A Case Study of Private Middle School Principals' and Parents' Perceptions of Student Bullying

ERIC Educational Resources Information Center

Taylor, David

2013-01-01

Student bullying is an ongoing educational, social, and public health phenomenon facing countless students, parents, and educators. Educators and parents are challenged with distinguishing student bullying from normal student conflict. The purpose of this qualitative multiple case study was to compare private middle school principals' and middle…

Case Study of the Triad Approach: Expedited Characterization of Petroleum Constituents and PCBs Using Test Kits and a Mobile Chromatography Laboratory at the Former Cos Cob Power Plant Site

EPA Pesticide Factsheets

The case study was developed as part of EPA's ongoing initiative to promote the use of an integrated Triad approach to limit decision uncertainty at hazardous waste sites through the use of sound science.

RELIANCE ON GEOCODED MATERNAL RESIDENCE: IMPACT ON A POPULATION-BASED CASE-CONTROL STUDY OF AIR QUALITY AND BIRTH DEFECTS

EPA Science Inventory

Introduction: Unbiased geocoding of maternal residence is critical to the success of an ongoing population-based case-control study of exposure to five criteria air pollutants and the risk of selected birth defects in seven Texas counties between 1997 and 2000. The geocoded res...

Prospective memory in context: Moving through a familiar space.

PubMed

Smith, Rebekah E; Hunt, R Reed; Murray, Amy E

2017-02-01

Successful completion of delayed intentions is a common but important aspect of daily behavior. Such behavior requires not only memory for the intended action but also recognition of the opportunity to perform that action, known collectively as prospective memory. The fact that prospective memory tasks occur in the midst of other activities is captured in laboratory tasks by embedding the prospective memory task in an ongoing activity. In many cases the requirement to perform the prospective memory task results in a reduction in ongoing performance relative to when the ongoing task is performed alone. This is referred to as the cost to the ongoing task and reflects the allocation of attentional resources to the prospective memory task. The current study examined the pattern of cost across the ongoing task when the ongoing task provided contextual information that in turn allowed participants to anticipate when target events would occur within the ongoing task. The availability of contextual information reduced ongoing task response times overall, with an increase in response times closer to the target locations (Experiments 1-3). The fourth study, drawing on the Event Segmentation Theory, provided support for the proposal made by the Preparatory Attentional and Memory Processes theory of prospective memory that decisions about the allocation of attention to the prospective memory task are more likely to be made at points of transition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Case Study on the Professional Development of Elementary Teachers Related to Brain Research and the Strategies Used to Help Struggling Readers

ERIC Educational Resources Information Center

Denton, Valerie R.

2010-01-01

This case study examined the impact of classroom interventions for struggling readers as changed/improved by teachers who participated in ongoing professional development on brain research studies. It investigated how teachers' knowledge of brain research impacted their instruction and the interventions they implemented in elementary classrooms.…

Developing and Using a Logic Model for Evaluation and Assessment of University Student Affairs Programming: A Case Study

ERIC Educational Resources Information Center

Cooper, Jeff

2009-01-01

This dissertation addresses theory and practice of evaluation and assessment in university student affairs, by applying logic modeling/program theory to a case study. I intend to add knowledge to ongoing dialogue among evaluation scholars and practitioners on student affairs program planning and improvement as integral considerations that serve…

Ongoing outbreak with well over 4,000 measles cases in Italy from January to end August 2017 − what is making elimination so difficult?

PubMed Central

Filia, Antonietta; Bella, Antonino; Del Manso, Martina; Baggieri, Melissa; Magurano, Fabio; Rota, Maria Cristina

2017-01-01

We report an ongoing measles outbreak in Italy, with over 4,400 cases reported in 20 Regions from January to August 2017. Median age was 27 years, 88% of the cases were unvaccinated. The highest incidence was in infants below one year of age and 7% of cases occurred among healthcare workers. Three deaths occurred and two cases of encephalitis were reported. Wide immunity gaps and nosocomial transmission are major challenges to measles elimination in Italy. PMID:28933342

An Online Training Course to Learn How to Teach Online

ERIC Educational Resources Information Center

Bachy, Sylviane; Lebrun, Marcel

2015-01-01

This case study deals with the implementation of ongoing training, offered wholly through distance and online learning, and conducted within the framework of an inter-university partnership linking two European countries. The case story relates the experience of several instructional designers (called "Academic Advisors" in this part of…

24 CFR 35.935 - Ongoing lead-based paint maintenance activities.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., Department of Housing and Urban Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Rehabilitation § 35.935 Ongoing lead-based paint maintenance activities. In the case of a rental... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Ongoing lead-based paint...

24 CFR 35.935 - Ongoing lead-based paint maintenance activities.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., Department of Housing and Urban Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Rehabilitation § 35.935 Ongoing lead-based paint maintenance activities. In the case of a rental... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Ongoing lead-based paint...

24 CFR 35.935 - Ongoing lead-based paint maintenance activities.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., Department of Housing and Urban Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Rehabilitation § 35.935 Ongoing lead-based paint maintenance activities. In the case of a rental... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Ongoing lead-based paint...

24 CFR 35.935 - Ongoing lead-based paint maintenance activities.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Department of Housing and Urban Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Rehabilitation § 35.935 Ongoing lead-based paint maintenance activities. In the case of a rental... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Ongoing lead-based paint...

24 CFR 35.935 - Ongoing lead-based paint maintenance activities.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., Department of Housing and Urban Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES Rehabilitation § 35.935 Ongoing lead-based paint maintenance activities. In the case of a rental... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Ongoing lead-based paint...

The Link between the Process of Change and Coaching in an Organization--A Case Study

ERIC Educational Resources Information Center

Jim, Josephine

2016-01-01

The aim of this case study was to highlight coaching in the process of change using a real life information technology and operational change project in an institution. It demonstrates the critical importance of coaching in change management, for successful change to occur. Any sustaining change requires ongoing coaching as an integral part of the…

Examining Child Welfare Decisions and Services for Asian-Canadian Versus White-Canadian Children and Families in the Child Welfare System.

PubMed

Lee, Barbara; Fuller-Thomson, Esme; Fallon, Barbara; Black, Tara; Trocmé, Nico

2017-05-01

Using administrative child welfare data from the Ontario Child Abuse and Neglect Data System (OCANDS), this study compared the profiles of Asian-Canadian and White-Canadian children and families that experienced a case closure after an investigation instead of being transferred to ongoing child protection services (CPS). Child protection investigations involving Asian-Canadian and White-Canadian children and families that were transferred to ongoing CPS presented a different profile of case characteristics and caregiver and child clinical needs. Asian-Canadian children and families received ongoing CPS for over a month longer than White-Canadian children and families and were less likely (odds ratio [ OR] = 0.39) to be reinvestigated for any form of maltreatment-related concerns within 1 year after case closure. It appears that child protection investigations involving Asian-Canadian children and families are less likely to be closed prematurely than White-Canadian children and families, and the child protection system may be meeting the needs of Asian-Canadian communities. Alternatively, it is possible there is unaccounted biases that may be reflective of systemic problem of discriminative practices in the child protection system. Further research is needed to explore this phenomenon.

Preliminary findings indicate nosocomial transmission and Roma population as most affected group in ongoing measles B3 genotype outbreak in Bulgaria, March to August 2017.

PubMed

Kurchatova, Anna; Krumova, Stefka; Vladimirova, Nadezhda; Nikolaeva-Glomb, Lubomira; Stoyanova, Asya; Kantardjiev, Todor; Gatcheva, Nina

2017-09-07

From March to August 2017, 165 measles cases were reported from three regions in Bulgaria. The age range was 0-55 years and 66% of the cases were under 9 years. The Roma population was disproportionally affected (89% of cases), 41% cases were unvaccinated and in 24 cases there was nosocomial transmission mostly in paediatric departments. A child under 12 months of age died. Control measures have been taken and the investigation is still ongoing. This article is copyright of The Authors, 2017.

Ongoing outbreak with well over 4,000 measles cases in Italy from January to end August 2017 - what is making elimination so difficult?

PubMed

Filia, Antonietta; Bella, Antonino; Del Manso, Martina; Baggieri, Melissa; Magurano, Fabio; Rota, Maria Cristina

2017-09-14

We report an ongoing measles outbreak in Italy, with over 4,400 cases reported in 20 Regions from January to August 2017. Median age was 27 years, 88% of the cases were unvaccinated. The highest incidence was in infants below one year of age and 7% of cases occurred among healthcare workers. Three deaths occurred and two cases of encephalitis were reported. Wide immunity gaps and nosocomial transmission are major challenges to measles elimination in Italy. This article is copyright of The Authors, 2017.

Mike's Educational Program: Long Island, New York. Case Study. Social Relationships of Children and Adolescents with Deaf-Blindness Research Project.

ERIC Educational Resources Information Center

Mar, Harvey H.; Sall, Nancy

This case study describes the educational history and current program of Mike, a mainstreamed sixth-grader with deaf-blindness. It addresses the boy's successes and the ongoing challenges faced by his family, his educational team, and his peers. Background information notes his diagnosis of total blindness and moderate to severe hearing loss, his…

Ongoing outbreak of invasive listeriosis, Germany, 2012 to 2015.

PubMed

Ruppitsch, Werner; Prager, Rita; Halbedel, Sven; Hyden, Patrick; Pietzka, Ariane; Huhulescu, Steliana; Lohr, Dorothee; Schönberger, Katharina; Aichinger, Elisabeth; Hauri, Anja; Stark, Klaus; Vygen, Sabine; Tietze, Erhard; Allerberger, Franz; Wilking, Hendrik

2015-01-01

Listeriosis patient isolates in Germany have shown a new identical pulsed-field gel electrophoresis (PFGE) pattern since 2012 (n = 66). Almost all isolates (Listeria monocytogenes serotype 1/2a) belonged to cases living in southern Germany, indicating an outbreak with a so far unknown source. Case numbers in 2015 are high (n = 28). No outbreak cases outside Germany have been reported. Next generation sequencing revealed the unique cluster type CT1248 and confirmed the outbreak. Investigations into the source are ongoing.

Mainstream Classroom Teachers and ESL Students.

ERIC Educational Resources Information Center

Clair, Nancy

1995-01-01

This case study argues that teachers are ill-prepared to give English-as-a-Second-Language students the instruction they need for integration into mainstream classrooms, and advocates ongoing teacher study groups as a replacement for traditional one-shot workshops. (Contains 21 references.) (LR)

Call for NASA Mission Supporting Observations

NASA Astrophysics Data System (ADS)

Binzel, Richard P.

2018-04-01

Lightcurve observations are requested to support NASA missions planned for launch to study main-belt and Trojan asteroids. In some cases, the rotations of the target asteroids are unknown. In other cases, the periods are well established and ongoing measurements will deliver the precision needed to deduce the rotation phase at the time of encounter more than a decade away.

A View from the Elementary Schools: The State of Reform in Chicago. A Report of the Steering Committee, Consortium on Chicago School Research.

ERIC Educational Resources Information Center

Bryk, Anthony S.; And Others

Through a synthesis of ongoing case studies covering over 500 schools, this report highlights the story of school reform in the Chicago Public Schools (Illinois) at the elementary school level. The analysis draws on a case-study syntheses of field research over the past 3 years, new analyses of survey data from principals and teachers, and…

Ongoing data reduction, theoretical studies, and supporting research in magnetospheric physics

NASA Technical Reports Server (NTRS)

Scarf, F. L.; Greenstadt, E. W.

1982-01-01

The investigators published a very large number of space science research papers, and in almost all cases these papers involved correlative multi-spacecraft studies. A tabulation of these research papers is provided. Quarterly progress reports for the second contractual period are included.

Undergraduate Research and Economic Development: A Systems Approach in Wisconsin

ERIC Educational Resources Information Center

Van Galen, Dean; Schneider-Rebozo, Lissa; Havholm, Karen; Andrews, Kris

2015-01-01

This chapter presents the state of Wisconsin and the University of Wisconsin System as an ongoing case study for best practices in systematic, intentional, statewide programming and initiatives connecting undergraduate research and economic development.

Past and Future Work on Radiobiology Mega-Studies: A Case Study At Argonne National Laboratory

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

Haley, Benjamin; Wang, Qiong; Wanzer, Beau

2011-09-06

Between 1952 and 1992, more than 200 large radiobiology studies were conducted in research institutes throughout Europe, North America, and Japan to determine the effects of external irradiation and internal emitters on the lifespan and tissue toxicity development in animals. At Argonne National Laboratory, 22 external beam studies were conducted on nearly 700 beagle dogs and 50,000 mice between 1969 and 1992. These studies helped to characterize the effects of neutron and gamma irradiation on lifespan, tumorigenesis, and mutagenesis across a range of doses and dosing patterns. The records and tissues collected at Argonne during that time period have beenmore » carefully preserved and redisseminated. Using these archived data, ongoing statistical work has been done and continues to characterize quality of radiation, dose, dose rate, tissue, and gender-specific differences in the radiation responses of exposed animals. The ongoing application of newly-developed molecular biology techniques to the archived tissues has revealed gene-specific mutation rates following exposure to ionizing irradiation. The original and ongoing work with this tissue archive is presented here as a case study of a more general trend in the radiobiology megastudies. These experiments helped form the modern understanding of radiation responses in animals and continue to inform development of new radiation models. Recent archival efforts have facilitated open access to the data and materials produced by these studies, and so a unique opportunity exists to expand this continued research.« less

Methodology or method? A critical review of qualitative case study reports.

PubMed

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2014-01-01

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

Beacon Charter School Needs a School: A Case of Capital Outlay of Charters in a Public District

ERIC Educational Resources Information Center

Wronowski, Meredith L.

2017-01-01

The case study presented below is a representation of a real-world, ongoing situation involving a public school district's capital outlay for charter schools within its boundaries. One particular charter, Beacon Charter School, was promised a permanent building by the public school district that also acts as its authorizer. However, recent events…

An Approach to Using Toxicogenomic Data in US EPA Human ...

EPA Pesticide Factsheets

This draft report is a description of an approach to evaluate genomic data for use in risk assessment and a case study to illustrate the approach. The dibutyl phthalate (DBP) case study example focuses on male reproductive developmental effects and the qualitative application of the available genomic data. The case study presented in this draft document is a separate activity from any of the ongoing IRIS human health assessments for the phthalates. This draft report is a description of an approach to evaluate genomic data for use in risk assessment and a case study to illustrate the approach. The dibutyl phthalate (DBP) case study example focuses on male reproductive developmental effects and the qualitative application of the available genomic data.

Student Self Governance: A Case Study

ERIC Educational Resources Information Center

Deegan, William L.

1974-01-01

Reports on a study which reviewed student successes and failures in an on-going student controlled program, where accountability, persistence and continuing commitment were required. Several conclusions are presented and weaknesses noted in these programs, many of which can be seen in faculty and administrative programs, too. (Author/PC)

Prospective Randomized Trial Comparing Embryo Transfers of Cases with and without Catheter Rotation during Its Withdrawal.

PubMed

Yayla Abide, Cigdem; Ozkaya, Enis; Sanverdi, Ilhan; Bostancı Ergen, Evrim; Kurek Eken, Meryem; Devranoglu, Belgin; Bilgiç, Bulent Emre; Kilicci, Cetin; Kayatas Eser, Semra

2018-05-14

To compare embryo transfer (ET) technique based on catheter rotation during its withdrawal in cases with unexplained infertility in a prospective, randomized trial (NCT03097042). Two hundred intracytoplasmic sperm injection (ICSI) patients undergoing ET with cleaving or blastocyst-stage fresh embryos were randomized into 2 groups: cases with (n = 100), and without (n = 100) catheter rotation during its withdrawal. Groups were matched for age and some clinical parameters. A soft catheter was used to transfer a single embryo with catheter rotation during its withdrawal in the study group and without rotation in the control. The use of a stiff catheter or tenaculum was not needed in any case. Groups were compared in terms of cycle characteristics and clinical pregnancy rates. Pregnancy rate was significantly higher in the study group (41 vs. 26%, p = 0.04). Clinical pregnancy rate was also significantly higher in the study group (39 vs. 25%, OR 1.9 [1.1-3.5], p = 0.05). On the other hand, the ongoing pregnancy rate was similar between the 2 groups (33 vs. 23%, p = 0.2). Catheter rotation during its withdrawal may be associated with increased pregnancy and clinical pregnancy rates; however, the difference in ongoing pregnancy rates did not reach statistical significance. © 2018 S. Karger AG, Basel.

Bleeding and infection with external ventricular drainage: a systematic review in comparison with adjudicated adverse events in the ongoing Clot Lysis Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR-III IHV) trial.

PubMed

Dey, Mahua; Stadnik, Agnieszka; Riad, Fady; Zhang, Lingjiao; McBee, Nichol; Kase, Carlos; Carhuapoma, J Ricardo; Ram, Malathi; Lane, Karen; Ostapkovich, Noeleen; Aldrich, Francois; Aldrich, Charlene; Jallo, Jack; Butcher, Ken; Snider, Ryan; Hanley, Daniel; Ziai, Wendy; Awad, Issam A

2015-03-01

Retrospective series report varied rates of bleeding and infection with external ventricular drainage (EVD). There have been no prospective studies of these risks with systematic surveillance, threshold definitions, or independent adjudication. To analyze the rate of complications in the ongoing Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR III) trial, providing a comparison with a systematic review of complications of EVD in the literature. Patients were prospectively enrolled in the CLEAR III trial after placement of an EVD for obstructive intraventricular hemorrhage and randomized to receive recombinant tissue-type plasminogen activator or placebo. We counted any detected new hemorrhage (catheter tract hemorrhage or any other distant hemorrhage) on computed tomography scan within 30 days from the randomization. Meta-analysis of published series of EVD placement was compiled with STATA software. Growing or unstable hemorrhage was reported as a cause of exclusion from the trial in 74 of 5707 cases (1.3%) screened for CLEAR III. The first 250 patients enrolled have completed adjudication of adverse events. Forty-two subjects (16.8%) experienced ≥1 new bleeds or expansions, and 6 of 250 subjects (2.4%) suffered symptomatic hemorrhages. Eleven cases (4.4%) had culture-proven bacterial meningitis or ventriculitis. Risks of bleeding and infection in the ongoing CLEAR III trial are comparable to those previously reported in EVD case series. In the present study, rates of new bleeds and bacterial meningitis/ventriculitis are very low despite multiple daily injections, blood in the ventricles, the use of thrombolysis in half the cases, and generalization to >60 trial sites.

Autism Spectrum Disorders in Hispanics and Non-Hispanics

ERIC Educational Resources Information Center

Chaidez, Virginia; Hansen, Robin L.; Hertz-Picciotto, Irva

2012-01-01

Objectives: To compare differences in autism between Hispanic and non-Hispanics. We also examined the relationship between multiple language exposure and language function and scores of children. Methods: The Childhood Autism Risks from Genetics and the Environment (CHARGE) study is an ongoing population-based case-control study with children…

Factors in Sustaining Professional Learning Community

ERIC Educational Resources Information Center

Kilbane, James F., Jr.

2009-01-01

School change efforts to develop schools as learning communities result in schools that are constantly learning and thus changing. This collective case study of four schools involved in a 4-year reform effort begins to examine the ongoing sustainability of a learning community. The study draws insights about the sustainability of learning…

Building a Recycling Program: A Case Study in Success.

ERIC Educational Resources Information Center

Sabol, Laurie

1992-01-01

Presents the development and ongoing operation of a library recycling program established at Bowling Green State University in Ohio. Discusses the initiation and projects of the library recycling committee, logistics, and future projections for library recycling operations. (two references) (MCO)

Implementation of a mechanical CPR device in a physician staffed HEMS - a prospective observational study.

PubMed

Rauch, Simon; Strapazzon, Giacomo; Brodmann, Monika; Fop, Ernst; Masoner, Christian; Rauch, Lydia; Forti, Alessandro; Pietsch, Urs; Mair, Peter; Brugger, Hermann

2018-04-28

In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device (LUCAS 2; Physio Control, Redmond, WA, USA) in a physician staffed helicopter emergency medical service (HEMS) in South Tyrol, Italy. During the study period (06/2013-04/2016), 525 OHCA cases were registered by the dispatch centre, 271 (51.6%) were assisted by HEMS. LUCAS 2 was applied in 18 (6.6%) of all HEMS-assisted OHCA patients; ten were treated with LUCAS 2 at the scene only, and eight were transported to hospital with ongoing CPR. Two (11.1%) of the 18 patients survived long term with full neurologic recovery. In seven of eight patients transferred to hospital with ongoing CPR, CPR was ceased in the emergency room without further intervention. Retrospectively, all HEMS-assisted OHCA cases were screened for proposed indication criteria for prolonged CPR. Thirteen patients fulfilled these criteria, but only two of them were transported to hospital. Based on these results, we propose a standard operating procedure for HEMS-assisted patients with refractory OHCA in a region without hospitals with ECLS capacity.

EndoVascular and Hybrid Trauma Management (EVTM) for Blunt Innominate Artery Injury with Ongoing Extravasation

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

Bilos, Linda, E-mail: linda.bilos@regionorebrolan.se; Pirouzram, Artai; Toivola, Asko

Innominate artery (IA) traumatic injuries are rare but life-threatening, with high mortality and morbidity. Open surgical repair is the treatment of choice but is technically demanding. We describe a case of blunt trauma to the IA with ongoing bleeding, treated successfully by combined (hybrid) endovascular and open surgery. The case demonstrates the immediate usage of modern endovascular and surgical tools as part of endovascular and hybrid trauma management.

Is it relevant? Influence of trial manipulations of prospective memory context on task interference.

PubMed

Lourenço, Joana S; Maylor, Elizabeth A

2014-01-01

Prospective memory (PM) research has often investigated if having an intention interferes with ongoing activities, but rarely by linking the intention to a particular context. We examined effects of trial-by-trial changes in whether the context (defined by colour) was relevant for the nonfocal PM task. The ongoing task involved speeded decisions about the position (left/right) of the upper-case letter in a pair, and the PM task consisted of pressing an additional key if the upper-case and lower-case letters were in a specified colour and the same letter. Trials switched between two colours either randomly or predictably in eight-trial blocks. We also manipulated the presence/absence of occasional same-letter pairs in the irrelevant context. Results showed higher cost of having a nonfocal PM task when ongoing stimuli matched than when they mismatched the target's colour. Moreover, cost for intention-irrelevant stimuli was minimized, though never eliminated, by blocking match/mismatch trials. These findings highlight the role that local changes in intention-related context play in task interference and support a view of monitoring as a flexible mechanism. Additionally, the study introduced a novel way of embedding intention-related events in the irrelevant context shortly before the occurrence of PM targets, with results tentatively suggesting that such events might impair target detection.

Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia

PubMed Central

Allotey, Pascale; Reidpath, Daniel D.; Devarajan, Nirmala; Rajagobal, Kanason; Yasin, Shajahan; Arunachalam, Dharmalingam; Imelda, Johanna Debora; Soyiri, Ireneous; Davey, Tamzyn; Jahan, Nowrozy

2014-01-01

Background Community engagement is an increasingly important requirement of public health research and plays an important role in the informed consent and recruitment process. However, there is very little guidance about how it should be done, the indicators for assessing effectiveness of the community engagement process and the impact it has on recruitment, retention, and ultimately on the quality of the data collected as part of longitudinal cohort studies. Methods An instrumental case study approach, with data from field notes, policy documents, unstructured interviews, and focus group discussions with key community stakeholders and informants, was used to explore systematically the implementation and outcomes of the community engagement strategy for recruitment of an entire community into a demographic and health surveillance site in Malaysia. Results For a dynamic cohort, community engagement needs to be an ongoing process. The community engagement process has likely helped to facilitate the current response rate of 85% in the research communities. The case study highlights the importance of systematic documentation of the community engagement process to ensure an understanding of the effects of the research on recruitment and the community. Conclusions A critical lesson from the case study data is the importance of relationships in the recruitment process for large population-based studies, and the need for ongoing documentation and analysis of the impact of cumulative interactions between research and community engagement. PMID:24804983

Methodology or method? A critical review of qualitative case study reports

PubMed Central

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2014-01-01

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners. PMID:24809980

Academic Studies amid Violent Conflict: A Study of the Impact of Ongoing Conflict on a Student Population

ERIC Educational Resources Information Center

Ben-Tsur, Dalia

2009-01-01

This paper explores the impact of violent conflict on undergraduate students. In order to strengthen student resilience during periods of heightened insecurity, teachers and institutions must identify the difficulties that their students may be experiencing. Based on a case study of students in Israel, this paper identifies specific difficulties…

A 20-Year Examination of the Perceptions of Business School Interns: A Longitudinal Case Study

ERIC Educational Resources Information Center

Cook, Sherry James; Stokes, Amy; Parker, Richard Stephen

2015-01-01

The authors examined students' attitudes toward specific elements of an ongoing internship program. The study sample consisted of 816 student interns from 25 different colleges and universities. Results indicate that despite significant changes in instructional design and the incorporation of new technologies into the learning environment,…

The Perception of Bullying among School Administrators: A Case Study

ERIC Educational Resources Information Center

Nieves, Yvette

2017-01-01

This research study examined the perspective of school administrators on the issue of bullying. Bullying behavior is an on-going issue in education that continues to plague educational communities. School administrators are responsible for fostering positive school climates conducive to teaching and learning. There was a gap in the literature…

Virtual Environments and the Ongoing Work of Becoming a Singapore Teacher

ERIC Educational Resources Information Center

Zuiker, Steven J.; Ang, Doreen

2011-01-01

The study explores the intersection between cyberinfrastructure and models of teacher education and professional development in Singapore. A case study explores how a pre-service and an in-service workshop in a virtual environment support efforts to understand and enlist constructivist pedagogies for classroom learning and to foster continuous…

Study Abroad as Professional Development: Voices of In-Service Spanish Teachers

ERIC Educational Resources Information Center

Jochum, Christopher J.; Rawlings, Jared R.; Tejada, Ana María

2015-01-01

The purpose of this qualitative inquiry was to understand how four in-service Spanish teachers interpreted their participation in a summer study abroad program and how the experience contributed to their ongoing professional development and language proficiency. Using a multiple case design (Simons, 2009; Stake, 2005; Yin, 2009), the researchers…

The "Synergies" Research-Practice Partnership Project: A "2020 Vision" Case Study

ERIC Educational Resources Information Center

Falk, John H.; Dierking, Lynn D.; Staus, Nancy L.; Wyld, Jennifer N.; Bailey, Deborah L.; Penuel, William R.

2016-01-01

This paper, describes "Synergies," an on-going longitudinal study and design effort, being conducted in a diverse, under-resourced community in Portland, Oregon, with the goal of measurably improving STEM learning, interest and participation by early adolescents, both in school and out of school. Authors examine how the work of this…

Are all after-hours diagnostic imaging appropriate? An Australian Emergency Department pilot study.

PubMed

Gardiner, Fergus William; Zhai, Shaun

2016-12-01

This study was aimed at determining the extent to which after-hours diagnostic imaging is appropriate within the case hospital's Emergency Department. This was amid growing concerns of the inappropriateness of some medical investigations within the Australian health-care system. After-hours referral data and patient notes were used in reviewing the clinical case. Diagnostic imaging was deemed appropriate if reflective of clinical guidelines, and if not reflective, whether the investigation changed the patient's ongoing management. Results indicated that 96.37% of after-hours diagnostic imaging adhered to clinical guidelines and was appropriately requested, with 95.85% changing the ongoing management of the patient. The most sought after diagnostic imaging procedures were Chest X-Ray (30.83%), and CT Brain (16.58%), with 99.16% and 98.44 appropriateness respectively. Chest pain (14.49%) and motor vehicle accidents (8.12%) were the leading reason for ordering after-hours imaging. This study provided an Emergency Department example as it relates to after-hours diagnostic imaging appropriateness. This study found that most after-hours referrals were appropriate.

Ongoing large measles outbreak with nosocomial transmission in Milan, northern Italy, March-August 2017.

PubMed

Amendola, Antonella; Bianchi, Silvia; Frati, Elena R; Ciceri, Giulia; Faccini, Marino; Senatore, Sabrina; Colzani, Daniela; Lamberti, Anna; Baggieri, Melissa; Cereda, Danilo; Gramegna, Maria; Nicoletti, Loredana; Magurano, Fabio; Tanzi, Elisabetta

2017-08-17

A large measles outbreak has been ongoing in Milan and surrounding areas. From 1 March to 30 June 2017, 203 measles cases were laboratory-confirmed (108 sporadic cases and 95 related to 47 clusters). Phylogenetic analysis revealed the co-circulation of two different genotypes, D8 and B3. Both genotypes caused nosocomial clusters in two hospitals. The rapid analysis of epidemiological and phylogenetic data allowed effective surveillance and tracking of transmission pathways. This article is copyright of The Authors, 2017.

Ongoing large measles outbreak with nosocomial transmission in Milan, northern Italy, March–August 2017

PubMed Central

Amendola, Antonella; Bianchi, Silvia; Frati, Elena R; Ciceri, Giulia; Faccini, Marino; Senatore, Sabrina; Colzani, Daniela; Lamberti, Anna; Baggieri, Melissa; Cereda, Danilo; Gramegna, Maria; Nicoletti, Loredana; Magurano, Fabio; Tanzi, Elisabetta

2017-01-01

A large measles outbreak has been ongoing in Milan and surrounding areas. From 1 March to 30 June 2017, 203 measles cases were laboratory-confirmed (108 sporadic cases and 95 related to 47 clusters). Phylogenetic analysis revealed the co-circulation of two different genotypes, D8 and B3. Both genotypes caused nosocomial clusters in two hospitals. The rapid analysis of epidemiological and phylogenetic data allowed effective surveillance and tracking of transmission pathways. PMID:28840825

A case study from a nursing and occupational therapy perspective - Providing care for a patient with a traumatic brachial plexus injury.

PubMed

Wellington, Beverley; McGeehan, Claire

2015-02-01

This paper presents a case study that demonstrates how collaborative working between professionals enhanced the holistic care for a patient following a traumatic brachial plexus injury. The paper will describe the patient's journey of care from initial presentation, diagnosis and assessment, acute care provision, discharge & rehabilitation to ongoing supportive counselling. The care encompasses input from both a nursing and occupational therapy perspective. Copyright © 2014 Elsevier Ltd. All rights reserved.

An Approach to Using Toxicogenomic Data in US EPA Human ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate Case Study. This report outlines an approach to evaluate genomic data for use in risk assessment and a case study to illustrate the approach. The dibutyl phthalate (DBP) case study example focuses on male reproductive developmental effects and the qualitative application of genomic data because of the available data on DBP. The case study presented in this report is a separate activity from any of the ongoing IRIS human health assessments for the phthalates. The National Center for Environmental Assessment (NCEA) prepared this document for the purpose of describing and illustrating an approach for using toxicogenomic data in risk assessment.

Case Studies of Two High-Poverty High-Performing Schools

ERIC Educational Resources Information Center

Gehrke, Lori R.

2010-01-01

The existing literature on learning organizations emphasize that leadership and strong organizational culture are central to their successful development. Whereas schools continue to face government control, accountability, and financial restraints, they are also working diligently to engage in ongoing school improvement practices to provide…

32 CFR 326.17 - Exemptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... piece of information in the early stages of an investigation. In some cases, it is only after the... investigation on that individual is taking place, and might weaken the on-going investigation, reveal... might in itself provide an answer to that individual relating to an on-going investigation. The conduct...

Identification of dengue type 2 virus in febrile travellers returning from Burkina Faso to France, related to an ongoing outbreak, October to November 2016.

PubMed

Eldin, Carole; Gautret, Philippe; Nougairede, Antoine; Sentis, Mélanie; Ninove, Laetitia; Saidani, Nadia; Million, Matthieu; Brouqui, Philippe; Charrel, Remi; Parola, Philippe

2016-12-15

Dengue fever is rarely reported in travellers returning from Africa. We report two cases of dengue fever in travellers returning from Burkina Faso to France. One of them presented a severe dengue fever with ALT > 1,000 IU/L and pericarditis. Serotype 2 was identified. The cases reflect a large ongoing outbreak with over 1,000 reported cases between August and November in the capital city. Clinicians should consider dengue fever in malaria-negative febrile travellers returning from Africa. This article is copyright of The Authors, 2016.

Preimplantation genetic diagnosis and screening by array comparative genomic hybridisation: experience of more than 100 cases in a single centre.

PubMed

Chow, J Fc; Yeung, W Sb; Lee, V Cy; Lau, E Yl; Ho, P C; Ng, E Hy

2017-04-01

Preimplantation genetic screening has been proposed to improve the in-vitro fertilisation outcome by screening for aneuploid embryos or blastocysts. This study aimed to report the outcome of 133 cycles of preimplantation genetic diagnosis and screening by array comparative genomic hybridisation. This study of case series was conducted in a tertiary assisted reproductive centre in Hong Kong. Patients who underwent preimplantation genetic diagnosis for chromosomal abnormalities or preimplantation genetic screening between 1 April 2012 and 30 June 2015 were included. They underwent in-vitro fertilisation and intracytoplasmic sperm injection. An embryo biopsy was performed on day-3 embryos and the blastomere was subject to array comparative genomic hybridisation. Embryos with normal copy numbers were replaced. The ongoing pregnancy rate, implantation rate, and miscarriage rate were studied. During the study period, 133 cycles of preimplantation genetic diagnosis for chromosomal abnormalities or preimplantation genetic screening were initiated in 94 patients. Overall, 112 cycles proceeded to embryo biopsy and 65 cycles had embryo transfer. The ongoing pregnancy rate per transfer cycle after preimplantation genetic screening was 50.0% and that after preimplantation genetic diagnosis was 34.9%. The implantation rates after preimplantation genetic screening and diagnosis were 45.7% and 41.1%, respectively and the miscarriage rates were 8.3% and 28.6%, respectively. There were 26 frozen-thawed embryo transfer cycles, in which vitrified and biopsied genetically transferrable embryos were replaced, resulting in an ongoing pregnancy rate of 36.4% in the screening group and 60.0% in the diagnosis group. The clinical outcomes of preimplantation genetic diagnosis and screening using comparative genomic hybridisation in our unit were comparable to those reported internationally. Genetically transferrable embryos replaced in a natural cycle may improve the ongoing pregnancy rate and implantation rate when compared with transfer in a stimulated cycle.

An ongoing multifamily group in a women's shelter.

PubMed

Rhodes, Rosetta M; Zelman, Arthur B

1986-01-01

A mental health clinic's consultation to a spouse abuse center led to formation of an ongoing multifamily group that included all residents of the shelter and their children of all ages. The theoretical framework is outlined and group dynamics are highlighted by case material focused on illustrating specific intervention techniques.

Access to Sign Language Interpreters in the Criminal Justice System.

ERIC Educational Resources Information Center

Miller, Katrina R.

2001-01-01

This study surveyed 46 professional sign language interpreters working in criminal justice settings and evaluated 22 cases to evaluate access issues for individuals with hearing impairments. Recommendations to increase the accessibility of interpreting services included providing ongoing awareness training to criminal justice personnel and…

Classroom Observation Practice in Career Schools: A Multiple Case Study

ERIC Educational Resources Information Center

Withers, Marya G.

2017-01-01

Post-secondary career school educational leaders are charged with formulating sufficient, ongoing, and effective faculty development programming to ensure the delivery of quality education in their unique trade-expert led institutions. Classroom observations, which include substantive feedback exchanges from trained personnel are well documented…

Mentoring and Supervision for Teacher Development.

ERIC Educational Resources Information Center

Reiman, Alan J.; Thies-Sprinthall, Lois

The fields of instructional supervision, adult development, teacher education and mentoring, and ongoing professional development are synthesized in this text. Examples and case studies are drawn from local systems in North Carolina as well as state, national, and international public school/university consortia to identify emerging trends in…

Organisational Learning and HRD: How Appropriate Are They for Small Firms?

ERIC Educational Resources Information Center

Saru, Essi

2007-01-01

Purpose: The purpose of this paper is to study human resource development (HRD) and organisational learning issues in a small expert organisation. Design/methodology/approach: This is a qualitative single case study conducted in one Finnish SME. It is part of an ongoing study. It is descriptive in nature and the aim is to find out whether the…

Governance of water resources in the phase of change: a case study of the implementation of the EU Water Framework Directive in Sweden.

PubMed

Hammer, Monica; Balfors, Berit; Mörtberg, Ulla; Petersson, Mona; Quin, Andrew

2011-03-01

In this article, focusing on the ongoing implementation of the EU Water Framework Directive, we analyze some of the opportunities and challenges for a sustainable governance of water resources from an ecosystem management perspective. In the face of uncertainty and change, the ecosystem approach as a holistic and integrated management framework is increasingly recognized. The ongoing implementation of the Water Framework Directive (WFD) could be viewed as a reorganization phase in the process of change in institutional arrangements and ecosystems. In this case study from the Northern Baltic Sea River Basin District, Sweden, we focus in particular on data and information management from a multi-level governance perspective from the local stakeholder to the River Basin level. We apply a document analysis, hydrological mapping, and GIS models to analyze some of the institutional framework created for the implementation of the WFD. The study underlines the importance of institutional arrangements that can handle variability of local situations and trade-offs between solutions and priorities on different hierarchical levels.

A Case Study of Schooling Practices at an "Escuela Secundaria" in Mexico

ERIC Educational Resources Information Center

de Souza, Marcela

2013-01-01

This article reports results of a qualitative study conducted at a public "escuela secundaria" (U.S. grades 7, 8, and 9) in Guadalajara, Mexico, during the spring of 2010. As the second phase of an ongoing project, the main goal was to learn from direct classroom observation about the most prevalent teaching and institutional practices…

Knowledge Discovery Process: Case Study of RNAV Adherence of Radar Track Data

NASA Technical Reports Server (NTRS)

Matthews, Bryan

2018-01-01

This talk is an introduction to the knowledge discovery process, beginning with: identifying the problem, choosing data sources, matching the appropriate machine learning tools, and reviewing the results. The overview will be given in the context of an ongoing study that is assessing RNAV adherence of commercial aircraft in the national airspace.

Negotiating Policy in an Age of Globalization: Exploring Educational "Policyscapes" in Denmark, Nepal, and China

ERIC Educational Resources Information Center

Carney, Stephen

2009-01-01

This article aims to explore processes of policy implementation with respect to an ongoing empirical study in three very different sites: (1) Denmark; (2) Nepal; and (3) China. Rather than treat these investigations in the traditional manner of separate and contained national case studies, the author attempts to create a "policyscape"…

Identity and Cross-Border Student Mobility: The Mainland China-Hong Kong Experience

ERIC Educational Resources Information Center

Xu, Cora Lingling

2015-01-01

This article is drawn from research in an ongoing multiple case study of the identity constructions of tertiary-level border-crossing students from mainland China to Hong Kong. It begins by outlining the contextual and conceptual background of the study, followed by the presentation and discussion of the three aspects of identity being…

Effects of Communities of Reflecting Peers on Student-Teacher Development--Including In-Depth Case Studies

ERIC Educational Resources Information Center

Fund, Zvia

2010-01-01

Despite continuing interest in teacher reflection and an extensive body of research on peer assessment, the interaction between these areas has not been sufficiently investigated. This study on reflection and peer feedback is part of an ongoing action research addressing the design and pedagogical model of a theoretically oriented teacher training…

Value of amniocentesis versus fetal tissue for cytogenetic analysis in cases of fetal demise.

PubMed

Bryant Borders, Ann E; Greenberg, Jessica; Plaga, Stacey; Shepard-Hinton, Megan; Yates, Carin; Elias, Sherman; Shulman, Lee P

2009-01-01

Use of fetal tissue for cytogenetic analysis in cases of second- and third-trimester fetal demise frequently results in unacceptably high failure rates. We reviewed our ongoing use of amniocentesis prior to uterine evacuation to determine if this provided a better source of cells for cytogenetic analysis. We compared cytogenetic results using fetal tissues obtained following uterine evacuation to our ongoing use of amniotic fluid cell obtained by transabdominal amniocentesis prior to uterine evacuation from 2003 to 2008. In 49 of the 63 cases evaluated by fetal tissue biopsies performed after uterine evacuation, a karyotypic analysis was obtained (77.8%). Among the 38 cases evaluated by amniocentesis, an amniotic fluid sample and fetal cytogenetic results were obtained in all 38 (100%) cases. Our findings indicate that amniocentesis is a more reliable source of cytogenetic information than fetal tissue in cases of second- and third-trimester fetal demise.

Studying health information from a distance: refining an e-learning case study in the crucible of student evaluation.

PubMed

Booth, Andrew; Levy, Philippa; Bath, Peter A; Lacey, Terence; Sanderson, Mark; Diercks-O'Brien, Gabi

2005-12-01

To present a formative evaluation of the impact of a multimedia case study as a component of a masters course in health informatics delivered by distance learning. First and second year health informatics students undertaking four core modules of a masters programme at the University of Sheffield. Individual qualitative user surveys and interviews. Formative evaluation has played a significant role in refining the case study through its text-based, intermediate and CD-ROM based stages. Feedback from students has resulted in clarification of case study tasks, clearer definition of teaching roles and a revised approach to assessment. At the same time it has highlighted the importance of ongoing revision and maintenance in keeping the scenarios realistic and current. The multimedia case study has met many of its original aims in providing greater cohesion for core modules and encouraging greater levels of interaction and multidisciplinary collaboration.

Progress towards an AIS early detection monitoring network for the Great Lakes

EPA Science Inventory

As an invasion prone location, the lower St. Louis River system (SLR) has been a case study for ongoing research to develop the framework for a practical Great Lakes monitoring network for early detection of aquatic invasive species (AIS). Early detection, however, necessitates f...

Insight and Action Analytics: Three Case Studies to Consider

ERIC Educational Resources Information Center

Milliron, Mark David; Malcolm, Laura; Kil, David

2014-01-01

Civitas Learning was conceived as a community of practice, bringing together forward-thinking leaders from diverse higher education institutions to leverage insight and action analytics in their ongoing efforts to help students learn well and finish strong. We define insight and action analytics as drawing, federating, and analyzing data from…

Homegrown Internationalization: Local Language Diversity as a Resource for Global Educational Initiatives

ERIC Educational Resources Information Center

Crutchfield, Anne

2016-01-01

This case study explored internationalization, diversity, and language through the eyes of students, instructors, and administrators at a multicultural community college in Hawai'i. The purpose was to uncover participants' beliefs and attitudes about ongoing campus-wide internationalization efforts as well as to investigate their broader…

A Tale of English Polytechnic Lecturers' Decision Making

ERIC Educational Resources Information Center

Abdullah, Suhaily; Majid, Faizah Abd

2016-01-01

Teacher decision making involves a selection of options that leads to thinking processes, underlying teaching in language classroom contexts. Due to this, as a small part of an on-going postgraduate research, this exploratory case study shares the initial findings on the lecturers' decision-making effects on their classroom orientation. Four…

Sustaining Professional Learning Communities: Case Studies

ERIC Educational Resources Information Center

Hipp, Kristine; Huffman, Jane; Pankake, Anita; Olivier, Dianne

2008-01-01

The purpose is to document the ongoing development of two schools in becoming professional learning communities and the effects of meaningful collaboration on teacher learning. The question that guides this research is: How does a school become a sustainable professional learning community? The theoretical framework is based on the work of Senge,…

FLAX: Flexible and Open Corpus-Based Language Collections Development

ERIC Educational Resources Information Center

Fitzgerald, Alannah; Wu, Shaoqun; Marín, María José

2015-01-01

In this case study we present innovative work in building open corpus-based language collections by focusing on a description of the opensource multilingual Flexible Language Acquisition (FLAX) language project, which is an ongoing example of open materials development practices for language teaching and learning. We present language-learning…

Applying Indigenizing Principles of Decolonizing Methodologies in University Classrooms

ERIC Educational Resources Information Center

Louie, Dustin William; Pratt, Yvonne Poitras; Hanson, Aubrey Jean; Ottmann, Jacqueline

2017-01-01

This case study examines ongoing work to Indigenize education programs at one Canadian university. The history of the academy in Canada has been dominated by Western epistemologies, which have devalued Indigenous ways of knowing and set the grounds for continued marginalization of Indigenous students, communities, cultures, and histories. We argue…

Learning While Leading: A Multiple Case Study of Principals' Ways of Knowing

ERIC Educational Resources Information Center

Cale, Marsha Caudill

2017-01-01

Excellent school leadership is undeniably linked to improved student achievement. Due to the impact administrators have on school and student success, it is critical that current and aspiring principals receive high-quality training and support. Superior principal preparation programs and ongoing training opportunities are fundamental to…

Ongoing hepatitis A outbreak in Europe 2013 to 2014: imported berry mix cake suspected to be the source of infection in Norway.

PubMed

Guzman-Herrador, B; Jensvoll, L; Einoder-Moreno, M; Lange, H; Myking, S; Nygard, K; Stene-Johansen, K; Vold, L

2014-04-17

On 7 March 2014, an increase in hepatitis A virus (HAV) infections was identified in Norway. As of 12 April, 19 cases of HAV infection with a virus strain identical to an ongoing European outbreak have been identified. Six probable cases are currently under investigation. On 11 April, a frozen berry mix cake imported from another European country was found as the likely source of the outbreak; the importer has withdrawn the product in Norway.

Ongoing contraception after use of emergency contraception from a specialist contraceptive service.

PubMed

Cameron, Sharon T; Glasier, Anna; Johnstone, Anne; Rae, Leanne

2011-10-01

A consultation for emergency contraception (EC) gives way to an opportunity to provide women with an ongoing effective method of contraception. A review of the case notes of women seeking EC from a large family planning clinic in Edinburgh, Scotland, was conducted to determine what percentage of women were provided with an effective method of ongoing contraception. Case notes of 460 women presenting for EC over a 2-year period were reviewed. Women were of mean age 26 years (range 15-49 years) and presented because they had used no contraception (47%), experienced condom failure (42%) or missed oral contraceptive pills (9%). Only 2% (n=11) were given an intrauterine device for EC. All women who had missed contraceptive pills prior to taking EC opted to continue this method. Only 23% (n=89) of women using no method or condoms at EC received supplies of an effective contraceptive method (pills, patch, injectable). Two thirds (n=263) of the women chose condoms for ongoing contraception. Research is required to develop strategies to improve the uptake of effective contraception after EC. Copyright © 2011 Elsevier Inc. All rights reserved.

Arterial blood gases during and their dynamic changes after cardiopulmonary resuscitation: A prospective clinical study.

PubMed

Spindelboeck, Walter; Gemes, Geza; Strasser, Christa; Toescher, Kathrin; Kores, Barbara; Metnitz, Philipp; Haas, Josef; Prause, Gerhard

2016-09-01

An arterial blood gas analysis (ABG) yields important diagnostic information in the management of cardiac arrest. This study evaluated ABG samples obtained during out-of-hospital cardiopulmonary resuscitation (OHCPR) in the setting of a prospective multicenter trial. We aimed to clarify prospectively the ABG characteristics during OHCPR, potential prognostic parameters and the ABG dynamics after return of spontaneous circulation (ROSC). ABG samples were collected and instantly processed either under ongoing OHCPR performed according to current advanced life support guidelines or immediately after ROSC and data ware entered into a case report form along with standard CPR parameters. During a 22-month observation period, 115 patients had an ABG analysis during OHCPR. In samples obtained under ongoing CPR, an acidosis was present in 98% of all cases, but was mostly of mixed hypercapnic and metabolic origin. Hypocapnia was present in only 6% of cases. There was a trend towards higher paO2 values in patients who reached sustained ROSC, and a multivariate regression analysis revealed age, initial rhythm, time from collapse to CPR initiation and the arterio-alveolar CO2 difference (AaDCO2) to be associated with sustained ROSC. ABG samples drawn immediately after ROSC demonstrated higher paO2 and unaltered pH and base excess levels compared with samples collected during ongoing CPR. Our findings suggest that adequate ventilation and oxygenation deserve more research and clinical attention in the management of cardiac arrest and that oxygen uptake improves within minutes after ROSC. Hyperventilation resulting in arterial hypocapnia is not a major problem during OHCPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Continuous traumatic stress as a mental and physical health challenge: Case studies from South Africa.

