Primary Teacher Educators' Perception of Desired and Achieved Pedagogical Content Knowledge in Geography Education in Primary Teacher Training

ERIC Educational Resources Information Center

Blankman, Marian; van der Schee, Joop; Volman, Monique; Boogaard, Marianne

2015-01-01

This paper presents the findings of a study conducted among primary geography teacher educators. The research examines the perceptions of educators of primary teacher students' desired and achieved levels of substantial knowledge, syntactic knowledge, and beliefs about the subject of geography. The findings indicate that primary teacher educators…

A Scale Development for 21st Century Skills of Primary School Students: A Validity and Reliability Study

ERIC Educational Resources Information Center

Boyaci, S. Dilek Belet; Atalay, Nurhan

2016-01-01

The objective of the present study is to develop a measurement tool to assess 21st Century learning and innovation skills of primary school students. Study data was collected from 632 fourth grade students in five different primary schools during 2014-2015 academic year and data obtained from 609 fourth grade students were utilized in the study.…

The impact of primary care on emergency department presentation and hospital admission with pneumonia: a case–control study of preschool-aged children

PubMed Central

Emery, Diane P; Milne, Tania; Gilchrist, Catherine A; Gibbons, Megan J; Robinson, Elizabeth; Coster, Gregor D; Forrest, Christopher B; Harnden, Anthony; Mant, David; Grant, Cameron C

2015-01-01

Background: In children, community-acquired pneumonia is a frequent cause of emergency department (ED) presentation and hospital admission. Quality primary care may prevent some of these hospital visits. Aims: The aim of this study was to identify primary care factors associated with ED presentation and hospital admission of preschool-aged children with community-acquired pneumonia. Methods: A case–control study was conducted by enrolling three groups: children presenting to the ED with pneumonia and admitted (n=326), or discharged home (n=179), and well-neighbourhood controls (n=351). Interviews with parents and primary care staff were conducted and health record review was performed. The association of primary care factors with ED presentation and hospital admission, controlling for available confounding factors, was determined using logistic regression. Results: Children were more likely to present to the ED with pneumonia if they did not have a usual general practitioner (GP) (odds ratio (OR)=2.50, 95% confidence interval (CI)=1.67–3.70), their GP worked ⩽20 h/week (OR=1.86, 95% CI=1.10–3.13) or their GP practice lacked an immunisation recall system (OR=5.44, 95% CI=2.26–13.09). Lower parent ratings for continuity (OR=1.63, 95% CI=1.01–2.62), communication (OR=2.01, 95% CI=1.29–3.14) and overall satisfaction (OR=2.16, 95% CI=1.34–3.47) increased the likelihood of ED presentation. Children were more likely to be admitted when antibiotics were prescribed in primary care (OR=2.50, 95% CI=1.43–4.55). Hospital admission was less likely if children did not have a usual GP (OR=0.22, 95% CI=0.11–0.40) or self-referred to the ED (OR=0.48, 95% CI=0.26–0.89). Conclusions: Accessible and continuous primary care is associated with a decreased likelihood of preschool-aged children with pneumonia presenting to the ED and an increased likelihood of hospital admission, implying more appropriate referral. Lower parental satisfaction is associated with an increased likelihood of ED presentation. PMID:25654661

"Why Are They Bombing Innocent Iraqis?": Political Literacy among Primary Pupils

ERIC Educational Resources Information Center

Maitles, Henry; Deuchar, Ross

2004-01-01

This article presents case studies of political literacy among primary pupils. While researching primary pupils' understanding of "enterprise", the researchers added interviews connecting this concept to the Iraq war. A sample of 10 non-representative Scottish primary schools from seven local education authorities has provided the…

Primary Prevention: Reducing Institutional Racism/Sexism Through Consultation. Case Study.

ERIC Educational Resources Information Center

O'Neil, James M.; Conyne, Robert

This paper presents a two-year primary prevention intervention aimed at reducing institutional racism and sexism at a large midwestern university. A case study format is used to describe the history, process, and outcomes of the consultation that resulted in proactive change in the institution. Definitions of primary prevention are given and the…

Distributed Leadership: Key to Improving Primary Students' Mathematical Knowledge

ERIC Educational Resources Information Center

Larson, Matthew R.; Smith, Wendy M.

2013-01-01

The purpose of this article is to present the findings of a quantitative study focused on primary mathematics teachers who participated in an intensive professional development program and then had leadership responsibility for the implementation of a new primary mathematics curriculum in their district. The study examines the effect of the…

Primary School Principals' Self-Monitoring Skills

ERIC Educational Resources Information Center

Konan, Necdet

2015-01-01

The aim of the present study is to identify primary school principals' self-monitoring skills. The study adopted the general survey model and its population comprised primary school principals serving in the city of Diyarbakir, Turkey, while 292 of these constituted the sample. Self-Monitoring Scale was used as the data collection instrument. In…

Critical Thinking Dispositions of Pre-Service Turkish Language Teachers and Primary Teachers

ERIC Educational Resources Information Center

Maltepe, Sadet

2016-01-01

The present study aimed to determine critical thinking dispositions of pre-service Turkish language and primary teachers in terms of several variables by employing descriptive survey design. The study group consisted of 215 senior students attending Turkish Language Teaching and Primary Education Departments of Necatibey Faculty of Education at…

Investigation of Primary Mathematics Student Teachers' Concept Images: Cylinder and Cone

ERIC Educational Resources Information Center

Ertekin, Erhan; Yazici, Ersen; Delice, Ali

2014-01-01

The aim of the present study is to determine the influence of concept definitions of cylinder and cone on primary mathematics student teachers' construction of relevant concept images. The study had a relational survey design and the participants were 238 primary mathematics student teachers. Statistical analyses implied the following: mathematics…

Assessment of the Effectiveness of the Educational Environment Supported by Computer Aided Presentations at Primary School Level

ERIC Educational Resources Information Center

Kose, Erdogan

2009-01-01

The objective of this study is to assess the effectiveness of the educational environment supported by computer aided presentations at primary school. The effectiveness of the environment has been evaluated in terms of students' learning and remembering what they have learnt. In the study, we have compared experimental group and control group in…

The Use of Interactive Computer Animations Based on POE as a Presentation Tool in Primary Science Teaching

ERIC Educational Resources Information Center

Akpinar, Ercan

2014-01-01

This study investigates the effects of using interactive computer animations based on predict-observe-explain (POE) as a presentation tool on primary school students' understanding of the static electricity concepts. A quasi-experimental pre-test/post-test control group design was utilized in this study. The experiment group consisted of 30…

Beyond Electronic Brochures: An Analysis of Singapore Primary School Web Sites

ERIC Educational Resources Information Center

Hu, Chun; Soong, Andrew Kheng Fah

2007-01-01

This study aims to investigate how Singapore primary schools use their web sites, what kind of information is contained in the web sites, and how the information is presented. Based on an analysis of 176 primary school web sites, which represent all but one of the country's primary schools, findings indicate that most of Singapore's primary school…

Helping Families Improve: An Evaluation of Two Primary Care Approaches to Parenting Support in the Netherlands

ERIC Educational Resources Information Center

de Graaf, Ireen; Onrust, Simone; Haverman, Merel; Janssens, Jan

2009-01-01

The present study evaluated two primary care parenting interventions. First, we evaluated the most widely used Dutch practices for primary care parenting support. Second, we assessed the applicability of the Primary Care Triple P approach, which is now being utilized in a wide variety of primary care settings. Both interventions target parents of…

Food waste quantification in primary production - The Nordic countries as a case study.

PubMed

Hartikainen, Hanna; Mogensen, Lisbeth; Svanes, Erik; Franke, Ulrika

2018-01-01

Our understanding of food waste in the food supply chain has increased, but very few studies have been published on food waste in primary production. The overall aims of this study were to quantify the total amount of food waste in primary production in Finland, Sweden, Norway and Denmark, and to create a framework for how to define and quantify food waste in primary production. The quantification of food waste was based on case studies conducted in the present study and estimates published in scientific literature. The chosen scope of the study was to quantify the amount of edible food (excluding inedible parts like peels and bones) produced for human consumption that did not end up as food. As a result, the quantification was different from the existing guidelines. One of the main differences is that food that ends up as animal feed is included in the present study, whereas this is not the case for the recently launched food waste definition of the FUSIONS project. To distinguish the 'food waste' definition of the present study from the existing definitions and to avoid confusion with established usage of the term, a new term 'side flow' (SF) was introduced as a synonym for food waste in primary production. A rough estimate of the total amount of food waste in primary production in Finland, Sweden, Norway and Denmark was made using SF and 'FUSIONS Food Waste' (FFW) definitions. The SFs in primary production in the four Nordic countries were an estimated 800,000 tonnes per year with an additional 100,000 tonnes per year from the rearing phase of animals. The 900,000 tonnes per year of SF corresponds to 3.7% of the total production of 24,000,000 tonnes per year of edible primary products. When using the FFW definition proposed by the FUSIONS project, the FFW amount was estimated at 330,000 tonnes per year, or 1% of the total production. Copyright © 2017 Elsevier Ltd. All rights reserved.

Conducting Museum Education Activities within the Context of Developing a Nature Culture in Primary School Students: MTA Natural History Museum Example

ERIC Educational Resources Information Center

Dilli, Rukiye

2016-01-01

The present study, aiming to develop nature culture in primary school students and to help them to become acquainted with their close environment, is a quasi-experimental study. Museum education activities were conducted with the study group which consisted of 128 fourth-grade primary school students. At the end of the study, the students gained…

Innovative Approaches to Achieving Universal Primary Education and Its Democratization: A Synopsis.

ERIC Educational Resources Information Center

Ranaweera, A. Mahinda

This paper presents information culled from a study of 200 publications about innovative approaches towards achieving universal primary education (UPE) and its democratization. The first part of the paper addresses the topics of children's right to primary education, the role of primary education in eradicating adult illiteracy, and the difficulty…

A Survey of Rural Primary School Music Education in Northeastern China

ERIC Educational Resources Information Center

Sun, Zuodong; Leung, Bo Wah

2014-01-01

China has been instituting national basic education curriculum reforms since 2001. This study provides an updated understanding of present-day, rural primary school music education in Northeastern China's Tonghua region. A total of 126 rural primary music teachers and 674 students from 28 primary schools in the region were surveyed using a…

Parental Influence on Academic Achievement among the Primary School Students in Trinidad

ERIC Educational Resources Information Center

Johnson, Emmanuel Janagan; Descartes, Christine H.

2017-01-01

The present study examined the level of parental influence on academic achievement in primary school students who prepare for the National-level test at standard five (grade 6), Secondary Entrance Examinations in Trinidad. A sample of 128 students studying standard five from primary schools was randomly selected. The data were analysed using SPSS.…

Teachers' Performance Motivation System in Thai Primary Schools

ERIC Educational Resources Information Center

Pasathang, Sarojn; Tesaputa, Kowat; Sataphonwong, Pattananusron

2016-01-01

This research aims to: 1) study the present conditions and desirable condition of the motivation systems as well as how to find methods for motivating the performance of teachers in primary schools, 2) develop a motivation system for the performance of teachers in primary schools, 3) study the effects of using the motivation system for compliance…

Effects of Continuing Professional Development on Group Work Practices in Scottish Primary Schools

ERIC Educational Resources Information Center

Thurston, A.; Christie, D.; Howe, C. J.; Tolmie, A.; Topping, K. J.

2008-01-01

The present study investigated the effects of a continuing professional development (CPD) initiative that provided collaborative group work skills training for primary school teachers. The study collected data from 24 primary school classrooms in different schools in a variety of urban and rural settings. The sample was composed of 332 pupils,…

Childhood respiratory illness presentation and service utilisation in primary care: a six-year cohort study in Wellington, New Zealand, using natural language processing (NLP) software.

PubMed

Dowell, Anthony; Darlow, Ben; Macrae, Jayden; Stubbe, Maria; Turner, Nikki; McBain, Lynn

2017-08-01

To identify childhood respiratory tract-related illness presentation rates and service utilisation in primary care by interrogating free text and coded data from electronic medical records. Retrospective cohort study. Data interrogation used a natural language processing software inference algorithm. 36 primary care practices in New Zealand. Data analysed from January 2008 to December 2013. The records from 77 582 children enrolled were reviewed over a 6-year period to estimate the presentation of childhood respiratory illness and service utilisation. This cohort represents 268 919 person-years of data and over 650 000 unique consultations. Childhood respiratory illness presentation rate to primary care practice, with description of seasonal and yearly variation. Respiratory conditions constituted 46% of all child-general practitioner consultations with a stable year-on-year pattern of seasonal peaks. Upper respiratory tract infection was the most common respiratory category accounting for 21.0% of all childhood consultations, followed by otitis media (12.2%), wheeze-related illness (9.7%), throat infection (7.4%) and lower respiratory tract infection (4.4%). Almost 70% of children presented to their general practitioner with at least one respiratory condition in their first year of life; this reduced to approximately 25% for children aged 10-17. This is the first study to assess the primary care incidence and service utilisation of childhood respiratory illness in a large primary care cohort by interrogating electronic medical record free text. The study identified the very high primary care workload related to childhood respiratory illness, especially during the first 2 years of life. These data can enable more effective planning of health service delivery. The findings and methodology have relevance to many countries, and the use of primary care 'big data' in this way can be applied to other health conditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The ORIGINS of Primary Health Care and SELECTIVE Primary Health Care

PubMed Central

Cueto, Marcos

2004-01-01

I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations’ political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care. These debates led to the development of an alternative, more restricted approach, known as selective primary health care. My study examined library and archival sources; I cite examples from Latin America. PMID:15514221

Second Primary Head and Neck Cancers After Non-Head and Neck Primary Cancers.

PubMed

Schlieve, Thomas; Heidel, R Eric; Carlson, Eric R

2016-12-01

The purpose of the present study was to determine the rate of second primary head and neck cancer development among patients with a primary cancer diagnosed outside the head and neck region, to present the clinical characteristics of this population, and to determine whether any variables are associated with survival. We designed a case series based on a sample of patients diagnosed with head and neck cancer who had previously been diagnosed with cancer located outside the head and neck region. The primary predictor variable was a diagnosis of cancer outside the head and neck region. The primary outcome variable was the diagnosis of a second cancer in the head and neck region. χ 2  Goodness-of-fit tests were used to test for differences between the observed and expected rates. A total of 19,406 cancers were diagnosed at the University of Tennessee Cancer Institute during the study period from July 1, 2004 to June 30, 2014. The rate of second primary head and neck cancer among patients with a non-head and neck primary cancer was 0.2%. These 40 cancers occurred among a total of 849 head and neck squamous cell carcinoma (HNSCC) cases (5%) diagnosed during the study period. The most common location for a second primary HNSCC was the gingiva (27.5%), followed by the oral tongue (17.5%). Significantly more gingival cancers were diagnosed than expected (P < .001) and significantly fewer tongue cancers than expected (P = .01). The most common primary cancer was prostate (27.5%), followed by breast (25%). The median survival was 28.5 months after the second primary diagnosis. A nonsignificant effect was found for age (P = .30), tobacco use (P = .12), gender (P = .60), TNM stage (P = .29), and treatment protocol (P = .96) on survival. The development of a second primary HNSCC in a population of patients with non-head and neck primary cancers is associated with decreased overall survival. The most common presentation of a second primary HNSCC in our study was in the gingiva and the most common primary cancer was in the prostate. Clinicians should consider the increased proportion of gingival cancers in this population when examining patients and be aware of the decrease in overall survival. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin.

PubMed

Jain, Avani; Srivastava, Madhur Kumar; Pawaskar, Alok Suresh; Shelley, Simon; Elangovan, Indirani; Jain, Hasmukh; Pandey, Somnath; Kalal, Shilpa; Amalachandran, Jaykanth

2015-01-01

To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or primary tumor was detected by any other investigation were excluded from the analysis. Totally, 163 patients with pathological diagnosis of malignancy but no apparent sites of the primary tumor were finally selected for analysis. The site of probable primary malignancy suggested by PET-CECT was confirmed by biopsy/follow-up. PET-CECT suggested probable site of primary in 128/163 (78.52%) patients. In 30/35 remaining patients, primary tumor was not detected even after extensive work-up. In 5 patients, where PET-CECT was negative, primary was found on further extensive investigations or follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of the study were 95.76%, 66.67%, 88.28% and 85.71% respectively. F-18 FDG PET-CECT aptly serves the purpose of initial imaging modality owing to high sensitivity, negative and positive predictive value. PET-CECT not only surveys the whole body for the primary malignancy but also stages the disease accurately. Use of contrast improves the diagnostic utility of modality as well as help in staging of the primary tumor. Although benefits of using PET-CECT as initial diagnostic modality are obvious from this study, there is a need for a larger study comparing conventional methods for diagnosing primary in patients with MUO versus PET-CECT.

Developments in Motivation and Achievement during Primary School: A Longitudinal Study on Group-Specific Differences

ERIC Educational Resources Information Center

Hornstra, Lisette; van der Veen, Ineke; Peetsma, Thea; Volman, Monique

2013-01-01

To gain insight in developmental trajectories of motivation during upper primary school, the present study focused on how different aspects of students' motivation, i.e., task-orientation, self-efficacy, and school investment develop from grade three to six of primary school and how these developments differ for boys and girls, and students with…

Insight into the epidemiology of cutaneous squamous cell carcinoma with perineural spread.

PubMed

Warren, Timothy A; Whiteman, David C; Porceddu, Sandro V; Panizza, Benedict J

2016-09-01

Perineural spread (PNS) of cutaneous squamous cell carcinoma of the head and neck (SCCHN) can be associated with poor outcomes. Disease understanding and awareness is limited leading to delayed diagnosis and treatment. The purpose of this study was to identify epidemiological features of patients with PNS of cutaneous SCCHN. Tumor characteristics and demographics of patients with PNS of cutaneous SCCHN managed through a single institution were collected between 1998 and 2013. One hundred twenty patients were included in this study. The majority had a history of skin cancer (85.8%). The median time from primary tumor treatment to PNS symptom onset was 16 months (range, 1-86 months). A total of 34.2% had no perineural invasion (PNI) detected in the primary, and 22.5% had no known primary tumor. Only 5.8% of the patients had nodal involvement at presentation. Patients can present with PNS from cutaneous SCCHN with no known primary tumor or with primary tumors without PNI. The majority of patients presented without regional nodal involvement. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1416-1420, 2016. © 2016 Wiley Periodicals, Inc.

Integrated primary care, the collaboration imperative inter-organizational cooperation in the integrated primary care field: a theoretical framework

PubMed Central

Valentijn, Pim P; Bruijnzeels, Marc A; de Leeuw, Rob J; Schrijvers, Guus J.P

2012-01-01

Purpose Capacity problems and political pressures have led to a rapid change in the organization of primary care from mono disciplinary small business to complex inter-organizational relationships. It is assumed that inter-organizational collaboration is the driving force to achieve integrated (primary) care. Despite the importance of collaboration and integration of services in primary care, there is no unambiguous definition for both concepts. The purpose of this study is to examine and link the conceptualisation and validation of the terms inter-organizational collaboration and integrated primary care using a theoretical framework. Theory The theoretical framework is based on the complex collaboration process of negotiation among multiple stakeholder groups in primary care. Methods A literature review of health sciences and business databases, and targeted grey literature sources. Based on the literature review we operationalized the constructs of inter-organizational collaboration and integrated primary care in a theoretical framework. The framework is being validated in an explorative study of 80 primary care projects in the Netherlands. Results and conclusions Integrated primary care is considered as a multidimensional construct based on a continuum of integration, extending from segregation to integration. The synthesis of the current theories and concepts of inter-organizational collaboration is insufficient to deal with the complexity of collaborative issues in primary care. One coherent and integrated theoretical framework was found that could make the complex collaboration process in primary care transparent. This study presented theoretical framework is a first step to understand the patterns of successful collaboration and integration in primary care services. These patterns can give insights in the organization forms needed to create a good working integrated (primary) care system that fits the local needs of a population. Preliminary data of the patterns of collaboration and integration will be presented.

Teaching Discrete Mathematics Entirely from Primary Historical Sources

ERIC Educational Resources Information Center

Barnett, Janet Heine; Bezhanishvili, Guram; Lodder, Jerry; Pengelley, David

2016-01-01

We describe teaching an introductory discrete mathematics course entirely from student projects based on primary historical sources. We present case studies of four projects that cover the content of a one-semester course, and mention various other courses that we have taught with primary source projects.

Implementing Primary Social and Emotional Aspects of Learning (SEAL) Small Group Interventions: Recommendations for Practitioners

ERIC Educational Resources Information Center

Lendrum, Ann; Humphrey, Neil; Kalambouka, Afroditi; Wigelsworth, Michael

2009-01-01

This article presents an extended vignette describing a good practice model for implementing SEAL small group work at "Mellington Primary", a fictional school. The vignette/model was developed from in-depth case studies at five primary schools in the north-west of England during a national evaluation of primary SEAL by the authors. The…

Teaching Basic Programming Concepts to Young Primary School Students Using Tablets: Results of a Pilot Project

ERIC Educational Resources Information Center

Fokides, Emmanuel

2018-01-01

The study presents the results of a project in which tablets and a ready-made application were used for teaching basic programming concepts to young primary school students (ages 7-9). A total of 135 students participated in the study, attending primary schools in Athens, Greece, divided into three groups. The first was taught conventionally. The…

The antimicrobial effectiveness of 25% propolis extract in root canal irrigation of primary teeth.

PubMed

Verma, Manjesh Kumar; Pandey, Ramesh Kumar; Khanna, Richa; Agarwal, Jyotsna

2014-01-01

The choice of irrigating solution used in root canals of primary teeth is complicated by their complex morphology and paucity of associated literature. Propolis is a natural product that has gained interest in this context due to its antibacterial effectiveness against several endodontic pathogens. The present study was undertaken to assess the potential of water-soluble 25% propolis extract against microorganisms present in root canals of primary teeth during endodontic procedures. The child patients in the age group of 4-7 years with radiographic evidence of carious pulp exposure were included in the study. Definitive selection was done after gaining access into the pulp chamber and root canals of the selected teeth. The clinical and radiographic evidence of pathosis was ruled out for inclusion in the study. The selected teeth were divided into two groups randomly. In Group A 0.9% isotonic saline and in Group B 25% extract water-soluble propolis were used as irrigating solution, respectively. The bacterial samples were collected both pre- and post-irrigation and were transferred for microbial assay. STAISTISTICAL ANALYSIS: Wilcoxon matched signed rank test was used to compare the pre-and post-irrigation bacterial counts. Mann-Whitney test was used to compare the mean change (pre-post) in bacterial colony counts of groups in the study. Antimicrobial effectiveness of 25% water-soluble extract of propolis in the root canals of primary teeth was confirmed in the present study. The reduction in the mean bacterial colony counts of all the isolated bacteria was noticed higher in Group B than Group A. The results of the present study have confirmed that the antibacterial effectiveness of water-soluble extract of propolis in the root canals of primary teeth in vivo. Considering the low toxicity concerns and antibacterial effectiveness, water-soluble extract of 25% propolis can be advocated as a root canal irrigant in endodontic treatment of primary teeth.

Clinicopathological Analysis of Glomerular Disease of Adult Onset Nephrotic Syndrome in an Indian Cohort- A Retrospective Study

PubMed Central

Suryawanshi, Mayur; Karnik, Swapnil

2017-01-01

Introduction Primary glomerular disease presenting with adult onset nephrotic syndrome are a major cause of chronic renal failure worldwide. The spectrum of renal disease presenting with nephrotic syndrome has undergone a gradual change globally over the course of time. However, there still exist regional differences in the incidence of primary glomerular diseases causing adult onset nephrotic syndrome. Aim To observe the spectrum of renal diseases presenting with adult onset nephrotic syndrome with comparative analysis of changing trends over the last five decades with regards to Western and Indian literature. Materials and Methods Subjects included patients with age of 18-80 years presenting with nephrotic syndrome. Renal biopsies with immunofluoroscence studies were performed in all patients. Baseline clinical parameters of serum urea, creatinine, albumin, globulin, cholesterol, 24 hour urine protein and urine microscopy were recorded. Descriptive statistics was used and results were expressed as frequencies, percentages, and mean±standard deviation. Results A total of 227 patients (72% males) were included for the study. Primary glomerular diseases formed 74.01% of total cases and majority of patients included males in the 4th decade. Minimal Change Disease (MCD) (15.8%) including its variants was the most common primary glomerular disease for adult onset of nephrotic syndrome followed by Mesangial proliferative Glomerulonephritis (MSGN) (13.2%). Membranous nephropathy and Type I Membranoproliferative Glomerulonephritis (MPGN) individually accounted for 12.3% of patients. Focal and Segmental Glomerulosclerosis (FSGS) accounted for only 11% of patients. Although, increased incidence of FSGS has been observed worldwide, there exist important regional differences in primary glomerular diseases in Indian population. MCD remains a major glomerular disease for adult onset nephrotic syndrome in different parts of India. Conclusion Our study over three years represents important data of regional variations of primary glomerular diseases presenting with adult onset nephrotic syndrome. PMID:28658768

An analysis of computerization in primary care practices.

PubMed

Condon, James V; Smith, Sherry P

2002-12-01

To remain profitable, primary care practices, the front-line health care providers, must provide excellent patient care and reduce expenses while providing payers with accurate data. Many primary care practices have turned to computer technology to achieve these goals. This study examined the degree of computerization of primary care providers in the Augusta, Georgia, metropolitan area as well as the level of awareness of the Health Insurance Portability and Accountability Act (HIPAA) by primary care providers and its potential effect on their future computerization plans. The study's findings are presented and discussed as well as a number of recommendations for practice managers.

Primary diffuse large B-cell lymphoma of the corpora cavernosa presented as a perineal mass

PubMed Central

Carlos, González-Satué; Ivanna, Valverde Vilamala; Gustavo, Tapia Melendo; Joan, Areal Calama; Javier, Sanchez Macias; Luis, Ibarz Servio

2012-01-01

Primary male genital lymphomas may appear rarely in testis, and exceptionally in the penis and prostate, but there is not previous evidence of a lymphoma arising from the corpora cavernosa. We report the first case in the literature of a primary diffuse cell B lymphoma of the corpora cavernosa presented with low urinary tract symptoms, perineal pain and palpable mass. Diagnosis was based on trucut biopsy, histopathological studies and computed tomographic images. PMID:22919138

Primary Trait Analysis to Assess a Learner-Centered, Upper-Level Mathematics Course

ERIC Educational Resources Information Center

Alsardary, Salar; Pontiggia, Laura; Hamid, Mohammed; Blumberg, Phyllis

2011-01-01

This study presents a primary trait analysis of a learner-centered, discrete mathematics course based on student-to-student instruction. The authors developed a scoring rubric for the primary traits: conceptual knowledge, procedural knowledge, application of understanding, and mathematical communication skills. Eleven students took an exam…

Intracranial meningioma as primary presentation for an undiagnosed collision metastatic breast cancer: Case report and literature review

PubMed Central

Farrag, Ashraf; Ansari, Jawaher; Ali, Muhammad; Sunbuli, Ghanem; Kassem, Hassan; Al Hamad, Abdul-Aziz

2018-01-01

Intracranial metastasis from breast cancer is a relatively common finding, however, the appearance of breast cancer metastasis in a meningioma is very rare. Several cases of tumor-to-tumor metastasis and collision tumors have been reported previously, with meningioma being implicated as the most common benign intracranial neoplasm to harbour the metastasis. Occasionally, the discovery of a tumor-to-meningioma metastasis may herald the diagnosis of an occult primary malignancy. Careful histopathological assessment of the resected meningioma specimen is pivotal to the management of these patients, as this will alter the treatment plan and prognosis considerably. Intracranial meningioma with collision breast cancer as primary presentation of an undiagnosed metastatic breast cancer is extremely rare. The current study presents a case of intracranial meningioma with collision breast cancer as a primary presentation, and reviews the available evidence for this unusual disease entity. PMID:29725531

Intracranial meningioma as primary presentation for an undiagnosed collision metastatic breast cancer: Case report and literature review.

PubMed

Farrag, Ashraf; Ansari, Jawaher; Ali, Muhammad; Sunbuli, Ghanem; Kassem, Hassan; Al Hamad, Abdul-Aziz

2018-05-01

Intracranial metastasis from breast cancer is a relatively common finding, however, the appearance of breast cancer metastasis in a meningioma is very rare. Several cases of tumor-to-tumor metastasis and collision tumors have been reported previously, with meningioma being implicated as the most common benign intracranial neoplasm to harbour the metastasis. Occasionally, the discovery of a tumor-to-meningioma metastasis may herald the diagnosis of an occult primary malignancy. Careful histopathological assessment of the resected meningioma specimen is pivotal to the management of these patients, as this will alter the treatment plan and prognosis considerably. Intracranial meningioma with collision breast cancer as primary presentation of an undiagnosed metastatic breast cancer is extremely rare. The current study presents a case of intracranial meningioma with collision breast cancer as a primary presentation, and reviews the available evidence for this unusual disease entity.

Long-Term Effects of Primary Schools on Educational Positions of Students 2 and 4 Years after the Start of Secondary Education

ERIC Educational Resources Information Center

Vanwynsberghe, Griet; Vanlaar, Gudrun; Van Damme, Jan; De Fraine, Bieke

2017-01-01

Although the importance of primary schools in the long term is of interest in educational effectiveness research, few studies have examined the long-term effects of schools over the past decades. In the present study, long-term effects of primary schools on the educational positions of students 2 and 4 years after starting secondary education are…

Measuring Inviting School Climate: A Case Study of a Public Primary School in an Urban Low Socioeconomic Setting in Kenya

ERIC Educational Resources Information Center

Okaya, Tom Mboya; Horne, Marj; Lamig, Madeleine; Smith, Kenneth H.

2013-01-01

The present study utilized the Inviting School Survey-Revised (ISS-R) (Smith, 2005b, 2013) based on Invitational Theory and Practice (Purkey & Novak, 2008) to examine the school climate of a public primary school in a low urban socio-economic setting in Kenya. School climate was defined as the perceptions of primary school teachers and pupils…

Severe hyponatraemia in foals: clinical findings, primary diagnosis and outcome.

PubMed

Collins, N M; Axon, J E; Carrick, J B; Russell, C M; Palmer, J E

2016-06-01

To evaluate severe hyponatraemia in foals presenting as medical emergencies to an intensive care unit (ICU) in order to determine the prevalence, clinical findings, primary diagnosis and outcome. Retrospective case study of records from Thoroughbred foals aged less than 3 months presenting to an ICU as medical emergencies in 2002-12; foals with severe hyponatraemia (serum sodium <122 mmol/L) on admission laboratory data were identified. Data retrieved included signalment, clinical findings, laboratory results, primary diagnosis, treatment and outcome. Severe hyponatraemia was identified in 69/1718 Thoroughbred foals (4%) presenting to the ICU during the study period. Of the 69 foals, 11 (15.9%) presented with neurological signs attributable to hyponatraemic encephalopathy and 7 of these foals had seizures; other neurological signs included obtundation, ataxia and apparent blindness. The three most common primary diagnoses of the 69 foals with severe hyponatraemia were renal disease (18/69, 26.1%), enterocolitis (16/69, 23.2%) and uroperitoneum (15/69, 21.7%). Treatment was directed at the primary disease and correction of the hyponatraemia. A total of 50 of the 69 foals (72.5%) with severe hyponatraemia survived to hospital discharge and 38 of them (76%) survived at least 12 months following discharge. The prevalence of severe hyponatraemia in this study population was 4%. The majority of foals with severe hyponatraemia did not demonstrate direct clinical manifestations as a result of the low serum sodium concentration. The outcome of foals with severe hyponatraemia was mostly favourable. © 2016 Australian Veterinary Association.

Urine sampling techniques in symptomatic primary-care patients: a diagnostic accuracy review.

PubMed

Holm, Anne; Aabenhus, Rune

2016-06-08

Choice of urine sampling technique in urinary tract infection may impact diagnostic accuracy and thus lead to possible over- or undertreatment. Currently no evidencebased consensus exists regarding correct sampling technique of urine from women with symptoms of urinary tract infection in primary care. The aim of this study was to determine the accuracy of urine culture from different sampling-techniques in symptomatic non-pregnant women in primary care. A systematic review was conducted by searching Medline and Embase for clinical studies conducted in primary care using a randomized or paired design to compare the result of urine culture obtained with two or more collection techniques in adult, female, non-pregnant patients with symptoms of urinary tract infection. We evaluated quality of the studies and compared accuracy based on dichotomized outcomes. We included seven studies investigating urine sampling technique in 1062 symptomatic patients in primary care. Mid-stream-clean-catch had a positive predictive value of 0.79 to 0.95 and a negative predictive value close to 1 compared to sterile techniques. Two randomized controlled trials found no difference in infection rate between mid-stream-clean-catch, mid-stream-urine and random samples. At present, no evidence suggests that sampling technique affects the accuracy of the microbiological diagnosis in non-pregnant women with symptoms of urinary tract infection in primary care. However, the evidence presented is in-direct and the difference between mid-stream-clean-catch, mid-stream-urine and random samples remains to be investigated in a paired design to verify the present findings.

Language Teacher Burnout and School Type

ERIC Educational Resources Information Center

Mukundan, Jayakaran; Zare, Pezhman; Zarifi, Abdolvahed; Manaf, Umi Kalthom Abdul; Sahamid, Husniah

2015-01-01

The present study was an attempt to explore the level of burnout among primary school teachers in Malaysia. In addition, the study tried to determine if the school type has any significant influence on teachers' burnout level. To this end, 714 primary school teachers participated in the study. They were teaching at Malay (SK), Tamil (SJKT), and…

Study of Emotional Intelligence Patterns with Teachers Working in Public Education

ERIC Educational Resources Information Center

Balázs, László

2015-01-01

The data necessary for the empirical research presented it this study were provided by 572 people, from altogether 26 schools. The schools included 18 primary schools, 7 secondary training institutions and 1 primary and secondary school. The major question of the study related to the pedagogues' emotional intelligence, more precisely if the…

Inside the Primary Classroom.

ERIC Educational Resources Information Center

Simon, Brian

1980-01-01

Presents some of the findings of the ORACLE research program (Observational Research and Classroom Learning Evaluation), a detailed observational study of teacher-student interaction, teaching styles, and management methods within a sample of primary classrooms. (Editor/SJL)

Jaundice in primary care: a cohort study of adults aged >45 years using electronic medical records.

PubMed

Taylor, Anna; Stapley, Sally; Hamilton, William

2012-08-01

Jaundice is a rare but important symptom of malignant and benign conditions. When patients present in primary care, understanding the relative likelihood of different disease processes can help GPs to investigate and refer patients appropriately. To identify and quantify the various causes of jaundice in adults presenting in primary care. Historical cohort study using electronic primary care records. UK General Practice Research Database. Participants (186 814 men and women) aged >45 years with clinical events recorded in primary care records between 1 January 2005 and 31 December 2007. Data were searched for episodes of jaundice and explanatory diagnoses identified within the subsequent 12 months. If no diagnosis was found, the patient's preceding medical record was searched for relevant chronic diseases. From the full cohort, 277 patients had at least one record of jaundice between 1 January 2005 and 31 December 2006. Ninety-two (33%) were found to have bile duct stones; 74 (27%) had an explanatory cancer [pancreatic cancer 34 (12%), cholangiocarcinoma 13 (5%) and other diagnosed primary malignancy 27 (10%)]. Liver disease attributed to excess alcohol explained 26 (9%) and other diagnoses were identified in 24 (9%). Sixty-one (22%) had no diagnosis related to jaundice recorded. Although the most common cause of jaundice is bile duct stones, cancers are present in over a quarter of patients with jaundice in this study, demonstrating the importance of urgent investigation into the underlying cause.

Clinical presentation, diagnosis, and pharmacotherapy of patients with primary brain tumors.

PubMed

Newton, H B; Turowski, R C; Stroup, T J; McCoy, L K

1999-01-01

To briefly review the clinical presentation and diagnosis of patients with primary brain tumors, followed by an in-depth survey of the pertinent pharmacotherapy. A detailed search of the neurologic, neurosurgical, and oncologic literature for basic science research, clinical studies, and review articles related to chemotherapy and pharmacotherapy of primary brain tumors. Relevant studies on tissue culture systems, animals, and humans examining the mechanisms of action, pharmacokinetics, clinical pharmacology, and treatment results of chemotherapeutic agents for primary brain tumors. In addition, studies of pharmacologic agents administered for supportive care and symptom control are reviewed. Primary brain tumors derive from cells within the intracranial cavity and generally present with headache, seizure activity, cognitive changes, and weakness. They are diagnosed most efficiently with magnetic resonance imaging. After diagnosis, the most common supportive medications include corticosteroids, gastric acid inhibitors, and anticonvulsants. Chemotherapy is adjunctive treatment for patients with malignant tumors and selected recurrent or progressive benign neoplasms. In general, the most effective chemotherapeutic drugs are alkylating agents such as the nitrosoureas, procarbazine, cisplatin, and carboplatin. Other agents used include cyclophosphamide, methotrexate, vincristine, and etoposide. Angiogenesis inhibitors and gene therapy comprise some of the novel therapeutic strategies under investigation. The efficacy of chemotherapy for primary brain tumors remains modest. Novel agents must be discovered that are more specific and attack tumor cells at the molecular level of tumorigenesis. Furthermore, strategies must be developed to counteract the pervasive problem of brain tumor chemoresistance.

Preliminary investigation of the kinetics of primary creep of a two phase gamma TiAl alloy

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

Hayes, R.W.

1993-11-01

It is the intent of this communication to present and discuss some data regarding the kinetics of primary creep of a two phase gamma TiAl alloy which had been studied previously to determine the mechanisms giving rise to the minimum strain rate. In order to study the kinetics of primary creep of the present gamma TiAl alloy an approach previously taken by Dorn et al and also recently employed by Argon and Bhattacharya was taken. Dorn et al demonstrated that at a given constant stress, the strain rate during primary creep is governed by a combined time-temperature parameter [Theta] =more » t exp([minus]Q/RT) where Q is the activation energy for self diffusion which many times also governs the process of steady-state creep. It was shown that at the same constant stress level all primary creep curves were found to collapse on one another when the primary creep strain is plotted as a function of [Theta][sup (9)].« less

Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin

PubMed Central

Jain, Avani; Srivastava, Madhur Kumar; Pawaskar, Alok Suresh; Shelley, Simon; Elangovan, Indirani; Jain, Hasmukh; Pandey, Somnath; Kalal, Shilpa; Amalachandran, Jaykanth

2015-01-01

Background: To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). Materials and Methods: A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or primary tumor was detected by any other investigation were excluded from the analysis. Totally, 163 patients with pathological diagnosis of malignancy but no apparent sites of the primary tumor were finally selected for analysis. The site of probable primary malignancy suggested by PET-CECT was confirmed by biopsy/follow-up. Results: PET-CECT suggested probable site of primary in 128/163 (78.52%) patients. In 30/35 remaining patients, primary tumor was not detected even after extensive work-up. In 5 patients, where PET-CECT was negative, primary was found on further extensive investigations or follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of the study were 95.76%, 66.67%, 88.28% and 85.71% respectively. Conclusions: F-18 FDG PET-CECT aptly serves the purpose of initial imaging modality owing to high sensitivity, negative and positive predictive value. PET-CECT not only surveys the whole body for the primary malignancy but also stages the disease accurately. Use of contrast improves the diagnostic utility of modality as well as help in staging of the primary tumor. Although benefits of using PET-CECT as initial diagnostic modality are obvious from this study, there is a need for a larger study comparing conventional methods for diagnosing primary in patients with MUO versus PET-CECT. PMID:26170563

Three-meter telescope study

NASA Technical Reports Server (NTRS)

Wissinger, A.; Scott, R. M.; Peters, W.; Augustyn, W., Jr.; Arnold, R.; Offner, A.; Damast, M.; Boyce, B.; Kinnaird, R.; Mangus, J. D.

1971-01-01

A means is presented whereby the effect of various changes in the most important parameters of a three meter aperature space astronomy telescope can be evaluated to determine design trends and to optimize the optical design configuration. Methods are defined for evaluating the theoretical optical performance of axisymmetric, centrally obscured telescopes based upon the intended astronomy research usage. A series of design parameter variations is presented to determine the optimum telescope configuration. The design optimum requires very fast primary mirrors, so the study also examines the current state of the art in fabricating large, fast primary mirrors. The conclusion is that a 3-meter primary mirror having a focal ratio as low as f/2 is feasible using currently established techniques.

Teaching Interactive Practices and Burnout: A Study on Italian Teachers

ERIC Educational Resources Information Center

Mameli, Consuelo; Molinari, Luisa

2017-01-01

The purpose of the present study was to analyse the role played by teaching interactive practices (measured through a self-report Likert scale) in predicting teacher burnout, after controlling for school grade (primary vs. secondary school) and teaching experience. Participants were 282 Italian teachers equally distributed between primary and…

Elementary School Teachers' Use of Technology during Mathematics Teaching

ERIC Educational Resources Information Center

Polly, Drew

2014-01-01

Various educational technologies have been advanced as potential vehicles to transform teaching and learning. Still, research studies have documented that primary school teachers struggle to integrate technology in meaningful ways. This article presents the findings of a year-long study in which the author frequently observed three primary school…

The Cost-Effectiveness of Interactive Radio Instruction for Improving Primary School Instruction in Honduras, Bolivia and Lesotho.

ERIC Educational Resources Information Center

Tilson, Thomas D.; And Others

Findings are presented from studies on the use of radio for teaching primary school children mathematics in Honduras and Bolivia and English as a Second Language in Lesotho. Interactive radio instruction (IRI) is so called because of the active participation of the students. Although lessons are presented by conventional radio, scripts are written…

Sudden suffocation with cancer of unknown primary: a case report and review of diagnostic approach.

PubMed

Tehrani, Omid S; Ahmad, Omar; Vypritskaya, Ekaterina; Chen, Emily; Hasan, Saba

2012-10-01

A case of a 31-year-old woman with sudden respiratory distress is presented. Preliminary evaluations and imaging studies did not reveal the underlying cause. Workup during hospital stay showed advanced metastatic cancer of unknown primary origin. This is an unusual presentation of cancer of an unknown primary involving the thyroid with sudden suffocation. It suggests that malignancies involving the thyroid gland should be considered in patients with abrupt onset of respiratory distress. Also, this case shows the application of fine needle aspiration in diffuse thyroid enlargements mimicking thyroiditis without nodules. Diagnostic approach to cancer of unknown primary origin (CUP) is reviewed in further detail.

Primary pulmonary NK/T-cell lymphoma: A case report and literature review.

PubMed

Qiu, Yajuan; Hou, Junna; Hao, Dexun; Zhang, Dandan

2018-06-01

Extranodal natural killer (NK)/T-cell lymphoma (ENKTL) is an aggressive disease with poor prognosis. The lung is a relatively rare site of involvement. The current study presents a case of primary pulmonary ENKTL with fever and dyspnea, mimicking pneumonia and initially treated with empirical antibiotics. The patient demonstrated rapid deterioration and died shortly following diagnosis. To the best of our knowledge, large-scale investigations referring to primary pulmonary ENKTL are not available. As a result, the exact incidence and clinical features of primary pulmonary ENKTL are unknown. In the current report, a literature review is presented to discuss the clinical characteristics, diagnosis, treatment, and prognosis factors of this malignant disease.

Primary renal angiosarcoma with progressive clinical course despite surgical and adjuvant treatment: A case report

PubMed Central

CELEBI, FILIZ; PILANCI, KEZBAN NUR; SAGLAM, SEZER; BALCI, NUMAN CEM

2015-01-01

Angiosarcoma is an extremely rare, high-grade malignancy, which accounts for <2% of all soft-tissue sarcomas. Cases of primary renal angiosarcoma represent 1% of these. Angiosarcomas involving the kidney usually originate from metastatic skin lesions or primary visceral lesions and most often occur in the sixth and seventh decades of life. The present study describes a case of primary renal angiosarcoma that presented as a large right-sided renal mass with symptoms of flank pain. Despite surgical removal of the tumor, recurrent disease with associated lung metastases was identified at the surgical site following adjuvant chemotherapy. The patient succumbed to the disease 13 months after the diagnosis. PMID:25789072

Comparative study of the primary cilia in thyrocytes of adult mammals

PubMed Central

Utrilla, J C; Gordillo-Martínez, F; Gómez-Pascual, A; Fernández-Santos, J M; Garnacho, C; Vázquez-Román, V; Morillo-Bernal, J; García-Marín, R; Jiménez-García, A; Martín-Lacave, I

2015-01-01

Since their discovery in different human tissues by Zimmermann in 1898, primary cilia have been found in the vast majority of cell types in vertebrates. Primary cilia are considered to be cellular antennae that occupy an ideal cellular location for the interpretation of information both from the environment and from other cells. To date, in mammalian thyroid gland, primary cilia have been found in the thyrocytes of humans and dogs (fetuses and adults) and in rat embryos. The present study investigated whether the existence of this organelle in follicular cells is a general event in the postnatal thyroid gland of different mammals, using both immunolabeling by immunofluorescence and electron microscopy. Furthermore, we aimed to analyse the presence of primary cilia in various thyroid cell lines. According to our results, primary cilia are present in the adult thyroid gland of most mammal species we studied (human, pig, guinea pig and rabbit), usually as a single copy per follicular cell. Strikingly, they were not found in rat or mouse thyroid tissues. Similarly, cilia were also observed in all human thyroid cell lines tested, both normal and neoplastic follicular cells, but not in cultured thyrocytes of rat origin. We hypothesize that primary cilia could be involved in the regulation of normal thyroid function through specific signaling pathways. Nevertheless, further studies are needed to shed light on the permanence of these organelles in the thyroid gland of most species during postnatal life. PMID:26228270

Prevalence of early loss of primary teeth in 5-10-year-old school children in Chidambaram town.

PubMed

Ahamed, S Syed Shaheed; Reddy, Venugopal N; Krishnakumar, R; Mohan, Muthu G; Sugumaran, Durai K; Rao, Arun P

2012-01-01

The premature loss of primary teeth may reduce arch length required for the succeeding tooth and, hence, predisposes crowding, rotation and impaction of the permanent teeth. There are only limited studies carried out about the prevalence of early loss of primary teeth. The present study was performed to evaluate the prevalence of early loss of primary teeth in school children in Chidambaram town in Tamilnadu, India. A total of 1121 school children (561 boys and 560 girls) between 5 and 10 years of age were selected for the study. An experienced examiner performed all clinical examinations under natural light. Data including age and missing tooth was collected. Microsoft Excel/2000 (Microsoft Office XP) data spreadsheet was used and later exported to the Statistical Package for Social Science (SPSS) for Windows (version 10.0). Descriptive statistics was applied and, from the results, chi-square tests were applied at a level of significance of 5% (P < 0.05). The results showed that 16.5% of the sample had early loss of primary teeth, but no differences were observed between genders (P > 0.05). The greatest prevalence was found among the 8-year olds (5.08%), and the most commonly missing teeth were the right lower primary first molars (16.82%). It can be concluded that the prevalence of early loss was high and that the lower primary molars were the most commonly missing teeth in the present study.

Psychiatric treatment received by primary care patients with panic disorder with and without agoraphobia

PubMed Central

Marcks, Brook A.; Weisberg, Risa B.; Keller, Martin B.

2013-01-01

Objective Although the majority of individuals with panic disorder first present to the primary care setting, little is known about the psychiatric treatment primary care patients with the disorder typically receive. The purpose of the current study was to explore characteristics of treatment received by those with panic disorder with and without agoraphobia, examine demographic and clinical predictors of receiving treatment, and explore treatment barriers. Methods This study uses data from the Primary Care Anxiety Project (PCAP), which is a naturalistic, longitudinal study of anxiety disorders in primary care patients. This study presents data on 235 PCAP participants diagnosed with panic disorder with (N=150) or without agoraphobia (N=85) at the study intake assessment. Results Many patients with panic disorder were not receiving psychiatric treatment at study intake, with those without agoraphobia being less likely to receive treatment. Psychotropic medications were the treatment of choice, with SSRIs/SNRIs being the most commonly received class of medications. Only 39% of those with panic disorder with agoraphobia and 24% of those without agoraphobia were receiving psychotherapy, and use of empirically supported interventions was rare. The most common treatment barriers were: not believing in utilizing medication/therapy for emotional problems and not receiving a treatment recommendation from one’s provider. Conclusions The findings suggest a need for better treatment dissemination, in addition to making interventions more accessible and/or adapting them to the particular needs of primary care patients. PMID:19487354

The Prevalence and Treatment Outcomes of Primary Tooth Injuries

PubMed Central

Arikan, Volkan; Sari, Saziye; Sonmez, Hayriye

2010-01-01

Objectives: The aim of the present study was to evaluate the type and prevalence of primary tooth injuries, as well as their treatment and treatment outcomes, among children referred to the Department of Pedodontics at the Ankara University Faculty of Dentistry in Turkey. Methods: The study population consisted of patients applying to the department with a primary tooth injury over a period of 21 months. Fifty-one patients presented with trauma to 99 primary teeth. Clinical and radiographic examinations were conducted on each patient. Age, sex, time, cause of injury, and number of teeth affected were recorded, and the type of trauma was identified according to Andreasen’s classification. The teeth were treated by one of the authors. Results: The majority of trauma occurred between the ages of 2 and 4. The most common type of injury was lateral luxation (33.3%). Most injuries (33.3%) presented during May. The most common form of treatment was follow-up only (39.4%), followed by extraction (29.3%) and root canal treatment (12.1%). The average follow-up period was 11 months. During the follow-up period, complications were observed in 4 teeth. Conclusions: The study results show that in the absence of acute symptoms, parents tend not to apply to a dental clinic for children’s injuries. This finding highlights the importance of informing the public about primary tooth injuries and their consequences. PMID:20922165

Primary School EFL Teachers' Attitudes towards Creativity and Their Perceptions of Practice

ERIC Educational Resources Information Center

Al-Nouh, Nowreyah A.; Abdul-Kareem, Muneera M.; Taqi, Hanan A.

2014-01-01

Teachers perform an important job by encouraging creativity in their lessons and among their pupils. Thus, the present study aims to examine primary school EFL teachers' attitudes towards creative thinking and their perceptions of what goes on in the classroom. Participants were 434 female primary school EFL teachers, chosen randomly, teaching all…

Primary School Puberty/Sexuality Education: Student-Teachers' Past Learning, Present Professional Education, and Intention to Teach These Subjects

ERIC Educational Resources Information Center

Goldman, Juliette D. G.; Coleman, Stephanie J.

2013-01-01

Primary school teachers are often tasked with puberty/sexuality education for students who are undergoing sexual maturation at ever-earlier ages. This study explores the changing trajectories of the pre-service learning and teaching of primary school puberty/sexuality education at an urban university, including student-teachers' childhood…

The Perceived Credibility of Scientific Claims, Paranormal Phenomena, and Miracles among Primary Teacher Students: A Comparative Study.

ERIC Educational Resources Information Center

Keranto, Tapio

2001-01-01

Presents data collected concerning scientific, religious, and magic-occult connections from Finnish, Estonian, and Michigan primary teacher students to answer questions such as Do we find any differences between the credibility estimates?, Are there any differences between primary teacher students raised in different societies and educated in…

Enhancing Children's Success in Science Learning: An Experience of Science Teaching in Teacher Primary School Training

ERIC Educational Resources Information Center

Ferreira, Maria Eduarda; Porteiro, Ana Cláudia; Pitarma, Rui

2015-01-01

The Environmental Studies curricular area, taught at primary school level in Portugal, is a challenging context for curricular interdisciplinarity and the achievement of small-scale research and creative and innovative experiences, inside and outside the classroom. From that assumption, we present, under the master course of primary teacher…

Primary School Students' Ideas Concerning the Apparent Movement of the Moon

ERIC Educational Resources Information Center

Starakis, John; Halkia, Krystallia

2010-01-01

In the present study, primary school students' ideas concerning the apparent movement of the Moon are investigated. The research was carried out in five primary schools of Athens (Greece) with a sample of forty (40), fifth and sixth grade students. Semistructured interviews were used to gather scientific data and students had the opportunity to…

Primary Progressive Aphasia in a Bilingual Speaker: A Single-Case Study

ERIC Educational Resources Information Center

Zanini, Sergio; Angeli, Valentina; Tavano, Alessandro

2011-01-01

We report on the case of an elderly bilingual woman presenting with a diagnosis of primary progressive aphasia. The participant's native language was Friulian (L1), a predominantly oral Romance language, and her second language was Italian (L2), formally learned at primary school in oral and written forms. We investigated her linguistic abilities…

The Intercultural and Non-Formal Learning Processes of Children in Primary School Exchange Programmes in France and Germany

ERIC Educational Resources Information Center

Melin, Valérie; Wagner, Bernd

2015-01-01

This paper is based on educational anthropology, and presents the initial findings of a three-year international comparative study of primary school children's learning-processes during travel and cross-cultural encounters. A French-German research team investigated and here reports on primary school exchange programmes. Open coding of the…

Turkish EFL Teachers' Perceptions and Practices of Foreign Language Assessment in Primary Education

ERIC Educational Resources Information Center

Kirkgoz, Yasemin; Babanoglu, Muzaffer Pinar; Agçam, Reyhan

2017-01-01

The present study aimed to investigate perceptions of EFL teachers working at state primary schools on core language skills, assessment types and question types used in assessing student's foreign language development and proficiency during an academic year. Data were gathered from 56 EFL teachers working at 42 primary state schools in Turkey…

Mathematics Learning Difficulties in Primary Education: Teachers' Professional Knowledge and the Use of Commercially Available Learning Packages

ERIC Educational Resources Information Center

Van Steenbrugge, H.; Valcke, M.; Desoete, A.

2010-01-01

The present study builds on teachers' professional knowledge about mathematics learning difficulties. Based on the input of 918 primary school teachers, an attempt is made to develop an overview of difficult curriculum topics in primary school mathematics. The research approach builds on new conceptions about the professional identity of teachers…

Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders.

PubMed

Auld, Fiona; Maschauer, Emily L; Morrison, Ian; Skene, Debra J; Riha, Renata L

2017-08-01

Melatonin is a physiological hormone involved in sleep timing and is currently used exogenously in the treatment of primary and secondary sleep disorders with empirical evidence of efficacy, but very little evidence from randomised, controlled studies. The aim of this meta-analysis was to assess the evidence base for the therapeutic effects of exogenous melatonin in treating primary sleep disorders. An electronic literature review search of MEDLINE (1950-present) Embase (1980- present), PsycINFO (1987- present), and Scopus (1990- present), along with a hand-searching of key journals was performed in July 2013 and then again in May 2015. This identified all studies that compared the effect of exogenous melatonin and placebo in patients with primary insomnia, delayed sleep phase syndrome, non 24-h sleep wake syndrome in people who are blind, and rapid eye movement-behaviour disorder. Meta-analyses were performed to determine the magnitude of effect in studies of melatonin in improving sleep. A total of 5030 studies were identified; of these citations, 12 were included for review based on the inclusion criteria of being: double or single-blind, randomised and controlled. Results from the meta-analyses showed the most convincing evidence for exogenous melatonin use was in reducing sleep onset latency in primary insomnia (p = 0.002), delayed sleep phase syndrome (p < 0.0001), and regulating the sleep-wake patterns in blind patients compared with placebo. These findings highlight the potential importance of melatonin in treating certain first degree sleep disorders. The development of large-scale, randomised, controlled trials is recommended to provide further evidence for therapeutic use of melatonin in a variety of sleep difficulties. Copyright © 2016 Elsevier Ltd. All rights reserved.

Large-scale phylogenomic analyses indicate a deep origin of primary plastids within cyanobacteria.

PubMed

Criscuolo, Alexis; Gribaldo, Simonetta

2011-11-01

The emergence of photosynthetic eukaryotes has played a crucial role in evolution and has strongly modified earth's ecology. Several phylogenetic analyses have established that primary plastids arose from a cyanobacterium through endosymbiosis. However, the question of which present-day cyanobacterial lineage is most closely related to primary plastids has been unclear. Here, we have performed an extensive phylogenomic investigation on the origin of primary plastids based on the analysis of up to 191 protein markers and over 30,000 aligned amino acid sites from 22 primary photosynthetic eukaryotes and 61 cyanobacteria representing a wide taxonomic sampling of this phylum. By using a number of solutions to circumvent a large range of systematic errors, we have reconstructed a robust global phylogeny of cyanobacteria and studied the placement of primary plastids within it. Our results strongly support an early emergence of primary plastids within cyanobacteria, prior to the diversification of most present-day cyanobacterial lineages for which genomic data are available.

Using ClinicalTrials.gov to supplement information in ophthalmology conference abstracts about trial outcomes: a comparison study.

PubMed

Scherer, Roberta W; Huynh, Lynn; Ervin, Ann-Margret; Dickersin, Kay

2015-01-01

Including results from unpublished randomized controlled trials (RCTs) in a systematic review may ameliorate the effect of publication bias in systematic review results. Unpublished RCTs are sometimes described in abstracts presented at conferences, included in trials registers, or both. Trial results may not be available in a trials register and abstracts describing RCT results often lack study design information. Complementary information from a trials register record may be sufficient to allow reliable inclusion of an unpublished RCT only available as an abstract in a systematic review. We identified 496 abstracts describing RCTs presented at the 2007 to 2009 Association for Research in Vision and Ophthalmology (ARVO) meetings; 154 RCTs were registered in ClinicalTrials.gov. Two persons extracted verbatim primary and non-primary outcomes reported in the abstract and ClinicalTrials.gov record. We compared each abstract outcome with all ClinicalTrials.gov outcomes and coded matches as complete, partial, or no match. We identified 800 outcomes in 152 abstracts (95 primary [51 abstracts] and 705 [141 abstracts] non-primary outcomes). No outcomes were reported in 2 abstracts. Of 95 primary outcomes, 17 (18%) agreed completely, 53 (56%) partially, and 25 (26%) had no match with a ClinicalTrials.gov primary or non-primary outcome. Among 705 non-primary outcomes, 56 (8%) agreed completely, 205 (29%) agreed partially, and 444 (63%) had no match with a ClinicalTrials.gov primary or non-primary outcome. Among the 258 outcomes partially agreeing, we found additional information on the time when the outcome was measured more often in ClinicalTrials.gov than in the abstract (141/258 (55%) versus 55/258 (21%)). We found no association between the presence of non-matching "new" outcomes and year of registration, time to registry update, industry sponsorship, or multi-center status. Conference abstracts may be a valuable source of information about results for outcomes of unpublished RCTs that have been registered in ClinicalTrials.gov. Complementary additional descriptive information may be present for outcomes reported in both sources. However, ARVO abstract authors also present outcomes not reported in ClinicalTrials.gov and these may represent analyses not originally planned.

Sulforaphane suppressed LPS-induced inflammation in mouse peritoneal macrophages through Nrf2 dependent pathway.

