 4-month history of a painful and pruritic eruption consisting of crusted plaques and blisters on his face, scalp and chest. The patient suffered from headaches and malaise but was afebrile. Two skin biopsies revealed an epidermis which was eroded and covered by locules of serum and neutrophils. In the underlying dermis, there was a marked mixed inflammatory reaction including lymphocytes, neutrophils and numerous eosinophils. There was exocytosis of eosinophils into several follicles with areas of follicular mucinosis. A diagnosis of necrotizing eosinophilic folliculitis was made based upon the clinical and histopathological findings. The diagnosis was supported by the rapid response to a combination of indomethacin and cephalexin. The patient has taken continuous indomethacin (with rabeprazole and misoprostol cover) and cephalexin for 2 years. If treatment is withdrawn he experiences a flare of his disease within 2 weeks. This case highlights the potentially chronic nature of this disease.

Establishment of CDC Global Rapid Response Team to Ensure Global Health Security.

PubMed

Stehling-Ariza, Tasha; Lefevre, Adrienne; Calles, Dinorah; Djawe, Kpandja; Garfield, Richard; Gerber, Michael; Ghiselli, Margherita; Giese, Coralie; Greiner, Ashley L; Hoffman, Adela; Miller, Leigh Ann; Moorhouse, Lisa; Navarro-Colorado, Carlos; Walsh, James; Bugli, Dante; Shahpar, Cyrus

2017-12-01

The 2014-2016 Ebola virus disease epidemic in West Africa highlighted challenges faced by the global response to a large public health emergency. Consequently, the US Centers for Disease Control and Prevention established the Global Rapid Response Team (GRRT) to strengthen emergency response capacity to global health threats, thereby ensuring global health security. Dedicated GRRT staff can be rapidly mobilized for extended missions, improving partner coordination and the continuity of response operations. A large, agencywide roster of surge staff enables rapid mobilization of qualified responders with wide-ranging experience and expertise. Team members are offered emergency response training, technical training, foreign language training, and responder readiness support. Recent response missions illustrate the breadth of support the team provides. GRRT serves as a model for other countries and is committed to strengthening emergency response capacity to respond to outbreaks and emergencies worldwide, thereby enhancing global health security.

A biopsychosocial model for the management of patients with sickle-cell disease transitioning to adult medical care.

PubMed

Crosby, Lori E; Quinn, Charles T; Kalinyak, Karen A

2015-04-01

The lifespan of patients with sickle-cell disease (SCD) continues to increase, and most affected individuals in high-resource countries now live into adulthood. This necessitates a successful transition from pediatric to adult health care. Care for transitioning patients with SCD often falls to primary care providers who may not be fully aware of the many challenges and issues faced by patients and the current management strategies for SCD. In this review, we aim to close the knowledge gap between primary care providers and specialists who treat transitioning patients with SCD. We describe the challenges and issues encountered by these patients, and we propose a biopsychosocial multidisciplinary approach to the management of the identified issues. Examples of this approach, such as transition-focused integrated care models and quality improvement collaboratives, with the potential to improve health outcomes in adulthood are also described.

How Should Clinicians Counsel a Woman with a Strong Family History of Early-Onset Alzheimer's Disease about Her Pregnancy?

PubMed

Mapes, Marianna V; O'Brien, Barbara M; King, Louise P

2017-07-01

Counseling patients regarding the benefits, harms, and dilemmas of genetic testing is one of the greatest ethical challenges facing reproductive medicine today. With or without test results, clinicians grapple with how to communicate potential genetic risks as patients weigh their reproductive options. Here, we consider a case of a woman with a strong family history of early-onset Alzheimer's disease (EOAD). She is early in her pregnancy and unsure about learning her own genetic status. We address the ethical ramifications of each of her options, which include genetic testing, genetic counseling, and termination versus continuation of the pregnancy. Our analysis foregrounds clinicians' role in helping to ensure autonomous decision making as the patient reflects on these clinical options in light of her goals and values. © 2017 American Medical Association. All Rights Reserved.

Challenges and opportunities for meningococcal vaccination in the developing world.

PubMed

Shaker, Rouba; Fayad, Danielle; Dbaibo, Ghassan

2018-05-04

Meningococcal disease continues to be a life threatening infection with high morbidity and mortality even in appropriately treated patients. Meningococcal vaccination plays a major role in the control of the disease; however, implementing vaccination remains problematic in the developing world. The objective of this review is to identify the challenges facing the use of meningococcal vaccines in the developing world in order to discuss the opportunities and available solutions to improve immunization in these countries. Inadequate epidemiologic information necessary to implement vaccination and financial challenges predominate. Multiple measures are needed to achieve the successful implementation of meningococcal conjugate vaccination programs that protect against circulating serogroups in developing countries including enhanced surveillance systems, financial support and aid through grants, product development partnerships that are the end result of effective collaboration and communication between different interdependent stakeholders to develop affordable vaccines, and demonstration of the cost-effectiveness of new meningococcal vaccines.

A level-set method for pathology segmentation in fluorescein angiograms and en face retinal images of patients with age-related macular degeneration

NASA Astrophysics Data System (ADS)

Mohammad, Fatimah; Ansari, Rashid; Shahidi, Mahnaz

2013-03-01

The visibility and continuity of the inner segment outer segment (ISOS) junction layer of the photoreceptors on spectral domain optical coherence tomography images is known to be related to visual acuity in patients with age-related macular degeneration (AMD). Automatic detection and segmentation of lesions and pathologies in retinal images is crucial for the screening, diagnosis, and follow-up of patients with retinal diseases. One of the challenges of using the classical level-set algorithms for segmentation involves the placement of the initial contour. Manually defining the contour or randomly placing it in the image may lead to segmentation of erroneous structures. It is important to be able to automatically define the contour by using information provided by image features. We explored a level-set method which is based on the classical Chan-Vese model and which utilizes image feature information for automatic contour placement for the segmentation of pathologies in fluorescein angiograms and en face retinal images of the ISOS layer. This was accomplished by exploiting a priori knowledge of the shape and intensity distribution allowing the use of projection profiles to detect the presence of pathologies that are characterized by intensity differences with surrounding areas in retinal images. We first tested our method by applying it to fluorescein angiograms. We then applied our method to en face retinal images of patients with AMD. The experimental results included demonstrate that the proposed method provided a quick and improved outcome as compared to the classical Chan-Vese method in which the initial contour is randomly placed, thus indicating the potential to provide a more accurate and detailed view of changes in pathologies due to disease progression and treatment.

[Comparison between methods as polling booth survey and face-to-face interview in understanding the high-risk behavior among HIV-positive clients of female sex workers].

PubMed

Wu, Peili; Zhou, Chu; Zhou, Yang; Ren, Xianlong; Chen, Xi; Zhao, Junshi; Deng, Xiaojun; Rou, Keming; Wu, Zunyou

2015-04-01

Face-to-face interview (FTFI) and polling booth survey (PBS) were applied to compare the high risk behavior among HIV-positive clients of female sex workers (CFSWs). This study was conducted in antiretroviral therapy (ART) out-patients centers in Hengyang city, where clients who had been informed on their HIV-positive status for 6 months or longer were recruited. FTFI was first used to tackle on 8 sensitive questions related to sexual behavior, followed by PBS to poke on the same questions. Results from FTFI and PBS were then compared. Compared with FIFI, results in the PBS showed higher proportion of participants who reported "having had history of sexually transmitted diseases before knowing that they were infected with HIV" (40.6% vs. 24.2%) but lower proportions on "frequency of having sex with regular sexual partner less than 4 times per month" and "using condoms consistently with regular sexual partners in past 6 months (44.4% vs. 63.0%)". There were no significant differences in the remaining 5 questions shown in the results from the two methods. HIV-positive CFSWs continued to practice unsafe sexual behaviors after knowing their HIV related status. Compared with FTFI, PBS seemed to have revealed higher proportion of unsafe sex behaviors, so as to generated more reliable data. While comparing with PBS, the traditional FTFI might have underestimated the risk behaviors among those HIV-positive CFSWs.

A Comparison of Face to Face and Video-Based Self Care Education on Quality of Life of Hemodialysis Patients

PubMed Central

Hemmati Maslakpak, Masumeh; Shams, Shadi

2015-01-01

Background End stage renal disease negatively affects the patients’ quality of life. There are different educational methods to help these patients. This study was performed to compare the effectiveness of self-care education in two methods, face to face and video educational, on the quality of life in patients under treatment by hemodialysis in education-medical centers in Urmia. Methods In this quasi-experimental study, 120 hemodialysis patients were selected randomly; they were then randomly allocated to three groups: the control, face to face education and video education. For face to face group, education was given individually in two sessions of 35 to 45 minutes. For video educational group, CD was shown. Kidney Disease Quality Of Life- Short Form (KDQOL-SF) questionnaire was filled out before and two months after the intervention. Data analysis was performed in SPSS software by using one-way ANOVA. Results ANOVA test showed a statistically significant difference in the quality of life scores among the three groups after the intervention (P=0.024). After the intervention, Tukey’s post-hoc test showed a statistically significant difference between the two groups of video and face to face education regarding the quality of life (P>0.05). Conclusion Implementation of the face to face and video education methods improves the quality of life in hemodialysis patients. So, it is suggested that video educational should be used along with face to face education. PMID:26171412

Mapping face encoding using functional MRI in multiple sclerosis across disease phenotypes.

PubMed

Rocca, Maria A; Vacchi, Laura; Rodegher, Mariaemma; Meani, Alessandro; Martinelli, Vittorio; Possa, Francesca; Comi, Giancarlo; Falini, Andrea; Filippi, Massimo

2017-10-01

Using fMRI during a face encoding (FE) task, we investigated the behavioral and fMRI correlates of FE in patients with relapse-onset multiple sclerosis (MS) at different stages of the disease and their relation with attentive-executive performance and structural MRI measures of disease-related damage. A fMRI FE task was administered to 75 MS patients (11 clinically isolated syndromes - CIS, 40 relapsing-remitting - RRMS - and 24 secondary progressive - SPMS) and 22 healthy controls (HC). fMRI activity during the face encoding condition was correlated with behavioral, clinical, neuropsychological and structural MRI variables. All study subjects activated brain regions belonging to face perception and encoding network, and deactivated areas of the default-mode network. Compared to HC, MS patients had the concomitant presence of areas of increased and decreased activations as well as increased and decreased deactivations. Compared to HC or RRMS, CIS patients experienced an increased recruitment of posterior-visual areas. Thalami, para-hippocampal gyri and right anterior cingulum were more activated in RRMS vs CIS or SPMS patients, while an increased recruitment of frontal areas was observed in SPMS vs RRMS. Areas of abnormal activations were significantly correlated with clinical, cognitive-behavioral and structural MRI measures. Abnormalities of FE network occur in MS and vary across disease clinical phenotypes. Early in the disease, an increased recruitment of areas typically devoted to face perception and encoding occurs. In SPMS patients, abnormal functional recruitment of frontal lobe areas might contribute to the severity of clinical manifestations.

Skin Condition Finder

MedlinePlus

... 2 Select Gender Male Female 3 Select Body Location Scalp Face Neck Chest Back Arm Armpit Stomach ... a body location to continue. 3 Select Body Location Face Forehead Ear Eye Nose Cheek/Beard Area ...

Pruning or tuning? Maturational profiles of face specialization during typical development.

PubMed

Zhu, Xun; Bhatt, Ramesh S; Joseph, Jane E

2016-06-01

Face processing undergoes significant developmental change with age. Two kinds of developmental changes in face specialization were examined in this study: specialized maturation, or the continued tuning of a region to faces but little change in the tuning to other categories; and competitive interactions, or the continued tuning to faces accompanied by decreased tuning to nonfaces (i.e., pruning). Using fMRI, in regions where adults showed a face preference, a face- and object-specialization index were computed for younger children (5-8 years), older children (9-12 years) and adults (18-45 years). The specialization index was scaled to each subject's maximum activation magnitude in each region to control for overall age differences in the activation level. Although no regions showed significant face specialization in the younger age group, regions strongly associated with social cognition (e.g., right posterior superior temporal sulcus, right inferior orbital cortex) showed specialized maturation, in which tuning to faces increased with age but there was no pruning of nonface responses. Conversely, regions that are associated with more basic perceptual processing or motor mirroring (right middle temporal cortex, right inferior occipital cortex, right inferior frontal opercular cortex) showed competitive interactions in which tuning to faces was accompanied by pruning of object responses with age. The overall findings suggest that cortical maturation for face processing is regional-specific and involves both increased tuning to faces and diminished response to nonfaces. Regions that show competitive interactions likely support a more generalized function that is co-opted for face processing with development, whereas regions that show specialized maturation increase their tuning to faces, potentially in an activity-dependent, experience-driven manner.

Financial protection effects of modification of China's New Cooperative Medical Scheme on rural households with chronic diseases.

PubMed

Wang, Jing; Chen, Lina; Ye, Ting; Zhang, Zhiguo; Ma, Jingdong

2014-07-15

Several years have passed since the rural New Cooperative Medical Scheme (NCMS) in China was established and policies kept continuous improvement. Its policies on chronic diseases vary by county but have certain shared characteristics. Following this modification of medical insurance policy, this study reassesses the provision of insurance against expenditure on chronic diseases in rural areas, and analyzes its effect on impoverishment. We conducted an empirical study using multi-stage stratified random sampling. We surveyed 1,661 rural households in three provinces and analyzed the responses from 1,525 households that participated in NCMS, using descriptive and logistic regression analysis. The NCMS has reduced the prevalence of poverty and catastrophic health expenditure (CHE), as measured by out-of-pocket (OOP) payments exceeding 40% of total household expenditure, by decreasing medical expenditure. It provides obvious protection to households which include someone with chronic diseases. However, these households continue to face a higher financial risk than those without anyone suffering from chronic diseases. Variables about health service utilization and OOP payment differed significantly between households with or without people suffering from chronic disease. And CHE risk is commonly associated with household income, the number of family members with chronic diseases, OOP payment of outpatient and inpatient service in all three provinces. To reduce CHE risk for these households, it is critical to decrease OOP payments for health services by enhancing the effective reimbursement level of NCMS and strictly regulating the providers' behaviors. We recommend that a combinatory changes should be made to the rural health insurance scheme in China to improve its effect. These include improving the NCMS benefit package by broadening the catalogue of drugs and treatments covered, decreasing or abolishing deductible and increasing the reimbursement ratio of outpatient services for people with chronic diseases, together with expansion of insurance fund, and modifying health providers' behaviors by payment reform.

A Comparative Study of Factors Related to Student Performance in Online and Traditional Face-to-Face MBA Courses That Are Quantitative and Qualitative in Nature

ERIC Educational Resources Information Center

Davis, Carenado V.

2013-01-01

Online learning environments have been embraced by many institutions, faculty, and students as a viable adult learning option to the traditional face-to-face learning environment. As this mode of delivery for instruction continues to grow in acceptance, it is important to understand the characteristics of adult learners, the historical progression…

Evaluation of Text Messaging Effects on Health Goal Adherence in the Management of Participants With Chronic Diseases.

PubMed

Stagg, Sharon J; Speroni, Karen Gabel; Daniel, Marlon G; Eigenbrode, Melissa; Geisler, Lori

The study purpose was to determine whether text messaging health-related messages, questions, and reminders to community case management participants with chronic diseases increased health goal adherence. This study was conducted by a rural community case management, hospital-affiliated program. This pilot, quasiexperimental study measured health goal adherence, the degree to which an individual continues work toward self-identified health goals under limited supervision, before and after a text messaging intervention. All participants were receiving community case management services for chronic disease. Participants completed baseline and follow-up surveys regarding a text messaging intervention. Most participants were African Americans, had diabetes, with equal numbers by gender, an average age of 57.8 years, and had been in the community case management program for 3-5 years. Participants were sent a total of 1,654 messages/questions and 571 reminders. At follow-up, respondents who reported "Did you work on your health goals?" increased significantly (p = .0430). However, no differences were found for "Did you go to your health care appointments?" and "Did you take your medicines as you should?" No differences were noted in reported visits/hospitalizations overall or specifically at the research site. Lastly, study member visit/hospitalization numbers did not change significantly at follow-up. Although text messaging is not meant to take the place of face-to-face interactions, it does provide community case managers with an additional modality of communication with patients to offer support and important care reminders, and to facilitate patient participation in his or her care.

Management of Paediatric Ulcerative Colitis, Part 1: Ambulatory Care- an Evidence-Based Guideline from ECCO and ESPGHAN.

PubMed

Turner, Dan; Ruemmele, Frank M; Orlanski-Meyer, Esther; Griffiths, Anne M; Carpi, Javier Martin de; Bronsky, Jiri; Veres, Gabor; Aloi, Marina; Strisciuglio, Caterina; Braegger, Christian P; Assa, Amit; Romano, Claudio; Hussey, Séamus; Stanton, Michael; Pakarinen, Mikko; de Ridder, Lissy; Katsanos, Konstantinos; Croft, Nick; Navas-López, Victor; Wilson, David C; Lawrence, Sally; Russell, Richard K

2018-05-30

The contemporary management of ambulatory ulcerative colitis (UC) continues to be challenging with ∼20% of children needing a colectomy within childhood years. We thus aimed to standardize daily treatment of paediatric UC and inflammatory bowel diseases (IBD)-unclassified through detailed recommendations and practice points. These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the Paediatric IBD Porto group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). An extensive literature search with subsequent evidence appraisal using robust methodology was performed before two face-to-face meetings. All 40 included recommendations and 86 practice points, were endorsed by 43 experts in Paediatric IBD with at least an 88% consensus rate. These guidelines centre on initial use of mesalamine (including topical), before using steroids, thiopurines and, for more severe disease, anti-TNF. The use of other emerging therapies and the role of surgery are also covered. Algorithms are provided to aid therapeutic decision making based on clinical assessment and the paediatric UC activity index (PUCAI). Advice on contemporary therapeutic targets incorporating the use of calprotectin and the role of therapeutic drug monitoring are presented, as well as other management considerations around pouchitis, extraintestinal manifestations, nutrition, growth, psychology and transition. A brief section on disease classification using the PIBD-classes criteria and IBDU is also part of these guidelines. These guidelines provide a guide to clinicians managing children with UC and IBDU to provide modern management strategies while maintaining vigilance around appropriate outcomes and safety issues.

Teleoperated control system for underground room and pillar mining

DOEpatents

Mayercheck, William D.; Kwitowski, August J.; Brautigam, Albert L.; Mueller, Brian K.

1992-01-01

A teleoperated mining system is provided for remotely controlling the various machines involved with thin seam mining. A thin seam continuous miner located at a mining face includes a camera mounted thereon and a slave computer for controlling the miner and the camera. A plurality of sensors for relaying information about the miner and the face to the slave computer. A slave computer controlled ventilation sub-system which removes combustible material from the mining face. A haulage sub-system removes material mined by the continuous miner from the mining face to a collection site and is also controlled by the slave computer. A base station, which controls the supply of power and water to the continuous miner, haulage system, and ventilation systems, includes cable/hose handling module for winding or unwinding cables/hoses connected to the miner, an operator control module, and a hydraulic power and air compressor module for supplying air to the miner. An operator controlled host computer housed in the operator control module is connected to the slave computer via a two wire communications line.

The real-time link between person perception and action: Brain potential evidence for dynamic continuity

PubMed Central

Freeman, Jonathan B.; Ambady, Nalini; Midgley, Katherine J.; Holcomb, Phillip J.

2010-01-01

Using event-related potentials, we investigated how the brain extracts information from another’s face and translates it into relevant action in real-time. In Study 1, participants made between-hand sex categorizations of sex-typical and sex-atypical faces. Sex-atypical faces evoked negativity between 250-550 ms (N300/N400 effects), reflecting the integration of accumulating sex-category knowledge into a coherent sex-category interpretation. Additionally, the lateralized readiness potential (LRP) revealed that the motor cortex began preparing for a correct hand response while social category knowledge was still gradually evolving in parallel. In Study 2, participants made between-hand eye-color categorizations as part of go/no-go trials that were contingent on a target’s sex. On no-go trials, although the hand did not actually move, information about eye color partially prepared the motor cortex to move the hand before perception of sex had finalized. Together, these findings demonstrate the dynamic continuity between person perception and action, such that ongoing results from face processing are immediately and continuously cascaded into the motor system over time. The preparation of action begins based on tentative perceptions of another’s face before perceivers have finished interpreting what they just saw. PMID:20602284

The real-time link between person perception and action: brain potential evidence for dynamic continuity.

PubMed

Freeman, Jonathan B; Ambady, Nalini; Midgley, Katherine J; Holcomb, Phillip J

2011-01-01

Using event-related potentials, we investigated how the brain extracts information from another's face and translates it into relevant action in real time. In Study 1, participants made between-hand sex categorizations of sex-typical and sex-atypical faces. Sex-atypical faces evoked negativity between 250 and 550 ms (N300/N400 effects), reflecting the integration of accumulating sex-category knowledge into a coherent sex-category interpretation. Additionally, the lateralized readiness potential revealed that the motor cortex began preparing for a correct hand response while social category knowledge was still gradually evolving in parallel. In Study 2, participants made between-hand eye-color categorizations as part of go/no-go trials that were contingent on a target's sex. On no-go trials, although the hand did not actually move, information about eye color partially prepared the motor cortex to move the hand before perception of sex had finalized. Together, these findings demonstrate the dynamic continuity between person perception and action, such that ongoing results from face processing are immediately and continuously cascaded into the motor system over time. The preparation of action begins based on tentative perceptions of another's face before perceivers have finished interpreting what they just saw. © 2010 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business

Mapping spontaneous facial expression in people with Parkinson's disease: A multiple case study design.

PubMed

Gunnery, Sarah D; Naumova, Elena N; Saint-Hilaire, Marie; Tickle-Degnen, Linda

2017-01-01

People with Parkinson's disease (PD) often experience a decrease in their facial expressivity, but little is known about how the coordinated movements across regions of the face are impaired in PD. The face has neurologically independent regions that coordinate to articulate distinct social meanings that others perceive as gestalt expressions, and so understanding how different regions of the face are affected is important. Using the Facial Action Coding System, this study comprehensively measured spontaneous facial expression across 600 frames for a multiple case study of people with PD who were rated as having varying degrees of facial expression deficits, and created correlation matrices for frequency and intensity of produced muscle activations across different areas of the face. Data visualization techniques were used to create temporal and correlational mappings of muscle action in the face at different degrees of facial expressivity. Results showed that as severity of facial expression deficit increased, there was a decrease in number, duration, intensity, and coactivation of facial muscle action. This understanding of how regions of the parkinsonian face move independently and in conjunction with other regions will provide a new focus for future research aiming to model how facial expression in PD relates to disease progression, stigma, and quality of life.

Continuing challenges in influenza

PubMed Central

Webster, Robert G.; Govorkova, Elena A.

2014-01-01

Influenza is an acute respiratory disease in mammals and domestic poultry that emerges from zoonotic reservoirs in aquatic birds and bats. Although influenza viruses are among the most intensively studied pathogens, existing control options require further improvement. Influenza vaccines must be regularly updated because of continuous antigenic drift and sporadic antigenic shifts in the viral surface glycoproteins. Currently, influenza therapeutics are limited to neuraminidase inhibitors; novel drugs and vaccine approaches are therefore urgently needed. Advances in vaccinology and structural analysis have revealed common antigenic epitopes on hemagglutinins across all influenza viruses and suggest that a universal influenza vaccine is possible. In addition, various immunomodulatory agents and signaling pathway inhibitors are undergoing preclinical development. Continuing challenges in influenza include the emergence of pandemic H1N1 influenza in 2009, human infections with avian H7N9 influenza in 2013, and sporadic human cases of highly pathogenic avian H5N1 influenza. Here, we review the challenges facing influenza scientists and veterinary and human public health officials; we also discuss the exciting possibility of achieving the ultimate goal of controlling influenza’s ability to change its antigenicity. PMID:24891213

Continuing to Confront COPD International Patient Survey: methods, COPD prevalence, and disease burden in 2012–2013

PubMed Central

Landis, Sarah H; Muellerova, Hana; Mannino, David M; Menezes, Ana M; Han, MeiLan K; van der Molen, Thys; Ichinose, Masakazu; Aisanov, Zaurbek; Oh, Yeon-Mok; Davis, Kourtney J

2014-01-01

Purpose The Continuing to Confront COPD International Patient Survey aimed to estimate the prevalence and burden of COPD globally and to update findings from the Confronting COPD International Survey conducted in 1999–2000. Materials and methods Chronic obstructive pulmonary disease (COPD) patients in 12 countries worldwide were identified through systematic screening of population samples. Telephone and face-to-face interviews were conducted between November 2012 and May 2013 using a structured survey that incorporated validated patient-reported outcome instruments. Eligible patients were adults aged 40 years and older who were taking regular respiratory medications or suffered with chronic respiratory symptoms and reported either 1) a physician diagnosis of COPD/emphysema, 2) a physician diagnosis of chronic bronchitis, or 3) a symptom-based definition of chronic bronchitis. The burden of COPD was measured with the COPD Assessment Test (CAT) and the modified Medical Research Council (mMRC) Dyspnea Scale. Results Of 106,876 households with at least one person aged ≥40 years, 4,343 respondents fulfilled the case definition of COPD and completed the full survey. COPD prevalence ranged from 7% to 12%, with most countries falling within the range of 7%–9%. In all countries, prevalence increased with age, and in all countries except the US was greater among men (range 6%–14%) than among women (range 5%–11%). A significant disease burden was observed when considering COPD symptoms or health status, and showed wide variations across countries. Prevalence of moderate-to-severe dyspnea (mMRC scale ≥2) ranged from 27% to 61%, and mean CAT score ranged from 16.0 to 24.8, indicating medium-to-high impairment. Conclusion This survey, representing 12 countries, showed similar rates of estimated COPD prevalence across countries that were higher than those reported a decade ago in the original Confronting COPD International Survey. A significant burden of COPD was demonstrated by symptoms and health care-resource use, similar to that reported in the original survey. PMID:24944511

Autistic traits are linked to reduced adaptive coding of face identity and selectively poorer face recognition in men but not women.

PubMed

Rhodes, Gillian; Jeffery, Linda; Taylor, Libby; Ewing, Louise

2013-11-01

Our ability to discriminate and recognize thousands of faces despite their similarity as visual patterns relies on adaptive, norm-based, coding mechanisms that are continuously updated by experience. Reduced adaptive coding of face identity has been proposed as a neurocognitive endophenotype for autism, because it is found in autism and in relatives of individuals with autism. Autistic traits can also extend continuously into the general population, raising the possibility that reduced adaptive coding of face identity may be more generally associated with autistic traits. In the present study, we investigated whether adaptive coding of face identity decreases as autistic traits increase in an undergraduate population. Adaptive coding was measured using face identity aftereffects, and autistic traits were measured using the Autism-Spectrum Quotient (AQ) and its subscales. We also measured face and car recognition ability to determine whether autistic traits are selectively related to face recognition difficulties. We found that men who scored higher on levels of autistic traits related to social interaction had reduced adaptive coding of face identity. This result is consistent with the idea that atypical adaptive face-coding mechanisms are an endophenotype for autism. Autistic traits were also linked with face-selective recognition difficulties in men. However, there were some unexpected sex differences. In women, autistic traits were linked positively, rather than negatively, with adaptive coding of identity, and were unrelated to face-selective recognition difficulties. These sex differences indicate that autistic traits can have different neurocognitive correlates in men and women and raise the intriguing possibility that endophenotypes of autism can differ in males and females. © 2013 Elsevier Ltd. All rights reserved.

Neglected tropical diseases: now more than just 'other diseases'--the post-2015 agenda.

PubMed

Molyneux, David H

2014-09-01

Neglected tropical diseases (NTDs) have become recognised as important health problems facing at least a billion people in the low-income countries and the poorest communities in middle-income countries. WHO plays a leading role in developing strategies to address these diseases, pharmaceutical companies provide drug donations to treat or control the NTDs and many partners from different constituencies have become increasingly committed to their control or elimination. This review looks to the post-2015 agenda and emphasises that despite the progress made over recent years, if the targets established are to be achieved, then not only will additional financial resources be required to up-scale treatments and increase access, but increased applied and operational research will be necessary to address problems and human capacity in NTD skills will need to be strengthened. Continuing advocacy for the relevance of control or elimination of NTDs must be placed in the context of universal health coverage and access to donated essential medicines for the poor as a right. The evidence that investment in NTD interventions are cost-effective and impact not only on health, but also to enhance socio-economic development, must be refined and promulgated. The global burden of disease attributable to NTDs requires reassessment to appropriately define the true burden, while the potential for unexpected events, political, climatic, environmental as well as biological, have the potential to reduce future progress towards the agreed post-2015 targets. NTD progress towards the WHO Roadmap targets and the fulfilment of the World Health Assembly Resolution 66.12 of 2013 demand continued commitment from all partner constituencies when challenges emerge. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Accustomed to Her Face

NASA Image and Video Library

2007-06-26

After nearly three years at Saturn, the Cassini spacecraft continues to observe the planet retinue of icy moons. Rhea cratered face attests to its great age, while its bright wisps hint at tectonic activity in the past

29 CFR 1917.91 - Eye and face protection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) MARINE TERMINALS Personal Protection § 1917.91 Eye and face protection. (a)(1)(i) The employer... requirements covering eye protection against radiant energy, see § 1917.152(h). (b) Eye protection equipment...

29 CFR 1917.91 - Eye and face protection.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) MARINE TERMINALS Personal Protection § 1917.91 Eye and face protection. (a)(1)(i) The employer... requirements covering eye protection against radiant energy, see § 1917.152(h). (b) Eye protection equipment...

29 CFR 1917.91 - Eye and face protection.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) MARINE TERMINALS Personal Protection § 1917.91 Eye and face protection. (a)(1)(i) The employer... requirements covering eye protection against radiant energy, see § 1917.152(h). (b) Eye protection equipment...

Meaning of living with severe chronic obstructive lung disease: a qualitative study.

PubMed

Marx, Gabriella; Nasse, Maximilian; Stanze, Henrikje; Boakye, Sonja Owusu; Nauck, Friedemann; Schneider, Nils

2016-12-08

To explore what it means for patients to live with chronic obstructive pulmonary disease (COPD) as an incurable and constantly progressing disease. Qualitative longitudinal study using narrative and semistructured interviews. This paper presents findings of the initial interviews. Analysis using grounded theory. Lung care clinics and community care in Lower Saxony, Germany. 17 patients with advanced-stage COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) III/IV). Analysis shows that these patients have difficulties accepting their life situation and feel at the mercy of the disease, which could be identified as a core-experienced phenomenon. Over a long period of time, patients have only a vague feeling of being ill, caused by uncertain knowledge, slow progress and doubtful attribution of clinical symptoms of the disease (causal conditions). As an action strategy, patients try to maintain daily routines for as long as possible after diagnosis. Both effective standard and rescue medication, which helps to reduce breathlessness and other symptoms, and the feeling of being faced with one's own responsibility (intervening conditions) support this strategy, whereby patients' own responsibility is too painful to acknowledge. As a consequence, patients try to deny the threat to life for a long period of time. Frequently, they need to experience facing their own limits, often in the form of an acute crisis, to realise their health situation. The experience of the illness is contextualised by a continuous increase in limited mobility and social isolation. In order to help patients to improve disease awareness, to accept their life situation and to improve their reduced quality of life, patients may benefit from the early integration of palliative care (PC), considering its multiprofessional patient-centred and team-centred approach. Psychological support and volunteer work, which are relevant aspects of PC, should be appropriate to address psychosocial needs. More research is needed to evaluate how patients could benefit from early PC. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Antecedences to Continued Intentions of Adopting E-Learning System in Blended Learning Instruction: A Contingency Framework Based on Models of Information System Success and Task-Technology Fit

ERIC Educational Resources Information Center

Lin, Wen-Shan; Wang, Chun-Hsien

2012-01-01

The objective of this study is to propose a research framework that investigates the relation between perceived fit and system factors that can motivate learners in continuing utilizing an e-learning system in blended learning instruction. As learners have the face-to-face learning opportunity in interacting with lecturers, the study aims at…

A survey of Alberta physicians' use of and attitudes toward face masks and face shields in the operating room setting.

PubMed

Davis, Philip J; Spady, Donald; Forgie, Sarah E D

2007-09-01

There is little evidence that surgical mask use by physicians in the operating room (OR) reduces surgical site infections (SSIs), but masks do protect the wearer from potentially infectious splashes. Face shields offer even more protection because they cover the eyes, but they may be perceived as offering less protection to the patient than do masks. The objectives of this study were to ascertain if there were predictors to determine which OR physicians are continuing to use masks and what their reasons are for doing so, and which OR physicians would accept face shields and their reasons for doing so. We surveyed the province of Alberta's surgeons, general practice (GP) surgeons, anesthesiologists, and GP anesthetists to determine how many physicians in the OR wear surgical masks, their reasons for wearing surgical masks (ethical, legal, protection of the patient, protection of the wearer), and if they believe that face shields offer more protection to the patient or to the wearer. We also sought to examine which demographic factors affected their responses. The data were examined with chi(2) analysis to assess the relationships of age and practitioner type, and for various outcome variables. A significance level of P < .05 was accepted as statistically significant. The sex of the physician did not affect his/her responses. Older physicians believe that the OR team has an ethical and legal responsibility to wear surgical masks; masks are worn to prevent the spread of disease, not because it is tradition to do so; masks protect the wearer more than do face shields; and wearing face shields alone will subject the patient to higher rates of SSIs. Surgeons are more likely than are anesthesiologists to wear surgical masks in the OR and wear a surgical mask and a face shield if the patient has risk factors for a blood borne infection. According to our survey, age and profession were the most important variables that affected the potential use of surgical masks and face shields. Younger OR physicians likely would be amenable to using face shields in addition to masks in the OR to protect themselves from exposure to blood or bodily fluids.

Blood banking in China.

PubMed

Shan, Hua; Wang, Jing-Xing; Ren, Fu-Rong; Zhang, Yuan-Zhi; Zhao, Hai-Yan; Gao, Guo-Jing; Ji, Yang; Ness, Paul M

2002-11-30

While transfusion-transmissible diseases, including AIDS and viral hepatitis, continue to spread especially in developing countries, the issue of safeguarding the world's blood supply is of paramount importance. China houses more than 20% of the earth's population, and thus its blood supply has the potential to affect the global community. In recent years, Chinese blood centres have tried to improve the nation's blood safety. Although substantial progress has already been made, many daunting difficulties remain. Traditional cultural barriers need to be overcome to successfully mobilise volunteer blood donors. Gaps in information and technology still need to be closed. Insufficiency of economic resources also restrict the blood bank industry. Other developing countries face many of the same challenges as China.

Women & Housing: A Report on Sex Discrimination in Five American Cities.

ERIC Educational Resources Information Center

National Council of Negro Women, New York, NY.

Public hearings and workshops were held in five metropolitan areas to gather data about the problems women in American cities face when they try to acquire and maintain a place to live. The chief findings were: (1) women have faced and continue to face discrimination in marketing, lending, and shelter-related services; (2) discrimination against…

Cognitive Behavioural Therapy: From Face to Face Interaction to a Broader Contextual Understanding of Change

ERIC Educational Resources Information Center

Jahoda, A.; Dagnan, D.; Kroese, B. Stenfert; Pert, C.; Trower, P.

2009-01-01

Cognitive behavioural therapy (CBT) is increasingly used to address the emotional and interpersonal problems of people with ID. There is a limited but promising evidence base supporting this activity. However, these individuals face real and continuing challenges in their lives that have implications for their self and interpersonal perceptions.…

The role of apoptosis in respiratory diseases.

PubMed

Pierce, Janet D; Pierce, Jana; Stremming, Stephanie; Fakhari, Mahtab; Clancy, Richard L

2007-01-01

The purpose of this article is to define apoptosis and describe how this cellular pathway is relevant to the pathogenesis of different respiratory diseases. This will assist clinical nurse specialists in understanding how new drugs and therapies inhibit and stimulate apoptotic pathways. Clinical nurse specialists need to expand their knowledge concerning the role of apoptosis so that they can better expand their spheres of influence. The 4 stages of apoptosis are discussed, as well as the various apoptotic pathways involved with asthma, emphysema, and acute respiratory distress syndrome that promote and inhibit apoptosis in patients. It is crucial for clinical nurse specialists to know what apoptosis is and how it relates to different pathophysiologic states. The challenge facing clinical nurse specialists is how to be kept informed and current concerning molecular and cellular mechanisms that are important in the practice setting. Strategies needed to maintain expertise include acquiring new knowledge, developing new skills, and changing attitudes about molecular biology. Apoptosis must become a significant part of any health professionals' continuing educational program because it has been recognized as the pathway to most any disease. Clinical nurse specialists who understand apoptosis and its pathways can use this knowledge to aid in the prevention and treatment of respiratory diseases.

Spaced Retrieval Enhances Memory for a Name-Face-Occupation Association in Older Adults with Probable Alzheimer's Disease

ERIC Educational Resources Information Center

Cherry, Katie E.; Walvoord, Ashley A. G.; Hawley, Karri S.

2010-01-01

The authors trained 4 older adults with probable Alzheimer's disease to recall a name-face-occupation association using the spaced retrieval technique. Six training sessions were administered over a 2-week period. On each trial, participants selected a target photograph and stated the target name and occupation at increasingly longer retention…

Preventive chemotherapy as a strategy for elimination of neglected tropical parasitic diseases: endgame challenges.

PubMed

Bockarie, Moses J; Kelly-Hope, Louise A; Rebollo, Maria; Molyneux, David H

2013-08-05

Global efforts to address neglected tropical diseases (NTDs) were stimulated in January 2012 by the London declaration at which 22 partners, including the Bill & Melinda Gates Foundation, World Bank, World Health Organization (WHO) and major pharmaceutical companies committed to sustaining and expanding NTD programmes to eliminate or eradicate 11 NTDs by 2020 to achieve the goals outlined in the recently published WHO road map. Here, we present the current context of preventive chemotherapy for some NTDs, and discuss the problems faced by programmes as they consider the 'endgame', such as difficulties of access to populations in post-conflict settings, limited human and financial resources, and the need to expand access to clean water and improved sanitation for schistosomiasis and soil-transmitted helminthiasis. In the case of onchocerciasis and lymphatic filariasis, ivermectin treatment carries a significant risk owing to serious adverse effects in some patients co-infected with the tropical eye worm Loa loa filariasis. We discuss the challenges of managing complex partnerships, and maintain advocacy messages for the continued support for elimination of these preventable diseases.

Preventive chemotherapy as a strategy for elimination of neglected tropical parasitic diseases: endgame challenges

PubMed Central

Bockarie, Moses J.; Kelly-Hope, Louise A.; Rebollo, Maria; Molyneux, David H.

2013-01-01

Global efforts to address neglected tropical diseases (NTDs) were stimulated in January 2012 by the London declaration at which 22 partners, including the Bill & Melinda Gates Foundation, World Bank, World Health Organization (WHO) and major pharmaceutical companies committed to sustaining and expanding NTD programmes to eliminate or eradicate 11 NTDs by 2020 to achieve the goals outlined in the recently published WHO road map. Here, we present the current context of preventive chemotherapy for some NTDs, and discuss the problems faced by programmes as they consider the ‘endgame’, such as difficulties of access to populations in post-conflict settings, limited human and financial resources, and the need to expand access to clean water and improved sanitation for schistosomiasis and soil-transmitted helminthiasis. In the case of onchocerciasis and lymphatic filariasis, ivermectin treatment carries a significant risk owing to serious adverse effects in some patients co-infected with the tropical eye worm Loa loa filariasis. We discuss the challenges of managing complex partnerships, and maintain advocacy messages for the continued support for elimination of these preventable diseases. PMID:23798692

Business continuity management in emerging markets: the case of Jordan.

PubMed

Sawalha, Ihab H; Anchor, John R

2012-01-01

Despite their considerable growth in last few decades, emerging markets (EM) face numerous risks that have the potential to slow down or obstruct their development. Three main issues are discussed in this paper: first, the risks facing organisations operating in emerging markets and Jordan in particular; secondly, the role of business continuity management (BCM) in emerging markets; and thirdly, potential factors that underpin the role of BCM in emerging markets. These issues are significant, as they represent the role of BCM in highly dynamic and fast changing business environments. The paper provides a discussion of the significance of BCM in reducing or preventing risks facing organisations operating in emerging markets, especially those in Jordan.

Conscious awareness is required for holistic face processing

PubMed Central

Axelrod, Vadim; Rees, Geraint

2014-01-01

Investigating the limits of unconscious processing is essential to understand the function of consciousness. Here, we explored whether holistic face processing, a mechanism believed to be important for face processing in general, can be accomplished unconsciously. Using a novel “eyes-face” stimulus we tested whether discrimination of pairs of eyes was influenced by the surrounding face context. While the eyes were fully visible, the faces that provided context could be rendered invisible through continuous flash suppression. Two experiments with three different sets of face stimuli and a subliminal learning procedure converged to show that invisible faces did not influence perception of visible eyes. In contrast, surrounding faces, when they were clearly visible, strongly influenced perception of the eyes. Thus, we conclude that conscious awareness might be a prerequisite for holistic face processing. PMID:24950500

The Social Construction of Inflammatory Bowel Disease Using Social Media Technologies.

PubMed

Frohlich, Dennis Owen

2016-11-01

Many people with inflammatory bowel disease (IBD), sometimes lacking adequate face-to-face sources of support, turn to online communities to meet others with the disease. These online communities are places of support and education, but through the use of social media communication technologies, people with IBD are redefining what it means to live with the disease. This ethnographic study followed 14 online communities to understand how people with IBD used social media technologies to construct their own meanings about living with the disease. The following redefinitions were observed: the refiguring of the body is beautiful; inflammatory bowel disease is serious and deadly; inflammatory bowel disease is humorous; the disease makes one stronger; and the disease is invisible, but needs to be made visible. This study will help health communication scholars understand how technology is appropriated by patients, and will help practitioners understand how their patients conceptualize their disease.

Neonates’ responses to repeated exposure to a still face

PubMed Central

Pilling, Karen; Watt, Rachel; Pal, Attila; Orvos, Hajnalka

2017-01-01

Aim The main aims of the study were to examine whether human neonates’ responses to communication disturbance modelled by the still-face paradigm were stable and whether their responses were affected by their previous experience with the still-face paradigm. Methods The still face procedure, as a laboratory model of interpersonal stress, was administered repeatedly, twice, to 84 neonates (0 to 4 day olds), with a delay of an average of 1.25 day. Results Frame-by-frame analysis of the frequency and duration of gaze, distressed face, crying, sleeping and sucking behaviours showed that the procedure was stressful to them both times, that is, the still face effect was stable after repeated administration and newborns consistently responded to such nonverbal violation of communication. They averted their gaze, showed distress and cried more during the still-face phase in both the first and the second administration. They also showed a carry-over effect in that they continued to avert their gaze and displayed increased distress and crying in the first reunion period, but their gaze behaviour changed with experience, in the second administration. While in the first administration the babies continued averting their gaze even after the stressful still-face phase was over, this carry-over effect disappeared in the second administration, and the babies significantly increased their gaze following the still-face phase. Conclusion After excluding explanations of fatigue, habituation and random effects, a self-other regulatory model is discussed as a possible explanation for this pattern. PMID:28771555

Neonates' responses to repeated exposure to a still face.