PubMed

Kaminer, Debra; Eagle, Gillian; Crawford-Browne, Sarah

2018-07-01

This article discusses the condition of continuous traumatic stress as common on the African continent and in other international settings characterised by very high levels of ongoing violence and threat of community, political or war-related origin. Through consideration of three case studies from South Africa, contexts of continuous traumatic stress are described, and the mental health and physical health effects of living in such contexts are elaborated. Cautions are raised about attempting to transpose existing posttraumatic stress models onto individuals exposed to situations of continuous traumatic stress, and guidelines for optimal interventions with such cases are proposed.

Coming to terms: a case study of hospice collaboration challenges.

PubMed

Pietroburgo, Julie; Bush, Richard

Recent research has focused on the growing phenomenon of mergers, collaborations, and alliances among nonprofit organizations and what makes such arrangements work. Examination of failed collaborative efforts is perhaps just as instructive. This case study examines recent attempts at collaboration between 2 nonprofit hospice organizations. The study finds that despite compelling reasons for and significant commonalities on which to base collaboration, the organizations were initially unable to forge any ongoing and substantive collaborative arrangement because of insurmountable cultural factors and past history. Furthermore, without imminent external pressures to collaborate, these organizations had insufficient motivation to attempt to move beyond their differences. The case also reviews the changed circumstances and factors that later facilitated partnering attempts.

UK Health and Social Care Case Studies: Iterative Technology Development.

PubMed

Blanchard, Adie; Gilbert, Laura; Dawson, Tom

2017-01-01

As a result of increasing demand in the face of reducing resources, technology has been implemented in many social and health care services to improve service efficiency. This paper outlines the experiences of deploying a 'Software as a Service' application in the UK social and health care sectors. The case studies demonstrate that every implementation is different, and unique to each organisation. Technology design and integration can be facilitated by ongoing engagement and collaboration with all stakeholders, flexible design, and attention to interoperability to suit services and their workflows.

Trauma-Focused CBT for Youth who Experience Ongoing Traumas

PubMed Central

Cohen, Judith A.; Mannarino, Anthony P.; Murray, Laura A.

2011-01-01

Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will this in some way impair their responding to current or ongoing trauma? The paper addresses practical strategies for implementing one evidence-based treatment, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with ongoing traumas. Collaboration with local therapists and families participating in TF-CBT community and international programs elucidated effective strategies for applying TF-CBT with these youth. These strategies included: 1) enhancing safety early in treatment; 2) effectively engaging parents who experience personal ongoing trauma; and 3) during the trauma narrative and processing component focusing on a) increasing parental awareness and acceptance of the extent of the youths’ ongoing trauma experiences; b) addressing youths’ maladaptive cognitions about ongoing traumas; and c) helping youth differentiate between real danger and generalized trauma reminders. Case examples illustrate how to use these strategies in diverse clinical situations. Through these strategies TF-CBT clinicians can effectively improve outcomes for youth experiencing ongoing traumas. PMID:21855140

Preeclampsia-Associated Hormonal Profiles and Reduced Breast Cancer Risk Among Older Mothers

DTIC Science & Technology

2003-04-01

Preeclampsia has been linked to reduced breast cancer risk, and this reduction may be especially marked among women who bear their first child later...in life. In this ongoing case-control study, we examine the hormonal profiles of older Colorado mothers with and without a history of preeclampsia in...premenopausal, and are free of serious chronic disease. Cases are 14 Denver area women who experienced preeclampsia in their first pregnancy; controls are 13

How Does a Sales Team Reach Goals in Intercultural Business Negotiations? A Case Study

ERIC Educational Resources Information Center

Vuorela, Taina

2005-01-01

This paper is a report of an on-going study of intercultural business negotiations. Two meetings were under scrutiny: a company-internal strategy meeting of a sales team ("the sellers' internal meeting"), which was analysed on a general level for goals and other background information; a client negotiation with the same sellers meeting a potential…

Developmental Trajectories in Adolescents and Adults With Autism: The Case of Daily Living Skills

ERIC Educational Resources Information Center

Smith, Leann E.; Maenner, Matthew J.; Seltzer, Marsha Mailick

2012-01-01

Objective: This study aimed to investigate the longitudinal course of daily living skills in a large, community-based sample of adolescents and adults with autism spectrum disorders (ASD) over a 10-year period. Method: Adolescents and adults with ASD (n = 397) were drawn from an ongoing, longitudinal study of individuals with ASD and their…

Clearing the Highest Hurdle: Human-Based Case Studies Broaden Students' Knowledge of Core Evolutionary Concepts

ERIC Educational Resources Information Center

Werth, Alexander J.

2009-01-01

An anonymous survey instrument was used for a ten year study to gauge college student attitudes toward evolution. Results indicate that students are most likely to accept evolution as a historical process for change in physical features of non-human organisms. They are less likely to accept evolution as an ongoing process that shapes all traits…

USING A LIFE-CYCLE APPROACH TO ACHIEVE SUSTAINABLE MUNICIPAL SOLID WASTE MANAGEMENT STRATEGIES IN THE UNITED STATES

EPA Science Inventory

The paper discusses a computer-based decision support tool that has been developed to assist local governments in evaluating the cost and environmental performance of integrated municipal solid waste (MSW) managment systems. ongoing case studies of the tool at the local level are...

Project SMARTArt: A Case Study in Elementary School Media Literacy and Arts Education

ERIC Educational Resources Information Center

Jolls, Tessa; Grande, Denise

2005-01-01

With ongoing professional development and with appropriate tools, teachers are able to internalize information-process skills. Once they understand these process skills, they are able to apply them to any media content and to transform their teaching, without the need for a "cookbook" approach, reliant only on textbooks. Instead,…

A decade of aquatic invasive species (AIS) early detection method development in the St. Louis River estuary

EPA Science Inventory

As an invasion prone location, the St. Louis River Estuary (SLRE) has been a case study for ongoing research to develop the framework for a practical Great Lakes monitoring network for early detection of aquatic invasive species (AIS). Early detection, however, necessitates findi...

Distance Learners' Perspective on User-Friendly Instructional Materials at the University of Zambia

ERIC Educational Resources Information Center

Simui, F.; Thompson, L. C.; Mundende, K.; Mwewa, G.; Kakana, F.; Chishiba, A.; Namangala, B.

2017-01-01

This case study focuses on print-based instructional materials available to distance education learners at the University of Zambia. Using the Visual Paradigm Software, we model distance education learners' voices into sociograms to make a contribution to the ongoing discourse on quality distance learning in poorly resourced communities. Emerging…

Plasma Treatment for Severe Influenza Deemed Well-Tolerated in Clinical Study | Frederick National Laboratory for Cancer Research

Cancer.gov

The upcoming flu season is just around the corner, and an ongoing challenge for researchers has been how to best respond to cases of severe influenza in the event of an outbreak. The Frederick National Laboratory for Cancer Research has helped the Na

Professional Learning of Teachers in Ethiopia: Challenges and Implications for Reform

ERIC Educational Resources Information Center

Tuli, Fekede; Tynjälä, Päivi

2015-01-01

Continuous professional development of teachers is of growing interest globally, as it is considered vital to cope effectively with ongoing changes and to improve the quality of education. This qualitative case study explores potential and actual barriers that hinder teachers' professional development in Ethiopian schools. Data was collected via…

Integrating species distributional, conservation planning, and individual based population models: A case study in critical habitat evaluation for the Northern Spotted Owl

EPA Science Inventory

Background / Question / Methods As part of the ongoing northern spotted owl recovery planning effort, we evaluated a series of alternative potential critical habitat scenarios using a species-distribution model (MaxEnt), a conservation-planning model (Zonation), and an individua...

Managing Chronic Pain in People with Learning Disabilities: A Case Study

ERIC Educational Resources Information Center

Lewis, Sarah; Bell, Dorothy; Gillanders, David

2007-01-01

Chronic pain is a prevalent, under-diagnosed problem in the learning disability population. This is in part due to communication problems, unrecognized pain behaviours and the effects of medication. As a consequence, chronic pain often goes untreated and causes ongoing distress. This paper initially describes the main research that has been…

Educating Professionals--Perceptions of the Research--Teaching Nexus in Accounting: A Case Study

ERIC Educational Resources Information Center

Lubbe, Ilse

2015-01-01

The teaching-research "nexus" has been an area of historic and ongoing controversy within universities and discussions into the nexus between teaching and research continues to expand. Within the accounting discipline, where new knowledge is perceived to be located "outside" the university, academics struggle to describe and…

Raptor Electrocution: A Case Study on Ecological Traps, Sinks, and Additive Mortality

ERIC Educational Resources Information Center

Dwyer, James F.

2009-01-01

The recovery from human persecution of some upper trophic level wildlife species coupled with ongoing expansion of human-dominated landscapes is leading to increased human-wildlife interactions in urban environments. Raptors in particular are drawn to high resource concentrations of potential nest sites and prey, and are colonizing cities across…

A Case Study on the Failure of Management Controls around Expected Benefit Development

ERIC Educational Resources Information Center

Parsons, Earl H.

2013-01-01

Organization leaders manage change through projects to realize specific expected benefits. Under Expectation-Confirmation theory, expected benefits can be used to judge the ongoing viability and final success of the project. Organization leaders often develop management controls to ensure that the expected benefits are defined to allow their use…

Beginning Teacher Induction in Secondary Schools: A Best Practice Case Study

ERIC Educational Resources Information Center

Kearney, Sean

2017-01-01

Beginning teacher induction is becoming an increasingly popular process in acculturating teachers to their new careers. The problems that teachers face early in their careers are well known, and effective and ongoing induction is one of the foremost practices for alleviating the pressures that teachers face early in their careers. While induction…

What Happens When Induction Goes Wrong: Case Studies from the Field

ERIC Educational Resources Information Center

Kearney, Sean

2016-01-01

Although induction programmes are widely held to alleviate the pressures beginning teachers face early in their careers, what happens when beginning teachers do not receive adequate induction? While the research advocates effective and ongoing induction to acculturate new teachers to their careers, there is little research on the effects of…

Connections: Facilitating Social Supports for Students with Deaf-Blindness in General Education Classrooms.

ERIC Educational Resources Information Center

Goetz, Lori; O'Farrell, Nora

1999-01-01

This article describes a three-component package to facilitate social supports for students who are deaf-blind in general education classes. The components are: ongoing provision of information, provision of interactive, multiple communication media, and facilitation of social interactions. Case studies of four students with deaf-blindness…

A Multiple Case Study Approach to Explore Generational Theory to Enhance Online Continuing Nursing Education

ERIC Educational Resources Information Center

Foecke, Jan

2017-01-01

Nurses are expected to participate in ongoing professional development, whether that is higher education to obtain another degree or continuing nursing education (CNE) to enhance knowledge or skills, maintain licensure, and/or maintain certification. Because there are generational differences that can affect adult education, learning preferences…

The Relevance of "Personal Mastery" to Leadership: The Case of School Principals in Singapore

ERIC Educational Resources Information Center

Retna, Kala S.

2011-01-01

School leadership literature suggests that school effectiveness and ongoing improvement rely on school leaders and principals. Despite significant contributions made by principals towards teaching and learning in schools, there have been few studies that explore principals' perceptions of the factors underpinning their successes and achievements.…

High School Students' Understanding of Acid-Base Concepts: An Ongoing Challenge for Teachers

ERIC Educational Resources Information Center

Damanhuri, Muhd Ibrahim Muhamad; Treagust, David F.; Won, Mihye; Chandrasegaran, A. L.

2016-01-01

Using a quantitative case study design, the "Acids-Bases Chemistry Achievement Test" ("ABCAT") was developed to evaluate the extent to which students in Malaysian secondary schools achieved the intended curriculum on acid-base concepts. Responses were obtained from 260 Form 5 (Grade 11) students from five schools to initially…

Contrasting Cases of Calculus Students' Understanding of Derivative Graphs

ERIC Educational Resources Information Center

Haciomeroglu, Erhan Selcuk; Aspinwall, Leslie; Presmeg, Norma C.

2010-01-01

This study adds momentum to the ongoing discussion clarifying the merits of visualization and analysis in mathematical thinking. Our goal was to gain understanding of three calculus students' mental processes and images used to create meaning for derivative graphs. We contrast the thinking processes of these three students as they attempted to…

Assessing College Students' Perceptions of a Case Teacher's Pedagogical Content Knowledge Using a Newly Developed Instrument

ERIC Educational Resources Information Center

Jang, Syh-Jong

2011-01-01

Ongoing professional development for college teachers has been much emphasized. However, previous research on learning environments has seldom addressed college students' perceptions of teachers' PCK. This study aimed to evaluate college students' perceptions of a physics teacher's PCK development using a newly developed instrument and workshop…

Secondary Student Motivation to Participate in a Year 9 Australian Elective Classroom Music Curriculum

ERIC Educational Resources Information Center

McEwan, Rob

2013-01-01

Despite strong philosophical arguments supporting the inclusion of music in all students' education, declining student participation rates in school music activities during the middle years of schooling remain an ongoing issue for music education researchers. This paper presents the findings of a case study examining the motivational factors…

Professional Development in the Digital Age: Case Studies of Blended Communities of Practice

ERIC Educational Resources Information Center

Wagner, Jennifer Michelle

2010-01-01

The need for sustainable, meaningful teacher professional development to support the rising professional demands remains an on-going challenge for education. The use of current technologies, such as online learning systems, to leverage the development of learning communities, including communities of practice (CoPs), where teachers with a common…

Research and Action: The Role of an Educational Center.

ERIC Educational Resources Information Center

Flugman, Bert

1986-01-01

Discusses the Center for Advanced Study in Education (CASE) in Manhattan as a representative research and development center in a collaborative role with the New York City Schools. Presents its role as educational problem solver for immediate solutions rather than for interesting findings. Provides examples of three on-going problem solving…

Video-Stimulated Recall as a Catalyst for Teacher Professional Learning

ERIC Educational Resources Information Center

Geiger, Vince; Muir, Tracey; Lamb, Janeen

2016-01-01

The purpose of this article is to examine the potential of video-catalysed reflective practice for supporting ongoing teacher professional learning in numeracy. We explore this potential through a synthesis of two case studies that investigated different approaches to supporting teacher reflection on practice through the use of video-stimulated…

Embodying Exclusion: The Daily Melancholia and Performative Politics of Struggling Early Adolescent Readers

ERIC Educational Resources Information Center

Enriquez, Grace

2011-01-01

Examining the body as a site and product of various ongoing discursive processes can provide insight about how identity impacts students' learning and understanding of their classroom experiences. This qualitative case study investigates how two, urban, eighth-grade students responded to being identified as struggling readers, concentrating…

Rethinking Schools as Learning Organisations.

ERIC Educational Resources Information Center

O'Sullivan, Fergus

For 2 decades, schools in the United Kingdom and in western economies in general have experienced rapid change. Many schools, however, look less like learning organizations today than they did before the introduction of the Education Reform Act in 1988. This paper reports on an ongoing series of case studies of school improvement that developed…

Youth Intervention for Peace Project: Burundi Case Study

ERIC Educational Resources Information Center

Bigirindavyi, Jean-Paul

2004-01-01

The experience of Rwanda's genocide in 1994 shocked the world into disbelief as Western media finally focused their attention on the region's ongoing conflict. Yet little is being done today to prevent the reproduction of a parallel disaster in its twin country, Burundi, where similar conflict patterns may spark another intensely violent civil…

Singing in "La Voce Della Luna" Italian Women's Choir in Melbourne, Australia

ERIC Educational Resources Information Center

Southcott, Jane; Joseph, Dawn

2015-01-01

Australia is a country of ongoing migration that embraces diversity, creative expression and cultural activity. Membership of community music groups by older people can enhance life quality, and may provide a space through which cultural and linguistic identity may be shared and celebrated. This qualitative phenomenological case study explores…

Building Scientific Confidence in the Development and Evaluation of Read-Across Using Tox21 Approaches (SOT Annual Meeting)

EPA Science Inventory

Acceptance of read-across is an ongoing challenge and several efforts are underway to identify and address major uncertainties associated with read-across. Several approaches have been proposed but to date few case studies if any have evaluated how Tox21 approaches may be instruc...

Mitigating Errors of Representation: A Practical Case Study of the University Experience Survey

ERIC Educational Resources Information Center

Whiteley, Sonia

2014-01-01

The Total Survey Error (TSE) paradigm provides a framework that supports the effective planning of research, guides decision making about data collection and contextualises the interpretation and dissemination of findings. TSE also allows researchers to systematically evaluate and improve the design and execution of ongoing survey programs and…

The Politics of Distributing Leadership: Reconsidering Leadership Distribution in Two Texas Elementary Schools

ERIC Educational Resources Information Center

Maxcy, Brendan D.; Nguyen, Thu Su'o'ng Thi.

2006-01-01

Recent work on distributed leadership extends an ongoing critique of conventional "heroic" leader portrayals. This article examines work in this area seeking implications for democratic school governance. With material from case studies of two Texas schools, it considers frameworks presented by Spillane, Halverson, and Diamond and by…

Enhancing Conservation Education Opportunities in Nature Reserves in Tropical Countries: A Case Study in Belize.

ERIC Educational Resources Information Center

Rome, Abigail; Romero, Bart

1998-01-01

To meet the educational needs of residents and visitors at a nature reserve in Belize, educators developed a program to teach participating students and provide ongoing educational resources for future visitors. Fifteen North-American college students received academic training in rainforest ecology and environmental education. They then created…

Characterization of the dengue outbreak in Nuevo Leon state, Mexico, 2010.

PubMed

Leduc-Galindo, D; Gloria-Herrera, U; Rincón-Herrera, U; Ramos-Jiménez, J; Garcia-Luna, S; Arellanos-Soto, D; Mendoza-Tavera, N; Tavitas-Aguilar, I; Garcia-Garcia, E; Galindo-Galindo, E; Villarreal-Perez, J; Fernandez-Salas, I; Santiago, G A; Muñoz-Jordan, J; Rivas-Estilla, A M

2015-04-01

We studied serotypes circulating dengue virus (DENV) cases, entomological Breteau index, rain-fall index and epidemiology of groups affected during the 2010 outbreak in Nuevo Leon, Mexico. From 2,271 positive cases, 94% were dengue classic and 6% dengue hemorrhagic fever; DENV1 was mainly isolated (99%) (Central-American lineage of American-African-genotype). We found correlation between two environmental phenomena (Increment of rainfall and vector-indexes) (p ≤ 0.05) with epidemiological, clinical and risk of DENV-1 ongoing transmission.

Large and ongoing outbreak of haemolytic uraemic syndrome, Germany, May 2011.

PubMed

Frank, C; Faber, M S; Askar, M; Bernard, H; Fruth, A; Gilsdorf, A; Hohle, M; Karch, H; Krause, G; Prager, R; Spode, A; Stark, K; Werber, D

2011-05-26

Since early May 2011, an increased incidence of haemolytic uraemic syndrome (HUS) and bloody diarrhoea related to infections with Shiga toxin-producing Escherichia coli (STEC) has been observed in Germany, with most cases in the north of the country. Cases reported from other European countries had travelled to this area. First results of a case–control study conducted in Hamburg suggest an association between the occurrence of disease and the consumption of raw tomatoes, cucumber and leaf salad.

VIRTUAL REALITY HYPNOSIS FOR PAIN CONTROL IN A PATIENT WITH GLUTEAL HIDRADENITIS:A CASE REPORT1

PubMed Central

SOLTANI, MARYAM; TEELEY, AUBRIANA M.; WIECHMAN, SHELLEY A.; JENSEN, MARK P.; SHARAR, SAM R.; PATTERSON, DAVID R.

2012-01-01

This case report describes the use of hypnotic analgesia induced through immersive three-dimensional computer-generated virtual reality, better known as virtual reality hypnosis (VRH), in the treatment of a patient with ongoing pain associated with gluteal hidradenitis, The patient participated in the study for two consecutive days white hospitalized at a regional trauma centre. At pretreatment, she reported severe pain intensity and unpleasantness as well as high levels of anxiety and nervousness. She was then administered two sessions of virtual reality hypnotic treatment for decreased pain and anxiety. The patient’s ratings of ‘time spent thinking about pain’, pain intensity, ‘unpleasantness of pain’, and anxiety decreased from before to after each daily VRH session, as well as from Day One to Day Two. The findings indicate that VRH may benefit individuals with severe, ongoing pain from a chronic condition, and that a controlled clinical trial examining its efficacy is warranted. PMID:23205274

Project Photofly: New 3d Modeling Online Web Service (case Studies and Assessments)

NASA Astrophysics Data System (ADS)

Abate, D.; Furini, G.; Migliori, S.; Pierattini, S.

2011-09-01

During summer 2010, Autodesk has released a still ongoing project called Project Photofly, freely downloadable from AutodeskLab web site until August 1 2011. Project Photofly based on computer-vision and photogrammetric principles, exploiting the power of cloud computing, is a web service able to convert collections of photographs into 3D models. Aim of our research was to evaluate the Project Photofly, through different case studies, for 3D modeling of cultural heritage monuments and objects, mostly to identify for which goals and objects it is suitable. The automatic approach will be mainly analyzed.

A correlation-based flux partitioning method and its application to a vineyard in California’s central valley: a case Study

USDA-ARS?s Scientific Manuscript database

The persistent and ongoing California drought has not only tasked already-limited water resources, it has also hampered crop production and damaged the state’s economy. In order to minimize the adverse effects of drought and ensure the sustainability of California agriculture, policymakers, resource...

Micropolitics and Rural School Consolidation: The Quest for Equal Educational Opportunity in Webster Parish

ERIC Educational Resources Information Center

Williams, Sheneka M.

2013-01-01

School consolidation in rural districts has been ongoing since the 1800s. Although many district personnel tout economic inefficiency as a reason for consolidation to occur, micropolitics among school board members, parents, and the business community often drive the consolidation process. This article presents a qualitative case study of Webster…

A Case Study to Explore the Impact of Knowledge Management Systems on Workplace Diversity Programs

ERIC Educational Resources Information Center

Gautier, Michael

2012-01-01

The ongoing debate over the definition and application of workplace diversity policies results in a wide range of viewpoints. There are a number of theoreticians who feel that if diversity is more than avoidance of discrimination, that the traditional body of anti-discrimination programs such as the Equal Employment Opportunity (EEO) efforts…

Treatment Effect Heterogeneity in a Science Professional Development Initiative: The Case for School Capacity

ERIC Educational Resources Information Center

Bruch, Sarah; Grigg, Jeffrey; Hanselman, Paul

2010-01-01

This study focuses on how the treatment effects of a teacher professional development initiative in science differed by school capacity. In other words, the authors are primarily concerned with treatment effect heterogeneity. As such, this paper complements ongoing evaluation of the average treatment effects of the initiative over time. The…

University Teaching and Social Cohesion in the Age of AIDS: A South African Case Study

ERIC Educational Resources Information Center

Lesko, Nancy

2007-01-01

In the context of ongoing social divisions, lack of coherent leadership by government, and even divisiveness over medical advances and public health mandates, how might universities respond? What university actions can support "social cohesion" in a society splintered by class, race, gender, colonial legacies, the history of apartheid,…

Building Lean Supply Chain and Manufacturing Skills through an Interactive Case Study

ERIC Educational Resources Information Center

Ozelkan, Ertunga C.; Teng, S. Gary; Johnson, Thomas; Benson, Tom; Nestvogel, Dean

2007-01-01

With the ongoing global pressure to cut costs and focus on quality, many companies have been implementing "lean manufacturing" concepts to survive in the competitive marketplace. Thus it is imperative that engineering and business graduates are equipped with the lean principles, and are ready to take ownership of lean initiatives as they enter the…

Use of Online Assessment Tools by Instructional Designers-by-Assignment: Necessary Features and Functionalities

ERIC Educational Resources Information Center

Halloran, Jo-Ann

2013-01-01

Government entities set criteria for institutions that have teacher educator programs to use online assessment tools to show continuous ongoing evaluation, and use data from the tools to guide the improvement of courses. The purpose of this qualitative, multi-case study was to discover how Instructional Designers-by-Assignment (IDBA) are using…

Inquiry-Based Chemistry Education in a High-Context Culture: A Qatari Case Study

ERIC Educational Resources Information Center

Qureshi, Sheila; Vishnumolakala, Venkat Rao; Southam, Daniel C.; Treagust, David F.

2017-01-01

This research took place within the context of ongoing educational reforms to promote inquiry-based science instruction and a desire to draw evidence to inform adoptions of western pedagogical practices in a high-context culture like Qatar. We report on the outcomes from Process Oriented Guided Inquiry Learning (POGIL) in a foundation chemistry…

Teachers' Learning in Online Communities of Practice: Two Case Studies from Australia

ERIC Educational Resources Information Center

Hanewald, Ria

2013-01-01

Australia is a vast land with a dispersed population especially in rural or remote areas, which is geographically located in the Asian region. This has a strong bearing on its initial education (pre-service) and the ongoing professional development (in-service) of teachers. The vastness of Australia causes professional isolation and a lack of…

3 CFR 8762 - Proclamation 8762 of November 30, 2011. World AIDS Day, 2011

Code of Federal Regulations, 2012 CFR

2012-01-01

... World AIDS Day, 30 years after the first cases of HIV/AIDS were reported, we stand with the individuals... transmission. Studies on the use of antiretroviral medications to prevent infection of HIV-negative individuals show promising results. And research is ongoing to devise new prevention methods that may one day offer...

The Status of Violence Prevention in West Virginia Elementary Schools: A Case Study

ERIC Educational Resources Information Center

Pentasuglia-Filipek, Kristal Gayle

2009-01-01

While there is no absolute deterrent of school violence, West Virginia has taken definitive steps to try to ensure safety in our public schools. Since the launch of the Safe School initiative in 1995, training for principals, teachers and school personnel on crisis intervention and management plans have been ongoing. Students have undergone…

Art Making as a Mental Health Recovery Tool for Change and Coping

ERIC Educational Resources Information Center

Van Lith, Theresa

2015-01-01

The intrinsic benefits of art making may be implicated in how and why people with mental illness turn to art therapy to aid their recovery. In this longitudinal multiple case study adult participants (N = 12) with severe and ongoing mental illness were recruited through their involvement in diverse community mental health art therapy programs. An…

Chinese Academics under the Reformed Remuneration System: A Case Study

ERIC Educational Resources Information Center

Xueyan, Xu

2015-01-01

As part of ongoing efforts to attract and keep talents, Chinese governments and universities have initiated a series of reforms to improve faculty salaries over the past decades. However, the reformed salary policies do not work as well as expected. According to the field data, the formed salary policies had posted a new set of challenges to…

Contextualization and Authenticity in TBLT: Voices from Chinese Classrooms

ERIC Educational Resources Information Center

Chen, Qi; Wright, Clare

2017-01-01

In view of ongoing debates about the future of task-based language teaching (TBLT) in contexts of English as a foreign language (EFL), we present a detailed case study of teacher beliefs and practices regarding TBLT conducted in a secondary school in mainland China with a long history of communicative and task-based teaching approaches. We used a…

Preparing Teachers to Meet the Needs of Latino and ELL Students: A Case Study of a Federal Grant

ERIC Educational Resources Information Center

Beal, Heather K. Olson; Rudolph, Amanda M.

2015-01-01

Due to increased public school accountability, heightened scrutiny of higher education, ongoing demographic shifts, and lean economic times, many in higher education are turning to the federal grant system for financial support to facilitate needed program improvements because other funding sources have been diminished or eliminated. Teacher…

Ecological consequences of fragmentation and deforestation in an urban landscape: a case study

Treesearch

W.C. Zipperer; T.W. Foresman; S.P. Walker; C.T. Daniel

2012-01-01

Landscape change is an ongoing process even within established urban landscapes. Yet, analyses of fragmentation and deforestation have focused primarily on the conversion of non-urban to urban landscapes in rural landscapes and ignored urban landscapes. To determine the ecological effects of continued urbanization in urban landscapes, tree-covered patches were mapped...

Beyond the Numbers: Data Use for Continuous Improvement of Programs Serving Disconnected Youth

ERIC Educational Resources Information Center

Pate, Austin; Lerner, Jennifer Brown; Browning, Andrea

2012-01-01

This publication is a series of in-depth case studies to examine how three programs which serve a disconnected youth population are utilizing data as a tool for continuous program improvement and ongoing accountability. The report features the following programs: (1) Roca, an organization in Massachusetts which engages the highest-risk youth in…

Transient suppression of seizures by repetitive transcranial magnetic stimulation in a case of Rasmussen's encephalitis.

PubMed

Rotenberg, Alexander; Depositario-Cabacar, Dewi; Bae, Erica Hyunji; Harini, Chellamani; Pascual-Leone, Alvaro; Takeoka, Masanori

2008-07-01

Repetitive transcranial magnetic stimulation (rTMS) has been applied with variable success to terminate the seizures of epilepsia partialis continua. The rationale for using this technique to suppress ongoing seizures is the capacity of rTMS to interrupt ongoing neuronal activity, and to produce a lasting decrease in cortical excitability with low-frequency (1 Hz) stimulation. We report a case of epilepsia partialis continua in a child with Rasmussen's encephalitis, in whom seizures were transiently suppressed by 1-Hz rTMS delivered in nine daily 30-minute sessions. In this case, total ictal time was significantly reduced during stimulation, but the daily baseline seizure rate remained unchanged. Notably, the detection and quantification of this short-lived improvement were enabled by recording EEG continuously during the rTMS session. Thus, we present this case to illustrate a potential utility of combined continuous EEG recording and rTMS in seizure treatment.

Acute liver injury associated with a newer formulation of the herbal weight loss supplement Hydroxycut.

PubMed

Araujo, James L; Worman, Howard J

2015-05-06

Despite the widespread use of herbal and dietary supplements (HDS), serious cases of hepatotoxicity have been reported. The popular herbal weight loss supplement, Hydroxycut, has previously been implicated in acute liver injury. Since its introduction, Hydroxycut has undergone successive transformations in its formulation; yet, cases of liver injury have remained an ongoing problem. We report a case of a 41-year-old Hispanic man who developed acute hepatocellular liver injury with associated nausea, vomiting, jaundice, fatigue and asterixis attributed to the use of a newer formulation of Hydroxycut, SX-7 Clean Sensory. The patient required hospitalisation and improved with supportive therapy. Despite successive transformations in its formulation, potential liver injury appears to remain an ongoing problem with Hydroxycut. Our case illustrates the importance of obtaining a thorough medication history, including HDS, regardless of new or reformulated product marketing efforts. 2015 BMJ Publishing Group Ltd.

Acute liver injury associated with a newer formulation of the herbal weight loss supplement Hydroxycut

PubMed Central

Worman, Howard J

2015-01-01

Despite the widespread use of herbal and dietary supplements (HDS), serious cases of hepatotoxicity have been reported. The popular herbal weight loss supplement, Hydroxycut, has previously been implicated in acute liver injury. Since its introduction, Hydroxycut has undergone successive transformations in its formulation; yet, cases of liver injury have remained an ongoing problem. We report a case of a 41-year-old Hispanic man who developed acute hepatocellular liver injury with associated nausea, vomiting, jaundice, fatigue and asterixis attributed to the use of a newer formulation of Hydroxycut, SX-7 Clean Sensory. The patient required hospitalisation and improved with supportive therapy. Despite successive transformations in its formulation, potential liver injury appears to remain an ongoing problem with Hydroxycut. Our case illustrates the importance of obtaining a thorough medication history, including HDS, regardless of new or reformulated product marketing efforts. PMID:25948859

Bite wounds and antibiotic prescription among patients presenting to an Australian emergency department.

PubMed

Birdsey, Matthew; Edwards, Gail; Abetz, Jeremy; Jennings, Natasha; Mitra, Biswadev

2016-07-01

Emergency department presentations after mammalian bites may be associated with injection of bacteria into broken skin and may require prophylactic antibiotics to prevent subsequent infection. We aim to describe the epidemiology of patients presenting with a mammalian bite injury and antibiotic choice to an Australian adult tertiary centre. A retrospective cohort study was performed capturing all presentations after mammalian bite wounds between 01 Jan 2014 and 31 Dec 2014. An explicit chart review was conducted to determine management of each case. Cases were subgrouped into high- and low-risk groups as defined by the Australian Therapeutic Guidelines for animal bites. There were 160 cases of mammalian bite wounds included, with 143 (89.4%) patients grouped as high-risk and 17 (10.6%) patients identified as low-risk. High-risk features were delayed presentation > 8 hours (57 patients, 35.6%), bites to the head, hand or face (113 patients, 70.6%), and puncture wounds unable to be adequately debrided (74 patients, 46.3%). There was a significant association with delayed presentation of more than eight hours and clinically established infection [OR 36.2; 95% CI: 12.6-103.6; P < 0.001]. Prescriptions for antibiotics that adhered to current guidelines occurred in 99 (61.9%) cases. This study highlights variability in antibiotic prescription practice among clinicians and the need for ongoing education on antibiotic stewardship. Intervention strategies, including ongoing education, are indicated to improve adherence to antibiotic guidelines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Mental Retardation and the Law: A Report on Status of Current Court Cases.

ERIC Educational Resources Information Center

Levine, Jan Martin, Ed.

Brief reports on the status of approximately 75 ongoing or recently decided court cases in states of relevance to the mentally retarded are provided. Cases cover the following issues: commitment, community living and services, criminal law, discrimination, guardianship, institutions and deinstitutionalization, medical/legal issues, parental rights…

Trajectories of Resilience, Resistance, and Distress during Ongoing Terrorism: The Case of Jews and Arabs in Israel

ERIC Educational Resources Information Center

Hobfoll, Stevan E.; Palmieri, Patrick A.; Johnson, Robert J.; Canetti-Nisim, Daphna; Hall, Brian J.; Galea, Sandro

2009-01-01

This is the 1st longitudinal examination of trajectories of resilience and resistance (rather than ill-being) among a national sample under ongoing threat of mass casualty. The authors interviewed a nationally representative sample of Jews and Arabs in Israel (N = 709) at 2 times during a period of terrorist and rocket attacks (2004?2005). The…

The Development of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A Case Study

PubMed Central

Boisseau, Christina L.; Farchione, Todd J.; Fairholme, Christopher P.; Ellard, Kristen K.; Barlow, David H.

2013-01-01

A detailed description of treatment utilizing the Unified Protocol (UP), a transdiagnostic emotion-focused cognitive-behavioral treatment, is presented using a clinical case example treated during the most current phase of an ongoing randomized controlled trial of the UP. The implementation of the UP in its current, modular version is illustrated. A working case conceptualization is presented from the perspective of the UP drawing from theory and research that underlies current transdiagnostic approaches to treatment and consistent with recent dimensional classification proposals (Brown & Barlow, in press). Treatment is illustrated module-by-module describing how the principles of the UP were applied in the presented case. PMID:23997572

Genetic Association Study of Ancestry-Matched African American Prostate Cancer Cases and Control

DTIC Science & Technology

2009-04-01

TO THE ABOVE ADDRESS. 1. REPORT DATE 1 April 2009 2 . REPORT TYPE Final 3. DATES COVERED 1 April 2008 – 31 March 2009 4. TITLE AND SUBTITLE...matching, we have identified and confirmed several prostate cancer susceptibility loci in this study population, on chromosomes 2 , 8 and 17. These and...prostate cancer susceptibility loci in these studies, on chromosomes 2 , 8, and 17. These and other ongoing studies will provide unprecedented insight

Gulf War Illness and the Health of Gulf War Veterans

DTIC Science & Technology

2008-11-01

after his return.432 Seventy- five Gulf War personnel were hospitalized for chicken pox during deployment.1431 Only a few cases of viral hepatitis were...and independent of circulating uranium levels. Of particular interest are findings from an ongoing study at the University of New Mexico indicating that...periods, can produce chronic neurological or behavioral effects. The New Mexico study is an important example of a particularly relevant approach

Adolescent neglect, juvenile delinquency and the risk of recidivism.

PubMed

Ryan, Joseph P; Williams, Abigail B; Courtney, Mark E

2013-03-01

Victims of child abuse and neglect are at an increased risk of involvement with the juvenile justice and adult correctional systems. Yet, little is known about the continuation and trajectories of offending beyond initial contact with law enforcement. Neglect likely plays a critical role in continued offending as parental monitoring, parental rejection and family relationships are instrumental in explaining juvenile conduct problems. This study sought to determine whether neglect is associated with recidivism for moderate and high risk juvenile offenders in Washington State. Statewide risk assessments and administrative records for child welfare, juvenile justice, and adult corrections were analyzed. The sample was diverse (24 % female, 13 % African American, 8 % Hispanic, 5 % Native American) and included all moderate and high risk juvenile offenders screened by juvenile probation between 2004 and 2007 (n = 19,833). Official records from child protection were used to identify juvenile offenders with a history of child neglect and to identify juvenile offenders with an ongoing case of neglect. Event history models were developed to estimate the risk of subsequent offending. Adolescents with an ongoing case neglect were significantly more likely to continue offending as compared with youth with no official history of neglect. These findings remain even after controlling for a wide range of family, peer, academic, mental health, and substance abuse covariates. Interrupting trajectories of offending is a primary focus of juvenile justice. The findings of the current study indicate that ongoing dependency issues play a critical role in explaining the outcomes achieved for adolescents in juvenile justice settings. The implications for improved collaboration between child welfare and juvenile justice are discussed.

Automation and apps for clinical dental biomechanics.

PubMed

Adams, Bruce W

2016-09-01

The aim of this research summary is to introduce the current and ongoing work using smartphone video, tracking markers to measure musculoskeletal disorders of cranial and mandibular origin, and the potential significance of the technology to doctors and therapists. The MPA™ biomechanical measuring apps are in beta trials with various doctors and therapists. The technique requires substantial image processing and statistical analysis, best suited to server-side processing. A smartphone environment has enabled a virtual laboratory, which provides automated generation of graphics and in some cases automated interpretation. The system enables highly accurate real-time biomechanics studies using only a smartphone and tracking markers. Despite the technical challenges in setting up and testing of the virtual environment and with interpretation of clinical relevance, the trials have enabled a demonstration of real-time biomechanics studies. The technology has prompted a lot of discussion about the relevance of rapid assessment tools in clinical practice. It seems that a prior bias against motion tracking and its relevance is very strong with occlusion related use cases, yet there has been a general agreement about the use case for cranial movement tracking in managing complex issues related to the head, neck, and TMJ. Measurement of cranial and mandibular functions using a smartphone video as the input have been investigated. Ongoing research will depend upon doctors and therapists to provide feedback as to which uses are considered clinically relevant.

Modalities of Generalization Through Single Case Studies.

PubMed

Zittoun, Tania

2017-06-01

The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

Training Law Enforcement Officials on Responding to Equine Calls

ERIC Educational Resources Information Center

Anderson, Kathleen P.; Stauffer, Gary; Stauffer, Monte; Anderson, Doug; Biodrowski, Kristie

2016-01-01

The occurrence of equine abuse/neglect cases is an ongoing issue. However, officials responding to equine cases are rarely experienced in handling horses. Therefore, workshops teaching basic horse husbandry were offered to better equip and prepare officials to respond to equine cases. Trainings consisted of both classroom and hands-on sessions.…

Rurality and Resilience in Education: Place-Based Partnerships and Agency to Moderate Time and Space Constraints

ERIC Educational Resources Information Center

Ebersohn, Liesel; Ferreira, Ronel

2012-01-01

In an ongoing longitudinal intervention study (STAR) we found that, although similarities existed in the way teachers promoted resilience, rural schools (in comparison to other STAR case schools) took longer to implement strategies to buoy support and found it difficult to sustain such support. Using rurality we wanted to understand how forces,…

Transnational Experiences, Language Competences and Worldviews: Contrasting Language Policies in Two Recently Migrated Greek Families in Luxembourg

ERIC Educational Resources Information Center

Kirsch, Claudine; Gogonas, Nikolaos

2018-01-01

Against the backdrop of the ongoing crisis-led migration from Southern to Northwestern Europe, the present paper reports on a case study of two families who have recently migrated from Greece to Luxembourg. Luxembourg has a trilingual education system and many pupils of migrant background face difficulties on this account. Drawing on the framework…

Exploring Contemporary Legal Issues in Schools from a Social Justice Frame: The Need for Ongoing Professional Development and Training for Practicing Educational Leaders

ERIC Educational Resources Information Center

Brackett, David A.; Perreault, George; Sparkman, William; Thornton, Billy W.; Barclay, Nicholas

2014-01-01

Most educational leadership preparation programs include classes designed to provide a broad survey of legal issues in the profession. Soon after these future leaders complete course requirements, their knowledge base can be outdated. We discuss, through relevant research along with theoretical and actual case studies, contemporary legal issues…

Overcoming the Challenges of Retaining Novice Teachers in a County Public School

ERIC Educational Resources Information Center

Albert, Ernst

2017-01-01

Retaining novice teachers in a Northeast Florida county public school is an ongoing challenge. Research indicates that 14% of new teachers will leave the field within 5 years. The purpose of this case study was to investigate the major factors that contributed to this unique group of novice teachers' decisions to continue to teach at the school…

Making Connections: Using Online Discussion Forums to Engage Students in Historical Inquiry

ERIC Educational Resources Information Center

Blankenship, Whitney

2009-01-01

The ongoing interpretive case study that the author highlights in this article focused on students' use of online discussion forums within a problem-based inquiry classroom. The focus of inquiry during the year centered on two historical questions: What does it mean to be an American? What is America's place in the world? The participants in this…

A Design-Based Research Approach to Improving Professional Development and Teacher Knowledge: The Case of the Smithsonian Learning Lab

ERIC Educational Resources Information Center

Zinger, Doron; Naranjo, Ashley; Amador, Isabel; Gilbertson, Nicole; Warschauer, Mark

2017-01-01

Incorporating technology in classrooms to promote student learning is an ongoing instructional challenge. Teacher professional development (PD) is a central component of teacher education to support student use of technology and can improve student learning, but PD has had mixed results. In this study, researchers investigated a PD program…

The Burden of Responsibility: Elite Students' Understandings of Civic Participation in Singapore

ERIC Educational Resources Information Center

Sim, Jasmine B.-Y.

2012-01-01

Elder statesman Lee Kuan Yew maintains that a society ruled by elites is necessary to provide for high growth and social progress. Elitism conjures a class divide; an ongoing concern is a disconnection between elite and the citizens it has to represent. In the tradition of political socialization, and using the case study approach, this article…

Promoting the Development of a Supportive Learning Environment through Action Research from the "Middle Out"

ERIC Educational Resources Information Center

Hodgson, David; May, Steve; Marks-Maran, Diane

2008-01-01

This paper reports on a case study of a supportive learning environment initiative (SLEI) for students on health and social care undergraduate programmes in one English university. It involved the development of small scale support projects that are firmly grounded in the outcomes of prior research as well as the ongoing experience of students and…

Personal Smartphones in Primary School: Devices for a PLE?

ERIC Educational Resources Information Center

Honegger, Beat Döbeli; Neff, Christian

2011-01-01

This paper describes the goals and first results of an ongoing two year case study in a European primary school (5th primary class) where the teacher and all students were equipped with a personal smartphone. Students are allowed to use phone and internet services at no charge and to take home their smartphones after school. In this project the…

The New Landform's Here! We're Somebody Now!! The Role of Discursive Practices on Place Identity

ERIC Educational Resources Information Center

Petrzelka, Peggy

2004-01-01

On the border of western Iowa, a new landform--the "Loess Hills," is being created. While scientific discourse surrounding the landform has been ongoing for a century, "discovery" of the landform by local residents is a recent occurrence, stimulated by socioeconomic changes resulting from the "farm crisis." As this case study shows, the initial…

Women as the Aggressors in Intimate Partner Homicide in Houston, 1980s to 1990s

ERIC Educational Resources Information Center

Titterington, Victoria B.; Harper, Laura

2005-01-01

Objective: The purpose of this study was to inform the ongoing quest for efficacious treatment of domestically violent women by (a) describing their representation in cases of intimate partner homicide over the period of 1985-1999 in Houston, Texas, and (b) by utilizing a measure known as the spousal sex ratio of killing (SROK), determining…

Preservice Teachers' Conceptions about Computers: An Ongoing Search for Transformative Appropriations of Modern Technologies

ERIC Educational Resources Information Center

Katic, Elvira K.

2008-01-01

Due to the variety of text forms that are being created as a result of improving information technologies, understandings of literacy must be broadened to include a variety of meaning-making modes in order to include different social, cultural, and material contexts. The following case study examined the conceptions of technology held by two…

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

ERIC Educational Resources Information Center

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

2014-01-01

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

The Aftermath of the Port Arthur Incident: The Response by Project Hahn to Adolescent Needs.

ERIC Educational Resources Information Center

Adams, Allan; Sveen, Robert L.; Denholm, Carey J.

This paper provides background information about the Project Hahn adventure-based program and its ongoing involvement with the Port Arthur Recovery Group to assist 42 adolescents directly affected by the murders of 36 people by a lone gunman in Tasmania in 1996. Case studies relate personal, social, and community issues faced by these adolescents,…

Building Citywide Systems for Quality: A Guide and Case Studies for Afterschool Leaders

ERIC Educational Resources Information Center

Yohalem, Nicole; Devaney, Elizabeth; Smith, Charles; Wilson-Ahlstrom, Alicia

2012-01-01

A quality improvement system (QIS) is an intentional effort to raise the quality of afterschool programming in an ongoing, organized fashion. There are a number of reasons the QIS is gaining popularity. The main reasons community leaders are drawn to improving quality is that they know that 1) higher quality programs will mean better experiences…

Caught between the Ethnic Sides: Children Growing up in a Divided Post-War Community

ERIC Educational Resources Information Center

Ajdukovic, Dean; Biruski, Dinka Corkalo

2008-01-01

The war-related process of disintegration of a highly integrated and multi-ethnic community is described using a series of studies done in the city of Vukovar (Croatia) as a case example. After analyzing the key points of the community social breakdown, the three roots of ongoing ethnic division are explored: the feelings of being betrayed by…

Use of a novel saline/bipolar radiofrequency energy instrument as an adjunct for arresting ongoing solid organ surface and laceration bleeding in critically injured patients.

PubMed

Ball, Chad G; Campbell, Andre; Grondin, Sean C; Dixon, Elijah; DuBose, Joseph; McBeth, Paul B; Lall, Rohan

2016-09-01

Solid organ (liver, spleen and kidney) haemorrhage is often life threatening and can be difficult to stop in critically ill patients. Traditional techniques for arresting this ongoing bleeding include coagulation by high voltage cautery (Bovie), topical haemostatic application, and the delivery of ignited argon gas. The goal of this study was to evaluate the efficacy of a new energy device for arresting persistent solid organ haemorrhage. A novel instrument utilizing bipolar radiofrequency (RF) energy which acts to ignite/boil dripping saline from a simple hand piece was employed to arrest ongoing bleeding from solid organ injuries at 2 high volume, level 1 trauma centres. This instrument is extrapolated from experience within elective hepatic resections. Standard statistics were employed (p<0.05=significant). From January 2013 to January 2015, 36 severely injured patients (mean injury severity score=31; blunt mechanisms=32/36 (89%)) underwent use of this new saline/RF energy instrument to arrest ongoing haemorrhage from the liver (29), spleen (5) and kidney (2). Of these patients, 25 received instrument use during an initial laparotomy, while 11 patients underwent use following removal of sponges during a return laparotomy after an initial damage control procedure. Success in arresting ongoing haemorrhage was 97% (35/36) in these highly selected cases. The surgeons reported an 'ease of use' score of 4.9 out of 5. No postoperative complications (including delayed haemorrhage) were noted as a direct result of the energy instrument. This simple saline/RF energy instrument has the potential to arrest ongoing solid organ surface/capsular bleeding, as well as moderate haemorrhage associated with deep lacerations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intravenous subhypnotic propofol in central pain: a double-blind, placebo-controlled, crossover study.