PubMed

Lin, Wen; Wu, Rachel T; Wu, Tienyuan; Khor, Tin-Oo; Wang, Hu; Kong, Ah-Ng

2008-10-15

Sulforaphane (SFN) is a natural isothiocyanate that is present in cruciferous vegetables such as broccoli and cabbage. Previous studies have shown that SFN is effective in preventing carcinogenesis induced by carcinogens in rodents, which is related in part to its potent anti-inflammation properties. In the present study, we compared the anti-inflammatory effect of SFN on LPS-stimulated inflammation in primary peritoneal macrophages derived from Nrf2 (+/+) and Nrf2 (-/-) mice. Pretreatment of SFN in Nrf2 (+/+) primary peritoneal macrophages potently inhibited LPS-stimulated mRNA expression, protein expression and production of TNF-alpha, IL-1beta, COX-2 and iNOS. HO-1 expression was significantly augmented in LPS-stimulated Nrf2 (+/+) primary peritoneal macrophages by SFN. Interestingly, the anti-inflammatory effect was attenuated in Nrf2 (-/-) primary peritoneal macrophages. We concluded that SFN exerts its anti-inflammatory activity mainly via activation of Nrf2 in mouse peritoneal macrophages.

Lung cancer in symptomatic patients presenting in primary care: a systematic review of risk prediction tools

PubMed Central

Schmidt-Hansen, Mia; Berendse, Sabine; Hamilton, Willie; Baldwin, David R

2017-01-01

Background Lung cancer is the leading cause of cancer deaths. Around 70% of patients first presenting to specialist care have advanced disease, at which point current treatments have little effect on survival. The issue for primary care is how to recognise patients earlier and investigate appropriately. This requires an assessment of the risk of lung cancer. Aim The aim of this study was to systematically review the existing risk prediction tools for patients presenting in primary care with symptoms that may indicate lung cancer Design and setting Systematic review of primary care data. Method Medline, PreMedline, Embase, the Cochrane Library, Web of Science, and ISI Proceedings (1980 to March 2016) were searched. The final list of included studies was agreed between two of the authors, who also appraised and summarised them. Results Seven studies with between 1482 and 2 406 127 patients were included. The tools were all based on UK primary care data, but differed in complexity of development, number/type of variables examined/included, and outcome time frame. There were four multivariable tools with internal validation area under the curves between 0.88 and 0.92. The tools all had a number of limitations, and none have been externally validated, or had their clinical and cost impact examined. Conclusion There is insufficient evidence for the recommendation of any one of the available risk prediction tools. However, some multivariable tools showed promising discrimination. What is needed to guide clinical practice is both external validation of the existing tools and a comparative study, so that the best tools can be incorporated into clinical decision tools used in primary care. PMID:28483820

Approach to economic evaluation in primary care: review of a useful tool for primary care reform.

PubMed

McBrien, Kerry A; Manns, Braden

2013-06-01

To present an overview of the methods of economic evaluation in health care, using examples of studies applicable to primary care. The main concepts discussed in this article were derived from expert opinion and substantiated with well respected textbooks and comprehensive Canadian guidelines. Examples of cost-effectiveness estimates were taken from the published literature. We describe the basic principles of economic evaluation and provide an introduction to its interpretation, using examples of studies applicable to primary care. A basic understanding of health economics will allow primary care practitioners to begin to incorporate economic data, including that from economic evaluations when they are available, into resource planning for their practices.

Primary sternum diffuse large B-cell lymphoma: A case report and review of the literature

PubMed Central

TONG, MENG-YING; ZHANG, XIAN; YU, ZHE; SUN, XIU-HUA; LI, SHUANG; ZHANG, YANG

2015-01-01

Primary bone lymphoma (PBL) is a rare disease, accounting for >1% of all cases of malignant lymphoma. Diffuse large B-cell lymphoma (DLBCL) is the most common histological type of PBL. The present study reported the case of a 68-year-old male with primary bone DLBCL, originally occurred in the sternum, which is a rare form of presentation. Computed tomography (CT), magnetic resonance imaging and bone emission CT were performed, followed by immunohistochemical analysis of a biopsy specimen, and the results were used to establish the diagnosis. At the time of diagnosis, no osseous involvement was observed. The clinical, radiological and histological features of PBL can mimic other medical conditions, thereby making the diagnosis difficult, and frequently leading to delays in treatment. The present study investigated the clinical features, management and prognosis of PBL, and reviewed previous relevant cases. PMID:26137117

Childhood Emotional Abuse and Neglect as Predictors of Psychological and Physical Symptoms in Women Presenting to a Primary Care Practice

ERIC Educational Resources Information Center

Spertus, Ilyse L.; Yehuda, Rachel; Wong, Cheryl M.; Halligan, Sarah; Seremetis, Stephanie V.

2003-01-01

Objective: There were two aims to this study: first to examine whether emotional abuse and neglect are significant predictors of psychological and somatic symptoms, and lifetime trauma exposure in women presenting to a primary care practice, and second to examine the strength of these relationships after controlling for the effects of other types…

Emotional Symptoms in Inattentive Primary School Children: A Population-Based Study

ERIC Educational Resources Information Center

Sorensen, Lin; Hugdahl, Kenneth; Lundervold, Astri Johansen

2008-01-01

Objective: The present study investigates teacher and parent reports of inattention and emotional symptoms in 6,229 primary school children. Method: The assessment included the Emotional Symptoms subscale and the Impact scale from the Strengths and Difficulties Questionnaire and the inattention items from the Swanson, Nolan, and Pelham IV…

Pedagogy, Performance and Politics: Issues in the Study of Primary Education.

ERIC Educational Resources Information Center

Campbell, R. J.; Kyriakides, L.

2000-01-01

Presents an essay review of Inside the Primary Classroom, 20 Years On, which reports on a 1976 study of teacher-student interaction in English elementary classrooms (the ORACLE project) and discusses the next 20 years of elementary education in England, examining curriculum reform, educational policy, educational research, and related politics.…

Teachers' Burnout, Depression, Role Ambiguity and Conflict

ERIC Educational Resources Information Center

Papastylianou, Antonia; Kaila, Maria; Polychronopoulos, Michael

2009-01-01

The present study investigates issues associated with teachers' burnout in primary education as related to depression and role conflict-ambiguity. At the time of the study the participants (562 teachers) were working in seventy nine (79) Primary Education State Schools in Greece (Athens and two prefectures in the southern part of the country). The…

Constraints on primary and secondary particulate carbon sources using chemical tracer and 14C methods during CalNex-Bakersfield

EPA Science Inventory

The present study investigates primary and secondary sources of organic carbon for Bakersfield, CA, USA as part of the 2010 CalNex study. The method used here involves integrated sampling that is designed to allow for detailed and specific chemical analysis of particulate matter ...

Assessing CLIL at Primary School: A Longitudinal Study

ERIC Educational Resources Information Center

Serra, Cecilia

2007-01-01

This paper presents aspects of a longitudinal study assessing integrative bilingual learning based on Content and Language Integrated Learning (CLIL), implemented in three Swiss primary schools. From Grades 1 to 6, three classes of German-speaking pupils were taught 50% of the curriculum, notably mathematics, in Italian or in Romansh as a second…

Writing Instruction in Jordan: Past, Present, and Future Trends

ERIC Educational Resources Information Center

Al-Jarrah, Rasheed S.; Al-Ahmad, Sayyah

2013-01-01

This study investigated English-language writing instruction in Jordan at three levels, namely primary and secondary state schools, a private school, and a state university. To address this issue, the researchers used tape-recorded interviews and class observations as primary tools of collecting data for the study. It turned out that a host of…

Cultural Variability in Parent and Child Achievement Attributions: A Study from Hong Kong

ERIC Educational Resources Information Center

Phillipson, Sivanes

2006-01-01

The primary aim of the present study was to investigate whether variations exist in child and parent attributions in predicting child academic achievement within a culture and between cultures. Participants were 158 students and their parents from three different primary schools in Hong Kong, including one British international school consisting…

A Man with Pancreatic Head Mass Lesion on Endoscopic Ultrasound and Granuloma on Cytopathology.

PubMed

Rad, Neda; Heidarnezhad, Arash; Soheili, Setareh; Mohammad-Alizadeh, Amir Houshang; Nikmanesh, Arash

2016-01-01

Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma. Computed tomography-guided core needle biopsy was performed and eventually histological examination showed granuloma that was coherent with the diagnosis of primary pancreatic lymphoma. Primary pancreatic lymphoma is a rare entity presenting with nonspecific symptoms, laboratory and radiological findings. Computed tomography results in combination with clinical and radiological studies generally provide guidance for appropriate investigation.

A Man with Pancreatic Head Mass Lesion on Endoscopic Ultrasound and Granuloma on Cytopathology

PubMed Central

Rad, Neda; Heidarnezhad, Arash; Soheili, Setareh; Mohammad-Alizadeh, Amir Houshang; Nikmanesh, Arash

2016-01-01

Primary pancreatic lymphoma is an unlikely malignancy accounting for less than 0.5% of pancreatic tumors. Clinical presentation is often nonspecific and may be clinically misdiagnosed as pancreatic adenocarcinoma. Here we present an Iranian case of primary pancreatic lymphoma in a 47-year-old male suffering from jaundice and 20% weight loss. Endoscopic ultrasound revealed a mixed echoic mass lesion at the head of pancreas. The patient underwent endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass and histopathologic diagnosis revealed granuloma. Computed tomography-guided core needle biopsy was performed and eventually histological examination showed granuloma that was coherent with the diagnosis of primary pancreatic lymphoma. Primary pancreatic lymphoma is a rare entity presenting with nonspecific symptoms, laboratory and radiological findings. Computed tomography results in combination with clinical and radiological studies generally provide guidance for appropriate investigation. PMID:28100998

Comparing Primary and Secondary Mathematics Teachers' Preferences Regarding Values about Mathematics Teaching in Turkey and Germany

ERIC Educational Resources Information Center

Dede, Yüksel

2015-01-01

This study presents a small part of a larger study investigating Turkish and German mathematics teachers' and their students' values (Values in Mathematics Teaching in Turkey and Germany). The main focus of the study was school levels of the teachers working at primary and secondary schools. The interactions related to nationality were also of…

The Integration of Biodiversity Education in the Initial Education of Primary School Teachers: Four Comparative Case Studies from Europe

ERIC Educational Resources Information Center

Lindemann-Matthies, Petra; Constantinou, Constantinos; Junge, Xenia; Kohler, Karlheinz; Mayer, Jurgen; Nagel, Ueli; Raper, George; Schule, Diane; Kadji-Beltran, Chrysanthi

2009-01-01

In this article, we present results from an international research study on biodiversity education in pre-service education of primary school teachers. The study was carried out between 2004-2006 in four teacher education institutions in Cyprus, England, Switzerland and Germany. We used document analyses and in-depth interviews with 27 teacher…

The Mediating Role of Principals' Transformational Leadership Behaviors in Promoting Teachers' Emotional Wellness at Work: A Study in Israeli Primary Schools

ERIC Educational Resources Information Center

Berkovich, Izhak; Eyal, Ori

2017-01-01

The present study aims to examine whether principals' emotional intelligence (specifically, their ability to recognize emotions in others) makes them more effective transformational leaders, measured by the reframing of teachers' emotions. The study uses multisource data from principals and their teachers in 69 randomly sampled primary schools.…

Morbidity pattern of traditional Chinese medicine primary care in the Hong Kong population.

PubMed

Wong, Wendy; Lam, Cindy Lo Kuen; Bian, Xiang Zhao; Zhang, Zhang Jin; Ng, Sze Tuen; Tung, Shong

2017-08-08

Primary care manages >90% of illnesses requiring medical services in Hong Kong, in which 9,513 registered Chinese medicine practitioners (CMPs) provide 8.2% of the consultations. This is the first study aimed to determine the morbidity pattern in different Traditional Chinese Medicine (TCM) primary care settings in Chinese population. 55,312 patients' encounters were classified by the International Classification of Primary Care-2 (ICPC-2) from 260 of CMPs. Mean patient age was 50.5 years, with more females than males (67.0% vs 33.0%). Most patients consulted CMPs for chronic (64% vs 33.7%) rather than acute conditions. Among the 30% of patients, hypertension (49.5%) or diabetes (18.5%) were the most common co-morbidity. The most common problems presenting to CMP were respiratory (24.9%), musculoskeletal complaints (22.7%), cough (11.7%), and lower back pain (6.6%). To our knowledge, this was the first study permitting direct comparison with that presenting to Western medicine (WM) primary care by ICPC-2 systems. The results confirmed the role of CMP in primary care for musculoskeletal or chronic illnesses that they may have also received conventional WM treatment. We recommend greater effort and more resources should be invested to promote interdisciplinary communication to ensure safety and synergy of TCM and WM in primary care.

Primary Pre-Service Teachers' Skills in Planning a Guided Scientific Inquiry

ERIC Educational Resources Information Center

García-Carmona, Antonio; Criado, Ana M.; Cruz-Guzmán, Marta

2017-01-01

A study is presented of the skills that primary pre-service teachers (PPTs) have in completing the planning of a scientific inquiry on the basis of a guiding script. The sample comprised 66 PPTs who constituted a group-class of the subject "Science Teaching," taught in the second year of an undergraduate degree in primary education at a…

Primary School Teachers' Practices and Troubles with the Students Who They Think Have Undiagnosed Difficulties in Verbal Communication, Reading and Writing

ERIC Educational Resources Information Center

Ergen, Yusuf; Elma, Cevat

2018-01-01

The primary school Turkish program was basically built on three learning domains. These are the learning domains of verbal communication, reading and writing. The purpose of the present study is to determine primary school teachers' practices and difficulties related to students considered to have undiognosed verbal communication, reading and…

Breast abscess as the initial manifestation of primary pure squamous cell carcinoma: a rare presentation and literature review.

PubMed

Salemis, Nikolaos S

2011-01-01

Primary squamous cell carcinoma of the breast is a very rare tumor accounting for less than 0.4% of all breast cancers. Fewer than 100 cases have been reported in the literature so far. The diagnosis requires strict pathologic criteria to be fulfilled. Due to the rarity of this tumor the optimal treatment and prognosis are both unclear. Breast abscess as the initial presentation of a primary squamous cell breast carcinoma is an extremely rare clinical entity. In this study, we describe a case of a 61-year-old postmenopausal woman who presented with typical manifestations of a breast abscess and was diagnosed with a pure primary squamous cell breast carcinoma. Diagnostic evaluation and management of the patient are discussed along with a review of the literature. Despite its rarity, the possibility of a primary pure squamous cell breast carcinoma should always be considered in the differential diagnosis in postmenopausal patients presenting with manifestations of a breast abscess, especially in those who respond poorly to the initial treatment. Physicians should be aware of this rare malignancy in order to avoid delays in diagnosis and treatment.

Prevalence of urinary tract infection (UTI) in sequential acutely unwell children presenting in primary care: exploratory study.

PubMed

O'Brien, Kathryn; Stanton, Naomi; Edwards, Adrian; Hood, Kerenza; Butler, Christopher C

2011-03-01

Due to the non-specific nature of symptoms of UTI in children and low levels of urine sampling, the prevalence of UTI amongst acutely ill children in primary care is unknown. To undertake an exploratory study of acutely ill children consulting in primary care, determine the feasibility of obtaining urine samples, and describe presenting symptoms and signs, and the proportion with UTI. Exploratory, observational study. Four general practices in South Wales. A total of 99 sequential attendees with acute illness aged less than five years. UTI defined by >10(5) organisms/ml on laboratory culture of urine. Urine samples were obtained in 75 (76%) children. Three (4%) met microbiological criteria for UTI. GPs indicated they would not normally have obtained urine samples in any of these three children. However, all had received antibiotics for suspected alternative infections. Urine sample collection is feasible from the majority of acutely ill children in primary care, including infants. Some cases of UTI may be missed if children thought to have an alternative site of infection are excluded from urine sampling. A larger study is needed to more accurately determine the prevalence of UTI in children consulting with acute illness in primary care, and to explore which symptoms and signs might help clinicians effectively target urine sampling.

Multiple Primary Merkel Cell Carcinomas Presenting as Pruritic, Painful Lower Leg Tumors

PubMed Central

Blumenthal, Laura; VandenBoom, Timothy; Melian, Edward; Peterson, Anthony; Hutchens, Kelli A.

2015-01-01

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine tumor of the skin which almost exclusively presents as a solitary tumor. It is most often seen on sun-exposed regions, historically almost exclusively on the head and neck, with only rare case reports on the extremities. Although recent studies have shown increased incidence with up to 20% on the extremities, here we present one of these rare emerging presentations, with the addition of a unique treatment option. Our patient is an 80-year-old male with a 3-month history of multiple raised, rapidly enlarging tumors on the right ankle. Two separate biopsies were performed and demonstrated sheets and clusters of small blue cells filling the dermis with scant cytoplasm, dusty chromatin, and nuclear molding. Subsequent immunohistochemical stains confirmed the diagnosis of multiple primary MCC. Despite the characteristic immunohistochemical profile of primary MCC, the possibility of a metastatic neuroendocrine carcinoma from an alternate primary site was entertained, given his unusual clinical presentation. A complete clinical workup including CT scans of the chest, abdomen, and pelvis showed no evidence of disease elsewhere. Instead of amputation, the patient opted for nonsurgical treatment with radiation therapy alone, resulting in a rapid and complete response. This case represents an unusual presentation of primary MCC and demonstrates further evidence that radiation as monotherapy is an effective local treatment option for inoperable MCC. PMID:26594171

Facial recognition in primary focal dystonia.

PubMed

Rinnerthaler, Martina; Benecke, Cord; Bartha, Lisa; Entner, Tanja; Poewe, Werner; Mueller, Joerg

2006-01-01

The basal ganglia seem to be involved in emotional processing. Primary dystonia is a movement disorder considered to result from basal ganglia dysfunction, and the aim of the present study was to investigate emotion recognition in patients with primary focal dystonia. Thirty-two patients with primary cranial (n=12) and cervical (n=20) dystonia were compared to 32 healthy controls matched for age, sex, and educational level on the facially expressed emotion labeling (FEEL) test, a computer-based tool measuring a person's ability to recognize facially expressed emotions. Patients with cognitive impairment or depression were excluded. None of the patients received medication with a possible cognitive side effect profile and only those with mild to moderate dystonia were included. Patients with primary dystonia showed isolated deficits in the recognition of disgust (P=0.007), while no differences between patients and controls were found with regard to the other emotions (fear, happiness, surprise, sadness, and anger). The findings of the present study add further evidence to the conception that dystonia is not only a motor but a complex basal ganglia disorder including selective emotion recognition disturbances. Copyright (c) 2005 Movement Disorder Society.

The diagnosis of urinary tract infections in young children (DUTY): protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness.

PubMed

Downing, Harriet; Thomas-Jones, Emma; Gal, Micaela; Waldron, Cherry-Ann; Sterne, Jonathan; Hollingworth, William; Hood, Kerenza; Delaney, Brendan; Little, Paul; Howe, Robin; Wootton, Mandy; Macgowan, Alastair; Butler, Christopher C; Hay, Alastair D

2012-07-19

Urinary tract infection (UTI) is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY) study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted.The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens.We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results) most strongly associated with a positive urine culture result. We will then use economic evaluation to compare the cost effectiveness of the candidate prediction rules. This study will provide novel, clinically important information on the diagnostic features of childhood UTI and the cost effectiveness of a validated prediction rule, to help primary care clinicians improve the efficiency of their diagnostic strategy for UTI in young children.

The diagnosis of urinary tract infections in young children (DUTY): protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness

PubMed Central

2012-01-01

Background Urinary tract infection (UTI) is common in children, and may cause serious illness and recurrent symptoms. However, obtaining a urine sample from young children in primary care is challenging and not feasible for large numbers. Evidence regarding the predictive value of symptoms, signs and urinalysis for UTI in young children is urgently needed to help primary care clinicians better identify children who should be investigated for UTI. This paper describes the protocol for the Diagnosis of Urinary Tract infection in Young children (DUTY) study. The overall study aim is to derive and validate a cost-effective clinical algorithm for the diagnosis of UTI in children presenting to primary care acutely unwell. Methods/design DUTY is a multicentre, diagnostic and prospective observational study aiming to recruit at least 7,000 children aged before their fifth birthday, being assessed in primary care for any acute, non-traumatic, illness of ≤ 28 days duration. Urine samples will be obtained from eligible consented children, and data collected on medical history and presenting symptoms and signs. Urine samples will be dipstick tested in general practice and sent for microbiological analysis. All children with culture positive urines and a random sample of children with urine culture results in other, non-positive categories will be followed up to record symptom duration and healthcare resource use. A diagnostic algorithm will be constructed and validated and an economic evaluation conducted. The primary outcome will be a validated diagnostic algorithm using a reference standard of a pure/predominant growth of at least >103, but usually >105 CFU/mL of one, but no more than two uropathogens. We will use logistic regression to identify the clinical predictors (i.e. demographic, medical history, presenting signs and symptoms and urine dipstick analysis results) most strongly associated with a positive urine culture result. We will then use economic evaluation to compare the cost effectiveness of the candidate prediction rules. Discussion This study will provide novel, clinically important information on the diagnostic features of childhood UTI and the cost effectiveness of a validated prediction rule, to help primary care clinicians improve the efficiency of their diagnostic strategy for UTI in young children. PMID:22812651

Dental anomalies in primary dentition and their corresponding permanent teeth.

PubMed

Gomes, R R; Fonseca, J A C; Paula, L M; Acevedo, A C; Mestrinho, H D

2014-05-01

The objectives of this paper are to estimate the prevalence of dental anomalies in primary dentition in a sample of 2- to 5-year-old Brazilian preschool children, determine their distribution, and investigate their occurrence in the succedaneous teeth of the sample compared with a control group of children with no dental anomalies in the primary dentition. The one-stage sample comprised 1,718 two to five-year-old children with fully erupted primary dentition clinically examined for dental anomalies. All children presenting dental anomalies underwent panoramic radiographs. Descriptive statistics were performed for the studied variables. A control group matched by sex and age was studied to compare the prevalence ratio for dental anomalies in the permanent dentition. The prevalence of dental anomalies in the primary dentition was 1.8 %, with no significant statistical difference between sexes. Double teeth were the most frequently observed. Dental anomalies on the succedaneous permanent teeth were diagnosed in 54.8 % of the children with affected primary dentition. The prevalence ratio (PR) for dental anomalies in the succedaneous permanent teeth was 17.1 (confidence interval (CI) 5.33-54.12) higher compared with the control group, higher in children with bilateral anomalies (PR = 31.2, CI 10.18-94.36). An association between anomalies of the permanent dentition and the presence of dental anomalies in primary teeth was observed, especially when they occur bilaterally. The results in the present study have a clinical relevance in the diagnosis of children with dental anomalies in primary dentition. Early identification of these anomalies can aid the dentist in planning dental treatment at the appropriate time.

Psychiatric treatment received by primary care patients with panic disorder with and without agoraphobia.

PubMed

Marcks, Brook A; Weisberg, Risa B; Keller, Martin B

2009-06-01

Although the majority of individuals with panic disorder first present to the primary care setting, little is known about the psychiatric treatment that primary care patients with the disorder typically receive. The purpose of this study was to explore characteristics of treatment received by patients with panic disorder with agoraphobia and by those with panic disorder without agoraphobia, examine demographic and clinical predictors of receiving treatment, and explore treatment barriers. This study used data from the Primary Care Anxiety Project (PCAP), which is a naturalistic, longitudinal study of anxiety disorders among primary care patients. This study presents data for 235 PCAP participants diagnosed at the study intake assessment as having panic disorder with agoraphobia (N=150) or without agoraphobia (N=85). Many patients with panic disorder were not receiving psychiatric treatment at study intake (38%), with those without agoraphobia being less likely to receive treatment. Psychotropic medications were the treatment of choice, with selective serotonin reuptake inhibitors or serotonin and norepinephrine reuptake inhibitors being the most commonly received class of medications (34%). Only 38% of those with panic disorder with agoraphobia and 24% of those with panic disorder without agoraphobia were receiving psychotherapy, and the use of empirically supported interventions was rare. The most common treatment barriers were not believing in using medication or therapy for emotional problems and not receiving a treatment recommendation from one's provider. The findings suggest a need for better treatment dissemination, in addition to making interventions more accessible or adapting them to the particular needs of primary care patients.

You can't treat what you don't diagnose: An analysis of the recognition of somatic presentations of depression and anxiety in primary care.

PubMed

Gates, Kristin; Petterson, Stephen; Wingrove, Peter; Miller, Benjamin; Klink, Kathleen

2016-12-01

Research suggests that 13-25% of primary care patients who present with physical complaints have underlying depression or anxiety. The goal of this paper is to quantify and compare the frequency of the diagnosis of depression and anxiety in patients with a somatic reason for visit among primary care physicians across disciplines. Data obtained from the National Ambulatory Medical Care Survey (NAMCS) from 2002 to 2010 was used to quantify primary care patients with somatic presentations who were given a diagnosis of depression or anxiety. The Patient Health Questionnaire (PHQ)-15, Somatic Symptom Scale, and the Child Behavior Checklist for Ages 6-18 were used to define what constituted a somatic reason for visit in this study. Of the patients presenting with a somatic reason for visit in this nationally representative survey, less than 4% of patents in family or internal medicine were diagnosed with depression or anxiety. Less than 1% of patients were diagnosed with depression or anxiety in pediatrics or obstetrics and gynecology. Less than 2% of patients with somatic reasons for visit in any primary care specialty had documented screening for depression. The rates of diagnosis of depression and anxiety in patents presenting with somatic reasons for visit were significantly less than the prevalence reported in the literature across primary care disciplines. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Developing Pedagogical Practices in Myanmar Primary Schools: Possibilities and Constraints

ERIC Educational Resources Information Center

Hardman, Frank; Stoff, Christian; Aung, Wan; Elliott, Louise

2016-01-01

This paper presents the findings of a baseline study of pedagogic practices used by Myanmar primary teachers in the teaching of mathematics and Myanmar language at Grades 3 and 5. The main purpose of the baseline study was to inform the design of teacher education programmes and allow for subsequent evaluations of interventions designed to improve…

The Analysis of the Relationship between Primary Learning Styles and Learning Objects in an Online Environment

ERIC Educational Resources Information Center

Özdemir, Muzaffer

2016-01-01

This study investigates the relationships between the primary learning styles of students and different learning objects presented simultaneously in an online learning environment in the context of the usage levels of these objects. A total of 103 sophomores from a Turkish State University participated in the study. Felder-Solomon Index of…

Minority Voices: A Case Study of Children and Parents in a Manchester Primary School

ERIC Educational Resources Information Center

Winterbottom, Christian; Leedy, Allyson K.

2014-01-01

Presently, there are a growing number of ethnic minority students in the primary schools in northwest England. Through sociocultural theory, this paper examines student and parent perspectives of their experiences in the schools. Using a qualitative methodology, including observation, in-depth interviews, and field notes this case study focused on…

A Qualitative Study of Factors Influencing Racial Diversity in Environmental Education: Preliminary Results

Treesearch

Kathy James; Leo H. McAvoy

1992-01-01

This study presents preliminary result interviews with people of color working in environmental education and interpretation throughout the United States. The three primary questions asked were these? (1) What path led each individual to a career in environmental education; (2) How does each individual define environmentalism? and (3) What are the primary issues this...

The Impact of Socio-Economic Status on Parental Involvement in Turkish Primary Schools: Perspective of Teachers

ERIC Educational Resources Information Center

Bellibas, Mehmet Sukru; Gumus, Sedat

2013-01-01

This exploratory qualitative study investigates the effects of socio-economic status on parental involvement in public primary schools in Turkey. The study aims to examine how teachers in these schools present the scope of current parental involvement, to what factors teachers ascribe the barriers to parental involvement, and whether teachers'…

An Exploratory Study on How Primary Pupils Approach Systems

ERIC Educational Resources Information Center

Koski, Marja-Ilona; de Vries, Marc

2013-01-01

This paper presents a study of systems thinking among 27 primary pupils (8-10 years old) and their teacher. The study included a pre-test for the teacher and the pupils, lesson planning, the actual lesson and a post-test for the pupils. The research focused on finding an answer to three questions: (1) do pupils see a system as a structure…

Evaluation and Development of Digital Competence in Future Primary School Teachers at the University of Murcia

ERIC Educational Resources Information Center

Gutiérrez Porlán, Isabel; Serrano Sánchez, José Luis

2016-01-01

This paper presents the findings of a study carried out in the academic year 2014-2015 at the faculty of Education of the University of Murcia with first year degree students in Primary Education studying Research and ICT. The study started with the application of the DIGCOM questionnaire to analyze the digital competences of 134 students. The…

1:1 Mobile Inquiry Learning Experience for Primary Science Students--A Study of Learning Effectiveness

ERIC Educational Resources Information Center

Looi, C.-K.; Zhang, B.; Chen, W.; Seow, P.; Chia, G.; Norris, C.; Soloway, E.

2011-01-01

This paper presents the findings of a research project in which we transformed a primary (grade) 3 science curriculum for delivery via mobile technologies, and a teacher enacted the lessons over the 2009 academic year in a class in a primary school in Singapore. The students had a total of 21 weeks of the mobilized lessons in science, which were…

Preschool and Primary School Influences on the Development of Children's Early Numeracy Skills between the Ages of 3 and 7 Years in Germany

ERIC Educational Resources Information Center

Anders, Yvonne; Grosse, Christiane; Rossbach, Hans-Gunther; Ebert, Susanne; Weinert, Sabine

2013-01-01

Few studies have investigated how preschool and primary school interact to influence children's cognitive development. The present investigation explores German children's numeracy skills between age 3 (1st year of preschool) and age 7 (1st year of primary school). We first identified the influence of preschool experience on development while…

The Pattern of Electronic Game Use and Related Bodily Discomfort in Hong Kong Primary School Children

ERIC Educational Resources Information Center

Lui, Donald P. Y.; Szeto, Grace P. Y.; Jones, Alice Y. M.

2011-01-01

The present study examined the usage pattern of electronic game devices among primary school children in Hong Kong. Commonly used types of games devices were grouped into three main categories: large-screen/TV-based games, small handheld game devices and active game devices. A survey was conducted among 476 students in a local primary school, with…

Interested Reader or Uninterested Dissembler?: The Identities Constructed by Upper Primary Aged Dyslexic Pupils during Silent Reading Sessions

ERIC Educational Resources Information Center

Anderson, Rosemary

2009-01-01

This article discusses the identities that may be constructed by upper primary aged pupils during silent reading sessions. The findings presented are taken from a 2-year ethnographic case study, which investigated how four dyslexic pupils, aged 10-11 (Y5-6), coped with the classroom reading they encountered at a large primary school in northern…

Girls' Drop-Out from Primary Schooling in the Middle East and North Africa: Challenges and Alternatives.

ERIC Educational Resources Information Center

Mehrah, Golnar

The present situation in the Middle East and North Africa Region (MENA) regarding primary school drop-out and repetition, with special reference to the situation of the girl child, is examined in this study. The in-school as well as out-of-school causes of primary school drop-out are examined, and solutions that help reduce or eliminate the…

From Recipient to Contributor: The Story of a Social Justice Leader in a Hong Kong Primary School

ERIC Educational Resources Information Center

Szeto, Elson

2014-01-01

This article presents a principal's story of social justice practice in a Hong Kong primary school. The narration accounts for the notion of social justice through his practice in various ways. Studying in a "rooftop" primary school located in a public housing area in Hong Kong was the principal's salient memory of his first year of…

Psychosocial stressors contributing to emergency psychiatric service utilization in a sample of ethno-culturally diverse clients with psychosis in Toronto.

PubMed

Rotenberg, Martin; Tuck, Andrew; McKenzie, Kwame

2017-09-02

Understanding the psychosocial stressors of people with psychoses from minority ethnic groups may help in the development of culturally appropriate services. This study aimed to compare psychosocial factors associated with attendance at an emergency department (ED) for six ethnic groups. Preventing crises or supporting people better in the community may decrease hospitalization and improve outcomes. A cohort was created by retrospective case note analysis of people of East-Asian, South-Asian, Black-African, Black-Caribbean, White-North American and White-European origin groups attending a specialized psychiatric ED in Toronto with a diagnosis of psychosis between 2009 and 2011. The psychological or social stressors which were linked to the presentation at the ED that were documented by the attending physicians were collected for this study. Logistic regression models were constructed to analyze the odds of presenting with specific stressors. Seven hundred sixty-five clients were included in this study. Forty-four percent of the sample did not have a psychiatrist, and 53% did not have a primary care provider. Social environmental stressors were the most frequent psychosocial stressor across all six groups, followed by issues in the primary support group, occupational and housing stressors. When compared to White-North American clients, East-Asian and White-European origin clients were less likely to present with a housing stressor, while Black-African clients had decreased odds of presenting with primary support group stressor. Having a primary care provider or psychiatrist were predominantly protective factors. In Toronto, moving people with chronic mental health conditions out of poverty, increasing the social safety net and improving access to primary care and community based mental health services may decrease many of the stressors which contribute to ED attendance.

Hyperhidrosis Prevalence and Demographical Characteristics in Dermatology Outpatients in Shanghai and Vancouver.

PubMed

Liu, Yudan; Bahar, Rayeheh; Kalia, Sunil; Huang, Rachel Yuanshen; Phillips, Arlie; Su, Mingwan; Yang, Sen; Zhang, Xuejun; Zhou, Pingyu; Zhou, Youwen

2016-01-01

There is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence. This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations. In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence. The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in Shanghai and Vancouver. The data were gathered according to patients' self-reports only and the sample size was relatively small in some groups after stratification for gender, ethnicity and age. Prevalence of primary HH and late-onset HH is similar in dermatology outpatients independent of geographical locations. However, certain specific HH subtypes can show great variations according to ethnicity, age, body mass index and sex.

The tumour biology of synchronous and metachronous colorectal liver metastases: a systematic review.

PubMed

Slesser, A A P; Georgiou, P; Brown, G; Mudan, S; Goldin, R; Tekkis, P

2013-04-01

Forty to fifty percent of colorectal cancer (CRC) patients develop colorectal liver metastases (CLM) that are either synchronous or metachronous in presentation. Clarifying whether there is a biological difference between the two groups of liver metastases or their primaries could have important clinical implications. A systematic review was performed using the following resources: MEDLINE from PubMed (1950 to present), Embase, Cochrane and the Web of Knowledge. Thirty-one articles met the inclusion criteria. The review demonstrated that the majority of studies found differences in molecular marker expression between colorectal liver metastases and their respective primaries in both the synchronous and metachronous groups. Studies investigating genetic aberrations demonstrated that the majority of changes in the primary tumour were 'maintained' in the colorectal liver metastases. A limited number of studies compared the primary tumours of the synchronous and metachronous groups and generally demonstrated no differences in marker expression. Although there were conflicting results, the colorectal liver metastases in the synchronous and metachronous groups demonstrated some differences in keeping with a more aggressive tumour subtype in the synchronous group. This review suggests that biological differences may exist between the liver metastases of the synchronous and metachronous groups. Whether there are biological differences between the primaries of the synchronous and metachronous groups remains undetermined due to the limited number of studies available. Future research is required to determine whether differences exist between the two groups and should include comparisons of the primary tumours.

Does access to general dental treatment affect the number and complexity of patients presenting to the acute hospital service with severe dentofacial infections?

PubMed

Bowe, Conor M; Gargan, Mary Louise; Kearns, Gerard J; Stassen, Leo F A

2015-01-01

This is a retrospective study to review the treatment and management of patients presenting with odontogenic infections in a large urban teaching hospital over a four-year period, comparing the number and complexity of odontogenic infections presenting to an acute general hospital in two periods, as follows: Group A (January 2008 to March 2010) versus Group B (April 2010 to December 2011). The background to the study is 'An alteration in patient access to primary dental care instituted by the Department of Health in April 2010'. a) to identify any alteration in the pattern and complexity of patients' presentation with odontogenic infections following recent changes in access to treatment via the Dental Treatment Services Scheme (DTSS) and the Dental Treatment Benefit Scheme (DTBS) in April 2010; and, b) to evaluate the management of severe odontogenic infections. Data was collated by a combination of a comprehensive chart review and electronic patient record analysis based on the primary discharge diagnosis as recorded in the Hospital In-Patient Enquiry (HIPE) system. Fifty patients were admitted to the National Maxillofacial Unit, St James's Hospital, under the oral and maxillofacial service over a four-year period, with an odontogenic infection as the primary diagnosis. There was an increased number of patients presenting with odontogenic infections during Group B of the study. These patients showed an increased complexity and severity of infection. Although there was an upward trend in the numbers and complexity of infections, this trending did not reach statistical significance. The primary cause of infection was dental caries in all patients. Dental caries is a preventable and treatable disease. Increased resources should be made available to support access to dental care, and thereby lessen the potential for the morbidity and mortality associated with serious odontogenic infections. The study at present continues as a prospective study.

Using ClinicalTrials.gov to Supplement Information in Ophthalmology Conference Abstracts about Trial Outcomes: A Comparison Study

PubMed Central

Scherer, Roberta W.; Huynh, Lynn; Ervin, Ann-Margret; Dickersin, Kay

2015-01-01

Background Including results from unpublished randomized controlled trials (RCTs) in a systematic review may ameliorate the effect of publication bias in systematic review results. Unpublished RCTs are sometimes described in abstracts presented at conferences, included in trials registers, or both. Trial results may not be available in a trials register and abstracts describing RCT results often lack study design information. Complementary information from a trials register record may be sufficient to allow reliable inclusion of an unpublished RCT only available as an abstract in a systematic review. Methods We identified 496 abstracts describing RCTs presented at the 2007 to 2009 Association for Research in Vision and Ophthalmology (ARVO) meetings; 154 RCTs were registered in ClinicalTrials.gov. Two persons extracted verbatim primary and non-primary outcomes reported in the abstract and ClinicalTrials.gov record. We compared each abstract outcome with all ClinicalTrials.gov outcomes and coded matches as complete, partial, or no match. Results We identified 800 outcomes in 152 abstracts (95 primary [51 abstracts] and 705 [141 abstracts] non-primary outcomes). No outcomes were reported in 2 abstracts. Of 95 primary outcomes, 17 (18%) agreed completely, 53 (56%) partially, and 25 (26%) had no match with a ClinicalTrials.gov primary or non-primary outcome. Among 705 non-primary outcomes, 56 (8%) agreed completely, 205 (29%) agreed partially, and 444 (63%) had no match with a ClinicalTrials.gov primary or non-primary outcome. Among the 258 outcomes partially agreeing, we found additional information on the time when the outcome was measured more often in ClinicalTrials.gov than in the abstract (141/258 (55%) versus 55/258 (21%)). We found no association between the presence of non-matching “new” outcomes and year of registration, time to registry update, industry sponsorship, or multi-center status. Conclusion Conference abstracts may be a valuable source of information about results for outcomes of unpublished RCTs that have been registered in ClinicalTrials.gov. Complementary additional descriptive information may be present for outcomes reported in both sources. However, ARVO abstract authors also present outcomes not reported in ClinicalTrials.gov and these may represent analyses not originally planned. PMID:26107924

Sulforaphane suppressed LPS-induced inflammation in mouse peritoneal macrophages through Nrf2 dependent pathway

PubMed Central

Lin, Wen; Wu, Rachel T; Wu, Tienyuan; Khor, Tin-Oo; Wang, Hu; Kong, Ah-Ng

2008-01-01

Sulforaphane (SFN) is a natural isothiocyanate that is present in cruciferous vegetables such as broccoli and cabbage. Previous studies have shown that SFN is effective in preventing carcinogenesis induced by carcinogens in rodents, which is related in part to its potent anti-inflammation properties. In the present study, we compared the anti-inflammatory effect of SFN on LPS-stimulated inflammation in primary peritoneal macrophages derived from Nrf2 (+/+) and Nrf2 mice. Pretreatment of SFN in Nrf2 (+/+) primary peritoneal macrophages potently inhibited LPS-stimulated mRNA expression, protein expression and production of TNFα, IL-1β, Cox-2 and iNOS. HO-1 expression, which is significantly augmented in LPS-stimulated Nrf2 (+/+) primary peritoneal macrophages by SFN. Interestingly, the anti-inflammatory effect was attenuated in Nrf2 (−/−) primary peritoneal macrophages. We concluded that SFN exerts its anti-inflammatory activity mainly via activation of Nrf2 in mouse peritoneal macrophages. PMID:18755157

The Subfascial Approach to Primary and Secondary Breast Augmentation with Autologous Fat Grafting and Form-Stable Implants.

PubMed

Sampaio Goes, João Carlos; Munhoz, Alexandre Mendonça; Gemperli, Rolf

2015-10-01

This article presents an overview of the subfascial approach to primary and secondary breast augmentation with form-stable implants associated with autologous fat grafting. Although breast augmentation is a well-studied procedure, there are few previous reports concerning the subfascial technique and, especially, this technique associated with lipofilling. Consequently, the authors present their experience with a form-stable, anatomically shaped silicone gel breast implant, which has recently been approved in the United States following FDA clinical trials. Primary and secondary breast augmentations using form-stable implants resulted in satisfactory outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Colorado Longitudinal Twin Study of Reading Disability

ERIC Educational Resources Information Center

Wadsworth, Sally J.; DeFries, John C.; Olson, Richard K.; Willcutt, Erik G.

2007-01-01

The primary objectives of the present study are to introduce the Colorado Longitudinal Twin Study of Reading Disability, the first longitudinal twin study in which subjects have been specifically selected for having a history of reading difficulties, and to present some initial assessments of the stability of reading performance and cognitive…

Surgical Outcomes of Primary Versus Post-Neoadjuvant Chemotherapy Breast Conservation Surgery: A Comparative Study from a Developing Country.

PubMed

Agarwal, Gaurav; Sonthineni, Chaitra; Mayilvaganan, Sabaretnam; Mishra, Anjali; Lal, Punita; Agrawal, Vinita

2018-05-01

In India and other developing countries, breast conservation surgery (BCS) rates in breast cancer patients are low due to advanced disease at presentation and misconceptions about BCS outcomes. Many patients presenting with large or locally advanced breast cancers (LABC) can be offered post-neoadjuvant chemotherapy (NACT) BCS, safety of which is not as well established as that of primary BCS. This retrospective study compared pathological and surgical outcome parameters in patients undergoing primary and post-NACT BCS. All non-metastatic breast cancer patients undergoing BCS during 2011-2015 with 1-year follow-up were included. Outcome parameters in form of margin infiltration, ipsilateral breast tumor recurrence (IBTR) rates and IBTR-free survival were compared between primary and post-NACT BCS patients groups. One hundred and twenty-nine patients underwent BCS; 95 underwent primary and 34 post-NACT BCS. Patients in both groups underwent similar multimodality treatment as per institutional protocols. Post-NACT patients more frequently required oncoplastic volume displacement or replacement surgery (p = 0.002). Re-excision of infiltrated margins was needed more frequently in primary BCS compared with post-NACT BCS group (14.4 vs. 8.8%; p = 0.40). IBTR (Mean follow-up = 30.7 months) was seen in 8.8% post-NACT patients compared with 2.1% primary BCS (p = 0.114). IBTR-free survival did not differ significantly between the groups in stage-wise comparison. Post-NACT BCS is safe even in large tumors and LABC, though many require oncoplastic procedures for satisfactory cosmesis. In a developing country where many patients present with large breast cancers or LABC, the benefits of BCS can be offered to a majority with the help of NACT, without compromising the chances of cure.

Prevalence of primary hyperaldosteronism in a systemic arterial hypertension league.

PubMed

Ribeiro, Maria Jacqueline Silva; Figueiredo Neto, José Albuquerque de; Memória, Edson Viriato; Lopes, Maíra de Castro; Faria, Manuel dos Santos; Salgado Filho, Natalino; Oliveira, Thiara Castro de

2009-01-01

Until recently, primary hyperaldosteronism was considered a rare cause of secondary hypertension. However, in recent years, many studies have suggested that this disease can affect up to 20% of hypertensive individuals. To determine the prevalence of primary hyperaldosteronism in hypertensive patients treated at the hypertension league of a university hospital. Serum aldosterone and plasma renin activity levels were measured in 105 patients while they were undergoing standard antihypertensive treatment, with the exception of those using betablockers and spironolactone, in fasting condition and after rest in the supine position for 20 minutes. Those with an aldosterone/plasma renin activity ratio > 25 were submitted to the saline suppression test and, after the confirmation of the autonomy of aldosterone secretion, a computed tomography of the adrenals was performed. The results are presented as percentages and means and standard deviations. Of the 105 patients, 6.54% presented refractory hypertension. Nine presented an aldosterone/plasma renin activity ratio > 25 (8.5% of the total). Of these, 08 were submitted to the saline suppression test and 01 (with refractory hypertension) had the diagnosis of primary hyperaldosteronism confirmed (0.96% of the total). A computed tomography of the adrenals was performed, which showed normal results. The prevalence of primary hyperaldosteronism in the studied sample was 0.96% of the total. However, when only the patients with refractory hypertension were evaluated, the prevalence was 14.3%.

Structural Arrangement Trade Study. Volume 1: Reusable Hydrogen Composite Tank System (RHCTS) and Graphite Composite Primary Structures (GCPS). Executive summary

NASA Astrophysics Data System (ADS)

1995-03-01

This volume is the first of a three volume set that discusses the structural arrangement trade study plan that will identify the most suitable configuration for an SSTO winged vehicle capable of delivering 25,000 lbs to a 220 nm circular orbit at 51.6 deg inclination. The Reusable Hydrogen Composite Tank System (RHCTS), and Graphite Composite Primary Structures most suitable for intertank, wing and thrust structures are identified. This executive summary presents the trade study process, the selection process, requirements used, analysis performed and data generated. Conclusions and recommendations are also presented.

Structural Arrangement Trade Study. Volume 1: Reusable Hydrogen Composite Tank System (RHCTS) and Graphite Composite Primary Structures (GCPS). Executive summary

NASA Technical Reports Server (NTRS)

1995-01-01

This volume is the first of a three volume set that discusses the structural arrangement trade study plan that will identify the most suitable configuration for an SSTO winged vehicle capable of delivering 25,000 lbs to a 220 nm circular orbit at 51.6 deg inclination. The Reusable Hydrogen Composite Tank System (RHCTS), and Graphite Composite Primary Structures most suitable for intertank, wing and thrust structures are identified. This executive summary presents the trade study process, the selection process, requirements used, analysis performed and data generated. Conclusions and recommendations are also presented.

The Contribution of Teachers' Peer-and Self-Assessment for the Implementation of Active Learning Strategies: Perceptions of Ethiopia Primary School Teachers

ERIC Educational Resources Information Center

Mengistie, Solomon Melesse

2014-01-01

The present study tries to investigate the contribution of primary school teachers' peer- and self- assessment for effective implementation of active learning in their actual classrooms. In this study, areas in which self-reflection and peer assessment include three broad categories, such as methods of teaching and learning, instructional resource…

Status of Biodiversity and Its Conservation in the Kobadak River Basin of Maheshpur Upazila, Jhenaidah, Bangladesh

ERIC Educational Resources Information Center

Uddin, Jashim Md.

2015-01-01

This research project represents the Status of Biodiversity and Its Conservation of Kobadak River basin of Maheshpur Upazila. The study was designed to develop a set of information about the present condition of biodiversity of the study area. Both primary and secondary data have been used to fulfill the survey successfully. Primary data have been…

Gender Differences in Primary and Secondary Education: Are Girls Really Outperforming Boys?

ERIC Educational Resources Information Center

Driessen, Geert; van Langen, Annemarie

2013-01-01

A moral panic has broken out in several countries after recent studies showed that girls were outperforming boys in education. Commissioned by the Dutch Ministry of Education, the present study examines the position of boys and girls in Dutch primary education and in the first phase of secondary education over the past ten to fifteen years. On the…

Digital Educational Games and Mathematics. Results of a Case Study in Primary School Settings

ERIC Educational Resources Information Center

Fokides, Emmanuel

2018-01-01

The study presents the results of a project in which a series of digital games were used for teaching Mathematics to first, fourth, and sixth-grade primary school students (ages 6-7, 8-9, and 11-12). Mathematics was selected as the teaching subject because of the difficulties students face in understanding basic math concepts. Although digital…

Characterizing Teaching Effectiveness in the Joint Action Theory in Didactics: An Exploratory Study in Primary School

ERIC Educational Resources Information Center

Sensevy, Gérard

2014-01-01

This paper presents an exploratory study of two consecutive reading sessions conducted in primary school by two different teachers. Our purpose is twofold. From a theoretical viewpoint, we propose a tentative set of conditions of teaching effectiveness by relying on the Joint Action Theory in Didactics. From a methodological viewpoint, drawing on…

Primary Teachers' Particle Ideas and Explanations of Physical Phenomena: Effect of an In-Service Training Course

ERIC Educational Resources Information Center

Papageorgiou, George; Stamovlasis, Dimitrios; Johnson, Phil Michael

2010-01-01

This paper presents a study concerning Greek primary school teachers' (n = 162) ideas about the particulate nature of matter and their explanations of physical phenomena. The study took place during an in-service training course where the effectiveness of a specially designed intervention was tested. A key feature was an approach based on the…

Reasoning Abilities in Primary School: A Pilot Study on Poor Achievers vs. Normal Achievers in Computer Game Tasks

ERIC Educational Resources Information Center

Dagnino, Francesca Maria; Ballauri, Margherita; Benigno, Vincenza; Caponetto, Ilaria; Pesenti, Elia

2013-01-01

This paper presents the results of preliminary research on the assessment of reasoning abilities in primary school poor achievers vs. normal achievers using computer game tasks. Subjects were evaluated by means of cognitive assessment on logical abilities and academic skills. The aim of this study is to better understand the relationship between…

The Role of Socio-Cognitive Variables in Predicting Learning Satisfaction in Smart Schools

ERIC Educational Resources Information Center

Firoozi, Mohammad Reza; Kazemi, Ali; Jokar, Maryam

2017-01-01

The present study aimed to investigate the role of Socio-Cognitive variables in predicting learning satisfaction in Smart Schools. The population was all the primary school students studying in smart schools in the city of Shiraz in the school year 2014-2015. The sample, randomly chosen through multi-stage cluster sampling, was 383 primary school…

The Effectiveness of Project-Based Learning on Pupils with Learning Difficulties Regarding Academic Performance, Group Work and Motivation

ERIC Educational Resources Information Center

Filippatou, Diamanto; Kaldi, Stavroula

2010-01-01

This study focuses upon the effectiveness of project-based learning on primary school pupils with learning difficulties regarding their academic performance and attitudes towards self efficacy, task value, group work and teaching methods applied. The present study is a part of a larger one that included six Greek fourth-grade primary school…

The contribution of Physician Assistants in primary care: a systematic review

PubMed Central

2013-01-01

Background Primary care provision is important in the delivery of health care but many countries face primary care workforce challenges. Increasing demand, enlarged workloads, and current and anticipated physician shortages in many countries have led to the introduction of mid-level professionals, such as Physician Assistants (PAs). Objective: This systematic review aimed to appraise the evidence of the contribution of PAs within primary care, defined for this study as general practice, relevant to the UK or similar systems. Methods Medline, CINAHL, PsycINFO, BNI, SSCI and SCOPUS databases were searched from 1950 to 2010. Eligibility criteria: PAs with a recognised PA qualification, general practice/family medicine included and the findings relevant to it presented separately and an English language journal publication. Two reviewers independently identified relevant publications, assessed quality using Critical Appraisal Skills Programme tools and extracted findings. Findings were classified and synthesised narratively as factors related to structure, process or outcome of care. Results 2167 publications were identified, of which 49 met our inclusion criteria, with 46 from the United States of America (USA). Structure: approximately half of PAs are reported to work in primary care in the USA with good support and a willingness to employ amongst doctors. Process: the majority of PAs’ workload is the management of patients with acute presentations. PAs tend to see younger patients and a different caseload to doctors, and require supervision. Studies of costs provide mixed results. Outcomes: acceptability to patients and potential patients is consistently found to be high, and studies of appropriateness report positively. Overall the evidence was appraised as of weak to moderate quality, with little comparative data presented and little change in research questions over time. Limitations: identification of a broad range of studies examining ‘contribution’ made meta analysis or meta synthesis untenable. Conclusions The research evidence of the contribution of PAs to primary care was mixed and limited. However, the continued growth in employment of PAs in American primary care suggests that this professional group is judged to be of value by increasing numbers of employers. Further specific studies are needed to fill in the gaps in our knowledge about the effectiveness of PAs’ contribution to the international primary care workforce. PMID:23773235

The Security Education Concepts in the Textbooks of the National and Civic Education of the Primary Stage in Jordan--An Analytical Study

ERIC Educational Resources Information Center

Al-Edwan, Zaid Suleiman

2016-01-01

The present study aimed at exploring the concepts of the security education in the textbooks of the national and civic education of the higher primary stage in Jordan. It adopted the descriptive analytical method. The study sample consisted of the textbooks of the national and civic education for the basic eighth, ninth and tenth grades. To…

Factors Contributing to the Accumulation of Primary Teacher's Debts to the Government of Tanzania: A Case Study for Dar Es Salaam Region

ERIC Educational Resources Information Center

Kombo, Ibun

2015-01-01

This paper presents the findings of the study which was conducted to determine factors contributing to the accumulation of primary school teacher's debts to the Government of Tanzania, a case study of Dar es Salaam Region in its three municipalities namely, Ilala, Kinondoni and Temeke. Data was obtained through sampling method which also helped to…

A Sociolinguistics Study on the Use of the Javanese Language in the Learning Process in Primary Schools in Surakarta, Central Java, Indonesia

ERIC Educational Resources Information Center

Saddhono, Kundharu; Rohmadi, Muhammad

2014-01-01

This study aims at describing the use of language at primary schools grade 1, 2, and 3 in Surakarta. The study belongs to descriptive qualitative research. It emphasizes in a note which depict real situation to support data presentation. Content analysis is used as research methodology. It analyzes the research result of the observed speech event.…

[Drug using risks screening in primary care patients using the ASSIST test: Cross sectional study].

PubMed

López-Rodríguez, Juan A; Rigabert, Alina; Gómez Llano, M Nieves; Rubio, Gabriel

2018-03-15

The aim of this study is to estimate risky-drug use patterns of consumption of primary care patients. Multicentric descriptive cross-sectional study. five primary health care centers of the South of Madrid. all patients between 16-100 year-old consulting with their family physician. Spanish-validated World Health Organization ASSIST test was use to screen risky drug use in primary care. Total points scored at the test were obtained. A sum of 441 screening test were collected. Mean age was 51,3 years and 51.6% of patients presented a moderate-severe risky drug use out of the nine drugs tested. The more frequent drug use screened were tobacco (41.7%) followed by alcohol (15.4%), hypnotics (13.7%) and cannabis (5.7%). Differences were found between genders in the patterns: men had higher risky drug uses compared to women regarding alcohol and cannabis. Women had higher sedatives/hypnotics consumption prevalence. A 16% of patients presented with polyconsumption drug use patterns. There is risk derived from drug misuse in primary care for tobacco, alcohol, hypnotics and cannabis as detected by the ASSIST test. There is a higher rate of hypnotics than expected. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

The epidemiology of malpractice claims in primary care: a systematic review

PubMed Central

Wallace, E; Lowry, J; Smith, S M; Fahey, T

2013-01-01

Objectives The aim of this systematic review was to examine the epidemiology of malpractice claims in primary care. Design A computerised systematic literature search was conducted. Studies were included if they reported original data (≥10 cases) pertinent to malpractice claims, were based in primary care and were published in the English language. Data were synthesised using a narrative approach. Setting Primary care. Participants Malpractice claimants. Primary outcome Malpractice claim (defined as a written demand for compensation for medical injury). We recorded: medical misadventure cited in claims, missed/delayed diagnoses cited in claims, outcome of claims, prevalence of claims and compensation awarded to claimants. Results Of the 7152 articles retrieved by electronic search, a total of 34 studies met the inclusion criteria and were included in the narrative analysis. Twenty-eight studies presented data from medical indemnity malpractice claims databases and six studies presented survey data. Fifteen studies were based in the USA, nine in the UK, seven in Australia, one in Canada and two in France. The commonest medical misadventure resulting in claims was failure to or delay in diagnosis, which represented 26–63% of all claims across included studies. Common missed or delayed diagnoses included cancer and myocardial infarction in adults and meningitis in children. Medication error represented the second commonest domain representing 5.6–20% of all claims across included studies. The prevalence of malpractice claims in primary care varied across countries. In the USA and Australia when compared with other clinical disciplines, general practice ranked in the top five specialties accounting for the most claims, representing 7.6–20% of all claims. However, the majority of claims were successfully defended. Conclusions This review of malpractice claims in primary care highlights diagnosis and medication error as areas to be prioritised in developing educational strategies and risk management systems. PMID:23869100

Orbital schwannomatosis in the absence of neurofibromatosis.

PubMed

Koktekir, Bengu Ekinci; Kim, H Jane; Geske, Mike; Bloomer, Michelle; Vagefi, Reza; Kersten, Robert C

2014-11-01

The aim of this study was to describe 3 cases of primary orbital schwannomatosis without associated systemic neurofibromatosis. This is a retrospective interventional study of 3 patients who presented with multiple, distinct masses in the orbit (n = 3) as well as in the hemiface (n = 1). The clinical presentation, imaging features, surgical procedures, and outcomes were defined. Two women and a man presented with of exophthalmos and diplopia. Pain was the most prominent complaint in 2 patients. None of the patients had associated systemic neurofibromatosis by history or examination. Radiologic evaluation with computed tomography or magnetic resonance imaging of orbit revealed multiple well-demarcated intraconal and extraconal masses. Masses were excised, and histopathology confirmed all masses to be schwannomas. Postoperative follow-up was uneventful with alleviation of primary complaints in all patients. Multiple orbital schwannomas (primary orbital schwannomatosis) may be observed in patients without systemic association of neurofibromatosis. Management includes surgical excision of the tumors to achieve relief from their mass effects.

Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care.

PubMed

Skapinakis, Petros; Lewis, Glyn; Mavreas, Venetsanos

2003-03-01

Unexplained fatigue has been extensively studied but most of the samples used were from Western countries. To present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care. Method Secondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview. The prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17-4.33) and 15.05 (95% CI 10.85-20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries. In less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.

A Qualitative Study on Incentives and Disincentives for Care of Common Mental Disorders in Ontario Family Health Teams

PubMed Central

Silveira, Jose; Mckenzie, Kwame

2016-01-01

Background: An opportunity to address the needs of patients with common mental disorders (CMDs) resides in primary care. Barriers are restricting availability of treatment for CMDs in primary care. By understanding the incentives that promote and the disincentives that deter treatment for CMDs in a collaborative primary care context, this study aims to help contribute to goals of greater access to mental healthcare. Method: A qualitative pilot study using semi-structured interviews with thematic analysis. Results: Participants identified 10 themes of incentives and disincentives influencing quality treatment of CMDs in a collaborative primary care setting: high service demands, clinical presentation, patient-centred care, patient attributes, education, physician attributes, organizational, access to mental health resources, psychiatry and physician payment model. Conclusion: An understanding of the incentives and disincentives influencing care is essential to achieve greater integration and capacity for care for the treatment of CMDs in primary care. PMID:27585029

Presenting the facts about smoking to adolescents: effects of an autonomy-supportive style.