PubMed

Nagy, Emese; Pilling, Karen; Watt, Rachel; Pal, Attila; Orvos, Hajnalka

2017-01-01

The main aims of the study were to examine whether human neonates' responses to communication disturbance modelled by the still-face paradigm were stable and whether their responses were affected by their previous experience with the still-face paradigm. The still face procedure, as a laboratory model of interpersonal stress, was administered repeatedly, twice, to 84 neonates (0 to 4 day olds), with a delay of an average of 1.25 day. Frame-by-frame analysis of the frequency and duration of gaze, distressed face, crying, sleeping and sucking behaviours showed that the procedure was stressful to them both times, that is, the still face effect was stable after repeated administration and newborns consistently responded to such nonverbal violation of communication. They averted their gaze, showed distress and cried more during the still-face phase in both the first and the second administration. They also showed a carry-over effect in that they continued to avert their gaze and displayed increased distress and crying in the first reunion period, but their gaze behaviour changed with experience, in the second administration. While in the first administration the babies continued averting their gaze even after the stressful still-face phase was over, this carry-over effect disappeared in the second administration, and the babies significantly increased their gaze following the still-face phase. After excluding explanations of fatigue, habituation and random effects, a self-other regulatory model is discussed as a possible explanation for this pattern.

A systematic literature review of evidence-based clinical practice for rare diseases: what are the perceived and real barriers for improving the evidence and how can they be overcome?

PubMed

Rath, Ana; Salamon, Valérie; Peixoto, Sandra; Hivert, Virginie; Laville, Martine; Segrestin, Berenice; Neugebauer, Edmund A M; Eikermann, Michaela; Bertele, Vittorio; Garattini, Silvio; Wetterslev, Jørn; Banzi, Rita; Jakobsen, Janus C; Djurisic, Snezana; Kubiak, Christine; Demotes-Mainard, Jacques; Gluud, Christian

2017-11-22

Evidence-based clinical practice is challenging in all fields, but poses special barriers in the field of rare diseases. The present paper summarises the main barriers faced by clinical research in rare diseases, and highlights opportunities for improvement. Systematic literature searches without meta-analyses and internal European Clinical Research Infrastructure Network (ECRIN) communications during face-to-face meetings and telephone conferences from 2013 to 2017 within the context of the ECRIN Integrating Activity (ECRIN-IA) project. Barriers specific to rare diseases comprise the difficulty to recruit participants because of rarity, scattering of patients, limited knowledge on natural history of diseases, difficulties to achieve accurate diagnosis and identify patients in health information systems, and difficulties choosing clinically relevant outcomes. Evidence-based clinical practice for rare diseases should start by collecting clinical data in databases and registries; defining measurable patient-centred outcomes; and selecting appropriate study designs adapted to small study populations. Rare diseases constitute one of the most paradigmatic fields in which multi-stakeholder engagement, especially from patients, is needed for success. Clinical research infrastructures and expertise networks offer opportunities for establishing evidence-based clinical practice within rare diseases.

Severe infusion reactions to fabry enzyme replacement therapy: rechallenge after tracheostomy.

PubMed

Nicholls, K; Bleasel, K; Becker, G

2012-01-01

A 34-year-old male patient with Fabry disease (OMIM 301500) commenced enzyme replacement therapy (ERT) with Agalsidase alfa, with positive clinical response. Infusion reactions, initially mild and easily managed, commenced during his 13th infusion, and continued over the next 3 years. Severity of reactions subsequently increased despite very slow infusion, extended prophylactic medication and attempted desensitisation, requiring regular intensive care unit (ICU) admissions. Facial oedema and flushing, throat tightness, headache and joint pain typically occurred 4-36 h after completion of most infusions, responding rapidly to subcutaneous adrenaline. Low titre specific IgG seroconversion was noted at 12 months, with subsequent reversion to negative after 5 years, despite persistence of infusion reactions. Specific IgE and skin testing was negative. Trial of ERT product switch to Agalsidase-beta resulted in no improvement in reactions. At 5 years, ERT was ceased in the face of recurrent ICU readmissions. In the face of progressive clinical deterioration, he underwent tracheostomy to allow recommencement of ERT. Two years later, he has clinically improved on regular attenuated dose Agalsidase-beta, administered by slow infusion in a local hospital setting.

Learning from history, predicting the future: the UK Dutch elm disease outbreak in relation to contemporary tree disease threats

PubMed Central

Potter, Clive; Harwood, Tom; Knight, Jon; Tomlinson, Isobel

2011-01-01

Expanding international trade and increased transportation are heavily implicated in the growing threat posed by invasive pathogens to biodiversity and landscapes. With trees and woodland in the UK now facing threats from a number of disease systems, this paper looks to historical experience with the Dutch elm disease (DED) epidemic of the 1970s to see what can be learned about an outbreak and attempts to prevent, manage and control it. The paper draws on an interdisciplinary investigation into the history, biology and policy of the epidemic. It presents a reconstruction based on a spatial modelling exercise underpinned by archival research and interviews with individuals involved in the attempted management of the epidemic at the time. The paper explores what, if anything, might have been done to contain the outbreak and discusses the wider lessons for plant protection. Reading across to present-day biosecurity concerns, the paper looks at the current outbreak of ramorum blight in the UK and presents an analysis of the unfolding epidemiology and policy of this more recent, and potentially very serious, disease outbreak. The paper concludes by reflecting on the continuing contemporary relevance of the DED experience at an important juncture in the evolution of plant protection policy. PMID:21624917

Climate change and allergic disease.

PubMed

Shea, Katherine M; Truckner, Robert T; Weber, Richard W; Peden, David B

2008-09-01

Climate change is potentially the largest global threat to human health ever encountered. The earth is warming, the warming is accelerating, and human actions are largely responsible. If current emissions and land use trends continue unchecked, the next generations will face more injury, disease, and death related to natural disasters and heat waves, higher rates of climate-related infections, and wide-spread malnutrition, as well as more allergic and air pollution-related morbidity and mortality. This review highlights links between global climate change and anticipated increases in prevalence and severity of asthma and related allergic disease mediated through worsening ambient air pollution and altered local and regional pollen production. The pattern of change will vary regionally depending on latitude, altitude, rainfall and storms, land-use patterns, urbanization, transportation, and energy production. The magnitude of climate change and related increases in allergic disease will be affected by how aggressively greenhouse gas mitigation strategies are pursued, but at best an average warming of 1 to 2 degrees C is certain this century. Thus, anticipation of a higher allergic disease burden will affect clinical practice as well as public health planning. A number of practical primary and secondary prevention strategies are suggested at the end of the review to assist in meeting this unprecedented public health challenge.

eConsultations to Infectious Disease Specialists: Questions Asked and Impact on Primary Care Providers' Behavior.

PubMed

Murthy, Ruchi; Rose, Gregory; Liddy, Clare; Afkham, Amir; Keely, Erin

2017-01-01

Since 2010, the Champlain BASE (Building Access to Specialist Advice through eConsultation) has allowed primary care providers (PCPs) to submit clinical questions to specialists through a secure web service. The study objectives are to describe questions asked to Infectious Diseases specialists through eConsultation and assess impact on physician behaviors. eConsults completed through the Champlain BASE service from April 15, 2013 to January 29, 2015 were characterized by the type of question asked and infectious disease content. Usage data and PCP responses to a closeout survey were analyzed to determine eConsult response time, change in referral plans, and change in planned course of action. Of the 224 infectious diseases eConsults, the most common question types were as follows: interpretation of a clinical test 18.0% (41), general management 16.5 % (37), and indications/goals of treating a particular condition 16.5% (37). The most frequently consulted infectious diseases were as follows: tuberculosis 14.3% (32), Lyme disease 14.3% (32), and parasitology 12.9% (29). Within 24 hours, 63% of cases responded to the questions, and 82% of cases took under 15 minutes to complete. In 32% of cases, a face-to-face referral was originally planned by the PCP but was no longer needed. In 8% of cases, the PCP referred the patient despite originally not planning to make a referral. In 55% of cases, the PCP either received new information or changed their course of action. An eConsult service provides PCPs with timely access to infectious disease specialists' advice that often results in a change in plans for a face-to-face referral. © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Digital Storytelling: Conveying the Essence of a Face-to-Face Lecture in an Online Learning Environment

ERIC Educational Resources Information Center

Baim, Susan A

2015-01-01

As the percentage of university-level courses delivered online continues to increase, instructors who rely on storytelling approaches to convey key concepts in lecture-based coursework will likely face the need to translate their oral storytelling modules into one or more formats that are suitable for use in an online learning environment. While…

Investigation of Effects of Face Rotation on Race Processing: An ERPs Study

ERIC Educational Resources Information Center

Montalan, Benoit; Veujoz, Mathieu; Boitout, Alexis; Leleu, Arnaud; Camus, Odile; Lalonde, Robert; Rebai, Mohamed

2013-01-01

Recent ERP research has indicated that the processing of faces of other races (OR) and same race (SR) as the perceiver differs at the perceptual level, more precisely for the N170 component. The purpose of the present study was to continue the investigation of the race-of-face processing across multiple orientations. Event-related brain potentials…

Famous faces and voices: Differential profiles in early right and left semantic dementia and in Alzheimer's disease.

PubMed

Luzzi, Simona; Baldinelli, Sara; Ranaldi, Valentina; Fabi, Katia; Cafazzo, Viviana; Fringuelli, Fabio; Silvestrini, Mauro; Provinciali, Leandro; Reverberi, Carlo; Gainotti, Guido

2017-01-08

Famous face and voice recognition is reported to be impaired both in semantic dementia (SD) and in Alzheimer's Disease (AD), although more severely in the former. In AD a coexistence of perceptual impairment in face and voice processing has also been reported and this could contribute to the altered performance in complex semantic tasks. On the other hand, in SD both face and voice recognition disorders could be related to the prevalence of atrophy in the right temporal lobe (RTL). The aim of the present study was twofold: (1) to investigate famous faces and voices recognition in SD and AD to verify if the two diseases show a differential pattern of impairment, resulting from disruption of different cognitive mechanisms; (2) to check if face and voice recognition disorders prevail in patients with atrophy mainly affecting the RTL. To avoid the potential influence of primary perceptual problems in face and voice recognition, a pool of patients suffering from early SD and AD were administered a detailed set of tests exploring face and voice perception. Thirteen SD (8 with prevalence of right and 5 with prevalence of left temporal atrophy) and 25 CE patients, who did not show visual and auditory perceptual impairment, were finally selected and were administered an experimental battery exploring famous face and voice recognition and naming. Twelve SD patients underwent cerebral PET imaging and were classified in right and left SD according to the onset modality and to the prevalent decrease in FDG uptake in right or left temporal lobe respectively. Correlation of PET imaging and famous face and voice recognition was performed. Results showed a differential performance profile in the two diseases, because AD patients were significantly impaired in the naming tests, but showed preserved recognition, whereas SD patients were profoundly impaired both in naming and in recognition of famous faces and voices. Furthermore, face and voice recognition disorders prevailed in SD patients with RTL atrophy, who also showed a conceptual impairment on the Pyramids and Palm Trees test more important in the pictorial than in the verbal modality. Finally, in 12SD patients in whom PET was available, a strong correlation between FDG uptake and face-to-name and voice-to-name matching data was found in the right but not in the left temporal lobe. The data support the hypothesis of a different cognitive basis for impairment of face and voice recognition in the two dementias and suggest that the pattern of impairment in SD may be due to a loss of semantic representations, while a defect of semantic control, with impaired naming and preserved recognition might be hypothesized in AD. Furthermore, the correlation between face and voice recognition disorders and RTL damage are consistent with the hypothesis assuming that in the RTL person-specific knowledge may be mainly based upon non-verbal representations. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Blended learning in continuing medical education. Evaluation of an innovative curriculum "bipolar and bipolar spectrum disorders"].

PubMed

Greil, W; von Stralendorff, I; Mandl, H

2011-07-01

In this article a blended learning concept in continuing medical education is evaluated over a broad range of ages, as there is little data on this topic so far. The aims of this study were to document the blended learning concept, to evaluate the subjective gain of knowledge, as well as didactic and virtual means. Finally the actual usage and accreditation are reported. The curriculum referred to the topic of bipolar disorder, combined episodes of face-to-face instruction and individual web-based learning over a period of 3 months. The didactic concept was very well accepted by the participants (N=346) and was evaluated as very user-friendly. The most appreciated dimensions were "subjective gain of knowledge" and "support by media tutor". Nearly 80% participated in both face-to-face as well in both web-based episodes. The component of web-based learning was accredited by the responsible institution (State Medical Association) with increasing number of credits over a period of 3 years. Blended learning is a useful didactic concept in continuing medical education of psychiatrists independent of the age of the participants.

Newborn screening 50 years later: access issues faced by adults with PKU

PubMed Central

Berry, Susan A.; Brown, Christine; Grant, Mitzie; Greene, Carol L.; Jurecki, Elaina; Koch, Jean; Moseley, Kathryn; Suter, Ruth; van Calcar, Sandra C.; Wiles, Judy; Cederbaum, Stephen

2013-01-01

Fifty years after the implementation of universal newborn screening programs for phenylketonuria, the first disease identified through newborn screening and considered a success story of newborn screening, a cohort of adults with phenylketonuria treated from birth provides valuable information about effects of long-term treatment for inborn errors of metabolism in general, and phenylketonuria specifically. For phenylketonuria, newborn screening allows early implementation of the phenylalanine-restricted diet, eliminating the severe neurocognitive and neuromotor impairment associated with untreated phenylketonuria. However, executive function impairments and psychiatric problems are frequently reported even for those treated early and continuously with the phenylalanine-restricted diet alone. Moreover, a large percentage of adults with phenylketonuria are reported as lost to follow-up by metabolic clinics. While a group of experts identified by the National Institutes of Health convenes to update treatment guidelines for phenylketonuria, we explore individual patient, social, and economic factors preventing >70% of adult phenylketonuria patients in the United States from accessing treatment. As more conditions are identified through newborn screening, factors affecting access to treatment grow in importance, and we must continue to be vigilant in assessing and addressing factors that affect patient treatment outcomes and not just celebrate amelioration of the most severe manifestations of disease. Genet Med 2013:15(8):591–599 PMID:23470838

Newborn screening 50 years later: access issues faced by adults with PKU.

PubMed

Berry, Susan A; Brown, Christine; Grant, Mitzie; Greene, Carol L; Jurecki, Elaina; Koch, Jean; Moseley, Kathryn; Suter, Ruth; van Calcar, Sandra C; Wiles, Judy; Cederbaum, Stephen

2013-08-01

Fifty years after the implementation of universal newborn screening programs for phenylketonuria, the first disease identified through newborn screening and considered a success story of newborn screening, a cohort of adults with phenylketonuria treated from birth provides valuable information about effects of long-term treatment for inborn errors of metabolism in general, and phenylketonuria specifically. For phenylketonuria, newborn screening allows early implementation of the phenylalanine-restricted diet, eliminating the severe neurocognitive and neuromotor impairment associated with untreated phenylketonuria. However, executive function impairments and psychiatric problems are frequently reported even for those treated early and continuously with the phenylalanine-restricted diet alone. Moreover, a large percentage of adults with phenylketonuria are reported as lost to follow-up by metabolic clinics. While a group of experts identified by the National Institutes of Health convenes to update treatment guidelines for phenylketonuria, we explore individual patient, social, and economic factors preventing >70% of adult phenylketonuria patients in the United States from accessing treatment. As more conditions are identified through newborn screening, factors affecting access to treatment grow in importance, and we must continue to be vigilant in assessing and addressing factors that affect patient treatment outcomes and not just celebrate amelioration of the most severe manifestations of disease.

Evidence supporting the match/mismatch hypothesis of psychiatric disorders.

PubMed

Santarelli, Sara; Lesuis, Sylvie L; Wang, Xiao-Dong; Wagner, Klaus V; Hartmann, Jakob; Labermaier, Christiana; Scharf, Sebastian H; Müller, Marianne B; Holsboer, Florian; Schmidt, Mathias V

2014-06-01

Chronic stress is one of the predominant environmental risk factors for a number of psychiatric disorders, particularly for major depression. Different hypotheses have been formulated to address the interaction between early and adult chronic stress in psychiatric disease vulnerability. The match/mismatch hypothesis of psychiatric disease states that the early life environment shapes coping strategies in a manner that enables individuals to optimally face similar environments later in life. We tested this hypothesis in female Balb/c mice that underwent either stress or enrichment early in life and were in adulthood further subdivided in single or group housed, in order to provide aversive or positive adult environments, respectively. We studied the effects of the environmental manipulation on anxiety-like, depressive-like and sociability behaviors and gene expression profiles. We show that continuous exposure to adverse environments (matched condition) is not necessarily resulting in an opposite phenotype compared to a continuous supportive environment (matched condition). Rather, animals with mismatched environmental conditions behaved differently from animals with matched environments on anxious, social and depressive like phenotypes. These results further support the match/mismatch hypothesis and illustrate how mild or moderate aversive conditions during development can shape an individual to be optimally adapted to similar conditions later in life. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

Antingens for a Vaccine that Prevents Severe Malaria

DTIC Science & Technology

2009-03-01

SUPPLEMENTARY NOTES 14. ABSTRACT Malaria is the primary infectious disease threat facing the U.S. soldier, and is the leading cause of all...causalities during tropical deployments. The long-term objective of this project is to identify and prepare the malaria parasite forms causing severe...17-50 INTRODUCTION: Malaria is the primary infectious disease threat facing the U.S. solider, and is the leading cause of all

Implementation of medical retina virtual clinics in a tertiary eye care referral centre.

PubMed

Kortuem, Karsten; Fasler, Katrin; Charnley, Amanda; Khambati, Hussain; Fasolo, Sandro; Katz, Menachem; Balaskas, Konstantinos; Rajendram, Ranjan; Hamilton, Robin; Keane, Pearse A; Sim, Dawn A

2018-01-06

The increasing incidence of medical retinal diseases has created capacity issues across UK. In this study, we describe the implementation and outcomes of virtual medical retina clinics (VMRCs) at Moorfields Eye Hospital, South Division, London. It represents a promising solution to ensure that patients are seen and treated in a timely fashion METHODS: First attendances in the VMRC (September 2016-May 2017) were included. It was open to non-urgent external referrals and to existing patients in a face-to-face clinic (F2FC). All patients received visual acuity testing, dilated fundus photography and optical coherence tomography scans. Grading was performed by consultants, fellows and allied healthcare professionals. Outcomes of these virtual consultations and reasons for F2FC referrals were assessed. A total number of 1729 patients were included (1543 were internal and 186 external referrals). The majority were diagnosed with diabetic retinopathy (75.1% of internal and 46.8% of external referrals). Of the internal referrals, 14.6% were discharged, 54.5% continued in VMRC and 30.9% were brought to a F2FC. Of the external referrals, 45.5% were discharged, 37.1% continued in VMRC and 17.4% were brought to a F2FC. The main reason for F2FC referrals was image quality (34.7%), followed by detection of potentially treatable disease (20.2%). VMRC can be implemented successfully using existing resources within a hospital eye service. It may also serve as a first-line rapid-access clinic for low-risk referrals. This would enable medical retinal services to cope with increasing demand and efficiently allocate resources to those who require treatment. © 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.

Multidimensional severity assessment in bronchiectasis: an analysis of seven European cohorts

PubMed Central

McDonnell, M J; Aliberti, S; Goeminne, P C; Dimakou, K; Zucchetti, S C; Davidson, J; Ward, C; Laffey, J G; Finch, S; Pesci, A; Dupont, L J; Fardon, T C; Skrbic, D; Obradovic, D; Cowman, S; Loebinger, M R; Rutherford, R M; De Soyza, A; Chalmers, J D

2016-01-01

Introduction Bronchiectasis is a multidimensional disease associated with substantial morbidity and mortality. Two disease-specific clinical prediction tools have been developed, the Bronchiectasis Severity Index (BSI) and the FACED score, both of which stratify patients into severity risk categories to predict the probability of mortality. Methods We aimed to compare the predictive utility of BSI and FACED in assessing clinically relevant disease outcomes across seven European cohorts independent of their original validation studies. Results The combined cohorts totalled 1612. Pooled analysis showed that both scores had a good discriminatory predictive value for mortality (pooled area under the curve (AUC) 0.76, 95% CI 0.74 to 0.78 for both scores) with the BSI demonstrating a higher sensitivity (65% vs 28%) but lower specificity (70% vs 93%) compared with the FACED score. Calibration analysis suggested that the BSI performed consistently well across all cohorts, while FACED consistently overestimated mortality in ‘severe’ patients (pooled OR 0.33 (0.23 to 0.48), p<0.0001). The BSI accurately predicted hospitalisations (pooled AUC 0.82, 95% CI 0.78 to 0.84), exacerbations, quality of life (QoL) and respiratory symptoms across all risk categories. FACED had poor discrimination for hospital admissions (pooled AUC 0.65, 95% CI 0.63 to 0.67) with low sensitivity at 16% and did not consistently predict future risk of exacerbations, QoL or respiratory symptoms. No association was observed with FACED and 6 min walk distance (6MWD) or lung function decline. Conclusion The BSI accurately predicts mortality, hospital admissions, exacerbations, QoL, respiratory symptoms, 6MWD and lung function decline in bronchiectasis, providing a clinically relevant evaluation of disease severity. PMID:27516225

Performance and accountability : challenges facing the Department of Transportation

DOT National Transportation Integrated Search

2001-02-14

For surface transportation safety, DOT continues to face challenges in improving the safety of highways and pipelines. While the Department of Transportation appears to be making progress on some initiatives to reduce the number of large truck crashe...

Space-time models for a panzootic in bats, with a focus on the endangered Indiana bat

USGS Publications Warehouse

Thogmartin, Wayne E.; King, R. Andrew; Szymanski, Jennifer A.; Pruitt, Lori

2012-01-01

Knowledge of current trends of quickly spreading infectious wildlife diseases is vital to efficient and effective management. We developed space-time mixed-effects logistic regressions to characterize a disease, white-nose syndrome (WNS), quickly spreading among endangered Indiana bats (Myotis sodalis) in eastern North America. Our goal was to calculate and map the risk probability faced by uninfected colonies of hibernating Indiana bats. Model covariates included annual distance from and direction to nearest sources of infection, geolocational information, size of the Indiana bat populations within each wintering population, and total annual size of populations known or suspected to be affected by WNS. We considered temporal, spatial, and spatiotemporal formulae through the use of random effects for year, complex (a collection of interacting hibernacula), and yearxcomplex. Since first documented in 2006, WNS has spread across much of the range of the Indiana bat. No sizeable wintering population now occurs outside of the migrational distance of an infected source. Annual rates of newly affected wintering Indiana bat populations between winter 2007 to 2008 and 2010 to 2011 were 4, 6, 8, and 12%; this rate increased each year at a rate of 3%. If this increasing rate of newly affected populations continues, all wintering populations may be affected by 2016. Our models indicated the probability of a wintering population exhibiting infection was a linear function of proximity to affected Indiana bat populations and size of the at-risk population. Geographic location was also important, suggesting broad-scale influences. For every 50-km increase in distance from a WNS-affected population, risk of disease declined by 6% (95% CI=5.2-5.7%); for every increase of 1,000 Indiana bats, there was an 8% (95% CI = 1-21%) increase in disease risk. The increasing rate of infection seems to be associated with the movement of this disease into the core of the Indiana bat range. Our spatially explicit estimates of disease risk may aid managers in prioritizing surveillance and management for wintering populations of Indiana bats and help understand the risk faced by other hibernating bat species.

Conscious awareness is required for holistic face processing.

PubMed

Axelrod, Vadim; Rees, Geraint

2014-07-01

Investigating the limits of unconscious processing is essential to understand the function of consciousness. Here, we explored whether holistic face processing, a mechanism believed to be important for face processing in general, can be accomplished unconsciously. Using a novel "eyes-face" stimulus we tested whether discrimination of pairs of eyes was influenced by the surrounding face context. While the eyes were fully visible, the faces that provided context could be rendered invisible through continuous flash suppression. Two experiments with three different sets of face stimuli and a subliminal learning procedure converged to show that invisible faces did not influence perception of visible eyes. In contrast, surrounding faces, when they were clearly visible, strongly influenced perception of the eyes. Thus, we conclude that conscious awareness might be a prerequisite for holistic face processing. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Local Food Policies Can Help Promote Local Foods and Improve Health: A Case Study from the Federated States of Micronesia

PubMed Central

Lorens, Adelino; Pretrick, Moses; Tara, Mona J; Johnson, Emihner

2011-01-01

The Federated States of Micronesia (FSM) and other countries throughout the Pacific are facing an epidemic of non-communicable disease health problems. These are directly related to the increased consumption of unhealthy imported processed foods, the neglect of traditional food systems, and lifestyle changes, including decreased physical activity. The FSM faces the double burden of malnutrition with both non-communicable diseases and micronutrient deficiencies, including vitamin A deficiency and anemia. To help increase the use of traditional island foods and improve health, the Island Food Community of Pohnpei has initiated a program in the FSM to support and promote local food policies, along with its Go Local awareness campaign. Such local food policies are defined broadly and include individual and family commitments, community group local food policies and policies established by government, including presidential proclamations and increased taxation on soft drinks. The aim of this paper is to describe this work. An inter-agency, community- and research-based, participatory and media approach was used. Partners are both non-governmental and governmental. The use of continuing awareness work along with local food policy establishment and the acknowledgement of the individuals and groups involved are essential. The work is still in the preliminary stage but ad hoc examples show that this approach has had success in increased awareness on health issues and improving dietary intake on both an individual and group basis. This indicates that further use of local food policies could have an instrumental impact in FSM as well as other Pacific Island countries in promoting local foods and improving dietary intake and health, including the control of non-communicable diseases and other dietary-related health problems. PMID:22235156

Local food policies can help promote local foods and improve health: a case study from the Federated States of Micronesia.

PubMed

Englberger, Lois; Lorens, Adelino; Pretrick, Moses; Tara, Mona J; Johnson, Emihner

2011-11-01

The Federated States of Micronesia (FSM) and other countries throughout the Pacific are facing an epidemic of non-communicable disease health problems. These are directly related to the increased consumption of unhealthy imported processed foods, the neglect of traditional food systems, and lifestyle changes, including decreased physical activity. The FSM faces the double burden of malnutrition with both non-communicable diseases and micronutrient deficiencies, including vitamin A deficiency and anemia. To help increase the use of traditional island foods and improve health, the Island Food Community of Pohnpei has initiated a program in the FSM to support and promote local food policies, along with its Go Local awareness campaign. Such local food policies are defined broadly and include individual and family commitments, community group local food policies and policies established by government, including presidential proclamations and increased taxation on soft drinks. The aim of this paper is to describe this work. An inter-agency, community- and research-based, participatory and media approach was used. Partners are both non-governmental and governmental. The use of continuing awareness work along with local food policy establishment and the acknowledgement of the individuals and groups involved are essential. The work is still in the preliminary stage but ad hoc examples show that this approach has had success in increased awareness on health issues and improving dietary intake on both an individual and group basis. This indicates that further use of local food policies could have an instrumental impact in FSM as well as other Pacific Island countries in promoting local foods and improving dietary intake and health, including the control of non-communicable diseases and other dietary-related health problems.

[Implementation and evaluation of a blended learning course on gastroesophageal reflux disease for physicians in Latin America].

PubMed

Cohen, Henry; Margolis, Alvaro; González, Nicolás; Martínez, Elisa; Sanguinetti, Alberto; García, Sofía; López, Antonio

2014-01-01

Integrating evidence-based clinical practice guidelines on gastroesophageal reflux disease into medical practice is of prime importance in Latin America, given its high prevalence in this region. The aim of this project was to implement and assess an educational intervention on gastroesophageal reflux disease, aimed at primary care physicians in Latin America, with contents based on current clinical guidelines. The course included initial activities, whether face-to-face or through distance learning, and a 2-month period of Internet study and interaction. A pilot test was carried out in Uruguay, which was then repeated in 5 countries (Mexico, Colombia, Venezuela, Argentina and again in Uruguay). A global template was designed, which was then adapted to each of the countries: this was done with the participation of local institutions and leaders. Local credits were given for recertification. Participation was free. Of 3,110 physicians invited to participate, 1,143 (36.8%) started the course. Of these, 587 (51.4%) accessed at least half the contents of the course and 785 (68.7%) took part in the clinical discussions. A total of 338 (29.6%) completed all the requirements of the course and received a certificate. Among physicians who took both the pre- and post-intervention knowledge tests, scores improved from 60 to 80% (P<.001). Ninety-two percent of planned changes in clinical practice were related to the pedagogic aims of the course. In conclusion, a multifaceted, 2-phase continuing education course was successfully imparted in Latin America, with an overall design that was adapted to each country. Determination of specific needs and the participation of national experts were fundamental to the success of the course. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

iConnect CKD - Virtual Medical Consulting: a web-based Chronic Kidney Disease, Hypertension and Diabetes Integrated Care Program.

PubMed

Katz, Ivor J; Pirabhahar, Saiyini; Williamson, Paula; Raghunath, Vishwas; Brennan, Frank; O'Sullivan, Anthony; Youssef, George; Lane, Cathie; Jacobson, Gary; Feldman, Peter; Kelly, John

2017-05-04

Chronic kidney disease (CKD) patients overwhelm specialist services and can potentially be managed in the primary care (PC). Opportunistic screening of high risk (HR) patients and follow-up in PC is the most sustainable model of care. A 'virtual consultation' (VC) model instead of traditional face to face (F2F) consultations was used, aiming to assess efficacy and safety of the model. Seventy patients were recruited from PC sites and hospital clinics, and followed for one year. The HR patients (eGFR < 30 ml/min/1.73 m 2 +/- albuminuria >30 mg/mmol/L) were randomised to either VC or F2F. Patients were monitored 6 monthly by a Clinical Nurse Specialist (CNS). The specialist team provided virtual or clinical support and included a Nephrologist, Endocrinologist, Cardiologist and Renal 'Palliative' Supportive Care. Sixty one (87%) patients were virtually tracked or consulted with 14 (23%) being HR. At 12 months there was no difference in outcomes between VC and F2F patients. All patients were successfully monitored. GPs reported high level of satisfaction and supported the model, but found software integration challenging. Patients found the system attractive and felt well managed. Specialist consults occurred within a week and if a second specialist opinion was required it took another two weeks. The program demonstrated safe, expedited and efficient follow up with a clinical and web based program. Support from the GPs and patients was encouraging, despite logistical issues. Ongoing evaluation of VC services will continue and feasibility to larger networks and more chronic diseases remains the long term goal. This article is protected by copyright. All rights reserved.

Supportive care needs in Hong Kong Chinese women confronting advanced breast cancer.

PubMed

Au, Angel; Lam, Wendy; Tsang, Janice; Yau, Tsz-kok; Soong, Inda; Yeo, Winnie; Suen, Joyce; Ho, Wing M; Wong, Ka-yan; Kwong, Ava; Suen, Dacita; Sze, Wing-Kin; Ng, Alice; Girgis, Afaf; Fielding, Richard

2013-05-01

Women with advanced breast cancer (ABC) are living longer, so understanding their needs becomes important. This cross-sectional study investigated the type and extent of unmet supportive care needs in Hong Kong Chinese women with advanced breast cancer. Face-to-face interviews were conducted among women with stage III or stage IV disease mostly awaiting chemotherapy (76%) to identify unmet needs using the Supportive Care Needs Survey Short Form, psychological morbidity using the Hospital Anxiety and Depression Scale, symptom distress using the Memorial Symptom Assessment Scale, and satisfaction with care using the Patient satisfaction questionnaire (PSQ-9). About 27-72% of 198/220 (90%) women (mean age = 53.4 ± 9.74 (standard deviation) years) identified needs from the health system, information, and patient support (HSIPS) domain as the top 15 most prevalent unmet needs. 'having one member of hospital staff with whom you can talk to about all aspect of your condition, treatment, and follow-up' was most cited by 72% of the patients, with remaining unmet needs addressing mostly desire for information. Unmet need strength did not differ between women with stage III and stage IV disease, whereas women with first time diagnosis reported greater health system and information unmet needs compared with women with recurrent disease. Stepwise multiple regression analyses revealed that symptom distress was consistently positively associated with all but sexuality need domains, whereas low satisfaction with care was associated with HSIPS (β = 3.270, p < 0.001) and physical and daily living (β = 2.810, p < 0.01) domains. Chinese women with ABC expressed need for continuity of care and improved information provision. High symptom distress was associated with lower levels of satisfaction with care. These unmet needs appear to reflect current care services shortcomings. Copyright © 2012 John Wiley & Sons, Ltd.

ESPEN guidelines on definitions and terminology of clinical nutrition.

PubMed

Cederholm, T; Barazzoni, R; Austin, P; Ballmer, P; Biolo, G; Bischoff, S C; Compher, C; Correia, I; Higashiguchi, T; Holst, M; Jensen, G L; Malone, A; Muscaritoli, M; Nyulasi, I; Pirlich, M; Rothenberg, E; Schindler, K; Schneider, S M; de van der Schueren, M A E; Sieber, C; Valentini, L; Yu, J C; Van Gossum, A; Singer, P

2017-02-01

A lack of agreement on definitions and terminology used for nutrition-related concepts and procedures limits the development of clinical nutrition practice and research. This initiative aimed to reach a consensus for terminology for core nutritional concepts and procedures. The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed a consensus group of clinical scientists to perform a modified Delphi process that encompassed e-mail communication, face-to-face meetings, in-group ballots and an electronic ESPEN membership Delphi round. Five key areas related to clinical nutrition were identified: concepts; procedures; organisation; delivery; and products. One core concept of clinical nutrition is malnutrition/undernutrition, which includes disease-related malnutrition (DRM) with (eq. cachexia) and without inflammation, and malnutrition/undernutrition without disease, e.g. hunger-related malnutrition. Over-nutrition (overweight and obesity) is another core concept. Sarcopenia and frailty were agreed to be separate conditions often associated with malnutrition. Examples of nutritional procedures identified include screening for subjects at nutritional risk followed by a complete nutritional assessment. Hospital and care facility catering are the basic organizational forms for providing nutrition. Oral nutritional supplementation is the preferred way of nutrition therapy but if inadequate then other forms of medical nutrition therapy, i.e. enteral tube feeding and parenteral (intravenous) nutrition, becomes the major way of nutrient delivery. An agreement of basic nutritional terminology to be used in clinical practice, research, and the ESPEN guideline developments has been established. This terminology consensus may help to support future global consensus efforts and updates of classification systems such as the International Classification of Disease (ICD). The continuous growth of knowledge in all areas addressed in this statement will provide the foundation for future revisions. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd.. All rights reserved.

The role of animal models in the pharmacological evaluation of emerging anti-inflammatory agents for the treatment of COPD.

PubMed

Fox, J Craig; Fitzgerald, Mary F

2009-06-01

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease that has been relatively under researched compared to other inflammatory diseases. Indeed, thus far there have been no anti-inflammatory therapies specifically approved for COPD and the available anti-inflammatory therapies were originally developed for asthma. The challenges facing research in COPD are multi-faceted; the mechanisms underlying the complex and heterogeneous pathology of this disease require unravelling; the role of inflammation in disease progression needs to be confirmed and new drugs with potential to successfully treat COPD need to be identified. Many of the compounds in the clinic today have been identified through the work performed in a range of animal models of COPD. These models have provided us with an understanding of disease pathology and potential mechanistic pathways and have given us the means to prioritise new chemical entities before entry into the clinic. This review will summarise currently available models of COPD and highlight how they have been used to take a first generation of anti-inflammatory therapies for COPD into clinical development. The predictive nature of these animal models will become clear as these therapies are clinically evaluated. The recurring challenge will be to take emerging pre-clinical and clinical data and use it to continually improve animal models so that they remain a valuable tool in the drug discovery process.

RRR for NNN-a rapid research response for the Neglected Tropical Disease NGDO Network: a novel framework to challenges faced by the global programs targeting neglected tropical diseases.

PubMed

Toledo, Chelsea E; Jacobson, Julie; Wainwright, Emily C; Ottesen, Eric A; Lammie, Patrick J

2016-03-01

While global programs targeting the control or elimination of five of the neglected tropical diseases (NTDs)-lymphatic filariasis, onchocerciasis, soil-transmitted helminthiasis, schistosomiasis and trachoma-are well underway, they still face many operational challenges. Because of the urgency of 2020 program targets, the Bill & Melinda Gates Foundation and the U.S. Agency for International Development devised a novel rapid research response (RRR) framework to engage national programs, researchers, implementers and WHO in a Coalition for Operational Research on NTDs. After 2 years, this effort has succeeded as an important basis for the research response to programmatic challenges facing NTD programs. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Supramolecular networks with electron transfer in two dimensions

DOEpatents

Stupp, Samuel I.; Stoddart, J. Fraser; Shveyd, Alexander K.; Tayi, Alok S.; Sue, Chi-Hau; Narayanan, Ashwin

2016-09-13

Organic charge-transfer (CT) co-crystals in a crossed stack system are disclosed. The co-crystals exhibit bidirectional charge transfer interactions where one donor molecule shares electrons with two different acceptors, one acceptor face-to-face and the other edge-to-face. The assembly and charge transfer interaction results in a pleochroic material whereby the optical absorption continuously changes depending on the polarization angle of incident light.

30 CFR 57.22213 - Air flow (III mines).

Code of Federal Regulations, 2013 CFR

2013-07-01

... nearest the face, shall be at least 6,000 cubic feet per minute, or 9,000 cubic feet per minute in longwall and continuous miner sections. The quantity of air across each face at a work place shall be at...

30 CFR 57.22213 - Air flow (III mines).

Code of Federal Regulations, 2011 CFR

2011-07-01

... nearest the face, shall be at least 6,000 cubic feet per minute, or 9,000 cubic feet per minute in longwall and continuous miner sections. The quantity of air across each face at a work place shall be at...

Learning temporal rules to forecast instability in continuously monitored patients

PubMed Central

Dubrawski, Artur; Wang, Donghan; Hravnak, Marilyn; Clermont, Gilles; Pinsky, Michael R

2017-01-01

Inductive machine learning, and in particular extraction of association rules from data, has been successfully used in multiple application domains, such as market basket analysis, disease prognosis, fraud detection, and protein sequencing. The appeal of rule extraction techniques stems from their ability to handle intricate problems yet produce models based on rules that can be comprehended by humans, and are therefore more transparent. Human comprehension is a factor that may improve adoption and use of data-driven decision support systems clinically via face validity. In this work, we explore whether we can reliably and informatively forecast cardiorespiratory instability (CRI) in step-down unit (SDU) patients utilizing data from continuous monitoring of physiologic vital sign (VS) measurements. We use a temporal association rule extraction technique in conjunction with a rule fusion protocol to learn how to forecast CRI in continuously monitored patients. We detail our approach and present and discuss encouraging empirical results obtained using continuous multivariate VS data from the bedside monitors of 297 SDU patients spanning 29 346 hours (3.35 patient-years) of observation. We present example rules that have been learned from data to illustrate potential benefits of comprehensibility of the extracted models, and we analyze the empirical utility of each VS as a potential leading indicator of an impending CRI event. PMID:27274020

Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program.

PubMed

Milette, Katherine; Thombs, Brett D; Maiorino, Kristina; Nielson, Warren R; Körner, Annett; Peláez, Sandra

2018-05-09

The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to communicate and advocate more effectively. Rehabilitation professionals can support people with scleroderma by providing them with information on connecting with scleroderma patient organizations or by facilitating local patient support networks.

Normal mere exposure effect with impaired recognition in Alzheimer's disease.

PubMed

Willems, Sylvie; Adam, Stéphane; Van der Linden, Martial

2002-02-01

We investigated the mere exposure effect and the explicit memory in Alzheimer's disease (AD) patients and elderly control subjects, using unfamiliar faces. During the exposure phase, the subjects estimated the age of briefly flashed faces. The mere exposure effect was examined by presenting pairs of faces (old and new) and asking participants to select the face they liked. The participants were then presented with a forced-choice explicit recognition task. Controls subjects exhibited above-chance preference and recognition scores for old faces. The AD patients also showed the mere exposure effect but no explicit recognition. These results suggest that the processes involved in the mere exposure effect are preserved in AD patients despite their impaired explicit recognition. The results are discussed in terms of Seamon et al.'s (1995) proposal that processes involved in the mere exposure effect are equivalent to those subserving perceptual priming. These processes would depend on extrastriate areas which are relatively preserved in AD patients.

Spaced-retrieval effects on name-face recognition in older adults with probable Alzheimer's disease.

PubMed

Hawley, Karri S; Cherry, Katie E

2004-03-01

Six older adults with probable Alzheimer's disease (AD) were trained to recall a name-face association using the spaced-retrieval method. We administered six training sessions over a 2-week period. On each trial, participants selected a target photograph and stated the target name, from eight other photographs, at increasingly longer retention intervals. Results yielded a positive effect of spaced-retrieval training for name-face recognition. All participants were able to select the target photograph and state the target's name for longer periods of time within and across training sessions. A live-person transfer task was administered to determine whether the name-face association, trained by spaced-retrieval, would transfer to a live person. Half of the participants were able to call the live person by the correct name. These data provide initial evidence that spaced-retrieval training can aid older adults with probable AD in recall of a name-face association and in transfer of that association to an actual person.

Age-related differences in the quality of life in end-stage renal disease in patients enrolled in hemodialysis or continuous peritoneal dialysis.

PubMed

Laudański, Krzysztof; Nowak, Zbigniew; Niemczyk, Stanisław

2013-05-20

The aim of the present study was to compare the experience elderly and younger patients in terms of emotional status, disease perception, methods of coping with the end-stage renal disease (ESRD) stress, and health-related quality of life in 2 different settings of renal replacement therapy: hemodialysis (HD) and continuous ambulatory peritoneal dialysis programs (CAPD). Specifically, we hypothesized that younger people will more frequently use goal-oriented strategies to cope with illness-related stress and elderly patients will use more strategies related to the control of emotion. A total of 69 HD patients, 40 CAPD patients, and 89 healthy volunteers were analyzed. The Situation and Trait Anxiety Inventory, the Profile of Mood States, the Cognitive Stress Appraisal Questionnaire, and the Nottingham Health Profile were used to assess anxiety, long-term emotional status, coping mechanisms, and health-related quality of life. Data were collected on several biochemical and demographic variables. Our study revealed that younger and elderly people on dialysis faced quite different problems. Younger people in both RRT groups had statistically higher assessment of ESRD as loss or challenge and they more frequently used distractive and emotional preoccupation coping strategies. Depression, confusion, and bewilderment dominate the emotional status of both patient populations, especially in the younger cohort. Both HD(young) and CAPD(young) patients complained more about lack of energy, mobility limitations, and sleep disturbances as compared to their elderly HD and CAPD counterparts. There are different needs and problems in younger and elderly patients on renal replacement therapy. Younger people required more ESRD-oriented support to relieve their health-related complaints to the level observed in their peers and needed extensive psychological assistance in order to cope with negative emotions related to their disease.