PubMed

Canavero, S; Bonicalzi, V

2004-01-01

To validate IV subhypnotic propofol, a gamma-aminobutyric acid A (GABA-A) agonist, as a diagnostic test for central pain. The efficacy of systemic propofol (0.2 mg/kg IV bolus) was evaluated in a double-blind, placebo-controlled and crossover fashion on both spontaneous ongoing pain and allodynia in 44 patients with chronic central pain of both brain and cord origin. Propofol was significantly superior to the placebo (Intralipid, Kabi Pharmacia) in reducing the intensity of spontaneous ongoing pain for up to 1 hour after the injection: 24 of 44 patients (55%) receiving propofol showed a significant reduction in spontaneous pain, whereas only 6 patients showed this after the placebo. Propofol also significantly reduced the intensity of both mechanical and cold allodynia. In a few cases, only the evoked components were abolished but not the spontaneous pain. In general, the side effects were minimal and consisted mainly of transitory burning upon injection of both propofol and placebo and slight lightheadedness in a few cases. Systemic propofol induces analgesic effects on all studied components of central pain and highlights the key role of GABA modulation in central pain.

Understanding of evaluation capacity building in practice: a case study of a national medical education organization.

PubMed

Sarti, Aimee J; Sutherland, Stephanie; Landriault, Angele; DesRosier, Kirk; Brien, Susan; Cardinal, Pierre

2017-01-01

Evaluation capacity building (ECB) is a topic of great interest to many organizations as they face increasing demands for accountability and evidence-based practices. ECB is about building the knowledge, skills, and attitudes of organizational members, the sustainability of rigorous evaluative practices, and providing the resources and motivations to engage in ongoing evaluative work. There exists a solid foundation of theoretical research on ECB, however, understanding what ECB looks like in practice is relatively thin. Our purpose was to investigate what ECB looks like firsthand within a national medical educational organization. The context for this study was the Acute Critical Events Simulation (ACES) organization in Canada, which has successfully evolved into a national educational program, driven by physicians. We conducted an exploratory qualitative study to better understand and describe ECB in practice. In doing so, interviews were conducted with program leaders and instructors so as to gain a richer understanding of evaluative processes and practices. A total of 21 individuals participated in the semistructured interviews. Themes from our qualitative data analysis included the following: evaluation knowledge, skills, and attitudes, use of evaluation findings, shared evaluation beliefs and commitment, evaluation frameworks and processes, and resources dedicated to evaluation. The national ACES organization was a useful case study to explore ECB in practice. The ECB literature provided a solid foundation to understand the purpose and nuances of ECB. This study added to the paucity of studies focused on examining ECB in practice. The most important lesson learned was that the organization must have leadership who are intrinsically motivated to employ and use evaluation data to drive ongoing improvements within the organization. Leaders who are intrinsically motivated will employ risk taking when evaluation practices and processes may be somewhat unfamiliar. Creating and maintaining a culture of data use and ongoing inquiry have enabled national ACES to achieve a sustainable evaluation practice.

Exploiting Social Media for Army Operations: Syrian Civil War Use Case

DTIC Science & Technology

2014-07-01

language translation and intercultural communication . Local expertise goes beyond language and cultural gaps though, in that it provides a naturalistic way...security and counter-terrorism. The information exchanged in SM sites and the networks of people who interact with these online communities can provide...the networks of people who interact with these online communities can provide insights into ongoing events. For example, SM could provide ongoing

A Simple Case Study of a Grid Performance System

NASA Technical Reports Server (NTRS)

Aydt, Ruth; Gunter, Dan; Quesnel, Darcy; Smith, Warren; Taylor, Valerie; Biegel, Bryan (Technical Monitor)

2001-01-01

This document presents a simple case study of a Grid performance system based on the Grid Monitoring Architecture (GMA) being developed by the Grid Forum Performance Working Group. It describes how the various system components would interact for a very basic monitoring scenario, and is intended to introduce people to the terminology and concepts presented in greater detail in other Working Group documents. We believe that by focusing on the simple case first, working group members can familiarize themselves with terminology and concepts, and productively join in the ongoing discussions of the group. In addition, prototype implementations of this basic scenario can be built to explore the feasibility of the proposed architecture and to expose possible shortcomings. Once the simple case is understood and agreed upon, complexities can be added incrementally as warranted by cases not addressed in the most basic implementation described here. Following the basic performance monitoring scenario discussion, unresolved issues are introduced for future discussion.

The Effectiveness of University Programs, Services, and Practices in Retaining Student Veterans Transitioning to Higher Education: Voices of Student Veterans--A Case Study Analysis Approach at Two Universities

ERIC Educational Resources Information Center

Lopez, Eddie S.

2013-01-01

With an active war ongoing for nearly thirteen years, the nation has been experiencing hundreds of thousands of returning solders as a result of the military drawdown of troops from Iraq and Afghanistan. The intent of this research study was to understand the effectiveness of university programs, services, and practices in retaining student…

HIV/AIDS, beersellers and critical community health psychology in Cambodia: a case study.

PubMed

Lubek, Ian; Lee, Helen; Kros, Sarath; Wong, Mee Lian; Van Merode, Tiny; Liu, James; McCreanor, Tim; Idema, Roel; Campbell, Catherine

2014-01-01

This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

Maximizing Team Performance: The Critical Role of the Nurse Leader.

PubMed

Manges, Kirstin; Scott-Cawiezell, Jill; Ward, Marcia M

2017-01-01

Facilitating team development is challenging, yet critical for ongoing improvement across healthcare settings. The purpose of this exemplary case study is to examine the role of nurse leaders in facilitating the development of a high-performing Change Team in implementing a patient safety initiative (TeamSTEPPs) using the Tuckman Model of Group Development as a guiding framework. The case study is the synthesis of 2.5 years of critical access hospital key informant interviews (n = 50). Critical juncture points related to team development and key nurse leader actions are analyzed, suggesting that nurse leaders are essential to maximize clinical teams' performance. © 2016 Wiley Periodicals, Inc.

What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis.

PubMed

Groenewoud, Eva R; Cantineau, Astrid E P; Kollen, Boudewijn J; Macklon, Nick S; Cohlen, Ben J

2013-01-01

BACKGROUND Frozen-thawed embryo transfer (FET) enables surplus embryos derived from IVF or IVF-ICSI treatment to be stored and transferred at a later date. In recent years the number of FET cycles performed has increased due to transferring fewer embryos per transfer and improved laboratory techniques. Currently, there is little consensus on the most effective method of endometrium preparation prior to FET. METHODS Using both MEDLINE and EMBASE database a systematic review and meta-analysis of literature was performed. Case-series, case-control studies and articles in languages other than English, Dutch or Spanish were excluded. Those studies comparing clinical and ongoing pregnancy rates as well as live birth rates in (i) true natural cycle FET (NC-FET) versus modified NC-FET, (ii) NC-FET versus artificial cycle FET (AC-FET), (iii) AC-FET versus artificial with GnRH agonist cycle FET and (iv) NC-FET versus artificial with GnRH agonist cycle FET were included. Forest plots were constructed and relative risks or odds ratios were calculated. RESULTS A total of 43 publications were selected for critical appraisal and 20 articles were included in the final review. For all comparisons, no differences in the clinical pregnancy rate, ongoing pregnancy rate or live birth rate could be found. Based on information provided in the articles no conclusions could be drawn with regard to cancellation rates. CONCLUSIONS Based on the current literature it is not possible to identify one method of endometrium preparation in FET as being more effective than another. Therefore, all of the current methods of endometrial preparation appear to be equally successful in terms of ongoing pregnancy rate. However, in some comparisons predominantly retrospective studies were included leaving these comparisons subject to selection and publication bias. Also patients' preferences as well as cost-efficiency were not addressed in any of the included studies. Therefore, prospective randomized studies addressing these issues are needed.

Proceedings of the DARPA/AFWAL Review of Progress in Quantitative Nondestructive Evaluation, held 14-18 July 1980, Scripps Institution of Oceanography, La Jolla, California.

DTIC Science & Technology

1981-09-01

them presumably as plan proceeds. A work package description is in- an adjunct in ongoing failure studies . It would cluded for each block on the...Furthermore, the two limiting cases in the unit theoreti-al and laboratory results, lhe most amplitude study are the square wave and the ex - important reason is...of Denver Research Institute ...................................................... 87 STUDY PROGRAM FOR ENCAPSULATION MATERIALS INTERFACE FOR LOW-COST

Cooking and oxygen. An explosive recipe.

PubMed

Burns, H L; Ralston, D; Muller, M; Pegg, S

2001-02-01

Home oxygen therapy is commonly prescribed for the treatment of chronic obstructive pulmonary disease (COPD). The risks of smoking while using this therapy have been well described. To discuss the Royal Brisbane Hospital Burns Unit's experience and present case studies which illustrate the danger of alternative ignition sources while using home oxygen. The dangers of home oxygen therapy can be minimised by careful patient selection, education and ongoing monitoring.

Towards a Culturally Inclusive, Integrated, and Transdisciplinary Media Education Curriculum: Case Study of an International MA Program at the University of Lapland

ERIC Educational Resources Information Center

Rasi, Paivi; Ruokamo, Heli; Maasiita, Mari

2017-01-01

Internationalization presents both opportunities and challenges for higher education policies and curricula, as well as for teaching and learning methods. This article describes and discusses ongoing exploration and development of the planned curriculum of the MA in Media Education at the Faculty of Education at the University of Lapland, Finland,…

Examining Education, Media, and Dialogue under Occupation: The Case of Palestine and Israel. Critical Language and Literacy Studies

ERIC Educational Resources Information Center

Nasser, Ilham; Berlin, Lawrence N.; Wong, Shelley

2011-01-01

This book is an in-depth examination of education and media under occupation. The contributors to this volume engage dialogue to explore these domains and their roles and functioning under occupation while keeping an eye toward resolution, using the on-going conflict between Palestine and Israel as the focus. The uniqueness of this collection is…

The e-Learning Tool Voxopop and Its Benefits on Oral Skills: Activities for Final Year Students of German

ERIC Educational Resources Information Center

Stollhans, Sascha

2015-01-01

This case study demonstrates how Voxopop, a voice based e-learning tool, can be used to practise oal skills in the target language by presenting activities which have been developed for students of German at the University of Nottingham. The focus lies on an ongoing innovative project designed to improve final year students' oral skills by having…

Moving to the Rhythm of Africa: A Case Study of a Tertiary Educator's Understanding of Multicultural Dance in Teacher Education

ERIC Educational Resources Information Center

Joseph, Dawn

2013-01-01

Australia is proud of its rich and varied array of the Arts depicting a range of cultural diversity formed by ongoing migration. Although the complex issues of dance, culture and identity are interconnected, forming a multicultural society in Australia, dance education is a powerful platform to transmit and promote togetherness where understanding…

Transformation and Decolonisation of Mathematics Education for Sustainable Development: A Case Study of Its Learning Trend in Nigeria

ERIC Educational Resources Information Center

Salami, I. A.; Okeke, C. I. O.

2017-01-01

The quest to contextualise education in Africa has been on-going for a while and many countries have been making efforts towards it. During this time of educational review, conscious efforts should be made to identify problematic levels of some subjects that are dreadful to the learners to pave the way for curriculum re-design for context…

Developing a Process for Sustained Climate Assessment in the US Southwest Region

NASA Astrophysics Data System (ADS)

Duncan, B.; Rick, U. K.; McNie, E. C.

2017-12-01

Climate information needs often vary across states, regions, and sectors. While a national assessment provides foundational guidance about the science and impacts of climate change, there is also value in an ongoing climate assessment process with a more targeted regional geographic scale and sectoral focus. Such a process could provide timely and relevant climate information that is sometimes more detailed than what can be included in a national assessment, while also providing a foundation of knowledge and relationships that can be drawn on in larger-scale assessment processes. In the Sustained Climate Assessment in the Southwest project, researchers are investigating opportunities for sustained assessment in the US Southwest National Climate Assessment (NCA) region - an area that consists of Arizona, California, Colorado, Nevada, New Mexico, and Utah. This work is focused on identifying key elements of an ongoing climate assessment process for the region in collaboration with climate service providers and users, with the goal of connecting providers and users to increase access to information and understanding of climate impacts in decision-making contexts. It is focused on four key sectors that represent a range of existing capacity in the region: water, oceans and coasts, agriculture, and transportation. Recommendations for an ongoing assessment process may vary by sector - a reflection of the capacity and opportunity associated with each. In this presentation, we will share case studies of particularly useful or successful existing assessment activities and identify common characteristics across the case studies. We will also share preliminary recommendations for a regional sustained climate assessment process that draws on the broad existing capacity for climate assessment in the region and complements national-scale assessment processes.

Treatment planning capability assessment of a beam shaping assembly for accelerator-based BNCT.

PubMed

Herrera, M S; González, S J; Burlon, A A; Minsky, D M; Kreiner, A J

2011-12-01

Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) a theoretical study was performed to assess the treatment planning capability of different configurations of an optimized beam shaping assembly for such a facility. In particular this study aims at evaluating treatment plans for a clinical case of Glioblastoma. Copyright © 2011 Elsevier Ltd. All rights reserved.

How African American and Hispanic High School Students in an Urban Charter High School May Benefit from the Early College High School Model of Receiving College Credits?

ERIC Educational Resources Information Center

Pitchford-Nicholas, Gloria Jean

2015-01-01

The preparedness of students to enter college is an ongoing issue of national concern. The purpose of the study was to conduct a mixed method descriptive case study to answer the question: "How African-American and Hispanic High School Students in an Urban Charter High School may benefit from the Early College High School Model of receiving…

Environmental Factors Contributing to Wrongdoing in Medicine: A Criterion-Based Review of Studies and Cases

PubMed Central

DuBois, James M.; Carroll, Kelly; Gibb, Tyler; Kraus, Elena; Rubbelke, Timothy; Vasher, Meghan; Anderson, Emily E.

2012-01-01

In this paper we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. PMID:23226933

Improving Patient Safety with X-Ray and Anesthesia Machine Ventilator Synchronization: A Medical Device Interoperability Case Study

NASA Astrophysics Data System (ADS)

Arney, David; Goldman, Julian M.; Whitehead, Susan F.; Lee, Insup

When a x-ray image is needed during surgery, clinicians may stop the anesthesia machine ventilator while the exposure is made. If the ventilator is not restarted promptly, the patient may experience severe complications. This paper explores the interconnection of a ventilator and simulated x-ray into a prototype plug-and-play medical device system. This work assists ongoing interoperability framework development standards efforts to develop functional and non-functional requirements and illustrates the potential patient safety benefits of interoperable medical device systems by implementing a solution to a clinical use case requiring interoperability.

Biopiracy and the ethics of medical heritage: the case of India's traditional knowledge digital library'.

PubMed

Kidd, Ian James

2012-09-01

Medical humanities have a central role to play in combating biopiracy. Medical humanities scholars can articulate and communicate the complex structures of meaning and significance which human beings have invested in their ways of conceiving health and sickness. Such awareness of the moral significance of medical heritage is necessary to ongoing legal, political, and ethical debates regarding the status and protection of medical heritage. I use the Indian Traditional Knowledge Digital Library as a case study of the role of medical humanities in challenging biopiracy by deepening our sense of the moral value of medical heritage.

Musculoskeletal symptoms and job strain among nursing personnel: a study over a three year period.

PubMed Central

Josephson, M; Lagerström, M; Hagberg, M; Wigaeus Hjelm, E

1997-01-01

OBJECTIVES: To examine the variation of symptoms from the neck, shoulders, and back over a three year period among female nursing personnel and the relation between job strain and musculoskeletal symptoms. METHODS: At a county hospital the female nursing personnel answered a questionnaire at baseline and then once a year over a period of three years. There were 565, 553, 562, and 419 subjects who answered the questionnaire at the first, second, third, and fourth survey, respectively. Of the study group, 285 nursing personnel answered the questionnaire on four occasions. Ongoing symptoms of the neck, shoulders, and back were assessed by means of a 10 point (0-9) scale with the verbal end points "no symptoms" and "very intense symptoms." Cases were defined as nursing personnel reporting ongoing symptoms, score > 6, from at least one of the body regions. For assessments of job strain, a Swedish version of Karasek and Theorell's model was used. RESULTS: Of the 285 subjects, 13% were defined as cases at all four assessments, and 46% varied between cases and not cases during the study period. In the repeated cross sectional surveys the estimated rate ratio (RR) for being a case was between 1.1 and 1.5 when comparing the group with job strain and the group without job strain. For the combination of job strain and perceived high physical exertion the estimated RR was between 1.5 and 2.1. When the potential risk factors were assessed one, two, or three years before the assessment of symptoms the estimated RR for becoming a case was between 1.4 and 2.2 when comparing the group with job strain and the group without job strain. CONCLUSION: Almost half of the healthcare workers varied between being a case and not, over a three year period. The analysis indicated that job strain is a risk factor for musculoskeletal symptoms and that the risk is higher when it is combined with perceived high physical exertion. PMID:9423583

Using risk-tracing snowball approach to increase HIV case detection among high-risk populations in Cambodia: an intervention study.

PubMed

Chhim, Srean; Macom, John; Pav, Chettana; Nim, Nirada; Yun, Phearun; Seng, Sopheap; Chhim, Kolab; Tuot, Sovannary; Yi, Siyan

2017-10-18

Early HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection. This study was conducted from April 1 to September 30, 2016 at two NGO clinics in Phnom Penh, Cambodia. Respondent driven sampling method was adapted to develop RTSA to reach high-risk populations, including key populations and the general population who have social connections with key populations. Bivariate and multivariate logistic regression analyses were conducted. During the implementation period, 721 clients walked in for HIV testing (walk-in group), and all were invited to be seeds. Of the invited clients, 36.6% agreed to serve as seeds. Throughout the implementation, 6195 coupons were distributed to seeds or recruiters, and resulted in 1572 clients visiting the two clinics with coupons (RTSA group), for a coupon return rate of 25.3%. The rate of newly identified HIV cases among the RTSA group was significantly lower compared to that in walk-in group. However, the highest number of newly identified HIV cases was found during the implementation period, compared to both pre- and post-implementation period. Although statistically not significant, the mean CD4 count of newly identified HIV cases detected through RTSA was almost 200 cells/mm3 higher than that in the walk-in group. Although the rate of newly identified HIV cases among the RTSA group was lower than that in the walk-in group, the inclusion of RTSA in addition to the traditional walk-in method boosted new HIV case detection in the two participating clinics. A higher mean CD4 count for the RTSA group may reveal that RTSA may be able to detect HIV cases earlier than the traditional walk-in approach. Further research is needed to understand whether RTSA is a cost-effective intervention to prevent ongoing spread of the HIV among high-risk populations in Cambodia.

Commentary on "Trauma to the Psyche and Soma"

ERIC Educational Resources Information Center

Bryant, Richard A.; Hopwood, Sally

2006-01-01

This case report addresses assessment and treatment considerations for a patient suffering from posttraumatic stress disorder (PTSD) in the context of mild traumatic brain injury and ongoing pain. Management of this case is based on the application of evidence-based therapy, and of cognitive behaviour therapy, for PTSD reduction. Assessment and…

Leyla and Mahmood--Emotions in Social Science Education

ERIC Educational Resources Information Center

Blennow, Katarina

2018-01-01

Purpose: The paper explores what emotions do in social science education through two specific cases and discusses the relation between emotion and politicization in the subject education. Method/approach: The cases are selected from an on-going dissertation project that uses interviews, video and observations in examining how social science…

After-hour Versus Daytime Shifts in Non-Operating Room Anesthesia Environments: National Distribution of Case Volume, Patient Characteristics, and Procedures.

PubMed

Gabriel, Rodney A; Burton, Brittany N; Tsai, Mitchell H; Ehrenfeld, Jesse M; Dutton, Richard P; Urman, Richard D

2017-09-01

The objective of this study was to characterize workload during all hours of the day in the non-operating room anesthesia (NORA) environment and identify what type of patients and procedures were more likely to occur during after-hours. By investigating data from the National Anesthesia Clinical Outcomes Registry, we characterized the total number of ongoing NORA cases per hour of the day (0 - 23 h). Results were presented as the mean hour and standard error (SE). Multivariable logistic regression was applied to assess the association of various patient, procedural, and facility characteristics with time of day (after-hours = 17:01-06:59 local time versus day-time). Included in this analysis, there were a total of 4,948,634 cases performed on non-holiday weekdays. The mean hour for ongoing cases for gastroenterology, cardiac, radiology and "other" were: 10.8 with standard error (SE) of 0.002, 11.5 (SE of 0.005), 11.2 (SE of 0.005), and 10.8 (SE of 0.002), respectively. Pairwise differences between means for each NORA specialty were all statistically significant (p < 0.0001). During after-hour shifts (4.3% of cases), patients with higher American Society of Anesthesiologists physical status classification scores had increased odds for undergoing a NORA procedure, while procedures that were more physiologically complex had decreased odds. With the increasing demand for NORA services, it is prudent that we fully understand the challenges of providing safe and efficient anesthetic services particularly in locations where fewer resources are available.

Chikungunya from the Caribbean: the importance of appropriate laboratory tests to confirm the diagnosis.

PubMed

Magurano, Fabio; Zammarchi, Lorenzo; Baggieri, Melissa; Fortuna, Claudia; Farese, Alberto; Benedetti, Eleonora; Fiorentini, Cristiano; Rezza, Giovanni; Nicoletti, Loredana; Bartoloni, Alessandro

2015-04-01

Chikungunya virus (CHIKV) appeared for the first time in the Western Hemisphere--the French West Indies--in December of 2013. From there, the virus has spread to other Caribbean islands. Following the diagnosis of first autochthonous CHIKV cases in the Caribbean island of Saint Martin, a large outbreak is ongoing in the Americas. As of September 12, 2014, a total of 706,093 suspected and 9803 confirmed CHIKV cases have been reported in the Americas. This case study highlights the possibility of false-negative immunochromatographic CHIKV immunoglobulin M (IgM) tests and the need of confirmatory tests for suspected cases. Moreover, a greater spread of virus together with the presence of a mosquito vector (Aedes albopictus) enhances the risk of autochthonous transmission in Europe.

Learning to Read Across Time: Negotiations and Affiliations of a Reader, Grades 1-8. WCER Working Paper No. 2008-9

ERIC Educational Resources Information Center

Compton-Lilly, Catherine

2008-01-01

A case study of one child, Alicia, is used to explore how children's identities as readers are constructed across time as they move thorough school. Attention to time helps us attend to how students draw on ongoing, familial, and historical resources in ways that are both recursive and future-oriented as they construct themselves as readers across…

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

ERIC Educational Resources Information Center

Cammarata, Laurent; Haley, Corey

2018-01-01

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

UNAMID: A Case Study

DTIC Science & Technology

2009-03-09

hybrid approach (one of the "WAYS") and the available resources (the "MEANS") appropriate to resolve Darfur`s crisis (the “ENDS”)? Is UNAMID...Darfur crisis and the root of the conflict. The next three highlight the most important aspects with reference to political, tactical and strategic...considerations regarding the ongoing Darfur 2 crisis and the role of UNAMID in that complex environment. Finally, I will offer my response to the

Generalized Method for the User Evaluation of Purchased Information Services. Report Number Three; Monthly Report (October 1 to November 30, 1975).

ERIC Educational Resources Information Center

Hall, Homer J.

Four case histories were studied in an on-going project to develop a method for user selection of purchased scientific and technical information services. The issues involved were: (1) the value of computer search services to a small branch of a company technical library; (2) the special decision-making factors used for selecting items of very…

The marketing audit: a new perspective on library services and products.

PubMed Central

Wakeley, P J; Poole, C; Foster, E C

1988-01-01

A marketing audit enables a library to look at audiences, services, and products with a structured approach. The audit can be used to assess operations and to provide a framework for ongoing decision making, evaluation, and long-range planning. An approach to the audit process is presented and its application is demonstrated in a case study featuring the American Hospital Association Resource Center. PMID:3066426

Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges

PubMed Central

Grammens, Tine; Schirvel, Carole; Leenen, Sylvie; Shodu, Nathalie; Hutse, Veronik; Mendes da Costa, Elise; Sabbe, Martine

2017-01-01

We describe characteristics of an ongoing measles outbreak in Wallonia, Belgium, and difficulties in control measures implementation. As at 12 March 2017, 177 measles cases were notified, of which 50% were 15 years and older, 49% female. Atypical clinical presentation and severe complications, mainly among adults, in combination with late notification, low or unknown vaccination coverage of contacts, infected healthcare workers and increased workload due to contact tracing, are the main concerns for outbreak management. PMID:28488998

Update on chancroid: an important cause of genital ulcer disease.

PubMed

Langley, C

1996-08-01

Chancroid is a major cause of genital ulcer disease worldwide, and occurred at epidemic rates in the United States in the late 1980s. Though the recent epidemic in the U.S. appears to be waning, a number of areas continue to report significant numbers of cases. Chancroid is a particular concern, because, like other diseases that cause genital ulceration, it is associated with an increased risk for transmission or acquisition of human immunodeficiency virus (HIV). Recent studies have advanced the understanding of chancroid epidemiology, and new diagnostic tests may improve the ability to recognize and appropriately treat chancroid. Increased awareness of chancroid, with appropriate treatment for suspected lesions, along with public health efforts to implement prevention in high-risk populations, will be critical to prevent ongoing transmission of chancroid, and potentially ongoing transmission of HIV.

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

PubMed Central

O’Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich

2018-01-01

Objectives Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Design Systematic scoping review. Data sources MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Study selection Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. Results The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). Conclusions This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. PMID:29705769

Person-centred web-based support--development through a Swedish multi-case study.

PubMed

Josefsson, Ulrika; Berg, Marie; Koinberg, Ingalill; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt; Ranerup, Agneta; Lundin, Carina Sparud; Skärsäter, Ingela

2013-10-19

Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In summary, the main intention of the project outlined here is to contribute with both a synthesis of results on meta-level from four cases and a substantial contribution to the field person-centred care.

75 FR 82053 - Notification of a New Privacy Act System of Records, Effort to Outcomes-Case Management System...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... to facilitate on-going tracking and management of these services, leading to greater self-sufficiency... Congress. Comments Due Date: January 28, 2011. ADDRESSES: Interested persons are invited to submit comments... SYSTEM NAME: Efforts to Outcome Case Management Tracking System for DHAP-Ike. SYSTEM LOCATION: Baltimore...

IgV(H) and bcl6 somatic mutation analysis reveals the heterogeneity of cutaneous B-cell lymphoma, and indicates the presence of undisclosed local antigens.

PubMed

Franco, Renato; Camacho, Francisca I; Fernández-Vázquez, Amalia; Algara, Patrocinio; Rodríguez-Peralto, José L; De Rosa, Gaetano; Piris, Miguel A

2004-06-01

Our understanding of the ontology of B-cell lymphomas (BCL) has been improved by the study of mutational status of IgV(H) and bcl6 genes, but only a few cases of cutaneous BCL have been examined for this status. We analyzed IgV(H) and bcl6 somatic mutations in 10 cutaneous BCL, classified as follicular (three primary and one secondary), primary marginal zone (two cases), and diffuse large BCL (three primary and one secondary). We observed a lower rate (<2%) of IgV(H) mutation in all marginal zone lymphomas, and a preferential usage of V(H)2-70 (one primary follicular and two primary diffuse large BCL). Fewer than expected replacement mutations in framework regions (FR) were observed in three primary follicular lymphomas (FLs) and in all diffuse large BCL, indicating a negative antigen selection pressure. Ongoing mutations were observed in eight of 10 cases. Only two primary FLs and two diffuse large BCL showed bcl6 somatic mutation. These data support the heterogeneous nature of the different cutaneous BCL, and specifically the distinction between cutaneous follicular and marginal zone lymphomas. The biased usage of V(H)2-70, the low rate of replacement mutation in the FR, and the presence of ongoing mutation imply that local antigens could modulate the growth of primary cutaneous BCL.

The use of effective treatments: the case of an adolescent girl with anorexia nervosa in the context of a conversion disorder.

PubMed

Goldstein, Mandy; Madden, Sloane; Peters, Lorna

2013-04-01

The use of empirically supported treatment (EST) has been shown to enhance treatment outcome. The purpose of this case study was to suggest that ESTs further encourage effective reconceptualisation and the ongoing delivery of effective treatment, especially in the case of complex or atypical presentations or response to treatment. This report describes the case of an adolescent girl who underwent Maudsley family-based treatment for anorexia nervosa (AN) for a period of 12 months. Atypical response lead to an understanding of her presentation as representing a primary conversion disorder, within which AN symptoms were conceptualised as another somatic conversion of emotional distress. The report details her clinical presentation and management over the course of her illness. The case offers an important opportunity to explore the central role of the use of ESTs in guiding effective treatment delivery.

Listening to the user: A case study

NASA Technical Reports Server (NTRS)

Pryor, H. E.

1976-01-01

The managers of the NASA Scientific and Technical Information System consistently maintain that whatever scientific and technical information services and products are provided must be geared primarily to user needs and not simply system compatibility and convenience. A system evaluation study begun in 1973 and continued to the present is described. The thrust of this on-going examination is to regularly evaluate the usefulness of the present information system to those it is intended to serve, engineers and scientists working in their professional roles, and to identify areas and ways in which the system can be made more responsive to user needs. Techniques used have covered the range from personal, in-depth interviews to widely distributed questionnaires. The findings have been positive. Many refinements made to on-going programs and projects and new endeavors begun in direct response to stated user needs are discussed. In the main these needs are not unreasonable and thus can be responded to with cost effective system modifications.

Flow Diverters for Intracranial Aneurysms

PubMed Central

Alderazi, Yazan J.; Kass-Hout, Tareq; Prestigiacomo, Charles J.; Gandhi, Chirag D.

2014-01-01

Flow diverters (pipeline embolization device, Silk flow diverter, and Surpass flow diverter) have been developed to treat intracranial aneurysms. These endovascular devices are placed within the parent artery rather than the aneurysm sac. They take advantage of altering hemodynamics at the aneurysm/parent vessel interface, resulting in gradual thrombosis of the aneurysm occurring over time. Subsequent inflammatory response, healing, and endothelial growth shrink the aneurysm and reconstruct the parent artery lumen while preserving perforators and side branches in most cases. Flow diverters have already allowed treatment of previously untreatable wide neck and giant aneurysms. There are risks with flow diverters including in-stent thrombosis, perianeurysmal edema, distant and delayed hemorrhages, and perforator occlusions. Comparative efficacy and safety against other therapies are being studied in ongoing trials. Antiplatelet therapy is mandatory with flow diverters, which has highlighted the need for better evidence for monitoring and tailoring antiplatelet therapy. In this paper we review the devices, their uses, associated complications, evidence base, and ongoing studies. PMID:24967131

A social cybernetic analysis of simulation-based, remotely delivered medical skills training in an austere environment: developing a test bed for spaceflight medicine.

PubMed

Musson, David M; Doyle, Thomas E

2012-01-01

This paper describes analysis of medical skills training exercises that were conducted at an arctic research station. These were conducted as part of an ongoing effort to establish high fidelity medical simulation test bed capabilities in remote and extreme "space analogue" environments for the purpose studying medical care in spaceflight. The methodological orientation followed by the authors is that of "second order cybernetics," or the science of studying human systems where the observer is involved within the system in question. Analyses presented include the identification of three distinct phases of the training activity, and two distinct levels of work groups-- termed "first-order teams" and "second-order teams." Depending on the phase of activity, first-order and second-order teams are identified, each having it own unique structure, composition, communications, goals, and challenges. Several specific teams are highlighted as case examples. Limitations of this approach are discussed, as are potential benefits to ongoing and planned research activity in this area.

What's in a Label? Is Diagnosis the Start or the End of Clinical Reasoning?

PubMed

Ilgen, Jonathan S; Eva, Kevin W; Regehr, Glenn

2016-04-01

Diagnostic reasoning has received substantial attention in the literature, yet what we mean by "diagnosis" may vary. Diagnosis can align with assignment of a "label," where a constellation of signs, symptoms, and test results is unified into a solution at a single point in time. This "diagnostic labeling" conceptualization is embodied in our case-based learning curricula, published case reports, and research studies, all of which treat diagnostic accuracy as the primary outcome. However, this conceptualization may oversimplify the richly iterative and evolutionary nature of clinical reasoning in many settings. Diagnosis can also represent a process of guiding one's thoughts by "making meaning" from data that are intrinsically dynamic, experienced idiosyncratically, negotiated among team members, and rich with opportunities for exploration. Thus, there are two complementary constructions of diagnosis: 1) the correct solution resulting from a diagnostic reasoning process, and 2) a dynamic aid to an ongoing clinical reasoning process. This article discusses the importance of recognizing these two conceptualizations of "diagnosis," outlines the unintended consequences of emphasizing diagnostic labeling as the primary goal of clinical reasoning, and suggests how framing diagnosis as an ongoing process of meaning-making might change how we think about teaching and assessing clinical reasoning.

"No Longer from Pyramids to the Empire State Building": Why Both Western Civilization and World Civilization Should Be Part of the History Major--A Case Study

ERIC Educational Resources Information Center

Voeltz, Richard A.

2010-01-01

In 2005, Peter Stearns wrote, "The ongoing debate between partisans of Western civilization surveys and fans of world history continues with no signs of any abatement." No one can deny that the rise of world history has been a phenomenon in American higher education over the past 30 years. Most high school students now take some version…

"E-tivities from the Front Line": A Community of Inquiry Case Study Analysis of Educators' Blog Posts on the Topic of Designing and Delivering Online Learning

ERIC Educational Resources Information Center

Wright, Phemie

2014-01-01

Designing and implementing successful online learning has been at the forefront of institutional agendas since digital learning increased in market demand over the last decade. However there is still ongoing debate as to the "how" of this arduous task. The Community of Inquiry (CoI) is one learning design method that has seen potential…

Folate and Breast Cancer: Role of Intake, Blood Levels, and Metabolic Gene Polymorphisms

DTIC Science & Technology

2006-06-01

polymorphisms . The specific aims are 1) methodological training in the analysis of gene - gene and gene -environment interactions by studying folate...evaluation of folate intake, plasma folate, and metabolic gene polymorphisms in relation to breast cancer risk: Months 1-19. b. Prepare blood samples...isolated for the folate and gene polymorphism assays among the 184 cases and matched controls. The folate assays are on-going at this time and over

The contribution of case study design to supporting research on Clubhouse psychosocial rehabilitation.

PubMed

Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2015-10-01

Psychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated. The paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design. While the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.

Clinical Signs and Blood Test Results Among Humans Infected With Zoonotic Simian Foamy Virus: A Case-Control Study.

PubMed

Buseyne, Florence; Betsem, Edouard; Montange, Thomas; Njouom, Richard; Bilounga Ndongo, Chanceline; Hermine, Olivier; Gessain, Antoine

2018-06-05

A spillover of simian foamy virus (SFV) to humans, following bites from infected nonhuman primates (NHPs), is ongoing in exposed populations. These retroviruses establish persistent infections of unknown physiological consequences to the human host. We performed a case-control study to compare 24 Cameroonian hunters infected with gorilla SFV and 24 controls matched for age and ethnicity. A complete physical examination and blood test were performed for all participants. Logistic regression and Wilcoxon signed rank tests were used to compare cases and controls. The cases had significantly lower levels of hemoglobin than the controls (median, 12.7 vs 14.4 g/dL; P = .01). Basophil levels were also significantly lower in cases than controls, with no differences for other leukocyte subsets. Cases had significantly higher urea, creatinine, protein, creatinine phosphokinase, and lactate dehydrogenase levels and lower bilirubin levels than controls. Cases and controls had similar frequencies of general, cutaneous, gastrointestinal, neurological, and cardiorespiratory signs. The first case-control study of apparently healthy SFV-infected Cameroonian hunters showed the presence of hematological abnormalities. A thorough clinical and laboratory workup is now needed to establish the medical relevance of these observations because more than half of cases had mild or moderate anemia. NCT03225794.

The epidemiological scenario of feline sporotrichosis in Rio de Janeiro, State of Rio de Janeiro, Brazil.

PubMed

Pereira, Sandro Antonio; Gremião, Isabella Dib Ferreira; Kitada, Amanda Akemi Braga; Boechat, Jéssica Sepulveda; Viana, Paula Gonçalves; Schubach, Tânia Maria Pacheco

2014-01-01

Sporotrichosis is a mycosis affecting both humans and animals. Within the context of the ongoing sporotrichosis epidemic in the State of Rio de Janeiro, Brazil, sick cats plays an important role in the zoonotic transmission. The aim of this study was to update the number of feline cases diagnosed at the Fundação Oswaldo Cruz (2005-2011). The medical records of the cats followed were reviewed; the inclusion criterion was the isolation of Sporothrix spp. in culture. In total, 2,301 feline cases were identified. These results should alert sanitary authorities to the difficulties associated with sporotrichosis control.

Rules for success in environmental negotiations

USGS Publications Warehouse

Taylor, J.G.; Burkardt, N.; Lamb, B. L.

1995-01-01

Scientists at the Mid-Continent Ecological Science Center of the National Biological Service conducted a series of case studies of Federal Energy Regulatory Commission license consultations. The goal of these studies was to test hypotheses about factors that contribute to success in interagency negotiations. Based on their analysis of six case studies, the researchers constructed a list of ten "rules for success." Examples include: Analyze the incentives of each party to negotiate, paying special attention to parties who gain by not negotiating; Clarify the technical issues so that all agree and they coincide with resource management objectives; and Make sure the final agreement is feasible from both a physical and a policy perspective so that it can actually be implemented. These rules can be used to plan for negotiations and to diagnose ongoing negotiations.

Connecting Humans and Water: The Case for Coordinated Data Collection

NASA Astrophysics Data System (ADS)

Braden, J. B.; Brown, D. G.; Jolejole-Foreman, C.; Maidment, D. R.; Marquart-Pyatt, S. T.; Schneider, D. W.

2012-12-01

"Water problems" are fundamentally human problems -- aligning water quality and quantity with human aspirations. In the U.S., however, the few ongoing efforts to repeatedly observe humans in relation to water at large scale are disjointed both with each other and with observing systems for water quality and quantity. This presentation argues for the systematic, coordinated, and on-going collection of primary data on humans, spanning beliefs, perceptions, behaviors, and institutions, alongside the water environments in which they are embedded. Such an enterprise would advance not only water science and related policy and management decisions, but also generate basic insights into human cognition, decision making, and institutional development as they relate to the science of sustainability. In support of this argument, two types of original analyses are presented. First, two case studies using existing data sets illustrate methodological issues involved in integrating natural system data with social data at large scale: one concerns the influence of water quality conditions on personal efforts to conserve water and contribute financially to environmental protection; the other explores relationships between recreation behavior and water quality. Both case studies show how methodological differences between data programs seriously undercut the potential to draw inference about human responses to water quality while also illustrating the scientific potential that could be realized from linking human and scientific surveys of the water environment. Second, the results of a survey of water scientists concerning important scientific and policy questions around humans and water provide insight into data collection priorities for a coordinated program of observation.

Inflammation and white matter degeneration persist for years after a single traumatic brain injury.

PubMed

Johnson, Victoria E; Stewart, Janice E; Begbie, Finn D; Trojanowski, John Q; Smith, Douglas H; Stewart, William

2013-01-01

A single traumatic brain injury is associated with an increased risk of dementia and, in a proportion of patients surviving a year or more from injury, the development of hallmark Alzheimer's disease-like pathologies. However, the pathological processes linking traumatic brain injury and neurodegenerative disease remain poorly understood. Growing evidence supports a role for neuroinflammation in the development of Alzheimer's disease. In contrast, little is known about the neuroinflammatory response to brain injury and, in particular, its temporal dynamics and any potential role in neurodegeneration. Cases of traumatic brain injury with survivals ranging from 10 h to 47 years post injury (n = 52) and age-matched, uninjured control subjects (n = 44) were selected from the Glasgow Traumatic Brain Injury archive. From these, sections of the corpus callosum and adjacent parasaggital cortex were examined for microglial density and morphology, and for indices of white matter pathology and integrity. With survival of ≥3 months from injury, cases with traumatic brain injury frequently displayed extensive, densely packed, reactive microglia (CR3/43- and/or CD68-immunoreactive), a pathology not seen in control subjects or acutely injured cases. Of particular note, these reactive microglia were present in 28% of cases with survival of >1 year and up to 18 years post-trauma. In cases displaying this inflammatory pathology, evidence of ongoing white matter degradation could also be observed. Moreover, there was a 25% reduction in the corpus callosum thickness with survival >1 year post-injury. These data present striking evidence of persistent inflammation and ongoing white matter degeneration for many years after just a single traumatic brain injury in humans. Future studies to determine whether inflammation occurs in response to or, conversely, promotes white matter degeneration will be important. These findings may provide parallels for studying neurodegenerative disease, with traumatic brain injury patients serving as a model for longitudinal investigations, in particular with a view to identifying potential therapeutic interventions.

Analyzing the Interprofessional Working of a Home-Based Primary Care Team.

PubMed

Smith-Carrier, Tracy; Neysmith, Sheila

2014-09-01

Increasingly, interprofessional teams are responsible for providing integrated health care services. Effective teams, however, are not the result of chance but require careful planning and ongoing attention to team processes. Based on a case study involving interviews, participant observation, and a survey, we identified key attributes for effective interprofessional working (IPW) within a home-based primary care (HBPC) setting. Recognizing the importance of a theoretical model that reflects the multidimensional nature of team effectiveness research, we employed the integrated team effectiveness model to analyze our findings. The results indicated that a shared vision, common goals, respect, and trust among team members – as well as processes for ongoing communication, effective leadership, and mechanisms for conflict resolution – are vital in the development of a high-functioning IPW team. The ambiguity and uncertainty surrounding the context of service provision (clients' homes), as well the negotiation of external relationships in the HBPC field, require further investigation.

In Brief: Refugee numbers could increase due to climate change

NASA Astrophysics Data System (ADS)

Zielinski, Sarah

2007-05-01

Climate change could push the number of refugees globally to more than one billion by 2050, according to a new report from the British charity Christian Aid. Currently, there are about 155 million `internally displaced persons' worldwide, driven from their homes due to conflict, ethnic persecution, or natural disasters. The addition of climate change and growing population numbers could exacerbate these ongoing problems. In the report, Mali is presented as a case study where ongoing climate change is forcing farmers to find other ways to feed their families; one result is an increased number of people attempting to migrate to Europe. The report calls on rich nations to devote US$100 billion each year to help poor people adapt to changing weather patterns. The report, ``Human tide: the real migration crisis,'' is available at http://www.christian-aid.org.uk/indepth/705caweekreport/

Protecting genetic materials and genetic information: a case study of Guthrie Cards in Victoria.

PubMed

Lawson, C; Smith, R

2001-11-01

The authors are privileged to have been provided with correspondence about a dispute over the ongoing storage of genetic material (as Guthrie Cards) in Victoria. The correspondence details confusion over the roles of government and the private sector service provider in accounting for the storage, use and destruction of these stored genetic materials collected as part of a government public health program. The purpose in publishing this account is to highlight the present inadequacies in current practices and the ongoing potential for a crisis in the management of collected genetic materials through a lack of appropriate regulation, transparency and accountability. The article suggests measures to remedy some of the existing inadequacies in contractual arrangements and recommends that the government retain ownership and control of both the genetic materials and the derived information to ensure some accountability in the present legal environment.

Measles outbreak linked to European B3 outbreaks, Wales, United Kingdom, 2017.

PubMed

Currie, Jonny; Davies, Llion; McCarthy, Joanne; Perry, Malorie; Moore, Catherine; Cottrell, Simon; Bowley, Mererid; Williams, Chris; Shankar, Ananda Giri; Stiff, Rhianwen

2017-10-01

The United Kingdom achieved interrupted endemic measles transmission for 36 months in 2016. Despite this, ongoing challenges from sporadic measles cases typically imported from abroad remain. We summarise a B3 measles genotype outbreak in south-east Wales occurring between May and September 2017, linked with other European outbreaks, and lessons learnt. Seventeen confirmed cases and one probable case occurred principally in education and healthcare-settings. Six confirmed cases attended healthcare settings when infectious, without being isolated.

Black Box Thinking: Analysis of a Service Outsourcing Case in Insurance

ERIC Educational Resources Information Center

Witman, Paul D.; Njunge, Christopher

2016-01-01

Often, users of information systems (both automated and manual) must analyze those systems in a "black box" fashion, without being able to see the internals of how the system is supposed to work. In this case of business process outsourcing, an insurance industry customer encounters an ongoing stream of customer service issues, with both…

30 CFR 285.111 - When and how does MMS charge me processing fees on a case-by-case basis?

Code of Federal Regulations, 2011 CFR

2011-07-01

... application or request and it will have a unique processing cost, such as the preparation of an Environmental Assessment (EA) or Environmental Impact Statement (EIS). (1) Processing costs will include contract oversight... costs. (b) We will assess the ongoing processing fee for each individual application or request...

Assessing Outcome in Cognitive Behavior Therapy for Child Depression: An Illustrative Case Series

ERIC Educational Resources Information Center

Eckshtain, Dikla; Gaynor, Scott T.

2009-01-01

Recent meta-analytic data suggest a need for ongoing evaluation of treatments for youth depression. The present article calls attention to a number of issues relevant to the empirical evaluation of if and how cognitive behavior therapy for child depression works. A case series of 6 children and a primary caregiver received treatment--individual…

Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges.

PubMed

Grammens, Tine; Schirvel, Carole; Leenen, Sylvie; Shodu, Nathalie; Hutse, Veronik; Mendes da Costa, Elise; Sabbe, Martine

2017-04-27

We describe characteristics of an ongoing measles outbreak in Wallonia, Belgium, and difficulties in control measures implementation. As at 12 March 2017, 177 measles cases were notified, of which 50% were 15 years and older, 49% female. Atypical clinical presentation and severe complications, mainly among adults, in combination with late notification, low or unknown vaccination coverage of contacts, infected healthcare workers and increased workload due to contact tracing, are the main concerns for outbreak management. This article is copyright of The Authors, 2017.

Refugee Health: An Ongoing Commitment and Challenge

PubMed Central

Efird, Jimmy T.; Bith-Melander, Pollie

2018-01-01

Refugees represent a diverse group of displaced individuals with unique health issues and disease risks. The obstacles facing this population have their origins in war, violence, oppression, exploitation, and fear of persecution. Regardless of country of origin, a common bond exists, with refugees often confronting inadequate healthcare resources, xenophobia, discrimination, and a complex web of legal barriers in their new homelands. In many cases, the plight of refugees is multigenerational, manifesting as mental health issues, abuse, poverty, and family disruption. The health trajectory of refugees remains an ongoing commitment and challenge. PMID:29342831

Automatic updating of times remaining in surgical cases using bayesian analysis of historical case duration data and "instant messaging" updates from anesthesia providers.

PubMed

Dexter, Franklin; Epstein, Richard H; Lee, John D; Ledolter, Johannes

2009-03-01

Operating room (OR) whiteboards (status displays) communicate times remaining for ongoing cases to perioperative stakeholders (e.g., postanesthesia care unit, anesthesiologists, holding area, and control desks). Usually, scheduled end times are shown for each OR. However, these displays are inaccurate for predicting the time that remains in a case. Once a case scheduled for 2 h has been on-going for 1.5 h, the median time remaining is not 0.5 h but longer, and the amount longer differs among procedures. We derived the conditional Bayesian lower prediction bound of a case's duration, conditional on the minutes of elapsed OR time. Our derivations make use of the posterior predictive distribution of OR times following an exponential of a scaled Student t distribution that depends on the scheduled OR time and several parameters calculated from historical case duration data. The statistical method was implemented using Structured Query Language (SQL) running on the anesthesia information management system (AIMS) database server. In addition, AIMS workstations were sent instant messages displaying a pop-up dialog box asking for anesthesia providers' estimates for remaining times. The dialogs caused negotiated interruptions (i.e., the anesthesia provider could reply immediately, keep the dialog displayed, or defer response). There were no announcements, education, or efforts to promote buy-in. After a case had been in the OR longer than scheduled, the median remaining OR time for the case changes little over time (e.g., 35 min left at 2:30 pm and also at 3:00 pm while the case was still on-going). However, the remaining time differs substantially among surgeons and scheduled procedure(s) (16 min longer [10th percentile], 35 min [50th], and 86 min [90th]). We therefore implemented an automatic method to estimate the times remaining in cases. The system was operational for >119 of each day's 120 5-min intervals. When instant message dialogs appearing on AIMS workstations were used to elicit estimates of times remaining from anesthesia providers, acknowledgment was on average within 1.2 min (95% confidence interval [CI] 1.1-1.3 min). The 90th percentile of latencies was 6.5 min (CI: 4.4-7.0 min). For cases taking nearly as long as or longer than scheduled, each 1 min progression of OR time reduces the median time remaining in a case by <1 min. We implemented automated calculation of times remaining for every case at a 29 OR hospital.