PubMed

Williams, G C; Cox, E M; Kouides, R; Deci, E L

1999-09-01

To test the self-determination model of health-related behavior by examining whether the degree to which adolescents experience an appeal to not smoke as autonomy supportive would affect their autonomous motivation for not smoking and, in turn, their behavior of either refraining from smoking or smoking less, and to validate the measures of perceived autonomy support and autonomous motivation for not smoking. Two studies of physicians presenting information about not smoking using 2 message styles, 1 of which was designed to be more autonomy supportive. The preliminary study involved nonrandomized assignment to message style and only immediate assessment of perceptions, motivation, and behavior, while the primary study involved randomized assignment and 4-month longitudinal assessments. Nearly 400 ninth- through 12th-grade students at 2 suburban high schools in upstate New York. Adolescents' perceptions of the presentations' autonomy supportiveness of the presenters, as well as adolescents' autonomous motivation for not smoking and their self-reports of smoking. The primary study also assessed change in students' autonomous motivation and change in their self-reported smoking during 4 months. In both studies, the measures were reliable and valid. Students perceived significantly (P = .04 and P<.001, respectively) greater autonomy support in the "It's Your Choice" presentation, after controlling for whether the students were smokers. Perceived autonomy supportiveness of the presentation was positively correlated with autonomous reasons for not smoking in the preliminary study and with increases in autonomous motivation for not smoking in the primary study. Change in autonomous reasons for not smoking significantly (P<.001) predicted reduction in smoking during 4 months. When adolescents perceived messages about not smoking as autonomy supportive, they had more autonomous motivation for not smoking, and that, in turn, predicted a decrease in their self-reports of smoking.

Treatment of Advanced Glaucoma Study: a multicentre randomised controlled trial comparing primary medical treatment with primary trabeculectomy for people with newly diagnosed advanced glaucoma-study protocol.

PubMed

King, Anthony J; Fernie, Gordon; Azuara-Blanco, Augusto; Burr, Jennifer M; Garway-Heath, Ted; Sparrow, John M; Vale, Luke; Hudson, Jemma; MacLennan, Graeme; McDonald, Alison; Barton, Keith; Norrie, John

2017-10-26

Presentation with advanced glaucoma is the major risk factor for lifetime blindness. Effective intervention at diagnosis is expected to minimise risk of further visual loss in this group of patients. To compare clinical and cost-effectiveness of primary medical management compared with primary surgery for people presenting with advanced open-angle glaucoma (OAG). Design : A prospective, pragmatic multicentre randomised controlled trial (RCT). Twenty-seven UK hospital eye services. Four hundred and forty patients presenting with advanced OAG, according to the Hodapp-Parish-Anderson classification of visual field loss. Participants will be randomised to medical treatment or augmented trabeculectomy (1:1 allocation minimised by centre and presence of advanced disease in both eyes). The primary outcome is vision-related quality of life measured by the National Eye Institute-Visual Function Questionnaire-25 at 24 months. Secondary outcomes include generic EQ-5D-5L, Health Utility Index-3 and glaucoma-related health status (Glaucoma Utility Index), patient experience, visual field measured by mean deviation value, logarithm of the mean angle of resolution visual acuity, intraocular pressure, adverse events, standards for driving and eligibility for blind certification. Incremental cost per quality-adjusted life-year (QALY) based on EQ-5D-5L and glaucoma profile instrument will be estimated. The study will report the comparative effectiveness and cost-effectiveness of medical treatment against augmented trabeculectomy in patients presenting with advanced glaucoma in terms of patient-reported health and visual function, clinical outcomes and incremental cost per QALY at 2 years. Treatment of Advanced Glaucoma Study will be the first RCT reporting outcomes from the perspective of those with advanced glaucoma. ISRCTN56878850, Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Oscillatory fluid flow influences primary cilia and microtubule mechanics.

PubMed

Espinha, Lina C; Hoey, David A; Fernandes, Paulo R; Rodrigues, Hélder C; Jacobs, Christopher R

2014-07-01

Many tissues are sensitive to mechanical stimuli; however, the mechanotransduction mechanism used by cells remains unknown in many cases. The primary cilium is a solitary, immotile microtubule-based extension present on nearly every mammalian cell which extends from the basal body. The cilium is a mechanosensitive organelle and has been shown to transduce fluid flow-induced shear stress in tissues, such as the kidney and bone. The majority of microtubules assemble from the mother centriole (basal body), contributing significantly to the anchoring of the primary cilium. Several studies have attempted to quantify the number of microtubules emanating from the basal body and the results vary depending on the cell type. It has also been shown that cellular response to shear stress depends on microtubular integrity. This study hypothesizes that changing the microtubule attachment of primary cilia in response to a mechanical stimulus could change primary cilia mechanics and, possibly, mechanosensitivity. Oscillatory fluid flow was applied to two different cell types and the microtubule attachment to the ciliary base was quantified. For the first time, an increase in microtubules around primary cilia both with time and shear rate in response to oscillatory fluid flow stimulation was demonstrated. Moreover, it is presented that the primary cilium is required for this loading-induced cellular response. This study has demonstrated a new role for the cilium in regulating alterations in the cytoplasmic microtubule network in response to mechanical stimulation, and therefore provides a new insight into how cilia may regulate its mechanics and thus the cells mechanosensitivity. Copyright © 2014 Wiley Periodicals, Inc.

Prevalence of enamel defects in primary and permanent teeth in a group of schoolchildren from Granada (Spain).

PubMed

Robles, Maria-Jesús; Ruiz, Matilde; Bravo-Perez, Manuel; González, Encarnación; Peñalver, Maria-Angustias

2013-03-01

The purpose of this study was to determine and compare the prevalence and presentations of developmental defects of the enamel (DDE) in the primary and permanent dentitions of a group of healthy schoolchildren residing in Granada (Spain). A total of 1,414 healthy schoolchildren were examined using modified DDE criteria for recording enamel defects. The prevalence of DDE of any type was 40.2% in primary dentition and 52% in permanent dentition (p<0.033). Of the 31,820 primary and permanent teeth examined in the study, 699 (4.1%) primary and 1,232 (8.3%) permanent teeth had some form of DDE. Diffuse opacity was the most common type of DDE observed in primary teeth, and demarcated opacity in the permanent teeth. Enamel hypoplasia was the least prevalent defect in both dentition types. The study population showed a high prevalence of DDE in primary as well as in permanent dentition, reflecting the current increasing trend of this condition, which should be considered as a significant public health problem.

Modulated Electron Emission by Scattering-Interference of Primary Electrons

NASA Astrophysics Data System (ADS)

Valeri, Sergio; di Bona, Alessandro

We review the effects of scattering-interference of the primary, exciting beam on the electron emission from ordered atomic arrays. The yield of elastically and inelastically backscattered electrons, Auger electrons and secondary electrons shows a marked dependence on the incidence angle of primary electrons. Both the similarity and the relative importance of processes experienced by incident and excident electrons are discussed. We also present recent studies of electron focusing and defocusing along atomic chains. The interplay between these two processes determines the in-depth profile of the primary electron intensity anisotropy. Finally, the potential for surface-structural studies and limits for quantitative analysis are discussed, in comparison with the Auger electron diffraction (AED) and photoelectron diffraction (PD) techniques.

Learner-Oriented Virtual Learning: A Booster to Primary School Learners

ERIC Educational Resources Information Center

Singaravelu, G.

2013-01-01

The present study enlightens the impact of Learner- Oriented-Virtual Learning in enriching knowledge in Environmental Education at primary level.To achieve the expected competency in Biodiversity, various approaches were adopted in the class room transaction which were not fruitful. Hence the researcher practiced the Learner-Oriented-Virtual…

Improving Primary Teachers' Attitudes toward Science by Attitude-Focused Professional Development

ERIC Educational Resources Information Center

van Aalderen-Smeets, Sandra I.; van der Molen, Juliette H. Walma

2015-01-01

This article provides a description of a novel, attitude-focused, professional development intervention, and presents the results of an experimental pretest-posttest control group study investigating the effects of this intervention on primary teachers' personal attitudes toward science, attitudes toward teaching science, and their science…

Irish Educational Studies. Vol. 4 No. 2.

ERIC Educational Resources Information Center

McKernan, Jim, Ed.

1984-01-01

The following papers dealing with education in Ireland are presented: "The Educational agenda: A View of the Future" (H. T. Sockett); "Curriculum and Policy in Irish Post-Primary Education" (B. O'Reilly); "A Response to Barney O'Reilly on Curriculum and Policy in Irish Post-Primary Education" (D. G. Mulcahy);…

Pre-Service Primary Teachers' Attitudes towards Inclusive Education

ERIC Educational Resources Information Center

Varcoe, Linda; Boyle, Christopher

2014-01-01

Research has demonstrated that an important factor in the success of inclusive education is dependent upon teachers' attitudes. Based on this evidence, the present study investigated the impact of a range of teacher variables in association with training on primary pre-service teachers' attitudes by examining total inclusion scores, positive…

Progranulin-Associated Primary Progressive Aphasia: A Distinct Phenotype?

ERIC Educational Resources Information Center

Rohrer, Jonathan D.; Crutch, Sebastian J.; Warrington, Elizabeth K.; Warren, Jason D.

2010-01-01

The neuropsychological features of the primary progressive aphasia (PPA) syndromes continue to be defined. Here we describe a detailed neuropsychological case study of a patient with a mutation in the progranulin ("GRN") gene who presented with progressive word-finding difficulty. Key neuropsychological features in this case included gravely…

Professional Learning in Mathematical Reasoning: Reflections of a Primary Teacher

ERIC Educational Resources Information Center

Herbert, Sandra; Widjaja, Wanty; Bragg, Leicha A.; Loong, Esther; Vale, Colleen

2016-01-01

Reasoning is an important aspect in the understanding and learning of mathematics. This paper reports on a case study presenting one Australian primary teacher's reflections regarding the role played by a professional learning program in her developing understanding of mathematical reasoning. Examination of the transcripts of two interviews…

The Use of ICTs in the Cameroonian School System: A Case Study of Some Primary and Secondary Schools in Yaoundé

ERIC Educational Resources Information Center

Ngoungouo, Abass

2017-01-01

This paper presents the results of a study carried out on some primary and secondary schools of Yaoundé, Republic of Cameroon. The said study aimed at analyzing and evaluating the use of ICTs by teachers in the Cameroonian school system. More precisely, it sought to identify the types of ICTs used by teachers, to evaluate the state of equipment of…

Prospective study of periostitis and finger clubbing in primary biliary cirrhosis and other forms of chronic liver disease.

PubMed Central

Epstein, O; Dick, R; Sherlock, S

1981-01-01

The association of finger clubbing and periostitis has been reported in primary biliary cirrhosis and, more rarely, in other forms of chronic liver disease. The prevalence of periostitis and its relationship to finger clubbing is unknown. In this prospective study, we have determined the prevalence of periostitis and finger clubbing in 74 patients with primary biliary cirrhosis and 54 with other forms of chronic liver disease. Clubbing was present in 24% of patients with primary biliary cirrhosis, 29% with HBsAg negative chronic active hepatitis, and 23% in the group of miscellaneous liver diseases. Symmetrical periostitis affecting the tibiae and fibulae occurred in 35% of patients with primary biliary cirrhosis, 29% with chronic, active hepatitis and 40% of patients in the miscellaneous group. The distal radii and ulnae were affected in only eight patients (6%). In primary biliary cirrhosis, the presence of finger clubbing was strongly associated with periostitis (P less than 0.01), but this association was uncommon in other forms of chronic liver disease. In all forms of chronic liver disease periostitis commonly occurs in the absence of finger clubbing. Marked tenderness over the distal leg bones is a reliable sign of underlying periostitis, but this sign is present in only a third of affected patients. This study indicates that periostitis affecting the lower leg bones is common in patients with chronic liver disease, and its presence should be sought whether or not the patient has finger clubbing. Images Fig. 2 PMID:7227854

Fostering Positive Peer Relations in the Primary Classroom through Circle Time and Co-Operative Games

ERIC Educational Resources Information Center

Mary, Latisha

2014-01-01

The aim of this study was to investigate the role of co-operative games and circle time activities in fostering positive peer relations in two French Primary classrooms (N = 40). It presents French teachers' and pupils' perceptions of a set of co-operative games and circle time activities implemented within a year long study on personal, social…

The Impact of Social and Emotional Learning Programs on the Emotional Competence and Academic Achievement of Children in Greek Primary School

ERIC Educational Resources Information Center

Babalis, Thomas; Tsoli, Konstantina; Artikis, Constantinos T.; Mylonakou-Keke, Iro; Xanthakou, Yota

2013-01-01

The present study examined the relationship between emotional intelligence, academic achievement and school climate among primary school students. The purpose of the study was to investigate the impact of social and emotional learning programs on the emotional intelligence and the academic achievement of 143 students in the 5th and 6th grade of…

A Categorisation of Teacher Feedback in the Classroom: A Field Study on Feedback Based on Routine Classroom Assessment in Primary School

ERIC Educational Resources Information Center

Eriksson, Elisabeth; Björklund Boistrup, Lisa; Thornberg, Robert

2017-01-01

The aim of the present study was to examine and categorise teachers' strategies for feedback in day-to-day communication in primary school. The different feedback categories constructed and grounded in data are applicable to feedback on learning and knowledge as well as on behavioural skills. Qualitative classroom observations were conducted in 4…

An Maith Leat an Ghaeilge? An Analysis of Variation in Primary Pupil Attitudes to Irish in the Growing up in Ireland Study

ERIC Educational Resources Information Center

Devitt, Ann; Condon, Joe; Dalton, Gene; O'Connell, Jane; Ní Dhuinn, Melanie

2018-01-01

This paper presents an analysis of primary schoolchildren's attitudes to the Irish language, Gaeilge, in the context of national policy in the Republic of Ireland. In particular, the study examines the factors (social, cultural, cognitive and organisational) that may be related to a pronounced excess in disengagement with Irish over and above…

Evidence for an Evolutionary Cheater Strategy--Relationships Between Primary and Secondary Psychopathy, Parenting, and Shame and Guilt.

PubMed

Lyons, Minna T

2015-01-01

In the present study, shame and guilt proneness were investigated in relation to primary and secondary psychopathy, looking at parental care as a possible mediator. A sample of 388 volunteers participated in an on-line study, completing several self-report measurements. Primary psychopathy, robust to parental care and sex of the participant, was associated with lower guilt proneness after a private transgression and lower negative self-evaluations after a public transgression. Secondary psychopathy was not associated with guilt or shame proneness. Paternal care played a mediating role between primary psychopathy and guilt, but only in male participants. High paternal care was associated with lower guilt repair in high psychopathy males, suggesting that a positive father-son relationship might be essential for development of exploitive strategies in primary psychopathy. The results highlight the fundamental differences between primary and secondary psychopathy, and provide support for the idea that primary psychopathy is an evolutionary cheater-strategy.

Small bowel obstruction from distant metastasis of primary breast cancer: a case report.

PubMed

Oh, Seung Jae; Park, Seon Young; Kim, Ji Young; Yim, Hyunee; Jung, Yongsik; Han, Sae Hwan

2018-02-01

Gastrointestinal (GI) tract metastasis of primary breast cancer is very rare. We present a patient with small bowel obstruction from distant metastasis of primary breast cancer. Each characteristic features of concern of GI tract distant metastasis from many pervious studies has been reported differently. We should remember that GI tract metastasis may coexist when patients with breast cancer have intermittent or recurrent abdominal pain with or without obstructive symptoms.

Danish method study on cervical screening in women offered HPV vaccination as girls (Trial23): a study protocol.

PubMed

Thamsborg, Lise Holst; Andersen, Berit; Larsen, Lise Grupe; Christensen, Jette; Johansen, Tonje; Hariri, Jalil; Christiansen, Sanne; Rygaard, Carsten; Lynge, Elsebeth

2018-05-26

The first birth cohorts of women offered human papillomavirus (HPV) vaccination as girls are now entering cervical screening. However, there is no international consensus on how to screen HPV vaccinated women. These women are better protected against cervical cancer and could therefore be offered less intensive screening. Primary HPV testing is more sensitive than cytology, allowing for a longer screening interval. The aim of Trial23 is to investigate if primary HPV testing with cytology triage of HPV positive samples is a reasonable screening scheme for women offered HPV vaccination as girls. Trial23 is a method study embedded in the existing cervical screening programme in four out of five Danish regions. Without affecting the screening programme, women born in 1994 are randomised to present screening with liquid-based cytology every third year (present programme arm) or present screening plus an HPV test (HPV arm). The study started 1 February 2017 and will run over three screening rounds corresponding to 7-8 years. The primary endpoint is cervical intraepithelial neoplasia grade 3 or above. The trial is undertaken as a non-inferiority study including intention-to-treat and per-protocol analyses. The potential effect of primary HPV screening with a 6-year interval will be calculated from the observed data. The study protocol has been submitted to the ethical committee and deemed a method study. All women are screened according to routine guidelines. The study will contribute new evidence on the future screening of HPV vaccinated birth cohorts of women. All results will be published in open-access journal. NCT03049553; Pre-results. © 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.

Unusual Presentation of a Primary Ewing's Sarcoma of the Spine with Paraplegia: A Case Report.

PubMed

Kannan, Karthik Kailash; Sundarapandian, Rajkumar Jayachandran; Surulivel, Vignesh Jayabalan

2015-03-01

Ewing's sarcoma is a primary malignancy of the bone affecting individuals in the second decade of life. Primary sarcomas of the spine are rare and the occurrence of Primary Ewing's sarcoma in the spine is very rare. Ewing's sarcoma occurring in the spine is divided into two types, Ewing's sarcoma of sacral spine which are very aggressive with poor prognosis and Ewing's sarcoma of the non sacral spine which is an extremely rare occurrence. Patient may present with neurological deficit when the tumour extends into the spinal canal causing spinal cord compression. Magnetic resonance imaging (MRI) is very sensitive in diagnosing the tumour and defining the extent of the tumour. Here we report an 18-year-old boy who presented with back pain and complete paraplegia of two months duration. The MRI gave a differential diagnosis of infective pathology due to the fluid collection in the paraspinal region, followed by primary malignancy as the second diagnosis. Patient underwent posterior spinal decompression and stabilization, and intaoperatively there was significant collection of pus whose culture showed no growth. The histopathology and immunohistochemistry studies confirmed the diagnosis of Ewing's sarcoma and patient was started on combination chemotherapy and radiotherapy.

Primary benign brachial plexus tumors: an experience of 115 operated cases.

PubMed

Desai, Ketan I

2012-01-01

Primary benign brachial plexus tumors are rare. They pose a great challenge to the neurosurgeon, because the majority of patients present with minimal or no neurological deficits. Radical to complete excision of the tumor with preservation of neurological function of the involved nerve is an ideal surgical treatment option with benign primary brachial plexus tumor surgery. We present a review article of our 10-year experience with primary benign brachial plexus tumors surgically treated at King Edward Memorial Hospital and P.D. Hinduja National Hospital from 2000 to 2009. The clinical presentations, radiological features, surgical strategies, and the eventual outcome following surgery are analyzed, discussed, and compared with available series in the world literature. Various difficulties and problems faced in the management of primary benign brachial plexus tumors are analyzed. Irrespective of the tumor size, the indications for surgical intervention are also discussed. The goal of our study was to optimize the treatment of patients with benign brachial plexus tumors with minimal neurological deficits. It is of paramount importance that brachial plexus tumors be managed by a peripheral nerve surgeon with expertise and experience in this field to minimize the neurological insult following surgery.

Systemic amyloidosis: unusual presentation mistaken for a recurrent scabies infection.

PubMed

Haley, Erin M; Nabatian, Adam S; Kopp, Sandra A; Falasca, Gerald F; Haupt, Helen M; Halpern, Analisa V

2014-06-01

We report the case of a 63-year-old woman with a history of undifferentiated connective-tissue disease, polyarthritis, and bilateral carpal tunnel syndrome who presented with generalized pruritus and erythematous and excoriated papules on the trunk and extremities. Empiric scabies treatment was unsuccessful. Patch testing and T-cell receptor gene rearrangement studies were unremarkable. The patient was found to have mild interstitial lung disease and hypogammaglobulinemia. Eventually a diagnosis of primary systemic amyloidosis was made after she developed frank lingual hypertrophy despite normal initial serum protein electrophoresis and negative abdominal fat pad aspiration. Diagnosis was confirmed with lingual biopsy. This case demonstrates an unusual presentation of primary systemic amyloidosis consisting of arthritis and intense debilitating pruritus without primary skin lesions for a full year prior to diagnosis of multiple myeloma. The patient responded to treatment with chemotherapy and corticosteroids.

Coexistence of primary biliary cirrhosis and myasthenia gravis: a case study.

PubMed

Horigome, H; Nomura, T; Saso, K; Joh, T; Ohara, H; Akita, S; Sobue, S; Mizuno, Y; Kato, Y; Itoh, M

2000-01-01

We present a case that suggests a relationship between primary biliary cirrhosis and myasthenia gravis. A 43-year-old Japanese woman was admitted to the Nagoya City University Medical School, First Department of Internal Medicine with abnormal liver function in August 1991. She had had ptosis of the right eye since 1990. She had not been treated for liver disease. Ptosis of the right eye and hepatomegaly were present. Serum laboratory examinations revealed elevated biliary enzymes and IgM levels; tests were positive for antimitochondrial antibody and antiacetylcholine antibody. Liver histology revealed chronic non-suppurative destructive cholangitis and led to a diagnosis of primary biliary cirrhosis. The tensilon test was positive. Electromyography with repetitive motor nerve stimulation revealed a neuromuscular junction defect; i.e., the primary characteristic of myasthenia gravis. The patient was diagnosed with myasthenia gravis. Although the development of myasthenia gravis has previously been reported in patients with primary biliary cirrhosis during D-penicillamine administration, this is a very rare case of the coexistence of both diseases before such treatment.

Evaluating the primary and ready biodegradability of dianilinodithiophosphoric acid.

PubMed

Lin, Weixiong; Sun, Shuiyu; Xu, Pingting; Dai, Yongkang; Ren, Jie

2016-04-01

Dianilinodithiophosphoric acid (DDA) is widely used as sulfide mineral flotation collector in China. It is necessary to investigate the biodegradability of DDA to provide the fundamental knowledge to assess the environmental fate in the risk assessment of DDA and to design and operate the DDA flotation wastewater biological treatment plant. In the present study, the primary and ready aerobic biodegradations of DDA were studied and the primary biodegradation kinetic model of DDA was developed. The results show that DDA displays a good primary biodegradability and its biodegradation ratio reaches 99.8 % in 7 days. In contrast, DDA is not easily ready biodegradable; hence, it is a partially biodegradable organic compound. The primary aerobic biodegradation kinetics can be described using the first-order reaction kinetics equation: C = 19.72191e(-0.01513t).

Primary Bladder Neurofibroma: A Rare Case with Clinical Implications and Diagnostic Challenges.

PubMed

Umakanthan, Srikanth; Naik, Ramadas; Bukelo, Maryann Margaret; Rai, Sharada; Prabhu, Laxman

2015-09-01

Neurofibroma of the genito-urinary tract is rare. Urinary bladder is the commonest organ involved in cases of urinary tract involvement. Patients present early in life and there is male preponderance. We discuss here a case of primary neurofibroma of the urinary bladder in a 52-year-male presenting with haematuria, irritative bladder symptoms and pelvic mass. Cystoscopy showed a swelling in the left lateral wall. A transurethral biopsy revealed neurofibroma of the urinary bladder. Immunohistochemical studies confirmed the diagnosis.

Primary Bladder Neurofibroma: A Rare Case with Clinical Implications and Diagnostic Challenges

PubMed Central

Naik, Ramadas; Bukelo, Maryann Margaret; Rai, Sharada; Prabhu, Laxman

2015-01-01

Neurofibroma of the genito-urinary tract is rare. Urinary bladder is the commonest organ involved in cases of urinary tract involvement. Patients present early in life and there is male preponderance. We discuss here a case of primary neurofibroma of the urinary bladder in a 52-year-male presenting with haematuria, irritative bladder symptoms and pelvic mass. Cystoscopy showed a swelling in the left lateral wall. A transurethral biopsy revealed neurofibroma of the urinary bladder. Immunohistochemical studies confirmed the diagnosis. PMID:26500913

Charge composition of high energy heavy primary cosmic ray nuclei. Ph.D. Thesis - Catholic Univ. of Am.

NASA Technical Reports Server (NTRS)

Price, R. D.

1974-01-01

A detailed study of the charge composition of primary cosmic radiation for about 5000 charged nuclei from neon to iron with energies greater than 1.16 GeV/nucleon is presented. Values are obtained after corrections were made for detector dependences, atmospheric attenuation, and solar modulation. New values of 38.5, 32.4, 23.7, and 16.8 g/sq cm for the attenuation mean free paths in air for the same charge groups are presented.

LUTE primary mirror materials and design study report

NASA Astrophysics Data System (ADS)

Ruthven, Greg

1993-02-01

The major objective of the Lunar Ultraviolet Telescope Experiment (LUTE) Primary Mirror Materials and Design Study is to investigate the feasibility of the LUTE telescope primary mirror. A systematic approach to accomplish this key goal was taken by first understanding the optical, thermal, and structural requirements and then deriving the critical primary mirror-level requirements for ground testing, launch, and lunar operations. After summarizing the results in those requirements which drove the selection of material and the design for the primary mirror are discussed. Most important of these are the optical design which was assumed to be the MSFC baseline (i.e. 3 mirror optical system), telescope wavefront error (WFE) allocations, the telescope weight budget, and the LUTE operational temperature ranges. Mechanical load levels, reflectance and microroughness issues, and options for the LUTE metering structure were discussed and an outline for the LUTE telescope sub-system design specification was initiated. The primary mirror analysis and results are presented. The six material substrate candidates are discussed and four distinct mirror geometries which are considered are shown. With these materials and configurations together with varying the location of the mirror support points, a total of 42 possible primary mirror designs resulted. The polishability of each substrate candidate was investigated and a usage history of 0.5 meter and larger precision cryogenic mirrors (the operational low end LUTE temperature of 60 K is the reason we feel a survey of cryogenic mirrors is appropriate) that were flown or tested are presented.

LUTE primary mirror materials and design study report

NASA Technical Reports Server (NTRS)

Ruthven, Greg

1993-01-01

The major objective of the Lunar Ultraviolet Telescope Experiment (LUTE) Primary Mirror Materials and Design Study is to investigate the feasibility of the LUTE telescope primary mirror. A systematic approach to accomplish this key goal was taken by first understanding the optical, thermal, and structural requirements and then deriving the critical primary mirror-level requirements for ground testing, launch, and lunar operations. After summarizing the results in those requirements which drove the selection of material and the design for the primary mirror are discussed. Most important of these are the optical design which was assumed to be the MSFC baseline (i.e. 3 mirror optical system), telescope wavefront error (WFE) allocations, the telescope weight budget, and the LUTE operational temperature ranges. Mechanical load levels, reflectance and microroughness issues, and options for the LUTE metering structure were discussed and an outline for the LUTE telescope sub-system design specification was initiated. The primary mirror analysis and results are presented. The six material substrate candidates are discussed and four distinct mirror geometries which are considered are shown. With these materials and configurations together with varying the location of the mirror support points, a total of 42 possible primary mirror designs resulted. The polishability of each substrate candidate was investigated and a usage history of 0.5 meter and larger precision cryogenic mirrors (the operational low end LUTE temperature of 60 K is the reason we feel a survey of cryogenic mirrors is appropriate) that were flown or tested are presented.

Primary pleuropulmonary synovial sarcoma with brain metastases in a paediatric patient: an unusual presentation.

PubMed

Chirmade, Pushpak Chandrakant; Parikh, Sonia; Anand, Asha; Panchal, Harsha; Patel, Apurva; Shah, Sandip

2017-01-01

Primary lung neoplasms are rare in children. The most common primary lung malignancies in children are pleuropulmonary blastoma and carcinoid tumour. Synovial sarcoma (SS) accounts for approximately 1% of all childhood malignancies. In absolute terms, the SS of the lungs and pleura are extremely rare and pose a diagnostic difficulty. Soft tissue sarcomas usually have a high potential for metastases, however, metastasis to the brain is rare, even in widely disseminated disease, and it has been described only in 3 case reports previously. Primary pleuropulmonary SS with brain metastases is even rarer. Here we present a case of an 11-year-old boy who presented with respiratory complaints, viz. fever and cough for 20 days. Initial impression was lung abscess, however, on histopathological, immunohistochemical and molecular study, the disorder was diagnosed as synovial sarcoma. After a week from the first consult, the child developed neurological symptoms, viz., an episode of convulsion and gradually worsening power of the lower limb. Computed tomography scan and Magnetic Resonance Spectroscopy was suggestive of brain metastases. Given the rarity of primary lung neoplasms in children, clinical detection remains a challenge. Delayed diagnoses are common as respiratory symptoms may be attributed to inflammatory or infective processes. Primary pleuropulmonary synovial sarcoma is a rare tumour and it is not known to commonly metastasise to the brain. Though rare, primary pleuropulmonary SS should be considered an important differential among peadiatric primary lung neoplasms due to its potential for curability if detected early, and more aggressive metastatic pattern, e.g. brain metastases making early detection imperative.

Hyperhidrosis Prevalence and Demographical Characteristics in Dermatology Outpatients in Shanghai and Vancouver

PubMed Central

Kalia, Sunil; Huang, Rachel Yuanshen; Phillips, Arlie; Su, Mingwan; Yang, Sen; Zhang, Xuejun; Zhou, Pingyu; Zhou, Youwen

2016-01-01

Background There is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence. Objectives This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations. Methods In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence. Results The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in Shanghai and Vancouver. Limitations The data were gathered according to patients’ self-reports only and the sample size was relatively small in some groups after stratification for gender, ethnicity and age. Conclusion Prevalence of primary HH and late-onset HH is similar in dermatology outpatients independent of geographical locations. However, certain specific HH subtypes can show great variations according to ethnicity, age, body mass index and sex. PMID:27105064

Nocardia yamanashiensis in an immunocompromised patient presenting as an indurated nodule on the dorsal hand.

PubMed

Anzalone, C Lane; Cohen, Philip R; Tarrand, Jeffrey J; Diwan, Abdul H; Prieto, Victor G

2013-01-01

Nocardia are ubiquitous, aerobic, gram-positive actinomycetes. Nocardiosis typically occurs in immunocompromised patients, although immunocompetent individuals can also be affected. The purpose of this case study is to review the clinical characteristics and treatments of a unique form of cutaneous nocardiosis. We retrospectively reviewed the medical literature using PubMed, searching the terms cutaneous, host, immunocompromised, Nocardia, primary, yamanashiensis. Patient reports and previous reviews of the subject were critically assessed and the salient features are presented. Cutaneous nocardiosis typically presents as pustular nodules and the lesions may progress to become abscesses, cellulitis, granulomas or keloid-like tumors. N. brasiliensis is the predominant species involved in primary cutaneous nocardiosis; other common Nocardia species involved in human disease are N. farcinica, N. abscessus, N. cyriacigeorgica, and N. nova. Only two individuals (including the patient presented here) with primary cutaneous infection by N. yamanashiensis have been described in the literature; a third clinical isolate was recovered from a lung biopsy. Nocardia yamanashiensis is a rare clinical form of primary cutaneous nocardiosis. 16S ribosomal gene sequencing, as well as Gram stain and modified Fite acid-fast stain, play a vital role in identifying this clinical variant.

Continuous Trailing-Edge Flaps for Primary Flight Control of a Helicopter Main Rotor

NASA Technical Reports Server (NTRS)

Thornburgh, Robert P.; Kreshock, Andrew R.; Wilbur, Matthew L.; Sekula, Martin K.; Shen, Jinwei

2014-01-01

The use of continuous trailing-edge flaps (CTEFs) for primary flight control of a helicopter main rotor is studied. A practical, optimized bimorph design with Macro-Fiber Composite actuators is developed for CTEF control, and a coupled structures and computational fluid dynamics methodology is used to study the fundamental behavior of an airfoil with CTEFs. These results are used within a comprehensive rotorcraft analysis model to study the control authority requirements of the CTEFs when utilized for primary flight control of a utility class helicopter. A study of the effect of blade root pitch index (RPI) on CTEF control authority is conducted, and the impact of structural and aerodynamic model complexity on the comprehensive analysis results is presented. The results show that primary flight control using CTEFs is promising; however, a more viable option may include the control of blade RPI, as well.

Unusual recurrent tongue spindle cell carcinoma with marked anaplasia occurring at the site of glossectomy for a well-differentiated squamous cell carcinoma: A case report.

PubMed

Okuyama, Kohei; Fujita, Shuichi; Yanamoto, Souichi; Naruse, Tomofumi; Sakamoto, Yuki; Kawakita, Akiko; Omori, Keisuke; Tsuchihashi, Hiroki; Umeda, Masahiro

2017-09-01

Spindle cell carcinoma (SpCC), which predominantly arises in the oral, pharyngeal and laryngeal mucosal tissues, is composed of a mixture of squamous and sarcomatoid components. The present study describes the case of a 62-year-old woman with SpCC recurrence 4 years after an initial surgery to remove a well-differentiated primary squamous cell carcinoma (SCC) of the tongue. The recurrent tumor was spherical and located deep within the tongue tissue, which differs from the typical manifestation of ulcerated masses of the mucosa. The majority of cases of recurrence involving SpCC are associated with radiotherapeutic treatment of the primary malignancy; however, the patient in the present study had not received postoperative radiotherapy for SCC. Furthermore, the recurrent tumor in the present case exhibited marked anaplasia and sarcomatoid features, and the absence of SCC elements upon biopsy rendered histological diagnosis difficult. In summary, the present findings suggest that immunohistochemical examination and identification of SCC components are essential for ensuring the accuracy of the histological diagnosis of recurrent SpCC following a primary epithelial malignancy.

Unusual recurrent tongue spindle cell carcinoma with marked anaplasia occurring at the site of glossectomy for a well-differentiated squamous cell carcinoma: A case report

PubMed Central

Okuyama, Kohei; Fujita, Shuichi; Yanamoto, Souichi; Naruse, Tomofumi; Sakamoto, Yuki; Kawakita, Akiko; Omori, Keisuke; Tsuchihashi, Hiroki; Umeda, Masahiro

2017-01-01

Spindle cell carcinoma (SpCC), which predominantly arises in the oral, pharyngeal and laryngeal mucosal tissues, is composed of a mixture of squamous and sarcomatoid components. The present study describes the case of a 62-year-old woman with SpCC recurrence 4 years after an initial surgery to remove a well-differentiated primary squamous cell carcinoma (SCC) of the tongue. The recurrent tumor was spherical and located deep within the tongue tissue, which differs from the typical manifestation of ulcerated masses of the mucosa. The majority of cases of recurrence involving SpCC are associated with radiotherapeutic treatment of the primary malignancy; however, the patient in the present study had not received postoperative radiotherapy for SCC. Furthermore, the recurrent tumor in the present case exhibited marked anaplasia and sarcomatoid features, and the absence of SCC elements upon biopsy rendered histological diagnosis difficult. In summary, the present findings suggest that immunohistochemical examination and identification of SCC components are essential for ensuring the accuracy of the histological diagnosis of recurrent SpCC following a primary epithelial malignancy. PMID:28781811

Primary School Children and Self Harm: The Emotional Impact upon Education Professionals, and Their Understandings of Why Children Self Harm and How This Is Managed

ERIC Educational Resources Information Center

Simm, Rebecca; Roen, Katrina; Daiches, Anna

2010-01-01

There is evidence suggesting that self harm among young people is beginning earlier, in childhood and adolescent years. This paper reports on a qualitative study of primary school staff responses to self harm among children. Some studies with adolescents show self harm presents challenges to education professionals who may lack training or…

The 747 primary flight control systems reliability and maintenance study

NASA Technical Reports Server (NTRS)

1979-01-01

The major operational characteristics of the 747 Primary Flight Control Systems (PFCS) are described. Results of reliability analysis for separate control functions are presented. The analysis makes use of a NASA computer program which calculates reliability of redundant systems. Costs for maintaining the 747 PFCS in airline service are assessed. The reliabilities and cost will provide a baseline for use in trade studies of future flight control system design.

History of Physics as a Tool to Detect the Conceptual Difficulties Experienced by Students: The Case of Simple Electric Circuits in Primary Education

ERIC Educational Resources Information Center

Leone, Matteo

2014-01-01

The present paper advocates the use of History of Science into the teaching of science in primary education through a case study in the field of electricity. In this study, which provides both historical and experimental evidence, a number of conceptual difficulties faced by early nineteenth century physicists are shown to be a useful tool to…

Prevalence of methicillin-resistant staphylococci in canine pyoderma cases in primary care veterinary practices in Canada: A preliminary study.

PubMed

Joffe, Daniel; Goulding, Fiona; Langelier, Ken; Magyar, Gabor; McCurdy, Les; Milstein, Moe; Nielsen, Kia; Villemaire, Stephanie

2015-10-01

Pyoderma in dogs is most commonly caused by Staphylococcus spp., and significant emergence of methicillin resistance in staphylococcal pyoderma has been reported. This preliminary study of the prevalence of methicillin resistance in canine pyoderma cases in Canadian primary care veterinary practices revealed that methicillin-resistant Staphylococcus spp. were present in 12.1% of 149 staphylococcal positive skin culture cases.

Mechanism of free radical generation in platelets and primary hepatocytes: A novel electron spin resonance study.

PubMed

Wang, Chiun-Lang; Yang, Po-Sheng; Tsao, Jeng-Ting; Jayakumar, Thanasekaran; Wang, Meng-Jiy; Sheu, Joen-Rong; Chou, Duen-Suey

2018-01-01

Oxygen free radicals have been implicated in the pathogenesis of toxic liver injury and are thought to be involved in cardiac dysfunction in the cirrhotic heart. Therefore, direct evidence for the electron spin resonance (ESR) detection of how D‑galactosamine (GalN), an established experimental hepatotoxic substance, induced free radicals formation in platelets and primary hepatocytes is presented in the present study. ESR results demonstrated that GalN induced hydroxyl radicals (OH•) in a resting human platelet suspension; however, radicals were not produced in a cell free Fenton reaction system. The GalN‑induced OH• formation was significantly inhibited by the cyclooxygenase (COX) inhibitor indomethasin, though it was not affected by the lipoxygenase (LOX) or cytochrome P450 inhibitors, AA861 and 1‑aminobenzotriazole (ABT), in platelets. In addition, the present study demonstrated that baicalein induced semiquinone free radicals in platelets, which were significantly reduced by the COX inhibitor without affecting the formed OH•. In the mouse primary hepatocytes, the formation of arachidonic acid (AA) induced carbon‑centered radicals that were concentration dependently enhanced by GalN. These radicals were inhibited by AA861, though not affected by indomethasin or ABT. In addition, GalN did not induce platelet aggregation prior to or following collagen pretreatment in human platelets. The results of the present study indicated that GalN and baicalein may induce OH• by COX and LOX in human platelets. GalN also potentiated AA induced carbon‑centered radicals in hepatocytes via cytochrome P450. The present study presented the role of free radicals in the pathophysiological association between platelets and hepatocytes.

Effect of implant macro-design on primary stability: A prospective clinical study.

PubMed

Lozano-Carrascal, Naroa; Salomó-Coll, Oscar; Gilabert-Cerdà, Marta; Farré-Pagés, Nuria; Gargallo-Albiol, Jordi; Hernández-Alfaro, Federico

2016-03-01

Implant restorations have become a high predictable treatment option. Several caracteristics such as surgical technique and implant design can influence the treatment outcomes. The aim of the present study was to evaluate the influence of implant macro-design on primary stability measured with resonance frequency analysis (RFA) and insertion torque (IT). Material and Mehods: A total of 47 implants divided in two groups: Test group (TI): 22 Tapered MIS® Seven implants; Control group (CI): 25 cylindrical Astra® Osseospeed implants. All implants were inserted following the manufacturers' standard protocols. Implant primary stability was measured at the moment of implant placement by registering insertion torque values (ITv) and ISQ values by means of Osstell™ Mentor (ISQv) (Integration Diagnostic Ltd., Goteborg, Sweden). In the mandible, mean ISQv for tapered implants (TI) was 71.67±5.16 and for cylindrical implants (CI) 57.15±4.83 (p=0.01). Mean insertion torque was 46.67±6.85 Ncm for TI and 35.77±6.72 Ncm for CI (p=0.01). In the maxilla, mean ISQ was 67.2±4.42 for tapered implants and 49.17±15.30 for cylindrical implants (p=0.01). Mean insertion torque for TI was 41.5±6.26 Ncm and for CI 39.17±6.34 Ncm (p>0.05). For tapered implants, no correlation could be found between implant diameter and primary stability. But for cylindrical implants there was a statistically significant correlation between implant diameter and primary stability: ITv (p=0.03); ISQv (p=0.04). Within the limits of the present study, tapered shaped implants achieve higher primary stability measured through ISQ and insertion torque values. Moreover, for cylindrical implants positive correlation has been established between implant diameter and primary stability.

Outsourcing Physical Education in Primary Schools: Evaluating the Impact of Externally Provided Programmes on Generalist Teachers

ERIC Educational Resources Information Center

Whipp, Peter R.; Hutton, Heidi; Grove, J. Robert; Jackson, Ben

2011-01-01

In place of generalist delivery, externally provided physical activity programmes (EPPAPs) are potentially an effective method for offering primary school students specialist physical education (PE) instruction, as well as providing training for generalist classroom teachers. In the present study, a group of generalist teachers were interviewed…

Accountability Practices in the History of Danish Primary Public Education from the 1660s to the Present

ERIC Educational Resources Information Center

Ydesen, Christian; Andreasen, Karen E.

2014-01-01

This paper focuses on primary education accountability as a concept and as an organizational practice in the history of Danish public education. Contemporary studies of education policy often address questions of accountability, but the manifestations of school accountability differ significantly between different national settings. Furthermore,…

Primary School Leadership in England: Performativity and Matters of Professionalism

ERIC Educational Resources Information Center

Keddie, Amanda

2017-01-01

This article presents interview data from a study involving nine primary school leaders. Five are leaders of local authority schools while four are leaders of schools within a large academy chain. The article examines their perspectives about the current regimes of performativity in the English education context and, in particular, the…

Literacy in ESL: Pedagogical and Cultural Pathfinding in Fiji.

ERIC Educational Resources Information Center

Lotherington-Woloszyn, Heather

Although English is a colonial heritage in Fiji, it links the country's different ethnic groups and is the language of instruction for formal education. This paper examines pedagogical and cultural implications of the present primary English curriculum, based on findings from an empirical study of primary English teaching in Fiji. It reviews the…

The Experience of the Hidden Curriculum for Autistic Girls at Mainstream Primary Schools

ERIC Educational Resources Information Center

Moyse, R.; Porter, J.

2015-01-01

This article presents the findings of ethnographic case studies of three girls on the autistic spectrum attending mainstream primary schools and illustrates the difficulties they experience and the ways in which these are often unrecognised. The observations of the girls and subsequent individual interviews with their mothers, class teachers,…

Semantic Categorization and Reading Skill across Dutch Primary Grades: Development Yes, Relationship No

ERIC Educational Resources Information Center

Gijsel, Martine A. R.; Ormel, Ellen A.; Hermans, Daan; Verhoeven, L.; Bosman, Anna M. T.

2011-01-01

In the present study, the development of semantic categorization and its relationship with reading was investigated across Dutch primary grade students. Three Exemplar-level tasks (Experiment 1) and two Superordinate-level tasks (Experiment 2) with different types of distracters (phonological, semantic and perceptual) were administered to assess…

Empathy and Critical Thinking: Primary Students Solving Local Environmental Problems through Outdoor Learning

ERIC Educational Resources Information Center

Ampuero, David; Miranda, Christian E.; Delgado, Luisa E.; Goyen, Samantha; Weaver, Sean

2015-01-01

The present study explores the outcomes of teaching empathy and critical thinking to solve environmental problems. This investigation was done throughout the duration of an environmental education course within a primary school located in central Chile. A community-based research methodology was used to understand the formation of empathy and…

From Earth to Space--Advertising Films Created in a Computer-Based Primary School Task

ERIC Educational Resources Information Center

Öman, Anne

2017-01-01

Today, teachers orchestrate computer-based tasks in software applications in Swedish primary schools. Meaning is made through various modes, and multimodal perspectives on literacy have the basic assumption that meaning is made through many representational and communicational resources. The case study presented in this paper has analysed pupils'…

Measuring ICT Use and Contributing Conditions in Primary Schools

ERIC Educational Resources Information Center

Vanderlinde, Ruben; Aesaert, Koen; van Braak, Johan

2015-01-01

Information and communication technology (ICT) use became of major importance for primary schools across the world as ICT has the potential to foster teaching and learning processes. ICT use is therefore a central measurement concept (dependent variable) in many ICT integration studies. This data paper presents two datasets (2008 and 2011) that…

Teachers' Views about Pupil Diversity in the Primary School Classroom

ERIC Educational Resources Information Center

Kaldi, Stavroula; Govaris, Christos; Filippatou, Diamanto

2018-01-01

The present study explores Greek primary school teachers' perceptions and views on pupil diversity in the classroom environment. A large-scale survey was carried out in order to examine teachers' perceptions about pupil diversity and to identify personal and/or educational characteristics that can influence or predict these perceptions. The…

The Contribution of Segmental and Suprasegmental Phonology to Reading Comprehension

ERIC Educational Resources Information Center

Veenendaal, Nathalie J.; Groen, Margriet A.; Verhoeven, Ludo

2016-01-01

The aim of the present study was to examine the relation between decoding and segmental and suprasegmental phonology, and their contribution to reading comprehension, in the upper primary grades. Following a longitudinal design, the performance of 99 Dutch primary school students on phonological awareness (segmental phonology) and text-reading…

Beginning a Journey with Music Education: Voices from Pre-Service Primary Teachers

ERIC Educational Resources Information Center

Kenny, Ailbhe

2017-01-01

This study examines pre-service primary teachers' first engagement with music education at university level in the Republic of Ireland. Data from focus group interviews and coursework present voices from the students in prolematising their learning journeys with music education. These qualitative research methods are used to investigate student…

Love Is Bad for You: Parables and Practical Fictions in the Romantic Primary Classroom

ERIC Educational Resources Information Center

Galman, Sally Campbell

2014-01-01

This article presents tentative findings from an ongoing study of female preservice teachers' stories about love, gender, and work in primary level (K-6) teacher preparation. Analyses of data from 26 phenomenological interviews with White, female pre-service teachers enrolled in teacher preparation programs frames one sample participant "love…

A Digital View of History: Drawing and Discussing Models of Historical Concepts

ERIC Educational Resources Information Center

Manfra, Meghan McGlinn; Coven, Robert M.

2011-01-01

Digital history refers to "the study of the past using a variety of electronically reproduced primary source texts, images, and artifacts as well as the constructed narratives, accounts, or presentations that result from digital historical inquiry." Access to digitized primary sources can promote active instruction in historical thinking. A…

Intensity-modulated radiotherapy for cervical node squamous cell carcinoma metastases from unknown head-and-neck primary site: M. D. Anderson Cancer Center outcomes and patterns of failure.

PubMed

Frank, Steven J; Rosenthal, David I; Petsuksiri, Janjira; Ang, K Kian; Morrison, William H; Weber, Randal S; Glisson, Bonnie S; Chao, K S Clifford; Schwartz, David L; Chronowski, Gregory M; El-Naggar, Adel K; Garden, Adam S

2010-11-15

Conventional therapy for cervical node squamous cell carcinoma metastases from an unknown primary can cause considerable toxicity owing to the volume of tissues to be irradiated. In the present study, hypothesizing that using intensity-modulated radiotherapy (IMRT) would provide effective treatment with minimal toxicity, we reviewed the outcomes and patterns of failure for head-and-neck unknown primary cancer at a single tertiary cancer center. We retrospectively reviewed the records of 52 patients who had undergone IMRT for an unknown primary at M.D. Anderson Cancer Center between 1998 and 2005. The patient and treatment characteristics were extracted and the survival rates calculated using the Kaplan-Meier method. Of the 52 patients, 5 presented with Stage N1, 11 with Stage N2a, 23 with Stage N2b, 6 with Stage N2c, 4 with Stage N3, and 3 with Stage Nx disease. A total of 26 patients had undergone neck dissection, 13 before and 13 after IMRT; 14 patients had undergone excisional biopsy and presented for IMRT without evidence of disease. Finally, 14 patients had received systemic chemotherapy. All patients underwent IMRT to targets on both sides of the neck and pharyngeal axis. The median follow-up time for the surviving patients was 3.7 years. The 5-year actuarial rate of primary mucosal tumor control and regional control was 98% and 94%, respectively. Only 3 patients developed distant metastasis with locoregional control. The 5-year actuarial disease-free and overall survival rate was 88% and 89%, respectively. The most severe toxicity was Grade 3 dysphagia/esophageal stricture, experienced by 2 patients. The results of our study have shown that IMRT can produce excellent outcomes for patients who present with cervical node squamous cell carcinoma metastases from an unknown head-and-neck primary tumor. Severe late complications were uncommon. Copyright © 2010 Elsevier Inc. All rights reserved.

Intensity-Modulated Radiotherapy for Cervical Node Squamous Cell Carcinoma Metastases From Unknown Head-and-Neck Primary Site: M. D. Anderson Cancer Center Outcomes and Patterns of Failure

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

Frank, Steven J., E-mail: sjfrank@mdanderson.or; Rosenthal, David I.; Petsuksiri, Janjira

2010-11-15

Purpose: Conventional therapy for cervical node squamous cell carcinoma metastases from an unknown primary can cause considerable toxicity owing to the volume of tissues to be irradiated. In the present study, hypothesizing that using intensity-modulated radiotherapy (IMRT) would provide effective treatment with minimal toxicity, we reviewed the outcomes and patterns of failure for head-and-neck unknown primary cancer at a single tertiary cancer center. Methods and Materials: We retrospectively reviewed the records of 52 patients who had undergone IMRT for an unknown primary at M.D. Anderson Cancer Center between 1998 and 2005. The patient and treatment characteristics were extracted and themore » survival rates calculated using the Kaplan-Meier method. Results: Of the 52 patients, 5 presented with Stage N1, 11 with Stage N2a, 23 with Stage N2b, 6 with Stage N2c, 4 with Stage N3, and 3 with Stage Nx disease. A total of 26 patients had undergone neck dissection, 13 before and 13 after IMRT; 14 patients had undergone excisional biopsy and presented for IMRT without evidence of disease. Finally, 14 patients had received systemic chemotherapy. All patients underwent IMRT to targets on both sides of the neck and pharyngeal axis. The median follow-up time for the surviving patients was 3.7 years. The 5-year actuarial rate of primary mucosal tumor control and regional control was 98% and 94%, respectively. Only 3 patients developed distant metastasis with locoregional control. The 5-year actuarial disease-free and overall survival rate was 88% and 89%, respectively. The most severe toxicity was Grade 3 dysphagia/esophageal stricture, experienced by 2 patients. Conclusion: The results of our study have shown that IMRT can produce excellent outcomes for patients who present with cervical node squamous cell carcinoma metastases from an unknown head-and-neck primary tumor. Severe late complications were uncommon.« less

Design development of graphite primary structures enables SSTO success

NASA Astrophysics Data System (ADS)

Biagiotti, V. A.; Yahiro, J. S.; Suh, Daniel E.; Hodges, Eric R.; Prior, Donald J.

1997-01-01

This paper describes the development of a graphite composite wing and a graphite composite intertank primary structure for application toward Single-Stage to Orbit space vehicles such as those under development in NASA's X-33/Reusable Launch Vehicle (RLV) Program. The trade study and designs are based on a Rockwell vertical take-off and horizontal landing (VTHL) wing-body RLV vehicle. Northrop Grumman's approach using a building block development technique is described. Composite Graphite/Bismaleimide (Gr/BMI) material characterization test results are presented. Unique intertank and wing composite subcomponent test article designs are described and test results to date are presented. Wing and intertank Full Scale Section Test Article (FSTA) objectives and designs are outlined. Trade studies, supporting building block testing, and FSTA demonstrations combine to develop graphite primary structure composite technology that enables developing X-33/RLV design programs to meet critical SSTO structural weight and operations performance criteria.

[Working conditions and common mental disorders among primary health care workers from Botucatu, São Paulo State].

PubMed

Braga, Ludmila Candida de; Carvalho, Lidia Raquel de; Binder, Maria Cecília Pereira

2010-06-01

Common mental disorders (CMD) present high prevalence among general populations and workers with important individual and social consequences. This cross-sectional and descriptive study explores the relationship between psychological job demands, job control degree and job support and prevalence of CMD among primary health care workers of Botucatu - SP. The data collection was carried out using an unidentified self-administered questionnaire, with emphasis on items relating to demand-control-support situation and occurrence of CMD (Self Reporting Questionnaire, SRQ-20). The data were stored using the software Excel / Office XP 2003, and the statistical analyses were performed in SAS system. It was evidenced that 42.6% of primary health care workers presented CMD. The observed association - high prevalence of CMD with high-strain job (Karasek model) and low prevalence of CMD with low-strain job - indicates that, in the studied city, primary health care work conditions are contributive factors to workers' illness. The survey reveals the need of interventions aiming at caring the workers and also gets better work conditions and increase social support at work.

Determinants of late presentation for induced abortion care.

PubMed

Waddington, Ashley; Hahn, Philip M; Reid, Robert

2015-01-01

To determine whether demographic or patient factors contribute to later presentation (10 to 12 weeks' gestational age) for induced abortion in a Canadian abortion clinic. Women attending a hospital-based abortion clinic between April and September 2012 were asked to complete a survey. The characteristics of women who presented early (EPs; gestational age < 10 weeks) were compared with those of late presenters (LPs; gestational age ≥ 10 weeks) using t tests for means and Fisher exact tests for rates. Among women referred to the clinic by a primary care provider, LPs were more likely than EPs to report "a delay in obtaining a referral" (20.8% vs. 6.1%; P = 0.007). While there was no significant difference between the groups in reporting that "someone tried to discourage [them] from having an abortion" (26.45% for EPs, 32.4% for LPs; P = 0.421), LPs were more likely to report that discouragement "caused a delay in making arrangements" (45.5% vs. 16.7%; P = 0.019). Of women who had access to a primary care provider, it was more common for the primary care provider to be aware of the pregnancy among LPs than among EPs (80.6% vs. 63.1%; P = 0.015). Some women delay presenting for abortion because of discouragement from friends and family. It is unclear whether there are educational or policy interventions that can have an impact on this delay, and this warrants further study. There may be ways of addressing the delay in referral by primary care providers. Further study into the causes for delay in referral for abortion is warranted.

[Primary hyperaldosteronism due to unilateral adrenal hyperplasia with surgical resolution].

PubMed

Rubio-Puchol, O; Garzón-Pastor, S; Salom-Vendrell, C; Hernández-Mijares, A

Unilateral adrenal hyperplasia is a rare cause of primary hyperaldosteronism (around a 3%) that has surgical treatment. A case of a patient with hypertension resistant to conventional therapy in treatment with 7 drugs who presented with primary hyperaldosteronism due to unilateral adrenal hyperplasia is presented. A left adrenalectomy was performed, and the patient had a good clinical response, with no need of any drug after 2 years of surgery. Unilateral adrenal hyperplasia is a different entity and it is not an asymmetric variant of the bilateral adrenal hyperplasia. In the study of patients with primary hyperaldosteronism and imaging tests with absence of adenoma is a diagnosis that must be considered before cataloguing patients with bilateral adrenal hyperplasia and start a medical treatment, because unilateral adrenal hyperplasia would have a surgical resolution. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

Antibiotic resistance rates and physician antibiotic prescription patterns of uncomplicated urinary tract infections in southern Chinese primary care

PubMed Central

Kung, Kenny; Au-Doung, Philip Lung Wai; Ip, Margaret; Lee, Nelson; Fung, Alice; Wong, Samuel Yeung Shan

2017-01-01

Uncomplicated urinary tract infections (UTI) are common in primary care. Whilst primary care physicians are called to be antimicrobial stewards, there is limited primary care antibiotic resistance surveillance and physician antibiotic prescription data available in southern Chinese primary care. The study aimed to investigate the antibiotic resistance rate and antibiotic prescription patterns in female patients with uncomplicated UTI. Factors associated with antibiotic resistance and prescription was explored. A prospective cohort study was conducted in 12 primary care group clinics in Hong Kong of patients presenting with symptoms of uncomplicated UTI from January 2012 to December 2013. Patients’ characteristics such as age, comorbidity, presenting symptoms and prior antibiotic use were recorded by physicians, as well as any empirical antibiotic prescription given at presentation. Urine samples were collected to test for antibiotic resistance of uropathogens. Univariate analysis was conducted to identify factors associated with antibiotic resistance and prescription. A total of 298 patients were included in the study. E. coli was detected in 107 (76%) out of the 141 positive urine samples. Antibiotic resistance rates of E. coli isolates for ampicillin, co-trimoxazole, ciprofloxacin, amoxicillin and nitrofurantoin were 59.8%, 31.8%, 23.4%, 1.9% and 0.9% respectively. E. coli isolates were sensitive to nitrofurantoin (98.1%) followed by amoxicillin (78.5%). The overall physician antibiotic prescription rate was 82.2%. Amoxicillin (39.6%) and nitrofurantoin (28.6%) were the most common prescribed antibiotics. Meanwhile, whilst physicians in public primary care prescribed more amoxicillin (OR: 2.84, 95% CI: 1.67 to 4.85, P<0.001) and nitrofurantoin (OR: 2.01, 95% CI: 1.14 to 3.55, P = 0.015), physicians in private clinics prescribed more cefuroxime and ciprofloxacin (P<0.05). Matching of antibiotic prescription and antibiotic sensitivity of E. coli isolates occurred in public than private primary care prescriptions (OR: 6.72, 95% CI: 2.07 to 21.80 P = 0.001) and for other uropathogens (OR: 6.19, 95% CI: 1.04 to 36.78 P = 0.034). Mismatching differences of antibiotic prescription and resistance were not evident. In conclusion, nitrofurantoin and amoxicillin should be used as first line antibiotic treatment for uncomplicated UTI. There were significant differences in antibiotic prescription patterns between public and private primary care. Public primary care practitioners were more likely to prescribe first line antibiotic treatment which match antibiotic sensitivity of E. coli isolates and other uropathogens. Further exploration of physician prescribing behaviour and educational interventions, particularly in private primary care may helpful. Meanwhile, development and dissemination of guidelines for primary care management of uncomplicated UTI as well as continued surveillance of antibiotic resistance and physician antibiotic prescription is recommended. PMID:28486532

Do colorectal cancer patients diagnosed as an emergency differ from non-emergency patients in their consultation patterns and symptoms? A longitudinal data-linkage study in England

PubMed Central

Renzi, C; Lyratzopoulos, G; Card, T; Chu, T P C; Macleod, U; Rachet, B

2016-01-01

Background: More than 20% of colorectal cancers are diagnosed following an emergency presentation. We aimed to examine pre-diagnostic primary-care consultations and related symptoms comparing patients diagnosed as emergencies with those diagnosed through non-emergency routes. Methods: Cohort study of colorectal cancers diagnosed in England 2005 and 2006 using cancer registration data individually linked to primary-care data (CPRD/GPRD), allowing a detailed analysis of clinical information referring to the 5-year pre-diagnostic period. Results: Emergency diagnosis occurred in 35% and 15% of the 1029 colon and 577 rectal cancers. ‘Background' primary-care consultations (2–5 years before diagnosis) were similar for either group. In the year before diagnosis, >95% of emergency and non-emergency presenters had consulted their doctor, but emergency presenters had less frequently relevant symptoms (colon cancer: 48% vs 71% (P<0.001); rectal cancer: 49% vs 61% (P=0.043)). ‘Alarm' symptoms were recorded less frequently in emergency presenters (e.g., rectal bleeding: 9 vs 24% (P=0.002)). However, about 1/5 of emergency presenters (18 and 23% for colon and rectal cancers) had ‘alarm' symptoms the year before diagnosis. Conclusions: Emergency presenters have similar ‘background' consultation history as non-emergency presenters. Their tumours seem associated with less typical symptoms, however opportunities for earlier diagnosis might be present in a fifth of them. PMID:27537389

Loss of Proliferation and Antigen Presentation Activity following Internalization of Polydispersed Carbon Nanotubes by Primary Lung Epithelial Cells

PubMed Central

Kumari, Mandavi; Sachar, Sumedha; Saxena, Rajiv K.