What health professionals should know about the health effects of air pollution and climate change on children and pregnant mothers

PubMed Central

Poursafa, Parinaz; Kelishadi, Roya

2011-01-01

BACKGROUND: Health professionals face the adverse health effects of climate change and air pollution in their practices. This review underscores the effects of these environmental factors on maternal and children's health, as the most vulnerable groups to climate change and air pollution. METHODS: We reviewed electronic databases for a search of the literature to find relevant studies published in English from 1990 to 2011. RESULTS: Environmental factors, notably climate change and air pollution influence children's health before conception and continue during pregnancy, childhood, and adolescence. Experts have suggested that such health hazards may represent the greatest public health challenge that humanity has faced. The accumulation of greenhouse gases such as carbon dioxide, primarily from burning fossil fuels, results in warming which has an impact on air pollution particularly on levels of ozone and particulates. Heat-related health effects include increased rates of pregnancy complications, pre-eclampsia, eclampsia, low birth weight, renal effects, vector-borne diseases as malaria and dengue, increased diarrheal and respiratory disease, food insecurity, decreased quality of foods (notably grains), malnutrition, water scarcity, exposures to toxic chemicals, worsened poverty, natural disasters and population displacement. Air pollution has many adverse health effects for mothers and children. In addition to short-term effects like premature labour, intrauterine growth retardation, neonatal and infant mortality rate, malignancies (notably leukaemia and Hodgkin lymphoma), respiratory diseases, allergic disorders and anaemia, exposure to criteria air pollutants from early life might be associated with increase in stress oxidative, inflammation and endothelial dysfunction which in turn might have long-term effects on chronic non-communicable diseases. CONCLUSIONS: Health professionals have an exclusive capability to help prevent and reduce the harmful effects of environmental factors for high-risk groups, and should consider this capacity in their usual practice. PMID:22224116

Serbia: coronary and structural heart interventions from 2010 to 2015.

PubMed

Stojkovic, Sinisa; Milasinovic, Dejan; Bozinovic, Nenad; Davidovic, Aleksandar; Debeljacki, Dragan; Djenic, Nemanja; Hinic, Sasa; Jagic, Nikola; Micic, Olivera; Mitov, Vladimir; Neskovic, Aleksandar N; Nikolic, Milan; Sagic, Dragan; Stankovic, Goran

2017-05-15

Serbia's interventional community has been facing the multifaceted challenge of an ageing population with cardiovascular diseases as the primary cause of death nationwide, coronary artery disease (CAD) being the most prevalent subset. The following two fields of activity have marked the trajectory of progress in the field of interventional cardiology in Serbia: first, the expansion of the infrastructure, mainly through the opening of new catheterisation laboratories across all of the country's administrative regions, which has resulted in better accessibility to coronary interventions for the general population; second, the creation of national platforms for continuous education, training and the promotion of clinical research in interventional cardiology, with close programmatic links to European Association of Percutaneous Cardiovascular Interventions (EAPCI)-based educational initiatives, including the curriculum for interventional cardiology. As growth seems to be inherent to the concept of progress, we report here on the expanding numbers of coronary interventions in the period between January 2010 and December 2015, and the early experiences with structural heart interventions in Serbia.

Assessment of Caregiver Inventory for Rett Syndrome

PubMed Central

Lane, Jane B.; Salter, Amber R.; Jones, Nancy E.; Cutter, Gary; Horrigan, Joseph; Skinner, Steve A.; Kaufmann, Walter E.; Glaze, Daniel G.; Neul, Jeffrey L.; Percy, Alan K.

2017-01-01

Rett syndrome (RTT) requires total caregiver attention and leads to potential difficulties throughout life. The Caregiver Burden Inventory, designed for Alzheimer disease, was modified to a RTT Caregiver Inventory Assessment (RTT CIA). Reliability and face, construct, and concurrent validity were assessed in caregivers of individuals with RTT. Chi-square or Fisher’s exact test for categorical variables and t-tests or Wilcoxon two-sample tests for continuous variables were utilized. Survey completed by 198 caregivers; 70 caregivers completed follow-up assessment. Exploratory factor analysis revealed good agreement for Physical Burden, Emotional Burden, and Social Burden. Internal reliability was high (Cronbach’s alpha: 0.898). RTT CIA represents a reliable and valid measure, providing a needed metric of caregiver burden in this disorder. PMID:28132121

The tobacco-using periodontal patient: The role of the dental practitioner in tobacco cessation and periodontal diseases management

PubMed Central

Chaffee, Benjamin W.; Couch, Elizabeth T.; Ryder, Mark I.

2016-01-01

Although the prevalence of tobacco use has declined in some parts of the world, tobacco use remains a persistent and, in some cases, growing problem that will continue to be a fundamental challenge facing dental practitioners in the decades ahead. The dental practitioner has a unique opportunity and professional obligation to be a positive influence in reducing the economic and social burden inflicted by tobacco use on dental and general health. In this article, the current non-invasive, evidence-based approaches are presented for the dental practitioner to help patients avoid tobacco initiation, to encourage and assist patients’ in tobacco cessation, and to address tobacco-induced damage to periodontal supporting tissues. PMID:27045430

Geospatial technology and the "exposome": new perspectives on addiction.

PubMed

Stahler, Gerald J; Mennis, Jeremy; Baron, David A

2013-08-01

Addiction represents one of the greatest public health problems facing the United States. Advances in addiction research have focused on the neurobiology of this disease. We discuss potential new breakthroughs in understanding the other side of gene-environment interactions-the environmental context or "exposome" of addiction. Such research has recently been made possible by advances in geospatial technologies together with new mobile and sensor computing platforms. These advances have fostered interdisciplinary collaborations focusing on the intersection of environment and behavior in addiction research. Although issues of privacy protection for study participants remain, these advances could potentially improve our understanding of initiation of drug use and relapse and help develop innovative technology-based interventions to improve treatment and continuing care services.

A unified initiative to harness Earth’s microbiomes

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

Alivisatos, A Paul; Blaser, M. J.; Brodie, Eoin L.

2015-10-28

Nearly three billion years ago, photosynthetic cyanobacteria transformed Earth’s atmosphere from oxygen-poor to oxygen-rich, enabling the evolution of complex life (1). Microbes shaped our evolutionary origins and their vast impact continues: they are essential constituents of animals and plants and are the most widespread, abundant, and diverse life forms on our planet. Microbial activities enable life but can also imperil it, through unwelcome effects like greenhouse gas production and disease. With a rapidly growing population, centuries of land use, and a changing climate, our planet faces extraordinary challenges. Given their fundamental roles in agriculture, energy production, and the health ofmore » our oceans, forests, and human population, understanding the collective activities of Earth’s microbes has never been more crucial.« less

Key water issues now facing our nation

USGS Publications Warehouse

Hirsch, Robert M.; Miller, Timothy L.; Hamilton, Pixie A.; Gilliom, Robert J.

2008-01-01

Challenges to sustaining sufficient and high-quality water for human consumption, industry, farms, energy production, and ecosystem services continue to intensify in many parts of the Nation. We face four key water issues that call for support from the science and engineering communities.

Will a category cue attract you? Motor output reveals dynamic competition across person construal.

PubMed

Freeman, Jonathan B; Ambady, Nalini; Rule, Nicholas O; Johnson, Kerri L

2008-11-01

People use social categories to perceive others, extracting category cues to glean membership. Growing evidence for continuous dynamics in real-time cognition suggests, contrary to prevailing social psychological accounts, that person construal may involve dynamic competition between simultaneously active representations. To test this, the authors examined social categorization in real-time by streaming the x, y coordinates of hand movements as participants categorized typical and atypical faces by sex. Though judgments of atypical targets were largely accurate, online motor output exhibited a continuous spatial attraction toward the opposite sex category, indicating dynamic competition between multiple social category alternatives. The authors offer a dynamic continuity account of social categorization and provide converging evidence across categorizations of real male and female faces (containing a typical or an atypical sex-specifying cue) and categorizations of computer-generated male and female faces (with subtly morphed sex-typical or sex-atypical features). In 3 studies, online motor output revealed continuous dynamics underlying person construal, in which multiple simultaneously and partially active category representations gradually cascade into social categorical judgments. Such evidence is challenging for discrete stage-based accounts. (c) 2008 APA, all rights reserved

Wintering area DDE source to migratory white-faced ibis revealed by satellite telemetry and prey sampling.

PubMed

Yates, Michael A; Fuller, Mark R; Henny, Charles J; Seegar, William S; Garcia, Jaqueline

2010-01-01

Locations of contaminant exposure for nesting migratory species are difficult to fully understand because of possible additional sources encountered during migration or on the wintering grounds. A portion of the migratory white-faced ibis (Plegadis chihi) nesting at Carson Lake, Nevada continues to be exposed to dichloro-diphenyldichloro-ethylene (DDE) with no change, which is unusual, observed in egg concentrations between 1985 and 2000. About 45-63% of the earliest nesting segment shows reduced reproductive success correlated with elevated egg concentrations of >4 microg/g wet weight (ww). Local prey (primarily earthworms) near nests contained little DDE so we tracked the migration and wintering movements of 20 adult males during 2000-2004 to determine the possible source. At various wintering sites, we found a correlation (r (2) = 0.518, P = 0.0125, N = 11) between DDE in earthworm composites and DDE in blood plasma of white-faced ibis wintering there, although the plasma was collected on their breeding grounds soon after arrival. The main source of DDE was wintering areas in the Mexicali Valley of Baja California Norte, Mexico, and probably the adjacent Imperial Valley, California, USA. This unusual continuing DDE problem for white-faced ibis is associated with: the long-term persistence in soil of DDE; the earthworms' ability to bioconcentrate DDE from soil; the proclivity of white-faced ibis to feed on earthworms in agricultural fields; the species's extreme sensitivity to DDE in their eggs; and perhaps its life history strategy of being a "capital breeder". We suggest surveying and sampling white-faced ibis eggs at nesting colonies, especially at Carson Lake, to monitor the continuing influence of DDE.

Wintering area DDE source to migratory white-faced ibis revealed by satellite telemetry and prey sampling

USGS Publications Warehouse

Yates, M.A.; Fuller, M.R.; Henny, C.J.; Seegar, W.S.; Garcia, Jorge H.

2010-01-01

Locations of contaminant exposure for nesting migratory species are difficult to fully understand because of possible additional sources encountered during migration or on the wintering grounds. A portion of the migratory white-faced ibis (Plegadis chihi) nesting at Carson Lake, Nevada continues to be exposed to dichloro-diphenyldichloro-ethylene (DDE) with no change, which is unusual, observed in egg concentrations between 1985 and 2000. About 45-63% of the earliest nesting segment shows reduced reproductive success correlated with elevated egg concentrations of >4 ??g/g wet weight (ww). Local prey (primarily earthworms) near nests contained little DDE so we tracked the migration and wintering movements of 20 adult males during 2000-2004 to determine the possible source. At various wintering sites, we found a correlation (r 2 = 0.518, P = 0.0125, N = 11) between DDE in earthworm composites and DDE in blood plasma of white-faced ibis wintering there, although the plasma was collected on their breeding grounds soon after arrival. The main source of DDE was wintering areas in the Mexicali Valley of Baja California Norte, Mexico, and probably the adjacent Imperial Valley, California, USA. This unusual continuing DDE problem for white-faced ibis is associated with: the long-term persistence in soil of DDE; the earthworms' ability to bioconcentrate DDE from soil; the proclivity of white-faced ibis to feed on earthworms in agricultural fields; the species's extreme sensitivity to DDE in their eggs; and perhaps its life history strategy of being a "capital breeder". We suggest surveying and sampling white-faced ibis eggs at nesting colonies, especially at Carson Lake, to monitor the continuing influence of DDE. ?? 2009 Springer Science+Business Media, LLC.

Looking to the future of new media in health marketing: deriving propositions based on traditional theories.

PubMed

Della, Lindsay J; Eroglu, Dogan; Bernhardt, Jay M; Edgerton, Erin; Nall, Janice

2008-01-01

Market trend data show that the media marketplace continues to rapidly evolve. Recent research shows that substantial portions of the U.S. media population are "new media" users. Today, more than ever before, media consumers are exposed to multiple media at the same point in time, encouraged to participate in media content generation, and challenged to learn, access, and use the new media that are continually entering the market. These media trends have strong implications for how consumers of health information access, process, and retain health-related knowledge. In this article we review traditional information processing models and theories of interpersonal and mass media access and consumption. We make several theory-based propositions for how traditional information processing and media consumption concepts will function as new media usage continues to increase. These propositions are supported by new media usage data from the Centers for Disease Control and Prevention's entry into the new media market (e.g., podcasting, virtual events, blogging, and webinars). Based on these propositions, we conclude by presenting both opportunities and challenges that public health communicators and marketers will face in the future.

Age-related differences in brain electrical activity during extended continuous face recognition in younger children, older children and adults.

PubMed

Van Strien, Jan W; Glimmerveen, Johanna C; Franken, Ingmar H A; Martens, Vanessa E G; de Bruin, Eveline A

2011-09-01

To examine the development of recognition memory in primary-school children, 36 healthy younger children (8-9 years old) and 36 healthy older children (11-12 years old) participated in an ERP study with an extended continuous face recognition task (Study 1). Each face of a series of 30 faces was shown randomly six times interspersed with distracter faces. The children were required to make old vs. new decisions. Older children responded faster than younger children, but younger children exhibited a steeper decrease in latencies across the five repetitions. Older children exhibited better accuracy for new faces, but there were no age differences in recognition accuracy for repeated faces. For the N2, N400 and late positive complex (LPC), we analyzed the old/new effects (repetition 1 vs. new presentation) and the extended repetition effects (repetitions 1 through 5). Compared to older children, younger children exhibited larger frontocentral N2 and N400 old/new effects. For extended face repetitions, negativity of the N2 and N400 decreased in a linear fashion in both age groups. For the LPC, an ERP component thought to reflect recollection, no significant old/new or extended repetition effects were found. Employing the same face recognition paradigm in 20 adults (Study 2), we found a significant N400 old/new effect at lateral frontal sites and a significant LPC repetition effect at parietal sites, with LPC amplitudes increasing linearly with the number of repetitions. This study clearly demonstrates differential developmental courses for the N400 and LPC pertaining to recognition memory for faces. It is concluded that face recognition in children is mediated by early and probably more automatic than conscious recognition processes. In adults, the LPC extended repetition effect indicates that adult face recognition memory is related to a conscious and graded recollection process rather than to an automatic recognition process. © 2011 Blackwell Publishing Ltd.

Psychosocial impacts of quarantine during disease outbreaks and interventions that may help to relieve strain.

PubMed

Johal, Sarbjit S

2009-06-05

The threat of outbreak of infectious disease such as non-seasonal influenza A (H1N1), commonly referred to as Swine Flu, can provoke the implementation of public health control measures such as quarantine. This paper summarises the psychosocial consequences that may follow for patients and health care and other front-line workers when using quarantine controls. Those affected by quarantine are likely to report distress due to fear and risk perceptions. This distress can be amplified in the face of unclear information and communication that is common in the initial period of disease outbreaks. This paper outlines recommendations for care of those in quarantine and those working with them, such as helping to identify stressors and normalising their impact as much as possible. This should take place at all levels of response, from public information and communication messages to individual face-to-face advice and support.

What Recent History Has Taught Us About Responding to Emerging Infectious Disease Threats.

PubMed

Paules, Catharine I; Eisinger, Robert W; Marston, Hilary D; Fauci, Anthony S

2017-12-05

Presidential administrations face any number of unexpected crises during their tenure, and global pandemics are among the most challenging. As of January 2017, one of the authors had served under 5 presidents as the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. During each administration, the government faced unexpected pandemics, ranging from the HIV/AIDS pandemic, which began during the Reagan administration, to the recent Zika outbreak in the Americas, which started during the Obama administration. These experiences underscored the need to optimize preparation for and response to these threats whenever and wherever they emerge. This article recounts selected outbreaks occurring during this period and highlights lessons that were learned that can be applied to the infectious disease threats that will inevitably be faced in the current presidential administration and beyond.

School Supplies on a Budget

ERIC Educational Resources Information Center

Dyrli, Kurt O.

2008-01-01

This article reports on the challenge that parents, teachers, and district administrators face in continuing to provide essential school supplies to their students despite budget cuts. At the Verona Area (Wisconsin) School District, administrators, teachers, and parents have recently faced this common challenge. Increasingly dependent on funding…

Coordinated Transformation among Community Colleges Lacking a State System

ERIC Educational Resources Information Center

Russell, James Thad

2016-01-01

Community colleges face many challenges in the face of demands for increased student success. Institutions continually seek scalable interventions and initiatives focused on improving student achievement. Effectively implementing sustainable change that moves the needle of student success remains elusive. Facilitating systemic, scalable change…

The "double panda" sign in Leigh disease.

PubMed

Sonam, Kothari; Bindu, P S; Gayathri, Narayanappa; Khan, Nahid Akhtar; Govindaraju, C; Arvinda, Hanumanthapura R; Nagappa, Madhu; Sinha, Sanjib; Thangaraj, K; Taly, Arun B

2014-07-01

Although the "face of the giant panda" sign on magnetic resonance imaging (MRI) is traditionally considered to be characteristic of Wilson disease, it has also been reported in other metabolic disorders. This study describes the characteristic "giant panda" sign on MRI in a child with Leigh disease. The diagnosis was based on the history of neurological regression; examination findings of oculomotor abnormalities, hypotonia, and dystonia; raised serum lactate levels; and characteristic brain stem and basal ganglia signal changes on MRI. The midbrain and pontine tegmental signal changes were consistent with the "face of the giant panda and her cub" sign. In addition to Wilson disease, metabolic disorders such as Leigh disease should also be considered in the differential diagnosis of this rare imaging finding. © The Author(s) 2013.

Built-up outer wall and roofing sections for double walled envelope homes

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

Brodhead, B.

1980-01-01

A site built system that uses the inner envelope wall is described. Blocking and vertical nailers are attached to this wall and sheathed with foil faced drywall to create the envelope cavity. An outer layer of 3 1/2 in. of Expended Poly Styrene provides continuous solid insulation. The trusses are also sheathed in foil faced drywall and insulated with 5 1/2 in. of E.P.S. This effectively surrounds the building with a continuous vapor and infiltration barrier. Construction details as well as cost breakdowns are presented.

The genome projects: implications for dental practice and education.

PubMed

Wright, J T; Hart, T C

2002-05-01

Information from the Human Genome Project (HGP) and the integration of information from related areas of study and technology will dramatically change health care for the craniofacial complex. Approaches to risk assessment and diagnosis, prevention, early intervention, and management of craniofacial conditions are and will continue to evolve through the application of this new knowledge. While this information will advance our health care abilities, it is clear that the dental profession will face challenges regarding the acquisition, application, transfer, and effective and efficient use of this knowledge with regards to dental research, dental education, and clinical practice. Unraveling the human genomic sequence now allows accurate diagnosis of numerous craniofacial conditions. However, the greatest oral disease burden results from dental caries and periodontal disease that are complex disorders having both hereditary and environmental factors determining disease risk, progression, and course. Disease risk assessment, prevention, and therapy, based on knowledge from the HGP, will likely vary markedly for the different complex conditions affecting the head and neck. Integration of Information from the human genome, comparative and microbial genomics, proteomics, bioinformatics, and related technologies will provide the basis for proactive prevention and intervention and novel and more efficient treatment approaches. Oral health care practitioners will increasingly require knowledge of human genetics and the application of new molecular-based diagnostic and therapeutic technologies.

The Discovery and Development of Drug Combinations for the Treatment of Various Diseases from Patent Literature (1980-Present).

PubMed

Kleczkowska, Patrycja; Kowalczyk, Agnieszka; Lesniak, Anna; Bujalska-Zadrozny, Magdalena

2017-01-01

The search for a miracle drug that would help to alleviate multiple ailments, dates back many thousands of years before our era and continues until today. Various techniques have been used to obtain a formulation, that would give the desired therapeutic effect. The most popular approach includes drug coctails and multicomponent drugs. Polytherapy is widely accapted as an effective tool for the treatment of several diseases, however it is often faced with important drawbacks that may sometimes result in fatal adverse effects associated with unpredictable drug interactions. Conversly, hybrid compounds were found to be an attractive way to counterbalance the unwanted side effects derived from the administration of individual drug components. Futhermore, they can serve as effective and improved remedies for patients suffering from several diseases simultaneously, as different receptorrelated pharmacophores are used as structural components. This review covers patent literature from 1980 till now that highlights the progress that has been made in the discovery of hybrid compounds potentially useful in the treatment on various disorders, including pain states, neurodegenerative or infectious diseases. Additionally, this review was further enriched with findings from original research papers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The polar bear in the room: diseases of poverty in the Arctic.

PubMed

Nelson, Chris

2013-01-01

In the face of global warming, budgetary austerity and impoverished Arctic residents, the nations of the circumpolar region are presented with a number of difficult choices regarding the provision of health care to the far-flung and isolated regions of their northernmost provinces. Complicating that picture is the reality of neglected tropical diseases in areas far from their perceived normal equatorial range as well as endemic food-borne diseases, including protozoan and helminth parasites, respiratory and gastrointestinal diseases and vaccine-preventable illnesses. This paper discusses the problems of caring for the health and well-being of indigenous populations suffering from extreme poverty, isolation and discrimination in the circumpolar region. After presenting difficulties as supported by the extant literature, the paper continues by suggesting solutions that include novel telenursing applications, targeted distance-educational programs and local community-based health care assistant (HCA) vocational training. These programs will provide cost-effective care that increases life-spans, improves quality of life and provides opportunities to distressed populations in isolated rural communities of the Far North. The toolkit presented in the paper is intended to spur discussion on community health programs that could be adopted to provide proper and humane care for marginalized Arctic populations in an extreme and rapidly changing environment.

Perioperative management and complications in patients with obstructive sleep apnea undergoing transsphenoidal surgery: Our institutional experience.

PubMed

Rahimi, Eiman; Mariappan, Ramamani; Tharmaradinam, Suresh; Manninen, Pirjo; Venkatraghavan, Lashmi

2014-07-01

Patients with endocrine diseases such as acromegaly and Cushing's disease have a high prevalence of obstructive sleep apnea (OSA). There is controversy regarding the use of continuous positive airway pressure (CPAP) following transsphenoidal surgery. The aim of this study was to compare the perioperative management and complications, in patients with or without OSA undergoing transsphenoidal surgery. After Research Ethics Board approval, we retrospectively reviewed the charts of all patients who underwent transsphenoidal surgery in our institution from 2006 to 2011. Information collected included patients' demographics, pathology of lesion, history of OSA, anesthetic and perioperative management and incidence of perioperative complications. Patients with sleep study proven OSA were compared with a control group, matched for age, sex and pathology of patients without OSA. Statistical analysis was performed using t-test and Chi-square test and the P < 0.05 was considered to be significant. Out of a total 469 patients undergoing transsphenoidal surgery, 105 patients were found to be at risk for OSA by a positive STOP-BANG scoring assessment. Preoperative sleep study testing was positive for OSA in 38 patients. Post-operative hypoxemia (SpO2 < 90) occurred in 10 (26%) patients with OSA and was treated with high-flow oxygen through face mask (n = 7) and by CPAP mask (n = 3). In the OSA-negative group, 2 patients had hypoxemia and were treated with low-flow oxygen using face mask. There were no differences between the groups with respect to post-operative opioid use, destination, hospital stay or other complications. Post-operative hypoxemia in patients with OSA following transsphenoidal surgery can be treated in most but not all patients with high flow oxygen using the face mask. We were able to safely use CPAP in a very small number of patients but caution is needed to prevent complications. Further prospective studies are needed to determine the safe use of CPAP in patients after transsphenoidal surgery.

Parkinson Patients' Initial Trust in Avatars: Theory and Evidence.

PubMed

Javor, Andrija; Ransmayr, Gerhard; Struhal, Walter; Riedl, René

2016-01-01

Parkinson's disease (PD) is a neurodegenerative disease that affects the motor system and cognitive and behavioral functions. Due to these impairments, PD patients also have problems in using the computer. However, using computers and the Internet could help these patients to overcome social isolation and enhance information search. Specifically, avatars (defined as virtual representations of humans) are increasingly used in online environments to enhance human-computer interaction by simulating face-to-face interaction. Our laboratory experiment investigated how PD patients behave in a trust game played with human and avatar counterparts, and we compared this behavior to the behavior of age, income, education and gender matched healthy controls. The results of our study show that PD patients trust avatar faces significantly more than human faces. Moreover, there was no significant difference between initial trust of PD patients and healthy controls in avatar faces, while PD patients trusted human faces significantly less than healthy controls. Our data suggests that PD patients' interaction with avatars may constitute an effective way of communication in situations in which trust is required (e.g., a physician recommends intake of medication). We discuss the implications of these results for several areas of human-computer interaction and neurological research.

Parkinson Patients’ Initial Trust in Avatars: Theory and Evidence

PubMed Central

Javor, Andrija; Ransmayr, Gerhard; Struhal, Walter; Riedl, René

2016-01-01

Parkinson’s disease (PD) is a neurodegenerative disease that affects the motor system and cognitive and behavioral functions. Due to these impairments, PD patients also have problems in using the computer. However, using computers and the Internet could help these patients to overcome social isolation and enhance information search. Specifically, avatars (defined as virtual representations of humans) are increasingly used in online environments to enhance human-computer interaction by simulating face-to-face interaction. Our laboratory experiment investigated how PD patients behave in a trust game played with human and avatar counterparts, and we compared this behavior to the behavior of age, income, education and gender matched healthy controls. The results of our study show that PD patients trust avatar faces significantly more than human faces. Moreover, there was no significant difference between initial trust of PD patients and healthy controls in avatar faces, while PD patients trusted human faces significantly less than healthy controls. Our data suggests that PD patients’ interaction with avatars may constitute an effective way of communication in situations in which trust is required (e.g., a physician recommends intake of medication). We discuss the implications of these results for several areas of human-computer interaction and neurological research. PMID:27820864

Relationships of job hazards, lack of knowledge, alcohol use, health status and risk taking behavior to work injury of coal miners: a case-control study in India.

PubMed

Kunar, Bijay Mihir; Bhattacherjee, Ashis; Chau, Nearkasen

2008-01-01

Objective is to assess the relationships of job hazards, individual characteristics, and risk taking behavior to occupational injuries of coal miners. This case-control study compared 245 male underground coal miners with injury during the previous two-year period with 330 matched controls without injury during the previous five years. Data were collected via face-to-face interview and analyzed using the conditional logistic model. Handling material, poor environmental/working conditions, and geological/strata control- related hazards were the main risk factors: adjusted ORs 5.15 (95% CI 2.42-10.9), 2.40 (95% CI 1.29-4.47), and 2.25 (95% CI 1.24-4.07) respectively. Their roles were higher among the face-workers than among the non-face-workers. No formal education, alcohol consumption, disease, big-family, and risk-taking behavior were associated with injuries (2.36

30 CFR 75.342 - Methane monitors.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Methane monitors. 75.342 Section 75.342 Mineral... SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.342 Methane monitors. (a)(1) MSHA approved methane monitors shall be installed on all face cutting machines, continuous miners, longwall face...

45 CFR 1638.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Definitions. 1638.2 Section 1638.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION RESTRICTION ON SOLICITATION § 1638.2 Definitions. (a) In-person means a face-to-face encounter or a personal encounter via other...

45 CFR 1638.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Definitions. 1638.2 Section 1638.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION RESTRICTION ON SOLICITATION § 1638.2 Definitions. (a) In-person means a face-to-face encounter or a personal encounter via other...

45 CFR 1638.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Definitions. 1638.2 Section 1638.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION RESTRICTION ON SOLICITATION § 1638.2 Definitions. (a) In-person means a face-to-face encounter or a personal encounter via other...

Understanding and Unlocking the Potential of Online Academic Advising

ERIC Educational Resources Information Center

Flowers, Jefferson Lee

2012-01-01

Student support services, such as academic advising, promote college student retention and increased graduation rates. As educational institutions continue to face budgetary uncertainties, academic advising services are facing cuts that threaten their ability to provide student support. Online solutions are being advanced at many institutions, as…

Exploring Biotechnology Using Case-Based Multimedia

ERIC Educational Resources Information Center

Bergland, Mark; Lundeberg, Mary; Klyczek, Karen; Sweet, Jennifer; Emmons, Jean; Martin, Christine; Marsh, Katherine; Werner, Joy; Jarvis-Uetz, Michelle

2006-01-01

Today, teachers face more challenges than ever, and biology teachers face a special challenge. As technology continues to expand, biology teachers have a responsibility to keep students informed of technological and scientific advances. Biology teachers must also address ethical issues associated with these advances. In this paper, the authors…

30 CFR 75.342 - Methane monitors.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Methane monitors. 75.342 Section 75.342 Mineral... SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.342 Methane monitors. (a)(1) MSHA approved methane monitors shall be installed on all face cutting machines, continuous miners, longwall face...

Hydromechanical Advanced Coal Excavator

NASA Technical Reports Server (NTRS)

Estus, Jay M.; Summers, David

1990-01-01

Water-jet cutting reduces coal dust and its hazards. Advanced mining system utilizes full-face, hydromechanical, continuous miner. Coal excavator uses high-pressure water-jet lances, one in each of cutting heads and one in movable lance, to make cuts across top, bottom and middle height, respectively, of coal face. Wedge-shaped cutting heads advance into lower and upper cuts in turn, thereby breaking coal toward middle cut. Thrust cylinders and walking pads advance excavator toward coal face.

An Architectural Model of Visual Motion Understanding

DTIC Science & Technology

1989-08-01

of the Center for Visual Sciences of the University of Rochester. Their courage in the face of the overwhelming com- plexity of the human visual...analysis should perform better than either approach by itself. Notice that the problems of the two approaches are non-overlapping. Continuous methods face no...success. This is not terribly surprising, as the problem is inherently very difficult. Consider the problems faced by a unit that is trying to compute the

The Impact of Face Skin Tone vs. Face Symmetry on Perceived Facial Attractiveness.

PubMed

Vera Cruz, Germano

2018-01-01

The purpose of this study was to assess and compare the relative contribution of skin tone and symmetry on judgment of attractiveness regarding female faces. Two hundred and fifteen Mozambican adults were presented with a set of faces, and instructed to rate their degree of attractiveness along a continuous scale. Chi-square, factorial weight analyses and ANOVA were used to analyze the data. Face skin tone had a significant impact on the participants' attractiveness judgment of target faces. However, the target face skin tone contribution to the participants' attractiveness judgment (5% of the total variance) was much weaker than the contribution of the target face symmetry (85% of the total variance). These results imply that skin bleaching, common among Black people across sub-Saharan African countries, is not only dangerous to the health of those who practice it, but it is unlikely to make them appear much more attractive.

Limitations to soybean photosynthesis at elevated carbon dioxide in free-air enrichment and open top chamber systems.

PubMed

Bunce, James A

2014-09-01

It has been suggested that the stimulation of soybean photosynthesis by elevated CO2 was less in free-air carbon dioxide enrichment (FACE) systems than in open top chambers (OTC), which might explain smaller yield increases at elevated CO2 in FACE systems. However, this has not been tested using the same cultivars grown in the same location. I tested whether soybean photosynthesis at high light and elevated CO2 (ambient+180 μmol mol(-1)) was limited by electron transport (J) in FACE systems but by ribulose-bisphosphate carboxylation capacity (VCmax) in OTC. FACE systems with daytime and continuous CO2 enrichment were also compared. The results indicated that in both cultivars examined, midday photosynthesis at high light was always limited by VCmax, both in the FACE and in the OTC systems. Daytime only CO2 enrichment did not affect photosynthetic parameters or limitations, but did result in significantly smaller yields in both cultivars than continuous elevation. Photosynthesis measured at low photosynthetic photon flux density (PPFD) was not higher at elevated than at ambient CO2, because of an acclimation to elevated CO2 which was only evident at low measurement PPFDs. Published by Elsevier Ireland Ltd.

Leading Learning: The Role of School Leaders in Supporting Continuous Professional Development

ERIC Educational Resources Information Center

Stevenson, Michael; Hedberg, John G.; O'Sullivan, Kerry-Ann; Howe, Cathie

2016-01-01

In contemporary school settings, leaders seeking to support professional development are faced with many challenges. These challenges call for educators who can undertake professional learning that is continuous and adaptive to change. As a term, continuous professional development (CPD) reflects many different forms of professional development in…

The Strategies for Significant Survival of Postsecondary Centers for Continuing Education.

ERIC Educational Resources Information Center

Caldwell, Phyllis A.

While the financial survival of postsecondary institutions is being stressed, continuing education operarions are facing increasing difficulties in surviving and competing. Strategies are needed for the significant survival of continuing education operations at the small college. The Lifelong Learning Center and others like it need to be concerned…

Economic Burden for Informal Caregivers of Lung and Colorectal Cancer Patients

PubMed Central

Ramsey, Scott D.; Hornbrook, Mark C.; Atienza, Audie A.; van Ryn, Michelle

2010-01-01

Background. Informal care provides many benefits to cancer patients, but can be costly to caregivers. This study quantified the economic burden for informal caregivers of lung cancer (LC) and colorectal cancer (CRC) patients, examining differences by cancer type, phase of disease, stage at diagnosis, patient age, and relationship. Methods. A cross-sectional survey of caregivers of LC and CRC patients participating in the Share Thoughts on Care survey was conducted. Economic burden was calculated using the opportunity cost of caregiver time, the value of work hours lost, and out-of-pocket expenditures. Factors associated with economic burden to caregivers were modeled using fixed-effects generalized least squares estimation. Results. Informal caregivers (1,629) completed mailed surveys. Of these, 663, 822, and 144 were surveyed during the patient's initial phase (first year after diagnosis, not within 6 months of death), continuing phase (after 1 year, not within 6 months of death), and terminal phase (within 6 months of death) of disease, respectively. The accumulated economic burdens for caregivers were $7,028, $19,701, and $14,234 for those evaluated during the patient's initial phase, continuing phase, and terminal phase of disease, respectively. Economic burden was higher for caregivers of LC patients than CRC patients (p = .044) and for caregivers of patients diagnosed at stage 4 versus stage 1 (p = .001). Spouses faced higher economic burden than other relatives (p = .000) or friends (p = .000). Conclusions. Economic burden for informal caregivers of LC and CRC patients is substantial and should be included in estimates of the societal cost of cancer care. PMID:20667966

Metabolomics for Assessment of Nutritional Status

PubMed Central

Zivkovic, Angela M.; German, J. Bruce

2010-01-01

Purpose of review The current rise in diet-related diseases continues to be one of the most significant health problems facing both the developed and the developing world. The use of metabolomics – the accurate and comprehensive measurement of a significant fraction of important metabolites in accessible biological fluids – for the assessment of nutritional status, is a promising way forward. The basic toolset, targets, and knowledge are all being developed in the emerging field of metabolomics, yet important knowledge and technology gaps will need to be addressed in order to bring such assessment to practice. Recent findings Dysregulation within the principal metabolic organs (e.g. intestine, adipose, skeletal muscle, liver) are at the center of a diet-disease paradigm that includes metabolic syndrome, type 2 diabetes, and obesity. The assessment of both essential nutrient status, and the more comprehensive systemic metabolic response to dietary, lifestyle, and environmental influences (e.g. metabolic phenotype) are necessary for the evaluation of status in individuals that can identify the multiple targets of intervention needed to address metabolic disease. Summary The first proofs of principle building the knowledge to bring actionable metabolic diagnostics to practice through metabolomics are now appearing. PMID:19584717

Important skills for biomedical services: The perspectives of Malaysian employers and employees.

PubMed

Buntat, Yahya; Saud, Muhammad Sukri; Mokhtar, Mahani; Kamin, Yusri; Feh, Lim Set

2016-10-17

Increase in the occurrence of existing diseases, continual emergence of new or exotic diseases and re-emergence of old diseases have placed increasing demands on biomedical services in Malaysia. Biomedical technicians play an important role in operating biomedical instruments. However, there are no clear specifications about characteristics and traits for these semi-professional employees. Employers in a few studies claimed that biomedical graduates are not ready to enter and face challenges in the job market. Therefore, the purpose of this study is to identify technical and generic skills for a biomedical technician from the perspectives of the biomedical technicians and their employers. A quantitative survey design was employed whereby data were obtained through the administration of an instrument developed by the researchers. The sample consisted of 20 hospital managers and 186 biomedical technicians who are currently working in Malaysian government hospitals. The findings show that there are no difference in the perceptions of hospital managers and biomedical technicians regarding technical and non-technical skills. These findings resulted in a checklist which can be used for institutions to produce future biomedical technician graduates in order to meet job demands. However, future research is needed to validate the findings and explore the variables in depth.

Unique topics and issues in rheumatology and clinical immunology.

PubMed

Selmi, Carlo

2014-08-01

Clinicians are facing unexpected issues in everyday practice, and these may become counterintuitive or challenging. Illustrative examples are provided by the hypersensitivity to universally used immunosuppressants such as corticosteroids or antibiotics such as beta-lactam. Secondly, additional issues are represented by the discovery of new pathogenetic mechanisms involved in rheumatoid and psoriatic arthritis or other chronic inflammatory diseases, genomic susceptibility to enigmatic diseases such as giant cell arteritis, or the shared role of specific mediators such as semaphorins. Third, the therapeutic armamentarium has dramatically changed over the past decade following the introduction of biotechnological drugs, and new mechanisms are being proposed to reduce adverse events or increase the drug effectiveness, particularly on cardiovascular comorbidities. Finally, rare diseases continue to represent difficult cases, as for Cogan's syndrome, with limited literature available for clinical recommendations. For these reason, the present issue of Clinical Reviews in Allergy and Immunology is timely and dedicated to these and other unique topics in clinical immunology and allergy. The aim of this issue is thus to help clinicians involved in internal medicine as well as allergists and clinical immunologists while discussing new pathways that will prove important in the near future.

Leonardo da Vinci meets celiac disease.

PubMed

Zanchi, Chiara; Ventura, Giovanna; Di Leo, Grazia; Orzes, Nicoletta; Ronfani, Luca; Not, Tarcisio; Ventura, Alessandro

2013-02-01

Leonardo da Vinci's face symmetry derives from 3 equal craniofacial segments: trichion-nasion (tn), which represents the superior third of the face, nasion-subnasal (ns) that is the medium third of the face, and subnasal-gnathion (sg) that is the length of the lower third of the face. It has been reported that adult subjects with celiac disease (CD) can be identified on the basis of a greater extension of the forehead in comparison to the medium third of the face, with a high tn/ns ratio. The aim of the present study was to investigate the correlation between facial asymmetry and CD in childhood and adulthood. We studied 126 biopsy-proven patients with CD (76 children and 50 adults) and 102 healthy controls (43 children and 59 adults). Their faces were photographed; the pictures were edited using a software program to calculate the facial segments. The tn length was significantly different between adult celiac and adult controls (7.43 ± 1.46 cm vs 6.38 ± 1.73 cm, P = 0.001). The cutoff of 6.5 cm tn, derived from receiver operating characteristic curve analysis, identified 43 of 50 patients (sensitivity 86%), but 34 of 59 controls were positive (specificity 54.2%). The positive predictive value was 56%; however, the tn/ns ratio was not significantly different between celiacs and controls. Neither the tn length nor the tn/ns ratio in celiacs correlated to the time of gluten exposure. Adults, but not children, with celiac disease show a forehead extension significantly greater than controls, but this test's specificity appears too low to be used in the screening of CD.

Multidimensional severity assessment in bronchiectasis: an analysis of seven European cohorts.

PubMed

McDonnell, M J; Aliberti, S; Goeminne, P C; Dimakou, K; Zucchetti, S C; Davidson, J; Ward, C; Laffey, J G; Finch, S; Pesci, A; Dupont, L J; Fardon, T C; Skrbic, D; Obradovic, D; Cowman, S; Loebinger, M R; Rutherford, R M; De Soyza, A; Chalmers, J D

2016-12-01

Bronchiectasis is a multidimensional disease associated with substantial morbidity and mortality. Two disease-specific clinical prediction tools have been developed, the Bronchiectasis Severity Index (BSI) and the FACED score, both of which stratify patients into severity risk categories to predict the probability of mortality. We aimed to compare the predictive utility of BSI and FACED in assessing clinically relevant disease outcomes across seven European cohorts independent of their original validation studies. The combined cohorts totalled 1612. Pooled analysis showed that both scores had a good discriminatory predictive value for mortality (pooled area under the curve (AUC) 0.76, 95% CI 0.74 to 0.78 for both scores) with the BSI demonstrating a higher sensitivity (65% vs 28%) but lower specificity (70% vs 93%) compared with the FACED score. Calibration analysis suggested that the BSI performed consistently well across all cohorts, while FACED consistently overestimated mortality in 'severe' patients (pooled OR 0.33 (0.23 to 0.48), p<0.0001). The BSI accurately predicted hospitalisations (pooled AUC 0.82, 95% CI 0.78 to 0.84), exacerbations, quality of life (QoL) and respiratory symptoms across all risk categories. FACED had poor discrimination for hospital admissions (pooled AUC 0.65, 95% CI 0.63 to 0.67) with low sensitivity at 16% and did not consistently predict future risk of exacerbations, QoL or respiratory symptoms. No association was observed with FACED and 6 min walk distance (6MWD) or lung function decline. The BSI accurately predicts mortality, hospital admissions, exacerbations, QoL, respiratory symptoms, 6MWD and lung function decline in bronchiectasis, providing a clinically relevant evaluation of disease severity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cognitive Assessment of Patients With Alzheimer's Disease by Telemedicine: Pilot Study

PubMed Central

Carotenuto, Anna; Rea, Raffaele; Ricci, Giovanna; Fasanaro, Angiola Maria; Amenta, Francesco

2018-01-01

Background Approximately 46.8 million people are living with dementia worldwide and their number will grow in the next years. Any potential treatment should be administered as early as possible because it is important to provide an early cognitive assessment and to regularly monitor the mental function of patients. Information and communication technologies can be helpful to reach and follow patients without displacing them, but there may be doubts about the reliability of cognitive tests performed by telemedicine. Objective The purpose of this study was to evaluate the reliability of the Mini Mental State Examination (MMSE) and the Alzheimer’s Disease Assessment Scale cognitive subscale (ADAS-cog) tests administered in hospital by videoconference to patients with mild to moderate Alzheimer's disease. Methods The tests were administered to 28 Alzheimer's disease outpatients (8 male, mean age 73.88, SD 7.45 years; 20 female mean age 76.00, SD 5.40 years) recruited and followed in the Alzheimer’s Unit of the A Cardarelli National Hospital (Naples, Italy) at baseline and after 6, 12, 18, and 24 months of observation. Patients were evaluated first face-to-face by a psychologist and then, after 2 weeks, by another psychologist via videoconference in hospital. Results This study showed no differences in the MMSE and ADAS-cog scores when the tests were administered face-to-face or by videoconference, except in patients with more pronounced cognitive deficits (MMSE<17), in which the assessment via videoconference overestimated the cognitive impairment (face to face, MMSE mean 13.9, SD 4.9 and ADAS-cog mean 9.0, SD 3.8; videoconference, MMSE mean 42.8, SD 12.5 and ADAS-cog mean 56.9, SD 5.5). Conclusions We found that videoconferencing is a reliable approach to document cognitive stability or decline, and to measure treatment effects in patients with mild to moderate dementia. A more extended study is needed to confirm these results. PMID:29752254

Disease quantification on PET/CT images without object delineation

NASA Astrophysics Data System (ADS)

Tong, Yubing; Udupa, Jayaram K.; Odhner, Dewey; Wu, Caiyun; Fitzpatrick, Danielle; Winchell, Nicole; Schuster, Stephen J.; Torigian, Drew A.