Guillain-Barré syndrome risk among individuals infected with Zika virus: a multi-country assessment.

PubMed

Mier-Y-Teran-Romero, Luis; Delorey, Mark J; Sejvar, James J; Johansson, Michael A

2018-05-15

Countries with ongoing outbreaks of Zika virus have observed a notable rise in reported cases of Guillain-Barré syndrome (GBS), with mounting evidence of a causal link between Zika virus infection and the neurological syndrome. However, the risk of GBS following a Zika virus infection is not well characterized. In this work, we used data from 11 locations with publicly available data to estimate the risk of GBS following an infection with Zika virus, as well as the location-specific incidence of infection and the number of suspect GBS cases reported per infection. We built a mathematical inference framework utilizing data from 11 locations that had reported suspect Zika and GBS cases, two with completed outbreaks prior to 2015 (French Polynesia and Yap) and nine others in the Americas covering partial outbreaks and where transmission was ongoing as of early 2017. We estimated that 2.0 (95% credible interval 0.5-4.5) reported GBS cases may occur per 10,000 Zika virus infections. The frequency of reported suspect Zika cases varied substantially and was highly uncertain, with a mean of 0.11 (95% credible interval 0.01-0.24) suspect cases reported per infection. These estimates can help efforts to prepare for the GBS cases that may occur during Zika epidemics and highlight the need to better understand the relationship between infection and the reported incidence of clinical disease.

Tool for simplifying the complex interactions within resilient communities

NASA Astrophysics Data System (ADS)

Stwertka, C.; Albert, M. R.; White, K. D.

2016-12-01

In recent decades, scientists have observed and documented impacts from climate change that will impact multiple sectors, will be impacted by decisions from multiple sectors, and will change over time. This complex human-engineered system has a large number of moving, interacting parts, which are interdependent and evolve over time towards their purpose. Many of the existing resilience frameworks and vulnerability frameworks focus on interactions between the domains, but do not include the structure of the interactions. We present an engineering systems approach to investigate the structural elements that influence a community's ability to be resilient. In this presentation we will present and analyze four common methods for building community resilience, utilizing our common framework. For several existing case studies we examine the stress points in the system and identify the impacts on the outcomes from the case studies. In ongoing research we will apply our system tool to a new case in the field.

Filicidal abuse in the histories of 15 condemned murderers.

PubMed

Feldman, M; Mallouh, K; Lewis, D O

1986-01-01

This paper describes the family characteristics of 15 Death Row inmates. It documents extraordinary physical and/or sexual abuse in 13 cases. It describes murderous behaviors of parents toward children in 8 cases and documents ongoing hostility and neglect throughout childhood and adulthood. The paper explores the mechanisms by which such abuse may contribute to violent behaviors. It highlights the relevance of these findings to the outcome of sentencing in capital cases.

Model-Based Engineering Design for Trade Space Exploration throughout the Design Cycle

NASA Technical Reports Server (NTRS)

Lamassoure, Elisabeth S.; Wall, Stephen D.; Easter, Robert W.

2004-01-01

This paper presents ongoing work to standardize model-based system engineering as a complement to point design development in the conceptual design phase of deep space missions. It summarizes two first steps towards practical application of this capability within the framework of concurrent engineering design teams and their customers. The first step is standard generation of system sensitivities models as the output of concurrent engineering design sessions, representing the local trade space around a point design. A review of the chosen model development process, and the results of three case study examples, demonstrate that a simple update to the concurrent engineering design process can easily capture sensitivities to key requirements. It can serve as a valuable tool to analyze design drivers and uncover breakpoints in the design. The second step is development of rough-order- of-magnitude, broad-range-of-validity design models for rapid exploration of the trade space, before selection of a point design. At least one case study demonstrated the feasibility to generate such models in a concurrent engineering session. The experiment indicated that such a capability could yield valid system-level conclusions for a trade space composed of understood elements. Ongoing efforts are assessing the practicality of developing end-to-end system-level design models for use before even convening the first concurrent engineering session, starting with modeling an end-to-end Mars architecture.

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

Not Available

This publication is one in an ongoing series of case studies for "Laboratories for the 21st Century," a joint program of the U.S. Environmental Protection Agency and the U.S. Department of Energy Federal Energy Management Program. It is intended for all those who plan, design, and construct public and private-sector laboratory buildings. This study describes how the Nidus Center, a nonprofit incubator for life sciences and plan biotechnology established by Monsanto Company, employs daylighting, an energy-efficient mechanical system featuring energy recovery, and water conservation practices, among others, to save energy and money and help conserve natural resources.

Bringing Back a Healthy Buzz? Invertebrate Parasites and Reintroductions: A Case Study in Bumblebees.

PubMed

Brown, Mark J F; Sainsbury, Anthony W; Vaughan-Higgins, Rebecca J; Measures, Gavin H; Jones, Catherine M; Gammans, Nikki

2017-03-01

Reintroductions can play a key role in the conservation of endangered species. Parasites may impact reintroductions, both positively and negatively, but few case studies of how to manage parasites during reintroductions exist. Bumblebees are in decline at regional and global scales, and reintroductions can be used to re-establish extinct local populations. Here we report on how the risks associated with parasites are being managed in an ongoing reintroduction of the short-haired bumblebee, Bombus subterraneus, to the UK. Disease risk analysis was conducted and disease risk management plans constructed to design a capture-quarantine-release system that minimised the impacts on both the bumblebees and on their natural parasites. Given that bumblebee parasites are (i) generalists, (ii) geographically ubiquitous, and (iii) show evidence of local adaptation, the disease risk management plan was designed to limit the co-introduction of parasites from the source population in Sweden to the destination site in the UK. Results suggest that this process at best eliminated, or at least severely curtailed the co-introduction of parasites, and ongoing updates of the plan enabled minimization of impacts on natural host-parasite dynamics in the Swedish source population. This study suggests that methods designed for reintroductions of vertebrate species can be successfully applied to invertebrates. Future reintroductions of invertebrates where the parasite fauna is less well known should take advantage of next-generation barcoding and multiple survey years prior to the start of reintroductions, to develop comprehensive disease risk management plans.

The history of vaccinations in the light of the autism epidemic.

PubMed

Cave, Stephanie F

2008-01-01

Autism has been characterized as a behavioral disorder since it was first described by Leo Kanner in 1943. The number of autistic children has increased over the last decade. The incidence of autism was 1 in 10000 before the 1970s and has steadily increased to 1 in 150 in 2008 with a male:female predominance of 4:1. The cause of this epidemic has remained unknown, but several hypotheses have been studied. Many of these suggest an environmental trigger, such as the ethyl mercury contained in the preservative thimerosal, which has been used in vaccines since 1931. Other possible triggers associated with vaccinations are chemical toxins and live viruses. James has published studies suggesting a genetic predisposition in the families of autistic children, exposing them to a deficiency in glutathione and an inability to detoxify heavy metals. Vargas has shown autism to encompass ongoing inflammation in the brains of autistic children. The Hannah Poling vaccine decision was a landmark case. Poling's family was awarded funds for ongoing medical care of an autistic child who was found to have mitochondrial dysfunction exacerbated by vaccines that left her with autistic behavior and seizures. Several studies have emerged supporting the fact that a significant number of autistic children do have mitochondrial dysfunction. The impact that the Poling case will have on the ability of parents of autistic children to gain access to funds to enable them to properly care for their children remains to be seen.

Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature.

PubMed

O'Donovan, James; O'Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich; Winters, Niall

2018-04-28

Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Systematic scoping review. MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. © 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.

Impact of random and systematic recall errors and selection bias in case--control studies on mobile phone use and brain tumors in adolescents (CEFALO study).

PubMed

Aydin, Denis; Feychting, Maria; Schüz, Joachim; Andersen, Tina Veje; Poulsen, Aslak Harbo; Prochazka, Michaela; Klaeboe, Lars; Kuehni, Claudia E; Tynes, Tore; Röösli, Martin

2011-07-01

Whether the use of mobile phones is a risk factor for brain tumors in adolescents is currently being studied. Case--control studies investigating this possible relationship are prone to recall error and selection bias. We assessed the potential impact of random and systematic recall error and selection bias on odds ratios (ORs) by performing simulations based on real data from an ongoing case--control study of mobile phones and brain tumor risk in children and adolescents (CEFALO study). Simulations were conducted for two mobile phone exposure categories: regular and heavy use. Our choice of levels of recall error was guided by a validation study that compared objective network operator data with the self-reported amount of mobile phone use in CEFALO. In our validation study, cases overestimated their number of calls by 9% on average and controls by 34%. Cases also overestimated their duration of calls by 52% on average and controls by 163%. The participation rates in CEFALO were 83% for cases and 71% for controls. In a variety of scenarios, the combined impact of recall error and selection bias on the estimated ORs was complex. These simulations are useful for the interpretation of previous case-control studies on brain tumor and mobile phone use in adults as well as for the interpretation of future studies on adolescents. Copyright © 2011 Wiley-Liss, Inc.

A comparative study of the costliness of Manitoba hospitals.

PubMed

Shanahan, M; Loyd, M; Roos, N P; Brownell, M

1999-06-01

In light of ongoing discussions about health care policy, this study offered a method of calculating costs at Manitoba hospitals that compared relative costliness of inpatient care provided in each hospital. This methodology also allowed comparisons across types of hospitals-teaching, community, major rural, intermediate and small rural, as well as northern isolated facilities. Data used in this project include basic hospital information, both financial and statistical, for each of the Manitoba hospitals, hospital charge information by case from the State of Maryland, and hospital discharge abstract information for Manitoba. The data from Maryland were used to create relative cost weights (RCWs) for refined diagnostic related groups (RDRGs) and were subsequently adjusted for Manitoba length of stay. These case weights were then applied to cases in Manitoba hospitals, and several other adjustments were made for nontypical cases. This case mix system allows cost comparisons across hospitals. In general, hospital case mix costing demonstrated variability in hospital costliness, not only across types of hospitals but also within hospitals of the same type and size. Costs at the teaching hospitals were found to be considerably higher than the average, even after accounting for acuity and case mix.

Hypotonia

MedlinePlus

... will include a detailed examination of the nervous system and muscle function. In most cases, a neurologist (specialist in ... require ongoing care and support. Alternative Names Decreased muscle tone; Floppy infant ... Central nervous system and peripheral nervous system References Burnette WB. Hypotonic ( ...

A Prospective Study of Infectious Mononucleosis in College Students.

PubMed

Jason, Leonard A; Katz, Ben; Gleason, Kristen; McManimen, Stephanie; Sunnquist, Madison; Thorpe, Taylor

2017-01-01

The present study aims to prospectively investigate possible biological and psychological factors present in college students who will go on to develop chronic fatigue syndrome (CFS) following Infectious Mononucleosis (IM). Identification of risk factors predisposing patients towards developing CFS may help to understand the underlying mechanisms and ultimately prevent its occurrence. Our study is enrolling healthy college students over the age of 18. Enrollment began in March of 2013 and is ongoing. Biological and psychological data are collected when students are well (Stage 1), when they develop IM (Stage 2), and approximately 6 months after IM diagnosis (Stage 3). Two case studies demonstrate the progression of student symptomology across all three stages. The Case Studies presented illustrate the usefulness of a prospective research design that tracks healthy students, following their trajectory of IM illness to either a) full recovery or b) diagnosis with CFS.

A Prospective Study of Infectious Mononucleosis in College Students

PubMed Central

Jason, Leonard A.; Katz, Ben; Gleason, Kristen; McManimen, Stephanie; Sunnquist, Madison; Thorpe, Taylor

2017-01-01

Background The present study aims to prospectively investigate possible biological and psychological factors present in college students who will go on to develop chronic fatigue syndrome (CFS) following Infectious Mononucleosis (IM). Identification of risk factors predisposing patients towards developing CFS may help to understand the underlying mechanisms and ultimately prevent its occurrence. Our study is enrolling healthy college students over the age of 18. Enrollment began in March of 2013 and is ongoing. Methods Biological and psychological data are collected when students are well (Stage 1), when they develop IM (Stage 2), and approximately 6 months after IM diagnosis (Stage 3). Results Two case studies demonstrate the progression of student symptomology across all three stages. Conclusion The Case Studies presented illustrate the usefulness of a prospective research design that tracks healthy students, following their trajectory of IM illness to either a) full recovery or b) diagnosis with CFS. PMID:28717787

Life histories in occupational therapy clinical practice.

PubMed

Frank, G

1996-04-01

This article defines and compares several narrative methods used to describe and interpret patients' lives. The biographical methods presented are case histories, life-charts, life histories, life stories, assisted autobiography, hermeneutic case reconstruction, therapeutic employment, volitional narratives, and occupational storytelling and story making. Emphasis is placed the clinician as a collaborator and interpreter of the patient's life through ongoing interactions and dialogue.

[Reduced number of fatal and life-threatening reactions to food. Reporting by the medical profession has resulted in effective measures].

PubMed

Foucard, Tony; Yman, Ingrid Malmheden; Nordvall, Lennart

The results from the Swedish system for reporting severe and fatal reactions caused by food for the period 1993-96 were published in Lakartidningen in 1997. We now report the results for the period 1997-2003. The number of fatal cases has decreased from 1.75 to 0.86 per year and the number of life-threatening cases from 3 to I per year. The most gratifying result was the large decrease in severe reactions caused by soy, from 3 deaths and 6 life-threatening cases during the first 4-year period to just one life-threatening case during the following 7-year period. This reduction is probably largely due to an increased awareness of identified risk persons, but also to a reduced use of soy protein. The ongoing study illustrates the usefulness of a national system for reporting severe and fatal reactions caused by food.

A study of science leadership and science standards in exemplary standards-based science programs

NASA Astrophysics Data System (ADS)

Carpenter, Wendy Renae

The purpose for conducting this qualitative study was to explore best practices of exemplary standards-based science programs and instructional leadership practices in a charter high school and in a traditional high school. The focus of this study included how twelve participants aligned practices to National Science Education Standards to describe their science programs and science instructional practices. This study used a multi-site case study qualitative design. Data were obtained through a review of literature, interviews, observations, review of educational documents, and researcher's notes collected in a field log. The methodology used was a multi-site case study because of the potential, through cross analysis, for providing greater explanation of the findings in the study (Merriam, 1988). This study discovered six characteristics about the two high school's science programs that enhance the literature found in the National Science Education Standards; (a) Culture of expectations for learning-In exemplary science programs teachers are familiar with a wide range of curricula. They have the ability to examine critically and select activities to use with their students to promote the understanding of science; (b) Culture of varied experiences-In exemplary science programs students are provided different paths to learning, which help students, take in information and make sense of concepts and skills that are set forth by the standards; (c) Culture of continuous feedback-In exemplary science programs teachers and students work together to engage students in ongoing assessments of their work and that of others as prescribed in the standards; (d) Culture of Observations-In exemplary science programs students, teachers, and principals reflect on classroom instructional practices; teachers receive ongoing evaluations about their teaching and apply feedback towards improving practices as outlined in the standards; (e) Culture of continuous learning-In exemplary science programs teachers value continuous personal development, teachers are provided on-going science professional development opportunities to improve instructional practices, teachers reflect and share professional practices, and teachers establish professional learning communities within their classrooms; and (f) Culture of shared leadership-In exemplary science programs instructional leadership purposes and values are consistently shared among all stakeholders which are outlined in the standards. These results are potentially useful for understanding exemplary standards-based science programs and science instructional leadership practices as a model for science programs trying to improve science education so that all students can have a true scientific learning experience.

The Ongoing 2011 Eruption of Cordón Caulle (Southern Andes) and its Related Hazards

NASA Astrophysics Data System (ADS)

Amigo, A.; Lara, L. E.; Silva, C.; Orozco, G.; Bertin, D.

2011-12-01

On June 4, 2011, at 18:45 UTC, Cordón Caulle volcano (Southern Andes, 40.52S, 72.14W) erupted explosively after 51 years of quiescence. The last eruption occurred in 1960 and was triggered by the great Mw 9.5 Chile earthquake. The ongoing eruption started after 2 months of increased shallow seismicity as recorded by OVDAS (the volcano observatory at Sernageomin). This close monitoring effort allowed a timely eruption forecast with at least 3 hours of warning, which facilitated the crisis response. In addition to this successful performance, for the first time in Chile volcanic hazards were assessed in advance supporting the emergency management. In particular, tephra dispersal was daily forecasted using the ASHFALL advection-diffusion model and potential lahars and PDC impact zones were delineated according to numerical approaches. The first eruptive stage lasted 27 hours. It was characterized by ca. 15-km strong Plinian-like column, associated with the emission of 0.2 - 0.4 km3 of magma (DRE). Tephra fallout mostly occurred in Chile and Argentina, although fine particles and aerosols circumnavigated the globe twice, causing disruptions on air navigation across the Southern Hemisphere. The second ongoing eruptive stage has been characterized by persistent weak plumes and lava emission at effusion rates in the range of 20 and 60 m3/s, which total volume is estimated <0.20 km3 (at the end of July 2011). Eruptive products have virtually the same bulk composition as those of the historical 1921 and 1960 eruptions, corresponding to phenocryst-poor rhyodacites (67 - 70% SiO2) for what a pre-eruptive temperature of ca. 920C could be inferred. In contrast to the previous eruptive cycles, the ongoing eruption has not evolved (at the time of writing) as a fissure eruption although the vent is atop of fault scarp that borders the Pleistocene-Holocene extensional graben of the Cordón Caulle. This episode is a good case of successful eruption forecast and hazards assessment but it is also an important case-study of silicic eruptions in an arc segment where mostly mafic magmas have been erupted during the Holocene.

Therapeutic assessment with an adolescent: choosing connections over substances.

PubMed

Austin, Cynthia A; Krumholz, Lauren S; Tharinger, Deborah J

2012-01-01

This case study provides an in-depth example of a comprehensive therapeutic assessment with an adolescent (TA-A) and his parents. The TA-A addressed parental concerns about their son's drug experimentation as well as the adolescent's own private questions about his distinctiveness from others, all set against a backdrop of ongoing parental conflict and poor communication. The TA-A process and how it is specifically tailored to balance the needs of adolescents and their parents is discussed. Subsequently, each step of TA-A is illustrated through the case study. Research findings at the conclusion of the assessment and at follow-up indicated significant decreases in internalizing symptomology and school problems, increases in self-esteem and self-reliance, and improved family functioning as reported by the adolescent. At follow-up, the father spoke of developing a more assertive parenting approach and successful follow-through on recommendations. This case study provides a template for clinicians interested in conducting TA-A.

The underutilization of street markets as a source of food security indicators in famine early warning systems: a case study of Ethiopia.

PubMed

Companion, Michèle

2008-09-01

Famine Early Warning Systems (EWS) are reliant on data aggregated from multiple sources. Consequently, they are often insensitive to localized changes in food security status, leading to delayed response or interventions. While price and infrastructural data are often gathered, this case study suggests that local street markets and vendor knowledge are underutilized. Few efforts have been made to monitor systematically the street markets as an indicator of local stressors. Findings from Ethiopia show that knowledge generated by expanding food security indicators in this sector can be used in combination with EWS to facilitate earlier intervention in, or to monitor more effectively, on-going humanitarian crises. Indicators developed from this study are accurate, cost effective, and sensitive to local climatic and food stressors.

Ongoing mumps outbreak in Israel, January to August 2017

PubMed Central

Indenbaum, Viki; Hübschen, Judith M; Stein-Zamir, Chen; Mendelson, Ella; Sofer, Danit; Hindiyeh, Musa; Anis, Emilia; Abramson, Nitza; Haas, Eric J; Yosef, Yochi; Dukhan, Larisa; Singer, Shepherd Roee

2017-01-01

In Israel, 262 mumps cases were registered between 1 January and 28 August 2017 despite a vaccine coverage of ≥ 96%. The majority (56.5%) of cases were adolescents and young adults between 10 and 24 years of age. Nearly twice as many cases were reported in males than in females. Sequence information identified genotype G and suggested specific transmission chains in different religious communities, with the Muslim population in Jerusalem being most severely affected. PMID:28877843

The Biomechanics of Cranial Forces During Figure Skating Spinning Elements.

PubMed

Wang, David H; Kostyun, Regina O; Solomito, Matthew J

2015-03-01

Several facets of figure skating, such as the forces associated with jumping and landing, have been evaluated, but a comprehensive biomechanical understanding of the cranial forces associated with spinning has yet to be explored. The purpose of this case study was to quantify the cranial rotational acceleration forces generated during spinning elements. This case report was an observational, biomechanical analysis of a healthy, senior-level, female figure skating athlete who is part of an on-going study. A triaxial accelerometer recorded the gravitational forces (G) during seven different spinning elements. Our results found that the layback spin generated significant cranial force and these forces were greater than any of the other spin elements recorded. These forces led to physical findings of ruptured capillaries, dizziness, and headaches in our participant.

Patterns and correlates of co-occurrence among multiple types of child maltreatment

PubMed Central

Kim, Kihyun; Mennen, Ferol E.; Trickett, Penelope K.

2017-01-01

This study examined the patterns and correlates of the types of maltreatment experienced by adolescents aged 9–12, participating in an ongoing longitudinal study on the impact of neglect on children’s development. Using case record abstraction, the study compared the child protection classification and findings from the case record abstraction with regard to the rates of four types of maltreatment (i.e. physical, sexual, emotional abuse and neglect) as well as co-occurrence across multiple types of maltreatment. Next, the study examined the frequently observed patterns of child maltreatment. Finally, the study investigated whether aspects of caretaker functioning and the detailed incident characteristics in the cases of neglect differed by the number of different types of maltreatment the children experienced. Results showed significant discrepancies between the Child Protective Service classification and case record abstraction. Child Protective Service classification considerably underestimated the rate of co-occurrence across multiple types of maltreatment. Neglect accompanied by physical and emotional abuse was the most common form. Some of the caretaker functioning variables distinguished the number of types of maltreatment. Based on the findings, future-research directions and practice implication were discussed. PMID:29225485

Comparison of the clinical outcomes between fresh blastocyst and vitrified-thawed blastocyst transfer.

PubMed

Ku, Pei-Yun; Lee, Robert Kuo-Kuang; Lin, Shyr-Yeu; Lin, Ming-Huei; Hwu, Yuh-Ming

2012-12-01

To compare the clinical outcomes between fresh and vitrified-thawed day 5 blastocyst transfers. Retrospective case control study. Tertiary referral center. Patients 38 years of age or less who underwent IVF/ICSI cycles with fresh or frozen-thawed blastocysts transferred from June 1, 2009 to November 30, 2011 Vitrification and thawing of day 5 blastocysts using the Cryotop method. (Kitazato BioPharma Co., Ltd., Fuji city, Shizuoka, Japan) Clinical pregnancy rate, implantation rate, ongoing pregnancy rate, and multiple pregnancy rates. Of the 118 cycles in the fresh transfer group, 234 blastocysts were transferred. The clinical pregnancy rate was 66.1 % and implantation rate was 50.9 %. The ongoing pregnancy rate was 56.8 % and the rates for singleton and twin pregnancies were 53.7 % and 44.8 %. Of the 59 cycles in the vitrified-thawed group, 111 blastocysts were transferred. The clinical pregnancy rate was 59.3 % and implantation rate was 43.2 %. The ongoing pregnancy rate was 47.5 % and the rates for singleton and twin pregnancies were 60.7 % and 39.3 %. The clinical pregnancy rate, implantation rate and ongoing pregnancy rate did not differ significantly between the two groups. The implantation rates were not significantly different between the fresh and the vitrified-thawed groups. Thus, single embryo transfer may be considered in fresh cycles to decrease multiple pregnancy rates. The surplus embryos should be vitrified for the frozen embryo transfer to improve the cumulative pregnancy rate.

Case-control study on uveal melanoma (RIFA): rational and design

PubMed Central

Schmidt-Pokrzywniak, Andrea; Jöckel, Karl-Heinz; Bornfeld, Norbert; Stang, Andreas

2004-01-01

Background Although a rare disease, uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence rate of up to 1.0 per 100,000 persons per year in Europe. Only a few consistent risk factors have been identified for this disease. We present the study design of an ongoing incident case-control study on uveal melanoma (acronym: RIFA study) that focuses on radiofrequency radiation as transmitted by radio sets and wireless telephones, occupational risk factors, phenotypical characteristics, and UV radiation. Methods/Design We conduct a case-control study to identify the role of different exposures in the development of uveal melanoma. The cases of uveal melanoma were identified at the Division of Ophthalmology, University of Essen, a referral centre for tumours of the eye. We recruit three control groups: population controls, controls sampled from those ophthalmologists who referred cases to the Division of Ophthalmology, University of Duisburg-Essen, and sibling controls. For each case the controls are matched on sex and age (five year groups), except for sibling controls. The data are collected from the study participants by short self-administered questionnaire and by telephone interview. During and at the end of the field phase, the data are quality-checked. To estimate the effect of exposures on uveal melanoma risk, we will use conditional logistic regression that accounts for the matching factors and allows to control for potential confounding. PMID:15318944

Crew coordination concepts: Continental Airlines CRM training

NASA Technical Reports Server (NTRS)

Christian, Darryl; Morgan, Alice

1987-01-01

The outline of the crew coordination concepts at Continental airlines is: (1) Present relevant theory: Contained in a pre-work package and in lecture/discussion form during the work course, (2) Discuss case examples: Contained in the pre-work for study and use during the course; and (3) Simulate practice problems: Introduced during the course as the beginning of an ongoing process. These concepts which are designed to address the problem pilots have in understanding the interaction between situations and their own theories of practice are briefly discussed.

Sportsman hernia; the review of current diagnosis and treatment modalities.

PubMed

Paksoy, Melih; Sekmen, Ümit

2016-01-01

Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature.

High-Frequency Percussive Ventilation in Patients with Inhalation Injury

DTIC Science & Technology

1989-01-01

inhalation injury. 21). High-frequency ventilation has been shown to be ef- METHODS fective in several clinical and laboratory trials ( 1 -3, 6-8, 17). The...Bear II or Seimens 900C ventilator. In each case the ability to 1 4 Male 43.5 18 Pneumonia maintain normocapnia or an arterial 0, saturation of greater...42.5 1 Group II consists cf the first ten patients who were enrolled 4 1 Female 59 11 Pneumonia in an ongoing prospective study of the use of high

Ductal Carcinoma In Situ: The Whole Truth.

PubMed

Parikh, Ujas; Chhor, Chloe M; Mercado, Cecilia L

2018-02-01

Ductal carcinoma in situ (DCIS) is a noninvasive malignant breast disease traditionally described as a precursor lesion to invasive breast cancer. With screening mammography, DCIS now accounts for approximately 20% of newly diagnosed cancer cases. DCIS is not well understood because of its heterogeneous nature. Studies have aimed to assess prognostic factors to characterize its risk of invasive potential; however, there still remains a lack of uniformity in workup and treatment. We summarize current knowledge of DCIS and the ongoing controversies.

Imaging in conjunction with physical therapy in management of a patient with history of thoracic tumour

PubMed Central

Rendeiro, Daniel G.; Deyle, Gail D.; Boissonnault, William G.

2015-01-01

Background: Physical therapy care for musculoskeletal conditions includes an ongoing process that systematically considers and prioritises diagnostic hypotheses. These diagnostic hypotheses include those that are typical for common musculoskeletal conditions, and must also include more rare conditions that would require care outside the scope of practice of the physical therapist. When additional screening is required, physical therapists collaborate with other providers or directly order the appropriate tests to rule out suspected pathology. Case Description: This article illustrates the use of musculoskeletal imaging ordered by a physical therapist to guide ongoing management of a patient with back pain and a history of cancer. Outcomes: The patient successfully returned to moderate-intensity sport activities after a course of physical therapy. Discussion: This case provides an example of how clinical diagnostic reasoning combined with clinical privileges to order musculoskeletal imaging can facilitate diagnostic accuracy in a timely and cost-efficient manner. PMID:26309382

Emergence of new-onset psychotic disorder following recovery from LGI1 antibody-associated limbic encephalitis

PubMed Central

Moran, Nick

2017-01-01

Neuronal autoantibodies targeting cell surface antigens have been described in association with autoimmune encephalitides which frequently feature psychosis and other psychiatric disturbances alongside neurological signs and symptoms. Little has been written however about the long-term psychiatric status of individuals following recovery from the acute phase of autoimmune encephalitis, despite case series and anecdotal evidence suggesting this may be a cause of considerable disability. Here, we describe a man aged 58 years with no psychiatric history who developed a severe and acute psychotic disorder following resolution of a protracted course of limbic encephalitis associated with antibodies to leucine-rich glioma inactivated 1 protein. No indications of a gross ongoing inflammatory or encephalopathic process were present at presentation of his psychosis. Possible aetiologies of his acute psychosis are discussed. This case highlights the importance of ongoing psychiatric follow-up of patients following an episode of autoimmune encephalitis. PMID:28363946

The role of digital data entry in participatory environmental monitoring.

PubMed

Brammer, Jeremy R; Brunet, Nicolas D; Burton, A Cole; Cuerrier, Alain; Danielsen, Finn; Dewan, Kanwaljeet; Herrmann, Thora Martina; Jackson, Micha V; Kennett, Rod; Larocque, Guillaume; Mulrennan, Monica; Pratihast, Arun Kumar; Saint-Arnaud, Marie; Scott, Colin; Humphries, Murray M

2016-12-01

Many argue that monitoring conducted exclusively by scientists is insufficient to address ongoing environmental challenges. One solution entails the use of mobile digital devices in participatory monitoring (PM) programs. But how digital data entry affects programs with varying levels of stakeholder participation, from nonscientists collecting field data to nonscientists administering every step of a monitoring program, remains unclear. We reviewed the successes, in terms of management interventions and sustainability, of 107 monitoring programs described in the literature (hereafter programs) and compared these with case studies from our PM experiences in Australia, Canada, Ethiopia, Ghana, Greenland, and Vietnam (hereafter cases). Our literature review showed that participatory programs were less likely to use digital devices, and 2 of our 3 more participatory cases were also slow to adopt digital data entry. Programs that were participatory and used digital devices were more likely to report management actions, which was consistent with cases in Ethiopia, Greenland, and Australia. Programs engaging volunteers were more frequently reported as ongoing, but those involving digital data entry were less often sustained when data collectors were volunteers. For the Vietnamese and Canadian cases, sustainability was undermined by a mismatch in stakeholder objectives. In the Ghanaian case, complex field protocols diminished monitoring sustainability. Innovative technologies attract interest, but the foundation of effective participatory adaptive monitoring depends more on collaboratively defined questions, objectives, conceptual models, and monitoring approaches. When this foundation is built through effective partnerships, digital data entry can enable the collection of more data of higher quality. Without this foundation, or when implemented ineffectively or unnecessarily, digital data entry can be an additional expense that distracts from core monitoring objectives and undermines project sustainability. The appropriate role of digital data entry in PM likely depends more on the context in which it is used and less on the technology itself. © 2016 Society for Conservation Biology.

Person-centred web-based support - development through a Swedish multi-case study

PubMed Central

2013-01-01

Background Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons’ needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. Methods/Design The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. Discussion To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people’s experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In summary, the main intention of the project outlined here is to contribute with both a synthesis of results on meta-level from four cases and a substantial contribution to the field person-centred care. PMID:24139057

Legal liability for Agent Orange-related illnesses: a reassessment of the 2005 VAVA case and prospects for new litigation.

PubMed

Klickermann, Felix

2016-01-01

Attempts through the US courts to hold the corporations responsible for the production of dioxin-contaminated herbicides used by the US military in the 1960s and early 1970s liable for their ongoing health consequences have failed. This article scrutinizes the most recent judgement - that of the United States District Court for the Eastern District of New York handed down in 2005 following a lawsuit brought by the Vietnam Association of Victims of Agent Orange/dioxin (VAVA). It is argued that despite this judgement there is the potential to bring a further legal case, with some prospect of success, on the basis of: (i) debatable legal judgements in the 2005 decision; (ii) new scientific evidence on the health effects of exposure to Agent Orange; and (iii) cases brought in other jurisdictions. The article concludes by noting the underfunding of ongoing remediation efforts, especially for the provision of assistance to affected individuals, and argues that it is desirable to oblige the producers of the herbicides to contribute financially to these efforts.

Case-control study of severe life threatening asthma (SLTA) in adults: demographics, health care, and management of the acute attack

PubMed Central

Kolbe, J; Fergusson, W; Vamos, M; Garrett, J

2000-01-01

BACKGROUND—Severe life threatening asthma (SLTA) is important in its own right and as a proxy for asthma death. In order to target hospital based intervention strategies to those most likely to benefit, risk factors for SLTA among those admitted to hospital need to be identified. A case-control study was undertaken to determine whether, in comparison with patients admitted to hospital with acute asthma, those with SLTA have different sociodemographic and clinical characteristics, evidence of inadequate ongoing medical care, barriers to health care, or deficiencies in management of the acute attack.
METHODS—Seventy seven patients with SLTA were admitted to an intensive care unit (pH 7.17 (0.15), PaCO2 10.7 (5.0) kPa) and 239 matched controls (by date of index attack) with acute asthma were admitted to general medical wards. A questionnaire was administered 24-48 hours after admission.
RESULTS—The risk of SLTA in comparison with other patients admitted with acute asthma increased with age (odds ratio (OR) 1.04/year, 95% CI 1.01 to 1.07) and was less for women (OR 0.36, 95% CI 0.20to 0.68). These variables were controlled for in all subsequent analyses. There were no differences in other sociodemographic features. Cases were more likely to have experienced a previous SLTA (OR 2.04, 95% CI 1.20 to 3.45) and to have had a hospital admission in the last year (OR 1.86, 95% CI 1.09 to 3.18). There were no differences between cases and controls in terms of indicators of quality of ongoing asthma specific medical care, nor was there evidence of disproportionate barriers to health care. During the index attack cases had more severe asthma at the time of presentation, were less likely to have presented to general practitioners, and were more likely to have called an ambulance or presented to an emergency department. In terms of pharmacological management, those with SLTA were more likely to have been using oral theophylline (OR 2.14, 95% CI 1.35 to 3.68) and less likely to have been using inhaled corticosteroids in the two weeks before the index attack (OR 0.69, 95% CI 0.47 to 0.99). While there was no difference in self-management knowledge or behaviour scores, those with SLTA were more likely to have inappropriately used oral corticosteroids during the acute attack (OR 2.09, 95% CI 1.02 to 4.47).
CONCLUSIONS—In comparison with those admitted to hospital with acute severe asthma, patients with SLTA were indistinguishable on sociodemographic criteria (apart from male predominance), were more likely to have had a previous SLTA or hospital admission in the previous year, had similar quality ongoing asthma care, had no evidence of increased physical, economic or other barriers to health care, but had demonstrable deficiencies in the management of the acute index attack. Educational interventions, while not losing sight of the need for good quality ongoing care, should focus on providing individual patients with better advice on self-management of acute exacerbations.

 PMID:11083885

Lessons for Control of Heroin-Associated Anthrax in Europe from 2009–2010 Outbreak Case Studies, London, UK

PubMed Central

Abbara, Aula; Brooks, Tim; Taylor, Graham P.; Nolan, Marianne; Donaldson, Hugo; Manikon, Maribel

2014-01-01

Outbreaks of serious infections associated with heroin use in persons who inject drugs (PWIDs) occur intermittently and require vigilance and rapid reporting of individual cases. Here, we give a firsthand account of the cases in London during an outbreak of heroin-associated anthrax during 2009–2010 in the United Kingdom. This new manifestation of anthrax has resulted in a clinical manifestation distinct from already recognized forms. During 2012–13, additional cases of heroin-associated anthrax among PWIDs in England and other European countries were reported, suggesting that anthrax-contaminated heroin remains in circulation. Antibacterial drugs used for serious soft tissue infection are effective against anthrax, which may lead to substantial underrecognition of this novel illness. The outbreak in London provides a strong case for ongoing vigilance and the use of serologic testing in diagnosis and serologic surveillance schemes to determine and monitor the prevalence of anthrax exposure in the PWID community. PMID:24959910

Lessons for control of heroin-associated anthrax in Europe from 2009-2010 outbreak case studies, London, UK.

PubMed

Abbara, Aula; Brooks, Tim; Taylor, Graham P; Nolan, Marianne; Donaldson, Hugo; Manikon, Maribel; Holmes, Alison

2014-07-01

Outbreaks of serious infections associated with heroin use in persons who inject drugs (PWIDs) occur intermittently and require vigilance and rapid reporting of individual cases. Here, we give a firsthand account of the cases in London during an outbreak of heroin-associated anthrax during 2009-2010 in the United Kingdom. This new manifestation of anthrax has resulted in a clinical manifestation distinct from already recognized forms. During 2012-13, additional cases of heroin-associated anthrax among PWIDs in England and other European countries were reported, suggesting that anthrax-contaminated heroin remains in circulation. Antibacterial drugs used for serious soft tissue infection are effective against anthrax, which may lead to substantial underrecognition of this novel illness. The outbreak in London provides a strong case for ongoing vigilance and the use of serologic testing in diagnosis and serologic surveillance schemes to determine and monitor the prevalence of anthrax exposure in the PWID community.

A Bayesian CUSUM plot: Diagnosing quality of treatment.

PubMed

Rosthøj, Steen; Jacobsen, Rikke-Line

2017-12-01

To present a CUSUM plot based on Bayesian diagnostic reasoning displaying evidence in favour of "healthy" rather than "sick" quality of treatment (QOT), and to demonstrate a technique using Kaplan-Meier survival curves permitting application to case series with ongoing follow-up. For a case series with known final outcomes: Consider each case a diagnostic test of good versus poor QOT (expected vs. increased failure rates), determine the likelihood ratio (LR) of the observed outcome, convert LR to weight taking log to base 2, and add up weights sequentially in a plot showing how many times odds in favour of good QOT have been doubled. For a series with observed survival times and an expected survival curve: Divide the curve into time intervals, determine "healthy" and specify "sick" risks of failure in each interval, construct a "sick" survival curve, determine the LR of survival or failure at the given observation times, convert to weights, and add up. The Bayesian plot was applied retrospectively to 39 children with acute lymphoblastic leukaemia with completed follow-up, using Nordic collaborative results as reference, showing equal odds between good and poor QOT. In the ongoing treatment trial, with 22 of 37 children still at risk for event, QOT has been monitored with average survival curves as reference, odds so far favoring good QOT 2:1. QOT in small patient series can be assessed with a Bayesian CUSUM plot, retrospectively when all treatment outcomes are known, but also in ongoing series with unfinished follow-up. © 2017 John Wiley & Sons, Ltd.

Catnip and the alteration of human consciousness.

PubMed

Osterhoudt, K C; Lee, S K; Callahan, J M; Henretig, F M

1997-12-01

Uncertainty exists regarding the ability of catnip (Nepeta cataria) to affect human consciousness. We report a case of a toddler exhibiting central nervous system depression after consuming a large quantity of catnip. His obtundation was not attributable to another cause. We review the published literature describing the alleged psychoactive capabilities of catnip and present our case as further information for use in this ongoing controversy.

Reducing chronic obstructive pulmonary disease readmissions: the role of the durable medical equipment provider.

PubMed

Messenger, Robert W

2012-01-01

Exacerbation and frequent rehospitalization in chronic obstructive pulmonary disease exacts a heavy toll on the US health care system. To address these issues, new initiatives have been proposed that are largely based on financial penalties to promote patient education and postdischarge care. However, as laudable as these goals are, improving outcomes in the chronic obstructive pulmonary disease population is more confounding than it may first appear. Chronic hypoxia, cognitive dysfunction, poor nutrition, and economic disadvantage are just a few of the challenges that require creative solutions and ongoing support. Case managers need to utilize all the potential products and services that can assist in improving outcomes for these patients. Durable medical equipment providers are often viewed as purveyors of medical equipment that offer little in the form of clinical support. However, in many cases these providers represent an overlooked resource that provides individualized, highly structured patient education and ongoing support programs. The challenge is in identifying those durable medical equipment providers that offer patients contemporary technology, and have both the resources and the commitment to provide patient support that is amenable to the goals of the hospital. This article reviews many of the confounding issues that contribute to the frequent rehospitalization of chronic obstructive pulmonary disease patients. Recommendations to improve patient education and oxygen therapy outcomes are provided along with suggestions to aid in the vetting of durable medical equipment providers. Acute care hospitals, long-term acute care hospitals, extended care facilities, integrated delivery systems. 1. An understanding of the complex variables that play in the management of chronic obstructive pulmonary disease will help the case manager to plan an effective course of care. 2. Case managers need to ensure that patients receive long-term oxygen technology that supports their lifestyle, promotes compliance, and ultimately achieves the desired outcomes. 3. Case managers must advocate for coordinated, ongoing patient education and stress the need for continuing reinforcement. 4. Case managers must ensure that patients under their care be matched with durable medical equipment providers that provide the technology and support that favors positive clinical outcomes.

Online platform for applying space-time scan statistics for prospectively detecting emerging hot spots of dengue fever.

PubMed

Chen, Chien-Chou; Teng, Yung-Chu; Lin, Bo-Cheng; Fan, I-Chun; Chan, Ta-Chien

2016-11-25

Cases of dengue fever have increased in areas of Southeast Asia in recent years. Taiwan hit a record-high 42,856 cases in 2015, with the majority in southern Tainan and Kaohsiung Cities. Leveraging spatial statistics and geo-visualization techniques, we aim to design an online analytical tool for local public health workers to prospectively identify ongoing hot spots of dengue fever weekly at the village level. A total of 57,516 confirmed cases of dengue fever in 2014 and 2015 were obtained from the Taiwan Centers for Disease Control (TCDC). Incorporating demographic information as covariates with cumulative cases (365 days) in a discrete Poisson model, we iteratively applied space-time scan statistics by SaTScan software to detect the currently active cluster of dengue fever (reported as relative risk) in each village of Tainan and Kaohsiung every week. A village with a relative risk >1 and p value <0.05 was identified as a dengue-epidemic area. Assuming an ongoing transmission might continuously spread for two consecutive weeks, we estimated the sensitivity and specificity for detecting outbreaks by comparing the scan-based classification (dengue-epidemic vs. dengue-free village) with the true cumulative case numbers from the TCDC's surveillance statistics. Among the 1648 villages in Tainan and Kaohsiung, the overall sensitivity for detecting outbreaks increases as case numbers grow in a total of 92 weekly simulations. The specificity for detecting outbreaks behaves inversely, compared to the sensitivity. On average, the mean sensitivity and specificity of 2-week hot spot detection were 0.615 and 0.891 respectively (p value <0.001) for the covariate adjustment model, as the maximum spatial and temporal windows were specified as 50% of the total population at risk and 28 days. Dengue-epidemic villages were visualized and explored in an interactive map. We designed an online analytical tool for front-line public health workers to prospectively detect ongoing dengue fever transmission on a weekly basis at the village level by using the routine surveillance data.

An ongoing process: a qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence.

PubMed

Yeh, Mei-Yu; Che, Hui-Lian; Wu, Shu-Mei

2009-11-24

Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services.

An ongoing process: A qualitative study of how the alcohol-dependent free themselves of addiction through progressive abstinence

PubMed Central

2009-01-01

Background Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Methods Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. Results We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. Conclusion This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services. PMID:19930698

Progress Toward HIV Eradication: Case Reports, Current Efforts, and the Challenges Associated with Cure.

PubMed

Martin, Alyssa R; Siliciano, Robert F

2016-01-01

An estimated 35 million people worldwide are infected with HIV, yet a widely applicable cure strategy remains elusive. Recent case reports have suggested that curing HIV infection is possible, renewing excitement about research efforts. We describe those cases and discuss their relevance to the global HIV epidemic. We also review ongoing cure strategies that are transitioning from the lab to the clinic, and the assays and clinical assessments that can be used to evaluate cure interventions.

Ongoing mumps outbreak in Israel, January to August 2017.

PubMed

Indenbaum, Viki; Hübschen, Judith M; Stein-Zamir, Chen; Mendelson, Ella; Sofer, Danit; Hindiyeh, Musa; Anis, Emilia; Abramson, Nitza; Haas, Eric J; Yosef, Yochi; Dukhan, Larisa; Singer, Shepherd Roee

2017-08-31

In Israel, 262 mumps cases were registered between 1 January and 28 August 2017 despite a vaccine coverage of ≥ 96%. The majority (56.5%) of cases were adolescents and young adults between 10 and 24 years of age. Nearly twice as many cases were reported in males than in females. Sequence information identified genotype G and suggested specific transmission chains in different religious communities, with the Muslim population in Jerusalem being most severely affected. This article is copyright of The Authors, 2017.

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier.

PubMed

Ates, Ihsan; Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83.

Culturally Sensitive Intervention for Latina Women with Eating Disorders: A Case Study

PubMed Central

Reyes-Rodríguez, Mae Lynn; Baucom, Donald H.; Bulik, Cynthia M.

2014-01-01

Objective We describe cognitive-behavioral therapy for bulimia nervosa (CBT-BN) with a Latina woman that incorporates culturally relevant topics. Method A single case report of a 31-year-old monolingual Latina woman with BN describes the application of a couple-based intervention adjunctive to CBT-BN. Results The patient reported no binge and purge episodes by session 20 and remained symptom free until the end of treatment (session 26). Improvement was observed in the Eating Disorders Examination (EDE) comparing baseline (EDE=5.74) with post treatment (EDE=1.25). Conclusions The case illustrates how cultural adaptations such as including a family member, being flexible on topics and scheduling, and providing culturally relevant interventions can lead to successful completion of a course of therapy and facilitate ongoing interventions to ensure continued recovery. PMID:25598951

Can monaural temporal masking explain the ongoing precedence effect?

PubMed

Freyman, Richard L; Morse-Fortier, Charlotte; Griffin, Amanda M; Zurek, Patrick M

2018-02-01

The precedence effect for transient sounds has been proposed to be based primarily on monaural processes, manifested by asymmetric temporal masking. This study explored the potential for monaural explanations with longer ("ongoing") sounds exhibiting the precedence effect. Transient stimuli were single lead-lag noise burst pairs; ongoing stimuli were trains of 63 burst pairs. Unlike with transients, monaural masking data for ongoing sounds showed no advantage for the lead, and are inconsistent with asymmetric audibility as an explanation for ongoing precedence. This result, along with supplementary measurements of interaural time discrimination, suggests different explanations for transient and ongoing precedence.

Peripartum cardiomyopathy in the Hospital Albert Schweitzer District of Haiti.

PubMed

Fett, James D; Carraway, Robert D; Dowell, Duane L; King, Mary Etta; Pierre, Ronald

2002-05-01

This report details current epidemiologic information on peripartum cardiomyopathy in 1 district of Haiti and represents the initial report of an ongoing investigation that addresses potential etiologic and prognostic factors. Another goal is to alert the medical community of what appears to be a high-incidence area. A detailed peripartum cardiomyopathy registry has been implemented to include a review of case records from 1994 to 2000 and subsequently to identify new cases from February 1, 2000, to July 1, 2001. The Hospital Albert Schweitzer District of Haiti is a 600-square mile area with approximately 258,000 population served by a hospital, an associated clinic, and outlying health centers. There are approximately 7740 live births annually. This report details epidemiologic information on the HAS District peripartum cardiomyopathy patients including incidence, mortality rate, complications, and prognostic factors. There were 47 confirmed patients (retrospective cohort, 20 patients; prospective cohort, 27 patients), which was approximately 1 case per 400 live births (compared with an incidence of 1 case per 3000 to 4000 live births in the United States). There were 4 deaths (14% of 29 patients with follow-up), and 7 complications (pulmonary embolism, 1 case; hemiplegia, 1 case; subsequent deterioration of heart function, 5 cases). The prognosis for subsequent pregnancy was 4 of 5 cases (80%) of recurrent congestive heart failure. Peripartum cardiomyopathy appears to be relatively common in the Hospital Albert Schweitzer District of Haiti. A core group of patients is identified for ongoing epidemiologic and immunohematologic investigation of risk factors and potential etiologic factors.