2012-01-01

Interactions between poly-dispersed acid functionalized single walled carbon nanotubes (AF-SWCNTs) and primary lung epithelial (PLE) cells were studied. Peritoneal macrophages (PMs, known phagocytic cells) were used as positive controls in this study. Recovery of live cells from cultures of PLE cells and PMs was significantly reduced in the presence of AF-SWCNTs, in a time and dose dependent manner. Both PLE cells as well as PMs could take up fluorescence tagged AF-SWCNTs in a time dependent manner and this uptake was significantly blocked by cytochalasin D, an agent that blocks the activity of acto-myosin fibers and therefore the phagocytic activity of cells. Confocal microscopic studies confirmed that AF-SWCNTs were internalized by both PLE cells and PMs. Intra-trachially instilled AF-SWCNTs could also be taken up by lung epithelial cells as well as alveolar macrophages. Freshly isolated PLE cells had significant cell division activity and cell cycling studies indicated that treatment with AF-SWCNTs resulted in a marked reduction in S-phase of the cell cycle. In a previously standardized system to study BCG antigen presentation by PLE cells and PMs to sensitized T helper cells, AF-SWCNTs could significantly lower the antigen presentation ability of both cell types. These results show that mouse primary lung epithelial cells can efficiently internalize AF-SWCNTs and the uptake of nanotubes interfered with biological functions of PLE cells including their ability to present BCG antigens to sensitized T helper cells. PMID:22384094

rs3806268 of NLRP3 gene polymorphism is associated with the development of primary gout.

PubMed

Deng, Jianping; Lin, Wen; Chen, Yunpeng; Wang, Xin; Yin, Zhong; Yao, Chunhong; Liu, Tangbing; Lv, Yonghong

2015-01-01

The aim of the present study was to investigate the association between seven functional SNPs in NALP3 gene and the susceptibility to primary gout. A total of 247 patients with primary gout and 247 controls were selected in this study. Genotyping of NALP3 rs4612666, rs3806268, rs12239046, rs10754558, rs7512998, rs12137901 and rs12565738 was performed using the Sequenom MassARRAY platform. Comparison analysis showed that primary gout patients were more likely to have a higher body mass index, DBP, SBP, TG, urea nitrogen and uric acid (P < 0.05). According to logistic regression analysis, individuals carrying with the GG genotype of rs3806268 were associated with increased risk of primary gout when compared with the AA genotype (OR=1.83, 95% CI=1.03-3.26). However, no significant associations were identified for the remaining SNPs. In conclusion, we found a significant association between rs3806268 in NLRP3 gene and the risk of primary gout in a Chinese population. Further clinical and genetic studies are required to investigate the mechanisms underlying the association between NALP3 polymorphisms and the development of primary gout.

Jordanian Preservice Primary Teachers' Perceptions of Mentoring in Science Teaching

NASA Astrophysics Data System (ADS)

Abed, Osama H.; Abd-El-Khalick, Fouad

2015-03-01

Quality mentoring is fundamental to preservice teacher education because of its potential to help student and novice teachers develop the academic and pedagogical knowledge and skills germane to successful induction into the profession. This study focused on Jordanian preservice primary teachers' perceptions of their mentoring experiences as these pertain to science teaching. The Mentoring for Effective Primary Science Teaching instrument was administered to 147 senior preservice primary teachers in a university in Jordan. The results indicated that the greater majority of participants did not experience effective mentoring toward creating a supportive and reflexive environment that would bolster their confidence in teaching science; further their understanding of primary science curriculum, and associated aims and school policies; help with developing their pedagogical knowledge; and/or furnish them with specific and targeted feedback and guidance to help improve their science teaching. Substantially more participants indicated that their mentors modeled what they perceived to be effective science teaching. The study argues for the need for science-specific mentoring for preservice primary teachers, and suggests a possible pathway for achieving such a model starting with those in-service primary teachers-much like those identified by participants in the present study-who are already effective in their science teaching.

Determination of fracture toughness of human permanent and primary enamel using an indentation microfracture method.

PubMed

Hayashi-Sakai, Sachiko; Sakai, Jun; Sakamoto, Makoto; Endo, Hideaki

2012-09-01

The purpose of the present study was to examine the fracture toughness and Vickers microhardness number of permanent and primary human enamel using the indentation microfracture method. Crack resistance and a parameter indirectly related to fracture toughness were measured in 48 enamel specimens from 16 permanent teeth and 12 enamel specimens obtained from six primary teeth. The Vickers microhardness number of the middle portion was greater than the upper portion in primary enamel. The fracture toughness was highest in the middle portion of permanent enamel, because fracture toughness greatly depends upon microstructure. These findings suggest that primary teeth are not miniature permanent teeth but have specific and characteristic mechanical properties.

[Lens luxation in dogs: a retrospective study of 134 dogs (2000-2011)].

PubMed

Betschart; Hässig; Spiess

2014-03-01

This retrospective study evaluated cases of lens luxation in dogs that were documented at the University of Zurich Veterinary Teaching Hospital between 2000 and 2011. A total 134 dogs were included in the study. This population of dogs with lens luxation represents 0.41 % of all dogs presented to the Zurich Veterinary Teaching Hospital (32'523) and 3.02 % of all dogs presented to the ophthalmology service during the same time period. The 134 dogs represented over 40 different breeds, including mixed breeds. 63 of the dogs were male, 71 were female. The 134 dogs were divided in primary lens luxation (86 of the 134 dogs, 64 %) and secondary lens luxation (48 dogs, 36 %). The most frequent causes for secondary lens luxation were glaucoma (58 %), cataract (19 %) and trauma (17 %). This study shows the predisposition for primary lens luxations in terrier breeds, Chinese Crested dogs, Pinscher and Spitz. In contrast, Siberian Huskies, Basset Hounds, Bearded Collies, Cairn Terriers, mixed breed dogs, Bolonka Zwetna, Boston Terriers, Borzoi, Doberman, Eurasian, Leonberg, Luzerner Niederlaufhund and Weimaraner suffered significantly more often from secondary lens luxation. There was no sex predilection for primary or secondary lens luxation. Dogs with primary lens luxation were on average 7.39 ± 3.02 years old, which is significantly younger than the dogs with secondary lens luxation (9.12 ± 3.38 years). Dogs with primary lens luxation showed a significantly higher rate of a bilateral development than those with secondary lens luxation (85.5 % of the dogs with primary lens luxation and only 14.5 % of the dogs with secondary lens luxation showed it in both their eyes).

Medical errors in primary care clinics – a cross sectional study

PubMed Central

2012-01-01

Background Patient safety is vital in patient care. There is a lack of studies on medical errors in primary care settings. The aim of the study is to determine the extent of diagnostic inaccuracies and management errors in public funded primary care clinics. Methods This was a cross-sectional study conducted in twelve public funded primary care clinics in Malaysia. A total of 1753 medical records were randomly selected in 12 primary care clinics in 2007 and were reviewed by trained family physicians for diagnostic, management and documentation errors, potential errors causing serious harm and likelihood of preventability of such errors. Results The majority of patient encounters (81%) were with medical assistants. Diagnostic errors were present in 3.6% (95% CI: 2.2, 5.0) of medical records and management errors in 53.2% (95% CI: 46.3, 60.2). For management errors, medication errors were present in 41.1% (95% CI: 35.8, 46.4) of records, investigation errors in 21.7% (95% CI: 16.5, 26.8) and decision making errors in 14.5% (95% CI: 10.8, 18.2). A total of 39.9% (95% CI: 33.1, 46.7) of these errors had the potential to cause serious harm. Problems of documentation including illegible handwriting were found in 98.0% (95% CI: 97.0, 99.1) of records. Nearly all errors (93.5%) detected were considered preventable. Conclusions The occurrence of medical errors was high in primary care clinics particularly with documentation and medication errors. Nearly all were preventable. Remedial intervention addressing completeness of documentation and prescriptions are likely to yield reduction of errors. PMID:23267547

Primary gastric Burkitt lymphoma: a rare cause of life-threatening haematemesis.

PubMed

Ayoub, Fares; Forde, Justin J; Patel, Niraj; Markham, Merry

2017-08-22

Lymphomas are the second most common gastric malignancy following gastric adenocarcinoma. The majority of gastric lymphomas are either mucosa-associated lymphoid tissue lymphomas or diffuse large B-cell lymphomas. Primary gastric Burkitt lymphoma is a subtype of non-Hodgkin's lymphoma and represents an aggressive and rare malignancy with only a small number of cases reported worldwide. Clinical and radiological presentation is non-specific and mimics other gastric lymphomas. Diagnosis is established with pathological evaluation. Due to the paucity of cases, treatment of this condition is not well studied and is extrapolated from paediatric and adult literature of Burkitt lymphoma not isolated to the stomach. We present the case of a male patient with primary gastric Burkitt lymphoma who initially presented with life-threatening haematemesis, later achieving complete remission with treatment. We discuss the epidemiology, presentation and management of gastric Burkitt lymphoma. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Introducing the health coach at a primary care practice: a pilot study (part 2).

PubMed

Lanese, Bethany Sneed; Dey, Asoke; Srivastava, Prashant; Figler, Robert

2011-01-01

It is well known that the cost of healthcare in the United States is a poor value proposition. One of the primary goals of the healthcare reform act is to reduce cost while improving healthcare quality. The authors believe that adding a health coach helps to achieve this goal. In part I, the authors discuss the role of a health coach in the healthcare field. They present the findings from a pilot study at a primary care practice managing diabetes of patients using a health coach. The findings from the study suggest that adding a health coach helps in cost savings as well as improved health for the patients.

Evaluation of the Effectiveness of a Primary Preventive Dental Health Education Programme Implemented Through School Teachers for Primary School Children in Mysore City

PubMed Central

Naidu, Jaya; Nandlal, B.

2017-01-01

Aims and Objectives: The present study was conducted with the aim of evaluating the effectiveness of a Primary Preventive Dental Health Education Programme conducted for 6–12-year-old primary school children in Mysore City. Materials and Methods: A total of 12 schools, one each in the category of Government, Aided, and Unaided, were randomly selected per zone viz., North, South, East, and West. These 12 schools constituted the study group where the Primary Preventive School Dental Health Education Programme (PPSDHEP) was implemented. Two additional schools were selected at random from the four zones to serve as the control. A total of 926 children participated in the study. The PPSDHEP involved the second-level transfer of preventive package wherein the oral health education was imparted to the school children by schoolteachers trained by the investigator. Among the parameters for evaluating the outcome of the programme were the pre and post-programme assessment (at the baseline and at follow-up, i.e., after 6 months) of knowledge, attitude, and practice (KAP), dental caries status, oral hygiene, and gingival health status. Results: The results suggest that the PPSDHEP resulted in bringing about an enhancement in the KAP towards oral health and also an improvement in dental caries, oral hygiene, and gingival health status of the school children in the study group. Conclusion: The present study supports the implementation of similar programmes in schools and the contention that schoolteachers are suitable personnel for imparting dental health education to school children on a regular basis. PMID:28462175

Computational Study of Primary Electrons in the Cusp Region of an Ion Engine's Discharge Chamber

NASA Technical Reports Server (NTRS)

Stueber, Thomas J. (Technical Monitor); Deshpande, Shirin S.; Mahalingam, Sudhakar; Menart, James A.

2004-01-01

In this work a computer code called PRIMA is used to study the motion of primary electrons in the magnetic cusp region of the discharge chamber of an ion engine. Even though the amount of wall area covered by the cusps is very small, the cusp regions are important because prior computational analyses have indicated that most primary electrons leave the discharge chamber through the cusps. The analysis presented here focuses on the cusp region only. The affects of the shape and size of the cusp region on primary electron travel are studied as well as the angle and location at which the electron enters the cusp region. These affects are quantified using the confinement length and the number density distributions of the primary electrons. In addition to these results comparisons of the results from PRIMA are made to experimental results for a cylindrical discharge chamber with two magnetic rings. These comparisons indicate the validity of the computer code called PRIMA.

Evaluation of psychiatric and genetic risk factors among primary relatives of suicide completers in Delhi NCR region, India.

PubMed

Pasi, Shivani; Singh, Piyoosh Kumar; Pandey, Rajeev Kumar; Dikshit, P C; Jiloha, R C; Rao, V R

2015-10-30

Suicide as a public health problem is studied worldwide and association of psychiatric and genetic risk factors for suicidal behavior are the point of discussion in studies across different ethnic groups. The present study is aimed at evaluating psychiatric and genetic traits among primary relatives of suicide completer families in an urban Indian population. Bi-variate analysis shows significant increase in major depression (PHQ and Hamilton), stress, panic disorder, somatoform disorder and suicide attemptamong primary compared to other relatives. Sib pair correlations also reveal significant results for major depression (Hamilton), stress, suicide attempt, intensity of suicide ideation and other anxiety syndrome. 5-HTTLPR, 5-HTT (Stin2) and COMT risk alleles are higher among primary relatives, though statistically insignificant. Backward conditional logistic regression analysis show only independent variable, Depression (Hamilton) made a unique statistically significant contribution to the model in primary relatives. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Personality Influences the Relationship Between Primary Emotions and Religious/Spiritual Well-Being.

PubMed

Hiebler-Ragger, Michaela; Fuchshuber, Jürgen; Dröscher, Heidrun; Vajda, Christian; Fink, Andreas; Unterrainer, Human F

2018-01-01

The study of human emotions and personality provides valuable insights into the parameters of mental health and well-being. Affective neuroscience proposes that several levels of emotions - ranging from primary ones such as LUST or FEAR up to higher emotions such as spirituality - interact on a neural level. The present study aimed to further explore this theory. Furthermore, we hypothesized that personality - formed by bottom-up primary emotions and cortical top-down regulation - might act as a link between primary emotions and religious/spiritual well-being. A total sample of 167 (78% female) student participants completed the Affective Neuroscience Personality Scale (primary emotions), the Big Five Personality Inventory and the Multidimensional Inventory of Religious/Spiritual Well-Being (higher emotions). Correlation analyses confirmed the link between primary and higher emotions as well as their relation to personality. Further regression analyses indicated that personality dimensions mediate the relationship between primary and higher emotions. A substantial interaction between primary emotions, personality dimensions, and religious/spiritual well-being could be confirmed. From a developmental perspective, cortical top-down regulation might influence religious/spiritual well-being by forming relevant personality dimensions. Hence, CARE as well as Agreeableness seem of special importance. Future studies might focus on implications for clinical groups.

Patient-centered variables in primary and team nursing.

PubMed

Hamera, E; O'Connell, K A

1981-03-01

Patient-centered variables and their relationship to primary and team nursing have rarely been studied. In the present study the investigation focused on the following patient-centered variables: nurturance received, patient involvement, and frequency of nurse-patient contacts. Baseline observational data were collected on 12 adult medical patients experiencing team nursing care. A primary nursing care approach was then implemented on the same nursing unit, and 6 months later 12 patients were observed under this system. Patients were directly observed 24 hours a day for 5 days of hospitalization and audiotaped, using a specimen record method. This method produced transcripts that were coded for nurturance, involvement, and nurse-patient contacts. Results of the study showed that there were no differences between primary and team nursing care groups in the number of contacts, nurturance, or patient involvement with all nursing personnel or with professional nurses. However, when the primary group was adjusted to include only those patients for whom primary nursing care was fully implemented, the primary group received more nurturance (p less than .05) and had a tendency to be more active involved than did the team group (p less than .10). These findings indicate that the institution of primary nursing care is related to increased quality of nursing care.

Personality Influences the Relationship Between Primary Emotions and Religious/Spiritual Well-Being

PubMed Central

Hiebler-Ragger, Michaela; Fuchshuber, Jürgen; Dröscher, Heidrun; Vajda, Christian; Fink, Andreas; Unterrainer, Human F.

2018-01-01

The study of human emotions and personality provides valuable insights into the parameters of mental health and well-being. Affective neuroscience proposes that several levels of emotions – ranging from primary ones such as LUST or FEAR up to higher emotions such as spirituality – interact on a neural level. The present study aimed to further explore this theory. Furthermore, we hypothesized that personality – formed by bottom-up primary emotions and cortical top-down regulation – might act as a link between primary emotions and religious/spiritual well-being. A total sample of 167 (78% female) student participants completed the Affective Neuroscience Personality Scale (primary emotions), the Big Five Personality Inventory and the Multidimensional Inventory of Religious/Spiritual Well-Being (higher emotions). Correlation analyses confirmed the link between primary and higher emotions as well as their relation to personality. Further regression analyses indicated that personality dimensions mediate the relationship between primary and higher emotions. A substantial interaction between primary emotions, personality dimensions, and religious/spiritual well-being could be confirmed. From a developmental perspective, cortical top-down regulation might influence religious/spiritual well-being by forming relevant personality dimensions. Hence, CARE as well as Agreeableness seem of special importance. Future studies might focus on implications for clinical groups. PMID:29615950

Primary synovial sarcoma of the thyroid with locally repeated relapses in short periods: A case report

PubMed Central

SHI, RONG-LIANG; QU, NING; GAO, LI-LI; LU, ZHONG-WU; SUN, GUO-HUA; JI, QING-HAI

2016-01-01

The primary occurrence of synovial sarcoma (SS) in the thyroid is quite rare. As other SS arise from the head and neck structure, it tends to present poor biological behaviors and is generally treated as a high-grade sarcoma. The present study reports the case of a 31-year-old male who presented a neck mass, involving the thyroid, as shown by ultrasonography. The tumor was resected by total thyroidectomy and diagnosed as SS by histopathology. However, the initial surgery was considered as incomplete (R2) and no adjuvant protocol was followed. At the follow-up, neck recurrences within local lymph nodes were found repeatedly. The tumor grade increased for the metastatic lesions, indicating poorer differentiations with repeated relapses. The accurate evaluations of the primary tumor facilitated it to tailor the initial treatments, otherwise, the prognosis may be deteriorated by inappropriate management. PMID:27330751

[Rabdomiosarcoma primario de corazón como causa de síncope recurrente en el adulto].

PubMed

Díaz-Pérez, Julio Alexander; Gómez-Arbeláez, Diego; Hurtado-Gomez, Gabriel Alexander

2011-01-01

Primary or secondary neoplasms can affect the heart. Secondary are more common. However, primary neoplasms are relevant because is a group with diverse genesis, behavior, treatment and clinical manifestations. We present a case of a 45 year-old woman, with recurrent syncope started 1 year before her first consult. She had palpitations and chest pain. Echocardiography identified a left atrium mass of 2.1x1.8 cm. Endomyocardial biopsy document a primary rhabdomyosarcoma of the heart. The patient dies after a overall-survival of 22 months. This case presented had a good study of its symptoms with an accurate diagnosis and early treatment, which provided prolonged survival of this rare and aggressive neoplasm.

Hyperarousal during sleep in untreated primary insomnia sufferers: A polysomnographic study.

PubMed

Hein, Matthieu; Senterre, Christelle; Lanquart, Jean-Pol; Montana, Xavier; Loas, Gwénolé; Linkowski, Paul; Hubain, Philippe

2017-07-01

Because some evidence favors the hyperarousal model of insomnia, we sought to learn more about the dynamics of this phenomenon during sleep. Polysomnographic data from 30 normative subjects and 86 untreated primary insomnia sufferers recruited from the database of the sleep laboratory were studied for whole nights and in terms of thirds of the night. Untreated primary insomnia sufferers had an increased sleep latency and excess of WASO, together with a deficit in REM and NREM sleep during the entire night. In terms of thirds of the night, they presented a major excess of WASO during the first and last thirds of the night but an excess of lesser importance during the middle third. A deficit in SWS was found during the first third of the night, but for REM, the deficit was present during both the first and last thirds. Primary insomnia sufferers had no SWS or REM deficit during the second third of the night. We found that the hyperarousal phenomenon occurs mainly during the sleep-onset period of the first and last thirds of the night and is less important during the middle third. These results open new avenues for understanding the pathophysiology of primary insomnia. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Adolescents' multiple versus single primary attachment figures, reorganization of attachment hierarchy, and adjustments: the important people interview approach.

PubMed

Umemura, Tomotaka; Lacinová, Lenka; Kraus, Jakub; Horská, Eliška; Pivodová, Lenka

2018-04-20

Using 212 adolescents from a central-European country (mean age = 14.02, SD = 2.05, ranged from 11 to 18 years; females = 54%) and a multi-informant method to measure adolescents' behavioral and emotional adjustments, the present study explored three aspects regarding the attachment hierarchy. (1) The three types of behavioral systems of Rosenthal and Kobak's important people interview (IPI) were initially validated using an exploratory factor analysis with a US sample. Using a confirmatory factor analysis with a Czech sample, we replicated these three behavioral systems: attachment bond, support seeking, and affiliation. (2) We found that adolescents who developed attachment bond to multiple primary attachment figures were likely to score lower on both teacher-rated and parent-rated internalizing problems compared to those who had a single primary attachment figure. These multiple primary attachment figures tended to be family members (not peers). (3) Early adolescents who placed parents low in their attachment hierarchy scored higher on self-reported negative affect and lower on self-reported positive affect compared to early adolescents who placed parents high. The present study highlights multiple (vs. single) primary attachment figures as a protective factor and the premature reorganization of attachment hierarchy as a risk factor for adolescents' emotional and affective adjustments.

Representation of Sound Objects within Early-Stage Auditory Areas: A Repetition Effect Study Using 7T fMRI

PubMed Central

Da Costa, Sandra; Bourquin, Nathalie M.-P.; Knebel, Jean-François; Saenz, Melissa; van der Zwaag, Wietske; Clarke, Stephanie

2015-01-01

Environmental sounds are highly complex stimuli whose recognition depends on the interaction of top-down and bottom-up processes in the brain. Their semantic representations were shown to yield repetition suppression effects, i. e. a decrease in activity during exposure to a sound that is perceived as belonging to the same source as a preceding sound. Making use of the high spatial resolution of 7T fMRI we have investigated the representations of sound objects within early-stage auditory areas on the supratemporal plane. The primary auditory cortex was identified by means of tonotopic mapping and the non-primary areas by comparison with previous histological studies. Repeated presentations of different exemplars of the same sound source, as compared to the presentation of different sound sources, yielded significant repetition suppression effects within a subset of early-stage areas. This effect was found within the right hemisphere in primary areas A1 and R as well as two non-primary areas on the antero-medial part of the planum temporale, and within the left hemisphere in A1 and a non-primary area on the medial part of Heschl’s gyrus. Thus, several, but not all early-stage auditory areas encode the meaning of environmental sounds. PMID:25938430

Primary breast cancer of the vulva: a case report.

PubMed

Diniz da Costa, Ana Teresa Minhoto; Coelho, Ana Maria; Lourenço, Alexandre Valentim; Bernardino, Margarida; Ribeirinho, Ana Luisa; Jorge, Carlos Calhaz

2012-04-01

The occurrence of primary breast cancer of the vulva is extremely rare (24 cases described in the English-language literature). We report a case of a primary breast carcinoma of the vulva. An 82-year-old woman presented with a nodule of the left labia minor, which was excised. The histologic examination revealed the presence of adenocarcinoma of mammary origin, positive for common breast markers and for estrogen and progesterone receptors. The study for orthotopic breast carcinoma was negative, as well as the study for metastatic disease. The diagnosis of primary breast carcinoma was established. Our patient was then submitted to pelvic and inguinal radiotherapy as well as an aromatase inhibitor (letrozole), and she remained completely asymptomatic. Because of the rarity of this condition, guidelines for therapy are unavailable. The management suggested in the literature is that of primary orthotopic breast neoplasm of a similar stage.

Cluster randomized trial in smoking cessation with intensive advice in diabetic patients in primary care. ITADI Study

PubMed Central

2010-01-01

Background It is a priority to achieve smoking cessation in diabetic smokers, given that this is a group of patients with elevated cardiovascular risk. Furthermore, tobacco has a multiplying effect on micro and macro vascular complications. Smoking abstinence rates increase as the intensity of the intervention, length of the intervention and number and diversity of contacts with the healthcare professional during the intervention increases. However, there are few published studies about smoking cessation in diabetics in primary care, a level of healthcare that plays an essential role in these patients. Therefore, the aim of the present study is to evaluate the effectiveness of an intensive smoking cessation intervention in diabetic patients in primary care. Methods/Design Cluster randomized trial, controlled and multicentric. Randomization unit: Primary Care Team. Study population: 546 diabetic smokers older than 14 years of age whose disease is controlled by one of the primary care teams in the study. Outcome Measures: Continuous tobacco abstinence (a person who has not smoked for at least six months and with a CO level of less than 6 ppm measured by a cooximeter) , evolution in the Prochaska and DiClemente's Transtheoretical Model of Change, number of cigarettes/day, length of the visit. Point of assessment: one- year post- inclusion in the study. Intervention: Brief motivational interview for diabetic smokers at the pre-contemplation and contemplation stage, intensive motivational interview with pharmacotherapy for diabetic smokers in the preparation-action stage and reinforcing intevention in the maintenance stage. Statistical Analysis: A descriptive analysis of all variables will be done, as well as a multilevel logistic regression and a Poisson regression. All analyses will be done with an intention to treatment basis and will be fitted for potential confounding factors and variables of clinical importance. Statistical packages: SPSS15, STATA10 y HLM6. Discussion The present study will try to describe the profile of a diabetic smoker who receives the most benefit from an intensive intervention in primary care. The results will be useful for primary care professionals in their usual clinical practice. Trial Registration Clinical Trials.gov Identifier: NCT00954967 PMID:20132540

Comparison of Values in 5th, 6th, 7th and 8th Grade Primary Education Music Class Students'? Workbooks According to Rokeach?s and Akbas's Value Classifications

ERIC Educational Resources Information Center

Çakirer, H. Serdar

2014-01-01

The aim of the present study is to compare the values in the songs of 5th, 6th, 7th and 8th grade primary education music classes students? workbooks according to the value categorizations proposed by Rockeach and Akbas and which values among the categories mentioned are taught to the students in the 5th, 6th, 7th and 8th grade primary education…

One Year Primary Patency of Infrapopliteal Angioplasty Using Drug- Eluting Balloons: Single Center Experience at King Hussein Medical Center

PubMed Central

Haddad, Sizeph Edward; Shishani, Jan Mohammad; Qtaish, Izzeddin; Rawashdeh, Mohammad Abdelmajeed; Qtaishat, Belal Saleh

2017-01-01

Objective: Conventional percutaneous transluminal angioplasty (PTA) for long lesions in the below-the-knee (BTK) arteries in patients presenting with critical limb ischemia (CLI) has high restenosis rates at 1 year. Our goal is to evaluate whether paclitaxel drug-eluting balloons (DEB) have higher 1 year primary patency rates compared to conventional PTA. Methods: This is a single-center, prospective, randomized trial that was conducted from June 2013 to December 2015. The aim of the study was to compare 1 year primary patency rates of DEB and PTA in BTK arteries in CLI patients. Inclusion criteria were patients presenting with CLI (Rutherford class 4 or greater), stenosis or occlusion ≥30 mm of at least one tibial artery, and agreement to 12-month evaluation. Exclusion criteria were life expectancy <1 year, allergy to paclitaxel, and contraindication to combined antiplatelet treatment. Follow-up was performed by clinical assessment, ankle brachial pressure index, Doppler ultrasound imaging, and conventional angiogram if indicated. Primary end point was 1 year primary patency, and secondary end points were target lesion revascularization (TLR) and major amputation. Statistical analysis was performed using Fischer's exact test. Results: Ninety-three patients with 106 lesions in the BTK arteries were enrolled in this study. One year primary patency was achieved in 26 (65%) and seven (17%) in the DEB and PTA groups (P = 0.006), respectively. TLR was performed in nine lesions (23%) and 29 lesions (71%) in DEB and PTA groups (P = 0.009), respectively. Major amputations occurred in one limb (2%) and two limbs (4%) in DEB and PTA groups (P = 0.6), respectively. Conclusion: Paclitaxel DEB has significantly higher 1 year primary patency rate associated with significantly less TLR than conventional PTA, following endovascular recanalization of BTK arteries in patients presenting with CLI. PMID:28852581

Pediatric primary Sjögren syndrome presenting with bilateral ranulas: A case report and systematic review of the literature.

PubMed

Means, Casey; Aldape, Mark A; King, Ericka

2017-10-01

Primary Sjögren syndrome is uncommon in children, and the standard clinical criteria used in diagnosis of adult Sjögren syndrome will miss many children with the disease. Floor of mouth ranulas have not been described in Sjögren syndrome. This study aims to describe a novel presentation of juvenile primary Sjögren syndrome, and to present a comprehensive systematic review of the literature regarding the presentation and diagnosis of Sjögren syndrome in children. Ovid MEDLINE. A MEDLINE literature search was performed using the following search terms: primary, Sjögren, disease, and children. Results were limited to human subjects and articles written in English between 1981 and 2014. Applicable articles were reviewed and qualitatively summarized. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRIMA). Initial MEDLINE search yielded 146 articles, 80 of which were excluded as not clinically pertaining to Sjögren syndrome. An additional 25 were excluded due to lack of pediatric-specific data. Systematic review of the literature revealed no reports of ranula in association with Sjögren syndrome. 6 papers were manually included from review of reference lists of included articles. Our review indicated that recurrent parotitis is the most commonly reported presenting symptom in children, followed by ocular and oral symptoms, musculoskeletal, and renal symptoms. Compared to adults, children are less likely to present with dry eyes and mouth. All studies were retrospective chart reviews, case series or case reports. This is the first report of a child presenting with floor of mouth ranulas in association with Sjögren syndrome. While recurrent parotitis is the most common presentation in children, other salivary gland and extra-salivary manifestations may be seen, and the clinician must maintain a high index of suspicion for underlying Sjögren syndrome. Copyright © 2017 Elsevier B.V. All rights reserved.

The role of the primary care team in the rapid response system.

PubMed

O'Horo, John C; Sevilla Berrios, Ronaldo A; Elmer, Jennifer L; Velagapudi, Venu; Caples, Sean M; Kashyap, Rahul; Jensen, Jeffrey B

2015-04-01

The purpose of the study is to evaluate the impact of primary service involvement on rapid response team (RRT) evaluations. The study is a combination of retrospective chart review and prospective survey-based evaluation. Data included when and where the activations occurred and the patient's code status, primary service, and ultimate disposition. These data were correlated with survey data from each event. A prospective survey evaluated the primary team's involvement in decision making and the overall subjective quality of the interaction with primary service through a visual analog scale. We analyzed 4408 RRTs retrospectively and an additional 135 prospectively. The primary team's involvement by telephone or in person was associated with significantly more transfers to higher care levels in retrospective (P < .01) and prospective data sets. Code status was addressed more frequently in primary team involvement, with more frequent changes seen in the retrospective analysis (P = .01). Subjective ratings of communication by the RRT leader were significantly higher when the primary service was involved (P < .001). Active primary team involvement influences RRT activation processes of care. The RRT role should be an adjunct to, but not a substitute for, an engaged and present primary care team. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessing removals for North Central forest inventories.

Treesearch

W. Brad Smith

1991-01-01

Discusses method used by the Forest Inventory and Analysis Unit for estimating timber removals. Presents the relationship of timber utilization studies, primary lumber mill studies, and forest inventory data.

Unusual Presentation of a Primary Ewing’s Sarcoma of the Spine with Paraplegia: A Case Report

PubMed Central

Sundarapandian, Rajkumar Jayachandran; Surulivel, Vignesh Jayabalan

2015-01-01

Ewing’s sarcoma is a primary malignancy of the bone affecting individuals in the second decade of life. Primary sarcomas of the spine are rare and the occurrence of Primary Ewing’s sarcoma in the spine is very rare. Ewing’s sarcoma occurring in the spine is divided into two types, Ewing’s sarcoma of sacral spine which are very aggressive with poor prognosis and Ewing’s sarcoma of the non sacral spine which is an extremely rare occurrence. Patient may present with neurological deficit when the tumour extends into the spinal canal causing spinal cord compression. Magnetic resonance imaging (MRI) is very sensitive in diagnosing the tumour and defining the extent of the tumour. Here we report an 18-year-old boy who presented with back pain and complete paraplegia of two months duration. The MRI gave a differential diagnosis of infective pathology due to the fluid collection in the paraspinal region, followed by primary malignancy as the second diagnosis. Patient underwent posterior spinal decompression and stabilization, and intaoperatively there was significant collection of pus whose culture showed no growth. The histopathology and immunohistochemistry studies confirmed the diagnosis of Ewing’s sarcoma and patient was started on combination chemotherapy and radiotherapy. PMID:25954672

The Importance of Somatic Symptoms in Depression in Primary Care

PubMed Central

Tylee, André; Gandhi, Paul

2005-01-01

Objective: Patients with depression present with psychological and somatic symptoms, including general aches and pains. In primary care, somatic symptoms often dominate. A review of the literature was conducted to ascertain the importance of somatic symptoms in depression in primary care. Data sources and extraction: MEDLINE, EMBASE, and PsychLIT/PsychINFO databases (1985–January 2004) were searched for the terms depression, depressive, depressed AND physical, somatic, unexplained symptoms, complaints, problems; somatised, somatized symptoms; somatisation, somatization, somatoform, psychosomatic; pain; recognition, underrecognition; diagnosis, underdiagnosis; acknowledgment, underacknowledgment; treatment, undertreatment AND primary care, ambulatory care; primary physician; office; general practice; attribution, reattribution; and normalising, normalizing. Only English-language publications and abstracts were considered. Study selection: More than 80 papers related to somatic symptoms in depression were identified using the content of their titles and abstracts. Data synthesis: Approximately two thirds of patients with depression in primary care present with somatic symptoms. These patients are difficult to diagnose, feel an increased burden of disease, rely heavily on health care services, and are harder to treat. Patient and physician factors that prevent discussion of psychological symptoms during consultations must be overcome. Conclusions: Educational initiatives that raise awareness of somatic symptoms in depression and help patients to reattribute these symptoms should help to improve the recognition of depression in primary care. PMID:16163400

Effect of implant macro-design on primary stability: A prospective clinical study

PubMed Central

Lozano-Carrascal, Naroa; Salomó-Coll, Oscar; Gilabert-Cerdà, Marta; Farré-Pagés, Nuria; Hernández-Alfaro, Federico

2016-01-01

Background Implant restorations have become a high predictable treatment option. Several caracteristics such as surgical technique and implant design can influence the treatment outcomes. The aim of the present study was to evaluate the influence of implant macro-design on primary stability measured with resonance frequency analysis (RFA) and insertion torque (IT). Material and Methods A total of 47 implants divided in two groups: Test group (TI): 22 Tapered MIS® Seven implants; Control group (CI): 25 cylindrical Astra® Osseospeed implants. All implants were inserted following the manufacturers’ standard protocols. Implant primary stability was measured at the moment of implant placement by registering insertion torque values (ITv) and ISQ values by means of Osstell™ Mentor (ISQv) (Integration Diagnostic Ltd., Goteborg, Sweden). Results In the mandible, mean ISQv for tapered implants (TI) was 71.67±5.16 and for cylindrical implants (CI) 57.15±4.83 (p=0.01). Mean insertion torque was 46.67±6.85 Ncm for TI and 35.77±6.72 Ncm for CI (p=0.01). In the maxilla, mean ISQ was 67.2±4.42 for tapered implants and 49.17±15.30 for cylindrical implants (p=0.01). Mean insertion torque for TI was 41.5±6.26 Ncm and for CI 39.17±6.34 Ncm (p>0.05). For tapered implants, no correlation could be found between implant diameter and primary stability. But for cylindrical implants there was a statistically significant correlation between implant diameter and primary stability: ITv (p=0.03); ISQv (p=0.04). Conclusions Within the limits of the present study, tapered shaped implants achieve higher primary stability measured through ISQ and insertion torque values. Moreover, for cylindrical implants positive correlation has been established between implant diameter and primary stability. Key words:Primary stability, tapered, cylindrical, conical, implant macro-design. PMID:26827067

Prospective study of the primary evaluation of 1016 horses with clinical signs of abdominal pain by veterinary practitioners, and the differentiation of critical and non-critical cases.

PubMed

Curtis, Laila; Burford, John Harold; Thomas, Jennifer Sara Marian; Curran, Marise Linda; Bayes, Tom Curtis; England, Gary Crane William; Freeman, Sarah Louise

2015-10-06

The majority of research on the evaluation of horses with colic is focused on referral hospital populations. Early identification of critical cases is important to optimise outcome and welfare. The aim of this prospective study was to survey the primary evaluation of horses with clinical signs of abdominal pain by veterinary practitioners, and compare the initial presentation of critical and non-critical cases. Data from 1016 primary evaluations of horses presenting with clinical signs of colic were submitted by 167 veterinary practitioners across the United Kingdom over a 13 month period. The mean age of the study population was 13.5 years (median 12.0, range 0-42). Mean heart rate on primary presentation was 47 beats/min (median 44, range 18-125), mean respiratory rate was 20 breaths/min (median 16, range 6-100), and median gastrointestinal auscultation score (0-12, minimum-maximum) was 5 (range 0-12). Clinical signs assessed using a behavioural severity score (0-17, minimum-maximum), were between 0 and 6 in 70.4 % of cases, and 7-12 for 29.6 % of cases. Rectal examination was performed in 73.8 % of cases. Cases that responded positively to simple medical treatment were categorised retrospectively as 'non-critical'; cases that required intensive medical treatment, surgical intervention, died or were euthanased were categorised as 'critical'. Eight-hundred-and-twenty-two cases met these criteria; 76.4 % were 'non-critical' and 23.6 % were 'critical'. Multivariable logistic regression was used to identify features of the clinical presentation associated with critical cases. Five variables were retained in the final multivariable model: combined pain score: (OR 1.19, P < 0.001, 95 % CI 1.09-1.30), heart rate (OR 1.06, P < 0.001, 95 % CI 1.04-1.08), capillary refill time >2.5 s (OR 3.21, P = 0.046, 95 % CI 1.023-10.09), weak pulse character (OR 2.90, P = 0.004, 95 % CI 1.39-5.99) and absence of gut sounds in ≥1 quadrant (OR 3.65, P < 0.001, 95 % CI 2.08-6.41). This is the first study comparing the primary presentation of critical and non-critical cases of abdominal pain. Pain, heart rate, gastrointestinal borborygmi and simple indicators of hypovolaemia were significant indicators of critical cases, even at the primary veterinary examination, and should be considered essential components of the initial assessment and triage of horses presenting with colic.

Classroom-Based Assessment and the Issue of Continuity between Primary and Secondary School Languages Programs

ERIC Educational Resources Information Center

Hill, Kathryn

2010-01-01

This article presents selected findings from an ethnographic study of classroom-based assessment practices in languages classrooms (Indonesian) in the final year of primary (Year 6) and the first year of secondary (Year 7), respectively. In particular, the paper focuses on differences between the respective year levels in how learning was assessed…

Investigating Fresh Water--Some Ideas That Have Been Used Successfully in Primary Schools in the ACT.

ERIC Educational Resources Information Center

Shoring, Nola

2003-01-01

Outlines some strategies used in primary schools in the Australian Capital Territory (ACT) to teach science. Teachers wanting to investigate freshwater conducted experiments and drew concepts for reuse, recycling, and conservation. Presents two case studies using these activities to show how this theme can be used to introduce and consolidate a…

Child Maltreatment Prevalence and Mental Disorders Outcomes among American Indian Women in Primary Care

ERIC Educational Resources Information Center

Duran, Bonnie; Malcoe, Lorraine Halinka; Sanders, Margaret; Waitzkin, Howard; Skipper, Betty; Yager, Joel

2004-01-01

Objective: To examine (1) the prevalence, types, and severity of child abuse and neglect (CAN) and (2) the relationship between CAN and lifetime psychiatric disorders among American Indian women using primary care services. Methods: A cross-sectional study was conducted among 234 American Indian women, age 18-45 who presented for outpatient…

Validation of the Chinese Version of the Social Emotional Health Survey-Primary

ERIC Educational Resources Information Center

Wang, Cixin; Yang, Chunyan; Jiang, Xu; Furlong, Michael

2018-01-01

The Social Emotional Health Survey-Primary (SEHS-P) was originally developed to assess U.S. elementary students' positive psychological traits: gratitude, zest, optimism, and persistence, and the higher-order latent construct of covitality. The present study evaluated the validity of a Chinese version of SEHS-P with a sample of 653 Chinese…

Turkish Student Teachers' Ideas about Diagrams of a Flower and a Plant Cell

ERIC Educational Resources Information Center

Topsakal, Unsal Umdu; Oversby, John

2012-01-01

In the present study, the understandings of student teachers (training for the primary phase and Master's degree students from a primary science and technology education department) about flowers and plant cells using the method of drawing in combination with interviews are explored. The data were gathered from 116 student teachers and 10 Master's…

The Impact of Teachers' Organizational Trust Perceptions on Organizational Cynicism Perception

ERIC Educational Resources Information Center

Polat, Soner

2013-01-01

The aim of this study is to present the impact of primary school teachers' organizational trust perceptions on organizational cynicism. The research is based on descriptive survey model, with its population consisting of teachers working in primary schools in Korfez District of Kocaeli Province. Sampling was not needed and preferred as it was…

What Specific Science Abilities and Skills Are Romanian Students Developing during Primary Education? A Comparison with the Abilities Tested by the TIMSS 2011 Inquiry

ERIC Educational Resources Information Center

Ciascai, Liliana; Dulama, Maria-Eliza

2013-01-01

The results of Romanian students at international comparative TIMSS and PISA tests have constantly proven to be unsatisfactory. The present paper aims at analyzing the school syllabi "Mathematics and Environment exploration", "Environmental Education" and "Natural Sciences" studied during primary education in Romania…

Changes in Beliefs Regarding Good Teachers and the Characteristics of Child Development of Primary Education Students

ERIC Educational Resources Information Center

Vitulic, Helena Smrtnik; Lesar, Irena

2017-01-01

In a longitudinal study, we determine the beliefs of primary education students regarding the factors of academic achievement, good teachers, and the developmental characteristics of children, and we present which experiences mostly shape these beliefs. The same group of students (N = 59) completed the same questionnaire at the beginning of their…

The Pedagogical Potential of Drawing and Writing in a Primary Science Multimodal Unit

ERIC Educational Resources Information Center

Wilson, Rachel E.; Bradbury, Leslie U.

2016-01-01

In consideration of the potential of drawing and writing as assessment and learning tools, we explored how early primary students used these modes to communicate their science understandings. The context for this study was a curricular unit that incorporated multiple modes of representation in both the presentation of information and production of…

The Impact of Inattention and Emotional Problems on Cognitive Control in Primary School Children

ERIC Educational Resources Information Center

Sorensen, Lin; Plessen, Kerstin J.; Lundervold, Astri J.

2012-01-01

Objective: The present study investigated the predictive value of parent/teacher reports of inattention and emotional problems on cognitive control function in 241 children in primary school. Method: Cognitive control was measured by functions of set-shifting and working memory as assessed by the Behavior Rating Inventory of Executive Function…

Semantic Interference during Object Naming in Agrammatic and Logopenic Primary Progressive Aphasia (PPA)

ERIC Educational Resources Information Center

Thompson, Cynthia K.; Cho, Soojin; Price, Charis; Wieneke, Christina; Bonakdarpour, Borna; Rogalski, Emily; Weintraub, Sandra; Mesulam, M-Marsel

2012-01-01

This study examined the time course of object naming in 21 individuals with primary progressive aphasia (PPA) (8 agrammatic (PPA-G); 13 logopenic (PPA-L)) and healthy age-matched speakers (n=17) using a semantic interference paradigm with related and unrelated interfering stimuli presented at stimulus onset asynchronies (SOAs) of -1000, -500, -100…

The Effects of Video Feedback Coaching for Teachers on Scientific Knowledge of Primary Students

ERIC Educational Resources Information Center

van Vondel, Sabine; Steenbeek, Henderien; van Dijk, Marijn; van Geert, Paul

2018-01-01

The present study was aimed at investigating the effects of a video feedback coaching intervention for upper-grade primary school teachers on students' cognitive gains in scientific knowledge. This teaching intervention was designed with the use of inquiry-based learning principles for teachers, such as the empirical cycle and the posing of…

Prospective Primary Teachers' Prior Experiences, Conceptions, and Pedagogical Valuations of Experimental Activities in Science Education

ERIC Educational Resources Information Center

García-Carmona, Antonio; Criado, Ana M.; Cruz-Guzmán, Marta

2018-01-01

A diagnostic study is presented of the prior experiences, conceptions, and pedagogical valuations of prospective primary teachers (PPTs) about experimental activities (ExA's) in science education. The participants were 121 PPTs who, in small teams, responded to various questions related to ExA. Their responses were analysed interpretively with…

Principals' Attitudes towards Risky Internet Use of Primary School Students: The Role of Occupational Factors

ERIC Educational Resources Information Center

Touloupis, Thanos; Athanasiades, Christina

2018-01-01

The present study aimed to investigate primary school principals' attitudes towards risky internet use of school-aged students and how occupational factors, such as work self-efficacy, job satisfaction, and burnout, may affect these attitudes especially in a context of economic crisis, which has adversely affected working conditions and duties of…

A Content Analysis of School Anti-Bullying Policies in Northern Ireland

ERIC Educational Resources Information Center

Purdy, Noel; Smith, Peter K.

2016-01-01

This original study presents a content analysis of 100 primary and post-primary school anti-bullying policies in Northern Ireland using a 36-item scoring scheme. Overall schools had 52% of the items in their policies. Most schools included reference to physical, verbal, relational, material and cyberbullying but a minority mentioned racist,…

Influences and Constraints in the Primary School: An Explorative Study. Report Number 4.

ERIC Educational Resources Information Center

Vandenberghe, R.; And Others

The selection of the subjects taught at present in the primary schools and the way they are taught is not accidental. The subjects taught are determined by a network of interactions and communications between the school and other persons and institutions. Using the results of a teacher questionnaire, this report examines operational curricula and…

"People Are Suspicious of Us": A Critical Examination of Father Primary Carers and English Early Childhood Services

ERIC Educational Resources Information Center

Roberts-Holmes, Guy P.

2009-01-01

Positive father involvement and investment in the early years is of importance for children's later emotional, cognitive and social well-being. This article critically examines the multiple motivations and barriers experienced by the growing number of father primary carers. The small-scale research study presented suggests that for a…

Dimensional analysis of depressive, anxious and somatic symptoms presented by primary care patients and their relationship with ICD-11 PHC proposed diagnoses.

PubMed

Ziebold, Carolina; Goldberg, David P; Reed, Geoffrey M; Minhas, Fareed; Razzaque, Bushra; Fortes, Sandra; Robles, Rebeca; Lam, Tai Pong; Bobes, Julio; Iglesias, Celso; Cogo-Moreira, Hugo; García, José Ángel; Mari, Jair J

2018-06-04

A study conducted as part of the development of the Eleventh International Classification of Mental Disorders for Primary Health Care (ICD-11 PHC) provided an opportunity to test the relationships among depressive, anxious and somatic symptoms in PHC. Primary care physicians participating in the ICD-11 PHC field studies in five countries selected patients who presented with somatic symptoms not explained by known physical pathology by applying a 29-item screening on somatic complaints that were under study for bodily stress disorder. Patients were interviewed using the Clinical Interview Schedule-Revised and assessed using two five-item scales that measure depressive and anxious symptoms. Structural models of anxious-depressive symptoms and somatic complaints were tested using a bi-factor approach. A total of 797 patients completed the study procedures. Two bi-factor models fit the data well: Model 1 had all symptoms loaded on a general factor, along with one of three specific depression, anxiety and somatic factors [x2 (627) = 741.016, p < 0.0011, RMSEA = 0.015, CFI = 0.911, TLI = 0.9]. Model 2 had a general factor and two specific anxious depression and somatic factors [x2 (627) = 663.065, p = 0.1543, RMSEA = 0.008, CFI = 0.954, TLI = 0.948]. These data along with those of previous studies suggest that depressive, anxious and somatic symptoms are largely different presentations of a common latent phenomenon. This study provides support for the ICD-11 PHC conceptualization of mood disturbance, especially anxious depression, as central among patients who present multiple somatic symptoms.

Cervical lymph node metastases of squamous cell carcinoma from an unknown primary: outcomes and patterns of failure.

PubMed

Mistry, R C; Qureshi, S S; Talole, S D; Deshmukh, S

2008-01-01

Management of cervical lymph nodes metastases of squamous cell carcinoma (SCC) from primary of unknown origin (PUO) is contentious and there is insignificant data from India on this subject. To present experience of management of these patients treated with curative intent at a single institution. Retrospective study of patients treated between 1989-1994 in a tertiary referral cancer centre. Eighty-nine patients were evaluated in the study period and their survival compared with patients with common sites of primary in the head and neck with comparable node stage. Kaplan-Meier method. The clinical stage of the neck nodes at presentation was N1 in 11%, N2a in 28.5%, N2b in 22.5%, N3 in 35% and Nx in 3.4% patients. All patients underwent surgery and 70 patients received more than 40Gy postoperative radiotherapy. Twenty-nine (32.6%) patients had relapse of which 19 (21%) were in the neck. Postoperative radiotherapy did not influence the neck relapse (p=0.72). Primary was detected in 13 patients (14.6%) on subsequent follow up. The overall five and eight-years survival was 55% and 51% respectively. The overall five-year survival was better compared to patients with known primary with comparable node stage. Patients with cervical lymph nodes metastases of SCC from PUO have reasonable survival and low rate of development of subsequent primary when treated with surgery and radiotherapy. The overall survival is comparable to that of patients with known primary and hence an attempt at cure should always be made.

Primary adenocarcinoma of the thymus: an immunohistochemical and molecular study with review of the literature

PubMed Central

2013-01-01

Background Primary adenocarcinoma of thymus is extremely rare. Case presentation This is a case of primary adenocarcinoma with intestinal differentiation and focal mucin production in the thymus. Thymic cyst was associated with this tumor. Intestinal differentiation was confirmed by immunohistochemical stain with positivity for CDX-2, CK20, villin, MOC31 and focal positivity of CK7. Array comperative genomic hybridization (CGH) analysis showed a complex pattern of chromosomal imbalances including homozygous deletion at the HLA locus in chromosomal region 6p21.32. Conclusion This rare tumor shows a similar genetic aberration with other studied thymic epithelial tumors. PMID:23725376

A simple apparatus for the experimental study of non-steady flow thrust-augmenter ejector configurations

NASA Technical Reports Server (NTRS)

Khare, J. M.; Kentfield, J. A. C.

1979-01-01

A flexible, and easily modified, test rig is described which allows a one dimensional nonsteady flow stream to be generated, economically from a steady flow source of compressed air. This nonsteady flow is used as the primary stream in a nonsteady flow ejector constituting part of the test equipment. Standard piezo-electric pressure transducers etc. allow local pressures to be studied, as functions of time, in both the primary and secondary (mixed) flow portions of the apparatus. Provision is also made for measuring the primary and secondary mass flows and the thrust generated. Sample results obtained with the equipment are presented.

[The effectiveness of endonasal electrophoresis of neuroprotective agents used in the rehabilitative treatment of the patients presenting with primary open angle glaucoma].

PubMed

Nazarova, G A; Konchugova, T V; Iurova, O V; Sichinava, N V; Turova, E A; Rassulova, M A; Morozova, N E

2013-01-01

The objective of the present study was to estimate the effectiveness of the peptide drug cortexin used to treat primary open angle glaucoma. It was shown that endonasal electrophoresis of cortexin resulted in more pronounced positive changes in the dynamics of clinical, functional, perimetric, and electrophysiological characteristics compared with intramuscular administration of the same drug to the patients of the control group. This difference was apparent both immediately after the termination of the treatment and during the long-term follow-up.

Attitude-referenced radiometer study. Part 2: Primary calibration system

NASA Technical Reports Server (NTRS)

Williamson, W. R.; Otte, A. A.

1971-01-01

A primary calibration system, PCS, for infrared radiometers has been developed, built, and tested. The system allows radiometers to be calibrated with less than 1 percent error for use in earth coverage horizon measurements, earth resources surveys, and synoptic meteorological measurement. The final design, fabrication and test of the PCS are reported. A detailed description of the PCS construction is presented, along with the results of a complete series of functional tests. Test to verify the source thermal characteristics, collimator reflectance, and output beam characteristics are described and their results presented.

Low resolution spectroscopy of selected Algol systems

NASA Astrophysics Data System (ADS)

Devarapalli, Shanti Priya; Jagirdar, Rukmini; Parthasarathy, M.; Sahu, D. K.; Mohan, Vijay; Bhatt, B. C.; Thomas, Vineet S.

2018-04-01

The analysis of spectroscopic data for 30 Algol-type binaries is presented. All these systems are short period Algols having primaries with spectral types B and A. Dominant spectral lines were identified for the spectra collected and their equivalent widths were calculated. All the spectra were examined to understand presence of mass transfer, a disk or circumstellar matter and chromospheric emission. We also present first spectroscopic and period study for few Algols and conclude that high resolution spectra within and outside the primary minimum are needed for better understanding of these Algol type close binaries.

Cluster randomized trial in smoking cessation with intensive advice in diabetic patients in primary care. ITADI Study.

PubMed

Roig, Lydia; Perez, Santiago; Prieto, Gemma; Martin, Carlos; Advani, Mamta; Armengol, Angelina; Roura, Pilar; Manresa, Josep Maria; Briones, Elena

2010-02-04

It is a priority to achieve smoking cessation in diabetic smokers, given that this is a group of patients with elevated cardiovascular risk. Furthermore, tobacco has a multiplying effect on micro and macro vascular complications. Smoking abstinence rates increase as the intensity of the intervention, length of the intervention and number and diversity of contacts with the healthcare professional during the intervention increases. However, there are few published studies about smoking cessation in diabetics in primary care, a level of healthcare that plays an essential role in these patients. Therefore, the aim of the present study is to evaluate the effectiveness of an intensive smoking cessation intervention in diabetic patients in primary care. Cluster randomized trial, controlled and multicentric. Randomization unit: Primary Care Team. 546 diabetic smokers older than 14 years of age whose disease is controlled by one of the primary care teams in the study. Continuous tobacco abstinence (a person who has not smoked for at least six months and with a CO level of less than 6 ppm measured by a cooximeter) , evolution in the Prochaska and DiClemente's Transtheoretical Model of Change, number of cigarettes/day, length of the visit. Point of assessment: one- year post- inclusion in the study. Brief motivational interview for diabetic smokers at the pre-contemplation and contemplation stage, intensive motivational interview with pharmacotherapy for diabetic smokers in the preparation-action stage and reinforcing intevention in the maintenance stage. A descriptive analysis of all variables will be done, as well as a multilevel logistic regression and a Poisson regression. All analyses will be done with an intention to treatment basis and will be fitted for potential confounding factors and variables of clinical importance. Statistical packages: SPSS15, STATA10 y HLM6. The present study will try to describe the profile of a diabetic smoker who receives the most benefit from an intensive intervention in primary care. The results will be useful for primary care professionals in their usual clinical practice. Clinical Trials.gov Identifier: NCT00954967.

Metastatic serous carcinoma presenting as inflammatory carcinoma over the breast-Report of two cases and literature review.

PubMed

Panse, Gauri; Bossuyt, Veerle; Ko, Christine J

2018-03-01

Non-mammary metastases involving breast are rare and most commonly involve the breast parenchyma. Infrequently, metastasis from an extramammary primary site presents as inflammatory carcinoma over the breast. Diagnosis of such lesions can be challenging, especially in patients with coexisting primary breast carcinoma. Few such cases have been described in literature; however, none of the previously reported cases had a prior history of primary breast carcinoma. We present 2 patients with history of breast carcinoma and serous carcinoma of ovarian/peritoneal origin that presented with inflammatory carcinoma over the breast. Biopsies from breast tissue showed atypical cells in the dermis forming cords and papillary structures. Histopathologic differential diagnosis included infiltrating ductal carcinoma of breast origin and metastatic serous carcinoma. Immunohistochemical studies showed that the tumor cells were positive for markers of ovarian origin such as PAX-8 and CA-125 and negative for breast markers such as GATA-3, thus supporting the diagnosis. In summary, we describe the unusual presentation of metastatic serous carcinoma as inflammatory carcinoma over breast and discuss the diagnostic challenges in patients with coexisting primary breast and ovarian malignancies. We also review the morphologic features of tumors of breast and ovarian origin and the immunohistochemical stains to differentiate these 2 entities. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Renal manifestations of primary mitochondrial disorders

PubMed Central

Finsterer, Josef; Scorza, Fulvio

2017-01-01

The aim of the present review was to summarize and discuss previous findings concerning renal manifestations of primary mitochondrial disorders (MIDs). A literature review was performed using frequently used databases. The study identified that primary MIDs frequently present as mitochondrial multiorgan disorder syndrome (MIMODS) at onset or in the later course of the MID. Occasionally, the kidneys are affected in MIDs. Renal manifestations of MIDs include renal insufficiency, nephrolithiasis, nephrotic syndrome, renal cysts, renal tubular acidosis, Bartter-like syndrome, Fanconi syndrome, focal segmental glomerulosclerosis, tubulointerstitial nephritis, nephrocalcinosis, and benign or malign neoplasms. Among the syndromic MIDs, renal involvement has been most frequently reported in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes syndrome, Kearns-Sayre syndrome, Leigh syndrome and mitochondrial depletion syndromes. Only in single cases was renal involvement also reported in chronic progressive external ophthalmoplegia, Pearson syndrome, Leber's hereditary optic neuropathy, coenzyme-Q deficiency, X-linked sideroblastic anemia and ataxia, myopathy, lactic acidosis, and sideroblastic anemia, pyruvate dehydrogenase deficiency, growth retardation, aminoaciduria, cholestasis, iron overload, lactacidosis, and early death, and hyperuricemia, pulmonary hypertension, renal failure in infancy and alkalosis syndrome. The present study proposes that the frequency of renal involvement in MIDs is probably underestimated. Diagnosis of renal involvement follows general guidelines and treatment is symptomatic. Thus, renal manifestations of primary MIDs require recognition and appropriate management, as they determine the outcome of MID patients. PMID:28515908

The prevalence of crowding, attrition, midline discrepancies and premature tooth loss in the primary dentition of children in Jeddah, Saudi Arabia.