2017-03-01

The derivation of quantitative information from images to make quantitative radiology (QR) clinically practical continues to face a major image analysis hurdle because of image segmentation challenges. This paper presents a novel approach to disease quantification (DQ) via positron emission tomography/computed tomography (PET/CT) images that explores how to decouple DQ methods from explicit dependence on object segmentation through the use of only object recognition results to quantify disease burden. The concept of an object-dependent disease map is introduced to express disease severity without performing explicit delineation and partial volume correction of either objects or lesions. The parameters of the disease map are estimated from a set of training image data sets. The idea is illustrated on 20 lung lesions and 20 liver lesions derived from 18F-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT scans of patients with various types of cancers and also on 20 NEMA PET/CT phantom data sets. Our preliminary results show that, on phantom data sets, "disease burden" can be estimated to within 2% of known absolute true activity. Notwithstanding the difficulty in establishing true quantification on patient PET images, our results achieve 8% deviation from "true" estimates, with slightly larger deviations for small and diffuse lesions where establishing ground truth becomes really questionable, and smaller deviations for larger lesions where ground truth set up becomes more reliable. We are currently exploring extensions of the approach to include fully automated body-wide DQ, extensions to just CT or magnetic resonance imaging (MRI) alone, to PET/CT performed with radiotracers other than FDG, and other functional forms of disease maps.

47 CFR 32.4200 - Long term debt and funded debt.

Code of Federal Regulations, 2010 CFR

2010-10-01

... applied to securities issued or assumed by the company, means the excess of the book or face amount of the... consideration received at their sale. (4) The face amount of debt reacquired prior to maturity that has not been... 32.4200 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES...

An Inventory and Use Analysis of Information Systems on Small Farms in Pennsylvania

ERIC Educational Resources Information Center

Adams, Jean S.

2007-01-01

Across the United States, today's farm operators face continuing challenges from global competition, increasing production costs, changing technology, increased regulations, scarce resources, and lower profit margins. To face these challenges, farm operators need to gather and utilize information allowing them to make informed decisions. Several…

E-Coaching Systems: Convenient, Anytime, Anywhere, and Nonhuman

ERIC Educational Resources Information Center

Warner, Teri

2012-01-01

Technologies continue to evolve to provide more compelling and interactive learning opportunities. Coaching has traditionally been face-to-face or by email. By combining the new technologies with coaching, learning developers now have the opportunity to develop an asynchronous, online, nonhuman coaching system, or e-coaching system. An e-coaching…

Differences in Business Undergraduate Perceptions by Preferred Classroom Learning Environment

ERIC Educational Resources Information Center

Blau, Gary; Mittal, Neha; Schirmer, Michael; Ozkan, Bora

2017-01-01

Online education continues to grow at business schools. The authors compared undergraduate business student perceptions across three different classroom learning delivery environments: online, hybrid, and face to face. Based on the survey responses using two independent samples, the authors' analyses found that students who preferred online…

Facing the New Millennium: Making Friends with the Future.

ERIC Educational Resources Information Center

Roueche, John E.; Roueche, Suanne D.

2000-01-01

Asserts that building relationships with constituents remains the best strategy for ensuring the future institutional survival of community colleges. Examines some of the conditions that community colleges will be facing in the future, such as increasing numbers of students to serve, the continuing need for remedial/developmental education, and…

30 CFR 18.22 - Boring-type machines equipped for auxiliary face ventilation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Boring-type machines equipped for auxiliary... AND ACCESSORIES Construction and Design Requirements § 18.22 Boring-type machines equipped for auxiliary face ventilation. Each boring-type continuous-mining machine that is submitted for approval shall...

30 CFR 18.22 - Boring-type machines equipped for auxiliary face ventilation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Boring-type machines equipped for auxiliary... AND ACCESSORIES Construction and Design Requirements § 18.22 Boring-type machines equipped for auxiliary face ventilation. Each boring-type continuous-mining machine that is submitted for approval shall...

30 CFR 18.22 - Boring-type machines equipped for auxiliary face ventilation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Boring-type machines equipped for auxiliary... AND ACCESSORIES Construction and Design Requirements § 18.22 Boring-type machines equipped for auxiliary face ventilation. Each boring-type continuous-mining machine that is submitted for approval shall...

30 CFR 18.22 - Boring-type machines equipped for auxiliary face ventilation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Boring-type machines equipped for auxiliary... AND ACCESSORIES Construction and Design Requirements § 18.22 Boring-type machines equipped for auxiliary face ventilation. Each boring-type continuous-mining machine that is submitted for approval shall...

30 CFR 18.22 - Boring-type machines equipped for auxiliary face ventilation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Boring-type machines equipped for auxiliary... AND ACCESSORIES Construction and Design Requirements § 18.22 Boring-type machines equipped for auxiliary face ventilation. Each boring-type continuous-mining machine that is submitted for approval shall...

Online Learning: Cross-Cultural Development in Time Poor Environments

ERIC Educational Resources Information Center

Cameron, Heather; Limberger, Jacqui

2004-01-01

Faced with a unique problem of providing cross-cultural awareness training on a continuing basis, Griffith University, located in Brisbane, Queensland developed an innovative program to meet the challenges it faced. A key strategy in the University's Indigenous Recruitment Strategy was to establish a cross-cultural awareness program sensitising…

E-Learning in Business

ERIC Educational Resources Information Center

Schweizer, Heidi

2004-01-01

e-Learning is replacing face-to-face classroom instruction in a growing number of businesses, but what is the prospect for the continued proliferation of e-learning in business? On one hand, the quality of instruction, the cost-effectiveness of new technology, a supportive e-learning educational culture, an expansion of the Internet, an increase…

75 FR 80529 - Privacy Act of 1974, as Amended

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-22

... license when a record on its face, or in conjunction with other records, indicates a violation or..., order, or license when a record on its face, or in conjunction with other records, indicates a violation... contact for organizations (including organizations that apply for recognition as a sponsor of continuing...

Practical Applications and Experiences in K-20 Blended Learning Environments

ERIC Educational Resources Information Center

Kyei-Blankson, Lydia, Ed.; Ntuli, Esther, Ed.

2014-01-01

Learning environments continue to change considerably and is no longer confined to the face-to-face classroom setting. As learning options have evolved, educators must adopt a variety of pedagogical strategies and innovative technologies to enable learning. "Practical Applications and Experiences in K-20 Blended Learning Environments"…

CFD analysis on gas distribution for different scrubber redirection configurations in sump cut.

PubMed

Zheng, Y; Organiscak, J A; Zhou, L; Beck, T W; Rider, J P

2015-01-01

The National Institute for Occupational Safety and Health's Office of Mine Safety and Health Research recently developed a series of models using computational fluid dynamics (CFD) to study the gas distribution around a continuous mining machine with various fan-powered flooded bed scrubber discharge configurations. CFD models using Species Transport Model without reactions in FLUENT were constructed to evaluate the redirection of scrubber discharge toward the mining face rather than behind the return curtain. The following scenarios are considered in this study: 100 percent of the discharge redirected back toward the face on the off-curtain side of the continuous miner; 100 percent of the discharge redirected back toward the face, but divided equally to both sides of the machine; and 15 percent of the discharge redirected toward the face on the off-curtain side of the machine, with 85 percent directed into the return. These models were compared against a model with a conventional scrubber discharge, where air is directed away from the face into the return. The CFD models were calibrated and validated based on experimental data and accurately predicted sulfur hexafluoride (SF 6 ) gas levels at four gas monitoring locations. One additional prediction model was simulated to consider a different scrubber discharge angle for the 100 percent redirected, equally divided case. These models identified relatively high gassy areas around the continuous miner, which may not warrant their use in coal mines with medium to high methane liberation rates. This paper describes the methodology used to develop the CFD models, and the validation of the models based on experimental data.

[Fibromyalgia patients' perceptions of the impact of the disease in the workplace].

PubMed

Briones-Vozmediano, Erica; Ronda-Pérez, Elena; Vives-Cases, Carmen

2015-04-01

To explore the perceptions of patients with fibromyalgia (FM) on the problems they experience in the workplace, to discuss how they face and adapt to the limitations imposed by the symptoms of this disease. An exploratory qualitative study conducted in 2009. Associations of patients of FM from Valencia (Spain). Sixteen patients (13 women and 3 men) diagnosed with FM by a rheumatologist, of different ages and occupations, selected from key informants and the snowball technique. Pragmatic sample. Semi-structured interviews until saturation of information when no new information emerged. Qualitative content analysis using the software Atlas.ti-5, to generate and assign codes, forming categories and identifying a latent theme. We identified four categories: difficulties in meeting the work demands, need for social support in the workplace, strategies adopted to continue working, and resistance to leave the employment. A theme which crosscut these categories emerged: FM patientś motivation to continue in the labour market. Addressing the specific needs of patients it is essential in order to helping them to stay in the labour market, according to their capabilities. Awareness programs about the consequences of FM in the workplace are needed to achieve the collaboration of managers, entrepreneurs, occupational health professionals and primary care physicians and nurses. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

An Island of Stability: Art Images and Natural Scenes - but Not Natural Faces - Show Consistent Esthetic Response in Alzheimer's-Related Dementia.

PubMed

Graham, Daniel J; Stockinger, Simone; Leder, Helmut

2013-01-01

Alzheimer's disease (AD) causes severe impairments in cognitive function but there is evidence that aspects of esthetic perception are somewhat spared, at least in early stages of the disease. People with early Alzheimer's-related dementia have been found to show similar degrees of stability over time in esthetic judgment of paintings compared to controls, despite poor explicit memory for the images. Here we expand on this line of inquiry to investigate the types of perceptual judgments involved, and to test whether people in later stages of the disease also show evidence of preserved esthetic judgment. Our results confirm that, compared to healthy controls, there is similar esthetic stability in early stage AD in the absence of explicit memory, and we report here that people with later stages of the disease also show similar stability compared to controls. However, while we find that stability for portrait paintings, landscape paintings, and landscape photographs is not different compared to control group performance, stability for face photographs - which were matched for identity with the portrait paintings - was significantly impaired in the AD group. We suggest that partially spared face-processing systems interfere with esthetic processing of natural faces in ways that are not found for artistic images and landscape photographs. Thus, our work provides a novel form of evidence regarding face-processing in healthy and diseased aging. Our work also gives insights into general theories of esthetics, since people with AD are not encumbered by many of the semantic and emotional factors that otherwise color esthetic judgment. We conclude that, for people with AD, basic esthetic judgment of artistic images represents an "island of stability" in a condition that in most other respects causes profound cognitive disruption. As such, esthetic response could be a promising route to future therapies.

An Island of Stability: Art Images and Natural Scenes – but Not Natural Faces – Show Consistent Esthetic Response in Alzheimer’s-Related Dementia

PubMed Central

Graham, Daniel J.; Stockinger, Simone; Leder, Helmut

2013-01-01

Alzheimer’s disease (AD) causes severe impairments in cognitive function but there is evidence that aspects of esthetic perception are somewhat spared, at least in early stages of the disease. People with early Alzheimer’s-related dementia have been found to show similar degrees of stability over time in esthetic judgment of paintings compared to controls, despite poor explicit memory for the images. Here we expand on this line of inquiry to investigate the types of perceptual judgments involved, and to test whether people in later stages of the disease also show evidence of preserved esthetic judgment. Our results confirm that, compared to healthy controls, there is similar esthetic stability in early stage AD in the absence of explicit memory, and we report here that people with later stages of the disease also show similar stability compared to controls. However, while we find that stability for portrait paintings, landscape paintings, and landscape photographs is not different compared to control group performance, stability for face photographs – which were matched for identity with the portrait paintings – was significantly impaired in the AD group. We suggest that partially spared face-processing systems interfere with esthetic processing of natural faces in ways that are not found for artistic images and landscape photographs. Thus, our work provides a novel form of evidence regarding face-processing in healthy and diseased aging. Our work also gives insights into general theories of esthetics, since people with AD are not encumbered by many of the semantic and emotional factors that otherwise color esthetic judgment. We conclude that, for people with AD, basic esthetic judgment of artistic images represents an “island of stability” in a condition that in most other respects causes profound cognitive disruption. As such, esthetic response could be a promising route to future therapies. PMID:23471005

Endometriosis – A Chameleon: Patientsʼ Perception of Clinical Symptoms, Treatment Strategies and Their Impact on Symptoms

PubMed Central

Wimberger, P.; Grübling, N.; Riehn, A.; Furch, M.; Klengel, J.; Goeckenjan, M.

2014-01-01

Introduction: Endometriosis is a chronic disease with differing clinical presentations. Treatment strategies depend mainly on clinical presentation and patient lifestyle. In women newly diagnosed with endometriosis, it is often difficult to understand the pathophysiologic origin, the potential individual impairment due to disease and the different treatment options. Compliance with the selected treatment is therefore often not optimal. Material and Methods: In a descriptive study, data of 51 women with endometriosis (mean age 36.2 years ± 11.3) were analyzed according to the predominant clinical presentation: asymptomatic disease, disease with typical symptoms, ovarian cysts or infertility. Results: More than 50 % of patients ascribed a therapeutic benefit to surgical intervention or endocrine treatment, especially women in the subgroup with dysmenorrhea who received combined treatment. It should be noted that in the group of women facing infertility, more than half stated that they could not decide on the value of diagnostic and therapeutic reproductive medicine. Nevertheless, more than half of the women in this group became pregnant within two years after the initial diagnosis. Discussion: When deciding on the best treatment strategy for endometriosis, it is important to take account of potential pain and infertility. Womenʼs perception of endometriosis will vary depending on their symptoms, the time of diagnosis and their lifestyle. Offering continuous information on clinical aspects and manifestations of the disease may improve treatment outcomes. Personalized counseling is an essential part of the clinical management of the disease. PMID:25364034

Information needs and requirements in patients with brain tumours and their relatives.

PubMed

Reinert, Christiane; Rathberger, Katharina; Klinkhammer-Schalke, Monika; Kölbl, Oliver; Proescholdt, Martin; Riemenschneider, Markus J; Schuierer, Gerhard; Hutterer, Markus; Gerken, Michael; Hau, Peter

2018-06-01

Patients with brain tumours face a number of medical and social challenges. Previous studies have shown that these patients and their relatives need a high level of patient-oriented information and counselling. However, these needs are often underestimated. In this single-centre cross-sectional study, we evaluated, for the first time, the information needs of patients with brain tumours and their relatives depending on diagnosis, age and level of education. The participants were interviewed using pre-specified questionnaires. Answers were evaluated descriptively using standard statistical methods. A total of 888 questionnaires were sent out. The return rate was 50.7%. The majority of patients (nP = 103; 59.9%) and a higher proportion of relatives (nR = 103; 72.5%; p = 0.019) wished to receive a maximum of information. The majority (79.7% of patients; 83.1% of relatives) also stated that they preferred a personal, face-to-face meeting as primary source of information. The need for information increased with education (p = 0.015), and decreased with tumour grade (p = 0.025) and age (p = 0.118). Our data indicate that patients with brain tumours and their relatives have high information needs throughout their disease and continuously require information and counselling. Optimal provision of information is based on personal preferences, which needs to be evaluated appropriately. Patient-oriented information and counselling are parts of a successful communication strategy that can improve cancer care significantly.

Most common patterns of acne in male adolescents: a population-based study.

PubMed

Duquia, Rodrigo P; de Almeida, Hiram L; Breunig, Juliano A; Souzat, Paulo R M; Göellner, Caroline D

2013-05-01

Acne vulgaris is a common skin disease affecting more than 85% of adolescents and often continuing into adulthood. Population-based studies to assess the patterns and severity of acne have not been achieved. The aim of this study was to assess the most common patterns of facial and trunk acne in young (18-year-old) men in a representative sample of male adolescents in a city in southern Brazil and to investigate the severity of inflammatory and non-inflammatory lesions in these individuals. In Brazil, military service is compulsory for all males. Every adolescent male must report to his military service headquarters to submit to a medical screening examination. The study included 2201 adolescents, each of whom underwent a skin examination conducted by a dermatologist to identify and quantify all non-inflammatory (comedones) and inflammatory (papules, pustules, and nodules) lesions. Non-inflammatory lesions (comedones) were observed on 1487 individuals, and inflammatory lesions (papules and pustules) were noted on 1497 individuals. The most common patterns of facial acne were the full-face, bilateral malar and frontal mentonian distributions. This is the first population-based study to evaluate patterns of acne. Facial involvement was very prevalent, and the frontal region was found to dominate patterns of distribution of acne vulgaris. Comedonian acne of the face was much more intense and affected the entire face. In inflammatory facial acne, the majority of the study subjects exhibited up to five lesions in the region under study. © 2013 The International Society of Dermatology.

Patient support groups in the management of Wilson disease.

PubMed

Graper, Mary L; Schilsky, Michael L

2017-01-01

Patient support groups serve an important function for those affected by a disease but especially for people with a rare disease. Because of the complexity of Wilson disease there are some unique and difficult problems faced by groups that advocate for these patients. We give a comparative overview of the differences between groups that support people with more common diseases and groups that serve the rare disease population. The history and current status of the Wilson Disease Association and other worldwide Wilson disease groups are described and information about other organizations that support Wilson disease in additional ways is explained. The specific challenges faced in the support of Wilson disease patients are outlined and possible solutions proposed. Drawing from experience in speaking with many patients, we discuss some of the most common questions that are asked by patients who are seeking a possible diagnosis or are already on treatment. There are many options for improving patient advocacy efforts in the future that we hope will be accomplished. © 2017 Elsevier B.V. All rights reserved.

Framing international trade and chronic disease

PubMed Central

2011-01-01

There is an emerging evidence base that global trade is linked with the rise of chronic disease in many low and middle-income countries (LMICs). This linkage is associated, in part, with the global diffusion of unhealthy lifestyles and health damaging products posing a particular challenge to countries still facing high burdens of communicable disease. We developed a generic framework which depicts the determinants and pathways connecting global trade with chronic disease. We then applied this framework to three key risk factors for chronic disease: unhealthy diets, alcohol, and tobacco. This led to specific 'product pathways', which can be further refined and used by health policy-makers to engage with their country's trade policy-makers around health impacts of ongoing trade treaty negotiations, and by researchers to continue refining an evidence base on how global trade is affecting patterns of chronic disease. The prevention and treatment of chronic diseases is now rising on global policy agendas, highlighted by the UN Summit on Noncommunicable Diseases (September 2011). Briefs and declarations leading up to this Summit reference the role of globalization and trade in the spread of risk factors for these diseases, but emphasis is placed on interventions to change health behaviours and on voluntary corporate responsibility. The findings summarized in this article imply the need for a more concerted approach to regulate trade-related risk factors and thus more engagement between health and trade policy sectors within and between nations. An explicit recognition of the role of trade policies in the spread of noncommunicable disease risk factors should be a minimum outcome of the September 2011 Summit, with a commitment to ensure that future trade treaties do not increase such risks. PMID:21726434

Framing international trade and chronic disease.

PubMed

Labonté, Ronald; Mohindra, Katia S; Lencucha, Raphael

2011-07-04

There is an emerging evidence base that global trade is linked with the rise of chronic disease in many low and middle-income countries (LMICs). This linkage is associated, in part, with the global diffusion of unhealthy lifestyles and health damaging products posing a particular challenge to countries still facing high burdens of communicable disease. We developed a generic framework which depicts the determinants and pathways connecting global trade with chronic disease. We then applied this framework to three key risk factors for chronic disease: unhealthy diets, alcohol, and tobacco. This led to specific 'product pathways', which can be further refined and used by health policy-makers to engage with their country's trade policy-makers around health impacts of ongoing trade treaty negotiations, and by researchers to continue refining an evidence base on how global trade is affecting patterns of chronic disease. The prevention and treatment of chronic diseases is now rising on global policy agendas, highlighted by the UN Summit on Noncommunicable Diseases (September 2011). Briefs and declarations leading up to this Summit reference the role of globalization and trade in the spread of risk factors for these diseases, but emphasis is placed on interventions to change health behaviours and on voluntary corporate responsibility. The findings summarized in this article imply the need for a more concerted approach to regulate trade-related risk factors and thus more engagement between health and trade policy sectors within and between nations. An explicit recognition of the role of trade policies in the spread of noncommunicable disease risk factors should be a minimum outcome of the September 2011 Summit, with a commitment to ensure that future trade treaties do not increase such risks.

Railroad safety statistics annual report 2006

DOT National Transportation Integrated Search

2008-04-01

It is hoped that the information provided in this publication will provide insight into the most : significant safety issues facing the rail industry and, in turn, lead to continued rail safety : improvements. Only by continuing our understanding abo...

Railroad safety statistics annual report 2002

DOT National Transportation Integrated Search

2004-03-01

It is hoped that the information provided in this publication will provide insight into the most significant safety issues facing the rail industry and, in turn, lead to continued rail safety improvements. Only by continuing our understanding about h...

Railroad safety statistics annual report 2001

DOT National Transportation Integrated Search

2003-07-01

It is hoped that the information provided in this publication will provide insight into the most significant safety issues facing the rail industry and, in turn, lead to continued rail safety improvements. Only by continuing our understanding about h...

Geriatric teledermatology: store-and-forward vs. face-to-face examination.

PubMed

Rubegni, P; Nami, N; Cevenini, G; Poggiali, S; Hofmann-Wellenhof, R; Massone, C; Bilenchi, R; Bartalini, M; Cappelli, R; Fimiani, M

2011-11-01

Telemedicine could be useful in countries like Italy to meet the needs of elderly patients and in particular in those in precarious general conditions, for whom travelling even short distances can pose considerable practical and economical difficulties. The aim of this study was to determine the efficacy of store-and-forward teledermatology vs face-to-face consultations in elderly patients. A total of 130 geriatric patients with skin diseases requiring dermatological examination were enrolled. The patients examined, consisting of 60 men (46.15%) and 70 women (53.85%), were aged between 66 and 97 years (mean age 80.58 years). Three dermatologists of the department, with equal experience took turns in face-to-face examination and teledermatology (store-and-forward). To compare face-to-face dermatological examinations with the asynchronous store-and-forward approach of teledermatology, we considered diagnostic agreement (ICD-9 code), therapeutic agreement and concordance of diagnostic confidence. One hundred and fourteen of 130 patients were diagnosed with the same ICD-9 code, making a total observed agreement of 87.7% with a Cohen's κ estimated of 0.863. Agreement between therapies was 69.6% (Cohen's κ = 0.640). As it concerns diagnostic confidence, dermatologists appeared generally slightly less certain of their diagnosis by telemedicine. Store-and-forward teledermatology can improve diagnostic and therapeutic care for skin disease in elderly who lack easy and/or direct access to dermatologists. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

Coeliac disease: the association between quality of life and social support network participation.

PubMed

Lee, A R; Wolf, R; Contento, I; Verdeli, H; Green, P H R

2016-06-01

There is little information available on the use of social support systems for patients with coeliac disease (CD). We performed a cross-sectional study aiming to examine the association between participation in different types of social support networks and quality of life (QOL) in adults with CD. A survey including a validated CD specific QOL instrument was administered online and in-person to adults with CD who were following a gluten-free diet. Participation in social support networks (type, frequency and duration) were assessed. Among the 2138 participants, overall QOL scores were high, averaging 68.9 out of 100. Significant differences in QOL scores were found for age, length of time since diagnosis and level of education. Most (58%) reported using no social support networks. Of the 42% reporting use of social support networks (online 17.9%, face-to-face 10.8% or both 12.8%), QOL scores were higher for those individuals who used only face-to-face social support compared to only online support (72.6 versus 66.7; P < 0.0001). A longer duration of face-to-face social support use was associated with higher QOL scores (P < 0.0005). By contrast, a longer duration and increased frequency of online social support use was associated with lower QOL scores (P < 0.03). Participation in face-to-face social support networks is associated with greater QOL scores compared to online social support networks. These findings have potential implications for the management of individuals with CD. Emphasis on face-to-face support may improve long-term QOL and patient outcomes. © 2015 The British Dietetic Association Ltd.

Athletes with Implantable Cardioverter Defibrillators

PubMed Central

Ponamgi, Shiva P.; DeSimone, Christopher V.; Ackerman, Michael J.

2015-01-01

Summary Athletes with an implantable cardioverter defibrillator (ICD) represent a diverse group of individuals who may be at an increased risk of sudden cardiac death (SCD) when engaging in vigorous physical activity. Therefore, they are excluded by the current guidelines from participating in most competitive sports except those classified as low intensity, such as bowling and golf. The lack of substantial data on the natural history of the cardiac diseases affecting these athletes, as well as the unknown efficacy of implanted ICDs in terminating life-threatening arrhythmias occurring during intense exercise, have resulted in the restrictive nature of these now decade old guidelines. Recently, there is emerging data, derived from a few retrospective studies and a large prospective registry that demonstrates the relative safety of high-risk athletes participating in competitive sports and challenges the prohibitive nature of these guidelines. Nevertheless, the safe participation of all athletes with an ICD in competitive sports continues to be contemplated. The increased number of inappropriate shocks, damage to the ICD/pacemaker system, and the questionable efficacy of the delivered shock in the setting of vigorous physical activity are some of the main challenges faced by these athletes who choose to continue participation in competitive sports. The fear of SCD and ICD shocks faced by these athletes is also associated with a negative psychological burden and affects their quality of life, as does restricting them from all competitive sports. Therefore, shared decision making is necessary between the clinician and athlete after carefully analyzing the risks and benefits associated with competitive sports participation. PMID:26100423

Self-reported adherence to a therapeutic regimen among patients undergoing continuous ambulatory peritoneal dialysis.

PubMed

Lam, Lai Wah; Twinn, Sheila F; Chan, Sally W C

2010-04-01

This paper is a report of a study conducted to examine self-reported adherence to a therapeutic regimen for continuous ambulatory peritoneal dialysis. Studies of patients' adherence during dialysis have primarily focused on haemodialysis and have frequently yielded inconsistent results, which are attributed to the inconsistent tools used to measure adherence. Levels of adherence to all four components of the therapeutic regimen (i.e. dietary and fluid restrictions, medication, and the dialysis regimen) among patients receiving peritoneal dialysis have not been examined, especially from a patient perspective. A total population sample was used. A cross-sectional survey was carried out by face-to-face interviews in 2005 in one renal clinic in Hong Kong. A total of 173 patients undergoing peritoneal dialysis (56% of the total population) participated in the study. Patients perceived themselves as more adherent to medication (83%; 95% confidence interval 77-88%) and dialysis (93%; 95% confidence interval 88-96%) prescriptions than to fluid (64%; 95% confidence interval 56-71%) and dietary (38%; 95% confidence interval 30-45%) restrictions. Those who were male, younger or had received dialysis for 1-3 years saw themselves as more non-adherent compared with other patients. Healthcare professionals should take cultural issues into consideration when setting dietary and fluid restriction guidelines. Additional attention and support are required for patients who identify themselves as more non-adherent. To help patients live with end-stage renal disease and its treatment, qualitative research is required to understand how they go through the dynamic process of adherence.

CE: Can Your Older Patients Drive Safely?

PubMed

Staplin, Loren; Lococo, Kathy H; Mastromatto, Tia; Sifrit, Kathy J; Trazzera, Kathleen M

2017-09-01

: In many areas of the world, driving is an essential part of life and for reasons of comfort, convenience, and security remains the primary mode of transportation among older adults. Both normal aging and diseases that are more prevalent in advanced age can substantially reduce older drivers' functional abilities, elevating their risk of involvement in motor vehicle accidents and serious injury or death. Identifying and intervening with older drivers at increased crash risk is an important aspect of preventive medicine. The authors discuss the specific driving risks adults face as they age and how nurses can raise older patients' awareness of these risks. They also discuss the importance of connecting older adults to community resources that may help them continue driving safely for a longer period or find alternative transportation options.

Using Interorganizational Partnerships to Strengthen Public Health Laboratory Systems

PubMed Central

Kimsey, Paul; Buehring, Gertrude

2013-01-01

Due to the current economic environment, many local and state health departments are faced with budget reductions. Health department administrators and public health laboratory (PHL) directors need to assess strategies to ensure that their PHLs can provide the same level of service with decreased funds. Exploratory case studies of interorganizational partnerships among local PHLs in California were conducted to determine the impact on local PHL testing services and capacity. Our findings suggest that interorganizational forms of cooperation among local PHLs can help bolster laboratory capacity by capturing economies of scale, leveraging scarce resources, and ensuring access to affordable, timely, and quality laboratory testing services. Interorganizational partnerships will help local and state public health departments continue to maintain a strong and robust laboratory system that supports their role in communicable disease surveillance. PMID:23997305

When is it permissible to dismiss a family who refuses vaccines? Legal, ethical and public health perspectives.

PubMed

Halperin, Beth; Melnychuk, Ryan; Downie, Jocelyn; Macdonald, Noni

2007-12-01

Although immunization is one of the most important health interventions of the 20th century, cases of infectious disease continue to occur. There are parents who refuse immunization for their children, creating a dilemma for the primary care physician who must consider the best interest of the individual child as well as that of the community. Some physicians, when faced with parents who refuse immunization on behalf of their children, choose to dismiss these families from their practice. Given the existing shortage of primary care physicians across Canada, this decision to dismiss families based on vaccine refusal has far-reaching implications. The present article explores this issue in the Canadian context from a legal, ethical and public health perspective.

Public health challenges in sun protection.

PubMed

Eide, Melody J; Weinstock, Martin A

2006-01-01

Sunscreens are a popular choice for protection from ultraviolet radiation, and hence, important components in the public health campaign to reduce the burden of skin cancer. Public health messages in skin cancer prevention have been used effectively in educational campaigns. The benefits of sunscreen extend beyond skin cancer prevention into other aspects of health and disease prevention: sunscreen decreases the risk for sunburn during physical activity outdoors and seems not to increase the risk for osteoporosis. Public health efforts have laid a solid foundation on which to face the continuing challenge of promoting and developing effective public health campaigns and health policies that encourage sunscreen use, sun protection, and the primary prevention of skin cancer. In this article, the controversies, concerns, and challenges of sunscreen use as it relates to public health are discussed.

The tobacco-using periodontal patient: role of the dental practitioner in tobacco cessation and periodontal disease management.

PubMed

Chaffee, Benjamin W; Couch, Elizabeth T; Ryder, Mark I

2016-06-01

Although the prevalence of tobacco use has declined in some parts of the world, tobacco use remains a persistent and, in some cases, growing problem that will continue to be a fundamental challenge facing dental practitioners in the decades ahead. Dental practitioners have a unique opportunity and professional obligation to be a positive influence in reducing the economic and social burden inflicted by tobacco use on dental and general health. In this article, the current noninvasive, evidence-based approaches are presented for dental practitioners to help patients avoid initiating tobacco use, to encourage and assist patients in ceasing tobacco use and to address tobacco-induced damage to periodontal supporting tissues. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Automated detection of preserved photoreceptor on optical coherence tomography in choroideremia based on machine learning.

PubMed

Wang, Zhuo; Camino, Acner; Hagag, Ahmed M; Wang, Jie; Weleber, Richard G; Yang, Paul; Pennesi, Mark E; Huang, David; Li, Dengwang; Jia, Yali

2018-05-01

Optical coherence tomography (OCT) can demonstrate early deterioration of the photoreceptor integrity caused by inherited retinal degeneration diseases (IRDs). A machine learning method based on random forests was developed to automatically detect continuous areas of preserved ellipsoid zone structure (an easily recognizable part of the photoreceptors on OCT) in 16 eyes of patients with choroideremia (a type of IRD). Pseudopodial extensions protruding from the preserved ellipsoid zone areas are detected separately by a local active contour routine. The algorithm is implemented on en face images with minimum segmentation requirements, only needing delineation of the Bruch's membrane, thus evading the inaccuracies and technical challenges associated with automatic segmentation of the ellipsoid zone in eyes with severe retinal degeneration. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A review of smart homes- present state and future challenges.

PubMed

Chan, Marie; Estève, Daniel; Escriba, Christophe; Campo, Eric

2008-07-01

In the era of information technology, the elderly and disabled can be monitored with numerous intelligent devices. Sensors can be implanted into their home for continuous mobility assistance and non-obtrusive disease prevention. Modern sensor-embedded houses, or smart houses, cannot only assist people with reduced physical functions but help resolve the social isolation they face. They are capable of providing assistance without limiting or disturbing the resident's daily routine, giving him or her greater comfort, pleasure, and well-being. This article presents an international selection of leading smart home projects, as well as the associated technologies of wearable/implantable monitoring systems and assistive robotics. The latter are often designed as components of the larger smart home environment. The paper will conclude by discussing future challenges of the domain.

Healthcare Benefits for Veterans: What Home Care Clinicians Need to Know.

PubMed

Erickson-Hurt, Carma; McGuirk, Dianne; Long, Carol O

2017-05-01

As the world prepares for an increasingly aging population with chronic debilitating diseases, the demand for home healthcare services is increasing. As such, home healthcare clinicians face increased pressure to find resources and continuing support for patients. One area that may be underutilized is accessing Veteran benefits. Home healthcare clinicians care for Veterans every day, and knowing what benefits are available and how to access those benefits can help some Veterans who may be struggling with healthcare needs. Home healthcare clinicians may find understanding Veteran's health benefits intimidating and may falsely assume that a Veteran is aware of his or her benefits. Staying current on home healthcare benefits can be challenging and this article is intended to provide an overview of current and relevant information regarding Veteran health benefits.

Mission Continuity Planning: Strategically Assessing and Planning for Threats to Operations.

ERIC Educational Resources Information Center

Qayoumi, Mohammad H.

This book covers the principles of risk and risk management and offers a framework for analyzing the significant, often unforeseen threats facing higher education institutions today. It examines the critical elements of a disaster preparedness plan and addresses business continuity and mission continuity planning. The book also provides tools for…

Dynamics and Control of Tethered Satellite Formations for the Purpose of Space-Based Remote Sensing

DTIC Science & Technology

2006-08-01

remote sensing mission. Energy dissipation is found to have an adverse effect on foundational rigid body (Likins-Pringle) equilibria. It is shown that a continuously earth-facing equilibrium condition for a fixed-length tethered system does not exist since the spin rate required for the proper precession would not be high enough to maintain tether tension. The range of required spin rates for steady-spin motion is numerically defined here, but none of these conditions can meet the continuously earth-facing criteria. Of particular note is the discovery that applying certain

Infectious Disease and National Security: Strategic Information Needs

DTIC Science & Technology

2006-01-01

reemerging diseases once thought to be in decline. The world now faces the threat of a human influenza pandemic aris- ing from the recently emerged...Surveillance, Including Early Warning . . . . . . . . . . . . . . . . . . . . . . . 44 Sources Include Information on Diseases in Humans , Animals, and...Sources Addressing Human , Animal, and Plant Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 5.5. Information

The effects of obesity on doctor-diagnosed chronic diseases in Africa: empirical results from Senegal and South Africa.

PubMed

Asfaw, Abay

2006-01-01

While inadequate food and communicable infectious diseases have been a concern of researchers and policy makers in Africa, little attention has been given to obesity and chronic, non-communicable diseases. Africa is not usually associated with obesity and chronic diseases. Yet there has been a sharp rise in the incidence of obesity and chronic diseases, a major public health problem in many countries. The paper examines the impact of obesity on the prevalence of four doctor-diagnosed chronic diseases in Senegal and South Africa. The results reveal that obese respondents were 4.7, 2.8, and 4.8% more likely to face the risks of arthritis, diabetes, and heart diseases in South Africa and 6.5 and 7.4% more likely to face the risks of heart disease and asthma in Senegal than their lean counterparts. Obesity imposes a real and substantial danger, affecting the prevalence of chronic diseases. Unchecked it can be a major public health problem, impose a serious challenge to the health sector, and can jeopardize future developments.

A Qualitative Examination of Community College Instructors' Strategies for Engaging Students with Physical Disabilities

ERIC Educational Resources Information Center

Kusek, Thomas A.

2017-01-01

Community colleges continually experience increasing enrollment of students with physical disabilities. This basic qualitative study implemented face-to-face interviews of 10 community college faculty members that have a variety of academic and disciplines and have assisted students with disabilities. Participants were asked questions developed…

Digitizing Ethiopic: Coding for Linguistic Continuity in the Face of Digital Extinction

ERIC Educational Resources Information Center

Zaugg, Isabelle Alice

2017-01-01

Despite the growing sophistication of digital technologies, it appears they are contributing to language extinction on a par with devastating losses in biodiversity. With language extinction comes loss of identity, inter-generational cohesion, culture, and a global wealth of knowledge to address future problems facing humanity. Linguists estimate…

Mission-Based Management in Higher Education: How Do Academic Department Chairpersons Align Decision-Making with Their Organizational Mission?

ERIC Educational Resources Information Center

Hlavac, Craig

2012-01-01

The academic department chairperson continues to face significant challenges in the administration of the contemporary university. Due to retrenchment resultant from the 2008 Global Financial Crisis (GFC), higher education has already faced significant financial cutbacks, and more reductions seem inevitable. Particularly susceptible are…

49 CFR 398.5 - Parts and accessories necessary for safe operation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... inches of space between the backrests or between the edges of the opposite seats when face to face.... 398.5 Section 398.5 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL... vehicle, or cause or permit it to be operated, unless it is equipped in accordance with said requirements...

The Impact of Mentoring Programs on Teachers in Urban Middle Schools

ERIC Educational Resources Information Center

Wider, Beyonka Shantel

2012-01-01

Retaining teachers is a pressing issue facing many urban middle schools in the southern US. Urban middle schools continually face increased teacher turnover rates in spite of state mandated induction and mentoring programs. Drawing from Maslow's hierarchy of needs theory, the purpose of the qualitative case study was to examine urban middle…

Using FACE systems to screen wheat cultivars for yield increases at elevated CO2

USDA-ARS?s Scientific Manuscript database

Because of continuing increases in atmospheric CO2, identifying cultivars of crops with larger yield increases at elevated CO2 may provide an avenue to increase crop yield potential in future climates. Free-air CO2 enrichment (FACE) systems have most often been used with multiple replications of ea...

Steps to Offering Low Vision Rehabilitation Services through Clinical Video Telehealth

ERIC Educational Resources Information Center

Ihirig, Carolyn

2016-01-01

Telehealth clinical applications, which allow medical professionals to use telecommunications technologies to provide services to individuals remotely, continue to expand in areas such as low vision rehabilitation, where evaluations are provided to patients who live in rural areas. As with face-to-face low vision rehabilitation, the goal of…

The Paradox of Transformative Learning among Mid-Career Professionals

ERIC Educational Resources Information Center

Agger-Gupta, Niels; Etmanski, Catherine

2014-01-01

Royal Roads University (RRU) is a special purpose university in British Columbia, Canada. Since 1995, this university has focused primarily on multi-sectoral and interdisciplinary graduate education for working professionals. Most programs are offered in a blended online and face-to-face format, which enables adult learners to continue in their…

Shallow Roots Require Constant Watering: The Challenge of Sustained Impact in Educational Programs

ERIC Educational Resources Information Center

Rosen, Yigal; Perkins, David

2013-01-01

Socially-oriented educational programs often face societal barriers. Peace education in a region of prolonged conflict faces a negative socio-political environment that works against its effects. The media, leadership, educational system and other societal institutions continue to express a culture of conflict. Recent studies show that the effects…

The Effects of Technological Overload on Children: An Art Therapist's Perspective

ERIC Educational Resources Information Center

Klorer, P. Gussie

2009-01-01

Children today are continually bombarded with visual and auditory stimulation, and many make their connections in cyberspace to the detriment of real-time face-to-face encounters with other people. The negative effects of multitasking and technological overload on children and adolescents are discussed in this viewpoint article from the…

Instructional Supervision: A Descriptive Study Focusing on the Observation and Evaluation of Teachers in Cyberschools

ERIC Educational Resources Information Center

Farley, Gregory Charles

2010-01-01

Since 1996, K-12 schools are increasingly moving from a traditional, face-to-face educational environment to an online learning environment utilizing technologies to deliver instruction primarily via the Internet. As this trend continues, administrators familiar with traditional supervisory methods will observe and evaluate teachers of online…

Active Learning with Interactive Videos: Creating Student-Guided Learning Materials

ERIC Educational Resources Information Center

Baker, Ariana

2016-01-01

Distance learning programs across the country continue to grow and evolve. In order to support these programs, librarians are often expected to convert face-to-face classes and reference sessions to the online environment. Due to the necessity of explaining information literacy concepts and demonstrating the access and use of library resources,…

A Qualitative Exploration of Cyber-Bystanders and Moral Engagement

ERIC Educational Resources Information Center

Price, Deborah; Green, Deborah; Spears, Barbara; Scrimgeour, Margaret; Barnes, Alan; Geer, Ruth; Johnson, Bruce

2014-01-01

Studies have found that moral disengagement plays a significant role in the continuation of bullying situations (Bonanno, 2005); however, the moral stance of cyber-bystanders--those who witness online bullying--is not yet clear. While research into traditional face-to-face bullying reported that peers would probably or certainly intervene to…

Career Development with Transgender College Students: Implications for Career and Employment Counselors

ERIC Educational Resources Information Center

Scott, David A.; Belke, Stephanie L.; Barfield, Hannah G.