Discuss the impact technological advances in equipment and materials have made on the delivery and outcome of endodontic treatment.

PubMed

Lababidi, Emad Aldin

2013-12-01

Recent advances in endodontic equipment and materials have considerably changed the manner in which endodontic treatment is delivered. Specific technological advances, including nickel-titanium instruments, ultrasonic instruments and the dental operating microscope have been associated with increased efficiency and efficacy of treatment and simplification of delivery. The effects of most of these changes have been tested via in vitro studies and case reports. Ongoing studies should constantly investigate what effects technological advances might have on the outcome of endodontic treatment. © 2013 Australian Society of Endodontology.

GnRH antagonist versus long agonist protocols in IVF: a systematic review and meta-analysis accounting for patient type.

PubMed

Lambalk, C B; Banga, F R; Huirne, J A; Toftager, M; Pinborg, A; Homburg, R; van der Veen, F; van Wely, M

2017-09-01

Most reviews of IVF ovarian stimulation protocols have insufficiently accounted for various patient populations, such as ovulatory women, women with polycystic ovary syndrome (PCOS) or women with poor ovarian response, and have included studies in which the agonist or antagonist was not the only variable between the compared study arms. The aim of the current study was to compare GnRH antagonist protocols versus standard long agonist protocols in couples undergoing IVF or ICSI, while accounting for various patient populations and treatment schedules. The Cochrane Menstrual Disorders and Subfertility Review Group specialized register of controlled trials and Pubmed and Embase databases were searched from inception until June 2016. Eligible trials were those that compared GnRH antagonist protocols and standard long GnRH agonist protocols in couples undergoing IVF or ICSI. The primary outcome was ongoing pregnancy rate. Secondary outcomes were: live birth rate, clinical pregnancy rate, number of oocytes retrieved and safety with regard to ovarian hyperstimulation syndrome (OHSS). Separate comparisons were performed for the general IVF population, women with PCOS and women with poor ovarian response. Pre-planned subgroup analyses were performed for various antagonist treatment schedules. We included 50 studies. Of these, 34 studies reported on general IVF patients, 10 studies reported on PCOS patients and 6 studies reported on poor responders. In general IVF patients, ongoing pregnancy rate was significantly lower in the antagonist group compared with the agonist group (RR 0.89, 95% CI 0.82-0.96). In women with PCOS and in women with poor ovarian response, there was no evidence of a difference in ongoing pregnancy between the antagonist and agonist groups (RR 0.97, 95% CI 0.84-1.11 and RR 0.87, 95% CI 0.65-1.17, respectively). Subgroup analyses for various antagonist treatment schedules compared to the long protocol GnRH agonist showed a significantly lower ongoing pregnancy rate when the oral hormonal programming pill (OHP) pretreatment was combined with a flexible protocol (RR 0.74, 95% CI 0.59-0.91) while without OHP, the RR was 0.84, 95% CI 0.71-1.0. Subgroup analysis for the fixed antagonist schedule demonstrated no evidence of a significant difference with or without OHP (RR 0.94, 95% CI 0.79-1.12 and RR 0.94, 95% CI 0.83-1.05, respectively). Antagonists resulted in significantly lower OHSS rates both in the general IVF patients and in women with PCOS (RR 0.63, 95% CI 0.50-0.81 and RR 0.53, 95% CI 0.30-0.95, respectively). No data on OHSS was available from trials in poor responders. In a general IVF population, GnRH antagonists are associated with lower ongoing pregnancy rates when compared to long protocol agonists, but also with lower OHSS rates. Within this population, antagonist treatment prevents one case of OHSS in 40 patients but results in one less ongoing pregnancy out of every 28 women treated. Thus standard use of the long GnRH agonist treatment is perhaps still the approach of choice for prevention of premature luteinization. In couples with PCOS and poor responders, GnRH antagonists do not seem to compromise ongoing pregnancy rates and are associated with less OHSS and therefore could be considered as standard treatment. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Strategic decision making under climate change: a case study on Lake Maggiore water system

NASA Astrophysics Data System (ADS)

Micotti, M.; Soncini Sessa, R.; Weber, E.

2014-09-01

Water resources planning processes involve different kinds of decisions that are generally evaluated under a stationary climate scenario assumption. In general, the possible combinations of interventions are mutually compared as single alternatives. However, the ongoing climate change requires us to reconsider this approach. Indeed, what have to be compared are not individual alternatives, but families of alternatives, characterized by the same structural decisions, i.e. by actions that have long-term effects and entail irrevocable changes in the system. The rationale is that the structural actions, once they have been implemented, cannot be easily modified, while the management decisions can be adapted to the evolving conditions. This paper considers this methodological problem in a real case study, in which a strategic decision has to be taken: a new barrage was proposed to regulate Lake Maggiore outflow, but, alternatively, either the present barrage can be maintained with its present regulation norms or with a new one. The problem was dealt with by multi-criteria decision analysis involving many stakeholders and two decision-makers. An exhaustive set of indicators was defined in the participatory process, conducted under the integrated water resource management paradigm, and many efficient (in Pareto sense) regulation policies were identified. The paper explores different formulations of a global index to evaluate and compare the effectiveness of the classes of alternatives under both stationary and changing hydrological scenarios in order to assess their adaptability to the ongoing climate change.

The benefits of motivational interviewing and coaching for improving the practice of comprehensive family assessments in child welfare.

PubMed

Snyder, Elizabeth H; Lawrence, C Nicole; Weatherholt, Tara N; Nagy, Paul

2012-01-01

The engagement of families in child welfare services is critical for successful outcomes related to safety, permanency, and child and family well-being. Motivational interviewing (MI), an effective approach to working with individuals struggling with alcohol and drug addiction, has great appeal for use with families involved with the child welfare system. Consequently, many social service agencies are beginning to integrate MI into their training curriculum. However, research has shown that training in MI alone is not enough; ongoing coaching is crucial in order to transfer learned MI skills into practice.The current study employs qualitative interview data from case-workers in order to examine the implementation of MI and long-term coaching within the child welfare system. Findings showed that MI can be implemented successfully within the child welfare system, and that caseworkers believed MI, supported by ongoing coaching, to be a valuable tool in engaging families in the assessment process.

Developing a national health research system: participatory approaches to legislative, institutional and networking dimensions in Zambia.

PubMed

Chanda-Kapata, Pascalina; Campbell, Sandy; Zarowsky, Christina

2012-06-06

For many sub-Saharan African countries, a National Health Research System (NHRS) exists more in theory than in reality, with the health system itself receiving the majority of investments. However, this lack of attention to NHRS development can, in fact, frustrate health systems in achieving their desired goals. In this case study, we discuss the ongoing development of Zambia's NHRS. We reflect on our experience in the ongoing consultative development of Zambia's NHRS and offer this reflection and process documentation to those engaged in similar initiatives in other settings. We argue that three streams of concurrent activity are critical in developing an NHRS in a resource-constrained setting: developing a legislative framework to determine and define the system's boundaries and the roles all actors will play within it; creating or strengthening an institution capable of providing coordination, management and guidance to the system; and focusing on networking among institutions and individuals to harmonize, unify and strengthen the overall capacities of the research community.

Debris mitigation methods for bridge piers.

DOT National Transportation Integrated Search

2012-06-01

Debris accumulation on bridge piers is an on-going national problem that can obstruct the waterway openings at bridges and result in significant erosion of stream banks and scour at abutments and piers. In some cases, the accumulation of debris can a...

Debris mitigation methods for bridge piers : tech transfer summary.

DOT National Transportation Integrated Search

2012-06-01

Problem statement: Debris accumulation on bridge piers is an on-going national problem that can obstruct waterway openings at bridges and also result in significant erosion of stream banks and scour at abutments and piers. : In some cases, debris acc...

Oregon’s Strategy to Confront Prescription Opioid Misuse: A Case Study

PubMed Central

McCarty, Dennis; Bovett, Rob; Burns, Thomas; Cushing, Judy; Glynn, Mary Ellen; Kruse, Senator Jeff; Millet, Lisa M.; Shames, Jim

2014-01-01

Governor John Kitzhaber appointed a Prescription Drug Taskforce to address Oregon’s opioid epidemic. This case study reviews the Taskforce’s participation in the National Governors Association State Policy Academy on Reducing Prescription Drug Abuse. To address the challenge of the misuse and abuse of prescription opioids, the Taskforce developed a strategy for practice change, community education and enhanced access to safe opioid disposal using stakeholder meetings, consensus development, and five action steps: 1) fewer pills in circulation, 2) educate prescribers and the public on the risks of opioid use, 3) foster safe disposal of unused medication, 4) provide treatment for opioid dependence, and 5) continued leadership from the Governor, health plans and health professionals. Although the story is ongoing, there are lessons for leadership in other states and for public health and medical practitioners throughout the country. PMID:25168199

Surfing with spirochaetes: an ongoing syphilis outbreak in Brighton.

PubMed

Poulton, M; Dean, G L; Williams, D I; Carter, P; Iversen, A; Fisher, M

2001-10-01

There has been a recent shift in the epidemiology of early syphilis in the developed world with sporadic outbreaks on a historic low level of background disease. Here we describe an ongoing outbreak of syphilis in Brighton. Data collected on all patients with a diagnosis of early infectious syphilis at Brighton GUM clinic. 30 cases of early syphilis were diagnosed over a 25 month period beginning in July 1999. 28 were homosexual or bisexual men, giving a rate of 134 cases per 100 000 homosexual men. The cases reported a median of three sexual contacts (range 1-50) in the preceding 6 months and 77% had concurrent regular and casual partners. 83% of contacts were casual and untraceable. Over one third (11) of these cases reported oral sex as their only risk factor for syphilis acquisition and were unaware of this transmission route. 70% were diagnosed with primary or secondary infection, the remaining 30% being asymptomatic with early latent infection. Eight of the cases were HIV positive and a further eight remain untested for HIV. At least one concurrent STI was found in 40% of cases. Regular outbreak control meetings, involving relevant healthcare professionals, were held to plan appropriate interventions. The high rate of casual and untraceable contacts in this outbreak suggest that alternative control measures are necessary, including on-site testing and further health education regarding the oral transmission of syphilis. Continued vigilance for syphilis is essential, especially in those patients who are HIV positive.

Toxoplasmosis masking non-Hodgkin's lymphoma: a case report.

PubMed

Mighell, A; Carton, A; Carey, P; High, A

1995-12-01

A 39-year-old female with persistent cervical lymphadenopathy is reported. Initial investigations resulted in a diagnosis of toxoplasmosis, but subsequently the patient proved to have high grade immunoblastic non-Hodgkin's lymphoma. This paper highlights the difficulties in accurately diagnosing some cases of either toxoplasmosis or lymphoma, and briefly mentions some of the ongoing technical advances which will increase diagnostic specificity and sensitivity by early detection of genetic mutations.

Lymphogranuloma venereum: a hidden emerging problem, Barcelona, 2011.

PubMed

Vargas-Leguas, H; Garcia de Olalla, P; Arando, M; Armengol, P; Barbera, Mj; Vall, M; Vives, A; Martin-Ezquerra, G; Alsina, M; Blanco, J; Munoz, C; Caballero, E; Andreu, A; Ros, M; Gorrindo, P; Dominguez, A; Cayla, Ja

2012-01-12

From the beginning of 2007 until the end of 2011, 146 cases of lymphogranuloma venereum (LGV) were notified to the Barcelona Public Health Agency. Some 49% of them were diagnosed and reported in 2011, mainly in men who have sex with men. Almost half of them, 32 cases, were reported between July and September. This cluster represents the largest since 2004. This article presents the ongoing outbreak of LGV in Barcelona.

Primary hepatic artery embolization in pediatric blunt hepatic trauma.

PubMed

Ong, Caroline C P; Toh, Luke; Lo, Richard H G; Yap, Te-Lu; Narasimhan, Kannan

2012-12-01

Non-operative management of isolated blunt hepatic trauma is recommended except when hemodynamic instability requires immediate laparotomy. Hepatic artery angioembolization is increasingly used for hepatic injuries with ongoing bleeding as demonstrated by contrast extravasation on the CT scan. It is used primarily or after laparotomy to control ongoing hemorrhage. Hepatic angioembolization as part of multimodality management of hepatic trauma is reported mainly in adults, with few pediatric case reports. We describe our institution experience with primary pediatric hepatic angioembolization and review the literature with regard to indications and complications. Two cases (3 and 8 years old), with high-grade blunt hepatic injuries with contrast extravasation on the CT scan were successfully managed by emergency primary hepatic angioembolization with minimal morbidity and avoided laparotomy. To date, the only reports of pediatric hepatic angioembolization for trauma are 5 cases for acute bleeding and 15 delayed cases for pseudoaneurysm. The role of hepatic angioembolization in the presence of an arterial blush on CT in adults is accepted, but contested in a pediatric series, despite higher transfusion rate and mortality rate. We propose that hepatic angioembolization should be considered adjunct treatment, in lieu of, or in addition to emergency laparotomy for hemostasis in pediatric blunt hepatic injury. Copyright © 2012 Elsevier Inc. All rights reserved.

Neutralizing antibodies to botulinum neurotoxin type A in aesthetic medicine: five case reports

PubMed Central

Torres, Sebastian; Hamilton, Mark; Sanches, Elena; Starovatova, Polina; Gubanova, Elena; Reshetnikova, Tatiana

2014-01-01

Botulinum neurotoxin injections are a valuable treatment modality for many therapeutic indications as well as in the aesthetic field for facial rejuvenation. As successful treatment requires repeated injections over a long period of time, secondary resistance to botulinum toxin preparations after repeated injections is an ongoing concern. We report five case studies in which neutralizing antibodies to botulinum toxin type A developed after injection for aesthetic use and resulted in secondary treatment failure. These results add to the growing number of reports in the literature for secondary treatment failure associated with high titers of neutralizing antibodies in the aesthetic field. Clinicians should be aware of this risk and implement injection protocols that minimize resistance development. PMID:24379687

Dissemination of compressed satellite imagery within the Navy SPAWAR Central Site Product Display environment

NASA Technical Reports Server (NTRS)

Kiselyov, Oleg; Fisher, Paul

1995-01-01

This paper presents a case study of integration of compression techniques within a satellite image communication component of an actual tactical weather information dissemination system. The paper describes history and requirements of the project, and discusses the information flow, request/reply protocols, error handling, and, especially, system integration issues: specification of compression parameters and the place and time for compressor/decompressor plug-ins. A case for a non-uniform compression of satellite imagery is presented, and its implementation in the current system id demonstrated. The paper gives special attention to challenges of moving the system towards the use of standard, non-proprietary protocols (smtp and http) and new technologies (OpenDoc), and reports the ongoing work in this direction.

A case for increased private sector involvement in Ireland's national animal health services

PubMed Central

2008-01-01

Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands). PMID:21851708

A case for increased private sector involvement in Ireland's national animal health services.

PubMed

More, Simon J

2008-02-01

Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands).

The scientific status of childhood dissociative identity disorder: a review of published research.

PubMed

Boysen, Guy A

2011-01-01

Dissociative identity disorder (DID) remains a controversial diagnosis due to conflicting views on its etiology. Some attribute DID to childhood trauma and others attribute it to iatrogenesis. The purpose of this article is to review the published cases of childhood DID in order to evaluate its scientific status, and to answer research questions related to the etiological models. I searched MEDLINE and PsycINFO records for studies published since 1980 on DID/multiple personality disorder in children. For each study I coded information regarding the origin of samples and diagnostic methods. The review produced a total of 255 cases of childhood DID reported as individual case studies (44) or aggregated into empirical studies (211). Nearly all cases (93%) emerged from samples of children in treatment, and multiple personalities was the presenting problem in 23% of the case studies. Four US research groups accounted for 65% of all 255 cases. Diagnostic methods typically included clinical evaluation based on Diagnostic and Statistical Manual of Mental Disorder criteria, but hypnosis, structured interviews, and multiple raters were rarely used in diagnoses. Despite continuing research on the related concepts of trauma and dissociation, childhood DID itself appears to be an extremely rare phenomenon that few researchers have studied in depth. Nearly all of the research that does exist on childhood DID is from the 1980s and 1990s and does not resolve the ongoing controversies surrounding the disorder. Copyright © 2011 S. Karger AG, Basel.

Existing data sources for clinical epidemiology: Scandinavian Cohort for osteonecrosis of the jaw – work in progress and challenges

PubMed Central

Schiodt, Morten; Larsson Wexell, Cecilia; Herlofson, Bente Brokstad; Giltvedt, Karen Marie; Norholt, Sven Erik; Ehrenstein, Vera

2015-01-01

Osteonecrosis of the jaw (ONJ) is a severe side effect associated with antiresorptive treatment. Monitoring of ONJ using routine databases in Scandinavian countries is a challenge owing to lack of valid algorithms and to heterogeneous referral practices. The aim of this paper is to describe the process of establishing a Scandinavian ONJ Cohort enrolling all ONJ cases related to antiresorptive treatment arising in Denmark, Norway, and Sweden between 2011 and 2019. The initial purpose of the cohort is to support an ongoing pharmacovigilance study of denosumab and zoledronic acid in Denmark, Norway, and Sweden. The three countries, with their 199 clinics, departments, and units of oral and maxillofacial surgery, both hospital-based and freestanding, differ somewhat in referral practices of the ONJ patients. By directly contacting all providers of care to ONJ patients in the three countries, we established a network for reporting incident cases to each country’s research database directly or through a member of the Scandinavian ONJ task force as a liaison. The task force includes a Scandinavian coordinator and three national coordinators collaborating directly with the clinics. A uniform ONJ registration form has been developed, and the relevant medical community has been informed either directly or through presentations at professional meetings. A website with study information is published in each country, and data entry is ongoing. This large-scale systematic uniform registration of ONJ cases in Denmark, Norway, and Sweden, with an underlying total population of more than 20 million people, merged into the Scandinavian ONJ Cohort, will contribute to better knowledge and understanding of this challenging group of patients, and ultimately, help improve patient care. The Scandinavian ONJ Cohort as a whole and its component national ONJ research databases may offer the potential for large-scale multinational intervention and safety studies in the future. PMID:25657594

HMG versus rFSH for ovulation induction in developing countries: a cost-effectiveness analysis based on the results of a recent meta-analysis.

PubMed

Al-Inany, Hesham G; Abou-Setta, Ahmed M; Aboulghar, Mohamed A; Mansour, Ragaa T; Serour, Gamal I

2006-02-01

Both cost and effectiveness should be considered conjointly to aid judgments about drug choice. Therefore, based on the results of a recent published meta-analysis, a Markov model was developed to conduct a cost-effectiveness analysis for estimation of the cost of an ongoing pregnancy in IVF/intracytoplasmic sperm injection (ICSI) cycles. In addition, Monte Carlo micro-simulation was used to examine the potential impact of assumptions and other uncertainties represented in the model. The results of the study reveal that the estimated average cost of an ongoing pregnancy is 13,946 Egyptian pounds (EGP), and 18,721 EGP for a human menopausal gonadotrophin (HMG) and rFSH cycle respectively. On performing a sensitivity analysis on cycle costs, it was demonstrated that the rFSH price should be 0.61 EGP/IU to be as cost-effective as HMG at the price of 0.64 EGP/IU (i.e. around 60% reduction in its current price). The difference in cost between HMG and rFSH in over 100,000 cycles would result in an additional 4565 ongoing pregnancies if HMG was used. Therefore, HMG was clearly more cost-effective than rFSH. The decision to adopt a more expensive, cost-ineffective treatment could result in a lower number of cycles of IVF/ICSI treatment undertaken, especially in the case of most developing countries.

Encephalitis Surveillance through the Emerging Infections Program, 1997–2010

PubMed Central

Glaser, Carol A.

2015-01-01

Encephalitis is a devastating illness that commonly causes neurologic disability and has a case fatality rate >5% in the United States. An etiologic agent is identified in <50% of cases, making diagnosis challenging. The Centers for Disease Control and Prevention Emerging Infections Program (EIP) Encephalitis Project established syndromic surveillance for encephalitis in New York, California, and Tennessee, with the primary goal of increased identification of causative agents and secondary goals of improvements in treatment and outcome. The project represents the largest cohort of patients with encephalitis studied to date and has influenced case definition and diagnostic evaluation of this condition. Results of this project have provided insight into well-established causal pathogens and identified newer causes of infectious and autoimmune encephalitis. The recognition of a possible relationship between enterovirus D68 and acute flaccid paralysis with myelitis underscores the need for ongoing vigilance for emerging causes of neurologic disease. PMID:26295485

Sportsman hernia; the review of current diagnosis and treatment modalities

PubMed Central

Paksoy, Melih; Sekmen, Ümit

2016-01-01

Groin pain is an important clinical entity that may affect a sportsman’s active sports life. Sportsman’s hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman’s hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman’s hernia at our hospital between 2011–2014, in light of current literature. PMID:27436937

Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

PubMed

Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl

2016-01-01

Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Influence of interlocutor/reader on utterance in reflective writing and interview

NASA Astrophysics Data System (ADS)

Collyer, Vivian M.

2010-03-01

The influence of the Other on utterance is foundational to language study. This analysis contrasts this influence within two modes of communication: reflective writing and interview. The data source is derived from the reflective writings and interview transcripts of a twelfth-grade physics student. In this student's case, reflective writing includes extensive utterances, utilizing rhetorical devices to persuade and reconcile with his reader. In the interview, on-going back-and-forth utterances allow the two participants to negotiate a co-constructed meaning for religion. Implications for the classroom are briefly discussed.

Fecal Microbial Therapy – Promises and Pitfalls

PubMed Central

Merenstein, Daniel; El-Nachef, Najwa; Lynch, Susan V.

2015-01-01

A rapidly-expanding range of diverse human diseases are now associated with perturbations to the gastrointestinal microbiome. Fecal microbial transfer (FMT) has been used with high rates of efficacy to treat gastrointestinal microbiome perturbation associated with recurrent Clostridium difficile infection, and is now being considered for other indications. Here we discuss the gut microbiome, review published and on-going studies using FMT as a treatment modality for human disease, consider the regulatory aspects of FMT and outline some factors that should be considered in cases where this therapeutic strategy is being contemplated. PMID:24796803

Coding in Muscle Disease.

PubMed

Jones, Lyell K; Ney, John P

2016-12-01

Accurate coding is critically important for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of administrative coding for patients with muscle disease and includes a case-based review of diagnostic and Evaluation and Management (E/M) coding principles in patients with myopathy. Procedural coding for electrodiagnostic studies and neuromuscular ultrasound is also reviewed.

Indoor chemistry: research opportunities and challenges.

PubMed

Nazaroff, W W; Goldstein, A H

2015-08-01

In this editorial, we have highlighted key research opportunities and challenges in four topical themes for indoor chemistry: human occupants as agents influencing indoor chemistry; oxidative chemistry; surface phenomena; and semivolatile organic compounds. In each case, enough prior work has been done to demonstrate the importance of the theme and to create a foundation for future studies. Extensive achievements and ongoing progress in (outdoor) atmospheric chemistry—both in the analytical methods developed and in the scientific knowledge created—also contribute to a strong foundation from which to achieve rapid research progress in this exciting new domain.

Numerical solutions of acoustic wave propagation problems using Euler computations

NASA Technical Reports Server (NTRS)

Hariharan, S. I.

1984-01-01

This paper reports solution procedures for problems arising from the study of engine inlet wave propagation. The first problem is the study of sound waves radiated from cylindrical inlets. The second one is a quasi-one-dimensional problem to study the effect of nonlinearities and the third one is the study of nonlinearities in two dimensions. In all three problems Euler computations are done with a fourth-order explicit scheme. For the first problem results are shown in agreement with experimental data and for the second problem comparisons are made with an existing asymptotic theory. The third problem is part of an ongoing work and preliminary results are presented for this case.

Early findings in outbreak of haemolytic uraemic syndrome among young children caused by Shiga toxin-producing Escherichia coli, Romania, January to February 2016.

PubMed

Peron, Emilie; Zaharia, Alina; Zota, Lavinia Cipriana; Severi, Ettore; Mårdh, Otilia; Usein, Codruta; Bălgrădean, Mihaela; Espinosa, Laura; Jansa, Josep; Scavia, Gaia; Rafila, Alexandru; Serban, Amalia; Pistol, Adriana

2016-01-01

As at 29 February 2016, 15 cases of haemolytic uraemic syndrome with onset between 25 January and 22 February were reported among children between five and 38 months in Romania, and three of them died. Cases were mostly from southern Romania. Six cases tested positive for Escherichia coli O26 by serology. Fruits, vegetables, meat and dairy products were among the possible common food exposures. Investigations are ongoing in Romania to control the outbreak.

Increased risk of yellow fever infections among unvaccinated European travellers due to ongoing outbreak in Brazil, July 2017 to March 2018.

PubMed

Gossner, Céline M; Haussig, Joana M; de Bellegarde de Saint Lary, Chiara; Kaasik Aaslav, Kaja; Schlagenhauf, Patricia; Sudre, Bertrand

2018-03-01

Since December 2016, Brazil has faced a large outbreak of yellow fever with ca 1,500 confirmed human cases. In the first 2 months of 2018, Brazil reported almost as many cases as in 2017 as a whole. In these 2 months, five imported cases were reported among unvaccinated European travellers. Three had travelled to Ilha Grande, a popular destination among European tourists. Physicians and European travellers visiting Brazil should follow yellow fever vaccination recommendations.

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier

PubMed Central

Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

ABSTRACT Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. How to cite this article Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83. PMID:29201732

Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 - linked to other German cities and European countries.

PubMed

Werber, Dirk; Michaelis, Kai; Hausner, Marius; Sissolak, Dagmar; Wenzel, Jürgen; Bitzegeio, Julia; Belting, Anne; Sagebiel, Daniel; Faber, Mirko

2017-02-02

Since 14 November 2016, 38 cases of hepatitis A have been notified in Berlin; of these, 37 were male and 30 reported to have sex with men (MSM). Median age of MSM cases is 31 years (range: 24-52 years). Phylogenetic analysis revealed three distinct sequences, linking cases in Berlin to those in other German cities and to clusters recognised in other European countries in 2016. This article is copyright of The Authors, 2017.

Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 – linked to other German cities and European countries

PubMed Central

Werber, Dirk; Michaelis, Kai; Hausner, Marius; Sissolak, Dagmar; Wenzel, Jürgen; Bitzegeio, Julia; Belting, Anne; Sagebiel, Daniel; Faber, Mirko

2017-01-01

Since 14 November 2016, 38 cases of hepatitis A have been notified in Berlin; of these, 37 were male and 30 reported to have sex with men (MSM). Median age of MSM cases is 31 years (range: 24–52 years). Phylogenetic analysis revealed three distinct sequences, linking cases in Berlin to those in other German cities and to clusters recognised in other European countries in 2016. PMID:28183391

Integration of DNA sample collection into a multi-site birth defects case-control study.

PubMed

Rasmussen, Sonja A; Lammer, Edward J; Shaw, Gary M; Finnell, Richard H; McGehee, Robert E; Gallagher, Margaret; Romitti, Paul A; Murray, Jeffrey C

2002-10-01

Advances in quantitative analysis and molecular genotyping have provided unprecedented opportunities to add biological sampling and genetic information to epidemiologic studies. The purpose of this article is to describe the incorporation of DNA sample collection into the National Birth Defects Prevention Study (NBDPS), an ongoing case-control study in an eight-state consortium with a primary goal to identify risk factors for birth defects. Babies with birth defects are identified through birth defects surveillance systems in the eight participating centers. Cases are infants with one or more of over 30 major birth defects. Controls are infants without defects from the same geographic area. Epidemiologic information is collected through an hour-long interview with mothers of both cases and controls. We added the collection of buccal cytobrush DNA samples for case-infants, control-infants, and their parents to this study. We describe here the methods by which the samples have been collected and processed, establishment of a centralized resource for DNA banking, and quality control, database management, access, informed consent, and confidentiality issues. Biological sampling and genetic analyses are important components to epidemiologic studies of birth defects aimed at identifying risk factors. The DNA specimens collected in this study can be used for detection of mutations, study of polymorphic variants that confer differential susceptibility to teratogens, and examination of interactions among genetic risk factors. Information on the methods used and issues faced by the NBDPS may be of value to others considering the addition of DNA sampling to epidemiologic studies.

Knowledge exchange systems for youth health and chronic disease prevention: a tri-provincial case study.

PubMed

Murnaghan, D; Morrison, W; Griffith, E J; Bell, B L; Duffley, L A; McGarry, K; Manske, S

2013-09-01

The research teams undertook a case study design using a common analytical framework to investigate three provincial (Prince Edward Island, New Brunswick and Manitoba) knowledge exchange systems. These three knowledge exchange systems seek to generate and enhance the use of evidence in policy development, program planning and evaluation to improve youth health and chronic disease prevention. We applied a case study design to explore the lessons learned, that is, key conditions or processes contributing to the development of knowledge exchange capacity, using a multi-data collection method to gain an in-depth understanding. Data management, synthesis and analysis activities were concurrent, iterative and ongoing. The lessons learned were organized into seven "clusters." Key findings demonstrated that knowledge exchange is a complex process requiring champions, collaborative partnerships, regional readiness and the adaptation of knowledge exchange to diverse stakeholders. Overall, knowledge exchange systems can increase the capacity to exchange and use evidence by moving beyond collecting and reporting data. Areas of influence included development of new partnerships, expanded knowledge-sharing activities, and refinement of policy and practice approaches related to youth health and chronic disease prevention.

A Multiphase Design Strategy for Dealing with Participation Bias

PubMed Central

Haneuse, S.; Chen, J.

2012-01-01

Summary A recently funded study of the impact of oral contraceptive use on the risk of bone fracture employed the randomized recruitment scheme of Weinberg and Wacholder (1990, Biometrics 46, 963–975). One potential complication in the bone fracture study is the potential for differential response rates between cases and controls; participation rates in previous, related studies have been around 70%. Although data from randomized recruitment schemes may be analyzed within the two-phase study framework, ignoring potential differential participation may lead to biased estimates of association. To overcome this, we build on the two-phase framework and propose an extension by introducing an additional stage of data collection aimed specifically at addressing potential differential participation. Four estimators that correct for both sampling and participation bias are proposed; two are general purpose and two are for the special case where covariates underlying the participation mechanism are discrete. Because the fracture study is ongoing, we illustrate the methods using infant mortality data from North Carolina. PMID:20377576

Connecting Advanced and Secondary Mathematics

ERIC Educational Resources Information Center

Murray, Eileen; Baldinger, Erin; Wasserman, Nicholas; Broderick, Shawn; White, Diana

2017-01-01

There is an ongoing debate among scholars in understanding what mathematical knowledge secondary teachers should have in order to provide effective instruction. We explore connections between advanced and secondary mathematics as an entry point into this debate. In many cases, advanced mathematics is considered relevant for secondary teachers…

Trust, fear, stigma and disruptions: community perceptions and experiences during periods of low but ongoing transmission of Ebola virus disease in Sierra Leone, 2015.

PubMed

Nuriddin, Azizeh; Jalloh, Mohamed F; Meyer, Erika; Bunnell, Rebecca; Bio, Franklin A; Jalloh, Mohammad B; Sengeh, Paul; Hageman, Kathy M; Carroll, Dianna D; Conteh, Lansana; Morgan, Oliver

2018-01-01

Social mobilisation and risk communication were essential to the 2014-2015 West African Ebola response. By March 2015, >8500 Ebola cases and 3370 Ebola deaths were confirmed in Sierra Leone. Response efforts were focused on 'getting to zero and staying at zero'. A critical component of this plan was to deepen and sustain community engagement. Several national quantitative studies conducted during this time revealed Ebola knowledge, personal prevention practices and traditional burial procedures improved as the outbreak waned, but healthcare system challenges were also noted. Few qualitative studies have examined these combined factors, along with survivor stigma during periods of ongoing transmission. To obtain an in-depth understanding of people's perceptions, attitudes and behaviours associated with Ebola transmission risks, 27 focus groups were conducted between April and May 2015 with adult Sierra Leonean community members on: trust in the healthcare system, interactions with Ebola survivors, impact of Ebola on lives and livelihood, and barriers and facilitators to ending the outbreak. Participants perceived that as healthcare practices and facilities improved, so did community trust. Resource management remained a noted concern. Perceptions of survivors ranged from sympathy and empathy to fear and stigmatisation. Barriers included persistent denial of ongoing Ebola transmission, secret burials and movement across porous borders. Facilitators included personal protective actions, consistent messaging and the inclusion of women and survivors in the response. Understanding community experiences during the devastating Ebola epidemic provides practical lessons for engaging similar communities in risk communication and social mobilisation during future outbreaks and public health emergencies.

Supporting interruption management and multimodal interface design: three meta-analyses of task performance as a function of interrupting task modality.

PubMed

Lu, Sara A; Wickens, Christopher D; Prinet, Julie C; Hutchins, Shaun D; Sarter, Nadine; Sebok, Angelia

2013-08-01

The aim of this study was to integrate empirical data showing the effects of interrupting task modality on the performance of an ongoing visual-manual task and the interrupting task itself. The goal is to support interruption management and the design of multimodal interfaces. Multimodal interfaces have been proposed as a promising means to support interruption management.To ensure the effectiveness of this approach, their design needs to be based on an analysis of empirical data concerning the effectiveness of individual and redundant channels of information presentation. Three meta-analyses were conducted to contrast performance on an ongoing visual task and interrupting tasks as a function of interrupting task modality (auditory vs. tactile, auditory vs. visual, and single modality vs. redundant auditory-visual). In total, 68 studies were included and six moderator variables were considered. The main findings from the meta-analyses are that response times are faster for tactile interrupting tasks in case of low-urgency messages.Accuracy is higher with tactile interrupting tasks for low-complexity signals but higher with auditory interrupting tasks for high-complexity signals. Redundant auditory-visual combinations are preferable for communication tasks during high workload and with a small visual angle of separation. The three meta-analyses contribute to the knowledge base in multimodal information processing and design. They highlight the importance of moderator variables in predicting the effects of interruption task modality on ongoing and interrupting task performance. The findings from this research will help inform the design of multimodal interfaces in data-rich, event-driven domains.

Concordance Between Self-Reported Childhood Maltreatment Versus Case Record Reviews for Child Welfare-Affiliated Adolescents.

PubMed

Negriff, Sonya; Schneiderman, Janet U; Trickett, Penelope K

2017-02-01

The present study used data from an ongoing longitudinal study of the effects of maltreatment on adolescent development to (1) describe rates of maltreatment experiences obtained from retrospective self-report versus case record review for adolescents with child welfare-documented maltreatment histories, (2) examine self-reported versus child welfare-identified maltreatment in relation to mental health and risk behavior outcomes by maltreatment type, and (3) examine the association between the number of different types of maltreatment and mental health and risk behavior outcomes. Maltreatment was coded from case records using the Maltreatment Case Record Abstraction Instrument (MCRAI) and participants were asked at mean age = 18.49 about childhood maltreatment experiences using the Comprehensive Trauma Interview (CTI). Results showed that an average of 48% of maltreatment found by the MCRAI for each type of maltreatment were unique cases not captured by the CTI, whereas an average of 40% self-reported maltreatment (CTI) was not indicated by the MCRAI. Analyses with outcomes showed generally, self-reported maltreatment, regardless of concordance with MCRAI, was related to the poorest outcomes. The difference in associations with the outcomes indicates both self-report and case record review data may have utility depending on the outcomes being assessed.

Concordance Between Self-Reported Childhood Maltreatment Versus Case Record Reviews for Child Welfare–Affiliated Adolescents: Prevalence Rates and Associations With Outcomes

PubMed Central

Negriff, Sonya; Schneiderman, Janet U.; Trickett, Penelope K.

2017-01-01

The present study used data from an ongoing longitudinal study of the effects of maltreatment on adolescent development to (1) describe rates of maltreatment experiences obtained from retrospective self-report versus case record review for adolescents with child welfare–documented maltreatment histories, (2) examine self-reported versus child welfare–identified maltreatment in relation to mental health and risk behavior outcomes by maltreatment type, and (3) examine the association between the number of different types of maltreatment and mental health and risk behavior outcomes. Maltreatment was coded from case records using the Maltreatment Case Record Abstraction Instrument (MCRAI) and participants were asked at mean age = 18.49 about childhood maltreatment experiences using the Comprehensive Trauma Interview (CTI). Results showed that an average of 48% of maltreatment found by the MCRAI for each type of maltreatment were unique cases not captured by the CTI, whereas an average of 40% self-reported maltreatment (CTI) was not indicated by the MCRAI. Analyses with outcomes showed generally, self-reported maltreatment, regardless of concordance with MCRAI, was related to the poorest outcomes. The difference in associations with the outcomes indicates both self-report and case record review data may have utility depending on the outcomes being assessed. PMID:27777329

Efficacy, safety and tolerability of ongoing statin plus ezetimibe versus doubling the ongoing statin dose in hypercholesterolemic Taiwanese patients: an open-label, randomized clinical trial

PubMed Central

2012-01-01

Background Reducing low-density lipoprotein cholesterol (LDL-C) is associated with reduced risk for major coronary events. Despite statin efficacy, a considerable proportion of statin-treated hypercholesterolemic patients fail to reach therapeutic LDL-C targets as defined by guidelines. This study compared the efficacy of ezetimibe added to ongoing statins with doubling the dose of ongoing statin in a population of Taiwanese patients with hypercholesterolemia. Methods This was a randomized, open-label, parallel-group comparison study of ezetimibe 10 mg added to ongoing statin compared with doubling the dose of ongoing statin. Adult Taiwanese hypercholesterolemic patients not at optimal LDL-C levels with previous statin treatment were randomized (N = 83) to ongoing statin + ezetimibe (simvastatin, atorvastatin or pravastatin + ezetimibe at doses of 20/10, 10/10 or 20/10 mg) or doubling the dose of ongoing statin (simvastatin 40 mg, atorvastatin 20 mg or pravastatin 40 mg) for 8 weeks. Percent change in total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C) and triglycerides, and specified safety parameters were assessed at 4 and 8 weeks. Results At 8 weeks, patients treated with statin + ezetimibe experienced significantly greater reductions compared with doubling the statin dose in LDL-C (26.2% vs 17.9%, p = 0.0026) and total cholesterol (20.8% vs 12.2%, p = 0.0003). Percentage of patients achieving treatment goal was greater for statin + ezetimibe (58.6%) vs doubling statin (41.2%), but the difference was not statistically significant (p = 0.1675). The safety and tolerability profiles were similar between treatments. Conclusion Ezetimibe added to ongoing statin therapy resulted in significantly greater lipid-lowering compared with doubling the dose of statin in Taiwanese patients with hypercholesterolemia. Studies to assess clinical outcome benefit are ongoing. Trial registration Registered at ClinicalTrials.gov: NCT00652327 PMID:22621316

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya

PubMed Central

2014-01-01

Background In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). Methods From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. Results We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. Conclusions The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies. PMID:24517198

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya.

PubMed

Khagayi, Sammy; Tate, Jacqueline E; Onkoba, Reuben; Parashar, Umesh; Odhiambo, Frank; Burton, Deron; Laserson, Kayla; Feikin, Daniel R

2014-02-11

In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies.

The Comparison Of Dome And HMD Delivery Systems: A Case Study

NASA Technical Reports Server (NTRS)

Chen, Jian; Harm, Deborah L.; Loftin, R. Bowen; Tyalor, Laura C.; Leiss, Ernst L.

2002-01-01

For effective astronaut training applications, choosing the right display devices to present images is crucial. In order to assess what devices are appropriate, it is important to design a successful virtual environment for a comparison study of the display devices. We present a comprehensive system, a Virtual environment testbed (VET), for the comparison of Dome and Head Mounted Display (HMD) systems on an SGI Onyx workstation. By writing codelets, we allow a variety of virtual scenarios and subjects' information to be loaded without programming or changing the code. This is part of an ongoing research project conducted by the NASA / JSC.

Forecasting quantities of disused household CRT appliances--a regional case study approach and its application to Baden-Württemberg.

PubMed

Walk, Wolfgang

2009-02-01

Due to special requirements regarding logistics and recycling, disused cathode ray tube (CRT) appliances are handled in some countries as a separate waste fraction. This article presents a forecast of future household waste CRT quantities based on the past and present equipment of households with television sets and computer monitors. Additional aspects taken into consideration are the product life time distribution and the ongoing change in display technology. Although CRT technology is fading out, the findings of this forecast show that quantities of waste CRT appliances will not decrease before 2012 in Baden-Württemberg, Germany. The results of this regional case study are not quantitatively transferable without further analysis. The method provided allows analysts to consider how the time shift between production and discard could impact recycling options, and the method could be valuable for future similar analyses elsewhere.

Teacher-Researcher Professional Development: Case Study at Kansas State University

NASA Astrophysics Data System (ADS)

Rebello, N. Sanjay; Fletcher, Peter R.

2006-02-01

We report on a case study which provides professional development to advanced undergraduate and graduate research team members of the Kansas State University Physics Education Research (KSU-PER) group. An integral component of a student's professional development is the opportunity to participate in a range of research activities and work in collaboration — both as a mentor and a junior researcher with a range of individuals. In order to coordinate and facilitate these opportunities KSU-PER established an ongoing research project investigating students' conceptions of the physics underlying devices. The project utilized an integrated methodological and administrative framework — combining elements from grounded theory, phenomenology and action research. This framework provides a forum and research setting allowing junior and experienced researchers to act in various project management roles and perform a range of research activities. We will conclude by reflecting upon our experiences.

Integrating strategic environmental assessment with industry planning: a case study of the Pasquai-Porcupine forest management plan, Saskatchewan, Canada.

PubMed

Noble, Bram F

2004-03-01

Strategic environmental assessment (SEA) is gaining widespread recognition as a tool for integrating environmental considerations in policy, plan, and program development and decision-making. Notwithstanding the potential of SEA to improve higher-order decision processes, there has been very little attention given to integrating SEA with industry planning practices. As a result, the benefits of SEA have yet to be fully realized among industrial proponents. That said, SEA practice is ongoing, albeit informally and often under a different label, and is proving to be a valuable tool for industry planning and decision-making. Based on a case study of the Pasquai-Porcupine forest management plan in Saskatchewan, Canada, this paper illustrates how an integrated approach to SEA can contribute to industry environmental decision-making and can enhance the quality and deliverability of industry plans.

"Skip the infection, get the injection": a case study in emergency preparedness education.

PubMed

Adams, Lavonne M; Canclini, Sharon B; Frable, Pamela Jean

2015-01-01

The frequency of natural and manmade disasters along with increasing potential for public health emergencies emphasizes the need for emergency preparedness education. Because nurses are the largest group of health professionals to meet the needs of those affected by disasters and public health emergencies, schools of nursing need to prepare graduates who are knowledgeable about disaster and public health emergency management. The use of core competencies may be a means to ensure consistent application of best practices in disaster health care. The next step in competency development involves validation through evidence. Through documentation and dissemination of their experiences with emergency preparedness education, schools of nursing can provide supportive evidence to aid in competency development. The purpose of this paper is present a case study of an ongoing and evolving public health nursing education project consistent with disaster health care and emergency preparedness competencies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Characteristics of childhood tuberculosis patients registered under RNTCP in Varanasi, Uttar Pradesh.

PubMed

Thakur, Harshad P

2013-01-01

Childhood tuberculosis (TB) reflects on-going transmission. Data on childhood TB from TB registers under Revised National Tuberculosis Control Program of 2008 and 2009 in Varanasi district was analyzed. Proportion of childhood TB was 8.3% of total registered cases 12,242. It was lower than estimated 10-20% in endemic areas. In rural Tuberculosis Units childhood case detection was poor. Case detection in ≤5 years was very less. The childhood cases were detected mainly in adolescent age group. Thus, childhood TB is remaining a under diagnosed/under reported disease in India. It needs attention to increase the detection of childhood TB cases to control TB in general population.

The development of an acute care case manager orientation.

PubMed

Strzelecki, S; Brobst, R

1997-01-01

The authors describe the development of an inpatient acute care case manager orientation in a community hospital. Benner's application of the Dreyfus model of skill acquisition provides the basis for the orientation program. The candidates for the case manager position were expert clinicians. Because of the role change it was projected that they would function as advanced beginners. It was also predicted that, as the case managers progressed within the role, the educational process would need to be adapted to facilitate progression of skills to the proficient level. Feedback from participants reinforced that the model supported the case manager in the role transition. In addition, the model provided a predictive framework for ongoing educational activities.

A facilitated approach to family case conferencing for people with advanced dementia living in nursing homes: perceptions of palliative care planning coordinators and other health professionals in the IDEAL study.

PubMed

Luckett, Tim; Chenoweth, Lynnette; Phillips, Jane; Brooks, Deborah; Cook, Janet; Mitchell, Geoffrey; Pond, Dimity; Davidson, Patricia M; Beattie, Elizabeth; Luscombe, Georgina; Goodall, Stephen; Fischer, Thomas; Agar, Meera

2017-10-01

Palliative care for nursing home residents with advanced dementia is often sub-optimal due to poor communication and limited care planning. In a cluster randomized controlled trial, registered nurses (RNs) from 10 nursing homes were trained and funded to work as Palliative Care Planning Coordinators (PCPCs) to organize family case conferences and mentor staff. This qualitative sub-study aimed to explore PCPC and health professional perceptions of the benefits of facilitated case conferencing and identify factors influencing implementation. Semi-structured interviews were conducted with the RNs in the PCPC role, other members of nursing home staff, and physicians who participated in case conferences. Analysis was conducted by two researchers using a thematic framework approach. Interviews were conducted with 11 PCPCs, 18 other nurses, eight allied health workers, and three physicians. Perceived benefits of facilitated case conferencing included better communication between staff and families, greater multi-disciplinary involvement in case conferences and care planning, and improved staff attitudes and capabilities for dementia palliative care. Key factors influencing implementation included: staffing levels and time; support from management, staff and physicians; and positive family feedback. The facilitated approach explored in this study addressed known barriers to case conferencing. However, current business models in the sector make it difficult for case conferencing to receive the required levels of nursing qualification, training, and time. A collaborative nursing home culture and ongoing relationships with health professionals are also prerequisites for success. Further studies should document resident and family perceptions to harness consumer advocacy.

Grid-enabled mammographic auditing and training system

NASA Astrophysics Data System (ADS)

Yap, M. H.; Gale, A. G.

2008-03-01

Effective use of new technologies to support healthcare initiatives is important and current research is moving towards implementing secure grid-enabled healthcare provision. In the UK, a large-scale collaborative research project (GIMI: Generic Infrastructures for Medical Informatics), which is concerned with the development of a secure IT infrastructure to support very widespread medical research across the country, is underway. In the UK, there are some 109 breast screening centers and a growing number of individuals (circa 650) nationally performing approximately 1.5 million screening examinations per year. At the same, there is a serious, and ongoing, national workforce issue in screening which has seen a loss of consultant mammographers and a growth in specially trained technologists and other non-radiologists. Thus there is a need to offer effective and efficient mammographic training so as to maintain high levels of screening skills. Consequently, a grid based system has been proposed which has the benefit of offering very large volumes of training cases that the mammographers can access anytime and anywhere. A database, spread geographically across three university systems, of screening cases is used as a test set of known cases. The GIMI mammography training system first audits these cases to ensure that they are appropriately described and annotated. Subsequently, the cases are utilized for training in a grid-based system which has been developed. This paper briefly reviews the background to the project and then details the ongoing research. In conclusion, we discuss the contributions, limitations, and future plans of such a grid based approach.

Long-Term Immune Alterations Accompanying Chronic Posttraumatic Stress Disorder following Exposure to Suicide Bomb Terror Incidents during Childhood.