PubMed

Alamoudi, N

1999-01-01

The aim of the present study is to evaluate the prevalence of crowding, attrition, midline discrepancies and premature loss of primary molars in primary dentition of children resident in Jeddah, Saudi Arabia. Five hundred and two (502) children aged 4-6 years old residing in the city of Jeddah, Saudi Arabia provide the data for the analysis. Crowding was found in 14.7% of the subjects crowding in the maxilla occurred in 27 (5.4%) of the children, and 67 (13.4%) in the mandible. Simultaneous crowding in maxilla and mandible was present in 20 (3.98%) of the subject. The prevalence of crowding was significantly higher in the mandible than the maxilla (P > 0.01) and higher in male (P < 0.05). Midline shift was present in 10% of the children with females showing a significantly higher prevalence than the males (P < 0.001). Attrition was present in 167 (33.3%) of the children. One hundred and sixty children (31.9%) had attrition in enamel, and only 7(1.4%) had attrition, which exposed the dentin. Thirty-one (6.2%) out of 502 children had 51 (0.5%) missing teeth out of total number of 10,040 teeth. Tooth #84 was most commonly lost tooth (P < .025). Overall premature loss of 1st primary molars was found to be significantly higher than 2nd primary molars (P < .001).

Endoscopic third ventriculostomy for treatment of adult hydrocephalus: long-term follow-up of 163 patients.

PubMed

Isaacs, Albert M; Bezchlibnyk, Yarema B; Yong, Heather; Koshy, Dilip; Urbaneja, Geberth; Hader, Walter J; Hamilton, Mark G

2016-09-01

OBJECTIVE The efficacy of endoscopic third ventriculostomy (ETV) for the treatment of pediatric hydrocephalus has been extensively reported in the literature. However, ETV-related long-term outcome data are lacking for the adult hydrocephalus population. The objective of the present study was to assess the role of ETV as a primary or secondary treatment for hydrocephalus in adults. METHODS The authors performed a retrospective chart review of all adult patients (age ≥ 18 years) with symptomatic hydrocephalus treated with ETV in Calgary, Canada, over a span of 20 years (1994-2014). Patients were dichotomized into a primary or secondary ETV cohort based on whether ETV was the initial treatment modality for the hydrocephalus or if other CSF diversion procedures had been previously attempted respectively. Primary outcomes were subjective patient-reported clinical improvement within 12 weeks of surgery and the need for any CSF diversion procedures after the initial ETV during the span of the study. Categorical and actuarial data analysis was done to compare the outcomes of the primary versus secondary ETV cohorts. RESULTS A total of 163 adult patients with symptomatic hydrocephalus treated with ETV were identified and followed over an average of 98.6 months (range 0.1-230.4 months). All patients presented with signs of intracranial hypertension or other neurological symptoms. The primary ETV group consisted of 112 patients, and the secondary ETV consisted of 51 patients who presented with failed ventriculoperitoneal (VP) shunts. After the initial ETV procedure, clinical improvement was reported more frequently by patients in the primary cohort (87%) relative to those in the secondary ETV cohort (65%, p = 0.001). Additionally, patients in the primary ETV group required fewer reoperations (p < 0.001), with cumulative ETV survival time favoring this primary ETV cohort over the course of the follow-up period (p < 0.001). Fifteen patients required repeat ETV, with all but one experiencing successful relief of symptoms. Patients in the secondary ETV cohort also had a higher incidence of complications, with one occurring in 8 patients (16%) compared with 2 in the primary ETV group (2%; p = 0.010), although most complications were minor. CONCLUSIONS ETV is an effective long-term treatment for selected adult patients with hydrocephalus. The overall ETV success rate when it was the primary treatment modality for adult hydrocephalus was approximately 87%, and 99% of patients experience symptomatic improvement after 2 ETVs. Patients in whom VP shunt surgery fails prior to an ETV have a 22% relative risk of ETV failure and an almost eightfold complication rate, although mostly minor, when compared with patients who undergo a primary ETV. Most ETV failures occur within the first 7 months of surgery in patients treated with primary ETV, but the time to failure is more prolonged in patients who present with failed previous shunts.

Primary enzyme quantitation

DOEpatents

Saunders, G.C.

1982-03-04

The disclosure relates to the quantitation of a primary enzyme concentration by utilizing a substrate for the primary enzyme labeled with a second enzyme which is an indicator enzyme. Enzyme catalysis of the substrate occurs and results in release of the indicator enzyme in an amount directly proportional to the amount of primary enzyme present. By quantifying the free indicator enzyme one determines the amount of primary enzyme present.

Falling on stony ground? A qualitative study of implementation of clinical guidelines' prescribing recommendations in primary care.

PubMed

Rashidian, Arash; Eccles, Martin P; Russell, Ian

2008-02-01

We aimed to explore key themes for the implementation of guidelines' prescribing recommendations. We interviewed a purposeful sample of 25 participants in British primary care in late 2000 and early 2001. Thirteen were academics in primary care and 12 were non-academic GPs. We asked about implementation of guidelines for five conditions (asthma, coronary heart disease prevention, depression, epilepsy, menorrhagia) ensuring variation in complexity, role of prescribing in patient management, GP role in prescribing and GP awareness of guidelines. We used the Theory of Planned Behaviour to design the study and the framework method for the analysis. Seven themes explain implementation of prescribing recommendations in primary care: credibility of content, credibility of source, presentation, influential people, organisational factors, disease characteristics, and dissemination strategy. Change in recommendations may hinder implementation. This is important since the development of evidence-based guidelines requires change in recommendations. Practitioners do not have a universal view or a common understanding of valid 'evidence'. Credibility is improved if national bodies develop primary care guidelines with less input from secondary care and industry, and with simple and systematic presentation. Dissemination should target GPs' perceived needs, improve ownership and get things right in the first implementation attempt. Enforcement strategies should not be used routinely. GPs were critical of guidelines' development, relevance and implementation. Guidelines should be clear about changes they propose. Future studies should quantify the relationship between evidence base of recommendations and implementation, and between change in recommendations and implementation. Small but important costs and side effects of implementing guidelines should be measured in evaluative studies.

Jigsaw Variations and Attitudes about Learning and the Self in Cognitive Psychology

ERIC Educational Resources Information Center

Crone, Travis S.; Portillo, Mary C.

2013-01-01

Jigsaw classroom research has primarily explored racial relationships at the primary and secondary educational levels. The present study explored whether the jigsaw classroom would have an effect on students' attitudes about their own academic abilities and practices at the university level. The present study also sought to illuminate the…

The Pedagogy of Primary Historical Sources in Mathematics: Classroom Practice Meets Theoretical Frameworks

NASA Astrophysics Data System (ADS)

Barnett, Janet Heine; Lodder, Jerry; Pengelley, David

2014-01-01

We analyze our method of teaching with primary historical sources within the context of theoretical frameworks for the role of history in teaching mathematics developed by Barbin, Fried, Jahnke, Jankvist, and Kjeldsen and Blomhøj, and more generally from the perspective of Sfard's theory of learning as communication. We present case studies for two of our guided student modules that are built around sequences of primary sources and are intended for learning core curricular material, one on logical implication, the other on the concept of a group. Additionally, we propose some conclusions about the advantages and challenges of using primary sources in teaching mathematics.

Speech profile of patients undergoing primary palatoplasty.

PubMed

Menegueti, Katia Ignacio; Mangilli, Laura Davison; Alonso, Nivaldo; Andrade, Claudia Regina Furquim de

2017-10-26

To characterize the profile and speech characteristics of patients undergoing primary palatoplasty in a Brazilian university hospital, considering the time of intervention (early, before two years of age; late, after two years of age). Participants were 97 patients of both genders with cleft palate and/or cleft and lip palate, assigned to the Speech-language Pathology Department, who had been submitted to primary palatoplasty and presented no prior history of speech-language therapy. Patients were divided into two groups: early intervention group (EIG) - 43 patients undergoing primary palatoplasty before 2 years of age and late intervention group (LIG) - 54 patients undergoing primary palatoplasty after 2 years of age. All patients underwent speech-language pathology assessment. The following parameters were assessed: resonance classification, presence of nasal turbulence, presence of weak intraoral air pressure, presence of audible nasal air emission, speech understandability, and compensatory articulation disorder (CAD). At statistical significance level of 5% (p≤0.05), no significant difference was observed between the groups in the following parameters: resonance classification (p=0.067); level of hypernasality (p=0.113), presence of nasal turbulence (p=0.179); presence of weak intraoral air pressure (p=0.152); presence of nasal air emission (p=0.369), and speech understandability (p=0.113). The groups differed with respect to presence of compensatory articulation disorders (p=0.020), with the LIG presenting higher occurrence of altered phonemes. It was possible to assess the general profile and speech characteristics of the study participants. Patients submitted to early primary palatoplasty present better speech profile.

The Effect of Using XO Computers on Students' Mathematics and Reading Abilities: Evidences from Learning Achievement Tests Conducted in Primary Education Schools in Mongolia

ERIC Educational Resources Information Center

Yamaguchi, Shinobu; Sukhbaatar, Javzan; Takada, Jun-ichi; Dayan-Ochir, Khishigbuyan

2014-01-01

In 2008, Mongolia took part in One Laptop per Child (OLPC) project. Since that time, over 10,000 students in grades 2-5 in 43 primary education schools are using XO computers. This paper presents the findings of a study conducted in 2012 to evaluate the impact of the OLPC initiatives on students' literacy and math skills. This study covered 14…

Factor structure of parent and teacher ratings of the ODD symptoms for Malaysian primary school children.

PubMed

Gomez, Rapson

2017-02-01

This present study used confirmatory factor analysis (CFA) to examine the applicability of one-, two- three- and second order Oppositional Defiant Disorder (ODD) factor models, proposed in previous studies, in a group of Malaysian primary school children. These models were primarily based on parent reports. In the current study, parent and teacher ratings of the ODD symptoms were obtained for 934 children. For both groups of respondents, the findings showing some support for all models examined, with most support for a second order model with Burke et al. (2010) three factors (oppositional, antagonistic, and negative affect) as the primary factors. The diagnostic implications of the findings are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

The importance of teacher interpersonal behaviour for student attitudes in Brunei primary science classes

NASA Astrophysics Data System (ADS)

den Brok, Perry; Fisher, Darrell; Scott, Rowena

2005-07-01

This study investigated relationships between students' perceptions of their teachers' interpersonal behaviour and their subject-related attitude in primary science classes in Brunei. Teacher student interpersonal behaviour was mapped with the Questionnaire on Teacher Interaction (QTI) and reported in terms of two independent dimensions called Influence (teacher dominance vs submission) and Proximity (teacher cooperation vs opposition). While prior research using the QTI mainly focused on secondary education, the present study was one of the first in Brunei and in primary education and one of few studies to use multilevel analysis. Data from 1305 students from 64 classes were used in this study. Results indicated strong and positive effects of Influence and Proximity on students' enjoyment of their science class and supported findings of earlier work with the QTI.

Post-Primary Education and Capabilities: Insights from Young Women in Rural Uganda

ERIC Educational Resources Information Center

Jones, Shelley K.

2015-01-01

This paper presents findings from the third stage of a longitudinal, qualitative study involving nine female participants from a class cohort in a secondary school in rural Uganda. Since 2004-05, this study has tracked the progress of these young women's lives, and the present aspect of the study explores the ways in which they have found that…

The Correlation between the Fourth Grade Students' Level of Functional Literacy and Metacognitive Awareness

ERIC Educational Resources Information Center

Özenç, Emine Gül; Dikici, Hidayet

2016-01-01

The present study aims at presenting the relationship between the fourth grade primary school students' level of functional literacy and metacognitive awareness. The study group of the research is made up of 406 fourth grade students attending school during 2015-2016 academic year in Nigde. This study adopts survey model and its data collection…

Counselling in Primary Care: Past, Present, and Future.

ERIC Educational Resources Information Center

Eatock, John

2000-01-01

Presents a brief history of the growth of counseling in primary care. Discusses the challenges for primary care counselors and counseling, as well as the need for coordination, regulation and management. Also discusses the imperative for research support and the unique nature of counseling in primary care including challenges to its survival. (MKA)

Current management and prognostic factors in physiotherapy practice for patients with shoulder pain: design of a prospective cohort study.

PubMed

Karel, Yasmaine H J M; Scholten-Peeters, Wendy G M; Thoomes-de Graaf, Marloes; Duijn, Edwin; Ottenheijm, Ramon P G; van den Borne, Maaike P J; Koes, Bart W; Verhagen, Arianne P; Dinant, Geert-Jan; Tetteroo, Eric; Beumer, Annechien; van Broekhoven, Joost B; Heijmans, Marcel

2013-02-11

Shoulder pain is disabling and has a considerable socio-economic impact. Over 50% of patients presenting in primary care still have symptoms after 6 months; moreover, prognostic factors such as pain intensity, age, disability level and duration of complaints are associated with poor outcome. Most shoulder complaints in this group are categorized as non-specific. Musculoskeletal ultrasound might be a useful imaging method to detect subgroups of patients with subacromial disorders.This article describes the design of a prospective cohort study evaluating the influence of known prognostic and possible prognostic factors, such as findings from musculoskeletal ultrasound outcome and working alliance, on the recovery of shoulder pain. Also, to assess the usual physiotherapy care for shoulder pain and examine the inter-rater reliability of musculoskeletal ultrasound between radiologists and physiotherapists for patients with shoulder pain. A prospective cohort study including an inter-rater reliability study. Patients presenting in primary care physiotherapy practice with shoulder pain are enrolled. At baseline validated questionnaires are used to measure patient characteristics, disease-specific characteristics and social factors. Physical examination is performed according to the expertise of the physiotherapists. Follow-up measurements will be performed 6, 12 and 26 weeks after inclusion. Primary outcome measure is perceived recovery, measured on a 7-point Likert scale. Logistic regression analysis will be used to evaluate the association between prognostic factors and recovery. The ShoCoDiP (Shoulder Complaints and using Diagnostic ultrasound in Physiotherapy practice) cohort study will provide information on current management of patients with shoulder pain in primary care, provide data to develop a prediction model for shoulder pain in primary care and to evaluate whether musculoskeletal ultrasound can improve prognosis.

Terrain Portrayal for Synthetic Vision Systems Head-Down Displays Evaluation Results

NASA Technical Reports Server (NTRS)

Hughes, Monica F.; Glaab, Louis J.

2007-01-01

A critical component of SVS displays is the appropriate presentation of terrain to the pilot. At the time of this study, the relationship between the complexity of the terrain presentation and resulting enhancements of pilot SA and pilot performance had been largely undefined. The terrain portrayal for SVS head-down displays (TP-HDD) simulation examined the effects of two primary elements of terrain portrayal on the primary flight display (PFD): variations of digital elevation model (DEM) resolution and terrain texturing. Variations in DEM resolution ranged from sparsely spaced (30 arc-sec) to very closely spaced data (1 arc-sec). Variations in texture involved three primary methods: constant color, elevation-based generic, and photo-realistic, along with a secondary depth cue enhancer in the form of a fishnet grid overlay.

Looking at Practice: Revealing the Knowledge Demands of Teaching Data Handling in the Primary Classroom

ERIC Educational Resources Information Center

Leavy, Aisling

2015-01-01

In the evolving field of mathematics education, there is the need to maintain the relationship between what is presented in college level preparation courses and the skills required to teach mathematics in classrooms. This research examines the knowledge demands placed on 73 pre-service primary teachers as they use lesson study to plan and teach…

The Role of Primary Caregiver Vocabulary Knowledge in the Development of Bilingual Children's Vocabulary Skills

ERIC Educational Resources Information Center

Buac, Milijana; Gross, Megan; Kaushanskaya, Margarita

2014-01-01

Purpose: The present study examined the impact of environmental factors (socioeconomic status [SES], the percent of language exposure to English and to Spanish, and primary caregivers' vocabulary knowledge) on bilingual children's vocabulary skills. Method: Vocabulary skills were measured in 58 bilingual children between the ages of 5…

Does Classroom Composition Make a Difference: Effects on Developments in Motivation, Sense of Classroom Belonging, and Achievement in Upper Primary School

ERIC Educational Resources Information Center

Hornstra, Lisette; van der Veen, Ineke; Peetsma, Thea; Volman, Monique

2015-01-01

The present study investigated the effects of socioeconomic and ethnic classroom composition on developments in students' motivation, sense of classroom belonging, and achievement. A sample of 722 primary school students completed questionnaires from 3rd to 6th grade. Latent growth curve analyses revealed that the reading comprehension scores of…

Elephants, Donuts and Hamburgers: Young Children Co-operating To Co-operate and Co-operating To Compete in Two Primary Schools.

ERIC Educational Resources Information Center

Maras, P.; Lewis, A.; Simonds, L.

1999-01-01

Presents a study in which 152 5- to 6-year-old children worked alone or in groups, cooperatively and competitively, over four weeks. Identifies three traits: individualism/collectivism, sociability, and altruism. Examines these traits by gender and age. Discusses implications for primary school pedagogy and social psychological research. (CMK)

Social Justice: A Case-Study Examining the Influence of Primary Headteachers in Two Manchester Schools

ERIC Educational Resources Information Center

Winterbottom, Christian; Winterbottom, Shauna S.

2017-01-01

Presently, there are a growing number of students in the primary schools in northwest England who are living in broken communities, exacerbated by the most recent global recession. Through social justice theory, this paper examines the influence of head teachers as they look to balance administrative and pedagogical experiences in the schools.…

Creative and Collaborative Problem Solving in Technology Education: A Case Study in Primary School Teacher Education

ERIC Educational Resources Information Center

Lavonen, Jari; Autio, Ossi; Meisalo, Veijo

2004-01-01

In this article, the Creative Technology Education Project (CTEP) is presented, and phases of problem-solving processes in which the participating primary school student teachers generate alternatives and evaluate ideas are analyzed. The aims of this project were to introduce technology education goals and contents to these students, as well as to…

Using Self-Efficacy to Measure Primary School Teachers' Perception of ICT: Results from Two Studies

ERIC Educational Resources Information Center

Fanni, F.; Rega, I.; Cantoni, L.

2013-01-01

The aim of this article is twofold. First, the final results of two research projects, which investigated the impact of Information and Communication Technology (ICT) on primary schools teachers in disadvantaged areas in Brazil (BET k-12) and South Africa (MELISSA), are presented and discussed. Second, the Self-Efficacy construct is proposed as a…

"I'm the Best in Maths. Boys Rule, Girls Drool." Masculinities, Mathematics and Primary Schooling

ERIC Educational Resources Information Center

Bhana, Deevia

2005-01-01

This article presents elements of an ethnographic study of gendered identities among boys and girls in the early years of primary schooling. Foregrounding group work in mathematics as a key arena for the production of young masculine identities, this article goes some way to addressing what is absent from sociological portrayals of young children,…

Bring Your Own Device (BYOD) and Teacher Pedagogy in a New Zealand Primary School

ERIC Educational Resources Information Center

Rae, Genevieve; Dabner, Nicki; Mackey, Julie

2017-01-01

The practice of students bringing their own mobile devices (BYOD) to school is increasingly being used to leverage digital learning opportunities in New Zealand schools. This paper presents a summary of the findings from a case study that explored the experiences of three primary school teachers as they introduced BYOD into their classrooms for…

WebQuests in Special Primary Education: Learning in a Web-Based Environment

ERIC Educational Resources Information Center

Kleemans, Tijs; Segers, Eliane; Droop, Mienke; Wentink, Hanneke

2011-01-01

The present study investigated the differences in learning gain when performing a WebQuest with a well-defined versus an ill-defined assignment. Twenty boys and twenty girls (mean age 11; 10), attending a special primary education school, performed two WebQuests. In each WebQuest, they performed either a well-defined or an ill-defined assignment.…

Neoliberalism and Pedagogical Practices of Alienation: A Case Study Research on the Integrated Curriculum in Greek Primary Education

ERIC Educational Resources Information Center

Noula, Ioanna; Govaris, Christos

2018-01-01

In this article, we present insights from an ethnographic research that investigated the concept of citizenship in primary schools in Greece. We explored children's experiences of citizenship in school approaching citizenship as a set of habits that prescribe what is considered 'legitimate' in the public sphere. We focused on structures and agents…

Engaging with Emergent Bilinguals and Their Families in the Pre-Primary Classroom to Foster Well-Being, Learning and Inclusion

ERIC Educational Resources Information Center

Mary, Latisha; Young, Andrea S.

2017-01-01

This article presents data from a longitudinal study undertaken in a pre-primary classroom of 3-4-year-old emergent bi/plurilingual children during their first year of formal schooling in France. It focuses on how the teacher's intercultural competence facilitated the emergent bilingual children's transition from home to school and fostered…

Investigation of the Values Found in Primary Education Science and Technology Textbooks in Turkey

ERIC Educational Resources Information Center

Benzer, Elif

2013-01-01

In this study, the value types of 6, 7 and 8 class text books which take place in the primary education science and technology education program, have been targeted for investigation for the present rate of these values in different textbooks, and, whether they changed in accordance with class variables (class, subject content, and divisions of…

Learning to Learn in Years 1 and 2 of Hungarian Primary Schools

ERIC Educational Resources Information Center

Habók, Anita

2015-01-01

Learning to learn (L2L) is an important component of lifelong learning. First, the article discusses various possible definitions of L2L and identifies the most comprehensible definition, which provides the basis for the analysis. Subsequently, it presents the results of a pilot study carried out in the early stage of primary education. This study…

Teachers' Opinions on the Incorporation of Environmental Education in the Nigerian Primary School Curriculum

ERIC Educational Resources Information Center

Jekayinfa, Alice Arinlade; Yusuf, Abdul Raheem

2008-01-01

This paper presents the report of a research carried out in Kwara Sate of Nigeria to seek the opinions of teachers on the incorporation of Environmental Education (EE) in the Nigerian Primary School Curriculum. The descriptive survey method was employed for the study. 200 teachers were selected through stratified random sampling technique to cater…

Emotions and Sensemaking: A Consideration of a Community College Presidential Transition

ERIC Educational Resources Information Center

Kearney, Kerri S.

2013-01-01

A change in primary leadership for a community college presents distinct challenges for its employees. The case study research reported in this article is based on emotions and sensemaking data that were collected at an urban community college in the midst of a presidential transition. Analysis of the data led to a primary focus on the period of…

Changes in the Perceived Epidemiology of Primary Hyperaldosteronism

PubMed Central

Fagugli, Riccardo Maria; Taglioni, Chiara

2011-01-01

Primary aldosteronism has been considered a rare disease in the past years, affecting 1% of the hypertensive population. Subsequently, growing evidence of its higher prevalence is present in literature, although the estimates of disease range from 5 up to 20%, as in type 2 diabetes and resistant hypertension. The main reasons for these variations are associated with the selection of patients and diagnostic procedures. If we consider that hypertension is present in about 20% of the adult population, primary aldosteronism can no longer be considered a rare disease. Patients with primary aldosteronism have a high incidence of cardiovascular, cerebrovascular and kidney complications. The identification of these patients has therefore a practical value on therapy, and to control morbidities derived from vascular damage. The ability to identify the prevalence of a disease depends on the number of subjects studied and the methods of investigation. Epidemiological studies are affected by these two problems: there is not consensus on patients who need to be investigated, although testing is recommended in subjects with resistant hypertension and diabetes. The question of how to determine aldosterone and renin levels is open, particularly if pharmacological wash-out is difficult to perform because of inadequate blood pressure control. PMID:21837271

The relationship between bruxism, sleep quality, and headaches in schoolchildren

PubMed Central

Bortoletto, Carolina Carvalho; Salgueiro, Mônica da Consolação Canuto; Valio, Renata; Fragoso, Yara Dadalti; Motta, Pamella de Barros; Motta, Lara Jansiski; Kobayashi, Fernanda Yukie; Fernandes, Kristianne Porta Santos; Mesquita-Ferrari, Raquel Agnelli; Deana, Alessandro; Bussadori, Sandra Kalil

2017-01-01

[Purpose] Present study aimed to evaluate the relationship between sleep bruxism and headache in school children. [Subjects and Methods] This study was conducted with 103 children aged 3–6 years. The exclusion criteria were early tooth loss, dental appliance was used, physical or psychological limitations, chronic disease and continuous medication. Sleep bruxism was diagnosed based on an indication by parents of the occurrence of teeth clenching/grinding and incisor/occlusal tooth wear, following the criteria of the American Academy of Sleep Medicine. Sleep quality was evaluated by a questionnarie, detailing the child’s sleep characteristics. [Results] Forty-nine children (47.6%) were diagnosed with sleep bruxism. Those with sleep bruxism were 3.25-fold more likely to present headache. Children whose parents were separated had a significantly greater frequency of sleep bruxism and primary headache. The relative risk of exhibiting primary headache was 13.1 among children with sleep bruxism whose parents were separated. [Conclusion] Children with SB demonstrated a greater risk of having primary headache and those whose parents were separated had a greater chance of having headache. Only sleep bruxism was associated with headache, clenching the teeth during waking hours was not correlated with primary headache. PMID:29200617

Measurements Methods for the analysis of Nuclear Reactors Thermal Hydraulic in Water Scaled Facilities

NASA Astrophysics Data System (ADS)

Spaccapaniccia, C.; Planquart, P.; Buchlin, J. M. AB(; ), AC(; )

2018-01-01

The Belgian nuclear research institute (SCK•CEN) is developing MYRRHA. MYRRHA is a flexible fast spectrum research reactor, conceived as an accelerator driven system (ADS). The configuration of the primary loop is pool-type: the primary coolant and all the primary system components (core and heat exchangers) are contained within the reactor vessel, while the secondary fluid is circulating in the heat exchangers. The primary coolant is Lead Bismuth Eutectic (LBE). The recent nuclear accident of Fukushima in 2011 changed the requirements for the design of new reactors, which should include the possibility to remove the residual decay heat through passive primary and secondary systems, i.e. natural convection (NC). After the reactor shut down, in the unlucky event of propeller failures, the primary and secondary loops should be able to remove the decay heat in passive way (Natural Convection). The present study analyses the flow and the temperature distribution in the upper plenum by applying laser imaging techniques in a laboratory scaled water model. A parametric study is proposed to study stratification mitigation strategies by varying the geometry of the buffer tank simulating the upper plenum.

Optimal Treatment Decision for Brain Metastases of Unknown Primary Origin: The Role and Timing of Radiosurgery

PubMed Central

Han, Hyun Jin; Chang, Won Seok; Jung, Hyun Ho; Park, Yong Gou

2016-01-01

Background Up to 15% of all patients with brain metastases have no clearly detected primary site despite intensive evaluation, and this incidence has decreased with the use of improved imaging technology. Radiosurgery has been evaluated as one of the treatment modality for patients with limited brain metastases. In this study, we evaluated the effectiveness of radiosurgery for brain metastases from unknown primary tumors. Methods We retrospectively evaluated 540 patients who underwent gamma knife radiosurgery (GKRS) for brain metastases radiologically diagnosed between August 1992 and September 2007 in our institution. First, the brain metastases were grouped into metachronous, synchronous, and precocious presentations according to the timing of diagnosis of the brain metastases. Then, synchronous and precocious brain metastases were further grouped into 1) unknown primary; 2) delayed known primary; and 3) synchronous metastases according to the timing of diagnosis of the primary origin. We analyzed the survival time and time to new brain metastasis in each group. Results Of the 540 patients, 29 (5.4%) presented precocious or synchronous metastases (34 GKRS procedures for 174 lesions). The primary tumor was not found even after intensive and repeated systemic evaluation in 10 patients (unknown primary, 34.5%); found after 8 months in 3 patients (delayed known primary, 1.2%); and diagnosed at the same time as the brain metastases in 16 patients (synchronous metastasis, 55.2%). No statistically significant differences in survival time and time to new brain metastasis were found among the three groups. Conclusion Identification of a primary tumor before GKRS did not affect the patient outcomes. If other possible differential diagnoses were completely excluded, early GKRS can be an effective treatment option for brain metastases from unknown primary tumor. PMID:27867920

Comparative characteristics of primary hyperparathyroidism in pediatric and young adult patients.

PubMed

Nicholson, Kristina J; McCoy, Kelly L; Witchel, Selma F; Stang, Michael T; Carty, Sally E; Yip, Linwah

2016-10-01

Primary hyperparathyroidism is rare in pediatric patients. Our study aim was to compare primary hyperparathyroidism in pediatric (<19 years) and young adult (19-29 years) patients. A prospectively collected database from a single, high-volume institution was queried for all patients age <30 years who had initial parathyroidectomy for primary hyperparathyroidism yielding 126/4,546 (2.7%) primary hyperparathyroidism patients representing 39 pediatric and 87 young adult patients. Presenting symptoms, operative data, and postoperative course were compared for patients age 0-19 years and 20-29 years. Sporadic primary hyperparathyroidism was present in 81.7% and occurred less often in pediatric patients than young adult patients (74.4% vs 86.2%, P = .12). Among patients with hereditary primary hyperparathyroidism, multiple endocrine neoplasia type 1 was the most common type. Multiglandular disease was common in both pediatric (30.7%) and young adult (21.8%) patients. Following parathyroidectomy, 3 (2.3%) patients had permanent hypoparathyroidism and none had permanent recurrent laryngeal nerve paralysis. Biochemical cure at 6 months was equally likely in pediatric and young adult patients (97.1% vs 93.6%, P = .44) with comparable follow-up (78.4 months vs 69.1 months, P = .66) and rates of recurrent disease (5.9% vs 10.3%, P = .46). Recurrence was due to multiple endocrine neoplasia 1-related primary hyperparathyroidism in all cases. Although primary hyperparathyroidism is sporadic in most patients <19 years, they are more likely to have multiple endocrine neoplasia type 1-associated primary hyperparathyroidism (23%). Parathyroidectomy for primary hyperparathyroidism can be performed safely in pediatric patients with a high rate of cure. Follow-up for patients with hereditary disease is necessary. Copyright © 2016 Elsevier Inc. All rights reserved.

FBI fingerprint identification automation study. AIDS 3 evaluation report. Volume 1: Compendium

NASA Technical Reports Server (NTRS)

Mulhall, B. D. L.

1980-01-01

The primary features of the overall study are encompassed and an evaluation of an automation system is presented. Objectives of the study are described, methods of evaluation are summarized and conclusions about the system's feasibility are presented. Also included is a brief history of fingerprint automation activities within the FBI, the organization of the FBI, a bibliography of documents and records, a data dictionary and a reference set of all of the transparencies presented throughout the study.

Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

PubMed

Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

2014-01-01

The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

The Prevalence of Stages of Heart Failure in Primary Care: A Population-Based Study.

PubMed

Jorge, Antonio Lagoeiro; Rosa, Maria Luiza G; Martins, Wolney A; Correia, Dayse Mary S; Fernandes, Luiz Claudio M; Costa, Jean A; Moscavitch, Samuel D; Jorge, Bruno Afonso L; Mesquita, Evandro T

2016-02-01

Planning strategies to prevent heart failure (HF) in developing countries require epidemiologic data in primary care. The purpose of this study was to estimate the prevalence of HF stages and their phenotypes, HF with preserved ejection fraction (HFPEF), and HF with reduced EF (HFREF) and to determine B-type natriuretic peptide (BNP) levels to identify HF in the adult population. This is a cross-sectional study including 633 individuals, aged ≥45 years, who were randomly selected and registered in a primary care program of a medium-sized city in Brazil. All participants were underwent clinical evaluations, BNP measurements, electrocardiograms, and tissue Doppler echocardiography in a single day. The participants were classified as stage 0 (healthy, 11.7%), stage A (risk factors, 36.6%), stage B (structural abnormalities, 42.7%), or stage C (symptomatic HF, 9.3%). Among patients with HF, 59% presented with HFPEF and 41% presented with HFREF. The mean BNP levels were 20 pg/mL(-1) in stage 0, 20 pg/mL(-1) in stage A, 24 pg/mL(-1) in stage B, 93 pg/mL(-1) in HFPEF, and 266 pg/mL(-1) in HFREF. The cutoff BNP level with optimal sensitivity (92%) and specificity (91%) to identify HF was 42 pg/mL(-1). The present study demonstrated a high prevalence of individuals at risk for HF and the predominance of HFPEF in a primary care setting. The clinical examination, along with BNP and tissue Doppler echocardiography, may facilitate early detection of stages A and B HF and allow implementation of interventions aimed at preventing progression to symptomatic HF. Copyright © 2015 Elsevier Inc. All rights reserved.

Lack of a close confidant: prevalence and correlates in a medically underserved primary care sample.

PubMed

Newton, Tamara; Buckley, Amy; Zurlage, Megan; Mitchell, Charlene; Shaw, Ann; Woodruff-Borden, Janet

2008-03-01

The present study examined prevalence of lack of a close confidant in a medically underserved primary care sample, and evaluated demographic, medical, and psychological correlates of patients' deficits in close, personal contact. Adult patients (n = 413) reported on confidant status and symptoms of depression and anxiety. Sociodemographic and medical information were obtained through chart review. One-quarter of patients endorsed lack of a close confidant. Past month anxiety and depression symptoms, but not medical status, were associated with unmet socioemotional needs. Implications for primary healthcare interventions are discussed.

The Marine Resources Experiment Program (MAREX)

NASA Technical Reports Server (NTRS)

1982-01-01

The Satellite Ocean Color Science Working Group was established to consider the scientific utility of repeated satellite measurements of ocean color, especially for measuring global ocean chlorophyll and for studying the fate of global primary productivity in the sea. Results of the group's deliberations are presented. The scientific requirements are given for ocean color data from a CZCS follow on sensor in order to address global primary productivity, fishery, and carbon storage problems. Some specific experiments, called the marine resource experiment and designed to determine critical nutrient fluxes, photosynthetic rates, and primary productivity and biomass, are outlined.

Alkylsilyl Peroxides as Alkylating Agents in the Copper-Catalyzed Selective Mono-N-Alkylation of Primary Amides and Arylamines.

PubMed

Sakamoto, Ryu; Sakurai, Shunya; Maruoka, Keiji

2017-07-06

The copper-catalyzed selective mono-N-alkylation of primary amides or arylamines using alkylsilyl peroxides as alkylating agents is reported. The reaction proceeds under mild reaction conditions and exhibits a broad substrate scope with respect to the alkylsilyl peroxides, as well as to the primary amides and arylamines. Mechanistic studies suggest that the present reaction should proceed through a free-radical process that includes alkyl radicals generated from the alkylsilyl peroxides. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Differential proteomic profiling of primary and recurrent chordomas.

PubMed

Chen, Su; Xu, Wei; Jiao, Jian; Jiang, Dongjie; Liu, Jian; Chen, Tenghui; Wan, Zongmiao; Xu, Leqin; Zhou, Zhenhua; Xiao, Jianru

2015-05-01

Chordomas are locally destructive tumors with high rates of recurrence and a poor prognosis. The mechanisms involved in chordoma recurrence remain largely unknown. In the present study, we examined the proteomic profile of a chordoma primary tumor (CSO) and a recurrent tumor (CSR) through mass spectrum in a chordoma patient who underwent surgery. Bioinformatic analysis of the profile showed that 359 proteins had a significant expression difference and 21 pathways had a striking alteration between the CSO and the CSR. The CSR showed a significant increase in carbohydrate metabolism. Immunohistochemistry (IHC) confirmed that the cancer stem cell marker activated leukocyte cell adhesion molecule (ALCAM or CD166) expression level was higher in the recurrent than that in the primary tumor. The present study analyzed the proteomic profile change between CSO and CSR and identified a new biomarker ALCAM in recurrent chordomas. This finding sheds light on unraveling the pathophysiology of chordoma recurrence and on exploring more effective prognostic biomarkers and targeted therapies against this devastating disease.

Fear of losing money? Aversive conditioning with secondary reinforcers.

PubMed

Delgado, M R; Labouliere, C D; Phelps, E A

2006-12-01

Money is a secondary reinforcer that acquires its value through social communication and interaction. In everyday human behavior and laboratory studies, money has been shown to influence appetitive or reward learning. It is unclear, however, if money has a similar impact on aversive learning. The goal of this study was to investigate the efficacy of money in aversive learning, comparing it with primary reinforcers that are traditionally used in fear conditioning paradigms. A series of experiments were conducted in which participants initially played a gambling game that led to a monetary gain. They were then presented with an aversive conditioning paradigm, with either shock (primary reinforcer) or loss of money (secondary reinforcer) as the unconditioned stimulus. Skin conductance responses and subjective ratings indicated that potential monetary loss modulated the conditioned response. Depending on the presentation context, the secondary reinforcer was as effective as the primary reinforcer during aversive conditioning. These results suggest that stimuli that acquire reinforcing properties through social communication and interaction, such as money, can effectively influence aversive learning.

Gastrointestinal metastasis from primary lung cancer. Case series and systematic literature review.

PubMed

Balla, Andrea; Subiela, José D; Bollo, Jesús; Martínez, Carmen; Rodriguez Luppi, Carlos; Hernández, Pilar; Pascual-González, Yuliana; Quaresima, Silvia; Targarona, Eduard M

2018-04-01

Aim of the present study is to report clinical characteristics and outcomes of patients treated in authors' hospital for GI metastasis from primary lung cancer, and to report and analyse the same data concerning patients retrieved from a systematic literature review. We performed a retrospective analysis of prospectively collected data, and a systematic review using the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Ninety-one patients were included, 5 patients from the authors' hospital and 86 through PubMed database using the keywords "intestinal metastasis" AND "lung cancer". The median time between primary lung cancer diagnosis and GI metastasis diagnosis was 2 months and the median overall survival was 4 months. This group of patients present a poor prognosis and the gold standard treatment is not defined. None of the reported treatments had a significant impact on survival. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Design development of graphite primary structures enables SSTO success

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

Biagiotti, V.A.; Yahiro, J.S.; Suh, D.E.

1997-01-01

This paper describes the development of a graphite composite wing and a graphite composite intertank primary structure for application toward Single-Stage to Orbit space vehicles such as those under development in NASA{close_quote}s X-33/Reusable Launch Vehicle (RLV) Program. The trade study and designs are based on a Rockwell vertical take-off and horizontal landing (VTHL) wing-body RLV vehicle. Northrop Grumman{close_quote}s approach using a building block development technique is described. Composite Graphite/Bismaleimide (Gr/BMI) material characterization test results are presented. Unique intertank and wing composite subcomponent test article designs are described and test results to date are presented. Wing and intertank Full Scale Sectionmore » Test Article (FSTA) objectives and designs are outlined. Trade studies, supporting building block testing, and FSTA demonstrations combine to develop graphite primary structure composite technology that enables developing X-33/RLV design programs to meet critical SSTO structural weight and operations performance criteria. {copyright} {ital 1997 American Institute of Physics.}« less

Transformation of primary human hepatocytes in hepatocellular carcinoma.

PubMed

Montalbano, Mauro; Rastellini, Cristiana; Wang, Xiaofu; Corsello, Tiziana; Eltorky, Mahmoud A; Vento, Renza; Cicalese, Luca

2016-03-01

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Currently, there is limited knowledge of neoplastic transformation of hepatocytes in HCC. In clinical practice, the high rate of HCC local recurrence suggests the presence of different hepatocyte populations within the liver and particularly in the tumor proximity. The present study investigated primary human hepatocyte cultures obtained from liver specimens of patients affected by cirrhosis and HCC, their proliferation and transformation. Liver samples were obtained from seven HCC cirrhotic patients and from three patients with normal liver (NL). Immediately after surgery, cell outgrowth and primary cultures were obtained from the HCC lesion, the cirrhotic tissue proximal (CP, 1-3 cm) and distal (CD, >5 cm) to the margin of the neoplastic lesion, or from NL. Cells were kept in culture for 16 weeks. Morphologic analyses were performed and proliferation rate of the different cell populations compared over time. Glypican-3, Heppar1, Arginase1 and CD-44 positivity were tested. The degree of invasiveness of cells acquiring neoplastic characteristics was studied with a transwell migration assay. We observed that HCC cells maintained their morphology and unmodified neoplastic characteristics when cultured. Cells isolated from CP, showed a progressive morphologic transformation in HCC-like cells accompanied by modification of markers expression with signs of invasiveness. Absence of HCC contamination in the CP isolates was confirmed. In CD samples some of these characteristics were present and at significantly lower levels. With the present study, we are the first to have identified and describe the existence of human hepatocytes near the cancerous lesion that can transform in HCC in vitro.

Full-text publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings (2010-2012): a retrospective observational study.

PubMed

Komagamine, Junpei; Yabuki, Taku

2018-06-22

To determine the publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings and the factors associated with publication. A retrospective observational study. All abstracts presented at the Japan Primary Care Association Annual Meetings (2010-2012). Publication rates were determined by searching the MEDLINE database for full-text articles published by September 2017. Data on presentation format (oral vs poster), affiliation of the first author, number of authors, number of involved institutions, journal of publication and publication date were abstracted. Of the 1003 abstracts evaluated, 38 (3.8%, 95% CI 2.6% to 5.0%) were subsequently published in peer-reviewed journals indexed in the MEDLINE database. The median time to publication was 15.5 months (IQR, 9.3-29.3 months). More than 95% of published abstracts were published within 4 years. The publications appeared in 23 different journals (21 English-language journals and two Japanese-language journals). Based on univariate analysis using binary logistic regression, publication was more frequent for oral presentations (7.3%vs2.0% for poster presentations; OR 3.91,95% CI 1.98 to 7.75), and for first authors affiliated with university-associated institutions (6.4%vs2.4% for first authors affiliated with non-university-associated institutions; OR 2.75,95% CI 1.42 to 5.30). Based on multivariate analysis, oral presentation and first author affiliation with a university-associated institution were still the only independent predictive factors for publication (adjusted OR 3.50(95% CI 1.72 to 7.12) and adjusted OR 2.35(95% CI 1.19 to 4.63), respectively). Even among 151 abstracts presented orally by first authors affiliated with a university-associated institution, only 18 abstracts (11.9%) were subsequently published in peer-reviewed journals. The publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings was extremely low. Further studies are warranted to investigate the barriers to publication among investigators who participate in conferences where the publication rate is extremely low. © 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.

A multicentre randomised controlled trial of levetiracetam versus phenytoin for convulsive status epilepticus in children (protocol): Convulsive Status Epilepticus Paediatric Trial (ConSEPT) - a PREDICT study.

PubMed

Dalziel, Stuart R; Furyk, Jeremy; Bonisch, Megan; Oakley, Ed; Borland, Meredith; Neutze, Jocelyn; Donath, Susan; Sharpe, Cynthia; Harvey, Simon; Davidson, Andrew; Craig, Simon; Phillips, Natalie; George, Shane; Rao, Arjun; Cheng, Nicholas; Zhang, Michael; Sinn, Kam; Kochar, Amit; Brabyn, Christine; Babl, Franz E

2017-06-22

Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines, with current treatment protocols based solely on non-experimental evidence and expert opinion. The current standard of care, phenytoin, is only 60% effective, and associated with considerable adverse effects. A newer anti-convulsant, levetiracetam, can be given faster, is potentially more efficacious, with a more tolerable side effect profile. The primary aim of the study presented in this protocol is to determine whether intravenous (IV) levetiracetam or IV phenytoin is the better second line treatment for the emergency management of CSE in children. 200 children aged between 3 months and 16 years presenting to 13 emergency departments in Australia and New Zealand with CSE, that has failed to stop with first line benzodiazepines, will be enrolled into this multicentre open randomised controlled trial. Participants will be randomised to 40 mg/kg IV levetiracetam infusion over 5 min or 20 mg/kg IV phenytoin infusion over 20 min. The primary outcome for the study is clinical cessation of seizure activity five minutes following the completion of the infusion of the study medication. Blinded confirmation of the primary outcome will occur with the primary outcome assessment being video recorded and assessed by a primary outcome assessment team blinded to treatment allocation. Secondary outcomes include: Clinical cessation of seizure activity at two hours; Time to clinical seizure cessation; Need for rapid sequence induction; Intensive care unit (ICU) admission; Serious adverse events; Length of Hospital/ICU stay; Health care costs; Seizure status/death at one-month post discharge. This paper presents the background, rationale, and design for a randomised controlled trial comparing levetiracetam to phenytoin in children presenting with CSE in whom benzodiazepines have failed. This study will provide the first high quality evidence for management of paediatric CSE post first-line benzodiazepines. Prospectively registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR): ACTRN12615000129583 (11/2/2015). UTN U1111-1144-5272. ConSEPT protocol version 4 (12/12/2014).

A five-primary photostimulator suitable for studying intrinsically photosensitive retinal ganglion cell functions in humans

PubMed Central

Cao, Dingcai; Nicandro, Nathaniel; Barrionuevo, Pablo A.

2015-01-01

Intrinsically photosensitive retinal ganglion cells (ipRGCs) can respond to light directly through self-contained photopigment, melanopsin. IpRGCs also receive synaptic inputs from rods and cones. Thus, studying ipRGC functions requires a novel photostimulating method that can account for all of the photoreceptor inputs. Here, we introduced an inexpensive LED-based five-primary photostimulator that can control the excitations of rods, S-, M-, L-cones, and melanopsin-containing ipRGCs in humans at constant background photoreceptor excitation levels, a critical requirement for studying the adaptation behavior of ipRGCs with rod, cone, or melanopsin input. We described the theory and technical aspects (including optics, electronics, software, and calibration) of the five-primary photostimulator. Then we presented two preliminary studies using the photostimulator we have implemented to measure melanopsin-mediated pupil responses and temporal contrast sensitivity function (TCSF). The results showed that the S-cone input to pupil responses was antagonistic to the L-, M- or melanopsin inputs, consistent with an S-OFF and (L + M)-ON response property of primate ipRGCs (Dacey et al., 2005). In addition, the melanopsin-mediated TCSF had a distinctive pattern compared with L + M or S-cone mediated TCSF. Other than controlling individual photoreceptor excitation independently, the five-primary photostimulator has the flexibility in presenting stimuli modulating any combination of photoreceptor excitations, which allows researchers to study the mechanisms by which ipRGCs combine various photoreceptor inputs. PMID:25624466

Surgical outcomes for liposarcoma of the lower limbs with synchronous pulmonary metastases.

PubMed

Illuminati, Giulio; Ceccanei, Gianluca; Pacilè, Maria Antonietta; Calio, Francesco G; Migliano, Francesco; Mercurio, Valentina; Pizzardi, Giulia; Nigri, Giuseppe

2010-12-01

Surgical resection of pulmonary metastases from soft tissues sarcomas has typically yielded disparate results, owing to the histologic heterogeneity of various series and the presentation times relative to primary tumor discovery. It was our hypothesis that with expeditious, curative surgical resection of both, primary and metastatic disease, patients with liposarcoma of the lower limb and synchronous, resectable, pulmonary metastases might achieve satisfactory outcomes. A consecutive sample clinical study, with a mean follow-up duration of 30 months. Twenty-two patients (mean age, 50 years), each presenting with a liposarcoma of the lower limb and synchronous, resectable, pulmonary metastases, underwent curative resection of both the primary mass and all pulmonary metastases within a mean of 18 days from presentation (range 9-32 days). Mean overall survival was 28 months, disease-related survival (SE) was 9% at 5 years (±9.7%), and disease-free survival was 9% at 5 years (±7.6%). Expeditious, curative resection of both--primary and metastatic lesions--yields acceptable near-term results, with potential for long-term survival, in patients with liposarcoma of the lower limb and synchronous pulmonary metastases. 2010 Wiley-Liss, Inc.

Diagnosis and management of endometriosis: the role of the advanced practice nurse in primary care.

PubMed

Mao, Alexandra J; Anastasi, Joyce K

2010-02-01

To discuss the etiology, clinical presentation, diagnosis, and management of endometriosis for the advanced practice nurse (APN) in primary care. Selected research, clinical studies, clinical practice guidelines, and review articles. Commonly encountered by the APN in primary care, endometriosis is a chronic, progressive inflammatory disease characterized by endometrial lesions, cysts, fibrosis, or adhesions in the pelvic cavity, causing chronic pelvic pain and infertility in women of reproductive age. Because of its frequently normal physical examination findings, variable clinical presentations, and nonspecific, overlapping symptoms with other conditions, endometriosis can be difficult to diagnose. As there currently are no accurate noninvasive diagnostic tests specific for endometriosis, it is imperative for the APN to become knowledgeable about the etiology, clinical presentation, diagnosis, and current treatment options of this disease. The APN in primary care plays an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. APNs can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease. Practice recommendations include timely diagnosis, pain management, infertility counseling, patient education, and support for quality of life issues.

Transport for abciximab facilitated primary angioplasty versus on-site thrombolysis with a liberal rescue policy: the randomised Holland Infarction Study (HIS).

PubMed

Dieker, Hendrik-Jan; van Horssen, Elvira V; Hersbach, Ferry M R J; Brouwer, Marc A; van Boven, Ad J; van 't Hof, Arnoud W J; Aengevaeren, Wim R M; Verheugt, Freek W A; Bär, Frits W H M

2006-08-01

As of to date, the only large transportation trial comparing on-site fibrin-specific thrombolysis with transfer for primary angioplasty in patients presenting in a referral centre is the DANAMI-2 trial, with only 3% rescue angioplasty. The Holland Infarction Study (HIS) compared abciximab facilitated primary angioplasty (FP) with on-site fibrin-specific thrombolytic therapy (TT) with a liberal protocol-driven rescue angioplasty (transport to intervention centre in case < 50% ST resolution at 60 min). Patients in a referral centre without shock and < 4.5 h of chest pain presenting with ST-elevation having > or = 12 mm ST-segment shift were randomised to either strategy. Of the originally planned 900 patients only 48 were included due to suspension of financial funding. Death, recurrent MI and stroke at one year was 8% for the FP-group and 22% for the TT-group (p = 0.2). Two hours after randomisation the rates of complete ST-segment resolution (> or =70%) were 52% and 35%, respectively (p = 0.2). This prematurely discontinued randomised transportation trial shows favorable trends with respect to long-term clinical outcome and early ST-resolution for abciximab facilitated primary angioplasty. In view of the real world delays associated with interhospital transport for primary angioplasty, treatment strategies focusing on early fibrin-specific lysis with a liberal selective rescue policy are warranted.

Primary intrapulmonary solitary fibrous tumours

PubMed Central

Lin, Xia; Xiang, Yingming; Shi, Hongcan; Zhang, Fangbiao

2018-01-01

Due to the extreme rarity of primary intrapulmonary solitary fibrous tumours (SFTs), their clinical course, imaging characteristics, diagnosis, treatment and prognosis are poorly understood. The present study therefore assessed the diagnosis and management of primary intrapulmonary SFTs and systematically reviewed previously reported cases in the literature. A total of 5 patients who underwent resection for primary intrapulmonary SFTs were enrolled in the present study and their clinical course, tumour characteristics, management and survival were assessed in this retrospective study. Relevant studies regarding primary intrapulmonary SFTs were searched using PubMed and tumour characteristics, clinicopathologic features, therapeutic strategy and survival outcomes were reviewed. Of the 5 cases, all were males, with a mean age of 57.6 years (range, 37–68 years). All patients were asymptomatic and were identified incidentally on routine computed tomography examination. A total of 3 patients underwent thoracotomy and 2 patients underwent video-assisted thoracoscopic surgery. All tumours were completely resected. Postoperative haemorrhage occurred in 1 patient and he received surgical intervention for haemostasis. The average hospital stay was 15 (4–22) days, and no mortality occurred. The mean length of the postoperative follow-up was 37.6 (1–67) months. One patient was lost to follow-up, and 4 patients were asymptomatic. A total of 19 studies were identified from database searches. They included a total of 45 patients: Twenty-three males and 22 females (mean age, 59.4 years; range, 7–81 years). A total of 12 patients were asymptomatic, and pain and coughing were the major symptoms. Five, one, two, four, and 17 tumours occurred in the right upper lobe, right middle lobe, right lower lobe, left upper lobe and left lower lobe, respectively. A total of 39 patients underwent surgery, 1 patient underwent radiotherapy, and 1 patient underwent radiofrequency ablation. A total of 22 patients were followed up and the mean length of the postoperative follow-up was 48 (1–168) months. One patient was diagnosed with chest wall metastases, and 5 patients succumbed to mortality. To conclude, primary intrapulmonary SFTs are extremely rare and typically identified incidentally. The present findings indicated that the left lower lobe was the most common site location and complete surgical resection is a safe and effective treatment. PMID:29467886

Isolated primary lymphedema tarda of the upper limb.

PubMed

Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

2013-03-01

Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

Your Travtek Driving Experience -- Rental Users Study Data Summary

DOT National Transportation Integrated Search

1993-11-01

THIS REPORT DOCUMENTS THE QUESTIONNAIRE DATA COLLECTED AND THE INSTRUMENTS USED FOR THE TRAVTEK EVALUATION TASK BL - RENTAL USERS STUDY. IT PRESENTS SUMMARY STATISTICS FOR THE PRIMARY DRIVERS DERIVED FROM THE RENTER STUDY, WHICH WAS CONDUCTED FROM MA...

Effect of continuous quality improvement analysis on the delivery of primary percutaneous revascularization for acute myocardial infarction: a community hospital experience.

PubMed

Caputo, Ronald P; Kosinski, Robert; Walford, Gary; Giambartolomei, Alex; Grant, William; Reger, Mark J; Simons, Alan; Esente, Paolo

2005-04-01

As time to reperfusion correlates with outcomes, a door-to-balloon time of 90 +/- 30 min for primary percutaneous coronary revascularization (PCI) for the treatment of acute myocardial infarction has been recently established as a guideline by the ACC/AHA. The purpose of this study is to assess the effects of a continuous quality assurance program designed to expedite primary angioplasty at a community hospital. A database of all primary PCI procedures was created in 1998. Two groups of consecutive patients treated with primary PCI were studied. Group 1 represented patients in the time period between 1 June 1998 to 1 November 1998 and group 2 represented patients in the period between 1 January 2000 and 16 June 2000. Continuous quality assurance analysis was performed. Modifications to the primary angioplasty program were initiated in the latter group. Time intervals to certain treatment landmarks were compared between the groups. Significant decreases in the time intervals from emergency room registration to initial electrocardiogram (8.4 +/- 8.2 vs. 3.7 +/- 19.5 min; P < 0.001), presentation to the catheterization laboratory to arterial access (13.5 +/- 12.9 vs. 11.6 +/- 5.8 min; P < 0.001), and emergency room registration to initial angioplasty balloon inflation (132.0 +/- 69.2 vs. 112 +/- 72.0 min; P < 0.001) were achieved. For the subgroup of patients presenting with diagnostic ST elevation myocardial infarction, a large decrease in the door-to-balloon time interval between group 1 and group 2 was demonstrated (114.15 +/- 9.67 vs. 87.92 +/- 10.93 min; P = NS), resulting in compliance with ACC/AHA guidelines. Continuous quality improvement analysis can expedite care for patients treated by primary PCI in the community hospital setting. Copyright 2005 Wiley-Liss, Inc.

Squamous cell carcinoma presenting with trigeminal anesthesia: An uncommon presentation of head & neck cancer with unknown primary.

PubMed

Shah, Ameer T; Dagher, Walid I; O'Leary, Miriam A; Wein, Richard O

The differential diagnosis of facial anesthesia is vast. This may be secondary to trauma, neoplasm, both intracranial and extracranial, infection, and neurologic disease. When evaluating a patient with isolated facial anesthesia, the head and neck surgeon often thinks of adenoid cystic carcinoma, which has a propensity for perineural invasion and spread. When one thinks of head and neck squamous cell carcinoma with or without unknown primary, the typical presentation involves dysphagia, odynophagia, weight loss, hoarseness, or more commonly, a neck mass. Squamous cell carcinoma presenting as facial anesthesia and perineural spread, with no primary site is quite rare. Case presentations and review of the literature. Trigeminal anesthesia is an uncommon presentation of head and neck squamous cell carcinoma with unknown primary. We present two interesting cases of invasive squamous cell carcinoma of the trigeminal nerve, with no primary site identified. We will also review the literature of head and neck malignancies with perineural spread and the management techniques for the two different cases presented. Copyright © 2016 Elsevier Inc. All rights reserved.

Language Preference and Development of Dementia Among Bilingual Individuals

PubMed Central

McMurtray, Aaron; Saito, Erin; Nakamoto, Beau

2015-01-01

In bilingual individuals, regression to a primary language may be associated with development of cognitive impairment and increased risk for development of dementia. This report describes two bilingual patients who presented with early symptoms of dementia after regression to their primary language. The results of this study may help clinicians identify aging bilingual patients who are beginning to develop cognitive impairment or dementia and suggest that further studies on the long term cognitive effects of bilingualism and interactions with the aging process are indicated. PMID:19842364

Language preference and development of dementia among bilingual individuals.

PubMed

McMurtray, Aaron; Saito, Erin; Nakamoto, Beau

2009-10-01

In bilingual individuals, regression to a primary language may be associated with development of cognitive impairment and increased risk for development of dementia. This report describes two bilingual patients who presented with early symptoms of dementia after regression to their primary language. The results of this study may help clinicians identify aging bilingual patients who are beginning to develop cognitive impairment or dementia and suggest that further studies on the long term cognitive effects of bilingualism and interactions with the aging process are indicated.

Primary human immunodeficiency virus infection presenting as elevated aminotransferases.

PubMed

Chen, Yi-Jan; Tsai, Hung-Chin; Cheng, Ming-Fang; Lee, Susan Shin-Jung; Chen, Yao-Shen

2010-06-01

Primary human immunodeficiency virus type 1 (HIV-1) infection is often under-diagnosed because of its nonspecific presentations. Elevated aminotransferase levels is one of its clinical manifestations, but is infrequently reported in the literature. The objective of this study was to investigate cases of elevated aminotransferases as a manifestation of primary HIV-1 infection. A retrospective chart review from October 1990 to May 2009 of HIV-1 infected patients in a registered database at a tertiary hospital was conducted to identify patients diagnosed with primary HIV-1 infection. An elevated aminotransferase level was broadly defined as above-normal values of alanine or aspartate aminotransferases. Acute hepatitis markers were determined using stored serum samples. Twenty-three of the 827 (2.8%) patients were identified as having a primary HIV-1 infection. All were male, with a median age of 26 years (range, 19-77 years), and the majority were men who had sex with men (19/23, 82.6%). The most common clinical manifestations were fever (95.7%), elevated aminotransferases (65.2%), fatigue (47.8%), and pharyngitis (47.8%). The median CD4 lymphocyte count was 374/μL (range, 109-674/μL) and the median log HIV viral load was 5.0 (range, 4.3-5.9). For the 15 patients with abnormal liver function tests, the median aspartate aminotransferase level was 112 U/L (range, 62-969 U/L) and the median alanine aminotransferase level was 146 U/L (range, 42-1,110 U/L). Elevated aminotransferases may be an initial manifestation of primary HIV infection and is more common than expected. Primary HIV-1 infection should be one of the differential diagnoses considered in young men presenting with unexplained, new-onset liver function impairment. Copyright © 2010 Taiwan Society of Microbiology. Published by Elsevier B.V. All rights reserved.