2011-01-01

The number of transgender college students continues to increase every year. These students face unique challenges that many college and university career centers are not prepared to handle. This article describes some of the challenges facing transgender students and college career centers. A professional development design is proposed to assist…

Examining the Academic Counseling Courses as a Support Service in Distance Learning

ERIC Educational Resources Information Center

Cekerol, Kamil; Bozkaya, Mujgan

2010-01-01

Academic counseling courses, in which learner support is provided in a face-to-face environment, maintain their importance and continuity since the beginning of the distance education system in Anadolu University. Academic counseling courses, which are carried out by getting support from various universities, are conducted by bringing the…

A Numerical Methods Course Based on B-Learning: Integrated Learning Design and Follow Up

ERIC Educational Resources Information Center

Cepeda, Francisco Javier Delgado

2013-01-01

Information and communication technologies advance continuously, providing a real support for learning processes. Learning technologies address areas which previously have corresponded to face-to-face learning, while mobile resources are having a growing impact on education. Numerical Methods is a discipline and profession based on technology. In…

Statistics Student Performance and Anxiety: Comparisons in Course Delivery and Student Characteristics

ERIC Educational Resources Information Center

Hedges, Sarai

2017-01-01

The statistics education community continues to explore the differences in performance outcomes and in student attitudes between online and face-to-face delivery methods of statistics courses. In this quasi-experimental study student persistence, exam, quiz, and homework scores were compared between delivery methods, class status, and programs of…

A Letter to Our next President

ERIC Educational Resources Information Center

Ladson-Billings, Gloria

2008-01-01

The next president of the United States faces monumental challenges in the areas of national defense, the economy, and health care. However, one daunting domestic issue the nation must face is the continued educational inequity that exists between children of color and their white counterparts in our schools. This article looks at four facets of…

Union for International Cancer Control International Session: healthcare economics: the significance of the UN Summit non-communicable diseases political declaration in Asia.

PubMed

Akaza, Hideyuki; Kawahara, Norie; Masui, Tohru; Takeyama, Kunihiko; Nogimori, Masafumi; Roh, Jae Kyung

2013-06-01

The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized an international session as part of the official program of the 71st Annual Meeting of the Japanese Cancer Association to discuss the topic "Healthcare Economics: The Significance of the UN Summit non-communicable diseases (NCDs) Political Declaration in Asia." The presenters and participants discussed the growing cost of cancer in the Asian region and the challenges that are faced by the countries of Asia, all of which face budgetary and other systemic constraints in tackling and controlling cancer in the region. The session benefited from the participation of various stakeholders, including cancer researchers and representatives of the pharmaceutical industry. They discussed the significance of the UN Political Declaration on the prevention and control of NCDs (2011) as a means of boosting awareness of cancer in the Asian region and also addressed the ways in which stakeholders can cooperate to improve cancer control and treatment. Other issues that were covered included challenges relating to pharmaceutical trials in Asia and how to link knowledge and research outcomes. The session concluded with the recognition that with the onset of a super-aged society in most countries in Asia and an increasing focus on quality of life rather than quantity of life, it is more important than ever for all stakeholders to continue to share information and promote policy dialogue on cancer control and treatment. © 2013 Japanese Cancer Association.

Modulation of fusiform cortex activity by cholinesterase inhibition predicts effects on subsequent memory.

PubMed

Bentley, P; Driver, J; Dolan, R J

2009-09-01

Cholinergic influences on memory are likely to be expressed at several processing stages, including via well-recognized effects of acetylcholine on stimulus processing during encoding. Since previous studies have shown that cholinesterase inhibition enhances visual extrastriate cortex activity during stimulus encoding, especially under attention-demanding tasks, we tested whether this effect correlates with improved subsequent memory. In a within-subject physostigmine versus placebo design, we measured brain activity with functional magnetic resonance imaging while healthy and mild Alzheimer's disease subjects performed superficial and deep encoding tasks on face (and building) visual stimuli. We explored regions in which physostigmine modulation of face-selective neural responses correlated with physostigmine effects on subsequent recognition performance. In healthy subjects physostigmine led to enhanced later recognition for deep- versus superficially-encoded faces, which correlated across subjects with a physostigmine-induced enhancement of face-selective responses in right fusiform cortex during deep- versus superficial-encoding tasks. In contrast, the Alzheimer's disease group showed neither a depth of processing effect nor restoration of this with physostigmine. Instead, patients showed a task-independent improvement in confident memory with physostigmine, an effect that correlated with enhancements in face-selective (but task-independent) responses in bilateral fusiform cortices. Our results indicate that one mechanism by which cholinesterase inhibitors can improve memory is by enhancing extrastriate cortex stimulus selectivity at encoding, in a manner that for healthy people but not in Alzheimer's disease is dependent upon depth of processing.

Global Binary Continuity for Color Face Detection With Complex Background

NASA Astrophysics Data System (ADS)

Belavadi, Bhaskar; Mahendra Prashanth, K. V.; Joshi, Sujay S.; Suprathik, N.

2017-08-01

In this paper, we propose a method to detect human faces in color images, with complex background. The proposed algorithm makes use of basically two color space models, specifically HSV and YCgCr. The color segmented image is filled uniformly with a single color (binary) and then all unwanted discontinuous lines are removed to get the final image. Experimental results on Caltech database manifests that the purported model is able to accomplish far better segmentation for faces of varying orientations, skin color and background environment.

Selecting a Subset of Stimulus-Response Pairs with Maximal Transmitted Information

DTIC Science & Technology

1992-03-01

Maathe19tical 19 AT RCODS1.SBJCEM (continue on reverse if necessary and idertif by bock number) VSystem designer. are often faced with the task of...Gary K. Poock, Asoctate Advisor -- ~arlR’ Jones, Chairman Command, Co t and Communications Academic Group ii ABSTRACT System designers are often faced ...performance. 3. Stimulus-Response Pairs System designers are often faced with the task of choosing which of several stimuli should be used to represent 6 a

The dumbest mistake I ever made.

PubMed

Reichman, O Howard

2015-01-01

Life as a Neurological Surgeon is a foreboding responsibility and a gratifying opportunity. Having the confidence and trust of individuals faced with a life or death situation requires extensive training and experience. Curiosity provides the motivation to continuously seek better understanding of complex disease problems, better technology, improved diagnostic capability, and surgical skills. Solution of these challenges has been a constant process for several decades and continues to pose opportunities for progress. Early observation of results provides important information, but in many circumstances it may require long-term evaluation to fully document the benefit, or lack of benefit, for any treatment procedure. The focus of attention by the Neurological Surgeon must be on the proper immediate management of each given situation, but it is also important, and a responsibility to consider the long-term consequences or results. This presents a difficult challenge because patients move into distant places and Neurological Surgeons frequently move to accept new opportunities. It is expensive and cumbersome to retain records for many years. It is also unpredictable which patient's information will become particularly significant. It is an opportunity to describe experience with four patients to illustrate this dilemma.

Neonatal pulmonary physiology.

PubMed

Davis, Ryan P; Mychaliska, George B

2013-11-01

Managing pulmonary issues faced by both term and preterm infants remains a challenge to the practicing pediatric surgeon. An understanding of normal fetal and neonatal pulmonary development and physiology is the cornerstone for understanding the pathophysiology and treatment of many congenital and acquired problems in the neonate. Progression through the phases of lung development and the transition to postnatal life requires a symphony of complex and overlapping events to work in concert for smooth and successful transition to occur. Pulmonary physiology and oxygen transport in the neonate are similar to older children; however, there are critical differences that are important to take into consideration when treating the youngest of patients. Our understanding of fetal and neonatal pulmonary physiology continues to evolve as the molecular and cellular events governing these processes are better understood. This deeper understanding has helped to facilitate groundbreaking research, leading to improved technology and treatment of term and preterm infants. As therapeutics and research continue to advance, a review of neonatal pulmonary physiology is essential to assist the clinician with his/her management of the wide variety of challenging congenital and acquired pulmonary disease. © 2013 Published by Elsevier Inc.

Complex systems thinking in emergency medicine: A novel paradigm for a rapidly changing and interconnected health care landscape.

PubMed

Widmer, Matthew A; Swanson, R Chad; Zink, Brian J; Pines, Jesse M

2017-12-27

The specialty of emergency medicine is experiencing the convergence of a number of transformational forces in the United States, including health care reform, technological advancements, and societal shifts. These bring both opportunity and uncertainty. 21ST CENTURY CHALLENGES: Persistent challenges such as the opioid epidemic, rising health care costs, misaligned incentives, patients with multiple chronic diseases, and emergency department crowding continue to plague the acute, unscheduled care system. The traditional approach to health care practice and improvement-reductionism-is not adequate for the complexity of the twenty-first century. Reductionist thinking will likely continue to produce unintended consequences and suboptimal outcomes. Complex systems thinking provides a perspective and set of tools better suited for the challenges and opportunities facing public health in general, and emergency medicine more specifically. This article introduces complex systems thinking and argues for its application in the context of emergency medicine by drawing on the history of the circumstances surrounding the formation of the specialty and by providing examples of its application to several practice challenges. © 2017 John Wiley & Sons, Ltd.

The effects of a culturally gender-specifying peripheral cue (headscarf) on the categorization of faces by gender.

PubMed

Megreya, Ahmed M

2015-06-01

Faces convey a wealth of cues that influence social categorizations and subsequent cognition and behavior. This study examined the effects of wearing a headscarf on face categorization by gender using Egyptian observers who have an extensive exposure with headscarf-framed female faces. A typical headscarf (worn by females) enhanced perceived femininity whereas an atypical headscarf (worn by males) reduced perceived masculinity. Regardless of whether the faces were presented briefly, or until participants responded, the typical headscarf had no effect on categorizing female faces but the atypical headscarf greatly slowed down categorizing male faces. However, a typical headscarf advantage was noticed when the atypical headscarf condition was removed. In addition, both typical and atypical headscarf effects were greatly strengthened when faces were presented as negatives. These data provide support to the dynamic continuity account of social categorization that suggests a competition among multiple simultaneous representations until a construal is stabilized. Copyright © 2015 Elsevier B.V. All rights reserved.

Experience Shapes the Development of Neural Substrates of Face Processing in Human Ventral Temporal Cortex.

PubMed

Golarai, Golijeh; Liberman, Alina; Grill-Spector, Kalanit

2017-02-01

In adult humans, the ventral temporal cortex (VTC) represents faces in a reproducible topology. However, it is unknown what role visual experience plays in the development of this topology. Using functional magnetic resonance imaging in children and adults, we found a sequential development, in which the topology of face-selective activations across the VTC was matured by age 7, but the spatial extent and degree of face selectivity continued to develop past age 7 into adulthood. Importantly, own- and other-age faces were differentially represented, both in the distributed multivoxel patterns across the VTC, and also in the magnitude of responses of face-selective regions. These results provide strong evidence that experience shapes cortical representations of faces during development from childhood to adulthood. Our findings have important implications for the role of experience and age in shaping the neural substrates of face processing in the human VTC. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

"Blindsight" and subjective awareness of fearful faces: Inversion reverses the deficits in fear perception associated with core psychopathic traits.

PubMed

Oliver, Lindsay D; Mao, Alexander; Mitchell, Derek G V

2015-01-01

Though emotional faces preferentially reach awareness, the present study utilised both objective and subjective indices of awareness to determine whether they enhance subjective awareness and "blindsight". Under continuous flash suppression, participants localised a disgusted, fearful or neutral face (objective index), and rated their confidence (subjective index). Psychopathic traits were also measured to investigate their influence on emotion perception. As predicted, fear increased localisation accuracy, subjective awareness and "blindsight" of upright faces. Coldhearted traits were inversely related to subjective awareness, but not "blindsight", of upright fearful faces. In a follow-up experiment using inverted faces, increased localisation accuracy and awareness, but not "blindsight", were observed for fear. Surprisingly, awareness of inverted fearful faces was positively correlated with coldheartedness. These results suggest that emotion enhances both pre-conscious processing and the qualitative experience of awareness, but that pre-conscious and conscious processing of emotional faces rely on at least partially dissociable cognitive mechanisms.

Using a smartphone-based self-management platform to support medication adherence and clinical consultation in Parkinson's disease.

PubMed

Lakshminarayana, Rashmi; Wang, Duolao; Burn, David; Chaudhuri, K Ray; Galtrey, Clare; Guzman, Natalie Valle; Hellman, Bruce; Ben James; Pal, Suvankar; Stamford, Jon; Steiger, Malcolm; Stott, R W; Teo, James; Barker, Roger A; Wang, Emma; Bloem, Bastiaan R; van der Eijk, Martijn; Rochester, Lynn; Williams, Adrian

2017-01-01

The progressive nature of Parkinson's disease, its complex treatment regimens and the high rates of comorbid conditions make self-management and treatment adherence a challenge. Clinicians have limited face-to-face consultation time with Parkinson's disease patients, making it difficult to comprehensively address non-adherence. Here we share the results from a multi-centre (seven centres) randomised controlled trial conducted in England and Scotland to assess the impact of using a smartphone-based Parkinson's tracker app to promote patient self-management, enhance treatment adherence and quality of clinical consultation. Eligible Parkinson's disease patients were randomised using a 1:1 ratio according to a computer-generated random sequence, stratified by centre and using blocks of variable size, to intervention Parkinson's Tracker App or control (Treatment as Usual). Primary outcome was the self-reported score of adherence to treatment (Morisky medication adherence scale -8) at 16 weeks. Secondary outcomes were Quality of Life (Parkinson's disease questionnaire -39), quality of consultation for Parkinson's disease patients ( Patient-centred questionnaire for Parkinson's disease ), impact on non-motor symptoms (Non-motor symptoms questionnaire), depression and anxiety (Hospital anxiety and depression scale) and beliefs about medication (Beliefs about Medication Questionnaire) at 16 weeks. Primary and secondary endpoints were analysed using a generalised linear model with treatment as the fixed effect and baseline measurement as the covariate. 158 patients completed the study (Parkinson's tracker app = 68 and TAU = 90). At 16 weeks Parkinson's tracker app significantly improved adherence, compared to treatment as usual (mean difference: 0.39, 95%CI 0.04-0.74; p  = 0.0304) with no confounding effects of gender, number of comorbidities and age. Among secondary outcomes, Parkinson's tracker app significantly improved patients' perception of quality of consultation (0.15, 95% CI 0.03 to 0.27; p  = 0.0110). The change in non-motor symptoms was -0.82 (95% CI -1.75 to 0.10; p  = 0.0822). 72% of participants in the Parkinson's tracker app group continued to use and engage with the application throughout the 16-week trial period. The Parkinson's tracker app can be an effective and novel way of enhancing self-reported medication adherence and quality of clinical consultation by supporting self-management in Parkinson's disease in patients owning smartphones. Further work is recommended to determine whether the benefits of the intervention are maintained beyond the 16 week study period.

Impaired neural processing of dynamic faces in left-onset Parkinson's disease.

PubMed

Garrido-Vásquez, Patricia; Pell, Marc D; Paulmann, Silke; Sehm, Bernhard; Kotz, Sonja A

2016-02-01

Parkinson's disease (PD) affects patients beyond the motor domain. According to previous evidence, one mechanism that may be impaired in the disease is face processing. However, few studies have investigated this process at the neural level in PD. Moreover, research using dynamic facial displays rather than static pictures is scarce, but highly warranted due to the higher ecological validity of dynamic stimuli. In the present study we aimed to investigate how PD patients process emotional and non-emotional dynamic face stimuli at the neural level using event-related potentials. Since the literature has revealed a predominantly right-lateralized network for dynamic face processing, we divided the group into patients with left (LPD) and right (RPD) motor symptom onset (right versus left cerebral hemisphere predominantly affected, respectively). Participants watched short video clips of happy, angry, and neutral expressions and engaged in a shallow gender decision task in order to avoid confounds of task difficulty in the data. In line with our expectations, the LPD group showed significant face processing deficits compared to controls. While there were no group differences in early, sensory-driven processing (fronto-central N1 and posterior P1), the vertex positive potential, which is considered the fronto-central counterpart of the face-specific posterior N170 component, had a reduced amplitude and delayed latency in the LPD group. This may indicate disturbances of structural face processing in LPD. Furthermore, the effect was independent of the emotional content of the videos. In contrast, static facial identity recognition performance in LPD was not significantly different from controls, and comprehensive testing of cognitive functions did not reveal any deficits in this group. We therefore conclude that PD, and more specifically the predominant right-hemispheric affection in left-onset PD, is associated with impaired processing of dynamic facial expressions, which could be one of the mechanisms behind the often reported problems of PD patients in their social lives. Copyright © 2016 Elsevier Ltd. All rights reserved.

Challenges faced in long term ventricular assist device support.

PubMed

Ikegami, Hirohisa; Kurlansky, Paul; Takeda, Koji; Naka, Yoshifumi

2016-08-01

The development of ventricular assist device (VAD) has been one of the revolutionary advancements in end-stage heart failure management. Although the device has developed and improved significantly over the last few decades, we still face multiple challenges. This review will discuss quality of life, survival, and clinically encountered complications in patients with VAD support. The literature was extensively reviewed for studies describing the above topic area. We describe the impact of major challenges faced in VAD support and discuss their future and expectations. Expert commentary: The technological advancement of VADs has contributed to major improvement of overall survival, enhancement of quality of life and decrease of incidence of complications. It is expected that technologies will continue to evolve. At the same time, the indications for and timing of device implantation, and selection of device type are continuously important in clinical practice setting.

[Psychometric validation of the telephone memory test].

PubMed

Ortiz, T; Fernández, A; Martínez-Castillo, E; Maestú, F; Martínez-Arias, R; López-Ibor, J J

1999-01-01

Several pathologies (i.e. Alzheimer's disease) that courses with memory alterations, appears in a context of impaired cognitive status and mobility. In recent years, several investigations were carried out in order to design short batteries that detect those subjects under risk of dementia. Some of this batteries were also design to be administrated over the telephone, trying to overcome the accessibility limitations of this patients. In this paper we present a battery (called Autotest de Memoria) essentially composed by episodic and semantic memory tests, administered both over the telephone and face to face. This battery was employed in the cognitive assessment of healthy controls and subjects diagnosed as probable Alzheimer's disease patients. Results show the capability of this battery in order to discriminate patients and healthy controls, a great sensibility and specificity, and a nearly absolute parallelism of telephone and face to face administrations. These data led us to claim the usefulness and practicality of our so called .

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan

PubMed Central

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient’s economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households. PMID:29445672

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan.

PubMed

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient's economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households.

A Comparative Study on the Practice of Continuous Assessment between Addis Ababa and Unity Universities

ERIC Educational Resources Information Center

Zeleke, Aytaged Sisay

2013-01-01

This paper aims to explore the practice of continuous assessment at Unity University College and Addis Ababa University. It has also investigated constraints instructors say they have been facing in implementing continuous assessment. Students' attitudes about the practice of this assessment mode towards their course achievements were explored.…

Academic Continuity: Staying True to Teaching Values and Objectives in the Face of Course Interruptions

ERIC Educational Resources Information Center

Day, Terence

2015-01-01

Academic continuity planning is an emerging tool for dealing with class cancellation associated with natural disasters, acts of violence and the threat of pandemics. However, academic continuity can also be an issue with respect to less dramatic events, such as power outages, inclement weather, or the temporary unavailability of an instructor,…

Strategies for conserving forest genetic resources in the face of climate change

Treesearch

John Bradley St. Clair; Glenn Thomas Howe

2011-01-01

Conservation of genetic diversity is important for continued evolution of populations to new environments, as well as continued availability of traits of interest in genetic improvement programs. Rapidly changing climates present new threats to the conservation of forest genetic resources. We can no longer assume that in situ reserves will continue to preserve existing...

Early recognition of Cushing's disease: a case study.

PubMed

Iuliano, Sherry L; Laws, Edward R

2013-08-01

To present a case study of a 34-year-old woman with Cushing's disease and provide nurse practitioners (NPs) with the understanding of the clinical presentation needed for early recognition and treatment of the disease. A comprehensive review of published literature on Cushing's disease. Findings from history, physical examination, and diagnostic studies of a woman presenting to primary care NPs, physicians and other healthcare providers with multiple symptoms of Cushing's disease. Cushing's disease is the result of the pituitary gland producing excess amounts of adrenocorticotropic hormone (ACTH) causing the overproduction of cortisol. The disease is fairly rare and is seen mostly in women. Common chief complaints include increased facial hair, weight gain, amenorrhea, changes in the face, neck, and abdomen, with muscle wasting of the lower extremities. Untreated, diabetes mellitus and hypertension can occur and increase the patient's morbidity and mortality. Early recognition and appropriate referral can reverse the signs and symptoms over time and lead to a significantly improved quality of life. This case presented the challenges faced by NPs and physicians in diagnosing patients with Cushing's disease. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Dental anatomy and pathology encountered on routine CT of the head and neck.

PubMed

Steinklein, Jared; Nguyen, Vinh

2013-12-01

Although dental CT is not routinely performed at hospital imaging centers, dental and periodontal disease can be recognized on standard high-resolution CT of the neck and face. These findings can have significant implications with regard to not only dental disease, but also diseases of the sinuses, jaw, and surrounding soft tissues. This article serves to review dental and periodontal anatomy and pathology as well as other regional entities with dental involvement and to discuss the imaging findings. Recognition of dental and periodontal disease has the potential to affect management and preclude further complications, thereby preserving the smile, one of the most recognizable and attractive features of the human face and, unfortunately, often disease ridden. Although practicing good oral hygiene and visiting the dentist for regular examinations and cleanings are the most effective ways to prevent disease, some patients do not take these preventative measures. Thus, radiologists play a role in diagnosing dental disease and complications such as chronic periodontitis and abscesses, nonhealing fractures and osteomyelitis, oroantral fistulas, tumoral diseases, osteonecrosis of the jaw, and other conditions.

Web-Based Cancer Communication and Decision Making Systems: Connecting Patients, Caregivers, and Clinicians for Improved Health Outcomes

PubMed Central

DuBenske, Lori L.; Gustafson, David H.; Shaw, Bret R.; Cleary, James F.

2011-01-01

Over the cancer disease trajectory, from diagnosis and treatment to remission or end of life, patients and their families face difficult decisions. The provision of information and support when most relevant can optimize cancer decision making and coping. An interactive health communication system (IHCS) offers the potential to bridge the communication gaps that occur among patients, family, and clinicians and to empower each to actively engage in cancer care and shared decision making. This is a report of the authors' experience (with a discussion of relevant literature) in developing and testing a Web-based IHCS—the Comprehensive Health Enhancement Support System (CHESS)—for patients with advanced lung cancer and their family caregivers. CHESS provides information, communication, and coaching resources as well as a symptom tracking system that reports health status to the clinical team. Development of an IHCS includes a needs assessment of the target audience and applied theory informed by continued stakeholder involvement in early testing. Critical issues of IHCS implementation include 1) need for interventions that accommodate a variety of format preferences and technology comfort ranges; 2) IHCS user training, 3) clinician investment in IHCS promotion, and 4) IHCS integration with existing medical systems. In creating such comprehensive systems, development strategies need to be grounded in population needs with appropriate use of technology that serves the target users, including the patient/family, clinical team, and health care organization. Implementation strategies should address timing, personnel, and environmental factors to facilitate continued use and benefit from IHCS. An interactive health communication system (IHCS) offers one platform for providing the information, communication, and coaching resources that cancer patients and their families need to understand the disease, find support, and develop decision-making and coping skills. One such IHCS—the Comprehensive Health Enhancement Support System (CHESS)—has evolved over the past 20 years. Based on our recent experience creating and testing a new version of CHESS—“Coping with Lung Cancer: A Network of Support”—this article outlines the issues faced in developing and implementing such a system within the cancer context. PMID:21041539

Germs, genomics and global public health: How can advances in genomic sciences be integrated into public health in the developing world to deal with infectious diseases?

PubMed

Pang, T

2009-12-01

Scientific and technological advances derived from the genomics revolution have a central role to play in dealing with continuing infectious disease threats in the developing world caused by emerging and re-emerging pathogens. These techniques, coupled with increasing knowledge of host-pathogen interactions, can assist in the early identification and containment of outbreaks as well as in the development of preventive vaccination and therapeutic interventions, including the urgent need for new antibiotics. However, the effective application of genomics technologies faces key barriers and challenges which occur at three stages: from the research to the products, from the products to individual patients, and, finally, from patients to entire populations. There needs to be an emphasis on research in areas of greatest need, in facilitating the translation of research into interventions and, finally, the effective delivery of such interventions to those in greatest need. Ultimate success will depend on bringing together science, society and policy to develop effective public health implementation strategies to provide health security and health equity for all peoples.

[Social stigma and the families of patients with tuberculosis: a study based on cluster and multiple correspondence analysis].

PubMed

Touso, Michelle Mosna; Popolin, Marcela Paschoal; Crispim, Juliane de Almeida; Freitas, Isabela Moreira de; Rodrigues, Ludmila Barbosa Bandeira; Yamamura, Mellina; Pinto, Ione Carvalho; Monroe, Aline Aparecida; Palha, Pedro Fredemir; Ferraudo, Antônio Sérgio; Villa, Tereza Cristina Scatena; Arcêncio, Ricardo Alexandre

2014-11-01

The social stigma associated with TB is a challenge facing management of the area of public health care. The aim of this study was to investigate the social stigma in families of patients with TB and identify the profile of those who are affected by the event in relation to socioeconomic and demographic conditions. It is a cross-sectional study that was conducted in 2011 in the city of Ribeirão Preto, state of São Paulo, Brazil, with a sample of 110 individuals. The data were analyzed using the univariate descriptive technique and cluster and multiple correspondence assessment. The stigmatized groups tend to have lower scholarity, incipient access to the media and little understanding about TB, as opposed to those that have higher educational levels, continuous access to the media, consider themselves well informed and show proactive attitudes to deal with the disease. The identification of varied profiles highlights the need to develop health interventions to cater to the singularities of families with respect to the social stigma of the disease.

CFD gas distribution analysis for different continuous-miner scrubber redirection configurations

PubMed Central

Zheng, Y.; Organiscak, J.A.; Zhou, L.; Beck, T.W.; Rider, J.P.

2018-01-01

The U.S. National Institute for Occupational Safety and Health (NIOSH)’s Pittsburgh Mining Research Division (PMRD) recently developed a series of models using computational fluid dynamics (CFD) to study gas distribution around a continuous mining machine with various fan-powered flooded bed scrubber discharge configurations in an exhaust curtain working face. CFD models utilizing species transport model without reactions in FLUENT were constructed to evaluate the redirection of scrubber discharge toward the mining face rather than behind the return curtain. The study illustrates the gas distribution in the slab (second) cut. The following scenarios are considered in this study: 100 percent of the discharge redirected back toward the face on the off-curtain side; 100 percent of the discharge redirected back toward the face, but divided equally to both sides; and 15 percent of the discharge redirected toward the face on the off-curtain side, with 85 percent directed toward the return curtain. These models are compared against a model with a conventional scrubber discharge where air is directed away from the face into the return. The models were validated against experimental data, proving to accurately predict sulfur hexafluoride (SF6) gas levels at four gas monitoring locations. This study includes a predictive simulation examining a 45° scrubber angle compared with the 23° angle for the 100 percent redirected, equally divided case. This paper describes the validation of the CFD models based on experimental data of the gas distribution results. PMID:29375242

CFD gas distribution analysis for different continuous-miner scrubber redirection configurations.

PubMed

Zheng, Y; Organiscak, J A; Zhou, L; Beck, T W; Rider, J P

2017-01-01

The U.S. National Institute for Occupational Safety and Health (NIOSH)'s Pittsburgh Mining Research Division (PMRD) recently developed a series of models using computational fluid dynamics (CFD) to study gas distribution around a continuous mining machine with various fan-powered flooded bed scrubber discharge configurations in an exhaust curtain working face. CFD models utilizing species transport model without reactions in FLUENT were constructed to evaluate the redirection of scrubber discharge toward the mining face rather than behind the return curtain. The study illustrates the gas distribution in the slab (second) cut. The following scenarios are considered in this study: 100 percent of the discharge redirected back toward the face on the off-curtain side; 100 percent of the discharge redirected back toward the face, but divided equally to both sides; and 15 percent of the discharge redirected toward the face on the off-curtain side, with 85 percent directed toward the return curtain. These models are compared against a model with a conventional scrubber discharge where air is directed away from the face into the return. The models were validated against experimental data, proving to accurately predict sulfur hexafluoride (SF 6 ) gas levels at four gas monitoring locations. This study includes a predictive simulation examining a 45° scrubber angle compared with the 23° angle for the 100 percent redirected, equally divided case. This paper describes the validation of the CFD models based on experimental data of the gas distribution results.

Content and Methods used to Train Tobacco Cessation Treatment Providers: An International Survey.

PubMed

Kruse, Gina R; Rigotti, Nancy A; Raw, Martin; McNeill, Ann; Murray, Rachael; Piné-Abata, Hembadoon; Bitton, Asaf; McEwen, Andy

2017-12-01

There are limited existing data describing the training methods used to educate tobacco cessation treatment providers around the world. To measure the prevalence of tobacco cessation treatment content, skills training and teaching methods reported by tobacco treatment training programs across the world. Web-based survey in May-September 2013 among tobacco cessation training experts across six geographic regions and four World Bank income levels. Response rate was 73% (84 of 115 countries contacted). Of 104 individual programs from 84 countries, most reported teaching brief advice (78%) and one-to-one counseling (74%); telephone counseling was uncommon (33%). Overall, teaching of knowledge topics was more commonly reported than skills training. Programs in lower income countries less often reported teaching about medications, behavioral treatments and biomarkers and less often reported skills-based training about interviewing clients, medication management, biomarker measurement, assessing client outcomes, and assisting clients with co-morbidities. Programs reported a median 15 hours of training. Face-to-face training was common (85%); online programs were rare (19%). Almost half (47%) included no learner assessment. Only 35% offered continuing education. Nearly all programs reported teaching evidence-based treatment modalities in a face-to-face format. Few programs delivered training online or offered continuing education. Skills-based training was less common among low- and middle-income countries (LMICs). There is a large unmet need for tobacco treatment training protocols which emphasize practical skills, and which are more rapidly scalable than face-to-face training in LMICs.

Deficits in Cross-Race Face Learning: Insights From Eye Movements and Pupillometry

PubMed Central

Goldinger, Stephen D.; He, Yi; Papesh, Megan H.

2010-01-01

The own-race bias (ORB) is a well-known finding wherein people are better able to recognize and discriminate own-race faces, relative to cross-race faces. In 2 experiments, participants viewed Asian and Caucasian faces, in preparation for recognition memory tests, while their eye movements and pupil diameters were continuously monitored. In Experiment 1 (with Caucasian participants), systematic differences emerged in both measures as a function of depicted race: While encoding cross-race faces, participants made fewer (and longer) fixations, they preferentially attended to different sets of features, and their pupils were more dilated, all relative to own-race faces. Also, in both measures, a pattern emerged wherein some participants reduced their apparent encoding effort to cross-race faces over trials. In Experiment 2 (with Asian participants), the authors observed the same patterns, although the ORB favored the opposite set of faces. Taken together, the results suggest that the ORB appears during initial perceptual encoding. Relative to own-race face encoding, cross-race encoding requires greater effort, which may reduce vigilance in some participants. PMID:19686008

Describing the epidemiology of rheumatic diseases: methodological aspects.

PubMed

Guillemin, Francis

2012-03-01

Producing descriptive epidemiology data is essential to understand the burden of rheumatic diseases (prevalence) and their dynamic in the population (incidence). No matter how simple such indicators may look, the correct collection of data and the appropriate interpretation of the results face several challenges: distinguishing indicators, facing the costs of obtaining data, using appropriate definition, identifying optimal sources of data, choosing among many survey methods, dealing with estimates precision, and standardizing results. This study describes the underlying methodological difficulties to be overcome so as to make descriptive indicators reliable and interpretable.

Curriculum-Based Virtual Field Trips: Career Development Opportunities for Students with Disabilities

ERIC Educational Resources Information Center

Elleven, Russell; Wircenski, Michelle; Wircenski, Jerry; Nimon, Kim

2006-01-01

Many changes are taking place in our country. Technology continues to impact on the workplace, demographics are changing the face of our neighborhoods, communities, and work environments. Globalization is placing greater demands on the economy and on workers. Educators and employers must face the challenge of how to prepare learners for new roles…

Don't Silence "The Dinosaurs": Keeping Caution Alive with Regard to Social Work Distance Education

ERIC Educational Resources Information Center

Sawrikar, Pooja; Lenette, Caroline; McDonald, Donna; Fowler, Jane

2015-01-01

Distance education (DE) in social work programs and studies on its comparable effectiveness with face-to-face education continue to increase. Yet not all faculty are convinced of the results, and this study explores why. Three case studies indicate that reservations center on valuing the process of learning and nonverbal communication. Issues…

Losing New Graduate Bedside Nurses: A Practice Improvement Initiative

ERIC Educational Resources Information Center

Miller, Beverly

2017-01-01

New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention…

Shared Prosperity and the California Economy: Implications for California's Workforce Investment System.

ERIC Educational Resources Information Center

Levy, Stephen

Despite 6 years of economic growth, California's workforce investment system faces the following challenges: (1) meeting the needs of workers who do not earn enough to bring their families significantly above the poverty level; (2) meeting the needs of employers who face continuing shortages of workers with needed skills; and (3) meeting the needs…

78 FR 40317 - Highly Migratory Species; Atlantic Shark Management Measures; Amendment 5a

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... process. Generally, SEDAR stock assessments have three stages. Meetings in these stages may be face-to-face or by webinar or conference call. All meetings are open to the public. The first stage of the... from 2008-2011. If fishing continues in a fashion similar to the years 2008-2011, all three quotas in...

Effective Pedagogical Practices in Online English Language Teacher Education

ERIC Educational Resources Information Center

Rodriguez, Migdalia Elizabeth

2016-01-01

Internet technology has made possible for students to be able to have access to continuous learning. Currently, online education has gained credibility and academic leaders' belief about its value has increased in the US (2014 Survey of Online Learning). Studies are no longer solely focused on comparing face-to-face to online learning, but on…

New Systemic Roles Facilitating the Integration of Face-to-Face and Virtual Learning

ERIC Educational Resources Information Center

Furey, Doug; Stevens, Ken

2008-01-01

The introduction of web-based education in Canadian schools, as in other developed countries, has been particularly noticeable in rural areas. Small schools in rural communities have continued to get smaller as families relocate in urban areas in search of increased educational and vocational opportunities. There are a number of issues common to…

Strategies to Enhance Student Success: A Discourse Analysis of Academic Advice in International Student Handbooks

ERIC Educational Resources Information Center

Romerhausen, Nick J.

2013-01-01

As the population of international students continues to rise at U.S. colleges and universities, multiple academic obstacles pose barriers to success. Research on strategies of intervention has primarily included face-to-face interactions while an exploration of other assistance approaches is minimal in comparison. This study explored the role…

Inclusion of Students with Disabilities in South African Higher Education

ERIC Educational Resources Information Center

Mutanga, Oliver

2018-01-01

Globally, few students with disabilities progress to higher education. This is mostly due to avoidable barriers they face as they navigate different educational structures from lower levels. Even for those few students who make it to higher education, they continue to face challenges. A qualitative study was carried out at the University of the…

Influence of Geographic Affiliation on Student Performance in Online Geology and Meteorology Courses

ERIC Educational Resources Information Center

Sumrall, Jeanne L.; Clary, Renee M.; Larson, Erik B.

2017-01-01

The online learning environment can add substantial advantages to learning such as continuous access to material and the ability to foster learning through additional visual supplemental materials, but it can also add further challenges that may not be as evident when teaching traditional, face-to-face courses. An individual's place affiliation…

Evaluation of e-earning Outcomes: Experience from an Online Psychotherapy Education Programme

ERIC Educational Resources Information Center

Blackmore, Chris; Tantam, Digby; van Deurzen, Emmy

2008-01-01

SEPTIMUS is a one-year Europe-wide postgraduate theoretical course for psychotherapists and counsellors provided entirely via the Internet. It may be used as part of a training course, with face-to-face elements provided locally, or for continuing professional development. The course was developed at the University of Sheffield in collaboration…

Predictors of Teacher Satisfaction with Online Professional Development: Evidence from the USA's e-Learning for Educators Initiative

ERIC Educational Resources Information Center

Reeves, Todd D.; Pedulla, Joseph J.

2011-01-01

Online professional development (OPD) is proliferating in an effort to eliminate barriers to high-quality in-service teacher training. Using the Internet as a vehicle for continuing professional development, however, introduces new concerns largely absent in its face-to-face counterpart. For example, evidence from the USA's e-Learning for…

Language and Cultural Challenges Facing Business Faculty in the Ever-Expanding Global Classroom

ERIC Educational Resources Information Center

Vogel, Glen M.

2013-01-01

More than 690,000 foreign students studied in the United States during the 2009-10 academic year. As non-native English-speaking students continue to pour into American educational institutions, one question many educators have is: are these international students adequately prepared for the language and cultural demands they will face when they…

Logic Models as a Way to Support Online Students and Their Projects

ERIC Educational Resources Information Center

Strycker, Jesse

2016-01-01

As online enrollment continues to grow, students may need additional pedagogical supports to increase their likelihood of success in online environments that don't offer the same supports as those found in face to face classrooms. Logic models are a way to provide such support to students by helping to model project expectations, allowing students…

The Continuing Significance of Racism in the Lives of Asian American College Students

ERIC Educational Resources Information Center

Museus, Samuel D.; Park, Julie J.

2015-01-01

Asian Americans are one of the most misunderstood populations in higher education, and more research on this population is warranted. In this investigation, authors sought to understand the range of ways that Asian American students experience racism on a daily basis in college. They analyzed data from 46 individual, face-to-face qualitative…

Videoconferencing a Stroke Assessment Training Workshop: Effectiveness, Acceptability, and Cost

ERIC Educational Resources Information Center

Miller, Patricia A.; Huijbregts, Maria; French, Esme; Taylor, Denise; Reinikka, Kirsti; Berezny, Laura; Fry, Sherri; Grunin, Anna; Harvey, Melissa

2008-01-01

Introduction: Videoconferencing (VC) is becoming a common method for the delivery of continuing education (CE) to clinicians in remote locations. The purpose of this study was to compare the effectiveness, acceptability, and costs of a full-day training workshop (TW) delivered through two different formats: face-to-face (FTF) and VC. The TW was…

Intelligent Virtual Assistant's Impact on Technical Proficiency within Virtual Teams

ERIC Educational Resources Information Center

Graham, Christian; Jones, Nory B.

2016-01-01

Information-systems development continues to be a difficult process, particularly for virtual teams that do not have the luxury of meeting face-to-face. The research literature on this topic reinforces this point: the greater part of database systems development projects ends in failure. The use of virtual teams to complete projects further…

Audiences and Outcomes in Online and Traditional American Government Classes Revisited

ERIC Educational Resources Information Center

Botsch, Robert E.; Botsch, Carol S.

2012-01-01

In 1997 we first offered American government classes online as well as face-to-face classes. We administered pre- and posttests to our students to measure their general knowledge of American government, political attitudes, demographics, and some behaviors. Following an initial report in 2001, we continued to gather data for 10 more years; this…

Parkinson's disease and dopaminergic therapy—differential effects on movement, reward and cognition

PubMed Central

Hughes, L.; Ghosh, B. C. P.; Eckstein, D.; Williams-Gray, C. H.; Fallon, S.; Barker, R. A.; Owen, A. M.

2008-01-01

Cognitive deficits are very common in Parkinson's disease particularly for ‘executive functions’ associated with frontal cortico-striatal networks. Previous work has identified deficits in tasks that require attentional control like task-switching, and reward-based tasks like gambling or reversal learning. However, there is a complex relationship between the specific cognitive problems faced by an individual patient, their stage of disease and dopaminergic treatment. We used a bimodality continuous performance task during fMRI to examine how patients with Parkinson's disease represent the prospect of reward and switch between competing task rules accordingly. The task-switch was not separately cued but was based on the implicit reward relevance of spatial and verbal dimensions of successive compound stimuli. Nineteen patients were studied in relative ‘on’ and ‘off’ states, induced by dopaminergic medication withdrawal (Hoehn and Yahr stages 1–4). Patients were able to successfully complete the task and establish a bias to one or other dimension in order to gain reward. However the lateral prefrontal cortex and caudate nucleus showed a non-linear U-shape relationship between motor disease severity and regional brain activation. Dopaminergic treatment led to a shift in this U-shape function, supporting the hypothesis of differential neurodegeneration in separate motor and cognitive cortico–striato–thalamo–cortical circuits. In addition, anterior cingulate activation associated with reward expectation declined with more severe disease, whereas activation following actual rewards increased with more severe disease. This may facilitate a change in goal-directed behaviours from deferred predicted rewards to immediate actual rewards, particularly when on dopaminergic treatment. We discuss the implications for investigation and optimal treatment of this common condition at different stages of disease. PMID:18577547

The current status of positron emission tomography.

PubMed

Digby, W; Keppler, J

2000-01-01

Positron emission tomography (PET), invented over 25 years ago, is the only imaging technique that provides images of the biological basis of disease. Since disease is a biological process, PET routinely detects disease when other imaging studies, such as CT and MRI, are normal. In addition to its clinical effectiveness, PET has been shown to reduce costs, primarily due to the elimination of other less accurate diagnostic tests and ineffective surgeries. PET has been determined to be applicable to a number of specific applications in the areas of: imaging cancer patients, characterizing myocardial blood flow and viability, and brain imaging in various physiological and pathologic conditions. Tremendous progress has been made in resolving the regulatory and reimbursement issues facing the field of PET. Working with HCFA, representatives of the Institute for Clinical PET and the Society of Nuclear Medicine have brought about expanded HCFA coverage for PET. When HCFA first authorized payment for PET, all coverage decisions were restricted to HCFA and an expanded national coverage policy. HCFA revised its national coverage policy in 1997; this was the first of several steps taken by HCFA towards careful expansion of PET reimbursement. In March 1999, three new indications for whole-body PET scans were added to Medicare's coverage policy. The Institute for Clinical PET is continuing to work with HCFA on continued, appropriate expansion of the coverage policy. This article is partially excerpted from a written statement made by Terry Douglass, Ph.D., president of CTI, Inc., on May 12, 1999, before the Senate Committee on Commerce, Science and Transportation and its Subcommittee on Science, Technology and Space. This was part of the committee's study of "Emerging Technologies in the New Millennium."

Re-irradiation of metastatic disease in the neck from xeroderma pigmentosum.