PubMed

Shalev, Amit; Benarroch, Fortunato; Goltser-Dubner, Tanya; Canetti, Laura; Saloner, Chen; Roichman, Asael; Cohen, Haim; Galili-Weisstub, Esti; Segman, Ronen

2018-06-27

Long-term immune alterations have been proposed to play a mechanistic role in posttraumatic stress disorder (PTSD) as well as in its associated increase in medical morbidity and mortality. Better characterization of altered immune function may help identify diagnostic and prognostic biomarkers and potentially targets for preventive intervention. As part of an ongoing study, we conducted a preliminary case-control comparison of resting immune inflammatory profiles between terror victims treated in childhood at the emergency department over the previous decade, who developed chronic PTSD upon long-term follow-up, and healthy controls. Our preliminary results in a subsample of this ongoing study support and extend elevated resting levels of granulocyte colony-stimulating factor, interleukin-4, and regulated on activation, normal T cell expressed and secreted in childhood onset chronic PTSD. Chronic immune alterations may participate in inflammatory activation and signal to the CNS through the neurovascular unit, as well as modulate the neuroendocrine axis. Better characterization and understanding of these preliminary findings may point to diagnostic and prognostic biomarkers and potentially elucidate mechanistic involvement of immune activation in PTSD. © 2018 S. Karger AG, Basel.

MICROBES IN DRINKING WATER: RECENT EPIDEMIOLOGICAL RESEARCH TO ASSESS WATERBORNE RISKS

EPA Science Inventory

The waterborne transmission of enteric pathogens to humans causes illnesses that occur as an epidemic (a temporal excess of cases over some background level of disease), often called an outbreak, or as endemic disease (a background of ongoing disease prevalence that can be consta...

Serial murder in America: case studies of seven offenders.

PubMed

Beasley, James O

2004-01-01

This article summarizes and compares information on seven interviewed serial killers in an ongoing project designed to study similarities and differences among these individuals. The aim of this article is to increase our collective knowledge of the dynamics of serial murder by examining the perpetrators' backgrounds, as well as the unique ways in which they view themselves and the world around them. Although qualitative interview research alone is not sufficient to fully understand such behavior, it is useful in many ways. Some of the information discussed based on the seven offenders interviewed is compared with broader epidemiological studies, and the strengths and limitations of each type of research are discussed. Published in 2004 by John Wiley & Sons, Ltd.

Integration of Bim, Web Maps and Iot for Supporting Comfort Analysis

NASA Astrophysics Data System (ADS)

Gunduz, M.; Isikdag, U.; Basaraner, M.

2017-11-01

The use of the Internet is expanding and the technological capabilities of electronic devices are evolving. Today, Internet of Things (IoT) solutions can be developed that were never even imaginable before. In this paper, a case study is presented on the joint use of Building Information Model (BIM), Geographical Information Systems (GIS) and Internet of Things (IoT) technologies. It is a part of an ongoing study that intends to overcome some problems about the management of complex facilities. In the study, a BIM has been converted and displayed in 2D on Google Maps, and information on various sensors have been represented on the web with geographic coordinates in real-time.

Preliminary report: outbreak of Legionnaires disease in a hotel in Calp, Spain, update on 22 February 2012.

PubMed

Vanaclocha, H; Guiral, S; Morera, V; Calatayud, M A; Castellanos, M; Moya, V; Jerez, G; Gonzalez, F

2012-02-23

Research is ongoing on eighteen cases of Legionellosis, including four deaths, identified among tourists and employees in a hotel in Calp, Spain. Cases occurred during a period of two months, indicating the possibility of a point-source transmission at the hotel. An environmental investigation identified several positive samples in the hotel, which as a precautionary measure, was closed until requested improvements were made. Surveillance measures currently remain active.

Incubation period as part of the case definition of severe respiratory illness caused by a novel coronavirus.

PubMed

Nishiura, H; Mizumoto, K; Ejima, K; Zhong, Y; Cowling, Bj; Omori, R

2012-10-18

Non-specific symptoms of acute respiratory viral infections make it difficult for many countries without ongoing transmission of a novel coronavirus to rule out other possibilities including influenza before isolating imported febrile individuals with a possible exposure history. The incubation period helps differential diagnosis, and up to two days is suggestive of influenza. It is worth including the incubation period in the case definition of novel coronavirus infection.

Diagnosis and treatment of impulse control disorders in patients with movement disorders.

PubMed

Mestre, Tiago A; Strafella, Antonio P; Thomsen, Teri; Voon, Valerie; Miyasaki, Janis

2013-05-01

Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson's disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson's disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease has been developed specifically for Parkinson's disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine.

Ongoing pregnancies in patients with unexplained recurrent pregnancy loss: adverse obstetric outcomes.

PubMed

Cozzolino, Mauro; Rizzello, Francesca; Riviello, Chiara; Romanelli, Chiara; Coccia Elisabetta, Maria

2018-05-25

To investigate the incidence of adverse pregnancy outcomes in couples with an unexplained Recurrent Pregnancy Loss (RPL) history, a retrospective cohort study was conducted between 2014 and 2015. The study group (A) included couples with an unexplained RPL, and the control group (B) was composed of couples who attended the Low-Risk Antenatal Unit during the same period. On the other hand, 53 couples were included in the study group (A) and on the other hand, 65 in the control group (B). Women with previous unexplained recurrent pregnancies loss had a significantly increased risk of gestational diabetes with 12 cases (22.6%) in the study group and 3 cases (4.6%) in the control (OR: 6.048; 95% CI: 1.607-22.762; p = 0.007). A slight increase in the risk of preterm delivery and hepatic cholestasis was observed in the study group (6 cases, 11.3%, in study group and 1 case, 1.5% in the controls (OR: 8.170; 95% CI: 0.951-70.158; p = 0.0555). Women with a history of RPL delivered more frequently by caesarean section (OR: 3.252; 95% CI: 1.460-7.241; p = 0.0039). Women with a history of RPL were at an increased risk for adverse pregnancy outcomes, mainly gestational diabetes. Therefore, a closer surveillance during the antenatal period is recommended in this group of patients.

Diversity and Equality in Academic Publishing: The Case of Educational Leadership

ERIC Educational Resources Information Center

Mertkan, Sefika; Arsan, Nihan; Inal Cavlan, Gozde; Onurkan Aliusta, Gulen

2017-01-01

There have been ongoing criticisms of the field of educational leadership and management with respect to over-reliance on research from "Western" contexts. However, evidence on the extent to which voices alternative to the dominant "Western" discourse are represented in the international English-medium discourse of educational…

Co-Occurrence of Developmental Disorders: The Case of Developmental Dyscalculia

ERIC Educational Resources Information Center

Rubinsten, Orly

2009-01-01

Five to seven percent of children experience severe difficulties in learning mathematics and/or reading. Current trials that are focused on identifying biological markers suggest that these learning disabilities, known as Developmental Dyscalculia (DD) and Dyslexia (for reading), are due to underlying brain dysfunctions. One ongoing controversy…

A Relationship Marketing Approach to Academic Initiative Planning: A Case in Point

ERIC Educational Resources Information Center

Mobley, Mary F.; Basciano, Peter

2012-01-01

Many higher education initiatives are dependent upon the development of multiple relationships across academic and support functions. The probability of achieving superior initiative outcomes rests, in part, on the construction of an infrastructure that supports the goals, strategies, tactics, and ongoing mission of a defined project. Through…

78 FR 66934 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... be received within 60 days of this notice. Proposed Project Report of Verified Case of Tuberculosis... Mycobacterium tuberculosis and about 10% of these persons will develop tuberculosis (TB) disease at some point in their lives. The purpose of this project is to continue ongoing national tuberculosis surveillance...

Primary Grade Teachers' Conceptions of Giftedness and Talent: A Case-based Investigation

ERIC Educational Resources Information Center

Brighton, Catherine M.; Moon, Tonya R.; Jarvis, Jane M.; Hockett, Jessica A.

2007-01-01

Despite the ongoing, extensive focus on the more equitable representation of gifted students from diverse populations, poor and minority students remain underserved by gifted education proportional to their representation in the broader student population (Donovan & Cross, 2002; U.S. Department of Education, 1993). One possible factor contributing…

Designing Personalized Learning Products for Middle School Mathematics: The Case for Networked Learning Games

ERIC Educational Resources Information Center

Evans, Michael A.; Pruett, Jordan; Chang, Mido; Nino, Miguel

2014-01-01

Middle school mathematics education is subject to ongoing reform based on advances in digital instructional technologies, especially learning games, leading to recent calls for investment in "personalized learning." Through an extensive literature review, this investigation identified three priority areas that should be taken into…

Supporting Diverse Learners through Professional Learning for Teachers

ERIC Educational Resources Information Center

Winnen, Ashley Newman

2016-01-01

School leaders use professional learning practices as a strategy to improve teaching and therefore student learning. As student populations become more ethnically and socioeconomically diverse, teachers need ongoing training to meet the needs of today's students. One successful elementary school in Colorado was the focus of this case study…

Evaluation of ULV applications against Old World sand fly species in equatorial Kenya

USDA-ARS?s Scientific Manuscript database

Reducing populations of phlebotomine sand flies in areas prevalent for leishmaniases is of ongoing importance to U.S. military operations. Collateral reduction of sand flies or human cases of leishmaniases during pesticide campaigns against vectors of malaria indicate that residuals like DDT can be ...

Exploring Blended Learning for Science Teacher Professional Development in an African Context

ERIC Educational Resources Information Center

Boitshwarelo, Bopelo

2009-01-01

This paper explores a case of teacher professional development in Botswana where a blended learning solution was attempted. The analysis of the implementation environment reveals deficiencies in policy, schools (workplaces), and training providers. The paper concludes with three recommendations: 1) Schools should support ongoing teacher learning…

Evaluation of ULV applications against Old World sand fly (Diptera: Psychodidae) species in equatorial Kenya

USDA-ARS?s Scientific Manuscript database

Reducing populations of phlebotomine sand flies in areas prevalent for human leishmaniases is of ongoing importance to US military operations and civilian populations in endemic regions. Collateral reduction of sand flies or human cases of leishmaniases during pesticide campaigns against vectors of ...

Selection bias in population-based cancer case-control studies due to incomplete sampling frame coverage.

PubMed

Walsh, Matthew C; Trentham-Dietz, Amy; Gangnon, Ronald E; Nieto, F Javier; Newcomb, Polly A; Palta, Mari

2012-06-01

Increasing numbers of individuals are choosing to opt out of population-based sampling frames due to privacy concerns. This is especially a problem in the selection of controls for case-control studies, as the cases often arise from relatively complete population-based registries, whereas control selection requires a sampling frame. If opt out is also related to risk factors, bias can arise. We linked breast cancer cases who reported having a valid driver's license from the 2004-2008 Wisconsin women's health study (N = 2,988) with a master list of licensed drivers from the Wisconsin Department of Transportation (WDOT). This master list excludes Wisconsin drivers that requested their information not be sold by the state. Multivariate-adjusted selection probability ratios (SPR) were calculated to estimate potential bias when using this driver's license sampling frame to select controls. A total of 962 cases (32%) had opted out of the WDOT sampling frame. Cases age <40 (SPR = 0.90), income either unreported (SPR = 0.89) or greater than $50,000 (SPR = 0.94), lower parity (SPR = 0.96 per one-child decrease), and hormone use (SPR = 0.93) were significantly less likely to be covered by the WDOT sampling frame (α = 0.05 level). Our results indicate the potential for selection bias due to differential opt out between various demographic and behavioral subgroups of controls. As selection bias may differ by exposure and study base, the assessment of potential bias needs to be ongoing. SPRs can be used to predict the direction of bias when cases and controls stem from different sampling frames in population-based case-control studies.

Computer-Aided Design/Computer-Assisted Manufacture Monolithic Restorations for Severely Worn Dentition: A Case History Report.

PubMed

Abou-Ayash, Samir; Boldt, Johannes; Vuck, Alexander

Full-arch rehabilitation of patients with severe tooth wear due to parafunctional behavior is a challenge for dentists and dental technicians, especially when a highly esthetic outcome is desired. A variety of different treatment options and prosthetic materials are available for such a clinical undertaking. The ongoing progress of computer-aided design/computer-assisted manufacture technologies in combination with all-ceramic materials provides a predictable workflow for these complex cases. This case history report describes a comprehensive, step-by-step treatment protocol leading to an optimally predictable treatment outcome for an esthetically compromised patient.

Restoration of Function With Acupuncture Following Severe Traumatic Brain Injury: A Case Report.

PubMed

Wolf, Jacob; Sparks, Linda; Deng, Yong; Langland, Jeffrey

2015-11-01

This case report illustrates the improvement of an acupuncture-treated patient who incurred a severe traumatic brain injury (TBI) from a snowboarding accident. Over 4 years, the patient progressed from initially not being able to walk, having difficulty with speech, and suffering from poor eyesight to where he has now regained significant motor function, speech, and vision and has returned to snowboarding. A core acupuncture protocol plus specific points added to address the patient's ongoing concerns was used. This case adds to the medical literature by demonstrating the potential role of acupuncture in TBI treatment.

Pattern and profile of electric burn injury cases at a Burn centre.

PubMed

Cheema, Saeed Ashraf

2016-01-01

Electrical burns are quite different from thermal and chemical burns. This study is from a centre which deals with job related electric burn injuries alone and thus can give a pure account of the electric burns and discuss the related peculiarities. Study aims to highlight the differences in the mechanism of electric burn injury, its mode of presentation, morbidity, complications and thus the treatment strategies as compared to rest of the burn injuries. This is a descriptive case series study of first consecutive 61 electric burn victims treated at a Burn Unit and Plastic Surgery centre. Cases were admitted and resuscitated at the emergency, and further treated at burn unit. Thorough history, examination findings and operative procedures were recorded. Patients were photographed for record as well. Emergency operative procedures, wound management, soft tissue coverage procedures and complications during the hospital stay were recorded and studied. Twenty cases (33%) were in the fifth decade of life. High voltage electric burn injury was seen in 42 (69%) of the cases. Whereas only 9 cases were treated conservatively, other 52 cases had 24 fasciotomies and 71 debridements. Series witnessed 10 expiries, and 22 amputations and all these were result of high voltage electric burns. Twenty eight soft tissue coverage procedures were carried out. Electric burn injuries are altogether different from rest of the burn injuries and must be treated accordingly. These injuries are peculiar for ongoing damage, extensive trauma, complications and prolonged morbidity. Treatment requires a high degree of suspicion, more aggressive management to unfold and minimize the deep seated insult.

[Profile of bacterial resistance in pediatric urinary tract infections in 2014].

PubMed

Flammang, A; Morello, R; Vergnaud, M; Brouard, J; Eckart, P

2017-03-01

In pediatric units, bacteria-producing extended-spectrum-betalactamase (ESBL) have an increasing prevalence among bacteria causing febrile urinary tract infections (UTIs). The purpose of this study was to evaluate the epidemiology of bacteria resistance patterns observed in UTIs, in order to assess the current antibiotic treatment protocols. This study is based upon a single-center retrospective chart review of the cytobacteriological urine cultures performed in UTIs between 1 January and 31 December 2014, in the medical pediatric unit of the Caen University Hospital. Out of the total of 219 cases of UTI, 26.9% were recurrences of UTI, 18.3% were infections in infants less than 3 months old, 21% of the patients suffered from underlying uropathy, and 16.4% of the patients had recently been exposed to antibiotics. In 80.3% of the cases, Escherichia coli was found, while Enterococcus faecalis was found in 5.6%. The antibiograms proved that 33.5% of the bacteria were sensitive. Half of E. coli were resistant to ampicillin, 4.9% to cefixime, 4.9% to ceftriaxone, 1.1% to gentamicin, and 27.8% to trimethoprim-sulfamethoxazole. Nine E. coli and one Enterobacter cloacae produced ESBL, accounting for 4.6% of the UTIs. We did not find any bacteria-producing high-level cephalosporinase. Cefixime resistance was statistically linked to ongoing antibiotic treatment (OR=5.98; 95% CI [1.44; 24.91], P=0.014) and underlying uropathy (OR=6.24; 95% CI [1.47; 26.42], P=0.013). Ceftriaxone resistance was statistically related to ongoing antibiotic treatment (OR=6.93; 95% CI [1.45; 33.13], P=0.015). These results argue in favor of maintaining intravenous ceftriaxone for probabilistic ambulatory treatment. However, in case of hospitalization, cefotaxime can replace ceftriaxone, due to its lower ecological impact. Moreover, it is necessary to continue monitoring bacterial resistance and regularly review our treatment protocols. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The response to September 11: a disaster case study.

PubMed

Crane, Michael A; Levy-Carrick, Nomi C; Crowley, Laura; Barnhart, Stephanie; Dudas, Melissa; Onuoha, Uchechukwu; Globina, Yelena; Haile, Winta; Shukla, Gauri; Ozbay, Fatih

2014-01-01

The response to 9/11 continues into its 14th year. The World Trade Center Health Program (WTCHP), a long-term monitoring and treatment program now funded by the Zadroga Act of 2010, includes >60,000 World Trade Center (WTC) disaster responders and community members ("survivors"). The aim of this review is to identify several elements that have had a critical impact on the evolution of the WTC response and, directly or indirectly, the health of the WTC-exposed population. It further explores post-disaster monitoring efforts, recent scientific findings from the WTCHP, and some implications of this experience for ongoing and future environmental disaster response. Transparency and responsiveness, site safety and worker training, assessment of acute and chronic exposure, and development of clinical expertise are interconnected elements determining efficacy of disaster response. Even in a relatively well-resourced environment, challenges regarding allocation of appropriate attention to vulnerable populations and integration of treatment response to significant medical and mental health comorbidities remain areas of ongoing programmatic development. Copyright © 2014 Icahn School of Medicine at Mount Sinai. All rights reserved.

Trajectories of Resilience, Resistance, and Distress During Ongoing Terrorism: The Case of Jews and Arabs in Israel

PubMed Central

Hobfoll, Stevan E.; Palmieri, Patrick A.; Johnson, Robert J.; Canetti-Nisim, Daphna; Hall, Brian J.; Galea, Sandro

2010-01-01

This is the 1st longitudinal examination of trajectories of resilience and resistance (rather than ill-being) among a national sample under ongoing threat of mass casualty. The authors interviewed a nationally representative sample of Jews and Arabs in Israel (N = 709) at 2 times during a period of terrorist and rocket attacks (2004–2005). The resistance trajectory, exhibiting few or no symptoms of traumatic stress and depression at both time points, was substantially less common (22.1%) than has previously been documented in studies following single mass casualty events. The resilience trajectory, exhibiting initial symptoms and becoming relatively nonsymptomatic, was evidenced by 13.5% of interviewees. The chronic distress trajectory was documented among a majority of participants (54.0%), and a small proportion of persons were initially relatively symptom-free but became distressed (termed delayed distress trajectory; 10.3%). Less psychosocial resource loss and majority status (Jewish) were the most consistent predictors of resistance and resilience trajectories, followed by greater socioeconomic status, greater support from friends, and less report of posttraumatic growth. PMID:19170460

Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia.

PubMed

Morin, Mélanie; Carroll, Marie-Soleil; Bergeron, Sophie

2017-07-01

Pelvic floor muscle physical therapy is recommended in clinical guidelines for women with provoked vestibulodynia (PVD). Including isolated or combined treatment modalities, physical therapy is viewed as an effective first-line intervention, yet no systematic review concerning the effectiveness of physical therapy has been conducted. To systematically appraise the current literature on the effectiveness of physical therapy modalities for decreasing pain during intercourse and improving sexual function in women with PVD. A systematic literature search using PubMed, Scopus, CINHAL, and PEDro was conducted until October 2016. Moreover, a manual search from reference lists of included articles was performed. Ongoing trials also were reviewed using clinicaltrial.gov and ISRCTNregistry. Randomized controlled trials, prospective and retrospective cohorts, and case reports evaluating the effect of isolated or combined physical therapy modalities in women with PVD were included in the review. Main outcome measures were pain during intercourse, sexual function, and patient's perceived improvement. The literature search resulted in 43 eligible studies including 7 randomized controlled trials, 20 prospective studies, 5 retrospective studies, 6 case reports, and 6 study protocols. Most studies had a high risk of bias mainly associated with the lack of a comparison group. Another common bias was related to insufficient sample size, non-validated outcomes, non-standardized intervention, and use of other ongoing treatment. The vast majority of studies showed that physical therapy modalities such as biofeedback, dilators, electrical stimulation, education, multimodal physical therapy, and multidisciplinary approaches were effective for decreasing pain during intercourse and improving sexual function. The positive findings for the effectiveness of physical therapy modalities in women with PVD should be investigated further in robust and well-designed randomized controlled trials. Morin M, Carroll M-S, Bergeron S. Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia. Sex Med Rev 2017;5:295-322. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The relationship between measured moisture conditions and fungal concentrations in water-damaged building materials.

PubMed

Pasanen, A L; Rautiala, S; Kasanen, J P; Raunio, P; Rantamäki, J; Kalliokoski, P

2000-06-01

We determined the moisture levels, relative humidity (RH) or moisture content (MC) of materials, and concentrations of culturable fungi, actinomycetes and total spores as well as a composition of fungal flora in 122 building material samples collected from 18 moisture problem buildings. The purpose of this work was to clarify if the is any correlation between the moisture parameters and microbial levels or generic composition depending on the type of materials and the time passed after a water damage. The results showed an agreement between the concentrations of total spores and culturable fungi for the wood, wood-based and gypsum board samples (r > 0.47). The concentrations of total spores and/or culturable fungi correlated with RH of materials particularly among the wood and insulation materials (r > 0.79), but not usually with MC (r < 0.45). For the samples collected from ongoing damage, there was a correlation between RH of materials and the concentrations of total spores and culturable fungi (r > 0.51), while such a relationship could not be observed for the samples taken from dry damage. A wide range of fungal species were found in the samples from ongoing damage, whereas Penicillia and in some cases yeasts dominated the fungal flora in the dry samples. This study indicates that fungal contamination can be evaluated on the basis of moisture measurements of constructions in ongoing damage, but the measurements are not solely adequate for estimation of possible microbial growth in dry damage.

Water Consumption as Source of Arsenic, Chromium, and Mercury in Children Living in Rural Yucatan, Mexico: Blood and Urine Levels.

PubMed

Arcega-Cabrera, F; Fargher, L F; Oceguera-Vargas, I; Noreña-Barroso, E; Yánez-Estrada, L; Alvarado, J; González, L; Moo-Puc, R; Pérez-Herrera, N; Quesadas-Rojas, M; Pérez-Medina, S

2017-10-01

Studies investigating the correlation between metal content in water and metal levels in children are scarce worldwide, but especially in developing nations. Therefore, this study investigates the correlation between arsenic, chromium, and mercury concentrations in drinking and cooking water and in blood and urine samples collected from healthy and supposedly non-exposed children from a rural area in Yucatan, Mexico. Mercury in water shows concentrations above the recommended World Health Organization (WHO) value for drinking and cooking water. Also, 25% of the children show mercury in urine above the WHO recommended value. Multivariate analyses show a significant role for drinking and cooking water as a vector of exposure in children. Also, the factor analysis shows chronic exposure in the case of arsenic, as well as an ongoing detoxification process through urine in the case of mercury. Further studies should be done in order to determine other potential metal exposure pathways among children.

Shock wave attenuation by water droplets

NASA Astrophysics Data System (ADS)

Eliasson, Veronica; Wan, Qian; Deiterding, Ralf

2017-11-01

The ongoing research on shock wave attenuation is fueled by the desire to predict and avoid damage caused by shock and blast waves. For example, during an explosion in an underground mine or subway tunnel, the shock front is forced to propagate in the direction of the channel. In this work, numerical simulations using water droplets in a 2D channel are conducted to study shock wave attenuation. Four different droplet configurations (1x1, 2x2, 3x3, and 4x4) are considered, where the total volume of water is kept constant throughout all the cases. Meanwhile, the incident shock Mach number was varied from 1.1 to 1.4 with increments of 0.1. The physical motion of the water droplets, such as the center-of-mass drift and velocity, and the energy exchange between air and water are quantitatively studied. Results for center-of-mass velocity, maximum peak pressure and impulse will be presented for all different cases that were studied. NSF CBET-1437412.

Feasibility and design study of a frictionless air mover for thermal management of electronics

NASA Astrophysics Data System (ADS)

Schacht, R.; Hausdorf, A.; Wunderle, B.

2014-07-01

A frictionless air mover concept is introduced in this paper. As opposed to a piezoelectric driven fan, the air mover is based on a flexible blade whose vibration is driven by means of a magnetic field. The blade is based on a polymer material. The paper presents the results of a feasibility analysis and an on-going comprehensive design study. The performance of the prototype amounted to 65% of a comparable piezoelectric fan. To enhance the performance, two different blade materials were investigated, as well as the influence of the coil shape and value. A further goal is to reduce the size and to investigate the influence of a casing. The design study resulted in a prototype of size of 50 × 14 × 35 mm2 including a casing. The performance could be doubled, to attain a volumetric flow rate of dot V ~14 l/min and a static pressure of ρstat = 3 Pa.

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

PubMed

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

2017-12-21

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

Chelonitoxism outbreak caused from consuming turtle, Eastern Samar, Philippines, August 2013.

PubMed

Ventura, Ray Justin; Ching, Paola Katrina; de los Reyes, Vikki Carr; Sucaldito, Ma Nemia; Tayag, Enrique

2015-01-01

On 21 August 2013, the Event-based Surveillance and Response system of the Department of Health, Philippines captured a foodborne illness event among residents of a coastal village in Eastern Samar, Philippines. The suspected cause was the consumption of a sea turtle found near the village. A team from the Department of Health was sent to conduct an outbreak investigation. A case was defined as any person in Arteche, Eastern Samar, who developed dry mouth and burning sensation in the throat from 15 August to 27 August, 2013. Severity of the disease was classified as mild, moderate or severe. We conducted records review, environmental investigation, interviews of key informants and a retrospective cohort study. Sixty-eight cases were identified; four died (case fatality rate = 6%). All cases had a history of turtle meat consumption. Dose-dependent relationship was noted between amount of turtle meat consumed and the risk of illness. In the cohort study, consumption of turtle meat and turtle meat soup were associated with illness. This study identified turtle meat as the source of this foodborne outbreak and emphasized the dangers of consuming turtle meat. Other reported cases of turtle meat poisoning in the Philippines suggest that turtle consumption is an ongoing practice in the country. By publishing information about sea turtle poisoning outbreaks in the Philippines, we hope to raise awareness of the potential severe health effects from ingesting these endangered sea creatures.

Long-term in vivo left ventricular assist device study for 284 days with Gyro PI pump.

PubMed

Ohtsuka, G; Nakata, K; Yoshikawa, M; Takano, T; Glueck, J; Sankai, Y; Takami, Y; Mueller, J; Sueoka, A; Letsou, G; Schima, H; Schmallegger, H; Wolner, E; Koyanagi, H; Fujisawa, A; Baldwin, J C; Nosé, Y

1999-06-01

A totally implantable centrifugal artificial heart has been developed. The plastic prototype, the Gyro PI 601, passed 2 day hemodynamic tests as a functional total artificial heart (TAH), 2 week screening tests for anti-thrombogenecity, and a 1 month system feasibility study. Based upon these results, a metallic prototype, the Gyro PI 700 series, was subjected to long-term in vivo left ventricular assist device (LVAD) studies of over 1 month. The Gyro PI 700 series has the same inner dimension and same characteristics of the Gyro PI 601 such as an eccentric inlet port, a double pivot bearing system, and a magnet coupling system. The PI metallic pump is also driven with the Vienna DC brushless motor actuator like the PI 601. The pump-actuator package was implanted in 3 calves in the preperitoneal space, bypassing from the left ventricular (LV) apex to the descending aorta. Case 1 achieved a 284 day survival. Case 2 was euthanized early at 72 postoperative days as a result of the functional obstruction of the inlet port due to the excessive growth of the calf. There was no blood clot inside the pumps of either case. Case 3 is on-going (22 days on July 24, 1998). During these periods, all cases showed no physiological abnormalities. In conclusion, the PI 700 series pump has excellent results as a long-term implantable LVAD.

Integrating knowledge generation with knowledge diffusion and utilization: a case study analysis of the Consortium for Applied Research and Evaluation in Mental Health.

PubMed

Vingilis, Evelyn; Hartford, Kathleen; Schrecker, Ted; Mitchell, Beth; Lent, Barbara; Bishop, Joan

2003-01-01

Knowledge diffusion and utilization (KDU) have become a key focus in the health research community because of the limited success to date of research findings to inform health policies, programs and services. Yet, evidence indicates that successful KDU is often predicated on the early involvement of potential knowledge users in the conceptualization and conduct of the research and on the development of a "partnership culture". This study describes the integration of KDU theory with practice via a case study analysis of the Consortium for Applied Research and Evaluation in Mental Health (CAREMH). This qualitative study, using a single-case design, included a number of data sources: proposals, meeting minutes, presentations, publications, reports and curricula vitae of CAREMH members. CAREMH has adopted the following operational strategies to increase KDU capacity: 1) viewing research as a means and not as an end; 2) bringing the university and researcher to the community; 3) using participatory research methods; 4) embracing transdisciplinary research and interactions; and 5) using connectors. Examples of the iterative process between researchers and potential knowledge users in their contribution to knowledge generation, diffusion and utilization are provided. This case study supports the importance of early and ongoing involvement of relevant potential knowledge users in research to enhance its utilization potential. It also highlights the need for re-thinking research funding approaches.

The effect of semantic context on prospective memory performance.

PubMed

Thomas, Brandon J; McBride, Dawn M

2016-01-01

The current study provides evidence for spontaneous processing in prospective memory (PM) or memory for intentions. Discrepancy-plus-search is the spontaneous processing of PM cues via disruptions in processing fluency of ongoing task items. We tested whether this mechanism can be demonstrated in an ongoing rating task with a dominant semantic context. Ongoing task items were manipulated such that the PM cues were members of a semantic category (i.e., Body Parts) that was congruent or discrepant with the dominant semantic category in the ongoing task. Results showed that participants correctly responded to more PM cues when there was a category discrepancy between the PM cues and ongoing task items. Moreover, participants' identification of PM cues was accompanied by faster ongoing task reaction times when PM cues were discrepant with ongoing task items than when they were congruent. These results suggest that a discrepancy-plus-search process supports PM retrieval in certain contexts, and that some discrepancy-plus-search mechanisms may result from the violation of processing expectations within a semantic context.

Ongoing outbreak of dengue type 1 in the Autonomous Region of Madeira, Portugal: preliminary report.

PubMed

Sousa, C A; Clairouin, M; Seixas, G; Viveiros, B; Novo, M T; Silva, A C; Escoval, M T; Economopoulou, A

2012-12-06

Following the identification of two autochthonous cases of dengue type 1 on 3 October 2012, an outbreak of dengue fever has been reported in Madeira, Portugal. As of 25 November, 1,891 cases have been detected on the island where the vector Aedes aegypti had been established in some areas since 2005. This event represents the first epidemic of dengue fever in Europe since 1928 and concerted control measures have been initiated by local health authorities.

Public health response to an outbreak of Legionnaires' disease in Edinburgh, United Kingdom, June 2012.

PubMed

McCormick, D; Thorn, S; Milne, D; Evans, C; Stevenson, J; Llano, M; Donaghy, M

2012-07-12

We report an outbreak comprising 50 confirmed cases of Legionnaires' disease in Edinburgh, Scotland, June 2012. In addition, there were 49 suspected cases. Epidemiological evidence suggests that a common outdoor airborne exposure occurred over south-west Edinburgh. This probably emanated from cooling towers in the north-east of the affected area, although not yet clearly linked by scientific evidence. The co-ordinated public health, environmental and clinical response helped prevent ongoing exposure and mitigated associated mortality and morbidity.

Ongoing nationwide outbreak of Salmonella Agona associated with internationally distributed infant milk products, France, December 2017.

PubMed

Jourdan-da Silva, Nathalie; Fabre, Laetitia; Robinson, Eve; Fournet, Nelly; Nisavanh, Athinna; Bruyand, Mathias; Mailles, Alexandra; Serre, Estelle; Ravel, Magali; Guibert, Véronique; Issenhuth-Jeanjean, Sylvie; Renaudat, Charlotte; Tourdjman, Mathieu; Septfons, Alexandra; de Valk, Henriette; Le Hello, Simon

2018-01-01

On 1 December 2017, an outbreak of Salmonella Agona infections among infants was identified in France. To date, 37 cases (median age: 4 months) and two further international cases have been confirmed. Five different infant milk products manufactured at one facility were implicated. On 2 and 10 December, the company recalled the implicated products; on 22 December, all products processed at the facility since February 2017. Trace-forward investigations indicated product distribution to 66 countries.

Advancing Our Understanding of the Etiologies and Mutational Landscapes of Basal-Like, Luminal A, and Luminal B Breast Cancers

DTIC Science & Technology

2013-10-01

random digit dialing (RDD) interviewers. To support this and on-going training, Ms. Taylor will develop a question by question (QxQ)specification...from each other. All Page 9 triple-negative cases will be evaluated for EGFR and cytokeratin 5/6 using IHC so basal-like cases can be identified...by PCR amplification of the identified exons in tumor and matched normal DNA followed by PCR cleanup using Agencourt Ampure XP reagents and then

Advancing Our Understanding of the Etiologies and Mutational Landscapes of Basal-Like, Luminal A, and Luminal B Breast Cancers

DTIC Science & Technology

2013-10-01

will oversee the training of the study’s field and random digit dialing (RDD) interviewers. To support this and on-going training, Ms. Taylor will...luminal A and luminal B cases can be distinguished from each other. All Page 9 triple-negative cases will be evaluated for EGFR and cytokeratin 5/6...point mutations and small indels will be validated by PCR amplification of the identified exons in tumor and matched normal DNA followed by PCR

Commentary: Factors predicting family court decisions in high-conflict divorce.

PubMed

Stover, Carla Smith

2013-01-01

Factors that predict custody and visitation decisions are an important area of research, especially in the context of high-conflict divorce. In these cases, youths are at significantly higher risk for exposure to ongoing conflict, violence, and triangulation in their parents' disputes. What variables courts and evaluation clinics use to make custody decisions and whether they are the most salient requires further study. The work by Raub and colleagues in this issue extends our understanding of important factors considered by the courts and custody evaluators in high-conflict divorce and points to directions for future research in this area.

Academic Momentum at University/College: Exploring the Roles of Prior Learning, Life Experience, and Ongoing Performance in Academic Achievement across Time

ERIC Educational Resources Information Center

Martin, Andrew J.; Wilson, Rachel; Liem, Gregory Arief D.; Ginns, Paul

2014-01-01

In the context of "academic momentum," a longitudinal study of university students (N = 904) showed high school achievement and ongoing university achievement predicted subsequent achievement through university. However, the impact of high school achievement diminished, while additive effects of ongoing university achievement continued.…

Trust, fear, stigma and disruptions: community perceptions and experiences during periods of low but ongoing transmission of Ebola virus disease in Sierra Leone, 2015

PubMed Central

Meyer, Erika; Bunnell, Rebecca; Bio, Franklin A; Jalloh, Mohammad B; Sengeh, Paul; Hageman, Kathy M; Carroll, Dianna D; Conteh, Lansana; Morgan, Oliver

2018-01-01

Social mobilisation and risk communication were essential to the 2014–2015 West African Ebola response. By March 2015, >8500 Ebola cases and 3370 Ebola deaths were confirmed in Sierra Leone. Response efforts were focused on ‘getting to zero and staying at zero’. A critical component of this plan was to deepen and sustain community engagement. Several national quantitative studies conducted during this time revealed Ebola knowledge, personal prevention practices and traditional burial procedures improved as the outbreak waned, but healthcare system challenges were also noted. Few qualitative studies have examined these combined factors, along with survivor stigma during periods of ongoing transmission. To obtain an in-depth understanding of people’s perceptions, attitudes and behaviours associated with Ebola transmission risks, 27 focus groups were conducted between April and May 2015 with adult Sierra Leonean community members on: trust in the healthcare system, interactions with Ebola survivors, impact of Ebola on lives and livelihood, and barriers and facilitators to ending the outbreak. Participants perceived that as healthcare practices and facilities improved, so did community trust. Resource management remained a noted concern. Perceptions of survivors ranged from sympathy and empathy to fear and stigmatisation. Barriers included persistent denial of ongoing Ebola transmission, secret burials and movement across porous borders. Facilitators included personal protective actions, consistent messaging and the inclusion of women and survivors in the response. Understanding community experiences during the devastating Ebola epidemic provides practical lessons for engaging similar communities in risk communication and social mobilisation during future outbreaks and public health emergencies. PMID:29629189

Recovery collapse coincident with ongoing carbon cycle perturbations following the Permian-Triassic mass extinction

NASA Astrophysics Data System (ADS)

Petsios, E.; Bottjer, D. J.

2016-12-01

The Permian-Triassic mass extinction, the largest extinction of the Phanerozoic, is attributed to volcanic outgassing from the Siberian Traps and the resulting climate change. Ongoing volcanism in the Early Triassic is implicated for continued carbon cycle instability following the initial event, reflected in large inorganic carbon isotope excursions throughout the 5 Mya interval. Recent paleoecological studies have shown that timing of recovery from the extinction in the Early Triassic is highly complex, differing between regions, with documented cases of "early" recovery in some environments. The importance of specific environmental factors, such as oxygen levels and sea surface temperatures, in aiding or hindering recovery following the extinction is the topic of ongoing study. Here we present an ecological survey of marine benthic communities from the Lower Triassic Blacktail Creek outcrop of the Dinwoody Formation, correlated bed-for-bed with inorganic carbon isotope values. We observe incipient recovery as communities show increasing richness and evenness throughout the section, followed by a `collapse' with a return of high dominance, low richness fauna coincident with large δ13Ccarb shifts. We observe a statistically significant correlation between the magnitude of δ13Ccarb excursions and benthic community complexity over a stratigraphic section, implying a shared causal mechanism acting at the local scale. The globally correlatable nature of these observed carbon isotope shifts, as well as an absence of lithologic evidence for oxygen limitation, points to thermal stress brought on by pulses of volcanism as the shared cause between recovery collapse and carbon cycle perturbations. We propose that the "early" recovery at Blacktail Creek was truncated by recurrent greenhouse gas induced thermal spikes, highlighting the interplay of local and global environmental conditions in expediting or hindering Early Triassic recovery.

Progress toward poliomyelitis eradication--Chad, January 2011-August 2012.

PubMed

2012-10-26

In 1988, the World Health Assembly launched the Global Polio Eradication Initiative (GPEI) to interrupt transmission of wild poliovirus (WPV). By January 2012, indigenous WPV transmission had been interrupted in all countries except Afghanistan, Pakistan, and Nigeria. However, importation of WPV caused outbreaks in 29 and reestablished transmission in four, previously polio-free African countries during 2003-2011. Transmission after WPV importation is considered reestablished when it continues for ≥ 12 months; in Chad, transmissions of WPV type 3 (WPV3) and WPV type 1 (WPV1) were reestablished. WPV3 was imported from Nigeria in 2007 and continued to circulate; the latest reported WPV3 case occurred on March 10, 2011. Transmission of WPV1 continued after a WPV1 case was imported from Nigeria in September 2010; the latest reported WPV1 occurred on June 14, 2012. This report updates previous reports and describes polio eradication activities and progress in Chad during January 2011-August 2012, as of October 2, 2012. Five WPV1 cases were reported during January-August 2012, compared with 111 WPV1 cases and three WPV3 cases reported during the same period in 2011. Five circulating type 2 vaccine-derived poliovirus (cVDPV2) cases occurred during July-August 2012. Current progress suggests that Chad could interrupt reestablished WPV transmission in 2012, although limitations in surveillance hamper the ability to detect ongoing transmission. Furthermore, with ongoing endemic WPV transmission in Nigeria, Chad remains at risk for new WPV importations. Efforts to strengthen surveillance and enhance routine and campaign immunization performance will need to continue in Chad to ensure interruption of reestablished WPV transmission, limit circulation after any WPV importation, and interrupt transmission of cVDPV.

Case-control Studies on the Effectiveness of Breast Cancer Screening: Insights from the UK Age Trial.

PubMed

van der Waal, Daniëlle; Broeders, Mireille J M; Verbeek, André L M; Duffy, Stephen W; Moss, Sue M

2015-07-01

Ongoing breast cancer screening programs can only be evaluated using observational study designs. Most studies have observed a reduction in breast cancer mortality, but design differences appear to have resulted in different estimates. Direct comparison of case-control and trial analyses gives more insight into this variation. Here, we performed case-control analyses within the randomized UK Age Trial. The Age Trial assessed the effect of screening on breast cancer mortality in women ages 40-49 years. In our approach, case subjects were defined as breast cancer deaths between trial entry (1991-1997) and 2004. Women were ages 39-41 years at entry. For every case subject, five control subjects were selected. All case subjects were included in analyses of screening invitation (356 case subjects, 1,780 controls), whereas analyses of attendance were restricted to women invited to screening (105 case subjects, 525 age-matched controls). Odds ratios (OR) were estimated with conditional logistic regression. We used and compared two methods to correct for self-selection bias. Screening invitation resulted in a breast cancer mortality reduction of 17% (95% confidence interval [CI]: -36%, +6%), similar to trial results. Different exposure definitions and self-selection adjustments influenced the observed breast cancer mortality reduction. Depending on the method, "ever screened" appeared to be associated with a small reduction (OR: 0.86, 95% CI: 0.40, 1.89) or no reduction (OR: 1.02, 95% CI: 0.48, 2.14) using the two methods of correction. Recent attendance resulted in an adjusted mortality reduction of 36% (95% CI: -69%, +31%) or 45% (95% CI: -71%, +5%). Observational studies, and particularly case-control studies, are an important monitoring tool for breast cancer screening programs. The focus should be on diminishing bias in observational studies and gaining a better understanding of the influence of study design on estimates of mortality reduction.

Hantavirus pulmonary syndrome in Argentina, 1995-2008.

PubMed

Martinez, Valeria P; Bellomo, Carla M; Cacace, Maria Luisa; Suarez, Paola; Bogni, Liliana; Padula, Paula J

2010-12-01

We report a large case series of hantavirus pulmonary syndrome (HPS) in Argentina that was confirmed by laboratory results from 1995 through 2008. The geographic and temporal distribution of cases by age, sex, fatality rate, and risk factors for HPS was analyzed. A total of 710 cases were unequally distributed among 4 of the 5 Argentine regions. Different case-fatality rates were observed for each affected region, with a maximum rate of 40.5%. The male-to-female ratio for HPS case-patients was 3.7:1.0; the case-fatality rate was significantly higher for women. Agriculture-associated activities were most commonly reported as potential risk factors, especially among men of working age. Although HPS cases occurred predominantly in isolation, we identified 15 clusters in which strong relationships were observed between members, which suggests ongoing but limited person-to-person transmission.

Application of the analytic hierarchy process to a sustainability assessment of coastal beach exploitation: a case study of the wind power projects on the coastal beaches of Yancheng, China.

PubMed

Tian, Weijun; Bai, Jie; Sun, Huimei; Zhao, Yangguo

2013-01-30

Sustainability assessments of coastal beach exploitation are difficult because the identification of appropriate monitoring methodologies and evaluation procedures is still ongoing. In particular, the most suitable procedure for the application of sustainability assessment to coastal beaches remains uncertain. This paper presents a complete sustainability assessment process for coastal beach exploitation based on the analytic hierarchy process (AHP). We developed an assessment framework consisting of 14 indicators derived from the three dimensions of suitability, economic and social value, and ecosystem. We chose a wind power project on a coastal beach of Yancheng as a case study. The results indicated that the wind power farms on the coastal beach were not completely in keeping with sustainable development theory. The construction of the wind power farms had some negative impacts. Therefore, in the design stage, wind turbines should be designed and planned carefully to minimize these negative impacts. In addition, the case study demonstrated that the AHP was capable of addressing the complexities associated with the sustainability of coastal beaches. Copyright © 2012 Elsevier Ltd. All rights reserved.

Head or brain injuries and Alzheimer's disease: A nested case-control register study.

PubMed

Tolppanen, Anna-Maija; Taipale, Heidi; Hartikainen, Sirpa

2017-12-01

Many previous studies have been limited by self- or proxy-reported injury or short follow-up. We investigated whether head or brain injuries are associated with Alzheimer's disease (AD), possible modifying factors and dose-response relationship. Nested register-based case-control study of all community dwellers who received clinically verified AD diagnosis in Finland in 2005 to 2011 (n = 70,719) and one to four matched controls for each case (n of controls = 282,862). The magnitude of association between hospital-treated head and/or brain injuries was strongly dependent on the lag time between exposure and outcome. With a 5-year lag time, head injury (adjusted odds ratio; 95% confidence interval 1.19; 1.15-1.23) or brain injury (1.23; 1.18-1.29) was associated with higher risk of AD. Dose-response relationship with number and severity of injuries was observed. Associations were stronger in those with earlier onset of AD. Stronger associations with shorter lag times indicate that head and/or brain injuries may also reflect the ongoing AD disease process. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Gene expression in thiazide diuretic or statin users in relation to incident type 2 diabetes.

PubMed

Suchy-Dicey, Astrid; Heckbert, Susan R; Smith, Nicholas L; McKnight, Barbara; Rotter, Jerome I; Chen, Yd Ida; Psaty, Bruce M; Enquobahrie, Daniel A

2014-01-01

Thiazide diuretics and statins are used to improve cardiovascular outcomes, but may also cause type 2 diabetes (T2DM), although mechanisms are unknown. Gene expression studies may facilitate understanding of these associations. Participants from ongoing population-based studies were sampled for these longitudinal studies of peripheral blood microarray gene expression, and followed to incident diabetes. All sampled subjects were statin or thiazide users. Those who developed diabetes during follow-up comprised cases (44 thiazide users; 19 statin users), and were matched to drug-using controls who did not develop diabetes on several factors. Supervised normalization, surrogate variable analyses removed technical bias and confounding. Differentially-expressed genes were those with a false discovery rate Q-value<0.05. Among thiazide users, diabetes cases had significantly different expression of CCL14 (down-regulated 6%, Q-value=0.0257), compared with controls. Among statin users, diabetes cases had marginal but insignificantly different expression of ZNF532 (up-regulated 15%, Q-value=0.0584), CXORF21 (up-regulated 11%, Q-value=0.0584), and ZNHIT3 (up-regulated 19%, Q-value=0.0959), compared with controls. These genes comprise potential targets for future expression or mechanistic research on medication-related diabetes development.

Breathing as a Fundamental Rhythm of Brain Function.

PubMed

Heck, Detlef H; McAfee, Samuel S; Liu, Yu; Babajani-Feremi, Abbas; Rezaie, Roozbeh; Freeman, Walter J; Wheless, James W; Papanicolaou, Andrew C; Ruszinkó, Miklós; Sokolov, Yury; Kozma, Robert

2016-01-01

Ongoing fluctuations of neuronal activity have long been considered intrinsic noise that introduces unavoidable and unwanted variability into neuronal processing, which the brain eliminates by averaging across population activity (Georgopoulos et al., 1986; Lee et al., 1988; Shadlen and Newsome, 1994; Maynard et al., 1999). It is now understood, that the seemingly random fluctuations of cortical activity form highly structured patterns, including oscillations at various frequencies, that modulate evoked neuronal responses (Arieli et al., 1996; Poulet and Petersen, 2008; He, 2013) and affect sensory perception (Linkenkaer-Hansen et al., 2004; Boly et al., 2007; Sadaghiani et al., 2009; Vinnik et al., 2012; Palva et al., 2013). Ongoing cortical activity is driven by proprioceptive and interoceptive inputs. In addition, it is partially intrinsically generated in which case it may be related to mental processes (Fox and Raichle, 2007; Deco et al., 2011). Here we argue that respiration, via multiple sensory pathways, contributes a rhythmic component to the ongoing cortical activity. We suggest that this rhythmic activity modulates the temporal organization of cortical neurodynamics, thereby linking higher cortical functions to the process of breathing.

A Discussion of Change Theory, System Theory, and State Designed Standards and Accountability Initiatives.

ERIC Educational Resources Information Center

McNeal, Larry; Christy, W. Keith

This brief paper is a presentation that preceeded another case of considering the ongoing dialogue on the advantages and disadvantages of centralized and decentralized school-improvement processes. It attempts to raise a number of questions about the relationship between state-designed standards and accountability initiatives and change and…

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Reasonable funding methods. 1.412(c)(3)-1... Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for purposes of section 412...