The challenge of diagnosing a malignancy metastatic to the ovary: clinicopathological characteristics vary and morphology can be different from that of the corresponding primary tumor.

PubMed

Lobo, João; Machado, Bianca; Vieira, Renata; Bartosch, Carla

2017-01-01

An accurate diagnosis of metastases to the ovary is essential for adequate patient management. The aim of this retrospective study was to characterize clinicopathological features of metastatic malignancies that presented as an ovarian mass and compare them with their corresponding primary tumors. We reviewed clinical files and histological material of 120 patients with metastases to the ovary, diagnosed in our center between 2000 and 2014. Metastases were diagnosed before (18 %), synchronously (33 %), or after (49 %) the primary tumor was identified; 25 % were single, 40 % were unilateral; 47 % were ≥13 cm. Most originated from the gastrointestinal tract (73 %), followed by breast (13 %), and female reproductive organs (10 %). Gross features varied with primary tumor site. Metastases from gastrointestinal malignancies were significantly larger and frequently showed necrosis. Metastases to the appendix were cystic (94 %), and almost all metastases to the stomach (96 %) and breast (87 %) were solid. The predominant histological pattern was discordant in 44 % cases, mostly due to cystic changes in ovarian metastases which were observed across several histological types. Other metastases showed a predominant histological pattern which was present only focally in the primary tumor. Metastases showed significantly more edema, necrosis, and hemorrhage, but less lymphovascular invasion and inflammatory infiltrate than the corresponding primary tumors. Metastases to the ovary present highly variable clinicopathological features which frequently differ from those of the corresponding primary tumor. A metastasis should always be considered in the differential diagnosis of an ovarian mass. All clinical, imaging, macroscopic, and histological aspects must be taken into account to establish a correct diagnosis which is essential for adequate treatment.

On the Negative Attitude towards Left-Handedness of Pupils

ERIC Educational Resources Information Center

Makashvili, Malkhaz; Taliashvili, Tamar

2009-01-01

Present study was aimed to determine the reasons behind negative attitude of some teachers to the left-handed writing of their pupils. Total of 745 primary school teachers of both sexes, mean age 34, Caucasians, citizens of the Republic Georgia, served as respondents in the study presented. Teachers were requested to answer in writing the…

Market study: 3-D eyetracker

NASA Technical Reports Server (NTRS)

1977-01-01

A market study of a proposed version of a 3-D eyetracker for initial use at NASA's Ames Research Center was made. The commercialization potential of a simplified, less expensive 3-D eyetracker was ascertained. Primary focus on present and potential users of eyetrackers, as well as present and potential manufacturers has provided an effective means of analyzing the prospects for commercialization.

Help-seeking and antibiotic prescribing for acute cough in a Chinese primary care population: a prospective multicentre observational study.

PubMed

Wong, Carmen Ka Man; Liu, Zhaomin; Butler, Chris C; Wong, Samuel Yeung Shan; Fung, Alice; Chan, Dicken; Yip, Benjamin Hon Kei; Kung, Kenny

2016-01-21

Acute cough is a common reason to prescribe antibiotics in primary care. This study aimed to explore help-seeking and antibiotic prescribing for acute cough in Chinese primary care population. This is a prospective multicentre observational study that included adults presenting with acute cough. Clinicians recorded patients' presenting symptoms, examination findings and medication prescription. Patients completed symptom diaries for up to 28 days by charting their symptom severity and recovery. Adjusted binary logistic regression models identified factors independently associated with antibiotic prescription. Primary care clinicians (n=19) recruited 455 patients. A total of 321 patients (70.5%) returned their completed symptom diaries. Concern about illness severity (41.6%) and obtaining a prescription for symptomatic medications (45.9%), rather than obtaining a prescription for antibiotics, were the main reasons for consulting. Antibiotics were prescribed for 6.8% (n=31) of patients, of which amoxicillin was the most common antimicrobial prescribed (61.3%), as it was associated with clinicians' perception of benefit from antibiotic treatment (odds ratio (OR): 25.9, 95% confidence interval (CI): 6.7-101.1), patients' expectation for antibiotics (OR: 5.1, 95% CI: 1.7-11.6), anticipation (OR: 5.1, 95% CI: 1.6-15.0) and request for antibiotics (OR 15.7, 95% CI: 5.0-49.4), as well as the severity of respiratory symptoms (cough, sputum, short of breath and wheeze OR: 2.7-3.7, all P<0.05). There was a significant difference in antibiotic prescription rates between private primary care clinicians and public primary care clinicians (17.4 vs 1.6%, P=0.00). Symptomatic medication was prescribed in 98.0% of patients. Mean recovery was 9 days for cough and 10 days for all symptoms, which was not significantly associated with antibiotic treatment. Although overall antibiotic-prescribing rates were low, there was a higher rate of antibiotic prescribing among private primary care clinicians, which warrants further exploration and scope for education and intervention.

Seeing touch is correlated with content-specific activity in primary somatosensory cortex.

PubMed

Meyer, Kaspar; Kaplan, Jonas T; Essex, Ryan; Damasio, Hanna; Damasio, Antonio

2011-09-01

There is increasing evidence to suggest that primary sensory cortices can become active in the absence of external stimulation in their respective modalities. This occurs, for example, when stimuli processed via one sensory modality imply features characteristic of a different modality; for instance, visual stimuli that imply touch have been observed to activate the primary somatosensory cortex (SI). In the present study, we addressed the question of whether such cross-modal activations are content specific. To this end, we investigated neural activity in the primary somatosensory cortex of subjects who observed human hands engaged in the haptic exploration of different everyday objects. Using multivariate pattern analysis of functional magnetic resonance imaging data, we were able to predict, based exclusively on the activity pattern in SI, which of several objects a subject saw being explored. Along with previous studies that found similar evidence for other modalities, our results suggest that primary sensory cortices represent information relevant for their modality even when this information enters the brain via a different sensory system.

Primary Occipital Ewing's Sarcoma with Subsequent Spinal Seeding.

PubMed

Alqahtani, Ali; Amer, Roaa; Bakhsh, Eman

2017-01-01

Ewing's sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing's sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis. Computed tomography (CT) imaging showed a mass in the left posterior fossa compressing the brainstem. The patient then underwent surgical excision followed by adjuvant chemoradiation therapy. Two years later, the patient presented with severe lower back pain and urinary incontinence. Whole-spine magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) seeding from the L5 to the S4 vertebrae. Primary cranial Ewing's sarcoma is considered in the differential diagnosis of children with extra-axial posterior fossa mass associated with destructive permeative bone lesions. Although primary cranial Ewing's sarcoma typically has good prognosis, our patient developed metastasis in the lower spine. Therefore, with CNS Ewing's sarcoma, screening of the entire neural axis should be taken into consideration for early detection of CSF seeding metastasis in order to decrease the associated morbidity and mortality.

Information processing occurs via critical avalanches in a model of the primary visual cortex

NASA Astrophysics Data System (ADS)

Bortolotto, G. S.; Girardi-Schappo, M.; Gonsalves, J. J.; Pinto, L. T.; Tragtenberg, M. H. R.

2016-01-01

We study a new biologically motivated model for the Macaque monkey primary visual cortex which presents power-law avalanches after a visual stimulus. The signal propagates through all the layers of the model via avalanches that depend on network structure and synaptic parameter. We identify four different avalanche profiles as a function of the excitatory postsynaptic potential. The avalanches follow a size-duration scaling relation and present critical exponents that match experiments. The structure of the network gives rise to a regime of two characteristic spatial scales, one of which vanishes in the thermodynamic limit.

Galanin: A Role in Mesolimbic Dopamine-Mediated Instrumental Behavior?

PubMed Central

Robinson, John K.; Brewer, Ariel

2008-01-01

ROBINSON, J.K. and Brewer, A. Galanin: A Role in Mesolimbic-Dopamine Mediated Instrumental Behavior? NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2008. The involvement of the neuropeptide galanin in the consumption of the primary “commodities” of food and water is well established. However, the present review describes anatomical and behavioral evidence that suggests that galanin may also modulate ascending mesolimbic dopamine function and thereby play an inhibitory role in the systems by which instrumental behavior is energized toward acquiring primary commodities. General anatomical frameworks for this interaction are presented and future studies that could evaluate it are discussed. PMID:18632153

Supporting the improvement and management of prescribing for urinary tract infections (SIMPle): protocol for a cluster randomized trial

PubMed Central

2013-01-01

Background The overuse of antimicrobials is recognized as the main selective pressure driving the emergence and spread of antimicrobial resistance in human bacterial pathogens. Urinary tract infections (UTIs) are among the most common infections presented in primary care and empirical antimicrobial treatment is currently recommended. Previous research has identified that a substantial proportion of Irish general practitioners (GPs) prescribe antimicrobials for UTIs that are not in accordance with the Guidelines for Antimicrobial Prescribing in Primary Care in Ireland. The aim of this trial is to design, implement and evaluate the effectiveness of a complex intervention on GP antimicrobial prescribing and adult (18 years of age and over) patients’ antimicrobial consumption when presenting with a suspected UTI. Methods/design The Supporting the Improvement and Management of Prescribing for urinary tract infections (SIMPle) study is a three-armed intervention with practice-level randomization. Adult patients presenting with suspected UTIs in primary care will be included in the study. The intervention integrates components for both GPs and patients. For GPs the intervention includes interactive workshops, audit and feedback reports and automated electronic prompts summarizing recommended first-line antimicrobial treatment and, for one intervention arm, a recommendation to consider delayed antimicrobial treatment. For patients, multimedia applications and information leaflets are included. Thirty practices will be recruited to the study; laboratory data indicate that 2,038 patients will be prescribed an antimicrobial in the study. The primary outcome is a change in prescribing of first-line antimicrobials for UTIs in accordance with the Guidelines for Antimicrobial Prescribing in Primary Care in Ireland. The study will take place over 15 months with a six-month intervention period. Data will be collected through a remote electronic anonymized data-extraction system, a text-messaging system and GP and patient interviews and surveys. The intervention will be strengthened by the implementation of a social marketing framework and an economic evaluation. Trial registration This intervention is registered at ClinicalTrials.gov, ID NCT01913860. PMID:24359543

[Review of estimation on oceanic primary productivity by using remote sensing methods.

PubMed

Xu, Hong Yun; Zhou, Wei Feng; Ji, Shi Jian

2016-09-01

Accuracy estimation of oceanic primary productivity is of great significance in the assessment and management of fisheries resources, marine ecology systems, global change and other fields. The traditional measurement and estimation of oceanic primary productivity has to rely on in situ sample data by vessels. Satellite remote sensing has advantages of providing dynamic and eco-environmental parameters of ocean surface at large scale in real time. Thus, satellite remote sensing has increasingly become an important means for oceanic primary productivity estimation on large spatio-temporal scale. Combining with the development of ocean color sensors, the models to estimate the oceanic primary productivity by satellite remote sensing have been developed that could be mainly summarized as chlorophyll-based, carbon-based and phytoplankton absorption-based approach. The flexibility and complexity of the three kinds of models were presented in the paper. On this basis, the current research status for global estimation of oceanic primary productivity was analyzed and evaluated. In view of these, four research fields needed to be strengthened in further stu-dy: 1) Global oceanic primary productivity estimation should be segmented and studied, 2) to dee-pen the research on absorption coefficient of phytoplankton, 3) to enhance the technology of ocea-nic remote sensing, 4) to improve the in situ measurement of primary productivity.

The Development and Validation of a Rapid Assessment Tool of Primary Care in China

PubMed Central

Mei, Jie; Liang, Yuan; Shi, LeiYu; Zhao, JingGe; Wang, YuTan; Kuang, Li

2016-01-01

Introduction. With Chinese health care reform increasingly emphasizing the importance of primary care, the need for a tool to evaluate primary care performance and service delivery is clear. This study presents a methodology for a rapid assessment of primary care organizations and service delivery in China. Methods. The study translated and adapted the Primary Care Assessment Tool-Adult Edition (PCAT-AE) into a Chinese version to measure core dimensions of primary care, namely, first contact, continuity, comprehensiveness, and coordination. A cross-sectional survey was conducted to assess the validity and reliability of the Chinese Rapid Primary Care Assessment Tool (CR-PCAT). Eight community health centers in Guangdong province have been selected to participate in the survey. Results. A total of 1465 effective samples were included for data analysis. Eight items were eliminated following principal component analysis and reliability testing. The principal component analysis extracted five multiple-item scales (first contact utilization, first contact accessibility, ongoing care, comprehensiveness, and coordination). The tests of scaling assumptions were basically met. Conclusion. The standard psychometric evaluation indicates that the scales have achieved relatively good reliability and validity. The CR-PCAT provides a rapid and reliable measure of four core dimensions of primary care, which could be applied in various scenarios. PMID:26885509

Gastric involvement in patients with primary mediastinal large B-cell lymphoma.

PubMed

Papageorgiou, Sotirios G; Sachanas, Sotirios; Pangalis, Gerassimos A; Tsopra, Olga; Levidou, Georgia; Foukas, Periklis; Rondogianni, Phoivi; Sotiropoulos, Vasileios; Ioannidou, Helen-Dikaia; Gassiamis, Argyris; Iliakis, Theodoros; Korkolopoulou, Penelope; Angelopoulou, Maria K; Pappa, Vasiliki; Konstantopoulos, Konstantinos; Vassilakopoulos, Theodoros P

2014-11-01

Gastric involvement is unusual in primary mediastinal large B-cell lymphoma (PMLBCL), which has not yet been adequately studied. The aim of this retrospective study was to investigate the frequency of gastric involvement in 204 consecutive patients with PMLBCL that presented at 23 hospitals in Greece. Two out of 204 patients (1.0%) had gastric involvement at presentation. The first patient had symptomatic gastric disease manifested as upper gastrointestinal (GI) hemorrhage, which was the presenting symptom (first case reported in the literature). The second patient underwent positron emission tomography/computed tomography (PET/CT) at baseline staging which revealed abnormal gastric uptake. Histological examination revealed discordant lymphomatous involvement (MALT lymphoma, in a 33-year old female). The estimated frequency of gastric involvement by conventional staging was 1/204 (0.49%), but no cases were identified among asymptomatic patients. Among asymptomatic patients who underwent PET/CT at baseline staging, the PET/CT-based frequency of gastric involvement was 7.1%, but lymphomatous gastric involvement was discordant. Finally, the frequency of gastric involvement in primary progressive or relapsed disease was 2.2%. Our study shows that gastric involvement is uncommon but can be seen in different clinical settings at presentation or at progression/relapse of PMLBCL. PET/CT-based staging may provide more accurate information regarding the true incidence of sub-clinical gastric involvement in this entity, but histological confirmation is essential in order to confirm the diagnosis. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

The Contributions of Primary and Secondary Memory to Working Memory Capacity: An Individual Differences Analysis of Immediate Free Recall

ERIC Educational Resources Information Center

Unsworth, Nash; Spillers, Gregory J.; Brewer, Gene A.

2010-01-01

The present study tested the dual-component model of working memory capacity (WMC) by examining estimates of primary memory and secondary memory from an immediate free recall task. Participants completed multiple measures of WMC and general intellectual ability as well as multiple trials of an immediate free recall task. It was demonstrated that…

Are Males and Females Still Portrayed Stereotypically? Visual Analyses of Gender in Two Hong Kong Primary English Language Textbook Series

ERIC Educational Resources Information Center

Yang, Chi Cheung Ruby

2016-01-01

The present study examines how gender is represented in the visuals (or illustrations) of two English Language textbook series used in most primary schools in Hong Kong. Instead of conducting frequency counts of the occurrence of male and female characters in illustrations, or the spheres of activities they engaged in as in many previous textbook…

How People Live. Language Arts Theme Units: Cross-Curricular Activities for Primary Grades.

ERIC Educational Resources Information Center

McAllister, Elizabeth A.; Hildebrand, Joan M.; Ericson, Joann H.

This book is part of a series of books presenting ready-to-use instructional units on themes typically taught in the primary grades. The topics focus on science, math, social studies or literature, but use language arts skills consistently in each unit. Each book in the series also uses as many frames of mind or intelligences as possible. Within a…

The Primary Student Teachers' Views about a Blended Learning Application in a Basic Physics Course

ERIC Educational Resources Information Center

Taskin Ekici, Fatma; Kara, Izzet; Ekici, Erhan

2012-01-01

In this study we present an overview of the undergraduate blended Physics course that has been supported by the Moodle platform. The course that has been applied is a basic physics course for primary student teachers. The aim of Moodle is to create an online learning environment which helps students to have a virtual space where they can share…

Cognition, Affect and Relationality: Experiences of Student Teachers in a Course on Multiculturalism in Primary Teacher Education in Aotearoa/New Zealand

ERIC Educational Resources Information Center

de Oliveira Andreotti, Vanessa; Fa'afoi, Amosa; Sitomaniemi-San, Johanna; Ahenakew, Cash

2014-01-01

This article presents an analysis of journal entries of student teachers in a course on multicultural and language studies in primary education in Aotearoa/New Zealand, which was informed by a discursive strand of postcolonial theory, in particular Gayatri C. Spivak's ideas of education "to-come" as an "un-coercive rearrangement of…

Exploring Primary Children's Views and Experiences of the School Ground: The Case of a Greek School

ERIC Educational Resources Information Center

Christidou, Vasilia; Tsevreni, Irida; Epitropou, Maria; Kittas, Constantinos

2013-01-01

The present study explores the use of a conventional school ground of a primary school and its potential as a space for creative play and environmental learning. Children's play behavior and views of the school ground are explored, as well as their vision for its improvement. The research constitutes part of a wider school ground project and was…

An Exploratory Study of GP Perceptions of the Impact of a Primary Care Counselling Service on Their Practice

ERIC Educational Resources Information Center

Schafer, Tim; Amoateng, Geoffrey; Wrycraft, Nick

2009-01-01

This paper presents the results of research into GP perceptions of the impact of on-site counselling on general practice. The research is part of a larger evaluation of a local enhanced primary care mental service. The initial survey and in-depth interviews with GPs reported here focused on the pre-existing counselling service. The results suggest…

The Animals Around Us. Language Arts Theme Units: Cross-Curricular Activities for Primary Grades.

ERIC Educational Resources Information Center

McAllister, Elizabeth A.; Hildebrand, Joan M.; Ericson, Joann H.

This book is part of a series of books presenting ready-to-use instructional units on themes typically taught in the primary grades. The topics focus on science, math, social studies or literature, but use language arts skills consistently in each unit. Each book in the series also uses as many frames of mind or intelligences as possible. Within a…

The Use of History and Philosophy of Science as a Core for a Socioconstructivist Teaching Approach of the Concept of Energy in Primary Education

ERIC Educational Resources Information Center

Rizaki, Aikaterini; Kokkotas, Panagiotis

2013-01-01

The present study should be thought as a socioconstructivist teaching approach (a teaching model) for the concept of energy in primary education. It contains important and crucial aspects of the History and Philosophy of Natural Sciences, introduces the concept of energy using the macroscopic framework of thermodynamics, takes into consideration…

Comparative Examination of the Primary School Science Curricula in Turkey (Curricula of 1992, 2001, 2005, 2013 and 2017)

ERIC Educational Resources Information Center

Hamurcu, Hülya

2018-01-01

In the present study, the science course curricula of 1992, 2001, 2005, 2013 and 2017 taught at the primary school level in Turkey have been examined comparatively in terms of four main elements (Target, Content, Educational Status, and Measurement and Evaluation). The reason for investigating the science curriculum at five key years was to…

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users' and health professionals' perceptions.

PubMed

Solberg, Hilde Strøm; Steinsbekk, Aslak; Solbjør, Marit; Granbo, Randi; Garåsen, Helge

2014-11-08

Development of more self-management support programmes in primary health care has been one option used to enhance positive outcomes in chronic disease management. At present, research results provide no consensus on what would be the best way to develop support programmes into new settings. The aim of the present study was therefore to explore users' and health professionals' perceptions of what would be the vital elements in a self - management support programme applicable in primary health care, how to account for them, and why. Four qualitative, semi-structured focus group interviews were conducted in Central Norway. The informants possessed experience in development, provision, or participation in a self-management support programme. Data was analysed by the Systematic Text Condensation method. The results showed an overall positive expectation to the potential benefits of development of a self-management support programme in primary health care. Despite somewhat different arguments and perspectives, the users and the health professionals had a joint agreement on core characteristics; a self-management support programme in primary health care should therefore be generic, not disease specific, and delivered in a group- based format. A special focus should be on the everyday- life of the participants. The most challenging aspect was a present lack of competence and experience among health professionals to moderate self-management support programmes. The development and design of a relevant and applicable self-management support programme in primary health care should balance the interests of the users with the possibilities and constraints within each municipality. It would be vital to benefit from the closeness of the patients' every-day life situations. The user informants' perception of a self-management support programme as a supplement to regular medical treatment represented an expanded understanding of the self-management support concept. An exploring approach should be applied in the development of the health professionals' competence in practice. The effect of a self-management support programme based on the core characteristics found in this study needs to be evaluated.

Exposure to subliminal arousing stimuli induces robust activation in the amygdala, hippocampus, anterior cingulate, insular cortex and primary visual cortex: a systematic meta-analysis of fMRI studies.

PubMed

Brooks, S J; Savov, V; Allzén, E; Benedict, C; Fredriksson, R; Schiöth, H B

2012-02-01

Functional Magnetic Resonance Imaging (fMRI) demonstrates that the subliminal presentation of arousing stimuli can activate subcortical brain regions independently of consciousness-generating top-down cortical modulation loops. Delineating these processes may elucidate mechanisms for arousal, aberration in which may underlie some psychiatric conditions. Here we are the first to review and discuss four Activation Likelihood Estimation (ALE) meta-analyses of fMRI studies using subliminal paradigms. We find a maximum of 9 out of 12 studies using subliminal presentation of faces contributing to activation of the amygdala, and also a significantly high number of studies reporting activation in the bilateral anterior cingulate, bilateral insular cortex, hippocampus and primary visual cortex. Subliminal faces are the strongest modality, whereas lexical stimuli are the weakest. Meta-analyses independent of studies using Regions of Interest (ROI) revealed no biasing effect. Core neuronal arousal in the brain, which may be at first independent of conscious processing, potentially involves a network incorporating primary visual areas, somatosensory, implicit memory and conflict monitoring regions. These data could provide candidate brain regions for the study of psychiatric disorders associated with aberrant automatic emotional processing. Copyright © 2011 Elsevier Inc. All rights reserved.

Archiving Primary Data: Solutions for Long-Term Studies.

PubMed

Mills, James A; Teplitsky, Céline; Arroyo, Beatriz; Charmantier, Anne; Becker, Peter H; Birkhead, Tim R; Bize, Pierre; Blumstein, Daniel T; Bonenfant, Christophe; Boutin, Stan; Bushuev, Andrey; Cam, Emmanuelle; Cockburn, Andrew; Côté, Steeve D; Coulson, John C; Daunt, Francis; Dingemanse, Niels J; Doligez, Blandine; Drummond, Hugh; Espie, Richard H M; Festa-Bianchet, Marco; Frentiu, Francesca; Fitzpatrick, John W; Furness, Robert W; Garant, Dany; Gauthier, Gilles; Grant, Peter R; Griesser, Michael; Gustafsson, Lars; Hansson, Bengt; Harris, Michael P; Jiguet, Frédéric; Kjellander, Petter; Korpimäki, Erkki; Krebs, Charles J; Lens, Luc; Linnell, John D C; Low, Matthew; McAdam, Andrew; Margalida, Antoni; Merilä, Juha; Møller, Anders P; Nakagawa, Shinichi; Nilsson, Jan-Åke; Nisbet, Ian C T; van Noordwijk, Arie J; Oro, Daniel; Pärt, Tomas; Pelletier, Fanie; Potti, Jaime; Pujol, Benoit; Réale, Denis; Rockwell, Robert F; Ropert-Coudert, Yan; Roulin, Alexandre; Sedinger, James S; Swenson, Jon E; Thébaud, Christophe; Visser, Marcel E; Wanless, Sarah; Westneat, David F; Wilson, Alastair J; Zedrosser, Andreas

2015-10-01

The recent trend for journals to require open access to primary data included in publications has been embraced by many biologists, but has caused apprehension amongst researchers engaged in long-term ecological and evolutionary studies. A worldwide survey of 73 principal investigators (Pls) with long-term studies revealed positive attitudes towards sharing data with the agreement or involvement of the PI, and 93% of PIs have historically shared data. Only 8% were in favor of uncontrolled, open access to primary data while 63% expressed serious concern. We present here their viewpoint on an issue that can have non-trivial scientific consequences. We discuss potential costs of public data archiving and provide possible solutions to meet the needs of journals and researchers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cell-type-specific and differentiation-status-dependent variations in cytotoxicity of tributyltin in cultured rat cerebral neurons and astrocytes.

PubMed

Oyanagi, Koshi; Tashiro, Tomoko; Negishi, Takayuki

2015-08-01

Tributyltin (TBT) is an organotin used as an anti-fouling agent for fishing nets and ships and it is a widespread environmental contaminant at present. There is an increasing concern about imperceptible but serious adverse effect(s) of exposure to chemicals existing in the environment on various organs and their physiological functions, e.g. brain and mental function. Here, so as to contribute to improvement of and/or advances in in vitro cell-based assay systems for evaluating brain-targeted adverse effect of chemicals, we tried to evaluate cell-type-specific and differentiation-status-dependent variations in the cytotoxicity of TBT towards neurons and astrocytes using the four culture systems differing in the relative abundance of these two types of cells; primary neuron culture (> 95% neurons), primary neuron-astrocyte (2 : 1) mix culture, primary astrocyte culture (> 95% astrocytes), and passaged astrocyte culture (100% proliferative astrocytes). Cell viability was measured at 48 hr after exposure to TBT in serum-free medium. IC50's of TBT were 198 nM in primary neuron culture, 288 nM in primary neuron-astrocyte mix culture, 2001 nM in primary astrocyte culture, and 1989 nM in passaged astrocyte culture. Furthermore, in primary neuron-astrocyte mix culture, vulnerability of neurons cultured along with astrocytes to TBT toxicity was lower than that of neurons cultured purely in primary neuron culture. On the other hand, astrocytes in primary neuron-astrocyte mix culture were considered to be more vulnerable to TBT than those in primary or passaged astrocyte culture. The present study demonstrated variable cytotoxicity of TBT in neural cells depending on the culture condition.

Basic instinct undressed: early spatiotemporal processing for primary sexual characteristics.

PubMed

Legrand, Lore B; Del Zotto, Marzia; Tyrand, Rémi; Pegna, Alan J

2013-01-01

This study investigates the spatiotemporal dynamics associated with conscious and non-conscious processing of naked and dressed human bodies. To this effect, stimuli of naked men and women with visible primary sexual characteristics, as well as dressed bodies, were presented to 20 heterosexual male and female participants while acquiring high resolution EEG data. The stimuli were either consciously detectable (supraliminal presentations) or were rendered non-conscious through backward masking (subliminal presentations). The N1 event-related potential component was significantly enhanced in participants when they viewed naked compared to dressed bodies under supraliminal viewing conditions. More importantly, naked bodies of the opposite sex produced a significantly greater N1 component compared to dressed bodies during subliminal presentations, when participants were not aware of the stimulus presented. A source localization algorithm computed on the N1 showed that the response for naked bodies in the supraliminal viewing condition was stronger in body processing areas, primary visual areas and additional structures related to emotion processing. By contrast, in the subliminal viewing condition, only visual and body processing areas were found to be activated. These results suggest that naked bodies and primary sexual characteristics are processed early in time (i.e., <200 ms) and activate key brain structures even when they are not consciously detected. It appears that, similarly to what has been reported for emotional faces, sexual features benefit from automatic and rapid processing, most likely due to their high relevance for the individual and their importance for the species in terms of reproductive success.

Your TravTek driving experience : rental users study : data summary

DOT National Transportation Integrated Search

1993-11-01

This report documents the questionnaire data collected and the instruments used for the TravTek : Evaluation Task Bl - Rental Users Study. It presents summary statistics for the primary drivers : derived from the renter study, which was conducted fro...

Presentation and outcome of clinical poor performance in one health district over a 5-year period: 2002–2007

PubMed Central

Cox, Stephen J; Holden, John D

2009-01-01

Background The detection, assessment, and management of primary care poor performance raise difficult issues for all those involved. Guidance has largely focused on managing the most serious cases where patient safety is severely compromised. The management of primary care poor performance has become an increasingly important part of primary care trust (PCT) work, but its modes of presentation and prevalence are not well known. Aim To report the prevalence, presentation modes, and management of primary care poor performance cases presenting to one PCT over a 5-year period. Design of study A retrospective review of primary care poor performance cases in one district. Setting St Helens PCT administered 35 practices with 130 GPs on the performers list, caring for 190 110 patients in North West England, UK. Method Cases presenting during 2002–2007 were initially reviewed by the chair of the PCT clinical executive committee. Anonymised data were then jointly reviewed by the assessor and another experienced GP advisor. Results There were 102 individual presentations (20 per year or one every 2–3 weeks) where clinician performance raised significant cause for concern occurred over the 5-year period. These concerns related to 37 individual clinicians, a range of 1–14 per clinician (mean 2.7). Whistleblowing by professional colleagues on 43 occasions was the most common presentation, of which 26 were from GPs about GPs. Patient complaints (18) were the second most common presentation. Twenty-seven clinicians were GPs, of whom the General Medical Council (GMC) were notified or involved in 13 cases. Clinicians were supported locally, and remedying was exclusively locally managed in 14 cases, and shared with an external organisation (such as the GMC or deanery) in another 12. Conclusion Professional whistleblowing and patient complaints were the most common sources of presentation. Effective PCT teams are needed to manage clinicians whose performance gives cause for concern. Sufficient resources and both formal and informal ways of reporting concerns are essential. PMID:19401017

CURRICULUM GUIDE IN CONSERVATION EDUCATION.

ERIC Educational Resources Information Center

HERRINGTON, EUGENE H.; ROBBINS, LARRY

THIS CURRICULUM GUIDE PRESENTS CONSERVATION OF NATURAL RESOURCES AS AN INTEGRATED NATURAL SCIENCE STUDY. NATURAL RESOURCES ARE SEEN AS BEING INORGANIC (MINERALS, AIR, WATER, AND SOIL) OR ORGANIC (PLANT, ANIMAL, AND HUMAN). THESE RESOURCES ARE PRESENTED AS SUGGESTED CLASSROOM ACTIVITIES DESIGNED FOR THE PRIMARY, INTERMEDIATE, AND JUNIOR HIGH…

Understanding metal homeostasis in primary cultured neurons. Studies using single neuron subcellular and quantitative metallomics.

PubMed

Colvin, Robert A; Lai, Barry; Holmes, William R; Lee, Daewoo

2015-07-01

The purpose of this study was to demonstrate how single cell quantitative and subcellular metallomics inform us about both the spatial distribution and cellular mechanisms of metal buffering and homeostasis in primary cultured neurons from embryonic rat brain, which are often used as models of human disease involving metal dyshomeostasis. The present studies utilized synchrotron radiation X-ray fluorescence (SRXRF) and focused primarily on zinc and iron, two abundant metals in neurons that have been implicated in the pathogenesis of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease. Total single cell contents for calcium, iron, zinc, copper, manganese, and nickel were determined. Resting steady state zinc showed a diffuse distribution in both soma and processes, best defined by the mass profile of the neuron with an enrichment in the nucleus compared with the cytoplasm. Zinc buffering and homeostasis was studied using two modes of cellular zinc loading - transporter and ionophore (pyrithione) mediated. Single neuron zinc contents were shown to statistically significantly increase by either loading method - ionophore: 160 million to 7 billion; transporter 160 million to 280 million atoms per neuronal soma. The newly acquired and buffered zinc still showed a diffuse distribution. Soma and processes have about equal abilities to take up zinc via transporter mediated pathways. Copper levels are distributed diffusely as well, but are relatively higher in the processes relative to zinc levels. Prior studies have observed iron puncta in certain cell types, but others have not. In the present study, iron puncta were characterized in several primary neuronal types. The results show that iron puncta could be found in all neuronal types studied and can account for up to 50% of the total steady state content of iron in neuronal soma. Although other metals can be present in iron puncta, they are predominantly iron containing and do not appear to be associated with ferritin cages or transferrin receptor endosomes. The iron content and its distribution in puncta were similar in all neuron types studied including primary dopaminergic neurons. In summary, quantitative measurements of steady state metal levels in single primary cultured neurons made possible by SRXRF analyses provide unique information on the relative levels of each metal in neuronal soma and processes, subcellular location of zinc loads, and have confirmed and extended the characterization of heretofore poorly understood cytoplasmic iron puncta.

A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis.

PubMed

Contandriopoulos, Damien; Brousselle, Astrid; Dubois, Carl-Ardy; Perroux, Mélanie; Beaulieu, Marie-Dominique; Brault, Isabelle; Kilpatrick, Kelley; D'Amour, Danielle; Sansgter-Gormley, Esther

2015-02-27

Integrating Nurse Practitioners into primary care teams is a process that involves significant challenges. To be successful, nurse practitioner integration into primary care teams requires, among other things, a redefinition of professional boundaries, in particular those of medicine and nursing, a coherent model of inter- and intra- professional collaboration, and team-based work processes that make the best use of the subsidiarity principle. There have been numerous studies on nurse practitioner integration, and the literature provides a comprehensive list of barriers to, and facilitators of, integration. However, this literature is much less prolific in discussing the operational level implications of those barriers and facilitators and in offering practical recommendations. In the context of a large-scale research project on the introduction of nurse practitioners in Quebec (Canada) we relied on a logic-analysis approach based, on the one hand on a realist review of the literature and, on the other hand, on qualitative case-studies in 6 primary healthcare teams in rural and urban area of Quebec. Five core themes that need to be taken into account when integrating nurse practitioners into primary care teams were identified. Those themes are: planning, role definition, practice model, collaboration, and team support. The present paper has two objectives: to present the methods used to develop the themes, and to discuss an integrative model of nurse practitioner integration support centered around these themes. It concludes with a discussion of how this framework contributes to existing knowledge and some ideas for future avenues of study.

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) project: an open-label pragmatic randomised control trial comparing the efficacy of differing therapeutic agents for primary care detoxification from either street heroin or methadone [ISRCTN07752728].

PubMed

Oldham, Nicola S; Wright, Nat M J; Adams, Clive E; Sheard, Laura; Tompkins, Charlotte N E

2004-04-29

Heroin is a synthetic opioid with an extensive illicit market leading to large numbers of people becoming addicted. Heroin users often present to community treatment services requesting detoxification and in the UK various agents are used to control symptoms of withdrawal. Dissatisfaction with methadone detoxification 8 has lead to the use of clonidine, lofexidine, buprenorphine and dihydrocodeine; however, there remains limited evaluative research. In Leeds, a city of 700,000 people in the North of England, dihydrocodeine is the detoxification agent of choice. Sublingual buprenorphine, however, is being introduced. The comparative value of these two drugs for helping people successfully and comfortably withdraw from heroin has never been compared in a randomised trial. Additionally, there is a paucity of research evaluating interventions among drug users in the primary care setting. This study seeks to address this by randomising drug users presenting in primary care to receive either dihydrocodeine or buprenorphine. The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) project is a pragmatic randomised trial which will compare the open use of buprenorphine with dihydrocodeine for illicit opiate detoxification, in the UK primary care setting. The LEEDS project will involve consenting adults and will be run in specialist general practice surgeries throughout Leeds. The primary outcome will be the results of a urine opiate screening at the end of the detoxification regimen. Adverse effects and limited data to three and six months will be acquired.

Intratumor heterogeneity and clonal evolution in an aggressive papillary thyroid cancer and matched metastases.

PubMed

Le Pennec, Soazig; Konopka, Tomasz; Gacquer, David; Fimereli, Danai; Tarabichi, Maxime; Tomás, Gil; Savagner, Frédérique; Decaussin-Petrucci, Myriam; Trésallet, Christophe; Andry, Guy; Larsimont, Denis; Detours, Vincent; Maenhaut, Carine

2015-04-01

The contribution of intratumor heterogeneity to thyroid metastatic cancers is still unknown. The clonal relationships between the primary thyroid tumors and lymph nodes (LN) or distant metastases are also poorly understood. The objective of this study was to determine the phylogenetic relationships between matched primary thyroid tumors and metastases. We searched for non-synonymous single-nucleotide variants (nsSNVs), gene fusions, alternative transcripts, and loss of heterozygosity (LOH) by paired-end massively parallel sequencing of cDNA (RNA-Seq) in a patient diagnosed with an aggressive papillary thyroid cancer (PTC). Seven tumor samples from a stage IVc PTC patient were analyzed by RNA-Seq: two areas from the primary tumor, four areas from two LN metastases, and one area from a pleural metastasis (PLM). A large panel of other thyroid tumors was used for Sanger sequencing screening. We identified seven new nsSNVs. Some of these were early events clonally present in both the primary PTC and the three matched metastases. Other nsSNVs were private to the primary tumor, the LN metastases and/or the PLM. Three new gene fusions were identified. A novel cancer-specific KAZN alternative transcript was detected in this aggressive PTC and in dozens of additional thyroid tumors. The PLM harbored an exclusive whole-chromosome 19 LOH. We have presented the first, to our knowledge, deep sequencing study comparing the mutational spectra in a PTC and both LN and distant metastases. This study has yielded novel findings concerning intra-tumor heterogeneity, clonal evolution and metastases dissemination in thyroid cancer. © 2015 Society for Endocrinology.

On the measurement of pilot perceptual workload - A comparison of assessment techniques addressing sensitivity and intrusion issues

NASA Technical Reports Server (NTRS)

Casali, J. G.; Wierwille, W. W.

1984-01-01

A flight simulator-based study was conducted to examine fourteen distinct mental workload estimation measures, including opinion, secondary task, physiological, and primary task measures. Both the relative sensitivity of the measures to changes in mental workload and the differential intrusion of the changes on primary task performance were assessed. The flight task was varied in difficulty by manipulation of the presentation rate and complexity of a hazard-perception task that required each of 48 licensed pilots to rely heavily on their perceptual abilities. Three rating scales (Modified Cooper-Harper, Multi-descriptor, and Workload-Compensation-Interference/Technical Effectiveness), two secondary task measures (time estimation and tapping regularity), one physiological measure (respiration frequency), and one primary task measure (danger-condition response time) were reliable indicants of workload changes. Recommendations for applying the workload measures are presented.

Brain metastases in patients diagnosed with a solid primary cancer during childhood: experience from a single referral cancer center.

PubMed

Suki, Dima; Khoury Abdulla, Rami; Ding, Minming; Khatua, Soumen; Sawaya, Raymond

2014-10-01

Metastasis to the brain is frequent in adult cancer patients but rare among children. Advances in primary tumor treatment and the associated prolonged survival are said to have increased the frequency of brain metastasis in children. The authors present a series of cases of brain metastases in children diagnosed with a solid primary cancer, evaluate brain metastasis trends, and describe tumor type, patterns of occurrence, and prognosis. Patients with brain metastases whose primary cancer was diagnosed during childhood were identified in the 1990-2012 Tumor Registry at The University of Texas M.D. Anderson Cancer Center. A review of their hospital records provided demographic data, history, and clinical data, including primary cancer sites, number and location of brain metastases, sites of extracranial metastases, treatments, and outcomes. Fifty-four pediatric patients (1.4%) had a brain metastasis from a solid primary tumor. Sarcomas were the most common (54%), followed by melanoma (15%). The patients' median ages at diagnosis of the primary cancer and the brain metastasis were 11.37 years and 15.03 years, respectively. The primary cancer was localized at diagnosis in 48% of patients and disseminated regionally in only 14%. The primary tumor and brain metastasis presented synchronously in 15% of patients, and other extracranial metastases were present when the primary cancer was diagnosed. The remaining patients were diagnosed with brain metastasis after initiation of primary cancer treatment, with a median presentation interval of 17 months after primary cancer diagnosis (range 2-77 months). At the time of diagnosis, the brain metastasis was the first site of systemic metastasis in only 4 (8%) of the 51 patients for whom data were available. Up to 70% of patients had lung metastases when brain metastases were found. Symptoms led to the brain metastasis diagnosis in 65% of cases. Brain metastases were single in 60% of cases and multiple in 35%; 6% had only leptomeningeal disease. The median Kaplan-Meier estimates of survival after diagnoses of primary cancer and brain metastasis were 29 months (95% CI 24-34 months) and 9 months (95% CI 6-11 months), respectively. Untreated patients survived for a median of 0.9 months after brain metastasis diagnosis (95% CI 0.3-1.5 months). Those receiving treatment survived for a median of 8 months after initiation of therapy (95% CI 6-11 months). The results of this study challenge the current notion of an increased incidence of brain metastases among children with a solid primary cancer. The earlier diagnosis of the primary cancer, prior to its dissemination to distant sites (especially the brain), and initiation of presumably more effective treatments may support such an observation. However, although the actual number of cases may not be increasing, the prognosis after the diagnosis of a brain metastasis remains poor regardless of the management strategy.

Primary Hyperventilation in the Emergency Department: A First Overview

PubMed Central

Pfortmueller, Carmen Andrea; Pauchard-Neuwerth, Sandra Elisabeth; Leichtle, Alexander Benedikt; Fiedler, Georg Martin; Exadaktylos, Aristomenis Konstantinos; Lindner, Gregor

2015-01-01

Background Primary hyperventilation is defined as a state of alveolar ventilation in excess of metabolic requirements, leading to decreased arterial partial pressure of carbon dioxide. The primary aim of this study was to characterise patients diagnosed with primary hyperventilation in the ED. Methods Our retrospective cohort study comprised adult (≥16 years) patients admitted to our ED between 1 January 2006 and 31 December 2012 with the primary diagnosis of primary (=psychogenic) hyperventilation. Results A total of 616 patients were eligible for study. Participants were predominantely female (341 [55.4%] female versus 275 [44.6%] male respectively, p <0.01). The mean age was 36.5 years (SD 15.52, range 16-85). Patients in their twenties were the most common age group (181, 29.4%), followed by patients in their thirties (121, 19.6%). Most patients presented at out-of-office hours (331 [53.7%]. The most common symptom was fear (586, 95.1%), followed by paraesthesia (379, 61.5%) and dizziness (306, 49.7%). Almost a third (187, 30.4%) of our patients had previously experienced an episode of hyperventilation and half (311, 50.5%) of patients had a psychiatric co-morbidity. Conclusion Hyperventilation is a diagnostic chimera with a wide spectrum of symptoms. Patients predominantly are of young age, female sex and often have psychiatric comorbidities. The severity of symptoms accompanied with primary hyperventilation most often needs further work-up to rule out other diagnosis in a mostly young population. In the future, further prospective multicentre studies are needed to evaluate and establish clear diagnostic criteria for primary hyperventilation and possible screening instruments. PMID:26110771

Primary Hyperventilation in the Emergency Department: A First Overview.

PubMed

Pfortmueller, Carmen Andrea; Pauchard-Neuwerth, Sandra Elisabeth; Leichtle, Alexander Benedikt; Fiedler, Georg Martin; Exadaktylos, Aristomenis Konstantinos; Lindner, Gregor

2015-01-01

Primary hyperventilation is defined as a state of alveolar ventilation in excess of metabolic requirements, leading to decreased arterial partial pressure of carbon dioxide. The primary aim of this study was to characterise patients diagnosed with primary hyperventilation in the ED. Our retrospective cohort study comprised adult (≥16 years) patients admitted to our ED between 1 January 2006 and 31 December 2012 with the primary diagnosis of primary (=psychogenic) hyperventilation. A total of 616 patients were eligible for study. Participants were predominantely female (341 [55.4%] female versus 275 [44.6%] male respectively, p <0.01). The mean age was 36.5 years (SD 15.52, range 16-85). Patients in their twenties were the most common age group (181, 29.4%), followed by patients in their thirties (121, 19.6%). Most patients presented at out-of-office hours (331 [53.7%]. The most common symptom was fear (586, 95.1%), followed by paraesthesia (379, 61.5%) and dizziness (306, 49.7%). Almost a third (187, 30.4%) of our patients had previously experienced an episode of hyperventilation and half (311, 50.5%) of patients had a psychiatric co-morbidity. Hyperventilation is a diagnostic chimera with a wide spectrum of symptoms. Patients predominantly are of young age, female sex and often have psychiatric comorbidities. The severity of symptoms accompanied with primary hyperventilation most often needs further work-up to rule out other diagnosis in a mostly young population. In the future, further prospective multicentre studies are needed to evaluate and establish clear diagnostic criteria for primary hyperventilation and possible screening instruments.

Prevalence of undifferentiated fever in adults of Rawalpindi having primary dengue fever.

PubMed

Zafar, Humaira; Hayyat, Abbas; Akhtar, Naeem; Rizwan, Syeda Fatima

2013-06-01

The objectives of the study were to highlight early subclinical presentation of dengue viral infection (DVI) as an undifferentiated febrile illness. The descriptive cross-sectional study was carried out at Microbiology Department, Rawalpindi Medical College from March to September 2009. Stratified random sampling was used to select subjects from various urban and rural areas of Rawalpindi, and Serum IgG anti-dengue antibodies were detected by using 3rd generation enzyme-linked immunosorbent assay (ELISA). Out of the total 240 subjects, 69 (28.75%) were found to be positive for anti-dengue IgG antibodies. Of the positive cases, 41 (59.4%) - comprising 31 (44.9%) urban residents - and 10 (14.4%) rural residents presented with a previous history of undifferentiated fever (p<0.05). It was concluded that primary DVI can present as subclinical form in healthy population residing in rural and urban areas of Rawalpindi, which is an alarming situation indicating the spread of disease in the study area.

Small bowel intussusception due to a primary non-Hodgkin's lymphoma. An unusual presentation and clinical course.

PubMed

Salemis, Nikolaos S; Tsiambas, Evangelos; Liatsos, Christos; Karameris, Andreas; Tsohataridis, Efstathios

2010-12-01

Adult intussusception is a rare clinical entity accounting for 5% of all intussusceptions. Symptoms and signs are often vague and non-specific making a preoperative diagnosis difficult. The purpose of this study is to present a rare case of a jejuno-jejunal intussusception due to primary intestinal non-Hodgkin's lymphoma in a patient with an unusual clinical course. A 78-year-old man presented with a 1-month history of abdominal pain, nausea, epigastric fullness, and weight loss. Computed tomography scan and ultrasonography findings were suggestive of small bowel intussusception. Laparotomy revealed a jejuno-jejunal intussusception caused by a primary B cell non-Hodgkin's lymphoma 20 cm distal to the ligament of Treitz. Resection without prior reduction was performed. The patient refused postoperative adjuvant chemotherapy. Seven months later, he presented with upper gastrointestinal bleeding, and the diagnostic evaluation revealed gastric infiltration of large B cell non-Hodgkin's lymphoma. Despite chemotherapy, he died of disseminated progressive disease 7 months later. Adult jejuno-jejunal intussusception due to primary non-Hodgkin's lymphoma is a rare clinical entity. A high index of suspicion is needed as symptoms and signs are not pathognomonic. Appropriate investigations can lead to a prompt preoperative diagnosis. Resection without prior reduction is the treatment of choice. Our patient's refusal of postoperative adjuvant chemotherapy likely resulted in relapse of the disease in another part of the gastrointestinal tract.

"Just dreaming of them": The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ).

PubMed

Beier, Klaus M; Oezdemir, Umut C; Schlinzig, Eliza; Groll, Anna; Hupp, Elena; Hellenschmidt, Tobias

2016-02-01

The Berlin Project for Primary Prevention of Child Sexual Abuse by Juveniles (PPJ) offers diagnostic and therapeutic help to 12-to-18-year-old juveniles with a sexual preference for the prepubescent and/or early pubescent body of children and who apply for treatment on a voluntary basis. The project goal is to prevent primary or recurrent child sexual abuse as well as primary or recurrent use of child abuse images. Treatment aims to enable affected juveniles to obtain control over their conflictual sexual behaviors. In the present article, the origin of the PPJ; its main approach, including the conception of a media campaign; as well as results from the first year of a three-year study are presented. Further, initial characterizations of juveniles taking part in the project for the first 12 months are provided. The results confirmed that the group of 12-to-18-year-old juveniles with a sexual preference for prepubescent and/or early pubescent minors exists as a target group for primary preventive measures and that they can be assessed for their sexual preferences. Copyright © 2015 Elsevier Ltd. All rights reserved.

Public Sculpture: America's Legacy. America Past and Present. Study Guide.

ERIC Educational Resources Information Center

Powe, Faye; Carter, Richard, Ed.

This guide presents public sculpture as an effective instructional tool, with the primary emphasis on works contributing to a sense of national or community identity. Sculptures are introduced according to the chronology of persons or events commemorated. The 10 lessons focus on United States history from the Civil War to the present. Unit 1:…

Algorithms for the diagnosis and treatment of restless legs syndrome in primary care

PubMed Central

2011-01-01

Background Restless legs syndrome (RLS) is a neurological disorder with a lifetime prevalence of 3-10%. in European studies. However, the diagnosis of RLS in primary care remains low and mistreatment is common. Methods The current article reports on the considerations of RLS diagnosis and management that were made during a European Restless Legs Syndrome Study Group (EURLSSG)-sponsored task force consisting of experts and primary care practioners. The task force sought to develop a better understanding of barriers to diagnosis in primary care practice and overcome these barriers with diagnostic and treatment algorithms. Results The barriers to diagnosis identified by the task force include the presentation of symptoms, the language used to describe them, the actual term "restless legs syndrome" and difficulties in the differential diagnosis of RLS. Conclusion The EURLSSG task force reached a consensus and agreed on the diagnostic and treatment algorithms published here. PMID:21352569

Histological heterogeneity in primary and metastatic classic combined hepatocellular-cholangiocarcinoma: a case series.

PubMed

De Vito, Claudio; Sarker, Debashis; Ross, Paul; Heaton, Nigel; Quaglia, Alberto

2017-11-01

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare and aggressive primary liver cancer with both hepatocellular and cholangiocellular differentiation. Due to its bi-phenotypic component, cHCC-CC is a heterogeneous tumour and histopathological analysis of metastatic deposits is poorly characterized. In this retrospective study, we describe four patients in whom the histology from resected specimens of both primary and recurrent and/or metastatic tumour was available for comparison and immunohistochemical characterization. Our study shows that recurrent or metastatic deposits replicate the heterogeneity of the primary cHCC-CC, that even originally small foci of divergent differentiation can become predominant later on and that hepatocellular and cholangiocellular components can show different tropism in distant organs. In our experience, the behaviour of recurrent/metastatic cHCC-CC is unpredictable and histological examination is necessary to guide treatment options at present.

Survival of primary condylar-constrained total knee arthroplasty at a minimum of 7 years.

PubMed

Maynard, Lance M; Sauber, Timothy J; Kostopoulos, Vasileios K; Lavigne, Gregory S; Sewecke, Jeffrey J; Sotereanos, Nicholas G

2014-06-01

The purpose of the present study is to retrospectively analyze clinical and radiographic outcomes in primary constrained condylar knee arthroplasty at a minimum follow-up of 7 years. Given the concern for early aseptic loosening in constrained implants, we focused on this outcome. Our cohort consists of 127 constrained condylar knees. The mean age of patients in the study was 68.3 years, with a mean follow-up of 110.7 months. The diagnosis was primary osteoarthritis in 92%. There were four periprosthetic distal femur fractures, with a rate of revision of 0.8%. No implants were revised for aseptic loosening. Kaplan-Meier survivorship analysis with removal of any component as the end point revealed that the 10-year rate of survival of the primary CCK was 97.6% (95% CI, 94%-100%). Copyright © 2014. Published by Elsevier Inc.

Status of groundwater quality in the Santa Barbara Study Unit, 2011: California GAMA Priority Basin Project

USGS Publications Warehouse

Davis, Tracy A.; Kulongoski, Justin T.

2016-10-03

Groundwater quality in the 48-square-mile Santa Barbara study unit was investigated in 2011 as part of the California State Water Resources Control Board’s Groundwater Ambient Monitoring and Assessment (GAMA) Program Priority Basin Project. The study unit is mostly in Santa Barbara County and is in the Transverse and Selected Peninsular Ranges hydrogeologic province. The GAMA Priority Basin Project is carried out by the U.S. Geological Survey in collaboration with the California State Water Resources Control Board and Lawrence Livermore National Laboratory.The GAMA Priority Basin Project was designed to provide a statistically unbiased, spatially distributed assessment of the quality of untreated groundwater in the primary aquifer system of California. The primary aquifer system is defined as that part of the aquifer corresponding to the perforation interval of wells listed in the California Department of Public Health database for the Santa Barbara study unit. This status assessment is intended to characterize the quality of groundwater resources in the primary aquifer system of the Santa Barbara study unit, not the treated drinking water delivered to consumers by water purveyors.The status assessment for the Santa Barbara study unit was based on water-quality and ancillary data collected in 2011 by the U.S. Geological Survey from 23 sites and on water-quality data from the California Department of Public Health database for January 24, 2008–January 23, 2011. The data used for the assessment included volatile organic compounds; pesticides; pharmaceutical compounds; two constituents of special interest, perchlorate and N-nitrosodimethylamine (NDMA); and naturally present inorganic constituents, such as major ions and trace elements. Relative-concentrations (sample concentration divided by the health- or aesthetic-based benchmark concentration) were used to evaluate groundwater quality for those constituents that have federal or California regulatory and non-regulatory benchmarks for drinking-water quality. For inorganic, organic, and special-interest constituents, a relative-concentration greater than 1.0 indicates a concentration greater than the benchmark and is classified as high. Inorganic constituents are classified as moderate if relative-concentrations are greater than 0.5 and less than or equal to 1.0 and are classified as low if relative-concentrations are less than or equal to 0.5. For organic and special-interest constituents, the boundary between moderate and low relative-concentrations was set at 0.1.Aquifer-scale proportion was used as the primary metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the areal percentage of the primary aquifer system with a relative-concentration greater than 1.0 for a particular constituent or class of constituents. Moderate and low aquifer-scale proportions were defined as the areal percentage of the primary aquifer system that had moderate and low relative-concentrations, respectively. Two statistical approaches—grid based and spatially weighted—were used to calculate aquifer-scale proportions for individual constituents and constituent classes. Grid-based and spatially weighted estimates were comparable in this the study (within 90-percent confidence intervals). Grid-based results were selected for use in the status assessment unless, as was observed in a few cases, a grid-based result was zero and the spatially weighted result was not zero, in which case, the spatially weighted result was used.Inorganic constituents that have human-health benchmarks were present at high relative-concentrations in 5.3 percent of the primary aquifer system and at moderate concentrations in 32 percent. High aquifer-scale proportions of inorganic constituents primarily were a result of high aquifer-scale proportions of boron (5.3 percent) and fluoride (5.3 percent). Inorganic constituents that have aesthetic-based benchmarks, referred to as secondary maximum contaminant levels, were present at high relative-concentrations in 58 percent of the primary aquifer system and at moderate concentrations in 37 percent. Iron, manganese, sulfate, and total dissolved solids were the inorganic constituents with secondary maximum contaminant levels present at high relative-concentrations.In contrast, organic and special-interest constituents that have health-based benchmarks were not detected at high relative-concentrations in the primary aquifer system. Of the 218 organic constituents analyzed, 10 were detected—9 that had human-health benchmarks. Organic constituents were present at moderate relative-concentrations in 11 percent of the primary aquifer system. The moderate aquifer-scale proportions were a result of moderate relative-concentrations of the volatile organic compounds methyl tert-butyl ether (MTBE, 11 percent) and 1,2-dichloroethane (5.6 percent). The volatile organic compounds 1,1,1-trichloroethane, 1,1-dichloroethane, bromodichloromethane, chloroform, MTBE, and perchloroethene (PCE); the pesticide simazine; and the special-interest constituent perchlorate were detected at more than 10 percent of the sites in the Santa Barbara study unit. Perchlorate was present at moderate relative-concentrations in 50 percent of the primary aquifer system. Pharmaceutical compounds and NDMA were not detected in the Santa Barbara study unit.

Primary Prevention of Sexual Violence in Aotearoa New Zealand.

PubMed

Dickson, Sandra; Willis, Gwenda M

2017-03-01

The extensive and sometimes profoundly damaging effects of sexual violence and large numbers of victims necessitate dedicated attention to primary prevention efforts. Few studies have examined the scope of current prevention activities or their fit with empirical research into effective prevention strategies. The current article presents findings from a survey of primary prevention activities in non-Māori and bicultural communities within Aotearoa New Zealand. Forty-four respondents representing 42 agencies responded to a comprehensive survey that canvased types of sexual violence primary prevention activities undertaken, sexual violence primary prevention programs, and barriers and supports to sexual violence prevention work. Consistent with findings from previous international surveys, the focus of primary prevention work in New Zealand was on sexual violence education and increasing awareness. Findings are discussed in the context of the sexual violence prevention literature and what works in prevention more broadly to help identify promising initiatives as well as gaps in current practices. Recommendations for advancing sexual violence primary prevention research are also provided.

Metastatic Pheochromocytoma/Paraganglioma Related to Primary Tumor Development in Childhood or Adolescence: Significant Link to SDHB Mutations

PubMed Central

King, Kathryn S.; Prodanov, Tamara; Kantorovich, Vitaly; Fojo, Tito; Hewitt, Jacqueline K.; Zacharin, Margaret; Wesley, Robert; Lodish, Maya; Raygada, Margarita; Gimenez-Roqueplo, Anne-Paule; McCormack, Shana; Eisenhofer, Graeme; Milosevic, Dragana; Kebebew, Electron; Stratakis, Constantine A.; Pacak, Karel

2011-01-01

Purpose To present data on the high rate of SDHB mutations in patients with metastatic pheochromocytoma/paraganglioma whose initial tumor presentation began in childhood or adolescence. Patients and Methods From 2000 to 2010, 263 patients with pheochromocytoma/paraganglioma were evaluated through the National Institutes of Health (NIH), Bethesda, MD. Of the 263 patients, 125 patients were found to have metastatic disease; of these 125 patients, 32 patients presented with a tumor before 20 years of age. An additional 17 patients presented with a tumor before 20 years of age but demonstrated no development of metastatic disease. Genetic testing for mutations in the VHL, MEN, and SDHB/C/D genes was performed on patients without previously identified genetic mutations. Results Of the 32 patients who presented with metastatic disease and had their primary tumor in childhood or adolescence, sequence analysis of germline DNA showed SDHB mutations in 23 patients (71.9%), SDHD mutations in three patients (9.4%), VHL mutations in two patients (6.3%), and an absence of a known mutation in four patients (12.5%). The majority of these 32 patients (78.1%) presented with primary tumors in an extra-adrenal location. Conclusion The majority of patients with metastatic pheochromocytoma/paraganglioma who presented with a primary tumor in childhood/adolescence had primary extra-adrenal tumors and harbored SDHB mutations. Except for primary tumors located in the head and neck where SDHD genetic testing is advised, we recommend that patients who present with metastatic pheochromocytoma/paraganglioma with primary tumor development in childhood or adolescence undergo SDHB genetic testing before they undergo testing for other gene mutations, unless clinical presentation or family history suggests a different mutation. PMID:21969497

Age Differences in Goal Concordance, Time Use, and Well-Being

ERIC Educational Resources Information Center

Chen, Yiwei; Lee, Yue-Ting; Pethtel, Olivia L.; Gutowitz, Michael S.; Kirk, Robert M.