PubMed

Wei, C C; Sanfilippo, N J; Myssiorek, D

2010-06-01

Xeroderma pigmentosum, an autosomal recessive disease that occurs with a frequency of 1:250,000, is caused by a genetic defect in nucleotide excision repair enzymes. Mutation of these enzymes leads to the development of multiple basal cell and squamous cell carcinomas. We present a case of xeroderma pigmentosum in a patient with cervical and intraparotid metastatic disease from recurrent cutaneous squamous cell carcinomas of the face and scalp, treated with neck dissection and re-irradiation. With the illustrative case report, we include a literature review of diagnosis, prognostic factors, and treatment, with emphasis on surgical and radiation treatment of cervical metastatic disease from recurrent skin carcinomas. A xeroderma pigmentosum patient presented to our clinic with a 2-cm right submental and 1-cm right infra-auricular mass after resection of multiple squamous cell carcinomas of the scalp and face, and external-beam radiation therapy to the right face and neck. Fine-needle aspiration biopsy of the submental mass revealed poorly differentiated squamous cell carcinoma. The patient was brought to the operating room for a right modified radical neck dissection and excision of the right submental and intraparotid mass. Surgical pathology revealed 3 level ia and supraclavicular lymph nodes that were positive for metastatic squamous cell carcinoma. Re-irradiation to the entire right hemi-neck and left submandibular nodal region was performed using opposed oblique portals for the upper neck and a low anterior en face hemi-neck portal. The left parotid region was also included in the re-irradiation volume. Treatment was completed without delayed complications or recurrences to date. To our knowledge, this is the first case report in the literature of a patient with xeroderma pigmentosum who subsequently developed metastatic disease from recurrent cutaneous squamous cell carcinoma. Because of the rarity of xeroderma pigmentosum, this case report is also the first to describe re-irradiation to treat cervical and intraparotid metastatic disease in a xeroderma pigmentosum patient.

Cognitive Assessment of Patients With Alzheimer's Disease by Telemedicine: Pilot Study.

PubMed

Carotenuto, Anna; Rea, Raffaele; Traini, Enea; Ricci, Giovanna; Fasanaro, Angiola Maria; Amenta, Francesco

2018-05-11

Approximately 46.8 million people are living with dementia worldwide and their number will grow in the next years. Any potential treatment should be administered as early as possible because it is important to provide an early cognitive assessment and to regularly monitor the mental function of patients. Information and communication technologies can be helpful to reach and follow patients without displacing them, but there may be doubts about the reliability of cognitive tests performed by telemedicine. The purpose of this study was to evaluate the reliability of the Mini Mental State Examination (MMSE) and the Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog) tests administered in hospital by videoconference to patients with mild to moderate Alzheimer's disease. The tests were administered to 28 Alzheimer's disease outpatients (8 male, mean age 73.88, SD 7.45 years; 20 female mean age 76.00, SD 5.40 years) recruited and followed in the Alzheimer's Unit of the A Cardarelli National Hospital (Naples, Italy) at baseline and after 6, 12, 18, and 24 months of observation. Patients were evaluated first face-to-face by a psychologist and then, after 2 weeks, by another psychologist via videoconference in hospital. This study showed no differences in the MMSE and ADAS-cog scores when the tests were administered face-to-face or by videoconference, except in patients with more pronounced cognitive deficits (MMSE<17), in which the assessment via videoconference overestimated the cognitive impairment (face to face, MMSE mean 13.9, SD 4.9 and ADAS-cog mean 9.0, SD 3.8; videoconference, MMSE mean 42.8, SD 12.5 and ADAS-cog mean 56.9, SD 5.5). We found that videoconferencing is a reliable approach to document cognitive stability or decline, and to measure treatment effects in patients with mild to moderate dementia. A more extended study is needed to confirm these results. ©Anna Carotenuto, Raffaele Rea, Enea Traini, Giovanna Ricci, Angiola Maria Fasanaro, Francesco Amenta. Originally published in JMIR Mental Health (http://mental.jmir.org), 11.05.2018.

A reference case for economic evaluations in osteoarthritis: an expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

PubMed

Hiligsmann, Mickaël; Cooper, Cyrus; Guillemin, Francis; Hochberg, Marc C; Tugwell, Peter; Arden, Nigel; Berenbaum, Francis; Boers, Maarten; Boonen, Annelies; Branco, Jaime C; Maria-Luisa, Brandi; Bruyère, Olivier; Gasparik, Andrea; Kanis, John A; Kvien, Tore K; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Pinedo-Villanueva, Rafael; Pinto, Daniel; Reiter-Niesert, Susanne; Rizzoli, René; Rovati, Lucio C; Severens, Johan L; Silverman, Stuart; Reginster, Jean-Yves

2014-12-01

General recommendations for a reference case for economic studies in rheumatic diseases were published in 2002 in an initiative to improve the comparability of cost-effectiveness studies in the field. Since then, economic evaluations in osteoarthritis (OA) continue to show considerable heterogeneity in methodological approach. To develop a reference case specific for economic studies in OA, including the standard optimal care, with which to judge new pharmacologic and non-pharmacologic interventions. Four subgroups of an ESCEO expert working group on economic assessments (13 experts representing diverse aspects of clinical research and/or economic evaluations) were charged with producing lists of recommendations that would potentially improve the comparability of economic analyses in OA: outcome measures, comparators, costs and methodology. These proposals were discussed and refined during a face-to-face meeting in 2013. They are presented here in the format of the recommendations of the recently published Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, so that an initiative on economic analysis methodology might be consolidated with an initiative on reporting standards. Overall, three distinct reference cases are proposed, one for each hand, knee and hip OA; with diagnostic variations in the first two, giving rise to different treatment options: interphalangeal or thumb-based disease for hand OA and the presence or absence of joint malalignment for knee OA. A set of management strategies is proposed, which should be further evaluated to help establish a consensus on the "standard optimal care" in each proposed reference case. The recommendations on outcome measures, cost itemisation and methodological approaches are also provided. The ESCEO group proposes a set of disease-specific recommendations on the conduct and reporting of economic evaluations in OA that could help the standardisation and comparability of studies that evaluate therapeutic strategies of OA in terms of costs and effectiveness. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Development of a conceptual framework for understanding financial barriers to care among patients with cardiovascular-related chronic disease: a protocol for a qualitative (grounded theory) study.

PubMed

Campbell, David J T; Manns, Braden J; Hemmelgarn, Brenda R; Sanmartin, Claudia; King-Shier, Kathryn M

2016-01-01

Patients with cardiovascular-related chronic diseases may face financial barriers to accessing health care, even in Canada, where universal health care insurance is in place. No current theory or framework is adequate for understanding the impact of financial barriers to care on these patients or how they experience financial barriers. The overall objective of this study is to develop a framework for understanding the role of financial barriers to care in the lives of patients with cardiovascular-related chronic diseases and the impact of such barriers on their health. We will perform an inductive qualitative grounded theory study to develop a framework to understand the effect of financial barriers to care on patients with cardiovascular-related chronic diseases. We will use semistructured interviews (face-to-face and telephone) with a purposive sample of adult patients from Alberta with at least 1 of hypertension, diabetes, heart disease or stroke. We will analyze interview transcripts in triplicate using grounded theory coding techniques, including open, focused and axial coding, following the principle of constant comparison. Interviews and analysis will be done iteratively to theoretical saturation. Member checking will be used to enhance rigour. A comprehensive framework for understanding financial barriers to accessing health care is instrumental for both researchers and clinicians who care for patients with chronic diseases. Such a framework would enable a better understanding of patient behaviour and nonadherence to recommended medical therapies and lifestyle modifications.

Occupational Therapists With Oncology Exposure: Perceived Needs on Adults and Older Adults With Cancer-Related Cognitive Impairments.

PubMed

Ulfers, Sara S; Berg, Christine

2017-07-01

Cancer-related cognitive impairments (CRCI) can limit participation in meaningful activities before, during, and after cancer treatment. This study explored occupational therapists' perceived knowledge gaps and needs regarding CRCI in adults and older adults. An online survey was sent to a convenience sample of 60 practitioners at facilities throughout the continuum of care and 176 directors and faculty in accredited occupational therapy programs. Using a snowball sampling approach, recipients were asked to forward the survey to other occupational therapists. One hundred seven occupational therapists participated. The majority (92%) responded that it would be beneficial to attend a face-to-face continuing education program; preferences for the content and design of a continuing competency seminar are described. These findings support the development and delivery of continuing competence programs tailored toward occupational therapists' CRCI knowledge needs.

The impact of face skin tone on perceived facial attractiveness: A study realized with an innovative methodology.

PubMed

Vera Cruz, Germano

2017-12-19

This study aimed to assess the impact of target faces' skin tone and perceivers' skin tone on the participants' attractiveness judgment regarding a symmetrical representative range of target faces as stimuli. Presented with a set of facial features, 240 Mozambican adults rated their attractiveness along a continuous scale. ANOVA and Chi-square were used to analyze the data. The results revealed that the skin tone of the target faces had an impact on the participants' attractiveness judgment. Overall, participants preferred light-skinned faces over dark-skinned ones. This finding is not only consistent with previous results on skin tone preferences, but it is even more powerful because it demonstrates that the light skin tone preference occurs regardless of the symmetry and baseline attractiveness of the stimuli.

Directions in nutritional assessment: Biomarkers and bio-indicators - providing clarity in the face of complexity

USDA-ARS?s Scientific Manuscript database

Among the greatest challenges facing the Nutrition community is integrating nutrition into all aspects of global efforts in health promotion and disease prevention. Despite compelling evidence of its importance to human development, a full appreciation of how nutrition affects health is still lackin...

Motions of the hand expose the partial and parallel activation of stereotypes.

PubMed

Freeman, Jonathan B; Ambady, Nalini

2009-10-01

Perceivers spontaneously sort other people's faces into social categories and activate the stereotype knowledge associated with those categories. In the work described here, participants, presented with sex-typical and sex-atypical faces (i.e., faces containing a mixture of male and female features), identified which of two gender stereotypes (one masculine and one feminine) was appropriate for the face. Meanwhile, their hand movements were measured by recording the streaming x, y coordinates of the computer mouse. As participants stereotyped sex-atypical faces, real-time motor responses exhibited a continuous spatial attraction toward the opposite-gender stereotype. These data provide evidence for the partial and parallel activation of stereotypes belonging to alternate social categories. Thus, perceptual cues of the face can trigger a graded mixture of simultaneously active stereotype knowledge tied to alternate social categories, and this mixture settles over time onto ultimate judgments.

Attractiveness judgments and discrimination of mommies and grandmas: perceptual tuning for young adult faces.

PubMed

Short, Lindsey A; Mondloch, Catherine J; Hackland, Anne T

2015-01-01

Adults are more accurate in detecting deviations from normality in young adult faces than in older adult faces despite exhibiting comparable accuracy in discriminating both face ages. This deficit in judging the normality of older faces may be due to reliance on a face space optimized for the dimensions of young adult faces, perhaps because of early and continuous experience with young adult faces. Here we examined the emergence of this young adult face bias by testing 3- and 7-year-old children on a child-friendly version of the task used to test adults. In an attractiveness judgment task, children viewed young and older adult face pairs; each pair consisted of an unaltered face and a distorted face of the same identity. Children pointed to the prettiest face, which served as a measure of their sensitivity to the dimensions on which faces vary relative to a norm. To examine whether biases in the attractiveness task were specific to deficits in referencing a norm or extended to impaired discrimination, we tested children on a simultaneous match-to-sample task with the same stimuli. Both age groups were more accurate in judging the attractiveness of young faces relative to older faces; however, unlike adults, the young adult face bias extended to the match-to-sample task. These results suggest that by 3 years of age, children's perceptual system is more finely tuned for young adult faces than for older adult faces, which may support past findings of superior recognition for young adult faces. Copyright © 2014 Elsevier Inc. All rights reserved.

Ethical Issues in Continuing Professional Education.

ERIC Educational Resources Information Center

Lawler, Patricia Ann

2000-01-01

Continuing professional education practitioners often face ethical dilemmas regarding their obligations to multiple stakeholders and issues arising in new arenas such as the workplace, distance education, and collaboration with business. Codes of ethics can guide practice, but practitioners should also identify their personal core values system…

Danger ahead: the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region, 1990-2015.

PubMed

2018-05-01

The Eastern Mediterranean Region faces several health challenges at a difficult time with wars, unrest, and economic change. We used the Global Burden of Disease 2015 study to present the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region from 1990 to 2015. Ischemic heart disease was the leading cause of death in the region in 2015, followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 25% for diarrheal diseases to an increase of about 42% for diabetes and tracheal, bronchus, and lung cancer. Collective violence and legal intervention increased by 850% during the time period. Diet was the leading risk factor for disability-adjusted life years (DALYs) for men compared to maternal malnutrition for females. Childhood undernutrition was the leading risk factor for DALYs in 1990 and 2005, but the second in 2015 after high blood pressure. Our study shows that the region is facing several health challenges and calls for global efforts to stabilise the region and to address the current and future burden of disease.

The anterior-ventrolateral temporal lobe contributes to boosting visual working memory capacity for items carrying semantic information.

PubMed

Chiou, Rocco; Lambon Ralph, Matthew A

2018-04-01

Working memory (WM) is a buffer that temporarily maintains information, be it visual or auditory, in an active state, caching its contents for online rehearsal or manipulation. How the brain enables long-term semantic knowledge to affect the WM buffer is a theoretically significant issue awaiting further investigation. In the present study, we capitalise on the knowledge about famous individuals as a 'test-case' to study how it impinges upon WM capacity for human faces and its neural substrate. Using continuous theta-burst transcranial stimulation combined with a psychophysical task probing WM storage for varying contents, we provide compelling evidence that (1) faces (regardless of familiarity) continued to accrue in the WM buffer with longer encoding time, whereas for meaningless stimuli (colour shades) there was little increment; (2) the rate of WM accrual was significantly more efficient for famous faces, compared to unknown faces; (3) the right anterior-ventrolateral temporal lobe (ATL) causally mediated this superior WM storage for famous faces. Specifically, disrupting the ATL (a region tuned to semantic knowledge including person identity) selectively hinders WM accrual for celebrity faces while leaving the accrual for unfamiliar faces intact. Further, this 'semantically-accelerated' storage is impervious to disruption of the right middle frontal gyrus and vertex, supporting the specific and causative contribution of the right ATL. Our finding advances the understanding of the neural architecture of WM, demonstrating that it depends on interaction with long-term semantic knowledge underpinned by the ATL, which causally expands the WM buffer when visual content carries semantic information. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

The role of nurses and dietitians in managing paediatric coeliac disease.

PubMed

Fok, Chi-Yee; Holland, Kate Sara; Gil-Zaragozano, Elena; Paul, Siba Prosad

Coeliac disease (CD) is an immune-mediated genetic condition elicited by the ingestion of gluten, leading to proximal small bowel enteropathy. It affects around 1% of the population, although only a small proportion of cases are actually diagnosed. It is a multisystem disorder presenting with both gastrointestinal and extra-intestinal manifestations such as diarrhoea, abdominal pain, constipation, vomiting, iron deficiency anaemia, faltering growth, dental enamel defects, short stature, liver disease, arthropathy and recurrent aphthous ulcers. Nurses, working in different clinical settings, are best placed for early recognition and diagnosis of CD in children. Suspicion of CD should lead to immunoglobulin A (IgA)-based anti-tissue transglutaminase antibody screening tests and a diagnosis confirmed by an intestinal biopsy. Modification of European (ESPGHAN) guidelines now enables CD to be diagnosed without a small-bowel biopsy in a select group of symptomatic children. A gluten-free diet should preferably be started by paediatric dietitians. Strict adherence to a gluten-free diet is essential to maintain good health and to prevent long-term complications. A case study demonstrating some of the challenges that may be faced in children with CD in clinical practice is described. Specialist nurse-led CD clinics are gaining popularity and have been found to be equally effective in providing continuity of quality care.

Cardiovascular benefits and safety profile of acarbose therapy in prediabetes and established type 2 diabetes

PubMed Central

Hanefeld, Markolf

2007-01-01

Dysglycaemic disease is one of the most important health issues facing the world in the 21st century. Patients with type 2 diabetes and individuals with prediabetes are at risk of developing macrovascular and microvascular complications. Long-term management strategies are therefore required that are effective at controlling dysglycaemia, well tolerated and, ideally, offer additional cardiovascular disease (CVD) risk-reduction benefits. The efficacy, safety and tolerability of the α-glucosidase inhibitor acarbose have been well-established in a wide range of patient populations in both clinical and community trials. In addition, acarbose has been shown to reduce cardiovascular complications in type 2 diabetes and prevent hypertension and CVD in individuals with impaired glucose tolerance (IGT). Acarbose has a very good safety profile and, owing to its straightforward, non-systemic mode of action, avoids most adverse events. The most common side-effects of acarbose are mild-to-moderate gastrointestinal complaints that subside as treatment continues. They can be minimised through the use of an appropriate stepwise dosing regimen and careful choice of diet. Acarbose is therefore a valuable option for the management of type 2 diabetes and, as the only oral antidiabetes agent approved for the treatment of prediabetes, can help to improve clinical management across the dysglycaemic disease continuum. PMID:17697384

Intranasal Insulin Therapy for Cognitive Impairment and Neurodegeneration: Current State of the Art

PubMed Central

de la Monte, Suzanne M.

2015-01-01

Introduction Growing evidence supports the concept that insulin resistance plays an important role in the pathogenesis of cognitive impairment and neurodegeneration, including in Alzheimer's disease (AD). The metabolic hypothesis has led to the development and utilization of insulin- and insulin agonist-based treatments. Therapeutic challenges faced include the ability to provide effective treatments that do not require repeated injections and also minimize potentially hazardous off-target effects. Areas covered This review covers the role of intra-nasal insulin therapy for cognitive impairment and neurodegeneration, particularly Alzheimer's disease. The literature reviewed focuses on data published within the past 5 years as this field is evolving rapidly. The author provides evidence that brain insulin resistance is an important and early abnormality in Alzheimer's disease, and that increasing brain supply and utilization of insulin improves cognition and memory. Emphasis was placed on discussing outcomes of clinical trials and interpreting discordant results to clarify the benefits and limitations of intranasal insulin therapy. Expert Opinion Intranasal insulin therapy can efficiently and directly target the brain to support energy metabolism, myelin maintenance, cell survival, and neuronal plasticity, which begin to fail in the early stages of neurodegeneration. Efforts must continue toward increasing the safety, efficacy, and specificity of intranasal insulin therapy. PMID:24215447

Blood, AIDS, and bureaucracy: the crisis and the tragedy.

PubMed

Schmidt, Paul J

2011-10-01

The politics of health were never tested more than when AIDS surfaced at the beginning of the 1980s in the industrialized nations. In those countries, it became the most important medical crisis of the last half of the 20th century. Today, the significance of AIDS remains as not only an unrelenting disease but also as a disease that continues to affect social and political life throughout the entire world. The connection between blood transfusion and AIDS is now under control in the industrialized countries but only because of lessons that took too long to learn over the past 25 years. That process had different roots and effects depending on the various national blood programs and policies in different countries. That is illustrated by comparing events in France, Japan, Canada, and the United States that differed in donor and patient populations and on decisions made and secrets kept. Some of the problems persist to this day in parts of the world. Overall, the lessons learned from what happened with blood early in the AIDS epidemic apply to other aspects of human disease and could help in facing the new problems that are sure to appear in the future. Copyright © 2011 Elsevier Inc. All rights reserved.

Effects of habitat fragmentation on a stream-dwelling species, the flattened musk turtle Sternotherus depressus

USGS Publications Warehouse

Dodd, C.K.

1990-01-01

The flattened musk turtle Sternotherus depressus has disappeared from more than half of its former range because of habitat modifications to stream and river channels in the Warrior River Basin, Alabama. Only 6·9% of its probable historic range contains relatively healthy populations, and most populations are fragmented by extensive areas of unsuitable habitat. Turtles in the best remaining habitats continue to be vulnerable to disease and human-related disturbance, collecting and habitat modification. These factors lead to population declines and abnormal population structure. Habitat fragmentation, especially in small populations, increases vulnerability to human-caused catastrophes and demographic accidents, and could lead to eventual extinction. The threats facing fragmented populations of this turtle probably parallel those affecting many other stream-dwelling species throughout the southeastern United States.

Hyperpigmentation therapy: a review.

PubMed

Desai, Seemal R

2014-08-01

With an increasing number of multicultural patients and those of different backgrounds presenting in dermatology clinics, issues facing patients with higher Fitzpatrick skin classifications, often referred to as skin of color patients, are on the rise. Knowledge of the diagnostic dilemmas, cutting edge treatment options, and latest clinical research in the diagnosis and management of cutaneous anomalies in skin of color patients is of paramount importance. Of the most common complaints in patients with skin of color is hyperpigmentation. Despite the availability of multiple treatments for the condition, hyperpigmentation continues to present clinical management challenges for dermatologists. Difficulty may be traced to physician or patient reluctance to use certain agents or interventions, failure to identify and avoid contributing factors, and insufficient attention paid to the psychosocial aspects of the disease. This review addresses a variety of issues including the diagnosis and management of hyperpigmentation.

The juxtaposition of ageing and nursing: the challenges and enablers of continuing to work in the latter stages of a nursing career.

PubMed

Clendon, Jill; Walker, Léonie

2016-05-01

To identify why some nurses cope well with continuing to work as they age and others struggle. There is a need to understand better the challenges older nurses face and how they manage them. Secondary analysis of existing data. Data collected in two separate studies were analysed. The first study (2012) was an online, anonymous survey that collected free text (qualitative) and categorical data (n = 3273, 57·6% response rate). The second (2014) was an explorative, descriptive study that collected data through focus groups and interviews (n = 46). Qualitative data from both studies were analysed using David Thomas' () general inductive approach. Research Ethics Committee approval was gained for the 2012 and 2014 studies. Data were categorised in two themes: the challenges of ageing and nursing; and factors that enable nurses to continue to practice. Physical challenges, fatigue, guilt, ageism and demands to complete continuing education were considered challenges. Maintaining personal fitness, self care, flexible working and a strong belief in their ability to contribute to the profession were present in older nurses who continued to practice. While older nurses face growing physical and cognitive challenges as they age, they demonstrate strong resilience in the face of these challenges. It is recommended nurses seek support from their workplaces early to address challenges. Organisations must address ageism in the workplace and provide practical interventions such as supporting changes to work hours, shifting nurses to less physical roles and providing career planning to support resilience in older workers. © 2016 John Wiley & Sons Ltd.

The financial crisis in Italy: implications for the healthcare sector.

PubMed

de Belvis, Antonio Giulio; Ferrè, Francesca; Specchia, Maria Lucia; Valerio, Luca; Fattore, Giovanni; Ricciardi, Walter

2012-06-01

The global economic and financial crisis is having and impact on the Italian healthcare system which is undergoing a devolution process from the central government to regions and where about one third of the regional governments (mainly in the central and southern part of the country) are facing large financial deficits. The paper briefly describes the current macro scenario and the main responses taken to face the crisis and highlights the downside risks of introducing "linear" cuts in the allocation of resources. While justified by the risk of a national debt default, present fiscal policies might increase inequalities in access to care, deteriorate overall health indicators and population wellbeing, and sharpen existing difference in the quality of care between regions. Preliminary evidence shows that the crisis is affecting the quality of nutrition and the incidence of psychiatric disorders. During this difficult financial situation Italy is also facing the risk of a major reduction in investments for preventive medicine, Evidence Based Medicine infrastructures, health information systems and physical capital renewal. This cost-cutting strategy may have negative long term consequences Also, important achievement in terms of limiting waiting lists, improving continuity of care and patients' centeredness, and promoting integration between social and health care may be negatively affected by unprecedented resources' cuts. It is essential that in such a period of public funding constraints health authorities monitor incidence of diseases and access to care of the most vulnerable groups and specifically target interventions to those who may be disproportionally hit by the crisis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The face evoked steady-state visual potentials are sensitive to the orientation, viewpoint, expression and configuration of the stimuli.

PubMed

Vakli, Pál; Németh, Kornél; Zimmer, Márta; Kovács, Gyula

2014-12-01

Previous studies demonstrated that the steady-state visual-evoked potential (SSVEP) is reduced to the repetition of the same identity face when compared with the presentation of different identities, suggesting high-level neural adaptation to face identity. Here we investigated whether the SSVEP is sensitive to the orientation, viewpoint, expression and configuration of faces (Experiment 1), and whether adaptation to identity at the level of the SSVEP is robust enough to generalize across these properties (Experiment 2). In Experiment 1, repeating the same identity face with continuously changing orientation, viewpoint or expression evoked a larger SSVEP than the repetition of an unchanged face, presumably reflecting a release of adaptation. A less robust effect was observed in the case of changes affecting face configuration. In Experiment 2, we found a similar release of adaptation for faces with changing orientation, viewpoint and configuration, as there was no difference between the SSVEP for the same and different identity faces. However, we found an adaptation effect for faces with changing expressions, suggesting that face identity coding, as reflected in the SSVEP, is largely independent of the emotion displayed by faces. Taken together, these results imply that the SSVEP taps high-level face representations which abstract away from the changeable aspects of the face and likely incorporate information about face configuration, but which are specific to the orientation and viewpoint of the face. Copyright © 2014 Elsevier B.V. All rights reserved.

Vaccine development for emerging virulent infectious diseases.

PubMed

Maslow, Joel N

2017-10-04

The recent outbreak of Zaire Ebola virus in West Africa altered the classical paradigm of vaccine development and that for emerging infectious diseases (EIDs) in general. In this paper, the precepts of vaccine discovery and advancement through pre-clinical and clinical assessment are discussed in the context of the recent Ebola virus, Middle East Respiratory Syndrome coronavirus (MERS-CoV), and Zika virus outbreaks. Clinical trial design for diseases with high mortality rates and/or high morbidity in the face of a global perception of immediate need and the factors that drive design in the face of a changing epidemiology are presented. Vaccines for EIDs thus present a unique paradigm to standard development precepts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding the Implications of HIV Disease in Women.

ERIC Educational Resources Information Center

Carney, Jamie S.

2003-01-01

In this article, counselors are urged to become knowledgeable about the many issues and stressors that women with HIV disease face. This article provides an overview of such concerns, including disease characteristics, progression, and symptoms. In addition, psychological, social, and relationship concerns are identified in relation to parenting,…

Incentives for Reporting Infectious Disease Outbreaks

ERIC Educational Resources Information Center

Malani, Anup; Laxminarayan, Ramanan

2011-01-01

The global spread of diseases such as swine flu and SARS highlights the difficult decision governments face when presented with evidence of a local outbreak. Reporting the outbreak may bring medical assistance but is also likely to trigger trade sanctions by countries hoping to contain the disease. Suppressing the information may avoid trade…

Women and HIV Disease: An Emerging Social Crisis.

ERIC Educational Resources Information Center

Stuntzner-Gibson, Denise

1991-01-01

Addresses major social issues faced by women with human immunodeficiency virus (HIV) disease and explores gender differences in HIV transmission, disease progression, and diagnosis. Discusses how women's sexuality and reproductive rights are affected. Examines specific issues regarding HIV-infected women who use intravenous drugs, women of color,…

Go Grrrls: A Randomized Controlled Trial of a Gender-Specific Intervention to Reduce Sexual Risk Factors in Middle School Females.

PubMed

LeCroy, Craig Winston; McCullough Cosgrove, Jenny; Cotter, Katie; Fordney, Marie

2018-04-01

Adolescent females continue to face health consequences associated with risky sexual behaviors such as unintended pregnancies and sexually transmitted diseases. The purpose of this study was to investigate the efficacy of a gender-specific intervention targeted to early adolescent females. This study used an intent to treat randomized clinical trial comparing a broad-based female empowerment curriculum with a dose-matched science and technology female leadership curriculum. The sample ( N = 801) was recruited from schools and was implemented in community-based settings mostly in an after school context. Assessments were conducted at baseline, postintervention, 6-, and 18-month follow-up time periods. Both groups in the study obtained good implementation and engagement. The average attendance rate was 81% of program sessions. There were significant differences between the two groups favoring the intervention group on measures of sexually transmitted disease knowledge and condom technical skills. On a measure of condom self-efficacy, there was a significant trend. At the postassessment, there was a significant difference on the intentions to reduce sexual risk behaviors. Both the intervention and control groups made gains on the self-assertive behavior scale. Gender-specific programs for early adolescent females can help reduce indicators that are related to sexual risk reduction. More long-term follow-up is needed to assess impact on sexual behaviors. Efforts directed at a younger population of females should continue to be researched for potential in reducing sexual risks.

Neoadjuvant chemotherapy in the treatment of locally advanced cervical carcinoma in pregnancy: a report of two cases and review of issues specific to the management of cervical carcinoma in pregnancy including planned delay of therapy.

PubMed

Tewari, K; Cappuccini, F; Gambino, A; Kohler, M F; Pecorelli, S; DiSaia, P J

1998-04-15

Women diagnosed with invasive cervical carcinoma during pregnancy are faced with difficult decisions regarding therapy and the fate of their unborn child. A modest treatment delay for International Federation of Gynecology and Obstetrics Stage I cervical lesions is considered acceptable in patients who wish to continue their pregnancy. Two patients with locally advanced cervical carcinoma diagnosed early in the second trimester strongly desired continuation of their pregnancies. They were treated with neoadjuvant chemotherapy until the third trimester, and then underwent delivery and definitive surgical treatment. The patients were evaluated during pregnancy for evidence of a clinical response to chemotherapy. Intraoperative findings and pathologic analysis of the surgical material provided further objective data regarding disease status. Both patients experienced a dramatic reduction in tumor volume, rendering radical hysterectomy feasible at the time of cesarean section. In addition, both patients tolerated chemotherapy well and there were no adverse fetal effects. Favorable neonatal outcomes were achieved. One patient experienced recurrence within 5 months of surgery, whereas the other patient remained without evidence of disease for 2 years. To the authors' knowledge, these reports constitute the first description of the use of neoadjuvant chemotherapy for invasive squamous cell carcinoma of the cervix in pregnancy (MEDLINE 1966-1997). This therapeutic option should be considered in selected women with locally advanced cervical carcinoma who do not want termination of their pregnancy.

Factor for felons: how can we provide haemophilia care to the incarcerated?

PubMed

Lambing, A; Kachalsky, E; Mueller, L M; Kuriakose, P

2015-11-01

In 2011, 6.98-million offenders were documented in the adult correctional system, with state operating costs designated 12% towards medical care ($11.97 day per inmate) for the general population. Common co-existing health problems identified are: arthritis (13%), hypertension (11%), asthma (10%) and heart problems (6%). Less than 5% of inmates have health issues related to cancer, diabetes, liver or renal problems and communicable diseases. The leading cause of death is suicide (33.2%), followed by heart disease (26.1%). Despite these statistics quality is lacking. Given these statistics, one would expect that a small proportion of patients from Hemophilia Treatment Center (HTC) will spend some time within the justice system. Currently there are no data addressing haemophilia care needs while incarcerated. This article will review the current health care issues in the adult correctional system. Additionally, six case reports of incarcerated haemophiliacs will be highlighted exploring the successes and challenges with maintaining haemophilia care addressing the priority of meeting the haemophilia care needs verses the penal system regulations. It can be expected that at some point, the HTC will experience a patient incarcerated for some period of time. The HTC will continue to advocate for their patient within this system, despite the many challenges faced. Despite the challenges outlined, ongoing communication and education with the correctional system, education of the medical personnel and prison personnel remains the priority as we advocate for our patients. Continued strategies in these areas are paramount. © 2015 John Wiley & Sons Ltd.

Preliminary Testing of an Asthma Distance Education Program (ADEP) for School Nurses in Appalachia

ERIC Educational Resources Information Center

Putman-Casdorph, Heidi; Pinto, Susan

2011-01-01

Asthma remains one of the most challenging chronic illnesses faced by school nurses both nationally and in the State of West Virginia. There is a clear need to provide ongoing continuing asthma education to school nurses. However, nurses face many barriers to receiving this education. The purpose of this pilot project was to develop and evaluate…

Clickers in the Flipped Classroom: Bring Your Own Device (BYOD) to Promote Student Learning

ERIC Educational Resources Information Center

Hung, Hsiu-Ting

2017-01-01

Flipped classrooms continue to grow in popularity across all levels of education. Following this pedagogical trend, the present study aimed to enhance the face-to-face instruction in flipped classrooms with the use of clickers. A game-like clicker application was implemented through a bring your own device (BYOD) model to gamify classroom dynamics…

Perceptions of Community of Associate Degree Nurse Learners in an RN-to-BSN Online Program

ERIC Educational Resources Information Center

Rebar, Cherie R.

2010-01-01

Registered Nurses (RNs), when educated in an Associate Degree (AD) program, learn in a face-to-face environment. Today's preferred standard of education for RNs is to achieve a minimum of a Bachelor's degree. For convenience while they continue working, numerous AD-prepared nurses seek online education to complete their Bachelor of Science in…

Planning a school physics experiment

NASA Astrophysics Data System (ADS)

Blasiak, Wladyslaw

1986-09-01

One is continually faced with the need to make decisions; physics, might form the vehicle for teaching the difficult art of decision making. Teachers should direct the abilities and skills of their students toward optimising the choices with which they are faced. Examples of such choices occur in the design of physics experiments and this therefore offers a good opportunity for such instruction.

Despite Faculty Skepticism: Lessons from a Graduate-Level Seminar in a Hybrid Course Environment

ERIC Educational Resources Information Center

Palmer, Megan M.; Shaker, Genevieve; Hoffmann-Longtin, Krista

2014-01-01

Despite the fact that online education continues to grow, the vast majority of faculty remain skeptical that online courses can yield the same student learning outcomes as traditional face-to-face courses. In an effort to determine if online graduate courses can be effective, in this study we explore the extent to which qualities commonly found in…

Librarian instruction-delivery modality preferences for professional continuing education

PubMed Central

Lynn, Valerie A.; Bose, Arpita; Boehmer, Susan J.

2010-01-01

Objectives: Attending professional continuing education (CE) is an important component of librarianship. This research study identified librarians' preferences in delivery modalities of instruction for professional CE. The study also identified influential factors associated with attending CE classes. Methods: Five instruction-delivery modalities and six influential factors were identified for inclusion in an online survey. The survey completed by members of the American Library Association (ALA), Special Libraries Association (SLA), and Medical Library Association (MLA) provided the data for analysis of librarian preferences and influential factors. Results: The majority of respondents were MLA members, followed by ALA and SLA members. Librarians from all three library associations preferred the face-to-face instructional modality. The most influential factor associated with the decision to attend a professional CE class was cost. Conclusions: All five instruction-delivery modalities present useful structures for imparting professional CE. As librarians' experience with different modalities increases and as technology improves, preferences in instruction delivery may shift. But at present, face-to-face remains the most preferred modality. Based on the results of this study, cost was the most influential factor associated with attending a CE class. This may change as additional influential factors are identified and analyzed in future studies. PMID:20098656

Librarian instruction-delivery modality preferences for professional continuing education.

PubMed

Lynn, Valerie A; Bose, Arpita; Boehmer, Susan J

2010-01-01

Attending professional continuing education (CE) is an important component of librarianship. This research study identified librarians' preferences in delivery modalities of instruction for professional CE. The study also identified influential factors associated with attending CE classes. Five instruction-delivery modalities and six influential factors were identified for inclusion in an online survey. The survey completed by members of the American Library Association (ALA), Special Libraries Association (SLA), and Medical Library Association (MLA) provided the data for analysis of librarian preferences and influential factors. The majority of respondents were MLA members, followed by ALA and SLA members. Librarians from all three library associations preferred the face-to-face instructional modality. The most influential factor associated with the decision to attend a professional CE class was cost. All five instruction-delivery modalities present useful structures for imparting professional CE. As librarians' experience with different modalities increases and as technology improves, preferences in instruction delivery may shift. But at present, face-to-face remains the most preferred modality. Based on the results of this study, cost was the most influential factor associated with attending a CE class. This may change as additional influential factors are identified and analyzed in future studies.

A prospective study on the use of teledermatology in psychiatric patients with chronic skin diseases.

PubMed

Seghers, Amelie C; Seng, Kok Han; Chio, Martin T W; Chia, Emileen; Ng, See Ket; Tang, Mark B Y

2015-08-01

To compare the use of live interactive teledermatology versus conventional face-to-face consultation in long-term, institutionalised psychiatric patients with chronic skin diseases. All institutionalised psychiatric patients at the Institute of Mental Health with follow-up appointments at the National Skin Centre were assessed for eligibility and invited to participate. Recruited patients were first seen by a dermatologist via videoconferencing, and then by another dermatologist in person, within 1 week. Clinical outcome measures were then assessed by a third independent dermatologist. The following outcome measures were assessed for each paired patient visit: inter-physician clinical assessment, diagnosis, management plan, adverse events and total patient turnaround time (PTAT) for each consultation. There were a total of 13 patients (mean age, 64.6 years; range 44-80) with 27 patient visits. All were male patients with chronic schizophrenia. The predominant skin condition was chronic eczema and its variants (62%), followed by cutaneous amyloidosis (23%) and psoriasis (15%). The level of complete and partial agreement between the teledermatology and face-to-face consultation was 100% for history-taking and physical examination and 96% for the investigations, diagnosis, management plan and the treatment prescribed. The PTAT for teledermatology was 23 min, compared to 240 min for face-to-face consultations. No adverse events were reported. Teledermatology was as effective as face-to-face consultation and reduced the PTAT by 90%, resulting in increased patient convenience, operational efficiency and reduced manpower need. Our study supports the safe and cost-effective use of teledermatology for the follow-up of chronic skin conditions in psychiatric patients. © 2015 The Australasian College of Dermatologists.

Oculomotor guidance and capture by irrelevant faces.

PubMed

Devue, Christel; Belopolsky, Artem V; Theeuwes, Jan

2012-01-01

Even though it is generally agreed that face stimuli constitute a special class of stimuli, which are treated preferentially by our visual system, it remains unclear whether faces can capture attention in a stimulus-driven manner. Moreover, there is a long-standing debate regarding the mechanism underlying the preferential bias of selecting faces. Some claim that faces constitute a set of special low-level features to which our visual system is tuned; others claim that the visual system is capable of extracting the meaning of faces very rapidly, driving attentional selection. Those debates continue because many studies contain methodological peculiarities and manipulations that prevent a definitive conclusion. Here, we present a new visual search task in which observers had to make a saccade to a uniquely colored circle while completely irrelevant objects were also present in the visual field. The results indicate that faces capture and guide the eyes more than other animated objects and that our visual system is not only tuned to the low-level features that make up a face but also to its meaning.

The Role of Collegial Interaction in Continuing Professional Development

ERIC Educational Resources Information Center

Gagliardi, Anna R.; Wright, Frances C.; Anderson, Michael A. B.; Davis, Dave

2007-01-01

Introduction: Many physicians seek information from colleagues over other sources, highlighting the important role of interaction in continuing professional development (CPD). To guide the development of CPD opportunities, this study explored the nature of cancer-related questions faced by general surgeons, and how interaction with colleagues…

Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial).

PubMed

James, Erica L; Ewald, Ben; Johnson, Natalie; Brown, Wendy; Stacey, Fiona G; Mcelduff, Patrick; Booth, Angela; Yang, Fan; Hespe, Charlotte; Plotnikoff, Ronald C

2014-12-29

Physical inactivity is fourth in the list of risk factors for global mortality. General practitioners are well placed to offer physical activity counseling but insufficient time is a barrier. Although referral to an exercise specialist is an alternative, in Australia, these allied health professionals are only publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. Accordingly, this trial aims to determine the efficacy of GP referral of insufficiently active patients (regardless of their chronic disease status) for physical activity counseling (either face-to-face or predominately via telephone) by exercise specialists, based on patients' objectively assessed physical activity levels, compared with usual care. If the trial is efficacious, the equivalence and cost-effectiveness of face-to-face counseling versus telephone counseling will be assessed. This three arm pragmatic randomized trial will involve the recruitment of 261 patients from primary care clinics in metropolitan and regional areas of New South Wales, Australia. Insufficiently active (less than 7000 steps/day) consenting adult patients will be randomly assigned to: 1) five face-to-face counseling sessions, 2) one face-to-face counseling session followed by four telephone calls, or 3) a generic mailed physical activity brochure (usual care). The interventions will operationalize social cognitive theory via a behavior change counseling framework. Participants will complete a survey and seven days of pedometry at baseline, and at three and 12 months post-randomization. The primary analyses will be based on intention-to-treat principles and will compare: (i) mean change in average daily step counts between baseline and 12 months for the combined intervention group (Group 1: face-to-face, and Group 2: telephone) and usual care (Group 3); (ii) step counts at 3 months post-randomization. Secondary outcomes include: self-reported physical activity, sedentary behavior, quality of life, and depression. If referral of primary care patients to exercise specialists increases physical activity, this process offers the prospect of systematically and sustainably reaching a large proportion of insufficiently active adults. If shown to be efficacious this trial provides evidence to expand public funding beyond those with a chronic disease and for delivery via telephone as well as face-to-face consultations. Australian New Zealand Clinical Trials Registry ACTRN12611000884909 .

Successful Outflow Reconstruction to Salvage Traumatic Hepatic Vein-Caval Avulsion of a Normothermic Machine Ex-Situ Perfused Liver Graft

PubMed Central

Athanasopoulos, Panagiotis G.; Hadjittofi, Christopher; Dharmapala, Arinda Dinesh; Orti-Rodriguez, Rafael Jose; Ferro, Alessandra; Nasralla, David; Konstantinidou, Sofia K.; Malagó, Massimo

2016-01-01

Abstract Donor organ shortage continues to limit the availability of liver transplantation, a successful and established therapy of end-stage liver diseases. Strategies to mitigate graft shortage include the utilization of marginal livers and recently ex-situ normothermic machine perfusion devices. A 59-year-old woman with cirrhosis due to primary sclerosing cholangitis was offered an ex-situ machine perfused graft with unnoticed severe injury of the suprahepatic vasculature due to road traffic accident. Following a complex avulsion, repair and reconstruction of all donor hepatic veins as well as the suprahepatic inferior vena cava, the patient underwent a face-to-face piggy-back orthotopic liver transplantation and was discharged on the 11th postoperative day after an uncomplicated recovery. This report illustrates the operative technique to utilize an otherwise unusable organ, in the current environment of donor shortage and declining graft quality. Normothermic machine perfusion can definitely play a role in increasing the graft pool, without compromising the quality of livers who had vascular or other damage before being ex-situ perfused. Furthermore, it emphasizes the importance of promptly and thoroughly communicating organ injuries, as well as considering all reconstructive options within the level of expertise at the recipient center. PMID:27082550

Facing possible illness detected through screening--experiences of healthy women with pathological cervical smears.

PubMed

Hounsgaard, Lise; Petersen, Lone Kjeld; Pedersen, Birthe D

2007-12-01

The aim of this study is to gain knowledge about women's perceptions of illness based on their abnormal PAP smears, following screening for cervical cancer. The study uses a phenomenological, hermeneutic approach inspired by Ricoeur's theory of interpretation. Twelve women, aged between 23 and 59 years, were consecutively selected and then followed by participant observation during their examinations and treatment in hospital. They were interviewed on entering the study, a week following their surgery, and 6 months later. The material collected was analysed through a dialectic process consisting of a face-value review of participant experiences (naive reading), structural analysis and, critical interpretation of what it means to be potentially ill. The women were unprepared to find that their screening results showed abnormal cells, indicative of incipient genital cancer. They were frustrated by the results as they had not experienced any symptoms and felt well, despite being diagnosed with a potential disease. Being diagnosed with abnormal cells caused the participants to feel anxious. Their anxiety had subsided 6 months after the cells had been removed. For those who did not require treatment, anxiety flared up with recurrent check-ups. The bio-medical differentiation between pre-stage and actual cancer provided no comfort to the participants, who continued to see themselves as having early stage cancer.

Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

PubMed

Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

2017-06-04

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders

PubMed Central

Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

2017-01-01

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as “relatively low”, contrasting with 21.4% rated as “relatively high”. Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders. PMID:28587226

Successful Outflow Reconstruction to Salvage Traumatic Hepatic Vein-Caval Avulsion of a Normothermic Machine Ex-Situ Perfused Liver Graft: Case Report and Management of Organ Pool Challenges.

PubMed

Athanasopoulos, Panagiotis G; Hadjittofi, Christopher; Dharmapala, Arinda Dinesh; Orti-Rodriguez, Rafael Jose; Ferro, Alessandra; Nasralla, David; Konstantinidou, Sofia K; Malagó, Massimo

2016-04-01

Donor organ shortage continues to limit the availability of liver transplantation, a successful and established therapy of end-stage liver diseases. Strategies to mitigate graft shortage include the utilization of marginal livers and recently ex-situ normothermic machine perfusion devices. A 59-year-old woman with cirrhosis due to primary sclerosing cholangitis was offered an ex-situ machine perfused graft with unnoticed severe injury of the suprahepatic vasculature due to road traffic accident. Following a complex avulsion, repair and reconstruction of all donor hepatic veins as well as the suprahepatic inferior vena cava, the patient underwent a face-to-face piggy-back orthotopic liver transplantation and was discharged on the 11th postoperative day after an uncomplicated recovery. This report illustrates the operative technique to utilize an otherwise unusable organ, in the current environment of donor shortage and declining graft quality. Normothermic machine perfusion can definitely play a role in increasing the graft pool, without compromising the quality of livers who had vascular or other damage before being ex-situ perfused. Furthermore, it emphasizes the importance of promptly and thoroughly communicating organ injuries, as well as considering all reconstructive options within the level of expertise at the recipient center.

EN FACE IMAGING OF PACHYCHOROID SPECTRUM DISORDERS WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY.

PubMed

Dansingani, Kunal K; Balaratnasingam, Chandrakumar; Naysan, Jonathan; Freund, K Bailey

2016-03-01

To correlate clinical manifestations with choroidal morphology in pachychoroid disorders, including central serous chorioretinopathy, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, and polypoidal choroidal vasculopathy, using en face swept-source optical coherence tomography (OCT). Patients with pachychoroid spectrum diagnoses were identified nonconsecutively through a review of charts and multimodal imaging. Each eye was categorized as uncomplicated pachychoroid, pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, or polypoidal choroidal vasculopathy. All patients included in this series then underwent bilateral swept-source OCT. Sixty-six eyes of 33 patients were included. Numbers assigned to diagnostic categories were 8 uncomplicated pachychoroid, 13 pachychoroid pigment epitheliopathy, 27 central serous chorioretinopathy, 15 pachychoroid neovasculopathy, and 3 polypoidal choroidal vasculopathy. One eye was classified as normal. Swept-source OCT choroidal thickness maps confirmed increased thickness under the areas of pachychoroid pigment epitheliopathy, central serous chorioretinopathy, type 1 NV (pachychoroid neovasculopathy), or polyps (polypoidal choroidal vasculopathy). En face swept-source OCT showed dilated outer choroidal vessels in all eyes. In several eyes with a chronic disease, focal choriocapillaris atrophy with inward displacement of deep choroidal vessels was noted. Although clinical manifestations of pachychoroid spectrum disorders vary considerably, these entities share morphologic findings in the choroid, including increased thickness and dilated outer choroidal vessels. En face swept-source OCT localizes these changes to disease foci and shows additional findings that may unify our understanding of disease pathogenesis.

Pleasant and unpleasant odour-face combinations influence face and odour perception: An event-related potential study.

PubMed

Cook, Stephanie; Kokmotou, Katerina; Soto, Vicente; Fallon, Nicholas; Tyson-Carr, John; Thomas, Anna; Giesbrecht, Timo; Field, Matt; Stancak, Andrej

2017-08-30

Odours alter evaluations of concurrent visual stimuli. However, neural mechanisms underlying the effects of congruent and incongruent odours on facial expression perception are not clear. Moreover, the influence of emotional faces on odour perception is not established. We investigated the effects of one pleasant and one unpleasant odour paired with happy and disgusted faces, on subjective ratings and ERP responses to faces. Participants rated the pleasantness of happy and disgusted faces that appeared during 3s pleasant or unpleasant odour pulses, or without odour. Odour pleasantness and intensity ratings were recorded in each trial. EEG was recorded continuously using a 128-channel system. Happy and disgusted faces paired with pleasant and unpleasant odour were rated as more or less pleasant, respectively, compared to the same faces presented in the other odour conditions. Odours were rated as more pleasant when paired with happy faces, and unpleasant odour was rated more intense when paired with disgusted faces. Unpleasant odour paired with disgusted faces also decreased inspiration. Odour-face interactions were evident in the N200 and N400 components. Our results reveal bi-directional effects of odours and faces, and suggest that odour-face interactions may be represented in ERP components. Pairings of unpleasant odour and disgusted faces resulted in stronger hedonic ratings, ERP changes, increased odour intensity ratings and respiratory adjustment. This finding likely represents heightened adaptive responses to multimodal unpleasant stimuli, prompting appropriate behaviour in the presence of danger. Copyright © 2017. Published by Elsevier B.V.

Neurological abnormalities in localized scleroderma of the face and head: a case series study for evaluation of imaging findings and clinical course.

PubMed

Lis-Święty, Anna; Brzezińska-Wcisło, Ligia; Arasiewicz, Hubert

2017-09-01

Localized scleroderma (LoS) of the face and head is often associated with neurological manifestations and/or imaging abnormalities in the central nervous system (CNS). We present an analysis of 20 cases of LoS affecting the face and head. The CNS symptoms and/or abnormalities in high-resolution computed tomography (HRCT) and/or magnetic resonance imaging (MRI) were observed in 12 patients (60%). In addition to the mild and unspecific disorders (e.g. headaches), serious neurological complications probably in the course of vasculitis were revealed: epilepsy (in two patients), epilepsy and pyramidal sings (in one patient). Neurological disorders and LoS occurred at the same time (in three patients) or at the course of the disease (nine patients) and no later than 29 years since the onset of the disease. No link between neurological disorders and the LoS clinical morphology, immunological and other laboratory parameters has been established. CNS involvement is not correlated with the clinical course of the facial and head LoS and may occur years after the disease initial symptomatology. Imaging follow-up is not required if there is not any emerging neurological symptom. In some cases, however, both HRCT and MRI are useful for monitoring disease evolution and addressing therapeutic choices.

Empowering Local Organizations and Decision-makers in a Changing Climate: EO-guided Environmental Surveillance of Cholera and Rotavirus for South Asia

NASA Astrophysics Data System (ADS)

Akanda, A. S.; Hasan, M. A.; Jutla, A.; Aziz, S.; Alam, M.; Ahsan, G. U.; Huq, A.; Colwell, R. R.

2017-12-01

Despite significant advancements in scientific research, diarrheal diseases remain a leading cause of mortality and morbidity in the developing world. Although under-5 child mortality due to such diseases is dropping, prevalence of most diarrheal diseases has increased over past decades, exerting a terrible toll on global public health. Providing safe water and sanitation access, and a safe and clean environment in a sustainable manner remains a critical challenge in the face of rapid population growth, urbanization and increasing threats of natural hazards in a changing climate. We focus on the Bengal Delta region of South Asia, where Cholera and Rotavirus diarrhea continue to have a devastating impact on the public health burden. Climatic change and anthropogenic forcings have greatly affected available water quantity and quality, while the lack of effective institutions and capacity have greatly affected the water-sanitation and public health sectors. The region suffers from recurring dry season freshwater scarcity and temperature extremes, salinity intrusion in coastal areas, inland flooding during monsoons, and resulting water contamination across the delta region. We use earth observation (EO) datasets and techniques to develop a series of tools for surveillance, analysis and decision support to empower government, academic, and non-government stakeholder organizations in South Asia to monitor changes in environmental conditions related to the two most devastating diarrheal diseases, cholera and rotavirus. The developed tools will enable decision makers and stakeholders to significantly increase their understanding of the threats to public health and environmental and climatic conditions related to these diseases, ways to monitor future projections of disease risk, and help identify required policy interventions and strategies to strengthen prevention efforts and limit disease burden in near- (tactical) and long- (strategic) terms.

Palauans who chew betel nut: social impact of oral disease.

PubMed

Quinn Griffin, M T; Mott, M; Burrell, P M; Fitzpatrick, J J

2014-03-01

Chewing betel nut is a tradition extending from Southeast Asia to the Pacific. Globally, betel nut is the fourth main psychotropic substance containing a stimulant, arecoline, that has a similar effect to nicotine. In Palau, there is broad acceptance of betel nut chewing. One of the largest immigrant groups in Hawaii is the Palauans. Chewing betel nut has significant social implications that make it difficult for those who engage in this practice to separate potential oral disease from the social importance. However, little is known about the social impact of oral disease from chewing betel nut on Palauans in Hawaii. The study aimed to describe the perceptions of betel-chewing Palauans in Hawaii regarding betel nut and to determine the social impact of oral disease among these individuals. Descriptive study conducted on the island of Oahu, Hawaii with 30 adult Palauans. Data were collected using the Oral Health Impact Profile-14 to measure perceptions of social impact of oral disease on well-being. Demographic and general health information was collected. Participants perceived little negative social impact of oral disease on well-being. Families, peers and society exert a strong influence on the decision to chew betel nut, a known carcinogen. Participants in this study showed little concern on the impact of betel nut chewing on their oral health. They continue the habit in spite of the awareness of potential for oral disease. Nurses face challenges in educating Palauans about the negative aspects of betel nut, particularly those related to oral health especially when they do not perceive problems. Nurses must be involved in the development of health policies to design and implement strategies to promote behavioural change, and to ensure clinical services that are culturally sensitive to betel nut chewers. © 2014 International Council of Nurses.

Current and future vaccines and vaccination strategies against infectious laryngotracheitis (ILT) respiratory disease of poultry.

PubMed

García, Maricarmen

2017-07-01

Infectious laryngotracheitis (ILT) is an economically important respiratory disease of poultry that affects the industry worldwide. Vaccination is the principal tool in the control of the disease. Two types of vaccines, live attenuated and recombinant viral vector, are commercially available. The first generation of GaHV-1 vaccines available since the early 1960's are live viruses, attenuated by continuous passages in cell culture or embryos. These vaccines significantly reduce mortalities and, in particular, the chicken embryo origin (CEO) vaccines have shown to limit outbreaks of the disease. However, the CEO vaccines can regain virulence and become the source of outbreaks. Recombinant viral vector vaccines, the second generation of GaHV-1 vaccines, were first introduced in the early 2000's. These are Fowl Pox virus (FPV) and Herpes virus of turkeys (HVT) vectors expressing one or multiple GaHV-1 immunogenic proteins. Recombinant viral vector vaccines are considered a much safer alternative because they do not regain virulence. In the face of challenge, they improve bird performance and ameliorate clinical signs of the disease but fail to reduce shedding of the challenge virus increasing the likelihood of outbreaks. At the moment, several new strategies are being evaluated to improve both live attenuated and viral vector vaccines. Potential new live vaccines attenuated by deletion of genes associated with virulence or by selection of CEO viral subpopulations that do not exhibit increased virulence upon passages in birds are being evaluated. Also new vector alternatives to express GaHV-1 glycoproteins in Newcastle diseases virus (NDV) or in modified very virulent (vv) serotype I Marek's disease virus (MDV) were developed and evaluated. Copyright © 2016 Elsevier B.V. All rights reserved.

Learning temporal rules to forecast instability in continuously monitored patients.

PubMed

Guillame-Bert, Mathieu; Dubrawski, Artur; Wang, Donghan; Hravnak, Marilyn; Clermont, Gilles; Pinsky, Michael R

2017-01-01

Inductive machine learning, and in particular extraction of association rules from data, has been successfully used in multiple application domains, such as market basket analysis, disease prognosis, fraud detection, and protein sequencing. The appeal of rule extraction techniques stems from their ability to handle intricate problems yet produce models based on rules that can be comprehended by humans, and are therefore more transparent. Human comprehension is a factor that may improve adoption and use of data-driven decision support systems clinically via face validity. In this work, we explore whether we can reliably and informatively forecast cardiorespiratory instability (CRI) in step-down unit (SDU) patients utilizing data from continuous monitoring of physiologic vital sign (VS) measurements. We use a temporal association rule extraction technique in conjunction with a rule fusion protocol to learn how to forecast CRI in continuously monitored patients. We detail our approach and present and discuss encouraging empirical results obtained using continuous multivariate VS data from the bedside monitors of 297 SDU patients spanning 29 346 hours (3.35 patient-years) of observation. We present example rules that have been learned from data to illustrate potential benefits of comprehensibility of the extracted models, and we analyze the empirical utility of each VS as a potential leading indicator of an impending CRI event. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The INSPIRED study: a randomised controlled trial of the Whole Person Model of disease self-management for people with type 2 diabetes.

PubMed

Clarke, David M; Baird, Donita E; Perera, Dinali N; Hagger, Virginia L; Teede, Helena J

2014-02-08

The prevalence of type 2 diabetes has increased dramatically in the last decade, and is continuing to rise. It is a chronic condition, often related to obesity, diet and sedentary lifestyles, and can lead to significant health complications, disability and early death. Diabetes is commonly associated with depression, which can impact significantly on a person's ability to manage their illness and, consequently, on disease outcomes. Disease self-management is fundamental in diabetes and requires support from multiple health professionals and the active participation of the person, including in maintaining a healthy lifestyle. The Whole Person Model was developed in order to integrate emotional and behavioural aspects into a self-management program for people with type 2 diabetes. Here we describe a study designed to test the efficacy of the Whole Person Model of disease self-management in type 2 diabetes. In a parallel-group randomised trial, 180 people with type 2 diabetes of between 2-10 years duration will be recruited via invitation through the Australian National Diabetes Services Scheme. Participants will undergo baseline assessment, followed by randomisation to either intervention or control condition. Control participants will receive fact sheets containing key information about diabetes self-management. The intervention group will receive the INSPIRED (Individual Support & Resources for Diabetes) Manual and be assigned a Health Coach. The INSPIRED Manual consists of six modules that provide key information about diabetes and disease management using the Whole Person Model. Engagement is facilitated by interactive tasks and contact with a Health Coach over seven weeks--an introductory face-to-face session, and six subsequent contacts by phone following each module. Follow-up assessments occur at 13 weeks (post-intervention) and 26 weeks. Primary outcomes include blood glucose management (HbA1c), weight and mood. Secondary outcomes include level of exercise, confidence to manage diabetes, and psychosocial well-being. The Whole Person Model is designed to enable health professionals to address mood disturbance without pathologizing any disorders and, in the context of the chronic illness, empowering behavior change and self-management. If proven effective, this model will strengthen capacity of the healthcare workforce to foster and support effective diabetes self-management. Australia and New Zealand Clinical Trials Register, ACTRN12613000391774.

En-face optical coherence tomography in the diagnosis and management of age-related macular degeneration and polypoidal choroidal vasculopathy.

PubMed

Lau, Tiffany; Wong, Ian Y; Iu, Lawrence; Chhablani, Jay; Yong, Tao; Hideki, Koizumi; Lee, Jacky; Wong, Raymond

2015-05-01

Optical coherence tomography (OCT) is a noninvasive imaging modality providing high-resolution images of the central retina that has completely transformed the field of ophthalmology. While traditional OCT has produced longitudinal cross-sectional images, advancements in data processing have led to the development of en-face OCT, which produces transverse images of retinal and choroidal layers at any specified depth. This offers additional benefit on top of longitudinal cross-sections because it provides an extensive overview of pathological structures in a single image. The aim of this review was to discuss the utility of en-face OCT in the diagnosis and management of age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). En-face imaging of the inner segment/outer segment junction of retinal photoreceptors has been shown to be a useful indicator of visual acuity and a predictor of the extent of progression of geographic atrophy. En-face OCT has also enabled high-resolution analysis and quantification of pathological structures such as reticular pseudodrusen (RPD) and choroidal neovascularization, which have the potential to become useful markers for disease monitoring. En-face Doppler OCT enables subtle changes in the choroidal vasculature to be detected in eyes with RPD and AMD, which has significantly advanced our understanding of their pathogenesis. En-face Doppler OCT has also been shown to be useful for detecting the polypoid lesions and branching vascular networks diagnostic of PCV. It may therefore serve as a noninvasive alternative to fluorescein and indocyanine green angiography for the diagnosis of PCV and other forms of the exudative macular disease.

Facial and oral aspects of some venereal and tropical diseases.

PubMed

Ramos-E-Silva, Marcia

2004-01-01

Diseases of the tropical areas include some venereal diseases, and they are still very prevalent in some countries; Brazil is one of them. Very few cases are originated in large cities, as Rio de Janeiro, but at the University Hospital of the Federal University of Rio de Janeiro we also see those patients who come from the interior of the State of Rio de Janeiro or from other states to seek medical care at better equipped hospitals for this type of investigation and therapy. Venereal and tropical dermatoses have many different cutaneous manifestations and may affect skin in several locations. The face is one of the affected areas especially when the disease has a predilection for cartilage, oral and/or nasal mucosa. Alterations observed on the skin of the face and on the mucosa of the mouth of some tropical diseases, such as leprosy, leishmaniasis, paracoccidioidomycosis, donovanosis, and syphilis, as they are observed in Brazil, are presented and discussed in this article.

A review of recent literature - nurse case managers in diabetes care: equivalent or better outcomes compared to primary care providers.

PubMed

Watts, Sharon A; Lucatorto, Michelle

2014-07-01

Primary care has changed remarkably with chronic disease burden growth. Nurse case managers assist with this chronic disease by providing if not significantly better care, than equivalent care to that provided by usual primary care providers. Chronic disease management requires patient-centered skills and tools, such as registries, panel management, review of home data, communicating with patients outside of face-to-face care, and coordinating multiple services. Evidence reviewed in this article demonstrates that registered nurse care managers (RNCM) perform many actions required for diabetes chronic disease management including initiation and titration of medications with similar or improved physiologic and patient satisfaction outcomes over usual care providers. Selection and training of the nurse case managers is of utmost importance for implementation of a successful chronic disease management program. Evidence based guidelines, algorithms, protocols, and adequate ongoing education and mentoring are generally cited as necessary support tools for the nurse case managers.

Tuning of temporo-occipital activity by frontal oscillations during virtual mirror exposure causes erroneous self-recognition.

PubMed

Serino, Andrea; Sforza, Anna Laura; Kanayama, Noriaki; van Elk, Michiel; Kaliuzhna, Mariia; Herbelin, Bruno; Blanke, Olaf

2015-10-01

Self-face recognition, a hallmark of self-awareness, depends on 'off-line' stored information about one's face and 'on-line' multisensory-motor face-related cues. The brain mechanisms of how on-line sensory-motor processes affect off-line neural self-face representations are unknown. This study used 3D virtual reality to create a 'virtual mirror' in which participants saw an avatar's face moving synchronously with their own face movements. Electroencephalographic (EEG) analysis during virtual mirror exposure revealed mu oscillations in sensory-motor cortex signalling on-line congruency between the avatar's and participants' movements. After such exposure and compatible with a change in their off-line self-face representation, participants were more prone to recognize the avatar's face as their own, and this was also reflected in the activation of face-specific regions in the inferotemporal cortex. Further EEG analysis showed that the on-line sensory-motor effects during virtual mirror exposure caused these off-line visual effects, revealing the brain mechanisms that maintain a coherent self-representation, despite our continuously changing appearance. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

[Predictors for 'successful quitting smoking' among males carried out in a smoking cessation clinic].

PubMed

Wu, Lei; He, Yao; Jiang, Bin; Zuo, Fang; Liu, Qinghui; Zhang, Li; Zhou, Changxi; Liu, Miao; Chen, Hongyan

2014-07-01

To investigate the predictors for 'quitting' among male smokers in a smoking cessation clinic. The target population consisted of smokers who volunteered to seek treatment for cessation at our clinic in Beijing. Smokers received face-to-face counseling and psychological intervention at the first visit by trained physicians and standardized telephone discussion, was carried out with counselors at 1 week, 1/3/6 months a follow-up study. The main outcomes would involve 'successful quitting' at the 7-day point, continuous quit rates at 3 and 6 months as well as the predictors of 'quitting'. From October 2008 to December 2012, we collected 355 eligible male smokers among whom 255 had completed the 6-month follow-up program. Results from the analysis (n = 255) showed that the quitting rates at the 7-day point and 3 months were 34.9% and 25.5%, while the rates were 25.1% and 18.3% among the 355 smokers who had the intention for treatment. Data from the stepwise logistic regression model analysis showed that lower exhaled CO level at the first visit, higher perceived confidence in quitting, lower expenditure on cigarettes and had diagnosed tobacco-related chronic diseases by physicians, were important predictors for quitting smoking. The main reasons of failure to quit were addiction of tobacco cigarette, craving for cigarettes to relieve pressure from work, peer influence from other smokers, lack of mental preparation and perseverance to quit, etc. Smokers who smoked less cigarettes, had higher perceived confidence in quitting and had physician-diagnosed tobacco-related chronic diseases seemed easier to quit. Regular follow-up intervention services for smokers should be established to enhance the motivation for quitting so as to create a favorable environment for the smokers.

Autonomic responses to cold face stimulation in sickle cell disease: a time-varying model analysis.

PubMed

Chalacheva, Patjanaporn; Kato, Roberta M; Sangkatumvong, Suvimol; Detterich, Jon; Bush, Adam; Wood, John C; Meiselman, Herbert; Coates, Thomas D; Khoo, Michael C K

2015-07-14

Sickle cell disease (SCD) is characterized by sudden onset of painful vaso-occlusive crises (VOC), which occur on top of the underlying chronic blood disorder. The mechanisms that trigger VOC remain elusive, but recent work suggests that autonomic dysfunction may be an important predisposing factor. Heart-rate variability has been employed in previous studies, but the derived indices have provided only limited univariate information about autonomic cardiovascular control in SCD. To circumvent this limitation, a time-varying modeling approach was applied to investigate the functional mechanisms relating blood pressure (BP) and respiration to heart rate and peripheral vascular resistance in healthy controls, untreated SCD subjects and SCD subjects undergoing chronic transfusion therapy. Measurements of respiration, heart rate, continuous noninvasive BP and peripheral vascular resistance were made before, during and after the application of cold face stimulation (CFS), which perturbs both the parasympathetic and sympathetic nervous systems. Cardiac baroreflex sensitivity estimated from the model was found to be impaired in nontransfused SCD subjects, but partially restored in SCD subjects undergoing transfusion therapy. Respiratory-cardiac coupling gain was decreased in SCD and remained unchanged by chronic transfusion. These results are consistent with autonomic dysfunction in the form of impaired parasympathetic control and sympathetic overactivity. As well, CFS led to a significant reduction in vascular resistance baroreflex sensitivity in the nontransfused SCD subjects but not in the other groups. This blunting of the baroreflex control of peripheral vascular resistance during elevated sympathetic drive could be a potential factor contributing to the triggering of VOC in SCD. © 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

Lessons Learned: Engaging Culturally Diverse Families in Neurodevelopmental Disorders Intervention Research

ERIC Educational Resources Information Center

Ratto, Allison B.; Anthony, Bruno J.; Pugliese, Cara; Mendez, Rocio; Safer-Lichtenstein, Jonathan; Dudley, Katerina M.; Kahn, Nicole F.; Kenworthy, Lauren; Biel, Matthew; Martucci, Jillian L.; Anthony, Laura G.

2017-01-01

Low-income and ethnic minority families continue to face critical disparities in access to diagnostic and treatment services for neurodevelopmental conditions, such as autism spectrum disorder and attention deficit hyperactivity disorder. Despite the growing cultural diversity of the United States, ethnic minority children and families continue to…

47 CFR 1.62 - Operation pending action on renewal application.

Code of Federal Regulations, 2010 CFR

2010-10-01

... on its face that it relates to an activity not of a continuing nature, or where the non-continuing.... 1.62 Section 1.62 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE... license any proper and timely application for renewal of license with respect to any activity of a...

"Faces" and Complexities of Continuing Higher Education Units: A Postmodern Approach

ERIC Educational Resources Information Center

Stephenson, Sandria S.

2010-01-01

This study examines the dynamics of continuing higher education units within the sociopolitical context of higher education institutions. A qualitative approach to data collection and analysis was the study's design, while the theoretical frame was a postmodern, symbolic, theoretical approach to organizational studies. Results show that continuing…

Continuous Improvement in State Funded Preschool Programs

ERIC Educational Resources Information Center

Jackson, Sarah L.

2012-01-01

State funded preschool programs were constantly faced with the need to change in order to address internal and external demands. As programs engaged in efforts towards change, minimal research was available on how to support continuous improvement efforts within the context unique to state funded preschool programs. Guidance available had…

Improving Affordability of Higher Education through Buying Consortia

ERIC Educational Resources Information Center

Isaak, Larry A.; Trembath, Robert J.; Sebesta, James

2009-01-01

Many public and private higher education institutions continue to experience flat or reduced state budget allocations, coupled with tuition and fees that continue to exceed inflation. Finding proactive and innovative approaches to reduce costs without sacrificing quality of instruction and service is truly the challenge facing facility and…

Reimagining Christian Higher Education

ERIC Educational Resources Information Center

Hulme, E. Eileen; Groom, David E., Jr.; Heltzel, Joseph M.

2016-01-01

The challenges facing higher education continue to mount. The shifting of the U.S. ethnic and racial demographics, the proliferation of advanced digital technologies and data, and the move from traditional degrees to continuous learning platforms have created an unstable environment to which Christian higher education must adapt in order to remain…

Continuing Education in Architecture: The Process, the Issues, the Challenge.

ERIC Educational Resources Information Center

Frandson, Phillip E.

1980-01-01

The author sees three critical issues facing the architecture field: (1) the communications gap between client and practitioner; (2) humanization of the environment; and (3) financial, spatial, material, and societal constraints. He examines the role of continuing education and professional associations in responding to those challenges, which are…

Being BOLD: The neural dynamics of face perception.

PubMed

Gentile, Francesco; Ales, Justin; Rossion, Bruno

2017-01-01

According to a non-hierarchical view of human cortical face processing, selective responses to faces may emerge in a higher-order area of the hierarchy, in the lateral part of the middle fusiform gyrus (fusiform face area [FFA]) independently from face-selective responses in the lateral inferior occipital gyrus (occipital face area [OFA]), a lower order area. Here we provide a stringent test of this hypothesis by gradually revealing segmented face stimuli throughout strict linear descrambling of phase information [Ales et al., 2012]. Using a short sampling rate (500 ms) of fMRI acquisition and single subject statistical analysis, we show a face-selective responses emerging earlier, that is, at a lower level of structural (i.e., phase) information, in the FFA compared with the OFA. In both regions, a face detection response emerging at a lower level of structural information for upright than inverted faces, both in the FFA and OFA, in line with behavioral responses and with previous findings of delayed responses to inverted faces with direct recordings of neural activity were also reported. Overall, these results support the non-hierarchical view of human cortical face processing and open new perspectives for time-resolved analysis at the single subject level of fMRI data obtained during continuously evolving visual stimulation. Hum Brain Mapp 38:120-139, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Advantages of using ‘omics’ technologies and bioinformatics for analyzing the impact of pathogens on sugarbeet

USDA-ARS?s Scientific Manuscript database

Throughout the history of American sugarbeet production, research has proceeded hand-in-hand with the emergence of new diseases, and sugarbeet scientists have used the technologies available to improve disease management and crop yield in the face of the emerging disease pressures. Many traditional...

Health Care Utilization among Migrant Latino Farmworkers: The Case of Skin Disease

ERIC Educational Resources Information Center

Feldman, Steven R.; Vallejos, Quirina M.; Quandt, Sara A.; Fleischer, Alan B., Jr.; Schulz, Mark R.; Verma, Amit; Arcury, Thomas A.

2009-01-01

Context: Skin diseases are common occupational illnesses for migrant farmworkers. Farmworkers face many barriers in accessing health care resources. Purpose: Framed by the Health Behavior Model, the purpose of this study was to assess health care utilization for skin disease by migrant Latino farmworkers. Methods: Three hundred and four migrant…

Do Human Fetuses Anticipate Self-Oriented Actions? A Study by Four-Dimensional (4D) Ultrasonography

ERIC Educational Resources Information Center

Myowa-Yamakoshi, Masako; Takeshita, Hideko

2006-01-01

Using four-dimensional (4D) ultrasonography, arm and hand movements toward the face were examined in 27 human fetuses at 19 to 35 weeks of gestation, thereby enabling the continuous monitoring of their faces and other surface features such as the extremities. More than half of the observed arm movements resulted in the hand touching the mouth…

A Survey of nearby, nearly face-on spiral galaxies

NASA Astrophysics Data System (ADS)

Garmire, Gordon

2014-09-01

This is a continuation of a survey of nearby, nearly face-on spiral galaxies. The main purpose is to search for evidence of collisions with small galaxies that show up in X-rays by the generation of hot shocked gas from the collision. Secondary objectives include study of the spatial distribution point sources in the galaxy and to detect evidence for a central massive blackhole.

Feedback 2.0 in Online Writing Instruction: Combining Audio-Visual and Text-Based Commentary to Enhance Student Revision and Writing Competency

ERIC Educational Resources Information Center

Grigoryan, Anna

2017-01-01

The continued increase in the number of students participating in online degree programs has led to an increase in the number of students taking online composition courses. Currently, most online writing programs replicate approaches used in face-to-face composition courses and simply transfer them to the online learning environment. However,…

Two Strategic Decisions Facing Fusion

NASA Astrophysics Data System (ADS)

Baldwin, D. E.

1998-06-01

Two strategic decisions facing the U.S. fusion program are described. The first decision deals with the role and rationale of the tokamak within the U. S. fusion program, and it underlies the debate over our continuing role in the evolving ITER collaboration (mid-1998). The second decision concerns how to include Inertial Fusion Energy (IFE) as a viable part of the national effort to harness fusion energy.

An Examination of Factors That Impact the Retention of Online Students at a For-Profit University

ERIC Educational Resources Information Center

Sorensen, Chris; Donovan, Judy

2017-01-01

Online learning has continued to grow in recent years. However, retaining students in online courses and programs has posed a challenge. Whether the university is public, private, offers both face-to-face and online programs, or is 100% online, retaining students in online programs can be an issue. This study reflects the widespread desire at a…

Online Synchronous vs. Asynchronous Software Training through the Behavioral Modeling Approach: A Longitudinal Field Experiment

ERIC Educational Resources Information Center

Chen, Charlie C.; Shaw, Ruey-shiang

2006-01-01

The continued and increasing use of online training raises the question of whether the most effective training methods applied in live instruction will carry over to different online environments in the long run. Behavior Modeling (BM) approach--teaching through demonstration--has been proven as the most effective approach in a face-to-face (F2F)…

Building a Student-Centred Learning Framework Using Social Software in the Middle Years Classroom: An Action Research Study

ERIC Educational Resources Information Center

Casey, Gail

2013-01-01

This article discusses the development of the online spaces that were used to create a learning framework: a student-centred framework that combined face-to-face teaching with online social and participatory media. The author, as part of her Doctoral research study, used action research as a mechanism for continual improvement as she redesigned…

Aging and Emotion Recognition: Not Just a Losing Matter

PubMed Central

Sze, Jocelyn A.; Goodkind, Madeleine S.; Gyurak, Anett; Levenson, Robert W.

2013-01-01

Past studies on emotion recognition and aging have found evidence of age-related decline when emotion recognition was assessed by having participants detect single emotions depicted in static images of full or partial (e.g., eye region) faces. These tests afford good experimental control but do not capture the dynamic nature of real-world emotion recognition, which is often characterized by continuous emotional judgments and dynamic multi-modal stimuli. Research suggests that older adults often perform better under conditions that better mimic real-world social contexts. We assessed emotion recognition in young, middle-aged, and older adults using two traditional methods (single emotion judgments of static images of faces and eyes) and an additional method in which participants made continuous emotion judgments of dynamic, multi-modal stimuli (videotaped interactions between young, middle-aged, and older couples). Results revealed an age by test interaction. Largely consistent with prior research, we found some evidence that older adults performed worse than young adults when judging single emotions from images of faces (for sad and disgust faces only) and eyes (for older eyes only), with middle-aged adults falling in between. In contrast, older adults did better than young adults on the test involving continuous emotion judgments of dyadic interactions, with middle-aged adults falling in between. In tests in which target stimuli differed in age, emotion recognition was not facilitated by an age match between participant and target. These findings are discussed in terms of theoretical and methodological implications for the study of aging and emotional processing. PMID:22823183

Face Pareidolia in the Rhesus Monkey.

PubMed

Taubert, Jessica; Wardle, Susan G; Flessert, Molly; Leopold, David A; Ungerleider, Leslie G

2017-08-21

Face perception in humans and nonhuman primates is rapid and accurate [1-4]. In the human brain, a network of visual-processing regions is specialized for faces [5-7]. Although face processing is a priority of the primate visual system, face detection is not infallible. Face pareidolia is the compelling illusion of perceiving facial features on inanimate objects, such as the illusory face on the surface of the moon. Although face pareidolia is commonly experienced by humans, its presence in other species is unknown. Here we provide evidence for face pareidolia in a species known to possess a complex face-processing system [8-10]: the rhesus monkey (Macaca mulatta). In a visual preference task [11, 12], monkeys looked longer at photographs of objects that elicited face pareidolia in human observers than at photographs of similar objects that did not elicit illusory faces. Examination of eye movements revealed that monkeys fixated the illusory internal facial features in a pattern consistent with how they view photographs of faces [13]. Although the specialized response to faces observed in humans [1, 3, 5-7, 14] is often argued to be continuous across primates [4, 15], it was previously unclear whether face pareidolia arose from a uniquely human capacity. For example, pareidolia could be a product of the human aptitude for perceptual abstraction or result from frequent exposure to cartoons and illustrations that anthropomorphize inanimate objects. Instead, our results indicate that the perception of illusory facial features on inanimate objects is driven by a broadly tuned face-detection mechanism that we share with other species. Published by Elsevier Ltd.

Skin Diseases: Skin Health and Skin Diseases

MedlinePlus

... The two most common types are basal cell cancer and squamous cell cancer. Melanoma, a more serious type of skin ... The two most common types are basal cell cancer and squamous cell cancer. They usually form on the head, face, ...

Brain Metabolic Dysfunction in Capgras Delusion During Alzheimer's Disease: A Positron Emission Tomography Study.

PubMed

Jedidi, H; Daury, N; Capa, R; Bahri, M A; Collette, F; Feyers, D; Bastin, C; Maquet, P; Salmon, E

2015-11-01

Capgras delusion is characterized by the misidentification of people and by the delusional belief that the misidentified persons have been replaced by impostors, generally perceived as persecutors. Since little is known regarding the neural correlates of Capgras syndrome, the cerebral metabolic pattern of a patient with probable Alzheimer's disease (AD) and Capgras syndrome was compared with those of 24-healthy elderly participants and 26 patients with AD without delusional syndrome. Comparing the healthy group with the AD group, the patient with AD had significant hypometabolism in frontal and posterior midline structures. In the light of current neural models of face perception, our patients with Capgras syndrome may be related to impaired recognition of a familiar face, subserved by the posterior cingulate/precuneus cortex, and impaired reflection about personally relevant knowledge related to a face, subserved by the dorsomedial prefrontal cortex. © The Author(s) 2013.

Challenges and opportunities in clinical translation of biomedical optical spectroscopy and imaging

NASA Astrophysics Data System (ADS)

Wilson, Brian C.; Jermyn, Michael; Leblond, Frederic

2018-03-01

Medical devices face many hurdles before they enter routine clinical practice to address unmet clinical needs. This is also the case for biomedical optical spectroscopy and imaging systems that are used here to illustrate the opportunities and challenges involved. Following initial concept, stages in clinical translation include instrument development, preclinical testing, clinical prototyping, clinical trials, prototype-to-product conversion, regulatory approval, commercialization, and finally clinical adoption and dissemination, all in the face of potentially competing technologies. Optical technologies face additional challenges from their being extremely diverse, often targeting entirely different diseases and having orders-of-magnitude differences in resolution and tissue penetration. However, these technologies can potentially address a wide variety of unmet clinical needs since they provide rich intrinsic biochemical and structural information, have high sensitivity and specificity for disease detection and localization, and are practical, safe (minimally invasive, nonionizing), and relatively affordable.

Face recognition in age related macular degeneration: perceived disability, measured disability, and performance with a bioptic device.

PubMed

Tejeria, L; Harper, R A; Artes, P H; Dickinson, C M

2002-09-01

(1) To explore the relation between performance on tasks of familiar face recognition (FFR) and face expression difference discrimination (FED) with both perceived disability in face recognition and clinical measures of visual function in subjects with age related macular degeneration (AMD). (2) To quantify the gain in performance for face recognition tasks when subjects use a bioptic telescopic low vision device. 30 subjects with AMD (age range 66-90 years; visual acuity 0.4-1.4 logMAR) were recruited for the study. Perceived (self rated) disability in face recognition was assessed by an eight item questionnaire covering a range of issues relating to face recognition. Visual functions measured were distance visual acuity (ETDRS logMAR charts), continuous text reading acuity (MNRead charts), contrast sensitivity (Pelli-Robson chart), and colour vision (large panel D-15). In the FFR task, images of famous people had to be identified. FED was assessed by a forced choice test where subjects had to decide which one of four images showed a different facial expression. These tasks were repeated with subjects using a bioptic device. Overall perceived disability in face recognition did not correlate with performance on either task, although a specific item on difficulty recognising familiar faces did correlate with FFR (r = 0.49, p<0.05). FFR performance was most closely related to distance acuity (r = -0.69, p<0.001), while FED performance was most closely related to continuous text reading acuity (r = -0.79, p<0.001). In multiple regression, neither contrast sensitivity nor colour vision significantly increased the explained variance. When using a bioptic telescope, FFR performance improved in 86% of subjects (median gain = 49%; p<0.001), while FED performance increased in 79% of subjects (median gain = 50%; p<0.01). Distance and reading visual acuity are closely associated with measured task performance in FFR and FED. A bioptic low vision device can offer a significant improvement in performance for face recognition tasks, and may be useful in reducing the handicap associated with this disability. There is, however, little evidence for a correlation between self rated difficulty in face recognition and measured performance for either task. Further work is needed to explore the complex relation between the perception of disability and measured performance.

Face recognition in age related macular degeneration: perceived disability, measured disability, and performance with a bioptic device

PubMed Central

Tejeria, L; Harper, R A; Artes, P H; Dickinson, C M

2002-01-01

Aims: (1) To explore the relation between performance on tasks of familiar face recognition (FFR) and face expression difference discrimination (FED) with both perceived disability in face recognition and clinical measures of visual function in subjects with age related macular degeneration (AMD). (2) To quantify the gain in performance for face recognition tasks when subjects use a bioptic telescopic low vision device. Methods: 30 subjects with AMD (age range 66–90 years; visual acuity 0.4–1.4 logMAR) were recruited for the study. Perceived (self rated) disability in face recognition was assessed by an eight item questionnaire covering a range of issues relating to face recognition. Visual functions measured were distance visual acuity (ETDRS logMAR charts), continuous text reading acuity (MNRead charts), contrast sensitivity (Pelli-Robson chart), and colour vision (large panel D-15). In the FFR task, images of famous people had to be identified. FED was assessed by a forced choice test where subjects had to decide which one of four images showed a different facial expression. These tasks were repeated with subjects using a bioptic device. Results: Overall perceived disability in face recognition did not correlate with performance on either task, although a specific item on difficulty recognising familiar faces did correlate with FFR (r = 0.49, p<0.05). FFR performance was most closely related to distance acuity (r = −0.69, p<0.001), while FED performance was most closely related to continuous text reading acuity (r = −0.79, p<0.001). In multiple regression, neither contrast sensitivity nor colour vision significantly increased the explained variance. When using a bioptic telescope, FFR performance improved in 86% of subjects (median gain = 49%; p<0.001), while FED performance increased in 79% of subjects (median gain = 50%; p<0.01). Conclusion: Distance and reading visual acuity are closely associated with measured task performance in FFR and FED. A bioptic low vision device can offer a significant improvement in performance for face recognition tasks, and may be useful in reducing the handicap associated with this disability. There is, however, little evidence for a correlation between self rated difficulty in face recognition and measured performance for either task. Further work is needed to explore the complex relation between the perception of disability and measured performance. PMID:12185131

Wavelet-based associative memory

NASA Astrophysics Data System (ADS)

Jones, Katharine J.

2004-04-01

Faces provide important characteristics of a person"s identification. In security checks, face recognition still remains the method in continuous use despite other approaches (i.e. fingerprints, voice recognition, pupil contraction, DNA scanners). With an associative memory, the output data is recalled directly using the input data. This can be achieved with a Nonlinear Holographic Associative Memory (NHAM). This approach can also distinguish between strongly correlated images and images that are partially or totally enclosed by others. Adaptive wavelet lifting has been used for Content-Based Image Retrieval. In this paper, adaptive wavelet lifting will be applied to face recognition to achieve an associative memory.

Meta-analytic review of the development of face discrimination in infancy: Face race, face gender, infant age, and methodology moderate face discrimination.

PubMed

Sugden, Nicole A; Marquis, Alexandra R

2017-11-01

Infants show facility for discriminating between individual faces within hours of birth. Over the first year of life, infants' face discrimination shows continued improvement with familiar face types, such as own-race faces, but not with unfamiliar face types, like other-race faces. The goal of this meta-analytic review is to provide an effect size for infants' face discrimination ability overall, with own-race faces, and with other-race faces within the first year of life, how this differs with age, and how it is influenced by task methodology. Inclusion criteria were (a) infant participants aged 0 to 12 months, (b) completing a human own- or other-race face discrimination task, (c) with discrimination being determined by infant looking. Our analysis included 30 works (165 samples, 1,926 participants participated in 2,623 tasks). The effect size for infants' face discrimination was small, 6.53% greater than chance (i.e., equal looking to the novel and familiar). There was a significant difference in discrimination by race, overall (own-race, 8.18%; other-race, 3.18%) and between ages (own-race: 0- to 4.5-month-olds, 7.32%; 5- to 7.5-month-olds, 9.17%; and 8- to 12-month-olds, 7.68%; other-race: 0- to 4.5-month-olds, 6.12%; 5- to 7.5-month-olds, 3.70%; and 8- to 12-month-olds, 2.79%). Multilevel linear (mixed-effects) models were used to predict face discrimination; infants' capacity to discriminate faces is sensitive to face characteristics including race, gender, and emotion as well as the methods used, including task timing, coding method, and visual angle. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Follow-Up Consultation Through a Healthcare Kiosk for Patients with Stable Chronic Disease in a Primary Care Setting: A Prospective Study.