Doctor, It Hurts When I Do This

DTIC Science & Technology

2009-10-01

procedures is 520 pages. For comparison, Moby Dick is a minnow-sized 420 pages and even Tolstoy’s epic War and Peace is dwarfed at 699 pages. As the... advertised to be. The ongoing events in the financial world offer an interest- ing case in point. The global financial system has become highly

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Reasonable funding methods. 1.412(c)(3)-1 Section...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Reasonable funding methods. 1.412(c)(3)-1...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Reasonable funding methods. 1.412(c)(3)-1...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

Standardized Patients Provide a Reliable Assessment of Athletic Training Students' Clinical Skills

ERIC Educational Resources Information Center

Armstrong, Kirk J.; Jarriel, Amanda J.

2016-01-01

Context: Providing students reliable objective feedback regarding their clinical performance is of great value for ongoing clinical skill assessment. Since a standardized patient (SP) is trained to consistently portray the case, students can be assessed and receive immediate feedback within the same clinical encounter; however, no research, to our…

Section 504 in American Public Schools: An Ongoing Response to Change

ERIC Educational Resources Information Center

Schraven, Jodie; Jolly, Jennifer L.

2010-01-01

This paper seeks to specifically focus on the evolution of civil rights case law and legislation as it pertains to educating students with disabilities, specifically the often implemented but poorly understood Section 504 provisions. The purpose of this paper is to examine historical influences that precipitated the implementation of Section 504…

Emotional Speech Acts and the Educational Perlocutions of Speech

ERIC Educational Resources Information Center

Gasparatou, Renia

2016-01-01

Over the past decades, there has been an ongoing debate about whether education should aim at the cultivation of emotional wellbeing of self-esteeming personalities or whether it should prioritise literacy and the cognitive development of students. However, it might be the case that the two are not easily distinguished in educational contexts. In…

Teaching Single-Case Evaluation to Graduate Social Work Students: A Replication

ERIC Educational Resources Information Center

Wong, Stephen E.; O'Driscoll, Janice

2017-01-01

A course teaching graduate social work students to use an evidence-based model and to evaluate their own practice was replicated and evaluated. Students conducted a project in which they reviewed published research to achieve a clinical goal, applied quantitative measures for ongoing assessment, implemented evidence-based interventions, and…

Write Makes Might: A Case for the Neglected Skill.

ERIC Educational Resources Information Center

Duncan, Annelise M.

Of all the language skills, writing is the most difficult challenge for language teachers because students have less experience with written expression. Stimulated by audio-visual materials throughout their lives, students are novices in the discipline of writing. Making writing an ongoing part of foreign language acquisition from the first day in…

Acute Flaccid Paralysis: The New, The Old, and The Preventable

PubMed Central

Macesic, N.; Hall, V.; Mahony, A.; Hueston, L.; Ng, G.; Macdonell, R.; Hughes, A.; Fitt, G.; Grayson, M. L.

2016-01-01

Acute flaccid paralysis (AFP) has a changing epidemiology with ongoing polio outbreaks and emerging causes such as nonpolio enteroviruses and West Nile virus (WNV). We report a case of AFP from the Horn of Africa that was initially classified as probable polio but subsequently found to be due to WNV. PMID:26788545

Particle statistics and lossy dynamics of ultracold atoms in optical lattices

NASA Astrophysics Data System (ADS)

Yago Malo, J.; van Nieuwenburg, E. P. L.; Fischer, M. H.; Daley, A. J.

2018-05-01

Experimental control over ultracold quantum gases has made it possible to investigate low-dimensional systems of both bosonic and fermionic atoms. In closed one-dimensional systems there are many similarities in the dynamics of local quantities for spinless fermions and strongly interacting "hard-core" bosons, which on a lattice can be formalized via a Jordan-Wigner transformation. In this study, we analyze the similarities and differences for spinless fermions and hard-core bosons on a lattice in the presence of particle loss. The removal of a single fermion causes differences in local quantities compared with the bosonic case because of the different particle exchange symmetry in the two cases. We identify deterministic and probabilistic signatures of these dynamics in terms of local particle density, which could be measured in ongoing experiments with quantum gas microscopes.

The Swine Flu Triage (SwiFT) study: development and ongoing refinement of a triage tool to provide regular information to guide immediate policy and practice for the use of critical care services during the H1N1 swine influenza pandemic.

PubMed

Rowan, K M; Harrison, D A; Walsh, T S; McAuley, D F; Perkins, G D; Taylor, B L; Menon, D K

2010-12-01

To use, existing critical care and early pandemic, data to inform care during the pandemic influenza A 2009 (H1N1) pandemic (with a possible use for triage - if the demand for critical care seriously exceeded supply). To monitor the impact of the H1N1 pandemic on critical care services, in real time, with regular feedback to critical care clinicians and other relevant jurisdictions to inform ongoing policy and practice. Modelling of data and cohort study. Modelling - 148 adult, general critical care units in England, Wales and Northern Ireland in the Intensive Care National Audit & Research Centre Case Mix Programme. Cohort study - 192 acute hospitals in England, Wales, Northern Ireland, Scotland and the Republic of Ireland. Modelling - 105,397 admissions to adult, general critical care units. Cohort study - 1728 H1N1 pandemic-related admissions referred and assessed as requiring critical care. Modelling - requirement for organ support and acute hospital mortality. Cohort study - survival to the end of critical care. Modelling - cancelled or postponed, elective or scheduled surgery resulted in savings in calendar days of critical, Level 3 and advanced respiratory care of 17, 11 and 10%, respectively. These savings varied across units. Using routine, physiological variables, the best triage models, for all and for acute respiratory admissions, achieved only satisfactory concordance of 0.79 and 0.75, respectively. Application of the best model on all admissions indicated that approximately 12.5% of calendar days of critical care could be saved. Cohort study - research governance approvals were achieved for 192 acute hospitals, for 91 within 1 day of central research and development approval across the five countries. A total of 1725 cases (562 confirmed) were reported. Confirmed cases were young (mean age of 40 years), had low severity of acute illness on presentation [61% CURB-65 (confusion, urea, respiratory rate, blood pressure, age over 65 years) 0-1], but had long stays in critical care (median 8.5 days) and were likely to be ventilated (77% for median 9 days). Risk factors for acute hospital death were similar to those for general critical care admissions. SwiFT was rapidly established. Models based on routine physiology suggested limited value for triage. More data and further modelling are warranted. The magnitude of the pandemic did not approach the worst-case scenario modelling, and UK-confirmed H1N1 cases appeared similar to those reported internationally. The National Institute for Health Research Health Technology Assessment programme.

Individualized decision-making in IVF: calculating the chances of pregnancy.

PubMed

van Loendersloot, L L; van Wely, M; Repping, S; Bossuyt, P M M; van der Veen, F

2013-11-01

Are we able to develop a model to calculate the chances of pregnancy prior to the start of the first IVF cycle as well as after one or more failed cycles? Our prediction model enables the accurate individualized calculation of the probability of an ongoing pregnancy with IVF. To improve counselling, patient selection and clinical decision-making in IVF, a number of prediction models have been developed. These models are of limited use as they were developed before current clinical and laboratory protocols were established. This was a cohort study. The development set included 2621 cycles in 1326 couples who had been treated with IVF or ICSI between January 2001 and July 2009. The validation set included additional data from 515 cycles in 440 couples treated between August 2009 and April 2011. The outcome of interest was an ongoing pregnancy after transfer of fresh or frozen-thawed embryos from the same stimulated IVF cycle. If a couple became pregnant after an IVF/ICSI cycle, the follow-up was at a gestational age of at least 11 weeks. Women treated with IVF or ICSI between January 2001 and April 2011 in a university hospital. IVF/ICSI cycles were excluded in the case of oocyte or embryo donation, surgically retrieved spermatozoa, patients positive for human immunodeficiency virus, modified natural IVF and cycles cancelled owing to poor ovarian stimulation, ovarian hyperstimulation syndrome or other unexpected medical or non-medical reasons. Thirteen variables were included in the final prediction model. For all cycles, these were female age, duration of subfertility, previous ongoing pregnancy, male subfertility, diminished ovarian reserve, endometriosis, basal FSH and number of failed IVF cycles. After the first cycle: fertilization, number of embryos, mean morphological score per Day 3 embryo, presence of 8-cell embryos on Day 3 and presence of morulae on Day 3 were also included. In validation, the model had moderate discriminative capacity (c-statistic 0.68, 95% confidence interval: 0.63-0.73) but calibrated well, with a range from 0.01 to 0.56 in calculated probabilities. In our study, the outcome of interest was ongoing pregnancy. Live birth may have been a more appropriate outcome, although only 1-2% of all ongoing pregnancies result in late miscarriage or stillbirth. The model was based on data from a single centre. The IVF model presented here is the first to calculate the chances of an ongoing pregnancy with IVF, both for the first cycle and after any number of failed cycles. The generalizability of the model to other clinics has to be evaluated more extensively in future studies (geographical validation). Centres with higher or lower success rates could use the model, after recalibration, by adjusting the intercept to reflect the IVF success rates in their centre. This project was funded by the NutsOhra foundation (Grant 1004-179). The NutsOhra foundation had no role in the development of our study, in the collection, analysis and interpretation of data; in writing of the manuscript, and in the decision to submit the manuscript for publication. There were no competing interests.

Malignant Mesothelioma in a Motor Vehicle Mechanic.

PubMed

Meisenkothen, Christopher

2017-02-01

Case reports remain an important source of data in the debate over the carcinogenic effect of asbestos-containing automotive friction products. This report documents a case of pleural mesothelioma accompanied by asbestos bodies in the lung tissue of a career auto mechanic with no other known sources of exposure. Previously unreported historical and contemporary exposure data are also discussed in the context of providing additional support for the proposition that work with asbestos-containing automotive products presents a risk of significant exposure. While there remains a body of negative epidemiology that fails to find an increased risk of disease among auto workers, those data must be approached with caution. Many of those studies have drawn technical criticisms, which are beyond the scope of this report, but they remain a key part of the legal defense mounted by defendant-companies who are involved in asbestos-related litigation. This ongoing debate provides the context for the continued relevance of case reports such as this one, as well as the presentation of new and previously unpublished exposure data.

[Adherence to the Ongoing Education Program for family doctors in a southeastern Brazilian state].

PubMed

d'Ávila, Luciana Souza; Assis, Lucília Nunes de; Melo, Marilene Barros de; Brant, Luiz Carlos

2014-02-01

Ongoing Health Education is a strategy for transformation of health practices, though the adherence of professionals is one of the challenges facing its implementation. Thus, the objective of this study was to investigate the factors associated with adherence of family doctors to the Ongoing Education Program in a southeastern Brazilian state from the perception of supervisors. It is a cross-sectional and quantitative study with the use of online questionnaires. Data were analyzed using the chi-square test with ongoing correction to determine the association between structure, topics, activities and difficulties of the supervisors working in Ongoing Health Education, difficulties of the physicians in Primary Health Care (PHC) and poor and good adherence to the program. Excellent medical participation was statistically related to the adequacy of physical space (p = 0.001), a multidisciplinary approach (p = 0.035) and epidemiological aspects (p = 0.043). Low adherence was associated with the inadequacy of the physical structure, difficulty understanding the methodology, less time in a supervisory position, multiple workdays, among others. A good adherence to Ongoing Health Education is a possibility for collective reconstruction of the everyday work of physicians in Primary Health Care.

Candidate gene association studies in syndromic and non-syndromic cleft lip and palate

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

Daack-Hirsch, S.; Basart, A.; Frischmeyer, P.

1994-09-01

Using ongoing case ascertainment through a birth defects registry, we have collected 219 nuclear families with non-syndromic cleft lip and/or palate and 111 families with a collection of syndromic forms. Syndromic cases include 24 with recognized forms and 72 with unrecognized syndromes. Candidate gene studies as well as genome-wide searches for evidence of microdeletions and isodisomy are currently being carried out. Candidate gene association studies, to date, have made use of PCR-based polymorphisms for TGFA, MSX1, CLPG13 (a CA repeat associated with a human homologue of a locus that results in craniofacial dysmorphogenesis in the mouse) and an STRP foundmore » in a Van der Woude syndrome microdeletion. Control tetranucleotide repeats, which insure that population-based differences are not responsible for any observed associations, are also tested. Studies of the syndromic cases have included the same list of candidate genes searching for evidence of microdeletions and a genome-wide search using tri- and tetranucleotide polymorphic markers to search for isodisomy or structural rearrangements. Significant associations have previously been identified for TGFA, and, in this report, identified for MSX1 and nonsyndromic cleft palate only (p = 0.04, uncorrected). Preliminary results of the genome-wide scan for isodisomy has returned no true positives and there has been no evidence for microdeletion cases.« less

Fertility drug use and the risk of ovarian tumors in infertile women: a case-control study.

PubMed

Asante, Albert; Leonard, Phoebe H; Weaver, Amy L; Goode, Ellen L; Jensen, Jani R; Stewart, Elizabeth A; Coddington, Charles C

2013-06-01

To assess the influence of infertility and fertility drugs on risk of ovarian tumors. Case-control study (Mayo Clinic Ovarian Cancer Study). Ongoing academic study of ovarian cancer. A total of 1,900 women (1,028 with ovarian tumors and 872 controls, frequency matched on age and region of residence) who had provided complete information in a self-report questionnaire about history of infertility and fertility drug use. None. Effect of infertility history, use of fertility drugs and oral contraception, and gravidity on the risk of ovarian tumor development, after controlling for potential confounders. Among women who had a history of infertility, use of fertility drugs was reported by 44 (24%) of 182 controls and 38 (17%) of 226 cases. Infertile women who used fertility drugs were not at increased risk of developing ovarian tumors compared with infertile women who did not use fertility drugs; the adjusted odds ratio was 0.64 (95% CI, 0.37, 1.11). The findings were similar when stratified by gravidity and when analyzed separately for borderline versus invasive tumors. We found no statistically significant association between fertility drug use and risk of ovarian tumors. Further larger, prospective studies are needed to confirm this observation. Published by Elsevier Inc.

How to include the variability of TMS responses in simulations: a speech mapping case study

NASA Astrophysics Data System (ADS)

De Geeter, N.; Lioumis, P.; Laakso, A.; Crevecoeur, G.; Dupré, L.

2016-11-01

When delivered over a specific cortical site, TMS can temporarily disrupt the ongoing process in that area. This allows mapping of speech-related areas for preoperative evaluation purposes. We numerically explore the observed variability of TMS responses during a speech mapping experiment performed with a neuronavigation system. We selected four cases with very small perturbations in coil position and orientation. In one case (E) a naming error occurred, while in the other cases (NEA, B, C) the subject appointed the images as smoothly as without TMS. A realistic anisotropic head model was constructed of the subject from T1-weighted and diffusion-weighted MRI. The induced electric field distributions were computed, associated to the coil parameters retrieved from the neuronavigation system. Finally, the membrane potentials along relevant white matter fibre tracts, extracted from DTI-based tractography, were computed using a compartmental cable equation. While only minor differences could be noticed between the induced electric field distributions of the four cases, computing the corresponding membrane potentials revealed different subsets of tracts were activated. A single tract was activated for all coil positions. Another tract was only triggered for case E. NEA induced action potentials in 13 tracts, while NEB stimulated 11 tracts and NEC one. The calculated results are certainly sensitive to the coil specifications, demonstrating the observed variability in this study. However, even though a tract connecting Broca’s with Wernicke’s area is only triggered for the error case, further research is needed on other study cases and on refining the neural model with synapses and network connections. Case- and subject-specific modelling that includes both electromagnetic fields and neuronal activity enables demonstration of the variability in TMS experiments and can capture the interaction with complex neural networks.

Collaboration leads to enhanced curriculum.

PubMed

Valerius, J; Mohan, V; Doctor, D; Hersh, W

2015-01-01

In 2007, we initiated a health information management (HIM) track of our biomedical informatics graduate program, and subsequent ongoing program assessment revealed a confluence of topics and courses within HIM and clinical informatics (CI) tracks. We completed a thorough comparative analysis of competencies derived from AMIA, AHIMA, and CAHIIM. Coupled with the need to streamline course offerings, the process, described in this paper allowed new opportunities for faculty collaboration, resulted in the creation of a model assessment for best practice in courses, and led to new avenues of growth within the program. The objective of the case study is to provide others in the informatics educational community with a model for analysis of curriculum in order to improve quality of student learning. We describe a case study where an academic informatics program realigned its course offerings to better reflect the HIM of today, and prepare for challenges of the future. Visionary leadership, intra-departmental self-analysis and alignment of the curriculum through defined mapping process reduced overlap within the CI and HIM tracks. Teaching within courses was optimized through the work of core faculty collaboration. The analysis of curriculum resulted in reduction of overlap within course curriculum. This allowed for additional and new course content to be added to existing courses. Leadership fostered an environment where top-down as well as bottom-up collaborative assessment activities resulted in a model to consolidate learning and reduce unnecessary duplication within courses. A focus on curriculum integration, emphasis on course alignment and strategic consolidation of course content raised the quality of informatics education provided to students. Faculty synergy was an essential component of this redesign process. Continuous quality improvement strategy included an ongoing alignment of curriculum and competencies through a comparative analysis approach. Through these efforts, new innovation was possible.

Predicting the evolution of large cholera outbreaks: lessons learnt from the Haiti case study

NASA Astrophysics Data System (ADS)

Bertuzzo, Enrico; Mari, Lorenzo; Righetto, Lorenzo; Knox, Allyn; Finger, Flavio; Casagrandi, Renato; Gatto, Marino; Rodriguez-Iturbe, Ignacio; Rinaldo, Andrea

2013-04-01

Mathematical models can provide key insights into the course of an ongoing epidemic, potentially aiding real-time emergency management in allocating health care resources and possibly anticipating the impact of alternative interventions. Spatially explicit models of waterborne disease are made routinely possible by widespread data mapping of hydrology, road network, population distribution, and sanitation. Here, we study the ex-post reliability of predictions of the ongoing Haiti cholera outbreak. Our model consists of a set of dynamical equations (SIR-like, i.e. subdivided into the compartments of Susceptible, Infected and Recovered individuals) describing a connected network of human communities where the infection results from the exposure to excess concentrations of pathogens in the water, which are, in turn, driven by hydrologic transport through waterways and by mobility of susceptible and infected individuals. Following the evidence of a clear correlation between rainfall events and cholera resurgence, we test a new mechanism explicitly accounting for rainfall as a driver of enhanced disease transmission by washout of open-air defecation sites or cesspool overflows. A general model for Haitian epidemic cholera and the related uncertainty is thus proposed and applied to the dataset of reported cases now available. The model allows us to draw predictions on longer-term epidemic cholera in Haiti from multi-season Monte Carlo runs, carried out up to January 2014 by using a multivariate Poisson rainfall generator, with parameters varying in space and time. Lessons learned and open issues are discussed and placed in perspective. We conclude that, despite differences in methods that can be tested through model-guided field validation, mathematical modeling of large-scale outbreaks emerges as an essential component of future cholera epidemic control.

Problem-oriented patient record model as a conceptual foundation for a multi-professional electronic patient record.

PubMed

De Clercq, Etienne

2008-09-01

It is widely accepted that the development of electronic patient records, or even of a common electronic patient record, is one possible way to improve cooperation and data communication between nurses and physicians. Yet, little has been done so far to develop a common conceptual model for both medical and nursing patient records, which is a first challenge that should be met to set up a common electronic patient record. In this paper, we describe a problem-oriented conceptual model and we show how it may suit both nursing and medical perspectives in a hospital setting. We started from existing nursing theory and from an initial model previously set up for primary care. In a hospital pilot site, a multi-disciplinary team refined this model using one large and complex clinical case (retrospective study) and nine ongoing cases (prospective study). An internal validation was performed through hospital-wide multi-professional interviews and through discussions around a graphical user interface prototype. To assess the consistency of the model, a computer engineer specified it. Finally, a Belgian expert working group performed an external assessment of the model. As a basis for a common patient record we propose a simple problem-oriented conceptual model with two levels of meta-information. The model is mapped with current nursing theories and it includes the following concepts: "health care element", "health approach", "health agent", "contact", "subcontact" and "service". These concepts, their interrelationships and some practical rules for using the model are illustrated in this paper. Our results are compatible with ongoing standardization work at the Belgian and European levels. Our conceptual model is potentially a foundation for a multi-professional electronic patient record that is problem-oriented and therefore patient-centred.

Reflection: a critical proficiency essential to the effective development of a high competence in communication.

PubMed

Adams, Cindy L; Nestel, Debra; Wolf, Peter

2006-01-01

Reflection, or the ability to step back from an experience and consider it critically, in an analytical, non-subjective manner, is an essential aspect of problem solving and decision making, and also of effective communication with clients and colleagues. Reflective practice has been described as the essence of professionalism and is therefore a core professional skill; rarely, however, has it been explicitly taught in veterinary curricula, and it has only a recent history in undergraduate human medical curricula. We describe here two preliminary case studies, one in a veterinary medical education context and the other within a human medical education framework, as examples of approaches to assessing a student's ability for ''reflection.'' The case studies also illustrate some of the key principles. Both of the case studies described had as their end goal the enhancement of communication skills through critical reflection. At Monash University, Australia, the majority of students were assessed as being at a level of ''reflection in development.'' The students in the Ontario Veterinary College case study showed moderately good use of self-awareness and critical reflection as a basis for modifying and integrating communication skills into practice. While both preliminary case studies point to the fact that students recognize the importance of communication and value the opportunity to practice it, few students in either case study identified the importance of reflection for lifelong learning and professional competence. Opportunities to complete critical reflection exercises in other parts of curricula and outside of communication would likely reinforce its importance as a generic skill. Ongoing scholarly approaches to teaching, learning, and evaluating reflection and self-awareness are needed.

Ongoing change of site conditions important for sustainable forest management planning

NASA Astrophysics Data System (ADS)

Bidló, András; Horváth, Adrienn; Gulyás, Krisztina; Gálos, Borbála

2016-04-01

Observed tree mortality of the last decades has shown that the vulnerable forest ecosystems are especially affected by the recurrent, long lasting droughts, heat waves and their consequences. From all site conditions climate is changing the fastest, in this way it can be the largest threatening factor in the 21st century. Beyond climate, soil characteristics are playing an important influencing role. Until now, silvicultural technologies and species preferences of many countries are prescribed by binding regulation based on climate conditions that are assumed to be constant over time. Therefore the aim of our research was to investigate the ongoing and projected change of site conditions that are considered to be of primary importance in terms of tree species selection. For a case study region in Hungary (Keszthely Mountains, near to Lake Balaton) long-term climate tendencies have been determined for the period 1961-2100, as well as a detailed soil sample analysis has been carried out including ~100 sites. Results show a 0.5 degree increase of temperature and a 6-7 % decrease of the precipitation amount for the summer months in the last decades. For the future, significant warming and drying of summers is expected. Decrease of the summer precipitation sum can exceed 25 % until the end of the century, probability of extreme hot days may increase. These tendencies together with the unfavourable soil conditions and biotic damages can be the reason of the ongoing forest dieback. One of the characteristic soil type of the region is rendzina with a thin topsoil layer and an unfavourable water holding capacity. These properties are limiting the amount of available water for plants, especially in case of intense precipitation events. Black pine stands planted on rendzinas after many years of grazing; therefore erosion may have played a significant role. Not only microclimate conditions but also soil types show a large diversity within a relatively small distance. However, tree mortality has been observed also in stands on favourable soils (rusty brown forest soil, brown earth, lessivated brown forest soil) because these soil sites can only mitigate the damage of extremes. Consequently, there is ongoing change of site conditions that are important for the sustainable forest management planning. Therefore it is an urgent need to rethink regulations considering the changing climate and soil conditions in order to decide about sustainable tree species preference and to maintain forest cover. Keywords: climate change impacts, forest mortality, adaptation, sustainable forest management planning Acknowledgements: Research is supported by the "Agroclimate.2" (VKSZ_12-1-2013-0034) EU-national joint funded research project.

Hydatid cyst of urinary bladder associated with pregnancy:a case report.

PubMed

Kanagal, Deepa V; Hanumanalu, Lokeshchandra C

2010-07-01

Echinococcosis or hydatid disease which is caused by Echinococcus group of cestodes is very rare in pregnancy. While liver and lungs are commonly involved, other sites can be rarely affected. The management of hydatid disease in pregnancy is challenging in view of varied presentation and manifestation. We report a case of hydatid cyst arising from the bladder associated with pregnancy and presenting with abdominal pain. The cyst was surgically removed and the bladder wash was given with povidone-iodine. The postoperative recovery was uneventful with ongoing pregnancy. This is to our knowledge, the first case of hydatid cyst arising from the bladder associated with pregnancy to be reported.

Hospital financing reform and case-mix measurement: An international review

PubMed Central

Wiley, Miriam M.

1992-01-01

A review of reforms in the financing of hospital services in eight European countries and Australia reveals a commitment to a common objective of relating resource use to hospital workload by means of a standardized case-mix framework in the pursuit of greater efficiency. While this objective is also shared with the U.S. prospective payment system (PPS), it is noteworthy that the majority of countries reviewed favor a global budgeting approach to financing hospital services. Ongoing evaluation of these reforms should facilitate an assessment of the merits of case-mix adjusted global budgeting relative to the patient-based alternative. PMID:10122001

On the Analysis of Case-Control Studies in Cluster-correlated Data Settings.

PubMed

Haneuse, Sebastien; Rivera-Rodriguez, Claudia

2018-01-01

In resource-limited settings, long-term evaluation of national antiretroviral treatment (ART) programs often relies on aggregated data, the analysis of which may be subject to ecological bias. As researchers and policy makers consider evaluating individual-level outcomes such as treatment adherence or mortality, the well-known case-control design is appealing in that it provides efficiency gains over random sampling. In the context that motivates this article, valid estimation and inference requires acknowledging any clustering, although, to our knowledge, no statistical methods have been published for the analysis of case-control data for which the underlying population exhibits clustering. Furthermore, in the specific context of an ongoing collaboration in Malawi, rather than performing case-control sampling across all clinics, case-control sampling within clinics has been suggested as a more practical strategy. To our knowledge, although similar outcome-dependent sampling schemes have been described in the literature, a case-control design specific to correlated data settings is new. In this article, we describe this design, discuss balanced versus unbalanced sampling techniques, and provide a general approach to analyzing case-control studies in cluster-correlated settings based on inverse probability-weighted generalized estimating equations. Inference is based on a robust sandwich estimator with correlation parameters estimated to ensure appropriate accounting of the outcome-dependent sampling scheme. We conduct comprehensive simulations, based in part on real data on a sample of N = 78,155 program registrants in Malawi between 2005 and 2007, to evaluate small-sample operating characteristics and potential trade-offs associated with standard case-control sampling or when case-control sampling is performed within clusters.

Exploring the business case for ambulatory electronic health record system adoption.

PubMed

Song, Paula H; McAlearney, Ann Scheck; Robbins, Julie; McCullough, Jeffrey S

2011-01-01

Widespread implementation and use of electronic health record (EHR) systems has been recognized by healthcare leaders as a cornerstone strategy for systematically reducing medical errors and improving clinical quality. However, EHR adoption requires a significant capital investment for healthcare providers, and cost is often cited as a barrier. Despite the capital requirements, a true business case for EHR system adoption and implementation has not been made. This is of concern, as the lack of a business case can influence decision making about EHR investments. The purpose of this study was to examine the role of business case analysis in healthcare organizations' decisions to invest in ambulatory EHR systems, and to identify what factors organizations considered when justifying an ambulatory EHR. Using a qualitative case study approach, we explored how five organizations that are considered to have best practices in ambulatory EHR system implementation had evaluated the business case for EHR adoption. We found that although the rigor of formal business case analysis was highly variable, informants across these organizations consistently reported perceiving that a positive business case for EHR system adoption existed, especially when they considered both financial and non-financial benefits. While many consider EHR system adoption inevitable in healthcare, this viewpoint should not deter managers from conducting a business case analysis. Results of such an analysis can inform healthcare organizations' understanding about resource allocation needs, help clarify expectations about financial and clinical performance metrics to be monitored through EHR systems, and form the basis for ongoing organizational support to ensure successful system implementation.

Ethical issues in human genome epidemiology: a case study based on the Japanese American Family Study in Seattle, Washington.

PubMed

Austin, Melissa A

2002-04-01

Recent completion of the draft sequence of the human genome has been greeted with both excitement and skepticism, and the potential of this accomplishment for advancing public health has been tempered by ethical concerns about the protection of human subjects. This commentary explores ethical issues arising in human genome epidemiology by using a case study approach based on the ongoing Japanese American Family Study at the University of Washington in Seattle (1994-2003). Ethical issues encountered in designing the study, collecting the data, and reporting the study results are considered. When developing studies, investigators must consider whether to restrict the study to specific racial or ethnic groups and whether community involvement is appropriate. Once the study design is in place, further ethical issues emerge, including obtaining informed consent for DNA banking and protecting the privacy and confidentiality of family members. Finally, investigators must carefully consider whether to report genotype results to study participants and whether pedigrees illustrating the results of the study will be published. Overall, the promise of genomics for improving public health must be pursued based on the fundamental ethical principles of respect for persons, beneficence, and justice.

SAFE trial: an ongoing randomized clinical study to assess the role of cardiotoxicity prevention in breast cancer patients treated with anthracyclines with or without trastuzumab.

PubMed

Meattini, Icro; Curigliano, Giuseppe; Terziani, Francesca; Becherini, Carlotta; Airoldi, Mario; Allegrini, Giacomo; Amoroso, Domenico; Barni, Sandro; Bengala, Carmelo; Guarneri, Valentina; Marchetti, Paolo; Martella, Francesca; Piovano, Pierluigi; Vannini, Agnese; Desideri, Isacco; Tarquini, Roberto; Galanti, Giorgio; Barletta, Giuseppe; Livi, Lorenzo

2017-05-01

Over the years, thanks to the addition of new generation systemic agents, as well as the use of more advanced and precise radiotherapy techniques, it was able to obtain a high curability rate for breast cancer. Anthracyclines play a key role in the treatment of breast disease, with a well-known benefit on disease-free survival of patients with positive nodal status. Trastuzumab have shown a significant outcome advantage after 1-year administration in case of HER2-positive disease. Unfortunately, significant increase in cardiotoxicity has been observed after anthracyclines and trastuzumab therapies. Even though the cardiology and oncology community strongly recommend a cardiotoxicity prevention strategy for this subset of patients, there is still no consensus on the optimal patient's approach. We aimed to review the published and ongoing researches on cardioprevention strategies and to present the SAFE trial (CT registry ID: NCT2236806; EudraCT number: 2015-000914-23). It is a randomized phase 3, four-arm, single-blind, placebo-controlled study that aims to evaluate the effect of bisoprolol, ramipril or both drugs, compared to placebo, on subclinical heart damage evaluated by speckle tracking cardiac ultrasound in non-metastatic breast cancer patients.

Assessing the extent to which current clinical research is consistent with patient priorities: a scoping review using a case study in patients on or nearing dialysis.

PubMed

Jun, Min; Manns, Braden; Laupacis, Andreas; Manns, Liam; Rehal, Bhavdeep; Crowe, Sally; Hemmelgarn, Brenda R

2015-01-01

There is growing acknowledgement that engaging patients to identify their research priorities is important. Using a case study of patients on or nearing dialysis, we sought to assess the extent to which recently completed and ongoing clinical research was consistent with priorities identified by patients, caregivers, and clinicians. Over a 4-year sampling frame (January 2010 to December 2013), we systematically searched the medical literature (top 5 nephrology and top 10 general medicine journals accessed through MEDLINE via Ovid), international randomized controlled trial (RCT) registries, and national government and kidney research funding organizations (Canada, U.S., Australia, and U.K.) for published clinical studies, registered RCTs, and funded clinical studies, respectively. Published clinical studies, registered RCTs, and funded clinical studies were categorized as to whether or not they were consistent with the top 10 research priorities identified by patients, their caregivers, and clinicians in a recent comprehensive research priority setting exercise. The search yielded 4293 published articles, 688 RCTs, and 70 funded studies, of which 1116 articles, 315 RCTs, and 70 funded studies were eligible for inclusion. Overall 194 published studies (17.4 %), 71 RCTs (22.5 %), and 15 funded studies (21.4 %) included topics consistent with the top 10 research priorities identified by patients. Four of the top 10 research priorities, including strategies to improve the management of itching, increase access to kidney transplantation, assess the psychosocial impact of kidney failure, and determine the effects of dietary restriction received virtually no attention. The top 10 priorities we used to categorize included studies were identified by Canadian patients, caregivers, and clinicians. The top research priorities may vary across different countries. The proportion of published studies that are consistent with the top 10 priorities could be different in nephrology journals with lower impact factors. Studies related to kidney transplantation and the psychosocial impact of kidney failure may have been published in journals not included in our search strategy. The majority of recently completed or ongoing clinical studies in patients on or nearing dialysis do not address the top research priorities of patients, raising concerns that current clinical research may not be meeting the needs of the ultimate consumer, in this case, patients on or nearing dialysis. Greater involvement of patients in research is required to bridge the gap between research and patients' needs.

Telepresence work station system definition study, part 2

NASA Technical Reports Server (NTRS)

1987-01-01

This study effort has shown that the development of a space robotic servicing system is totally feasible. More importantly, many of the key elements of such a system are currently available as the result of previous and ongoing technical efforts. In many cases, decisions remain to be made concerning tradeoffs between options available to satisfy system technology requirements. The primary recommendation resulting from this study is for the development of a flight test bed system that could be used to establish a performance database to assist some of the necessary technical decisions described in the study package. A properly design flight test bed system would prove tremendously useful in terms of rapidly evaluating technology in a realistic setting and would be a great benefit in the development of the operational system.

Success rates of pre-hospital difficult airway management: a quality control study evaluating an in-hospital training program.

PubMed

Trimmel, Helmut; Beywinkler, Christoph; Hornung, Sonja; Kreutziger, Janett; Voelckel, Wolfgang G

2018-03-16

Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported. This is a subgroup analysis of pre-hospital airway interventions performed by non-anesthesiologist EMS physicians between 2006 and 2016. The dataset is part of a retrospective quality control study performed in the ground EMS system of Wiener Neustadt, Austria. Difficult airway missions recorded in the electronic database were matched with the hospital information system and analyzed. Nine hundred thirty-three of 23060 ground EMS patients (4%) required an airway intervention. In 48 cases, transient bag-mask-valve ventilation was sufficient, and 5 patients needed repositioning of a pre-existing tracheostomy cannula. Eight hundred thirty-six of 877 patients (95.3%) were successfully intubated within two attempts; in 3 patients, a supraglottic airway device was employed first line. Management of 41 patients with failed tracheal intubation comprised laryngeal tubes (n = 21), intubating laryngeal mask (n = 11), ongoing bag-mask-valve ventilation (n = 8), and crico-thyrotomy (n = 1). There was no cannot intubate/cannot ventilate situation. Blood gas analysis at admission revealed hypoxemia in 2 and/or hypercapnia in 11 cases. During the 11-year study period, difficult airways were encountered in 5% but sufficiently managed in all patients. Thus, the training regime presented might be a feasible and beneficial model for training of non-anesthesiologist emergency physicians as well as paramedics.

First Insight into the Population Structure of Mycobacterium tuberculosis in Saudi Arabia▿ †

PubMed Central

Al-Hajoj, Sahal A. M.; Zozio, Thierry; Al-Rabiah, Fahad; Mohammad, Viquar; Al-Nasser, Maryam; Sola, Christophe; Rastogi, Nalin

2007-01-01

This study constitutes a first attempt to describe the genetic population structure and drug resistance of the tubercle bacilli circulating in Saudi Arabia. A total of 1,505 clinical isolates of M. tuberculosis, isolated between 2002 and 2005 from seven regions of Saudi Arabia, were studied. The sample studied showed a male-to-female sex ratio of 1.27, with half of the cases among foreign-born individuals and 47% within the 21- to 40-year-old age group; a total resistance rate of 19.7%; and multiple drug resistance of 4.5%. Upon spoligotyping, a total of 387 individual patterns were obtained (clustering rate, 86.4%; 182 clusters containing between 2 and 130 isolates per cluster). A total of 94% of the strains matched the spoligotype patterns in an international database. Nearly 81% of the isolates in this study belonged to established phylogeographic clades: Central Asian (CAS), 22.5%; ill-defined T clade, 19.5%; East African-Indian (EAI), 13.5%; Haarlem, 7.5%; Latin American-Mediterranean, 7.2%; Beijing, 4.4%; Manu, 2.7%; X, 0.9%; and Bovis, 0.9%. Two clonal complexes with unique spoligotyping signatures (octal codes 703777707770371 and 467777377413771) specific to Saudi Arabia were identified. These belonged to the CAS and EAI clades, respectively, as confirmed upon secondary typing using mycobacterial interspersed repetitive units (MIRUs). The results obtained underline the predominance of historic clones of principal genetic group 1, which are responsible for roughly 45% of all tuberculosis cases in Saudi Arabia. The high rate of clustering observed might be an indication of rapid ongoing transmission within certain communities and/or subpopulations in Saudi Arabia; nonetheless, spoligotyping is known to overestimate clustering, and only a systematic second-line typing, such as MIRUs, coupled with a better tuberculosis registry and epidemiological investigations would allow us to know the exact rate of ongoing transmission and associated risk factors in Saudi Arabia. PMID:17507515

DIESEL EXHAUST EXPOSURE INCREASES SEVERITY OF AN ONGOING INFLUENZA INFECTION

EPA Science Inventory

Numerous studies have shown that air pollutants including diesel exhaust (DE) alter host defense responses, resulting in decreased resistance to respiratory infection. The purpose of this study was to evaluate the effects of DE exposure on the severity of an ongoing influenza in...

Ongoing exposure versus intense periodic exposure to military conflict and terror attacks in Israel.

PubMed

Lahad, Mooli; Leykin, Dmitry

2010-12-01

The manifestation of posttraumatic stress disorder (PTSD) symptoms in two clinical samples in Israel (N = 212) was examined. Individuals suffering ongoing exposure to shelling were compared with subjects exposed to intense periodic exposure. Elevated arousal and avoidance symptoms, but not intrusion were reported in the ongoing exposure group. When compared by age, young participants in the ongoing exposure group had significantly lower PTSD scores, whereas no differences were found between participants among the intense periodic exposure age groups. No gender differences in symptoms were found among participants from intense periodic exposure, whereas in the other ongoing group the difference was in avoidance. Results are discussed in light of past research on exposure to terrorism. Copyright © 2010 International Society for Traumatic Stress Studies.

Afferent Drive Elicits Ongoing Pain in a Model of Advanced Osteoarthritis

PubMed Central

Okun, Alec; Liu, Ping; Davis, Peg; Ren, Jiyang; Remeniuk, Bethany; Brion, Triza; Ossipov, Michael H.; Xie, Jennifer; Dussor, Gregory O.; King, Tamara; Porreca, Frank

2012-01-01

Osteoarthritis (OA) is a chronic condition characterized by pain during joint movement. Additionally, patients with advanced disease experience pain at rest (i.e., ongoing pain)that is generally resistant to non-steroidal anti-inflammatory drugs (NSAIDs). Injection of monosodium iodoacetate (MIA) into the intra-articular space of the rodent knee is a well-established model of OA that elicits weight-bearing asymmetry and referred tactile and thermal hypersensitivity. Whether ongoing pain is present in this model is unknown. Additionally, the possible relationship of ongoing pain to MIA dose is not known. MIA produced weight asymmetry, joint osteolysis, and cartilage erosion across a range of doses (1, 3, and 4.8 mg). However, only rats treated with the highest dose of MIA showed conditioned place preference to a context paired with intra-articular lidocaine, indicating relief from ongoing pain. Diclofenac blocked the MIA-induced weight asymmetry but failed to block MIA-induced ongoing pain. Systemic AMG9810, a TRPV1 antagonist, effectively blocked thermal hypersensitivity, but failed to block high dose MIA-induced weight asymmetry or ongoing pain. Additionally, systemic or intra-articular HC030031, a TRPA1 antagonist, failed to block high dose MIA-induced weight asymmetry or ongoing pain. Our studies suggest that a high dose of intra-articular MIA induces ongoing pain originating from the site of injury that is dependent on afferent fiber activity but apparently independent of TRPV1 or TRPA1 activation. Identification of mechanisms driving ongoing pain may enable development of improved treatments for patients with severe OA pain and diminish the need for joint replacement surgery. PMID:22387095

Hantavirus Pulmonary Syndrome in Argentina, 1995–2008

PubMed Central

Bellomo, Carla M.; Cacace, María Luisa; Suárez, Paola; Bogni, Liliana; Padula, Paula J.

2010-01-01

We report a large case series of hantavirus pulmonary syndrome (HPS) in Argentina that was confirmed by laboratory restuls from 1995 through 2008. The geographic and temporal distribution of cases by age, sex, fatality rate, and risk factors for HPS was analyzed. A total of 710 cases were unequally distributed among 4 of the 5 Argentine regions. Different case-fatality rates were observed for each affected region, with a maximum rate of 40.5%. The male-to-female ratio for HPS case-patients was 3.7:1.0; the case-fatality rate was significantly higher for women. Agriculture-associated activities were most commonly reported as potential risk factors, especially among men of working age. Although HPS cases occurred predominantly in isolation, we identified 15 clusters in which strong relationships were observed between members, which suggests ongoing but limited person-to-person transmission. PMID:21122213

Compulsory licensing often did not produce lower prices for antiretrovirals compared to international procurement.

PubMed

Beall, Reed F; Kuhn, Randall; Attaran, Amir

2015-03-01

Compulsory licensing has been widely suggested as a legal mechanism for bypassing patents to introduce lower-cost generic antiretrovirals for HIV/AIDS in developing countries. Previous studies found that compulsory licensing can reduce procurement prices for drugs, but it is unknown how the resulting prices compare to procurements through the Global Fund to Fight AIDS, Tuberculosis, and Malaria; UNICEF; and other international channels. For this study we systematically constructed a case-study database of compulsory licensing activity for antiretrovirals and compared compulsory license prices to those in the World Health Organization's (WHO's) Global Price Reporting Mechanism and the Global Fund's Price and Quality Reporting Tool. Thirty compulsory license cases were analyzed with 673 comparable procurements from WHO and Global Fund data. Compulsory license prices exceeded the median international procurement prices in nineteen of the thirty case studies, often with a price gap of more than 25 percent. Compulsory licensing often delivered suboptimal value when compared to the alternative of international procurement, especially when used by low-income countries to manufacture medicines locally. There is an ongoing need for multilateral and charitable actors to work collectively with governments and medicine suppliers on policy options. Project HOPE—The People-to-People Health Foundation, Inc.

Diagnosis and treatment of impulse control disorders in patients with movement disorders

PubMed Central

Mestre, Tiago A.; Strafella, Antonio P.; Thomsen, Teri; Voon, Valerie

2013-01-01

Impulse control disorders are a psychiatric condition characterized by the failure to resist an impulsive act or behavior that may be harmful to self or others. In movement disorders, impulse control disorders are associated with dopaminergic treatment, notably dopamine agonists (DAs). Impulse control disorders have been studied extensively in Parkinson’s disease, but are also recognized in restless leg syndrome and atypical Parkinsonian syndromes. Epidemiological studies suggest younger age, male sex, greater novelty seeking, impulsivity, depression and premorbid impulse control disorders as the most consistent risk factors. Such patients may warrant special monitoring after starting treatment with a DA. Various individual screening tools are available for people without Parkinson’s disease. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease has been developed specifically for Parkinson’s disease. The best treatment for impulse control disorders is prevention. However, after the development of impulse control disorders, the mainstay intervention is to reduce or discontinue the offending anti-Parkinsonian medication. In refractory cases, other pharmacological interventions are available, including neuroleptics, antiepileptics, amantadine, antiandrogens, lithium and opioid antagonists. Unfortunately, their use is only supported by case reports, small case series or open-label clinical studies. Prospective, controlled studies are warranted. Ongoing investigations include naltrexone and nicotine. PMID:23634190

Exploring the Media Mix during IT-Offshore Project

NASA Astrophysics Data System (ADS)

Wende, Erik; Schwabe, Gerhard; Philip, Tom

Offshore outsourced IT projects continue to gain relevance in the globalized world scenario. The temporal, geographical and cultural distances involved during the development of software between distributed team members result in communication challenges. As software development involves the coding of knowledge, the management of knowledge and its transfer remain critical for the success of the project. For effective knowledge transfer between geographically dispersed teams the ongoing selection of communication medium or the media channel mix becomes highly significant. Although there is an abundance of theory dealing with knowledge transfer and media channel selection during offshore outsourcing projects, the specific role of cultural differences in the media mix is often overlooked. As a first step to rectify this, this paper presents an explorative outsourcing case study with emphasis on the chosen media channels and the problems that arose from differences in culture. The case study is analyzed in light of several theoretical models. Finally the paper presents the idea of extending the Media Synchonicity theory with cultural factors.

Development of a competency mapping tool for undergraduate professional degree programmes, using mechanical engineering as a case study

NASA Astrophysics Data System (ADS)

Holmes, David W.; Sheehan, Madoc; Birks, Melanie; Smithson, John

2018-01-01

Mapping the curriculum of a professional degree to the associated competency standard ensures graduates have the competence to perform as professionals. Existing approaches to competence mapping vary greatly in depth, complexity, and effectiveness, and a standardised approach remains elusive. This paper describes a new mapping software tool that streamlines and standardises the competency mapping process. The available analytics facilitate ongoing programme review, management, and accreditation. The complete mapping and analysis of an Australian mechanical engineering degree programme is described as a case study. Each subject is mapped by evaluating the amount and depth of competence development present. Combining subject results then enables highly detailed programme level analysis. The mapping process is designed to be administratively light, with aspects of professional development embedded in the software. The effective competence mapping described in this paper enables quantification of learning within a professional degree programme, and provides a mechanism for holistic programme improvement.

MMS Observation of Magnetic Reconnection in the Turbulent Magnetosheath

NASA Astrophysics Data System (ADS)

Vörös, Z.; Yordanova, E.; Varsani, A.; Genestreti, K. J.; Khotyaintsev, Yu. V.; Li, W.; Graham, D. B.; Norgren, C.; Nakamura, R.; Narita, Y.; Plaschke, F.; Magnes, W.; Baumjohann, W.; Fischer, D.; Vaivads, A.; Eriksson, E.; Lindqvist, P.-A.; Marklund, G.; Ergun, R. E.; Leitner, M.; Leubner, M. P.; Strangeway, R. J.; Le Contel, O.; Pollock, C.; Giles, B. J.; Torbert, R. B.; Burch, J. L.; Avanov, L. A.; Dorelli, J. C.; Gershman, D. J.; Paterson, W. R.; Lavraud, B.; Saito, Y.

2017-11-01

In this paper we use the full armament of the MMS (Magnetospheric Multiscale) spacecraft to study magnetic reconnection in the turbulent magnetosheath downstream of a quasi-parallel bow shock. Contrarily to the magnetopause and magnetotail cases, only a few observations of reconnection in the magnetosheath have been reported. The case study in this paper presents, for the first time, both fluid-scale and kinetic-scale signatures of an ongoing reconnection in the turbulent magnetosheath. The spacecraft are crossing the reconnection inflow and outflow regions and the ion diffusion region (IDR). Inside the reconnection outflows D shape ion distributions are observed. Inside the IDR mixing of ion populations, crescent-like velocity distributions and ion accelerations are observed. One of the spacecraft skims the outer region of the electron diffusion region, where parallel electric fields, energy dissipation/conversion, electron pressure tensor agyrotropy, electron temperature anisotropy, and electron accelerations are observed. Some of the difficulties of the observations of magnetic reconnection in turbulent plasma are also outlined.

Successful life outcome and management of real-world memory demands despite profound anterograde amnesia

PubMed Central

Duff, Melissa C.; Wszalek, Tracey; Tranel, Daniel; Cohen, Neal J.

2010-01-01

We describe the case of Angie, a 50 year-old woman with profound amnesia (General Memory Index = 49, Full Scale IQ = 126) following a closed head injury in 1985. This case is unique in comparison to other cases reported in the literature in that, despite the severity of her amnesia, she has developed remarkable real-world life abilities, shows impressive self awareness and insight into the impairment and sparing of various functional memory abilities, and exhibits ongoing maturation of her identity and sense of self following amnesia. The case provides insights into the interaction of different memory and cognitive systems in handling real-world memory demands, and has implications for rehabilitation and for successful life outcome after amnesia. PMID:18608659

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

Larson, Kyle B.; Tagestad, Jerry D.; Perkins, Casey J.