2012-01-01

The primary purpose of the present study was to investigate age differences in goal concordance, time use, and Well-Being. Past research has found that despite age-related decline in life circumstances (e.g., health), the Well-Being of older adults is as high as young adults. The present study used a novel approach to explore the Paradox of…

State of Maine Alcohol and Other Drug Use: An Assessment of Students in Grades 6-12. Risk and Protective Factors, 1996.

ERIC Educational Resources Information Center

Dana, Robert Q.

Primary findings of the Maine Student Drug Survey, administered during the academic year 1995-96, are presented. Highlights of the study findings, selected prevalence findings, selected risk and protective factor findings, policy recommendations, and recommendations for future research are presented. The questionnaire and the study are described…

Leadership in Boys' Education: 16 Case Studies from Public and Private, Rural and Urban, Primary and Secondary Schools.

ERIC Educational Resources Information Center

Fletcher, Richard, Ed.; Hartman, Deborah, Ed.; Browne, Rollo, Ed.

Concern about boys' education in Australia and New Zealand led to the Leadership in Boys' Education Conference in May 1999. This book contains edited conference presentations focusing on boys' educational needs. The book also presents case studies related to academic achievement, school structure, discipline and bullying, broadening boys' options,…

Plastic scintillator with effective pulse shape discrimination for neutron and gamma detection

DOEpatents

Zaitseva, Natalia P.; Carman, M Leslie; Cherepy, Nerine; Glenn, Andrew M.; Hamel, Sebastien; Payne, Stephen A.; Rupert, Benjamin L.

2016-04-12

In one embodiment, a scintillator material includes a polymer matrix; and a primary dye in the polymer matrix, the primary dye being a fluorescent dye, the primary dye being present in an amount of 5 wt % or more; wherein the scintillator material exhibits an optical response signature for neutrons that is different than an optical response signature for gamma rays. In another embodiment, a scintillator material includes a polymer matrix; and a primary dye in the polymer matrix, the primary dye being a fluorescent dye, the primary dye being present in an amount greater than 10 wt %.

Design of the POINT study: Pharmacotherapy Optimisation through Integration of a Non-dispensing pharmacist in a primary care Team (POINT).

PubMed

Hazen, Ankie C M; Sloeserwij, Vivianne M; Zwart, Dorien L M; de Bont, Antoinette A; Bouvy, Marcel L; de Gier, Johan J; de Wit, Niek J; Leendertse, Anne J

2015-07-02

In the Netherlands, 5.6 % of acute hospital admissions are medication-related. Almost half of these admissions are potentially preventable. Reviewing medication in patients at risk in primary care might prevent these hospital admissions. At present, implementation of medication reviews in primary care is suboptimal: pharmacists lack access to patient information, pharmacists are short of clinical knowledge and skills, and working processes of pharmacists (focus on dispensing) and general practitioners (focus on clinical practice) match poorly. Integration of the pharmacist in the primary health care team might improve pharmaceutical care outcomes. The aim of this study is to evaluate the effect of integration of a non-dispensing pharmacist in general practice on the safety of pharmacotherapy in the Netherlands. The POINT study is a non-randomised controlled intervention study with pre-post comparison in an integrated primary care setting. We compare three different models of pharmaceutical care provision in primary care: 1) a non-dispensing pharmacist as an integral member of a primary care team, 2) a pharmacist in a community pharmacy with a predefined training in performing medication reviews and 3) a pharmacist in a community pharmacy (care as usual). In all models, GPs remain accountable for individual medication prescription. In the first model, ten non-dispensing clinical pharmacists are posted in ten primary care practices (including 5 - 10 000 patients each) for a period of 15 months. These non-dispensing pharmacists perform patient consultations, including medication reviews, and share responsibility for the pharmaceutical care provided in the practice. The two other groups consist of ten primary care practices with collaborating pharmacists. The main outcome measurement is the number of medication-related hospital admissions during follow-up. Secondary outcome measurements are potential medication errors, drug burden index and costs. Parallel to this study, a qualitative study is conducted to evaluate the feasibility of introducing a NDP in general practice. As the POINT study is a large-scale intervention study, it should provide evidence as to whether integration of a non-dispensing clinical pharmacist in primary care will result in safer pharmacotherapy. The qualitative study also generates knowledge on the optimal implementation of this model in primary care. Results are expected in 2016. NTR4389 , The Netherlands National Trial Register, 07-01-2014.

Primary cutaneous adenosquamous carcinoma of the penis: the first characterization of HPV status in this rare and diagnostically challenging entity with review of glandular carcinomas of the penis.

PubMed

Rush, P S; Shiau, J M; Hibler, B P; Longley, B J; Downs, T M; Bennett, D D

2016-12-01

Glandular and pseudoglandular tumors of the penile skin are extremely uncommon and can present diagnostic challenges. Primary adenosquamous carcinoma of the penis is an extremely rare tumor, composed of distinct areas of malignant squamous and glandular cells, making it a diagnostically challenging entity. The World Health Organization (WHO) recognizes several subtypes of squamous cell carcinoma (SCC), each with its own distinctive pathologic appearance, clinical associations and prognosis. Among these variants is the exceedingly uncommon adenosquamous carcinoma (ASC), representing 1%-2% of all SCC of the penis. Recent large studies have interrogated the presence of human papillomavirus (HPV) in malignant penile tumors and have shown specific morphologic patterns and clinical presentations to associate with HPV status. However, given the rarity of the adenosquamous variant of SCC, it has largely been excluded from these studies. The glandular components of these lesions can present a confusing appearance, particularly when a large tumor is represented on a small biopsy. Here we describe a difficult histologic presentation of this rare tumor, with the first published characterization of the HPV status of this subtype. This case represents a distinctly unusual case of metastatic HPV-positive primary cutaneous adenosquamous carcinoma of the penis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Multimodal Writing Process: Changing Practices in Contemporary Classrooms

ERIC Educational Resources Information Center

Edwards-Groves, Christine Joy

2011-01-01

This paper presents research exploring "writing and text construction" practices in contemporary primary classrooms. In particular, the ways 17 teachers and their students engaged with technologies in the construction of classroom texts were investigated. The case studies presented prompt the necessity to extend more traditional…

Visual Disability Among Juvenile Open-angle Glaucoma Patients.

PubMed

Gupta, Viney; Ganesan, Vaitheeswaran L; Kumar, Sandip; Chaurasia, Abadh K; Malhotra, Sumit; Gupta, Shikha

2018-04-01

Juvenile onset primary open-angle glaucoma (JOAG) unlike adult onset primary open-angle glaucoma presents with high intraocular pressure and diffuse visual field loss, which if left untreated leads to severe visual disability. The study aimed to evaluate the extent of visual disability among JOAG patients presenting to a tertiary eye care facility. Visual acuity and perimetry records of unrelated JOAG patients presenting to our Glaucoma facility were analyzed. Low vision and blindness was categorized by the WHO criteria and percentage impairment was calculated as per the guidelines provided by the American Medical Association (AMA). Fifty-two (15%) of the 348 JOAG patients were bilaterally blind at presentation and 32 (9%) had low vision according to WHO criteria. Ninety JOAG patients (26%) had a visual impairment of 75% or more. Visual disability at presentation among JOAG patients is high. This entails a huge economic burden, given their young age and associated social responsibilities.

Primary care support for tackling obesity: a qualitative study of the perceptions of obese patients.

PubMed

Brown, Ian; Thompson, Joanne; Tod, Angela; Jones, Georgina

2006-09-01

Obesity has become a major public health issue and there is concern about the response of health services to patients who are obese. The perceptions of obese patients using primary care services have not been studied in depth. To explore obese patients' experiences and perceptions of support in primary care. Qualitative study with semi-structured interviews conducted in participants' homes. Five general practices contrasting in socioeconomic populations in Sheffield. Purposive sampling and semi-structured interviewing of 28 patients with a diverse range of ages, backgrounds, levels of obesity and experiences of primary care services. Participants typically felt reluctance when presenting with concerns about weight and ambivalence about the services received. They also perceived there to be ambivalence and a lack of resources on the part of the health services. Participants showed a strong sense of personal responsibility about their condition and stigma-related cognitions were common. These contributed to their ambivalence about using services and their sensitivity to its features. Good relationships with primary care professionals and more intensive support partly ameliorated these effects. The challenges of improving access to and quality of primary care support in tackling obesity are made more complex by patients' ambivalence and other effects of the stigma associated with obesity.

Configurations of Activity: From the Coupling of Individual Actions to the Emergence of Collective Activity. A Study of Mathematics Teaching Situation in Primary School

ERIC Educational Resources Information Center

Veyrunes, Philippe; Gal-Petitfaux, Nathalie; Durand, Marc

2009-01-01

This article presents and uses the notion of configuration of activity, which extends the Norbert Elias's original concept of social configuration based on the study and analysis of individual and collective activity. Although this concept embraces all types of social activities, in the present study the authors used it to describe and analyse…

Knowing Your Limits: A Qualitative Study of Physician and Nurse Practitioner Perspectives on NP Independence in Primary Care.

PubMed

Kraus, Elena; DuBois, James M

2017-03-01

The shortage of primary care providers and the provisions of the Affordable Care Act (ACA) have spurred discussion about expanding the number, scope of practice (SOP), and independence of primary care nurse practitioners (NPs). Such discussions in the media and among professional organizations may insinuate that changes to the laws governing NP practice will engender acrimony between practicing physicians and NPs. However, we lack empirical, descriptive data on how practicing professionals view NP independence in primary care. The aim of the present study was to explore and describe the attitudes about NP independence among physicians and NPs working in primary care. A qualitative study based on the principles of grounded theory. Thirty primary care professionals in Missouri, USA, including 15 primary care physicians and 15 primary care NPs. Semi-structured, in-depth interviews, with data analysis guided by grounded theory. Participants had perspectives that were not well represented by professional organizations or the media. Physicians were supportive of a wide variety of NP roles and comfortable with high levels of NP independence and autonomy. Physicians and NPs described prerequisites to NP independence that were complementary. Physicians generally believed that NPs needed some association with physicians for patient safety, and NPs preferred having a physician readily accessible as needed. The theme "knowing your limits" was important to both NPs and physicians regarding NP independence, and has not been described previously in the literature. NP and physician views about NP practice in primary care are not as divergent as their representative professional organizations and the news media would suggest. The significant agreement among NPs and physicians, and some of the nuances of their perspectives, supports recommendations that may reduce the perceived acrimony surrounding discussions of NP independent practice in primary care.

Using the Fennema-Sherman Mathematics Attitude Scales with lower-primary teachers

NASA Astrophysics Data System (ADS)

Ren, Lixin; Green, Jennifer L.; Smith, Wendy M.

2016-06-01

The Fennema-Sherman Mathematics Attitude Scales (FSMAS) are among the most popular instruments used in studies of attitudes toward mathematics. However, the FSMAS has been mainly used among student populations and rarely used with teachers. In the present study, three scales from the FSMAS— Confidence, Effectance Motivation, and Anxiety—were revised and used with lower-primary (kindergarten to third grade) teachers. This study includes three parts: (1) a pilot study to ensure the modifications made to the FSMAS were appropriate to use with teachers, (2) confirmatory factor analyses to assess the factor structure of the revised FSMAS with 225 lower-primary teachers, and (3) measurement invariance analyses using data from a similar sample of 171 lower-primary teachers to examine whether the revised FSMAS measures each construct in the same way as in the previous sample. The final three-factor model, after removing three problematic items, achieves acceptable model fit, with each construct meeting all conditions for strict measurement invariance. Additionally, repeated measures analyses were performed on data collected from 39 in-service lower-primary teachers who participated in an elementary mathematics specialist program to examine the use of the revised FSMAS in program evaluation. Overall results suggest that researchers and program evaluators may use the revised FSMAS to reliably measure lower-primary teachers' mathematical attitudes, and it can be a valuable tool for evaluating the effectiveness of professional development programs.

Synchronous thyroid metastasis from lung adenocarcinoma.

PubMed

Rossini, Matteo; Ruffini, Livia; Ampollini, Luca; Cozzani, Federico; Del Rio, Paolo

2015-01-01

Metastases from other primary malignancies to the thyroid gland are clinically uncommon, far less frequent than any malignant primary neoplasm, mostly affecting elderly patients. Recent autopsy studies have shown that metastases to the tyroid is relatively common, with a prevalence of of 1,9-24%. We present a case of a man (72 years old) with lung cancer and synchronous metastasis to thyroid gland. Typically the interval between the diagnosis of the primary tumor and the detection of thyroid metastasis is from one month to 26 years. Clinical manifestation of thyroid metastases are rare Thyroid cancer, Thyroid metastases, Thyroidectomy.

A Pilot Study of the Attractive Features of Active Videogames Among Chinese Primary School Children.

PubMed

Lau, Patrick W C; Lau, Erica Y; Wang, Jing Jing; Choi, Cheong-Rak; Kim, Chang Gyun

2017-04-01

The present study (1) explored the attractive features that affect Chinese primary school children's preferences of active videogames (AVGs) and (2) contrasted these findings with those in the Western literature. A total of 22 Chinese primary school children were recruited and interviewed. Four AVGs (Wii "Boxing," "Wii Fit™ Plus Obstacle Run"; "EyeToy Knockout", "EyeToy Keep ups") from two commercial consoles (Nintendo® Wii™ and Sony PlayStation ® 2 "EyeToy ® ") were employed. Participants used four selected AVGs for 3 minutes each. After each play period, children (1) described the strengths and weaknesses of each game as well as rated the attractive features of each game based on a 16-item questionnaire and (2) rated up to 5 items that were most influential regarding their AVG preferences. Participants indicated that control was the most significant feature, followed by feedback, goal, and graphics. The top five rated features imply that the perception of competence was the most appealing aspect and expected outcome of Chinese children who play AVGs. Compared with the Western findings regarding attractive AVG features, the present study found certain similarities as well as significant differences among Chinese AVG players. Based on the present study, control, feedback, goal, and graphics are the most significant features that attract Chinese children to play AVGs. Physical exertion, social interaction, competition, and learning outcomes, which are valued according to Western studies, were not mentioned as significant features by Chinese children. These findings demonstrate a need to investigate the effect of cultural background in AVG study design.

The 6th Grade Primary History Book and the Reactions of the Greek and Cypriot Educational Communities and Societies

ERIC Educational Resources Information Center

Kimitris, Petros N.

2017-01-01

The present study was designed to explore the role of Rebousi et al's primary 6th grade history school book in evaluating the experience of a nation but also to examine the causes behind the reactions of political parties, historians and the wider public. History books and politics have very deep roots that reflect on old responsibilities,…

Choice of Scottish Gaelic-Medium and Welsh-Medium Education at the Primary and Secondary School Stages: Parent and Pupil Perspectives

ERIC Educational Resources Information Center

O'Hanlon, Fiona

2015-01-01

Results are presented of a comparative study of the reasons for parental choice of Scottish Gaelic-medium and Welsh-medium primary education in the year 2000 and of the reasons for pupils' decisions to continue with Gaelic or Welsh-medium education at secondary school in 2007. Parents in both contexts cited the quality of Celtic-medium education…

Noise and Stress in Primary and Secondary School Children: Noise Reduction and Increased Concentration Ability through a Short but Regular Exercise and Relaxation Program

ERIC Educational Resources Information Center

Norlander, Torsten; Moas, Leif; Archer, Trevor

2005-01-01

The present study examined whether a short but regularly used program of relaxation, applied to Primary and Secondary school children, could (a) reduce noise levels (in decibels), (b) reduce pupils' experienced stress levels, and (c) increase the pupils' ability to concentrate, as measured by teachers' estimates. Noise levels in 5 classrooms (84…

Inclusive Education and the Cultural Representation of Disability and Disabled People within the English Education System: The Influence of Electronic Media in the Primary School

ERIC Educational Resources Information Center

Hodkinson, Alan

2012-01-01

This paper examines the picture of disability portrayed within the electronic media presented to primary-aged pupils in England. The study employed proto-text analysis to examine 494 separate electronic resources which contained 4485 illustrations, 930 photographs and 59 video clips. The major finding of the research is that the media examined…

The Effectiveness of Electronic Mind Maps in Developing Academic Achievement and the Attitude towards Learning English among Primary School Students

ERIC Educational Resources Information Center

Aljaser, Afaf M.

2017-01-01

The present study aimed to identify the effect of using electronic Mind Maps on the academic achievement of the fifth-grade primary female students in the English language curriculum compared to the traditional teaching method adopted in the teacher's guide. It also aimed to indicate the attitudes of the fifth-grade female students towards the use…

Regulatory Mechanisms for Nursing Training and Practice: Meeting Primary Health Care Needs. World Health Organization Technical Report Series No. 738. Report of a WHO Study Group.

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

A report on laws and regulations governing nursing education and practice in 81 countries belonging to the World Health Organization and effects on primary health care is presented by an international group of experts. Suggestions for training and licensure are provided to national governments and nursing regulatory bodies to promote the goal of…

A Multilingual Approach to Analysing Standardized Test Results: Immigrant Primary School Children and the Role of Languages Spoken in a Bi-/Multilingual Community

ERIC Educational Resources Information Center

De Angelis, Gessica

2014-01-01

The present study adopts a multilingual approach to analysing the standardized test results of primary school immigrant children living in the bi-/multilingual context of South Tyrol, Italy. The standardized test results are from the Invalsi test administered across Italy in 2009/2010. In South Tyrol, several languages are spoken on a daily basis…

Greek Primary School Children's Representations of the Urban Environment as Seen through Their Drawings

ERIC Educational Resources Information Center

Stokas, Dimitrios; Strezou, Elena; Malandrakis, George; Papadopoulou, Penelope

2017-01-01

In the present study, we explore aspects of Greek primary school children's representations about the urban environment through the use of drawings and their relation to sustainability. For that purpose, 104 children, aged 9-12 (4th and 6th grades), were asked to make two drawings of their town: one as it is now and another as they would like it…

Survey of primary processors in New York, 1999.

Treesearch

Bruce Hansen; Sloane Crawford; Iris Baker; Melody Akers

2002-01-01

This report presents the results of a survey of primary wood processors in New York and surrounding states and Canada that relied on New York?s forests for at least a portion or their roundwood receipts in 1999. The previous survey of wood use and production in New York was conducted in 1993. At that time New York was a net importer of round wood. The latest study...

Alaska's Living Tundra. Alaska Wildlife Week, 25-29 April 1988. Unit 6: Primary Teacher's Guide; Upper Elementary Teacher's Guide; Junior/Senior High School Teacher's Guide; Supplement.

ERIC Educational Resources Information Center

Quinlan, Susan E.

Despite its cold and barren appearance, Alaska's tundra supports a surprising variety of insects, birds, and mammals. In this document, three teacher's guides (for primary, upper elementary, and junior and senior high schools) and a supplementary resource packet present a comprehensive unit of study on Alaska's living tundra. The five lessons in…

Secondary intracranial neoplasia in the dog: 177 cases (1986-2003).

PubMed

Snyder, J M; Lipitz, L; Skorupski, K A; Shofer, F S; Van Winkle, T J

2008-01-01

This study investigates the frequency, location, and clinical findings associated with 177 secondary brain tumors in dogs. Secondary intracranial neoplasia is more common than primary intracranial neoplasia in dogs during the time period studied, and hemangiosarcoma (HSA) is the most common secondary intracranial tumor. One hundred and seventy-seven client-owned dogs presented to the Matthew J. Ryan Veterinary Hospital between 1986 and 2003. Medical records were searched for a diagnosis of intracranial neoplasia in dogs who underwent complete postmortem examination. Of these dogs, those with a diagnosis of primary intracranial neoplasia were excluded. Of the 177 secondary brain tumors, 51 (29%) were HSAs, 44 (25%) were pituitary tumors, 21 (12%) were lymphosarcomas, and 21 (12%) were metastatic carcinomas. The average age at diagnosis was 9.6 +/- 3.0 years. Most tumors were located in the cerebrum, and a mentation change was the most common presenting clinical sign. On postmortem examination, the same tumor that was in the brain was also present in the lung in 84 cases (47%), in the kidney in 62 cases (35%), and in the heart in 55 cases (31%). Secondary intracranial neoplasia in dogs was more common than primary intracranial neoplasia during the time period studied. Many of these dogs had related disease in other body systems that was apparent on diagnostic tests such as thoracic radiography.

Preventive effect of piracetam and vinpocetine on hypoxia-reoxygenation induced injury in primary hippocampal culture.

PubMed

Solanki, P; Prasad, D; Muthuraju, S; Sharma, A K; Singh, S B; Ilavzhagan, G

2011-04-01

The present study investigates the potential of Piracetam and Vinpocetine (nootropic drugs, known to possess neuroprotective properties) in preventing hypoxia-reoxygenation induced oxidative stress in primary hippocampal cell culture. The hippocampal culture was exposed to hypoxia (95% N(2), 5% CO(2)) for 3h and followed by 1h of reoxygenation (21% O(2) and 5% CO(2)) at 37 °C. The primary hippocampal cultures were supplemented with the optimum dose of Piracetam and Vinpocetine, independently, and the cultures were divided into six groups, viz. Control/Normoxia, Hypoxia, Hypoxia+Piracetam, Hypoxia+Vinpocetine, Normoxia + Piracetam and Normoxia+Vinpocetine. The cell-viability assays and biochemical oxidative stress parameters were evaluated for each of the six groups. Administration of 1mM Piracetam or 500 nM Vinpocetine significantly prevents the culture from hypoxia-reoxygenation injury when determined by Neutral Red assay, LDH release and Acetylcholine esterase activity. Results showed that Piracetam and Vinpocetine supplementation significantly prevented the fall of mitochondrial membrane potential, rise in ROS generation and reduction in antioxidant levels associated with the hypoxia-reoxygenation injury. In conclusion, the present study establishes that both Piracetam and Vinpocetine give neuroprotection against hypoxia-reoxygenation injury in primary hippocampal cell culture. Copyright © 2010 Elsevier Ltd. All rights reserved.

Dental treatment in the primary dentition of 7-12 year-old Swedish schoolchildren.

PubMed

Alm, Anita; Wendt, Lill-Kari; Koch, Göran

2003-01-01

In most Swedish counties, epidemiological data on the permanent dentition are collected on all patients aged 7-19 years. For the primary dentition, epidemiological data are only reported for the 3-6-year-old age groups. The purpose of the present study was to investigate what treatments had been made in the primary dentition during the period when the children were 7 to 12 years old. The sample size constituted 10% of all children born in 1987 and regularly treated at Public Dental Service clinics in Jönköping County between 7 and 12 years of age. Data were extracted from the dental records. The most common treatments--new restorations and replacements of restorations--comprised 72% of all treatment. Replacements of restorations constituted 31% of all restorations performed between 7 and 12 years of age, and a majority (81%) of these had been made when the children were 7-9 years old. The mean defs value at 6 years of age was 1.9. The mean number of treatments performed per child between 7 and 12 years of age was 2.5. The result of the present study indicates that more treatments in the primary dentition are performed after 6 years of age than before.

Large Crater Clustering tool

NASA Astrophysics Data System (ADS)

Laura, Jason; Skinner, James A.; Hunter, Marc A.

2017-08-01

In this paper we present the Large Crater Clustering (LCC) tool set, an ArcGIS plugin that supports the quantitative approximation of a primary impact location from user-identified locations of possible secondary impact craters or the long-axes of clustered secondary craters. The identification of primary impact craters directly supports planetary geologic mapping and topical science studies where the chronostratigraphic age of some geologic units may be known, but more distant features have questionable geologic ages. Previous works (e.g., McEwen et al., 2005; Dundas and McEwen, 2007) have shown that the source of secondary impact craters can be estimated from secondary impact craters. This work adapts those methods into a statistically robust tool set. We describe the four individual tools within the LCC tool set to support: (1) processing individually digitized point observations (craters), (2) estimating the directional distribution of a clustered set of craters, back projecting the potential flight paths (crater clusters or linearly approximated catenae or lineaments), (3) intersecting projected paths, and (4) intersecting back-projected trajectories to approximate the local of potential source primary craters. We present two case studies using secondary impact features mapped in two regions of Mars. We demonstrate that the tool is able to quantitatively identify primary impacts and supports the improved qualitative interpretation of potential secondary crater flight trajectories.

Barriers to the Treatment of Mental Illness in Primary Care Clinics in Israel.

PubMed

Ayalon, Liat; Karkabi, Khaled; Bleichman, Igor; Fleischmann, Silvia; Goldfracht, Margalit

2016-03-01

The present study examined physicians' perceived barriers to the management of mental illness in primary care settings in Israel. Seven focus groups that included a total of 52 primary care Israeli physicians were conducted. Open coding analysis was employed, consisting of constant comparisons within and across interviews. Three major themes emerged: (a) barriers to the management of mental illness at the individual-level, (b) barriers to the management of mental illness at the system-level, and (c) the emotional ramifications that these barriers have on physicians. The findings highlight the parallelism between the experiences of primary care physicians and their patients. The findings also stress the need to attend to physicians' emotional reactions when working with patients who suffer from mental illness and to better structure mental health treatment in primary care.

Study protocol of EMPOWER participatory action research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hypertension outcomes in primary care.

PubMed

Ramli, Anis S; Lakshmanan, Sharmila; Haniff, Jamaiyah; Selvarajah, Sharmini; Tong, Seng F; Bujang, Mohamad-Adam; Abdul-Razak, Suraya; Shafie, Asrul A; Lee, Verna K M; Abdul-Rahman, Thuhairah H; Daud, Maryam H; Ng, Kien K; Ariffin, Farnaza; Abdul-Hamid, Hasidah; Mazapuspavina, Md-Yasin; Mat-Nasir, Nafiza; Miskan, Maizatullifah; Stanley-Ponniah, Jaya P; Ismail, Mastura; Chan, Chun W; Abdul-Rahman, Yong R; Chew, Boon-How; Low, Wilson H H

2014-09-13

Chronic disease management presents enormous challenges to the primary care workforce because of the rising epidemic of cardiovascular risk factors. The chronic care model was proven effective in improving chronic disease outcomes in developed countries, but there is little evidence of its effectiveness in developing countries. The aim of this study was to evaluate the effectiveness of the EMPOWER-PAR intervention (multifaceted chronic disease management strategies based on the chronic care model) in improving outcomes for type 2 diabetes mellitus and hypertension using readily available resources in the Malaysian public primary care setting. This paper presents the study protocol. A pragmatic cluster randomised controlled trial using participatory action research is underway in 10 public primary care clinics in Selangor and Kuala Lumpur, Malaysia. Five clinics were randomly selected to provide the EMPOWER-PAR intervention for 1 year and another five clinics continued with usual care. Each clinic consecutively recruits type 2 diabetes mellitus and hypertension patients fulfilling the inclusion and exclusion criteria over a 2-week period. The EMPOWER-PAR intervention consists of creating/strengthening a multidisciplinary chronic disease management team, training the team to use the Global Cardiovascular Risks Self-Management Booklet to support patient care and reinforcing the use of relevant clinical practice guidelines for management and prescribing. For type 2 diabetes mellitus, the primary outcome is the change in the proportion of patients achieving HbA1c < 6.5%. For hypertension without type 2 diabetes mellitus, the primary outcome is the change in the proportion of patients achieving blood pressure < 140/90 mmHg. Secondary outcomes include the proportion of patients achieving targets for serum lipid profile, body mass index and waist circumference. Other outcome measures include medication adherence levels, process of care and prescribing patterns. Patients' assessment of their chronic disease care and providers' perceptions, attitudes and perceived barriers in care delivery and cost-effectiveness of the intervention are also evaluated. Results from this study will provide objective evidence of the effectiveness and cost-effectiveness of a multifaceted intervention based on the chronic care model in resource-constrained public primary care settings. The evidence should instigate crucial primary care system change in Malaysia. ClinicalTrials.gov NCT01545401.

A study of the pattern, management and outcome of penetrating colon injuries in Sagamu.

PubMed

Tade, A O; Thanni, L O A; Ayoade, B A

2009-09-01

Colon injuries are increasingly being treated safely by primary repair in spite of the high risk of septic complications. This is a retrospective study of the pattern, management and outcome in patients treated for penetrating colon injuries at Olabisi Onabanjo University Teaching Hospital, Sagamu over a 7 year period (January 1995-December 2001). Records of thirty-two patients were studied. Gunshots (75 percent) and knife stabs (18.75 percent) accounted for ninety-four percent of penetrating colon injuries. Associated intra-abdominal injuries were present in 22 patients (68.8 percent). Eight (twenty-five percent) patients presented in shock. Moderate to major faecal contamination was present in 30 (93.8%) patients. Severe colon injury occurred in nine patients. The eighteen patients with right colon wounds were managed by primary repair. All the fourteen patients with left colon wounds had a diverting colostomy alongside repair or resection. Complications included wound infection (56.7 percent) and septicaemia (31.7 percent). Eleven patients died, giving an overall mortality rate of 34.4 percent. Mortality was significantly associated with shock on admission (p<0.02), degree of faecal contamination (p<0.05) and severity of colon injury (p<0.01). Colostomy did not affect mortality. (P<0.1). In this study primary repair was employed in 56% of patients with penetrating colon injuries. The routine use of diverting colostomy for all left colon injuries can no longer be justified in current surgical practice as colostomy did not affect mortality.

The activation pattern of macrophages in giant cell (temporal) arteritis and primary angiitis of the central nervous system.

PubMed

Mihm, Bernhard; Bergmann, Markus; Brück, Wolfgang; Probst-Cousin, Stefan

2014-06-01

To determine if the pattern of macrophage activation reflects differences in the pathogenesis and clinical presentation of giant cell arteritis and primary angiitis of the central nervous system, specimens of 10 patients with giant cell arteritis and five with primary angiitis of the central nervous system were immunohistochemically studied and the expression of the macrophage activation markers 27E10, MRP14, MRP8 and 25F9 was determined in the vasculitic infiltrates. Thus, a partly different expression pattern of macrophage activation markers in giant cell arteritis and primary angiitis of the central nervous system was observed. The group comparison revealed that giant cell arteritis cases had significantly higher numbers of acute activated MRP14-positive macrophages, whereas primary angiitis of the central nervous system is characterized by a tendency toward more MRP8-positive intermediate/late activated macrophages. Furthermore, in giant cell arteritis comparably fewer CD8-positive lymphocytes were observed. These observations suggest, that despite their histopathological similarities, giant cell arteritis and primary angiitis of the central nervous system appear to represent either distinct entities within the spectrum of granulomatous vasculitides or different stages of similar disease processes. Their discrete clinical presentation is reflected by different activation patterns of macrophages, which may characterize giant cell arteritis as a more acute process and primary angiitis of the central nervous system as a more advanced inflammatory process. © 2013 Japanese Society of Neuropathology.

Transcriptomic Analysis of Ciguatoxin-Induced Changes in Gene Expression in Primary Cultures of Mice Cortical Neurons.

PubMed

Rubiolo, Juan Andrés; Vale, Carmen; Boente-Juncal, Andrea; Hirama, Masahiro; Yamashita, Shuji; Camiña, Mercedes; Vieytes, Mercedes R; Botana, Luis M

2018-05-10

Ciguatoxins are polyether marine toxins that act as sodium channel activators. These toxins cause ciguatera, one of the most widespread nonbacterial forms of food poisoning, which presents several symptoms in humans including long-term neurological alterations. Earlier work has shown that both acute and chronic exposure of primary cortical neurons to synthetic ciguatoxin CTX3C have profound impacts on neuronal function. Thus, the present work aimed to identify relevant neuronal genes and metabolic pathways that could be altered by ciguatoxin exposure. To study the effect of ciguatoxins in primary neurons in culture, we performed a transcriptomic analysis using whole mouse genome microarrays, for primary cortical neurons exposed during 6, 24, or 72 h in culture to CTX3C. Here, we have shown that the effects of the toxin on gene expression differ with the exposure time. The results presented here have identified several relevant genes and pathways related to the effect of ciguatoxins on neurons and may assist in future research or even treatment of ciguatera. Moreover, we demonstrated that the effects of the toxin on gene expression were exclusively consequential of its action as a voltage-gated sodium channel activator, since all the effects of CTX3C were avoided by preincubation of the neurons with the sodium channel blocker tetrodotoxin.

Effects of temporal primary-tone arrangement on DPOAE properties in humans

NASA Astrophysics Data System (ADS)

Zelle, Dennis; Krokenberger, Michael; Gummer, Anthony W.; Dalhoff, Ernst

2018-05-01

Distortion-product otoacoustic emissions (DPOAEs) emerge as a by-product of the nonlinear amplification of sound waves in the cochlea when presenting two tones of frequencies f1 and f2. According to a widely accepted model, DPOAEs comprise two main components, which can be separated in the time domain using short stimulus pulses. The present study utilized two acquisition paradigms with different primary-tone arrangements, denoted as SP-f1 and SP-f2, to investigate the nonlinear-distortion component arising near the f2-tonotopic site on the basilar membrane. In SP-f2, a conventional paradigm, the f1 tone was presented for 25 ms, whereas the f2 tone was switched on 5 ms after f1 onset for frequency-dependent durations between 3 and 11 ms to elicit the DPOAE. SP-f1 interchanged the temporal arrangement and durations of the primary tones. DPOAEs were recorded at eight frequencies (f2 = 1 - 8 kHz; f2/f1 = 1.2) and five primary-tone levels L2 = 30 - 70 dB SPL in 56 normal-hearing ears from 33 subjects. Comparison between the corresponding DPOAE responses revealed significantly larger amplitudes and shorter latencies of the nonlinear-distortion component for SP-f1, i.e. when the f1 short pulse triggers DPOAE generation.

Impact of the 5As Team study on clinical practice in primary care obesity management: a qualitative study

PubMed Central

Asselin, Jodie; Salami, Eniola; Osunlana, Adedayo M.; Ogunleye, Ayodele A.; Cave, Andrew; Johnson, Jeffrey A.; Sharma, Arya M.; Campbell-Scherer, Denise L.

2017-01-01

Background: The 5As [Ask, Assess, Advise, Agree, Assist] of Obesity Management Team study was a randomized controlled trial of an intervention that was implemented and evaluated to help primary care providers improve clinical practice for obesity management. This paper presents health care provider perspectives of the impacts of the intervention on individual provider and team practices. Methods: This study reports a thematic network analysis of qualitative data collected during the 5As Team study, which involved 24 chronic disease teams affiliated with family practices in a Primary Care Network in Alberta. Qualitative data from 28 primary care providers (registered nurses/nurse practitioners [n = 14], dietitians [n = 7] and mental health workers [n = 7]) in the intervention arm were collected through semistructured interviews, field notes, practice facilitator diaries and 2 evaluation workshop questionnaires. Results: Providers internalized 5As Team intervention concepts, deepening self-evaluation and changing clinical reasoning around obesity. Providers perceived that this internalization changed the provider-patient relationship positively. The intervention changed relations between providers, increasing interdisciplinary understanding, collaboration and discovery of areas for improvement. This personal and interpersonal evolution effected change to the entire Primary Care Network. Interpretation: The 5As Team intervention had multiple impacts on providers and teams to improve obesity management in primary care. Improved provider confidence and capability is a precondition of developing effective patient interventions. Trial registration: ClinicalTrials.gov, no.: NCT01967797. PMID:28450428

NHEXAS PHASE I MARYLAND STUDY--LIPIDS IN BLOOD ANALYTICAL RESULTS

EPA Science Inventory

The Lipids in Blood data set presents concentrations of cholesterol and total triglycerides in blood serum. The data set presents measurements for up to 2 lipids in 358 blood samples over 79 households. Each sample was collected via a venous sample from the primary respondent w...

Tabla de Especificaciones e Instructivo sobre Elaboracion de Pruebas Objetivas en la Ensenanza Primaria, para las asignaturas de Estudios Sociales, Idioma Espanol, Matematicas y Ciencias Naturales (Specification Tables and Instructions for the Construction of Objective Tests in the Primary Grades in Social Studies, Spanish, Mathematics, and Natural Sciences).

ERIC Educational Resources Information Center

Ministerio de Educacion, Guatemala City (Guatemala). Direccion de Bienestar Estudiantil y Educacion Especial.

This booklet presents specification tables illustrating the relative importance given to topics on tests within a particular subject area. The general subject areas are social studies, Spanish, mathematics, and natural sciences. Tables are provided for final exams in each of these areas for several primary grades, illustrating the importance of…

The Erevan howardite: Petrology of glassy clasts and mineral chemistry

NASA Technical Reports Server (NTRS)

Nazarov, M. A.; Ariskin, A. A.

1993-01-01

The Erevan howardite is a polymict regolith breccia containing xenoliths of carbonaceous chondrites. In this work, we studied glassy clasts, which could be considered as primary quenched melts, and mineral chemistry of the breccia. The study reveals that the Erevan howardite consists of common rocks of the HED suite. However, unique glassy clasts, which are present in some eucritic melts, were identified. The mineral chemistry and the simulation of crystallization of the melts suggest that the compositions of the melts reflect those of some primary lithologies of EPB.

Der Aufbau mentaler Modelle durch bildliche Darstellungen: Eine experimentalle Studie uber die Bedeutung der Merkmalsdimensionen Elaboriertheit und Strukturierheit im Sachunterricht der Grundschule (The Development of Mental Processes through Graphic Representation with Diverging Degrees of Elaboration and Structurization: An Experimental Study Carried Out in Elementary Science Instruction in Primary School).

ERIC Educational Resources Information Center

Martschinke, Sabine

1996-01-01

Examines types of graphical representation as to their suitability for knowledge acquisition in primary grades. Uses the concept of mental models to clarify the relationship between external presentation and internal representation of knowledge. Finds that students who learned with highly elaborated and highly structured pictures displayed the…

Topographic Distribution of Stimulus-Specific Adaptation across Auditory Cortical Fields in the Anesthetized Rat

PubMed Central

Nieto-Diego, Javier; Malmierca, Manuel S.

2016-01-01

Stimulus-specific adaptation (SSA) in single neurons of the auditory cortex was suggested to be a potential neural correlate of the mismatch negativity (MMN), a widely studied component of the auditory event-related potentials (ERP) that is elicited by changes in the auditory environment. However, several aspects on this SSA/MMN relation remain unresolved. SSA occurs in the primary auditory cortex (A1), but detailed studies on SSA beyond A1 are lacking. To study the topographic organization of SSA, we mapped the whole rat auditory cortex with multiunit activity recordings, using an oddball paradigm. We demonstrate that SSA occurs outside A1 and differs between primary and nonprimary cortical fields. In particular, SSA is much stronger and develops faster in the nonprimary than in the primary fields, paralleling the organization of subcortical SSA. Importantly, strong SSA is present in the nonprimary auditory cortex within the latency range of the MMN in the rat and correlates with an MMN-like difference wave in the simultaneously recorded local field potentials (LFP). We present new and strong evidence linking SSA at the cellular level to the MMN, a central tool in cognitive and clinical neuroscience. PMID:26950883

Physico-chemical quality of drinking water in villages of Primary Health Centre, Waghodia, Gujarat (India).

PubMed

Desai, Gaurav; Vasisth, Smriti; Patel, Maharshi; Mehta, Vaibhav; Bhavsar, Bharat

2012-07-01

16 water samples were collected to study the physical and chemical quality of water of main source of drinking water in the villages of Primary Health Centre, Waghodia of Vadodara district of Gujarat. The values recommended by Indian Standard for Drinking Water (IS 10500:1991) were used for comparison of observed values. The study indicates that the contamination problem in these villages is not alarming at present, but Waghodia being industrial town, ground water quality may deteriorate with passage of time, which needs periodical monitoring. The study provides the local area baseline data which may be useful for the comparison of future study.

The role of Primary Healthcare in the coordination of Health Care Networks in Rio de Janeiro, Brazil, and Lisbon region, Portugal.

PubMed

Lapão, Luís Velez; Arcêncio, Ricardo Alexandre; Popolin, Marcela Paschoal; Rodrigues, Ludmila Barbosa Bandeira

2017-03-01

Considering the trajectory of Rio de Janeiro e Lisboa region regarding strengths of the their health local systems to achieve health for all and equity, the study aimed to compare the organization of the Primary Healthcare from both regions, searching to identify the advancement which in terms of the Delivery Health Networks' coordination. It is a case study with qualitative approach and assessment dimensions. It was used material available online such as scientific manuscripts and gray literature. The results showed the different grades regarding Delivery Health Networks. Lisboa region present more advancement, because of its historic issues, it has implemented Primary Healthcare expanded and nowadays it achieved enough maturity related to coordination of its health local system and Rio de Janeiro suffers still influence from historic past regarding Primary Healthcare selective. The both regions has done strong bids in terms of electronic health records and telemedicine. After of the study, it is clearer the historic, cultural and politics and legal issue that determined the differences of the Primary Healthcare coordinator of the Delivery Health Network in Rio de Janeiro and Lisboa region.

Mutational analysis of multiple lung cancers: Discrimination between primary and metastatic lung cancers by genomic profile.

PubMed

Goto, Taichiro; Hirotsu, Yosuke; Mochizuki, Hitoshi; Nakagomi, Takahiro; Shikata, Daichi; Yokoyama, Yujiro; Oyama, Toshio; Amemiya, Kenji; Okimoto, Kenichiro; Omata, Masao

2017-05-09

In cases of multiple lung cancers, individual tumors may represent either a primary lung cancer or both primary and metastatic lung cancers. Treatment selection varies depending on such features, and this discrimination is critically important in predicting prognosis. The present study was undertaken to determine the efficacy and validity of mutation analysis as a means of determining whether multiple lung cancers are primary or metastatic in nature. The study involved 12 patients who underwent surgery in our department for multiple lung cancers between July 2014 and March 2016. Tumor cells were collected from formalin-fixed paraffin-embedded tissues of the primary lesions by using laser capture microdissection, and targeted sequencing of 53 lung cancer-related genes was performed. In surgically treated patients with multiple lung cancers, the driver mutation profile differed among the individual tumors. Meanwhile, in a case of a solitary lung tumor that appeared after surgery for double primary lung cancers, gene mutation analysis using a bronchoscopic biopsy sample revealed a gene mutation profile consistent with the surgically resected specimen, thus demonstrating that the tumor in this case was metastatic. In cases of multiple lung cancers, the comparison of driver mutation profiles clarifies the clonal origin of the tumors and enables discrimination between primary and metastatic tumors.

[Assessment of stress in childhood: Children's Daily Stress Inventory (Inventario Infantil de Estresores Cotidiano, IIEC)].

PubMed

Trianes Torres, María Victoria; Blanca Mena, María José; Fernández Baena, Francisco J; Escobar Espejo, Milagros; Maldonado Montero, Enrique F; Muñoz Sánchez, Angela María

2009-11-01

The present study introduces the Children's Daily Stress Inventory (Inventario Infantil de Estresores Cotidianos, IIEC) as a measure that assesses daily stress in primary school children. The inventory was applied to a sample of 1094 primary school students. The final version includes 25 dichotomic items covering the areas of health, school/peers, and family. The score is obtained by adding the total of positive answers. Analyses of items, reliability and several external pieces of evidence of validity based on relations with other variables are presented. The results show adequate psychometric properties for the assessment of daily stress in children.

Activating people to address their health care needs: learning from people with lived experience of chronic illnesses.

PubMed

Stanhope, Victoria; Henwood, Benjamin F

2014-08-01

One of the primary goals of health care reform is improving the quality and reducing the costs of care for people with co-morbid mental health and physical health conditions. One strategy is to integrate primary and behavioral health care through care coordination and patient activation. This qualitative study using community based participatory research methods informs the development of integrated care by presenting the perspectives of those with lived experience of chronic illnesses and homelessness. Themes presented include the internal and external barriers to addressing health needs and the key role of peer support in overcoming these barriers.

From cottage industry to a dominant mode of primary care: stages in the diffusion of a health care innovation (retail clinics).

PubMed

McKinlay, John B; Marceau, Lisa D

2012-09-01

Primary health care is essential to population health and there is increasing need for it, especially with an aging population with multiple comorbidities. Primary health care in the U.S. is widely considered in an ever-deepening crisis. This paper presents a detailed case study of the recent rise of a "disruptive innovation" - retail clinics - which have the potential to transform the face of primary health care in the US. We describe six stages in the diffusion of retail clinics, from cottage industry to a dominant mode for the delivery of primary health care, and consider sociopolitical influences that facilitate and impede their emerging potential. Retail clinics may provide a strategic opportunity to re-engineer the primary health care system, although they may also produce worrisome unanticipated consequences. Discussion concerning the potential threats and opportunities posed by retail clinics occurs in the absence of sound evidence concerning their comparative effectiveness and quality-of-care. This case study identifies the sociopolitical influences and processes that determine whether health care innovations rise or fall, and highlights critically important points along the pathway to health system change. Copyright © 2012 Elsevier Ltd. All rights reserved.

Multiple jet study data correlations. [data correlation for jet mixing flow of air jets

NASA Technical Reports Server (NTRS)

Walker, R. E.; Eberhardt, R. G.

1975-01-01

Correlations are presented which allow determination of penetration and mixing of multiple cold air jets injected normal to a ducted subsonic heated primary air stream. Correlations were obtained over jet-to-primary stream momentum flux ratios of 6 to 60 for locations from 1 to 30 jet diameters downstream of the injection plane. The range of geometric and operating variables makes the correlations relevant to gas turbine combustors. Correlations were obtained for the mixing efficiency between jets and primary stream using an energy exchange parameter. Also jet centerplane velocity and temperature trajectories were correlated and centerplane dimensionless temperature distributions defined. An assumption of a Gaussian vertical temperature distribution at all stations is shown to result in a reasonable temperature field model. Data are presented which allow comparison of predicted and measured values over the range of conditions specified above.

Primary tracheobronchial tumors in children.

PubMed

Varela, Patricio; Pio, Luca; Torre, Michele

2016-06-01

Primary tracheobronchial tumors are rare lesions that can be benign or malignant, with different location along the airway tree. Symptoms may include wheezing, chronic pneumonia, asthma, chest pain, recurrent cough, atelectasis, haemoptysis, and weight loss. Due to the heterogeneity of symptoms, diagnosis can be difficult and the airway involvement can lead progressively to a bronchial or tracheal obstruction. Due to the rarity of primary tracheobronchial tumors in children, there are not any oncological guidelines on pre-operative work-up, treatment, and follow-up. Only few reports and multicentric studies are reported. In most cases, surgical resection seems to be the treatment of choice. Brachytherapy, endoscopic treatment, and chemotherapy are rarely described. In this article we present an overview on these rare tumors, including pathological aspects, clinical presentation, imaging assessment, and endoscopic or open surgical treatments. We discuss different surgical approaches, according with tumor location. Copyright © 2016 Elsevier Inc. All rights reserved.

Pretreatment costs of care and time to initial treatment for patients with cancer of unknown primary.

PubMed

Walker, Mark S; Weinstein, Laura; Luo, Roger; Marino, Ingrid

2018-06-01

Time to treatment and pretreatment costs may be affected by unknown primary tumor site. This retrospective study used electronic medical record data from patients in ten US community oncology practices. Eligible patients were ≥18 years, diagnosed with cancer of unknown primary (CUP) or known metastatic solid tumor, and presented between 1 January 2012 and 30 June 2014. Patients with CUP (n = 294) had a longer interval than non-CUP patients (n = 92) from presentation to treatment initiation (1.18 vs 0.49 months, p < 0.0001), and had higher pretreatment costs (US$27,882 vs US$20,449, p = 0.0075). When analyzed as monthly cost, the difference between groups in log-cost per month was nonsignificant. Higher pretreatment costs in CUP patients appeared attributable to significantly longer time to initiation of therapy.

Metals and Disease: A Global Primary Health Care Perspective

PubMed Central

Mamtani, Ravinder; Stern, Penny; Dawood, Ismail; Cheema, Sohaila

2011-01-01

Metals are an important and essential part of our daily lives. Their ubiquitous presence and use has not been without significant consequences. Both industrial and nonindustrial exposures to metals are characterized by a variety of acute and chronic ailments. Underreporting of illnesses related to occupational and environmental exposures to chemicals including metals is of concern and presents a serious challenge. Many primary care workers rarely consider occupational and environmental exposures to chemicals in their clinical evaluation. Their knowledge and training in the evaluation of health problems related to such exposures is inadequate. This paper presents documented research findings from various studies that have examined the relationship between metal exposures and their adverse health effects both in developing and developed countries. Further, it provides some guidance on essential elements of a basic occupational and environmental evaluation to health care workers in primary care situations. PMID:22007209

Evaluation of the National Assessment of Educational Progress. Study Reports

ERIC Educational Resources Information Center

Buckendahl, Chad W.; Davis, Susan L.; Plake, Barbara S.; Sireci, Stephen G.; Hambleton, Ronald K.; Zenisky, April L.; Wells, Craig S.

2009-01-01

The "Evaluation of the National Assessment of Educational Progress: Study Reports" describes the special studies that comprised the design of the evaluation. In the Final Report, the authors presented a practical discussion of the evaluation studies to its primary, intended audience, namely policymakers. On this accompanying CD, readers…

Industrial Location Research Studies: Reports 17-25.

ERIC Educational Resources Information Center

Fantus Co., Inc., New York, NY.

Nine industrial-location research studies of the Appalachian region are presented in this document. These studies relate to the casting, plastic, metal, and food industries. Each study devotes sections to (1) a profile of the industry, (2) the industry's prospects for growth, (3) technology and trends, (4) primary factors influencing selection of…

ADHD in the Arab World: A Review of Epidemiologic Studies

ERIC Educational Resources Information Center

Farah, Lynn G.; Fayyad, John A.; Eapen, Valsamma; Cassir,Youmna; Salamoun, Mariana M.; Tabet, Caroline C.; Mneimneh, Zeina N.; Karam, Elie G.

2009-01-01

Objective: Epidemiological studies on psychiatric disorders are quite rare in the Arab World. This article reviews epidemiological studies on ADHD in all the Arab countries. Method: All epidemiological studies on ADHD conducted from 1966 through th present were reviewed. Samples were drawn from the general community, primary care clinical…

Primary Diffuse Large B-Cell Lymphoma in a Patient with Rubinstein-Taybi Syndrome: Case Report and Review of the Literature.

PubMed

Sy, Christopher; Henry, James; Kura, Bhavani; Brenner, Andrew; Grandhi, Ramesh

2018-01-01

Rubinstein-Taybi syndrome (RSTS) is a rare, congenital syndrome that is known to be associated with neoplasms of various organ systems. Evaluation and treatment of such patients is challenging, given the cognitive delay and heterogeneity of pathologic presentations that define this syndrome. Presented here is a case of a patient with RSTS, diagnosed at birth, who presented with subtle symptoms of lethargy and a change in behavior. He was found to have a large (7.0-cm × 4.7-cm), right-sided brain mass that was eventually diagnosed as a primary central nervous system lymphoma. To the best of our knowledge, this is the first reported case of a primary central nervous system lymphoma presenting in a patient with RSTS. This was confirmed through microscopic and histologic studies. The large size attained by this mass in our patient highlights the increased scrutiny and surveillance needed to provide the best care for these patients. A multidisciplinary team approach is ideal as successful treatment of our patient using surgical debulking, appropriate chemotherapy, and close postoperative follow-up has resulted in an excellent clinical outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Overvaluation of shape and weight in adolescents with anorexia nervosa: does shape concern or weight concern matter more for treatment outcome?

PubMed

Byrne, Catherine E; Kass, Andrea E; Accurso, Erin C; Fischer, Sarah; O'Brien, Setareh; Goodyear, Alexandria; Lock, James; Le Grange, Daniel

2015-01-01

Overvaluation of shape and weight is a key diagnostic feature of anorexia nervosa (AN); however, limited research has evaluated the clinical utility of differentiating between weight versus shape concerns. Understanding differences in these constructs may have important implications for AN treatment given the focus on weight regain. This study examined differences in treatment outcome between individuals whose primary concern was weight versus those whose primary concern was shape in a randomized controlled trial of treatment for adolescent AN. Data were drawn from a two-site randomized controlled trial that compared family-based treatment and adolescent focused therapy for AN. Chi-square tests and logistic regression analyses were conducted. Thirty percent of participants presented with primary weight concern (n = 36; defined as endorsing higher Eating Disorder Examination (EDE) Weight Concern than Shape Concern subscale scores); 60 % presented with primary shape concern (n = 72; defined as endorsing higher EDE Shape Concern than Weight Concern scores). There were no significant differences between the two groups in remission status at the end of treatment. Treatment did not moderate the effect of group status on achieving remission. Results suggest that treatment outcomes are comparable between adolescents who enter treatment for AN with greater weight concerns and those who enter treatment with greater shape concerns. Therefore, treatment need not be adjusted based on primary weight or primary shape concerns.

Histopathology reveals correlative and unique phenotypes in a high-throughput mouse phenotyping screen

PubMed Central

Adissu, Hibret A.; Estabel, Jeanne; Sunter, David; Tuck, Elizabeth; Hooks, Yvette; Carragher, Damian M.; Clarke, Kay; Karp, Natasha A.; Project, Sanger Mouse Genetics; Newbigging, Susan; Jones, Nora; Morikawa, Lily; White, Jacqueline K.; McKerlie, Colin

2014-01-01

The Mouse Genetics Project (MGP) at the Wellcome Trust Sanger Institute aims to generate and phenotype over 800 genetically modified mouse lines over the next 5 years to gain a better understanding of mammalian gene function and provide an invaluable resource to the scientific community for follow-up studies. Phenotyping includes the generation of a standardized biobank of paraffin-embedded tissues for each mouse line, but histopathology is not routinely performed. In collaboration with the Pathology Core of the Centre for Modeling Human Disease (CMHD) we report the utility of histopathology in a high-throughput primary phenotyping screen. Histopathology was assessed in an unbiased selection of 50 mouse lines with (n=30) or without (n=20) clinical phenotypes detected by the standard MGP primary phenotyping screen. Our findings revealed that histopathology added correlating morphological data in 19 of 30 lines (63.3%) in which the primary screen detected a phenotype. In addition, seven of the 50 lines (14%) presented significant histopathology findings that were not associated with or predicted by the standard primary screen. Three of these seven lines had no clinical phenotype detected by the standard primary screen. Incidental and strain-associated background lesions were present in all mutant lines with good concordance to wild-type controls. These findings demonstrate the complementary and unique contribution of histopathology to high-throughput primary phenotyping of mutant mice. PMID:24652767

[Screening for bipolar disorder in primary care patients with psychological symptoms].

PubMed

Aragonès, Enric; López-Rodríguez, Juan A; Escobar-Rabadán, Francisco; Téllez-Lapeira, Juan; Mínguez, José; Párraga, Ignacio; Suárez-Hernández, Tatiana; Piñero, María José; Guzón, Marta-Magdalena

2015-03-01

To estimate the proportion of positive results in the screening of bipolar disorder (BD) among primary care patients presenting with psychological symptoms, and to analyze their characteristics. Multicenter cross-sectional study. Nineteen Primary Care clinics in different Spanish regions. A total of 360 consecutive primary care patients aged 18 to 70, presenting with psychological symptoms. Screening for BP was performed by means of the Mood Disorders Questionnaire. Data on quality of life (EuroQol-5D) and functional impairment (Sheehan Disability Inventory) were obtained. Data on psychiatric comorbidity and data on the use of psychotropic medication were acquired by review of medical records. Of the patients screened, 11.9% were positive (95%CI: 8.8%-15.7%). Only two patients had a diagnosis of BP in their clinical records and, although more than half received treatment with antidepressants, only two received treatment with mood stabilizers. Positive screening is associated with work, social and family dysfunction, greater perceived stress and poor quality of life. BD screening in primary care patients with psychological problems leads to a striking proportion of positive results, indicating that there may be a significant prevalence of BP patients, most of them undiagnosed and untreated. Further research is needed to determine the role that Primary Care can or should assume in the screening, diagnosis and management of this disorder. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Risk factors for development of primary bladder squamous cell carcinoma

PubMed Central

Hubbard, R; Swallow, D; Finch, W; Wood, SJ; Biers, SM

2017-01-01

INTRODUCTION The aim of this study was to investigate the prevalence of risk factors for primary squamous cell carcinoma (SCC) of the bladder. MATERIALS A total of 90 cases of primary SCC of the bladder were identified through multicentre analysis. Patient demographics, stage and grade of cancer at presentation, management and outcomes were recorded. The presence of known risk factors (catheter use, neuropathic bladder, smoking history, recurrent urinary tract infection and bladder stones) was also documented. RESULTS Over half of the patients had at least one identifiable risk factor for the development of primary bladder SCC: 13.9% of patients had a history of catheter use (clean intermittent self-catheterisation [CISC] in 11.1%), 10.0% of patients had a neuropathic bladder, 27.8% were smokers or ex-smokers and 20.0% had a documented history of recurrent urinary tract infection. Statistical analysis of the results showed no association between risk factors and grade of tumour at presentation. CONCLUSIONS These data further support the association between primary bladder SCC and several of the well documented risk factors for its development. Chronic use of CISC may confer a greater risk for development of SCC than thought previously. Further evidence of the role of CISC in primary SCC is required to justify routine screening and to determine exactly when surveillance of the bladder should begin for this group of patients. PMID:27869492

Media Panel: A Presentation of a Program. Report No. 4

ERIC Educational Resources Information Center

Rosengren, Karl Erik; Windahl, Swen

Media Panel is a research program directed toward media habits, causes and effects of TV use among children and adolescents, and viewer/media interaction in general. Results of this longitudinal study from 1970 to the present are presented in three sections focusing on the early work of the group, the preschool panel, and the primary school panel.…

Analysis of Chinese women with primary ovarian insufficiency by high resolution array-comparative genomic hybridization.

PubMed

Liao, Can; Fu, Fang; Yang, Xin; Sun, Yi-Min; Li, Dong-Zhi

2011-06-01

Primary ovarian insufficiency (POI) is defined as a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years. The etiology of primary ovarian insufficiency in human female patients is still unclear. The purpose of this study is to investigate the potential genetic causes in primary amenorrhea patients by high resolution array based comparative genomic hybridization (array-CGH) analysis. Following the standard karyotyping analysis, genomic DNA from whole blood of 15 primary amenorrhea patients and 15 normal control women was hybridized with Affymetrix cytogenetic 2.7M arrays following the standard protocol. Copy number variations identified by array-CGH were confirmed by real time polymerase chain reaction. All the 30 samples were negative by conventional karyotyping analysis. Microdeletions on chromosome 17q21.31-q21.32 with approximately 1.3 Mb were identified in four patients by high resolution array-CGH analysis. This included the female reproductive secretory pathway related factor N-ethylmaleimide-sensitive factor (NSF) gene. The results of the present study suggest that there may be critical regions regulating primary ovarian insufficiency in women with a 17q21.31-q21.32 microdeletion. This effect might be due to the loss of function of the NSF gene/genes within the deleted region or to effects on contiguous genes.