PubMed

Bahadin, Juliana; Shum, Eugene; Ng, Grace; Tan, Nicolette; Sellayah, Pushpavalli; Tan, Sze Wee

2017-05-01

The global healthcare kiosk market is growing, and kiosks are projected to be a larger part of healthcare delivery in the coming decades. We developed an unmanned healthcare kiosk that automates the management of stable patients with chronic conditions to complement face-to-face primary care physician (PCP) visits. The aim of our study was to show that the kiosk could be a feasible means of delivering care for stable patients with chronic conditions and could generate cost savings for the management of patients with stable chronic disease. We conducted a prospective single-arm study of 95 participants with well-controlled chronic cardiovascular diseases who visited our clinic in Singapore every 3 months for review and medication refill. During their subsequent appointments for chronic disease management at 3 and 6 months, participants used the kiosk instead of consulting a physician. All participants who used the kiosk were also evaluated by a nurse clinician (NC). The kiosk assessment of whether the patient was well controlled was then compared to the NC's assessment to determine rates of agreement. Patient satisfaction was evaluated through a questionnaire, and any adverse outcomes were documented. Cohen's κ for agreement between the kiosk and the NC assessment of patients' chronic care control was 0.575 (95% CI, 0.437-0.713). The modest agreement was due to differences in systolic blood pressure measurements between the kiosk and the NC. The 96% of participants who completed two kiosk visits were all satisfied with the kiosk as a care delivery alternative. None of the participants managed through the kiosk suffered any adverse outcomes. Use of the kiosk resulted in a reduction of 128 face-to-face PCP visits. Healthcare kiosks can potentially be used to complement primary care clinician visits for managing patients with stable chronic diseases and can generate cost savings.

"Face-to-Face" with Addiction: The Spontaneous Production of Self-Portraits in Art Therapy

ERIC Educational Resources Information Center

Hanes, Michael J.

2007-01-01

In this brief report, two examples are presented of self-portraits spontaneously produced by chemically dependent patients who participated in art therapy while in an acute inpatient psychiatric hospital. The author concludes that self-portraits provide true-to-life representations of the diseased aspects of the self and enable patients to…

Preventive Health Education Needs Among Rural Farm and Rural Nonfarm Adults.

ERIC Educational Resources Information Center

Leadley, Samuel M.; And Others

Focusing on heart disease and cancer, the study compared the preventive health education needs of farm and nonfarm rural adults. During July and August 1975, face-to-face interviews were conducted with 57 men and 161 women living in Armstrong and Butler Counties, Pennsylvania. The sample included 119 commercial farm households and 99 rural nonfarm…

Joining forces for genetic conservation

Treesearch

Gary Man; Emily Boes; Rhoda Maurer; Michael Dosmann; Matt Lobdell; Kevin Conrad; Mike Kintgen; Rebecca Sucher; Martin Nicholson; David Stevenson; Brianna McTeague; Evan Heck; Richard A. Sniezko

2017-01-01

Facing a Challenge Non-native diseases and insects as well as a changing climate pose serious threats to native trees in North America. Genetic variation in a species is key to its enduring persistence in the face of these abiotic and biotic threats. Efforts to conserve genetic diversity of North American tree at-risk species will ensure the genetic...

Unconscious Evaluation of Faces on Social Dimensions

PubMed Central

Stewart, Lorna H.; Ajina, Sara; Getov, Spas; Bahrami, Bahador; Todorov, Alexander; Rees, Geraint

2012-01-01

It has been proposed that two major axes, dominance and trustworthiness, characterize the social dimensions of face evaluation. Whether evaluation of faces on these social dimensions is restricted to conscious appraisal or happens at a preconscious level is unknown. Here we provide behavioral evidence that such preconscious evaluations exist and that they are likely to be interpretations arising from interactions between the face stimuli and observer-specific traits. Monocularly viewed faces that varied independently along two social dimensions of trust and dominance were rendered invisible by continuous flash suppression (CFS) when a flashing pattern was presented to the other eye. Participants pressed a button as soon as they saw the face emerge from suppression to indicate whether the previously hidden face was located slightly to the left or right of central fixation. Dominant and untrustworthy faces took significantly longer time to emerge (T2E) compared with neutral faces. A control experiment showed these findings could not reflect delayed motor responses to conscious faces. Finally, we showed that participants' self-reported propensity to trust was strongly predictive of untrust avoidance (i.e., difference in T2E for untrustworthy vs neutral faces) as well as dominance avoidance (i.e., difference in T2E for dominant vs neutral faces). Dominance avoidance was also correlated with submissive behavior. We suggest that such prolongation of suppression for threatening faces may result from a passive fear response, leading to slowed visual perception. PMID:22468670

Atypical Face Perception in Autism: A Point of View?

PubMed

Morin, Karine; Guy, Jacalyn; Habak, Claudine; Wilson, Hugh R; Pagani, Linda; Mottron, Laurent; Bertone, Armando

2015-10-01

Face perception is the most commonly used visual metric of social perception in autism. However, when found to be atypical, the origin of face perception differences in autism is contentious. One hypothesis proposes that a locally oriented visual analysis, characteristic of individuals with autism, ultimately affects performance on face tasks where a global analysis is optimal. The objective of this study was to evaluate this hypothesis by assessing face identity discrimination with synthetic faces presented with and without changes in viewpoint, with the former condition minimizing access to local face attributes used for identity discrimination. Twenty-eight individuals with autism and 30 neurotypical participants performed a face identity discrimination task. Stimuli were synthetic faces extracted from traditional face photographs in both front and 20° side viewpoints, digitized from 37 points to provide a continuous measure of facial geometry. Face identity discrimination thresholds were obtained using a two-alternative, temporal forced choice match-to-sample paradigm. Analyses revealed an interaction between group and condition, with group differences found only for the viewpoint change condition, where performance in the autism group was decreased compared to that of neurotypical participants. The selective decrease in performance for the viewpoint change condition suggests that face identity discrimination in autism is more difficult when access to local cues is minimized, and/or when dependence on integrative analysis is increased. These results lend support to a perceptual contribution of atypical face perception in autism. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Unconscious evaluation of faces on social dimensions.

PubMed

Stewart, Lorna H; Ajina, Sara; Getov, Spas; Bahrami, Bahador; Todorov, Alexander; Rees, Geraint

2012-11-01

It has been proposed that two major axes, dominance and trustworthiness, characterize the social dimensions of face evaluation. Whether evaluation of faces on these social dimensions is restricted to conscious appraisal or happens at a preconscious level is unknown. Here we provide behavioral evidence that such preconscious evaluations exist and that they are likely to be interpretations arising from interactions between the face stimuli and observer-specific traits. Monocularly viewed faces that varied independently along two social dimensions of trust and dominance were rendered invisible by continuous flash suppression (CFS) when a flashing pattern was presented to the other eye. Participants pressed a button as soon as they saw the face emerge from suppression to indicate whether the previously hidden face was located slightly to the left or right of central fixation. Dominant and untrustworthy faces took significantly longer time to emerge (T2E) compared with neutral faces. A control experiment showed these findings could not reflect delayed motor responses to conscious faces. Finally, we showed that participants' self-reported propensity to trust was strongly predictive of untrust avoidance (i.e., difference in T2E for untrustworthy vs neutral faces) as well as dominance avoidance (i.e., difference in T2E for dominant vs neutral faces). Dominance avoidance was also correlated with submissive behavior. We suggest that such prolongation of suppression for threatening faces may result from a passive fear response, leading to slowed visual perception. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Fabrication technique for a custom face mask for the treatment of obstructive sleep apnea.

PubMed

Prehn, Ronald S; Colquitt, Tom

2016-05-01

The development of the positive airway pressure custom mask (TAP-PAP CM) has changed the treatment of obstructive sleep apnea. The TAP-PAP CM is used in continuous positive airway pressure therapy (CPAP) and is fabricated from the impression of the face. This mask is then connected to a post screwed into the mechanism of the TAP3 (Thornton Anterior Positioner) oral appliance. This strapless CPAP face mask features an efficient and stable CPAP interface with mandibular stabilization (Hybrid Therapy). A technique with a 2-stage polyvinyl siloxane face impression is described that offers improvements over the established single-stage face impression. This 2-stage impression technique eliminates problems inherent in the single-stage face impression, including voids, compressed tissue, inadequate borders, and a rushed experience due to the setting time of the single stage. The result is a custom mask with an improved seal to the CPAP device. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Face recognition ability matures late: evidence from individual differences in young adults.

PubMed

Susilo, Tirta; Germine, Laura; Duchaine, Bradley

2013-10-01

Does face recognition ability mature early in childhood (early maturation hypothesis) or does it continue to develop well into adulthood (late maturation hypothesis)? This fundamental issue in face recognition is typically addressed by comparing child and adult participants. However, the interpretation of such studies is complicated by children's inferior test-taking abilities and general cognitive functions. Here we examined the developmental trajectory of face recognition ability in an individual differences study of 18-33 year-olds (n = 2,032), an age interval in which participants are competent test takers with comparable general cognitive functions. We found a positive association between age and face recognition, controlling for nonface visual recognition, verbal memory, sex, and own-race bias. Our study supports the late maturation hypothesis in face recognition, and illustrates how individual differences investigations of young adults can address theoretical issues concerning the development of perceptual and cognitive abilities. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Monocular Advantage for Face Perception Implicates Subcortical Mechanisms in Adult Humans

PubMed Central

Gabay, Shai; Nestor, Adrian; Dundas, Eva; Behrmann, Marlene

2014-01-01

The ability to recognize faces accurately and rapidly is an evolutionarily adaptive process. Most studies examining the neural correlates of face perception in adult humans have focused on a distributed cortical network of face-selective regions. There is, however, robust evidence from phylogenetic and ontogenetic studies that implicates subcortical structures, and recently, some investigations in adult humans indicate subcortical correlates of face perception as well. The questions addressed here are whether low-level subcortical mechanisms for face perception (in the absence of changes in expression) are conserved in human adults, and if so, what is the nature of these subcortical representations. In a series of four experiments, we presented pairs of images to the same or different eyes. Participants’ performance demonstrated that subcortical mechanisms, indexed by monocular portions of the visual system, play a functional role in face perception. These mechanisms are sensitive to face-like configurations and afford a coarse representation of a face, comprised of primarily low spatial frequency information, which suffices for matching faces but not for more complex aspects of face perception such as sex differentiation. Importantly, these subcortical mechanisms are not implicated in the perception of other visual stimuli, such as cars or letter strings. These findings suggest a conservation of phylogenetically and ontogenetically lower-order systems in adult human face perception. The involvement of subcortical structures in face recognition provokes a reconsideration of current theories of face perception, which are reliant on cortical level processing, inasmuch as it bolsters the cross-species continuity of the biological system for face recognition. PMID:24236767

Social marketing to eliminate leprosy in Sri Lanka.

PubMed

Williams, P G; Dewapura, D; Gunawardene, P; Settinayake, S

1998-01-01

Leprosy is a chronic infectious disease which, if untreated, can lead to permanent and progressive nerve damage and thus to deformities of the limbs, eyes, and face. People with leprosy have long been ostracized by society. The clinical signs of leprosy include insensitive skin lesions and thickened peripheral nerves. Untreated infectious leprosy cases are the main source of infection, transmitting the disease through nasal secretions. People with low cell-mediated immunity are at risk of developing clinically active leprosy irrespective of gender, age, or social class. The World Health Organization (WHO) has, since 1982, recommended multiple drug therapy (MDT) against leprosy, an approach capable of curing the disease within 1 year and interrupting its transmission. According to WHO, leprosy is currently a public health problem in 55 countries and more than 20% of the estimated 1.15 million cases of leprosy worldwide remain undetected. Although Sri Lanka was the first country in South Asia to provide MDT to all registered leprosy patients, first making it available in 1984, the disease continues to be transmitted due to the large number of undetected cases in the country. An ongoing social marketing program was therefore launched in 1990 by the local health ministry and the Novartis Foundation for Sustainable Development to eliminate leprosy from Sri Lanka. The program encourages people with suspicious skin lesions to seek diagnosis and care, teaches health care providers to recognize leprosy and refer cases for treatment, and helps the general public to understand that leprosy is just a normal disease. The socially marketed product is MDT, provided free-of-charge by the Novartis Foundation to all leprosy patients.

Multiple factors, including non-motor impairments, influence decision making with regard to exercise participation in Parkinson's disease: a qualitative enquiry.

PubMed

O'Brien, Christine; Clemson, Lindy; Canning, Colleen G

2016-01-01

To explore how the meaning of exercise and other factors interact and influence the exercise behaviour of individuals with Parkinson's disease (PD) enrolled in a 6-month minimally supervised exercise program to prevent falls, regardless of whether they completed the prescribed exercise or not. This qualitative study utilised in-depth semi-structured interviews analysed using grounded theory methodology. Four main themes were constructed from the data: adapting to change and loss, the influence of others, making sense of the exercise experience and hope for a more active future. Participation in the PD-specific physiotherapy program involving group exercise provided an opportunity for participants to reframe their identity of their "active" self. Three new influences on exercise participation were identified and explored: non-motor impairments of apathy and fatigue, the belief in a finite energy quota, and the importance of feedback. A model was developed incorporating the themes and influences to explain decision-making for exercise participation in this group. Complex and interacting issues, including non-motor impairments, need to be considered in order to enhance the development and ongoing implementation of effective exercise programmes for people with PD. Exercise participation can assist individuals to reframe their identity as they are faced with losses associated with Parkinson's disease and ageing. Non-motor impairments of apathy and fatigue may influence exercise participation in people with Parkinson's disease. Particular attention needs to be paid to the provision of feedback in exercise programs for people with Parkinson's disease as it important for their decision-making about continuing exercise.

Malpractice in treatment of sinonasal disease by otolaryngologists: a review of the past 10 years.

PubMed

Winford, Tyler W; Wallin, Jordan L; Clinger, John D; Graham, Aaron M

2015-03-01

Sinonasal disease is a common condition treated by otolaryngologists. Malpractice in this area is the most common litigation faced by otolaryngologists. This study analyzes malpractice in the treatment of sinonasal disease. Case series, review of legal records. Legal databases. Using 2 different computerized legal databases, the phrase medical malpractice was searched with terms related to sinonasal disease involving court cases in the past 10 years (2004-2013), yielding 26 cases. The cases were analyzed for pertinent data regarding plaintiffs, presenting complaint, practice setting, type of malpractice, resulting injury, result of verdict, and amount of reward or settlement. Chronic sinusitis (42%) was the most common presenting symptom. Many cases included multiple types of alleged malpractice, with the most common being negligent technique (38%) and lack of informed consent (27%). The most common alleged injuries included cerebrospinal fluid leak, meningitis, nasal obstruction, and orbital trauma. Defendants prevailed in 13 of 18 cases in which outcomes were known, with mean award of $225,000 and mean settlement of $212,500. The cases won by plaintiffs were all in a private practice setting. Otolaryngologists should be aware of the causes of malpractice litigation as it relates to treatment of sinonasal disease. Lack of informed consent continues to be a common allegation, and surgeons should ensure complete informed consent is obtained and well documented. A unified and complete database of medical malpractice cases is needed to allow for further analysis of specialty-related claims. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

The KRA Canal and Thai Security

DTIC Science & Technology

2002-06-01

created pockets of minorities; many carry diseases such as elephantiasis and malaria. For example, Ranong Province is presently facing the recurrence...of elephantiasis . This disease, which had long disappeared from Thailand, is now spreading rapidly.42 Furthermore, some of the illegal workers are

Genetic Testing

MedlinePlus

... is often the only way to determine if symptoms could possibly be related to celiac disease. For a person who faces this situation, a negative gene test would indicate that symptoms are not the result of celiac disease. A positive gene test, however, does not diagnose ...

Policy making for vaccine use as a driver of vaccine innovation and development in the developed world.

PubMed

Seib, Katherine; Pollard, Andrew J; de Wals, Philippe; Andrews, Ross M; Zhou, Fangjun; Hatchett, Richard J; Pickering, Larry K; Orenstein, Walter A

2017-03-07

In the past 200years, vaccines have had unmistakable impacts on public health including declines in morbidity and mortality, most markedly in economically-developed countries. Highly engineered vaccines including vaccines for conditions other than infectious diseases are expected to dominate future vaccine development. We examine immunization vaccine policy as a driver of vaccine innovation and development. The pathways to recommendation for use of licensed vaccines in the US, UK, Canada and Australia have been similar, including: expert review of disease epidemiology, disease burden and severity; vaccine immunogenicity, efficacy and safety; programmatic feasibility; public demand; and increasingly cost-effectiveness. Other attributes particularly important in development of future vaccines are likely to include: duration of immunity for improved vaccines such as pertussis; a greater emphasis on optimizing community protection rather than direct protection only; programmatic implementation, feasibility, improvements (as in the case of development of a universal influenza vaccine); public concerns/confidence/fears related to outbreak pathogens like Ebola and Zika virus; and major societal burden for combating hard to treat diseases like HIV and antimicrobial resistant pathogens. Driving innovation and production of future vaccines faces enormous economic hurdles as available approaches, technologies and regulatory pathways become more complex. As such, cost-mitigating strategies and focused, aligned efforts (by governments, private organizations, and private-public partnerships) will likely be needed to continue to spur major advances in vaccine technologies and development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Old Disease and New Challenges: Major Obstacles of Current Strategies in the Prevention of Pertussis

PubMed Central

Sedighi, Iraj; Karimi, Abdollah; Amanati, Ali

2016-01-01

Context Universal immunization against Bordetella pertussis has partially controlled the burden of the disease and its transmission. However, according to recent data, the epidemiology of this vaccine-preventable disease has changed. Now, younger infants, adolescents, and adults are at greater risk of infection. This article has studied the interaction between the various factors involved in the changing epidemiology of pertussis and the major obstacles faced by the current strategies in its prevention. Evidence Acquisition In this narrative review, the most recently published sources of information on pertussis control measures, consisting of textbooks and articles, have been reviewed. We focused on the more recent data about the changing epidemiology or pertussis in Scopus through the use of the MeSH-term words [pertussis] or [whooping cough] and [epidemiology] or [outbreak] or [resurgence], but our search was not restricted to this particular strategy; we also tried to find all of the most recent available data in the general field through other means. Results Primary and booster doses of the pertussis vaccine seem to partially control transmission of the disease, but despite the different preventive strategies available, pertussis continues to cause mortality and morbidity among high-risk groups. Conclusions Adding booster doses of acellular pertussis vaccine to the current national immunization practices with whole-cell vaccines for young adults and pregnant women seems to be a good option for controlling mortality and morbidity among high-risk groups such as very young infants. PMID:27729960

Emerging viral diseases of fish and shrimp

PubMed Central

Walker, Peter J.; Winton, James R.

2010-01-01

The rise of aquaculture has been one of the most profound changes in global food production of the past 100 years. Driven by population growth, rising demand for seafood and a levelling of production from capture fisheries, the practice of farming aquatic animals has expanded rapidly to become a major global industry. Aquaculture is now integral to the economies of many countries. It has provided employment and been a major driver of socio-economic development in poor rural and coastal communities, particularly in Asia, and has relieved pressure on the sustainability of the natural harvest from our rivers, lakes and oceans. However, the rapid growth of aquaculture has also been the source of anthropogenic change on a massive scale. Aquatic animals have been displaced from their natural environment, cultured in high density, exposed to environmental stress, provided artificial or unnatural feeds, and a prolific global trade has developed in both live aquatic animals and their products. At the same time, over-exploitation of fisheries and anthropogenic stress on aquatic ecosystems has placed pressure on wild fish populations. Not surprisingly, the consequence has been the emergence and spread of an increasing array of new diseases. This review examines the rise and characteristics of aquaculture, the major viral pathogens of fish and shrimp and their impacts, and the particular characteristics of disease emergence in an aquatic, rather than terrestrial, context. It also considers the potential for future disease emergence in aquatic animals as aquaculture continues to expand and faces the challenges presented by climate change. PMID:20409453

Emerging viral diseases of fish and shrimp

USGS Publications Warehouse

Winton, James R.; Walker, Peter J.

2010-01-01

The rise of aquaculture has been one of the most profound changes in global food production of the past 100 years. Driven by population growth, rising demand for seafood and a levelling of production from capture fisheries, the practice of farming aquatic animals has expanded rapidly to become a major global industry. Aquaculture is now integral to the economies of many countries. It has provided employment and been a major driver of socio-economic development in poor rural and coastal communities, particularly in Asia, and has relieved pressure on the sustainability of the natural harvest from our rivers, lakes and oceans. However, the rapid growth of aquaculture has also been the source of anthropogenic change on a massive scale. Aquatic animals have been displaced from their natural environment, cultured in high density, exposed to environmental stress, provided artificial or unnatural feeds, and a prolific global trade has developed in both live aquatic animals and their products. At the same time, over-exploitation of fisheries and anthropogenic stress on aquatic ecosystems has placed pressure on wild fish populations. Not surprisingly, the consequence has been the emergence and spread of an increasing array of new diseases. This review examines the rise and characteristics of aquaculture, the major viral pathogens of fish and shrimp and their impacts, and the particular characteristics of disease emergence in an aquatic, rather than terrestrial, context. It also considers the potential for future disease emergence in aquatic animals as aquaculture continues to expand and faces the challenges presented by climate change.

Preventing thalassemia in Lebanon: successes and challenges in a developing country.

PubMed

Abi Saad, Michele; Haddad, Anthony G; Alam, Elie S; Aoun, Sanaa; Maatouk, Pascale; Ajami, Najat; Khairallah, Therese; Koussa, Suzanne; Musallam, Khaled M; Taher, Ali T

2014-01-01

Thalassemia continues to be a major health burden. The chronicity of the disease and the high cost of life-long treatment make prevention strategies crucial in the management of this disease. In this article, we revisit different successful prevention strategies, and underline the Lebanese model. The Chronic Care Center (CCC), Beirut, is the only specialized center in Lebanon for the treatment and prevention of thalassemia. The current number of patients registered up to August 2013 was 724, representing cases from all over Lebanon. In 1994, the center launched a national prevention program following the World Health Organization (WHO) recommendations. The major activities of the program include awareness campaigns, screening for thalassemia carriers in the general population and high risk groups, registry of new cases and follow-up on the mandatory premarital law (established at the same time). Screening programs showed a carrier rate of around 2.3% in the general population, and 4.0-41.0% in high risk groups. The major pitfall in the law is that only persons with a mean corpuscular volume (MCV) of >70.0 fL are asked to perform further hemoglobin (Hb) testing. A significant decrease in the number of new cases of thalassemia patients in Lebanon reflects the efforts deployed in the prevention of the disease. However, some limitations are faced in reaching a complete eradication of the disease, mainly due to the fact that abortion is illegal and due to pitfalls and incorrect implementation of the premarital law.

The reachability of contagion in temporal contact networks: how disease latency can exploit the rhythm of human behavior.

PubMed

Colman, Ewan; Spies, Kristen; Bansal, Shweta

2018-05-15

The symptoms of many infectious diseases influence their host to withdraw from social activity limiting their potential to spread. Successful transmission therefore requires the onset of infectiousness to coincide with a time when the host is socially active. Since social activity and infectiousness are both temporal phenomena, we hypothesize that diseases are most pervasive when these two processes are synchronized. We consider disease dynamics that incorporate behavioral responses that effectively shorten the infectious period of the pathogen. Using data collected from face-to-face social interactions and synthetic contact networks constructed from empirical demographic data, we measure the reachability of this disease model and perform disease simulations over a range of latent period durations. We find that maximum transmission risk results when the disease latent period (and thus the generation time) are synchronized with human circadian rhythms of 24 h, and minimum transmission risk when latent periods are out of phase with circadian rhythms by 12 h. The effect of this synchronization is present for a range of disease models with realistic disease parameters and host behavioral responses. The reproductive potential of pathogens is linked inextricably to the host social behavior required for transmission. We propose that future work should consider contact periodicity in models of disease dynamics, and suggest the possibility that disease control strategies may be designed to optimize against the effects of synchronization.

Upper Face: Clinical Anatomy and Regional Approaches with Injectable Fillers.

PubMed

Sykes, Jonathan M; Cotofana, Sebastian; Trevidic, Patrick; Solish, Nowell; Carruthers, Jean; Carruthers, Alastair; Moradi, Amir; Swift, Arthur; Massry, Guy G; Lambros, Val; Remington, B Kent

2015-11-01

The use of facial fillers has been rapidly increased as the range of injectable products and indications continues to expand. Complications may arise from improper placement or technique. This article highlights the importance of anatomic knowledge when using injectable fillers in the face. A detailed review of the clinical anatomy of the upper face is performed. Regional approaches are described using the applied anatomy to efficiently and safely augment the different subunits of the upper face. Key aspects of safe and successful injection of fillers in the upper face include a thorough knowledge of the location of fat compartments and neurovascular structures. Awareness of these structures enables the practitioner to maximize injections, while avoiding damage to important nerves and vessels. A detailed knowledge of the anatomy and properties of the product is paramount to maximize the efficacy while minimizing the risk of complications.

Thermal shields for gas turbine rotor

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

Ross, Christopher W.; Acar, Bulent

A turbomachine including a rotor having an axis and a plurality of disks positioned adjacent to each other in the axial direction, each disk including opposing axially facing surfaces and a circumferentially extending radially facing surface located between the axially facing surfaces. At least one row of blades is positioned on each of the disks, and the blades include an airfoil extending radially outward from the disk A non-segmented circumferentially continuous ring structure includes an outer rim defining a thermal barrier extending axially in overlapping relation over a portion of the radially facing surface of at least one disk, andmore » extending to a location adjacent to a blade on the disk A compliant element is located between a radially inner circumferential portion of the ring structure and a flange structure that extends axially from an axially facing surface of the disk.« less

Long-Term Multifunctional Outcome and Risks of Face Vascularized Composite Allotransplantation.

PubMed

Roche, Nathalie A; Blondeel, Phillip N; Vermeersch, Hubert F; Peeters, Patrick C; Lemmens, Gilbert M D; De Cubber, Jan; De Letter, Miet; Van Lierde, Kristiane

2015-10-01

Vascularized composite allotransplantation (VCA) to reconstruct complex centrally located facial defects and to restore vital functions in a 1-staged procedure has worldwide gained acceptance. Continuous long-term multidisciplinary follow-up of face transplant patients is mandatory for surveillance of the complications associated with the immunosuppressive regime and for functional assessment of the graft. In December 2011, our multidisciplinary team performed a digitally planned face transplant at the Ghent University Hospital, Belgium on a 55-year-old man with a large central facial defect after a high-energy ballistic injury. The patient was closely followed to assess functional recovery, immunosuppressive complications, overall well-being, and quality of life. Three years postoperatively, the patient and his family are very satisfied with the overall outcome, and social reintegration in the community is successful. Motor and sensory functions have recovered near normal. Infectious and medical complications have been serious but successfully managed. Immunosuppressive maintenance therapy consists of corticoids, tacrolimus, and mycophenolate mofetil in minimal doses. Epithetic reconstruction of both eyes gave a tremendous improvement on the overall aesthetic outcome. Despite serious complications during the first 12 months, multifunctional outcome in the first face transplant in Belgium (#19 worldwide) is successful. This should be attributed to the continuous and long-term multidisciplinary team approach. As only few reports of other face transplant patients on long-term follow-up are available, more data need to be collected and reported to further outweigh the risk benefit ratio of this life changing surgery.

Class and University Education: Inter-Generational Patterns in Canada. NALL Working Paper.

ERIC Educational Resources Information Center

Livingstone, D. W.; Stowe, Susan

Young people from lower class origins continue to face major barriers to university education in Canada. This paper documents both substantial inter-generational class mobility and continuing inequalities in formal educational attainments by class origins. While Canada now has the world's higher educational attainments in its youth cohort and has…

A Primer on Logistic Regression.

ERIC Educational Resources Information Center

Woldbeck, Tanya

This paper introduces logistic regression as a viable alternative when the researcher is faced with variables that are not continuous. If one is to use simple regression, the dependent variable must be measured on a continuous scale. In the behavioral sciences, it may not always be appropriate or possible to have a measured dependent variable on a…

Fiscal Year 2011 U.S. Government Financial Statements: The Federal Government Faces Continuing Financial Management and Long-Term Fiscal Challenges

DTIC Science & Technology

2012-03-01

GAO annually audits the consolidated financial statements of the U.S. government. The Congress and the President need reliable, useful, and timely...based consolidated financial statements . Unless these weaknesses are adequately addressed, they will, among other things, continue to (1) hamper the

Time course of influence on the allocation of attentional resources caused by unconscious fearful faces.

PubMed

Jiang, Yunpeng; Wu, Xia; Saab, Rami; Xiao, Yi; Gao, Xiaorong

2018-05-01

Emotionally affective stimuli have priority in our visual processing even in the absence of conscious processing. However, the influence of unconscious emotional stimuli on our attentional resources remains unclear. Using the continuous flash suppression (CFS) paradigm, we concurrently recorded and analyzed visual event-related potential (ERP) components evoked by the images of suppressed fearful and neutral faces, and the steady-state visual evoked potential (SSVEP) elicited by dynamic Mondrian pictures. Fearful faces, relative to neutral faces, elicited larger late ERP components on parietal electrodes, indicating emotional expression processing without consciousness. More importantly, the presentation of a suppressed fearful face in the CFS resulted in a significantly greater decrease in SSVEP amplitude which started about 1-1.2 s after the face images first appeared. This suggests that the time course of the attentional bias occurs at about 1 s after the appearance of the fearful face and demonstrates that unconscious fearful faces may influence attentional resource allocation. Moreover, we proposed a new method that could eliminate the interaction of ERPs and SSVEPs when recorded concurrently. Copyright © 2018 Elsevier Ltd. All rights reserved.

Articular cartilage tissue engineering: the role of signaling molecules

PubMed Central

Kwon, Heenam; Paschos, Nikolaos K.; Hu, Jerry C.; Athanasiou, Kyriacos

2017-01-01

Effective early disease modifying options for osteoarthritis remain lacking. Tissue engineering approach to generate cartilage in vitro has emerged as a promising option for articular cartilage repair and regeneration. Signaling molecules and matrix modifying agents, derived from knowledge of cartilage development and homeostasis, have been used as biochemical stimuli toward cartilage tissue engineering and have led to improvements in the functionality of engineered cartilage. Clinical translation of neocartilage faces challenges, such as phenotypic instability of the engineered cartilage, poor integration, inflammation, and catabolic factors in the arthritic environment; these can all contribute to failure of implanted neocartilage. A comprehensive understanding of signaling molecules involved in osteoarthritis pathogenesis and their actions on engineered cartilage will be crucial. Thus, while it is important to continue deriving inspiration from cartilage development and homeostasis, it has become increasing necessary to incorporate knowledge from osteoarthritis pathogenesis into cartilage tissue engineering. PMID:26811234

Early Childhood Caries

PubMed Central

Kawashita, Yumiko; Kitamura, Masayasu; Saito, Toshiyuki

2011-01-01

Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC) is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with fluoride and diet counseling. However, these strategies alone are not sufficient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suffering from dental caries. PMID:22007218

Brief report: glycemic control, quality of life, and school experiences among students with diabetes.

PubMed

Wagner, Julie; Heapy, Alicia; James, Amy; Abbott, Gina

2006-09-01

To investigate the relationships among perceived school experiences, diabetes control, and quality of life (QOL) in children with diabetes. Fifty-eight children with type 1 diabetes and their parents participated. The typical child was 12 years old, had diabetes for 5 years, and attended public, suburban, middle/junior high schools with 300-500 students. Children whose parents reported that school personnel received diabetes training showed significantly better diabetes control than those who reported untrained school personnel. Children who reported their classmates received diabetes training had significantly better QOL than those who reported untrained classmates. Children who reported greater flexibility in performing diabetes care tasks at school had significantly better diabetes control than children who reported less flexibility. Students with diabetes continue to face challenges at school. Training staff and classmates and allowing students the maximum appropriate flexibility in diabetes care appears beneficial for disease control and QOL.

The laboratory efficiencies initiative: partnership for building a sustainable national public health laboratory system.

PubMed

Ridderhof, John C; Moulton, Anthony D; Ned, Renée M; Nicholson, Janet K A; Chu, May C; Becker, Scott J; Blank, Eric C; Breckenridge, Karen J; Waddell, Victor; Brokopp, Charles

2013-01-01

Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners.

Anger in palliative care: a clinical approach.

PubMed

Philip, J; Gold, M; Schwarz, M; Komesaroff, P

2007-01-01

Anger in patients and families is a common problem in the care of persons with advanced disease. Whereas it is widely accepted that anger may be a justifiable reaction to significant illness and loss, it frequently creates difficulties for the doctors involved in care. In particular, there is often a personal impact on the doctor at whom anger is directed. This paper examines results of qualitative research with palliative care workers in the context of the broader published literature and the authors' clinical experiences. The ability to interact effectively with angry patients is a skill that is often learned with experience and is extremely useful in both transforming the patients' reaction into a more creative emotion and in developing a therapeutic relationship. Despite conscientious efforts, however, a few patients continue to be angry. A practical approach to anger, useful for the clinician directly involved in care, is outlined along with some strategies to adopt in the face of persistent anger.

Yemen in a Time of Cholera: Current Situation and Challenges.

PubMed

Al-Mekhlafi, Hesham M

2018-03-19

Since early 2015, Yemen has been in the throes of a grueling civil war, which has devastated the health system and public services, and created one of the world's worst humanitarian disasters. The country is currently facing a cholera epidemic the world's largest on record, surpassing one million (1,061,548) suspected cases, with 2,373 related deaths since October 2016. Cases were first confirmed in Sana'a city and then spread to almost all governorates except Socotra Island. Continued efforts are being made by the World Health Organization and international partners to contain the epidemic through improving water, sanitation and hygiene, setting up diarrhea treatment centers, and improving the population's awareness about the disease. The provision of clean water and adequate sanitation is imperative as an effective long-term solution to prevent the further spread of this epidemic. Cholera vaccination campaigns should also be conducted as a preventive measure.

Next step in the ongoing arms race between myxoma virus and wild rabbits in Australia is a novel disease phenotype

PubMed Central

Kerr, Peter J.; Cattadori, Isabella M.; Liu, June; Sim, Derek G.; Dodds, Jeff W.; Brooks, Jason W.; Kennett, Mary J.; Holmes, Edward C.

2017-01-01

In host–pathogen arms races, increases in host resistance prompt counteradaptation by pathogens, but the nature of that counteradaptation is seldom directly observed outside of laboratory models. The best-documented field example is the coevolution of myxoma virus (MYXV) in European rabbits. To understand how MYXV in Australia has continued to evolve in wild rabbits under intense selection for genetic resistance to myxomatosis, we compared the phenotypes of the progenitor MYXV and viral isolates from the 1950s and the 1990s in laboratory rabbits with no resistance. Strikingly, and unlike their 1950s counterparts, most virus isolates from the 1990s induced a highly lethal immune collapse syndrome similar to septic shock. Thus, the next step in this canonical case of coevolution after a species jump has been further escalation by the virus in the face of widespread host resistance. PMID:28808019

Experimental and early investigational drugs for angina pectoris.

PubMed

Elgendy, Islam Y; Winchester, David E; Pepine, Carl J

2016-12-01

Ischemic heart disease (IHD) is a major cause of death and disability among Western countries and angina pectoris is the most prevalent symptomatic manifestation. Strategies to improve management of chronic stable angina are a priority. Areas covered: A comprehensive review was conducted using the Medline and Cochrane databases as well as the clinical trial databases in the United States and Europe. Traditional therapies for angina will be discussed. This review particularly emphasizes investigational therapies for angina (including pharmacological agents, cell and gene based therapies, and herbal medications). Expert opinion: There has been renewed interest in older anti-angina agents (e.g., perhexiline, amiodarone, and phosphodiestrase-5 inhibitors). Other anti-inflammatory agents (e.g., allopurinol and febuxostat) are currently undergoing evaluation for angina therapy. Therapeutic angiogenesis continues to face some challenges. Future trials should evaluate the optimum patient population that would benefit from this form of therapy.

Experimental and early investigational drugs for angina pectoris

PubMed Central

Elgendy, Islam Y.; Winchester, David E.; Pepine, Carl J.

2016-01-01

Introduction Ischemic heart disease (IHD) is a major cause of death and disability among Western countries and angina pectoris is the most prevalent symptomatic manifestation. Strategies to improve management of chronic stable angina are a priority. Areas covered A comprehensive review was conducted using the Medline and Cochrane databases as well as the clinical trial databases in the United States and Europe. Traditional therapies for angina will be discussed. This review particularly emphasizes investigational therapies for angina (including pharmacological agents, cell and gene based therapies, and herbal medications). Expert commentary There has been renewed interest in older anti-angina agents (e.g., perhexiline, amiodarone, and phosphodiestrase-5 inhibitors). Other anti-inflammatory agents (e.g., allopurinol and febuxostat) are currently undergoing evaluation for angina therapy. Therapeutic angiogenesis continues to face some challenges. Future trials should evaluate the optimum patient population that would benefit from this form of therapy. PMID:27791405

The Laboratory Efficiencies Initiative: Partnership for Building a Sustainable National Public Health Laboratory System

PubMed Central

Moulton, Anthony D.; Ned, Renée M.; Nicholson, Janet K.A.; Chu, May C.; Becker, Scott J.; Blank, Eric C.; Breckenridge, Karen J.; Waddell, Victor; Brokopp, Charles

2013-01-01

Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners. PMID:23997300

Prisons and public health: emerging issues in HIV treatment adherence.

PubMed

Frank, L

1999-01-01

Correctional facilities in the United States are faced with challenges in providing appropriate and timely HIV treatment to incarcerated HIV-infected inmates. Prison and jails, due to their structure, operation, and staff, may present many barriers to HIV treatment and adherence to complicated and expensive HIV treatment regimens. Changes and modifications of prison health care delivery are required to accommodate the needs of HIV-infected inmates. Approaches to improving correctional HIV care and treatment include training health care personnel, prevention education for inmates, increasing access to voluntary HIV testing, comprehensive treatment planning, and continuity of care. Policy changes for correctional systems include adopting current HIV care standards and immediate evaluation for and access to HIV treatment upon entry into the institution. These changes can have a significant impact on the quality of care for inmates, ultimately improving their quality of life and reducing the morbidity and mortality of HIV disease for incarcerated populations.

Lorcaserin: drug profile and illustrative model of the regulatory challenges of weight-loss drug development.

PubMed

Bays, Harold E

2011-03-01

Lorcaserin is a selective 5-hydroxytryptamine receptor 2c agonist developed as a weight-loss drug. Phase II and III clinical trials support lorcaserin as not only reducing adiposity (i.e., fat mass), but also as improving the metabolic diseases commonly associated with adiposopathy (i.e., fat dysfunction). At the time of this writing, regulatory processes continue towards evaluating lorcaserin as a potentially marketed weight-loss and weight-maintenance agent. Some of the challenges facing lorcaserin are similar to the difficulties encountered by all investigational weight-loss therapeutic agents, which include evolving paths towards approval. While important for clinicians to understand approval hurdles for all therapeutics, it is especially critical for researchers and developers to grasp the unique regulatory complexities of anti-obesity agents. This article profiles lorcaserin as an illustrative example of general drug development regulatory processes, and specifically details the unique challenge of weight-loss drug development.

[Patients living with HIV/AIDS and co-infection by tuberculosis: difficulties associated with treatment compliance or dropout].

PubMed

de Sousa Filho, Manoel Pereira; Luna, Izaildo Tavares; da Silva, Kelanne Lima; Pinheirod, Patrícia Neyva da Costa

2012-06-01

Research carried out in Fortaleza-CE, between March and April 2011, with the objective of describing the difficulties that influence non-compliance to tuberculosis treatment or treatment dropout in patients infected with Human Immunodeficiency Virus. Qualitative study with data collected through a semi-structured interview, applied to patients with acquired immunodeficiency syndrome and with co-infection of tuberculosis. The Collective Subject's Speech was used for result analysis. Patients reported difficulties related to socioeconomic aspects, lifestyle and drug use. The consumption of alcohol and illicit drugs were factors that led to the discontinuance of the therapeutic process of the disease. We conclude that the barriers related to social economical aspects and to lifestyle are more difficult to be faced for a continuous compliance to treatment, making the role played by health professionals necessary, supported by more effective public and social policies.

The Changing Face of Vascular Interventional Radiology: The Future Role of Pharmacotherapies and Molecular Imaging

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

Tapping, Charles R., E-mail: crtapping@doctors.org.uk; Bratby, Mark J., E-mail: mark.bratby@ouh.nhs.uk

2013-08-01

Interventional radiology has had to evolve constantly because there is the ever-present competition and threat from other specialties within medicine, surgery, and research. The development of new technologies, techniques, and therapies is vital to broaden the horizon of interventional radiology and to ensure its continued success in the future. In part, this change will be due to improved chronic disease prevention altering what we treat and in whom. The most important of these strategies are the therapeutic use of statins, Beta-blockers, angiotensin-converting enzyme inhibitors, and substances that interfere with mast cell degeneration. Molecular imaging and therapeutic strategies will move awaymore » from conventional techniques and nano and microparticle molecular technology, tissue factor imaging, gene therapy, endothelial progenitor cells, and photodynamic therapy will become an important part of interventional radiology of the future. This review looks at these new and exciting technologies.« less

Lysosomal storage disorders: A review of the musculoskeletal features.

PubMed

James, Rebecca A; Singh-Grewal, Davinder; Lee, Senq-J; McGill, Jim; Adib, Navid

2016-03-01

The lysosomal storage disorders are a collection of progressive, multisystem disorders that frequently present in childhood. Their timely diagnosis is paramount as they are becoming increasingly treatable. Musculoskeletal manifestations often occur early in the disease course, hence are useful as diagnostics clues. Non-inflammatory joint stiffness or pain, carpal tunnel syndrome, trigger fingers, unexplained pain crises and short stature should all prompt consideration of a lysosomal storage disorder. Recurrent ENT infections, hepatosplenomegaly, recurrent hernias and visual/hearing impairment - especially when clustered together - are important extra-skeletal features. As diagnostic and therapeutic options continue to evolve, children with lysosomal storage disorders and their families are facing more sophisticated options for screening and treatment. The aim of this article is to highlight the paediatric presentations of lysosomal storage disorders, with an emphasis on the musculoskeletal features. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).