This study was conducted with the support of the U.S. Department of Energy’s (DOE’s) Wind and Water Power Technologies Office (WWPTO) as part of ongoing efforts to minimize key risks and reduce the cost and time associated with permitting and deploying ocean renewable energy. The focus of the study was to discuss a possible approach to exploring scenarios for ocean renewable energy development in Hawaii that attempts to optimize future development based on technical, economic, and policy criteria. The goal of the study was not to identify potentially suitable or feasible locations for development, but to discuss how such anmore » approach may be developed for a given offshore area. Hawaii was selected for this case study due to the complex nature of the energy climate there and DOE’s ongoing involvement to support marine spatial planning for the West Coast. Primary objectives of the study included 1) discussing the political and economic context for ocean renewable energy development in Hawaii, especially with respect to how inter-island transmission may affect the future of renewable energy development in Hawaii; 2) applying a Geographic Information System (GIS) approach that has been used to assess the technical suitability of offshore renewable energy technologies in Washington, Oregon, and California, to Hawaii’s offshore environment; and 3) formulate a mathematical model for exploring scenarios for ocean renewable energy development in Hawaii that seeks to optimize technical and economic suitability within the context of Hawaii’s existing energy policy and planning.« less

Elementary General Education Teachers' Knowledge of and Experience Teaching Students with Disabilities in Science and Social Studies

NASA Astrophysics Data System (ADS)

Rice, Diane

In Grades 3 to 5 at a suburban southeastern elementary school, the percentage of students with disabilities (SWDs) who do not meet state standards in science and social studies is greater than that of their nondisabled peers. To address this disparity, district administrators required that proficiency ratings increase for SWDs without providing general education (GE) teachers with training. A qualitative bounded case study was used to understand how GE teachers constructed their knowledge of and met SWDs instructional needs and to understand GE teachers' needs as they worked toward meeting the district goals. Piaget's constructivist learning theory served as the conceptual framework for this study. A purposeful sample of 6 GE teachers, 2 each from Grades 3-5 whose classrooms included SWDs, volunteered to participate in open-ended interviews. Qualitative data were analyzed using provisional coding and pattern coding. A primary finding was that the participants identified teacher collaboration and professional development necessary to accommodate SWDs in the GE setting. This finding led to a recommendation that school leaders provide ongoing professional development for GE teachers as well as ongoing opportunities for collaboration between GE and special education teachers. These endeavors may contribute to positive social change by providing GE teachers instructional strategies and accommodations for meeting the learning needs of SWDs to increase the number and percentage of SWDs who meet the state standards and district goals in science and social studies.

Generic Skills for Graduate Accountants: The Bigger Picture, a Social and Economic Imperative in the New Knowledge Economy

ERIC Educational Resources Information Center

Bunney, Diane; Sharplin, Elaine; Howitt, Christine

2015-01-01

The case for integrating generic skills in university accounting programmes is well documented in the literature, but the implementation of strategies designed to teach generic skills in the context of accounting courses has posed ongoing challenges for academics and course administrators. The imperative for generic skills in accounting programmes…

Not Missing the Future: The Case for Technology and Business Process Change

ERIC Educational Resources Information Center

VanDenBerg, Doug

2010-01-01

As technology has evolved, the opportunity to transform and enhance the business processes of academic records managers has become more attractive. Many institutions embrace business-process change as a part of their ongoing strategy, but others defer--or simply avoid--any such change. But now more than ever, according to this author, it is…

Cutaneous Leishmaniasis: Knowledge, Attitude and Practices of the Inhabitants of the Kani Forest Tribal Settlements of Tiruvananthapuram District, Kerala, India

ERIC Educational Resources Information Center

Nandha, B.; Srinivasan, R.; Jambulingam, P.

2014-01-01

Cutaneous leishmaniasis (CL) is reported among Kani tribes in forest settlements of Tiruvananthapuram district, Kerala, India. Epidemiological investigations are ongoing and 27 histopathologically confirmed cases of CL have been reported from five settlements indicating transmission of disease within settlements. One of the priorities for…

Impact of Recasts on the Accuracy in EFL Learners' Writing

ERIC Educational Resources Information Center

Degteva, Olga

2011-01-01

Since the famous Truscott's "The case against grammar correction in L2 writing class" (1996) there has been an ongoing debate in SLA research about the value of corrective feedback and its different forms. A growing number of empirical research is now investigating the question, and although more and more evidence is obtained against Truscott's…

Pathogenesis and transmission of H7N9 influenza virus in poultry

USDA-ARS?s Scientific Manuscript database

Background: The recent and ongoing outbreak of H7N9 influenza in China has resulted in many human cases with a high fatality rate. Poultry have been suspected as the source of infection based on sequence analysis and virus isolations from live bird markets; however it’s not clear which species of ...

36 CFR 1202.90 - What NARA systems of records are exempt from release under the National Security Exemption of the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... are exempt from release under the National Security Exemption of the Privacy Act? 1202.90 Section 1202... from release under the National Security Exemption of the Privacy Act? (a) The Investigative Case Files... interfere with ongoing investigations and law enforcement or national security activities and impose an...

36 CFR 1202.90 - What NARA systems of records are exempt from release under the National Security Exemption of the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... are exempt from release under the National Security Exemption of the Privacy Act? 1202.90 Section 1202... from release under the National Security Exemption of the Privacy Act? (a) The Investigative Case Files... interfere with ongoing investigations and law enforcement or national security activities and impose an...

36 CFR 1202.90 - What NARA systems of records are exempt from release under the National Security Exemption of the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... are exempt from release under the National Security Exemption of the Privacy Act? 1202.90 Section 1202... from release under the National Security Exemption of the Privacy Act? (a) The Investigative Case Files... interfere with ongoing investigations and law enforcement or national security activities and impose an...

Some Syndromes Among Suicidal People: The Problem of Suicide Potentiality.

ERIC Educational Resources Information Center

Wold, Carl I.

An on-going research project at the Los Angeles Suicide Prevention Center is attempting to describe the potential suicide. Comparisons on a rating scale were made among patients who commit suicide and a random sample of case histories from the coroner's office. Approximately 10 syndromes or subgroupings of people who commit suicide have been…

E. N. Anderson: Caring for place: ecology, ideology, and emotion in traditional landscape management

Treesearch

Susan Stevens Hummel

2016-01-01

Anderson is deeply concerned with inadequate responses to ongoing global environmental degradation. Accordingly, he offers cases of traditional societies that survived over long time periods without destroying their environments. His focus is on ways humans think about plants, animals, and landscapes because of his conviction that stories about them are what make us...

Developing Capacity for Research and Teaching in Higher Education: A Case of Makerere University

ERIC Educational Resources Information Center

Mugimu, Christopher B.; Nakabugo, Mary Goretti; Katunguka-Rwakishaya, Eli

2013-01-01

Research and teaching are key pillars in higher education. This article examines the factors associated with the current faculty research and teaching agenda at Makerere University (MU) and explores the realities of ongoing capacity building for faculty in research and teaching. This research was guided by the following questions: What motivates…

Insights from a Financial Literacy Task Designer: The Curious Case of Problem Context

ERIC Educational Resources Information Center

Sawatzki, Carly

2016-01-01

As part of ongoing design-based research exploring financial literacy teaching and learning, ten tasks termed "financial dilemmas" were trialled by 14 teachers and more than 300 Year 5 and 6 students in 4 government primary schools in urban Darwin. Drawing on data related to two tasks--"Catching the bus" and "Buying…

Social Learning as a Key Factor in Sustainability Transitions: The Case of Okayama City

ERIC Educational Resources Information Center

Didham, Robert J.; Ofei-Manu, Paul; Nagareo, Masaaki

2017-01-01

The Okayama Education for Sustainable Development (ESD) Project is an ongoing initiative in Okayama City, Japan, established in 2005 by the Regional Centre of Expertise (RCE) Okayama and the Okayama Municipal Government with the aim "to create a community where people learn, think and act together towards realising a sustainable…

Lawfare: The Colombian Case

DTIC Science & Technology

2010-05-01

Colombia is legislation conceived between 1998 and 1999 by the administration of President Andrés Pastrana and continued by President Alvaro Uribe , backed...speech to the diplomatic corps accredited in Bogota, President Alvaro Uribe stated, “In Colombia...or insurgent activity.7 The government’s successful passage in 2002 of President Alvaro Uribe’s Democratic Security Policy complemented the ongoing

Building and Sustaining Talent: Creating Conditions in High-Poverty Schools That Support Effective Teaching and Learning

ERIC Educational Resources Information Center

Almy, Sarah; Tooley, Melissa

2012-01-01

Improving teaching effectiveness is a hot topic for policymakers around the country these days. The gathering movement marks an important step forward in the ongoing effort to strengthen our nation's schools. In many cases, however, these efforts start and stop with improving outdated, inadequate teacher evaluation systems. Such approaches fail to…

76 FR 56455 - DaVita, Inc.; Analysis of Agreement Containing Consent Orders To Aid Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... agreement package can be obtained from the FTC Home Page (for September 2, 2011), on the World Wide Web, at... to ongoing dialysis treatments. The relevant geographic markets for the provision of dialysis... case in many of the geographic markets identified in the Commission's complaint. Each of the geographic...

Systemic and Topical Use of Tranexamic Acid in Spinal Surgery: A Systematic Review

PubMed Central

Winter, Sebastian F.; Santaguida, Carlo; Wong, Jean; Fehlings, Michael G.

2015-01-01

Study Design Combination of narrative and systematic literature reviews. Objectives Massive perioperative blood loss in complex spinal surgery often requires blood transfusions and can negatively affect patient outcome. Systemic use of the antifibrinolytic agent tranexamic acid (TXA) has become widely used in the management of surgical bleeding. We review the clinical evidence for the use of intravenous TXA as a hemostatic agent in spinal surgery and discuss the emerging role for its complementary use as a topical agent to reduce perioperative blood loss from the surgical site. Through a systematic review of published and ongoing investigations on topical TXA for spinal surgery, we wish to make spine practitioners aware of this option and to suggest opportunities for further investigation in the field. Methods A narrative review of systemic TXA in spinal surgery and topical TXA in surgery was conducted. Furthermore, a systematic search (using PRISMA guidelines) of PubMed (MEDLINE), EMBASE, and Cochrane CENTRAL databases as well as World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov (National Institutes of Health), and International Standard Randomized Controlled Trial Number registries was conducted to identify both published literature and ongoing clinical trials on topical TXA in spinal surgery. Results Of 1,631 preliminary search results, 2 published studies were included in the systematic review. Out of 285 ongoing clinical trials matching the search criteria, a total of 4 relevant studies were included and reviewed. Conclusion Intravenous TXA is established as an efficacious hemostatic agent in spinal surgery. Use of topical TXA in surgery suggests similar hemostatic efficacy and potentially improved safety as compared with intravenous TXA. For spinal surgery, the literature on topical TXA is sparse but promising, warranting further clinical investigation and consideration as a clinical option in cases with significant anticipated surgical site blood loss. PMID:27099820

Data-driven outbreak forecasting with a simple nonlinear growth model

PubMed Central

Lega, Joceline; Brown, Heidi E.

2016-01-01

Recent events have thrown the spotlight on infectious disease outbreak response. We developed a data-driven method, EpiGro, which can be applied to cumulative case reports to estimate the order of magnitude of the duration, peak and ultimate size of an ongoing outbreak. It is based on a surprisingly simple mathematical property of many epidemiological data sets, does not require knowledge or estimation of disease transmission parameters, is robust to noise and to small data sets, and runs quickly due to its mathematical simplicity. Using data from historic and ongoing epidemics, we present the model. We also provide modeling considerations that justify this approach and discuss its limitations. In the absence of other information or in conjunction with other models, EpiGro may be useful to public health responders. PMID:27770752

Time management in health care social work.

PubMed

Sheridan, M S

1988-01-01

Health care social workers face significant problems in controlling and managing time. Among the causes are increased demands for service, economy measures in health care, and the concurrent responsibility which social workers often have for both ongoing case management and crisis coverage. Individuals and social work departments can increase productivity through streamlining case management, increasing use of available resources, and generating new resources. With planning and preparation, many emergencies can be moved into the expected work flow. The social work profession needs to address time management problems and expectations in a more realistic and systematic way.

International risk of yellow fever spread from the ongoing outbreak in Brazil, December 2016 to May 2017.

PubMed

Dorigatti, Ilaria; Hamlet, Arran; Aguas, Ricardo; Cattarino, Lorenzo; Cori, Anne; Donnelly, Christl A; Garske, Tini; Imai, Natsuko; Ferguson, Neil M

2017-07-13

States in south-eastern Brazil were recently affected by the largest Yellow Fever (YF) outbreak seen in a decade in Latin America. Here we provide a quantitative assessment of the risk of travel-related international spread of YF indicating that the United States, Argentina, Uruguay, Spain, Italy and Germany may have received at least one travel-related YF case capable of seeding local transmission. Mitigating the risk of imported YF cases seeding local transmission requires heightened surveillance globally. This article is copyright of The Authors, 2017.

Brief psychotic disorder in a middle aged Nigerian following the terrorist attacks in America-case report.

PubMed

Omigbodun, O O; Okunade, T A

2002-01-01

This case report illustrates the sudden onset, brief course and remission of a psychotic illness in a middle-aged Nigerian starting soon after she heard about the terrorist attacks in America. Vulnerability factors including personality traits and other concurrent life events were identified in the patients. Common mental disorder associated with terrorist attacks, disasters and armed robbery, and the need for health workers to be sensitised to these disorders are discussed in light of the ongoing violence in parts of Nigeria.

International risk of yellow fever spread from the ongoing outbreak in Brazil, December 2016 to May 2017

PubMed Central

Dorigatti, Ilaria; Hamlet, Arran; Aguas, Ricardo; Cattarino, Lorenzo; Cori, Anne; Donnelly, Christl A; Garske, Tini; Imai, Natsuko; Ferguson, Neil M

2017-01-01

States in south-eastern Brazil were recently affected by the largest Yellow Fever (YF) outbreak seen in a decade in Latin America. Here we provide a quantitative assessment of the risk of travel-related international spread of YF indicating that the United States, Argentina, Uruguay, Spain, Italy and Germany may have received at least one travel-related YF case capable of seeding local transmission. Mitigating the risk of imported YF cases seeding local transmission requires heightened surveillance globally. PMID:28749337

Type 1 wild poliovirus and putative enterovirus 109 in an outbreak of acute flaccid paralysis in Congo, October-November 2010.

PubMed

Grard, G; Drexler, J F; Lekana-Douki, S; Caron, M; Lukashev, A; Nkoghe, D; Gonzalez, J P; Drosten, C; Leroy, E

2010-11-25

An outbreak of flaccid paralysis syndrome in adults is ongoing in Congo. Molecular analysis of faecal, throat and cerebrospinal samples identified wildtype 1 poliovirus and an additional enterovirus C strain related to enterovirus 109 as the cause. As of 22 November, the cumulative number of cases was 409, of which 169 (41.3%) were fatal. This is one of the largest wild type 1 poliovirus outbreaks ever described associated with an unusually high case fatality rate.

Unusual increase in reported cases of paratyphoid A fever among travellers returning from Cambodia, January to September 2013.

PubMed

Tourdjman, M; Le Hello, S; Gossner, C; Delmas, G; Tubiana, S; Fabre, L; Kerléguer, A; Tarantola, A; Fruth, A; Friesema, I; Thorstensen Brandal, L; Lawrence, J; Fisher, I; Dufour, M; Weill, F X; de Valk, H

2013-09-26

From January to September 2013, a marked increase in notifications of Salmonella Paratyphi A infections among travellers returning from Cambodia occurred in France. An investigation revealed 35 cases without a common source: 21 in France, five in Germany, three in the Netherlands, one in Norway, one in the United Kingdom, four in New-Zealand. Data suggest an ongoing event that should trigger further investigation. Travellers to Cambodia should observe preventive measures including good personal hygiene and food handling practices.

The Use of a Dehydrated Amnion/Chorion Membrane Allograft in Patients Who Subsequently Undergo Reexploration after Posterior Lumbar Instrumentation

PubMed Central

Subach, Brian R.; Copay, Anne G.

2015-01-01

Background Context. Products that can reduce development of epidural fibrosis may reduce risk for ongoing pain associated with development of scar tissue and make subsequent epidural reexploration easier. Purpose. To evaluate the use of dehydrated human amnion/chorion membrane (dHACM) on the formation of soft tissue scarring in the epidural space. Study Design. Case series. Patient Sample. Five patients having transforaminal lumbar interbody lumbar fusion (TLIF) with posterior instrumentation and implantation of dHACM in the epidural space and subsequent epidural reexploration. Outcome Measures. Degree of scar tissue adjacent to the epidural space at reexploration. Intraoperative and postoperative complications related to dHACM and patient reported outcomes. Methods. The degree of scar tissue adjacent to the epidural space was assessed during the reexploration surgery. Patients' outcomes were collected using standard validated questionnaires. Results. Four of 5 cases had easily detachable tissue during epidural reexploration. Angiolipoma of 10% was noted in 1 case and 5% in 2 cases. Significant improvements in patient reported outcomes were observed. No intraoperative or postoperative complications occurred. Conclusions. Our findings suggest that dHACM implant during TLIF may have favorable effects on epidural fibrosis and is well tolerated. Further studies with larger cohorts are required to prove our results. PMID:25653880

Time course of ongoing activity during neuritis and following axonal transport disruption.

PubMed

Satkeviciute, Ieva; Goodwin, George; Bove, Geoffrey M; Dilley, Andrew

2018-05-01

Local nerve inflammation (neuritis) leads to ongoing activity and axonal mechanical sensitivity (AMS) along intact nociceptor axons and disrupts axonal transport. This phenomenon forms the most feasible cause of radiating pain, such as sciatica. We have previously shown that axonal transport disruption without inflammation or degeneration also leads to AMS but does not cause ongoing activity at the time point when AMS occurs, despite causing cutaneous hypersensitivity. However, there have been no systematic studies of ongoing activity during neuritis or noninflammatory axonal transport disruption. In this study, we present the time course of ongoing activity from primary sensory neurons following neuritis and vinblastine-induced axonal transport disruption. Whereas 24% of C/slow Aδ-fiber neurons had ongoing activity during neuritis, few (<10%) A- and C-fiber neurons showed ongoing activity 1-15 days following vinblastine treatment. In contrast, AMS increased transiently at the vinblastine treatment site, peaking on days 4-5 (28% of C/slow Aδ-fiber neurons) and resolved by day 15. Conduction velocities were slowed in all groups. In summary, the disruption of axonal transport without inflammation does not lead to ongoing activity in sensory neurons, including nociceptors, but does cause a rapid and transient development of AMS. Because it is proposed that AMS underlies mechanically induced radiating pain, and a transient disruption of axonal transport (as previously reported) leads to transient AMS, it follows that processes that disrupt axonal transport, such as neuritis, must persist to maintain AMS and the associated symptoms. NEW & NOTEWORTHY Many patients with radiating pain lack signs of nerve injury on clinical examination but may have neuritis, which disrupts axonal transport. We have shown that axonal transport disruption does not induce ongoing activity in primary sensory neurons but does cause transient axonal mechanical sensitivity. The present data complete a profile of key axonal sensitivities following axonal transport disruption. Collectively, this profile supports that an active peripheral process is necessary for maintained axonal sensitivities.

Cost effectiveness of universal umbilical cord blood gas and lactate analysis in a tertiary level maternity unit.

PubMed

White, Christopher R H; Doherty, Dorota A; Cannon, Jeffrey W; Kohan, Rolland; Newnham, John P; Pennell, Craig E

2016-07-01

There is an increasing body of literature supporting universal umbilical cord blood gas analysis (UCBGA) into all maternity units. A significant impediment to UCBGA's introduction is the perceived expense of the introduction and associated ongoing costs. Consequently, this study set out to conduct the first cost-effectiveness analysis of introducing universal UCBGA. Analysis was based on 42,100 consecutive deliveries ≥23 weeks of gestation at a single tertiary obstetric unit. Within 4 years of UCBGA's introduction there was a 45% reduction in term special care nursery (SCN) admissions >2499 g. Incurred costs included initial and ongoing costs associated with universal UCBGA. Averted costs were based on local diagnosis-related grouping costs for reduction in term SCN admissions. Incremental cost-effectiveness ratio (ICER) and sensitivity analysis results were reported. Under the base-case scenario, the adoption of universal UCBGA was less costly and more effective than selective UCBGA over 4 years and resulted in saving of AU$641,532 while adverting 376 SCN admissions. Sensitivity analysis showed that UCBGA was cost-effective in 51.8%, 83.3%, 99.6% and 100% of simulations in years 1, 2, 3 and 4. These conclusions were not sensitive to wide, clinically possible variations in parameter values for neonatal intensive care unit and SCN admissions, magnitude of averted SCN admissions, cumulative delivery numbers, and SCN admission costs. Universal UCBGA is associated with significant initial and ongoing costs; however, potential averted costs (due to reduced SCN admissions) exceed incurred costs in most scenarios.

EXPOSURE TO DIESEL EXHAUST ENHANCES THE SEVERITY OF AN ONGOING INFLUENZA INFECTION.

EPA Science Inventory

Numerous studies have shown that air pollutants including diesel exhaust (DE), alter host defense responses to decrease resistance to respiratory infection. The purpose of this study was to evaluate the effects of DE exposure on the severity of an ongoing influenza infection in ...

Detecting ongoing intimate partner violence in the emergency department using a simple 4-question screen: the OVAT.

PubMed

Ernst, Amy A; Weiss, Steven J; Cham, Elaine; Hall, Louise; Nick, Todd G

2004-06-01

We wanted to prospectively evaluate the use of a brief screening tool for ongoing intimate partner violence (IPV), the OVAT, and to validate this tool against the present Index of Spouse Abuse (ISA). The design was a prospective survey during randomized 4-hour shifts in an urban emergency department setting. The scale consists of four questions developed based on our previous work. The ISA was compared as the gold standard for detection of present (ongoing) IPV. Of 362 eligible patients presenting during 75 randomized 4-hour shifts, 306 (85%) completed the study. The prevalence of ongoing IPV using the OVAT was 31% (95% CI 26% to 36%). For the ISA, the prevalence was 20% (95% CI 16% to 25%). Compared with the ISA, the sensitivity of the OVAT in detecting ongoing IPV was 86%, specificity 83%, negative predictive value 96%, positive predictive value 56%, with an accuracy of 84%. In conclusion, four brief questions can detect ongoing IPV to aid in identifying the victim.

Whole genome sequencing reveals an outbreak of Salmonella Enteritidis associated with reptile feeder mice in the United Kingdom, 2012-2015.

PubMed

Kanagarajah, Sanch; Waldram, Alison; Dolan, Gayle; Jenkins, Claire; Ashton, Philip M; Carrion Martin, Antonio Isidro; Davies, Robert; Frost, Andrew; Dallman, Timothy J; De Pinna, Elizabeth M; Hawker, Jeremy I; Grant, Kathie A; Elson, Richard

2018-05-01

Analysis of whole genome sequencing data uncovered a previously undetected outbreak of Salmonella Enteritidis that had been on-going for four years. Cases were resident in all countries of the United Kingdom and 40% of the cases were aged less than 11 years old. Initial investigations revealed that 30% of cases reported exposure to pet snakes. A case-control study was designed to test the hypothesis that exposure to reptiles or their feed were risk factors. A robust case-definition, based on the single nucleotide polymorphism (SNP) profile, increased the power of the analytical study. Following univariable and multivariable analysis, exposure to snakes was the only variable independently associated with infection (Odds ratio 810 95% CI (85-7715) p < 0.001). Isolates of S. Enteritidis belonging to the outbreak profile were recovered from reptile feeder mice sampled at the retail and wholesale level. Control measures included improved public health messaging at point of sale, press releases and engagement with public health and veterinary counterparts across Europe. Mice destined to be fed to reptiles are not regarded as pet food and are not routinely tested for pathogenic bacteria. Routine microbiological testing to ensure feeder mice are free from Salmonella is recommended. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Type 2 diabetes mellitus: A risk factor for Helicobacter pylori infection: A hospital based case-control study

PubMed Central

Devrajani, Bikha Ram; Shah, Syed Zulfiquar Ali; Soomro, Aftab Ahmed; Devrajani, Tarachand

2010-01-01

Objective: To determine the frequency of Helicobacter pylori (H. pylori) infection in diabetic and non-diabetic patients and to compare the frequency of H. pylori infection in both groups. Study Design: Case control. Place and Duration: Department of Medicine, Liaquat University Hospital from October 2007 to March 2008. Materials and Methods: This hospital-based case-control study was conducted on 148 subjects and divided into two groups i.e. type 2 diabetics and non-diabetics; each group consisting of 74 patients. All diabetic patients of ≥ 35 years of age, both gender and the known cases with history of dyspepsia, epigastric pain or bloating for more than a month were screened for Helicobacter pylori infection. The collected data of both groups was evaluated and separated for analysis. Results: Majority of the patients were male with mean age ± SD, 52.86 ± 8.51. Among the diabetic group, HpSA was positive in 54/74 (73%), whereas in the non-diabetic group HpSA was positive in 38/74 (51.4%) cases. Fasting blood glucose was identified as low in 04 (5.40%) H. pylori infected - diabetic patients where as the blood glucose level of 07 (9.45%) known diabetic patients was raised despite the ongoing medication. Conclusion: Diabetic patients are more prone and at risk to acquire H. Pylori infection. Therefore proper monitoring of blood glucose level and screening for H. pylori infection are effective preventive measures for this life threatening infection. PMID:20431802

The Budapest Meeting 2005 intensified networking on ethics of science: the case of reproductive cloning, germline gene therapy and human dignity.

PubMed

Van Steendam, Guido; Dinnyés, András; Mallet, Jacques; Meloni, Rolando; Casabona, Carlos Romeo; González, Jorge Guerra; Kure, Josef; Szathmáry, Eörs; Vorstenbosch, Jan; Molnár, Péter; Edbrooke, David; Sándor, Judit; Oberfrank, Ferenc; Cole-Turner, Ron; Hargittai, István; Littig, Beate; Ladikas, Miltos; Mordini, Emilio; Roosendaal, Hans E; Salvi, Maurizio; Gulyás, Balázs; Malpede, Diana

2006-10-01

This paper reports on the meeting of the Sounding Board of the EU Reprogenetics Project that was held in Budapest, Hungary, 6-9 November 2005. The Reprogenetics Project runs from 2004 until 2007 and has a brief to study the ethical aspects of human reproductive cloning and germline gene therapy. Discussions during The Budapest Meeting are reported in depth in this paper as well as the initiatives to involve the participating groups and others in ongoing collaborations with the goal of forming an integrated network of European resources in the fields of ethics of science.

A conflict model for the international hazardous waste disposal dispute.

PubMed

Hu, Kaixian; Hipel, Keith W; Fang, Liping

2009-12-15

A multi-stage conflict model is developed to analyze international hazardous waste disposal disputes. More specifically, the ongoing toxic waste conflicts are divided into two stages consisting of the dumping prevention and dispute resolution stages. The modeling and analyses, based on the methodology of graph model for conflict resolution (GMCR), are used in both stages in order to grasp the structure and implications of a given conflict from a strategic viewpoint. Furthermore, a specific case study is investigated for the Ivory Coast hazardous waste conflict. In addition to the stability analysis, sensitivity and attitude analyses are conducted to capture various strategic features of this type of complicated dispute.

Coping with "absence-presence": noncustodial fathers' parenting behaviors.

PubMed

Baum, Nehami

2004-07-01

This article is based on the view that the nature of the divorced father's involvement with his children is affected by psychological processes that enable him to separate his parental from his spousal role and identity. It argues that the ability to cope with the simultaneous absence of the spousal role and identity and presence of the paternal role and identity is a key factor in shaping the divorced father's behavior toward his children. The article illustrates the claim in 3 case studies showing (a) parental functioning marred by ongoing conflict with the children's mother, (b) disengagement, and (c) stable and consistent parental functioning within the inevitable limitations of noncustodial fatherhood.

Here's the beef: A case study in organizational transformation

NASA Technical Reports Server (NTRS)

Huseonica, William F.; Giardino, Marco J.

1992-01-01

The Science and Technology Lab (STL) is tasked with the design, development, and application of the science and engineering services. Formed in the early 1970's STL adhered to many traditional attitudes including barriers to communication, excessive management control, parochial strategies, unclear measures of success, lack of customer focus, underutilization of people, and excessive administrative burdens on scientists and engineers. The challenge for the STL was to maximize customer satisfaction through the effective and efficient application of the notable skills and talents of the STL's workforce. In this way, the Lab would begin its exciting journey toward becoming world class. A discussion of this on-going transformation is presented.

BPMN, Toolsets, and Methodology: A Case Study of Business Process Management in Higher Education

NASA Astrophysics Data System (ADS)

Barn, Balbir S.; Oussena, Samia

This chapter describes ongoing action research which is exploring the use of BPMN and a specific toolset - Intalio Designer to capture the “as is” essential process model of part of an overarching large business process within higher education. The chapter contends that understanding the efficacy of the BPMN notation and the notational elements to use is not enough. Instead, the effectiveness of a notation is determined by the notation, the toolset that is being used, and methodological consideration. The chapter presents some of the challenges that are faced in attempting to develop computation independent models in BPMN using toolsets such as Intalio Designer™.

Hemifacial microsomia: from gestation to childhood.

PubMed

Werler, Martha M; Starr, Jacqueline R; Cloonan, Yona K; Speltz, Matthew L

2009-03-01

Hemifacial microsomia (HFM) is a variable, complex malformation involving asymmetric hypoplasia of the face and ear. Little is known about the risk factors for or consequences of HFM. In this study, we describe 3 studies that have been or are currently being conducted to further our understanding of this malformation. The first completed study examined whether HFM risk is related to maternal exposures that may affect blood flow. In that case-control study, interview data from 230 mothers of children in the case group and 678 mothers of children in the control group suggested that maternal use of vasoactive medications in the first trimester, particularly in combination with cigarette smoking, was associated with increased risks of HFM. The second study is currently underway, in which we are evaluating whether HFM risk is related to genetic variation in pathways associated with vasculogenesis and hemostasis, using DNA collected in the first study. The third ongoing study observes children with HFM to identify psychosocial, cognitive, dental, and medical sequelae. When the children from the original case-control study are 6 or 7 years of age, mothers and teachers complete self-administered questionnaires that cover a wide range of psychosocial development domains. Preliminary analyses of 115 case and 314 control children suggest that children with HFM may have worse teacher-reported academic performance and possibly higher levels of internalizing behavior problems than control children. When data on the full study sample are available, further analyses will determine whether the preliminary findings remain and if they vary by HFM phenotype, parenting style, or indicators of social risk.

On the relationship between human papilloma virus vaccine and autoimmune diseases.

PubMed

Pellegrino, Paolo; Carnovale, Carla; Pozzi, Marco; Antoniazzi, Stefania; Perrone, Valentina; Salvati, Dionigi; Gentili, Marta; Brusadelli, Tatiana; Clementi, Emilio; Radice, Sonia

2014-07-01

The human papilloma virus (HPV) vaccines were introduced to reduce the incidence of cervical cancer. The bivalent vaccine is effective against HPV-16, -18, -31, -33 and -45 while the quadrivalent vaccine is effective against HPV-16, 18, 31, 6 and 11 types. The immunisation, recommended for adolescent females, has led to high vaccine coverage in many countries. Along with the introduction of the HPV vaccines, several cases of onset or exacerbations of autoimmune diseases following the vaccine shot have been reported in the literature and pharmacovigilance databases, triggering concerns about its safety. This vaccination programme, however, has been introduced in a population that is at high risk for the onset of autoimmune diseases, making it difficult to assess the role of HPV vaccine in these cases and no conclusive studies have been reported thus far. We have thus analysed and reviewed comprehensively all case reports and studies dealing with either the onset of an autoimmune disease in vaccinated subject or the safety in patients with autoimmune diseases to define the role of the HPV vaccines in these diseases and hence its safety. A solid evidence of causal relationship was provided in few cases in the examined studies, and the risk vs. benefit of vaccination is still to be solved. The on-going vigilance for the safety of this vaccine remains thus of paramount importance. Copyright © 2014 Elsevier B.V. All rights reserved.

Dengue Virus Serotype 2 Established in Northern Mozambique (2015-2016).

PubMed

Oludele, John; Lesko, Birgitta; Mahumane Gundane, Isabel; de Bruycker-Nogueira, Fernanda; Muianga, Argentina; Ali, Sadia; Mula, Flora; Chelene, Imelda; Falk, Kerstin I; Barreto Dos Santos, Flávia; Gudo, Eduardo Samo

2017-11-01

After the report of an outbreak of dengue virus serotype 2 in 2014 in Nampula and Pemba cities, northern Mozambique, a surveillance system was established by the National Institute of Health. A study was performed during 2015-2016 to monitor the trend of the outbreak and confirm the circulating serotype of dengue virus (DENV). After the inclusion of consenting patients who met the case definition, samples from 192 patients were tested for the presence of nonstructural protein 1 antigen, and 60/192 (31%) samples were positive. Further analysis included DENV IgM antibodies, with 39 (20%) IgM positive cases. Reverse transcriptase (RT) PCR was performed for identification of the prevailing DENV serotype; 21/23 tested samples were DENV-2 positive, with DENV-2 present in both affected cities. When sequencing DENV, phenotype Cosmopolitan was identified. The surveillance indicates ongoing spread of DENV-2 in northern Mozambique 2 years after the first report of the outbreak.

[Representation of Internal Medicine in G-DRG System - Analysis of Reasons for Prolonged Length of Stay].

PubMed

Siam, Kristina; Roeder, Norbert; Fölsch, Ulrich R; Spies, Hans-Friedrich

2017-08-01

Background  There is an ongoing discussion within the German Society of Internal Medicine (DGIM) and the Professional Association of German Internists (BDI) about the appropriate depiction and remuneration of internal medicine in the G-DRG. Method  Therefore, cases with a significantly prolonged length of stay were analyzed in a multicenter study. 124 cases from 6 hospitals were collected for evaluation. Results  The results show that the observed prolongation of hospitalization was mainly due to medical reasons. Discussion  Thus, patients with unclear symptoms and consequently need for a thorough workup could not be identified to cause longer inpatient stay. Instead, treatment complications and comorbidities led to extended hospitalization. The results also reveal prolonged hospitalization as a consequence of unsettled or delayed postdischarge care e. g. in rehabilitation facilities. © Georg Thieme Verlag KG Stuttgart · New York.

Neonatal thyrotoxicosis with severe supraventricular tachycardia: case report and review of the literature.

PubMed

Abbasoğlu, Aslıhan; Ecevit, Ayşe; Tuğcu, Ali Ulaş; Erdoğan, Lkay; Kınık, Sibel Tulgar; Tarcan, Aylin

2015-03-01

Neonatal thyrotoxicosis is a rare condition caused by the transplacental passage of thyroid stimulating immunoglobulins from mothers with Graves' disease. We report a case of neonatal thyrotoxicosis with concurrent supraventricular tachycardia (SVT). The female infant, who was born by section due to breech delivery and meconium in the amniotic fluid at 36 weeks of gestation, presented with tachycardia on day 7. Her heart rate was between 260 and 300 beats/min, and an electrocardiogram revealed ongoing SVT. Sotalol was effective after two cardioversions in maintaining sinus rhythm. Thyroid function studies revealed hyperthyroidism in the infant, and her mother was found to have Graves' disease. Since symptoms and signs can vary, especially in preterm infants with neonatal hyperthyroidism, we want to emphasize the importance of prenatal care and follow-ups of Graves' disease associated pregnancies and management of newborns after birth.

Hantavirus Pulmonary Syndrome in the United States.

PubMed

Fabbri, Marilyn; Maslow, Melanie J.

2001-06-01

Since the first outbreak of hantavirus pulmonary syndrome (HPS) in 1993, understanding of the vast distribution and potential impact of hantaviruses has grown. At least 277 cases of HPS have been documented in the United States. The full clinical spectrum has yet to be elucidated, and one outbreak suggested the possibility of person-to-person transmission. New research has identified the b-3 integrins as cellular receptors for hantaviruses and has determined the pivotal role of the immune system in pathogenesis. Rapid diagnosis has been facilitated by a new immunoblot assay to detect Sin Nombre virus infection. Treatment remains primarily supportive; however, a placebo- controlled trial of ribavirin is ongoing. Extracorporeal membrane oxygenation may be a potential therapy in severe cases; inhaled nitric oxide needs further study. Vaccines developed against hantaviruses associated with hemorrhagic fever and renal syndrome might be effective against HPS-associated strains.

Wave Excitation in Accretion Disks by Protoplanets

NASA Astrophysics Data System (ADS)

Koller, J.; Li, H.

2002-05-01

The ongoing discoveries of extrasolar planets in the recent years revealed remarkable properties and unexpected results concerning the formation process. We studied the perturbation of a protostellar accretion disk by a companion utilizing APOLLO, a fast hydro disk code well tested in the case of accretion disks without a companion (Li et al. 2001, ApJ, 551, 874). We consider limiting cases where the companion's mass is much smaller than the central protostar and resides in a circular keplerian orbit. The gravitational field of the protoplanet, embedded in a numerically thin disk, generates spiral density waves and Rossby instabilities resulting in a non-axisymmetric density distribution. We present nonlinear hydro simulations to investigate those non-axisymmetric density distribution with different disk and planet parameters in order to understand how disks respond to a fixed companion in orbit. This work has been supported by IGPP at LANL (award # 1109) and NASA (grant # NAG5-9223).

Neurological Nuance: Hodgkin lymphoma presenting with Guillain-BarrÉ syndrome.

PubMed

Anderson, Dustin; Beecher, Grayson; Steve, Trevor A; Jen, Ho; Camicioli, Richard; Zochodne, Douglas W

2017-04-01

Hodgkin lymphoma (HL) is a common lymphoid malignancy rarely associated with Guillain-Barré syndrome (GBS). In most cases, GBS does not precede HL. We describe a patient with acute inflammatory demyelinating polyneuropathy who fulfilled criteria for GBS that heralded undiagnosed HL. Cerebrospinal fluid (CSF) studies revealed albuminocytologic dissociation with significant protein elevation (250 mg/dl). The patient worsened during intravenous immunoglobulin (IVIg) therapy. Constitutional symptoms with elevated inflammatory markers prompted further investigation, and imaging revealed an anterior mediastinal mass confirmed on biopsy to be HL. Chemotherapy yielded early clinical improvement. GBS preceding HL is rare, and this case highlights the importance of considering HL in the setting of GBS. Marked elevations in CSF protein, ongoing deterioration despite administration of IVIg, and constitutional symptoms with elevated inflammatory markers may be clues to possible HL-induced GBS. Muscle Nerve 55: 601-604, 2017. © 2016 Wiley Periodicals, Inc.

Endomyocardial fibrosis in Sudan: clinical and echocardiographic features

PubMed Central

Khalil, Siddiq Ibrahim; Khalil, Suha; El Tigani, Salma; Saad, Hanan A

2017-01-01

Summary Objective: Endomyocardial fibrosis (EMF) is a rare disease and is often an underdiagnosed and forgotten cardiomyopathy. The objective of this study was to document the current frequency of EMF in Sudan by defining and selecting cases from patients attending the echocardiography laboratory. Additionally we aimed to create an EMF registry for Sudan. Methods: The study started in January 2007 and is on-going. All the patients attending our echocardiography clinics in four different hospitals in Khartoum, Sudan, were included. Transthoracic echocardiography was used as the main diagnostic and selection tool. The diagnosis of EMF was based on predefined criteria and definitions, and was further supported by additional clinical, ECG, laboratory and chest X-ray findings. Results: Out of 4 332 cases studied, 23 (0.5%) were found to have features of EMF. Females constituted 52% and the age range was 24 to 67 years. All patients presented with dyspnoea grades III–IV. Advanced heart failure with gross fluid overload was seen in 54% of cases and ascites was seen in 30%. EMF was biventricular in 53%, left ventricular in 29% and right ventricular in 18% of cases. Apical and ventricular wall fibrosis was found in all cases, followed by atrial enlargement, atrioventricular valve incompetence, ventricular cavity obliteration, restrictive flow pattern and pericardial effusion. Additional echocardiographic features are defined and discussed. Conclusion: Although a rare disease, cases of EMF can be identified in Sudan if a high index of suspicion is observed. New echocardiographic features of ventricular wall layering, endocardial fibrous shelf and endomyocardiopericarial fibrosis were identified and are discussed. PMID:28906536

Human embryonic curvature studied with 3D ultrasound in ongoing pregnancies and miscarriages.

PubMed

Bogers, Hein; van Uitert, Evelyne M; van Ginkel, Sharon; van der Mooren, Elisabeth D H; Groenenberg, Irene A L; Eilers, Paul H C; Exalto, Niek; Steegers, Eric A P; Steegers-Theunissen, Régine P M

2018-05-01

Embryonic growth is often impaired in miscarriages. It is postulated that derangements in embryonic growth result in abnormalities of the embryonic curvature. This study aims to create first trimester reference charts of the human embryonic curvature and investigate differences between ongoing pregnancies and miscarriages. Weekly ultrasonographic scans from ongoing pregnancies and miscarriages were used from the Rotterdam periconceptional cohort and a cohort of recurrent miscarriages. In 202 ongoing pregnancies and 33 miscarriages, first trimester crown rump length and total arch length were measured to assess the embryonic curvature. The results show that the total arch length increases and shows more variation with advanced gestation. The crown rump length/total arch length ratio shows a strong increase from 8 +0 to 10 +0 weeks and flattening thereafter. No significant difference was observed between the curvature of embryos of ongoing pregnancies and miscarriages. The majority of miscarried embryos could not be measured. Therefore, this technique is too limited to recommend the measurement of the embryonic curvature in clinical practice. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Effects of ongoing task context and target typicality on prospective memory performance: the importance of associative cueing

NASA Technical Reports Server (NTRS)

Nowinski, Jessica Lang; Dismukes, Key R.

2005-01-01

Two experiments examined whether prospective memory performance is influenced by contextual cues. In our automatic activation model, any information available at encoding and retrieval should aid recall of the prospective task. The first experiment demonstrated an effect of the ongoing task context; performance was better when information about the ongoing task present at retrieval was available at encoding. Performance was also improved by a strong association between the prospective memory target as it was presented at retrieval and the intention as it was encoded. Experiment 2 demonstrated boundary conditions of the ongoing task context effect, which implicate the association between the ongoing and prospective tasks formed at encoding as the source of the context effect. The results of this study are consistent with predictions based on automatic activation of intentions.

Pinpointing clusters of apparently sporadic cases of Legionnaires' disease.

PubMed Central

Bhopal, R. S.; Diggle, P.; Rowlingson, B.

1992-01-01

OBJECTIVES--To test the hypothesis that many non-outbreak cases of legionnaires' disease are not sporadic and to attempt to pinpoint cases clustering in space and time. DESIGN--Descriptive study of a case series, 1978-86. SETTING--15 health boards in Scotland. PATIENTS--203 probable cases of non-outbreak, non-travel, community acquired legionnaires' disease in patients resident in Scotland. MAIN MEASURES--Date of onset of disease and postcode and health board of residence of cases. RESULTS--Space-time clustering was present and numerous groups of cases were identified, all but two being newly recognised. Nine cases occurred during three months within two postcodes in Edinburgh, and an outbreak was probably missed. In several places cases occurred in one area over a prolonged period--for example, nine cases in postcode districts G11.5 and G12.8 in Glasgow during five years (estimated mean annual incidence of community acquired, non-outbreak, non-travel legionnaires' disease of 146 per million residents v 4.8 per million for Scotland). Statistical analysis showed that the space time clustering of cases in the Glasgow and Edinburgh areas was unusual (p = 0.036, p = 0.068 respectively). CONCLUSION--Future surveillance requires greater awareness that clusters can be overlooked; case searching whenever a case is identified; collection of complete information particularly of date of onset of the disease and address or postcode; ongoing analysis for space-time clustering; and an accurate yet workable definition of sporadic cases. Other researchers should re-examine their data on apparently sporadic infection. PMID:1586784

IMPACCT Kids’ Care: a real-world example of stakeholder involvement in comparative effectiveness research

PubMed Central

Likumahuwa-Ackman, Sonja; Angier, Heather; Sumic, Aleksandra; Harding, Rose L; Cottrell, Erika K; Cohen, Deborah J; Nelson, Christine A; Burdick, Timothy E; Wallace, Lorraine S; Gallia, Charles; DeVoe, Jennifer E

2015-01-01

The Patient-Centered Outcomes Research Institute has accelerated conversations about the importance of actively engaging stakeholders in all aspects of comparative effectiveness research (CER). Other scientific disciplines have a history of stakeholder engagement, yet few empirical examples exist of how these stakeholders can inform and enrich CER. Here we present a case study which includes the methods used to engage stakeholders, what we learned from them, and how we incorporated their ideas in a CER project. We selected stakeholders from key groups, built relationships with them and collected their feedback through interviews, observation and ongoing meetings during the four research process phases: proposal development, adapting study methods, understanding the context and information technology tool design and refinement. PMID:26274796

Virtual Archaeodrome for the Archaeological Site from Ulpia Traiana Sarmizegetusa

NASA Astrophysics Data System (ADS)

Angheluţǎ, L. M.; Rǎdvan, R.; Chelmuş, A. I.; Ratoiu, L.; Cortea, I. M.; Ghervase, L.

2017-05-01

This paper presents an ongoing work within a national project regarding the scientific investigation of one of the most important archaeological sites in Romania: Ulpia Traiana Sarmizegetusa. Although the project has many objectives, in this paper we will focus on the development work of a virtual archaeodrome for the archaeological park. In this regard several field campaigns were organized using the ART4ART mobile laboratory for in-situ non-invasive scientific data acquisition and an online instrument for data reporting and visualizing is currently under development. This work represents a case study of several archaeological assets comprising chronologically layered historical studies, high resolution 3D digital models, ground penetrating radar survey and airborne imaging: LIDAR, multispectral and aerial photogrammetry.

IMPACCT Kids' Care: a real-world example of stakeholder involvement in comparative effectiveness research.

PubMed

Likumahuwa-Ackman, Sonja; Angier, Heather; Sumic, Aleksandra; Harding, Rose L; Cottrell, Erika K; Cohen, Deborah J; Nelson, Christine A; Burdick, Timothy E; Wallace, Lorraine S; Gallia, Charles; DeVoe, Jennifer E

2015-08-01

The Patient-Centered Outcomes Research Institute has accelerated conversations about the importance of actively engaging stakeholders in all aspects of comparative effectiveness research (CER). Other scientific disciplines have a history of stakeholder engagement, yet few empirical examples exist of how these stakeholders can inform and enrich CER. Here we present a case study which includes the methods used to engage stakeholders, what we learned from them, and how we incorporated their ideas in a CER project. We selected stakeholders from key groups, built relationships with them and collected their feedback through interviews, observation and ongoing meetings during the four research process phases: proposal development, adapting study methods, understanding the context and information technology tool design and refinement.

Stirling engine application study

NASA Technical Reports Server (NTRS)

Teagan, W. P.; Cunningham, D.

1983-01-01

A range of potential applications for Stirling engines in the power range from 0.5 to 5000 hp is surveyed. Over one hundred such engine applications are grouped into a small number of classes (10), with the application in each class having a high degree of commonality in technical performance and cost requirements. A review of conventional engines (usually spark ignition or Diesel) was then undertaken to determine the degree to which commercial engine practice now serves the needs of the application classes and to detemine the nature of the competition faced by a new engine system. In each application class the Stirling engine was compared to the conventional engines, assuming that objectives of ongoing Stirling engine development programs are met. This ranking process indicated that Stirling engines showed potential for use in all application classes except very light duty applications (lawn mowers, etc.). However, this potential is contingent on demonstrating much greater operating life and reliability than has been demonstrated to date by developmental Stirling engine systems. This implies that future program initiatives in developing Stirling engine systems should give more emphasis to life and reliability issues than has been the case in ongoing programs.