[Primary intestinal lymphangiectasia: twenty years of experience at a Mexican tertiary care hospital].

PubMed

Valdovinos-Oregón, D; Ramírez-Mayans, J; Cervantes-Bustamante, R; Toro-Monjaraz, E; Cázares-Méndez, M; Cadena-León, J; Zárate-Mondragón, F; Montijo-Barrios, E

2014-01-01

Primary intestinal lymphangiectasia is a rare congenital disease described by Waldmann in 1961 that is a consequence of obstruction of the lymphatic drainage of the small bowel with secondary lymph vessel dilation. This distorts the architecture of the villi and causes a leakage of lymph into the intestinal lumen, resulting in protein-losing enteropathy and malabsorption. To describe the clinical, biochemical, radiologic, endoscopic, and histologic characteristics in children with primary intestinal lymphangiectasia. A retrospective observational, descriptive, cross-sectional study was conducted that reviewed the case records of children diagnosed with primary intestinal lymphangiectasia that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 1, 1992 to September 30, 2012. Four patients were found that presented with primary intestinal lymphangiectasia. Three of them had been diagnosed before 3 years of age. All the patients presented with chronic diarrhea, edema, lymphopenia, hypocalcemia, and hypogammaglobulinemia, and 3 patients presented with hypocholesterolemia. Bowel transit time, endoscopy, and intestinal biopsies were characteristic of this pathology. Intestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

Primary malignant perivascular epithelioid cell neoplasm (PEComa) of the bone mimicking granular cell tumor in core biopsy: A case report and literature review

PubMed Central

Sadigh, Sam; Shah, Preya; Weber, Kristy; Sebro, Ronnie; Zhang, Paul J.

2018-01-01

The present study investigated the case of a 46-year-old female with primary malignant perivascular epithelioid cell neoplasm (PEComa) of the femur. The patient presented with a 5-month history of right distal thigh pain following trauma. Radiographs of the right distal femur revealed a mixed lytic and sclerotic lesion with subtle areas of cortical destruction and soft tissue extension, consistent with an aggressive tumor. A core biopsy revealed an epithelioid tumor with granular cell features, but a definitive diagnosis could not be made. Due to the aggressive features on radiologic evaluation, the patient underwent a resection of the distal femur and reconstruction with a distal femoral megaprosthesis and hinged knee replacement. The post-resection pathology led to a final diagnosis of primary bone PEComa, with histologic features including epithelioid, granular cell and spindled cell morphologies and biphasic immunoreactivity for melanocytic and smooth muscle markers. The large tumor size (>5 cm), rapid mitotic rate, infiltrative growth pattern, high nuclear grade and cellularity, and the presence of necrosis rendered this a malignant PEComa. The present study discussed the case, including radiographic (radiographs, magnetic resonance imaging and positron emission tomography scans) and histologic appearance and a literature review. PMID:29435023

Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics.

PubMed

Krupski, Antoinette; Graves, Meredith C; Bumgardner, Kristin; Roy-Byrne, Peter

2015-11-01

The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users. Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed. In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost. Compared to their housed counterparts, homeless participants were also more likely to have been admitted to specialized chemical dependency treatment and/or detoxification services, to have been arrested for a felony or gross misdemeanor, and to report having psychiatric problems in the prior 30 days. Additional support may be necessary for homeless patients presenting in primary care to benefit from substance abuse treatment given their more severe drug use problems coupled with their co-morbid health, psychiatric, and psychosocial problems. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving mental health service users' with medical co-morbidity transition between tertiary medical hospital and primary care services: a qualitative study.

PubMed

Cranwell, Kate; Polacsek, Meg; McCann, Terence V

2016-07-26

Mental health service users have high rates of medical co-morbidity but frequently experience problems accessing and transitioning between tertiary medical and primary care services. The aim of this study was to identify ways to improve service users' with medical co-morbidity care and experience during their transition between tertiary medical hospitals and primary care services. Experience-based co-design (EBCD) qualitative study incorporating a focus group discussion. The study took place in a large tertiary medical service, incorporating three medical hospitals, and primary care services, in Melbourne, Australia. A purposive sample of service users and their caregivers and tertiary medical and primary care clinicians participated in the focus group discussion, in August 2014. A semi-structured interview guide was used to inform data collection. A thematic analysis of the data was undertaken. Thirteen participants took part in the focus group interview, comprising 5 service users, 2 caregivers and 6 clinicians. Five themes were abstracted from the data, illustrating participants' perspectives about factors that facilitated (clinicians' expertise, engagement and accessibility enhancing transition) and presented as barriers (improving access pathways; enhancing communication and continuity of care; improving clinicians' attitudes; and increasing caregiver participation) to service users' progress through tertiary medical and primary care services. A sixth theme, enhancing service users' transition, incorporated three strategies to enhance their transition through tertiary medical and primary care services. EBCD is a useful approach to collaboratively develop strategies to improve service users' with medical co-morbidity and their caregivers' transition between tertiary medical and primary care services. A whole-of-service approach, incorporating policy development and implementation, change of practice philosophy, professional development education and support for clinicians, and acceptance of the need for caregiver participation, is required to improve service users' transition.

Primary percutaneous coronary intervention for acute ST elevation myocardial infarction: Outcomes and determinants of outcomes: A tertiary care center study from North India.

PubMed

Dubey, Gajendra; Verma, Sunil Kumar; Bahl, Vinay Kumar

Primary percutaneous coronary intervention (PCI) is the current standard of care for acute ST elevation myocardial infarction (STEMI). Most of the data on primary PCI in acute STEMI is from western countries. We studied the outcomes of primary PCI for acute STEMI at a tertiary care center in North India. Consecutive patients undergoing primary PCI for STEMI were prospectively studied during the period from February 2103 to May 2015. The outcomes assessed were all cause in hospital mortality, factors associated with mortality, major adverse cardiac and cerebrovascular event rate (composite of all cause in hospital mortality, non-fatal re infarction and stroke) and procedural complications. 371 patients underwent primary PCI during the study period. The mean age was 54 years and 82.7% were males. The mean total ischemia time and door to balloon times were 6.8h and 51min respectively. 96.4% patients underwent successful primary PCI. The total in hospital mortality was 12.9%. Mortality with cardiogenic shock at presentation was 66.7% while non-shock mortality was 2.6%. In hospital MACCE rate was 13.5%. Factors significantly associated with mortality were KILLIP class (OR: 8.4), door to balloon time (OR 1.02), final TIMI flow (OR 0.44) and severe LV dysfunction (OR 22.0). Procedure related adverse events were rare and there was no non-CABG associated major TIMI bleeding. Primary PCI for acute STEMI is feasible in our setup and associated with high success rate, low mortality in non-shock patients and low complication rates. Copyright © 2016. Published by Elsevier B.V.

Clinical study of Mineral Trioxide Aggregate in primary molars. Comparison between Grey and White MTA--a long term follow-up (84 months).

PubMed

Cardoso-Silva, Cristina; Barbería, Elena; Maroto, Myriam; García-Godoy, Franklin

2011-02-01

The aim of the present study was to conduct a clinical and radiographic long-term evaluation of pulpotomy in temporary molars performed with Grey and White Mineral Trioxide Aggregate (MTA) and compare the results of Grey and White MTA pulpotomies in a sample of 233 primary molars with a maximum follow-up period of 84 months. The sample was selected from patients treated at the Department of Pediatric Dentistry, Faculty of Dentistry, Complutense University of Madrid, Spain. This prospective study included first and second primary molars treated with pulpotomy with Grey or White MTA, controlled for a maximum follow-up period of 84 months. Statistical analysis of clinical and radiographic findings was completed using ANOVA (P<0.05). Follow-up evaluations, performed every 6 months, revealed that only 2 molars treated with White MTA presented abscess and pathological mobility. Radiographic examination of the 210 molars revealed unfavourable pulp response in only 6 molars (internal or furcation root resorption), without statistically significant differences between Grey and White MTA. Two radiological findings were noticed: dentine bridge formation and partial or total root canal stenosis. Grey MTA induced a higher percentage of dentine bridges with statistically significant differences (P<0.05), and a higher percentage of pulp canal stenosis, without a statistically significant difference. Grey and White MTA presented high levels of clinical and radiographic success. Although the present study showed evidence of a very good biologic response with both types of MTA, Grey MTA showed significantly higher number of dentine bridge formation than White MTA. Copyright © 2010 Elsevier Ltd. All rights reserved.

Comparison of Bacterial Community Composition of Primary and Persistent Endodontic Infections Using Pyrosequencing.

PubMed

Tzanetakis, Giorgos N; Azcarate-Peril, M Andrea; Zachaki, Sophia; Panopoulos, Panos; Kontakiotis, Evangelos G; Madianos, Phoebus N; Divaris, Kimon

2015-08-01

Elucidating the microbial ecology of endodontic infections (EIs) is a necessary step in developing effective intracanal antimicrobials. The aim of the present study was to investigate the bacterial composition of symptomatic and asymptomatic primary and persistent infections in a Greek population using high-throughput sequencing methods. 16S amplicon pyrosequencing of 48 root canal bacterial samples was conducted, and sequencing data were analyzed using an oral microbiome-specific and a generic (Greengenes) database. Bacterial abundance and diversity were examined by EI type (primary or persistent), and statistical analysis was performed by using non-parametric and parametric tests accounting for clustered data. Bacteroidetes was the most abundant phylum in both infection groups. Significant, albeit weak associations of bacterial diversity were found, as measured by UniFrac distances with infection type (analyses of similarity, R = 0.087, P = .005) and symptoms (analyses of similarity, R = 0.055, P = .047). Persistent infections were significantly enriched for Proteobacteria and Tenericutes compared with primary ones; at the genus level, significant differences were noted for 14 taxa, including increased enrichment of persistent infections for Lactobacillus, Streptococcus, and Sphingomonas. More but less abundant phyla were identified using the Greengenes database; among those, Cyanobacteria (0.018%) and Acidobacteria (0.007%) were significantly enriched among persistent infections. Persistent infections showed higher phylogenetic diversity (PD) (asymptomatic: PD = 9.2, standard error [SE] = 1.3; symptomatic: PD = 8.2, SE = 0.7) compared with primary infections (asymptomatic: PD = 5.9, SE = 0.8; symptomatic: PD = 7.4, SE = 1.0). The present study revealed a high bacterial diversity of EI and suggests that persistent infections may have more diverse bacterial communities than primary infections. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Basic Instinct Undressed: Early Spatiotemporal Processing for Primary Sexual Characteristics

PubMed Central

Legrand, Lore B.; Del Zotto, Marzia; Tyrand, Rémi; Pegna, Alan J.

2013-01-01

This study investigates the spatiotemporal dynamics associated with conscious and non-conscious processing of naked and dressed human bodies. To this effect, stimuli of naked men and women with visible primary sexual characteristics, as well as dressed bodies, were presented to 20 heterosexual male and female participants while acquiring high resolution EEG data. The stimuli were either consciously detectable (supraliminal presentations) or were rendered non-conscious through backward masking (subliminal presentations). The N1 event-related potential component was significantly enhanced in participants when they viewed naked compared to dressed bodies under supraliminal viewing conditions. More importantly, naked bodies of the opposite sex produced a significantly greater N1 component compared to dressed bodies during subliminal presentations, when participants were not aware of the stimulus presented. A source localization algorithm computed on the N1 showed that the response for naked bodies in the supraliminal viewing condition was stronger in body processing areas, primary visual areas and additional structures related to emotion processing. By contrast, in the subliminal viewing condition, only visual and body processing areas were found to be activated. These results suggest that naked bodies and primary sexual characteristics are processed early in time (i.e., <200 ms) and activate key brain structures even when they are not consciously detected. It appears that, similarly to what has been reported for emotional faces, sexual features benefit from automatic and rapid processing, most likely due to their high relevance for the individual and their importance for the species in terms of reproductive success. PMID:23894532

Is hypertension predictive of clinical recurrence in posterior reversible encephalopathy syndrome?

PubMed

Li, Richard; Mitchell, Peter; Dowling, Richard; Yan, Bernard

2013-02-01

Posterior reversible encephalopathy syndrome (PRES) has a distinctive clinical presentation and typical neuroimaging findings. However, data on its clinical course and recurrence are scarce. This study aims to investigate its clinical profile and factors that predict recurrence. We included patients diagnosed with PRES between 2005 and 2010 and collected data on demographics, presenting symptoms, co-morbidities, risk factors, clinical parameters, MRI findings, complications and recurrence. Patients were categorized into two groups: PRES due to primary hypertension and PRES due to secondary causes. Correlation with presenting symptoms, radiological features, and recurrence were analyzed. PRES was identified in 28 patients. Fourteen (50%) had primary hypertension. Secondary causes included immunosuppression-related (39%), preeclampsia/eclampsia (7%), and marijuana-intake-related (4%) causes. Patients presented with altered mental status (79%), headache (75%), seizure (68%), visual disturbance (39%) and hemiparesis (21%). On MRI 93% had the typical parietal-occipital involvement. The frontal lobe was affected in 64%, cerebellum in 29%, brainstem in 21%, and basal ganglia in 11%. About 36% had cortical involvement; 21% had diffusion-restricted lesions. Non-aneurysmal subarachnoid haemorrhage was found in 18% of patients and intracerebral hemorrhage in 14% of patients. No significant difference existed in presenting symptoms and the MRI distribution of vasogenic edema between the primary hypertension group and the secondary causes group. Recurrence occurred in four patients (14.3%, 95% confidence interval 4.2-33.7) and was significantly associated (p=0.05) with primary hypertension as the etiology. Intensive monitoring and treatment of hypertension is recommended for reducing morbidity. Copyright © 2012 Elsevier Ltd. All rights reserved.

Implementation and evaluation of the 5As framework of obesity management in primary care: design of the 5As Team (5AsT) randomized control trial

PubMed Central

2014-01-01

Background Obesity is a pressing public health concern, which frequently presents in primary care. With the explosive obesity epidemic, there is an urgent need to maximize effective management in primary care. The 5As of Obesity Management™ (5As) are a collection of knowledge tools developed by the Canadian Obesity Network. Low rates of obesity management visits in primary care suggest provider behaviour may be an important variable. The goal of the present study is to increase frequency and quality of obesity management in primary care using the 5As Team (5AsT) intervention to change provider behaviour. Methods/design The 5AsT trial is a theoretically informed, pragmatic randomized controlled trial with mixed methods evaluation. Clinic-based multidisciplinary teams (RN/NP, mental health, dietitians) will be randomized to control or the 5AsT intervention group, to participate in biweekly learning collaborative sessions supported by internal and external practice facilitation. The learning collaborative content addresses provider-identified barriers to effective obesity management in primary care. Evidence-based shared decision making tools will be co-developed and iteratively tested by practitioners. Evaluation will be informed by the RE-AIM framework. The primary outcome measure, to which participants are blinded, is number of weight management visits/full-time equivalent (FTE) position. Patient-level outcomes will also be assessed, through a longitudinal cohort study of patients from randomized practices. Patient outcomes include clinical (e.g., body mass index [BMI], blood pressure), health-related quality of life (SF-12, EQ5D), and satisfaction with care. Qualitative data collected from providers and patients will be evaluated using thematic analysis to understand the context, implementation and effectiveness of the 5AsT program. Discussion The 5AsT trial will provide a wide range of insights into current practices, knowledge gaps and barriers that limit obesity management in primary practice. The use of existing resources, collaborative design, practice facilitation, and integrated feedback loops cultivate an applicable, adaptable and sustainable approach to increasing the quantity and quality of weight management visits in primary care. Trial registration NCT01967797. PMID:24947045

Implementation and evaluation of the 5As framework of obesity management in primary care: design of the 5As Team (5AsT) randomized control trial.

PubMed

Campbell-Scherer, Denise L; Asselin, Jodie; Osunlana, Adedayo M; Fielding, Sheri; Anderson, Robin; Rueda-Clausen, Christian F; Johnson, Jeffrey A; Ogunleye, Ayodele A; Cave, Andrew; Manca, Donna; Sharma, Arya M

2014-06-19

Obesity is a pressing public health concern, which frequently presents in primary care. With the explosive obesity epidemic, there is an urgent need to maximize effective management in primary care. The 5As of Obesity Management™ (5As) are a collection of knowledge tools developed by the Canadian Obesity Network. Low rates of obesity management visits in primary care suggest provider behaviour may be an important variable. The goal of the present study is to increase frequency and quality of obesity management in primary care using the 5As Team (5AsT) intervention to change provider behaviour. The 5AsT trial is a theoretically informed, pragmatic randomized controlled trial with mixed methods evaluation. Clinic-based multidisciplinary teams (RN/NP, mental health, dietitians) will be randomized to control or the 5AsT intervention group, to participate in biweekly learning collaborative sessions supported by internal and external practice facilitation. The learning collaborative content addresses provider-identified barriers to effective obesity management in primary care. Evidence-based shared decision making tools will be co-developed and iteratively tested by practitioners. Evaluation will be informed by the RE-AIM framework. The primary outcome measure, to which participants are blinded, is number of weight management visits/full-time equivalent (FTE) position. Patient-level outcomes will also be assessed, through a longitudinal cohort study of patients from randomized practices. Patient outcomes include clinical (e.g., body mass index [BMI], blood pressure), health-related quality of life (SF-12, EQ5D), and satisfaction with care. Qualitative data collected from providers and patients will be evaluated using thematic analysis to understand the context, implementation and effectiveness of the 5AsT program. The 5AsT trial will provide a wide range of insights into current practices, knowledge gaps and barriers that limit obesity management in primary practice. The use of existing resources, collaborative design, practice facilitation, and integrated feedback loops cultivate an applicable, adaptable and sustainable approach to increasing the quantity and quality of weight management visits in primary care. NCT01967797.

Primary energy reconstruction from the charged particle densities recorded at 500 m distance from shower core with the KASCADE-Grande detector

NASA Astrophysics Data System (ADS)

Toma, G.; Apel, W. D.; Arteaga, J. C.; Bekk, K.; Bertaina, M.; Blümer, J.; Bozdog, H.; Brâncuş, I. M.; Buchholz, P.; Cantoni, E.; Chiavassa, A.; Cossavella, F.; Daumiller, K.; de Souza, V.; di Pierro, F.; Doll, P.; Engel, R.; Engler, J.; Finger, M.; Fuhrmann, D.; Ghia, P. L.; Gils, H. J.; Glasstetter, R.; Grupen, C.; Haungs, A.; Heck, D.; Hörandel, J. R.; Huege, T.; Isar, P. G.; Kampert, K.-H.; Kang, D.; Kickelbick, D.; Klages, H. O.; Link, K.; Łuczak, P.; Ludwig, M.; Mathes, H. J.; Mayer, H. J.; Melissas, M.; Milke, J.; Mitrică, B.; Morello, C.; Navarra, G.; Nehls, S.; Oehlschläger, J.; Ostapchenko, S.; Over, S.; Palmieri, N.; Petcu, M.; Pierog, T.; Rebel, H.; Roth, M.; Schieler, H.; Schröder, F. G.; Sima, O.; Trinchero, G. C.; Ulrich, H.; Weindl, A.; Wochele, J.; Wommer, M.; Zabierowski, J.

2011-05-01

Previous EAS investigations have shown that for a fixed primary energy the charged particle density becomes independent of the primary mass at certain (fixed) distances from the shower axis. This feature can be used as an estimator for the primary energy. We present results on the reconstruction of the primary energy spectrum of cosmic rays from the experimentally recorded S(500) observable (the density of charged particles at a distance of 500 m to the shower core as measured in a plane normal to the shower axis) using the KASCADE-Grande detector array. The KASCADE-Grande experiment is hosted by the Karlsruhe Institute for Technology - Campus North, Karlsruhe, Germany, 110 m a.s.l. and operated by an international collaboration. The obtained primary energy spectrum is presented along with the result of another reconstruction technique presently employed at KASCADE-Grande.

Block 2 Solid Rocket Motor (SRM) conceptual design study. Volume 1: Appendices

NASA Technical Reports Server (NTRS)

1986-01-01

The design studies task implements the primary objective of developing a Block II Solid Rocket Motor (SRM) design offering improved flight safety and reliability. The SRM literature was reviewed. The Preliminary Development and Validation Plan is presented.

Rail-Highway Crossing Resource Allocation Procedure. User's Guide. 2nd edition.

DOT National Transportation Integrated Search

2006-01-01

This report presents findings from a customer satisfaction study conducted in Cobb County, Georgia. The primary hypothesis of this study is that it is possible to develop customer satisfaction measures that are a reliable determinant of roadway quali...

Strategies for improving patient recruitment to focus groups in primary care: a case study reflective paper using an analytical framework.

PubMed

Dyas, Jane V; Apekey, Tanefa; Tilling, Michelle; Siriwardena, A Niroshan

2009-09-22

Recruiting to primary care studies is complex. With the current drive to increase numbers of patients involved in primary care studies, we need to know more about successful recruitment approaches. There is limited evidence on recruitment to focus group studies, particularly when no natural grouping exists and where participants do not regularly meet. The aim of this paper is to reflect on recruitment to a focus group study comparing the methods used with existing evidence using a resource for research recruitment, PROSPeR (Planning Recruitment Options: Strategies for Primary Care). The focus group formed part of modelling a complex intervention in primary care in the Resources for Effective Sleep Treatment (REST) study. Despite a considered approach at the design stage, there were a number of difficulties with recruitment. The recruitment strategy and subsequent revisions are detailed. The researchers' modifications to recruitment, justifications and evidence from the literature in support of them are presented. Contrary evidence is used to analyse why some aspects were unsuccessful and evidence is used to suggest improvements. Recruitment to focus group studies should be considered in two distinct phases; getting potential participants to contact the researcher, and converting those contacts into attendance. The difficulty of recruitment in primary care is underemphasised in the literature especially where people do not regularly come together, typified by this case study of patients with sleep problems. We recommend training GPs and nurses to recruit patients during consultations. Multiple recruitment methods should be employed from the outset and the need to build topic related non-financial incentives into the group meeting should be considered. Recruitment should be monitored regularly with barriers addressed iteratively as a study progresses.

A Trade Study of Two Membrane-Aerated Biological Water Processors

NASA Technical Reports Server (NTRS)

Allada, Ram; Lange, Kevin; Vega. Leticia; Roberts, Michael S.; Jackson, Andrew; Anderson, Molly; Pickering, Karen

2011-01-01

Biologically based systems are under evaluation as primary water processors for next generation life support systems due to their low power requirements and their inherent regenerative nature. This paper will summarize the results of two recent studies involving membrane aerated biological water processors and present results of a trade study comparing the two systems with regards to waste stream composition, nutrient loading and system design. Results of optimal configurations will be presented.

Three forms of somatization presenting in primary care settings in Spain.

PubMed

García-Campayo, J; Lobo, A; Pérez-Echeverría, M J; Campos, R

1998-09-01

The objective of this paper is to study the prevalence and clinical characteristics of functional, hypochondriacal, and presenting somatization (FSTS, HSTS, and PSTS, respectively) defined by standardized criteria, as well as the validity of their distinction in primary care in Spain. A two-stage epidemiological study of a representative sample (N = 1559) of primary care patients was carried out. In the first phase, the validated Spanish versions of General Health Questionnaire, Mini-Mental State Examination, and CAGE were used. In the second phase, the Standardized Polyvalent Psychiatric Interview, an interview for the multiaxial assessment of medical patients, was employed. The prevalence of any form of somatization in Spain was 21.3% (FSTS: 16.2%, PSTS: 9.4%, HSTS: 6.7%). Overlap of any of the three clinical forms was very frequent (42.7%). FSTS patients tended to be more chronic and showed higher scores in fatigue but lower scores in both depression and anxiety. Chronicity was frequent among somatizers, particularly in those who fulfilled more than one kind of somatization. Differences in diagnostic distribution among the three groups were also observed. In conclusion, this is the first study giving support to the validity of the distinction among three types of somatization in Spain, but overlap was more frequent than reported in North American studies.

Fraternal Twin Tumours of the Oesophagus and Stomach Presenting in the Advanced Stage - A Rare Case with a Fatal End.

PubMed

Sreeram, Saraswathy; Venkataramana, Chaithra Gowthuvalli; Kini, Jyoti Ramanath; Rao, Ranjitha; Murali, Nirupama

2017-04-01

Synchronous primary tumours of the aerodigestive tract presenting with different histologies is a very rare event. A case with such an association is presented here. A 50-year-old lady presented with symptoms of abdominal obstruction like abdominal pain, distention and vomiting since one month. Her radiological imaging and biopsies revealed a primary oesophageal squamous cell carcinoma and primary gastric adenocarcinoma. Western medical literature has shown the occurrence of multiple synchronous cancers; however, cases from India have seldom been reported. Early screening, correct diagnosis and appropriate plans of management are crucial to reduce the morbidity and mortality of such patients who bear the burden of not just one, but multiple primary cancers.

Laron syndrome (primary growth hormone insensitivity): a unique model to explore the effect of insulin-like growth factor 1 deficiency on human hair.

PubMed

Lurie, R; Ben-Amitai, D; Laron, Z

2004-01-01

Classical Laron syndrome is a recessive disease of primary insulin-like growth factor 1 (IGF-1) deficiency and primary growth hormone insensitivity. Affected children have, among other defects, sparse hair growth and frontal recessions. The hair is thin and easy to pluck. Young adults have various degrees of alopecia, more pronounced in males. The aim of the present study was to investigate the effect of primary IGF-1 deficiency on hair structure. The study sample included 11 patients with Laron syndrome--5 children (2 untreated) and 6 adults (5 untreated). Hairs were examined by light and electron microscopy. The most significant structured defect, pili torti et canaliculi, was found in 2 young, untreated patients. Grooving, tapered hair and trichorrhexis nodosa were found in the remainder. IGF-1-treated patients had either none or significantly fewer pathological changes compared to the untreated patients. This is the first documentation of the role of primary IGF-1 deficiency on hair structure in human beings. Copyright 2004 S. Karger AG, Basel

On the Study of Cognitive Bidirectional Relaying with Asymmetric Traffic Demands

NASA Astrophysics Data System (ADS)

Ji, Xiaodong

2015-05-01

In this paper, we consider a cognitive radio network scenario, where two primary users want to exchange information with each other and meanwhile, one secondary node wishes to send messages to a cognitive base station. To meet the target quality of service (QoS) of the primary users and raise the communication opportunity of the secondary nodes, a cognitive bidirectional relaying (BDR) scheme is examined. First, system outage probabilities of conventional direct transmission and BDR schemes are presented. Next, a new system parameter called operating region is defined and calculated, which indicates in which position a secondary node can be a cognitive relay to assist the primary users. Then, a cognitive BDR scheme is proposed, giving a transmission protocol along with a time-slot splitting algorithm between the primary and secondary transmissions. Information-theoretic metric of ergodic capacity is studied for the cognitive BDR scheme to evaluate its performance. Simulation results show that with the proposed scheme, the target QoS of the primary users can be guaranteed, while increasing the communication opportunity for the secondary nodes.

A randomised controlled trial of a lengthened and multi-disciplinary consultation model in a socially deprived community: a study protocol.

PubMed

Whitford, David L; Chan, Wai-Sun

2007-06-28

There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more particularly it promises relevance to primary care. Current Controlled Trials ISRCTN70578736.

Comics as a Literary-Didactic Method and Their Use for Reducing Gender Differences in Reading Literacy at the Primary Level of Education

ERIC Educational Resources Information Center

Kerneža, Maja; Košir, Katja

2016-01-01

The aim of the present study was to examine the effect of the systematic use of comics as a literary-didactic method to reduce gender differences in reading literacy and reading motivation at the primary level of education. It was assumed that the use of comics would have a positive effect on pupils' reading literacy and reading motivation, while…

Patient safety in primary care: a survey of general practitioners in The Netherlands.

PubMed

Gaal, Sander; Verstappen, Wim; Wensing, Michel

2010-01-21

Primary care encompasses many different clinical domains and patient groups, which means that patient safety in primary care may be equally broad. Previous research on safety in primary care has focused on medication safety and incident reporting. In this study, the views of general practitioners (GPs) on patient safety were examined. A web-based survey of a sample of GPs was undertaken. The items were derived from aspects of patient safety issues identified in a prior interview study. The questionnaire used 10 clinical cases and 15 potential risk factors to explore GPs' views on patient safety. A total of 68 GPs responded (51.5% response rate). None of the clinical cases was uniformly judged as particularly safe or unsafe by the GPs. Cases judged to be unsafe by a majority of the GPs concerned either the maintenance of medical records or prescription and monitoring of medication. Cases which only a few GPs judged as unsafe concerned hygiene, the diagnostic process, prevention and communication. The risk factors most frequently judged to constitute a threat to patient safety were a poor doctor-patient relationship, insufficient continuing education on the part of the GP and a patient age over 75 years. Language barriers and polypharmacy also scored high. Deviation from evidence-based guidelines and patient privacy in the reception/waiting room were not perceived as risk factors by most of the GPs. The views of GPs on safety and risk in primary care did not completely match those presented in published papers and policy documents. The GPs in the present study judged a broader range of factors than in previously published research on patient safety in primary care, including a poor doctor-patient relationship, to pose a potential threat to patient safety. Other risk factors such as infection prevention, deviation from guidelines and incident reporting were judged to be less relevant than by policy makers.

Unusual presentations of melanoma: melanoma of unknown primary site, melanoma arising in childhood, and melanoma arising in the eye and on mucosal surfaces.

PubMed

Sondak, Vernon K; Messina, Jane L

2014-10-01

Most melanomas present as primary tumors on the skin surface in adults; however, melanomas also arise in the eye and on the mucosal surfaces or present as apparently metastatic disease without any known history of a cutaneous primary. Melanoma is also being diagnosed during childhood more frequently than ever. Surgeons need to be aware of and understand these unusual presentations of melanoma to optimally manage their patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Primary Amenorrhea Associated with Hyperprolactinemia in Polyglandular Autoimmune Syndrome Type II: A Case Report.

PubMed

Cottas, Luiza Tizziotti; Borges, Maria de Fátima; Oliveira, Lívia Prata Santos; Resende, Ana Luísa Mantovani; Ataíde, Meire Soares; Resende, Elisabete Aparecida Mantovani Rodrigues

2018-06-27

Polyglandular autoimmune syndrome type II (PGA-II) is a rare immunoendocrinopathy syndrome characterized by the occurrence of autoimmune Addison disease along with diabetes mellitus type 1 and/or autoimmune thyroid disease. Here, we report the case of a 23-year-old female with PGA-II who was followed up at the dermatology and endocrinology clinics of the Universidade Federal do Triângulo Mineiro, located in the state of Minas Gerais, Brazil. First, the patient presented diffuse skin hyperpigmentation, vitiligo; and in sequence, due to vomiting, appetite and weight loss, hypoglycemia, amenorrhea, and galactorrhea, the patient was then diagnosed with PGA-II. The patient also presented intense hyperprolactinemia due to primary hypothyroidism. The late diagnosis of PGA-II is frequent because the disorder is uncommon and has non-specific clinical manifestations. This report emphasizes the significance of a timely diagnosis and appropriate treatment to reduce morbidity and mortality associated with these diseases, especially Addison disease. The present study reports a rare case of a patient with PGA-II with primary amenorrhea associated with hyperprolactinemia. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

Primary intraosseous squamous cell carcinoma arising in an odontogenic keratocyst previously treated with marsupialization: case report and immunohistochemical study.

PubMed

Martínez-Martínez, Marisol; Mosqueda-Taylor, Adalberto; Delgado-Azañero, Wilson; Rumayor-Piña, Alicia; de Almeida, Oslei Paes

2016-04-01

A rare case of primary intraosseous squamous cell carcinoma arising in an odontogenic keratocyst (OKC) is presented here, with the clinical and histologic features of the first biopsy showing characteristics of OKC and the second biopsy disclosing a squamous cell carcinoma. Immunoprofile of this case was compared with five cases of classical OKC by using cytokeratins CK5, CK14, and CK19, CD138, p63, Ki-67, p53, and bcl-2. Classic OKCs showed expected positivity, mainly in the basal and/or suprabasal layers with most antibodies, except for p53, which was negative, whereas the present case showed irregular positivity in all layers, indicating that this can be useful for differential diagnosis and suggesting a possible role in malignant transformation into primary intraosseous squamous cell carcinoma. In conclusion, immunohistochemical differences between the first biopsy of the present case and classic OKC suggest that immunohistochemistry can be helpful in cases with areas of subtle initial malignant transformation. Copyright © 2016 Elsevier Inc. All rights reserved.

Analytically optimal parameters of dynamic vibration absorber with negative stiffness

NASA Astrophysics Data System (ADS)

Shen, Yongjun; Peng, Haibo; Li, Xianghong; Yang, Shaopu

2017-02-01

In this paper the optimal parameters of a dynamic vibration absorber (DVA) with negative stiffness is analytically studied. The analytical solution is obtained by Laplace transform method when the primary system is subjected to harmonic excitation. The research shows there are still two fixed points independent of the absorber damping in the amplitude-frequency curve of the primary system when the system contains negative stiffness. Then the optimum frequency ratio and optimum damping ratio are respectively obtained based on the fixed-point theory. A new strategy is proposed to obtain the optimum negative stiffness ratio and make the system remain stable at the same time. At last the control performance of the presented DVA is compared with those of three existing typical DVAs, which were presented by Den Hartog, Ren and Sims respectively. The comparison results in harmonic and random excitation show that the presented DVA in this paper could not only reduce the peak value of the amplitude-frequency curve of the primary system significantly, but also broaden the efficient frequency range of vibration mitigation.

Investigating the nature of interprofessional collaboration in primary care across the Western Health Region of Brasília, Brazil: A study protocol.

PubMed

Pinho, Diana; Parreira, Clelia; Queiroz, Elizabeth; Abbad, Gardênia; Reeves, Scott

2018-03-01

Primary care can provide a supportive context for the development of interprofessional collaborative practice owing to its nature and dynamics. In Brazil, a number of practice changes have already occurred to primary care, notably the implementation of the Family Health Strategy which promoted interprofessional collaboration (IPC). In Brasilia, a new arrangement was implemented in 2016 that focused on an expansion of primary healthcare. However, it is not clear how these reforms will affect the nature of IPC or the delivery of patient care. The article presents a study protocol which describes a study that aims to explore the nature of IPC in the context of primary care in the Western Health Region of Brasilia. A sequential mixed methods design will be used to gather both quantitative and qualitative data. Initially, we will translate, cross-culturally adapt, and validate an IPC scale for a survey of primary care teams. We will then undertake a series of focus groups with a purposeful sample of team members to explore the results from the survey. Quantitative data will be analysed with descriptive and multivariate statistics. A content analysis will be undertaken with the focus group data. We expect that the results will illuminate a range of elements linked to IPC in primary care as well as identify areas for improving IPC skills, patient safety, quality of care, and healthcare outcomes in this clinical context.

Missing an opportunity: the embedded nature of weight management in primary care

PubMed Central

Osunlana, A. M.; Ogunleye, A. A.; Sharma, A. M.; Campbell‐Scherer, D.

2015-01-01

Summary The 5As Team study was designed to create, implement and evaluate a flexible intervention to improve the quality and quantity of weight management visits in primary care. The objective of this portion of the study was to explore how primary care providers incorporate weight management in their practice. 5AsT is a randomized controlled trial (RCT) on the implementation of a 6‐month 5 As Team (5AsT) intervention designed to operationalize the 5As of obesity management in primary care. Data for the qualitative portion of the study presented here included semi‐structured interviews with 29 multidisciplinary team providers and field notes of intervention sessions. Thematic analysis was undertaken. A key pattern that emerged from the data was that healthcare providers usually do not address obesity as a primary focus for a visit. Rather, obesity is embedded in a wide range of primary care encounters for other conditions. Implications were it can take extra time to discuss weight, it can be inappropriate to bring up weight as a topic, and treating risk factors and root causes of obesity have indirect benefits to patient weight management. Our findings have implications for obesity treatment approaches and tools that assume a discreet weight management visit. The embedded nature of obesity management in primary care can be harnessed to leverage multiple opportunities for asking and assessing root causes of obesity, and working longitudinally towards individual health goals. PMID:26303812

Whooping cough in school age children presenting with persistent cough in UK primary care after introduction of the preschool pertussis booster vaccination: prospective cohort study

PubMed Central

Fry, Norman K; Campbell, Helen; Amirthalingam, Gayatri; Harrison, Timothy G; Mant, David; Harnden, Anthony

2014-01-01

Objective To estimate the prevalence and clinical severity of whooping cough (pertussis) in school age children presenting with persistent cough in primary care since the introduction and implementation of the preschool pertussis booster vaccination. Design Prospective cohort study (November 2010 to December 2012). Setting General practices in Thames Valley, UK. Participants 279 children aged 5 to 15 years who presented in primary care with a persistent cough of two to eight weeks’ duration. Exclusion criteria were cough likely to be caused by a serious underlying medical condition, known immunodeficiency or immunocompromise, participation in another clinical research study, and preschool pertussis booster vaccination received less than one year previously. Main outcome measures Evidence of recent pertussis infection based on an oral fluid anti-pertussis toxin IgG titre of at least 70 arbitrary units. Cough frequency was measured in six children with laboratory confirmed pertussis. Results 56 (20%, 95% confidence interval 16% to 25%) children had evidence of recent pertussis infection, including 39 (18%, 13% to 24%) of 215 children who had been fully vaccinated. The risk of pertussis was more than three times higher (21/53; 40%, 26% to 54%) in children who had received the preschool pertussis booster vaccination seven years or more previously than in those who had received it less than seven years previously (20/171; 12%, 7% to 17%). The risk of pertussis was similar between children who received five and three component preschool pertussis booster vaccines (risk ratio for five component vaccine 1.14, 0.64 to 2.03). Four of six children in whom cough frequency was measured coughed more than 400 times in 24 hours. Conclusions Pertussis can still be found in a fifth of school age children who present in primary care with persistent cough and can cause clinically significant cough in fully vaccinated children. These findings will help to inform consideration of the need for an adolescent pertussis booster vaccination in the United Kingdom. Study registration UK Clinical Research Network portfolio ID 8361. PMID:24961836

Perceived effects of the economic recession on population mental health, well-being and provision of care by primary care users and professionals: a qualitative study protocol in Portugal

PubMed Central

Frasquilho, Diana; Cardoso, Graça; Pereira, Nádia; Silva, Manuela; Caldas-de-Almeida, José Miguel; Ferrão, João

2017-01-01

Introduction Economic recession periods can pose accentuated risks to population’s mental health and well-being as well as additional threats to health systems. Users and health professionals are key stakeholders in care delivery; however, little attention has been given to their experiences of the crisis. This paper presents a qualitative study protocol to assess users’ and health professionals’ perceptions about the effects of the post-2008 economic recession on mental health and care delivery in the Lisbon Metropolitan Area, Portugal. Methods and analysis The methodology to assess perceived effects of the economic recession by primary care users and professionals on population mental health, well-being and provision of care is presented. Focus groups with users and semistructured interviews with health professionals will be carried out in three primary healthcare units in Lisbon areas especially affected by the crisis. Thematic analysis of full-transcribed interviews will be conducted using an iterative and reflexive approach. Ethics and dissemination The study protocol was approved by the Ethics Committee of NOVA Medical School, NOVA University of Lisbon. The findings will be useful for other researchers and policy-makers to develop and implement the assessment of prevailing experiences of users and health professionals on the effects of the economic recession on mental health and quality of care in primary health context, promoting their involvement and contribution to services responsiveness. PMID:28871022

Gastric metastasis from invasive lobular breast cancer, mimicking primary gastric cancer: A case report.

PubMed

Kim, Dae Hoon; Son, Seung-Myoung; Choi, Young Jin

2018-03-01

Gastric metastasis from invasive lobular breast cancer is relatively rare, commonly presented among multiple metastases, several years after primary diagnosis of breast cancer. Importantly, gastric cancer that is synchronously presented with lobular breast cancer can be misdiagnosed as primary gastric cancer; therefore, accurate differential diagnosis is required. A 39-year-old woman was visited to our hospital because of right breast mass and progressive dyspepsia. Invasive lobular carcinoma of breast was diagnosed on core needle biopsy. Gastroscopy revealed a diffuse scirrhous mass at the prepyloric antrum and diagnosed as poorly differentiated adenocarcinoma on biopsy. Synchronous double primary breast and gastric cancers were considered. Detailed pathological analysis focused on immunohistochemical studies of selected antibodies, including those of estrogen receptors, gross cystic disease fluid protein-15, and caudal-type homeobox transcription factor 2, were studied. As a result, gastric lesion was diagnosed as metastatic gastric cancer originating from breast. Right breast conserving surgery was performed, and duodenal stent was inserted under endoscopic guidance to relieve the patient's symptoms. Systemic chemotherapy with combined administration of paclitaxel and trastuzumab was initiated. Forty-one months after the diagnosis, the patient is still undergoing the same therapy. No recurrent lesion has been identified in the breast and evidence of a partial remission of gastric wall thickening has been observed on follow-up studies without new metastatic lesions. Clinical suspicion, repeat endoscopic biopsy, and detailed histological analysis, including immunohistochemistry, are necessary for diagnosis of metastatic gastric cancer from the breast.

Prognosis estimation under the light of metabolic tumor parameters on initial FDG-PET/CT in patients with primary extranodal lymphoma

PubMed Central

Okuyucu, Kursat; Ozaydın, Sukru; Alagoz, Engin; Ozgur, Gokhan; Oysul, Fahrettin Guven; Ozmen, Ozlem; Tuncel, Murat; Ozturk, Mustafa; Arslan, Nuri

2016-01-01

Abstract Background Non-Hodgkin’s lymphomas arising from the tissues other than primary lymphatic organs are named primary extranodal lymphoma. Most of the studies evaluated metabolic tumor parameters in different organs and histopathologic variants of this disease generally for treatment response. We aimed to evaluate the prognostic value of metabolic tumor parameters derived from initial FDG-PET/CT in patients with a medley of primary extranodal lymphoma in this study. Patients and methods There were 67 patients with primary extranodal lymphoma for whom FDG-PET/CT was requested for primary staging. Quantitative PET/CT parameters: maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival. Results SUVmean, MTV and TLG were found statistically significant after multivariate analysis. SUVmean remained significant after ROC curve analysis. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was chosen as 5.15. After the investigation of primary presentation sites and histo-pathological variants according to recurrence, there is no difference amongst the variants. Primary site of extranodal lymphomas however, is statistically important (p = 0.014). Testis and central nervous system lymphomas have higher recurrence rate (62.5%, 73%, respectively). Conclusions High SUVmean, MTV and TLG values obtained from primary staging FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in primary extranodal lymphoma. SUVmean is the most significant one amongst them for estimating recurrence/metastasis. PMID:27904443

Primary quantum yields of NO2 photodissociation

NASA Technical Reports Server (NTRS)

Gardner, Edward P.; Sperry, Paul D.; Calvert, Jack G.

1987-01-01

The quantum yields of formation of NO, O2, and NO2 loss are measured for NO2 vapor at low pressures (0.13-0.30 torr) irradiated at 334-405 nm wavelengths and temperature in the range 273-370 K in order to study the primary quantum efficiencies of NO2 photodecomposition. The temperature and wavelength dependences of the primary quantum efficiencies are examined. It is observed that the primary quantum efficiencies increase rapidly from near zero at 424 nm to near unity for excitation at wavelengths less than 394 nm. The theory of Pitts et al. (1964) that the energy deficiency for photodissociation of NO2 excited at wavelengths greater than 397.9 nm is due to the rotational and vibrational energy of the NO2 molecules is confirmed by the data. Values for the primary quantum yields of NO2 photodecomposition as a function of wavelength are presented.

Ginsenoside compound K promotes β-amyloid peptide clearance in primary astrocytes via autophagy enhancement.

PubMed

Guo, Jinhui; Chang, Li; Zhang, Xin; Pei, Sujuan; Yu, Meishuang; Gao, Jianlian

2014-10-01

The aim of the present study was to investigate the effect of ginsenoside compound K on β-amyloid (Aβ) peptide clearance in primary astrocytes. Aβ degradation in primary astrocytes was determined using an intracellular Aβ clearance assay. Aggregated LC3 in astrocyte cells, which is a marker for the level of autophagy, was detected using laser scanning confocal microscope. The effect of compound K on the mammalian target of rapamycin (mTOR)/autophagy pathway was determined using western blot analysis, and an enzyme-linked immunosorbent assay was used for Aβ detection. The results demonstrated that compound K promoted the clearance of Aβ and enhanced autophagy in primary astrocytes. In addition, it was found that phosphorylation of mTOR was inhibited by compound K, which may have contributed to the enhanced autophagy. In conclusion, compound K promotes Aβ clearance by enhancing autophagy via the mTOR signaling pathway in primary astrocytes.

Preliminary investigation on the effects of primary airflow to coal particle distribution in coal-fired boilers

NASA Astrophysics Data System (ADS)

Noor, N. A. W. Mohd; Hassan, H.; Hashim, M. F.; Hasini, H.; Munisamy, K. M.

2017-04-01

This paper presents an investigation on the effects of primary airflow to coal fineness in coal-fired boilers. In coal fired power plant, coal is pulverized in a pulverizer, and it is then transferred to boiler for combustion. Coal need to be ground to its desired size to obtain maximum combustion efficiency. Coarse coal particle size may lead to many performance problems such as formation of clinker. In this study, the effects of primary airflow to coal particles size and coal flow distribution were investigated by using isokinetic coal sampling and computational fluid dynamic (CFD) modelling. Four different primary airflows were tested and the effects to resulting coal fineness were recorded. Results show that the optimum coal fineness distribution is obtained at design primary airflow. Any reduction or increase of air flow rate results in undesirable coal fineness distribution.

Development of Multiple Primary Cancers in Lung Cancer Patients: Appalachian Versus Non-Appalachian Populations of Kentucky.

PubMed

Pravosud, Vira; Huang, Bin; Tucker, Thomas; Vanderford, Nathan L

2017-12-01

The aim of this study was to investigate whether patients with lung cancer in Appalachian Kentucky are more likely to develop multiple primary cancers than patients in non-Appalachian Kentucky. Additional analyses were conducted to identify other factors that may be associated with an increased hazard of developing multiple primary cancers in patients with lung cancer. The data for this retrospective, population-based cohort study of 26,456 primary lung cancer patients were drawn from the Kentucky Cancer Registry. For inclusion in the study, patients must have been diagnosed between January 1, 2000 and December 31, 2013 and they must either have continually resided in Appalachian Kentucky or continually resided in non-Appalachian Kentucky. Cases were excluded if the patient was diagnosed as having additional primary cancers within 3 months of the initial diagnosis of primary lung cancer. The medical records for each case were examined to determine whether the patient was subsequently diagnosed as having additional primary cancers. The Cox proportional hazards model was then used to assess whether there was an association between the region in which the patients live and the likelihood of developing multiple primary cancers. Time to event was considered as the time from diagnosis to either death or development of a second primary cancer. The results presented here indicate that the risk of developing multiple primary cancers is the same for patients with lung cancer throughout Kentucky (hazard ratio [HR] 1.002, P = 0.9713). We found no evidence for a greater hazard in patients from Appalachia; however, additional analyses revealed several high-risk groups. Male patients and older patients had a significantly greater hazard of developing multiple primary cancers (HR 1.169, P = 0.012 and 1.015, P = 0.0001, respectively). In addition, patients who underwent surgery and those who were diagnosed initially as having an earlier stage of cancer also were more likely to develop multiple primary cancers (HR 1.446, P = 0.0003 and 0.684, P = 0.0015, respectively). This is a negative study. Patients with primary lung cancer living in Appalachian Kentucky are not at a greater risk of developing multiple primary cancers than those residing in non-Appalachian Kentucky. High-risk groups identified in this study are male patients and older patients. The increased hazard seen in patients who underwent surgery or those who were diagnosed as having earlier stages of lung cancer are likely an artifact of these patients living longer and, therefore, having more time to develop additional primary cancers.

Black youth suicide: literature review with a focus on prevention.

PubMed Central

Baker, F. M.

1990-01-01

The national rates of completed suicide in the black population between 1950 and 1981 are presented, including age-adjusted rates. Specific studies of black suicide attempters and completed suicides by blacks in several cities are discussed. Methodological problems with existing studies and national suicide statistics are presented. Proposed theories of black suicide are reviewed. Based on a summary of the characteristics of black suicide attempters reported by the literature, preventive strategies--primary, secondary, and tertiary--are presented. PMID:2204709

The Use of Interactive Computer Animations Based on POE as a Presentation Tool in Primary Science Teaching

NASA Astrophysics Data System (ADS)

Akpınar, Ercan

2014-08-01

This study investigates the effects of using interactive computer animations based on predict-observe-explain (POE) as a presentation tool on primary school students' understanding of the static electricity concepts. A quasi-experimental pre-test/post-test control group design was utilized in this study. The experiment group consisted of 30 students, and the control group of 27 students. The control group received normal instruction in which the teacher provided instruction by means of lecture, discussion and homework. Whereas in the experiment group, dynamic and interactive animations based on POE were used as a presentation tool. Data collection tools used in the study were static electricity concept test and open-ended questions. The static electricity concept test was used as pre-test before the implementation, as post-test at the end of the implementation and as delay test approximately 6 weeks after the implementation. Open-ended questions were used at the end of the implementation and approximately 6 weeks after the implementation. Results indicated that the interactive animations used as presentation tools were more effective on the students' understanding of static electricity concepts compared to normal instruction.

Job satisfaction of primary health-care providers (public sector) in urban setting.

PubMed

Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Sharma, Nandini

2013-07-01

Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01). Age and education level of health care providers don't show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi.

Depth and Patterns of Adnexal Involvement in Primary Extramammary (Anogenital) Paget Disease: A Study of 178 Lesions From 146 Patients.

PubMed

Konstantinova, Anastasia M; Shelekhova, Ksenya V; Stewart, Colin J; Spagnolo, Dominic V; Kutzner, Heinz; Kacerovska, Denisa; Plaza, Jose A; Suster, Saul; Bouda, Jiri; Pavlovsky, Michal; Kyrpychova, Liubov; Michal, Michal; Guenova, Emmanuella; Kazakov, Dmitry V

2016-11-01

Extramammary Paget disease (EMPD) is a rare neoplasm usually presenting in the anogenital area, most commonly in the vulva. Adnexal involvement in primary EMPD is a very common feature and serves as a pathway for carcinoma to spread into deeper tissue. The depth of carcinomatous spread along the appendages and the patterns of adnexal involvement were studied in 178 lesions from 146 patients with primary EMPD. Hair follicles and eccrine ducts were the adnexa most commonly affected by carcinoma cells. The maximal depth of involvement was 3.6 mm in this series. When planning topical therapy or developing novel local treatment modalities for EMPD, this potential for significant deep spread along adnexa should be taken into account.

Cytologic evaluation of cervical lymph node metastases from cancers of unknown primary origin.

PubMed

Pusztaszeri, Marc P; Faquin, William C

2015-01-01

Fine-needle aspiration biopsy (FNAB) is often the first diagnostic procedure performed in patients with head and neck (HN) masses. Metastatic squamous cell carcinoma (SCC) to cervical lymph nodes is by far the most common malignancy aspirated in the HN, but in approximately 3-10% of patients, a primary tumor will not be found even after complete clinico-radiological workup. Several HN cancers are associated with oncogenic viruses, including HPV-associated SCC and EBV-associated nasopharyngeal carcinoma (NPC). While the primary tumor is sometimes small or undetectable, patients often present initially with cervical lymph node metastases. HPV-associated SCC and EBV-associated NPC are typically non-keratinizing carcinomas that can mimic several other poorly differentiated HN cancers by FNAB but have a significantly better prognosis. Therefore, the precise classification of the metastatic disease in the FNAB material is very useful since it can facilitate the subsequent location of the primary tumor, and it can provide prognostic and therapeutic information as well. In this review, we discuss the major entities that can present as a metastatic cancer of unknown primary in cervical lymph node other than supraclavicular, including their cytologic features and the role of ancillary studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Vascular status in human primary and permanent teeth in health and disease.

PubMed

Rodd, Helen D; Boissonade, Fiona M

2005-04-01

The present study sought to compare the vascular status of human primary teeth with that of human permanent teeth, and to determine whether caries or painful pulpitis was associated with changes in vascularity. Coronal pulps were removed from 62 primary and 62 permanent mandibular molars with a known pain history. Teeth were categorized as intact, moderately carious or grossly carious. Pulp sections were labelled with Ulex europaeus I lectin (UEIL), which is a marker of human vascular endothelium. Image analysis was then used to quantify the percentage area of UEIL-labelled tissue (vascularity) and the number of blood vessels present within three regions: the pulp horn, the subodontoblastic region, and the mid-coronal pulp. Only the mid-coronal region of the primary tooth pulp was found to be significantly more vascular than the corresponding area of the permanent tooth pulp. Both dentitions showed a significant increase in vascularity within the pulp horn region with caries progression, but this was not accompanied by an increase in vessel number. There was no correlation between vascularity and pain symptoms. These findings suggest that the primary tooth pulp is more vascular than its successor within the mid-coronal region. However, the functional and clinical significance of this finding remains speculative.

Can patients at risk for persistent negative symptoms be identified during their first episode of psychosis?

PubMed

Malla, Ashok K; Norman, Ross M G; Takhar, Jatinder; Manchanda, Rahul; Townsend, Laurel; Scholten, Derek; Haricharan, Raj

2004-07-01

Patients with schizophrenia who show persistent negative symptoms are an important subgroup, but they are difficult to identify early in the course of illness. The objective of this study was to examine characteristics that discriminate between first-episode psychosis (FEP) patients in whom primary negative symptoms did or did not persist after 1 year of treatment. Patients with a DSM-IV diagnosis of FEP whose primary negative symptoms did (N = 36) or did not (N = 35) persist at 1 year were contrasted on their baseline and 1-year characteristics. Results showed that patients with persistent primary negative symptoms (N = 36) had a significantly longer duration of untreated psychosis (p < .005), worse premorbid adjustment during early (p < .001) and late adolescence (p < .01), and a higher level of affective flattening (p < .01) at initial presentation compared with patients with transitory primary negative symptoms. The former group also showed significantly lower remission rates at 1 year (p < .001). Multiple regression analysis confirmed the independent contribution of duration of untreated psychosis, premorbid adjustment, and affective flattening at baseline to the patients' likelihood of developing persistent negative symptoms. It may therefore be possible to distinguish a subgroup of FEP patients whose primary negative symptoms are likely to persist on the basis of characteristics shown at initial presentation for treatment.

Sporadic Jakob-Creutzfeldt Disease Presenting as Primary Progressive Aphasia

PubMed Central

Johnson, David Y.; Dunkelberger, Diana L.; Henry, Maya; Haman, Aissatou; Greicius, Michael D.; Wong, Katherine; DeArmond, Stephen J.; Miller, Bruce L.; Gorno-Tempini, Maria Luisa; Geschwind, Michael D.

2015-01-01

Objective To report the clinical, neuropsychological, linguistic, imaging, and neuropathological features of a unique case of sporadic Jakob-Creutzfeldt disease in which the patient presented with a logopenic variant of primary progressive aphasia. Design Case report. Setting Large referral center for atypical memory and aging disorders, particularly Jakob-Creutzfeldt disease. Patient Patient presenting with logopenic variant primary progressive aphasia initially thought to be due to Alzheimer disease. Results Despite the long, slow 3.5-year course, the patient was shown to have pathology-proven sporadic Jakob-Creutzfeldt disease. Conclusions These findings expand the differential of primary progressive aphasia to include prion disease. PMID:23400721

The impact of out-of-hospital models of care on paediatric emergency department presentations.

PubMed

Viner, Russell M; Blackburn, Frances; White, Francesca; Mannie, Randy; Parr, Tracy; Nelson, Sara; Lemer, Claire; Riddell, Anna; Watson, Mando; Cleugh, Francesca; Heys, Michelle; Hargreaves, Dougal S

2018-02-01

To estimate the potential impact of enhanced primary care and new out-of-hospital models (OOHMs) on emergency department (ED) presentations by children and young people (CYP). Observational study. Data collected prospectively on 3020 CYP 0-17.9 years from 6 London EDs during 14 days by 25 supernumerary clinicians. CYP with transient acute illness, exacerbation of long-term condition (LTC), complex LTC/disability and injury/trauma were considered manageable within OOHM. OOHMs assessed included nurse-led services, multispecialty community provider (MCP), primary and acute care system (PACS) plus current and enhanced primary care. Diagnosis, severity; record of investigations, management and outcome that occurred; objective assessment of clinical need and potential alternative management options/destinations. Of the patients 95.6% had diagnoses appropriate for OOHM. Most presentations required assessment by a clinician with skills in assessing illness (39.6%) or injuries (30.9%). One thousand two hundred and ninety-one (42.75%) required no investigations and 1007 (33.3%) were provided only with reassurance. Of the presentations 42.2% were judged to have been totally avoidable if the family had had better health education.Of the patients 26.1% were judged appropriate for current primary care (community pharmacy or general practice) with 31.5% appropriate for the combination of enhanced general practice and community pharmacy. Proportions suitable for new models were 14.1% for the nurse-led acute illness team, MCP 25.7%, GP federation CYP service 44.6%, comprehensive walk-in centre for CYP 64.3% and 75.5% for a PACS. High proportions of ED presentations by CYP could potentially be managed in new OOHMs or by enhancement of existing primary care. © 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.

Microtensile bond strength of contemporary adhesives to primary enamel and dentin.

PubMed

Marquezan, Marcela; da Silveira, Bruno Lopes; Burnett, Luiz Henrique; Rodrigues, Célia Regina Martins Delgado; Kramer, Paulo Floriani

2008-01-01

The purpose of this study was to assess bond strength of three self-etching and two total-etch adhesive systems bonded to primary tooth enamel and dentin. Forty extracted primary human molars were selected and abraded in order to create flat buccal enamel and occlusal dentin surfaces. Teeth were assigned to one of the adhesive systems: Adper Scotch Bond Multi Purpose, Adper Single Bond 2, Adper Prompt L-Pop, Clearfil SE Bond and AdheSE. Immediately to adhesive application, a composite resin (Filtek Z250) block was built up. After 3 months of water storage, each sample was sequentially sectioned in order to obtain sticks with a square cross-sectional area of about 0.72 mm2. The specimens were fixed lengthways to a microtensile device and tested using a universal testing machine with a 50-N load cell at a crosshead speed of 0.5 mm/min. Microtensile bond strength values were recorded in MPa and compared by Analysis of Variance and the post hoc Tukey test (a = 0.05). In enamel, Clearfil SE Bond presented the highest values, followed by Adper Single Bond 2, AdheSE and Adper Scotch Bond Multi Purpose, without significant difference. The highest values in dentin were obtained with Adper Scotch Bond Multi Purpose and all other adhesives did not present significant different values from that, except Adper Prompt L-Pop that achieved the lowest bond strength in both substrates. Adper Scotch Bond Multi Purpose and Adper Single Bond 2 presented significantly lower values in enamel than in dentin although all other adhesives presented similar results in both substrates. contemporary adhesive systems present similar behaviors when bonded to primary teeth, with the exception of the one-step self-etching system; and self-etching systems can achieve bond strength values as good in enamel as in dentin of primary teeth.